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Mr. Andrew Lansley (South Cambridgeshire) (Con): I am grateful to the Secretary of State for the customary hour's advance sight of his statement. The House will have seen copious leaks of the White Paper and will be able to judge how many of them were informed speculation and how many were just spin. In any case, after all that, what have we got? Labour's big conversation has turned out to be all talk. After seven years of a lack of priority for public health, all the Government can offer is gimmicks and a nanny state. [Interruption.] As one would expect, the Secretary of State—[Interruption.]
Mr. Speaker: Order. Hon. Members must allow the hon. Gentleman to speak.
Mr. Lansley: At least they are awake while I am speaking, Mr. Speaker.
The Secretary of State did not admit to the extent of the Government's failures on public health, so let me tell the House about them. Levels of obesity in this country have risen by more than a third in the last decade, and at a rate far greater than in the rest of Europe. Obesity may soon be this country's greatest preventable cause of disease and premature death. The proportion of people who smoke, which fell by a third in the 1970s and 1980s has been virtually unchanged since 1997. British teenagers are now among the healthiest drinkers—[Laughter]—I mean the heaviest drinkers in Europe. We are seeing serious levels of liver disease—[Interruption.] I am sorry that Government Members find this funny, because liver clinics in hospitals are treating increasingly younger people with serious liver disease. Several thousand young people are dying from the consequences of liver disease and liver failure.
The number of new HIV diagnoses has doubled since 1997. Sexually transmitted infections are increasing. Chlamydia incidence has more than doubled and that of gonorrhoea has increased several times more than previous recorded levels. We have seen serious syphilis outbreaks where previously there were none. MMR vaccination rates are down to 82 per cent. because the Government lost control and public confidence in vaccination went down. The number of hepatitis C reports has doubled and up to 200,000 people may have the disease but be undiagnosed. TB is up by 15 per cent. and respiratory disease is this country is twice the EU average. According to the Joseph Rowntree Charitable Trust,
Listening to the Secretary of State, one would imagine this was year zero in public health. But five years ago, the Government published a White Paper on public health. At that time, the current Secretary of State for Culture, Media and Sport was the Minister of State in the Department of Health. That document said nothing about tackling obesity at the very time when it was rising in this country much faster than in other European countries. In contrast, the 1992 "Health of the Nation" White Paper published by the Conservative
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Government set out plans for tackling obesity and was regarded by the World Health Organisation as a ground-breaking document.
Five years ago, the Government said that they would introduce a sports strategy. Since then, young people have been doing less exercise. There has been a reduction in time spent on physical activity and fewer children participate in sport out of school. The lack of sport and exercise in recent years is at least as significant a cause of rising obesity in children as their diet. Of the £700 million promised four years ago from the lottery for sport in schools and communities, barely 1 per cent. has been spent.
In the document published five years ago, the Government said that health action zones would tackle inequalities. Now they have been abandoned. Five years ago, the Government said that the Health Development Agency was going to tackle public health problems, but now they say that it is to be abolished. It was all talk, just as the present White Paper is all talk. Again, five years ago, the Government said in their White Paper:
yet now they believe in the new nanny state approach, but not in doing things that really work.
For years, public health needs have lacked priority, the public health service has fragmented and the messages given out by Government have been inconsistent and incoherent. Yet the Government have not understood that the solution lies in reversing those failings. [Interruption.] The Government should give public health a priority and create a unified and influential service. They should provide coherent and consistent messages based on evidence. Instead, the Secretary of State reaches for more gimmicks and for bans.
Four months ago, the Secretary of State said smoking was one of life's small pleasures, but today he wants to ban it in public places. [Interruption.] Does he not realise that, in the time that it takes to implement legislation, the industry could and would deliver a voluntary code? That would remove smoking from up to 80 per cent. of the space available in public houses. It would ban it from the bar area, and people behind the bar would not be able to smoke.
