A report has criticised Theresa May for failing to match her rhetoric on health inequality after “watering down” a programme on child obesity.
The Health Committee called the Prime Minster’s decision to change the childhood obesity strategy “disappointing”, and said it was at odds with her promise to put the “burning injustice” of health inequality “top of her list for action”.
“The disappointing watering down of the childhood obesity strategy, published in August, demonstrates the gap in joined-up evidence-based policy to improve health and wellbeing”, the report said.
“In her first speech as Prime Minister, Theresa May put reducing health inequalities at the top of her list for action, highlighting the ‘burning injustice’ that if you are poor you will die on average nine years earlier than if you are rich.”
The committee also said last year’s cuts to public health were a “false economy” and risked widening health inequality.
“After taking on responsibility for public health, local authorities were dealt an in-year cut of £200 million last year and now face further real terms cuts to public health budgets. Cuts to public health and the front line services they deliver are a false economy as they not only add to the future costs of health and social care but risk widening health inequalities”, it said.
“The government must recognise that tackling health inequalities and improving public health will not primarily happen in hospitals, even though hospitals receive the lion’s share of health funding. Rather, it requires a whole life course approach, tackling the wider determinants of health in local communities, effective action on prevention and early intervention, and through joined-up policy making at a national level. There is a growing mismatch between spending on public health and the significance attached to prevention in the NHS 5 Year Forward View.”
The committee called for a new Cabinet Office minister position, which would be “given specific responsibility for embedding health across all areas of Government policy.” It said there was little evidence of progress in public health strategy across government departments.
It also called for the Government to put various health considerations into planning and licensing law, which it said would improve health in local communities.
“Public health does not primarily take place in hospitals but within local communities and the committee heard general but not universal support for the move of public health to local authorities but also concerns about the resulting fragmentation of some services and issues that have arisen over the transition.
“The Committee urges the Government to make good on its commitment to health in all policies by enshrining health as a material consideration in planning and licensing law. The Committee heard evidence that this would help local government to directly improve the health of their local communities and reduce health inequalities. Local authorities need the levers to be able to take effective action to protect local communities and this is especially important given the cuts to their budgets.”
It said that while some local authorities had seen progress, health outcomes varied, and funding should be managed accordingly.
“Changes to local government funding, especially the removal of ring-fencing of the public health grant, must be managed so as not to further disadvantage areas with high deprivation and poor health outcomes”, it said.
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