Reducing Health Inequality

Lucy Allan Excerpts

Thursday 24th November 2016 Commons Chamber

[Lucy Allan (Telford) (Con)]

It is a pleasure to follow the hon. Member for Heywood and Middleton (Liz McInnes), who made important and serious points. I congratulate my hon. Friend the Member for Totnes (Dr Wollaston) on securing this incredibly important debate. I thank her and other Members who have participated for their work in this place to highlight this issue, and for the excellent debate that we have had.

This issue is about unequal lives and life chances. Naturally, like all Members, I take every opportunity that I can to talk about everything that makes me proud to represent my constituency, whether that is Telford’s industry, its history of innovation and enterprise, its vibrant new town, its green spaces or its high-tech businesses and jobs, all of which I have spoken about with great pride and at some length. However, sometimes, as the hon. Member for Stockton North (Alex Cunningham) so eloquently did, we must raise the issues that deeply affect the quality of life of our constituents. Those issues need to be addressed, but they are too often overlooked and glossed over, which can make those who experience these difficulties feel left behind and ignored.

Telford is a former mining area on the east Shropshire coalfield. It became a new town in the 1960s. With business, jobs and new growth it is starting to thrive in many ways, yet it retains significant areas of deprivation, with a total of 13 super output areas ranked in the 10% most deprived areas nationally. Hand in hand with areas of deprivation and disadvantage come marked health inequalities, which exist relative to both the national average and that for the west midlands, as well as—pertinently—relative to the surrounding, more affluent rural area of Shropshire. That area has more good schools, higher incomes and significantly better health outcomes, judged by any measure we might care to choose. Whether it is obesity, life expectancy or smoking rates, the outcomes are significantly better in surrounding Shropshire.

To take obesity, which Simon Stevens has dubbed “the new smoking” as a killer disease, 72% of adults in Telford are overweight or obese, which is an increase on last year’s figure and one of the highest rates in the country. That compares with a rate of 65% in neighbouring, more affluent rural Shropshire. Some 32% of adults in Telford are obese compared with 24.4% nationally; in Shropshire, the figure is 23.1%. I congratulate and admire organisations in Telford that are doing such good work to tackle that. However, the figure is continuing to increase, and we cannot ignore it—we must talk about it and take it more seriously.

I want to take this opportunity to flag up the statutory obligations of local CCGs, NHS England and the Secretary of State to address health inequalities, in particular because Telford and Shropshire continue to undergo a controversial reorganisation of future healthcare provision. The Health and Social Care Act 2012 introduced legal duties on the Secretary of State, NHS England and CCGs to reduce health inequalities and move towards greater investment in healthcare where levels of deprivation are higher. NHS guidance for commissioners says that

“health inequalities must be properly and seriously taken into account when making decisions”

and that it is necessary to demonstrate that the appropriate weight has been given to tackling health inequalities. I know from my experience as non-executive director of an NHS trust that the NHS is committed to that objective and that tackling health inequalities is at the heart of all it does, but somehow that is not happening.

It is right that decisions are made locally by local health commissioners, but we need to ensure that commissioners pay due regard to health inequalities and that they evidence the fact that they have done so. That is not about box ticking or paying lip service to an ideal.

Telford and Shropshire are in the third year of a review into the reconfiguration of the area’s healthcare provision, which includes a women and children’s centre and an A&E. While I welcome the proposed additional investment in health provision for the wider area of Telford and Shropshire, I want to be a voice for my constituents, so I want to ensure that health inequality is prioritised both in the decision-making process and when new investment is brought to the area.

As the review of Telford and Shropshire’s healthcare draws to a close after a protracted and expensive process, it has been confirmed that the preferred option is to close Telford’s newly opened women and children’s centre at Princess Royal hospital and to rebuild it in the more affluent area served by Royal Shrewsbury hospital. In addition, it is suggested that there should be extra investment in emergency care at Royal Shrewsbury hospital. My constituents are rightly concerned about that proposal. Not only is the much-needed investment to be redirected elsewhere, but Telford may lose other key services. Telford has the greatest need, the fastest growing population, as a rapidly expanding new town, and, above all, the greatest inequality of health outcomes. Too often in Telford we hear that rural sparsity is prioritised for additional investment, rather than deprivation, health inequalities and need. That is wrong.

I am pleased to have had the opportunity to raise this issue. I ask the Minister to give us assurances that addressing health inequalities in Telford, and in other areas of deprivation and need where there is a stark contrast with more affluent neighbouring areas, will be prioritised. As my hon. Friend the Member for Plymouth, Sutton and Devonport (Oliver Colvile) said, resource really must follow need.