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Health Inequalities
04 March 2020
Lead MP
Jonathan Ashworth
Debate Type
General Debate
Tags
NHSMental Health
Other Contributors: 53
At a Glance
Jonathan Ashworth raised concerns about health inequalities in the House of Commons. A government minister responded. Other MPs also contributed.
How the Debate Unfolded
MPs spoke in turn to share their views and ask questions. Here's what each person said:
Lead Contributor
Opened the debate
The debate notes the publication of Health Equity in England: The Marmot Review 10 Years On, expressing concern over its findings that improvements to life expectancy have stalled since 2010 and declined for the poorest women. It highlights growing health disparities between wealthy and deprived areas, increased time spent in poor health across England, and attributes these inequalities to austerity measures. The motion calls on the Government to end cuts, invest in public health, implement Marmot's recommendations, publish allocations for April urgently, and devise a strategy addressing social determinants of health.
Toby Perkins
Lab
Chesterfield
He agrees that inequalities in health outcomes are evident but also stresses the widening access gaps to healthcare services due to austerity. He points out additional cuts affecting local government funding, disproportionately impacting deprived areas.
Olivia Blake
Lab
Sheffield Hallam
She presents Sheffield's figures showing a nearly nine-year life expectancy gap between the least and most deprived deciles for women. She highlights that austerity has particularly affected cities like Sheffield, noting its impact on life expectancy ahead of International Women’s Day and the Budget.
Zarah Sultana
Your Party
Coventry South
She draws attention to health disparities within short geographical distances in Coventry, exemplifying a 13-year gap between St Michael's and Stoneleigh. She urges tackling economic inequality and poverty as means to reduce these stark differences.
Eleanor Laing
Con
Epping Forest
Announced a time limit for back-bench speeches due to the high number of speakers wishing to contribute. She emphasised flexibility in keeping this time limit, particularly for maiden speeches.
Jo Churchill
Con
Bosworth
Moved an amendment supporting the government's commitment to reducing health inequalities by levelling up outcomes across different areas and social circumstances. Emphasised the complexity of addressing these issues and acknowledged Professor Marmot’s work.
Geraint Davies
Lab
Croydon Central
Asked the Minister for decisive action on air quality issues, such as promoting electric vehicles and imposing higher taxes on diesel to reduce premature deaths. Highlighted how these measures could help alleviate health inequalities in poorer communities.
Jo Churchill
Various
The Minister emphasised the complexity of addressing health inequalities, which involves multiple government departments. She highlighted that preventing ill health is about more than just access to healthcare services and requires integration across housing, transport, education, welfare, and the economy. The Minister acknowledged the public health budget has been maintained this year and expressed her commitment to reducing inequalities through a long-term sustainable approach. She also discussed initiatives such as smoking cessation programmes and support for alcohol misuse. Furthermore, she mentioned investing in drug addiction services and ensuring local areas set specific goals to narrow health inequalities.
Toby Perkins
Lab
Chesterfield
Asked the Minister whether research on health inequalities had mentioned local government cuts, especially in poorer areas, which have resulted in a significant reduction in health education and prevention work. He highlighted that these factors contribute significantly to why health inequalities continue to be such a major problem.
Andrew Murrison
Con
South West Wiltshire
Emphasised the importance of addressing smoking as a significant factor in excess mortality between social classes. He argued that reducing these disparities requires tackling smoking rates, particularly among disadvantaged groups, which exacerbates inequalities.
Debbie Abrahams
Lab
Oldham East and Saddleworth
Asked the Minister to commit to considering the impact of policies on health inequalities as they are developed. She referenced seminal works like “The Spirit Level” to highlight that reducing wealth and power inequalities can increase life expectancy, social mobility, and educational attainment across communities.
Jamie Stone
Lib Dem
Caithness, Sutherland and Easter Ross
Suggested using ex-smokers like himself as ambassadors for smoking cessation programmes. He highlighted the importance of peer support in quitting smoking.
Jo Churchill
Con
Basingstoke
We are creating an extra 50 million appointments and growing the workforce by 6,000 more doctors and 26,000 wider primary care professionals over five years. Targeted enhanced recruitment scheme aims to recruit trainees in areas with high vacancy rates, such as Plymouth and County Durham. We will increase TERS from 276 to 500 places in 2021, then up to 800 places in 2020.
Mike Amesbury
Lab
Wallasey
Asked the Minister a question but was not given way to due to time constraints.
Central Ayrshire
Welcomed what the Minister has said, noting that it's surprising to hear talk of starting to take action now after a decade-long Conservative-led Government. Emphasised the wider context of health beyond the NHS and highlighted the social determinants of health as defined by Michael Marmot. Criticised lack of policy implementation despite welcome reviews.
