Health Inequalities: Office for Health Improvement and Disparities

Stephanie Peacock Excerpts

Wednesday 26th January 2022 Westminster Hall

[Stephanie Peacock (Barnsley East) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Twigg. I congratulate my hon. Friend the Member for Bootle (Peter Dowd) on securing this important debate. When the Government launched the Office for Health Improvement and Disparities, renamed from the Office for Health Promotion, the Secretary of State said that it was not just a name change but

“a statement of intent—a driving mission to ‘level up’ health and ensure everyone has the chance to live happy and healthy lives.”

That is a mission that I sincerely hope all his Cabinet colleagues will commit to truly delivering on. The issue goes to the heart of the inequalities in communities such as mine. Sadly, it is an issue that has only got worse over the last decade. In the Government’s most recent national deprivation data, Barnsley ranked in the bottom 15% of the country for levels of income. Of the 318 local authority areas in the entire country, Barnsley ranked as the 19th worst for health deprivation and disability.

The Secretary of State has said that the top two priorities for the new office are preventing poor mental and physical health and improving access to health services, as has been discussed in today’s debate. As things stand, Barnsley is well above the national average for diagnoses of depression, arterial disease, learning disabilities, high blood pressure, heart failure, epilepsy, diabetes, dementia, obesity and heart disease. Barnsley East residents are almost twice as likely as residents anywhere else in the country to suffer from chronic obstructive pulmonary disease, much as a result of the thousands of men who worked down the pit. Around 8,000 miners have sadly lost their lives over the last two years.

I have raised the issue of covid death certificates with the Government on several occasions. I directly ask the Minister, again, whether she can give us an update on what the Government are doing to change guidance—it is a very simple ask—to ensure that industrial diseases are recorded on death certificates if someone, sadly, dies of covid. That is important to make sure that families receive the compensation to which they are entitled.

We cannot look at health inequalities in isolation, because income and health inequality are fundamentally linked. The ONS reports that the difference in life expectancy between the least and most deprived areas in England is 9.4 years for men and 7.6 years for women. The difference in the number of years lived in good health between the most and least deprived areas can be as much as 20. While areas such as Kensington and Westminster thrive, northern working-class towns such as Barnsley continue to be left behind.

There can be no justification for the levels of inequality that we face. Whether someone lives in Westminster or Barnsley, they deserve to live well. We have a long way to go if we are to tackle these health inequalities. They are not only an enormous challenge that the Government need to address today; they mean reversing more than a decade of decline.

--- Later in debate ---

[Maggie Throup]

If I may, I will write to the hon. Lady on that so I can make sure that my facts are completely clear, rather than giving her an answer that may not be quite accurate.

In recognition of the strong relationship between work and health, the joint work and health unit was established in 2015. It has invested in a programme of trials and tests to identify effective models of health and employment support, and it is now using that learning to develop and/or roll out services to support disabled people and people with long-term health conditions to enter and stay in employment. The 2021 spending review confirmed that the public health grant will be maintained in real terms for the spending review period, so local councils can continue to invest in prevention and essential public health services. The distribution of that grant is heavily weighted towards the areas that face the greatest population health challenges, with per capita funding almost 2.5 times greater for the most deprived authorities than for the least deprived. The allocation at local authority level will be announced shortly.

The role that local authorities play in improving public health is far broader than simply the important services and interventions funded through the public health grant. That grant is part of a wider package of targeted investment in improving the public’s health over the spending review period, including £300 million to tackle obesity; £170 million to improve the “best start in life” offer available to families, including breastfeeding advice and parent-infant mental health support; and an additional £560 million to support improvements in the quality and capacity of drug and alcohol treatment, which was announced as part of the drugs strategy. In addition, we have made over £12 billion available to local councils since the start of the pandemic to address the costs and impacts of covid-19. Of this money, £6 billion was non-ringfenced, because we recognise that local authorities are best placed to decide how to manage the major covid-19 pressures in their local areas.

[Stephanie Peacock]

I made a point in my speech about an issue that affects my area, regarding covid death certificates and industrial disease. Would the Minister either respond to it now or write to me about it?

[Maggie Throup]

I was going to answer the hon. Lady’s point shortly, but I will answer it now. I will write to her on the important issue she raised about industrial disease. We need to ensure we have everything in place to enable families to access the different forms of support available to them.

