Debate on the Address

My Lords, the whole House would like to congratulate the noble Lord on his maiden speech and the manner in which he delivered it, and on the obvious love for Manchester that came through almost everything that he said. As well as education, he has a great knowledge of the health service—rather too much in my view. I see to my alarm that he was secretary of the Stockport Community Health Council between 1981 and 1987, which exactly coincides with the period when I was Secretary of State for Health. Although he did not quite say so, I know he feels how much better things were then than they are now. At least we had community health councils in those days. The noble Lord had a very distinguished career in the other place from 1987, in which time he had a range of opposition and government jobs, all of which he did excellently. But I leave to last his greatest achievement. He was educated at Bishop Vesey’s Grammar School in Sutton Coldfield. As Sutton Coldfield is a constituency that I represented for27 years, I congratulate him on that. It is a fine school and it self-evidently has fine old boys. We very much look forward to hearing him again very soon. It is always difficult with these broad debates to decide what subject to choose. I should dearly like to speak about pensions policy. I hear what the noble Lord, Lord Warner, said about the success of government policy. I would have preferred to talk about the destruction of occupational pensions, the ludicrous rule of compulsory annuities at 75 andthe parliamentary commissioner’s report which the Government have ignored. I would dearly like to have returned to the notorious 3 July meeting between Health Ministers and Labour Party representatives on the future of community hospitals. When I last raised that subject the noble Lord, Lord Warner, said how eager he was to reply in detail to it but, sadly, he left it to the 13th minute of a 12-minute dinner-hour debate to do so. But there will be other occasions on which these subjects can be aired. Instead, I should like to concentrate on an area where there are very few opportunities for debate and where all too often the whole subject is simply swept under the carpet. I refer to HIV/AIDS and sexually transmitted infection generally. I must say that I was confirmed in my decision to concentrate on that by listening to the replies by the noble Lord, Lord Warner, to questions this afternoon—rose-tinted replies which I fear would not be shared by very many people on the ground. Perhaps I may summarise the position we face in this country. Currently, more than 70,000 people are living with HIV in the United Kingdom. On present trends, that number will go over the 100,000 mark in the next two or three years. Those who told me in 1986 that I was exaggerating the threat and over-reacting to it might like to reflect on those figures and on their breakdown, which show that there were almost 8,000 new HIV diagnoses in 2005. About a third of people with HIV do not realise that they have it. Gay men are at particular risk, quite apart from the heterosexually acquired HIV that is mostly acquired in Africa. There is now undoubted evidence that the safe-sex messages of the 1980s are being widely ignored. In addition to the HIV figures, we have seen an explosion in other sexual diseases in the past 10 years. There were over 100,000 new diagnoses of chlamydia in 2005. That is a 20 per cent increase since 1996. There has been a 55 per cent increase in gonorrhoea since 1996, and a big increase in syphilis as well. As it happens, this is the 20th anniversary to the month of when I, with the support of a special Cabinet committee, launched our AIDS campaign, ““Don’t Die of Ignorance””. We used television, radio and posters, and we sent leaflets to every home in the country. The results of that campaign were striking. Our follow-up reports showed that over 95 per cent of the public understood the danger of AIDS and the detail. Even more significantly perhaps, in a way, they also supported the Government by that proportion in mounting such a campaign. As far as the figures were concerned, our record compared well with that of other European countries, not only for HIV but for other sexually transmitted diseases, which came down. Of course, we did other things, such as the clean-needle exchange for addicts, which brought HIV infection in that area permanently down. It is a great tragedy that other countries such as Russia do not follow our lead there. The irony is that we have known for 20 years some of the prevention policies that work. We have known how to promote good health and how to prevent infection. So with that knowledge, what has been the quality of our response in this country? Frankly, our response has been lamentable. I do not absolve my own Government from some responsibility here. But this is the Queen’s Speech of this Government, and it is time to judge their policy. In all conscience, they carry a greater responsibility. It took the new Government of 1997 four years to even publish a strategy, while all the time the figures were getting worse. It then took Ministers another three years to publish a White Paper, Choosing Health, in November 2004. Speaking personally, I was encouraged by what that White Paper said. I was encouraged that there might be new drive and new hope. I was encouraged that the White Paper recognised the Government’s responsibility to young people. Above all, I was encouraged that new resources were to be devoted to this area. Between 2005 and 2008, £300 million was to be injected to improve sexual health services, including £50 million for a new national advertising campaign. That point was mentioned by my noble friend Lord Howe, at Questions today. What has been the result? Ten days ago, the Government announced a new advertising campaign to combat sexual disease. It will cost not £50 million, or £40 million, or even £10 million. It will actually cost £3.6 million. There is no guarantee of more, and there is absolutely no guarantee of £50 million. I do not argue for a moment that the kind of campaign that I carried out 20 years ago could be repeated today. Time has moved on, and the challenge has developed. However, I argue that the scale of the campaign that we mounted was right. It concerns me that the scale of the current campaign is plainly inadequate and does not remotely match up to the challenge that this country faces. I argue also that the overall strategy of the Department of Health over the past years has been wrong. You do not mount a high-profile, successful campaign in this area and then go off the air forthe next two decades. Basically, that is what has happened. I deplore the inactivity and complacence that Ministers have shown and, most of all, I deplore the failure adequately to warn and guide people in this country. Even worse in some ways has been the position regarding the spending of the other £250 million earmarked for improving clinics and better services. That spending was examined by the Independent Advisory Group on Sexual Health and HIV in its report of June 2006. The noble Baroness, Lady Gould, is chairman of that group. What did it find? Almost two-thirds of the primary care trusts surveyed had withheld some or all of their allocation for sexual health, primarily to reduce their financial deficits. Those deficits were not, goodness knows, caused by sexual health services; they were not remotely responsible. The group found that all aspects of sexual health covered by the White Paper had suffered. It found staff cuts, clinic closures and cuts in existing budgets, let alone extra spending. The report was from an independent committee that was not, I suspect, prone to overstate its case. It summarised its conclusion in a sentence, stating: "““It is completely unacceptable that PCTs are inflicting such wholesale damage on sexual health services by withholding much-needed funding, just at the time when services need to be modernising to tackle the sexual health crisis””." That is the position and it is shameful. There is no ready-made lobby on health promotion that is ready to take to the streets, particularly in the area of sexual health, although I suspect that tens of thousands of young people would welcome good and objective advice in this area and that tens of thousands of parents would also welcome the fact that that good advice was being given. We seem to have gone backwards in public debate in some ways. It was in 1916 that a royal commission was set up to look at the spread of venereal disease. It proposed clinics providing free, confidential and speedy treatment. Today, the crisis is great, but the response is broken-backed. There is only one way that the position can be changed—by a Government determined to see change, by Health Ministers backed by their colleagues. What is needed is political leadership and it is that leadership that this Government have failed to provide. We are all accustomed to political arguments and debate, but this is a failure of policy that, frankly, makes me angry.