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Health Promotion
12. Mr. Levitt: To ask the Secretary of State for Health what measures he proposes to promote good health in schools. [7954]
Mr. Dobson: Healthy schools will be a major target of our new health strategy for England. We will be working in partnership with the Department for Education and Employment and local authorities to promote the health
and well-being of schoolchildren. A major objective will be to improve the nutritional value of school meals by introducing national nutritional standards.
Mr. Levitt: I thank my right hon. Friend for that answer. It will be applauded throughout the country. Will he ensure that there is maximum co-operation among education staff, health service staff and parents at a local level in the effective promotion of our young children's health?
Mr. Dobson: I can certainly give my hon. Friend that assurance. I should like at this time to pay tribute to the efforts of Derbyshire county council, in the face of all sorts of abuse from the Conservatives, in maintaining a very high standard of school meal services and trying to keep the price down. We should not underestimate the value of a decent meal for many children from deprived homes. We have now reached the stage where children are not able to wait for the school dinner in the middle of the day; some of them have to be given breakfast because they are going so short of food. As was said in the debate on the introduction of local authority provision of school meals in 1906, a hungry child cannot learn.
Mr. Garnier: Can the Secretary of State tell me how much of the money that he mentioned in answer to his hon. Friend the Member for North-West Leicestershire (Mr. Taylor) will be spent on promoting health in schools in Leicestershire?
Mr. Dobson: No. The hon. and learned Gentleman, who has been in the House more than 10 weeks, ought to have a rough idea of the fact that the amount of money that will be spent in schools in Leicestershire will, generally, be determined by Leicestershire county council, Leicester city council or--I believe--even Rutland council. We are determined that there will be national nutritional standards which all authorities will have to reach. One of the meanest, nastiest acts of the previous Government was to take away those national nutritional standards, undermining the health of tens of thousands of the poorest children in the land.
Mr. MacShane: Is my right hon. Friend aware that, because of the weather, one of the problems facing schools this summer is a plague of nits in young children's hair? It may not be a problem for him or me, since there is no hair to hide in. From talking to many head teachers, it is apparent that the problem has arisen because the school nurse became an almost extinct species under the previous Government. Will my right hon. Friend talk with our right hon. Friend the Secretary of State for Education and Employment to see what can be done to ensure that school nurses are brought back and children's hair is properly examined? [Interruption.] It is a serious problem, despite the laughter of Opposition Members.
Mr. Dobson: I can confirm to my hon. Friend that our hon. Friend the Minister for Public Health is discussing with the chief medical officer and others what we do at a local level to promote public health and, in particular, give not just the necessary health advice but health help to schools so that the nit nurse reappears.
Mr. Nicholls: The right hon. Gentleman would doubtless agree that he hopes that the Government's
commitment to ban tobacco advertising will play its part in promoting the health of young children. If that is so and if tobacco is as bad as we have heard today, should not the Government seize the moral high ground and ban it completely--or is his right hon. Friend the Chancellor simply too addicted to the revenue from it?
Mr. Dobson: The hon. Gentleman gets worse. I think that everybody in the country recognises that banning tobacco is not a practical proposition, because of all the consequences that would flow from it. Nevertheless, we have an obligation to try to stop the tobacco companies--which kill 120,000 of their customers every year--targeting their advertising on children so that they can recruit another 120,000 people to kill off a few years later.
Public Health Strategies
13. Ms Southworth: To ask the Secretary of State for Health what action he is taking to promote local health strategies to improve public health. [7955]
Ms Jowell: Our strategy for public health recognises that we must operate at three levels if we are to make a real impact. First, Government must do those things that only Government can do. Secondly, individuals must make informed choices about those aspects of their life styles that influence their health. Thirdly, at a local level, health and local authorities must work together and with business, schools and the whole range of local stakeholders to deliver local targets within the framework of a national strategy.
Ms Southworth: Is my hon. Friend aware that, according to the Confederation of British Industry, more than 187 million working days were lost in 1996 due to sickness and ill health, which cost the country £12 billion? In my constituency, local businesses have worked with Warrington Community Healthcare NHS trust to develop a healthy businesses initiative and promote health care for their employees, which includes screening for visual display unit users, health and sickness screening and first aid training to improve workplaces. What can my hon. Friend do to spread that good practice across the country and ensure healthy workplaces for all?
