Tackling Health Tackling Health InequalitiesInequalities

The Acheson Report (1998) The Acheson Report (1998) confirmed what had previously confirmed what had previously been identified by the Black been identified by the Black Report (1980). There was a clear Report (1980). There was a clear link between health and wealth.link between health and wealth.

Collectivism v Collectivism v IndividualismIndividualism

These are two competing These are two competing approaches to welfare provision approaches to welfare provision (state support). They can be (state support). They can be applied to the provision of health applied to the provision of health care and benefits. care and benefits.

CollectivismCollectivism

Traditionally, Labour have opted for a Traditionally, Labour have opted for a collectivist approach as they recognise collectivist approach as they recognise the link between poverty and ill health. the link between poverty and ill health. Forming the Government in 1997, they Forming the Government in 1997, they adopted this approach, which meant adopted this approach, which meant significant financial support would be significant financial support would be offered by the State, whilst recognising offered by the State, whilst recognising that some people needed more that some people needed more guidance than others in terms of health guidance than others in terms of health – The Nanny State. – The Nanny State.

IndividualismIndividualism

The Conservatives had previously The Conservatives had previously felt that ‘The Nanny State’ had felt that ‘The Nanny State’ had created an environment where created an environment where people failed to take responsibility people failed to take responsibility for themselves. Individualism for themselves. Individualism encourages people to be self-encourages people to be self-sufficient and not rely on others, sufficient and not rely on others, favouring private health care as far favouring private health care as far as possible.as possible.

Areas to ResearchAreas to Research

The Smoking BanThe Smoking Ban Age to purchase tobaccoAge to purchase tobacco Well Men Services/Well Men Services/

Well Men ClinicsWell Men Clinics Free School MealsFree School Meals Changes to Alcohol LawsChanges to Alcohol Laws HPV VaccinationHPV Vaccination Tackling ObesityTackling Obesity 5 a day/Healthy Eating Initiatives5 a day/Healthy Eating Initiatives Prescription Charges (Scotland)Prescription Charges (Scotland) Greater Provision of TreatmentsGreater Provision of Treatments

You must gather the following information:

Describe what this policy/approach actually is.

Explain who they are targeted at or who is most likely to benefit.

To what extent have they been successful?

The Smoking BanThe Smoking Ban

On March 26On March 26thth 2006, Smoking was banned in 2006, Smoking was banned in all public places in Scotland.all public places in Scotland.

By Summer 2007, this was the case for all of By Summer 2007, this was the case for all of the UK.the UK.

What groups would be most affected by this?What groups would be most affected by this?

Age to purchase Age to purchase tobaccotobacco The legal age for buying tobacco products The legal age for buying tobacco products

increased from 16 to 18 in the UK on 1increased from 16 to 18 in the UK on 1stst October 2007.October 2007.

In Scotland, cigarette vending machines have In Scotland, cigarette vending machines have been banned.been banned.

Vendors must also have a license as is the Vendors must also have a license as is the case with alcohol retailers.case with alcohol retailers.

Well Man Services/Well Man Services/Well Man ClinicsWell Man Clinics

These clinics specialise in male health care. These clinics specialise in male health care. Men can attend and have a general health Men can attend and have a general health check, sometimes known as a Health MOT.check, sometimes known as a Health MOT.

The hope is this will remove some of the fear The hope is this will remove some of the fear and possibly embarassment that men face in and possibly embarassment that men face in terms of their own health.terms of their own health.

The Health MOT could focus on diet, alcohol, The Health MOT could focus on diet, alcohol, smoking and exercise. However, you also smoking and exercise. However, you also have the opportunity to get advice on other have the opportunity to get advice on other issues that you wouldn’t want to discuss with issues that you wouldn’t want to discuss with your own Doctor. your own Doctor.

Free School MealsFree School Meals

In Scotland, all pupils from Primary 1-3 receive free In Scotland, all pupils from Primary 1-3 receive free school meals.school meals.

Furthermore, beyond this stage, those students Furthermore, beyond this stage, those students from families on a low income qualify for free from families on a low income qualify for free school meals. school meals.

There has been suggestions that there’s a link There has been suggestions that there’s a link between diet and educational attainment due to between diet and educational attainment due to increased levels of concentration. This is an increased levels of concentration. This is an attempt to address both health and wealth attempt to address both health and wealth inequalities. inequalities.

