Health inequalities in the UK: remedy requires action beyond redistribution of wealth

Abstract

When the Labour government came to power in 1997, one of its stated aims was to reduce health inequalities in the UK. With this in mind it commissioned Sir Donald Acheson to produce a report on the matter which, unsurprisingly, indicated that health inequalities were strongly related to wealth inequalities, and that social and economic policy was a greater determinant of this than healthcare policy.1 Now over 10 years on, the matter has been revisited, with the Department of Health publishing a progress report.2 It is an excellent document, but sadly short on evidence of tangible improvement in several areas. In a post-publication speech to the Fabian Society,3 the then Health Secretary Alan Johnson tried to make political capital, stating that under the Conservatives mortality rates between men in the highest and lowest socioeconomic groups had widened. This is true; however, what he failed to acknowledge is that his own government has had a dozen years to close the gap, and has not done so. In short, this is because the government's economic policy has been targeted at helping the very rich, while attempting to help the poor through redistribution of wealth, chiefly on a regional basis. In this essay, I shall argue that this strategy is flawed, has failed to address the underlying reasons for poverty, and placed an unsustainable pressure on middle-income earners, not least healthcare workers. Peter Mandelson famously stated that ‘New Labour is intensely relaxed about people getting filthy rich’, while Tony Blair, ever the populist, stated that limiting the earning power of Premiership footballers was not in his job description. In the early months of the government, it was perhaps necessary to reassure the money markets that Labour was not anti-business. Indeed, its economic policy has favoured the rich. The huge wages …