First, it is a pleasure to follow the hon. Member for Dartford (Dr. Stoate) in this debate, as both he and I have put some of the issues that we have talked about into practice. We both entered a competition for MPs’ fitness with Men’s Fitness magazine. I pay tribute to the hon. Gentleman for winning the competition, but I warn him that I came top on the running machine, so I hope he has the stamina to listen to what I have to say. It is also a pleasure to follow the hon. Memberfor North-East Derbyshire (Natascha Engel) and I want to answer her central question. She asked whythe Opposition have brought about today’s debate. The reason is very simple: a central plank in the Government’s public health policy—addressing health inequalities—has been a failure.There has been much discussion this afternoon about the distant past, but in the near past—the last nine years—life expectancy has still been seven to eight years lower in the poorest parts of the country and the inequality has widened by two years for men and five years for women. The crucial reason is not a lack of good intentions, but a lack of understanding that investment in public health—not in clinical services, however critical—is most important for successfully addressing health inequalities.The chief medical officer’s annual report on public health spelled that out very clearly. He said that investment in public health was falling as a proportion of expenditure in the NHS, that the number of public health professionals was static and that public health budgets had been raided and used to fund deficits. We heard a raft of statistics showing why the Government’s policy is failing. Alcohol-related deaths are up; tuberculosis infections are up; syphilis up; chlamydia up; obesity rising; smoking declining, but inequalities persist among smokers.The failure to understand the difference between morbidity and mortality is critical because, in the end, the incidence of poor public health has to be matched with investment in public health and the incidence of disease has to be matched with investment in clinical services. The result of that misunderstanding is a grossly unfair funding formula.I would like to tell the House about my own area of Guildford and Waverley. The hospital and community health services budget for 2007-08 is increased by 2 per cent. because there are many older people, but it is reduced by 25 per cent. because of a lack of deprivation. What is the impact? Last year, my constituents had to wait twice as long as people in Manchester for ear, nose and throat elective surgery. They had to wait nearly twice as long for breast surgery compared with people in the Health Secretary’s Leicester constituency; and three times as long for trauma and orthopaedic work as people living in the Prime Minister’s Sedgefield constituency.Now, this year, as a result of problems in the funding formula, my constituents face the closure of Milford hospital, a community rehabilitation hospital, and of the Royal Surrey County hospital—one of the top accident and emergency hospitals in the country, which happens to have the joint lowest mortality rate, as well as being a foremost cancer specialist centre.I want to brief, so I shall make just one final point. Another vital factor for public health is stability in budgets, but in my area of Guildford and Waverley, there was a budget increase of £9 million last year, while this year it has been told to reduce spending by £16 million. There is a phrase for that—boom and bust. If we are to change people’s attitudes—we have talked about the importance of doing that this afternoon—it requires sustained investment over a period of time, not boom and bust.Today, the Prime Minister is reported to be telling the NHS Confederation that service improvements in NHS hospitals are being implemented to ensure that the very sick have speedy access to specialist care, but also to treat people more conveniently closer to home.Anne Main: On that very point of access to specialist care and specialist nurses, two out of four specialist breast cancer nursing posts have been frozen in my hospital owing to cuts and deficits, yet there has been a target that all those diagnosed with breast cancer should have access to specialist nursing—a targetmet only in 74 per cent. of cases in my area.By withdrawing funding and making cuts, the Government are penalising specialist nurses.Mr. Hunt: From what my hon. Friend says, it is clear that my constituency is not the only area suffering from boom and bust.I return to what the Prime Minister is saying. He talks about all these so-called improvements, but which part of the country is he talking about? In my part of the country, he is closing our local hospitals, closing our accident and emergency services and health inequalities are rising. Inequality in access to health care is rising and the Prime Minister has delivered a boom that has become a bust. People are saying that enough is enough.