In her capacity as Shadow Minister for Public Health, Sharon was invited to speak to a group of Socialist Health Association members in the North East about public health and prevention. In her speech, Sharon raised concerns over the progress of the Five Year Forward View's promise of a "radical upgrade in prevention and public health" and how the crisis and mismanagement the NHS is facing is currently not allowing this promise to be fulfilled.
You can read Sharon's speech below:
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Thank you for inviting me to speak to you this morning.
The Socialist Health Association is an organisation of academic specialists, medical practitioners and those with health interests within the organisation, and I know that myself and the rest of the Shadow Health team greatly appreciate the work you do to support Labour’s approach to all matters related to health policy.
Health inequality is an issue which we continually need to work on to get right, especially here in the North, where it is well documented that our region and other northern regions have persistently poorer health than the rest of the country. This gap has widened over the last four decades.
Figures show this to be the case, with latest public health outcomes data showing that the North-East and the North-West have the lowest life expectancy compared to London and the South-East, which have the highest.
It was highlighted in the Due North report that since 1965, there have been 1.5 million excess premature deaths in the North due to the disparity in health outcomes.
This is something that cannot be ignored.
This shows what we all know to be true: people in the more deprived areas of the country do not live as long as those in more affluent areas.
This is exacerbated by the fact that those short lives can also be unhealthy lives. Long-term health conditions, cancer prevalence, and addictions are all far more common in more deprived areas of the country.
It is not only the health of people which is affected by health inequalities, but also there is an economic argument to be made too. In England, as a whole, the cost to the NHS of treating illnesses and diseases arising from health inequalities is estimated at £5.5 billion a year, and ill-health means a loss to industry of £31 to £33 billion each year in productivity.
If we are to improve health outcomes and reduce health inequalities in our region, and indeed across the country where there are pockets of persistent inequality, then it is important that we look at how our health and social services are working now and how we need to ensure services are working towards improving the health of our nation, especially through prevention.
The NHS, Social Care and Public Health Funding
It goes without saying that this winter saw our NHS face unprecedented challenges which has pushed it virtually to the brink.
In the week of 9th January to 15th January, we saw 69 trusts out of 152 reporting serious operational pressures at some point during that given week – with the average deemed to be 50 Trusts a day reporting operational pressures.
There are countless stories in the media about the pressures the NHS is facing, and sadly, the Government have buried their heads in the sand and acted as if the issue isn’t as bad as it is in reality.
Whilst we are seeing the NHS facing a crisis, we are also seeing yet another reorganisation of services at a local level through Sustainability and Transformation Plans (STPs).
Whilst in principle, the idea of improving integrated services through STPs is a welcome idea, there are real and perceived concerns on the ground – not just here in the North, but across the country – that the efficiency savings are all about cuts, rather than improving clinical services for patients.
Pair all of this with the pressures in adult social care services, which saw a cut in funding of £4.6 billion in the last Parliament and experts warning there is an expected £1.9 billion funding gap in social care this year alone, then there is no wonder why there is no ability to seriously address health outcomes and inequalities.
Even in my own area of policy – public health - we are beginning to see what could be a crisis.
Whilst the total spend on public health is just over 4% of GDP, the then Chancellor in 2015, announced a £200 million in-year cut to the pot of money, and then in the Autumn Statement announced an average, real-terms cut of 3.9% until 2020.
It is estimated that that by 2020-21, public health funding will fall to just over £3billion, compared to the £3.47billion in 2015-16.
Even though the Government has ring-fenced this money when it reaches local authorities, there is no guarantee it will continue in the next spending round in 2018.
It is hypothetical what will happen, but when local authorities are strapped for cash already, if the ring fence is removed, there is a real concern that those councils with difficult decisions to make may take from this budget to plug other areas.
This can in some way be backed by current figures on the cuts we are seeing to public health services, as reported in the Health Select Committee’s report: Public Health, post-2013, where they cited figures by the Association of Directors of Public Health.
These figures showed the stark impact of the cuts we are already seeing. Take for example, health checks in 2015-16 which saw a cut of 27% and soared to 59% in 2017-17 with a 1% decommissioning.
