Greater London Authority Bill

moved Amendment No. 44: 44: Clause 21, page 19, line 36, leave out from ““health”” to end of line 38 The noble Baroness said: The awesome number of amendments in this group is entirely due to the fact that an awesome number of health inequalities are mentioned in the Bill. My amendments would change the words ““health inequalities”” to ““public health””. I shall expand on that a little. The changes to Clause 22 are important. We broadly welcome the Mayor being required to provide a health strategy for London, but it needs to be of a different kind—or certainly wider than that envisaged by the clause. The Minister in the other place defined ““health inequalities”” as, "““inequalities in respect of life expectancy of general state of health””—" as a result of— "““general health determinants””—[Official Report, Commons, Greater London Authority Bill Committee, 11/1/07; col. 119.]" General health determinants include housing, transport services, employment prospects, ease or difficulty of access to public services and lifestyle or behaviour aspects. Although those are very important, it is not clear that they would also encompass the important organisational aspects of public health, such as the prevention and spread of infection, the protection of the public from epidemics such as avian flu, tuberculosis, HIV/AIDS, and other health problems of diabetes, obesity, and so on. The protection of the public from epidemics is an extremely important part of the role of public health bodies, and it is important to have policies that bring co-ordination from the health service and other public bodies in the face of disasters, whether they are London-wide or confined to a smaller area. Serious infection was the basis of public health policy—that is where it all first started. It would seem a great mistake to jettison any of that, even by implication. Serious public health matters are currently managed by various organisations—particularly the strategic health authorities—but they should be incorporated into a London-wide public health strategy. Health inequalities will focus on the disparity between health outcomes in various parts of London and on the matters that the Minister in the other place described. This information is gathered by all local authorities in a number of ways for a number of reasons. Some local authorities try to take action. Some of the issues are extremely intangible and very difficult to deal with so they are not immediately practical issues, which public health is. For that reason, I want to see the words ““health inequalities”” changed. I do not have a problem with health inequalities being an aspect of the health strategy, but I do not think they can be the only aspect of it. The role of whoever is the health adviser—we shall come back to that—must encompass the wider public health aspect of the job. If not, London willget advice from somewhere. It is essential that the combined role takes account of all aspects of public health. I shall give the Committee a definition of public health. It is, "““the science and art of preventing disease, prolonging life and promoting health through the organised efforts and informed choices of society, organisations, public and private, communities and individuals””." It is the protection of those communities. I beg to move.