Health Inequalities

The driving force behind this Government’s approach to health is the principle that whoever a person is and whatever their background, they should receive the same world-class services as everyone else, based on need and not the ability to pay. That is why at its core, our 10-year plan for health looks to stamp out health inequalities, freeing up billions to move critical resources such as medicines and equipment to the regions and patients that need them most. Only a Labour Government will protect the NHS as a service free at the point of use, rebuild it, and make it fit for the future for everyone in our country.

I call Perran Moon.

Meur ras, Mr Speaker. Carn to Coast runs GP surgeries across my Camborne, Redruth and Hayle constituency, including the surgery where my father practised for over 30 years. It is struggling under intense pressure, with deep-rooted health inequalities linked to the surrounding areas of deprivation. While I welcome the review of the Carr-Hill formula as part of the 10-year health plan, will the Secretary of State come to Cornwall and visit a Carn to Coast health centre with me, to see the innovative work that is already being undertaken and to discuss how the reforms will support health outcomes in the most deprived areas?

I can certainly give my hon. Friend that commitment. The damage that was wreaked by the previous Government, not just across our health service but across every other part of Government, means that the gap between the health of the poorest parts of our country and that of the wealthiest has widened enormously. We have seen real challenges in general practice, which is why there are 300 more patients per GP in the poorest communities compared with the richest, and that particularly affects rural and coastal communities with higher levels of deprivation. We are going to carry out a review of the Carr-Hill formula. That formula has to work for general practice, and I would be delighted to come and see the work that the team at Carn to Coast are doing.

In Kensington and Bayswater, there is now a staggering 19-year gap in life expectancy between men living in Notting Dale and those living in Holland Park—which are just hundreds of metres apart—and that gap has grown in recent years. The Minister knows that this is a whole-of-society issue to do with housing, employment and education, but can he outline what steps the Department are taking to help inner-city areas with very high levels of health inequality, such as that experienced by my constituents in Kensington?

I am grateful to my hon. Friend for pointing out those stark differences in healthy life expectancy within a single inner London borough that contains some of the richest people on earth, as well as some of the poorest in our country. As for what we are doing as a Government, in addition to making sure that funding follows need and that we are tackling deprivation, our approach to neighbourhood health should make sure that we are working proactively in those communities that have the highest level of need, including pockets of deprivation within areas of higher affluence. Of course, as our plan recognises and as our mission-driven approach addresses, there are so many social determinants of ill health, including poverty, a lack of good work, damp housing, dirty air, and an inability to access culture and leisure opportunities that are affordable for everyone, not just the privileged few. Those are the issues that this Government are addressing, consistent with the Labour values that got us elected.

For residents of New Court Place care home in Borehamwood, wheelchairs are their lifeline. However, they are being badly let down by AJM Healthcare, their NHS wheelchair provider, with multiple unresolved assessments, bad communications and waiting times for repairs and replacements unbelievably extending to four years. Residents with physical and intellectual disabilities feel let down, overlooked and traumatised. In tackling health inequalities, can I urge the Secretary of State to look urgently at this provider and come to the aid of people who desperately need our help?

I can certainly give the right hon. Gentleman the assurance that my Department will look into the provider that he raises. One reason I was proud that this Government increased the disabled facilities grant is that it means not just more ramps, handrails and accessible kitchens and bathrooms, but dignity, independence, freedom and quality of life. That is precisely what the right hon. Gentleman’s constituents are being deprived of if they do not have wheelchairs that meet their needs. I would be delighted to look into this, and I am extremely angry that the failures he raises require me to do so.

Does the Secretary of State agree that public health is at the heart of addressing the long list of inequalities he has just highlighted? I am deeply concerned that a major reorganisation of local government and the cutting of budgets to the integrated care board will undermine the co-ordination that currently exists in Oxfordshire to deliver public health. Can the Secretary of State assure me and my constituents that public health will continue to be a priority at the heart of the prevention strategy, and that funding for public health will rise in future years to make that possible?

I can certainly give the hon. Gentleman reassurance that the work we are doing to streamline and rationalise the amount of money we are spending on NHS bureaucracy means that we will free up resources that can be spent on the frontline, improving patient care and public health. Thanks to the decisions taken by my Department, the Deputy Prime Minister and, of course, my right hon. Friend the Chancellor of the Exchequer, investment in public health is rising and the spending power of local authorities is improving. That is all good news for public health.

I call the shadow Minister.

Tackling health inequalities requires a strong workforce. I recently met a constituent who is about to qualify as a nurse, but she has been unable to find work. She is not alone; this is a widespread problem. The reasons she has been given include recruitment freezes to save money and nurses brought in from overseas instead. We need more nurses to tackle health inequalities, so will the Secretary of State ensure that trusts are funded to support and employ new nurses, and to prioritise British nurses for British jobs?

I can certainly assure the shadow Minister that the chief nursing officer and I are working proactively to deal with nursing unemployment. We are also working with the leadership of the NHS to make sure that we are reducing our reliance on overseas workers. Grateful though I am to all the healthcare workers who come from overseas to work in our health and care services—the service would fall over tomorrow if they all left, so we should be extremely grateful—there is certainly an overreliance, and that is what we are addressing. I have to say to the shadow Minister, though, that both those issues are a result of appalling workforce planning, for which the previous Government bear a huge amount of responsibility.