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Contract changes ‘could spell the end of rural practices’

The Dispensing Doctors’ Association has warned that the proposed changes to the GP contract could spell the end of the viability of rural practice and has called for GPs to demand urgent action from their MPs.

Several DDA board members have written to their MPs to highlight the threat to rural practices, including DDA vice chairman Dr Allan Tennant, Dr Richard West, Dr Mark Ironmonger and Dr Philip Koopowitz.

Dr Tennant wrote: ‘The proposal to change to the GP contract includes a proposal to base funding on deprivation. This will see monies being transferred from rural to urban practices, when there is no correlation between deprivation and practice workload. If there was evidence that GPs in poor urban areas did more work, I would not be writing to you.’

He added: ‘This is not about GPs’ pay, although less money in the contract will see a further fall in pay and therefore increase the recruitment problem in rural areas. The contract also provides the monies to pay for the whole service – so there will be less resources within practices for nurses, healthcare assistants, admin staff, cleaners. Practices will have to reduce services.’

Meanwhile, Dr West wrote: ‘I am aware of the tight funding settlement and the only way this will work is if general practice takes on work previously done in hospitals. GPs will not be able to do this unless we are supported to do so. In addition, it is important that rural areas are not penalised just to suit the departments funding formulae. I would be great full if you could investigate and reassure me that resources are not being moved from rural patients to urban patients.’

Dr Ironmonger’s letter said: ‘Deprivation … used as an index to calculate spend, makes no sense, as it costs the same to treat, say, a diabetic patient, in any part of Kent or London. The proposal to rapidly phase out MPIG will make the situation even more dire. Rural practices, often dependent on MPIG, tend to be small and vulnerable, with little chance of joining forces with others and may become historic, being replaced by Virgin Health style premises.’

The DDA said it has already received response to its campaign from MPs.

Dr Tennant’s local MP Nic Dakin wrote back: ‘I will certainly draw Andy Burnham’s attention to the issues raised in your email about the potentially negative impact of the changes being proposed to GP contracts. It’s important that the knowledge and evidence from people at the sharp end, like yourself, is fed into people like Andy.’

The GPC has yet to make a move on a protest action over the impending imposition on practices despite calls from LMC secretaries to consider a boycott of commissioning.