Joint bid to tackle region’s health inequalities ‘would be a big step’

THE CHAIRMAN of the body representing NHS leaders says the next “big step forward” for the nation’s health service is the creation of a system where the NHS and other local services work together to tackle the health inequalities that blight Yorkshire.

Wakefield-born Lord Victor Adebowale, who chairs the NHS Confederation, says the huge life expectancy gaps between areas have been cruelly exposed during the pandemic and are an example of a “wicked problem” which can’t be solved in one go.

But he said bringing the health outcomes in the poorer parts of the country up to those of the most affluent was a key part of the Government’s “levelling up agenda” as he added: “There’s no wealth without health, so it’s not ‘either-or’, it’s ‘and-and’.”

Lord Adebowale, a ‘People’s Peer’ in the House of Lords and a former chief executive of social enterprise turning point, told The Yorkshire Post’s podcast Pod’s Own Country that the life expectancy in Hull was two years less than the national average.

He said: “And that’s a problem because your active life expectancy is also reduced. So you start getting multiple issues in your 50s instead of in your 70s. And then you’re in and out of hospital more. So it’s morally unacceptable and not why the NHS was established. It’s also economically and operationally unsustainable.

“So we have to tackle it. It’s unreasonable and irrational for us to have that kind of differential in life expectancy and active life expectancy across the country and within regions.

“Now, some of that isn’t all down to health. And as Michael Marmot, renowned epidemiologist, has pointed out, a lot of these issues related to housing, jobs, transport, etc.

“But health has a big part to play in ensuring that it actually works to reverse the inverse care law [where people most in need of care are the least likely to receive it] and not to exacerbate it.”

Lord Adebowale said that members of the NHS confederation, which represents the leaders of NHS trusts around the country, saw health inequalities as “in the top five issues of their concern”.

The Yorkshire Post has reported that poor health accounts for one third of the productivity gap between the North and the rest of the UK, at a cost of £13.2bn a year.

A possible solution, as Lord Adebowale describes it, is the concept of ‘population health’, where a health system is designed around a population in a particular area and measures are put in place that benefit everyone.

Something similar to this is already in place in West Yorkshire, where the integrated care system encourages hospital trusts, primary care, community services and local government to work together “to move the health of the population up”. He said: You could argue these problems are wicked problems, they have never been solved in one leap throughout the history of the health and social care movement.

“But they’ve been rapid steps forward, from the creation of the NHS itself in 1948, right through to the creation of NHS trusts and the primary care and primary healthcare and public health.

“So all these things have been steps forward. And the next big step forward, I think, is public health, by design, population health by design, and how we work with our partners in local government to deliver that single point of contact and healthcare for all, that’s the point.”

There’s no wealth without health, so it’s not ‘either-or’. Lord Victor Adebowale, chairman of the NHS Confederation.