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London Assembly Reports - Health and Public Services

Reports may be downloaded, free of charge, in PDF and RTF formats - the site help page provides information about these formats.

For further information on any of the reports below, please contact Sarah Hurcombe, Assistant Scrutiny Manager, email: sarah.hurcombe@london.gov.uk.

Response to the Mayor's draft health inequalities strategy

January 2010
Response to the Mayor's draft health inequalities strategy PDF
Response to the Mayor's draft health inequalities strategy RTF

Boris Johnson’s vision for tackling health inequalities in the capital is at risk of being sidelined unless he clearly sets out his priorities and the initiatives he will take forward to help achieve them. While Health and Public Services Committee welcomes the publication of the Mayor’s draft health inequalities strategy, it warns in its response that partners will find it hard to determine their own priorities when it is unclear what the Mayor and the GLA group will be doing.

The Committee says the Mayor should also provide details of how he will bring together local partners and break down organisational ‘silos’ as part of the strategy delivery plan.

The Committee makes recommendations to maximise the impact and effectiveness of the draft strategy:

  • The Mayor must set firm targets for the GLA and its functional bodies for how they will tackle health inequalities and deliver their proposed actions
  • Funding arrangements should take into account the capacity of smaller community groups to bid for money
  • The Mayor must raise the profile of work to tackle health inequalities amongst London partners.

Young Londoners' sexual health: an update review

August 2009
Young Londoners' sexual health: an update review PDF
Young Londoners' sexual health: an update review RTF

Our report reveals that young Londoners' sexual health is still among the worst in the country, despite innovative projects and improvements to the way services work. It finds that teenage pregnancy rates in 18 London boroughs are higher than the national average.

The Committee makes specific recommendations to address the barriers to improving young people's sexual health in London:

  • Sex and relationship education should be a core component of the soon-to-be mandatory personal, social and health education curriculum
  • Pan-London branding and improved sharing of good practice and joint working for the chlamydia screening programme and sexual health media campaigns.
  • The Mayor's forthcoming Health Inequalities Strategy should include measures to improve young Londoners' sexual health and reduce rates of teenage pregnancy.
  • A sexual health champion should be appointed to encourage the implementation of good practice across the capital.

This report follows up on the Committee's 2005 investigation into the sexual health of young Londoners

Written submissions received by the Committee during the investigation is also available.

Response to The Way Forward

July 2009
Response to The Way Forward PDF
Response to The Way Forward RTF

Our response calls on the Mayor to give greater clarity on his plans to tackle violence against women in the capital. It asks for more information about costs, the partners involved, their responsibilities and timeframes for implementation. The response welcomes the Mayor's commitment to tackling violence against women but makes recommendations to maximise the impact and effectiveness of the draft strategy.

Too much too young: Alcohol misuse among young Londoners

June 2009
Too much too young - report PDF
Too much too young - report RTF

Too much too young - report for young Londoners PDF
Too much too young - report for young Londoners RTF

Our report reveals that the capital’s 11-15 year olds now drink the equivalent of 180,000 bottles of lager every week – and the amount they drink is on the rise. The investigation found a lack of senior leadership both locally and regionally means efforts to tackle the problem are not always effectively prioritised or co-ordinated. To address this, the Committee believes the Mayor and local leaders need to focus more effort on tackling alcohol.

Alcohol misuse: Media info PDF
Alcohol misuse: Media info RTF

As part of the investigation, the Committee commissioned a report by the Institute of Alcohol Studies, which is available to view below:

A Profile of Young Londoners’ Drinking PDF
A Profile of Young Londoners’ Drinking RTF

The Committee also conducted a series of workshops with young Londoners.

Engagement with YP PDF
Engagement with YP RTF

Written submissions received by the Committee during the investigation is also available.