Or weight management support which saw a 32% reduction and 9% decommissioning in 15-16, which then rises to 52% reduction and 12% decommissioning in 2015-16.
What we are seeing in the NHS, social care and public health is a complete mismanagement and lack of commitment to fund these important services properly.
This is something I have raised with Health Ministers across the House of Commons: if you cut from one area in the health and social care service, you will see a knock on affect in others.
This has unsurprisingly been met with disregard from ministers who fail to recognise the impact their mismanagement is having on these vital services and the health of the country.
It must be remembered, that for a region – such as our own – where ill-health and health inequalities are clearly apparent that this approach to our health services will have a serious impact on regions which are already at the lower end of the spectrum of dealing with health problems.
Yet, also this approach, especially to public health, goes completely against NHS England’s Five Year Forward View, which promised: “a radical upgrade in prevention and public health” and the Prime Minister’s own commitment to reduce health inequalities when she took office.
It is clear that the radical upgrade and desire to address these issues are not being met. In fact, it could be described as going backwards, or at best, staying still. Neither option is a welcome one.
However, if we remember the state of the NHS currently, which is fighting crisis after crisis every day, then it is not surprising that this worthy commitment to prevention and reducing health inequalities is not being worked towards.
How do we address this?
What we need to see is this radical upgrade made a central theme to any approach to improve services and not see them cut to the bone.
For me, improving the health of our nation is not just a health priority but a social justice one as well.
Because of persistent ill-health and poor health outcomes, people here in the North are not being allowed to reach their fullest potential and instead held back by inaction to improve their health, both through interventions but also providing them with the tools to improve their health themselves.
To do this, the NHS needs to bring forward a new funding settlement for the NHS and social care in the upcoming Budget, which will not only give the NHS the vital funding it needs to deal with increasing pressures, but also in order that it can begin to achieve its vision of radically upgrading prevention and public health as called for in the Five Year Forward View.
This should also include a rethink on the current approach to public health – the false economy of reducing funding when pressures remain the same, or increased, shows a complete lack of joined up thinking by the Government. And this is something I will push them to rethink at every available opportunity that I have as Labour’s Shadow Minister for Public Health.
It seems illogical to me that you cut prevention budgets, which will just present problems further down river in the NHS which as we know is already facing difficulties when coping with the demands it has now.
However, it cannot all be about funding. Labour’s approach at the last General Election was two-fold: one, ensuring interventions happen when necessary, especially at younger ages to correct bad habits which could lead to ill-health in adulthood, and second, ensuring that adults have the tools in their arsenal to make healthy lifestyle choices to live fulfilling lives.
This is something that I hope to continue to build upon in my time as Labour’s spokesperson on public health and ensure that any policies we propose will help seriously shift us away from the current situation where persistent health inequalities remain the norm.
Conclusion
To end, health inequalities are a serious issue that cannot be ignored. Reports after reports have shown that we have not made many serious inroads into health inequalities, and that is why it calls for a radical approach which doesn’t weaken the already fragile state of affairs we are seeing.
With innovation and political will, we can ensure the gap in health inequalities shrinks and health outcomes improve. To do this, we need that step change in ethos called for in the Five Year Forward View towards prevention but an NHS which itself is healthy enough to seriously begin to work towards this vision – if that does not happen, then it will never be achieved.
I hope in the discussions that we can start the process of doing just that, and I hope that you will all feed your thoughts and ideas into the Health and Social Care Commission.
Thank you.
Sharon speaks at the North East's Socialist Health Association's seminar on public health
In her capacity as Shadow Minister for Public Health, Sharon was invited to speak to a group of Socialist Health Association members in the North East about public health and...
In her capacity as Shadow Minister for Public Health, Sharon responded to a Backbench Business Debate on Breast Cancer Drugs, specifically the drug, Kadcyla and other drugs used for treatment of breast cancer.
Image copyright BBC Parliament 2017
You can read Sharon's speech here: Breast Cancer Drugs Backbench Business Debate 26.01.17
Speech pasted below:
Breast Cancer Drugs Backbench Business Debate 26.01.17
In her capacity as Shadow Minister for Public Health, Sharon responded to a Backbench Business Debate on Breast Cancer Drugs, specifically the drug, Kadcyla and other drugs used for treatment...
