To ask His Majesty’s Government what assessment they have made of the paper by the Journal of Epidemiology and Community Health Bearing the burden of austerity: how do changing mortality rates in the UK compare between men and women? published on 4 October 2022.
My Lords, it is a pleasure to open this debate and to welcome the noble Lord, Lord Evans of Rainow, to the House and to the ministerial merry-go-round. I look forward to hearing his maiden speech.
All too often, Ministers come to Parliament to present cold numbers about taxes, spending cuts, wages, pensions or benefits freezes and make absolutely no mention of the human cost associated with their plans. Never-ending austerity continues to deprive people of good food, housing and healthcare. It creates hunger, disease, anxiety, insecurity and mental health problems, huge waiting lists for hospital treatment and, ultimately, premature death. I have been in this House for just over two years now but have never heard any Minister explain the ethics of austerity or the human consequences of their cold decisions.
The paper Bearing the burden of austerity: how do changing mortality rates in the UK compare between men and women? was written by four renowned international scholars and published in October 2022. It reported that between 2012 and 2019 there were nearly 335,000 excess deaths in England and Scotland. The death toll includes over 250,000 men and 84,000 women. The cause of death is austerity imposed by the Government. The research methodology behind the paper is well articulated in it, if anybody is interested in critiquing it. Between 2012 and 2019, the Government handed billions in tax cuts to corporations and the rich. They also handed hundreds of billions in quantitative easing to speculators and gamblers. This free money fuelled asset price inflation and produced a record number of billionaires. However, the same process was not used to alleviate poverty, and the Government condemned millions to poverty. By 2019, some 14.5 million people, 22% of the population, were living in poverty. This included 8.1 million working-age adults, 4.3 million children and 2.1 million pensioners.
Since 2010, the Government have incessantly attacked low and middle-income families. The real wages of workers have been supressed and even today, the average real wage is lower than in 2007. Public sector workers have been especially targeted and have received below inflation pay rises. This hits women hard because more than half of the public sector workforce is female. Workers’ share of GDP in the form of wages and salaries is barely 50%, compared to 65.1% in 1976. No other industrialised nation has experienced this rate of decline in the wages of its workers. Low wages result in low savings, so people do not have an adequate buffer or resilience for a rainy day. The less well-off have a shorter life expectancy. The cause is not some invisible hand of fate but the visible hand of a Government who have impoverished people and condemned them to early death.
My Lords, I thank the noble Lord, Lord Sikka, for securing this important debate. I also look forward to hearing from the noble Lord, Lord Evans, in his maiden speech.
The paper at the heart of this debate provides a useful focus, because it highlights one of the worst health outcomes that we have seen in the past 10 years: that of widening inequalities. It is also helpful because, by focusing on the impact of austerity, we begin to see that public health is impacted by many factors besides healthcare access—factors called the social determinants of health. Those include housing, our jobs, our environment, our education and much more. They can be summed up as the opportunities that we have to lead healthy lives. The Heath Foundation noted that 50% of people in the most deprived areas report poor health by the age of 55 to 59, which is more than two decades earlier than in the least deprived areas. It is not just about life expectancy; it is also about healthy life expectancy.
The debate is poignant also because it comes at a time of great strain on the NHS and on social care, and at a time when those other determinants of health are challenging for many of us. We are also at a moment when I hope we are beginning to realise the importance of prevention of ill health, which is essential for the sustainability of our healthcare system.
Over the years, many organisations have agreed on the need for a strategy for health and health equality, but the long-promised and long-awaited health disparities White Paper is nowhere to be seen. Meanwhile, those subject to health inequalities are more likely to be affected by healthcare pressures and to struggle in the coming economic climate. It is in these conditions that inequalities in health can only worsen.
In the absence of a strategy to tackle health inequalities, I propose that recognising and supporting the work of faith groups could be key to a real improvement in both prevention and access to healthcare. Faith groups hold the deep trust of the people they serve, with unrivalled knowledge of their communities. I recently had the opportunity to convene the Health Inequalities Action Group, which brought together faith leaders, healthcare professionals and civil society leaders to explore the intersection of faith, health inequality and health in London. London currently has the biggest gap in life expectancy between its local authorities of any region in England.
