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Public Health (England)

My hon. Friend makes a good point. A paper published this month, entitled ““The future of health visiting in Bedfordshire and Hertfordshire””, by the Bedfordshire and Hertfordshire Local Medical Committee Ltd quotes a report by Amicus, which is a fantastic union, as I am a member of it. The Amicus ““Who cares?”” campaign reported that the number of whole-time equivalent health visitor jobs slumped to a 12-year low for England in 2005. That seems to conflict with the Minister’s comment in her opening speech that they were at an all-time high. The report was written jointly with health visitors. It went on:"““The meeting recognised that it is now necessary for Health Visitors to concentrate their sparse resources on the under 5s; Health Visitors reluctantly feeling that they have no alternative but to reduce their input into older children and the rest of the family, unless absolutely necessary, and the elderly. GPs are already aware of the loss of specific health promotion activities formerly carried out by Health Visitors since the move to a geographical basis rather than being practice allocated, naming specifically the loss of obesity clinics and smoking cessation activities.””" The current funding crisis within our PCT is causing a lot of concern to our general practitioners and to health visitors. The impact of those cuts is being felt by local service users. We have been told that reductions in acute services will be offset by placing more services within local communities. That in itself may not be a bad thing. However, the experience of the Hertfordshire Partnership NHS Trust, our mental health trust, was that it lost beds while at the same time having to reduce services within the community. Specific services reduced include alcohol-related services. The issue of alcohol abuse, and treating those who are prone to such abuse, are as important, if not more important, than drug addiction, bearing in mind that alcohol is far more widely used and more widely abused. Among the other services that have been cut within local communities are some that I would regard as public health services, including helping people suffering from depression or early-stage mental health illnesses. Often if we catch these illnesses at the beginning, when people start to be troubled by them, we can avoid significant costs and treatments further downstream. Those are all areas of concern. Of course if we are not treating early-stage depression in the community, we eventually get greater pressure on GP services—GPs are already stressed and dealing with a large number of people—and then we get over-prescription of expensive medicines. Funding in our PCT is of huge concern, and paying back the deficit over the next two years is having an impact on local services.