Thérèse Coffey is ditching the government’s long-promised white paper on health inequalities, despite the 19-year gap in life expectancy between rich and poor, the Guardian has been told.
The health secretary has decided to not publish a document that was due to set out plans to address the stark inequalities in health that the Covid-19 pandemic exposed.
It was meant to appear by last spring and be a key part of then prime minister Boris Johnson’s declared mission to level up Britain. It was due to set out “bold action” to narrow the wide inequalities in health outcomes that exist between deprived and well-off areas, between white and BAME populations, and between the north and south of England.
“It’s dead. It’s never going to appear. The white paper is being canned,” said one source familiar with the situation.
A second source with knowledge of Coffey’s intentions said: “The disparities paper is toast. My understanding of why they’ve pulled it is [that it’s] ideological — the white paper is an affront to this government’s view of what makes for health.”
However, the Department of Health and Social Care (DHSC) denied that Coffey had decided not to publish the white paper. “This is inaccurate. No decisions have been taken,” a spokesperson said.
Health experts reacted with dismay to reports of the paper being scrapped. “We expect the government to keep its commitment to addressing health disparities in an upcoming white paper and would have grave concerns if this long-planned paper were delayed or shelved,” said Dr Habib Naqvi, director of the NHS Race and Health Observatory.
“We need to see priorities and an action plan set out to address a number of serious and longstanding health inequalities. This should be a priority, particularly given the cost of living crisis and the impact this is having on diverse communities.”
Coffey’s decision follows the Truss government’s decision to review, with a view to scrapping, existing and planned measures to tackle the obesity crisis, such as banning buy-one-get-one-free offers and adverts for junk food being shown on TV before 9pm. That plan has sparked a huge backlash, with ex-Conservative leader William Hague, dozens of health organisations and 26 former health ministers all publicly criticising it as unwise and dangerous.
Sajid Javid, the then health secretary, told MPs on 2 February that he would publish “in spring 2022” a white paper on “health disparities”. It would tackle “unacceptable disparities in health outcomes” and help to “break the link between people’s background and their prospect for a healthy life”.
However, almost eight months on, it has still not appeared. Coffey’s DHSC has no plans to publish it, contradicting repeated pledges by Javid that it would do so. In May he said it would appear “shortly” and would address problems that have been “neglected for too long”, such as the shortage of GPs working in poor areas.
In June he said the white paper was an important part of his “vision for the year ahead”. However, he and then chancellor Rishi Sunak resigned from the cabinet on 5 July, in a move that set in train a series of events that led to Boris Johnson resigning as prime minister and being succeeded by Liz Truss, who has also made Coffey deputy prime minister.
The government committed to bringing forward the whitepaper when it published a separate white paper on levelling up earlier this year. However, it was a notable omission in Coffey’s new 14-page Our Plan for Patients plan to improve the NHS, which she unveiled last week.
“Health is inextricably linked to income, housing, education, employment and our environment, and while these issues can all be partly tackled through local interventions, we need sustained national policy action that is joined up across all government departments to really level up Britain’s health,” said Jim McManus, president of the Association of Directors of Public Health.
William Roberts, the chief executive of the Royal Society for Public Health, said: “It is incredibly disappointing to hear that the disparities white paper is being scrapped. This was a clear opportunity to tackle the vast inequalities and disparities that we currently face. Disparities have continued to increase over the last two years and are only set worsen with the cost-of-living crisis. To address this now is essential if we are to build back the nation’s health and wealth to help rebuild our economy.”
