IT is a promise that Scottish Governments keep on making, that they will tackle the health inequalities between the rich and the poor, but sadly no government in recent years has made any significant difference. It is still the case in Scotland that a child born in a nice suburb will probably live for up to 30 years more than one born in a deprived area. A Scot is also more likely to fare better with cancer and heart disease if they are better-off and the picture with alcohol-related illness is much the same. Scotland’s health inequalities are profound and deep and, in many cases, they are getting worse.

The most up-to-date situation is laid out in the Chief Statistician’s new report on health inequalities and it is depressing reading. On coronary heart disease, the death rate in Scotland is a third of what it was in 1997 but deaths in 45-74 year olds are 4.6 times greater among the most deprived compared to the least deprived.

As for alcohol-related illness, hospital admissions among under-75s are six times more common in the most deprived areas. The gap between the poorest and the national average has been narrowing, but in 2016 it widened again and the gap is now the biggest it has been since 2003.

The figures on cancer are just as troubling. Among 45 to 74-year-olds, mortality is 2.4 times higher in the most deprived compared to least deprived areas, which is worse than it was 20 years ago when the rates were 2.0 times higher in the most deprived areas. Among other disturbing statistics in the report is the fact that premature mortality among 15 to 44-year-olds from suicides, drug deaths, and assaults is six times higher in the most deprived areas and has been increasing over the past two years.

The Government is right to say in its response to the report that the reason for the health inequalities run very deep, but its record on tackling the problem is mixed. On the positive side, the new cancer strategy is promising. It will take several years before we are likely to see any results, but the £100million is being spent in many of the right areas: new radiotherapy equipment for instance and the recruitment of new and better qualified staff.

But in another important area, the Government is not doing enough. The investment in cancer services is welcome, but we know there are deep social inequalities in the uptake of screening and treatment. Better-off patients are much more likely to take advantage of any improvements to health services – indeed, this might explain why, as healthcare improves, so too do inequalities.

The answer is one that the Government seems reluctant to accept: the targeting of healthcare where it can make the most difference. The primary care needs are greater in poorer communities, and yet the investment there is scarcely more than it is in more affluent areas. This is the wrong way round. The new figures from the Chief Statistician this week have underlined the great health inequalities in our country; we will only begin to tackle them by targeting healthcare much more at where it is needed most.