Urgent and Emergency Care Review

Alex Cunningham Excerpts

Tuesday 12th November 2013 Commons Chamber

[Alex Cunningham (Stockton North) (Lab)]

The crisis in nurse vacancies and recruitment highlighted today by the Royal College of Nursing affects the North Tees and Hartlepool NHS Foundation Trust, which tells me that it has been forced to recruit trained nurses from the Philippines, as there are insufficient UK nurses available. What is the Secretary of State doing to address that particular part of his failure?

[Mr Hunt]

I have to gently say to the hon. Gentleman that recruiting nurses from the Philippines did not happen for the first time under this Government. One reason why those nurse vacancies have gone up is that the Government decided to conduct a public inquiry into what happened at Mid Staffs. The system reacts to that by wanting to hire more nurses, and I think that he should welcome that, not criticise it.

Tobacco Packaging

Alex Cunningham Excerpts

Thursday 7th November 2013 Commons Chamber

[Alex Cunningham (Stockton North) (Lab)]

I understand the time constraints, Mr Deputy Speaker.

I, too, am grateful to the Backbench Business Committee for giving us an opportunity to debate this issue. I am pleased to be following the hon. Member for Harrow East (Bob Blackman), who has more than earned his spurs through his campaign.

On the last occasion when we tried to encourage the Government to act in this regard, speakers were restricted to just three minutes, and even a number of Members on the other side of the argument shared our frustration because they had so little time to put their case. Many Members in all parts of the House are still far from happy that the Government are delaying the decision to do the right thing and implement the proposals for standardised packaging—a delay that will lead to countless more young people starting to smoke.

[Pete Wishart]

No doubt the hon. Gentleman is aware of the efforts that have been made in Scotland, and wishes to congratulate the Scottish Government on the fact that we are going to introduce standardised packaging as well as minimum pricing. We are going to do that because we take the issue of public health very seriously, and because we do not have Lynton Crosby advising us.

[Alex Cunningham]

I will congratulate any Government who are making the right decision on plain packaging.

I am aware that some Members fear that a fall in demand for tobacco will cost many of their constituents their jobs. I know that they will stand up and speak for the industry, but they will also be speaking for their constituents. I hope that the prospect of improved health, a smaller burden on the national health service and the protection of children will make them think again. I also hope that today’s debate will focus not on the cynical speculation that surrounds the drivers of tobacco policy and the influence that the tobacco lobbyists are able to exert, but on the decidedly positive effects that standardised packaging could bring, and the harm that is likely to result if the Government continue to insist on dragging their feet.

Reducing the prevalence of tobacco use is a key public health priority. None of us needs reminding of the consequences of smoking, which remains the leading cause of preventable mortality in the UK. Half the number of lifetime smokers will die from smoking-related diseases, which means that there may be 100,000 preventable deaths each year. One in five adults continues to smoke, and many people continue to take up the habit, including 573 children aged between 11 and 15 each and every day.

[Dr Wollaston]

Does it not strike the hon. Gentleman as strange that the Government claim to be delaying the introduction of standardised packaging because they want to wait for more evidence, but at the same time are virtually rushing into regulation to make e-cigarettes a medicinal product, although there is mounting evidence that, if anything, they could cause harm?

[Alex Cunningham]

I agree that we also need to look into the issues surrounding the smoking of electronic cigarettes.

The Government should be acting on this matter. The evidence has already been presented to the House today. It is unquestionable that we need to take action now, and save children and young people from an addictive habit that will devastate their lives.

As I have said many times before, while I disagreed with the former Health Secretary, the right hon. Member for South Cambridgeshire (Mr Lansley), about a number of issues, I believe that the best thing he ever said was that he wanted the tobacco industry to have “no business” in the UK. I hope that the new Under-Secretary of State for Health, the hon. Member for Battersea (Jane Ellison), shares that goal, and will pursue it with the vigour that it deserves. I welcome her recent assertion that

“Stopping children and young people smoking is a priority for us all”.

However, actions speak louder than words.

Since the Government’s consultation closed 15 months ago, Australia has become the first country to introduce standardised packaging for tobacco products. That is already changing attitudes. Our own Government’s inaction in failing to enact measures similar to those in Australia poses a major threat to tobacco control. However, I was pleased to hear the new Under-Secretary of State tell the House during Health questions last month that

“new information ... not just from this country but from around the world… is under very active consideration.” —[Official Report, 22 October 2013; Vol. 569, c. 132.]

I should welcome her confirmation of the timetable for the completion of that consideration and the making of a definitive decision.

I have no doubt that standardised packaging for tobacco products is necessary to quell demand. Smoking is an addiction that begins in childhood, and tobacco packaging is designed to be attractive, catching the eye of young people in particular. I am aware of the damage that this horrible habit is doing to people in my constituency, young and old alike, many of whom live in some of the most deprived wards in the country. We need to take active steps to reduce the incidence of smoking, and to implement measures to prevent future uptake. The decision to delay progress with standard packaging will needlessly condemn hundreds of thousands more to a life of addiction because some think it “cool” to smoke. Plain packaging fits the bill. Not only is there a real need for it, but it is a solution that is wanted and workable.

It is worth noting that, during a Westminster Hall debate in September, the former Under-Secretary of State for Public Health, the hon. Member for Broxtowe (Anna Soubry), recounted her own experiences of tobacco addiction and its horrendous consequences. Fortunately, she was able to kick the habit. It is significant that she recalled the “power of the packet”, and spoke openly of choosing a particular brand of cigarette for her first pack

“because they were green, gorgeous and a symbol of glamour.”—[Official Report, 3 September 2013; Vol. 567, c. 23WH.]

Indeed, she made a superb case for standardised packaging as a means of preventing future uptake. I hope that that, along with evidence provided by fellow Members today, will remind the Health Secretary of the strong supporting evidence, and persuade him to delay no more. Perhaps he will even go so far as to do the right thing and give Members the right to vote on the issue, thus allowing the will of Parliament to be implemented.

The United Kingdom has previously taken a leading role in this regard, certainly in Europe. It has some of the most comprehensive tobacco control policies in the world, not least the tobacco control plan, which led to the introduction of smoke-free public places and the banning of displays on retail premises. It is clear that the current Government have recognised, at least to some degree, the raft of negative consequences that can arise from ready access to branded packaging, yet Ministers remain adamant that the evidence we have is not substantial enough, and continue to insist that non-legislative solutions are better suited to the task in hand.

