GP partnerships 'like collapsing Jenga stack' after Javid threat to nationalise practices

Sajid Javid's decision to back a report calling for the end of the GMS contract within a decade is directly putting GPs off taking up partnership roles, a parliamentary committee has heard.

Houses of Parliament
Houses of Parliament (Photo: grandriver/Getty Images)

Giving evidence to the Health and Social Care Committee's inquiry on the future of general practice last week, Dr Pauline Grant, a GP partner from Southampton, said current uncertainty about the future meant that the partnership model was 'collapsing bit by bit'.

Dr Grant was giving evidence in a session focused on continuity of care, but she told committee MPs that if the government wanted to embed continuity of care into general practice it needed to first decide whether it wanted a partnership-based or salaried service.

'We're in total uncertainty,' Dr Grant said. 'What's happening is that you're pulling the rug out from the partnership model, and it's collapsing bit by bit. And at the moment we're like a Jenga stack – there's holes everywhere. If you pull out the last one it's going to collapse.'

GP partnership model

In March this year health and social care secretary Sajid Javid endorsed a report by the Policy Exchange think tank, which called for the GMS contract to be scrapped within a decade with GPs becoming predominantly salaried within large scale providers, including hospital trusts.

Dr Grant told MPs that by endorsing the report Mr Javid had created huge uncertainty about the future of GP partnerships.

She said: 'Who is going to buy into a partnership if it's not going to be here in 2030? Nobody. So we've got partners leaving and none coming into the bottom. Whenever anybody leaves at the top, I have to buy their share.'

Dr Grant said that she bought into her practice initially with £60,000. 'Each time a partner leaves I have to put in another £10,000, another £12,000, another £20,000. And in the end they'll be three partners and we'll own a third of everything,' she said.

She told MPs that general practice could still deliver continuity of care with a salaried service, but that  the whole system was currently 'so destabilised that it's hard to plan'.

Nationalising general practice

At the UK LMCs conference earlier this month GP leaders warned that plans to nationalise general practice or push GPs to integrate with hospitals were an existential threat to the profession

LMCs said that a nationalised general practice service was not in the best interests of patients, and urged BMA leaders to take 'all necessary action' to defend the GP partnership model and independent contractor status.

Earlier in the Health and Social Care Committee's hearing Dr Grant also highlighted the value for money provided by GP partnerships. She said that 'as a rough estimate' moving to a salaried system where GPs worked a set number of hours could mean the NHS needed 50% more doctors to do the work required.

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