Browse content similar to 24/11/2016. Check below for episodes and series from the same categories and more!
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members to bomb views on that. But I will certainly be leader colleagues | :00:00. | :00:00. | |
in defence the importers that he and other honourable members attached to | :00:00. | :00:10. | |
this matter. Point of order, Mr Alex Salmond. During business questions, | :00:11. | :00:16. | |
in answer to the right Honourable member for Rhondda, the Leader of | :00:17. | :00:21. | |
the Coasting to suggest there was? Over with their resolution would | :00:22. | :00:25. | |
come forward on the second reading of the boundaries Bill but this has | :00:26. | :00:32. | |
class overwhelmingly last Friday. You will remember that there was one | :00:33. | :00:36. | |
example in the last parliament with this happens, I wasn't viewed at the | :00:37. | :00:42. | |
time. Due to the incoherence of the Coalition Government not being able | :00:43. | :00:45. | |
to agree itself, that many previous leaders of the house have been on | :00:46. | :00:49. | |
record many times saying that such a procedural device would not be used | :00:50. | :00:54. | |
as a means of impeding progress on a bill such as the bill we put forward | :00:55. | :01:04. | |
last Friday. Leaders of the house, and the support of the whole house. | :01:05. | :01:08. | |
The present leader of the house in his short tenure has had that, as | :01:09. | :01:12. | |
exemplified by his magnificent statement earlier on in the session. | :01:13. | :01:19. | |
But can I say to you that if a Leader of the House loses support | :01:20. | :01:23. | |
across the chamber by such 's procedural shenanigans, if that's | :01:24. | :01:26. | |
what he meant, then he would be long in his tenure. -- he won't be long | :01:27. | :01:34. | |
in his tenure. that, the right honourable member for Rhondda. He | :01:35. | :01:44. | |
said it was feared an of not enough members turned up to vote, then it | :01:45. | :01:52. | |
should fall. Well, we all turned up last week in large numbers, taking | :01:53. | :01:59. | |
him at his word, carried by 257 votes, to 35, including members of | :02:00. | :02:03. | |
the Conservative benches. Surely it be enabled to go to committee now by | :02:04. | :02:07. | |
the Leader of the House's own logic, because there were plenty of people | :02:08. | :02:11. | |
who turned up to vote, and the people who did not were the people | :02:12. | :02:16. | |
who maybe did not want the bill. Very well. I will ask the leader if | :02:17. | :02:20. | |
he wants to say anything, he is not obliged to do so, but these are | :02:21. | :02:25. | |
essentially political matters, but I have comments to make in due course. | :02:26. | :02:34. | |
Both sides of the House are concerned by this issue, but by | :02:35. | :02:37. | |
convention, money resolutions follow, and that has been a | :02:38. | :02:40. | |
tradition of this House. There is only one occasion I can see, which | :02:41. | :02:50. | |
is what he referred to. The majority the House gave to that bill last | :02:51. | :02:56. | |
Friday was in fact the biggest majority other than the other one | :02:57. | :02:58. | |
that did not get a money resolution. I do hope that we can get a | :02:59. | :03:05. | |
statement from the leader that they will not -- that a money resolution | :03:06. | :03:08. | |
will follow, as speedily as other money resolutions have come. If it | :03:09. | :03:16. | |
will help matters, I want to make clear that all I was saying earlier | :03:17. | :03:22. | |
is that there is a process to be followed when a Private members Bill | :03:23. | :03:28. | |
receives a second reading. First of all, the government, particularly | :03:29. | :03:33. | |
the Treasury, have to consider whether a money resolution is needed | :03:34. | :03:36. | |
and what the scope of that is, and then it has to be drafted. So that | :03:37. | :03:42. | |
is the process going through at the moment, and I need say no more than | :03:43. | :03:48. | |
that. It might be helpful, both to the right honourable gentleman who | :03:49. | :03:51. | |
raised the original point of order and to all who have subsequently | :03:52. | :03:56. | |
taken part in this brief exchange, if I say the following. Ministers | :03:57. | :04:00. | |
are responsible for what they say, as are other honourable members, let | :04:01. | :04:10. | |
me however confirm two things. First, the decision as to whether a | :04:11. | :04:16. | |
bill requires a money resolution is for the cleric of legislation, not | :04:17. | :04:22. | |
the Treasury. I understood the meaning of the leader's remarks | :04:23. | :04:27. | |
earlier was to the effect it was for Treasury ministers to decide on | :04:28. | :04:33. | |
tabling a money resolution. -- clerk of the Treasury. I confirm that it | :04:34. | :04:42. | |
is indeed for them to decide upon the tabling. The question of the | :04:43. | :04:49. | |
requirement is determined by the clerk of legislation. I hope that | :04:50. | :04:57. | |
responds by me helps both distinguished privy counsellors in | :04:58. | :05:08. | |
this matter. In which case, I wonder whether the clerk of legislation has | :05:09. | :05:12. | |
decided if it needs money resolution already? The short answer is yes, | :05:13. | :05:16. | |
the clerk of legislation has so decided that it does. We're not | :05:17. | :05:23. | |
going to have an extended conversation on the matter. At least | :05:24. | :05:31. | |
not any more extended than we have had, but I think I have made the | :05:32. | :05:36. | |
position clear. People can seek advice from whomsoever, and the | :05:37. | :05:38. | |
government may choose to seek advice from the Treasury. In my experience | :05:39. | :05:45. | |
the Treasury is ready invariably to offer advice, whether that is wanted | :05:46. | :05:49. | |
on zero. It may very well offer it, and people may want the advice, but | :05:50. | :05:54. | |
the fact is that it is the clerk of legislation who decides whether that | :05:55. | :05:59. | |
is required. Look, let me go as to -- so far as to say it is | :06:00. | :06:06. | |
overwhelmingly the norm that the tabling then follows. I do not think | :06:07. | :06:13. | |
that the Leader of the House has sought to gainsay that. He confirms | :06:14. | :06:18. | |
through a very helpful shaking off the head that he has not sought to | :06:19. | :06:25. | |
gainsay that. I hope that will suffice today. If there are no | :06:26. | :06:34. | |
further points of order, if the appetite has been satisfied for | :06:35. | :06:39. | |
today, we moved to the backbench motion on the support further | :06:40. | :06:44. | |
arrangements of people affected by contaminated blood and blood | :06:45. | :06:48. | |
products. To move the motion, I called Diana Johnson. Thank you. I | :06:49. | :06:54. | |
begged them you've -- move the motion on the order paper. I would | :06:55. | :07:01. | |
like to start with the backbench committee, who have always been | :07:02. | :07:07. | |
generous in understanding the importance of this to our | :07:08. | :07:10. | |
constituents. This is the third backbench business debate we have | :07:11. | :07:15. | |
had on the subject. It has now been over 45 years since the first people | :07:16. | :07:19. | |
who get infected with HIV, hepatitis C and other viruses from NHS | :07:20. | :07:24. | |
supplied blood products. Their lives and those of their families were | :07:25. | :07:29. | |
changed forever by this tragedy. The contaminated blood scandal is now | :07:30. | :07:33. | |
rightly recognised by a grave injustice, the worst disaster in the | :07:34. | :07:39. | |
history of the country's health service. But those affected are | :07:40. | :07:42. | |
still waiting for the proper financial settlement which | :07:43. | :07:45. | |
recognises the school effect this scandal has had on them and their | :07:46. | :07:48. | |
families. This group of people have campaigned for too many years for | :07:49. | :07:53. | |
justice, at the same time dealing with illness and disability. The | :07:54. | :07:56. | |
current financial support for those affected are simply not fit for | :07:57. | :08:01. | |
purpose, and this fact was laid bare in the enquiry of the all-party | :08:02. | :08:07. | |
group for haemophilia in January last year. One quote in the first | :08:08. | :08:13. | |
page of the report said, you cannot give us back our health, but you can | :08:14. | :08:18. | |
give us back our dignity. This torture abroad has been too long for | :08:19. | :08:22. | |
many of us, but for the rest of us please let this be the final road to | :08:23. | :08:28. | |
closure. Thankfully, we all now agree that the current support | :08:29. | :08:32. | |
arrangements cannot continue, and we need to create a scheme that gives | :08:33. | :08:36. | |
this community back their dignity. I welcome the efforts of the previous | :08:37. | :08:40. | |
Prime Minister in what he did in office. And I would also like to | :08:41. | :08:45. | |
welcome the honourable member for Oxford West and Abingdon to her new | :08:46. | :08:51. | |
post and I welcome global Lord prior in his new position. I was happy to | :08:52. | :08:56. | |
meet with him last week alongside other APPG members to discuss the | :08:57. | :08:59. | |
new support arrangements. While we all agree that there is a need for a | :09:00. | :09:06. | |
reform scheme, I cannot agree with the Department of Health that the | :09:07. | :09:09. | |
settlement they have proposed is sufficient. And the purpose of this | :09:10. | :09:13. | |
backbench debate is to highlight those aspects of the new support | :09:14. | :09:17. | |
scheme that will not actually provide the support these people | :09:18. | :09:23. | |
need, following the hasty announcement made by the Prime | :09:24. | :09:26. | |
Minister as he left office in July. So in my speech I want to stress | :09:27. | :09:31. | |
five key issues which the Department of Health urgently need to address. | :09:32. | :09:37. | |
The first is the country differences in the schemes between Wales, | :09:38. | :09:39. | |
Scotland and Northern Ireland. Firstly we need to know what support | :09:40. | :09:45. | |
people in fore countries of the United Kingdom will get. Scotland | :09:46. | :09:48. | |
and England have set out their own separate support schemes, but people | :09:49. | :09:53. | |
in Wales and especially Northern Ireland desperately need some | :09:54. | :09:58. | |
certainty about the help they will receive. I will give way. And I | :09:59. | :10:05. | |
thank her for giving way. And thank her for bringing forward this debate | :10:06. | :10:09. | |
along with other honourable and right honourable members. Could I | :10:10. | :10:12. | |
say that I have been in touch with the Minister for health in Northern | :10:13. | :10:17. | |
Ireland and that there is no progress in relation to this | :10:18. | :10:22. | |
particular issue, and I and other honourable members from Northern | :10:23. | :10:25. | |
Ireland have constituents who have suffered from the ill effects of | :10:26. | :10:28. | |
contaminated blood for over 45 years. That is worrying to hear | :10:29. | :10:37. | |
there is no progress on what is going to happen in Northern Ireland, | :10:38. | :10:41. | |
so that is something the Minister needs to provide to the House what | :10:42. | :10:46. | |
is going on. -- explain to the House. I thank her for giving way. | :10:47. | :10:52. | |
What is clear is the Scottish scheme is more generous than England. Which | :10:53. | :10:56. | |
she agree that at the very least the government should have parity, and | :10:57. | :11:00. | |
in particular that nobody should be worse off under the new scheme than | :11:01. | :11:05. | |
they were under the old scheme? He makes that point well and I will | :11:06. | :11:09. | |
come on to compare and contrast the Scottish scheme, which I think is | :11:10. | :11:19. | |
more generous. I will give way. The difference between the schemes is | :11:20. | :11:24. | |
important because we will have honourable members representing | :11:25. | :11:25. | |
constituencies across the UK who have constituents with one person | :11:26. | :11:30. | |
getting compensation from an English scheme and one person getting | :11:31. | :11:34. | |
composition from a Scottish scheme, and it may be a different amount of | :11:35. | :11:38. | |
money and different level of compensation. I think he makes a | :11:39. | :11:44. | |
very important point. I think this is perhaps one of these unintended | :11:45. | :11:48. | |
consequences of devolution, we are ending up with this mishmash of | :11:49. | :11:52. | |
schemes, concerning the people affected. One of my constituents | :11:53. | :11:59. | |
says exactly that point, it is unfair that the Scottish settlement | :12:00. | :12:04. | |
is so different to the settlement for him in Stratford-upon-Avon, but | :12:05. | :12:09. | |
one of my constituents in the public gallery will remind the House that | :12:10. | :12:12. | |
there are less than 300 primary beneficiaries left and it is | :12:13. | :12:15. | |
important that they are not forgotten. That is a very important | :12:16. | :12:24. | |
point, and I will move on to that in a little while. That was my first | :12:25. | :12:27. | |
concern, about the different schemes available. Secondly, I think this is | :12:28. | :12:33. | |
an important point as well. We know that at some point next year the | :12:34. | :12:38. | |
existing five trusts will be amalgamated into a single body to | :12:39. | :12:42. | |
administer the scheme. I am deeply troubled by the fact that the | :12:43. | :12:45. | |
administration of the new scheme looks likely to be done by a | :12:46. | :12:49. | |
profit-making private company and I know that companies have attended | :12:50. | :12:58. | |
meetings with Department of Health officials about the new contract. | :12:59. | :13:01. | |
Formal tender submissions will be made soon, with the decision made | :13:02. | :13:06. | |
next year. No minister in the Department of Health have the | :13:07. | :13:10. | |
courtesy to tell the APPG of his plans, neither were the | :13:11. | :13:14. | |
beneficiaries asked for their views in the Serbian January 16, and even | :13:15. | :13:18. | |
in the department's response in the survey published in July, made no | :13:19. | :13:23. | |
mention of this prospect. Alongside honourable members on both sides, I | :13:24. | :13:34. | |
cannot... Let me remind the House of how many in this community were | :13:35. | :13:39. | |
infected in the first place. Many contracted HIV and hepatitis C from | :13:40. | :13:42. | |
American blood products supplied by profit-making private companies. The | :13:43. | :13:48. | |
United States, unlike the UK, has always allowed the commercial | :13:49. | :13:52. | |
purchasing of blood products, these were often donated by people who | :13:53. | :13:56. | |
desperately needed money and so were willing to be less than honest about | :13:57. | :14:01. | |
their chances of infection. This was the reason that so many harbour such | :14:02. | :14:07. | |
distrust of private companies. I will give way. I am grateful. I have | :14:08. | :14:15. | |
been contacted by constituents in Dublin who tell me how grateful we | :14:16. | :14:18. | |
are to her for the lead and campaigning she has done on this. I | :14:19. | :14:22. | |
want to place that on record. One in particular has written to me about | :14:23. | :14:27. | |
allegations of impropriety in relation to doctors being encouraged | :14:28. | :14:30. | |
by pharmaceutical companies to use plasma concentrates instead of a | :14:31. | :14:38. | |
different method and blood transfusions, does she agree that | :14:39. | :14:42. | |
this should be investigated? Yes, I am happy to agree that this should | :14:43. | :14:46. | |
be investigated. I want to return to this concern people have about the | :14:47. | :14:51. | |
use of private companies. We also know that in the past six years | :14:52. | :14:56. | |
there has been a sense of mistrust by the disability assessment regime | :14:57. | :15:00. | |
which was operated by a TOS before they walked away from the contract | :15:01. | :15:07. | |
with the DWP. If there is one thing which could fatally undermine | :15:08. | :15:11. | |
progress towards a better support scheme it is this, that the plans | :15:12. | :15:14. | |
for the new scheme be administered by a private company, and I strongly | :15:15. | :15:19. | |
urge the government to look again at these plans and show empathy for the | :15:20. | :15:23. | |
people who have been affected. Give way. Could I congratulate her for | :15:24. | :15:32. | |
her tireless work on this particular topic. Would she agree with me that | :15:33. | :15:37. | |
there is a deep issue here about trust, not just in relation to the | :15:38. | :15:42. | |
potential new providers, but in relation to what happened | :15:43. | :15:44. | |
previously, were some of the survivors or the families who | :15:45. | :15:51. | |
survived, victims who passed away, that senior health professionals | :15:52. | :15:55. | |
knew about the contamination but decided for cost reasons they needed | :15:56. | :15:56. | |
to continue with the intervention. One of the points I want to make the | :15:57. | :16:05. | |
Tehran is for the needs still for some form of enquiry. I'll come to | :16:06. | :16:09. | |
that in a moment. I want to continue with this point about why who runs | :16:10. | :16:15. | |
the scheme is so important. One of the big criticisms of the new scheme | :16:16. | :16:20. | |
is a continuation of discretionary payments. I think Department of | :16:21. | :16:23. | |
Health officials still are not listening to concerns raised about | :16:24. | :16:28. | |
this. The enquiry uncovered huge issues, with a highly conditional | :16:29. | :16:33. | |
and purely managed discretionary support scheme. As one respondent | :16:34. | :16:37. | |
told us, the whole system seemed designed to make you feel like a | :16:38. | :16:44. | |
beggar. I also believe that the current administrators of the trust | :16:45. | :16:48. | |
had not fought hard enough for their beneficiaries, which legally they | :16:49. | :16:52. | |
could have done, but instead, they saw their role as dispassionate | :16:53. | :16:56. | |
managers and conduits to the Department of Health. They left the | :16:57. | :17:00. | |
affected community alone to fight for themselves. If the new support | :17:01. | :17:04. | |
scheme ends up being managed by Aptos or capita, it will do nothing | :17:05. | :17:08. | |
to address these fundamental issues, it could even make the situation | :17:09. | :17:16. | |
much worse and add insult to injury. I call on the Minister to say she | :17:17. | :17:19. | |
will do the right thing and scrap plans for a private profit-making | :17:20. | :17:25. | |
scheme administrator and replace the current scheme with with the more | :17:26. | :17:30. | |
beneficiary organisation with no profit motive. I would also ask the | :17:31. | :17:34. | |
Minister to set out what kind of discretionary support the new scheme | :17:35. | :17:38. | |
will provide, as it remains unclear whether any or all of the current | :17:39. | :17:42. | |
support will continue, and this does contrast starkly with the Scottish | :17:43. | :17:47. | |
scheme, where the financial review group agreed that nobody should | :17:48. | :17:52. | |
receive less financial support under the new scheme. So will the | :17:53. | :17:57. | |
government urgently provide the same guarantee and publish full details | :17:58. | :18:00. | |
of any obligations which the new scheme administrators will be | :18:01. | :18:05. | |
subject to? There are also issues with the current welfare benefits | :18:06. | :18:08. | |
assessment regime, that many people are having to go through, for | :18:09. | :18:19. | |
example, moving from DLE onto PIP, so that individuals can be passport | :18:20. | :18:24. | |
it straight onto benefits, and I hope the minister will agree that is | :18:25. | :18:27. | |
the sensible way forward for the people affected. My third point in | :18:28. | :18:32. | |
the third issue I am concerned about relates to the families of those | :18:33. | :18:37. | |
affected needing better support under this scheme. Under the new | :18:38. | :18:42. | |
English proposals, widows and widowers will continue to be | :18:43. | :18:46. | |
eligible for discretionary support, whatever that means, and I have | :18:47. | :18:49. | |
already raised concerns about that. This will come top of the new | :18:50. | :18:56. | |
?10,000 lump sum, provided their loved ones died partially as a | :18:57. | :19:01. | |
result of contracting HIV or hepatitis seen. But I've already | :19:02. | :19:05. | |
heard from many clinicians telling me that this could see many people | :19:06. | :19:09. | |
excluded from the system, simply because their partner's death | :19:10. | :19:13. | |
certificate did not include mention of HIV or hepatitis C, sometimes at | :19:14. | :19:21. | |
the family's request. But these new proposals could be considerably less | :19:22. | :19:24. | |
generous than the support that some widows already received, because of | :19:25. | :19:31. | |
the huge? Hanging over exactly what discretionary helper can under the | :19:32. | :19:38. | |
reform scheme. Thank you for giving way and also the leading this. I | :19:39. | :19:45. | |
have at least two constituents, who sadly passed away as a consequence | :19:46. | :19:51. | |
of contaminated blood and the disease they contracted. For their | :19:52. | :19:55. | |
loved ones, the concern is absolutely what she indicates, that | :19:56. | :20:00. | |
the dependence on potential discretionary payments is | :20:01. | :20:06. | |
insufficient, the one off payment as it is not to be backed up by the | :20:07. | :20:12. | |
regularity of annual payments means those people have to give up work | :20:13. | :20:15. | |
and give up their own opportunity to have a pension. That leads me onto | :20:16. | :20:24. | |
my next point, which was about the Scottish proposals, which offer a | :20:25. | :20:29. | |
better settlement and guarantee the believed 75% of their partner's | :20:30. | :20:34. | |
previous entitlement in addition to continued access to the Scottish | :20:35. | :20:39. | |
discretionary scheme. This gives some much-needed security in the way | :20:40. | :20:42. | |
the English scheme does not, so I would ask the Minister whether she | :20:43. | :20:47. | |
will look again at adopting the Scottish model and provide more | :20:48. | :20:50. | |
guarantees on non-discretionary support for Windows and widowers. My | :20:51. | :20:56. | |
fourth point is about support for primary beneficiaries, which was | :20:57. | :21:01. | |
raised in a previous intervention. We would ask that the government | :21:02. | :21:05. | |
looks again at some private beneficiaries who need better | :21:06. | :21:11. | |
support than currently provided. I had an e-mail this morning from | :21:12. | :21:16. | |
someone who has hepatitis B, contracted through contaminated | :21:17. | :21:20. | |
blood products, he was not, under the skin, eligible for any help at | :21:21. | :21:26. | |
all, but is obviously suffering. I would hope that the Minister would | :21:27. | :21:29. | |
be prepared to look at the very small group of people who are not | :21:30. | :21:38. | |
covered. Secondly, if more assistance was provided, this would | :21:39. | :21:41. | |
reduce the need for discretionary support they are great deal of our | :21:42. | :21:46. | |
constituents' worries. I would urge the Department of Health to contrast | :21:47. | :21:49. | |
the support announced in the Scottish scheme and look into | :21:50. | :21:52. | |
whether more ongoing payments could be made. I applaud her for bringing | :21:53. | :22:03. | |
this debate to the House. I see that the new payment scheme is an | :22:04. | :22:07. | |
improvement, I didn't particularly want to speak up from one of my | :22:08. | :22:14. | |
constituents, he is one of the 256 out of the 1250 haemophiliacs, who | :22:15. | :22:20. | |
is infected with multiple viruses. Their lives have been devastated, | :22:21. | :22:25. | |
absolutely blighted by this, and they feel they really are not being | :22:26. | :22:29. | |
fairly treated in this new arrangement and I wonder if she | :22:30. | :22:34. | |
would consider expanding on whether we could help them a little bit | :22:35. | :22:39. | |
more. I do want to come onto ways that I think the current funding the | :22:40. | :22:43. | |
government have put together could be used more effectively to assist | :22:44. | :22:49. | |
more people who have been infected by receiving contaminated blood, | :22:50. | :22:53. | |
including her constituents. I just want to talk a little bit about the | :22:54. | :22:57. | |
overall funding of the new scheme. There is much that the government | :22:58. | :23:01. | |
could do to improve the scheme without additional cost to the | :23:02. | :23:05. | |
public purse. Even in the Scottish proposals, particularly for Windows | :23:06. | :23:09. | |
and primary beneficiaries, if they were adopted in England, this would | :23:10. | :23:15. | |
fall in the budget allocated every year. This is set out in an analysis | :23:16. | :23:21. | |
conducted by the Haemophiliacs Society, which was presented to the | :23:22. | :23:24. | |
Department of Health last week's meeting, and I hope officials | :23:25. | :23:30. | |
considered it carefully. Any need for additional funding could come | :23:31. | :23:37. | |
from to identifiable sources. If we sell our stake in plasma UK, and any | :23:38. | :23:45. | |
reserves left in the accounts of the three discretionary charities were | :23:46. | :23:50. | |
near closed next year, I think could also be made available. Further, can | :23:51. | :24:01. | |
I ask, will this continue to be rolled over to support beneficiaries | :24:02. | :24:06. | |
in the next year? At last week's meeting, it appeared that any | :24:07. | :24:11. | |
unspent money would have to be given back to the Treasury, and I think | :24:12. | :24:15. | |
that would be a gross act of betrayal towards those affected. I | :24:16. | :24:19. | |
want to move onto my conclusion, which is, does the Department of | :24:20. | :24:24. | |
Health except that there are new scheme is one that still has | :24:25. | :24:28. | |
substantial issues needing to be addressed? The new support scheme | :24:29. | :24:31. | |
will not command the full confidence of the people it needs to. Indeed, | :24:32. | :24:37. | |
in some crucial respects, it will be worse than the system it replaces. | :24:38. | :24:46. | |
Two final points on behalf of both the APPG. The APPG still believe | :24:47. | :24:50. | |
there should be a lump sum payments as part of any new scheme, to give | :24:51. | :24:54. | |
people the opportunity to decide for themselves what is best for them, | :24:55. | :24:57. | |
either a regular payment or a one-off lump sum. She is very | :24:58. | :25:10. | |
generous. I wanted to put to her, why can't lump sum payments be an | :25:11. | :25:14. | |
alternative to regular payments? Why does the government have to be | :25:15. | :25:19. | |
grudging on this matter? These are people to whom the government or the | :25:20. | :25:23. | |
huge debt and obligation and it should be a properly funded scheme. | :25:24. | :25:26. | |
We should have a proper investigation of this, so we can | :25:27. | :25:31. | |
have the truth in what is a terrible scandal and staying on this country. | :25:32. | :25:37. | |
He puts that point very well, and I do think, from the work that the | :25:38. | :25:44. | |
APPG did on this and the Honourable member for North Beds did, in terms | :25:45. | :25:48. | |
of talking to people about what they would like to see happen in this and | :25:49. | :25:53. | |
any new revised scheme, one of the options people did see if they'd | :25:54. | :25:56. | |
like to be able to think about whether a lump sum payment was | :25:57. | :25:59. | |
better for them than regular payments. Giving people the ability | :26:00. | :26:04. | |
to make those decisions for themselves is really quite | :26:05. | :26:09. | |
important. The second point from the APPG's point of view, is we still | :26:10. | :26:14. | |
believe that we need to have a Hillsborough style panel and quietly | :26:15. | :26:18. | |
to allow people to tell their stories, say what happened to them | :26:19. | :26:22. | |
and how it affected them. I'm happy to give weight to my right | :26:23. | :26:25. | |
honourable friend, who has great knowledge on this point. She is | :26:26. | :26:33. | |
making a very, very powerful case, as she always does. I congratulate | :26:34. | :26:37. | |
her on the way in which she is doing so. I think she is right for that | :26:38. | :26:44. | |
potential that a Hillsborough style enquiry offers. I know that the | :26:45. | :26:48. | |
Prime Minister is a great fan of that process and has said so on | :26:49. | :26:53. | |
previous occasions. I think we just need to be a bit careful that the | :26:54. | :27:00. | |
setting up of such an enquiry doesn't put all of the important and | :27:01. | :27:04. | |
urgent issues she has raised into the shade, while that process takes | :27:05. | :27:08. | |
place. The two things need to be separate. I agree with him, he makes | :27:09. | :27:17. | |
that point very well. We do need to make sure that any new support | :27:18. | :27:20. | |
scheme moves quickly, we need to get on with this. The Prime Minister, | :27:21. | :27:28. | |
when he apologised on behalf of the nation 18 months ago, also allocated | :27:29. | :27:33. | |
some money, 25 million. And that has been spent yet, as I understand it, | :27:34. | :27:38. | |
and we do need to make sure that any scheme is introduced as quickly as | :27:39. | :27:43. | |
possible, obviously with concerns we have being addressed. The two things | :27:44. | :27:47. | |
can go in parallel, we can have that panel enquiry to give people that | :27:48. | :27:53. | |
opportunity for a truth and reconciliation enquiry. I still | :27:54. | :27:56. | |
think it is an important requirement for any real sense of justice being | :27:57. | :28:04. | |
achieved and the closure. Very grateful for a second intervention. | :28:05. | :28:06. | |
Could I make the point that there are documents in which families who | :28:07. | :28:14. | |
have suffered a loss following this scandal, have expressed, that they | :28:15. | :28:17. | |
would like to get hold of those documents and see them and see what | :28:18. | :28:22. | |
happened and who knew what. They just what that sense of justice. I | :28:23. | :28:28. | |
will now conclude. I know you later speeches members will want to raise | :28:29. | :28:33. | |
the deeply moving stories of their own constituents. That is the same | :28:34. | :28:37. | |
reason that has led me to campaign on this issue over many years. Was | :28:38. | :28:43. | |
mindful of the struggles faced by my own constituents, Glenn Robinson. | :28:44. | :28:47. | |
When was diagnosed with hepatitis C following aged operation when he was | :28:48. | :28:52. | |
just 19. He's had to live with the virus of his life and is still | :28:53. | :28:55. | |
waiting for a proper recognition of the way this has affected him. I | :28:56. | :28:58. | |
hope the minister and government will my work to ensure that Glenn | :28:59. | :29:03. | |
and others can live the rest of their lives in dignity. I'm going to | :29:04. | :29:11. | |
impose a ten minute limit to start with and then we'll see how we get | :29:12. | :29:23. | |
on. Could I begin by congratulating her for her consistency in relation | :29:24. | :29:29. | |
to this issue. And the work that she and the all-party group of done over | :29:30. | :29:34. | |
a length of time. I also thank the Backbench Business Committee to for | :29:35. | :29:41. | |
allowing this to come forward. We start by knowing that this is not | :29:42. | :29:49. | |
her portfolio responsibility, and I personally know how difficult it is | :29:50. | :29:52. | |
to be dealing with something that isn't actually in your own | :29:53. | :29:55. | |
portfolio. So I know she will communicate very faithfully what the | :29:56. | :30:01. | |
debate passes on to work, though she will not be in a position to pass | :30:02. | :30:07. | |
all the questions we will raise. Without that we are here again | :30:08. | :30:10. | |
raising the question is should be an important point that she will bring | :30:11. | :30:14. | |
forward, both as Secretary of State and others. In relation to the | :30:15. | :30:19. | |
speech, a couple of points which I will emphasise and pick up. Firstly, | :30:20. | :30:27. | |
on the administration of the scheme, can I say how much I agree with her | :30:28. | :30:30. | |
on the point about who should run it. This is not one of those we were | :30:31. | :30:37. | |
looking to outsource because it's an ideological issue or anything like | :30:38. | :30:41. | |
that, there is something that is really important at the heart of | :30:42. | :30:45. | |
this issue, and we know from everything we know from the United | :30:46. | :30:49. | |
States, that the plot profit motive in selling the blood in the first | :30:50. | :30:53. | |
place was the primary source of everything that flowed since. And | :30:54. | :30:58. | |
accordingly, to recognise that and have some sensitivity on that is | :30:59. | :31:03. | |
really important. I think the government can run some things. I | :31:04. | :31:08. | |
think running something publicly is a good thing. You have to choose, | :31:09. | :31:12. | |
and we have all lived in a political lives from the government running | :31:13. | :31:17. | |
British Telecom and British Airways and things have changed, but there | :31:18. | :31:21. | |
are some things that are actually important that they are publicly | :31:22. | :31:24. | |
owned and publicly run and dealt with and this is one of them. | :31:25. | :31:38. | |
And how this is handled, with the group who will act on the half of | :31:39. | :31:45. | |
the beneficiaries rather than on the half of the government interest, | :31:46. | :31:47. | |
which has to be carefully put together. Would he agree with me | :31:48. | :31:56. | |
that one area in which the private sector could play a part and should | :31:57. | :31:59. | |
be, is contributing to the compensation. There is an analogy | :32:00. | :32:05. | |
and off-the-shelf scheme we could look at which is how thalidomide | :32:06. | :32:09. | |
victims were supported themselves with a composite of public funding | :32:10. | :32:14. | |
and funding from the drug companies responsible, and like the Scottish | :32:15. | :32:18. | |
scheme, that has brought us an annual payment to allow those people | :32:19. | :32:26. | |
who struggle with conditions due to this, this can be afforded to the | :32:27. | :32:32. | |
survivors of loved ones who passed away because of contaminated blood. | :32:33. | :32:38. | |
The compensation on thalidomide was on a clear accountability and | :32:39. | :32:44. | |
responsibility are lying, which the company admitted. This has not been | :32:45. | :32:49. | |
completely the same, but I can come on to financial matters in a second. | :32:50. | :32:55. | |
Can I move on from the speech, which I support, and say it is a matter of | :32:56. | :32:59. | |
some despair that we are here again. I remember those friends that came | :33:00. | :33:04. | |
to the public meetings in the House of Commons, saying they were sick of | :33:05. | :33:07. | |
coming to the House of Commons, they had been here so often over the | :33:08. | :33:12. | |
years. The one main thing I would be grateful if my honourable friend | :33:13. | :33:15. | |
would take forward to government, I have not been able to get the point | :33:16. | :33:19. | |
over. This dripping approach over the years is not working. The | :33:20. | :33:25. | |
government can find money at various times for bigger fears, if there is | :33:26. | :33:32. | |
a national disaster -- natural disaster, a banking collapse, vast | :33:33. | :33:35. | |
sums of money suddenly appear. We have not been able to give this | :33:36. | :33:39. | |
issue the same priority, and it cries out for it because the fact we | :33:40. | :33:43. | |
are here again means the issues will not go away, they cannot be dealt | :33:44. | :33:48. | |
with on a drip by drip bases, and someone has not grasped how | :33:49. | :33:53. | |
important it really is to settle this for so many reasons. I will not | :33:54. | :34:00. | |
rehearse the history of it, but will raise the business -- raised the | :34:01. | :34:06. | |
business by way of a backbench debate. I will also not read some of | :34:07. | :34:11. | |
the accounts of individuals involved La Paz because frankly I find it too | :34:12. | :34:14. | |
difficult to read them into the record, and I cannot do it again. I | :34:15. | :34:20. | |
would like to make a couple of points and three comments on where | :34:21. | :34:24. | |
we might go from no. I campaigned on this for many years, I campaigned in | :34:25. | :34:30. | |
government and opposition, when I was minister and when I wasn't. I | :34:31. | :34:35. | |
was pleased the honourable lady mentioned David Cameron because I | :34:36. | :34:40. | |
think his response to the question I raised at Prime Minister's Questions | :34:41. | :34:44. | |
on October 2013 began the current change of events and continued the | :34:45. | :34:47. | |
progress that had been made over many years. I was grateful he saw | :34:48. | :34:52. | |
myself and that constituent of hours, and he seemed to understand | :34:53. | :35:00. | |
more money was going into this game. In June I was invited again to join | :35:01. | :35:04. | |
the Prime Minister in the Department of Health, at which point I went | :35:05. | :35:09. | |
campaigning as far as the public was concerned. I know that some people | :35:10. | :35:14. | |
misinterpreted that. My position in the Department of Health was not | :35:15. | :35:17. | |
conditional on the fact I had been involved with contaminated blood, | :35:18. | :35:20. | |
neither was my decision in the Foreign Office or my decision to | :35:21. | :35:24. | |
leave the Department of Health earlier this year, but the | :35:25. | :35:29. | |
ministerial convention is clear. You cannot have two colleagues firing on | :35:30. | :35:35. | |
the same issue, I did indeed go quiet for a time publicly, but | :35:36. | :35:39. | |
inside the department I made my own representations. I also want to put | :35:40. | :35:45. | |
on record my appreciation of what the honourable member for Battersby | :35:46. | :35:51. | |
did for the scheme. I think I made a mistake when the original proposals | :35:52. | :35:57. | |
on the current scheme came forward in January earlier this year. I sat | :35:58. | :36:03. | |
beside her on the bench and understood the gist of it, but did | :36:04. | :36:06. | |
not understand the detail that only became clear in the consultation. I | :36:07. | :36:11. | |
made a mistake by thinking at that time we had solved the problem. We | :36:12. | :36:16. | |
clearly haven't. I hope I have contributed to the debate as we | :36:17. | :36:22. | |
tried to deal with these proposals. As the honourable lady said, they | :36:23. | :36:27. | |
move us on from where we were, but we're not yet there, and I might say | :36:28. | :36:31. | |
a couple of things as to where we might call. Firstly, I think we got | :36:32. | :36:36. | |
in the original proposals the discretionary payment wrong, and | :36:37. | :36:40. | |
number of discretionary payments made have become effectively fixed, | :36:41. | :36:44. | |
and people have become dependent upon them. That should have been | :36:45. | :36:47. | |
known to the department, but clearly it was not in enough detail. And has | :36:48. | :36:55. | |
led to people feeling they may not be as financially compensated as | :36:56. | :36:58. | |
they are at present. That cannot be the case, we cannot have a situation | :36:59. | :37:02. | |
and I am not so bid prepared to support anything that would make | :37:03. | :37:34. | |
people I thank him for the work he has done and for the work of the | :37:35. | :37:38. | |
honourable member for Kingston-upon-Hull. My constituent | :37:39. | :37:39. | |
is co-infected with many conditions as a result of receiving | :37:40. | :37:41. | |
contaminated blood. It has affected every part of his body and his life, | :37:42. | :37:44. | |
and he worries he may lose up to ?6,000 in discretionary payments and | :37:45. | :37:47. | |
that the cost of his many treatments may count against a settlement. We | :37:48. | :37:49. | |
know that the Minister is listening carefully. Does he he joined me in | :37:50. | :37:54. | |
urging the honourable gentleman to look carefully at this? I do. | :37:55. | :38:07. | |
Regarding payment, I do not think people were fully aware that the | :38:08. | :38:10. | |
discretionary payments had in fact become fixed and a fixed part of | :38:11. | :38:14. | |
peoples income. There is much better awareness now, and I think that is | :38:15. | :38:19. | |
essential because people are extremely worried because they do | :38:20. | :38:22. | |
not see that included in specific terms in the scheme and I hope that | :38:23. | :38:26. | |
will be part of it. I would also like to see a small amount of money | :38:27. | :38:33. | |
