The next item on our agenda this afternoon is the statement by the Minister for Social Services and Public Health on the Public Health (Wales) Bill. I call on the Minister for Social Services and Public Health, Rebecca Evans

Thank you, Deputy Presiding Officer. I was pleased yesterday to introduce the Public Health (Wales) Bill, with its explanatory memorandum, to the National Assembly for Wales. The Bill affirms this Welsh Government’s continuing commitment to taking a lead on public health and doing the maximum we can to further improve and protect the health of people in Wales.

We know the public health challenges we face are constantly evolving and becoming increasingly complex. Tackling them requires a comprehensive and multi-faceted response. While legislation has an important and proven role, it cannot bring about all the improvements and protections we want to see on its own. Instead, it forms one intrinsic part of a broader agenda—an agenda which includes our work across the breadth of Government to address the causes of ill health, as well as our tailored public health services, programmes, policies and campaigns. Taken together, they all make a cumulative positive contribution, helping us to prevent avoidable harm and reach our aspirations for a healthy and active Wales, and all closely linked to the principles of prudent healthcare.

While a single piece of legislation cannot be a panacea to resolve all public health challenges, it can make a very positive and practical difference. That is what this Bill seeks to achieve. It takes action in a number of specific areas for the benefit of particular groups within society as well as for communities as a whole.

Apart from a small number of minor technical changes, the Bill contains the provisions originally considered by the previous Assembly, including those agreed at the amending stages. The only exception is the removal of the provisions that would have restricted the use of nicotine inhaling devices in some public places. This step has been taken in recognition of the need to build consensus across this Assembly and to ensure that the numerous benefits that the Bill seeks to deliver for Wales can be realised.

The Bill covers a number of important public health issues. It creates a distinct smoke-free regime for Wales, with the existing restrictions on smoking in enclosed public places and workplaces extended to cover school grounds, hospital grounds and public playgrounds—a change intended to benefit children, patients and visitors. It also allows for further settings to be made smoke-free in the future if certain conditions are satisfied and if supported by this Assembly.

The Bill supports the existing protections for children and young people, preventing them from getting hold of tobacco and nicotine products by the creation of a national register of retailers of these products, and a new offence of knowingly handing over tobacco or nicotine products to under-18s. These important measures will help enforcement authorities carry out their responsibilities more effectively and further protect children from harm. The Bill creates a mandatory licensing system for practitioners who carry out special procedures—acupuncture, body piercing, electrolysis and tattooing—helping to protect people who choose to have these procedures from the potential harm that can happen if they are poorly carried out. The Bill also prohibits the intimate body piercing of children under 16, providing another important protection for our young people.

While some actions in the Bill are intended to benefit specific groups, others will benefit whole communities. First, by requiring public bodies to carry out health impact assessments in certain circumstances, we will help ensure that, before key decisions are made, they are informed by a full consideration of their potential effects on physical and mental health and well-being. Second, communities will benefit from the proposed changes to the way pharmaceutical services are planned in Wales to better meet the needs of local communities. And third, communities will benefit from the improved planning of provision and access to toilets for use by the public—an issue that affects everyone but which has particular public health resonance for certain groups.

The Bill has of course already benefited from extensive consultation over a number of years and from detailed scrutiny during the fourth Assembly. The process of scrutiny has already directly strengthened the Bill in a number of ways. It led to extending the smoke-free regime to the new settings of school grounds, hospital grounds and public playgrounds. It strengthened the Bill by protecting children from the specific health harms that can be caused by tongue piercings, and it directly led to the inclusion of important provisions about health impact assessments. Nonetheless, I am sure that the Bill will benefit from further rigorous scrutiny on a range of issues and from discussion on points of detail. So, I look forward to the scrutiny process that will now follow and to the constructive engagement of the many organisations who will have an interest in making this Public Health (Wales) Bill a success, and in maximising the benefits of the legislation for the people of Wales.

Thank you very much. Angela Burns.

Thank you, Deputy Presiding Officer. I’m pleased to see the Public Health (Wales) Bill resurface after the ridiculous farrago we saw earlier this year, and I would restate this party’s commitment to enabling e-cigarettes to be one of a number of tools in the smoking cessation toolbox.

Minister, there is very little in this Bill that I would quarrel with. In fact, given the stated objective of the Public Health (Wales) Bill, which is to use appropriate legislation to improve and protect the health and well-being of the population of Wales, I find that there are a number of areas that I wish to explore to see if we can bring forward more robust legislation in order to achieve that aim. I would also wish to examine better some of the fiscal implications of the proposed Bill.

