A critical evaluation of British government policy in addressing health inequalities since 1997. Shortly after taking office in 1997 the Labour Government commissioned a study to examine inequalities in health of the UK nation. The resulting finding where published in The Acheson report (Independent Inquiry into Inequalities in Health, 1998), the report made a number of recommendations based upon evidence and set priority areas of health inequalities to be tackled. Unfortunately however, the Report failed to provide costing for these recommendations. The report placed great weight behind recommendations such as; Health Impact Assessment, if a policy would have an impact on health it should be measured and judged in regard to its effect on health inequalities, if possible it should lean towards the lowest social class wherever possible to reduce inequalities. The highest priority should be those policies aimed at young children, expectant mothers and women of childbearing age, policies which closed the gap on income inequalities and households on state benefits. Further policy areas included, education, employment, housing and environment, mobility and nutrition (Acheson, 1998). Achesons aim with his recommendations was to raise the level up for worst off, the report found health inequalities at that time where excessive and unwanted i.e. life expectancy was up but not healthy life expectancy and life expectancy was rising more for higher social classes, mortality rates were falling, premature mortality from major causes were higher in lower social classes, infant mortality was decreasing but the class divide was not, greater alcohol and drug dependence was found in lower social class men and average incomes had risen but had risen much more for top per cent of the population than for bottom per cent of the population (Lowdell et al, 1999). The DoHs green paper ‘Our Healthier Nation’ (DoH, 1998c) aimed to improve the health of the nation and focused on improving the health of the lowest social classes in society. It brought together government, public agencies and the public to form a ‘Contract for Health’, which targeted heart disease and stroke, mental health, accidents and cancer. The DoHs white paper ‘Saving Lives our Healthier Nation’ (1999a) provided a strategy to implement this, it stressed the need that health inequalities should be reduced and confirmed the targets suggested in the green paper (DoH, 1998b) but disappointingly failed to set targets for health inequalities. The DoHs ‘Action Report’ (DoH, 1999b) whilst accepting the Acheson Reports finding it also referred to policies for a fairer society by constructing healthy communities, it set about to reduce the death rates in people under 75 by at least a fifth for cancer, coronary heart disease and stroke. It aimed to reduce accidents by at least a fifth, serious injury by at least a tenth and tackling mental illness by reducing death rates from suicide by at least a fifth by 2010. To help achieve these targets and to overcome the lack of costing provided by the Acheson Report £21 billion in funding for the NHS was pledged, short term projects and initiatives like Healthy Citizens programme was introduced along with NHS Direct, Health Skills, Expert Patients, Healthy living centre and Health Action Zones (HAZs) to help break down barriers in providing services to all (DoH, 1999b). The ‘NHS Plan’ (DoH, 2000) contained a chapter ‘Improving health and reducing inequalities’ with targets announced in February 2001 which focussed on infant mortality and life expectancy. The targets aimed by 2010 to have reduced the gap in infant mortality (IM) in children under one by 10% in manual groups and the population as a whole. Also to reduce the gap by 10% of the lowest life expectancy from birth and the nation as a whole, although infant mortality fell to 5.6 from 5.8 deaths per 1000 births in 2000 and had fallen to 4.7 per 1000 by 2005-07 there was a 0.5% widening of...
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