Review threatens future of the MPIG

The darzi review Report implies the end of the MPIG and practices are under pressure to open late.

Professor Sir Ara Darzi

The next stage of the Darzi review is likely to further threaten the future of the MPIG.

Under the current GMS contract, 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.

GP reported this spring that the DoH believed the MPIG was not permanent and should be phased out (GP, 25 May).

Removing the MPIG would enable patient choice to play a greater role in defining practice pay, it argued.

The interim report titled 'Our NHS, Our Future' by health minister and surgeon Lord Ara Darzi, published last week, outlines further work that needs to be done by a 10-strong advisory board.

Problems to tackle include 'how to provide a more equitable link between the funding that a GP practice receives and the number of patients for whom it provides care, and the relative needs of its local population, based on the principles that practices should be fairly rewarded for taking on new patients and that "money follows the patient" if he or she chooses to switch practices', the report says.

It suggests exploring how to help patients switch GPs easily and register with practices near their workplace.

The review will look at whether there should be local quality framework targets and an independent process for setting quality framework outcomes.

The review team will include five GPs: BMA Council member Dr Sam Everington, NHS Alliance chairman Dr Michael Dixon, RCGP chairman Professor Mayur Lakhani, former head of the Improvement Foundation Sir John Oldham and Dr David Colin-Thome, the DoH's national clinical director for primary care. The final review will be published in June 2008.

Asked whether the DoH wants less MPIG funding, GPC deputy chairman Dr Richard Vautrey said: 'The DoH would like less money in the contract, and to claw back money received from the new contract negotiations.'

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