MPs attack Labour inaction on health inequality
Labour chair of public accounts committee laments ‘bad story of missed opportunities’ in tackling health inequality.
Labour’s stewardship of the NHS produced an alarming health gap that saw people living in the poorest neighbourhoods in England die almost two years before those in the rest of the country, in what the head of the public accounts committee today calls a “bad story of missed opportunities”.
Margaret Hodge, the Labour chair of the committee, said that despite the doubling of the NHS budget and rising prosperity levels there had been “lots of reports and inaction about health inequality”.
“New Labour came in in 1997 and announced it would put reducing health inequalities at the heart of tackling the root causes of ill-health. But it was unacceptable that health inequalities only became a NHS priority in 2006, and primary care trusts not required to report on it until 2007. It was too late.”
The committee’s report found that, as a result, the gap in life expectancy between the poorest areas and the national average grew by 7% for men and 14% for women, and Labour missed its own targets on public health. It says that the Department of Health did not have enough resources and lacked leadership and a “clear focus on health inequalities”.
“This was a bad story … of missed opportunities,” said Hodge, who said the premature mortality amounted to 3,335 excess deaths across the country. There were not enough family doctors in poor areas and no ideas to prevent public health problems rather than reacting to crises in, for example, obesity.
The report says two-thirds of the poorest places in the country still had “lower levels of GP coverage than the national average of 60 GPs per 100,000 population”. In the north-east, the report said, this dropped as low at 25 per 100,000.
Hodge, a minister in the last government, said Labour should have forced GPs in “single-handed practices” to band together in bigger practices in poorer areas, and paid new doctors more money to work in difficult areas. Single-handed practices make up 22% of all GP surgeries in poor areas.
“We should have drawn up new contracts, closed down single-GP practices and basically told them who to hire and how much to pay them,” she said, pointing out 10 of the 146 measures outlined in a doctor’s contract rewarded physicians for focusing on the neediest groups.
The committee’s response comes as the health secretary, Andrew Lansley, is preparing a white paper on public health to be published this month. The report says that at present around 4% of the NHS budget is spent on public health, although actual spending is not easy to identify. It calls on the government to develop “transparency and accountability for this [money]”.
Hodge said the committee had identified three public health prevention strategies – stopping smoking, high blood pressure and lowering cholesterol – which cost £24m out of a total budget of £3.9bn. “But it was not spent. We are too reluctant to spend on prevention in this country and end up spending billions on treatments.”
The government welcomed the report, saying it was committed to renegotiating doctors’ contracts so that disadvantaged areas could deal with their population’s health needs. “We’ve already set out proposals for how areas with the poorest health will be given money to help them be healthy, and public health budgets will be ringfenced,” said Anne Milton, the public health minister. “We need a new approach to improve the health of the poorest, fastest.”
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