There is little doubt that individuals living in areas of socio-economic deprivation suffer poorer health. [
1] In 1980 the Research Working Group chaired by Sir Douglas Black produced an authoritative report documenting inequalities in health in Britain. [
2] This stimulated a widespread response and since then much more evidence has accumulated about health inequalities in many different countries, [
1] including Ireland. [
3] In particular, both standardised mortality rates [
4] and infant mortality rates [
5] are correlated with socio-economic deprivation in Ireland. The all-cause mortality rate on the island of Ireland in the lowest occupational class is 100–200% higher than in the highest occupational group. [
6] There is also evidence that morbidity is highest in general practices serving socio-economically deprived areas. This includes psychiatric morbidity, [
7] cardiovascular disease,[
8] diabetes, [
9] cerebrovascular disease, [
10] and psychological distress. [
11] Inequalities in health are often compounded by inequalities in access to health care. In Dublin, for example, there is evidence that general practices are heavily concentrated in more wealthy areas. [
12] Patients from deprived areas are also more likely to have higher consultation rates [
13,
14] and prescribing costs. [
15] Individuals living in these areas have a higher need and use of social services. [
16]
However, little of a concrete nature has been put in place to address this imbalance between health inequalities and access to health services. Primary and secondary care services are configured to give advantage to those with the least health need. There is little evidence from the literature in Ireland or the UK of attempts to reconfigure primary care in socio-economically deprived areas in order to address health inequalities.