made available for the things that were thrown up through the system | :38:34. | :38:38. | |
that are not recognised. I am thinking particularly of a family | :38:39. | :38:43. | |
where two young boys lost their father and two uncles, and they were | :38:44. | :38:47. | |
taken into care, and the lives were changed usually because of it. Now | :38:48. | :38:51. | |
part of the scheme fits the agony they went through and I wonder if | :38:52. | :38:56. | |
there could be some recognition of that. In relation to the enquiry, I | :38:57. | :39:08. | |
must reiterate my determination that there must be some form of enquiry | :39:09. | :39:14. | |
into what has happened. It is on the record, the sense of scandal around | :39:15. | :39:26. | |
this, and materials have been spoken about being scrapped. And I quote, | :39:27. | :39:32. | |
there was a decision to clean up the files and stop some of the | :39:33. | :39:35. | |
incriminating evidence. This cannot be the case that we have this issue | :39:36. | :39:43. | |
that has led to so many deaths, and it is not that public space for | :39:44. | :39:49. | |
those affected to no. The process did well with Hillsborough and | :39:50. | :39:58. | |
Bloody Sunday, and is clouded. I do not think a public enquiry is the | :39:59. | :40:04. | |
necessary vehicle. But in some way... I will not get any further if | :40:05. | :40:16. | |
I give more interventions. I think some process of that remains | :40:17. | :40:22. | |
essential that we press upon. Thirdly, can I now raised | :40:23. | :40:26. | |
specifically the issue of those who were co-infected. The majority of | :40:27. | :40:32. | |
those infected by contaminated blood were mostly hepatitis C infected. A | :40:33. | :40:38. | |
number were co-infected with HIV and hepatitis C, and it is known that of | :40:39. | :40:44. | |
that number there are some 250 only left alive. I think the degree of | :40:45. | :40:48. | |
suffering of those co-infected is different to those who have been | :40:49. | :40:54. | |
mono infected. There is monitoring and treatment for hepatitis C, which | :40:55. | :40:56. | |
we all welcome and has changed the we all welcome and has changed the | :40:57. | :41:01. | |
outlook considerably for many of those infected. For the co-infected, | :41:02. | :41:05. | |
this is not available. This is a discrete group which cannot grow | :41:06. | :41:08. | |
larger. It is diminishing all the time. They have had things that have | :41:09. | :41:14. | |
affected their lives that have not affected others, their length of | :41:15. | :41:17. | |
life at the beginning. I know of those who when they were young were | :41:18. | :41:21. | |
told they may only have five or six years left. The education they were | :41:22. | :41:25. | |
going through was of no consequence, nor was looking through any sum of | :41:26. | :41:31. | |
money because they were not going to live. The outlook is different | :41:32. | :41:36. | |
because they have been able to stay alive, but their condition is still | :41:37. | :41:40. | |
serious and varies from day to day. From that diminishing number, the | :41:41. | :41:46. | |
possibility of lump sums might be the possibility. They do not want to | :41:47. | :41:51. | |
be dependent on the system. They want recognised what they have lost | :41:52. | :41:55. | |
and the opportunity is lost, and a lump sum might be the answer to | :41:56. | :41:59. | |
that. I would be very grateful if some consideration will be given to | :42:00. | :42:03. | |
the co-infected, because I think much of the debate tends to be for | :42:04. | :42:08. | |
the majority, and they do not think that is necessarily wrong, and what | :42:09. | :42:11. | |
is being provided for the majority is important, but the co-infected | :42:12. | :42:17. | |
matter. We have been here too often, and sadly I doubt if the Minister | :42:18. | :42:22. | |
responsible will be the last to talk about this. But we will not leave | :42:23. | :42:29. | |
this. It is a collective shame because government after government | :42:30. | :42:32. | |
will not grasp that this needs a final settlement. This issue cries | :42:33. | :42:36. | |
out for a settlement and we will not stop. I am very pleased to speak in | :42:37. | :42:44. | |
this debate on the half of children who have lost their father and a | :42:45. | :42:49. | |
mother who has lost her son, and a spouse who lost her husband. And for | :42:50. | :42:54. | |
the many people who still suffer an injustice. I want to focus my | :42:55. | :42:59. | |
remarks on the question of transparency in the public sphere. | :43:00. | :43:07. | |
As the Member for north-east Beds mentioned earlier, it has become | :43:08. | :43:11. | |
obvious that there has become evidence -- and it was stated that | :43:12. | :43:23. | |
when he went to the Department of Health while health minister runs | :43:24. | :43:27. | |
boxes of notes on the subject that this raised questions in his mind. | :43:28. | :43:30. | |
He decided he needed a team to deal with this. But when he returned a | :43:31. | :43:34. | |
week later all the paperwork had been shredded. So, I wonder whether | :43:35. | :43:40. | |
we could, through this debate, perhaps ask the Minister to reply in | :43:41. | :43:45. | |
writing to us whether we could give permission to others who perhaps no | :43:46. | :43:50. | |
more to come forward. I agree with the honourable member that perhaps | :43:51. | :43:55. | |
it is not correct to have a full-scale, lengthy enquiry. There | :43:56. | :43:58. | |
must be some way of holding individuals to account who knew | :43:59. | :44:06. | |
more. That covers the justice point. But the other point that is linked | :44:07. | :44:09. | |
in with this is the question of trust in health providers. As I am | :44:10. | :44:15. | |
sure you're aware through listening to this debate, there was a wide | :44:16. | :44:20. | |
knowledge at the time, even from health professionals, and I wonder | :44:21. | :44:23. | |
whether we could also see whether health professionals who may have | :44:24. | :44:26. | |
been working in the National Health service at the time be able to shed | :44:27. | :44:30. | |
some light on how it could possibly be the case that individuals knew | :44:31. | :44:35. | |
about the contamination but decided not to continue with it and the use | :44:36. | :44:43. | |
of contaminated products for reasons of cost and because it was said | :44:44. | :44:51. | |
there was no alternative. We're in this situation now, years later, | :44:52. | :44:56. | |
trying to find the truth. Now was the time look at these questions of | :44:57. | :45:01. | |
trust and justice. Could I add my voice to those of the two speakers | :45:02. | :45:09. | |
in this debate who have said that by bringing in a TOS and other private | :45:10. | :45:17. | |
providers it could help in resolving this matter, and could we look at | :45:18. | :45:21. | |
this as being an NHS led process, which underlines honesty and a sense | :45:22. | :45:29. | |
of communicating well with those who have suffered to many years of | :45:30. | :45:30. | |
trauma from this situation. Could I also put on record the | :45:31. | :45:39. | |
excellent work of the all-party group and that of the haemophilia | :45:40. | :45:45. | |
community, who has helped MPs researched this matter so | :45:46. | :45:48. | |
diligently? And who have called for this proper investigation for so | :45:49. | :45:52. | |
many years now. And once again thank the honourable member for Kingston | :45:53. | :45:57. | |
upon Hull North for bringing forward this debate. Thank you. Thank you. | :45:58. | :46:04. | |
Can I congratulate my honourable friend for securing this debate? All | :46:05. | :46:12. | |
the fine work done on the all-party group in keeping this in the public | :46:13. | :46:20. | |
eye. I associate myself with many of the previous speaker's comments, | :46:21. | :46:25. | |
which I shall not repeat. I would like to highlight a couple of my | :46:26. | :46:30. | |
constituents who are have suffered the terrible effects of this | :46:31. | :46:35. | |
scandal. I spoke again this week to one of my constituents who | :46:36. | :46:41. | |
contracted hepatitis C, following a blood transfusion at the age of 17, | :46:42. | :46:47. | |
40 years ago. She told me she had received some terribly bad news. Her | :46:48. | :46:54. | |
illness had progressed to cirrhosis of the liver. She is currently | :46:55. | :46:59. | |
undertaking tests and biopsies to find out how long she has left to | :47:00. | :47:04. | |
live. I ask the host to imagine a kind of strain of family have been | :47:05. | :47:08. | |
living with all these years, knowing that her condition would probably | :47:09. | :47:13. | |
get worse and yet hoping that it would not. Helen Wilcox has had four | :47:14. | :47:24. | |
strokes, suffers from rheumatoid arthritis and osteoarthritis. She | :47:25. | :47:27. | |
takes 35 tablets a day and can barely get out of bed. | :47:28. | :47:32. | |
Understandably, Helen Wilcox says she has no life. She doesn't go out | :47:33. | :47:37. | |
and you can make plans. She barely has the energy to bring up her | :47:38. | :47:45. | |
children. And had to give up her job ten years ago. I'm sure that the | :47:46. | :47:48. | |
Minister will agree that she and her family deserve the certainty and | :47:49. | :47:53. | |
clarity of a decent settlement in keeping with the pain and suffering | :47:54. | :48:00. | |
she has endured. And she is not alone. Many of my reliable friends | :48:01. | :48:04. | |
will have similar stories from the constituencies. And another victim | :48:05. | :48:12. | |
in my constituency, Richard Warwick, was multiplying affected with HIV, | :48:13. | :48:19. | |
hepatitis C and hepatitis B, by the NHS. And has had his life ruined | :48:20. | :48:27. | |
through no fault of his own. Of the 13 classes in the special school -- | :48:28. | :48:37. | |
of the 13 children in the class of the special school he attended, only | :48:38. | :48:41. | |
four are still alive. He has campaigned long and hard. One of the | :48:42. | :48:46. | |
most heartbreaking and emotional meetings I had was speaking with his | :48:47. | :48:50. | |
parents, who told me about the impact it had on their lives, | :48:51. | :48:54. | |
particularly about their terribly difficult decision to decide against | :48:55. | :49:00. | |
having a family on the basis of the health implications that would have. | :49:01. | :49:09. | |
I welcome the points made by the haemophilia Society, that the new | :49:10. | :49:14. | |
payment scheme is an improvement on proposals from the original January | :49:15. | :49:18. | |
consultation. I think it makes sense to one single scheme going forward, | :49:19. | :49:23. | |
rather than multiple schemes. I am pleased more money has been | :49:24. | :49:29. | |
identified to pay to the victims. On behalf of my constituents and others | :49:30. | :49:34. | |
like them, I would ask the Minister to ensure that no one is worse off | :49:35. | :49:40. | |
under the new system, take into account where those who are | :49:41. | :49:52. | |
receiving discretionary payments... Would he give way? Thank you. He is | :49:53. | :49:57. | |
giving a very emotional speech. It is hard to listen to these things. I | :49:58. | :50:02. | |
would speak up for the idea of the lump sum payment. For the cull | :50:03. | :50:08. | |
infected because they have even more strange than others. If we could | :50:09. | :50:13. | |
help out with that, and there are becoming fewer and fewer of them, I | :50:14. | :50:17. | |
think it is up to us to try to make their lives as good as we possibly | :50:18. | :50:23. | |
can. She makes a very good point. It echoes the comments of the chair of | :50:24. | :50:26. | |
the all-party group, that perhaps that should be an option that could | :50:27. | :50:34. | |
be taken. Of course, the victims have lived with their illnesses for | :50:35. | :50:39. | |
decades. Now they want to insure families are compensated for losses | :50:40. | :50:43. | |
they endured because of it. Referring back to Mr Warwick, he | :50:44. | :50:47. | |
also had to give up his job many years ago. When his employers | :50:48. | :50:52. | |
discovered he was infected with HIV, he was asked to leave. This meant | :50:53. | :50:58. | |
his wife became the main breadwinner. She could only work | :50:59. | :51:01. | |
part-time because the rest of her time is devoted to his care. Given | :51:02. | :51:07. | |
the fact that she might be near to or at retirement, it might be | :51:08. | :51:11. | |
difficult for her to find a full-time job. Mr Warwick tells me | :51:12. | :51:15. | |
that he wants more than anything to be able to put his mind to rest by | :51:16. | :51:21. | |
knowing that Mrs Warwick will continue to receive monthly payments | :51:22. | :51:25. | |
throughout her lifetime. I urge the Minister to think about the terrible | :51:26. | :51:31. | |
impact this injustice has had on Helen Wilcox, Richard Warwick and | :51:32. | :51:35. | |
their families. And many others like them. And offer them greater clarity | :51:36. | :51:40. | |
and a fear settlement so that they can have peace of mind this | :51:41. | :51:47. | |
Christmas. Thank you. Can I commence in the same vein that other | :51:48. | :51:51. | |
honourable and writable members have done, which is to pay tribute to the | :51:52. | :51:59. | |
work done by the Member for Hull North? I see other members across | :52:00. | :52:07. | |
the chamber who have also played a part. This is not a party political | :52:08. | :52:11. | |
issue. The core of this issue is quite simply about doing the right | :52:12. | :52:17. | |
thing. It is Parliament and all-party groups at its best when | :52:18. | :52:24. | |
members come together to deal with the difficult stories such as we | :52:25. | :52:30. | |
have just heard. Based on personal stories of our constituents. I have | :52:31. | :52:35. | |
two constituents who have given me quite an inspirational lead in | :52:36. | :52:40. | |
attacking the problem. Debra has HIV. She received it from a partner | :52:41. | :52:48. | |
who himself had received contaminated blood products. She | :52:49. | :52:51. | |
didn't tell her at the time. It took several years to work out that all | :52:52. | :52:56. | |
her health problems had derived from this infection. He obviously became | :52:57. | :53:01. | |
her ex-partner and that person later died of his illness. But Debra has | :53:02. | :53:07. | |
never been able to hold down a job because of the continuing, | :53:08. | :53:12. | |
persistent illness and nature. Also, in common with the previous | :53:13. | :53:18. | |
description, has been asked to leave her job before now. The career has | :53:19. | :53:23. | |
been badly affected. Neal has hepatitis C. He got it as a | :53:24. | :53:28. | |
haemophilia patient as a child and again he is unable to hold down a | :53:29. | :53:33. | |
job. That means he is unable to hold down decent housing. Part of the | :53:34. | :53:38. | |
problem affecting him means that his body retains water and he has to go | :53:39. | :53:42. | |
to hospital regularly to have his body drained of excess fluid. She | :53:43. | :53:48. | |
can work, but he has great problems with fatigue. His whole life has | :53:49. | :53:53. | |
been dominated by this. I make a point to the House that the only | :53:54. | :53:59. | |
mistake, the only crime that these constituents of mine and other | :54:00. | :54:04. | |
honourable members have committed is to be unlucky. That is the only | :54:05. | :54:08. | |
thing they have done. They were unlucky in the circumstances of | :54:09. | :54:16. | |
being given contaminated blood products or receiving an infection | :54:17. | :54:22. | |
from another partner. Without being told of the circumstances. And the | :54:23. | :54:26. | |
other victims, as we have said, of what could be considered a crime. I | :54:27. | :54:33. | |
cannot get away from the fact that we need to be doing more still for | :54:34. | :54:37. | |
people whose basic problem is that they were unlucky at a difficult | :54:38. | :54:47. | |
time in their life. My concern is, when we simplify things, they also | :54:48. | :54:53. | |
become less valuable. But the current system is chaotic at the | :54:54. | :54:57. | |
moment. As honourable members have said, when it is simplified and | :54:58. | :55:03. | |
schemes are brought together, no recipient should be any worse. I | :55:04. | :55:08. | |
welcome the amalgamation of the different types of schemes. Up until | :55:09. | :55:16. | |
now, there has been perhaps unwitting or deliberate policy of | :55:17. | :55:20. | |
divide and rule, so there are various different types of schemes | :55:21. | :55:25. | |
for different types of sufferers. We know as well there are different | :55:26. | :55:30. | |
schemes and levels of schemes across the different countries of the | :55:31. | :55:33. | |
United Kingdom. We have the absurd situation whereby somebody who is | :55:34. | :55:38. | |
living in England might be able to qualify for a Scottish scheme | :55:39. | :55:41. | |
because it is based on the country that the recipient was in at the | :55:42. | :55:46. | |
time that he or she was infected. It seems to me the House to be a level | :55:47. | :55:51. | |
of consistency and fairness for people who are rightly angry and | :55:52. | :55:58. | |
rightly feeling let down, they are forced to look at the circumstances | :55:59. | :56:02. | |
of other victims and compare themselves, rather than look to the | :56:03. | :56:07. | |
real culprits in this situation, which are the companies, private | :56:08. | :56:13. | |
companies so eloquently described earlier who put profit before | :56:14. | :56:16. | |
patient safety all those years ago and have never been brought to | :56:17. | :56:20. | |
account. In that respect, I support the call is to have a proper | :56:21. | :56:25. | |
enquiry. I put down some questions to the Department of Health on this | :56:26. | :56:29. | |
matter a short while ago. It transpires that has never been any | :56:30. | :56:33. | |
compensation paid by these corporations at all. They have never | :56:34. | :56:41. | |
been sought for compensation. One honourable member pointed out it | :56:42. | :56:44. | |
might be difficult to pin down exactly who was responsible and | :56:45. | :56:47. | |
wine, but there needs to be an effort at least to track down those | :56:48. | :56:52. | |
responsible and make them contribute for their misdemeanours. I did ask | :56:53. | :57:00. | |
Deborah annual further comments. And what they would be looking at here. | :57:01. | :57:04. | |
Deborah is going to lose money under the current proposals. No doubt | :57:05. | :57:09. | |
about that. She found the words of the former Prime Minister David | :57:10. | :57:15. | |
Cameron rather distasteful when he told us that today I am proud to | :57:16. | :57:18. | |
provide them with the support they deserve. Deborah has every right to | :57:19. | :57:26. | |
be angry. She gleaned from that that she deserved to be worse off as an | :57:27. | :57:32. | |
HIV infected partner. She is unclear whether money is going. She wants to | :57:33. | :57:41. | |
know where the money is going to. Is the money the same? Again, I go back | :57:42. | :57:50. | |
to this idea that if victims of this scandal are losing money, they are | :57:51. | :57:54. | |
being asked to turn in on themselves, rather than direct their | :57:55. | :58:04. | |
fire at the real culprits. There is a feeling that the scheme will be | :58:05. | :58:14. | |
taking financial support from those who have no cure, who were forced to | :58:15. | :58:19. | |
take toxic medication to keep them alive and struggle with mental | :58:20. | :58:26. | |
illnesses and the stigma. Despite medication, people are still dying | :58:27. | :58:30. | |
from HIV and AIDS. There is a sense that Deborah has that by moving the | :58:31. | :58:33. | |
schemes around, there is a sense of robbing Peter to pay Paul. Neill | :58:34. | :58:41. | |
also supports the idea of the Hillsborough - style enquiry. | :58:42. | :58:52. | |
?15,500 is far too low, he points out. It doesn't take into account | :58:53. | :58:56. | |
how much the expense is of being ill, travelling to and from | :58:57. | :58:59. | |
hospitals up and down the country and he asks again that payments be | :59:00. | :59:04. | |
linked to inflation, otherwise they grow ever slower. He mentioned the | :59:05. | :59:13. | |
Hillsborough style enquiry and I wanted to add my support to the | :59:14. | :59:21. | |
proposal for this to be considered by the government. I took up the | :59:22. | :59:30. | |
case of the stepfather of one of my constituents, who received unheated | :59:31. | :59:33. | |
Scottish blood products after they had been withdrawn in Scotland. He | :59:34. | :59:37. | |
received them in England. There was a time lag in England. We don't know | :59:38. | :59:42. | |
how many people were affected in this way. He ended up dying. There | :59:43. | :59:46. | |
is a particular sense of injustice they are. Does he feel this is | :59:47. | :59:51. | |
another reason why this sort of enquiry is necessary? I absolutely | :59:52. | :59:56. | |
do. We need to get to the truth. Victims, families and surviving | :59:57. | :00:03. | |
members of families deserve the truth. Culprits need to be held to | :00:04. | :00:09. | |
account. It seems there is knowledge this was going on at the time. The | :00:10. | :00:17. | |
truth is, and honourable member for Bednar -- Bedfordshire made this | :00:18. | :00:21. | |
point, this matter will not go away. The longer it goes on, the greater | :00:22. | :00:29. | |
will be the calls for a final resolution. The government has an | :00:30. | :00:32. | |
opportunity and I'm grateful the Minister will be sure to listen | :00:33. | :00:36. | |
today to do the right thing, too left that black cloud of uncertainty | :00:37. | :00:46. | |
and to end this very eloquently put by the honourable member for | :00:47. | :00:51. | |
Bedfordshire, drip- drip approach to get a final solution and a final | :00:52. | :00:58. | |
answer to this question. That will give certainty which has been | :00:59. | :00:59. | |
missing for so long. Madam Deputy Speaker, I want to pay | :01:00. | :01:09. | |
tribute to my honourable friend and the honourable lady. Without them, | :01:10. | :01:16. | |
we wouldn't have got as far as we have. With them, we have got to go | :01:17. | :01:22. | |
way because there is still more to do. I don't want to repeat what they | :01:23. | :01:28. | |
have said, but I do want to say, the hosting library which produced a | :01:29. | :01:36. | |
very good debate pack, which I think is useful to people. I commend the | :01:37. | :01:44. | |
tainted blood website which has a timeline and a chronology which | :01:45. | :01:50. | |
reminds us the first case of haemophiliacs being infected with | :01:51. | :02:01. | |
Hep C was known in 1961. We know this was designed to help, Philly | :02:02. | :02:08. | |
acts, but it has harmed them. I know about this a bit indirectly. In | :02:09. | :02:13. | |
1975, my wife received eight pints of blood and went on to come and | :02:14. | :02:19. | |
join us in the House of Commons. She was before the factor eight had been | :02:20. | :02:25. | |
spread around and the first member of my family unknowingly to take an | :02:26. | :02:34. | |
HIV test was my mother who had a pancreatic operation and had to have | :02:35. | :02:38. | |
a lot of blood, she heard what was going on and went to be tested. When | :02:39. | :02:44. | |
I was a minister in Northern Ireland in 1989, 90, because of a friend of | :02:45. | :02:51. | |
mine who had been infected with HIV and AIDS after the blood was | :02:52. | :02:56. | |
infected, I spent a lot of time doing the best I could within my | :02:57. | :02:59. | |
department giving advice on trying to bring these issues into the open. | :03:00. | :03:05. | |
I pay tribute to those of my constituents and my friends who have | :03:06. | :03:09. | |
given me the insight into their circumstances living with Hep C, | :03:10. | :03:13. | |
living with HIV and living with AIDS. I want to make a few extra | :03:14. | :03:22. | |
points, the first is, is it possible all the people who are affected by | :03:23. | :03:28. | |
infection could have something on their medical notes which stops | :03:29. | :03:37. | |
every new hospital, clinician, and caregiver asking the questions as to | :03:38. | :03:41. | |
why they have this problem. The first thing people should be | :03:42. | :03:45. | |
entitled to is an understanding that the circumstances requires them not | :03:46. | :03:51. | |
to have to say several times a year to strangers why they need the care | :03:52. | :03:57. | |
and help. The second thing, given some of the specialist treatment and | :03:58. | :04:00. | |
I welcome the advances in dealing with Hep C, people who live away | :04:01. | :04:06. | |
from London, come to specialist hospitals, having to get here | :04:07. | :04:13. | |
reasonably early, and travel costs need to be met. We should have some | :04:14. | :04:25. | |
way in making sure that the difficulties in finding | :04:26. | :04:30. | |
accommodation and paying for their needs, we can be more sympathetic. | :04:31. | :04:33. | |
The last thing I want to say, for those who are very young, who were | :04:34. | :04:39. | |
very young at the time, not the people of my age coming towards | :04:40. | :04:44. | |
retirement years, not that I have to retire soon! But some of those who | :04:45. | :04:48. | |
are young, who are perhaps coming up to middle age, they may have felt | :04:49. | :04:53. | |
lonely because they didn't feel they could have an active social life, | :04:54. | :04:59. | |
probably some have had no particular interest in pursuing higher | :05:00. | :05:04. | |
education to a degree they could work. They probably have, besides | :05:05. | :05:09. | |
physical health issues, probably the need for other therapy, that people | :05:10. | :05:13. | |
go out of their way to put arms around them and get around them | :05:14. | :05:18. | |
properly and meet all their needs in a way they find acceptable. I wish | :05:19. | :05:24. | |
colleagues in the Department of Health well. These aren't easy | :05:25. | :05:28. | |
issues to tackle. I know perfectly well the Treasury has a job of | :05:29. | :05:34. | |
trying to oversee every bit of the department's changes and spending. I | :05:35. | :05:38. | |
will say to the Prime Minister, I hope she will do whatever | :05:39. | :05:42. | |
predecessor did, after a few months of letting this debate settle down, | :05:43. | :05:46. | |
meet with my right honourable friend and the honourable lady and | :05:47. | :05:48. | |
representatives of the haemophilia Society and say, are we getting it | :05:49. | :05:55. | |
right? Is there more we can do? Because the Prime Minister's | :05:56. | :05:59. | |
position is bringing the relevant departments together and say, what | :06:00. | :06:03. | |
can we do to get rid of most of the problems. The one question I will | :06:04. | :06:06. | |
ask my honourable friend on the front bench to an answer today, is | :06:07. | :06:12. | |
is the government still giving help to the haemophilia Society? The load | :06:13. | :06:15. | |
on them has been increased by this work. Their involvement has been | :06:16. | :06:20. | |
important both to governments, those affected and those who are trying to | :06:21. | :06:24. | |
represent both. If the haemophilia Society is being charged extra cots, | :06:25. | :06:30. | |
the government can provide the funds be used to provide. I am grateful. | :06:31. | :06:41. | |
We come into politics, not for politics or high office, but because | :06:42. | :06:44. | |
we care and want to make a difference to lives. If I ever get | :06:45. | :06:51. | |
round to writing a list of my political heroes, the honourable | :06:52. | :06:54. | |
member for Hull North has secured her place on that. Many people have | :06:55. | :07:01. | |
been affected by this, not just for those infected, but their families | :07:02. | :07:06. | |
and loved ones, people who are grieving the loss of someone they | :07:07. | :07:11. | |
thought they would have longer with. A great distance has been made, but | :07:12. | :07:15. | |
we have a long way to go to see real justice. I am here to represent my | :07:16. | :07:22. | |
constituent Alex Smith. He was infected by hepatitis C, but to add | :07:23. | :07:26. | |
insult, his wife died from the same infection from a blood transfusion | :07:27. | :07:31. | |
while she was giving birth to their child. He has suffered the loss of | :07:32. | :07:36. | |
his wife, raised children by himself, he has been ill himself, | :07:37. | :07:41. | |
has not been able to work. What I resent about the approach to this, | :07:42. | :07:46. | |
it feels inhumane. It feels as though the starting point is, how | :07:47. | :07:50. | |
much money is the government willing to pay and then working within that | :07:51. | :07:54. | |
money, rather than looking at it from a human being point of view. I | :07:55. | :07:59. | |
struggle with the idea that the best on offer is to offer the victims of | :08:00. | :08:06. | |
blood contamination, just about living above the poverty line, the | :08:07. | :08:13. | |
hopes, the dreams, the ambition, the potential of so many people have | :08:14. | :08:17. | |
been ruined. Not just by the contamination, but by the treatment | :08:18. | :08:20. | |
they have received by the hospital in trying to find out information | :08:21. | :08:25. | |
and get their own medical records. In poor diagnosis, poor treatment | :08:26. | :08:29. | |
and trying to get justice and fair funding to make sure they can live a | :08:30. | :08:35. | |
decent life. It is more than the infection taking hold of people, it | :08:36. | :08:40. | |
is the issue in the way it has been handled, has dominated the lives of | :08:41. | :08:43. | |
tens of thousands of people. Their lives have been put on hold while | :08:44. | :08:48. | |
they try to get answers, trying to seek justice and where they can just | :08:49. | :08:51. | |
about keep their heads above water when the knot comes on the door | :08:52. | :08:55. | |
because the bailiff is there, when the red letter comes because you | :08:56. | :08:58. | |
could not pay the utility bill, council tax or the rent. I feel | :08:59. | :09:05. | |
government has a duty, not to be themselves accountable for what went | :09:06. | :09:13. | |
on in the 70s and 80s. We cannot act set -- accept the garment is | :09:14. | :09:20. | |
responsible for that, but they are responsible today. The government | :09:21. | :09:24. | |
relaxed the humanity required, the recognition of the pain and | :09:25. | :09:27. | |
suffering so many have gone through and the willingness to give answers | :09:28. | :09:33. | |
and justice for people who have been affected. I absolutely give my | :09:34. | :09:35. | |
support for the call for an independent enquiry. There are many | :09:36. | :09:40. | |
questions that haven't been answered, that do need to be | :09:41. | :09:43. | |
answered. Not just for the victims and their families, but make sure | :09:44. | :09:46. | |
the same mistakes don't happen again. I read the Manchester evening | :09:47. | :09:52. | |
News yesterday and there was an excellent investigation carried out, | :09:53. | :09:56. | |
heartbreaking investigation carried out about how patients were treated | :09:57. | :10:02. | |
by the Pennine acute trust. The stories about children who died | :10:03. | :10:07. | |
because of ill treatment. What was most hurtful about that, wasn't just | :10:08. | :10:13. | |
the poor treatment, it was the way the hospital didn't face up to the | :10:14. | :10:18. | |
mistakes are made, the way it tried to block information coming out and | :10:19. | :10:21. | |
when the journalist tried to get the information, it was withheld and | :10:22. | :10:26. | |
frustrated when it was due to be released in the public interest. | :10:27. | :10:30. | |
That is the experience of many people who are affected by blood | :10:31. | :10:33. | |
contamination as well. When they try to seek information they should have | :10:34. | :10:39. | |
been entitled to, medical records, details of who knew what and when, | :10:40. | :10:43. | |
they are frustrated by the medical institutions who were responsible | :10:44. | :10:47. | |
for that infection in the first place. It is a gross in just met. If | :10:48. | :10:52. | |
you are trying to move on in your life, the fact so many cannot see | :10:53. | :10:57. | |
clarity or a future and the government, to be honest, has taken | :10:58. | :11:01. | |
far too long to come forward with a comprehensive plan to address the | :11:02. | :11:06. | |
answers that are very much needed in this situation. I would urge the | :11:07. | :11:10. | |
government, for no party political gain, it is beyond party politics, | :11:11. | :11:16. | |
it is about human beings, to come forward with a properly funded and | :11:17. | :11:20. | |
logical scheme that doesn't just keep people out of poverty, but | :11:21. | :11:24. | |
reflects they have the right to live a decent and fulfilling life. Come | :11:25. | :11:30. | |
forward with an answer that peels the lid to get to the answers people | :11:31. | :11:35. | |
need to know about how did this happen and learn lessons to make | :11:36. | :11:39. | |
sure it cannot happen again. And more than that, this is the issue we | :11:40. | :11:43. | |
are debating today, but there are lots of people who were affected by | :11:44. | :11:48. | |
poor public service and when they tried to get answers, they were | :11:49. | :11:51. | |
frustrated. If there is one thing this place can do in that case, | :11:52. | :11:55. | |
absolutely apologise, if it is needed, but more than that, be the | :11:56. | :12:00. | |
champions for justice and help them get the answers they deserve. Since | :12:01. | :12:07. | |
being elected to this House, every Friday at surgery I have had one or | :12:08. | :12:13. | |
two of my constituents who I will hopefully share with you in a few | :12:14. | :12:17. | |
moments I have two address the House about this extraordinary tragedy in | :12:18. | :12:23. | |
many ways. I have had, rightly so lived with them, all the | :12:24. | :12:29. | |
frustrations, the false hope in many ways. Hopefully we will finally come | :12:30. | :12:37. | |
to a settlement. Before I start, can I pay tribute to the honourable | :12:38. | :12:43. | |
member from Kingston upon Hull for the incredible work she has done in | :12:44. | :12:46. | |
leading us on a cross-party basis, to get the message across from all | :12:47. | :12:53. | |
those people, those human beings, the human suffering. May I also | :12:54. | :12:56. | |
congratulate the Minister on her role and pay tribute to her | :12:57. | :13:03. | |
predecessor who work hard with many others to try to get to a full and | :13:04. | :13:08. | |
final settlement. I hope the Prime Minister and the Treasury will be | :13:09. | :13:11. | |
listening carefully to this debate and that it is not beyond us to work | :13:12. | :13:16. | |
together now, to get what we have been promising our constituents, | :13:17. | :13:21. | |
these people, through no crime of their own who have been infected | :13:22. | :13:27. | |
with HIV, Hep C, that they will actually get a settlement and as the | :13:28. | :13:31. | |
previous Prime Minister said, nobody will be worse off. This is a | :13:32. | :13:40. | |
question about fairness, in my view. The member for the City of Chester | :13:41. | :13:47. | |
quite rightly emphasised. I don't think it is fair that my | :13:48. | :13:56. | |
constituents should feel that people infected in Scotland should get a | :13:57. | :14:01. | |
better deal than they do in Stratford. The difficulty for Mr M, | :14:02. | :14:15. | |
as I will refer to him, because it is important I maintain his privacy, | :14:16. | :14:19. | |
is that for a very long time there has been something called a | :14:20. | :14:24. | |
discretionary payment, which in reality is not discretionary in any | :14:25. | :14:30. | |
way. It is absolutely that he relies upon, to make sure at the end of the | :14:31. | :14:33. | |
month he can balance the books, he can live just well enough to be able | :14:34. | :14:39. | |
to feel that he has regained his dignity and his freedom in many | :14:40. | :14:47. | |
ways. The difficulty for the Minister is clearly that there is | :14:48. | :14:56. | |
this sum of money, but I would urge the government to relook at this. | :14:57. | :15:01. | |
Because I think it could, and my constituents are considering this, | :15:02. | :15:06. | |
lead to a legal challenge if people feel that they are being unfairly | :15:07. | :15:15. | |
treated over the Scottish settlements or other parts of our | :15:16. | :15:16. | |
country. To now move on to another | :15:17. | :15:30. | |
constituent whose anonymity I am protecting. Her issue is with the | :15:31. | :15:44. | |
McFarlane trust. It isn't just her feeling that the trust was not fit | :15:45. | :15:45. | |
for purpose. The message to the front bench is it | :15:46. | :16:04. | |
would be an outrage if the McFarlane trust carried on in any way in | :16:05. | :16:09. | |
dealing with my constituents. They simply are not fit for purpose. I | :16:10. | :16:18. | |
would end my speech with another gentleman who has been infected with | :16:19. | :16:23. | |
hepatitis C. And remind colleagues of the urgency. We can't come back | :16:24. | :16:31. | |
next year and be debating this again and looking at a settlement again. | :16:32. | :16:37. | |
Just this morning, I received a call from the gentleman's wife. She works | :16:38. | :16:45. | |
in our NHS. She told me he has been admitted to hospital with severe | :16:46. | :16:49. | |
deterioration in his liver due to the advancing hepatitis C. He may | :16:50. | :16:55. | |
not be around by the time we come to a settlement. I would urge the | :16:56. | :16:59. | |
Minister to remind her government that this is about fairness and | :17:00. | :17:04. | |
speed settlement. Thank you very much indeed. During this debate | :17:05. | :17:10. | |
today, firstly I want to pay tribute to my honourable friend, the | :17:11. | :17:14. | |
honourable Lady for Kingston-upon-Hull for her strong | :17:15. | :17:22. | |
campaigning zeal regarding this particular subject. The contaminated | :17:23. | :17:26. | |
blood scandal has touched the lives of many people over the past 40 | :17:27. | :17:32. | |
years. Many people have sadly died, leaving loved ones who have spent | :17:33. | :17:39. | |
lives caring for them. The contaminated blood and blood | :17:40. | :17:47. | |
products scandal did not just affect the lives of those infected, it | :17:48. | :17:50. | |
changed the lives of their families as well. We have had many debate | :17:51. | :17:55. | |
here and in Westminster Hall calling for a final and Phil settlement for | :17:56. | :18:03. | |
those infected. What we have today is an improvement on what was | :18:04. | :18:07. | |
offered in January, but still we have a distance to go, to give those | :18:08. | :18:11. | |
people and their families that means they need to have a decent standard | :18:12. | :18:17. | |
of living and questions do remain unanswered about why those blood | :18:18. | :18:23. | |
products that were infected and infected others were imported from | :18:24. | :18:28. | |
the United States and perhaps other places. Into Northern Ireland and | :18:29. | :18:37. | |
beyond. Whilst she is not the Minister responsible, I hope she | :18:38. | :18:41. | |
will be able to answer those questions today, but also will | :18:42. | :18:47. | |
preserve Lord prior in the other place to ensure we do get answers | :18:48. | :18:50. | |
because, as the honourable member across the House from Mid | :18:51. | :18:57. | |
Bedfordshire said, there is collective shame regarding this | :18:58. | :19:05. | |
issue. This is an issue without political barriers because it has | :19:06. | :19:09. | |
impacted on families right throughout the UK. And I would like | :19:10. | :19:14. | |
to refer to the matter of my intervention earlier to highlight | :19:15. | :19:17. | |
the issues we face in Northern Ireland. I have written to the | :19:18. | :19:23. | |
health minister in Northern Ireland, Michelle O'Neill, Asda has been no | :19:24. | :19:28. | |
announcement yet on the scheme for Northern Ireland. And she said to | :19:29. | :19:35. | |
back in early August, ask the Prime Minister's statement in the House of | :19:36. | :19:38. | |
Commons, I am currently considering options for the future of financial | :19:39. | :19:42. | |
support for patients and families in the North of Ireland before making a | :19:43. | :19:49. | |
decision. This is a similar answer to those I have received from her | :19:50. | :19:58. | |
predecessors. There is no particular urgency, no particular recognition | :19:59. | :20:03. | |
or acknowledgement that this is a serious case, that it impacted on | :20:04. | :20:08. | |
peoples lives. I have written again to the Minister to urge her to | :20:09. | :20:12. | |
address this as soon as possible. And I would appreciate if the | :20:13. | :20:22. | |
Minister could inform us of any forthcoming conversations with her | :20:23. | :20:24. | |
counterpart in Northern Ireland. People affected in Northern Ireland | :20:25. | :20:30. | |
