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Business
Lord Grocott: My Lords, with permission, I shall say a few words about business tomorrow and on Thursday. The House will be well aware that parliamentary life is not entirely predictable, but it is particularly unpredictable in the last two days before prorogation. Therefore, although my colleagues and I will obviously make sure as far as we can that everyone knows precisely the order of business, I ask noble Lords to keep an eye on the annunciator from time to time and switch it from whatever channel they are watching at the time. That would be appreciated.
On the precise timing on the Pensions Bill and the Hunting Bill, as the House will know, the Commons is currently considering those Bills. We shall have the Commons amendments in print tomorrow morning. So far as this House is concerned, the deadline for tabling Motions and amendments in respect of the Pensions Bill and the Hunting Bill will be noon tomorrow.
Health White Paper
3.19 p.m.
The Parliamentary Under-Secretary of State, Department of Health (Lord Warner): My Lords, with permission I wish to repeat a Statement made in the other place by my right honourable friend the Secretary of State for Health. The Statement is as follows:
- "I wish to make a Statement concerning the publication of a White Paper outlining the Government's policy on health improvement.
"Over the past eight months of the consultation we have seen speculation after speculation of the content of this White Paper and alleged leak after alleged leak. Some of it has, unfortunately, been relatively accurate. Most of it has been highly inaccurate and some of it has been sheer fantasy. Today I want to tell the House the reality.
"Last century saw undreamt of progress in the health of the people of England, gathering pace after 1948 as the establishment of the NHS enabled free universal provision of immunisation, screening and treatment to make inroads into ill health and premature death.
"It should be a matter of pride that a child born today is likely to live nine and a half years longer than one born on the eve of the formation of the NHS in 1948.
"However, the role of government in the prevention of ill health during this time was often characterised by a top-down approach.
"This White Paper is different. It is about enabling people to exercise their choice; it is about extending opportunity and offering security to those who want to choose a healthier life; and it is about people improving themselves.
"For in this White Paper it is the public, not Whitehall, who have for the first time set the agenda and identified what "for their own good" means. Over the past eight months we have consulted, discussed, listened, canvassed and calculated public opinion on a wider scale than ever before to get in touch with people's real concerns and to ask what they wanted and how they could be helped to realise their aims.
"They know that in recent years new opportunities have been opening up rapidly. But with them come growing inequalities, and, on the other hand, paradoxically, affluence and comfort bring their own health challenges—growing obesity, lack of exercise, more casual sexual relations.
"Faced with these many people want more opportunities to live healthier lifestyles. They know that they will become healthier only through their own efforts. However, they look to government to assist them with information about healthy and unhealthy choices—not to make the decisions for them, but to provide them with clear information to allow them to make the decisions.
"Now that the NHS is improving waiting times, reducing waiting lists and improving emergency care departments, that frees up the time, space and resources needed for effective action on prevention to help people make those changes.
"That is why this White Paper commits us to ensuring that health services such as sexual health services, NHS Stop Smoking Services and obesity services all now benefit fully from the same drive for modernisation and improvement that is spreading across the rest of the NHS.
"Our starting point is informed choice. That means an approach which respects the freedom of individual choice in a diverse, open and more questioning society. It also means addressing inequalities—the differences that locality and social conditions can make—so that everyone can have real choices. It is a sad fact that even today a male child born in Manchester lives at least seven years less than a child born in Kensington and Chelsea. Those inequalities cannot be tolerated any longer.
"To improve the nation's health we need everybody to have the chance to make more healthy choices—not just the better off.
"We will not be successful in tackling these inequalities unless we work in different ways. We need to reach people where they live their lives and provide services that are accessible to them but also derive from their own local communities.
"That is why the Deputy Prime Minister and I were determined that this White Paper would set out action that maximises the positive impact that local authorities and others can have to help people to make those healthier choices.
"For example, beginning this coming spring, the Communities for Health programme will bring all parts of the community together—statutory and voluntary organisations, businesses and individuals—in campaigns to improve local health.
"Working with local government we will be targeting funding to give greater priority to areas of high health need. New investment in primary care facilities for some 50 per cent of the population by 2008 will focus on the most deprived areas of our communities.
"In our widespread consultation people made clear that they often want to change but that they lack accessible help and advice. So, to help the public to make healthy choices we will provide them with clear information on those choices. Building on the success of NHS Direct, which received 7 million advice and assistance calls last year, we will introduce a completely new service—Health Direct—a telephone, online and digital TV information service to make advice on health, nutrition and diet available to everyone in this country, not just the better off.
"We will give special help to specific groups. Thirty years ago almost half the adult population of this country—46 per cent—smoked. Today it is 26 per cent. We will take another 2 million people off that figure over the next five years. Ultimately, people need to make this decision to improve their own health themselves, and to give up smoking everywhere, not only at work and in the pub, but at home as well. The Government cannot make this decision; it is a personal decision. However, we can help, as we helped 125,000 quitters last year through the NHS Stop Smoking Services. That is why we will be radically extending our campaign against smoking and why we will extend our smoking cessation services.
"We will introduce action to put hard-hitting picture warnings on cigarette packets; further restrictions on tobacco advertising; tough action on shops that sell cigarettes to children; improvements in the way the NHS helps people to stop smoking and to stay stopped; further reductions in tobacco smuggling; and, as I will outline later, we will see smoke-free environments becoming the norm both at work and at leisure.
