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The Health Disparities White Paper that was set to look at how a person’s health is determined by the broader environmental and social context they live in, has been officially dropped by the government after months of speculation.
The move has received widespread criticism from health organisations who said that only by considering the wider determinants of health will efforts to help people live longer, healthier lives succeed.
These issues will now be fed into the Major Conditions Strategy that was published last week, which aims to narrow health inequalities and gain an extra five extra years of Healthy Life Expectancy (HLE) by 2035.
The Royal College of Physicians, however, said that focusing on access and outcomes alone will not be enough to close the almost 20 year gap that exists in healthy life expectancy between the most and least deprived.
The College is part of the Inequalities in Health Alliance, a coalition of over 200 healthcare organisations which was launched in October 2020. It is calling for a cross-government strategy to reduce health inequalities and adopt a ‘child health in all policies’ approach.
Dr Sarah Clarke, president of the RCP, said: “The long-awaited Health Disparities White Paper promised a dedicated focus on health inequality, one where the Department of Health and Social Care would work with the ‘whole of government to consider health disparities at each stage at which they arise including the wider determinants of health.”
Lack of focus on children in Major Conditions Strategy
The Royal College of Paediatrics and Child Health (RCPCH) said by abandoning the Health Disparities White Paper, the singular focus needed to effectively address health inequalities had been lost.
It is also ‘deeply concerned’ at the apparent lack of focus on children and young people in the Major Conditions Strategy, which seems more focused on treatment than prevention. So far, it remains unclear how health inequalities will be individually addressed nor if there will be any specific focus on children and young people.
RCPCH President, Dr Camilla Kingdon, said by truly valuing all children, whatever circumstances they are born into, we create a healthier citizen, less dependent on the state in the future and more able to rise to the many challenges of modern-day life.
She added: “It is truly disappointing to hear that the government has abandoned plans to publish its Health Disparities White Paper. In its place, we have yet another plan to publish a strategy when what we really need is urgent action. As paediatricians we know how desperately real change is needed to tackle entrenched and ever-growing child health inequalities across the UK.
“Health inequalities are estimated to cost the NHS an extra £4.8bn a year and recent findings from the ONS show that since early 2020, almost 400,000 people exited the jobs market with long-term health problems. The government knows there is a problem, yet we still have no clear strategy that considers the role of every department and every available policy in tackling health inequalities, including those that start in childhood.”
The Health Foundation said that the decision to scrap the white paper has removed all the remaining momentum behind the health inequalities agenda.
In a blog post, it said that history shows us that focusing on medical conditions means activity gravitates towards early diagnosis and treatment within the NHS.
It added that the decision was deeply disappointing because good health remains out of reach for far too many people in the UK, that deep inequalities in health between the poorest and wealthiest are widening, and that failing to address poor health and economic inactivity will slow the economic recovery the nation desperately needs.