The NHS scheme was brought into the UK almost 70 years ago – a lifeline for people at the time suffering post-war austerity. Family doctors were known for their independence in the profession; and at that time the NHS was hotly debated in the political world, just like the Government plan to make doctors work seven days a week. But how independent are GPs today? The ability to ‘manage’ general practice remains mainly with the GPs themselves; however, there is criticism about whether this independence within the NHS is good for the country.

GPs involvement in the Local Medical Committee.

Practices are required to contribute to the operational costs of the Local Medical Committee (LMC). However, not all GPs contribute to the Voluntary Levy, which supports the work of the General Practitioners Committee (GPC) of the BMA, showing that they are only keen to further their own individual pursuits.

Membership of the BMA

All GPs can join the BMA as individual members. However, only around 15,000 GPs recently responded to a Workload Survey undertaken by the BMA, out of around 35,561 GPs registered to practice in England, meaning many GPs are not registered with the BMA. This shows that some GPs may not wish to be a part of NHS schemes – especially since an annual fee to join is in place here.

Membership of RCGPs

Members of the Royal College of General Practitioners (RCGPs) are GPs on the GMC’s medical practitioner register. This is an achievement and it could be argued that this membership further emphasises the individual’s commitment to general practice, and their own independence.

Involvement in Federations

Practices are now becoming more involved in ‘Federations’ or ‘Alliances’. The BMA has registered over 60 groups of doctors all over the country and the keenness to tackle the problems of general practice and work together to improve services is surely a strong sign of independence.

Salaried contracts

A recent survey carried out by KingfisherPM suggests that salaried GPs are filling far more part-time posts than full-time. A salaried service was seen as a way forward in general practice but now, this does not appear to be the case. The current preference is to become or remain in ‘partnerships’ and to still own premises.

Training Practice

Around 50% of GP Practices are training practices. This on the one hand shows a commitment to the future generations of GPs but it also shows a respect for the independence of general practice.

Ownership of Premises

Owning premises has always been an expression of independence; and a recent BMA poll suggests that 40% of those surveyed felt that their premises were now inadequate, despite a major investment in new premises over the last 20 years. This shows that GPs take pride in where they work and feel that it expresses their independence in the field.

Information Technology

GP Practices have taken on board technological advances – things have moved on from the days of repeat prescriptions printed from a BBC Acorn computer to the NHS Spine! GPs are good at taking these advances on board but there is still that independent resistance around not wanting to use NHS email addresses, by keeping their own personal work email addresses.

Is this independence good both for GPs and for patients? General practice has changed immensely and today, the average patient sees their GP at least 6 times a year, with 90% of NHS consultations in general practice. However, the worry is ‘overload’. After all, how long will it be under the present system that GPs will be able to remain independent?