Health Bill

The Secretary of State for Health said that this is a landmark Bill, and so it has proved for the Government. I have counted the speeches by Back Benchers today. We have had a total of 25—a remarkable effort—of which those from Labour Members for the Government counted three, but two were against, and I am honestly not clear about two others. That is something of an embarrassment for the Secretary of State. The right hon. Member for Rother Valley (Mr. Barron) spoke eloquently about health inequalities, a theme that ran through the debate. He specifically mentioned that 85 per cent. of pubs in Corby were likely to be exempt under the Bill and he was very concerned about the inequalities that that might engender. The hon. Member for Northavon (Steve Webb) was pressed on cannabis and he needs to construct a more cogent response. The Liberal Democrats support the Government’s ban on smoking, but wish to liberalise the smoking of cannabis. I am not sure whether we heard a change of policy today, but the hon. Gentleman may wish to revisit the issue at some point. The right hon. Member for Holborn and St. Pancras (Frank Dobson) also talked about health inequalities and made the valid point that there is a real risk that smoking will be concentrated in those pubs that do not sell food, which risks turning such pubs into smoking dens. Like my right hon. Friend the Member for Charnwood (Mr. Dorrell), I am a liberal Conservative, but I am persuaded that the do-nothing option is untenable, given the evidence that we now have about the effects of second-hand smoke. We have to act, given the evidence that second-hand smoke causes problems. If we do not do so, we are failing our constituents. The question is how we reach the situation in which the majority of our constituents do not smoke and we reduce the incidence of lung cancer, cardiovascular disease, sudden infant death syndrome and so on. The hon. Member for Stoke-on-Trent, North (Joan Walley) also talked eloquently about health inequalities. Last night, my right hon. Friend the Member for Bromley and Chislehurst (Mr. Forth) was with me in a pub. We were not drinking; he was smoking, but I was not. He gave a classic ““cry freedom”” speech, which was very stimulating. The hon. Member for Derby, North (Mr. Laxton) was the first supporter of the Government. He gave a tour de force in which he attacked the bourgeoisie and I was thrown back 50 years to a time of class warfare. If his thesis were correct, perhaps the best way to reduce health inequalities would be to increase smoking, because then the bourgeoisie would get sicker and those whom he defined as working class would get healthier. I may be confused: the hon. Gentleman certainly sounded confused in his contribution. My right hon. Friend the Member for North-West Hampshire (Sir George Young) made a fantastic speech that drew an important distinction between private and public spaces. He and I agreed on the Tobacco Advertising and Promotion Act 2002, when I was very new to this place, and we share a passion for reducing smoking. I certainly have that passion, both professionally and politically. The hon. Member for Liverpool, Riverside (Mrs. Ellman) rightly talked about Ireland and its experience and the lessons that we can learn. She also pointed out that 59 per cent. of pubs in Liverpool do not serve food and therefore could fall into the smoking den trap, about which many of us are concerned. My hon. Friend the Member for Beckenham (Mrs. Lait) talked about optical services and the other aspects of the Bill that risk being sidelined by our passion to address the smoking elements. The hon. Member for Lewisham, Deptford (Joan Ruddock) said that the Bill is unworkable, and that point was echoed by several of her colleagues. In bringing forward the measure, the Secretary of State has asked the House to give her more or less a blank cheque, which will allow her and her successors to fill in the important detail at leisure through regulation. I believe that the chief medical officer is relying on that blank cheque in withholding his threatened resignation. I presume that he hopes for a comprehensive ban through regulation at some point in the future. Although the Bill is primarily about smoking, we should not ignore its important additional features. We can agree on many of them, although we shall seek clarification and improvement in Committee. For example, why does part 3 contain no clarity over pharmacy supervision or standard operating procedures? We need the detail on how many pharmacies one person will be able to supervise. Why does part 4 apparently give PCTs carte blanche to charge pharmacists to set up new contracts? Will part 4 indeed favour larger chains at the expense of the high street, and therefore reduce choice? Why have ophthalmic services been bolted on to the Bill in advance of the Government’s consultation on general ophthalmic services? Will the Government accept that PCTs that are strapped for cash will be tempted to degrade eye tests that they buy? To what extent will small high street opticians struggle under the new regime? Will the Minister outline the intended contents of the hospital-acquired infection code of practice? Will its benefits outweigh the cost of the yet more paperwork, tick boxes and administrative hassle that our hard-pressed professionals have to cope with? Why have the Government ignored Sir Nigel Crisp’s view that target-driven high bed occupancy lies at the heart of our high MRSA rates? The hon. Member for Sutton and Cheam (Mr. Burstow) did not talk about smoking cannabis, but he laid into ventilation without offering any evidence when pressed. That brings me to the very good speech by the hon. Member for Sunderland, North (Bill