Intended for healthcare professionals


Health of people in rural parts of Britain is being neglected

BMJ 2005; 330 doi: (Published 27 January 2005) Cite this as: BMJ 2005;330:216
  1. Zosia Kmietowicz
  1. London

The healthcare needs of people living in rural parts of the United Kingdom are being neglected, as health policies continue to focus on centralising services in large cities while ignoring those of more distant communities, says a BMA report.

Up to a quarter of people in the United Kingdom live in rural settings, and research shows that for some illnesses they have worse health than people in urban areas, says the report. For example, people from more remote parts of the United Kingdom are less likely than those in cities to have their stomach, breast, or colorectal cancers diagnosed. They also die sooner from prostate and lung cancer than people who live closer to specialist cancer centres.

The report says the image of the “rural idyll” is unfounded and that that there are pockets of poor and disadvantaged people living throughout rural areas, often close to people living in very different circumstances.

Dr Vivienne Nathanson, head of ethics and science at the BMA, said: “Deprivation in rural communities has been ignored for a long time. There is a real case of the haves and the have nots. There are those with private transport who can access services, while those with lower incomes have limited access and choice.”

Poor recruitment of doctors can also restrict access to health services, says the report. Although some rural areas have large numbers of doctors applying for GP posts, others, such as very remote and deprived areas, have problems. Posts in these areas tend to stay vacant for longer than those in deprived urban areas.

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Without private transport, access to health care can be difficult in rural areas


The report calls for a rethink in the way health services are developed and for a separate agenda for rural areas. It makes 15 key recommendations on how the difficulties facing rural communities can be tackled. Improving public transport in rural communities is essential and needs to be taken into account when health services for these areas are planned, says the report. New ways to provide health services to rural communities also need to be considered.

The report gives an example of how telemedicine has helped people in the Falkland islands, where some people live 100 miles from a health centre. Patients can send photographs and test results through the internet.

To aid recruitment in rural areas more medical students should be given the opportunity to choose a rural placement, says the report. And more people from rural communities should be encouraged to go to medical school, as they will often then opt to work in such areas once qualified.

Healthcare in a Rural Setting can be seen at

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