Health Inequalities: Office for Health Improvement and Disparities

Jim Shannon Excerpts

Wednesday 26th January 2022 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to serve under your chairmanship, Mr Twigg. I thank the hon. Member for Bootle (Peter Dowd) for setting the scene. He is a man known for setting the scene well, and we appreciate his contribution—I think every one of us will have been heartened by what he has said today. I wish to make a contribution as my party’s health spokesperson. I am pleased to be here to discuss the evident disparities and inequalities in our health system, both on the mainland and back home in Northern Ireland. I know the Minister is not responsible for health in Northern Ireland, but I will give examples that will hopefully spur those who speak in this debate.

We must ensure that everyone has access to efficient healthcare. I will speak about three groups of people: those with mental health issues, those who are homeless and those with addictions. The Office for Health Improvement and Disparities officially launched in October 2021, as part of a restructuring of health bodies in England and throughout the UK. I am pleased that the OHID will co-ordinate local and central Government to initiate improvements in public health. The purpose of the OHID is clear. If it delivers on that purpose, everyone present will be more than pleased because many of the issues would be addressed.

I thank the Government for listening and learning from the lessons of the pandemic, and that information has now been taken ultimately to improve our health service. The Minister has said that our Government have three priorities to work on. The first priority is preventing poor mental and physical health. One in four people in the UK—25% of the population—and 19% of adults in Northern Ireland suffer from poor mental health, so that should be prioritised. The second priority is addressing health inequalities. Health is devolved, but this must be a priority for the Department across the whole of the United Kingdom. The third priority is working with partners within and outside Government to respond to the wider health determinants. These partners also have a responsibility for public health outside England.

I will talk about addiction issues and why it is so important that we address them within this campaign and policy, which the Minister will reply to shortly. In Northern Ireland, and in my constituency in particular, alcohol and drug-related indicators continue to show some of the largest health inequalities monitored in Northern Ireland, with rates in the most deprived areas five times those of the least deprived areas for drug-related mortality, and four times those for alcohol-related mortality. I suspect that other hon. Members will also state those mortality figures for people with drug or alcohol addiction issues. The inequality seems to be, unfortunately, in the areas where people have a poor quality of surroundings and less money, and therefore they are the ones we need to focus on because of the high risk of mortality that is prominent.

The King’s Fund has ascertained that health inequalities are avoidable and depend on people’s access to care; the quality and experience of care; behavioural risks to health, such as smoking and drinking; and wider determinants of health, such as housing circumstances and social factors and decisions. All these things combine to put pressure on people. Crisis, an organisation that campaigns to end homelessness, has contacted me in relation to tackling the disease of disparity. That is quite a term: the disease of disparity. Yes, it is a disease and it needs to be addressed. People who are homeless face some of the poorest health outcomes in society.

Some of the statistics are as follows. People experiencing homelessness are three times more likely to be diagnosed with a severe respiratory health issue. I did not know that until I got that information from Crisis, but it is a fact. The average age of death among homeless people is 46 for men and 42 for women, as the hon. Member for Stockport (Navendu Mishra) referred to. In this day and age that is totally unacceptable. We must address that issue. At the same time, I read in the papers—I do not know whether it is true—that people are living longer. Will someone who is homeless live longer? They will not, and therefore that must be addressed. I hope the Minister can respond to that.

Finally, a recent study found that people facing homelessness in major cities, such as Belfast or London, have levels of frailty like that of a 90-year-old. Again, that is another combination of issues. The barriers blocking greater equality for our health service are just astonishing, and these have only been exacerbated by the pandemic. It is about time that we started prioritising, and that starts with everyone being given the same allowances to access our truly admirable NHS.

Lastly, it is time for the OHID to monitor the provision of commissioned services for those who are socially disadvantaged and cannot access sustainable healthcare. I urge the Minister to commit to producing guidance and support on what actually works in the provision of health and social care services. I believe our duty in this House is to speak up for those who need speaking up for. Today, I am doing just that.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health and Social Care (Maggie Throup)]

It is a pleasure to serve under your chairmanship, Mr Twigg. I congratulate the hon. Member for Bootle (Peter Dowd) on bringing forward this extremely important debate. It has been really interesting and, with many people contributing, it has been quite rounded. The hon. Gentleman spoke passionately and knowledgeably about the issue, as did other Members. We have probably done the issue a disservice by having only an hour and a half to debate it. I look forward to further debates.

It is time to shift the centre of gravity of the health system from treating disease to building good health. To do that, we have to focus on the people and places who face the worst health outcomes. That is why on 1 October 2021, we launched the Office for Health Improvement and Disparities. The mission of OHID is to improve the health of our country so that everyone can expect to live longer in good health, and to break the link between people’s background and their prospects for a healthy life.

OHID is doing that by working with the rest of Government, the healthcare system, local government and industry, to bring together expert advice, analysis and evidence in policy development and implementation. As a number of hon. Members mentioned, covid has shone a light on the poor underlying health of certain groups in the population, the depth of health disparities and the implications for our health, economy and society.

Health disparities across the UK are stark. As the hon. Member for Bootle highlighted, in the borough of Sefton, where his constituency is located, the life expectancy deprivation gap is 11.8 years for women and 12.5 years for men. Health disparities can be driven by a range of factors, including education, income, employment and early years experiences. Therefore, OHID aims to systematically tackle the top preventable risk factors for poor health by looking actively at the evidence on health disparities and the ways in which we can go further to address them.

The new Health Promotion Taskforce, which was set up by the Prime Minister, will drive and support the whole of Government to go further in improving health and reducing disparities, because many of the factors most critical to good physical and mental health are the responsibility of partners beyond the health service. This new Cabinet Committee, now chaired by the Secretary of State for Health and Social Care, brings Departments together around the objective of reducing ill health and health disparities. It also provides a new opportunity to work together actively on the most important health issues and agree new ways to address them collectively. I hope that helps reassure colleagues that the new taskforce is at the top of Government, and is determined to bring all Departments together to tackle this agenda.

[Jim Shannon]

In my contribution, I referred to the contact that I have had with Crisis on homelessness. Will the contact that the Minister has referred to include those groups? They have the facts. She will have heard what I said about the disparities between those who, like us, live in a well-off area, and those who do not and have not got a home. Homelessness is deadly.

[Maggie Throup]

I reassure the hon. Gentleman that tackling homelessness is a high priority for this Government.

As hon. Members have mentioned, the Government will shortly publish a landmark levelling-up White Paper that will set out bold new policy interventions to improve livelihoods and opportunities in all parts of the UK, and to reduce the disparities between different parts of the UK. Poor health is stopping people accessing quality education and jobs with good career prospects, limiting their career progress, and undermining local prosperity and the general wellbeing of communities across the UK. Of course, it would be wrong of me to pre-announce the contents of that important White Paper.

Tackling health disparities promotes economic prosperity by increasing productivity and reducing strain on public services, including the economic cost of preventable ill health to the NHS and the welfare system. To address those issues, we are investing in tackling the key contributors, such as obesity and smoking. We are also investing £500 million to transform Start4Life and family health services.