The poorest people in Scotland are 72% more likely to end up in hospital emergency beds than the richest, according to a major new study today which reveals the impact of Scotland’s health inequalities on the NHS.
They are also 66% more likely to attend A+E and, on average, spend 22% longer in hospital than the wealthiest Scots.
Commenting today, former Prime Minister Gordon Brown, and the founder of Our Scottish Future, warns that unless health inequalities are closed, the NHS will “not be able to cope” with increasing demand.
It comes as Mr Brown holds an event today (Wednesday) with the UK’s leading health inequalities researcher Sir Michael Marmot on the inequalities crisis at St Bryce’s Church, Kirkcaldy. He is calling for the UK and Scottish Governments to work together on a new plan to slash the health gap in communities.
The OSF report finds that doing so would effectively solve the NHS winter crisis. If admission rates for the poorest were the same as the richest, it would free up 1,510 emergency beds every day, or 10% of Scotland’s entire capacity.
Similarly, it would slash A+E attendances by 670 people every day, reducing admissions by 16%
The report, entitled “Closing the Gap: How cooperation can reduce Scotland’s health inequalities” written by health researcher Andrew Mooney, proposes a series of wide-ranging reforms both in Scotland and across the UK to reduce health inequalities including more support for health care in deprived areas of Scotland.
It follows a major Health Foundation report also published this week which has examined the gap between rich and poor in Scotland.
Writing in the foreword to today’s report, Mr Brown declares:
“Scotland’s NHS will be unable to cope – and waiting lists will continue to be at record levels – unless we dramatically reduce the inequalities in Scotland that are causing poorer health among those on low incomes and a higher demand for accident and emergency services, hospital beds, and prescriptions.”
He adds: “The NHS urgently needs more investment and fair remuneration for its hard working nurses, ambulance workers, and staff. This needs to be matched with a strategy to end health inequalities which disfigure our country and cut short too many lives. This strategy should be based on a cooperative approach, with Scotland working hand in hand with the rest of the UK.”
The report’s figures are based on data provided by Public Health Scotland for financial year 2019/20, which set out hospital activity based on levels of deprivation.
They show that:
- The poorest quintile in Scotland had 72% more emergency bed days per head than those in the richest quintile.
- The poorest quintile in Scotland had 66% more A+E attendances than those living in the richest quintile. If the A&E needs of our whole society matched those of the least deprived quintile, A&E departments would have around 670 fewer people attending each day. This equates to 16% of daily A&E attendances in Scotland, substantially reducing demand.
The report blames the vast disparity on NHS use on a number of causes, primarily the lack of access to early healthcare intervention in deprived areas, and the more complex health needs faced by poorer households.
It makes a series of recommendations for both the UK and Scottish Governments to follow which, the report argues, will help reduce pressure on hospitals.
- Fully fund “Deep End” practices based in Scotland’s most deprived areas
- Give councils power to create a “Preventative Health Subsidy” to boost spending in poorer areas
- Create a UK wide Health Insights Unit, led by the four CMOs, to bring UK wide experts together to examine effective responses and communications
- A UK wide commitment to restore Children’s Centres to improve early years health
- A UK wide commitment to establish “SureStart+” centres to support teenagers
- Wider access to the Lifelong Learning Entitlement Scheme, helping people in mid-career retrain
- A UK wide consultation on the future of social security
- A Scotland wide data set to analyse health inequalities and a statutory health inequalities impact assessment on all policy
- A new UK wide network of “Marmot City Regions”
In his conclusion, author Andrew Mooney declares: “Today in Scotland, one of the great predictors to the life chance of a new-born child is where they were born. Our current crises, including cost-of-living, are already showing signs of adversely affecting health. Through cooperation, pooling our resources, and working together across the United Kingdom, we can address these challenges and ensure everyone benefits.”