Transport
Debate between Chi Onwurah and Guy Opperman(9 months ago)
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Guy Opperman
I have read the report. The hon. Gentleman will be aware that, for example, one reason for the complications is that the number of people working from home has increased by 40%. We have a plan to tackle that with the record investment that is being made to Mayors.
Chi Onwurah
Walking and cycling prevent 1,500 serious long-term health conditions on Tyneside every year, according to the walking and cycling index, and they bring in £400 million in economic benefits, so it is no wonder that half of Tynesiders want to walk or wheel more, and that two fifths want to cycle more, but if they are to do that, the streets need to be made safer. What is the Minister doing, apart from undermining low traffic neighbourhoods, to make our streets safer for walking, wheeling and cycling?
Guy Opperman
With great respect to the hon. Lady, she knows full well that her council attempted to have an active travel scheme in Jesmond, and it so messed it up that it had to scrap the scheme. The LTN was scrapped, and there were 23,000 objections and a considerable waste of money. With due respect, active travel is doing a great job, and we support it, but councils have to take local communities with them.
[Official Report, 21 March 2024, Vol. 747, c. 1038.]
Letter of correction from the Under-Secretary of State for Transport, the hon. Member for Hexham (Guy Opperman):
An error has been identified in my response to the hon. Member for Newcastle upon Tyne Central (Chi Onwurah).
The correct response is:
Oral Answers to Questions
Debate between Chi Onwurah and Guy Opperman(9 months ago)
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Chi Onwurah (Newcastle upon Tyne Central) (Lab)
The Parliamentary Under-Secretary of State for Transport (Guy Opperman)
This Government are investing more than any other in active travel. Around £15 million has been provided to Newcastle upon Tyne since 2020-21 to deliver high-quality infrastructure. That is supported by over £2 million of funding to Transport North East to improve capability across the region. Active Travel England supports local authorities in delivering maximum value for money by ensuring that schemes comply with the relevant guidance, and councils receive tailored support from the Government.
Chi Onwurah
Walking and cycling prevent 1,500 serious long-term health conditions on Tyneside every year, according to the walking and cycling index, and they bring in £400 million in economic benefits, so it is no wonder that half of Tynesiders want to walk or wheel more, and that two fifths want to cycle more, but if they are to do that, the streets need to be made safer. What is the Minister doing, apart from undermining low traffic neighbourhoods, to make our streets safer for walking, wheeling and cycling?
Guy Opperman
With great respect to the hon. Lady, she knows full well that her council attempted to have an active travel scheme in Jesmond, and it so messed it up that it had to scrap the scheme. The LTN was scrapped, and there were 23,000 objections and a considerable waste of money. With due respect, active travel is doing a great job, and we support it, but councils have to take local communities with them.
Real-Time Bus Information: North-East
Debate between Chi Onwurah and Guy Opperman(10 months, 3 weeks ago)
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The Parliamentary Under-Secretary of State for Transport (Guy Opperman)
I was delighted only last week to take the 148 into work here in Westminster, having visited the local bus depot in Camberwell.
Guy Opperman
The hon. Lady has had 15 minutes. I have barely finished my first sentence, and she wants to interrupt me.
Guy Opperman
The situation is that the last bus I took was the 148 last week. [Interruption.]
Guy Opperman
I was coming to the issue of real-time information on what is called the bus open data service. The Public Service Vehicles (Accessible Information) Regulations 2023, which were formulated in collaboration with local authorities, Guide Dogs and various other disability organisations, came into force on 1 October 2023, so the idea that we are not doing anything is, with respect, wrong. When it comes to real-time information, there are apps such as Google Maps, Trainline, Apple Maps, Citymapper and Moovit in every major region across England.
Guy Opperman
I am trying to respond to the points raised by the hon. Member for Newcastle upon Tyne North (Catherine McKinnell). Is this a work in progress? Yes, it is, but it gives passengers control over how they travel on buses. The app helps them save time and plan their journeys.
Guy Opperman
One second. I cannot be accused of not answering the point when I am trying to answer the questions asked by both the hon. Member for Newcastle upon Tyne Central and the hon. Member for Newcastle upon Tyne North.
In 2020, we launched the bus open data service to support the digital transformation of bus services. It requires all bus operators of local services in England to open up high-quality, accurate and up-to-date passenger information, including timetables, fares, tickets and vehicle location information. Those improvements are clearly designed to give a better journey experience and provide people with the information they need to plan. That is clearly in all our interests.
Chi Onwurah
But the Minister is not answering my questions, and I fear—if it is in order, I will put it in this way—that he may be unintentionally misleading the House: he said that the Google app and other apps give people the information necessary to plan and control their journeys. Google does not provide real-time bus information in the north-east. If the Minister is not aware of that, he needs to spend more time on the buses and less time answering questions without giving the facts.