I will come back to OHID for a moment. OHID has regional teams, which will have a vital role in working with integrated care systems at regional level. OHID will produce important data and information resources, which will be vital to ICS work in improving population health. Through ICSs, we will improve local working on population health and reduce health disparities.

One of the key objectives of these reforms is to give integrated care boards the responsibility and the ability to tackle health inequalities, as made clear in NHS England guidance. This will also reinforce the role of local authorities as champions of health in local communities and empower the NHS to improve poor health.

I will answer a few of the questions that have been asked. The hon. Member for North Tyneside (Mary Glindon) raised e-cigarettes. I commend her for the work that she does through the all-party parliamentary group for vaping, and I reassure her that OHID will continue to monitor and publish evidence and reviews on e-cigarettes. Our tobacco control plan will be published later this year, outlining our smokefree 2030 plans.

The hon. Member for Westmorland and Lonsdale (Tim Farron) highlighted disparities affecting rural communities. He raised a number of issues specific to his constituency, and I am sure that the relevant Health Minister will be happy to meet him to discuss them in more detail.

The hon. Members for Bootle and for Salford and Eccles (Rebecca Long Bailey) asked why we use the terms “disparities” and “inequalities”. I reassure them that the terms are used interchangeably, and it is important to understand that a term itself does not impact on our understanding of a problem or our response to it.

I thank the hon. Member for Bootle again for securing a debate on such an important issue. The pandemic has highlighted the impact of health disparities on people’s life outcomes and the pressures on the wider health and care system. The establishment of OHID, the creation of the new Health Promotion Taskforce Cabinet Committee and targeted investment in public health demonstrate that the Government are fully committed to tackling health disparities. I genuinely believe that by working together across Government, and with local authorities and the NHS, we can make a huge difference in improving health, life expectancy and life outcomes, particularly for the most vulnerable in our society.

Covid-19 Update

Stephanie Peacock Excerpts

Tuesday 9th February 2021 Commons Chamber

[Stephanie Peacock (Barnsley East) (Lab)]

People are at home with the windows closed and the heating on: those are potential conditions for carbon monoxide poisoning, whose symptoms are very similar to those of covid-19. What are the Government doing to enforce legislation on that issue and make the public aware of that silent killer?

[Matt Hancock]

The hon. Lady raises an important point, which is taken into account in the work that we are doing to push forward high-quality ventilation, which is good for tackling carbon monoxide poisoning and for trying to reduce the risk of the spread of covid.

Public Health

Stephanie Peacock Excerpts

Wednesday 6th January 2021 Commons Chamber

[Stephanie Peacock (Barnsley East) (Lab) [V]]

This new lockdown is a position that none of us wanted to be in, and I begin by paying tribute to all our key workers.

Although there is a light at the end of the tunnel, in the form of the vaccine, this Government’s inability to react quickly and with clear leadership has meant that people have lost their lives and their livelihoods. The Conservative former Chancellor, George Osborne, was right when he wrote yesterday, “In hoping for the best, we have failed to prepare for the worst.” The Government must not waste the time given to them in this third lockdown. The vaccine programme must be delivered with the speed and efficiency that people have been promised, alongside an effective Test and Trace system.

The economic impact of the crisis has been catastrophic. In Barnsley East, over 3,500 people are now recorded as being on universal credit, unemployment has risen, and the local food bank has seen demand increase by 300%. This is unacceptable and avoidable. Statutory sick pay in this country is completely inadequate. The UK falls behind the standards set by some of our European neighbours. A higher earner whose wage is cut due to sickness is more likely to be able to absorb the financial blow. Statutory sick pay is currently set at a flat rate of £95.85 a week. How is someone on the minimum wage or a lower income supposed to cope with such a reduction? They cannot choose to pay less of their rent, mortgage or bills.

The UK is one of the very few European countries that still pays sick pay in this way. I acknowledge that the Government introduced a one-off payment for people on low incomes who are isolating, but there is a lot of evidence to show that it is not working and that too many people are falling through the gaps. Take for example the man in Barnsley who, when asked if he would isolate if he was contacted by Test and Trace, said, “No, probably not.” When asked why, he explained, “If I don’t work, my family don’t eat.” People want to do the right thing, but simply cannot afford to. Proper statutory sick pay would make it much easier for people to take a test and isolate, which is crucial to stopping the spread of this deadly virus.

