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Public Health

Volume 533: debated on Tuesday 18 October 2011

4. What assessment he has made of the potential effects of NHS reorganisation on the protection and improvement of public health. (74850)

Our reforms put public health at the heart of the new system. The creation of Public Health England, alongside significant new functions and, for the first time, ring-fenced budgets for local authorities, will give public health an unprecedented level of priority. The new local authority role integrates public health with other local authority functions that impact on people’s health.

Under the previous Government, NHS Hull saw excellent results in improving public health. Under the current Government, Kingston upon Hull’s teaching primary care trust has seen a 2.6% cut this year compared with Kingston upon Thames PCT getting a 2% increase—and Hull city council has a 9% cut in its funding as well. What does the Minister think will happen to public health in areas such as Hull with those kinds of cuts?

I think that public health in areas such as Hull will do exceptionally well. I point out to the hon. Lady that under the previous Government, what happened in practice was that public health budgets were raided constantly and we did not get improvements. If she looks at the figures, she will see that inequalities in health widened.

Does my hon. Friend agree that despite the previous Government’s good intentions on public health, health inequalities have widened, as she has rightly said, obesity rates are going up, smoking among young girls is going up, and alcohol abuse is a serious problem? Does she agree that it is right to deliver services with local authorities and to get into local communities and schools if we want to address these big public health challenges?

My hon. Friend is absolutely right. Local authorities have a long and proud tradition of improving the public’s health. Public Health England will bring together a fragmented system and strengthen our national response on emergencies and health protection. It will help public health delivery at a local level with proper evidence and leadership.

Contrary to the Minister’s statement that the Health and Social Care Bill will put public health at the heart of the health service, 40 directors of public health and 400 public health academics, including Michael Marmot, wrote to The Daily Telegraph to say that the Health and Social Care Bill will

“widen health inequalities; waste much money on attempts to regulate and manage competition; and undermine the ability of the health system to respond…to communicable disease outbreaks”,

and that it will

“disrupt, fragment and weaken the country’s public health capabilities.”

How can the Minister put her judgment against that of those doctors and experts? Is not the proposal that more than 40 specialist neonatal units may lose staff in the coming year an example of the weakening of public health that is involved in the Bill and the Government’s proposals?

I draw the hon. Lady’s attention to the fact that the Health and Social Care Bill proposes for the first time a duty on the Secretary of State to have regard to health inequalities, which, I repeat, widened under the previous Government. I also point out to her that the letter to peers signed by Professor Marmot and others welcomed the emphasis on establishing a closer working relationship between public health and local government. I suggest that the hon. Lady gets out more, because she would hear from public health doctors and local authorities on the ground who welcome these changes.