There is already a wealth of evidence that standardised packaging works, and new evidence is being published all the time. A systematic review of 37 peer-reviewed studies, carried out by the university of Stirling for the Department of Health, found standard packaging to be less attractive while also improving the effectiveness of health warnings, thereby reducing smoking uptake among young people. The review also found that standardised packs were perceived as having less “clutter” to detract from the all-important health warnings, with the monotony and sincerity of the packaging serving to enhance their seriousness and believability. Since then at least 12 additional studies have been published, and the growing body of research consistently reports that standardised packaging would reduce the appeal of tobacco products and increase the effectiveness of health warnings.

Lest there be any doubt, let me add that the evidence from Australia confirms those findings. Not only do those who smoke cigarettes from standardised packs perceive their cigarettes to be of a lower quality than those from branded packs, but there is a demonstrated tendency to perceive cigarettes as less satisfying.

[Simon Wright]

Is the hon. Gentleman aware that the number of calls to Quitline, Australia’s smoking cessation service, has increased considerably since the introduction of the new law in that country?

[Alex Cunningham]

We can all choose which part of the briefing we wish to cite. It is clear to me that standardised packaging is working in Australia, and I am sure that it will continue to do so. The hon. Member for Harrow East mentioned that 81% of people were likely to have thought about quitting at least once a day during the past week, and I think that that too is an important statistic.

What further evidence does the Secretary of State need to see before he commits himself decisively to making these life-saving changes? Pressure on smoking must be continuous and relentless, because we are fighting a pervasive, lethal and powerful addiction. We cannot afford to waver or hesitate. Every year more than 200,000 people under the age of 16 start to smoke, and that is 200,000 too many. Even if plain packaging just halves the number of new young smokers who are currently attracted to the slim, colourful and glamorous packs, it will have had a major impact on hundreds of thousands of lives.

If we wait the suggested three years for evidence from Australian legislation to emerge, little if any progress will be made. Incidentally, in the United Kingdom fewer people are attempting to quit with the help of the national health service for the first time in five years. The current prospect is unacceptable. The Government must act now to prevent further tragedy, rather than adopting the leisurely timetable that has been proposed by some who think that they know better, or perhaps have vested interests.

Let me drive the point home. More than 250 people die prematurely every year from smoking-related diseases in my local authority area of Stockton-on-Tees. We have a lung cancer rate of 67.1 per 100,000 people, which is a staggering 40% higher than the national average, and figures show that 610 children aged between 10 and 14 are already regular smokers.

I recall young people referring to cigarettes as “cancer sticks”, but many still think it cool to smoke. I see them walking to school, cigarette in hand or mouth, and it upsets me to think that had the Government acted, many of them would not have been attracted to the habit at all. Attempts are being made in the other place to introduce new clauses to the Children and Families Bill which would create a requirement for standardised packaging, and it is also possible that my own proposals to render it illegal to smoke in any vehicle where children are present will be reintroduced.

[Jake Berry]

Will the hon. Gentleman give way?

[Alex Cunningham]

No.

I hope the Government will do the right thing by pre-empting the votes in the other place and announcing they will introduce their own legislation and put this matter to bed once and for all. No company should be allowed to promote such a deadly product through advertising and marketing. The glamorised packet in the hands of a young person is the most powerful marketing tool the industry now has left. Let us deny it to it without delay.

The case for standard packs is strong, and the need for action is urgent. A few weeks ago I spoke of the two sides in this debate: on the one side, the rich and utterly cynical industry that is quite happy to market products that still kill more than 100,000 people across the UK every year—more than the next six most common causes of preventable death—and on the other side, the medical and health community, politicians from all parties, and the general public. In the middle are the Government. Ministers from the Prime Minister himself down through the ranks know there is evidence that standardised packs will work for the better. I hope they will announce action now and give our people a better chance at better health.

--- Later in debate ---

[Dan Jarvis (Barnsley Central) (Lab)]

Although I disagree with much of what we have just heard, it is a pleasure to follow the hon. Member for Ribble Valley (Mr Evans). I am grateful that we, once again, have a chance to speak about the merits of standardised packaging. I also spoke on the subject in the debate that took place earlier in the year. Like many other right hon. and hon. Members, I spoke of the devastating effects that smoking-related illnesses have on families and individuals throughout our country. In the 10 months after the Government closed the consultation on this matter, no meaningful action was taken. During that time, 150,000 children will have started to smoke and, as we have heard, addiction results in the death of half its long-term users. Fifteen months have now passed, so we have had another five months during which we have had the opportunity to reduce significantly the 100,000 smoking-related deaths that take place each year. Sadly, yet again, no action has been taken by this Government.

We cannot neglect our duty to give all children and young people the best start in all areas of life. Health, education, decent housing and physical and emotional security are some of the very basics we should strive to achieve. Without them, children do not have an equal chance in life. By failing to protect children from the dangers of smoking when they are too young to make a truly informed choice, we are failing to provide each child with their very basic rights. The reform is simple and the potential gains are immense. There is a reason why smoking-related deaths are labelled as “preventable”. The question is how long, and how many lives will it take, before the Government act.

One thing is clear: standardised cigarette packaging will be introduced. This country has historically taken a strong line on the regulation of harmful products consumed by young people: in 2005, we tightened regulations on the advertising of alcohol, ensuring that advertising did not link to youth culture or irresponsible behaviour; to prevent passive smoking, we banned smoking in public places; to prevent children from taking up smoking at a young age, we made it illegal for shops to sell cigarettes to under-18s; and to prevent cigarettes from being glamorised, we ended sports sponsorship and billboard advertising.

We have put legislation in place to make adult consumers fully aware of the risks associated with smoking, launching nationwide health campaigns and offering tailored support for those who want to quit. Evidence and public support has helped successive Governments strive to improve the health of our nation. We must continue that tradition and strive to give young people every opportunity to live a healthy life. If we are to improve public health, cut preventable deaths and prevent young people from taking up a habit that could cause them significant harm, the course of action that is open to us is clear: standardised cigarette packaging, which can and would improve the health of future generations.

