Health Inequalities: Office for Health Improvement and Disparities

Siobhain McDonagh Excerpts

Wednesday 26th January 2022 Westminster Hall

[Siobhain McDonagh (Mitcham and Morden) (Lab)]

It is a pleasure to serve under your chairship, Mr Twigg. I congratulate my hon. Friend the Member for Bootle (Peter Dowd) on securing this particularly important debate.

The Minister will be aware of the Tudor Hart law: the areas with the best health are more likely to receive better health services. As my late mum—a lifelong nurse—would have said, “Much gets more.” There can be few greater examples of that than in south-west London, where an imminent planning application proposes to open a new hospital in healthy, wealthy Belmont, but at a cost: the downgrading, in the heart of a pandemic, of both Epsom and St Helier Hospitals. In the wild west of south London’s NHS, it is almost as if coronavirus never happened. Under those reckless plans, St Helier will lose its A&E, intensive care, children’s unit, maternity services, renal services and 62% of its beds to a wealthier area of considerably better health—so much for levelling up.

We have seen this plan on repeat. Funding is allocated and everyone pretends that three possible sites are being considered for development: Epsom, St Helier or Belmont. Evidence of widening health inequalities is presented by the bucketload, but a reason is always found to choose Belmont as the winning site. The reality is that, at the time of the latest decision, there were more than twice as many people with bad or very bad health within a mile of St Helier than within a mile of Belmont. The local population is significantly larger, with considerably more dependent children and elderly people. It is a plan that flies in the face of any supposed commitment to tackling health inequalities.

The programme points to its deprivation analysis—a document that considered deprivation by borough, rather than by proximity to each of the possible sites. Why does that matter? It matters because it disguises huge inequalities within boroughs, such as the 10-year difference in life expectancy between parts of Merton.

The true analysis of deprivation could not be clearer. Some 42 of the 51 most deprived areas in the catchment are nearest St Helier. Given that, hon. Members can surely see how ridiculous it is that the Belmont site received a higher score for supposedly tackling deprivation. Is it any wonder that health inequalities keep widening? While the programme considered old age as a decisive factor in the location of acute services, the depressing reality is that old age in Mitcham looks very different from old age in Belmont.

Health inequalities in south London are stark, and not just by geography. Black, Asian and minority ethnic residents are more likely to have underlying conditions such as diabetes, lupus and kidney failure and are at a higher risk of developing heart disease and hypertension. Black women are five times more likely to die in childbirth than white women, and are more likely to require neonatal or specialist care baby units. Such facts are of paramount importance for this hospital reconfiguration, as 64 of the 66 areas across the catchment with the highest proportion of BAME residents are nearest St Helier. Just one is nearest Belmont. Under those plans, many women will see maternity services moved further away. The programme’s solution is to encourage more women to have a home birth, which is obviously dependent on the risk to mum and baby and is currently chosen by just 3% of women in the catchment area.

The reality is that my constituents will not travel to Belmont. It is quicker from every corner of Mitcham and Morden to reach St George’s Hospital or Croydon. That is a completely terrifying prospect, because St George’s is already coping with too many women having children there, its A&E is in the bottom quartile for space standards, and the Care Quality Commission has demanded that fewer patients attend the site.

Where does this leave us? The planning application for the Belmont site is imminent, and the cost of the proposals is soaring—the latest estimate is almost £600 million. Improving St Helier would not only keep services where they are needed most, but save £161 million. I ask the Minister to take the unequivocal evidence that I have presented and, if she genuinely wants to close health inequalities under her watch, insist that these proposals are reconsidered. Stop wasting taxpayer’s money and leave these vital services at St Helier’s current site.