Here they come, further cuts in your income

Roll up, roll up! Watch carefully now ladies, gentlemen, esteemed GPs - now you see it, now you don't.

Prepare to be dazzled, stunned and astounded by the amazing, disappearing Doctors' and Dentists' Review Body (DDAB) award.

Yes, it's true, the DDRB and the DoH can really perform magic. The Review Body has recommended a 2.7 per cent global sum uplift for 2008/9. Yet, this pay rise will only result in an overall increase in global sum payments of a mere 0.2 per cent, thanks to a tricky piece of sleight of hand.

Every practice will have its global sum increased by 2.7 per cent, no doubts there. However, every practice with an MPIG will have its correction factor reduced so that the combined final global sum is no higher than its original MPIG.

That's right folks, for the majority of practices that means another year of zero global sum increases - in other words another year of real terms income cuts.

But this isn't how it was meant to be, cries more than one voice in the audience. Quite so, in the new GMS contract GPs accepted, the correction factor floated above the global sum unaffected by any changes until core practice income rose above MPIG levels.

Indeed, in January 2006 when GP revealed that the government and NHS Employers were considering this very plan to cut correction factors, GPC representatives were quick to reject even the idea of such a change.

The story was 'wildly inaccurate' said a GPC representative, the correction factor could only be cut if the Carr-Hill formula was revised or replaced.

Yet, at time of writing, several hours after the latest announcement, there is little sign of angry protest or indeed much of any protest from the GPC.

But there is reason for protest. The effect of the conjuring trick is to create new inequalities. The relatively small number of practices not using the MPIG will receive the 2.7 per cent increase in full, giving them much greater resources than colleagues.

Such an imbalance is unlikely to help attract GPs to under-doctored areas or ensure high quality in any area.

Of course in England and Scotland (and maybe Wales) there is still 1.3 per cent investment to be distributed through areas such as extended hours. (Northern Irish practices will only have the DDRB reward.)

And so extended hours will be forced on the majority of practices which will need to find the 2.75 per cent pay rises for nurses out of 2004 funding levels.

The DoH may have conjured up some new spin, but this will do nothing to really tackle inequalities or improve services as it claims. It is empty promises out of thin air.

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