Responses to our report are available to download

The Health and Public Services Committee response to Post Office Ltd’s consultation on the London Area Plan Proposal

April 2008
Response to Post Office Ltd’s consultation on the London Area Plan Proposal PDF
Response to Post Office Ltd’s consultation on the London Area Plan Proposal RTF

The Health and Public Services Committee submitted a response to Post Office Ltd’s consultation on its proposal for London’s network of post offices, as part of the Network Change Programme.

Consultation on the draft Health Inequalities Strategy

Response from the Health and Public Services Committee
March 2008
Consultation on the draft Health Inequalities Strategy PDF
Consultation on the draft Health Inequalities Strategy RTF

The Health and Public Services Committee submitted its views on the Mayor's draft Health Inequalities Strategy.

Healthcare for London: a framework for action

The Health and Public Services Committee’s response to the consultation
February 2008
Healthcare for London: a framework for action PDF
Healthcare for London: a framework for action RTF

The Health and Public Services Committee submitted further views as part of this stage of consultation on the development of the Healthcare for London Framework.

Behind the screen

Breast screening uptake and radiotherapy waiting times in London
March 2008
Behind the screen PDF
Behind the screen RTF

More than a third of women in London who are invited to be screened for breast cancer are failing to take up the offer, our report found. London has the lowest uptake of breast cancer screening in the country – 13 percent below the national average of 75 percent. The report shows large disparities in the uptake of screening across London boroughs. Havering and Bexley have the highest uptake, while Westminster, Kensington & Chelsea, and Tower Hamlets have the lowest.

The report recommends a London-wide call and recall service, which offers appointments to women outside working hours and at a location of their choice. It calls for NHS London to sponsor an incentive scheme to encourage GPs to promote the screening programme using an electronic flagging and letter system. Other recommendations include:

  • All London PCTs should carry out audits of their populations in relation to breast cancer screening and radiotherapy.
  • The Department of Health should assess the practicalities of implementing a three year rolling media campaign in London targeting risk groups. It should also require all Screening Programmes to send letters to women over the screening age range every three years reminding them they are entitled to screening appointments.
  • NHS London must lead the capital’s five cancer networks to set up a pan-London coordination of radiotherapy treatment services in line with the Cancer Reform Strategy.

The following letter(s) was/were received in response to this report:
Letter from Ann Keen, MP, Parliamentary under Secretary of State for Health, Department of Health PDF only
Letter from Jane Moore, Associate Regional Director of Public Health, NHS London PDF only

Teething problems

November 2007
Teething problems PDF
Teething problems RTF

The capital has more NHS dentists than most other parts of the country, but only half of Londoners are using them according to our report. Only 51 percent of Londoners and just under two-thirds of children went to an NHS dentist in the two years to March 2007, and our survey found around 205,000 adults in the capital may never visit a dentist. This is despite there being 51 NHS dentists per 100,000 Londoners, compared to a national average of 42 dentists to every 100,000 people elsewhere in England.

The report makes a number of recommendations:

  • The Department of Health (DH) should revise the dental charge banding structure to encourage people to regularly go to the dentist. The DH should also base PCT’s dental funding allocations on what local people need, rather than basing it on what has been provided in that area in the past, which may not take account of London’s growing population.
  • The DH should look at explicitly building in preventive care in the way PCTs manage and monitor dental contracts and consider whether dentists should be financially rewarded for providing preventive advice.
  • A London PCT dental network should be set up to enable PCTs to share and discuss good practice in commissioning services that better meet local needs.

The full results of a survey undertaken as part of this investigation are also available to download:

Dentistry survey PDF
Dentistry survey RTF

The following letter(s) was/were received in response to this report (please note that the following PDF files contain scanned documents):
Letter from Barry Cockcroft, Department of Health PDF
Letter from James Stanton, on behalf of Cllr Don Jordon, Royal Kingston PDF
Letter from Miles Freeman, Hammersmith and Fulham PCT PDF
Letter from Ruth Carnall, NHS London PDF
Letter from Simon Tanner, Regional Director of Public Health for London PDF

Response to the Mayor's Refugee Integration Strategy

October 2007
Response to the Mayor's Refugee Integration Strategy PDF
Response to the Mayor's Refugee Integration Strategy RTF

The Committee met with representatives of the GLA’s Policy and Partnerships Directorate in October 2007 to discuss the consultation draft of the Mayor’s Refugee Integration Strategy. The Mayor is taking strategic leadership of refugee integration work for London and the strategy aims to tackle the social exclusion faced by refugees and to move towards equality of opportunity for refugees in London.

