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Ms Johnson: With the greatest respect, the hon. Gentleman misunderstands my point. Also, I am concerned that my primary care trust, which was in balance in the last financial year, had to bail out his PCT in the East Riding, which massively overspent. There are higher health inequalities among my constituents than among those in the East Riding, so I am not going to take any lectures from the hon. Gentleman. I am concerned that yesterday a lot of Opposition Members spoke about wanting additional funding for their constituencies and constituents. They failed to grasp the bigger picture in relation to public health. All that Conservative Members seem to be interested in is keeping money going into the acute sector. They do not seem to be able to grasp that, if we put money into the preventive public health agenda now, that will save money in the long run. It is a shame that there still seems to be a disappointing, old-fashioned view among Opposition Members.
I want to turn to a few of the interesting and exciting initiatives that are happening in Hull, which, as I have said, has poor health standards. We have high levels of coronary heart disease and teenage pregnancy, but we are starting to address and turn around some of those issues. That does not happen overnight. A generational commitment has to be made. We already have a joint director of public health, Dr. Wendy Richardson, who is jointly appointed with the PCT and the local authority. She is doing an excellent job.
That leads me on to a piece of work that has been jointly commissioned. The local authority and the PCT are on board. The scheme is about free healthy school meals in all our primary and special schools in the city and it is the only initiative of its type in the United Kingdom. It focuses on the nutritional and educational benefits of getting children to eat well while they are at school. It is called the eat well, do well scheme and the children all get a free breakfast, free fruit throughout primary school, and free lunches and after-school refreshments, all of which are healthy.
I point out to the hon. Member for Southport, in particular, that take-up has increased. In some of our schools in the city centre, take-up of free healthy school meals is more than 90 per cent. The pilot, which has been going on for about two and a half years, is being evaluated by Hull university. Professor Colquhoun is providing interim reports, which all show that the policy is having a dramatic effect on the well-being of children in our primary schools. We might not see the savings from the scheme for 20, 30 or 40 years, when the children will have grown up and might otherwise have developed problems such as coronary heart disease, cancer and diabetes. However, we are making the investment now, and that fits in well with investing now to save for the future.
The scheme is making a real difference to educational achievement in the city, but the public health angle is the key reason why it should continue. It is disappointing that the Liberal Democrat council has an old-fashioned view—a silo mentality—of what local authorities should provide and what health services should provide. I am keen on examining ways of pooling budgets so that joint work can be carried out, given that such projects can provide positive outcomes.
I am not suggesting for one moment that such a scheme should be implemented throughout the whole
country. I am interested in what works locally. We have talked a lot about local initiatives for local problems. The scheme seems to be working in Kingston upon Hull, but I am not sure that it is needed somewhere like Kingston upon Thames. There is great public support for the scheme. A poll that was held between 27 and 31 January by the Hull Daily Mail, my local paper, showed that 76.6 per cent. of respondents supported continuing the scheme as free for all children in primary and special schools. That shows that there is a real commitment to the scheme in the local community. It is depressing that there is such an old-fashioned silo mentality about what local authorities should and should not provide. We all have a duty to improve the public health of our communities. I will take up what the hon. Gentleman said about public health needing all the friends that it can get. He is absolutely right; it is just a great shame that the Lib Dems are not friends of public health.
Teenage pregnancy has been an ongoing problem for the city of Hull for many years, but the Labour Government have put resources into trying to tackle it. They have given resources to provide education about the means to avoid teenage pregnancy. They are tackling the underlying circumstances that motivate young people to get pregnant, and they are supporting young parents to get back into education and training and to access health services so that they can make positive choices about future conceptions. The latest figures show that the trend is going down again, which is welcome, but there is still some way to go.
I want to focus on two projects that show best practice involving boys and young men. There is a sexual health project in Hull for those people that is run by Cornerhouse, which undertakes one-to-one support and group work and trains staff working with young people around the city. Additionally, work that is going on with young fathers has been highlighted as a model of best practice. However, there is still a funding problem with that. Unfortunately, the Lib Dem council seems to fail to understand that it has a duty to this mainstream scheme. The primary care trust is providing 50 per cent. of the funding and the local authority should be providing 50 per cent. There seems to have been a problem involving the Liberal Democrat council accepting its responsibility. It is a great shame that the council is not a friend of public health.
The doula project in Hull is unique to the city because it is the only project in the country that uses volunteer doulas who are trained to get alongside and befriend pregnant women and to provide extra support to mothers in the early weeks and months after birth. The excellent project helps to provide a focus on public health by working with young families, especially mothers. It is funded through Newland and Avenues Sure Start, which highlights the commitment to improving public health across the piece.
We need to consider pooling budgets and to examine local area agreements and strengthening the role of local strategic partnerships. We need to make sure that public health is at the centre of local policies and the decisions that are taken locally. At the moment, we are still acting as if we are in silos and do not all have a responsibility for public health, but we all do.
