In his address to the Fabians today Alan Johnson drew a clear dividing line between Labour and Conservative approaches to health inequality. Johnson argued that a chasm has now opened up between the two parties. At a fundamental level, it’s a simple choice between “laissez-faire versus intervention. A policy of inaction or active government.”
This is what Johnson refers to as the ‘red meat’ of politics. It’s a pertinent time to raise the issue of health inequality, as this year marks the centenary of the publication of Beatrice Webb’s Minority Report, as well as being the 30th anniversary of the completion of Sir Douglas Black’s seminal work on health inequality.
Health inequality can be both complex and deeply entrenched, linked with a variety of social factors – from housing to education. As Johnson admitted at the lecture: “health inequalities are as important for Margaret Beckett [in her role as Minister of State for Housing] as they are for me.”
No-one doubts great strides have been made. Take child poverty: in 1998, 3.4 million children – one in four – were living in absolute poverty. This has now been halved.
Of course, there is still a huge amount of work to be done in combating health inequality. Social injustice is ‘still killing people on a grand scale’, as the last WHO report has demonstrated.
In today’s Britain, the difference between a long life or an early death is often still just a few miles: a boy in the suburb of Calton, Glasgow, can expect to live 28 years less than one brought up in nearby Lenzie. One born in Hampstead, London, will live around 11 years longer than a boy from St Pancras – just five stops away on the underground.
Britain can’t afford to repeat the mistake of the Thatcher government and ignore what Sir Douglas Black pointed out 30 years ago: that tackling health inequality will require a government that is prepared to confront the underlying issue of poverty with ambition, imagination and investment.
Or we could simply choose to leave the most vulnerable in our society to face the tender mercies of the market. But we’ve been down that road before, and the consequences were spectacularly dire. From the early 70’s to the early 90’s, the lifespan of the highest socio-economic groups continued to improve. The lifespan of the lowest socio-economic groups, however, not only failed to improve – they actually fell, for the first time since the Victorian era.
For all of Mrs Thatcher’s professed love for ‘Victorian values’, this is one element of the Victorian age we can all agree should have no place in today’s Britain.