HIGHLAND doctors are calling on Scotland's top GP to lay bare the scale of the split in the profession over the new contract, amid anger that practices in more affluent urban areas are gaining over those in rural and deprived areas.

Members of the Highland Local Medical Committee have written to Dr Alan McDevitt, the chair of the BMA GP committee, demanding that a full regional breakdown of the vote is published in the new year.

They believe it will show that the contract is disproportionately supported by GPs based in the Central Belt who are gaining financially under the controversial new GP workload formula.

The Herald: Dr Iain KennedyDr Iain Kennedy

Dr Iain Kennedy, medical secretary of Highland LMC and a North Scotland GP representative on the BMA Scottish Council, said: "The overwhelming majority of our members in the Highlands are voting no, and furthermore we are actively seeking from the BMA and from the negotiators a regional breakdown of the poll in Scotland because we believe that that is being concealed from the GPs in Scotland."

Read more: Majority of Scottish GP leaders back new contract despie fears over practice staffing and profits

GPs have until January 4 to vote in favour or against accepting the new Scottish GP contract, but the final decision lies with the 40 members of the Scottish GP Committee who will vote on January 18.

Highland LMC, backed by organisations including the Rural GPs of Scotland, want the regional breakdown printed on the agenda at the SGPC meeting.

Under the new contract's Scottish Workload Allocation Formula (SWAF), 602 practices - which represent 68 per cent of GPs in Scotland - will share in a £23 million windfall, while 354 - mostly outside the Central Belt - will lose out and require propping up via income protection payments to ensure they do not end up worse off.

However, Dr Kennedy and his colleagues fear that there is no guarantee that these top ups will not be clawed back in future, for example if a partner retires and the cost of a replacement is not met by the Government.

Read more: Rural GPs fear new GP contract will slash practice funding

As workload is calculated in terms of patient attendances, critics also argue that the SWAF is skewed in favour of urban practices with high levels of elderly and middle class "worried well" patients who are more likely to visit their GP needlessly.

In comparison, rural GPs tend to handle fewer appointments but provide a broader service than city-based practices, while those in deprived areas - with high levels of unmet need - struggle to attract patients into surgeries even when they are ill.

As a result, 14 of Scotland's 50 most deprived practices will require income protection, while some in wealthy postcodes such as Morningside and Gullane will gain.

A map created by the Rural GP Association of Scotland shows that some practices - with red dots - are losing up to 87.6 per cent of their current funding under the new formula, while others, marked with green dots, will see their share of funding under the formula increase by up to 62.2 per cent.

The Herald: Map shows practices gaining and losing under SWAF Map shows practices gaining and losing under SWAF

Dr Kennedy, who is based in Inverness, said the £23m promised to a majority of GPs was a "financial inducement to vote yes", despite other concerns that the contract will eventually pave the way to a salaried GP model replacing the independent contractor model, and a loss of autonomy for GPs over their take-home pay and ability to hire practice staff directly.

Read more: Record number of GP practices in Scotland now run directly by health boards 

Chair of BMA Scotland’s GP Committee Dr Alan McDevitt said there was "no time limit" on the protection of practice funding, and insisted it was "entirely wrong to suggest that any practice would see a reduction in funding as a result of the proposed contract."

He said the process for the poll was agreed at the SGPC meeting in August, attended by all of Scotland’s LMCs representatives.

He added: “There was no request or discussion around a regional breakdown of the poll results at this meeting. We will be receiving results as a total and also broken down by type of GP (partner, sessional, trainee, etc). The proposal for the poll question and breakdown was based on the process for the previous contract in 2003.”