Health

Geraint Davies Excerpts

Tuesday 14th May 2019 Commons Chamber

[Jonathan Ashworth]

As my hon. Friend indicates, government is about choices. The Government have chosen to give big tax cuts to some of the richest and most privileged people in society while cutting the public health services on which the most vulnerable rely. That tells us all we need to know about the Tory approach to the national health service.

[Geraint Davies (Swansea West) (Lab/Co-op)]

My hon. Friend has eloquently linked poverty and life expectancy. Does he agree that when we look at statistics such as the 64,000 people who die prematurely as a result of air pollution, that is focused on poorer people who live near busy roads? When we look at people who die from diabetes who have been force-fed processed foods, there is another correlation. The common theme is partly the support that the Government give to manufacturers of sugar, diesel and so on. That disproportionately hits poorer areas and ends up killing more people.

[Jonathan Ashworth]

The House has no greater champion of clean air than my hon. Friend. He is quite right—we have to tackle the wider social determinants of ill health, including pollution. We would introduce a clean air Bill. I am disappointed that the Government do not seem to agree that that is necessary.

I shall run through—[Interruption.] The Secretary of State is chuntering. He will have a chance to respond to the points that I have made. We all accept that smoking is a No. 1 cause of ill health and early death, causing about 115,000 deaths a year. Some 480,000 hospital admissions are attributable to smoking, which is an increase of 6% since 2013. That costs the NHS £2.5 billion a year—it costs primary care £1 billion and social care £760 million—but because of public health cuts, smoking cessation services in communities have faced cuts of £3 million. Over half of local authorities have been forced to cut services. Some local authorities have had to decommission smoking cessation services altogether, and 100,000 smokers no longer have access to any local authority-commissioned support. The number of people using smoking cessation services to help them quit has decreased by 11%—the sixth year in a row that the figure has fallen.

That means that smoking cessation services are, in the words of The BMJ,

“withering on the vine as councils are forced to redeploy funding to other areas”

Those cuts will lead to the risk of more people developing cancer and to higher costs for the NHS. It is a similar story with drug and alcohol services, which have seen cuts of £162 million, with more cuts to come this year.

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[Matt Hancock]

My right hon. Friend anticipates my very next point. It is important to get value for the extra taxpayers’ money we put in. I always try to refer to it as taxpayers’ money, because there is no Government money or NHS money. Every single penny we put into the NHS—rightly, in my view—comes from the taxes that people pay, and it should be treated with the respect that that deserves.

[Geraint Davies]

The thesis of a strong NHS is based on a strong economy, yet will he accept that under this Government since 2010 overall debt has gone from 45% of GDP to nearly 90% of GDP? It is not about tax; it is just borrowed money from a failing economy.

[Matt Hancock]

No. I agree with the hon. Gentleman about the importance of clean air, but I gently point out that dealing with the deficit—the annual amount by which the Government was overspending—is, and must be, the precursor to getting the debt down. Now, thankfully, the debt is falling relative to the economy, but there has been an awful lot of hard work to get us there.

Let us look at some of the things the NHS is delivering. The entire population now has access to evening and weekend GP appointments. More than a million GP appointments a month are now booked online, and consultation increasingly takes place online. More than three million repeat prescriptions are done online. There are more than 2 million more operations a year than in 2010, and we see 11.5 million more out-patient appointments than in 2010. Since last year, more than 500 extra beds a day have been freed up in hospitals.

When it comes to the future, only yesterday we announced that a new treatment aid for brain cancer can be rolled out across the country, benefiting up to 2,000 patients, all because of the extra money we are putting in. My right hon. Friend the Member for Wokingham (John Redwood) is quite right that in return for the extra taxpayers’ money we are putting in, we must get extra out, too.

[Matt Hancock]

The public health grant is settled in the spending review. The NHS settlement has come before the spending review, and the public health grant is only one part of the approach to public health. In 2015, this House agreed, with broad acceptance across parties—I know the hon. Gentleman was not in the House then—that local authorities should take responsibilities for public health, to ensure that the entirety of local authority activity could be focused on better public health.

Public health is not just what happens in the NHS, with councils or in GP surgeries or hospitals. For instance, the Government have taken a global lead in getting social media companies to remove suicide and self-harm content online because of the danger that poses to people’s mental health, and in particular that of children and young people. That is a public health issue. Likewise, the efforts we are making to reduce air pollution in the environment Bill—a broader piece of legislation than just a clean air Act—are about a public health matter. It is not in the public health grant, but it is a public health matter.

[Geraint Davies]

rose—

[Anna Soubry]

rose—

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[Matt Hancock]

I respect the right hon. Lady’s work as Public Health Minister—she was excellent in that role—and I was going to turn to this point. It is very important that we understand the base we are starting from, but we also have the spending review, in which these budgets will be settled, and that is clearly an important cross-Government question that we will be addressing in the coming months.

