... especially not good news...The National Audit Office's report, Tackling inequalities in life expectancy in areas with the worst health and deprivation, takes a long, hard look at DH's achievements as regards inequalities. And the verdict? A good effort, but not exactly value for money.
"The Department of Health has made a concerted effort to tackle a very difficult and long-standing problem. However, it was slow to take action and health inequalities were not a top priority for the NHS until 2006. We recognize that this is a very complicated issue and that it took time to develop an evidence base. 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.
"The Department should target its efforts on the most deprived areas of the country and develop costed proposals to maintain or increase investment in preventative interventions to tackle the conditions which lead to health inequalities."
Amyas Morse, head of the National Audit Office, 2 July 2010.
Health Policy Insight casts a wise look back to Julian Tudor Hart's inverse care law.
Wednesday 7 July 2010
Unfair distribution
The recently revised NICE guidelines on COPD provide some grim reading. Currently, NICE says that COPD affects between 2% and 4% of the population, but the burden of the disease falls heavily on areas of deprivation: "men aged 20-64 employed in unskilled manual occupations being 14 times more likely to die from chronic obstructive pulmonary disease than those in professional occupations ." At the moment, COPD is the UK's 5th leading cause of death but this is expected to rise, with the condition becoming the 3rd leading cause of mortality worldwide. And it doesn't stop there: NICE's review suggests that this is a substantially under-diagnosed condition, under-represented in death certificates and in primary care prevalence assessments.
More about health budgets
Two recent articles in the BMJ argue that it’s not just about ringfencing health budgets: social welfare and the health of the nation are far more entwined than that. Joan Benach and others look at the international situation, while David Stuckler and colleagues examine the UK perspective in more detail.
Age UK (the name for the merger between Age Concern and Help the Aged) argues that the Autumn spending review should include ringfencing of social care budgets, too. The King’s Fund’s John Appleby also notes ominously that the real extent of cuts will only be made clear in the Autumn spending review and looks at the ripple effect for health of cuts and the Office for Budget Responsibility’s prediction of slower economic growth.
Age UK (the name for the merger between Age Concern and Help the Aged) argues that the Autumn spending review should include ringfencing of social care budgets, too. The King’s Fund’s John Appleby also notes ominously that the real extent of cuts will only be made clear in the Autumn spending review and looks at the ripple effect for health of cuts and the Office for Budget Responsibility’s prediction of slower economic growth.
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