The government is like a dog chasing its tail in the quest to narrow the health inequality gap Fifteen years ago I spent an afternoon spotting used condoms on a housing estate in Birmingham with the then health minister Tessa Jowell. It was the launch of the Labour Government's drive to reduce health inequalities, one of the first pledges it made on winning power in 1997. There was no doubting Ms Jowell's commitment to the project or her energy in seeing it through. She repeatedly cited the shocking gap in life expectancy between people living in inner city Manchester and the Surrey stockbroker belt. Despite her efforts, and that of successive governments, that gap is even wider for older people today. Everyone, rich and poor, is healthier than they were in the late 1990s, but as health improves it is always the rich for whom it improves most. The reason is that those who are better off, better educated and better informed are in a better position to take advantage of the latest health advice or initiative. The rich smoke less, eat more fruit and vegetables, are more likely to have their blood pressure and cholesterol measured and treated, and are first in the queue for coronary interventions such as angioplasty. Like a dog chasing its tail, ministers chase a goal that is always tantalisingly out of reach.