Ms Jowell: I thank my hon. Friend for that question. I would be most interested to receive further information about the local initiative that she describes, as a major part of our public health strategy will be the development of healthy workplaces and working with businesses and industry to make the business case for public health.
Mr. Baldry: Does the Minister accept that one of the most important parts of any local health strategy is the relationship between social services and local health authorities? Is she aware that, at any one time, between 10 per cent. and 20 per cent. of beds in the Horton general hospital in Banbury are blocked by patients waiting for care in the community funding? That exacerbates the hospital's budget problems and, as a result, 12 surgical beds and a day hospital for the elderly were closed yesterday. Will the hon. Lady conduct a survey across the country to determine how many beds are blocked by patients awaiting social service funding for care in the community?
Ms Jowell: Once again, a Conservative Member abdicates any responsibility for the circumstances of the
past 10 years that have created the situation that he now regrets. We believe that local partnerships are essential, and we are concerned to see that the responsibilities of health authorities and local social services authorities are discharged properly. However, our local initiatives will embrace a far wider range of organisations to combat deprivation and meet our election commitment to tackling the root causes of ill health."The Health of the Nation"
14. Mr. Mitchell: To ask the Secretary of State for Health what changes he proposes to make to "The Health of the Nation" strategy. [7957]
Mr. Dobson: The previous Government's health strategy had some merits, but focused far too much on personal life style issues. We shall shift the balance in order to tackle the root causes of ill health, such as air pollution, poor housing, unemployment and low wages.
Mr. Mitchell: I am delighted to hear that there will be changes to "The Health of the Nation" strategy, because it did not make sufficient allowances for the consequences of poverty and bad social conditions--both of which increased so much under the last Government--for health. However, will my right hon. Friend assure me that we will not throw out the baby with the bath water? A strategy of targeting is useful in bringing resources to crucial areas--particularly in primary care--and it is a valuable instrument in popular health education and in strengthening personal responsibility for attaining those targets.
Mr. Dobson: I agree entirely with my hon. Friend. It is true that national targets tend to obscure what goes on locally, so we need local targets as well. It is true also that we are dealing with some of the major sources of ill health among the most deprived people in England by improving and building new houses through the release of capital receipts from the sale of council housing, by creating jobs that will be funded from the windfall tax and by tackling the health problems that result from dependency on low wages through our proposal to introduce a national minimum wage--which is always readily condemned by Conservative Members, who do not give a damn about the health of those who are worse off.
Stillbirth and Mortality Rates
15. Mrs. Brinton: To ask the Secretary of State for Health if he will make a statement on the rates of (a) stillbirth and (b) mortality amongst (i) manual and (ii) non-manual groups in the last year for which figures are available. [7958]
Mr. Boateng: In 1995, stillbirth rates for all registrations where manual or non-manual status could be assigned were 5.9 per 1,000 total births among manual groups and 4.5 per 1,000 total births among non-manual groups. Rates were thus more than 30 per cent. higher in manual groups.
The most robust figures for similar comparisons of overall mortality relate to men of working age. Over the period 1991 to 1993, death rates among men aged 20 to
64 were 524 per 100,000 in manual groups and 325 per 100,000 in non-manual groups. Rates were thus more than one and a half times higher in manual groups.
Mrs. Brinton:
Does my hon. Friend agree that those are shocking and persistent inequalities and that we are reaching the end of 20th century, not mired in the Victorian era? Does he further agree that those terrible figures are a result of the policies of poverty, unemployment and deprivation promoted by the previous Administration? Furthermore, what strategies does he have to deal with them?
Mr. Boateng:
I agree with my hon. Friend on all counts. I am happy to give what assistance I can. We are concerned to attack the root causes of deprivation and disadvantage. The proposals of my hon. Friend the Minister for Public Health will make a good start in that direction. We are determined to address the whole needs of the whole nation, in marked contrast to Opposition Members.
Dr. Brand:
Will the Minister also look at the way in which provision for services provided by the professionals who are most concerned with these ghastly figures is targeted in the areas where it is most required? I am thinking of health visitors, district nurses and school nurses.
Mr. Boateng:
I very much share the hon. Gentleman's concern. In terms of the preparation of women who are about to give birth, we must ensure that we support the health care professionals in reaching out to those women who currently are not given the support from their partners or families that is vital if people are to bring children into the world who are hale and hearty. We will indeed work with health care professionals to ensure that their work is most effective in tackling some of these appalling figures.
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