When we first had the idea in 1996 of creating a national organisation to represent fully qualified GPs who were not working as GP principals, we wrote several letters to the medical press asking if other GPs would be interested in joining us in this quest. One of the many replies came from Adrian Midgley who was at that stage running the Exeter Non-Principal Group. Adrian suggested that rather than refer to this group as ‘locums’ we ought instead to refer to them as “non-principals”. The name had an instant appeal – it perfectly and simply described and defined the type of GP that this fledgling organisation would represent. No GP would have think twice about what the term meant.

At a time when non-principals were feeling very much the underdogs of general practice, a sharp and crisp definition was what was needed to help bring them abruptly into the medico-political arena.

In May 2003 the NANP held its 4^th National Conference entitled “Flexible Careers Positive Choice”. Both by its intention and its conclusion, the conference marked both the transcendence and absurdity of the term “non-principal”. As a phrase it has served its purpose and the time has now come to adopt a term that unequivocally rejects its negative phraseology and avoids the pitfalls of its frequent misinterpretation as ‘un-principled’.

The Search For A New Name

The great thing about the term Non-Principal was that it encompassed all the different types of GP not working as a principal, from the highly independent and flexible self-employed GP locum to those employed assistants with significant and limiting contractual obligations.

Unfortunately the term itself is inherently negative, defining itself by something that it isn’t rather than positively identifying itself. It is confusing when heard and means absolutely nothing to our patients.

Here are some of the terms that have been considered.

Independent

Certainly many non-principals feel the benefits of working outside the constraints of a partnership and thus feel themselves to be independent. Others too would argue that as non-principals they are working independently of the NHS. Despite this however, a large group of non-principals are never-the-less constrained, albeit willingly and to their advantage, to a contract of employment with their employing practice and therefore would be hard to convince that they work independently of all reasonable constraints.

Freelance

Many professions outside of medicine have a large contingent of colleagues who refer to themselves as freelance – journalists, graphic designers, teachers (supply), IT consultants. This would apply equally well to locum GPs but again would exclude employed non-principals for the reasons given above.

Sessional

This name was first proposed by Andrew Dearden at the NANP’s 3^rd Conference in Bristol 2000. Unlike the terms ‘independent’ and ‘freelance’ it describes the way in which a non-principal works or what s/he does in a similar way to the term ‘non-principal’ rather than allude to their contractual status. In this way it avoids discriminating between employed and self-employed non-principals yet maintains a usefully descriptive terminology that still manages to draw an important distinction from other GPs.

National Adoption of Sessional GP

If the term ‘non-principal’ were to be replaced, it would have to be with the general agreement of other national bodies, in particular the GPC NP sub-committee, the BMA, RCGP, Department of Health, NHS Executive and GMC and of course all the UK’s NP groups. Arguably the NANP could seek to change its name without agreement in the expectation that others would follow, but such is the desire to loose the term non-principal that its quite likely agreement will be found.

Alternatively, another apposite moment would be when the New GMS Contract is officially adopted on 1^st April 2004.

What name to replace “NANP”

If the new term “Sessional GP” were to be adopted in place of Non-Principal, the NANP would have to consider a change in its name.

• The obvious choice would be for a straight swap to National Association of Sessional GPs – NASGP. This maintains the word ‘national’ in its title, which took approximately 18 months for special dispensation to be given by the Department of Health in order to allow Companies House in Cardiff to allow us to use this term.

• An alternative suggestion is “Association of Sessional GPs” which allows for the snappy acronym of “ASGP”.

Questions & Answers

Q When I click on the link why do I get directed to information on an erectile dysfunction drug?

A Firstly, its nothing personal. Some email programmes automatically ‘wrap’ after 76 characters so the last bits of the weblink were cut off in some emails. If this has happened click on ‘LATEST NEWS’ and you’ll get a less flaccid link.

Q I don’t have a doctors.net.uk username and password.

A All GMC registered doctors can apply for one online at www.doctors.net.uk. If you don’t wish to vote on the doctors.net.uk site simply email us your vote or comments instead – this isn’t an election, simply a means by which NANP council can gauge our members’ views.

Q Why bother changing the name?

A Arguably this is all a load of existentialist angst. But also one of the most frequently asked questions at non-principal meetings and conferences is “when are we going to drop the term ‘non-principal’?”. At such events and when campaigning on behalf of our members to a breadth of medical organisations we would much prefer to use a term free of any negative connotations [non-principal] or historical bias [locum] that defines our members as fully qualified GPs who have made a positive choice to work in their chosen context.

Q But ‘Freelance’ or ‘Independent’ are much better names!

A Agreed – a much better term for ‘locum’ but a misleading term for employed types of non-principals such as retainers, assistants etc. Just to really confuse you, remember that a locum is a non-principal but a non-principal is not a locum - a locum is merely a type of non-principal. Read our discussion document at www.nasgp.org.uk/news for a more detailed and less confusing explanation.

Q I don’t want to change the way I refer to myself. I’m quite happy with the term: non-principal/sessional/locum/freelance/assistant/retainer/salaried/independent/FCS/returner/portfolio/flexible/JUST PLAIN GP!

A Good. All we’re asking for is your opinion as to how the NANP refers to its members – how you refer to your self is entirely up to you.
 

You hit the jackpot with your latest e-mail...I totally endorse the name change idea and think 'Sessional GP' is excellent - so take me for a resounding 'yes'! NASGP member 20.1.04

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