19.06.18
NHS should offer GP partners salaried employment, says Lord Darzi
GPs should be offered the option of moving to salaried employment, according to Lord Darzi.
The former Labour health minister’s recommendations are set out in his 10 point plan for the NHS, published by the Institute for Public Policy Research (IPPR), in which he has called general practice the “jewel in the crown” of the NHS.
In 1948, when the NHS was founded, physical and psychiatric hospitals were brought into public ownership, while general practice remained, for the most part, in the private sector.
Lord Darzi argues that this has made it harder to move to primary care at scale at pace because it requires small organisations to take on big contracts or form partnerships.
He also claims that this has put more pressure on GPs, who must run a business as well as provide medical care, with stress and dissatisfaction amongst UK GPs “disproportionately high.”
Recently, the Royal College of GPs (RCGP) reported that GPs are entering an “incredibly pressurised” profession.
Although Darzi accepts that some will think the partnership model should be retained, he said that it is not right for everyone, with increasing numbers of GPs who do not want to become partners because of the levels of responsibility and financial risk involved.
It also requires “geographical immobility,” and Darzi argues that there is evidence to suggest that many GPs would be open to moving to a salaried model.
Therefore, he has recommended that the NHS welcomes GPs into the health service as full employees, on the same basis as their hospital-based colleagues, as part of a transition to Integrated Care Trusts, with GPs salaried for their core clinical services, allowing those who wish to retain their existing contracts to do so.
He said that these changes would remove the risk and stress for many GPs.
In addition, Lord Darzi has recommended that there should be new funding streams for the provision of enhanced services in order to preserve the “entrepreneurial and innovative characteristics of much of general practice.”
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