18 September 2009

Closing the gap is a disturbing but unexpected report from the Care Quality Commission (CQC) about inequalities in health and access to health services in England.

The CQC report looks at smoking and cardiovascular disease; let me focus on the latter. Two quotations sum it all up.

There is an inequality in diagnosis and getting treatment: “The more deprived an area is, the less likely it is that GPs record CVD [cardiovascular disease], resulting in poorer access to treatment” (Closing the gap page 4).

There is a consequent basic inequality in final outcome: “Deaths from coronary heart disease are three times higher among unskilled men than among professionals, and around fifty percent higher in South Asian communities than in the general population” (page 9).

The chair of the CQC, Barbara Young, says robustly, “We cannot rest while health inequalities exist on the scale they do.” That is a positive approach and the commission makes practical recommendations for primary care trusts to improve their health services.

Cornwall as a whole is not among the most deprived parts of England but there are several deprived communities in the county. The CQC findings and recommendations presumably apply there. Some of the health inequalities associated with deprivation will be the result of the lifestyle and economic aspects of people’s lives and they can be difficult to change. However, it should be a priority in healthcare in Cornwall to tackle these inequalities, to bring everyone and everywhere up to much nearer the best. The primary care trust has a positive strategic aim of reducing inequalities but deprivation does not appear explicitly to be acknowledged.

Everyone who cares about people and life here should be ensuring that we “cannot rest” until we are doing very much better.