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Mapped: New Scottish contract 'set to create urban-rural divide'

A map which shows which practices will receive additional funding under the first phase of the new Scottish GP contract shows a clear urban-rural divide, the Rural GP Association of Scotland has said.

The heatmap which identifies which practices will get an increase in income should the contract go ahead ‘epitomises the lack of rural provision’, said Dr David Hogg, chair of the Rural GP Association.

He added it was not just a rural-urban problem but a fundamental problem with the workload allocation formula.

But the BMA stressed no practice would lose income and this was about additional resources addressing underfunding of practices.

Dr Hogg said while they had expected to see differences, they had not expected the map, which they put together from publically available data, to be so stark.

He added that the map highlighted their concern that the new contract was going to be ‘destablising’ for general practice and would not enable the delivery of realistic medicine.

‘We genuinely want to assist and collaborate on this but we feel the SGPC don’t understand our concerns and the underlying anxieties our members have,’ he said.

Dr Iain Kennedy, medical secretary at Highland LMC, where members have been calling for a regional breakdown of the contract poll results, said his members were angry after seeing the map.

‘A picture says a thousand words,’ he said. ‘Our members have completely lost trust now they have seen this map.’

He added that it seemed the BMA was going against its core values of putting all doctors at the heart of every decision.

‘Our members are feeling betrayed that so much of Scotland’s GPs could be abandoned.’

He added there was a lot of good in the new contract but they needed to go back to the drawing board on the formula among other things.

‘I would also point out this is not just a rural issue – city, town and rural GPs of Highland are united on this.’

A vote on whether to adopt the new contract is open to all GPs and GP trainees from 7 December to 4 January.

The BMA predicts that almost two thirds of GP practices would see their overall funding increase under a new funding formula and there will be a minimum earnings expectation to ensure no GP partner earns less than £80,430.

Plans place the GP as the expert medical generalist at the head of a multi-disciplinary team of pharmacists, nurses and physiotherapists.

Dr Alan McDevitt, BMA Scotland chair, said: ‘It is entirely wrong to suggest that any practice will be disadvantaged under the proposed new contract.

‘Every practice in Scotland will benefit from an income and expenses guarantee that is not time limited and will be uplifted along with wider practice expenses.’

He added that the 2004 formula had meant a substantial amount of work associated with elderly and deprived populations that was carried out by practices was not financially recognised.

‘The proposed new contract will see additional funds invested so that this shortfall is filled, while ensuring that remote and rural practices continue to get the additional funding that the 2004 contract delivered for them.’

A Pulse survey of over 200 Scottish GPs found that the vote was on a knife edge at the end of November, with 33% of GPs intending to vote for the contract, compared with 32% against, with the remaining undecided.

Scottish contract funding heatmap

scotland heatmap

Percentage change in income allocation

Red: -87.6 to 0.1

Green: 0.1 to 29.7


Click here for interactive map

Source: Rural GP Association of Scotland

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Readers' comments (6)

  • Vinci Ho

    Based on this map , one has to question the equality of these outcome projections.
    A range of -87.6% all the way to +29.7%
    This is splitting the Scottish colleagues right in the middle and rural colleagues should not have the feeling they had been betrayed.

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  • so in the urban midlands of scotland can bugger off

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  • I think that those representing rural GPs need to draw their teeth here a little bit.
    I think everyone supports rural GP and over the years by and large, they have received additional funding to compensate for the special circumstances and challenges of servicing their smaller, but more widely separated populations.
    The heat map represents allocation of immediate additional funding being injected to try and help those practices facing the most immediate challenges, particularly those who have lost out sociodemographically to the increasing influences of increasing age. I was at a city BMA roadshow in November and despite this, much mention was made by Dr McDevitt of the special circumstances of the rural situation which may need different treatment as things go forward. To me that does not sound like they are being ignored. It is astounding that it is our capital city Edinburgh which is probably struggling the most to attract new GPs.
    Every sympathy with the rural situation, but I sense here that the tail is trying to wag the dog.

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  • Divide & conquer! I don't know about everyone else but take home pay (which I'm mercenary enough to consider of some importance)is going down the tubes. Guaranteeing MPIG & doing nothing about reductions in other income & increasing expenses is a pretty poor offer.

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  • Have to agree with Angus here.

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  • I think this is more nuanced than the map shows.
    Although clearly some central scotland practices are doing better I think their gains are often quite small (and if they are MPIG practices whey have had NO increases for than a decade) Also some practices in the central belt are losers too
    So terrible for rural practicies and not very good for many other practices

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