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GP partnership model at ‘end of its life’, says Labour leader

GP partnership model at ‘end of its life’, says Labour leader

The Labour Party leader has said the GP partnership model is ‘coming to an end of its life’ and that the NHS needs ‘more salaried GPs’.

He also hinted at a new GP appointments system, differentiating between patients who want continuity of care or to be seen quickly – with the latter group being offered a ‘digital’ solution.

Speaking on BBC Radio 4 this morning, Sir Keir Starmer said GPs are ‘the front door’ of the NHS, with Labour already having said ‘that we need to change the model there’.

‘The partnership model in many cases is coming to an end of its life and we need to have more salaried GPs. We need more GPs, that is why we have got a big training programme,’ he said.

Later, in a major NHS policy speech in Essex, Sir Keir went on to pledge that within five years under a Labour government, people will get seen by a GP when they need.

Labour’s new five-year pledge also includes faster ambulance responses, shorter A&E waiting times and shorter waits for specialist hospital appointments.

A Labour Government would bring back ‘the highest satisfaction levels on record’ in GPs, Sir Keir promised.

And he said this would requite a number of ‘shifts’ including moving ‘care away from hospitals and closer to the community’.

Sir Keir said: ‘The NHS must become a Neighbourhood Health Service. I’ll put it bluntly – at the moment we aren’t good enough at treating people early in the community. We leave it to hospitals – and quite often that’s too late. And if we change this it will save lives and money.

‘That’s why we’re going to improve GP access – end the 8am scramble. We’ll train more GPs, but we’ll also make the future of general practice more sustainable.’

‘As the contractor model declines in some communities, we won’t let patients go without the care they need. We’ll bring fragmented services together, make sure salaried GPs serve all communities. And we’ll modernise the appointments system,’ he said.

‘For those who want real continuity of care – we’ll bring back the family doctor, that’s what people with long-term conditions need. But for those who just want a quick appointment at their convenience, who want a digital consultation, we’ll give those patients a different route.

‘Seriously – it can’t be beyond us to offer different options for different people. We’ve just got to roll up our sleeves and get it done.’

Last month, Labour’s shadow health secretary Wes Streeting had said he remained ‘open minded’ about the future of the GP partnership model, seemingly rowing back on comments from earlier in the year.

In January, Mr Streeting had said Labour wanted to ‘tear up’ the ‘murky, opaque’ GP contract, while considering abolishing the GP partnership model in favour of a salaried service.

Labour previously pledged ‘thousands more GPs’ to ‘bring back the family doctor and guarantee face-to-face appointments to all who want them’. 

This was part of a promise to train 15,000 doctors a year, doubling the current figure, however GPs criticised the party’s focus on ‘soundbites’ rather than on meaningful policy.

Labour also claimed that 18% of patients attending A&E last year did so because they were not able to get a GP appointment, amounting to 4.5 million attendances.



Please note, only GPs are permitted to add comments to articles

Turn out The Lights 22 May, 2023 10:27 am

They will need to pump a lot more money into primary care to fulfil this.I would say the partnership model has been put to death.

Michael Mullineux 22 May, 2023 10:28 am

Delusional waffle

Charles Tinsley 22 May, 2023 10:52 am

great stuff, I look forward to them making an offer for the use of my premises, labour and expertise.

Barry Sullman 22 May, 2023 10:52 am

Do they understand that salaried GPs work to a specific job plan, whereas partners work until they collapse? Partners do so much more than just see patients, whereas salaried GPs only see patients. A salaried service will lose innovation and the work till you drop culture of partners.

Cameron Wilson 22 May, 2023 11:19 am

Totally agree with all comments above!
No surprises but at least the cards are on the table. All at BMA thinking that the were going to get an NHS saving deal for us at the frontline, must realise that the game is up. Why oh why they haven’t got an alternative lined up beggars belief. Surely we should be proposing an other option, rather than meekly accept some half baked nonsense dreamed up by Politicians who will promise the earth and fund/manage inadequately with the expectation that the deficit is made up by the efforts of the workforce.
Interesting times ahead!

Steve McOne 22 May, 2023 11:20 am

Let them find out 😉 the politicians thought taking over OOH work was a good idea….They won’t know how much value for money GP partners are until they lose us.

