Patients are three times more likely to find a general practitioner in a well-off area than in a socially-deprived area, a new survey shows.
Dr Tom O'Dowd, Professor of General Practice and Community Health at Trinity College Dublin, will be giving details of the study when he addresses the annual meeting of the Irish College of General Practitioners in Kilkenny.
Researchers in his department have analysed the location of GPs' surgeries in Dublin and compared these findings with an index of social deprivation. The results will highlight the inequality in terms of ready access to a GP. Prof O'Dowd will challenge delegates to consider the implications of the research for social inequality and access to healthcare.
There are historical reasons for the lack of GP surgeries in deprived areas. To run a financially viable medical practice it was necessary for doctors to cross-subsidise their socially-deprived locations with a second practice in a more affluent area.
"We must incentivise medical work in deprived areas. We need to attach an importance to working in these areas which will attract the best graduates," he says. "What is more, I am sure working in deprived communities will help young doctors to find a vocation."
Dr O'Dowd will ask family doctors to consider becoming stronger advocates for their patients. They must first recognise the reason this is not happening at present. A weak primary care team is a barrier, as is a lack of definition on what represents a core GP service.
"What is evident from the 1998 Comptroller and Auditor General's report is that there has been a considerable investment in the structure of general practice through the indicative drug-budgeting scheme but without a matching investment in service provision." Dr O'Dowd will suggest it is now time to start a debate on fairness and equity within the health service.
"There is a need for GPs who meet unfairness on a day-to-day basis to stand up and tell it as it is," he says.
The social inequality in healthcare session will also be addressed by Father Harry Bohan, chairman of Rural Resource Development, and by Mr Pat McLoughlin, director of planning and commissioning, Eastern Regional Health Authority. The ICGP meeting continues until Sunday.