Health Bill

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 are very sensitive to the effects of tobacco smoke, and experimental studies have shown that smoking one or two cigarettes per day has a similar effect on platelet aggregation to that seen in non-smokers exposed to environmental tobacco smoke for 20 minutes.””" 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, 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:"““So when you are talking about exposure from particles which are known to affect health, and there are plenty of studies to show that particulate matter affects health, some of the places where you get the very greatest exposure is in the indoor environment in smoky pubs””." If we exempt clubs, we will drive smokers to them and they will become even more lethal.