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Dr. Reid: I do not quite know how to respond to that. There was not much there in the way of constructive suggestions. As a matter of fact, I do not know whether the hon. Gentleman had time to read anything that was supplied, but there is a whole section on mental health, which he does not appear to have seen.
If I pin together everything that the hon. Gentleman said, it was that just because we cannot do everything, we should not do anything. That is the philosophy that ran through it. For instance, it is true that we are prepared to take the legislative and regulatory path to ensure that people are protected from second-hand smoke, but the idea that that somehow prevents the industry from moving ahead with smoke-free areas is utter fantasy. Leaving aside the fact that the industry has had several decades to do that, let me make it plain that I would welcome the industry moving ahead. If the industry wants to move, before we have legislation in place, to exactly the point at which we want to legislate, we will all enjoy that. Now, though, that is just an excuse from the Conservatives for doing nothing.
Similarly, on Ofcom, it is true that it opposed a total ban on television advertising of foods for children, but we are not proposing a total ban and Ofcom was not opposed to restrictions. Once again, because the Conservatives say we cannot do everything, they claim we cannot do anything at all.
Similarly, we are asking the Food Standards Agency, together with the industry, to work out a simplified form of indicating the nutritional value of food, but that does not stop us conducting a campaign at the European level as well. On the Government Benches, we are capable of walking and chewing gum at the same time. We can do several things at once. Just because we are not doing everything does not mean we cannot do several things.
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I am rather disappointed by the hon. Gentleman's response. The world has moved on in the past quarter of a century, but it is obvious to me that the Conservative party has not moved with it. What we heard today, again, were the same tired clichés and the same old vapid slogans—an accumulation of several centuries of Tory philosophy and thought dedicated to doing nothing and changing nothing. They are always on the side of the status quo, and always on the side of the producer and against the consumer. We are not going to act that way. Having consulted the people of this country, we are going to give them the information and resources that they need and the back-up and support they need. We are going to give that to everybody, not just the better off, so that they can make choices for themselves and their families that will give them a longer, healthier life.
Mr. David Hinchliffe (Wakefield) (Lab): In contrast to the Opposition, I warmly welcome today's statement, which is both comprehensive and brave in many respects. The Government have listened to a range of recommendations, including from the Health Committee, picked them up and run with them, and I genuinely appreciate the steps that have been taken.
I wish to press my right hon. Friend on two points. One concern of mine is to put public health in the engine room of government. What steps have been taken structurally to ensure that public health concerns are addressed collectively across Departments when policies are being developed? Secondly, I accept that the Government are taking brave steps on the smoking issue, but I am slightly disappointed by the exemption, which will cause concerns. From my limited experience of standing at public bars, I am at a loss to understand how it will be possible to prevent smoke from elsewhere in a public bar getting to the bar area. I am particularly interested in the legal advice that the Government have received under health and safety legislation about protecting the interests of those staff working in bars where smoking will continue to be permitted.
Dr. Reid: I thank my hon. Friend for all the work that he and the Health Committee have done on this issue. They have been a catalyst and, in some ways, a cattle prod for Ministers to make progress. He makes two very good points. The first is the nature of our approach across government. It is essential to recognise that people can make healthy choices, but they cannot always make them in circumstances of their own choosing. Therefore, people's social circumstances, and in some cases their geographical locality, can help or hinder them in making healthy choices.
We have tried across government to work together and, indeed, we have established a Cabinet Committee—Misc. 27 for the "afactionados" who like to know such names—on which I can get together with my right hon. Friends the Deputy Prime Minister and the Secretary of State for Culture, Media and Sport to try to ensure that in schools, on sports fields and across the health service we are working towards a common end.
I realise that the smoking exemption will be controversial. My hon. Friend said that he had limited experience of standing at bars. As someone who has perhaps a little more experience of doing that, I have thought about the issue carefully and discussed, argued and debated it. I have tried to balance the protection of
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people going about their daily business at work and at leisure who want to do so in a smoke-free atmosphere and who want to avoid the damage, pollution and inconvenience of second-hand smoke—people talk to me about their clothes smelling of smoke—with remembering that this is England and we take people's freedoms seriously. We should not try to prevent people from doing what is legal by other means. I have tried to provide an exemption that will not require a huge bureaucratic invention, because pubs are already classified into those that serve food and those that do not. It will also mean that people will not be forced into alleyways or out of the bar room and into their own living rooms to smoke even more there, because most of the evidence about the damage of passive smoking is based on those who live with a smoker. We have to be careful that in trying to solve one problem, we do not create another.
