BACK TO BLACK
| Published date | 01 June 1983 |
| Author | DAVID J. HUNTER |
| DOI | http://doi.org/10.1111/j.1467-9299.1983.tb00514.x |
| Date | 01 June 1983 |
NOTESAND
SURVEYS
BACK
TO
BLACK
In 1979 the Royal Commission on the National Health Service reminded anyone
who may have forgotten that the
NHS’S
raison d’etre
was to make health services
available to all, irrespective of income, age, sex, race, place and
so
on. But the
Commissioners only touched lightly on the apparent failure of the
NHS
to achieve
the central objective for which it had ostensibly been created. The omission was
corrected a year later when the
DHSS
working group on inequalities in health
reported
(DHSS
1980). The report (known as the Black report after the working
group’s chairman, Sir Douglas Black, a former Chief Scientist at the
DHSS)
was a
milestone in the continuing debate on social inequality generally, for the group
brought together a mass of data showing powerfully how the
NHS
has made little
headway in removing marked inequalities in life chances within the population.
The significance of the findings was not appreciated in government circles and the
Secretary of State disassociated himself from the report’s recommendations,
refusing to commit the Government
to
action of any kind.
The Black report was quietly slipped out during the ’silly season’
-
a ploy
intended to catch social policy watchers unawares.
It
almost succeeded and, for a
short time, it looked as if the report’s impact would be as disappointing as had
been its reception by the Secretary of State (then Patrick Jenkin)
in
his foreword to
the report. In the event almost the opposite occurred, and, in the words of one
observer (Illsley 1980a,ll) precisely ’because of its frosty official reception,
its
rumoured under-printing, as well as its intrinsic excellence (the report rapidly
attained) the rare, sought-after, Lady Chatterley-like quality of a scientific
obscenity‘. There was a scramble to obtain copies at
f8
each and, overnight, the
DHSS
found itself embroiled
in
a damage control operation worthy of a scene from
Yes
Minister.
As
so
often happens when a government department wishes to bury a report it
finds uncomfortable and not in harmony with current dogma, the Black report,
nearly three years on, remains very much alive. Indeed, its appearance in
paperback (Townsend and Davidson (eds.) 1982) must assure
it
of increased
longevity, though the efforts of others who have sought to keep the debate alive
through a steady stream
of
summaries and commentaries should not be
overlooked. The report has also been taken seriously by both the Labour and
Social Democratic Parties who have made
its
principal recommendations central
planks in their respective strategies for health.
The mark
I1
version of the Blackreport, primarily the work of Peter Townsend, a
member of the working group, is tighter than the original and benefits from
Public Administration
Vol.
61
Summer 1983 (209-216)
0
1983 Royal Institute
of
Public
Administration
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