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12 Feb 2003 : Column 1003—continued


Mr. Deputy Speaker (Sir Alan Haselhurst): We now come to motions 6, 7, 8, 9, 10 and 11, which, with the leave of the House, I shall put together.

Motion made, and Question put forthwith, pursuant to Standing Order No. 118(6)(Standing Committees on Delegated Legislation),


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Question agreed to.


Manchester Airport

8.44 pm

Mr. George Osborne (Tatton): I wish to present a petition on behalf of many of my constituents who live in the villages of Plumley, Lower Peaver, Chelford and Lostock Green against the Government's plans to expand Manchester airport.

The petition states:

To lie upon the Table.

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Health Inequalities (Hemsworth)

Motion made, and Question proposed, That this House do now adjourn.—[Dan Norris.]

8.46 pm

Jon Trickett (Hemsworth): I am grateful to the House authorities for allowing me to lead this short debate. I am pleased that my hon. Friend the Under-Secretary is in her place on the Treasury Bench.

All sorts of studies over many years deal with health inequality. I was interested to read the Wanless report, which examined premature death in some detail. Derek Wanless used the expression PYLL—potential years of life lost. He suggested that, as a nation, we have not done well historically in relation to our comparator countries. According to the Wanless report, we have the worst record on premature mortality. That is disturbing.

For example, we are 25 per cent. worse off than Sweden when we compare the potential years of lives lost in both countries. The Government are doing a great deal to tackle the problem through their emphasis on financing, reforming and modernising the health service. However, although the statistic is worrying, there are variations in the nation. A statistic that covers a nation perhaps conceals as much as—or more than—it reveals.

The Wanless report drew our attention to major health inequality in our society. The report states:

Premature mortality is not the only feature of the class system that unfortunately continues to exist to some extent in our society. Limiting, long-standing illness is also prevalent among what Derek Wanless describes as the "lower social classes". He does not use that term pejoratively. Of those suffering from limiting, long-standing illness, 32 per cent. are manual workers, whereas only 17 per cent. are in social class 1. The figure for the former category is almost double that of the latter.

My constituency consists of several mining villages and small towns, where deprivation is a major feature. It is possible to identify the character of my constituency in some detail. The Government produced an index of multiple deprivation, which shows that four wards in Hemsworth constituency are among the most deprived communities. Approximately 50,000 people live in the wards of Featherstone, Hemsworth, South Kirkby, South Elmsall and Upton. Figures for employment, income, housing conditions, literacy and numeracy or any other factor show acute and widespread problems of deprivation.

As Wanless and many other students of the matter predicted, along with general deprivation goes health deprivation. Sadly, when I examined the deprivation figures relating to my constituency along with the health deprivation figures, the same four wards—more or less contiguous—containing 50,000 people proved to be the most health-deprived as well as the most deprived in general. Two of them, Hemsworth and South Kirby—inhabited by probably 25,000 people—are among the worst 2 per cent. in the country. I doubt that there are many other constituencies, if any, that feature both such acute health deprivation and such a chronic spread across such a large area.

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I do not want to bore the House, but I could produce a string of statistics relating to, for instance, coronary heart disease, mental illness, drug abuse and deaths from cancer. I shall confine myself to some particularly troubling figures relating to premature death from certain illnesses—troubling because I find them inexplicable.

It could be considered predictable for the incidence of lung cancer in a former mining community to be 22 per cent. higher than the national average, although that is a frightening statistic. It is hard to understand, however, why our cervical cancer rate should be 47 per cent. higher than the national average. That suggests that something troubling is happening in the constituency. And why should the figures relating to mental health problems be so high, particularly among women?

As the local Member of Parliament, I felt very dejected on discovering the high rate of male suicides. An alarming number of young men commit suicide between the ages of 15 and 34. Something must be going badly wrong with communities that were traditionally so strong and stable when they were mining communities.

In a mining community, respiratory diseases might be expected. What troubles me is that, according to the statistics, the problem is much worse than could ever be imagined. Deaths in Wakefield as a whole—and the problem is particularly acute in my constituency—from chronic bronchitis and emphysema are 400 per cent. of the national average. Four times the number of people who would be expected to die from those diseases are dying from them: that is twice the average of 200 per cent. in what is described as the coalfield cluster.Why should women be dying from asthma at 253 per cent. of the national average rate? Women did not work on the ground; they were not exposed to coal dust as the men were.

No doubt the Minister will want to make some general comments, but I look forward to further correspondence on the specific issues of cervical cancer, suicide rates among young men, the alarmingly high rates of death from chronic bronchitis and emphysema, and female deaths from asthma. I feel that they require some analysis and some understanding.

It is possible to argue that some of the statistics—which I think will alarm anyone who looks at them—are part of the heritage of the mining industry, and also of the way in which that industry collapsed overnight and the immense social deprivation that followed. I believe that some things at least are beginning to change, and that some hope is being offered. The money that the Chancellor is investing in the health service is starting to feed through, which is welcome.

