The King’s Speech: tough on health inequality, tough on the causes of health inequality
This King’s Speech has rightly been described as a plan for growth, but if you scratch beneath the surface it is also a bold plan to tackle the deep health inequalities that blight our country.
Health inequalities are the most pernicious form of injustice, meaning people live shorter and less healthy lives because of the inequalities they face. Within Labour’s health mission, there is an ambitious objective to halve the gap in healthy life expectancy, ensuring that more people live in good health for longer.
I have seen first hand just how important this pledge is as I led on a new strategy to tackle health inequalities in Bury, an area where on a short journey there are two streets with an 18 year gap in life expectancy between the richest and poorest.
Labour Councils across the country have shown deep ambition to tackle health inequalities in their areas, but for the last 14 years have come up against the challenges of a Government pulling in the opposite direction. For example, in 2023 the Government scrapped its Health Disparities White Paper. This stands in contrast to the passion of the last Labour Government, where Tessa Jowell announced new Public Health measures in the first 100 days and which later commissioned renowned epidemiologist Professor Sir Michael Marmot to conduct his landmark ‘Healthy Lives, Fairer Society’ report. Now, in Wes Streeting and Andrew Gwynne, Labour have people once again committed to making a difference to fighting this injustice.
But the reason that the impact of this King’s Speech’s on health has gone under the radar is because our public debate on health focuses on the medical and not the social. In his report, Professor Marmot found that the biggest driver of inequalities in health were the ’social determinants’, ranging from housing and employment to power. Those are the inequalities that this King’s Speech seeks to tackle.
One of the biggest social determinants is that of housing. The inextricable link between health and housing was acknowledged in a previous Labour Government when the founder of the NHS Nye Bevan was served as Health and Housing Secretary. Tragically, we saw this link all too clearly in 2020 when Awab Ishaak, a two year old boy in Rochdale died because of mould in his home. That is why the new Planning Bill is so important, by building the next generation of housing and upgrading our housing stock, the Government is investing in the health of future generations.
Another key social determinant of health inequalities is employment. Poverty, driven by poorly-paid and insecure jobs, is a driver of ill health, as we saw during the Covid pandemic. To address this, the King’s Speech contains an Employment Rights Bill, introducing a vast new swathe of powers to workers on zero hours contracts and fire and rehire. By implementing the New Deal for Working People and making work pay, the Government will boost wages, living standards and healthy life expectancy.
Likewise, evidence from across Public Health shows us that empowered societies are healthy societies. For example, when examining the impact of devolution on health inequalities in Greater Manchester between 2016 and 2019 the Lancet found a 0.7 year increase in life expectancy. This is not yet enough and much of this progress will have been eroded by the deep inequalities of the Covid years, but it demonstrates the clear link between devolution and tackling health inequalities. That’s why the Government’s announcement of a new Take Back Control Act is so exciting and is one of the greatest transfers of power from Whitehall to communities in British history. By devolving a swathe of new powers, not just to local authorities but to communities, the Government is building the empowered communities needed to tackle health inequity.
More broadly, tackling these social determinants show a tangible connection between politics and people’s lives. At a time when trust in politics is at a record low, this builds the vital story that this new Government is on their side and delivering in a way that they can feel.
So after fourteen gruelling and wasted years, rebuilding this country and its social fabric will be immensely difficult, but this King’s Speech shows that the new Labour Government is committed to being both tough on health inequality and tough on the causes of health inequality.
If you enjoyed this piece, see Healthy Homes: Labour’s Five National Missions Should Recognise The Connection Between Growth, Homes, And Health.
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