The evidence is clear: advertising works. If it did not, tobacco companies throughout the world would not spend huge amounts of money to reach out to new and existing consumers. Last year. Cancer Research UK released a report on the influence that marketing has on young people. It stated:

“All 19 quantitative studies found standard packs less attractive than branded equivalents, to both adults and children”

and that

“13 qualitative studies found that standard packs consistently received lower ratings on projected personality attributes (such as ‘popular’ and ‘cool’) than branded packs”.

All that reinforces the World Health Organisation’s conclusion:

“Marketing of tobacco products encourages current smokers to smoke more, decreases their motivation to quit and urges young people to start”.

Over half of long-term smokers die from a smoking-related disease, and that amounts to more than 100,000 people each year. In my constituency, 283 people per 100,000 die each year from smoking-related diseases. An estimated 1,110 young people aged between 10 and 14 are classified as regular smokers. Given that nationally each year more than 200,000 young people under 16 are beginning to smoke, inaction amounts to nothing less than neglect. For Barnsley alone, smoking creates a bill amounting to £75.3 million each year; financially, and socially, the costs of smoking are high.

The evidence is clear, and the only thing lacking clarity in this debate is the reason behind the Government’s failure to act. By introducing standardised packaging, Britain would send an important message that we are a country that prioritises our children’s health and well-being. By failing to act, the Government are prioritising business interest over the health of young people and future generations.

[Alex Cunningham]

My hon. Friend used the word “neglect” and said that we could be neglecting our young people by failing to act. Does he agree that this is a genuine child protection issue?

[Dan Jarvis]

I agree with my hon. Friend. We are in this place to make judgments about what is in the interests of our constituents, and it is my judgment, as it is his and, I believe, that of the majority of hon. Members, that it is in the short-term, medium-term and long-term public interest of our constituents to introduce standardised cigarette packaging.

I therefore strongly believe that the arguments against plain packaging—standardised packaging—and the justification for the Government’s “wait and see” approach are inconsistent. First, introducing standardised packaging is not aimed at stigmatising adults who already smoke. This is not about limiting choice for adult consumers; standardised packaging does not change what is inside the packet, but is a measure to protect children who are more easily influenced by marketing. Secondly, some hon. Members have argued that introducing such a measure would limit the tobacco industry’s right to advertise. Instead, we should be asking ourselves whether, by allowing the continuation of the status quo, we are infringing on the right of every young person to have a healthy childhood, and increasing their chances of taking up a habit that could have significant health implications for them for the rest of their life.

It is regrettable that I, along with many other hon. Members, must persist in relaying the facts to a Government who, as of yet, seek to ignore the evidence in front of them. This country has been an international leader in public health policy and we should continue to be so. We will have standardised packaging at some point in the future—it is just a question of when. Fundamentally, standardised cigarette packaging is about improving the nation’s health and giving each child the best possible chance of living a healthy life. The choice is theirs when they are an adult, but the responsibility is ours now. I urge the Government to act.

--- Later in debate ---

[Mr Kevin Barron (Rother Valley) (Lab)]

I congratulate the hon. Member for Harrow East (Bob Blackman) on securing this important debate. Like him, I am an officer of the all-party group on smoking and health, and I also believe that tobacco control transcends the usual party differences. In my years in the House, that has certainly been the case for anti-tobacco policy.

Members will know that back in 2006 the previous Labour Government conceded a free vote on ending smoking in enclosed public places. The vote was won by a majority of more than 200, which showed that the proposal had strong support. The Government might want to find a similar means of getting themselves out of their awkward position, as they have been accused of being in bed with the tobacco industry because they have blocked the introduction of standardised packaging. The Children and Families Bill, which is now in Committee in the other place, might present such an opportunity.

The hon. Member for Harrow East rightly drew our attention to the fact that most smokers start their lethal addiction when they are children and that, for many years, the tobacco industry has advertised and marketed its products to make them as attractive to young people as possible. We all know that eight out of 10 smokers start by the age of 19 and that more than 207,000 11 to 15-year-olds become smokers each year. One in two of them, if they remain smokers, will die a premature death. In this country, in the region of 100,000 premature deaths a year are caused by the habit of smoking.

I am sorry that the hon. Member for Ribble Valley (Mr Evans) is no longer in the Chamber. He made the argument that the 12 million smokers in this country were all adults. Of course, most of them are adults—that is absolutely true—but at what age did they start smoking? Statistics on the number of people who start smoking at the age of 21 are insignificant. I started smoking years before I could legally buy cigarettes. I was smoking at the age of 12, and I stopped at the age of 24. The vast majority of people I was at secondary school with smoked. We were just trying to emulate other people. I also came from a poor, working-class family, and in theory there was not the money to buy cigarettes, but we used to find it. I say to the hon. Member for Hornchurch and Upminster (Dame Angela Watkinson) that if we look at the incidence of smoking now, social classes 4 and 5 have the majority of smokers and of premature deaths.

The importance of packaging is well understood by the tobacco companies. They dodge the existing health warnings and packaging requirements with great skill and ingenuity. I draw the attention of the House to the packaging of Benson & Hedges Silver Slide. Benson & Hedges in this country is owned by Japan Tobacco International, one of the big four international companies. People slide the cigarettes out of the pack, so it is not the standard packaging that was around when I was smoking back in the 1950s and 1960s. The outside of the Silver Slide package looks pretty normal but, unlike most packs, it is opened by pressing the side opening where it says “Push and Slide”, which exposes a tray containing the cigarettes. Printed on the tray are the words:

“I owe my success to having listened respectfully to the very best advice, and then going away and doing the exact opposite”,

which is a quote from G. K. Chesterton. The initials B&H are highlighted for a little extra brand identity on the slide. I suggest that the design has the obvious purpose of reinforcing a key tobacco industry marketing message that has been used with success for many years, particularly to recruit young people to smoke and to discourage quitters. That message is pretty simple—smoking is cool and an act of rebellion, and it is adult and transgressive. The hon. Member for Harrow East rightly pointed out that that marketing strategy is set out clearly in the internal documents that were published as a result of the US master settlement agreement with the industry.

[Alex Cunningham]

Is my right hon. Friend aware of the advertising in America for Vogue cigarettes, which says:

“The Vogue cigarette style was based on 1950s couture. The cigarettes that are preferred by women from across the world. Their lengthened appearance is an attribute of their femininity”?

Does he think that that is another example of the industry aiming to glamorise smoking?

