FYI – new report from National Audit Office in England
on previous govt efforts to tackle health inequalities
Press release and link to report below
Best wishes
David McDaid
LSE Health and Social Care
http://www.nao.org.uk/publications/1011/health_inequalities.aspx
"The
Department of Health has made a concerted effort to tackle a very difficult and
long-standing problem. However, it was slow to take action and health
inequalities were not a top priority for the NHS until 2006. We recognize that
this is a very complicated issue and that it took time to develop an evidence
base. However, the best, cost-effective interventions have been identified and
now must be employed on a larger scale in order to have a greater impact and
improve value for money.
"The
Department should target its efforts on the most deprived areas of the country
and develop costed proposals to maintain or increase investment in preventative
interventions to tackle the conditions which lead to health inequalities."
Amyas Morse, head
of the National Audit Office, 2 July 2010
The
Department of Health has made a serious attempt to tackle health inequalities
across
Given the
slowness in applying cost-effective interventions on the scale required in the
early and mid-2000s, the NAO was unable to conclude that the Department’s
approach provided value for money up to this time. More recently the improved
take-up of these interventions is likely to have improved value for money.
The NAO
report found that, although life expectancy overall has increased, the gap in
life expectancy between the national average and the Government’s
dedicated “spearhead” areas has continued to widen. The Department
will not meet its target to reduce the health inequalities gap by 10 per cent
by 2010, as measured by life expectancy at birth, if current trends continue.
The
Department’s strategy, published in 2003, lacked effective mechanisms to
achieve the target because the evidence base was still being developed. It was
not until 2006-07 that the strategy was matched by focused action to tackle
health inequalities, leaving little time for these actions to have an impact
before the 2010 target date.
Three
key, cost-effective interventions to reduce the gap in life expectancy were
identified by the Department’s 2007 Health Inequalities Intervention
Tool: increase the prescribing, first, of drugs to control blood pressure and,
secondly, of drugs to reduce cholesterol, by 40 per cent; and double the
capacity of smoking cessation services. But these interventions have not yet
been used on the scale required to close the gap and progress in improving the
take-up of these interventions is not monitored.
Primary
care trusts are required to address health inequalities from within their
general budgets and, therefore, it is not possible to identify how much money
has been spent. PCTs in spearhead areas had £230 more per head to spend than
the PCTs in non-spearheads, but there is evidence that some of the extra money
is absorbed by higher hospital costs in deprived areas.
David McDaid
Senior Research Fellow, LSE Health and Social Care and European
Observatory on Health Systems and Policies,
WC2A 2AE
e-mail: [log in to unmask]