Wednesday, 9 November 2016

Public Health Bill (Re)Introduced

(Pic : BBC)

As you probably all know, the Fourth Assembly's Public Health Bill was troubled at several points, mainly because it proposed to ban "vaping" in public places in line with tobacco.

A deal was thrashed out which would've seen the vaping ban limited to schools, places serving food and public transport. However, the Bill was voted down at the last minute because of Leighton Andrews' infamous "cheap date" remark in relation to a separate law, which Plaid Cymru took exception to (What the f**k was that?).

I haven't changed my mind that it was voted down for the wrong reasons, but with all that water under the bridge, a new version of the Bill was put before AMs on Monday by Minister for Public Health & Social Services, Rebecca Evans (Lab, Gower).

Bill here (pdf); explanatory memorandum here (pdf). There's also a briefing from the Assembly's Members Research Service here which goes into more detail on the legal and policy justifications underpinning the Bill.

What does the new Public Health Bill propose?

It's mostly a copy-and-paste of the first Bill (Tattoos, Bans & Bogs) with a few minor changes, but can be summarised as follows.

Smoking Bans & Tobacco Retailers

(See also - Vice Nation : Tobacco)

The Bill:

  • Extends smoking bans to all workplaces, school grounds, hospital grounds and public playgrounds.
  • Gives Welsh Ministers the power to make regulations to designate another type of building a "smoke-free premises" or vehicle a "smoke-free vehicle", but also the power to designate certain buildings as exempt (i.e smoking rooms in hotels, members clubs).
  • Places a duty on managers of smoke-free premises to display appropriate "no smoking" signs.
  • Requires the registration of people operating as tobacco and nicotine product retailers ("tobacco" defined as including cigarette papers and "nicotine products" includes e-cigarettes).
  • Amends the Children & Young Persons Act 1993 to extend restricted sales to under-18 to all nicotine products (which includes e-cigs, shisha).
  • Makes it an offence to :
    • Smoke tobacco in a smoke-free premises or smoke-free vehicle (as outlined by regulations). Violators are liable to a fine of up to £200.
    • Fail to prevent someone smoking in a smoke-free premises or smoke-free vehicle. Violators are liable to a fine of up to £2,500.
    • Fail to comply with signage regulations. Liable to a fine of up to £1,000.
    • Sell tobacco/nicotine products without registration. Liable to an unlimited fine determined by magistrates.
    • Sell tobacco/nicotine at a place other than the registered address (except movable stalls), or fail to give notice of a change of registered address. Fine of up to £500.
    • Knowingly hand over tobacco or nicotine products to under-18s (sale or not). This includes internet and telephone sales. Fine of up to £2,500.

Tattoos & Piercings

(Pic : Buzzfeed)

(See also – Vice Nation : Tattoos & Piercings)

The Bill:
  • Defines a "special procedure" as: acupuncture, electrolysis (laser hair removal), tattoos and body piercings.
  • Defines "intimate piercing" as a piercing of the genitalia (including the mons pubis and perineum aka. "gooch"), bellybutton, breasts or buttocks. Tongue piercings have been included (its exclusion was a point I made with the last Bill), but lip piercings still aren't included.
  • Requires any individuals performing "special procedures" to be licenced. Licences will be issued by local authorities. Individuals can be licenced to perform more than one special procedure. It appears as though licences will last for three years from date of issue. Healthcare professionals are exempt.
  • Requires Welsh ministers to issue regulations on mandatory licensing criteria (i.e. record-keeping, premises, display of licences), which may include giving local authorities the power to withhold licences until a premises has been inspected.
  • Gives local authorities the power to revoke licences if licence holders fail to meet licensing criteria, or if their non-compliance presents a risk to human health. They can also issue stop notices and remedial action notices for the licence holder to undertake.
  • Makes it an offence to :
    • Perform special procedures without a licence, continue in contravention of a stop notice or remedial action notice, make a false statement etc. Liable to a fine of up to £1,000.
    • Perform an "intimate piercing" on, or make an arrangements for an intimate piercing on, a person aged under-16. Liable to a fine of up to £2,500. Medical procedures are exempt.