Smoking cessation services have been mentioned. Now, the smoking rate has fallen since 2010 from 20.1% of the population to 14.9%, which is excellent, although it is part of a fall over a generation, not just the last 10 years. Likewise, the drug use rate has fallen from over 10% to 8.5%. We have to provide the services for those we still need to get off smoking and to support people to stop using drugs, but the number of people smoking and using drugs has fallen too.

On clean air, the World Health Organisation has called the clean air strategy we published an example for the rest of the world to follow, so I think in this area the necessary action we are taking should be being welcomed across this Chamber.

[Geraint Davies]

I know the Secretary of State accepts that the environment Bill is the vehicle to deliver cleaner air, but is he aware that, as it stands, it does not include indoor air quality? Given that we spend 90% of our time inside and that the medical research now shows a cocktail effect of outdoor dirty air conflating with indoor air that has poisons in it—from sprays, cleaning products, chemicals in furniture and all the rest—if we are to properly tackle the problem of dirty air causing 64,000 deaths a year, indoor air quality has to be included in the environment Bill. Will he press the Secretary of State for the Environment, Food and Rural Affairs to ensure that it is?

[Matt Hancock]

The Secretary of State for Environment, Food and Rural Affairs and I are working incredibly closely on this because clean air is a public health matter. The challenge is that, although measuring outdoor air quality is essentially a public matter and in public buildings it may well be a public matter, inside most people’s homes it is far harder to make a direct intervention, but I accept the premise of the hon. Gentleman’s point. It may be something we can look at in public spaces. [Interruption.] He mentions schools and hospitals. I accept the premise of that point and I think it is something we can take away. The same is true inside vehicles, but that is a wider question.

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[Geraint Davies (Swansea West) (Lab/Co-op)]

Air pollution—the silent, invisible killer—is now leading to 64,000 premature deaths in Britain each year. The figure was thought to be 40,000 by the Royal College of Physicians, but it has now been updated by the European Heart Journal. Pollution is now the biggest killer in the world—bigger even than smoking. We know that 8.8 million people die from air pollution, compared with 7.2 million who die from smoking. People are killed, or their lives are prematurely ended by heart attacks, heart disease, lung cancer, lung disease and strokes. Air pollution is also a massive cause of dementia. Pregnant mothers have their foetuses impacted by the particulates that they breathe in, and children in so-called clean air zones have a 10% lower lung capacity and much worse mental health issues.

I am therefore pleased that The Times is now supporting a five-point action plan to tackle air pollution. It supports the idea of a clean air Act, and I have a Clean Air Bill going forward. People have a right to clean air, and it is important that local authorities and others have the resources to deliver that. It is also important that the Government get off their seat and say that, instead of banning all new diesel and petrol cars by 2040, we should do so by 2030. After all, that ambition is now held by India, China, Ireland and others, and we really need to do much more. We need to ban traffic from idling outside schools, and we need to ensure that the 40 cities in Britain that breach the World Health Organisation standards do more to stop older vehicles entering city centres and charge them. We need to monitor local levels of air pollution through local authorities and the Environment Agency, so that people have the figures and the power to campaign to stop pollution. It is also important that we stop building new schools next to busy roads.

In addition to that, my Clean Air Bill sets out a fiscal strategy for tackling air pollution. Fuel duty on diesel has been frozen since 2010. There is no differential between that and petrol, let alone electric cars. We require electric car infrastructure across Britain, but the Government have given that responsibility to BP, which of course has a vested interest in keeping fossil fuel on the road. We also need proper testing. Volkswagen was fined in the United States following the testing scandal, but not in Britain, and 300,000 VWs still have not been called back for correction. The Government are hurtling ahead with expanding airport capacity, leading to more dirty air. We need to do more on ports, with a maritime strategy that ensures that ships coming into port are connected to electric power. We should be converting to electric trains, but Swansea, which was promised electrification, is getting diesels.

It is also important that the environment Bill considers both indoor and outdoor air. I am pleased that the Secretary of State put it on the record today that schools and hospitals should be included in the Bill, and I will certainly be holding him to his word. People inhale all sorts of dangerous chemicals when indoors through cleaning agents, which may be sprayed on people’s bodies, fire retardants in sofas and so on.

We must ensure that high standards are enforced. Members will know that ClientEarth has taken the Government to court over their failure to protect people from dirty air, and we need an assurance that if we do Brexit—I very much hope that we do not—enforceable standards will be in place to ensure that people are safe. Put simply, children and the rest of us have a right to clean air, but the Government are failing in their duty to deliver that right. They need to get on and protect our public health, protect our future and deliver clean air.