Minister defends handling of practice MPIG cuts

Health minister Dr Daniel Poulter has defended the government's decision to withdraw MPIG and said NHS England is supporting practices through the funding changes.

Parliament: MPs debated MPIG reforms (photo: Ian Bottle)
Parliament: MPs debated MPIG reforms (photo: Ian Bottle)

Dr Poulter was responding to questions from Jim Fitzpatrick MP (Lab, Poplar and Limehouse) over the effects of MPIG cuts on practices in Tower Hamlets, east London.

Mr Fitzpatrick yesterday visited the Jubilee Street Practice in his constituency with shadow health ministers Andy Burnham and Liz Kendall. 

Jubilee Street has said has said it will close in October unless a solution is found to losses of £903,000 as correction factor payments worth £219,508 a year are withdrawn.

Outlier practices affected by cuts

Rushanara Ali (Lab, Bethnal Green and Bow) told the minister there were five outlier practices affected by the cuts in Tower Hamlets.

Dr Poulter repeated the government’s position that NHS England ‘has considered the very small number of significant outlier practices for which alternative arrangements may need to be made to ensure appropriate services are maintained for local people’.

He said the net effect of all recent funding changes for all 721 GMS practices in London was ‘an overall funding increase of £731,000’.

Mr Fitzpatrick quoted deputy head of primary care for north central and east London, Rylla Baker, who admitted that the cumulative effect of funding changes was ‘significantly greater’ for some practices.

Ms Baker wrote: ‘Although the situation with the loss of MPIG is, for most practices manageable, when the practices take into account other changes in funding that impact on them, the cumulative impact is significantly greater and practices such as Jubilee Street have said that if there is no mitigation against the loss the practice will not be viable.’

She added: ‘It is also relevant to point out that this is an issue that is not limited to Tower Hamlets.’

London group to assess MPIG problems

Dr Poulter said NHS England’s area teams in London had ‘set up a task and finish group to look at the support that might be offered to practices’.

‘I understand that NHS England’s area team in London has been in regular contact with individual practices in Tower Hamlets to offer them ongoing support regarding these changes.’

He added: ‘We have announced that NHS England is supporting practices as they phase in the changes to the minimum practice income guarantee and to QOF payments.’

A spokeswoman told GP that NHS England London region had ‘convened a working group with the LMCs across London and the Office of London CCGs to consider what arrangements might be put in place to support practices in the changes they will need to make’.

‘Where the MPIG change is more than an average year on year £3 per weighted patient reduction, we have offered to meet with the practice (together with the LMC and the CCG if the practice so desires) to discuss their unique challenges and ways in which these may be overcome.

‘This meeting will involve conducting an examination/review of income and expenditure including pensionable income, as well as gaining a better understanding of the demographics of the practice population. We will then discuss practical changes that might be made as well as future options for the practice, which might include collaboration with other local practices, technological possibilities and workforce considerations.

‘We will also be offering practices some organisational development input to plan for the delivery of changes.’

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