- DEPARTMENT
OF HEALTH 97/282 Thursday 16th October 1997 HEALTHY HOMES FOR HEALTHY
LIVES
- Minister Pledges Action To Tackle Health Inequalities For Lone Parents And
Their Children.
Department
of Health Press Release
98/023 Wednesday 21st January 1998
- Our Healthier Nation - Publication Of The Green Paper On Public
Health. Department
of Health Press Release 98/050 Thursday 5th February 1998
- Nhs To Have Legal Duty Of Ensuring Quality For First Time - Milburn.
Department
of Health Press release 98/141 Monday 13th April 1998
- Further Drive Towards National Standards Of High-Quality Healthcare -
Frank Dobson Tackles "Unacceptable Variation" In Nhs Care And
Treatment. Department
of Health Press Release 98/144 Thursday 16th April 1998
- Poor Men Die Youngest - Minister Launches Booklet To Help Men To Help
Themselves. Department
of Health Press Release 98/175 Monday 11th May 1998
- Colin Guthrie (Letters, December 30) puts his finger on the key challenge for health policy. Research over the last two decades has shown that the bulk of the higher rates of sickness, accidents and deaths experienced by the poor is caused by obscene wealth gaps and the adverse psycho-social conditions that go with them. Japan, with relatively low gaps between rich and poor, has strikingly high life expectancy. Guardian letters, 10 January 2001.
- Alan Milburn, the health secretary, will today signal a historic shift in NHS policy when he announces a 10-year plan to reduce infant mortality and premature adult deaths in the poorest parts of England.
In a speech that is meant to unveil the "big idea" for Labour's general election manifesto on health, he will announce the first government targets to reduce the most flagrant examples of health inequalities that are blighting the lives of the poor.
Unlike previous targets for reducing NHS waiting lists and increasing the input of re sources flowing into the service, the new targets will focus on health outcomes. Guardian 28 February 2001.
- Labour's former health secretary berates the government's promotion of
'foundation' hospitals. Frank Dobson Guardian
Tuesday June 4, 2002
- After the jubilation must come the reckoning. There is far more
inequality in Britain today than there was in 1977. Polly Toynbee Guardian
Wednesday June 5, 2002
- Foundation hospitals will get the lions share of money and staff leaving
NHS hospitals to languish, writes Geoff Martin. Society
Thursday June 6, 2002
- Improving the health of the nation and reducing health inequalities is
one of the government's key health policy priorities - but one that is
proving stubbornly elusive to make quick progress on. Guardian
Monday June 24, 2002
- Public health: the issue explained. Patrick Butler Guardian
Monday June 24, 2002
- Caution urged over foundation hospitals plan. Guardian
Friday June 28, 2002
- Africa has been let down by rich nations. Leader
Saturday June 29, 2002 The Guardian
- PM rejects alarm at 'two-tier' NHS plan. Cabinet adviser cautions
against haste on decentralising hospitals. John Carvel, social
affairs editor Saturday
June 29, 2002 The Guardian
- Main points from the cross-cutting reviews. Society
Monday July 15, 2002
- Comment: Cross cutting review: health inequalities. New hope
flowers in public health. The chancellor's cross cutting review
signals that the government has twigged that channelling more money into
public health programmes will result in massive NHS savings in the
long-term. It's about time, writes Geof Rayner. Society
Wednesday July 17, 2002
- As the incidence of Aids increases in sub-Saharan Africa, the Home
Office approach to HIV-positive asylum seekers is becoming harsher.
Liz McGregor Guardian
Wednesday July 31, 2002
- Dobson lays into hospital changes. Michael White, political editor
Guardian
Thursday August 8, 2002
- The prime minister, Tony Blair, is to take personal charge of a
government-wide commitment to tackling widening health inequalities in a
move aimed at reducing the deep-rooted health gap between rich and poor.
Patrick Butler
Wednesday November 20, 2002
- Old age and poverty sadly go hand in hand in many industrial cities and
towns. But they are not the only areas where living on benefits is a harsh
fact of life for older people. Mike George reports.
Wednesday May 21, 2003 The Guardian
- Government moves to increase patient choice are driving down waiting
lists but could jeopardise equal access to healthcare, a prominent health
thinktank has warned. Tash Shifrin
Thursday June 5, 2003
- Pushy, assertive patients who come to the surgery armed with lists of
questions are taking more than their fair share of time with the doctor - at
the expense of the less articulate. Jo Revill, health editor
Sunday June 15, 2003 The Observer
- The days when doctor knew best are long gone. Now the most effective way
to get the healthcare you want is to be assertive. Luisa Dillner explains.
Tuesday June 17, 2003 The Guardian
- 'Pushy patients' have been accused of taking up unnecessarily lengthy
appointment time with GPs at the expense of less assertive patients (News,
last week). Letters
Sunday June 22, 2003 The Observer
- The middle classes have more choice in an NHS that has failed poorer
groups in society, the new health secretary, John Reid, admitted yesterday.
Patrick Butler
Friday June 27, 2003 The Guardian
- The new health secretary, John Reid, today underlined his commitment to
ensure that the NHS does more for poorer families with a new three-year plan
to tackle widening health inequalities. Matt Weaver
Wednesday July 2, 2003
- The government's anti-poverty drive could grind to a halt unless a
radical change is undertaken, a Cabinet Office paper has conceded. Patrick
Wintour, chief political correspondent
Thursday July 3, 2003 The Guardian
- The poor are being punished by creeping erosion of free treatment under the
NHS, the National Consumer Council (NCC) warns today after investigating
increases in what people have to pay for prescriptions, eye tests and dental
treatment. John Carvel
Wednesday July 9, 2003 The Guardian
- Local authorities and the NHS will be set targets to reduce health
inequalities across England, the public health minister, Melanie Johnson has
announced. David Batty
Friday October 31, 2003
- Middle-class people benefit more from the NHS than the poor, according to a
report today from senior government advisers that overturns the long-standing
boast of ministers that the health service's greatest virtue was fairness to
all-comers. John Carvel, social affairs editor
Friday November 7, 2003 The Guardian
- It's not just the poor that are hit by the cold. Many middle-class OAPs
suffer because they live in a single room and can afford little fuel, says Neasa
MacErlean.
