Doctors in areas of England with the fewest ethnic minorities spend more than four times as much on contraception prescriptions per 1,000 women as those with the largest ethnic minority populations, new data shows.
Last week, a Channel 4 documentary, Davina McCall’s Pill Revolution, turned the spotlight on the current state of contraception in the UK.
Now research carried out by an independent company on behalf of the programme has highlighted the disparity in the availability of birth control across the country. It also found that the richest areas in England spend 73% more on prescriptions than the poorest.
Health campaigners say that cuts in the last 10 years mean that general practices in some parts of England now make a loss when offering women coils or implants, and that declining numbers of GPs are receiving specialist training.
The women’s health ambassador for England, Professor Lesley Regan, said that women find it harder to access contraception now than 10 years ago. Last year saw a record number of abortions – 214,869 in England and Wales – with a rise in younger women and existing mothers.
GPrX, which provides NHS prescribing data, examined the numbers of prescriptions from GP surgeries, student health services and sexual health clinics and matched them to local demographics.
It found that the 10% of practices with the most women from ethnic minorities spent an average of £419 per 1,000 women aged 15 to 50 on prescriptions for contraception. In contrast, the 10% of practices with the fewest minorities spent £1,871 per 1,000 women – more than four times as much.
Similarly, doctors wrote £918 of prescriptions per 1,000 women in the top 10% most-deprived parts of England, while those in the richest 10% spent £1,590. Overall, the number of contraception items prescribed fell from 9.9 million in 2018 to 8.7 million in 2022.
GPs mostly prescribe short-acting contraception such as daily pills – a core GP service – while longer-term methods, such as coils and implants, are funded by local authorities and part of the enhanced service.
Dr Anne Connolly, a Bradford GP who chairs the Primary Care Women’s Health Forum, said that the crisis in GP recruitment and reduced funding in some parts of England meant that surgeries may lose money by offering the enhanced service.
“In many areas, we’re finding that GPs and nurses who want to deliver that service can’t,” she said. GPs also require training to deliver the enhanced service, and younger doctors cannot access training easily.
“We’re calling for a nationally agreed and fair fitting fee that would stop GPs and nurses being told they can’t fit [coils etc] because they’re running at a loss.
“The second thing is an improvement to access to training and reducing some of the hurdles so that you don’t have to be out of pocket to do the training.”
Connolly also said the government’s new women’s health hubs needed to be local so that women did not need to travel long distances to get access to contraception – a major barrier for poorer women.
Meanwhile, darker-skinned women are being excluded from using the contraceptive patch because it is only made with a single skintone, according to the Reproductive Justice Initiative. The group has launched a petition to persuade the manufacturer, Gedeon Richter, to make a more discreet transparent patch.
Simphiwe Sesane, the founder of Black Nurses and Midwives UK, which supports the petition, said: “It’s been around for 20 years. We need to be in a space where we are considering black and brown people, and I think a lot of the time pharmaceutical companies don’t do that.”
