Age discrimination squeezes GP partnerships

Most young professionals setting out on their career path see a structure of steps that will take them through some years of development towards an ultimate goal.

This is much less so for the average young GP who has three options: taking a salaried role, becoming a locum or seeking a partnership. These are options available at any stage in their career rather than one following another.

However, one, the partnership route, is far more restricted than in the past as GP's recent report on locum activity and opportunities for the new generation of GPs revealed (21 March). And NHS figures show a 10 per cent rise in the numbers of salaried GPs and a 1.3 per cent fall in partners in England over the past year.

Yes, there are additional or sideways career moves that GPs can make such as becoming GPSIs or educators, or taking the more managerial role with a primary care organisation or by entering medical politics.

But these are asides to the main goal of partnership.

Now it seems a further squeeze is being put on the availability of partnerships. In the past it was possible to create opportunities for partnerships through practices having a clause in their agreement fixing a retirement date for partners. This is now in doubt under new age discrimination legislation.

Of course it is harsh to say that able and enthusiastic GPs must give up their practices at a certain age, but outlawing this does reduce further the likelihood of partnership opportunities being available.

This in turn has to have an effect on recruitment and retention of doctors in general practice. Signing away one's life to a seemingly endless term as a salaried GP - possibly a relatively lowly paid one for an APMS contractor - may not hold much appeal for some doctors.

The risk is that as partnership opportunities narrow, there will be a return to the recruitment troubles of the days before new GMS. As opening hours extend and primary care takes on more services, this could overstrain the profession to a dangerous degree.

It is unreasonable to ask partners who have worked hard to build practices to opt out before they are ready. So perhaps it is time to look at the career structure in general practice. To ask, in fact, whether it is still appropriate or practical to have partnership as the only realistic lure to attract new blood.

General practice can be seen as an all-or-nothing - partnership or bust - proposition, but this might no longer be sustainable.

The RCGP has looked at the structure of practices and the learning needs of both existing and new GPs. Now it may be time for it to consider a new career structure.

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