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Surge in salaried GPs threatens traditional practice

A huge shift towards a salaried workforce has raised fears for the future of traditional general practice.

The number of salaried GPs has doubled since the introduction of the new GP contract, with a 58.9% increase last year alone, according to the latest workforce figures.Meanwhile the number of GP partners fell by 5.6% last year, with some GPs complaining practices are reluctant to share profits by taking on new partners.The issue has been taken up by the GPC, which warned practices must nurture younger doctors or place the future of general practice in danger.Dr Hamish Meldrum, GPC chair, said: 'There has to be a balance there. That balance has to be, at the same time, bringing on younger doctors who want to get involved. 'We have to be conscious as a profession that if we allow [loss of partners] to happen too much, we're creating dangers for ourselves.'A total of 5,400 GPs worked as salaried or assistant GPs in 2006, compared with 3,398 in 2005 and 2,742 in 2004. Dr Richard Fieldhouse, chief executive of the National Association of Non-Principals, warned many salaried GPs faced difficult working conditions.'There is a lot of exploitation out there, with doctors not having a pay rise for years,' he said.An increasing number of GPs were opting to work on a salaried basis because of the greater flexibility avail-able, but the overall trend away from partnerships was worrying, he said.'Partnerships are like a marriage – being a salaried GP is like being an au pair. It's not quite an equal footing.'Dr David Barrett, a salaried GP in Coventry, said partnership posts were increasingly hard to find.'It is only human nature to try and protect large salary increases,' he said. 'But GPs owe it to each other not to do so at the expense or exploitation of their salaried GP colleagues. I think the Government has started GPs off on a game of \\"divide and conquer\\" and unfortunately we might just be playing ball.'But Dr Nicola Hambridge, a GP partner in Leeds who previously worked as a salaried GP, said many salaried GPs failed to understand the financial pressure partners faced following a two-year pay freeze.'If you take on a partner, it's a risk,' she said. 'It's a much bigger thing than taking on a salaried doctor.' Dr Suraj Sharma, a part-time GP in Liverpool, worked for 25 years as a principal before taking early retirement, and returned to work as a salaried GP in order to focus on treating patients.'I decided I should return as a salaried GP because there would be too much paperwork, too much responsibility,' he said. 'Every day the goalposts were changing.'

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