Poverty to have priority in NHS

BMJ 1997; 314 doi: (Published 21 June 1997) Cite this as: BMJ 1997;314:1781
  1. John Warden, parliamentary correspondent
  1. BMJ

    How to break the link between poverty and ill health is shaping up as the major health initiative of Britain's new government.

    The prime minister, Tony Blair, has confirmed that the findings of the 1980 Black report on health inequalities is to be updated by Sir Donald Acheson, a former chief medical officer. Casting aside reservations that prevailed during the 18 years of Conservative rule, Mr Blair said that there was no doubt at all of a link between inequality and poor health. Two days earlier Sir Donald had discussed the terms of his review with the health secretary, Frank Dobson; the public health minister, Tessa Jowell; and the current chief medical officer, Sir Kenneth Calman.

    Sir Douglas Black's report, Report on Inequalities in Health Related to Social Class, was commissioned by a Labour government but suppressed by the incoming Conservative administration, which rejected its main finding–that most ill health is associated with social status and conditions rather than individual behaviour.


    Sir Douglas Black found that poor living conditions affect health


    Labour's decision to appoint a minister for public health, with a wide remit across all government departments, recognised that the validity of the Black report has been reinforced by evidence that health inequalities between social groups are widening.

    Sir Donald, who was chief medical officer from 1983 to 1991, has been asked to recommend on the basis of scientific evidence where the government can take the most effective action to improve public health. The government's strategy will be launched at a health department conference on 7 July.

    The director of the King's Fund Health Policy Institute, Ken Judge, said: “What we don't want is another description of the problem. We need a careful analysis of the causes and an evaluation of policy options.”

    The Liberal Democrats' spokesman on public health, Dr Peter Brand, said, “I cannot imagine a new inquiry reaching a different conclusion. We do not need an update of the Black report, we need the original one put into action.”

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