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Rapid Responses: Rapid Responses published:
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Social Collusion. We all conspire in health inequalities.
- Colin Guthrie (3 December 1998)
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Reducing inequality is a two-edged sword.
- Richard Naftalin (3 December 1998)
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Re: Reducing inequality is a two-edged sword.
- Barry Blatt (9 December 1998)
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Colin Guthrie, General Practitioner and MPH student at Glasgow University 1448, Dumbarton Road, Glasgow, G149DW
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As a GP in Glasgow I find this report toothless and duplicitous. Taking some of these key recommendations.... * All policies likely to affect health should be evaluated in terms of their impact on health inequalities. We have a Council determined to build a new motorway on the south side of the city which will pollute from increased traffic levels and run the very real risk of releasing chromium into the environment ( from old car manufacture in the sixties )The area affected, the Gorbals, houses a deprived community who will suffer further injustice just to ensure that the more affluent can commute more speedily from their leafy cul-de-sacs. It looks as if this socially devisive and destructive M74 extension may get the go-ahead due to the economic clout of a small group of self- serving Glasgow businessmen. Where is the equity here? Can anyone medical ever forget the million pounds taken from Bernie Ecclestone by the incoming Labour administration and the agreement that all racing cars can bristle with tobacco logos until well into the next millenium? Smoking is linked with deprivation and we know from a recent Lancet study that boys who follow motor-racing are twice as likely to start smoking. * Reducing income inequalities and improving the living standards of households receiving social security benefits. I see a lot of families who are at the brink of such payments and are in a peculiar financial limbo where their income is damned whatever they try and do. *Improvement in the availability of social housing for the less well off. Certainly not in Glasgow. This council is now arranging for the total privatisation of it's housing stock. debts are so huge the only way out is to sell the everything to a private company. The tenants are pracically up in arms about it. If a private company owns the housing then their will be no such thing as 'social housing'. This Government is therefore encouraging a company to profit from housing the most vulnerable section of society. What chance will there then be of any 'improvement in availability'? *Policies to increase the availability and accessibility of foodstuffs to supply an adequate and affordable diet. This is rich coming from an administration that has just ditched its long promised Food Standards Agency. This agency might have brought some legislative teeth to our food industry which is a very unhealthy monopoly with high prices and poor quality being maintained by three supermarket chains. The poor need cheap,good quality,nutritious food provided locally in their area.They do not have transport to get to supermarkets and yet this administration continues to permit large supermarket developments on the edge of out towns and cities.This deprives the poor of what limited choice they once had as their High street shops curl up and die in the face of this unfair competition. Social exclusion? No, this is much worse than that. The middle classes have taken from the deprived what little they had left and used it for ourselves with the continuing connivance of policy makers. This must be social collusion. |
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Richard Naftalin, Professor of Physiology King's College London, Strand London WC2R 2LS
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It is obvious that the cheapest way of reducing inequalities in health and education provision is to reduce the standard of service to the wealthy. Thus, closing grammar schools, making the motorist pay for hospital treatments of accidents, introduction of a means tested charges for such luxury items as sports injury clinics, antenatal clinics, etc would have the desired effect of reducing the educational and health status of the wealthy. This would improve the inequality ratio, which is of such concern to Health and Government Statisticians and SAVE money. Surely this Old Labour reflex "of beggar my neighbour" which Dr Colin Guthrie appears to be advocating is something that should be avoided. The Acheson Report should be welcomed and should not be used as ammunition to fight ancient class wars, but as a springboard to new initiatives which might improve the overall health of the Nation. |
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Barry Blatt, Freelance medical journalist
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Dr Guthrie does not seem to be advocating 'reducing the quality of care given to the wealthy', just a fair deal for all. Acheson's key point seems to me to be that redistributove taxes are going to have to be key part of reducing inequality in health, as in inequality in any other matter. Unfortunately, the Labour government was elected on the premise that they would not increase taxes, leaving them with little room for manouver on housing, ecucation etc. It remains to be seen if they are going to get anywhere in reducing inequality without a large injection of cash to those parts of the country like Glasgow that are in a pretty serious sate of decline. I know of places in my own patch, Leeds, where civilisation has all but ceased to exist, crushed under crime, deprivation, depression and the sheer apathy they bring to both the population and the authorities they expect to do something about it. Another good point raised by Dr Guthrie is the democratic deficit. Much development is in the interests of the developers and no-one else. I think he is going a bit far in his conspiracy theories, but I think he is right to say that money is only spent on development where it will give a quick and obvious return of more money for the investor. This is the unacceptable face of capitalism - cash only exists to make more cash, and bugger the human element. Markets must be restrained by democratic accountability and we just haven't got that. Go and talk to your local tree sitting fraternity - most are bats, but you will find a tidy number of people that are doing what they are doing out of a sense of disempowerment and disenchatment with the current political system. It would be nice if their energy could be harnessed to something more substantial than saving snails. |
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