TY - JOUR T1 - Poor access to care: rural health deprivation? JF - British Journal of General Practice JO - Br J Gen Pract SP - 567 LP - 568 VL - 56 IS - 529 AU - A Gordon Baird AU - Nat Wright Y1 - 2006/08/01 UR - http://bjgp.org/content/56/529/567.abstract N2 - The White Paper Our health, our care, our say: a new direction for community services should offer something for rural health care.1 ‘Rural’ merited five mentions; lay responses about poor health provision to the citizens' summit are mentioned twice. Two innovative approaches developed in rural areas deserved reference but the Paper only once referred to the need to develop rural services. It failed to focus on how to address rural health issues. Whether this is our fairy godmother speaking remains a big question for rural GPs.The Kerr report for Scotland2 had a section on health inequalities that mentions ‘rural’ only once. The recommendations made by the BMA3 in 2005 remain undelivered, and it is not clear how they can be delivered as the BMA has disbanded its rural committee.In England (the least rural country of the UK) the rural population comprises 19% of the total. These 9.5 million people equate to the population of London and the West Midlands. In Wales and Scotland the figure is nearer 40%. It is inconceivable that any national plan would fail to take into account the specific needs of a population of this proportion. Perversely, changes are occurring in both primary and secondary care that actually reduce the health resources available to the rural population.Mortality rates for road traffic accidents,4,5 asthma,6 and cancer are worse in rural areas.7 Cancer is diagnosed at a later stage8 and intervention rates for coronary artery disease (key government targets for health improvement) are lower.9 Rural patients are admitted to hospital less frequently than urban patients.10 Neither the NHS improvement plan11 nor NHS cancer plans12 … ER -