Reid treads carefully on 'nannying' by the NHS

A white paper on public health billed as the best chance in a generation to turn the NHS from a "sickness" service to a health service will be published today. It will set out the Government's plans for tackling the growing threats to health from rising rates of obesity, drinking and sexually transmitted infections as well as tackling the single biggest cause of ill health - smoking.

A white paper on public health billed as the best chance in a generation to turn the NHS from a "sickness" service to a health service will be published today. It will set out the Government's plans for tackling the growing threats to health from rising rates of obesity, drinking and sexually transmitted infections as well as tackling the single biggest cause of ill health - smoking.

But doctors and campaigners look certain to be disappointed by ministers' decision to avoid legislative intervention and emphasise the responsibility of individuals to look after their own health, backed by better information and voluntary curbs on commercial organisations.

The Secretary of State for Health, John Reid, is opposed to telling people how to live their lives and ministers believe any hint of nannying in the White Paper would be a vote loser.

But there are urgent social and economic reasons for switching emphasis from treating illness to preventing ill health. Sir Derek Wanless, the former NatWest chairman commissioned by the Chancellor, Gordon Brown, to examine future demands on the NHS, reported in February this year that the burden of chronic disease was growing and threatened to overwhelm the service.

More than 17 million people in Britain have chronic health problems requiring long-term care and preventing that number growing has become the political priority.

The Wanless report said smoking rates must be halved during the next 20 years and the problems of obesity and health inequalities tackled now if the main threats to our future health were to be averted. The prize would be a £30bn a year saving on the annual cost of the NHS in 20 years' time. "Individuals are primarily responsible for their own health and their families' health but the Government has a major role in the process by providing the necessary framework for success," the report said. "Activity is needed on a wide front to help individuals to take responsibility."

Mr Reid is determined to avoid charges of nannying people and instead help people to lead healthier lives by providing them with the information to make healthier choices.

He is expected to call for voluntary curbs on television adverts for junk food before 9pm, when children are watching, backed by the threat of an outright ban if food companies do not comply. There will be new measures to help consumers identify foods high in fat, sugar and salt, possibly based on a traffic-light labelling system.

A health MOT will be offered to patients and a personal health plan drawn up with health advisers appointed in deprived communities to offer help with changing diet or improving fitness. Employers will be urged to help people change their lifestyles and assist the return to work of the long-term sick, to avoid the development of chronic problems. Measures to combat binge drinking, improve sexual health and reduce obesity will be included.

But ministers look certain to come under fire for failing to impose a ban on smoking in public places. A spokesman for the British Beer and Licensing Association said it believed it had secured agreement from ministers for a voluntary arrangement under which smoking would be banned from eating areas in pubs and restaurants within 12 months and extended to bar areas in three years. Within four years smoking would be restricted to designated rooms.