GP leaders at the BMA have written to the Labour Party, urging a discussion in a bid to change its position on the future of the partnership model.
There had been some confusion over Labour’s position on the GP partnership model earlier this year – with shadow health secretary Wes Streeting offering conflicting opinions.
However party leader Sir Keir Starmer made the position clear last month when he said the GP partnership model is ‘coming to an end of its life’ and that the NHS needs ‘more salaried GPs’.
BMA representatives have now written to call for a roundtable with Sir Keir and Labour’s health team, to discuss the GP partnership model ‘within the parameters’ of Labour’s NHS mission.
The letter, signed by acting GPC England chair Dr Kieran Sharrock and BMA sessional GP committee co-chairs Dr Bethan Roberts and Dr Samira Anane, welcomed Labour’s ‘commitment to supporting the NHS’, including tackling workforce issues and lack of investment.
But they added that they ‘do not agree that abandoning the independent contractor model is the answer’.
The letter said: ‘The independent contractor model supports tailored cost effective healthcare for population health, allowing innovation and agile delivery cutting across communities and individuals.
‘Appropriately resourced and supported, the independent contractor model leads to retention, job satisfaction for sessional and contractor GPs, and high levels of continuity and patient care.’
In January, shadow health secretary Wes Streeting had said Labour wanted abolish partnerships but he later backtracked, saying he had ‘no intention’ to nationalise general practice and that it had all been part of a deliberate approach to ‘set the cat amongst the pigeons’.
Labour’s plans for NHS reforms also include doubling the number of medical school places, producing ‘thousands more GPs’, however some GPs questioned the length of time this will take to bear fruit.
The GPC letter sent this week said: ‘Your current plans to expand the doctor workforce will be one vital part of the solution in the long-term, but in the short-term retaining the current workforce is essential.
‘In general practice we know that this can be helped by removing bureaucratic targets, supporting practices with inflationary pressures and freeing up contractors to deliver care rather than holding them to restrictive contracts.’
The committee chairs also said they had been in ‘regular contact’ with Mr Streeting who had shown a commitment to ‘considering the challenges facing general practice and developing Labour policy to address this’.
As there appears to be no new money for the extra GPs promised they can only be paid for by reducing partner income that is above an average salaried GP earnings.
This sits behind the income publishing contract change. Nobody will be able to argue that 1 partner earning over 150k is better value than 2 salaried GPs at 75k when access is an issue.
Partnership will only exist within a leadership role in a sessional job if we have an eventual surplus of new GPs and no new money to pay them.
AJ salaried GPs now will now with ease look to 10800-11600 sessional rates so not sure where you are getting the 75K from ?
Salaried GPs, with on costs, for an 8 session job currently earn around £114,400 (based on baseline £11,000 per year). Partners typically earn around 20-30% more, but for that they gnerally work much longer hours, contribute very significantly to the management of the practice and absorb all the extra workload and risk.
Over-simplifying and/or misrepresenting the picture (‘2 salaried doctors = 1 partner’) just allows those who would deprofessionalise us and rob us of our autonomy to create a false narrative that justifies and enables their plans.
If we are all to go salaried under the NHS, we should argue that NHSE
– can absorb all the liabilities we currently hold – estates, staff etc
– can pay us for the business aspects of the practices that we have evolved (I understand that the ATMedics sale set a ‘practice business value’ of around £300 per patient) – and make it tax-free, please
– can employ us under the same terms and conditions as our NHS consultant colleagues (who for some reason enjoy much better protection) = e.g. one dedicated paperwork session for every patient-facing session, dedicated sessions for teaching, training, management roles etc – at an intensity that leaves us plenty of time and energy for private practice.
Obviously they will never be able to run functional general practice once partners have gone – *but that will no longer be our problem*.
Wow, Labour have a position, a point of principle, you say?! Why, you never…
I met Keir Starmer in the street near the surgery while walking midday saturday six months ago. I introduced myself and pointed to the Surgery in the background, and he introduced his wife and son, and was then moved on by his minders. I then spoke to my surgery colleages and all agreed that I contact him to offer a meeting on any terms. I received the email reply that he had no capacity to meet;
Dear Martin,
Thank you very much for your message which has reached Keir’s constituency office. He has asked me to respond on his behalf.
I’m afraid that Keir doesn’t have capacity for a meeting at the moment, but I have shared your details with his visit team for if he makes an official visit to your local area at some point in the future.
You are very welcome to share your thoughts in writing so I can pass them on to my colleagues who work on health policy. It is crucial for them to hear from front line staff about their concerns about the challenges they are facing and suggestions for where things can be improved.
I look forward to hearing from you.
Best wishes,
Annie Peterman
Constituency Office Manager
Office of Keir Starmer MP
So I tried again making email contact with a view to meet. i sent the following email:
Dear Sir Keir
A personalised reply to you following Annie Peterman’s response:
The answer is in your question: personal contact and experience is essential to establish for you and your policy makers; a health policy based on liaison with experienced doctors in practice becomes credible rather than dissociated. I qualified as a doctor 1976, and this month is 41 years since i started working at Temple Fortune Health Centre London NW11- and continue to work for many problem reasons including healthcare recruitment and retention.
A true story: At our surgery GP now retired told me that around 1970 the practice operated from two houses, no computer then, but knew all his patients. At the end of a long evening surgery a lady remained seated in the waiting room unrecognised to Dr who called in each patient by recognised name-he inquired and her reply was: “You wrote me a letter about the NHS and I thought I would come down and discuss with you. I’m your MP, My name is Margaret Thatcher. ” They subsequently got on well friendship, even with their differences of opinion.
I have seen a significant change from regular meetings of doctors with administration. To re-start, I would like to repeat my offer to meet on any terms, on/off the record, open/private in order to bring awareness the increasing realities of daily medical work.
I received an email reply:
Thank you for your follow up message. I’ve made a note of your interest in a meeting, but I am afraid that Keir is unable to commit to anything at present.
Some of us have sadly seen the decline in the relation between medical profession and the Health Dept politicinas change from liaison meetings towards minimal contact.
So when reading this article about GP leaders wishing to meet politicians- we wish them well!
Red or Blue doesnt matter GP parnerships are not what they want.They have not learned from the 2004 out of hours fiasco.Poorer service costing 4 x as much and no one to bail it out .Plan B BMA please.
spot on @9 June, 2023 9:58 am