News

Time to neuter the ‘fat cats’

The government must introduce progressive taxation, end ‘fat cat’ pay rises, and increase the minimum wage, if it is to have any hope of narrowing the widening gulf in health experience in the UK, public health organisations have told healthmatters.

The Public Health Alliance (PHA) and Association for Public Health (APH) have both welcomed the recent Acheson report on Inequalities in Health, which confirmed that ill-health in the UK is often rooted in inequalities in income, employment, housing and education.

But they feel that by focusing almost exclusively on the report’s recommendations on ending ‘social exclusion’, the government will only make a limited impact on health inequalities.

PHA chair Geof Rayner, said: ‘The issue is not just about people feeling excluded, but also about people being excluded. The government must address the growth of economic inequalities - something that is often avoided by only talking about social exclusion.’

Maria Duggan, policy adviser to the APH, added that the government had taken some tentative steps towards redistribution in its tax policy, ‘but we’d want to see a greater commitment to that. Without tackling income inequalities we won’t see a real reduction in health inequalities.’

APH chief executive Donald Reid bluntly called on the government to ‘increase the income of the poorest tenth, raise the minimum wage and prevent ‘fat cat people’ from paying themselves wage rises three times larger than their employees’. Nothing is worse for your health than living in poverty while everyone around you is getting richer, he said.

The Acheson report, published towards the end of last year, suggests that the widening health gap between rich and poor in the UK could be bridged by making health inequalities, rather than health, the main focus of government policies. It points out that since 1980, average income for the richest tenth of the UK population has grown by 60-68 per cent, while for the poorest tenth it has fallen by 8 per cent (when housing costs are included).

‘All policies likely to have a direct or indirect effect on health... should be formulated in such a way that by favouring the less well off they will, wherever possible, reduce such inequalities,’ it says.

The report outlines a 39-point strategy, but Sir Donald Acheson, the chair of the independent inquiry, warned that it would not work if the government resorted to ‘cherry picking’ one or two of the ‘more sexy’ recommendations.

The recommendations include a shift in the tax burden ‘from regressive to more progressive forms of taxation and fiscal policies (so far rejected by the Labour government, which has pledged to stick to the tax policies of the previous Conservative administration).

The report also calls for an upgrading of benefits and pensions, and for measures to increase the uptake of benefits in entitled groups.

As healthmatters went to press, the APH was organising a seminar on implementing Acheson, including experts from a range of disciplines and people with experience of living in poverty. Some of the views arising from the seminar are due to be presented at the annual Public Health Forum on 17-18 March, following which a new public health body (the UK Public Health Alliance) will be formed, incorporating the APH and PHA.