Sunday November 9, 2003 The Observer
- Agitators will inherit the earth. Every time the 'right to choose' is
extended, the poor get second-best. Roy Hattersley
Monday
November 17, 2003 The Guardian
- It's Labour's rebels who block choice. The critics are wrong - foundation
hospitals trust patients to decide. John Reid
Wednesday November 19, 2003 The Guardian
- New medical chief to tackle inequalities. Tash Shifrin
Friday November 21, 2003
- Failed asylum seekers lose free NHS care. Gaby Hinsliff, chief political
correspondent
Sunday December 21, 2003 The Observer
- Forcing foreigners to pay upfront for NHS treatment is immoral and likely to
increase racism, the health secretary, John Reid, was warned yesterday as he
revealed his plans to tackle "health tourism". Sarah Hall, political
correspondent
Monday December 29, 2003 The Guardian
- Doctors' leaders warned last night that the profession would not act as an
agent of the state to deny free treatment to foreign patients caught by rules
against "health tourism" to be announced by the government today. John Carvel,
social affairs editor
Tuesday December 30, 2003 The Guardian
- Patients who have foreign accents may be asked to show passports, visas,
travel documents, payslips, bank records and council tax paybooks before getting
free treatment on the NHS, under a government crackdown on "health tourists".
John Carvel, social affairs editor
Wednesday December 31, 2003 The Guardian
- The government failed yesterday to justify its claim that health tourism
costs British taxpayers "hundreds of millions of pounds a year" when it emerged
that its evidence was an exaggeration of an unpublished submission from a debt
collection agency in Gwynedd. John Carvel
Wednesday December 31, 2003 The Guardian
- Knowing when foreigners ought to be charged for NHS treatment is only part
of the problem: recovering the money is often more of a headache. John Carvel
Wednesday December 31, 2003 The Guardian
- In place of fear. Leader
Wednesday December 31, 2003 The Guardian
- Closing the door on health tourists. Letters
Thursday January 1, 2004 The Guardian
- About 800,000 parents in poorer families will get free fruit and
vegetables through a voucher system announced yesterday by John Reid, the
health secretary. John Carvel
Tuesday February 17, 2004 The Guardian
-
Vivienne Parry finds that even classic medical research can be based on a one
size fits all attitude.
Thursday March 11, 2004 The Guardian
- The leader of Britain's doctors warned yesterday that the government is
creating a two-tier NHS where getting high-quality treatment will depend more on
luck than clinical need. James Johnson, who chairs the British Medical
Association, said ministers were in danger of destroying the character of the
health service in their zeal for promoting patient choice and hitting political
targets. John Carvel, social affairs editor
Monday
April 19, 2004 The Guardian
- The government is to risk a clash with the medical profession by announcing
a crackdown on failed asylum seekers and other non-EU nationals receiving free
NHS treatment from GPs. The health minister John Hutton will publish proposals
this month to make patients signing on with a family doctor sign a declaration
that they are UK residents entitled to free care. John Carvel, social affairs
editor
Monday May 3, 2004 The Guardian
- GPs will be required to find out if new patients have the right to live in
the UK and, if not, they may charge for treatment under plans to crack down on
health tourism. The government proposals are in response to a perception among
some doctors and the public that the NHS is under pressure from foreigners
visiting Britain to get free medical care. This concern is intertwined with
suspicion of asylum seekers, many of whom are in need of some sort of treatment
when they arrive. Sarah Boseley, health editor
Saturday May 15, 2004 The Guardian
- Britain's midwives are lining up to oppose plans to make them 'shop' asylum
seekers or women from other EU countries who claim a free childbirth on the
NHSJo Revill, health editor
Sunday May 16, 2004 The Observer
- Inequality is fattening. People will get thinner only when they have things
that are worth staying thin for - self-esteem, social status and jobs. Polly
Toynbee
Friday May 28, 2004 The Guardian
- Doctors have launched a campaign demanding "the best the NHS can offer" for
asylum seekers and refugees and branding checks on patients' asylum status
"unethical and inefficient". The Medical Practitioners' Union (MPU), part of the
'super-union' Amicus, has started a petition against government rules
withholding NHS hospital care from asylum seekers whose claims have failed.
Ministers are currently consulting on plans that will also exclude failed asylum
seekers from receiving NHS GP services. Tash Shifrin
Monday June 7, 2004
- High rates of cancer and heart disease among the working classes will be
tackled under government plans to narrow the 'health gap' between the rich and
the poor. While deaths from the two major killers have been falling, the trend
has been driven largely by rapidly improving health among middle class patients,
who are less likely to smoke, have a better diet and consult their doctors more
readily. Health Secretary John Reid is concerned that the NHS too often fails to
understand the reasons why poorer people take risks with their health and wants
spending to be better targeted. Gaby Hinsliff, chief political correspondent
Sunday June 27, 2004 The Observer
- Independent NHS inspectors accused the government last night of
shortchanging patients in some of the poorest parts of England by denying their
local hospitals and GPs a fair share of resources. The Healthcare Commission
disclosed that NHS trusts in areas with the greatest medical problems were
losing up to 20% of the money they were due under the official formula for
assessing local health needs, agreed in December 2002. They are being starved of
cash because ministers feared the consequences of reallocating resources from
well-heeled areas that were found to be overfunded. John Carvel, social affairs
editor
Thursday July 8, 2004 The Guardian
- NHS managers today called for a special investment fund for health
improvement in the wake of a watchdog's report showing that poorer areas with
worse health were being starved of cash. The NHS Confederation argues that
ringfencing money for long-term public health improvements will prevent it being
sucked into day to day priorities such as waiting list surgery and medical
services. Tash Shifrin
Thursday July 8, 2004
- Healthcare professionals should help patients build up the knowledge and
skills to take a more active role in looking after their health, according to
consumer campaigners. The National Consumer Council (NCC) said today that the
only way to close the gap in healthcare inequalities between rich and poor was
to improve people's confidence to manage their own health.
Wednesday August 4, 2004
- Doctors are rebelling over plans that would lead to thousands of refugees
being refused life-saving treatment for HIV on the National Health Service. The
Observer has learnt that specialists on a key health committee have refused to
help draw up rules that would determine whether asylum seekers or other
immigrants with the virus get antiretroviral drugs. One said: 'It is morally
repugnant for us to have to look at someone's immigration status before giving
them the treatment they need. Let's be clear about this: if they don't get the
treatment, it's a death sentence.' Jo Revill, health editor
Sunday
August 8, 2004 The Observer
- The government was accused yesterday of failing to tackle the HIV/Aids
crisis in its own back yard while focusing on trying to help the international
battle against the disease. The National Aids Trust said sexual health had
dropped off the list of national priorities with anti-HIV funds no longer
ring-fenced. This has meant a drop in education and prevention programmes and
long waiting times for tests. People at high risk of infection, including
prostitutes and injecting drug users, were treated as criminals while the NHS's
attitude towards failed asylum seekers needed reviewing. James Meikle, health
correspondent
Monday
August 9, 2004 The Guardian
- Social exclusion: the facts. The National Consumer Council has put together
a dossier highlighting the "double disadvantages" faced by Britain's poorer
people in the hope of bringing about change. But just how much are poorer people
being financially penalised?
