Health experts from the Scottish Academy of Medical Royal Colleges and Facilities (“the Scottish Academy”) are calling for political parties to commit to ending all forms of health inequality, ahead of next year’s Scottish Parliament election.
The Scottish Academy represents the collective clinical and professional views of Scotland’s medical professions. It is warning that the lasting health impact of COVID-19 on Scotland’s poorest households – as well as on other vulnerable groups including the elderly and those living with disabilities – could be devastating unless mitigating action is taken by politicians.
The health impact of COVID-19 on low income households is already emerging. Research by the National Records of Scotland revealed that people from the most deprived parts of Scotland are more than twice as likely to die from COVID-19 as those from affluent communities. And the highest proportion of confirmed COVID-19 cases (24%) was accounted for by those living in the 20% most deprived areas, according to analysis for the Scottish Government.
The Scottish Academy, has proposed five key measures in its election manifesto which could help reduce health inequality in Scotland:
- Ensuring that everyone has income at a level that supports healthy living, through policies such as progressive taxation and guaranteed minimum income.
- Ensuring that everyone in Scotland has access to a high-quality education and that any barriers to higher educational attainment is removed for all groups.
- Improving access to active transport across Scotland.
- Taking bold action to address the societal damage of drug and alcohol misuse.
- A mandatory health impact assessment integrated into policy making in all Scottish Government departments.
These proposals recognise that the social determinants of health are as important as a high-quality NHS.
The Scottish Academy also believes that access to the NHS in Scotland can be improved by investing in digital resources, particularly for the most isolated in society, such as the elderly and those who live in remote and rural areas.
And their manifesto calls for an increase in the number of medical student places, to meet the needs for an increased medical workforce in the NHS in Scotland, as well as action to reduce drug and alcohol related harms.
Dr Miles Mack, Chair of the Scottish Academy, said:
“This has been a challenging year for healthcare services and staff in Scotland, as it has been around the world.
“The impact of coronavirus has been felt by us all. However, there is emerging evidence that the pandemic has disproportionately impacted people in Scotland’s most deprived communities.
“The Scottish Academy believes that urgent work must be undertaken to mitigate this, including policies to reduce the impact of the social determinants of ill health.
“In the lead up to the election next May, we are asking political parties to adopt our manifesto call for a commitment to end all forms of health inequality. We are also calling for better health by prevention, investment to build on new ways of working and better collaboration across all sectors in Scottish society.
“Alongside action on the social determinants of ill health, the Scottish Academy is looking for NHS leaders to identify solutions to address the risk of health exclusion, including digital exclusion, for vulnerable patients such as the elderly, particularly those living in remote and rural areas.
“The NHS must also focus on health education and prevention for all ages, ensure that equality impact assessments are undertaken in any intended service redesign, and resource health services according to the need of the population served.”
Professor Jackie Taylor, Vice-Chair of the Scottish Academy and President of the Royal College of Physicians and Surgeons of Glasgow added:
“The COVID-19 pandemic has brought out the best in our NHS and its staff, but has also highlighted the fundamental problems in terms of the underlying health of our population and the longstanding workforce challenges that we’ve faced for many years.
“The next session of the Scottish Parliament will be a vital period in the post-Covid recovery, development and delivery of health services across Scotland.
“A clear medical workforce strategy is urgently required to ensure that the NHS in Scotland trains and employs doctors with the right skills and knowledge to deliver the best possible health outcomes for our population. A pipeline of medical practitioners is required which meets the rising demands of our NHS.
“We must ensure that the voice of our profession is heard, so that the expertise and experience of Scotland’s health professionals is at the centre of the policies which are developed.
“We look forward to engaging with political parties and candidates from across the political spectrum to provide that expertise.”
Professor Mike Griffin, President of the Royal College of Surgeons of Edinburgh welcomed and echoed the Scottish Academy’s call for all parties across the political spectrum to work towards ending health inequalities in Scotland.
“This has to mean bold and active policy to improve transport, education and living conditions as well as investment in the Scottish NHS”, he said.
“The release of Sir Michael Marmot’s Build Back Fairer report this week highlighted the detrimental impact of the COVID-19 pandemic on already existing health and social inequalities across the UK.
“The Royal College of Surgeons of Edinburgh calls for Scotland to lead the way on tackling the issue of health and social inequalities through the proscriptions outlined in the Scottish Academy’s manifesto.”
Professor Angela Thomas, acting president of the Royal College of Physicians of Edinburgh said:
“We are pleased that the Scottish Academy is focusing on some key workforce issues, alongside health inequality, medical training, investment in the NHS including digital healthcare, and drug and alcohol related harms.
“This has been an incredibly challenging year for all of us, including our hard-working but exhausted healthcare staff, who have had their time to train, time to teach and time to research significantly reduced due to the pandemic.
“We need to ensure that we have a workforce who feel supported and are ready to continue taking on COVID-19 or similar challenges in future.
“It is vital, therefore, that priority is given to helping our healthcare staff make up for lost training and research time.
“And given the drug deaths crisis that we are currently in, it’s good that the Scottish Academy is committed to reducing drug related harms, as well as alcohol related harms – something that already heavily influences the policy work of the Royal College of Physicians of Edinburgh”.
Dr Carey Lunan, Chair of the Royal College of General Practitioners in Scotland welcomed the high priority that the Scottish Academy has given to addressing persisting and damaging health inequalities in Scotland:
“The COVID-19 pandemic has simply shone a spotlight on pre-existing health and social inequalities in Scotland. It has raised awareness of the plight of many of our most vulnerable citizens, but has also worsened many of the inequalities that they face on a daily basis.
“This is unacceptable and we need to ensure that as we rebuild our society, and the NHS, that the underpinning principle is equity. If the NHS is not at its best where it needed the most, then health inequalities will worsen further, and we cannot let this happen”.
The full manifesto document can be downloaded here: