Smokefree 2030

Andrew Gwynne Excerpts

Tuesday 26th April 2022 Westminster Hall

[Andrew Gwynne (Denton and Reddish) (Lab)]

It is a pleasure to serve under your chairmanship, Ms Nokes. I begin by thanking the hon. Member for Harrow East (Bob Blackman) for his tireless work in this area, along with my hon. Friends, and for the way he opened the debate. I also wish him a happy birthday.

Over the past 50 years, positive steps have been taken towards ending smoking, on both sides of the House. I am pleased to be here today responding to the debate on behalf of the shadow health and social care team from Her Majesty’s Opposition, because, from my point of view, it is a matter of great pride that I was in Parliament when Labour’s smoking ban was passed into law in 2006. It has become one of the defining public health achievements of the last Labour Government. The positive impact that it has had on the health of the nation is plain to see.

However, there is still much more to do, as we have heard in various speeches this morning. Smoking continues to be the leading preventable cause of ill health and mortality in England. The NHS estimates that 78,000 people in the UK die from smoking each year, with many more living with debilitating smoking-related illnesses. Smoking causes 44,000 cancer diagnoses per year, with almost 70% of all cases of lung cancers caused by smoking.

Smoking blights communities right across the country and contributes to the yawning health inequalities that we currently witness. However, smoking affects not only those who choose to do it; it affects many people around them, too. For example, a child who is exposed to second-hand or passive smoke has an increased risk of cot death, and of developing chest infections, meningitis and many other serious conditions.

The consequences of smoking are stark and affect not only our health, but our economic prosperity. My constituency of Denton and Reddish in Greater Manchester sits across the boroughs of Tameside and Stockport. Each year, smoking costs Tameside over £95 million in lost productivity and health and social care costs, and in Stockport that figure is just above £77 million. In my constituency, 22% of adults smoke, which is well above the national average of 14.5%. We will never truly level up while smoking continues to hold communities and individuals in a vice grip. We need to take robust and radical steps if we are to have any hope of reaching smokefree 2030.

Unfortunately, as we have heard in various contributions, there has been characteristic dither and delay from this Government, I am afraid to say. We were promised an updated tobacco control plan last year, but so far it has failed to materialise. The Government like to talk the talk on smoking cessation services but, as we have heard from numerous contributions, they have brutally slashed the local authority funding that allows those very services to exist.

The public health grant has been cut by £1 billion in real terms since 2015-16, and stop smoking services have suffered a funding decline of around one third over the same period, as we heard from the hon. Member for Harrow East. The Government cannot have it both ways; either they are for a smokefree 2030, and therefore they should support smoking cessation services, or they are not, in which case they should ditch the warm words. I will take the Government at face value—they want a smokefree 2030—so let us get that investment reinvested in smoking cessation services and let us restore public health funding.

I would be grateful if the Minister set out in her response a timeline for publishing the next tobacco control plan, and I want her to commit to publishing Javed Khan’s independent review into smokefree 2030 policies by no later than the end of May. Furthermore, can she outline what plans her Department has to improve access to smoking cessation services, and will she admit that stinging cuts to the public health grant have left communities such as mine, and those of many other hon. Members here today, worse off?

Yesterday, Members voted on the Government’s Health and Care Bill. The all-party parliamentary group on smoking and health set out several recommendations, as we heard from my hon. Friend the Member for Stockton North (Alex Cunningham), on how to achieve a smokefree 2030. Several of those recommendations were tabled as amendments to the Bill. Labour Members were proud to support many of those amendments and proposals, yet the Government refused to back them, much to the disappointment of health leaders and politicians across the House.

The need for a smokefree 2030 has been reinforced during the course of the pandemic. We know that during the first year of the coronavirus crisis, the number of 18 to 34-year-olds who classed themselves as smokers increased by a quarter, from 21.5% to 26.8%. That is a huge increase and one that will have a lasting negative impact on the health of people across the country, unless they are given the tools to stop smoking for good.

In short, we are falling behind. We have a smokefree 2030 ambition, but very little in the way of funding and a seeming lack of urgency from the Government to publish the tobacco control plan.

[Mary Glindon]

My hon. Friend is probably aware that I am an advocate for vaping. Major reports by the former Public Health England and the Royal College of Physicians have highlighted the reduced risk potential of vape products. Does he agree that the Government must address consumer misperceptions regarding the relative risk reduction of vaping compared with smoking combustible cigarettes?

[Andrew Gwynne]

I thank my hon. Friend for that intervention, and I think my answer will be very similar to that given by the hon. Member for Harrow East earlier. Yes, vaping has a clear role to play in reducing people’s addiction to nicotine and tobacco products, and clearly it has health benefits over smoking. However, I am increasingly concerned, partly because I see it in my own constituency—I recognise that this is only anecdotal evidence, but I see kids vaping. There is no good reason for children in Tameside or Stockport, or anywhere else in the United Kingdom, to be vaping.

I think the Government have to look very clearly at what is happening here, because vaping has a real role to play in helping people to wean themselves off nicotine and tobacco products, which I support. However, if we are starting to see children vaping because it is seen as the cool thing to do, as a replacement for what smoking was back in the day, then I think that is a cause of real concern that needs to be looked at. Like the hon. Member for Harrow East, I really do see the benefits of vaping, but we have to tread with caution, because we are starting to see the next generation of vapers being created. I want all children to be not just smokefree but vape-free. As I said, children have no reason to vape.

In closing, can the Minister say whether she recognises our concern about the lack of a tobacco control plan; whether she recognises the need to do more in such a short period, because we are now only eight years away from 2030; and whether she will pledge to resume public awareness campaigns about smoking and start to get really serious, as I know she wants to be, about a smokefree 2030?

Javed Khan’s independent review is exceptionally welcome, but we need to know that his recommendations will not be brushed aside. The tobacco control plan, when it comes, must contain the bold measures needed to create a healthier and more resilient nation. I give the Minister my word that the Labour party is ready and waiting to support the Government on that. We will give her the backing she needs to drive through the necessary reforms in Parliament. We cannot afford to waste more time. The clock is ticking, and as each second passes a smokefree 2030 slips further from our grip. Let us take this opportunity to redouble our efforts, with support from across the House, to make a smokefree 2030 a reality.

Childhood Cancer Outcomes

Andrew Gwynne Excerpts

Tuesday 26th April 2022 Commons Chamber

[Andrew Gwynne (Denton and Reddish) (Lab)]

I sincerely thank the hon. Member for Gosport (Dame Caroline Dinenage) for securing the debate, for all the work that she does to raise awareness of childhood cancer outcomes, and for the powerful way she spoke.