I note the desire to create a national register of retailers of tobacco and nicotine products, and this is a move I support. However, Minister, given the costs this would incur, what consideration have you given to that duty being carried out by local authorities? After all, they already license premises to sell alcohol, and I would suggest to you that most premises selling alcohol, be it a supermarket, pub, corner shop, will also be the ones wishing to retail tobacco and nicotine products. I do accept that there will be some venues that might specialise in nothing but the sale of tobacco and nicotine products, but they can be added, I would have thought at lower cost, to the existing licensing regime.

I note the intent to prohibit the handing over of tobacco or nicotine products to anyone under 18. Minister, have you given thought to what penalties you would apply and upon whom? It would be most concerning if the retailer were deemed responsible for over-18s buying cigarettes and the like and then handing them over to under-18s just around the corner. How will you catch, prove and punish any perpetrator?

I note the very welcome protection for minors you have proposed by banning intimate piercings. Under that same intent to protect a minor, could you give strength to laws around tattooing and body modifications, given that many tattoos and some body modifications are also in areas deemed intimate? I’ve understood your concerns over prohibition making something more attractive, but this is about child protection and my understanding is that, also, the industry would like to see more regulation for their protection as well.

I note the requirement for local authorities to prepare local strategy plans to reflect the need for public toilets. To be frank, Minister, you could drive a coach and horses through this element of the Bill. I’d be interested to know how you think this could deal with arterial routes, tourist areas with high tourism footfall but low community need, and more rural areas. Do you not think that there also needs to be an overarching national plan to tie together the local plans and fill the gaps?

Minister, Wales is home to some of the most polluted areas in the UK. The A472 road near Crumlin has the highest rate of pollution in any area outside of London, predominantly caused by congestion from heavy-duty vehicles. People living in the area are increasingly being exposed to harmful pollutants, which is denigrating their health. Research is enabling us to have a far fuller understanding of just how harmful long-term exposure to air pollutants is for our health. Damage by air pollutants can be linked to cancer, asthma, heart disease, stroke, diabetes, obesity and dementia. In 2010, harm from air pollutants contributed to 1,320 deaths in Wales, and this plays a major role in many of our health challenges.

Minister, the Government must ensure that local authorities are fulfilling their role effectively. Local government does have a requirement to effectively monitor the local air quality and alert the public when levels exceed guidelines. Equally, they have a responsibility to deliver localised air management strategies. So, it is essential that these are being delivered in tandem with national strategic objectives.

Are you coming to a conclusion, please?

I’m so sorry, I did take guidance earlier, Deputy Presiding Officer, and was told I had time.

Well, you’re in danger of almost taking as long as the Minister to introduce the statement.

My apologies.

Could the public health Bill not legislate to monitor air pollution outside of Welsh schools? My initial investigations indicate that the issue of monitoring pollution levels outside schools could be factored into the Bill and that they could be enacted, providing we’re mindful of EU law and will not cut across the Wales Bill.

Finally, Minister, I would raise the subject of the fact that the public health Bill contains no measures to improve the physical fitness of the nation. With leisure centres under such pressure, Minister, could this public health Bill not look at the possibility of us opening up our school buildings to provide a locus in local communities to enable people, especially those who are receiving ongoing medical help and need to have the exercise regimes that I spoke of when I spoke to the First Minister earlier in questions—. That could be a centre for them to be able to go to where they don’t have to travel so far. I do believe, Minister, that fitness is absolutely key because, if you look at any of the population predictions, then we are in for one heck of a ride in the years to come because of obesity and our general ill health. And if you will be brave and through this Bill take issue on public health through physical fitness, and look at children, young people and adults, then this party will support you in that brave step, because by being brave today we can really make a dramatic difference to the health of our nation tomorrow. Thank you.

I thank the spokesperson for the warm way in which she has welcomed the return of the Bill to the Assembly, and for her constructive comments this afternoon. I look forward to working with Members across all parties as we develop the Bill in the months to come.

Your first question related to the fiscal implications of the Bill, and, at that point, I’d direct your attention to the explanatory memorandum, which also includes the regulatory impact assessment. It does include some detail in terms of what we would expect the cost of the Bill to be for Welsh Government, local authorities and for others as well. We’ve been really keen throughout the development of the Bill to minimise the cost to local government, because we understand the pressures that they are under at the moment. For example, with the part of the Bill that deals with the food hygiene system, the Bill allows local authorities to keep the receipts that they receive when they hand out a fixed penalty notice, for example, so that they can reinvest that in terms of doing their duties to inspect premises, and so on.

