20 October 2016
Article by Philippa Watkins, National Assembly for Wales Research Service
The previous Welsh Government introduced its Public Health (Wales) Bill in June 2015. The Bill set out a series of specific proposals in priority areas of public health policy. It aimed to create social conditions that are conducive to good health and where avoidable harms can be prevented.
The Welsh Government is expected to reintroduce the Public Health Bill in November. It has previously stated that this will be in the form of the previous Bill as amended at stage 3, but without the sections restricting the use of electronic cigarettes in enclosed public places.
The Bill included 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.
- Creating a mandatory licensing scheme to regulate 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.
- 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.
Key changes made at stage 2
Stage 2 was carried out in the Health and Social Care Committee in January and February 2016. A number of amendments were agreed. In addition, the then Minister for Health and Social Services, Mark Drakeford, indicated that the Welsh Government would bring forward, or consider, further amendments in a number of areas at stage 3.
Part 2 Tobacco and nicotine products
Treating tobacco and nicotine inhaling devices differently
In the Bill as introduced, the use of nicotine inhaling devices (NIDs) was placed under the same restriction in public places/workplaces as smoking tobacco cigarettes. The most significant change to this part of the Bill at stage 2 resulted from amendments which set out different approaches for tobacco and for NIDs in terms of restricting their use. This was in response to concerns that treating tobacco and NIDs in the same way could send out a message that they are equally harmful.
**As noted earlier, the provisions restricting the use of nicotine inhaling devices in enclosed public places will not now be brought forward**
Extending the restriction to other, non-enclosed areas
Opposition amendments to place a ban on smoking tobacco in non-enclosed children’s play areas, school grounds, and hospital grounds onto the face of the Bill were not agreed at stage 2. The Minister indicated that he would be willing to consider bringing forward Government amendments at stage 3.
Part 3 Special procedures
The list of special procedures (acupuncture, body piercing, electrolysis, tattooing) on the face of the Bill remained unchanged. Opposition amendments to add branding, scarification, sub-dermal implantation and tongue splitting to the list were not agreed at stage 2. The Minister stated that a greater exploration of the associated risks of harm was needed before considering adding them to the legislation.
The Minister did note an intention to consult early on the principle of adding more procedures to the list shortly after the Bill’s enactment, stating that the consultation will include the above procedures, and also others that were identified during the passage of the Bill so far, such as dermal rolling, colonic irrigation, and wet cupping.
Licensing criteria and conditions
Amendments were passed to add key licensing criteria to the face of the Bill. Applicants would be required to demonstrate knowledge of infection control and first aid in the context of the relevant special procedure. Applicants must also demonstrate knowledge of the duties imposed on them as a person authorised to perform a special procedure.
The mandatory licensing conditions (which control the conduct of practitioners who have received a license) were also amended to include conditions covering proof of age of an individual on whom a special procedure is to be performed, infection control, and first aid. The mandatory licensing conditions, specified in regulations, must also relate to intoxication, to prevent a licence holder from performing a special procedure on an individual who is, or who appears to be, intoxicated by virtue of drink, drugs or any other means.
Level of fine imposed
Amendments were passed to remove the limit on the fine associated with offences in relation to special procedures, amending it from a level 3 to an unlimited fine.
Part 4 Intimate piercing
The tongue was added to the list of intimate body parts listed on the face of the Bill in relation to intimate piercing restrictions, due to the associated risk of harm. This means it would be an offence to perform, or make arrangements to perform, a tongue piercing on a person who is under the age of 16 years.
Level of fine imposed
Amendments were passed to remove the limit on the fine associated with the offence of performing, or making arrangements to perform, an intimate piercing on a child from a level 4 to an unlimited fine.
Part 5 Pharmaceutical services
No amendments were agreed to this part of the Bill at stage 2.
Part 6 Provision of toilets
This part of the Bill was amended at stage 2 to require that Welsh Ministers must (rather than ‘may’) issue guidance to support local authorities when developing their local toilets strategies, and to set out in more detail what the guidance must include.
Additionally, the Bill was amended to require local authorities to prepare and publish interim progress statements (as recommended by the Health and Social Care Committee at stage 1). This was a new requirement, and was in addition to the duty on local authorities (in the Bill as introduced) to fully review their strategies no later than one year after the end of an electoral term.
Part 7 Miscellaneous – food hygiene rating offences
The Bill was amended at stage 2 to make a minor technical amendment to the Food Hygiene Rating (Wales) Act 2013 so that the receipts from fixed penalty notices for non-compliance with the food hygiene rating scheme must be used by food authorities (primarily local authorities) to enforce the scheme. This will bring the Food Hygiene Rating (Wales) Act into line with the provisions of the Public Health (Wales) Bill, under which receipts from fixed penalty notices issued under Chapters 1 and 2 of Part 1 must be used by enforcement authorities to support the new duties imposed on them in these chapters of the Bill.
Health impact assessment
During stage 2, the Welsh Government committed to bring forward a stage 3 amendment to include health impact assessment (HIA) on the face of the Bill. HIA is a process which considers the extent to which the health and well-being of a population may be affected, whether positively or negatively, by a proposed policy, plan or programme.
At stage 1, the Health and Social Care Committee heard from stakeholders that mandatory HIA would provide a mechanism to avoid or minimise negative impacts on the health and well-being of communities, and maximise health benefits where possible. The Committee’s stage 1 report recommended that the Bill be amended to include a requirement to undertake mandatory HIAs when developing certain policies or plans.
Opposition amendments in this area had been tabled at stage 2, but were not moved in light of the commitment given by the Minister.
Key changes made at stage 3
As indicated at stage 2, the Bill was amended at stage 3 by Welsh Government amendments introducing a requirement for public bodies to carry out health impact assessments. The circumstances in which health impact assessments must be undertaken would be specified in regulations.
Welsh Government amendments were agreed which set out additional, non-enclosed areas where smoking and use of nicotine inhaling devices would be restricted, namely school grounds, hospital grounds, and public playgrounds.
Key documents relating to the Bill, including Explanatory Memoranda, Committee reports, and transcripts of proceedings can be accessed via the Public Health (Wales) Bill web page