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Blair's health reforms have gone too far

GPs have strongly condemned the Government's failure to toughen up plans to ban smoking in public places, warning patients in deprived areas would be the losers.

They branded the plans 'an absolute disgrace' and said practices in deprived parts of the country would face an even greater share of smoking-related workload.

Health Secretary Patricia Hewitt defied expectations last week by announcing the Government would retain exemptions for pubs that do not serve food and private members' clubs.

But a study in the BMJ has shown people in deprived areas are more likely to live close to pubs that will be exempt than those in affluent areas, while a BMA survey found exemptions would be more common in the Midlands and North.

Dr Rob Dawson, a GP in Rowlands Gill, Tyne and Wear, said: 'It's an absolute disgrace that the Government cannot look at the evidence staring them in the face. This can only imply more people in the North will be allowed to die from smoking-related diseases. Does that imply the North-East is less valued than the South-East?'

Dr Kailash Chand, secretary of West Pennine LMC and a GP in Aston-under-Lyne, Greater Manchester, said: 'The decision for a partial ban is a mistake, tragedy and wasted opportunity.'

GPs said overburdened practices in deprived areas would continue to face high burdens of smoking-related disease as their patients missed out on the benefits of the ban.

GPC negotiator Dr Peter Holden, a GP in Matlock, Derbyshire, condemned the partial ban as 'bonkers', adding: 'It's a very reasonable assumption that health inequalities [may widen] and GPs who work in those areas are going to have more work to do.'

Dr Simon Clay, a GP in the urban deprived area of Erdington, north Birmingham, said: 'I think that over the course of time there will be a greater incidence of smoking-related disease that needs to be managed by GPs working in deprived areas, but I think the greater concern is the health of the population.'

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