Viewpoint: Gerada was right to spark independent contractor debate

Writing for, BMA deputy chairman Dr Kailash Chand sifts through the pros and cons of losing independent contractor status - and finds it's no easy decision.

Dr Kailash Chand: just how independent are GPs?
Dr Kailash Chand: just how independent are GPs?

Professor Clare Gerada, the outgoing RCGP chairwoman, caused something of a stir last week when she called for a debate about the future of GPs' independent contractor status.

It was a call that has undoubtedly worked, with a great deal of discussion now taking place, not least on GP’s website.

On the one hand, it is obvious why some GPs might be attracted to this idea. In theory it could lead to a better working environment while at the same time keeping GPs within the NHS and focused on patient care.

But attractive as this sounds, will many GPs willing give up their independent contractor status? Most of the GPs I know don't want to be a doctor who clocks in and clocks out nor do they want their patients to view them as someone like that. They want to be intimately involved with patients in planning services and getting things right at a local level – one of the key functions of the independent contractor status that helps embed GPs in their local communities.

Equally, many will no doubt cast a wary look to the sky at the huge reorganisation that will have to come with sweeping away the independent contractor status: it would be a huge administration task to switch all UK GPs from one model to another.

I suspect most GPs, though certainly not all, will want to stick with their current status, but before we put this debate to rest, it is worth examining the current 'independent' status and ask, is it really as independent as we might like to think it is?

The NHS Act 2012 has resulted in more mandatory competition which is affecting many GPs and last year the GP contract was subject to imposed changes that resulted in a wave of pointless yet time consuming box ticking.  Some of these targets are clearly politically, rather than clinically, driven.

In this context, we could question what sort of independence GPs increasingly have.

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