Health Bill [HL]

My Lords, I know that this Bill comes to us with the best of intentions and, indeed, I agree with some parts of it, particularly those mentioned by the noble Lord, Lord Walton of Detchant, who is always absolutely fascinating to listen to, both because of his knowledge and because we respect him so much. However, I put down my name to speak because of my great concern about the clauses on tobacco. I should like to make it quite clear that I do not smoke. I have not smoked a single cigarette in my life. I claim no virtue for that, although when I was growing up everybody smoked. It was just that I hated the smell and the look of cigarettes, so I have never had anything to do with smoking and I can say truly that I loathe it. I rejoice when people stop smoking and I cheer when youngsters do not start. I am 100 per cent in favour of unceasing teaching about the dangers of smoking. So far, I am absolutely with the noble Baroness, Lady Howarth of Breckland. Although she is not in her place at the moment, I cannot forbear to congratulate her on still having a local post office. Thousands and thousands of us have no such advantage. Smoking is a perfectly legal pursuit. To make it illegal to see what people can legally buy is, I think, the nanny state writ large. Lawmaking is rarely easy. There is no shining path along which Bills can be driven without there being objects and principles that clash head-on with each other. Those principles will arise whether we like it or not and there are always difficult decisions to be made. We cannot pretend that a principle does not exist if it is slightly inconvenient to the passing of a certain part of a certain law. After all, one man’s human rights can very easily be another man’s denial of human rights. In this regard, we are considering legal steps to deny freedom of choice and freedom to act legally. I simply cannot swallow that. I believe passionately in freedom under the law. Surely the hallmark of every civilised state in the world is the freedom for people to act in accordance with the law as they wish. I believe so strongly in that principle that I would go to the stake for it. However much I desire to see people, especially young people, not smoking, I simply cannot sacrifice the principle of freedom under the law. As I have said, I am a firm advocate of the use of teaching to influence people and I would greatly regret it if that changed. It seems that smoking has reduced in this country not as a result of what Governments have done over the past 10 years but because more and more information has come out about how desperately dangerous it is to smoke and because so many people have seen loved ones in their own families and circle of friends die. Looking back, they can see that, yes, they did smoke, which undoubtedly was a contributory factor to their death. Had they not smoked, perhaps they would still be alive. I am bothered by the suggestion that cigarettes should be sold in plain packets free of wording. You cannot have a plain wrapper with writing all over it, so bang goes another effective method of ramming home the message that jolly well should be rammed home. For the life of me, I cannot see the sense in suggesting that cigarette packets should be plainly wrapped and kept under the counter when it is perfectly legal to have them. For goodness’ sake, let us give people the facts and let them make up their own minds. It is also very odd suddenly to say that cigarettes should be produced and sold in plain packets while at the same time the manufacturers of everything else sold in packets or jars, from soups to cough pastilles—anything that we buy in the supermarket—must put what is inside that packet or jar on the outside. Apparently, that is not to be the case for cigarettes. It is going to change and I simply cannot understand why. I found some confusion between proposed new Sections 7A and 7B in Clause 19. New Section 7A(1) states: "““A person who in the course of business displays tobacco products, or causes tobacco products to be displayed … is guilty of an offence””." But Section 7B states: "““No offence is committed under section 7A if—""(a) the tobacco products are displayed in the course of a business which is part of the tobacco trade””." I thought that that was slightly odd until I read it through carefully. I presume that it means that if you are selling hats, handbags, china or anything other than tobacco, you must not display tobacco advertising or tobacco products. But why on earth would you want to? That puzzles me. Why would you want to put up an expensive display about cigarettes if you are selling other things? Further down this page of the Bill is material that would be splendid for a comedy sketch: you must not display unless someone aged over 18 asks you to display, in which case you can display. Can you tell by the requester’s appearance how old they are? There are more bits about that and it gets still more complicated. It is okay to display if someone aged over 18 asks you to, but if someone under the age of 18 comes into the shop, what are you to do? Do you shove the packet of cigarettes under the counter or put a cloth over it—now you see it, now you don’t? The next bit says that if the displayer thought that the said person was over 18, then it would probably be all right. But I am not sure, because then we go on to how it shall be decided why or if the displayer thought that. What steps had he taken to discover the truth? Had or had he not ““exercised all due diligence”” in reaching that conclusion? My word, we are into heavy weather here. Finally, we turn to what ““a requested display”” means. The poor person D with the mysterious age mentioned in the Bill—we do not really know whether is he 18 or under 18 and it has to be proved—must have asked to buy a tobacco product, which surely he would not have done if he had gone out to buy a hat or a handbag. This is a contorted part of the Bill, to which perhaps some amendments will be tabled in Committee. It calls for a few. The Government want to make smoking illegal but they dare not do so. There is a rather unpleasant element: one of the reasons why they do not want to is that they get a lot of money from smoking being legal. They are quite prepared to rake in the money with one hand—all Governments have done this—and put down firm rules about smoking on the other. That is a difficult concept to accept. The Government dare not make it illegal to smoke, so they want to make it as difficult as they can to do so. It is a denial of people’s rights to live freely under the law, according to the law, and to do what they wish to do, which is what happens in a free country. To say that the Bill wants more choice in the NHS belies its contents because of what I have just said. However, there is merit in the Bill. For instance, we learn that the NHS constitution will put privacy and dignity at the heart of care. I am all for that. Some noble Lords will know that I have made a fuss about that for a long time. But will all those good words translate into a promise that cannot be fulfilled? Earlier in the debate, it was mentioned that we still have mixed wards. I have campaigned against mixed wards for a long time, as they contravene a person’s right to privacy and dignity. I have asked many times about that. On one occasion, the Minister on the Front Bench told me that 93 per cent of all people going into hospital went into segregated wards. That is wonderful, I thought. Then I made my own inquiries and found that the only reason why the Minister could say that was that a great many wards had been redesignated and called something else. They were mixed wards but they were called assessment wards. It is all right to be in a mixed assessment ward because it is not called a mixed ward. That is really playing with words. If that is the only way forward, the constitution will not provide what it says is intended. On that point, we have to recognise that dignity is enormously important, particularly for elderly people, who have so much dignity stripped from them when they are in hospital. It is still not fully recognised within our hospitals how many elderly people detest being called by their Christian names by people who are young enough to be their grandsons and granddaughters. Those people may be important medical doctors or consultants, but this is not something that the older generation can accept easily. I should have thought that that would be an easy way to permit a patient to have dignity. I beg the Minister to take that on board, because it means a lot to elderly people who are in hospital. To be told that we are no longer able to contemplate segregated wards, as we were quite recently, worries me a lot. Does that part of the constitution mean that we will be able to segregate, as we have been promised so many times? While we still have mixed wards, patients will have neither privacy nor dignity. Finally, will the Minister say what Clause 17 on page 22 means? Am I correct in deducing that it relates to the suspension not of consultants and hospital doctors but to non-medics only? I have worried about suspension of hospital doctors for many years. I have a thick file of doctors who have been suspended unfairly. I once introduced a Bill about that. I take it that Clause 17 refers only to non-medics. Is the Minister confident that the present system of dealing with the suspension of hospital doctors is fair and acceptable to the medical groupings, given that the situation has been so sad and bad in the past?