GPs are the key to helping the NHS tackle health inequalities

GPs can help safeguard the future of the NHS by ensuring it is engaged in its core purpose, which is to reverse the inverse care law, Lord Victor Adebowale told the RCGP annual conference.

Lord Victor Adebowale (Photo: Pete Hill)
Lord Victor Adebowale (Photo: Pete Hill)

Lord Adebowale, chief executive of Turning Point a social enterprise that provides support services to people in some of the poorest parts of the UK, said that health inequalities should be at the core of all health and social care debate.

He said that life expectancy increases had stalled and ‘in places where Turning Point works it’s going backwards’. The gap between active life expectancy also meant that people in middle class areas were fit and active into their 70s, whereas if you’re poor ‘you’re starting to get ill at 50’.

‘I don’t know about you but I’m outraged about that because the NHS was designed to do the opposite,' Lord Adebowale said.

Inverse care law

Lord Adebowale said the inverse care law, which refers to the fact that those who need health and social care the most tend to get it the least, also cost the NHS about £4.6bn, which should make it a policy priority.

‘Inequality and inequity costs,’ he said. ‘It drives me crazy that it’s not the core [of health and social policy debate]. In 20 years' time that’s how the impact of the NHS is going to be measured because we’re going to be paying more and more for not dealing with that issue.’

GPs were at the forefront of tackling health ineqaulities, Lord Adebowale told the conference. ‘You are the people who in my view are going to protect and engage the future NHS in it’s core purpose, which is to reverse the inverse care law.’

He set out a number of ways he believed that GPs could do this. He said GPs should become involved in social enterprises because they were proven to work and they employ people from the poorest areas.

GPs should also engage with primary care networks because ‘when GPs come together to focus on population health you start being the seed of understanding that can drive things like integration. And there’s evidence that it actually makes your jobs easier because you’re sharing the challenge’.

GPs should also push for technology that helps to address the inverse care law and be involved in ‘co-producing’ solutions, Lord Adebowale said.

Finally, he said, GPs ‘need to help the policy makers answer the question’.

‘You should be taking the argument about the inverse care law to the policymakers,’ Lord Adebowale said. ‘You need to take the moral argument and the economic argument. It’s not a political issue – it’s common sense. It’s about the future of the NHS. It’s about why the NHS matters.

‘It’s reminding them about why the NHS is a religion in this country. It’s because we remember it’s one of the few services we created. It wasn’t created in Whitehall it was created by poor people for poor people in Tredegar.’

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