Karin Smyth
Lab
Bristol South
Agreed with Philippa Whitford about the social determinants of health and noted Labour's appreciation and direction towards these determinants pre-2010.
Central Ayrshire
Critiqued the cuts to public health in England, noting that they amount to £850 million. Emphasised the negative impacts on smoking cessation projects, drugs and alcohol services, sexual health initiatives, and social care funding. Pointed out that child poverty has increased with 4 million children affected. Also highlighted the closure of 1,000 Sure Start centres and the decline in education funding. Mentioned a £6 billion gap in social care and an increase in homelessness due to housing issues. Highlighted stalled life expectancy for women and widening health inequalities.
Andrew Murrison
Con
South West Wiltshire
Asked Philippa Whitford to compare and contrast the situation in Scotland with other parts of the UK, questioning her claim about narrowed health inequalities in Scotland.
Central Ayrshire
Responded that while child poverty has increased across the UK, Scotland's rate is still lower due to initiatives like building affordable housing. Criticised the government for failing to deliver on promises such as starter homes.
Munira Wilson
Lib Dem
Twickenham
Agreed with Philippa Whitford, highlighting that children living in poverty are more likely to suffer from mental health issues due to varying levels of funding for mental health services across different areas.
Daniel Poulter
Con
Central Suffolk and North Ipswich
Poulter highlighted the impact of health inequalities on addiction services, noting that poverty and deprivation correlate with poor health outcomes. He criticised recent legislative changes made under the Health and Social Care Act 2012 which have led to a deterioration in addiction service quality due to local government commissioning and funding constraints. Poulter cited Dame Carol Black’s report indicating a significant reduction in drug and alcohol treatment spending, resulting in fragmented services and increased worker caseloads. He emphasised the need for integrated care with mental health, housing, and criminal justice systems, advocating for better service delivery and recruitment of specialised workers.
Jon Ashworth
Lab
Leicester South
Ashworth briefly supported Poulter’s argument, questioning if fragmented commissioning processes are hindering the recruitment of addiction psychiatrists. He highlighted a critical shortage in training posts for addiction psychiatry in London.
Mary Foy
Lab
City of Durham
In her maiden speech, Mary Foy paid tribute to her predecessor and discussed the rich history and social challenges faced by her constituency. She highlighted past economic hardships under Conservative rule and health crises due to inadequate NHS resources. Foy emphasised the current impact of austerity measures and inequality in life expectancy based on socio-economic status. She also mentioned a child born prematurely lacking necessary medical equipment, leading to long-term disabilities. The speech advocated for Labour's approach to addressing social injustices and improving public health by tackling broader issues such as education, housing stability, and income security.
Paul Beresford
Con
17:23:00
Beresford congratulated Mary Foy on her speech and spoke about the issue of child dental health. He shared his experience working in deprived areas of east London, highlighting grim statistics for tooth decay among children in deprived areas compared to less deprived ones. Beresford discussed the financial burden on NHS due to hospital admissions related to tooth decay and advocated for water fluoridation as a proven method to reduce tooth decay among children.
Lee Anderson
Reform
Ashfield
Anderson acknowledged the challenge of health inequalities but praised the current government's investment in the NHS. He stressed the need for individuals to make better lifestyle choices and mentioned his local community initiative, Huthwaite Hub, which offers social activities aimed at reducing loneliness among isolated individuals.
Tom Hunt
Lab
Ipswich
Hunt suggested that a community wealth fund could be established to address health inequalities in areas like Bridge ward in Ipswich, where healthy life expectancy is notably lower than the national average. This proposal aims to strengthen local communities' resilience against such disparities.
Lee Anderson
Reform
Ashfield
Agrees with the positive impact of the budget on health and wealth in Ashfield, emphasising better jobs, education, and training. Highlights £75 million funding for town centre development and plans to open old train lines. Mentions personal experience with NHS care.
Colleen Fletcher
Lab
Coventry North East
Critiques the Government's economic policies since 2010, highlighting increased health inequalities in Coventry. Cites data on life expectancy gaps and poor health outcomes among deprived communities. Emphasises the importance of addressing social conditions to improve health.
Derek Thomas
Con
St Ives
Raises concerns about dental care access issues in Cornwall and Isles of Scilly, citing data on low dentist visitation rates among adults and children. Highlights personal stories from constituents facing long waits or no access to NHS dentists.
Central Ayrshire
Questions the dental contract's impact, agreeing that it discourages preventive care and contributes to low dentist availability in some areas. Suggests a need for review of the current system.