Guy Opperman
Clearly, there is a five-year review that comes through in 2025, as the hon. Lady identified. All aspects will be considered. She mentioned the shortage of bus drivers. We have a plan to address that, and we are working on trying to get—
Chi Onwurah
I did not mention bus drivers once. I do not know whether the Minister is reading from a previous speech, but I did not mention a shortage of bus drivers. The debate is on real-time information in the north-east. Can the Minister possibility speak to that?
Guy Opperman
The hon. Lady criticised the fact that buses were not there at the appropriate time. There is a common problem: it is unquestionably the case that bus operators up and down the country have a driver shortage. If there was a full complement of drivers, they would be more able to fill the gaps that occur from time to time. Doing that requires more drivers, which is why there is a plan, with local jobcentres and skills bootcamps, to train them up and ensure that we have a full complement—without a shadow of a doubt. That would enable bus operators to provide more regular services and not have gaps, which unquestionably exist. Does that help in terms of real-time information? Clearly, gaps makes it difficult. I am acutely conscious that there are problems with the roll-out. The service was introduced only in the last couple of years, and it is being rolled forward and improved on a daily basis.
Let me address some of the other points raised by the hon. Lady. Franchising is a matter for the Labour party to pursue if it wishes to do so, but the evidence seems to show that it will lead to fewer services, not more. Clearly, the matter of how the Labour party is going to pay for that prospect is an interesting one. It is unquestionably the case that we want to see greater collaboration between the apps, and that it something that we are happy to do.
I am also happy to write to the hon. Lady to address any point in relation to the enforcement of the Public Service Vehicles (Accessible Information) Regulations 2023 by local bus companies. It is unquestionably the case that the regulations apply from, in the final instance, October 2026. They require the majority of local bus and coach service to incorporate audible and visible route, destination and upcoming stop announcements, which are particularly important for disabled people; we hope that they will be welcomed.
Finally, I stress that we have commissioned research to understand disabled people’s experience of bus services and the infrastructure serving them. That is important. I acknowledge and appreciate that there are ongoing problems, although they are being slowly but surely addressed by the change in the regulations and the rules. We want to ensure that all people in society have the opportunity to use a bus on a regular basis.
Question put and agreed to.
Oral Answers to Questions
Debate between Chi Onwurah and Guy Opperman(1 year, 6 months ago)
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The Minister for Employment (Guy Opperman)
The Department for Work and Pensions has reduced the standard deduction cap from 40% to 25% of the standard allowance since 2019. Where a person feels they cannot afford benefit overpayment recoveries, they are encouraged to contact the Department.
Chi Onwurah
Across the north-east, 120,000 children are impacted by universal credit deductions. Take my constituent Amanda: she has two small children, yet her entire personal allowance of £300 a month was deducted, and on top of that she was sanctioned because of tech issues with her work journal. I have worked to support her, as has Citizens Advice Newcastle, but of course she had to go to a food bank. Does the Minister think that is a working system?
Guy Opperman
In recent years, the standard cap has been reduced, as I said, from 40% to 25%. Reducing the threshold further would risk key social obligations such as child maintenance not being met. We aim to continue to strike the right balance between ensuring that protections are in place and allowing claimants to retain as much of their award as possible.
Oral Answers to Questions
Debate between Chi Onwurah and Guy Opperman(1 year, 9 months ago)
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The Minister for Employment (Guy Opperman)
My hon. Friend will be aware of the 50-plus champions, the midlife MOT, the sector-based work academies and the skills bootcamps specifically for over-50s. The mighty Port Vale football club held a fantastic recent jobs fair attended by 1,400 customers, including many over-50s; 600 job offers resulted and there were 100 employers present. That is the sort of thing that the Department is doing.
Chi Onwurah (Newcastle upon Tyne Central) (Lab)
As the recent Britishvolt investment shows, the north-east has real strengths in growing sectors such as battery technology, green energy and life sciences. Does the Minister agree that it is not possible for nationally controlled training programmes to really support people into employment in these emerging sectors? Will he therefore devolve responsibility to those in local areas who know local skills and local opportunities?
Guy Opperman
Local DWP jobcentres work hand in glove with local employers. It is very different in Banff and in Brixton—it is very different up and down the country. That is what we do with sector-based work academies, skills bootcamps and innovation pilots on a local basis in each individual jobcentre.
Oral Answers to Questions
Debate between Chi Onwurah and Guy Opperman(3 years, 11 months ago)
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Guy Opperman
We plan to use existing Government letters on the attendance allowance and state pension, and other letters that the Government send out, to help to promote pension credit. We are also discussing a joint working arrangement with the BBC. We continue to make all efforts to try to promote pension credit.
