Tackling ‘deep’ health inequalities: the test of health policy?
Having spent the week before this Labour party conference coordinating a joint response to the draft guidance on Joint Strategic Needs Assessments (JSNAs) and Joint Health and Wellbeing Strategies (JHWSs), I have been thinking a lot about the health inequalities faced by people with multiple and complex needs.
Our joint response is supported by 11 organisations representing different elements of multiple and complex needs: Clinks, Drugscope, Homeless Link, Making Every Adult Matter, Mind, Mencap, Rethink, Safer Future Communities, St Mungo’s, Turning Point and Revolving Doors. It highlights our joint concern that the revised guidance does not provide a strong enough ambition on the role of JSNAs and JHWSs in tackling the ‘deep’ inequalities faced by people with multiple and complex needs. It also underlines the lack of clear link with other outcomes frameworks and the lack of definition of integration or involvement.
With these issues fresh in my mind, I was keen to make it to a fringe event on health inequalities. I did so on Monday, when I attended the Socialist Health Association’s fringe meeting entitled ‘Health inequality now’. Speakers included Diane Abbot MP, shadow minister for public health and Easington MP Grahame Morris.
Much of the discussion focused around how to improve the health of the most deprived communities in Britain. Speakers emphasised the shocking range in life expectancy between different areas – Diane Abbot reminded the audience of the famous statistic that life expectancy falls by 10 years as you travel from Westminster to Canning Town on the Jubilee line – and within areas – Grahame Morris described a difference in life expectancy of 8.2 years within County Durham.
However, although one speaker referred to the chronic health inequalities experienced by people in prison, there was little discussion of groups facing ‘deep’ health inequalities. I was keen to find out what the panel thought about tackling ‘deep’ as well as ‘wide’ inequalities, and posed a question on the subject. There was resounding agreement that it is vital to address both at the same time.
Diane Abbot responded saying it’s not so much about ‘deep’ inequalities but ‘unattractive’ inequalities; those faced by offenders, people who are homeless, sex workers, and so on. She expressed concern that under localism, local authorities and clinical commissioning groups will prioritise issues raised by those with the most social capital, leaving less vocal groups behind. Diane was clear of the need to show leadership on this issue, and that she believes the test of Labour health policy should be how it responds to these ‘deep’ and ‘unattractive’ health inequalities.
Professor Steve Field’s work on Inclusion Health, started under the last administration, makes an important contribution to tackling the ‘deep’ health inequalities faced by four socially excluded groups: homeless people, sex workers, vulnerable migrants and Gypsy, Roma and Traveller communities.
Diane Abbot’s statement that tackling ‘deep’ inequalities should be a test of the Labour’s health policy well compliments this work (now being led from within government), and takes us a step closer to the cross-party consensus needed. However, it is vital that momentum is retained if this commitment it to make it into the 2015 manifesto. And it is not just an issue for Labour. Tackling ‘deep’ and ‘unattractive’ health inequalities should be a test of all parties’ health policies.
