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ON THE RECORD
TESSA JOWELL INTERVIEW
RECORDED FROM TRANSMISSION BBC-1 DATE: 29.6.97
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JOHN HUMPHRYS: Tessa Jowell you're the first Public
Health Minister as I said a minute ago. Isn't that a bit of a PR exercise in
truth because the government doesn't really believe it can radically reduce
health inequalities does it?
TESSA JOWELL: Well we do believe that we can reduce
health inequalities and this is certainly not a public relations or cosmetic
exercise. We are absolutely determined, as we set out in our manifesto, to
tackle the route causes of ill health, that lie in poverty, unemployment,
living in a polluted environment, fear of crime. All these facts of inner city
life today are bad for people's health and we intend to tackle them.
HUMPHRYS: That's a given, because that's been
proven over and over again. But you say that you are going to tackle them.
What sort of target...
JOWELL: Well you say, let me just say .....
HUMPHRYS: Few people would argue that.
JOWELL: Well, the previous government did.
HUMPHRYS: We're not talking about the previous
government now, we're talking about you.
JOWELL: But let's say we've had eighteen years
when the link between poverty and ill health was not recognised. We clearly
recognise that there is a link between poverty and ill health and we intend to
act on it.
HUMPHRYS: In that case you will have set yourself
targets as to what it is you are going to do. What sort of targets have you
got, how are you going to know whether things are improving or not?
JOWELL: Well this is what we will be doing over
the next few months.
HUMPHRYS: You haven't got any yet?
JOWELL: Setting targets in the context of
broader government policy, as your film made absolutely clear this is not an
achievement at reducing health inequlities that can be achieved by me or indeed
the Department of Health alone. And arguably, our policies in relation to
Welfare to Work, integrated public transport, reducing air pollution, making
the streets safer, are all as much public health policies, as things that will
be done within the Department of Health.
HUMPHYRYS: Yeah, but they're not targets are they.
When I talk about targets, I mean for instance closing the gap between
people..wealthy people who live longer, poorer people who die earlier, closing
that gap, getting rid of that gap.
JOWELL: Well we do intend that our action will
close that gap. If you look at the centrality of employment in our
government's policy. Why is employment so important, employment is so
important because that's the way you tackle social exclusion. Social exclusion
is extremely is extremely bad for your health so we do intend to establish
targets. We will do that by working across government departments. We will
look very closely at the impact of Welfare to Work on improving people's
health. We will look at very particularly...you see it's important to
understand that it's not just a matter of reaching national targets because as
the film very clearly showed there are enormous regional variations. You know
the man in Surrey can expect eleven years more healthy life than the man in
Manchester. Even within Liverpool there are enormous variations in life
expectancy.
HUMPHRYS: Right, but you are setting targets to
get rid of all that.
JOWELL: We will be setting targets that are the
most powerful targets to measure our success in reducing inequality.
HUMPHRYS: When?
JOWELL: We will be coming forward with a Green
Paper in the autumn and a White Paper next year. These will be based on
consultation in order that the targets are measureable and are believed by
those who will be responsible for implementing them to be achieveable.
HUMPHRYS: Give me a flavour then of what one of
those targets might be, what are we talking about here?
JOWELL: I think, is we look for instance at
reducing the dreadful rate of accidents in childhood. Children from social
class five are five times more likely to die in an accident before they're
fifteen than children from social class one. Now, in that context a policy in
relation is a manifesto commitment. Safe routes to schools is a very important
way of beginning to meet that awful fact. So we need to look across
government, we need to be very clear about what belongs as the responsibility
of central government, what central government can do to enable change, at a
local level, what can be done by building local alliances, cross-communities,
between local and health authorities and then what we need to look to to change
the behaviour of individuals. It's this very delicate combination of
measures that we believe will reduce the inequalities that are such a scar on
our society today.
HUMPHRYS: Right. You talk about changing the
behaviour of individuals - smoking - that's a problem that afflicts poor people
more than it afflicts wealthier people, for all sorts of reasons. You've told
us you are going to ban cigarette advertising and sponsorship. What else are
you going to do to stop us smoking?
