Memorandum by the British Heart Foundation
(WP 15)
1. The British Heart Foundation (BHF) is
leading the battle against heart and circulatory disease—the
UK's biggest killer. The Charity is a major funder and authority
in cardiovascular research, education and care. The BHF relies
predominantly on voluntary donations to meet its aims. In order
to increase income and maximise the impact of its work, the BHF
also works with other organisations to combat premature death
and disability from cardiovascular disease.
2. Rather than commenting generally on the
overall document, the BHF would like to highlight three key areas
where we believe the proposals can be strengthened to help the
Government to achieve its public health goals. Overall we believe
that the Government's Public Health White Paper provides a solid
platform for transforming the NHS from a disease focused system
to a health promoting system.
SMOKING
3. The BHF commends the Government for its
measures to further restrict tobacco advertising and support smokers
to quit.
4. The BHF strongly recommends that the
Government implement a full ban on smoking in indoor areas including
pubs
5. We do not believe that the partial ban
on smoking will help the Government achieve its goals. We believe
the proposed legislation is inappropriate, unfair and illogical.
Inappropriate because it is virtually unenforceable and littered
with inconsistencies
6. Unfair because it condemns workers in
pubs that don't serve food to an occupational health risk that
is not tolerated for any other workers. The Government's own Scientific
Committee on Tobacco and Health identifies bar staff as the occupational
group most at risk from secondhand smoke. Once the principal is
agreed that smokefree environments protect the health of workers,
all employees must be protected—including the thousands
of bar workers who will not be covered under the White Paper's
proposals.
7. Illogical because it will increase the
inequalities that the White Paper aims to reduce. Smoking rates
among manual workers are 50% higher than non-manual workers (BHF,
2004, Coronary Heart Disease Statistics, page 87). Drink only
pubs tend to be situated in poorer communities. The policy as
it stands will also encourage more pubs to stop serving food and
go "drink only"—this could seriously undermine
the Government's alcohol policy.
8. The Wanless Report (2004) suggests that
"a workplace smoking ban in England might reduce smoking
prevalence by around four percentage points—equivalent to
a reduction from the present 27% prevalence rate to 23% if a comprehensive
workplace ban were introduced". Evidence from jurisdictions
who have introduced a full ban suggests that a ban also acts as
a trigger for people to reduce the amount of cigarettes they smoke.
9. The BHF strongly recommends that the
timescale for the introduction of the legislation be brought forward.
The proposed length of the timescale leading up to a ban is a
reflection of the need for difficult negotiations between central
Government, local authorities and businesses ahead of implementing
a policy which is littered with inconsistencies. On the other
hand, a full, clear ban on smoking in all enclosed public places
would take less than four years to fully implement.
PHYSICAL ACTIVITY
10. Whilst the BHF welcomes the White Paper's
promotion of sport, we are concerned that physical activity and
sport are often treated as though they are interchangeable terms.
The greatest gain in improving population physical activity levels
will come from active living initiatives, not sport initiatives.
11. The BHF recommends that the physical
activity delivery plan should have an equal emphasis on non-sport
physical activity strategies.
LOCAL HEALTH
INFORMATION
12. The BHF welcomes the White Paper's recommendation
to develop a standard set of local health information that can
be linked to other local data sets. There is a need for accurate
data on coronary heart disease rates, risk factors and risk conditions
at the local level.
13. The BHF recommends that the Government
consult with stakeholders on the data to be included in the standard
set of local health information.
CORPORATE PARTNERSHIPS
14. The BHF notes the White Paper's emphasis
on voluntary codes of practice with industry, particularly the
food, broadcasting and advertising sectors.
15. We have concern with the lack of detail
on the Government's expectations of these voluntary codes, timeframes
and consequences of non-compliance.
16. The BHF recommends the Government produce
a detailed plan on industry codes which covers the issues of expectations,
timeframes and consequences of non-compliance.
CHILDHOOD OBESITY
17. The BHF is particularly concerned with
the emphasis on voluntary codes of practice with regard to childhood
obesity. Obesity is an increasing threat to the health and well-being
of our children. Between 1984 and 1994 the prevalence of obesity
in English primary school children increased by 140% (Chinn and
Rona, 2001, BMJ 322). Nothing suggests that this trend
has slowed in the last 10 years.
18. Sustain warns that every year that the
legislation is delayed, an estimated 40,000 children will become
obese.
19. Childhood obesity is too important an
issue to leave to more consultation and voluntary industry codes.
The BHF believes the time is right for comprehensive legislation
to ensure that children's food is healthy.
20. The Children's Food Bill (www.childrensfoodbill.org.uk)
proposes legislation to end junk food advertising to children,
stop junk food vending in schools and provide healthy school meals.
The BHF recommends that this Bill become law at the earliest possible
date.
SCHOOLS
21. While we recognise the Government's
efforts towards ensuring all chidren have access to at least two
hours of high quality PE and school sport every week, the BHF
recommends that the aspiration should be for school children to
participate in three hours per week of physical activity.
22. The BHF recommends that children should
have their Body Mass Index measured annually at school, with poor
results being followed up by specialised support services. The
Government's timeframe on providing clusters of schools with a
shared school nurse by 2010 seems very long—and we are unconvinced
that a shared school nurse between large clusters of schools will
satisfy demand.
CONCLUSION
23. The BHF wishes the Committee well in
its consideration of submissions and would be happy to give oral
evidence or to provide additional evidence as requested.
January 2005
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