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Mr. Charles Walker (Broxbourne) (Con): The Minister is being very generous in giving away again, but does she agree that mental health is one of the greatest areas of inequality? The high-profile areas such as heart disease and cancer get a lot of coverage and support, but mental health is almost forgotten and seems to lag behind. What message will she give me to take back to my charities in Waltham Cross and Cheshunt concerning the support that the Government will give to help them deliver services that are critically important?

Caroline Flint: The hon. Gentleman makes the very valid point that people who suffer from mental health
 
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problems often have other health problems that need to be attended to. They deserve to be focused on as much as anyone else in the health agenda, in terms both of prevention and of the provision of better services to meet their needs. However, we must ensure that other service providers—of housing, employment, education and so on—look hard at the different challenges that different groups face. As was mentioned in the debate the other week, people with mental health problems should certainly be able to feel that they have a right to be heard by those who provide other services.

Rosie Cooper (West Lancashire) (Lab): I agree with the hon. Member for Broxbourne (Mr. Walker) that some groups are denied access, with a resulting increase in health inequality. My example, which is analogous to the mental health example, is disability. My parents are deaf and from the age of four I used to do all the interpreting at any medical consultation that they had. The Government have done a tremendous job in tackling health inequalities—[Interruption.]

Mr. Deputy Speaker: Order. The hon. Lady is making a legitimate intervention. Perhaps she can make her point quickly.

Rosie Cooper: Thank you, Mr. Deputy Speaker. My point was that providing interpreting services or enabling teletext subtitle services on televisions help to get people such as my parents into hospital. My dad needed treatment, but when I arrived four hours later he was dressed to go home because he was bored and could not talk to anybody.

Caroline Flint: My hon. Friend makes an excellent point, sharing the experience of her parents who had hearing problems. When we identify services and needs, it is important that we engage with people such as my hon. Friend's parents to talk about their needs, instead of just assuming that we know best, we will provide something and patients will have to lump it. That is not what people want from their health service. If handled properly and correctly, such engagement will provide savings, as well as better health outcomes. If we do not do that early, we could be storing up an expensive problem for later down the line.

I have been frank about the fact that there is more to be done in tackling health inequalities. We have set ourselves a challenging agenda, but we are committed to delivering it so that every citizen, regardless of where they live, their social class, ethnic group, disability, or any other challenge that they face as individuals, can expect the same opportunities for—even if they may be delivered in different ways according to their needs—and expectations of, good health.

3.32 pm

Mr. Andrew Lansley (South Cambridgeshire) (Con): I am glad to have the opportunity to follow the Minister and contribute to this debate. I thank the Government for making time available for it. It may be at the periphery of parliamentary time, but it is on the Floor of the House and we appreciate that. I am not sure how long it has been since the subject of tackling health
 
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inequalities has been debated. The Minister did not say that it was the Government's intention to have regular debates on the issue, but I hope that it is. It is certainly one of the priorities that my right hon. Friend the Member for Witney (Mr. Cameron) set out for us at the beginning of the year.

It was the Government's intention to publish an annual status report on health inequalities, but the first report took two years. They said in July 2003 that the Department of Health would publish an annual report on health inequality indicators, related to the health inequality targets. The first was published in August 2005. A letter in the British Medical Journal in September described its publication as Labour's Black report moment, because it had been buried in the middle of August. Why did they do that? For the same reason that the Minister did not give the figures when I invited her to tell us the changes in the two national targets identified by the Government for measuring health inequalities. I do not see why not, because as she explained, the point of national targets is to focus people's attention on them, so it does not make much sense to publish them at a time when people will not notice them. Equally, if they are going in the wrong direction, the Government should be rigorous about what they will do to deal with that.

The figures are straightforward. The relative gap in life expectancy for men has increased by nearly 2 per cent. and for women by 5 per cent. The latest figures on infant mortality confirm the previously reported trend. Despite overall improvements, the relative gap between the routine and manual groups and the population as a whole has widened over recent years, since the target baseline. The overall infant mortality rate was five deaths per thousand live births, while the rate for those in routine and manual groups was six per thousand. In 2001 to 2003, the infant mortality rate in the latter group was 19 per cent. higher than in the total population; it was 16 per cent. higher in 2000 to 2002 and 13 per cent. higher in the baseline period, so the relative gap has widened—from 13 to 19 per cent.

The Minister said that it was important to look at the finer detail, but the detail she referred to showed things going in the right direction. However, the infant mortality rate among sole registrations—births registered only by the mother—rose to 7.4 per thousand live births, compared with 6.6 per cent. in 2002. In 2003, the mortality rate in the routine and manual social group rose to 6.1 per thousand, compared with 5.8 in 2002—an absolute rather than a relative rise in that one-year period.

Mr. Graham Stuart: Have not the Government failed to deal with health inequalities and is not that why they did not meet their promises? Does my hon. Friend agree that the Minister should tell the House that that will not happen again? If the Minister's top NHS priority truly is to tackle the appalling gap between the poorest and the better-off in our society, she must set targets and meet them, and report to the House not annually but every six months. That is what she should do, rather than giving us waffle and rhetoric, while people at the bottom of our society are all too often let down by the Government.

Mr. Lansley: I am grateful to my hon. Friend. In a nutshell, the burden of what I wanted to say is that, if
 
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one is to deal with health inequalities, it is vital to focus on the relative gap between the most and least healthy, and between the richest and the poorest. It is not good enough to elide aggregate progress and relative failure. For example, the Minister—as Ministers always do—talked about the absolute reductions in mortality from cancer and coronary heart disease, on a trend that I am sure she will not deny was pretty well established in the latter part of the 1970s for coronary heart disease and the early 1980s for cancer.

The point is that in all such trends we need to look at mortality rates and find the real inequalities. We may be making considerable progress on cancer treatments, but the relative gap may be widening. At the same time, there are many deaths from lung disease, which the Minister did not mention. The British Thoracic Society tells us:

Social inequality in respect of the incidence of respiratory disease is much greater than that in respect of cancers. There is a gap. Eight times more deaths—3,800—are caused by respiratory disease as a result of social inequalities compared with the impact of such inequalities on coronary heart disease, which results in 500 deaths. The Minister did not mention this, but if people are talking about relative mortality rates and the things that bear on them to the greatest extent, they spend more time referring to lung disease than to cancers and coronary heart disease respectively.

Mr. Kevan Jones (North Durham) (Lab): I am impressed by the hon. Gentleman's conversion and that of the right hon. Member for Witney (Mr. Cameron) to noting the policy importance of this issue—something that has been ignored in the past. If he and the right hon. Gentleman are so committed to tackling this issue, will he support the extra funding that the Government have put into doing so? Will he also support directing extra funds to places such as North Durham and Easington in County Durham, which have some of the greatest problems with health inequalities? Would a Conservative Government support us if other hon. Members and I asked for extra money to go there, rather than to the leafy suburbs that many Conservative Members represent?


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