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Independents' Day

Don’t try to bully me with a GMC hearing

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Pass me the diazepam. I am full of rage and need to share. The source of my ire? This ludicrous situation:

‘Well, Dr Norris, you aren’t employed by us are you?’

‘No. I’m self-employed.’

‘Right. So you don’t get any annual leave, sick leave, maternity benefits and so on. You also don’t have a notice period other than the mutual cancellation policy that you requested we sign.’

‘Once again, correct.’

‘Smashing. So, here is a letter saying we are not going to pay you as much for the work you do. We’ve chopped your pay by a third and want you on the payroll. But we aren’t going to give you any of the rights of an employee. What do you reckon?’

‘No thanks. I’ll pass.’

‘Right – we’ll refer you to the GMC.’

This has been the brilliant solution of a number of hospitals, acute trusts, out-of-hours organisations and other large employers across the country to recent changes in the law that mean they have to pay tax and national insurance contributions for the self-employed (GPs could have to pay locum tax and national insurance under new legislation,

It’s a mess, for everyone: doctors, hospitals and practices. Everyone is confused. That said, anyone who threatens to report a doctor to the GMC over a tax issue needs a slap. They can have no idea what a GMC referral means or they would never even suggest it. If they do and are still suggesting it, they’ve just joined Nigel Farage on the list of my least favourite people. A GMC referral should be reserved for the most serious breaches of duty. An unfounded allegation can mean months, or even years, of uncertainty, distress and a personal and professional toll that often finishes a doctor’s career. I have seen it time and again.

The logic behind these threats is that if a self-employed doctor decides not to book further work as a result of unilateral changes in their working conditions, it puts patient safety at risk and is therefore GMC-able. Let’s be clear. It isn’t.

Does some sort of loyalty clause apply to one-sided contract changes that pay less and give no benefits? No. The headlines rapidly follow, about locums ‘holding the NHS to ransom’. Well if there were doctors aplenty that would be fine but there aren’t, because the NHS is breaking them.  

The Government isn’t bothered. The NHS is no longer allowed to care for its staff. It just can’t. Instead of recognising and addressing the lack of doctors (and, no, promising to train 5,000 new GPs doesn’t count), the knives are out for those who decide they are fed up of being trampled on.

How dare you suggest my decision not to work for you any more means I am a danger to patients and should lose my livelihood?

When we get the dreaded election results next month, expect to see more of this as the contempt for the whole profession continues to grow. A wise man once said ‘ “No” is a complete sentence’. We need to start saying it a lot more.


Dr Zoe Norris is a GP in Hull

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Readers' comments (17)

  • Are not the organisations responsible to pay the market rate for the services provided,Or does the NHS not follow free market principals.IF they set a rate which doesnt cover the costs and renumerate individuals what other industry forces people to work at a loss,of forces them to work.Bordering on slavery.Anyone for stacking sleves in Tescos of flippin burger in McDaonalds.

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  • This is a far bigger issue than people realise. For a number of years the elite of the world have been grabbing money from the middle class. It is an even bigger issue in USA. Everyone has to work for less, apart from the 0.0001%. Ultimately the only answer is the withdrawal of labour. Particularly when there is no one waiting in the wings to take our jobs. Currently it is still impossible for computers to take over much of our work, although in the long term I think this could be our biggest threat. The traditional reluctance amongst health professionals to with draw labour will eventually end. Timing depends on further reduction in income and deteriorating working conditions. Do not expect any support from the BMA.

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  • Have doctors really been referred to the GMC in this scenario?? If they have that is utterly deplorable and those responsible should realise exactly what they put the doctor and his family through.
    I left partnership following burn out/GMC referral. I cannot describe how terrifying and degrading the experience was.
    Working as a locum afterwards was a breath of fresh air in comparison but I'm even winding that down following the latest IR35 changes (which no practice wants).
    No more GP after December for me and no new bookings either (unless I really, really like the practice).
    Time to move on to the next phase of my career - after 21 years as a GP I'm excited to be leaving. Says it all.

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  • My son had booked his appraisal but the appraiser had a family bereavement and had to leave the country for a period
    His locum agency threatened my son with gmc referral for nonengagement with the appraisal process as the appraisal was delayed
    However they kindly offered to do his appraisal urgently for him for £400!

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  • I'm sure you are limiting the details for publication ,but it seems to me that whoever threatened a doctor with a gmc referral in this situation should be reported to their own equivalent body for unprofessional behaviour and dismissed from any job which would put them in a position to make the same threats again. Further, it should be widely publicised that anyone using a verbal or written threat of gmc referral inappropriately should be subject to their own disciplinary procedures-it seems to me it would be an appropriate issue for BMA representatives to take up similar cases for their members

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  • Just leave the country..... it IS the best way to fight back. Its effectively withdrawing labour, the 'powers' that be can do nothing about it, they can't threaten you, and leaves you with a decent income, less stress and the idiots you leave behind can talk to themselves in the mirror.... the fewer the number of doctors left in the country the stronger their bargaining position becomes. Janine please name and shame the locum agency..... I worked locum for years, only once used an agency, never again.... they are just in it for themselves, why help anyone else get rich off your hard work? Plenty of work available if you carpet bomb with emails..... you just cut the middle men out of it, practice saves, locum earns more....everyones happy except the agency, who no-one really needs anyway, lets be honest, its just a few of our greedy colleagues trying to exploit others....

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  • you can come and work with us Dr Norris anytime! we would be honoured to have you and I bet you are great with patients! we have had to cut the locums days down unfortunately. you can't pay less as otherwise we would lose the good will that we have with our colleagues and be in a bigger pickle than we are already! thankfully we have managed to retain most of our team and the guys and gals have been ok with it.

    why on earth would I want to risk losing my doctors! why on earth would they risk wanting to lose theirs! you should inform the partners what this person said to you in their name!

    it is a major disciplinary offence.

    - anonymous salaried!

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  • Good article Zoe

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  • you wouldn't be withdrawing labour you would just be applying it elsewhere to the benefit of different patients.
    who would care about a GMC referral for this anyway as would never go anywhere

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  • A human rights lawyer would make mincemeat of any attempt to the GMC to santion a doctor for withdrawing their labour (subject to proper notice etc).

    Egregious bullying by an employer which ought to put them at risk of a law suit too.

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