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Public Health (England)

I am sorry, but I will not give way to the hon. Gentleman. The rate of HIV infection here is 1.6 times the European average. Alcohol consumption has been flat-lining in the United Kingdom, but falling elsewhere. British people can expect more years of unhealthy life than people in most European countries. Our abortion and teenage pregnancy rates top the European league table. TB per head of population a stone’s throw from here exceeds the level found in several developing countries identified as TB hotspots. The Minister likes to speak of encouraging best practice, but she has given no indication of what lessons she has learnt from our neighbours who are doing rather better than us. We have heard from the chief medical officer about the poor state of the specialty of public health. England has haemorrhaged directors of public health posts, and the reconfiguration of primary care trusts is leading to further reductions; yet on 3 October 2005, strategic health authority finance directors were told:"““the Department of Health is working to ensure that the overall numbers of public health posts are not reduced.””" Clearly it is not working hard enough, as the number of posts has fallen from 300 to 152. In the local government reorganisation of 1974, public health doctors ceased to be medical officers of health employed by councils and they retreated to the NHS. I am delighted that the Government are now encouraging joint NHS-local government appointments, but what assessment has the Minister made of the catastrophic fall in the number of public health doctors, and what measures will she take to repair that broken specialty? Yesterday I met representatives of Alcohol Concern. The organisation has received reports of significant cuts in alcohol services, which it ascribes to deficits. Eighteen months ago, £15 million was announced for alcohol services, but Alcohol Concern reckons that it has disappeared. I wonder whether the Minister can account for it. Alcohol Concern contrasts alcohol services with services related to other forms of substance abuse. Those are funded and regulated through the National Treatment Agency for Substance Misuse, which means that the money is ring-fenced. Three times as many people die from alcohol as succumb to the effects of drugs, and in public health terms the evidence would lead us to prioritise alcohol. So much for evidence-based policy-making. The Minister rightly talks about smoking. It is captain of the men of death, but she did not compare the fall of 10 per cent. in smoking rates between 1980 and 1990 with the 3 per cent. fall on Labour’s watch. I hope the Health Act 2006 may save the 600 lives a year that are said to be lost to passive smoking. Indeed, I look forward to debating on Monday a raft of statutory instruments supplementary to the anti-smoking clauses of the 2006 Act, and I look forward to supporting, for example, a proposal to raise the age for sale of tobacco from 16 to 18. But what a horlicks the Government’s stewardship of those smoking clauses was. The Secretary of State campaigned for an exemption for private clubs in the morning, experienced a damascene conversion over lunch, and voted against the exemption in the afternoon. Another, far less amusing U-turn was the withdrawal of the highly effective national quit smoking campaign last year to save cash. What was the result? Calls to the national helpline plummeted by 30 per cent. over the relevant quarter and there was a 10 per cent. fall in quitters after five successive years of increases. So much for evidence-based policy making, and a strong argument for ring-fenced public health funding. An even stronger argument is the strange disappearance of funds destined for sexual health campaigns. In January last year we learned that £50 million was going on safe sex campaigns; £4 million materialised. When my noble Friend Earl Howe asked in November what had happened to the balance, Lord Warner replied:"““My Lords, it is stored carefully in the coffers of the NHS.””—[Official Report, House of Lords, 21 November 2006; Vol. 687, c. 236.]" A fat lot of good it will do in the coffers of the NHS. What is the money doing there? It is there as part of a slush fund to offset the Government’s NHS deficit and, of course, to shore up the job of the Secretary of State for Health, which depends upon it. The problem with politicians is that they hold in insufficient esteem the evidence base that underpins evidence-based policy making. Celebrity-based policy making is an entirely different matter. Call me an old cynic, but I wonder whether Anita Roddick’s brave announcement—and it was a brave announcement—about her having hepatitis C has energised the Department of Health into launching what we understand will be a welcome publicity campaign for hepatitis. The Hepatitis C Trust, which I met on Tuesday, is understandably extremely miffed that it has not been consulted by the Minister. It points out that ““Health Challenge England”” ignores hepatitis C completely, as evidently do most PCTs, which have left the hepatitis C action plan, such as it is, on the shelf gathering dust. Given the alarming increase in hepatitis C, the trust is understandably alarmed. I ask the Minister to speak to the trust, which feels upset about the way it has been treated. It is upset about what appears to be a knee-jerk reaction by the Department in response to recent media events. It is interesting that guru Wanless himself says:"““What we do not need is simply a list of frenetic and uncoordinated short-term activity, which can be stopped as easily and quickly as it began””," by which he means—[Interruption.] The Minister says rubbish, but that is what her guru said.