Health Inequalities

Kevin Barron Excerpts

Wednesday 20th March 2019 Westminster Hall

[Sir Kevin Barron (Rother Valley) (Lab)]

Thank you for calling me, Mr Hollobone. I am pleased to be here this afternoon and that the hon. Member for Telford (Lucy Allan) has brought up this matter of health inequalities. She mentioned the Health Committee of the previous Session. I chaired the Health Committee under the last Labour Government, which looked into health inequalities and found that there are great difficulties in moving on from that.

In 2010, the Marmot review on health inequalities was published. Since then, we have had legislation. I was on the Committee for the Health and Social Care Act 2012. I was really pleased that health inequalities and population health was a big issue, and it was put in statute that those things needed addressing. I am sad to say that I have not heard a murmur from Ministers since then in relation to reducing health inequalities.

As my hon. Friend the Member for Oldham East and Saddleworth (Debbie Abrahams) said, Sir Michael Marmot was a leader on this matter. He is now involved in the Institute of Health Equity, which, in September last year, released a fascinating publication. In conjunction with that publication, Sir Michael Marmot wrote on his blog about the complexity of health equalities, a point recognised by the hon. Member for Telford and my hon. Friend the Member for Oldham East and Saddleworth. Sir Michael Marmot wrote:

“There has been a contradiction at the heart of recommendations for action on health inequalities. No one is more concerned with health than those of us in the health sector. But the key determinants of health inequalities lie outside the health care system. It is not so much what doctors do, or don’t do, for patients that cause health inequalities, but the conditions in which people are born, grow, live, work and age.”

That is absolutely true. To be fair, the coalition Government tried to bring in legislation that would help people to recognise that, not only in the health service, but in the wider world.

The report published last September, “Reducing Health Inequalities Through New Models of Care: A Resource for New Care Models”, is really worth reading. Sometimes I despair when I hear Members of Parliament saying that we do not want new models or changes in the health service, because this is what happens and that is how it should be. In fact, the Institute of Health Equity provides some great guidance that we could all learn from, in terms of what should or should not be done.

One issue highlighted in that report is that the Public Services (Social Value) Act 2012 came into force in 2013, across the public sector. The report says:

“The Act states that for public bodies procuring service contracts over a certain threshold”—

both examples given are below £200,000—

“the authority must consider: ‘a) how what is being proposed to be procured might improve the economic, social and environmental wellbeing of the relevant area, and b) how, in conducting the process of procurement, it might act with a view to securing that improvement.’”

That is exciting, at one level. However, on the next page, regarding take-up of those considerations, the report states:

“Social value contracting is still relatively underdeveloped within the NHS, even though it is a legal requirement. Only 13 per cent of CCGs were able in recent research to evidence active use of the Act.”

Under those circumstances, it seems to me—it is not just the NHS, but the rest of the public sector—that we need to concentrate our minds, as a nation, on how we get through this issue. It is an issue not only of health, but of many other things.

The report talks about using

“social prescribing to create action on social determinants”.

The Minister—in her life before being elected—comes from close to the borough of Rotherham. Rotherham Social Prescribing service has won national awards for how it works with different communities. Voluntary Action Rotherham also works with different voluntary groups—not groups that deliver health services as such—to ensure that people get the help that they need now. Social prescribing, in my view, is a way to get away from the health service and into the wider communities, and it is an avenue that this House should encourage. I hope the Minister agrees with that.