The Secretary of State for Health, Stephen Dorrell, was warned by the National Audit Office (NAO) that the National Health Service was failing to meet three key targets which it set four years ago for reducing obesity, drinking among women, and smoking by 11- to 15-year-olds.
The Health of the Nation targets are a central plank in the Government's campaign for a healthier country, and the findings of the NAO will come as an embarrassment for ministers.
The report said that the Department of Health had set a target of reducing obesity among men by 25 per cent by 2005, but the number of overweight men had more than doubled to 12 per cent.
Women, however, appear to be worse at fighting the flab. The NAO found that obesity had nearly doubled to more than 15 per cent of the female population, in spite of the NHS target of reducing the percentage of fat women by one-third by 2005.
Perhaps more worrying for the Government is the continued rise in smoking amongschoolchildren, in spite of its attempts to cut the trend, including bans on tobacco advertising near schools.
The Government set a target of reducing smoking among 11- to 15-year- olds by one-third by 1994 after finding that 8 per cent of all children in that age group were smokers. But the NAO found that 8 per cent was probably the low point. It remained at 10 per cent before rising to 12 per cent. "This suggests that the actions taken or co-ordinated by the Department of Health to reduce smoking among children have not been successful," the report says.
Mr Dorrell yesterday rejected pressure to ban advertising of tobacco products. He denied that such a ban would help to stop young people smoking, and insisted that higher prices were more likely to stop young people taking up the habit.
However, the Government has come under fire from the Liberal Democrat health spokesman, Simon Hughes, for allowing one school to be sponsored by a tobacco company.
The report is likely to increase the pressure for more concerted action to reduce preventable illness. The NAO report on the Government's Health of the Nation targets, set in 1992, found that progress was being made in 11 areas, including strokes, breast cancer for 50- to 69-year-olds, suicide, lung cancer for men under 75, accidents, and gonorrhoea.
It was making some progress towards its targets in six other areas, including cigarette smoking among men and women, the consumption of saturated fats in food, and under-age pregnancies.
But there was too little information to make a judgement on the targets for blood pressure, cervical cancer, skin cancer and giving up smoking in pregnancy. There had been no change in lung cancer in women under 75, or in drinking among men. And there was insufficient useful data on mental illness leading to suicide, or on drug misusers sharing needles (a prevalent cause of Aids).
The NAO called on the Government to take further action where targets were not being met, and to improve the supply of data. But it did not offer any practical ideas on how Mr Dorrell could act to change people's lifestyles.
There are initiatives being planned to tackle obesity and teenage smoking, but as long as children regard smoking as fashionable, they are unlikely to take the warnings seriously. The anti-Aids campaign raised questions about the value of shock advertising on young people.
Virginia Bottomley, the former Secretary of State for Health, used to tell her officials: "Nanny knows best". But another former health minister, Edwina Currie, was accused of adopting a hectoring tone when she advised people about their dietary habits. Mr Dorrell, a thin man who drinks little, and who does not smoke, may be the right role model for the targets, but he has no plans to act as the nation's nanny.