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RCGP chair calls for all GPs to become salaried

The RCGP chair has called for a historic re-evaluation of the independent contractor model of general practices in her final address to RCGP members at the college’s conference today in Harrogate.

Professor Clare Gerada said that the time of GP practices working in isolation ‘has passed’ and called for a move towards provider organisations led by GPs to reduce fragmentation of care and reduce costs.

Professor Clare Gerada told Pulse last month that she would be examining GPs giving up independent contractor status in her new role as clinical chair for primary care transformation in London with NHS England.

She was then joined in her call by Professor Azeem Majeed, head of the Department of Primary Care and Public Health at Imperial College London and a part-time GP in South London, who said primary care should drop capitation-based funding in favour of methods that link workload more closely to funding.

Professor Gerada told the conference today: ‘We have to go forward together – and it will involve grasping some nettles.

‘We will have to examine historic systems – like the independent contractor model – and ask ourselves: is this 1940s model – created as a pragmatic solution at the time – still fit for the 21st century?


‘We might also need to look at how we work together as small businesses, and ask the same question. I believe GP practices working in isolation have served their purpose well, but their time has passed.’

She said that independent practices would have to become providers of health and social care, within a ‘geographically aligned area coming together and pooling resources’.

She later told Pulse and posted on Twitter that she would support the whole profession were to become salaried and employees of the NHS.

She added that this was the direction of travel for the NHS before the ‘one of the historic misjudgement of all time’ or the Health and Social Care Act.

She said: ‘Ironically, if the coalition hadn’t imposed its unwanted and unnecessary top-down reorganisation, this move towards integration would probably have happened anyway.’

Professor Gerada highlighted figures that were released by the college today that showed general practice faces a ‘catastrophe’ after 7% drop in funds since 2010.

She also praised her successor as RCGP chair, Dr Maureen Baker, who takes over next month as a ‘formidably talented woman’.

She said: ‘We are very fortunate indeed to have her as our next chair. She knows the college inside out. She has great intelligence, determination, and courage. Our college can only flourish with Maureen at the helm.’