WHEN you mention the word “health” most people think about the NHS but health is about more than the absence or control of disease – it is about real physical and mental wellbeing. Of course, this is oversimplistic but our chances of good health are often determined by policies that are totally unconnected with the NHS or health policy which is why I am such a believer in the approach of “Health in All Policies” across all levels of government.

There is now a greater understanding of the impact of Adverse Childhood Experiences (ACEs) in later life and, sadly, poverty is one of the most widespread. The association of poverty and deprivation with ill health was first demonstrated in 1980 in a report by Sir Douglas Black (a Scot) who was President of the Royal College of Physicians.

Unfortunately, as Margaret Thatcher’s Government did not like its findings, very few copies were ever printed and it was certainly not acted upon. His findings have, however, been confirmed in subsequent studies which clearly show that poverty and deprivation are the biggest drivers of ill health – increasing the risk of almost every illness, both mental and physical, and reducing both length and quality of life. Academics estimate that 1400 children die each year in the UK as a direct result of poverty due to higher rates of premature birth, infant mortality, road accidents, house fires, violence, suicide and addiction.

The problem is that eight years of Tory-led Governments have driven more people into financial hardship, as the need for food banks demonstrates, with the worst affected being the disabled, female pensioners, lone parents and, of course, their children.

The combined cuts to social security have left the poorest third of UK households an average of £745 worse off and child poverty is expected to rise from 30% to 37% by 2020. While we talk about “child” poverty, the relentless stress of “family” poverty in childhood increases the risk of poor mental and physical health. It reduces educational attainment and, therefore, work opportunities and increases the chances of ending up in the criminal justice system.

Trying to deal with the ramifications and sequelae of child poverty is expensive, so our principle is to invest in our children, and their families, in the first place. Providing more affordable high-quality housing, and childcare, the biggest financial outlays of most families, aims to reduce the financial stress which contributes to mental ill health among those struggling to make ends meet. The Scottish Government try to protect people in Scotland from many of them, by mitigating the bedroom tax, creating the Scottish Welfare Fund and maintaining free school meals in Scotland.

They are trying to improve the outlook for our children through a Child Poverty Bill and developing more supportive employability and disability support services but we do not have full control of either the economic levers or social security and, with the Scottish budget itself having been cut by 8.4%, the Scottish Government cannot fully protect the Scottish people from Tory austerity.

Under Tory-led Governments, self-interest has been promoted and the principle of shared “social security” undermined.

Their relentless talk about “workless” households ignores the fact that two out of three of children living in poverty have a parent who is in work but which may be insecure or low paid. The return to Victorian-era principles of the “deserving and undeserving poor” and “Devil take the hindmost” have been rejected by Scottish voters at every ballot box since the 1950s!

Poverty is the biggest driver of ill health – and Tory austerity is the biggest driver of poverty!

We have our health challenges in Scotland but the best way to tackle them is to put “Health and Wellbeing” at the heart of all policy decisions and to build the fairer Scotland we all want to live in.

Dr Philippa Whitford is a breast surgeon and SNP MP for Central Ayrshire