A complete ban on smoking in all enclosed public places is likely to be introduced in England, Patricia Hewitt, the Secretary of State for Health, has said.
In the strongest indication yet that the Government is moving towards an outright ban, Ms Hewitt told the British Medical Association yesterday it depended on the weight of public opinion.
Speaking to the Association's annual meeting in Manchester, she was briefly jeered for sticking to the Government's proposal for a partial ban, which would exempt pubs that do not serve food and is currently out for consultation. But she made it plain that a move to a total ban could happen quickly.
John Garner, a GP in Edinburgh, asked Ms Hewitt when England would follow Scotland and the Irish Republic in introducing a total ban in all enclosed areas. She said: "I know [a partial ban] is not popular with the medical profession. I also know that certain groups feel quite strongly if they do choose to have a cigarette with a pint they should be free to do so." "My sense is that as this [the partial ban] gets put in place and as public attitudes continue to strengthen it is probably only a matter of time before we end up in the same position as Ireland and Scotland." Ireland banned smoking in all public places last year and the Scottish Parliament is voting on a similar law tomorrow.
As the first Health Secretary to attend the Association's annual conference, where doctors traditionally tear government policy apart, Ms Hewitt said she felt like Daniel entering the lion's den. A few representatives growled "rubbish" and "not good enough" as she explained how staff in pubs where smoking was allowed would be protected by an "exclusion zone" round the bar. But the majority warmly applauded her relaxed performance in which she alluded to her Australian parentage and invited representatives to address her as Patricia.
Speaking later, James Johnson, the chairman of the BMA said: "A total ban is on the cards. Patricia Hewitt is a member of the Cabinet and a cabinet minister can't stand up and say the set of proposals the Government has just gone out to consultation on is rubbish. I think [what she said] is about as strong a hint as you can get from a cabinet minister." Ms Hewitt offered doctors two further olive branches. She announced a relaxation of the rules banning NHS consultants from working for independent treatment centres offering fast-track surgery and lifted the threat of widespread hospital closures in the NHS market.
The ban on consultants was introduced to prevent poaching of NHS surgeons by treatment centres offering salaries more than three times the NHS rate. Consultants who have fulfilled their NHS contract will be able to moonlight for the centres in their own time, or take a full-time job unless they are in shortage NHS specialties such as radiology.
Ms Hewitt said hospitals that failed to attract sufficient patients in the NHS market would be dealt with by replacing their leadership or changing their services. "We will not close the hospital because it is not performing ... That would be crazy."
Jennie Blackwell, 27, a junior doctor from the North-west, accused Ms Hewitt of shifting bottlenecks within the NHS by imposing the four-hour waiting time target in accident and emergency. She said patients were moved from A&E to a holding ward for monitoring where patients could wait for up to 10 hours.Reuse content