can stay in the current scheme, as long as the English scheme remains | :20:31. | :20:37. | |
on reformed. At once the new English administrator is replaced, that | :20:38. | :20:46. | |
leaves my constituents and the constituents of my honourable friend | :20:47. | :20:53. | |
and other infected people in Northern Ireland and great peril. | :20:54. | :20:56. | |
And we do not want that to happen. And in fact the haemophilia Society | :20:57. | :21:02. | |
has raised this as a particular issue in their document. And it | :21:03. | :21:12. | |
would -- I would also remind the House that the Irish government took | :21:13. | :21:15. | |
the courageous decision some years ago to do except responsibility for | :21:16. | :21:21. | |
this tragedy, which has compromised the health and immunity of so many | :21:22. | :21:25. | |
people. They delivered a compensation scheme. I thank my Bob | :21:26. | :21:32. | |
Friend giving way. Just on that point. It is important because the | :21:33. | :21:36. | |
House has been misinformed of this number of times in previous debates. | :21:37. | :21:42. | |
The scheme for compensation in the Irish Republic was established even | :21:43. | :21:47. | |
before liability was acknowledged. The tribunal system for compensation | :21:48. | :21:58. | |
was established. That is what is missing still in the UK. Thank you | :21:59. | :22:11. | |
for that helpful intervention. That illustrated quite clearly that the | :22:12. | :22:16. | |
needs of people came first, before all of the other extraneous matters. | :22:17. | :22:23. | |
I welcome the fact there has been some progress in this, but there are | :22:24. | :22:27. | |
matters the government must address, if it wants to be responsible for | :22:28. | :22:32. | |
the long overdue settlement that these people require and are | :22:33. | :22:37. | |
entitled to. It is not clear what we all face, following 2020. People | :22:38. | :22:44. | |
need time to plan and should not have the worry of the scheme | :22:45. | :22:47. | |
deteriorating or being pulled out from under their feet. I am also | :22:48. | :22:59. | |
concerned by the lack of clarity. I have spoken many times in the | :23:00. | :23:03. | |
chamber about constituents of mine who have been affected by | :23:04. | :23:06. | |
contaminated blood and they have given me permission to name them. | :23:07. | :23:10. | |
One constituent I have known for most of my life, Brian, has to go to | :23:11. | :23:18. | |
weekly hospital appointments and has associated health problems. Over a | :23:19. | :23:24. | |
year ago, he was diagnosed with non-Hodgkin's lymphoma. Thankfully | :23:25. | :23:28. | |
he is in remission. Two other constituents who live in cocaine, | :23:29. | :23:42. | |
twins, both infected, both haemophiliacs, have found their | :23:43. | :23:57. | |
lives were affected. -- who live in Kilcean. They were unable to work | :23:58. | :24:01. | |
and unable to provide further families. The strain and challenges | :24:02. | :24:12. | |
that people face cannot be overlooked. It is a direct result of | :24:13. | :24:15. | |
this tragic situation. That can never really be a remedy for the | :24:16. | :24:19. | |
lives of those who were affected, but the government can recognise | :24:20. | :24:24. | |
their suffering and alleviate the financial strain on the experience | :24:25. | :24:29. | |
as a result of it. And try and resolve what the honourable member | :24:30. | :24:33. | |
for Mid Bedfordshire talked about. The collective shame. And that | :24:34. | :24:37. | |
legacy of shame that goes back over many many governments, to try to | :24:38. | :24:44. | |
bring some form of relief to people. Some of those people sadly have | :24:45. | :24:49. | |
passed on. Regular payments must be replaced and access to ask -- | :24:50. | :24:55. | |
discretionary grants must be made available. Like the Member for | :24:56. | :25:02. | |
Kingston-upon-Hull who has been such a stout campaigner on behalf of | :25:03. | :25:07. | |
these individuals, I too would like some form of enquiry. Added don't | :25:08. | :25:12. | |
want that enquiry to hold up whatever form of compensation will | :25:13. | :25:18. | |
be available eventually. But what I would say is we need to find out the | :25:19. | :25:22. | |
reasons and the causes. And hope those people who did this -- hold | :25:23. | :25:34. | |
those people who did this accountable. This must never happen | :25:35. | :25:37. | |
again. The government has made progress on this, but it must ensure | :25:38. | :25:43. | |
this is a fool and a settlement, allied to an enquiry. That is what | :25:44. | :25:48. | |
these people deserve and so vitally need. And for which they are along | :25:49. | :25:55. | |
overdue, for those lost lives, for those compromised lives and for | :25:56. | :25:59. | |
those lives that have been so damaged by bad health as a result of | :26:00. | :26:03. | |
those infected and contaminated blood products. Thank you. It is a | :26:04. | :26:13. | |
pleasure to take part in this debate. I would like to thank the | :26:14. | :26:28. | |
member from Kingston-upon-Hull for ensuring this debate. I rise as a | :26:29. | :26:36. | |
Scottish member representing a Scottish constituency in this debate | :26:37. | :26:41. | |
for two reasons. Firstly, on behalf of constituents like Cathy Young, a | :26:42. | :26:48. | |
stage one widow and a member of the Scottish forum who wishes to express | :26:49. | :26:52. | |
solidarity to those in other parts of the UK who find themselves in a | :26:53. | :26:54. | |
different scheme. The infection did not take place in | :26:55. | :27:10. | |
Scotland but elsewhere in the UK, so another scheme is used. That is an | :27:11. | :27:15. | |
important point. Honourable members in other parts of the UK will find | :27:16. | :27:19. | |
they have constituent part of the Scottish scheme. And it looks like | :27:20. | :27:28. | |
they will benefit greater than that. My constituent wrote to me last | :27:29. | :27:32. | |
night and said, for me personally being a widow, obviously those still | :27:33. | :27:37. | |
living with the horror of this disaster must be financially looked | :27:38. | :27:51. | |
after and not just be fobbed off. I would like widows and children of | :27:52. | :28:01. | |
those who have passed away to be respected. Justice is long overdue. | :28:02. | :28:08. | |
I sent my full support to all those affected by this disaster. I wish to | :28:09. | :28:14. | |
raise issues with the proposed Scottish scheme that require this | :28:15. | :28:22. | |
place to carry out some work. As the Haemophelia Society point out, the | :28:23. | :28:26. | |
Scottish scheme is comparatively more generous. Patient involvement | :28:27. | :28:41. | |
in government and means testing has been involved. The Department of | :28:42. | :28:49. | |
Health could adopt many aspects of the Scottish scheme and still fall | :28:50. | :28:54. | |
within its allocated budget, according to our analysis. The | :28:55. | :28:57. | |
all-party group is calling for the government to adopt these measures. | :28:58. | :29:03. | |
And to reverse plans for a profit-making private administrator | :29:04. | :29:08. | |
of the discretionary scheme. Any additional funds to support those | :29:09. | :29:17. | |
affected could be phones from the government stake sale of the plasma | :29:18. | :29:23. | |
resources Branch. Those with both HIV and hepatitis C | :29:24. | :29:41. | |
will have patients increased from ?30,000 to ?37,000 to reflect | :29:42. | :29:49. | |
additional health needs. When a patient dies, the spouse will | :29:50. | :29:54. | |
continue to receive 75% of the payment. There will be a ?50,000 | :29:55. | :30:03. | |
lump sum payment for hepatitis C. Those who have already received the | :30:04. | :30:06. | |
law payment will receive an additional payment. A grant scheme | :30:07. | :30:14. | |
will be set up to cover additional needs. Scottish funding for the | :30:15. | :30:22. | |
scheme will be ?1 million per year. The Scottish Government will aim to | :30:23. | :30:26. | |
deliver the new scheme through a single body, so those affected no | :30:27. | :30:30. | |
longer need to apply to more than one body for funding. | :30:31. | :30:36. | |
The timing of this payment system will depend on Her Majesty 's | :30:37. | :30:42. | |
customs revenues and the Department of Health. What discussions have the | :30:43. | :30:48. | |
department had with HMRC to pass on the relevant tax officer payments | :30:49. | :30:53. | |
can be made to those entitled to compensation and they can receive | :30:54. | :30:56. | |
this without the minimum of fuss? This will ensure those who receive | :30:57. | :31:03. | |
compensation are not liable to tax. This has to happen, whichever | :31:04. | :31:08. | |
mechanism is used to make the new payments. To use the existing scheme | :31:09. | :31:14. | |
to make new payments, I understand, all the devolved nations must agree | :31:15. | :31:17. | |
and at this moment, only Scotland has signed up to do that. Before the | :31:18. | :31:23. | |
Scottish team is established, an important decision is to be taken, | :31:24. | :31:27. | |
which includes changes to the thresholds for receiving ongoing | :31:28. | :31:33. | |
support, the ability for those to apply for those medical records and | :31:34. | :31:36. | |
an appeals procedure for those who think they should be in the Scottish | :31:37. | :31:42. | |
scheme. That might happen to those residents in Scotland who reside | :31:43. | :31:45. | |
elsewhere. A procedure for converting ongoing payments into a | :31:46. | :31:49. | |
lump sum and how the new discretionary scheme will operate in | :31:50. | :31:55. | |
practice. We will welcome the replacement of the five trusts with | :31:56. | :32:00. | |
a single scheme administrator. However the news the new | :32:01. | :32:02. | |
administrator under the proposed English scheme is likely to be a | :32:03. | :32:06. | |
profit-making private company, something which was not mentioned in | :32:07. | :32:10. | |
the consultation documents, will be met with considerable concern. As I | :32:11. | :32:15. | |
understand it, the process for the new scheme administrator started in | :32:16. | :32:21. | |
2016 and is now expected, following a transition period, the new scheme | :32:22. | :32:26. | |
admin will take over in May 20 17th but it appears that new deadline has | :32:27. | :32:29. | |
been pushed forward. It is of concern to many members of the | :32:30. | :32:40. | |
companies have met with the Department of Health to bid for this | :32:41. | :32:48. | |
contract. It is a complex beneficiary and it needs to be dealt | :32:49. | :32:53. | |
with in a sympathetic way. All of us have concerns, as is likely the | :32:54. | :32:56. | |
successful bidder is a private company, it is not clear how the | :32:57. | :33:00. | |
discretionary aspects of the scheme will be delivered. Will the | :33:01. | :33:03. | |
Department of Health publish a set of principles and the budget will be | :33:04. | :33:11. | |
up to the scheme administrator to consider applications for grants and | :33:12. | :33:19. | |
other support. The Scottish scheme as an alternative recommendations. | :33:20. | :33:29. | |
In terms of discretionary support, the Scottish scheme will be better | :33:30. | :33:34. | |
funded whereas the English scheme will see a modest 25% increase in | :33:35. | :33:43. | |
2018, 19. There are a couple of issues I want to raise before I | :33:44. | :33:53. | |
conclude my remarks. The number of concerns have been made principally | :33:54. | :33:55. | |
around the issues raised by the member for Walden worst and that is | :33:56. | :34:00. | |
in relation to health records. We know for a fact people who are | :34:01. | :34:08. | |
infected by this disaster have, on death certificates, not the words | :34:09. | :34:13. | |
HIV or hepatitis C, for very understandable reasons at the time, | :34:14. | :34:20. | |
because of the stigma that was attached to those conditions. I | :34:21. | :34:25. | |
would like to ask the Minister if the scheme administrator of the | :34:26. | :34:28. | |
government is considering that issue and there are people infected by | :34:29. | :34:33. | |
this where their death certificate says something different, but | :34:34. | :34:35. | |
medical records will indicate. I will give way. I think he has made a | :34:36. | :34:42. | |
good point to the Minister. The other question, you may have been | :34:43. | :34:46. | |
plotting, but if he doesn't I will, how will government tried to get to | :34:47. | :34:52. | |
those who may have died 25 years ago whose spouses may not know about | :34:53. | :34:56. | |
this offer? Not everyone is involved in the networks. It is very | :34:57. | :35:03. | |
important and it is also up to us to raise that issue with our | :35:04. | :35:08. | |
constituents. He is quite right, there are people who don't know, who | :35:09. | :35:13. | |
have lost partners years ago, about that and I thank him for his | :35:14. | :35:17. | |
intervention. I hope the Minister will consider that point. So clear | :35:18. | :35:25. | |
points about tax, to ensure the compensation is not subject to tax. | :35:26. | :35:28. | |
That would be ludicrous and the issue of death certificates. I thank | :35:29. | :35:35. | |
you, Mr Deputy Speaker for allowing me to participate in this debate and | :35:36. | :35:38. | |
all members who have contributed, it has been a first-class debate, thank | :35:39. | :35:45. | |
you, sir. I am grateful for the opportunity to participate in this | :35:46. | :35:51. | |
debate. I would like to thank the business committee for scheduling | :35:52. | :35:54. | |
this session and the member is responsible for bringing forward | :35:55. | :35:59. | |
this motion. Particularly the honourable member for Kingston upon | :36:00. | :36:02. | |
Hull North for leading this debate and the work she has carried out. | :36:03. | :36:09. | |
She summarised the situation clearly and forcefully and I am grateful to | :36:10. | :36:12. | |
her for outlining the risk of private operators administrating the | :36:13. | :36:18. | |
scheme, concern raised by several members today on all sides of the | :36:19. | :36:21. | |
House. A recurring theme has been that of justice and the question | :36:22. | :36:26. | |
about how much is known about the contamination at the time. It has | :36:27. | :36:30. | |
been asked and it deserves an answer. This subject is one of the | :36:31. | :36:33. | |
most terrible chapters in the history of our NHS, truly horrific | :36:34. | :36:37. | |
and impacting upon tens of thousands of people and their families, | :36:38. | :36:42. | |
ongoing, in some cases, for over 40 years. Many have died and some have | :36:43. | :36:48. | |
been left with long-term disability and hardship. Relatives have had to | :36:49. | :36:51. | |
sacrifice career is to provide care and support and in some cases, | :36:52. | :36:56. | |
carers and the bonds have become infected. I have had a letter from | :36:57. | :37:00. | |
one surviving victim whose partner was subsequently infected and died. | :37:01. | :37:07. | |
They have to deal with such difficulties with enduring courage | :37:08. | :37:11. | |
and I wonder where many have found the strength from, physically, | :37:12. | :37:14. | |
emotionally and financially, which brings me on to the proposed changes | :37:15. | :37:19. | |
to the current X Gracia payments. As my honourable friend, the member for | :37:20. | :37:25. | |
Glasgow South West has illustrated, in Scotland will see an annual | :37:26. | :37:30. | |
payment for those with HIV and advanced hepatitis C increased to | :37:31. | :37:35. | |
?27,000 a year, set at a level to reflect average earnings. I think | :37:36. | :37:39. | |
this point about average earnings is extremely important. It is not about | :37:40. | :37:43. | |
poverty, it is about a decent standard of living. Those | :37:44. | :37:48. | |
co-infected with HIV in Hep C will have payments increased to 37,000 to | :37:49. | :37:53. | |
reflect their additional health needs. Where the patient dies, their | :37:54. | :38:01. | |
partner will receive 75% of the previous annual entitlement. That is | :38:02. | :38:04. | |
important because many have given up their own careers. Bravo those | :38:05. | :38:09. | |
infected with chronic hepatitis C will receive a ?50,000 lump sum | :38:10. | :38:17. | |
payment and an additional sum. The Scottish discretionary support | :38:18. | :38:21. | |
scheme is set to see its funding trouble, have an independent | :38:22. | :38:24. | |
mechanism and there is a general guarantee no individual will be | :38:25. | :38:28. | |
worse off than they are at present. To simplify things, those infected | :38:29. | :38:32. | |
will no longer have to apply to more than one body for funding as the | :38:33. | :38:36. | |
Scottish Government aims to deliver the scheme through a single body. | :38:37. | :38:40. | |
Government arrangements are still to be detailed for this new | :38:41. | :38:44. | |
organisation but likely to be administered by National Service | :38:45. | :38:48. | |
Scotland. It is also worth remembering, the Scottish Government | :38:49. | :38:53. | |
is committed to miss -- reviewing the stage one on stage to hepatitis | :38:54. | :39:01. | |
C distinction. The Scottish scheme is more generous. It is not without | :39:02. | :39:05. | |
its detractors, particularly those with less health impacts who will | :39:06. | :39:08. | |
not receive the more generous payments propose. It is important we | :39:09. | :39:13. | |
continue to listen to the views of beneficiaries as we design and | :39:14. | :39:16. | |
implement the new Scottish scheme. To that end, future evidence of | :39:17. | :39:22. | |
payment criteria will be carried out. In Scotland we want to improve | :39:23. | :39:27. | |
the scheme for everyone, the greater priority for those with the severest | :39:28. | :39:31. | |
needs must be given. We have heard of the many tragic, individual cases | :39:32. | :39:35. | |
throughout the UK and I will spare you further examples from those I | :39:36. | :39:38. | |
have received details. I would like to focus on some of the questions | :39:39. | :39:42. | |
which have been raised with me by victims and their support groups and | :39:43. | :39:45. | |
I hope the Minister can assist some answers. First, the compensation | :39:46. | :39:51. | |
schemes of which there are five different organisations funded by | :39:52. | :39:54. | |
the UK health department including the three devolved health | :39:55. | :39:57. | |
authorities, need in order to use existing schemes to make the new | :39:58. | :40:01. | |
Scottish payments, requires four or four Nations of the UK to agree and | :40:02. | :40:09. | |
there must be agreement. Only Scotland is signed up and there will | :40:10. | :40:14. | |
be a Scotland wide payment system, but the timing of this will depend | :40:15. | :40:17. | |
upon the UK Government hater master your and the Department of Health | :40:18. | :40:23. | |
and I will ask the UK Government is not stand in the way of the Scottish | :40:24. | :40:27. | |
payments. Which brings me to my second as, Westminster must pass tax | :40:28. | :40:34. | |
order so none of the payments are liable to fall tax. This must happen | :40:35. | :40:37. | |
whichever mechanism is used to make any payments. Another question is | :40:38. | :40:43. | |
what more can be done about cross-border infections? The current | :40:44. | :40:47. | |
scheme is based upon where the individual was infected rather than | :40:48. | :40:51. | |
residency. This means the English schemes affect numbers of Scottish | :40:52. | :40:56. | |
residence and the Scottish scheme will affect those are resident in | :40:57. | :41:04. | |
England. Hepatitis C sufferers are acutely aware of the cold and during | :41:05. | :41:07. | |
the heating bills go through the roof. If they cannot heat their | :41:08. | :41:13. | |
home, they are at risk of death through colds, flu and other | :41:14. | :41:19. | |
illnesses. Perhaps ministers can provide a rationale for wanting | :41:20. | :41:26. | |
remove the fuel payment. Also the liver damage test is outdated and we | :41:27. | :41:30. | |
should look at the impact it is having on the whole body and this | :41:31. | :41:33. | |
might be amplified by those who have made positive lifestyle choices, | :41:34. | :41:39. | |
such as sustaining from alcohol and his liver appears to be less | :41:40. | :41:43. | |
affected. Some certainty is sought regarding future funding. In | :41:44. | :41:49. | |
conclusion, I always try to be positive and look forward to the | :41:50. | :41:53. | |
future, but given the age of many victims and their medical | :41:54. | :41:55. | |
complications, people are dying every week. Every year, there are | :41:56. | :42:01. | |
fewer. Thousands have died and this is too little, too late. | :42:02. | :42:05. | |
Positiveness is extremely difficult to find in those circumstances, | :42:06. | :42:08. | |
however I am grateful to have had the opportunity to take part in this | :42:09. | :42:12. | |
excellent and consensual debate. Thank you. It is indeed a pleasure | :42:13. | :42:22. | |
to speak on such an important debate this afternoon. I want to first and | :42:23. | :42:29. | |
foremost though, thoroughly thank my honourable friend, the member for | :42:30. | :42:34. | |
Hull North, who for many years now, has championed and pushed on this | :42:35. | :42:39. | |
vitally important matter. Her work cannot and must not go unrecognised. | :42:40. | :42:43. | |
I am sure people across the country and across the House today will want | :42:44. | :42:50. | |
to join me in doing that. Thank you. The experiences of those men and | :42:51. | :42:54. | |
women affected by this awful scandal should never be out of our minds, as | :42:55. | :42:59. | |
we continue to do all we can to support them. To do all that we can | :43:00. | :43:03. | |
for them is paramount knowing that what ever we do will not be enough | :43:04. | :43:07. | |
to give them back their life or a life without suffering or pain. HIV | :43:08. | :43:13. | |
and hepatitis are terrible conditions. Someone living with HIV | :43:14. | :43:18. | |
or hepatitis full face fears of developing other conditions and have | :43:19. | :43:23. | |
defaced the stigma that comes with these conditions. It is welcome and | :43:24. | :43:26. | |
this is the first time this House has had the chance to debate the new | :43:27. | :43:31. | |
scheme since it was announced and continue to hold the government to | :43:32. | :43:35. | |
account to do more. It is important we now have the chance to discuss | :43:36. | :43:39. | |
this in a considered and comprehensive manner. And my | :43:40. | :43:43. | |
contribution today, I want to touch upon three areas. Firstly, the | :43:44. | :43:48. | |
current funding system in England, secondly, the involvement of private | :43:49. | :43:51. | |
companies to administer support to beneficiaries and thirdly, the need | :43:52. | :43:56. | |
for an independent, Hillsborough style panel to recognise the | :43:57. | :43:59. | |
failures of the system that these people have had to live with. It was | :44:00. | :44:04. | |
announced that a new financial arrangement system would be | :44:05. | :44:08. | |
introduced earlier in the year and a public consultation was conducted to | :44:09. | :44:13. | |
get views and opinions on how this would take shape. Whilst it is | :44:14. | :44:16. | |
welcome to see a somewhat modest increase in the annual payment to | :44:17. | :44:22. | |
people with HIV, hepatitis C at stage two and those who are | :44:23. | :44:26. | |
co-infected, as well as those first guaranteed ongoing payments for | :44:27. | :44:32. | |
people with stage one hepatitis C, it is concerning that these payments | :44:33. | :44:36. | |
to fall short of what has been drawn up in Scotland. Also the current | :44:37. | :44:40. | |
English system has no mention of support for people who have been | :44:41. | :44:45. | |
cleared of hepatitis C prior to the chronic stage, who, despite fighting | :44:46. | :44:49. | |
of the disease, may still exhibit symptoms ranging from fatigue, to | :44:50. | :44:52. | |
mental health issues and even diabetes. These people have never | :44:53. | :44:59. | |
been entitled to any support and continue to get non-. The scheme | :45:00. | :45:02. | |
also does not include support for those infected with other viruses | :45:03. | :45:08. | |
such as hepatitis B, D or E and for these people it has meant continuous | :45:09. | :45:12. | |
monitoring of their liver function. It is estimated this group is | :45:13. | :45:18. | |
extremely small and according to the haemophilia Society, would be a | :45:19. | :45:20. | |
minimal cost to the department for health. | :45:21. | :45:26. | |
The new scheme does little to nothing for bereaved partners, | :45:27. | :45:32. | |
parents are children of those who have sadly died from disease | :45:33. | :45:39. | |
contaminated through the contracted blood scandal. I hope the Minister | :45:40. | :45:47. | |
in her reply can give us some reassurance that these concerns have | :45:48. | :45:50. | |
been noted and she will go away and look at what more can be done to | :45:51. | :45:55. | |
help those people who I have just mentioned. There are also concerns | :45:56. | :45:58. | |
regarding the discretionary payments which thankfully received, despite | :45:59. | :46:04. | |
being announced in the consultation earlier this year that they could be | :46:05. | :46:07. | |
scrapped. They should be welcomed, but there is a clear concerned it | :46:08. | :46:18. | |
will not support those with HIV or those who are calling affected. The | :46:19. | :46:22. | |
government will need to consider this impact and what more of the | :46:23. | :46:25. | |
need to do. It is worrying the government have yet to make clear | :46:26. | :46:29. | |
what the minimum and maximum discretionary support people will be | :46:30. | :46:35. | |
able to receive its. I understand the infected blood reference group | :46:36. | :46:39. | |
are currently considering this policy and we will hear more about | :46:40. | :46:42. | |
this in the New Year. Would it not be worthwhile for the Minister to | :46:43. | :46:46. | |
give us some indication now so that those who will depend on less money | :46:47. | :46:51. | |
and the years to come can have some reassurances, especially as we enter | :46:52. | :46:55. | |
this festive period? There are many questions to be answered that is why | :46:56. | :46:59. | |
I hope that in the time allowed to the Minister today, she will give us | :47:00. | :47:05. | |
both in this House and those who will be watching this debate the | :47:06. | :47:10. | |
reassurances they need. The new scheme will bring about a | :47:11. | :47:15. | |
replacement to the current system whereby five trusts across the | :47:16. | :47:18. | |
country who administer the payments will be amalgamated into one. I know | :47:19. | :47:24. | |
this has been welcomed. Yet there is one very concerning point that needs | :47:25. | :47:29. | |
to be addressed by the Minister. And was so eloquently put by my | :47:30. | :47:32. | |
honourable friend who opened this debate. That is the potential | :47:33. | :47:36. | |
involvement of a private sector company, such as Capita, who have | :47:37. | :47:47. | |
bid in the tender process, along with other companies. This was never | :47:48. | :47:52. | |
included in any talks with the all-party group on haemophilia and | :47:53. | :47:55. | |
blood contamination. There was no consultation with the affected | :47:56. | :48:00. | |
community, no mention in the department's responds to the survey. | :48:01. | :48:04. | |
Yet we are seeing at happening now. The concern here is that many of the | :48:05. | :48:11. | |
thousands of people affected by this mistake, which must be remembered | :48:12. | :48:15. | |
was often made by US private companies, feel aggrieved that the | :48:16. | :48:22. | |
potential involvement of a profit-making private company. This | :48:23. | :48:25. | |
is justified, especially when it was a mistake of a private company that | :48:26. | :48:30. | |
put them in their current situation. There should be no profit-making | :48:31. | :48:36. | |
when it comes to compensating for the failures of the private sector. | :48:37. | :48:40. | |
This was highlighted well by my noble friend earlier. Also mentioned | :48:41. | :48:50. | |
by the former health minister. The Member for North East Bedfordshire. | :48:51. | :49:02. | |
Also by the survey conducted of nearly 1000 people affected, who | :49:03. | :49:06. | |
clearly had concerns of the involvement of a profit-making | :49:07. | :49:08. | |
private company. It is important those affected have their say in the | :49:09. | :49:13. | |
administering of the payments and support. Therefore I would be | :49:14. | :49:17. | |
interested to hear the Minister's thoughts on their involvement, such | :49:18. | :49:22. | |
as we have seen in Scotland. Weather has been an alternative scheme | :49:23. | :49:27. | |
operator which includes beneficiary involvement, along with giving us | :49:28. | :49:34. | |
answers on why private involvement is now being considered but was | :49:35. | :49:39. | |
never consulted upon. Finally, my last point is the issue on | :49:40. | :49:44. | |
coordinating an independent panel, in the style we solve for | :49:45. | :49:48. | |
Hillsborough. The Prime Minister in September promised she would keep an | :49:49. | :49:51. | |
open mind to the idea of an independent panel, yet has sadly | :49:52. | :49:56. | |
quash this idea. The rational given is we have had two public enquiries | :49:57. | :50:01. | |
into this matter already by Lord Archer and Lord Penrose. And this | :50:02. | :50:07. | |
may be the case, but it is important we consider this approach to helping | :50:08. | :50:12. | |
people get the justice they deserve. Especially since it is clear that | :50:13. | :50:16. | |
neither of the two enquiries met the needs of the affected community. The | :50:17. | :50:31. | |
affected communities are calling for something which is strongly | :50:32. | :50:34. | |
supported by this side of the House, and that is the need for a truth is | :50:35. | :50:42. | |
in process. Will she give way? Thank you. It is on that point of the need | :50:43. | :50:50. | |
for some vehicle of enquiry into the real background here. I pointed out | :50:51. | :50:59. | |
earlier that in the situation in the Irish Republic, compensation was | :51:00. | :51:04. | |
established in 1995. There was an act in 1997. Following the tribunal | :51:05. | :51:09. | |
of enquiry, the state admitted liability, so there was further | :51:10. | :51:14. | |
legislation in 2002. The liability rested on the fact the tribunal | :51:15. | :51:24. | |
found the state knew there was a risk but carried on, as did the UK | :51:25. | :51:35. | |
and others. I am sure the Minister can understand the concerns across | :51:36. | :51:38. | |
the House and out in the community with the affected people and their | :51:39. | :51:45. | |
families. Before she replies, I would take this chance to ask her | :51:46. | :51:49. | |
not to enter into the same language that was used by the Prime Minister, | :51:50. | :51:54. | |
to use the lack of support for an independent panel is being down to | :51:55. | :51:58. | |
the delay in the support system being introduced. It has clearly | :51:59. | :52:03. | |
been put that an independent panel with the clear defined terms of | :52:04. | :52:08. | |
reference would not impede on the developing implementation of the new | :52:09. | :52:11. | |
system. I hope the Minister will keep this in mind in her reply and | :52:12. | :52:16. | |
recognise how important it is for those affected to get the | :52:17. | :52:20. | |
reconciliation they have fought so long for. The government must be | :52:21. | :52:32. | |
and listening. This is an important and listening. This is an important | :52:33. | :52:38. | |
issue we must get right. I want to thank the Member for Kingston upon | :52:39. | :52:47. | |
Hull North for her steadfast campaign in this area. For those who | :52:48. | :52:56. | |
have died because of the serious mistake and those who are still | :52:57. | :53:00. | |
living with the rapper customs of this mistake, and those who have | :53:01. | :53:03. | |
fought it off but still live with the impact of it, they are all the | :53:04. | :53:08. | |
respect and dignity they deserve. I hope the Minister in her reply will | :53:09. | :53:19. | |
give them just that. Thank you. I would like to congratulate the | :53:20. | :53:24. | |
Member for Kingston upon Hull North and all the members of the all-party | :53:25. | :53:28. | |
in the four haemophilia and contaminated blood, for helping to | :53:29. | :53:33. | |
secure this debate. And I thank the backbench business committee for | :53:34. | :53:40. | |
providing time for it. It has been a moving debate. It has been | :53:41. | :53:43. | |
nonpartisan and I would like to thank all members from across the | :53:44. | :53:47. | |
House for the constructive way in which they have approached the | :53:48. | :53:52. | |
debate. I would like to formally add my personal apology to all those who | :53:53. | :53:56. | |
have been affected by these tragic circumstances and the impact it has | :53:57. | :54:00. | |
had on so many families. And to thank all colleagues and | :54:01. | :54:11. | |
constituents -- all constituents of colleagues for being brave enough in | :54:12. | :54:18. | |
lowering their stories to be told in the House today. I wish I could | :54:19. | :54:21. | |
refer to all constituents who are mentioned today, but I listed them | :54:22. | :54:26. | |
down and that would take most of the debating time we have today. I'd | :54:27. | :54:30. | |
like to say thank you to all those who allowed their stories to be | :54:31. | :54:35. | |
told. This is exactly why the government is introducing the | :54:36. | :54:39. | |
reforms we have been debating today to the existing support schemes, | :54:40. | :54:43. | |
alongside a commitment within the Spending Review period of up to 125 | :54:44. | :54:50. | |
million for those affected until 2020, which will more than double | :54:51. | :54:54. | |
the annual spend over the next five years. I think we should be upfront | :54:55. | :54:59. | |
however in the beginning in recognising that nothing can make up | :55:00. | :55:02. | |
for the suffering and loss that those families have experienced, and | :55:03. | :55:07. | |
no financial support can't change what has happened to them. But I do | :55:08. | :55:12. | |
hope that all of those here today will recognise this is significantly | :55:13. | :55:16. | |
more than any previous administration has provided, and | :55:17. | :55:19. | |
recognise how seriously the government is taking this issue. I | :55:20. | :55:23. | |
would like to join other colleagues in paying tribute to the previous | :55:24. | :55:29. | |
Prime Minister and my predecessor, the Member for Battersea, for all | :55:30. | :55:34. | |
their work on this issue, and reiterate the statement that the aim | :55:35. | :55:36. | |
of this support scheme is that nobody will be worse off. As many | :55:37. | :55:42. | |
colleagues have said, it is time that our reforms should bring an end | :55:43. | :55:46. | |
to the tortured road that far too many people affected have been | :55:47. | :55:51. | |
through. And it is time for a more comprehensive and accessible scheme | :55:52. | :55:55. | |
that gives those affected back their dignity. But as I hope is clear from | :55:56. | :56:00. | |
this debate, not all the details are yet resolved. I hope to answer as | :56:01. | :56:03. | |
many questions as I can today, but I'm certain that the noble Lord | :56:04. | :56:08. | |
prior will be listing closely to this debate and so he will be in | :56:09. | :56:14. | |
contact with all of those who are here today to ensure we can resolve | :56:15. | :56:21. | |
details that I cannot get to in the time available. Let's start with | :56:22. | :56:25. | |
where we are. The reforms guarantee that all those chronically infected | :56:26. | :56:29. | |
will for the first time receive a regular annual payment in | :56:30. | :56:33. | |
recognition of what has happened to them. It includes all those 2400 | :56:34. | :56:41. | |
individuals with chronic hepatitis C stage one who previously received no | :56:42. | :56:45. | |
ongoing payment, but will now expect to receive ?3500 per year. Increases | :56:46. | :56:52. | |
to existing annual payments have also been announced. These are not | :56:53. | :56:56. | |
designed to guarantee a reasonable standard of living in a cell. It | :56:57. | :57:03. | |
needs to be considered in a whole package of support being available. | :57:04. | :57:13. | |
The Member for Glasgow South West has rightfully raised this. I would | :57:14. | :57:20. | |
like to address some of the issues raised about finances. The budget | :57:21. | :57:32. | |
for the scheme comes within the Department of Health's budget, not | :57:33. | :57:36. | |
the Treasury budget. If there is an underspend in any one year, the | :57:37. | :57:39. | |
money will remain within the Department of Health and if any | :57:40. | :57:46. | |
payments should be made in that year and a file into the next year, we | :57:47. | :57:51. | |
can take that money forward. I would like to address concerns raised | :57:52. | :57:57. | |
about the tendering for the scheme. The shadow minister is I am afraid | :57:58. | :58:01. | |
not quite correct that Capita and another company have already put | :58:02. | :58:13. | |
forward our bid. We have not yet sent an invitation to tender. I'm | :58:14. | :58:17. | |
absolutely sure that the concerns raised in this debate will be heard. | :58:18. | :58:21. | |
And concerns about trust and the history of the situation will be | :58:22. | :58:28. | |
well understood by all those involved in the design. I am | :58:29. | :58:32. | |
grateful for the Minister clarifying the position around the tender. | :58:33. | :58:37. | |
Could she confirm that the only organisations and businesses that | :58:38. | :58:41. | |
have been invited in for conversations with the Department of | :58:42. | :58:46. | |
Health were two mentioned earlier? Is that correct or not? I have had | :58:47. | :58:52. | |
no meetings on this issue because it is not within my departmental brief. | :58:53. | :58:56. | |
I'm happy to try and find out if she would like. I would like to move on | :58:57. | :59:02. | |
to some other issues because we are quite tight four-time. I would like | :59:03. | :59:12. | |
to talk about the budget. The pressures on the health budget will | :59:13. | :59:15. | |
come as no surprise to anyone here today. We had an animated debate | :59:16. | :59:20. | |
about that just this week. I would like to assure everybody in this | :59:21. | :59:25. | |
House that even in the context of those pressures, we fought hard to | :59:26. | :59:30. | |
protect the money for this scheme through tough budget negotiations, | :59:31. | :59:34. | |
in order to fulfil commitments that were made and to ensure that the | :59:35. | :59:39. | |
concerns of those affected are addressed as far as possible. I | :59:40. | :59:44. | |
would like in the context of that to talk in a little bit more detail | :59:45. | :59:48. | |
about some of the concerns that have been raised today by colleagues. | :59:49. | :59:52. | |
Colleagues have rightly raise the issue of support for the bereaved. | :59:53. | :59:58. | |
And those relying upon discretionary payments. That is why we have | :59:59. | :00:04. | |
introduced the one-off payment of ?10,000 to brief partners or spouses | :00:05. | :00:08. | |
of primary beneficiaries where infection contributed to their death | :00:09. | :00:12. | |
and in recognition of their relationship at the time of death. I | :00:13. | :00:18. | |
will give way in one second. I want to respond to the point made about | :00:19. | :00:26. | |
the certification of death. We understand that death certification | :00:27. | :00:33. | |
may not state direct contribution, so the policy which is to be | :00:34. | :00:37. | |
published will recognise other ways to show a causal link of infection | :00:38. | :00:41. | |
upon death. We would like to make sure that is not a barrier to | :00:42. | :00:45. | |
support under the scheme. I give way. | :00:46. | :00:52. | |
Can we get some clarity on matters where the death certificate isn't | :00:53. | :00:58. | |
ascertained and whether there will be more flexibility around that | :00:59. | :01:04. | |
providing hepatitis can be proven? He makes a very important point and | :01:05. | :01:08. | |
those are the issues which have been wrestled with at the moment by the | :01:09. | :01:12. | |
Department and we are trying to resolve those at the moment. But, we | :01:13. | :01:19. | |
do realise that Access ability to the bereaved for the payment scheme | :01:20. | :01:25. | |
and the discretionary support scheme is going to be important. I am not | :01:26. | :01:34. | |
able to give the complete details of the discretionary scheme at the | :01:35. | :01:44. | |
moment. In 2017, 18 a single scheme will replace the three discretionary | :01:45. | :01:48. | |
support schemes. It will be transparent and flexible so it can | :01:49. | :01:54. | |
