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Session 2005 - 06
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Standing Committee Debates
Health Bill

Health Bill

Column Number: 81

Standing Committee E

The Committee consisted of the following Members:


Mr. Eric Illsley, Mr. Martin Caton, †

Ann Winterton

†Blunt, Mr. Crispin (Reigate) (Con)
†Butler, Ms Dawn (Brent, South) (Lab)
†Dorries, Mrs. Nadine (Mid-Bedfordshire) (Con)
Engel, Natascha (North-East Derbyshire) (Lab)
†Ennis, Jeff (Barnsley, East and Mexborough) (Lab)
†Flint, Caroline (Parliamentary Under-Secretary of State for Health)
†Hodgson, Mrs. Sharon (Gateshead, East and Washington, West) (Lab)
†Joyce, Mr. Eric (Falkirk) (Lab)
†Kennedy, Jane (Minister of State, Department of Health)
†Kidney, Mr. David (Stafford) (Lab)
†Lansley, Mr. Andrew (South Cambridgeshire) (Con)
†Merron, Gillian (Lord Commissioner of Her Majesty’s Treasury)
†Murrison, Dr. Andrew (Westbury) (Con)
†Reed, Mr. Jamie (Copeland) (Lab)
†Webb, Steve (Northavon) (LD)
†Williams, Stephen (Bristol, West) (LD)
†Young, Sir George (North-West Hampshire) (Con)
John Benger, Gordon Clarke, Committee Clerks
† attended the Committee

Column Number: 83

Thursday 8 December 2005

[Ann Winterton in the Chair]

Health Bill

9 am

The Chairman: I welcome members of the Committee on this not-so-fine morning. May I remind everybody to switch off their mobile phones, which can disturb the work of the Committee.

Clause 3


Amendment proposed [6 December]: No. 35, in page 2, line 40, at end insert—

    ‘(   )   Regulations made under subsection (1) shall not provide for premises or areas of premises not to be smoke-free if they are premises or areas of premises to which children have access.’.—[Mr. Lansley.]

Question again proposed, That the amendment be made.

The Parliamentary Under-Secretary of State for Health (Caroline Flint): Lady Winterton, it is a pleasure to serve under you this morning, and one that I do not think that I have had before.

Before we adjourned on Tuesday, the hon. Member for South Cambridgeshire (Mr. Lansley) was explaining why he believed that, within the tightly defined areas that will be exempted from our smoke-free policy, there should be further provision for preventing smoking in areas where there are likely to be children. The reach of our proposals for smoke-free areas in places where children go should not be underestimated. For example, we have said that every shopping mall, café and leisure centre should be smoke free. We can all agree that a lot of families with children are likely to be in such areas. That is a huge step forward in protecting children from smoke. In addition, our proposals cover restaurants and cafés where food is being eaten, whether or not they are licensed.

One development in the past 15 years has been the way in which the pub trade has created more of a family atmosphere by providing food on its premises, and often facilities where younger children can play. That is welcome; it makes the experience a family activity. Our proposals will cover all those places.

So I do not agree with the hon. Member for South Cambridgeshire that somehow the Bill does not cover the needs of children. It tackles the needs of adults who want to work and choose to socialise in smoke-free places and, as a by-product, the very places in which smoking will not be allowed are those to which children are encouraged to go—there are rather more of those than there are licensed premises.

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Dr. Andrew Murrison (Westbury) (Con): Children tend to be at home rather a lot. Does the Minister agree with the Defence Secretary’s assessment that the measures might, paradoxically, increase the exposure of family members to tobacco smoke, because people will resist the temptation to go to the pub and will instead take their six-packs, drink them in the front room and smoke in front of their children?

Caroline Flint: I looked at the report of the Health Committee’s interview of the former Health Secretary. He was referring to the increase—I think that I mentioned it on Tuesday—in off-licence sales, videos and DVDs. More families are socialising at home in both England and Ireland. He pointed to the importance of recognising that whatever we do in respect of public places, we should never take our eye off the ball in relation to families. The fact is that adults smoke in the home and in the car in front of their children. Although we do not seek to legislate to stop that, we should make every effort to make people aware of the dangers to themselves and to their children of smoking.

