Health and Social Care Bill

Lord Sharkey Excerpts

Wednesday 16th November 2011 Lords Chamber

Moved by

[Lord Sharkey]

65A: Clause 8, page 4, line 37, at end insert “in particular, public information and advice campaigns, especially those aimed at improving the levels of early diagnosis of serious conditions”

[Lord Sharkey]

My Lords, each of the four amendments in my name is a probing amendment. All the amendments refer to one particular aspect of NHS activity: public health information and advice campaigns. The Department of Health has a long and distinguished history in deciding which issues need such campaigns, and actually running, funding and monitoring the campaigns. In this area there is a very large body of experience and expertise that resides in the Department of Health. Many of these public health campaigns have been very successful. Thousands and thousands of lives have been saved as a direct outcome, and these campaigns are an established and key part of the public health armoury.

The most obvious part of many public health information and advice campaigns is often the mass media component, but there is always much more to it than that. In June 2004, the Health Development Agency noted that these campaigns typically also involve the mobilising and supporting of local agencies and professionals who have direct contact with the campaign target, bringing together partnerships of public, private, professional and voluntary organisations, and encouraging local and national policy changes so as to create a supportive environment in which people are more able or willing to change their behaviour. Devising and managing these campaigns is a demanding and difficult job. The Department of Health has been doing this job very well for decades. Importantly, it has been doing this job centrally. This is not just a reflection of the current NHS architecture. For the public health and information campaigns to work efficiently, simple direction and control is a necessary requirement.

The Department of Health is running a national obesity campaign and a national dementia campaign. In January there will also be a national campaign aimed at raising awareness of the symptoms of bowel cancer. Each of these campaigns builds upon a solid foundation of knowledge and experience of the issues, and of what it takes to run a successful campaign—knowledge and experience held, not exclusively, but very largely, in the Department of Health. Each of these campaigns can reasonably expected to be directly responsible for saving thousands of lives, and for improving the efficiency of the NHS.

The success of the original and groundbreaking HIV/AIDS campaigns in the 1980s, under the direction of my noble friend Lord Fowler, is well known. That success continues. Recently, regional pilots of dementia and bowel cancer campaigns have shown, for bowel cancer, a 48 per cent increase in the number of people visiting their GP with symptoms, and for dementia, 63 per cent of people aware of the campaign said that they would visit their GP if they saw any possible symptoms. There is a long-standing and proven ability of public health information and advice campaigns to generate early awareness and early action, both things absolutely critical for dealing effectively with some of the more serious medical conditions.

Success rates in cancer treatment are a prime example of this. We know that England’s cancer survival rates are currently poorer than those of many comparable countries. I know that we are part of the International Cancer Benchmarking Partnership to try to understand why this is, but without waiting for a definitive answer, it is quite clear that early diagnosis is an absolutely critical factor. In Improving Outcomes: A Strategy for Cancer, published in January of this year, the Department of Health notes that improving public awareness of the signs and symptoms of cancer and encouraging people to visit their GP when they have these symptoms, is a key ambition. That is why the Department of Health last year provided £9 million to support cancer awareness campaigns. It is a crucial feature of these campaigns, and most others, that they are very largely given priority, direction and funding centrally by the Department of Health.

My concern, and the point of my amendments, is that in the new architecture of the NHS, this central direction and funding will disappear, either suddenly, or more likely, gradually, as current and planned campaigns reach the end of their lives. I entirely accept that the Government understand the merit of public health information and advice campaigns and would want them to continue. I am much less certain, however, that they will continue in any effective form if responsibility for them is diffused throughout the system and central control and funding vanishes. It is not of course that I think that there will be local objections in principle to public health information and advice campaigns, but in hard-pressed localities there may well be a temptation to assign lower priorities and less funding to them. Even if the local need for such campaigns is acknowledged and acted on, making sure that the campaigns are properly devised, properly run and properly integrated will present difficulties without clear central oversight.

--- Later in debate ---

[Baroness Northover]

My Lords, my apologies if I leapt up far too soon. I caught the noble Lord’s colleague’s eye and it looked as though no one would be speaking from that side of the Chamber. However, I am incredibly glad to hear what is in fact cross-party support for this kind of campaign. The noble Lord is absolutely right: the part that charities play and have played in many of these campaigns is absolutely critical, not the least of which is Cancer Research UK and its various campaigns. Therefore, I thank the noble Lord for his contribution.

[Lord Sharkey]

I thank all noble Lords who have spoken to the amendments and I thank the Minister for her response. I should also like to register the propensity of all Governments to make sudden cuts to public information campaigns. Last year, the Government announced a freeze on their £540 million annual publicity budget. On 29 May this year, they announced a partial thaw, with expenditure of £44 million on four campaigns in England. This followed the publication of a Department of Health report called Changing Behaviour, Improving Outcomes, which found that, for example, after the cessation of campaigns, calls to the Change4Life information line fell by 90 per cent, calls to the FRANK drugs line fell by 22 per cent and visits to the NHS Smokefree website fell by 50 per cent.

All that illustrates my continuing concern that it is too easy to cut public health information campaigns and that it might be even easier in devolved organisations. Therefore, notwithstanding the Minister’s helpful response, I continue to believe that we need safeguards against such cuts written into the Bill. I look forward to discussing this again on Report. I beg leave to withdraw the amendment.

Amendment 65A withdrawn.