Victoria Borwick, Deputy Mayor of London

Health Inequalities in London conference, Wednesday 29 October 2014

“Good morning and thank you for inviting me to speak at today’s conference on health inequalities in London.

As many of you will be aware, the Mayor has a duty to develop a Health Inequalities Strategy that sets out proposals and policies for promoting the reduction of health inequalities in London.

This Strategy was published in 2010 and has five core objectives. These are:

1. Empowering individuals and communities to improve their own health and well-being and the well-being of others

2. Improving access to high quality health and social care services particularly for Londoners who have poor health outcomes, for example people experiencing problems with alcohol and drug use.

3. Reducing income inequality and the negative consequences of relative poverty.

4. Increasing the opportunities for people to access the potential benefits of work and other forms of meaningful activity

5. Developing and promoting London as a healthy place for all.

These objectives are taken forward by using the Mayor’s influence, working collaboratively with others and sharing expertise. He also has a statutory health advisor, Yvonne Doyle, who is the Regional Director of Public Health England (London).

Looking forward, let me go through how some of these plans are being actioned.

The Well London programme has been coordinated by the GLA since 2007and is based in local communities. This programme is working to empower and engage people to strengthen their own and their community’s foundations of good health. To date, £12 million of funding from the Big Lottery has allowed the delivery of programmes in 31 of London’s most deprived neighbourhoods,targeting around 80,000 people. Measurable improvements have taken place in participants’ mental well-being, physical activity, diet, knowledge and skills, confidence and social networks. I have visited some of the schemes in London, such as the Aberfeldy Estate in Tower Hamlets, and have been impressed by what is being achieved by the programme. This includes uptake of training and volunteering opportunities, employment, and greater community cohesion.

We are also leading two other pan London programmes in partnership with London boroughs – the Healthy Schools programme and the London Healthy Workplace Charter. Over three quarters of London boroughs are now working with us on these programmes with over a thousand schools participating. In fact one of the best parts of my role recently has been visiting schools throughout London congratulating them on their success. We see Healthy Schools as not just being about food on the plate but about empowering and supporting children in making the right decisions and choices for the future.

We also have a key role to play in mainstreaming health considerations into all Mayoral strategies and policies, for example the London Plan, air quality and Transport for London policies. We currently have public health specialists working with Transport for London and the London Plan team to help maximize the opportunities to promote health and reduce health inequalities in these areas.

We also try to use the Mayor’s profile to raise awareness of health issues and campaigns led by the GLA and external partners. For example, earlier this month we marked World Mental Health Day at City Hall. The country’s Chief Medical Officer, Professor Dame Sally Davies, recently published her annual report. In it, she stated that mental illness accounts for 28% of the country’s burden of disease, but treatments for mental illness account for only 13% of the nation’s health spend. Earlier this year the Mayor published the costs of this inequality in London Mental Health: the invisible costs of mental ill health.

We are also contributing to this agenda through work on income and employment. Over 18,800 workers in the capital now benefit from over 200 accredited employers paying the London Living Wage, with another 90 employers working towards accreditation. There is increasing evidence that employers who pay the London Living Wage experience lower staff turnover, lower sickness absence, and higher staff morale, with employees experiencing higher levels of well-being[1].

In terms of supporting young people into work, the Mayor’s Apprenticeship Campaign doubled the number of apprenticeships in London in a single year (2010/11), from 20,000 to 40,000. The campaign has also increased awareness of the benefits of apprenticeships amongst London employers and developed a pipeline of apprenticeship opportunities in key target and emerging sectors, such as the digital economy.

The 2012 Olympic and Paralympic Games saw the profile of volunteers and volunteering rise substantially. Through the work of Team London, the Mayor has maintained enthusiasm and momentum behind volunteering. This approach has made volunteering easier and improved its profile, using the Games to inspire a new generation of volunteers.

We are excited by the publication of the London Health Commission report chaired by Lord Darzi. This was an independent enquiry to examine how London’s health and healthcare can be improved.

