Public Health: County Durham

Phil Wilson Excerpts

Wednesday 12th June 2019 Westminster Hall

[Phil Wilson (Sedgefield) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Owen. I congratulate my hon. Friend—

[Mr Kevan Jones]

Right honourable.

[Phil Wilson]

He is my right hon. Friend, as he reminds me. I congratulate my right hon. Friend the Member for North Durham (Mr Jones) on securing this timely debate. He has been a real campaigner on this issue in County Durham for many years, and I know he takes a real interest in the public health issues we face in Durham.

The backdrop to the debate is this: we face cuts to public health provision in the north-east of England, primarily in County Durham, at the same time as we see a parade of candidates to be leader of the Conservative party, virtually all of whom want to cut taxes by billions of pounds. I am beginning to wonder where exactly the money will come from for any kind of public sector provision. Those claims of future tax cuts will probably end up being unfunded after Brexit, considering that the pot of tax money for the public sector will be reduced anyway.

As my right hon. Friend said, we may face cuts to public health services of around £18 million in Durham. I reiterate what he said about Surrey and Hertfordshire: under the new formula, there will be a £14.4 million increase for Surrey and a £12.6 million increase for Hertfordshire. That cannot be right when we consider the problems we have with health and healthcare provision in Durham. Sedgefield grew up, as a community, on coal. The number of men who worked down the collieries and are still alive today but have ailments related to that industry, such as lung disease and arthritis, just goes to prove that there is a requirement not to cut funding but to increase it.

If we look at random at some areas of health, we see that the figures for Sedgefield are worse than the national average in all of them. It has higher than the national average cases of dementia, patients on antidepressant drugs, patients on painkillers, asthma sufferers, people with high blood pressure, people with depression—the list goes on and on. We are talking about a formula devised by algorithm rather than by listening to what healthcare professionals say the county needs. People in Durham can expect to live a decent life in good health for seven years less than people in Surrey and nine years less than people in Hertfordshire.

Great strides have been made over the years in the use of the public health grant in County Durham. For example, the smoking rate has reduced from 22% to 14%. However, smoking during pregnancy is still an issue and still above the national average. About 20% of the people who live in Durham—I think that is about 114,000 people—are under 19. They should all be due some kind of safeguarding provision. If the cuts go ahead, will we have the health visitors to provide that? The cuts will affect the safeguarding of young people. If drug and alcohol services are reduced, the police will have to deal with an even greater problem of rising crime.

The chief executive of the Tees, Esk and Wear Valleys NHS mental health trust came to see me about the cuts a couple of weeks ago. Because of cuts to public health, fewer and fewer health visitors and school nurses are going to schools and people’s homes. Because that provision is not there, the trust has to see people it would not otherwise have seen because they would have been seen at home or school. Its provision for people with mental health problems is being put under more and more stress. The cuts are impacting on services other than those provided through public health funding.

One thing for which public health services have mandatory responsibility is health visiting services for those under the age of five. The breastfeeding initiation rate in County Durham is 59%, compared with 74% in England as a whole. Health visitors play a pivotal role in helping and encouraging women to continue to breastfeed their babies until they are at least six months old. Public Health England guidance acknowledges:

“Mothers who are young, white, from routine and manual professionals and who left education early are least likely to breastfeed.”

Cutting the public health grant to an area in which many women fit that profile and which is already way behind on breastfeeding rates would once again penalise an area with real need.

Then we have obesity. In the fight to keep the population healthy and active, healthy weight is of core importance to the public health agenda. An estimated 14% of adults on GP registers across the Sedgefield constituency are obese, with the figure in some areas as high as 19%. Five of the 15 neighbourhoods with the highest rates of obesity are in County Durham. In the south-east, which may end up with increased public health provision, those rates are in single digits—around 8%, if not less. In Richmond Park, the figure is 3.6%.

The common theme in all this is that if we cut public health provision in our communities, other providers will be affected. Those providers, which otherwise would not have had to provide those services, will end up doing more and more. The mental health trust told me that case loads are skyrocketing for some of its workers. How, for example, will they be able to look after young people with mental health issues that are not picked up at school or in the home? Those young people will be passed along the road to mental health trusts, which will not be able to cope because they, too, face cuts. That needs to be addressed.

[Mr Kevan Jones]

Does my hon. Friend agree that, especially in mental health, the outcomes for an individual are better if we intervene early, at a young age, rather than leaving problems untreated for many years?

[Phil Wilson]

That is absolutely right, and that is an issue that the mental health trust raised. If those issues are picked up in the early years or when someone is still at school, they can be resolved. Leaving them just puts extra strain on the mental health trusts in the area.

I want to end on a positive note. I had some schoolchildren in Parliament yesterday from the primary schools in Ferryhill and Chilton. Cleves Cross Primary School in Ferryhill has a whole host of initiatives around mental health, eating properly and so on. Around the village, it is setting up edible walkways: instead of flower beds, it is planting vegetables, which people can pick when they mature. It is great that schools are coming up with those great initiatives, but if the same thing is to happen in schools across Country Durham, there needs to be central provision from public health services.

For wellbeing, there are initiatives to make sure that children have meals together with their families, and to ensure that if there are problems, other children and friends from school are invited along to share those meals. Such initiatives for those aged seven to 10 bode well for the future, and the public health service in Durham needs to look at them, but they must be funded.

We also need to think about how we develop best practice, so that we see such initiatives not just in Ferryhill and Chilton but in Consett, Barnard Castle, Durham city, Esh Winning and Easington—all over County Durham. There needs to be some strategy. As my right hon. Friend said, we need some kind of audit or impact assessment of what cuts to public health mean to areas like ours. What is the reasoning behind making cuts in Durham, where services are needed, and increasing funding in places such as Surrey and Hertfordshire, where they will not be?

[Albert Owen (in the Chair)]

Order. Before I call Dr Roberta Blackman-Woods, I remind Members that this an hour-long debate. I will call the Front-Bench speakers at 5.25 pm, with five minutes for the Opposition and 10 minutes for the Minister, allowing Mr Jones a couple of minutes to finish the debate.

--- Later in debate ---

[Seema Kennedy]

Of course we want evidence. The shadow Minister says from a sedentary position that it is not working. We did an impact assessment in 2015-16 and we are reviewing all the evidence in preparation for the next spending review.

[Phil Wilson]

Just for clarification, did the Minister actually say that the formula is not working?

[Mrs Hodgson]

No; I said that.