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Tim Farron : Is not the right hon. Gentleman guilty of not giving due balance to the right of the non-smoker and of classifying a space as private when, in fact, it is public? We are speaking about balancing liberties. As a liberal Conservative, surely he recognises that some liberties encroach upon the liberties of others and should therefore be curtailed.
Mr. Dorrell: I shall come on, if I may, to that argument. I was trying to respond specifically to the argument that "a ban on smoking will help me give it up", which I do not think is a guide to policy.
Mr. Barron: When the right hon. Gentleman was Secretary of State for Health, he did not spend anywhere near the amount of money that the present Government have spent on smoking cessation. Ireland had a smoking prevalence of one in three before the ban. After 18 months of the ban, the smoking prevalence is one in four. Does the right hon. Gentleman agree that there is a lot to be gained from taking such actionnot banning smoking, but banning it in places such as pubs and clubs?
Mr. Dorrell: I shall make two points in reply to that. First, during our years in government, tobacco consumption fell, and I think I am right in saying that it is starting to rise now, particularly among teenage girls. Secondly, the argument that if we deliver a reduced level of smoking, we deliver a public health gain is transparently true; that is not in dispute. The question is whether that is a basis for legislative action. That is the second argument that I shall come to.
Frank Dobson: In his liberal Conservatism, the right hon. Gentlemanwho usually talks more sense than he is talking nowpredicates his entire argument on the idea that smokers can come to a voluntary decision. They are smokers because they are addicts, and we owe it to addicts to help them break their addiction.
I do not agree with that argument. There are very few people, if any, who are clinically unable to give up smoking. I entirely accept that it is difficult, but the right hon. Gentleman needs to be careful of that argument. He is in danger of saying that the people of whom he spoke, in low-income and disadvantaged groups, are unable to make on their own behalf
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decisions which, from the level of tobacco consumption, one can see that better off people have made. That is not true and it is a patronising argument for us even tacitly to endorse.
The next argument is closely allied to the argument that a ban will help people give up smoking. It is the argument behind public health targets related to tobacco consumption. As Secretary of State for Health, I was always uneasy about public health targets that could be delivered not as a result of Government action, not as a result of collective action, but only as a result of private decisions by private citizens. It is not a proper basis for public policy to introduce a measure that I find objectionable for the reasons that I am describing, in order to deliver some public health objective about reducing tobacco consumption, which can be delivered only by private citizens making a private choice about their own private behaviour. The job of the public health Minister is to use resources in a way that is targeted at health need, but always to understand that private citizens should be free to make their own decisions about the way they lead their lives.
The third argument that is advanced is that we should introduce a smoking ban in order to create a more pleasant environment for people like me who do not like going into smoky pubsagain, not a good guide for public policy, and not a reason for compulsion, though a very strong reason for individual publicans and restaurateurs to introduce no-smoking policies in their establishments, which attract people like me and presumably do not attract those who want to go in and be able to smoke.
On the final argument, it was interesting that the hon. Member for Northavon rested his argument in favour of a smoking ban almost exclusively on the grounds of a safer working environment. All around the country, employers and employees have for a generation been agreeing no-smoking policies in their establishments, without the assistance of the Government. I applaud that. In my own business we operate a no-smoking policy because that is the decision that the individuals on the sites have collectively reached. I do not believe that a ban should be imposed from here, because individual employers and employees should be free to decide the matter for themselves.
In addition to the public health driver that explicitly informs smoking bans, there is a strong whiff of political correctnesswe know the scientific facts and what is good for the people who send us here. Our righteousness is reinforced when we present that argument, because we can quote scientific evidence to support our assertions of what is good for people. We then make the fatal leapthis is where I part company from the prevailing majoritythat because we know how people could better lead their lives from a health point of view, we should use our available powers to lead them to do things that they would not choose to do for themselves.
The Prime Minister is fond of talking about respect, and he is dead right when he says that we should learn better to respect each other. We should understand, for example, that two adult citizens in a free societythis is almost the definition of a free societycan look at the same set of facts, come to two diametrically opposite conclusions and both be right. We will have learned the
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real meaning of respect when we respect the conclusions that other people reach when they are presented with the same facts as us, but reach opposite conclusions.