Mr. Andrew Lansley (South Cambridgeshire) (Con) rose—

Caroline Flint: My right hon. Friend was also reflecting concerns. Over the past six months a number of hon. Members as well as people outside the House have asked me whether the measures would lead to more smoking in the home. In the past six months new evidence from the Royal College of Physicians and reports based on the Irish experience suggest that such displacement is unlikely, so I am happy to say that there is no direct evidence that the Bill would lead to more smoking in the home. However, we must remember that the trend over the past 10 years has possibly been for more leisure activities and drinking to take place in the home, not only because alcohol is sold in shops and supermarkets as well as on licensed premises, but because, with the advent of DVDs and videos, some families choose to socialise at home. Drink is part of that scene, as, I am afraid, is smoking, and children are sometimes present.

Mr. Lansley: When I sought to intervene, the Minister was saying that parents would be free to continue to smoke in front of their children in private places, but that the changes brought about by the Bill would help children in public places. However, part of the difficulty is that in some areas of the country a large number of establishments would be exempt. I have referred to the report in the British Medical Journal that analysed Telford and the Wrekin and suggested that two thirds of pubs in deprived areas would be exempt. If we took clubs into the equation, 80 per cent. of establishments in deprived areas would be exempt. Therefore, in some areas not only are children likely to be exposed to smoke in the home, but some of the social establishments to which their parents are most likely to go will probably continue to allow smoking. We will not reinforce parents’ understanding of the
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damaging effects of smoke on their children unless they are aware that in public places they should not expose their children to second-hand smoke.

Caroline Flint: I am always interested in the contributions of Conservative Front-Bench spokespeople on this issue, because they are quite confusing. As far as I am aware, the hon. Gentleman does not believe that we should be legislating at all at present.

Mr. Lansley: We have been through all that.

Caroline Flint: I am afraid that it is pertinent. On one hand, the hon. Gentleman argues that if the Conservative party were in power its policy would be self-regulation for another three years and then to review the position with a view, possibly, to going as far as we go in the Bill or perhaps further.

Mr. Lansley rose—

Caroline Flint: Let me finish the point. Conservative policy on this issue is confusing not only for the public but for Conservative Back Benchers. On one hand, the hon. Gentleman is promoting his party’s policy of further self-regulation, and on the other hand he seeks further distinctions within the limited exemptions that we propose. As I have said, it should be acknowledged that the places that will have a total ban are overwhelmingly the sort where children go either with their parents or on their own. Therefore, I have no doubt that, because it reduces exposure to second-hand smoke in public places, children will benefit from the Bill.

However, there are difficulties in creating a further distinction by categorising exempted places. Let me give the hon. Gentleman an example. We want to allow an exemption in adult hospices, but the amendment would mean that a child might not be able to visit a relative or parent in their room, and the patient might be confined to their room because of the nature of their illness. I can think of a number of other scenarios in which that might create a problem for children. The hon. Gentleman has not thought about that and is thinking more about licensed premises. I believe that a further distinction is unnecessary and that the criteria for premises being allowed an exemption are already tight.

Steve Webb (Northavon) (LD) rose—

Mr. Lansley rose—

Caroline Flint: Parents must make a choice about going to the limited number of public places that are exempted, but we have said that we will review the exemptions within three years. One issue that we can review and evaluate is whether children are disproportionately exposed to second-hand smoke in exempted places, particularly licensed premises.

I will give way to the hon. Member for Northavon (Steve Webb) and then to the hon. Member for South Cambridgeshire.

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Steve Webb: I want to offer some evidence in support of the Minister’s position. In Ireland there has been a total ban and the overall prevalence of smoking has dropped markedly, even if there is some displacement of the sort suggested by the hon. Member for Westbury (Dr. Murrison). Some people who would have smoked in the pub are now smoking at home to the detriment of their children, but there has been such a dramatic reduction in the amount of smoking overall that there are now far fewer homes in Ireland where people smoke. That must be good and the Minister may conclude that it would be better to go for a more comprehensive ban.

Caroline Flint: Well, it is always interesting to look at and reflect on what happens in different countries. When places such as California, New York and Norway introduced partial bans, they applied initially to workplaces and public places and were extended to bars last, for some of the reasons I have outlined. I am sure that those places also saw a decrease in smoking.