You asked about the register of retailers. All retailers of tobacco and nicotine products will be required to be on the national register. There’d be a proposed fee of £30 for the first premises and £10 for each additional premises owned by the business. That register will provide local authorities with a definitive list of the retailers within their areas selling either tobacco or cigarette papers, nicotine products or a combination of these items, with the aim of reducing the likelihood of under-18s accessing these products. We will be naming either a local authority or another organisation as the authority that will manage that national register.

We’re aiming to keep it as simple as possible to minimise the burden on business, so retailers will only need to notify the registration authority of any changes to the details of their entry once they’ve registered, rather than formally re-registering every three years, which is why a formal licensing system would have actually put more burden on business. That is why we’ve opted for this approach. It will also be a helpful resource in terms of local authorities being able to disseminate information, advice, guidance and support for businesses on their register, because, at the moment, they do rely to a large extent on local intelligence, which is quite fragmented. So, now they’ll be able to be aided much more robustly in their enforcement duties as well. I’m glad that you have welcomed that part of the Bill as well.

In terms of handing over of tobacco, what that means in practice is that it will be an offence for an individual to hand over tobacco to somebody under the age of 18. The aim is to prevent young people obtaining tobacco and nicotine products through the internet or through telephone orders, and this Bill is very much about keeping pace with changes that are happening in society and in the way that we access different things. The offence applies to, for example, bags and delivery boxes used by supermarkets, but it doesn’t capture fully enclosed envelopes because we can’t reasonably expect people to know what’s inside a closed envelope when that’s handed over. So, delivery drivers handing over tobacco or nicotine products to somebody who appears to be under 18 will be expected to carry out the age verification check, similar to those that are carried out by shop assistants in such situations as well. This will be enforced by local authorities.

With regard to intimate piercing, we seek through the Bill to prohibit the intimate piercing of a person who is under the age of 16 in Wales in any setting, and it also extends to making it an offence to make arrangements to perform such a procedure. So, for the purposes of the Bill, intimate piercing includes piercing of the nipples, breasts, genitalia, buttocks and tongue, and that was introduced in the amending stages when the Bill previously went through the Assembly. Again, the aim there is both to protect young people from the potential harms that could be caused by an intimate piercing, but also to avoid circumstances where they’re put in potentially vulnerable situations. Many practitioners, you’re right, already choose not to undertake these intimate piercings on children and young people anyway, but this will bring things into line across Wales. We can certainly have further discussions at the next stages in the passage of the Bill through the Assembly with regard to extending the intimate areas to tattoos, for example. I’m not sure whether that was discussed at any length in the previous stages at the Assembly, but I look forward to having those discussions with you as well.

Just to, very quickly, reflect on your concerns about toilets, the Welsh Government will issuing guidance to all local authorities in assisting them in developing their local toilet strategies. Within that, we will be asking them to look at users of highways, active travel routes and visitors to sites for events of cultural, sporting, historic, popular or national significance as well. So, it’s intended to be a wide-ranging and robust piece of work. Again, pollution isn’t included within the Bill, but I’m sure this is something that we’ll discuss in detail in the next stages.

Thank you very much, Deputy Presiding Officer. May I thank the Minister for this statement? Even though this Bill isn’t perfect, as I will explain further, I do welcome the Bill as it currently stands. It’s a shame that the content of what is before us wasn’t placed on the statute book previously, but I was one of those people who couldn’t accept the previous Bill because of the restriction on the use of e-cigarettes. Even though we can’t say, of course, that they cause no harm, I do believe that there is a place for them as something that’s less harmful thank smoking tobacco. So, I’m very pleased that that element has been expunged from this new Bill.

We will work constructively on this Bill now, as it stands. Assembly Members, all of us, and those of us who are members of the health committee will do that work. And I look forward to starting that scrutiny process and to seek elements that we can improve and strengthen, despite the fact that this Bill, to some extent, has been through a scrutiny and amendment process already.

Gan fod digonedd o gyfleoedd craffu i ddod, nid wyf am gyflwyno rhestr hir o gwestiynau heddiw. Fe wnaf ddweud, fodd bynnag, ei fod yn achos pryder i mi nad oes dim yma i fynd i'r afael â gordewdra na chamddefnyddio alcohol na hybu gweithgarwch corfforol, fel y clywsom funud yn ôl, ac yn hynny o beth, gellid ei weld fel cyfle a gollwyd. Ond, mae hwn yn Fil defnyddiol. Mae yn cynnwys rhai mesurau defnyddiol a byddwn yn ymgysylltu yn adeiladol gydag ef ac yn parhau i chwilio am gyfleoedd i weithredu yn rhai o’r meysydd eraill hynny.

