Health Inequalities (North-East)

Grahame Morris Excerpts

Tuesday 24th January 2012 Westminster Hall

[Ian Swales (Redcar) (LD)]

It is a pleasure to speak under your chairmanship, Mrs Riordan. I congratulate the hon. Member for Newcastle upon Tyne Central (Chi Onwurah) on securing the debate. I agree with her that the issue of health inequalities is of great importance to all MPs and particularly those of us who represent constituencies in the north-east. Having been born in Leeds, I was delighted to emigrate to the north-east in my early 20s.

First, I would like to refer to the July 2010 National Audit Office report, which was specifically about “Tackling inequalities in life expectancy in areas with the worst health and deprivation”, and to the subsequent hearing of the Public Accounts Committee and the report that it produced in November 2010. That report was in effect a catalogue of action by the previous Government and bears detailed reading. It said that the Department of Health had been

“exceptionally slow to tackle health inequalities…we find it unacceptable that it took it until 2006—nine years after it announced the importance of tackling health”—

[Grahame M. Morris (Easington) (Lab)]

Will the hon. Gentleman accept that tackling health inequalities effectively requires a broad range of actions, including tackling things such as educational under-achievement, the need for warm homes, and child poverty, which go across a broad range of Departments, not just the Department of Health?

[Ian Swales]

I absolutely agree with that and will go on to say more about it. The Department of Health has an important role in being the umbrella Department for monitoring action in this area, however. The report went on to say that the Department recognised its failings, admitting that it had been

“slow to put in place the key mechanisms to deliver the target it had used for other national priorities”

and

“slow to mobilise the NHS to take effective action.”

However, I agree with the hon. Gentleman that there is much more to this than simply the NHS.

There certainly has not been a shortage of reports on this subject. The Department of Health issued 15 major publications on the issue, starting in 1998 and rising to a crescendo in 2010. In fact, 2007 was the only year in which the previous Government did not issue a publication.

--- Later in debate ---

[Grahame M. Morris (Easington) (Lab)]

It is a pleasure to serve under your chairmanship for the first time, Mrs Riordan. I congratulate my hon. Friend the Member for Newcastle upon Tyne Central (Chi Onwurah) on securing this debate. The number of Opposition Members who are present today is a testament to the issue’s importance. I wish we had a little longer to speak, because I will have to truncate my remarks.

I served on the Committee that considered the Health and Social Care Bill, and I am a member of the Health Committee. As someone who has worked in the health service for more than a dozen years, I can say that the subject is very close to my heart. I am grateful to a number of organisations for their work, including the Association of North-East Councils, the National Education Association, the Campaign for Warm Homes, Durham county council, the North East Public Health Observatory and Health Works, which won a national award last week for its innovative and pioneering work in tackling health inequalities at the very heart of my constituency, and I thank that organisation for the information that it provided to Members for this debate.

The NHS reforms contained in the Health and Social Care Bill are only one aspect—a very important aspect—of how Government policies will increase health inequalities. We must make it clear that there is no consensus on this matter. There is clear blue water between the views of the Opposition, who think that resources should be applied to the areas of greatest need to address real and fundamental problems, and the attitude of Government Members. Across every Department, coalition policies will exacerbate socio-economic inequalities and, ultimately, health inequalities, as indicated by Professor Sir Michael Marmot in his report. I wanted to mention some figures in my region, but I do not have enough time.

Chronic obstructive pulmonary disease, or COPD, is particularly prevalent in the north-east. It is often associated with heavy industry, coal mining and the like. Last year, my own primary care trust received a national award for its innovative approach to tackling this public health issue within our community. COPD costs the NHS an estimated £491 million every year.

Mortality rates in the north-east are higher than in the rest of England, accounting for 6% of all deaths in England, and the inequality gap appears to be increasing, which is a real concern.

I want to focus on two significant issues in the limited time that I have: first, inequalities in access to health service, which is a key factor that influences health outcomes; and secondly, the broader problem of health inequalities produced by deep-seated differences of social class.

