Mental Health

Rushanara Ali Excerpts

Wednesday 9th December 2015 Commons Chamber

[Rushanara Ali (Bethnal Green and Bow) (Lab)]

The Secretary of State talks about the pressures on children. One in five children is in need of treatment and is being turned away, including from A&E. There is a real crisis in service provision, with £200 million reduced from the mental health budget. As he reflects on how big a challenge this is, does he not think his Government’s response is completely inadequate? That is not good enough, despite the good efforts being made. He needs to step up and improve the situation, particularly for young people.

[Mr Hunt]

I accept that we need to improve the provision of mental health services for children, but I do not accept the hon. Lady’s characterisation. She will know that in the final Budget before the general election, the previous coalition Government committed £1.25 billion over this Parliament to improving child mental health provision and perinatal mental health support. That has been honoured by this Government, and we are in the process of working out how to roll that out. It is something that the Minister for Community and Social Care, my right hon. Friend the Member for North East Bedfordshire (Alistair Burt), spends a lot of time thinking about.

Before we discuss precisely what things need to happen—I think they should be done in a bipartisan spirit—we should recognise that really important progress has been made in recent years. I want to start with some of the achievements made by the previous Labour Government, who increased funding for the NHS and, within that, for mental health services. They oversaw a significant expansion of the mental health workforce and big improvements in in-patient care, with 70% of mental health patients being seen in private rooms. They increased the use of new drugs and therapies, including psychotherapy. Those were important steps forward.

Under the coalition Government in the previous Parliament, we saw a record investment of £11.7 billion in mental health services at a time of huge pressure on public finances. We passed the parity of esteem clause in the Health and Social Care Act 2012, something we Conservative Members are incredibly proud of. The first access targets were set for talking therapies for psychosis. We are starting to end the distortion that the right hon. Member for North Norfolk talked about, which saw targets for physical health access sucking resources away from local mental health provision over a sustained period.

We have seen particular progress in two areas. It is important to mention them; it provides encouragement that when we decide to focus on improving specific areas of mental health provision, we can make real progress. First, on talking therapies, the NHS is now recognised as a world leader. The number of people getting help from talking therapies quadrupled from 182,000 people starting treatment in 2009-10, to 800,000 starting treatment last year. The total number of people helped in the previous Parliament was 3 million, compared with just 226,000 people helped in the Parliament before that—a thirteenfold increase.

We are hitting the new access target to reach 15% of those needing it, although we are not quite hitting the recovery target; I hope we can put that right soon. That model is being looked at very closely by Scandinavian countries, and a pilot, based on what we have done here, is starting in Stockholm. We can be very proud of that important progress.

The last Parliament saw a 50% increase in dementia diagnosis rates, up from 41% at the start of the Parliament to 67% at the end of the Parliament—the highest dementia diagnosis rate in the world. We have 1.3 million dementia friends and 120 dementia-friendly communities. We have seen a doubling in funding for dementia research, with a new ambition to find a cure or disease-modifying therapy by 2025. In the spending round, the Prime Minister announced funding for a new dementia research institute; that will be another important step forward.

Oral Answers to Questions

Rushanara Ali Excerpts

Tuesday 13th October 2015 Commons Chamber

[Ruth Cadbury (Brentford and Isleworth) (Lab)]

2. How much additional investment there will be in children and young people’s mental health services in 2015-16.

[Rushanara Ali (Bethnal Green and Bow) (Lab)]

5. How much additional investment there will be in children and young people’s mental health services in 2015-16.

[Bill Esterson (Sefton Central) (Lab)]

7. How much additional investment there will be in children and young people’s mental health services in 2015-16.

--- Later in debate ---

[Alistair Burt]

No. I take the hon. Lady’s point, but we are committed to spending £1.25 billion over the Parliament. We will not be able to spend the £250 million this year, but it will be included in future years. The reason is that we have to make sure it is effectively and properly spent and it is a phased programme. She will be delighted to know that in her constituency there will be an extra £536,000 for children’s mental health services.

