Tuesday 14th May 2019

(4 years, 11 months ago)

Commons Chamber
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Jonathan Ashworth Portrait Jonathan Ashworth (Leicester South) (Lab/Co-op)
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I beg to move,

That an humble Address be presented to Her Majesty, that she will be graciously pleased to give directions that the following papers be laid before Parliament: any briefing papers or analysis provided to the Secretary of State for Health and Social Care or his Ministers since 9 July 2018 including impact assessments of public health spending reductions and any assessments made on falling life expectancy and the minutes of all discussions between the Department of Health and Social Care and NHS England on funding pay risks for Agenda for Change staff working on public health services commissioned by local authorities.

A child born at this very moment in the very poorest of communities—whether in inner cities like Manchester or my own city, Leicester, or in towns such as Blackpool or Burnley—will have a life expectancy that is around nine years lower than that of a child born at this very moment in some of the wealthiest communities, such as Chelsea, Westminster or east Dorset, and they will enjoy 18 fewer healthy years of life. Two babies born today could have years of difference in life expectancy and years of difference in healthy living, due entirely to the circumstances into which they are born. The child born in the very poorest of areas is more likely to leave school obese and almost 70% more likely to be admitted to A&E. That child is less likely to receive measles, mumps and rubella vaccinations, more likely to take up smoking as a teenager, and more likely to need the help of specialist mental health services at some point.

Of course, health inequalities have always existed, throughout the 71-year history of the national health service, but nine years of desperate, grinding austerity have brought us record food bank usage and in-work poverty, and seen child poverty increase to 4 million, with 123,000 children today growing up homeless in temporary accommodation—a 70% increase since 2010. Some 4,700 of our fellow citizens sleep rough on our streets, an increase of 15%, and, tragically, nearly 600 of them die on our streets. There have also been savage cuts to public services, including social care, which have left 600,000 elderly and vulnerable people without support. We have seen nine years of all that, and we should be shocked, because the advances in life expectancy that we all take for granted and that have steadily improved for 100 years are grinding to a halt.

Diana Johnson Portrait Diana Johnson (Kingston upon Hull North) (Lab)
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My hon. Friend is setting out clearly why the Opposition called for this important debate. Does he agree that the fact that for the first time since Victorian times we are seeing life expectancy falling for the poorest women in the most disadvantaged communities in our country, where the cuts have been heaviest, is a sad indictment of nine years of Conservative rule?

Jonathan Ashworth Portrait Jonathan Ashworth
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Absolutely. Not only are there indications that advances in life expectancy are going backwards, particularly for women, but the Institute for Fiscal Studies has been quite clear today in launching its Deaton review:

“In 2001, women born in the 10% most affluent areas could expect to live 6.1 years longer than women born in the 10% most deprived areas; by 2016, the gap stood at 7.9 years.”

That is why we secured this debate.

--- Later in debate ---
Lisa Cameron Portrait Dr Cameron
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Yes, that is an absolutely fantastic point. I was going to mention the fact that our local sports and leisure facility has an agreement with the NHS that GPs can prescribe sports facilities to people so that they can have an exercise regime designed specifically for them. If they can benefit from such a regime, that can maximise their health. All these things actually save money in the long term, and that is why public health is so crucial. We really are investing for the good of the nation.

From my own experience of working in addiction services many years ago, I know that we have to take on board the fact that there are huge levels of comorbidity with mental health. Often, people in addiction services have a history of trauma. They are self-medicating with alcohol or drugs, and they are not coping with life due to their underlying mental health issues. However, those very same people are often refused access to mental health services treatment until they have dealt with their addiction. That is a circular argument, and those who are struggling with mental health and addiction problems never really get the support that they need or deserve. That is why integrated services in relation to addiction are so important.

Diana Johnson Portrait Diana Johnson
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I am interested to hear about what is happening with drug and alcohol services in Scotland, particularly the 9% budget increase that the hon. Lady mentioned. Has she had the same experience that I have had in Hull, where more and more people on the streets seem to be taking Spice, which turns them in an obvious way into someone who is taking drugs and which is causing real problems on the streets? Is that happening in Scotland as well? We have seen an 18% cut in drug and alcohol services since 2013.

Lisa Cameron Portrait Dr Cameron
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This is always a difficult situation, because when people self-medicate, they tend to take the drugs that are available. They may take something that has an impact on their behaviour and personality, which may then have an impact on their life if they become involved in crime and so on. The types of drugs that are coming on to the market seem to lower people’s inhibitions, so they can get into terrible difficulties with the criminal justice system, but their difficulties—their underlying trauma and addiction—are not dealt with. That money is welcome, but we have a long way to go to ensure that we also deal with other issues.

Finally, it is important not to forget about our veterans when it comes to public health. These individuals who have served us may be invisible, silent or hidden in the background, but they need interventions and they need us to reach out. I wanted to mention the excellent Veterans First Point service in Lanarkshire for providing counselling without a waiting list to our local veterans to ensure that their needs are met.

I thank everybody who will take part in this extremely important and timely debate. The more that we can do in terms of public health, the better success we will have in years to come in dealing with inequality and the underlying issues that mean those in our society who did not get the best start do not get the chances that they deserve. We can achieve that only by working together on a cross-Government basis, with local councils and within communities, and I look forward to working with everybody in the Chamber who has an interest in moving this issue forward to ensure that progress is made.