A Hackney GP has called on patients to back her online campaign to protect funding for GP surgeries in deprived areas or risk losing them to private companies.
Dr Sarah Williams, a GP at the Nightingale Practice in Hackney, says she has been forced to act after one East London surgery announced it could close within a year with a further 12 in Hackney facing a similar threat.
However, she said every practise in the borough could ultimately be at risk as the government seeks to renegotiate GP contracts in the coming years.
The government is phasing out MPIG (Minimum Practice Income Guarantee) payments – a temporary measure introduced in 2004 to stop surgeries going bust after a change in the way GP surgeries were funded – and replacing it with a formula that will see practises in deprived areas losing millions of pounds a year.
The changes are not expected to save the government any money rather to redistribute it based on patient numbers and their age.
But GPs say the new formula will divert money from well-staffed practises that spend more time with patients with higher rates of disease who often require interpretors, which tend to be in inner-city areas, to more affluent areas that have smaller practices and see greater numbers of older, but healthier patients.
Dr Williams said: “Personally, I would be surprised if pretty not every GP surgery will not be under threat in the next seven years from this.
“When a firm of accountants looked at a 100 London GP surgeries on their books they noticed that the practises that would lose out the most, it was the practises with fewer patients per doctor with high disease prevalence. It’s a disincentive to practices striving hard to provide good care to vulnerable patients.”
She said that while it was unlikely that patients would be left without a doctor they could be left with an inferior service ran by private healthcare firms.
She said: “These practises will go out of business, the contract will go out to tender and that’s when the private sector comes in offering a very low cost service. But you do wonder how anybody will be able to make a go of it. You could end up with a situation where every couple of years, whoever is doing it thinks it isn’t viable and gives up and someone else comes in, so it wont be general practise as people know it.”
At a demonstration calling for the government to rethink its plans last week hundreds of health professionals, patients and campaigners marched through Tower Hamlets where the first GP practise is expected to close because of the changes.
The award winning Jubilee Street Practice is set to lose around £220,000 a year by 2021 with the cuts brought in incrementally over the next seven years. It has been singled out for its good work in tackling high rates of disease and adopting new practises.
The British Medical Association has calculated that 98 practises are at immediate risk across England with 12 in Hackney, five in Tower Hamlets and five in Newham.
Coral Jones, a Hackney GP and honorary president of Hackney BMA who was on the march, said: “These MPIG payments were there to account for deprivation. People in deprived areas have high needs. The government says we have to become leaner and use Skype, but there’s no replacement for meeting face-to-face.”
Ruth Taylor, a GP from Newham, who was also on the march, said the government was running a deliberate campaign to privatise healthcare services.
She said: “The best form of healthcare comes from general taxation but now the government is privatising large parts of the NHS. They have a deliberate policy of reducing the funding to GP surgeries so they can be taken over by private healthcare institutions which they have close links to.”
Dr Williams agreed. She said: “I think it’s a government agenda to get rid of NHS GPs. I think they would be more than happy if general practise was run by a few large private companies. [But] what we really want is a fair funding formula for all GPs and deprivation to be taken into account.
“The winners will be the people in the areas that are fine already – middle class people, who aren’t that ill because they eat well, don’t smoke and have better health already. And the losers are the poor deprived people who didn’t have much to begin with.
“Maybe that’s because the government doesn’t think they have much of a voice. They’re not so important electorally. People in these areas are not Conservative voters.”
NHS England said it was talking with Local Medical Committees, an arm of the British Medical Association that represent GPs, to try and address any risk of practises closing.
A spokesperson said: “GPs were informed two years ago that the MPIG would be phased out over a seven-year period and changes started in April 2014 – allowing time for practices to adjust to the gradual withdrawal of this transitional funding.
“However, we do understand the challenges that some London GPs are facing as a result of the changes. That is why we have met with some practices and have established a working group with the Office of London CCGs and Local Medical Committees from across the capital to consider what arrangements might be put in place to support those affected, and we are continuing to look at other ways we can help going forward.”
Williams said it was the first time she had ever got involved in campaigning, but given the consequences felt forced to act.
She said: “I can’t stand by and watch general practise be driven into the ground. If in ten years time they are all private practises and some says ‘that happened on your watch, what did you do to help’, I have to feel I did everything I could to stop it. And i think we can stop it.”
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