[Rushanara Ali]

The organisation YoungMinds found that one in five mental health trusts had had to freeze or cut budgets every year in the last Parliament, and at the moment 40,000 young people are being refused mental health treatment. What guarantees can the Minister give that the money promised by the Chancellor recently will actually be made available and that trusts will not continue to cut mental health budgets?

[Alistair Burt]

The hon. Lady makes a fair point. While we invest money nationally in services, people complain that locally clinical commissioning groups have not been funnelling the money down. Two things should help: first, for the first time the national access and working time targets, which the Government have introduced, will provide a means of monitoring what CCGs are doing; and, secondly, the new scorecard for CCGs will look explicitly to ensure that a proportion of the increase to a CCG goes into mental health services. The hon. Lady will also be pleased to know that in her own CCG area there will be an extra £521,000 for children’s mental health services.

Oral Answers to Questions

Rushanara Ali Excerpts

Tuesday 15th July 2014 Commons Chamber

[The Parliamentary Under-Secretary of State for Health (Jane Ellison)]

My hon. Friend is right to suggest that we want to drive consistency across the country, and NHS England is taking great notice of the cancer patient experience survey in a number of areas of cancer care. It has been a real driver of change where it has identified variation. I am sure he will welcome the fact that the overall range of variation for many indicators relating to prostate cancer has narrowed. None the less, we want to see NHS England working with NHS Improving Quality—NHS IQ—and others to ensure that struggling organisations are brought up to the standards of the best. The survey is a good way of driving that.

[Rushanara Ali (Bethnal Green and Bow) (Lab)]

T3. Since 2010, the percentage of patients who say that they can see their GP within 48 hours has halved from 80% to 40%. Given the pressure on the NHS, and especially on accident and emergency services, will the Secretary of State explain why the Government’s reforms are threatening to close 98 surgeries around the country, including five in Tower Hamlets? Will he publish the full list today?

[Mr Jeremy Hunt]

Let me gently explain to the hon. Lady that she has excellent GP provision in Tower Hamlets, led by Dr Sam Everington. It is a model of what can happen under the Government’s reforms. The way in which we are going to make it easier for people to see their GP is with additional capacity. We have 1,000 more GPs during this Parliament, and we have achieved that only because we took the difficult decision to get rid of 19,000 managers, which was bitterly opposed by the hon. Lady and the Labour party.

GP Services (Tower Hamlets)

Rushanara Ali Excerpts

Tuesday 13th May 2014 Westminster Hall

[Jim Fitzpatrick (Poplar and Limehouse) (Lab)]

It is a pleasure to see you in the Chair this afternoon, Mr Streeter. I am grateful to Mr Speaker for affording me the opportunity to hold this debate, to the Minister for being here to listen and respond and to my parliamentary neighbour, my hon. Friend the Member for Bethnal Green and Bow (Rushanara Ali), for taking an interest and supporting the debate.

My remarks are designed to defend Tower Hamlets GP services. I am a great admirer of all that they have achieved, especially over the past 15 years. I called for this debate for three reasons. The first is to find out more about the nature of the problem facing GP services in Tower Hamlets. The second is to determine whether the Government accept that there is a problem. The third is, hopefully, to identify a solution.

The picture is confused and many aspects must be considered, but the real concern is that primary care budgets are being cut, and not only in Tower Hamlets. In response to my written question about average annual changes to GP income in Tower Hamlets, the Minister stated that there would be

“a decrease of £184,000 spread across 21 GMS practices.”—[Official Report, 6 May 2014; Vol. 580, c. 126W.]

However, The Guardian has reported that the Jubilee Street practice alone

“will be down £77,263 by the end of 2014-15”

and that it had “already lost £30,000 QOF”—quality and outcomes framework—

“income last year and will lose its £219,508 a year MPIG allocation incrementally over the next seven years—the accumulated loss due to MPIG alone amounting to over £903,000.”

The figures do not add up.

[Rushanara Ali (Bethnal Green and Bow) (Lab)]

As well as the Jubilee Street surgery, four other practices in Tower Hamlets are reported to be part of the 98 surgeries facing closure, but we do not know where they are. Will the Minister commit to publish a list of those surgeries and to place that list in the House of Commons Library?