JOWELL: Well, banning tobacco advertising will
be a very powerful measure in reducing smoking among young people and let me
just very briefly say that our record in relation to smoking and young people
is appalling. One in three of our fifteen year olds is a regular smoker. We
have had no success because of the previous Government's refusal to ban tobacco
advertising in reducing the rate at which children take up smoking. So, that
will be the focus of our policy and efforts in relation to reducing death and
illness through smoking.
HUMPHRYS: You could do an awful lot very quickly
by making cigarettes much more expensive, couldn't you?
JOWELL: The Budget will take place in three
days' time...
HUMPHRYS: I rather thought you were going to
comment on the Budget, but as a matter of general principle, do you think
that's a good idea.
JOWELL: Those are matters for the Chancellor and
he will announce those in the context of the Budget. What we're doing is - in
two weeks' time - convening an anti-smoking summit, which will bring together
leaders of industry, leaders of medicine, public opinion formers in order to
make clear the Government's determination to tackle smoking - not just through
a ban on advertising but we'll be looking for advice on a wide range of
measures. But, what we intend to do is to proceed on the basis of what will
work.
HUMPHRYS: Right.
JOWELL: And then establish the co-operation
across Government to put those policies into place.
HUMPHRYS: It's hard to think what that gathering
of the great and the good might tell you that you don't already know. I mean,
for instance let us assume that it comes up and says something that we already
know. Does work because it's happens in the United States very effectively,
indeed - and that is banning smoking in public places. If they say: yeah, we
think that's a good idea, would you do that?
JOWELL: Well, I don't think that we should be
leaping to ban things if we can actually achieve progress.
HUMPHRYS: Well, why not if you want to stop it
happening?
JOWELL: Well, if we can achieve progress by
agreement, by voluntary agreement then, that's a better way to proceed.
That's why because of the importance of establishing co-operation with
industry, with employers. That's why industry and employers will be invited to
the anti-smoking summit.
HUMPHRYS: Look.
JOWELL: There is-You know, many employers
already have anti-smoking policies.
HUMPHRYS: They're voluntary - yes.
JOWELL: Voluntary agreements which are working
well. We don't want to legislate where exising agreements are working well.
HUMPHRYS: Right. But where they're not?
JOWELL: Well, we'd legislate to ban advertising
because it's absolutely clear and figures to be published this week by the
Health Education Authority will make this point very clear that young people,
despite the fact that there is a voluntary agreement to limit tobacco
advertising, young people - more than fifty per cent of those interviewed -
believe that they have seen cigarettes advertised on television. They believe
they've seen cigarettes advertised on television because so many sporting
events are sponsored by tobacco companies. That's why we intend to ban tobacco
advertising.
HUMPHRYS: Right. But three years ago, you
introduced a Private Members' Bill yourself designed to make it unlawful to
smoke in public places, except in designated smoking areas. What's happened to
change your mind?
JOWELL: Well, in Opposition I and others of my
colleagues brought forward measures which were a reflection of the frustration
with the refusal of the then Government to take the action that was necessary.
HUMPHRYS: And now you're in Parliament and you
don't want to do it!
JOWELL: Given that our Government is committed
to banning tobacco advertising which the previous Government, despite all the
others-
HUMPHRYS: Well, that's not the same as what you've
talked about. OK, you've talked about tobacco advertising, we're now talking
about something you wanted to do so badly three years ago - you wanted a
Private Members' Bill to put it into force. Now, you're in power and you have
the power to do it, you're saying you won't? A bit odd, isn't it, if you're
serious?
JOWELL: Yeah, but we're absolutely certain that
through a combination of voluntary measures-
HUMPHRYS: Well-
JOWELL: -and a statutory ban on advertising,
that we can have the effect by the achievement of that combined impact of those
measures that means that it's not necessary to legislate for everything. You
only legislate when it's absolutely clear that you can't achieve what you want
to achieve by voluntary means.
