Vital Signs: Health inequalities

Briefing · Parliament

MPs and peers debate widening healthy life expectancy gaps and whether legislation, targets and cross-government action can close them

1. 01The Health Bill's committee stages, spread across June and July, produced the most sustained argument about health inequalities. Dr Peter Prinsley moved an amendment in the fourth sitting to place a clear duty on the Secretary of State to have regard to health improvement and inequalities, citing a 16-year gap in life expectancy between richest and poorest parts of the UK. Karin Smyth, for the Government, said clause 4 already restates and reaffirms that commitment, and argued in the fifteenth sitting that a rigid statutory timetable for healthy life expectancy targets risked creating a process-heavy framework that prioritised reporting over delivery. Liberal Democrat Dr Danny Chambers countered in that same sitting by tabling new clauses 14, 79 and 80, which would have required a statutory target, a cross-governmental public health committee chaired by the Prime Minister, and a duty on all ministers to consider health outcomes.
2. 02Several members across different debates drew attention to falling healthy life expectancy as a concrete measure of the problem. Lord Sikka noted in the Lords Economic Affairs Committee debate on 4 September that healthy life expectancy for males in parts of Blackpool stands at 50.9 years and in parts of Scotland at 44.8 years for males. Debbie Abrahams told the Work and Pensions Committee on 16 July that in her former industrial constituency of Oldham East and Saddleworth, healthy life expectancy for men is 56 years, against a national average already itself historically low at 60.7. Baroness Bottomley told the same Lords debate that healthy life expectancy had fallen by more than two years in the past decade.
3. 03Baroness Nargund made repeated calls, in the Lords debate on government political priorities on 3 September and in the child poverty debate on 18 June, for a cross-governmental health board or Cabinet sub-committee reporting to the Prime Minister, arguing that the DHSC alone cannot close geographic gaps and citing an 18-year difference in life expectancy between the best and worst postcodes in the UK. In the direction of government debate on 2 September she asked the Leader of the House to confirm that reducing health inequalities would be at the heart of the regional growth agenda.
4. 04Place-specific and population-specific health inequalities featured widely. Fleur Anderson noted in a 15 July debate on estate regeneration a 10-year life expectancy difference between one side of her Putney constituency and the other. Lord Scriven raised in two separate sessions, on 20 July and 25 June, that people with learning disabilities die on average 20 years earlier than the general population and pressed the Government to move to a statutory independent review of each such death. Iqbal Mohamed said in the 4 September debate on the Infants, Parents and Carers Bill that health outcomes in his Dewsbury and Batley constituency depended on income and place, pointing to poverty, poor housing and barriers to healthcare access.
5. 05The lung cancer screening and cardiovascular disease debates in late June and early July connected health inequalities explicitly to deprivation. Stephen Kinnock told the 25 June national lung cancer screening debate that lung cancer is one of the cancers most strongly associated with deprivation and that tackling it is about reducing some of the most persistent health inequalities in society. Patrick Hurley told the 2 July heart disease debate that people in the most deprived communities in the north-west are more than twice as likely to die prematurely from cardiovascular disease, and called for prevention to be at the heart of the Government's approach.