[2nd Allocated Day]

Of course it comes down to money, but it also comes down to fairness in how the money is allocated. That must relate to an overall sense of direction to deal with health inequalities. I want to discuss very specifically three amendments that I have tabled, but I did not want to go into the detail without associating myself with some of the concerns that exist across the country which have not yet been resolved. I speak as an honorary vice-president of the Chartered Institute of Environmental Health. I tabled the amendments to ensure that we do not just pay lip service to environmental and public health, and that we truly get a Bill that is fit for purpose in respect of the prevention agenda and the new arrangements under which we will be operating, which should give more status and priority to environmental health. I want to speak in favour of the Government looking either now or in the other place at the case for a chief environmental health officer for England. The reason for that is the fact that, historically, there was a post of chief environmental health officer, going back to the days before 1974 when local authorities last had lead responsibilities for public health services and when each authority had a medical officer for health. Today, England has a chief medical officer, but not a chief environmental health officer. I heard what the Minister said about that, but I urge him to have further talks, if necessary, with the professionals to see how we could ensure that a chief environmental health officer for England was appointed. Earlier we talked about Wales, where there is a chief environmental health officer post. In all the arrangements in Wales and in Northern Ireland, there is a recognition of the role played by environmental health in promoting health and well-being, and of the importance, therefore, of ensuring there is an environmental health input to policy making at the highest level and at the strategic level. I believe that is what England currently lacks. If the Bill is to give a higher profile to public health services, and the lead in public health is to be provided by local authorities, which is where the environmental health work force is located, it is necessary to make corresponding arrangements such as my new clause could facilitate, if the Government gave it serious consideration. It is envisaged that if we had a chief environmental health officer, he or she could focus on a preventive approach to achieving good health outcomes, and in particular the wider determinants of good health and well-being. I see that post holder reviewing relevant data, advising the Department of Health, Public Health England, NICE and the chief medical officer on preventive strategies and the wider determinants of health, as well as overseeing the development of good practice within local authorities and their partner organisations. In response to points made earlier, let me add that an annual report to Parliament by the Secretary of State on the work of the chief environmental health officer could ensure the accountability of that official. Amendments 1242 and 1243 would place a duty on public health authorities to work in co-operation with their public health partners. Without that duty, the co-ordination that was mentioned earlier will not be achieved. There will be no mechanism for all the different strands of policy and health care provision to come together. As all Members know, not all local authorities in England are to be public health authorities. For example, in areas of England with two-tier local government, the powers and duties apply to county councils but not to district councils. For example, in my constituency Staffordshire county council, rather than Newcastle borough council, will have the responsibility but not the environmental health officers to perform the role. A duty to co-operate could make a significant difference. The public health work force directly controlled by local authorities will be carrying out the work. I urge the Secretary of State to consider that. There is a precedent in respect of children's safeguarding and in respect of the emergency services. Although I object to many aspects of the Bill and will not support it, if it goes through it should at least contain the safeguard for public health that a duty to co-operate would provide.