The independent inquiry into inequalities in health

Is welcome, but its recommendations are too cautious and vague

News p 1471

Twenty years ago the secretary of state for social services of the last Labour government appointed Sir Douglas Black to chair a working group to review information on inequalities in health and suggest policy and research that should follow from this review.1 The report appeared in 1980 and received a cold reception from the new Conservative government.2 The climate for the reception of the Black report's successor—the independent inquiry into inequalities in health, chaired by Sir Donald Acheson and published this week3—is hopefully different. How do its findings and recommendations compare?

For 17 years of Conservative government the Labour party made political capital out of the non-implementation of the recommendations of the Black report. The announcement before the 1997 election that, if elected, Labour would commission an independent review into inequalities in health was therefore welcome.4 When launching the inquiry in July 1997 the minister for public health criticised the health strategy of the previous administration for “its excessive emphasis on lifestyle issues” which “cast the responsibility back on to the individual.”5 Given the history of the Black report—released with no press release and only 260 copies—the commitment to publish the new report was encouraging, as was the statement that “its conclusions, based on evidence, will contribute to the development of a new strategy for health.”3 The review's terms of reference, however, included the stipulation that it must …