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GP Funding in Scotland Favouring More Affluent Areas

By Practice Group Leader, Personal Injury

GPs in less affluent areas of Scotland are not getting the funding they need to tackle growing health inequalities, according to a new study.

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Researchers at the University of Glasgow’s Institute of Health and Wellbeing and the University of Dundee, found that although GPs serving more deprived areas had more patients suffering from ‘multi-morbidity,’ they were not receiving the levels of funding needed to meet clinical needs.

For the purposes of the research, ‘multi-morbidity’ was defined as two or more chronic health conditions, five or more chronic conditions, and combinations of physical and mental health conditions.

The Scottish government-commissioned research, which examined almost every GP practice in Scotland, revealed that surgeries in the poorest areas of the country had 38 per cent more patients suffering from multiple chronic physical and mental health conditions than those serving patients in the richest areas.

The average NHS spend per patient per year in the top 10 per cent most affluent areas of Scotland was found to be £127, compared to the £120 spent per patient per year in the bottom 10 per cent most deprived areas.

Seven pounds clearly doesn’t sound like a huge amount of money but that seven pounds can pay for an additional 2,000 GP appointments every year. Such appointments can make a significant difference to patients who are crying out to be seen by their doctor and, in some cases, can mean patients avoiding late diagnosis for conditions such as cancer, paving the way for potentially life-saving early treatment.

Although the Scottish government insists that spending on GP services has increased by more than £88m, the research suggests the Scottish Allocation Formula (SAF) - which determines how funding is distributed between GP practices and is supposed to increase GPs’ resources in poorer parts of the country - is still unfairly weighted in favour of the richest areas.

Professor Graham Watt, of Glasgow University’s Institute of Health and Wellbeing, said: “Until allocation formulas in Scotland and the rest of the UK take into account the earlier onset of morbidity in more deprived areas, such funding systems will remain inequitable and continue to be part of the problem of health inequalities rather than part of the solution.”

On average, people living in the most deprived areas of Scotland are more likely to suffer with both physical and mental health conditions and die more than 10 years earlier than those in the richest areas. GPs in the poorest areas as a result have on average a 20 per cent higher workload in terms of the number of consultations they perform with multi-morbid patients. Despite this, they do not receive extra funding to address these needs.

The researchers emphasise that finding the right funding formula is not so straightforward given the fact that, for example, although GP practices in poorer areas have higher numbers of younger patients with multiple health conditions, those in more affluent areas have higher numbers of vulnerable, elderly patients.

Nevertheless, it is a disgrace that patients who live in the most deprived areas are being allocated less funding than patients in the wealthiest areas, particularly given that those poorer areas are home to double the number of patients with combined levels of complex physical and mental multi-morbidity.

Stuart Cochran is a senior personal injury solicitor at Slater and Gordon in Edinburgh.

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