As Shadow Minister for Public Health, Sharon responded to a debate in Westminster Hall on the recently published Accelerated Access Review and the the impact that implementing these recommendations could have on issues surrounding access to drugs for people with long-term conditions, specifically cystic fibrosis and the drug, Orkambi.
You can read Sharon's speech here: Sharon Hodgson MP Accelerated Access Review Westminster Hall Debate 13.12.16
Speech pasted below:
Accelerated Access Review Westminster Hall Debate 13.12.16
As Shadow Minister for Public Health, Sharon responded to a debate in Westminster Hall on the recently published Accelerated Access Review and the the impact that implementing these recommendations could...
As Shadow Minister for Public Health, Sharon spoke during a secondary legislation committee on the approval of the Draft Consumer Rights (Enforcement and Amendments) Order 2016. This Order was to update current tobacco regulations in line with the Consumer Rights Act 2015. In her contribution, Sharon welcomed the order, along with the need to continue on the route to a smoke-free society and for the Government to finally publish their long awaited Tobacco Control Plan.
You can read Sharon's speech here: Sharon Hodgson MP Consumer Rights (Enforcement and Amendments) Order 2016 Secondary Legislation 12.12.16
Speech pasted below:
Consumer Rights (Enforcement and Amendments) Order 2016 Secondary Legislation 12.12.16
As Shadow Minister for Public Health, Sharon spoke during a secondary legislation committee on the approval of the Draft Consumer Rights (Enforcement and Amendments) Order 2016. This Order was to...
As Shadow Minister for Public Health, Sharon responded to a debate on the progress on the implementation of the Cancer Strategy for England. In her speech, Sharon raised the need to improve preventative measures, especially around smoking and obesity, which are seen as two of the most preventable contributors to cancer, and also issues around workforce capacity and capability.
You can read Sharon's speech here: Sharon Hodgson MP Cancer Strategy Backbench Business Debate 08.12.16
Speech pasted below:
Cancer Strategy Backbench Business Debate 08.12.16
As Shadow Minister for Public Health, Sharon responded to a debate on the progress on the implementation of the Cancer Strategy for England. In her speech, Sharon raised the need...
As part of her long-standing campaigns against ticket touting and on improving access to free school meals, Sharon spoke during the Report Stage of the Digital Economy Bill on two amendments, which would ban the misuse of bots when buying tickets and also on sharing data between local authorities and schools to improve the take-up of free school meals, which have been proven to be beneficial to a child's life.
You can read Sharon's speech here: Sharon Hodgson MP Report Stage of the Digital Economy Bill 28.11.16
Speech pasted below:
Mrs Hodgson
I want to speak for my two or three minutes in support of new clause 19 and new clause 31. I welcome these two new clauses after my many years of campaigning to put fans first and to improve access to free school meals.
Hungry children struggle to learn in school, and they fall behind their peers. That is why it is important that we improve the provision that is on offer and the access to it, and new clause 19 will do just that. This policy proposal was first introduced by my right hon. Friend the Member for Birkenhead (Frank Field) as a ten-minute rule Bill earlier this year. I have fully supported this policy change, and I congratulate my hon. Friends on the Front Bench on bringing it forward. It is estimated that having a child on free school meals can save a family up to £400 a year. A school will net £1,320 a year for each child who is currently on free school meals or who has been in receipt of free school meals in the previous five years. The proposed changes are simple and have been tried and tested by Calderdale Council and Greenwich Council, which have both used data sharing to improve the take-up of free school meals and, in turn, pupil premium in their boroughs.
I want to speak briefly to new clause 31. I thoroughly welcome this new clause, which has been introduced by the hon. Member for Folkestone and Hythe (Damian Collins) on behalf of the Culture, Media and Sport Committee after its excellent short inquiry into bots and ticket touting a few weeks ago—I had the pleasure, as I said earlier, of witnessing it at first hand—following the amendment originally tabled by the hon. Member for Selby and Ainsty (Nigel Adams) and supported by the Labour Front-Bench team and me. The new clause would take us one step closer to sorting the market out, but it is not a silver bullet; far from it. Alongside the new clause, we need the enforcement of existing legislation, such as the Consumer Rights Act 2015, and the implementation of the Waterson review recommendations on the secondary ticketing market.
