Anti-smoking group Action on Smoking and Health (ASH) says serious thought should be given to a ban on smoking in cars.

In a report which says smoking costs the NHS 2.7 billion pounds a year, the lobby group argues that millions of children and young people are exposed to second-hand smoke in vehicles every day.

Similar bans are in place elsewhere in the world and a poll shows that the British public also supports such action.

Pro-smoking groups say such suggestions are just an attempt to stigmatise smokers and bully them into quitting. Lobby group Forest says such moves are an attack on the freedoms of adult smokers.

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A simmering row between family doctors and the government has erupted after Health Minister Ben Bradshaw accused GPs of stifling competition by operating “gentlemen’s agreements” not to poach each others’ patients.

Laurence Buckman, chair of the British Medical Association’s GP Committee, told the BBC the claim was “absolute nonsense”, but then rather undermined his own argument by adding:

“Nor are we going to compete for patients, that is not the way general practice works.”

But that is precisely the way the government wants general practice in England to work in future. It wants to improve patient access to family doctors and believes offering the public a choice of GP surgeries will be a popular and vital element of its plan.

It has already arm-twisted doctors into agreeing to offer extra evening and weekend appointments and is building 150 polyclinics — now referred to as “GP-led health centres” — open early till late, seven days a week, where patients can get seen without needing to register.

“My view is you can compete and collaborate at the same time,” David Colin-Thorne, the government’s national clinical director for patient care, told a media briefing. “Patients need choice to drive up quality and for flexibility.”

Mayur Lakhani, a former chairman of the Royal College of General Practitioners, told the same briefing that his research into the medical experience of black and minority ethnic people had found they were afraid they would be struck off their surgery’s register if they complained about their GP.

When they did try to change to another practice, they were faced with a long list of questions asking why they wanted to move.

“That shows the big culture change we have to undertake. The receiving practice, instead of welcoming a change, were actually putting barriers up,” said Lakhani.

“I don’t think patients will change GPs and practices every six months, but I think the ability to do that is very important.”

Family doctors will come under greater scrutiny, with their surgery’s performance against quality standards and the views of local patients published on the NHS Choices website.

The government wants to sweep away the days of being stuck with an unsatisfactory GP practice. The question will be whether it can keep pumping in the resources — and keep doctors sufficiently on-side — to make sure there are enough GPs around for patient choice to become a reality.