Wednesday
September 15, 2004
- A widening of the life expectancy gap between the prosperous south and the
conurbations of north Britain was disclosed yesterday by the Office for National
Statistics. John Carvel, social affairs editor
Saturday
October 16, 2004 The Guardian
- Private healthcare will benefit poor, says Reid. Patrick Wintour, chief
political correspondent
Wednesday January 19, 2005 The Guardian
- People in the cities of northern England are almost twice as likely to die
of cancer as those in affluent areas of the south, the Commons public accounts
committee says in a report issued today. Their cancer is likely to be more
advanced by the time it is diagnosed and they are less likely to survive, it
says after investigating the disease which accounts for a quarter of all deaths.
John Carvel, social affairs editor
Tuesday
January 25, 2005 The Guardian
- People in the most prosperous neighbourhoods of England enjoy 17 more years
of fit and active life than those in the poorest, the Office for National
Statistics said yesterday. The most thorough analysis of health inequalities yet
undertaken found the connection between income and wellbeing is much stronger
than previously thought. John Carvel
Friday February 25, 2005 The Guardian
- The NHS must do more to address heart disease in the poorest communities,
where high levels of smoking and obesity mean people are at the greatest risk of
dying from it, the Healthcare Commission says today. Sarah Boseley, health
editor
Monday March 7, 2005 The Guardian
- An international charity well known for providing aid to impoverished groups
in developing countries has now set its sights on helping deprived Londoners, it
emerged today. Hélène Mulholland and agencies
Monday May 23, 2005
- Médecins du Monde, an organisation usually associated with medical care for
the poor and sick of developing countries, is planning to set up three clinics
in London to treat people the NHS does not reach. The organisation says it has
three target groups of vulnerable people whose needs are not being met:
vulnerable migrants, homeless people and street sex workers. Anybody who has
their application to stay in the UK turned down is no longer eligible for NHS
care, even if they remain here for some time before returning home. Sarah
Boseley
Tuesday May 24, 2005 The Guardian
- Thousands of deaths from cancer might be prevented each year by reducing the
north-south divide in terms of poverty, smoking and drinking, experts said
yesterday. Incidence and death rates for cancers of the lung, voice-box, lip,
mouth and throat are all higher than average in the former industrial areas of
northern England and central Scotland, according to a cancer atlas published by
the Office of National Statistics (ONS). James Meikle, health correspondent
Wednesday
July 6, 2005 The Guardian
-
Two million people are unable to register for NHS dental care because of a
national shortage of 1,850 dentists, MPs revealed today in a report criticising
the slow pace of change on dental reforms. There are "dismaying" variations in
dental health across England with a clear north-south divide, according to a
report published today by the House of Commons public accounts committee. Debbie
Andalo and agencies
Thursday July 14, 2005
- Inequality kills. What counts is not wealth or poverty, says Polly Toynbee
after reading Richard G Wilkinson's The Impact of Inequality, but your place on
the social ladder.
Saturday
July 30, 2005 The Guardian
- People in the poorest communities with the biggest social needs are getting
a raw deal from the welfare state, said a report yesterday from the Joseph
Rowntree Foundation. It found that areas with relatively poor standards of
health have fewer doctors per head of population. John Carvel, social affairs
editor
Friday September 2, 2005 The Guardian
- Your article about Ryzard (No
direction home, October 19) draws attention to the fact that migrant workers
cannot claim benefits and may be refused NHS treatment. Is a nurse from overseas
(quite a proportion of the total) to be denied treatment in the hospital they
work in? What happens if someone is working in a hospital for mentally ill
people and joins the 40,000 attacked each year? Will they be treated on the NHS
or will they have to go private and sue their attacker (presumably without legal
aid) for the cost? The government is quite prepared to have large parts of our
economy operated by foreign labour but is not willing to pay them the benefits
us natives get. Phil McShane Nuffield department of surgery, John Radcliffe
hospital, Oxford
Wednesday October 26, 2005 The Guardian
-
As the December deadline looms, the delivery of the government's flagship
patient choice policy is in doubt. The e-booking computer system won't be up and
running for a year, many GPs are disengaged from the choice initiative, and
hospitals are feeling the financial strain of money following the patient.
Technology can be fixed, professionals can be won over, and finances plugged,
but the biggest risk of patient choice may be its impact on the under-reported
problem of healthcare inequalities. Patient choice risks widening health
inequalities, says Joe Farrington-Douglas.
Wednesday November 16, 2005 The Guardian
-
The first evidence that financial problems in the NHS are forcing trusts to
ration operations came yesterday with an announcement that overweight people in
East Anglia will be denied replacement joints, even if they are in serious pain.
East Suffolk primary care trusts said patients will no longer be considered for
hip and knee replacements at Ipswich hospital if they have a body mass index of
more than 30, the clinical definition of obesity. John Carvel, social affairs
editor Wednesday November 23, 2005 The Guardian
- The decision by some NHS trusts to deny hip and knee replacement surgery to
obese patients has been criticised by doctors.
Last
month it emerged that obese people would not be entitled to such surgery on the
NHS in East Suffolk. The ruling came as part of a series of measures to be
taken by the three primary care trusts in the area in an attempt to save money
locally for the NHS. It is believed that the risks of operating on obese
patients are higher and the treatment may be less effective, with replacement
joints wearing out sooner. But Nicholas Finer, a consultant in obesity medicine
at Addenbrooke's Hospital in Cambridge, challenged claims that surgery could be
withheld on the grounds of increased risks for obese people, saying no evidence
supports withholding joint replacement from obese people.
Friday December 16, 2005 6:58 AM
- Those who want to shrink the state forget who pays the bills. Conservatives
must do more than back social enterprise to dispel their reputation as blinkered
tax-cutters. Polly Toynbee
Friday
January 13, 2006 The Guardian
- Five years after the government launched its reforming 10-year cancer plan,
surviving the disease still depends on where you live, a parliamentary select
committee said yesterday. Those in London and the south have a better chance of
beating the disease and better access to drugs, said the public accounts
committee. The National Institute for Clinical Excellence (Nice) was set up to
end "postcode prescribing", but the breast cancer drug Herceptin, for instance,
was given to 90% of women in some areas in 2003 and to just 10% in others. Sarah
Boseley
Thursday January 26, 2006 The Guardian
- NHS prescription
charges work against aims of new white paper. The Commons health select
committee has been told that the prescription charging system makes it more
difficult to reduce health inequalities for people in underserved deprived
areas.
Summary by Keep our NHS Public
of
British Medical Journal 10 February 2006
- We must choose equality. The government's drive to give more choice in
public services risks excluding minority ethnic communities, warns Nick Johnson.
Wednesday March 1, 2006
- Importance of
relative measures in policy on health inequalities. Government figures
showing a reduction in health inequalities for diseases such as cancer and heart
disease are misleading, according to a study by health economist Allan Low and
Director of public health, Anne Low. The government sometimes uses relative gaps
between groups, and at other times absolute gaps. The authors say: "Lack of
transparency in this regard has led to the inconsistent use of relative and
absolute gaps in government targets going unquestioned. It has also resulted in
confusion over how to establish local health improvement targets that are
consistent with national policy on reducing health inequalities."
