Lessons from the COVID-19 pandemic can help GPs tackle health inequalities

GPs can use evidence from the COVID-19 pandemic to put pressure on the government over tackling health inequalities, senior doctors have said.

Dr Iona Heath
Dr Iona Heath

Speaking at a Question Time-style event at the RCGP annual conference in London, held in association with the World Organisation of Family Doctors Europe (WONCA Europe), GPs said it was vital for the medical profession to use evidence of health inequalities exposed by the pandemic to drive change.

Asked when the health systems could begin to treat COVID-19 like flu or other seasonal illnesses, former RCGP president Dr Iona Heath said it was important that the UK did not simply go back to how things were pre-pandemic.

She said: 'In a way I don’t want us to get over it completely. The higher rate of COVID-19 has become pathognomonic of an unequal society. And we are doing nothing as far as I can see about tackling that fundamental underlying cause of the inequality in our country that has been reflected in such grossly different death rates across different demographics, races, income levels. It has been absolutely a mirror image of the injustices in our society.

Health inequality

'So I think we need to hold onto it in that way. The UK has had a very, very high rate, there are countries in Europe that have had a much lower rate and they have tended to be the more equitable countries.'

She added that the unequal impact of COVID-19 across the UK population meant it could be described as a 'syndemic' rather than a pandemic. 'It’s not a pandemic, it’s a syndemic,' she told the conference. 'In a pandemic everyone is at equal risk. In a syndemic you are at risk according to the context within which you live. We should call it a syndemic because that’s what it is.'

Dr Heath condemned the UK's failure to fully acknowledge the 'differential vulnerability of different communities' to the threat posed by COVID-19.

'The really distressing thing about surviving the pandemic in this country is our failure even to acknowledge to the degree required the differential vulnerability of different communities,' she said. 'And there seems to be absolutely no political will to do anything about it.

Pandemic

'Take the financial inequality [in society] - the income differentials are shameful and reflected in the pandemic. We have to keep pressure on government about socioeconomic inequality being the single biggest determinant of who lives and who dies.'

London GP Dr Oge Ilozue argued that the UK response to COVID-19 showed that 'if you put resources in you can deliver outcomes', and that this lesson could be used to drive down health inequality.

'COVID-19 revealed health inequalities, and we know health inequality exists,' she said. 'It is important to use the legacy and learning from COVID-19 and extrapolate that to other areas - cancer, diabetes, cardiovascular disease. There are certain communities - ethnic minorities - that have such poorer outcomes in every area and we need to do more to address that.

'We've seen with the pandemic that where there is political and economic will, things happen in terms of solutions. We need to make sure - we as GPs know where the needs are - and we need to keep the pressure up on what needs to have resource and political will put into it, working closely with public health.'

Children

Dr Heath also warned that a key message in terms of the differential impact of the pandemic on different parts of the population was the impact on children.

'We have learned that children are damaged when we shut them out of school and that young people are harmed when we try to educate them entirely remotely. I think there is an embedded message in that about remote general practice.

'We must never forget the harm that has been inflicted on the younger generations and especially on the children in the name of protecting people who are mostly of my generation or older. It is not the cultural tradition of any country for the young to be sacrificed for the old - and I think it's an interesting ethical challenge as we move forward.'

Read more from the RCGP annual conference

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