Byddaf i hefyd yn achub ar y cyfle hwn, yn olaf, i ofyn hyn i'r Gweinidog: a wnaiff hi gytuno â mi y dylai’r Bil hwn, mewn gwirionedd, fod yn llawer cryfach ac y gallai fod yn llawer cryfach a’i fod yn cael ei rwystro gan ddiffyg pwerau? A yw hi'n cytuno â mi y dylai fod gennym ni’r pwerau, er enghraifft, i wahardd neu gyfyngu ar hysbysebu bwyd sothach neu i gyflwyno treth ar fwyd a diod afiach a siwgr ac yn y blaen, a phe byddai’r gallu gennym i wneud hynny, y gallai hwn yn wir fod yn Fil llawer mwy pellgyrhaeddol?

I thank the Member for those comments and obviously share your clear disappointment that the Bill wasn’t passed at the previous stage in the Assembly, but I’m looking forward to working constructively with you as we move forward on it.

You mentioned several items that you are disappointed they aren’t addressed in the Bill, but of course, legislation is only one part of the way in which we address the challenges that you outlined. For example, not everything needs legislation—we’re doing many things in terms of tackling obesity, both at a Wales level and working constructively with the UK Government at EU level as well. Many of the levers that affect the food industry, for example, are held at UK Government level and at a European level, which is why we’ve been supportive of the UK Government’s efforts in terms of the sugary drinks industry levy. We’re keen to see some real progress made on that, and quite quickly as well.

Also, in Wales, we have the Healthy Child Wales programme, which I was pleased to launch in April of this year. This will provide practitioners and health visitors with the opportunity to have real, meaningful engagement with families on a consistent basis across Wales. At those meetings, things such as healthy living, diet, exercise, smoking, substance misuse—all of these different elements can be discussed in order to support the family to make healthy choices, both for the mother and the children, but for the family as a whole, as well.

We have the 10 Steps to a Healthy Weight programme as well, and that, again, seeks to give children the very best start in life in terms of their physical health. We already have other legislation, such as the active travel Act, which we’re implementing, to try and make active and healthy choices of walking and cycling much easier for people.

In schools, we have a Wales network of healthy schools and we have a great variety of school-based sports and physical activity programmes, which are being delivered in schools and also through Sport Wales.

You referred to substance misuse. Again, there’s nothing specific on this in the Bill in terms of alcohol and drug use, for example, but we’re working very hard to prevent and reduce harm through our action plan. You’ll recall that, only a month or two ago, the Assembly agreed our delivery plan for the next two years with regard to substance misuse, preventing harm, for example, through educating children and making sure that the advice and information we give keeps up to date with the modern trends, with the new psychoactive substances and so on, but also reducing harm for those people who already have substance misuse issues—for example, by introducing our take-home naloxone programme, which prevents overdose. I’m hearing great stories of how that is actually saving lives in our communities. Mohammad Asghar mentioned just last week the drug administration rooms and we’re actively looking at whether or not we would want to introduce those and taking advice from an expert group as well.

You and Angela Burns also mentioned leisure facilities and the fact that they’re not in the Bill, but again, there are things we can do outside of legislation—for example, the facilities blueprint, which is recently being produced, in order to make sure that we take a more strategic approach to the availability of sporting premises and leisure facilities in our communities. The sports facility grant we made available for local authorities to have a grant of up to £1 million in order to invest in improving or developing new facilities locally, as well. So, there is a great deal going on in the public health sphere beyond the legislation itself, although I know that there’ll be a keenness to address many of these issues as we move through the scrutiny stages.

I’m also very pleased that we’re reintroducing this Bill, which has some very important conditions attached to it. I’m delighted to hear that Plaid Cymru is urging you to do something about obesity. I just wondered whether there was any possibility of including anything of a regulatory nature in this Bill, because although there are many things that the Government is doing to try and tackle obesity, we know that the full weight of the advertising industry is encouraging people to eat all the wrong things, rather than vegetables. The Olympic Games were used as an absolute fest of junk food advertising—except, in one case, Aldi were using it to promote vegetables and fruit, and they should be commended for doing that. But most advertising is done on things like sugary drinks, not on vegetables.