4.44 pm
Mr. David Amess (Southend, West) (Con): I suppose that any debate on public health will be wide-ranging, and this one certainly has been. Increasingly, debates on health follow a familiar pattern: the Government claim that the health service is performing splendidly and are very critical of how it was under Conservative Governments. Indeed, the Government say that life in Britain is wonderful and that it was awful under Conservative Governments. Listening to the Prime Minister being interviewed by John Humphrys this morning, I realised that he is suffering from a health problem—he is deluded—and the problem is catching. I listened very carefully to what the Minister with responsibility for public health had to say. I have always said that I think her very genuine in her commitment to public health, but I was concerned about her overall strategy. We have these debates—I do not suppose that we listen to each other—and nothing changes. However, I want to touch on three subjects, hoping, in an optimistic frame of mind, to make an impact.
Health outcomes have improved dramatically; 150 years ago men lived, on average, to age 40 and women to 41, but today men live to 77 and women to 81. More extraordinary is the infant death rate, because it has fallen from more than 100 deaths for every 1,000 births in 1905 to five deaths for every 1,000 in 2004. Those results are wonderful, and the Minister is right to nod. Throughout the world all those outcomes are improving. The worry that my colleagues and I have is that on those two points our outcomes are not as good as those of any number of other countries. In a debate on public health the House might consider why that is.
My hon. Friend the Member for Westbury (Dr. Murrison) was entirely right to refer to the chief medical officer’s report. I would not describe the chief medical officer as a Conservative party lackey. In his annual report on public health, he devoted a whole chapter to public health budgets, which he entitled, “Raiding public health budgets can kill”. He went on to state that he had talked extensively to public health professionals throughout the NHS over the past two years and the following points consistently emerged from their accounts.
“Expressed commitment to public health by many health bodies is not matched by concerted action.”
That must be a worry for the Government. The second point was 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 the skills that had been acquired over time.”
Those are two points that have been made by the chief medical officer, not Conservative Members, and I ask the Minister, who I dare say will not have a great deal of time to wind up the debate, if she will comment on them.
The second issue that I want to raise is the Health Committee’s report on obesity, which was ground-breaking and has had enormous effect. I know that the Minister with responsibility for public health took it very seriously. In praising industry and enterprise, I want to praise Sainsbury’s—I do not have shares in Sainsbury’s, but I might be offered some—which this
week launched the most comprehensive alcohol labelling system to date. It is an excellent strategy and it is certainly what the Health Committee asked for.
I cannot believe that the Minister is content with the childhood obesity situation. In 1999 the Government abandoned the targets in the Conservative Government’s first ever public health White Paper, which aimed to reduce rates of obesity in the general population to 6 per cent. among men and 8 per cent. among women. Current projections are that by 2010 the figures will have risen, and 33 per cent. of men and 28 per cent. of women will be obese. In addition, the National Audit Office has criticised the Government’s progress towards meeting the obesity public service agreement targets.
As for childhood obesity, in 1995, 9.9 per cent. of children aged between two and 10 were obese, and that figure has steadily risen to 13.4 per cent. The Minister is only too well aware of the arguments on why that is, but what we would welcome are solutions. I welcome Ofcom’s decision to ban advertisements for unhealthy food. I remember when three Ministers gave evidence to the Health Committee on the subject—in fact, I think that the Under-Secretary of State for Health, the hon. Member for Bury, South (Mr. Lewis) was on the Committee—and there was an argument about the banning of advertisements for unhealthy food, so it is good that a ban has been introduced.
I am concerned about the Public Accounts Committee report. It made eight recommendations that any hon. Member may read, and its conclusions were very worrying. For instance, it says:
“Important messages on diet and lifestyle have yet to get through to parents and children as clearly or as effectively as required.
To date, there has been little comprehensive, published research on the effectiveness of prevention and treatment strategies for child obesity and, consequently, the Departments have...done little to intervene directly with individual children who are obese or at risk of becoming so or their parents.”
I have two other, quick points to mention; I know that four other colleagues wish to speak, and I do not believe in being greedy with the time.
My hon. Friend mentioned hepatitis C, and I happen to be the chairman of the all-party hepatology group. This week, Dame Anita Roddick attended our reception, and I am delighted to say that I awarded her an Oscar, ahead of Sunday’s Oscars, in which I hope Dame Helen Mirren, a Leigh-on-Sea girl who went to St. Bernard’s high school in my constituency, will get an award. I was delighted to give Dame Anita Roddick an Oscar because she has been brave in putting her head above the parapet; I understand what my hon. Friend was getting at when he mentioned the subject. She spoke to us in a direct fashion, and although she was not overtly critical of the Government, I pass on to the Minister the fact that the grant of £70,000 to the Hepatitis C Trust is not overly generous. These days, we all have so little time to listen to each other, but the Hepatitis C Trust does listen to people. It tries to reassure them and deal with their anxieties, so when budgets are being considered, it would be nice if the trust were given more money.
