Health: Public Health Responsibility Deal

Lord Brooke of Alverthorpe Excerpts

Thursday 27th June 2013 Grand Committee

[Lord Brooke of Alverthorpe]

I thank the noble Lord, Lord Clement-Jones, for this debate. I see that a number of us who have debated these topics previously are present. My interests in this arena are declared in the Register of Lords’ Interests, although I might add that I am frequently sent messages by the All-Party Parliamentary Beer Group inviting me to various events—presumably, where I would get free beer. I assume that when we get the long-awaited review of the register of interests and of how we deal with people who lobby us, it may also have a look at what happens with some of those activities.

I also wait with great interest to hear how the noble Earl responds to this debate and to the questions posed by the noble Lord, Lord Clement-Jones. I, too, have a fair number of questions for him. Noble Lords will recall that, when the public health responsibility deal was launched by Andrew Lansley in 2011, he made much of its benefits accruing through public health, commercial and voluntary organisations working in partnership to agree practical actions to secure more progress more quickly and with less cost than would have been the case with legislation. He emphasised that the strength of the deal lay in the diversity of organisations that it brings together. In the event, those aspirations of bringing several groups together were not met, and fairly early on we saw some of the major players depart from the scene.

However, I would concede—and I would not be churlish enough to fail to say—that a number of developments have taken place since the scheme was introduced. Like the noble Lord, Lord Clement-Jones, I am very pleased to see the recently announced front-of-pack nutrition traffic lights labelling scheme coming in. That is good progress, but it has taken us years to get to that position. When it was left to the voluntary approach by industry, there were mainly two separate schemes, and they were unable to bring them together to work. We now have people coming together but, regrettably, it is anticipated that 20% will still not comply, even with the voluntary scheme. What will happen in those circumstances, given the consequences that we encounter when we come to deal with health issues, which I shall address later?

It is because of the response that we have had and because the health industry generally, and some of the NGOs, were so unhappy about the way in which they felt that the Government would be influenced by the drinks industry that they wanted to pull away from participating in the scheme overall. In reviewing where it should go in future, I believe that it will be fundamental to assess whether it really has validity if we cannot take the health industry with us. I should like to hear from the Minister what he intends to do about that when we come to the end of the review.

The Royal College of Surgeons and the BMA are the people who are dealing, on a daily basis, with the three major preventable killer diseases that confront us: smoking, alcohol and obesity. As recently as 5 March, their position has been supported by no less than Jeremy Hunt, the Secretary of State for Health, who advises us, following a major study, that Britain is now falling behind many western countries in progress on managing preventable disease. The Secretary of State went on to say that the UK needs a “call to action”, although he did not define precisely what that call to action would be. We all recognise that there is no simple silver bullet that will answer these problems, but there is a multitude of approaches that could be taken. I hope that today the noble Earl will give us an indication of where the Government stand on their approach to those three major topics and on trying to bring them together so that we can start to recover some of the ground which, according to the Secretary of State, we are now losing when compared with a fair number of other major European countries.

In this context, I know that the Policy Innovation Research Unit of the London School of Hygiene and Tropical Medicine has undertaken its scoping review. Will it be engaged to do further work and, if so, what terms of reference will it be given and to what extent will there be consultation among the wider health community, as well as the commercial side, on this further work? I also notice that Drinkaware has recently undertaken a review and audit of its work and that it has identified some quite significant deficiencies in its operations. Questions have been raised about the adequacy of the evidence base used for its campaigning work. Questions have also been asked about its independence. Again, it works too much in isolation and at too great a distance from the NGOs and the health profession. I know that consultations will be taking place over a wider front by Drinkaware, but I should like to know the noble Earl’s initial views on that, having read, as I am sure he has, the review that has taken place.

The Government’s strategy on alcohol has been predicated primarily on minimum unit pricing. Under my Government, the balance on alcohol licensing moved towards being in favour of the industry and recent legislation has shifted the fulcrum more to the centre, giving local democracy and local interests against commercialism a better stand. However, I was surprised to learn from the debate in the House of Commons last week that the Government have been contemplating abandoning the time-old tradition of requiring people applying for alcohol licences to publish their applications in local newspapers. There is strong opposition to this in the Commons and I hope that the Government will not proceed with it, as it flies in the face of localism and the chance to try to control what happens within your locality. Again, I should be grateful for the noble Earl’s comments on that.

Finally, I raise a little point that I have been campaigning on for years about including the number of calories in the labelling of alcohol products. We have been running this for about three years and we seem to be no further forward. Is there any chance of an indication that some headway is being made?

My last point does not relate directly to the responsibility deal, because much of the industry does not accept that it is responsible for the harm that alcohol causes. Will the Government give some thought to the concept that a new funding stream for the NHS could be drawn from the private sector to help to meet the cost of the harms which arise from alcohol and tobacco and particularly from the growth of obesity through fats, sugars and salt? We know the problems that the NHS will face in the future, although very little concern was expressed about its funding by the Chancellor yesterday. However, as all parties know, with the ageing population, changing lifestyles and the continuing growth in the cost of technology and drugs, the health service will be in real difficulties in the future. We need new funding streams and we might explore whether the private sector, which has responsibility for some of the harm, should be required to pay for it if it does not respond on a voluntary basis.