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HEALTH SECRETARY'S PLANS TO IMPROVE HEALTH IN POOREST AREAS

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The secretary of state for health, Alan Milburn, yesterday announced that the government will publish the first-eve...
The secretary of state for health, Alan Milburn, yesterday announced that the government will publish the first-ever health inequalities targets for England. They will concentrate on reducing infant mortality rates and the number of premature adult deaths in the poorest parts of England.
Speaking at the Royal College of Physicians, Mr Milburn also announced that there will be a new national service framework for long-term health conditions. Eighty thousand schoolchildren in 510 schools will also start receiving free fruit in schools from today to improve child health and nutrition.
The new infant mortality target aims to reduce the gap in infant deaths between different social classes. Starting with children under one year, the target for 2010 will be to reduce by at least 10 per cent the gap in infant mortality rates between manual groups and the population as a whole. There is also a target to reduce, by at least 10 per cent, the gap between the fifth of health authorities with the
lowest life expectancy at birth and the population as a whole by 2010.
Mr Milburn said: 'In poorer communities the NHS now has a key role to play. By working in partnership with local people, local government and local organisations the NHS can make a huge contribution to narrowing health inequalities. And to focus the efforts of the NHS we will now set for the first time ever clear national targets to reduce those health inequalities.
'Our first national target will be to reduce health inequality amongst children. Health at the beginning of life is the foundation for health throughout life. There is clear evidence from long-term studies that health status in the first years of life can be tracked throughout life. There is a clear gradient in infant mortality
between social classes too.
'We are the first government committed to the eradication of child poverty. The measures we have taken are lifting 1 million children out of poverty. Now we make a new commitment to help ensure every child has a fair start in life.
'So our first health inequality target is: to reduce the health gap between children in different social classes. Starting with children under one year, by 2010 we will reduce by at least 10 per cent the gap in infant mortality between manual groups and the population as a whole.
In setting this target, we expect the national infant mortality rate to fall for the first time below 5 deaths per thousand live births by 2006 and to result in approximately 3000 children's lives being saved by 2010.
'The wider action we are taking will help deliver these commitments. But achieving this ambitious target will require more specific action too.
'So we will extend sure start, a government-wide programme to increase opportunities for disadvantaged young children, so that it reaches one third of under 4s living in poverty by 2004.
'There will be targeted help for pregnant women to give up smoking because of its correlation with miscarriage, low birth weight and high levels of perinatal death.
'I can announce that we will develop a new national service framework for long term health conditions. The NSF will have a particular focus on the needs of people with neurological disease and brain and spinal injury.
'It will include services for people with epilepsy, Multiple Sclerosis, Parkinson's Disease and other similar conditions. The NSF will overcome the lottery in care and ensure health and social services work together in all parts of the country to provide the right level of care and treatment for people with long term health conditions.
'Those people are more often poor or live in the poorest parts of our country. There is a particularly strong correlation between social class and long-term health conditions such as diabetes and epilepsy; and a fundamental and consistent link between poverty and ill-health. I believe government has a responsibility to attempt to break that link.
'We will also build on the very real reductions that have taken place in the incidence of cot death. Babies from the most disadvantaged social groups have a higher death rate from Sudden Infant Death Syndrome compared to babies from more advantaged backgrounds.
'One of the ways we hope to support mothers from disadvantaged backgrounds is by extending postnatal care by midwives to help improve rates of breastfeeding and early detection of postnatal depression since both can have a profound effect on the future of the child.
'There will be more support for parents by training more nurses, midwives and health visitors. There will be increased investment in neonatal intensive care provision. And underpinning this national crusade to improve children's health - for example to tackle childhood illnesses like asthma - there will be a new National Service Framework setting in place new national standards for children's services.
'As a result of these actions - and the government's wider programme to end child poverty - our ambition now can be to give every child the best possible start in life.
'These initiatives will improve health, narrow inequalities and save lives. Many of them will be focussed on areas where deprivation is highest and health is poorest.
'There must be specific action to reduce wider health inequalities in these areas too. So today, I can announce our second national health inequality target: to reduce the difference in life expectancy between areas with the lowest life expectancy and the national average.
'Starting with Health authorities, by 2010 we will reduce by at least 10% the gap between the fifth of areas with the lowest life expectancy at birth and the population as a whole.
'And today I can also announce a further new investment in primary care. The NHS Plan committed us to improve 3,000 primary care premises to make them fit for purpose through a new joint venture with the private sector - NHS LIFT. Newcastle, Manchester, Salford & Trafford, Sandwell, Barnsley, Camden & Islington and East London all urgently need better primary care facilities. They are all areas of
high health need. It is right that these will be the first six areas for extra investment through NHS LIFT.
'They will not be the only areas to benefit. There will be more investment to come. There is much, much more to be done to give people the health services they need. But we now must move on from concentrating solely on our National Health Service and concentrate now on our national health - on health outcomes and standards rather
than just inputs and structures.
'That will mean a continued emphasis on getting waiting times down because faster care does mean better health. It also means a constant effort to ensure we have the staff, beds and equipment we need to improve care for patients.
'Today I have been able to announce a major programme to improve health chances. A new blueprint for services for people with long term health conditions. New targets to reduce health inequalities. New action to enable them to be achieved.
'The health inequalities which scar our nation are real life not a sound-bite or a slogan. They are concentrated in the poorest parts of our country; they are deepest amongst the poorest people in our country. They represent the most fundamental challenge to the opportunity society we seek to build.'
Notes
1. National Service Frameworks (NSFs) have already been introduced for Coronary Heart Disease and Mental Health. Further NSFs on Diabetes and Older People have also been announced and will be published this year. The next phase of the NSF programme will include Renal Services, Children's Services and Long-term Health Conditions.
2. Details of the NHS Lift can be found on the Department of Health website in press notice 2000/0717, published Wednesday 6 December 2000.
3. Further material will be available at www.doh.gov.uk/healthinequalities.
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