Article by Philippa Watkins, National Assembly for Wales Research Service
Today, 8 June 2015, the Welsh Government introduces its Public Health (Wales) Bill. The Bill sets out a series of specific proposals in priority areas of public health policy. It aims to create social conditions that are conducive to good health and where avoidable harms can be prevented. According to the Explanatory Memorandum, the Bill’s preventative approach reflects prudent healthcare principles
by seeking to intervene at points with significant potential for long-term benefits, both for the health of individuals and in avoiding the longer term burdens caused by avoidable ill health.
What does the Bill do? The Bill includes provision for the following: Tobacco and nicotine products
- Restricting the use of nicotine inhaling devices such as electronic cigarettes in enclosed and substantially enclosed public and work places, bringing the use of these devices into line with existing provisions on smoking.
- Creating a national register of retailers of tobacco and nicotine products.
- Adding to the offences which contribute to a Restricted Premises Order (RPO). (An RPO prohibits the sale of tobacco products from a premises).
- Prohibiting the handing over of tobacco or nicotine products to people under the age of 18.
Special procedures
- Creating a mandatory licensing scheme for practitioners and businesses carrying out ’special procedures’, namely acupuncture, body piercing, electrolysis and tattooing.
- Introducing a ban on the intimate piercing of people under 16 years old.
Pharmaceutical services
- Changing the way Health Boards make decisions about pharmaceutical services by making sure these are based on assessments of pharmaceutical need in their areas.
Provision of toilets
- Requiring local authorities to prepare local toilets strategies for the provision of, and access to, toilets for public use, based on the needs of their communities.
What the Bill doesn’t include Minimum unit pricing for alcohol, one of the more contentious proposals in the earlier White Paper consultation, is not included in the Public Health Bill. On 28 April 2015 the First Minister told the Assembly:
Whilst we believe that minimum unit alcohol pricing is a key public health measure, after careful consideration, we’ll not include a provision in the Public Health Bill whilst there is still some uncertainty about the timing of the European judgment on Scotland’s Alcohol (Minimum Pricing) (Scotland) Act 2012, but we do intend to publish a draft Bill relating to the minimum price of alcohol for public consultation in due course.
The lack of actions to tackle obesity was highlighted as a concern by some stakeholders responding to the White Paper. Proposals in this area were limited to setting nutritional standards for specified settings, namely pre-school and care home settings. The Royal College of Physicians commented:
we are very disappointed to see that this is the extent of the Welsh Government commitment in this white paper on measures to tackle obesity and physical inactivity in Wales.
The Welsh Government intends that the proposal to introduce nutritional standards will build on the work previously undertaken in schools and hospitals and will be achieved through secondary legislation and/or guidance. The Public Health Bill itself is therefore silent on tackling obesity and physical inactivity. The Welsh Government has stated that it continues to consider a range of actions to tackle obesity in Wales, ‘the majority of which do not require primary legislation or could be considered using existing legislative powers’. Consultation The Public Health Bill was introduced following an extensive period of consultation. In 2012/13 a Green Paper sought views on whether a public health bill was needed in Wales, and the potential role of legislation in driving improvements in population health. There was particular support for the suggestion that health issues should be considered in all policy development. On publishing a White Paper for consultation (spring 2014), the Welsh Government stated that this ‘health in all policies’ approach would be taken forward through the Well-being of Future Generations Bill, and that a Public Health Bill would focus on a set of practical actions in discrete areas of public health policy. Responding to the White Paper, some stakeholders expressed disappointment at how limited the proposals for the Public Health Bill were, describing a loss of aspiration and a ‘significant step backwards from the more innovative high-level proposals contained in the preceding Green Paper’. The Welsh Government has continued to emphasise that the Public Health Bill will focus on specific areas where legislation is an appropriate lever, and that this Bill will be complementary to the overarching approach taken forward in the Future Generations legislation. Whether the Well-being of Future Generations Act will satisfy the concerns of stakeholders may be open to question. The health sector have been critical that this legislation is nowhere near explicit enough in pushing the health agenda. Public Health Wales stated:
The [Future Generations] Bill has been drafted in a manner which fails to include health in the common aim and health in all policies is merely implicit. This means that there is every chance that despite two potentially impactful pieces of legislation that could set public health in Wales on a trajectory to be envied on the international stage, Wales could be left with no notable levers to make the strategic, large scale changes that are needed to address public health challenges.
The Public Health (Wales) Bill is expected to be referred to the Health and Social Care Committee for Stage 1 consideration of the general principles of the Bill. Further articles on each of the Public Health Bill’s proposals will be published as part of a series throughout the week.
