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Independents' Day

At-risk rural practices should be 'looking to help themselves' says health minister

The Government has rejected a last-ditch plea to form a special protection fund to ensure the survival of a few dozen English rural GP practices amid MPIG funding reforms, with a health minister suggesting practices should be ‘looking to help themselves’ to survive.

In a House of Commons debate concerning the minimum practice income guarantee (MPIG), health minister Dr Dan Poulter said he is ‘confident’ the formula the Government has devised ‘will support rural practices into the future’, rejecting calls for a similar central fund to protect rural practices as has been agreed in Wales and Scotland.

Instead Dr Poulter said surgeries must be ‘looking to help themselves’ - including making effiency savings on IT, back-office services and administration costs - and should consider turning themselves into dispensing practices to gain extra funding.

It would be a ‘matter for area teams’ to consider alternative funding options should the practices still be at risk of closure having exhausted all other options, he added.

NHS England has announced there are almost 100 practices who are set to lose £3 per patient as a result of the Government’s plan to withdraw MPIG, and a further 200 who will lose more than £2 per patient.

Pulse has reported that practices are considering cutting hours as a result of the decision, and the subsequent refusal of local area teams to provide financial support.

Liberal Democrat MP for West Morland and Lonsdale Tim Farron, whose constituency includes two remote rural communities in the Lake District, argued for a central fund to protect at-risk practices.

He said: ‘The process of removing the minimum practice income guarantee and redistributing the funds per capita is a staggeringly blunt instrument. It is the ultimate one-size-fits-all policy, which treats small rural practices the same as large urban ones.’

Mr Farron added: ‘The minister will know that strategic small surgery funds have been established in Scotland and Wales. They are ring-fenced at the centre to ensure that no surgery that needs to remain open is closed by accident. Rural communities in England suffer from poor funding in social care, secondary care and primary care.’

However Dr Poulter said: ‘That is a matter for area teams to look at. The first approach that area teams will take is to ask, “Where can we make efficiency savings that will mean there is more money for front-line patient care, such as IT, back-office services and administration costs?”.’

‘That has got to be the first thing: surgeries looking to help themselves. Later on down the line, if everything else has been exhausted, the area team will have to make a decision about whether other mechanisms are in place to provide additional support.’

He added: ‘Rural GPs may also be able to increase their income in other ways. For example, dispensing practices tend to be in rural areas, although not exclusively. That is potentially another way to provide additional income for a practice, as well as important support for the community, which can have closer-to-home access to prescribed medications and drugs.’

Dr Poulter said he was ‘confident’ that the funding formula ‘will support rural practices into the future.’

Readers' comments (12)

  • Vinci Ho

    Watched BBC report on a rural area practice , do believe they are at risk of closing down . To say 'help themselves' follows the evil 'Big Society' ideology of Darth Vader i.e. Sort out yourself .
    Those with no virtue holding high position in a hierarchy spread the evil through the most.
    By the way , the name attached to 'efficiency saving' finishes today......

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  • Of course rural practices have it easy if they need more money - they can simply branch out into farming and fruit picking . There are so many furrows one can plough . Perhaps a veterinary practice on the side or a bit of badger culling would help. Just use your imagination - collecting empty bottles ,there's another -easy see.

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  • Factory Poulter farming .

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  • Poulter might one day need the help of a rural GP while driving through the back and beyond in his Bentley. But the doors will be locked as he is clutching his chest because he will have shut down all the bloody practices.

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  • Bob Hodges

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  • this is great news we finally have support for dispensing possibly for the first time in my working life from a senior government minister the DDA must use this in negotiations with the DOH and this message must get out to CCG boards many of whom are hostile to dispensing doctors perhaps a change in the rules allowing practices to dispense to patients within a mile of chemists might help as well

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  • Keith Taylor

    I can't imagine for one minute the practices at risk have not considered how they can make savings.There is no doubt that "the one size fits all" funding model just cannot work in remote rural areas where a GP surgery is required to serve the local population. Rural practice may already be dispensing so where are the additional income streams going to come from? Is it going to take a surgery to close before this broad brush approach is reconsidered - clearly the policy makers do not understand the full impact of these changes on the rural practice!

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  • Practice dispensing is not a cross-subsidy for underfunding of General Practice. Dispensing Practices were a consideration of pharmaceutical needs assessments in 2011, if there are not already dispensing practices in rural areas it is unlikely that more will be allowed to open. Dr Poulter has based his assumptions on a poor knowledge and/or a bad briefing.

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  • Bob Hodges

    Ministers basing assumptions on a poor or absent knowledge base and/or bad/mendacious briefing you say Brian?

    What ever next?

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