I thank my right hon. Friend the Member for Alyn and Deeside (Mark Tami), who spoke with personal experience; my hon. Friends the Members for Coventry North West (Taiwo Owatemi), for Dulwich and West Norwood (Helen Hayes), and for Leeds East (Richard Burgon); and my right hon. Friend the Member for Hayes and Harlington (John McDonnell). I also thank the right hon. Member for Romsey and Southampton North (Caroline Nokes) and the hon. Members for Scunthorpe (Holly Mumby-Croft), for Delyn (Rob Roberts), for Stroud (Siobhan Baillie), for South Cambridgeshire (Anthony Browne), for St Ives (Derek Thomas), for Sevenoaks (Laura Trott), for Tonbridge and Malling (Tom Tugendhat), for Meon Valley (Mrs Drummond), for North Norfolk (Duncan Baker), for Hartlepool (Jill Mortimer), for North Antrim (Ian Paisley), for Strangford (Jim Shannon), for Airdrie and Shotts (Ms Qaisar), for East Renfrewshire (Kirsten Oswald), and for Kirkcaldy and Cowdenbeath (Neale Hanvey), as well as the SNP spokesperson, the hon. Member for Coatbridge, Chryston and Bellshill (Steven Bonnar).

I think we all agree and speak with one voice today. This is Parliament at its best. We do not often give ourselves a good name outside of this building, but I think today we have done our constituents and those who send us here thoroughly proud. This is what Parliament does and does well.

I pay tribute to Sophie Fairall and her mum Charlotte, constituents of the hon. Member for Gosport. The bravery, kindness and determination that Sophie showed during her treatment are an inspiration to us all. There is nothing worse and more senselessly tragic than a child being diagnosed with cancer. For many people, that does not even bear thinking about, but the fact is that it needs to be thought about. It needs to be a focus for politicians and policy makers from across the political spectrum. Only by doing that can we give young people and their families the support that they need, and work towards tackling this cruel disease.

As has been noted, although defined as rare, cancer remains the most common cause of childhood death outside infancy and the most common disease-related cause of death in teenagers and young adults. There are several different cancers that children can be diagnosed with; the most common are acute leukaemias and cancers of the brain and spinal cord. Rarer cancers include retinoblastoma or muscle and bone cancers. Different cancers require different treatments, and it is important that access to care reflects that.

This debate is specifically about cancer outcomes, of which there are many. We have all heard utterly heartbreaking stories of children who have lost their lives to cancer—a tragedy that is truly beyond measure—but there are also stories of families and children who have been placed under extraordinary pressures and who have struggled to navigate the confusing and often frightening world of treatment. It is our duty in this House to ensure that the Government do everything they can to support children and their families living through that ordeal.

There has been some positive cross-party collaboration on this issue, and I am grateful that the Lords amendments to the Health and Care Bill relating to cancer outcomes objectives were agreed and that the Government worked constructively with Members of both Houses to achieve that. There have also been positive steps taken with regard to principal treatment centres for children’s cancer and paediatric oncology shared care units.

However, there is so much more we need to do. There are still too many reports of parents being forced to seek alternative care abroad, of poor experiences for patients and their families and of poor quality of life. Worryingly, there are also reports that referrals to principal treatment centres are only occurring in about half of all cases, despite that being contrary to NICE guidance.

As the Teenage Cancer Trust notes, the experiences of young people with cancer can be affected from the very start of their cancer journey until well after treatment has finished. We therefore need to ensure that there is sufficient mental, physical and emotional support in place to help young people through this exceptionally difficult time. I would be grateful if, in her response, the Minister could set out what plans there are to enhance wellbeing support for children and young people diagnosed with cancer, as well as for those who are recovering.

I am incredibly concerned that spiralling waiting lists could lead to missed or delayed cancer diagnoses and thus to worse health outcomes. Early diagnosis is key to improving survival chances and allows for early intervention and treatment. What steps are the Government taking to address that concern? Will the Minister commit to doing more to raising awareness among the general public of how to spot early signs of potential childhood cancers?

There are also issues with research, and I will raise a few key points that I hope the Minister will respond to in her speech. In its cancer services recovery plan, the Government committed to working with the National Institute for Health Research to support the recovery of cancer clinical trials, including for children and young people, by the summer of 2021. Can the Minister update the House on progress on that commitment? Furthermore, given the funding challenges that charities are facing, especially in the aftermath of the pandemic, can she outline what steps the Government will be taking to assist the cancer research sector in its recovery?

Improving childhood cancer outcomes and quality of life must be a priority for any Government. The Labour party is committed to ensuring that our research workforce has the expertise needed to improve childhood cancer outcomes. That work could come alongside training and retraining the staff our NHS needs, as well as developing a proper workforce strategy that gives our health service the tools to provide all young patients with timely care. Furthermore, our pledge to place a qualified mental health professional in every school would ensure that young people living with cancer had the holistic support they so deserve.

In conclusion, I once again pay tribute to the incredible bravery of the campaigners, family members and young cancer patients who work so tirelessly to raise awareness and improve childhood cancer outcomes. I know I speak for the whole House when I say that it is my sincere hope that this debate and the contributions that we have heard on both sides of the Chamber today not only raise awareness of childhood cancer, but facilitate further action from the Government to improve outcomes and access to treatment. This is Parliament at its best.

Oral Answers to Questions

Andrew Gwynne Excerpts

Tuesday 19th April 2022 Commons Chamber

[Mr Speaker]

I call the shadow Minister, Andrew Gwynne.

[Andrew Gwynne (Denton and Reddish) (Lab)]

Warm words from the Secretary of State, but people in the most deprived parts of England are almost three times as likely to lose their lives from an avoidable cause as those in the least deprived areas. With the cost of living soaring and the Resolution Foundation estimating that 1.3 million people will be pushed into poverty as a result of the Chancellor’s spring statement, those inequalities will worsen. Why will the Secretary of State not just admit that his Government have failed the poorest communities, and start doing something about it?

[Sajid Javid]

The hon. Gentleman acts as though health inequalities are something that has just emerged under this Government. There have been long-running health inequalities in this country over decades under successive Governments, and this Government are putting in record investment and coming up with the ideas to deal with them. As ever, the Labour party has no idea how to deal with the challenges this country faces.

Civil Proceedings

Andrew Gwynne Excerpts

Tuesday 29th March 2022 Commons Chamber

[Andrew Gwynne (Denton and Reddish) (Lab)]

I start by echoing the Minister’s thanks to healthcare and frontline public service workers and, indeed, the public for all they have done to get us to this point after two years of the pandemic. I am grateful for the opportunity to respond to the two motions before the House today on behalf of Her Majesty’s loyal Opposition.

Clearly, as the shadow public health Minister, I will be focusing primarily on elements of the motions that relate to public health, but I will also touch on the extension of the justice provisions relating to coroners’ inquests and remote hearings. I know my colleagues on the Bill Committees for the Judicial Review and Courts Bill and the Police, Crime, Sentencing and Courts Bill have already engaged constructively with the Government on those provisions and supported their being moved on to statute.

However, we have called for the Government to provide further evidence on the impact that those measures, particularly remote hearings, may have on people with disabilities and those who are digitally excluded. I would be grateful if the Minister reiterated those concerns to her colleagues in the Ministry of Justice—I notice the Under-Secretary of State for Justice, the hon. Member for South Suffolk (James Cartlidge) sitting alongside her—and urge them to put the appropriate safeguards in place. With a Crown court backlog already at 60,000—caused, I may add, by the Government’s short-sightedness and incompetence—we must ensure that inequality is not further entrenched in our justice system.

Moving on to public health, the Coronavirus Act 2020 was an unprecedented Act for unprecedented times. It enabled the Government to take rapid and wide-ranging steps to limit the spread of covid-19, and in turn to protect lives, livelihoods and our national health service. Correctly, it was never intended to last forever. Vaccination, as the Minister has said, has proved an invaluable tool in our fight against coronavirus, and it is thanks to our incredible scientists, our NHS staff and the British public that we are able to be here today to debate the end of many of the Act’s provisions.

It is important to note, however, that covid has not gone anywhere—it is still very much here. It has certainly not gone anywhere for the 1.5 million people who are living with the symptoms of long covid, or the 800,000 clinically vulnerable and immunosuppressed people who continue to call on the Government for better clarity and access to antiviral and retroviral treatment. I would be grateful if, in her closing remarks, the Minister outlined what steps the Government will be taking to better support those communities, and when full guidance will be given on free testing provision. In three days’ time, the general public will be unable to access free lateral flow tests, yet there is still no guidance on which groups will remain eligible for free testing.

[Mr Perkins]

On behalf of the numerous immuno-suppressed people in Chesterfield and their families who have contacted me, I thank my hon. Friend for what he has just said. He is absolutely right that many of them still feel prisoners in their own home and feel utterly ignored, and the Government’s failure on sick pay has only added to their sense of being forgotten. Will he reinforce the message to the Government that those people are not being properly catered for?

[Andrew Gwynne]

I thank my hon. Friend for his kind remarks. I have met numerous groups representing the clinically vulnerable, the clinically extremely vulnerable and the immunosuppressed communities, and the level of anxiety and worry in those communities is clear. While we have all, to some extent, been able to get back to as near a normal life as possible, those communities still feel isolated, under pressure and incredibly concerned about what mixing and social interaction would mean for them, were they to get coronavirus.

[Debbie Abrahams]

On top of those groups, which my hon. Friend is right to mention, there are also family carers, who are concerned that they may be prevented from having access to their family members in care homes without adequate testing, which they will be forced to pay for if it is not clear that they are included in the free testing.

[Andrew Gwynne]

My hon. Friend is absolutely right. Many of the people who are classed as clinically vulnerable, clinically extremely vulnerable or immunosuppressed are looked after by members of the family or friends who will come into the house to look after them, rather than by paid carers. Were free lateral flow testing to be extended at least to the CV, CEV and IS communities—not for those people themselves, but for the people coming in to communicate and interact with them—it would at least give them some degree of confidence that coronavirus is not being brought through the front door.

[Ms Lyn Brown (West Ham) (Lab)]

I reiterate what my hon. Friends the Members for Oldham East and Saddleworth (Debbie Abrahams) and for Chesterfield (Mr Perkins) have said about the immunosuppressed community and the most vulnerable. I too have had numerous emails from those who are very concerned about the direction of travel. The lack of access to lateral flow tests is particularly concerning, not only for those people, but for those they come into contact with. My general practitioner has spoken to me about his concerns about antivirals. Does my hon. Friend agree that the limited cohort to whom antivirals are available is very small? My GP and I are concerned that the Government are missing a trick on this one: allowing GPs to prescribe antivirals where they think it is essential might help massively to keep people out of hospital.

[Andrew Gwynne]

My hon. Friend hits on an important point for debate at some stage in the near future. There is a concern that the cohort that has been drawn up for access to antivirals is not as wide as it could be, and certainly not as wide as in other European countries. We must also think about how we provide the maximum level of confidence to those communities.

For me, an ideal package to protect the immunosuppressed and clinically vulnerable would be the availability of free lateral flow tests for people coming to visit those who are clinically vulnerable or immunosuppressed, a drug such as Evusheld that would give at least 70% confidence—similar to the efficacy of the vaccine—to those people who are not able to be protected by the vaccine, and then access to antivirals if they become symptomatic.

I have asked the Minister on a number of occasions when we can expect information on the eligibility for free testing and have not even received an approximate date for when it will be published. That is totally unacceptable. We urgently need that clarity, given that we are three days away.

I draw colleagues’ attention to the provisions in the motions relating to sick pay that are set to expire. Here in the United Kingdom, we have one of the worst levels of sick pay in the OECD. Statutory sick pay currently sits at just £96.35; that, I am afraid, is shameful. I could not live on that and feed my family, and I am not sure the Minister could either. The 2 million low-paid workers who earn less than the lower earnings limit of £120 receive nothing. That is before we consider self-employed people, who continue to remain ineligible for statutory sick pay. Self-employed people were badly let down over the course of the pandemic. A recent study by the Community trade union shows that a majority of self-employed people were rejected from vital covid isolation support payments. In suspending the temporary provision that allowed workers to receive statutory sick pay from the first day of their illness, the Government are stubbornly sticking to their regressive attitude to sick pay, which will continue to have a lasting negative impact on public health.

In recent remarks, the Prime Minister urged the public to exercise “restraint and responsibility” to avoid spreading the virus. This Government love to lecture us on personal responsibility while also pricing people out of making the right decisions. We should not be forcing people to choose between putting food on the table or infecting their colleagues. As well as being morally reprehensible, the sorry state of sick pay in this country will lead to more workers getting sick, leading to worse public health outcomes and, in the long term, costing the country far more in reduced productivity.

[Jeremy Corbyn]

I absolutely agree with my hon. Friend about rates of sick pay. Is he aware that the levels of poverty since the end of the pandemic are increasing, that access to food banks is in greater demand than ever before, and that statutory sick pay often leads people to take serious risks because they have no alternative but to go out and try to work, even though they may well be displaying symptoms, in order to feed themselves and their families? That is a disgraceful situation in this country, and it can be dealt with by having a proper system of decent statutory sick pay as every other European country does.

[Andrew Gwynne]

My right hon. Friend is absolutely right. Of course, for too many people in this country, that is the reality of their day-to-day to living—and we know that it is going to get worse. I should remind the Government that we are in the middle of a cost of living crisis, although I appreciate that they may not have realised that given the Chancellor’s spring statement last week and his inexplicable decision to clobber working people with the highest tax burden in 70 years. Inflation is at a 30-year high, energy prices are sky-rocketing, and we are facing the biggest drop in living standards since the 1950s. I really do fear that, as my right hon. Friend said, more and more people will be drawn into levels of poverty that we have not seen in this country for a very long time.