--- Later in debate ---

[Jake Berry (Rossendale and Darwen) (Con)]

A lot of the points I was going to make have already been made, but I will start by saying that I absolutely support anything that is proven to reduce smoking. On that evidence-based test, I am delighted to congratulate the schools in my constituency of Rossendale and Darwen that have made fantastic progress on reducing the number of young people who take up smoking. Nationally, there is a good-news story to tell about the fall in the number of people who smoke and who take up smoking. The number is less than 20% of adults for the first time since records began, and there have been continued falls in the number of young people ever taking up smoking.

Many of us have had experience of cancer. Members, including my hon. Friend the Member for Harrow East (Bob Blackman), whom I congratulate on securing this debate, have spoken movingly about their own family experience with cancer. It is a horrendous disease and that is why I am growing a moustache for Movember.

I think that lots of people who smoke are realistic about the risks. There cannot be many of them who do not know that smoking has a direct link to cancer and that it ends lives more quickly than may otherwise be the case. Some 12 million people still exercise their free choice to smoke cigarettes, however.

Many of the Members who are in favour of plain packaging have said that it will be a next step, but what they really mean is that it will be the next step on the road to banning smoking. Let us not beat about the tobacco bush: if people want to ban smoking—a legitimate habit of 12 million people in this country—let us have a debate about it. Some have spoken about taking incremental steps towards banning smoking in cars. I was tempted to intervene on the hon. Member for Stockton North (Alex Cunningham) to ask how such a ban could be enforced, but I invite him to tell me now.

[Alex Cunningham]

Nobody wanted to wear seat belts when legislation was introduced, but the vast majority of people started to do so. I think that about 90% now do so. I believe that people would adhere to a law if we introduced it. If not, we would need just a few cases in court and I am sure it would then start to happen.

[Jake Berry]

I guess that the reason why people wear seat belts is that it is a criminal offence not to do so. If the hon. Gentleman is suggesting that smoking in cars should be made a criminal offence, that just reinforces my point about the desire of certain people on the other side of the debate to ban smoking. If that is what people want, we should have an active debate about it and give people who smoke legitimately an opportunity to have their say.

During this Parliament alone, the Government have increased NHS funding by £12 billion, given people access to the cancer drug fund and protected public spending with regard to local authority public health budgets. That is good progress and I am proud to be part of a Government delivering it. Limits on the display of tobacco products have also recently been introduced in larger stores. Anyone who has been to a supermarket recently will have seen the white signs that slide backwards and forwards to disguise tobacco products, and they will be introduced in smaller retailers in 2015. I support that and think it is a good thing.

The ban on vending machines in pubs is particularly good. I started smoking by buying cigarettes by the men’s loo in a pub in Liverpool, where I was brought up. It is the easiest way to buy cigarettes under age, so I am delighted with and support the ban. The way in which the Government have continued to increase the tax on cigarettes has also been good. I think that making them more expensive discourages people from taking up smoking. I support all that action, but such action must be based on benefits.

[Jake Berry]

I think it is right to say that if tobacco was discovered today it probably would be banned. I also think that if alcohol was discovered today it probably would be banned. That does not mean that we should seek to do so.

I am very pleased with the progress the Government have made. The evidence shows that we have reduced to a record low the number of people who smoke, but there are still things left on the to-do list. First and foremost, we need to look at the evidence from Australia. If it demonstrates that plain packaging has reduced the amount that people smoke, we should take it up and I would not oppose it. I do not accept, however, that that has yet been proven. Part of being in this House, in government or in opposition is to have an evidence-based debate about outcomes. I do not think that we have the evidence or that the outcome will be a reduction in the amount that people smoke. We also do not yet know the impact of disguising packages in supermarkets, which may have the effect we seek without increasing the regulation on the tobacco industry.

We need much more rigorous enforcement against under-age sales. It is illegal to buy cigarettes under the age of 18. People under that age can have consensual sex and they can go to Afghanistan to fight in the Army, and the Opposition and the Liberal Democrats think that they should have the right to vote, but they are not allowed to buy cigarettes. We should have much more rigorous enforcement of the existing laws against selling cigarettes to under-18s, rather than rush to introduce new laws on plain packaging and banning smoking in cars.

[Alex Cunningham]

Will the hon. Gentleman give way?

[Jake Berry]

No, I will not.

The European Union has recently legislated on banning 10-cigarette packs and menthol cigarettes. I do not support the ban of 10-cigarette packs. People who smoke often purchase a packet of 10 cigarettes as a way of rationing themselves, and people who are trying to cut down on smoking will also buy them. I understand that this is about increasing the price of the first packet of cigarettes that someone buys, but making people buy 20 cigarettes at a time will increase the amount they smoke and encourage them to smoke more. That will be the unintended consequence of what is probably a well-intended piece of EU legislation and I am disappointed that the Government supported it.

Legislation banning menthol cigarettes also went through the European Parliament just a few weeks ago. I do not understand why the hundreds of thousands—millions even—of people in this country who smoke menthol cigarettes should have them taken away from them. People have to be able to make their own decisions. If they want to smoke normal or menthol cigarettes, they should be free to do so.

This House also needs to give much more attention to legislation with regard to electronic cigarettes. I do not smoke normal cigarettes. Having moved on to electronic cigarettes as a way of giving up, I know that they can be a hugely positive medicinal aid if someone is desperate to give up smoking. To talk about cigarettes as they are today is to talk about old technology. Within the next year or 18 months, in the United States of America more fluid for electronic cigarettes is likely to be sold than traditional cigarettes. It is a large, unregulated industry. We need to get a handle on it and an overview of it and scrutinise its potential benefits or, indeed, dangers. We need to start considering legislation with regard to electronic cigarettes and try to prevent young people from taking them up.

I know from experience in my local pub, the Robin Hood in Helmshore in my constituency, that more people are starting to smoke electronic cigarettes because they can do so while standing at the bar. Young people are starting to smoke them because they can get champagne, truffle, cherry and bubble gum flavours. We need to debate this important development in order to have some sort of control and to protect young people from, to be frank, the inappropriate glamorisation of the electronic cigarette.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health (Jane Ellison)]

It is a genuine pleasure to respond to this Backbench Business Committee debate. I was a member of the Committee when my hon. Friend the Member for Harrow East (Bob Blackman), who initiated the debate, made a bid for it, although at the time I did not expect to respond to it, so I am in an interesting position. My hon. Friend made a great bid and we have had a terrific debate. I am grateful for the contributions from all hon. Members.

