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Dr. Richard Taylor (Wyre Forest) (Ind): It is a great pleasure to follow the hon. Member for Belfast, South (Dr. McDonnell), another member of the medical profession.

I pay tribute to the right hon. Member for Rother Valley (Mr. Barron), who chaired the Health Committee while it produced two extremely strong and useful reports. I am delighted to see that the Secretary of State has returned. She said that she had not yet made up her mind. I am rather more naive than the right hon. Member for North-West Hampshire (Sir George Young), and I believe that we could persuade some Members who have the luxury of a free vote to change their mind.

I speak as unofficial, unappointed, unelected medical adviser to the House. Even the youngest Members may have the beginning of coronary artery atheroma, that terrible condition that narrows the coronary arteries and leads relentlessly to heart attacks, usually in later life but often in relative youth. I think everyone knows that the risk factors we recognise are smoking, diabetes, a poor family history and hypertension; but we all know people in none of those categories who, out of the blue, have dropped dead of a heart attack, or have had a severe heart attack. Without those risk factors, each one of us could be sitting on our own particular time bomb.

Those of us who have reached my age do not play squash and the like because it is known that sudden exertion is one of the precipitating factors, but it is not generally known that passive smoking is also an acute precipitating factor. The atheroma builds up over the years. We have in our blood things called platelets, which normally help the blood to clot in the right place; but, according to a booklet from the Royal College of Physicians,

Platelets aggregate. They lump together. They increase the atheroma, increase the blockage, and possibly cause a complete occlusion. As has been said, the risks of cancer of the lung are linear, but that does not apply to the risks of coronary artery disease. So the ban on smoking in public places must be extended to all workplaces. It is no good saying that 99 per cent., or even 99.9 per cent., of people are protected; the last fraction of a per cent. deserve equal protection.

I want briefly to consider particulates—the tiny bits held in the smoke exhaled by smokers and, even worse, in the side-stream smoke that drifts away from the end of a cigarette as the smoker wafts it casually in the hand. A particle labelled as PM2.5—the label denotes its size,
 
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which is 2.5 microns—can get right into the lungs and is responsible for a lot of damage. Dr. Richard Edwards, a senior lecturer in public health from Manchester, told the Health Committee on 20 October about a study in the north-west that compared the level of PM2.5 found on heavy traffic roads with that found in smoky pubs. Some 20 to 50 micrograms per cu m were found on heavy traffic roads, but 1,400 micrograms per cu m were found in smoky pubs—28 times the former level. He concluded:

If we exempt clubs, we will drive smokers to them and they will become even more lethal.

Dr. Stoate: I am very grateful to my esteemed medical colleague for giving way on this important point. Does he therefore agree that because ventilation systems cannot remove these particulates in sufficient quantities, simply ventilating a pub's atmosphere will not reduce them to a safe level? He is therefore right to say that a total ban is the only credible way forward.

Dr. Taylor: I thank my hon. Friend—I will call him my hon. Friend, even though he is on the other side of the House—for that intervention, with which I entirely agree. The Health Committee heard conclusive evidence to suggest that it is not possible to ventilate pubs in an affordable way. The comparison was made with operating theatres, but they have air conditioning systems with positive pressure, which blows everything out to prevent germs from coming in. Such a system cannot be replicated in pubs and clubs.

I conclude with two quotes. When, at last November's "Britain against cancer" conference, the head of Glasgow university's centre for oncology was asked what his single greatest wish was in respect of cancer prevention, he said:

Professor Dame Carol Black, the president of the Royal College of Physicians, told the Health Committee:

Mr. John Grogan (Selby) (Lab): It is a great pleasure to follow the hon. Member for Wyre Forest (Dr. Taylor); I was feeling quite healthy until he spoke.

Once in a political generation, one gets the chance, if one is lucky enough to sit on these Benches, to vote for a public health measure that will affect the health of    thousands—perhaps hundreds of thousands—of members of our society. As the right hon. Member for North-West Hampshire (Sir George Young) reminded us, no political party in this House has a monopoly on such measures. I am thinking here of the public health Acts of the 19th century, of the sewerage legislation, and of the clean air legislation of the 1950s and 1960s. The most successful of the Acts passed by our predecessors ended discussion about that topic for a generation. The legislation was clear and simple and it established a political settlement. We have a similar opportunity before us today.
 
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I share the ambition of the hon. Member for Wyre Forest to persuade the Secretary of State to go that little bit further and to complete what is unfinished business. I hope to speak directly to her today, because the issue is clubs against pubs: should we extend the ban to members' clubs, as well as pubs? We have heard that 150,000 people, if not more, work in members' clubs, and I have always felt that the health of a bar worker in a club is every bit as important as that of a bar worker in a pub. Some Members have suggested that perhaps bar workers should change jobs if they do not like the premises that they work in. That shows a lack of understanding of the bars and clubs in our communities. In some communities, it is not easy for such workers to get another job.

Jim Sheridan (Paisley and Renfrewshire, North) (Lab): Much has been made of the employee's ability to choose whether or not to work in a pub or a club. If private clubs are excluded from this legislation, when someone who is offered a job in a club refuses to take it, they would rightly be denied any social security benefits whatsoever. So where is the choice?

6.15 pm

Mr. Grogan: I agree entirely with my hon. Friend. The House has a responsibility to provide some certainty tonight. If we exempt clubs, we will be faced with years of legal action. Indeed, the Joint Committee on Human Rights suggested that if we distinguish between members' clubs and pubs, we may face legal action from bar workers in clubs, trade unions and so on. Businesses and clubs need certainty.

I have been telephoned, in my role as chairman of the all-party group on beer, by licensees from all over the country. I shall give just two examples, which happen to come from Doncaster and Leicester. The licensee of the Rockingham Arms, in Doncaster, told me that his pub is opposite the Comrades club, which is a social club near Doncaster race course, and that all he wants is a fair bat and ball—the chance to compete with it on equal terms. Of course, many of his regulars are also members of the club. We have to face the fact that the likely flow of traffic will be smokers shifting from pubs to the clubs of which they are a member. If we pass an exemption for clubs in this House tonight, it will constitute a St. Valentine's day massacre of many pubs. Pubs will close up and down the land and Members will have to face not just their licensees, but the darts team and the football team that has nowhere to go. Some pub charity Christmas raffles will no longer take place. Pubs are a vital part of our local community.

Mr. Laurence Robertson: Has the hon. Gentleman considered the logical conclusion of his argument, which is that there is great demand for pubs in which people can smoke?

Mr. Grogan: On health and safety grounds alone, we must face the reality of the situation. According to an American study, a non-smoking bar worker in a pub has a 20 times greater risk of developing cancer than a non-smoking bar worker in a non-smoking environment. We must be cognisant of that fact.

I want to address the remarks made by the hon. Member for South Cambridgeshire (Mr. Lansley), in case I can persuade him, as well as my own Front
 
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Benchers, of my argument. I have always regarded him as the epitome of modern Conservatism, which involves a belief in simple regulation and market forces. It therefore beggars belief that he is advocating a very complicated regulatory system involving local authority inspectors visiting clubs to see whether children are present, and which will lead to many of our pubs being unable to compete on equal terms with clubs.


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