Lyn Brown (West Ham) (Lab): I thank my hon. Friend the Member for Wigan (Mr. Turner) not only for securing the debate, but for the careful way in which he put forward his arguments and also for mentioning Newham many times. I thank him too for characterising the debate not as one between north and south, but as one about health inequalities. I am really grateful to him for framing the debate in that way.

This debate is very important for my constituency, which is the eleventh poorest part of England and Wales. In the distance of the short journey on the Jubilee line from here in Westminster to my home in Newham, life expectancy for children decreases by six years. Put simply, my local authority does not have the money that it needs to deal with health inequalities. In the year 2007, the locality where people live should not determine lifespan, but the reality is that it does.

I acknowledge, as have other hon. Members, the findings of the Black and Acheson reports that health inequality has its determinants in poverty, low income, poor housing, lack of education, lack of security and high levels of stress. It is therefore clear that any redress in health inequality needs to engage more players than the NHS alone. My hon. Friend the Member for Wigan mentioned that we need a partnership with the Department for Communities and Local Government in dealing with these issues, and he is absolutely right.

There is no need to be an expert in Maslow’s hierarchy of needs to understand that living on a low income in a high-cost capital has an impact on healthy choices—food, leisure and education choices—and therefore on the stress levels of families struggling to make ends meet while living cheek by jowl with the enormous wealth of the City. It does not take a genius to understand that it is very difficult for families in temporary accommodation, living in the private sector in homes that they can barely afford, and moving every few months or years while they wait the 13 years that it takes to get a house in the public sector, to have a lifestyle that maintains good health.

Newham has a housing waiting list of 30,000 families—families that are moved from place to place while they wait, often unable to put down roots in an area, and are therefore unable to find their way on to doctors’ waiting lists. If they are successful in registering on the very full lists, they are often then subject to another move and another search for the most basic of health requirements—access to a doctor. Is it any surprise, therefore, that such families access their health care erratically, through the accident and emergency services of the local hospital, too late for there to be an impact on their health? That results in a shorter lifespan and means that such people live longer in ill health than those in better circumstances.

The continued inequalities experienced by my constituents are exemplified by the infant mortality rate, which in Newham fell by 4 per cent. between 1998-2000 and 2003-05, although it fell by more than 10 per cent. in London as a whole. Obviously, all improvements in health are welcome, but the worrying growth in inequality simply cannot be ignored. There are clear inequalities in outcomes, but also great disparities in inputs, such as funding per person. North-east London contains several deprived boroughs with some of the lowest life expectancies in England. In 2004-05, the average expenditure per weighted head of the population was £1,090, compared with the north-west London figure of £1,311. Indeed, according to the Government’s own weighted capitation calculations, and as my hon. Friend kindly stated, Newham Primary Care Trust currently receives £15 million less than it should each year. Such underfunding in an area such as mine is frankly immoral.

Last year, I was forced to have a meeting with the then Secretary of State for Health to express my deep concern at the requirement made by NHS London that Newham PCT contribute 3 per cent. of its 2006-07 budget to a financial risk pool for London. The risk pool was required to ensure that the NHS in London as a whole was in financial balance. Although I understand that requirement from the wider perspective of getting the NHS on budget, it is hard to stomach given the local circumstances. Newham PCT has a consistent record of hitting its financial targets. The deficit in London had been run up by other PCTs, many of which have been, and continue to be, overfunded according to weighted capitation targets. My hon. Friend referred to that too. Along with other demands, such as that for a 15 per cent. saving on management and administration costs by 2008 as a consequence of commissioning a patient-led NHS, the requirements mean that the PCT is facing significant financial pressures while attempting to make real progress towards narrowing health inequalities.

I am confident that this Labour Government are facing up to the enormous challenge of inequalities in health care—something that the previous Government failed to do. However, while there is much to praise, good intentions will be carried through only if constituencies such as West Ham and the other constituencies mentioned here this morning receive better and more appropriate funding and health care—health care designed around the needs and realities of living in a borough such as my own.