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A faulty production line

Pay them? It's a joke!

From a GP trainer (name and address supplied)...

Re-your story about possible plans to ask training practices to contribute to the salaries of registrars (News, 21 September). This sounds like a political attempt to reduce pressure for a long overdue increase in trainers' grants.

Overheads for a registrar almost eat up all of the grant anyway. The suggestion we might have to pay registrars on top exterminates any business case for being a GP trainer. The idea of basing this on research done at the end of their attachment when registrars are at their most productive shows the Yes, Minister mentality is thriving in Richmond House.

We are a five-GP practice with two trainers and one GP on the trainers' course. We train because we seek to be a cutting-edge practice and feel this is greatly helped by the huge intellectual stimulation that training provides.

We also run a business and the business case has to be made. Currently it is just about OK although not great. If the Department of Health wants to assassinate the training of future GPs at a stroke, then they have found a winner.

From Dr Denise Bladen, Market Drayton, Shropshire...

Training practices should not have to pay for their registrars. We have just become a training practice, but I would withdraw if we had to pay them. We are already struggling.

From Dr Phil Rayner, trainer and VTS course organiser Calverton, Notts...

This seems a pretty outrageous proposal and I would anticipate mass resignations of trainers. Certainly this is the view of myself and my four partners in a long-standing training practice.

I accept that GP registrars contribute a lot to a practice, but they also require a lot of support and time to train/debrief and administer paperwork.

From Dr Steve Hawkins, Cornwall...

I have been training for 20 years and, much as I enjoy it, it is time-consuming and a GP registrar's contribution to the workload is vastly less than it would have been some years ago.

We were without a GP registrar on maternity leave for a few months last year and, in terms of workload, the practice did not notice a difference.

I did – there was substantially less work for me to do with no registrar to worry about. I would stop tomorrow if I had to pay for the privilege.

And as for paying for F2 docs...

From Dr Barry Newport, Lightwater, Surrey...

As a GP trainer, I read with incredulity your story about the Government considering plans to ask training practices to contribute towards the costs of registrars. The plan, if it were to be adopted, would be disastrous for the future of GP training.

Now is the time of year when trainers are needing to make a commitment if they want a GP registrar next February, and presumably our practices would be affected, if the plans became a reality during 2006/7.

How many of us, as employers, will be prepared to commit ourselves to paying a salary out of our own pockets to someone who is unable to practise independently, whom we haven't yet met and who may be allocated to us?

The resolution of this very serious situation cannot wait for the pay Review Body report.

From Dr John Orchard, Alfreton, Derbyshire...

As a GP trainer, former course organiser and adviser to Sheffield deanery, I feel strongly that if I were to be asked to pay the service component of my registrar's salary, I should have the right to select my registrar.

Having had to report a recent registrar to the GMC fitness to practise panel, I have little confidence in the selection centres.

The current process effectively discriminates against the sort of registrar we need – male British graduates who are willing to commit to full-time working. Without such graduates general practice will become fragmented with total lack of continuity and consistency of treatment.

There are several wonderful motivated full-time female practitioners, but there are many more part-time practitioners of both sexes all too ready to say 'I only work two days a week' with no willingness to acknowledge the stress that full-time commitment brings.

Any change in registrars' remuneration must be negotiated with trainers' representatives – and I don't mean the Committee of General Practice Education Directors.

Name & address supplied,

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