This is completely the wrong time for the Government to remove provisions that give people the financial support to self-isolate while also ending free tests. Surely the Minister cannot continue to defend this patently self-defeating policy. If people cannot afford to test and they cannot afford to self-isolate, what does the Minister think will happen? Do the Government think that covid will magically vanish? Of course it will not. Living with covid does not mean ignoring the fact that it exists. It does not mean turning back the clock to 2019 and forgetting that the pandemic ever happened. The pandemic happened, covid is here, and for too many people covid will still be an issue going forward.

In terms of living with covid, only Labour has set out a proper plan that would prepare us for new variants while securing our lives, livelihoods, and liberties. We would prioritise testing and make it fit for the future, fix sick pay, and learn the lessons of the pandemic. The Conservatives’ plan is to repeat the phrase “personal responsibility” over and over again, and hope that no one notices that there actually is no plan. We cannot simply turn back the clock and pretend that covid never happened.

[Mr Perkins]

I entirely agree with my hon. Friend. Does he, like me, feel that the term “personal responsibility” would be slightly less nauseating if it did not come from a Prime Minister in Downing Street where 20 people are today receiving fines from the police for their failure to display any kind of personal responsibility while demanding it from some of the poorest people in the country?

--- Later in debate ---

[Andrew Gwynne]

It does stick in the throat a little hearing “personal responsibility” regurgitated time and again when we now know what happened in Downing Street, that the rules were broken and that the laws made in this House were broken. [Interruption.] The Minister says, “We don’t know that”, but we do, because 20 people have just received fines, and that means the law was broken.

We must not simply turn the clock back and pretend that covid never happened. Over the past two years we have seen the impact of painfully inadequate sick pay, and we have seen the benefits of access to free testing. We must learn from both those things. We have also lost more than 160,000 citizens in the course of this pandemic. I fear that, although the numbers are much smaller than they were, that toll will rise day on day, week on week, and year on year. We have real lessons to learn.

[Debbie Abrahams]

We would also make sure that we fulfilled our commitment to the international community on providing the vaccinations that it needs. There are still more than 2 billion people who are unvaccinated, and that will accelerate the risk of new variants that may be even more lethal.

[Andrew Gwynne]

My hon. Friend is absolutely right.

Although we will continue to hold this Government to account, we will not oppose these measures today. There are real questions about covid that have to be asked by us and answered by Ministers, because too many are still unanswered. We owe that to the families of those who did not survive the pandemic, and we owe it to the whole country that stood by the rules throughout thick and thin to get us to where we are today, even when some in Government were not doing that. It is time for the Government to get serious. It is time for the Government to treat the British public with the respect that they deserve. It is time for a proper plan to live with covid.

Covid-19: Deteriorating Long-Term Health Conditions

Andrew Gwynne Excerpts

Thursday 10th March 2022 Westminster Hall

[Andrew Gwynne (Denton and Reddish) (Lab)]

It is a pleasure to serve under your chairmanship, Mrs Cummins.

I, too, congratulate the hon. Member for Bromley and Chislehurst (Sir Robert Neill), both on securing this debate through the Backbench Business Committee and on the powerful and detailed way he opened the debate today. I particularly thank him for sharing his and his wife’s experiences of rehabilitation and recovery from a stroke.

The last two years have placed extraordinary pressures on our healthcare systems, social lives and livelihoods. To protect the NHS, we were forced to make unprecedented decisions and put in place measures to stem the tide of covid-19 infections. We are now in a far better position, and the vaccine roll-out has allowed us to reclaim the freedoms and liberties that we were forced to forgo. However, in the wake of the pandemic, we now face a new challenge—one that will impact the public health of the country for generations to come.

As Members from both sides of the Chamber have passionately conveyed, we face a crisis with long-term healthcare and deteriorating conditions. As health leaders have noted, during the pandemic many professionals who provide rehabilitation services were deployed to other acute services for covid-19 patients. That resulted in reduced support for those with long-term pre-existing health conditions, and worse prognoses as a result. Examples of long-term conditions that have been particularly hard hit are included in the excellent “Moving forward stronger” report, which has been referenced by several Members.

The report, co-authored by charities and organisations including the Alzheimer’s Society, the Stroke Association, Macmillan Cancer Support and Age UK, paints an incredibly stark picture of the current situation in long-term care and rehabilitation. The Alzheimer’s Society outlines an almost 6% fall in dementia diagnosis rates. That puts individuals at risk of further deterioration, as reduced diagnosis ultimately results in reduced access to care. Diagnosis rates are also highlighted by Macmillan Cancer Support, which notes in the report that, as a direct result of the pandemic,

“there are more people being diagnosed at a later stage with more complex rehabilitation needs.”

Diagnosis is just one part of the problem. Cancer waiting times have been in freefall since 2010 and have now reached record levels. When Labour left office, 80% of patients who received an urgent GP referral for suspected cancer were seen for their first treatment within 62 days, which is above the target. Under successive Conservative Governments since 2010, that figure has plummeted. The NHS performance standard of 85% has not been hit since 2014. Right now, almost 30% of patients are having to wait anxiously for longer than two months to be seen for suspected cancer that may or may not be spreading.

That trend is also made clear by the Stroke Association, which highlighted that in 2019-20 only 34% of stroke survivors received guideline levels of physiotherapy and that only 19% received the right amount of speech and language therapy. Is the Minister aware of these statistics, and what is her Department planning to do to address them? Make no mistake: ignoring rehabilitation and long-term care has a massive impact on patients and the NHS more broadly. If we do not provide people with the proper treatment as soon as they need it, they will rely on the health system more and more. Put simply, rehabilitation is preventative.

The “Moving forward stronger” report makes several clear recommendations to the Government. I would be grateful if the Minister gave an assessment of these in her response. In particular, I would be interested—as I am sure other Members would—to hear her thoughts on the recommendation to ensure that each integrated care system has a regional rehabilitation lead and that a national clinical lead is appointed to implement a national rehabilitation strategy.

I think there is a consensus across the Chamber that we need to get a grip on long-term health conditions and that these issues have probably been neglected for far too long. They had not been brought into such public view before covid-19 hit, but it is important that we work across parties to ensure that they are dealt with.

I want to touch on something that the hon. Member for Strangford (Jim Shannon) mentioned: long covid, which is something that I suffer with. Recent statistics show that there are now 1.5 million long covid sufferers in the UK, with over 685,000 people living with symptoms for more than a year. I can tell the hon. Gentleman that brain fog is not fun for a politician. Seeing the words, but not being confident that you have grabbed them and put them in the right order, is really quite debilitating and hits your confidence hard. I have struggled with it, and I know many other people struggling with brain fog and other symptoms. I say to the Minister that the number of people with long covid is growing. Unless we urgently tackle the condition, I fear that we will face extraordinary pressures on our workforce and, indeed, on the healthcare system. Will she reassure long covid sufferers that her Department takes the condition seriously and will do everything it can to provide the requisite support and research to tackle it?

