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Call over “deprived area” GP numbers

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2 November 2010

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MPs have called for GPs to be offered higher wages to work in poorer parts of the country.

The Public Accounts Committee (PAC) made the call in a bid to narrow the health gap between rich and poor.

In its report the committee slammed Labour for allowing the gap to widen while in power by not getting to grips with GP shortages in important areas.

The MPs said: “The Department of Health should identify, as a matter of urgency, what measures it can take to drive up the numbers of GPs in deprived areas, including using direct financial incentives to encourage GPs into areas of greatest health need.”

Tony Blair pledged to put reducing life expectancy differences at the heart of his policy after winning the general election in 1997.

One fifth of the country was identified as having deep deprivation, and local authorities were given extra money and help to improve health. A target was set to close the gap with the rest of the country by 10% between 2000 and the end of 2010.

However, a baby boy born in those areas between 2006 and 2008 is now expected to live for 75.8 years and a girl for 80.4 years, whereas the average life expectancy of the population as a whole is 77.9 for boys and 82 for girls.

That means although life expectancy as a whole has increased, the gap has widened by 7% for boys and 14% for girls since 1995/7.

The PAC report said the DH had tried to address a “complex and intractable problem”, but “did not set about its task with sufficient urgency or focus”.

The Labour chairman of the PAC, Margaret Hodge, said: “The Department of Health has been exceptionally slow to tackle this problem. The Department knew in 1997, for instance, that certain low-cost treatments, such as those to help smokers quit and those to prevent heart attacks, could have a major effect in deprived areas, but such treatments have still not been adopted on the scale required.”

Dr Richard Vautrey, Deputy Chairman of the British Medical Association’s GPs Committee, said there needed to be “enough GPs working in our deprived communities by improved centralised workforce planning”.

Copyright © Press Association 2010

Parliament

Should GPs be paid more to work in poorer parts of the country? Your comments (terms and conditions apply):

“I think some commentators have missed the point, which is whether GPs in deprived areas should receive more funding relative to other GPs. The total funding for all GPs would probably remain the same. I agree with the comment above – when you work in a deprived area you know how much more difficult it is to achieve anything. Deprived areas are often in the inner city and can be much more diverse. When patients need an interpreter, that means a double appointment. Obviously we are happy to provide that, but if you have a lot of such patients it really adds up. There is no additional funding for this, so the resources come either by having a reduced service, or from the GPs pocket, or by the GPs working harder than GPs in other areas. Usually a combination of all three. It is high time this inequity was addressed. This is not about paying GPs more, it’s about providing proper funding that recognises the higher costs of providing care in those areas” – Name and address withheld

“I work in practice that is classed as being in a deprived area within our PCT whereas my neighbouring surgeries are not. We are constantly reminded by the PCT that we are the highest referrer and highest prescriber, but nothing is done to support our overburdened workload. The social/economic/mental health problems are all meant to be dealt within a 10-minute appointment and within the same funding as everyone else. (The current formula simply doesn’t work.) I don’t think GPs should be paid more, but I do think more funding should be allocated/dedicated to helping those of us out who work very hard to give all patients a good service with overstretched resources” – Name and address withheld

“I don’t think that GPs should be paid more to work in deprived areas. It sends out the wrong message besides the fact that they have enjoyed incrementally higer pay rises than almost any other profession in the country during the past 15 years. They are under no more pressure than other professionals who work in areas of high deprivation, such as housing and social services. I see no reason why GPs should be singled out for special treatment and excluded from the lopsided austerity measures the government has introduced. I appreciate that the some members of the public can be rude and diffcult to deal but the majority of us that work in the public sector have to put up with that. It isn’t pleasant but is a reality of everyday life that can be dealt with firmly but politely. I think the majority of GPs most probably do a great job but there is no reason why they should be singled out for special treatment” – Name and address withheld

“I will answer with another question, should staff be paid more?” – Sharon Riley, Lancashire

“Yes, we have to work so hard just to make people understand even the simplest thing. Vaccinations and smears a constant uphill struggle, aggression an every day occurrence. I suspect we are seen as some sort of ‘authority’ figures and since we do not have magic wands to sort out housing, poor school attendance by ill disciplined kids, loss of benefits etc we get a lot of aggravation. I simply would not dream of speaking to anyone in the way patients often speak to staff here. Totally unrealistic expectations of what drs can and cannot do misread internet information leading to complaints which are totally unfounded. I could go on but it is nothing practice managers in deprived areas do not already know. Patients need to be more responsible for their own health but if you cannot read or listen in many cases what chance do you have?” – Name and address withheld