Life Expectancy: Pensions, Health and Insurance

Lord Markham Excerpts

Wednesday 26th April 2023 Lords Chamber

[Lord Rooker]

To ask His Majesty’s Government how changes in life expectancy as measured by the Office for National Statistics have affected planning for pensions, health and insurance.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Markham) (Con)]

The Government consider a range of metrics when determining our approach to pensions, health and insurance, including life expectancy where relevant. We are committed to improving health life expectancy by five years by 2035 and to reducing the gap between areas where it is highest and lowest by 2030. Our major conditions strategy will focus on health conditions that contribute most to morbidity and mortality.

[Lord Rooker (Lab)]

I thank the Minister, but is he aware that Office for National Statistics figures show that life expectancy, which is a key indicator of national health, has stalled in the UK since 2010 for the first time in 120 years? Is he aware that one consequence of this is that over half of families in England cannot get a funeral in less than three weeks, and 17% cannot get one for over a month? Funeral directors are running out of storage space because of what is happening. There are far too many early deaths under this Government, as shown in the report from the Government Actuary’s Department, placed in the Library last week, which states that before the pandemic the UK had the lowest life expectancy of any major European country.

[Lord Markham (Con)]

I am aware that there has been a similar phenomenon across all the G7 western nations. Life expectancy has been plateauing for the last few years, and the only country to buck that trend is Japan. A lot of this is to do with obesity, which I know noble Lords regard as a very important issue. While we are improving issues such as alcohol intake, the impact of obesity on healthy lifestyles is an important factor that we will need to tackle.

[Lord Allan of Hallam (LD)]

My Lords, as well as falls in overall life expectancy, there have been significant falls in disability-free life expectancy, as shown in the recent ONS figures. Can the Minister describe the steps his department is taking to understand why more people are acquiring long-term conditions earlier in their lives, and to ensure that health and social care services are geared up to meet that extra demand?

--- Later in debate ---

[Lord Markham (Con)]

This goes very much to our strategy of improving healthy life expectancy by five years by 2035. “Healthy” is a key component of that, taking the major conditions strategy and looking at the six major causes of death—cancers, heart disease, respiratory issues, dementia, and mental health and musculoskeletal issues—and what we can do on each one to improve lifestyles.

[Lord Forsyth of Drumlean (Con)]

My Lords, considering inflationary pay demands in the health service, has my noble friend given enough emphasis to the benefits provided in the form of final salary index-linked pensions? Is there not a conflict between being concerned about inflation and knowing that you will be protected? How long is it possible to sustain such a system?

[Lord Markham (Con)]

I know that my health brief is broad but including pensions and insurance in it is quite a challenge. Like other noble Lords, I am very aware of the impact of inflation on the final salary scheme and on lifestyles, and of the fact that not many employers can afford the schemes any more—apart from, dare I say it, government. That has an impact. However, I am happy to meet my noble friend to go through this in further detail.

[Lord Winston (Lab)]

My Lords, the Government have made a pledge that they know perfectly well they cannot keep. There is no way that this massive morbidity will be reduced: obesity is not the answer. If he looks carefully, he will see what the Science and Technology Committee—chaired by the noble Lord, Lord Patel, who may want to comment—showed: that it is clearly due to deprivation in poorer parts of the country, which leads to a much shorter life. The Government need to deal with this holistically; it is not the problem of the Department of Health and Social Care but a much wider issue.

[Lord Markham (Con)]

As ever, there are multiple factors at play. That is what the Office for Health Improvement and Disparities is all about: making sure that we are tackling this in exactly the holistic way the noble Lord mentioned, going back to all the major conditions that are causes of death and tackling each one by one. The 10 million cancer screenings save 10,000 lives a year, and our breast cancer screenings save 1,300 lives. There is a lot to do but a lot that we are doing already.

[Lord Patel (CB)]

My Lords, in his introductory remarks, the Minister quoted the Government’s ambition to extend healthy life expectancy by five years by 2035. Can he put some numbers to it? What age are we talking about?

[Lord Markham (Con)]

My understanding is that people are predicted to live a healthy life until around age 63. It is about looking at that aspect as well; it is not just about the length of life but how well we live it.

[Lord Robathan (Con)]

My Lords, last week, the Institute for Government issued a paper that said that every obesity strategy since the first one, in 1992, had failed. It also pointed out that taxes would have to rise to deal with the epidemic in obesity and type 2 diabetes. Can the Government bring together a decent strategy to help all the people who are overweight, so that they live longer and we have a healthier society?

[Lord Markham (Con)]

My noble friend is correct: it is a key issue. There have been successes such as the sugar tax levy, which has reduced sugar consumption by about 40%. But clearly, you need only to look at the statistics to see that all western nations, including the UK, are facing this problem. It is a challenge that we have to attack. We can learn a lot in this space from Japan, where employers and the whole society are very much involved in the healthy lifestyles of their workers and people.

[Baroness Merron (Lab)]

My Lords, life expectancy for those with a learning disability is particularly shocking: only four in 10 live to see their 65th birthday, nearly half of their reported deaths are avoidable, and those living in the north-west and the Midlands are at greater risk. What action are the Government taking to address the specific barriers faced by people with learning disabilities in getting access to the timely, quality healthcare which could perhaps extend their life expectancy?

[Lord Markham (Con)]

As noble Lords are aware, we have been putting significant investment into mental health; from memory, there has been a £2 billion-plus increase over the last year. In recognition that learning disability is an issue we particularly need to tackle, as the noble Baroness is aware, we are putting investment into schools so they can identify it early on. Some 35% of schools now have the right educational leads in this space, and the figure will rise to 50% next year. It is a big improvement, but do we need to do more? Absolutely.

[Baroness Cumberlege (Con)]

My Lords, my noble friend will be aware that for many years, the UK has enjoyed increases in life expectancy but now we are getting reports that the rate of increase is declining. What plans—I have given my noble friend notice of this question—do the Government have to reverse this trend?

[Lord Markham (Con)]

My noble friend, whom I thank for that question, has characterised this issue in exactly the right way. Life expectancy is still increasing, but not at the rate it was. That is why the major conditions strategy was launched. I can give one example: cancer is one of the six major killers, and we are seeing 20% more cancer patients this year than we were pre-pandemic. So there are improvements in this space, and that is what the major conditions strategy is all about; but clearly, the record investment we are putting in needs to show that sort of output.

[Baroness Wheatcroft (CB)]

My Lords, the Minister’s ambition to increase life expectancy is not being helped by the current wave of doctors strikes, with extended waiting lists certainly bringing down life expectancy rates in some quarters. Can he tell the House why he and other Ministers will not get round the table now, with no preconditions, to discuss how this might be brought to a speedy end?

[Lord Markham (Con)]

The noble Baroness is absolutely correct: any strike action is regrettable, and we have a part to play, as do the unions, in trying to make sure that we reach a sensible place. We feel we have done that for nurses and ambulance drivers with the Agenda for Change, and clearly, we want to do the same for doctors. I think all noble Lords can agree that we do not want the impact on patients and healthy outcomes that strikes cause.