To ask Her Majesty’s Government, further to the report by the Institute of Health Equity Build Back Fairer in Greater Manchester: Health Equity and Dignified Lives, published on 30 June, what steps they are taking to address the (1) disparities in life-expectancy, and (2) social conditions, in England’s most deprived areas compared to the rest of the population.
My Lords, the Government welcome Professor Marmot’s report and his insights into this important area. Reducing health inequalities is a core aim of the new office for health promotion. Under the Chief Medical Officer, the OHP will work with partners across government, the NHS, business and society to systemically tackle preventable risk factors, improve the nation’s health and narrow health inequalities.
I thank the Minister for her Answer. The main findings of the Marmot report about gross and growing inequalities in life expectancy are sobering. What makes the situation even worse is that awareness of this was heightened by research and documentation more than 20 years ago. In what way do the policies of the present Government differ from the failed policies of previous Governments over the last decades?
My Lords, the Government have put a renewed emphasis on prevention in their approach to tackling health inequalities. That is taking place over a number of areas—for example, in the new obesity strategy and the smoking cessation strategy—that will help us close this gap, which is too wide and something we should all be concerned about.
My Lords, deepening inequality and poverty, especially child poverty, are key social determinants of the worsening health inequalities identified by Sir Michael Marmot, who argues that they must be central to the Government’s levelling-up agenda. How exactly does that agenda address the poverty and inequality that the report shows are damaging health and well-being so badly?
My Lords, the levelling-up agenda will be about improving life chances across the UK, and the Government’s proposals in that area will be set out in a White Paper later this year. The noble Baroness has given me the opportunity to expand on some of the other important government policies that the noble and right reverend Lord asked about, so I say that introducing the national living wage and the pupil premium has focused support on those most in need.
My Lords, yesterday’s report highlights the need for an ambitious new framework to reduce health inequalities, focusing far more sharply on the wider social determinants of health to make a reality of building back fairer from Covid, which has cruelly exposed and amplified inequalities in life expectancy. Given that mental health problems are the number one cause of death for men under 50, and the leading cause of maternal death in the UK, what immediate steps are the Government taking to improve the mental health of at-risk groups living in deprived areas?
My Lords, absolutely: as part of the NHS long-term plan, the Government have committed to improving mental health services and increasing the funding that goes to those services, as a proportion of overall funding, in every year of that plan.
My Lords, inequalities in healthcare have long plagued the NHS. Inequalities exist not only in years spent in ill health and shorter life expectancy but in referrals of care, leading to poor health outcomes for people from deprived communities. With waiting lists running into the millions, dealing with this effectively is a priority. To this end, does the Minister think that NHS plans for clinical validation as a way of tackling waiting lists are likely to worsen inequalities in access to treatments?
My Lords, clinical validation is, at its heart, about adapting to the need to manage larger and longer waiting lists and tackle those. Patients will be treated in order of clinical priority and then by length of wait to reduce the harm by waiting. But I reassure the noble Lord that his point is very well made and that, in the NHS recovery plan, there are eight actions to reduce inequalities in the restoration of services, including reporting on providing services to the poorest 20% of neighbourhoods and black and Asian patients.
Was my noble friend rather surprised that she had to get to page 94 of the summary before there was any mention of obesity as a cause of inequalities in health, given that it is one of the major things that both undermines health over time and has exacerbated susceptibility to mortality from Covid?
My Lords, being somewhat familiar with Professor Marmot’s work, I know it is incredibly wide-ranging and looks at a huge number of the determinants of health. But my noble friend is absolutely right that obesity is a big part of our health agenda, which is why the Government have set out a number of areas where we will take further action to support people to reduce levels of obesity across the country.
In the light of Sir Michael Marmot’s report, will the Minister commit to providing an early opportunity for this House to debate the impact of Covid-19 on Her Majesty’s Government’s much-advertised agenda for levelling up, particularly relating to children and young people in those regions with the greatest level of deprivation?
My Lords, I had the pleasure of sitting in on an excellent debate on a similar subject last week. Unfortunately I do not lead the House’s timetable, but I will make the submission on behalf of the right reverend Prelate.
I am very pleased to hear that the Government have noted the report, but I would like the Minister to confirm whether the Government have actually consulted or used Sir Michael Marmot, who is the UK’s foremost academic in the field of health equity or lack of it. His research is being used, so I would like to know: when did the Government, or representatives of the Government or the Minister’s department, meet Sir Michael Marmot and his team? Are the findings of this research and the research from last year being taken into account with the levelling-up plans?
My Lords, on the specifics of any meetings, I am happy to write to the noble Baroness. I point to the creation of the new office for health promotion and the fact that the guiding mantra that sits behind it is very much aligned with the agenda Sir Michael Marmot has set out. I know that is a key priority for the Chief Medical Officer as we come out of the pandemic and take this work forwards.