Sir Douglas Black

Professor of medicine whose famous report on inequality and health fell foul of the Thatcher government

Sir Douglas Black was one of medicine's most important and well loved individuals. His many achievements included a professorship of medicine in Manchester, research on salt and water balance, persuading the profession in the 1940s and 1950s that the NHS was a good thing, and the presidency of the Royal College of Physicians. But he is best known for his 1980 Black report, which spelt out the social inequalities in health and proposed ways of reducing them.

In 1977 the then Labour government's health secretary, David Ennals, chaired an expert committee investigating why the NHS had apparently failed to reduce social inequalities in health, and he commissioned Black to write a report. The result was published—or, rather, suppressed—in 1980, when the Conservatives had come to power. The Black report was not to Mrs Thatcher's liking and was never printed; instead, 260 photocopies were distributed in a half hearted fashion on Bank Holiday Monday. However, the report had a huge impact on political thought in the United Kingdom and overseas. It led to an assessment by the Office for Economic Co-Operation and Development and the World Health Organization of health inequalities in 13 countries—though not on UK government policy. Penguin Books later published a shorter version of the report.

Black provided convincing figures that showed what many suspected—that the poorest had the highest rates of ill …