Health Inequalities

Jamie Stone Excerpts

Wednesday 4th March 2020 Commons Chamber

[Jo Churchill]

The hon. Lady will appreciate that I cannot speak for all Departments, but it is my job to drive home the value of health in those Departments and to ensure that, as she says, we think about the broader consequences across the policy-making piece.

In answer to my right hon. Friend the Member for South West Wiltshire (Dr Murrison), smoking does remain one of the most significant public health challenges. It affects disadvantaged groups in particular and exacerbates inequalities. That is particularly apparent when looking at smoking rates in pregnancy. Three weeks ago, I visited Tameside Hospital in Greater Manchester to see its smoking cessation work. It started with a much higher than average smoking rate, and having a tailored public health budget in the locality has allowed it drive down into the inequality within the community. It has a specialist smoking cessation midwife to help these young women, their families and their partners give up smoking—for their own health, yes, but also for the health of their babies.

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

I packed in smoking 15 years ago. I cannot understand why the NHS does not use people like me to go out there and help other people pack it in.

[Jo Churchill]

I thank the hon. Member—he has just got himself a job as an ambassador. I congratulate him on quitting smoking, because it is hard.

The specialist centre showed me that with the right holistic support and encouragement, the health of both mum and baby can be improved. Such services will be crucial in achieving the ambition of becoming a smoke-free society by 2030.

Similarly, we must tackle the health harms caused by alcohol, and support those who are most vulnerable and at risk from alcohol misuse. Through the NHS plan, up to 50 hospitals with the highest rates of alcohol dependency-related admissions will have alcohol care teams. That could prevent more than 50,000 admissions every five years. Currently, eight of those teams are in operation, providing seven-day services focused on those areas with the highest levels of admissions related to alcohol dependency.

Alcohol addiction has a devastating impact on individuals and their families, and it is unfair that children bear the brunt of their children’s condition. I know that this topic is dear to the heart of the hon. Member for Leicester South (Jonathan Ashworth), who has spoken about it movingly. I pay tribute to the way he has influenced this agenda in this place. I am pleased so say that we are investing another £6 million over three years to help fund support for this vulnerable group.

As is often the case with addiction, there is a toxic mixture of several items. On substance misuse, last Thursday I attended the UK-wide drug summit in Glasgow, along with Home Office Ministers and Ministers from the devolved Administrations. We discussed the challenges associated with drug misuse and listened to Dame Carol Black present her findings from the first phase of her review. I am pleased that my Department will fund and commission the second phase of the review, which will make policy recommendations on treatment, prevention and recovery. Only through the combined efforts of different Departments working together can we hope holistically to improve the health and other outcomes of people with substance misuse problems. Many of us know from our constituency work that they often bounce between various parts of the system. Local authority leadership and action on public health prevention is vital as it will help to focus local measures to decrease health inequalities. As a condition of receiving long term plan funding, every local area across England must set out specific and measurable goals, and ways by which they will narrow health inequalities over the next five and 10 years. Local areas know their localities best.

--- Later in debate ---

[Dr Whitford]

I do. I respect the work that Labour did, and child poverty was falling. Interestingly, the upturn in child poverty we have seen did not happen with the crash in 2008; it happened after the 2012 welfare changes. That is striking. The impact of Government policy has been austerity in every way and in every approach to individuals, families and communities. We have seen slow income growth for the vast majority of people over the last decade. There has been absolute inequality. The majority of the growth that there has been, has been at the top. The national living wage simply is not a living wage. More people are in insecure work—zero-hours contracts, the gig economy—and do not have protections. As the shadow Health Secretary mentioned, in all the discussion about covid-19, we have been trying to highlight that people on low pay and insecure contracts do not get sick pay, yet we will be asking them to stay at home for two weeks and self-isolate. In the meantime, the wealthiest people have actually trebled their wealth. So categorically we have not all been in it together over the last 10 years.

In addition, we have seen a restriction on public expenditure. The regressive welfare cuts of 2012 and 2016 have reduced support for families by 40%: the benefit cap, the benefits freeze, the two-child limit, the five-week wait for universal credit, which puts people in rent arrears and debt, personal independence payments, the bedroom tax. Eighty per cent. or more of these cuts have affected women directly because they tend to be lower paid, to be carers and to rely more on services. In the main, they are responsible for children. The disabled have also been particularly hard hit. We have not seen a cumulative impact assessment of female lone parents who are disabled and have three or more children. Some of them have had their income slashed.

There have been cuts to local government and services. Interestingly, the least deprived areas face 16% of cuts, while the most deprived on average had 31% cut from their local government budget. I have heard Labour Members talk about between 40% and 60% cuts in their local government budgets. There are changes in the pipeline to move £300 million from local authorities in the north to the south. I wonder if that will be reversed now that the Conservative party has won some seats in the north.

