Greater London Authority Bill

My Lords, I wish to speak briefly to Amendment No. 40 in this group, to which the noble Baroness has just referred. I am grateful to my noble friend Lady Darcy de Knayth for mentioning in Grand Committee—because I was abroad at the time—my support for the amendment, which prompted the Government to introduce this one. I now return the compliment and say that my noble friend would have been here to support the amendment but for the lateness of the hour. As I say, I support the amendment to include London boroughs and the Common Council among the bodies whose role in the implementation of the health inequalities strategy is to be described. But first I want to say a few words about the health inequalities strategy itself. This is good news for disabled Londoners who are disadvantaged in each of the areas the strategy will cover: housing, transport, employment prospects, access to public services and lifestyle. Only last week at Question Time we discussed the DRC research which showed that people with a mental health problem or a learning disability receive poorer quality primary healthcare, suffer more chronic symptoms and die younger than other citizens. People with learning disabilities and people with mental health problems are more likely to suffer from major illnesses, to develop them younger and die of them sooner than other citizens. The DRC also identified major difficulties faced by people with a mental health problem or learning disability in accessing the primary healthcare services that would tackle these problems. Despite the fact that people in these groups had a higher risk of ill health and were more likely to develop serious illnesses, they were less likely to receive the health checks and treatment which other patients with the same risk factors routinely receive. The health inequalities strategy will potentially provide a powerful vehicle for addressing these problems. I, too, take the points that the noble Baroness, Lady Hanham, made about public health, but I also agree very much with the noble Baroness who spoke from the Liberal Benches that it is important not to lose the focus on health inequalities. The strategy is a particularly welcome development for people with visual impairments. Every day 100 people begin to lose their sight but 50 of them need not. Half of all sight loss is avoidable. In the first place, the illnesses that most often cause sight loss are bound up with general health inequality, lifestyle and other factors. This may be why visual impairment is disproportionately associated with learning disability. Secondly, your chances of successfully avoiding sight loss due to glaucoma or diabetes depend on early diagnosis, yet a third of people have not had their eyes tested in the past two years. In its Open Your Eyes report last year, the Royal National Institute of Blind People, in respect of which I declare an interest as chairman, called for a major campaign to promote the need for regular eye tests. I hope very much that the strategy will help to promote regular eye tests; otherwise, we fear that the number of blind people will double in the next two decades as a result of increasing longevity. Blindness is closely correlated with old age. Indeed, 90 per cent of blind people are over pension age. Early diagnosis is nothing without rapid treatment and, indeed, effective rehabilitation for those for whom sight loss cannot be avoided. I was pleased that the noble Baroness, Lady Morgan, referred in Grand Committee to the duty of London boroughs and PCTs to make joint strategic needs assessments of the health and social care needs of their local populations. Different populations around London have very different risk profiles for diseases that cause sight loss so it is right to involve boroughs in targeting the response. On these grounds, therefore, I very much welcome this important amendment.