Smoking row delays health reform plans

Government plans to revamp public health care have been delayed because of a ministerial row over a public smoking ban.

The public health White Paper had been due for publication next week.

But it has now suffered fresh delays after Health Secretary John Reid came under strong pressure from other ministers to introduce a ban.

Several drafts of the flagship document have been drawn up, but sources said there were a series of "last-minute arguments" over the nature of any ban on smoking in public places. Ministers are said to be "remarkably conspiratorial" about the paper as drafts go backwards and forwards across Whitehall.

These mostly involved minor changes to the language in a bid to find a compromise.

The document has hit a second problem as next week the devolved Scottish administration is poised to announce a blanket ban on smoking in public.

Spin doctors are understood to have advised ministers to avoid the White Paper coming out at the same time, and it appears to be less radical than the Scottish plan.

The White Paper is expected to focus on the "individual's responsibility for their own health".

Its key theme will be a call for the NHS to become a "national service for health" instead of treating only those who are ill.

The focus will be to turn towards "prevention of illness" and central to the paper is the idea of a personal health plan, in which doctors would give advice on staying healthy.

Health MOTs, as they have already been dubbed, have been widely denounced as gimmicks and GPs are concerned it will only add to their workload. To counter accusations of nanny state-ism, the plans are to be voluntary.

The White Paper was drawn up after a report by Sir Derek Wanless warned the rise in "lifestyle" diseases such as cancer, heart disease and some forms of diabetes will place a huge financial burden on the NHS in the future.

He said the public should become "fully engaged" in their own health.

This week the British Medical Association set its own " prescription for public health". Dr Vivienne Nathanson, head of Science and Ethics at the BMA, said: "Obesity, sexually transmitted infections, alcohol abuse and smoking-related illness are all soaring.

"The Government must act now to turn around the UK's declining standards of health and safeguard the wellbeing of future generations."

Anna Coote, of health think tank the King's Fund, said there must be a recognition that the NHS cannot act alone in improving public health, and many other organisations would have to participate.

She said: "I hope it will have a really sensitive balance between things it is going to ban and things that help people make healthy choices.

"I would love to see a total smoking ban in public places. As it has been such as success in Ireland and New York, we would be crazy not to do it here."

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