Higher Modern Studies Wealth and Health

1. Higher Modern Studies Wealth and Health

2. Areas of the course that can be examined are limited Causes of inequalities in wealth and health Extent of wealth and health inequalities Consequences of inequalities in wealth and health Government strategies to deal with these inequalities Success of these strategies The extent to which the founding principles of the Welfare State/ NHS are being met Collectivist v Individualist v Third Way debate

3. In 2007 the 2 Social Issues questions were; Causes of inequalities in wealth and health Extent of wealth and health inequalities Consequences of inequalities in wealth and health Government strategies to deal with these inequalities Success of these strategies The extent to which the founding principles of the Welfare State/ NHS are being met Collectivist v Individualist v Third Way debate

4. In 2008 the 2 Social Issues questions were; Causes of inequalities in wealth and health Extent of wealth and health inequalities Consequences of inequalities in wealth and health Government strategies to deal with these inequalities Success of these strategies The extent to which the founding principles of the Welfare State/ NHS are being met Collectivist v Individualist v Third Way debate

5. Poor education Benefit reliance Employment law Level of benefits Illness & disability Burden of taxation race Unemployment & Low Income Government policies Spending on health Health education Lone parents gender Economic policies which encourage or restrict growth Social class and health Complexity of the benefits system Illness and age education Health Health provision race age gender Discrimination and harassment Glass ceiling Types of job Pension levels Means- testing Career breaks Causes of inequalities in wealth and health

6. Government Strategies to overcome inequalities in Wealth and Health Wealth inequalities have an enormous impact on health inequalities Therefore the main Government strategy to overcome health inequalities is to tackle wealth inequalities.

7. Social Inclusion reconnecting people with work community education health Government strategies to tackle Wealth and Health inequalities

8. Government strategies to tackle Health inequalities Individual responsibility for health is promoted through education in schools, GP surgeries, clinics and hospitals and through advertising campaigns. Individual responsibility for wealth is encouraged through persuading people to get off welfare and into work. A major theme of the strategies of successive Labour Governments since 1997 is to promote more individual responsibility for health and wealth through… EDUCATION

9. Health promoting schools – encourage healthy eating and exercise Measures to tackle wealth inequalities “Working together for a healthier Scotland” Sure Start Help children and carers overcome social exclusion Healthy Living Centres To promote good health in disadvantaged areas Government strategies to tackle Health inequalities Reduce waiting lists Laws Anti -smoking Campaigns on TV in press and through NHS NHS GP practices to provide more education and preventative services Make more use of private sector Alcohol abuse Obesity and exercise Smoking bans in Scotland in England

10. Jobcentre Plus Welfare to Work Programme to tackle unemployment New Deal Low Income National Minimum Wage Working Tax Credit Gender and Race Government strategies to tackle Wealth inequalities Old Age Pension Credit New Deal, NMW etc to improve family income Children Employment Equality (Age) Regulations 2006 Winter Fuel Allowance Sure Start programme Uprating Child Benefit As above but also old equal opportunity laws and Equality Act

11. 1. Get more people back into work 2. Reduce the number of low paid workers 8. Modernise the NHS. 7. Reduce waiting lists and waiting times 3. Reduce and eventually eliminate the number of children living in poverty 6. Increase the the proportion of GDP spent on health in the UK and bring it up to the level of our European neighbours. 4. Reduce the number of elderly people living in poverty 5. Reduce the differences in health caused by social class Extent of success of current government policies to end wealth and health inequalities The main government policies

12. Extent of success of current government policies to end wealth and health inequalities TARGET 1 – to get more people back into work • SUCCESS • In February 2008 • 5.2% were unemployed - down from 7.2% in 1997 • 29.4 million people in work – highest number on record • Claimant count was 794,000 – lowest in 32 years • HOWEVER • Unemployment rate up from 4.7% in 2004 • Lower unemployment more to do with a strong than government policies and his risen since credit crunch. • Two-fifths of those getting work are out-of-work again within six months. 

