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Mr. Deputy Speaker: Order. I have to say to the hon. Lady, as I said to the hon. Member for Tewkesbury (Mr. Robertson), that that is not a matter for the Chair. I certainly cannot determine the content and shape of the Secretary of State's speech.

Ms Hewitt: I am most grateful to you, Mr. Deputy Speaker. I did indeed say that we would legislate for prisons and for care homes, and that I trusted that those exemptions would not be controversial. If they are controversial, I am sure that they will be discussed in more detail, not only this evening but in Committee.

Lynne Jones: Will the Secretary of State give way?

Ms Hewitt: I really want to bring my speech to an end.

The Bill is a landmark in the protection of people's health and of public health in our country. It will continue to improve our national health service. I am confident that all my right hon. and hon. Friends, whatever their views on the specific matter of exemptions, will join me in supporting it—unlike the Conservatives, who had 18 years in which they could have acted on this scourge to public health but chose to do nothing.

I commend the Bill to the House.

5.2 pm

Mr. Andrew Lansley (South Cambridgeshire) (Con): I am sure that the House is grateful to the Secretary of State for giving way so frequently, although I hope to be considerably briefer to allow time for the many Back Benchers who wish to speak.
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We are not, I am afraid, presented with a landmark Bill in public health. It was our intention, had we been elected in May, to introduce a public health Bill that would have achieved landmark changes in public health. It would have reorganised public health to enable public health directors to use dedicated resources across the public and private sectors, ending the fragmentation of recent years. It would have addressed the whole range of public health issues, including sexually transmitted infections, where the Government have failed lamentably. I have discovered in the past few days that there is to be no advertising of positive sexual health messages to young people this year, in circumstances where sexually transmitted infections are at epidemic levels. A Government who abolished the Health Education Authority and have presided over the highest rate of rising obesity in western Europe have allowed sexually transmitted infections to reach epidemic levels, as compared with a Conservative Government who acted on the problems relating to HIV and AIDS in the 1980s and secured a much lower incidence of HIV. This country now has the fastest rising levels of HIV since 1997.

The Bill is not a landmark measure in public health even as regards smoking. The reduction in the prevalence of smoking was faster in the 1980s than it has been since 1997.

Dr. Ian Gibson (Norwich, North) (Lab): Why does the hon. Gentleman believe that it has taken more than 50 years since the epic work of Sir Richard Doll, who sadly died this year, to do something about the problem? The Conservative party was in office for a large part of that time and did nothing about smoking, although the evidence for second-hand smoking and smoking among doctors existed since the work of Richard Doll. Has that failure anything to do with the dirty tricks campaign of the tobacco industry, which tries to defend the evil weed in the United States?

Mr. Lansley: I hope that the hon. Gentleman will have the opportunity to speak later when he can explain what he means by that last comment. I am not an apologist for the tobacco industry. I was simply pointing out that the reduction in the prevalence of smoking was faster in the 1980s. He knows that—I attended the conference that he chaired on the battle against cancer. There has been a long-term reduction in, for example, lung cancer mortality but there are worrying indications. It was wisely noted earlier that difficulties remain with the prevalence of smoking in elements of the population. That is especially true of working-class communities and young women. Smoking by young people has barely reduced in the past five years. He knows from the statistics that were presented to his conference of the all-party parliamentary group on cancer last Thursday that not only has the incidence of lung cancer mortality in young women risen, but overall mortality rates for women are not reducing compared with the substantial reductions in men.

Mr. McFadden: The hon. Gentleman mentioned the proposals that a public health Bill would have contained if the Conservative party had won the election. Would such a Bill have provided for a full ban on smoking?

Mr. Lansley: Before the election, we made it clear in a document that was published in February that we
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believe that individuals are primarily responsible for their health. Indeed, the Secretary of State made more or less the same point. We therefore want to proceed when possible through voluntary measures and self-regulatory solutions rather than legislative ones.

If I am to disappoint Labour Members, I will disappoint some of my colleagues, too. As we made clear before the election, we would have included provisions in a public health Bill to enforce a reduction in smoking in circumstances in which a self-regulatory solution had not been effective in three years. We did not propose a comprehensive ban. We proposed that, first, wherever non-smokers had access—including licensed premises as well as workplaces—they should not be exposed to second-hand smoke. That is different from private houses and private clubs. Secondly, wherever children had access, they should not be exposed to second-hand smoke. Thirdly—again reflecting a point similar to one that the Secretary of State made—workers in the hospitality industry, such as people who work behind a bar, should not be exposed to second-hand smoke.

Although not a comprehensive ban, our proposals bore a close resemblance to those that the Secretary of State reportedly pressed on her Cabinet colleagues before the publication of the Bill but was prevented from implementing. The proposals that we are discussing are not those that the Secretary of State wanted to introduce.

Bob Spink (Castle Point) (Con): My hon. Friend makes some excellent points. On self-regulation and choice, does he agree that, for the Bill to be more effective, we need clarity on the position of private members' clubs, especially those that serve food, and the way in which they can hold annual ballots on smoke-free places in those clubs?

Mr. Lansley: I accept my hon. Friend's contention that we need clarity. That applies to many provisions. The detail of many aspects of the Bill will be filled in later. That is an all-too-depressing characteristic of measures that the Government have presented in recent years.

Chris Bryant: Will the hon. Gentleman give way?

Mr. Lansley: No, I want to answer the point of my hon. Friend the Member for Castle Point (Bob Spink) about private members' clubs. The Secretary of State appeared to accept that we were making substantial progress with self-regulatory solutions but claimed that it was not fast enough. She is not proposing to give the industry any additional time to achieve that. For the industry, the flexibility that is inherent in self-regulatory solutions is important commercially.

Whatever may be said about the desirability of limiting the liberty of smokers, private members' clubs should be treated as an extension of a private home in the sense that a club has members who can make decisions about what happens in their club. It seems burdensome for legislation to interfere in that and to prevent members from taking such decisions.
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Chris Bryant: As far as I can understand the hon. Gentleman's argument, he is saying that, if the Conservative party had been elected, it was hoping that the market would provide, over the next few years, substantial numbers of clubs and bars where people would be able to go without having to suffer passive smoking. Can he name three bars, apart from those in the House, or pubs anywhere in the country that have gone non-smoking already?

Mr. Lansley: Yes, there is one in Cambridge, which Greene King owns. There is also a large Wetherspoon pub. Unfortunately, it took the Regal cinema in Cambridge and turned the premises into the largest bar area in the country. As it is Wetherspoon, that is non-smoking. I think that I can find the hon. Gentleman at least three such pubs.

To correct the hon. Gentleman—having done so, I must move on to what is in the Bill rather than what might have been in Conservative legislation—I did not say that the market would deliver these things. I said that there would be a self-regulatory solution. I appreciate that there are market pressures, but such pressures can take a long time to have an impact. We were aiming for a self-regulatory solution. He should accept—although Ministers appear not to have accepted it—that, throughout the hospitality industry and in the British Beer and Pub Association and elsewhere, substantial measures have already been put in place to try to deliver smoke-free solutions for customers. The way in which the Government propose to interfere with what might otherwise have been achieved on that basis is excessive.

I am a shadow Secretary of State for Health, and in my view there is no acceptable outcome other than that we deliver much reduced smoking and smoke-free environments for everybody who wants them. There should be smoke-free environments for children, but there is no reference in the Bill to children. There is nothing that says that, wherever children are present, second-hand smoke should not be permitted, although the evidence of the Scientific Committee on Tobacco and Health points to the impact of second-hand smoke on respiratory disease, on asthma and on sudden infant death syndrome.

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