Once-in-a-generation opportunity to tackle Scotland's health inequalities post-pandemic, say team of experts

The Covid-19 pandemic offers a once-in-a-generation opportunity to invest in Scotland’s health services and reduce health inequalities, a sweeping new report has found.

Staff attending to a patient in the ICU. Picture: Lisa Ferguson

A joint commission from the Lancet medical journal and London School of Economics has produced some of the most comprehensive analysis of the UK’s pandemic response so far.

It highlights how population health lags behind that of other high-income countries, and points to low funding, limited social care resources and health inequalities as key factors.

The commission, made up of 33 leading research, policy, management, and clinical experts from the four nations, calls for increased taxes to fund the NHS, a focus on recruitment and retention of staff, and better integration between health and social care.

Their research highlights inequalities between Scotland and other UK nations, with life expectancy lower in Scotland.

Scotland, Northern Ireland and the North of England also have worse oral health and higher rates of oral cancer, which the report attributes to higher rates of deprivation.

Health inequalities are related to politics, history, environment, and services, the commission’s report states, and while the NHS cannot address all underlying societal issues the authors argue it should be able to improve access to services.

The pandemic has highlighted these inequalities, with the greatest effects and highest mortality rates in deprived areas.

Professor Moira Whyte, co-author and Professor of Respiratory Medicine at Edinburgh University, said more must be done to address health inequalities in Scotland.

“Health inequalities within Scotland have widened in recent years – with women and men living in the least deprived areas likely to live 17 and 13 years longer in good health, respectively, than those in the most deprived places,” she said.

"There have undoubtedly been some positive developments, including free school meals and work to further integrate health and social care, but we need to do more to tackle the underlying causes that drive health inequalities if Scotland is to fulfil its potential to become a healthier nation.”

Co-research lead Dr Emma Pitchforth, from Exeter University, said the UK’s four nations must better work together to reshape the future of the NHS.

“Clearly all countries have differences in their systems, but we're arguing that there needs to be agreement on a level of collaboration and coordination around these key areas: workforce planning; preparedness for future health events; and common data,” she said.

“It is challenging to come to these agreements, but we're 20 years into devolution and it probably shows a maturity in devolution if we can have agreement in these common areas.

“We essentially have a common labour pool, and we still have common professional education and regulation, so it makes a lot of sense to be having better cooperation and coordination in these key areas.”

Candidate Mairi Gougeon said the SNP has pledged to remobilise the NHS after the pandemic.

"We will increase NHS frontline spending by at least 20 per cent, which will increase funding of frontline services by over £2.5 billion, and in the first 100 days of government, we will deliver a pay-rise for NHS staff, open the first three fast-track cancer diagnosis centres, and publish an NHS Recovery Plan,” she said.

“We will also lay the groundwork for vital longer-term reforms – including taking the first steps to establish a National Care Service.”

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