In a compelling address at the Chamber and IQVIA Midlands Seminar, Professor Bola Owolabi challenged the prevailing discourse on health inequalities. Rather than dwelling on “deficits and despair”, Owolabi emphasised the need for leaders to be purveyors of hope. Drawing on extensive consultations since January 2021, Owolabi articulated a powerful vision statement aimed at addressing the longstanding issue of health disparities.
Beyond equality: The call for equity
Owolabi underscored the importance of guaranteeing exceptional quality healthcare for all, with a specific emphasis on inclusivity. She acknowledged the three dimensions of inequality: access, experience, and outcomes. By advocating for equity of access, she challenged the presumption that everyone starts on equal footing, recognising the diverse needs of different groups in society. She stated “we talk about the equity of access, not equality of access, because equality has a set of presumptions and assumptions that we all start from the same baseline”.
Challenging misconceptions surrounding the origins of health inequalities, Owolabi highlighted the human cost that existed even before the COVID-19 pandemic. she refuted the notion that the pandemic caused these inequalities, citing stark statistics on life expectancy gaps for various vulnerable groups.
“There is an erroneous assumption that the COVID-19 Pandemic caused health inequalities. And I want to correct that assumption by saying we went into the pandemic knowing that people with learning disabilities had a life expectancy gap of 10 to 15 years compared to the rest of the population… if you happen to be black and you have learning disability, then your life expectancy is 43. And of course, if you then happened to be pregnant, the mortality rate for black African women in childbirth and the year following delivery, it’s four times the mortality compared to their white counterparts. The pandemic didn’t cause all of that. That was the state in which we went into the pandemic and that’s the human cost that I want to talk about”.
Bola Owolabi
Integrated Care Systems (ICS) emerged as a focal point in Owolabi’s discourse, presenting an opportunity to address health inequalities on a legal footing. she urged a future evaluation of ICS, particularly its impact on inequalities in access, experience, and outcomes for diverse populations.
The business case: an intersect between health equity and economics
Intriguingly, Owolabi then delved into the business case for tackling health inequalities, presenting data on NHS treatment costs and economic implications. She emphasised the economic burden of health inequalities, making a compelling argument that addressing these disparities is not just a moral and ethical imperative but also a sound economic strategy. She stated “people in our most socioeconomically disadvantaged groups start with long term conditions earlier, in some cases ten to 15 years earlier. They accumulate those long term conditions faster. They live with them for longer and that translates directly into higher health care expenditure”.
The intersection of health inequalities and patient safety then took center stage, with Owolabi citing discussions with the World Economic Forum and referencing a BMJ paper. She explored the financial implications of patient safety issues, arguing for reinvestment of funds spent on legal claims into frontline care. She contended “I can’t help but think, within these financially straightened times that we’re in, if those millions in claims were reinvested into frontline care, the difference that could make”.
Core 20 plus five
Owolabi stressed the importance of setting a clear direction, fostering a positive culture of improvement, and ensuring accountability. She outlined strategic priorities, including the restoration of NHS services, mitigating digital exclusion, and strengthening leadership. Discussion “Core 20 Plus Five”, a focused initiative to drive meaningful change in healthcare systems, she elaborated on the associated delivery ecosystem, incorporating community connectors, innovation reorientation, collaborative efforts, and accelerator sites to translate the framework into tangible actions. “Core 20 plus five is about holding ourselves as a healthcare system to account we recognize that having a framework. Is probably the easiest thing. It’s about how we translate that into meaningful action at the front line” She asserted.
Concluding with a call to collectively commit to addressing health inequalities, Owolabi urged a shift from considering it too difficult to a space where tangible progress can be made. In doing so, she laid out a comprehensive leadership framework to guide efforts in reducing health disparities.
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