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Allison say while we’ve improved our fi nancial effi ciency as a sector, we’ve reduced access for many

Conclusions Councils may be faced with a stark choice – moving even further to a commercial model and excluding more of those most in need, or thinking about how they can justify additional short- or long-term investment that is more focused on addressing health inequalities. They may also question whether leisure facilities are the best way to do this. Some councils will simply accept that leisure centres can make little or no contribution to addressing health inequalities and at best they will operate in a way that assists with the health maintenance of people who are most willing and able to pay. There will, however, be some councils and operators that will be willing to find innovative solutions to address both health improvement and health inequalities. This will require councils to invest more and operators to change 1. how they use membership schemes so they don’t exclude people unnecessarily, 2. how they set and use concessionary charging so it doesn’t exclude people and, 3. how they develop inclusive programming that doesn’t involve specific

groups in short-term interventions at the expense of being included in a more universal service. This means changing how the system works. As Sir Michael Marmot argues in his report Health Equity in England: The Marmot Review 10 years on, ( in order to address deep-seated health inequalities, we must use the totality of resources in a concerted way, rather than relying on ‘additional’ pots. “Focusing solely on the most disadvantaged will not reduce health inequalities sufficiently,” said Marmot. “To reduce the steepness of the social gradient in health, actions must be universal, but with a scale and intensity that is proportionate to the level of disadvantage. We call this proportionate universalism.” Generating a clear and accurate picture of how our leisure centres are being used and how they are recovering will be a big step towards redesigning a service that is truly universal but proportionate to need. Moving Communities is not only a great chance to demonstrate our public value but also an opportunity to improve our contribution to addressing rising health inequalities. ● ©Cybertrek 2021 Issue 5 2021