My Lords, I thank my noble and, might I add, numerate friend Lord Sikka for obtaining this debate. It is a topic of much discussion and no little misunderstanding. I look forward to the maiden speech of the noble Lord, Lord Evans. I cannot help but remember my maiden speech, which I had to give in Grand Committee; it does not have exactly the same grandeur as making your maiden speech in the Chamber, so the noble Lord has my sympathy, but it is the content that counts.
I want to talk more about mortality in general. Figures and comparisons relating to mortality always need to be considered with care. The report before us is important and topical; my noble friend Lord Sikka set out the issues clearly. I just want, in the few minutes available, to put them into a wider historical context and then say something about what we know from the latest mortality figures.
Throughout the 20th century, the United Kingdom saw significant increases in life expectancy, influenced not just by medical advances but, more significantly, by better incomes and living conditions, as well as changing habits—particularly the reduction in smoking. Yet, while mortality rates continued to improve during the first decade of this century, the improvements have stalled since 2011. For certain groups, they have gone into reverse. The work before us today, along with other reports, unequivocally points the finger for this regrettable turn at the impact of austerity since 2010—no little coincidence.
Of particular concern is the fact that inequalities in life expectancy between the richest and the poorest have widened since 2011. While people in wealthier areas of the UK continue to live longer, for those living in the most deprived areas, life expectancy is stalling or even reversing. What this tells us is that the adverse trends affecting the less advantaged groups in our society are not inevitable. It is a question of social policies.
My lords, I thank the noble Lord, Lord Sikka, for securing this debate and I welcome the Minister, the noble Lord, Lord Evans of Rainow, to the House and his ministerial role. I wish him well and look forward to his maiden speech. It is a tough ask to give a maiden speech and answer the questions raised, but I have no doubt that he will do it well. I am aware that, not only as an experienced parliamentarian but with his background, he is well aware of the human cost of social deprivation and the resulting health inequalities and mortality.
The subject of today’s debate is austerity and its subsequent effect on health inequalities, including mortality. I will focus more on the latter—the health inequalities—but I accept the conclusions of the observational study reported on the subject in the Journal of Epidemiology and Community Health.
It is 60 years since the Black report highlighted the association of deprivation and ill health. The Marmot reviews of 2010 and 2020, already mentioned by the right reverend Prelate the Bishop of London, spelled out in detail the health inequalities related to deprivation. Apart from the years from 1999 to 2009, no Government have tried to put in place policies to reduce health inequalities.
As already mentioned, deprived populations have lower life expectancies, spend many more years in ill-health, fewer years in good health, have a high incidence of long-term health conditions including cancers, and poor outlooks, not to mention an increased number of stillbirths and infant deaths. Health inequality means that the most deprived spend a significant part of their lives in misery. Government policies and major health events may exacerbate the situation, as I have no doubt that the current cost of living and NHS crisis will, but the root cause of health inequalities is social deprivation.
As inequalities are well characterised, the focus now should be on what interventions are effective and how they can be used. The perceived impression is that there is a lack of value placed on taking a long-term, whole-system approach to create a connected and cost-cutting policy and learning from previous approaches to reduce health inequalities. There is also an impression that the NHS is not given sufficient focus to reduce health inequalities. The message is that there is a lack of attention given to social determinants of inequality in current policy-making. The important question today should be: what plans and policies will the Government put in place to reduce health inequalities and therefore increase mortality in the deprived population?
My Lords, I thank the noble Lord, Lord Sikka, for tabling this debate and bringing this important paper to our attention. I look forward to hearing the Minister’s maiden speech. I made mine some time ago, but I have only recently taken up a Front-Bench position. It is quite a transition to move from Back Benches to Front Benches in terms of workload and the need to learn quickly.
I congratulate the researchers on looking into this question and on the clarity with which they have presented their findings. As content licensing is a long-standing interest of mine, I was pleased to find that this is an open-access publication, licensed under a Creative Commons licence. This maximises the opportunity for people to share and build on the work done by the team, as long as they provide the correct attribution.
The paper helps to fill out a picture which has been emerging through a number of different research projects into the harmful effects of severe cuts in government funding on life and good health expectancy, particularly the cuts which took place in the early part of the 2010s. The linkage between austerity policies and mortality rates seems clear, as described very effectively by the noble Lord, Lord Sikka, and is something that we must have top-of-mind when considering policies for the new recession which unfortunately appears to be headed our way. The noble Lord’s call for Bills to be accompanied by an assessment of the human impact was well made.
