EXTRA funding for GPs must be targeted to the most deprived areas to tackle Scotland's long-standing health inequalities, medics have said.
Dr Miles Mack, chair of the Royal College of GPs in Scotland, said the extra £500 million which the Scottish Government has pledged for primary care by the end of the current parliament offered a "major opportunity" to end the anomaly which sees practices in the poorest communities - with the highest rates of serious and chronic health problems - receive only a fraction more investment that those in the wealthiest postcodes.
The phenomenon, known as the "inverse care law", has been blamed for entrenching major health inequalities such as the 28-year gulf in life expectancy for males in Lenzie and Calton, less than eight miles apart.
However, any shake-up of the funding formula has been controversial while the share of NHS spending allocated to GP's shrank from 9.8 per cent in 2005/6 to a record low of 7.2 per cent in 2015/16.
The cash boost announced by First Minister Nicola Sturgeon in October last year means GP practices and health centres will receive 11 per cent of the NHS budget by 2021.
Dr Mack said: “The £500 million extra funding is a major opportunity to invest in general practice and lessen the effects of the inverse care law, under which those most in need of healthcare have least access to it.
"The root cause of the inverse care law has to be addressed in order to effectively tackle the health inequalities resulting from it."
However, Dr Mack stressed that extra investment in deprived practices "should not be at the cost of remote and rural areas", which are more expensive to run.
The latest statistics show that GP practices in the most deprived 10 per cent of postcodes are receiving just £3.79 more per patient than those in the least deprived tenth. But when the top 20 per cent is compared against the bottom 20 per cent, practices in the most deprived twenty percent of postcodes are actually receiving £1.34 less per patient.
This is despite previous research in 2015 showing that the prevalence of patients with combined mental and physical illnesses was 120 per cent higher in the most deprived Scottish postcodes compared to the wealthiest, with premature deaths among under-75s also 142 per cent higher.
It comes amid ongoing negotiations between the Scottish Government and the BMA to finalise the new GP contract for Scotland, which includes the Scottish Allocation Formula - the equation used to calculate funding quotas per practice.
Alison Johnstone, leader of the Scottish Greens, said the funding model had to change.
She said: “I know that the Scottish Government is committed to a review of the Scottish Allocation Formula and we would wish that review to lead to a revised formula which results in increased allocations to practices in deprived areas.
"Fairer funding for these patients would help GPs to have longer consultation with their patients, as the results of a recent BMA survey calls for.”
First Minister Nicola Sturgeon previously said that the new GP contract provided a "good opportunity" to revise the formula, but it remains unclear whether it will be overhauled.
Health Secretary Shona Robison said: “Adjusting the Scottish Allocation Formula might help to tackle health inequalities. The formula has been reviewed, and we are currently considering the potential impact of implementing the review findings at individual GP practice level.”
Ms Robison added that the number of community Links Workers based at GP surgeries in disadvantaged areas would also increase to 250 over the next five years, to provide one-on-one support for patients struggling with "poverty, debt and isolation which are making them feel unwell".
Professor Graham Watt, who has spearheaded research into the maldistribution of GP funding in Scotland, said extra Links workers were a "welcome addition but a minor solution to the inverse care law".
Dr Alan McDevitt, Chair of BMA Scotland’s GP committee said: “General practitioners across the country are suffering due to workload capacity issues. To address this we need greater investment in all practices."
Why are you making commenting on The Herald only available to subscribers?
It should have been a safe space for informed debate, somewhere for readers to discuss issues around the biggest stories of the day, but all too often the below the line comments on most websites have become bogged down by off-topic discussions and abuse.
heraldscotland.com is tackling this problem by allowing only subscribers to comment.
We are doing this to improve the experience for our loyal readers and we believe it will reduce the ability of trolls and troublemakers, who occasionally find their way onto our site, to abuse our journalists and readers. We also hope it will help the comments section fulfil its promise as a part of Scotland's conversation with itself.
We are lucky at The Herald. We are read by an informed, educated readership who can add their knowledge and insights to our stories.
That is invaluable.
We are making the subscriber-only change to support our valued readers, who tell us they don't want the site cluttered up with irrelevant comments, untruths and abuse.
In the past, the journalist’s job was to collect and distribute information to the audience. Technology means that readers can shape a discussion. We look forward to hearing from you on heraldscotland.com
Comments & Moderation
Readers’ comments: You are personally liable for the content of any comments you upload to this website, so please act responsibly. We do not pre-moderate or monitor readers’ comments appearing on our websites, but we do post-moderate in response to complaints we receive or otherwise when a potential problem comes to our attention. You can make a complaint by using the ‘report this post’ link . We may then apply our discretion under the user terms to amend or delete comments.
Post moderation is undertaken full-time 9am-6pm on weekdays, and on a part-time basis outwith those hours.
Read the rules hereLast Updated:
Report this comment Cancel