Vital primary care funding goes where

EQUALITY of care is a sacred pillar of the NHS. How often is the mantra that our healthcare system is “free at the point of delivery and based on need, not the ability to pay” touted as evidence of its moral superiority over other nations’ models?

In theory, all patients should be treated equally. But we know this is not the case, from “postcode lotteries” for drug access to how far cancer patients must travel for treatment.

Perhaps the biggest gulf is found in primary care, where a long-standing failure to link investment with deprivation has been blamed for entrenching and exacerbating Scotland’s health inequalities, the widest in Western Europe.

Here is a fairly shocking figure: average GP funding for each patient each year is only seven per cent higher for the most deprived 10 per cent of the population than for the most affluent 10 per cent. This is despite 20 per cent more GP visits among the poorest patients, a 120 per cent increase in the prevalence of patients with combined mental and physical illnesses and a 142 per cent increase in mortality among under-75s.

Despite the massive burdens of ill health facing general practice in the most deprived communities, their share of funding is only fractionally higher than practices whose patients are the most affluent and statistically healthiest in the country.

This phenomenon is not new. It is known as the “inverse care law”, and was first coined in 1971 to describe this maldistribution of good medical care.

A major report on the issue in late 2015 led First Minister Nicola Sturgeon to reassure MSPs that the new GP contract, due to be finalised next year, offered “a good opportunity” to revise the Scottish Allocation Formula, the equation used to calculate funding

‘‘ A long-standing failure to link investment with deprivation has been blamed for exacerbating health inequalities