Coronavirus Vaccine

Stephanie Peacock Excerpts

Wednesday 2nd December 2020 Commons Chamber

[Matt Hancock]

We will not only follow the model; we will promote it. The link between the local authority and the national system in York has indeed had the effect that the hon. Member rightly describes, and the teamwork between the two has meant that the figures in York—I was looking at them this morning—are coming right down. I pay tribute to everybody in York. It is an example of the national and local systems working together. We have to get the case rates right down all the way across North Yorkshire—indeed, everywhere in Yorkshire—and I am sure that we can.

[Stephanie Peacock (Barnsley East) (Lab)]

Barnsley has fewer GPs than areas down south, so will the Secretary of State explain his plan to ensure that places such as my constituency are not left behind in the roll-out of the vaccine?

Breast Cancer Diagnosis and Services: Covid-19

Stephanie Peacock Excerpts

Thursday 12th November 2020 Westminster Hall

[Stephanie Peacock (Barnsley East) (Lab)]

It is a pleasure to serve under your chairmanship, Ms McVey. I pay tribute to the hon. Member for North Warwickshire (Craig Tracey) for securing this important debate. He has spoken incredibly passionately and covered a wide range of issues relating to breast cancer. I want to focus my remarks on two issues. First, I want to speak about the need for a cancer recovery plan to deal with the backlog in breast cancer screening tests and get cancer treatments up and running again. Secondly, I want to speak about the need for urgent action to prevent the widening health inequality gap in this country.

Over the past few months, we have seen spiralling wait lists, the longest since records began. That has had a direct and devastating impact on people’s health. I have heard stories of frontline workers who have had their cancer screen test delayed, only to find out months later that their cancer has spread. It is a simple fact that the sooner someone has a cancer diagnosis, the more likely they are to survive. In March, breast cancer screening programmes were put on hold. One week into the second national lockdown, people are worried that that might happen again, and they fear for loved ones who might not get the care that they need.

In response to a parliamentary question that I asked, the Government revealed that nearly 10,000 women are waiting for a breast cancer screening in Barnsley alone, and more than 30,000 women in South Yorkshire. We have a postcode lottery in this country when it comes to breast cancer screening and mortality rates. Depending on where someone lives, they can be up to a third less likely to have attended a breast cancer screening in the last three years. Staffing pressures have directly impacted the capacity of the NHS to screen patients for suspected cancer, affecting the speed at which patients are diagnosed.

A Public Health England report found that the number of empty consultant breast radiologist posts in the country doubled between 2010 and 2016. The same report revealed that all breast radiologists in Yorkshire and the Humber are due to retire by 2025. Has the Minister’s Department assessed the impact of the pandemic on recruitment, and will she outline the Department’s plans to deal with the staffing crisis?

Health inequality in this country is not new. Life expectancy in Barnsley is five years lower than in Kensington and Chelsea. The pandemic threatens to widen existing health inequalities as areas such as mine face the double impact of more covid-19 cases and severe financial hardship because of the restrictions. As has already been mentioned in the debate, we need comprehensive, accurate data on patients and populations to map health inequalities across the country. This includes improving the cancer outcomes and services dataset so that patients and local providers can quickly and easily compare information on all cancers, including breast cancer. More needs to be done to support local providers to ensure they submit information to the dataset. It is the first step towards recognising the scale of health inequalities faced by this country and taking action to increase service improvement.

Covid-19 has not been a great leveller. Inequalities in care, treatment and diagnosis have come to light during the pandemic. At the same time, it is now widely recognised that societal inequalities have increased certain populations’ likelihood of suffering complications from the virus. It is clear that unless the Government act now to reduce the unequal impact of covid-19, those inequalities will become further entrenched, directly impacting the health and wellbeing of people across the UK.

Covid-19 Update

Stephanie Peacock Excerpts

Tuesday 10th November 2020 Commons Chamber

[Matt Hancock]

I really hope that the talks that are under way can come to a set of principles and a set of rules across the UK for Christmas. So many people travel across the UK, including to and from Wales, over the Christmas period, even more so than in the rest of the year, and I hope that we can bring this to fruition.

[Stephanie Peacock (Barnsley East) (Lab)]

Last week the Prime Minister said that not enough people are self-isolating when asked to. Does the Secretary of State accept that this might be because those traced by the covid app are not entitled to the same financial support as if they receive a phone call?

