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21. Mr. Andrew Miller (Ellesmere Port and Neston) (Lab): What steps are being taken to ensure that Government (a) websites and (b) electronic services are designed to meet the needs of the general public. [198122]

The Minister for the Cabinet Office (Ruth Kelly): Designing websites and services around customer needs has always been at the heart of the Government drive to put services online. The Cabinet Office has made extensive guidance available to public sector web managers through the publication of guidelines for UK Government websites.

Mr. Miller: I welcome my hon. Friend's answer and her response to my hon. Friend the Member for Wolverhampton, South-West (Rob Marris), but will she look at the available tools developed by companies such as Nomensa, which are aimed at people with visual impairments; and will she ensure that they become the norm as soon as possible on every Government-supported website?

Ruth Kelly: I pay tribute to the work that my hon. Friend has done in drawing attention to this matter, as well as other matters to do with information technology and the way in which citizens' experience can benefit from the use of internet technology. He is right to highlight the work of companies that promote tools to aid, for example, individuals with visual impairment. Through the web accessibility guidelines, the Government are committed to creating websites that are both visually appealing and user-centred. They should be accessible to people with various disabilities and individual needs, and we are committed to advancing that work.

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Public Health White Paper

12.32 pm

The Secretary of State for Health (Dr. John Reid): Mr. Speaker, I wish to make a statement concerning the publication of the White Paper outlining the Government's policy on health improvement.

Over the past eight months of the consultation we have seen speculation after speculation about the contents of the White Paper and alleged leak after alleged leak. I regret the fact that some of that, unfortunately, has been relatively accurate. Much of it has been highly inaccurate and some of it has been sheer fantasy. Today, I want to tell the House the reality.

Last century saw undreamt of progress in the health of the people of England, gathering pace after 1948 as the establishment of the NHS permitted free universal provision of immunisation, screening and treatment to make inroads into ill health and premature death. It should be a matter of pride that a child born today is likely to live nine and a half years longer than one born on the eve of the formation of the national health service in 1948.

The role of Government, however, in the prevention of ill health during that period was often characterised by a top-down approach. This White Paper is different. It is about enabling people to exercise choice; it is about extending opportunity and offering security to those who want to choose a healthier life; it is about people improving themselves. In the White Paper, it is the public, not Whitehall, who, for the first time have set the agenda and identified what "for their own good" means. Over the past eight months, we have consulted, discussed, listened, canvassed and calculated public opinion on a wider scale than ever before to get in touch with people's real concerns, to ask what they wanted and how they could help to realise their aims.

People know that in recent years new opportunities have been opening up rapidly, but with them come growing inequalities. Paradoxically, affluence and comfort often bring their own health challenges—growing obesity, lack of exercise and more casual sexual relations. Faced with these, many people want more opportunities to live healthier lifestyles. They know that they will become healthier only through their own efforts. However, they look to Government to assist them with information about healthy and unhealthy choices—not to make the decisions for them, but to provide them with clear information to allow them to make the decisions.

Now that the NHS is improving waiting times, reducing waiting lists and improving emergency care departments, that frees up time and space in the NHS for effective action on prevention, to help people make those changes and decisions for themselves. That is why this White Paper commits us to ensuring that health services such as sexual health services, the NHS stop smoking services and obesity services all benefit fully from the drive for modernisation and improvement that is spreading across the rest of the NHS.

Our starting point is informed choice. That means an approach that respects the freedom of individual choice in a diverse, open and more questioning society. It also means addressing inequalities so that everyone can have
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real choice—addressing the differences that locality and social conditions make. [Interruption.] It may not interest those interrupting, but it is a sad fact that even today a male child born in Manchester lives at least seven years less than a child born in Kensington and Chelsea. Those inequalities cannot be tolerated any longer. To improve the nation's health, we need everybody to have the chance to make more healthy choices, not just the better-off.

We will not be successful in tackling these inequalities unless we work in different ways. We need to reach people where they live their lives, and provide services that are accessible to them and that derive from their local communities. That is why the Deputy Prime Minister and I were determined that this White Paper would set out action that maximises the positive impact that local authorities and others can have to help people make those healthier choices. For example, this coming spring the communities for health programme will bring all parts of the community and locality together—statutory and voluntary organisations, businesses and individuals—in campaigns to improve local health. Working with local government we will be targeting funding to give greater priority to areas of high health need. New investment in primary care facilities for some 50 per cent. of the population by 2008 will focus on the most deprived areas of our communities.

In our widespread consultation, people made it clear that they often want to change, but they lack accessible help and advice. So, to help the public make healthy choices, we will provide them with clear information on those choices. Building on the success of NHS Direct, which had 7 million advice and assistance calls last year, we will introduce a completely new service—Health Direct, a telephone, online and digital TV information service, making advice on health, nutrition, diet and a whole spectrum of public health issues available to everyone, not just to the better-off.

We will give specific help to specific groups. Thirty years ago, almost half the adult population of this country—46 per cent.—smoked. Today the figure is 26 per cent. We will take another 2 million people off that figure over the next five years. Ultimately, people need to make the decision to improve their own health themselves, and to give up smoking everywhere, not only at work and in the pub, but at home as well. The Government cannot make that decision; it is a personal decision. We can help, as we helped 125,000 quitters last year through NHS smoking cessation services. We are radically extending our campaign against smoking and will extend our smoking cessation services.