So, would it be possible to include in the Bill, say, banning advertising of junk food before the 9 o’clock watershed? Do we have the powers to do that? And also, although I welcome the sugary drink levy, it doesn’t go nearly far enough, because sadly, sugar is present in nearly all the processed food that is being flogged at the moment. Is there any possibility of being able to introduce a wider levy on sugary items, which also might take into account the amount of salt and fat also being used to flog goods being presented as food? I appreciate that these are difficult issues because most food is manufactured across the UK, but I’d really welcome your views on this matter.

I thank you very much for raising these issues. With regard to the advertising industry and what we can do there, the Cabinet Secretary and I were very disappointed that the UK Government’s obesity strategy didn’t take any action in terms of addressing advertising aimed at children and young people particularly. We wouldn’t have the powers here in order to legislate in that area, so the Cabinet Secretary and I have written to the UK Government expressing our disappointment and our hope that they will turn their attention to this in due course. I think there are opportunities to support Welsh food and drink businesses through our food and drink action plan, which has been led by the Cabinet Secretary for Environment and Rural Affairs. Within that department, we have two centres, one in north Wales and one in south Wales, which are able to support businesses to become more innovative. Part of that can be reformulating their products to reduce the salt that they use, to reduce the fat that they use and the sugar that they use, but still maintain the kind of taste that the product is well known for. So, there are ways we can support our home-grown food and drink businesses in order to make more healthy products, which will make them more attractive to consumers as well.

Thank you for your statement, Minister, and for kindly providing a briefing to opposition spokespeople ahead of the introduction of the Bill. Wales has one of the best health services in the world, yet we also have some of the poorest health in Europe, and we must do whatever we can to address this. UKIP welcome the introduction of the Public Health (Wales) Bill, and we look forward to working with all parties in the Chamber to scrutinise and improve the Bill.

I welcome the introduction of a national register of tobacco and nicotine products, and its intention to uphold restrictions on selling such products to children and young people. We hope the register will also help to regulate the e-cigarette market. Currently, there is nothing stopping any person from cooking up batches of e-cig fluid in a bathtub and selling it at a local market, car boot sale or from a trolley on the high street. While I believe that e-cigarettes are a much safer alternative to traditional tobacco products and that the vast majority of retailers are responsible, end users have no surety that the product they are buying is safe. They simply do not know what the fluid they are buying contains or the conditions in which it was made. Minister, what consideration have you given to using the public health Bill to regulate the production of e-cigarette fluids?

Bought from a reputable source, e-cigarettes are orders of magnitude, safer than smoking traditional cigarettes, and, while it is preferable that smokers quit altogether, the reality is that many will not, even after accessing the Welsh Government’s gold-standard smoking-cessation schemes. Therefore, it is highly preferable that those smokers move to the much safer e-cigarettes. Public Health England advocate the use of e-cigarettes as an alternative to smoking and issue guidance to employers stating they may consider allowing people to use e-cigarettes at work if it is part of a policy to help tobacco smokers kick the habit. As we currently have 19 per cent of the adult population of Wales who smoke, we should be considering every avenue open to us to reduce the number. Minister, Public Health England and the Royal College of Physicians state that e-cigarettes are 95 per cent safer than smoking tobacco. Therefore, what consideration have you given to using this Bill to reverse some of the bans we have seen being introduced on e-cigarettes?

On other aspects of the Bill, we welcome moves to regulate special procedures and intimate piercing. The inclusion of health impact assessments is most welcome. I look forward to receiving greater detail on the impact pharmaceutical needs assessments will have in rural areas during Stage 1 scrutiny in committee.

Finally, Minister, we question the introduction of local toilet strategies. Without adequate access to public toilets, many disabled people, older people and people with health conditions are unable to leave their home. The British Toilet Association estimates that there are 40 per cent fewer public toilets in the UK than there were 10 years ago. We should place a duty on local authorities to either provide public toilets or ensure adequate public access to toilets, not simply drawing up a strategy. Minister, will you consider strengthening this part of the Bill? Thank you once again, Minister, for your statement, and I look forward to working with you to ensure that we deliver a Bill that delivers real public health benefits for Wales. Diolch yn fawr.

I thank the Member for those comments and, again, for the very constructive way in which the party has sought to engage with the Bill at this early stage. With regard to the register of e-cigarettes, I’m really pleased to say that e-cigarettes will be included in the register of retailers. This is the only part of the Bill where you will find e-cigarettes, because you’ll be familiar with the fact that the First Minister made a commitment not to include the banning of the use of e-cigarettes in public spaces within this Bill. However, we are including them in the proposed register because, in the White Paper, a number of correspondents, particularly from the local government sector, said it would be appropriate for registration requirements to be extended to the retailers of nicotine products, including electronic cigarettes. The Chartered Trading Standards Institute conducted a rapid review of the Nicotine Inhaling Products (Age of Sale and Proxy Purchasing) Regulations 2015, which came into force in October of last year. So, this is a new piece of research, which found that a total of 634 test purchases of e-cigarette products were made by young volunteers under the age of 18, and the results showed that compliance with the new regulations prohibiting nicotine inhaling products being sold to people under the age of 18 is still very low, with 39 per cent of young people being able to purchase them. So, I think it is, as you say, right that e-cigarettes should be included on the proposed register. The fact that they’ll be on there will help enforcement authorities with their enforcement duties as well.