I am also confident that we could expect the industry to achieve a smoke-free environment wherever children have access. Typically, the Secretary of State did not even mention the central importance of achieving smoke-free environments in those public places to which children have access. The Government's approach simply risks delaying progress. It could send smokers home and thus expose families and children to more second-hand smoke.
On the advertising of foods for children, Ofcom said this year—[Interruption.]
Mr. Speaker:
Order. The House will settle down. Some of the hon. Members who are shouting have put their names down to be called to make a contribution from the Back Benches, but I shall refuse to call them if they do not settle down. If the shouting continues, what could happen is that the House might hear only the Front-Bench spokesmen, and perhaps the Chairman of the Health Committee, and no one else.
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Mr. Lansley: On the advertising of foods for children, Ofcom this year said that a total ban on such advertising would be "ineffective and disproportionate". The FSA and the industry are working towards a new advertising code, so is not the Secretary of State offering a mere gimmick?
Traffic-light labelling of food is another half-baked idea that the Department communicated to the press.
Mr. David Hinchliffe (Wakefield) (Lab): It is not.
Mr. Lansley: The traffic-light labelling is based on the concept of good or bad food, but what matters is whether a diet is good or bad. How would the system work? If a wholemeal bread roll is low in sugar, moderate in fats and high in salt, would it merit a green, amber or red light? If fruit juices, cheese or fish have red traffic lights, how will people understand that they can form part of a healthy diet? How does a crude traffic-light system deal with the major differences between the diets of adults and of children?
Different people need different diets. If I had high cholesterol, I would eat less in the way of fats. If I had high blood pressure, I would reduce my salt intake and I would reduce my sugar intake if I had diabetes. Traffic-light systems do not enable people to get the information that they need, but the Secretary of State should say whether he has such a system in mind. If he does, will it be acceptable to industry, and to the European Commission?
Does the Secretary of State agree that food labelling should be based on information about foods' nutritional value and their contribution to a good diet? That means people should be given information about the recommended daily amount of calories, fats, sugar and salt. Such a system would be well understood by the public, it is essential when it comes to putting together a good diet, and it is not likely to fall foul of EU restrictions. Adopting such a system would mean that Britain would lead the European debate on these matters. Will the Secretary of State accept that the Opposition are right to argue for a scheme like that in preference to a crude traffic-light system?
The inadequacies of the statement that the House has just heard are too many to list, but some are really striking. Where is the commitment to mental health, and especially to the provision of access to services for the 75 per cent. of young people who have mental health problems yet have no access to those services? Where is the commitment to a national campaign aimed at all young people to encourage and empower them to resist peer pressure to engage in early or unprotected sex, or in the misuse of drugs or the abuse of alcohol?
Where is the commitment to an immediate national roll-out of chlamydia testing? What attempt is being made to ensure that people who attend genito-urinary clinics are not turned away? One third of clinics now report that they frequently have to do that. Where is the commitment to evidence-based screening by family doctor services, as opposed to the gimmicks of asking GPs to turn into lifestyle gurus or sending people to fitness trainers? The Secretary of State may want a Carole Caplin approach to health policy, but we have
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an NHS short of physiotherapists, community nurses, midwives, district nurses, chiropody services, occupational therapists, dentists and radiographers. The Government need to sort out their priorities.
The White Paper is a missed opportunity. The public health service needs a Cabinet champion. It needs the restoration of a high status role for public health professionals, which they had when they were medical officers of health. It needs independent, evidence-based reports and recommendations from an independent public health commission. It needs a service with focus, with resources and with the ability to lever change. We need behavioural change, not a nanny state. We need public health teams with staffing and resources to do the job, able to engage GPs, health visitors and school nurses—in each school—in delivering the service.
We need Government-wide action. We need sport. We need exercise for young people. We need other Departments that have not been delivering on their part of the public health obligation to do so. We need a Government—they will be the next Conservative Government—who will take the action to give us organisation, resources and leverage across the public and private sectors to deliver public health objectives. In doing so, we will support an NHS that is genuinely focused on promoting good health and reducing disease—we will not leave the NHS simply to treat the consequences of public health failures.
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