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Are GPs more open to a salaried service?

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So the big idea for GPs to move to a salaried service was voted down.

I fully expected to say ‘shot down in flames’ but that wasn’t actually the case.

Because, around the room, there was a lot more support for the motion than you might expect.

Many local leaders said that the recruitment and retention of GPs demanded radical solutions, and moving to a salaried model would have to be considered.

One speaker, Dr Thomas Kilnoch, pointed to a survey carried out it Merseyside, that found that only 6% of trainees wanted to go into partnerships.

It follows the news from Scotland that they were going to move ‘as close as possible’ to a fully salaried model.

Elsewhere, areas such as Hull and London have mooted the idea of a fully salaried model.

Meanwhile,one GP told me today that one of her partners had calculated their hourly pay at £13.50.

There is still huge opposition against moving to a salaried model,and I hardly have to spell out the reasons for this.

But, another year of general practice in decline, with partner pay declining even more, and it will be interesting to see whether a similar motion gains more support next year.

Jaimie Kaffash is news editor at Pulse

Readers' comments (7)

  • Most Salaried GPs will be in favour of an ALL-Partnership model. But the existing partners don't want to bring up this option for discussion.

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  • as a salaried GP - nope I'n not in favour.

    the question is why do GP's do salaried posts ?

    - convenience (family responsibilities, child care, can't commit to partnerships etc)
    - there are not enough good partnerships out there. no fault of the partners but the current contract is 'suicidal' so why would anyone by into the current contract
    - to cover NHS pension. many drs including myself work a few sessions salaried for the NHS pension and locum elsewhere to top up pay. That's why if yoy go after locums or make increase our pensions you will find many docs headinf to the private sector.

    - what i want is a decent partnership contract and i'm just waiting like many others for that to occur. if a dcent contract does not materalise I would want to look at alternative models. If a dental type model existed I probably would already be a partner.

    - I know of no salaried dr who actually sees patients full time who wants to remain a salaried dr. those salaried who are happy with it seem to those that don't do much front line care or manage others.

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  • No

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  • The salaried model has been projected as a dreaded option that will bring about the demise of general practice. However, the weariness is beginning to show and there is certainly more than expected support for this option. It isn’t at all surprising if you consider that there is a dearth of candidates willing to risk their necks and peace of mind diving into partnerships. For the salaried model to be acceptable to most of the GPs, you would need hours and progression bands regulated as for hospital Consultants. indemnity cover by NHS, a work life balance that gives you the comfort of shutting the door behind you and not worrying about the sky falling when you are on leave. The devil is in the detail and to make it feasible and palatable , it would need a choice of the right spices. The problematic bit may be how you allay fears of a drop in engagement and initiative once GPs don’t see themselves in the driving seat. In general.

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  • Una Coales

    If you want a glimpse into what a salaried GP service would look like, then look to America where Obama's Affordable Care Act forcing all Americans to buy insurance has driven many family physicians into working as salaried doctors, seeing 2000-2500 pts each and treating TEN problems in 13 minutes. They are now urgently looking for an escape route, a physician MBA programme to join a hedge fund, changing to higher earning specialties, etc. http://www.thedailybeast.com/articles/2014/04/14/how-being-a-doctor-became-the-most-miserable-profession.html?via=mobile&source=twitter

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  • good article souds bad in USA also regarding over regulation but im not sure 24 patients per day is bad as they mention.
    what I don't know is how I thought gp land was going to be so great when I worked in hospital when in fact I ended up feeling like a hostage to patient demand as the article in the US describes the relationship so well. Now locumming my stress is gone and even lower during the months I work in Canada. If only I could do this indefinitely raher than get sucked in to something suffocating as may happen eventually.

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  • During my training I worked in a rural training centre in India where there was a queue of 6-80 people and there were three doctors seen three patients at the same time with a shared couch behind a curtain:) There were no problems- no hassles and the patients were grateful they were being looked after. The Consultants on the other hand were so much involved that in the evenings when they went for a walk some of them would end up doing an informal round to see how things were going on.
    This is an observation. Life was simple and I am talking her of salaried doctors and Consultants as this was a general hospital under the Employees State Insurance scheme.
    It is the overregulation; the bureaucracy and the paperwork that is stressful - not being salaried or a partner.

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