The Intraurban Ecology of Primary Medical Care: Patterns of Accessibility and Their Policy Implications

Patterns of intraurban accessibility to primary medical care in four major Scottish cities are examined in the context of existing public policy and against the background of intraurban patterns of community well-being. Certain regularities are observed in the spatial ecology of family doctors' surgeries, and the notion of an ‘inverse care law’ is discussed. A modified interaction model is introduced and used to analyse local accessibility to primary care facilities. Results indicate that disparities in accessibility tend to compound many other patterns of socioeconomic disadvantage. The formulation of public policies concerned with medical deprivation and area deprivation is discussed in the light of these results.