support the beneficiaries most in need. Until those details have been | :01:55. | :01:58. | |
worked out, it would not be fair to speculate on exactly what they will | :01:59. | :02:02. | |
be. But until we are in a position to introduce that new system, I do | :02:03. | :02:07. | |
want to reassure you that the current discretionary payment will | :02:08. | :02:11. | |
stay in place and I would also like to reassure you that the policy of | :02:12. | :02:20. | |
?10,000 for the wreathed partners and spouses will be published by DH | :02:21. | :02:25. | |
and it will be communicated to all major stakeholders to make sure we | :02:26. | :02:33. | |
reach out to those bereaved a long time ago to make both these policies | :02:34. | :02:39. | |
as accessible as possible. We do realise these payments can never | :02:40. | :02:42. | |
make up for the personal loss of the wreathed partners or their spouses | :02:43. | :02:47. | |
have experienced. We are trying to make sure the process is as smooth | :02:48. | :02:51. | |
and effective as possible with as few barriers as possible so it does | :02:52. | :02:56. | |
not make individuals feel as though they are having to jump through | :02:57. | :03:04. | |
loopholes. I will give way. I thank the Minister for giving way. In | :03:05. | :03:09. | |
relation to the point echoed by the member about death certificates and | :03:10. | :03:12. | |
asking that is going to be dealt with in a sympathetic fashion, | :03:13. | :03:18. | |
someone with a death certificate will not say how HIV but hepatitis C | :03:19. | :03:24. | |
and the government is going to look at that? The issue of death | :03:25. | :03:29. | |
certificates is one we are alive to an Bondad government is trying to | :03:30. | :03:32. | |
address and I hope we will be consulting closely with the relevant | :03:33. | :03:36. | |
groups to make sure we deal with it in a sympathetic manner as possible. | :03:37. | :03:41. | |
I thank the Minister for giving way. One thing the Minister could comment | :03:42. | :03:47. | |
on the points I made, particularly about the Northern Ireland executive | :03:48. | :03:52. | |
and if it would be possible for further phone calls to be made to | :03:53. | :03:58. | |
the Minister of health in Northern Ireland to accelerate this process | :03:59. | :04:01. | |
and enable payments and the scheme to be made available? If the | :04:02. | :04:07. | |
honourable lady will have patience, I have an entire section on the | :04:08. | :04:11. | |
devolved nations coming up. I would like to move on a little bit before | :04:12. | :04:18. | |
then to speak a little bit about the other sections of the scheme. The | :04:19. | :04:28. | |
government's response to the consultation makes it clear they | :04:29. | :04:32. | |
will be able to access discretionary on the tested basis. But this is not | :04:33. | :04:37. | |
the end of the story. Mike officials will continue to work with a group | :04:38. | :04:43. | |
of experts on the details of the policy for this new detail for the | :04:44. | :04:46. | |
bereaved and wide elements of the payment as soon as the policy is | :04:47. | :04:50. | |
confirmed the department will publish it and give guidance as to | :04:51. | :04:53. | |
who is eligible and how to access the payment as easy as possible. I | :04:54. | :04:59. | |
recognise, as has been clear, some feel the new payments that have been | :05:00. | :05:03. | |
announced are sufficient. They are based on consultation response and | :05:04. | :05:11. | |
judgment was made to provide support to the widest group of people | :05:12. | :05:15. | |
possible to recognise the pain and suffering of those who have been | :05:16. | :05:22. | |
affected this tragedy. There are never any right answers when | :05:23. | :05:26. | |
designing support in recognition of such awful circumstances. Difficult | :05:27. | :05:30. | |
judgments have to be made in relation to prioritise in support | :05:31. | :05:33. | |
and we did consult on the proposals and use the sponsors gathered to | :05:34. | :05:44. | |
make payments to all individuals, rather than waiting for people to | :05:45. | :05:49. | |
get more ill be receiving support. I would like to speak about the issues | :05:50. | :05:56. | |
raised by the honourable lady, the member for Kingston upon Hull about | :05:57. | :05:59. | |
other viruses. We have not expanded the scheme to include other viruses, | :06:00. | :06:06. | |
including the CJD. On the case of this, it is already every Seiji de | :06:07. | :06:12. | |
compensation scheme that offers no-fault compensation. It was set up | :06:13. | :06:18. | |
by the government for these patients and their families in recognition of | :06:19. | :06:22. | |
their wholly exceptional circumstances. The scheme provides | :06:23. | :06:27. | |
payments in 250 cases from a trust fund of 67.5 million. Over 41 | :06:28. | :06:33. | |
million has been paid out by the trust today. The currently aren't | :06:34. | :06:37. | |
any proposals to extend the infected blood system of the payments to | :06:38. | :06:43. | |
include other viruses or infections that are contracted through other | :06:44. | :06:47. | |
routes other than NHS supplied infected blood. This is on the basis | :06:48. | :07:03. | |
of the advisory and hepatitis B was not involved when they were set up | :07:04. | :07:07. | |
because the screening test had been introduced in the 1970s and there | :07:08. | :07:13. | |
are other reasons for not including hepatitis E, which I am happy to | :07:14. | :07:17. | |
write to the honourable lady about in more detail, should she wish me | :07:18. | :07:24. | |
to do so. But many colleagues have referred to the Scottish Government | :07:25. | :07:31. | |
reforms and here we arrived at the devolved nations section which the | :07:32. | :07:38. | |
honourable lady for Southdown has raised and we are working closely | :07:39. | :07:42. | |
with officials from Northern Ireland in keeping them up today on our | :07:43. | :07:48. | |
progress with implementation. Those beneficiaries will be eligible under | :07:49. | :07:52. | |
the Northern Irish scheme to continue to receive support at their | :07:53. | :07:56. | |
current levels. I am happy to raise her concerns with the Noble Lord to | :07:57. | :08:02. | |
ensure he is aware of her concerns and raising the issue of the | :08:03. | :08:07. | |
potential impact for Northern Irish victims. Another member has raised | :08:08. | :08:14. | |
the importance of coordination between the devolved nations and the | :08:15. | :08:20. | |
support schemes and on the significance of the pointy has | :08:21. | :08:23. | |
raised on the coordination of business, it is important for me to | :08:24. | :08:28. | |
ask my noble friend, the Lord prior to contact him directly on those | :08:29. | :08:33. | |
points so they can be coordinated in an effective way. But I would like | :08:34. | :08:36. | |
to reassure him on one point he raised, and that is the ?500 Winter | :08:37. | :08:42. | |
Fuel Payment is now automatically included in the payment people in | :08:43. | :08:47. | |
England are getting as part of this support scheme. This means they do | :08:48. | :08:53. | |
not have to apply for it, as was the case previously. I hope he will | :08:54. | :08:56. | |
accept this is some progress in that area. But many colleagues point to | :08:57. | :09:04. | |
the Scottish scheme as a blue blueprint for what they like to see | :09:05. | :09:07. | |
in England but there are some differences, as the honourable | :09:08. | :09:16. | |
gentleman noted. There are individuals with hepatitis C stage | :09:17. | :09:19. | |
one who do not receive an annual payment. We have introduced an | :09:20. | :09:24. | |
annual payment for them and they can get support now rather than waiting | :09:25. | :09:27. | |
for their health to deteriorate before they are legible for support. | :09:28. | :09:32. | |
The Scottish Government have chosen to provide a lump sum payment and | :09:33. | :09:37. | |
there are currently no proposals for annual payments to hepatitis C stage | :09:38. | :09:44. | |
one group. We have also put in place some other measures to avoid the | :09:45. | :09:51. | |
sense which has been raised by the honourable member for Hammersmith, | :09:52. | :09:55. | |
that this support is begrudging and the comments made by the honourable | :09:56. | :10:01. | |
lady the Kingston upon Hull that people should feel like they are | :10:02. | :10:04. | |
being treated as beggars. We have put in measures to avoid this. One | :10:05. | :10:09. | |
of them is what we have announced in the public consultation, people | :10:10. | :10:14. | |
should feel they don't have to jump through hoops to feel worthy of | :10:15. | :10:20. | |
support. We have no intention of introducing individual health | :10:21. | :10:23. | |
assessments as a means of making people feel as though they don't | :10:24. | :10:25. | |
have to prove their eligibility. One of the other key elements is a | :10:26. | :10:32. | |
special categories mechanism with an appeal for hepatitis C stage one, | :10:33. | :10:36. | |
who considered the impact of their infection of the treatment for | :10:37. | :10:40. | |
hepatitis C is similar to or greater than those at stage two. So that | :10:41. | :10:48. | |
they may qualify qualify for stage two annual payments. This is a | :10:49. | :10:53. | |
particularly beneficial aspect of this scheme. Finally, there are | :10:54. | :10:56. | |
others who have raised the issue of those who could clear Hep C | :10:57. | :11:03. | |
infection and they will remain entitled to compensation under this | :11:04. | :11:08. | |
scheme. The Shadow minister is right that those who clear the virus | :11:09. | :11:15. | |
during the acute phase are not included in the scheme because the | :11:16. | :11:19. | |
body does fight off the infection before the Sophia health impacts and | :11:20. | :11:22. | |
that has been the judgment of the expert advisory group. The last | :11:23. | :11:29. | |
thing I would like to turn to you is the public enquiry, which of | :11:30. | :11:33. | |
colleagues have raised. I will give way. Could she just outline the | :11:34. | :11:41. | |
question that come up in the debate in relation to tax orders and the | :11:42. | :11:46. | |
discussion she has had with HMRC on that issue? I thought I had already | :11:47. | :11:54. | |
answered that, these schemes are exempt from tax and we are | :11:55. | :11:57. | |
continuing to ensure ongoing schemes will be subject to the same tax | :11:58. | :12:02. | |
rules. The Prime Minister has made it clear that they do not believe a | :12:03. | :12:06. | |
public enquiry would provide further information. The five things that a | :12:07. | :12:14. | |
public enquiry could achieve according to media reports is | :12:15. | :12:17. | |
establishing the facts, learning from events, preventing every | :12:18. | :12:22. | |
parents, catharsis and understanding of what happened, rebuilding | :12:23. | :12:26. | |
confidence and accountability. Given in the UK, action was taken as soon | :12:27. | :12:30. | |
as possible to introduce testing and safety measures for blood and blood | :12:31. | :12:34. | |
products as they became available, as well as the introduction of | :12:35. | :12:40. | |
health and heated products. As well, considering the government has | :12:41. | :12:44. | |
published all documents associated with this event and from the period | :12:45. | :12:49. | |
19721985 in line with the Freedom of Information Act, it is difficult to | :12:50. | :12:54. | |
see what more information could be made available through a public | :12:55. | :13:00. | |
enquiry. However, I am sure campaigners will continue to make | :13:01. | :13:08. | |
their case. We have also made a lot of when this year's payments will be | :13:09. | :13:15. | |
made. I was appointed as the Parliamentary under Secretary of | :13:16. | :13:18. | |
State and I made resolving this issue one of my priorities. I am not | :13:19. | :13:22. | |
prepared to suffer any further delays, it is not fair to affected | :13:23. | :13:26. | |
patients that they should suffer this continuing uncertainty that has | :13:27. | :13:32. | |
been raised by colleagues. So I have told the Department they must | :13:33. | :13:40. | |
announce the scheme immediately. I am pleased to announce the letters | :13:41. | :13:44. | |
to all stage one hepatitis C sufferers will be sent out on the | :13:45. | :13:48. | |
11th of November informing them of their new annual payment and asking | :13:49. | :13:52. | |
them to claim this through the existing schemes. The schemes have | :13:53. | :13:59. | |
said they will be able to make these payments by the 22nd of December, | :14:00. | :14:04. | |
subsequently letters to those at stage two and those with HIV have | :14:05. | :14:08. | |
been sent this week. There are additional payments to be made | :14:09. | :14:12. | |
before Christmas. The schemes are planning to send all letters to | :14:13. | :14:16. | |
bereaved partners and spouses before Christmas with the aim of making | :14:17. | :14:20. | |
their new lump sums before the end of the financial year and certainly | :14:21. | :14:25. | |
during March 20 17. Details of the payment schedules are available on | :14:26. | :14:29. | |
the website of the scheme. All payments and increased payments will | :14:30. | :14:34. | |
be backdated from April 2016, or the date of the adjoining schemes if | :14:35. | :14:39. | |
later. I do believe it is right the government's focus is to consider | :14:40. | :14:42. | |
how best to implement the scheme with a budget that is affordable and | :14:43. | :14:47. | |
redesign the inconsistencies that we have heard exist and support those | :14:48. | :14:51. | |
most affected by these tragic events now and into the future. I will | :14:52. | :14:54. | |
continue to listen to the concerns of those affected and I do hope that | :14:55. | :15:00. | |
in answering this debate, I have responded to those concerns as | :15:01. | :15:05. | |
effectively as I possibly can today. I will try to be very brief. I just | :15:06. | :15:10. | |
wanted to thank all the excellent contributions we have had today from | :15:11. | :15:15. | |
members across the chamber. I think I was very grateful because I did | :15:16. | :15:19. | |
speak for quite a long time at the beginning, but I missed out some | :15:20. | :15:23. | |
important things such as the fact this new scheme is only in place | :15:24. | :15:28. | |
until the end of the spending review in 2021. That is of concern to many | :15:29. | :15:30. | |
people. I was remiss not to mention the | :15:31. | :15:41. | |
shadow all public health minister. I want to welcome her to her new role. | :15:42. | :15:47. | |
Pastor recognise this is not the Minister's one policy area, I was | :15:48. | :16:00. | |
relieved she was able to talk about underspend. Hopefully any underspend | :16:01. | :16:11. | |
will be used to help beneficiaries. Her comments on death certificates | :16:12. | :16:15. | |
was welcomed. I am still very worried about the tendering process | :16:16. | :16:20. | |
the government seem to be set on pursuing, to decide on the new | :16:21. | :16:24. | |
administrator for the scheme. I think it is absolutely wrong if the | :16:25. | :16:29. | |
government to a private sector provider to do that. You'll never | :16:30. | :16:35. | |
comment I wish to make was about welcoming the stage one hepatitis C | :16:36. | :16:42. | |
payments. I am happy to give way. Who ever does administer the scheme, | :16:43. | :16:46. | |
can we hope the government will say to them, if there are anomalies are | :16:47. | :16:51. | |
cases which come outside the rules, they will be free to tell the | :16:52. | :16:56. | |
government they should change them? There is a big debate to follow with | :16:57. | :17:03. | |
a lot of we speakers. Are now eating into that time. I will be quick. | :17:04. | :17:11. | |
?3500 is not a large amount of money for people who been affected. Under | :17:12. | :17:16. | |
the Scottish model, there is that ?30,000 lump sum payment made if | :17:17. | :17:21. | |
they have already received the 20,000 lump sum payment. Over the | :17:22. | :17:25. | |
spending period, and not sure the government can really say they are | :17:26. | :17:32. | |
helping those stage one C people more than is happening in Scotland. | :17:33. | :17:37. | |
I wanted to do that on the record. But thank you. The question is as on | :17:38. | :17:47. | |
the order paper. As many are of the opinion say I. The I smack habit. We | :17:48. | :17:52. | |
have 11 backbench contributions to the next debate. | :17:53. | :18:03. | |
The Prime Minister referred to the burning injustice in life expectancy | :18:04. | :18:18. | |
between the richest and poorest in our society. The purpose of this | :18:19. | :18:22. | |
debate today is to try to assist the government in how to tackle that | :18:23. | :18:28. | |
life expectancy gap. I would urge her to look not just at that, but | :18:29. | :18:33. | |
the gap in the healthy life expectancy, because what we know is | :18:34. | :18:40. | |
that if you are born based on ONS data from 2012, if you are born in | :18:41. | :18:47. | |
Tower Hamlets as a woman, your life expectancy will be 52.7 years. In | :18:48. | :18:54. | |
Richmond on Thames, it will be 72.1 years. A gap of around 20 years. | :18:55. | :19:00. | |
That gradient, the social gradient for disability free life expectancy | :19:01. | :19:11. | |
is even greater. This is not just a social justice issue, but also an | :19:12. | :19:16. | |
issue which adds hugely to the cost to the NHS and economic cost more | :19:17. | :19:22. | |
widely. Is a compelling economic and social justice case for tackling | :19:23. | :19:27. | |
this. So what should she do? In a nutshell, she should follow the | :19:28. | :19:31. | |
evidence, start immediately, start with the very youngest in our | :19:32. | :19:37. | |
society, even before they are born. And follow all the wider | :19:38. | :19:42. | |
determinants of health. I think she should take across government | :19:43. | :19:45. | |
approach because of that, with leadership at the highest level in | :19:46. | :19:50. | |
Cabinet. She needs to take the long view. Many of the benefits of this | :19:51. | :19:56. | |
will be coming evident in 20 or 30 years' time. But not ignore that | :19:57. | :20:00. | |
there are quick wins. She needs to look at all of the things that need | :20:01. | :20:04. | |
to be done to tackle this. I would like to start because I hope this | :20:05. | :20:08. | |
will be a consensual debate, in congratulating the Labour government | :20:09. | :20:12. | |
for the work needed to tackle health inequalities which is starting to | :20:13. | :20:18. | |
pay dividends. I would like to pay tribute to Sir Michael marmot and | :20:19. | :20:25. | |
for his ground-breaking work. The blueprint issued in 2010 forms the | :20:26. | :20:30. | |
basis of what we do. Giving every child the best possible start in | :20:31. | :20:36. | |
life. Allowing people of all ages to maximise capabilities and exercise | :20:37. | :20:41. | |
control over their lives. It is about healthy environment and | :20:42. | :20:45. | |
communities. Standards of living and housing. It is about preventing | :20:46. | :20:51. | |
ill-health as well. There are many members across this House that will | :20:52. | :20:56. | |
speak with great expertise on the wider determinants of health. I know | :20:57. | :21:01. | |
that tackling this starts long before people come into contact with | :21:02. | :21:06. | |
health services. But that is still an enormously important part of | :21:07. | :21:11. | |
tackling health inequalities. I will focus on those aspects today. | :21:12. | :21:18. | |
Preventing early deaths, we need to look at all those lifestyle issues | :21:19. | :21:22. | |
around smoking and obesity. We need to look at issues of preventing | :21:23. | :21:31. | |
suicide, the greatest single cause of death in men under the age of 49. | :21:32. | :21:37. | |
Public-health plays such a critical role. There was a call for a radical | :21:38. | :21:44. | |
upgrade in public health. We have seen cuts to public health budgets | :21:45. | :21:49. | |
and that is very disappointing. It will severely impact on the | :21:50. | :21:55. | |
government's ability to tackle health inequalities. When we look at | :21:56. | :21:58. | |
what is happening in public health, we have seen from a survey from the | :21:59. | :22:03. | |
Association of directors of public health, who surveyed members in | :22:04. | :22:11. | |
February this year, this is affecting areas like weight | :22:12. | :22:16. | |
management, drugs, smoking cessation and alcohol. These are all key | :22:17. | :22:21. | |
determinants we need to tackle. In my own area, part of which covers | :22:22. | :22:28. | |
Torbay, cats to cancel budgets for public health of around ?345,000 are | :22:29. | :22:34. | |
resulting in the decommissioning of healthy lifestyle services, | :22:35. | :22:38. | |
affecting education, affecting active intervention and supporting a | :22:39. | :22:43. | |
network of fantastic volunteers. I really regret this will be going | :22:44. | :22:49. | |
ahead and call on the government to stop the cuts to public health at I | :22:50. | :22:53. | |
would like to tackle a few key areas. First of all smoking. Smoking | :22:54. | :22:58. | |
is still the biggest cause of preventable death in the United | :22:59. | :23:02. | |
Kingdom. 100,000 people are dying every year prematurely as a result | :23:03. | :23:07. | |
of smoking. And so I hope in her closing remarks the Minister will be | :23:08. | :23:11. | |
able to update the House on her plans for the Tobacco control plan. | :23:12. | :23:20. | |
I will give way. 25 years ago, I took an interest in how many death | :23:21. | :23:26. | |
certificates mentioned smoking. The answer was four. It may be larger | :23:27. | :23:34. | |
now. I think we should be encouraging it should be recorded. | :23:35. | :23:45. | |
We need to learn the lessons in cutting drink-driving deaths. These | :23:46. | :23:55. | |
are extremely important points. There are things that government can | :23:56. | :24:01. | |
do in terms of policy to make sure the incentives are there within the | :24:02. | :24:06. | |
system to make that happen. For example, the drink-drive limit I | :24:07. | :24:10. | |
think is a very important point. Going back to smoking, the reality | :24:11. | :24:15. | |
here is it is a key driver for health inequality. If we want to | :24:16. | :24:20. | |
make a difference in that gap in disability free life expectancy, | :24:21. | :24:24. | |
were not likely to do that without tackling smoking. It accounts for | :24:25. | :24:31. | |
more than half of the difference in premature deaths between the highest | :24:32. | :24:37. | |
and lowest social economic groups. I would like to briefly touched on | :24:38. | :24:41. | |
obesity because this is something the health committee has also looked | :24:42. | :24:46. | |
at. Just to put this in context, looking at data from the child | :24:47. | :24:50. | |
measurement programme, the most recent, what we know is that just | :24:51. | :24:58. | |
looking at your sex, 26% of the most disadvantaged children are leaving | :24:59. | :25:02. | |
your sex not just overweight but obese. It 11.7 of the least deprived | :25:03. | :25:10. | |
children. Overall, it means that for schools for all children leaving in | :25:11. | :25:15. | |
your sex, one in three are now obese or overweight. This is storing up | :25:16. | :25:20. | |
catastrophic lifetime problems for them. It is not something we can | :25:21. | :25:26. | |
continue to ignore. In our report, we called for bold and brave action. | :25:27. | :25:34. | |
Although I welcome many aspects of the childhood obesity plan, for | :25:35. | :25:39. | |
example the sugary drinks levy is already having an impact, I think it | :25:40. | :25:44. | |
has been widely acknowledged there were glaring deficiencies and missed | :25:45. | :25:50. | |
opportunities in the plan. I would like to have seen far greater | :25:51. | :25:55. | |
emphasis on marketing and promotion being tackled. 40% of voters bought | :25:56. | :26:10. | |
in the supermarket is bought under marketing and promotion. Sometimes | :26:11. | :26:14. | |
we focus entirely on what people should not do. We could have an | :26:15. | :26:21. | |
opportunity to look up a -- look at what people should do. Shifting the | :26:22. | :26:29. | |
balance to a healthy lifestyle would've helped. The affordability | :26:30. | :26:34. | |
of good nutritious food is a huge factor. I urge the Minister to to | :26:35. | :26:39. | |
encourage that that to be brought back into the strategy. With the | :26:40. | :26:43. | |
sugary drinks levy, extending it to other drinks, those that have sugar | :26:44. | :26:50. | |
added to milky products. There is no reason why that should be necessary. | :26:51. | :26:58. | |
I also welcome the plan and its mention of the Daily Mail. I met an | :26:59. | :27:10. | |
inspirational headteacher. She talks about the strategy. And how having | :27:11. | :27:15. | |
leadership from directors of public health makes a real difference. I | :27:16. | :27:18. | |
hope the Minister will urge and update the House until those values | :27:19. | :27:23. | |
can be taken forward. We shouldn't just think about obesity, we should | :27:24. | :27:31. | |
think about physical activity and the benefits it can bring to school | :27:32. | :27:39. | |
children. When money is so restricted, making health a material | :27:40. | :27:45. | |
consideration in planning matters. It was stressed in the report. I | :27:46. | :27:51. | |
don't think this would be a brake on growth. I think it would be a brake | :27:52. | :27:55. | |
on unhealthy growth and allow local authorities to have the leverage | :27:56. | :28:00. | |
power when you're making licensing decisions, making planning decisions | :28:01. | :28:04. | |
for communities. This is something the government could do with | :28:05. | :28:09. | |
low-cost but enormous benefit. I wonder if the Minister would refer | :28:10. | :28:14. | |
to that. There is an area the health committee is actively considering at | :28:15. | :28:18. | |
the moment and that is how we reduce the toll of deaths from suicide. For | :28:19. | :28:28. | |
men, the Samaritans have identified that those living in the most | :28:29. | :28:31. | |
deprived areas are ten times more likely to end their lives by suicide | :28:32. | :28:33. | |
than those in the most affluent areas. We know there are many things | :28:34. | :28:40. | |
that contribute to this. Economic recessions, debt, unemployment. Many | :28:41. | :28:44. | |
factors. But I think again when we look at trying to tackle health | :28:45. | :28:50. | |
inequality, we will not really make the inroads that we need to make | :28:51. | :28:56. | |
unless we look at the inequality in suicide and particularly the | :28:57. | :28:59. | |
inequality as it affects men. Three quarters of those who die by suicide | :29:00. | :29:04. | |
are men. I hope the Minister will look carefully at the emerging | :29:05. | :29:10. | |
evidence from our current enquiry as they are actively considering the | :29:11. | :29:14. | |
refresh to the strategy. And do so at every point, looking at how we | :29:15. | :29:17. | |
tackle health inequality in doing so. I would also like the Minister | :29:18. | :29:25. | |
to look at the impact on drugs and alcohol on health inequality. When | :29:26. | :29:29. | |
we look at the fact there are 700,000 children living in the | :29:30. | :29:33. | |
United Kingdom with an alcohol dependent parent, that is a | :29:34. | :29:38. | |
staggering cause of health inequality, with huge implications | :29:39. | :29:44. | |
for their life chances. But also for the individuals involved. Again, | :29:45. | :29:49. | |
alcohol has a gradient for deprivation. We know there is clear | :29:50. | :29:53. | |
evidence about what works. We have had very encouraging news from | :29:54. | :29:59. | |
Scotland. Scottish courts have ruled that minimum pricing is legal. I am | :30:00. | :30:05. | |
disappointed the Scotch whiskey association has yet again taken this | :30:06. | :30:09. | |
to a further stage of appeal. As soon as these hurdles are cleared, | :30:10. | :30:14. | |
think it would be a great shame if England were undermining potentially | :30:15. | :30:18. | |
ground-breaking work in Scotland, by allowing people to buy across the | :30:19. | :30:22. | |
border. I think it will be a great shame if we don't follow suit at the | :30:23. | :30:27. | |
earliest possible opportunity in introducing minimum pricing. | :30:28. | :30:34. | |
I think it is disappointing, but perhaps there is a lot to look up | :30:35. | :30:43. | |
from Scotland in terms of what we have done with the smoking ban, | :30:44. | :30:50. | |
which England then took up? I congratulate the Scottish | :30:51. | :30:52. | |
Government, it does seem to be the case of West Scotland Leeds, England | :30:53. | :30:55. | |
will eventually follow. But Scotland is good at following the evidence | :30:56. | :31:00. | |
and I call on us to do likewise here. I am particularly concerned | :31:01. | :31:05. | |
that the benefits that come about when Scotland does introduce minimum | :31:06. | :31:09. | |
pricing, would be undermined if we didn't follow suit here. I would | :31:10. | :31:13. | |
call on them to do that as soon as per the. In summary, because I know | :31:14. | :31:19. | |
there are many other members who wish to speak. There is a huge | :31:20. | :31:23. | |
amount we can do, not all of it has a cost. I would urge the Minister in | :31:24. | :31:29. | |
summing up to actually look at all the possibilities to stick with the | :31:30. | :31:34. | |
agenda, taking a cross government approach, but to make sure there is | :31:35. | :31:38. | |
leadership at the highest level. It was hugely encouraging the Prime | :31:39. | :31:41. | |
Minister said those words in Downing Street. We are calling on her to | :31:42. | :31:50. | |
appoint somebody at Cabinet level to take over responsibility for health | :31:51. | :31:53. | |
inequalities and putting those fine words into action. The question is | :31:54. | :32:04. | |
as on the order paper. I rise to express my support for the work of | :32:05. | :32:08. | |
the health committee under the superb leadership of the honourable | :32:09. | :32:13. | |
member for Totnes. I also pay tribute to the Prime Minister for | :32:14. | :32:16. | |
her description of health inequalities as a burning injustice | :32:17. | :32:22. | |
and for placing it at the top of her agenda, as virtually the first thing | :32:23. | :32:25. | |
she did as Prime Minister of this country. This is an unusual debate | :32:26. | :32:34. | |
that in backbenchers are usually trying to press the government to | :32:35. | :32:39. | |
take on a priority. This is a kind of top-down issue, where the need to | :32:40. | :32:46. | |
tackle health inequalities has been forcibly expressed by the Prime | :32:47. | :32:50. | |
Minister and we are trying to translate those words in this debate | :32:51. | :32:57. | |
into effective action. For those of us who have grappled with the nuts | :32:58. | :33:02. | |
and bolts of tackling the obscenity of health inequalities, because that | :33:03. | :33:06. | |
is what it is in the 21st century. The Prime Minister's words were, | :33:07. | :33:14. | |
enormously encouraging, because they demonstrated the leadership that | :33:15. | :33:18. | |
this issue requires if these awful statistics are to be properly | :33:19. | :33:26. | |
addressed. I want to set this in its historical context in order to | :33:27. | :33:32. | |
demonstrate the in approach which bans the 37 years from the first | :33:33. | :33:38. | |
woman Prime Minister to the second. While life expectancy had improved | :33:39. | :33:43. | |
dramatically since the creation of the NHS in 1948. By the 1970s there | :33:44. | :33:49. | |
was a strong suspicion that persistent health inequalities | :33:50. | :33:52. | |
existed and they were defined largely by social class. There was, | :33:53. | :33:59. | |
however, an absence of easily understood statistical evidence on | :34:00. | :34:05. | |
which to base a clear assertion. The then Health Secretary in 1977 | :34:06. | :34:11. | |
commissioned the president of the Royal College of physicians to chair | :34:12. | :34:15. | |
a working group that would report to government on the extent of health | :34:16. | :34:19. | |
inequalities in the UK and how best to address them. The report proved | :34:20. | :34:25. | |
conclusively, that death rates from many diseases were higher among | :34:26. | :34:28. | |
those in the lower social classes, stripped bare, this was the first | :34:29. | :34:34. | |
official acknowledgement that the circumstances into which a person | :34:35. | :34:38. | |
was born would largely determine when they died. This remains the | :34:39. | :34:47. | |
thrust of the argument expressed by the health committee report, except | :34:48. | :34:51. | |
they have added the new dimensional highlighted in the indicators for | :34:52. | :34:55. | |
health inequalities in November 2015, of the difference in years | :34:56. | :35:03. | |
spent in good health. Where there is an extraordinary gap between the | :35:04. | :35:08. | |
most and least disadvantaged of almost 17 years. By the time the | :35:09. | :35:13. | |
Black report was published a new government had been elected, which | :35:14. | :35:17. | |
displayed its enthusiasm for tackling health inequalities by | :35:18. | :35:21. | |
reluctantly publishing less than 300 copies of the Black report in the | :35:22. | :35:25. | |
depths of the summer recess on an August bank holiday Monday, with the | :35:26. | :35:29. | |
forward from the new Health Secretary, who couldn't even raise | :35:30. | :35:36. | |
the enthusiasm to dampen the rapport with faint praise. He dammed it and | :35:37. | :35:40. | |
virtually ignored it and that remained the case for 18 years. | :35:41. | :35:46. | |
During which, and this is important because people assume health as | :35:47. | :35:50. | |
improved for everyone since the 1940s, and by and large it has. But | :35:51. | :35:58. | |
many of the problems that black highlighted got worse. The mortality | :35:59. | :36:02. | |
rate among young men of working age in the early 1970s was almost twice | :36:03. | :36:08. | |
as high in unskilled groups as for those in professional groups. By the | :36:09. | :36:15. | |
early 1990s, it was three times as high. The most awful statistic that | :36:16. | :36:20. | |
begun to emerge in the 1980s was that those who were long-term | :36:21. | :36:25. | |
unemployed, with 35 times more likely to commit suicide than those | :36:26. | :36:34. | |
in work. It would be inconceivable today for a Health Secretary to be | :36:35. | :36:38. | |
as dismissive of an issue so critical to the life chances of so | :36:39. | :36:46. | |
many. But we are also more aware today than we were then that health | :36:47. | :36:50. | |
care is only part of the problem. Indeed, the Minister has a difficult | :36:51. | :36:56. | |
job, it's almost a minor part, calculated that between 15 and 25%. | :36:57. | :37:07. | |
Professor, the world leading epidemiologist established the | :37:08. | :37:11. | |
social determinants of health as the report in the late 1990s explained, | :37:12. | :37:18. | |
poverty, low wages, occupational stress, unemployment, poor housing, | :37:19. | :37:22. | |
environmental pollution, poor education, limited access to | :37:23. | :37:28. | |
transport and the Internet, crime and disorder and a lack of | :37:29. | :37:33. | |
recreational facilities all have an impact on people's health. Beverages | :37:34. | :37:40. | |
five Giants, disease, once, ignorance, squalor and idleness were | :37:41. | :37:43. | |
more pithy than Polen at it way of describing the problem. And | :37:44. | :37:52. | |
beverage's brother-in-law page tourney, set the template we should | :37:53. | :37:57. | |
follow. He said the issue was not about some romantic illusion that | :37:58. | :38:01. | |
men are equal in character and intelligence, rather it is about | :38:02. | :38:05. | |
eliminating the inequalities that had their source not individual | :38:06. | :38:13. | |
differences but in organisation. The report, which I commissioned as | :38:14. | :38:20. | |
Health Secretary in 2008, to form policy in 2010 onwards. | :38:21. | :38:22. | |
Unfortunately electorate decided we wouldn't be there to carry it out, | :38:23. | :38:27. | |
but it recommended six policy areas where we should focus upon. The best | :38:28. | :38:34. | |
start in life, maximising capabilities and control, fair | :38:35. | :38:37. | |
employment and good work, healthy standard of living, healthy and | :38:38. | :38:42. | |
sustainable places and communities, strength and role in provision of | :38:43. | :38:45. | |
ill health prevention. These six areas were advised to be focused | :38:46. | :38:53. | |
with the scale and intensity proportionate to the level of | :38:54. | :38:56. | |
disadvantage. He called this proportionate universalism. The | :38:57. | :39:04. | |
Coalition Government recommended the recommendations. They responded with | :39:05. | :39:07. | |
a policy of healthy lives and healthy people with a focus on | :39:08. | :39:10. | |
individual lifestyle and behavioural change. This, as Sir Michael pointed | :39:11. | :39:16. | |
out, is only one part of the problem, just as the NHS is only one | :39:17. | :39:21. | |
part of the solution. What's more, the only piece of cross Goldman 's | :39:22. | :39:30. | |
-- cross government coordination was scrapped in 2012. The select | :39:31. | :39:34. | |
committee on Public health and today's debate, together with the | :39:35. | :39:38. | |
Prime Minister's pledge give us an opportunity to capitalise on the | :39:39. | :39:43. | |
brilliant work done by Sir Michael and his institution of health equity | :39:44. | :39:48. | |
at UCL. And the political consensus, I am pleased to say, now exists | :39:49. | :39:54. | |
around this issue, by forging a fresh and dynamic response across | :39:55. | :39:57. | |
government to tackling health inequalities. One of the committee | :39:58. | :40:04. | |
's recommendations was a Cabinet Office minister be given specific | :40:05. | :40:08. | |
responsibility for leading on this issue across government. I have a | :40:09. | :40:14. | |
more radical suggestion. I believe the Prime Minister herself should | :40:15. | :40:18. | |
take personal responsibility for this issue. The Prime Minister is | :40:19. | :40:22. | |
also first Lord of the Treasury and the minister responsible for the | :40:23. | :40:26. | |
civil service. Previous prime ministers have taken on other | :40:27. | :40:32. | |
ministerial positions. Wellington was Home Secretary, Defence | :40:33. | :40:35. | |
Secretary and Commonwealth Secretary. Churchill was Prime | :40:36. | :40:40. | |
Minister and Defence Secretary. It would be a wonderful example for the | :40:41. | :40:45. | |
Prime Minister to follow up her words by saying, I am going to lead | :40:46. | :40:50. | |
on this, I am going to chair the cross government committee that | :40:51. | :40:54. | |
tackles health inequalities. I think it needs that level of leadership, | :40:55. | :40:58. | |
because only then will there be meaningful cross departmental work | :40:59. | :41:06. | |
to tackle this. I echo the health committee's view that devolving | :41:07. | :41:09. | |
public health to local authorities was the right thing to do, not | :41:10. | :41:12. | |
everything in the health and social care bill was approved by us on | :41:13. | :41:17. | |
these benches, or many other people, but that was the right thing to do. | :41:18. | :41:22. | |
Their cuts in budget need to be restored. 200 million in year cuts | :41:23. | :41:26. | |
and I would suggest the ring fencing should be extended to at least the | :41:27. | :41:35. | |
end of this Parliament. With so many problems local government have, if | :41:36. | :41:37. | |
you break the ring fence on public health, it is going to go elsewhere | :41:38. | :41:43. | |
and not be focused on these issues. Only a minority of health inequality | :41:44. | :41:47. | |
issues involved the Department of Health, but in closing I want to | :41:48. | :41:50. | |
highlight one that certainly does. The biggest cause of hospitalisation | :41:51. | :41:55. | |
for children between the ages of five and 14 is dental problems. | :41:56. | :42:05. | |
Thousands of children went into hospital to be any the tie is done | :42:06. | :42:09. | |
have 30 extracted over the past year. 11,000 more than the second | :42:10. | :42:17. | |
biggest cause of hospitalisation for children, which is abdominal and | :42:18. | :42:23. | |
pelvic pain. Believe it or not, it was the 12th highest cause for | :42:24. | :42:26. | |
hospitalisation of tiny children below the age of four. This is a | :42:27. | :42:34. | |
health equality issue. Almost all of the children who went into hospital | :42:35. | :42:38. | |
will be from deprived communities, including 700 from the city I | :42:39. | :42:44. | |
represent. There is a safe and proven way to dramatically reduce | :42:45. | :42:49. | |
tooth decay in children, which also has a beneficial effect on adults. | :42:50. | :42:55. | |
