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Public Health: a stitch in time.

OXFAM tell us that, globally, inequality is reaching new extremes. The richest 1% now have more wealth than the rest of the world combined. Power and privilege is being used to skew the economic system to increase the gap between the richest and the rest. 

When doorstepped by charitably minded souls who were concerned that less well-off people might die without the benefit of public relief, investment banker Scrooge retorted, 'they had better do it and decrease the surplus population'.

Dicken's Christmas fairytale, written in 1843, has been credited with pressuring the British establishment to pass the first Public Health Act in 1848. A less romantic pressure was the realisation that the rich could not protect themselves from the spread of diseases of poverty, such as cholera, without sharing some of life's advantages with those at the bottom of society.

Oblivious to our own dependency on public services, such as environmental health, waste recycling and highway repairs, there are few campaigning on the streets at the news that Local Government faces a further 24% cut to its already decimated budgets.

Public Health is no longer part of the NHS and now sits within the County Council. Its budget, previously ring-fenced, is no longer immune. With cuts of £3m this year and further cuts to come, an urgent review of preventive healthcare is already underway. Early intervention, sexual health clinics, drug and alcohol services, obesity management and smoking cessation are all to be trimmed.

You may not use or value any of the services under threat. You may even accept inequality as inevitable. Some people do. You may not be convinced, as I am, that prevention is better than cure. However you choose to reassure yourself, history tells us that only a tiny minority can afford to insulate themselves from the dis-ease of an unequal society.

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