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There are a few key areas to update you on this month – firstly sessional involvement in LMCs, which Vicky Weeks has blogged on. I have been invited to speak at the LMC secretaries conference later this month in London. All LMCs are represented here and it’s a chance to follow up the work that the sessional subcommittee are doing in the regions they represent and want to work with LMCs to get as many salaried and locum GPs involved with their LMC as possible. Changes to the structure of GPC mean that over the next few years, the voices that make up GPC at national level will increasingly come from LMCs. Having strong sessional representation locally will be the only way to get that translated into national action. With the growing sessional workforce, it’s vital to get involved. We will be sharing ideas with LMCs on how they can help sessional doctors join, and trying to make it easier for sessional doctors to get support in LMC work.
Secondly, there have been headlines and discussions on line about the impact the Uber ruling might have for locum and salaried GPs. This centred around whether self-employed taxi drivers working through Uber, were entitled to receive the minimum wage and paid annual leave. The BMA legal team have looked at the judgement in detail:
This is the same for GP locums, partners and for OOH GPs – these are the three that have been specifically questioned on the various listservers where this issue has been discussed, but it applies similarly to all GPs and indeed anyone apart from Uber drivers.
However, because an appeal will be lodged we can’t give any definite advice yet on whether this will or won’t affect GPs. Until the appeal is heard, there won’t be a clear outcome. While there look to be similarities between locum GPs working through agencies, and the Uber case, I’m assured by clever legal folk that it’s more complex than that. We will get you more details when the appeal is heard.
I have also had meetings with RCGP and HEE, been exploring death in service protection for locums and getting my head round the various GP workforce programmes and initiatives that are taking place.
I have met with Andrew Dearden, BMA Treasurer, to look at how the BMA can better serve the needs of its sessional members. The BMA have set up a dedicated group to address this which I and Matt Mayer will work on. This will be both short and long term so I’m hoping to see some changes soon.
It is GPC England this week and I will update you following that.
Zoe Norris is chair of the sessional GP subcommittee
Follow her @dr_zo
In Scotland some Health boards insist that OOH GPs have tax deducted at source and then pay a pension contribution even for those who are not part of the NHS scheme ie retired. However locum GPs are paid gross and no pension contributions even when employed by the same board. This means they do not pay the same employee contribution and nor do they receive the employer contribution. Both are treated as contractorseven though their environment is completely controlled. It seems to me that there is a hybrid situation where the doctor is exploited and gets no benefits whereas the employer and HMRC get benefits but with minimal costs or responsibilities.
The BMA and LMCs have difficulty representing both principals and sessional GPs as they are employer and employee; not too mention the conflict re GP and consultant. What is correct for one group may well impact on the other group and they will not be happy. Eg OOH GPs are part of the GP family but the local LMC is dominated by GP principals most of whom have no interest in OOH -in fact their interests are diametrically opposed. So the LMC will not take up issues for the OOH GPs. Salaried GPs are employees of the Board - so they should be represented by the LNC but here they are the minority to the hospital doctors both consultant and junior staff so they are not represented by this group either. The BMA is dominated by both principals and consultants and I have had difficulty getting support to obtain Terms and Conditions from the Board despite having been employed for 10 years. A serious examination of the systems is required to ensure minority groups are adequately represented. Scottish Workforce said the issue was for the Board to determine; BMA said they could not tax the issue because I didn't have Terms and Conditions. Chocolate teapots come to mind. The Salaried GP contract apparently doesn't apply. All the rhetoric about Staff Governance etc is nonsense. Only when I challenged the system and could produce the job description I had been given in 2004 was there any sense. Is it any surprise I took early retirement?
HEE? Listservers? WTF?
If power is going more towards local LMCs, is there going to be an affect on the way that sessional GPs are going to be represented centrally by GPC? Will there be a need for a sessional GP subcommittee if we're going to be in the majority - there isn't a 'partner' subcommittee, for example?
HEE = Health Education England.
Listservers = the internal email system for GPC and the BMA.
With power moving towards LMCs, the representation of sessional GPs will depend on a few things. Firstly, how many sessional GPs are involved with LMCs locally, and secondly, the need for national agreement and negotiations on sessional matters. I am speaking to the LMC secretaries conference next week but it will very much depend on what LMCs want, and what the future role of GPC is in national negotiations. In short, I don't know!
I'm a sessional GP rep for my very forward thinking LMC and I think this will be disastrous for us, and this comes from my GP partner LMC chair too! The thing is, most sessional see LMCs as worse than irrelevant. Worse, because they represent the interests of the employer, not the employee. We simply can't get sessional GPs interested, and having been on this LMC for nearly a year I tend to agree. I'm still a BMA member, but seriously switching my allegiances to the NASGP who are at least not my employer.