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- Page navigation anchor for Re: Should general practice give up the independent contractor status?Re: Should general practice give up the independent contractor status?Your feature in the June issue on the independent contractor status (ICS) is important, but the contributions so far have not outlined some of the key issues. First, although a minority arrangement within the NHS, independent contractors are the normal status for professions in the community like accountants, architects, barristers, dentists, solicitors, and surveyors.ICS means self-employment and leads usually to partnership practice. Partnership practice means sharing and collaboration between the partners, which is an adult-adult relationship and much the best model for sharing and collaboration between doctors and patients. Salaried hierarchies are essentially a mechanism to control people.The legal basis of salaried service has been examined by the Court of Appeal which has confirmed that it is a “master /servant relationship.”1 In practice, this makes many salaried doctors answerable to managers, who decide what equipment and what secretarial support they can have. Hospital consultants have a gagging clause in their contracts, which independent contractors do not have.The independent contractor status is a privilege and an important role with additional responsibilities. In return it brings a big say in working arrangements and the privilege of a greater locus of control.Female general practitioners, regist...Show MoreCompeting Interests: DPG is Patron of the National Association for Patient Participation and has been a Managing Partner in General Practice, and so an independent contractor, for 38 years and also has held part-time salaried employment in two universities and an NHS regional health authority.
- Page navigation anchor for RE: Should general practice give up the independent contractor status?RE: Should general practice give up the independent contractor status?Azeem Majeed and Naureen Bhatti make a compelling case for giving up independent contractor status while Rebecca Rosen suggests that this would result in ‘some wins’ but would not be worth the disruption that enforcing it would cause. In fact no enforcement is necessary. The inevitable demise of independent contractor status is already being facilitated by our profession.Roger Jones rightly points out that many GPs are opting for salaried roles. Uncertainty over the future of general practice combined with inflated fears of the responsibilities of partnership undoubtedly play a role in this choice but for many young GPs a salaried assistantship is the only employment option on offer. In an Increasingly difficult economic climate, partnerships are replacing partners with assistants not to meet the needs of the next generation of GPs but as the only means they have of maintaining or increasing the incomes of the remaining partners. However, subsidising partners’ incomes from the lower pay of assistants is an uncoupling from economic reality that can have only one consequence.The government’s intention to make general practice a seven day service is both good for patients and a tool for promoting practice federation, the key to modernising primary care. Combining this with a clamp on primary care funding appears illogical but ensures that more and more partners will be replaced by...Show MoreCompeting Interests: None declared.