Brian Jarman on the deprivation index, 1990
Apr 22, 01:25 PM
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Brian Jarman was professor of primary health care at Imperial College London from 1983 – 1998. In this interview with College President Denis Pereira Gray in 2010, he talks about the introduction of his underprivileged area score in 1990 – which became commonly known as the Jarman Index.
The idea was to give pay in the inner-city areas in proportion to workload so that each GP got the same pay per unit of work – not an easy thing to do. And they decided that meant that the majority of GPs would be worse off and so it wouldn’t work. However, John being a fair person as I left the room he said come back Brian, we’ll give you one chance. If you come back in 3 months’ time, we will choose 5 areas randomly and we will ask the GPs at the LMC to shade the electoral wards according to the degree to which the patients in the area increase their workload or pressure on their services. And when we meet in 3 months we will see if there’s any overlap. And when we looked at the maps, there was only 1.4 or 1.6% of pairs of wards differed. So I then went for my first ever LMC GP conference at the Logan Hall. You have two minutes to speak … And I put it forward and they voted, having seen these figures, unanimously to accept the methodology. Purely theoretical, nothing happened, until 1990, the new White Paper – I suppose the Thatcher White Paper on primary care – came out and the day before, three parts of the department of health ask us for underprivileged area scores so I realised that they were going to use them. And they started paying GPs on that basis.
The idea was to give pay in the inner-city areas in proportion to workload so that each GP got the same pay per unit of work – not an easy thing to do. And they decided that meant that the majority of GPs would be worse off and so it wouldn’t work. However, John being a fair person as I left the room he said come back Brian, we’ll give you one chance. If you come back in 3 months’ time, we will choose 5 areas randomly and we will ask the GPs at the LMC to shade the electoral wards according to the degree to which the patients in the area increase their workload or pressure on their services. And when we meet in 3 months we will see if there’s any overlap. And when we looked at the maps, there was only 1.4 or 1.6% of pairs of wards differed. So I then went for my first ever LMC GP conference at the Logan Hall. You have two minutes to speak … And I put it forward and they voted, having seen these figures, unanimously to accept the methodology. Purely theoretical, nothing happened, until 1990, the new White Paper – I suppose the Thatcher White Paper on primary care – came out and the day before, three parts of the department of health ask us for underprivileged area scores so I realised that they were going to use them. And they started paying GPs on that basis.