My Lords, in the debate on the Queen's Speech, we are often called upon to display considerable feats of ingenuity in pulling together the threads of what is always a wide-ranging debate. The point raised by the noble Lord, Lord Colwyn, about the licensing of musicians takes the debate even wider.
I enjoyed the reminiscences of the noble Lord, Lord Fowler, about the glory days of the old DHSS, although I thought that his reference to a comment that I made rather a long time ago was a bit below the belt. Later, I shall demonstrate—to my satisfaction, at least—that there is a coherent line between what I said then and what I say tonight. None the less, I agree with the implication of what he said: however we cut the cake in Whitehall, we must always work across departmental boundaries. There are strong links between ill health and the other problems that we face, such as unemployment, poor housing, poor educational achievement or, as the noble Baroness, Lady Carnegy of Lour, mentioned, the insecurity faced by so many young people. We will always have to work together throughout Whitehall to sort out such problems.
The issue for health, in the wider sense, is the irony that, although today we are healthier and more prosperous and live longer, the health gap between the most disadvantaged in our society and the rest is very wide. At birth, men in Manchester can expect to live nearly 10 years less than their counterparts in north Dorset; women in Manchester can expect to live nearly seven years less than women in west Somerset. That is why we must have a radical programme to tackle health inequalities. I say to the noble Lord, Lord Chan, that that is why we have made the reduction of such inequalities a key criterion for the allocation of NHS resources to different parts of the country. It is why we must do everything that we can to encourage healthier lifestyles, improve diet and physical activity and tackle drug and alcohol misuse.
I believe that we can see encouraging progress. There has been a reduction in teenage pregnancies among the under-16s and under-18s. On sexual health more generally, I agree with the noble Lord, Lord Fowler, that we cannot be complacent. I share his view that a focus on public health promotion is essential, and that is what we seek to have. I pay tribute to the noble Lord's leadership, in his time as Secretary of State, over the issue of AIDS.
It is not just a matter of sexual health. We must ensure that there is a healthy start to life, through action to reduce infant mortality. The Sure Start programme, targeted at disadvantaged children and their families, has much to offer. We must do more to help people to improve their diet. I am glad to report that, from this autumn, nearly 600,000 children will receive a free piece of fruit every day in school. Physical activity is equally important, and I pay tribute to my noble friend Lady Pitkeathley for the work of the New Opportunities Fund in sponsoring healthy living centres and for the new programme to encourage physical exercise. I do not believe that one can overestimate the importance of that. We shall do everything that we can to encourage the NHS to support schools in that important programme.
Smoking is equally important. The smoking cessation services that we have launched are showing great signs of success. I thank my noble friend Lord Faulkner for his generosity in relation to the Tobacco Advertising and Promotion Act. I pay tribute to the noble Lord, Lord Clement-Jones, for his initiative in bringing it forward, and no doubt the noble Earl, Lord Howe, would want to thank the noble Lord, Lord Faulkner, for his kind remarks on that matter.
As far as the implementation of the Act is concerned, we have announced that the commencement date for most of the Act's provisions will be February 2003. We have power to make regulations allowing sponsorship agreements to continue in certain circumstances until 2006. We intend to make those regulations in the near future and are currently consulting on them.
As regards the approved code of practice on smoking in the workplace, the Government are giving careful consideration to the commission's proposals. As part of that process the Health and Safety Commission has been asked to consider further both the implications of the code of practice on the hospitality sector and the role the public places charter can play.
I agree with my noble friends concerning the common agricultural policy and we would certainly, as a country, like to see tobacco subsidies phased out. We are working closely with the European Commission. I assure my noble friend that we take up that issue as every opportunity arises.
Sticking with the public health arena, I would like to say to the noble Earl, Lord Baldwin, that I welcome him back to our debates on fluoridation. I want to confirm the assurance that he has been given by the Chief Medical Officer that we shall not use the Medical Research Council report to discredit the York report. I am happy to write to him on the further matters that he raised in our debate today. I consider dentistry an important component of public health. The noble Lord, Lord Colwyn, will know that we are working very hard with the BDA and the profession to find a way to get ourselves through the treadmill impact and have the right incentives to encourage dentists to work under the NHS dental contract. The noble Lord will know that I have a great deal of respect for the dentistry profession and I am as committed as the Government are to finding a way through.
The noble Lord, Lord Chan, emphasised the key role of primary care trusts in relation to public health and the important role that they have to play. I agree with that. That is why we were determined to place public health at the primary care trust level. I believe that the noble Lord has shown the potential of primary care trusts to take those public health programmes forward. Certainly, I believe that they have an important contribution to make to our overriding commitment to break the cycle in which previous generations have condemned children to a lifetime of ill health, merely because of where they lived or what their parents did for a living.
That is why it has been so important to reduce unemployment, and to make good progress towards our target of reducing the number of children in low income households by a quarter by 2004, as the first step on the road to eradicating child poverty within a generation. I agree with the noble Baroness, Lady Barker, that the funding of old age is just as important in that context.
That brings me to the question of pensions. My noble friend Lady Hollis dealt with a number of the issues that have been raised. It is clear that the Green Paper will be of great importance. I hope that when it is published it will commend itself to the noble Lord, Lord Higgins. As a former member of an Equitable Life AVC scheme I have a particular interest in a number of the matters raised by noble Lords tonight.
I hope that the noble Lord, Lord Higgins, will forgive me for not being drawn on the questions he raised in relation to the Penrose inquiry. I believe that we need to wait for that inquiry to report and the timetable is very much a matter for Lord Penrose.