Commentary Reduction of health inequalities Section 22: The health inequalities strategy
54.Section 22 inserts into the GLA Act 1999 a new section 309E that requires the Mayor to prepare and publish a health inequalities strategy containing proposals and policies for promoting the reduction of health inequalities between persons living in London. Those proposals and policies are to be addressed to mitigating differences in general health determinants (as defined). The strategy must identify issues that appear to the Mayor to be major health issues where there are health inequalities, identify those health inequalities, specify priorities for reducing them and describe the role of any relevant person or body in implementing the strategy. Relevant persons and bodies include the Authority, any functional body, any London borough council, the Common Council of the City of London, the Health Adviser, any Strategic Health Authority for London, Primary Care Trusts established for London, NHS Trusts and NHS Foundation Trusts with hospitals, establishments or facilities in London and other bodies and persons with responsibilities, in relation to London, with respect to general health determinants.
55.This section also inserts into the GLA Act 1999 section 309F which defines “health inequalities between persons living in Greater London” as health inequalities between persons living in or in different parts of London or between persons of different descriptions living in or in different parts of London. “Health inequalities” is defined as inequalities in respect of life expectancy or general state of health resulting from differences in general health determinants. General health determinants are matters such as standards of housing, transport services, public safety, employment prospects, earning capacity and other matters affecting levels of prosperity, degree of ease or difficulty of access to public services, the use or level of use of substances such as tobacco, other aspects of lifestyle or personal behaviour that are, or may be, harmful to health and other determinants except genetic or biological factors.
56.New section 309G specifies that in preparing or revising the health inequalities strategy the Mayor must have regard to any guidance given by the Secretary of State as to matters to be taken into account. The Mayor and Health Adviser must collaborate and co-operate in the preparation or revision of the strategy and in ascertaining the issues to be identified in it. The Mayor must also consult those relevant bodies that appear to him to be likely to be affected by the strategy. (The Mayor is not required to consult the Authority or any functional body under this provision, because he must consult them under section 42(1) of the GLA Act 1999.)
57.New section 309H empowers the Secretary of State to direct the Mayor to revise the health inequalities strategy where it is inconsistent with national policies and where that inconsistency would have a detrimental effect on achieving the objectives of those policies. Where such a direction is issued the Mayor must revise the strategy accordingly. The Secretary of State must consult the Mayor before giving a direction.