Despite saying recently that cuts to the minimum practice income guarantee (MPIG) were out of MPs’ hands, Health Secretary Jeremy Hunt has encouraged campaigners by accepting that rural practices could be detrimentally affected by the withdrawal of MPIG top-ups to core pay.

Campaigners who are trying to protect rural practices from the effects of MPIG withdrawal met Mr Hunt along with the Health Secretary and Foreign Secretary William Hague, who is also backing their campaign.

The group is lobbying for an alternative, as under the proposals announced last year, MPIG would be removed completely over seven years from 2014 in order to make practice funding more equitable.

However, since many smaller rural practices in the UK receive as much as half their core pay from the top-up, campaigners believe that its withdrawal could lead to many practices being severely affected and even to the permanent closure of some.

NHS England, which is managing the plans, has said that it was prepared to negotiate different contractual arrangements with the GPC for the ‘very small’ number of practices that are heavily reliant on MPIG, although it stopped short of one proposal to grant practices in rural areas ‘specialist centre’ status.

Mr Hunt has said that there can be no return to the MPIG and that its future will be decided by NHS England rather than ministers so that the decision strikes “the right balance between the issues of rurality, age and social deprivation”.

Meanwhile, a spokesperson for the Department of Health said that it understands that rural practices form a vital role in the communities they serve and that it is currently working with NHS England to consider how best to manage the impact of changes to the MPIG in affected areas.