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At the heart of general practice since 1960

Someone earning more than you? Good for them

I'm a locum so can sit on the fence on the issue of salaried GPs' contracts.

I agree that the model contract does favour the employee and so it should - after all it's the BMA's model and they are the employees' union. What it fails to acknowledge is that the employers are not large trusts but small - usually fewer than five full-time equivalent partner - practices that simply don't have the resources or budgets to cover all eventualities an employee may have. This situation is even worse for PMS practices that have less help from PCTs.

Partnership is not for everyone and the option of being salaried is certainly very appealing for a subset of doctors. Equally, money is very appealing to partners and greed can sometimes make individuals very shortsighted.

Exploitation is really what is at the heart of this issue. If we put our money in a savings account we can't expect a great rate of return but we know

it's safe. If we put it on the stock market we stand to win or lose. This is the difference between salaried GPs and partners and this is why their philosophy differs so much.

Looking at our income and job security from the outside, we are all very lucky. But all GPs - salaried, sessional or partners - are feeling disenfranchised. If partners hadn't had successive annual pay cuts they wouldn't be looking to pass those cuts on. Their discontent is simply passed down the chain. Everyone should feel the squeeze.

Negotiate, maintain communication, work hard and if you are not happy, leave. But don't moan - we're all bloody fortunate to be where we are and if someone earns more than you, good for them.

Dr Oliver Denton, Birmingham

When trying to provide a good service, it is difficult when salaried GPs take time for maternity leave as this often stretches to a year. This causes service disruption for the patient and problems with filling the post. Sometimes with locums it is quite a headache, especially when they have no incentive to work towards the QOF.

Also the reimbursements from the health authority for maternity absence are meagre compared with the old days, and our partnership has had to stop taking any additional drawings in the last year because of the drop in income.

The galling part is that our doctor is only coming back part-time (previously full-time) and won't be doing some of the crucial hours that all us full-timers have to do, that is extended hours. This confines the numbers on our rota and effectively increases the workload. We certainly cannot compete with private enterprise if these constraints continue to hamper us.

Dr Paolo Fargnoli, Buckden, Cambridgeshire

Soon there won't be any young GPs left. We are looking to move abroad, work for private companies or simply give up entirely. When partners start to retire we won't be available to take over. Even if we want to, we won't have the experience to run practices.

Current discontent among salaried GPs will start to filter down and medical students will choose other specialties. Before too long we will have another recruitment crisis.

Dr Leigh Norris, Nantwich, Cheshire

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