Rapid Responses to:
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Rapid Responses: Rapid Responses published:
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![[Read Rapid Response]](/icons/misc/sectionDOWN.gif)
Cover up? No. Biased and positive spin? Perhaps.
- Nigel Dudley (9 September 2005)
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Health Inequalities
- Caroline Flint (9 September 2005)
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Re: Health Inequalities
- Nigel Dudley (9 September 2005)
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Health inequalities: preventive health services complement tax and benefit measures
- Susan Michie (18 September 2005)
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Nigel Dudley, Consultant in Elderly Medicine St James's University Hospital, LEEDS LS9 7TF
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The implied assertion by Davey Smith et al in the complete version of the letter that this was a cover up - an assertion implied by the use of the word "deliberate" that was omitted from the BMJ published letter - is mistaken.[1] A cover up would have been if the authors of the report had failed to include a material fact and finding in the report such as the widening inequalities in life expectancy and infant mortality. At best, the Department of Health could be accused of bias in the way that it apparently chose the timing of the release after an election and chose to point out the thrilling development of "health trainers" to help those who seem to require such assistance. Personally, I would much prefer to see such resources invested in the therapist deficit for the many stroke units around the country but that would not be exciting news although it would perhaps do far more to help a greater number of people. [1]Shaw ME Personal trainers, shifting goalposts, and widening health inequalities. http://bmjjournals.com/cgi/eletters/331/7514/419#115362 (The views expressed are my own and not those of my employing organisation.) Competing interests: Consultant in Elderly and Stroke Medicine feeling sorry for trust managers trying to live in hard financial times when resources could be used for better effects on older population health and wellbeing! |
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Caroline Flint, Minister for Public Health Department of Health, Richmond House, 79 Whitehall, London, SW1A 2NS
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Your article (Latest government report on health inequalities ‘hushed up’) repeats claims that the Government suppressed its health inequalities report. This is nonsense. “Tackling Health Inequalities”, actively promoted and announced via a press release issued to 1300 journalists and media outlets received widespread coverage including stories in national and regional press. Professor Sir Michael Marmot, the report author, was extensively interviewed. We can, therefore, hardly be accused of a ‘hushed up release’. We are determined to reduce health inequalities. The report showed that we are moving in the right direction and highlighted the further work that needs to be done. However, the report’s data dated back to 2003. Last November, we published the Choosing Health White Paper aimed at improving health and tackling health inequalities. Health trainers are one of many initiatives in Choosing Health which will help narrow the inequalities gap by helping people to make healthier choices in their daily lives. Infant mortality rates, a key indicator of health inequalities, have fallen in the “routine and manual” group as well as the total population. Government action including Sure Start, better neonatal services, stop smoking services, breastfeeding campaigns are all having an impact. Progress is slower in more disadvantaged areas which is why spearhead primary care trusts are piloting many of the key Choosing Health recommendations, including health trainers, in those areas. Health inequalities are and will continue to be a Government priority. Yours, Caroline Flint
Competing interests: None declared |
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Nigel Dudley, Consultant in Elderly Medicine St James's University Hospital LEEDS LS9 7TF
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It is good to see the responsible Minister from the Department of Health put in such a robust challenge to an outrageous claim of something being "hushed up". If there was any irresponsible behaviour going on in the Department of Health over information disclosure then it has the advantage at this time of the public being served by four female Ministers; the French dramatist Jean Giraudoux said: "There is nothing so wrong in this world that a sensible woman can't set it right in the course of an afternoon." With four, any problems should be solved and set right in a few hours! (The views expressed are my own and not those of my employing body.) Competing interests: As before. |
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Susan Michie, Professor of Health Psychology University College London, London WC1E 7HB
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Whilst social, environmental and fiscal policies are key to reducing inequalities in income, education and health, this should not be pitted against interventions aimed at individuals. For example, although much more should be done at these levels to ensure safer working environments, this is not an argument against health and safety training of individual employees. Similarly, whilst housing, tax and benefits policies are central to reducing inequalities in health, this should not be pitted against training people in how to achieve the goals they set for themselves to improve their health. NHS health trainers will be available to all, but will target those least well off. The strategies that people develop to improve their health may include acting at a social level and addressing root causes of ill health, as well as acting at an individual level. Interventions at the economic, political and social level will not achieve their potential unless complemented by interventions at the individual level. Competing interests: None declared |
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