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Independents' Day

Labour should be 'honest' about plans for 'another NHS reorganisation', says GPC

GP leaders have called on the Labour party to be ‘honest’ about plans for ‘another NHS reorganisation’ ahead of next year’s general election.

The GPC said the Labour party should immediately seek to involve GPs in talks about future models of delivering general practice, after shadow health secretary Andy Burnham repeated his calls for GPs to work as salaried employees in a fringe event at the Labour conference in Manchester yesterday.

Mr Burnham is due to spell out Labour’s plans for the NHS in his main speech to the conference tomorrow, but revealed that the NHS will be the ‘key election issue’.

Speaking in a debate organised by the Nuffield Trust, Mr Burnham repeated plans to combine health and social care budgets and hand them to the health and wellbeing boards, while referring to the current Government’s NHS reforms as ‘the reorganisation that never ends… because it is such a bloody mess’.

He further repeated repeated his wish, expressed in an exclusive interview with Pulse earlier this month, for GPs to work as salaried employees of integrated care organisations. He said he was ‘not proposing the abolition of independent contractors’ but added that he doesn’t ‘think it helps to build care around the person and that is why we must explore these models’ which he said could ‘sit alongside’ each other.

He said ‘younger GPs’ may find it more attractive to work as salaried doctors in these integrated care organisations, which would care for the ‘most vulnerable’ patients in society, while the independent contract GPs continued to provide the ‘episodic care’ to the rest of the population.

Mr Burnham added: ‘I can see a model where the GP sits at the centre of a team, an integrated team with the physio, the district nurse, and is actively day-to-day monitoring the care of the frail elderly population, whereas there still will be a call for the more episodic use of general practice, the coughs and colds, the usual stuff. I think we should embrace those different futures and be open about that.’

However, GPC chair Dr Chaand Nagpaul said: ‘Having heard Andy Burnham’s remarks I think it is clear that what he is talking about are some significant organisation changes. He is talking about merging the CCG budget and social care budget into one and merging organisations into one. This is reorganisation. He is talking about integrated care organisations bringing together GPs and other healthcare professionals, and creating a salaried GP workforce. That to me is clearly a reorganisation and a restructuring.

‘What is important, what the public should not be fed, is the idea that it is not a reorganisation when in fact it is clear that the policies are spelling out a major reorganisation. And unlike previous restructuring, what really must happen at the earliest possible stage is to involve the profession. I do believe that proposals to dilute, or rather to get rid of the independent contractor status, are misguided – the arguments are misguided and do not understand the absolute bargain that GPs provide as a result of an independent contractor status model.’

Readers' comments (11)

  • The problem is Burnham will set the salary at £70,000-£80,000 and that is not going to attract the numbers he wants,it all about supply and demand a full time locum can earn £120,000 a year with 6weeks holiday,why work for a sweat shop like VIrgin,Malling health or Capita when you can do it yourself

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  • Is it just me, or did any body else pick up the derogatory "more episodic use of general practice, the coughs and colds, the usual stuff" remark. He is as cluless as Ceremy Junt! Slimy F£"%W$T.

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  • Burnham needs to talk to and/or shadow a few normal GPs and attempt to gain some understanding of what we do before redesigning primary care on such a shaky foundation

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  • Id work for 80 000. That's more than I get as a full time locum 9-11 sessions per week and I only have about 14 days off a year because I don't want to lose the income.
    you only earn more if you work somewhere no one wants to live like Lincolnshire. Partners seem to think locums live in the land of milk and honey. Truth is if I broke my leg or something worse and couldn't work for a while id probably have to sell my house.

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  • If the choices we have come the next election are anything to go by, general practice in its current form does not have a future. Time for gps to really consider jumping ship. No NHS reforms would work without the GP workforce. It's clear we are a scarce resource too. Why do we take this rubbish from pie in the sky politicians? State what we need to provide a functioning primary care inside the NHS or go truly independent. We are in a powerful position. Problem is the BMA / GPC do not really know what they want. There is no realistic acceptable vision and they want to tag along and keep a status quo which is not fit for purpose and try to mitigate any daft ideas by politicians to ensure the status quo. Even if the politicians asked the GPC tomorrow " right tell us what you need to get general practice working" the GPC would not know what to ask for. Can the GPC please Set out a vision for the benefit of your members primarily and the general public which might actually provide better care for the public and return autonomy, balance and pride to the profession? The elephant in the room is funding. Either increase capitation to general practice to at least £140 pp per year and if this is not affordable to the government, allow copayment in primary care. Copayment should apply to all patients regardless of income.The government is very keen on personal health budgets so give everyone one. An amount in their benefits, tax credits , state pensions etc to allow patients to choose and pay for their health in primary care to a limit. Only then will the patients take responsibility for their own health and the issue of demand can be tackled as well. If they have spent their budget on theatre tickets or booze, tough. No healthcare. Do gooders please note this is reasonable as we don't have a national service for food and housing and healthcare is no different. Provide secondary care services for free for essential areas such as acute medical surgical care, cancer services etc but strictly define what will and what will not be provided. Allow a top up premium service to those who are prepared to pay for secondary care allowing earlier access. This funding can then go to providing better care to those who can't and is likely to reduce waiting lists. The NHS cannot continue to offer unrestricted services on a very limited budget. The solution is not about providing the best service and universal care within the current budget constraints. This is impossible. The solution is to raise money for better care in other ways as it's clear the state will not fund it. A funding system which allows prompt quality care for all and hands some personal responsibility for health back to the patient.

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  • Ahmed Nana, what vision!! I completely agree with everything you said. Now where are the anti-mail readers comments witheregard to how the Gurdianistas will view this radicalisation of the NHS as we know it??

    If you cannot afford it you cannot have it!!
    Nothing is free...... especially the NHS.

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  • "Do gooders please note this is reasonable as we don't have a national service for food and housing and healthcare is no different."

    "Do badders", please note, there has been a massive rise in the number of foodbanks over the last few years, as many in work can't afford to provide food for their families.

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  • @1114. They may be going to food banks but they all have an iPhone 4s, new trainers a large flat screen TV and smoke like a pipe. Personal responsibility only comes when you have to make choices and pay.

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  • The poor will always be with us but this is no reason not to move to co-payments because moving on from so-called 'free' appointments will be affordable to the rump of the middle class whilst those on benefits will be subsidized. It beggars belief that the GPC are unable to harness the power that GPs have by virtue of their scarcity, instead preferring to sit on the side-lines as the NHS sinks slowly into the quagmire of dwindling resources and increasing bureaucracy. Do we really want to be part of a generation that sat by and watched UK GPs asset-stripped by large corporations who offshore their profits from the NHS budget or would we rather build a service that is honest, transparent, sustainable and able to compete with the best that our European neighbours can offer?

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  • Oh oh, troll "other health" is out again.

    Since when do we have nation wide government paid food bank with unlimited top ups run by professionals?

    May be you need to start looking a it beyond your nose?

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