Health Bill [HL]

My Lords, I take part in today’s debate on this Bill with a degree of trepidation. As a resident of Scotland, I am more likely to use the services of NHS Scotland, for which I have the highest possible praise, although my wife and I have recently had superb service from accident and emergency departments in two London hospitals. My opening remarks refer to subjects that are not mentioned in this Bill. During the passage of the last Health Bill, I tried hard, and with a degree of support throughout the House, to secure an amendment to put the full price of prescribed drugs on the medication itself. I intend to introduce a similar amendment to this Bill. Patients would be encouraged to finish their full course, thus saving repeat prescriptions. I have always felt strongly that all prescription drugs ought to have their full value clearly printed on them, so that patients know exactly what they are getting for their prescription charge. One must not forget that many prescribed drugs are outstanding value for money. Sadly, I must declare an interest as a diabetic. As such, I am exempt from prescription charges, but I greatly welcome the relief that has recently been awarded to those with such long-term illnesses as cancer. I turn now to health insurance, which is, I accept, a controversial subject. In order to further reduce waiting lists and the heavy load on the National Health Service, I have long advocated that insurance health premiums ought to be allowed against income tax. Private health insurance is a very large proportion of annual expenditure for those who opt for it, particularly if a wife and children are also involved. I am also particularly concerned about car parking charges at National Health Service hospitals, especially for lower-paid members of staff. In many cases it is almost unviable for them to go to work at all. Many patients attending accident and emergency departments have no idea how long they will be hospitalised and are often dismayed to find that they have been fined on returning to their vehicle. This must be terribly morally wrong. I intend to table an amendment that I hope the Government will feel is reasonable and, indeed, sensible. One has only to look at hospital car parks at weekends to realise how easy it is to park, compared to a weekday. Sadly, this must show how top-heavy the management of the National Health Service has become. I declare an interest as an ardent member of the Lords and Commons Pipe and Cigar Smokers’ Club. During the passage of the Health Bill in 2006, I tabled an amendment that would have prohibited the sale of all tobacco products. My views on smoking are well documented in Hansard. I believe strongly that Her Majesty’s Government are being incredibly hypocritical towards those who smoke. If we are not meant to smoke, we should not be able to buy tobacco in the first place. Her Majesty’s Government must make up their mind as to whether tobacco is a legal product. If it is legal, the sellers must surely be allowed to promote what they have to sell. Many noble Lords have mentioned smuggling. The figures that I have researched most carefully show that the amount lost to the Treasury as a result of smuggled tobacco is £3.8 billion. I repeat that figure: £3.8 billion. In these times of economic downturn, I cannot understand why every effort is not being made to correct this situation. Perhaps the Minister can explain what action is being taken, or what measures the Government are prepared to take, to recover this huge—I emphasise that—amount of lost revenue. Here, for once, I agree with the noble Lord, Lord Faulkner of Worcester. I now turn specifically to the tobacco provisions of Clauses 18 to 22. They do not, as other noble Lords have mentioned, have a rightful place in this Bill. The purpose of the Bill, so wisely and eloquently expressed by the Minister, is principally to legislate for aspects of the next-stage review of the National Health Service. The tobacco provisions are about the environment and conditions for the sale of tobacco products at retail level, from supermarkets to small shops. The provisions in this Bill that ban tobacco product displays are purely consumer protection measures, just as is the Tobacco Advertising and Promotion Act 2002, which these provisions amend. They should be elsewhere and should not have been injected inappropriately into this Bill. The noble Lord, Lord Stoddart of Swindon, made these points with his usual vigour. These proposals make no legal sense. Under the Bill, it will be an offence to display a product that it remains entirely legal to sell. As other noble Lords have said, this simply cannot make sense. One must not forget that it undermines the rights of commercial freedom under Article 10 of the European Convention on Human Rights and, indeed, is contrary to the principles of free movement of goods already enshrined in Article 28 of European Community treaty. The Department of Health claims that the purpose of the display ban is to reduce smoking among young people, and I fully support this commendable objective. However, the evidence that the department cites in support of a ban is weak, inconclusive and unconvincing. I am sure that the evidence can be well and closely scrutinised in Committee. I am at least as concerned about how the Department of Health, in its report on the consultation undertaken on its proposals, has played down and diminished the effect that its proposals are likely to have on small-scale retailers. Those retailers are typically small businesses serving a local community. They are invariably family businesses. They are certainly not familiar with responding to government consultations, particularly when those consultations are not produced in their mother tongue, as was the case in this instance. It must not be forgotten that 76 per cent of these small businesses are owned by people from Commonwealth countries. The Bill will saddle them with a whole new raft of regulations on display, on how to deal with and serve their smoker customers, on signage and on how they must indicate prices to their customers. For them, the one-off and continuing costs of complying with the regulations will be unreasonable and completely unjustified burdens, as the noble Lord, Lord Naseby, said. In the case of the smoke-free provisions of the Health Bill in 2006, the Department of Health predicted that there would be increased trading and profitability. The real impact, evident well before the current economic depression, was precisely the opposite, with businesses actually closing down. The last smoking ban has already claimed the jobs of 44,000 people in the pub industry. It is feared that, if these proposals become law, a further 59,000 jobs will be in jeopardy. I have no faith in the department’s predictions of the outcome of its display ban. I would rather put my faith in those small retailers; after all, they are at the coal-face of the retail industry. I have talked to many of them in recent days. They know why children smoke, even if the Department of Health does not; it has nothing whatever to do with displays of tobacco products in their shops. They are in the front line of denying access to tobacco products by the underaged. They should not now be burdened with regulations serving absolutely no necessary purpose. The noble Baroness, Lady Golding, made that point with her usual great clarity. Many communities in both urban and rural areas have already lost their local pub and their post office. Surely it is madness now, particularly in this economic climate, to strangle the small community shop with red tape. The Government claim that they support small businesses, while they are spending billons of pounds bailing out failed financial institutions and supporting major industries. I believe most strongly that they need to demonstrate their support for small businesses by removing this display ban completely from the Bill. I look forward to the Bill’s further stages.