Doctors alone cannot solve health inequalities
Though we live in a modern democratic country with a well deserved reputation for justice, freedom and fair play, we still do not provide a level playing field for all of our citizens. Of course there are all sorts of political dimensions we can discuss, but I want to look specifically at healthcare. As practicing healthcare professionals, we all know that some people are better able to use the NHS than others, meaning they can also end up receiving better healthcare. This is not a criticism of these individuals or of the NHS. The reasons for such health inequalities are numerous and diverse and include education, social class, expectations and experience. This clearly makes finding solutions difficult, but that should not deter us from trying.
A good example of health inequalities featured recently in the Univadis news service, in an article with the headline 'Inequality leads to late cancer diagnoses'. According to the article, "socio-demographic inequalities account for around 5,600 cancer diagnoses made at an advanced stage each year in England" (click here).
Interestingly deprivation correlated with late presentation of specific cancers such as melanoma, breast and prostate. Yet, the very next article published in the Univadis news tells us that one of the NHS Commissioning board's objectives is to make a positive impact on 'premature deaths' (click here).
Hopefully healthcare professionals will play a valuable role in helping to detect serious illness at an earlier stage. In turn, this could improve clinical outcomes, but we cannot achieve this completely on our own. It requires political, public health and media initiatives, changing of public attitudes and consistent high quality public education. In reality, these actions cost money, while issues like this rarely remain at the top of the political agenda and only occasionally attract widespread media attention. Who then, if the message does not get across to the general public, gets the blame? Why, doctors of course!
Dr Harry Brown, editor-in-chief Univadis
By Dr Harry Brown