We will introduce action to put hard-hitting picture warnings on cigarette packets; further restrictions on tobacco advertising; tough action on shops that sell cigarettes to children; improvements in the way in which the NHS helps people to stop smoking and to stay stopped; and further reductions in tobacco smuggling. And, as I will outline later, we will see smoke-free environments becoming the norm both at work and at leisure.

Others have told us that they would like help too. Many people today, such as busy mums, have told us that they want their families to eat more healthily, but they need more easily accessible and simple information to guide them. Together with the Food Standards Agency, retailers and the food industry, we will develop
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a simple code for processed food to indicate fat, sugar and salt content for shoppers to help people choose what they require for a healthy and balanced diet.

Our general approach is, of course, to recognise the right of adults to make their own informed choices, but people, particularly parents, feel differently about children. Parents know that their children's health is primarily their responsibility, but in our discussions they told us that government, businesses and anyone who has an influence also shares that particular responsibility to protect children from premature exposure to a world of adult choices, and they want the security of knowing that that will be done. That is why my right hon. Friend the Secretary of State for Culture, Media and Sport and I will ask Ofcom to consult on advertising to children on television and will work with the industry to limit other forms of advertising to children outside television itself.

Led by my right hon. Friend the Secretary of State for Education and Skills, we will develop our approach to health in schools to ensure that everything that a school does—lessons, sport, food, school nurses, personal, social and health education—is brought together in an co-ordinated whole school approach to health to start children on the right path to a healthy life.

We will increase activity for children in schools. The Government are investing an unprecedented amount—more than £1 billion up to 2006—in physical education and school sport. We are developing more sports specialist academies, strengthening the protection for school playing fields and helping more children to walk or cycle safely to school. In an age in which obesity has trebled in a generation, and in which, if the number of obese children continues to rise, we face the prospect of children having a shorter life expectancy than their parents. To be effective, the support that we provide to combat that must be personally tailored to the realities of individual lives, with services and support personalised sensitively and flexibly and provided conveniently.

Through new technology and investment, we intend to offer everyone in England the opportunity to develop their personal health guide and, starting with the areas of greatest disadvantage, we will provide people with NHS health trainers to support their motivation in making the difficult decisions to choose healthy lifestyles. That which the better-off regard as of assistance in a healthy lifestyle should be available to the rest of the people of England too.

Healthy living starts at a young age, which is why we have decided to provide funding so that by 2010 every PCT in England will be resourced to have at least one full-time school nurse working with each cluster of primary schools and secondary schools in their area.

One of our greatest challenges is in respect of sexual health. It is a staggering fact that no fewer than one in 10 sexually active young women is today infected with chlamydia. We have to bring this problem out of the shadows and into the forefront of our attention. We therefore intend to launch a new national campaign targeted particularly at those at risk of catching sexually transmitted infections or of unplanned pregnancies; to accelerate the implementation of our chlamydia
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screening programme to cover the whole of England by 2007; and to offer the same fast access to high quality genito-urinary medicine services that patients expect of other NHS treatment—in other words, by 2008 everyone referred to a genito-urinary medicine clinic should be able to have an appointment not within weeks but within 48 hours, and we will make that a priority.

We recognise, too, the damage that excessive alcohol can have on individuals, families and society at large. That is why we will work with the Portman Group to cut down on binge drinking and with industry to develop a voluntary social responsibility scheme for alcohol producers and retailers in order to protect young people; support Ofcom in strengthening the rules on broadcast advertising of alcohol, particularly to protect the under-18s; and invest to improve services to help the NHS to tackle alcohol problems at an early stage.

But there is another area where people want a greater degree of security and protection in maintaining a healthy lifestyle for themselves and their families. I have stressed throughout that our approach has been guided by informed choice on the part of individuals, with Government playing our role in providing information, encouragement and support to assist individuals in making the healthy choices. We do that because we believe that in a free society men and women ultimately have the right within the law to choose their own lifestyle, even when it may damage their own health.

People do not, however, have the right to damage the health of others or to impose on them an intolerable degree of inconvenience or nuisance. We therefore intend to shift the balance significantly in favour of smoke-free environments. From 2006, we propose to introduce changes to ensure that all Government Departments will be smoke-free; that all enclosed public places and workplaces—other than licensed premises, which are dealt with separately—will be smoke-free; that all restaurants will be smoke-free; and that all pubs and bars preparing and serving food will be smoke-free. Other pubs and bars—about 20 per cent. of those in England—and membership clubs will be free to choose whether to allow smoking or to be smoke-free, but smoking in the bar area will be prohibited everywhere.

We will therefore ensure that people are able to go to their workplace or to choose to go out for a meal or a drink without damage, inconvenience or pollution from second-hand smoke, but do so in a way which, while protecting that right of the majority, still allows a degree of choice—albeit more limited than before—to the minority. I believe that that is a sensible solution that balances the protection of the majority with personal freedom for the minority in England.

This White Paper promotes the opportunity for healthy living in a manner and scale unseen before. It envisages investing at least £1 billion in public health over the next three years. It treats our fellow citizens as adults capable of making their own decisions, while providing advice, information, encouragement, resources and personal support for those who want to make the healthy choices and protection from the effects of those who do not want to make those choices. It begins the transition of our health care away from just a national treatment system for illness and towards a true national health service. It offers the opportunity for healthy living to everyone who wants to take it, and the security of knowing that for those who do so a degree of
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protection will be afforded to them and their families. In doing so, it begins to fulfil at last the founding vision of a true national health service. I commend it to the House.

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