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Independents' Day

Ethnicity ruled out of Carr-Hill despite workload evidence

By Ian Cameron

Academics have cast doubt over whether the ethnic background of patients should be included in the formula that determines GP income ­ despite finding it is a factor in their workload.

Research by the Centre for Health Economics at the University of York found 'non-white patients' were more likely to consult their GP than 'white' patients.

Indian, Pakistani and Bang-ladeshi patients were 1.3 times more likely to consult.

GPs with a high number of patients from minority ethnic groups have called for ethnicity to be included in the Carr-Hill formula to account for their increased workload.

But Hugh Gravelle, study author and professor of economics at the centre, said there were significant variations between ethnic groups which meant a single 'ethnicity' factor would be too simple.

Getting a breakdown of the ethnicity of each practice's list and developing a formula that addressed variation between ethnic groups would be too complicated, he added.

'You can't take these sort of figures and say [such variations] should be in a resource allocation formula,' he said.

'There are pretty large disparities in patterns of utilisation across ethnic minority groups and you should not lump them together as one.

'You need detailed data on the ethnic composition of a list. It might work but there's no routine way and given what's available you would be a bit chary putting in an

ethnicity variable.'

But GPs maintained it would not be difficult to get the required data and ethnicity should be included. Dr Gillian Braunold, GPC member and a GP in east London, said public health data held by primary care organisations could be used to estimate the proportions of ethnic minorities in a given area.

'It's garbage to say it's too complicated,' she said.

Dr Anant Prasad, a GP in Bolton, said it would be easy to identify patients on his list from ethnic minorities.

'Ethnic minority consultation rates are incomparable to those with local people. Their consultations can also be longer,' he said. 'It should have been in [the formula] from the start,' he added.

The Carr-Hill formula will be reviewed in April 2006.

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