GPs at the Deep End

I am a GP working in a deprived urban area in Ireland. I would like to express my enormous appreciation of the Deep End series that has been running in the Journal since January. I would describe it as having been thrown a lifebelt, if that's not overstretching the analogy. To see one's experience named and, indeed, validated in this way has been very liberating. It must be a bit like a patient with an uncommon illness finding a support group. One of the many insights of the work has been to point out that it is not just governments who do not appreciate the issues, but our own unions, colleges, and indeed GP colleagues.

This was eloquently demonstrated by the letter from Steven and Jackson in the April Journal.1 This is a critical time for general practice in both the UK and Ireland as funding mechanisms come under review. Here in Ireland the average capitation payment in newer deprived suburban areas is 60% of the norm, because it is based on age (despite the greater than twofold mortality). It would be good to have some tools we could use to accurately describe and quantify the nature of the work, as opposed to the health outcomes that are well documented.

We need to persuade the sources of funding, and society as a whole, that it makes sense to address not just health inequality, but inequality of health service provision.

• © British Journal of General Practice, January 2011