While the paper does not reach definitive conclusions on its original hypothesis that women’s mortality would have been affected more than men’s, it adds to the evidence base for austerity affecting different communities and highlights the need for continued research in the area. I hope that the Government and the Minister encourage this, as there is a tendency for Governments not to look at things that appear to criticise previous government policy, but, in this case, the public interest strongly lies in us continuing to understand what happened during that period of austerity in order to inform future policy.
My Lords, I thank my noble friend for securing this debate and for his comprehensive introduction on the context and key findings of the study. I also congratulate the authors on an authoritative piece of work underlining, in particular, the disproportionate affect that austerity has had on women, with a greater financial impact and the loss of key support across vital health, social welfare, housing and education services. I also welcome the Minister and look forward to his maiden speech and response to the debate, and to working with him in the future.
As noble Lords have said, this debate is timely, especially in view of the shocking figures from the ONS, which were discussed in your Lordships’ House earlier this week and were the subject of a brutal analysis on the front page of yesterday’s Times. Some 50,000 more people than normal died over the past 12 months and there were 1,600 more deaths during Christmas week, as the long wait for ambulances, cold weather and surging flu infections took their toll. Excluding the two pandemic years, 2022 was one of the worst years on record, despite the Government continuing to cite the pandemic as the main source and cause of the dire problems we face. I understand that, today, the Office for Health Improvement and Disparities is publishing its excess death report on the causes that have contributed to these deaths. Can the Minister update the Committee on this and provide further insight to help us understand the extent of the crisis and the actions the Government need to take?
The study ranges across key community care and health inequalities, which have been ably covered by other speakers in this short debate. I look forward to the Minister’s response to the thoughtful and expert questions that have been raised. The study shows the adverse changes in mortality rates in the UK from the early 2010s onwards, with increasing death rates among more deprived areas, which the right reverend Prelate the Bishop of London and other noble Lords spoke very forcefully about, particularly in relation to the work of the Black and Marmot reviews.
My Lords, it is a great honour to be here to make the final contribution to this debate. I thank all your Lordships for your kind words of welcome. As a newly appointed Lords Whip, it falls to me to respond on behalf of His Majesty’s Government to this interesting debate. As your Lordships have all noted, this happens also to be my maiden speech.
If I may, I will now turn to the customary part of a maiden speech. I must thank noble Lords for the great welcome they have given me to this place. I also thank Black Rod, the Clerk of the Parliaments, the doorkeepers and police, and particularly my supporters: my noble friends Lord Davies of Gower and Lady Williams of Trafford. We are all very lucky to have such outstanding public services in this place. Needless to say, I am most grateful to my wife Cheryl and my children, George, Tom and Sophie, who have been very supportive in my political and business career. Unfortunately, that has meant I have not always been around in Rainow as often as I would have liked. For things such as homework, sea cadets, rugby, horse-riding and ballet, I have not always been there to support them. But Rainow is of course an idyllic, ancient and rural community; it is a wonderful place to live and work, and to bring up a family.
On a personal note, I am the product of a working-class family, born in a post-war south Manchester council estate. I attended a local comprehensive school, which I left with few qualifications to stack shelves in a local supermarket. However, I developed a passion for politics and an aspiration for business development. I studied at night school for 10 years to get qualified during that period. Working in the technology, aviation and hospitality sectors in senior business development roles, I was able to earn a good living and provide for my family. I hope and believe that my business background will add value to this place. Change is a constant and it is something we need to get right if Great Britain is to prosper in an increasingly competitive and uncertain world.
My Lords, the disadvantage of the Minister making his maiden speech at the end of the debate is that there is nobody to welcome him at the end of it, so I shall just exceed my brief and congratulate him on an excellent maiden speech. I welcome him most warmly to the House.
2:49 pm
Sitting suspended.
Lone parents, the disabled, carers, the unemployed and those experiencing hard times are particularly targeted by the Government. Women make up the majority of social security recipients and have been more affected by social security cuts and benefit freezes, which basically punish the poor for being poor.