The Committee’s response to the consultation on the strategy recommends that: the strategy team engages with PCTs and other NHS Trusts as soon as possible to secure their support for the strategy. The strategy includes proposals for improving refugee and asylum seeker women’s knowledge of and access to antenatal and other maternity services the strategy emphasises the importance of developing a comprehensive, community based TB screening in London for refugees and asylum seekers a survey is conducted of London’s refugees and asylum seekers as soon as possible to provide baseline information to help monitor and evaluate the strategy.

Still Missing the Point?

September 2007
Still Missing the Point? PDF
Still Missing the Point? RTF

Our report reveals London’s infant immunisation rates are so low that the chance of a serious outbreak of measles is worryingly high. It warns just over half (52 percent) of the capital’s children are fully immunised against measles, mumps and rubella. This compares to a national average of 74 percent, and is well below the level required to prevent a severe outbreak. The report also identifies significant variation in the immunisation rates across London boroughs.

The report makes recommendations to help bring the capital’s immunisation rates up to population immunity levels, which would make a serious outbreak unlikely.

A Heartbeat Away… Emergency Life Support Training in London

June 2007
Emergency Life Support Training in London PDF
Emergency Life Support Training in London RTF

Every year, around 6,000 Londoners die from a cardiac arrest before they reach hospital. Yet our report reveals the capital has one of the lowest levels of people trained in emergency life support (ELS) in the country.

Find out where to get emergency life support training.

The following letters were received in response to this report:
Letter from Boris Johnson, Mayor of London PDF
Letter from Nick Hughes, The London Organising Committee of the Olympic Games and Paralympic Games Ltd PDF

Post Offices in London: future directions

July 2007
Post Offices in London: future directions PDF
Post Offices in London: future directions RTF

March 2007
Response to Post Offices consultation PDF
Response to Post Offices consultation RTF

Post offices play a crucial role in their communities, not least because in some neighbourhoods they might be the only place where people can get free access to cash and claim their pensions and benefits. In the past few years, more than 300 branches have closed across the capital, and a growing number of branches have been franchised. The Health and Public Services Committee therefore decided to investigate the impact of closures and franchising, and the future role of post offices in our communities. This investigation also provided an opportunity to follow up on a previous (2004) report on post offices.

As a part of this investigation, the Committee submitted a response to the government's consultation on the post office network.

Navigating the mental health maze

March 2007
Navigating the mental health maze PDF
Navigating the mental health maze RTF

More than a million Londoners have a mental health problem, yet accessing the right treatment and support can be difficult because of long waiting lists, confusing referral procedures, and a lack of information about what is available. This report sets out recommendations to improve access to mental health services in the capital, including the need to agree a single pan-London referral system for specialist mental health services.

As part of our investigation, we conducted a survey among users of mental health services in London. The full results of this survey are also available to download:

Mental health survey report PDF
Mental health survey report RTF

NHS London

November 2006

At its meeting on 1 November 2006, the Committee questioned the Chair and Chief Executive of NHS London, the new Strategic Health Authority. Following this meeting, a letter was sent to Ruth Carnall, the Chief Executive, to follow up on key issues. This letter together with her response are available below.

Letter to Ruth Carnall, NHS London PDF
Letter to Ruth Carnall, NHS London RTF
Response from Ruth Carnall, NHS London PDF only

The 2012 Olympic Games: benefiting Londoners health

September 2006

Health and 2012 - Draft London Delivery Plan PDF
Health and 2012 - Draft London Delivery Plan RTF

A strategy for maximising the health benefits of the 2012 Olympic and Paralympic Games is under development. The Committee met with representatives of the Regional Public Health Group in July 2006 to discuss this strategy. The Committee also responded to a consultation on the draft strategy in September 2006. The Committee's consultation response and the draft strategy are available for download.

