Professor Graham Watt claims there is an “astonishing” lack of detail in Scottish Government policy when it comes to tackling the problem.
Watt, who co-ordinates GPs working in Scotland’s most deprived areas, has spoken out following a report last week which said Scotland’s record on child health in poor areas was amongst the worst in Western Europe.
In a hard-hitting message to Nicola Sturgeon’s administration ahead of its budget, he suggested tax rises were required to alleviate the devastating impact on health of living in poverty.
He also accused the government of being reluctant to take action for fear of losing support ahead of a second Scottish independence referendum.
“Everybody has intellectual opposition to injustice, but in order to address it you need to have an understanding of how it operates at ground level within society,” said Watt. “That’s more difficult because it involves choices and decisions which in times of austerity are difficult decisions. That’s why politicians have turned their back on tax as a solution. But to try and get Scandinavian levels of care with American levels of tax just doesn’t equate.
“I think there’s a problem for a government which seems not to want to annoy anybody for fear of alienating support for independence. I wonder whether the government’s apparent wish not to annoy anybody with controversial policies is in order to protect its broad support for its main issue.
“Actually there is a bigger question, which is what kind of society do people want to live in and if the government can’t solve this particular problem then what’s so special about an independent Scotland? Ultimately are we a generous, giving, sharing society or are we an acquisitive, selfish non-sharing society? That’s the big question.”
Watt – who co-ordinates GPs at the Deep End, a group comprising 100 doctor’s practices operating in the worst-off parts of Scotland – was critical of the Scottish Government’s health plan.
GPs at the Deep End has been campaigning for more to be done to combat the “inverse care law”, which describes the fact that there is no more GP funding in deprived areas than in affluent areas, despite poor communities grappling with more severe health issues.
Watt was angered when there was no mention of this problem in the government’s keynote Health and Social Care Delivery Plan published at the end of last year.
“For the government’s NHS policy not to mention this particular issue is astonishing. If they don’t recognise it or talk about it, how can they deal with it?” he said.
Last week’s report by the Royal College of Paediatrics and Child Health highlighted Scotland’s poor record of unnecessary child deaths, obesity amongst youngsters and the health problems caused by poverty.
It found more than 210,000 Scottish children are living in poverty, 27 per cent are overweight or obese, and 400 children die each year, with a “significant number” of deaths potentially avoidable.
Watt expressed frustration that the problems identified by the report had existed for decades yet action had not been taken.
“I was writing about this 25 years ago and the grimmest thing about this report is that it is not new. It is discovered every six months and gets the headlines,” he said.
Speaking to Scotland on Sunday, Watt said some policies such as early intervention to improve health when children are still young were good in principle but not enough resources were being devoted to the problem.
“The policy that’s being prescribed is the right policy but the dose that is being prescribed is not sufficient. I think we have probably got good policies, but they are under-powered and under-resourced.”
More needs to be done to help family doctors in the poorest areas, who suffer more stress and have less time to spend with patients than those in rich areas, he added.
Watt said: “There is good evidence that in poor areas consultations in general practice are shorter, they achieve less and the GPs are under greater stress. It means that things that could be prevented or delayed, postponed or lessened, aren’t treated that way and occur as problems that require out-of-hours A&E emergency attendances.”
Treating the health of parents was also crucial to improving the outlook for children growing up in the most impoverished areas.
Last night Labour MSP Neil Findlay agreed more resources were required to tackle Scotland’s reputation as the sick child of Europe.
Findlay said: “Prof Watt hits the nail on the head. The government cannot go on pretending they want the best health services in the world and fair and equal society when there is no evidence of this being backed up by resources being redirected to areas of most need.
“The NHS delivery plan should have as its focus an all-out attack on health inequality with policies and resources from across government directed to this end, but I see no evidence of that. It also completely fails to mention the key issue of the inverse care law.
“Unless we address the fundamental issues, using the tax system and other levers, then there will be no impact on the health and wealth inequality that continues to scar Scotland.”
Public health minister Aileen Campbell said the Scottish Government was committed to tackling the impact of poverty on health.
“We recognise that deeply ingrained health inequalities continue to persist in Scotland, and we are absolutely committed to reducing these,” she said.
“At its root this is an issue of income inequality – we need a shift in emphasis from dealing with the consequences to tackling the underlying causes, such as ending poverty, promoting fair wages, supporting families and improving our environments.”