Karin Smyth
Lab
Bristol South
In 1980, the Black report highlighted that only a significant public expenditure programme could address health inequalities. The Thatcher Government rejected this report as unrealistic, leading to ongoing issues. The NHS has limited impact on reducing health disparities and may even exacerbate them due to better-off patients having easier access to services. Progress was made in the 1990s but the targets were removed in 2011 under the current government, resulting in significant harm to deprived communities. Bristol South's neighbourhoods are among the most deprived, with high claims for personal independence payments and carer’s allowance. Women in Bristol face a longer period of poor health compared to the national average. The Marmot report indicates stark figures on health inequalities. Early intervention is critical, and local government must play a key role in addressing these issues.
Anne Marie Morris
17:55:00
Good health is crucial for individual and community happiness and prosperity. Health outcomes are influenced by personal factors, life circumstances such as deprivation, and the quality of healthcare provision. Rural areas face unique challenges not well addressed in official reports or data analysis. The definitions and data collection methods used do not accurately reflect the needs of rural communities, leading to inadequate funding and support. My constituency is a prime example of how flawed assumptions about car ownership affect funding allocations. There are significant consequences related to demographic profiles and geographic factors, such as importing older people who require more complex healthcare services.
Luke Evans
Con
Hinckley and Bosworth
Patient behaviour in rural areas differs from urban settings. Rural residents often delay seeking medical help due to the challenges of travelling long distances, which can worsen health issues. This behaviour is not captured accurately by current data analysis methods.
Anne Marie Morris
17:55:00
Rural areas need more funding for primary care and training doctors who can handle complex co-morbidities common in these regions. The infrastructure barriers, such as poor road and rail connections, limit access to healthcare services. We also face a shortage of geriatricians due to demographic shifts. High rates of isolation and loneliness contribute to higher suicide levels among rural residents. Current funding mechanisms are inadequate, leading to poor financial performance and difficulty meeting targets in regions like Devon. The situation can be improved if the Government accepts that one-size-fits-all solutions do not work for rural communities.
Several hon. Members
17:55:00
rose—
Jamie Stone
Lib Dem
Caithness, Sutherland and Easter Ross
Praised speeches by Members for City of Durham and Coventry North West. Told the tale of Mr Billy Sutherland's survival after being buried in a snowdrift to illustrate the risks faced by constituents due to maternity service downgrading. Argued that pregnant mothers must not lose out on decent health services, urging the Scottish Government to address the issue.
Guildford
Welcomed NHS long-term plan's focus on tackling health inequalities. Noted life expectancy differences within Guildford constituency between north and south of A3. Highlighted work by the Guildford health and wellbeing board to produce a report addressing unmet needs until 2022. Emphasised the importance of empowering community volunteers in reducing health inequalities.
Mitcham and Morden
Critiqued NHS proposal for Epsom and St Helier University Hospitals NHS Trust, highlighting proposed downgrading affecting deprived areas. Questioned decision-making process regarding funds allocation and deprivation proximity analysis. Advocated for health inequalities to be at the heart of decisions on spending the £500 million promised by the Government.
Miriam Cates
Con
Penistone and Stocksbridge
Discussed barriers to healthy lifestyles in deprived areas including low household income, infrastructure issues, and lack of information. Emphasised importance of community groups in providing practical health advice and supporting individuals towards healthier living.
Catherine West
Lab
Hornsey and Friern Barnet
Commended the speech of Miriam Cates and congratulated the new MPs. Promoted the Haringey fairness commission's work, highlighting that 25% of workers in Haringey do not receive the London living wage, which impacts health. Emphasised the need for local authorities to address income inequality and its effects on health, citing research from Professor Marmot and others.
Edward Timpson
Con
Eddisbury
Focused on childhood obesity as a critical issue affecting health inequalities. Cited statistics showing 33% of children aged two to 15 are overweight or obese, with the highest rates among socioeconomically disadvantaged children. Discussed measures like the national childhood obesity plan and school food standards.
Judith Cummins
Lab
Bradford South
Addressed health inequality in access to NHS dentistry, emphasising that it is underfunded and undervalued. Highlighted regional disparities in dental care, noting 40% of children in Bradford have tooth decay. Suggested reforms like improving the dental contract and rolling out the starting well programme.
Paul Bristow
Con
Peterborough
Spoke about autism awareness and proposed an autism strategy for Peterborough, aiming to improve outcomes for people with autism. Emphasised the importance of accurate diagnosis and noted that autism is a lifelong development disability affecting 700,000 in the UK.
Virendra Sharma
Lab
Ealing, Acton
Health inequalities remain acute in Ealing, with significant disparities between the richest and poorest areas. Ethnic minorities face serious health issues, including organ donation awareness gaps affecting young people like Rohan. The Government should expedite their tobacco control plan to address oral tobacco's disproportionate impact on BAME communities. Additionally, public health spending cuts must be reversed to enable local councils to provide essential advice and services for mental health, sexual health, smoking cessation, and substance abuse. A real living wage increase is necessary to alleviate overall deprivation.