Some of the key points of the Committee's response are:

  • The draft strategy lacks information about how initiatives will be funded
  • Plans to engage Londoners in the evaluation of the strategy need to be developed as soon as possible if they are to be effective
  • The plan needs to explain how the NHS will recruit enough sports medicine specialists and allied health professionals to staff the games, and provide services for the National Sports and Exercise Medicine Centre (NSEMC) after the Games.

Letter from Joanne McCartney PDF
Letter from Joanne McCartney RTF

Response to consultation on the draft "Health and 2012" plan for London PDF
Response to consultation on the draft "Health and 2012" plan for London RTF

Provision of Youth Services

During 2005 the Health and Public Services Committee looked at activities for young people aged 13-19 in London including sport clubs, youth centres, arts workshops, parks, etc. The Committee investigated what there is at present and how to make this better, and also what money is available, how things are organised, how this is changing and what people think. As part of this work the Committee held a public meeting on youth provision in October 2005.

The Committee conducted some follow-up work in autumn 2006 around youth opportunity cards - a kind of a type of smartcard for young people, one of the Government's proposals outlined in the discussion document Youth matters. These cards are designed to hold credits that can be spent on positive activities such as youth and sports clubs. The Committee met with representatives of Camden and Tower Hamlets Councils in November 2006 to discuss the pilots for youth opportunity cards, and the reasons why these pilots had been delayed.

For further information see the following Health and Public Services Committee agendas:

London's Drought

July 2006
London's Drought PDF
London's Drought RTF

London is currently experiencing a drought following many months of below average rainfall. Water shortages caused by the lack of rainfall have been compounded by massive amounts of leakage from the capital’s water pipes, and increasing demand on our limited supplies.

The Health and Public Services Committee therefore decided to investigate what water companies and others are doing to tackle water shortages in the capital, and what impacts these efforts are having. The Committee found that although water companies, Ofwat and other agencies are working to improve the security of London’s water supply, more must be done, particularly to reduce leakage, increase water metering, and improve the information being given to customers.

Counting the Cots

Neonatal care services in London
May 2006
Counting the Cots PDF
Counting the Cots RTF

Around 11,000 babies born every year in London need the extra care provided in neonatal units, and this number is on the increase. Our report examines how neonatal care services in the capital are coping with the growing pressure put on them and also looks at parents’ experiences of the care their babies received, and their involvement in that care.

The Committee found that neonatal services in London are generally working well, thanks to recent investment and committed, experienced staff. However, neonatal units across the capital are understaffed and are working at much higher occupancy levels than is recommended. Cot shortages mean that babies regularly have to be transferred to hospitals far from their homes. Parents’ experiences are mixed. Although happy with the medical care their babies received, many felt that staff needed to do more to involve parents in their babies’ care. Our report makes several recommendations that we believe will ensure neonatal care services in London continue to improve, and cope with the increasing demands put upon them.

The following letter(s) was/were received in response to this report (please note that the following PDF files contain scanned documents):
Letter from Trish Morris-Thompson, NHS London PDF

Changes to the NHS in London

Committee's response to government consultation
March 2006
Changes to the NHS in London PDF
Changes to the NHS in London RTF

The Government announced that the NHS must change how it delivers and commissions primary care services in order to meet proposals in Commissioning a Patient-led NHS. The Health and Public Services Committee investigated the impacts of these proposals on London, and in March 2006 submitted a response to the Government's consultation on the changes. The response and covering letter are available to download.

An urgent need

The state of London’s public toilets
March 2006
An urgent need PDF
An urgent need RTF

There is a real concern about the declining quantity and quality of public toilet provision in the city – a shortage that causes problems for those who live and work here as well as visitors to London.  It impacts on public health and environmental issues, in terms of street cleanliness, social disorder and infections.

