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CAMHS won't see you now

Salaried GPs cannot be immune to pay squeeze

During contract discussions with my salaried associate some months ago, I looked at a copy of the model contract, which she had got from the BMA.

I found it full of references to hospital staff conditions, which I felt did not apply in general practice, as well as references to the long defunct Whitley Council terms.

Assuming this is the model BMA contract referred to in Pulse, I can quite see why many practices are shying away from it.

I would agree with Dr Fieldhouse's statement that it should be improved (I would say completely rewritten) rather than binning the whole idea.

I don't feel, as a principal employing a salaried associate, that I am bound by any model contract. Employment legislation binds me to certain minimum requirements in terms of sick pay and maternity leave, for example. Common decency towards my medical colleagues dictates that I offer them fair and reasonable terms, and I'd be happy to sign up to a model contract that was up to date and sensible.

For sickness I offer six months on full pay then six months on half pay, for example, because this is what I've always expected prior to entering general practice myself - although I'm not sure how I'd cope as a singlehanded GP if it came down to it.

At the end of the day it's down to negotiation between the practice and the salaried GP as to the agreed terms and the employee has to push for the conditions they feel are fair.

But in the current climate of a freeze on practice income and falling profits, I don't think salaries should be increasing for employees at the expense of falling partners' shares.

Dr Andrew Hamilton, Unst, Shetland

Although I accept there are a large number of salaried GPs who would like to become partners, and I sympathise with them, there are also many salaried GPs who have no interest in becoming partners and taking on a share of the business and its responsibilities.

It is not appropriate to reward those salaried GPs who only wish to see patients and then go home in as favourable a manner as those who wish to commit over and above these basic requirements, when profits are at risk and expenses (particularly staff costs) are rising.

Attitudes to pay in primary care have to get into the real world. GP surgeries are small businesses and for them to survive in the current climate, pay freezes - or even cuts - and redundancies are quite likely.

Name and address supplied

The sense of frustration among non-principal GPs who wish to be partners is palpable. The supposition we partners have greater responsibility and time commitment is very valid - personally I was in at 7am today and didn't leave until 7pm.

However, the assumption partners are superdocs and the only GPs willing to work hard is wrong. There are many salaried GPs out there who would be willing and able to do my job. On the other hand, I also think that rather vitriolic criticism of partnership - as greedy and so on - is misguided, especially

as part of a championing of private providers such as Virgin as their employers.

Ultimately, most of us have an inherent wish to do the best for our patients. Richard Branson does not have patients, only shareholders, and this group is even more difficult to please when it come to the bottom line.

Dr Dean Hatfull, Fareham, Hampshire

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