Too many professions are full of middle class people and genuine social mobility is severely limited, the former Labour health secretary Alan Milburn has concluded in a new report.

As social mobility adviser to the Deputy Prime Minister Nick Clegg, Milburn said there needed to be a “galvanised effort” and a “bigger drive” to make professions such as medicine and journalism much more accessible to those from less well-off backgrounds.

The report said: “There are significant areas for improvement. There is no one profession that can say it has cracked the fair access problem. Indeed, almost no profession has a clear plan for doing so. Despite rhetoric to the contrary, all too often the reality is that the fair access agenda remains sidelined in most professions. That is unacceptable and must change.”

Things needed to change, the report said, including promoting career awareness and aspiration in schools, encouraging employers to recruiting from outside the “narrow range” of universities and regions, preventing work experience and internships from being “a lottery”, improving the selection processes for various careers, and pushing ahead with diversifying entry to professions because “the graduate grip on the labour market is still strong”.

“There’s a series of barriers that, maybe inadvertently, the professions put in the way of those with ability and aptitude from a variety of backgrounds getting even the first foot on the ladder into the professions,” Milburn told the BBC. “It’s partially about how they provide work experience opportunities, internships, their recruitment processes, where they recruit from.”