London has experienced the highest decline in the number of local authority owned and run public toilets in the country.  Things can be done to change this around.  There needs to be a complete rethink about the role that this public service has in a 21st century world city.  The report’s recommendations include:

  • Local Authorities should have a statutory duty to provide adequate publicly accessible toilets.
  • That the Mayor publish a London-wide map of available public toilets
  • Local Authorities improve sign posting of public toilets and encourage commercial premesis to make their facilities available to all. 
  • Planning consent should require double the number of women’s toilets as men’s in all new developments or refurbishment schemes.
  • The repeal of legislation banning local authorities from charging for urinals.

Response to the Mayor’s Draft Older People’s Strategy

February 2006
Response to Older People’s Strategy PDF
Response to Older People’s Strategy RTF

This report is the London Assembly’s response to the consultation draft of the Mayor of London’s Older People’s Strategy entitled: “Towards an older people’s strategy for London, a draft Mayoral strategy for consultation”, published in November 2005.

General comments:

  • The Committee agreed that the various sections of the strategy should be better integrated throughout the document and linked to each other and to other relevant strategies. For example: health and well-being - the section on transport should also consider older people’s access to health services using public transport, and the health section should highlight references to the Mayor’s Food Strategy. The section on advice and advocacy should similarly be better integrated with other themes of the strategy, notably the pensions and income section.
  • The Committee welcomes the objective of co-ordinating existing and proposed plans to make London a better place for older people. There is a clear need for an action plan to give the details of how the policies and proposals will be implemented and achieved, and the Committee looks forward to receiving this after the Strategy has been further refined.

Street Prostitution in London

November 2005
Street Prostitution in London PDF
Street Prostitution in London RTF

The London Assembly's Safer London Committee has published its report 'Street Prostitution in London', a review of prostitution and community safety in London. The aim of the review was to examine the impact of prostitution on London’s local communities, in particular local residents, and to keep a community safety focus.

The report recommends that the Home Office should fund more drug referrals and exit programmes to help tackle London’s prostitution problems. It also calls for a common strategy across London to help prevent vulnerable women and young people from prostituting themselves.

Improving young people's sexual health

November 2005
Improving young people's sexual health PDF
Improving young people's sexual health RTF

The rate of sexually transmitted infections are increasing across the country, with the highest rates of increase in London. Our young people have been particularly affected, with 16 - 25 years olds displaying the largest increases in rates of infection. The Committee focused on young people’s access to services, and their access to information and advice on sexually transmitted diseases.

The Committee were concerned at the level of knowledge that young people have about the risks to themselves and others of unprotected sex and believed that the single most important step to improve all young peoples’ sexual health over the long-term is to implement a more comprehensive programme of sex and relationships education in secondary schools. The committee also found that as tackling sexual health is not a priority target, it is still not given the importance or resources it deserves. This is not acceptable and needs to change.

Secretary of State's response to the sexual health report:

Response - PDF only

Building London, saving lives

Improving health and safety in construction
November 2005
Building London, saving lives PDF
Building London, saving lives RTF

The construction industry accounts for half of all fatal injuries in the workplace and on average two people are seriously injured every working day. The industry and Government have successfully introduced a range of schemes to improve workers' safety, but the report finds that there are still areas for improvement. With 40% of new building funded by public bodies we urge the public sector to use this purchasing power more effectively. In particular, construction for the London 2012 Olympic Games should set new standards in safe working.

MRSA in London

October 2005
MRSA in London PDF
MRSA in London RTF

London has hospitals with worldwide reputations, but also some with the highest rates of MRSA in England. The report looks at MRSA, what it is, how it can be acquired and what factors influence its spread. The Committee makes a number of recommendations on improving record keeping and what other actions are required to reduce MRSA. Examples of good practice show that MRSA infection can be reduced but this practice must become commonplace.