John Evans 22 May, 2023 11:29 am

Agree with above – the idiots never understood what a bargain 24hr GP responsibility was – seemingly haven’t learned – post contract out of hours cover delivered worse service at a higher cost – getting rid of partnerships will be the same – the only positive is that the GPs might get a pay rise when the supply demand problem is handed to the service rather than being bailed out by the GP partners.

Dr N 22 May, 2023 11:29 am

Brilliant news. £50,000 a year to rent my premises off me and I want it fully redecorated every five years. Twenty patients a day. A few days off whenever I get a snotty nose and someone else to sort out the problems when the other staff take a few days off with a snotty nose.

Wes and Keir are as clueless as they all have been. Anyone seen Steve Barclay recently?

Nick Mann 22 May, 2023 12:07 pm

If Labour could get beyond power, control, and Mandelson, it would become obvious that general practice’s success was built on and by GPs’ professional autonomy and leadership.
‘Awkward’ GPs were and are key to cost effective primary care. Salaried GPs, salaried to Partnerships are the workhorses of the system. GPs salaried to Trusts, ICSs, or corporations cannot function in the same way.
Abolition of the PCN DES and a return to core funding is essential to free up GPs’ time and resources, to concentrate on responding to patients’ medical issues and not spurious and unevidenced performance targets.

Hugo Hammersley 22 May, 2023 12:35 pm

“Later, in a major NHS policy speech in Essex, Sir Keir went on to pledge that people will get seen by a GP when they need, within five years, under a Labour government”.
Love the bit about a five-year wait to see a GP. Thanks, Sir Keir; glad to hear you’re on the case!

ian owen 22 May, 2023 12:41 pm

at the same time fewer folk want to become partners: salaried/locum is the preferred way. So it’s something that was coming through the back door anyway. Another 10000 WTE GP’s and it should even work. Maybe

Reply moderated
Centreground Centreground 22 May, 2023 12:42 pm

Abject stupidity for which the English language has no words- Starmer is the example of how the NHS has been destroyed and and will continue to undermined by politicians and he is a shocking example of how little understanding politicians have of the NHS and of political incompetence.

A Non 22 May, 2023 1:06 pm

Brainless crap, his sentences don’t even make sense, he’s not even attempting to say anything meaningful because he’s confident no body has a clue what he’s talking about..just that he’s talking and it sounds like he cares. Really its utter bollards

David Church 22 May, 2023 1:13 pm

I am not sure I understand what they are going to actually do.
5 years seems a long time to wait to see your GP of choice.
So, rather than taking people into hospitals, will ambulance crews be doing surgery and fixing fractires in the community with portable XRay machines and District Nurses assisting and anaesthetising patients?

Not on your nelly 22 May, 2023 1:35 pm

I predict an overnight exponential increase in locum chamber formation and private GP practice.

Adam Crowther 22 May, 2023 1:50 pm

Hmm 🤔 convenience, continuity, immediate, long standing community focussed cheaper salaried service. Sounds like the impossible Labour dream. We shall have no NHS service and for those that can afford it a superb private service no doubt 😢

Some Bloke 22 May, 2023 2:02 pm

looks like a lot of us think that Labour got it badly wrong, and I agree. looking at one of the latest polls- their double digit lead over conservatives is just about double digit at 11% now, total share of the vote 40%, so we may yet live to see another coalition government. (Labout-Conserve one would be very amusing one to see) so I am not planning to hand the keyes from the surgery over to ICB just yet.

Rogue 1 22 May, 2023 2:49 pm

Yes bring it on.
Buy out my practice at market rate. Then ill work my limited sessions
But they will want Safeguarding, MMT, PCN+Alliance meetings done, Audits, etc
Block out a session for each of those…..

P Aulakh 22 May, 2023 3:12 pm

Don’t forget CPD / study leave to get the hrs for appraisals!

Truth Finder 22 May, 2023 3:16 pm

It’s about taking away Professional freedom and controlling you that dictator. 10 years not a single day off sick but as a salaried I would not bother. QoF, CQC etc will not be our problem.

David Evans 22 May, 2023 3:30 pm

At last somebody facing up to the reality of delivering a primary care service fit for purpose.
Nevertheless it will be a major challenge.

