UK Policies Tackling Health Inequalities

Introduction

Health inequalities are avoidable and unjust differences in an individual’s health across the wider population and between the given groups of population. Some authors use ‘inequalities' in denoting the differences between 'inequalities' and groups to denote unjust and unfair differences between groups. Health inequalities tend to go against social justice principles because they are inevitable. They neither occur by chance nor randomly. They are determined socially by circumstances beyond the control of an individual. People are disadvantaged by these circumstances thus limiting their chances to live happily and longer. Health inequalities in the UK imply that the right of every person to the highest achievable standards of mental and physical health is not equally enjoyed across the larger population (Marmot & Bell, 2012). Health inequalities wealth research has been issued for a long period of time and a lot of it within the UK, where diminishing inequalities of health has been a stipulated policy given priority. A lot of effort has been put in place by the UK's government in order to reduce health inequalities concern, often supported by healthcare dissertation help. However, health inequalities have continued to widen. This has particularly been attributed to the absence of a public mandate for the policies of social-economy that a lot of studies suggest are needed. It has, therefore, promoted public health advocacy call to ensure that policymakers of the future have a well-defined public mandate in order to pursue policies that are supported by evidence (Ledwith, 2011). Advocacy of effective public health calls for consensus around coherent policy objectives. This paper extensively elaborates on mechanisms and initiatives that the UK's government has put in place in order to tackle health inequalities issue.

Uk's government for a couple of decades has been at the frontline in the battle of health inequities. It has implemented a lot of policies and different initiatives in order to reduce this major concern among the citizens of greater UK. Some of these policies and initiatives are discussed below.

The sure start policy: The UK policy of sure start initiative focuses on improving the chances of life for the families and their young children particularly those families that are living in poverty. This has been achieved by changing existing services pattern. Five hundred programs by the year 2004 reached approximately one-third of the number of children living in poverty and were present exclusively to those young children who resided in sure start sectors. It remains doubtful whether children living in poverty in other areas stand a chance to benefit on this policy.

The child poverty: The U. K’s government aimed at reducing the number of children that are living in poverty by a quarter by the end of 2004. U.K has the highest child poverty rates (measured using households with a total income of sixty per cent of the income of the median) of organizations for developing countries and economic cooperation; it stands at approximately twenty per cent (Davies et al., 2014). The policies entail aiming at marginalized communities, launching new benefits and increasing the levels of welfare benefit (which focuses on supporting workers that are less paid and child care subsidies). Some positive signs are evident enough even though the progress is inconclusive. There has been a significant fall in the number of children below sixty per cent of the median income, however, it is hard to assign these changes to policies. Majority of the children that have been relieved out of poverty were at the edge of the poverty line thus creating a residuary group that cannot be reached by the existing policies.

The initiatives of area-based

The UK's government has aimed at policies on particular geographical areas to battle poverty.

Health Action Zone: These partnerships of interagency were set up in twenty-six areas of poor health and deprivation in England, encompassing thirteen million people. Every HAZ focuses on devising and implementing a plan that battles health inequalities. HAZ has however suffered persistent organizational transformation since they were established in 1997. It has continually been used by the government as a tool for reforms in various sectors. For instance, resources of HAZ have been offered to the current primary caring trust (The prime minister office 2003). Health Action Zones have frequently set up projects of short-term that prove to be hard to integrate within organisations of the mainstream (Gilchrist, 2009).

Redistribution of Welfare.

There has been an overall and modest redistribution of welfare and income by the government to the poorer groups. However, redistribution traditional reforms (mainly taxation) has been met by rejection. The government considers paying employees as an ideal way of getting rid of poverty. Therefore, it has connected payments of benefit to employees. Policies of this kind provide reduced levels but do not deal with inequality since they don't care to progressively redistribute income.

Tax credits: Various tax credits have been introduced by the government to assist in the provision of employment based on befits for the adults. The “New Deal" programs (for the disabled persons and lone parents) that provide incentives such as employer subsidies and costs for childcare have been linked with these tax credits in order to allow a given group of people into employment. Their effect should be mild on employment. For instance, the tax credit of working family has been projected to elevate the rate of employment of single mother by three per cent points (Wininson & Pickett, 2010).

Health care: Healthcare remains to be a fundamental mechanism for implementation of policy even though it contributes very little in the battle against health inequalities. However, NHS continues to be the baseline in U.K health policy. The country in several instances directs its attention invariably towards the National Health Service, frequently stifling issues of public health. For instance, there has been a controversial debate about whether ministry for public health responsibility should be left within the DOH, dominated by the NSH (Brownell et al., 2010). The house of commons in 2001 issued a recommendation that the responsibility should remain with the DOH and its external profile elevated. A lot of reforms have been made by NHS however some targets have been made to cut down mortality and mobility from the "big destroyers". These targets include: A national target made on cancer to assist in reducing the rate of deaths in people living under the age of seventy-five by a fifth, to cut down the rate of deaths in people under the age of seventy-five by a tenth and to reduce the rate of deaths from undetermined injury and suicide by at least a fifth (Hall, 2015).