Finally, I want to focus on the mental health crisis, which is one of the issues to come out of the pandemic. There is no doubt that the lockdowns affected people’s mental health. In England, an estimated 10 million people have additional mental health support needs as a direct consequence of the pandemic. Two thirds of them had pre-existing mental health conditions that have been worsened by the pandemic, so perhaps the Minister could tell us what action the Government are planning to take to help those people.

Mental health care in this country needs a real injection of both political vigour and resources. It needs urgent attention, and those who access treatment at the moment experience, on average, a three-and-a-half-year gap between the recognised onset of illness and the start of treatment. In order to provide some solutions, the next Labour Government will guarantee mental health treatment within a month for all who need it, as well as recruit 8,500 new staff so that 1 million extra people can access treatment every year by the end of our first term in office. This is an ambitious but wholly necessary plan, which will not only revolutionise care, but meaningfully address the impact of the pandemic on our nation’s mental health.

I thank again the hon. Member for Bromley and Chislehurst for the way that he introduced the debate, and I thank other Members for contributing to it. The one thing that comes out of this—it was a compelling case put by Member after Member—is that we need a proper strategy to reform long-term care in this country. We will support the Government in doing that, but we need action now.

Draft Human Medicines (Coronavirus and Influenza) (Amendment) Regulations 2022 Draft Human Medicines (Amendments Relating to the Early Access to Medicines Scheme) Regulations 2022

Andrew Gwynne Excerpts

Tuesday 8th March 2022 General Committees

[Andrew Gwynne (Denton and Reddish) (Lab)]

It is a pleasure to see you in the Chair, Ms Rees. I also wish to join the Minister in paying tribute to all those who got us through the last two years in relatively one piece. It has been a remarkable effort on behalf of so many people and serves to show how exemplary our health and care staff and others in public services from local government right the way through to national Government have been in getting us through the pandemic.

The covid-19 pandemic has been the most serious domestic challenge we have had to face in the post-war era. It would be remiss of me not to mention that, in the last two years, we have seen more than 150,000 lives lost. The impact on our own lives and liberties has been totally unprecedented. There were times when it felt like there was no light at the end of the tunnel, on those long lockdown days when we would stay at home, away from friends and loved ones, only to flick on the news and see the numbers of cases rising and rising. A lot has changed since those first few months. Thanks to our NHS, our incredible scientists and the British public, who have been vaccinated in their millions, we have several highly effective covid-19 vaccines. The entire eligible population has been offered a third booster dose and, while the virus is still with us, we are in a much stronger position than back in March 2020. The impact of the vaccination programme cannot be overstated. It has allowed us to reclaim our liberties, which we were forced to forfeit back in 2020, driven down hospitalisations and saved countless lives.

This statutory instrument continues this good work and it will be of no surprise that Labour finds it non-contentious and will support it today. Indeed, it is wholly necessary that the amendments to the human medicines regulations are made. The statutory instrument enables us to continue with mass vaccination campaigns for covid-19 and influenza and extends temporary provisions relating to manufacturing licences and marketing authorisations. It permanently broadens the healthcare groups that are entitled to administer parenteral vaccines in an NHS or local authority setting and enables community pharmacists to deliver flu and covid vaccines outside their normal premises.

The changes are sensible and will ensure that in any future mass vaccination roll-out, the requisite resources will be available to administer vaccinations. That will be particularly useful over the winter months, when we will need to contend with seasonal influenza alongside a potentially large uptick of covid-19 cases.

As I say, covid has not disappeared and we need to be prepared and ensure that the population remains protected against rising case numbers and possible mutations. That also means ensuring we do more to reduce health inequality in vaccine uptake. The under-30s, some ethnic minority groups and pregnant women disproportionately make up the estimated 8.5% of the 12-plus population who remain unvaccinated. We cannot afford to be complacent, and we need to be doing as much as possible to encourage people to take up the vaccine. It would be helpful if the Minister could set out what further action his Department will take to reduce those inequalities in vaccine uptake and outline how the extension of the provisions will enable his Department to tackle vaccine hesitancy better.

On the second SI before the Committee, the early access to medicines scheme has been place for almost eight years, and it is managed by the MHRA. It aims to provide patients with life-threatening or seriously debilitating conditions access to medicines that are either not authorised generally or for the specific clinical use proposed. It provides necessary regulatory flexibility for medicines that can often be a matter of life or death. More 100 medicines have been granted promising innovative medicine status and more than 40 scientific opinions have been awarded in areas with unmet patient need. The Labour party support that wholeheartedly. Cutting-edge medication and treatment can often take years to receive full approval and in that time lives can be lost. It speaks to the necessity of the scheme that more than 1,600 patients have benefited from EAMS medicines since the scheme’s implementation.

An example of the efficacy of EAMS was given in a recent article on it published by the British Liver Trust. It cited Roche’s Tecentriq, which helps to treat people with lung cancer. Because of EAMS, 63 patients were able to access the drug after a specialist review, which gave those individuals access to life-saving treatments four months’ earlier than expected. Four months is an exceptionally long time when suffering from a life-threatening condition and can make all the difference to long-term outcomes. Pharmaceutical companies have raised concerns that EAMS is not delivering an attractive proposition for the industry and that the scale of early patient access originally envisioned has not been delivered. Given the example cited by the British Liver Trust, however, I do not think such concerns stand scrutiny.

The EAMS independent review, published back in 2016, identified areas for improvement. The SI addresses some of those concerns, but I will seek further clarifications from the Minister in due course. Placing EAMS on a statutory footing will give pharmaceutical companies and patients necessary legal clarity. I am grateful that the SI is clear about the need to continue to protect patient safety and that it aims to simplify EAMS’s requirements where feasible.

It is notable that the proposed legislation will support the collection of real-world data, which will no doubt incentivise medical innovation. I am also grateful that the SI makes it clear that patient consent to data collection is not a condition of EAMS supply.

I have a particular keen interest in EAMS as Labour’s lead in the shadow health team for clinically vulnerable, extremely vulnerable and immunocomprised people. Recently I heard from a charity about the anti-viral drug Evusheld. It is a preventive antibody treatment for the benefit of people with compromised immune systems, who cannot get a sufficient antibody boost from vaccines. That medication received approval in the United States and France in December last year, but patients in the UK cannot yet access that treatment because the approval process is ongoing.

It has been reported that for some pharmaceutical companies there is a black hole in the system once the marketing authorisation is granted. Once MA is approved, EAMS designation falls away, and that can lead to a gap of several months in which no further patients can gain access to a given drug as it goes through NICE’s final assessment. That treatment gap has been recognised in the independent review and by pharmaceutical companies and charities. Can the Minister offer an assessment of that, and say whether the Department is considering a mechanism to ensure smoother transition from EAMS to full Health TechConnect and NICE approval?

