2. Areas of the course that can be examined are limited
Causes of inequalities in wealth and health
Consequences of inequalities in wealth and health
Government strategies to deal with these inequalities
Success of these strategies
Extent of wealth and health inequalities
The extent to which the founding principles of the NHS are being
met
Collectivist v Individualist v Third Way debate
3. In 2007 the 2 questions in the Social Issues section were
Causes of inequalities in wealth and health
Consequences of inequalities in wealth and health
Government strategies to deal with these inequalities
Success of these strategies
Extent of wealth and health inequalities
The extent to which the founding principles of the NHS are being
met
Collectivist v Individualist v Third Way debate
4. This workshop will therefore concentrate on
Causes of inequalities in wealth and health
Government strategies to deal with these inequalities
Success of these strategies
5. Causes of
inequalities in
wealth and health
Unemployment
& Low Income
Government
policies
age
gender
Glass
ceiling Career
breaks
Types of
job
race
Economic policies
which encourage
or restrict growth
Burden of
taxation
Employment law Level of
benefits
Spending
on
health
Health
education
Poor education Trade cycle
Illness &
disability
Lone parents
race
gender
Social class and health
Pension
levels
Complexity
of the
benefits
system
Means-
testing
Illness and
age
Health
provision
Discrimination
and
harassment
education
Habits
and
health
6. Government Strategies to overcome inequalities in
Wealth and Health
Wealth inequalities have an enormous impact on health
inequalities
Therefore
a major
Government
strategy to
overcome
health
inequalities
is to tackle
wealth
inequalities.
8. Government
strategies to tackle
Health inequalities
A major theme of the strategies of successive Labour Governments
since 1997 is to promote more individual responsibility for health and
wealth through.
EDUCATION
Individual responsibility for
health is promoted through
education in schools, GP
surgeries, clinics and hospitals
and through advertising
campaigns.
Individual responsibility
for wealth is encouraged
through persuading people
to get off welfare and
into work.
9. Government
strategies to tackle
Health inequalities
Anti -
smoking
Obesity and
exercise
Alcohol
abuse
Smoking bans
in Scotland
in England
Make
more use
of private
sector
GP practices to
provide more
education and
preventative
services
Reduce
waiting
lists
Measures
to tackle
wealth
inequalities
Healthy Living Centres
To promote good
health in
disadvantaged areas
Health promoting
schools – encourage
healthy eating and
exercise “Working together
for a healthier
Scotland”
Campaigns on TV
in press and
through NHS
Laws
NHS
Sure Start
Help children and
carers overcome
social exclusion
10. Government
strategies to tackle
Wealth inequalities
Welfare to Work
Programme to
tackle
unemployment Low
Income
As above
but also
equal
opportunity
laws
Gender
and Race
Pension
Credit
Winter
Fuel
Allowance
Employment
Equality
(Age)
Regulations
2006
New Deal, NMW
etc to improve
family income
Uprating Child
Benefit
Sure Start
programme
New Deal
National Minimum Wage
Working Tax Credit
Jobcentre Plus
Children
Old
Age
11. Extent of success of current government policies to end
wealth and health inequalities
The main
government
policies
get more
people
back into
work
reduce and eventually
eliminate the number
of children living in
poverty
reduce the
number of
elderly people
living in
poverty
reduce the
differences in
health caused by
social class
increase the the
proportion of GDP
spent on health in
the UK and bring it
up to the level of
our European
neighbours.
reduce waiting
lists and waiting
times
Modernise
the NHS.
12. Extent of success of current government policies to end
wealth and health inequalities
TARGET – to get more people back into work
SUCCESS
In February 2008
• 5.2% were unemployed - down from 7.2% in 1997
• 29.4 million people in work – highest number on record
• Claimant count was 794,000 – lowest in 32 years
HOWEVER
• Unemployment rate up from 4.7% in 2004
• Is lower unemployment more to do with a strong economy and
not government policies?
• Two-fifths of those getting work are out-of-work again within
six months.
13. Extent of success of current government policies to end
wealth and health inequalities
TARGET – reduce number of people on low pay
SUCCESS
• The proportion of workers aged 22+ who are low paid (£7
an hour in 2007) fell between 2002 to 2005
• The pay gap between low paid men and low paid women has
narrowed.