It involves flora dating water up to the Ottoman level of one part per | :42:56. | :43:03. | |
million. The cost is small, for every ?1 spent there is a return to | :43:04. | :43:08. | |
the taxpayer of ?12 after five years and ?22 after ten years. The | :43:09. | :43:14. | |
evidence from the West Midlands to the North East, two countries across | :43:15. | :43:17. | |
the world, has been there now for many years. A child in Hull aged | :43:18. | :43:26. | |
five has 87.4% more tooth extractions than a child living in | :43:27. | :43:34. | |
fluoridated Warsaw. The whole of the medical profession, the dentist | :43:35. | :43:38. | |
profession, the BMA and the Department of Health have recognised | :43:39. | :43:43. | |
this for many years. In Hull we intend to fluoridated water as part | :43:44. | :43:47. | |
of a consolidated policy to tackle this element of health inequality. | :43:48. | :43:51. | |
We need the Department of Health to show moral leadership in encouraging | :43:52. | :43:57. | |
local authorities in deprived areas to pursue fluoridation and support | :43:58. | :44:04. | |
them when they do. The Health Secretary retains ultimate | :44:05. | :44:06. | |
responsibility for public health, including health prevention. Here is | :44:07. | :44:12. | |
one issue where he can begin the process of reducing hospital | :44:13. | :44:15. | |
admissions by encouraging preventative action and in terms of | :44:16. | :44:20. | |
health inequalities giving poor kids prosperous kids teeth. I agree with | :44:21. | :44:30. | |
him completely. Has he solved the problem how water supply companies | :44:31. | :44:32. | |
and businesses can feel protected and not find themselves facing | :44:33. | :44:41. | |
unjustified claims or difficulties? My understanding, as this is an | :44:42. | :44:48. | |
intervention on a conclusion, by putting the focus onto local | :44:49. | :44:53. | |
authorities, and I have talked to Yorkshire water on this, it changes | :44:54. | :44:57. | |
the whole dynamic of how various conspiracy theorists can attack this | :44:58. | :45:08. | |
issue. It is a great pleasure to be able to follow the Right Honourable | :45:09. | :45:12. | |
member and his very thoughtful speech. To those debates on reducing | :45:13. | :45:17. | |
health and inequalities is very far reaching, so I want to focus on | :45:18. | :45:24. | |
obesity, as I chaired the party group on obesity and sits on the | :45:25. | :45:27. | |
health select committee responsible for producing the report. | :45:28. | :45:33. | |
To make no apologies for talking about obesity again in this chamber. | :45:34. | :45:43. | |
-- today I make no apologies. This poses a major threat to our nation. | :45:44. | :45:48. | |
With more than one in five children being overweight or obese before | :45:49. | :45:52. | |
they start primary school, and with this figure rising to more than one | :45:53. | :45:58. | |
in three as they start secondary school, our future generations are | :45:59. | :46:05. | |
at risk of developing serious health complications. Recent data has shown | :46:06. | :46:16. | |
a continuing widening inequality gap in these categories. 60% of the most | :46:17. | :46:21. | |
deprived boys aged five to 11 are predicted to be overweight or obese | :46:22. | :46:29. | |
by 2020. Just 16% of boys in the more affluent group. 60% versus 16%. | :46:30. | :46:38. | |
Overall, 36% of the most deprived children are predicted to be | :46:39. | :46:42. | |
overweight or obese by 2020. Compared to just 19% of the most | :46:43. | :46:50. | |
affluent. These vast inequalities must be tackled. We need to take | :46:51. | :46:56. | |
brave and bold action. Every study around at the moment shows that | :46:57. | :47:02. | |
higher obesity rates are linked to deprivation. Critically, the | :47:03. | :47:04. | |
national Child measurement programme showed the gap between areas less | :47:05. | :47:10. | |
affected and those where child obesity is less affected is growing. | :47:11. | :47:23. | |
This is a wake-up call. The future many young people face could be | :47:24. | :47:34. | |
complicated with the riddles of obesity. Diabetes, heart disease and | :47:35. | :47:38. | |
cancer. Strain on public services. The emotional impact as well on our | :47:39. | :47:50. | |
population. Medics report that cases of type 2 diabetes are occurring in | :47:51. | :47:55. | |
children. Until recently, it was just seen as a disease of the older | :47:56. | :48:02. | |
population. Action is needed to prevent a public health calamity. | :48:03. | :48:08. | |
Moving away from child obesity, I want to focus on the overall impact | :48:09. | :48:15. | |
of obesity in adults. It's important we provide parents with every tool | :48:16. | :48:18. | |
possible to make sure they can be great role models when it comes to | :48:19. | :48:23. | |
what we eat and our lifestyles. Thank you for giving way. I am sure | :48:24. | :48:29. | |
my honourable friend is aware that Tesco announced last week some major | :48:30. | :48:37. | |
differences to sugar in drinks. It was done off their own bat. I wonder | :48:38. | :48:46. | |
what my rubble friend's views are about pressure from supermarkets to | :48:47. | :48:51. | |
influence the outcome for children? She makes a good point. Waitrose and | :48:52. | :48:57. | |
Morrisons have also done this. And I am sure many more. It is good major | :48:58. | :49:02. | |
retailers are taking on board the severity of this challenge we face | :49:03. | :49:09. | |
as a nation and globally as well. But parents need to be role models, | :49:10. | :49:16. | |
retailers need to be role models and sometimes the need to do more. It is | :49:17. | :49:25. | |
not just child obesity link to social class. So is adult obesity. | :49:26. | :49:34. | |
The highest level of excess weight is found amongst the lowest | :49:35. | :49:50. | |
socioeconomic groups. Obesity is the single biggest preventable cause of | :49:51. | :49:54. | |
cancer after smoking. With the government acknowledging the | :49:55. | :50:01. | |
importance of early cancer diagnosis and dedicated NHS staff at all | :50:02. | :50:06. | |
levels committed to delivering this, surely everything which can be put | :50:07. | :50:12. | |
in place must be put in place? In addition to cancer, obesity leads to | :50:13. | :50:17. | |
a greater risk of type 2 diabetes and heart disease. These are all | :50:18. | :50:21. | |
conditions which are life changing and life limiting. I am sure people | :50:22. | :50:25. | |
now understand there is a link between obesity and diabetes, but | :50:26. | :50:31. | |
sadly I fear so many people think they can take a pill and keep | :50:32. | :50:34. | |
diabetes under control. Sadly far too many people sufferers with | :50:35. | :50:40. | |
diabetes have found this is not the case. Many need lower limb | :50:41. | :50:49. | |
amputations. Many suffer kidney disease, liver disease and sight | :50:50. | :50:54. | |
loss. Action must be taken now to turn around what I believe has | :50:55. | :51:02. | |
become an obesity epidemic. Everything had talked about today | :51:03. | :51:06. | |
should prompt a review of the Department of Health's child obesity | :51:07. | :51:10. | |
plan. Despite a government leading the world in producing the plan for | :51:11. | :51:15. | |
action, many, myself included, said when it was published it was quite a | :51:16. | :51:21. | |
let down. I stand by that view today. This simply wasn't enough | :51:22. | :51:26. | |
detail in the 13 page document. It was aspirational rather than a | :51:27. | :51:34. | |
focused plan of action. It ignored the recommendations of Public Health | :51:35. | :51:37. | |
England. It didn't set firm timescales to turn the tide on | :51:38. | :51:41. | |
childhood obesity. The plan we have is insufficient for the scale of the | :51:42. | :51:49. | |
task we have to tackle. We need to do more. We need clear actions and | :51:50. | :51:56. | |
queer timescales. There is a fine balance between the nanny state, | :51:57. | :52:02. | |
between business cooperation and parental responsibility. I'm sure it | :52:03. | :52:06. | |
is not impossible to find common ground. Yes it is the responsibility | :52:07. | :52:12. | |
of parents to ensure children eat healthily and are physically active | :52:13. | :52:16. | |
and learn good habits to last a lifetime, but that by itself has | :52:17. | :52:20. | |
proven time and time again it is not sufficient. Parents need more help. | :52:21. | :52:24. | |
The current child obesity plan cannot and will not give them what | :52:25. | :52:28. | |
we need. It would be a mistake to think the answer is lie in | :52:29. | :52:36. | |
regulating business. Demonising the food and drink sector is unhelpful | :52:37. | :52:42. | |
and unfair. Some producers, manufacturers and retailers are | :52:43. | :52:47. | |
already taking great strides in encouraging healthy consumer | :52:48. | :52:50. | |
behaviour and we must commend them for doing this. We welcome these | :52:51. | :52:55. | |
actions. Evidence suggests the least affluent households in the UK have | :52:56. | :53:02. | |
higher exposure to junk food advertising. The soft drinks levy is | :53:03. | :53:21. | |
likely to have a positive impact. Just as the current plan does not | :53:22. | :53:26. | |
help parents, it does nothing for the business that would be better | :53:27. | :53:30. | |
served by clear goals and reformulation and for advertising | :53:31. | :53:35. | |
and labelling and four time frames in which these need to be achieved. | :53:36. | :53:40. | |
Publicly and privately, many sectors know that they themselves would be | :53:41. | :53:46. | |
better served by clearer, more far reaching government recommendations | :53:47. | :53:50. | |
that at least gave a certainty for the future. We may be horrified by | :53:51. | :54:00. | |
the data figures we read on a daily basis. Cancer Research UK revealed | :54:01. | :54:05. | |
this week that teenagers drink almost a bathtub of sugary drinks I | :54:06. | :54:18. | |
hear on average. Will she give way? I am very grateful. She is making an | :54:19. | :54:23. | |
excellent speech. Very thoughtful. There has been nothing I have | :54:24. | :54:27. | |
disagreed with so far, she will be pleased to hear. Would she agree | :54:28. | :54:34. | |
with me about how disappointed I was about the targets removed from the | :54:35. | :54:41. | |
child obesity plan? Targets around having childhood obesity and figures | :54:42. | :54:48. | |
about advertising and marketing which would have helped? I am just | :54:49. | :55:00. | |
coming on that. Thank you. We know that child obesity levels will not | :55:01. | :55:03. | |
drop tomorrow. What we need to see some signs in the next few years | :55:04. | :55:09. | |
that they are declining. The foundations of an effective strategy | :55:10. | :55:14. | |
are readily available in the form of recommendations from Public Health | :55:15. | :55:17. | |
England and the health committee's report. I would like to hear a firm | :55:18. | :55:25. | |
commitment for the soft drinks levy. Clear goals for product reform. | :55:26. | :55:33. | |
Action on junk food advertising during family viewing. Promotions | :55:34. | :55:44. | |
such as being given a free bar of chocolate with a newspaper. Such | :55:45. | :55:52. | |
measures will ensure we have a strategy rather than just a vision. | :55:53. | :55:57. | |
Will be able to tackle the obesity challenge we find in our society | :55:58. | :56:03. | |
today. Thank you. Thank you. Thanks to the honourable member who is the | :56:04. | :56:13. | |
chair of the health committee. And to the backbench committee for | :56:14. | :56:21. | |
providing the time. The speech from the honourable member demonstrated | :56:22. | :56:26. | |
clearly their knowledge in this area. It is a pleasure to follow the | :56:27. | :56:34. | |
honourable member. And to learn more about obesity. Many will say that | :56:35. | :56:40. | |
health inequality stems from the overarching inequality of education | :56:41. | :56:43. | |
and opportunity both across the country and even within communities. | :56:44. | :56:50. | |
And it is true. Mountable friend outlined the historical context for | :56:51. | :56:55. | |
all that. Health inequality starts even before birth. Before a child is | :56:56. | :57:00. | |
born into affluence or poverty. Long before they have the opportunity of | :57:01. | :57:05. | |
starting a good mercenary or are left to make use of what is left. | :57:06. | :57:13. | |
Health inequality begins in the womb and the child's development could be | :57:14. | :57:17. | |
very much restricted or enhanced by the diet of the mother, the tendency | :57:18. | :57:22. | |
to drink alcohol or smoking pregnancy, and dozens of other | :57:23. | :57:29. | |
factors relating to antenatal care. Where you live has an impact. It can | :57:30. | :57:36. | |
be mitigated by the actions of the NHS, local authorities and | :57:37. | :57:39. | |
government. Economic kind of intervention is needed to support | :57:40. | :57:43. | |
people who support is needed. It is that issue of resources. Everything | :57:44. | :57:50. | |
from budgets to mount to discourage smoking in pregnancy, to hospital | :57:51. | :57:56. | |
provisions which need to be the best in areas of greatest needs. I want | :57:57. | :58:02. | |
to talk about the north-east of England to illustrate the reality of | :58:03. | :58:11. | |
health inequalities. Government policy is putting the brakes on the | :58:12. | :58:16. | |
process made in the years up to 2010. Some facts. There is a life | :58:17. | :58:21. | |
expectancy gap of 17 years between men in the most deprived ward in | :58:22. | :58:26. | |
Stockton compared with the least deprived. 12 years for women. This | :58:27. | :58:33. | |
gap has increased by? Yours over a five-year gap. I fear it will | :58:34. | :58:38. | |
continue to grow. Called development is an important contributor. | :58:39. | :58:50. | |
In Stockton, a child who has a low quality of health due to parental | :58:51. | :59:01. | |
lifestyle is more likely to be out of school, especially when it comes | :59:02. | :59:07. | |
to dental health. 72% of children in the most deprived areas have tooth | :59:08. | :59:17. | |
decay. Solutions were offered. In my constituency, the biggest causes of | :59:18. | :59:23. | |
early death are cardiovascular disease, cancer and smoking related | :59:24. | :59:35. | |
diseases. 1500 hospital stays per year more than the average related | :59:36. | :59:41. | |
to alcohol. Smoking-related deaths, 320 worse than the average for | :59:42. | :59:54. | |
England. 57% of people living in the north-east, 1.2 million individuals | :59:55. | :59:59. | |
aged 18 and over, have suffered at least one is due to the drinking of | :00:00. | :00:05. | |
others in the last 12 months. 62% of people, not least one heavy drinker. | :00:06. | :00:18. | |
-- know at least one heavy drinker. One in five binge drinks on a weekly | :00:19. | :00:24. | |
basis. Over 60% of us worry about violence caused by drinking and 90% | :00:25. | :00:28. | |
of us are concerned about people being drunk and rowdy in public. | :00:29. | :00:32. | |
There is a strong relationship between alcohol and crime, almost | :00:33. | :00:36. | |
half of all crime is alcohol-related and it is having a significant | :00:37. | :00:41. | |
impact on individuals and communities. | :00:42. | :00:52. | |
Nearly 9000 children start smoking in the north-east region every year, | :00:53. | :00:59. | |
according to Cancer Research UK. The north-east has the highest rate of | :01:00. | :01:06. | |
economic activity in England. Up to June 2015, 20 3.5% of the working | :01:07. | :01:11. | |
age population was inactive with a quarter of that inactivity due to | :01:12. | :01:15. | |
ill health. The regional unemployment rate is the highest at | :01:16. | :01:21. | |
7.9%. Life expectancy is lower than the English average. Men and women | :01:22. | :01:25. | |
in the North East typically live over a year less than the national | :01:26. | :01:30. | |
average. My constituency reflects the picture across the poorer parts | :01:31. | :01:33. | |
of the country and evidence from charity and experts on these issues, | :01:34. | :01:37. | |
show them to be highly significant. The British Lung foundation created | :01:38. | :01:42. | |
a briefing and found people living in the poorest areas will die seven | :01:43. | :01:48. | |
years earlier than those in the richest. There is a correlation, | :01:49. | :01:52. | |
backed with evidence that affluence and opportunities affect your help. | :01:53. | :01:57. | |
Cancer Research UK has carried out research that shows inequality is | :01:58. | :02:01. | |
linked to 15,000 extra cases of cancer in England and children from | :02:02. | :02:05. | |
the most deprived groups are twice as likely to be obese than the least | :02:06. | :02:09. | |
deprived groups. Quite a dire picture across the north-east | :02:10. | :02:13. | |
region, but not for the want of action by health groups, local | :02:14. | :02:18. | |
authorities and charities. They have had some remarkable successes over | :02:19. | :02:27. | |
the years despite the poor hand dealt them, but they need the | :02:28. | :02:30. | |
support of government to make better progress. In order to reduce health | :02:31. | :02:32. | |
inequalities we need more resources to support those who seek help, and | :02:33. | :02:34. | |
investment in health service to detect illnesses earlier, do have a | :02:35. | :02:37. | |
greater role for health care in schools, stop those 9000 children a | :02:38. | :02:41. | |
year taking up smoking and to ensure the NHS has the means to be able to | :02:42. | :02:45. | |
look after and treat everybody that needs it. But back to Stockton. How | :02:46. | :02:52. | |
do we ensure those in Stockton are not at a significant disadvantage | :02:53. | :02:55. | |
from birth compare to those in more affluent areas? We stop in the | :02:56. | :02:59. | |
beginning, investment in early years education making sure all children | :03:00. | :03:03. | |
have the best start and can reach their key development milestones to | :03:04. | :03:07. | |
the best of their ability. Or, before they are born. The borough | :03:08. | :03:11. | |
council has taken a number of measures to address the health | :03:12. | :03:13. | |
inequality within the borough with the delivery of the health and | :03:14. | :03:18. | |
well-being strategy, increasingly shape to ensure a targeted approach | :03:19. | :03:23. | |
to those who need support. The Stockton seasonal health and | :03:24. | :03:26. | |
well-being strategy coordinator targeted approach to making sure | :03:27. | :03:28. | |
those who need the most support are getting at. 18,000 people received a | :03:29. | :03:34. | |
winter warmth assessment, making sure their home is prepared for the | :03:35. | :03:39. | |
winter. Stockton council working with Public Health England to | :03:40. | :03:43. | |
implement a child dental health programme in schools, including | :03:44. | :03:46. | |
nursery. Even in nursery and reception children. In our poorest | :03:47. | :03:52. | |
wards, the council runs a community led initiative which focuses on | :03:53. | :03:58. | |
outcomes for children up to three. Cognitive development, speech and | :03:59. | :04:01. | |
language development and nutrition. These schemes ensure children have | :04:02. | :04:07. | |
more opportunities to break this health inequality in my constituency | :04:08. | :04:10. | |
to promote a healthier and safer upbringing. But they all need | :04:11. | :04:16. | |
resources, which are sadly diminishing. I could now go on to | :04:17. | :04:21. | |
bleat about the Pudil the north-east got from the coalition and now gets | :04:22. | :04:25. | |
from the Tory government. The movement of health resources from | :04:26. | :04:29. | |
north to the south, the huge cuts to local authority spending, which has | :04:30. | :04:33. | |
impacted the ability to maintain services they need to close the | :04:34. | :04:37. | |
quality gap. But I won't. But I will remind the government that whilst | :04:38. | :04:42. | |
new hospital projects and Liberal Democrat and Tory constituencies | :04:43. | :04:45. | |
planned by the last Labour government went ahead in 2010, the | :04:46. | :04:52. | |
one to serve my own and neighbouring constituencies was axed. Our health | :04:53. | :04:57. | |
trust is a remarkable job in difficult circumstances and I hope | :04:58. | :05:01. | |
one day they will have the 21st-century hospital and facilities | :05:02. | :05:05. | |
they need to serve our community and close the inequality gap. Maybe the | :05:06. | :05:11. | |
provision of a hospital should form part of the transformation plan for | :05:12. | :05:15. | |
our region. The study based the potential downgrading of our | :05:16. | :05:19. | |
hospital and potential loss of our accident Emergency department. The | :05:20. | :05:23. | |
challenge posed by health inequality is not just in my area, it is bigger | :05:24. | :05:28. | |
than any other individual parent, bigger than any local authority and | :05:29. | :05:32. | |
health trust. There must be a unified strategy to ensure health | :05:33. | :05:36. | |
and equality is a thing of the past and my constituents, and as well as | :05:37. | :05:40. | |
the constituents of many in this chamber have the best start to live | :05:41. | :05:43. | |
under good quality of life to follow. Need early intervention, we | :05:44. | :05:50. | |
need help for people with mental health problems and greater action | :05:51. | :05:53. | |
to break the cycle of health inequality in the poorest areas of | :05:54. | :05:57. | |
our country. We had one of the gloomiest outlooks for the country | :05:58. | :06:03. | |
from the Chancellor yesterday, he spoke of the uncertainty ahead of | :06:04. | :06:05. | |
rising debt and borrowing and falling growth and tax revenues. My | :06:06. | :06:15. | |
great fear is that if the tough years ahead, coupled with the | :06:16. | :06:17. | |
failure of the government to properly fund public health, the NHS | :06:18. | :06:24. | |
and social care, we will see health inequalities Grot and the huge gap | :06:25. | :06:27. | |
in life expectancy will not be closed for many decades. Mr Deputy | :06:28. | :06:32. | |
Speaker, we shouldn't have a country where the future opportunities and | :06:33. | :06:37. | |
health of children is determined by their socio- economic status, or the | :06:38. | :06:40. | |
availability of resources to tackle the issues around smoking, alcohol, | :06:41. | :06:47. | |
drugs and inactivity. But one where children yet to be born, have the | :06:48. | :06:50. | |
freedom to choose which parts they want to take without the negative | :06:51. | :06:53. | |
health implications holding them back. Thank you. I have to say, I | :06:54. | :07:02. | |
entered this debate with trepidation about those people have spoken | :07:03. | :07:07. | |
before me. I hope I can live up to them. Can I congratulate the member | :07:08. | :07:15. | |
opposite, the shadow spokesman, and who I have worked closely with on | :07:16. | :07:20. | |
issues to do with basketball as well. Can I register an interest as | :07:21. | :07:28. | |
well. Can I congratulate my honourable friend who is a fellow | :07:29. | :07:33. | |
Devon MP. Some of the issues I may be talking about one she may | :07:34. | :07:39. | |
something about as well. Congratulations on securing this | :07:40. | :07:47. | |
debate. In my constituency, there is an 11 year life expectancy | :07:48. | :07:50. | |
difference between the north-east of my patch, which is where the | :07:51. | :07:54. | |
professionals live, and the south-west, which is best known for | :07:55. | :08:00. | |
its dockyard. Last week, I chaired a supper implement with health | :08:01. | :08:05. | |
practitioners and academics, over iron deficiency and anaemia in | :08:06. | :08:10. | |
Devon. It is a condition where the body, and I'm not going to pretend I | :08:11. | :08:14. | |
am a medical expert, which you can probably tell, but it is a condition | :08:15. | :08:20. | |
where the body has low red blood cell counts, resulting in less | :08:21. | :08:25. | |
oxygen getting to organs and tissues. It can have serious | :08:26. | :08:29. | |
consequences, often leading to more admissions to hospital or | :08:30. | :08:37. | |
deterioration in health. This is a result of poverty, especially, but | :08:38. | :08:41. | |
not exclusively, amongst the over 75 's. I was horrified to learn that | :08:42. | :08:48. | |
Plymouth is top of the national list for iron deficiency. The rates of | :08:49. | :08:53. | |
iron deficiency anaemia are four times the national average. Indeed, | :08:54. | :08:57. | |
in north, east and West Devon, which includes Plymouth, there were 1530 | :08:58. | :09:07. | |
in patients with this in 2014 and 19% increase on 2013 and following | :09:08. | :09:12. | |
the steady rise over the past few years. I understand in 2014, this | :09:13. | :09:17. | |
amounted to an avoidable cost to the local health economy of just over ?1 | :09:18. | :09:22. | |
million as well. During my comments, which I will make now, I want to | :09:23. | :09:27. | |
concentrate on NHS England's recent announcement and desire, to close | :09:28. | :09:36. | |
three GP surgeries in my Plymouth, Sutton and Devonport constituency by | :09:37. | :09:40. | |
March next year. This action, which I fear will serve to put greater | :09:41. | :09:51. | |
pressure on the hospital, I am told the reason why NHS England is | :09:52. | :09:55. | |
considering these closures is the size of the GP practices. I | :09:56. | :10:01. | |
understand there is a report which suggests that should not be the only | :10:02. | :10:08. | |
thing taken into account. The GP practice has a 1800 patient | :10:09. | :10:15. | |
practice. Hyde Park, 2800 and Saint Barnabas, 1700. They are considered | :10:16. | :10:22. | |
to be unsustainable and too small, despite the fact they are growing | :10:23. | :10:27. | |
practices. I have mentioned some of these issues before, but I have no | :10:28. | :10:31. | |
problem repeating them. I was told closing these practices is not down | :10:32. | :10:35. | |
to saving money, but deliver better value for money. However, before I | :10:36. | :10:41. | |
speak about both issues, let me put my own constituency into some | :10:42. | :10:49. | |
context. It runs from the a 38 to the River Tame. It is home to one of | :10:50. | :10:55. | |
the largest universities in the country, with thousands of students, | :10:56. | :10:59. | |
thousands of whom live in the city centre. It is unable and a Royal | :11:00. | :11:05. | |
Marine commander garrison city, as the health Minister, for whom I was | :11:06. | :11:12. | |
a previous Parliamentary Secretary two, in a previous life, knows only | :11:13. | :11:13. | |
too well. Fortunately Perth Plymouth, the MoD | :11:14. | :11:33. | |
announced the Royal Marines and their families would be transferred | :11:34. | :11:38. | |
from shipping in the north of Devon, our brave in Scotland and Taunton, | :11:39. | :11:44. | |
just up the M5. Whilst the city's population is growing, this will put | :11:45. | :11:51. | |
more pressure on schools, hospitals, both that the Rufford and GP | :11:52. | :11:58. | |
practices. Although Plymouth has a global reputation for Marine science | :11:59. | :12:03. | |
and engineering research, it is a low-wage and low skills economy. It | :12:04. | :12:08. | |
is an inner city, something pretty unique for a conservative to | :12:09. | :12:13. | |
represent, if I might say so. I do not have a single piece of | :12:14. | :12:16. | |
countryside in my constituency, unless of course you include the | :12:17. | :12:23. | |
pony Sanctuary, which is a rather muddy field. In the run-up to the | :12:24. | :12:29. | |
2010 general election, when I won the seat on the third attempt, the | :12:30. | :12:33. | |
Conservative Party pledged to do something about health care in | :12:34. | :12:36. | |
deprived inner cities. We started to make a good two word and in 2014, | :12:37. | :12:42. | |
the member for central and Suffolk and North Ipswich, one of the | :12:43. | :12:50. | |
ministers, it to open the GP practice which is now very much | :12:51. | :12:54. | |
under threat. Other facilities on the campus include minor injuries | :12:55. | :13:00. | |
unit, the Devonport health centre and the pharmacy. The GP practice | :13:01. | :13:05. | |
was set up by Plymouth community health care, and the Peninsula | :13:06. | :13:13. | |
medical School. There was and a desperate need to provide | :13:14. | :13:16. | |
tailor-made alternative service to the existing practice. Then, the | :13:17. | :13:23. | |
Marlborough Street practice. Now the health centre for this deprived | :13:24. | :13:28. | |
community, and the need to look after drug users and the city | :13:29. | :13:33. | |
homeless in hostels such as the neighbouring Salvation Army | :13:34. | :13:37. | |
hospital. The practice, also offers practical placements for students at | :13:38. | :13:41. | |
the Plymouth medical school. Until earlier this year, it was funded by | :13:42. | :13:47. | |
a social enterprise which found it too expensive to maintain. Despite | :13:48. | :13:53. | |
Devonport's real deprivation, NHS England did not want to get involved | :13:54. | :13:58. | |
in providing a contract to the Cumberland GP practice which is | :13:59. | :14:01. | |
consequently been operating without a formal contract and is managed by | :14:02. | :14:08. | |
Access health care. I understand that whilst the neighbouring | :14:09. | :14:11. | |
Devonport health practice has not been offering... | :14:12. | :14:27. | |
NHS England's reason for putting the GP practice under threat is because | :14:28. | :14:36. | |
it would be too small and is operating in and sustained, | :14:37. | :14:40. | |
unsuitable, cramped premises. Unless we are very careful, we could | :14:41. | :14:46. | |
potentially put more pressure on the acute emergency unit, which is | :14:47. | :14:53. | |
already under pressure. NHS England's proposals for three GP | :14:54. | :15:03. | |
practices in the summer recess. NHS England expected me under the | :15:04. | :15:05. | |
members of Parliament expected us to be won parliamentary trips are | :15:06. | :15:10. | |
taking a holiday. Hard luck, I was there. I put together a series of | :15:11. | :15:15. | |
meetings with the City Council director of public health, the | :15:16. | :15:18. | |
leader of the Council, the member for adult social care, people from | :15:19. | :15:23. | |
NHS England, the dean of the medical School and the Doctor Who runs the | :15:24. | :15:25. | |
GP practice. At that meeting, I suggested the | :15:26. | :15:35. | |
Cumberland GP practice should share a the health centre was my brand-new | :15:36. | :15:41. | |
building, which has space and operates as a federation, sharing | :15:42. | :15:44. | |
receptionists and backroom staff. The City Council's health and | :15:45. | :15:48. | |
well-being board supported it following an inquiry that read some | :15:49. | :15:52. | |
of measures to allow the Cumberland GP practice to continue. However, I | :15:53. | :15:56. | |
understand that Devonport health care might not be willing to do | :15:57. | :16:00. | |
this, and it appears that the Devonport community may be deprived | :16:01. | :16:04. | |
of a second GP practice that patients will have no choice in | :16:05. | :16:09. | |
which Doctor they go to. The new Devon CCG is looking at ways in | :16:10. | :16:14. | |
which it might try and keep the Cumberland GP practice open, but it | :16:15. | :16:19. | |
needs space in the short-term whilst it considers alternative locations I | :16:20. | :16:24. | |
have also had representation of patients at Boghead Park and Saint | :16:25. | :16:29. | |
Barnabas surgeries at Hyde Park, although Doctor Stephen Warren is | :16:30. | :16:33. | |
keen to continue as a GP following a heart attack, he has transferred | :16:34. | :16:37. | |
ownership of his practice to access health care, as he no longer wishes | :16:38. | :16:41. | |
to deal with the backroom task of administration, which is part of | :16:42. | :16:44. | |
running a practice. He argues that his and his partners' growing 2800 | :16:45. | :16:51. | |
practice has attracted outstanding reviews and he would not be able to | :16:52. | :16:56. | |
inform his patients where he was going if he relocated to another | :16:57. | :17:01. | |
practice. He also thinks that some patients like to have a relationship | :17:02. | :17:05. | |
with an individual doctor, who they can see speedily, rather than having | :17:06. | :17:11. | |
to wait weeks. It is like having your own personal bank manager, is | :17:12. | :17:15. | |
it not? I think that is important. Saint Barnabas surgery, also run by | :17:16. | :17:18. | |
access health care, was set up in a new development next to a | :17:19. | :17:21. | |
residential care home for the elderly, were patients do not have | :17:22. | :17:26. | |
to walk very far. In all three cases, NHS England, for technical | :17:27. | :17:32. | |
reasons, gave patients only 24 hours notice of their initial engagement. | :17:33. | :17:37. | |
I must say, I found the public consultation process is frankly | :17:38. | :17:41. | |
utterly appalling. And I wrote to NHS England asking to give more time | :17:42. | :17:46. | |
to engage with local communities, and I am grateful that they actually | :17:47. | :17:51. | |
did bother to listen. Recently, as my constituency surgery, I was asked | :17:52. | :17:54. | |
to write to NHS England to ask whether they had engaged with other | :17:55. | :17:58. | |
GP surgeries. And with Derriford Hospital, and whether it consulted | :17:59. | :18:03. | |
them, because some GPs will have to accommodate more patients. This is a | :18:04. | :18:06. | |
very big issue. But there are wider issues of all others. At the moment, | :18:07. | :18:11. | |
the commissioners in North, east and West Devon spend a higher amount of | :18:12. | :18:18. | |
money East Devon than in the West locality. The government success | :18:19. | :18:20. | |
regime is keen to correct this so that resources are focused on | :18:21. | :18:28. | |
deprived communities such as Devonport. Finally... I thank him | :18:29. | :18:32. | |
for giving way. It was just an observation, really. Given the | :18:33. | :18:36. | |
detail that my honourable friend has gone into how he seems to be the | :18:37. | :18:39. | |
presenting his community in these deprived areas, how very fortunate | :18:40. | :18:44. | |
they are to have this concerned MP in this inner-city area. I will try | :18:45. | :18:55. | |
to intervene to a similar extent later as well. Thank you! Yes, there | :18:56. | :19:01. | |
have been no mentions of jobs in this debate at all. Finally, as my | :19:02. | :19:06. | |
honourable friend Maynor, I am the government's pharmacy champion, and | :19:07. | :19:09. | |
the government is reviewing the role of pharmacy to take pressure off our | :19:10. | :19:13. | |
GPs and Major acute hospitals, like Derriford. Much has been made of the | :19:14. | :19:19. | |
6% cut, but there has been very little publicity of the ?90 million | :19:20. | :19:23. | |
that is going to be made available through the government's pharmacy | :19:24. | :19:27. | |
access fund. Perhaps, my honourable friend made use for winding up | :19:28. | :19:30. | |
speech to give us slightly more information about all of this, and | :19:31. | :19:34. | |
explain how the Department of Health is going to provide the resources | :19:35. | :19:38. | |
performances to take pressure off GPs by delivering flu jabs, | :19:39. | :19:41. | |
opticians, mental health and obviously smoking stuff as well. A | :19:42. | :19:47. | |
nationwide minor ailment facility. If she cannot do that now, perhaps | :19:48. | :19:51. | |
she might like to write to me about it. Mr Deputy Speaker, Plymouth | :19:52. | :19:54. | |
putt-mac health services under real pressure. We do not have -- | :19:55. | :20:00. | |
Plymouth's health services are under real pressure. Part of the | :20:01. | :20:03. | |
constituency are very deprived and we need to do something about those | :20:04. | :20:07. | |
living your life expectancy difference. The government must make | :20:08. | :20:11. | |
sure that resources follow health needs. Finally, we need to make much | :20:12. | :20:16. | |
more use of pharmacies, as my honourable friend the Minister | :20:17. | :20:19. | |
knows, I am the government's pharmacy champion so what are going | :20:20. | :20:22. | |
to do to make sure that pharmacy have the funding and how they will | :20:23. | :20:26. | |
be able to operate as well? Thank you. Thank you, Mr Deputy Speaker, | :20:27. | :20:32. | |
for calling me to speak on this very important debate, one which in my | :20:33. | :20:37. | |
opinion is overdue. May I place on record my thanks to the Chair of the | :20:38. | :20:41. | |
Health Select Committee, the Member for Totnes, and also my thanks to | :20:42. | :20:44. | |
the backbench business committee for allowing the time. Today, I wish to | :20:45. | :20:49. | |
focus my remarks on one particular area of health inequality, an area | :20:50. | :20:53. | |
which receives disproportionately less funding than most others, and | :20:54. | :20:58. | |
sadly receives far less attention from government ministers than | :20:59. | :21:01. | |
Israeli due. The area I am of course talking about is dental and oral | :21:02. | :21:07. | |
health inequality. -- ban is really cheap. You ask most people to | :21:08. | :21:14. | |
describe what health inequality in this country look like, the name a | :21:15. | :21:18. | |
long waiting lists for common ailments, difficulties in GPs and | :21:19. | :21:21. | |
the rationing of licensed drugs from those suffering from treatable | :21:22. | :21:25. | |
diseases. I could of course go on. But most, Mr Deputy Speaker, would | :21:26. | :21:28. | |
not immediately name dental and oral health. But inequality in dental and | :21:29. | :21:34. | |
oral health is just as widespread across this country as in many other | :21:35. | :21:39. | |
important inequalities violated, quite rightly, in today's debate. -- | :21:40. | :21:46. | |
inequality is highlighted. Let me share with the House some unfit | :21:47. | :21:51. | |
figures which have caused me more than a few sleepless nights. | :21:52. | :21:55. | |
Official figures revealed that five-year-old children in Bradford | :21:56. | :22:00. | |
are 4.5 times more likely to suffer from tooth decay than their peers in | :22:01. | :22:04. | |
the right honourable member for South West Surrey, the Health | :22:05. | :22:10. | |
Secretary's constituency. The number of women, children admitted to | :22:11. | :22:13. | |
hospital for truth extraction usually requiring a general | :22:14. | :22:16. | |
anaesthetic has gone up by one quarter over the last four years. -- | :22:17. | :22:22. | |
tooth extraction. 667 children spent time in hospital for this entirely | :22:23. | :22:25. | |
avoidable reason within Bradford alone, just in the last year. I | :22:26. | :22:32. | |
certainly will. Thank you. As somebody born in Bradford, and I can | :22:33. | :22:37. | |
barely proudly say I have only got one filling in my teeth at my age, | :22:38. | :22:43. | |
it is also, as with obesity, partly due to parental responsibility as | :22:44. | :22:51. | |
well as environmental factors. That is an interesting point and I will | :22:52. | :22:54. | |
come onto some of those issues later on during my speech. And according | :22:55. | :23:00. | |
to the latest figures, almost one third, that is 32%, of children in | :23:01. | :23:03. | |
Bradford have not seen a dentist for more than two years and as the House | :23:04. | :23:07. | |
will be aware, ideally they should attend for a checkup every six | :23:08. | :23:14. | |
months. Dental and oral health continues to be the Cinderella of | :23:15. | :23:19. | |
health provision, something nice still have, something to be tackled | :23:20. | :23:22. | |
after the good ship NHS returns to calmer waters, only due to | :23:23. | :23:28. | |
much-needed extra finances once the financial black holes elsewhere in | :23:29. | :23:30. | |
the NHS have been plugged. Such inequality in dental and oral health | :23:31. | :23:34. | |
is plain wrong. An unspoken injustice intraday's society, and | :23:35. | :23:39. | |
tackling it cannot and should not be your after you're kicked down the | :23:40. | :23:44. | |
road like the proverbial can. Tooth decay, Mr Deputy Speaker, is an | :23:45. | :23:49. | |
almost entirely preventable disease. It is a scandal, without | :23:50. | :23:51. | |
exaggeration, that the number one reason for children between the ages | :23:52. | :23:55. | |
of five and nine being admitted to hospital is tooth decay. It is a | :23:56. | :23:59. | |
scandal, Mr Deputy Speaker, not only because it causes children needless | :24:00. | :24:04. | |
pain and suffering, but in this final posterity, it wastes countless | :24:05. | :24:09. | |
millions in NHS resources but its impact goes much deeper than this. | :24:10. | :24:14. | |
-- this year posterity. In an increasingly competitive and | :24:15. | :24:18. | |
globalised world, with the need for children to exceed in school, | :24:19. | :24:24. | |
improve their skills and excel in internationally benchmark exams, | :24:25. | :24:27. | |
