Health inequalities. Volume II, Written evidence / House of Commons, Health Committee.

  • Great Britain. Parliament. House of Commons. Health Committee
Date:
c2008
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Licence: Open Government Licence

Credit: Health inequalities. Volume II, Written evidence / House of Commons, Health Committee. Source: Wellcome Collection.

    9/370 (page 1)
    Written evidence Memorandum by the Department of Health (HI 01) THE CONTRIBUTION OF THE NHS TO REDUCING HEALTH INEQUALITIES The Health Select Committee announced, on 27 November, an inquiry into health inequalities. The inquiry will examine the extent to which the NHS can help achieve a reduction in health inequalities, particularly through primary care and public health services. The Department’s response to the issues identified by the Committee is set out below. THE CONTRIBUTION OF THE NHS TO REDUCING HEALTH INEQUALITIES [ISSUE: the extent to which the NHS can contribute to reducing health inequalities, given many of the causes of inequalities relate to other policy areas e.g. taxation, employment, housing, education and local government] KEY MESSAGE: reducing health inequalities requires a balanced approach between action in the NHS and action on the social determinants of health 1. Inequalities in health status and outcomes are determined by how and where people make a start in life and their early life experience, their education and occupational status, exposure to lifestyle and the environmental risks and diseases their life course predisposes them to. 2. The NHS affects peoples before birth to the end of life and helps to reduce risks throughout peoples sometimes too short a life journey. The NHS champions action to reduce health inequalities across government, regions, and communities, acting to help change peoples life course or mitigate the impacts of risks along the way, providing leadership and advocating for change. 3. People who live in the most deprived and challenging communities tend to experience the greatest health inequalities but health inequalities exist across all communities. NHS reforms have developed systems and processes to help reach people in the most disadvantaged groups and areas. 4. The setting of health inequality targets for the NHS established for the first time a set of national challenging improvements that the NHS, in partnership with other public services, must strive to achieve. The targets are to reduce health inequalities by 10% by 2010 as measured by infant mortality and to reduce health inequalities by 10% by 2010 as measured by life expectancy at birth. 5. Life expectancy has never been higher. Across all socioeconomic groups, life expectancy has increased year on year, and the NHS has played a significant role in this achievement. Cancer and cardiovascular disease rates are improving and the investment in health services has reached record levels. Similarly, infant mortality rates for all socioeconomic groups are at a historic low level but the rate of improvement has been greater in higher socioeconomic groups than for other groups. 6. The focus of government policy in the last decade has been to establish measures that still deliver overall improvements in life expectancy—but also reduce the relative inequalities across areas. The Acheson inquiry 7. Health inequalities are the result of inequalities in living and working conditions, food supply and access to essential goods and services such as education and health care. The Independent Inquiry into Inequalities in Health (1998) concluded that tackling these inequalities requires action on a broad front if it is to be effective. Hence, the inquiry report highlighted the issues around poverty and income, education, employment and environment as well as the specific actions and the role of the NHS. This approach reflected the scientific evidence that emphasised the interrelated nature of the causes of these inequalities. It said that action that focuses solely on one aspect of policy is likely to be less effective than action linked to relevant factors in other policy areas. 8. Government policy on tackling health inequalities has reflected this balanced approach over the last 10 years. The Department of Health (DH) and the NHS have played key roles, catalysing and promoting actions through the engagement of partners across government and wider society which are focused on improving the health of those experiencing the greatest inequality of outcome. The NHS Plan and the national targets 9. The NHS Plan (2000) highlighted the role of the NHS as a service committed to prevent as well as treat ill health. 10. It announced the first-ever national health inequalities targets for England providing a catalyst for national action in tackling health inequalities. The current version of the target reaffirmed in the new CSR is: to reduce inequalities in health outcomes by 10% by 2010 as measured by infant mortality and life expectancy at birth