Tuesday 14th May 2019

(5 years, 1 month ago)

Commons Chamber
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Jonathan Ashworth Portrait Jonathan Ashworth
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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.

Gloria De Piero Portrait Gloria De Piero (Ashfield) (Lab)
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A family came to see me to tell me about their alcoholic son who, in the past year, had been taken to hospital by ambulance 35 times, and had spent four weeks over that year in hospital. All that they wanted was support services to help him get his addiction under control. The urgent care was there, but that was not good enough for them. It is devastating for him, but it makes no financial sense for the NHS.

Jonathan Ashworth Portrait Jonathan Ashworth
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My hon. Friend makes an eloquent and powerful point. She is absolutely right. It makes absolutely no sense to cut alcohol addiction services, as that fails a number of vulnerable people in society and only increases pressures on the wider NHS.

The NHS recognises the pressures on alcohol services. It announced in its long-term plan that it wanted to roll out alcohol care teams in hospitals—a proposal that I made at the Labour party conference last year. At the same time, public health budgets are cutting alcohol addiction services in our communities. Years of investment under the Labour Government in drug and alcohol treatment and recovery centres helped to reduce HIV, hepatitis and drug-related deaths, and also helped to reduce drug-related crime and wider social harms. Yet the number of those receiving treatment and in recovery for alcohol problems has fallen by 17% since 2013. When alcohol misuse costs wider society £18 billion a year in crime and lost productivity, and when drug misuse is also a factor in so much crime, surely these cuts represent the very worst type of short-term thinking—cutting proven preventive services for a short-term saving but ignoring the bigger and longer-term human and financial cost.

What about weight management programmes? The Government pride themselves on their obesity strategy, but when the NHS spends £5 billion on obesity, when there are 617,000 hospital admissions because of obesity, when 18% of hospital beds are occupied by a person with diabetes, when 25% of care home residents have diabetes, and when we have one of the worst childhood obesity rates in western Europe, why are weight management programmes being cut in communities? One GP told Pulse magazine:

“This is crazy. It makes conversations between GPs and patients very difficult. They say, “you tell me that I need to lose weight, but the only help you can give me is advice and a diet sheet printed off Google.”

Another GP told Pulse:

“You try to refer someone for bariatric surgery but they can only have it if they’ve undergone 12 months of a weight management programme—but there isn’t one.”