What the Health Bill will mean

Last year's Public Health White Paper outlined plans for a smoking ban
across workplaces in England after pressure from health professionals
and campaigners who argued second-hand smoke was harming workers.

Only private members clubs and pubs which do not serve food would be exempt.

But the subsequent consultation raised concerns pubs, especially in
poor areas, would stop serving food to avoid the ban - widening health
inequalities - and whether a one metre smoke-free exclusion zone
around bars was enough to protect workers in those pubs.

Weeks of discussion at cabinet level followed during the autumn of
this year in which various proposals were discussed.

In the end, the bill sticks largely to the original proposal, but
allows scope for another consultation on how to protect bar workers
which could lead to smoking only being allowed in pubs in sealed
rooms.

It also brings forward by 18 months the deadline for full
implementation to summer 2007. There will be a full review of the ban
within three years, the Department of Health has said.

The measures contrast with the full ban in place in the Republic of
Ireland, and the proposed bans for Scotland and Northern Ireland.

CONTROLLED DRUGS

Dame Janet Smith's inquiry into the Shipman murders found there was a
need for "modernisation and rationalisation" of the controlled drugs
systems, which covers drugs such as diamorphine (medical heroin) and
sedatives such as barbiturates.

She said there has been virtually no revision of legislation relating
to controlled drugs since the 1970s.

And this system had allowed the GP, who killed up to 275 people over a
23-year period, to obtain large amounts of diamorphine undetected.

The bill makes a number of proposals, including giving health managers
the right to enter GP premises, allowing closer scrutiny of doctors.

At the moment the law in the area is unclear, and means managers
cannot insist on entering surgeries.

The NHS is also being given a duty to work with other authorities such
as social services and police in cases where controlled drugs are
misused.

Primary care trusts, which are in charge of commissioning services
from GPs, should also have an officer with responsibility for
controlled drugs.

HOSPITAL INFECTIONS

Hospitals will have to adhere to tighter hygiene regulations

The bill will also tackle one of the most controversial problems
facing health services - hospital-acquired infections such as MRSA.

MRSA, which is linked to nearly 1,000 deaths a year, has dogged the
NHS in recent years with concerns about hospital cleanliness.

Included in the document is legislation binding hospitals, care homes
and other NHS services to a new hygiene code of conduct.

While hygiene standards are taken into account during hospital
inspections, NHS trusts do not have a statutory duty to ensure
standards are adhered to.

The bill gives the Healthcare Commission powers to issue improvement
notices, and if trusts fail to comply managers could lose their jobs
or face intervention from the government or Monitor, in the case of
foundation trusts.

The code, which will be constantly updated, sets certain standards for
things such as hand washing and cleaning wards.

PHARMACIES

Pharmacists are set to play an ever increasing role in health care in
coming years.

They are being encouraged to become involved in care traditionally
considered outside their remit such as blood pressure testing,
diabetes care and providing smoking cessation clinics.

The bill sets out changes to pharmacist training programmes to reflect this.

And it also reforms the requirements set out in the NHS Act 1977
regarding the supervision required by pharmacists.

At the moment they are effectively tied to the dispensing counter so
they can issue prescriptions.

But the bill proposes allowing other staff such as pharmacy
technicians to hand out drugs as long as the pharmacists ensures a
safe system is kept to.

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