Health Inequalities

Toby Perkins Excerpts

Wednesday 4th March 2020 Commons Chamber

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

I beg to move,

That this House notes the publication of Health Equity in England: The Marmot Review 10 Years On; is concerned by its findings that since 2010 improvements to life expectancy have stalled for the first time in more than 100 years and declined for the poorest women in society, that the health gap between wealthy and deprived areas has grown, and that the amount of time people spend in poor health has increased across England; agrees with the review that these avoidable health inequalities have been exacerbated by cuts to public spending and can be reduced with the right policies; and calls on the Government to end austerity, invest in public health, implement the recommendations of the review, publish public health allocations for this April as a matter of urgency, and bring forward a world-leading health inequalities strategy to take action on the social determinants of health.

A former Health Secretary, Frank Dobson, whom we sadly lost towards the end of last year, said:

“Inequality in health is the worst inequality of all. There is no more serious inequality than knowing that you’ll die sooner because you’re badly off.”

He was absolutely right. Poverty and deprivation mean that people become ill quicker and die sooner. The current Health Secretary—I understand why he cannot be here for this debate; I do not criticise him for that, given what is going on, and we welcome the Under-Secretary of State, the hon. Member for Bury St Edmunds (Jo Churchill), to the Chamber—said, when we last debated health inequalities, that

“extending healthy life expectancies is a central goal of the Government, and we will move heaven and earth to make it happen.”—[Official Report, 14 May 2019; Vol. 660, c. 153.]

Well, last week the respected academic, Sir Michael Marmot, gave us his assessment of the Government’s attempts to move heaven and earth to narrow those inequalities and extend healthy life expectancy.

[Mr Toby Perkins (Chesterfield) (Lab)]

I absolutely congratulate my hon. Friend on bringing this crucial issue to the Chamber. The health inequalities that we have seen in our communities are bad enough, and the additional inequalities regarding access to GP appointments are even worse, but we are also seeing cuts in local government funding hitting the most deprived areas and adding to those inequalities we are already aware of.

[Jonathan Ashworth]

My hon. Friend makes that point very well. Not only are there inequalities in health outcomes, but inequalities are opening up in access to health services.

I said that I understood why the Secretary of State cannot be here, but he has now joined his colleagues on the Front Bench. I will state, just for the record so that he can be reassured, that I did not criticise him for not being here—I said that I entirely understood why he could not be here. But he is always welcome to listen to my pearls of wisdom, of course.

Michael Marmot’s analysis was shocking, and his conclusions devastating. Let me remind the House of what Professor Marmot found: for the first time in more than 100 years, life expectancy has essentially flattened overall since 2010, and has actually declined for women in the poorest areas of England. In last week’s Opposition day debate, the Health Secretary told Opposition Members that we must debate these issues based on the facts. In fairness, he said that there were life expectancy differences between, for example, Blackpool and Buckingham. [Interruption.] Indeed—gulfs. The Secretary of State made that point. If I may say so, however, I do not believe that he was as clear as he could have been in presenting the full picture for the benefit of Members. When we look at the figures, we see that for more than 100 years, life expectancy has been increasing by about one year every four years. More recently, from 2001 to 2010, the increase was 0.3 years for each calendar year for men and 0.23 years for women. Between 2011 and 2018, the average rate of increase was 0.07 years for males and 0.04 years for women. By any standards, that is a truly dramatic lowering in the rate of improvement in life expectancy between 2011 and 2018.

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[Jo Churchill]

The hon. Gentleman makes a good point, but it typifies the problems we deal with, because air pollution is the responsibility of the Department for Environment, Food and Rural Affairs, the Department for Transport and the Department of Health and Social Care. They all have a role to play, and we must ensure we take account of that—it is important that we think about all these different challenges. Helping people to live longer healthier lives while narrowing the gap between the richest and the poorest needs action, a point made by the hon. Member for Coventry South (Zarah Sultana).

[Mr Perkins]

Will the Minister give way?

[Jo Churchill]

If the hon. Gentleman will just bear with me and let me make a little more progress, I will come back to him.

Going forward, I am clear that we must integrate good health into decisions on housing, transport, education, welfare and the economy, because we know that preventing ill health, both physical and mental, is about more than just access to our health services.

--- Later in debate ---

[Jo Churchill]

I will come on to that point in a few minutes, if my right hon. Friend will bear with me.

[Mr Perkins]

The Minister is right that this is a very complicated issue and that health inequalities have existed for a considerable amount of time. On the research she refers to, will she tell us whether local government cuts, which have been greater in the poorest areas, with a significant reduction in health education and prevention work, were mentioned as factors for why this continues to be such a major problem?

[Jo Churchill]

The problems we are dealing with are complex across the piece, which is why we have held the public health budget at the same level this year so that we can start to deliver on them. It is important that local people have local ownership over the issues and challenges in their area, because one size will not fit all.