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House of Lords Hansard
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09 July 2015
Volume 764

Question

Asked by

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To ask Her Majesty’s Government whether they carried out an equality impact assessment before deciding on the recent in-year budget cut to public health funding.

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My Lords, we pay close attention to equalities considerations when deciding how to distribute the public health grant between local authorities. The Department of Health is about to consult on how to implement the savings and we will address our equalities duties in full when announcing our final decisions.

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My Lords, I thank the Minister for his reply, but given that these cuts will impact on teenage pregnancy programmes for the young, domestic violence programmes for women, HIV prevention programmes for gay men and some members of the BME community and TB prevention programmes for the poor and homeless, will he say where the equality is in that?

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The noble Baroness will know that decisions on these matters are left to local authorities, and we wish to give them as much discretion as we can.

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My Lords, there is not much discretion if the Treasury decides to take away £200 million in-year on public health programmes from local authorities. If the intention is to squeeze the public health budget, will the Government therefore take action at national level to compensate for this by legislating to reduce the amount of fat, salt and sugar in food and drinks that are aimed mainly at children and young people?

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My Lords, prevention is very important to the Government and a very important part of the NHS Five Year Forward View. The reduction of £200 million in the grant to local authorities should be seen in the context of a total grant of £3.2 billion; it is a 6% reduction. Public Health England has a campaign to raise awareness of the damage that sugar and salt, as well as smoking and alcohol, can do to people’s lives.

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My Lords, if the noble Lord takes into consideration not only the cuts to this budget but those to other local authority budgets, he will see that this will mean a reduction in youth services, the closure of young people’s centres and a range of preventive services for children being reduced. Will that not have a cumulative effect on the general health of the nation, and certainly on the protection of children?

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My Lords, the NHS is facing a challenge over the next five years to achieve productivity savings of some £22 billion. If we wish to have a sustainable, tax-funded health service in the long term, we have to make these savings. I have no doubt that over this time this will cause difficulties, but, again, it has to be seen in the context that we have a national debt of more than £1 trillion and a public sector borrowing requirement that must come down.

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My Lords, does the Minister not agree that, of all the places to cut the National Health Service budget, it is incredibly short-sighted to do so in areas to do with prevention because, although there may be short-term savings to be made there, in the long term it will build up problems which will cost a great deal more in the future?

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I repeat my earlier response that prevention is extremely important. We are looking at a relatively small reduction of £200 million out of a total public health budget of more than £5 billion.

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My Lords, does this mean that campaigns on alcohol and drug abuse will be cut? Is the Minister aware that there is a great increase in liver disease and hepatitis C?

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The decisions about which services to reduce must lie with local authorities.

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My Lords, does the Minister realise that many of the contracts for public health are already let in the medium term? Is the proposed cut on uncommitted funding, or are the Government proposing to give some help to local authorities who have no way of ending those contracts?

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The noble Baroness raises a good question. This will be a crucial part of our consultation, which will take place very soon.

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Does the Minister not recognise that, as was the case in our recent debate on diabetes, wise investment in public spending on health can save billions later, not only in terms of the tragedies in the lives of people who experience suffering from something such as diabetes but also in the weight placed on the public purse to fund the health service?

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I agree fully with the noble Lord. Early prevention is crucial, not just for diabetes but for a whole range of mental health issues as well, and prevention will remain a critical part of the five-year forward view.

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My Lords, will my noble friend make arrangements for someone to survey local supermarket shelves and record the number of items for sale that have either no added sugar or are sugar free? Will he then arrange for a similar survey to be conducted among the major supermarkets in the United States? After which, will he explain to us what government policy will be applied to try to get us even in the same vicinity as the sugar reductions that are available to American purchasers?

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My noble friend raises a very interesting point. I will certainly bring it to the attention of Public Health England and, depending on its reaction, I will be happy to come back to the House and give the noble Lord the answer to his question.

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My Lords, the Government are placing new duties on local authorities in terms of the anti-drugs strategy, and Public Health England, very rightly and admirably, is seeking to develop its contribution to the strategy ambitiously and appropriately. Will the Minister ask his right honourable friend the Secretary of State for Health to give a very strong moral lead, at least to urge local authorities not to reduce spending in this area, which is so crucial to the health and safety of young people in particular?

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I will certainly have a word with my friend the Secretary of State for Health. Clearly the Government have an important role in this area; I will have a discussion with him and come back to my noble friend.

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My Lords, this is my first opportunity to ask the noble Lord a question and I welcome him to his new brief. If he were looking at the evidence-based delivery of services, the evidence shows that 40% of illnesses are related to lifestyle. If that is the case, why do we not have a national plan for public health and prevention of disease, rather than leaving it to local authorities, where it will vary?

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The noble Lord raises an interesting point, which we may come back to in the debate later. Public health spending is divided into two: £3.2 billion is decentralised to local authorities and the remaining amount, some £2 billion, is retained by Public Health England—which does have a national plan, but it may be that the plan could be better articulated.