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Health Inequalities

I congratulate my hon. Friend the Member for Wigan (Mr. Turner) on securing the debate. I am most grateful to the hon. Member for South-West Norfolk (Christopher Fraser) for explaining his situation. It is valuable for us to be able to understand what has happened; we all have three or four things to do at once. I am most grateful to him; I was a little shocked, but am no longer. I was very impressed by my hon. Friend’s opening contribution. He clearly outlined the shameful situation that the national health service was in before 1997 and the staggering range of services and level of investment that there has been in the NHS, certainly in the past 10 years. It has been overwhelming, in some ways, to see, in my patch, James Cook university hospital becoming one of the national cardiac centres. It has also been valuable that the university hospital of North Tees has developed teaching capabilities as well as serious competences in many areas of the health service. Like my hon. Friend I am keen to put on record the fact that the Government have supplied considerable investment. However, like other hon. Members I often feel that we have an inflexible formula, which works on averages, so that the chronically deprived areas in our constituencies, which frequently experience serious health hazards, are outside that formula. The special interest group of municipal authorities within the Local Government Association has often spoken to the Secretary of State for Health, and other Ministers. The point is always pressed that fair funding must be seen to be a fact throughout the health service and throughout Great Britain. I agree, but my problem is that I do not see fair funding. I do not have any problem with research-based hospitals and teaching-based hospitals receiving phenomenal increases in their funding. I realise that they must have them. However, I believe equally that the time is long overdue for us to pay attention to areas such as, in my own patch, Mandale and Victoria ward. There, average life expectancy is 58. In Hartburn and Fairfield there are very low levels of deprivation. It is delightful that they have people with above-average salaries, with the lifestyles that they accommodate. Those people have a life expectancy of 78. That is a serious issue, and it is long overdue to be dealt with. It has been sidelined by statisticians or by people who are trying to construct a formula that works for all people. I accept unequal spending, but not unequal treatment of people and their needs. In wards with a high deprivation factor the characteristics are pretty universal. I am convinced that all hon. Members would say the same about them. Those characteristics are: low birth rates for children; high rates of illegitimate births to teenage girls; obesity rates that are a significant contributor to poor health; and significant incidence of cardiac problems and cancer. The issue is not just health, but much more. It is a question of poor rented private housing, long-term sickness, pools of permanent unemployment, and part-time and low-paid work. All those contribute to the situation, as does cigarette smoking. Who am I to complain about that? I do complain, as hon. Members can well imagine, and ask people not to do it, but when they are dealing with enormous stress a cigarette becomes their friend. We must move in to support and help, reassure them and get their trust, and get them off that frankly filthy habit. The characteristics of parts of the wards in my constituency are the same as are found in other hon. Members’ constituencies, so how is it that we still do not deal with the problems? Why does our funding formula, which may or may not be generous, not include the people in those areas? Why does it not involve asking when they went to the GP last and which clinic they visit? Those people do not trust and are not confident; they have no self-belief and do not put themselves first. They are the last in the queue. We—individuals—are persuading them to take up all sorts of opportunities, but it is the job of the national health service. My local authority works closely with the health service. The relationship between social services and the primary care trust is a keen one. As my hon. Friend the Member for Wigan said, our Supporting People grant was 177 per cent. off what it should have been. When I have made that argument I have received nods of sympathy and little else. Sympathy ain’t what I am here for. I want action that drives resources to people who need them. Stockton’s PCT and the local authority social services offer a model of excellence. They share knowledge and resources. They work the streets. However, it is a hard routine getting people to trust, to come on board, to hear the good news and to hear about the services that should be available to them. The absolute statement for me is that my local PCT is 6 per cent. below where it should be. Our Supporting People budget is below where it should be. Our health budget is below where it should be. We cannot ensure that the work that needs to be done in very high deprivation pools is done if we do not have the people to work those streets and the resources to employ them. I am therefore saying to my hon. Friend the Minister that we need greater specificity in the way that deprivation is handled in all budgets, but most particularly in the health budget. I was delighted to read some of the material from the Advisory Committee on Resource Allocation. It is clear that ACRA believes that we have to use weighted capitation. It is clear that it wants a separate health inequalities formula. It believes that if we are not specific about the work that we ask PCTs to do, we will never give to all people that which they deserve—fairness. Good health and good living standards should be theirs as of right, not because of someone fighting for that. I would appreciate hearing what the Minister has to say about ACRA. I want to know when the Government will come on board with this. I would like to believe that he will tell us that the Mandale, Victoria, Hartburn and Fairfield distributions will be acknowledged in the future and that all people will be treated fairly under the funding formula.