The DoH was rather hurt at charges of villainy: ‘We didn't
slip it
out, we tried to get the newspapers interested’

Michael White

Health Service Journal, 18 August 2005

Switching on Radio 4's Today programme, I found Labour's
Frank Dobson slugging it out with Nick Herbert, a new
Conservative MP keen to put NHS funding on an insurance basis.

'Check your figures, sunshine' the former health secretary
told him in his cheerful, bruiser's way. Mr Herbert, 42, had
been making good points about private provision, but Dobbo,
65, kept him on the ropes. It made me proud to be an oldie.

Back to real life. Was there a coverup last week when the
Department of Health quietly slipped out the latest report
from its scientific reference group of health inequalities,
chaired by Professor Sir Michael Marmot?

Some certainly think so. The Politics of Health Group
co-chair Dr Alex Scott-Samuel e-mailed me immediately: 'How
ironic that, 25 years after the Black report slipped
reluctantly into the public domain during the August
parliamentary recess, after three months in the grasp of the
Thatcher government, similar treatment has been accorded to
a report documenting the failure of the most neo-liberal
government since Thatcher.'

He was referring to two things. One was the famous Black
report on class and health inequality. A big issue for
Dobbo, whose father died young, the report was commissioned
by a Labour government, then buried by Tory health secretary
Patrick Jenkin, who published a paltry 260 copies over the
August bank holiday of 1980.

The other is that the Marmot report (Dr Scott-Samuel tells
us it's available at
www.dh.gov.uk/assetRoot/04/11/76/98/04117698.pdf) says the
differences between the infant mortality and adult life
spans of the richest and poorest families has widened under
Labour.

For example, infant death rates for the lowest
socio-economic groups were 19 per cent higher in 2001-03
than for the total population, compared with only 13 per
cent in 1997-99. In 2001-03 there were six infant deaths per
1,000 live births at the bottom of the scale, and only 3.5
at the top. The top-to-bottom life expectancy gap has also
widened by 2 per cent for men and 5 per cent for women.

As public health minister Caroline Flint was quick to point
out, there were 'encouraging signs' of improvement in some
respects: a fall in child poverty, a better record on heart
attacks and strokes.

'This report gives no grounds for complacency that enough
has been done' to meet Whitehall's 2010 targets, said Sir
Michael, who placed it in the context of a century of
'dramatic improvements' for all social classes, though not
enough among the poor. Masterful tact; that's how they get
knighthoods.

What offended some observers, including Tory health
spokesman Andrew Lansley, was that ministers simultaneously
announced plans to send 12 'health trainers' into deprived
areas; a pledge from the public health white paper.

A typically 'token and trivial scheme' to deflect attention,
said Mr Lansley. Poverty and diet must be tackled too, said
the Lib Dem spokesman, Steve Webb.

But they didn't say it very loudly. The issue was aired on
Today, and I spotted it in the Mail ('Labour breaks health
vow') and The Daily Telegraph - nowhere else.

Even the broadsheets were still too preoccupied with the
arrest of Islamic militants and threats of an NHS heart op
for Omar Bakri Mohammed. ‘I'll do it,’ volunteered a
Telegraph reader before home secretary Charles Clarke
blocked the cleric's return from Lebanon, saving both the
NHS and the Benefits Agency time and money.

When I rang my friends at the DoH, they were rather hurt at
charges of villainy. An embargoed press release had been
issued on Wednesday for use on Thursday. ‘We didn't slip it
out, we tried to get the newspapers interested,’ protested one.

The Marmot figures only got to 2003, so are out-of-date, and
the health trainers plan was an attempt to throw the issues
forward, I was told. Yes, but Ms Flint's press release
('Health trainers for disadvantaged areas') stressed
progress, not disappointment, in its first sentence.
You decide. In Whitehall's defence I would only say that
Number 10 is always badgering ministries for good news
announcements in the dog days of August and complains if
they do not get much coverage. It's a dog's life. And
trainers are surely a good idea.

Michael White is politcal editor of The Guardian.