HC Deb 20 June 1995 vol 262 cc136-9
2. Ms Janet Anderson

To ask the Secretary of State for Health what action her Department is taking to reduce cross-regional variations in health. [27712]

6. Mr. Bayley

To ask the Secretary of State for Health what new initiatives she intends to take to reduce regional and social class variations in the health of the population. [27716]

The Secretary of State for Health (Mrs. Virginia Bottomley)

We are tackling variations in health by working to improve health across the whole population, by allocating funding according to need, and by ensuring that health authorities are able to assess the needs of their local population and target spending accordingly.

Ms Anderson

Can the Secretary of State explain why the death rate from cervical cancer in the Burnley, Pendle and Rossendale area is 60 per cent. higher than the national average, and more than twice the rate in her constituency of Surrey, South-West?

Mrs. Bottomley

Before giving a substantive reply to the hon. Lady, I should like briefly to pay tribute to the late Lord Ennals, who held my present office for several years. I knew him personally since my childhood, and he was a great campaigner and a great enthusiast, especially on mental health issues, so it seems appropriate to mention his contribution to the House today, when we are to discuss the Mental Health (Patients in the Community) Bill.

In answer to the hon. Lady, the key question is why her party resisted the GP contract that introduced additional encouragement for screening for cervical cancer. Our strategies have directed help to where it is most needed, and developed practical policies that have achieved change, so that the hon. Lady now has in her constituency not only a cervical screening programme but an effective breast screening programme. Difficulties involving variations in health outcome exist in this country, as in every country. The difference between the Labour party and ourselves is that we have practical policies for addressing and reducing those inequalities.

Mr. Bayley

Does the Secretary of State agree with the British Medical Association that the wealth gap and the health gap are both widening—in its words, as the direct, if unintentional, result of policy choices by the Government? When will the Government change those policies, which have led, for instance, to the scandal that, in Gateshead, infants are 12 times more likely to die in their first year of life than are infants in the Prime Minister's constituency of Huntingdon?

Mrs. Bottomley

I agree with the BMA that our "The Health of the Nation" strategy is one of the most important initiatives that we have developed in recent years. It has been commended by the World Health Organisation and the Organisation for Economic Co-operation and Development, and as a result of it we can now bring the different Departments together to tackle the task of improving health.

In the same way, we expect local health alliances to form, so that the health authorities and the local authorities can develop practical policies to deliver change. Over the past 10 years, infant mortality rates have fallen from 11 to 6.5 per thousand, and life expectancy at birth has increased from 71.8 to 73.8 years. Those figures have improved, and infant mortality has fallen, for all social groups and in all regions.

Dame Jill Knight

Does my right hon. Friend agree that the biggest and most important link between poverty and ill health is poor housing, and that much—indeed, the overwhelming bulk—of poor housing is administered by local government? If so, how often do she and her colleagues discuss health and housing matters with the Minister for Local Government, Housing and Urban Regeneration?

Mrs. Bottomley

As ever, my hon. Friend has hit the issue precisely. The Labour party talks about equality, but delivers a shambles. It has no practical policies for delivering any of its objectives. We have recently been subjected to the news that it plans a great act of vandalism against precisely the strategic changes in the health service that have enabled us to identify areas of difficulty and to take forward practical policies.

My hon. Friend is absolutely right about the link between housing and health, as she is about many other factors. My hon. Friend the Under-Secretary of State and I frequently meet Housing Ministers to discuss practical ways in which to take policies forward. People would be better served by Labour local authorities who took their stewardship more seriously, and, instead of talking the rhetoric of improving quality, took practical action, as the Conservative party has.

Sir Anthony Grant

When considering cross-regional variations, will my right hon. Friend bear in mind the fact that hospitals such as Addenbrooke's and Papworth are centres of excellence equal to any London hospital, and that they happen to be in one of the fastest growing areas of the country, whereas London is the slowest growing area? On that basis, is she aware that her policy on hospitals is absolutely bang right?

Mrs. Bottomley

I thank my hon. Friend. He is one of a number of extremely distinguished and eminent opinion formers who take the view that the change in London was long overdue, and that, if there has been a problem in London, it has been the inadequate primary care services. That is why our decision, for example, to introduce deprivation payments for GPs in poorer areas, which means that they can get up to £30,000 more, is the right way forward—the practical action to deliver the necessary change.

Mr. Nicholas Brown

I thank the Secretary of State for her tribute to Lord Ennals, which is, of course, both appreciated and echoed by the Opposition.

On the substance of the question, can I ask the Secretary of State whether, in spite of all the evidence to the contrary, it is still her view that the Government should continue to deny the link between poverty and health inequalities?

Mrs. Bottomley

As ever, the Labour party is simplistic in its analysis. Of course income is a factor, and so are heredity, education, housing and unemployment; but our party supports a wealth-creating, job-creating economy, which means that we have below-average, falling unemployment—1,000 fewer on the unemployment registers every day. I suggest that those in the Labour party who are genuinely concerned about the wealth and well-being of the people of this country should applaud a Government who have so singularly successfully improved the standing of our nation and the employment prospects of our people and, in practical terms, substantially improved the health service.

Mrs. Roe

Does my right hon. Friend agree that the health needs of deprived populations are best met by developing the community health services provided by GPs and their teams? Will she confirm that that will remain at the heart of the new NHS?

Mrs. Bottomley

Undoubtedly, the development of and improvements in primary care have been among the most important changes in recent years. That is the first priority in the guidance that we have issued to the service this year.

I think that those who believe in primary care 'are perplexed that among the many acts of vandalism being prepared by the Labour party is the undermining or destruction of GP fundholding, which has so singularly led to successes and changes in primary care. It should pay more attention to how it can build on the successes, and, above all, make sure that the substantial extra resources going to local authorities for community care are properly spent and wisely used in the interests of the most vulnerable in the community.