Is Scotland’s new GP contract addressing the inverse care law?

Mercer, S., Lunan, C., Henderson, D. and Blane, D. N. (2023) Is Scotland’s new GP contract addressing the inverse care law? Future Healthcare Journal, 10(3), pp. 287-290. (doi: 10.7861/fhj.2023-0068) (PMID:38162197) (PMCID:PMC10753203)

Abstract

Scotland, like many countries around the world, has wide health inequalities resulting, in part, from the longstanding ‘inverse care law’, in which a mismatch between patient needs and provision of care in general practice in deprived areas results in poorer care and worse patient outcomes compared with affluent areas. In early 2018, Scotland embarked on a new GP contract, a stated aim of which was to reduce healthcare inequalities. National data on avoidable mortality showed a 4.8 (2019) and 4.9 (2021)-fold higher rate in the most deprived compared with the most affluent decile of the population. However, the distribution of whole-time equivalent (WTE) general practice clinicians per 10,000 patients, including GPs, and practice-employed practice nurses and other allied healthcare professionals, showed the opposite trend in both 2019 and 2022, with fewer WTE clinicians of all types in GP practices in deprived areas compared with affluent areas. These findings suggest that radical change is needed to reverse the inverse care law in Scotland.

• Item Type: Articles
• Additional Information: This work was carried out as part of a study on the inverse care law in Scotland funded by the Health Foundation [Grant reference: FR-0002805].
• Keywords: Primary care, inequalities, Scotland.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Blane, Dr David
• Authors: Mercer, S., Lunan, C., Henderson, D., and Blane, D. N.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care
• Journal Name: Future Healthcare Journal
• Publisher: Royal College of Physicians
• ISSN: 2514-6645
• ISSN (Online): 2514-6653
• Copyright Holders: Copyright: © Royal College of Physicians 2023
• First Published: First published in Future Healthcare Journal 10(3): 287-290
• Publisher Policy: Reproduced with permission of the publisher