I do share the concerns that the previous Minister had in terms of the impact of e-cigarettes on young people and the normalisation of smoking, and the normalisation of smoking whether it is through traditional cigarettes or e-cigarettes, because recent research has shown us that primary school-age children in Wales are more likely to have used e-cigarettes than tobacco. Six per cent of 10 to 11-year-olds and 12 per cent of 11 to 16-year-olds have used an e-cigarette at least once. So, it is an issue. I think it’s fair to say that the jury is probably still out in terms of the health benefits or costs in terms of e-cigarettes. I feel like the weight is moving against e-cigarettes in terms of the advice that the World Health Organization has given just this week. However, just to be clear, e-cigarettes beyond the register won’t be included in this Bill.

You moved on then to talk about special procedures. The Bill seeks to create a compulsory national licensing system for practitioners of special procedures, so defined in the Bill as acupuncture, body piercing, electrolysis and tattooing. This system will mean that to perform any of those procedures an individual must be licensed, and also that premises or the vehicle from which they operate must be approved. So, the aim here is to drive up standards in relation to the performance of special procedures and reduce the associated health risks, such as infection and transmission of blood-borne viruses as well. I know this is an issue that had a lot of interest in terms of scrutiny in the previous Assembly.

Our health impact assessments are going to offer a systematic means of taking health into account as part of decision-making and planning processes. So, this is really bringing life to our aspiration of health in all policies. The Bill includes provisions that will require Welsh Ministers to make regulations about the circumstances in which public bodies in Wales must carry out health impact assessments. So, the aim is that those assessments should be limited to policies, plans and programmes that have outcomes of national or major significance, or that will have a significant effect at the local level as well. The precise circumstances where they’ll be required will be set out in regulations following a process of consultation.

Just briefly there you referred to pharmacy and the pharmaceutical needs assessment and the importance of supporting rural pharmacies. I think that this is part of taking the strategic approach and making sure that people who live in rural communities have access to community pharmacies. I feel, as I’m sure many others do, they are underused resources at the moment. Pharmacists go through a great deal of training. They have a huge amount of expertise, and I feel that in the spirit of prudent healthcare they are able to operate at a higher level to offer more services than many do at the moment. So, the pharmaceutical needs assessment, and then the decisions that follow that, will hopefully make access to pharmacies and pharmacist advice more reliable in rural communities.

Finally, with regard to access to toilets, local authorities will be required to publish that local strategy to which you refer. But then, they will also have to provide details as to how they will propose to meet the population needs assessment. This isn’t just about toilets. This includes changing facilities for babies and changing places facilities for disabled people as well.

As others said earlier, Minister, I think it is very important that we get a more physically active population in Wales. I do believe that community-focused schools, as Angela Burns touched on, are a very important way forward. I also think that air pollution hasn’t had sufficient attention. I met with a group recently, for example, that told me that capital conversion costs for their particular fuel for taxi fleets, for example, would repay itself over a two-year period and make quite a dramatic impact on better air quality in our inner urban areas. I am sure there must be many other examples of how we can get much better air quality in Wales that we could practically make progress on quite quickly.

But what I really wanted to ask about is two things, really. One is smoking. I think we’ve made considerable progress in making smoking less socially acceptable. Smoking rates have come down, and that’s been a huge benefit to health in Wales. You allow in your statement for the possibility of further areas of restriction to be developed. One that I know has quite a lot of popular support in my experience is restricting smoking so that it’s not possible in outdoor restaurant and cafe areas where there’s seating and tables. I think people think that that’s particularly important in the summer, where some people see it as a choice between either not enjoying the fine weather or breathing in second-hand smoke, which for some people is particularly problematic, given their health conditions. And minimum alcohol pricing, Minister: I wonder if you could say something in terms of your thoughts on how that can be taken forward in Wales, again given the impact of alcohol abuse and immoderate alcohol consumption on health in Wales.

