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The hole at the heart of the five-year plan

Dr John Couch seems to imply that salaried partners and locums are less important to general practice medicine than principals (Features, June 28).

General practice is changing and we

should be pleased that our new GPRs are getting experience from a variety of practices before securing a post. They are not only learning but are also disseminating knowledge they have gained from hospital jobs and their study.

Most locums work extremely hard and are willing to do all aspects of GP work. There is a tendency in some practices to dump as much work as possible on to the locum – far more than a principal would do in the same time and often more than is safe practice.

Paying locums for each visit has stopped the habit that some practices had developed of leaving all the visits for the locum.

It is only right I am paid properly for the work I do but I do not agree that locums earn more than principals.

I am very worried about the explosion of salaried posts. Some practices are using these new salaried partners as cheap locums. Salaried GPs should be included in any medical decisions the practice takes and should certainly not be treated as second-class doctors.

Parity partners do take a higher income to deal with practice administration so should not feel aggrieved by the salaried partner's easier out-of-hours workload.

I disagree totally with the stated views on locum agencies. I have helped to set up two locum agencies using local doctors to service local practices. This was in response to a need for quality locums and also to avoid the exploitation of locums by some practices through double-booking or the non-payment or underpayment of fees.

A good agency finds work, negotiates fees, chases payment, monitors locum standards, arbitrates in disputes, matches locums to practice requirements and facilitates the educational and social needs of the locums.

In the past new young partners had to wait years to reach parity. I agree that there should be a differential for more senior partners but only because they have earned it – not because it is their right. Maybe general practice should have a career structure like industry, accountancy and teaching where seniority brings greater rewards but greater responsibility and often greater workload.

Dr Couch has obviously had some difficult experiences with locums and salaried partners. Relationships have to be a two-way process and perhaps a more responsive approach to locums and salaried partners would prove more satisfactory all round.

Dr Irene Mawby, Chair

Worcestershire Non-Principal Group

Worcester

Dr John Couch seems to imply that salaried partners and locums are less important to general practice medicine than principals (Features, June 28).

General practice is changing and we

should be pleased that our new GPRs are getting experience from a variety of practices before securing a post. They are not only learning but are also disseminating knowledge they have gained from hospital jobs and their study.

Most locums work extremely hard and are willing to do all aspects of GP work. There is a tendency in some practices to dump as much work as possible on to the locum – far more than a principal would do in the same time and often more than is safe practice.

Paying locums for each visit has stopped the habit that some practices had developed of leaving all the visits for the locum.

It is only right I am paid properly for the work I do but I do not agree that locums earn more than principals.

I am very worried about the explosion of salaried posts. Some practices are using these new salaried partners as cheap locums. Salaried GPs should be included in any medical decisions the practice takes and should certainly not be treated as second-class doctors.

Parity partners do take a higher income to deal with practice administration so should not feel aggrieved by the salaried partner's easier out-of-hours workload.

I disagree totally with the stated views on locum agencies. I have helped to set up two locum agencies using local doctors to service local practices. This was in response to a need for quality locums and also to avoid the exploitation of locums by some practices through double-booking or the non-payment or underpayment of fees.

A good agency finds work, negotiates fees, chases payment, monitors locum standards, arbitrates in disputes, matches locums to practice requirements and facilitates the educational and social needs of the locums.

In the past new young partners had to wait years to reach parity. I agree that there should be a differential for more senior partners but only because they have earned it – not because it is their right. Maybe general practice should have a career structure like industry, accountancy and teaching where seniority brings greater rewards but greater responsibility and often greater workload.

Dr Couch has obviously had some difficult experiences with locums and salaried partners. Relationships have to be a two-way process and perhaps a more responsive approach to locums and salaried partners would prove more satisfactory all round.

Dr Irene Mawby, Chair

Worcestershire Non-Principal Group

Worcester

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