PARLIAMENTARY DEBATES

HOUSE OF COMMONS

OFFICIAL REPORT

First Standing Committee on Statutory Instruments, &c.

DRAFT HEALTH AND PERSONAL SOCIAL SERVICES (SPECIAL AGENCIES) (NORTHERN IRELAND) ORDER 1989

Wednesday 24 January 1990

LONDON

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1

The Committee consisted of the following Members:

Chairman: MR. NORMAN HOGG

Arnold, Mr. Tom (Hazel Grove)

Churchill, Mr. (Davyhulme)

Cook, Mr. Frank (Stockton, North)

Davis, Mr. David (Boothferry)

Flannery, Mr. Martin (Sheffield, Hillsborough)

Forman, Mr. Nigel (Carshalton and Wallington)

Forsythe, Mr. Clifford (Antrim, South)

Gorst, Mr. John (Hendon, North)

Grylls, Mr. Michael (Surrey, North-West)

Hannam, Mr. John (Exeter)

Hind, Mr. Kenneth (Lancashire, West)

Marshall, Mr. Jim (Leicester, South)

Needham, Mr. Richard (Parliamentary Under-Secretary of State for Northern Ireland)

Paice, Mr. James (Cambridgeshire, South-East)

Pendry, Mr. Tom (Stalybridge and Hyde)

Redmond, Mr. Martin (Don Valley)

Sackville, Mr. Tom (Bolton, West)

Welsh, Mr. Michael (Doncaster, North)

Mr. B. M. Hutton, Committee Clerk

2
3 First Standing Committee on Statutory Investments, &c. Wednesday 24 January 1990

[MR. NORMAN HOGG in the Chair]

DRAFT HEALTH AND PERSONAL SOCIAL SERVICES (SPECIAL AGENCIES) (NORTHERN IRELAND) ORDER 1989

10.30 a.m.

The Parliamentary Under-Secretary of State for Northern Ireland (Mr. Richard Needham): I beg to move, "That the Committee has considered the draft Health and Personal Social Services (Special Agencies) (Northern Ireland) Order 1989." The purpose of the order is to provide the Department of Health and Social Services with powers to set up special agencies in Northern Ireland. Comparable provisions already exist in the National Health Service Act 1977 which cover England and Wales. No equivalent legislation is available in Northern Ireland, and the order will bring us into line with England and Wales. The order provides for the establishment of special health and social services agencies. It also gives the Department power to direct special agencies to carry out specified tasks. The first purpose for which the new order will be used is to establish a health promotion agency similar to those in England and Wales. The role of the new agency will be to support all those in the statutory and voluntary sectors who are doing all they can to reduce our appalling record of bad health. We have little to be proud of in our past, but I believe that we now have a chance to promote real improvements in health care and preventive medicine. The Government have a strong commitment to health education and consider that a statutory agency is needed to provide greater impetus. We have demonstrated our commitment to that by our recent decision to increase the health promotion budget for 1990–91 by more than 60 per cent. to £900,000. The new agency is fortunate in that it will be building on the firm foundations laid down by the existing promotion unit. The director of the unit, Dr. Jane Wilde, to whom I pay special tribute for her work while she has been running that unit, and her team have done much over the past 18 months to pave the way. Much has already been achieved which is exciting and innovative in health promotion, and I am sure that the statutory agency will take that work forward. We are already moving down the road to better health, and the agency's major task will be to meet the World Health 4 Organisation's target of Health for All by the year 2000. I commend the order to the Committee.

10.32 a.m.

