The Government is removing the Minimum Practice Income Guarantee (MPIG) used to support small medical practices.
These are more expensive to run and I can quite understand why, in these straitened times, the government’s wish is for NHS funding to be be used as efficiently as possible. The removal of the MPIG will almost certainly lead to the closure of small one-doctor practices. In urban areas, patients will be able to transfer to nearby practices with minimal inconvenience but, the situation for patients from rural areas is far more serious.
The Head of Primary Care Commissioning for NHS England has identified 98 “outlier” practices which will suffer the most substantial financial losses from the removal of MPIG; so serious that some of them may be forced to close. Despite this he has announced there will be no national solution to this problem. By contrast, the Scottish Government has put the abolition of MPIG on hold and the Welsh Government has guaranteed it will protect the practices that will be hardest hit, such as single-handed rural practices.
The total cost of MPIG is currently some £21m.
By 2021 this sum will have been redistributed among all practices so some will actually be better off. The cost of protecting the 98 rural practices that will be hardest hit must surely be only a small fraction of that £21m. The local practice that will be badly affected by this is Slaidburn Country Practice which serves the people of the Hodder Valley. The practice has been told to seek a local solution, but apparently neither of the Clitheroe Practices is interested in a merger that would keep Slaidburn open as a branch surgery.
Were the practice to close, the people of Slaidburn would face a round trip of 17 miles to and from Clitheroe Health centre, at a time when their bus service has already been severely reduced. The situation for those dwelling in outlying farms is even worse. One such is so far beyond the Slaidburn surgery, along narrow winding rural roads, that they would face a round trip of over 33 miles to visit the doctor; with a doctor called on to make a home visit facing the same in reverse. I would imagine the situation for people living in even more remote areas is worse than this.
The government cannot blame this on the law of unintended consequences because, having been made aware of the effects of the removal of the MPIG, rather than going away to have a rethink, they have announced they are not prepared to find, let alone fund, a national solution.
Anthony A Cooper,
Peel Park Avenue, Clitheroe