Rural GP sends out SOS over MPIG funding cuts

Lancashire GP Dr Karen Massey fears her practice will not survive beyond 2014/15 if plans to cut MPIG top-ups to core pay go ahead, and is mounting a campaign to protect rural practices.

Dr Karen Massey (centre) fears her practice may not survive MPIG cuts
Dr Karen Massey (centre) fears her practice may not survive MPIG cuts

When GP magazine rang Dr Massey's Slaidburn Country Practice, she answered the call herself. 'It's a small practice,' she explained.

The practice has just over 1,000 patients, and needless to say Dr Massey is a single-hander. Her practice is 'the smallest numerically and the largest geographically' in the area. The removal of MPIG, which the government plans to phase out over seven years from 2014, will hit the Slaidburn practice hard.

'Ours is huge, we were one of the ex-inducement practices. It was a scheme that was introduced under the Red Book for practices with fewer than 1,200 patients. I think there were 120 in Scotland and 5 in England.

'The extra funding was replaced with MPIG in 2004 – a third of our core funding comes from the MPIG correction factor top-up – it basically equates to our entire practice profits.'

On the face of it, the sums involved are relatively small - the removal of MPIG would strip around £91,000 from Dr Massey's practice over the seven-year period.

But she says: 'We think that even after the first lot of cuts next year there is a good chance the practice will be unviable then. We are involved with other local practices, and in the process of identifying other small practices that are affected in the hope of mounting a national campaign.'

She adds: 'You don’t come into rural general practice to earn a load of money. I do the job here because I love it.

'Even taking into account the dispensing income, we still don’t earn as much as the average GP – if you take out dispensing it’s pretty bleak indeed. But that’s not the reason we do it – I could be a locum and earning a lot more.'

Rurality needs to be accounted for in weighting practice funding, she argues. 'I think rurality needs to be recognised like weighting for deprivation and funded appropriately. Just because we are in a rural area doesn't mean patients don't deserve access close to home – the government is always talking about that.'

The DH acknowledges that around 100 GP practices could be hit hard and struggle to survive if MPIG changes go ahead.

GPC deputy chairman Dr Richard Vautrey said: 'The changes to MPIG are a result of the contract imposition and we made it clear last year that if the government imposed changes in this way without considering how to deal with outliers it could be a disaster to those practices.

'Practices need to be told as soon as possible what the final payment per patient they will receive will be. However this also depends on what happens to PMS funding.'

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