(1 day, 23 hours ago)
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Afzal Khan (Manchester Rusholme) (Lab)
Thank you, Madam Deputy Speaker, for the opportunity to raise an issue that is incredibly important to me and increasingly pressing for my constituents. I thank my hon. Friend the Minister for being here to respond to the debate.
The Government inherited a dire set of economic circumstances. Years of Tory funding cuts to local authorities and public services have been detrimental to communities, so I am pleased that the Labour Government have committed to handing power back to communities, as well as making commitments to reducing health inequalities. Disparities in community health and access to vital services are causing difficulties across the country, but they have had a disproportionate impact on my constituents.
My constituency of Manchester Rusholme is urban and incredibly diverse. I am proud to represent so many different communities. We also have many students and young people living in the constituency. Although we are discussing health inequalities, the issue goes far beyond health services. We need a wider debate about the many aspects that contribute towards our mental and physical health. As well as accessible and equal healthcare, that includes access to safe and clean local environments, stable work and income and secure and affordable housing. I will discuss the importance of those elements throughout the debate.
As Members know, I am passionate about protecting our local natural environments. We all know how beneficial fresh air and green spaces are to our health and wellbeing, but in Manchester, research shows that many have just 1 square metre of garden space. That means that turning parks and community green spaces into attractive outdoor environments is even more crucial. My constituency celebrates its diversity, and our parks are often where different cultures meet in exercise, play and enjoyment. We are lucky to have beautiful and historic parks such as Alexandra Park and Platt Fields Park.
Parks are also a space for those living in a city to escape high air pollution by acting as a carbon sink, absorbing and storing carbon dioxide from the atmosphere. In Manchester, more than 1,200 people die a year as a direct result of toxic air, with babies, pregnant women, elderly people and people with respiratory illnesses most at risk. More than 54,000 children in Greater Manchester also suffer from asthma. We therefore must improve air quality in cities, including utilising public transport and making it easier and safer to travel by walking, wheeling or cycling. Without that, we risk isolating many people from society.
However, even parks are not safe from air pollution. While community green spaces should be an escape from damaging air pollution, evidence from Asthma and Lung UK suggests that less than 1% of the 43,000 public playgrounds in the UK meet guidelines set by the World Health Organisation. I have heard from young people in Ardwick about the air pollution near their school. In Ardwick Green Park, which is bordered by two main roads, children are at constant risk from the emissions just by playing outside. While we must improve access to local parks, we also need to improve air quality more broadly to create truly safe and clean natural spaces.
Jim Shannon (Strangford) (DUP)
May I commend the hon. Gentleman on bringing this debate forward? I spoke to him beforehand to get his thoughts. Does he agree that one of the great things that has happened is that the Minister in government has set aside planning for spaces where people can age well and live in an area designed for them to grow old? That is accelerating, including in Manchester Rusholme, to which he is referring, with some £1.5 billion of funding. That is welcome. As chair of the all-party parliamentary group for healthy homes and buildings, does he agree that along with the 1.5 million houses that the Government are committed to ensuring will be built, environmental areas must be set aside? Trees are the lungs of the world, and trees have to be part of this, and they need to be planted for the future.
Afzal Khan
I could not agree more with the hon. Member. We need to do more to ensure that there is clean air for everyone, because it is essential for each of us to survive.
Another significant obstruction to community health is extensive waste, fly-tipping and litter. Wards in my constituency are plagued by high levels of fly-tipping and a lack of awareness of how to dispose of waste safely and legally. Fly-tipping and litter are an eyesore for residents and cause problems within communities. Countless constituents have written to me about them.
Let me take this opportunity to pay tribute to the brilliant work done by locally led groups in my constituency to target these issues, including the Friends of Park groups, Moss Side Eco Squad, Upping It, and all those who individually “green” their alleyways and litter-pick. However, while being hugely beneficial to us all, their work should not be necessary. I have also been pleased to support the initiatives that the Government are already taking, such as the drink container deposit scheme, to encourage recycling. I thank my own local authority, Manchester City Council, for putting even more funds into dealing with fly-tipping this year to get to the root cause. We know that tackling this problem systematically is vital.
As well as being clean, green and tidy, our local environments must be safe, but high levels of knife violence have caused problems in Manchester for many years. Over the last three years, Greater Manchester police has recorded more than 2,000 crimes of possessing an
“article with a blade or point”.
Knife crime has also led to the tragic deaths of numerous young people in recent years, sadly including some of my own constituents. We cannot continue to let our young people down by allowing them to fall into violence. I am relieved that the Home Secretary is taking this issue seriously, and has already banned the ownership of certain dangerous knives. I am also grateful for the work of community groups in my constituency such as Mero’s World, the Hideaway Youth Project, Youth on Solid Ground and Moss Side Millennium Powerhouse to raise awareness of the terrible reality of knife violence,make bleed packs more accessible for responsive action, and give young people a safe place to go. We must work on preventive measures to stop knife violence devastating our communities: that must remain a top priority.
