A sea change in the structure of the general practice workforce has been revealed in an exclusive survey by GP.
Almost 600 locums were questioned on working patterns and rates of pay, with 49 per cent reporting a fall in demand for their services over the past year.
The same percentage complained that rates of pay had remained static, reflecting the pay cuts sustained by established GPs over recent years.
The survey of 595 locums across the UK, many of whom are young, newly qualified GPs, revealed widespread discontent at the lack of work, falling pay and limited career opportunities.
Average gross annual income varies wildly across England, with locums in London earning as much as £130,000, compared with £48,000 in the North East.
Rates of pay per day ranged from £280 in the South East to £700 in the West Midlands.
Many GPs were doing locum work due to a lack of partnerships. They complained of a 'two-tier system' where partners paid salaried GPs or locums inconsistently.
Data published separately by the NHS Information Centre this month show the number of GP partners in England has fallen by 1.3 per cent over the past year, while the number of salaried GPs has increased by 11.3 per cent, to over 6,022.
Locums reported competition for places across the UK and 10 per cent of respondents said that their pay had decreased.
'I can't get any work; is it the same all round the country?' said a locum in north east England.
'Workload and pay have gone down drastically compared with last year. I am not getting as much work as I used to,' said a locum from the South East.
Another, from South Central England, said: 'A two-tier system is developing. Largely male partners are employing young GPs as salaried doctors or long-term locums - with no employment rights and low pay.'
GPC deputy chairman Dr Richard Vautrey said that recent contract changes had caused uncertainty for practices employing GPs.
'Partners are less willing to offer long-term opportunities because they are unsure about the future,' he said. The variations in pay were a reflection of health inequalities in certain regions, added Dr Vautrey.
'The GPC hopes practices would offer GPs the chance to join partnerships to improve the long-term health of general practice. Locums should seek advice if they think they are being paid poorly,' he said.
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