To ask His Majesty’s Government what assessment they have made of the fall in healthy life expectancy over the last decade in England; and what plans they have to address this.

My Lords, I beg leave to ask the Question standing in my name on the Order Paper and I declare an interest as founder and trustee of the charity Health Equality Foundation.

My Lords, the fall in healthy life expectancy over the last decade is unacceptable and underlines the scale and complexity of the challenges we face. Through the 10-year health plan, we are taking action to tackle the drivers of ill health and inequality, including reviewing the Carr-Hill funding formula, to better match resources to need, and creating a smoke-free UK.

I thank my noble friend the Minister for that response. The Health Foundation’s report, Healthy Life Expectancy Trends in the UK: A Watershed Moment, published in April this year, makes it clear that healthy life expectancy is a key measure of our population’s health. The gap between the most deprived and the most affluent areas has grown, with those in the wealthiest areas now living up to 20 years longer. Social determinants of health affect healthy life expectancy—

Question!

I am coming to that. What plans do the Government have to address the social determinants of health across all government departments, because a single department cannot handle this? How can we close this gap?

My noble friend’s assessment of the situation is right. That is why we are working across government on the wider determinants of health, including matters such as the Warm Homes Plan and the homelessness strategy. Alongside that, the 10-year health plan focuses on prevention and narrowing inequalities. The aim is to improve all conditions that will support longer, healthier lives across the whole country.

My Lords, the Minister will be aware that one of the key determinants of healthy life expectancy is diet. In the 10-year health plan, the Government have a welcome section on improving the dietary health of the nation. It was therefore disturbing to note in the Telegraph a few days ago a report that said the Government are going to pull back on these commitments. Can the Minister please confirm to the House that the Government have no intention of pulling back on the commitments to improve dietary health?

It is an important area of government activity and I certainly do not recognise the comments that were in the Telegraph. I can confirm to noble Lords that we have a whole package of measures to tackle obesity, including restricting junk food advertising on TV and online aimed at children and giving local councils stronger powers to block new fast food outlets. That is still the case.

My Lords, is the Minister aware that there are scientists who are propagating nonsense that nothing can be done about the obesity epidemic because it is all genetic? These people are saying that the individual cannot be relied upon to take action and that it must be the Government who do it. It is complete nonsense, because the individual can take responsibility—and, indeed, millions are taking injections to do that very thing.

I recognise the noble Lord’s point. We are certainly seeking to give individuals the ability to grasp the opportunity to live well for longer and to support them in their choices. For example, in addition to the points I made to the noble Lord, Lord Krebs, we are working on restricting volume price promotions such as “buy three for the price of two” offers on less healthy food and drink.

My Lords, given that the UK is an outlier compared to similar countries, what work are the Government doing to introduce proactive, preventive health measures, such as routine health MOTs for people, to try to reverse this trend?

I welcome the noble Baroness to her Front Bench on the important matter of health and social care. I am most grateful for her question. We have to be ambitious, which is what the 10-year health plan is doing, in transforming how we tackle the biggest causes of ill health. We are going to take a whole-society approach and a whole-person approach, rather than dealing just with conditions. To the points made earlier, we will be working with individuals—as in the public—and in partnership with business and civil society.

My Lords, ever since the Marmot report, we have known that poor-quality employment is a key driver of lower healthy life expectancy. The Employment Rights Act is a big step forward, but does my noble friend the Minister agree that we need action on asbestos removal from workplaces and public places, more boots on the ground in the shape of health and safety inspectors, and a boost to occupational health services in the UK?

My noble friend is right. I very much welcome the provisions in the Employment Rights Act and in other areas; it is a good example of cross-government working. We are pursuing this through Keep Britain Working, which will reduce economic inactivity and focus on workplace health provision, as my noble friend says. I believe that will help address poverty and support healthy working. All those measures will help healthy life expectancy.

My Lords, my succinct question is this. Given that healthy life expectancy has fallen despite record levels of NHS spending, with obesity, diabetes and poor mental health continuing to rise, can the Minister explain what specifically will be different in the Government’s approach, beyond simply increasing treatment capacity to prevent more people spending longer periods of their lives in ill health?

As I mentioned in an earlier answer, this is a long-term and complex matter which has developed over a number of years. It is totally unacceptable that a woman in Hartlepool, for example, will enter ill health some 19 years earlier than a woman in Richmond-upon-Thames. It is about embedding action on health in policies across government. However, as I mentioned, it is also about redesigning the system around the three shifts: emphasis on prevention rather than on sickness, in particular, but also a move to community-based health services, so that people can access healthcare where and when they need it, and, of course, digital access, too.

My Lords, healthy life expectancy is a mix of two data: a more precise life expectancy and a much cruder self-reporting of the stages of health. This leads to a confusing interpretation and therefore is not helpful in policy-making decisions. We have to find and seek better information about healthy life expectancy and the parameters that affect it, to be more effective in policy decisions. Does the Minister agree?

I definitely agree. That is why data, particularly that which drives us to make funding decisions to get funding to where it is needed most, is absolutely crucial. I find the term “healthy life expectancy” more useful than what used to be called “life expectancy”. That, to me, was always only one side of the coin. However, I take on board the point that the noble Lord makes.

My Lords, people with a learning disability enter periods of multimorbidity and chronic illness 20 to 30 years earlier than those without a learning disability. What are the Government going to do to stop this national scandal?

I accept that this is completely unacceptable. There are groups, including those the noble Lord rightly raises, which have an even worse healthy life expectancy. As I mentioned, we will be redesigning the system and making the shifts in the 10-year plan, in order that we target the areas and the groups that need it most. I can certainly tell the noble Lord that the most recent prevalence review on mental health will include those who have ADHD, those with autism and those with learning disability. That will take us forward, too.

My Lords, can my noble friend the Minister say how the Government will achieve their shift from treating sickness to maximising prevention, as outlined in their 10-year plan, and particularly how they will shift resources, reporting and other necessary things?

My noble friend is right to ask about maximising prevention, as that will be a key shift in our National Health Service. In addition to the points I have already made, we are working within the NHS to do more to support our approach to prevention. In addition to what I have already mentioned and the system changes, we will, for example, strengthen our vaccination and screening programmes, including by improving the uptake of child immunisation. We are working to improve the detection, treatment and management of the behavioural and clinical risk factors that drive this burden of disease and affect healthy life expectancy.