13. Extent of success of current government policies to end wealth and health inequalities TARGET 2 – reduce number of people on low pay • SUCCESS • The proportion of workers aged 22+ who are low paid (£7 an hour in 2007) fell between 2002 to 2005 • The pay gap between low paid men and low paid women has narrowed. • HOWEVER • The proportion of low paid workers has not fallen between 2005 and 2008 • There is still a substantial gap between low paid men and low paid women • 50% of children living on a low income are in households where at least one adult is working

14. Extent of success of current government policies to end wealth and health inequalities TARGET 3. – reduce and eliminate children living in poverty • SUCCESS • The number of children in low income households fell from 4.4 million in 1999 to 3.8 million in 2006 • HOWEVER • The number of children in poverty is still 3.8 million • The government target was to reduce child poverty by 25% by 2006. They are 500,000 short of their target • 50% of children living on a low income are in households where at least one adult is working

15. Extent of success of current government policies to end wealth and health inequalities TARGET 4 – reduce the number of elderly people living in poverty • SUCCESS • The proportion of pensioners living in low income households fell from 29% in 1997 to 17% in 2006. • Among single pensioners, the rate has halved over the period, from 40% to 20%. • HOWEVER • 17% of pensioners still live in poverty • a third of pensioner households entitled to Pension Credit are not claiming it.

16. Extent of success of current government policies to end wealth and health inequalities TARGET 5 – reduce the differences in health caused by social class • SUCCESS • There is some evidence to show that mortality rates from cancer and heart disease are falling. • HOWEVER • The reduction in mortality rates from heart disease and cancer is across all socio-economic groups, so the health gap still exists • There is no evidence to suggest any progress in reducing health inequalities caused by social class in areas such as infant death and low birthweight

17. Extent of success of current government policies to end wealth and health inequalities TARGET 6 – increase the the proportion of GDP spent on health in the UK • SUCCESS • The government has raised spending on health to 9% of GDP which is similar to our European neighbours. • HOWEVER • Much of the extra spending went on increases in pay and other cost pressures such as the cost of drugs. Therefore the extra money available for extra patient services is only 2.4%.

18. Extent of success of current government policies to end wealth and health inequalities TARGET 7 – reduce waiting lists and waiting times • SUCCESS • Since 2000, the waiting lists have been shortened significantly and waiting times of more than 12 months have been eliminated. • HOWEVER • Some of the improvement has been the result of the way in which waiting times are calculated. For example counting the waiting time for each stage in a diagnosis and treatment not the overall wait time.

19. Extent of success of current government policies to end wealth and health inequalities TARGET 8 – Modernise the NHS • SUCCESS • In 1997, the average age of NHS buildings was older than the NHS (ie over 50 years old). In 2005, less than 25% are that old. • By 2005, the NHS had 68 new hospitals built or being built out of the planned target of 100 new hospitals • HOWEVER • Critics argue that PFI will cost the NHS more in the medium to long term which will cut services in the future and that many of these new hospitals reduce bed numbers and deliver poor quality buildings which will cost more.

20. Extent of success of current government policies to end wealth and health inequalities TARGET – Reduce ill-health by banning smoking in public places • SUCCESS • Researchers found a 17% drop in the number of people admitted for heart attacks in the year since the ban came into force, compared with an average 3% reduction a year over the previous decade. The reduction was most marked among non-smokers, with a 20% fall, compared with a 14% drop among smokers. • Other research published by the British Medical Journal, found a 39% reduction in second-hand smoke exposure among primary school children in Scotland, and a 49% reduction among adult non-smokers • The number of all heart attack admissions in 9 Scottish hospitals fell by more than 550, from 3,235 in the year to March 2006, to 2,684 in the year to March 2007. Among non-smokers, the reduction was from 1,630 to 1,306.

21. Summary • Causes of inequalities in wealth and health • Government policies • Unemployment and low income • Family size and structure (lone parent) • Age – old people and children • Gender and race Wealth inequalities have an enormous impact on health inequalities Government strategies to reduce inequalities • Social inclusion • Emphasis on people taking individual responsibility through education and incentives • Welfare to work • Advertising campaigns and health promoting schools and NHS • Directing resources towards the old and children • Legislation eg NMW or Smoking Bans The government has had mixed success in meeting its targets but overall it is more positive than negative.