§ 7. Mr. RookerTo ask the Secretary of State for Health what progress is being made in respect of the mortality reduction targets set out in "The Health of the Nation", Cm. 1986.
§ Mrs. Virginia BottomleyThe latest figures show that good progress is being made towards virtually all the mortality targets set out in "The Health of the Nation" White Paper. The targets were deliberately set to be challenging and it is most encouraging that so much has already been achieved.
§ Mr. RookerSpeaking between two planted questions, may I ask whether the Minister accepts that poverty is an important factor in determining death rates? That is shown by the fact that deaths from coronary heart disease among poor men and poor women are respectively 44 per cent. and 61 per cent. higher than would otherwise be expected. Does the right hon. Lady appreciate that in the past 15 years in just four regions of the country—the north, the north-west, 747 Yorkshire and Merseyside—there have been 125,000 more deaths from coronary heart disease than should otherwise have been expected? That amounts to the Government, by their neglect, killing off two constituencies of Labour voters.
§ Mrs. BottomleyI am with the hon. Gentleman to the extent that the Government are committed to wealth creation, job creation and the relief of poverty, and we have been remarkably successful in that. I am also with him to the extent that I am aware of the severe problem of coronary heart disease in his constituency. That is why I hope that he will welcome the £23 million going into primary care in the Birmingham area precisely so that more GPs can deal with those issues and with the multi-factor causation of coronary heart disease and strokes. A great number of factors are involved; the whole point of "The Health of the Nation" strategy is to look into the causes of disease.
The hon. Gentleman may like to know that the health of the nation has improved for all income groups and all social classes, and perinatal mortality has decreased, as a result of the success of the health reforms and the work that we have been undertaking.
§ Mrs. RoeDoes my right hon. Friend agree that the highly successful programme of childhood immunisation has made a major contribution to reducing the numbers of untimely deaths and improving the health and well-being of children? Will she take this opportunity to reinforce the message that, with the threat of a measles epidemic, it is vital that parents ensure that their children are vaccinated?
§ Mrs. BottomleyI thank my hon. Friend. I can confirm the great success of the immunisation campaign. It is bizarre that the Labour party so stubbornly resisted the new GP contract, which has resulted in well over 90 per cent. of children being immunised against avoidable childhood diseases.
That is just one of many ways in which we set a target that we not only met but beat. The introduction of the hib meningitis vaccine has resulted in an 80 per cent. fall in those cases in only a year. This country now has its largest ever immunisation programme. Some 7 million schoolchildren are to be immunised in November. We hope that the scheme will be widely supported because it is the effectiveness and success of the national health service that enables us to implement that important policy.
§ Mrs. WiseWhat account is the Secretary of State taking of the clear links that have been established between unemployment and mortality and ill health? What is the right hon. Lady doing about that, and will she restrain her hon. Friends from hounding the unemployed and persuade her Government to act to provide more real jobs?
§ Mrs. BottomleyI am vigorously championing the success of the Prime Minister and other members of the Government in reducing the number of unemployed. A reduction of 400,000 in the number of unemployed since the end of 1992 is a remarkable achievement. I am certainly not pursuing populist gimmicks such as compulsory paternity leave which would be imposed by Brussels and would drive jobs out. A minimum wage would also be counter-productive in terms of providing 748 real jobs for our people. I want to make sure not only that we have people in employment but that we have healthy people in employment.
§ Mr. SimsIs not the progress towards meeting the targets in "The Health of the Nation" extremely encouraging? But does my right hon. Friend share my disappointment at the poor figures in relation to reducing the incidence of smoking among young people and especially girls? What are her plans to reduce the largest avoidable cause of premature death?
§ Mrs. BottomleyMy hon. Friend is a persistent and wise champion of the cause of reducing the extent of smoking. As he will know, in that respect we have been more successful than any other European country apart from the Netherlands. That is largely because we believe that price is a crucial variable. Every 10 per cent. increase in price leads to a 3 to 6 per cent. fall in consumption. We are meeting the target for adults and pregnant women. The problem is in meeting the target for young people. The most important factors are parental disapproval and education in schools. I am pleased that through our "Health of the Nation" strategy we are reinforcing our messages to parents and to those in control of young people and are increasing the extent of anti-smoking education.