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NHS Plan sets target to reduce inequality

The government’s decision to create national targets on health inequalities, announced in the new NHS Plan, has been widely welcomed by health service commentators and public health activists.

According to the plan, the targets aim to ‘narrow the health gap in childhood and throughout life between socio-economic groups and between the most deprived areas and the rest of the country’.

A new health poverty index is also to be developed by 2002, to combine data about health status, access to health services and uptake of preventive services. It will include data on ‘the opportunities to pursue and maintain good health, for example access to affordable nutritious food, physical activity and a safe, clean environment’.

Rabbi Julia Neuberger, chief executive of the King’s Fund, said the decision to draw up inequalities targets was ‘fantastically important’. Work to get the worst-off in Britain healthier was ‘much overdue’, she said.

Spokesperson for the National Heart Forum Sir Sandy Macara added: ‘It is very important that we address the social inequalities that people suffer. If you are born into a lower social class group your chance of dying from heart disease of any type is three times as great as if you are in a professional class.’

But UKPHA chief executive John Nicholson warned that it would take more than targets to tackle inequalities in health.

‘We need to see concerted action, across all government departments, to ensure that the health of the whole population is improved, through employment, education, environment and most of all through reversing the widening gap in wealth and income.

‘Ensuring best value in the NHS means ensuring that people have good housing, diet and living standards, so that they should not need its support to treat the illnesses that result from poverty and inequality.’

However, concern has been expressed at the government’s decision to continue building health facilities through the Private Finance Initiative and its announcement of a new ‘concordat’ between the NHS and the private sector (see opposite).

In terms of elective care the concordat may ‘take the form of NHS doctors and nurses using operating theatres and facilities in private hospitals or the NHS buying certain services’. In critical care the NHS and the private sector will ‘be able to transfer patients to and from each other whenever clinically appropriate’, the plan says.

Unison head of health Bob Abberley, while welcoming the overall thrust of the plan as an ‘ambitious and radical shake-up’ of the NHS, was cautious about formalising closer links with the private sector.

‘The use of private healthcare, where the NHS cannot carry out operations in the desired time scale, should only be adopted as a stop-gap measure until new NHS facilities come on stream.’

The NHS Plan can be found on the internet at www.nhs.uk/plan. Copies are available from the Stationery Office. Tel: 0870 600 5522