Clause 129

Part of Health and Social Care Bill – in a Public Bill Committee at 1:30 pm on 24th January 2008.

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Photo of Anne Milton Anne Milton Shadow Minister (Health) 1:30 pm, 24th January 2008

I beg to move amendment No. 67, in clause 129, page 85, leave out lines 20 and 21 and insert—

‘(a) have regard to the standards set out in statements under section 41 of the Health and Social Care Act 2008, and

(b) produce an annual health improvement plan.’.

The amendment, crucially, would insert into the Act a duty on primary care trusts to produce an annual health improvement plan. All NHS bodies currently have a duty, under section 45 of the Health and Social Care (Community Health and Standards) Act 2003, to ensure that they have arrangements in place for the purpose of monitoring and improving the quality of care. Clause 129 would amend the National Health Service Act 2006 to insert a duty on primary care trusts to make arrangements to secure continuous improvement in the quality of care provided by or for them. This new version of the duty is intended to be more closely aligned with that imposed on local authorities by section 3 of the Local Government Act 1999. The existing duty in section 45 of the 2003 Act would cease to apply in relation to English NHS bodies. Responsibilities for the duty of care would thus be placed with commissioners of NHS services and primary care trusts.

The amendment would put a condition on PCTs to produce an annual health improvement plan. I believe it is still the case that primary care trusts produce an annual health report. That is important as it reports on what has happened within its area in the previous year. However, that focus on future improvement is crucial. Many parts of the Bill, in relation to maternity grants, the weighing and measuring of children and here under the clause, make reference to the public’s health. I would urge the Minister, as I said in my brief intervention on the discussion of the previous clause, that this is non-party-political issue. We will move on to obesity and I am restraining myself from talking about it now, but it is terribly important that we deliver better health for the public.

Public health is in many ways a dispiriting area to work in because, particularly with measures that have long-term outcomes, one is looking for improvements over the course of five years. The health improvement plan would help those working in the field to keep their focus and allow them to be measured against what they are delivering and indeed, measure themselves. It is disappointing that on the state of public health in July 2006, the chief medical officer warned that raiding public health budgets can kill. Although it is not so much the case this year, in previous years we have seen PCTs’ responses to budget deficits as raiding the public health budgets. Unfortunately, public health money is always seen as soft money, partly because of those long time frames for outcomes—there is no immediacy. I do not know that newspapers such as the Daily Mail report public health very much and it does not have the sexy image that many other parts of healthcare have, but it is equally if not more important.

If we look at the figures for the number of people employed in public health—I should reiterate my interest, which is that my husband is a public health physician—between 2005 and 2006, with no more recent figures available, the number of full-time equivalent public health staff in the NHS was cut by 4 per cent. It went down from 1,324 to 1,268. Of those, the number of public health consultants was cut by 6 per cent., going down to 687. PCTs are working with  tight financial constraints these days and there is a feeling that they must deliver on those headline figures. It is absolutely crucial that we get PCTs to focus on public health improvement; to produce a plan would make a substantial difference.