Health inequality

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I sometimes wish we could have articles in the accountancy press of the sort that are published in magazines like the British Medical Journal. Last week a GP called Iona Heath had a stunning article in that journal under the title 'Let's get tough on the causes of health inequality. As Dr Heath noted:

The UK government has a clearly stated commitment to tackling health inequalities, while perversely allowing disparities in wealth to widen. The problem is that health inequality is directly related to socioeconomic inequality and cannot be separated from its underlying cause or solved independently. It is convenient for governments to believe that this can be done but the medical profession should not collude with them.

As she then noted, in the 1840s two profoundly important reports were written in London. One was on the need for improved sanitation. As Dr Heath notes:

the results were enormously beneficial, saved many lives and redressed health inequalities to some extent.

Most public health physicians think sanitation has done more for health than pharmaceutical products ever have.

The other report was Engels "The Condition of the Working Class in England". As Dr Heath notes of this:

Engels was primarily concerned with social justice and his work and influence led eventually to profound social upheaval and change in many countries, with enduring benefits for the poorest people.

Now I'm no Marxist. I have no idea if Dr Heath is. I don't really care to be honest. My point is this. Her claim is right if we consider the UK alone. We have reasonable working hours, protection for employees, the end of child labour, maternity and paternity leave, paid holidays and so many other benefits precisely because of a belief in social justice. Whatever the rights and wrongs of communism (and as it manifested itself it was clearly wrong) this distinct and separate social concern has delivered more good than sanitation. The benefit for health is therefore greater than that of both sanitation and pharmacy. But we are at risk of forgetting this. As Dr Heath says:

The UK remains a markedly unequal society, ranked 21st out of 27 in the European Union in terms of the proportion of the population living in relative poverty.

This creates health inequality. That is known to be true. In that case, whatever her motives Dr Heath is write to say:

Doctors have a clear responsibility to pursue political answers alongside technical ones and to seek out and draw public attention to injustice as a cause of ill health. ... Doctors have a responsibility for advocacy - to speak out on behalf of the powerless.

I think that true of accountants as well. So why aren't more doing so? Can it really be true that most accountants just don't care?


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