Health and Social Care Bill

My Lords, this is a brief probing amendment that is mirrored by my noble friend’s Amendment 75A, which is identical. I originally thought that I had tabled this as a new clause and it had appeared as an amendment. I would like to take the opportunity, by the way, to apologise to the House for being missing when a couple of the amendments that are in my name were moved by other noble Lords. My absence was unavoidable. The reason for the amendment is straightforward: it is to test the views on the creation of a chief environmental health officer for England. Historically, of course, there has been a chief environmental health officer position since the days before 1974, when I was elected to the other place. It was abolished, I think, on 1 April 1974 during the massive reorganisation that year. That was the last time local authorities had the lead responsibility for public health services. Each local authority had a medical officer of health in those days—in Birmingham, in fact, we called them the chief medical officer of health. Today, England has a Chief Medical Officer of health, but not a chief environmental health officer. The amendment, and my noble friend’s new clause, proposes that the Secretary of State should appoint a chief environmental health officer for England. In Wales, there is a chief environmental health officer in post. In Scotland and Northern Ireland, there are arrangements that are similar to that. Indeed, there are things happening in the devolveds that are streets ahead of what is happening in England. I have to say that my experience is that Westminster, in the centre, is completely unaware of it all, mainly because, regretfully, there is not a degree of communication. The respect agenda is not actually being played out in practice. Nevertheless, these things are happening elsewhere and there is a good case for making similar arrangements in England. This would recognise the role played by environmental health in promoting health and well-being and the importance of assuring environmental health input into policy-making at the highest level. That is part of the key issue: to get it involved at the highest level. There are some other amendments, for a further debate, that relate to the complications—again, unique in England—of two-tier local government. This issue does not arise in Wales, Scotland and Northern Ireland. There is a complete mishmash in England. The way in which we inherited the current two-tier local government structure was not planned. That actually highlights some of the difficulties with environmental health, which cannot be done and is not done at county level, of course, although I will save that point for other amendments. England currently lacks this input into policy-making at the highest level. The appointment of a chief environmental health officer would assist in that area. I am very guided in this by the Chartered Institute of Environmental Health. It has made some very positive remarks about the Bill and given some input into this part of the Bill, in no way to whinge or criticise but rather to strengthen the Bill. It is envisaged that the chief environmental health officer will focus on a preventive approach to achieving good health outcomes, and in particular on the wider determinants of good health and well-being. The postholder will be able to review the relevant data and advise the Department of Health, Public Health England, NICE and the Chief Medical Officer. It is envisaged as part of the package of proposals and amendments that the chartered institute has proposed that the chief environmental health officer answers to the Chief Medical Officer to have that input into preventive strategies and the wider determinants of health, in the widest sense that the public understand it, and to oversee the development of good practice within local authorities and their partner organisations. There is a real impact on local government because of the way in which the Bill moves aspects of what I will call the NHS into local government. It is crucial that people in local government, particularly environmental health officers, working as they are in a multitude of areas of activity for local government, feel that there is a head of profession to develop good practice, provide leadership at the very top and have input into policy and policy-making at the very highest level. An annual report to Parliament by chief environmental health officer for England would not go amiss. This is a probing amendment to test whether the Government have thought about this. It would be interesting to know what discussions they have had with local government. It would be very interesting indeed if the Minister could explain and show the House the benefit of any discussions the Government have had with Wales, Scotland and Northern Ireland about ideas of difference. Devolution means that things will be different. I make it absolutely clear that I am not arguing for things to be the same, but there are benefits that you can learn from discussion, and I am not clear that there have been such discussions. At the moment, England will be the loser, in particular because of the mishmash of two-tier local government, without the central leadership that a chief environmental health officer could provide. I beg to move.