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You may be interested to see the full text of my (heavily edited) letter in yesterday's Health Service Joournal Alex -------- Original Message -------- Subject: Tackling health inequalities Date: Thu, 11 Aug 2005 14:26:02 +0100 To: [log in to unmask] Helen Mooney and Mary-Louise Harding (Could public health trusts win war on inequalities? 11th August, p12) appear to suggest that the intellectually bankrupt concepts of choice and contestability coupled with the morally bankrupt imposition of private sector provision within the NHS are capable of reducing inequalities. Nothing could be further from the truth. The new Department of Health report 'Tackling health inequalities: Status report on the Programme for Action' demonstrates that health inequalities between the worst off fifth of areas in England and the population as a whole actually increased in both of the government's headline target areas - life expectancy and infant mortality - between 1997 and 2003. This is despite the government’s effusive rhetoric on inequalities and the epidemic of NHS inequalities policies. Abundant evidence demonstrates that what is required to tackle inequalities is an 'upstream' focus on policy action at the level of the fundamental causes rather than at the level of their ‘downstream’ disease impacts. The government’s macroeconomic, trade, international development and foreign policies depend on the maintenance of global and national inequality: not only have they no hope of reducing it, they inevitably work in the opposite direction to domestic equity policies. Furthermore, the patriarchal attitudes which underpin these policies (aggression, risk taking, over-competitiveness, emotional illiteracy) are on the increase. The sad thing is that all the causes of inequality are amenable to government action – on the one hand through movement towards a demilitarised, egalitarian, publicly provided welfare society, on the other through the promotion of parenting and socialisation practices which don't emphasise excessive masculine gender roles. Sincerely, Alex Scott-Samuel *************************************** Dr Alex Scott-Samuel Joint Chair, Politics of Health Group www.pohg.org.uk ****************************************