As a salaried GP and Labour voter, I was alarmed to read Wes Streeting’s comments that he would “tear up the contract” to make all GPs salaried employees (Report, 7 January). Some of his proposals are sensible – increasing the number of medical school places, reforming pension rules, and having more nurses and physiotherapists in surgeries. However, at a time when record numbers of GPs are leaving the profession, and a third of current GPs are considering doing so, it seems bizarre to set up this confrontation.
Mr Streeting is right that increased investment should be met with improvements in standards of care, but this proposal is shortsighted and raises several big questions. With partners going above and beyond, how will their goodwill and hard work be replaced if they are essentially demoted to being employees? Furthermore, how will the managerial, educational and clinical expertise of partners be replaced when they inevitably leave medicine earlier than they would have done?
With a limited budget, how does the government plan to compensate GP partners, some of whom have invested tens of thousands of pounds of their own money into their surgeries? Lastly, who will make decisions about hiring, practice policies, quality improvement and much more in the absence of partners? Will it be externally hired managers with no stake in the surgery or awareness of its needs?
Mr Streeting has spoken of his own experience as a patient, and these experiences are invaluable in improving standards of care. However, his words here, alongside statements like “vaccinations are money for old rope and a good money spinner” (which is false) make it obvious that he has never worked in the health service, that he misunderstands some of the big issues facing general practice, and that he vastly underestimates the value of partnerships. We need politicians who understand (or are willing to learn to understand) the reality of problems facing general practice. Mr Streeting may paint statements like this as obstructive and resistant, but his is a misguided and flawed plan.
Joe McFarlane
Bolton
• The statement from the shadow health secretary, Wes Streeting, that a Labour government would make GPs salaried NHS staff is excellent news. In one move, this would improve the access to and quality of care: for their patients (most of whom are unaware that GP practices are run as a business); those GPs who are already salaried by the practices but not partners (the great majority of whom are female GPs); the practice nurses (who bear a huge amount of the practice work); and receptionists, secretarial staff and many others who contribute to the work of a practice. Labour should then consider more effective policing of time spent by hospital consultants engaged in private practice compared with their NHS contract.
Dr Jeremy Bending
Retired consultant physician, Amble, Northumberland
