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Salaried and locum GPs need proper representation

GMC Arora

Last week, at the UK LMCs Conference, the leader of the BMA’s Sessional GPs Committee signalled an intention to break away from the main GP Committee (GPC). That sentence may not make a huge amount of sense to many readers. But it is significant, and let me explain why.

The GPC has always represented all GPs and negotiates on behalf of all GPs. The problem is, it was structured for a time when salaried, locum or portfolio GPs barely existed. Now, around half of the GP workforce is ‘sessional’ – ie, salaried or locum. Yet the UK GPC only includes around 20 sessional GPs, out of around 70 members – and many of these are former partners. (Please note, it was raised post publication that two of the three members of the GPC England Executive – which negotiates with NHS England – are sessional GPs. Ed)

This means that sessional GP representatives feel that issues that are of importance to half the workforce don’t get the prominence they require. This includes a salaried model contract, transparency around locum fees and ensuring salaried GPs get their pay rise as recommended by the DDRB.

There is also no ignoring the fact that sessional GPs are overwhelmingly female (and there is a lot to say about the problems with sexism in the BMA). The Sessional GPs Committee published a report on the gender pay gap, and I understand there was some disquiet over a perceived ‘lack of fireworks’ (as one GP put it) from the BMA on the report. The report by Ijeoma Omambala on the GPC’s representation quoted unverified figures that the Sessional GPs Committee received £70,000 in funding, compared with the £2m received by the main committee.

There is, of course, a huge problem here for the BMA. In that, for issues involving terms and conditions – the main issues we are talking about here – sessionals would not be negotiating with the various NHS bodies or governments, but with GP partners. Which is awkward for the BMA, to say the least.

To add more complication, partners point to the way the GPC is funded. Without getting too technical, they pay the lion’s share of the running of the GPC through levies to LMCs. There is a counterargument that this levy is accounted for in the global sum in England at least. But there are further voluntary levies from practices that aren’t covered.

There are other strong sessional GP groups. But regardless, the GPC is meant to negotiate on behalf of all GPs and it does feel as though salaried GP issues are an afterthought at times (and maybe we at Pulse need to accept our role in this). The profession still seems in favour of a partnership model, but as long as this continues, we all need to accept that the non-partner proportion of the workforce is almost certainly going to grow, and they need to know the people fighting their corner are in fact working to their best interests.

While their negotiators represent both sides of the negotiating table – and one side more than the other – I don’t blame them for feeling like this isn’t the case.

Jaimie Kaffash is editor of Pulse. Follow him on Twitter @jkaffash or email him at editor@pulsetoday.co.uk.

READERS' COMMENTS [3]

Vinci Ho 19 May, 2022 9:35 am

Several points, Jaimie:
(1) As I wrote under recent Shaba’s article(will copy that in the box underneath), there is a political reality that this government, until the next election, had already made up their mind to move all GPs towards salaried roles . Of course , we , all GPs , can fight according to our own ‘common’ consensus through democratic processes. It does not , however , take away the reality and circumstances are making life of GP partners near impossible to survive . And the pressure is passed onto our salaried ( and locum)colleagues.
(2) I believe we can only be realistic and honest to ourselves what is safe for ourselves and hence , our patients while looking at the big picture . Once again , here comes my silly TV quotes:
‘’The pessimist looks down and hits his head. The optimist looks up and loses his footing. The realist looks forward and adjusts his path accordingly.’’
King Robert Kirkman
The Walking Dead
(3) Partners and salaried GPs of all genders and ethnic groups are our colleagues as well as soldiers in the frontline, fighting a war against an enemy with ‘Command and Control’ and its huge propaganda machine . The battle field is never , ever , a level playing field .
And I always say , ‘the castle under external attacks often collapses by implosion before the enemies triumph’
So have we really recognised this reality with the sense of ‘awareness and presence ‘ ( the two words I learnt most in my current therapies and meditation😳😂 )?
(4) As I wrote before , BMA/GPC ( RCGP as well)have grown successfully( arguably) into a size that it will naturally follow the common trajectory of losing establishments : becoming out of touch , leaders being stuck in the summit of the ivory tower, calamities and even occasionally , shenanigans.
Then they try to over-each pleasing everyone creating a vicious cycle with negative feedbacks . Logically , growing internal conflicts will eventually ferment into self destruction . One cannot blame people looking for alternative membership and destinations.
(5) On equality , respect and liberty (not necessarily freedom) , I give you my self-made motto:
‘We let our differences and disputes ferment into confrontation and discrimination. With spices of prejudice and arrogance , we treat each other in harms way’🙏

Vinci Ho 19 May, 2022 9:43 am

And this is my comment under Shaba’s recent brilliant article ‘Hoodwinking the profession’:

Vinci Ho
17 May, 2022 10:18 pm
I think there is a political reality we need to recognise here :
(1) This government has made up their mind to end independent status of GPs , which is something GPs of my generation (age 57 this year ) has been talking about this inevitable last 10 years
(2) At the end of the day , it is still about terms and conditions of whatever this next GP contract will become . Speculation remains speculation. Nothing is black and white until officially signed . Of course , it is about whoever representing us will get something ‘sensible’ on the negotiating table . Arguably , we should be awarded as consultants in primary care .
And I am conscious that many GP colleagues ( partners or salaried ones) are sceptical about the political abilities of BMA/GPC with all kinds of contentious issues going inside its establishment. But whoever or whichever are to represent all GPs in this historic moment , it is only a fine line between negotiation and extortion facing up against our enemy. We need some Wise Mind ( a balance between the two types of mindfulness: Reasonable Mind and Emotional Mind; learnings in my current therapy 😳😎)with some luck .
(3) From the point of protecting colleagues, I think we need to understand especially our young colleagues need an opportunity to see some prospects of a future that they can take for their next 20 years of life . Youth is NOT wasted on the young( never agree with Mr Shaw on his famous saying ). I wish I had the magic power to ensure that is to happen for all of them ……..
At the moment , I am just an old witness of history at a defining moment ……

Andrew Buist 21 May, 2022 10:36 am

I genuinely recognise the frustration of sessional GPs, they must be given a better share of the BMA resources for GPs but that has to be within the GPC set up, it would be a great mistake to split into separate branch of practices.
GPCUK is not currently fit for purpose, it needs a significant overhaul to reflect not just changes in contract status of individuals but also the reality of devolution and 4 GMS contracts across the UK. The chairs of the 6 constituent committees (4 nations, sessionals and trainees) attempted to achieve this in March but it was rejected because there’s a majority of England based GPs who do not want the change. They must realise that their focus needs to move towards GPC England on contract issues, leaving GPCUK to deal with all the shared 4 nation issues.