[Matt Hancock]

We are working on ways to ensure that those who are traced through the app also get support. The challenge is that the app is, by its nature, and by the design principles that our friends and colleagues in the tech industry insisted on, anonymous. Therefore, translating an anonymous system on the app into an identified payment is a challenging process that we are working through.

Coronavirus

Stephanie Peacock Excerpts

Tuesday 15th September 2020 Commons Chamber

[Matt Hancock]

I absolutely keep an open mind on all these things. We are constantly looking at the evidence and data, and updating policy accordingly. We have made the decision on the basis that I explained. Of course, I understand the other point of view, but the cause of simplicity and clarity of explanation won the day.

[Stephanie Peacock (Barnsley East) (Lab)]

My constituent in Barnsley has been trying for seven days to get a test for her teenage son after he was sent home from school with a temperature. She has been offered a test in Bolton, Edgbaston and Oldham, and nearly 400 miles away, in Inverness. When will the Secretary of State stop denying that there is a problem, apologise to my constituent and sort out access to testing, once and for all?

[Matt Hancock]

I ask the hon. Lady to get in contact with me about that individual case; 686 people in Barnsley got tests yesterday, and I am sure we can ensure that her constituent gets that test.

Covid-19 Update

Stephanie Peacock Excerpts

Thursday 16th July 2020 Commons Chamber

[Matt Hancock]

I am very happy to do that—I would not deny the Chair of the Liaison Committee his wishes on that—and I am very much looking forward to appearing before the Science and Technology Committee next week to answer any questions it might have.

[Stephanie Peacock (Barnsley East) (Lab)]

What does the Secretary of State say to the man in Barnsley who, when asked if he was contacted by test and trace and he would isolate, said no; when asked if he got covid symptoms he would isolate, said he would have to think about it, but probably not; and when asked why, said it was because if he does not go to work, his kids cannot eat. This is the stark reality for many people in this country. What are the Government doing to make sure that people have the financial support so they can follow the Government guidance?

[Matt Hancock]

The hon. Lady asks an important question, and it is a question that we address by ensuring there is local support available, in particular when there is a local lockdown. Of course, there is the statutory support that is available, and good employers will ensure that people are supported. Our overall principle is that people should not be penalised for doing the right thing, and I would say to the man, “Please, get the test, and if you are asked to isolate, isolate, and make sure that you seek the support that’s available”.

Independent Medicines and Medical Devices Safety Review

Stephanie Peacock Excerpts

Thursday 9th July 2020 Commons Chamber

[Ms Dorries]

I cannot comment on Primodos due to pending legal action.

[Stephanie Peacock (Barnsley East) (Lab)]

For too long, female patients have had crippling pain dismissed as “women’s problems”. As the Minister said, women have been failed, so can I press her further on the recommendations of this report? Will the Government appoint a patient safety commissioner to ensure that women are taken seriously and that terrible mistakes like this do not happen again?

[Ms Dorries]

We will be considering all the recommendations and returning to the House with a full report as soon as possible.

Coronavirus

Stephanie Peacock Excerpts

Tuesday 7th July 2020 Commons Chamber

[Matt Hancock]

The policies we have put in place with the local action are precisely targeted to reduce the risk of a second wave nationally. Nevertheless, as we turn to winter and the weather gets colder, there are signs of some seasonality in this virus, meaning that we will have to be much more careful, both because of the potential impact on how easily the virus transmits and because of changes in behaviour—we know that outdoors is safer and it is just harder to be outdoors in winter. So we must remain vigilant as a country.

[Stephanie Peacock (Barnsley East) (Lab)]

When the impact of covid-19 on the beauty industry was raised in the Chamber last week, the Prime Minister laughed, despite the fact that it contributes £30 billion to the economy and accounts for one in 60 jobs. Further to the question by the right hon. Member for New Forest East (Dr Lewis), what engagement have the Government had with the sector? Given that hairdressers and pubs are now open, when can beauty salons expect to open too?

[Matt Hancock]

The decisions that we have taken are based on clinical advice on the risk, because we know that being face to face, when in close contact, is more high-risk than not being face to face. That has been the basis on which the decisions have been taken. Of course I understand the impact on the beauty industry. As I said, my right hon. Friend the Business Secretary is leading on this issue and we will make progress when we safely can.