Greater London Authority Bill

Amendment No. 43 provides for the health adviser to be an employee of the GLA, and to be appointed by the Mayor, rather than being the regional director of public health for London. I strongly resist this amendment. The regional director for public health, as the person with strategic responsibility for public health in London, is clearly the most appropriate person to be the health adviser to the Mayor and Assembly. She is uniquely placed to work across a range of organisations, ensuring that they all pull in the same direction to improve the health of all Londoners and reduce the shocking levels of health inequalities between them. The Mayor, of course, has a crucial role to play, and is directly or indirectly responsible for many aspects of London life which influence Londoners’ health, from transport to public safety. Equally, other aspects of public health, such as improving the quality of health services delivered to Londoners, immunisation, and resilience planning in respect of health services, are clearly the responsibility of the NHS. It is therefore right that the health adviser, as London’s regional director of public health, remains accountable to the Department of Health and the strategic health authority, not to the Mayor. The current health adviser arrangement ensures that the Mayor and Assembly are provided with expert advice from the person responsible for public health in London and that there is a formal link between the GLA, the strategic health authority and the Department of Health. The GLA surely wants the most senior public health official in London advising it. The adviser, by definition, advises the Mayor and Assembly. She does not take decisions on their behalf. The current adviser has proved that she does not need to be accountable to the Mayor in order to provide advice on fulfilling his legal obligations with regardto health and health inequalities. These informal arrangements have been in place since 2000, and most people would agree that they work well. Amendment No. 45 loosens the requirement that the health adviser is the regional director for public health by suggesting instead that the health adviser may be the regional director. We resist this amendment for similar reasons. The noble Baroness, Lady Hamwee, picked up a couple of technical points. I think I need to write to her about them. My noble friend Lord Harris has been answered by the noble Baroness, Lady Hanham. I think I have picked up the points that have been raised, and I hope that the noble Baroness will withdraw the amendment.