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12 Feb 2003 : Column 1008—continued

9.4 pm

The Parliamentary Under-Secretary of State for Health (Ms Hazel Blears): I congratulate my hon. Friend the Member for Hemsworth (Jon Trickett) on securing the debate, and welcome the opportunity to respond to the points that he has made. He painted a graphic picture of the problems that his constituents face, and he is right to make us aware of them.

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Health inequalities are avoidable; they are fundamentally unfair and the whole Government are committed to tackling them. This matter is not just for the Department of Health; it involves everyone in the Government. It involves housing, transport, the environment, employment and all the issues that my hon. Friend highlighted. There are good personal, social and economic arguments for improving the nation's health. Good health is fundamental to communities. It is good that people in general are living longer since the advent of the national health service, but progress is not the same for everyone and there are still too many dramatic inequalities. The blunt truth is that in the Wakefield local authority area, life expectancy at birth is 74.6 years for men and 79.4 years for women—which does not compare well with Chelsea and Kensington and Dorset, where people enjoy much better life expectancies. Men and women in my hon. Friend's area live within the 20 per cent. of local authority areas where life expectancy is shortest.

Reducing health inequalities is a big challenge for any Government. We have not just described health inequalities; we have taken action and are determined to make a difference. Almost one of the first things that we did in government was to institute the Acheson inquiry into the extent of health inequalities and to gather evidence about their causes and the effectiveness of possible solutions and remedies in trying to close the enormous health inequalities gap.

Sir Donald found that inequalities in health status ranged across geographical areas, social class, gender and ethnicity—and that many of those differences had widened over the previous 20 years. Such a picture, he said, highlighted the need for the Government to act on a very broad front.

The findings of that inquiry have helped drive our work within the NHS and across government. Action on inequalities featured strongly in the NHS plan. In February 2001, we announced the first-ever national targets to reduce the health gap in life expectancy and infant mortality. We have tried to approach the problem right across government, looking at action on poverty, education, employment, housing, environment and transport.

My hon. Friend was right to highlight the biggest killers. There are inequalities in relation to cancer and coronary heart disease in terms of excess deaths and inequity of access to basic health services. We are trying to target specific help for key risk factors, launching the most ambitious programme ever to tackle smoking in the UK. Every primary care trust now offers world-class smoking cessation services. Since April 2001, nicotine replacement therapy has been available on prescription to help people to stop smoking. The cancer plan has ambitious targets to reduce smoking among manual groups from 32 to 26 per cent. by 2010, which will have a significant impact on excess deaths from cancer and coronary heart disease.

Diet is also important. The national school fruit scheme represents the most ambitious and dramatic programme to improve child nutrition since the second world war. By the end of July, 1 million children will receive a free piece of fruit each school day. The new

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opportunities fund will provide £42 million to scale up that scheme over the next two years, and from 2004 every four to six-year-old will be eligible for a free piece of fruit each school day. We are also beginning to trial free carrots and tomatoes, which I understand are going down extremely well in pilot areas. The five-a-day community pilot initiatives will try to improve affordability and access to fruit and vegetables, particularly in disadvantaged communities. That scheme will be supported by £10 million from the new opportunities fund over the next two years.

I know from a previous Adjournment debate and my hon. Friend's comments tonight that he has a real interest in exercise referral schemes. There is substantial evidence to support the role of physical activity in promoting good health. The LEAP programme, jointly funded by the Department of Health and national partners, aims at testing different evidence-based community approaches to increasing the numbers of adults and children in deprived areas who take regular, moderate-intensity physical activity. Some 36 primary care trusts have submitted formal bids to nine regional panels. My hon. Friend highlighted the bid from his area with the support of the Coalfields Regeneration Trust and other partners. Those bids are being examined and the nine successful pilots—one in each public health region—will be announced in early March. I certainly undertake to consider all the submissions carefully, including the scheme in my hon. Friend's area.

We must try to act nationally as well as locally when tackling health inequalities. The Government are doing a great deal, through the national minimum wage and the various tax credits, to increase family incomes and improve education. For example, the sure start programme gives children and young families a decent start in life, and the national strategy for neighbourhood renewal has regeneration programmes through single regeneration budgets. We also have the new deal for communities.

We have now had the cross-cutting spending review on health inequalities, with every Department lined up to tackle the problems together. Indeed, the spending review settlements are partly predicated on Departments' contribution to combating health inequalities. It will be interesting to see what each Department can do.

My hon. Friend will be aware that over the next three years the allocation made to Eastern Wakefield PCT will grow by more than 32 per cent. That is a significant level of investment and it should deliver real benefits and results. I know that the allocation still falls short of the target, but the significant investment will help to tackle the health inequalities that he mentioned.

The NHS in the Hemsworth area is part of a regional initiative to ensure that both the capital investment and revenue spending by the NHS achieves maximum value. That includes employing local people and procuring goods locally to regenerate the local economy at the same time as providing health services. That work is supported by the regional development agency, Yorkshire Forward. That innovative approach to spending NHS money will improve not only people's health but their chances of employment to bring hope back to the coalfield communities about which my hon. Friend spoke so eloquently.

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Through "Shifting the Balance of Power", we are trying to put the vast majority of the NHS's budget into the PCTs on the front line, so that they can do what is important to local communities. The Eastern Wakefield PCT, which covers my hon. Friend's constituency, has been very proactive in the area of public health and has a very good record. It works closely with the local strategic partnership. The Hemsworth Partnership has a range of initiatives, including a public health road show in November, which was attended by more than 1,000 people. The event focused on issues such as diet and exercise, smoking, sexual health, teenage pregnancy and domestic violence. Those issues are important to all my hon. Friend's constituents, and a similar road show is planned for this year to heighten awareness further.

The West End Project is involved in the regeneration of former pit houses and an environmental clean up of the area. My hon. Friend mentioned the problem of substance misuse in the area. I know that the Wakefield Accord is a mentoring, advice and employment service for people affected by substance misuse. The area also has GASPED, a support service for the parents of drug misusers—something that is not always at the forefront of provision. The outreach service known as the Hemsworth van goes out into communities to try to support people there. The health action zone has provided a good foundation for the whole prevention agenda, including the Hemsworth parenting project, the integrated family centre in South Elmsall, and the promoting positive health project, which is also based in Hemsworth.

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Much is being done, but it is clear that there is much more to do. My hon. Friend highlighted some deeply troubling statistics on coronary heart disease, cancer, mental health and suicide. I am happy to enter into further discussion with him to see how we can discover the underlying causes for those problems in his community. I am also more than happy to continue to work with him to support local people as they start to take control of the agenda and begin to feel more empowered in looking after their own health.

My hon. Friend mentioned the important issue of long-term chronic diseases in his area and the difference between the social classes. He will be interested in the expert patients programme, which helps people with chronic diseases to become experts in their own care and partners in improving their health. Ensuring that local people are in charge of that agenda is key to its success.

We are also pressing on with the improvement of primary care facilities, with the local improvement finance trust—or LIFT—project starting to refurbish primary care in areas such as Hemsworth. The personal medical service pilot scheme will also provide better GP services.

Tackling health inequalities is a long-term programme that is a top priority across government. Poorer people get sick more often and die sooner than the better off. It is as simple as that. We are determined to close the gap so that everyone, whatever their background or class, has the chance to live a longer and healthier life in the future.

Question put and agreed to.

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