Summary by Keep our NHS Public
of
British Medical Journal 21 April 2006
- Long
live the NHS. A coalition of groups have sent a joint letter to the Times
defending a tax funded healthcare system against attacks from groups like
Reform. The letter is signed by the British Medical Association, the Chartered
Society of Physiotherapy, Diabetes UK, the Family Planning Association,
Macmillan Cancer Support, the New Health Network, the NHS Confederation, the
Royal College of Midwives, the Royal College of Nursing, Unison, the Sainsbury's
Centre for Mental Health, and Turning Point. It says: "In the week of the 60th
anniversary of the second reading of the NHS Bill, we would like to take the
opportunity to state our belief that the United Kingdom is fortunate to have one
of the fairest health systems in the world where no one need fear becoming
bankrupt because of their need to fund their healthcare. It has dedicated staff
who are driven by a passion for patient care and has been transforming itself
into a 21st-century healthcare system of which we can all be proud. The
continued commitment of
funding through tax ensures
equity
for patients but also makes economic sense because it is the cheapest way of
collecting money. If a system is unaffordable through tax it is not affordable
through any other funding system.
International experience
shows there is no necessary link between how systems perform and how they are
funded. Any move to a health insurance system to charge patients for their care
would increase bureaucracy and would leave those who need the most care with the
greatest financial burden. We are not complacent. The NHS will need to respond
to the tide of rising expectations and need by improving efficiency and
responsiveness. With the dedication and commitment of staff we believe that the
NHS can continue its transformation and be a model for other countries."
Summary by
Keep our NHS Public
of Times 27 April 2006
- Hewitt ignored St
Helier warnings. Patricia Hewitt ignored public health advice on health
inequalities to site the
new south
London critical care hospital at St Helier rather than Sutton. Hewitt
overturned the decision of the local NHS, saying that the hospital siting should
"give priority to the needs of those communities that suffer the worst
social and economic disadvantage". But when she said
this she already had a report prepared at her request, which advised her to
accept the judgement of the local NHS and concluded that "there is no essential
difference between the two sites in terms of their impact on health
inequalities". Conservative MP for Epsom, Chris Grayling, accused the government
of "blatant political gerrymandering", as the hospital was sited in a Labour
area.
Summary by
Keep our NHS Public
of Health Service Journal 11 May 2006
- The price of
everything. David Janner-Klausner argues that introducing a
market into local
health provision can in theory increase user 'choice'.
But in practice the most likely result is that a few giant firms will end up
running all the services in ever-larger areas. He writes: "There is a risk that
the mechanisms introduced to increase choice will harm the
very communities that
Le Grand
argues would benefit most from it. The point is not only to provide choice, but
also to understand the nature of it, including who the operators are, whom they
employ and whether the competition between them will be real…The reality will be
the emergence of a small number of suppliers, awarded ever-larger contracts. A
similar consolidation has taken place in the bus market following
deregulation…For smaller companies, training, innovation and participating in
bidding processes costs proportionately more than for larger ones. If they need
to invest to fulfil a contract, they are likely to be considered a risky
prospect by lenders because their income streams are not as diverse as those of
larger providers. If they are
charities,
their ability to assume risk is even more limited…if commissioners try to
include knowledge-sharing clauses in contracts, they are likely to find that
contractors put a price on sharing their intellectual property with competitors,
if they are willing to do so at all. This will make market-based provision more
expensive and will slow down innovation when the goal is to speed it up…Since
the government is committed to developing local markets, the likely outcome is
that larger companies will have the edge. Furthermore, commissioners will be
tempted to get together and offer larger contracts, as this can cut costs.
Smaller companies will lose out and agglomeration is almost inevitable. The
impact on costs and quality of outcomes is unclear to say the least.
Summary by
Keep our NHS Public
of
Public Finance 12 May 2006
- Patient Choice
'favours the educated'. The government is pressing ahead with an extension
to its Patient Choice initiative,
despite new evidence from the Department of Health that shows well-educated
patients benefit most from the reforms. Since January 1, patients have been able
to choose where they receive their hospital treatment from a list of at least
four providers. But from this week patients can also choose to be treated at the
32 existing foundation trusts. But research commissioned by the DoH from
consultancy Rand Europe, the King's Fund think-tank and City University, London,
revealed that Patient Choice risks widening health
inequalities. The study surveyed 1,000 people in England who had been
referred to hospital over the past five years. It found patients with formal
educational qualifications were more likely to choose a hospital with higher
clinical standards. Those without qualifications placed less importance on
above-average clinical quality.
Summary by
Keep our NHS Public
of
Public Finance 2 June 2006
- To those that
have shall be given. New research into GP referral rates in primary care
trusts in England yields startling results: referrals seem to decline steadily
as deprivation and need increase. The analysis has
been conducted by data analysts Dr Foster Intelligence. The Airedale PCT in
West Yorkshire, for instance, had one of the lowest rates, with referrals
42% below the norm. At the other end of the scale, Barnet's practices in
suburban north
London had a referral rate 52% above average. All three Bradford trusts,
next to Airedale, had referral rates 30%-35% below average, as did Blackburn
with Darwen PCT in
Lancashire. By contrast, Richmond and Twickenham in south London,
Huntingdonshire in
Cambridgeshire, North East
Oxfordshire and South West Oxfordshire referred at more than double those
rates. Summary by
Keep our NHS Public of
Guardian
14 June 2006
-
Watchdog delivers wake-up call over PBC shortcomings. The Audit Commission
has sent the Government a wake-up call over its plans for
practice-based
commissioning, highlighting inadequate incentives, poor value for money and
conflicts of interest. It said the Government's flagship scheme risks "exacerbating
financial pressures", "widening inequalities" and
wasting money. The criticisms are drawn from an investigation of four PCTs
selected for being "relatively successful" implementers of the scheme.
Summary by
Keep our NHS Public
of Pulse 16 June 2006
- We are making our children ill with unrealisable expectations. Young people
are paying the price for an economy driven by dissatisfaction, in which social
mobility is in sharp decline. George Monbiot
Tuesday
June 27, 2006 The Guardian
- Smokers who need heart
bypasses and alcoholics who need liver transplants
should not get
them free on the NHS, according to four out of 10 hospital doctors. A
quarter of those questioned in a survey also believe obese patients should not
be given free anti-obesity drugs or receive free orthopaedic treatments.
