Scottish health: Inequalities still 'substantial', Audit Scotland says
Scotland still suffers from major health inequalities despite successive Holyrood governments treating the issue as a priority, a report has warned.
Spending watchdog Audit Scotland said that, despite improvements, differences between those from poorer and well-off backgrounds were still substantial.
The report said strategies to tackle the problem had seen little impact.
The Scottish government said it was focussing on the underlying causes of health inequality.
Opposition parties said people had a responsibility to take care of themselves - but called on ministers to do more.
The Audit Scotland report said overall health in Scotland had improved in the past 50 years, but there were still deep-seated inequalities, largely because of deprivation, although age, gender and ethnicity were also factors.
Men in the most deprived areas died 11 years earlier than those in the most affluent, with the age gap 7.5 years for women, said the report.
People in deprived areas also had higher rates of heart disease, obesity, diabetes and problems with drug and alcohol abuse.
Audit Scotland said it was unclear how much money NHS boards and councils were spending on the issue - and what it was being spent on.
It also said:
- GPs play a critical role in reducing inequalities, but their distribution does not fully reflect the higher levels of ill health
- The distribution of other primary health care services, such as pharmacies and dentists, is more closely matched to need
- National strategies which aim to improve health and reduce health inequalities have so far shown limited evidence of impact
- There may be a lack of shared understanding about what is meant by "health inequalities".
The Scottish government has now been urged to set national indicators to monitor progress on reducing health inequalities and to look again at how NHS resources and other spending is used to tackle the problem.
Caroline Gardner, the auditor general for Scotland, said: "Health inequalities are long-standing and entrenched in Scotland.
"Tackling this has been a priority for successive governments, but most indicators show the problem remains substantial."
Dr Alan McDevitt, chairman of the BMA's Scottish general practitioners committee, said: "GPs working in areas of high deprivation work in a particularly challenging environment and frequently see patients with multiple health needs and social problems.
"It is therefore difficult to provide the care each individual needs within the normal consultation time available and resources to support an increase to the average consultation time for GPs would mean they can spend more time with their patients."
Deputy Scottish Conservative leader Jackson Carlaw said: "I appreciate both the NHS and the Scottish government work hard in areas of deprivation to improve the wellbeing of people there.
"But this message clearly isn't getting through, and we need to understand why that is.
"Individuals, regardless of their background, also have to take responsibility for their own health."
Liberal Democrat health spokesman Jim Hume said: "Health inequalities result from social inequalities - poor housing, lack of opportunity and poverty.
"If the SNP is serious about creating a fairer Scotland, it must work across government to tackle this national sore."
Labour's Jackie Baillie added: "Everyone knows that our health inequalities are immense, but this report shows that five years into government, the SNP's health programmes lack focus, show few outcomes, health services are located in the wrong places and tracking progress is virtually impossible.
"Put simply, the SNP is failing Scotland's poorest and most deprived."
The Scottish government said it had recently reconvened its ministerial taskforce on health inequalities.
A government spokesman said: "The Equally Well framework sets out the Scottish government's strategy for reducing health inequalities, and this has already shifted the emphasis of our approach from dealing with the consequences of health inequalities to tackling the underlying causes such as poverty, employment, support for families and improving physical and social environments."
The spokesman added there was a strong emphasis on giving disadvantaged children the best start in life to boost their future chances.