Health targets ignore cigarette advertising

THE GOVERNMENT'S strategy for health, aiming to cut deaths from heart disease, strokes, cancer and suicides was launched to a broad welcome from Opposition MPs and health experts.

The prevention strategy - which includes targets to cut smoking by a third, reduce teenage pregnancies, and improve sexual and mental health - was dubbed 'a new landmark in the development of the NHS' by Virginia Bottomley, Secretary of State for Health.

For the first time it sets government targets for the reduction of death and disease, providing monitoring systems to check the targets are being met and promising a national survey of mental health.

But the strategy came under sustained fire for failing to ban tobacco advertising when smoking is the biggest cause of ill health, and for providing only the most limited acknowledgment of the link between poverty and ill-health.

Robin Cook, Labour's health spokesman, said the Government had the diagnosis but not the prescription right, adding: 'A White Paper that doesn't propose a single measure to combat poverty, homelessness or unemployment isn't a White Paper that offers better health for all.'

Mr Cook said the failure to mention directly links between poverty and poor diet, between homelessness and respiratory disease and between suicide and unemployment was because to do so 'would require the Government to admit that by increasing inequality it has increased ill-health'. He added the failure to ban tobacco advertising had everything to do with the 2,000 general election poster sites Imperial Tobacco provided for the Tories.

Critics, however, were impressed by the apparent seriousness with which the Government is taking the targets. It will spend pounds 500,000 explaining them to health authorities, and the extent to which they achieve the targets will be reviewed annually.

The White Paper sets targets in five key areas. These include reducing the death rates from coronary heart disease and strokes by 40 per cent by 2000; reducing the number of women who die from breast cancer by 25 per cent; the incidence of cervical cancer by 20 per cent; death rates for lung cancer in men by 30 per cent and in women by 15 per cent.

It makes a commitment to improve 'significantly the health and social functioning of the mentally ill', proposes a major survey on the state of mental health in England, and has a target of reducing the suicide rate by 15 per cent.

The White Paper seeks reductions of 15 per cent in cases of gonorrhoea and of 50 per cent in teenage pregnancies.

To achieve these targets a Cabinet committee will oversee and monitor programmes of action that will be designed at regional and local levels. Mrs Bottomley's intentions are for health and local authorities to work closely together but some national task forces will be set up.

The King's Fund Institute, a health think tank, welcomed the strategy but said it 'must pay attention to the poorest people on the margins of society'. Ken Judge, its director, said there was 'compelling evidence that a great deal of premature mortality is linked to poverty and deprivation' and the Government's approach 'will lack conviction until it begins to tackle health inequalities'.