[Jim Fitzpatrick]

I am grateful to my hon. Friend for asking the Minister that question and look forward to his response.

The Jubilee Street and St Katharine Docks practices are the two main affected surgeries in my constituency. They are professional, efficient and well-loved and respected by patients. Jubilee Street says that if its proposals to solve the dilemma are not addressed and no agreement is reached, it will have to give notice of closure by October this year.

Today, I accompanied my right hon. Friend the Member for Leigh (Andy Burnham) and my hon. Friend the Member for Leicester West (Liz Kendall), my colleagues in the shadow health team, on a visit to Jubilee Street to see first hand the problem. At the same time, we launched Labour’s NHS pledge on GP appointments within 48 hours, which I am sure the Minister has noted. What is causing the problem? I will be grateful for the Minister’s views. Is it the shift from deprivation indices to age in the new allocation funding formula from 2012? Is it the elimination of a percentage of the QOF indicators? Is it the seven-year phase out of the minimum income practice guarantee?

--- Later in debate ---

[Jim Fitzpatrick]

I had just asked the Minister three questions relating to what he thinks might be causing the problems confronting our GP practices. The fourth is whether it is because of the range of different contracts negotiated over the past decade, awarding different levels of funding for numbers of patients to different practices; and the fifth is whether it is because there is a shift of funding away from primary care, and, if so, where the money is going. Some 90% of NHS contact with patients is through primary care, but it receives less than 10% of the NHS spend, a point I will come back to later.

I would also be grateful if the Minister indicated who makes the decisions. Practices, in discussion with the local clinical commissioning group and NHS England, have been unable to identify exactly who determines the funding levels. Obviously, it is NHS England that implements ministerial policy, which is why I have an outstanding request to speak to the Minister responsible, who I understand is the noble Earl Howe. I have briefly mentioned that request to the Minister, who kindly said that he would pass on the message and reinforce the request that we have made directly to his office. I would like to have that meeting, and would be accompanied by clinicians and practice managers from Tower Hamlets to put the case.

Tower Hamlets primary care has much to be proud of in the past 15 years; at one point it was the fastest improving primary care trust in the UK. Practices such as Jubilee Street have cupboards full of awards. When I was first elected in 1997, complaints about NHS services and GP practices were numerous and regular, but they disappeared due to the investment by the Labour Government over many years and the dedication and professionalism of clinicians and staff in primary and secondary care.

My own GP practice in Ettrick street on the Aberfeldy estate in E14 is a great example of that first-class service and improvement; I thought that I had better mention it, because if the staff there knew that I was complimenting other practices but left out Dr Phillip Bennett-Richards, Dr Sarah Pitkanen and their colleagues, they would be mightily disappointed.

The local worry is that all that is about to change. Not only have Labour stalwarts such as London assembly member John Biggs—our mayoral candidate—and Councillor Rachael Saunders been on the issue, but local Conservative councillors have been expressing concerns, so the issue is not party political in that sense. I attended a meeting last week at the Mile End hospital with nearly 100 people and many GPs in attendance. I have had numerous e-mails from constituents concerned about what is going on, and I know that my hon. Friend the Member for Bethnal Green and Bow has, too. There are petitions with hundreds and hundreds of signatures springing up all over Tower Hamlets.

All that is against the background of increased pressure. The British Medical Association has said:

“It is estimated that 340 million consultations are undertaken every year. This is up 40 million since 2008.”

As I mentioned, it also said:

“Over 90% of all contacts with the NHS occur in general practice.”

The then-chair of the Royal College of General Practitioners, Dr Clare Gerada, called for

“an urgent increase in general practice’s share of the NHS budget from 9% to 10% so that 10,000 more GPs could be hired, in order to make GPs’ work loads sustainable.”

[Rushanara Ali]

Does my hon. Friend agree that, in a borough such as Tower Hamlets, with high levels of health inequalities, the fact that people cannot get GP appointments for days on end is scandalous? It will devastate people’s lives further and actually cost more, particularly by putting pressure on accident and emergency services while we are having an A and E crisis.