Sarah Hall, health correspondent
Thursday
June 29, 2006 The Guardian [Unequal treatment
positively correlated with poverty]
- Cancer patients and
women about to give birth who have been denied asylum in the UK are being
refused care
by NHS hospitals unless they can pay thousands of pounds for their treatment, it
is revealed today. Asylum seekers are vulnerable and
usually destitute, says a report from the Refugee Council, which says the
failure to treat people who are at risk of dying is a breach of the human rights
enshrined in the NHS core principles. Sarah Boseley, health editor
Thursday June 29, 2006 The Guardian
- Some of the poorest areas of
London with the worst health problems are to bear the brunt of a fresh round
of spending cuts
imposed by the new NHS chief executive, David Nicholson, to try to drag the
service out of the red. Health budgets for east London are being slashed in a
further wave of savings designed to meet a persisting £70m shortfall in NHS
funding in the capital. Tower Hamlets is to lose £2.4m, Newham £2.5m, and City
and Hackney £4.4m. Further east, Barking and Dagenham must hand back as much as
£6.7m. In another controversial part of the cuts package, all London NHS trusts
that provide services and which balanced their books last year must forfeit any
surplus they carried forward. Half of the 16 trusts affected are
mental health providers, which together must surrender £14.4m, cash they
saved and were reinvesting. David Brindle
Monday
August 7, 2006 The Guardian
- Report calls for
'radical action' to plug Manchester health gap. 'Concerted radical action'
is required to plug the growing health inequalities
gap across
Greater Manchester, according to a report from the Audit Commission. The
review found there is 'no clear leadership for the health inequalities agenda'
in the region. It criticises 'constant' local and national reconfiguration for
preventing progress in reducing the health inequalities gap and says
reconfiguration in the NHS 'is damaging the potential for more successful joint
developments'. The report concludes that leadership of the health inequalities
agenda in Greater Manchester is often via the director of public health and says
that changes to acute services are driven by new builds and clinical services
without any 'explicit' expectation that change will lead to improved health.
Faculty of Public Health president Professor Rod Griffiths said he was not
surprised by the findings: 'A lot of this is to do with the government's manic
desire to keep reorganising the health service it does not say much for the
government's vision that health inequalities in Greater Manchester are still so
bad.'
Summary by
Keep our NHS Public
of Health
Service Journal
7 September 2006
- Tony Blair today urged people to take more responsibility for their fitness
and diet, as a new study revealed a continuing north-south divide in the
nation's health. But the prime minister accepted that economic deprivation was a
key factor in poor public health. Asked about health inequalities on BBC
Breakfast, Mr Blair said: "I have to say it is to do with poverty. It's to do
with diet, it's to do with exercise. It starts at school and it starts with what
parents feed their children." Matt Weaver and agencies
Tuesday
October 10, 2006 Guardian Unlimited
-
Blair plans new social contract.
A new contract between the state and the citizen setting out what individuals
must do in return for quality services from hospitals, schools and the police is
one of the key proposals emerging from a Downing Street initiated policy review.
Examples include an expectation that a local health authority will only offer a
hip replacement if the patient undertakes to keep their weight down. The review
is likely to examine fundamentally the future relationship between citizen and
state. The public service commission has been asked to consider "whether it is
possible to move from an implicit one-way contract based on outputs, to one
based on explicit mutually agreed outcomes". It asks "should we be aiming for a
more explicit statement of the contract that covers both the service offered by
the public sector (what is in and what is not) and what is expected from
citizens (beyond paying taxes and obeying the law)". Summary by
Keep our NHS Public
of Guardian
24 November 2006
-
Private health
check-ups in executive scheme. A private company is performing thousands of
patient check-ups as part of a flagship scheme. Nurses employed by management
consultants Refer2Us are being brought in to screen people at risk of illnesses
such as heart disease in some of
Scotland's most
deprived communities. The first phase of the work in Lanarkshire is being funded
by drugs company AstraZeneca to the tune of £100,000. The situation has emerged
at a time when doctors and campaigners are calling for a moratorium on
private sector involvement
in the Scottish NHS to allow a public debate about the issue. Concern has been
expressed about contracting out work which is part of such a high-profile
Scottish Executive initiative to tackle the nation's
entrenched health inequalities. Four different health boards are piloting
the Keep Well project, which was announced by Health Minister Andy Kerr last
year. It targets people in poorer areas who are more likely to become ill but
less likely to seek healthcare. NHS Lothian, NHS Tayside and NHS Greater Glasgow
and Clyde said they had no plans to farm out the work to private firms. However,
NHS Lanarkshire, which has made the deal with Refer2Us and AstraZeneca, said
that it had turned to the private sector because of the high number of patients
needed to be seen. Senior doctors have questioned how patients will be handed
from the Refer2Us nurses to the NHS for follow-up treatment and advice, and how
this will affect the chance to build longer term relationships with
hard-to-reach patients. Professor Allyson Pollock, of the centre for
international public health policy at Edinburgh University, said: "The whole
point about Keep Well is for it to work it should be integrated into community
health services and this is an example of disintegration and fragmentation. The
health minister has repeatedly said they are doing things differently in
Scotland because they are integrating healthcare, but this is an example where
it is not happening." She added that in the United States it was a known tactic
of the pharmaceutical industry to become directly involved in the disease
management of patients. "We know the pharmaceutical purpose is to open and
expand markets," she added. A spokesman for NHS Lanarkshire said: "This
involvement is at no cost to the NHS and, without this contribution, it would
not have been possible to provide the benefits of Keep Well to patients as early
in the project… It is not an alternative to NHS Lanarkshire providing these
services. Summary by
Keep our NHS Public
of Herald 20 December 2006
- Poor babies 'up
to seven times' more likely to die. Babies born in poor parts of England or
to parents from ethnic minorities are up to seven times as likely to die before
the age of one as those born in the richest areas, a government review has
found. The Department of Health's Review of health inequalities: infant
mortality, published on February 7, found that the gap between the infant
mortality rate for the general population and that for the poorest social
classes has widened by six percentile points since 1999 to 19%. The infant
mortality rate in the general population was 4.9 deaths per 1,000 live births in
2004, but for infants born to parents in low-paid, manual and routine jobs, it
was 5.9 per 1,000 live births. This makes it unlikely that the government will
achieve its Public Service Agreement to reduce inequalities between the two
groups by 10% by 2010. Between 2002 and 2004, 9,132 infants under the age of one
died, and the review confirmed that a disproportionate number of these - 40% -
were born to low-income families. The review was commissioned by ministers
concerned with a lack of progress on the PSA target.
Summary by
Keep our NHS Public of Public
Finance 16 February 2007
- Doubts over bid
to charge foreigners for NHS care. A fresh drive to charge foreign
nationals, including illegal immigrants, for National Health Service care has
been announced by John Reid, the home secretary - but well ahead of the health
department being able to say how that will work in practice. Mr Reid announced
pilot schemes to be run in three unidentified trusts in which hospitals and GPs
will be able to check patients' eligibility for free treatment against data held
by the Border and Immigration Agency. From 2008, all foreign nationals will have
to have identity cards with records held on a national database. The Department
of Health rejected fears that the pilots would result in NHS medical records and
information being made available to law-enforcement officers. A spokesman said
"categorically" that the information flow would be one way - the immigration
agency providing data to the NHS. "We will not be breaching [medical]
confidentiality in any way, or handing over records or identity information to
the Border and Immigration Agency." In the past, the British Medical Association
has said it would be "totally unjustifiable" to try to charge impecunious failed
asylum-seekers who have no money. The Home Office appears to regard the pilot
schemes as a potentially important building block in the development of the
government's ID-card system. But Connecting for Health, the NHS information
technology programme, has consistently rejected the idea of using such cards to
establish entitlement to treatment.
