More questions than answers

Written by Tom Freeman on 27 March 2015

Yesterday's debate on health inequalities, led by Health and Sport Committee convener Duncan McNeil was fascinating and frustrating in equal measure.

McNeil had some trouble switching his microphone on, which rather ruined his dramatic opening, but nevertheless his speech was an excellent summary of the frustrations experienced by the committee and others when trying to look at solutions to tackling health inequalities.

"For more than 40 years, health inequalities have been driven by a growing disparity in income, power and wealth. Not one of the successive Governments in Edinburgh and London—ours, the SNP’s and that of the Conservatives and the Lib Dems—has dealt with that successfully," said McNeil, who quoted from an excellent evidence session with former Chief Medical Officer Sir Harry Burns and Sir Michael Marmot of the Institute of Health Equity.

Harry Burns had told the Committee the story of health inequalities was “bedevilled by people who knew the answer”, remembered McNeil.

"We will not add to that bedevilment. We do not have an answer, but we have lots of questions," he said.

What followed was fascinating, because the conveners of several other committees stood to give an account of how their committee was looking at inequality, and how all the various inequalities are inextricably linked.

Murdo Fraser, convener of the Economy, Energy and Tourism Committee said the time set aside had been too short. "Today we have merely scratched the surface. I hope that we can return to the issue, which is of such importance," he said.

Justice Committee convener Christine Graham reassured McNeil the work of other committees was not tokenism but  "when the issue of health inequalities is relevant, we certainly build it into our programmes."

Former Labour Health Secretary Malcolm Chisholm raised Marmot's idea of 'proportionate universalism' which recognises both targeted and universal approaches must happen in tandem. "Although we must take action for the most disadvantaged, unless we also deal with the upstream societal issues and create a more equal society, we will never solve the problem of health inequalities," he said.

Recognition, then, from all sides that a 'whole of government' approach to tackle inequality is needed. But will we see any really brave decisions by this government or any future one?

In the meantime I thoroughly recommend watching the Burns and Marmot evidence session, which can be found on the Parliament's Youtube channel. It is probably the most profound session I have witnessed at Holyrood.

This was taken from Holyrood's weekly health briefing. You can sign up to receive it free every Friday morning here

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