[Jim Fitzpatrick]

I agree entirely with my hon. Friend, and I am sure that the Minister also agrees that if we can treat people in general practice and prevent them from going to A and E, that is a much more efficient use of NHS resources. Her point is valid.

The House of Commons Library has produced for me a table of data on GP funding, which

“shows a shift on the share of funding for general practice from 10% in 2005-06 to 8.3% in 2012-13. The real terms change in spending over the past three years shows a fall of £432 million”.

At the same time, there has been an equivalent

“annual percentage decrease of 2.1% per year”

in GPs’ salaries through the same period.

So there we have it. There has been a 40 million increase in appointments but cuts in the share of the NHS budget; a significant real-terms fall in salaries; huge variation in funding at local level; and crises affecting many local practices in my constituency—some looking at closure, which would be a disaster for some of the most vulnerable people in our country.

I want not just to return to the Jubilee Street practice but to take the issue wider. The NHS deputy head of primary care for north central and east London, Rylla Baker, recently wrote:

“The situation has, unfortunately, developed further and we met with the Jubilee street practice earlier this week. Although the situation with the loss of MPIG”—

the minimum practice income guarantee—

“is, for most practices manageable, when the practices take into account other changes in funding that impact on them, the cumulative impact is significantly greater and practices such as Jubilee Street have said that if there is no mitigation against the loss the practice will not be viable… I have copied in Neil Roberts, Head of Primary Care for North Central and East London and Jane Milligan from the CCG as discussions are ongoing about the best way forward. It is also relevant to point out that this is an issue that is not limited to Tower Hamlets.”

We are hearing of numbers of practices in Hackney and Newham, two other impoverished boroughs, that are facing similar problems.

The Royal College of General Practitioners has said:

“In total, the phasing out of a key NHS funding stream called the Minimum Practice Income Guarantee…could affect a total 1,700 practices with the care of 12.2 m patients potentially under serious threat.”

I know that the Minister is deputising for his colleague Earl Howe—that is why I would like a face-to-face meeting with Earl Howe, or indeed with the Secretary of State—but I am keen to hear his response to the points I have raised. I am sure he has some information and data for us.

In Tower Hamlets, we have some of the poorest and most vulnerable people in the United Kingdom. There is the lowest life expectancy, on average, of anywhere in the UK. It is estimated that between 10% and 12% of residents are not registered on GP lists. Now, this crisis is coming to a head. I look forward to the Minister’s response, but I look forward more to a proper meeting with Earl Howe or with the Secretary of State, and I look forward most to arriving at a solution for the patients, the staff and the clinicians, so that we can protect and continue to provide first-class primary care services in Tower Hamlets.

Oral Answers to Questions

Rushanara Ali Excerpts

Tuesday 1st April 2014 Commons Chamber

[Jane Ellison]

That is one of the points people from the HeadSmart campaign raised when I met them, and of course I am happy to draw the attention of colleagues in the Department for Education to the hon. Lady’s concerns and make them aware of this exchange.

[Rushanara Ali (Bethnal Green and Bow) (Lab)]

7. What estimate he has made of the number of patients who have waited for more than four hours in accident and emergency departments in 2013-14 to date

[The Parliamentary Under-Secretary of State for Health (Jane Ellison)]

Despite 1.2 million more A and E attendances in England, nearly 96% of patients have been seen, treated, transferred and discharged within four hours of arrival at A and E. That excellent level of service is a credit to the hard work of front-line NHS staff across the whole NHS, and I am sure the whole House would want to thank them for that.

[Rushanara Ali]

I am disappointed that the Minister has not bothered to answer the question. I will answer it for her: nearly 1 million patients have had to wait for longer than four hours in A and E over the past 12 months —it is one of the worst figures in a decade. Will she and her Government get a grip and sort this out?

[Jane Ellison]

I did answer the question—I told the hon. Lady exactly how the NHS was performing. I have to say that Government Members slightly despair at the constant churlishness of Opposition Members who try to talk down the NHS and talk up a crisis. They are trying to talk the situation into fitting the rhetoric, but the NHS has performed really well this winter and many more people have been seen within the target. The average waiting time for someone to be seen is actually 30 minutes. The NHS has done well and she should join us in congratulating it on that.

