Opposition Day — [1(st) Allotted Day]
Stephen Dorrell (Charnwood, Conservative)
I doubt that I did everything that the chief medical officer recommended that I should do, but I would never have objected to anyone pointing out to me what the CMO had recommended and asking me why we were not doing it. My challenge to Ministers takes the form of the three recommendations in relation to the public health discipline that the CMO made, publicly, in July.
The first recommendation is:
"Consideration should be given to establishing a comprehensive review (the first in almost 20 years) into arrangements to improve and safeguard the health of the public."
Earlier in the debate, a misunderstanding arose between my hon. Friend the Member for South Cambridgeshire and me. The last review of the public health discipline in this country was carried out by Donald Acheson, who published his report in 1988—almost 20 years ago. The present chief medical officer recommends, and I agree, that it is high time that that work was reviewed, not least because Donald Acheson recommended a level of commitment to the public health discipline by 1998 that in 2006 is still not matched. I hope that Ministers will tell the House when they intend to honour that first recommendation.
The CMO's second recommendation is that
"Health service commissioners should take steps to satisfy themselves that expenditure on public health reflects the needs of their population."
I believe that Ministers accept that now. It is a pity that during the 10 years in which the Labour Government have been in office, they have not focused resourceson need through commissioning —[ Interruption. ] The Minister says that they have, but her predecessors in the period in which the right hon. Member for Holborn and St. Pancras was Secretary of State for Health did not believe in commissioning and made it clear that he intended to wind it up, so it is hard for her to make that claim for the whole 10 years in which Labour has been in office.
The third recommendation is that all NHS bodies should ensure that their public health capacity and capability are sufficient for their proper functioning. In his report the CMO makes it pretty clear that he does not believe that the present level of public health commitment is fit for purpose. Furthermore, he draws attention in his report to the fact that there is a twentyfold variation—this is a health inequality among the different parts of the country—in different PCT areas in their commitment to the public health discipline. That cannot be the record of a Government who accept the importance of public health as the backbone to well informed commissioning.
I conclude with the simple thought with which the chief medical officer heads the chapter on the subject in his report—"Raiding public health budgets can kill". It is like the advertisement on cigarette packets. Raiding public health budgets can kill: that is what the Government are doing, and that is the consequence for which they must accept responsibility.