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At the heart of general practice since 1960

DH pushes MPIG phase-out at same time as pay freeze

By Gareth Iacobucci

Ministers plan to press ahead with their phase-out of the MPIG even as they freeze net GP pay, in a move that leaves most practices facing a real-terms cut in income next year.

Chancellor Alistair Darling last week wrote to the Doctors' and Dentists' Review Body demanding just a 0.5% gross uplift for GPs, intended to result in a freeze in net pay.

But it emerged last week that there will be winners and losers even with that tiny amount of additional gross pay, with the DH planning to use last year's complex formula to apply differential uplifts to different parts of the contract.

In its evidence to the DDRB, the DH says that although there will be more talks on the details of the phase-out, it has an agreement ‘in principle' with the BMA to use last year's formula again for the 2010/11 award.

Under the formula, the 0.5% gross uplift to the GMS pot would be split in a 7:5:2:2 ratio between global sum, QOF, enhanced services and MPIG.

It means the 68% of practices still reliant on MPIG correction factors stand to get a real-terms reduction in pay, as they would receive only the smallest fraction of the uplift – in the region of 0.2% - while still facing rising bills for expenses.

GP leaders now find themselves faced with having an unpopular deal, creating thousands of loses among practices forced through again.

GPC chair Dr Laurence Buckman admitted the GPC had agreed in principle to adopt a similar funding formula to last year, but said this was dependent on GPs receiving an overall net uplift.

‘That's true. But you have to have an uplift in order to have redistribution,' he said. ‘You can't have a gradual erosion of the MPIG if there's no new money.'

GPC deputy chair Dr Richard Vautrey said applying the formula might not be realistic given the plans that had now emerged for a net freeze of GP pay.

‘You have to question how realistic that is. If you have a phase-out, this will effectively mean a massive pay cut for the vast majority of practices. We support the phasing out policy, but it has to be a rising tide.'

In its evidence to the DDRB, NHS Employers said 23% of practices came off MPIG this financial year, but that still leaves more than two-thirds reliant on it.

A DH spokesperson said: ‘Since 2004, some practices have received payments of up to 100% more than other GP colleagues to deliver the same essential care and services to patients. That is not fair to GPs or to patients which is why the Government have been seeking to bring MPIG to an end.'

Chancellor Alastair Darling has announced he intends to freeze GP pay Chancellor Alastair Darling has announced he intends to freeze GP pay Plans for pay

GPs under Darling
• Net pay set to be frozen in 2010 – a fourth freeze in five years – while use of formula to phase out MPIG will mean net income losses for most practices
• Pay rise of 1% recommended for salaried GPs
• GPs to be incentivised for performance through balanced scorecards

GPs under Osborne
• GP pay to be frozen again in 2011/12 under plans to hit all public sector workers earning £18,000 or more
• Plans to slash £1.5bn NHS spending a year by 2014 and cut PCT administrative costs by more than £2bn to return budgets to 2003/4 levels
• QOF to be focused on clinical outcomes

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