European Union (Withdrawal) Bill

Baroness Lister of Burtersett Excerpts

Committee: 8th sitting (Hansard - continued): House of Lords
Monday 19th March 2018 Lords Chamber

[Baroness Northover (LD)]

My Lords, I support this amendment on public health. I feel very strongly on this issue, having played my part as a member of the health team on the government Benches that took the then Health and Social Care Bill through the Lords. My responsibility was to take through the measures on public health; I had an academic background in a related area. We placed public health back with local authorities. We said that public health would be safe there, in its appropriate place. As we have heard, the 19th-century development of public health in Britain led the way in extending life for those living in cities globally, and it did so in a local authority setting. It was not antibiotics that transformed life expectancy, it was public health measures.

So has public health been safe? Not recently, I submit. With local authorities and social care in crisis, what chance for public health? So when the Faculty of Public Health flags to me its worries about public health if we leave the EU, I listen. Yet another threat from Brexit, it seems, as the noble Baroness, Lady Blackstone, pointed out. The Minister will be aware of the concerns from the Faculty of Public Health and others working in this most important field. I am sure he will assure us that there will be no reduction in standards if we leave the EU—in which case, enshrine that in the Bill.

The public health community is concerned that, without the safety net of EU law, we may see our existing high level of vital public health legislation, policy and practice eroded. This year we celebrate the 70th anniversary of the NHS, as the noble Lord, Lord Warner, pointed out. Public health is a critical part of that NHS, not a side issue. We know that diseases such as cardiovascular disease, cancers, chronic respiratory disease and diabetes account for around 40% of premature mortality in the UK, and they continue to place a significant burden on patients and the health service. These conditions are to a large extent preventable and their costs in human, social and economic terms largely avoidable. We also know that effective public health strategies to tackle these and other challenges deliver an extensive range of benefits. As the noble Baroness, Lady Chalker, and the noble Lord, Lord Deben, have referred to, we have been able to bring benefits and improvements worldwide by the promotion of public health, from sanitation onwards.

That is why safeguarding public health is vital. The Government have said they will continue to co-operate with the EU on disease prevention and public health and that the UK will continue to play a leading role in promoting public health globally, so the amendment would simply put that commitment in the Bill. I have heard those promises on public health. When I was in government, I was worried that public health in local authorities was not ring-fenced as we were ring-fencing the NHS. I was assured by our coalition partners that all would be well. I was particularly worried about the position of reproductive health, given how essential yet controversial that might be. The reason why I am supporting the amendment today is that those promises proved rather hollow, so no promises that the Minister gives tonight will ring true to me. Whatever he may genuinely feel or whatever may be in his brief, they could be out of the window should the UK decide that standards are to be lowered or costs cut in an effort to increase the UK’s competitiveness. That is why the amendment is so important.

[Baroness Lister of Burtersett (Lab)]

My Lords—

[Baroness Altmann]

My Lords—

--- Later in debate ---

[Baroness Lister of Burtersett]

My Lords, I want to say a few words—a very few, I promise—in support of the amendment. Decent public health provision is of special importance to people living in poverty and people living in deprived areas, whether we are talking about the impact of the daily cocktail of pollution referred to recently by the Chief Medical Officer of England and mentioned by the noble Lord, Lord Warner, as a prime example of why the amendment is needed; the incidence of obesity referred to by my noble friend Lady Blackstone; preventable stillbirths; or life expectancy, where some recent statistics have been very worrying. In the Longevity Science Panel study published last month, the life expectancy gap between England’s richest and poorest neighbourhoods has widened since 2001, and it identified income inequality as the biggest factor. Recent data from the Office for National Statistics indicate that life expectancy of the poorest girls in England has fallen for the first time on record since the 1920s.

These are stark examples of how health and illness follow a social gradient. Campbell Robb, chief executive of the Joseph Rowntree Foundation, was quoted in the Independent as saying:

“These figures should serve as a wake-up call: we need action to loosen poverty’s grip on the health of our nation”.


I hope that the Government will take note of this wake-up call and, as a minimum, accept the amendment, which sets out important guiding principles for public policy as we exit the European Union.

[Baroness Altmann]

My Lords—