London’s voluntary sector contributed to the compilation of this report in many ways, from attending events, submitting evidence and providing case studies. LVSC was also a member of an expert sub group for the report. We are very thankful for the vital role London’s voluntary sector played by sharing its intelligence and expertise on how London’s health can be improved.

Now that the report has been published we are considering what actions are best taken forward by the Mayor and where we work best with other partners.

In terms of considering the health inequalities components of the recommendations, a health inequalities impact assessment (HIIA) took place alongside the work of the London Health Commission. This included an initial assessment of the recommendations, which will be followed by discussions with policymakers on how to maximise the positive health and health inequalities impact of each recommendation. The initial assessment concluded that the majority of the London Health Commission recommendations will have beneficial effects on health and will contribute to reducing inequalities in health.

London’s voluntary and community sector play a hugely important role in reducing health inequalities in London. The voices and delivery power of the sector is reflected in all our work, from community development programmes to high profile communication campaigns.

The London Health Commission report highlights the role that London’s voluntary and community sector plays, from recommendations around parenting support, education programmes on self-management to better engagement for the NHS with Londoners. I encourage you to read this report and use it to consider how best to engage with commissioners and London health and social care providers.

We are currently refreshing the Mayor’s Health Inequalities Strategy delivery plan, covering the period 2015 to 2018. This plan is also looking at the new duties that exist through the health and social care reforms for reducing health inequalities in London. This supports the Mayor’s role in convening a London wide conversation on how different partners can work together to improve the health of Londoners.

Thank you again for inviting me to speak at your conference today and I look forward to hearing feedback from the day.”

1. Lines to take if questions arise on the Mayor’s role on health inequalities and/or the London Health Commission report

a) Questions on healthcare structures

The Mayor is not responsible for NHS services and has no powers over their planning or delivery in London.

He does however expect to see all Londoners receive high quality NHS services both now and in the future. You and his officers meet regularly with senior NHS officials from NHS England (London office) and the London Ambulance Service to seek assurances that the NHS is providing the best possible services for patients.

On the matter of hospital reconfiguration the Mayor has made it clear to the NHS in London that he expects all changes to be clinically-led, to have been through a meaningful process of consultation with the public, to reduce health inequalities where possible and to consider the needs of the whole population both now and in the future.

b) How can we feed into the Mayor’s Health Inequalities Strategy delivery plan refresh?

Two members of the GLA health team are leading a workshop on the refresh of the Health Inequalities Strategy delivery plan later this afternoon. If you cannot attend this workshop they will speak to you directly in terms of the best way of feeding into the refresh.

Details of the refresh are also on the london.gov.uk website in the health priorities section.

c) How will the London Health Commission recommendations support the voluntary and community sector in their role as key partners in reducing health inequalities in London?

There are a number of LHC recommendations that specifically refer to the role of London’s voluntary sector, for example better health for London’s children, management of long term health conditions and engagement.

Many recommendations concern commissioners in terms of how services are delivered, for example recommendations on how we support the most marginalised groups.

The Health Inequalities Impact Assessment team will be working with policymakers/ implementers to discuss how to maximise the positive health and health inequalities impact of each recommendation.

d) What power does the Mayor have to reduce health inequalities in London?

The Mayor has statutory duties to promote improvements in the health of Londoners and to promote a reduction in health inequalities. This is taken forward through his Health Inequalities Strategy, other strategies and policies, and the Authority’s core business, as described in the GLA Acts of 1999 and 2007.

The Health Inequalities Strategy works to improve the well-being of all Londoners and narrow the gap between those with the best and worst health. Its aim is to make London a city where everyone can thrive regardless of who they are or where they live.

The Health and Social Care Act 2012 transferred responsibilities for public health to local authorities. It did not give the GLA any health responsibilities.

[1] Wills, J. Linnekar, B. The costs and benefits of the London Living Wage (2012) http://www.geog.qmul.ac.uk/livingwage/pdf/Livingwagecostsandbenefits.pdf