Darzi prepares to attack practices over MPIGs

What will Lord Ara Darzi do next? That was the talk of an NHS Confederation meeting at the National Liberal Club in Whitehall last week, addressed by shadow Liberal Democrat health secretary Norman Lamb.

Last year GP revealed that the interim Darzi Review report implied the end of the MPIG - the final report is due next month.

Mr Lamb told last week's meeting that an NHS Confederation analysis had found that the MPIG was responsible for distributing more funds to practices in leafy suburbs than in the poorest communities.

He added that former health secretary Patricia Hewitt told the analysis briefing that now she was no longer in office she was free to say: 'This has got to go.' Is that the sound of alarm bells I hear ringing?

It was Patronising Patsy who overstepped her legal powers in 2006 when she retrospectively capped the dynamising factor used to bring GP pensions up to present-day values (GP, 21 March).

The GPC has questioned the legality of the latest Review Body report in proposing cuts to correction factors that would mean that the 90 per cent of practices with MPIGs would see no rise in existing global sums.

The GPC argues that paragraph 1.6 of the 2006/7 contract revisions considered by the Review Body should be seen in the context of the Statement of Financial Entitlements, which says that correction factors should be upgraded at the same rate as the global sum. MPIGs and correction factors are hugely important to practices because 90 per cent have them. But none of the debate about their future appears so far to have examined the reasons for their creation.

Cast your minds back to Black Wednesday in 2003 when the new GMS contract negotiators realised the lack of global sum funding meant that 90 per cent of practices would receive less core income.

MPIGs and correction factors were introduced as a last-minute fudge. Patronising Patsy and Lord Darzi appear to have forgotten the role that the DoH's negotiators played in the creation of MPIGs. Let's have a reasoned debate, but let's not present this to a positively anti-GP national media as a GP 'fiddle' to earn more. GPs are providing services at 2004 funding levels, despite the rising prices.

If the answer to the question: 'What will Lord Darzi do next?' is to propose the abolition of the MPIG, practices must be ready with the evidence about the threat this will pose and the value of general practice. To join our campaign, go to www.healthcarerepublic.com/value.

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