HL Deb 22 February 1995 vol 561 cc1116-9

3.6 p.m.

Lord Molloy asked Her Majesty's Government:

What impact their decision to withdraw central funding from the Health Education Authority will have on health education nationally.

The Parliamentary Under-Secretary of State, Department of Health (Baroness Cumberlege)

My Lords, funding for the Health Education Authority is not being withdrawn but in future will depend on the successful winning of contracts. We are confident that the new arrangements will strengthen both health education and promotion.

Lord Molloy

My Lords, I thank the noble Baroness for that reply. Does she not agree that all our great national institutions have to be examined from time to time and that the NHS is no exception? Does she also agree that the vital element of education in our NHS means so much to all the professions and all the ordinary people who are the patients of this great institution? Before anything of this nature is undertaken will she at least be prepared to seek the views of the people who are concerned—doctors, nurses, and other elements within our NHS?

Baroness Cumberlege

Yes, my Lords, but I think that the noble Lord may be under a misunderstanding. This is not education in terms of medical education. This is education in terms of health promotion.

Lord Ennals

My Lords, does the noble Baroness realise that many people are extremely worried about the decision which the department seems to have taken? Why should it be supposed that those who can get contracts—who can win them in the market—will be better judges of health education with regard to issues such as AIDS, smoking, drinking and so on? Why is it supposed that this will be better done than it has been under government supervision and under the Health Education Authority? Does she agree that this is an important task? Should not both Houses have the opportunity to discuss the matter before a decision is taken by the Government?

Baroness Cumberlege

My Lords, many of the contracts will be awarded by the Government to the Health Education Authority. When this decision was made, the chairman of the authority welcomed it. He saw it as a great opportunity for the Health Education Authority, in that it could compete for contracts to carry out programmes not only for the Government but for voluntary organisations, local government, health authorities and other organisations. The decision has been widely welcomed.

Lord Kilmarnock

My Lords, does the noble Baroness agree that since 1987 the Health Education Authority has played a major role in controlling the spread of HIV and AIDS in this country, with the result that the incidence in this country is far lower than among our Continental partners? With that in view, can she tell us how the commitment in section D.14 of The Health of the Nation for continuing public education campaigns for which specific responsibility is laid on the HEA will be carried forward after the change of status of that body next year?

Baroness Cumberlege

My Lords, it will depend on the HEA winning contracts for the work it is doing. I agree with the noble Lord that our progress in containing HIV and AIDS has been remarkable. If one looks at the Paris region alone, it has more AIDS cases than the whole of this country. Much of the credit for that goes to the HEA and, if I may add this, to the committee chaired by the noble Lord.

Lord Finsberg

My Lords, is my noble friend aware that the organisation does not enjoy the universal approbation which it appears to be accorded in this House? When I held the office which the Minister now holds, there were many complaints about the way that it was interfering and nannying. Some of its work was good, but it was not universally good. Will not the new system help to make it better than it has been?

Baroness Cumberlege

My Lords, my noble friend is absolutely correct in what he says. That is why the review was undertaken. It was felt though that the Government needed a health education authority but that it should be much more sensitive to people's needs and, indeed, carry out work which was responsible and felt to be of great value.

Baroness Masham of Ilton

My Lords, with the merging of health districts and FHSAs and the running down of regions, who will be responsible at the local level for ensuring that, whoever gives it, health education is carried out?

Baroness Cumberlege

My Lords, if the Bill that has gone through the other place is passed by this House and becomes an Act, then it will be done by the combined FHSAs and the health authorities.

Lord Carter

My Lords, is the Minister aware that there is considerable interest in the effectiveness of spending on health education? What systems are in place to measure that effectiveness? Will that work be affected by the new regime planned for the HEA?

Baroness Cumberlege

My Lords, yes, that will form part of the contract. We would expect every campaign to be well researched, pilot tested, put into practice and carefully monitored afterwards. The health of this nation improves year on year. Diphtheria and neonatal tetanus no longer occur and, indeed, measles and whooping cough are rarities in GP surgeries. It is interesting that the average length of life has increased—79 years for women and 73 years for men. However, I believe that that is reversed in your Lordships' House and that men outlive their wives.

Lord Butterfield

My Lords, in its new guise will the Health Education Authority be able to contract for any health promotion research?

Baroness Cumberlege

My Lords, in so far as it supports campaigns, but its main purpose will be to educate the public in ways based on research but not research in its purest terms.

The Lord Bishop of Peterborough

My Lords, I speak as a member of the Health Education Authority. As the noble Lord said, in the past the authority has been looked upon as an agent of the nanny state, of whatever colour. Oddly, this detaches us slightly from the Government—something which we welcome. Will the Minister assure us that that detachment is indeed welcome?

Baroness Cumberlege

My Lords, I endorse what the right reverend Prelate says. Because the Government now have confidence in the HEA, I am delighted to announce to your Lordships this afternoon that we have reappointed Mr. Tony Close as the chairman of the authority. I should like to pay tribute to him and also to the right reverend Prelate and my noble friend Lady Brigstocke, who have put a lot of time into the HEA.

Lord Kennet

My Lords, the noble Baroness stated that in its new guise, the HEA will be allowed to commission research in so far as that helps campaigns. Does that mean that it will not be allowed to commission research into what would be a good campaign to undertake?

Baroness Cumberlege

My Lords, no. First, it would tender for a contract that was being offered by the Government or by some other organisation. Clearly, in that contract there would be a requirement for the campaign to be well researched and based on research.

Lord Molloy

My Lords, is the Minister aware that this is an extremely important issue at which the whole nation is looking? I am extremely grateful to the Minister for saying that she would be prepared to discuss this matter. I have received representations from UNISON, the British Medical Association and the Royal College of Nursing. They are all important organisations. They had reservations about the old system but it had improved. They would like an opportunity to offer their support for the new system if they felt that it would work satisfactorily.

Baroness Cumberlege

My Lords, the new system will produce tremendous results.