5. 90-second Statements

Part of the debate – in the Senedd at 3:27 pm on 24 February 2021.

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Photo of David Rees David Rees Labour 3:27, 24 February 2021

Dr Julian Tudor Hart was one of the most influential and inspirational doctors of the twentieth century. He was a general practitioner who began his career shortly after the birth of the national health service, and most of his working life was spent as a GP serving the deprived mining community at Glyncorrwg, in my constituency of Aberavon. Here, he was able to further his research, combining his training in public health with the everyday care of his patients. He was able to study the effects of planned, anticipatory care over several decades, and thus was a strong advocate for preventative actions to avoid the need for treatment. He understood that effective primary care depends on a solid foundation of trust and continuity amongst all parties. This research led to the production of his paper on the inverse care law, which was published in The Lancet for the first time on 27 February 1971, thus celebrating its fiftieth anniversary this weekend. Dr Tudor Hart's work concluded that people in living in more deprived areas had higher death rates due to people's predisposition towards sickness as a result of circumstances or lack of a correct treatment. It was visionary, and became recognised throughout the world as a major piece of work on health inequalities, stating that the availability of good medical care tended to vary inversely with the needs of the population served. The paper considered the market distribution of medical care to be 'primitive and historically outdated'.

Market forces should not dictate the healthcare of communities. That should be based upon need and not status. I have strong socialist views and believe in this concept, that the need to address health inequalities cannot be owned by any one political party but should be owned by everyone. We frequently praise our fantastic NHS staff as they care for people across Wales, but if we wish to ensure that many people do not need to seek care in the first place, then we must continue to address the challenges that were identified by Dr Tudor Hart in his paper 50 years ago. It is concerning that the inverse care law remains as relevant today as it did 50 years ago. We must all commit to ensuring that it does not remain important over the next 50 years.