Chi Onwurah (Newcastle upon Tyne Central) (Lab) [V]
Oral Answers to Questions
Debate between Chi Onwurah and Guy Opperman(5 years, 8 months ago)
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Guy Opperman
Split payments are available on request. No information is needed to get a split payment. However, 60% of payments are already paid into a woman’s bank account. As I outlined to my hon. Friend the Member for Chelmsford (Vicky Ford), main carer recipient work is being done to ensure that this is done on a practical basis.
Chi Onwurah (Newcastle upon Tyne Central) (Lab)
State Pension Age: Women
Debate between Chi Onwurah and Guy Opperman(5 years, 10 months ago)
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The Parliamentary Under-Secretary of State for Work and Pensions (Guy Opperman)
I congratulate the hon. Member for Gower (Tonia Antoniazzi) on securing the debate. It is an opportunity for me to address some of the points that she raised, as far as I can, given that a judicial review is ongoing. There are obviously a number of key drivers behind the decision to make these changes by successive Governments, dating back well over 25 years. It is important to briefly restate them before I turn to her points.
This change was part of a wider trend towards gender equality. The decision was taken partly as a result of European and equality legal cases in the early 1990s relating to occupational pension provision. Life expectancy and state spending were also key factors in the changes to state pension age. Following the passing of the Pensions Act 1995, the actual and projected growth in the pensioner population continued faster than anticipated as a result of increasing longevity. As a result, it was clear that a state pension age fixed at 65 was no longer affordable, fair or sustainable.
The Labour Government between 1997 and 2010, and the hon. Lady’s predecessor who was the Member of Parliament at the time, took action in the form of the Pensions Act 2007, which introduced an increase in state pension age to 66, 67 and 68 for men and women. Further changes were brought in under the Pensions Act 2011, which accelerated the equalisation of women’s state pension age and brought forward the increase in men and women’s state pension age to 66 to complete by 2020.
The Pensions Act 2014 brought forward by eight years the increase in state pension age to 67 to complete by 2028, and introduced regular, independent reviews of the state pension age—the first of which was published by John Cridland in 2017—to ensure that the system remains fair, sustainable and affordable for taxpayers. It cannot be overstated how much life expectancy was one of the key drivers of the decisions of the Labour Government between 1997 and 2010, the coalition Government between 2010 and 2015, and the Conservative Government since then.
Chi Onwurah (Newcastle upon Tyne Central) (Lab)
I thank the Minister for giving way. I recognise the point he is making with regard to the equalisation of pensions between genders and increasing life expectancy, and we are all grateful to be living longer. But does he recognise that these mainly working-class women did manual and physically oppressive work, often starting at the age of 15, and they are not sharing in the benefits of longer life expectancy because of health inequalities? Does he recognise that inherent unfairness?
Guy Opperman
There are a number of points to be made, and I will try to address them. There are two key issues to look at: life expectancy as a nation, as assessed by the Office for National Statistics or reviewed independently by John Cridland, and healthy life expectancy. In terms of general life expectancy, after the second world war, a girl born was expected to live to 81 years and a boy to 77 years. By 2019, those figures had increased by more than 10 years for newly born girls and by more than 12 years for boys, to 92 and 89 years respectively. The hon. Lady made a point about healthy life expectancy.
Guy Opperman
I accept those points. That was specifically reviewed by John Cridland on an independent basis, as ordered by Parliament, in 2017. His report, a copy of which is in the Library, addresses those points.
I will make a couple of points on Cridland’s report before I come to the issue of period life expectancy. Cridland sets out the figures on the first page of his report. In 1917 only 24 people reached their 100th birthday. In 2016 6,000 did. The expectation is that by 2015 56,000 people will reach this milestone. He estimates that by approximately 2047 life expectancy could be 98 for women and 95 for men. Given that when the state pension was introduced in 1908 it had a retirement age of 70, only one in four people were expected to reach that age and life expectancy thereafter was nine years, there has been a dramatic improvement in life expectancy.
Severe Eating Disorders (North-East England)
Debate between Chi Onwurah and Guy Opperman(10 years, 6 months ago)
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Chi Onwurah
My hon. Friend makes an excellent point. Again, the testimony of those most intimately involved speaks to the excellence of the unit and the concern of people in Tyneside.
Guy Opperman (Hexham) (Con)
I congratulate the hon. Lady on securing this debate. Like her, I have had many letters of support from constituents who have been helped by the Richardson eating disorder service, and also from individual nurses and doctors, such as Dr Caroline Reynolds, the consultant psychiatrist at REDS, who have provided assistance to people with this terrible disease. Does the hon. Lady think it would be right for the mental health trust and NHS England, together and collectively, to review their decision and, going forward, address how they will recommission the service when the present contract ends?