Health Impact Assessments

A new inclusion in the Bill, which proposes (via regulations):
  • Public bodies carry out an assessment of the likely affect, both long-term and short-term, of a proposed action or decision on the mental and physical health of the people of Wales.
  • "Public bodies" includes the Welsh Government, local authorities, health boards, Arts Council, fire and rescue services, National Library & Museum etc.


The Bill amends the NHS Wales Act 2006 to:
  • Change the process by which local health boards approve providers of NHS pharmaceutical services by placing a duty on local health boards to assess pharmaceutical needs in their respective areas.
  • Introduce a "control of entry" test for prospective NHS pharmaceutical providers to ensure they'll meet the needs identified in the assessment.
  • Give local health boards the power to remove providers from the approved list if they continuously breach terms and conditions of service.

Public Toilets

(Pic : Assembly Research Service)
The Bill:
  • Places a duty on local authorities to prepare both a local toilets strategy - which assesses the need for public toilets in their area - and a statement setting out how the local authority intends to meet those needs. The strategy must be published within 12 months of the first local authority elections following the commencement of the Act.
  • Includes baby changing facilities and disabled changing facilities within the definition of "toilet".
  • Gives Welsh Ministers the power to issue guidance on the toilet strategy itself.
  • States that local authorities and community councils "may", but not "must", provide public toilets – though provision has to match the toilet strategy.
  • Grants local authorities the power to make bylaws regarding the conduct of people using public toilets.

What the new Bill doesn't include

(Pic : Mirror)

Apart from formally banning sales to under-18s, and registering retailers of all nicotine products, there are no other measures related to vaping/e-cigarettes. So there are no proposals for a ban on vaping/using e-cigarettes in public places. That doesn't mean a separate vaping law couldn't be introduced in the future, but at present it counts as a victory for those who've campaigned against the Bill.

There are no proposals to introduce a minimum per-unit price for alcohol either – which has been raised on-off down the years. There are also no measures to improve physical fitness and no proposals for a sugar tax/sugar levy.

As the fundamentals of the Bill have been previously agreed, it's highly unlikely to encounter much opposition in the Senedd unless a significant and controversial proposal is tacked on to it (like the examples I just mentioned).

However, the Bill will still have to go through the full legislative process, and a fresh set of eyes looking over it may result in things being picked up that haven't been previously. There are minor changes after all, like the inclusion of tongue piercings as an intimate piercing (I still think lips should) and health impact assessments.

How much is the Bill expected to cost?

At least half of the explanatory memorandum is dedicated to outlining the costs of the law and the different options considered. I'm going to stick to the preferred options in each case.

For extended smoking bans, it's expected to cost £211,000-328,000 over a five year period, with the measures being cost-neutral if it stops 4 children a year taking up smoking.

The new measures on tobacco licensing are expected to have a net cost of £257,000 over a five year period between 2017-18 and 2021-22, while further restrictions on under-18 sales are expected to cost £402,000-723,000 over the same period. In both cases the costs mainly fall on retailers and increased local authority enforcement after the law comes into force.

The costs relating to the licensing and regulation requirements of tattoo artists, piercings etc. are expected to be at least £2.38million, mostly falling on businesses and local authority enforcement teams. However, every complication from a tattoo or piecing that's avoided is expected to save the NHS between £95,000-£342,000 and result in a "quality of life bonus" of £60,000.

The under-16 intimate piercing ban is expected to cost between £362,000-£1.43million over five years depending on the cost of lost business, but there will be savings for the NHS.

The health impact assessment requirements are expected to cost public bodies £335,000-£795,000 over five years, while there's expected to be a total net saving/benefit resulting from the pharmaceutical measures of £7.84million between 2017 and 2022.

The measures relating to public toilet provision are expected to cost at least £2.42million over five years with about 3/5 of the cost falling on local authorities and the rest falling on the Welsh Government.

So as I work it out, the provisions are going to result in either a net cost of £238,000 or a net saving/benefit of~£1.47million – the memorandum gives a halfway figure of a net benefit of £738,000. When you take into consideration the possible associated savings for the NHS and boost to the economy and public health (such as providing better toilet facilities for tourists), it's safe to say the Bill is effectively cost neutral.


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