I thank you for those questions, and I neglected to address Angela’s point on the community-focused schools issue, so apologies for that. It is one of our manifesto commitments to make sure that we use the resources that we have in communities, particularly with regard to schools and the capital investment that we are making in twenty-first century schools, making those facilities available for the benefit of the wider community. Again, you mentioned the issue of pollution and air quality, which isn’t in the Bill, but I’m sure we will be having more detailed discussion on that issue as the Bill makes its progress through the various stages.

You were right to point out the significant progress that we’ve seen on the issue of smoking: 19 per cent of people in Wales now smoke, with our ambitious target to get to 16 per cent by 2020. I hope some of the measures in this Bill will certainly help us address that. I think it’s important to recognise, actually, that children and young people often get a bad rap, but in terms of smoking and alcohol consumption, actually, levels are at their lowest since records began amongst our young people. So, I think that we and they should be very proud of that as well. The Bill does provide for Welsh Ministers to extend the list of premises where smoking can’t take place. That can only be done through the affirmative procedure on the Assembly floor with a consultation. So, there could be opportunity at future stages for Ministers to extent the list, perhaps, to include the outdoor restaurants or cafeteria areas, for example, that you referred to, although again it might be something that we discuss as the Bill makes its way through the stages.

You referred to the minimum unit pricing issue. As you know, the Welsh Government has already consulted on this issue and had a favourable response in terms of it being something that could have an impact in terms of addressing harmful alcohol consumption in Wales. We do welcome the confirmation that Scotland’s Court of Session has given its approval to the Scottish Government’s plan to introduce a minimum unit price for alcohol. That determination was just a couple of weeks ago, on 21 October, so we’re still digesting what that means for Wales. But we do recognise as well that this might not be the end of the story, of course. It might well end up in the Supreme Court. So, we are keeping a very close eye on that and have a close interest in it, considering the way forward and what might be possible in Wales. We are very much of the view that introducing a minimum unit price for alcohol is one of the key measures that we can take to reduce alcohol-related harm. We are very keen to have similar legislation here in Wales, and we do see it as an essential part of the wider action we need to take within the context of our substance misuse delivery plan, which I referred to earlier. But, as I say, we’re watching the situation in Scotland and considering what we might be able to do.

Your statement refers to the creation in the Bill of a mandatory licensing system for practitioners carrying out special procedures—acupuncture, body piercing, electrolysis and tattooing—helping to protect people and so on. But when I wrote to you regarding the hair industry, you replied, on 27 October, that the regulation of hairdressing will not be included in the Public Health (Wales) Bill at introduction into the Assembly, scheduled for 7 November. Given that the hair industry in Germany must be registered and have a master craftsperson employed, but in the UK anyone can set up, and they don’t have to be qualified, trained or registered, despite providing dangerous procedures, including the use of chemicals on skin and hair, and given that the Bill as it stands does include beauty and procedures such as Botox and, I believe, dermal fillers, will you now give consideration, post introduction of the Bill, to the concerns raised by the industry in this respect?

I thank the Member for the question and I know this is something he has taken a particular interest in, and that the body representing hairdressers has also written to all Assembly Members on this particular issue as well.

It’s our view that industry regulation and health and safety are non-devolved, so it’s not something that we believe that we would have the powers to regulate within this Bill in any case. The reason we’ve chosen those four particular special procedures in terms of introducing the Bill to the Assembly was because these are ones that carry particular harm, or potential harm, I should say, because they puncture the skin and that could lead to infection, blood-borne viruses and so on. So, those are things that join together those four particular procedures. Also, they’re ones that local authorities are already familiar with, and I think it’s important when we introduce a Bill, certainly at this first stage, that local authorities are given a set of responsibilities that they are familiar with and are able to regulate within their current understanding, although I know a lot of training is already going on in anticipation of the successful passage of the Bill.

Just as was the case for no-smoking areas outdoors, the Bill does give power to Ministers in future to extend the list of special procedures should they choose to do so. Again, that would happen after consultation and via the affirmative process within the Assembly.

Most of the points I wanted to make have already been covered, but I did just want to say a bit about the public toilet strategy. I am concerned at how far we’ll be able to move forward the actual supply of public toilets by the Bill and I do think it is such a hugely important public health issue. I was visited in my constituency last week by a 92-year-old constituent who wants to start a campaign to have public toilets, because the last public toilet in Whitchurch has now been closed down, following the closure of the public toilet in Rhiwbina. It does mean that many elderly and disabled people don’t go out, because they’re not able to use the toilet. Schemes that have been brought in, such as to go in and use the toilets in the pub or the café—she said that they really don’t want to do that sort of thing because they get embarrassed going into a pub or a cafe, even if there’s a notice on the window saying that they are willing for people to use it.