It is good that we are debating this important issue now. It has been helpful for me, as a new Minister, to hear arguments put so eloquently from across the House, and I will try to respond to some of the specific points made and to set out the Government’s position. I recognise that I will disappoint some people, but I will try to give a flavour of the Government’s current position and mention some of the important measures we are taking on tobacco control.

As many hon. Members have said, tobacco use remains one of our most significant public health challenges. For me as a new Minister, over the past month briefing after briefing and chart after chart have illustrated how important and what a significant public health challenge tobacco control is. There is no question in my mind that it is an essential aspect of any Government’s commitment to reduce the number of people dying prematurely in our country, and it is essential to promoting the health and well-being of children. A number of speakers have made the point that two thirds of smokers say they were regular smokers before they became adults. Many have spoken about adult choice, but we must recognise that by the time many people are addicted to smoking, they are already an adult and the addiction started as a child.

As hon. Members know, the Government have decided to wait before deciding on standardised packaging, but I do not recognise some of the time frames that people have ascribed to our position. I said that during Health questions, and I repeat that the policy remains under active consideration.

Interesting points have been raised in the debate, including about emerging evidence from Australia and studies carried out elsewhere, some of which the shadow Minister referred to in her contribution. Evidence and information are emerging all the time, and we want to spend more time assimilating that information and considering the likely effect that standardised packaging would have in this country. It is sensible and sound politics, particularly when dealing with a controversial area and a litigious industry, to show the stages by which we reach a decision, and I am sure that Members appreciate that we must be able to evidence that decision.

[Alex Cunningham]

If we are going to allow another half a million young people to take up smoking over the next three years while the Government decide whether to introduce plain packaging, what measures will the Minister take to hit the big numbers that we know plain packaging—or standardised packaging—could affect?

[Jane Ellison]

I am glad that the hon. Gentleman corrected himself, because it is important that we do not call it plain packaging—it is standardised. I hear his point and will move on to address some of the specific issues. Many people have cited such numbers.

--- Later in debate ---

[Jane Ellison]

I can give my hon. Friend that commitment and I am giving this my urgent consideration. It is impossible to sit through a debate such as today’s, and hear the passion expressed by many hon. Members on both sides of the House, without going away, as the public health Minister, to give it one’s serious, urgent and active consideration.

I have laid out a little challenge to hon. Members to take this issue up at the local level. I appreciate that it is right that I should be held to account on this issue, but in the new world of devolved public health powers, I urge hon. Members to have those conversations with their health and wellbeing boards and with public health directors. In areas of the country where smoking prevalence among children is a difficult issue—some examples have been cited in the debate—our belief is that by devolving some of the power and, importantly, the ring-fenced budget to local authorities who know their communities best, they can begin to tackle the problem with great urgency and added innovation in a way that central Government cannot.

Public Health England has an important part to play. As a new, dedicated, professional public health service, it will be available to advise on local action to promote public health and encourage behaviour change to help people live healthier lives. It will put expert advice at the disposal of local authorities.

[Alex Cunningham]

The Minister has outlined some good ideas, but will she say whether she would support a free vote on this issue on the Floor of the House?

[Jane Ellison]

With respect, I am outlining these other aspects to underline the point that one policy is not sufficient to tackle this problem. There is a slight danger of believing that the approach is a silver bullet. It is an important policy that has been given serious consideration, and the case has been made for it, but we would still be debating how to stop children smoking, even if it were introduced.

[Alex Cunningham]

What about a free vote?

[Jane Ellison]

I will move on as I have tried to respond to the hon. Gentleman’s point.

Our local stop smoking services are among the best in the world. The fact is that smokers trying to quit do better if they use them. Research has found that

“English stop smoking services have had an increasing impact in helping smokers to stop in their first 10 years of operation”—

although I hear the challenge that has been made on the recent drop—

“and have successfully reached disadvantaged groups.”

The latter are obviously particularly important from a public health point of view.

This year, Public Health England has launched a new dedicated youth marketing programme. This marketing strategy aims at discouraging a range of risk behaviours, including tobacco use, among our young people. In this financial year, that is worth more than £1.5 million.

Tobacco Products (Plain Packaging)

Alex Cunningham Excerpts

Tuesday 3rd September 2013 Westminster Hall

[Mr Philip Hollobone (in the Chair)]

Order. The speeches from the Front Benches will start no later than 10.40, so we have 50 minutes remaining. Hon. Members have the right to take interventions, but the fewer there are, the better the chances of all hon. Members being able to speak, which is my sole objective this morning. I call Nick Smith.

[Alex Cunningham (Stockton North) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Hollobone—

[Mr Philip Hollobone (in the Chair)]

Order. I call Mr Nick Smith.

--- Later in debate ---

[Alex Cunningham (Stockton North) (Lab)]

It is a pleasure, Mr Hollobone, to speak under your chairmanship. I assure you that I will have my hearing tested.

I congratulate the hon. Member for Harrow East (Bob Blackman) on securing this debate. As he and colleagues throughout the House who are concerned about the Government’s decision not to implement standardised packaging for tobacco products said, this debate is not about scoring political points, but about holding the Government to account for what many of us consider to be a wrong move.

Clearly, the Government have recognised the negative consequences arising from ready access to non-standardised packaging, yet they drag their feet, are adamant that the evidence is not substantial enough and insist that non-legislative solutions are better suited to the task in hand. Pressure on smoking must be continuous and relentless because we are fighting a pervasive, lethal and powerful addiction. Plain packaging fits the bill. Not only is there a real need for it, but it is a solution that is both wanted and workable. Tobacco is the only consumer product that, if used as instructed, kills half of its long-term users. All tobacco products damage health, so it is right that they are treated differently from other consumer products.

I shall make it clear what that means. In my local authority area of Stockton, more than 250 people die prematurely every year from smoking-related diseases. We have a lung cancer rate of 67.1 per 100,000 people, which is a staggering 40% higher than the national average.

[Julie Elliott (Sunderland Central) (Lab)]

Does my hon. Friend agree that the way to protect children is to act now? Around 50 studies say that the measure would have an impact, so the Government need not wait for the results of the Australian change in the law.

[Alex Cunningham]

That is certainly the case. Children are the most vulnerable group and they need protection from exposure to lethal smoking in closed spaces such as cars and the tobacco industry’s never-ending search for new addicts. Marketing is known to pull children into smoking and the pack is just another marketing tool.

