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Government urged to pay ‘substantial’ incentives for GPs in deprived areas

By Gareth Iacobucci

The Government's systematic revamp of GP commissioning could inadvertently increase health inequalities unless substantial resources are diverted to deprived areas, a senior health policy expert at the King's FUnd has warned.

Speaking at a debate on public health this morning, the think tank's director of policy Dr Anna Dixon said the Government's ambitious reform agenda could threaten public health goals unless the right incentives were given to GPs.

The Government's NHS White Paper pledged that GP commissioning consortiums will receive extra incentive payments for improving health outcomes, with higher-than-average funding for practices in the most deprived areas.

However, practices will also see their pay cut if they are seen to provide a poor quality of care.

And Dr Dixon cautioned that health inequalities could increase if the incentives for GPs in deprived areas were not substantial.

‘In areas where primary care is not well developed, this could lead to greater inequalities,' she said.

‘We need to make sure we allocate resources to these deprived practices.'

‘We know incentives work, we have to make sure we get the incentives right so [GPs] seize the opportunity.'

Dr Dixon said the ‘potential mismatch' between the geographies of local authorities and GP consortiums could also endanger public health aims, as it could make it ‘more difficult to create partnerships', and cited a lack of public health data at GP practice level as another potential hurdle to overcome.

She also advised that the Government's new outcomes framework should not focus solely on ‘itemised outcomes' such as premature mortality, but also take into account ‘wider preventable activities'.

‘We need to make sure the delivery of the White Paper doesn't make the public health task more difficult,' she said.

Public health minister Anne Milton, also speaking at the event, said the upcoming public health White Paper would flesh out how local health improvement budgets will be allocated through new health premiums.

But she did not expand on the Government's plan to direct funding to GPs in the most deprived areas, and appeared to pour scorn on the notion that changes would only be realised through cash incentives.

‘It's a sad state of affairs when the only things that will happen are things that we pay for,' she said.

Government urged to pay 'substantial' incentives for GPs in deprived areas