Dear Editor,

As working GPs in Scotland’s “Deep End” practices who are also representatives of the Deep End Steering Group, we are both strong believers in the founding principles of the NHS and that healthcare resource should be allocated proportionate to the needs, and not the demands, of local populations.

This is critical to addressing health inequality.

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We have campaigned for many years for the need to adequately invest in general practice to achieve better population heath.

The mechanisms by which GPs receive funding and deliver services are complex and vary across Scotland, influenced by factors such as local geography and availability of staff.

This explains much of the variation in income across practices, but, nevertheless, we were concerned to read about the disproportionately high income received by a tiny minority of Scotland’s GPs and we believe that this may impact on the reputation of the whole profession.

Under the existing funding formula Deep End GPs do not get extra money and under the new formula they do not get much more.

Continuing to campaign for adequate resourcing of the independent contractor model requires the trust of Scottish Government and the public.

To enable this we would support greater transparency around the allocation and utilisation of resource, including transparency of GP incomes and we agree with the recommendation from Reform Scotland that GP accounts should be published.

We welcome the new contract guarantee of a minimum income for all GPs and we propose there should be an open debate between the profession and the Scottish Government as to what might constitute a reasonable maximum income.

Dr Irvine’s research 1shows that individual GP earnings are only one aspect of range of valuable insights.

These insights help us to understand the effects of sustained under-resourcing of general practice on the wider healthcare system. We would welcome the publication of these findings to more fully inform ongoing discussions about how we ensure a sustainable NHS in Scotland, and meaningfully tackle persisting health inequalities.

Signed

Dr David Blane (GP, Glasgow)

Dr Margaret Craig (GP, Glasgow)

Dr Lynsay Crawford (GP, Glasgow)

Dr Maria Duffy (GP, Glasgow)

Dr John Montgomery (GP, Glasgow)

Dr Catriona Morton (GP, Edinburgh)

Dr Anne Mullin (GP, Glasgow. Chair, GPs at the Deep End Steering Group)

Dr Jim O ’Neil (GP, Glasgow)

Dr Petra Sambale (GP, Glasgow)