Senior officials at Unite, which represents over 1.4 million members including 100,000 health workers, are seeking legal advice over a challenge to the government’s imposed MPIG withdrawal.
Plans for the challenge come just days after the RCGP demanded a financial bailout for the worst-affected practices and a guarantee that none would be forced to close.
Dr Ron Singer, president of the Unite doctors’ section, the Medical Practitioners' Union, and a GPC member, said union officials were ‘shocked’ by the threat to practices from the MPIG withdrawal and agreed at a meeting last Friday to consult lawyers.
The basis of the challenge, said Dr Singer, could be a letter sent to GPs by then health minister John Hutton during negotiations for the 2004 GP contract when MPIG was agreed.
MPIG in perpetuity
Dr Singer said the letter guaranteed the correction factor payments would be paid ‘in perpetuity’ and ‘swung’ GPs' support behind the new contract and funding formula.
The withdrawal imposed following the collapse of negotiations of the 2013/14 contract breached that guarantee, he said.
‘The promise was that MPIG would be in place to protect practices adversely affected by the new contract and the new funding formula - and it would be in place in perpetuity - was the phrase that was used,' Dr Singer said at a meeting of east London GP called in response to the threat of practice closures. ‘I think that a promise is a promise,' he added.
While BMA lawyers advised against a challenge at the time of the imposition, Dr SInger said Unite’s lawyers may be more willing to take a risk ‘even if they think success is less than 50%, because a legal challenge will show up the government and what it is trying to do’.
‘Unite is very concerned about state of the NHS and as the largest union in the country is preparing to defend the NHS,’ Dr Singer told GP.
Union officials shocked
‘When I described what is happening to practices in east London, as an example of what was happening to practices across the country, [union officials] were shocked. And these are people who are in touch, to an extent, with what is happening in the NHS.’
The MPIG changes were imposed by ministers in the 2013/14 contract and came into effect this month. While the MPIG correction factor payments will be redistributed into all practices' core funding over seven years, 40% of practices are set to lose out. In London 65% of practices face losses of over £2 a patient per year.
NHS England has identified 98 'outlier' practices which face losses of £3 a patient per year. Guidance issued to area teams suggested smaller practices could be merged, federated, made more efficient through cost cutting, or helped via other contracting and commissioning solutions.
Area teams have been told the list of outliers was only a guide and there was no guarantee all practices on the list will receive support.
Dr Singer said the union was in discussions and ‘beginning to firm up’ its plans.
A DH spokeswoman said: 'We want to ensure that patients have access to high quality GP services, no matter where they live. The system needs to be equitable so GP practices are paid fairly according to the number of patients and the services they need.
'The MPIG was introduced in 2004 to support practices moving to a new GP contract. The NHS will be supporting the most affected practices to adjust as these payments are gradually phased out over seven years, and the money will be reinvested in general practice.'
Free GMS financial forecast 2014/21
GPonline.com's sister website Medeconomics has teamed up with specialist medical accountants Ramsay Brown & Partners to provide all subscribers with a forecast of their practice's financial performance as the MPIG is phased out over the next seven years.