Woman and Equality: North of England

Tuesday 5th November 2024 Westminster Hall

11:00

[Mary Kelly Foy (City of Durham) (Lab)]

I beg to move,

That this House has considered inequalities faced by women in the north of England.

It is a pleasure to serve under your chairmanship, Sirusb Christopher. This debate is about the “Woman of the North” report, published in September 2024 by Health Equity North. I thank Health Equity North for the report and for their support for today’s debate, as well as all those who contributed to that vital research.

Women in the north of England face unequal challenges and inequalities in their lives and their health, compared with the rest of the country. They are more likely to work more hours for less pay and be in worse health. They are also more likely to be an unpaid carer, live in poverty and have fewer qualifications. In fact, the inequality between women living in the north of England and those in the rest of the country has grown over the past decade. It has harmed women’s quality of life and work and harmed their communities and families.

Today, I am going to debate the key findings of the research and highlight the report’s recommendations. The report does not make for easy reading. Even though the Minister, like me, will be all too aware of the impact of austerity on our communities, many of the findings will, I am sure, come as a shock, as they did for me.

I will not be able to cover everything, but I hope the debate will begin a dialogue between the Department and the contributors to this important research.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Lady for bringing this issue forward. First, there is an anomaly—there are two and a half times more self-employed men than women, with jobs and opportunities. Women have the skills and the talent, but one of the things that holds them back is childcare. It does not matter where someone is in this great United Kingdom of Great Britain and Northern Ireland: if they do not have childcare, they have nothing—they cannot get the opportunities. Last week on the TV it said that the cost of childcare for some families is as much as the mortgage. That is a massive issue.

[Mary Kelly Foy]

I could not agree more. That is why I am pleased that the Labour Government will be bringing in thousands of new nursery places and breakfast clubs, which will hopefully alleviate some of the problems of childcare. I know that childcare is an issue not just in the north of England but also in the north of Ireland.

I shall begin with employment. Employment rates for women in the north are lower than the national average of 72.2%. In my region, the north-east, the rate is just under 70%; in Yorkshire and the Humber, it is just over 70%; and in the Minister’s region, the north-west, it is just over 71%.

Disability and long-term sickness is a major issue in the north. All northern regions have levels of disability and long-term sickness higher than the national average, and considerably higher than the south-east. The report states that the resulting estimated economic cost is around £0.4 billion per annum. Compounding that is the fact that the median weekly wage for women in the north is below the national average for both full-time and part-time employment. For instance, the average weekly wage for a full-time working woman in the north-east is £569. That is much lower than the national average of £625 and considerably lower than the average weekly wage for women in London, £757. Overall, women in the north could be losing out on around £132 million a week.

In terms of education, the number of women without qualifications is higher in the north than it is in the south and the south-east. That leads to the next point about women and poverty—an issue that is worth its own debate. A higher percentage of families in the north are on universal credit than in regions in the south. In fact, the average number of families on universal credit across the north is 3% higher than in the south. The figure is even higher if London is excluded.

All 12 local authorities in the north-east have rates of absolute child poverty above the English average. By contrast, all 30 local authorities in the south-west have rates of absolute child poverty below the English average.

The north is also the region of unpaid care, with 12% of women in the north-east providing it—just under 2% higher than the national average. Health Equity North estimates that women in the north are providing around £10 billion a year in unpaid care. Harrowingly, it also estimates that, in the last decade, the life expectancy of girls born in the north of England has begun to stall and in some cases decrease. In addition, girls born in the north will not live as long in good health compared with the national average. For older women, menopause is often cited as a potential driver of change in women’s health, which makes it all the more concerning that there are regional differences in levels of hormone replacement therapy, with lower levels of HRT being prescribed in the north of England.

The picture is even more bleak when we consider pregnancy and reproductive health. We have seen the biggest increase in abortion rates between 2012 and 2021, and there has been a demonstrable relationship between austerity, the implementation of the Tory two-child limit and the increased rate of abortions. I should also add that the two-child limit itself affects over a million children in the country, and it impacts over 60,000 babies, children and young people in the north-east alone. Right now, over 25% of pregnant women in the north of England are living in the most deprived 10% of areas, with 40% of pregnant women living in the top 20% most destitute areas. Tragically, stillbirths are the highest in the most deprived communities, and highest among black African and Caribbean women living in the areas of greatest deprivation. Also, women living in poverty are at increased risk of death and depression. Subsequently, babies are at a higher risk of stillbirth, neonatal death, pre-term delivery and low birth weight.

The report also refers to smoking and pregnancy; I am glad to see that the Tobacco and Vapes Bill will receive its First Reading today. It would be good to hear from the Minister whether the Government will continue to fund the financial incentives scheme for pregnant smokers.

Women in the north of England have the highest rates of domestic violence abuse in the country, which is something that many children are exposed to. That also deserves its own debate. When we consider mental health, the report highlights that, in a cohort of over a million women aged between 16 and 65, from 2005 to 2018, the prevalence of mental illness was higher in three northern regions compared with the south of England. With severe mental illnesses, such as bipolar disorder and schizophrenia, the north-west and the north have higher prevalence rates. Lastly, the report covers the reality of marginalised women in the north, which includes a range of areas, from criminal justice to education and health, as well as issues related to homelessness and substance abuse. I do not have time to go into each point, but I encourage the Minister to read that section if he has not already, and I will either write to him about those issues or table parliamentary questions.

