We are all shamed by Scotland’s poor health record, but we are even more shamed by the wide socioeconomic inequalities in health. Inequalities that see the poorest, most disadvantaged bearing the greatest burden and suffering the most. Health inequalities are the unjust differences in life expectancy (how long we live) that are observed across our communities, cities, and country – differences determined by socioeconomic position or circumstances, determined by the unfair distribution of income, wealth, and power. In the Socialist Health Association Scotland, we believe we must tackle health inequalities that play out in health and disease, in life and death is the greatest challenge we face as a society.

The time for action on health inequalities is now. And we are delighted to announce that Neil Findlay MSP, Shadow Cabinet Secretary for Health and Wellbeing and the Scottish Labour Party have grasped this thistle and have commissioned the health inequalities policy review.

Our launch meeting, in the Scottish Parliament in February 2014, brought together a diverse “Reference Group” with representatives from community groups, activists, the voluntary sector, councils, health professionals, academia, Unions, the Labour Party, and the Socialist Health Association, and included a priority setting workshop.

The Reference Group agreed an overarching vision of the commission – to make tackling health inequalities a top priority and to propose a suite of policies for action. The Commission will have the following aims:

  1. To understand the scale and depth of health inequalities; thoroughly clarifying both the manifestations of health inequalities and the social, political and economic determinants of health inequalities.
  2. Across health and other public services to examine ways to tackle the Inverse Care Law and ensure resources are allocated proportionate to need.
  3. To consider short, medium and long term policies needed to tackle health inequalities (incognisance of current and potential future constitutional arrangements).
  4. To propose and cost specific policies that would help tackle health inequalities. This should take into account current spending realities, but could also consider what could/should be done with reallocating and reprioritising resources or under a financial situation that is different that differs from the current arrangement; this should look at both more generous settlements than those in place presently.
  5. To consider how and where cross-portfolio work could/should take place to tackle health inequalities.

We are planning to undertake a process of community engagement in the policy development process.

We have set a call for written evidence on the following questions:

  • What is the character of health inequalities? What do they mean for communities and families?
  • What role can health and other public services play in tackling health inequalities?
  • Are there any specific policies, initiatives or research evidence from Scotland, UK or internationally that you would propose to tackle health inequalities?

Other specific questions:

  • What can be done within current devolved arrangements to tackle health inequalities?
  • What further devolving of powers would enable health inequalities to be tackled?
  • What mechanisms can be deployed to better join up policy and public services to tackle health inequalities?
  • What can be done to tackle the Inverse Care Law in health and other public services?
  • Is democratisation of health services important in tackling health inequalities?
  • How would community development efforts be better supported to tackle health inequalities?
  • How could resource allocation (geographic and in other budget planning terms) to health and public services be re-allocated to tackle health inequalities?

To respond to this call, please submit written evidence email tommy.kane@scottish.parliament.uk by end of May 2014.

This article first appeared in Healthier Scotland – The Journal Published by Socialist Health Association Scotland March 2014

Dr David Conway is  Chair of Scottish Labour’s Health Inequalities Commission

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