It is wonderful to be with you today to discuss an important issue: public health.
Labour has always believed in the importance of championing our public health needs, staff and services. It is without a shadow of a doubt that health is a crucial area of policy for any government, and especially when the future of our public services are an important issue for many people. Health, therefore, should be given the prominence it deserves, as it affects all of our lives. It must be a top priority of any government to not only improve the health of our nation, so that we can be more productive in our working and social lives, but also ensure that our NHS is fighting fit for the future. Labour – as a government-in-waiting – are prepared for this task.
Yet, it is safe to say, that the NHS as it stands now is not as fighting fit as it should be due to continued Tory negligence. Jeremy Hunt likes to snipe back that this is Labour talking down the NHS, but the reality of the situation is we are fighting to defend it from his attacks. The saying remains true: you can never trust the Tories with our NHS. That is why over the last year, Labour’s Shadow Health team – led by Jonathan Ashworth – have held the Tories feet to the fire and held them accountable for their actions, or inaction, when it comes to the NHS – we are not letting them get away with anything! Labour founded the NHS, and it is Labour who will save the NHS. We will never allow it to be treat as second best. It is far too precious to allow that to happen.
These pressures we talk about were laid bare in NHS England’s Five Year Forward View Refresh, published in March, which showed the true scale of the challenges facing the health service. Whilst on the face of it there were welcome measures, it was clear if you read between the lines, that the Government have failed to give the NHS the funding it needs but also deserves.
This is especially true when it comes to public health, which we saw fall from being the third top priority in the vision to being slotted into the NHS 10-point Efficiency Plan. Whilst public health can save the NHS and other health services a lot of money and time, it should not solely be about cost-savings but should be the driver that supports us all to live healthier lives. This means championing better public health in our country which focuses on tackling the entrenched health inequalities we see in society, with the permeation of ill-health seen in our communities and ensuring our NHS is fighting fit going into the future.
This last point is something I touched upon when I spoke to the North East’s branch of the Socialist Health Association in January of this year; where I criticised the flopped “radical upgrade in prevention and public health” promised in NHS England’s Five Year Forward View. It was clear in January, just as it is clear now, that whilst we are seeing initiatives to improve public health, they are not going far enough – which is deeply concerning. This is what I call the “public health crisis”. What we have is the crisis in our NHS, manufactured by the Tories, which is having a knock-on effect on public health, as it leaves little space to invest money or time. This negligence of public health is all down to a lack of political will to step up to the plate and act on determinants of poor health, but the short-sighted cuts we are seeing too.
The scale and impact of these cuts were identified earlier this year, when the King’s Fund analysed DCLG data on local authority public health spending, following the settled landscape of all the reforms and shifting of responsibilities since 2013. And the prognosis was not good.
The King’s Fund identified the biggest losers in percentage terms were sexual health promotion and prevention, and wider tobacco control; both of which face eye-watering cuts of more than 30 percent. The conclusion of the analysis was damning to say the very least: “… there is little doubt that we are now entering the realm of real reductions in public health services. This is a direct result of the reduced priority that central government gives to public health.” This is creating a perfect storm that future generations will have to weather. Irresponsibility of the highest form of this Government. It is our moral duty not to put off dealing with public health issues until a later date. One, because it causes problems for future generations and two, it can have serious ramifications for our NHS.
It is a belief of mine – and one I know others in the room will share – that we must deal with issues at the source rather than further down-stream. That is why it is important that Labour, working in tandem with the Socialist Health Association and others, promotes a better vision for public health. At the snap General Election, Labour offered a visionary and forward-thinking approach to public health, which renewed our commitment as a Party to keep people fit and well. Much of what we focused on was to do with children and our promise to make Britain’s children the healthiest in the world – an ambition I have championed ever since becoming an MP. Though we focused on children – this does not mean what we were proposing would not have health benefits for adults, as our policies would have created healthier environments for everyone.
Our main pledge focused around clamping down on management consultancy costs in the NHS, which would recoup £250 million into the Treasury coffers and would be earmarked to fund our Child Health Fund, whilst we passed a Child Health Bill in Parliament. Both of these initiatives would provide us with the legislative capacity to ensure all departments inputted into a cross-departmental childhood obesity strategy to ensure every action taken by Government took into consideration the health of future generations, the Child Health Fund would help: it would implement the strategy, grow our public health workforce; support local authorities with health promotion; and, administer our Index of Child Health – to measure progress on four key indicators of children’s health: obesity, dental health, mental health and early years.
Yet, we didn’t stop there, we made clear that we would go further than the Tories’ dismal Childhood Obesity Plan and implement a ban on adverts promoting unhealthy food during primetime television – such as X Factor or Britain’s Got Talent – which is estimated to reduce children’s viewing of junk food advertising by 82%. We also set out that we would ring-fence public health budgets to protect services into the future, instead of seeing them wither on the vine as we have seen under the Tories.
