"The Health of the Nation" (Hansard, 6 July 1993)

§ 7. Mr. Callaghan
To ask the Secretary of State for Health if she will make a statement on the implementation of "The Health of the Nation".

§ Mrs. Virginia Bottomley
The White Paper, "The Health of the Nation", which was published a year ago, has been widely welcomed both within the NHS and further afield, not least by the World Health Organisation which described it as a model for others to follow. Progress towards meeting the targets set out in the White Paper is generally good. A wide range of activities is under way to ensure that we secure the improvements in health which are the overall aim of our policy. Much of the work is being reflected this week in a range of publications and events to mark the first anniversary of the White Paper.

§ Mr. Callaghan
I thank the Secretary of State for that rosy report on the state of the nation's health, but can she justify to the House her proposals to close so many of the nation's hospitals, including five in north Manchester alone? Is she aware that there is such a wave of anger that this weekend 500 people took to the streets of north Manchester opposing the closure of the Booth Hall children's hospital? In the light of that, will she reconsider her decision to close that hospital?

§ Mrs. Bottomley
As the hon. Gentleman knows, no decision has been taken on that matter, but the health of the nation cannot be measured in institutions which were built for generations past. Investment in health is important in primary care, family doctors and community nurses, emphasising prevention as well as cure. In the hon. Gentleman's health authority since 1979 there has been an increase of half as much again in the number of day cases, a two thirds fall in the one-year waiters, a 59 per cent. —nearly a 60 per cent.—increase in the number of general practitioners and a 67 per cent. increase in the number of dentists. That is a clear investment in health. Health is not only about institutions—in this country or anywhere else in the world.

§ Mrs. Roe
Does my right hon. Friend agree that "The Health of the Nation" White Paper has taken the health service a giant step forward towards its original goal of 174 securing improvements in the overall state of health? Does she also agree that the Labour party is constantly displaying its lack of vision by continuing to focus on input measures, such as the number of beds, when the health service is changing and the emphasis should be on improving health?

§ Mrs. Bottomley
My hon. Friend is exactly right. The health service should not be measured by the number of beds. It is not a furniture warehouse. We should measure the health service in terms of the number of patients treated. That is why the extra 400,000 patients treated in the past year represented such a great achievement for the staff involved.
The key element of the NHS, which we have at last been able to set in place so long after its establishment, is that it is a health service, not an illness service. It is about health, not health institutions. It is about prevention as well as cure. "The Health of the Nation" strategy, following the improvements in the family doctor services, "Working for Patients" and the establishment of trusts, is the third leg of the stool that will lead to a health service that will continue to be the envy of the world into the next century.

§ Mr. Blunkett
Given the Secretary of State's special understanding of the feelings and emotions of unmarried mothers, will she denounce as insensitive and hypocritical the comments made at the weekend by the Parliamentary Under-Secretary of State for Health, the hon. Member for Bolton, West (Mr. Sackville), who speaks for a Government who have cut family planning resources, who have reduced the school health service, who have failed to tackle teenage pregnancies and whose policies are designed to undermine and destroy rather than build up and secure responsibility and commitment to the family?

§ Mrs. Bottomley
I am a little surprised by the hon. Gentleman's approach. Be that as it may, however, I believe strongly that children need families. My hon. Friend the Parliamentary Under-Secretary of State was pointing out that rabid ideas of feminism are not the best approach to bringing up children and that children need mothers as well as fathers. I believe that my hon. Friend is exactly right and I also congratulate him on his work in talking about the importance of sex education in schools, where he has been taking a clear line that children need to be prepared for the world in which they are to live.
Family planning services have changed dramatically over the years. Now, 98 per cent. of GPs provide family planning services. That is why we have had a review to ensure that the clinics are focused on the needs of today and tomorrow and especially on the needs of the young.

§ Mr. Sims
One of the key aims of "The Health of the Nation" is a reduction in the incidence of coronary heart disease, in which two contributory factors are smoking and diet. I congratulate my right hon. Friend and the Government on their success before the European Court on the question of health warnings on cigarette packets, but can she tell us what steps she proposes to take to reduce smoking among 11 to 15-year-olds in the light of the chief medical officer's concern that targets may not be reached? Can she also tell us what success the nutritional task force, which she appointed in December, has had in persuading us all to follow healthier diets?

§ Mrs. Bottomley
My hon. Friend the Member for Chislehurst (Mr. Sims) has long been a champion in the fight against smoking. He will know that we have had greater success than almost any other European country in reducing smoking. Only the Netherlands has a better record than ours. The Netherlands shares our approach to the voluntary agreement on tobacco advertising, but also our policy of taking vigorous and determined action to ensure that we get the message home to young people as well as their parents. Children of parents who strongly disapprove of smoking are seven times less likely to smoke than other children.
Our success at the European Court is an example of our firm intent. The health warnings on our cigarette packets are 50 per cent. bigger than in any other country and we have chosen to use the most direct messages on those packages. We shall continue to strengthen the campaign because we intend to meet the target by the end of the century. In particular, as my hon. Friend rightly suggests, we need to renew the campaign against young people smoking.
The nutrition task force produced its new programme this morning. I hope that all hon. Members will study the programme carefully and let us have any further advice that can change the dietary habits of us all.