The tobacco industry is now prevented from conventional advertising in this country, so we must look abroad to discover its true intentions. I have been sent the wording on a US internet site advertising Vogue cigarettes, a brand that is owned by British American Tobacco and aimed at young women. They are on sale throughout the UK. One US site says:

“Vogue Cigarettes stand out among other cigarette brands for both their appearance and their unique recognisable taste...The all-white box design with a tiny coloured branch and different coloured leaves reflects the romantic essence that is Vogue Cigarettes”.

Another site says that

“the Vogue cigarette’s style was based on the 1950s couture…The length and the…appearance…is an attribute of the femininity”.

What crass nonsense! The tobacco industry calls these cigarettes “romantic” and “feminine”; I call them addictive and deadly. The real concern of the tobacco industry about standard packaging is, of course, that it would prevent them from marketing their products and recruiting new smokers, and there is a standard litany of excuses.

One is that standard packs would increase illicit trade. That myth has already been dealt with by the hon. Member for Harrow East. Another is that standard packs would put the packaging industry out of business, but let us not forget that we need to worry about the good health of the nation, and tough as it would be on employees and others involved in production and supplies, if that good health is to be achieved, we should not really be focusing on the downside. There are many other excuses too, from the damage that will be done to retailers and the loss of tax revenues, to the amazing claim from some in the industry that packaging does not really matter. So many excuses, so little evidence.

The case for standard packs is strong, and the need for action is urgent. On one side there is the rich and utterly cynical industry that is quite happy to market products that still kill more than 100,000 people across the UK every year—more than the next six most common causes of preventable death. On the other side is the medical and health community, politicians from all parties, and the general public. In the middle are the Government: they have lost the political will to act, so they must let Parliament decide.

--- Later in debate ---

[Anna Soubry]

My hon. Friend is most naughty. He asks me in a short period of time, when I have other matters to address, to answer about three or four questions all at once, most of which are completely irrelevant. We cannot say that there is a correlation between alcohol and tobacco; of course there is not. One can enjoy a glass of wine on an occasional basis. Indeed there is evidence that it can help certain people with their health. I am talking about the gentle consumption of alcohol or sugar. Indeed there is nothing wrong with eating sweets for goodness sake or even chips and other fatty substances. It is all a question of how much one eats; it should be part of a sensible and well-balanced diet. There is nothing in support of cigarettes or tobacco. It is about as barmy as saying, “If you want to help yourself after a stressful day, have a fag.” Cigarettes—tobacco—kill people and harm people’s health. Get it!

[Alex Cunningham]

The Minister is making a tremendous case—a better one than most of us—for standard packaging. Will she therefore persuade the Health Secretary that he does not have to wait for Back Benchers or others to take the matter to the Backbench Business Committee to get a vote on the Floor of the House of Commons? He can actually crack on now with tremendous support from across the House.

[Anna Soubry]

I suppose that I am sort of grateful for that intervention. It was not the most helpful, but it was a fair one and it is a good point that needs addressing. I have no difficulty in waiting for the evidence to emerge from Australia. It is on that point that I agree with the hon. Member for North Antrim (Ian Paisley). However, it is the only point on which we agree on this matter. It is important that we consider the evidence. Of course we know that the Irish Government have also said that they want to introduce this measure. Again, we will wait and see. It is no simple matter to introduce standardised packaging. There will be many challenges that the Irish will face in their attempts. It is right and fair that we wait to see all of that as it develops.

Hospital Mortality Rates

Alex Cunningham Excerpts

Tuesday 16th July 2013 Commons Chamber

[Mr Hunt]

My hon. Friend speaks wisely, because the first step towards sorting out these problems is to have a system that Ministers cannot interfere with so that when there is failure, regulators are able to speak out without any political pressure—without any Ministers leaning on them in the run-up to elections—in the interests of patients. That is why we are completely changing the CQC. We are introducing a chief inspector of hospitals, who will be the nation’s whistleblower and who will have the independence and freedom that the old CQC never had. I hope that will help the public feel more confident that where there are problems they are properly tackled and not swept under the carpet.

[Alex Cunningham (Stockton North) (Lab)]

Several times the Secretary of State has admitted that staffing cut drastically on his watch is a major factor in deteriorating care in the NHS—an NHS that has been in the charge of the Conservative party for more than three years. What is he going to do about restoring staffing levels?

[Mr Hunt]

Clinical staff numbers have gone up by 8,000 since 2010: there are 6,000 more doctors, 1,000 more midwives and 1,000 more health visitors. The numbers have gone up since 2010. If we followed the shadow Secretary of State’s advice and cut the NHS budget from its current levels, that would not be possible.

Oral Answers to Questions

Alex Cunningham Excerpts

Tuesday 11th June 2013 Commons Chamber

[Mr Hunt]

It would be my great pleasure to do so.

[Alex Cunningham (Stockton North) (Lab)]

T6. Three Health Ministers have indicated their support, and one even voted for it, so will the Secretary of State either introduce his own legislation or back new clause 17 to the Children and Families Bill to ban smoking in cars with children present?

[Anna Soubry]

Well, it is a very good point, and the hon. Gentleman knows my own feelings. [Laughter.] No; it is important that we always get the balance right between good public health measures and not getting the accusation from both sides of being a nanny state. [Interruption.] No, no; it is all right his getting agitated, but he knows my view, and I am happy to give him any assistance I can—my door is always open.

NHS Commissioning Board

Alex Cunningham Excerpts

Tuesday 5th March 2013 Commons Chamber

[Norman Lamb]

This comes down to a question of the legal drafting and a legitimate concern that the regulations did not meet the policy objectives set out clearly in the Health and Social Care Act and during the course of the debates on it in Parliament. We simply want to ensure that that objective is faithfully met.

[Alex Cunningham (Stockton North) (Lab)]

Professor Steve Field, who chaired the NHS Future Forum and is now deputy medical director of the NHS Commissioning Board, has said that the Government must make it clear how the regulations are “consistent with the commitments” they gave him. He said that he was clear that there must be “no backtracking” by the Government on the commitments that they gave the NHS Future Forum. The Minister suggested that he will satisfy those demands, and the demands of commissioners and doctors across the country. Is he really guaranteeing to do that today?

