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Public Health White Paper

I thank the Secretary of State for advance copy of his oral statement. I am sure that the House will also thank him for the advance copies of the White Paper, which were available before he made his statement. On Sunday the Health Secretary promised a White Paper that would"““take a radical new approach to public health””." Today he has published the White Paper, and it falls far short of his hype. He has had six years in opposition and six months in government to prepare for this White Paper, but it will disappoint many of those who are most committed to better public health in this country and most concerned that we still have a great deal further to go. For the most part, this White Paper is not new. It is not clear how it will help to improve public health, and it is not a guarantee that the big gains made in the last decade—in cancer screening, healthy food in schools, stopping smoking and free flu vaccines, as well as the big cut in deaths from heart disease—will be continued. However, in the spirit of responsible opposition, let me tell the Health Secretary that we can offer general support for his aims, which are very similar to those that we set out in our White Paper in 2004. I can promise him close scrutiny of his actions and those of his Government, because as the White Paper says, good public health depends on much more than what the NHS does. As he said in his statement, education, employment, environment and equality are the causes of the causes of poor health. However, the Government's wider policies, which will lead to higher unemployment, poorer housing, greater poverty and an end to the Sport for All programme in schools, will do more damage to public health than his White Paper will do good, and more to increase health inequalities than his plan will do to reduce them. So what did the Health Secretary say to the Chancellor about policies that will see a third of a million public sector staff on the dole? How hard has he argued against the Education Secretary's plan to axe the school sports partnerships, which have seen three times as many children playing competitive sport than six years ago, and nine out of 10 children playing more than two hours of sport each week? Why is it that everyone else in the Government is set to make announcements affecting public health—on alcohol taxation or pricing, for example —except the Health Secretary? Far from being, as he said, a genuine cross-Government strategy, the White Paper—like his last one, on NHS reform—shows that this a Health Secretary working alone and operating largely in isolation from the rest of Government. There is nothing new in ““nudge””, except the soundbite and how hard the Secretary of State is pushing it. We set out the importance of individual decisions and incentives, alongside the need for support services and Government action, in our White Paper on public health in 2004. The test for the Health Secretary is whether the Government will act when they can and when they are needed, especially to protect children. The legislation is in place to end point-of-sale displays of cigarettes. The evidence is there and the experts are clear. Cancer Research UK says that"““we need to put tobacco out of sight and out of mind to protect all young people. The Government has the opportunity to act with conviction and reduce the devastating impact that tobacco has on so many lives.””" Will the Secretary of State do that: yes or no? There is little new in this White Paper, and little is clear about how its plans will improve health and reduce health inequalities. It is 96 pages long but short on detail. We welcome in principle the lead responsibility for improving health being passed to local government, but can the Secretary of State guarantee the powers and the funds that it will need to do the job? Will he confirm that public health outcomes will also be part of the operating frameworks for the NHS and social care, because it would be a disaster if the NHS were now to decide that public health was not its job? We are concerned about the Secretary of State's responsibility deals. What exactly does he mean by that? What influence will industry have over future health policy? What does he say to the Liverpool health expert and Tory adviser, Professor Simon Capewell, who said that health experts on the public health commission"““were outnumbered and outvoted by people from Tesco, Diageo, and other food and drink manufacturers—and the Commission went with what the industry wanted…which is a scandal””?" What does he say when one of his own advisors offers that view? We welcome the health inclusion board and the new national public health service, although we thought that this Government were committed to cutting, not creating, quangos. But is not the fact that the inclusion board will tackle the health needs of groups such as homeless people, drug users, alcoholics and sex workers an admission that GPs on their own do not know, and will not commission, what they need for the future? Is not this one of the first in a series of bodges that will be needed to make the Secretary of State's massive reorganisation plans for the NHS actually work? Whatever he says, we and the public will judge him on what he does. Will he ensure that his £3 billion internal reorganisation of the NHS does not damage public health? Will he take tough decisions about Government action on tobacco? Will he make and win the big arguments in government about the damage to health that comes from no work, poor housing and bad education? In government, it is deeds that count, not words.