Lesson Starter

1. Lesson Starter • Outline the health inequalities that exist in the UK today.

2. What will I learn? The UK and Scottish Governments’ attempts to reduce health inequalities

3. Overview • raising the age to buy cigarettes to 18 years • national targets, eg to reduce heart disease, cancers • smoking bans introduced in Scotland (2006) and England (2007) • plans to abolish prescription charges in some parts of the UK • health promotions in specific local councils, eg breakfast clubs, fruit in schools, the Fuel Zone Points Reward Project were pupils collect points for making healthy food choices and can later redeem them for cinema tickets, video games, etc • banning of cigarettes vending machines in Scotland • banning of happy hours and other drinks promotions to curb binge drinking • free fruit in primary schools P1 and P2 • free school meals P1 – P3 in Scotland

4. What has been achieved? The Smoking Ban • Hoped it would dramatically reduce health inequalities in Scotland. • Recent health statistics indicate that Scots are living longer and that the death rates from cancer and heart disease are declining. • 2011-smoking rates amongst girls and boys has decreased. • Estimated that the ban could save 600 lives every year. • NHS revealed that the number of Scots giving up smoking has beaten the Scottish Government targets.

5. Give it up for the Baby • NHS Tayside has launched an initiative which offers pregnant women £31.50 per week in grocery vouchers if they give it up. • More than 40% of pregnant women in deprived areas of Tayside smoke during pregnancy.

6. Essay Practice • The Government has been unsuccessful in addressing health inequalities in Scotland. Discuss.

7. The government has been unsuccessful in addressing health inequalities to an extent and this essay will examine the arguments. • One area which the government has been successful in addressing is in relation to smoking. The UK has very high levels of smoking related illnesses and the government has been actively involved in tackling this issue. Smoking Bans have been introduced in Scotland (2006) and England (2007) in an attempt to discourage people from smoking and to reduce the impact of second hand smoke. In addition, other legislation has attempted to tackle the problem. The banning of the sale of tobacco in vending machines and the increase of the age to buy tobacco to 18 have been deliberate attempts to cut the number of smokers. There has already been a positive impact. Since 2011, the numbers of young people smoking has reduced and it is estimated that the Smoking Ban saves the lives of 600 Scots per year. Furthermore, the number of people quitting smoking has beaten Government targets. Therefore, it is clear that the Government has been successful in addressing health issues in the UK as anti-smoking legislation has led to a reduction in smoking-related deaths.

8. Do Health Campaigns Work? • A Fairer Healthier Scotland -commitment to focus on the biggest health challenge facing Scotland – health inequalities. • Spend millions on health campaigns. • Evidence suggests that the cuts in health promotion has seen the number calling drug abuse support line has fallen. • Another example is where the Government axed the flu vaccination campaign - a rise in deaths from flu.

9. Tackling Alcohol Abuse ‘It is no coincidence that as the price of alcohol has plummeted in recent decades, alcohol-related deaths, disease, crime and disorder have spiralled. It cannot be right that a man can exceed his weekly recommended alcohol limit for less than £3.50’

10. Tackling Alcohol Abuse • Scottish Government responded to the alcohol problem by introducing the minimum pricing on alcohol. • Nicola Sturgeon claimed it would lead to 1200 fewer hospital admissions annually. • ‘For too long many Scots have been drinking themselves into an early grave’ • Harry Burns supports the measure

11. Critics of the Minimum Pricing • Drinks industry. • Labour stated that it was a “tax on the poor” which would raise the profits of the supermarkets. • Will make no difference to problem drinks like Buckfast, but it will punish pensioners and people on low incomes.

12. Continue paragraph on Government attempts to tackle alcohol abuse • Make your point • Explain in detail with solid examples…mention government legislation. Discuss the positives and negatives of this government response. • Mini-conclusion – explain how what you have said answers the question.