Chi Onwurah
The hon. Gentleman makes an excellent point, and I certainly believe that the decision should and must be reviewed. It is clear that a number of hon. Members have been contacted by concerned constituents. Indeed, the right hon. Member for Berwick-upon-Tweed (Sir Alan Beith), who cannot attend this debate, asked me to say that he also had constituents who are affected.
Given that admissions in the north-east are 30% above the national average, and that the Royal College of Psychiatrists recommends that six beds per million of the population are needed for average admission rates, the north-east’s 2.8 million people need 23 beds. I will return to that figure, but first a word about the threatened unit that hon. Members have already referred to.
The Richardson eating disorder service is operated by Northumberland, Tyne and Wear NHS Foundation Trust. It is in the centre of Newcastle, with excellent transport links. It is acknowledged to be an outstanding unit, rated excellent by the Royal College of Psychiatrists and the Care Quality Commission. It has just won Beat’s clinical team of the year award. A stable, vastly experienced staff has been treating adult in and out-patients since 1997, and it has saved many lives. One sufferer said:
“I have suffered from anorexia nervosa for over 12 years and unfortunately during that time I have required many admissions to medical and eating disorder units”.
She names a number of them before going on to say:
“The admission to the Richardson was by far the most successful. I made such huge strides towards recovery and was the healthiest I have been since this all began.”
Chi Onwurah
My hon. Friend makes an excellent point. Indeed, if the criteria on which this decision was made were publicly available, we could perhaps tell which models NHS England considered and what it hoped to achieve. Unfortunately, there is no transparency, which is one of the key issues.
Problems started in 2010, when commissioned adult eating disorder in-patient beds were tendered and the contract was awarded to Tees, Esk and Wear Valleys NHS Foundation Trust, although it did not then operate an in-patient unit. It quickly established a 10-bed unit in Darlington, but on a site with poor transport links to the north. For clarity for those Members who may not be familiar with the north, Newcastle is to the north of Darlington.
The award was a shock to many people, not simply because of the result, but because of the lack of consultation. I should like to ask the Minister a specific question: against what criteria were proposed services considered to be better than award-winning ones already on offer in the Richardson? If he does not know, I hope that he will promise to find out. Was cost the driving factor? What was the evidence basis for the centralising of these critical mental health services?
The National Institute for Health and Care Excellence guidelines specifically state that for severe eating disorders patients should be treated near their homes, with the support of family and friends. These are often young, vulnerable people, who are not yet independent of their family, either financially or emotionally. As one told me,
“Seriously ill anorexics are often cognitively impaired as a result of severe starvation and separation from loving support, together with that the challenge to dangerous and entrenched behavioural traits is often too much to bear.”
Given the lack of consultation, the north-east specialised commissioning group was instructed to strengthen its relationships with stakeholders and report any other substantial changes or developments to the NHS scrutiny committee.
NEEDAG, formed by carers and patients concerned about the threat to the Richardson, hoped that at least five of the beds in the Richardson would continue to be used by those in the north of the region, given overall regional demand. However, in April 2012, the commissioner increased the number of beds at Darlington to 15—again, without any consultation, scrutiny or performance data by which to make judgments. When challenged, I am told that the commissioner said they were not obligated to consult anyone. I hope that the Minister will correct them on this point. It is possible that the top-down reorganisation of the NHS instituted by this Government may have led to them forgetting their obligations under the NHS constitution.
When Darlington was full, commissioners started sending very ill patients out of the area, instead of to the Richardson, saying that every commissioned bed in England, no matter where it was, had to be filled before a patient from Tyneside could be sent to Newcastle. That is how we have arrived at the ridiculous and tragic situation of our national health service sending vulnerable Tyneside patients to Glasgow, Norwich and London when there are empty beds in the Richardson unit in the centre of Newcastle.
The impact on vulnerable young people of being separated from their families undoubtedly makes it more difficult to recover—hence the NICE guidelines. The cost of visiting for families is enormous, both financially and emotionally. One parent wrote:
“This will then have an effect on our family’s mental health as we are all struggling to come to terms with the condition and to help M recover. I would refuse to let M be admitted so far away from home and would rather give up my full time job to look after her in the familiar and safe surroundings of home.”
Another parent who fought to win a place for their daughter at the Richardson said:
“We were very angry to have been put in the position of having to fight for a bed for our dangerously ill daughter at a time when all our energy was needed to comfort and support her through a very difficult time. The added pressure and anxiety it caused the whole family was dreadful.”