Smoking: Response to smokefree elements of the Health Improvement and Protection Bill

September 2005
Response to government consultation on smoking PDF
Response to government consultation on smoking RTF
Report on telephone survey on smoking - PDF only

The majority of the Health and Public Services Committee agreed to recommend that smoking should be banned in enclosed public places in response to a recent Government consultation on health protection. They believed that workers should be protected from the harmful effective of passive smoking regardless of their place of work. The Committee found that a partial ban would be ineffective at preventing health inequalities, would be harder to enforce and was unpopular, including amongst publicans. The Conservative Member, Angie Bray, did not agree with the response.

Under pressure - water pressure management in London

March 2005
Under pressure PDF
Under pressure RTF

The largely unseen 32,000 kilometres of piping delivers fresh water daily on demand to London’s seven and half million people. Thames Water is in charge of much of this vast and complex network. Maintaining and managing this system, much of it a hundred years old and in need of replacement or total overhaul, is a challenging and resource intensive task. The Health and Public Services Committee focuses on a number of serious concerns over the impact of a possible reduction in water pressure if Thames Water goes ahead with plans to lower water pressure across London with the aim of reducing leakage levels. In particular, the Committee highlights the following concerns:

  • the lack of communication between Thames Water and customers (including Local Authorities);
  • the likely cost of additional pumps and secondary backflow prevention devices needed to preserve water pressure levels and prevent contamination in buildings three storeys and above;
  • the impact on the economically and physically vulnerable;
  • concerns that constituents have been required, inappropriately, to enter into contracts for new pumping equipment;
  • the likely impact on combi-boilers and fittings;
  • the danger of “backflow” contamination;
  • the likely impact on the fire service.

The Committee made a series of recommendation to Thames Water and looks forward to a response within a two-month period.

Dublin's Smoke Free Pubs

March 2005

Report to HPS Committee PDF
Report to HPS Committee RTF

Jennette Arnold AM, Rapporteur for the London Assembly’s Health Committee, visited Dublin to investigate the Irish Smoke-Free at work policy. The objective of the visit was to see how the ban was devised and implemented, how well it is being complied with and what the costs and benefits have been.

Key Findings: The Irish Government kept the focus of the debate around the proposals on eradicating the harmful effects of second-hand smoke (or environment tobacco smoke, ETS) and on it being a public health issue aimed at protecting workers;

The Government refused to be side-tracked by the issue of the civil liberties of smokers; safeguarding the health of workers “trumped” the “right” to smoke. Pubs were first and foremost places of work. The Government reasoned that if bank workers and hairdressers had the protection of law why shouldn’t pub and bar workers enjoy the same protections?

Sexual health - forum for young people

On 10 March more than sixty teenagers came to City Hall to take part in a ground-breaking event to explore young people's views about sexual health. The day-long forum, part of the Committee's investigation into sexual health in the capital, sought to find out how young people would like to be taught about these issues and what services should be available to them. During workshops young people and health care professionals discussed sexual health education and treatment in some depth.

Why does sewage end up in the Thames?

On 3 August 2004, after torrential downpours in London, up to one million tons of so-called combined sewer outflows (rain, street detritus and sewage) went into the river Thames. Oxygen levels in the river fell and thousands of fish were killed.

At its hearing on 14 September 2004, the Health and Public Services Committee discussed with Thames Water and the Environment Agency the reasons why sewage can still end up in the Thames. The Committee heard that such sewage outflows were routine, happening some 50-60 times a year often after modest levels of rainfall. The main reason for these events is that the system of drains, most of which date back to Victorian times, cannot cope with the volume of material that flows through them when it rains over London. To avoid raw sewage backing up into the streets, it is directed to flow into the river.

A series of proposed solutions to this long-standing problem was set out in Thames Water's presentation to the Committee (PDF).

For a full record of the discussion between the Committee and Thames Water and the Environment Agency, please see the minutes of the Health and Public Services Committee.