Summary by
Keep our NHS Public of Financial
Times 8 March 2007
- Blow for Brown as poverty figures increase after years of decline.
Poverty has increased for the first time in almost a decade and the number of
children living in poor families has risen for the first time in six years, the
government admitted yesterday. Opposition politicians and poverty campaigners
said a core government policy was failing and warned that its 2010 target could
be missed by a million children, in spite of measures announced by Gordon Brown
in last week's budget. Official figures showed relative poverty - those living
on less than 60% of average incomes - rose to 12.7 million people in 2005-06,
from 12.1 million the year before.It brings to an end the longest period of
falling poverty since records began in 1961. The number of children living in
poor families rose by 200,000 to 3.8 million. A single person is now considered
poor if he or she earns less than £145 a week, while a couple with two children
is poor if their income is less than £332 a week. Ashley Seager
Wednesday March 28, 2007 The Guardian
- Ministers deliberately making asylum seekers destitute, say MPs.
Ministers are deliberately making vulnerable asylum seekers
destitute, a committee of MPs and peers claimed today.
They accused the government of inflicting unacceptable and inhumane treatment,
and described the asylum system as a "confusing mess". A deliberate policy of
refusing benefits to some asylum seekers combined with a ban on legal working
left many would-be refugees in "appalling" circumstances, a report by the Joint
Committee on Human Rights (JCHR) said. It highlighted one case of a destitute
Rwandan asylum seeker who suffered bowel cancer and had a colostomy bag but was
refused treatment
by a hospital and could not even register with a GP. In another, a woman was
forced to live rough for three months - sitting at crowded bus stops all night
because she was terrified of being alone - but on winning her asylum appeal was
ruled entitled to immediate support. It also reported how parents of a
three-week-old baby were housed in a "filthy, bug-infested room" in Leicester,
and how a penniless Chinese asylum seeker arrived "exhausted and distressed" at
an agency after carrying her newborn baby around in a towel for a week. Andrew
Dismore, chairman of the JCHR, said: "The system of asylum seeker support is a
confusing mess, and the policy of enforced destitution must cease. Press
Association
Friday March 30, 2007 Guardian Unlimited
- Rise in poverty worse than stated. The increase in people living in
poverty is worse than official figures claimed, it emerged yesterday, after the
Department of Work and Pensions found its statistics had underestimated the rise
by 100,000. Last month's figures showed the first rise in poverty in almost a
decade, ending the longest period of falling poverty since records began in
1961, and leading the Opposition and campaigners to warn that the government was
failing to tackle the issue it made a priority. Tania Branigan, political
correspondent
Tuesday April 24, 2007 The Guardian
- Inequality at same level as under Thatcher. Labour's decade in power
has failed to reverse the surge in inequality under Margaret Thatcher and Gordon
Brown's policies to support the less well-off are failing to prevent the gap
between rich and poor widening again, official figures showed yesterday. Larry
Elliott, economics editor
Friday May 18, 2007 The Guardian
- Finally ministers are off the leash and free to say the rich are too
bloody rich. Brown has now accepted what Blair would not: the growing gap
between rich and poor is splitting and damaging our society. Polly Toynbee
Friday May 18, 2007 The Guardian
- Single equality act under threat, warn campaigners. The government is
at risk of missing a once-in-a-lifetime opportunity to tackle discrimination as
internal disputes delay a single equality act, campaigners are warning. Labour
MPs have warned that radical action is needed to close the pay gap faced by
women and members of ethnic minorities, while the charity Age Concern yesterday
cautioned that the government would inevitably lose its battle against social
exclusion unless it outlawed ageism. But a long-awaited green paper, due for
publication this month following a two-year review of the law, has been
postponed again due to disagreements over its contents - which campaigners argue
are already too weak. The document is the first step towards a single equality
act, which is now unlikely to clear parliament before its fourth session begins
in November 2008. Angela Eagle, former race relations minister and MP for
Wallasey, warned: "This is one of those once in a lifetime chances to make
progress in a very important area which has been underdeveloped in the last few
years. Tania Branigan and John Carvel
Friday May
18, 2007 SocietyGuardian.co.uk
- Survey reveals stark contrasts in England's health. There is a clear
divide in the health of England's population with southerners living longer and
enjoying far healthier lifestyles than northerners, according to a government
survey. The Department of Health study, which was
published last night,
reveals that people living in councils in the north west have the worst health
profiles in England. Residents are more likely to die from smoking-related
illnesses, heart disease, strokes and cancer than anywhere else in the country.
Manchester has the lowest life expectancy for men at 72.5 years, well below
England's average of 76.9.
Liverpool has the lowest life expectancy for women at 78.1 years (average,
81.1 years). Liverpool also has the highest rate of hospital admissions for
alcohol-related problems at 652 per 100,000 (average, 248 per 100,000). Knowsley
has the highest rate of deaths from smoking at 366 deaths per 100,000 (average,
234 per 100,000). Manchester also had the highest levels of early death from
heart diseases and strokes at 151 per 100,000 (average, 900 per 100,000). David
Batty and agencies
Friday
June 22, 2007 Guardian Unlimited
- Lack of data hampers PCTs' efforts to ensure race equality in local
health services, says King’s Fund report. The ability of Primary Care Trusts
(PCTs) to understand the health needs of ethnically diverse communities and
improve access to services, is being undermined by a lack of data about who uses
which NHS services, according to an audit published today by the King’s Fund
Care & Health 23 June 2007
- Pregnant migrants are unfairly denied NHS treatment, says charity.
Report tells of lack of access to antenatal care. Clinic says findings
'rebut myth of health tourist'. Pregnant women are being denied antenatal care
by the NHS because of their immigration status, endangering mother and baby, a
medical charity has found. Médecins du Monde, which
normally works in deprived and developing parts of the world, set up a clinic in
London a year ago because of concerns that some people were struggling to get
healthcare in one of the world's richest cities. One year on, its experience
shows that the NHS, intended to be free to all, is not available to some of
those who need it and who, under the letter of the law, are entitled to medical
help. Sarah Boseley, health editor
Wednesday July 4, 2007 The Guardian
- Health Tourists- More costly to ignore than to treat. A new report
released today by Médecins du Monde UK, endorsed by Ken
Livingstone and Neil Gerrard, MP, found that measures imposed to stop so-called
health tourism are actually preventing vulnerable people living in the UK,
including pregnant women, from accessing vital treatment.