Mr. Jim Marshall (Leicester, South): May I first thank the Minister for taking us so meticulously through the order? He will be pleased to know, as I am sure the remainder of the Committee will be, that the opposition do not intend to oppose it but to wish it well. The Minister omitted to mention one detail, an important detail because it is the reason for the order. He will recall that the Health Education Council, which was disbanded in 1987, provided for England and Wales as well as Northern Ireland the kind of independent agency which the order provides specifically for Northern Ireland. The order is necessary because there is no provision under existing legislation, as there was for England and Wales, to establish such an agency in the Province. The Minister may recall that we were concerned when the Health Education Council was disbanded in 1987, because our view then was that it had shown commendable independence from Government. We were worried that the new health authorities established in England and Wales would be less independent of and more compliant to the Governments whims and wishes. I am sure that the Minister will recall those arguments, and I hope that he will be able to reassure me and the rest of the Committee that he wishes to see not a compliant health promotion agency in Northern Ireland but a sturdy, independent beast which will get to grips with what in many respects is the high degree of ill health in the Province. I am sure that the Minister and I agree that all the leading indicators on ill health and early death in the Province are substantially higher than for the remainder of the United Kingdom, and anything that can be done to promote good heath and lower those appalling figures must be beneficial. I hope that the Minister will give some assurances both on the independence of the new agency and on the kind of work that it will do to have a serious impact on those figures. I want to mention briefly two or perhaps three areas in which I think that the new agency should do some work. The first one I hesitate to mention, as members of the Committee who were here before 10.30 may have noticed that I hurriedly put out a cigarette before our proceedings began. As a smoker, I am reluctant to say this, but there is a real need to seek to reduce dependence upon cigarettes and nicotine in Northern Ireland, where smoking-related diseases are substantially higher than in the remainder of the United Kingdom. There must certainly be an increased impetus towards discouraging young people in particular from taking up smoking in the first instance and, if they are already hooked on the habit, towards reducing their dependence or getting them to stop smoking altogether. The second area I again mention with reluctance, as one who enjoys the food, particularly the meat 5 products, of the Province. While the food in Northern Ireland is good to eat, it certainly has a deleterious effect on one's general health. The fat content tends to be far too high and, as a result, the level of cholesterol in one's body is substantially higher when one leaves the Province after a short visit than when one arrived. Again I hope that the new health promotion agency will seek to encourage some changes in dietary habits, so that we can get to grips with the figures for heart disease and related diseases. I assure the Minister that my third point is my last, and it may be a little more provocative than those that I have made about smoking and dietary habits. It relates to other work that the new health promotion agency might consider promoting. There has been a reluctance in the Province to discuss sex education and the need for an expansion of birth control facilities in the Province. I hope that the new agency will recognise the need for further information and more facilities for birth control and will not be hidebound by perceived views in the Province but will be prepared to take risks and to go into areas which I believe in the past have tended to discourage investigation and advice. I hope that the new agency will be adventurous and independent and will be prepared to go against the perceived norms, whether they relate to smoking, diet or sex education. I certainly with it well and hope in 18 months' to two years' time that we shall see an improvement in the indices to which I have referred and also the wider availability of birth control in the Province. I wish the order well.

10.39 a.m.

Mr. Churchill (Davyhulme): I welcome the order most warmly and above all the provision for establishing a health promotion agency. It is a sad fact, but a true one none the less, that will all the bloodshed and loss of life from terrorism that there has been over the last 20 years in Northern Ireland, smoking, drinking and fat-saturated foods have each contributed significantly more to the death toll among the population of Ulster than the gunmen. I warmly welcome the fact that that is now to be addressed and I wish the health promotion agency every success in its endeavours.

10.40 a.m.

Mr. Clifford Forsythe (Antrim, South): My party welcomes any effort to improve the Health Service in Northern Ireland. As the Minister has given us an explanation about the agency and assured us that that is the object of the exercise, we shall certainly not oppose the order. I intended to say very little, but some of the remarks of the hon. Member for Leicester, South (Mr. Marshall) require a little comment. In some respects I must defend the Ulster fry in this context. My mother and father, who lived into their nineties, had their Ulster fry at least once a week, and many other people who, although they look after their health and their diet, have been used to eating a certain type of food. Other Members of Parliament have made comments in the past about food from the north of England and so 6 forth. We must put into context the part of the Kingdom that we are talking about, the type of food that people are used to and the fact that they enjoy it. After all, if we dieted, ate the proper food and lived until we were 100 but were miserable in the process, there would be no point. But cetainly I must defend the Ulster fry and, in that context, I mention the voluntary bodies which are doing their utmost to help in this campaign, in particular the Chest, Heart and stroke Association. I have to declare an interest, because until recently I was chairman of one of its branches, but I know that it does a great deal of good work and puts a great deal of money into research and so forth. I am sure that the Minister is aware of that. I do not want to detain the Committee, but I ask the Minister one question. Will he confirm that paragraph 6(6) of the schedule includes those engaged in the Health Service and local authority services in Great Britain? Apart from that, I support the order.

