The chief executive of Greater Glasgow health board has called for more money from a proposed shake-up of Scottish health service funding, under which it would already be a major beneficiary.
The Scottish Parliament's health and social care committee was told last week that Glasgow would see its funding rise by 17 per cent if the recommendations of the Fair Shares for All report by Strathclyde University principal Professor Sir John Arbuthnott were put into effect.
But Greater Glasgow health board chief executive Chris Spry said Glasgow would receive less cash for community services and 'a reduction by 22 per cent in the money available for physiotherapy and health visiting services, and this at a time when spending should be increasing'.
Sir John spent 18 months investigating the 20-year-old 'SHARE' distribution system and called for its replacement with a needs-based system.
The result would be a substantial shift in funds from areas such as Lothian to Glasgow and rural areas, although health minister Susan Deacon stressed that health boards will not see real-terms cuts in their budgets to achieve this.
The health and social services committee is taking evidence from interested parties, who have been told to keep their views to four A4 pages.
In its submission, Greater Glasgow health board says it believes the four areas of Scotland examined to create the formula did not accurately reflect needs in Glasgow, which has 10 of the poorest areas in Scotland.
It also expresses concern that health promotion costs were not included in the calculations, even though they play a significant part in its annual budget.
In response, Sir John told the committee that city health boards did not fully understand the costs involved in delivering health services in rural areas.
'Let us take the example of someone with an ulcer who lives on a croft in a remote or rural area, ' he said. 'How does that person get their ulcer dressed?
'They do not live within three miles of a health service clinic. Somebody, a health visitor or community health worker who lives 50 or 100 miles away, has to come and dress the ulcer.
'I respectfully suggest that Glasgow and Lanarkshire should be asked to think about that. Different health boards require different approaches.'
Sir John also argued that the funding recommendations in his report were about dividing up the overall budget, and not about making specific financing decisions for individual boards.
Such decisions would remain the remit of the boards, so predictions of a loss of community services were 'untenable' .
In its submission to the committee, Lanarkshire health board agrees that there are legitimate extra costs in rural areas.
But it adds: 'If the Arbuthnott recommendations are implemented in Lanarkshire's case, we would receive£733 per head of population.
'This is significantly less than Orkney, Shetland and the Western Isles, which receive£1,185 per head.'
Conservative MSP Mary Scanlon said that although her region, Highlands and Islands, would benefit from increased funding if the Arbuthnott report was implemented, she was concerned that a reduced budget for acute services in Lothian would have an impact on her constituents.
Many of them currently travel to Edinburgh for specialist treatment, she said.