HOWEVER
• The proportion of low paid workers has not fallen between
2005 and 2008
•There is still a substantial gap between low paid men and low
paid women
• 50% of children living on a low income are in households
where at least one adult is working
14. Extent of success of current government policies to end
wealth and health inequalities
TARGET – reduce and eliminate children living in poverty
SUCCESS
• The number of children in low income households fell from 4.4
million in 1999 to 3.8 million in 2006
HOWEVER
• The number of children in poverty is still 3.8 million
• The government target was to reduce child poverty by 25%
by 2006. They are 500,000 short of their target
• 50% of children living on a low income are in households
where at least one adult is working
15. Extent of success of current government policies to end
wealth and health inequalities
TARGET – reduce the number of elderly people living in poverty
SUCCESS
• The proportion of pensioners living in low income
households fell from 29% in 1997 to 17% in 2006.
• Among single pensioners, the rate has halved over the period,
from 40% to 20%.
HOWEVER
• 17% of pensioners still live in poverty
• a third of pensioner households entitled to Pension Credit
are not claiming it.
16. Extent of success of current government policies to end
wealth and health inequalities
TARGET – reduce the differences in health caused by social class
SUCCESS
• There is some evidence to show that mortality rates from
cancer and heart disease are falling.
HOWEVER
•The reduction in mortality rates from heart disease and
cancer is across all social classes
• There is no evidence to suggest any progress in reducing
health inequalities caused by social class in areas such
as infant death and low birthweight
17. Extent of success of current government policies to end
wealth and health inequalities
TARGET – increase the the proportion of GDP spent on health
in the UK
SUCCESS
• The government has raised spending on health to 9% of GDP
which is similar to our European neighbours.
HOWEVER
• Much of the extra spending went on increases in pay and
other cost pressures such as the cost of drugs. Therefore the
extra money available for extra patient services is only 2.4%.
18. Extent of success of current government policies to end
wealth and health inequalities
TARGET – reduce waiting lists and waiting times
SUCCESS
• Since 2000, the waiting lists have been shortened
significantly and waiting times of more than 12 months
have been eliminated.
HOWEVER
• Some of the improvement has been the result of the way
in which waiting times are calculated. For example
counting the waiting time for each stage in a
diagnosis and treatment not the overall wait time.
19. Extent of success of current government policies to end
wealth and health inequalities
TARGET – Modernise the NHS
SUCCESS
• In 1997, the average age of NHS buildings was older than the
NHS (ie over 50 years old). In 2005, less than 25% are that old.
•By 2005, the NHS had 68 new hospitals built or being built out
of the planned target of 100 new hospitals
HOWEVER
• Critics argue that PFI will cost the NHS more in the medium
to long term which will cut services in the future and
that many of these new hospitals reduce bed numbers
and deliver poor quality buildings which will cost more.
20. Extent of success of current government policies to end
wealth and health inequalities
TARGET – Reduce ill-health by banning smoking in public places
SUCCESS
• Researchers found a 17% drop in the number of people
admitted for heart attacks in the year since the ban
came into force, compared with an average 3% reduction
a year over the previous decade. The reduction was most
marked among non-smokers, with a 20% fall, compared
with a 14% drop among smokers.
• Other research published by the British Medical Journal,
found a 39% reduction in second-hand smoke exposure
among primary school children in Scotland, and a 49%
reduction among adult non-smokers
•The number of all heart attack admissions in 9 Scottish
hospitals fell by more than 550, from 3,235 in the year
to March 2006, to 2,684 in the year to March 2007.
Among non-smokers, the reduction was from 1,630 to
1,306.
21. Summary
Causes of inequalities in wealth and health
• Government policies
• Unemployment and low income
• Age – old people and children
• Gender and race
Wealth inequalities have an enormous impact on health inequalities
Government strategies to reduce inequalities
The government has had mixed success in meeting its targets but
overall it is more positive than negative.
Legislation eg NMW or Smoking Bans
Directing resources towards the old and children
Advertising campaigns and health promoting schools and NHS
Welfare to work
Emphasis on people taking individual responsibility through education
and incentives
Social inclusion
