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Health Inequalities

I congratulate the hon. Member for Wigan (Mr. Turner) on having started this very important debate. I shall start uncharacteristically by congratulating the Government on putting a lot of money into the health service—it is a lot of money—on registering the problem of socially differentiated outcomes in health and on endeavouring to address it. Sadly, that is where the congratulations stop, because they have not been successful hitherto. There are two possible explanations for that: one is that the Government are not particularly competent; the other is that it is a very hard problem to address. The facts are still fairly stark. I know the story that going eastwards on the Jubilee line, each station represents a year knocked off a local person’s life expectancy. I do not know whether anyone has checked that recently, but it is an often repeated mantra. I know the story about children in the inner-city Manchester area dying far sooner than those born in Kensington. I came across a chilling statistic the other day that the Government should think hard about: babies born in poor families in 2008 had a 70 per cent. higher than average chance of dying. That figure has worsened—worsened—since 1998. Allegations have been made about the ability of the UK to address health inequalities compared with other nations. The evidence on that is pretty mixed. I am not convinced that we are necessarily worse or better at addressing this issue than other European nations. Clearly, part of the problem is that we are dealing with an extremely difficult problem. Health inequalities are only partly an issue of NHS resources. They are also, as the right hon. Member for Oxford, East (Mr. Smith) said, an issue of housing, education, cultural factors in some areas, nutrition, smoking and drinking habits, and employment history—or lack of it. As unemployment goes up, health outcomes will undoubtedly get worse. Obviously, the NHS alone cannot address a problem of this nature and size and it looks to alliances with other agencies and branches of government, so there is now in many areas a plethora of partnerships. By themselves, they are no substitute for political policy and will. They can be, to some extent, cosmetic: once the partnerships are in place, everyone thinks that the job is done, although in fact progress is not quite what we would expect. None the less, it is a fact—many hon. Members have harped on this—that NHS resources, as well as objectives, count, and count decisively. Clearly, we need to apply resources at the PCT end to great effect. However, the whole business of allocating resources, as has become apparent in the debate, is extraordinarily contentious. Addressing inequalities is not quite the same as addressing need. The most in need, technically, are the elderly, because the worst thing that people can do for their health is get old. However, areas with high numbers of elderly people are not necessarily the same areas that have, for example, low weight ratios for babies, premature deaths and high rates of working-age invalidity, although in seaside towns—there has been a report on this relatively recently—there can be both.