Charlie’s Blog: Health Inequalities and Human Rights: Why Scotland Must Do Better

Charlie’s Blog: Health Inequalities and Human Rights: Why Scotland Must Do Better

This blog post is taken from the presentation Charlie McMillan gave on Wednesday 19th February to the Scottish Parliament’s Cross Party Group on Health Inequalities, facilitated by Voluntary Health Scotland (VHS).

Health is a human right. It’s not a privilege or something that should depend on where you live, how much you earn, or your background. Yet, in Scotland today, we are seeing shocking levels of health inequality that expose just how far we have to go in making this right a reality for everyone.

The Human Rights Perspective

The right to the highest attainable standard of physical and mental health is enshrined in international human rights law, from the Universal Declaration of Human Rights (1948) to the International Covenant on Economic, Social and Cultural Rights (1966). These frameworks set out clear obligations for governments to ensure healthcare is available, accessible, acceptable, and of good quality for all.

But human rights aren’t just legal principles—they are about dignity, fairness, and ensuring that no one is left behind. The reality is that, in Scotland, deep-rooted inequalities mean that for many people, this right is out of reach.

A 24-Year Gap in Healthy Life Expectancy

Perhaps the starkest example of Scotland’s health inequalities is the 24-year gap in healthy life expectancy between those in the most and least deprived areas. That’s 24 years where people in wealthier communities can expect to live in good health, while others face long-term illness, disability, or poor mental health much earlier in life.

The reasons behind this are complex, but the common thread is inequality—poverty, discrimination, and systemic barriers all play a role. People in lower-income communities are more likely to experience food insecurity, inadequate housing, job insecurity, and a lack of access to quality healthcare, all of which take a toll on physical and mental well-being.

COVID-19 and Longstanding Disparities

The pandemic laid bare these inequalities in the most brutal way. It wasn’t just about who caught the virus—it was about who could afford to stay home, who had access to proper support, and who suffered the long-term economic and health impacts. The effects of long COVID, vaccine injuries, and a lack of support for clinically vulnerable groups have further exposed the gaps in our healthcare system.

What Needs to Change?

Recent UN reviews of Scotland’s human rights commitments have made it clear: we are failing to tackle health inequalities effectively. Key areas that need urgent attention include:

· Mental health law reform to ensure those with mental health conditions receive proper care and support.

· Stronger action on poverty, particularly child poverty and its impact on health.

· Better data collection to understand the needs of disabled people and other marginalized groups.

· A national food security strategy to address the link between nutrition and long-term health outcomes.

· Recognition of environmental health issues, such as the impact of pollution on respiratory diseases.

A Call for Human Rights-Based Policy

A human rights approach means putting people first. It means that public policies should prioritise the most vulnerable, ensuring that budgets, services, and laws work to close the gaps, not widen them. This includes implementing human rights budgeting—ensuring that government spending actively reduces inequalities rather than reinforcing them.

The Scottish Government has made commitments to embedding human rights into law, but words are not enough. We need action, accountability, and real change. Health inequalities are not inevitable—they are the result of policy choices. If we truly believe that health is a human right, we must do better to make it a reality for all.

Charlie McMillan, Interim Director of the Human Rights Consortium Scotland