Poor standards of work, poor pay and job insecurity also contribute to low levels of community health. Job stability determines everything from a financial safety net to housing conditions, heating and eating nutritional food, but more than 13,000 people in my constituency are not in employment, which is more than the UK average. Nearly 14% of people rely on out-of-work benefits in Manchester, the eighth highest percentage in the country. As for those who are in work, more than 11% of people in Manchester are in low-paid employment, which is significantly higher than the national average. As we all know, low-paid work can damage both physical and mental health, increasing stress and anxiety levels, which are made worse by external factors such as the cost of living crisis. We also know that people from communities that experience racial inequality often have higher levels of unemployment than others. Those higher levels of unemployment and low-paid work in our area are detrimental to the general wellbeing of the community, and contribute to higher levels of poverty.
Furthermore, it is shocking that more than 47% of children in Manchester are living in poverty. That is the third highest proportion in the country. Growing up in poverty has an impact on childhood development, and plays a significant role in education and early-years experience. For example, children in the most disadvantaged areas are less likely to pass key GCSEs. Health Equals has found that children growing up in poverty are four times more likely than those from wealthier families to struggle with mental health issues by the time they are 11. This creates a worrying future for young people growing up in my constituency, who will be disproportionately affected by poor economic conditions. I am pleased that the Government are committed to breaking down those barriers that exist for young people. Children and young people cannot be forgotten in conversations about our local community, because they form a key group in our community who desperately need support that has previously been lacking.
A further issue that is fundamental to the health of our community is housing. Affordable, warm and safe housing should be a fundamental right, yet so many people are living without this necessity. In Manchester Rusholme, up to 40% of households privately rent—double the national average—yet over one in four privately rented homes across Manchester are non-decent. I am grateful for the Government’s efforts to deliver on our promise to transform the rented sector through the Renters’ Rights Bill, which will provide much-needed security for renters across the country.
I am proud to have such a diverse community living in my constituency, but no one should suffer due to their identity or background. For example, research shows that mixed-ethnicity households are more likely to live in houses with damp. Exposure to damp and mould can cause serious illnesses or worse, as we saw with the tragic death of Awaab Ishak. Given these inequalities, my constituents are disproportionately impacted by poor housing. Housing is a critical issue for my constituents, and takes up nearly 30% of all casework sent to me.
Housing in our area has become unaffordable and inaccessible, and is in poor condition. Outside the private rented sector, 28.5% of households in Manchester live in social rented homes—one of the highest rates for authorities outside London. I will continue to work with housing associations to ensure that all my constituents are in good-quality social housing. Being on the waiting list for social housing can take years, denying access to families and individuals in desperate need. I thank Manchester city council for being proactive in investing in even more social housing across my constituency so that everyone can live a healthier life.
I have outlined the disparities in local environments, employment and housing, and their impacts on both individual health and community health. On the back of that, I know my colleagues will agree that where someone lives should not determine how long they live, but in Manchester Rusholme we have the 19th lowest life expectancy of all constituencies, at 77.2 years—seven years lower than the figure for the healthiest communities. This large disparity is unacceptable and truly highlights the problem facing the constituency. It acts as a motivator for me to improve community health in any way possible.
The wider health inequalities seen across the UK are also detrimental for my constituents in Manchester Rusholme. For example, women in my constituency are suffering due to regional inequalities; women in the north-west are less likely to be treated for mental health conditions than those in other regions, as there is a gap in treatment based on where people live. In Manchester, black, Asian and minority ethnic communities were disproportionately impacted by the covid pandemic. We know that many mental and physical health impacts have been proven to be caused by discrimination.
We cannot deny the increasing pressure of the mental health crisis in Manchester. Hospital admissions for mental health conditions have increased among those aged under 18, as have mental health absences from work. Looking at the health of our communities should first involve looking at the health of residents. Addressing health inequalities is crucial to wider community health, and I thank the Caribbean and African Health Network and the neighbourhood health champions for their hard work in this area. As the Darzi review outlined, vital health disparities exist in almost all aspects of care due to the impact of poverty and homelessness, and disparities between ethnicities and for those with learning disabilities. We must act urgently to ensure that no one is left behind, and that our health service and the factors contributing to our health are equitable.
Our local community greatly determines our overall health and wellbeing, as well as that of wider society, but poor standards in health, the environment, work and housing detract from that wellbeing. The impact of these issues on households cannot be overstated, and quality of life cannot remain a postcode lottery. I thank all the charities, organisations and volunteers in my constituency for working to improve our community health, but the weight of improving wellbeing for the constituents of Manchester Rusholme cannot rest solely on their shoulders. I am therefore calling for a cross-governmental community health strategy to tackle the unequal access to a good quality of life through health, local environments, housing and standards of work. I am interested to hear the Labour Government long-term plans to ensure that everyone can live happier and healthier lives. We have an opportunity and a duty to protect our local communities, and to encourage them to prosper and flourish, as they have so much to offer.
