NHS slow to tackle health inequalities
pharmafile | July 6, 2010 | News story | | NHS, NHS targets
The NHS has not moved quickly enough to tackle inequalities in life expectancy in areas with the worst health and deprivation.
That is according to a new report from the National Audit Office (NAO), which suggests Labour’s 2003 strategy on the issue was not seriously adopted until three years later.
And while Primary Care Trusts in so-called ‘spearhead’ areas – where deprivation is greatest – have £230 more per head to spend than PCTs elsewhere, some of that extra money is absorbed by higher hospital costs, the NAO found.
Life expectancy overall has increased, but the gap between the national average and spearhead areas has continued to widen and the NHS will not reduce it by 10% by this year, as intended.
In 2007 the Department of Health said it needed to increase prescribing of drugs to control blood pressure and to reduce cholesterol by 40%, while doubling the capacity of smoking cessation services.
But the NAO, whose job is to look at the cost-effectiveness and efficiency of government, says these measures have not yet been used on the scale required.
Progress in improving their take-up is also not monitored, it points out, and therefore it cannot say whether they represent value for money.
“Health inequalities were not a top priority for the NHS until 2006,” explained NAO head Amyas Morse. “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.”
Efforts should be targeted at the most deprived areas of the country, with the NHS developing costed proposals, Morse added.
The NAO report follows the one published by Professor Sir Michael Marmot in February, Fair society, healthy lives – strategic review of health inequalities post-2010.
It covers much of the same ground, although Marmot examined wider social impacts on health inequalities, such as education, employment and housing, and concluded that the NHS pays more than £5.5 billion a year because of them.
The NAO has looked at NHS strategy, rather than at specific programmes, such as the delivery of the infant mortality element of the health inequalities Public Service Agreement (PSA) target.
“This report shows that efforts have been made to address health inequalities but that more needs to be done to tackle the deep-rooted social problems that cause ill health,” said health minister Anne Milton.
“I want to see the NHS, doctors and local government acting at the right time to improve the health of those who need it most,” she concluded.
Life expectancy in spearhead ares was 75.8 years for men and 80.4 years for women in 2006-08 – but the gap between this and the general population has widened by 7% and 14% respectively, the NAO says.
Adam Hill
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