The Government can no longer be a passive bystander in the fight against this epidemic

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The Independent Online

The State should not dictate to people how to live their lives. Citizens should be free to decide what they eat and drink, whether they smoke and, indeed, their sexual activities. These are matters of personal freedom and taste, so long as any choices made are not in breach of sensible legislation. Additionally, as we have seen all too often in history, blanket bans are not, as a rule, an effective method of either deterrence or encouraging people to behave in a more responsible manner.

The State should not dictate to people how to live their lives. Citizens should be free to decide what they eat and drink, whether they smoke and, indeed, their sexual activities. These are matters of personal freedom and taste, so long as any choices made are not in breach of sensible legislation. Additionally, as we have seen all too often in history, blanket bans are not, as a rule, an effective method of either deterrence or encouraging people to behave in a more responsible manner.

But even the most die-hard liberal has to recognise that governance carries with it protective responsibilities. And the scale of the crisis facing the public health system from the surge in obesity and smoking-related illnesses should force even the most libertarian among us to accept that the Government can no longer be a passive bystander.

Anyone who thinks the problems are exaggerated need only turn to the Wanless report into the future of the NHS published earlier this year. The service is at risk of collapsing under the burden of chronic disease, it warned, with more than 17 million people requiring long-term care from chronic conditions, and that number is projected to rise dramatically. Wanless identified the main threats to our health as smoking and obesity. Over the next 20 years, the former would have to be halved and the latter tackled, if the epidemic of diseases including heart and lung disease, diabetes and cancer, is not to bankrupt the health system, the report warned.

This is the stark backdrop to the reforms outlined by the Health Secretary, John Reid, in his white paper yesterday. And this is why he has proposed to ban smoking in public places, including restaurants and pubs that serve food, by the end of 2008. Mr Reid has gone further than many expected, but only as far he should. He was wise to stop short of an Irish-style total ban, leaving it open to establishments that sell no food beyond crisps or peanuts to continue to allow smoking. In effect, this gives businesses the freedom to decide whether or not to permit smoking - and allows smokers somewhere they can still socialise. Notwithstanding the inevitable disputes over whether sandwiches in plastic wrapping constitute prepared food, this means that all restaurants and 80 per cent of bars and public houses will be smoke-free within a few years.

The white paper's offensive on obesity contains similarly sensible steps such as easy-to-read nutritional guidance on food packets. It also contains the only other measure besides the smoking curbs which involves compulsion, and in this Mr Reid has been too much of a nanny. To impose voluntary restrictions on television advertising of junk foods before 9pm, with a legislative ban to follow by 2007 if the voluntary approach is not working, is misguided. Mr Reid aims to protect children. However, the problem, unlike with smoking, is not that the food is inherently dangerous if eaten sensibly, rather that it needs to be ingested in restricted amounts. Likewise, the idea of preventing soap operas from portraying people smoking is populist nonsense.

If we are to tackle the fat nation syndrome, it is vital to encourage people to take more exercise. Ultimately, the only way people can slim down is, after all, to consume fewer calories or burn off more of them. So while the white paper's emphasis on healthier meals and free fruit in schools is worthwhile, placing sport and physical education at the centre of the school curriculum is crucial. And although there are indications that the Government has belatedly recognised this, it is impossible unless schools have more playing fields and sports facilities. The proposal to make a personal health adviser available on the NHS to the obese is, on the other hand, a practical initiative that should be extended to everyone.

Mr Reid has sought to balance the demands of the medical establishment for intervention and compulsion against the political dangers of too much intervention. To a large degree, he has succeeded. But this is just the first step on the path to a healthier nation.

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