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Health Inequalities

I accept that inner cities, particularly London and many of our other major cities, have major problems. They have transient populations; people do not register for whatever reason and the Office for National Statistics has problems ensuring accuracy in the number of people it counts. I recognise all that and hope that ACRA, when it compiles its report and tries to ensure that PCTs get the right amount of money, takes it into account. Importantly, we must have a formula that is as accurate as possible and reflects the real needs of areas. If it does not, I advise my hon. Friend to apply for a Westminster Hall debate, so that she can make her points in more detail. I have no desire whatever to take money away from areas that have major problems; I want to ensure that areas such as mine, Cornwall and others, which have significant underfunding difficulties, are properly funded. Returning to the point that the hon. Member for St. Ives made about allocations, I should say that the average allocation was 11.3 per cent. over two years, which is a welcome and significant increase in funding. There is no doubt whatever that throughout the country the health service has been transformed over the years and will continue to be transformed by the amount of money going into it. The other aspect of the allocation was that at the end of the two years no PCT would be at a distance of more than 6.2 per cent. from its target—the position of the PCT in Cornwall and many others. To ensure that those PCTs were brought up to 6.2 per cent., there had to be a floor of 10.6 per cent.; in other words, no authority would have its allocation reduced by more than 0.7 per cent.—the difference between the 11.3 per cent. average allocation and their 10.6 per cent. allocation. I support the principle of floors. When huge changes must be made to PCT funding or, indeed, to any Government funding, it is right that they are managed properly. However, when the floor becomes so large, at 10.6 per cent., and the differences so huge, great problems are created. If the floor becomes too high and is coupled with PCTs that are massively over-target, it will take far too long under a pace-of-change formula for areas such as mine and those represented by other Members present today both to get the money to which they are entitled, and for authorities to get down to such figures. One of the first speeches that the Secretary of State made when he took office was to the annual conference of local authority children’s and adults’ services directors in October 2008. He said that local authorities were""uniquely positioned to play a major role in tackling the wider determinants of poor health, such as housing and transport, not to mention schools and children’s services… in partnership with the NHS"." I agree. The PCTs and local authorities are working together, pooling resources and personnel. The public health director in Wigan, for example, is a joint appointment between the local authority and the PCT. That is replicated in many areas throughout the country. It is important that that happens. The problem arises where the local authority is as underfunded as the health authority—the PCT. For example, for 2010-11 Wigan is almost £5.5 million—or 3.9 per cent.—below the amount that the Department for Communities and Local Government says it is entitled to under the formula. Hull is just over £7 million below, which is 4.5 per cent; yet Richmond in London is £18.5 million overfunded—a massive 193.8 per cent. When the "Supporting People" programme is added, Wigan is again underfunded to the tune of £5.5 million and Hull is underfunded by £2.3 million. The "Supporting People" programme is important and is trying to ensure that people are able to remain for as long as possible in their own homes, rather than having to go into more expensive and less desirable nursing homes, or other homes, and sometimes even into hospital. If we can get people out of those places and that is what they want, it is a cheaper and better solution all round. "Supporting People" is a good programme, but when it is underfunded, local authorities are underfunded and PCTs are underfunded too, there is a triple whammy of inability to supply the resources to satisfy the various health needs in the area. I just want to touch on the figures in the recent PCT allocations. I shall mention Wigan again, for obvious reasons. At the end of the two years we move £56,000 closer to our target, with the distance from target being £25,381,000. Using simple arithmetic, we can see that it will take us 453 years to achieve the target. I suspect that I will not be around then, but I take some comfort from the fact that looking at the issue in percentage terms, we would move 0.2 per cent. closer in the two years in question and we will only be 4.5 per cent. below. That will take only 22.5 years to achieve. I doubt whether I will be in the House then, but there is a chance that I will still be around to see that happen.