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End for income guarantee

The Government has demanded an end to the Minimum Practice Income Guarantee, claiming it is a barrier to patient choice.

The Community Health White Paper instructs NHS Employers to examine the 'impact on equity' of the MPIG during the upcoming review of the way practices are funded.

It stated that the MPIG was brought in to stop GP incomes falling when the new contract was introduced, but added that 'this had not happened.

'Indeed, most practice incomes have risen substantially.'

The way GPs were paid needed to be amended to ensure money followed the patient when they moved practice, the paper stated.

At the moment, less than 70 per cent of funding goes with the patient when they switch.

A Department of Health source said MPIG was a 'dampener' and getting rid of it 'would enable greater incentives for people to work in poorer areas'.

Dr Hamish Meldrum, GPC chair, said there would need to be a massive injection of cash into GPs' global sums to get rid of the MPIG, but this was 'highly unlikely'.

He added: 'There were some problems with the [Carr-Hill] formula but the biggest problem was a lack of money in the global sum.'

Dr Barbara Hakin, lead negotiator for NHS Employers, said both negotiating teams wanted to reduce reliance on the MPIG.

But she said the Government was 'naive' to expect there not to be 'significant MPIG payments' after the review was completed.

She said: 'I think they will be seeking from us to try and have some changes in 2007/8.

'The problem is we haven't started to explore how we would do it.'

Dr Eric Rose, a GP in Milton Keynes, said MPIG was 'a quick fix we are stuck with'.

He said: 'The only way to get people off MPIG is to put more money into the formula.

'They can't just withdraw substantial sums as it will destabilise practices.'

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