Health and Social Care Bill

I support a number of these amendments. Indeed, my name is harnessed to them. When the Minister wrote to us after Second Reading, he answered the noble Baronesses, Lady Eccles and Lady Gould, on the subject of the importance of the director of public health and their status. He said that the Government would expect them, "““to be of Chief Officer status with direct accountability to the Chief Executive for the delivery of local authority public health functions. We are currently considering the best approach to ensure that directors of public health have appropriate status””." How far has my noble friend got along that road and does he see any of these amendments, which so many of us support, as going some way to enhancing that status? I agree with my noble and learned friend Lord Mackay of Clashfern. These people have to be extremely brave and courageous and should be confident enough to open any door. They need to poke their nose into all sorts of areas and issues on which the local authorities will not want them to do so. Their annual report should be challenging. But they must have a proper status and be supported so that they cannot be fired just because they are awkward, uncomfortable and difficult people. That is why I very much support the idea that the Secretary of State should be involved in this, because I think that these people are exceptional, or should be—and I am sure that many of them are at the moment. They are moving into a very different type of culture. I have served in local government and I just know that in local government what is really most important is the idea of place. It is knowing your communities very well, the streets and the houses where people live—all sorts of intimate details about your voters. What really matters is that you get re-elected at the next election, so you are grounded in place. Directors of public health will be much more evidence-based, and they have to be analytical. So this is really a very different discipline that they will use to expose some of the difficulties in communities’ health in that area. They need the confidence and some sort of security so that they can be very uncomfortable—so that they can be difficult and say things that nobody wants to hear. Their annual report should be free from pressures from local authorities and those who employ them. These are very important amendments, and I hope that my noble friend will consider them seriously and see how in this very important area he can enhance the status, security and confidence of directors of public health.