Health — Debate
5:00 pm

Baroness Thornton (Baronesses in Waiting, HM Household; Labour)

My Lords, it is with great pleasure that I respond to this debate and to the opportunity provided by the noble Baroness, Lady Knight, to highlight the Government's public health agenda. I congratulate her and other noble Lords on an interesting debate. She has drawn attention to issues of which the NHS is aware and is acting on, from matrons to the organisation of wards and infection control, which are of course of great importance.

I do not accept the failures in regulation alleged by the noble Baroness, given that in the past there was virtually no accountability for doctors and other medical professions at local level, which is why we have focused during the past 10 years on giving our regulators a wide range of toughened enforcement powers and have enabled the new commission to take direct and independent action against service providers that fail to meet essential levels of safety and quality which people are entitled to expect.

I entirely agree with the noble Baroness that we need to deal with mixed-sex wards. The Government have never denied that. The Secretary of State announced in January a six-month drive to eliminate mixed-sex wards in hospitals. Three cornerstones underpin the programme: a £100 million privacy and dignity fund; improvement teams established to help those hospitals with challenges in this area; and working to establish financial covers in the context of the contracting framework between PCTs and hospital trusts.

The Government's approach to public health cannot be described simply by a list of initiatives. It is about how we deploy our health resources and the leadership that we provide in this area. Our leadership is a response to our passionate belief that good health is a shared priority from the bottom to the top of the nation. Our starting point was that in 1999, only 1.8 per cent of total health expenditure went on prevention and public health. We now spend more than 3.6 per cent—double that spent 10 years ago.

Not everyone sees that as a good thing. Earlier this year, my right honourable friend Dawn Primarolo, the Minister for Public Health, pointed out that there is a school of thought that there is no such thing as public health. According to that view, any intervention in public health and any act to give individuals or groups support, guidance or safeguards is somehow an attack on their liberty. She rejected that argument, and so do I. Choice and control can be an illusion when you are very poor and in ill health. For those living in such communities, it is practical, tailored, focused support that makes the difference. That is our aim. For example, the health of communities collaborative programme is working in 28 sites among the most disadvantaged communities to raise awareness of the signs and symptoms of cancer and cardiovascular disease and to encourage people who may have those symptoms to seek help early. It is a community-based approach to public health that can be tremendously successful.

We believe that we have come a long way towards our aim to provide services that reflect changes in people's lifestyle, habit, environment and society. We believe that our campaigns are now much more sophisticated than they were in their targeting and their understanding of people's motivation to change. For example, the smoking campaigns funded by the Department of Health have been widely acclaimed by marketing experts in both the public and private sectors. However, as noble Lords have mentioned, those campaigns cannot work on their own. That is why Change4Life is rooted in research about people's behaviour and how they change their lives. It tells people how they can make positive changes as well as warning of the dangers of obesity. Clearly it is up to individuals what they eat, drink or smoke. It is not the Government's intention to intervene unnecessarily or stand at their shoulder in the kitchen, as it were.

Our sexual health campaign has generated almost 1 million visits to the Condom Essential Wear website. More than half of 16 to 24-year-olds say that they are more likely to have a check up for a sexually transmitted infection as a result of seeing the advertising. We have already heard from the public and the media of lives saved following our stroke awareness publicity. Some may remember that I described FAST in your Lordships' House, with visual aids. One clinician in Kent has reported seeing around 200 patients as a result of the campaign's message. We estimate that the new cervical cancer vaccine will save the lives of up to 400 women a year.

There are other campaigns aimed at informing, supporting and empowering individuals and families to make healthy choices. These include seasonal flu immunisation, pandemic flu preparedness—I will refer to that again in a moment—stroke awareness, sexual health, HIV and having an NHS life check. All our major campaigns are evidence-based and subject to evaluation.

The noble Lord, Lord Addington, raised the issue of sporting and physical activity. Change4Life, launched in January 2009, focuses on pregnant women, parents of babies and toddlers and parents of pre-school and primary school children. In future years, we will see the development of programmes targeted at young people and adults. For example, £140 million was invested in our free swimming programme. The walking your way to health scheme, led by the Department of Health, Natural England and the British Heart Foundation, delivers nearly 2,000 walks to more than 30,000 people each week. We are determined that as part of our legacy for the Olympic Games, 2 million adults should be more active in 2012. This will include active travel, dance, gardening, and active conservation. We are measuring the activity that contributes to this target of 2 million people through an extended version of Sport England's active people survey.

The noble Lord kept asking me who is responsible for this. It is a cross-government activity. It can only be delivered across government. The Department of Health, for whose activities I am partly responsible for, has its part to play, as do all the other departments mentioned by the noble Lord. He also mentioned the sports and exercise consultants. We had an exchange about the importance of the provision of sufficiently qualified medical experts for the Games and about establishing consultants and medical facilities as part of the legacy of the Games.

The noble Lord, Lord Ramsbotham, made an eloquent comment about health in prisons. Like him, I am looking forward to reading the report of my noble friend Lord Bradley. I know that the Government will look very carefully at his recommendations. The challenge that we have—the noble Lord will be only too aware of this—is that, since 2006, all prison health services have been transferred to the NHS; we are mainstreaming their services. Therefore, our target is that prisoners receive the same standard of healthcare as we would expect in the rest of the community. However, we know that that is easier to say than deliver. Indeed, there is a great deal more to do.

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