Health Inequalities

Mike Amesbury Excerpts

Wednesday 4th March 2020 Commons Chamber

[Jo Churchill]

I appreciate that they need to know those figures, and they will know them extremely shortly.

I strongly believe that high-quality primary care is also crucial to early and preventive treatment, and key to reducing the health inequalities we are discussing. We are improving access to primary care by creating an extra 50 million appointments in general practice within the next five years, growing the workforce by 6,000 more doctors and 26,000 more wider primary care professionals. Within that, we want to target NHS resources, so that they can help their localities to level up. Through the targeted enhanced recruitment scheme, we are recruiting trainees to work in the areas of the country where we have had vacancies for years, particularly rural and coastal areas, such as Plymouth, and the coastal area of County Durham and North Yorkshire. It has already proved highly successful, with a fill rate of close to 100% last year, and over-subscription in many parts of the country. For that reason, we will increase the places on the TERS from 276 to 500 in 2021, and then up to 800 in 2020, to make sure that we get the skilled staff in the areas where they can do most good.

Practices, working together within primary care networks, will be asked to take action on health inequalities, to be agreed as part of the next 2021-22 GP contract. What happens in one’s early years, even before one pops out into the world, has an impact well into later life. Pregnancy and early years are therefore a key time to have an impact on inequalities. In particular, the fact that women’s life expectancy is so challenged is of acute importance to me. We have many challenges as we travel through life, and making sure that we are equipped to make the best of our lives, particularly as we often act as primary carers, is hugely important.

Pregnancy and early years are a key time to have an impact on inequalities. Many babies do get a fantastic start, but sadly it is not the case for everyone. Children in more deprived areas are more likely to be exposed to avoidable risks and have poorer outcomes by the time they start school. It is right that all universal support has a focus on reducing inequalities, and that it is targeting investment to meet higher needs. Many children are benefiting from investment in childcare and early years education. Fifteen hours of free early years education for disadvantaged two-year-olds and 15 hours of free early years education for all three and four-year-olds is key. We have also announced our commitment to modernise the healthy child programme to reflect the latest evidence to support families.

[Mike Amesbury (Weaver Vale) (Lab)]

Will the Minister give way?

[Jo Churchill]

No, I am going to push on. I would particularly like to give those people making their maiden speech, which is hugely important, the time to do so.

For a good start in life, we need to do better in oral health. Tooth decay is the most common oral disease among children, affecting one in four by the time they start school, and it is the most common reason for admission to hospital for children aged five to nine. It is largely preventable. Improving the oral health of children is a Public Health England priority, and a number of actions are under way. Supervised tooth-brushing and water fluoridation are two evidence-based areas in which we want to go further. When I met a number of dentists recently and asked them what they would do if they had the key that would enable them to do anything, they said that water fluoridation would be one of the key measures to reduce childhood inequality across the country. In 2016-17, one in six children had tooth decay in the south-east compared with one in three in the north, and the variation is even greater among local authorities. I am delighted that two authorities, Durham and Northumberland County Councils, recently announced formal proposals to increase water fluoridation, and I hope to be able to facilitate that.

Obesity is a challenge. It is shocking that children in poorer parts of the country are more than twice as likely to be overweight or obese. Children who are overweight or obese are increasingly developing type 2 diabetes and liver problems, they are more likely to experience bullying, low esteem and a lower quality of life, and they are highly likely to become overweight adults with a higher risk of cancer and heart and liver disease. This is a huge cost to the health and wellbeing of the individual, but also to the NHS and the wider economy.

National cardiovascular disease and diabetes prevention programmes have already been introduced, but we want to go further. NHS England has delivered a diabetes treatment and care programme aimed at reducing variation and improving outcomes for people living with diabetes, thus reducing inequalities. We published the third chapter of the childhood obesity plan in July 2019, with further measures to help to meet our ambition to halve childhood obesity by 2030 and reduce the gap between the most and the least deprived. We have seen some important successes. The average sugar content of drinks subject to the soft drinks industry levy decreased by 28.8% between 2015 and 2018. Significant investment has been made in schools to promote physical activity and healthy eating. The childhood obesity trailblazer programme works with local authorities to address the issue at local level, and that really helps, with authorities working together to ensure that the messages sent to children are healthy food messages. The programme has a strong focus on inequalities and ethnic disparities in the context of childhood obesity, and is helping five local authorities to take innovative action. We have a lot to gain, particularly if we help parents, especially in the most deprived areas, to help their children.

It is clear that there is a great deal to do. Let me reiterate that the Government have made real commitments to real action, and that we will increase our focus on the real challenges that people experience in their lives every day. Reducing health inequalities is not an issue that truly divides the House, and I look forward to hearing the suggestions of Members on both sides of the House so that we can move forward. Their contributions will help to fuel our purpose. We share the common goal of reducing inequalities, and we can work together to achieve it.