The modernisation of the health service is, of course, to be generally welcomed, although I should sound a note of caution. The population that I represent is very sparsely distributed, and not many people have access to cars. In the minds of some, modernisation might mean centralising services so that they are further away. I ask health service managers in my constituency, which is suffering from these particularly acute and chronic problems, not to do that. I fear that there is a sense of drift towards the centre in respect of specialisms, which I would deplore.

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At the same time, the health authority in Wakefield did leave substantial deficits. My noble Friend Lord Lofthouse, who is chairman of the acute trust, and his colleagues are doing everything that they can to reduce that deficit, but I implore the Minister to look carefully at the perhaps overly draconian way in which certain servants of the health service, and of Ministers, are pressing for reductions in the budget. They will be difficult to achieve in the short term, although I am assured that we can achieve them in the long term. The question of whether, given the problems that we face, Wakefield is badly underfunded by the formula is another issue, which I should like the Minister to reflect on in due course.

There are signs of new hope in the coalfield communities, given the beginnings of economic regeneration—fragile though that still is, I am sorry to say. The money that the Government have made available through the single regeneration budget and other special exercises is beginning to feed through into the coalfield communities. The Government's intention to tackle child poverty is a major step forward, as is the statutory minimum wage. All of those measures—which attempt to tackle inequalities, and in particular the most acute deprivation—are beginning to feed through and to bring some hope to our communities. However, those who, like me, live among mining communities that continue to collapse—in fact, they are imploding—would have to say that in some areas the hope of regeneration remains extremely fragile. I encourage the Government to do everything that they can to help with the regeneration of coalfield communities.

I know that the Deputy Prime Minister secured from the Chancellor a very large sum of money to help coalfield communities, which was made available to the Coalfields Regeneration Trust. The CRT understands the extent of the health problems in constituencies formerly based on coal mining, and I have discussed with its chief executive and officials on many occasions the problems that we face. The chief executive has said that, on the CRT's behalf, he would like to make a strategic intervention in the health of the Hemsworth constituency, which he acknowledges constitutes a particularly serious problem. In fact, he has described Hemsworth as a black hole that funding has yet to penetrate. The CRT has accepted that health should be one of its key ways of alleviating the problems in coalfield communities, but it has yet to find the possible solutions to some of the health problems that I briefly described.

On re-reading the Wanless report, it becomes clear that many of the factors that produce acute ill health, especially among manual workers and deprived communities, are susceptible to changes in behaviour. Smoking, obesity and lack of exercise are all factors that can be found in the communities that I represent. However, Wanless also says that a public health agenda always seems to come down to what we might loosely describe as the middle class. Often, it is the most deprived communities that are more resistant to the public health message and to changes in behaviour that might bring about some improvement in health conditions in the medium term. The Government need to be more imaginative in ensuring that their message is understood so that change can come about in deprived communities such as those that I described.

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I want to suggest a partial solution. Many of the people whom I represent have a particular interest in sport and exercise so, rather than trying to reach people through television advertisements or literature that they may not notice, we should use things in which they are interested as motivating factors. I am fascinated by the Department of Health's physical activity pilots. We are putting together an exciting and innovative pilot that will involve local general practitioners and the primary care trust. There will probably be between £60,000 and £70,000 from the private sector and a large amount has been promised by the Coalfields Regeneration Trust, as a strategic intervention.

We are still at the bidding stage. I realise that my hon. Friend the Minister has to treat all applications equally, but I hope that she will consider our application, which has several innovative features, and respond to it. Some of the best private sector practitioners are involved, spearheaded by the Fitness Industry Association, which has indicated that it will make available equipment and specialised coaching.

My vision is to create the partial regeneration of the health of the community by latching on to people's interest in sport and exercise. We already have some facilities, provided from lottery funding and supported by mainstream Government funding. They will be well used. We have some innovative general practitioners who are more than keen to work on physical activity pilots and the GP referral schemes, with which my hon. Friend is probably more familiar than I am. I encourage her to look into those schemes.

I wanted to draw the attention of the House to communities that were formerly powerful and strong and which created the wealth of this country through the coal mining industry. The country depended on such communities but they have been left derelict. I shall not go into the partisan reasons for that. Villages continue to die. People are still dying from the effects of the coal industry and from the deprivation in their communities. On average, people born in the UK may live for a shorter time than people in comparator countries, but the life expectancy of people born in Hemsworth is substantially less than average. As the MP for the area, I am sorry to have to say that.

We need to tackle the problems intelligently, rationally and urgently. I hope that my hon. Friend the Minister understands our problems and the depth of the health crisis that faces my constituency. I realise that she has a full diary, but I invite her to visit my constituency to look at our physical activity pilot and to tell us what she can do to help to alleviate the problems. Although it may be beyond her brief, will she ask her ministerial colleagues to consider the funding for Wakefield health authority? We are doing everything possible to correct the financial crisis; much effort and time is being devoted to solve that problem. However, I want the health services to be fully engaged in alleviating the health problems from which my communities suffer so badly.

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