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Health: Chief Medical Officer’s Recommendations

Volume 795: debated on Monday 21 January 2019


Asked by

To ask Her Majesty’s Government what steps they intend to take to implement the recommendations in the Annual Report of the Chief Medical Officer 2018, published on 21 December 2018.

My Lords, in her most recent annual report, the CMO set out a compelling vision for the future of healthcare by 2040. The Government are carefully considering all the recommendations made in this annual report and, as noble Lords will know, have taken substantive and sustained action on the contents of all previous reports. Indeed, the NHS Long Term Plan is addressing many of the issues that are at the heart of the CMO’s report, such as data, research and prevention.

My Lords, I am grateful to the Minister for that Answer. She will know that the CMO’s report was a devastating critique of the state of public health at the moment, showing wide inequalities in health, which have been widening under the current Government. She recommends strong fiscal action to increase taxes on tobacco and alcohol, as well as on foodstuffs with high contents of sugar and salt. The NHS England 10-year plan makes no mention of that. Will the Government accept the CMO’s recommendations?

My Lords, as I said, the Government take very seriously the CMO’s recommendations and in previous years have taken them on board. The Government are striving to address the inequalities, and, as we said in the Statement on the NHS plan, £4.5 billion is going into the preventive agenda through increased investment in primary medical and community care. We are addressing inequalities in obesity and are looking to reduce by 2030 the gap in obesity between children from the most and least deprived areas.

My Lords, one of the best ways to reduce health inequalities is to make sure that we have truly personalised medicine—which the CMO references in her report. She talks about health being transformed by 2040 by integrating biomedicine, technology and behavioural sciences. Can my noble friend say what the NHS is doing to embrace the innovations that will lead to this kind of healthcare?

My noble friend is absolutely right: emerging technologies will transform healthcare and are doing so already. Variables can transform the prevention, diagnosis and management of long-term conditions such as diabetes. Indeed, information from monitors worn by patients with atrial fibrillation can be downloaded by their clinicians. We are also looking at more creative solutions regarding artificial intelligence, which will go a long way to improving the healthcare of patients.

My Lords, given the target to halve childhood obesity in the areas of inequality, will the Government give urgent consideration to the recommendation that the soft drinks levy should be extended to sweetened milk-based drinks, and eliminate added sugar from commercial infant and baby foods?

My Lords, the Government have committed to review the soft drinks industry levy exemption for milk with added sugar in 2020, when we will have further information on the effectiveness of Public Health England’s voluntary reformulation programme. On baby food, product ranges that target babies and young children are now part of the Government’s reduction and reformulation programme.

My Lords, I think we all recognise the importance of the CMO’s report and her recommendation that local government is supported to encourage healthier living through preventive health programmes. When funding given to councils for such preventive strategies is being cut by 4% under the long-term plan, how do the Government propose to honour the suggestions outlined in her report?

My Lords, the Government take prevention very seriously. As the noble Baroness will be aware, the 2015 spending review made £16 billion of funding available for local authorities in England over a five-year period. That is in addition to what the NHS spends on prevention, including more than £1 billion in 2016-17 on our world-leading immunisation, vaccination and screening programmes. Of course, we also need to tackle wider detriments, which is why public health has been handed over to local authorities to look at wider determinates of ill health, including pollution, poor housing and the environment.

My Lords, how can it be acceptable that today the poor end of our society is deprived of eight years of life compared with the most affluent end of society? Is it not time that the Government took a firm grip on local authority budgets for public health? I know that the Minister has talked about this issue but at the moment, people are still being deprived.

My Lords, of course it is not right that there are health inequalities between people who are poor and those who are not. The Government are endeavouring to do everything they can to reduce those inequalities. I have talked about the obesity plan; we are also looking at diet, information and working with local authorities to improve the wider detriments of ill health. We have a world-leading strategy on obesity and salt intake. In this House we have discussed issues such as fluoride and folic acid, on which the Government continue to work.

My Lords, will my noble friend agree to investigate thoroughly the care of elderly people in their own homes as opposed to admitting them to casualty departments? There is a difference not only in cost but in care when those people are helped in their own homes.

My Lords, my noble friend is absolutely right. We need to ensure that we get even better at looking at integrated healthcare so that elderly people are looked after in their homes with the services they need. That is why we are looking at putting £4.5 billion into the NHS every year to find creative solutions to keep older people in their homes.

My Lords, following on from my noble friend’s question, some 85% of councils plan to reduce their public health budgets in the next year. Spending on obesity and sexual health programmes will be cut. How can the Government deliver their preventive health agenda or address the key issues raised in the CMO report in the light of all that?

My Lords, in answering the noble Baroness, Lady Jolly, I stated that we are working closely with local authorities to look at the wider detriments of ill health. We have put in place significant sums of money, including committing £20.5 billion to the NHS every year over the next five years. We are working closely with local authorities to see what works so that we can improve health in the local population. The lessons learned will be shared across the country.