Austerity: Life Expectancy

Lord Hanson of Flint Excerpts

Wednesday 18th April 2018 Westminster Hall

[Louise Haigh]

I am glad that my hon. Friend raises that important point, because I am not able to address all the factors behind declining life expectancy. The British Medical Association raised that point this week, saying it is very concerned about the 5 million children growing up in poverty and the implications that that will have in the future on life expectancy.

[David Hanson (Delyn) (Lab)]

I do not want to divert my hon. Friend from the main course of her speech, but she knows that, over the past 30 years, infant mortality has fallen by 60%, yet from 2015 onwards it has risen in England and Wales each year. Holywell Central and Flint Castle wards in my constituency have child poverty rates of 43% and 42%. We have seen an increase of 100 children in poverty in my constituency in the last year. This is a long-term issue, which we need to address.

[Louise Haigh]

My right hon. Friend is absolutely right: these are long-term issues, which need addressing. They are all the more heartbreaking because we have seen decades of progress, and we all assumed that that would only go in one direction; little did any of us imagine that we would see a rise in infant mortality in the sixth-richest country in the world. These figures are, quite frankly, inexcusable.

On social care, care homes in deprived communities often no longer receive enough to cover the costs of care, which inevitably compromises the quality that they are able to provide. For those in such communities who cannot afford private care homes, that reduction of quality, and in some cases the lack of any available residential care at all, has had a punishing effect.

All Members present will have received casework regarding those still in their homes in the community who rely on care packages. Their care is simply unacceptable, relying on care workers who are paid far too little and who often do upward of 25 care visits every single day. There is not a chance, even by unsustainably drawing on the boundless good will of those care workers, that visits could last for 30 minutes, as defined by official guidance. It is beyond the realms of possibility. Those millions of hours of lost contact time for the 470,000 vulnerable—predominantly elderly—people who use home care will have undoubtedly compromised their long-term care and support needs and the management of multiple conditions.

It perhaps should not be a surprise that the rise in mortality and the fall in life expectancy came from precisely that cohort—older women living alone in poorer areas. In many senses, they were the early-warning sign of the deeply troubling trend in increasing mortality. This cohort, more reliant than any other on a functioning, effective, compassionate state providing quality support, have been badly let down in recent years. It should be a source of national shame that elderly women in some of the most deprived areas of our country are living in isolation, not properly cared for, and are losing their lives because the state has not supported them. However, it is not just that cohort of women. Some 7% of the extra deaths in 2016-17 were of people aged between 20 and 60. Almost 2,000 more younger men and 1,000 more younger women have died than would have if progress had not stalled.

I am sure that the Minister cannot look at the evidence presented here today, or at the research undertaken over the past two years, and not want to take steps to tackle those shocking statistics and to prevent those lives from being cut short. It is therefore critical that Ministers and the Government take seriously the fall in life expectancy and the evidence behind the growth in mortality. Up to now, Public Health England has regrettably tried to attribute it to the greater prevalence of flu. However, as Loopstra noted in her report:

“If Public Health England’s attribution of rising mortality to cold weather and flu is correct, then it should lead to an elevation of mortality in regional swathes across the nation. However…trends have varied considerably across local authorities, with no apparent geographic patterning consistent with regional outbreaks.”

The rise in unexpected mortality and the concurrent fall in life expectancy represents a significant moment in the history of public health in this country, yet the Department of Health has so far rejected the call from public health professionals for an inquiry into the sharp rise in deaths. I repeat that call today, and ask the Minister to look very seriously at the evidence presented on the link between life expectancy and austerity.

I will end on the words of Danny Dorling and Stuart Gietel-Basten, who have undertaken so much of the research in this area:

“demography is not destiny. Projections are not predictions. There is no preordained inevitability that a million years of life need be lost…but only through politics comes the power to make the changes that are now so urgently needed.”

The Minister has that power in her hands, and there can be no more pressing question for her than to ask why the citizens of our country are dying sooner than they should. I hope she leaves no stone unturned in pursuit of that answer.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health (Jackie Doyle-Price)]

It is a pleasure to see you in the Chair, Mr Paisley. I thank all hon. Members who have contributed. Clearly, we all want the best possible outcomes for all our constituents, and it is in that spirit that we approach this debate. I congratulate the hon. Member for Sheffield, Heeley (Louise Haigh) on securing the debate. I know her constituency well. Actually, looking at hon. Members opposite, I know the constituency of the hon. Member for Lewisham, Deptford (Vicky Foxcroft) well, also. That really brings into stark relief some of the issues we are talking about, because at the heart of the issue of life expectancy is the issue of inequality. I can speak from personal experience in my own constituency. The hon. Member for Washington and Sunderland West (Mrs Hodgson) talked about the differences between north and south, and rich and poor. Within my constituency there is a 10-year difference in life expectancy in the two-mile trip from the north of my constituency to the south, where it is poorest.

We are all acutely aware that inequalities lead to lower life expectancy. It would be a poor Minister for Health—indeed, a poor Member of Parliament or anyone involved in public life—who did not think that was important. It is important that we address it and we are determined to do so. I will run through some things, which tell a better story than the stark figures we have heard today. I will also address some of the points made about those figures, because I think it would be premature to draw too many conclusions at this stage about the causes of those and whether this is a long-term trend.

My hon. Friend the Member for South West Bedfordshire (Andrew Selous) also made some wise points. Ultimately, we can only spend what we collect from taxpayers. We are having an active debate on the extent of the funding we need to make available for health and social care. In this 70th anniversary year of the founding of the NHS, it is appropriate to focus on that. We will continue, notwithstanding the fiscal challenges that we face, to prioritise spending on health.

It is important to emphasise that this dip in life expectancy is not unique to the UK. We have seen it elsewhere in Europe. We need to be circumspect about drawing too much by way of conclusion.

The hon. Member for Washington and Sunderland West mentioned the Prime Minister’s speech. I want to supply the context of the Government’s approach against the background of that speech. The Prime Minister made it a priority to fight injustice and inequality. Ultimately, we know that by focusing actions on the people, communities and localities with the greatest needs, we will achieve the best health outcomes. As the hon. Lady said, we will also reduce long-term demand on the NHS and social care services, so it is smart to focus our strategy on tackling inequality.

We need to be honest about facing up to what the sources of inequality are. Sometimes, those will make us uncomfortable. One of the most disadvantaged groups in our society is those with learning disabilities. They will live 20 years less than the rest of us. For me, that is a very uncomfortable truth to live with. Successive Governments have tried to direct resources to help that group of people, but it is still not working. That leads to the realisation that this is as much about behaviour and leadership as it is about money.

[David Hanson]

Putting that aside for one moment, could the Minister explain to Members of the House why infant mortality rose for the first time in 30 years in 2016 and 2017? If it is not linked to the issues that my hon. Friend the Member for Sheffield, Heeley (Louise Haigh) mentioned, what is it linked to?

[Jackie Doyle-Price]

The right hon. Gentleman knows that we have made tackling that a priority. It is too early to draw any conclusions. It is the case that poverty is a big source of inequality, but we need to do more work before drawing conclusions. Having developed the evidence, we will act. There is a reason that we have developed a national maternity safety strategy. There is a reason we are focusing resource on the perinatal phase, because we recognise it is critical. We will also continue to spend money on the healthy living supplements to give children a better start in life and to tackle some of those inequalities.