Independent contractor model may be unfit for 21st century, says Gerada

GPs should ask themselves whether the 1940s model of independent contractor status is still fit for the 21st century, according to RCGP chairwoman Professor Clare Gerada.

Professor Clare Gerada: independent contractor model dates from 1940s

Giving her final speech as chairwoman to the RCGP’s annual conference in Harrogate, West Yorkshire, today she urged GPs to pool resources with all providers of health and social care in an aligned geographic area.

Professor Gerada suggested the foundation of what she described as integrated care co-operatives led by GPs.

Professor Gerada said: ‘We must change our relationship with our specialist colleagues. The them and us division symbolised by the hospital entrance must become a thing of the past. In order to make this happen we are going to have to think of and answer some difficult questions about the way we do things currently.

‘Our healthcare system was set up to meet the needs of the population of post-war Britain.’

Now people are living longer and with more complex multiple conditions, she added. Continuity of care and fragmentation of services were both made worse by the coalition government’s recent NHS reforms, multiple providers and competition they introduced into the NHS.

‘We have to examine historic systems including the independent contractor model and ask ourselves: "Is this 1940s model created as a pragmatic solution at the time still fit for the 21st century?"

‘I believe GPs working in isolation have served their purpose well but their time has passed. Instead we need all providers of health and social care with a geographically-aligned area coming together to pool resources.’

She added these integrated care co-operatives would be provider organisations led by GPs aiming to reduce fragmentation, improve continuity and deliver value for money.

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