13. However, it could be argued that the government has not been successful in tackling health inequalities in relation to alcohol abuse. Scots drink more than in other parts of the UK and this means that Scotland has higher levels of liver disease and other alcohol related illnesses. In response the Scottish Government introduced the 2012 Alcohol (Minimum Pricing) (Scotland) Act. This set the minimum price per unit of alcohol to 50p and it is hoped that in time it will lead to a reduction in heavy drinking and lead to less hospital admissions for alcohol related health issues. However, there are many critics of this Act. For example, the prices of many “problem” drinks such as Buckfast are unaffected by the legislation and others have increased in price only slightly. On average a 4 pack of Tennents lager only increased in price by about £1. This shows that perhaps the legislation is not having the desired impact and that therefore the government has been unsuccessful in tackling health issues in relation to alcohol.

14. Equally Well Report 2008 • Key points from the report: • Health inequalities remain a significant challenge in Scotland • The poorest in our society die earlier • National and Local government and NHS, schools and employers all need to work together to reduce these inequalities.

15. General Health IssuesEqually Well Report 2008 • Emphasis to be placed on Early intervention • Getting it Right for Every Child (GIRFEC)- identifying children’s needs at any age and bringing together agencies that should be involved in their lives. • Health and Wellbeing as part of the Curriculum for Excellence. • Schools Health Promotion and Nutrition Act

16. Decline in Children’s Tooth Decay • An April 2011 report concluded that tooth decay among young people was at its lowest ever level. • Across Scotland 64% of 11 year olds are decay free.

17. Prescription Charges • ‘Prescription charges are a tax on ill health, and can be a barrier to good health for too many people’ • Too early to tell in Scotland but in Wales having a positive impact. • Has not led to a massive increase in prescription dispensed.

18. Arguments in Favour • It will make a significant contribution to achieving a healthier Scotland. Cost will no longer discourage the sick from consulting their doctor.

19. Arguments Against • Real cuts are being made in the NHS. Cannot afford to lose £57 million of income every year. The money is needed to employ more nurses and to provide better care.

20. Diet and Obesity • Working Together for a Healthier Scotland was influenced by the James Report (The James Report was a review of the health of young people in the UK) • Main aim was to try and stop children eating junk food.

21. Main Proposals • Introduce healthier food menus in schools. • Stop the sale of sweets, salty snacks and soft drinks inside school. • Set a legal limit on the age at which children are allowed out of school at lunch time • 2007 Schools Health Promotion Act • Aimed to establish uniform standards for all food and drink in school.

22. Critics of the Act • Some argue that it has had little impact in secondary schools. • Secondary pupils are allowed to leave school at lunchtime and may buy fatty foods and fizzy drinks.

23. Case Study: Healthy School Meal Scheme • Scottish Government in 2002 launched its £63.5 million initiative to get school children to switch from junk food to healthy eating- ‘from stodge to salads’. • Foods or drink with a high sugar or salt content were to be phased out and fresh fruit and water were to become the recommended food and drink.

24. However… • A report by Cordia, the company responsible for the catering highlights that tough regulations and legislation on health school meals has led to many pupils, especially Glasgow secondary pupils, rejecting canteen meals in favour of fast-food outlets. • Uptake of school meals in Glasgow has plunged from 61% in 2006 to 34% in 2010. • It is argued that because of the strict regulations that Scottish pupils now have a worse diet due to their rejection of school meals.

25. Devolution and the Welfare State • Within the UK, spending on health per person is higher in Scotland than in England. (Barnett Formula) • As health is a devolved power, decisions on health policy in Scotland are now made in Edinburgh not London.

26. Improved Health? • We have entered the age of austerity where cuts are being made to public services and unemployment is increasing- this will impact upon people’s health. • In general, the health of all citizens is improving. • Life expectancy of a man living in Glasgow has increased by 2.6 years. • The health gap between affluent and poorer areas has widened . • The gap in male life expectancy between East Dunbartonshire and Glasgow has risen from 6 to 7 years. • Smoking Ban success- 200,000 Scots have given up smoking over the last 10 years. • Scottish rate for declining coronary heart disease is not as good as the rest of the UK. • So much still has to be done with declining resources.