In response to this session, the Committee wrote to Elliott Morley, Minister of State at the Department for Environment, Food and Rural Affairs:
Letter to Elliott Morley, PDF
Letter to Elliott Morley, RTF

Response letter from Elliot Morley PDF
Response letter from Elliot Morley RTF

DoH response to report on fluoridation

May 2004

The Department of Health has responded to the Health Committee's report on fluoridation, Should Fluoride be added to London's Water?

DoH response to report on fluoridation PDF
DoH response to report on fluoridation RTF

The London Ambulance Service

May 2004
The London Ambulance Service PDF
The London Ambulance Service RTF (without tables)

This is the first joint scrutiny between the London Assembly, Association of London Government, and the London Boroughs. Enormous improvements have been made to the service, including the time taken to respond to potentially life threatening calls and the protection of children and vulnerable adults. Working in partnership with other agencies, the London Ambulance Service continues to ensure their preparedness for major emergencies. Improvements still need to be made to the Patient Transport Service and more work is needed to support patients with mental health needs. This report aims to stimulate debate and influence the future development of this important service.

Post Office Closures in London

April 2004
Post Office Closures in London PDF
Post Office Closures in London RTF

The Post Office Limited’s programme of closures could see between 400 to 500 post offices closing in London by the end of 2004. This means that around 35% to 45% of London’s 1,100 post offices could close. The Post Office has seen a fall in revenues since the Government changed the way benefits and pensions were paid. The Post Office has moved into some areas of banking, which we believe should be extended to include access to all the major high street banks, and so help raise social inclusion. The Committee recommends that the possible sale of travelcards and the congestion charge should be reviewed again. We also called for the Post Office to improve disabled access facilities at its branches. The Committee was concerned that the closure of a local post office, especially when coupled with the closure of a local bank or a food store moving out of town, can lead to the death of a high street. We recommend that the Post Office should engage with local businesses to consider relocations and new openings.

Living with the virus

A Scrutiny of HIV Services in London
March 2004
Living with the virus PDF
Living with the virus RTF

London has a higher proportion of people living with HIV than any other city in the UK. A third of people living with HIV do not know that they are infected. Although there are drugs that prevent the progression of HIV, there is no cure and no vaccine to prevent its spread. HIV is no longer seen as an issue of concern for the public and the level of HIV continues to rise. It is expected that the total number of new diagnoses for 2003 will be the highest ever.

There is an acute need for the Government and health service to refocus their priorities and embark on a wide ranging educational programme to raise awareness of the HIV pandemic. The experience of living with HIV in London is a challenging one, not only in terms of living with a long-term, life threatening condition, but also in overcoming barriers and learning to negotiate access to appropriate services and support. The report outlines ways in which these services could be better provided.

The power cut in London on 28 August 2003

February 2004
Power Cut PDF
Power Cut RTF

On the 28 August 2003 at 6.20pm London suffered a major power cut. The power cut was caused by a safety circuit with a wrong protection relay, which had been fitted by contractors. Power was restored in 30 minutes, but chaos reigned for the evening. Many commuters were stuck as only a reduced rail service was restored and most of the underground was out of action until the next day, due to the antiquated signalling systems used on the tube. The communication flow to the Mayor, transport staff and public was slow and limited. The Committee recommended that the utilities and other public service providers improve their external communications and that the plan for tube signals improvements under the PPP should be monitored.

Tuberculosis in London

November 2003
Tuberculosis in London PDF
Tuberculosis in London RTF

After a century in decline, tuberculosis is making a worrying comeback in London. While rates of infection have flattened out or dipped across the rest of the country, increasing numbers of Londoners are contracting the disease. Fifteen years ago, the capital accounted for three out of twenty cases in England and Wales; now, almost half of them are in London. This report looks into the implications of the resurgence of disease in the capital and explores some of the measures which are being adopted to tackle it.

Should Fluoride be added to London's Water?

November 2003
Fluoridation PDF
Fluoridation RTF

On the long running debate as to whether adding fluoride to drinking water is beneficial or harmful to people's health, Committee members were divided. But the Committee highlighted two key issues of concern for London - is it technically feasible to add fluoride to all London's water? And how will the Government ensure that there is a full consultation of Londoners?