James Daly
Con
Bury North
Proposes policies to address health inequalities in Bury: strengthening provision for children with autism and SEMH needs, creating a learning disability hub, fostering fair employment through skills hubs at Bury College, initiating an integrated public health hub pilot for substance abuse and wellbeing issues. Also suggests using community facilities like Gigg Lane to encourage physical activity among young people.
Janet Daby
Lab
Lewisham East
Highlights the impact of austerity on minority ethnic populations, noting factors such as rising child poverty and homelessness. Emphasises the need for data collection on ethnicity in health statistics to aid research. Urges training for health professionals on conditions like sickle cell disorder to reduce inequalities.
Bob Seely
Con
Isle of Wight
Discusses health inequalities linked to NHS trust operations, focusing on the Isle of Wight's unique healthcare challenges due to its remote location. Advocates for recognition of additional costs associated with small hospitals and seeks debates on the Unavoidably Small Hospitals programme to ensure Ministers understand these pressures.
Liz Twist
Lab
Blaydon and Consett
Stressed the importance of health equity, highlighting significant increases in life expectancy gaps between deprived and least-deprived areas in Gateshead. Cited statistics from the North East Child Poverty Commission on child poverty and its effects on physical and mental well-being. Recommended restoring the £1 billion real-terms cut to the public health grant for local authorities and increasing funding at the same rate as NHS.
Fleur Anderson
Lab
Putney
Linked health inequality to austerity policies, focusing on healthy food access, housing conditions, and air pollution in deprived areas of Roehampton. Noted lower life expectancy and healthier living years compared to other parts of the borough due to factors like poor housing, overcrowding, and mould issues which exacerbate asthma cases. Urged for a public health review of temporary accommodation and called for legally binding commitments to meet WHO guideline levels on air pollution.
Feryal Clark
Lab
Enfield North
Discussed the impact of funding cuts by the Tory government since 2010 in Enfield, highlighting the struggle against health inequalities despite local efforts. Raised concerns about low public health funding per head compared to other boroughs, high child poverty rates and poor health living conditions among residents. Called for a step change and investment in people's health across Enfield North.
Sharon Hodgson
Lab
Washington and Gateshead South
This has been an excellent debate, highlighting the decline in life expectancy and widening inequalities as reported by The Marmot Review. The report confirms that austerity policies have led to stalling life expectancies, especially for women in poorer areas. Labour Members emphasise the link between economic cuts and health deterioration, noting that premature deaths in poorer areas are twice as high compared to affluent areas. The speaker criticises the lack of investment in public health, children’s services, addiction services, and social care, despite prevention being a top priority for the Secretary of State. She also points out the vulnerability of workers on zero-hours contracts during the pandemic and the inadequacy of statutory sick pay. Labour supports free prescriptions as a measure to prevent illness and early deaths. The debate highlights regional disparities in life expectancy, with boys born in Blackpool expecting 53.3 years of healthy living compared to 71.9 years for those born in Richmond upon Thames, indicating an urgent need for Government action.
Nadine Dorries
Con
Mid Bedfordshire
Thanked all Members who had attended and spoken in the debate, highlighted the Prime Minister's commitment to a long and healthy life for everyone regardless of their background. Emphasised her personal understanding of the issue from growing up in an impoverished area. Discussed the Government’s focus on levelling up left-behind areas and addressing health inequalities. Mentioned the ONS's new life expectancy data showing an increase, though noting it was provisional. Highlighted investment in mental health care and NHS hospitals, primary care, and workforce. Acknowledged various Members' points including those related to addiction strategy, dentistry access, loneliness and social prescribing, rural inequalities, prevention measures, hospital issues, and social prescribing for community integration.
Nick Brown
Lab
Dewsbury
Claimed closure under Standing Order No. 36 and moved the debate to a vote.
Debbie Abrahams
Lab
Oldham East and Saddleworth
Corrected a previous statement about Daniella Obeng, stating that she had died from bronchopneumonia rather than suicide. Provided details of Daniella’s life and her struggles following the cessation of social security support, highlighting how health conditions impacted her ability to work and ultimately led to her death while on a singing contract in Qatar.
Government Response
Discussed various initiatives and policies aimed at reducing health inequalities, including funding for drug addiction services, alcohol care teams to prevent admissions related to alcohol dependency, and public consultations on prevention strategies. She also highlighted the importance of local leadership in implementing these measures. Discussed various points made during the debate, including commitments to an addiction strategy, increasing access to NHS dentistry, tackling loneliness and social prescribing, addressing rural inequalities, prevention measures, and initiatives for community integration through social prescribing.
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