We must not be afraid to overhaul the general practice model
We need to take a fresh look at the way general practice is run for a modern health service, says Dr KS Pandher
I for one welcome the moves to review the GP partnership model.
We need to look afresh at general practice in England. The current model is from the 60s and things have evolved – both medicine and management.
A damaging and wasteful three-tier system has developed.
At the top we have GP partners taking more CCG and other non-patient contact roles.
Then there are the salaried doctors, who I believe are being exploited, often asked to perform the partners’ role – but minus the profit share.
Below them come locums. We need to have an incentive for conversion of this group – they are becoming deskilled in chronic disease management and are tending to rely on new local guidelines for effective management of patients.
Partnerships are also profiting from increased valuation of the premises to which the public had contributed. These GPs should not benefit from taxpayers’ contributions.
In addition, we no longer need GP based dispensing practices in this day and age, with fast online deliveries available. The resources could instead be redirected into patient care.
We need centralised, state of the art premises based in each locality, not the numerous practices we currently have.
I believe the partnership model itself needs to be reviewed – the patients and staff of the practice should all have a vested interest in the practice by being allowed to hold shares in the practice, which should be non-profit making but linked to inflation. This would allow shareholders to have a say in the way the practice should be run to benefit the community. The current use of patient participation groups is not effective, in my opinion,in bringing about meaningful change.
The secondary care NHS model needs to be adopted in part. I suggest GPs are re-labelled as primary care consultants and paid salaries commensurate with hospital consultants’. (Note – to be a consultant you need at least eight years of training.)
Locums could continue to work alongside if they choose that route, but be regarded as staff grade doctors or associates and be remunerated as such. This will bring more GPs into a permanent role providing continuity of care.
Let us look at new ways of working and channel our energy into this rather than being negative all the time.
I do not think public will sympathise with us if we continue to moan without making necessary changes.
Dr KS Pandher is a GP in Oxford