Intended for healthcare professionals

Education And Debate

Better benefits for health: plan to implement the central recommendation of the Acheson report

BMJ 1999; 318 doi: (Published 13 March 1999) Cite this as: BMJ 1999;318:724
  1. Douglas Black, past president, Royal College of Physiciansa,
  2. J N Morris, emeritus professor of public healthb,
  3. Cyril Smith, past secretary, Economic and Social Research Councilc,
  4. Peter Townsend, visiting professor of international social policyd
  1. a The Old Forge, Whitchurch on Thames, Reading RG8 7EN,
  2. b Health Promotion Research Unit, London School of Hygiene and Tropical Medicine, London WC1E 7HT,
  3. c Cornwall Gardens, London SW7 4AE,
  4. d London School of Economics and Political Science, London WC2A 2AE
  1. Correspondence to: Professor Townsend

    Call for a plan to implement the message of the Acheson report

    As authors of the Black report, we welcome the report of the independent inquiry into inequalities in health by the scientific advisory group under the chairmanship of Sir Donald Acheson. 1 2 In particular, we welcome the attention given in the report to the increasing problems caused since the late 1970s by the rapidly widening gap in living standards. We also welcome recommendation number 3 (among the 39 principal recommendations) which specifies the need for policies to “reduce income inequalities and improve the living standards of households in receipt of social security benefits.”1 The report specifies that benefits in cash or in kind must be increased to reduce “poverty in women of childbearing age, expectant mothers, young children and older people.” Nine other recommendations (numbers 8, 13, 20, 21, 22, 27, 31, 35, 36) were explicitly linked to recommendation 3, reinforcing the call for integrated action to alleviate unemployment and the deprived condition of many ethnic minority groups, elderly and disabled people, and families with children; and increase benefit levels and real living standards. Another 10 recommendations are concerned with meeting material needs in schools, housing, the environment, transport, and diet.

    Summary points

    The 1998 Acheson report echoes the findings of the 1980 Black report that the gap in inequalities in health has been steadily increasing and that differences in material deprivation are a major cause of the increase

    The likely effects on inequalities in health of the chief policies implemented in the 1980s and 1990s still need to be estimated so that strategies to improve health can be improved

    The level of benefit that is minimally sufficient to maintain health and effective working and social capacity among different types of families needs to be defined and related to a programme to improve benefits

    A staged programme of the action needing …

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