It has been announced that the unit will be closed down, because it was said—cynically and cruelly—that it was not being used locally. If it was not being used locally, it was because NHS England was sending local people hundreds of miles away. Freedom of information requests submitted by NEEDAG show that Darlington’s 15 beds are full; that there are eight in-patients from the north-east in London, Sheffield, Leeds, Glasgow and Norwich; and that five patients have managed to win beds in the Richardson.
Guy Opperman
We all understand the need for and importance of centralised specialist services, whether they be stroke services or those under discussion, but given the number of people per capita in the north-east who suffer from this terrible disease, is there not a genuine case to be made for the two services to co-exist?
Chi Onwurah
The hon. Gentleman makes an excellent point. That is indeed the case. The number of in-patient admissions in the north-east as a result of severe eating disorders is 30% above the average, which suggests that about 23 beds are required. It would be possible to meet the NICE guidelines and retain the services in Darlington and in Newcastle, yet not meet the increasing demand for in-patient beds. There are a total of 28 in-patients from the north-east, but NHS England says that only 15 beds are needed; that clearly goes against the 23 calculated in accordance with guidelines.
NHS England argues that it is investing in the north-east, and that it is opening an intensive day unit in Newcastle that will reduce demand for in-patient care, but it has provided absolutely no evidence to support its claim. One parent said:
“For my daughter the thought of going back to the local community mental health teams fills her with dread.”
A day centre does not address the issues of isolation and support when in-patient care is needed.
Patients are so worried that two of them have decided to take both the trust and the commissioners to judicial review, based on the lack of consultation transparency. They are applying for legal aid, so we will be in the ridiculous situation of spending public money to both defend and attack a decision taken without the most basic public consultation.
Having written to the Minister of State, Department of Health, the hon. Member for North Norfolk (Norman Lamb), on the subject in the past, I know that he is sympathetic to the plight of sufferers of severe eating disorders and their families and friends. Both he and the Secretary of State have criticised sending patients hundreds of miles for treatment. I want the Under-Secretary of State for Health, the hon. Member for Central Suffolk and North Ipswich (Dr Poulter), to answer the questions I have already asked and the following two in particular.
First, does the Minister support the concentration of mental health services? In the case of heart surgery for children, we are told that concentration saves lives, because surgeons must be operating on many patients to retain their skills, but the mind does not physically work in the same way as the heart. Does he believe that there is something to be gained from making mental health into a production line? Why is it not possible to maintain beds in Darlington and Newcastle? Why is NHS England not following NICE advice? If the aim is to save money, is this truly a cost saving, or merely moving costs from the NHS to the sufferers of this terrible condition and their family and friends? Is it not outrageous that NHS England should be moving costs on to the most vulnerable and risking lives by doing so?
Secondly, on transparency, how can the Minister possibly support a process whereby there is no consultation on decisions that are so important to the lives of patients and their carers? Is that not in itself a reason to reverse the decision, given that the commissioners did not consult the people to whom they are accountable and in whose interests they are paid—and often paid very well—to commission services?
I will leave the last words to someone more intimately concerned with this than I am, who wrote to me:
“My friend’s beautiful and talented daughter has battled this terrible condition for many years with the help of the Richardson and the support of friends and family every single day that she has been in there. I truly believe that if the unit near to home closes and she feels far from this lifeline of support, she will give up her fight and that could be the end not only of her dream to take up her place at University but possibly, it’s not too dramatic to say, her life.”
North-East Independent Economic Review
Debate between Chi Onwurah and Guy Opperman(11 years, 3 months ago)
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Chi Onwurah
I know that many other Members wish to speak, so I shall not say all that I would like about what the Government have done to the apprenticeship programme, by devaluing apprenticeships, as well as not supporting them for older workers.
Chi Onwurah
I will move on to my closing remarks. We need leadership from Ministers and real power—
Health Inequalities (North-East)
Debate between Chi Onwurah and Guy Opperman(12 years, 11 months ago)
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Chi Onwurah (Newcastle upon Tyne Central) (Lab)
As a Member of Parliament, my priority must be the health and well-being of my constituents, and many MPs feel the same. Regional health inequalities are of profound concern and strike at the heart of our sense of fairness and equality: people are suffering unnecessarily in this country just because of the region in which they are born, and that undermines not only the idea that we are all in this together, but our very sense of national unity. At a time when the Scottish Government are seeking independence, does it help the case of those who believe in the Union, as I do, that a Brit born in Glasgow is likely to die 14 years earlier than one born in Chelsea?
As we shall see, health inequality is a complex subject, but the key question for the Minister is, do the Government recognise regional health inequalities in their health funding? I look forward to the Minister’s reply.
