Health: Women and Low-income Groups

Baroness Royall of Blaisdon Excerpts

Thursday 20th March 2014 Grand Committee

[Baroness Royall of Blaisdon (Lab)]

My Lords, following on from the noble Baroness, it is my fervent hope that before I die PSHE will be a core part of the curriculum in every school in this country. That is what we must fight for. I add my thanks to the noble Baroness, Lady Manzoor, for enabling us to have this important and wide-ranging debate. The speeches have given us terrific—and horrific—facts and figures, and much food for thought.

Like other noble Lords, I woke on Monday morning to read articles about the report from Oxfam, A Tale of Two Britains, which showed that the richest five families are worth more than the poorest 20% of people in this country—that is, 12.6 million people, almost the same as the number who live below the poverty line. These figures are deeply shocking and proof of the profound inequalities in our society. The report also said that, for the first time, more working households were in poverty than non-working ones and predicted that the number of children living below the poverty line could increase by 800,000 by 2020.

We know that there is a direct correlation between health inequalities and poverty. Many of the solutions to health inequalities lie outside the health sector—for example, with housing, good employment and security. As in so many areas, it is women who suffer most from health inequalities, not just personally but because they have responsibility for the health of children, partners and elderly parents. The Joseph Rowntree Foundation comments:

“Health and poverty are intertwined—being trapped in poverty piles on stress that perpetuates the cycle and worsens health further”.

I know that the Government will say they have taken action in the Budget to reduce poverty, but it is the reality for millions of people in this country. Next month, when last year’s Budget adjustments are made, they will still be living in poverty while millionaires are thousands of pounds better off.

Housing has a huge influence over people’s health: temporary accommodation; overcrowded rooms; damp walls; inadequate cooking facilities in B&B accommodation; cold homes because there is not enough money for the meter; and the stresses and strains of struggling to pay exorbitant rents. The Government will also say that they are taking steps to make affordable housing more accessible with schemes such as Help to Buy. Those schemes may well help some people and I am glad, but they do nothing to help people who are desperate to rent affordable homes, either from the public or the private sector; they merely create the potential for a housing bubble.

I am sure that we all agree with the conclusions of Sir Michael Marmot’s review on health inequalities, one of which is to ensure a healthy standard of living for all. Yet obesity is the plague of our era, first because of lack of activity and secondly because of poor diet: 26% of adults and 30% of children are classified as obese, the fourth highest level in the world. In a terrific debate last night on the report of the Olympic and Paralympic Legacy Committee, speaker after speaker spoke with concern about the need for greater emphasis on PE in the school day and how high-quality PE and sports programmes can boost school attendance, challenge anti-social behaviour, improve academic performance and, of course, make children healthier now and improve their future health. What are the Government going to do about this issue, which is inextricably linked to health inequalities? Last year, the National Children’s Bureau found that children living in deprived areas are nine times less likely than those living in affluent areas to have access to green space and places to play and to live in environments with better air quality.

Alongside exercise, a healthy and balanced diet is also essential but, given that Britain has some of the highest and most volatile food prices in western Europe, this is becoming harder and harder for people struggling with the squeeze on their household budget. Poverty means that, even though parents might know that fresh food is healthier than processed food, tinned and frozen food is often cheaper and, if you live in a B&B with a single gas ring or you are simply exhausted because of the stresses and strains of life, fast food looks like the only option. The health of many women often suffers because they regularly deprive themselves of food when the choice is between feeding themselves or their children. Yes, they can resort to food banks but only on three occasions can they suffer that indignity. I was extremely disappointed by the complacent and patronising response from the Government at Question Time today. It demonstrated a complete lack of understanding of the realities of life for so many people. My noble friend Lady Whitaker, who is in her place, said that since food banks got going at their present scale hospital admissions for malnutrition have increased by 74%. In answer, the Minister said,

“we are working with business and others to encourage people to adopt a healthier diet”.

That is not the appropriate answer. It demonstrated no grasp at all and a total lack of empathy, as did the continued emphasis on charitable giving. I celebrate the work of charities; food banks do a fantastic job, but I abhor the poverty that drives people to them.

On Tuesday, I had the privilege of spending a few hours with a young woman whom I first met when she was an inmate in HMP Eastwood Park. Thanks to her own resilience and work in the soap enterprise in the prison, of which I am the proud patron, she has turned her life around and is now in employment and caring for her children. We talked about inequalities and the problems that lead to women’s imprisonment, as well as their health problems, specifically mental health problems. The figures are stark: 70% of female sentenced prisoners suffer from two or more mental health disorders, yet, as in the general population, there is no parity between mental and physical health care. She suggested that, in order to help the women avoid problems following sentencing and to reduce consequential costs, every woman should have a mental health assessment before beginning her sentence. This seems an excellent idea and I would be grateful if I could discuss it further with the Minister together with Maria Thomas of the Shaw Trust, who has done a lot of work on this. I look forward to the responses from the Minister to the excellent questions raised today.