Over the years, like the Minister and the hon. Member for Selby and Ainsty, I have heard about examples—I have experienced it myself—of people trying to buy tickets but finding that they were already sold out, and within minutes finding those tickets up on the secondary market. I never relented; I refused to buy any tickets from touts, but one can only deduce that there is a serious issue about how the tickets get on to the secondary market so quickly. One way in which they do so is definitely through the use of bots. Fans are not getting a fair crack at getting tickets, just as the Minister and other Members have not had a fair crack at getting them.
In the past 18 months, there has been a massive escalation in the number of tickets harvested by the aggressive software used by touts, with these attacks becoming more and more sophisticated. Attacks appear to emanate from all over the world, but the majority of attacks on ticketing systems are orchestrated by UK-based and UK-resident touts. Some 30% to 50% of tickets for high-demand events are harvested by aggressive software and immediately placed for resale on viagogo, GetMeIn!, StubHub and Seatwave, despite the best efforts of the industry, which has tried to police itself and to bring in technical solutions. The industry has tried to sell tickets through fan clubs, but even those are attacked. Where tickets are sold by ballot, there are ballot bots. Where fan club registration is required, there are email-generating bots that flood systems with thousands of false identities. There is not one single way to offer tickets for sale to the public for which there is not already a bot out there that will attack the system.
The situation is deteriorating. Primary ticket sites have to detect an attack, examine the data, identify the software used, reverse engineer it and develop measures to prevent a further attack. That process can take months. In the meantime, a tout can simply pay a coder overseas a few hundred pounds to develop a new bot to circumvent the new security features. Bots can be coded to attack a specific ticketing system in as little as a day.
Although legislation is in place in the form of the Computer Misuse Act 1990, which has broad applications that could be used to address bots, it is 25 years old and it is yet to be tested in this regard. This is an arms race that the primary ticket sellers simply cannot win. The secondary market has already shown its blatant disregard of civil remedy legislation, such as the amendment to the Consumer Rights Act 2015, which is flouted daily. The only effective deterrent is a very clear criminal offence, with appropriate punishment on conviction, and that would be provided by new clause 31.
Report Stage of the Digital Economy Bill 28.11.16
As part of her long-standing campaigns against ticket touting and on improving access to free school meals, Sharon spoke during the Report Stage of the Digital Economy Bill on two...
As Shadow Minister for Public Health, Sharon responded to a debate on reducing health inequalities and the need for the Government to take action to address variations in health outcomes across the country. In her speech, she raised two specific interventions that the Government could go on: childhood obesity and publication of the Tobacco Control Plan.
You can read Sharon's speech here: Sharon Hodgson MP Reducing Health Inequalities Backbench Business Debate 24.11.16
Speech pasted below:
Reducing Health Inequalities Backbench Business Debate 24.11.16
As Shadow Minister for Public Health, Sharon responded to a debate on reducing health inequalities and the need for the Government to take action to address variations in health outcomes...
As Shadow Minister for Public Health, Sharon responded to a Backbench Business Debate on contaminated blood and blood products, secured by Diane Johnson, MP for Hull North, who has led on this issue for a number of years. In her speech, Sharon spoke about the support given to those affected by this scandal under the new system and those missed out, the involvement of private for-profit companies in the administering of payments, and also the need for an independent Hillsborough-style panel.
You can read Sharon's speech in Hansard here: Sharon Hodgson MP Contaminated Blood and Blood Products Backbench Business Debate 24.11.16
Speech pasted below:
Contaminated Blood and Blood Products Backbench Business Debate 24.11.16
As Shadow Minister for Public Health, Sharon responded to a Backbench Business Debate on contaminated blood and blood products, secured by Diane Johnson, MP for Hull North, who has led...
As Shadow Minister for Public Health, Sharon spoke in a debate on diabetes technologies and what more needs to be done to support those living with diabetes.
You can read Sharon's speech in Hansard here: Sharon Hodgson MP Diabetes Technologies Westminster Hall Debate 23.11.16
Speech pasted below:
Diabetes Technologies Westminster Hall Debate 23.11.16
As Shadow Minister for Public Health, Sharon spoke in a debate on diabetes technologies and what more needs to be done to support those living with diabetes. You can read...