I was born in Wallsend and grew up in Newcastle. In Newcastle, we are more likely to die early from cancer, heart disease and stroke. We tend to die younger, are more obese as children and are more likely to die from the cold as pensioners. We suffer more from the diseases of our industrial legacy, such as asbestosis. Last year in Newcastle, there were 89 early deaths from heart disease and stroke—19 more than the national average. Disability-free life expectancy for women in Newcastle is 3.3 years shorter than the English average. For men, it is 4.9 years shorter. Not only do we live shorter lives, but more of those shorter lives are spent with a disability.
Such inequalities are not unique to Newcastle. Thanks to the public health observatories set up by the previous Labour Government, we have a comprehensive view of the inequalities in health across the country. Every year, 37,000 people in the north die earlier than their counterparts in the south. That is enough people to fill a modern football stadium. A report published in the British Medical Journal last year said that the excess toll of ill health and disability in the north is
“decimating”
the region
“at the rate of one major city every decade”.
In Newcastle, one in 25 adults claim incapacity benefits for mental illness. That is four times the rate in the Secretary of State for Education’s constituency. Across the river in Gateshead, we have one of the highest levels of obesity in the country, and on the Wear, the 2010 chlamydia rate for 16 to 24-year-olds was almost three times the rate in Surrey.
Of course, there are inequalities within regions and within cities. The Institute for Ageing and Health at Newcastle university has produced an interesting map of the Tyne and Wear metro, which shows how life expectancy reduces by more than a decade as we ride from Ponteland north to Byker.
Although I see mainly north-east MPs here today, this is an issue for the whole country, for the Exchequer and for the Prime Minister, but given that the Prime Minister press-released yesterday’s visit to Leeds as a visit to the north-east, it is clear that his grasp of geography still leaves something to be desired.
Every year, health inequalities cost £31 billion to £33 billion in lost productivity, up to £32 billion in lost taxes and higher welfare payments and £5.5 billion in additional health care costs, so this is a problem for us all. It is important to emphasise that the poorer health in the north-east is not a function of the level of health care. The Newcastle Hospitals NHS Foundation Trust is in the top 10% of best-performing trusts in the UK. We have the Campus for Ageing and Vitality, the Centre for Life, the Great North Children’s Hospital, the Northern Institute for Cancer Research and the Northern Vascular Centre and Freeman Hospital’s Cardiothoracic Centre. They are world-class institutions.
Evidence going back six centuries tells us that the root causes of health inequalities are economic. The BMJ report that I mentioned earlier says:
“Social and economic factors are extremely reliable predictors of health”
If more resources are put into an area, its health improves, but if they are taken out, its health declines. The north-east has the lowest income per head in England, and in Newcastle, a quarter of the city’s neighbourhoods are in the 10% most deprived in the country. So the poorest are hit by a double whammy. Not only does poverty impact on their quality of life, but it reduces their life expectancy and makes them susceptible to a host of diseases.
It is also ironic that in the north-east we live with the health consequences of industries that were long ago allowed or even encouraged to die. Just last month, Cabinet papers showed how Margaret Thatcher’s Cabinet discussed the managed decline of the north. We are still dealing with that. Last year’s figures from the Health and Safety Executive show that rates of death from mesothelioma in the north-east are by far the highest in the country, and although we address the symptoms, we can do nothing for the causes. But in other areas we can and are tackling the causes.
The north-east has the highest number of mothers smoking during pregnancy—22%—so Fresh, a local charity, is working with local primary care trusts to make smoking history for children. Higher than average alcoholism in the north-east has resulted in excessive numbers of hospital stays for alcohol-related harm, so a campaign to reduce alcohol dependency is supported by local press, such as the Newcastle Journal and the Evening Chronicle. But I am worried that essential work to improve health in the north-east is threatened by measures that the Government are taking.
Under Labour, health funding doubled in real terms, waiting times reduced and death from heart disease and stroke went down by a massive 40%. The previous Government also worked hard to tackle poverty and its associated evils—poor housing, high fuel costs and low wages—but the inequalities remained. So although the health of people on low incomes improved significantly, the health of those on high incomes went up by the same amount or more. In some areas, health inequalities decreased. For example, the infant mortality health inequality for manual workers fell by almost a third to 12%. To understand why that is so, we must go back further than the previous Labour Government.
The Thatcher Government refused to acknowledge the relationship between poverty and ill health. The Department of Health was prohibited from using the phrase “health inequalities”. It had to talk about variations in health, and they were always couched in terms of its being people’s fault because they led such an unhealthy lifestyle.
