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Public Health (England)

The debate has been interesting, although perhaps a little too party political in certain respects. However, there have been some worthwhile contributions. The speech of the right hon. Member for Rother Valley (Mr. Barron) was passionately felt, although perhaps a little partisan for a Health Committee Chairman. He criticised our talk of widening health inequalities. Our central point, which seemed to escape him, is that health inequalities have widened under this Government. There is no point in talking about absolutes when it can be very well argued—certainly the evidence supports this—that in relative terms, the Government’s public health policy has not helped the lower-paid; in fact, it has failed them. That cannot be denied if we look at the figures, or the Government’s own target. The hon. Member for Southport (Dr. Pugh) rightly stressed the importance of recognising how health policy affects the elderly, and I agree with him. It is important to recognise that Government targets sometimes focus too much on acute services, to the neglect of those suffering from long-term medical conditions, even to the point where those with such conditions often consider themselves to be second-class citizens in the NHS. That is a valid point, and the balance needs to be addressed. The hon. Member for Kingston upon Hull, North (Ms Johnson) criticised our approach to public health but failed to mention, or recognise, any of the failures of the Government. That was a shame, because it did not make for much balance in her speech. My hon. Friend the Member for Southend, West (Mr. Amess) rightly talked about the Government being deluded in believing that their health policy was working, and he expressed the concern that all the evidence suggests that public health budgets are being raided, and he referred to the chief medical officer’s most recent report. The hon. Member for Dartford (Dr. Stoate) did not listen to my hon. Friend the Member for Westbury (Dr. Murrison) when he said that public health should be a Cabinet responsibility; that was clearly stated by my hon. Friend. My hon. Friend the Member for Bexleyheath and Crayford (Mr. Evennett) rightly pointed out that 24-hour drinking has increased the level of binge drinking in his constituency, and he expressed great concern about that. He reminded the House that according to the National Institute for Health and Clinical Excellence, alcohol-related disease accounts for some one in 26 NHS bed days, and more than one third of all accident and emergency attendance. He also rightly stressed the importance of the all-embracing approach to public health that is required—it cannot be left just to the Government—and the important role of education. May I congratulate the hon. Member for Waveney (Mr. Blizzard) on being probably one of few examples of the success of the Government’s public health policy? He rightly stressed the importance of a healthy diet, and I congratulate him on that, too. My hon. Friend the Member for Broxbourne (Mr. Walker) rightly mentioned his concern about cuts in Hertfordshire’s public health budget, and he linked them to cuts that are taking place elsewhere in the local health service because of deficits. That is bound to impact on local patients. To remain viable in the long run and for the good of our health, the NHS must change its emphasis from being a national sickness service that treats disease to a national health service that focuses on preventing it. By not addressing public health with a concerted effort now and in recent years, we are storing up problems that will have to be addressed through secondary care in future, resulting in worse outcomes for patients—a point that was made in all parts of the House. Indeed, the chief medical officer has argued that we are in what Derek Wanless called the ““slow uptake”” scenario in public health. That could mean extra costs in real terms to the NHS of £30 billion by 2022-23, and a difference in life expectancy of some three years for men and two and a half years for women. Despite all the claims by Ministers, there is a worsening picture of public health across the country. Sexually transmitted infections are rising. For example, cases of syphilis have increased by 1,600 per cent. since 1997. Cases of gonorrhoea have increased by 44 per cent, cases of chlamydia by 150 per cent., and cases of HIV have more than doubled—all since 1997. Meanwhile, the number of alcohol-related deaths has more than doubled during the last 10 years, and cases of tuberculosis have gone up by 10 per cent. in the last year alone. Moving on—if further evidence of failure is required—according to a report published by the Health Protection Agency in December 2006, the number of people newly diagnosed with hepatitis went up nearly fourfold between 1996 and 2005. As for obesity and diabetes, according to the Department of Health’s own figures, on current trends the proportion of girls who are overweight or obese is predicted to be 40 per cent. higher by 2010 than in 1997, and three in every four men and three in every five women will be overweight or obese. These are worrying figures—and they are the Department of Health’s own. Those figures clearly show a worsening public health situation across the country, and that, whatever Ministers may say or claim by way of success, the results prove otherwise. Indeed, the results are so bad that if they applied to an organisation outside politics, those responsible would probably be fired. I suppose that we have had the equivalent of that with the civil servants’ own survey within the Department of Health, which clearly demonstrated a lack of confidence in the Secretary of State. There comes a time when the Government must take responsibility for their actions, and after 10 years in government, that time is now. These growing public health problems are home-grown; they are of the Government’s own making. I suggest that to find the reasons for this poor public health record, we need look no further than the chief medical officer’s latest annual report, published last July. He points to the fact that the Government’s constant reorganisation of the NHS has hit public health particularly hard. He claims that reorganisation after reorganisation has caused considerable disruption to the provision of public health services and undermined staff morale. He has been very clear about that. The CMO also shares the concerns of many others that not only has public health been neglected, but the number of senior public health staff in England—including directors, consultants and specialists, but excluding academics—has been almost static since 1997. Perhaps most importantly, as hon. Members have pointed out—especially my hon. Friend the Member for Southend, West—Professor Sir Liam Donaldson devotes a whole chapter in his latest report to public health budgets. It is entitled ““Raiding public health budgets can kill””: his point could not be clearer. In that chapter, the CMO makes the point that in talking extensively to public health professionals throughout the NHS over the past two years—something that I would recommend Ministers to start doing—it emerges that public health budgets are regularly raided to find funding to reduce hospital financial deficits or to meet productivity targets in clinical services, losing funding and skills that have been acquired over time.