The other concern that I wanted to raise was about the advertising campaign. I know that the Minister and my hon. Friend the Member for Westbury locked horns
on the issue, and I will not get too involved in that, but I point out that the Hepatitis C Trust is concerned about the groups targeted. Let us consider all the dangers that we face today, what with the number of people getting tattoos. Groups felt concern about the way in which the advertising campaign was run. Dare I suggest that the Government would do well to turn to Saatchi & Saatchi, and other advertising agencies?
I was going to say that I will end with sex, but instead I shall say that I will end with a point about sexual health. The Minister is probably fed up with my endless questions about abortion, but I will not shut up about the matter. Only this week, a little baby whom one could hold in the palm of one’s hand—she weighed 10 oz, and measured 9 in—survived when she was born at under 23 weeks, so the issue is not going to go away. Before the general election, the three party leaders were firm in their belief that something had to be done because of advances in medical science, but nothing has happened. Every year in Britain, 300 babies are born aged between 22 and 23 weeks—babies born at 23 weeks have a 17 per cent. chance of survival—so the House must do something about the issue.
The Health Committee produced a report on the sexual health of the nation. The facilities we saw were pretty awful, and are not at all good compared with those overseas. Will the Minister say something about Chlamydia? The annual screening target is 945,000 16 to 24-year-olds, but so far we have screened 63,000 people, which is 6.7 per cent. of the target. As a result of that failure, many 16 to 24-year-olds will suffer and become infertile.
I am delighted that we have had this debate. If we are honest—and we are probably not entirely honest with one other in the Chamber at the moment—we know what the problems are, but it is the solutions that are the challenge. Until the British people are given the opportunity to decide at an election whether or not the Government are, as I mentioned earlier, suffering from delusions, we must work with the Labour Government, so I urge the Minister to see whether she can come up with some solutions.
4.56 pm
Dr. Howard Stoate (Dartford) (Lab): I am grateful for the opportunity to speak. I will keep my comments brief, as I know other colleagues wish to contribute.
I am grateful to the hon. Member for Southend, West (Mr. Amess) for saying that there will be an opportunity for the country to decide at the next election what kind of Government they want. I have waited all afternoon to hear what the Conservative policy is on public health. I intervened on the hon. Member for Westbury (Dr. Murrison) to ask what it is, and he wants to introduce screening for abdominal aneurisms. I entirely agree, and I hope that he is successful in persuading the Minister to introduce that screening. He wants ring fencing, too, for the public health budget, but, as I tried to explain in another intervention, that is almost impossible, as public health is the responsibility of all Government Departments. It would therefore be difficult to ring-fence
that budget. Personally, I would very much like a Cabinet-level public health Minister who could range across all Departments.
Mr. Baron: My hon. Friend the Member for Westbury (Dr. Murrison) made that point.
Dr. Stoate: It is interesting that it should be me who draws out Tory policy, because Opposition Members did not mention it in their speeches. [ Interruption. ] Perhaps I did not hear the hon. Member for Westbury say so.
The hon. Gentleman said that it was a pity that the Black report did not receive wider coverage. As I recall, it was suppressed by Baroness Thatcher because it was far too inflammatory, and it was almost impossible to obtain a copy. It was not until Peter Townsend published it in a Penguin book that the public were allowed to see it, and it was hardly looked at by the Conservative Government.
Dr. Murrison: I covered that in my speech. Can the hon. Gentleman tell me what happened to the Acheson report of 1999, which, as he should know full well, covered pretty much the same ground?
Dr. Stoate: That is a point for debate. As I recall, there was no public health Minister in the Conservative Government at that time.
As time is short, I do not wish to make too many points, as some of them have been touched on by colleagues. However, there are one or two things that I would like to raise. I chair the all-party pharmacy group, and I believe that pharmacists have an enormous role to play in promoting public health. They could do much more, and more public health measures could become an essential part of the pharmacy contract, so that they become universally available at all pharmacies and thus make an enormous contribution to public health. Will the Minister look at the GP contract and the way in which QOF—quality and outcomes framework—points work? We could achieve far more improvements in primary care if public health became an essential part of QOF. In particular, if a significant number of points were attached to the management of obesity, I am sure GPs would devote more time and effort to tackling that serious issue. The problem of advertising for kids has already been mentioned, and I am glad that that is now to be dealt with.
I am very concerned about the traffic light food labelling scheme, which certain retailers, for reasons of their own, refuse to accept. I fear that that will cause enormous confusion among consumers. The scheme will only work if all retailers adopt an accepted norm. The Food Standards Agency has done important work on the scheme, and I deeply regret that the largest retailer in the land refuses to accept it. I am pleased that the Minister has reported reductions in the salt content of processed foods, but we need to go a great deal further, because salt is a major issue.
I will not detain the House further, as many other Members wish to speak. I shall merely say that if we dealt with some of the issues that I have raised, we could make significant further improvements in public health that would benefit us all.
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