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Health Inequalities

Ever since my election to this House in 1997, health inequalities has been one of my major campaigns. I therefore congratulate my hon. Friend the Member for Wigan (Mr. Turner) on securing this important debate. Regrettably, Bolton is included in a list of the 15 per cent. most deprived boroughs in the country, with 37 per cent. of its population living in the 20 per cent. most deprived wards. Of the three Bolton parliamentary constituencies, mine demonstrates the most deprivation, followed by Bolton, North-East, then Bolton, West. The Royal Bolton hospital, which has the second busiest accident and emergency department in Greater Manchester, is situated in the heart of my constituency. Several diverse ethnic minority communities, mainly from south-east Asia, live in Bolton, particularly in my constituency. They present special challenges to the national health service, such as different diseases, cultures and styles of living. For example, 23 different languages are spoken in one of my primary schools. Such a situation is a challenge to the NHS. Bolton is a low-wage economy. The median pay is only £317.60 per week, compared with the England average of £369.40 and the north-west average, which stands at £344.20. Worklessness, as represented by those receiving jobseeker's allowance, incapacity benefit or severe disablement allowance, is high at 12.9 per cent. The figure reaches 49 per cent. in the most deprived wards in Bolton. In the past, the principal industries in the town were mining and cotton textiles, supported by heavy engineering. They have caused considerable incapacity and disablement, particularly in our older population. That is a feature of all the old industrial towns. In some Bolton wards, life expectancy today is under 67, with a 15-year gap between the rich and poor areas of the town. In 1997, the Wigan and Bolton health authority was considerably underfunded; I believe that the figure was about £14 million at that time. I compliment the Government on introducing the pace of change policy, which has brought more money to constituencies such as mine. Unfortunately, as my hon. Friend pointed out, the pace of that policy has been rather slow, and in some cases we have actually gone backwards, as I shall demonstrate. There are just not enough doctors or dentists in Bolton. That is particularly true of the most deprived areas of the town. Bolton's primary care trust, which is coterminous with the borough boundary, is currently just over 2 per cent. away from target in the three-year allocation leading up to 2007-08. That equates to a shortfall of £8 million. Compare that with affluent Richmond and Twickenham PCT, which receives 12 per cent., or £27 million, above target. As my hon. Friend said, such discrepancies simply cannot be right. In November 2004, the Government defined spearhead local authorities as those rated in the worst 20 per cent. in the country in three out of five categories, which my hon. Friend defined. Bolton qualifies in four of those categories. The average spearhead PCT was 1.1 per cent. or, on average, £2.6 million under target in 2006-07—Bolton is at 2 per cent.—while the non-spearhead PCTs received, on average, 0.5 per cent. or £1 million over target. The differential is reducing. Bolton PCT's figure has reduced, but only from 2.0975 per cent. to 2.035 per cent. Not surprisingly, especially in view of Bolton's health legacy, which I described, I would support accelerating a reduction in the health inequalities that have existed not only in my constituency but in others for far too long. A recent analysis of cancer mortality rates in the north-west for spearhead versus non-spearhead PCTs has shown an actual worsening of the position by 4.4 per cent. for men and 19.7 per cent. for women. Instead of the 6 per cent. absolute reduction required by the Government's public sector agreement targets to reduce health inequalities between the fifth most deprived areas and the rest by 2010, the gap has increased in the north-west. Stomach, cervical, lung, and bladder cancers are of greatest concern, especially among women. I assure the Minister that Bolton is doing everything possible within its financial capabilities to reduce the health inequalities in our town, even by using non-health pots of money such as neighbourhood renewal funding to pump-prime interventions, but we need more help than we are currently getting. That is what this debate is about.