Published: 30/09/2004, Volume II4, No. 5925 Page 8

Empowering the individual to master their environment and improve their health is the key philosophy behind the government's forthcoming public health white paper, health secretary John Reid said last week.

But despite this, Mr Reid hinted that the government might still be poised to deliver a ban on smoking in some public places.

He told public health managers that people should have the freedom to make their own choices on how to live their lives - 'apart from when exercising that freedom impacts on the health of those around them'.

His comments - to the Health Development Agency conference - came on the same day he told both pro and anti-smoking campaign groups that he had 'listened to all sides of this debate very carefully', and that 'the balance of evidence and opinion on this issue is such that the status quo cannot continue'.

In a speech that encompassed philosophical themes borrowed from a variety of sources ranging from the Enlightenment to Hegel, Mr Reid said he would not go into the detail of the much-anticipated white paper. But he was unequivocal that it would focus on 'individual motivation' as the 'engine' of reducing health inequalities.

But he added: 'The government needs to support disadvantaged people as they struggle to get motivated to either improve their health or take more control over their conditions, but it is their motivation that is the defining characteristic of change.'

Deputy chief medical officer Fiona Adshead said the paper would be driven by the Treasury public service agreement targets on health inequalities.

Addressing the conference, Ms Adshead - who has led on development of the policy - said public health professionals should prepare to 'get in the spirit of the opportunities' the white paper 'will bring, and really make it happen'.

'Perhaps the overriding message of the white paper is this really is a time to deliver a real change both for individuals and in communities, ' she said.

l HDA research on mother and child nutrition to be published later this autumn will call for a national NHS policy to help banish the social pressures that prevent women from breastfeeding.

The research, previewed at the conference, says that regional and NHS targets with 'supporting activities, penalties and incentives' are needed if the numbers of women breastfeeding - which has been shown to improve the health of mothers and babies - are to increase significantly.