Health

Rushanara Ali Excerpts

Tuesday 14th May 2019 Commons Chamber

[Matt Hancock]

We have made those resources available. The resources from the NHS to make PrEP available have been put forward. I find it deeply frustrating that in many areas that has not yet been delivered by local councils. We are working with local councils and urging them to take up the offer that is already available from the NHS. I totally understand and share the hon. Gentleman’s frustration. We are working to push local authorities to do this, but responsibility for public and sexual health services was transferred to local councils, as a result of a decision taken by this House. I am doing my part. I would love to work with him to ensure that it can actually be delivered on the ground because he is absolutely right that it is the right thing to do and the right direction to go in.

[Rushanara Ali (Bethnal Green and Bow) (Lab)]

The objective fact is that the public health grant has gone down by £700 million between 2014-15 and 2019-20. If a person gets on the tube at Westminster station and travels to Whitechapel station in my constituency, average life expectancy drops by six months at every stop. That is the reality in constituencies such as mine. My appeal to the Secretary of State, if he is serious about tackling health inequalities, is to back local authorities with the resources they need.

[Matt Hancock]

The public health grant is of course an important part of this, but it is only one part. The overall funding of the NHS is rising by £33.9 billion, the first £6.2 billion of which came on stream last month. I understand the hon. Lady’s point. That is on the money. On the health inequalities, I entirely agree with her that they should be tackled. Doing so is at the heart of the NHS long-term plan. It is a vital task that we do not shirk. Indeed, we embrace it and are addressing it.

Let me turn to the details of the motion. While I care deeply about making sure that we have the best possible health in this nation and the strongest possible NHS—and we are prepared to put the resources in to see that happen—I also care about good governance of the nation. The way that we are run is one of the reasons this country has been strong over generations, and I believe that using the Humble Address to undermine the ability of experts, clinicians, and civil servants to give me the benefit of their frank and wise advice not only undermines me as Secretary of State, but makes it harder to make good decisions. I know the shadow Secretary of State sits on the Front Bench with revolutionaries, but I thought he was a grown-up. I do not know what his mentor, Lord Mandelson, would make of his posturing today. Of course, we will object to the motion and, if he searched the depths of his heart, he would too.

The hon. Gentleman has obviously had a missive from the Leader of the Opposition’s office—LOTO, as it is called—telling him to present the Humble Address, but it is not his style. I hope that we can get back to debating these issues on a proper motion in the future. I respect and like the hon. Gentleman: he is a really nice guy. If he had asked for the information directly—perhaps he could have sent me a message on the app—

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[Rushanara Ali (Bethnal Green and Bow) (Lab)]

The health of the population should be the Government’s and Parliament’s highest priority. From the times of the ancient civilisations, enlightened authorities have sought to prevent disease, provide clean water and sanitation, and enable citizens to live long, healthy lives. In the UK, we have a long history of interventions to improve the health of the nation, from the great sanitation projects in the Victorian era, to the Clean Air Acts, slum clearances and inoculation programmes in the 20th century, and the public smoking ban in the 21st century. Of course, all of that was accelerated with the establishment of the national health service, yet in these first decades of our new century it is clear that something is going seriously wrong.

With all our medical and scientific advances, surely we should have ended preventable disease, enabled many more years of healthy life, and witnessed ever-lengthening life expectancies. But we know that the opposite is true, as many right hon. and hon. Members have pointed out. We face an explosion of obesity and obesity-related diseases, such as type 2 diabetes and coronary heart disease. We are in the depths of a mental health crisis, with ever-growing demand for ever-diminishing mental health services. Society faces the health risks from smoking, alcohol and drug misuse, and sexually transmitted diseases.

The thing that should make us really angry is the stark difference in health and life expectancy between rich and poor. These inequalities in health are a terrible scar on our society, no matter which side of the House we are on. How can we fail to be ashamed when a person’s life expectancy depends largely on their postcode and income, and what their parents did for a living? There are many incredibly positive things in my constituency, including some of the most improved schools, which have not only improved opportunity and life chances but played a role in tackling health inequality and improving wellbeing. I pay tribute to all the health professionals and community workers in the clinical commissioning group, including its chair Sam Everington and others, who have led the way on tackling the public health challenge, but the reality is that despite all their work my constituents face massive health inequalities.

With every tube stop between Westminster station and Whitechapel station, people’s life expectancy goes down by six months. That is a scandal. Tower Hamlets has the shortest life expectancy of all London boroughs, with men living on average five years less than men in Kensington and Chelsea. We have the 12th highest prevalence of diagnosed diabetes, major challenges with obesity among children, and high levels of smoking, HIV, sexually transmitted infections and drug addiction. Even though many of my constituents abstain from alcohol, Tower Hamlets unfortunately has the seventh highest number of people with alcohol dependency.

In 2017, Sir Michael Marmot warned that the historic rises in life expectancy—the result of centuries of improvements—had ground to a halt. It is almost beyond belief that centuries of progress should end on our watch. The Institute for Fiscal Studies has warned of some of the challenges, including around suicide, drug overdose and alcohol-related liver diseases, which are affecting middle-aged men throughout England. Given the scale of the challenge and the dangers of going backwards, what are Ministers doing about this? We would think they would be investing in the kinds of programmes that help to tackle the public health emergency, but instead we see significant funding cuts, as many Members have said. In my borough, we have lost £3 million since 2015-16—in one of the areas with the highest levels of deprivation and child poverty in the country.

We need Government investment to tackle the public health challenge. Otherwise, all the Government’s investment in the national health service will be undermined, as many have pointed out, and the Government will be missing a trick. We should in this debate be unified on the need to tackle the public health challenge in all our constituencies. Ministers talk about cross-party working, so my appeal to them is that they put that to the test and put in the investment to support local agencies, local authorities and health professionals. Let us deal with this appalling challenge by working together, because it is desperately needed.