A Scottish parliament committee is calling for urgent “bold and strategic” action at all levels of government across education, employment, housing, and income to tackle growing health inequalities in Scotland.

A wide-ranging report by the Health, Social Care and Sport Committee published today has recommended the Scottish government consider implementing an overarching national strategy for tackling health inequalities, to guide policy making and foster better collaboration between sectors.

During their inquiry into the issue, MSPs heard that a lack of strategic coordination between services in the past may have exacerbated inequality in some areas, concluding that a national strategy could better ensure that the socioeconomic determinants of health are addressed at all levels and in all local authorities.

A review of the design and delivery of public services, to ensure they are reducing rather than exacerbating inequalities, and a wider and more systematic application of health inequality impact assessments when designing policy are among the committee’s recommendations.

Other recommendations for the Scottish government are to review both the standard of housing and the deployment of free childcare provision, as well as strengthening its efforts to encourage public sector organisations to become living wage employers, along with a plea to embed community link workers in all GP surgeries across Scotland.

Gillian Martin MSP, Convener of the committee, says that actions taken to date to reduce health inequalities have largely failed, despite this being a key priority of the Scottish government since devolution, and that the cost of living crisis will further exacerbate the challenges:

“The reasons why we have failed to make progress in tackling health inequalities are many and varied. Reducing these will require bold and strategic action across all levels of government and by a range of government departments.

“Tackling health inequalities must be a major public health priority because lives literally depend on it.”

The committee heard in an evidence session that austerity measures by the UK government from 2010 onward are the single biggest contributor to health inequalities, and that much of the power to tackle this lies outwith devolved powers.

Welfare conditionality has meanwhile been a key driver of incomes reducing over this time, according to the report, and the committee has called for the UK government to address this as a priority.

The link between poverty and health inequalities was a key theme throughout the committee’s inquiry, with 74 of the 114 responses to its call for views highlighting the connection.

All levels of government should consider tackling poverty as a major public health priority, according to the committee, and the Scottish government should lay out in detail how it will measure and evaluate these interventions in the reduction of health inequalities.

The majority of the committee members have called for ongoing talks with the UK government on a minimum income guarantee to continue, as well for the two governments to explore the potential for a universal basic income pilot in Scotland.

Unpaid caregiving – which can often result in financial hardship, and poorer mental and physical health – should be formally recognised as a social determinant of health, according to the report.

A carer poverty strategy and a Scottish carers assistance benefit, both of which have been advocated for by Carers Scotland and taken on board by the committee, could lead to fairer financial support for carers and tackle health inequalities faced by this group.

The launch of a devolved Scottish carers assistance benefit was put to consultation earlier this year, and the Minister for Social Security committed to this being one of the Scottish government’s main focuses this year.

The Scottish government pledged to publish a carers strategy by the end of spring this year but this has yet to be launched.

Read more: Austerity blamed for Scotland’s health inequalities; Alternative pathway inquiry reveals obstacles; Ministers promise new carers strategy

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