Oliver children need to be healthy and energised to face the school | :24:28. | :24:33. | |
day. Too often, tooth pain arising from poor oral and dental health | :24:34. | :24:37. | |
hinders their school readiness, and peers there and broadband cripple | :24:38. | :24:41. | |
the development the ability to thrive, and socialise with each | :24:42. | :24:45. | |
other. A recent survey confirmed that more than one quarter of our | :24:46. | :24:47. | |
young people feel too embarrassed to smile or laugh due to the condition | :24:48. | :24:52. | |
of their teeth. For our teenagers, this injustice is no less, Mr Deputy | :24:53. | :24:57. | |
Speaker. More than ever, being ready to succeed and get on and make your | :24:58. | :25:02. | |
way any competitive job market... Thank you for reading this, and I | :25:03. | :25:07. | |
know that in my constituency I can tell someone's poverty by the state | :25:08. | :25:10. | |
of their teeth. Not only is it the decay issue, but it is not having | :25:11. | :25:14. | |
the money to have the necessary treatment, perhaps cosmetically, so | :25:15. | :25:18. | |
that the issues that she described about embarrassment and confidence | :25:19. | :25:23. | |
also kick in. I thank my honourable friend for that very valid and | :25:24. | :25:28. | |
important point. But disproportionate levels of poor oral | :25:29. | :25:31. | |
and dental health predominantly in deprived low-income areas, such as | :25:32. | :25:34. | |
those found in Bradford, hampers these young people from forging | :25:35. | :25:38. | |
their careers. Survey after survey confirms that young people who | :25:39. | :25:43. | |
suffer from poor oral and dental health these poor job prospects. | :25:44. | :25:47. | |
Dental and oral health plays, rightly or wrongly, an important | :25:48. | :25:53. | |
part in selling yourself intraday's competitive job market. Now, Mr | :25:54. | :25:56. | |
Deputy Speaker, I have said the depressing skill of the challenge, | :25:57. | :26:00. | |
but the question it begs is what we do? Or, perhaps more accurately, | :26:01. | :26:04. | |
what can and should the government do to tackle this scandal is health | :26:05. | :26:08. | |
inequality? As I highlighted to the former Prime Minister, Mr Cameron, | :26:09. | :26:12. | |
when I challenged him about this inequality in my constituency and | :26:13. | :26:15. | |
city, there are some simple step that can be taken. The first is due | :26:16. | :26:21. | |
to be implemented in the foreseeable future, that is tax on sugary | :26:22. | :26:25. | |
drinks. Although, the government's final proposal was very much weaker | :26:26. | :26:29. | |
than it should have been in my view, it was nevertheless a much welcomed | :26:30. | :26:32. | |
step in the right direction. The Royal College of Surgeons' faculty | :26:33. | :26:38. | |
of dental surgery, a professional body which sees these problems | :26:39. | :26:42. | |
first-hand in its day-to-day work, suggests a number of low-cost, | :26:43. | :26:45. | |
easily deliverable measures which could readily be adopted by | :26:46. | :26:50. | |
government. Tighter restrictions on advertising high sugar products on | :26:51. | :26:54. | |
television, such as restricting advertising and before the name PM | :26:55. | :26:59. | |
watershed. Limiting price promotions and supermarkets for high sugar food | :27:00. | :27:01. | |
and drinks and excluding these products from point locations, like | :27:02. | :27:08. | |
a checkout and counters. Most sensibly, limiting the availability | :27:09. | :27:11. | |
of high sugar food and drinks in our school system. But perhaps the most | :27:12. | :27:16. | |
important measure this Government could take is highlighted by the | :27:17. | :27:20. | |
British dental Association, to Expedia changes to the current | :27:21. | :27:24. | |
dental contract. Critical changes are long overdue. The first would be | :27:25. | :27:28. | |
to incentivise preventive work through the contract. The second and | :27:29. | :27:33. | |
most important would be to incentivise the dental profession to | :27:34. | :27:37. | |
establish new practices in deprived areas, areas which are so | :27:38. | :27:42. | |
desperately need them. They typically faced the least | :27:43. | :27:47. | |
availability. In my constituency, despite need being so high, there is | :27:48. | :27:51. | |
a simple shortfall of NHS dentist appointments. Very few NHS dentists | :27:52. | :27:56. | |
have open lists, meaning most in search of dental treatment simply | :27:57. | :27:59. | |
give up and most who are determined to end up finding one outside of the | :28:00. | :28:02. | |
city boundaries. That surely is not right. I understand the government | :28:03. | :28:07. | |
hopes to initially begin rolling out a reformed dental contract in 2018 | :28:08. | :28:14. | |
to 2019 onwards. But this is simply not fast enough. In closing, I | :28:15. | :28:19. | |
finish by asking a simple question. Is it just and equitable that a | :28:20. | :28:23. | |
five-year-old child within Bradford, my home city, is 4.5 times more | :28:24. | :28:29. | |
likely to suffer from tooth decay than their peers in the right | :28:30. | :28:32. | |
honourable member for South West Surrey, the Health Secretary's | :28:33. | :28:37. | |
constituency? I hope the House would agree with me that the answer is no. | :28:38. | :28:44. | |
Thank you. Rebecca. Thank you, Mr Deputy Speaker. I am very pleased to | :28:45. | :28:48. | |
follow the honourable member from Bradford, who gives a somewhat | :28:49. | :28:51. | |
shocking account of oral and dental health. I am also very dilated to | :28:52. | :28:59. | |
follow -- delighted to follow, and I come into the honourable member for | :29:00. | :29:03. | |
Totnes, for raising this issue and ably piloting in her speech the | :29:04. | :29:05. | |
impacts and causes of this health inequality. But I would like to | :29:06. | :29:10. | |
focus on an area which my honourable friend has not mentioned yet, and I | :29:11. | :29:16. | |
wanted to bring it to the Minister's attention. I particularly want to | :29:17. | :29:20. | |
talk about natural and green solutions to helping reduce and | :29:21. | :29:27. | |
prevent this greater disparity in inequality in health outcomes. I am | :29:28. | :29:31. | |
not suggesting that some of the things I am going to talk about are | :29:32. | :29:35. | |
the only solutions, but I do really believe that our natural environment | :29:36. | :29:39. | |
has a very important and often underestimated role to play in | :29:40. | :29:45. | |
improving our health and well-being. We know that health inequality can | :29:46. | :29:51. | |
cost up to ?70 billion per year, with those below the wealthiest | :29:52. | :29:55. | |
levels of society suffering the greatest degrees of inequality, and | :29:56. | :29:59. | |
many of our colleagues have expanded on that today. I have a particularly | :30:00. | :30:04. | |
deprived part of my constituency, it is called Falcon and is in the 4% | :30:05. | :30:07. | |
most deprived parts of the country. That is in Taunton Deane. Many of | :30:08. | :30:10. | |
the things mentioned today apply there as well. | :30:11. | :30:19. | |
People in these areas are ten years less likely to live in the | :30:20. | :30:27. | |
mysterious. -- people in deprived areas. So this would seem to me that | :30:28. | :30:34. | |
it is more than a coincidence, there must be a link. There is clearly | :30:35. | :30:38. | |
search to show disadvantaged people with greater access to green spaces | :30:39. | :30:45. | |
are likely to have better health outcomes. A good natural and built | :30:46. | :30:52. | |
environment can have a positive impact on mental and physical | :30:53. | :30:56. | |
health. It is not just the impact, it is actually the most cost | :30:57. | :31:01. | |
effective to talk about what I'm going to mention, which always makes | :31:02. | :31:06. | |
the Minister's eyes light up, if there can be cost savings. Many | :31:07. | :31:09. | |
people are beginning to realise this important link between health and | :31:10. | :31:14. | |
well-being and the natural environment. I am very heartened | :31:15. | :31:18. | |
that many service providers are already starting to think about this | :31:19. | :31:22. | |
and put people in place to deal with it. The Somerset wildlife trust, for | :31:23. | :31:28. | |
example, of which I am proud to be president, they appointed a health | :31:29. | :31:34. | |
and well-being manager, which are truly heartening. I will watch with | :31:35. | :31:37. | |
interest about the role played and what they will do to highlight the | :31:38. | :31:46. | |
issue. I am going to turn to mental health quickly. The natural world | :31:47. | :31:50. | |
can have a really positive impact on mental health. I am a firm believer | :31:51. | :31:56. | |
of the therapeutic power in a brisk walk in the beautiful Somerset may | :31:57. | :32:03. | |
be Cheshire countryside. How about a wonderful walk for restoring the | :32:04. | :32:09. | |
spirits... I will give way. Does she agree that one of the great problems | :32:10. | :32:14. | |
about mental health if it has been a Cinderella part of the health | :32:15. | :32:25. | |
service for too long? It has, it is one of the Cinderella subjects. And | :32:26. | :32:30. | |
the things I'm talking about, they are free, I am giving free therapy | :32:31. | :32:34. | |
because nature is free. It is such a beautiful thing and it really does | :32:35. | :32:38. | |
have power. What could be more relaxing than a walk by the | :32:39. | :32:45. | |
Wellington Monument in my constituency on the hills, and I | :32:46. | :32:48. | |
know hundreds of thousands of people got what they are, and lots of | :32:49. | :32:50. | |
people with disabilities go up because it is easy to get to and it | :32:51. | :32:57. | |
is flat. It beneficial, and I'm going to add that the Wellington | :32:58. | :33:01. | |
Monument raised my spirits yesterday, or the government did, | :33:02. | :33:06. | |
because they had just given as ?1 million for a restoration project, | :33:07. | :33:12. | |
and there will be loads of spin offs to the public and health and | :33:13. | :33:15. | |
well-being will be part of it because we will build a big | :33:16. | :33:17. | |
community project around at encouraging more people to go up | :33:18. | :33:21. | |
there. When I was looking for somewhere to live in London because | :33:22. | :33:24. | |
obviously I have to stay here in the week, one of the criterion I had to | :33:25. | :33:34. | |
include in when I had to stay was that I had to see a tree from my | :33:35. | :33:40. | |
window, and I can. I could not live without one. Can I congratulate her | :33:41. | :33:48. | |
on the points she is making. There is data to back up what she's | :33:49. | :33:54. | |
saying. Public England estimate that an inactive person is likely to | :33:55. | :34:00. | |
spend 37% more time in hospital than someone who is active, and active | :34:01. | :34:10. | |
people are 5.5% -- people who are inactive at 5.5% more likely to be | :34:11. | :34:13. | |
visiting doctors. Bid is good evidence behind this. Thank you for | :34:14. | :34:19. | |
that. I will give a few more statistics as I go through this | :34:20. | :34:24. | |
because I am not making this up. This is coming into our psyche. I | :34:25. | :34:29. | |
will give way. Can I encourage her, when she's here in London, to a boat | :34:30. | :34:34. | |
from Chelsea Harbour down to Greenwich, where you will see the | :34:35. | :34:41. | |
magnificent layout of a number trees occurring in the West, but there are | :34:42. | :34:45. | |
fewer of them than in the East of London. We do not need a forestry | :34:46. | :34:55. | |
debate! I think we want to get back to health. I went out on a boat this | :34:56. | :35:03. | |
morning, with Greenpeace, it was up the Thames, to look at Micro | :35:04. | :35:08. | |
plastics in water. And we did see some trees as well. And they do | :35:09. | :35:16. | |
serve a very good purposeful stop trees are important for taking in | :35:17. | :35:20. | |
air pollution, which -- the server very good purpose. They take in air | :35:21. | :35:30. | |
pollution, which is also very helpful. Mental health can be helped | :35:31. | :35:36. | |
with being in contact with nature, and as a keen gardener I can | :35:37. | :35:39. | |
absolutely vouch that getting your hands in the earth, planting seeds, | :35:40. | :35:44. | |
watching seasons change, definitely lifts the spirits and is a pick-up. | :35:45. | :35:55. | |
Give way. She makes a good point, it is not just about brisk walks to | :35:56. | :36:00. | |
help health. Last Friday I was helping some young children at a | :36:01. | :36:06. | |
junior school plant bulbs in their school grounds. The exercise we were | :36:07. | :36:13. | |
getting and being out on fresh air, and that is in a built-up area, | :36:14. | :36:15. | |
periurban, which must be a good thing for their health for the | :36:16. | :36:22. | |
future. She is absolutely right. I know that many schools have | :36:23. | :36:25. | |
gardening bits, and it is so much to be had from it in every respect. It | :36:26. | :36:31. | |
can help unemployed groups and all sorts of different groups. Physical | :36:32. | :36:38. | |
activity, but also watching things growing is very beneficial. The | :36:39. | :36:41. | |
Royal horticultural Society have done research to show 90% of UK | :36:42. | :36:46. | |
adults say that just looking at a garden make them feel better. Doing | :36:47. | :36:55. | |
something in it is better, but there was recent data about watching birds | :36:56. | :36:59. | |
on a bird table. And hedgehogs. If you got the chance to watch a | :37:00. | :37:02. | |
hedgehog that would make you incredibly happy because they are | :37:03. | :37:07. | |
still rare. I got excited when I saw one eating my cat food recently. I | :37:08. | :37:15. | |
will give way. I do not want to rain on her garden but would she agree | :37:16. | :37:19. | |
that there is also a negative impact of the surroundings -- if the | :37:20. | :37:25. | |
surroundings are not as good. 30% of people in Glasgow live beside vacant | :37:26. | :37:34. | |
land, which can have a negative effect. Yes, and we need to do | :37:35. | :37:38. | |
something with the community, and the Woodland Trust have some great | :37:39. | :37:44. | |
data, that if you live 500 metres from woodland, their health is | :37:45. | :37:46. | |
better because they are going into it but they are also looking at it, | :37:47. | :37:52. | |
they are enjoying it. And mental health charity has a report called | :37:53. | :37:59. | |
feel better outside, feel better inside, and they are advocating the | :38:00. | :38:05. | |
benefits of eco-therapy, which is really what I am talking about, | :38:06. | :38:08. | |
mental and physical well-being, and boosting skills and confidence to | :38:09. | :38:13. | |
get them back to work by doing things like gardening, farming, | :38:14. | :38:23. | |
growing food, exercise, conservation work. And 69% of people who took | :38:24. | :38:30. | |
part definitely saw an increase in their mental well-being, and 62% of | :38:31. | :38:32. | |
them thought the overall health improved. These projects help 250 | :38:33. | :38:40. | |
word people afterwards to find full-time work, and that saved the | :38:41. | :38:46. | |
nation money. In my constituency we have an agency called prospects, | :38:47. | :38:52. | |
which has a contract to help get the long run one -- long-term unemployed | :38:53. | :39:00. | |
get into employment. I've been out with them into an ancient woodland, | :39:01. | :39:04. | |
and it definitely helps not just engage with nature, but it gives | :39:05. | :39:07. | |
them confidence because they are speaking to each other, they are | :39:08. | :39:13. | |
atmosphere, and very many of those people are then able to have the | :39:14. | :39:16. | |
confidence to apply for jobs and get back to work. So it seems to me that | :39:17. | :39:21. | |
there is a very clear case for prescribing access to green space in | :39:22. | :39:26. | |
our armoury of traditional medicines to deal with the range of mental | :39:27. | :39:32. | |
health. Then there is physical health, the great outdoors is a | :39:33. | :39:37. | |
vastly underutilised tool in the wider sense, and many of my | :39:38. | :39:43. | |
colleagues have been talking about obesity, and the outdoors can play a | :39:44. | :39:46. | |
very important part in tackling our fight against obesity. Currently | :39:47. | :39:52. | |
obesity costs ?16 billion to the government, particularly childhood | :39:53. | :39:57. | |
obesity, which has been referred to, and those living in deprived areas | :39:58. | :40:02. | |
are twice as likely to be obese. So with this in mind, I would really | :40:03. | :40:10. | |
advocate some consideration being given to crime prescriptions. The | :40:11. | :40:12. | |
local Government Association has recently called on the UK to | :40:13. | :40:17. | |
implement a similar model to that used in New Zealand, and eight out | :40:18. | :40:21. | |
of ten GPs in New Zealand have been issuing these crime prescriptions to | :40:22. | :40:27. | |
patients. 72% have noticed a change in their health. So the Local | :40:28. | :40:30. | |
Government Association is encouraging GPs to try to ) moderate | :40:31. | :40:37. | |
physical activity goals for their patients, including things like | :40:38. | :40:39. | |
walks in the park, family classes walks in the park, family classes | :40:40. | :40:47. | |
they can go to, and a number of GPs are already using the schemes. One | :40:48. | :40:53. | |
of the pilots is encouraging them to visit the National Parks, which are | :40:54. | :40:56. | |
obviously beautiful and on their doorstep, and free to go into. So I | :40:57. | :41:01. | |
recommend all of these things. The chairman of the Local Government | :41:02. | :41:04. | |
Association health and well-being board said that by writing a | :41:05. | :41:10. | |
prescription like this, it would encourage so many more people to get | :41:11. | :41:16. | |
out, the doctor says you must do this, because often if the doctor | :41:17. | :41:20. | |
says you must take this tablet, you take it. If the doctor says you must | :41:21. | :41:24. | |
go out and walk, I think potentially you might do it. Anyway, to | :41:25. | :41:31. | |
conclude, there are a great many initiatives taking place, such as | :41:32. | :41:37. | |
NHS Forest, aiming to improve recovery time of patients and staff | :41:38. | :41:41. | |
by increasing access to NHS Gardens, in other words the locations on the | :41:42. | :41:47. | |
doorsteps of hospitals, and part of the health and social care act 2012 | :41:48. | :41:51. | |
there was a statutory duty placed on local authorities to create health | :41:52. | :41:55. | |
and well-being boards, however the health select committee has reported | :41:56. | :41:59. | |
that they find these were not working very successfully. They had | :42:00. | :42:03. | |
few powers. Perhaps this is something the Minister could | :42:04. | :42:06. | |
consider looking at as I believe they could really start to make a | :42:07. | :42:09. | |
big difference in moving this agenda forward. And there was the proposed | :42:10. | :42:15. | |
2015 nature and well-being act that was much discussed and debated, | :42:16. | :42:20. | |
which wanted to put nature at the heart of all the decisions we make | :42:21. | :42:27. | |
about health, education, the economy, flood resilience, and | :42:28. | :42:30. | |
perhaps we could look again at some of the ideas in there because there | :42:31. | :42:38. | |
are very good ideas. So we know that there are links between the access | :42:39. | :42:43. | |
to green space, and health, and it seems a no-brainer to me that if we | :42:44. | :42:47. | |
could improve access to green space and look into the idea of | :42:48. | :42:51. | |
prescribing these treatments, we could make a difference to help and | :42:52. | :42:56. | |
inequalities within health. It would be much easier if we had all the | :42:57. | :42:59. | |
data, if we could prove these benefits with the data, and help is | :43:00. | :43:03. | |
at hand because the wildlife trust have commissioned a piece of work, | :43:04. | :43:10. | |
the School of biological sciences at the University of Essex, to gather | :43:11. | :43:15. | |
just this data, and I think once we have got some solid facts we can | :43:16. | :43:21. | |
move forward. So I would really like to think that you will consider some | :43:22. | :43:27. | |
of these ideas, and when the Cabinet Minister for health and equality is | :43:28. | :43:30. | |
put in place, as was recommended by my honourable friend, or even the | :43:31. | :43:36. | |
Prime Minister, as recommended by the honourable friend from | :43:37. | :43:38. | |
Kingston-upon-Hull, when they have these in place, perhaps my green | :43:39. | :43:43. | |
points could be added to the agenda and we could move forward to a | :43:44. | :43:52. | |
healthier society. Thank you, Mr Deputy Speaker. It is a pleasure to | :43:53. | :43:56. | |
follow the honourable member, and I think she makes some very | :43:57. | :44:00. | |
interesting points. The intervention from my neighbour, the honourable | :44:01. | :44:03. | |
member for Glasgow Central was pertinent about the landscape in | :44:04. | :44:08. | |
Glasgow. I would like to begin by commending the honourable member, | :44:09. | :44:11. | |
who is campaigning efforts in health matters coupled with her ability to | :44:12. | :44:15. | |
challenge her own government is second to none. I thank her for | :44:16. | :44:20. | |
securing this debate and the backbench business committee for | :44:21. | :44:22. | |
allowing the time to take place today. It is clear that we are | :44:23. | :44:29. | |
united as a House and want to eradicate health and equality -- | :44:30. | :44:32. | |
inequality, but it is how we work together to achieve this. The | :44:33. | :44:37. | |
honourable member referred to the Prime Minister using her first | :44:38. | :44:41. | |
speech to proclaim her government would fight the burning injustice | :44:42. | :44:45. | |
that plague society, and I believe it is fair to say that most burning | :44:46. | :44:51. | |
injustices lead back to health inequality. Inequalities in health | :44:52. | :44:54. | |
are underpinned by greater societal inequalities, the conditions in | :44:55. | :45:00. | |
which we were conceived, born, grow up, live in, work in and grow old | :45:01. | :45:04. | |
in, have an immense impact on our lives. Essentially we're | :45:05. | :45:14. | |
Whilst they are on they are certainly not unavoidable. Many | :45:15. | :45:21. | |
constituents will needlessly die each and every year as a result of | :45:22. | :45:24. | |
these gross inequalities. This, wherever it occurs, the human and | :45:25. | :45:29. | |
moral tragedy that shames us all. During this debate, the Right | :45:30. | :45:32. | |
Honourable and honourable members from across these islands will quite | :45:33. | :45:36. | |
rightly speak about their constituent nations, regions, local | :45:37. | :45:40. | |
constituencies and the particular competencies. England will be a key | :45:41. | :45:44. | |
focus. However, I would like to compliment this debate by talking | :45:45. | :45:48. | |
specifically about Scotland, Glasgow and my constituency of Glasgow East. | :45:49. | :45:55. | |
Despite vast progress in life expectancy in Scotland over the past | :45:56. | :45:59. | |
150 years, are life expectancy remains law and are average | :46:00. | :46:03. | |
mortality rate remains higher than our neighbours across the UK and | :46:04. | :46:08. | |
throughout Europe. The poor health status of Scotland and our largest | :46:09. | :46:11. | |
city Glasgow are well-documented, and much of this is explained by the | :46:12. | :46:17. | |
experiences of deindustrialisation, deprivation and poverty. However, | :46:18. | :46:20. | |
there is no greater levels of mortality that cannot be explained | :46:21. | :46:25. | |
by deprivation, known as excess mortality. For example, premature | :46:26. | :46:31. | |
mortality rates are 20% higher in Scotland than in England and Wales, | :46:32. | :46:36. | |
even after deprivation is accounted for, and premature mortality rates | :46:37. | :46:40. | |
in Glasgow is 30% higher than it in equally deprived areas like | :46:41. | :46:44. | |
Liverpool and Manchester. The former has been dubbed the Scottish effect, | :46:45. | :46:51. | |
the latter the Glasgow effect. All that counts for approximately 5000 | :46:52. | :46:55. | |
extra, unexplained deaths per year in Scotland. That is 5000 people | :46:56. | :46:59. | |
dying prematurely, dying needlessly, over and above normal inequalities | :47:00. | :47:05. | |
in health. Traditionally, the cause of this has not been entirely | :47:06. | :47:09. | |
understood. Research suggests that the combination of change in | :47:10. | :47:15. | |
political power, increasing income inequalities, disempowerment and | :47:16. | :47:18. | |
deindustrialisation. The last one of which has impacted on people in many | :47:19. | :47:22. | |
ways, such as through unhealthy behaviours, psychosocial stress and | :47:23. | :47:27. | |
of course poverty. Indeed, in May of this year, the Glasgow Centre for | :47:28. | :47:32. | |
population and health, NHS Scotland and the University of the West of | :47:33. | :47:35. | |
Scotland and University College London produced a report entitled | :47:36. | :47:42. | |
History, Politics, Explaining The Excess Mortality In Glasgow And | :47:43. | :47:45. | |
Scotland, which confirmed deaths. The report was signed by over 30 | :47:46. | :47:49. | |
academics and health professionals and found that the city of Glasgow's | :47:50. | :47:54. | |
population was more vulnerable to factors which impacted on health | :47:55. | :47:58. | |
across the UK, such as poverty, deprivation, deindustrialisation and | :47:59. | :48:02. | |
economic decisions taken by the UK Government which have led to the | :48:03. | :48:07. | |
population having poor health outcomes. Such vulnerabilities arose | :48:08. | :48:11. | |
from notoriously high levels of deprivation over a sustained period | :48:12. | :48:15. | |
of time. Urban planning decisions in the post-war period, such as the | :48:16. | :48:21. | |
creation of monolithic, poor quality peripheral housing estates, the | :48:22. | :48:24. | |
regional economic policies of the UK Government and its Scottish office, | :48:25. | :48:28. | |
and local government responses to UK Government policies in the 1980s. | :48:29. | :48:33. | |
Again, where there are social economic inequalities, there are | :48:34. | :48:36. | |
health inequalities. These inequalities are not a mistake and | :48:37. | :48:47. | |
are not an accident, they are not inevitable and are not irreversible. | :48:48. | :48:49. | |
Income inequalities were relatively narrow in the UK until the late | :48:50. | :48:52. | |
1970s, and health inequalities declined dramatically. However, | :48:53. | :48:54. | |
income and wealth inequalities soared again during the 1980s, and | :48:55. | :49:00. | |
the 1990s, and likewise so that health inequalities. Again, this did | :49:01. | :49:03. | |
not happen by accident, nor did it happen in countries all across the | :49:04. | :49:07. | |
world. It happened in countries like the UK that made conscious decisions | :49:08. | :49:14. | |
to rollback state to minimal level possible, to slash public | :49:15. | :49:16. | |
expenditure like it was going out of fashion, to reconstruct the tax and | :49:17. | :49:22. | |
welfare system to be less redistributive and to champion the | :49:23. | :49:28. | |
wants of business and the financial at the expense of Leeds and workers | :49:29. | :49:31. | |
and their trade unions. It was an ideological driven Conservative | :49:32. | :49:35. | |
Government, hell bent on pursuing a neoliberal agenda at any cost, what | :49:36. | :49:40. | |
may stop Mr Speaker, my apologies, Madame Deputy Speaker! To break | :49:41. | :49:45. | |
somewhat from the conciliatory tone, there were worrying signs that this | :49:46. | :49:49. | |
would be mirrored by the previous government, but we do have a new | :49:50. | :49:52. | |
Prime Minister and she has offered encouraging words about her | :49:53. | :49:57. | |
government's indenture despite injustice but what she does matter | :49:58. | :50:01. | |
is what she says -- matters more than what she says. Hopefullytoday's | :50:02. | :50:11. | |
debate is a starting point. Measures would utilise taxation, legislation, | :50:12. | :50:14. | |
regulation and changes in the broader distribution of income and | :50:15. | :50:19. | |
power could help. As Michael Aamodt, Chair of them Marmont review, said | :50:20. | :50:24. | |
in 2010, "Are simply restoring economic growth, trying to return to | :50:25. | :50:29. | |
the status quo, while cutting public expenditure should not be an option. | :50:30. | :50:33. | |
Economic growth without reducing relative inequality will not reduce | :50:34. | :50:38. | |
health inequalities." The government must acknowledge that health | :50:39. | :50:42. | |
inequalities cannot be solved with health solutions alone, they are | :50:43. | :50:47. | |
rooted in poverty and income inequality, as well as across all | :50:48. | :50:49. | |
areas of government policy. Solutions from the Department of | :50:50. | :50:54. | |
Health, or the NHS, will not suffice, as outlined by the right | :50:55. | :51:00. | |
honourable member for Kingston upon Hull. Therefore, the government | :51:01. | :51:04. | |
should commit to a joined up, evidence -based approach of cross | :51:05. | :51:07. | |
departmental working with a specific minister form the Cabinet office | :51:08. | :51:11. | |
given the specific responsibility for embedding health as a priority | :51:12. | :51:16. | |
in all government policy. Madame Deputy Speaker, inequalities in | :51:17. | :51:20. | |
health are a matter of life and death, of health and sickness, of | :51:21. | :51:24. | |
well-being and misery. They represent misery on the greatest | :51:25. | :51:28. | |
skill and marginal. If the government is looking to fight | :51:29. | :51:34. | |
injustice, this is it. The only question is, are they up to the job | :51:35. | :51:40. | |
and are willing to do it? Fiona Bruce. Thank you. On the doorstep of | :51:41. | :51:46. | |
Number Ten, our Prime Minister taking up our leadership mantle even | :51:47. | :51:50. | |
inspirational social justice beach, aimed at ensuring there is a | :51:51. | :51:55. | |
reduction in health inequalities, including addressing the stark | :51:56. | :51:58. | |
realities of mental health challenges that so many families in | :51:59. | :52:01. | |
our communities live with daily. I want to speak about this, about the | :52:02. | :52:05. | |
importance of healthy early relationships in life, even | :52:06. | :52:09. | |
beginning before birth, of the mental health challenges that this | :52:10. | :52:16. | |
can involve, and then lastly just to conclude with a reference to alcohol | :52:17. | :52:26. | |
harm, with my hat on as the Chair of the Parliamentary group on that. | :52:27. | :52:28. | |
Building healthy relationships beginning before birth and | :52:29. | :52:31. | |
establishing these as building blocks within our family and | :52:32. | :52:34. | |
community life in our earliest years are absolutely key for the | :52:35. | :52:39. | |
prevention and reduction of mental health problems in childhood and the | :52:40. | :52:47. | |
road later life. This sites in the womb, I thought I would just -- this | :52:48. | :52:51. | |
starts in the womb. I thought I would commence by stating the early | :52:52. | :52:54. | |
life key facts, from the early lives of children here in the UK today. | :52:55. | :52:59. | |
Depression and anxiety affect 10-15 out of every 100 pregnant women. | :53:00. | :53:04. | |
Over one third of domestic violence begins in pregnancy. 1 million | :53:05. | :53:11. | |
children in the UK suffer from the type of problems, including ADHD, | :53:12. | :53:15. | |
conduct disorder, emotional problems and vulnerability to chronic | :53:16. | :53:17. | |
illness, which are increased by antenatal depression, anxiety and | :53:18. | :53:25. | |
stress. The UK is the world's worst for breast-feeding. 50% of | :53:26. | :53:30. | |
the-year-olds experience family breakdown. 15700 0-2 -year-olds live | :53:31. | :53:44. | |
in families classed as homeless. By addressing some of these, beginning | :53:45. | :53:51. | |
even before birth, we could help exponentially, particularly in terms | :53:52. | :53:54. | |
of not just the physical but also the mental health of so many of our | :53:55. | :53:58. | |
young people today. That helped lift their whole lives. We need to | :53:59. | :54:05. | |
support our youngest, so that we can increase their life chances and | :54:06. | :54:08. | |
reduce health inequalities that get in the way of them achieving their | :54:09. | :54:14. | |
full potential. Points on the compass of scientific advancement | :54:15. | :54:16. | |
are increasingly showing that the direction of travel for social | :54:17. | :54:20. | |
determinants of health significantly pointed towards experiences of bomb, | :54:21. | :54:28. | |
birth and beyond. Marmont's society healthy life report, referred to by | :54:29. | :54:31. | |
the previous number, published as long ago as debris 2010, offered its | :54:32. | :54:36. | |
top policy recommendation as giving every child the best start in life. | :54:37. | :54:41. | |
The 1001 critical base manifesto, the UK's only children's manifesto | :54:42. | :54:45. | |
which has the support of eight political parties, was launched just | :54:46. | :54:49. | |
two years ago in response to this report. A child's development is of | :54:50. | :54:58. | |
course mainly influenced initially by the primary caregiver, usually | :54:59. | :55:00. | |
their mother, but often their father. And also by others who are | :55:01. | :55:07. | |
engaged in helping with parenting of that child. Parenting begins before | :55:08. | :55:12. | |
birth. We have known for a long time that how we turn out depends both on | :55:13. | :55:16. | |
our genes and our environment. What scientists now realise is that the | :55:17. | :55:20. | |
influence of the environment begins in the womb and how the mother feels | :55:21. | :55:24. | |
during her pregnancy can change this environment and have a lasting | :55:25. | :55:27. | |
effect on the development of a child. So, we all need to support | :55:28. | :55:32. | |
and look after pregnant women, both for the sake and for the sake of | :55:33. | :55:35. | |
future generations. A stable and secure home learning environment is | :55:36. | :55:41. | |
critical in those early months. Children, right from their infancy, | :55:42. | :55:43. | |
need to be protected and nourished and stimulated, to think and | :55:44. | :55:48. | |
explore, to communicate and interact with their parents and others. | :55:49. | :55:53. | |
Babies are primed to be in relationships and their earliest | :55:54. | :55:58. | |
relationships really matter for the ABC, one to the building blocks | :55:59. | :56:04. | |
which lead to school readiness. It is in those earliest relationships | :56:05. | :56:09. | |
that we are influenced. That a young child's social brain develops, which | :56:10. | :56:13. | |
will influence their later life. 80% of our brain significantly developed | :56:14. | :56:16. | |
in those earliest years and through our earliest relationships. The | :56:17. | :56:22. | |
reason I am focusing on this is because this assures that healthy | :56:23. | :56:27. | |
relationships really matter. They matter for our health and well-being | :56:28. | :56:33. | |
throughout life. Give way? Thank you for giving way. I know that we are | :56:34. | :56:36. | |
trying to make this a non-partisan debate, but does she actually | :56:37. | :56:41. | |
recognise that all the things she is talking about actually require | :56:42. | :56:44. | |
resources and some of our most needy communities have seen a loss of | :56:45. | :56:48. | |
those resources in recent times? We need to do something to redress | :56:49. | :56:52. | |
that. Thank you for that intervention. We need to focus on | :56:53. | :56:55. | |
the fact that learning about and enjoying healthy relationships is a | :56:56. | :57:02. | |
key determinant of future physical and mental health. In the UK, | :57:03. | :57:07. | |
between 1.3 and 2.5 million years of lives are lost as a result of health | :57:08. | :57:12. | |
inequality in England. Many children never reach their potential | :57:13. | :57:16. | |
throughout their lives, and one of the reasons is because of a lack of | :57:17. | :57:20. | |
healthy relationships in your early years. Relationship breakdown is a | :57:21. | :57:27. | |
significant driver of poverty and health inequality. A comprehensive, | :57:28. | :57:31. | |
cross departmental strategy to combat health inequality must | :57:32. | :57:35. | |
include measures to strengthen healthy relationships and to combat | :57:36. | :57:43. | |
relationship breakdown, which is at epidemic levels in our country I am | :57:44. | :57:49. | |
a Chair of a mental health charity for children in my constituency. I | :57:50. | :57:59. | |
asked the CEO how many of the children that they help, how many of | :58:00. | :58:04. | |
the problems are as a result of poor form relationships, poor early | :58:05. | :58:10. | |
relationships. I should mention that this charity's overwhelmed by | :58:11. | :58:15. | |
requests from children, on the half of children, children as young as | :58:16. | :58:18. | |
four years old. Lucille looked at me and said," virtually all of them." | :58:19. | :58:25. | |
-- this CEO. It is an absolute critical factor in a child's early | :58:26. | :58:29. | |
development and healthy lives, particularly for mental health. It | :58:30. | :58:33. | |
is interesting that recently a wide-ranging survey by the Marriage | :58:34. | :58:37. | |
Foundation involving thousands of young people was published in May of | :58:38. | :58:42. | |
this year, it found that there was a noticeable difference between the | :58:43. | :58:44. | |
self-esteem levels of children who were brought up in stable households | :58:45. | :58:50. | |
compared with those who did not. The self-esteem influence is a predictor | :58:51. | :58:57. | |
of a range of real-world consequences in later life. When | :58:58. | :59:01. | |
relationships break down, they do break in all social economic groups, | :59:02. | :59:05. | |
but when they do break down, this disproportionately affects children | :59:06. | :59:09. | |
in one come families. Because they are less resilient to combat this. | :59:10. | :59:16. | |
Half of all children in the 20% least advantaged communities in the | :59:17. | :59:19. | |
country now no longer live in a home where they have healthy | :59:20. | :59:22. | |
relationships, now no longer live in a home, for example, where both | :59:23. | :59:26. | |
parents are still with them by the time they start school. I am not | :59:27. | :59:30. | |
saying you cannot have a healthy relationship with one parent or | :59:31. | :59:34. | |
another, but it is important that we grasp this nettle and appreciate | :59:35. | :59:40. | |
that healthy relationships with a range of people, including ideally | :59:41. | :59:43. | |
with a mother and a father, are good predictors of early health. So we | :59:44. | :59:49. | |
should support that and I think government should be brave enough, | :59:50. | :59:52. | |
and the health ministers should be brave enough, to actually tackle | :59:53. | :59:57. | |
this. For too long, ministers have shied away from tackling this arena | :59:58. | :00:00. | |
of looking at healthy relationships and yet we are quite happy about | :00:01. | :00:05. | |
helping people and educating young people about how to build healthy | :00:06. | :00:08. | |
bodies, physical health and life. Relationship breakdown as a root | :00:09. | :00:19. | |
cause of poverty. In a relationship breaks down, households suffered | :00:20. | :00:22. | |
dramatic income reductions, then there is an impact on infant | :00:23. | :00:28. | |
mortality rates, hospital and mittens, and others in poor health. | :00:29. | :00:42. | |
So I agree,... Need to look at how children centres can be extended to | :00:43. | :00:48. | |
family help, creating support for the whole family, something I | :00:49. | :00:54. | |
recommended recently. We need to look at how couple relationship | :00:55. | :00:59. | |
advice, not just parenting advice can be available, at how their is a | :01:00. | :01:05. | |
stronger focus on relationship education in schools in its early | :01:06. | :01:12. | |
lessons, we need to provide a fund so local authorities can share best | :01:13. | :01:21. | |
practice on this issue. -- moral education lessons. We need to tackle | :01:22. | :01:24. | |
the serious challenge of the mental health problems that so many of our | :01:25. | :01:30. | |
children have in school now, that so many headteachers say is a major | :01:31. | :01:34. | |
issue they can grapple with. -- have to grapple with. I would just like | :01:35. | :01:40. | |
to referred to the final part of my speech, to a different area, alcohol | :01:41. | :01:51. | |
