New GPs likely to seek full-time partnership

A GP poll has revealed that in future more GPs may work full-time.

The rise of the part-time GP may not be as inexorable as DoH figures have suggested, according to a snapshot poll of future GPs.

Fears about the future of general practice have taken root because of an avalanche of worrying statistics.

One in four GPs worked part-time in 2002, compared to fewer than one in 10 in 1995. An increasingly female-dominated workforce is the factor commonly believed to be behind the trend.

The extent of the male-female shift was exposed last month when South West London Strategic Health Authority became the first NHS region with more female than male GPs.

It is understood that women occupy up to three quarters of training posts, which means their dominance is set to grow.

However, interviews with future GPs at the BMA's 'GPs To Be' conference in Leeds earlier this month revealed the majority favoured full-time work.

Around 60 per cent of those questioned said they would work full-time, and slightly more female respondents than males said they would work full-time.

Their comments revealed a commitment to the traditional model of general practice.

Around 62 per cent of those interviewed wanted to be partners. They said involving the private sector in primary care was an option to be treated with caution. Many said it had no role to play at all. Most of those who felt some involvement was inevit-able called for strict limits.

Dr Dinesh Sirisena, an SHO in Leeds, said: 'I want to be a partner in a GP practice because it brings a more long-term relationship with your colleagues and patients.

'As a salaried GP, the partners can just get rid of you - there's no guarantee of that long-term relationship.'

He felt confident that finding a partnership would be possible because there is always a steady trickle of older GPs retiring.

Dr Divya Patel, an SHO in Leeds, was among a majority of female respondents who said they were keen to become partners. She said this was more attractive than a salaried job because it would allow her greater control over the practice she worked in and decisions about her patients. She planned to work full-time.

A number of future GPs said they would work as locums or salaried GPs initially, but aim to find partnerships as soon as possible.

Dr Harishchandra Medagedara, an SHO in Rhyl, said he would work as a salaried GP for a year after qualifying, then seek a partnership.

'I think I will make a better choice of partnerships after working for a while,' he said.

Locum work

Dr Martin Beastall, a GP registrar in Doncaster, said he would work as a locum at first, but would look for a partnership within a few years.

'I think it could be a struggle to find a partnership because there are more registrars now than in the past,' he said.

Dr Natasha Pomery, a locum registrar in Oxford, said she wanted to become a partner after a few years in general practice.

Around 40 per cent of future GPs said they would work part-time. Most said this was in order to fit with a partner's career or to have flexibility to pursue other interests.

Dr Hayley Hui, an SHO in Leicester, wanted to be a salaried GP because she felt daunted by the responsibility attached to a partnership: 'I'd like to take that responsibility off my shoulders. I don't mind working for others as long as it is a regular job.'

Opposition to private sector involvement in the NHS was strong among future GPs.

Dr Pomery was among 25 per cent who said the private sector should not be involved at all.

'I think the private sector has no role to play,' she said.

'It will engender a two-tier service because I think private providers will not be adequately regulated, will cherry pick services and worsen the postcode lottery. It would be a disaster if private provision is not carefully limited.'

Private sector providers

Dr Sirisena said he would be prepared to fight to keep the private sector out of the NHS: 'I think we are going down a slippery slope with the private sector.

'Money is being diverted away from the NHS because the government keeps sending people away for private operations,' he said. 'I would prefer the private sector not to be involved in NHS provision.'

Dr Hui said: 'I think private sector organisations will make GPs' futures difficult.

'GPs working for them will find they are far more harshly treated by their bosses than GPs working in traditional general practices.'

But some future GPs welcomed private providers. Dr Beastall believed that general practice would benefit from increased competition, and said he would work for a private provider as long as he was guaranteed clinical autonomy and patient services were not compromised.

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