[Norman Lamb]

I thank the hon. Gentleman for the question. I spoke directly to Steve Field about this yesterday and I am absolutely satisfied that the amended regulations will totally meet the commitments made during the passage of the Bill in the other place.

Oral Answers to Questions

Alex Cunningham Excerpts

Tuesday 15th January 2013 Commons Chamber

[Mr Hunt]

I am very happy to look into whether that is an area where my Department should take responsibility.

[Alex Cunningham (Stockton North) (Lab)]

My constituent, Elaine Catterick, has had a serious operation at the James Cook hospital on Teesside cancelled twice in three months—once with just a few hours’ notice. She has also learned that there are twice-daily meetings at the hospital to decide whose operation should be cancelled next, as staff struggle to cope with spending cuts. I hope that is not what the Secretary of State wanted from his reforms, so what is he going to do about it?

[Mr Hunt]

All cancelled operations are a concern. The number of cancelled operations was about 50% higher as a proportion of all operations under the previous Government, but no operation should be cancelled, and we will continue to do what we can to bring down the numbers.

Regional Pay (NHS)

Alex Cunningham Excerpts

Wednesday 7th November 2012 Commons Chamber

[Alex Cunningham (Stockton North) (Lab)]

It is impossible to underestimate the importance of this afternoon’s debate. It is of enormous national significance, but also, of course, of acute interest to my constituents. The idea of regional pay is very simple at its core—that an NHS worker in my Stockton North constituency should get significantly lower pay than an NHS worker in another part of the country for doing exactly the same job. The same applies to fire fighters such as my constituent Tony Dorling, whom I met a few minutes ago. He is worried about the cuts to his service and the impact of regional pay on his work, too.

With that in mind, I am surprised that this Government would see regional pay as a viable policy. In my view, that is the heart of the matter. Try as they may, I cannot believe that the Government could ever claim that it would be fair, and it seems that few people, if any, think it would be anything other than unfair, divisive and counter-productive.

How can we really expect a skilled NHS worker, hit by a pay cut, to continue to work in a busy hospital or clinic in a deprived area when a quieter health centre in a more affluent area offers a much better paid position 30 miles away? The reality of regional pay in the NHS is a brain drain away from the areas that need quality and dedicated staff most towards areas with better health outcomes, with the inevitable knock-on effect on health equalities.

Several colleagues have referred to the north-east and Teesside. Because of the impact it is having on my community and on our hard-working staff, it particularly distresses me that this Government have forced the North Tees and Hartlepool NHS Foundation Trust to slash another £40 million off its budget over the next two or three years. I am also distressed that that has led to a move to vary terms and conditions for its workers’ sick pay and even to a threat to sack them and re-employ them on different terms and conditions if the changes are rejected.

I am a former member of the board of the North Tees and Hartlepool trust. A couple of weeks ago, my hon. Friend the Member for Hartlepool (Mr Wright) and I met the chairman and the chief executive to find out exactly what was going on. Both gentlemen assured us that they did not support regional pay, but wanted to make a change in national terms and conditions, which they claimed had the support of staff—something very much disputed by the Royal College of Nursing. I saw why they chose that particular change, but I pleaded with them to think again and stick to nationally agreed terms and conditions to ensure that our needy area did not lose its staff to other areas. The people at North Tees and Hartlepool want a national agreement, and I would like to see health employers get back to the table with the trade unions to negotiate on that particular issue. We should totally avoid policies that widen health inequalities—coming from an area such as mine, I know about them—but this policy falls into that category.

Implementation is another issue. If we were to move towards a system of localised pay, negotiations would take place locally and those would take up a greater amount of the time of both managers and union representatives in different places all over the country. The NHS in its current form is not equipped to manage local pay negotiations and, frankly, lacks the skills to do that. This is just another disruptive set of changes that the NHS could do without, particularly during the implementation period of the Health and Social Care Act 2012. According to the RCN, the proposed policy, ostensibly designed to save money, will actually see the cost to the public purse increase.

I am proud to be a member of Unison, a campaigning union on behalf of employees and patients. Its head of health, Christina McAnea, sums up regional pay perfectly when she says:

“Regional pay would be a massively expensive, bureaucratic nightmare, designed to cause huge disruption and conflict.”

The British Medical Association is also opposed to any moves away from national terms and conditions, saying that such a move would have

“a significant negative impact on the NHS, staff and patients.”

The Government have yet to make a convincing case as to why a regional system of pay is preferable to the current national one. The current “Agenda for Change” works by setting a basic pay floor, which no health authority can go below with regard to pay. The BMA has said:

“A national approach to contract negotiations for NHS staff is both efficient and fair.”

Where a sufficient case can be made, the system allows for minor variations through high-cost area supplements and recruitment and retention premiums. Those provisions make sense for areas that are particularly high cost, such as inner London, but what the Government are proposing would explode the system of sensible divergence through levelling-up, and replace it with one that relentlessly levels down to the detriment of health workers in the areas with the highest need and demand.

The argument that cutting pay in the public sector will help to stimulate growth in the private sector is undermined by the group of 60 regional economic specialists who wrote to The Times to say that they could find

“no convincing evidence within these reports to support the Chancellor’s inference that such regionally or locally determined pay could boost the economic performance of regional economies. On the contrary, such a policy could reduce spending power, undermine many small and medium-sized businesses in areas of low pay, and aggravate geographical economic and social inequalities”—

even more inequalities. They go on to say:

“Moreover, for government, the medium and long-term economic and social costs could increase.”

If the NHS wants to continue to attract a work force of similar quality in different parts of the country, we need to continue with a national system for pay and reward within the current provisions of “Agenda for Change.” I would urge the NHS pay review body to reject outright any moves towards regional pay.

I am also concerned about the impact that moving towards a system of localised and regionalised pay would have on local economies. One of the things that has held us back in combating our stagnant and shrinking economy is low private sector pay. The Governor of the Bank of England has observed, in relation to growth, a clear link between a real fall in wages and consumer spending.

The TUC has argued that reducing public sector wages by 1% would hit local economies by at least £1.7 billion a year. I am not sure, even if regional pay were a good idea, that such a loss to the economy would be a price worth paying, and I am not convinced that the private sector in areas such as mine would welcome a local decline in disposable income.