Changes to Alcohol Changes to Alcohol LawsLaws Alcohol can only be purchased from Alcohol can only be purchased from

off-licenses between 10am and 10pm.off-licenses between 10am and 10pm. No happy-hours.No happy-hours. Alcohol can only be displayed in Alcohol can only be displayed in

specific alcohol areas.specific alcohol areas. ‘‘Challenge 25’ – even if you look over Challenge 25’ – even if you look over

18 but under 25, expect to be asked 18 but under 25, expect to be asked for proof of identity. Supermarkets are for proof of identity. Supermarkets are now using this approach.now using this approach.

Proposed changes to Proposed changes to Alcohol LawsAlcohol Laws Minimum price of 45p per unit of Minimum price of 45p per unit of

alcohol.alcohol. ‘‘Social Responsibility Fee’ paid by Social Responsibility Fee’ paid by

retailers.retailers. ‘‘Loss Leaders’ no longer an option Loss Leaders’ no longer an option

for retailers.for retailers.

HPV VaccinationHPV Vaccination

This is now available to girls aged This is now available to girls aged 12 and over in an attempt to 12 and over in an attempt to reduce the threat of cervical reduce the threat of cervical cancer.cancer.

5 a day/Healthy Eating 5 a day/Healthy Eating InitiativesInitiatives

‘‘5 a Day’ is the name given to a number of 5 a Day’ is the name given to a number of programmes put in place to encourage programmes put in place to encourage people to consume at least five portions of people to consume at least five portions of fruit and vegetables each day. fruit and vegetables each day.

Is there a link between social class and diet?Is there a link between social class and diet?

What groups do you think this has been What groups do you think this has been targeted at?targeted at?

Prescription Charges Prescription Charges (Scotland)(Scotland)In Scotland, prescription charges are currently £3 In Scotland, prescription charges are currently £3

but will be completely free from April 2011. The but will be completely free from April 2011. The cost in England is currently £7.20.cost in England is currently £7.20.

The young, the elderly, those with long-term The young, the elderly, those with long-term conditions and on benefits already benefit from conditions and on benefits already benefit from free prescription charges, however, those on a free prescription charges, however, those on a low income look set to benefit from this.low income look set to benefit from this.

It’s also in line with one of the ‘Founding Principles’ It’s also in line with one of the ‘Founding Principles’ of the NHS – Free at the point of use.of the NHS – Free at the point of use.

Free Personal Care for Free Personal Care for the Elderlythe ElderlyPersonal care is available without charge for Personal care is available without charge for

everyone in Scotland aged 65 and over who everyone in Scotland aged 65 and over who have been assessed by the local authority as have been assessed by the local authority as needing it.needing it.

This cost £358 million last year and is predicted This cost £358 million last year and is predicted to rise to £813 million by 2031. to rise to £813 million by 2031. Subsequently, there are serious question Subsequently, there are serious question marks over future levels of provision.marks over future levels of provision.

http://www.scotland.gov.uk/Resource/Doc/305166/0095748.pdf

Greater Provision of Greater Provision of TreatmentsTreatmentsContinually improving technology and Continually improving technology and

research has allowed the NHS to increase research has allowed the NHS to increase the types of treatment it can offer. For the types of treatment it can offer. For example, cancer drugs like Avastin are example, cancer drugs like Avastin are now available, Gastric Bands are an now available, Gastric Bands are an option for those considered morbidly option for those considered morbidly obese and even plastic surgery has been obese and even plastic surgery has been offered.offered.

How successful have How successful have these policies been?these policies been?

Adult smokingAdult smoking remains high though significant remains high though significant progress has been made in reducing smoking progress has been made in reducing smoking rates from 31% in 1999 to 24% in 2009.rates from 31% in 1999 to 24% in 2009.

The Scottish Government target to reduce the The Scottish Government target to reduce the percentage of pregnant women who smoke from percentage of pregnant women who smoke from 29% in 1995 to 20% by 2010 was met in 2008, 29% in 1995 to 20% by 2010 was met in 2008, with figures reducing to 19.2%. with figures reducing to 19.2%.