I am pleased that a substantial number of people have given up smoking in the past few years, and that is due to a combination of better information and better services. Importantly, some of our national campaigns have been run locally to make parents aware of the dangers to their children, and they have been an important factor in persuading people if not to stop smoking at least to choose not to smoke at home. However, there is still a long way to go. A survey earlier this year showed that a huge number of adult family members—parents and so on—smoke in front of their children in cars. There is more work to be done.

I believe strongly that the Bill pushes the balance towards a more smoke-free environment in public places and workplaces. The accusation was made that the Bill says nothing about children, but it is implicit, by the nature of places where there will be a total ban, that children will not be exposed to second-hand smoke in the places they frequent.

Mr. Lansley I am grateful to the Minister for giving way after a while. It seems that whenever I say something that she finds difficult, her reaction is to have a go at the Conservative party. We are not here to debate the Conservative party’s policy; we are here to debate the Bill. However, at the risk of repetition, I tell the Minister again that the Conservative party’s clearly expressed intention before the election was to implement legislative provisions so that smoking in public places to which children have access would not be permitted, but to allow a self-regulatory solution for up to three years. Before the election, the Government expressed their intention to introduce their measures in 2008. We believe that the flexibility and speed inherent in self-regulatory solutions is better then the rigidity and sometimes delay consequent on the production of primary legislation and statutory instruments.

I understand what the Minister says and I acknowledge that I am focused on licensed and club premises, and that the amendment might have unintended effects and not deliver precisely what is
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required, but is she saying that she is content that a substantial number of licensed and club premises will be able to admit children to areas where second-hand smoke is present?

9.15 pm

Caroline Flint: What I am saying is that the restrictions on exempted places are tight and I do not believe that there is an argument now for further limits in those premises. The justification for exempting private clubs is that adults choose to become members of such clubs. I shall stand corrected if Hansard shows that I am wrong, but I recollect that on Tuesday the hon. Member for Westbury referred to a private club as almost a parallel to a home in the sense of a private space. Private clubs are exempted on the basis that their members are adults who choose to sign up to the regulations of that club. They have a say in the running of the club—by their very nature, qualifying clubs must allow for that—so they have a say in determining whether smoking should be allowed at all or in certain areas. Many clubs already apply rules in that area, including no smoking in bars.

Therefore, while I understand the concern of the hon. Member for South Cambridgeshire about smoking in front of children, I do not think that the right way to proceed is to exempt such areas within the proposed exemptions. I think that our direction of travel is clear, and we have said that we will monitor from day one. I am happy to tell the Committee that one aspect that we can monitor is exposure of children to smoke in licensed premises that will be allowed to continue to have smoking. However, I feel fairly confident in saying that the danger spots for children are the sort of places that we have covered in the Bill with a total ban: restaurants, cafés, shops, shopping malls, leisure centres and other places where children go with their parents or on their own.

There may be occasions when parents take children to licensed premises, but I do not believe that that is as widespread as the hon. Gentleman suggests. I do not know whether he is talking about primary school children or teenage children, but many licensed establishments have their own informal arrangements for access by families and set the tone of the place for families. I would expect that many licensed establishments that will be exempted under the Bill will not be the sort of places to which children are taken at the moment or will be taken in the future.

Dr. Murrison: I would call a hotspot a place where a child spends a great deal of time and could be exposed to second-hand smoke. I do not agree with the Minister that such places tend to be restaurants or shopping malls. They tend predominantly to be their own homes. Does the Minister not understand that it is estimated that every year 17,000 children under the age of five are admitted to hospital as a result of second-hand smoke? Whatever she says and whatever the experience in Ireland, her Bill is likely to expose children to more second-hand smoke.

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All my hon. Friend the Member for South Cambridgeshire is trying to do is improve the Bill so that we give a clear message to parents that smoking in front of children of an impressionable age should be limited. Surely the Minister has read Professor Konrad Jamrozik’s research published in the British Medical Journal, which I referred to on Tuesday. It shows overwhelmingly that the ill-effects of second-hand smoke accrue as a result of exposure at home. Surely her focus should be there.

