Public Health Observatories

Ian Mearns Excerpts

Tuesday 17th May 2011 Commons Chamber

[Grahame M. Morris]

I am grateful to my hon. Friend for mentioning that important and contemporary report. I completely agree with Sir Michael Marmot’s findings— and Marmite is also very good for public health. Building on the work of Professor Townsend and Sir Douglas Black, Sir Michael Marmot states as one of his recommendations:

“Action taken to reduce health inequalities will benefit society in many ways. It will have economic benefits in reducing losses from illness associated with health inequalities. These currently account for productivity losses, reduced tax revenue, higher welfare payments and increased treatment costs.”

I mentioned the economic benefits of insulating houses. It would be a real step forward if the Marmot report’s six principal recommendations were incorporated and linked to quality standards in the public health outcomes framework that the National Institute for Health and Clinical Excellence is working on.

[Ian Mearns (Gateshead) (Lab)]

My hon. Friend mentioned the Black report, the Townsend report and the Marmot report, and I wonder whether Government officials and Ministers might in due course come to regard the Marmot review a little like Marmite—either loving it or hating it—in respect of its findings, because it is clear that the need to monitor what is going on in public health across the regions of England, such as the north-east, is vital for future policy developments.

[Grahame M. Morris]

Absolutely. That is a critical issue. In some respects, the Government have taken their eye off the ball. I will develop that point a little later and would like the Minister to respond to it.

As my hon. Friend pointed out, there is a clear and present danger of a reversal of health inequalities, which would be exacerbated by decisions taken elsewhere across Government. It is such an important issue, and one that I have long campaigned on. As someone who has worked in the health service and served on a local authority, I feel very passionately about it.

Remarkably, we are now considering proposals that risk losing our greatest weapon in tackling public health inequalities: evidence-based health intelligence. More recently, as my hon. Friends have noted, the Marmot review has restated the link between socio-economic factors and health, which are known as the wider determinants of health. One of the more serious threats to the future of public health intelligence is its future funding under the new arrangements proposed by the Government. In my view, the Secretary of State has shown little interest in the functioning of public health intelligence under these proposed structures.

Public health policies must take account of local circumstances as health inequalities remain stark, particularly in areas such as my constituency. For example, smoking-related deaths vary greatly across different parts of the country. Public health intelligence must drive public health practice. I appreciate that public health observatories self-generate revenue, alongside their Department of Health grant and moneys from primary care trusts and strategic health authorities. They also have opportunities to gain commissions from universities and charitable organisations, but it would be extremely risky to proceed down the Government’s proposed route without the certainty of their core Department of Health funding, which I understand is to be reduced by 30% this year.

Staff and people associated with the service have reported to me that valued employees are already being laid off at the north-west public health observatory, which is based at Liverpool John Moores university, and there is a similar situation at the north-east public health observatory. Local authorities commission the majority of public health services from a ring-fenced budget. What assurances can the Minister give me on safeguarding through this hiatus—this period of transition—and for the long term under the new arrangements?

I also thank David Kidney, the former Member for Stafford, who is now head of policy at the Chartered Institute of Environmental Health, for his assistance in preparing for this debate. The institute has stated its view that Public Health England must be established with a degree of independence, a point I made earlier, and with the ability to oversee arrangements for collecting, analysing and disseminating valuable data for public health services.

In short, it is now time for Ministers to provide concrete assurances that the role of public health intelligence, the collection of the evidence base and, in particular, public health observatories will be safeguarded for the future.