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Public Health

My Lords, with the leave of the House, I shall now repeat a Statement being made in another place by my right honourable friend the Secretary of State for Health. ““With permission Mr Speaker, I would like to make a Statement on public health. Today, the Government publish a public health White Paper with two clear aims: first, to protect and improve the health of the nation; and, secondly, to reduce health inequalities by improving the health of the poorest, fastest. The need for this White Paper is beyond question. Britain currently has among the highest rates of obesity and sexually transmitted infections in Europe. Smoking still claims 80,000 lives a year. Alcohol-related admissions to hospital are unacceptably high and, in recent years, inequalities in health have widened, rather than narrowed. As Professor Sir Michael Marmot’s review to my department put it, "‘dramatic health inequalities are still a dominant feature of health … across all regions’." There is a seven-year gap in life expectancy between the richest and poorest neighbourhoods, but a gap of nearly 17 years for disability-free life expectancy. About a third of all cases of circulatory disease, half of all cases of vascular dementia and many cancers could be avoided by reducing smoking, improving diet and increasing physical activity. We need to do better, and we will not make progress if public health continues to be seen just in terms of NHS provision and of state interventions. Two-thirds of our potential impact on life expectancy depends on issues outside healthcare. Factors like employment, education, environment and equality all are determinants of health. They are, as Michael Marmot put it, "‘the causes of the causes’," the underlying factors leading to poorer health. Unhealthy behaviours, like drinking too much, smoking or taking drugs are part of a complex chain of individual circumstances and social causes, typically rooted in poor aspiration, adverse peer pressure and low self-esteem. The human cost of poor health is obvious. So, too, is the financial one. Alcohol abuse costs us an estimated £2.7 billion and obesity costs an extra £4.2 billion each year to the NHS alone. And, while there are things we can do to help, we cannot resolve all the difficult issues from Whitehall. Hence, this White Paper has one clear message above all others: that it is time for politicians to stop telling people to make healthy choices, and time to start actually helping them to do it. There will be a profound shift in tone, attitude and outlook. Rather than nannying people, we will nudge them by working with industry to make healthy lifestyles easier. Rather than lecturing people about their habits, we will give them the support they need to make their own choices and, rather than dictating policies from the centre, we will support leadership from communities by giving local authorities more power to develop the right approaches for their communities. This White Paper is a genuine cross-government strategy. Through the Cabinet Sub-Committee on Public Health, we will put good health and well-being at the heart of all our policies. To do so, we will recognise that we need to provide support at key times in people’s lives. We will not only measure general well-being, we will seek to achieve it. For instance, because we know a mother’s health is key to a child’s health and development, we are investing in Sure Start children’s centres and 4,200 more health visitors to give families the support they need. Because we know that those who are unemployed for long periods are more likely to be admitted to hospital and more likely to die prematurely, we are transforming the welfare system, ending the benefits trap, and making sure that work always pays through a single universal credit. Because we know more people would cycle to work or school more often if there were safer routes for them to use, the Government are investing £560 million in sustainable transport. Subject to parliamentary approval, there will be a new dedicated public health service—Public Health England—which will provide the resources, the ideas, the evidence and the funding to support local strategies. Public Health England will bring together, within the Department of Health, expertise from a range of public health bodies, including the Health Protection Agency, the National Treatment Agency for Substance Misuse and the Chief Medical Officer’s department. It will work with industry and other government departments to shape the wider environment as it affects our health. It will also develop health protection plans””.