(6 years, 9 months ago)
Lords ChamberThe noble Baroness might send me her book so I can get her ideas on reaching adults with learning difficulties. Most adults with significant learning difficulties are likely to be on a range of benefits. That means that their dental care is free, if not for all, I suspect, then for some. She is absolutely right to point to sugar. We now have the sugar levy, which has had a really big impact. About 50% of drinks that would have been affected have been reformulated to either reduce or remove the application of that levy. That is a really good impact. On her point on advertising, we have very tough advertising rules in this country, including the banning of advertising of sweet drinks, sugary products and so on in children’s media. That is one of the reasons why we are seeing some hopeful signs on, for example, the number of extractions falling in primary care year on year.
My Lords, is the Minister aware that 41.5% of children have not visited the dentists for the year up to September 2017 and that many of these children are in the poorest communities of the country, many of which, as the noble Baroness, Lady Kennedy, said, are now dependent on charity for dental care? What action will he take to ensure that all children have proper access to NHS dentistry, wherever they live throughout the country?
The noble Baroness is right. About 59% of children have seen a dentist in the last two years, but of course that leaves 41% who have not. I have to say that that is an improving picture. On her two particular issues, there is NHS England’s Starting Well programme, which is targeted on 13 local authorities that have the worst oral health outcomes for children. The range is really quite dramatic from one area to the next. It has also developed a core offer to help every local authority commission better dental health for children.
(7 years, 11 months ago)
Lords ChamberThis party does believe in competition. But it also believes that the NHS’s supporting community pharmacies to a very large extent when 40% of them are in clusters of three or more within 10 minutes’ walk from each other, and paying an establishment fee to each of those pharmacies, is probably not a very good allocation of resources.
My Lords, have the Government yet published the cost-based evidence for the cuts to the community pharmacies budget, and what safeguards will they put in place to ensure that the most needy communities are not hit hardest by the cuts to the pharmacies budget?
The pharmacy access scheme is being set up to deliver exactly what the noble Baroness is asking for—that rural pharmacies and those in very deprived areas will receive greater payments than others. I am not quite sure what report she is referring to. I will have to look at her question afterwards and write to her.
(8 years ago)
Lords ChamberMy noble friend has slightly confused me, I am afraid. There is no question that fluoride has an impact on oral health. I am not aware of any evidence to suggest that it has other, detrimental impacts on children’s or other people’s health. We have huge inequalities throughout the United Kingdom, most of which are as a result of social deprivation, poor housing, high unemployment and the like. Those are the fundamental drivers of health inequalities, rather than health systems per se.
My Lords, given the harm caused by high levels of sugar added to some processed foods, does the Minister agree that the present restraints on the food industry are woefully inadequate? Does he further agree that much tougher measures need to be taken if the Government are to meet their own public health objectives on oral health, diabetes and obesity?
My Lords, the introduction of the sugar levy is evidence that the Government take this matter extremely seriously and believe that it cannot be left solely to industry to reduce sugar levels. The Treasury is due to report on the extent of the sugar levy on 6 December. As part of the obesity strategy, targets are being set for nine key categories of food eaten predominantly by children. The results of reduction over time will be made transparent and open. A combination of those measures should have an impact.
(8 years, 2 months ago)
Lords ChamberMy Lords, I rise to draw attention to Public Health and its contribution to the success of cutting smoking. I speak as someone who comes from Bristol, where the legacy of the tobacco industry has left generations suffering following the free cigarettes that were provided to workers as a matter of course. As has already been said, the estates in south Bristol, which were built to provide workers for the tobacco industry, are still among the most deprived in the country. Life expectancy there and in other parts of the city differs by 10 years and sometimes more. It is not just about death. It is about the quality of life for very many people in those communities.
When I was leader of the city council, I took a very active part in the Smoke Free Bristol campaign. The campaign was very successful because it captured the imagination of local people. The owners of clubs, bars and pubs were not all as enthusiastic, but very many of them could see the arguments, and we supported them and worked with them to bring the campaign in.
Equally, in the Public Health self-help groups, the fact that local people were trained to support each other —the health trainers and assistants were all local people —led to a much greater awareness of health within these communities. There was a wide range of projects, tackling not just smoking but such things as obesity, alcohol, depression and diabetes. I was very impressed with the progress that was made. However, the Public Health budget is being cut by 9.6% from 2015-16 to 2020. That is on top of the dramatic local authority cuts.
I would like the Minister to consider making this a priority. The emphasis on health that we have through Public Health, rather than on illness, has had a huge impact in these poorer communities. Public Health has enabled people-led schemes rather than professional-led schemes. I agree with others who have said that sustained investment and funding is absolutely vital if we are to do the things that are needed in these communities and to help people take responsibility for their own health.
(9 years, 4 months ago)
Lords ChamberThe decisions about which services to reduce must lie with local authorities.
My Lords, does the Minister realise that many of the contracts for public health are already let in the medium term? Is the proposed cut on uncommitted funding, or are the Government proposing to give some help to local authorities who have no way of ending those contracts?
The noble Baroness raises a good question. This will be a crucial part of our consultation, which will take place very soon.