HUMPHRYS: Alright. Let's-
JOWELL: And, that point has not yet been reached
in relation to smoking in public places. It has been-
HUMPHRYS: So, it's still possible, though?
JOWELL: -in relation to tobacco advertising.
HUMPHRYS: It's still possible, then, that you
might have this ban?
JOWELL: Well, I want to proceed, wherever
possible, on a voluntary basis. Our determination, however, is to make some
substantial inroad into the rate at which young people take up smoking. The
smokers of today are those middle-aged people with heart disease and lung
cancer of twenty and thirty years' time.
HUMPHRYS: Just another very quick thing on these
measures. We saw in that film that supermarkets don't like opening up in
places like Speke because, you know, there's lots of problems in an area like
that. Therefore they cause serious health problems because people don't buy
the kind of food they ought to buy. Now, you'd like to put pressure on them to
do that, would you?
JOWELL: Well, a number of supermarkets are
already working with local authorities to-I mean, for instance to keep stores
in city centres, while at the same time, as part of the planning agreement,
opening on the outskirts of towns. One major retailer, in pursuit of improving
the healthy eating of people who are very poor, markets their fresh fruit and
vegetables at the same discounted prices, in very small stores, as it does in
the large out of town supermarkets.
HUMPHRYS: You'd like to have more of that. Will
you put pressure on them to do it?
JOWELL: Well, I mean, it's not a matter of
putting pressure. These are-You know, many of the large retailers are already
doing this, are working in partnership with Local Authorities. We want to
build and strengthen those partnerships, but give them a very important
national context as well.
HUMPHRYS: Right. Should there be a kind of
'budget for health' you might even have an hypotheticated Health Tax or
something. Do you think that's a good idea in the long run?
JOWELL: Well, as you know-.
HUMPHRYS: I know you're not going to tell us what
Gordon Brown's gonna do.
JOWELL: I'm not going to tell you what.
HUMPHRYS: He probably...
JOWELL: Even if I knew what Gordon Brown was
going to do, I'm certainly not going to speculate about that. We'll all have
to wait until the Budget for that. But what my appointment as Minister for
Public Health does is to signal a very important change in our Government's
approach towards Health - that it's not just about doing what we're doing in
relation to the National Health Service and rebuilding a National Health
Service, creating a National Health Service which is fit for the future and in
which people can once again have confidence. But it's also understanding the
reasons why people get ill and why there are such enormous social class
variations in the suffering of illness. So that's why we want to harness the
resources of the whole of Government. That's why a commitment to tackling
inequalities in Health is at the heart of our Government's policy. And why we
are as interested and concerned about preventing ill health as we are about
curing it.
HUMPHRYS: But-But as you say, you have accepted
the link between poverty and ill health. So therefore the real solution here
lies in the hands of the Chancellor doesn't it? You've got to make the poor
wealthier - that's down to him. The truth is - apart from preaching a bit and
being a bit of a nanny - there's not much you can do.
JOWELL: I certainly don't intend to be a nanny,
I certainly don't intend to preach. I shall do my job with the authority of
our Manifesto and a Government which is committed to tackling inequalities.
Obviously working with the Chancellor, working with the Secretary of State for
the Environment, working with the Secretary of State for Education. It's our
joint effort and our joint commitment. They are as committed as Frank Dobson
or I am to reducing inequality.
HUMPHRYS: But is Gordon Brown? That's the
question. Is Gordon Brown? Redistribute wealth, you know?
JOWELL: Gordon Brown in leading our Welfare to
Work programme is taking some of the most important steps to improve the health
of people in this country.
HUMPHRYS: Ah, but he hasn't accepted what the
Black Report says has to be done has he?
JOWELL: It's very bad for your health and we
intend to tackle Unemployment, both for young people and people who have
been-whose lives have been blighted by long periods out of work and their
health will improve as a result.
HUMPHRYS: Tessa Jowell, thanks very much indeed.
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