The Joseph Rowntree Foundation has stated:
“From 2013-2019, ministers chose to reduce benefits in real terms by freezing their value or increasing them by a lower rate than inflation”.
If that was not bad enough, the Government also increased taxes on the less well-off. In 2010, the Government increased the standard rate of VAT from 17.5% to 20%. Inevitably, a greater proportion of less well-off people’s income goes in taxes. An analysis published by the TaxPayers’ Alliance, which is much closer to the Government’s ideology and cannot be accused of being a leftie organisation, stated that families in the lowest income categories paid 47.6% of their gross income in direct and indirect tax in 2017-18, compared to 33.5% paid by the richest 10%. Regressive tax policies continue.
The underfunding of public services has condemned perhaps millions, but certainly thousands, to hardship and death. In 2010, NHS England had a hospital waiting list of 2.5 million. By 2019 that had ballooned to nearly 4.5 million, due to underfunding, and now stands at 7.2 million. In 2016, the outcome of Exercise Cygnus informed the Government that the NHS would not be able to cope with a flu pandemic, but they still reduced the stock of PPE and the number of beds. Too many people have paid for that decision with their lives.
The Government’s taxation, wages, social security, public spending and other policies have inflicted death on innocent people. The paper which is the subject of this debate particularly draws attention to the gendered nature of the austerity, and notes that among poorer populations, death rates have worsened to a greater extent among females than males. Yet I have never seen a Conservative Budget that explains the gender impact of the Government’s policies. The last Budget, in November, mentioned women just once. There was really nothing there for women at all. I look forward to the Minister’s response and hope that he will refrain from citing the usual gaggle of this or that support being given to people, because none of that has prevented the death toll to which I referred.
We have just celebrated Christmas and its message that “Thou shalt love thy neighbour as thyself”, yet it hard to see any of that spirit in the Government’s policies when they focus only on the richer neighbours. Despite all the evidence, the deadly austerity policies continue. Can the Minister explain what the squeeze on low and middle-income families has achieved? People can clearly see that it has increased neither prosperity nor the happiness of the people. Millions rely upon food banks—tacit confirmation that government policies have failed. Schoolchildren are going hungry, while senior citizens are forced to make choices between heating and eating. Social squalor is increasing. Austerity has impeded economic development and deepened inequalities. It has increased insecurity and anxiety, and the need for health and social care. The underfunding of essential services has denied life to many.
During the Second World War, bombings by the Luftwaffe caused about 70,000 civilian deaths. Yet this Government have condemned 335,000 people to death, all in the name of some defunct economic ideology. Have any other UK Government inflicted this level of harm on their own people? If so, perhaps the Minister will name them. Every deceased person was someone’s relative or friend. Millions will live with that pain, knowing that their deaths were avoidable. What satisfaction do the Government get from their austerity policies? I would be grateful if the Minister, who speaks here for the Government, could commit to three specific pledges: first, to appoint an independent inquiry into the deaths caused by the Government’s policies; secondly, to redistribute income and wealth to reverse grotesque levels of inequality; thirdly, to ensure that the impact assessment of all Bills is accompanied by an assessment of the human consequences of the policies they contain.
Through two townhall sessions, we heard some extraordinary stories of faith groups which had stepped up in the pandemic to advocate for public health and deliver healthcare solutions in, for and with their communities. For example, we learned from a senior leader in the Jewish community in north London who had designed a vaccination service that hosted separate sessions for men and women with the Jewish Hatzola ambulance service. They also made sure that rabbis were vaccinated, because they understood the influence they carried in their communities. Another example was the setting up of a mortuary by a mosque in east London, because many were dying in the pandemic and “there was a lack of cultural knowledge about how a burial for the Muslim community happens, so we did it ourselves”.
Faith groups know well the people who often fall into the “hard to reach” category in public health. They are already serving them, not just with health services but for other needs. It is hard to overstate the value of this relational capital to advocate for good public health. There is a track record of successful partnerships between faith groups, local authorities and healthcare providers. For example, the South London Listens campaign saw community and faith leaders come together with citizens to work with three NHS trusts in south London to improve mental health services there post pandemic. The Faith Covenant, established by the APPG on Faith and Society and FaithAction, also does good work on collaboration and tackling mistrust between faith groups and local authorities.
