Health and Social Care

Kevin Barron Excerpts

Tuesday 2nd June 2015 Commons Chamber

[Kevin Barron (Rother Valley) (Lab)]

I have to say to the hon. Member for North West Norfolk (Mr Bellingham) that I thought his speech was going well until the last few seconds, when he decided to weaponise it and attack the Opposition Front Bench. I will try to keep my remarks brief.

Looking forward, rather than back, the picture looks quite gloomy for healthcare in this country. The NHS’s “Five Year Forward View” stated that there would be a £30 billion annual hole in the NHS budget by 2020, so the £8 billion that the Government have promised will still leave a gap of £22 billion a year. Yet all we talk about here is ambulance waiting times and things like that.

We are going to have to look quite radically at healthcare in this country. All the experts say that the funding gap can be filled only if there is a radical upgrade in prevention and in public health. There should be much greater emphasis on prevention, with local authorities using their responsibility for public health and leading the way locally. Priorities include tackling obesity, reducing alcohol-related health problems and smoking, and increasing levels of physical activity. Otherwise, the Government will have to find even more money for the NHS. The “Five Year Forward View” stated that,

“the future health of millions of children, the sustainability of the NHS, and the economic prosperity of Britain all now depend on a radical upgrade in prevention and public health.”

I have to say that was lacking in the speeches we heard this afternoon.

I believe that key to that is the continuing need to drive down the prevalence of smoking in this country. Smoking currently costs the NHS at least £2 billion a year, and more than £1 billion in social care costs. Nationally, the total cost of smoking to society is currently nearly £13 billion a year. We have been more effective in reducing smoking than in any other prevention measure, and we know what works. Over the past decade smoking rates have declined from one in four to one in five of adults, and the rate has been even faster among young children. Between 2003 and 2013 there was a 70% reduction in smoking by young children—a phenomenal figure. However, more clearly needs to be done, because there are still 100,000 people dying of smoking-related diseases in the UK, and 20 times more smokers than that are suffering from smoking-related diseases: not just cancer and heart and lung disease; smoking can also cause infertility, diabetes and dementia. There are over 450,000 admissions to hospital every year due to smoking.

The clock is ticking on the tobacco control plan that was put in place, which expires at the end of this year. A new, more ambitious strategy for the next five years is needed to help fill the hole in national health expenditure. For a new strategy to work, it needs proper funding. The “stop smoking” services cost less than £100 million a year and, according to the National Institute for Health and Care Excellence, they are one of the most cost-effective treatments there is. Spending on mass media campaigns to help motivate smokers to quit and prevent young people from taking up smoking was only £25 million at its peak, and highly cost-effective. We are talking about spending millions of pounds to save billions.

Funding is the key. At a time when Government funding is being cut at national and local level, new sources need to be found. According to the Institute for Fiscal Studies, local authority spending per head has been cut by nearly 25% between 2010 and 2015, with the sharpest cuts to the poorest communities. We all know that smoking rates are highest among the most disadvantaged in society, so these are precisely the communities needing the greatest level of investment, yet it is being removed. Let me remind people of a speech I made a few months ago in this House, in February or thereabouts, when following cuts in local authorities the then coalition Government had had to put an extra £26 million of emergency payments into some local authorities because of the bed-blocking situation. They did not have money for social care, and our hospitals had beds full of people who had no clinical or medical reason to be in hospital but were there because the cuts in local authorities had caused problems in those areas.

The tobacco industry, of course, still continues to do quite well. In this country alone, it makes profits of over £1 billion a year. Its deadly product may be legal but is also lethal to 50% of people who use it. In last year’s autumn statement, the Chancellor said:

“Smoking imposes costs on society and the Government believe that it is therefore fair to ask the tobacco industry to make a greater contribution.”

However, it has all gone ominously quiet since then. In the March 2015 Budget, all the Chancellor said on the tobacco levy was that he was continuing to consult. That is not good enough. If the Government are to succeed in the radical upgrade in prevention and public health necessary to save the NHS, it is essential that we have a new and even more ambitious tobacco control plan for England launched by the end of this year, and it should be paid for by a levy on the tobacco industries’ profits.