NHS 70th Anniversary

Rachael Maskell Excerpts

Wednesday 16th May 2018 Westminster Hall

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

Thank you, Mr Hosie, for chairing this morning’s important debate, and I thank my hon. Friend the Member for Blaenau Gwent (Nick Smith) for introducing it in the way that he did.

The incredible tributes that we have heard this past week to Dame Tessa Jowell have reminded us what a formidable politician she was, and how she centred her work around the important agenda of public health, backed up by the epidemiological evidence. We have had so many fantastic evidence-based reports, not least the work done by Michael Marmot in identifying the importance of the social determinants of our health outcomes. We know that various agendas meet around public health—social, economic, health and education agendas, and many more. That is why it is really important that we put our focus on the whole person and the impact that life has on people.

We have seen severe cuts, not least to our Sure Start centres, hundreds of which have closed. From the evidence that they produce, we know about the real impact that they have, particularly on our young people. Health visitors are an initiative that the Government took up in 2010, following Labour’s urging that we must increase the number of health visitors. That number has now fallen, from the 4,200 additional health visitors that David Cameron put right at the heart of his Government, back to the numbers before that Government. There is a real crisis among that vital workforce, with ever-increasing workloads.

We have had workforce cuts, financial cuts and service cuts in public health. Public health is about long-term outcomes, and when we are dealing with austerity and cuts, we are looking at having to support tomorrow, not the future. Public health has been a very poor relative in the austerity programme, and I can witness that in my city. In Acomb in York, since 2011 I have seen childhood obesity more than double among my community. I have also seen health checks cut; those are vital at the age of 40 to ensure that we put people’s health back on track.

Long-term contraception has been cut, and smoking cessation services demolished—unless, of course, people pay for them. We have seen a 90% fall in the number of people able to access smoking cessation services, in an area where the number of people who smoke is higher than the national average. Those are the real consequences of cuts. In York, the clinical commissioning group denies surgery to people who have a high body mass index or who smoke, yet the support services to help people change their lifestyle and behaviours are not there any more—a complete nonsense. That is why it is really important to put the focus back on public health.

Over the past week, I was most shocked by a letter I received about substance misuse services in York. York is now 148th out of 148 authorities when it comes to drug-related deaths of people in treatment and across the community as a whole. Most people will be shocked to hear that about York, but when I look at what our local council have done in absolutely slashing funding to those vital services, I am not really surprised—and, of course, the most severe cuts are still to come. What will that mean to the people in my community whose life chances are being taken away from them?

Across mental health services, the sustained lack of investment over such a long period is having a real impact on health outcomes. People have been hurt by cuts and hurt by political decisions. It need not be that way. We all know it is the most vulnerable, the poorest, the people who really need the state’s help who fall down when the state stands back.

We have heard so much about young people in the debate, for whom interventions are even lower than for older people. For people in their latter years, public health virtually does not feature. Yet, in the health service that Bevan created, everyone from cradle to grave could access the necessary good public health services. Such interventions save the NHS so much money—it is a no-brainer—so why cut those services? That question comes not just from me, but from directors of public health I meet regularly in my constituency, and across the board. They want to understand what will happen when the public health grant is withdrawn. I hope the Minister can reassure them today that he will ensure that they will receive the funding needed to sustain services into the future. They also want to know how the Department of Health and Social Care will work with directors of public health to ensure that their long-term goals for improving the community’s public health will be funded.

We need to look seriously at the workforce in public health, which has been decimated. We have to look at funding to sustain that for the future health of our nation. We need to look at outcomes, not just inputs. Let me take the child measurement programme as an example. It is a nonsense that we know now how obese children are, but we cannot afford the interventions to change the trajectory of those children’s lives. That means that the programme does not work. We need to examine how we change the life chances of so many people across the country.

I want to touch on the 70th birthday of the NHS, which is so important for so many of us, and draw the Minister’s attention to what we are doing in York. When I heard what his Department was rolling out, I thought it quite lacklustre—it lacked ambition—so I pulled together the health leaders in York to drive forward a public health initiative to mark the 70th birthday. It includes the clinical commissioning group, the acute trust, the mental health trust and the local authority. We are working together to launch in July, as part of that fantastic celebration, a whole programme intended to transform the health of our whole community.

I have a meeting with businesses to talk about how employers can change the life chances of people who work for them. We are meeting faith and community groups to talk to them about people that they engage with. We are going to have a touring pop-up event across the city over the NHS birthday to provide advice, health checks and services, and simple programmes, because we do not have a lot of money. I know from Health questions that the Minister will meet with me, as the Secretary of State said, to talk about this initiative. We are going to have health walks at lunchtimes. We are going to have basic tests to understand health measures, as well as advice, information, encouragement and the promotion of better understanding, looking at diet, exercise, behaviour and the choices that people made. We are determined to touch the thousands of lives of people in York on this 70th birthday, because we want to celebrate the future with everyone.

We know that so many people are being failed, and the most vulnerable are being failed the most, but we can change things around. Public health does not actually cost a lot of money compared with acute services. So, I trust that from today, we will take the spirit of Nye Bevan and ensure that we invest in the very people who will depend on our NHS in the future.