Call for immediate action to address health inequalities
News from BACP

15 September 2021

We’ve co-signed a letter to Boris Johnson along with other members of the Inequalities in Health Alliance

We’ve joined a call for the Prime Minister to take immediate action to address health inequalities that continue to disadvantage many people in society.

We’ve co-signed the letter to Boris Johnson along with nearly 200 organisations as part of the Inequalities in Health Alliance (IHA).

The letter calls for a cross-governmental strategy that addresses the underlying causes that are a barrier to good physical and mental health for many people.

The IHA believes that this strategy should consider the role of every government department and should identify the policy changes required on national issues - such as housing and employment - that will be relevant for all communities.

Our Third Sector Lead Jeremy Bacon said: "It’s important that this call to address health inequalities includes mental health.

Recognises barriers

"Our own work on developing our equality, diversity and inclusion strategy has a wide scope, and as a starting point recognises the many barriers and impediments that people from marginalised and disadvantaged communities face in getting the help that they need.

"There’s an important role for local organisations that understand and connect to communities to work to remove these barriers, but we also need government to adopt strategies across all departments that reduce disadvantages and their impact."

The COVID-19 pandemic has brought to light deep-rooted inequalities and the IHA believes that many deaths could have been prevented had there been better levels of general health before the pandemic.

The gap in healthy life expectancy between the richest and poorest in England was two decades prior to the pandemic, and one third of people aged 25 to 64 were economically inactive as a result of long term sickness or disability.

Our member Mel Halacre is a clinical director and therapist at Spokzpeople CIC, a not-for-profit organisation developing a disability-affirmative therapy approach.

She’s also a member of our Equality, Diversity and Inclusion Task and Finish group, working to develop our EDI strategy.

Overlooked

Mel said the mental health of people with disabilities has been ignored and overlooked by policy-makers and service commissioners for years.

"Often people with disabilities are getting by on very low incomes. Paying for private therapy just isn’t an option, and it is extremely difficult to access services that have a true understanding and ability to respond to the specific needs of disabled clients.

She added: "Service planning and commissioning remains narrowly focussed on physical needs at the expense of an holistic approach that includes understanding and responses to the range of complex and individual emotional and mental health needs.

Greater understanding

"We need a greater understanding of the hidden factors that prevent people accessing the support and help that they need to live healthy and productive lives, and a cross-governmental strategy focussed on addressing health inequalities is a vital step for individuals and society as a whole.

"As a profession, I hope that therapists without disability experience will draw upon their own COVID challenges to help them better understand their disabled clients."

The Inequalities in Health Alliance has requested a response and meeting with the Prime Minister to discuss its call.

Dear Prime Minister

We are writing as senior representatives of the Inequalities in Health Alliance (IHA) to ask you to take bold action to level up health as we move into the next phase of pandemic recovery.

Since our first letter in October 2020, we have been encouraged by the commitments your government has made that signal a welcome move towards a more joined-up approach to reducing health inequality. The Office for Health Improvement and Disparities and reference to ‘a new cross-government agenda which will look to track the wider determinants of health and reduce disparities’, the cross-government ministerial board on prevention and the Levelling Up white paper all hold great potential to be the catalyst we need to tackle health inequalities.

We now hope that you will take the next step: strengthen and underpin this work with an explicit cross-government strategy to reduce health inequalities, involving all government departments, led by and accountable to you.

The IHA membership represents patients, communities, doctors, nurses, public health and social care professionals, dentists, pharmacists, local authorities and others. Through this broad membership we have seen how the physical and mental health of people of all ages is affected by issues that are often beyond the control of the individual, and beyond the remit of the Department of Health and Social Care and the NHS.

It is children whose asthma is aggravated by the mould in their home or the traffic outside it. It is people who miss their hospital appointment because they can’t afford public transport or poor infrastructure make the journey a struggle. It is people who do not have the kitchen facilities to cook healthier food – and would not have the money or access to knowledge to do so even if they did.
Many deaths could have been prevented if there had been better levels of general health before the pandemic. The recovery from COVID-19 must be a turning point for the health of the nation.

Before the pandemic, the gap in healthy life expectancy between the richest and poorest in England was almost two decades. And that has a toll on individuals, regions and the country as a whole: in the areas of England with the lowest healthy life expectancy, more than a third of those aged 25 to 64 are economically inactive due to long-term sickness or disability. If we want to level up and build back better, we need an explicit health inequalities strategy, with clear measurable goals, that considers the role of every department and every available policy lever in tackling health disparities.
While it may seem that health inequality is a matter for the Department of Health and Social Care and the NHS, health and social care services can only try and cure the ailments created by the environments people live in. If we are to prevent ill health in the first place, we need to take action on issues such as poor housing, food quality, communities and place, employment, racism and discrimination, transport and air pollution.

A comprehensive cross-government strategy will reduce the cost to the public purse – health inequalities were estimated to cost the UK £31bn to £33bn each year before COVID-19. But a strategy will also, in the long-term, reduce pressure on and provide savings to the NHS. If we can improve levels of general physical and mental health, we will reduce the need for costly clinical interventions as people live healthier, more productive lives.
The areas with highest need should be prioritised for action and funding, but a nationwide cross-government approach will identify the policy changes required on national issues that will be relevant for all communities. Most, if not all, will improve our country’s economic health at the same time: as the Confederation of British Industry has said, better infrastructure will benefit businesses as well as the wider communities of which they are a part.

The Royal College of Physicians, as convenors of the IHA, has today published a short policy briefing setting out the case for a cross-government strategy to reduce health inequalities, which is enclosed. We would welcome the opportunity to meet to discuss this and how we can work with you and your government on this agenda.

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