The scheme is a great illustration of the fantastic work that can be done when industry works alongside healthcare agencies with the patient’s best interests at heart, but we must not take our foot off the pedal. We need to keep working to ensure that cutting-edge research is properly supported and the needs of patients are put first. My apologies to you, Ms Rees, for getting some of my words garbled; it is the long covid. That will be the excuse for evermore, I fear, but we are happy to support the SIs.

Oral Answers to Questions

Andrew Gwynne Excerpts

Tuesday 1st March 2022 Commons Chamber

[Andrew Gwynne (Denton and Reddish) (Lab)]

The Minister’s answer to my hon. Friend the Member for Kingston upon Hull East (Karl Turner) was quite frankly unbelievable. The fact is that waiting lists are projected to continue increasing year on year. NHS data shows huge regional inequalities in waiting times. Across the river, at Guy’s and St Thomas’ NHS Foundation Trust, over 70% of patients are being seen within 18 weeks, but in University Hospitals Birmingham NHS Foundation Trust just 38% of patients are being seen in that time. That is not levelling up, so exactly when do the Government plan on getting a grip on those health inequalities?

[Maria Caulfield]

I am disappointed that the hon. Gentleman is not happy with the investment going into Hull that will try to tackle some of those disparities, because we recognise that there are waiting lists.

[Andrew Gwynne]

They are going up.

[Maria Caulfield]

I do not know whether the hon. Gentleman realises that there has been a pandemic for two years. The Government have committed funding for elective recovery. We are investing in those areas that are in greatest need in the country, including Hull. I am sure that the residents of Hull welcome the investment that the Government are making in their hospital.

Dementia Research in the UK

Andrew Gwynne Excerpts

Thursday 10th February 2022 Commons Chamber

[Andrew Gwynne (Denton and Reddish) (Lab)]

I wholeheartedly thank my hon. Friend the Member for Oldham East and Saddleworth (Debbie Abrahams) for securing this vital debate, and for the work that she does as co-chair of the all-party parliamentary group on dementia. I also thank the Backbench Business Committee for granting the time for the debate. What it lacked in quantity of Members, given that it is the last debate before the recess, it certainly did not lack in quality.

I think there is unanimity on recognising the value of dementia research and on willing the Government to do more. That degree of unanimity is unusual in such an adversarial Chamber as the House of Commons, but we have had a good debate today. I pay tribute not just to my hon. Friend the Member for Oldham East and Saddleworth but to my hon. Friend the Member for Nottingham South (Lilian Greenwood), the right hon. and gallant Member for Beckenham (Bob Stewart), and the hon. Members for Bexhill and Battle (Huw Merriman), for Rutherglen and Hamilton West (Margaret Ferrier), for Strangford (Jim Shannon), and for Coatbridge, Chryston and Bellshill (Steven Bonnar).

Dementia is the only condition out of the 10 conditions with the highest mortality rates for which there is no treatment to prevent, cure or slow its progression. Almost 1 million people are currently living with dementia. Every three minutes, someone develops the condition. As we heard very powerfully from the hon. Member for Ochil and South Perthshire (John Nicolson), it affects not just the individual but those around them—their family and friends. Dementia is also severely underdiagnosed, and that has been further exacerbated by covid-19. There is a backlog of approximately 35,000 people aged 65 and over waiting for dementia diagnoses. I would be grateful if the Minister, in his response, could outline the specific measures that the Government will take to improve early detection of dementia. I also pay tribute to the many charities working on dementia, to the individuals working in research and, as the right hon. Member for Beckenham rightly did, to those caring for people with dementia—not just the professional carers, but the massive army of often family carers looking after their loved ones.

Unless we find a prevention or cure for the disease that causes dementia, the number of people in the UK living with the condition is likely to reach 2 million by 2050—a shocking statistic. As we have heard, dementia and Alzheimer’s disease were the leading cause of death in 2021. As the hon. Member for Bexhill and Battle said, in 2021, we were in the middle of the covid pandemic and rightly focused on the tragic deaths of people from covid-19-related illnesses, but dementia and Alzheimer’s topped the league table. Indeed, in 2019, 15.9% of all recorded female deaths were due to the condition. This is big, and I know that the Minister understands the severity. Those shocking statistics mean that dementia has consistently, for whatever reason, over a long period of time, suffered from under-investment in research.

Great work is being done in my constituency of Denton and Reddish in Greater Manchester, as it is across the United Kingdom. I pay particular thanks to those working in Tameside and Stockport memory services, who give the initial dementia diagnosis, provide individuals with initiating and monitoring medication, and connect them to support groups in their community. That kind of holistic approach to dementia care is crucial.

Dementia can be cured only with research, however, which is why I am also proud of the work that the Greater Manchester dementia research centre is doing in this field. The centre aims to connect people living with dementia to cutting-edge studies and to the National Institute for Health Research. The centre works across the UK through the UK Brain Health Network, which has researchers in Bristol, Edinburgh, London, Cambridge, Oxford, Cardiff and Belfast, and which aims to bring molecular diagnostics into routine practice throughout the country.

Alongside the wider Greater Manchester “Dementia United” strategy, that innovative work gives my constituents who suffer from dementia the research, support and clarity that they deserve. It is just one example of the really good work taking place across the country. We need world-class research to achieve the best quality of life for people and families living with dementia.

The Minister is perhaps one of the nicest people I have to face—other than you, Mr Deputy Speaker—and I know that he genuinely wants to do the right thing, which is good. He knows, however, as has been referred to on numerous occasions, that his Government’s 2019 election manifesto promised to pour £1.6 billion into dementia research over the next decade as part of the so-called dementia moonshot. There has been huge unanimity in the debate that we want to see that happen. That was a point made powerfully by my hon. Friend the Member for Nottingham South. Over two years on from the general election, we have seen no plans to deliver that funding increase. The latest figures show there has actually been a decrease in Government spending on dementia research, with funding down by over £20 million since 2016. It has gone down by £7.2 million per year under this Prime Minister. That is totally unacceptable. I hope that in his response the Minister will address how on earth that has been allowed to happen.

[Lilian Greenwood]

Does my hon. Friend agree that the reduction in Government funding is particularly concerning, because the pandemic has had a devastating impact on the ability of charities to fundraise? Medical research charities, which fund 51% of all medical research in the UK, have seen their ability to fundraise reduced drastically.

[Andrew Gwynne]

My hon. Friend makes a crucial point. There has been a perfect storm. As we have heard, there is a growing list of people waiting to be diagnosed properly with dementia as a consequence of the covid pandemic, and, as she rightly says, the very research groups doing in-depth analysis and research into this disease are largely reliant on charitable sources of funding, which have almost completely dried up over the course of the pandemic.

