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70 years of the NHS, but health inequalities still exist

July 16th 2018

With the NHS marking its 70th birthday, Victoria Winckler acknowledges its successes but highlights that health inequalities still exist.

The last couple of weeks has, rightly, seen the 70th anniversary of NHS celebrated with everything from theatre performances, bed pushes, tree plantings, fun runs and multi-faith events at Llandaff Cathedral.

There is good reason to celebrate

The NHS has seen dramatic improvements in people’s lives, with increased life expectancy, a huge reduction in infant mortality, and some diseases like TB and polio have all but disappeared. New treatments for many cancers are transforming survival rates and common conditions like high blood pressure and diabetes can now be managed.

But it’s not all good news

The NHS is one of the most equal health systems in the world, but it isn’t perfect. There are barely noticed differences in access to general practitioners, to waiting times, to the likelihood of emergency admissions and even the risk of dying in hospital.

To that must be added the significant impact on health of having a low income, few educational qualifications, a harmful environment and individual behaviours.

The result is that men living in the most deprived areas of Wales on average live nine years less than men in the least deprived, while for women the gap is seven years. Not only are poor people’s lives shorter, they are also unhealthier with people in deprived areas being much more likely to suffer from diseases such as cancer, heart disease, diabetes and asthma to name but a few.

What should be done?

Of course we should celebrate the NHS – warts and all it is still by far the best way that the vast majority of people can get the care they need.

But we should not self-congratulate. We should be asking some tough questions about why the least well-off have the biggest burden of disease and then get the worst health care – a combination that is literally fatal.

In the NHS’s anniversary year, the Bevan Foundation wants to find some practical solutions to help narrow the health gap between rich and poor. We want to look wider than the narrative that blames people for their own illnesses – because they smoke / don’t exercise / don’t eat their five a day. We want to look at how well the NHS is serving the most deprived parts of Wales and at whether the real enemy of good health is not that plate of chips but a damp, cold home, a stressful workplace or not enough money to live on.

The NHS is under undoubtable  pressure – it is already changing and will continue to do so in the future. As it morphs into an NHS for the next 70 years, it needs to do even more to narrow the gap in health between people in the most and least deprived parts of Wales. This means a whole raft of changes are needed, both within the NHS and in the wider environment.

With the help of our supporters, we will shortly begin a very modest programme of work on these issues. If you can help with a donation, we would be really grateful –

Victoria Winckler is Director of the Bevan Foundation. 


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