How could I fault Aditya Chakrabortty’s account of the failure to prioritise the nation’s health as he cites me as its inspiration (This is a life and death story for the UK – so why is it being brushed under the carpet?, 6 March). However, it is important to emphasise that the government is well aware of the gross health inequities that scar our nation and limit lives as well as economic prosperity, but chooses not to prioritise them. The ministerial response last month to the House of Lords report on ageing contains this shocking statistic: a girl born in Barnsley can expect an average of 53 years of good health, whereas one born in Wokingham can look forward to 71 healthy years – an extra 18 years.
Throughout the country deprivation accelerates ageing, which for many means an unnecessary premature exit from the labour market and premature need for social care. But the main focus of health policy is the manifesto commitment to reduce NHS waiting times, a target that has very little impact on health inequity. Instead, a radical programme is required to prevent the largely social and commercial determinants of ill-health, such as poverty, poor diets, lack of exercise, and air pollution.
In the absence of a national plan for health improvement (following Sweden two decades on), the regional mayors Andy Burnham and Oliver Coppard have produced their own 10-year initiatives to bear down on health inequities. If the government decides to change course these plans could easily be scaled up. But that requires a bold political choice to prioritise health as well as sickness.
Alan Walker
Emeritus professor of social policy and social gerontology, University of Sheffield
Aditya Chakrabortty is right to be outraged by the report on the decline of healthy life expectancy. However, it is but one metric that makes up a picture of health inequality, a principle that has hardly changed in a century or more. Health inequality is an issue that is rarely addressed with understanding in British politics and even less used intelligently to drive policy.
The Black report in 1980 and the Acheson report in 1998 precisely stated the failure to address these wider determinants of health, but their recommendations were never consistently pursued. The Tory administration put improvements into reverse after 2010, decimating the public health sector, for instance, but the issue was as crucial in 2010 as it is today. Sir Michael Marmot’s commitment to keeping this in the foreground is second to none. He said it in 2008 and it’s as true now, “social injustice is killing on a grand scale”.
Neil Blackshaw
Alnwick, Northumberland
Aditya Chakrabortty excoriates the Tories and Liberal Democrats for the economic austerity that led to the fall in our healthy life expectancy. He doesn’t mention Labour’s Gordon Brown or his chancellor Alistair Darling. In their manifesto, they warn of no fewer than seven “tough choices” should they win the 2010 election. These include £15bn “efficiency” savings, £11bn cuts in “overheads”, £5bn cuts in spending, £20bn raised from asset sales and, would you believe, 1p on national insurance contributions.
Sadly, all our parties share the blame for the groupthink that imposed mistaken neoliberal policies, and all need to learn lessons. With increased but fairer taxation we can already afford to treat the less fortunate with compassion and repair our public realm. We don’t need to wait for growth, we can do it now.
Peter Wrigley
Birstall, West Yorkshire
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