Public Health (England)

Part of Points of Order – in the House of Commons at 4:20 pm on 22 February 2007.

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Photo of John Pugh John Pugh Shadow Minister (Health) 4:20, 22 February 2007

I shall be relatively brief and I also hope to be a little more reflective and consensual than some of the other contributions have been so far.

Good public health is the holy grail of modern politics. It has massive implications, and it could be argued that this is the most important debate that we will have this week. Parliament has a track record of underplaying the issue. In the 19th century our predecessors only took seriously the harm and diseases caused by the drains of London and the befouled Thames when the smell actually reached this Chamber. Now we face a different pressure. Longevity is increasing, thanks to better medicine, therapies and drugs, but we have not seen the same increase in the period of good health enjoyed by people in their lifetime, which is increasing more slowly. The period of decline and dependency is growing. There is more immobility, dementia and bone and muscle wastage. As a result, there has been an increase in the chronic diseases of old age, which is coupled with a falling birth rate and huge medical costs. Those factors have been well illustrated by the Wanless report and the King's Fund. It is a serious problem and there is no realistic way at present that we can continue to fund it.

The only acceptable solution for a civilised society is to aim for a longer, but healthier old age. The ideal scenario for health economists would be a world in which people lived happily and healthily to 90 and then fell off their bicycle or died while out jogging. One change alone could transform matters and our calculations, and that is a successful means of preventing the onset and development of dementia and Alzheimer's. Research in that area is crucial, because if predictions in that area change, the public health scenario also changes.

It is clear that something must be done, and it is also clear that something can be done. If we consider the variations in health outcomes between inner cities and the suburbs—the fact that somebody born in Blackpool lives eight years less than somebody born in Kensington—we see a serious problem that needs addressing. We must be clear that more chronic diseases are the result of the use and abuse of the body during a lifetime. Over time, a bad lifestyle has deleterious effects. Obesity, for example, plays a part in the development of diabetes, heart disease and some cancers. That is a drab picture, but we must acknowledge that some significant progress has been made by several Governments. First, progress has been made in addressing occupational diseases. We no longer get the dreadful litany of asbestos, coal and chemical related complaints that we used to have. They are still around, but they have a date stamp on them. We have also had serious improvements in health and safety at work and elsewhere, although too many people still die in accidents on building sites and too many are run over on our roads. We have been extraordinarily successful in counteracting infant mortality and the diseases of childhood, through better antenatal and post-natal care and programmes of education and immunisation. Those also have their place in the adult world, and we look forward to better screening for diseases such as bowel cancer, better immunisation and greater awareness.

Enormous gains are to be had in public health. Recently a vote was held on the most successful public health breakthrough in the past 200 years. The winner was not penicillin or any other therapy or medical technology, but Chadwick's institution of drains. Second on the list was the invention of the contraceptive pill, so neither of those were medical technologies as such.

There are appreciable problems in public health, which I want briefly to deal with. Gains that are made in public health are generally long term and not immediately evident. If we do something about childhood obesity, its effects will not be immediate. We will not see better health outcomes straight away: we may see the difference in the children, but the long-term effects will kick in much later.

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Anne Barbara Balmer
Posted on 26 Feb 2007 7:35 pm (Report this annotation)

Mr Pugh, it is Mesothelioma day tomorrow, someone loses their life every five hours from the asbestos cancer Mesothelioma, figures are rising faster that government projections. Sufferers are getting younger and younger. Every day people are still being exposed to asbestos. Unless there is massive government funding to remove asbestos from the millions of public and private buildings and extensive health and safety education the date stamp you speak of is pie in the sky. School teachers, caretakers, prison warders, electricians, plumbers, builders are all are at risk as are the people they come into contact with. More government action NOW. Tomorrow is too late. People before profits!