Community led public services can transform inequalities, says report

Date: Thursday 22 October 2015

UNISON Labour Link Media ReleaseLaunch of Commission on Health Inequalities report will take place at 22 October, 9.00am UNISON Scotland, 14 West Campbell St., Glasgow 

The report of the Commission on Health Inequalities for the Scottish Labour Party calls for national leadership and community hubs to tackle health inequalities.

The Commission for Health Inequalities set up by Labour’s then shadow health minister, Neil Findlay MSP, has published its report today (22 October 2015) calling on the Labour Party to adopt radical policies to tackle Scotland’s enduring policy failure of health inequalities. The commission report calls on Labour Party to adopt a transformative agenda if it wants to change political priorities of the Scottish Parliament on this issue.

The report aims to prioritise this agenda across government. It proposes a breadth of policies to tackle health inequalities in Scotland.

Key policy recommendations include building of community hubs, with local multi disciplinary teams that join up services in real localities and which would also serve as community meeting places, where communities are free to set their own agenda. They would include various public services based under the same roof including social work, housing, health and leisure services such as community cafes. With advice shops that offer amongst other things debt, welfare and income maximisation advice. (Para 3.6 of report). These are the type of services envisaged by Christie, who recommended services designed from the bottom up with citizens at their heart, with a high degree of professional autonomy for front line teams.

It recommends the adoption of a progressive universalism approach whereby important basic universal services are targetted and tailored in proportion to community needs.

And it recommends the introduction of health inequality impact assessments for every policy devised by public bodies in Scotland. In other words anything that the Government and every other body do must always take cognisance of its impact on health inequalities. This would ensure that the Scottish Government would take a cross portfolio approach. (para 3.3 in report)

Other policy recommendations include free childcare, an end to the council tax freeze, using the Scottish Parliament new welfare powers and using procurement to end low pay and poor employment practices

Dr David Conway, Chair of the Health Inequalities Commission said, “Health inequalities are the manifestation of inequalities in income, wealth, and power. They result in upto 30 years difference in life expectancy between those born in the richest and poorest neighbourhoods.

There have been many reports on Scottish health inequalities over the years. This commission report is different because it is firmly focussed on what we can and must do in Scotland to tackle this enduring problem. It is a national shame that we have some of the worst health inequalities in the developed world.  We need to debunk the myth that there are no devolved powers available to take on this huge challenge and get on and do something about it. The commission recommendations come from a wide consultation with experts working in communities, the health service, local government, and trade unions; as well as from community engagement events.

The testimonies we heard from people working heroically in their communities painted a graphic picture of the miserable reality of poverty and inequality and the inadequate policy and resources we put into tackling health inequalities in Scotland.

If we are ever going to solve this issue we are going to have to fundamentally change our political priorities and choices taken in the Scottish Parliament”

A full list of the policy recommendations are in the report, some are repeated in the notes below.



David Conway, Chair of the Health Inequalities Commission and contributing author 07970 594697
Dave Watson, UNISON head of campaigns and contributing author, 07958 122409


Commission on Health Inequalities Report  for the Labour Party in Scotland was commissioned by Neil Findlay MSP when he was shadow minister for health. It is supported by Socialist Health Association.
The document also calls for a range of policies to tackle low pay and poor working conditions including:

  • Agency workers given parity with full-time employees.
  • To use procurement to ensure better pay and conditions protection for workers including paying the workforce at least the living wage,  to incorporate the value of lost tax credits in peoples low pay, and to end zero hours contracts and blacklisting trade unionists.
  •  Ensure the ‘Scottish Real Living Wage’ is paid in the Social Care sector.
  •  Encourage collective bargaining processes.
  • Ensure all Fair Work Convention recommendations are implemented.
  • Establish a Scottish Health & Safety Executive.
  • Raise the levels of Social Security payments to a level conducive to the minimum income for healthy living.
  • Abolish the cruel sanctions regime.
  • Review all employment and welfare policies devolved in the Scotland Bill and ensure that they are used to maximum potential to reduce health inequalities.

It also calls for Scottish Parliament to:

  • Lift the council tax freeze. Reform the regressive Council Tax and consider options for fairer local taxation.
  • Build a minimum of 10,000 new social houses each year. Transform the quality and quantity of social housing across Scotland.
  • Introduce better regulation of private rented sector including effective rent controls and consider extending the Housing Quality Standards to the Private Sector.
  • Provide free childcare at the point of use and extend breakfast clubs and free healthy meals to nursery schools.
  • Ensure schools strive to develop social, emotional, health and wellbeing agendas as a foundation for learning.
  • Reverse Cuts and boost spending at Further Education colleges.
  • Tackle the Mental Health Crisis in Scotland – We strongly recommend that mental health services are prioritised and invested in as a matter of urgency
  • Create national targets for reducing health inequalities.
  • Create a Cross-portfolio Cabinet Secretary for Health Equity.