Last week, the House of Lords started Committee stage of the Health and Care Bill and began discussing a suite of proposed amendments to the Bill about health inequality.

Speaking at this committee session Peers from across the House made clear that this Bill is a huge opportunity to eliminate health inequality, and for the Government to demonstrate their commitment to tackle the “disease of disparity” as the Secretary of State for Health, Sajid Javid MP pledged last year.

But currently, there was remarkable consensus that the Bill doesn’t go far enough, including for people who experience extreme social exclusion and cannot access the vital health services they need.

That’s why Crisis and a coalition of partner organisations are supporting amendments 152, 156 and 157, which enjoys cross-party support in the House of Lords, having being laid by Conservative Peer Lord Young of Cookham, and co-sponsored by Lord Shipley a Liberal Democrat, Baroness Neuberger and Baroness Watkins of Tavistock who sit as Crossbench Peers and Baroness Armstrong of Hill Top, a Labour Peer.

If accepted by the Government, they will help to ensure the NHS works better for people who are homeless, or experiencing other extreme forms of social exclusion, such as sex workers, Gypsy, Roma, Travellers, vulnerable non-UK nationals and people with substance misuse issues, who currently encounter significant barriers to accessing appropriate healthcare services.

What Peers said in support of changing the Bill

Without these amendments, the consensus from Peers across the House was that the Bill will fall short of its welcome ambitions. There were powerful interventions from several Members across the House, full of expertise and insightful testimony demonstrating the urgent need for action.

It was particularly welcome to see Peers from across the House speak passionately on the importance having a stable and secure home for someone’s health and wellbeing. Lord Young of Cookham spoke of his own experiences of being Ministers for Housing and Health.

He described seeing “how not having a stable home to live in is devastating for people’s physical and mental health,” and how this had led him work closely with organisations like Crisis to improve the Bill.

Lord Crisp, former Chief Executive of the NHS and senior civil servant in the Department of Health called a home an “absolute foundation for health and well-being,” providing crucial stability from where people can engage with wider services

Integrating health and housing across the NHS is, as Baroness Watkins of Tavistock, a former nurse said, “fundamental to reducing health inequalities.”

This integration must be embedded throughout the NHS at the highest levels - otherwise there will continue to be a postcode lottery of services for those who need it most.

Several Peers also urged the Government to recognise how accepting these amendments would help them to realise their commitment to levelling up, as it would address the entrenched imbalance of access and delivery of healthcare services. It was also clear to Peers that these amendments would undoubtedly help the Government to progress towards their welcome manifesto commitment of ending rough sleeping by 2024.

What happens next

In response to these issues raised, it was heartening to hear the Minister for Health and Social Care, Lord Kamall acknowledge that health inequalities are driven by a range of factors, beyond just physical and mental health. It was also welcome he offered further discussions with Peers on these amendments and the Government’s commitment in this area.

I hope during these discussions the Government recognises amendments 152, 156, 157 provide a huge opportunity to tackle the devastating impact social exclusion can have on health, and alleviate avoidable pressure on the NHS.

The consensus from Peers present at this Committee session was clear - the cost of doing nothing is too high, both to the individual and to our health service. I hope this opportunity is not lost, and we see this reflected in the Bill when it returns at Report Stage.