The BMA in Northern Ireland estimates that the registered population has increased by 40,000 since the new GMS contract came into force in 2004. But this increase, due to the success of the peace process and economic migration from Europe, has not been accompanied with extra money for practices.
This leaves a gap of around £2 million equating to around £2,000 per GP, according to the Northern Ireland GPC.
Dr Brian Dunn, Northern Ireland GPC chairman, said: 'We have raised the matter with the Department of Health, Social Services and Public Safety (DHSSPS).
'If extra funding is not made available then we will have to look at the options and one that would be considered is for GPs to say they cannot take any more patients on as they are not getting any funding for them.'
In Northern Ireland the global sum is calculated by dividing a fixed sum for 2002/3 by the population, a system the Northern Ireland GPC opposed at the time.
Dr Tom Black, Northern Ireland GPC vice chairman, said that population increase was prevalent in the cities of Belfast and Londonderry, which are attractive to migrant workers and former Northern Irish migrants returning home.
'There is renewed confidence in industry and the peace deal which is bringing more people into the area. It is an unusual situation that has, perhaps, taken the government by surprise but it remains that we are still being paid under the old population figures. It is not fair and I hope that the DHSSPS listens,' said Dr Black.
A DHSSPS spokesman confirmed that the matter had been raised by GPs but that, 'discussions are still ongoing', regarding whether extra funding would be made available.
GP first reported this last year (GP, 15 September 2006).
It also applies in Scotland where an extra 46,000 patients since 2003 means that global sum payments per patient have fallen by about 50p.
If the payment per patient had remained static, the average practice would be around £2,341 better off each year.
GPC Scotland is in talks with the government over the issue.
A different system operates in England and Wales where there are central top-ups to global sum funding even if the population increases.
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