10.43 a.m.

Mr. Needham: Perhaps I may answer first the last question asked by the hon. Member for Antrim, South (Mr. Forsythe). The answer is that I do not know. It is a technical point and, if I can find the answer, I shall let him know. On the general points made by the hon. Member for Antrim, South, I beg of him not to defend quite so vehemently the benefits of the Ulster fry. It may have worked wonderfully well for his parents; it may work for him. Time will tell. As my hon. Friend the Member for Davyhulme (Mr. Churchill) said, there is absolute proof that many thousands of people in Ulster have died unnecessarily over the years because of in-davisable diet, coupled with smoking and lack of proper exercise. If the hon. Member for Antrim, South wants to talk about the Ulster grill, I shall come with him, but the problem is the saturated fats, cholesterol in eggs and so on, coupled with lack of exercise and smoking. There is no doubt that we can do an enormous amount by change of diet and by taking exercise, and we can show people that it is not necessary to be a wealthy, middle-class, two-car family to improve one's health and quality of life. One of the major jobs of Dr. Wilde and her team, supported by the agency members, will be to get the message across at all levels. I agree with the hon. Member for Leicester, South (Mr. Marshall) that the schools are a crucial place in which to start. It must be done by persuasion and advice at all levels, a mixture of carrot and the occasional stick. I believe that we have not done as much as we should in Northern Ireland. As I said, the health promotion unit has taken sterling steps and has built on what the Health Education Council did in England, Wales and Northern Ireland, although I think that Dr. Lowry, who was the member of the Health Education Council for Northern Ireland on the United Kingdom body, accepts that having our own agency targeted at particular areas in ways which will attract, 7 interest and change the Northern Ireland people is a better way of doing it. When I was the Minister responsible for health in Northern Ireland, I put enormous emhasis on that part of our work. We have an excellent Health Service in Northern Ireland. It has often been said by such people as Frank Pantridge that Northern Ireland is the best place in the western world to have a heart attack because one gets quicker and better treatment than anywhere else in the western world. One of the reasons is that many more people have them. I am certain that the approach that we are developing through the agency will show results. I have no doubt that by the year 2000 we shall be saying that through our healthy cities campaign, Health for All, and so on, we shall be able to meet our targets and that there will be a substantial reduction in the incidence of coronary heart disease and in smoking-related diseases such as cancer and respiratory diseases. We are already beginning to see that happen. The hon. Member for Leicester, South referred to the independence of the agency and its members. I 8 agree that that is crucial. Anybody who knows those who are involved, either as the lay members or as the professional members who will move across from the unit to the agency will know not only of their dedication but of their independence. That is also laid down in the order. In no sense can it be a toothless body which has no real impact in the sensitive areas to which the hon. Gentleman referred, whether it be sex education, taking on the tobacco barons and the brewers or whatever it may be. I believe that the order has the support, which I welcome, of all the parties in Northern Ireland and in the House and, most important, of all the people of Northern Ireland. I am sure that it will be a major success.

Question put and agreed to.

Resolved, That the Committee has considered the draft Health and Personal Social Services (Special Agencies) (Northern Ireland) Order 1989.

Committee rose at twelve minutes to Eleven o'clock.

THE FOLLOWING MEMBERS ATTENDED THE COMMITTEE:

Hogg, Mr. Norman (Chairman)

Forman, Mr.

Forsythe, Mr. Clifford

Gorst, Mr.

Grylls, Mr.

Hannam, Mr.

Churchill, Mr.

Hind, Mr.

Marshall, Mr. Jim

Needham, Mr.

Redmond, Mr.

Sackville, Mr.