Exclusive: DoH to dump MPIG but new formula criticised

Health minister Andy Burnham has said the MPIG is not permanent and should be phased out, at the same time as the RCGP issued a damning verdict on the revised Carr-Hill formula.

In an exclusive interview, Mr Burnham said that the MPIG would be tapered off under DoH plans for a ‘decisive move away from paying people for existing’.

When the GMS contract was negotiated, it was agreed that it was ‘not a permanent feature’, he said. ‘It was something that was done to ease the transition to a new contract. The idea was to taper it over time, and for me that’s got to be right.’

Removing the MPIG would enable patient choice to play a greater role in defining practice pay, Mr Burnham said.

‘We are looking to an NHS where it’s the patient’s choice that matters — where does the patient want to go, which places are offering the services that people want. Every bit of the system will need to feel the effect of that,’ he said.

Under the current system, more than 90 per cent of GMS practices receive correction factor top-ups to global sums to prevent them earning less than they did under the Red Book.

A consultation on proposed changes to the GMS contract that could see the MPIG scrapped ended this month.

The RCGP’s response to the consultation, obtained by GP, says proposed improvements to the Carr-Hill formula would bring a slight improvement to fairness of resource distribution, but ‘more by accident than design’.

The most deprived practices in the country are the biggest losers under the new formula, because it fails to account fully for health need, the RCGP says.

‘Assumptions made — that the number of patients with major chronic illness, in nursing homes and speaking a different language are irrelevant to workload — are incorrect,’ it says.

GP leaders reacted angrily to the claim that MPIG was time-limited. GPC deputy chairman Dr Laurence Buckman called it ‘a real cheek’.

‘MPIG is there in perpetuity until such time as the need for it is removed by a rising tide,’ he said, adding that GPs were experiencing a ‘falling tide’, with pay freezes since the new contract came in.

The GPC will resist attempts to cut MPIG top-ups until funding is sufficient to give all practices better global sums under new GMS than they received under the Red Book, he said.

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