[Debbie Abrahams]

I was going to mention this when I wind up, but I could not agree more. Funds to medical research charities, such as Alzheimer’s Research UK and the Alzheimer’s Society, have more or less halved—an awful impact.

[Andrew Gwynne]

Absolutely. This is a crucial point and it is why the Government really must come good on their promises.

I also hope the Minister will update the House and give us a timetable for the publication of the dementia strategy. Patients living with dementia, and their loved ones, cannot wait for the Government to get their act together. We need a plan and we need it to go much faster to develop treatments to change lives. The Government must deliver now on their 2019 dementia moonshot manifesto promise to double Government funding into dementia research. No more excuses: that promise needs to be kept. As we have heard, funding is needed now more than ever in a research landscape that has been decimated by covid. Not only have charitable donations dried up, but a survey from Alzheimer’s Research UK found that more than a third of dementia researchers were considering leaving, or had left, academic research due to uncertainty around funding opportunities.

I want to raise the point made by my hon. Friend the Member for West Ham (Ms Brown) in an intervention on the hon. Member for Rutherglen and Hamilton West. She rightly made the point that too often these research projects are not necessarily seen as sexy. We have to make sure that that is not the case, because as I have said, they are so crucial. Labour is committed to doubling dementia research spending to over £160 million a year and to playing our part in finding a cure for this cruellest of diseases. That is a part of our commitment to not only protect but enhance the UK science base and achieve 3% of GDP spending on science and research across the economy.

Patients and their families must be a priority. That starts with dementia research, improved early diagnosis and world class clinical trials. Our goal must be to prevent, treat and ultimately cure this complex and often heartbreaking condition. That is why Labour’s suggestion of a 10-year plan of investment and reform for older and disabled people, including those with dementia, is so important. It would ensure that more people could access care and live in their homes for longer, while being supported by carers paid a proper living wage of £10 an hour.

British people deserve better. We need to meet the challenges of this century of ageing. We need to learn from the pandemic, because there are so many lessons that we can put into ordinary life. We need to treat those who are diagnosed with dementia with the respect that they deserve. This is not a party political point; there is unanimity across this House of Commons. We must redouble our efforts on research for dementia to improve care and support and, ultimately, to find a cure for this dreadful disease.

Future of the NHS

Andrew Gwynne Excerpts

Monday 31st January 2022 Westminster Hall

[Andrew Gwynne (Denton and Reddish) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Gray. This has been a spirited and emotional debate, and one that captures the unique place that the NHS holds in the heart of this nation. On behalf of the Labour Front Bench, I want to personally thank the petitioners and the campaigners behind the petition, because the NHS is more than just an institution. It is an example of the difference that politics, society and individuals can make. It gives us hope that Governments can make real differences to people’s lives, so long as there is the requisite willpower and determination to do so.

Over the last 12 years, NHS staff have had to move heaven and earth just to keep the service on its feet. They have faced extraordinary upheaval, underfunding, neglect and Government mismanagement. I would like to place on record my thanks to all NHS staff, at every level, for the work they have done—not just over the last 12 years and before, but particularly in the last two years, when we were hit by the covid pandemic and the NHS was placed under enormous strain. I am in awe of the work that the staff have done, but I am angry that they have had to step up to try to mitigate the failures of this Government.

Even before the pandemic, the scale of the crisis in the NHS was stark. Covid has compounded the problems, but it did not cause them. Any attempt by the Government to blame covid for the state of our national health service is nothing more than an abdication of responsibility.

This debate is about the future of the NHS, but to understand the future, we must understand how we got here in the first place and how the steps we must take are informed by principles that have been too easily forgotten by the Conservative Government. The NHS is Labour’s finest moment: emerging from the tragedy and upheaval of world war two, the British public decided to put their faith in a Labour Government. British people suffered from endemic health inequalities and squalid living conditions, and were bearing the brunt of decades of public health neglect.

The NHS, spearheaded by the great Aneurin Bevan and Clement Attlee, aimed to change all of that. Many said it could not be done, but it was. It was done through courage of conviction and a belief in the necessity of a service based on need rather than income—a simple principle with revolutionary consequences.

We now find ourselves in 2022, almost 74 years on. If the Labour pioneers who built our health service were here today, what would they see? They would see record waiting lists, an acute staffing crisis, morale at its lowest ebb, health inequalities growing, and a Government fundamentally incapable of addressing their own failings. Yet if they twisted the dials of their time machine to 2010, they would see an NHS in a pretty healthy condition. Waiting times had dropped, public satisfaction was at the highest level ever, and hospitals were staffed at record numbers. In 12 years, that progress has been systematically undone.

The first priority of the next Labour Government will therefore be to sort out the immediate mess that the Tories have left our health service in—once more. That means throwing everything at slashing waiting times and reducing the care backlog, and it means recruiting, training and retaining the staff we need across the NHS and social care. The last Labour Government brought average waiting times down from 18 months to 18 weeks. We will have to do the same again as a matter of urgency. That must all come alongside a long-term plan for the care workforce and wider reforms to fix social care.

However, the Government are doing none of that. Instead, they are faffing around with an unnecessary and distracting top-down reorganisation of the NHS, in the form of the Health and Care Bill, while doing precious little to tackle waiting lists or address the staffing crisis. I would be grateful if the Minister recognised those concerns in his response and outlined what steps the Government will take to ensure that any NHS reorganisation comes alongside a proper plan to address soaring waiting times and critical staffing shortages.

However, the future of the NHS is about more than just addressing the immediate crisis; it is also about adapting to the needs of our population and recognising that health is about more than just surgeries and hospitals. Last week, here in Westminster Hall, I spoke about health inequalities and about how health is all too often viewed as an isolated issue, without considering the external factors that influence our wellbeing. Wellbeing is linked to our communities, our access to green spaces, our mental health, our opportunities and much more. If we fail to consider those influencing factors, our health service will always be geared to address the symptom, as opposed to the root cause of the symptom.

That is why the future of our NHS relies on prioritising preventive health measures. One example of that is Labour’s recent announcement that we would recruit more than 8,500 mental health professionals to support 1 million more people every year. That is exactly the kind of progressive, proactive and preventive policy that the Government should be driving. Such an investment in mental health would mean that every community had access to a mental health hub for young people, and every school specialist support. Wellbeing would be addressed beyond the clinical setting, and the health consequences of stress, depression and anxiety addressed before they reached the hospital waiting room.

So far, I have seen little evidence from the Government that they realise the importance of preventive health measures. In fact, I would go as far to say that the withdrawal of funding from community centres, green spaces and sports clubs over the past 12 years shows that the Government are not sensible and are not serious about preventive health policy. In his response, perhaps the Minister will correct me on that and advise how the Government intend to reverse their disastrous cuts to local services, which have had a calamitous impact on health outcomes.

