Public Health (Bexley)

Anne Milton Excerpts

Wednesday 26th October 2011 Westminster Hall

[The Parliamentary Under-Secretary of State for Health (Anne Milton)]

It is a pleasure to serve under you this morning, Ms Osborne. I do not believe that we have met in Westminster Hall before.

I congratulate my hon. Friend the Member for Bexleyheath and Crayford (Mr Evennett) on securing the debate. He does not miss an opportunity to raise issues of public health in his constituency. As my hon. Friend and all of us do, I want to see a public health system worthy of its name, set up with the sole purpose of protecting and improving the health of everyone in this country. The public health White Paper outlines how we intend to achieve that, with ring-fenced funding, health and well-being boards and joint strategic needs assessment all playing a big role. Every element is designed with local needs in mind, so communities and local organisations in his constituency will be able to play a bigger role than ever in improving the public’s health. On the whole, the residents of Bexley are healthier than the national average, but that does not mean for one second that a great deal of work is not still to be done. People living in the most deprived areas of Bexley can expect to live up to seven years less than those living in the wealthiest areas, which is a staggering figure.

It was a pleasure to be joined by my hon. Friend the Member for Dartford (Gareth Johnson) and the hon. Member for Erith and Thamesmead (Teresa Pearce). My hon. Friend rightly mentioned the importance of cross-authority working. In particular, as we move into the new systems, I stress the need for public health leadership. People in Bexley will need a strong and visionary public health system with expert leadership. I am sure that the council and the local primary care trust are considering carefully how to provide such leadership after April 2013, when the breadth and importance of the local council’s responsibilities will increase enormously. Those are big challenges, but they also represent a fantastic opportunity, and Bexley is well placed to capitalise.

My hon. Friend the Member for Bexleyheath and Crayford discussed his grave concern about obesity and gave us some figures, such as that 20% of year 6 children are obese, which is 2% higher than the national average. That is a shame, and the problem is not unique to some areas of the country, because England has among the highest rates of obesity in the developed world. Recent figures show that levels of childhood obesity are stabilising and that adult obesity rates may be levelling out, but the overall rates remain extraordinarily high.

We published a document, which my hon. Friend referred to, “Healthy Lives, Healthy People: A call to action on obesity in England”, on 13 October to set out our approach. Through projects such as the healthy child programme, the national child measurement programme and the responsibility deal, we want to give clear and consistent messages on what the healthiest choices are and how people can make them. People need information and to recognise the harm that they do to their health by ignoring such choices. As I have said, local authorities will be at the forefront, and they will have that ring-fenced public health budget to use in ways that suit local people, doing far more good than a uniform approach that descends from on high in Whitehall.

The local NHS is taking steps to fight obesity and to encourage physical activity, in particular in children. The Bexley healthy schools project is working with every single one of Bexley’s schools and children’s centres, teaching children about the importance of healthy eating and physical activity. The parents’ education and children’s health project educates parents and carers about healthy and economical cooking. School food policies are also being reviewed with parents, pupils and staff, to ensure that children receive nutritionally balanced packed lunches that they will actually eat—there is no point in putting healthy food in front of children, if they then fail to eat it.

My hon. Friend mentioned Silver Star, and I am pleased that he got a tick for his own health, but he is absolutely right that type 2 diabetes is of considerable concern. I understand that the Bexley community diabetes project has had contact with nearly all diabetic patients in the borough. That project is centred on empowering patients and putting them at the heart of managing their condition while calling on health care professionals, when necessary. It is about personal responsibility, ownership and understanding that if people feel they have some control over their lives they do very much better. He also mentioned physical activity, and I thank him for specific mention of “Change for Life”—one of its successes is that it does not look like a Government-run programme—which has had a big impact. He might be interested to know that the brand will be used for action on alcohol in the new year.

We will be publishing an alcohol strategy in which communities and local government will again play a big part, because they will be able to take action based on what they think will work. Local councils are already involved with some of the social harms of alcohol—certainly anti-social behaviour and crime is of considerable concern—and with licensing. Local schemes and projects have contributed to Bexley having a lower than average rate of alcohol-related harm. For instance, the Bexley business support unit offers counselling, group work and medical help to people with alcohol problems. However, a great deal remains to be done. In April, an outreach service was commissioned to help people in the borough who had not used the services before or who find it difficult to access treatment. Data from the first six months of that service show that it has been successful.

On London as a whole, the Secretary of State for Health has backed a statutory London health improvement board, chaired by the Mayor of London. It is already drawing up plans for priority areas such as alcohol and childhood obesity and looking into promoting the use of existing licensing powers, helping accident and emergency departments share data on violence resulting from alcohol misuse and getting early interventions in place so people who misuse alcohol can get quick and effective advice, which is so important.

Smoking kills 80,000 people a year, and yet a persistent minority, which includes a significant number of people, continues to smoke. Each year, an estimated 320,000 children try smoking for the first time. The tobacco control plan to which my hon. Friend referred outlines our ambition to cut smoking rates in adults down to 18.5%, in 15-year-olds down to 12% and in pregnant women down to 11%. Many of us still feel that those figures are too high. Again, we need to give people information, but people also need support to quit. The plan demonstrates how we aim to achieve that. At the beginning of the month, tobacco sales from vending machines became illegal, which is a big start because such machines were a source of tobacco for children, and large, brightly coloured tobacco displays will soon be joining them in the ashtray of history. Displays will end on 6 April 2012 in large shops and three years later in small shops and other businesses in England.

My hon. Friend referred to Bexley’s stop smoking team, which helped 1,611 people give up last year, exceeding its target for the third year running. It has won awards, and he goes to great efforts on its behalf—this is not the first occasion on which he has mentioned it. Many people criticise local services, but it is right to acknowledge the tremendous job that they are doing. I hope that the Bexley team can spread that good practice around the areas in the vicinity. Anyone living or working in Bexley can access the service for free via a GP or participating pharmacy and, if that is not convenient, the team regularly provides services in more convenient locations such as libraries, children’s centres or a special bus outside a local supermarket.

My hon. Friend mentioned TB, and he rightly stated the specific problems for London. We always keep the evidence under review, and we are guided at all times by the Joint Committee on Vaccination and Immunisation. He is right that the issue is complex, but there is no doubt that London has more than its fair share of the problem. As I have said, strong public health leadership in such fields will be extremely important. I assure my hon. Friend and the other two hon. Members present in the Chamber today that the Department of Health and the London strategic health authority support the Mayor of London’s health inequalities strategy. Inequalities simply have no place in modern society, and everything that we can do to lessen them is worth pursuing. I want to see local councils arguing across the council chamber about how it is no longer fair for their residents to live less long that those of another council in the same area.

I thank my hon. Friend for giving me the opportunity to raise yet again the need for the public to improve their health. It matters to stop illness, disability and premature death, but it also matters as we live longer, because staying well as we live longer is becoming increasingly important to us all.