Public health
The government's has published its white paper on public health, calling for a ban on smoking and also covering issues including obesity, drinking and sexual and mental health.
Government Response: Department of Health
John Reid, health secretary, said: "It is clear we need to do more as a society to improve people's health. Having defeated many deadly infectious diseases, we now face the challenge of avoidable ill-health caused by poor diet, lack of exercise and smoking.
"These are challenges for all of us to address in our lifestyles - making our own choices about what to eat, how often to exercise and whether we smoke, drink too much, take drugs or engage in risky sexual activity.
"People make their own choices about health, but they have made plain in our consultation that they want the information, advice and support in making their own choices so, we need to ensure that people have the information they require to make properly informed choices; and that they are presented with genuine opportunities and the practical support to make healthy choices.
"We have listened to the public about what they want and looked hard at the evidence of what is effective. There is a role for everyone in this - individuals, communities, employers, parents, schools, the hospitality, food and leisure industries, and of course the NHS and local government.
"This government's role is to help ensure society moves in the right direction - by providing clear information for individuals, working with industry to deliver real progress and where necessary taking decisive action to ensure healthy choices are available to all."
Party Response: Liberal Democrats
Paul Burstow MP, Liberal Democrat health spokesman said: "If the Health Secretary admits that passive smoking kills and that there is no safe level of smoke, then there can not be any exceptions for a ban on smoking in enclosed public places. Dr Reid must understand that smoking still kills even when you are not eating food.
"Research makes it clear that ventilation systems cannot guarantee a safe working environment. The government seems content to put bar staff in harms way.
"Taken as a whole, this White Paper can be summed up as a policy of hesitation and more consultation.
"The government has dithered and delayed for seven years. To consult on a voluntary code of labelling and advertising fails to give consumers the information they need to make healthy choices.
"Simply tackling individual lifestyles ignores many fundamental causes of ill-health. The White Paper was silent on issues of poverty, poor housing and poor environment. We still do not have a Department for Health focused on getting the government to improve the health of the nation."
Party Response: Conservative
Andrew Lansley shadow health secretary said: "Four months ago, the Secretary of State said smoking was one of life's small pleasures. Today he wants to ban it in public places.
"Five years ago, in their White Paper the government said, 'We do not believe in the old
"Does he not realise that in the time taken to implement legislation, the industry could and would deliver a voluntary code, removing smoking from up to 80 per cent of pub space? I am confident that we could additionally expect them to achieve a smoke-free environment wherever children have access.
"The government's approach simply risks delaying progress and sending smokers home to expose families and children to more second-hand smoke. Conservatives believe that a self-regulation solution agreed with the industry is the best way to tackle smoking in public places."
Jim Thomson, CEO at the Depression
"Depression
"We do not undermine the gravity of smoking, binge drinking and obesity. However, these are highly visible health issues. The same cannot be said of the silent killers making their way to our shores in the guise of prescription medicines, and those charged with regulating medicines, and supplying them, would do well to wake up to the danger."
Stakeholder Response: Royal College of Physicians
Professor Carol Black, president of the Royal College of Physicians, said: "This white paper contains many welcome initiatives but is marred by missed opportunities in two key areas.
"We broadly welcome its recommendations and proposals on addressing health inequalities, sexual health and obesity that build on much of the work of the College with its partners. However it does not go far enough in tackling the two biggest causes of premature death in this country - smoking and alcohol misuse. We are disappointed that it fails to put in place a total ban on smoking in all public places and workplaces, or adequately address the issue of problem drinking.
"We will continue to work with government on implementing its proposals and improving the health of the public, while pressing the case for its recommendations to be strengthened.
"The College is committed to developing and supporting the training of health professionals in all aspects of the prevention of ill health."
On smoking, Professor
"We welcome the commitment to review nicotine regulation and will fully support initiatives in this area to make safe forms of nicotine available to smokers."
On alcohol, Professor Ian Gilmore, RCP registrar and chairman of the alcohol committee, said: "We are disappointed that alcohol has such a low profile in the white paper and that it fails to build on the government's alcohol harm reduction strategy. We do not feel that the Ofcom regulations have been strengthened enough and we are surprised that the government continues to talk about pilot interventions when the evidence base already exists for their implementation. However, mention of new monies for tackling alcohol problems from 2006 is welcome."
