Select Committee on Health First Report


9  Conclusions

131. Many distinguished scientists in this country and elsewhere have examined the now considerable body of evidence which shows the health effects of secondhand smoke. The World Health Organisation, the Chief Medical Officer, the Royal College of Physicians, SCOTH and the US Surgeon General have all concluded that secondhand smoke is a serious risk to health. Faced by these conclusions the previous Secretary of State for Health, Dr Reid MP, concluded that secondhand smoke was dangerous and proposed to introduce a ban on smoking in most workplaces. We support this ban.

132. However, Dr Reid also decided on two main groups of exemptions: for institutions where people live such as prisons, psychiatric institutions and nursing homes; and for clubs and pubs which do not serve food. Unfortunately, we are unable to judge their precise nature because the Bill provides that they are to be specified in regulations and no draft of these regulations has been published. This is unacceptable. The Government must publish a draft of the regulations before the report stage of the Bill. The situation is made worse because Crown properties are not included in the Bill. The Government should have informed the House of this important fact at an early stage. That it did not has been very misleading. We are also surprised that neither the MOD, the Director-General of HM Prison Service nor the Home Office Minister told us that their institutions were not covered by the Bill.

133. Institutions which are also dwellings, such as prisons, MOD properties and hospices, present special difficulties. These institutions plan to ban smoking to a greater or lesser extent. At least one mental health trust and two Young Offenders' Institutions have already implemented a ban. Others should follow suit, although we recognise that there may be a case for carefully provided exemptions, for example in high security prisons. Staff should not smoke on the premises.

134. The exemption for clubs and pubs where food is not served is illogical. It means that the workers who are most exposed to secondhand smoke, and therefore most at risk, will not be protected. We have sought from the Government a convincing rationale for this decision but have not found one. It defies logic. Dr Reid justified the policy before the Committee in February 2005 on a number of grounds, including the fact that few bar workers would die from exposure to SHS in pubs.

135. Subsequently the Government's explanation for its policy has changed. In her appearance before us, the Minister for Public Health was very well briefed, but the oral evidence she gave us was unconvincing. We doubt that she believes in the policy she espoused. Cutting through the Minister's answers, her defence of Government policy amounted to a statement that 'we must take people with us'. On further examination this is nothing more than the dubious contention that because a majority of the population were opposed to it, a ban in pubs should not be introduced because the public would not comply with it. The Government does not oppose a comprehensive ban in principle. It is implicit in what both she and the Secretary of State told us that once opinion polls indicate that a small additional shift in public support for a total ban, the Government will have no objection to one. In fact, this has already occurred. A majority of the population now support a ban.

136. The Minister also tried to suggest that the Government would protect workers by banning smoking within one metre of the bar, but under questioning admitted that this would not provide health benefits. The Government is to hold a further consultation about protecting bar workers but it is hard to see its purpose since only a ban will provide that protection.

137. The proposed exemptions for clubs and non-food pubs are opposed by the hospitality industry because they are unclear and will create unfair competition: pubs where smoking is banned will lose business to clubs, so will bingo halls. Even those in the industry opposed to a ban would prefer a comprehensive ban to the proposed legislation. The exemptions are also condemned by those interested in public health on the following grounds: they will discourage the growing culture of eating while we drink; instead they will encourage an old-fashioned culture of drinking without food in 'smoking' pubs. The exemptions will undermine the Government's goal of reducing health inequalities: drink-only pubs are concentrated in deprived areas. Finally, the exemptions fly in the face of medical opinion. The Chief Medical Officer told us that the Government's rejection of a comprehensive ban went against his advice; this is the first time his advice on a public health matter has been rejected. He came close to resigning over this issue. The exemptions are not in line with other legislation to protect workers' health as the Health and Safety Commission and trade unions pointed out: workers are not normally exposed to unnecessary danger regardless of public opinion.

138. The exemptions will reduce compliance and make enforcement more difficult. Adding to these problems are the low fines which will be insufficient to deter publicans who wilfully ignore or obstruct the legislation. The Government's proposals are a recipe for chaos.

139. During the inquiry the Committee visited Ireland. There we were able to see in operation an effective comprehensive ban with no exemptions for any pubs or clubs. It has been a great success. The exposure to carcinogens in bars has greatly decreased and improvements to bar workers' health is already apparent. After the ban came into effect, it rapidly became more popular: it was voted the best thing to have happened in 2004 in the New Year's Eve poll at the end of the year. The key to success, we were told, is clarity and political support, which ensured compliance. In England, unfortunately, we find muddle and confusion, Cabinet wrangles and half-hearted political commitment.

140. Since secondhand smoke is a danger to workers' health, all workers, especially bar staff who are most at risk, deserve protection. Bar staff should not have to suffer conditions which are unsafe and avoidable. The Government should introduce a comprehensive ban which includes all pubs and clubs which employ staff. As in Ireland, it would be a popular measure, which would become more popular after it had come into effect. We agree with the President of the Royal College of Physicians that: "There is nothing that this Government could do for health that would be better than to actually bring in this ban, absolutely nothing."[140]


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Prepared 19 December 2005