Equity in primary care

Karen Bloor () and Alan Maynard
Additional contact information
Karen Bloor: Centre for Health Economics, The University of York

No 141chedp, Working Papers from Centre for Health Economics, University of York

Abstract: The allocation of funding and the distribution of the workforce in primary care is very unequal in England. Whilst hospital resources have been allocated in relation to a weighted capitation formula in each of the component parts of the United Kingdom since the late 1970s, there have been minimal efforts to equalise the distribution of general practitioners and the budgets which finance them and the services they provide. The purpose of this paper is to illustrate both the existing inequalities in the distribution of primary care funding and the impact of alternative, simplistic but illustrative formulae which could be used as a basis for achieving more equitable funding of primary care in England. These calculations show hat a weighted capitation formula would have a significant impact on the old fourteen regions of the English NHS with major losses in funding and staffing levels in the South, particularly the South West, and major gains in the North of England. For example, using one of the models, the South West would have lost 14 per cent and the Northern region gained over 9% of FHSA expenditure with ‘RAWPed’ primary care budgets in 1990-91. The pursuit of greater equity in primary care funding may require a radical change in the GP contract, perhaps with it being replaced by franchises for primary care which are let to multi-disciplinary teams of providers. Such change requires careful evaluation to ensure that the hospital gatekeeper role of the GP is maintained and the incentives to ensure efficient use of scarce primary care resources are improved.

Keywords: RAWP; weighting; FHSA (search for similar items in EconPapers)
Pages: 32 pages
Date: 1995-10
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

Downloads: (external link)
http://www.york.ac.uk/media/che/documents/papers/d ... on%20Paper%20141.pdf First version, 1995 (application/pdf)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:chy:respap:141chedp

Access Statistics for this paper

More papers in Working Papers from Centre for Health Economics, University of York Contact information at EDIRC.
Bibliographic data for series maintained by Gill Forder ().