4.37 pm

Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)

I welcome the opportunity to speak in the Chamber for a second time today, on yet another important topic. This time we are debating health inequalities and I thank the Backbench Business Committee for allowing this debate to take place following the application by the hon. Member for Totnes (Dr Wollaston) and other hon. Members across the House. The hon. Lady made an excellent speech, and we are very grateful to her for that. I also want to thank other hon. Members across ​the House for their excellent contributions today. I especially want to highlight the excellent speeches by my right hon. Friend the Member for Kingston upon Hull West and Hessle (Alan Johnson) and my hon. Friends the Members for Stockton North (Alex Cunningham), for Bradford South (Judith Cummins), for Heywood and Middleton (Liz McInnes) and for Hackney South and Shoreditch (Meg Hillier).

I enjoyed the speeches by the hon. Member for Plymouth, Sutton and Devonport (Oliver Colvile)—a fellow member of the all-party parliamentary group on basketball—and by the hon. Member for Erewash (Maggie Throup), who made an excellent speech on obesity and childhood obesity. I also enjoyed the speech by the hon. Member for Glasgow Central (Alison Thewliss). As she knows, I agree with most of what she says, especially about breastfeeding. We have had an excellent debate, with excellent contributions all round.

When it comes to addressing health inequalities, there are many conversations about the need for systemic change to reverse the trends. However, in my contribution today I want to look at tangible specifics that the Minister can get to work on in her remit as Minister for Public Health. I will do that by looking at the current state of health inequality and then the two key areas of smoking and childhood obesity and what more can be done to address those signifiers. I will then move on to the cuts to public health grants, which are exacerbating the situation.

The most recent intervention on health inequality came from the Prime Minister, who used her first speech on the steps of Downing Street to highlight that,

“if you’re born poor, you will die on average 9 years earlier than others.”

We have heard clear examples of that from constituencies around the country. That welcome intervention set the tone of her Government’s serious work to address health inequalities.

It is hard not to agree when the facts speak for themselves. Two indicators from the most recent public health outcomes data show that London and the south-east have the highest life expectancy while the north-east and north-west have the lowest. The same pattern appears when looking at excess weight in adults, about which we have also heard today. Rotherham comes out the highest at 76.2% and Camden is the lowest at 46.5%. Those figures prove what we all know to be true: people living in more deprived parts of the country do not live as long as those in more affluent areas. Contributors to ill health such as smoking, excessive alcohol consumption—which we heard about from the hon. Member for Congleton (Fiona Bruce)—and obesity are more prevalent in deprived areas.

On a moral level, it is important for the Government to address such issues, so that we can improve our nation’s health, but there is also an economic argument to be made. If we have an unhealthy population, we will not be as productive. In England, the cost of treating illnesses and diseases arising from health inequalities has been estimated at £5.5 billion a year. As for productivity, ill health among working-age people means a loss to industry of £31 billion to £33 billion each year. Those two facts must spur the Government into action, but there are many issues to tackle and multiple ways for the Government to address them. Many such issues ​have been raised in the debate but, as I said, I will examine two key areas that the Minister must get right: smoking cessation and childhood obesity.

My first outing as shadow Public Health Minister was to debate the prevalence of tobacco products in our communities and the need for the Government to bring forward the new tobacco control plan.

The Parliamentary Under-Secretary of State for Health (Nicola Blackwood)

indicated assent.

Mrs Hodgson

The Minister is nodding, so she remembers it well. The Government need to set out key actions to work towards a smoke-free society. Smoking is strongly linked to deprivation and has major impacts on the health of those who do smoke, such as being more prone to lung cancer and COPD and facing higher mortality rates. If we look at that by region, which I have already established is a factor in health inequality, smoking levels are higher in the north-east at 19.9% compared with the lowest in the south-east at 16.6%. When looking at smoking by socioeconomic status, we find that smoking rate in professional and managerial jobs is less than half that in routine and manual socioeconomic groups, at 12% and 28% respectively.

In the debate held just over a month ago, the Minister was pushed on when the new tobacco control plan would be published. Concerns have been raised by various charities, including ASH, Fresh NE and the British Lung Foundation, about how the delay could jeopardise the work already done. Sadly, the Minister evaded my specific question back then, so I will ask her the same thing again: when can we expect the new plan? Will it be this year or next year? The plan will not only go a long way to work towards a smoke-free society, but help to reduce health inequalities in deprived areas. The Minister can surely understand that and the need to come forth with the plans.

The Minister knows that I also take a keen interest in childhood obesity. She has said repeatedly that the publication of the childhood obesity plan was the start of the conversation. Childhood obesity is the issue on everyone’s lips right now as it is the biggest public health crisis facing the country. I will not repeat the stats we all know about the number of children who start school obese and the number who leave obese—they are shocking. Many organisations and individuals, including Cancer Research UK, the Children’s Food Trust and Jamie Oliver, have made clear their dismay at the 13-page document that was snuck out in the summer and have said that it did not go far enough. Incidentally, it came out on the same day as the A-level results, so it looked like it was being hidden.

Obesity-related illnesses cost the NHS an estimated £5.1 billion a year, and obesity is the single biggest preventable cause of cancer after smoking. It is also connected to other long-term conditions such as arthritis and type 2 diabetes. When obesity is linked with socioeconomic status, we see real concern that the plan we have before us will not go far enough to reverse health inequality. National child measurement data show that obesity among children has risen, and based on current trends there could be about 670,000 additional cases of obesity by 2035, with 60% of boys aged five ​to 11 in deprived communities being either overweight or obese. There is a real need for the Government to come to terms with the fact that many believe the current plan is a squandered opportunity and a lot more must be done. That is why I hope the Minister will be constructive in her reply to this debate, giving us reassurances that move us on from this being “only the start”. At the end of her speech, the hon. Member for Erewash gave us a list of four or five items that we could start straightaway, which would certainly take us further on.

The Government have stalled or not gone far enough on the plans I have mentioned, but there is also deep concern that the perverse and damaging cuts to public health spending will widen the health inequality gap. The Minister knows the numbers that I have cited to her previously, but I will cite them again, even after my right hon. Friend the Member for Kingston upon Hull West and Hessle has done so. We are greatly concerned about the £200 million cut to local public health spending following last year’s Budget, which was followed by the average real-terms cut of 3.9% each year to 2020-21 in last year’s autumn statement. I want to add some further concerns that go beyond those raised by Labour.

Concerns were identified in a survey by the Association of Directors of Public Health, which found that 75% of its members were worried that cuts to public health funding would threaten work on tackling health inequalities. Those concerns are backed up by further evidence published by the ADPH, which found that local authorities are planning cuts across a wide range of public health services, because of central Government cuts. For example, smoking cessation services saw a 34% reduction in 2015-16, and that will become 61% in 2016-17, with 5% of services being decommissioned. That is seen across the board among local public health services and will be detrimental to reversing health inequalities. For the Government to fail to realise that cutting from this important budget will not help the overall vision on health inequality, set out by the Prime Minister earlier this year, is deeply worrying and shows a distinct lack of joined-up thinking around this issue.

In conclusion, health inequality is a serious issue that we cannot ignore or let the Government get wrong, as the health of our nation is so important, not only in a moral sense, but economically. I know the Minister will fully agree with the Prime Minister’s statement from earlier this year—there is no second-guessing that, as we all do—but we need radical proposals that get to the bottom of this persistent issue, which blights the lives of so many people living in our most deprived communities. We all want to see a healthier population, where nobody’s health is determined by factors outside their control, and we must all work together to get to the point where it is no longer the case that the postcode where somebody is born or lives determines how long they will live or how healthily they will live that life.