As Shadow Minister for Public Health, Sharon responded to a debate on Self-Care. In her speech, Sharon raised the need to ensure self care was fully supported by the Government o help reduce pressures on the wider NHS and health services and also the impact of cuts to public health funding will have on self care.
You can read Sharon's speech here: Sharon Hodgson MP Self Care Westminster Hall Debate 22.11.16
Speech pasted below:
Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)
It is an honour to serve under your chairmanship, Mr Walker. I welcome this important debate and the fact that it has been secured during Self Care Week -
Sir Kevin Barron
Just after it.
Mrs Hodgson
Just after Self Care Week. I commend my right hon. Friend the Member for Rother Valley (Sir Kevin Barron) for securing this debate and for his excellent speech, which shows his deep knowledge of and passion for all matters relating to the health of our nation, especially with regard to preventive health measures. I thank him for that.
This debate is especially important, as it is the first time we have had a dedicated debate on self-care in a very long time. We heard an excellent contribution from the hon. Member for Linlithgow and East Falkirk (Martyn Day). Before we hear from the Minister, I want to look at the issue of self-care and the wider picture of preventive measures through the lens of the cultural shift in the NHS away from care and repair to prevention and wellbeing promotion. I will also look at how aspects of current Government policy, such as the cuts to public health funding—I know I keep banging on about that, but it is important—is detrimental to our shared vision for an improved NHS and to achieving a healthier nation.
When NHS England’s “Five Year Forward View” was published just over two years ago, we were promised a radical upgrade in prevention and public health. That belief in reshaping the approach of the NHS and our health services away from a sickness alleviation service towards a wellbeing service that promotes healthier lifestyles choices, improved wellbeing and the prevention of ill health through behavioural change is supported across the NHS and in wider society.
That shift is paramount when we see the NHS in a state of crisis, with longer A&E waiting times and GP appointments becoming harder and harder to come by. One in four patients wait at least a week to see their GP. My husband had to wait three weeks to see the GP because it was not an emergency, but he thought it was an emergency; sometimes we do not know, and it is up to the doctor to decide what is important and what is not.
Some parts of the NHS are at crisis point. That is not a party political point at all; it is supported by health organisations such as the Nuffield Trust and the Health Foundation, which professed this time last year that the NHS was at risk of a “catastrophic collapse”. If the worrying trends in waiting times that I have described are ever to be reversed and we are to save the NHS, we need to have a wholesale rethink about the way we approach health policy. Prevention must be the key, and self-care should be a central part of that reconsidered approach.
Self-care is about empowering people and patients to maintain their own health through informed lifestyle choices, better awareness of symptoms and better awareness of when it is important to seek professional advice—for example, for possible cancer symptoms, where early diagnosis is absolutely crucial and a matter of life and death—and when an ailment can be treated by someone themselves in the appropriate manner by talking to their community pharmacist, as my right hon. Friend the Member for Rother Valley described on the occasion of a family holiday. With improved confidence, people can take control of their own health or long-term conditions much better and make decisions that are far better for the NHS.
It is completely understandable that when we are unsure about the cause of symptoms or the best course of treatment or care, our first port of call is the NHS. However, being more aware of how we can treat ourselves and having preventive practices in place that reduce the prevalence of ill health will help go some way towards pulling the NHS back from the brink. The NHS is a trusted bastion, but sadly we are seeing more and more people accessing NHS services when there is no need and when a chat to one of our excellent community pharmacists would have sufficed—for example, in the cases we have heard about today of splinters, paper cuts, hiccups or broken nails. A bit of common sense is all that is needed, certainly not a trip to A&E.
In 2014, A&E departments across the country dealt with 3.7 million visits for self-treatable conditions such as those mentioned today, as well as the common cold, flu or muscle pain, combined with 52 million visits to the GP for similar conditions. It is no wonder people cannot get an appointment when some people are going to see their GP for that sort of thing. That has an estimated cost to the NHS of more than £10 billion over the past five years, which is not a small or insignificant amount of money.
