Why is telling the truth greeted with outrage?

The fact of the matter is that Dr Reid had the bad taste to link health with social class

For some reason, whenever a politician states the obvious truth, it is usually described as a "gaffe". Dr John Reid, the Health Secretary, found himself in this position this week when he addressed the question of smoking. His views were unfamiliar from the mouth of a government minister, and a certain amount of outrage promptly followed.

For some reason, whenever a politician states the obvious truth, it is usually described as a "gaffe". Dr John Reid, the Health Secretary, found himself in this position this week when he addressed the question of smoking. His views were unfamiliar from the mouth of a government minister, and a certain amount of outrage promptly followed.

Speaking at a Big Conversation event, he said "I just do not think the worst problem on our sink estates by any means is smoking, but it is an obsession of the learned middle class. What enjoyment does a 21-year-old single mother of three living in a council sink estate get? The only enjoyment sometimes they have is to have a cigarette. My argument is that empowerment is different from instruction. You have got to be very careful that you do not say to the 75-year-old that 'you are better off if you are not going to be able to go to a working men's club and smoke'."

On the whole, it is quite difficult to see what is so outrageous about this. Smoking is not the worst problem in "sink estates"; a poor single mother might, indeed, have very few pleasures in her life, and take pleasure in smoking; no one, surely, contests that many, perhaps most, smokers do so because they enjoy it. Dr Reid is perfectly consistent; he advocates the labelling of unhealthy foods, and then leaving the consumer to make a choice. He is also in favour of letting the smoker have a choice, and not enforcing a ban.

All these seem either entirely uncontentious, or a perfectly respectable and rational position for a government minister to take. However, Ash, the anti-smoking group, described his comments as "incredibly patronising," and other voices swiftly followed.

In fact, one might have thought it was the opposite of patronising to point out that even the very poorest have a choice, and have pleasures. It is slightly surprising that the very poorest members of society can now afford to smoke - the other day, I was charged £5.20 for a packet of 20 Marlboro Lights in central London - but it is evidently the case that many poor people do so.

Dr Reid's point is one made by George Orwell long ago; that if you are in dire economic straits, it ought to make more sense to live on raw vegetables, drink tap water and walk everywhere, with the result that poverty would lead to very good health. In fact, poverty encourages many people to rely on small, wasteful treats, full of sugar and nicotine. This is a perfectly good point. Where, then, did Dr Reid go wrong?

The fact of the matter is that Dr Reid had the bad taste to link health with social class, or to mention social class at all. In Orwell's day, it was perfectly acceptable to talk in every context about social classes, and to observe, as he frequently does, that the working classes have bad teeth, worse diet and poorer health than the middle classes.

That observation probably still stands, now that you can barely find an NHS dentist and the temptations to eat repulsive fast food are everywhere. The very poor are more likely to smoke, to live on a poor-quality diet, to have more health problems than the middle classes, exacerbated, in some cases, by difficulties of access to good health care. It is difficult to deny any of this.

There is a sort of pretence, however, that the only reason for this is that the working classes are peculiarly vulnerable. There is some truth in this contention. For instance, if you are bringing up children on a really dire estate, it is much more likely that they will come into contact early with drugs. It is also true that any delicious food which is cheap enough for you to afford and not present you with any challenges will not be very good for you - I mean, you could stew oxtail and lentils for hours, and it would be cheap and good, but you probably aren't going to feel up to the task, are you?

But vulnerability is not the whole story. Where Dr Reid went wrong, and where he managed to cause offence, is that he evidently believes that everyone, even the poorest members in society, is perfectly capable of making a choice for themselves. The challenge for government, as he sees it, is to inform everyone as clearly as possible of the health risks involved in fast food, or smoking cigarettes, and subsequently accepting that people make choices.

I don't see how you can quarrel with that. Smoking is a pleasure to Dr Reid's single mother of three, just as it is to David Hockney, or to me, and all of us know that it is terribly bad for us. David Hockney or I can express in the newspapers our view that a smoking ban is a really bossy and nannyish thing for the government to be contemplating. The single mother, on the other hand, does not have a voice. It is actually quite refreshing to hear a government minister speculating plausibly that these might be her views.

For a good long time, when we hear ministers inventing such figures, and imagining what the single mother wants, what has tended to come out is what the Government wants, and what would be good for her, whatever her choice. And of course, it is much easier to do that by not being honest about the realities of working-class life.