Labour’s experience with infant mortality shows that targeted interventions can work. Infant mortality is really interesting, because it is a sensitive measure of immediate health, which is susceptible to direct interventions, such as the ones the Labour Government introduced, including improving the health of expectant mothers through the pregnancy health grant and of babies through Sure Start.
As the Labour-commissioned Marmot review demonstrated, to reduce health inequalities we cannot just focus on lifestyle factors; we need to address their social and economic root causes.
Guy Opperman (Hexham) (Con)
I have listened carefully to the hon. Lady’s arguments, and I congratulate her on this debate. It is good to see so many hon. Members from the north-east in the Chamber. She talks about inequalities, and referred to Surrey’s excellent mortality rates and alcohol abuse recovery rates compared with the north-east and Scotland—people in Glasgow have the lowest life expectancy rates in the country. Does she support the proposal for an alcohol Act that would statutorily restrict alcohol availability?
Chi Onwurah
I thank the hon. Gentleman for his intervention. As I said, the causes of health inequalities are complex. Alcohol dependency certainly varies significantly throughout the country. We need, and we are seeing, targeted campaigns to address that. I hope that the Government will introduce concrete measures to address alcohol dependency, such as legislation and a minimum price if that is appropriate.
Labour prioritised addressing health inequalities. We could not overcome the legacy of inequality in 13 years, but we made real progress, as the figures for infant mortality show. However, that is set to change. There are three main ways in which the Government are undermining work to reduce health inequalities.
First, the Government have changed the funding formula, and reduced the component designed to address health inequalities. I have been in Parliament for 19 months, and I have raised this matter directly with Ministers four times, not counting written questions. I am hoping it will be fourth time lucky for receiving a direct answer. Will the Minister confirm that in 2010 the Secretary of State decided, against the advice of the Advisory Committee on Resource Allocation, to reduce the health inequalities component of the primary care trust target funding allocation from 15% to 10%? Two weeks ago, during an exchange on the Floor of the House, the Secretary of State cited a 2.8% rise in funding when I asked him about changes to the funding formula. Will the Minister address the change to the formula, rather than the overall increases that the Government claim?
During a speech on the Floor of the House in December 2010, I asked the Secretary of State to confirm that more will be invested in health services for every man, woman and child in Newcastle for every year of the comprehensive spending review as the Government claim that they are increasing NHS spending. He declined to do so, so will the Minister step into the breach?
Clearly, if funding is changed to reduce the amount associated with health inequalities, the north-east will lose out. The Minister will say that the Government have ring-fenced public health spending and handed it over to local authorities. She may refer to the public health outcomes framework, which was published yesterday, just in time for today’s debate, and is very interesting reading. It includes 66 measures, which will be monitored, but they cannot distract from the assault on public health that the Government’s wide-ranging cuts represent for local authorities. For example, cuts to fuel poverty reduction programmes such as Warm Front will leave pensioners in Newcastle colder and more vulnerable to illness. Cuts to area-based grants such as the Supporting People programme mean there will be less investment in support services for those with mental health issues.
The second way in which the Government are undermining work to address health inequalities is the top-down, unnecessary and destructive health care reforms. It is estimated that they will cost £3 billion, and we now know that in the north-east the NHS has been asked to put aside £143 million for those organisational changes. The Government claim that efficiencies will make up for that, but the service is already being asked to meet the 1.5% efficiency cuts challenge at a time of wholesale reorganisation. As the Select Committee on Health said today, it is incredibly difficult, if not impossible, to make such efficiency savings when everything is changing.
In the north-east, our strategic health authority and primary care trusts are being abolished. Funding will be in the hands of GP consortia. Newcastle already has a pathfinder consortium in place. Newcastle Bridges GP commissioning consortia covers most of the city, and has shown that it is keen to work with other stakeholders across the city to promote public health, but it is having to make it up as it goes along in the face of huge uncertainty and change in the public sector and in the third sector, with unprecedented local authority cuts, watched over by an eager private sector that is keen to take advantage of the profit-making opportunities that the Prime Minister and the Health Secretary have promised.
A recent letter to the Health Service Journal, signed by more than 40 directors of public health and more than 100 public health academics, argued that the Bill will increase health inequalities, not reduce them. If the Government will not pay attention to what the Opposition say, perhaps they will pay attention to what the profession says. Michael Marmot told the Health Committee that there is little evidence that the health premium will reduce inequalities. Indeed, he said that it is most likely to increase them. Seven former presidents of the Faculty of Public Health have said that the Bill will “exacerbate inequalities”.
Health
Debate between Chi Onwurah and Guy Opperman(14 years ago)
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Chi Onwurah (Newcastle upon Tyne Central) (Lab)
A merry Christmas to you, Mr Speaker, and to the House.
