UK Mortality Rates

Lord Patel Excerpts

Thursday 12th January 2023 Grand Committee

[Lord Patel (CB)]

My lords, I thank the noble Lord, Lord Sikka, for securing this debate and I welcome the Minister, the noble Lord, Lord Evans of Rainow, to the House and his ministerial role. I wish him well and look forward to his maiden speech. It is a tough ask to give a maiden speech and answer the questions raised, but I have no doubt that he will do it well. I am aware that, not only as an experienced parliamentarian but with his background, he is well aware of the human cost of social deprivation and the resulting health inequalities and mortality.

The subject of today’s debate is austerity and its subsequent effect on health inequalities, including mortality. I will focus more on the latter—the health inequalities—but I accept the conclusions of the observational study reported on the subject in the Journal of Epidemiology and Community Health.

It is 60 years since the Black report highlighted the association of deprivation and ill health. The Marmot reviews of 2010 and 2020, already mentioned by the right reverend Prelate the Bishop of London, spelled out in detail the health inequalities related to deprivation. Apart from the years from 1999 to 2009, no Government have tried to put in place policies to reduce health inequalities.

As already mentioned, deprived populations have lower life expectancies, spend many more years in ill-health, fewer years in good health, have a high incidence of long-term health conditions including cancers, and poor outlooks, not to mention an increased number of stillbirths and infant deaths. Health inequality means that the most deprived spend a significant part of their lives in misery. Government policies and major health events may exacerbate the situation, as I have no doubt that the current cost of living and NHS crisis will, but the root cause of health inequalities is social deprivation.

As inequalities are well characterised, the focus now should be on what interventions are effective and how they can be used. The perceived impression is that there is a lack of value placed on taking a long-term, whole-system approach to create a connected and cost-cutting policy and learning from previous approaches to reduce health inequalities. There is also an impression that the NHS is not given sufficient focus to reduce health inequalities. The message is that there is a lack of attention given to social determinants of inequality in current policy-making. The important question today should be: what plans and policies will the Government put in place to reduce health inequalities and therefore increase mortality in the deprived population?

I hope that the Minister can inform the House of the Government’s plans. The absence of NHS policies in the levelling up Bill is a missed opportunity to address the serious issue of health inequalities. We are told that there will be a disparity Bill, but when will that be? Perhaps the Minister can say. The increasing health inequalities will continue to drag the NHS down. The resulting ill-health will mean low productivity and less economic growth. The Government have suggested that a Cabinet-level forum will be established, and the Prime Minister has promised to tackle this issue. Therefore, I hope that we will soon have government policies to do so, although I fear maybe not.

There is an urgent need to develop cost-cutting policies that will affect positive change and take a long-term view, reflecting that success is predicated on leadership by government and action from a range of organisations, outside help and care systems. Will we see such a plan from the Government before next summer?