Intended for healthcare professionals

Rapid response to:

News News Analysis

A decade on from Marmot, why are health inequalities widening?

BMJ 2019; 365 doi: https://doi.org/10.1136/bmj.l4251 (Published 17 June 2019) Cite this as: BMJ 2019;365:l4251

Rapid Response:

Re: A decade on from Marmot, why are health inequalities widening?

Experts in public health are calling for major policy reforms to tackle the growing disparities in life expectancy and worsening health inequalities. Wasn’t the NHS set up 71 years ago to tackle these very issues? And in spite of countless reforms and re-organisations since then it has failed miserably. So what new policies could these experts possibly have in mind that haven’t been tried before? Surely the lesson of the last 71 years is that the NHS is incapable of reducing health inequality because this is inextricably linked to economic inequality and it is this that needs to be tackled; so it is a political issue not a health issue.

A more promising approach would be that advocated by the late Prof George Miller, renowned epidemiologist, in his 2003 monograph “Dying for Justice” in which he calls for fundamental, radical and egalitarian reform of our taxation system that would increase tax on unearned rental income, especially from land, and reduce tax on income and consumption. Nothing less will have the slightest effect on the health inequality that Elwell-Sutton rightly describes as shocking.

Competing interests: No competing interests

23 June 2019
Justin A Robbins
Retired GP
n/a
Plymouth