London's Water Supply

October 2003
London's Water Supply PDF
London's Water Supply RTF

Thames Water has the highest level of water leakage in the United Kingdom. Since privatisation the rest of the country has been gradually improving its water leakage figures. However, Thames Water’s figures have actually worsened since 2000. We heard from the Environment Agency that the level of leakage is such that continuity of water supply for London cannot be guaranteed. If there is a moderate drought for the next two years, there is unlikely to be sufficient water to meet all Thames Water requirements. The way to limit the need for new water resources is to tackle leakage levels and so reduce overall consumption, in conjunction with consumer efficiency drives.

GP Recruitment and Retention: the Crisis in London

June 2003
GP recruitment and retention PDF
GP recruitment and retention RTF

The current average GP vacancy rate in London is 7%, a shortfall of about 350 GPs, which is equivalent to all the GPs working in Harrow and Wandsworth. With a large number of GPs either resigning or retiring in the next five years the situation is likely to get worse. The Health Committee believes there is much that could be done now to recruit more GPs and retain existing GPs, and has made positive recommendations to key health organisations to try and assist them in tackling this major problem in London. These include:

  • the recruitment of more refugee doctors already in London and overseas doctors, including those from the Commonwealth;
  • the implementation of an incentive scheme to encourage newly qualified doctors to stay and practise as GPs in London; and
  • better collection and monitoring of GP vacancy rate information.

The future of Mail Rail

April 2003
The future of Mail Rail PDF
The future of Mail Rail RTF

This report looks at the planned mothballing of the Mail Rail underground mail delivery operation. It calls on Royal Mail and the Mayor's Transport for London to take swift action to bring the line back into profitability so this important asset is not left to gather dust.

Access to Primary Care

A joint London Assembly and Mayor of London Scrutiny Report, April 2003
Access to Primary Care PDF
Access to Primary Care RTF

Every day tens of thousands of Londoners have contact with dentists, GPs, health visitors, high street chemists and opticians. London is a city experiencing highly complex health needs and the role primary care services play in maintaining and promoting the health of Londoners cannot be overemphasised. The recent reorganisation of the NHS has involved changes in the structure for the delivery of primary care. The Mayor of London and the London Assembly have undertaken the first London-wide consideration of access to primary care in the capital and how access might be improved. At the heart of this scrutiny is the consideration of whether the new NHS structures will deliver the improved primary care that London so desperately needs. The report brings together a wealth of best practice and data from all over London and beyond, and makes recommendations to health services on how they might improve access for Londoners.

Infant immunisation

January 2003
Infant immunisation PDF
Infant immunisation RTF

London's falling levels of infant immunisation cover present a real threat to the health of young (and not so young) Londoners, and are a grave threat to health professionals and families alike. Our scrutiny sets out the evidence in a clear and systematic fashion to show how London underperforms other UK and world cities. The report reveals that there is a significant gap in our understanding of why the level of infant immunisation cover has fallen through the late 1990s. Further, the report seeks to stimulate a national debate on a number of areas where radical action may be needed to deliver a service more suited to the 21st century.

Smoking in Public Spaces Report

April 2002
Smoking in Public Spaces Report PDF
Smoking in Public Spaces Report RTF

This is the London Assembly's report on smoking in public places. The Investigative Committee examined the scientific research on the damage to health from passive smoking and the particular vulnerability of children. The report finds that there has been relatively little research into the effects of short term exposure to passive smoke, for example people who visit a smoky pub or restaurant a couple of times per week. A need for more public education on the risks of passive smoking is also identified. The report looks at the availability of non-smoking areas in public places such as trains, buses, taxis, pubs and restaurants, and argues for the provision of more smoke free areas. The report makes detailed recommendations to the Government, the Mayor, the London Health Observatory, the London Health Commission, the Strategic Rail Authority and the hospitality industry.

 
 
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