GPs in the country's most deprived areas say "20 years of failure" to address health inequalities will not be reversed by tinkering on the edges of the problem.
A group of 360 doctors from 100 practices in areas of multiple deprivation, calling themselves GPs at The Deep End, gave damning evidence to Holyrood's Public Audit Committee investigation into health inequalities.
They said the flat distribution of GPs across the country contrasted with the steep social gradient in health trends and "dysfunctional links" between GPs and the rest of the NHS. This had resulted in "inverse care law and a partial explanation of 20 years of failure in addressing inequalities in health."
They called this: "A major obstacle as NHS Scotland searches for affordable ways of delivering integrated care for the increasing numbers of people with multiple health and health related problems.
"The status quo is a recipe for widening health inequality, as the NHS fails to deliver needs-based care, especially in areas of blanket deprivation."
Suffering two or more conditions, often one involving mental health, is most common in older people but in deprived areas the onset of such multimorbidity often happens at 50.
Dr Linda de Caestecker, director of public health at NHS Greater Glasgow and Clyde, said: "If we are truly going to tackle health inequalities, we need that much broader approach. We need to look at a much more equitable distribution of wealth, resources and power across society."
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