DOCTORS surgeries' are being underfunded in the poorest parts of Scotland creating a postcode lottery which is perpetuating severe health inequalities, according to experts.

The claim comes as a new study, funded by the Scottish Government, found GPs in the most deprived areas of the country receive £10 less than the average practice for each patient.

It emerged that practices which have the most patients with multiple problems are given less money than those in wealthier neighbourhoods where people enjoy better health.

The report's author said the finding challenges First Minister Nicola Sturgeon's claim that she wanted to see more "fairness and social justice" in Scotland.

Professor Graham Watt, of Glasgow University, said the problem was partly to blame for the failure to tackle the entrenched ill health in the poorest communities.

He demanded action, saying the findings would challenge whether there was any “beef” behind Ms Sturgeon's comments, made at last month's SNP conference.

Prof Watt said: “The way the funding system currently works is a reward for people who live a long time. But the rest of society could also live a long time if they had better health care.”

The study, which involved 956 GP practices, found those in the four least affluent parts receive an average of £117 per patient, compared to £127 across the rest of the country.

The centres serving the second wealthiest communities were given the highest levels of funding at £142 per patient, compared to £114, £116, and £120 per patient in areas ranked as having the highest levels of deprivation.

This in part reflects the extra money the current formula for determining GP funding awards practices in remote and rural areas.

Professor Watt said: “General practice is part of the problem of health inequalities because of this formula. We have got health inequalities which are the worst of any country in Western Europe and we think [the GP funding system] is not the only reason but one of the reasons we have made so little progress.”

The formula is intended to take deprivation as well as rurality into account, but Prof Watt said while it was "quite rightly" supportive of rural GPs it was only "trivial" in the weighting it gave poverty.

Yet, the study, published in the British Journal of General Practice, found practices in the most deprived areas had 38 per cent more patients with multiple health problems compared with the least deprived and double the number of patients with combined mental and physical illnesses.

Prof Watt said: "Consultation rates go up by 20 per cent from affluent to deprived areas, which only happens by shortening consultation time or by working a longer day. It short changes the patients and it puts the GPs under pressure and it means the system isn't coping and is more likely to spill over into out of hours, accident and emergency departments and hospital admissions."

With more funding he said, GP practices in the poorest areas could invest in more doctors and allow them to spend extra time with patients who have the most complex problems or increase the way they work with social services and other community support staff to try to help the most vulnerable. Govan Health Centre is currently testing this kind of approach including offering some people 30 minute consultations.

Prof Watt noted that all GPs are working under pressure, but said they were busy with different things.

Health Secretary Shona Robison said she was 'sympathetic' to the need to address funding for GPs in deprived areas.

She added: "In June, we also announced an additional £60 million for GP and primary care services – through our Primary Care Transformation Fund - which is being allocated to projects to reduce GP workload and encourage innovation in primary care. This fund will help GPs across the country, including those practices in deprived areas.

"When allocating funding for GPs, we take into account the additional needs of patients in deprived areas and provide extra funding to those practices located there. GP funding is weighted to reflect factors such as deprivation - as we know that this generally means their patients have more complex conditions resulting in an increased workload for the GP.

"However, we are sympathetic to the case that we need to do more to ensure GPs work in disadvantaged communities is backed up by the right levels of investment."

The current GP contract includes a commitment to review the formula for allocating resources, she said, adding: "GP contractual arrangements now place much more emphasis on patient care being provided by the whole clinical team, including nurses and pharmacists, and therefore the concept of average numbers of patients per GP is now less meaningful.

"This review will inform the development of a brand new Scottish GP contract from 2017, where we will seek to ensure that both GPs and patients get a fair deal. The impact of deprivation will be a part of this important work."

The study, which was carried out by researchers at Glasgow University's Institute of Health and Wellbeing and the University of Dundee, was funded by the the Chief Scientist Office of the Scottish Government Health Directorates.