On obesity, Professor
"We welcome the promotion of healthier eating and increased physical activity but are disappointed that no clearer timetable is suggested for this initiative. The messages in the white paper are right but the proof will be in the delivery. Although partnerships are suggested between the food industry, advertisers and the government to develop food labelling and advertising policies, there has already been a significant amount of consultation over these issues - what we need now is action."
Stakeholder Response: Stroke Association
A spokesman for the Stroke Association said: "It is vital that the public is given greater choice and access to information and initiatives to enable them to make informed decisions on healthy lifestyles that could help reduce their risk of stroke and associated conditions. It is estimated that about 40 per cent of strokes could be prevented by regular blood pressure checks, treatment for hypertension and taking steps to improve overall health . The Stroke Association therefore welcomes any initiatives that would empower the public to make constructive changes to their lifestyles.
"Whilst today's white paper addresses such issues, there are also a number of key points that the government also needs to introduce. These are detailed below, and were submitted as evidence by the Stroke Association as part of the public consultation process for this paper.
"Smoking; there must be a complete ban of smoking in all public spaces - the only way to effectively reduce the health risks associated with smoking.
"Food advertising; restrictions in junk food advertising should be mandatory rather than voluntary. There should also be frameworks in place to facilitate the mandatory regulation of so-called 'lite' or 'full of goodness' products, and to prevent the promotion of junk and other unhealthy foods through other means aside from television advertising such as sponsorship.
"Labelling; regulations should be in place to ensure consistent and clear labelling of food products. They should also include information on 'hidden' ingredients such as salt and sugar. The Stroke Association has recently successfully worked with the Food Standards Agency to raise awareness of health risks associated with excessive salt intake. We would welcome the opportunity to build on this partnership to help achieve this goal.
"Lifestyle; whilst the introduction of Health Direct is a step forward in providing advice and information on lifestyle, the government must ensure that all communities are reached by addressing the practical issues and misconceptions concerning healthy lifestyles. Many people may feel unable to make changes to their diet or undertake exercise regimes for reasons of cost, time or lifestyle. Perhaps they feel they do not have the time to prepare freshly made meals or find it difficult to go to local sports facilities for reasons of accessibility or cost. Practical advice and information needs to be in place to address these matters. This particularly is the case for those who have been especially difficult to reach in the past, such as those from low socio-economic backgrounds, ethnic minorities and people with disabilities. The Stroke Association welcomes the breadth of initiatives that the government has outlined to facilitate this, and look forward to their effective implementation to help those who would most benefit from such help, advice and support and tackle the health inequalities that currently exist.
"However, there are many other barriers to exercise and healthy living that are environmental and go beyond the scope of the Department of Health and the National Health Service. This includes greater accessibility and the creation of more open spaces, improved cycleway access and improved transport from cities to rural areas.
"The government needs to work in partnership with other organisations to ensure that these positive changes to public health are implemented effectively and target those who would most benefit from such measures. This should involve national and local government, GP surgeries, primary care trusts and community and patient groups.
Dame Deirdre Hutton, NCC chairwoman, said: "We are delighted that the idea of simple, at-a-glance, health-coded food labels is high on the government's agenda. A 'traffic light' system is an example of such a scheme, and the one NCC thinks is the best way to help today's busy consumers choose a healthy diet. But the key is to ask consumers what approach helps them most.
"To work effectively, the new labelling system will need to be applied consistently across all packaged and processed food. Existing information on food labels often confuses and misleads people, and does little to help them choose a healthy diet.
"Controls on junk food promotion to children are long overdue. On current trends more than half our children will be obese by 2020. So we are delighted that the government plans to limit children's exposure to all forms of junk food advertising, marketing and sponsorship, including through vending machines and packaging. This is a bold and welcome move.
"The tough new controls proposed for TV commercials for foods high in salt, sugar and fat during children's programmes and at other times when they are watching follow NCC's own recommendations to Ofcom earlier this year.
"Together with clear deadlines for implementation, these measures add up to an important first step in helping to de-fuse the nation's obesity time bomb. NCC will be lobbying hard over the coming months to ensure the government’s plans achieve their goal of making healthier lifestyles choices easier for everyone."
Stakeholder Response: Which?
