Again, the hon. Lady has blamed young women who smoke. Smoking may be a contributory factor, but she has not answered the point, which was that health professionals believe that
social deprivation, not gaps in medical services, is the underlying cause
of the increase in that period. I am still amazed that the hon. Lady has not taken that fact into account.
During Prime Minister's Question Time yesterday, there were references to a report from the Low Pay Unit and the Child Poverty Action Group. It showed that between 1979 and 1985—I acknowledge that it was three years ago—the number of people below pension age living on or below the poverty line rose from 2·9 million to 6·54 million, a rise of 120 per cent. It is no good the Government saying as they tried to do yesterday, that it is an old report and that things have got better since then. I promise the hon. Lady that things have not got better since then. The figures have not dropped—in fact, they will get worse. With the poll tax, more people will drop into the poverty trap.
The hon. Lady referred with pride to working with the Maternity Alliance and other organisations. I am glad that she acknowledges their worth. Four years ago, the Maternity Alliance produced a report called "Poverty in Pregnancy". The report looked in detail at the basic requirements for a healthy, nutritional diet for pregnant women. It concluded that pregnant women whose income came from benefits and those in very low wage families had incomes which were clearly insufficient to buy an adequate diet which would ensure their own and their babies' future good health. It estimated that benefits needed to be increased by at least one third, that the maternity grant needed to be restored to its original value, which at that time would have been £125, and that the seriously inadequate welfare foods policy needed radical improvement.
We have certainly had radical change since then, but we have not had radical improvement. The social security review has cut benefits and removed one of the most vulnerable groups—the under-16s—from any benefit. At one time, the maternity grant, albeit at a low level, was universal. It is now available only to those who are on benefit. Free school meals have gone, and welfare foods have been cut.
Does the Under-Secretary really believe that such actions—and by her own Department, too—are the right way to ensure that women have a good start for themselves and their families and have a healthy life?
The feminisation of poverty is not a new phenomenom. The hon. Lady quoted some women's journals from perhaps 100 years ago. At the beginning of the century, 60 per cent. of all Poor Law recipients were women. In 1988, 60 per cent. of all income support recipients are women. It is truly staggering that things have not changed over 88 years. Three quarters of the low paid are women. Yesterday's copy of The Independent contained a whole page of little bits on regional trends that were recently published by the Government. The article is headed:
Women's pay still lags behind
An extract states:
Progress towards equal pay appears extremely slow. Women's pay still lags far behind men in every part of the country, irrespective of prosperity.
The highest-paid women are in the South-east, where average weekly earnings are £167·60p, is well short of the earnings of the worst-paid men, who are in Northern Ireland and take home an average of £190·40p.
Women in manual jobs fare worst of all, averaging only £115·30 a week—£70 less than their male counterparts. Although these are full-time jobs, more than half the women so employed in East Anglia and Northern Ireland earn less than £100.
All those factors are relevant to our discussion about women's health. Thousands of women actually have to earn their poverty by working in the NHS and related local authority community services and subsequently get as a bonus ill health and a lack of opportunity to choose a
healthier lifestyle. I refer to nurses, therapists, administrators, technical workers, caterers, cleaners, laundry workers, home helps, day care and respite care workers, and, of course, the millions of unpaid carers at home, who are often isolated and unsupported in caring for their loved ones and who had to fight the Government through the European courts for financial recognition. All such people are low paid and below the threshold laid down by the Council of Europe.
We have just received an important report from the Policy Studies Institute on doctors and their careers. That report was commissioned by the DHSS. [Interruption.] The Under-Secretary points to herself. It was commissioned by her. I hope that she is interested in the results. So far, I have managed to read only the shortened version, as the longer one rather defeated me in the time available.
The pattern of discrimination and career prospects for women doctors mirrors the picture that we see everywhere. If there is a hierarchy, women are in powerless positions. If there is a grading structure, women are at the bottom of it. If there are pay differentials, women are on the lowest rates. The description of the effects on women doctors of working in the Health Service hold true of women in all professions and all women working in health and community services. The report states:
Exhausting and stressful hours of work"—
Perhaps hon. Ladies will include the House of Commons in this—
disrupted or non-existent family and social life, endless exams, the repeated scramble for short-term jobs that involve moving around the country, inflexible career structures and the increasing importance of patronage from powerful, and usually, male senior doctors, all conspire against women.
With the addition of a few substitute words, we could adapt that paragraph to refer to the House of Commons. However, that is a quote about women doctors, though it applies across the board in most professions. Yet, as we know, access to a woman doctor is now one of the most frequent requests that women voice with regard to their own health needs. Information on the availability of a woman GP is one of the most frequent responses made by a family practitioner committee, yet the Government's White Paper, "Promoting Better Health- will threaten the availability of women GPs and the services they offer. I do not know whether the Minister has seen the response of Women in Medicine. I assume that she has. It is a responsible organisation of women doctors and says that many of the proposals threaten the availability of women GPs and the services they offer.
The White Paper does not recognise or reward those aspects of work, often done by women GPs, which cannot be easily measured, such as the many forms of counselling. Instead, its emphasis is on a few countable targets, eg immunisations and cervical smears. Indeed, women could well be employed specifically to work in these limited areas of practice. They would lose job satisfaction, be inaccessible for consultation on other matters, and their wide range of skills would be wasted.
Changes in the way doctors are paid would encourage GPs to have more patients on their books. This would mean less time could be spent with each individual. Women, for a variety of reasons, on average consult their doctors more often than men do, and with more complicated problems. They, therefore, would be the hardest hit. …
Proposed changes threaten to remove valuable allowances from doctors who work reduced hours.
I hope that the Minister will take those views into account.
Support among women throughout the country for well woman centres has grown enormously. The services are run by women for women. Health education and mutual aid are provided in a positive and supportive manner. Well woman centres adopt an approach which encompasses the whole person rather than a set of symptoms. The whole person in her environment and its impact on her health is considered. That includes income, access to child care and community care, employment or unemployment, housing conditions, diet and the availability of healthy food in local shops and the sufficiency of income to buy it. All of those matters can be discussed in a well women centre.
I know that the Minister is a avid fan of healthy food. We all are, or ought to be.