[Jamie Stone]

Some years ago, when I was a councillor, I had a harrowing case involving a young female constituent who was clobbered by the bedroom tax. She has multiple sclerosis and she was going to lose a lot of cash. I want to put on the record my thanks to the Scottish Government for the action they took to ameliorate and offset that tax.

[Dr Whitford]

I thank the hon. Member for that recognition. The Scottish Government are spending more than £100 million every year in mitigating some of these cuts—they pay the bedroom tax and they have set up the Scottish welfare crisis fund—but that is money that should be going into devolved areas, not patching up austerity decisions here; it is not the role of the Scottish Parliament just to mitigate.

Public health in England has been cut by £850 million—again, the greatest cuts to the poorest areas—and it is exactly the same with future planned cuts. This has led to cuts in smoking cessation projects. There is no point standing up and talking about the importance of stopping smoking—we all know that. People who have smoked for decades need help to stop and those services are critical. We have also seen cuts to drugs and alcohol projects and to sexual health projects, and all those have an impact on the poorest people.

The Minister, who is no longer in her place, might have listened to Dame Carol at the drugs summit in Glasgow but, sadly, the Minister for Crime and Policing, the hon. Member for North West Hampshire (Kit Malthouse), did not. He came to Glasgow, made his speech and then left before all the expert evidence was given. We also hear of a social care gap across England of over £6 billion. Again, that affects women if they have to give up work to look after elderly relatives or disabled children. This rolling back of the state has affected the social determinants and increased health inequalities. Child poverty has increased, as we have heard, with 4 million children affected, and 1,000 Sure Start centres have been closed. Education funding is down. There is a housing crisis and therefore a rise in homelessness. People with insufficient funds to afford a healthy life are depending on food banks, and deprived communities are simply losing hope.

Poverty is simply the biggest driver of ill health and has the biggest individual impact on life expectancy. The increase in life expectancy in England has stalled for the first time in 120 years—the first time since 1900. The gap between the most and least deprived has widened: the gap is now almost 10 years for women and the life expectancy of some women in areas of the north-east of England has dropped by almost a year.

--- Later in debate ---

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

I really must praise the two excellent speeches by the hon. Members for City of Durham (Mary Kelly Foy) and for Coventry North West (Taiwo Owatemi). I rather fancy that those two Members will make their mark in this place in the years to come.

I want to tell the tale of Mr Billy Sutherland, who was a 63-year-old commercial traveller living in Wick. A good number of years ago, Billy set off from Wick on the A9, heading south. It was a winter’s day and the weather was not too bad when he left, but as he travelled further south towards the Ord of Caithness—the boundary between Caithness and Sutherland—it turned very nasty indeed. In the end, Billy drove into a snowdrift and could not get out of his car. The snow continued and eventually he was buried, in his car, 15 foot down. There was no trace of the car to be seen.

Billy was in that car for 80 hours. Eventually, the police found him by prodding the snow, and it clanged on the roof of the car. When they dug their way down to the car, they found that Billy was, astonishingly, alive and pretty well. He was not much the worse for his ordeal. Billy was a commercial traveller in ladies tights. As it got colder in his car over the 80 hours, he simply unwrapped more pairs of tights and put them on. It is an extraordinary tale. When he returned to Wick, he received a hero’s welcome.

I tell the tale because, until quite recently we enjoyed a consultant-led maternity service based at the Caithness General Hospital in Wick, but NHS Highland, in its infinite wisdom, decided to downgrade the service. As hon. Members know, because I have mentioned it before in this place, a great number of pregnant mothers now have to travel 104 miles from Wick to Inverness—a 208-mile return trip—to give birth to their babies. The vast majority of mothers have to do that.

What if it is winter? What if the ambulance gets stuck in a snowdrift? What if the mother’s contractions have started? What if the two emergency helicopters have been summoned to one road traffic accident in Lochaber and another in Morayshire? I have said it again and again: in my considered opinion, this is a tragedy waiting to happen. I make no apologies for raising it yet again in this place.

This debate is about equality of access to decent health services. I argue that my constituents in Caithness are losing out extremely badly indeed, and it annoys me intensely. In fairness, this is a matter that is devolved to the Scottish Government. I accept that and very much hope that the Scottish Government take the problem on board, because we cannot continue waiting for something dreadful to happen. When constituents come to me in Caithness, do I sit on my hands and say, “Well, it’s not a matter for Westminster,” or do I stand up and say something here? I make no apologies, because I think I owe it to the pregnant mothers.