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Gerada to 'start dialogue' on GPs' independent contractor status in new NHS England role


Many of us have a suspicion that independent contractor status is a 'dead Man walking'. Whether by accident or design it is hard to be sure? Let's see now...... Accident? We need to consider,as bloggers have commented, there were indeed financial advantages in the 2004 contract to employ salaried doctors in the subsequent year or two when profits were relatively high, prior to the relentless financial attrition since then -- this has prevented a generation of younger doctors obtaining partnership status, most of whom no longer want to do so I presume given the predicament the profession currently finds itself in. In other words, the perverse disincentive against employing young partners may indeed have contributed to the current recruitment difficulties, now that many partnerships wish to take on new/replacement partners. Design? We need to consider the following. Government/DOH have heaped vitriol through tabloid poodle press. Increased work load eg QOF, responsibility eg CCG involvement, bureaucracy, box ticking. Increased risk accrued by pressure to reduce referrals. Reduced resources -- taking away PMS cash this year the latest example. More favorable APMS contracts favouring private sector. CQC, revalidation, Professor Field appointed to lead yet another raft of monitoring -- the latest plank in government GP bashing. Is all this designed to make GP partners give up their independent contractor status? Anyway, some predictions -- There will be a pretense of engaging practices in reasonable discussion and negotiation. At the same time the government will continue to ignore the outcome of negotiations completely as they did last year, then impose unacceptable contracts and working conditions on GP partnerships. The requirements for reporting, revalidation and monitoring will relentlessly rise, all monitoring bodies, individuals and organisations dancing to the government tune Many practices, especially smaller ones, will close because it is cheaper for the government to let them do so rather than buying them out. Some GPs will loose their health, livelihood and go bankrupt. The private sector will be given vastly more favourable contracts to pick up the pieces which will ultimately cost a great deal more even in the short to medium term (just look at the funding for some APMS contracts per head). The NHS will evolve rapidly into a health maintenance organisation model which with hindsight we will realise was the vision all along. Politicians will have achieved their goal, bypassing the democratic process and debate as they did so successfully with the last White Paper. Welcome to the modern NHS, or should I say Welcome to America?

Posted date

11 Sep 2013

Posted time