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Health inequalities: 155 organisations urge Coffey to publish white paper

Health inequalities: 155 organisations urge Coffey to publish white paper
By Jess Hacker
3 October 2022



More than 155 health and care organisations have signed a letter urging the health secretary to commit to publishing a health disparities white paper by the end of the year.

Members of the Inequalities in Health Alliance warned that the NHS and DHSC will be left in an ‘unsustainable position’ trying to treat preventable illnesses without a cross-government plan in place.

Their letter comes amid reports, first unveiled by the Guardian, that Thérèse Coffey has ‘canned’ the paper on ‘ideological’ grounds, and that it is now ‘never going to appear’.

However, the Department of Health and Social Care told the paper the information was ‘inaccurate’, adding that ‘no decisions have been taken’.

The Government had committed to releasing a white paper on health disparities as part of the Boris Johnson administration’s ‘Levelling Up’ pledge – initially due last spring.

However Dr Coffey failed to mention the paper in her new ‘Plan for Patients’, raising alarm among health and care professional organisations about her intentions for publication.

The alliance noted that the patient plan ‘rightly’ acknowledged a lot of poor health is preventable.

But, it said, ‘while a crucial part of the picture, focussing on individual behaviours and access to services alone will not be enough to close the almost 20-year gap in healthy life expectancy’ that exists between England’s most and least deprived areas.

It said: ‘To prevent ill health in the first place, action needs to be taken on issues such as poor housing, lack of educational opportunity, child poverty, the commercial determinants of health (such as the availability of tobacco and marketing of alcohol), communities and place, employment, racism and discrimination, transport and air pollution.’

Members of the alliance – convened by the Royal College of Physicians (RCP) – who signed the letter include the BMA, NHS Confederation and NHS Providers, and the Academy of Medical Royal Colleges.

These members also flagged the need for urgency in light of the ongoing cost-of-living crisis, citing a May 2022 poll led by the RCP which found that 55% of people felt their health had been negatively affected by rising costs.

Commenting on the letter, Dr Layla McCay, director of policy at the NHS Confederation,said: ‘Whilst health leaders welcomed the general direction of travel set out by the Secretary of State’s recent statement, they were very disappointed to hear no tangible mention of how the government plans to address rapidly increasing health inequalities.

‘The government must now commit to publishing the health disparities white paper promised by the previous administration by the end of year, and in doing so show they understand the direct link between a population in good health and a healthy economy.’

She added that the country is ‘currently beset by a cost-of-living crisis that means concentrated central action on public health is needed as never before’.

A major Pulse investigation revealed as many as 474 GP practices have closed in the last nine years in the UK with the greatest proportion found in deprived areas.

And research led by the Health Foundation in August indicated that people in deprived areas get ill ten years earlier than those in the least deprived communities.

New guidance from NHS England last week set out that ICBs should prioritise system spending in areas which are deprived and have the highest health inequalities.

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