Deprivation index shows need for health policy on disadvantage

 

Sir, – The recent publication of the updated HP Deprivation Index by Pobal draws attention once more to the stark inequalities in Ireland, which have not changed much since the last census in 2011 (“Where are the most affluent and deprived areas in your county?”, November 10th).

Where you live is a matter of life and death in this country. Compared with the most affluent areas, death rates in areas of most deprivation are up to three times higher, and people also develop multiple chronic illnesses at a much younger age.

The Minister for Community Development Michael Ring, launching the report, drew attention to his department’s Rapid programme, which targets social deprivation in communities. The Department of Education has a special scheme called Deis to tackle disadvantage in schools.

This makes it all the more extraordinary that there is no such policy response from the Department of Health.

The consequences of inequality are nowhere more stark than in the health service, yet there is no systemic approach to resourcing services in areas of disadvantage.

Because the higher demands are not addressed, waiting times and the care that can be provided are much worse than in average areas.

Despite strong international evidence that a robust primary care service delivers effective care, there is no provision for disadvantage in the current funding model. The consequences of this are devastating for many of our patients, who cannot receive adequate care in the community, whether from public health nurses, general practice, or allied health professions like physiotherapy, occupational therapy, speech and language therapy, psychology and social workers.

Deep End Ireland is a group of GPs working in areas of disadvantage. We call on Minister for Health Simon Harris to address this policy deficit as a matter of urgency. – Yours, etc,

Dr EDEL McGINNITY,

Prof SUSAN SMITH,

Dr PATRICK O’DONNELL,

Dr DAVID GIBNEY,

Deep End Ireland,

Dublin 2.