Exclusive: Wales explores all-salaried GP service

Minister considers scrapping GMS contracts to make GPs 'easier to manage'.

The Welsh health minister has mooted a salaried-only GP service for the country.

In discussions on the future of primary care, Edwina Hart, minister for health and social services, told GP representatives that 'a salaried service should be considered'.

A spokesman for the Welsh Assembly government confirmed: 'The minister has asked officials to explore how a salaried GP service could be developed further in Wales.'

Wales is awaiting a consultation paper on the reorganisation of its health service.

GPC Wales negotiator and Morgannwg LMC secretary Dr Ian Millington said: 'The suggestion was that it would be easier to manage the service if GPs were salaried.

'In discussions over extended hours it was pointed out that this would be easier to achieve if the service were non-contracted,' he added.

'Employed status with its greater security and support has its attractions for an increasing number of doctors who want to work in general practice,' Dr Millington writes in the September Morgannwg LMC newsletter.

In parts of Wales primary care has only been deliverable through a salaried service.

Nationally, 8 per cent of GPs in Wales are salaried, compared with 18 per cent in England. But these figures distort the picture because they only count GPs who are employed by other GPs as salaried.

GPs directly employed by PCTs or local health boards are counted with independent contractors as GP providers.

Dr Millington said that in Morgannwg, salaried GPs currently make up over 40 per cent of the headcount workforce.

'Many doctors in Wales are salaried out of choice but a significant minority have been unable to obtain a partnership,' he said.

Dr David Bailey, chairman of GPC Wales, said that to switch to a salaried-only service, the Welsh Assembly government 'would have to buy out 500 practices across Wales and take over the risk management and the employment of 10,000 to 12,000 employees'.

He did not believe the proposal posed a serious threat.

GPC deputy chairman Dr Richard Vautrey added that there was 'no prospect of a salaried service in England, and probably not for Wales either'.

'We have an independent contractor system that has proved its worth time and time again, and we would be foolish to think that any other system could deliver to that sort of standard.'


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