Oral Answers to Questions

Rushanara Ali Excerpts

Tuesday 25th February 2014 Commons Chamber

[Mr Hunt]

It is intriguing that the shadow Secretary of State has chosen not to talk about a winter crisis, because it has not happened, despite the fact that he predicted it time after time. Let me tell him what was cavalier: the previous Labour Government’s refusal to give patients a right to opt out of giving their data to this programme, even though it was going on for their whole time in office. We believe that we should have a data revolution, but to do that we need to carry the public with us, which is why we need to have this important debate and give people the reassurance they deserve.

[Rushanara Ali (Bethnal Green and Bow) (Lab)]

6. What recent assessment he has made of the number of available mental health crisis beds for young people in England.

[Ms Karen Buck (Westminster North) (Lab)]

14. What recent assessment he has made of the number of available mental health crisis beds for young people in England.

[The Minister of State, Department of Health (Norman Lamb)]

NHS England has a rapid review under way to identify commissioning solutions to pressures on specialist beds for children and young people. It inherited varied provision across regions and a lack of capacity in some parts of the country for particular need. For the first time, available beds are monitored weekly, and small increases in capacity have already been secured.

[Rushanara Ali]

I thank the Minister for that answer, but 1,500 mental health beds have closed since 2011, which is causing a wider crisis, and a recent Care Quality Commission report found that, in one area over the previous year, 41 children had been detained in police cells because health-based places of safety were either not available or not staffed—and one of those children was 11 years old. How can that be acceptable?

[Norman Lamb]

The reduction in the number of mental health beds has been a long-term trend—it happened under the previous Labour Government—and rightly so, because we have to move away from institutional care. However, crisis beds must always be available. I completely agree that it is intolerable for children to end up in police cells, but that is not new; it has happened for many years and did not start in 2010. When we talk about parity of esteem, we mean it. There must be absolute equality between the ways in which mental and physical health are treated. Last week we launched a crisis care concordat to ensure that children do not end up in police cells.

Oral Answers to Questions

Rushanara Ali Excerpts

Tuesday 12th June 2012 Commons Chamber

[Alex Cunningham (Stockton North) (Lab)]

2. What the cost to the public purse was of NHS staff redundancies in 2011-12.

[Rushanara Ali (Bethnal Green and Bow) (Lab)]

3. What the cost to the public purse was of NHS staff redundancies in 2011-12.

[The Minister of State, Department of Health (Mr Simon Burns)]

Audited 2011-12 figures on NHS exit packages, including redundancies, are not yet available. The data will be available in the summer, once the Department’s annual report and accounts are laid before Parliament.

[Mr Burns]

No, of course I will not. What the hon. Gentleman fails to recognise is that the NHS must continually evolve to meet challenges and that this is the best chance the NHS has to improve and drive up standards. What he fails to mention in his question is that the £1.2 billion to £1.3 billion cost of the reform will lead, between now and the next election, to £4.5 billion of savings, £1.5 billion every year thereafter until 2020, and every single penny of that money will be reinvested in front-line services.

[Rushanara Ali]

We already know that this Government spent more than £168 million nationally making NHS staff redundant over 2010 and 2011, and more than £3.8 million in Tower Hamlets, where my constituency is based. Can the Minister tell the House how many of those staff were re-hired in the new system?

[Mr Burns]

Yes, there have been redundancies in the NHS, but 15,500 managers and administrators have ceased to work in the NHS, where the savings are reinvested in front-line services. There are also 4,161 extra doctors, 934 more midwives and 151 more health visitors. That is where we are concentrating the money—more front-line staff, fewer administrators.

