Greater London Authority Bill

Good. This has prompted a debate about public health. We need to be clear that we are talking about aspects of public health that are a subset of the whole wide range of what public health encompasses, over which the Mayor has influence. We are talking about a subset of public health, which includes areas in which health determinants come under the influence of the Mayor. What the noble Baroness has been talking about is public health in the widest possible sense. It is right that we should be looking at how the Mayor’s health inequality strategy dovetails with a wider London-wide effort, which plays into the role of the health adviser and why that adviser should be accountable to the strategic health authority and the Department of Health. The strategic health authority in London has responsibility for all the other aspects of health separate to those that we are talking about, which the Mayor has influence over. It is important that all of those are knitted together into a strategy that reaps real benefits for Londoners. That is the approach that is being built on here in the Bill. After this Committee, we should discuss how the mechanics of that will work in reality. As we have heard, tribute has been paid to the health adviser and the system has worked well, and we have the opportunity outside the Committee to work through the issues that the noble Baroness has raised. We believe strongly that the Bill’s focus on tackling health inequalities is justified, because broadening the remit of the strategy would dilute the focus on health inequalities, which urgently need addressing in London. Respondents to the consultation on the development of new powers supported action to address health inequalities being prioritised through the GLA. The current Mayor also supports the focus on health inequalities, and I am sure that he would share my view that such inequalities are unacceptable in London as a world city. The health inequalities strategy will provide the necessary impetus to tackling health inequalities by giving that work equal status with other mayoral strategies. For those reasons I strongly resist Amendments Nos. 47 and 48, which would rename the Mayor’s ““health inequalities”” strategy the ““public health”” strategy. The term public health is too broad and potentially covers a range of aspects outside the remit of the GLA. For the same reasons, I resist the related Amendments Nos. 51 to 53, which seek to change the specifications for the strategy in similar terms. I could go on about the consequential amendments, but I shall turn to Amendment No. 70, which would remove the duty on the Mayor to have regard to health inequalities in relation to mayoral strategies and to include in his strategies policies and proposals best calculated to promote a reduction of health inequalities. I come back to my point that we are focusing on the aspects of mayoral influence that affect public health in the widest possible sense. These concentrate on health inequalities. Amendment No. 60 simplifies the consultation process on the Mayor’s health inequalities strategy. Clause 22 requires the Mayor to consult the health adviser and bodies in London’s health sector about what he should include in the strategy. In doing so, it requires him to publish a final draft. We believe that it is unnecessary to require the Mayor to publish a final draft of the strategy in order to consult about what should be included in it. We are therefore removing new Sections 309G(6) and 309G(7) to make the consultation requirements more straightforward. I urge the noble Baroness to consider withdrawing her amendment and having a meeting to discuss what we have highlighted in this debate.