Our NHS was built to provide security. It was built to recognise that our prosperity is innately linked to our health, and that we all deserve to live long, fulfilling lives—all of us, irrespective of our background or where we have come from. It is an issue of basic respect. To be healthy and have access to care is not a privilege; it is a fundamental right of every human being, a right that we expect the Government to protect and defend at all costs. The job of the Government of the day is to pass the national health service on in a better condition than they found it in when they came to office. I am afraid to say that this Government have failed in that obligation massively.

I am hopeful, however, that with the right support, the right investment, the right approach and the right values—values matter when it comes to our health and wellbeing—Labour can undo years of neglect and equip the NHS with the tools it needs to survive and then to thrive. That day cannot come quickly enough.

[James Gray (in the Chair)]

We have a few minutes in hand so, unusually—although I am told it is perfectly in order—I will call the hon. Member for Middlesbrough, Andy McDonald, to make a brief contribution.

Health Inequalities: Office for Health Improvement and Disparities

Andrew Gwynne Excerpts

Wednesday 26th January 2022 Westminster Hall

[Andrew Gwynne (Denton and Reddish) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Twigg. I add my congratulations to my hon. Friend the Member for Bootle (Peter Dowd) on securing this debate and on the passionate way that he opened it.

Health inequalities are one of the defining issues of our time and are innately linked not only to how long we live, but to how well we live. Every person across this great country deserves to thrive and live a long, fulfilling and healthy life. That principle informed the creation of our national health service and it continues to drive the work that Opposition Members do.

As colleagues have done, I reinforce to the Minister the perilous position that we find ourselves in with regard to health inequalities. The pandemic has exacerbated the health inequalities that were already widening prior to the first lockdown. Indeed, in February 2020 the King’s Fund reported:

“Males living in the least deprived areas can, at birth, expect to live 9.4 years longer than males in the most deprived areas.”

For females, as we have heard, this gap is 7.4 years. That is not good enough.

Worse, the gap is increasing. Life expectancy has had a steady ascent for 100 years. That ascent began to plateau in 2011. Can the Minister advise what she thinks happened in 2010 that led to that abrupt stalling of life expectancy? It is very real. [Interruption.]

[Derek Twigg (in the Chair)]

Order. The sitting is suspended for 25 minutes for Divisions in the House.

--- Later in debate ---

On resuming—

[Andrew Gwynne]

Before I was interrupted by the Division bell, I was about to say that I have seen at first hand the injustice of health inequality. Denton, the main town in my constituency, where I grew up and have lived, is not a very large town. It has a population of 38,000 people spread over three council wards, and its area is 2.5 miles by 1.5 miles. I grew up in Denton West, which is one of the more prosperous wards in my constituency and in the borough of Tameside.

My best friend at secondary school lived in Denton South, which, conversely, is one of the poorest. We both went to the same school. We were two kids growing up in the same community, at the same school, doing the same things, hanging around together. Yet according to the average life expectancies, he will live 10 years less than I will. That cannot be acceptable, it is not acceptable, and it is one of the reasons I joined the Labour party and became politically active. Tackling those inequalities, not just in a small community such as Denton but across the country, is absolutely what we should be about, in order to improve outcomes for all.

The last decade has been a disaster in terms of inequality, and I say to the Minister that that is the direct consequence of political choices that her party has made. It is a consequence of a decline in real-terms local authority spending, a consequence of a reduction in per-person education spending—a consequence of 12 years of Conservative government. The fact is that it is impossible to corral health inequality into one box. As we have heard in this debate, it is closely tied to social determinants: where people grow up, their environment, their education and their disposable income all contribute to health inequalities. If we are to tackle the crisis, the Government must recognise that they cannot make policy decisions in a vacuum.

That leads me to the issue of the Office for Health Improvement and Disparities. I note that one of OHID’s key priorities is to

“develop strong partnerships across government, communities, industry and employers, to act on the wider factors that contribute to people’s health, such as work, housing and education”.

That is music to my ears. It is clearly a positive and welcome aspiration, but three months on from OHID’s launch, we have yet to see any clear indication that cross-Department work has actually been prioritised by the Government. This point has been made by the Inequalities in Health Alliance, an organisation with more than 200 members, including the Royal College of Physicians. The IHA has asked the Government to underpin and strengthen OHID’s work with an explicit cross-Government strategy to reduce health inequalities, involving all Departments, and led by and accountable to the Prime Minister. So far, the Government have been resistant to committing to that.

I would be grateful if the Minister, in her response, could advise us what assessment she has made of the request from the IHA and whether her Department will commit to developing a specific cross-Government strategy. In addition, can she set out how OHID will assess its own effectiveness, and what influence it will have on other Departments? Will she also outline what engagement OHID has had with other Departments since it was established back in October? We need to know that OHID is not just more warm words with very little in the way of positive action. The Government cannot point to OHID with one hand and then, with the other, undermine the work that it purports to do.

For example, last October, the very month in which OHID was formed, the Chancellor of the Exchequer ended the £20-a-week uplift to universal credit. That plunged 300,000 children into poverty pretty much overnight. That political decision obviously has a negative public health impact for people across the country, yet apparently that was not something the Chancellor either considered or seemed particularly concerned about at the time. Can the Minister advise us how OHID will prevent further such disastrous policies from being implemented? If she cannot, I simply do not see how it will solve the crisis of health inequality in this country. I would be grateful, too, if she could outline what role OHID will play with regard to the new integrated care systems. Some clarity on that would be very much appreciated, particularly in advance of the Health and Care Bill’s anticipated return to the Commons in the next few weeks.

Finally, I want to touch on the subject of levelling up and its relationship to health inequalities. It has become somewhat of a go-to phrase for the Government. It should perhaps be a cause of concern to the Minister that, more than two years into this Administration, the levelling-up White Paper still has not been published. On that note, I want to press her on what exactly the Government’s priorities are.

In 2020, Professor Sir Michael Marmot published “Build Back Fairer” in Greater Manchester, which called for several policy interventions from the Government. Professor Marmot proposed investment in jobs, housing, education and services, and made particular reference to tackling the social conditions that cause inequalities at local and community level. We saw local authority public health funding cut by 24% per capita in real terms between 2015-16 and 2020-21. That is the equivalent of a reduction of £1 billion, which cannot be right. We need to restore public health funding to local authorities, so that local teams are able to provide vital services that communities need to stay healthy.

In conclusion, we went into the pandemic with health inequalities already growing, which left Britain’s poorest areas, as well as those in black, Asian and minority ethnic communities, acutely vulnerable to covid-19. That is totally unacceptable. We are now in 2022; we should not be living in a society with such extreme levels of health inequality. It is not right, and it needs fixing. The Government must do more and can do more, and they must do better.

[Derek Twigg (in the Chair)]

The debate will finish no later than 4.25 pm. I know that the Minister is aware of the need to allow two or three minutes at the end for the hon. Member for Bootle (Peter Dowd) to wind up.