Intended for healthcare professionals

Education And Debate Modernising the NHS

Prevention and the reduction of health inequalities

BMJ 2000; 320 doi: (Published 20 May 2000) Cite this as: BMJ 2000;320:1399
  1. Sally Macintyre, director (
  1. MRC Social and Public Health Sciences Unit, University of Glasgow, Glasgow G12 8RZ

    This is the second of seven articles

    The secretary of state for health recently announced the establishment of six “modernisation action teams” to help develop a national plan for a national health service.1 The government has committed itself to improving public health and reducing inequalities in health. The decision to set up a “modernisation action team” on prevention and inequality is consistent with these goals. It is not clear, however, what this team is expected to do that is different from the analysis and recommendations contained in various recent government reports.27Saving Lives: Our Healthier Nation said its aim was “to improve the health of everyone, and the health of the worst off in particular.” 3 It acknowledged the role of social, economic, and environmental factors in influencing population health and inequalities in health but did not confine itself to non-NHS initiatives to improve population health. The Acheson inquiry gave careful consideration to recent trends in, possible causal models for, and policies to reduce inequalities in health and made 39 policy recommendations, three of them relating to the NHS.6 So attention has recently been given to the role of the NHS in promoting public health and reducing inequalities in health.8 9 What will this action team do that has not already been done fairly recently? Does the government think that all these reports were a waste of time or have failed, or that the situation has changed radically since they were published?

    Summary points

    The major drivers of health and the distribution of health lie outside the health service, so this plan should not confine itself to actions that could be taken by the NHS

    The government should review progress in implementing the Acheson …

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