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NHS can only be a 'sticking plaster' for rich and poor health gap

Efforts to close the gap have not 'made any significant difference', said a Holyrood committee.

Hospital Ward

The NHS cannot tackle the health gap between rich and poor by itself and can only provide a "sticking plaster" for such inequalities, according to the convener of Holyrood's Health Committee.

It has concluded that a "joined-up approach across a raft of policy areas" is needed to tackle the problem.

MSPs on the Scottish Parliament's Health and Sport Committee found that while there had been "many well-intended initiatives" aimed at reducing the differences in health between affluent communities and those in deprived areas "none has made any significant difference".

They also heard from experts that the effect of "lifestyle public health campaigns" encouraging people to eat more healthily, give up smoking, exercise more and drink less was "to widen inequalities rather than to narrow them".

The report said there was "agreement that some interventions, for example public health messages in relation to risky behaviours such as alcohol abuse, tobacco use, diet and exercise had been shown to have had little or no impact on health inequalities or, indeed, to have exacerbated them".

Committee convener Duncan McNeil said: "That your income, your education and where you live contribute to how healthy you are is an issue that as a society should bring us significant shame.

"Since devolution, successive governments have made this a political priority and invested significant amounts of public money in tackling this complex issue. But sadly none have made any significant difference."

He added: "Our NHS can offer a sticking plaster, but without a new approach we will not tackle the root causes of inequality and improve the health outcomes of thousands of people across Scotland."

In their report MSPs said that reducing health inequalities had been "a priority for every Scottish administration since devolution".

But they said: "Despite many well-intended initiatives, none has made any significant difference. Indeed, although health is improving, it is doing so less rapidly than in other European countries and although the latest figures are a little more encouraging, health inequalities remain persistently wide."

The committee concluded most causes of health inequalities are "rooted in wider social and income inequalities", as it stressed the need for a different approach.

The report said: "While there is no doubt that the NHS has a key role to play in tackling health inequalities and in measuring progress against the broad objectives of reducing health inequalities, it is clear that it cannot do so successfully entirely on its own, and the efforts to address the issue need to be made on a much wider number of fronts."

The committee is writing to the conveners of other Holyrood committees, urging them to consider what could be done to reduce wider inequalities, arguing this would "have a corresponding impact on health and wellbeing inequalities".

The MSPs said: "If real progress is to be made, significant efforts will, as we have stressed throughout the report, have to be made across a raft of policy areas and by different agencies collaborating and working more effectively together."

Bob Doris, deputy convener of the Health Committee, said: "There is no one size fits all solution to tackle health inequalities either for individuals or communities. There has clearly been the political will to tackle health inequalities, and our inquiry heard about groundbreaking work going on, for example to help young mums through the Family Nurse Partnership or through the early years collaborative.

"But we need to ensure that the NHS isn't left to pick up the pieces of wider inequalities, such as those being created by UK welfare reform, and that across Government health inequalities remain a priority - not just in health policy."

A Scottish Government spokeswoman said: "Scotland's health is improving, with people living longer, healthier lives. But despite our best efforts, health inequalities still exist. This Government is clear that these inequalities are rooted in poverty and income inequality and cannot be solved with health solutions alone.

"In the face of the UK Government's welfare cuts, we are using all the powers at our disposal, and working with all of our partners to tackle poverty and inequality and help people into work.

"Measures announced in the Programme for Government, coupled with decisive and targeted action to address alcohol consumption, reduce smoking rates, encourage active living, healthy eating and promoting positive mental health, all play their part in tackling health inequalities and delivering a more just society.

"Many people in Scotland are concerned about the welfare policies of the UK government and the implications they could have on them and their families. And that is why we want the necessary powers to develop a Scottish system which provides support for those who need it."

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