Caroline Flint: I think I have been very clear on this matter. As far as I am aware, there is no direct evidence—that includes the research evidence that the hon. Gentleman refers to—that reducing the number of places that allow smoking leads to an increase of smoking in the home. I said that on Tuesday and I say it again today. There have been two reports in the past six months—one from the Royal College of Physicians—that indicate that that is correct.

Of course smoking in the home is an important matter, and I acknowledge that some individuals have expressed concerns about it. However, as far as I am aware, there is no evidence that banning smoking in hospitals, the workplaces that are listed in the Bill and all social and public settings would lead to more smoking in the home. I acknowledge that changes in lifestyle in the past 20 years have affected how families socialise, drink and enjoy themselves, but that does not necessarily have anything to do with restrictions or bans on smoking in public places. That is just lifestyle and social development. If the hon. Gentleman is suggesting that our proposals will force people to smoke more at home, I would say to him that there is no evidence to back that up.

Dr. Murrison: That is what the Defence Secretary said.

Caroline Flint: No, it is not what the Defence Secretary said. I read what he said in the Health Committee, and I suggest that the hon. Gentleman read it as well. It might help him in his deliberations.

I find it ironic that the hon. Gentleman makes a big case about the dangers of smoking in the home. Some of my colleagues might infer that he seeks to ban smoking in the home, since he makes such huge play of it. I hope that none of us in this Committee are suggesting that we do that. I hope that we all recognise that smoking in front of children in the home or car, or in private places with families, is an important issue, but that we must tackle it in other ways. I do not believe that amendments to make areas in a limited number of licensed establishments smoke-free if children have access to them would contribute to reducing smoking at home—if that is his suggestion. I do not believe that there is sufficient evidence to suggest that restrictions on smoking, in and of themselves, increase smoking in the home.

Mrs. Nadine Dorries (Mid-Bedfordshire) (Con): I would like to bring in an example about children from lower socio-economic groups. A village in my constituency has a British Legion club. It is a private members’ club and will be exempt from the Bill. It
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serves food, and children are in the club all day Saturday and Sunday, Christmas, holidays and often in the evenings. The smoke in that club is so dense that it stings one’s eyes when one walks in. The children who are in there tend to be from lower socio-economic groups. Their parents have taken them there because it serves cheaper drinks and food, and there are as many children in there on any Saturday or Sunday as there are adults. If someone were to go into the next pub in the village that serves food—

The Chairman: Order. It might be helpful to the Committee if Members were aware that interventions should be relatively short. I have allowed a certain latitude but perhaps this should not be so in future. I know that the hon. Lady is a new Member and is perhaps not aware of it, but if she could make her interventions shorter, that would be very helpful to the Committee.

Mrs. Dorries: Sorry, Lady Winterton. I was giving an example of two bars in my constituency. In one there is no ban at the moment, and in that one there would be no children. The point I am trying to make is that, under the Bill, children from lower socio-economic groups will still be exposed to risk.

Caroline Flint: I cannot remember whether the hon. Lady was at the debate earlier in the week on private members’ clubs, but her colleagues were making the case that the question was for individual members of such clubs. The hon. Member for Westbury likened being a member of a private club to being a private resident.

I understand what people are saying about the dangers of second-hand smoke to children, but I do not believe that further restrictions to those covered by the exemptions are the right way forward. We should say to private members’ clubs, which people join knowing the rules, that it is a matter for parents to decide whether they wish their children to partake in activities in that club where their children will be exposed to smoke. That is a decision they make when they join those clubs. The hon. Lady is right: people join those clubs for different reasons, but they join as a private member, knowing the rules of the club and knowing that they can change the rules of the club if they wish. Parents can make a choice about whether they wish their children to be involved in activities in that club, whether it is smoke-free or not.

Private clubs are exempted under the Bill, so it would be illogical to turn the argument on its head by suggesting, “You can be a private club member, decide what you want to do and be exempt, but in this area we don’t agree that you have those rights or individual choice about what you do.” In some ways that would turn on its head the argument of allowing private clubs to be exempt in the first place.

