Boris Johnson launches vision for better public health » Local Government » 24dash.com

Conservative Candidate for Mayor of London Boris Johnson will today launch his vision to reform the existing London Health Commission and ring-fence London's spending on public health.

In a speech at the Policy Exchange, Mr Johnson will say: "I want to explain why I care passionately about public health and why I believe the Mayor of London not only can do something but is also morally obliged to do so, when you consider the huge health problems we face in the greatest city on earth.

"We have 57 per cent of the cases of HIV, and as many as 27 per cent of those infected may not be diagnosed. One million Londoners have had mental health problems. One in four drug users live in London.  And London has higher rates of obesity than the rest of England, accounting for the deaths of 4,000 Londoners every year.

"It is a scandal that a child born in Haringey is three times more likely to die at birth than a child born in Richmond, and that if you travel eight stops on the Jubilee Line, from Westminster to Canning Town, the average life expectancy of the surrounding communities declines by eight year. That is as great as the difference in life expectancy between Britain and Lebanon.

"It is absolutely right that the Mayor should be required, by statute, to have a strategy to deal with these inequalities.

"Of course I don't mean that I intend to have cadres of mayoral health advisers going round the boroughs and snatching cigarettes from the lips of people in Hammersmith and Fulham, who are twice as likely to be smokers as the people of Harrow.

"And I do not envisage that Mayoral staff will be calling time in the pubs and bars of Wandsworth, where you are twice as likely to be a binge drinker as you are in Newham.

"But I do believe that it is my job to support public health programmes across London, and to work with the boroughs in providing them. And by public health I mean all manner of means to help people to look after themselves, because all the evidence is that these preventative steps are the best way of saving colossal sums over the lifetime of the patient.

"As the Wanless report observed in 2004, more effective spending on public health could save the NHS £30 billion by 2022.

"In 2006 the Association of Directors of Public Health conducted a snapshot survey of 24 London PCTs, and found that only one pound in every six that was notionally allocated to public health was actually being spent on any such programme.

"It is quite wrong that the areas of greatest deprivation in London have the lowest spending on public health. For instance Tower Hamlets spends £5.87 per head while Kensington and Chelsea spends £21.26.

"It is obvious what is happening. In the most disadvantaged areas, money is being siphoned away from public health to compensate for financial mismanagement elsewhere.

"That is why I am today proposing that we ring-fence London's spending on public health and we reform the existing London Health Commission, set up by the Mayor in 2000, and give that body some meaning and some purpose; namely to work with the Mayor's office and with the boroughs to wage war against this inequality.

"And I would like to give the London Health Commission a new remit, to look at inequalities within boroughs, and not just between them because under the Spearhead programme we are in danger of overlooking the pockets of real deprivation within comparatively affluent boroughs.

"I am very pleased that Tim Crayford, President of the Association of Public Health Directors has agreed to draw up proposals, in a personal capacity, on the reformed remit of the London Health Commission, so that it will be ready to go with the new mayoralty on May 2.

"And I want to apply the political equivalent of a cardiac resuscitation jolt to the London Health Commission because it is time to coordinate policies, on education, housing, transport - everything which currently falls within the purview of the boroughs and the mayor, so that we begin to close a disgraceful gulf in our society that has widened in the last ten years, and which the current Mayor and Labour candidate does not see fit even to mention, even though it is plainly part of his duties.

"I want local directors of Public Health to have the freedom to invest their ring-fenced budgets in specific projects, while as Mayor I will be interpreting public health in the widest possible way.

“Of course the Mayor doesn't run healthcare in London, but he has a moral and statutory duty to speak up for Londoners and he can help them by telling them frankly what kind of healthcare they are actually getting.

“Why can't we have the Tough on Grime awards, a mayor's medal for the cleanest hospital? Or a Mayor's filth alert for the dirtiest? The data is all there. We don't need a single new official or a single new measurement to be taken.

”We just need someone in London to look at the whole picture and to defend the interests of Londoners against ill-thought out reforms.

“There is nothing in the Darzi report about public health, indeed there is a real risk that the £3 billion he proposes to spend on polyclinics could divert funds away from public health.

”It is the job of the Mayor to represent Londoners who are anxious about the downgrading or closure of London's 23 district general hospitals. It is the job of the Mayor to ask whether we are in danger of interrupting the link between patients and their GPs.

“Someone has to ask central government to be honest about which services it is proposing to cut in London. That someone is the Mayor.

“I want to stress again that my approach will be about enabling and not bullying. I don't want to nanny and I certainly don't want to coerce, but I do want to encourage the spread of information on the principle that where information spreads, disease doesn't.”