Health Inequalities

I inform the House that Mr Speaker has selected the amendment in the name of the Prime Minister.

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.

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.

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.

The latest figures for my city of Sheffield show that life expectancy is nearly nine years more for women from the least deprived decile than the most deprived, and that gap has widened significantly since 2010. Does my hon. Friend agree that, as we approach International Women’s Day and the Budget, we must be mindful of the toll that austerity has taken on our cities and across the country, especially in relation to life expectancy and quality of life?

I welcome my hon. Friend to her place. She is already an eloquent and passionate fighter for her constituents in Sheffield, and the point she makes is spot on: the reality is that 10 years of austerity has hit women hardest.

Will my hon. Friend give way?

I will give way to my hon. Friend, but then I must make some progress because, as I understand it, some Members want to make maiden speeches in the debate.

I thank my hon. Friend for giving way. Health inequalities between regions are stark, but there are also huge disparities across short distances. In my constituency, the life expectancy of men in St Michael’s is 13 years shorter than it is of men just 2.5 miles away in Stoneleigh, just south of Coventry. Does he agree that to reduce those shocking health differences, the Government need to tackle underlying economic inequality and systemic poverty, and reverse 10 years of Tory cuts?

Order. The hon. Lady’s intervention might not have seemed very long to her, and I appreciate that she is new to the House, but it was very long. I thank the hon. Member for Leicester South (Jonathan Ashworth) for what he said before he took that intervention. It would be much appreciated if the Front-Bench spokespeople took only a few interventions. This is a debate—we can have some interventions—but if Members who intend to intervene and then leave take up all the time at the beginning of the debate, those who sit here all afternoon will not get to speak at the end. We are talking about unfairness here, and that is unfair. The hon. Gentleman has been most courteous, and I know that the Minister has also been courteous in saying that she intends to take only a few interventions.

I am grateful, Madam Deputy Speaker, but the point made by my hon. Friend the Member for Coventry South (Zarah Sultana) was an excellent one. She is right: this variance in life expectancy and these widening health inequalities are surely intolerable, and we have been sent here by our constituents to do something about it.

Taking your guidance, Madam Deputy Speaker, I will try not to take any further interventions, because I am aware that Members want to make maiden speeches. I am sure that Members who have been in the House a bit longer will testify that I am usually very generous in taking interventions. I hope Members will understand.

I dare say that the Minister will pray in aid the Office for National Statistics data that came out last night, but that is just a single data point. The ONS data also shows that regional inequalities in health have widened since 2010 and confirms that life expectancy for women in the most deprived decile outside London and the north-west has fallen. The rate of increase in life expectancy slowed markedly after 2010, which just happens to coincide with the swingeing cuts to public services and working-age benefits that the Tory Government imposed upon our society.

When life expectancy stops improving, inequalities widen and health deteriorates. That is why Sir Michael Marmot found that time spent in poor health is increasing for men and women in the most deprived areas of England. He found that there is a north-south gap opening up, with some of the largest decreases seen in the most deprived 10% of neighbourhoods in the north-east. He found that the mortality rate among those aged 45 to 49 is increasing. So-called deaths of despair—the combined effect of increasing death rates from suicide, drug abuse and alcohol-related illness—are a phenomenon we have seen for many years in the United States, and they are now making their morbid presence felt here. Perhaps most shamefully of all, the most deprived 10% of children are now twice as likely to die as the most advantaged 10% of children, with children in more deprived areas more likely to face a serious illness during childhood and to have a long-term disability. Surely this stands as a devastating and shameful verdict on 10 years of Tory austerity and cuts. Of course, we have always had health inequalities since the NHS was created 70-odd years ago, but the point is that the Government should be trying to narrow them, not widen them, because as Professor Marmot says,

“if health has stopped improving it is a sign that society has stopped improving.”

Perhaps some will quibble with Marmot’s findings, but they coincide with what others have found. For example, the all-party group on longevity found a few weeks ago that men and women in our poorest areas are diagnosed with significant long-term conditions when they are, on average, only 49 and 47 years old respectively. The Institute for Fiscal Studies’ Deaton review has also warned about deaths of despair, pointing out that rates of long-standing illness and disability among people aged 25 to 54 have been increasing since 2013. The Royal College of Paediatrics and Child Health has today warned of stalling infant mortality rates and how a generation of children is being failed.

Order. Before I call the Minister to move the Government amendment, I should tell the House that we will start with a time limit on Back-Bench speeches of seven minutes, but that will very soon reduce to around five minutes, as there is a very large number of people who wish to speak. I am trying to keep the time limit a little more flexible for those who are making their maiden speeches.

I beg to move an amendment, leave out from “10 Years On” to end and insert:

“notes that Government is committed to level up outcomes to reduce the health gap between wealthy and deprived areas, and supports the Government’s commitment to delivering long-term improvements for everyone no matter who they are, where they live or their social circumstances.”

First, I would like to say that I really welcome this debate on health inequalities, which will help us all to discuss the challenges that we face. Every single one of us, no matter who we are, where we live, or our social circumstances, deserves to live a long and healthy life. Our determination to level up and reduce inequalities by improving the health of the poorest fastest is clear. The recent 10-year anniversary report produced by Professor Marmot comprehensively highlights the important issues, and I thank him for his tireless work in this space, because much of what he drew in the 2010 report is similar to now: these are really complex issues that are very hard to tackle.

The Minister will be aware that 64,000 people die prematurely from air quality problems, at a cost of £20 billion, and she is probably aware that those deaths tend to be concentrated among poorer areas and poorer families, so does she agree that we should take decisive action on such things as the electrification of cars and diesel duty so that we reduce overall deaths and thereby have a go at reducing health inequalities as well?

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).