Pass me the diazepam. I am full of rage and need to share. The source of my ire? This ludicrous situation:
‘Well, Dr Norris, you aren’t employed by us are you?’
‘No. I’m self-employed.’
‘Right. So you don’t get any annual leave, sick leave, maternity benefits and so on. You also don’t have a notice period other than the mutual cancellation policy that you requested we sign.’
‘Once again, correct.’
‘Smashing. So, here is a letter saying we are not going to pay you as much for the work you do. We’ve chopped your pay by a third and want you on the payroll. But we aren’t going to give you any of the rights of an employee. What do you reckon?’
‘No thanks. I’ll pass.’
‘Right – we’ll refer you to the GMC.’
This has been the brilliant solution of a number of hospitals, acute trusts, out-of-hours organisations and other large employers across the country to recent changes in the law that mean they have to pay tax and national insurance contributions for the self-employed (GPs could have to pay locum tax and national insurance under new legislation, pulsetoday.co.uk/news).
It’s a mess, for everyone: doctors, hospitals and practices. Everyone is confused. That said, anyone who threatens to report a doctor to the GMC over a tax issue needs a slap. They can have no idea what a GMC referral means or they would never even suggest it. If they do and are still suggesting it, they’ve just joined Nigel Farage on the list of my least favourite people. A GMC referral should be reserved for the most serious breaches of duty. An unfounded allegation can mean months, or even years, of uncertainty, distress and a personal and professional toll that often finishes a doctor’s career. I have seen it time and again.
The logic behind these threats is that if a self-employed doctor decides not to book further work as a result of unilateral changes in their working conditions, it puts patient safety at risk and is therefore GMC-able. Let’s be clear. It isn’t.
Does some sort of loyalty clause apply to one-sided contract changes that pay less and give no benefits? No. The headlines rapidly follow, about locums ‘holding the NHS to ransom’. Well if there were doctors aplenty that would be fine but there aren’t, because the NHS is breaking them.
The Government isn’t bothered. The NHS is no longer allowed to care for its staff. It just can’t. Instead of recognising and addressing the lack of doctors (and, no, promising to train 5,000 new GPs doesn’t count), the knives are out for those who decide they are fed up of being trampled on.
How dare you suggest my decision not to work for you any more means I am a danger to patients and should lose my livelihood?
When we get the dreaded election results next month, expect to see more of this as the contempt for the whole profession continues to grow. A wise man once said ‘ “No” is a complete sentence’. We need to start saying it a lot more.
Dr Zoe Norris is a GP in Hull