Just My Opinion 22 May, 2023 3:40 pm

This is just hot air to win votes.
He’s promising everything – more GPs, quicker appointments, reduced deaths from CVD, cancer and suicide, reducing A+E waits, better ambulance response times etc etc.
Seems like there’s no problem he can’t solve.
But here’s the problem – it’s impossible, even with all the money in the world, to do that in 5 years.
The staff do not exist. The capacity (GP premises and hospital beds) does not exist. From medical school to qualification, it takes 10 years to train a GP, up to 15 years for a consultant.

Truth Finder 22 May, 2023 4:12 pm

The out of touch man. “…under a Labour government, people will get seen by a GP when they need.”
“highest satisfaction….”-A free system leads to unlimited demands. Dissatisfaction and expectation will only rise. How deluded.

Finola ONeill 22 May, 2023 4:45 pm

I say Foxtrot Oscar Starmer.
I’ve just resigned from the Labour party as a member after reading his plans in the Guardian about the NHSApp and using our population level data.
GP partners stand in the way of exploiting NHS data and patients for the US pharmaceutical industry, genomics industry, digital tech and the like.
So I don’t think the two plans are unconnected.
Very depressing.

Turn out The Lights 22 May, 2023 5:46 pm

Red an Blue doesnt matter GP is finished in it current guise.Roll on something costing 4x as much with much less capacity just like the ooh debacle.

The Lox 22 May, 2023 7:33 pm

Oh dear. He is useless.

Mark Funnell 22 May, 2023 8:26 pm

The country is financially heavily indebted. I have seen nothing that says how the government will finance buy out of practice premises – possibly they think they can continue to pay us a rental & we will continue as landlords which is not likely to be sustained if we are all salaried.
As others have said there are not enough GPs to make this model work & in 5 years there will still not be as the lead time to increase numbers & make those new doctors into GPs exceeds that. Every politician is making promises to keep their seat without any focus on reality or being able to deliver on them.
Also the care closer to home, “Neighborhood Health Service” cannot be delivered without considerably more doctors. Am I a cynic or is dropping National for Neighborhood the start of a drift from universal services to a post code lottery?
Financial plans are subjected to scrutiny by the office for budget responsibility – sadly nobody stands up & tells the public when politicians make pie in the sky promises about the healthcare system.
Of course people will vote for someone who promises them better services without anyone telling them it cannot be done.
The NHS is in the worst state I have seen in 34yrs in the service and no current political plan shows any realistic hope for things to improve.
General practice massively reduces the secondary care work load yet we have been painted as the bad guys – nothing to do with politicians who promise people what they want, when they want it, & then express surprise that when the people cannot get this they go to A&E?
We do not take our children to the shop & tell them they can have anything they want – we show them the value of what they want & the cost & how to act responsibly to use their funds to get their priorities. It seems that our political masters never learned that lesson and are reaping the rewards.

David Mummery 22 May, 2023 8:59 pm

Why not call their bluff? Consultant style contract with capped workload, SPAs for CPD, teaching, research etc . Job plan could be 1 SPA if do < 5 clinical sessions and 2SPAs if do 5 or more. Sick leave, job rights, study leave all included. No joint and several liability. Good pay and conditions need negotiating and loss of partnership model is not logically linked with loss of independence ; independence via BMA and LMCs representation would have to be part of the deal.

mansukh shah 23 May, 2023 9:05 am

Salaried option for GP would be disaster. The plan is to have excess of GPs in the pool and then the salaried model can be brought in as supply would be plentiful with some GPs unemployed and subsequently profession can be controlled. There would no be job stability and one would be signing a contract with terms and conditions which may be distasteful for many of us who value our current status. The Goodwill factor that is being poured in to NHS by majority of staff in NHS can’t be costed and will be lost to the detriment of patients.

The Prime Minister 23 May, 2023 10:44 am


Matthew Shaw 23 May, 2023 2:23 pm

Will they miss us when we’re gone? It might cost 3-4 times as much. But it gives them control. Private option?

Slobber Dog 23 May, 2023 8:00 pm

As others have said, it’s about contract control and cost reduction.
Resistance is futile.
NHSE will impose.

SUBHASH BHATT 24 May, 2023 6:39 am

Difference between partner and salaried is medicine as vocation and employment. My shop when I work as partner and their shop when salaried. Go partner works his socks of to make sure good service is provided.

Nobbies Piles 24 May, 2023 7:30 am

Last year I worked full time even with a painful broken leg + crutches. Next year it’ll be a 10 week sick note, same as everyone else!