Health and Social Care Bill

Rushanara Ali Excerpts

Tuesday 13th March 2012 Commons Chamber

[Rushanara Ali (Bethnal Green and Bow) (Lab)]

I welcome today’s motion on the Health and Social Care Bill, because I know how precious the NHS is. We must do everything possible to protect it. I am proud of the fact that the Labour party founded the NHS. In 1997, when we took over from the previous Government, we had to rebuild a health service that was under-invested in and turn it into a world-class health service, which is what it is today. We reduced waiting times and invested in creating a health care system that delivered for patients. On our watch, there were 33,000 fewer deaths from heart disease each year, and we achieved the highest ever level of patient satisfaction. In my constituency we have seen real improvements locally and real successes in Tower Hamlets, with the highest childhood vaccination rates in London, improved health for those with chronic diseases such as diabetes, and reduced mortality rates from cancer and heart disease, although there is much more to do.

The Labour party has always been at the forefront of reform where it is needed and where it would benefit people on the ground. As my hon. Friends have already pointed out, we are talking about the difference between good reform and bad reform. My party will always support reform that is good for patients, but the Government’s plans do not offer that kind of reform. I have had thousands of letters and e-mails from constituents—

[Anna Soubry (Broxtowe) (Con)]

Thousands?

[Rushanara Ali]

Yes, thousands. I have had thousands of letters and e-mails from constituents—members of the public, as well as professionals—who oppose the Bill.

[Jim Shannon]

Will the hon. Lady give way?

[Rushanara Ali]

I am sorry, but I will not be able to give way.

Those people are opposed to the Bill. They have been campaigning and have joined the 170,000 people who have signed up to oppose the Bill. They oppose it because they know that it will damage health care. This Bill will damage life chances; it will destroy the NHS.

In Tower Hamlets we had the first clinical commissioning group calling on the Government to drop the Bill, led by the respected Dr Sam Everington, who said:

“Your government has interpreted our commitment to our patients as support for the Bill. It is not.”

It is shameful that the Government carried on trying to use his name in support of the Bill. Those in the clinical commissioning group are concerned about the unnecessary bureaucracy that the changes will create and about the impact on patient care. They know that top-down reforms and restructuring will detract from their ability to care for their patients. That is what they have said. I hope that the Government will listen today, because in areas such as my constituency, where child poverty is higher than elsewhere—half the children in my constituency live in poverty—and where there is an inextricable link between poverty, health and life expectancy, it is vital that we have a health service that delivers for people on the ground. This Bill will not do that—Ministers know that, so they should do something about it. [Interruption.]

[Madam Deputy Speaker (Dawn Primarolo)]

Order. I do not need any help chairing this debate; what I need is for Members to listen. If they want to have a private conversation they can go outside and have it, and then come back in for the vote.

[Rushanara Ali]

Thank you, Madam Deputy Speaker.

This Bill is effectively a form of backdoor privatisation of the NHS, with up to 49% of beds going to private patients. That will hurt my constituents and ordinary people up and down the country. That is why the Government need to think again. The Bill undermines the very principle of the NHS and the inspiration behind it. It highlights the fact that we cannot trust the Conservatives—or, now, some of the Liberals—with the NHS.

Waiting times are expected to go up. Already, between May 2010 and December 2011, they increased by 9%, and that will get worse. The Government need to take these issues seriously and start listening to people. In the east end, inequality continues to be a major concern, and we need to work together to reduce it. I reiterate the shadow Health Secretary’s request that we work together on this. The Government should listen, and they should drop the Bill.

As my hon. Friends have done, I appeal to the Government to think again, to think about the people of this country and to think about the people like those in my constituency who desperately need an NHS free at the point of delivery and free for those who need it. Those people do not need the marketisation and competition that are going to damage the health service. I call on the Government to drop the Bill.

Health and Social Care Bill

Rushanara Ali Excerpts

Tuesday 28th February 2012 Commons Chamber

[Mr Lansley]

I am grateful to my hon. Friend. That is indeed true, and it gives the lie, if you will forgive me, Mr Speaker, not to anybody in the House, but to those who would represent the legislation as having the effect of widening health inequalities. Health inequalities widened under the Labour Government. For the first time, our legislation will place on all NHS bodies and the Secretary of State a duty to tackle and reduce health inequalities.

[Rushanara Ali (Bethnal Green and Bow) (Lab)]

The Secretary of State will know that Tower Hamlets clinical commissioning group in my constituency has decided today to ask the Government to drop the Bill, citing the bureaucracy it will generate as a key reason. When the structures he has established to advise him tell him that they want no part in the nightmare that he is creating, is it not time to think again and drop the Bill?

