Tony Blair urged the nation yesterday to take more responsibility for its own health as he signalled a move away from the so-called nanny state.

In the second of a series of major speeches on domestic policy under the slogan "Our Nation's Future", the Prime Minister said the Government could not "make choices" for people to improve their wellbeing.

But he insisted that it would help individuals take the "healthy option". Failure to address bad lifestyles would put an "increasing strain" on the NHS, and hinder the quest to reduce social inequalities, he added.

Mr Blair told an audience in Nottingham: "In the future, health care cannot be just about treating the sick but must be about helping us to live healthily.

"This requires more from all of us, individuals, companies and Government.

"And for Government it has to encourage, it has to inform, but, if necessary, in a tougher way than ever before, it has to be prepared to act.

"The alternative will be a future in which the capacity of the NHS to treat us simply won't keep pace with the state of the country's health."

Mr Blair said the Labour Government had "explicitly" abandoned the "paternalistic state of the post-war years, not because that state did not fulfil a worthwhile task, but simply because such a state no longer fits the times".

Today's public health problems were "not, strictly speaking, public health problems at all", according to the Prime Minister.



Mr Blair said obesity was rising rapidly, and the social effects of alcohol abuse were "widespread and worsening". Smoking may account for half of the "health gap" between social classes, he added.

"These individual actions lead to collective costs. It is worth pausing for a moment to consider the consequences that inaction will bring. The economic burden of chronic dis-ease, including lost work, the early drawing down of pension entitlements and the need for palliative care, could be vast."

Mr Blair said a more "robust" approach to health was needed because everyone would pay the price for failure.

"That doesn't mean you stop treating people in the NHS who smoke, or force people to do what they don't choose to do," he said. "But it does mean that Government should play an active role in the way the enabling state should work: empowering people to choose responsibly."

Mr Blair said the Government was acting by insisting school meals become healthier, and pledged that if voluntary initiatives limiting advertising of junk food to children have not worked by 2007, legislation would be brought in.

But providing good information so people can make the right choices is often as important as legislation.

Dr Pat Spungin, founder of parental advice group, welcomed Mr Blair's comments, but said "real behavioural change" required more than "just Government lecturing".

"Our research shows that parents understand healthy eating for themselves and their children and they try to set a good example.

"They are far less confident about exercise. Parents worry about their own fitness but they are short of both the time and money to improve the situation."

Nick Stace, director of campaigns at Which?, said: "The Prime Minister is right to emphasise the importance of everyone playing their part in creating a healthier nation.

"Action is required to reduce the national blight on public health that the obesity time-bomb has created."