There are marked differences in GP supply across areas. We are investigating how far GPs in less salubrious areas require a compensating increase in income to induce them to practice in such areas. We are using the NPCRDC GP satisfaction surveys to examine the relationships between GP incomes and hours worked and practice and area characteristics.
We examined trends in inequality in the distribution of GPs and their sensitivity to the inequality measure and the method of need adjustment. The method of need adjustment made little difference. Inequality in the distribution of GPs in 1995 was less than inequality in other primary care resources and greater than inequalities in disposable income, SMRs, primary school expenditure, and HCHS expenditure. The decile ratio shows little change 1974-1995. Gini and Atkinson inequality indices indicate some reduction in inequality between 1974 and 1980 but little change thereafter. The standard deviation of need adjusted provision increased over the period. Areas which had the lowest GP provision in 1974 tended to have the lowest in 1995. We argue that controls on GP distribution imposed by the MPC which prevent the equalisation of net advantages across over and under doctored areas reduces the effectiveness of local initiatives to increase the attractiveness of under doctored areas.