Public Health and Inequality

Conference notes:

1. The report by Sir Michael Marmot and others: “Tackling health inequalities: Status report on the Programme for Action” published on 11th August shows a continuing widening of inequalities as measured by infant mortality and life expectancy at birth.

2. Proposals made by the Secretary of State for Health on 19th July and subsequently to introduce wide ranging consultations about the future of health and social care and of democratic involvement in their governance.

3. The decision announced on 2nd August to postpone the abolition of the Commission for Public and Patient Involvement in Health and to set up a review of public involvement and accountability in the NHS.

4. In this month, the 25th anniversary of the Black Report on Inequalities in Health, it is appropriate to recall that its recommendations, like those of the much more recent Acheson Report, called for wide ranging action by all Departments of State not just the Department of Health.

5. The publication on August 25th of research conducted by Dr Bhatti, Director of Public Health for Huddersfield which demonstrated that while admissions to hospital with heart attack was 38 % higher per head in deprived parts of that town the death rate was 317% higher.

6. The absence of any mechanism in the Party where differences between policy in England and that in Scotland and in Wales may be discussed.

Conference calls on the Government in respect of England and Wales

1. To adopt a much bolder and more radical approach to public health including :

  • a. a complete ban on smoking in all public places with NO exemptions as is proposed in Scotland
  • b. a comprehensive transport policy which both encourages physical exercise and reduces environmental pollution by promoting accessible and affordable public transport and by discouraging private motor car use by measures such as road use charges
  • c. substantial improvements in the diet of children through a complete ban on advertising of processed foods except at point of sale and through provision of free healthy school meals to all
  • d. effective measures to ensure that the obstruction of breastfeeding mothers is a criminal offence as it is in Scotland.

2. To give much higher priority to public health and to make public health the direct responsibility of a cabinet minister.

3. To evaluate proposals for the reform of health and social care primarily in terms of their impact on health and social inequalities and equity.

4. To transfer responsibility for public health and the commissioning of health services at local level away from appointed quangos to elected Local Authorities so permitting the abolition of Primary Care Trusts with their unelected boards and high administrative overheads.

What do you think?

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