The Health of the Nation

Part of the debate – in the House of Commons at 6:20 pm on 22nd October 1992.

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Photo of Mrs Marion Roe Mrs Marion Roe , Broxbourne 6:20 pm, 22nd October 1992

I am grateful for this opportunity to speak in the first health debate of this parliamentary Session—the first since I became Chairman of the Select Committee on Health. I am very proud and privileged to serve on such an important Committee. It has awesome responsibilities, as all who are involved in health care know so well. We shall certainly look forward to welcoming next week my right hon. Friend the Secretary of State to give evidence to our inquiry into tobacco advertising.

I pay tribute to my predecessor and to former members of the Committee who steered it so ably for 15 months. I am particularly grateful to the last Chairman. As part of his legacy, he has left me an excellent and acclaimed report on maternity services, about which I shall say more later.

Unlike the hon. Member for Sheffield, Brightside (Mr. Blunkett), I pay tribute to the Secretary of State for bringing forward publication of the White Paper "The Health of the Nation". There can be little controversy about the essence of the policy: to make people more aware of the need to be healthy.

When the hon. Member for Brightside complains about the Government's policies concerning poor housing and homelessness and their effect on health, I remind him, first, of the enormous sums of money that are being poured into the estate action programmes to revitalise derelict housing estates and, secondly, of the fact that the Labour party bitterly opposed housing action trusts, the purpose of which was to bring back into use thousands of empty homes, owned by Labour-controlled councils, that are in disrepair through neglect and bad management. So much for the Labour party's concern over homelessness.

The Select Committee on Health will shortly start an inquiry into NHS dental services, an inquiry which I hope the hon. Member for Brightside welcomes.

It is entirely sensible that the Government should concern themselves not just with being able to cope with ill health, and all that that brings with it, but with doing all that they can to prevent the onset of illness. Ill health is a tragedy, in terms not just of the waste of a country's resources but of the human cost—a matter of much greater concern to us all. It leads to the loss of the breadwinner, the awfulness of seeing a child suffer and the strain of long-term nursing or of coping with a relative who is severely disabled. All these things can bring with them untold human misery.

It is good to see the Government taking the initiative and, once again, being proactive rather than reactive. The health service reforms, for which successive Conservative Governments are responsible, are shaping a health service that is better able to meet the huge demands upon it. That is a subject for the nation's gratitude and pride. Millions more patients are receiving the treatment they require, and millions more are being treated for ailments that even 10 years ago could not be treated. Let us, however, be in no doubt that demand and public expectation will continue to put heavy pressure on our health services. That is why I welcome this initiative.

It is important that those of us who can do something to protect ourselves against ill health should do so, in order that the people who need treatment can receive it as quickly as possible. As a Conservative, I put great store by the responsibility of individuals to look after their own health, but that responsibility must be grounded in informed choice and a sharing of common objectives. We cannot legislate to stop people drinking, smoking, or even having sex, but we can and should inform them of the consequences of their actions.

Moreover, I believe that greater understanding of what is good and bad for us will lead to greater willingness of people to work together. For example, it is a pity that, when a family adopts a healthy diet at home, there is little encouragement, in schools or the staff canteen, for people to eat sensibly. Therefore, I am pleased that the White Paper places emphasis on health alliances between different agencies, groups and organisations. I hope that the Government will ensure that they all work together to produce common and easily understandable messages.

I congratulate the Government also on moving the health debate forward. As we have heard, much has been achieved already. Anybody who has seen a child with whooping cough or struck down with measles knows how sensible it is for children to be immunised. Similarly, any woman who has been saved from the horrors of cancer by timely screening is aware of the value of preventive medicine.

It is right that the goalposts should be widened, new targets set and our sights raised higher. While I applaud the Government on publishing the White Paper, I am concerned that the impetus that led to its publication should not be lost. When I read the White Paper, I was struck by the myriad good intentions. It speaks of targets to be attained, by means of strategies and schemes to be developed, of reports to be made and of action groups to be set up.

A great deal of activity is promised. Although a Cabinet Committee will oversee the implementation of the overall strategy—which I welcome as a positive sign of the Government's commitment, as well as their promise of periodic reports—would the Secretary of State contemplate issuing an annual report so that achievements could be recognised and unsatisfactory trends acted upon quickly? Such a report could be on the same lines as the chief medical officer's annual report on the state of public health. This one, however, should concentrate on the specific key areas and targets mentioned in the White Paper.

The White Paper contains many matters of enormous interest. My Committee will look at them, in particular at those which relate to pregnancy and childbirth. The Select Committee on Health has done an exceptional amount of hard work on the maternity services and has produced a report that has been well received by the Government and professionals alike. The importance of good maternity services for the welfare of the mother and the well being of the child cannot be emphasised enough. That is at the centre of the Committee's report. It places emphasis on the provision of continuity of care for the mother throughout pregnancy and childbirth.

There are many other recommendations, most of which are designed to promote the health care of both mother and baby so as to avoid complications or unnecessary illness—aims that are entirely compatible with those in the White Paper. Some of the recommendations, especially those at local level, are being acted on and others are being studied. At the last count, three committees were considering the different points that the Select Committee had raised. Midwives and I hope that the committees will report as soon as possible so that the Select Committee's recommendations can be acted on quickly.

I should like to take the debate on maternity services and the welfare of the mother one step further. Few people are aware that as many as 10 per cent. of all recently delivered women develop post-natal depression. In some cases, depression may be so severe that women need out-patient psychiatric help, and many need drug therapy. In view of its common occurrence, it is surprising that so little attention is given to it. Many books on pregnancy and childbirth hardly mention it, if at all, and it is not usually discussed in ante-natal classes.

Many mothers who are at risk could be picked up. Mothers who are most at risk are those who have had a history of mental illness or a tendency to it within the family, those who have experienced fertility problems and who experienced a difficult birth with their child—who may have experienced a lot of intervention—or those who experienced the trauma of a child being taken into special care.

My right hon. Friend the Secretary of State rightly pinpointed tackling mental illness as one of her key tasks. Mental illness is a double curse, because it is so destructive of a person's confidence and of his or her ability to help themselves. In that context, post-natal depression is doubly vindictive, because a mother becomes frightened for herself and particularly frightened about her ability to look after her baby. More could be done to recognise the dangers of this affliction. I urge my right hon. Friend to consider this matter as appropriate for inclusion in the overall objective of reducing the incidence of ill health caused by mental illness.