When you’re sick, you drop into your local GP as a first port of call – at least, that’s if you have one. General practices have been closing at an alarming rate, with well over 100 per year now closing for good according to an investigation by Pulse.
The problem affects some regions more than others – if you live in a rural or coastal area, you’re far more likely to have said goodbye to your local practice. Almost two thousand villages are now three miles from the nearest surgery, and some patients are now up to 15 miles away from the nearest health centre.
Companies such as Medical Defense Society – which provides indemnity for GPs – have said this trend must be reversed to protect doctors and patients.
That’s not all, though: GP services across the UK’s regions can vary dramatically. Local government data shows that huge variation between English regions has always existed. Closures mean the gaps are growing. Wales now has more GPs per head than England by a small margin: 6.5 per 10,000 compared to 6.4. Northern Ireland is enjoying an increase – the ratio is up to 6.7 per 10,000 people – while Scotland has resisted change the most, holding on to 7.6 GPs for every 10,000 people.
The issue is one of inequality – in a stretched system, young people living in cities like Edinburgh may find it easier to access healthcare than people who are vulnerable because of age or income. Coastal communities are among the UK’s most deprived, while Age UK notes that rural communities are about 5.5 years older than their urban counterparts.
This creates a widening gap between the healthiest and least healthy segments of the population and the problem is likely to get worse before it gets better.
It’s not all about GPs: A&E waiting times vary greatly across the UK, too. Northern Ireland has the worst and Scotland has the best; something which has been attributed to high levels of integration between hospitals and councils in Glasgow and Edinburgh.
As the population gets older, a major challenge for hospitals is helping elderly patients to get the care they need as efficiently as possible.
In Northern Ireland, 95,000 patients spent more than a year waiting for their first consultant-led outpatient appointment – compared to just 1,089 in England. This goes against NHS guidelines and represents a 43 per cent increase since 2017. The Department of Health has said “fundamental transformation” is the only solution for Northern Ireland.
In 2017-18, public spending was £9,080 per person in England, but far higher in Scotland, Wales and Northern Ireland. Northern Ireland spent the most, at £11,190 per person while Wales spent £10,397 on healthcare. These figures are partly because of the smaller populations of these regions, since higher per capita spending is needed to maintain infrastructure. Scotland spent £10,881 per person.
Mental health spending varies greatly across England – Surrey Heartlands spent £124 per person, while South Yorkshire and Bassetlaw spent £220. This is partly due to how budgets are calculated, with deprived areas receiving more funding, but it still creates different levels of access up and down the country.
Specialist hospitals – offering mental health services, maternity care and emerging treatments – are not evenly spread throughout the country. Cities such as Liverpool, Birmingham and Oxford have dedicated women’s hospitals, giving local women access to cutting-edge services in gynaecology and for premature babies, for instance.
Whether you are a newborn needing urgent paediatric care or a teen in mental health crisis, the care you have access to still varies greatly by region – right from funding to hospital facilities and general practice.
Scottish cities now stand head and shoulders above the rest of the country, while rural, coastal areas in Northern Ireland are among the worst places for healthcare. We might have a national health service – but the way in which we experience it varies depending on where in the nation we live.