A VOTE on the new Scottish GP contract should be annulled because doctors were not told about data showing that rural GPs are already struggling with higher expenses and lower incomes, a leading academic has warned.

Professor Philip Wilson said “far fewer” GPs would have voted yes in the poll if they had been made aware of an ‘Earnings and Expenses’ document available to lead negotiators.

Read more: Highland GPs call for regional breakdown of GP contract vote

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It is significant because under the proposed contract’s new workload-based formula, GPs in rural areas will see their share of funding slashed by up to 87.6 per cent while those in some urban practices – especially in the Central Belt – are set for substantial gains.

The poll closed on January 4, but the final decision on whether to accept the contract lies with the 40 members of the Scottish GP Committee who will vote on January 18.

Prof Wilson, an expert in primary care and director of the Centre for Rural Health at Aberdeen University, has written to Health Secretary Shona Robison and Dr Alan McDevitt, chair of the BMA's Scottish General Practitioners Committee, saying that the result should be annulled and the poll re-run. He said it was unfair that data which "confirms that rural GPs on average have higher expenses and lower incomes that urban GPs" was not flagged up to ordinary members.

He said: "I've spoken to lots and lots of GPs, and not a single one of them knew of its existence and that includes our local medical committee secretary. Apparently the primary care leads in each health board knew about it, but nobody else.

"The problem is that it absolutely doesn't fit with the message that the new contract is going to make everything better for everybody. It does make a fairly stark message that it is the practices which are already more disadvantaged that get nothing out of the new contract, while the ones that are already advantaged do."

Read more: Majority of GP leaders back new Scottish contract

The BMA and Scottish Government has insisted that no practice will end up worse off as any loss in funding under new formula will be made up through protection payments, ensuring that overall income remains at current levels. However, critics argue that it is creating a two-tier system which rewards practices with high patient demand but lower need - particularly those with a higher proportion of affluent elderly people - while those in rural and urban deprived areas will receive no funding boost or comparatively little.

The contract is expected to win the support of a majority of GPs as 68 per cent of partners will gain financially, but there are fears it will create a bitter split in the profession and exacerbate GP recruitment difficulties in rural areas as medical graduates will be more attracted to urban practices where the potential earnings are higher.

It has been rejected by 89 per cent of members in the Rural GP Association of Scotland and by Scotland's 'Deep End' practices, which are based in the most deprived communities.

Read more: New GP contract guarantees minimum income of £80,400

Prof Wilson, who is also a GP based in Inverness, said the poll should "be annulled with immediate effect because of a lack of due process and fair procedures". He said that the ballot papers sent out to GPs in December was accompanied by a Frequently Asked Questions document which "appears to be designed to elicit agreement with the terms of the new contract and contains none of the arguments against".

He added: "I have never before received a ballot paper from the Electoral Reform Society along with a document encouraging me to vote in only one way."

Dr McDevitt, who has led negotiations with the Scottish Government on the new contract, said: “While Professor Wilson is entitled to his own views on the proposed GP contract, the poll has allowed the whole of the profession in Scotland to have their say.

“The proposed contract is a significant step forward for the whole of general practice in Scotland, helping to substantially reduce business risks to GPs and return workload to sustainable levels.

“Like any major change, there has been a lot of healthy debate and discussion as we have engaged with GPs across the length and breadth of Scotland to explain what these proposals would mean for them.

“With the poll now closed, I am looking forward to hearing the feedback of the profession and their view of whether the contract should be implemented.”

A Scottish Government spokesman said: “The proposed contract was negotiated with the Scottish GP Committee of the British Medical Association. 

"The Review of the Scottish Allocation Formula and the Review of GP Earnings and Expenses informed the negotiations and were published on 13th November, alongside the contract offer. 

"The proposed contract will stabilise income, reduced workload, reduce risk and improve patient care.

"We will reply to Professor Wilson’s letter in due course.”