Too many GPs choose to work in the richest localities and neighborhoods, leaving poor parts of Britain short of health care. A commission charged with studying the problem suggested the government put limits on the number of doctors present where people have the most money, effectively forcing them to move to low-income locations.
According to the Social Market Foundation report, many poor areas of the country have nearly half as many doctors per capita as the richest ones. The government wants to intervene, also because the Minister of Health, Sajid Javid, pledged a few days ago to tackle the “disease of inequality”, which leads to the death of the poor almost ten years before the wealthy.
Care for low-income people is in fact very lacking in large parts of the country. Nationally, there is on average one full-time family doctor for every 2,289 patients. In Oxfordshire, where per capita income is highest, there are only 1,688 patients per doctor and 1,731 in West Suffolk. In Portsmouth, on the other hand, they rise to 2,559, and in Hull, Yorkshire, they are 2,761. Within the cities there are even more striking disparities, with the northern Irish Sea seaside resort Blackpool having 4,480 patients per full-time family doctor compared to Blackpool South’s 1,900.
The group of experts recommended that the government restore a body that Tony Blair had abolished, called the Medical Practices Committee. This institution had the power to refuse applications from general practitioners who indicated that they preferred areas already sufficiently covered by their colleagues. According to the Social Market Foundation, the trend of leaving poorer areas uncovered by health care is steadily increasing and is widening the inequality in the treatment of citizens. “The work of general practitioners – it is written in the report – should no longer be left to the logic of the market, as has happened in the last 20 years”.
Family doctors will not be told where they should go to practice their profession, as this would limit their freedom, but they will be told where they cannot go, with a compromise solution that should solve the problem.
The government had already allocated funds to give 20,000 pounds (23,000 euros) to every doctor who decides to move to a poor area, but the incentive was not enough. In addition to the lack of doctors, low-income areas are also plagued by the decline in in-person visits, which in some cities are less than 50%. The visits take place by telephone or e-mail, in a hasty way and not always adequate to the solution of the patient’s problems.
In addition to economic incentives, perhaps recalcitrant doctors should also be distributed a copy of “The Citadel”, the novel by Joseph Cronin published in 1937 which inspired many generations of doctors in Great Britain, the United States and Italy, thanks to the television drama of 1964 with Alberto Lupo as the protagonist.
In the story, Dr Andrew Manson goes to assist the people of a mining village in Wales, and is well-liked by all. But then he decides to move to London, where he opens a studio for the rich, prescribes expensive, useless medicines and adapts to the uptown practices of his colleagues, the same ones he fought against when he was young.
After various bitter vicissitudes, he will return to the poor in a small town in the West Midlands. An almost forgotten book, like the things it talked about.