Health and Care Bill

Baroness Greengross Excerpts

Lords Hansard - Part 1 & Committee stage
Thursday 13th January 2022 Lords Chamber

[Baroness Greengross (CB)]

My Lords, in October last year, during the debate on the Ageing: Science, Technology and Healthy Living report, the Minister, the noble Lord, Lord Kamall, confirmed that the Government maintain their commitment to ensuring that people live at least five extra healthy and independent years of life. A practical first step towards achieving that goal would be to ensure that tackling health inequalities is a priority in this legislation, and the amendments in this group seek to achieve that. We know that health inequality is a problem that has been getting worse, and we need to tackle it as an emergency. I support the amendments in the group calling for NHS England, NHS trusts and the integrated care strategy to collect relevant information and data, as well as to take the necessary action to prevent health inequalities and improve healthy living.

In 2010, as we know, Sir Michael Marmot published his report on health equity, finding that social position determined people’s health outcomes and that people at the lower end of the social gradient had worse health. At the time, the report recommended that the focus on improving this should not be targeted just at those from the most disadvantaged parts of the country but should take a universal approach to improving health outcomes, which is very much needed. The report highlighted the economic benefits of addressing health inequalities. In particular, it raised the issue of lost productivity, increased spending on welfare and lost tax revenues due to people having to leave work as a result of poor health.

Just before the pandemic, in 2020, Sir Michael Marmot did his 10-year review, and we know how alarming the findings of that report were. For the first time, life expectancy had stalled in the UK. In the poorest 10% in England, the life expectancy of women actually declined between 2010 and 2012 and between 2016 and 2018. Mortality rates for people between 45 and 49 years old increased, and in many cases those were deaths of despair, due to suicide or substance abuse. That is terrible news. The level of child poverty has also increased in the UK to 22%—compare that with Norway, for example, where child poverty is 10%. That is also alarming. The number of years lived in poor health across England has increased and continues to be worse in the poorest parts of the country.

We hear much about the so-called levelling-up agenda from the Government. One finds it hard not to dismiss it as little more than a glib and somewhat trite slogan, because there is little to back it up in real policy to try to address issues such as health inequality. However, I am an optimist and I see the Bill as a step towards trying to address these challenges. But to do this effectively we must have a better understanding of the drivers of health inequality. We must have plans at a local and national level to address those drivers. This group of amendments offers some solutions to start addressing health inequalities through this legislation. I look forward very much to the Minister’s response to these amendments and to hearing his view on how the Bill is going to achieve the Government’s goal of people living at least five extra healthy and independent years of life.