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Tackling inequalities key to Scotland's future - Minister
19/06/2008
A radical rethink of Scotland's public service delivery was unveiled today to tackle health inequalities.
Public Health Minister Shona Robison told the Scottish Parliament that urgent action was needed to turn around the prospects for Scotland's vulnerable and disadvantaged people.
Launching Equally Well, the report of the cross-cutting ministerial task force on health inequalities, Ms Robison described it as a blueprint to achieve generational transformation.
The report highlights the £1.78 billion being spent on tackling health inequalities over the next three years but recommends that this resource can deliver better outcomes by re-designing public services. This is backed by £15 million of new money to achieve this aim.
The Convention of Scottish Local Authorities - which represents Scotland's local authorities who are responsible for delivering key services such as housing, education and social work - have been fully involved in, and are fully supportive of, the task force's work.
Equally Well puts particular emphasis on the early years as that is when opportunities are greatest to create health by forging appropriate behaviour patterns and the ability to relate well to other people.
Ms Robison said:
"In a modern Scotland, it is scandalous that children can be condemned to a life of poor health and poverty simply because of where they were born or their family's circumstances.
"To make a lasting difference and achieve the generational transformation we desire, joined up working is crucial as is a focus on the very early years of a child's life.
"What is different about the approach we are proposing is that it will shift the emphasis from dealing with the consequences of health inequalities to tackling the underlying causes.
"Securing such radical change cannot happen overnight. However, just because something is difficult, or will take a long time, does not mean that we should not do it.
"I believe the rewards - in terms of a better quality of life for those who have the least - will be worth the efforts in our drive to make Scotland equally well."
COSLA's Health and Well-being Spokesperson, Cllr Ronnie McColl, said:
"COSLA fully supports the report of the task force. Scottish Local Government is determined to tackle health inequalities - it is a fundamental injustice that a person's health and well-being should be determined by social circumstances not of their choosing. Of course, many of the key services local government provides - education, social work, economic regeneration, housing - already help to improve the health outcomes of the most vulnerable people living in our communities. Yet, it is clear that we need to do more. That is why this report, with its emphasis on partnership working and early intervention, is so important.
"We need to become more proactive in tackling health inequalities. If we do not do this, we will merely be falling back on a strategy that addresses the manifestations of disadvantage rather than tackling the source of disadvantage. Consequently, nothing will change: poverty and other social inequalities will continue to place vulnerable families at risk. We know that it will be difficult to generate change and we appreciate that our objectives must be long-term; but with determination and leadership from the Scottish Government and COSLA, I believe that our aspirations can be realised."
The Chief Medical Officer Harry Burns said:
"In a long career in which I have been involved in many attempts to tackle health inequalities, this strategy seems to me to be the most innovative and the most likely to succeed.
"It is based on a comprehensive search for the underlying mechanisms which drive health inequalities, and a consideration of the policies most likely to deal with them. The challenge now is to turn the strategy into real action."
Key proposals in today's report include:
- Working with NHS Lothian to implement the Nurse Family Partnership approach to provide intensive support for young mothers. This is an intensive programme of home visits by highly trained nurses which aims to improve pregnancy outcomes, children's health and development. It will also aim to improve families' economic self sufficiency by encouraging young mothers to aspire to improving their lives by, for instance, finding work.
- Working with four NHS boards to strengthen school nursing and the wider school health resource, especially in the most deprived areas. Work has already begun and £7 million of new funding is available over the next three years to take this forward.
- £4 million funding available for Lloyds TSB Foundation's Inspiring Scotland programme to improve play opportunities for children most in need, recognising the importance of physical and social environments on health and wellbeing.
- Engaging with employers and the business community to open up job opportunities for people claiming health-related benefits who are able to move into work.
- The expansion of Keep Well checks to identify and support people with depression and anxiety.
- Development of a framework for regular health assessments for people with learning disabilities across Scotland.
An implementation plan will be published before the end of 2008 which will give further details about how Equally Well will be taken forward.
A number of test sites will be set up, in which clusters of public services will be redesigned, to demonstrate how change can improve people's health and wellbeing. The test sites will see public services working together with input from residents and frontline staff to gain an understanding of how people's interactions with services affect their health.
Key statistics:
- Life expectancy for men from the most deprived areas is 13 years lower than the Scottish average.
- Babies born to mothers living in the most deprived communities are more likely to have a low birth weight than those in the least deprived areas.
- The suicide risk for those living in the most deprived areas is double the Scottish average.
- Smoking accounts for almost a quarter of all deaths in Scotland. Smoking rates in the most deprived areas are four times higher than in the least deprived areas.
The ministerial task force on health inequalities brought together ministers from across the Scottish Government as well as representatives from the Convention of Scottish Local Authorities. Members included:
- Public Health Minister Shona Robison
- Community Safety Minister Fergus Ewing
- Schools Minister Maureen Watt
- Communities Minister Stewart Maxwell
- Children and Early Years Minister Adam Ingram
- Enterprise, Energy and Tourism Minister Jim Mather
- Environment Minister Mike Russell
- Chief Medical Officer for Scotland Dr Harry Burns
- Director, Glasgow Centre for Population Health Professor Carol Tannahill
- COSLA spokesman on Health and Wellbeing Councillor Ronnie McColl
- Chair of NHS Lanarkshire Ken Corsar
- Chief Executive of Lloyds TSB Foundation for Scotland Andrew Muirhead.