The report’s recommendations are spread across multiple departmental areas, so the Minister may want to follow up in writing if he prefers. One key recommendation of the “Woman of the North” report is that central Government should deliver a national health inequalities strategy—one that convenes Government Departments from across Whitehall to put health at the heart of all policies to address the wider determinants of health. Many of the policies announced in the Budget, as well as the Employment Rights Bill, will be welcome, such as uprating universal credit in line with inflation and tackling zero-hours contracts. Of course, we wait in anticipation for the child poverty taskforce strategy next year, and I sincerely hope that we will see an end to the Tory two-child limit. In addition, the report recommends that the Treasury should consider targeted support for pregnant women, as well as improving childcare. When it comes to local and regional government, which I know the Minister has experience in, the report suggests targeted support delivered to 11 to 18-year-olds through careers hubs in the areas of greatest deprivation and a higher level of the adult education budget for the north. Greater support is also required for women navigating the social security system and for social security uptake, and for women to transition back to their families and integrate into their communities after involvement in the criminal justice system.

Finally, with health and social care, NHS England could provide additional support and investment for women’s health hubs, and health services should be supported to collect routine data on ethnicity and other key demographic data. That would help deliver better information for service development and improve our understanding of different health needs. It would also explore the ways in which the services’ work can be adapted to address health inequalities across different population groups, with examples including providing cultural sensitivity training, adopting a trauma-informed approach to care and promoting person-centred approaches.

I have been an MP since 2019 and have spoken about health inequalities ever since I was elected. Today’s debate is not pleasant, but I am genuinely hopeful that we can turn a page under a Labour Government. We have already seen positive measures, such as those in the Employment Rights Bill and the Budget. I look forward to the Minister’s reply and hope to work with him alongside Health Equity North to deliver happiness and dignity for women in the north, which is long overdue.

11:11

[The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)]

It is a pleasure to serve under your chairmanship, Sir Christopher. I am grateful to be responding for the Government to this vital discussion brought to the House today by my hon. Friend the Member for City of Durham (Mary Kelly Foy) about the issues raised by the “Woman of the North” report. The report highlights the challenges facing women across the northern regions of England and I am pleased that the Government’s women’s health ambassador, Professor Dame Lesley Regan, delivered a keynote speech at the report’s launch in September, in which she spoke about the importance of addressing the health inequalities faced by women living in the north of England.

While the report brings into focus the striking health inequalities that women in the north contend with, our Government are committed to addressing those regional inequalities head on. I will be clear, up front, that the conditions outlined in the report are unacceptable in a country as resourceful as ours. Women in the north face stark inequalities, not just in health but, as we heard from my hon. Friend, in economic security and social support. Our response must be to tackle those on multiple fronts, and that work has already begun.

We are committed to working across Government to tackle wider inequalities that lead to poor health, focusing our health and care system on preventing ill health, shifting more care into the community and intervening earlier in life to raise the healthiest generation of children in our country’s history. We will improve healthy life expectancy for all and halve the gap in healthy life expectancy between different regions of England.

The Government are committed to prioritising women’s health as we build an NHS that is fit for the future, and women’s equality will be at the heart of our missions. We are considering how to take forward the women’s health strategy developed by the last Administration, but we want to align it with the Government’s missions and the forthcoming 10-year health plan. The report is therefore timely. As my hon. Friend set out so powerfully, reducing inequalities must be a central focus in our strategy going forward. We will carefully consider each of the report’s recommendations as we do that, and I will ensure that Ministers across Government have sight of the report and consider those recommendations that relate to their policy areas.

My hon. Friend mentioned women’s health hubs, which will be key to improving access to women’s health services and reducing the inequalities we care so passionately about tackling. They will do that by providing a set of integrated women’s health services in the community, centred on meeting women’s needs across their life. The Department has invested £25 million over the past year and over 2024-25 to support the establishment of at least one pilot women’s health hub in every integrated care system. I am pleased to say that integrated care systems in the north of England are making good progress on setting up their pilot hubs. For example, the funding is being used to set up three pilot hubs—two in Sunderland and Gateshead in the north-east and one in north Cumbria—with a strong focus on tackling inequalities and community outreach.

My hon. Friend also mentioned smoking, which is a huge driver of inequalities in too many communities, particularly, but not exclusively, in the north of England. She is right, and I can confirm—on the day the tobacco and vapes Bill receives its First Reading—that good-quality smoking cessation services remain a big part of the jigsaw in achieving a smoke-free UK. I can report that financial incentives are working well.

I mentioned some of the wider social inequalities that underpin poorer health chances, as did the hon. Member for Strangford (Jim Shannon). It is shocking that a woman in the north, working full time, may earn £56 less per week than the national average, and £188 less than a woman in London. Every part of the country has a vital contribution to make to our economy, but too many areas have been held back because decisions are often taken here in Westminster and not by local leaders who understand the ambitions, strengths and opportunities—and the weaknesses and threats—of the local population.