harm. I do not think it is entirely went to because when people | :01:52. | :01:53. | |
experience or fall into addiction it is often because they are looking | :01:54. | :01:58. | |
for a source of comfort that is missing because they have not got it | :01:59. | :02:04. | |
through the relationships the experience and why. I am not saying | :02:05. | :02:10. | |
that it is not right to enjoy drinking, but it needs to be healthy | :02:11. | :02:16. | |
drinking. Alcohol is a major issue in our society which I do not | :02:17. | :02:18. | |
believe the government is doing enough to address. To tackle health | :02:19. | :02:24. | |
inequality the government must do more. Let me give you an example. | :02:25. | :02:31. | |
The Chief Medical Officer in January this year published his | :02:32. | :02:36. | |
recommendation that it is wisest for pregnant women not to drink during | :02:37. | :02:42. | |
pregnancy. That is a choice pregnant women are being advised to make, yet | :02:43. | :02:51. | |
there has been inadequate publicity of that recommendation. I speak as | :02:52. | :02:59. | |
someone who is vice chair of the all-party group, we have heard | :03:00. | :03:04. | |
heart-rending evidence of the impact on their physical and mental | :03:05. | :03:10. | |
well-being. What is particularly important is that the evidence we | :03:11. | :03:15. | |
have heard is that women's bodies tolerate alcohol at different | :03:16. | :03:18. | |
levels, which is why the best advice is not to drink at all during | :03:19. | :03:23. | |
pregnancy, but I challenge health ministers particularly in the run-up | :03:24. | :03:29. | |
to Christmas to get this message out so people can hear it and make that | :03:30. | :03:32. | |
choice, because alcohol harm does not just impact on the health of the | :03:33. | :03:37. | |
individual, but those around that individual. One in five children | :03:38. | :03:46. | |
with a parent who drinks has adversely, alcoholism placated in | :03:47. | :03:57. | |
child abuse cases. -- is implicated. It impacts on emergency services, | :03:58. | :04:03. | |
and the all-party group will publish a report on this on the 6th of | :04:04. | :04:07. | |
December, which I am pleased that the honourable member contributed | :04:08. | :04:14. | |
to, so I hope members will take note of that because there is a | :04:15. | :04:18. | |
disproportionate impact that alcohol abuse is having on emergency | :04:19. | :04:24. | |
services but also on the number of accidents in home, the number of | :04:25. | :04:30. | |
accidents in the home, and this will spell that out. Again, a charity has | :04:31. | :04:36. | |
shown that between 2014 and 2015, the rate of alcohol-related | :04:37. | :04:44. | |
admissions in England had -- in the most deprived area was five times | :04:45. | :04:58. | |
higher. I also want to touch on the impact of cheap alcohol. Let me tell | :04:59. | :05:02. | |
you something that will surprise or shock you. It did me when I first | :05:03. | :05:07. | |
heard it. For the cost of a cinema ticket, it is possible to buy almost | :05:08. | :05:12. | |
7.5 litres of high-strength white cider. It contains as much alcohol | :05:13. | :05:22. | |
as 53 shots of vodka. Yet many, many people in a vulnerable state in | :05:23. | :05:27. | |
life, many homeless people, are drinking this product and it has | :05:28. | :05:32. | |
been likened to a death sentence. 78% of the deaths in hostels run by | :05:33. | :05:37. | |
the homeless charity Thames Reach were attributed to this | :05:38. | :05:41. | |
high-strength alcohol. So I urge ministers once again, because this | :05:42. | :05:46. | |
is not for the first time, for the sake of these most vulnerable | :05:47. | :05:54. | |
people, to consider a minimum unit price, which would sides and reduce | :05:55. | :06:03. | |
health inequality considerably. According to the Institute of | :06:04. | :06:08. | |
alcohol studies, it would result in eight out of ten lives being saved. | :06:09. | :06:23. | |
We also need improved alcohol treatment services. They are | :06:24. | :06:31. | |
inadequate. Over half of drug addicts receive treatment, but only | :06:32. | :06:37. | |
a fifth of alcohol dependent people do. Whinny better and more effective | :06:38. | :06:45. | |
alcoholism diagnosis and hospitals, better rehab programmes, and better | :06:46. | :06:47. | |
support the education to help those not fall | :06:48. | :07:01. | |
into the difficulty in the first place. -- we need better. Thank you. | :07:02. | :07:10. | |
It is a pleasure to follow the honourable member for Congleton. I | :07:11. | :07:12. | |
think she has made some very interesting points, and a very | :07:13. | :07:14. | |
convincing argument for introducing compulsory PSE in schools, something | :07:15. | :07:17. | |
the government do in terms of fostering good, healthy | :07:18. | :07:19. | |
relationships, which would go a long way to reducing health inequalities, | :07:20. | :07:25. | |
which is what we're here to debate today. I would like to congratulate | :07:26. | :07:31. | |
the honourable member for Totnes for securing the debate, and also to | :07:32. | :07:36. | |
thank the backbench business committee for recognising the | :07:37. | :07:40. | |
importance of the subject. I was pleased to hear the honourable | :07:41. | :07:43. | |
member for Totnes in her opening remarks referred to drug and alcohol | :07:44. | :07:48. | |
treatment services, as indeed did the honourable member of Congleton. | :07:49. | :07:58. | |
The future of substances treatment is in jeopardy, when so many places | :07:59. | :08:07. | |
are facing cuts, and it really is something we need to be addressing | :08:08. | :08:12. | |
when we are talking about health inequality. And I would like to add | :08:13. | :08:16. | |
to that list, I do not think anyone has mentioned it yet, but the | :08:17. | :08:20. | |
responsibility of local authorities in England to commission sexual | :08:21. | :08:23. | |
health services. Sexually transmitted infections at increasing | :08:24. | :08:29. | |
because of cost efficiency rather than clinical need seems to be the | :08:30. | :08:32. | |
overriding factor in commissioning the services. We do need to ring | :08:33. | :08:39. | |
fence funding around to sexual health services as a matter of | :08:40. | :08:44. | |
urgency. Otherwise we face a serious risk developing to public health. | :08:45. | :08:50. | |
But I want to concentrate in this debate with particular reference to | :08:51. | :08:59. | |
diabetes and diabetic care. And throughout my speech I will make | :09:00. | :09:06. | |
reference to the APPG diabetes report, entitled levelling up, | :09:07. | :09:10. | |
tackling variation in diabetes care, which was launched yesterday, and I | :09:11. | :09:14. | |
would also like to declare an interest as the secretary to that | :09:15. | :09:18. | |
group. It is an excellent report and I would urge anyone with an interest | :09:19. | :09:24. | |
in diabetes care and health in general to get a copy and read it. | :09:25. | :09:29. | |
We took evidence from people with diabetes from health care | :09:30. | :09:31. | |
professionals and when the call commissioning groups, and one theme | :09:32. | :09:38. | |
that came out from people with diabetes was inconsistent quality of | :09:39. | :09:43. | |
care. And I am pleased to say that the government and NHS England have | :09:44. | :09:48. | |
recognised that there is a need for improvement in diabetes services. | :09:49. | :09:56. | |
During the investigation NHS England announced ?40 million funding for | :09:57. | :09:59. | |
diabetes improvement. Diabetes being one of the six clinical priorities | :10:00. | :10:05. | |
in the improvement and assessment framework for clinical commissioning | :10:06. | :10:09. | |
groups, and it is vital that this opportunity to transform diabetic | :10:10. | :10:16. | |
services is taken. Our report identified three key areas that | :10:17. | :10:19. | |
people with diabetes need undeserved. The first one is | :10:20. | :10:25. | |
high-quality consultations with the right health care professionals. The | :10:26. | :10:30. | |
second and support to manage their condition. And the third is access | :10:31. | :10:37. | |
to key technology. On the first point, a big part of how care is | :10:38. | :10:44. | |
perceived by people with diabetes is how they are communicated with by | :10:45. | :10:48. | |
health care professionals. People said to us that sometimes they felt | :10:49. | :10:53. | |
they were being criticised an appointments for not meeting | :10:54. | :10:57. | |
treatment targets and dictated to about how to manage a condition that | :10:58. | :11:00. | |
they had to live with. Our report found that people who had an input | :11:01. | :11:04. | |
into their own care had better treatment outcomes. Consideration of | :11:05. | :11:09. | |
their own lifestyles alongside their diabetes management, as well as an | :11:10. | :11:18. | |
interpretation of NICU guidance to meet their needs Ledford tailored | :11:19. | :11:21. | |
treatment plans and it seems in this that collaboration has far better | :11:22. | :11:27. | |
results than confrontation. People speak to us about difficulty in | :11:28. | :11:30. | |
getting access to specialists with some reporting that services were | :11:31. | :11:38. | |
simply overwhelmed. Others said they had to proactively seek local | :11:39. | :11:42. | |
services to get a referral. But services that were really valued by | :11:43. | :11:51. | |
patients where nurses, dietetics and podiatry. Additionally people | :11:52. | :11:56. | |
affected by diabetes valued the pharmacist, and saw how the role | :11:57. | :11:59. | |
could be significantly expanded to provide greater information and | :12:00. | :12:02. | |
support, something that may well be worth reflecting upon, given the | :12:03. | :12:09. | |
government's recent course to pharmacy services. The next point, | :12:10. | :12:15. | |
giving support to help manage the condition, this showed a huge | :12:16. | :12:17. | |
variation in the information and education given to those with | :12:18. | :12:23. | |
diabetes. Those who attended structured education courses | :12:24. | :12:25. | |
generally reported that they find them valuable and that they helped | :12:26. | :12:31. | |
them better manage their condition. However, there is huge variation in | :12:32. | :12:35. | |
the offer and uptake of these courses, and in my own constituency | :12:36. | :12:40. | |
of Heywood and Middleton, only about 20% of people with diabetes are | :12:41. | :12:44. | |
offered these courses, with the uptake being even less. Clearly this | :12:45. | :12:51. | |
is a health inequality that needs to be addressed. One-off and report a | :12:52. | :12:55. | |
problem for those who worked was getting time off work to attend a | :12:56. | :13:01. | |
five-day intensive course, and for those with children, child care was | :13:02. | :13:04. | |
also reported as a problem. There is a lot of work to be done in | :13:05. | :13:09. | |
persuading employers that they will also reap the benefits of a happier, | :13:10. | :13:13. | |
healthier and more productive employee if they are reasonable | :13:14. | :13:21. | |
about allowing time off. The third point, access to key technologies, | :13:22. | :13:25. | |
serves to emphasise that technology now please a key role in diabetes | :13:26. | :13:30. | |
care, particularly for type one diabetes, but again patients face a | :13:31. | :13:38. | |
postcode lottery to get the help they need. This was given as a major | :13:39. | :13:43. | |
concern for parents of children with diabetes. Many type two diabetics | :13:44. | :13:47. | |
worryingly reported that they had to self fund their own blood glucose | :13:48. | :13:53. | |
meters and test strips, an essential test for self-management of the | :13:54. | :13:58. | |
condition. Some type one diabetics also reported the same thing. Which | :13:59. | :14:02. | |
sounds harsh, as it is a legal requirement that diabetics on | :14:03. | :14:05. | |
insulin must test before driving. And the DVLA now advises people who | :14:06. | :14:17. | |
take the medication that contains hypoglycaemia to test as well. | :14:18. | :14:24. | |
People were denied access to insulin pumps, which can also help diabetics | :14:25. | :14:30. | |
improve their condition and help health outcomes. Sadly inequalities | :14:31. | :14:34. | |
in health outcomes persist because only the better off are able to | :14:35. | :14:37. | |
access devices that make living with diabetes easier. The motion we are | :14:38. | :14:44. | |
discussing calls for support for policies to reduce health | :14:45. | :14:48. | |
inequality, and our report has identified four area as the | :14:49. | :14:49. | |
government should be looking at. The first is care and support | :14:50. | :15:01. | |
planning, the second support management, access to key | :15:02. | :15:04. | |
technologies and a strong, local diabetes system. Variation and | :15:05. | :15:09. | |
inequality in diabetes care shows us that good care can be achieved, but | :15:10. | :15:13. | |
our task and this Government's task is to make it happen everywhere. For | :15:14. | :15:17. | |
best practice to be shared in order to end the postcode lottery in | :15:18. | :15:23. | |
diabetes care and to tackle the diabetes crisis. Thank you, Madam | :15:24. | :15:31. | |
Deputy Speaker. It is a pleasure to follow the honourable lady for he | :15:32. | :15:35. | |
would and Middleton in the very important points that she was | :15:36. | :15:46. | |
making. I would like to the Member for bringing forward this important | :15:47. | :15:51. | |
debate today, and for everybody who has participated in their work in | :15:52. | :15:54. | |
this place today and for highlighting this issue and for the | :15:55. | :15:57. | |
very excellent debate that we have had. This issue is about unequal | :15:58. | :16:03. | |
lives and unequal life chances. Now, like all members, I naturally take | :16:04. | :16:08. | |
every opportunity that I can to talk about all that makes me proud to | :16:09. | :16:11. | |
represent my constituency, and whether it is Telford's industry, | :16:12. | :16:16. | |
its history of innovation and enterprise, its vibrant new town, | :16:17. | :16:20. | |
its green spaces, its high-tech businesses and jobs. All of which I | :16:21. | :16:23. | |
have spoken about with great pride and at some length. However, | :16:24. | :16:28. | |
sometimes we must, as the honourable member for Stockton North so | :16:29. | :16:33. | |
eloquently did, we must raise the issues that deeply affect the | :16:34. | :16:36. | |
quality of life of our constituents. The itches -- the issues that need | :16:37. | :16:42. | |
to be addressed, the issues that are too often overlooked and glossed | :16:43. | :16:46. | |
over. It is often the glossing over of these issues that makes those who | :16:47. | :16:51. | |
experience these difficulties feel left behind and ignored. Telford is | :16:52. | :16:57. | |
a finer, former miner -- a former mining area and became a new town in | :16:58. | :17:02. | |
the 1960s and with business, jobs and new growth, it is starting to | :17:03. | :17:06. | |
thrive in very many ways and yet retains significant areas of | :17:07. | :17:09. | |
deprivation, with a total of 13 super output areas that are ranked | :17:10. | :17:14. | |
in the 10% most deprived areas nationally. Hand-in-hand with areas | :17:15. | :17:21. | |
of deprivation and disadvantage are marked health inequalities. Hilt | :17:22. | :17:25. | |
inequalities that exist relative to the national average, and relative | :17:26. | :17:29. | |
to the West Midlands average. -- health inequalities. Pertinently | :17:30. | :17:33. | |
relevant to the surrounding Moore affluent rural area of Shropshire, | :17:34. | :17:37. | |
which has more good schools, higher incomes and significantly better | :17:38. | :17:41. | |
health outcomes. Judged by any measure you might care to choose, | :17:42. | :17:49. | |
obesity, less -- life expectancy or smoking, the outcomes are | :17:50. | :17:51. | |
significantly better in Shropshire. Today could be today for a moment, | :17:52. | :17:56. | |
which Simon Stephens. The new smoking, as a killer disease, in | :17:57. | :18:04. | |
Telford, 72% are overweight or obese, one of the highest rates in | :18:05. | :18:11. | |
the country. It compares to a lower number of it. 32% of adults in | :18:12. | :18:19. | |
Telford or obese, whereas in Shropshire the figure is 23.1. I | :18:20. | :18:22. | |
congratulate and admire organisations in Telford that are | :18:23. | :18:27. | |
doing such good work to tackle this. However, the figure is continuing to | :18:28. | :18:30. | |
increase and this is something we cannot ignore and something we must | :18:31. | :18:39. | |
talk about and take more seriously. I wanted to take this opportunity to | :18:40. | :18:43. | |
flag up the statutory obligations that local CCGs, NHS England and | :18:44. | :18:48. | |
indeed the Secretary of State has to address health inequalities. | :18:49. | :18:51. | |
Particularly want to do so as Telford and Shropshire continues to | :18:52. | :18:55. | |
undergo a controversial reorganisation of its future health | :18:56. | :18:59. | |
care provision. The Health and Social Care Act 2012 introduce legal | :19:00. | :19:05. | |
juices on the Secretary of State, NHS England and CCGs to reduce | :19:06. | :19:09. | |
health inequalities and to move towards greater investment in health | :19:10. | :19:14. | |
care levels of deprivation are higher. The NHS guidance says that | :19:15. | :19:23. | |
health inequalities must be properly and there is taken into account when | :19:24. | :19:25. | |
making decisions and it is necessary to demonstrate the appropriate | :19:26. | :19:30. | |
weight has been given to tackle health inequalities. I know that | :19:31. | :19:43. | |
this executive is committed to tackling health inequalities, and it | :19:44. | :19:45. | |
is at the heart of everything the NHS does, but somehow it is not | :19:46. | :19:49. | |
happening. It is right that local decisions are made locally by local | :19:50. | :19:52. | |
health commissioners, but we need to ensure that Commissioners pager | :19:53. | :19:56. | |
regard to health inequalities and that the evidence that they have | :19:57. | :20:00. | |
paid due regard to these inequalities. It is not about box | :20:01. | :20:04. | |
ticking or paying lip service to an ideal. In Telford Shropshire, we are | :20:05. | :20:09. | |
in the third year of a review into the reconfiguration of health care | :20:10. | :20:14. | |
provision, including women and children centre and and A And | :20:15. | :20:21. | |
whilst I welcome the proposed investment for the health provision | :20:22. | :20:24. | |
for the wider area of Telford and Shropshire as a whole, I wanted to | :20:25. | :20:27. | |
be a voice for my constituents and want to ensure that health | :20:28. | :20:31. | |
inequality is prioritised in the decision-making process, and when | :20:32. | :20:37. | |
bringing new investment to our area. As the review of Telford and | :20:38. | :20:40. | |
Shropshire's health care draws to a close after a protracted and | :20:41. | :20:45. | |
expensive process, it has been confirmed the preferred option is | :20:46. | :20:49. | |
the closure of Telford was made newly opened women and children | :20:50. | :20:54. | |
centre at Princess Royal hospital, and this is to be moved and rebuilt | :20:55. | :20:58. | |
in the more affluent area served by Royal Shrewsbury Hospital, and that | :20:59. | :21:01. | |
that hospitals should in addition have extra investment in emergency | :21:02. | :21:06. | |
care. My constituents are rightly concerned about this proposal, and | :21:07. | :21:11. | |
that not only is this much-needed investment to be redirected | :21:12. | :21:15. | |
elsewhere, but the Telford may also lose other key services. Telford has | :21:16. | :21:23. | |
the greatest need. It has the fastest growing population. It is a | :21:24. | :21:25. | |
rapidly expanding new town, and above all it has the greatest | :21:26. | :21:31. | |
inequality of health outcomes. We are steering too often in Telford | :21:32. | :21:37. | |
that rural sparsity is prioritised for additional investment or | :21:38. | :21:40. | |
funding, rather than deprivation, health inequalities and need. Madam | :21:41. | :21:45. | |
Deputy Speaker, this is wrong. I am pleased to have had this opportunity | :21:46. | :21:49. | |
to raise this issue, and I would ask the Minister in her summing up for | :21:50. | :21:56. | |
assurances that addressing health inequality both in Telford and other | :21:57. | :22:00. | |
areas of deprivation and meat, where there is a stark contrast between | :22:01. | :22:02. | |
more affluent neighbouring areas, to please prioritise health | :22:03. | :22:07. | |
inequalities, and as the honourable member for Plymouth and Devonport | :22:08. | :22:10. | |
said, that resource really must follow need. Thank you, Madam Deputy | :22:11. | :22:20. | |
Speaker. May I join colleagues across the House in congratulating | :22:21. | :22:23. | |
the honourable member for .net and her committee for their work in this | :22:24. | :22:30. | |
area, and on securing this debate today? -- for Totnes. The honourable | :22:31. | :22:34. | |
lady brings a calm and clear knowledge to every debate on health, | :22:35. | :22:38. | |
but on this one, this is where we do need a long-term vision and I know | :22:39. | :22:42. | |
that she, like me, wants to see that, whatever party is in | :22:43. | :22:46. | |
government. I stand to speak today both as an MP for a constituency | :22:47. | :22:51. | |
with a very large gap in health and well-being and life expectancy, very | :22:52. | :22:56. | |
much determined by place of birth, early years experience and poverty. | :22:57. | :23:00. | |
And of course as cheer of the Public Accounts Committee were just this | :23:01. | :23:04. | |
year alone my committee, Madam Deputy Speaker, has published ten | :23:05. | :23:08. | |
reports on the national Health Service, some of which shine a light | :23:09. | :23:12. | |
on the debate today. These show the huge pressures on the National | :23:13. | :23:16. | |
health budget and the huge increases in demand on that budget. Take for | :23:17. | :23:23. | |
example, just take diabetes, which is 4.8% of the population is | :23:24. | :23:27. | |
currently diabetic, set to rise to 8.8% in the next few years. As Chair | :23:28. | :23:32. | |
of the Public Accounts Committee, it is my role and the role of my | :23:33. | :23:37. | |
committee to look at funding very specifically looking at the economy, | :23:38. | :23:41. | |
the effectiveness and efficiency of how government spends taxpayers' | :23:42. | :23:45. | |
money. I want first of the doc about how we are spending the money | :23:46. | :23:50. | |
allocated to our health service, how it is key to tackling health | :23:51. | :23:54. | |
inequalities. -- I want first of all to talk. And then how we look at the | :23:55. | :23:57. | |
impact of decisions both within the health service and in other parts of | :23:58. | :24:01. | |
government on health inequalities, what we call in the committee of | :24:02. | :24:07. | |
shunting. So first of all, the NHS budget spending is in the region of | :24:08. | :24:10. | |
?110 billion per year and government is keen to industry reminder that | :24:11. | :24:16. | |
the moment that it has injected ?10 billion into the NHS over the | :24:17. | :24:19. | |
six-year period to 2016. At the same time, we see an ageing population, a | :24:20. | :24:24. | |
large and increasing demand, including on specialised services. | :24:25. | :24:29. | |
The health service is squeezed at each step of the journey. We have | :24:30. | :24:34. | |
had evidence from general practice, from the specialised services around | :24:35. | :24:39. | |
diabetes and neurology and on acute trusts and social care, all of which | :24:40. | :24:43. | |
show the impact on the budget. This has been caught up in what I would | :24:44. | :24:47. | |
have to say, Madam Deputy Speaker, is sadly rather childish debate over | :24:48. | :24:49. | |
headline figures. Very subtle changes in language offered from | :24:50. | :24:54. | |
government about who is too good. Ministers have moved from the mantra | :24:55. | :24:58. | |
that we have injected an extra 10 billion to send the NHS has been | :24:59. | :25:00. | |
given what had asked for. As though they are scolding a naughty child. | :25:01. | :25:07. | |
"We will manage with this within the NHS," as the Chancellor said | :25:08. | :25:09. | |
yesterday when I questioned him on why he had not considered the NHS | :25:10. | :25:13. | |
had it in the Autumn Statement. In today's Daily Mail, there is an | :25:14. | :25:18. | |
exaltation that the NHS, quoting sources close to government or in | :25:19. | :25:21. | |
government, that the NHS England is to manage its resources better and | :25:22. | :25:26. | |
can endlessly be given more money. I am Chair of the Public Accounts | :25:27. | :25:29. | |
Committee, this is taxpayers' money. I do not think we should endlessly | :25:30. | :25:33. | |
pour money into any government department without a lot of that | :25:34. | :25:36. | |
department. And I am clear that there are always efficiencies to be | :25:37. | :25:43. | |
found in a system so large and with such a large overall budget. Every | :25:44. | :25:46. | |
pound saved if the pound to spend on something else. That is really the | :25:47. | :25:53. | |
key point. Every pound feed and the Department of Health budget can be | :25:54. | :25:56. | |
spent on other things, public health in particular. But if we look at the | :25:57. | :25:59. | |
budget in the NHS, are highlighted at the beginning, there are many | :26:00. | :26:02. | |
pressures on it. But all of these discussions and figures being | :26:03. | :26:06. | |
bandied around, we need to take a closer look and in 2015 slashed 16, | :26:07. | :26:10. | |
the Department of Health but it was predicted to have a 2.45 billion | :26:11. | :26:18. | |
deficit, and the measures used this year, the last financial year, two | :26:19. | :26:20. | |
balance the budget were extraordinary, a one-off and led to | :26:21. | :26:23. | |
an unprecedented 3.5 page explanatory note from the Auditor | :26:24. | :26:28. | |
General alert in all of us, particularly the department, to | :26:29. | :26:32. | |
concerns he had that these were not replicable, not long-term and not | :26:33. | :26:35. | |
sustainable. He reiterated that any committee hearing only a few weeks | :26:36. | :26:40. | |
ago. If you look at the figures overall this year, just taking acute | :26:41. | :26:44. | |
trusts alone, and I will not spend too long going over figures in the | :26:45. | :26:48. | |
budget, the debate needs to move on on from that. Trusts overspend by | :26:49. | :26:55. | |
648 million and the deficit for the first six months forecast to the | :26:56. | :27:01. | |
year end is 669 million. So we are seeing a similar trend. We have seen | :27:02. | :27:06. | |
this trend increased quite largely, because this was a decision in 2011 | :27:07. | :27:10. | |
to allow for 4% efficiency savings across the NHS by the then | :27:11. | :27:16. | |
Chancellor of the Exchequer. Everybody in the system knew that | :27:17. | :27:20. | |
was not realistic, not on a long-term basis. People knew there | :27:21. | :27:24. | |
was going to be a problem with the budget two years or more out from | :27:25. | :27:29. | |
the crisis that we had in the budget settlement of the last financial | :27:30. | :27:33. | |
year. Yet there is not an open is about discussing how we spend money | :27:34. | :27:37. | |
on the NHS, what we spend it on and what we focus on. That brings me to | :27:38. | :27:42. | |
the issue of public health. We are seeing public health budgets raided | :27:43. | :27:46. | |
to deal with day-to-day crises, too often. We see money taken out of NHS | :27:47. | :27:51. | |
education. We see plans for transformation which is not | :27:52. | :27:54. | |
necessarily at all a bad thing, and the danger is if it is done in the | :27:55. | :27:57. | |
wrong climate, with the wrong tone, it can be seen as an excuse for | :27:58. | :28:01. | |
cuts. Transformation of services can be so much better for patients, for | :28:02. | :28:06. | |
preventative work and in terms of efficiency of spending of taxpayers' | :28:07. | :28:09. | |
money. Too often, the transformation plans we are seeing are going to be | :28:10. | :28:13. | |
driven by financial pressures. A lot of pressure was put on financial | :28:14. | :28:18. | |
directors of acute trusts, in particular, at the end of the last | :28:19. | :28:21. | |
financial year, many being encouraged to move capital funding | :28:22. | :28:24. | |
into the resources side of their budget in order to balance the book, | :28:25. | :28:29. | |
a short-term measure which can lead to underinvestment in facilities | :28:30. | :28:32. | |
that is invested in did actually save money and improve patient | :28:33. | :28:36. | |
experience. This short-term year-on-year, or even spending | :28:37. | :28:39. | |
review period planning, is just not going to tackle health inequalities. | :28:40. | :28:46. | |
We need a longer term approach. We need to prevent Michael ill-health | :28:47. | :28:49. | |
and treat your patience. And as others have highlighted, the age of | :28:50. | :28:56. | |
debt is increasing. -- we need to prevent ill-health. And treat | :28:57. | :29:01. | |
patients. I refer to a report that Public Health England brought out | :29:02. | :29:05. | |
towards the end of 2015, which highlights some of these figures, | :29:06. | :29:09. | |
including that the cost of treating illness and disease arising from | :29:10. | :29:13. | |
health inequalities estimated at around ?5.5 billion per year. If we | :29:14. | :29:20. | |
go back to cost shunting, a very big concern, if we do not tackle these | :29:21. | :29:23. | |
things, it is not just patient individually that suffer order | :29:24. | :29:27. | |
families, not just the taxpayer funding it, but there is a wider | :29:28. | :29:34. | |
impact on Friday. Productivity losses of up to ?34 billion per on. | :29:35. | :29:38. | |
Lost taxes and higher welfare payments cost in the region of 28- | :29:39. | :29:43. | |
?32 billion per annum. If we just tackle tobacco issues, and I go back | :29:44. | :29:47. | |
to what my honourable friend the Member for Totnes with him earlier | :29:48. | :29:50. | |
about smoking, in my neighbouring borough of Newham, it would be about | :29:51. | :29:54. | |
?61 million per annum as smoking was tackled. Which would make a big | :29:55. | :29:59. | |
contribution to the local health budget in east London. If you | :30:00. | :30:02. | |
replicate that across just east London, think what we could be | :30:03. | :30:06. | |
contributing to the NHS budget. Work they've lost to sickness are about | :30:07. | :30:11. | |
1.3% per week in London alone, lower than a lot of the country, and all | :30:12. | :30:14. | |
these things contributed to our productivity gap and have a big | :30:15. | :30:18. | |
effect. If we are going to do what the Chancellor said yesterday and | :30:19. | :30:21. | |
ensure that our workers producing 40 is what we are now producing and | :30:22. | :30:28. | |
five, we need workers who are well, that can work to the increased | :30:29. | :30:32. | |
retirement age to made it. I think of colleagues like the honourable | :30:33. | :30:34. | |
member for Glasgow East and others in Glasgow that represent a city | :30:35. | :30:37. | |
where people will die before they qualify for the state pension age, | :30:38. | :30:40. | |
and there are many people in my constituency, although that would | :30:41. | :30:43. | |
not be the average, would face that. That is a sign of a failure of | :30:44. | :30:47. | |
preventative work and tackling these health inequalities at the right | :30:48. | :30:52. | |
point. We also need to look in terms of joining up government, not just | :30:53. | :30:56. | |
the silos of what owes on within the various parts of the health budget, | :30:57. | :31:00. | |
but a boiler, healthier society. Take, for example, the land disposal | :31:01. | :31:04. | |
the government is undertaken in order to provide public land to | :31:05. | :31:05. | |
build new homes. We have seen that on the one hand, | :31:06. | :31:15. | |
and on my committee we have seen that in a great deal. In my area we | :31:16. | :31:19. | |
have seen Glenn at hospital, the site of a former workhouse in | :31:20. | :31:25. | |
Hackney. When the reorganisation of the NHS took place in 2011, it was | :31:26. | :31:33. | |
moved to a property company that the NHS holds centrally, managing NHS | :31:34. | :31:38. | |
Estates. So we no longer have local control over what to do on the site, | :31:39. | :31:41. | |
and given the state of homelessness locally, if we could provide more | :31:42. | :31:47. | |
homes on the site for families who were not overcrowded, we would do | :31:48. | :31:52. | |
more for public health and health inequalities than a lot of the | :31:53. | :31:57. | |
fiddling around than whether -- with whether they are here at the. My | :31:58. | :32:06. | |
committee will continue to push for one disposals, because from the | :32:07. | :32:10. | |
perspective of my constituency, if we can release land and provide | :32:11. | :32:13. | |
homes that would provide homes for key workers, this would contribute | :32:14. | :32:21. | |
to the outcomes of those departments, and I am determined | :32:22. | :32:24. | |
that government is clearer in its outcomes, and it may be that in | :32:25. | :32:27. | |
other constituencies that the needs might be, as the honourable member | :32:28. | :32:34. | |
highlighted, for green space, and other facilities that would improve | :32:35. | :32:37. | |
and promote health. If we do not have the wider view about what we're | :32:38. | :32:42. | |
doing with public assets, there is a danger that we will just sell to the | :32:43. | :32:48. | |
highest bidder and lose the chance for several generations. 1's land is | :32:49. | :32:53. | |
gone, it is gone. It is also important I touch on the increasing | :32:54. | :32:56. | |
challenge of homelessness, particularly in London and in my | :32:57. | :33:02. | |
constituency. London households in temporary accommodation now account | :33:03. | :33:06. | |
for three out of four of all such households in England. This is not a | :33:07. | :33:12. | |
surprise given the increasing price of houses, rent, the impact of the | :33:13. | :33:16. | |
benefit cap which means you cannot now rent as a bee or four-bedroom | :33:17. | :33:19. | |
home on housing benefit anywhere in London or the south-east of England, | :33:20. | :33:26. | |
and I have people who are coming to see me now, who five years ago even, | :33:27. | :33:32. | |
ten years certainly would not have come to see me about the housing. | :33:33. | :33:34. | |
They were living in the private sector, paying their rent, working. | :33:35. | :33:38. | |
But now, one woman who came to see me have lost her job because she was | :33:39. | :33:42. | |
unwell. She hoped to go back to work. Her job was a good job, but | :33:43. | :33:45. | |
not well paid, but with professional prospects. She became unwell, her | :33:46. | :33:49. | |
rent increased and she became notionally in arrears well trying to | :33:50. | :33:53. | |
find a new home because the benefits cap would not cover the rent. She | :33:54. | :33:59. | |
tried to find something in Hackney or the neighbouring six barrels, but | :34:00. | :34:04. | |
then nothing. Because of the complexities of how the housing | :34:05. | :34:08. | |
benefits were allocated, the landlord would not take her in and | :34:09. | :34:10. | |
why she had a guarantee that she would receive that benefit, and the | :34:11. | :34:15. | |
system does not allow for that. Women to no fault of her own,... She | :34:16. | :34:34. | |
is just one of many people I have experienced in this since being | :34:35. | :34:47. | |
elected member. If you're homeless, your 1.5 times more likely to have a | :34:48. | :34:54. | |
physical health problem, and 1.8% more likely to have a mental health | :34:55. | :34:57. | |
problem, but it seems to me that from the experience I have speaking | :34:58. | :35:03. | |
to people face-to-face, those are underestimates, may be masking a | :35:04. | :35:05. | |
temporary housing problem compared to the reality of what we're seeing. | :35:06. | :35:10. | |
That has a huge impact, and it is focused on the purist, also people | :35:11. | :35:18. | |
like them and I referred to, who hit a rocky patch in their life and | :35:19. | :35:21. | |
something has gone wrong causing a downward spiral towards | :35:22. | :35:23. | |
homelessness. We have so many hidden households in my constituency, | :35:24. | :35:27. | |
families living on the settee in the living room, sometimes an adult and | :35:28. | :35:32. | |
two children, and another family is living in the bedroom because they | :35:33. | :35:40. | |
do not qualify for housing at -- Council housing, or sometimes | :35:41. | :35:43. | |
because the legal status does not yet allow them to afford on their | :35:44. | :35:48. | |
income to rent privately and have no other options. Temporary | :35:49. | :35:51. | |
accommodation is costing Hackney Council 35 billion a year, and I | :35:52. | :35:56. | |
commend the Hackney Gazette which has done a lot to highlight | :35:57. | :35:59. | |
conditions in temporary accommodation and hostels in my | :36:00. | :36:02. | |
borough and across London. We have the homelessness reduction Bill | :36:03. | :36:05. | |
which passed through Parliament, but this is only part of the picture. | :36:06. | :36:11. | |
Saying that the councils must accept people who are homeless is fine, but | :36:12. | :36:15. | |
unless we have homes available to provide to those people at an | :36:16. | :36:17. | |
affordable level, we will not solve this problem. I will give way. Just | :36:18. | :36:24. | |
to point out that I believe ?10 million was given by the government | :36:25. | :36:28. | |
yesterday to help homes particularly in London, so things are being done | :36:29. | :36:32. | |
and things are on the move, and I would like to put that on record. | :36:33. | :36:39. | |
That pre-empts my next point that I wish to thank the government for | :36:40. | :36:46. | |
making some moods to give freedom and make sure they will not buy into | :36:47. | :36:55. | |
it on a ball basis, but also freeing up housing associations to use | :36:56. | :37:01. | |
government money for affordable housing set locally. The fact that | :37:02. | :37:06. | |
affordable housing would be 80% of private rent is ridiculous. Most of | :37:07. | :37:14. | |
the young people in Hackney share a home because they could not afford | :37:15. | :37:16. | |
to rent somewhere privately and certainly cannot get on the housing | :37:17. | :37:20. | |
ladder. So it will take a generation to solve this problem, so while I | :37:21. | :37:24. | |
welcome what the government has done, it could have been sooner. | :37:25. | :37:34. | |
Very often we speak in this House, those of us from London, and it is | :37:35. | :37:40. | |
as if we are a different world from others, but we do have this big of | :37:41. | :37:47. | |
homelessness, overcrowding and temporary use of accommodation. If I | :37:48. | :37:50. | |
could finish on a story that should never be true in our world, other | :37:51. | :37:53. | |
women living with her toddler and husband in a hostel because she was | :37:54. | :37:57. | |
waiting to get council housing. I used to say to people three years | :37:58. | :38:00. | |
ago, hang on in there and you will find a home. -- we will find a home | :38:01. | :38:07. | |
for you, but now it is a year or 18 months. She went to hospital to give | :38:08. | :38:10. | |
birth, and came back to that one room with her newborn baby, toddler | :38:11. | :38:17. | |
and husband. The people living in that hostel are vulnerable, not an | :38:18. | :38:21. | |
ideal environment to bring children home to, and a lot of people crowded | :38:22. | :38:25. | |
into one place without the support they need. This is not what anyone | :38:26. | :38:29. | |
in this House wants to see, I am sure, but we must tackle this | :38:30. | :38:33. | |
because all of the health problems that spin off that for older | :38:34. | :38:37. | |
generations of children living off that are immense. I had a plea from | :38:38. | :38:41. | |
my local constituents Lee as well as my national perspective that | :38:42. | :38:45. | |
tackling homelessness is a vital issue in contributing to tackling | :38:46. | :38:51. | |
health inequalities. Thank you very much. I am very proud to participate | :38:52. | :38:57. | |
in this debate and I am glad the honourable member for Totnes has | :38:58. | :39:00. | |
brought it to the House today because it is not only a very | :39:01. | :39:04. | |
important debate, but one which I have a lot of interest in. This was | :39:05. | :39:11. | |
one of the first issues, health inequalities, that I got interested | :39:12. | :39:17. | |
in as a teenager in modern studies. I could not understand why any | :39:18. | :39:19. | |
government would allow a situation to arise that would allow people in | :39:20. | :39:23. | |
