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Health Inequalities

The hon. Gentleman pinches a later part of my speech, and although I appreciate that he cannot stay in the Chamber for long, if he will excuse me, I would rather not answer him now. I will do so later and he can read it in Hansard. ACRA was asked to put greater emphasis on areas with health needs and to ensure that the resources went to tackling them. We should make it clear that ACRA is an independent body; it is not appointed by, or answerable to, the Government. The university of Bristol is its lead academic institution and the body is medically advised. Its report and allocations are robust and, being an independent body, it cannot tell the Secretary of State what to do. I accept that, but it is important that the body advises the Secretary of State on how to make allocations, as it has. I welcomed the report when it came out, because, as the hon. Member for St. Ives (Andrew George) said, areas of severe deprivation got quite an additional increase in the resource allocations to recognise their health inequalities and deprivation. We know from the Black report and all sorts of studies that are constantly but rightly paraded before us that deprivation is a major cause of ill health, so putting the emphasis on deprivation will ensure that resources go to tackle ill health. We know too that access to primary care is vital if we are to tackle ill health. One difficulty is that if people do not have good primary care in an area, they will use secondary care—the hospital, or the accident and emergency department—rather than their doctor. If they do not have one, or if they know that the surgery will be full because there are insufficient doctors in the area, they will not bother going. Instead, they will wait until their condition worsens to such an extent that hospitalisation is the only solution. That puts more pressure on the health service in general, and on the primary care trust in particular, because it has to pay for hospitalisation, whereas if it had had the resources to provide more access to primary care, people might have been treated much earlier and more cheaply.