Health Committee - Third Report
Health Inequalities
Here you can browse the report together with the Proceedings of the Committee. The published report was ordered by the House of Commons to be printed 26 February 2009.
Contents
Terms of Reference
Summary
1 Introduction
2 Health inequalities - extent, causes, and policies to tackle them
The extent of health inequalities
Measuring health inequalities
Causes of health inequalities
Lifestyle factors
Socio-economic factors
3 Designing and evaluating policy effectively
Inadequacy of evaluation
Difficulties in evaluating complex interventions
Poor design and introduction of interventions
Better evaluation
The ethical case for evaluation
Solutions
Conclusion
4 Funding for health inequalities
To what extent should health spending be redistributed to tackle health inequalities?
Tensions between the redistributive model and the NICE approach
NICE and health inequalities
How PCTs are funded to tackle health inequalities
The Resource Allocation formula
PCT spending on tackling health inequalities
Allocation of funds by PCTs
Choosing Health money
Cost effectiveness
Solutions
Conclusion
5 Specific health inequalities initiatives
Sure Start
Reasons for success and failure
The future: targeted or universal children's services?
Conclusion
Targets and the Cross-Cutting review
Progress towards meeting the target
Criticisms of the target
The Cross-Cutting Review
Conclusion
Support for 'Spearhead' areas
The national support team
The Health Inequalities Intervention Tool
Conclusion
6 The role of the NHS in tackling health inequalities
Clinical interventions to tackle health inequalities
Clinical effectiveness and cost effectiveness
Targeted vs universal
Treatment
Screening
Health promotion
Conclusion
Strategic Health Authorities and Primary Care Trusts
Leadership and commissioning
Public health
Access to services
Conclusion
Primary care services
The Quality and Outcomes Framework (QOF)
Beyond the QOF - other ways of tackling inequalities through GP services
Conclusion
Secondary care and specialist services
Referral to smoking cessation and other health promotion services
Conclusion
Early years NHS services—maternity and health visiting
Health visiting
Conclusion
7 Tackling health inequalities across other sectors and departments
Joined up working in Whitehall and Government
Joined up working at a local level
Nutrition
Teaching people to cook healthily at home
Food labelling
Conclusion
Health education and promotion in schools
,ul>Personal, social and health education
The wider role of schools in reducing health inequalities
Physical activity in schools
Conclusion
The built environment
A sense of identity and community
Green space
Access to health and other essential services
Physical activity and the built environment
Prevalence of fast food outlets
Conclusion
Tobacco control
Tobacco smuggling
Conclusion
8 A new approach to tackling health inequalities
Designing and evaluating policy effectively
Resource allocation and health inequalities
Specific health inequalities initiatives
Sure Start, Children's Centres and the early years
The role of the NHS in tackling health inequalities
Primary care services
Secondary and specialist services
NHS Early years services—health visiting and midwifery
PCTs and SHAs
Tackling health inequalities across other sectors and departments
Cookery and nutrition in schools
Food labelling
Health promotion in schools
The built environment
Tobacco control
Conclusions and recommendations
Formal Minutes
Witnesses
List of written evidence
List of further written evidence
List of unprinted evidence
List of Reports from the Health Committee
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