less well-off areas to disproportionately suffer ill-health | :39:24. | :39:28. | |
and die prematurely. I was frustrated reading about the inverse | :39:29. | :39:31. | |
care a lot, and I was angry then and I am still angry that political | :39:32. | :39:37. | |
decisions we take, it is actually the root cause of mortality and | :39:38. | :39:43. | |
morbidity that blights too many lives and our country. It is | :39:44. | :39:46. | |
unacceptable that male life expectancy in parts of Glasgow and | :39:47. | :39:52. | |
baby by 15 years. For men it goes from around the age of 66 to the age | :39:53. | :39:57. | |
of 81, the gap for women is 11 years. I got interested in politics | :39:58. | :40:01. | |
because I wanted to change that, I wanted to understand why and I | :40:02. | :40:04. | |
wanted to know what I could do to help. I joined the SNP when I was at | :40:05. | :40:08. | |
school, and I know that this debate has not been to party political, but | :40:09. | :40:12. | |
it is important to put this on the record because I could see the | :40:13. | :40:18. | |
health of Scotland's people has not been prioritised by Westminster. | :40:19. | :40:21. | |
When I was at school there was no Scottish parliament and no other way | :40:22. | :40:23. | |
of dealing with this issue ourselves. The Member for Stockton | :40:24. | :40:26. | |
North mentioned the Black report, and it is telling the way that | :40:27. | :40:30. | |
report was greeted, and that we're still talking about a lot of issues | :40:31. | :40:37. | |
now, and the report has not yet been implemented and the recent strategy | :40:38. | :40:40. | |
is still not as strong as it could be to deal with these issues and | :40:41. | :40:45. | |
tackle the underlying causes of health inequality. I believe the | :40:46. | :40:49. | |
Scottish parliament -- if the ScottishPower Parliament had -- | :40:50. | :40:53. | |
Scottish Parliament had all the powers, I we would be able to deal | :40:54. | :41:02. | |
with these issues more adequately. I do not disagree, I think she | :41:03. | :41:06. | |
misinterpreted what I did. It was actually the Member for Hull that | :41:07. | :41:14. | |
mention the report, and I was just indicating to him. There was no | :41:15. | :41:19. | |
offence meant. I must have got my wires crossed. I thank them both for | :41:20. | :41:23. | |
raising these points because it is important that we think about the | :41:24. | :41:27. | |
context of this debate and where we get to. The honourable member from | :41:28. | :41:32. | |
Glasgow East, and I have been reading the same report, and would | :41:33. | :41:36. | |
like to pay credit to the very in-depth work and dedication of the | :41:37. | :41:45. | |
Glasgow Central for public health. The team of researchers have done so | :41:46. | :41:47. | |
much to lay out the history of health inequality in Glasgow and | :41:48. | :41:52. | |
more widely in Scotland. They have done a huge amount of research and | :41:53. | :41:56. | |
came up with not only the history of it but with some solutions as well. | :41:57. | :42:00. | |
And I was first selected as a councillor in Glasgow, the most | :42:01. | :42:05. | |
recent report at that time was let Glasgow for luggage, and they have | :42:06. | :42:09. | |
done a great deal of work on Glasgow's mortality. It is not just | :42:10. | :42:16. | |
that there is an impact on Glasgow, but this excess mortality applies | :42:17. | :42:20. | |
across different causes of death, ages, gender, social strata, | :42:21. | :42:23. | |
although it is most pronounced in the working age population living in | :42:24. | :42:28. | |
the Buddhist neighbourhoods, living with alcohol, suicides particularly | :42:29. | :42:34. | |
among men, which is absolutely stark. In Liverpool it is an extra | :42:35. | :42:41. | |
4500 deaths over the years, from 2000 and 32 2007, and in Scotland it | :42:42. | :42:45. | |
is an extra 5000 deaths a year for each year between 2010 and 2012. It | :42:46. | :42:51. | |
is a very stark impact. I will not repeat what was said by my | :42:52. | :42:54. | |
honourable friend from Glasgow East, but what is important is that | :42:55. | :42:59. | |
governments of the time knew this was happening. The impact of their | :43:00. | :43:03. | |
policies was known. There was a notable effect on the urban change | :43:04. | :43:08. | |
that was happening. It was happening differently to Liverpool and | :43:09. | :43:11. | |
Manchester, and had a disproportionate effect on | :43:12. | :43:14. | |
population, the lag of which we still see today. Centre for | :43:15. | :43:24. | |
population reports and 1971 report called the Glasgow crisis, which | :43:25. | :43:28. | |
recognised the economically dangerous position Glasgow with | :43:29. | :43:30. | |
them, but nothing at that time was done. The urban regeneration | :43:31. | :43:33. | |
happening in Glasgow happened to the shopping centres in the middle of | :43:34. | :43:36. | |
town, not the areas that needed it the most. So this poverty and health | :43:37. | :43:41. | |
inequality is difficult to turn around, not something you're going | :43:42. | :43:49. | |
to fix just with a sugar tax, not with individual health measures. It | :43:50. | :43:50. | |
is a wide-ranging approach required from all levels of government. | :43:51. | :43:56. | |
Glasgow has worked hard to look at these issues. The Scottish | :43:57. | :44:00. | |
Government has invested heavily, administering a task force on health | :44:01. | :44:04. | |
inequality, but we need to keep working hard and trying more things, | :44:05. | :44:09. | |
working collaboratively to get a result on it. Clyde Gateway is an | :44:10. | :44:15. | |
urban regeneration company in my constituency, and you may ask why a | :44:16. | :44:20. | |
company that builds things is interested in health, they have been | :44:21. | :44:24. | |
working for eight years in Glasgow and Rutherglen, learning lessons | :44:25. | :44:28. | |
from previous regeneration efforts. They had brought down claiming | :44:29. | :44:35. | |
benefits from 38% to 29%. And that is remarkable in itself, but they | :44:36. | :44:40. | |
cannot go any further because they know that unless they start to | :44:41. | :44:42. | |
tackle underlying health issues keeping people out of work, they | :44:43. | :44:45. | |
will not be able to do that. So they are working in partnership with | :44:46. | :44:49. | |
local organisations and people, and crucially people are part of that, | :44:50. | :44:52. | |
they are not having things done to them, they are part of the solution | :44:53. | :44:55. | |
and they are making the community part of what is happening here. So | :44:56. | :45:01. | |
they have recently signalled the intention to seek a means of | :45:02. | :45:03. | |
tackling health inequalities. They want to work to improve diet, cancer | :45:04. | :45:07. | |
screening, which are both factors in the area's ill-health. There is a | :45:08. | :45:14. | |
lot of evidence that people in areas of deprivation are not taking up | :45:15. | :45:18. | |
screaming is the ad entitled to. So that might be around cancer | :45:19. | :45:22. | |
screening at uptake of free eye tests which can also be an indicator | :45:23. | :45:31. | |
of other conditions. The RNIB says it is really important people go | :45:32. | :45:32. | |
further eye tests early. We also want to do a job in Health | :45:33. | :45:41. | |
and Social Care Act rather than having stuff coming in from other | :45:42. | :45:45. | |
areas to do health to you. I wholeheartedly agree with the notion | :45:46. | :45:49. | |
that it ought to be everybody's business. It is not just the public | :45:50. | :45:52. | |
health officials do on their own, because it is clear that the root of | :45:53. | :45:56. | |
health and equalities can be found in income inequalities. In Scotland, | :45:57. | :46:00. | |
we are tackling some of the underlying cause is that we can do, | :46:01. | :46:04. | |
we have the Living Wage uptake in Scotland far exceeding other parts | :46:05. | :46:07. | |
of the country, we are supporting families in helping to improve | :46:08. | :46:17. | |
physical and social environment, improving housing, we have invested | :46:18. | :46:19. | |
in housing heavily, because a lot of the ill-health has come from damp, | :46:20. | :46:21. | |
substandard housing that was making people ill and that was not tackled | :46:22. | :46:24. | |
at that time. We have increased free school meals and continued | :46:25. | :46:27. | |
commitment to free prescriptions, concessionary travel, free personal | :46:28. | :46:30. | |
care and as the Member for Bradford South was talking about earlier on, | :46:31. | :46:34. | |
tooth-brushing. The rates in Scotland of tooth decay in primary | :46:35. | :46:39. | |
one children entering school around the mid-19 90s, when I was starting | :46:40. | :46:43. | |
secondary school, just under 40% of children had no dental cavities. | :46:44. | :46:49. | |
That is now just under 70% have no dental cavities. That is pretty | :46:50. | :46:53. | |
good, quite a shift to go from one to the other. To have 70% of | :46:54. | :46:57. | |
children start school with no tooth decay whatsoever is pretty good. We | :46:58. | :47:01. | |
still need to go a whole lot further, and initiatives like a | :47:02. | :47:04. | |
child mall where all children regularly get free toothbrushes and | :47:05. | :47:07. | |
toothpastes given out on really helpful in that effect. We are also | :47:08. | :47:14. | |
doing, as a couple of members mentioned, a lot of work in minimum | :47:15. | :47:17. | |
unit pricing to reduce alcohol consumption and to deal with a lot | :47:18. | :47:20. | |
of the issues that cause people to buy low cheap alcohol, which is | :47:21. | :47:26. | |
killing them. We have reduced smoking rates by, as I mentioned, | :47:27. | :47:30. | |
bringing in the smoking ban first and are doing a lot of work to | :47:31. | :47:34. | |
encourage active living, healthy eating and investment to improve | :47:35. | :47:37. | |
mental health services. You would expect me as the Chair of the | :47:38. | :47:40. | |
all-party group of inequalities to take the opportunity to talk about | :47:41. | :47:43. | |
breast-feeding as Bill and the impact that it can have on health | :47:44. | :47:48. | |
inequalities. James Peter Grant, the former director of Unicef during the | :47:49. | :47:51. | |
1980s, said exclusive breast-feeding goes a long way to cancelling out | :47:52. | :47:55. | |
the difference but between being born into poverty or being born into | :47:56. | :47:59. | |
affluence. It is a lot of breast-feeding takes the infant out | :48:00. | :48:02. | |
of poverty for those few vital months in order to give the child if | :48:03. | :48:05. | |
first started certain life compensate for the injustices of the | :48:06. | :48:09. | |
world into which you she was born. It is quite a statement. Sadly, | :48:10. | :48:13. | |
there is huge inequality within breast-feeding, particularly in the | :48:14. | :48:16. | |
UK. Women in areas of greater deprivation are far less likely to | :48:17. | :48:20. | |
breast-feed, and are also often paying them for more expensive | :48:21. | :48:26. | |
formula milk, which will put strain on the family budget. I was once | :48:27. | :48:29. | |
told by a Labour councillor in Glasgow in his experience there was | :48:30. | :48:33. | |
an inverse, perverse stigma around breast-feeding and his take on it | :48:34. | :48:37. | |
that if a woman breast-fed, it looked as though she was too poor to | :48:38. | :48:40. | |
afford formula. Cost was a big issue, and I have a doubt in my | :48:41. | :48:46. | |
ruler straight. Families are being penalised for a societal problem. | :48:47. | :48:50. | |
The UK does not provide enough support to various factors to ensure | :48:51. | :48:54. | |
mothers are able to breast-feed as long as they would want to. Some of | :48:55. | :48:57. | |
the economic agenda is having an impact on those important services | :48:58. | :49:01. | |
and coverage is free and across the country as both local volunteer | :49:02. | :49:04. | |
services are finding it harder to cope. -- coverage is fleeing. | :49:05. | :49:09. | |
Whatever mothers do, however they feed their children, there is blame | :49:10. | :49:12. | |
for mothers and many young woman have never seen anybody breast-feed. | :49:13. | :49:17. | |
There is also evident towns that the longer woman who, from other | :49:18. | :49:24. | |
countries -- the longer women who are from other countries stay here, | :49:25. | :49:28. | |
the less they breast-feed. There is a lot we can do and I met with a | :49:29. | :49:34. | |
minister earlier this week and then gladiator chiselling and keen Duggan | :49:35. | :49:36. | |
is to address the breast-feeding within the country. On a population | :49:37. | :49:43. | |
level, Unicef's preventing disease and saving recesses report points | :49:44. | :49:49. | |
out that the images could save significant amounts of May by | :49:50. | :49:52. | |
investing in first feeding services. They reckon there would be 3285 | :49:53. | :49:57. | |
fewer cases of hospital admission from gastrointestinal issues and | :49:58. | :50:04. | |
5916 for respiratory tract infection, which would save ?10 | :50:05. | :50:08. | |
million across the country, no mean feat. I think it is quite important. | :50:09. | :50:13. | |
There is also connected reductions in obesity, sudden infant death | :50:14. | :50:16. | |
syndrome and reducing first and ovarian cancer in the mother. | :50:17. | :50:20. | |
Breast-feeding is a significant public health intervention and I | :50:21. | :50:23. | |
think the Unicef call to action indicates how important this is. To | :50:24. | :50:28. | |
return briefly to the Glasgow centre of population of health, I would | :50:29. | :50:31. | |
like to summarise the view of their suggestions, as this is indeed the | :50:32. | :50:36. | |
purpose of today. We should not just look at the problems. The health | :50:37. | :50:41. | |
interventions on smoking and alcohol have helped, but in the main means | :50:42. | :50:47. | |
of resolving inequality, they have found it is not actually in those | :50:48. | :50:51. | |
health interventions, it is a wealth redistribution. It is the widening | :50:52. | :50:56. | |
gap in income perpetuated over many, many years by different governments. | :50:57. | :50:59. | |
Fair and progressive taxation and fair wages would make a huge | :51:00. | :51:03. | |
difference to this gap. Ensuring that all people have a sufficient | :51:04. | :51:09. | |
income is absolutely critical. The government is continuing to slash | :51:10. | :51:11. | |
Social Security spending and not only is it making a member but it is | :51:12. | :51:15. | |
making them ill. There is an NHS health Scotland reported this month | :51:16. | :51:18. | |
that said a quarter of lone parents in Scotland rated their health as | :51:19. | :51:23. | |
they are, bad or very bad. Those parents that have to look after | :51:24. | :51:28. | |
children. If there health is bad and very bad they are not able to be | :51:29. | :51:34. | |
effective parents. The impact on health of the bank as clear as. If | :51:35. | :51:39. | |
you are resorting to go to a good bank to get hand meals, not fresh | :51:40. | :51:43. | |
fruit and vegetables, thumping out of a kind you may not even be able | :51:44. | :51:47. | |
to heat, that will have an impact on your health, your mental health as | :51:48. | :51:53. | |
well. -- something out of a can. We need to support people to live a | :51:54. | :51:56. | |
life with dignity and one with choices, because choices should not | :51:57. | :52:00. | |
be a luxury. If you do not have any control over what happens to you in | :52:01. | :52:04. | |
life, that is going to have a huge impact on you and your family for | :52:05. | :52:11. | |
years to come. They also support and recommend one, affordable and | :52:12. | :52:15. | |
appropriate housing, as the Member for the Chair of the Public accounts | :52:16. | :52:18. | |
commission mentioned, if you do not have some more work for them to | :52:19. | :52:21. | |
live, that will have a huge impact. We need to learn from the mistakes | :52:22. | :52:25. | |
of the past and look more widely at the policies we pursue and the | :52:26. | :52:27. | |
things we think are important in the face, because they can have, as we | :52:28. | :52:31. | |
have seen in Glasgow, very long-lasting effects. Most | :52:32. | :52:37. | |
significantly, the world health organisation's principle of health | :52:38. | :52:40. | |
and policies. This must run through everything that government does that | :52:41. | :52:44. | |
impact on health. Yesterday, the Chancellor related field to address | :52:45. | :52:48. | |
not only health spending but help at all. I would argue that he is | :52:49. | :52:51. | |
billing the country, the people of this country, by not -- failing the | :52:52. | :52:58. | |
country, by not acknowledging everything the government wants to | :52:59. | :53:03. | |
achieve. Thank's thank you very much, Madame Deputy Speaker. It is | :53:04. | :53:05. | |
welcome to be speaking in this chamber for the second time today on | :53:06. | :53:11. | |
yet another very important topic, this time on health inequalities. I | :53:12. | :53:14. | |
thank the backbench business committee for allowing this debate | :53:15. | :53:18. | |
to take place following the application by the honourable member | :53:19. | :53:21. | |
for Totnes, another honourable members across the House, and she | :53:22. | :53:25. | |
spoke again in excellent speech on this topic, and we are very grateful | :53:26. | :53:32. | |
for that. I also want to thank other Honourable members from across the | :53:33. | :53:34. | |
House for the many excellent contributions we have heard today, | :53:35. | :53:38. | |
especially wanting to highlight the speeches from some of my honourable | :53:39. | :53:44. | |
friends, the member from Hull West and Hessle, Stockton North, Bradford | :53:45. | :53:49. | |
South, keyword and Middleton and Hackney South and Shoreditch, who | :53:50. | :53:53. | |
all gave excellent speeches, as well as the honourable member for | :53:54. | :53:57. | |
Plymouth, five sudden and Devonport. My fellow all-party basketball group | :53:58. | :54:02. | |
member! I particularly enjoyed his speech, as I did the Member for air | :54:03. | :54:08. | |
watch. Excellent speech on obesity and childhood obesity. And the | :54:09. | :54:11. | |
honourable member for Glasgow Central, who, as she knows, I agree | :54:12. | :54:15. | |
with most of what she says with regard to breast-feeding especially. | :54:16. | :54:18. | |
We have had an excellent debate, excellent contributions all round. | :54:19. | :54:22. | |
But when it comes to addressing health inequalities, there are many | :54:23. | :54:26. | |
conversations around the need for systemic change to reverse these | :54:27. | :54:29. | |
trends. However, my contribution today, I want to look at tangible | :54:30. | :54:33. | |
specifics that the Minister can get to work on in her remit as minister | :54:34. | :54:38. | |
for public health. I will do this by looking at the current state of | :54:39. | :54:43. | |
health inequalities, and then two key areas that smoking and childhood | :54:44. | :54:46. | |
obesity specifically, and what more should be done to address these | :54:47. | :54:50. | |
health inequalities at the fires. And then move onto the cuts to | :54:51. | :54:57. | |
public health grants, which are exacerbating the situation. The most | :54:58. | :54:59. | |
recent intervention on health inequality was by the Prime | :55:00. | :55:02. | |
Minister, used first speech on the steps of Downing Street to violate, | :55:03. | :55:06. | |
and I would, if you are born poor, you will die on average nine years | :55:07. | :55:11. | |
earlier than others. We have heard examples of this given clearly from | :55:12. | :55:18. | |
constituencies across the country. This was a welcome intervention and | :55:19. | :55:22. | |
clearly set the tone of her government to seriously work to | :55:23. | :55:24. | |
address health inequalities, and hard not to agree when the facts | :55:25. | :55:27. | |
speak for themselves. Using two examples from your most recent | :55:28. | :55:31. | |
public health outcomes indicators shows that by region, London and the | :55:32. | :55:37. | |
south east have the highest life expectancy, while the north-east and | :55:38. | :55:41. | |
north-west at the lowest. The same pattern appears when looking at | :55:42. | :55:45. | |
excess weight in adults, as we have heard today also, were rather than | :55:46. | :55:50. | |
converted 76.2%, the highest percentage, and can at 46.5%, at the | :55:51. | :55:56. | |
lower end of the scale. -- Camden. These figures clearly prove what we | :55:57. | :56:01. | |
more to be true, people living in more deprived parts of the country | :56:02. | :56:05. | |
do not live as long as those in more affluent areas, and in these | :56:06. | :56:08. | |
communities contributors to ill-health such as smoking, | :56:09. | :56:12. | |
excessive alcohol, as we heard also from the honourable member for | :56:13. | :56:19. | |
competent, -- from an honourable member, and obesity levels are more | :56:20. | :56:23. | |
prominent. It is important that the government addresses these issues so | :56:24. | :56:26. | |
that we can improve the health of our nation but there is also an | :56:27. | :56:29. | |
economic argument to be made. If we have an unhealthy population, we are | :56:30. | :56:34. | |
not being as productive as we can be. In England, the cost of treating | :56:35. | :56:40. | |
illnesses and diseases arising from health inequalities has been | :56:41. | :56:44. | |
estimated at 5.5 billion per year, and in terms of productivity, | :56:45. | :56:46. | |
ill-health among working eight people means a loss to the industry | :56:47. | :56:54. | |
or 31- ?33 billion each year. These two arguments must spread the | :56:55. | :56:58. | |
government into action. I know there are many issues to tackle, in | :56:59. | :57:01. | |
multiple ways, for the government -- and multiple ways for the government | :57:02. | :57:05. | |
to address them. Many have been raised today but as I previously | :57:06. | :57:09. | |
said, I will look at two key areas of importance for the Minister to | :57:10. | :57:12. | |
get right, smoking cessation and childhood obesity. My first outing | :57:13. | :57:18. | |
of shadow and is for public health was to debate the prevalence of | :57:19. | :57:22. | |
tobacco products in our communities and the need for the government to | :57:23. | :57:24. | |
bring forward the new Tobacco control plan. She remembers well! | :57:25. | :57:30. | |
And also to set out key actions to work towards a smoke-free society. | :57:31. | :57:36. | |
Smoking is strongly linked to deprivation and for those who do | :57:37. | :57:39. | |
smoke, it has major impact on their health, such as being more prone to | :57:40. | :57:45. | |
cancer and COPD and higher mortality rates. If we look at this by region, | :57:46. | :57:53. | |
as I have already established is a factor in health inequality, smoking | :57:54. | :57:57. | |
levels are higher in the north-east, at 19.9%, compared to lowest in the | :57:58. | :58:03. | |
South East, at 16.6%. Also looking at smoking by socioeconomic status, | :58:04. | :58:09. | |
we find these gaps or even wider. We find that smokers and professional | :58:10. | :58:14. | |
-- in professional and managerial jobs are less than half those in | :58:15. | :58:19. | |
routine and manual social economic groups, at 12% and 28% respectively. | :58:20. | :58:25. | |
During that debate, over a month ago, the Minister was pushed on when | :58:26. | :58:29. | |
the new Tobacco control plan would be published. Concerns have been | :58:30. | :58:34. | |
raised by various charities, including Ash, Fresh North-east And | :58:35. | :58:37. | |
The British Lung Foundation, on how the delay could jeopardise work done | :58:38. | :58:44. | |
already. Sadly the Minister evaded my specific question back then, so I | :58:45. | :58:48. | |
will ask again. Where will we be expecting the new plan? Next year or | :58:49. | :58:54. | |
this year? It will not only go a long way to work towards a | :58:55. | :58:57. | |
smoke-free society but will also help reduce health inequalities in | :58:58. | :59:01. | |
our deprived areas. Surely the Minister can understand that and the | :59:02. | :59:06. | |
need to come forth with the plans. Another area that the Minister knows | :59:07. | :59:09. | |
I have a keen interest in is around childhood obesity. They have | :59:10. | :59:15. | |
repeatedly said the publication of the sheltered obesity plan was the | :59:16. | :59:17. | |
start of the conversation. Childhood obesity is the issue that is on | :59:18. | :59:22. | |
everybody's with right now, at his -- as it is the biggest public | :59:23. | :59:27. | |
health crisis facing this country. I will not resolve the statistics we | :59:28. | :59:31. | |
have heard, they are shocking and we all know them. I know that many | :59:32. | :59:36. | |
organisations and individuals including Cancer Research UK, the | :59:37. | :59:40. | |
children of my food trust and Jamie Oliver have made very clear their | :59:41. | :59:44. | |
dismay at the 13 page document which was snuck out in the summer and have | :59:45. | :59:48. | |
said it could not go far enough. Incidentally, it was the same day as | :59:49. | :59:53. | |
the A-level results, so it obviously looked like it was being hidden. | :59:54. | :59:59. | |
Obesity related illnesses cost the NHS an estimated 5.1 billion per | :00:00. | :00:04. | |
year. But also it is the single biggest preventable cause of cancer, | :00:05. | :00:10. | |
after smoking, and is also connected to other long-term conditions, such | :00:11. | :00:14. | |
as arthritis and type two diabetes. And when obesity is linked with | :00:15. | :00:19. | |
socioeconomic status, there is real concern that the plan we have before | :00:20. | :00:23. | |
us will not go far enough to reverse health inequalities. National Child | :00:24. | :00:29. | |
measurement data shows that obesity among children has risen, and based | :00:30. | :00:34. | |
on current trends, it could be around 670,000 additional cases of | :00:35. | :00:41. | |
obesity by 2035, with 60% of boys aged 5-11 in deprived communities | :00:42. | :00:43. | |
either being overweight or obese. There is a real need for the | :00:44. | :00:51. | |
government to come to terms with the fact that many believe the current | :00:52. | :00:55. | |
plan we have is a squandered opportunity, and a lot more has to | :00:56. | :01:00. | |
be done. That is why I hope the Minister is constructive and her | :01:01. | :01:03. | |
reply to the debate and gives us three assurances that moves us on | :01:04. | :01:10. | |
from, and I quote, this is only the start. My honourable friend gave | :01:11. | :01:18. | |
Alistair at the end of her speech of four or that you could start | :01:19. | :01:23. | |
straightaway, and would certainly take us on. While the government has | :01:24. | :01:26. | |
stalled or not gone far enough on the plans mentioned a moment ago, | :01:27. | :01:30. | |
there is also concern that the perverse and damaging cuts to public | :01:31. | :01:34. | |
health inequality gap. The Minister health inequality gap. The Minister | :01:35. | :01:36. | |
knows the numbers I have given to knows the numbers I have given to | :01:37. | :01:39. | |
her previously, but I will give them again, even after my honourable | :01:40. | :01:48. | |
friend the Member for Hull West and -- but we're also concerned about | :01:49. | :01:52. | |
the cuts to public spending following last year's budget which | :01:53. | :01:55. | |
was followed by the average real term cut of 3.9% each year to 2020, | :01:56. | :02:02. | |
2021, in the Autumn Statement of last year. I want to add some | :02:03. | :02:06. | |
further concerns that will go beyond those raised in this side of the | :02:07. | :02:10. | |
House. Concerns identified in the survey by the Association of | :02:11. | :02:16. | |
directors of public health found 75% of their members were worried that | :02:17. | :02:20. | |
cuts to public health funding would threaten work on health | :02:21. | :02:23. | |
inequalities. These concerns are backed up by further evidence | :02:24. | :02:28. | |
published by a DPH, who found that local authorities are planning cuts | :02:29. | :02:32. | |
across a wide range of public services due to central government | :02:33. | :02:38. | |
cuts. For example, smoking cessation services saw a 30% reduction in | :02:39. | :02:47. | |
2015, 16, increasing to 51% in 16, 17, with 5% of services being | :02:48. | :02:54. | |
decommissioned. Cuts to this would be detrimental. The government | :02:55. | :03:02. | |
failing to realise that cutting this budget would not help is deeply | :03:03. | :03:10. | |
worrying, and shows a lack of joined up thinking around the issue. In | :03:11. | :03:16. | |
conclusion, health inequality is a serious issue we cannot ignore or | :03:17. | :03:19. | |
elect the government get long as the health of our nation is so | :03:20. | :03:23. | |
important, not only in a moral sense but also economically. I know the | :03:24. | :03:27. | |
Minister will agree with the Prime Minister's statement from earlier | :03:28. | :03:32. | |
this year than there is no second guessing that. What we need to see | :03:33. | :03:36. | |
its radical proposals getting to the bottom of this persistent issue, | :03:37. | :03:40. | |
which blights lives of so many people in our most deprived | :03:41. | :03:44. | |
communities. We all want to see a healthier population where nobody's | :03:45. | :03:51. | |
health is determined by factors outside your control, and we must | :03:52. | :03:54. | |
work together to get to the point with that is no longer the case that | :03:55. | :04:00. | |
the postcode where you were born or 11 determines how long you will live | :04:01. | :04:03. | |
or how healthily you will live the life. I would like to congratulate | :04:04. | :04:07. | |
the chair of the health select committee of her opening of this | :04:08. | :04:12. | |
debate, and to the backbench business committee for agreeing to | :04:13. | :04:18. | |
it. It has been a highly informed debate, but also wide-ranging, so I | :04:19. | :04:22. | |
will start by apologising, I will not be able to respond in detail to | :04:23. | :04:30. | |
all the points. I will reply in writing, but my colleagues are right | :04:31. | :04:34. | |
that the government has set this as a priority, and it is not surprising | :04:35. | :04:38. | |
that we share the responsibility of the size to reducing health | :04:39. | :04:45. | |
inequalities. Currently we are recognised as public leaders in | :04:46. | :04:51. | |
health, which has been achieved by avoiding temptation to put it in a | :04:52. | :04:58. | |
silo. The approach to treating health alone will not tackle is what | :04:59. | :05:02. | |
we know will be the most entrenched problems of our generation. We have | :05:03. | :05:06. | |
avoided our health only approach in the past, which is why the | :05:07. | :05:09. | |
Chancellor's Autumn Statement Chancellor's Autumn Statement | :05:10. | :05:11. | |
yesterday announced some important and relevant measures, like raising | :05:12. | :05:17. | |
the minimum wage, raising the income tax threshold and an additional 1.4 | :05:18. | :05:26. | |
billion to deliver 40,000 extra affordable homes, which is in | :05:27. | :05:28. | |
addition to the homelessness introduction Bill. It is right that | :05:29. | :05:35. | |
we also look to the work of industry and non-governmental actors, and I | :05:36. | :05:38. | |
am pleased to see the food and drink industry has made progress in recent | :05:39. | :05:46. | |
years. The focus on ball into the arrangements has been based on | :05:47. | :05:48. | |
calorie reduction, and sugar and portion sizes have been reduced with | :05:49. | :05:57. | |
many manufacturers tapping at 250 calories, which is an important step | :05:58. | :06:01. | |
forward. Some retailers have also played their part by removing sweets | :06:02. | :06:04. | |
from checkouts, while others have cut their own brand sugary drinks. | :06:05. | :06:12. | |
We welcome this and urge others to follow suit. We challenge industry | :06:13. | :06:18. | |
to make further substantial progress to stop we praise those who have had | :06:19. | :06:21. | |
success but will continue to challenge those who lagged behind. | :06:22. | :06:23. | |
Colleagues are right to highlight the importance of employment. It is | :06:24. | :06:26. | |
encouraging to see there are some gaps that are narrowing, as the | :06:27. | :06:31. | |
Chancellor said yesterday over the past year employment grew fastest in | :06:32. | :06:34. | |
the north-east, pay grew more strongly in the West Midlands, and | :06:35. | :06:40. | |
every new key -- UK nation Regents on improvement to employment. Health | :06:41. | :06:45. | |
Green paper is specifically focused on driving down the disability work | :06:46. | :06:50. | |
gap for those who wish to work. It is this emphasis on the social, | :06:51. | :06:54. | |
economic and environmental causes of inequalities that convinces me that | :06:55. | :06:59. | |
public health responsibilities as they are traditionally understood | :07:00. | :07:03. | |
set in local government, we're national action can be reinforced, | :07:04. | :07:10. | |
and resources targeted... I would like to respond to concerns raised | :07:11. | :07:14. | |
by my honourable friend for Plymouth Sutton regarding his GP practices. | :07:15. | :07:19. | |
When a GP practice closes, NHS England has a responsibility to make | :07:20. | :07:23. | |
sure that patients still have access to services, and that patients are | :07:24. | :07:26. | |
not misplaced. I am pleased to hear he is making progress on the matter, | :07:27. | :07:33. | |
but if he reaches a roadblock, I would be happy to raise his concerns | :07:34. | :07:38. | |
with the Minister for community health. While councils, as a number | :07:39. | :07:41. | |
of colleagues have raised, have had to make savings and are acting in | :07:42. | :07:44. | |
tough financial circumstances, they are still accessing ?16 billion in | :07:45. | :07:52. | |
terms of the public health grant, and they have shown that good | :07:53. | :08:02. | |
results can be achieved, there are some examples of outstanding | :08:03. | :08:04. | |
practice to which we should pay tribute today. The innovation fund | :08:05. | :08:10. | |
in collaboration with local gum and provides funding for services for | :08:11. | :08:25. | |
HIV testing, at a time when it is a key public health priority. As my | :08:26. | :08:31. | |
honourable friend rightly raised, we must focus on key determinants such | :08:32. | :08:36. | |
as obesity, smoking, drug abuse and alcohol. We are working closely with | :08:37. | :08:44. | |
our partners in the NHS, Ph.D., local government and schools to | :08:45. | :08:46. | |
deliver childhood obesity plan, which has been raised by many today. | :08:47. | :08:56. | |
We have consulted on the industry levy, and launched a broad sugar | :08:57. | :09:09. | |
production, which should impact... These measures will have second and | :09:10. | :09:13. | |
the benefits in terms of dental health and diabetes prevention. As | :09:14. | :09:16. | |
my honourable friend the Member for error wash membered, -- mentioned, | :09:17. | :09:27. | |
it is important of delivering a key part of that plan, which is an hour | :09:28. | :09:30. | |
of physical activity every day, and one of the ways we will make sure | :09:31. | :09:36. | |
this goes through effectively is introduce a healthy rating scheme in | :09:37. | :09:39. | |
primary schools to recognise and encourage | :09:40. | :09:49. | |
the way they deliver this. I agree with Lonrho board members... Parity | :09:50. | :10:21. | |
of extreme must be paired with care,... | :10:22. | :10:37. | |
Would need to refresh the suicide strategy with a focus on the | :10:38. | :10:44. | |
alarming figures of suicides among men, and the figure is about self | :10:45. | :10:49. | |
harm. There can be no complacency about the skill of the challenge, as | :10:50. | :10:59. | |
figures today remind us. We know that inequalities can be difficult | :11:00. | :11:03. | |
to tackle, and services are required to tackle this, so I am prioritising | :11:04. | :11:10. | |
the tobacco control strategy. I will use our efforts to target vulnerable | :11:11. | :11:18. | |
groups, such as pregnant women and addicts, to using data to understand | :11:19. | :11:29. | |
the policies. Can the Minister of a timescale for the Tobacco strategy? | :11:30. | :11:34. | |
I cannot because I am not satisfied it is as effective as I wanted to | :11:35. | :11:40. | |
be. In addition, I am taking action, I am pleased with the action we have | :11:41. | :11:46. | |
taken to improve standardised for cigarettes and other legislative | :11:47. | :11:49. | |
measures, and we have launched the world's first diabetes prevention | :11:50. | :11:56. | |
programme, and we had a good debate about how we can improve diabetes | :11:57. | :12:01. | |
cure, and we have one of the most effective immunisation programmes in | :12:02. | :12:04. | |
the world, showing our commitment to take action where evidence guides | :12:05. | :12:09. | |
us, but this action must be government at a local and national | :12:10. | :12:14. | |
level. Our job is to boot prevention and population health considerations | :12:15. | :12:18. | |
at the heart of everything we do as the five-year forward view made | :12:19. | :12:21. | |
clear. Devolution deals give areas local control over the social | :12:22. | :12:27. | |
determinants of health, such as economic growth, housing, health, | :12:28. | :12:31. | |
work, programmes and transport, and a focus on integrated public health | :12:32. | :12:36. | |
services within devolution promises to remove many barriers to | :12:37. | :12:40. | |
intervention we have discussed, making public-health everyone's | :12:41. | :12:44. | |
business, as the SNP spokesman said. With devolution, though, and as we | :12:45. | :12:49. | |
progress to the move towards business rates retention, as the | :12:50. | :12:54. | |
honourable member for Kingston-upon-Hull macro said, | :12:55. | :12:57. | |
transparency will be vital to ensure the outcomes in public health | :12:58. | :13:00. | |
improve. This is happening but we need to go further than do more to | :13:01. | :13:04. | |
engage local people and their elected councillors in highlighting | :13:05. | :13:09. | |
the unjustifiable parities that exist. Transparency relating to | :13:10. | :13:18. | |
accountability is a key part for me. Members across the House are right | :13:19. | :13:21. | |
to launch the challenge today, and I take on board the suggestions on how | :13:22. | :13:29. | |
we can collectively reduce health inequalities, but I hope that in | :13:30. | :13:31. | |
replying today, I have made clear that the only way they believe we're | :13:32. | :13:35. | |
going to make progress is to adopt a whole government and society | :13:36. | :13:39. | |
approach. We have to constantly remind ourselves that reducing these | :13:40. | :13:44. | |
inequalities is not just for the NHS or Public Health England, but for | :13:45. | :13:47. | |
the whole of government, as well as local areas, industries and all | :13:48. | :13:52. | |
members of the House. I reaffirm my commitment to work with the widest | :13:53. | :13:55. | |
range of partners in and out of government to make progress on this, | :13:56. | :13:59. | |
and I hope every single member today will do so, because we all our | :14:00. | :14:05. | |
constituents nothing less. I would like to thank colleagues from across | :14:06. | :14:11. | |
the House for a number of thoughtful contributions to this debate. This | :14:12. | :14:14. | |
is everybody's business and we now want to see the government | :14:15. | :14:17. | |
translates the ambition and the words into action. The question is | :14:18. | :14:29. | |
as on the order paper. The ayes have it. The ayes have it. I beg to move | :14:30. | :14:37. | |
this House adjourned. The question is that this House do know | :14:38. | :14:43. | |
adjourned. Sir William Cash. Thank you. I want to make clear my | :14:44. | :14:50. | |
Stromberg -- strong objection to proposals in section form a queue of | :14:51. | :14:54. | |
HS2 phase eight, West Midlands to crew consultation documents on | :14:55. | :15:01. | |
behalf of my constituents. I have registered my objection to HS2 many | :15:02. | :15:07. | |
times, and indeed my honourable friend the Member for Stafford and | :15:08. | :15:15. | |
Chesham and Amersham have also taken a strong line on the subject for a | :15:16. | :15:20. | |
long time. It is also true that there will be a bill in future, we | :15:21. | :15:26. | |
presume after December, when at some point there will be a hybrid bill on | :15:27. | :15:30. | |
which members of my constituency will be able to petition if the need | :15:31. | :15:38. | |
to do so. What I want to do is set out my objection is these initial | :15:39. | :15:50. | |
proposals. They amount to an area which is likely to become, we | :15:51. | :15:57. | |
believe, the depot at Crewe. | :15:58. | :16:00. |