Health Inequalities

Virendra Sharma Excerpts

Tuesday 23rd April 2013 Westminster Hall

[Mr Virendra Sharma (Ealing, Southall) (Lab)]

It is my great honour, Dr McCrea, to serve under your chairmanship.

It is crucial that everyone in this country, regardless of income or location, should have access to the same level of health care; social background should not be a determinant of health. Currently, people who live in the poorest neighbourhoods will die on average seven years earlier than those in the richest neighbourhoods, and the average difference in disability-free life expectancy is 17 years between the richest and the poorest. We should be concerned about health inequalities existing on that basis, because it shows not only that we are not all in this together but that people throughout the country are unnecessarily and unfairly suffering because of their social background.

[Rehman Chishti (Gillingham and Rainham) (Con)]

I congratulate the hon. Gentleman on securing the debate and on the work that he has done on the subject over the years. He was talking about life expectancy; in Medway, which covers three parliamentary constituencies, the difference in life expectancy between the most deprived 10% and the least deprived 10% is 9.6 years. He talked about all being in this together, but that 9.6 years did not arise in the past three years; that difference in life expectancy was present for many years under previous Governments as well.

[Mr Sharma]

I thank the hon. Gentleman for his important intervention, but we are not present as part of the blame culture. We are not debating what happened 10 years ago; we are talking about learning from the past and about how best to improve services. I am sure that the Minister will answer such questions, but I assure Members that I am not here to defend or not to defend, but to raise the issue, and to talk about what is happening in today’s terms and about why, what and how to improve.

The previous Labour Government committed themselves to reducing health inequalities. They made progress in meeting targets on infant mortality and headline indicators for life expectancy as a result of early intervention programmes and initiatives such as Sure Start. Reducing health inequalities is not only fair but makes economic sense.

[Stephen Barclay (North East Cambridgeshire) (Con)]

I am staggered by the hon. Gentleman’s statement about the previous Government making progress. The gap in life expectancy between deprived and wealthy areas widened under Labour, and there were more GPs per head of population in wealthy, healthy areas and fewer in poor, unhealthy areas. Can he explain why?

[Mr Sharma]

We are trying to avoid getting into the blame culture or blaming the previous Government. I am sure that that gap of 9.6 years or whatever was an improvement on previous years.

[Stephen Barclay]

Will the hon. Gentleman—

--- Later in debate ---

[Mr Sharma]

It is unnecessary to debate that. My point concerns what is happening today; I am not rude, arrogant or avoiding the issue, but the debate is about what is happening in the system, and the purpose is to find out what steps the Minister can assure us are being taken to improve the situation.

[Stephen Barclay]

It is worth putting it on the record that the cross-party Public Accounts Committee, chaired by a Labour Member, the right hon. Member for Barking (Margaret Hodge), looked at how in 1997 the Government were to put health inequalities at their heart and at setting targets in 2004, but those targets were not met. It is remiss of the hon. Gentleman to come to the Chamber today and to talk about the previous Government making progress when the gap in life expectancy increased, the GPs were in the wrong place and a cross-party Committee chaired by a Labour Member is saying that they failed to meet their targets.

[Mr Sharma]

I thank the hon. Gentleman for correction on that and I am sure that there are many other areas we could cover, but given the time available I want to complete my way of looking at the subject. He will have the opportunity, through the Minister, to talk about those questions.

Reducing health inequalities is not only fair but makes economic sense, as I said. Reducing such inequalities will diminish productivity losses from illness and cut welfare costs. My constituency is a diverse area with a high rate of deprivation and with about 19,100 children living in poverty. The impact on the health service is noticeable. The mortality rate is a lot higher than average, especially in the most deprived wards of the constituency. Diseases such as diabetes, coronary heart disease and tuberculosis are much more prevalent than in the rest of the country, and they are unfortunately directly related to the social inequalities in the area.

The coalition Government have shown a lack of commitment to reducing health inequalities, whether through their health policies or their socio-economic policies which will increase inequality between the richest and poorest. Through the Health and Social Care Act 2012, the Government have increased competition and opened up NHS services to tender from the private sector; if the section 75 regulations are pushed through the House of Lords tomorrow, patients with complex conditions that are perceived as less profitable will not be as readily treated by private providers. On top of that, the increase in private patients in hospitals after the lifting of the private bed cap will mean that access to beds for those who cannot afford private services will be restricted, increasing waiting times. In my own constituency, Ealing hospital will be downgraded and the A and E closed. Some of the poorest and most vulnerable people will therefore see the services that deal with their specific needs closed, and they will have to travel great distances, which they cannot afford to do, to get treatment.

Recent reviews and evidence have proved the link between health inequalities and wider social determinants such as income, employment, welfare and housing. The Government’s record gives us poor hope of progress in reducing those inequalities: fuel and food prices have gone up; increases in wages are less than those in the consumer or retail prices index, leaving people out of pocket every month; child poverty is increasing; homelessness is set to rise after the recent welfare cuts; and, as announced last week, unemployment is rising again. Those affected will only be more vulnerable to health difficulties, increasing the inequality between the richest and poorest in our society.

The Government need to commit themselves to reducing health inequalities to ensure that social background does not determine lifespan and quality of life. The previous Labour Government took some first steps towards reducing the health gap between the richest and poorest, but that progress is likely to be thwarted by the Government’s unfair policies. Can the Minister provide some reassurance from the Government that they are committed to reducing unfair and harmful health inequalities during their term?

--- Later in debate ---

[Anna Soubry]

I can say that absolutely. The hon. Member for Ealing, Southall asked whether the Government are committed to reducing health inequalities and making the sort of progress that we did not see in 13 years of the previous Government. I assure him that it is not just a question of blind intention, but an absolute fact that we have already done it.

[Interruption.] I am making a noise because I am removing the script of my speech. I am not good at following a script from my officials. They are extremely helpful, and it sometimes causes them concern that I go off script and speak off the cuff.

I am familiar with the Health and Social Care Act 2012. What the hon. Gentleman either does not know—this is not a criticism—or may have forgotten is that, for the first time ever, there is a statutory duty, not just on the Secretary of State, but throughout the NHS, to improve health inequalities. It is not a question of targets, which have not always delivered the right outcomes, and Mid-Staffordshire NHS Foundation Trust is a good example, as was identified in the Francis report. That duty is statutory so the Secretary of State and all those involved in the NHS must deliver, and the Secretary of State must give an annual account of how his work in leading the Department of Health and being the steward of the NHS in England has delivered a reduction in the sort of health inequalities that we all understand. That is there in law, but in 13 years in government, the hon. Gentleman’s party failed to do that.

[Mr Sharma]

I am not disputing the matter and, as I said at the beginning of my speech, I do not want a blame culture or to say what happened during those 13 years, but I ask the Minister to join me in my constituency on Saturday when thousands of people will march from Southall to Ealing. At the last march in September, there were more than 20,000 people, and we expect more this time. She will then know whether people believe that services have improved or got worse.

[Anna Soubry]

I am grateful to the hon. Gentleman but, with great respect, he does not understand that reducing health inequalities is not simply about saving an A and E department. I hope that, when the hon. Gentleman is marching on Saturday, he will remonstrate with anyone who has a banner saying “Fight the NHS cuts”. Whenever anyone looks at reconfiguration, they do so on the basis of how to make the service better.