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Oh Lord – why Darzi is missing the point

Editor’s blog

jaimie kaffash 2 duo 3x2

jaimie kaffash 2 duo 3x2

It’s hardly a surprise that a headline with ‘Lord Darzi’ – the former surgeon and health minister - and ‘salaried model’ attracts the ire of GPs.

Following on from his failed polyclinics of the previous decade, his latest idea is that all GPs should be offered the opportunity to become salaried to the NHS.

In a report for the Institute for Public Policy Research, he concludes that the independent contractor status has ‘put more pressure on GPs – to run a business as well as provide medical care – with levels of stress and dissatisfaction in the UK disproportionately high compared to other countries’.

The report then states: ‘More and more GPs do not want to become partners because of the levels of responsibility and financial risk involved in it as well as the geographical immobility it requires. Evidence suggests that many GPs would be open to moving to a salaried model.’

I don’t know whether Pulse should be flattered that the report’s evidence for this is one of our surveys from 2016.

But this is where his ideas fall down. The reason that our GP partner readers said they would take a salaried post if offered the right deal is not because of the ‘responsibility and risk involved’ inherent in partnerships – they went into partnerships, after all.

It’s because of the isolation they feel as GP numbers dwindle, which itself is a result of years of real-terms funding decreases, increased workload and increased regulation. Fix these and the majority would be delighted to remain as partners.

There is a real debate to be had over whether younger GPs will want to become partners in the future and how a future partnership model will look.

But, for current partners, it is not the model itself that is broken – it is the lack of resources. If he really wants to fix general practice, he should be lobbying for the profession to receive its fair share of the £20bn apparently stumped up by the Prime Minister.

Jaimie Kaffash is editor of Pulse

Readers' comments (15)

  • The surgeon trying to fix general practice again...bolloc*s!

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  • I assume he is still a Dr therefore I assume he is still doing an annual appraisal and I therefore assume he is providing evidence he is qualified in his role as the ‘ fixer of general practice ‘
    MSF anyone!

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  • Vinci Ho

    Even though he denied being a politician, behaving like a politician is enough for Simon Stevens and Jeremy Hunt to pick him as the ‘reformer’. It is a big reluctance for a Tory prime minister to declare possible tax rise to fund NHS on its 70th birthday . Hence , she wants to exploit as much political brownie points from this as possible. Linking the ‘Brexit dividends’ with this funding is duplicitous and strategic for her ‘no deal’ Brexit model.The fact that Tories don’t like general practice in its current form , is clearly pointing to a super/mega practice model:
    (1) Practice of at least 50,000 patients in size will be the only social norm
    (2) All GPs will be salaried : pay them £80,000 for 9 or even 10 sessions a week . GPs were too expensive ; there were too many part time GPs and locum cost too much. Let’s standardise the salary nationally and send GP partners to extinction.
    (3) Working by scale for seven day GP opening . Otherwise , use nurses or physician assistants to provide weekend appointments
    (4) Face to face consultations are too ‘expensive’ . Replace them with smartphone apps and electronic consultations. Bye bye Continuity of Care.
    (5) Thanks to section 75 in Health and Social Care Act(which the Tory will never repeal) , if these super/mega-practices run into financial troubles , an open procurement is always there ready for private companies to bid with their lives(lessons of Capita and Carillion are never to be learnt. Greed is always there; ‘’Greed is good .Greed works’’.)
    There will be no GMS contract anymore and APMS contract will earn a new name/label.
    Beware when the PM said that every penny must be well spent . The narrative will be spinning in such a fashion that only getting GPs even harder and ‘differently’ will justify this tax rise to fund NHS and only then every penny will be really well spent.

    Sadly history repeats again and again , highly educated and prestigious scholars and/or scientists were used by deceitful politicians to achieve hidden agendas . In their mind , they consciously believe they had found the solution to solve some real world dilemma, without the realisation that they had never left the top floor of the famous ivory tower..........

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  • AlanAlmond

    You articulate the issues involved extremely clearly, Lord Darzi and his crew don’t really get it. I doubt he’s in any way open to a reframing of his position, he’s old, he’s an ‘expert’ (ahh..hum) and too practiced at giving his opinion rather than absorbing those of others. Would that he could step off his polished platform, re-ignite a few dormant creative synapses and read this article.

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  • 1. Get rid of the requirement to hold GMS/PMS as an unlimited liability partnership. It's like being a name at Lloyds!

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  • (but without the upside and having to go to work each day)!

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  • THE GOVERNMENT ARE "BOXED-IN"...THEY CAN'T GIVE PARTNERS ANY MORE MONEY AND RESOURCES WITHOUT ADMITTING TO HISTORIC UNDERFUNDING AND CONTRADICTING THE "CRIMINAL AND THUGGISH" DAILY NUTTER THAT IS A LIKE A "PROPAGANDA MACHINE FOR A DICTATORSHIP".

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  • A lot of his clinical work was in the private sector as expected.
    Hardly a die hard NHS supporter.

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  • already given up hope NI GP

    You are all Dinosaurs
    The partnership model is as dead as a Dodo
    Young doctors don’t won’t partnerships
    They want protection and a life
    Wake up and smell the coffee
    The times they are a changing
    Sorry for all the metaphors but you can’t polish a turd!

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  • AlanAlmond

    Silver surfer.
    Do young lawyers ‘not want partnerships’?
    Is the partnership concept generally ‘dead as a dodo’?
    Or is there something about the government imposed NHS GP partnership model specifically that completely stinks?
    There’s more in the world than medicine and there are many ways to organise a partnership.
    The concept of partnership isn’t dead, it’s just been perverted by the government to such a degree that no one in their right mind would sign up for the type on offer. It needs reform to be what it should be, not replacing with a pale excuse for a career - salaried - that anyone doing for more than a few years will soon tire of. Saddling the next generation with a dead end career model that makes them slaves is a poor legacy to leave and nothing to be proud of.

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