As we have heard, in 1979 the Government’s chief scientific adviser, Sir Douglas Black, produced a report on the extent of health inequalities in the UK, and he acknowledged that the NHS could do much more to address those inequalities, alongside other improvements across the Government. As I mentioned earlier, those improvements include ones to child benefit, maternity allowances and pre-school education, as well as an expansion in child care and better housing. All those changes would address health inequalities.

Those findings by Sir Douglas Black were subsequently reinforced by further research and reports by Professor Peter Townsend and Sir Derek Wanless and more recently by Professor Sir Michael Marmot, all of whom I have had the pleasure to meet in one forum or another before and after I was elected to serve in the House.

There is a stark danger—a clear and present danger—of a downturn in the progress that has been made in addressing health inequalities because of decisions being made by the Government, both in the Department of Health and elsewhere, and severe cuts to services for the most vulnerable. That makes it all the more important that the NHS focuses on tackling health inequalities. Let us make no mistake: under Labour, good progress was made to address health inequalities, but a great deal more needs to be done.

I have served on the Health and Social Care Bill Committee for a year now, as well as on the Select Committee on Health, and I would argue that that Bill changes the fundamental aspects of our NHS. The NHS has been fragmented, with privately led commissioning, the reintroduction of a postcode lottery, an unco-ordinated health system and greater competition. That fragmentation risks entrenching the inequality of access to health services and health outcomes. Fragmentation is the antithesis of a co-ordinated approach. We need more co-ordination, more integration and a more focused approach.

Stephen Thornton, chief executive of the Health Foundation, talked about health inequalities when he was one of the expert witnesses who gave evidence to the Health and Social Care Bill Committee. He said:

“a duty needs to be placed on the national commissioning board and the consortia”—

the commissioning groups—

“to embed shared decision making in all care and treatment”.––[Official Report, Health and Social Care Public Bill Committee, 8 February 2011; c. 19.]

Only by reinforcing the duty on the commissioners themselves to reduce health inequalities is there any chance of achieving that goal.

The cuts that are falling across every Department are clearly hitting the poorest hardest. The Association of North East Councils has shown that the north-east will be worst affected by those cuts between now and 2013. Child poverty is rising in my constituency. Currently, one child in three in my constituency is living in poverty, but in the Eden Hill ward in Peterlee 48% of children are in poverty, and in Deneside in Seaham, which is next to where I live, the figure is 40%. Those figures should concern not only the local MP but the national Government.

Recently, the TUC produced figures after the unemployment figures were released that show that, on average, 7.5 jobseekers are chasing every vacancy, but in the constituency of my hon. Friend the Member for Hartlepool (Mr Wright) the figure is as high as 24 jobseekers chasing every vacancy. Youth unemployment is rocketing, and the coalition Government seem to have no intention of reducing health inequalities.

[Ian Lavery (Wansbeck) (Lab)]

I will make a very brief intervention. My hon. Friend has just mentioned statistics about child poverty, unemployment and jobseeker’s allowance applications, and earlier in the debate other colleagues talked about the inequalities in the north-east regarding the situation within the NHS. Those statistics and that situation are wholly unacceptable. The Prime Minister said before the election that he would attack the north-east first and then Northern Ireland second. That is happening. With the Welfare Reform Bill, there will be a continued attack on the north-east. Does my hon. Friend agree that that does not bode well for the future of the people in the north-east and that things can only get worse?

[Grahame M. Morris]

I am grateful to my hon. Friend for that intervention, and I agree with him. I was shocked to attend a meeting in my constituency last Friday about the contingency plans that are being put in place for emergency feeding centres after 2013. Those centres are the soup kitchens that we have not seen since the 1930s or the miners’ strike in 1984.

My final point is that the Labour Government produced the first ever targets to reduce health inequalities in the population, and the poorest were healthier when we left Government than they had been when we took office in 1997. My plea to the Minister is this: raise the standards and be a champion for public health and not an apologist.

[Mrs Linda Riordan (in the Chair)]

Order. I remind Members that I will call the Front-Bench spokespersons from 10.40 am onwards.