Chris Lancelot - GP practices must be free to develop the right staff skill-mix

Ah yes - the Beecroft report. Guaranteed to make most left-of-centre politicians foam at the mouth. How dare the coalition think of introducing a system which allows small businesses to sack workers at will?

Staff skill-mix: staff now need IT, business and accountancy skills
Staff skill-mix: staff now need IT, business and accountancy skills

Let's rewind a bit. As every businessman knows, current employment law works unevenly. A firm can't terminate the employment of an established member of staff without providing a redundancy package.

By contrast, staff can leave their employer at any time, without penalty - even when that same employer has spent time and money giving them specialised training.

More invidiously, although in theory firms can sack underperforming employees, the procedures are tortuous: if the case goes to an employment tribunal the employer will lose financially, whatever the verdict.

These problems are magnified in small businesses - and that includes general practice. We don't have HR departments, nor in-house legal skills, yet we have to follow the same convoluted disciplinary procedures as do the big firms - and are therefore all the more likely to make mistakes.

In small businesses, individual staff are crucial to the effectiveness of the entire operation. If just one person starts to struggle, the knock-on effects can be devastating.

Advancing years
Advancing years may gradually affect the sharpness of older staff - not sufficiently for a disciplinary sacking, but enough to make the rest of the practice staff feel overloaded and vulnerable. We can't even force staff to retire at 65 now.

The speed of change in general practice is also increasing relentlessly. Staff now need IT, business and accountancy skills.

Yet in law, GP partners remain liable for everything done by their employees, even though that same law makes it difficult for them to remove the people who are holding back the delivery of high-quality care.

Businesses exist to make a product or perform a service, not to provide employment. Harsh though they may seem, the recommendations of the Beecroft report are long overdue, will improve business efficiency and should be put into effect immediately.

The delivery of 21st century healthcare cannot be impeded because practices aren't free to develop the right skill-mix in their staff.

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