Youth smokingYouth smoking is reducing from a peak of 30% of 15 is reducing from a peak of 30% of 15 year olds being regular smokers in 1996 to 15% in year olds being regular smokers in 1996 to 15% in 2008 and there is now a majority of Scottish 15 year 2008 and there is now a majority of Scottish 15 year olds who report never having smoked.olds who report never having smoked.

The Smoking Ban & The Smoking Ban & Tobacco LawsTobacco Laws

http://www.ashscotland.org.uk/ash/8388.html

http://health.caledonianmercury.com/2010/09/15/scotland-to-miss-smoking-reduction-target/00864

However again in deprived areas, smoking in However again in deprived areas, smoking in pregnancy is significantly higher with 30% of pregnancy is significantly higher with 30% of pregnant women in the most deprived areas pregnant women in the most deprived areas recorded as smoking, compared to 6.7% of those recorded as smoking, compared to 6.7% of those living in the least deprived areas. living in the least deprived areas.

There has been a decrease in the number of There has been a decrease in the number of heart attacks in Scotland. (See article below)heart attacks in Scotland. (See article below)

http://www.ashscotland.org.uk/ash/8388.html

http://www.telegraph.co.uk/news/uknews/1562787/Scottish-smoking-ban-cuts-heart-attacks.html

Well Man Services/Well Man Services/Well Man ClinicsWell Man Clinics

Many councils have failed to implement this Many councils have failed to implement this because of the cost involved. West because of the cost involved. West Dunbartonshire is the only Council who claim Dunbartonshire is the only Council who claim it will meet the target.it will meet the target.

10 local authorities have stated they have no 10 local authorities have stated they have no intention of implementing this.intention of implementing this.

Some have offered to provide free Some have offered to provide free breakfasts.breakfasts.

Free School MealsFree School Meals

http://www.timesonline.co.uk/tol/news/uk/scotland/article7086703.ece

Scotland has the 8Scotland has the 8thth highest alcohol consumption highest alcohol consumption rate in the world.rate in the world.

The average person drank the equivalent of 89 The average person drank the equivalent of 89 bottles of wine during the year, down from more bottles of wine during the year, down from more than 94 bottles, according to new statistics. than 94 bottles, according to new statistics.

It was the largest drop in alcohol consumed since It was the largest drop in alcohol consumed since 1948, as health concerns and the recession 1948, as health concerns and the recession encouraged consumers to cut back. encouraged consumers to cut back.

The UK are consuming 13% less alcohol than in The UK are consuming 13% less alcohol than in 2004.2004.

Changes to Alcohol Changes to Alcohol LawsLaws

http://news.bbc.co.uk/1/hi/scotland/7903584.stm

9 out of 10 eligible Scottish schoolgirls have 9 out of 10 eligible Scottish schoolgirls have had at least one injection to help protect had at least one injection to help protect them from cervical cancer. 92.6% had the them from cervical cancer. 92.6% had the first jab, 91.1% had the second jab and first jab, 91.1% had the second jab and 86.9% the third.86.9% the third.

However, there are concerns about the However, there are concerns about the uptake amongst those who’ve left school. uptake amongst those who’ve left school. 45.9% the first jab and 38.4% the second.45.9% the first jab and 38.4% the second.

HPV VaccinationHPV Vaccination

http://www.nursingtimes.net/whats-new-in-nursing/primary-care/hpv-vaccine-uptake-very-encouraging/5019694.article

Obesity in children is now common. In Scotland, Obesity in children is now common. In Scotland, nearly, one in five (18%) boys and over one in ten nearly, one in five (18%) boys and over one in ten (14%) girls aged 2-15 years are obese. (14%) girls aged 2-15 years are obese.

Britons are eating 1% less fruit and 11% less Britons are eating 1% less fruit and 11% less vegetables than they did in 2008.vegetables than they did in 2008.

5 a day/Healthy Eating 5 a day/Healthy Eating InitiativesInitiatives

http://www.telegraph.co.uk/health/healthnews/7572108/Britons-eating-fewer-vegetables-despite-5-a-day-campaign.html

Prescription Charges Prescription Charges (Scotland)(Scotland)

Free Personal Care for Free Personal Care for the Elderlythe Elderly

Greater Provision of Greater Provision of TreatmentsTreatments

Life Expectancy in Life Expectancy in CaltonCalton