Self-care is a crucial preventive measure that must be developed further to ensure that the NHS is as resilient as possible and can respond in more effective and meaningful ways to the nation’s health. With all that in mind, it is deeply worrying that the vision set out in the “Five Year Forward View” has progressed little or not at all. That is seen most clearly through the Making Every Contact Count initiative, which aims to make NHS staff members an important part of boosting awareness of healthy living, rather than only administering healthcare to the sick. It is a fantastic initiative. In theory, that strategy can go far in addressing issues around lifestyle choices such as smoking, drugs, diet and alcohol consumption by just adding a one or two-minute conversation when a healthcare professional already has someone in front of them.
It is worrying that the progress and roll-out of that scheme is patchy, despite there being lots of good practice across the country, such as the social prescribing service in Rotherham that my right hon. Friend talked about. Where such system change is flourishing and showing that it can support a reduction in pressures on NHS services such as A&E and GP practices, it should be encouraged, and the roll-out should be far more substantial.
I hope the Minister can give us some reassurance on three key asks for the Make Every Contact Count initiative: first, that we see progress made on the scheme in the new year, as promised by Professor Fenton from Public Health England during the second oral evidence session for the APPG on primary care and public health inquiry; secondly, that best practice is made more readily available to improve provision across the country through the Self Care Forum’s database of best practice; and thirdly, that he commits to ensuring CCGs prioritise implementation of the scheme in their local areas and that training is provided for staff, to equip them to provide consistent self-care messaging.
It should not go without saying that there are examples across the country that show the innovative and positive impacts of improving self-care, such as a scheme in my own neck of the woods in South Tyneside—the neighbouring borough to my own—where a borough-wide conversation has been developed that shifts away from asking, “How can I help you?” and instead asks, “How can I help you to help yourself?”
Those initiatives need funding and encouraging from Government to succeed. However, what we are currently seeing has been described as a frustrating and perverse approach to preventive measures, with cuts to public health funding of £200 million in last year’s Budget, along with an average real-terms cut of 3.9% each year to 2021, announced in last year’s autumn statement. Hopefully tomorrow we will see our new Chancellor go some way to rectifying and reversing that; we can live in hope, unless the Minister has some insight into what the Chancellor will announce. We will keep our fingers crossed.
The Minister is well aware of my opinion on those cuts, because we discuss them every time we meet, and the need to rethink the whole approach, but it is not only me saying this. Only recently, the Health Committee, chaired by the hon. Member for Totnes (Dr Wollaston)—who I am sure would have been here today if not for the health debate coming up in the Chamber very soon—uncovered serious concerns about the finances and funding of the NHS and public health. In a letter to the Health Secretary in October, the Committee said:
“All the indicators suggest that demand is continuing to grow and that we need to go further on prevention”.
I could not agree more. These cuts are a false economy and are exacerbating the situation within our health services. We are seeing funding directed to our crisis-ridden A&E departments, which are having to crisis-manage failures that could have been addressed a lot sooner.
The Minister needs fully to understand that to make cuts to one part of our health service without considering the impact on other parts is leading us down the road to rack and ruin. To give him some understanding of the cuts, I suggest that he look at the Health Committee report “Public health post-2013”. The Select Committee does good work, but the Chair is not here to hear me highlight all this work. The report that I have just mentioned highlights research by the Association of Directors of Public Health, which found that local authorities are planning deep cuts to public health services due to the cuts coming from central Government to local authorities. It shows a marked rise for 2016-17 compared with 2015-16.
The Government need to have a wholesale rethink of the funding of the NHS and public health services that sees a redirection to prevention, which will go some way towards addressing many of the problems in our health service that are now being documented weekly. I hope that the Minister takes some time in his response to consider the points that I have raised in relation to public health funding and how current actions are failing the vision of the five year forward view and the health of our nation. Self-care needs properly to be funded and supported to be innovative, so that we ensure that the continuing crisis facing the NHS can be reversed. We cannot continue as we are, because our NHS is too precious to let it fail. The health of the nation needs to be protected, where possible, to enable people to lead long, happy and fulfilling lives.
Self-Care Westminster Hall Debate 22.11.16
As Shadow Minister for Public Health, Sharon responded to a debate on Self-Care. In her speech, Sharon raised the need to ensure self care was fully supported by the Government...