Health Authorities: Community Medicine Specialists (Hansard, 20 February 1986)

§ Lord Hunter of Newington
My Lords, I beg leave to ask the Question standing in my name on the Order Paper.

§ The Parliamentary Under-Secretary of State, Department of Health and Social Security (Baroness Trumpington)
My Lords, the latest staffing figures available centrally are for 30th September 1985. At that time, six district health authorities did not have any community medicine specialists in post. We require that all health authorities should have community medicine advice available even if they do not have a specialist in their employ.

§ Lord Hunter of Newington
My Lords, I thank the Minister for that reply. However, recognising the inadequacy of the inoculation programme, particularly against measles and whooping cough, and the deep public concern about communicable disease, do the Government not agree that there should be a standing public health committee in each district, of which the community medicine specialist, the environmental health officer and the chairman of the public health laboratory are members, and that they should be responsible not only for public health but for the education of the public?

§ Baroness Trumpington
My Lords, we have set up an inquiry into the future of the public health function which we have asked to report to us by the end of December this year. We will not be taking any firm decisions before then. I will of course ensure that the inquiry team considers the noble Lord's helpful suggestion when it meets.

§ Lord Maude of Stratford-upon-Avon
My Lords, can my noble friend tell us what is a community medicine specialist, what he or she does and whether it is necessary?

§ Baroness Trumpington
My Lords, it is necessary. The other name, which the noble Lord may know better, is district medical officer. Community medicine is a multi-faceted medical speciality capable of contributing at many points to the provision of effective health services and the improvement of the health of the whole population.

Lord Winstanley
My Lords, do not the Answer which the noble Baroness has given and the supplementary questions which have been addressed to her really underline the importance of resurrecting and re-establishing the old medical officer of health, who did such a very important job?

§ Baroness Trumpington
My Lords, it is really a matter for local feeling as to the name of such a person.

§ Lord Ennals
My Lords, with respect, is not the real question not whether the community medicine specialists are on the staff but whether they are part of the management team? Is the noble Baroness not aware that there is great concern both among community physicians and even more so among nurses that they are not included among the management team? In view of the point made by the noble Lord about the importance of inoculation and communicable diseases, all of which are the responsibility of the community physician, is this not quite a serious matter?

§ Baroness Trumpington
My Lords, community physicians are well represented among the ranks of general managers. At least 25 have taken up such posts, 11 at regional and district level.

§ Lord Kilmarnock
My Lords, can the noble Baroness say what, if anything, the Government are doing to help and encourage general practices to play a greater part in community medicine and, in particular, in relation to cervical cancer, which, I understand, is now assuming endemic proportions?

§ Baroness Trumpington
My Lords, that is a little wide of the original Question. If the noble Lord would like to ask me that question I should be delighted to answer it.

§ Baroness Seear
My Lords, if the community medicine specialist is in fact the same as a medical officer of health, what was the point in changing the name?

§ Baroness Trumpington
My Lords, many health authorities have retained the title of chief or district medical officer. Where this is not the case, it is often to recognise the broader responsibilities that community physicians have been given under general management, such as director of planning.

§ Lord Rodney
My Lords, can my noble friend say how many district health authorities have set up their own drugs advisory committees?

§ Baroness Trumpington
My Lords, no.

§ Baroness Seear
My Lords, did the noble Baroness say, "director of planning"? Planning what?

§ Baroness Trumpington
My Lords, there is a danger that by insisting on a particular title being used we may inhibit community physicians from taking on new and identified roles within their health authorities. Planning is one of the roles that they are fully capable of filling.

§ Lord Ennals
My Lords, I am so sorry to get up again, but in support of the supplementary question put by the noble Baroness, Lady Seear, surely planning is not part of the responsibility of community physicians. Does the Minister not agree that planning is a totally different task? Perhaps she means family planning or some other type of planning, but certainly not the normal concept of planning within a health authority.

§ Baroness Trumpington
My Lords, I have already referred to the fact that it is often nowadays given to the community physicians to have broader responsibilities than in the past when they served under general management. I stick by what I said: such as directors of planning.

§ Baroness Robson of Kiddington
My Lords, the noble Baroness has told us most helpfully that 25 of the (shall I say?) medical officers of health have taken senior managerial district jobs. Does she not agree that what is important to most of us in your Lordships' House is to find out how many community physicians are in fact part of the management team?

§ Baroness Trumpington
My Lords, I have a whole list of figures which I shall put in the Library. I shall send the noble Baroness a copy. I am sure the House would not wish to be wearied by long lists of figures at this stage of the afternoon.

§ Lord Broxbourne
My Lords, does my noble friend agree that while these questions of nomenclature are very fascinating, it is perhaps a case of "A rose by any other name"? Is it not a clear fact that the services rendered are valuable? Would it perhaps help this House if some well-intentioned noble Lord were to put down a Question for Written Answer to enable my noble friend to identify more specifically the duties and functions attaching thereto?

§ Baroness Trumpington
My Lords, it is hardly for me to answer that supplementary. It is somewhat rhetorical. The noble Lord is always full of good ideas.