However, there is still a variation of experience and a lack of literacy among both local authorities and healthcare professionals in how they relate to faith groups and vice versa. There is a lack of systematic recognition of the importance of faith to those who have one, which means that people do not feel that they have access to health services. On top of that, the extent of health inequalities can be misunderstood. There is also a lack of collection of ethno-religious data. As the Marmot Review 10 Years Onmakes clear, this is needed in the academic analysis of inequalities because, without such information, understanding ethnic inequalities is difficult.
We have had the opportunity to work to reduce health inequalities through both access to healthcare and the social determinants of health for prevention. Faith groups have something to offer here and could be transformational for health. What efforts are the Department of Health and Social Care making to engage with faith groups genuinely to ensure that health provision is being made more accessible? What effort is being made to ensure that effective data is collected so that we might have a clearer picture of local health inequalities?
To turn to the current situation, why are there reports in the press about very high excess deaths? It is because most of these reports compare historical data, but this underestimates deaths and demographic evolution and, as a result, overestimates excess deaths. What we need to do is to use the gold standard for this type of analysis, which is to use age-standardised mortality rates, removing the effect of the changing age structure. Clearly, as the population ages, we should expect more deaths.
However, if you dive into the figures, you find something interesting and important: there is little excess mortality explained by the demographics and Covid among the population over 65, but you find excess deaths in younger age groups, particularly those under 44. Two possible reasons for this can be dismissed; the pattern of excess deaths simply cannot be explained to any significant extent by the rollout of vaccines or the deferral of medical treatment due to the Covid epidemic that would otherwise have taken place. Absent these explanations, everything points to the increasing pressures on the NHS—particularly since last April—being the trigger.
I must refer here to the work of the Stuart McDonald, a partner at the consulting actuary firm LCP and star of this week’s BBC Radio 4 programme “More or Less”. I should mention in passing that I was once employed by LCP as a trainee many years ago. Stuart and his team have concluded in terms that:
“Our analysis suggests that a significant number of patients could be dying because of long delays accessing emergency care. We estimate this number at over 400 deaths each week between September and November, though it might be higher.”
He tweeted earlier today that:
“Data for December has just been published and paints an even worse picture. 2,200 additional deaths associated with A&E delays in December alone. That is 500 per week.”
Putting these two things together, the level of excess that we see is, to a significant extent, due to the long-term increases in waiting for medical treatment, exacerbated more recently by delays in accessing emergency care. This is the sharp end of austerity. The sooner it comes to an end, the better for the health and longevity of our whole population.
I hope that the Minister can inform the House of the Government’s plans. The absence of NHS policies in the levelling up Bill is a missed opportunity to address the serious issue of health inequalities. We are told that there will be a disparity Bill, but when will that be? Perhaps the Minister can say. The increasing health inequalities will continue to drag the NHS down. The resulting ill-health will mean low productivity and less economic growth. The Government have suggested that a Cabinet-level forum will be established, and the Prime Minister has promised to tackle this issue. Therefore, I hope that we will soon have government policies to do so, although I fear maybe not.
There is an urgent need to develop cost-cutting policies that will affect positive change and take a long-term view, reflecting that success is predicated on leadership by government and action from a range of organisations, outside help and care systems. Will we see such a plan from the Government before next summer?
While the paper looked at lifespan, with its focus on mortality rates, I want to mention the importance of looking at health span, defined as the period of life we spend in good health, free from chronic conditions and the disabilities of ageing. This builds on the comments made by both the right reverend Prelate the Bishop of London and the noble Lord, Lord Patel.
Health span is also likely to be affected by spending squeezes, especially if there are reductions in preventive health measures and delays in the treatments necessary to restore someone’s health. We can look at examples such as a delay in getting surgery to replace a hip or knee. That may not itself change your lifespan, but it certainly means more time spent living a life restricted by the health condition. This is the real cost of the increased waiting times we are seeing for elective surgery at present, which many people are sadly paying today: their health span has been reduced because they are unable to access surgery or other treatments that would enable them to live a fully healthy life again.
