Health

Rachael Maskell Excerpts

Tuesday 14th May 2019 Commons Chamber

[Matt Hancock]

We have not discussed obesity much during this debate, but the Government have a whole programme to tackle it. That includes tackling advertising and, in particular, tackling the pro-obesity environment in which too many children grow up. There is a broad range of actions on our agenda, with more to come.

[Rachael Maskell (York Central) (Lab/Co-op)]

Will the Secretary of State give way?

[Matt Hancock]

I will give way one final time, but I want to leave some time for Back-Bench speeches.

[Rachael Maskell]

The Secretary of State has boasted about the amount of money that is going into the NHS, but the Government have transferred public health services to local authorities, whose funding is being slashed, and as a result funding for those services is also being cut. Can the Secretary of State say how much of that NHS money will support the role of local authorities in delivering the public health agenda?

[Matt Hancock]

Local authorities and the NHS work very closely in delivering a huge number of services, and authorities often commission services back from the NHS. I can tell the hon. Lady that between 2013 and 2017, the number of attendances at sexual health centres increased by 13%. The suggestion made by many Opposition Members that there has been a cut in the number of such attendances is not supported by the facts.

We will not rest until we can solve these problems.

--- Later in debate ---

[Rachael Maskell (York Central) (Lab/Co-op)]

It is always a pleasure to follow my hon. Friend the Member for Heywood and Middleton (Liz McInnes), who brings her health expertise to this debate.

The discord between the Government’s narrative and reality could not be more stark. The long understood centrality of public health to addressing health inequalities was ably brought to the fore by Michael Marmot’s report a decade ago that highlighted the social determiners of poor health. We therefore cannot just look at health in this debate; we have to look at the wider impact of health across our society.

Of course the Government’s 10-year plan and long-term approach are welcome, but the reality is that there are serious funding cuts to the delivery of public health by local authorities. Half a million pounds is proposed to be slashed from York’s public health spending, which will have an impact on the services to be delivered.

Public health is about the long term, and the disadvantage for local authorities is that, with their strained budgets, they are having to focus on the emergencies today. Of course, local authorities have no levers over the NHS, which ultimately picks up the tab for the failure to deliver a public health agenda. Controls over the system is not in the right place.

Of course, the advantage of moving public health back out of health and into local authorities is that it impacts on education, the environment, the economy, housing and the wider community. We are deeply worried about the ending of public health grants. To date, there is no clear vision of how public health will be funded as we move past the comprehensive spending review. The clock is ticking and plans need to be made now.

In York, the health inequality is eight years between Clifton, the poorest area of my city, and the richest area. The council has slashed long-term contraception services, which has meant a rise in the number of unwanted pregnancies. Health checks have been cut, although they are a major intervention in prevention. We have also had smoking cessation services ceased; in 2010, we had 1,948 people using the smoking cessation service, whereas last year we had just 92.

On substance misuse, I must thank my friend Councillor Michael Pavlovic, whose forensic scrutiny of drug and alcohol service funding highlighted the serious £550,000 cut over a five-year period when usage was at a crisis. Shockingly, the drug death figures for York are the worst not only in Yorkshire, but in the whole country. The Government have not been taking a public health approach to substance misuse and it is vital that that now moves into a public health arena.

We have also seen alcohol being used hazardously in York, with 7% of my constituents—15,000 people—doing so. Some 10% of accident and emergency admissions were alcohol-related in 2014, and in December last year it was found that 33% of admissions to York Teaching Hospital involved people who were using alcohol. Of course, that leads to premature death. We also see the impact it has on the criminal justice system, with 75% of arrests involving alcohol. Alcohol is the influencing factor in a third of crimes. So investing in public health saves not only NHS spend, but wider service spend. Of course alcohol has an impact on the safeguarding of young people. In York it also has an impact on domestic violence. Yet York has 799 premises that sell alcohol. We know there is cost, risk and devastation, and we know there is an impact on wider public services, families and wider society. We therefore need a more comprehensive approach and properly funded public health services.

I ask the Minister whether the Government will look again to ensure that there is a comprehensive screening programme for people across the country, so that they can check in at the key point and transition phases in their lives to ensure their mental and physical wellbeing is reinstated. Local authorities being able to cut these services is of serious detriment.