Stalled progress in cutting smoking rates

(Title Image: via Wikipedia, all rights released)

Today is No Smoking Day and it was fitting that the summary of this week’s health questions starts with that.

Minister “playing with words” on e-cig safety

“Public Health Wales have shown in their projections that they’re expecting you as a Government to miss your target of reducing the prevalence of smoking across Wales to 16 per cent by 2020 and that you’re currently around five years behind achieving that particular target….I think that what we need to see is a radical sea change in the Government’s approach, particularly in terms of the use of e-cigarettes to promote the cessation of smoking.”
– Darren Millar AM (Con, Clwyd West)

Health Minister, Vaughan Gething (Lab, Cardiff S. & Penarth) said that contacts to the NHS Help Me Quit programme were up 20%. He also said it was more correct to say e-cigs were less harmful than tobacco than “much safer”.

Darren Millar said the Minister was “playing with words” and one of the main reasons Wales has hit smoking targets was because of the take up of e-cigarettes – which are available through quit smoking programmes in England but not in Wales. He also drew attention to the fact 20% of pregnant women in Wales smoke.

The Minister said language mattered as saying something was “safe” could be misleading. On maternal smoking he said the government were working with midwives:

“….to change some attitudes around smoking as well, because if you go outside almost every maternity unit in the country, you’ll find a bunch of fag butts outside. Now, there’s a challenge there for us about changing people’s perception of what they’re doing, not just for themselves, not just when they happen to be pregnant, but actually for other people going in and out of those particular units.”
– Health Minister, Vaughan Gething

Risk-aversion in the NHS

Helen Mary Jones AM (Plaid, Mid & West Wales) said that a 2016 OECD review of the Welsh NHS found that health boards didn’t have the right technical capabilities to drive change – needing a stronger guiding hand – while a parliamentary review found a risk-averse culture within the Welsh NHS. Was the Minister confident that these issues have been addressed?

She also raised the issue of funding:

“Spending on primary care has increased in cash terms by £74 million but that, of course, over the five years is a real terms cut. Spending on secondary care has swallowed up the vast majority of the increases, getting around £845 million extra. Now, this is a clear illustration to me of local health boards failing to move resources and services from hospitals into communities….”
– Helen Mary Jones AM

The Minister told the chamber that while the OECD review made some criticisms, it also dispelled the myth that the Welsh NHS was the worst in the UK. On the stronger hand issue, he regularly intervenes in the NHS where appropriate. He was proud to put more resources into the NHS, despite austerity.

Health & Active Travel

Huw Irranca-Davies AM (Lab, Ogmore) asked what discussions the health department has had with other parts of government on the role of active travel on health and wellbeing. There was clearly a distance between the aims of the Active Travel Act and delivery.

David Melding AM (Con, South Wales Central) was “amazed” by the amount of traffic generated by school runs and ending it would be a big step forward. Rhun ap Iorwerth AM (Plaid, Ynys Môn) asked if the health department could co-fund active travel schemes?

The Minister has noticed changed attitudes to walking and cycling to school himself and there was a challenge in re-normalising walking to school. There were a number of cross-department issues which could have health benefits, such as 20mph speed limits, which he was willing to look at.

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