[Mr Lansley]

I have been to Sam Everington’s practice in Bromley-by-Bow, which has been gearing itself up. It will use the powers in the Bill and will do so very effectively.

Health and Social Care (Re-committed) Bill

Rushanara Ali Excerpts

Wednesday 7th September 2011 Commons Chamber

[Nick de Bois]

I understand that the UK Stem Cell Strategic Forum recommended to the Government that there should be a regional centre of excellence, and I hope Ministers will let us know by letter if that policy is indeed being pursued, as I think it might deal with the issue that my hon. Friend raises.

Cord blood is a natural, safe, ethical and sustainable resource, and it offers many advantages over using traditional bone marrow transplants. We in this country should be proud that the NHS was one of the first bodies to recognise the potential importance of cord blood and significant breakthroughs were made in Britain. In 1996 an NHS cord bank was established, which is now working alongside the Anthony Nolan trust. At a time when the health service is mindful of the need to inform patients fully about their health care, the issue of the collection of a mother-baby’s cord blood does not seem to get the same degree of attention. The principles of full information and consent do not seem to apply to cord blood, which is, in general, treated as a waste product, unbeknown to parents, apart from in exceptional circumstances. By agreeing to my amendments, we can change that situation and the Government can demonstrate that they are giving a lead in the dissemination of information to expectant parents.

Last year academic research said that in order to have a truly effective operation we should strive to obtain 50,000 units of cord blood. I congratulate the Government, who have already committed £4 million to reach the first benchmark of 20,000 cord blood units. I commend the work of the Anthony Nolan trust and the NHS, which have also been sharing in building up to this target. Of course this is only the start, and I know that the Government have already expressed their commitment to helping to develop this very important work.

We have an opportunity for more lives to be saved, for valuable scientific research to be undertaken and for the UK to become a centre of excellence in cord blood. We can avoid the current situation whereby every day two people die waiting for a stem cell transplant, and 65,000 litres of cord blood are discarded every year. I welcome the Minister’s words of support and I appreciate the sentiments behind the Government’s thinking. I urge them to continue to get behind this valuable cause.

[Rushanara Ali (Bethnal Green and Bow) (Lab)]

I speak in support of amendment 1169, which seeks to strengthen the Secretary of State’s duty to reduce health inequalities. As presented in clause 3, the Secretary of State’s duty is insufficient to tackle the health inequalities in our society. The clause lacks strength, invites the Secretary of State to disregard its meaning and changes little in the way in which health inequalities will be tackled in the future. By supporting amendment 1169 we can ensure that the Secretary of State can be regularly and properly held to account for his duty to tackle health inequalities across England.

Tackling health inequalities is vital because this is, in many cases, a matter of life and death. The World Health Organisation’s Commission on Social Determinants of Health has said:

“Social justice…affects the way people live, their consequent chance of illness, and their risk of premature death. We watch in wonder as life expectancy and good health continue to increase in parts of the world and in alarm as they fail to improve in others.”

In our own country, Bevan’s dream for the NHS was for a service in which:

“No longer will wealth be an advantage nor poverty a disadvantage.”

Yet, despite the great strides that have been made there is much more to do, and the link between poverty and poor health remains.

[Dr Wollaston]

Will the hon. Lady give way?

[Rushanara Ali]

As there is not much time left, I would like to proceed in order to allow other colleagues to speak.

That link can be seen as clearly in London as anywhere else. According to the London health inequalities strategy,

“for men, life expectancy at ward level ranges from 71 years in Tottenham Green ward in Haringey to 88 years in Queen’s Gate ward in Kensington and Chelsea—a span of seventeen years”.

Despite the progress made nationally, in the borough of Tower Hamlets, in which my constituency sits, the rate of heart disease or stroke before the age of 75 is more than twice that of a more affluent area such as Surrey, and early cancer rates are nearly 50% higher.

