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Independents' Day

Freezing MPIG cuts until April would cost £11m, minister says

A health minister has claimed that freezing the withdrawal of the minimum price income guarantee for all GP practices for the rest of this financial year would cost £11m, which the GPC has said is a ‘relatively small amount’ of savings compared with the problems it causes practices.

Responding to a question from Meg Hillier, Labour MP for Hackney, health minister Dr Dan Poulter also revealed that practices that received MPIG payments were less deprived than average practices, with only 15% of them featuring in the 20% of areas identified as the most deprived in England.

But GP leaders said that the hardest hit practices served the more vulnerable communities and £11m was a ‘relatively small amount’ to keep these essential services running.

The figures have been revealed after NHS England had agreed to freeze the funding cuts for practices which stand to lose more than £3 per patient. However, the offer comes with a number of stringent terms and for two years only.

As of April this year, the Government begun phasing out the MPIG correction factor over seven years, with the funding redestributed across all practices, despite repeated warnings from GP leaders that the move would destabilise practices.

Ms Hillier had asked what what the ‘cost to the public purse’ would be if the MPIG withdrawal was frozen effective as of last month (1 August) and how many practices who received the payments were in the most deprived parts of England.

Dr Poulter said: ‘The freezing of the withdrawal of the MPIG could cost up to £11m in 2014-15. This is because the “global sum” payments - into which the reductions in MPIG are added for all practices - have already been set for the year.’

‘This estimated cost would be for 2014-15 only and assumes that any additional costs would only be for part of the year, ie from 1 August.’

However, GPC deputy chair Dr Richard Vautrey said that this was a small price to pay to retain these essential services.

He said: ‘£11m is a relatively small amount compared to the billions spent on the rest of the NHS but is a huge amount for general practices struggling to maintain services despite repeated cost cutting.’

He added: ‘The BMA has consistently pointed out that the Government’s decision to phase out MPIG will hit a broad range of practices with challenging circumstances. As has now been confirmed by ministers, this includes hundreds of GP practices serving deprived communities and will affect thousands of vulnerable patients. There are many other types of practices that will be hit, including those in rural areas, university campuses and the commuter belt all of who provide valuable services to their local communities.

NHS England agreed to freeze the cuts for the worst-hit practices earlier this year following campaigning from practices led by the Tower Hamlets-based Jubilee Street Practice and including efforts such as Pulse’s Stop Practice Closures campaign.

Readers' comments (12)

  • I think all these practices should just given in and quote "Dr" Poulter as main reason for closer. We'll see who will be complaining then

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  • What's new? General practice is a luxury successive governments clearly do not wish to afford.

    Henry VIII did the same to the monasteries.

    Whether this is a reasonable analogy depends whether you consider access to religion a necessity.

    In the US and most parts of Europe local access to qualified medical care from a doctor the patient knows and trusts is almost unheard of.

    They all have the (highly profitable) acute sector to deal with genuine emergencies, and (highly profitable) corporate pharmacy to deal with everything else.

    Why should the UK be any different from the rest of the world?

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  • How on earth would freezing mpig cost anything? Should be cost neutral if the funds are being "redistributed". Except they probably are not so its a farcical reduction in primary care funds. With no guarantees pms growth and mpig equivalent will be reinvested we are looking at a reduction in primary care income across the board. Shows a complete lack of common sense from nhs England! Also once more GPC argues the point in a bizzare way! There really is no hope for the grassroots !

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  • imagine the savings if we could get rid of Dan Poulter !

    actually imagine how much could be saved if we got rid of the following;

    1. NHSE
    2. CQC
    3. Monitor
    4. NICE
    5. the many many other quangoes and hanger-ons.

    do they actually provide patient care? No

    what do they really do? i mean have they actually improved clinical care since they were set up? do they justify the expense that is put in them?

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  • Dr Dan, so dashing. He worked really long hours, or maybe not. Who can tell the truth about a politician.

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  • Well if every GP prescribes by generic name which is good medical practice then the 11 million they saved by squeezing us will disappear in 3 days on Ibuprofen and senna prescriptions alone.

    GP`s need to understand that we won`t win the PR war by responding to drivel and what you can do is adopt scorch earth policy and avoid being a gatekeeper and open the flood gates to secondary care and watch the weasles squeal when the S*** hits the fan.
    Already local trusts are writing letters saying they can cope with 2WW referrals which went up last year due to cancer campaigns and again probably after agent Hunts verbal diarrhoea on name and shame.

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  • So Did Dan the Man answer Ms Hillier's question regarding how many practices who received the payments were in the most deprived parts of England?, I got the £11m response - just not the context for it

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  • Full response at

    It seems that MPIG practices are statistically a little under represented in the more deprived areas (but we don't know the relative sizes of the MPIGs) but there are still a lot of them!

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  • Thanks Gavin for the excellent link.
    The issue with MPIG is not "deprivation" or any other individual aspect of the tortous calculation that derived it, but that it is supposed to be a " keep the doors open core contract delivery remuneration".
    I hope the "underrepresentation" of MPIG reliant practices in deprived area is because LES/DES payments targeted on schemes to adress deprivation provide income for service in more enlightened areas.
    My personal issue would be the ease with which Westminster MP's sought to maker variation for London practices and not review the topic nationally.
    Whether or not you believe Radio 4 "civilisation ends north of Watford gap", there are humans getting increasingly hacked off with paying taxes to a London Parliament for second rate "national" services.
    If Scotland goes it alone I can see an argument for a reigional assembly for the North.
    Good ideas from Northerners.
    Guy Fawkes was born in York.

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  • If MPIG cuts go ahead, scores of good general practices will go bankrupt within 3 or 4 years, causing overload at neighbouring Practices. Patients will suffer. There is no alternative medical provision and the washout from Better Care Fund cannot replace these lost services. By all credible health policy and economic analyses, general practice works well. NHSE knows this, but pursues policies which undermine our viability. Where will our 13,000 patients go?

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