The Minister for Care (Stephen Kinnock)
I congratulate my hon. Friend the Member for Manchester Rusholme (Afzal Khan) on securing this important debate. Before I begin my remarks, I would like to pay tribute to some of the stellar charities that are working to reduce health inequalities: the Health Foundation, which is leading the way with its Health Equals mission; the People’s Health Trust, which is providing funding and support to left-behind communities; and the BHA for Equality, which was founded in 1990 to address the lack of quality information and services for black communities in Manchester.
I am responding on behalf of the Minister for Public Health—the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for West Lancashire (Ashley Dalton)—but I am more than happy to take this debate because I recognise many of the issues that my hon. Friend the Member for Manchester Rusholme mentioned from my own constituency. I am responding not just on behalf of the Government, but as an MP from a constituency with some of the highest levels of deprivation in the United Kingdom.
I agree with my hon. Friend that the levels of inequality between the better-off and worse-off in our country are a national scandal. Fourteen years of austerity measures and stagnant wages have disproportionately affected lower-income households, exacerbating both income and regional disparities. Places such as Manchester and Port Talbot have borne the brunt. The life expectancy for Mancunian men and women is significantly worse compared with their compatriots in the rest of England. A baby boy born in the Manchester royal infirmary can expect to live for just over 75 years, which is four years less than the English average. A baby girl born in Manchester can expect to live to the age of about 79 and a half, which is also four years less than in England as a whole.
My hon. Friend raises some issues that are not within my Department’s remit, including housing, knife crime and fly-tipping, but I completely understand why he has done so, because the determinants of ill health are wide and it is much more than a single factor that predicts healthy life expectancy. The Government know that we cannot address the challenges we face in the north-west with each Department in Whitehall siloed one from another, so we are taking a whole-of-Government approach to tackling inequalities through our health mission. That is chaired by the Prime Minister, who is lending his weight and authority from the centre of Government.
We have a laser focus on addressing the social determinants of health in a truly strategic way, and addressing the wider determinants of health to improve healthy life expectancy for all, while halving the gap in healthy life expectancy between different regions of England. We are prioritising prevention, shifting more care into the community and intervening earlier in life to raise the healthiest generation of children in our history. Addressing healthcare inequity is a core focus of our 10-year health plan to ensure that the NHS is there for anyone who needs it whenever they need it. We have established 11 working groups to take forward policy development that will feed into the plan. That includes working groups focused on how care should be designed and delivered to improve healthcare equity, alongside ensuring that access to healthcare services is effective and responsive. We look forward to updating the House once the plan is published in June.
Proximity to fast food outlets is strongly associated with obesity. Kids living in the most deprived communities are in proximity to twice the number of fast food outlets compared with wealthier areas. Nearly 3,500 schools across the country now have a major food outlet within 400 metres; that is 1,000 more schools than 10 years ago.
We have an outstanding mayor in Andy Burnham. Devolution gives him and other leaders in Greater Manchester the freedom and flexibility to set priorities locally. In December, the Government published the revised national planning policy framework for local authorities, which gave them stronger, clearer powers to block new fast food outlets near schools and where young people gather. This will stop the relentless targeting of children and young people by the fast food industry.
I am delighted that just last week, the Tobacco and Vapes Bill passed its Second Reading in the other place. Smoking is a scourge on deprived communities and contributes to poverty, ill health and a lower life expectancy. Britain is leading the world through landmark legislation to break the cycle of addiction and disadvantage by gradually ending the sale of tobacco products across the country. The Bill contains powers to extend the ban on smoking indoors to certain outdoor settings to reduce the harms of second-hand smoking, particularly around children and vulnerable people.
Over the past 14 years, a two-tier health system has emerged in our country. People who can afford it are increasingly going private to skip the queue, while those who cannot are left behind. We are determined to end two-tier healthcare in this country, so whether someone is the richest or the poorest person in Manchester, they get timely, quality treatment that is free at the point of use. Our elective reform plan will see more NHS patients able to choose to be treated in a private hospital, where there is capacity, paid for by the state. More capacity will be available for people in working-class areas of the country and for women stuck on waiting lists for gynaecological care. Where we can treat working people faster, we will, and we will make no apology for doing so—working-class patients in this country deserve the same choice, control and convenience as the wealthy expect—and I am delighted that waiting lists have been falling now for six months in a row.
The previous Labour Government did so much to reduce inequality: lifting millions of children out of poverty through Sure Start; giving a lifeline to working families through child tax credits; creating the minimum wage; and fixing the NHS after almost two decades of under-investment. It is a matter of profound regret that so much of that legacy has been undone over the past 14 years, but the people of Manchester don’t just want us to look back in anger; they want us to get on with the job of building homes, fixing the NHS and putting more money in people’s pockets. My right hon. and learned Friend the Prime Minister has spoken about the “class ceiling” that prevents children from getting ahead. I look forward to working with my hon. Friend the Member for Manchester Rusholme to shatter the class ceiling that hangs above his constituency and mine.
Question put and agreed to.