Columnist Dr Copperfield argues that the splintering of the general practice workforce will make contract negotiations challenging
Not knowing the details, I can’t comment on the individual case of the practice making salaried doctors redundant on the grounds of new ways of working – including the ‘skill mix’ provided by the ARRS army. But it’s certainly in tune with the funereal mood music of a sudden lack of locum vacancies and salaried posts.
And that I can comment on, with a carefully considered, ‘Blimey!’ Am I glad I’m not GPC chair at the moment. Can you imagine trying to negotiate a new contract when all the usual tropes of general practice have been turned on their head?
Workforce crisis? Apparently not, given the number of redundant and un- or under-employed GPs currently kicking their heels. Wanting to reward continuity within the contract? How do you reconcile that with the fragmentation of the new shiny multi-role version of general practice, unless of course you prefix the word with ‘dis’. Workload cap? I don’t think so, not when you’re showing GPs the door.
And, most of all, potential industrial action? Good luck with that. ARRS staff, remember, were supposed to plug a gap, not drive a coach and horses through it. How has this happened? What was once sold as a necessity is increasingly looking like a choice. Which is where the profession splits: into those who value the core generalist role and despair at its de-construction; versus those who think the diametric opposite, and worship at the skill-mix altar. So try getting strike-action consensus out of that.
If there is a sweet spot between those two extremes, then it’ll only surface if GPs are included in ARRS, as has been suggested. GPs would eat up more of the budget but be more, well, GP. If the direction of travel changed as a result, we’d know we hadn’t sold our professional soul down the river.
In the meantime, I repeat, blimey, good luck GPC, and, being old and salaried, yeah, I’ll take the redundancy pay, ta.
Dr Copperfield is a GP in Essex. Read more of his blogs here