Healthy Life Expectancy

Question

14:47:00

Asked by

To ask His Majesty’s Government what steps they are taking to reverse recent declines in healthy life expectancy, and to address poverty-related inequalities in life expectancy.

My Lords, it is unacceptable that who you are or where you live can impact healthy life expectancy. Reversing the decline in healthy life expectancy is a core part of this Government’s health mission. There is a long way to go but we are making good progress—exceeding our pledge to deliver an extra two million operations, scans and appointments by delivering well over three million, and addressing major health risks that particularly impact more deprived areas.

I thank my noble friend for her Answer. She may be aware that, this morning, the Health Foundation published a new international benchmarking report. It highlights that, in the 2010s, in all parts of the UK outside London, mortality rates increasingly lagged behind progress in the other 21 countries in the study and that, by 2021, mortality rates in the north-east and north-west of the UK were 20% higher than in the south-west. In light of this, will the Government heed the Health Foundation’s call for a new health inequality strategy that has a particular focus on those parts of the country that have faced long-term industrial decline?

My noble friend raises an extremely important point about inequality. The Health Foundation report focusing on the 2010s shines a light on the need to drive action, which we are doing across government through our missions, with a very ambitious goal and the right approach of halving the gap in healthy life expectancy between the richest and poorest regions. Although I am certainly very interested in what the Health Foundation report says, further strategy is not needed at this time because of the approach we are taking. But I assure my noble friend that in addressing health inequalities, including in areas of past industrial decline, we will be driving economic growth and removing health-related barriers to health, wealth and prosperity.

My Lords, people are not living as long as they were because of the obesity epidemic, which is killing people at an earlier age from a variety of very unpleasant diseases. Does the Minister agree that there are a lot of pseudoscientists around putting out propaganda that people cannot exercise personal responsibility and therefore government action must be taken? Could it be that those people do not want to see the end of the obesity epidemic because they are making so much money out of it?

The noble Lord always has interesting observations that I listen closely to. I certainly agree that obesity is a major contributor to ill health. Some 64% of the adult population is overweight or living with obesity, and it does indeed, as he says, pose a major health inequality issue. The approach has to be on many levels, and there is government action. For example, we have laid secondary legislation on TV and online advertising restrictions on less healthy foods. We got on with that because we thought it extremely important. Equally, we support people not just through policy or medical intervention, but by encouraging them to adopt a healthier lifestyle. The reasons why people are obese are complex, and we approach it in that way.

My Lords, I welcome His Majesty’s Government’s commitment to bringing forward a child poverty strategy. The interaction between mental ill-health and poverty is well known. Will the strategy address access to vital mental health support services, especially for those in more remote rural areas where they are difficult to access?

The right reverend Prelate is quite right to draw attention to mental health impacts and the inequality of their incidence. As I mentioned, there has to be a cross-government approach because if we address it through health alone, we will not succeed. Factors such as poor housing, low income, worklessness and disability, as well as ill health and many other factors, affect healthy life expectancy. That is why we are approaching it not by a separate strategy, but by a mission-led approach.

Through the work of people such as Professor Michael Marmot, the Government know about the different incidences of ill health across the country. Retailers, particularly food retailers and high street pharmacies, know about the incidence of ill health way in advance of that because they have the data on consumption and purchasing behaviours. Will the Government work with them, particularly the large supermarkets, to increase the availability of data in advance, so that we can prevent some of the incidence of ill health rather than getting the NHS to pay for it when it has happened?

Prevention is certainly the best approach. As noble Lords will be aware, one of the three pillars of the published 10-year plan is moving from sickness to prevention, so that will feature very much in the plan. We work closely with industry to ensure that government can benefit from its information and its approach, and that we can bring industry along with us to ensure that, collectively, we are taking the best approach to making healthier foods available. We also have to make sure that people have the resource to have healthier foods, as well as information. It is, again, a many-pronged approach, but that is why it has to be a joined-up approach.

My Lords, while accepting what the noble Baroness, Lady Alexander, and the Minister have said about social inequalities in health outcomes, there are other issues. For instance, period mortality affects life expectancy, so a male aged 65 will expect to live another 18.5 years and a female another 21 years. In turn, period life expectancy is affected by mortality rates so if you improve mortality rates, particularly for diseases where the rates are highest, you will improve life expectancy irrespective of social inequalities. That means that we need the health service to deliver high-quality care for those conditions which result in high mortality rates. Any forward plan or 10-year plan should address that issue. Does the Minister think that might be wise?

I do feel that that would be wise, and we as a Government have already shown that trajectory. To give just one example, smoking remains the preventable killer in our country, and the landmark Tobacco and Vapes Bill will deliver the ambition of a smoke-free UK. We will have a smoke-free generation and will gradually end the sale of tobacco products across the country. We have to break that cycle of addiction and disadvantage which is particularly focused on areas of greater disadvantage. As ever, the noble Lord speaks wise words.

My Lords, as somebody who has embraced the healthier lifestyle and healthy eating—far later than I should have done—I have looked at every strategy in the book and found one that works. I draw the Minister’s attention to the fact that Japan has the highest life expectancy in the world at birth. Multiple studies have put this down to both healthy eating habits and a strong culture of exercise, both of which are reinforced during school. With Committee of the Children’s Wellbeing and Schools Bill beginning today, what steps will His Majesty’s Government be taking to ensure that our children receive better health and exercise education to emulate the success of Japan?

I congratulate the noble Baroness on being an example to us all. She referred to learning from international examples, including Japan, and indeed we do. We know that some 12 million adults and approximately 2 million children are not physically active enough, so we are developing targeted plans to help children build healthy eating habits and embed physical activity support into routines. We will continue to work closely with DfE on this.