At least 1,250 PMS practices in England are facing income cuts as PCTs follow DoH orders to cut costs (GP, 17 March). DoH guidance says PMS practices that wish to return to GMS 'do not have entitlement to an MPIG'.
GPC deputy chairman Dr Laurence Buckman said that this was 'untested in law', and pledged to seek reassurances in negotiations with the DoH.
'I think PMS practices should have a right to an MPIG if they return to GMS,' he said. 'Practices would need something to protect them from a raw global sum.'
But he added that the GPC would reject any plan to give MPIG support to PMS practices if it 'drains everyone else's MPIG'.
'The DoH might say there is a limited pool of MPIG funding,' he said.
'We would want that pool inflated if more practices switched to GMS.'
Laurence Slavin, a specialist medical accountant at Ramsay Brown and Partners, agreed that it would not be viable for PMS practices to change to GMS without an MPIG.
But these practices are likely to see income drop after the DoH ordered PCTs to consider terminating PMS contracts that were not cost-effective.
GPC chairman Dr Hamish Meldrum said PCTs might try to claim back growth money offered to practices as an incentive to move to PMS.
'I have heard stories that PCTs want to go back over the past two or three years and take money back,' he said.
He said contracts would have been negotiated locally with annual reviews and problems should have been identified earlier.
GP leaders believe the PMS practices most at risk of pay cuts are those that switched contracts in the second and third waves - about a third of PMS practices.
PCTs were under orders to drive as many practices as possible into PMS contracts. The NHS Plan in 2000 set a target of a third of practices to be PMS by April 2004. This drove trusts to offer growth money to attract practices.
Dr Ron Singer, a PMS GP in north London and former member of the government's PMS implementation group, said: 'Significant growth was offered particularly in waves two and three, often with no formal mechanism to monitor what was delivered. There is a strong possibility that there are PMS practices with growth money that are not doing anything extra for it.'
Mr Slavin said PMS practices received £90,000 in growth money on average.
He said that PCTs were unlikely to offer PMS practices an MPIG because they were not obliged to do so.
- News focus, page 17; Opinion, page 23.