We know that with the right resources and leadership it is possible to reduce health inequalities. In the past 10 years, the rates of early death from cancer and from heart disease and stroke have fallen in my constituency, but they remain worse than those in other parts of the country. That is why it is vital for the Secretary of State to continue the focus on tackling health inequalities, for us to look at the cross-cutting issues affecting health and for there to be co-ordination across government, led by the Health Secretary.

Tackling health inequalities was central and integral to Labour’s policy making in government. I urge this Government to think again, to recognise the vital importance of continuing that commitment and to make sure that there is genuine accountability for reducing health inequalities.

I was saddened to see last month that the Government plan to reduce the funding allocated to tackling health inequalities by altering the weighting given to inequalities in the weighted capitation formula from 15% to 10%. That will lead to a reduction in funding of £20 million over the next three years in Tower Hamlets—

[Ben Gummer (Ipswich) (Con)]

Will the hon. Lady give way?

[Rushanara Ali]

I will not give way, because there is not much time left.

The borough is one of the poorest in the country, with high levels of health inequalities, and the change will have a direct and damaging effect on the health of my constituents and many others around the country.

[Mr Lansley]

rose—

[Rushanara Ali]

I will not give way, because the Secretary of State has had long enough to speak. He has had far too long to speak, and I have two minutes left.

The change will have a very damaging effect on my constituents, and if the formula is applied across the country it will increase inequality. I ask the Secretary of State again to show leadership and take responsibility—

[Mr Lansley]

rose—

[Rushanara Ali]

The Secretary of State has spoken for long enough—[Interruption.] He has spoken, but there has not been much content—[Interruption.]

[Madam Deputy Speaker (Dawn Primarolo)]

Order. The hon. Lady is entitled to make her speech and to be heard in this Chamber. As all Members know, this debate ends at 6 o’clock and there are still quite a few Members who have been present all the time who wish to speak.

[Rushanara Ali]

Thank you, Madam Deputy Speaker.

Amendment 1169 would be of great benefit in tackling health inequalities. It would make a real difference to people’s lives. Requiring the Secretary of State to lay an annual report before Parliament on progress towards ending health inequalities is therefore key in ensuring that proper accountability continues to exist. What is he afraid of? He could see the impact and put in place mechanisms to continue to improve, learning from the evidence and making progress. Considering how we can reduce inequalities in constituencies such as mine is a constructive way forward. I call on the Secretary of State to think again and accept this sensible amendment.

In conclusion, as the Marmot review stated, the

“link between social conditions and health is not a footnote to the ‘real’ concerns with health…it should become the main focus.”

Tackling health inequalities should be a central aim of health care policy for any Government, and the amendment would be crucial for achieving that. I hope that Members on both sides will back it and that the Secretary of State will take note.

[Margot James (Stourbridge) (Con)]

I want to support the leadership that the Bill ascribes to public health and the role of the patient and empowered individual in taking responsibility for their health care as far as is possible. I congratulate the Government on setting public health free, as I see it, and taking it out of its ivory tower. It has been in the preserve of the primary care trusts and although in some PCTs it is given life, in others it gathers dust and is vulnerable to financial raids from time to time as budget pressures build and people seek to take money from an area where the public do not necessarily see the results for a fairly long time and to give it in preference to things that cause short-term pain. Regardless of which party has been in government, that has always been the case with public health.

If we consider where public health can make a difference in preventing ill health, we can see that the future of the NHS depends on a much better preventive strategy. Perhaps the best thing that the previous Government did in health care policy was the smoking ban, which will probably save more lives in the long run than anything else. We could consider some of the other areas that are ripe for similar treatment. I do not mean that we should ban alcohol, but we could consider public health policy and what it could do to reduce the incidence of sexually transmitted diseases, HIV, alcohol abuse and mental health problems. Many of the issues to do with drugs are about education and prevention, too.

I am pleased to see links being built into other aspects of the Bill. Our proposals for public health in relation to mental health have been strongly welcomed by the Samaritans, because there is so much to do with mental health that takes place in the community. The involvement of local authorities and the leadership role given to them in the Bill should enable aspects of local government policy such as housing, children’s social services and adult and social care to be brought to bear in dealing with these problems.