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This is a prescription for self-medication that few will be willing to swallow

Jeremy Laurance
Wednesday 17 November 2004 01:00 GMT
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One theme can be traced through the White Paper like the lettering through a stick of rock - that people do not want to be told what is good for them. They want to decide for themselves.

One theme can be traced through the White Paper like the lettering through a stick of rock - that people do not want to be told what is good for them. They want to decide for themselves.

The Government's role should be to help them by providing credible information and by helping to create the right environment. In doing so ministers envisage spending more than £1bnon public health over three years.

The lesson of history, however, is that when left to themselves consumers are slow to change their habits. The Wanless report, commissioned by the Treasury to examine health trends, noted in February that 30 years of efforts to transform the NHS from a national sickness service that treats disease to a national health service that focuses on prevention had achieved "little change on the ground". A "step change" was needed which required strong leadership to achieve a "fully engaged" population committed to health improvement.

"The Government has a major role in the process by providing the necessary framework for success. Activity is needed on a wide front to help individuals to take responsibility," Sir Derek Wanless said.

John Reid insisted yesterday that it was "the public, not Whitehall, who have for the first time set the agenda" during the eight-month consultation on the White Paper. But the result is a compromise that tries to please everyone and ends up pleasing no one. Tim Lang, a professor of food policy at City University, London, said: "The culture of choice and information on which the White Paper seems to rely will not change, cannot change and never has changed entrenched powerful interests like the hugely powerful food sectors."

In the six priority areas targeted for action - smoking, obesity, exercise, drinking, sex, and mental health - the emphasis is on raising awareness, and voluntary moves designed to help people improve their lifestyles by eating healthily, taking up cycling, drinking less and using condoms. There are two exceptions - children, and activities that threaten the health of others, such as smoking - where compulsion is justified.

Mr Reid told the Commons yesterday: "Parents know their children's health is primarily their responsibility but they told us that government, business and anyone who has an influence also shares that responsibility to protect children from premature exposure to a world of adult choices. Parents want the security of knowing that will be done."

The average child watches 17 hours of television a week and more watch between 6pm and 9pm than at any other time. The food industry is to be given three years to agree voluntary curbs with the broadcasting regulator, Ofcom, on junk food advertising before the 9pm watershed. Other forms of advertising, through vending machines in schools and packaging, will be restricted to prevent advertisers switching from one medium to another.

To help consumers choose healthier foods, a "simple code" will be developed in consultation with the food industry to indicate fat, sugar and salt content. This could mean introducing a traffic-light system to distinguish between healthy and unhealthy foods.

A voucher scheme to provide fruit and vegetables to eligible pregnant women, breastfeeding mothers and young children in low-income families will begin next year, eventually covering 800,000 families. A campaign to tackle binge-drinking will include better labelling of bottles so consumers know how much they are drinking, combined with restrictions on advertising.

Increasing exercise for children in schools will be backed by more than £1bn invested up to 2006 to boost PE and school sports.

The White Paper also sets out efforts to improve adults' health, including providing people with "NHS health trainers" to give motivation to change diet or give up smoking, starting in deprived areas in 2006.

A campaign targeting sexual diseases and unplanned pregnancies will start and the chlamydia screening programme will cover England by 2007. By 2008, sexually transmitted disease clinics will see patients within 48 hours.

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