For those with short memories or who weren’t around at the time, the MPIG was an emergency measure introduced late in the contract negotiations in 2003 when it was discovered that application of the Carr-Hill formula would have been a catastrophe. It saved the day and ensured the vote went in favour of the contract.
Some might argue that the MPIG has served to maintain long-standing inequalities in income, but these were not completely random as there was a rational method of GP funding in place before the contract was revised.
The Scottish GPC has consistently stuck to the line that a national contract is best but, in recent negotiations to ‘tartanise’ the contract, they have achieved some helpful variations. Chief among these is the decision to keep the MPIG as it is. In truth they had no alternative. Abolishing the MPIG in Scotland would be a disaster.
At the start of the new contract, the number of Scottish practices without income from MPIG could be counted on the fingers of one hand. This was an indictment of the application of a UK formula to Scotland, which always had smaller list sizes and greater rurality. Since then, the proportion of practices without a correction factor has grown slowly, but the situation remains that GPs in most of rural Scotland and many deprived city areas still rely on the MPIG to keep practice income at a reasonable level.
The MPIG needs to stay in place until a formula is devised that takes into account the four nations’ long-standing differences. Many parts of general practice, and rural practice in particular, have seen erosion of income and difficulties in recruitment over the last few years. These are invariably practices with a correction factor. To remove this without a sensible replacement would be seriously damaging.
Dr Sandy Sutherland is a member of Lothian LMC and a GP in Tranent