Similarly, a failure to provide timely advice and support to somebody who is at risk of developing type 2 diabetes may lead to them facing health problems that could have been avoided, or at least mitigated, with the provision of the right public health services. Again, any impact on their lifespan may be years down the line, but their health span is more quickly and immediately shortened. I hope the Minister’s response covers points related to health inequalities, as well as those related to mortality.
Reflecting on some of the points made by other noble Lords, the right reverend Prelate the Bishop of London rightly drew our attention to the multifactorial nature of the determinants of health. We certainly need to look at issues such as housing, as well as more obvious issues related to health treatment. The noble Lord, Lord Davies of Brixton, helped us to understand how we should look at the mortality figures. In the debate yesterday, I learned a lot about how actuaries think, and the noble Lord is providing an incredible resource for all of us in understanding how to look at the data.
I close by again looking forward to hearing the Minister’s response. I congratulate him on his arrival to the Front Bench, and I hope he will be equally supportive of encouraging and—dare I say it?—funding more research into the kinds of projects and questions looked at in this paper. It is essential from the public interest point of view that we do not shy away from difficult questions about the effect of policies on people out there, in the real world, that we and this Parliament have decided on.
The study adds to the growing evidence of the deeply worrying changes to mortality trends in the UK, with a clarion call from the study’s authors to the Government to reverse harmful austerity policies and to instead implement measures that protect the most vulnerable in society. I look forward to the Minister’s response on this.
I have spoken many times on the adverse effect of austerity measures on women, as have noble Lords from across the House. These are clearly set out in the study: women are recipients of huge cuts in social security as lone parents, the carers of children, the elderly, people with disabilities and single pensioners without joint incomes. The axing of and cuts to vital public services in which women are employed, or which support families and caring activities, compound the impact on women and their physical and mental health.
I commend the excellent work of the Women’s Budget Group, which reinforces the extent to which public services have been weakened by 10 years of austerity going into the global pandemic in 2020. Its impact was reinforced by the statistics from my noble friend Lord Sikka and others. Government spending on public services as a share of GDP decreased from 47% to 40% in 2019, and central government funding for councils in England was cut by over 49% between 2010 and 2017-18. The group’s work with the Runnymede Trust showed just how austerity hit particular groups of women hard, especially black and ethnic minority women.
The JECH study refers to the intersectionality of gender, poverty and ethnicity in assessing and quantifying the impact of the cuts. For example, comparisons among the poorest of the population showed that white women lost 11% of their income compared with 8% of poor men, but for black and ethnic groups this was 14% and 9% respectively. Can the Minister tell the Committee what cross-government work is being undertaken to ensure joined-up work to address this?
I will focus especially on those with learning difficulties. The learning disabilities mortality review sets out the stark reality of the impact of increasing mortality rates on this key group. Currently, men with a learning disability die on average 22 years younger, and women 26 years younger, than their peers among the general population. Only four in 10 people with a learning disability live to see their 65th birthday, and in 2021 a shocking 49% of reported deaths were avoidable. Some 1,200 people die avoidably every year when timely access to good-quality healthcare could have saved them. These inequalities are national and systemwide, with huge regional differences in how services meet their needs. For example, those living in the north-west and the Midlands are at greater risk of avoidable deaths. Can the Minister explain what action the Government are taking to address the specific barriers to receiving good-quality healthcare for people with learning disabilities, regionally and nationally?
Finally, the charity Mencap has stressed the vital role that the GP learning disability register plays in raising awareness, but less than one-third of the estimated 1.2 million people in England with learning difficulties are recorded on it. Crucially, the register helps doctors and healthcare staff to understand the support needs of this key group. Mencap has called for a national campaign to increase the numbers on the register. It has also produced specific guidance to explain its value, aimed at black, Asian and minority ethnic communities. What steps are the Government taking to support the increased use of the GP register and ensure that GP surgeries actively encourage sign-up?
This has been an excellent and very thorough debate. I look forward to the Minister’s response.
Turning now to the debate, I am pleased to respond to noble Lords who have contributed on this important issue and thank the noble Lord, Lord Sikka, for securing this debate. I pay tribute to the Journal of Epidemiology and Community Health for its report, which explores whether there is a link between the Government’s action to reduce national debt and women’s stalling mortality rates. It concludes that the causal effect “remains unclear” but it raises important policy issues regarding gender differences in work and health, as well as health disparities more broadly.
