‘British’ poor [in England] lose doctors [in England] as ‘British’ wealthy [in England] gain them. Scotland still has more doctors and more practices so…?

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(c) Liverpool Echo

In the Observer today, confusing England with Britain, once again:

‘Fewer GPs are working in Britain’s deprived areas, despite government-funded incentives for new doctors to work among the poor. Wealthier areas, however, have seen the number of doctors rise. The exodus, uncovered by Labour MP Frank Field, is exacerbating the existing “under-doctoring” of deprived populations – the lack of family doctors in places where poorer people live. Experts said the widening divide between rich and poor areas in GP numbers – which is one of England’s starkest health inequalities – would force the least well-off to wait longer for an appointment, even though they are generally sicker and die earlier than the rest of the population.’

https://www.theguardian.com/society/2018/may/19/nhs-gp-doctors-health-poverty-inequality-jeremy-hunt-denis-campbell-deprived-areas

The evidence is entirely from England. The Herald and the Scotsman seem to have been able to resist the temptation to pretend it applies to Scotland and to blame the SNP for it after the former’s slap on the wrist for this case of misleading readers, reported in Hold the Front Page, two days ago:

‘The press watchdog has rapped a daily newspaper for erroneously reporting that statistics quoted in a report referred to Scotland – rather than the whole of the United Kingdom. The Herald, Glasgow, had blamed an “editing error” for the mistake, which had prompted a complaint to the Independent Press Standards Organisation. The Herald’s story, which was presented in the context of a new report released by Oxfam, stated that the gap between “the haves and have nots” in Scotland was growing. It added that the new report revealed “that in Scotland, the richest one per cent has more wealth than the bottom 50 per cent combined”.’

https://www.holdthefrontpage.co.uk/2018/news/press-watchdog-raps-daily-over-front-page-story-error/

There isn’t research evidence to directly prove there is no comparable problem in Scotland. That, in itself, is reassuring because if there was any evidence at all, you can be sure we’d have heard about it from Reporting Scotland and the others. What there is, is evidence suggesting it is less likely here, based on a superior number of GPs and of practices, across Scotland.

The latest figures for the number of GPs in the UK are:

  • 41 985 GPs in England – last published in Sept 2016
  • 4 953 GPs in Scotland (does not include locums) – last published Jan 2017 (350 locums in 2015)
  • 2 887 GPs in Wales (includes 634 locums) – last published 30 Mar 2016
  • 1 274 GPs in Northern Ireland (does not include locums) – last published Oct 2015

The number of locums in Scotland in 2015 was 350.

http://www.isdscotland.org/Health-Topics/General-Practice/Publications/2016-06-14/2016-06-14-PrimaryCareWorkforceSurveyScotland2015-Report.pdf

So, the ratio of GPs to overall population is:

  • England 1 GP for every 1262 people
  • Scotland 1 GP for every 999 people
  • Wales 1 GP for every 1060 people
  • N Ireland 1 GP for every 1421 people

The number of GP practices is:

  • 7 613 in England – last published in Sept 2016
  • 958 in Scotland – last published Jan 2017
  • 454 in Wales – last published 30 Mar 2016
  • 349 in Northern Ireland – last published Oct 2015

The number of practices is a limited statistic, nevertheless, it could give an indication of access in terms of geography.

The ratio of practices to overall population is:

  • England 1 practice for every 6962 people
  • Scotland 1 practice for every 5532 people
  • Wales 1 practice for every 6746 people
  • N Ireland 1 practice for every 5189 people

The relatively large number of practices in Northern Ireland, despite having the worst ratio of GPs to population might suggest a tendency only for smaller practices there. In contrast, Scotland having the best ratio of GPs to population along with a relatively high number of practices suggest better geographical access.

Above figures are from the BMA’s General practice in the UK – background briefing 2017

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7 thoughts on “‘British’ poor [in England] lose doctors [in England] as ‘British’ wealthy [in England] gain them. Scotland still has more doctors and more practices so…?

  1. bigjon999 May 20, 2018 / 4:10 pm

    The Guardian/Observer have for along time had trouble differentiating between UK, Britain and England. I guess for a London office they all seem virtually identical and any differences are all a long way away and too difficult to understand.

