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Health Inequalities

My hon. Friend is absolutely right and raises an important issue. We have not merely been underfunded for the past three years; the underfunding is historical and goes right back to 1948, when the NHS was formed. The number of GPs that our PCTs are able to employ and the number of interventions that we can make in our areas are seriously lower than in the areas that I have identified as being over target. That is not only because of the funding of the past three years, but because of the nature of the funding, historically. All that impacts on health inequalities. Whatever happens in this comprehensive spending round and whatever Ministers are able to do about the problem, the impact will not be immediate or dramatic—it will be a long haul. We must recognise that it will take a long time to reduce the health inequalities in our country, and we must make a start now. In August 2007, guidance was given to spearhead PCTs on reducing standard mortality ratios in a range of areas. In Wigan, although cancer mortality rates are down, they are not down as much as for the country as a whole, so the gap is widening. Life expectancy in Wigan is improving, but only at the national rate—the gap is staying the same. With cardiovascular diseases such as heart attack and stroke, our SMRs are consistently 40 per cent. higher than those for the UK, nationally. Those PCTs that have been identified as spearhead trusts have been given no extra funding to tackle those issues. Where specific funding has been given—for smoking cessation services, for example—and practice nurses have been used in GP surgeries to screen for cancers, there have been dramatic improvements. The lesson that we can learn from that is that additional resources bring improved results. In 1997, in a reversal of the disgraceful attitude of the previous Tory Government, Labour commissioned Sir Donald Acheson, the then chief medical officer, to review health inequalities. His report made 39 recommendations, only three of which were directly related to the NHS. Inequalities in health indicate that there is wider deprivation and have an impact on that deprivation. This is an important point. We are not just talking about inequalities of health as a result of deprivation: inequalities of health and in the way in which people are unable to contribute to the local economy help to create deprivation in those areas. Other agencies, particularly our local authorities, will have to tackle areas of multiple deprivation. That point was recognised in the 2002 Wanless report, in which Wanless drew particular attention to personal social services. Many local authorities and PCTs, including my own in Wigan, now have joint commissioning and pool the funding for those services. But there we hit yet another difficulty—many of the local authorities covering the areas in which PCTs have below-target funding are themselves inadequately funded. Just as the Department of Health has a formula to calculate health needs and allocate funding accordingly, so does the Department for Communities and Local Government. Just as that formula is not followed by the DOH, it is not followed by the DCLG. Almost inevitably, the local authorities that are underfunded in health are also underfunded in local government. Wigan is £10 million underfunded in local government, while Westminster is £18 million overfunded. Bradford is £12.5 million under, while Brent is £21.5 million over; Newham is £15 million under and Barking and Dagenham is £14 million under, while Richmond is £13.5 million over and Wandsworth is £49 million over.