Having said that, many children in some of our most deprived communities can be seen in the sorts of places that will be completely covered by the legislation. Some of the most deprived wards in the country are in my constituency and I see children in the shops and shopping malls of Doncaster, some of the leisure centres that still allow smoking, and in cafés of one sort
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or another. There are even still smoking areas in some cinemas. Bearing in mind where children go, either on their own or with parents, the Bill will substantially reduce the number of smoking environments to which children are exposed.

We are committed to reviewing the legislation, and one of the issues we can take into account as part of our evaluation is whether a disproportionate number of children have entered the limited number of bars where smoking will be allowed or whether the risks to those children have increased. In either case, I am not sure that that would happen or whether there would be any evidence for it.

Dr. Murrison: The Minister has made great play throughout the course of the Committee of the fact that it is a question not just of reducing smoking per se, but of sending people messages; it is a matter not just of reducing the amount of second-hand smoke, but of the message that is sent to a society as a whole. Does she not understand that all that my hon. Friend the Member for South Cambridgeshire is trying to do is to send that message about children? Surely she accepts that the amendment would give a clear message that it is simply not acceptable to smoke in front of children.

9.30 am

Caroline Flint: It is right to advise that it is not sensible to smoke in front of children. That is what we try to do through all our campaigns; we know that children are most exposed in the places where families have to make choices. We try to think of ways to reach those families, whether we are dealing with mothers expecting babies, support for giving up smoking, or whatever.

The Bill already sends out a strong message about our refusal to accept that self-regulation is the way forward. We have said that we need to legislate for most of our workplaces and public places, to increase the choice and reduce the exposure for those who do not smoke. I would have hoped that, following the logic of his argument, the hon. Member for Westbury (Dr. Murrison) would support the Bill. As I have said before, the vast majority of places where children go will be subject to a total ban as a result of the Bill.

Jeff Ennis (Barnsley, East and Mexborough) (Lab): I welcome you to the Chair, Lady Winterton, and I look forward to serving under your excellent chairmanship. On the subject of protecting children from cigarette smoke, may I say something in response to the hon. Member for Mid-Bedfordshire (Mrs. Dorries)? I used to live in a British Legion club—my dad was the steward—and I can endorse what she said about smoke getting in people’s eyes. I can remember serving behind the bar, and by the end of the evening my eyes were stinging. I had to go outside several times to get my breath and clear my eyes.

This subject is key to the Bill. As the Minister knows, I have tabled new clause 7, to raise the age of sale from 16 to 18—

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The Chairman: Order. You asked the most fantastically brief question in the House yesterday, Mr. Ennis, and bearing in mind what I said a few moments ago, and the fact that we are not discussing new clause 7, perhaps you could make this intervention very brief too.

Jeff Ennis: Thank you for that guidance, Lady Winterton. The question that I am asking—very briefly—is whether the Minister agrees that new clause 7 is another measure that we ought to try to incorporate and take cognisance of, in terms of the young people—

The Chairman: Order. We are not talking about new clause 7, so it is not a matter for debate now.

Caroline Flint: My hon. Friend is making an interesting point about his childhood. My grandparents were publicans, and we probably have some experience in common, as I spent the first years of my life living with them when they were running a public house. Perhaps I should have declared an interest at the outset.

As my hon. Friend and I know, licensed premises are private premises as well, so there are questions about how the amendment might affect publicans, stewards of British Legion clubs and so on, and their children. If a steward or licensee of an exempted licensed premises allowed their child to enter the bar area where people had been smoking, would that be an offence? The question is rather more complicated than hon. Members have suggested.

Opposition Members have said a lot about how to protect children from smoking, and smoking in the home. There are several different measures by which we can protect children better. One is using the law to increase enormously the number of smoke-free places. The second is tobacco control. The third is what we do to persuade families that they should make a choice for health, by not smoking in front of their children in their home or elsewhere.

Tobacco control is important. That is why I am pleased to confirm that next year we shall consult on a proposal to raise the age for the sale of tobacco from 16 to 18. I commend the intervention by my hon. Friend the Member for Barnsley, East and Mexborough (Jeff Ennis), which allowed us to reflect on his proposals and consider how we might take that forward.

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Prepared 9 December 2005