-----Original Message-----
From: Paul Caldwell <[log in to unmask]>
To: GP-UK Bulletin Board <[log in to unmask]>
Date: 11 March 1998 19:08
Subject: salaried service


< wants wrong anyway with a salaried service if we get loads of dosh, say
55K
plus superann.? >


When I interviewed for a VTS in the halcyon days of 1983 I said my main
reason for wishing to be a GP was that I wanted to be my own boss.  I know
this freedom has been eroded somewhat but is still not to be underestimated.

There are people within trusts and the health authorities itching to
standardise general practice and tell us how it should be done.  The
facilitators would flock in.

The scenario is superficially tempting but I don't think it would be the
relaxed, protected environment some might imagine.  I have a number of
consultant friends and can't see that their working conditions are any
better than ours.  They are, however, locked into a system which gives them
very little control over their working environment.  A current thread has
been examining workload and illustrates how it is within GPs power to make
significant changes to their working arrangements significantly improving
quality of life.  As a salaried GP how easy do you think it will be to
reduce the number of appointments you offer without a drop in income.  We
will probably be confronted with "GP episode targets" or some similar
nonsense.  Do you think it will be easy to decide for yourself how much
annual leave you will take or the length of your working day?

On a mercenary note, what will happen to cost/notional rent, self-employed
taxation status, non-GMS income.

Much successful innovation in GP has been finance driven, but has proved
highly effective in improving patient care.  Traditionally high investment
practices have been high income practices - well staffed and equipped, in
modern premises with well trained practice nurses.  What would happen to
innovation.

An optional salaried service is fine but as an imposition it would be about
power and control.

"I'd rather be a free man in my grave than living as a puppet or a slave"  -
well not quite but you get the gist.

Martin Bradley
[log in to unmask]



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