Scotland politics

Health inequality is Scotland's biggest issue, chief medical officer warns

Health inequality is the biggest issue facing Scotland right now, the chief medical officer has warned.

Sir Harry Burns told MSPs the issue could not be solved by the NHS alone, and more effort was needed from across society.

His comments came after a report from the spending watchdog said successive Scottish governments had failed to tackle health inequality.

Audit Scotland said there was a big gap between the poor and well-off.

The Audit Scotland report said overall health in Scotland had improved in the past 50 years, but there were still deep-seated inequalities, largely because of deprivation, although age, gender and ethnicity were also factors.

Men in the most deprived areas died 11 years earlier than those in the most affluent, with the age gap 7.5 years for women, said the report.

And it warned it was unclear how much money NHS boards and councils were spending on the issue and what it was being spent on, while adding that the location of GPs did not fully reflect the higher levels of ill health.

Social inequality

Sir Harry told the Scottish Parliament's public audit committee: "Health inequalities are the biggest issue facing Scotland just now, because not only are health inequalities a problem but health inequalities are really a manifestation of social inequality.

"Social complexity, social disintegration drives things like criminality, it drives things like poor educational attainment, it drives a whole range of things that we would want to see different in Scotland.

"The more attention we can get paid to the drivers of that situation, the better."

But Sir Harry also hit out at Audit Scotland's findings, telling the committee: "The unfortunate things about this report is that, if it had come out 20-odd years ago, it would have been really helpful.

"It doesn't pay much attention to the complex science that we now understand underlies the problem of health inequalities."

The chief medical officer added later: "I am very clear that we will not narrow health inequalities through actions taken by the NHS on its own."

The comment was echoed by Derek Feeley, chief executive of NHS Scotland, who said there was no simple solution to solving the issue.

He was also critical of the report, telling MSPs: "I do agree with the picture presented by Audit Scotland. I welcome their recognition of the scale and the scope of the challenge.

"I do regret however, the report is relatively narrowly focussed thereafter, once it does the analysis of the issue."

Mr Feeley also said indicators on the long-term monitoring of health inequalities were most recently published in October 2012.

And on the issue of NHS resources, such as GPs, he said: "Our priority to date has been not so much to dictate where practices should be located, but to work with GPs to make sure that the allocation formula and the contractual measures give sufficient propriety to deprivation - we're very willing to do more there."

The Scottish government said it had recently reconvened its ministerial taskforce on health inequalities.

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