Care & Health 5 July 2007
- UK residents
labelled as 'health tourists' have problems accessing health care. Some
people in the United Kingdom are struggling to access routine medical care,
including consultations with GPs and antenatal care, because they are wrongly
being labelled as "health tourists," says a report. The report, from the charity
Médecins du Monde UK, analyses the first year's activity
of the charity in London, where it set up a clinic in the east end to improve
access to health care for vulnerable people in and around the capital. The group
says that regulations introduced in April 2004 to charge "overseas visitors" for
NHS hospital treatment is making it difficult for some people who have
legitimate rights to NHS treatment to get routine care. In 2006 a total of 349
people came to the Médecins du Monde clinic for 435
consultations. The most common request was for help to register with a GP. But
worryingly, 39 pregnant women came to the clinic, half of whom had had no
previous antenatal care, and nearly a quarter of whom were at least 20 weeks
pregnant. Late access to maternity services is a risk factor for maternal death,
says the report. But it found that 70% of the pregnant women who had come to the
clinic had had difficulties in accessing primary care or antenatal services. At
least 30% had not been tested for HIV. Instead of saving money, as was intended,
the policy is likely to lead to increased costs because "those who are denied
care become so ill that they need to access emergency treatment," said Susan
Wright, director of Médecins du Monde UK. Paul Hunt, United Nations special
rapporteur on the right to the highest attainable standard of health, says in a
foreword to the report that "the rules governing entitlement to free NHS care in
England, which introduced new and greater restrictions on access to health care
for some migrants, seem to be taking us in the wrong direction. The legislation
appears to be incompatible with fundamental right to health principles."
Médecins du Monde, which generally provides health services to people in regions
of conflict, poverty, and natural disasters, is calling for the restrictions on
accessing UK health care based on immigration status to be removed, especially
to maternity services. In a joint statement, the heads of nine campaigning
groups, including Crisis, Doctors for Human Rights, Medact, and the Terrence
Higgins Trust, backed the charity's demands. "Any restrictions on access to NHS
health care based on immigration status pose public health problems, violate
international law, compromise the independence of health professionals, and are
likely to cost more than they save," they say in a statement. "We urge a return
to NHS principles to ensure that everyone living in the UK has access to medical
care, free at the point of need." Summary by
Keep our NHS Public of British
Medical Journal 13 July 2007
- A divided country: study reveals growing UK wealth segregation. Poor
and wealthy households in Britain are becoming more and more segregated from the
rest of society as the UK faces the highest inequality levels for 40 years,
according to a study published today. A report by the Joseph Rowntree Foundation
provides a groundbreaking geographical analysis of changes in the distribution
of wealth over time, and reveals an increasingly divided nation. It shows that
already rich areas - particularly the south-east of England - have become
disproportionately wealthier over four decades, while in areas of some cities
more than half of all households are now "breadline poor", on a level of
relative poverty with enough to live on but without access to opportunities
enjoyed by the rest of society, yet above the level of absolute poverty, or
"core poor". Lucy Ward, social affairs correspondent
Tuesday July 17, 2007 The Guardian.
Map: the gulf between Britain's rich and poor
- Urban Britain is heading for Victorian levels of inequality. The
chasm between rich and poor seen in London today resembles the Manchester that
Engels described in the 1840s. Tristram Hunt
Wednesday July 18, 2007 The Guardian
- Getting rights right. Primary care trusts need to develop a strategy
to tackle equality and human rights, writes Blair McPherson.
Friday
July 20, 2007 SocietyGuardian.co.uk
- North-south divide will narrow but not rich-poor gap, says report.
Britain's economy is likely to see a better balance of growth between regions as
the traditional divide between northern manufacturing and southern services
blurs and more companies opt to move out of the overcrowded south-east and
London, according to a leading City economist. However, the gap between the
richest and poorest could become worse, according to Roger Bootle, chief
economic adviser to professional services firm Deloitte and Touche. Writing in
the latest issue of the Deloitte economic review, Mr Bootle argues that the UK
economy is seriously unbalanced, with London and the south-east outstripping
other regions, especially the east Midlands, the north-east and Wales, which
have been disproportionately affected by the decline in manufacturing's share of
the economy. He warns that the coming squeeze on government spending, which
accounts for less than a third of gross domestic product in the south-east but
up to 60% in Wales, coupled with the continuing strength of London's financial
services sector, will mean "the 'haves' are likely to become 'have mores' and
the gap in incomes between the country's richest and poorest regions is likely
to increase". Mark Milner
Monday July 23, 2007 The Guardian
- Richest patients
choosing hospitals. Research from Bristol University has shown that
wealthier people travel further to be treated at their hospital of choice. The
research, carried out by Professor Carol Propper and her team, revealed that the
new "choose and book" system, will only aggravate the difference between rich
and poor. The researchers say GPs in less affluent areas, but not those in
richer areas, should encourage patients to exercise the right to choose
hospitals for treatment, and that poorer patients should be helped with travel
costs. Professor Propper said that more middle-class people were likely to get
their GPs to refer them their hospital of choice, and that poorer people may be
put off by the cost of travel.
Bristol Evening Post 7
August 2007
- NHS money should be focused on poor areas, voters say. The Government
is under pressure to close Britain's "health inequalities" gap amid growing
public concern that the poorest people get a raw deal from the National Health
Service.
Care & Health 19 September 2007
- Primary care
inequalities to be Johnson's top focus. In his first major speech as health
secretary, Alan Johnson has promised to tackle health inequalities and place
primary care at the centre of government efforts on the health service.
"Inequalities in health mirror wider injustices in society. But we could and
should be doing much more as a department to tackle them," he told an invited
audience at a New Health Network event. "We must ensure tackling health
inequalities is fully integrated into commissioning and the operational
framework," he said. "The prime minister and I will put improvements to primary
care at the forefront of our quest to improve the health of the whole nation,"
said Mr Johnson. Gordon Brown has already said he was prioritising access to
primary care and trusts have been instructed to produce plans to this effect. Mr
Johnson said: "The local GP practice is the principal gateway to the NHS so if
the quantity, the quality and accessibility of GP services are uneven it's no
wonder that health inequalities are prevalent." He said doctors' surgeries must
be open "at times that suit the patients rather than the practice." Mr Johnson
said the Department of Health would produce a strategy programme on access and
prevention and he would begin publishing life expectancy at ward level to
highlight health inequality. "Public health issues must be elevated to the top
of the national agenda by a DoH which takes an even more active role in
encouraging active lifestyles," he said. He added that the problem of alcohol
would be focused on over the next few months. Summary by
Keep our NHS Public of Health
Service Journal 20 September 2007
- NHS Confederation says a personalised NHS should reach out to the most
excluded. Moves to create a personalised NHS must start with the most
excluded and work to tackle health inequality, says the NHS Confederation today
in a new report called ‘In sickness and in health'.