"Others have told us that they would like help too. Many people today, such as busy mums, have told us that they want their families to eat more healthily, but that they need more, easily accessible and simple information to guide them.
"That is why, together with the Food Standards Agency, retailers and the food industry, we will develop a simple code for processed food to indicate fat, sugar and salt content for shoppers to help people choose what they need for a healthy and balanced diet.
"Our general approach is, of course, to recognise the right of adults to make their own informed choices. However, people, particularly parents, feel differently about children. Parents know that their children's health is primarily their responsibility,
- but they told us during our discussions that government, businesses and anyone who has an influence, also share that particular responsibility to protect children from premature exposure to a world of adult choices. Parents want the security of knowing that will be done.
"That is why, along with the Secretary of State at the Department for Culture, Media and Sport, we will be asking Ofcom to consult on advertising to children on television and why we will work with the industry to limit other forms of advertising to children outside television. That is also why, led by the Education Secretary, we will develop our approach to health in schools which looks at the effect of everything the school does—lessons, sport, food, school nurses, personal, social and health education—to ensure that these are brought together in a co-ordinated "whole school" approach to health to start children on the right path to a healthy life.
"That is why we will increase activity for children in schools. The Government are investing an unprecedented amount—over £1 billion to 2006—in PE and school sport; developing more sports specialist academies; strengthening the protection for school playing fields; and helping more children to walk or cycle safely to school. This is an age when obesity has trebled in a generation, and where, if the number of obese children continues to rise, we face the prospect of children having a shorter life expectancy than their parents.
"To be effective, support has to be tailored personally to the realities of individual lives, with services and support personalised sensitively and flexibly and provided conveniently.
"That is why—by new technology and investment—we intend to offer everyone in England the opportunity to develop their personal health guide and, starting with the areas of greatest disadvantage, we will provide people with NHS health trainers to support people's motivation in making the difficult decisions to choose healthy lifestyles. That has been limited to the well off, but it ought to be available to everyone in England.
"Healthy living starts at a young age. That is why we have decided to provide funding so that, by 2010, every primary care trust will be resourced to have at least one full-time school nurse working with each cluster of primary schools and secondary schools in their area.
"One of our greatest challenges is in the field of sexual health. It is a staggering fact that no fewer than one in 10 sexually active young women is today infected with chlamydia. We have to bring this problem out of the shadows and into the forefront of our attentions. We therefore intend to: launch a new national campaign targeted particularly at those at risk of catching sexually transmitted infections or of unplanned pregnancies; accelerate the implementation of our chlamydia screening programme to cover the whole of England by 2007;
- and offer the same fast access to high-quality genito-urinary medicine services that patients expect of other NHS treatment. In other words, by 2008 everyone referred to a genito-urinary medicine clinic should be able to have an appointment not within weeks, but within 48 hours. We will make that a priority.
"We recognise the damage that excessive alcohol can have on individuals, families and society at large. That is why we will work with the Portman Group to cut down on binge drinking, and with industry to develop a voluntary social responsibility scheme for alcohol producers and retailers, to protect young people. We will support Ofcom to strengthen the rules on broadcast advertising of alcohol, particularly to protect the under-18s; and we will invest to improve services to help the NHS to tackle alcohol problems at an early stage.
"There is another area where people want a greater degree of security and protection in maintaining a healthy lifestyle for themselves and their families. I have stressed that our approach has been guided by informed choice on the part of individuals, with government playing our role in providing information, encouragement and support in order to assist individuals in making the healthy choices. We do that because we believe that, in a free society, men and women ultimately have the right within the law to choose their own lifestyle, even when it may damage their own health.
"But people do not have the right to damage the health of others, or to impose an intolerable degree of inconvenience or nuisance on others. We therefore intend to shift the balance significantly in favour of smoke-free environments. From 2006, we propose to introduce changes to ensure that all government departments will be smoke free; all enclosed public places and workplaces—other than licensed premises, which are dealt with separately—will be smoke free; all restaurants will be smoke free; and all pubs and bars preparing and serving food will be smoke free. Other pubs and bars—about 20 per cent of those in England—and membership clubs will be free to choose whether to allow smoking or to be smoke free, but smoking in the bar area will be prohibited everywhere.
"We will therefore ensure that people will be able to go to their workplace or choose to go out for a meal or a drink without the damage, inconvenience or pollution from second-hand smoke. However, we will try to do that in a way which, while protecting that right of the majority, still allows a degree of choice—albeit a much more limited one than before—to the minority. This is a sensible solution, which balances protection for the majority with personal freedom for the minority in England.
"This White Paper promotes the opportunity for healthy living in a manner and on a scale unseen before. It envisages investing at least £1 billion over the next three years in public health. It treats our fellow citizens as adults capable of making their own decisions, while providing advice, information,
- encouragement, resources and personal support for those who want to make the healthy choices. It provides protection from the effects of those who do not wish to make healthy choices.
"It begins the transition of our healthcare away from just a national treatment system for illness, towards a true national health service. It offers the opportunity for healthy living to everyone who wants to take it and, for those who do, the security of knowing that a degree of protection will be afforded to them and their families. In doing so, it begins to fulfil at last the founding vision of a true national health service. I commend it to the House".
My Lords, that concludes the Statement.
3.34 p.m.
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