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Several hon. Members rose—

Mr. Deputy Speaker (Sir Alan Haselhurst): Order. Front Benchers have taken some 107 minutes of the total 186 minutes available for the debate. Seven hon. Members are seeking to catch my eye, which works out at a non-enforceable tariff of between seven and eight minutes each. I say that just for guidance.

4.46 pm

Ms Diana R. Johnson (Kingston upon Hull, North) (Lab): I was fortunate enough last week to speak in the mental health debate and, listening to the debate today, I believe that the focus on public health and mental health has taken a step forward since 1997. For my constituency, public health is one of the key issues that we need to get right.

The hon. Member for South Cambridgeshire (Mr. Lansley) mentioned behaviour and I have an example in my constituency. When Hull city council meets, it has a tea break at about 4 o'clock, at which it used to serve tea and cream scones. The portfolio holder for health decided that it would be better to provide apples and a bowl of nourishing soup. As hon. Members can imagine, that decision caused uproar at the time, but it sent a clear message. We are trying to promote healthy eating habits in Hull and the change sent a very positive message. I pay tribute to Councillor Glew who is battling hard in Hull to put public health at the top of the agenda.

Hull is ranked ninth out of 354 local authorities and districts in England in terms of deprivation. It is surrounded by the East Riding local authority, which is ranked 208th. I wish to compare some of the acute health statistics and show the difference with what is happening in my area. Hull has major health risks, with a high prevalence of smoking, a high consumption of alcohol and a bad diet. Those lead to high rates of coronary heart disease, diabetes and cancer.

I wish to make four points. I want to discuss Hull's health statistics; Hull and East Riding, and the unfairness in the funding available; what is happening in Hull now; and the positive and good aspects of what has been done since 1997. As I mentioned earlier, the local authority and the two primary care trusts in my area have a joint director of public health in Dr. Wendy Richardson, who is doing a sterling job. She has just published her annual report for 2005, in which she compares the life expectancy of men and women living in Hull and in Hambleton and Richmondshire, a rural area of north Yorkshire. She found that life expectancy for a man in Hull was 4.1 years less than for a man living
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in that north Yorkshire patch, just an hour up the road by car, while life expectancy for a woman in Hull was 2.6 years less. The mortality rate for Hull is 120, on a UK average of 100, which means that our rate is 20 per cent. higher than in the rest of the country. In Hambleton and Richmondshire, the rate is 89, 11 per cent. below the average.

I was delighted that this week we took the bold step of banning smoking in all enclosed public places. In the most deprived wards of my constituency, about 50 per cent. of people smoke, when the national average is about 26 per cent., so smoking is a real public health issue in Hull. Smokers are likely to live seven years less than non-smokers. As we have heard, Liverpool is trying to promote itself as a smoke-free city, as is Hull, so it is an enormous boost for a majority of Members to say that getting rid of smoking in public places is absolutely the right thing to do.

Coronary heart disease in Hull is about 50 per cent. higher than in the rest of England, so I contacted the two PCTs in my area to ask them about acute care for people suffering from that disease. Compared with Hull, East Riding has a higher percentage of people aged 65 or over, but Hull has higher rates of deprivation, so after taking age into account one would expect mortality from coronary heart disease, as well as rates of treatment, to be considerably higher in Hull. Deaths from CHD are much higher in Hull, across all age groups and both genders, compared with East Riding. However, after taking age and gender into consideration, the rate of treatment for CHD is slightly lower for males and much lower for females in Hull, which is shocking.

Similarly, the number of hip replacements, after taking into account age and gender, is more than a quarter more for males in East Riding than it is in Hull. For females, the difference is even more dramatic: there are almost twice as many hip replacements—91 per cent. more—for females in East Riding, a much more prosperous area.

Given the health profile of my constituency and the health needs of my constituents, those figures show that something is not right: there are health inequalities. People who live in East Riding may be more able and willing to visit their GPs, state their needs and demand treatment, whereas perhaps people in Hull do not have the same background and cannot stand up for themselves and say what they need, but the contrast is stark in terms of health inequalities.

The PCTs in east and west Hull will break even in the current financial year, which is a tribute to the hard work of their chief executives, chairs and boards. However, the PCT that covers East Riding is massively overspent, so the strategic health authority has asked Hull PCTs to provide funding to meet its problems. Again, when we desperately want to put money into Hull and ensure that health inequalities are reduced, we must give money to a much more affluent, much healthier area to meet the mismanagement of health service finance there, and I am very concerned and upset about that.

For the coming financial year, the SHA has already indicated that the PCTs in Hull must top-slice about £7.5 million, so that it can be put into the SHA's funds. That is intended to cover the problems of the
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East Riding and other PCTs in the area. The Labour Government need to get to grips with the mismanagement of those PCTs that are not providing the best financial management that they need. We need to ensure that the turnaround teams that are going into PCTs make the fundamental, structural changes to ensure that the PCTs meet their financial commitments and do not overspend. Despite that, Hull has a proud record in tackling public health problems.

We have a spearhead PCT. I am proud that we have led the way with health trainers. Parents have become involved in Sure Start, which provides what is almost a buddy method of operating with young parents that has worked very well, and I understand that health trainers will do so too. They will get alongside people from their own communities and offer them expert advice and guidance about improving health. I mentioned earlier that we have a joint director of public health. That is a positive step.

Our local authority has led the way on the eat well, do well proposals, whereby our young people in primary schools receive free, healthy school meals. They also receive fruit at break time. There is a real commitment to instil in our young people the need to eat healthily from a young age. We have also had initiatives such as free swimming for children to get them to exercise and to maintain that throughout their lives. Of course, Hull is lucky that it is a flat city, so people can cycle around it easily. We have one of the highest numbers of people cycling to work in the country.

Excellent work is also going on in our teenage pregnancy unit. Gail Teasdale, in particular, has led the way in making that a positive way to get to grips with some of the deep-seated reasons why women choose to have children at a very early age. Our PCTs' smoking cessation rates are getting much better.

I also pay tribute to the vibrant voluntary sector that we have in Hull. It is doing a lot of work with the health community. In particular, the Age Concern building in Hull has a healthy living centre to encourage healthy lifestyles among our older population. It has a gym for the over-60s and it is an eye-opener to go in there and see people who are well beyond 60 on their exercise bikes and the treadmill. That is the kind of vibrant voluntary sector organisation that we want to promote and work with.

We have the gateway housing market renewal pathfinder in Hull, which is all about trying to get to grips with some of the deep-seated problems of poor health and ensuring that we have decent housing for everyone. Of course, I have mentioned Sure Start, but it has a really important role to play in making those early interventions and ensuring that young families and children get the very best start in life.

All hon. Members recognise that we cannot just leave this to the NHS. We must make a joint effort with local authorities, parents, families and the voluntary sector. We must have the money that has been properly allocated, especially in Hull, and I explained why we are not getting that at the moment. Of course, we are allocated a little more money at the beginning because of our health needs, but we do not get the full amount because of what happens elsewhere. We took a bold step this week. Let us carry on being bold in tackling health inequalities, thus ensuring that the health inequality gap narrows for the next generation.
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4.58 pm

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