A STUDY published this week in the British Journal of General Practice shines a searchlight on one of the main causes of ‘health inequality’ in Britain.
Research carried out by Glasgow and Dundee universities into the working of GP funding formulas, which allocate to GP practices the amount they receive for each patient on their books, uncovered the fact that the most deprived areas in Scotland received £10 less per patient than those in more affluent areas.
The study of 956 GP practices across Scotland found that those in the four most deprived parts of the country received on average £117 per patient compared to £127 across the rest of the country. Those practices serving the second wealthiest areas were given the highest level of funding, £142 per patient while those areas ranked as having the highest levels of poverty and deprivation received either £114, £116 or £120 per patient.
The research found that practices in the most deprived areas had 38% more patients with multi-morbidity, compared to least deprived, and double the number of patients with combined mental and physical multi-morbidity. Multi-morbidity being defined as a person having two or more chronic health conditions, five or more chronic conditions and combinations of physical and mental conditions.
The study also shows that although practices in more deprived areas have younger populations, they also have higher levels of complex multi-morbidity, occurring at a much younger age. One GP, Dr Peter Cawston, said: ‘This formula has robbed the poorest and sickest people in Scotland to pay for GP care in affluent areas. It is far worse than we even thought – patients who live in poorer areas are allocated less money than patients in wealthy areas.’
Referring to the difference in patient funding Dr Cawston added: ‘That doesn’t sound very much, but with that £7 we could have offered 2,000 extra GP appointments a year. These are appointments people desperately need.’
On average, people living in deprived areas of Scotland die more than 10 years earlier than people in affluent areas and become ill in their 50s rather than their 70s. While this research was concerned with the effect of the GP funding formula in Scotland, where it is administered by the ruling nationalist SNP, the life and death issue of all the austerity cuts inflicted on the NHS by the Tories can be clearly seen across England.
A report by the Joseph Rowntree Foundation published earlier this year detailed how, since the Tory-led coalition came to office in 2010, the very poorest communities in England experienced the biggest cuts in public spending including health spending.
Official figures show that men in the most deprived areas live, on average, 9 years less than men in affluent areas – for women the difference is 6.9 years. What emerges from all these studies and research is the simple fact that the most affluent are being financed at the expense of workers’ health.
While the Tories and the SNP claim that funding levels for GPs is targeted to take into account the deprivation of areas served by GP practices, the reality is that the more affluent enjoy much higher levels.
This is in keeping with the unspoken belief of the ruling class that poverty and illness are the ‘fault’ of workers themselves, down to the stubborn refusal of the working class to have rich parents. As shameful as the health inequality is at the moment, it is set to get much worse as the Tories’ £12 billion spending cuts to welfare really start to bite home.
What is at stake is the very existence of the NHS, along with the welfare state itself, as a bankrupt British capitalist system can no longer afford any of the gains made in the past. The strike call by junior doctors has shown the way forward, the TUC must be forced to call out all unions in a general strike to kick out the Tories and go forward to a workers government and socialism. Only by the overthrow of bankrupt capitalism can a free NHS be guaranteed and the obscenity of health inequality banished forever.