Michelle Smyth, senior public affairs officer at Which?, said: "The white paper has at last laid down a foundation for action needed by government and industry. However, the 'food and health action plan' due in the new year will be the proof of the pudding.Without clear actions and timelines the government cannot hope to get commitment from the industry for change.
"Which? is pleased to see a government commitment to introducing a clear signposting system on foods. At last people will be able to see at a glance how healthy the food is.
"While the government's proposals on advertising of foods to kids, are welcome, it is disappointing to see that this important area has been subjected to yet another game of pass the parcel with responsibility for a decision now being passed to Ofcom."
Stakeholder Response: Health Development Agency
Dame Yve Buckland, chair of the Health Development Agency, said: "Overall, this comprehensive white paper contains a good balance of upstream proposals including a focus on health inequalities and vulnerable people, and highlighting the vital role of local government in helping to improve people’s opportunities to make healthy choices.
"In particular, the HDA welcomes the additional funding for the new National Institute of Health and Clinical Excellence, which will encompass and continue the success of the HDA’s work on evidence-based public health. We are very pleased that the achievements of the National Healthy Schools Programme, which is managed by the Health Development Agency, have been recognised, and that the Programme is to be extended. Also notable is the commitment to supporting certification programmes to ensure there is a specialist PHSE* teacher and nurse in each school.
"We welcome the investment in both public health infrastructure over the next three years and in skills at PCT level, and also the focus on implementation, which our regional offices are well placed to support.
"Prevention is better than cure – and tackling smoking is a perfect example. The ban on smoking in the NHS is welcome news; a move which the Health Development Agency has advocated. Whilst the general measures outlined are welcome, the absence of a total ban on smoking in all pubs and clubs is a missed opportunity.
"Nightclubs are likely to fall within the “10 - 30 per cent” of licensed premises not serving food that are exempt. Their customers are mostly in the 16-34 age group, which as pointed out in the HDA’s new Smoking Epidemic report, has the highest level of smoking prevalence at 36 per cent. The HDA report recommends that initiatives focussing on younger adults are important to reduce smoking-attributable deaths –this exemption will do nothing to de-normalise smoking in this age group.
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"However, it will be a real shame if indecisiveness on smoking overshadows the positive actions outlined in the rest of this landmark paper."
Stakeholder Response: World Cancer Research Fund
“We’re now seeing the results of that experiment - fatter, unhealthier children with a greater chance of developing serious chronic diseases in adulthood. This problem may also be linked to reduced physical activity, but commonsense tells us it’s time to cut the advertising to our kids as a start and show them that we’re concerned for their health. It’s a message to the food industry too that says we’re not prepared to let them dictate what our children eat. We’re delighted the White Paper appears to be tackling this important issue.
"However, it’s a pity this robust approach has not been taken with regard to smoking in pubs and restaurants. We strongly recommend that people avoid using tobacco and should be free to live and work in a smoke-free environment. It's time to get real on smoking so we are in favour of a ban on smoking in all work places, including pubs and bars.
"Smoking is bad for you, full stop. A ban on smoking in public bars and restaurants also sends a very clear signal to young people that smoking is harmful. It also provides a very positive environment in which to educate the young about the value of a healthy lifestyle, including eating plenty of fruit and vegetables and taking regular physical activity. These messages get lost when youngsters look around them and see that smoking - a major cause of cancer and other serious diseases - is effectively condoned. How does that help young people today make sensible decisions about other aspects of their health?
"We are pleased to see steps being taken to improve food labelling. A traffic light system will help but the government needs to look closely at the way so-called ‘healthier foods’ are marketed to consumers so that there is no confusion about the levels of fat and sugars they’re eating.
"There is still a huge mountain to climb in terms of curbing the escalating number of obesity cases in
"This growth in obesity cases will only increase the risk of developing cancer for many, and if numbers continue to rise, the long-term impact on cancer rates in the
"Studies have shown that we can reduce our risk of developing cancer by up to 40 per cent by making simple lifestyle changes such as eating more plant-based foods such as fruit and vegetables, taking regular exercise and watching our weight.
"The government needs to introduce much stronger measures to get the message across to people that by being overweight, unfit and unhealthy they are putting themselves at risk of many diseases including diabetes and heart disease, but also cancer, which I’m afraid to say few people realise. We need to encourage people to a healthier lifestyle."
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