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No safety net for global sum losers

Practices face losing up to 18 per cent of their global sum income with no MPIG protection under proposals for a radical reshaping of the allocation formula.

GPs in small-town and rural practices would be hardest hit, with GPC figures suggesting some could be stripped of 9 per cent or more of their total practice income.

NHS Employers made it clear there would be no money to fund a new MPIG for practices that lose out – claiming many GPs had historically been 'overpaid'.

In sharp contrast, inner-city practices are set for a windfall under the recommendations – some could see their global sum income leaping by as much as 31 per cent.

The changes, proposed by the formula review group, including negotiators from the GPC, NHS Employers and the Department of Health, will be out to consultation until May.

Philip Grant, NHS Employers negotiator and chair of the review group, made clear practices that lost out under the formula would not be bailed out.

'It is not so much a case of practices losing money, it is a case that some practices are being overpaid and these changes will rectify that.

'Putting money into the MPIG is not the answer. The aim should be to make it as fair as possible and eventually phase out the MPIG.'

The future of the MPIG will be decided by a separate review, to report to ministers after the review body has made its recommendations on GP earnings next month.

The formula review group suggested two options – the first being to retain current MPIG levels, which would mean 'some practices may see a reduction in current income'.

The second option, which the GPC favours, is to create a new MPIG bolstered by additional Government funding.

But GPC chair Dr Hamish Meldrum conceded it would be 'difficult' to persuade the Government to hand over more money.

The GPC is not advising GPs whether to endorse the changes but urges them to be aware the proposals may not be backed by income protection. It stressed implementing a new formula was 'a matter for negotiation'.

But affected GPs reacted angrily to the prospect of seeing their income plummet.

Dr Cati Moss, who works in a four-GP rural practice in Northamptonshire, said the revised formula would have a 'catastrophic effect' on her practice's income should rurality adjustment be removed.

Dr Robin Jackson, a GP in Lancaster, said: 'They are either incredibly stupid or they are out to get us. I wouldn't trust them to run a whelk stall.'

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