David Mummery 24 May, 2023 8:01 am

Err …..I’m really sorry but any suggestion that salaried GPs don’t see medicine as a vocation and just ‘clock in and out ‘ , is wrong and insulting . Salaried GPs are the clinical workhorses in Primary Care

Dr No 24 May, 2023 11:48 am

What a breath of fresh air! This will definitely make me hang on for a couple more years. Long enough to qualify for the Great GP Buyout of 2024. Will boost my lump sum nicely. Idiots.

Some Bloke 24 May, 2023 12:17 pm

to be fair, listenning to Kier on channel 4, I didnt get an impression that nationalising GP surgeries is their next mission. More like- we need to be prepared to step in and offer fully salaried alternative in places where there are no Partners left.

Richard Greenway 24 May, 2023 2:47 pm

Shame. If they don’t want GP to collapse -they badly need to retain Partners first. If people aspire to partnership again, then the system can rebuild. If you take them all out -you will lose premises expertise and goodwill.
Severely downgrading CQC to an assistance organisation for bottom 5% would save £240M + countless hours for CQC registered managers (mostly partners). Take over Data Controller role off GP partners -SARs straight to HMG. Reimburse fully for nationally agreed pay rises and tax rises on employees. All would be a start and cost little.

Rebecca Louise Hammersley 24 May, 2023 7:42 pm

The comments made above about salaried GPs make me very sad. I have been both in both roles and have worked just as hard and have been just as committed to patient care in both. The jobs are different and usually (but not always) one is paid at a higher rate. We need to be asking ourselves why people don’t want to be partners and some of the comments above illustrate clearly the issues. The ‘working until you drop’ mentality may work for some, but not for everyone. Please appreciate your salaried staff, as we are all doctors and highly trained professionals.

Sandra Teare 25 May, 2023 9:26 am

Agree with David Mummery’s and Rebecca Hammersley’s comments above.
I have been a GP for 30 years, mostly salaried ( regularly working at least 10 extra hours a week for free),now locum. The partnership model at its best has been world class, but has been in decline for years, with GP numbers falling and workload increasing for all of us. It is hard to see how the partnership model will survive as this trend continues. A fully salaried system would be likely to lead to increased government and managerial control, loss of autonomy and poorer working conditions cf. junior doctors and hospital consultants.
To insinuate that a salaried service would not work is because salaried GPs have no sense of vocation, and don’t work hard is insulting. Some of the disparaging comments made here by GP partners against their salaried colleagues are shocking, and increase division rather than cohesion.

Andrew Jackson 25 May, 2023 10:19 am

Talk to your salaried GPs about their aspirations on a regular basis.
Many would consider partnership within a strong model and with support.
those who don’t want it often have very good reasons and it isn’t about work ethic.
Develop partners in house by offering a pathway to it.
It is an incredible model when it works and the NHS will be much poorer without it.
What other NHS model can fix and implement an issue within a few days.

Shahzad Arif 25 May, 2023 7:58 pm

As predicted. Short-sighted politicians do not realise the value-for-money partnerships are. When costs rise, we take a pay cut yet innovate and creatively provide services, often at a loss in real terms. We can’t quit as we are invested in our practices. So bring in a salaried model and watch how expensive it becomes to run primary care. Game on!!

John Graham Munro 26 May, 2023 11:29 am

I’ve been a happy locum since I don’t know when.

David Jarvis 26 May, 2023 6:25 pm

Sadly if they start saying it is dead it will die. Most partners join and invest on a 30-35 year plan. The instability created by political tinkering and malfeasance( I am no longer convinced it is accidental) makes it impossible to commit to such a long term career plan thus partnerships become unattractive and will die due to lack of recruitment. Imposing a non-negotiated contract with reveal your pay clauses being close to the last straw. After 30+ years as a Dr none of any of their ideas are new just recycled like fashion. Flares anyone.

Mark Bloomfield 6 November, 2023 9:34 pm

Except when ANY of these politicians from either side say ‘more GPs’ they mean Physician Associates, ‘Advanced Practitioner’ Nurses, Paramedics, Pharmacists, Podiatrists (already happening) Physiotherapists, Mental Health, Social Prescribing etc. Bums on seats = more capacity in the ‘Primary Care Team’ Mission accomplished.