Etherington). He is something of an expert in this sphere because he has industrial experience and is a smoker, and in his useful contribution he defenestrated the argument that ventilation has nothing to offer. It is a pity that Ministers have not at least considered the possibility that ventilation might have something to offer in all this. The hon. Member for Strangford (Mrs. Robinson) supported a total ban on smoking and cited international experience, particularly in the Republic of Ireland, quite rightly. The hon. Member for North-West Leicestershire (David Taylor) is a complete ban man, and brought to mind the hon. Member for Derby, North (Mr. Laxton) in his reference to King James’s counterblast to tobacco. I am sorry that I missed some of the speech by my hon. Friend the Member for Southend, West (Mr. Amess). I understand that he spoke extremely knowledgeably about pharmacy and ophthalmology, and wondered whether either would be improved by the Bill. The hon. Member for Cardiff, North (Julie Morgan) asked for a free vote. The Conservative party will be offering its Members a free vote on this issue, and I call on the Minister to do her own Members the courtesy of offering the same. The Bill is chiefly about a smoking ban, which, in part 1 weighs most heavily on issues to do with personal choice and freedom, and has the greatest capacity to improve public health. Evidence-based public health is the only basis on which we should consider a ban. We must separate it entirely from amenity and nuisance, which are more properly dealt with elsewhere. Nowhere is the Government’s conflation of nuisance with ill health more obvious than in the great play made of banning smoking within some arbitrary distance of the bar. The Government have admitted that there is no evidence that banning smoking at the bar would yield health benefits. Their consultation document referred to it as a ““courtesy measure””. We cannot legislate for courtesy, but we can legislate for public health. I submit that the public health argument for the red line on our carpet here in the Chamber is stronger than that for the arbitrary line that the Health Secretary wants to scratch on pub floors. At least the two swords’ separation carries some logic in public health terms, and 80 per cent. of consultation respondents seemed to agree with that. The Government’s muddle-headedness extends to the artificial distinction between pubs that serve food and pubs that do not. To be fair, the illogical association of food and smoking was made by the Health Secretary’s predecessor. She may regret it—the chief medical officer certainly does—but this is her Bill and she is responsible for it. Sir Liam Donaldson is supported by the results of the Government’s consultation exercise, which showed that 90 per cent. of respondents were against exempting pubs that serve food. Clause 4 introduces the possibility of ban on smoking in a range of outdoor places. If it is not expedient to remove a toxin by banning it, we must control exposure to it by other means. If airborne contaminants in industry settings can be removed satisfactorily using ventilation, we should not dismiss out of hand such an engineering solution in the hospitality sector, yet that is precisely what Ministers have done. Exceptions to the ban are likely to be made by the Minister. Surely an insistence on such ventilation and acceptable levels of atmospheric contamination would be both a reasonable compromise and a possible benefit to exempt establishments that may have future employee claims to defend. The hon. Member for Wyre Forest (Dr. Taylor) is a self-confessed anti-smoking zealot. He talked about the Clean Air Act 1956. I am pleased about that because that Act was introduced by a Conservative Government. He continued to give us a tour de force of the rest of the Bill—quite a task, given its complexity. The hon. Member for Thurrock (Andrew Mackinlay) is one of the two supporters of the Government that I counted—[Interruption]—in respect of the Bill, I hasten to add, and unusually so. He talked with passion about MRSA. He also told us how smoking ended the sparkling ministerial career that was otherwise surely his for the taking. My hon. Friend the Member for Broxbourne (Mr. Walker) made a thoughtful, passionate speech that balanced libertarianism, good sense and pragmatism. The hon. Member for Stafford (Mr. Kidney) rightly praised the extended role of pharmacists and reflected the annoyance of opticians about the appearance of clauses 34 to 40 in the midst of the consultation on general ophthalmic services. My hon. Friend the Member for Tewkesbury (Mr. Robertson) rightly drew our attention to the illogicalities of the Bill and the division that it has caused in the Cabinet. The hon. Member for Barnsley, East and Mexborough (Jeff Ennis) referred to raising the age of sale of tobacco to 18—an interesting concept that perhaps contrasts with the ten-minute Bill and the comments made by the hon. Member for Bristol, West (Stephen Williams) earlier today. My hon. Friend the Member for Mid-Bedfordshire (Mrs. Dorries)—a nurse, of course—talked about MRSA and VRSA. Interestingly, the Nursing Standard pointed out on 8 March that 40 per cent. of nurses said that they did not have time to clean bed space between patients. Finally, the hon. Member for Wirral, West (Stephen Hesford) talked about drink driving. Tobacco is surely captain of the men of death. I spent 20 years trying to persuade people to stop smoking. As a politician, I had rather hoped to have a Bill that would be more likely to address smoking than this one. It is a missed opportunity. My hon. Friends will use their judgment and will vote freely. I hope the Minister will allow Labour Members to have a free vote, too.