Minimum Practice Income Guarantee

Oral Answers to Questions — Health – in the House of Commons at 11:30 am on 10th June 2014.

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Photo of Paul Blomfield Paul Blomfield Labour, Sheffield Central 11:30 am, 10th June 2014

What assessment he has made of the potential effect on health outcomes of phasing out minimum practice income guarantee funding from GP practices in England.

Photo of Daniel Poulter Daniel Poulter The Parliamentary Under-Secretary of State for Health

The minimum practice income guarantee payment is unfair because practices serving very similar populations are paid very different amounts per patient. The payments are being phased out over a seven-year period to allow practices time to adjust. The money released by doing this will be reinvested in the basic payments made to all general medical services practices, which are based on numbers of patients and key determinants of practice workload, such as the age and health needs of patients.

Photo of Paul Blomfield Paul Blomfield Labour, Sheffield Central

The minimum practice income guarantee was introduced to meet the specific needs of specific practices. Those needs have not changed. NHS England has drawn up a list of 100 practices across the country that will be threatened by its withdrawal. Five are in Sheffield and two are in my constituency. Will the Minister give a guarantee that no practice will close as a result of the withdrawal of the minimum practice income guarantee, and will he provide the funding to achieve that?

Photo of Daniel Poulter Daniel Poulter The Parliamentary Under-Secretary of State for Health

The point is this: the funding system set up by the previous Government was based on historical funding and did not necessarily recognise the needs of patients. One practice might have been paid more for historical reasons than another practice next door that might have been treating more patients. That was unfair; we have changed it. NHS England is working at local level with practices that are, for whatever reason, in financial difficulties to make sure that it can help them get to the right place.

Photo of George Freeman George Freeman Conservative, Mid Norfolk

The GP practice in Watton in my constituency is struggling with the recruitment of GPs and is now two short, which is putting pressure on services. Today I heard of the proposal from NHS England to deregister 1,500 patients and transfer them to neighbouring practices in the constituency, raising a whole series of issues. Will the Minister agree to meet me to talk about what should happen, including whether NHS England could fund some sort of locum service?

Photo of Daniel Poulter Daniel Poulter The Parliamentary Under-Secretary of State for Health

Yes, I would be delighted to meet my hon. Friend. It is important to see, where possible, collaboration between GP practices on back-office services and other savings that could be made—something the public sector needs to do more generally so that more money can be invested in patients. The Government are training more GPs; in future, we will see 50% of postgraduate medical training taking place in general practice, leading to a big increase in the number of GPs.

Photo of Andrew Slaughter Andrew Slaughter Shadow Minister (Justice)

Will the Minister look at the decision by clinical commissioning groups in north-west London to move funding away—contrary to what NHS England has proposed—from

GP practices and primary care in deprived areas such as Hammersmith to areas that have much better health outcomes?

Photo of Daniel Poulter Daniel Poulter The Parliamentary Under-Secretary of State for Health

I do not believe that that is the case. In looking at the changes, we need to factor in the point that the minimum practice income guarantee, which was a historical payment and not based on patient need or patient demand, is being phased out in order to achieve a more equitable solution. As a result, we can see that the global sum payments to GPs have risen from £66.25 per patient in 2013-14 to £73.56 per patient in 2014-15. Clearly, the global sum payment to GPs per patient has increased, which is a good thing for patients and the equitability of services.

Photo of Anne McIntosh Anne McIntosh Chair, Environment, Food and Rural Affairs Committee

Historically, there used to be a payment for the distance GPs or their patients travelled. The removal of minimum practice income guarantee funding may make certain rural practices unviable. Will the Government address that issue, and will the Minister look particularly at rurality and sparsity in order to address what is a very real issue for rural GPs?

Photo of Daniel Poulter Daniel Poulter The Parliamentary Under-Secretary of State for Health

My hon. Friend makes a very good point, and we know that rural practices have unique challenges. The point is that because the money from the minimum practice income guarantee is going to be reinvested in a global sum payment, and because the global sum payment per practice is increasing, one of the key determinants of that payment is, in fact, rurality, so that should be of benefit to many rural practices.

Photo of Andrew Gwynne Andrew Gwynne Shadow Minister (Health)

The situation is far more urgent than the Minister’s complacent answer suggests. One practice in a deprived part of London has said that it is weeks away from laying off staff and just months away from closure. The Royal College of General Practitioners says that 1,700 practices could be affected, with over 12 million patients potentially facing even longer waits for appointments. Is it not the case that until we have a Labour Government, GP services are going to be marginalised and patients are going to face ever-longer waits?

Photo of Daniel Poulter Daniel Poulter The Parliamentary Under-Secretary of State for Health

I am afraid that the distance between the real world out there for patients and the Labour Government’s record is very clear. Under the Labour Government’s record on general practice, 20% of patients were routinely unable to get a GP appointment within 48 hours, and a quarter of patients who wanted to book an appointment more than 48 hours in advance could not get one. That was what happened under Labour; that is Labour’s commitment to general practice and GP patients. Under this Government, we are making sure that there is equality of finance per patient according to patient need, and that is how health care decisions should be made.