By Derek McAuley Reproduced by permission of the Public Management and Policy Association. Although health inequalities have widened in the last five decades, tackling them is now central to the policy agenda of the New Labour Government. The author describes a need for innovative and exciting community-based solutions, but recognizes that a cultural change and new ways of working are required to move away from saving lives to promoting health. He argues that it is only by engaging with local communities that the NHS and local government will shift public perceptions away from health to health services.

The Social Exclusion Unit has launched a project to analyse the causes of low levels of employment and business start-ups in low-income areas. The project, which is part of a renewed focus on social exclusion and the root economic causes of community decline, aims to set out ways to increase jobs and business start-ups in order to close the gap and promote full employment in every region.Employment in the UK is at its highest level with over 27 million people in work. There are 242,000 more people in work than a year ago. Despite this buoyant employment scene, unemployment in the worst 5% of wards is more than double the average rate. The problem is complex because low income areas are sometimes close to economically vibrant areas suggesting factors other than shortage of jobs. Seven Sisters near Tottenham in London has claimant unemployment of 11.1% compared to 2.7% nationally despite being close to central London with good transport links to places with many job vacancies.

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A plan to integrate the NHS, social services, education, planning and employment to tackle widespread health inequalities has been announced by Health Secretary John Reid. The document provides a detailed toolkit for local organizations to change the way they deliver services to improve the health of disadvantaged groups.Launching the plan John Reid said: “Why should we accept that a man born in Manchester can expect to live, on average, ten years less than one born in Dorset and that a woman born in Manchester is likely to live seven years less than a woman born in West Somerset? And why should we accept that manual workers and some ethnic minorities appear condemned to suffer worse health just through an accident of birth?”

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