Page last updated at 00:01 GMT, Friday, 7 November 2008

Revamp of 'failing' health plans

By Nick Triggle
Health reporter, BBC News

Elderly pensioner
Life expectancy varies greatly from place to place

Ministers are preparing to completely revamp their strategy to tackle health inequalities in what is being interpreted as an admission of failure.

The Department of Health has asked World Health Organization expert Sir Michael Marmot do the groundwork for a new approach for England.

It is highly unlikely the 2010 target to cut the gap in infant mortality and life expectancy rates is going to met.

Experts said the problem was the huge gap in wealth had not been addressed.

The news comes as European health ministers and leading academics gather in London for a summit on health inequalities.

I believe that the steps we are taking to tackle the determinants of poor health will reduce inequality and improve the overall health and well-being of this country
Alan Johnson, health secretary

Ministers in England have pledged to reduce the inequality gap - measured by infant mortality and life expectancy - by 10% between 1997 and 2010.

But government data published in March showed the gap between the richest and poorest has actually widened in the past decade.

The approach in England has been characterised by interventions.

These have included measures such as the appointment of a network of health trainers to get people fit to ploughing money into poor areas to create schemes like sure start for young parents and children.

But research released during the middle of the two-day conference cast into doubt the success of such schemes.

A University of London study into nearly 8,000 children looked at the impact of sure start schemes on 14 outcomes covering immunisation, accidents, social behaviour and obesity.

It found benefits for just five of the outcomes, the Lancet reported.

In contrast, Sir Michael's previous work for the WHO has focussed more on socio-economic factors such as work, wages and the local environment.

And ministers are now asking him to use that experience to identify what works and what objectives and targets need to be set.

Wealth gap

Professor Danny Dorling, a health inequalities expert from Sheffield University, said: "It is clear the government's approach has not been working.

"The problem is that it has focused on the health gap but been content to let the wealth gap widen.

"The two are linked and until that is addressed they will struggle."

The government said it was still aiming to hit the 2010 target, although admitted it would be difficult.

Health Secretary Alan Johnson said he was determined to tackle health inequalities, pointing out that there has been some progress in recent years.

"I believe that the steps we are taking to tackle the determinants of poor health will reduce inequality and improve the overall health and well-being of this country.

"But our focus on health inequality must be relentless - it must be an integral part of every aspect of health and social policy."

A Department of Health spokesperson said Sir Michael was in a strong position to build on the work that had already been carried out.

"Sir Michael is not reviewing our current targets but renewing our commitment beyond 2010."

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