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DH figures reveal likely swings in practice funding from ‘destabilising’ MPIG phase-out



Exclusive: Thousands of GP practices which are still dependant on MPIG receive an average of £12,000 a year in correction factor payments, according to Department of Health figures which lay bare the likely impact of its planned changes to the GP contract.

Some 63% of practices in England currently receive some funding through the MPIG, and the DH has said that its plans to phase out the MPIG and move towards a more ‘equitable’ system of funding – set to be implemented between 2014 and 2021 – will see 50% of practices lose funding and the other 50% gain.

But new DH figures obtained by Pulse this week reveal just how reliant many GPs are on correction factor payments, and add fuel to GPC fears that the changes will be ‘destablising’ for many practices. The average £12,000 correction factor payment for practices still on the MPIG represents 4% of an average practice’s global sum income, but that figure masks huge variation. The DH said one unnamed practice receives a correction factor payment worth more than nine times its global sum total – some £370,000 a year.

The DH figures follow predictions from one leading medical accountant that phasing out the MPIG could lead to a ‘bloodbath’ in practice funding, with those with a list size of less than 4,000 facing possible closure.

But while much of the profession has expressed alarm at ministers’ plan to impose contractual changes, the phasing out of the MPIG has divided GPs.

Dr Om Aggarwal, a GPC member and GP in Cardiff, said: ‘I am a partner at a small practice, and oh yes, we will lose funding. Most practices in Wales stand to lose. It will be a question of survival.’

Dr Fiona Cornish, a GP in Cambridge, said the MPIG was vital even for practices not in deprived areas.

She said: ‘I know it is bad for our practice to get rid of it. We have loads of worried well, who are very demanding and take ages, but we don’t get paid much for them in terms of deprivation loading, so we need the MPIG.’

But Dr Brett la Hay, a GP in Tayside whose practice gets zero MPIG weighting, said the correction payments had entrenched inequality.

He said: ‘How can the BMA and the GPC continue to ignore that some practices are unfairly rewarded compared to those on low or zero MPIG? For once I am entirely siding with the Government on this issue and would ask the profession to think about the whole picture and not selfish self-interest.’

‘My practice has experienced seven years of this lower income and my patients have had lesser services because of it. “Destabilising” general practice just means some practices resent change. I resent the continuing disadvantage the MPIG gives to my patients.’

And Dr Tony Bentley, a GP whose Leicester practice has not received correction factor payments for for four or five years, said the MPIG was a ‘significant problem’ locally: ‘Some practices get significantly more pounds per patient, which means there are certainly remaining inequalities in funding, and seven years to address that seems inappropriately long. It should happen much quicker.’

‘There are significant funding anomalies still which mean that some practices are unable to provide as good a service for their patients as others and that is an inappropriate use of public funds.’

GPC chair Dr Laurence Buckman said: ‘The impact of losing MPIG ranges from none at all, to very little, to potentially devastating.’

‘The conference of LMCs has a policy that says the profession should move towards more equitable funding, but this needs to be done with consideration and involvement of practices. For some practices it will be very disturbing. There will be a lot of losers from this.’

The BMA is awaiting further clarification from the Government before modelling which practices will lose significant funding and which will gain, he added.