I was born in Wallsend in the 1960s, and my mother was born in Newcastle in the ’20s. What we had in common, which we share with any child of the north, was the impact of geography on our life chances. A child born in Newcastle today is expected to die five years before one born in South Cambridgeshire, the constituency of the Secretary of State for Health.
Of my mother’s six brothers and sisters, only one survived into adulthood. We have certainly made great strides since those dark days, but health is still a critical political, social and personal issue. Newcastle has world-beating hospitals—the Royal Victoria infirmary, the Freeman and the General hospital. We also have the Campus for Ageing and Vitality, the Centre for Life, the Great North children’s hospital and the Northern Institute for Cancer Research, but what we do not have is health equality.
The people of Newcastle are more likely to die early from cancer, heart disease or stroke. We tend to die younger, are more obese as children, and are more likely to die from the cold as pensioners. We suffer more from the diseases of our industrial legacy, such as asbestosis, and we are more likely to be born into poverty, experience mental illness and commit suicide. One in 25 adults in Newcastle claims incapacity benefit for mental illness, four times the rate in the constituency of the Secretary of State for Education.
I will be frank and say that I do not believe the last Government did enough to tackle the issue of mental health. It is the responsibility not only of health care providers but of social services, educators, the police and prison officers. The lack of co-ordination and support was tragically highlighted by the case of Raoul Moat earlier this year.
As a Newcastle MP, I consider my primary duty to be to work for the health and well-being of my constituents, so the existing inequalities concern me and I am worried that they will widen under the current Government. I hope that the Minister can offer me some reassurance. The previous Government doubled health funding in real terms, reduced waiting times and improved health outcomes. Deaths from heart disease and stroke went down by 40%. They also worked hard to tackle poverty and its associated evils, such as poor housing, low aspiration and unemployment, which all have an impact on health.
Improvements in those areas benefited the mental and physical health and well-being of all our constituents, but in Newcastle, inequalities have been maintained or even increased. In 1998, early death rates from heart disease and stroke were 19% higher in Newcastle than the national average. In 2007, they were 26% above a much reduced national average.
The last Government prioritised tackling health inequalities in 2006—too late, certainly, but as a result the North East strategic health authority, primary care trusts and hospitals are all working to address the problem. However, that is all set to change. The Government’s reforms to the NHS are estimated to cost £3 billion, without counting the cost of disruption and the loss of skills. Our strategic health authority and primary care trust are being abolished and funding will be in the hands of GP consortiums, of which Newcastle will host one of the first. The Government do not like targets, but will the Minister confirm that she expects the key measures of health inequality to reduce as a consequence of those changes? Will she also confirm that Newcastle will not have to pay anything for those reforms from its health allocation?
The Secretary of State recently wrote to me to say that the 2011-12 allocation for Newcastle represented a growth of 2.8%, including a change to the funding formula. Despite written questions, however, I have been unable to clarify how the changes will address health inequalities. The Government’s changes to formulas have tended to work against us in the north-east, so will the Minister confirm that more will be invested in health services for every man, woman and child in Newcastle in every year of the comprehensive spending review period?
Guy Opperman
Does the hon. Lady agree that the health service in Newcastle now covers not just her constituents in Newcastle but mine in Hexham, both because they are run by the same trusts and because the services are now so interdependent?
Chi Onwurah
The hon. Gentleman is absolutely right. Health services in Newcastle are accessed by a wide range of people from across the north-east.
Finally, the Minister will know that health depends on many factors. The Government’s wide-ranging cuts will have a negative impact on people’s health, especially the health of the most deprived. Cuts to fuel poverty reduction programmes such as Warm Front will leave pensioners in Newcastle cold, and therefore more vulnerable to illness. Cuts to area-based grants such as Supporting People mean that there will be less investment in support services for those with mental health problems, and cuts to the working neighbourhood fund mean that my constituents will have less help to get back into work, with all the health advantages that work brings.
I shall give the Minister a specific example. In Newcastle, about £10 million a year goes to charities to help deliver services for the vulnerable. The Government’s cuts mean that that figure will go down by 75%, which will have many consequences. One charity to which I have spoken estimates that it will have to close hostels, leading to the number of rough sleepers in the city rising by up to 500%. Rough sleeping obviously has terrible consequences for the health of the individual concerned, but Newcastle as a whole will also pay the cost. The police, health services, social services and the third sector will all have to focus more resources on those sleeping in the streets, reducing the help available to others—help that supports the health of the city.
There are many similar examples. Will the Minister assure me that she has assessed the impact of the cuts on Newcastle in the broadest sense, and that she is confident that the health inequalities between Newcastle and the rest of the country will be reduced over the term of this Government?