the quality of some of the GP's in inner city areas has historically been poor - it has never attracted the best, they go to the nice areas, leaving the people, who ironically need healthcare the most, with dubious staff. I can only see it getting worse, as GP's pay improves, little competition for posts, then you are highly likely to attract a type of person who likes the money, can put up with sub-standard healthcare facilites/infra-structure without getting frustrated, more than the type who want to make a difference. I know this is a generalisation, but it's also the reality of healthcare in inner cities.