Care & Health 5 October 2007
- North-south divide widens in health map of England. People living in
northern England are more likely than their southern neighbours to smoke and
drink to excess. Their mental health is poorer and life expectancy is up to
three years shorter than in the south. The regional health divide emerged
starkly in a health profile of England, published yesterday by the Department of
Health. It showed the NHS has made great strides in reducing the number of
people dying from cancer and heart attacks. Infant mortality is at its lowest
level and fewer people are smoking. But more people consider themselves in poor
health than when Labour came to power in 1997 and the inequalities between north
and south are wider than ever. John Carvel, social affairs editor
Tuesday
October 23, 2007 The Guardian
- The north-south divide moves north. David Ward
Wednesday October 24, 2007 The Guardian
- Variations persist in life expectancy by social class.
While life expectancy has risen for all social
classes over the last 30 years, people in professional occupations (Social Class
I) have the longest expectation of life, followed by managerial and technical
occupations (Social Class II), and so on. People in unskilled manual occupations
(Social Class V) have the shortest expectation of life.
Care & Health 25 October 2007
-
The fruits of Kiwi health reform. Slowly but surely, the health reform
tide in England is turning. Gordon Brown and health ministers have signalled
their intention to place much greater emphasis on public health than their
predecessors, alongside a continuing commitment to improve the performance of
the NHS. Lord Darzi's interim report on the NHS specifically highlighted the
need to make more progress in tackling health inequalities. With a boy born in
Manchester likely to die almost 10 years earlier than a boy born in Kensington
and Chelsea, a concerted drive to improve health by focusing on people most in
need seems certain to loom large in the next stage of health reform. Last week's
announcement that the government is planning 10 eco cities, designed to make it
easier for people to exercise, is an indication of the way in which ministers
are thinking. The risk with this approach is that it will become just another
initiative unless it is part of a well-designed public health strategy.
Ministers should look to New Zealand for lessons on how to avoid risk. Recent
analysis showed that the widening of health inequalities there has been stemmed
and, to some degree, reversed. Although the precise reasons are not fully known,
inequalities in New Zealand appear to have been tackled successfully as a result
of a long-term commitment to public health and primary care. Under prime
minister Helen Clark, New Zealand turned its back on the failed internal market
experiment of the 1990s, and set up health boards - integrated organisations
whose members are made up of some people elected by the public and others
appointed by the health minister - with responsibility for planning and
providing health and disability support services. Health inequalities in New
Zealand are most evident in the poorer health experienced by Maori and people
from the Pacific Islands. To address these inequalities, Clark's government
developed a health strategy in 2000 in which public health received as much
attention as healthcare services. The strategy included health boards working
with public agencies and third sector organisations to implement population-wide
programmes to address risk factors such as unhealthy diet and lack of exercise.
A major focus of these programmes has been to target support at hard-to-reach
groups by working with Maori and Pacific Island organisations. In the case of
people from the Pacific Islands, health boards have capitalised on the role that
religious life plays in these communities, by delivering health advice and
medical care with and through churches. Similarly, tribal structures have been
engaged to reach the groups most in need among Maori. Equally important has been
the emphasis on primary healthcare. Concerned at the adverse effects of charging
patients to see a GP, Clark's government developed a primary care strategy that
has resulted in an investment of NZ$2.2bn (£0.81bn) over seven years. The fees
paid by patients and the costs of prescriptions have fallen considerably, making
it easier for families on low incomes to get care. This has contributed to a
stronger emphasis on prevention in primary care, with a particular focus on the
management of people with diabetes. Patients in New Zealand find it much easier
to make an appointment than their counterparts in the UK because GPs lose income
if patients seek primary care from a practice other than the one where they are
registered. The Brown government would do well to consider how to adapt this
arrangement. An option would be to claw back funds GPs receive from the
government where practices have higher than expected use of services by patients
out of hours. This could be done while maintaining care free to patients at the
point of access - an aspect of the NHS superior to that found in New Zealand.
Another lesson from New Zealand is the value of local people involved in health
boards. The two-thirds of members elected by the public are chosen every three
years, with elections held at the same time as those for local authorities.
Turnout is around 40%, and most candidates stand as independents. New Zealand's
system has the twin virtues of engaging the community directly and avoiding the
risks of overcentralisation to which the NHS is so prone. There is a greater
willingness to deal with the challenges of the health system at a local level,
instead of pulling these challenges in to the government in Wellington. At a
time when the NHS is entering a much more difficult financial climate, Brown and
health ministers may well be attracted to an arrangement where the blame for the
NHS no longer gravitates towards Whitehall, but is dealt with by
locally-accountable bodies. Chris Ham
The Guardian Wednesday November 7 2007
- A much exaggerated death. For decades, commentators anticipated the
demise of the welfare state, but the true failure has been in the struggle with
inequalities. Malcolm Dean
The Guardian Wednesday November 7 2007
- Inequalities in life expectancy at 65 in UK. Men in
Glasgow City can
expect to live a further 13.8 years at age 65, the lowest life expectancy at
this age in the UK, according to local area data released for the first time by
the Office for National Statistics (ONS).
Care
& Health 28 November 2007
- Failed asylum seekers face healthcare ban. Controversial plans to bar
hundreds of thousands of illegal immigrants and failed asylum seekers from all
but emergency health services are being considered by the Home Office. Amid
claims the move will place increased strains on hospitals and inflame community
tensions, The Observer can reveal a joint Department of Health and Home Office
review examining proposals to restrict free access to GPs' surgeries for failed
asylum seekers and 'irregular migrants' is due to report in the new year. Jamie
Doward, home affairs editor
Sunday
December 2, 2007 The Observer
- NHS care 'favours
middle classes'. The NHS is a "divisive influence" which favours the
assertive middle classes over poorer people, a study says. The report by
centre-right think-tank Civitas said the health service was not providing equal
treatment to all. It pointed out that people in deprived areas were often more
in need of treatment, but less likely to get hip replacements or key x-rays. The
report called for more use of the private sector, but other experts said this
would just widen inequalities. Report author Nick Seddon said studies had shown
that those on lower incomes made more use of primary care, but were less likely
to be referred on for hospital treatment. He said this was partly attributable
to the fact that middle classes were more assertive, articulate and confident in
dealing with health professionals. He said part of the problem for the NHS was
that it had made little use of the private sector. But Alex Nunns, of the Keep
Our NHS Public campaign group, which represents health professionals, the public
and academics, said: "The middle classes will always make the best of a system.
In fact, there is evidence to show that when you involve the private sector, it
just exacerbates the situation." Summary by
Keep our NHS Public of BBC
11 December 2007
See Society Guardian index on
Social Exclusion and
on Health Mapping.
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