Better data to inform resource allocation and more evaluation of government policies are needed to tackle the widening gap in health inequalities, MPs have concluded.
A report on health inequalities from the House of Commons Health Committee also recommends that the Quality and Outcomes Framework that GPs work to should be subject to radical revision. And it wants secondary care to become another focus of health inequalities work within the NHS.
The report says that although health in the UK is improving, health inequalities between social classes have widened over the last 10 years, increasing by 4% amongst men and by 11% amongst women.
It acknowledges the government’s commitment to tackling health inequalities but criticises the government for launching too many policies without evaluation of their effectiveness.
The MPs urge the government to introduce its forthcoming vascular screening programme with great care so it does not miss the opportunity to make sure it is rigorously evaluated.
The Committee also finds that although the neediest primary care trust will receive 70% more funding than the least needy in 2009-10, too many PCTs have not received their full needs-based allocation. It recommends that the Department of Health should move quickly to put that right.
However, it also says the government should commission a study of how much PCTs are actually spending on health inequalities and that there should be more joined up working between PCTs and local authorities.
Meanwhile, Peter Smith, professor of health economics at York University, told MPs that a major area for improvement was data about relative population needs.
He added: “At the moment, the researchers who developed the formulae are very hamstrung by the limited data they have available.
“In other countries, which have universal electronic records of their citizens, they can work out which citizens should be allocated more expected finance than others, and so, from an individual perspective, they can create, if you like, almost an insurance premium.”
On the QOF, MPs echo the calls of observers who have been calling for more reward for outcome and not just process, so that, for example, GPs are rewarded for success with smoking cessation and not just for identifying smokers.
“It is clear that the QOF needs radical revision to fully take greater account of health inequalities and to improve its general focus on the product of patient health.”
MPs also argue that the focus on health inequalities in the NHS should include secondary as well as primary care. It says an inquiry should be made into how policies such as the Payment by Results framework and Standards for Better Health might address health inequalities.
Useful links:
Health Committee report on health inequalities
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