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Last week Phil Emmott, the former deputy chief executive of Bury PCT, said a serving PCT deputy chief executive told him that ‘broad hints' were being given to PCTs that only one doctor in the new Darzi surgeries need be vocationally trained.

The plans, which would require primary legislation, would introduce a fourth tier of GP. The ‘associate practitioner grade in general practice' would be different from partners, salaried GPs and registrars.

RCGP chairman Professor Steve Field said the college would ‘not support this'.

‘We believe in the need for highly-trained generalists. We do not believe there is a need for partly-trained generalists,' he said. 

But he pointed out that if hospital consultants are running clinics in primary care ‘there might be a situation where a hospital staff grade might be appropriate'.

Mr Bradshaw said that the suggestion was ‘complete nonsense'. 

Patients will be treated by ‘fully-trained medical professionals. The rules will not change.'

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