That is why the new Labour Government are committed to empowering local government, enabling it to pursue growth, create jobs and improve living standards, with support from central resources. Providing central support where needed, we will ensure that the places we are talking about have the strong governance arrangements, capacity and capability to deliver. In addition, as my right hon. Friend the Chancellor of the Exchequer set out in our first Budget last week, the national living wage will increase from £11.44 to £12.21 next April. That boost—one of the largest since the creation of the national minimum wage in 1998—benefits women, who make up a significant proportion of minimum wage earners.

Turning to mental health and domestic violence, the “Woman of the North” report revealed stark challenges facing northern women, with rising rates of mental illness and domestic violence. We have committed to taking a number of important measures to improve support for women, which we are already introducing those across Government. We are committed to an NHS that is responsive and accessible, with 8,500 new mental health workers to reduce waiting times, and a specialist mental health professional in every school. Young Futures hubs in every community will also offer open-access mental health support for young people, including girls.

Recognising healthcare’s role as a frontline for survivors, all NHS staff undertake mandatory safeguarding training, which includes a focus on domestic abuse. Furthermore, my Department has published and disseminated a working definition of trauma-informed practice for the health and care sector. NHS integrated care boards enable provision of more integrated services for victims and survivors. The Victims and Prisoners Act 2024 also places a new legal duty on integrated care boards to work with local authorities and with police and crime commissioners to join up the commissioning of victim support services.

One of the most striking points raised in the report is the extraordinary burden of unpaid care on northern women. Women who give over 50 hours a week in care duties deserve our utmost respect, as well as the support of this Government, and we are working to ensure that they have it. Our recent increase in the earnings threshold for carer’s allowance will help 60,000 more carers to maintain work while receiving financial support. For the first time, carers can now earn more without reducing hours, due to minimum wage rises. That will bring much-needed financial stability to carers and allow them to retain their links to the labour market, which is crucial.

We will continue to monitor and respond to the needs of carers, ensuring that they have the resources to support their families and wider communities. Moving forward, we will continue to assess the needs of carers, in the north and beyond, to ensure that we are offering tangible, effective assistance to those unsung heroes.

I put on record that the Government’s commitment to our northern communities, and to the women who drive them forward, is unwavering. We recognise that the strength of our nation rests on the health, security and potential of all women, regardless of where they live. But we know, as northern MPs, the stark inequalities that are far too prevalent in far too many parts of the regions that make up the north of England. For women in the north of England, we will ensure that we rebalance not only their health outcomes but the economic opportunities offered to them. It is not a matter only of justice, but of building a society that values every woman’s contribution equally and that provides her with the means to thrive.

Let me affirm that this Government, and I as the Minister responsible for public health and prevention—albeit a man—stand ready to support the women of the north, and every woman in this country, by addressing the entrenched inequalities that hold too many women back. Through our co-ordinated efforts across health, economic policy and social care, we will see the real benefits of a mission-led Government who do not work in silos but across the whole of Government to tackle the needs of the citizen—in this case women, including women in the north—as we march towards the decade of national renewal that the country voted for on 4 July.

That co-ordinated effort will be across health, economic policy, social care, housing, planning, transport, the environment and all public policy, such as education, skills and training. We will work towards a future where all women, wherever they are in this country—although I and my hon. Friend the Member for City of Durham are northerners, and this debate is about the north of England—can look forward to lives filled with good health, economic security and the opportunity to achieve their potential.

I will leave the House with just one thought. On my first day as public health Minister, I had lots of presentations to bring me up to speed on a range of policy areas, and the first was on life expectancy. There was a simple bar chart that showed two women: one who has the privilege of living in a less deprived part of England and one who has the misfortune of living in a more deprived part of England. The life expectancy of the woman in the less deprived part was just shy of 80—79.9 on average. For the other woman, it was 70—10 years were shorn off her life.

But that was not the most shocking part of the chart. The two bars were shaded in part in orange, which signified the healthy life expectancy of the two women. The woman who lives to nearly 80 in the less deprived part of England falls into ill health at 75. All of her working adult life is spent in good health, and she falls into ill health only in the final five years of her life. The other woman, who lives to 70, falls into ill health at 52. That shocked me to the core. Those are not statistics; they are people—people I and my hon. Friend represent. Indeed, there are inequalities across the country, and they are people you too represent, Sir Christopher.

Each person falling into ill health with another 15 or 16 years of adult working life to go is a tragedy on a personal level. It is the economics of the madhouse, because those people have potential—they have economic ability and hopes and dreams that are whipped away because of inequalities. It is the duty of Government to push that orange bar as close to retirement age as possible for those women, and preferably into retirement age. Look, let’s be ambitious: let’s put sickness beyond death. It is the duty of Government to tackle those health inequalities. I hope I have assured the House, and my hon. Friend the Member for City of Durham, that while I am in this ministerial post, it will be my No. 1 aim to make sure that we live healthier, happier, longer lives. Here’s to the women of the north.

Question put and agreed to.

11:28

Sitting suspended.