Lesson Starter Government Responses to Health Inequalities ‘The Government, not the individual, is responsible for ensuring people are healthy’ Do you agree or disagree with this statement? Give reasons to back up your point of view.

Today we will List and explain what the Scottish Government have introduced to try and tackle health inequalities and evaluate the success of these policies. Research and develop opinions on other government policies to reduce health inequalities.

I can… List and explain what the Scottish Government have introduced to try and tackle health inequalities and evaluate the success of these policies. Research and develop opinions on other government policies to reduce health inequalities using the internet.

Tackling Poor Health… As health is a devolved issue, most of the policies affecting the health of people in Scotland are decided by the Scottish Parliament. In 2008, the Scottish Government introduced its Equally-Well Policy. It focuses on young children as health problems that start then can last a lifetime. It aims to tackle the ‘big killer’ diseases: heart-disease and cancer. Reduce the problems caused by drugs and alcohol.

Task 1: The Scottish Parliament Scottish Parliament initiatives to tackle health inequalities In pairs, produce a diagram which outlines some of the things that the Scottish Parliament has done in an attempt to reduce health inequalities in Scotland.

You will now be presented with a variety of schemes that the Scottish Parliament has introduced to try to tackle health inequalities. As we go through them, add to your diagram. Scottish Parliament initiatives to tackle health inequalities

Government Responses to Health Inequalities and impact Smoking, Health and Social Care (Scotland) Act 2005 AKA “The Smoking Ban” (enforced as of 2006) Hoped it would dramatically reduce health inequalities in Scotland. A study of bar workers, using saliva, lung function and air quality tests, showed their respiratory health had greatly improved after the laws came in, thanks to the reduction in exposure to second hand smoke Estimated that the ban could save 600 lives every year. The ban was popular with British adults when it was implemented - and a recent poll of more than 12,000 people found that 78% of adults still support it

Government Responses to Health Inequalities and impact The Smoking Ban Amanda Sandford, research manager from Action on Smoking and Health (ASH) says it was long overdue. "When it started people wondered why we'd waited so long to do it. Non-smokers always found it unpleasant breathing in other people's smoke. "It is one of the most important public health acts in the last century. There's no question it's been hugely beneficial."

Government Responses to Health Inequalities and impact The Smoking Ban (2006) Results show benefits for health, changes in attitudes and behaviour and no clear adverse impact on the hospitality industry.

Abolition of Prescription Charges 2011 ‘Prescription charges are a tax on ill health, and can be a barrier to good health for too many people’ It will make a significant contribution to achieving a healthier Scotland. Cost will no longer discourage the sick from consulting their doctor. Nicola Sturgeon – Health Minister in 2011

Impact of Abolition of Prescription charges in Scotland according to the Scottish Government Hundreds of thousands of Scots with long term conditions are better off as a result of the abolition of prescription charges. Latest figures show that since 2007/08, the number of items dispensed for long term conditions such as asthma, crohns disease and diabetes has increased year on year, demonstrating the benefit of removing the barrier of cost. Since charges were scrapped in 2011, there has been an increase of more than 10,000 items for those with crohns disease and nearly 237,000 items for those with asthma. It is estimated that around 2 million, 40 per cent of the Scottish population have a long term condition. The policy is being held up as example of how decisions about Scotland are best taken in Scotland.

Impact of Abolition of Prescription charges in Scotland according to the Scottish Government Current Health Secretary Alex Neil said: “It is my firm belief that healthcare should be free at the point of access for everyone and that is why we scrapped prescription charges for all patients in Where we have the power to take decisions in Scotland, there are clear benefits for the people of Scotland. Prescription charges were nothing more than a tax on ill health that Scotland's poorest families could ill afford, and I am proud that in Scotland we took the decision to improve access to prescriptions for all. Scotland’s health service continues to lead the way, with take up of free eye examinations growing, and free personal care for all”.

Criticisms of Free Prescription Charges Ruth Davidson, Leader of the Scottish Conservatives said that “It’s well known across the UK there are free prescriptions in Scotland. What it doesn’t tell you is what that costs us. We have seen the number of nurses and midwives reduced by thousands. The people in Scotland are practically paying with their lives for this policy”. “The free prescription costs take money away from other parts of health spending. One of the contentions we in Scotland have had is that money could be used elsewhere within the health service.”

Minimum Pricing of Alcohol (2012) “It is no coincidence that as the affordability of alcohol has plummeted in recent decades, alcohol- related deaths, disease, crime and disorder have spiralled. It cannot be right that a man can exceed his weekly recommended alcohol limit for less than £3.50”. Nicola Sturgeon

Minimum Pricing of Alcohol (2012) Law changed so that each unit of alcohol costs at least 50p. Why? - People who are drinking at potentially harmful levels are most likely to benefit from the effects of minimum pricing. Research shows that people on a low income or who are living in deprived areas are more likely to suffer from a long term illness as a result of drinking too much. People who live in the most deprived areas of Scotland are six times more likely to die of an alcohol-related death than those in the least deprived areas.

Tackling Alcohol Abuse - impact Minimum pricing will impact most on harmful drinkers - those who regularly drink more than the sensible drinking guidelines. Those who drink within sensible guidelines will only be marginally affected simply because they only consume a small amount of alcohol and also because they do not tend to buy as much of the cheaper alcohol that would be most affected by a minimum price. The small increase in the cost of alcohol to moderate drinkers has to be seen in the context of the total costs of alcohol misuse - estimates suggest around £900 per year for every adult in Scotland.