These targets were not set up in terms of inequality however they can cover minima targets. Focus on public health has been hindered previously by the specialist services dominance and organisational structuring. The newly formed organisational services have been entrusted with the mandate to commission hospital services, improve primary care and to tackle issues of health inequalities. The same pressure persists although PCTs are more focused on the improvement of health.

Agreement of public service.

These are forms of a contract between the spending departments and the finance ministry. A lot of departments possess PSAs that can contribute to a reduction in health inequalities. PSA's analysis outlines the necessity for greater connection between outcomes and policy, and coherent accountability. The expansion of the role of the ministry of finance in social policy is denoted by the public service agreement (Costello et al., 2009).

The targets of health inequality

The report of the Acheson failed to recommend the targets that should be applied in cutting down health inequalities. In the draft about the strategy of public health, it failed to propose and set a national target due to the complexity of the causation and interact with many factors. Therefore, in 2001 two national targets were set and introduced by the government to assist in reducing the gap in health inequalities. These targets included the following; commencing with the children below the age of one year, to reduce the gap at least by ten per cent by 2010 between the population as a whole and the manual group. Another target set was that by 2010, commencing with the health authorities, to reduce the gap at least by ten per cent of the margin between those areas with a low life expectancy during birth and the whole population. Intermediate indicators have been set up by the national government of the U.K to offer the much-needed support to these long-term objectives. There exists a contrast with the twenty-eight focus sectors that are linked with Healthy people and the ten leading indicators of health (Mathews et al., 2013).

The review of cross-cutting.

The ministry of finance set up reviews of cross-cutting to notify the spending of the government in areas that go beyond the spending departments portfolios. Health inequalities became the main subject of a review of cross-cutting in 2001. Civil servants committee from different departments reviewed sources of official data and research evidence (Gagnon & Labont, 2013). They realized the necessity for a long-term governmental strategy to battle health inequalities and the essence of controlling policy of mainstream in all government sectors. They recommend a powerful focus on areas that deprived programs to enhance physical exercise and nutrition.

Process and structure

Joined Up Government

Intricate problems are multi-causal and therefore interventions of policy call upon the government to literally work across all departments challenges faced by other nations that have schemed up strategies that closely relate to that of the United Kingdom. An approach of "system-wide" in batting health inequalities has proven imperative however JUG may not be an appropriate method necessarily required. For instance, the formulation of policy may entail several departments but a mandate for implementation may still rest with one (Hiscock et al., 2013). Alternatively, policies of physical distribution could be less prone to the fragmented government dilemmas. Since the 1980s, policy and organisational reforms have fragmented services of the public among different providers thus confounding coordination. Government departments for a long time have ensured logically ideal services delivery but these silos of "vertical" policy have curtailed horizontal coordination. Challenges that are found outside the vertical silos are assumed to be lacking proper central coordination. Therefore, "wicked" or complex challenges such as health inequalities initiate specific problems. Departmental culture has hindered collaboration due to institutional and personal incentives that discourage joined-up government. Ministers and policymakers are generally not elevated to pursue initiatives of cross-departments. As departments struggle for resources, activities of cross-departments offer an opportunity and a chance to shield departmental territory. These kinds of inhibiting factors are used strongly in health inequalities (Rhodes, 2009).

Conclusion

After several years in the "wilderness, " health inequalities and social determinants are on the agenda of U.K policy. The issue has been denoted has "problems" of policy. Many researches and report of the Acheson assisted in raising health inequalities profile across the government and issued the fundamental basis for the development of policy. As this was important, the policy has made a lot of progress and also encountered many challenges (Scamler, 2012). Finding the problem in the agenda of policy is a remarkable progress on its own. Progress has also been witnessed in processes and structures of policymaking and in acknowledging the effect of all policies on inequalities of health. Setbacks are manifest in the light evidence involving ideal interventions, insufficient evidence of transition in intermediate outcomes and markers, weaker incentive to maintain JUG, and bad integration of policies of health inequalities within the system of the mainstream. These methods have been used to address pitfalls and make progress and to offer lessons to other nations that are engaged in policy struggles. Accounting for pitfalls or progress elsewhere is triggered by the "policy window" application model as it triumphs over contextual explanation and enhances global comparison and transfer of policy (Bryden et al.,2013). The three teams have been coupled widely and the policy window slightly opened. While this move on smoothly for development policy of the future, there is a need to consistently maintain the confluence in the long-term in order to reduce health inequalities. Through this, the scope and nature of health policy change direction from just healthcare concerns to cover the health social determinants.

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