PAC points finger at British Labour party for health inequalities

By Dr. Ananya Mandal, MDNov 2 2010

The cross-party Public Accounts Committee (PAC) has criticised the British Labour party for allowing inequalities during its 13 years of power. The MPs said on the acute shortage of General Practitioners, “The Department of Health (DoH) should identify, as a matter of urgency, what measures it can take to drive up the numbers of GPs in deprived areas, including using direct financial incentives to encourage GPs into areas of greatest health need.” Tony Blair pledged to put reducing life expectancy differences at the heart of his policy after winning the general election in 1997.

However reports have suggested that one fifth of the country lived in deep deprivation, and local authorities were given extra money and help to improve health. A target was set to close the gap with the rest of the country by 10% between 2000 and the end of 2010. Life expectancy in these areas between 2006-08 remains 75.8 years for boys and 80.4 years for girls. Average life expectancy of the population as a whole is 77.9 for boys and 82 for girls. That means, although life expectancy as a whole has increased, the gap has widened by 7% for boys and 14% for girls since 1995/97.

The report adds that two-thirds of the poorest places in the country still had “lower levels of GP coverage than the national average of 60 GPs per 100,000 population”. In the north-east, the report said, this dropped as low at 25 per 100,000.

The PAC report also said the DoH had tried to address a “complex and intractable problem”, but “did not set about its task with sufficient urgency or focus”. “The Department did not deploy its own resources effectively or coherently, was too slow in making health inequalities an NHS priority, and set a performance measure that proved too blunt an instrument to target those most in need effectively,” the committee added. Labour chair of the PAC, Margaret Hodge adds, “A central challenge for all governments is to reduce health inequalities between the affluent and the disadvantaged… The problem is complex but the fact that the gap continues to widen is of great concern, especially against a background of a general improvement in public health over the last decade…The Department of Health has been exceptionally slow to tackle this problem. The Department knew in 1997, for instance, that certain low cost treatments, such as those to help smokers quit and those to prevent heart attacks, could have a major effect in deprived areas, but such treatments have still not been adopted on the scale required.” The report says that at present around 4% of the NHS budget is spent on public health and calls on the government to develop “transparency and accountability for this [money]”.

The committee's response comes as the health secretary, Andrew Lansley, is preparing a white paper on public health to be published this month. The government welcomed the report, saying it was committed to renegotiating doctors’ contracts so that disadvantaged areas could deal with their population's health needs. Anne Milton, the public health minister said, “We've already set out proposals for how areas with the poorest health will be given money to help them be healthy, and public health budgets will be ‘ring fenced’… We need a new approach to improve the health of the poorest, fastest.”

In fact ministers revealed last night that GPs will be paid more money if they move to deprived parts of the country. Ministers say the incentive payments are vital to reduce the gap in life expectancy between rich and poor, which rose under Labour.