Though at present we are not in government to implement these ideas, this does not mean that we are taking child health of our radar. Far from it. As Jonathan announced at the beginning of the summer, Labour will be establishing a Child Health Forum, so we can work with experts to design a programme we can implement in Government so we can be proud of our record on improving children’s health. And I hope as many of you will help feed into this on-going work and contact Jon.
But it is not just children’s health we must improve, it is everyone’s health. Improving the health of our country is a matter of social justice – one of the core principles of the Labour Party.
Health inequality is an issue which we must continually work on to get right. Complacency should never be accepted as the norm when it comes to the health of our society. That is why we must do all that we can to address health inequality. We all know the conclusion of the facts around health inequality: people in more deprived areas of the country do not live as long or with as good health, compared to those in more affluent areas. This is health inequality in its most brutal form. This was why Sir Michael Marmot was right to say in his 2010 report that there is a social gradient in health: the lower a person’s social position, the worse his or her health will be. Sadly, this is something we have yet to see materialise in public health policy, with report after report arguing that we have not made serious inroads into health inequalities. That is why we must have a renewed campaign to address the social injustices of ill-health. We must do more. This is a stark realisation when only a couple of weeks ago, Sir Michael Marmot made an important, and eloquent, intervention into the discourse around health inequalities. He said: “the UK is becoming the sick men and women of Europe.” In his letter to the Times, Marmot identified that from 2011 to 2015, the increase in life expectancy was the slowest in Europe amongst women and the second slowest amongst men. This is worrying when from 1920 to 2010, life expectancy rose from 55 to 78 for men and 59 to 82 for women; roughly a one-year rise every four years.
Yet, in such a short period of time, we have seen the work of previous governments stalled by the current government, who as we know have not taken the health of our country seriously. We know exactly why this is: this is down to the government’s choices around austerity.
As I previously mentioned, we have seen public health services slashed, an NHS facing unprecedented pressures, social care and education crippled and people’s living standards weakened. Each of these have serious ramifications on our health. Marmot may have been more reserved in his suggestions about the impact of austerity, but we all know it has been a significant factor to the increase in poor health in our society.
How can it be right in the 21st century for a child to be born into a family living on a poor council estate and grow up with completely different life chances and health outcomes than a child born to a more affluent family. If this does not raise concern, then what will?
Social justice and equal opportunity are central to Labour values, and it is important that we reflect these in how we approach our health policies too. This is something that I have supported in the past, and still do to this day, including championing the 1001 Critical Days initiative which works to ensure that a child’s formative months and years help set them up for the future. Along with doggedly championing universal free school meals for the last 10 years, but also pushing on smoking and sexual health issues during my time as Shadow Minister for Public Health.
But it also means taking action for people now – who have been failed in their early lives. A Labour Government would make social justice a driver of all government policy, but it would also ensure that the health of the nation is considered in every step we take. Labour in opposition in Parliament and where we are in power across the country are doing just that, now.
Take for example, the excellent work of my colleague, Sue Hayman – Labour’s Shadow Environment Secretary – who has been leading the way on air quality and holding the Government to account on improving the environment we live in. Or ensuring families have decent, affordable housing to live in, rather than squalid private accommodation, as being done by our Mayor of London, Sadiq Khan. Or working to improve transport infrastructure that supports healthy lifestyles, such as that pledged by Andy Burnham in Manchester. Or in Wales, where we have seen the Welsh Labour Government give powers to Public Health Wales to scrutinise new legislation’s impact on health.
Labour has, and always will be, a proud champion of improved public health and ensuring it is considered as part of everything that we do. But it is important that we create systems where this is easier to do, and not just rely upon the values that drive us in the Labour Party, but instead embed them into the system. This is why I am interested to work more to improve the roles of Public Health England and local Directors of Public Health to ensure the health of our nation is kept high on the agenda.
It is initiatives like those I have mentioned which will help ensure that the social determinants of health are addressed, but it also about injecting innovative thinking into our approach to public health. By injecting innovation and utilising our political will, we can ensure the gap in health inequalities will shrink further and health outcomes improve. We must fully realise the vision set out in the Five Year Forward View as a promise to not only ourselves, but to the generations that come after us.
It is important that we work together to create and implement health policy that brings about real change for those who live in poor health; we cannot continue to allow people’s health to be determined by factors completely out of their control. Every one of us in this room shares that passion and drive to improve our nation’s health. We know we will never take our nation’s health for granted.
There is still a long way to go to improve our nation’s health, but with our collective passion, we can achieve a more equal, socially just, and most importantly, healthier society.
This was first published on Sharon Hodgson MP’s own website.