As set out by the Chancellor in his Autumn Statement and reiterated in the Prime Minister’s address, the Government are committed to reducing the national debt. This is a top priority but noble Lords will agree that a better future is one where our economy grows. It leads to better opportunities for all, particularly in work. We are improving job opportunities for women and ensuring that when women are in work, they are paid equally to men. We achieve this through a range of initiatives including our Great Britain-wide network of jobcentres, the job entry targeted support and restart scheme and DWP’s new progression offer for those already in work. We are committed to working with businesses to accelerate progress and make workplaces fairer. This is enabled by our ground-breaking pay transparency pilot, a number of new returners programmes and our task force on women-led high-growth enterprises.
Turning specifically to women’s health, we know that work and health are inextricably linked. Improving health improves wealth, with long-term ill health a leading cause of economic inactivity. Therefore, as well as addressing women’s access to work, we must ensure women have equal access to healthcare that addresses their specific needs. Although women in the UK on average live longer than men, women spend a significantly greater proportion of their lives in ill health and disability when compared with men. Greater focus must be placed on women-specific health issues such as miscarriage or menopause, and much progress must be made to ensure that women are better represented in vital clinical trials.
The Government are absolutely committed to improving women’s health outcomes. Our recent call for evidence received over 100,000 responses, which informed the first ever government-led Women’s Health Strategy for England. This approach marked a reset in the way the Government are looking at women’s health. The strategy set out how we can improve the way the health and care system listens to women’s voices and boost health outcomes for women and girls.
The final point from the report I want to address is the assessment of the disparities in mortality trends. There are stark disparities in how long people live and how long they live in good health across England. The Government remain committed to the ambition set out in the levelling-up White Paper to improve healthy life expectancy by five years by 2035. As a significant proportion of ill health is preventable, as the noble Lord mentioned, we are focusing on the major conditions which contribute to early mortality and reduce years of good health, as well as on factors such as smoking, poor diet, and alcohol, which disproportionately impact some communities. For instance, we have funded 220,000 blood pressure monitors for people diagnosed with uncontrolled high blood pressure, to empower people to monitor their own health.
We are also modernising NHS health checks, which prevent heart disease, stroke, type 2 diabetes and some cases of dementia and kidney disease, including developing a digital version to increase participation. The Government recognise how important it is to protect and promote the job opportunities and health of the British people, particularly the most vulnerable. The measures I have outlined today will help do that and I look forward to working with noble Lords across this House to share progress and improve the outcomes for women and girls.
I will attempt to answer as many questions as I can in the time available, but if I am unable to do so, please forgive me: I will write after this meeting. The noble Lord, Lord Sikka, asked me to explain why the Government have chosen to squeeze lower and middle-income families. We have announced further support for next year, designed to target the most vulnerable households. This cost of living support is worth £26 billion in 2023-24, in addition to the benefits uprating worth £11 billion to those of working age and the households of disabled people. I might also add that the Government increased the personal allowance to take some of the lowest paid out of tax altogether, while at the same time removing the personal allowance for the highest paid.
The right reverend Prelate the Bishop of London asked about health equality in the White Paper. The Government are committed to supporting individuals to live healthier lives and at the heart of this is improving access to and levelling up healthcare across the country. No decisions have been taken in relation to the White Paper, but we will publish further information on addressing health disparities in due course. I congratulate the right reverend Prelate on the faith work that she has done. I too do that in my own parish of Rainow, walking from church to church, but there are a lot of hills and valleys in the way and you have to be committed to do it.
The noble Lord, Lord Patel, asked what plans and policies the Government will put in place to reduce inequalities. The Department of Health and Social Care is investing £170 million in essential services in the 1,001 days of the Best Start for Life period. We have funded 220,000 blood pressure monitors; we are also modernising NHS checks to drive prevention of heart disease, stroke and type 2 diabetes.
The noble Baroness, Lady Wheeler, and the noble Lord, Lord Davies, asked whether the Government will comment on excess deaths. A detailed assessment is not yet available but it is likely that a combination of factors has contributed to the ONS measure of excess mortality, including high flu prevalence at the moment, ongoing challenges post pandemic, Covid-19 and health conditions such as heart disease and diabetes. As I say, I will write further to noble Lords after the meeting.