The rise in workload and its intensity is driving many GPs into freelance locum work where they can gain more control. However the pressure for ever more burdensome pre-employment checks means it is increasingly attractive for practices to contract locums via intermediaries which carry out these checks.
These might be agencies, chambers or increasingly web- or app-based commercial companies. IT solutions can help match demand and supply to the apparent benefits of both sides. However the myriad of legal challenges which Uber has faced from its drivers heralds a warning sign that this ‘shared economy’ may not be as free or fair as it might at first appear. There are those that argue that freelancers working through intermediaries need their own status of independent worker with their own protections. When signing up to work through an online platform here are some things you might want to consider as a locum:
1. Will the platform control your freedom as a freelancer? Does it set terms which you could have normally set yourself like cancellation terms? Does it compel you to accept work which you don’t want? Does the platform require exclusivity from the locum? Can, or has, the platform become dominant in the market (like Uber) which could mean that freelancers lose their ability to negotiate?
2. Does the platform set standards which are not established by other regulators like the need to demonstrate certain types of training?
3. Who does the platform see as its customer? If it charges the practice then its primary loyalty is to the practice not the locum. There will necessarily be a conflict of interest if it’s a ‘practice facing’ intermediary.
4. Can the platform deactivate you, without granting you any rights for fair treatment and of appeal on your part? As an employee you have certain rights (e.g. to unfair dismissal). What rights do you have if you are freelance working through a platform and they have become dominant and have de-activated your account?
5. Does the platform recognise trade unions for collective bargaining, like the GPC or BMA? An outcome of one of the legal cases involving Uber was a move to recognising trade unions for their freelancers, despite the fact that the relationship wasn’t one of employment.
6. Does the platform do anything to establish a standard of support from practices like suitable induction, IT login, orientation to the building and prompt payment of the fee and signing of superannuation forms? As a locum you would want an intermediary to do this and many locum chambers do.
7. Does that platform collect any performance data about the locum which can be used unfairly or to their disadvantage? How is this data is handled and for how long is it kept? What is your right of redress?
8. Does the platform manage data in such a way as to influence and incentivise behaviour which may result in ‘control’ of the locum, and advantage the practice? For example it could make the average hourly fees that the locum has negotiated visible to all practices looking to book.
9. Does the existence of the platform reduce the chances of locums forming organisations which can provide peer support for each other and ensure locums have a voice with local organisations?
10. Does the platform manage its matching of supply and demand according to an algorithm which exerts excessive control and may drive a ‘race to the bottom’ as far as fees are concerned?
Dr Paula Wright is a salaried GP, appraiser and tutor. She represents north east sessional GPs on the sessional subcommittee of GPC. These views are her own. You can follow her on Twitter @PFW69