Most GPs should be contracted by scaled providers such as hospital trusts, according to a new report with a foreword by the UK health secretary Sajid Javid.
Policy Exchange’s report makes scant mention of GP locums.
In one of just four references to the sector, authors focus on the ‘lucrative’ nature of locum work. In another, authors note that partnership has become ‘less attractive’ as the ‘differences in renumeration’ between partners, salaried and locum GPs have diminished.
Authors propose: “Under this arrangement we expect to see an increasing number of GPs salaried or employed by scaled providers [trusts, provider collaboratives, or large-scale primary care operators].
“This is not a nationalising of general practice: independent provision will continue to play a central role across primary care, but with incentives to work at a greater scale and with reformed approaches to contracting and reimbursement.”
Dr Richard Fieldhouse, NASGP chair, writes: “We would particularly like to see a response by Policy Exchange’s lack of inclusion of the 20,000 GPs working as locums, apart from the sweeping generalisations that locums only seem to be in this for the money.”
“I do question why the authors feel they can publish a ‘pragmatic proposal for reform’ of general practice without any due regard to the 25% or so of GPs who work as locums. In particular, their solution calls for GPs to all become salaried, when indeed many of us choose to work as locums because the salaried model didn’t work for us or our patients.”
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