    Liked by 2 people

  2. Alasdair Macdonald May 20, 2018 / 5:26 pm

    Despite your fairly straightforward analysis which contextualises the positions in the four countries and enables a fairer comparison to be made, BBC Scotland is still plugging away at the ‘shortages’ of GPs and the possible closures of GP surgeries. These are mainly in the northern, mainly rural or sparsely populated areas which have always experienced such difficulties, mainly because of the sparseness and the lack of other services which GPs, like the rest of us, desire for their families.

    In support of their reports the BBC quotes almost always statements issued by the BMA, which is the doctors’ trade union and, as such, is slanting things to suit the claims it is making on behalf of its members. As a trade unionist myself, I expected the various unions of which I was a member to present a strong case. But, as a voter, taxpayer, citizen, I also expect the management of public services to present the other side of the argument. I want good health services but I do not want to be ripped off by nightly paid NHS staff!

    In sparsely populated areas there have for most of my life been ‘remoteness’ enhancements for public services staff. In addition, there was always a tendency to recruit amongst professional services qualified people, ones who hailed from these areas, because, they still had family there, they had affinities to those areas.

    It is a complex picture, so let us have nuanced reporting and a proper public debate.

    The most recent piece on GMS, was based on a campaign about a doctor in England who has been struck off because of a fatality. The case is a complex one, and, from my reading, I think that the doctor has been treated harshly and there is a good argument in favour of reviewing how such things are dealt with. This would entail medical teams being able to review objectively why their systems did not serve the particular patient well. This requires a no-blame ethos. The case with this doctor means that in future circumstances, the NHS teams will adopt a defensive posture. Of course there should be investigations if a patient dies or suffers seriously, but, there should not be scapegoating.

    The campaign in support of this doctor is mainly by a group acting outside the BMA, which indicates reservations about the BMA and is primarily English based. There is a Scottish branch and it was two doctors from that who were interviewed. However, GMS, and the doctors used the ‘struck off’ case as a vehicle to make attacks on other aspects of NHS Scotland – resignations of consultants. In effect, by juxtaposing these aspects with the ‘struck off’ case, NHS Scotland was being portrayed as guilty by association. The increasing rates of loss of NHS staff across the UK is entirely a consequence of Brexit. To be fair, the two doctors acknowledged this, but there was still an implication: NHS Scotland bad.

    PS. An aside: both the Guardian and the New Statesman this week had puffs for the COLONEL. It seems as if her period of maternity leave is going to be used to ‘sell’ her to the people of England as the successor to an increasingly beleaguered, Mrs May. Because of her gayness, her apparently libertarian attitude to social issues (no mention of her support for the Rape Clause), her apparent pro Europe stance, her, ‘no nonsense character’ she is being created as something different who would appeal to the Blairites. The most rabid Tories will always vote Tory, because they recognise, above all else, the essentiality of having power.

    Liked by 2 people

  3. John May 20, 2018 / 6:41 pm

    The MSM really need to stop saying “the UK and Britain “when it is comes to discussing things that are different in the four nations , it confuses things for the non-political Scottish man in the street. They need to say “England ” when that is the country they are talking about and make it clear .They really should be honest .
    As for Davidson , someone somewhere is leading her up the garden path , if she believes this hype she is a bigger fool than I think she is ! .

    Liked by 1 person

    • Alasdair Macdonald May 20, 2018 / 7:41 pm

      John,

      I think that the England/Britain synonymisation is due to the fact that many in the media actually believe it to be so. Many are actually using the conflation intentionally, but, I think many in England and overseas really do think it is the case in the same way that many of us here are unaware that Holland is part of The Netherlands.

      With regard to THE COLONEL, she most certainly is NOT being led up the garden path. She is, indeed, ambitious – as ambitious as Boris Johnson, but is more self aware: she does not have his unselfconscious sense of entitlement.

      Liked by 1 person

  4. Derek May 20, 2018 / 7:52 pm

    Davidson doesn’t have to believe her own hype, all she has to do is persuade enough Conservatives to give her a safe seat somewhere in the sarf of England. she knows her position in Scotland is a lost cause, methinks.

    Liked by 1 person

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