Nigel Hawkes, Health Editor of The Times
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Health inequalities between rich and poor have widened since Labour came to office in 1997.
A report published yesterday shows that attempts to narrow the gaps have largely failed. In infant mortality and life expectancy, two important measures, the gap is wider now than it was then.
David Sinclair, head of policy at Help the Aged, said that the figures made a mockery of the Government's attempts to tackle rising inequality and represented a staggering failure.
“The starkest demonstration of the gap between rich and poor can be seen in the gulf in life expectancy between different social groups. Despite the Government's commitment that no-one should be disadvantaged by where they live, the reality is that people who are poor, or who live in poor communities die earlier” he said.
In 1995-97, the baseline for the life expectancy comparison, the average man had a life expectancy at birth of 75.1, while for those in the poorest areas it was 72.7 - a gap of 1.9 years. By 2004-06, life expectancy had risen on average to 77.3, but for the poor areas it was 75.3 - a gap of two years.
For women, the gap grew even more quickly. It was 1.4 years in 1995-97, but had risen to 1.6 years by 2004-06, an 11 per cent increase.
For child mortality, the gap has also widened, the report admits. In 1997-99, the baseline for this target, the average rate was 5.6 per 1,000 live births, while that for the poorest groups was 6.3, a gap of 14 per cent. By 2004-06, the average had fallen to 4.8, while the poorest group had reached 5.6, a gap of 17 per cent.
Cancer deaths showed no significant change in the gaps between rich and poor, but in heart deaths there was a widening in relative terms.
Other targets, such as under-18 conceptions, deaths in road traffic accidents, the number of GPs per 100,000 people, smoking prevalence and smoking in pregnancy, also show no change or widening gaps.
The sole exception among the health targets came in flu vaccinations, where the gap narrowed.
In her introduction to the report Dawn Primarolo, the Health Minister, claims to see “some signs of progress” but Sir Michael Marmot, chair of the scientific reference group on health inequalities, is more frank.
In his preface, he writes: “We are of the firm belief that there should be two central aims for health policy: improve overall health and reduce inequalities. The evidence shows success in the first but, as yet, not in the second, despite the welcome improvement in the health of the worst-off.
“It is simply too early to say if too little has been done or the right actions were not taken” he concludes.
Norman Lamb, the Liberal Democrat Shadow Health Secretary, said: “Widening health inequalities have been Labour's most shameful NHS failure. For the past decade, this Government has delivered little more than broken promises on reducing health inequality.
“Too much vital investment has been wasted on organisational upheaval and top-down bureaucracy.
“The terrible truth is that people from poor backgrounds and those unable to act as strong advocates for their own health continue to die younger and have a worse quality of life than the population as a whole.”
Dr Michael Dixon, chairman of the NHS Alliance, said that better primary care was the key to reducing inequalities. “Health Minister Lord Darzi's coming review of the NHS needs to focus on how primary care can lead the health service” he said.
“In particular, it must support strengthened practice-based commissioning, where local clinicians who know their patients make decisions about the services they need. That is the best way for the NHS to play its role in tackling health inequalities.”
Mr Sinclair said: “It's vital that targetted initiatives are developed to tackle rising health inequality - action is urgently needed to ensure better and more equitable access to GPs and preventative health care services.
“All too often, poorly served communities are poorer communities - leading to a cycle of disadvantage and poor health. Gaps in NHS provision have a direct impact on health inequalities.
“Without action to tackle health inequalities the Government's entire ageing strategy will be in jeopardy.”
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