Health Bill

I want to speak to parts 1 and 2 of the Bill, starting with the section on infection control issues in part 2. I have some doubts that the code of practice will make any more difference than all the guidance and circulars that have preceded it. What constitutes best infection control practice, as we have just heard from the hon. Member for Lewisham, Deptford (Joan Ruddock), is already clear. There is plenty of guidance around to be followed. For example, in 2000 the Department of Health issued a circular setting out a programme of action for the NHS on the management and control of hospital infections. To this day, there has been no national audit of compliance with that circular, and Health Ministers have consistently made it clear that the Government have no plans to undertake such an audit. Ensuring compliance with the existing guidance should have been a priority, and the fact that a statutory code is now felt to be necessary is, in truth, an admission of eight years of failure by this Government in controlling infections both in the community and in our hospitals. The problem has been where infection control sits in relation to the Government’s other health priorities. From reading the summary of responses to the Department’s consultation on the code, it is clear that many are worried that the guidance in the code will"““conflict with other policies that are already in place, such as those relating to bed occupancy.””" It is therefore no surprise that the report goes on to say:"““Many felt that the Code of Practice should specify which guidance is meant to take priority.””" That is absolutely right—it must do that. It is disturbing that more than a year after the National Audit Office published its progress report, that remains a concern among many in the NHS. The NAO found, at the time of its report last year, that half of NHS managers were struggling to reconcile the competing demands of Government waiting time targets and the management of hospital infections. The question is, will the code make clear what takes precedence—political targets or infection control? The response to my earlier intervention suggested a ““have the cake and eat it”” approach to that question, and to the issue generally. I hope that the Minister will clarify the matter later. Against a background of increasing financial instability and rising deficits there is cause for concern that NHS organisations will struggle to tick all the Government boxes and meet their obligations under the new code, but if a statutory code of practice gives infection control the priority that it needs, I for one will support it and consider it a worthwhile measure. Part 1 deals with the partial ban. Like others who have spoken today, I hope that a majority in the House will amend the Bill to provide for a comprehensive ban on smoking in enclosed public places. For many, it is a question of social justice. How can it be right to legislate to protect workers from the harmful effects of second-hand smoke in the majority of workplaces, and then fail to extend that protection to bar workers, who are often most at risk? During an average eight-hour shift, a bar worker can inhale environmental tobacco smoke that is equivalent to smoking a pack of 10 cigarettes a day. It is the overwhelming evidence that smoking harms non-smokers that leads me to support the introduction of a comprehensive ban on smoking in enclosed public places. If it were simply a case of smokers putting their own lives at risk I, as a Liberal, would respect their right to make that choice, but the right to smoke must be balanced against the rights of non-smokers in general and workers in particular. Second-hand smoke does harm. It can and does kill. There is no safe level of exposure to it. Last November, the Scientific Committee on Tobacco and Health reported that exposure to second-hand smoke significantly increased the risk of heart disease and lung cancer in non-smokers. In April this year, a study published by the British Medical Journal estimated that it was responsible for 617 deaths a year. Those are preventable deaths, but the health effects are much wider. According to Asthma UK, four fifths of the country’s 5 million asthma sufferers say that second-hand smoke makes their condition worse. I believe that a ban on smoking in enclosed public places must be seen first and foremost as a health and safety measure. Protecting workers from second-hand smoke should be the goal. The Government’s policy, however, does not achieve that end. It is not sufficient to argue that because the vast majority of workplaces will be covered by a ban, it is somehow acceptable to set aside the evidence and allow bar workers to be exposed to second-hand smoke. Proposals for a smoke-free buffer zone around the bar are pointless, unless the Government plan to legislate to change the laws of physics and stop smoke from drifting around the bar. Ventilation is not an answer. The best that it can offer is comfort for the customer. It does not provide safety for staff because it does not extract carcinogens from the atmosphere. Research suggests that more than 10,000 air changes an hour would be necessary to achieve ambient levels of particulates. That is equivalent to a mini-tornado blowing through the pub. A partial ban will fail, and not only on grounds of principle.