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Is the partnership model really obsolete?

The government has been urged to explore a totally salaried GP service, after a House of Lords report declared the traditional partnership model to be not fit for purpose. There’s a bittersweet irony in being accused of obsolescence by a bunch of dudes who literally go to work dressed in dead stoats because they looked criss on Edward III. It’s like being fat-shamed by Augustus Gloop, or done for speeding by Jamiroquai.

Thankfully the RCGP chair Dr Helen Stokes-Lampard was quick to condemn the report, with the RCGP proclaiming that the ‘GP Partnership model is still relevant and brings important benefits for patients‘. I’m not sure if she’s read the whole thing, because paragraph 72 quotes one, erm, Dr Helen Stokes-Lampard saying the partnership model of general practice is ‘not likely to be fit for the long-term future‘. It’s not a good look for a medical politician to start a public beef with herself. Naivete, or a Robert The Bruce Senior tactic? The new chair is such a canny performer I’m saddened to waver toward the latter.

The report’s conclusion that ‘the traditional small business model of general practice is no longer fit for purpose’ is a direct quote from another RCGP grandee, former chair Dr Clare Gerada, whose Hurley Group is about as far removed from a small business model as Wall Street is from Main Street. Dr Gerada, who self-identifies as a grassroots GP, employs over 200 salaried GPs, nurses and managers. Sadly, none of them made it to the Lords to give their views on the joys of working in a salaried system.

Meanwhile, just as another Hurley Group partner, NHS England Primary Care Director Arvind Madan, was urging us all to copy the Hurley model and federate into super practices, came the somewhat awkward revelation that one of their sites has been put into special measures.  There’s some Michelin-star schadenfreude to be savoured here, but I’m giving the Hurley the benefit of the doubt, since we all know CQC ratings are about as replicable as a Magic 8-ball in a tumble dryer.

I’m gonna lay my cards on the table: despite the parlous state of GP right now, I like the partnership model. It gives me a say in how I work, and it pays better than any salaried job I ever had. So I think it’s a crying shame that the Lords have concluded it should be chucked out after hearing only from those whose business interests perfectly insulate them from the loss of income and independence that its passing will bestow on the rest of us. 

Dr Pete Deveson is a GP in Surrey. You can follow him on Twitter @PeteDeveson