August 1980 will forever be remembered by public health doctors for it was then that the Department of Health published the Black report.

Commissioned by David Ennals (Labour) in 1977, Sir Douglas Black and his colleagues said that the death rate for men in social class V was twice that for men in social class I and that the gap between the two was increasing, not reducing as was expected. Wherever there was social disparity, there was disparity in health.

When the report appeared three years later, the Conservatives were in power. Cogently argued and hard to refute, only 260 copies of the report were made available on the day to the media and those were tatty photocopies (though Penguin later republished it).  There was no press conference and the report was allowed to mature undisturbed. It was more than 10 years before NHS policy began to take health inequalities seriously.

For a fuller account of the struggle, see