Tackling Alcohol Abuse – positive impact Almost all drinks bought in the pub are already sold well above any likely minimum price, so they wouldn't be affected. The minimum price of 50p per unit will mostly affect cheap white ciders and value spirits with high alcohol content which tend to be favoured by problem drinkers. The Chief Medical Officer believes that - like the smoking ban - minimum price would save lives within a year. The University of Sheffield estimated that the proposed minimum price of 50p per unit would result in the following benefits:

Tackling Alcohol Abuse – positive impact Alcohol related deaths would fall by about 60 in the first year and 318 by year ten of the policy. A fall in hospital admission of 1,600 in year 1, and 6,500 per year by year ten of the policy. A fall in crime volumes by around 3,500 offences per year A financial saving from harm reduction (health, employment, crime etc.) of £942m over ten years.

Tackling Alcohol Abuse - negative impact To see the negative side look at the following link:

Tackling Alcohol Abuse - negative impact Reduce living standards for those on low incomes as it affects those on low incomes the most. There is already substantial tax on alcohol. “Tax on the poor”. Encourage people to switch to illicit ‘home brews’ and replacement alcohol. This is potentially dangerous as it leaves people exposed to alcohol of an unknown quantity and composition. It will be an easy way for supermarkets to increase their profits. The government would be better off just increasing tax on alcohol so that society pockets the extra cost rather than supermarkets. Then the tax revenue raised could be used to fund the cost of treating alcohol related diseases.

Tackling Alcohol Abuse - negative impact Five European wine-producing nations are trying to block Scotland's plans for minimum alcohol pricing. France, Spain, Italy, Portugal and Bulgaria have said the policy is illegal, unfair and ineffective and could have a devastating impact on the wine and spirits industry (impact on jobs, economy, EU relations, trade). Of the 12 countries which have written to the Commission to express their views on the matter, only Ireland supported minimum pricing. The legality of the law is already being challenged in court by the Scotch Whisky Association (SWA) and two other trade bodies. First challenge rejected by court in Edinburgh but appeal on-going. May eventually go to Supreme Court in London or European Court of Justice AS OF YET THE LAW IS NOT ENFORCED IN SCOTLAND

Comedian Danny Bhoy on Drinking LODnm_ghttp:// LODnm_g _query=scotland+and+alcohol – Scotland and Alcohol clipshttp:// _query=scotland+and+alcohol

Diet/Obesity In 2010, Scottish Government estimated the cost of obesity as £457 million, most of which was avoidable Predict that by 2030, 40% of Scots will be obese unless action taken Cost to NHS could be billions of pounds , SG invested £200 million in tackling obesity Various campaigns such as “Active Schools” and “Hungry for Success” aimed at tackling childhood obesity. Hard to measure success at this stage but Government initiatives based on extensive research and consultation with health experts – will hopefully lead to reduction in obesity in Scotland.

Free School Meals - All Scottish P1-P3 pupils will get free school meals from January 2015, First Minister Alex Salmond has announced. He said the move, affecting 165,000 youngsters, would boost health and was worth £330 a year for each child to families. Will remove any possibility of free meals being a source of stigma during the first years of a child’s schooling; it will improve health and wellbeing. Pros and cons? The Schools (Health Promotion and Nutrition) (Scotland) Act – aims to put healthy eating at the heart of each school’s activities. Giving young people balanced school meals. Banned “junk food” from school cafeterias. Introduce healthier food menus in schools. Stop the sale of sweets, salty snacks and soft drinks inside school. Set a legal limit on the age at which children are allowed out of school at lunch time. Aimed to establish uniform standards for all food and drink in school. Pros and cons?

Government Health Promotion and Prevention Campaigns Scottish government has launched campaigns to tackle the ‘big killers’. e.g. Alex Ferguson's lung cancer adverts Health and Education Board for Scotland (HEBS) adverts – HEBS now merged with NHS Scotland

Government Health Promotion and Prevention Campaigns Success or failure? Difficult to measure success – millions of pounds invested in campaigns and advertisements for healthy eating, anti-smoking and alcohol etc. tes/Communications/hlthpromtnspend - spending on health promotion tes/Communications/hlthpromtnspend – SG invested £30 million in cancer research. This will increase the number of people who benefit as quickly as possible from the world- leading treatment and support we have for cancer patients and their relatives and carers in Scotland, reducing the impact of cancer and, as a result, reducing premature death in Scotland.

Overall, have government policies and campaigns improved health in Scotland? Overall Scotland’s health has improved in recent years…in some ways at least Smoking rates down…

Government Health Promotion and Prevention Campaigns – Success? Life expectancy up…

Government Health Promotion and Prevention Campaigns – Success? Alcohol issues…slight improvement

Government Health Promotion and Prevention Campaigns – Success? Death rates from certain illnesses have decreased…

Government Health Promotion and Prevention Campaigns – Success? However…obesity has increased…still a challenge for Scottish Government…will new policies/campaigns change this???

Government Health Promotion and Prevention Campaigns – Success? Still inequality in health between social classes – poor tend to be less healthy than rich This is an on-going problem for Scottish Government. However perhaps government is already doing enough – when do individuals have to take responsibility for themselves? Also still inequalities between genders, ethnic groups

Government Health Promotion and Prevention Campaigns – Success? Remember for an essay on government responses to health inequalities... 1.Identify several examples of government policies/initiatives to tackle poor health (in separate paragraphs) 2.Give HARD FACTS (knowledge points) 3.Analysis – explain impact of policies 4.Evaluate – Overall impact of particular policies (i.e. success in most areas except obesity) 5.For overall conclusion…explain the extent to which particular policies have been successful and whether government policies have been successful or not overall…in your opinion.

I can… List and explain what the Scottish Government have introduced to try and tackle health inequalities and evaluate the success of these policies. Research and develop opinions on other government policies to reduce health inequalities using the internet.