Deprivation payments in general practice: some spatial issues in resource allocation in the UK

The past decade has seen a substantial review of the organization of primary health care provision in the UK. The ideas for reform, detailed in the White Paper ‘Promoting Better Health’ (Health Departments of Great Britain, 1989), were put into effect through the ‘New Contract’ on 1 April 1990. In a reversal of the previous policy of promoting smaller list sizes adopted in the Charter of 1966 (British Medical Association, 1965), this ‘New Contract’ has re-emphasized the value of increasing patient list size by making the major share approximately 60%) of a GP’s basic practice allowance dependent on a capitation fee (a one-off annualpayment for each registered patient on a doctor’s list). Additional payments are made with respect to (i) numbers of new patients, (ii) patients over 75 and (iii) patients living in deprived areas (known as the Deprivation Supplement). This paper is concerned with some of the spatial issues relevant to the implementation of the deprived areas supplement.