Health Inequalities (North-East)

Alan Campbell Excerpts

Tuesday 24th January 2012 Westminster Hall

[Mr Alan Campbell (Tynemouth) (Lab)]

It is a pleasure to serve under your chairmanship, Mrs Riordan. I promise not to mention Leeds, which is nearer to your constituency than it is to the north-east.

I congratulate my hon. Friend the Member for Newcastle upon Tyne Central (Chi Onwurah) on securing this important debate. She set out very well the challenges facing our constituents in addressing health inequalities, which still exist in the north-east, despite the progress made over the 13 years of the Labour Government. I have to say I found the hon. Member for Redcar (Ian Swales) somewhat confusing and confused about the nature of those inequalities—I suppose confusion is one result of trying to face both ways.

I want to make three broad points, and I will be interested in the Minister’s response to them. The first is about health spending in the north-east. The Government’s view is that NHS spending will continue to grow overall in the next few years, and figures from the House of Commons Library certainly confirm that planned spending is set to grow in cash terms. For 2010-11, the cash figure is £102 billion; by 2014-15—at the end of the spending round—it is set to be £114.4 billion. If we look at the issue in real terms, however, and we take 2010-11 as a base figure, the broad trend is essentially flat.

I do not, however, want to argue that point. Instead, I want to ask how that spending affects the north-east and institutions in my constituency. The Government will no doubt tell us that there is a 3% increase for PCTs this year. They will say that is evidence of their commitment to growing budgets; in fact, that is, effectively, what the Secretary of State said on this morning’s “Today” programme. However, the tariff that funds hospital treatment has been reduced. Next year, the budget of Northumbria Healthcare NHS Foundation Trust, which serves my constituency and those of a number of Members here, will be reduced by 1.9%. Hospitals have a key role to play in not only treating patients, but addressing health inequalities, and I want to place on record the excellent work done at my local hospital—North Tyneside general hospital—particularly in treating diabetes and stroke, where we have made huge advances in the past few years, although we are still running to catch up.

My first question to the Minister, therefore, is this: if PCT budgets are rising, why are hospital budgets, which are already under pressure, being cut? Where is the money going? Is it to pay for reorganisation? Will the Minister confirm the fear that PCTs are required to put the extra money into contingency funds to pay not only for reorganisation, but for other things that might arise? Will she confirm that if those things do not arise, that money will be clawed back by the Department of Health and ultimately, one fears, by the Treasury? That helps to explain the difference between the planned expenditure that the Government announced and the actual expenditure in the past 12 months.

The second issue I want to turn to is alcohol-related harm. The north-east has a reputation for heavy drinking, which in some ways reflects our heavy industrial past. The region does significantly worse than the English average on alcohol-related hospital admissions. In February 2009, Balance, the north-east alcohol office, was launched, based on the excellent work of Fresh, which works for a smoke-free north-east. For the first time, we had a strategy that covered the whole region on this issue. One of Balance’s concerns—I remain to be convinced on this issue—relates to the introduction of a minimum unit price for alcohol. There was no consensus in the previous Government on the issue. The Home Office, of which I was proud to be a member, was sceptical about minimum unit pricing, because it was most concerned about addressing alcohol-related crime and disorder. However, the Department of Health, which was more concerned about individuals’ health, was more positive.

Just before Christmas, the Prime Minister entered the debate in The Daily Telegraph, saying that he was in favour of minimum unit pricing and will overrule any Department or Minister who stands in his way. As my hon. Friend the Member for Newcastle upon Tyne Central asked, will the Minister confirm that the Government will introduce proposals for minimum unit pricing and, if so, when? Will she confirm that the Department of Health supports the policy? Is she personally committed to it? Is the Secretary of State a supporter of it?

Thirdly, I want to acknowledge the points that have been made about health inequalities being addressed only if we go beyond NHS professionals and make sure that individuals make the right choices about issues such as smoking, how much alcohol they consume and whether they eat healthily. The Government have a role to play—if they had not played a role, we would not have made the progress that has been made in recent years.

In my constituency, there is a clear link between health inequality and deprivation. Life expectancy in the borough of North Tyneside is 76.8 years for a man and 81 years for a woman, which is about 18 months lower than the English average. However, in parts of my constituency, such as Chirton ward, Valley ward, Collingwood ward, central Whitley Bay and central North Shields, life expectancy can be about 11.5 years less for a man and over nine years less for a woman than it is in the least deprived areas of our country.

As we have been told, the Marmot review recommended that the focus should be on the social causes of health inequality, and it highlighted the need for an effective integrated approach. In my constituency, however, health inequality is worst among those groups and those areas that are most likely to be hit by cuts elsewhere. My hon. Friend the Member for Strangford (Jim Shannon) mentioned Northern Ireland. I recall, as he will, that the Prime Minister—then the Leader of the Opposition—was interviewed by Jeremy Paxman days before the general election. They talked about the scale of public spending cuts, and the Prime Minister was asked to name the regions that would be hit worst. The first one off the tip of his tongue was the north-east and the second was Northern Ireland, so my hon. Friend and I, as well as my other hon. Friends, are here to raise these issues because our regions face the most cuts overall.

Let me give an example of what that means. North Tyneside council has to make £48 million of cuts over the next four years. Next year and in subsequent years, it proposes to charge bowling clubs more to use bowling greens. It also proposes to close more bowling greens in my constituency than in any other part of the borough. The outcome will be that fewer people will be involved in the sport. Many of them will be pensioners, and my constituency has one of the highest numbers of pensioners of any in the country. The proposal could have an adverse impact on their physical and mental health.

I am concerned about getting a joined-up, integrated approach—which just is not happening. The region has a better than average record of reducing child poverty and premature winter deaths, but what effect will the proposed benefit changes have, and what about increasing energy prices, which the Government appear powerless to do anything about? What about the impact of cutting Warm Front? That will affect not just the bills of people who are trying to keep warm, but their health.

Do the Minister and the Government believe that central Government still have a role to play in reducing health inequality? Will the Minister confirm that she is raising the issue of health inequality across Government, wherever Departments want to take action? I tell her this: in our region alarm bells are ringing about the effects on health and a range of other matters. Or has her Department, as the report of the Select Committee on Health suggests today, put its focus and energy on a costly NHS reform Bill, which no one asked for and for which there is decreasing support?