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Why is social exclusion a priority from the general practice prospective? 1. Because GP’s think so “This (health inclusion) agenda…represents the reasons that I went into General Practice to begin with – to help people less fortunate than myself.” Professor Steve Field, GP, former RCGP chairman1 “…one of the big questions…is how we move from a minority (of GPs) doing it (health inclusion) to a majority across the country” Dr Sam Everington, GP, Bromley-by-Bow “…we’re not going to improve health outcomes unless we focus on this group…” Dr David Colin-Thome, National Clinic Director for Primary Care at the Department of Health 2. Because the experts say so “Social injustice is killing people on a grand scale” WHO 20082 “The big idea is that what matters is in determining mortality and health in a society is less the overall wealth of that society and more how evenly wealth is distributed. The more equally wealth is distributed the better the health of that society.” BMJ 19963 “The benefits of greater equality tend to be largest among the poor but seem to extend to almost everyone” Wilkinson and Pickett4 “Tackling health inequalities is a moral mission and question of social justice. That is the message that Professor Sir Michael Marmot…has been spreading…following the publication of his report “Fair Society, Healthy Lives”…the economic case (is) unarguable…’We cannot afford to do nothing’…action has to be for everyone ‘but with the scale and intensity that is proportionate to the level of disadvantage’ This philosophy is deemed ‘proportionate universalism’…In England, people in the poorest neighbourhoods will die seven years earlier on average than those in the richest areas…The average difference in disability-free life expectancy between the richest and poorest areas is 17 years.” BMA News, 20105 3. Because we can do a great deal to change the situation “The physicians are the natural attorneys of the poor, and social problems fall to a large extent within their jurisdiction” Rudolph Virchow6 “…leadership (by doctors) can and should be used to promote action in some of the biggest challenges facing us, such as health inequalities…” Professor Sir Ian Gilmore, President of the Royal College of Physicians “(the) IPSOS MORI (poll) in September 2009, shows the amazing levels of trust (92%) that still remains in doctors in the UK” Professor David Haslam, past President, Royal College of General Practitioners7 References 1. RCGP News, A voice for the voiceless: Coalition backs the health inclusion initiative. November 2010, page 2 2. Commission on Social Determinants of Health. Closing the gap in a generation: health equity through action on the social determinants of health. Final report of the Commission on Social Determinants of Health. Geneva: World Health Organisation, 2008 3. The big idea [Editor’s Choice]; BMJ 1996;312 (20 April) 4. Wilkinson R, Pickett K. The sprit level: why more equal societies almost always do better. Allen Lane, 2009 5. BMA News, Saturday April 24th 2010, page 11 6. Gilmore, Ian, Keith Brown Memorial Lecture, Liverpool Medical Institution, Transactions and Report 2009/10 pages 21 - 26 7. Haslam, David, address to the Fifth Ordinary Meeting of the LMI, January 2010, Liverpool Medical Institution, Transactions and Report 2009/10 pages 51 - 56 18th January 2010