The government’s 10 Year Health Plan for England: A welcome emphasis on prevention and addressing health inequalities, but less focus on the people who experience them.
The government’s 10 Year Health Plan for England sets out a vision to “create a new model of care, fit for the future”. The plan addresses several key calls made by People’s Health Trust based on the views of members of our Network of hundreds of grassroots organisations working on the front line of health inequality. We particularly welcome a focus on poverty as a driver of poor health and the importance of prevention, equity, and local collaboration.
But it falls short on the detail that would bring these principles into practice to improve health, and there is no plan for enacting a cross-departmental health inequalities strategy by adopting a formal ‘Health in All Policies’ approach. There are some brief mentions of some of the most marginalised and digitally excluded people, but others are not mentioned at all.
1. We welcome the plan’s emphasis on the importance of prevention, recognition of health inequalities, and also how it is vital to address the social and economic determinants of health, particularly in communities that experience the sharp end of poverty. This was our central ask in our consultation submission. However, aside from short sections on housing, good work, and aspects of addressing child poverty, the detail and substance of what this will mean in practice is limited.
2. While the plan does make clear that addressing health inequalities will address the government’s health mission, it does not substantively relate the plan to other missions of government. In our submission, we said it is vital that the government recognises the role of its other missions in the prevention of ill-health and does not see it only as a health system responsibility. Our call for this is exemplified through our work as part of the Inequalities in Health Alliance.
3. We specifically called for an equity approach in health, and we are pleased to see several mentions in the plan that equity plays an important part in health. This includes intention, in places, to focus resources on the places that have the highest levels of inequality both in terms of access to healthcare and in the wider social determinants of health. As we said in our submission, we know that equity is crucial to the removal of inequalities in health and we look forward to working with the government to explore ways that equity can be implemented across all aspects of the plan.
4. There is recognition of the value of partnerships and involvement of civil society in delivering this plan. However, we and our Network of community organisations will want to understand more clearly the ways and extent to which civil society organisations will be compensated for their work, and involved in co-design and delivery of the proposed ‘neighbourhood health services’, and this isn’t set out. Without being grounded in a wider anti-poverty strategy, suitable funding models that enable meaningful collaboration, this ambition will not be realised.
5. There is only brief attention or recognition of health inequalities in relation to class, racially minoritised communities, disabled people, older people, homeless people, people with learning disabilities and other people with protected characteristics, and no reference to LGBTQ+ people, people in prison, or people seeking asylum. As we stated in our submission, it will be vital that the 10 year plan takes fully into account the impact of protected characteristics, and class, in relation to health inequalities.
6. Given the emphasis on digital services and routes to increased access via apps and online platforms, we are concerned there is only one passing reference to homeless people, no mention of people seeking asylum or migrants, and very few references to older people. Without significant consideration of digital exclusion and access, including availability and affordability of this technology, much of this plan’s emphasis on digital healthcare could make this divide greater.
In the weeks ahead, we will continue to scrutinise the plan, and seek to influence its implementation to ensure that voices of experts in our Network of grassroots community organisations at the front line of tackling health inequalities continue to be heard.
Email SupportUs@peopleshealthtrust.org.uk if you would like to partner with us in our mission to stop people dying too young.