I have tried to strike a balance between the protection of the majority and the freedom of the minority. Let us see how that works. I think that it will be a compromise that will commend itself to the vast majority of people in England.
Mr. Paul Burstow (Sutton and Cheam) (LD): I thank the Secretary of State for the opportunity to see the statement in advance. I agree that doing nothing to tackle the causes of ill health is not an option. A report by the Treasury estimated that the cost of doing nothing would add £30 billion a year to the cost of health care by 2020. By how much does the Secretary of State believe his package will reduce that estimate?
The scientific evidence on second-hand smoking damaging health is overwhelming. Does the Secretary of State accept that passive smoking kills? What is a safe level of smoke? Does he accept the World Health Organisation research that shows that ventilation systems cannot guarantee a safe working environment? His proposals will consign those staff who work in pubs that do not serve food to an unsafe environment.
The Secretary of State's proposals on clear labelling are welcome, although we would prefer a mandatory scheme. How will he monitor the codes of practice to ensure that they are being complied with? He referred to schools, which play a vital part in reinforcing healthy habits of diet and exercise. Given that nutrition was but an afterthought in the current school meals standards, why does the White Paper say that it will be another three years before new standards for nutrition will be brought in?
The White Paper says next to nothing about poverty, poor housing and poor environment and the Department's role in developing health-promoting policies across government. Why are there no plans in the document for auditing the impact of Government policies on people's health—not just Department of Health policies but all Government policies? Clearly, there is a growing gap between the richest and the poorest in this country, and in terms of health it has grown over the past seven years.
We heard today that the Secretary of State spent eight months consulting, yet he has just announced that he plans to conduct more consultations—he wants more consideration and debate, and more voluntary codes. The White Paper demonstrates that the Government,
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far from having courage, in fact lack the courage to take the necessary action to deal with the wide range of public health threats posed in this country. Through his statement today, the Secretary of State is saying that he is willing to allow us all to continue eating, drinking and breathing smoke at the last chance saloon.
Dr. Reid: I shall start with the hon. Gentleman's last point. We think that what we are doing is proportionate to the challenges we face. It involves a combination of Government action, voluntary action and partnership, with legislation and regulation where necessary. There are a number of reasons why we are staging in action on smoking from 2006, 2007 and 2008. For instance, there may be a requirement for legislation for the latter stages. However, I can assure the hon. Gentleman that by 2006, Departments and the health service will be smoke free; by 2007, we intend that to apply right across all workplaces; and by 2008, all the regulations and legislation will, we hope, be in place for licensed premises. It is a matter of staging in and it will require legislation, not just reliance on voluntary measures.
The costs of what I announced in the White Paper are in the order of £1 billion, but many times that amount will be saved. The hon. Gentleman is correct—the Conservatives take a very short-sighted view when they fail to recognise that this is on the grounds not only of good health for the nation, but of efficiency for the NHS. It is impossible to say exactly how much will be saved as that will depend on the effectiveness of how we proceed, but it will be many times £1 billion. The process will be overseen by the National Institute for Clinical Excellence, which will be tasked to look at the effectiveness of the White Paper. That is not a full audit across government, but it goes some way towards it.
The hon. Gentleman asked me a straight question: do I accept that passive smoking damages health? Yes, I accept that. All the evidence shows that passive smoking increases the risk of cancer by about 23 or 24 per cent. and of coronary heart disease by about 25 per cent. I accept that. That is why I have done what I did today to try to protect people, including workers, because the vast majority will be working in an industry where 90-odd per cent. of restaurants and pubs—taking the two together—will be smoke free, and we will be prepared to legislate to ensure that in the remainder the bar area will be smoke free, too.
I think that I have covered most of the points that the hon. Gentleman made. Reviews are under way at present on nutrition in primary and secondary schools. We have looked at one and are in the course of considering the other, and I have been in close contact with my right hon. Friend the Secretary of State for Education and Skills on the matter.
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