Any grumbling concern about workload or money should really be addressed objectively as soon as possible
An unwell child poses that difficult question in every household where both parents work: whose job/meeting is more important today? It’s probably a generalisation but when babies or young children are involved it is usually the mother who will take the time off to care for them. This is an issue not specific to GPs, so would it be a problem if you noticed that it is always your (female) receptionist/secretary/practice nurse that takes time off instead of their husband who works in a local business? It is important as employers that you treat your employees fairly and that you also treat your partners fairly.
It might be useful to review your employment policy on compassionate leave as well as reviewing any reference to it in your partnership agreement. However, the best time to do this is not as a confrontation when a child or other relative is unwell, as your partner may be feeling anxious about the health of their offspring and perhaps be less able to view the situation objectively.
On the whole, any grumbling concern about workload or money should really be addressed objectively as soon as possible, instead of allowing them to build up and become divisive in the partnership. Sometimes it may be more successful to do this with a facilitator or even a session away from the practice.
As a GP couple, my husband and I took the decision to job-share just after our second child was born and just before our eldest child started school. Childcare was about to become more complex with two children and the addition of school calendar variation. My husband had been a full-time partner for four years and I had been a five- to six-session job sharing partner in a different practice. We applied for a full time position replacing a retiring partner in 2000. We started working alternate days of the week in the practice. We took a reduction in income obviously, but felt that it was worth it as the time would pass quite quickly which it has done.
This working pattern has meant that we have never needed childcare since then apart from the occasional day when grandparents are recruited. One of us has always been at home during their preschool years and there has always been someone at home after school and during the school holidays. For me, it also meant that I could work a full and often busy day without worrying about who was going to cook the dinner and get the kids ready for bed.
As the children have grown up and needed less of our time at home during the day, flexibility in our working week has meant that we have been able to take on other roles and increase our working sessions (and family income) in interesting things that complement general practice such as CCG work, boarding school health and the Medical Officers of Schools Association, insurance company work and ad hoc pieces of work for the now-defunct PCT.
We have to be extremely organised in ensuring everyone gets where they need to be with whatever equipment is required. There are still some days when one of the children is poorly and we have to make a decision about who stays home and as our daytimes now include other roles, but this is much less frequent than if we had both worked in separate partnership.
Drs Jonathan and Rebecca Pryse are GPs in Buckingham.
We have a small staff room which is also set up as a potential sick bay, for doctors’ children who have minor illnesses
When a colleague rings in to say they are unable to come in at short notice, for whatever reason, it is always a nightmare. General practice is not well suited to finding an immediate substitute to take on a fully booked day of patients, and nor is it an easy task to ring every patient and rearrange their appointment.
At the same time we pride ourselves on being a branch of medicine which is family friendly, and flexible and accommodating for men and women with young children. It is important to be understanding about the unpredictability of children’s illnesses and the rules of nurseries and schools which are often inflexible. It sounds as if it is probably the mother who is always the one taking time off to look after the sick child. The issue here is about why the father is not sharing the inconvenience to his practice. Obviously if the mother is still breastfeeding then there is no discussion. If I were in this position, I would suggest to my colleague that she (or he if the main absentee is the man) asks her spouse to share the days off equally, so that each practice is affected equally.
The other issue is about childcare in general, and how robust a back-up system is in place. Some GPs are lucky enough to have close family e.g. grandparents living nearby, who can step in on these occasions. Others, such as our current male registrar, come from overseas and have no local family. He rang in at 8.30 one morning this week to say that his children were sick, and he could not come in, for a fully booked on-call day. His wife, a hospital doctor, had not returned from her night shift and he was stuck. The next day his wife rang her hospital to say she was unable to come to work, so they shared the inconvenience between them. The ideal scenario is to have a circle of supporters around, who can step in, either family or friends.
We have a small staff room which is also set up as a potential sick bay, for doctors’ children who have minor illnesses. The sofa has been sprayed against spills, and all mod cons are available, from television and kitchen facilities to kind admin staff, who can keep an eye. This has avoided many missed days of work, and benefits everyone.
Dr Fiona Cornish is president of the Medical Women’s Federation and a GP in Cambridge.
Self-employed partners are not entitled to take any time off when their child is sick unless it is expressly written into the partnership deed
First, consider the extent of the ‘problem’ and put it into perspective. Separate days off are often more disruptive than continuous periods of long term absence for example, but consider also the frequency, the aptitude of the partner when they are at work and the extent their absence is affecting others.
Then, check your deed, which may permit a ‘reasonable’ amount of time off. Self-employed partners are not entitled to take any time off when their child is sick unless it is expressly written into the partnership deed.
Remember that dependent Leave (where this exists in the deed) is intended to deal with unforeseen matters and emergencies. If a partner knows in advance they are going to need time off, other arrangements should be agreed, e.g. annual or parental leave.
Bear in mind that government guidelines suggest one or two days is reasonable, sufficient to deal with the immediate care of the child and make arrangements for the longer term.
Check your insurance policy. Many practices now have ‘general absence’ cover as opposed to just locum sickness cover. There is no discretion under the statement of financial entitlements for the PCT or NHS Commissioning Board to pay for dependent leave locum reimbursement so the full cost is usually borne by the absent partner, or split between them and the partnership.
If you haven’t got a Partnership Deed then there is no right to time off. However, if you have permitted time off previously, you may have set a precedent. If you stop paying the partner his/her drawings this could be construed as discriminatory/victimisation and you could find yourself at an Employment Tribunal.
You could consider expulsion, but this is a high-risk, last resort solution. Do not approach the other practice.
Daphne Robertson is the Principal of DR Solicitors, a leading firm providing legal services to medical professionals