Joan Walley (Stoke-on-Trent, North) (Lab): I have the greatest respect for medical officers, and when the right hon. Member for Charnwood (Mr. Dorrell) was responsible for the health service, a substantial body of medical opinion called for bans such as those in the Bill. I congratulate the Government on going so far with what will hopefully be a landmark Bill on smoking. After 18 years of Tory Government, we should now make as much progress as possible.
The Bill could have gone much further than a partial ban on smoking. As I said in an intervention, my greatest concern is what the Bill will do for health inequalities. That concern is shared by not only Sir Liam Donaldson in his evidence to the Health Committee, but many other distinguished people. The Under-Secretary of State for Health, my hon. Friend the Member for Don Valley (Caroline Flint), who has responsibility for public health, must satisfy herself that the Government are dealing with health inequalities.
My primary care trust, which is a spearhead trust, is getting extra money to deal with health inequalitiesthe increase is some 9.4 per cent. this year and 8.4 per cent. next year. We do not want legislation that makes the matter worse, and the more that I look at the evidence and the situation on the groundI speak as an ex-smokerthe more I believe that the Government should use the time between now and Royal Assent to make sure that they are doing everything that they can to reduce health inequalities. The issue concerns changing behaviour, because nothing can be done by legislation alone. It involves hearts and minds as well as legislation, and properly trained enforcement officers will be important, too.
I was interested in the contribution by my right hon. Friend the Member for Rother Valley (Mr. Barron), who is Chairman of the Health Committee. On 24 November, the Committee took evidence from the Chartered Institute of Environmental Health, of which I am vice-president. In its comments, the CIEH makes it clear that it strongly opposes the proposed exemptions for pubs and clubs that do not serve food. The CIEH position is that all workers should be afforded an equal level of protection.
I have this to say to hon. Members who have already spoken: we are not discussing private places; we are discussing public places. There is no justification for exempting premises where workers are exposed to the greatest risk. The CIEH believes that its members will face the serious ethical issue whether it is professionally acceptable to participate in the enforcement of a law that unjustifiably fails to protect whole categories of vulnerable people and may be open to subsequent challenges under human rights legislation. I urge my hon. Friend the Minister to speak to those who will enforce the legislation.
I know that time is limited and that many other hon. Members want to speak. In the short time remaining, I shall refer to the issues that concern my local spearhead PCT. Smoking is the single most important cause of illness and death in Stoke-on-Trent, where it kills more
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than 450 people each year. Are we sure that it is right to leave the most vulnerable workers at risk from the dangers posed by breathing other people's tobacco smoke?
Exposure to second-hand tobacco smoke has been linked to lung cancer and heart disease since the 1980s, when many people started to campaign to bring about a ban on smoking. In my constituency, 64 per cent. of licensed premises do not serve food and will therefore be exempt from the smoke-free legislation. In the most deprived wards, however, 84 per cent. of pubs will be exempt, leaving both workers and the community at risk and contributing to the social acceptability and normalisation of smoking within those communities. Moreover, the PCT in Stoke-on-Trent and I believe that two out of every three smokers who want to quit are hindered by the environments in which they socialise.
Hon. Members have already covered many aspects of the debate. I shall briefly refer to the views of Charles Pantin, a consultant physician at the University hospital of north Staffordshire. He has written to me setting out the medical evidence on the risks to health from second-hand smoke, including the links to heart disease, asthma, reduced lung function, chest discomfort and all other associated illnesses.
This is a momentous opportunity for the Government to make a positive impact on smoke-free workplaces. We must make sure that we are doing everything that we can to help those who want to quit to do so and to prevent people from starting to smoke. This two-tier legislation does not send a simple, concise message. The Bill should contain a comprehensive, simple law to end smoking in the workplace. I urge the Minister to examine carefully the concerns raised by those hon. Members who want to see more being done to reduce health inequalities.
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