So, I just wondered how having a strategy would take things forward, and the other point I wanted to make, really, was people with young children as well—it is very important that they’re able to get access to public toilets. So, I think it’s a vital public health issue, and I just wonder how we can really take it forward with having a strategy.

I thank you for raising that particular issue, and I know that a survey by Help the Aged, as they were when they undertook the survey—now Age UK—found that more than half of older people found a lack of public toilets prevented them from going out as often as they would like, and that very much reflects the kind of story you’ve told us now about one of your constituents as well. I’ve met with Crohn’s and Colitis UK and they’ve said very much a similar kind of thing, that a fear of going out and not knowing whether they would be able to go to the toilet does hamper people’s well-being in terms of being able to access everything that the community is able to offer them. I do hope that this Bill will mean that requiring local authorities to have a local toilet strategy in place will mean better planning at a local level, in order to make sure that facilities do meet the needs of communities. Accessible, clean toilets that are well located in places like parks, promenades, cycle tracks and walking routes will help encourage people to take more active travel, and take more active routes as well, and I think this is all part of the wider public health picture.

In developing their strategies, there is the aim that local authorities will consider the wide range of facilities that are available, both in the public sector—so, public libraries, community and town halls, sport centres, theatres and museums, which perhaps people wouldn’t feel so concerned about going into—but also private sector buildings—those private businesses currently captured under the public facilities grant scheme, for example—when developing their strategy. Because although public toilets are often seen within that context of those standalone public toilets that are maintained by local authorities, the resources out there are much wider. But, I do understand people’s reticence to perhaps use public toilets that they feel that they’re not entitled to use. So, as part of the delivery of the Bill, we would look to do an advertising public awareness campaign, so that people are more aware of the toilets they can use in the locality, and perhaps that might break down some people’s reticence to use the toilets that are there in the community as well.

Minister, many questions have already been asked, and I support fully Julie Morgan’s points on public toilets. I think we need to ensure that the strategy is actually implemented, and that people have access to all facilities. And if there aren’t any there, that they can’t simply say, ‘We can’t afford it’, but that they do something about it because it’s critical that those facilities are available. And signposting to those facilities in the towns is also critical. My simple comment, as someone who sat through the previous incarnation of the Bill, is that I’m very pleased to see the nicotine aspect of registers, because nicotine is an addictive chemical and it’s clearly important to register those as well as tobacco. It’s therefore important because we wouldn’t want anybody selling that type of product, considering the implications that that addiction could have.

Just one point. One of the things we were held up on is the cosmetic procedures issue. We were told very carefully that the 2013 Sir Bruce Keogh report was instrumental in looking at this, and it has been done, it’s been reported on. What are you doing to actually look at whether recommendations from that report to the UK Government can be implemented in this Bill, so that we do cosmetic procedures? I know that there was very deep concern about some of the procedures that did pierce the skin, but were not included in here, and therefore could be under that umbrella, but also had perhaps some serious implications for people, because there is a desire in many young people today to have different looks and cosmetic procedures. Therefore, we need to ensure that all cosmetic procedures are carefully regulated to ensure that young people don’t come across a situation where they face a terrible life ahead of them because they took the wrong decision and there was no regulation in place.

Thank you for that question, and for your welcome for the nicotine register particularly. But with regard to the special procedures, I know that during the public health White Paper consultation, and through the previous Assembly scrutiny, many Members and Assembly Members suggested a list of special procedures that should be extended to include things such as those you suggest, like dermal fillers, colonic irrigation and tattoo removal, and all body modification procedures, such as tongue splitting, scarification and branding. I know these are all things that were explored by the committee at the last Assembly. These haven’t been included within the definition of special measures within the Bill, but as I say, the Bill does allow Ministers to amend via regulations the list of special procedures in due course. And I’m sure that we will revisit some of the eye-watering discussions you had in committee at the last stage.

In order to be added to the list though, Welsh Ministers must consider that the procedure is performed for either aesthetic or therapeutic purposes, and that the performance of the procedure is capable of causing harm to human health. Those would be the boundaries within which we could take these decisions under the Bill. And the amendment might add to or remove a type of description of a procedure from the list, or it might vary a description that is already contained within the list as well. The reason for that is to allow us to remain flexible and be able to respond to those changing practices, which you referred to, because this particular field is one that moves very quickly, and trends happen very quickly and change quickly too.

Thank you. Thank you, Minister. That’s it, no more speakers; thank you.