Doctors warn the Health Secretary that closure of university GP practices puts a generation at risk
Students and doctors have warned the Health Secretary, Jeremy Hunt, that he risks “failing an entire generation”, as university GP practices attempt to cope with funding cuts which they say threaten to shut down surgeries and wipe out vital sexual and mental health services for students.
Several specialist student practices have been disproportionately hit by changes to GP funding, which doctors say has “pulled away the safety net” for surgeries.
The Government began withdrawing the so-called minimum practice income guarantee (MPIG) in April. This is a serious blow for student GP practices, which are already penalised because the bulk of GP funding is now channelled towards elderly patients.
In a letter to the Health Secretary, the Student Health Association, which represents specialists in student healthcare, told Mr Hunt that there is “a real risk of practices going under and no longer being able to provide their expert care to their young adult patients”.
Their concerns centre on recent changes to the complex system of national funding for GPs. Student practices have historically suffered because funding allocations are largely linked to meeting targets for the treatment of specific conditions which are most prevalent in the elderly. More recently, specific funding for some conditions common among students, such as eating disorders, was cut.
However, until this year, much of this discrepancy was compensated for by the MPIG – a parachute fund introduced when many of the present funding arrangements were introduced in 2004. The MPIG was designed to enable practices that lost out under the new arrangements to maintain historic levels of funding.
Now the MPIG is being withdrawn, gradually over the next seven years. The Government argues that the money should be more evenly distributed across the GP sector, but around 100 practices have declared that they face closure without it.
The practices in trouble are, in almost all cases, those with atypical patient populations, which lose out under the “one-size-fits-all” funding formula: university practices, but also those serving inner-city populations or remote rural practices with small numbers of patients.
Dr Michele Wall, a senior partner at the Rowhedge Medical Practice near Colchester, which operates both a village surgery and a specialist student practice serving 8,500 patients at the University of Essex, said that the surgery would lose 30 per cent of its funding over the next seven years.
The cuts will result in specialist services including sexual health clinics and immunisations for students falling by the wayside, with the practice facing the potential loss of two of its five doctors.
“The Government is rationing care,” she told The Independent on Sunday. “If they’re not funding it properly, then there is no other word for it – they’re rationing it. University practices across the board are going to suffer. Students have significant needs, particularly in sexual and mental health.”
She said that while an average GP surgery received roughly £80 per patient, the complexities of the GP funding structure meant that a practice which served an exclusively student population would get only around £47 per patient – and would therefore be highly dependent on MPIG money.
Dr Dominique Thompson, the director of services at the University of Bristol Students’ Health Service and a GP in Bristol, said that funding for the treatment of mental health conditions common in student populations – including anxiety and panic disorder, social phobia and borderline personality disorder – was inadequate.
“One in four, at least, of student GP health consultations is for mental health,” she said. “I’m very worried that there’s an entire generation here coming through with all these, and the practices that have been looking after them are just not going to be funded to do it … they’re taking away the safety net, with the phrase, ‘we will have to adjust gradually’… really, that’s a euphemism for, ‘you’ll have to close’.”
Colum McGuire, vice-president for welfare at the National Union of Students, said that the NUS was “extremely worried” about the situation.
“On campus, medical surgeries are vital for student wellbeing, especially for mental health support during what can be a challenging time for many young people,” he said. “It is unacceptable for the Government to overlook the health needs of students and we need immediate action to make sure that they aren’t failed because of funding cuts.”
A Department of Health spokesperson said the Government was committed to student access to “high-quality GP services” and said the NHS will be “supporting the most affected practices” to “adjust” as MPIG payments are phased out over seven years.
NHS England has said it will “support” practices affected by the MPIG withdrawal, but GP leaders including Dr Thompson have said that little concrete financial backing is being offered.