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Health Inequalities

I think that this is the first time that I have had the pleasure and honour of serving under your chairmanship, Mr. Jones. It is a great pleasure to be under your tutelage and guidance for this one and a half hour debate that I have managed to secure on primary care trust health funding. It would be remiss if we did not first put into context just where we are at present, and how far we have travelled in the past 10 or 11 years. We should remember that just before the 1997 election, my party said that we had 24 hours to save the national health service. When we look back at some of the things that have happened since that time, we can see that it was not an idle boast and that we have actually achieved it. One of the first things that we did, of course, was to ensure that we increased the pay of nurses, doctors, auxiliaries and technicians so that they no longer had to scratch around looking for jobs and additional work outside the health service. We put in place proper career structures so that they could see that there was progression from one post to another right the way through, and, much more important than all of that, we put many more staff in all sections and categories in the NHS. The effect of those changes has been dramatic: waiting lists are down dramatically and waiting times have almost been eliminated. In Wigan borough, the time between going to a doctor and seeing a consultant is down to 18 weeks. I doubt if it could get much shorter than that. When we compare the present with the years between 1979 and 1997, we see that improvements have been made. Forty-hour waits on trolleys in accident and emergency were not unusual. They were highlighted in the papers all the time. People were forced to go to private practice not because they wanted to but simply because they could not bear to see themselves or their families continue in ill health and in pain. They could not wait the two to three years that it often took before they could see a consultant, let alone get treatment. We had the unenviable and disgraceful situation of workers in other areas going out on strike to support nurses who were trying to get a decent wage for themselves. All that happened between 1979 and 1997, and we have managed to overcome it. Probably the worst thing of all was the Black report, smuggled out on the eve of a bank holiday so that it would not get into the papers and would not be discussed, even in Parliament. When it came out, it was totally ignored by the Government of the time. Why was it ignored? Because it showed the disgraceful health inequalities that existed in our country. Not only that, it demanded action. The improvements at every level since 1997 are absolutely huge. Let me list a few of the improvements that we have seen in the Wigan borough. We have a walk-in centre at Leigh and a new A and E and trauma centre at Wigan hospital. We have a new cardiovascular unit, and an orthopaedic centre at Wrightington hospital. Just to remind Members, Wrightington was where the first ever hip replacement operations in this country were carried out. It is a world centre for orthopaedics and it has been improved. We have the Thomas Linacre out-patient centre, and, if all that does not work, we also have a new mortuary. All those new facilities and all the additional staff—consultants, doctors, nurses, technicians and auxiliaries—have led to dramatic improvements in the health of the people of Wigan and the entire country. We have also seen improvements in primary care, which is vitally important. We have new general practitioner-led health centres, which do away with GP surgeries in two-up, two-down houses with no parking facilities, no disabled access and no facilities to do anything other than the most basic of investigations. There are new polyclinics. One is at Boston house, only a quarter of a mile from where I live. A renal dialysis unit, physiotherapy and mental health services, GPs and pharmacists are all in one centre. People can go there and get proper treatment in one place. Others polyclinics are at Clare house, and in Ince and Leigh, and there are many more to come. They are hugely important in improving access to primary health care and the level of service. They offer a massive range of services that will improve people’s health—there is absolutely no doubt about that. However, we know that despite all those improvements, health inequalities still exist. Not only do they still exist but they have not really improved much in the past 10 years. Both the Secretary of State and the Minister are anxious to do something about that, and we want to help them to reduce health inequalities dramatically. When the current Secretary of State was appointed, he made it an absolute priority. He often quotes the statistic that for every station one passes on the Jubilee line going east from Westminster, people’s life expectancy decreases by one year. He stated:""People in poorer areas, with lower life expectancy, have always had the least access to primary care. Cambridgeshire has more than twice as many doctors as Manchester, and men in Cambridgeshire will live six years longer."" That is not acceptable in a modern society, and it is not acceptable in the UK. I welcome the many initiatives that have been put in place by the Secretary of State and his predecessors to tackle health inequalities: the healthy towns initiative, spearhead PCTs, the extra GP surgeries that are going into my constituency and many other under-doctored constituencies right across the country, and the open access GP surgeries that will be provided as well. However, welcome as those things are, I do not think that they will actually solve the problem. There needs to be more recognition that initiatives should be backed up by more and more core funding in areas with health inequalities. That has been recognised: one of the first things that the present Secretary of State did when he took office was to ask the Advisory Committee on Resource Allocation to look at the formula for dividing up health funding.