Regional pay in the NHS would cost, rather than save money. It would widen health inequalities. It would disadvantage deprived areas, create a bureaucratic mess and damage the economy. I have tried, during my short speech, to express what is wrong with regional pay, but I cannot put the case any better than my fellow north-east MP, the hon. Member for Hexham (Guy Opperman), a Conservative, who said:

“I…believe that regional pay is divisive and manifestly unfair.”—[Official Report, 20 June 2012; Vol. 456, c. 960.]

The Government would do well to listen to him.

Social Care (Local Sufficiency) and Identification of Carers Bill

Alex Cunningham Excerpts

Friday 7th September 2012 Commons Chamber

[Alex Cunningham (Stockton North) (Lab)]

I am delighted to speak in the debate and to follow the hon. Member for South Thanet (Laura Sandys), who made an eloquent speech, illustrated in particular by her mention that we are all affected—we all know somebody who is a carer and who probably has a tough life because of it.

The Bill is long overdue and I hope that the Government will allow it to reach the Committee stage for further discussion and development. For too long, we have taken carers for granted. We underestimate their invaluable contribution to the well-being of their families and communities—not to mention the economy. We fail to support carers, including children and young people, who often themselves suffer ill-health, and neglect the needs of carers who want to work outside their home. That is why the Bill is so important. It will go far in meeting carers’ needs, without placing huge additional financial burdens on local authorities already struggling to cope with the deep cuts they are having to implement.

I want to talk in particular about young carers—those under the age of 18 who undertake significant and, I would argue, often inappropriate caring responsibilities for their parents, grandparents or siblings. Let us be clear: they are children. Indeed, the average age of a young carer is a mere 12 years—12-year-olds whose only concerns should be enjoying their youth and playing with their friends. Instead, very often they simply lose their childhoods as they care for disabled parents, parents who may be drug dependent, and parents whom they love deeply. No one wants to get too graphic about the things children do for their parents, but among other things they feed them, get them to the toilet, help bath them and help them get dressed.

To take on that level of care for a loved one is remarkable. Carers provide constant support, comfort and companionship. As my hon. Friend the Member for Darlington (Jenny Chapman) once said, “They make the good days good and the hard days better.” We know how young carers are passionate about supporting their families. The majority of young carers want to care and few ask to stop caring altogether, but they also need to be supported. Many young carers, however, struggle through the education system without being recognised as young carers. Their needs and those of the people for whom they are caring are often identified only during a crisis.

The Bill would create a strategic duty on local authorities to ensure that schools are proactive in identifying young carers as soon as possible, with a similar duty on further and higher education bodies. The earlier young carers are identified, the more support can be made available to them and the person for whom they care. Many young carers go without being identified, and a key reason that young people drop out of university and college, as others have said, is that they are caring for someone, often a parent.

Let us not underestimate the scale of the problem. Recent surveys have pointed to a hidden army of UK young carers, with four times as many young carers in the UK as are officially recognised. The 2001 census identified only 175,000 young carers, 13,000 of whom care for more than 50 hours a week, but a survey of schoolchildren has indicated that there are about 700,000 young carers in the UK—an astounding figure. Even that does not tell the whole picture. In the UK almost 3 million children under the age of 16—equivalent to 23% of all children—live in households in which one family member is hampered in daily activities by a chronic physical or mental health problem, illness or disability, meaning that countless young people have caring responsibilities, including administering medication, washing, cooking and cleaning.

We have some great support for young carers in my constituency, and my wife Evaline is a volunteer director of the Eastern Ravens Trust, a local children’s charity that has been working for more than 50 years to support children and young people from the Stockton borough area who are experiencing social isolation. One scheme is the young carers project, which provides young carers with the opportunity to meet and socialise with other carers, letting them simply have fun and blow off steam. I love spending time with them and was delighted to see them in this very Chamber not long after I was elected.

The project has also received a grant from the Princess Royal Trust for Carers to focus on identifying those young carers in households with substance-misusing parents who need support to help them be children as well as carers. The grant has made it easier to identify and help some of the most vulnerable carers in our area. The steering group, Young Carers Aloud, also aims to raise awareness of young carers and their issues in Stockton and has devised a young carers card that it hopes can be used discreetly in schools to let teachers and staff know who young carers are, ensuring that they get the support they need. Often, those young carers do not want their peers to know about their personal situations.

The Bill will enable such work to be performed all over the country. Young carers I meet tell me that they often feel isolated at school, and that they are a frequent target for bullies, as other Members have said. They have difficulties concentrating in lessons, worrying about their parents or family member—“Are they at home?”, “Are they okay?”, “Have they had an accident?”, “Have they lost their memory today?” Young carers are often unable to complete their homework as they simply do not have enough time due to their caring responsibilities. As a result, such young people, because no one knows about their situation, are often punished—they might be given a detention after school, which means that they cannot be present for family members who rely on them.

Examples of young carers in my constituency include someone whom I will call Susan. She is only 12 years old, yet she is the primary carer of her disabled mum. She used to be quiet and shy, but since accessing support at the Eastern Ravens Trust she has blossomed into a confident, lovely girl. Another carer is Peter—again, not his real name—who, despite being only 14, has been supported by the Eastern Ravens Trust for over four years. Peter himself suffers from learning difficulties and epilepsy, and yet he is the primary carer for his disabled mum, who also has mental health issues.

Schools in my constituency try to help young people whom they know to be carers, but throughout the country there is a tremendous lack of support for young carers, who can feel stigmatised by teachers and peers lacking understanding of their situation and leave school or college prematurely, without completing qualifications.

[Diana Johnson]

I am interested in what my hon. Friend says about detentions. Was he as disappointed as I was when the Government introduced measures in the Education Act 2011 that removed the requirement that 24 hours’ notice be given when a child is given a detention? A number of representations were made about how that could affect young carers who had to return home speedily to look after the person they were caring for. Does that not show that other Departments are not as aware as they should be of issues affecting young carers?

[Alex Cunningham]

I very much agree with my hon. Friend. I have tremendous concerns, because a child who faces a detention might not turn up for it and end up getting deeper and deeper into trouble because of a lack of understanding among their teachers. That is all the more reason why we need the provisions in the Bill to ensure that young carers are identified and that responsibility is placed on schools to provide them with the necessary support.

[Mr Nuttall]

When that point about detentions was raised, did the schools Minister not make it clear that the detention would continue to have to be reasonable, that consideration would have to be given to all the circumstances and that teachers were well placed to understand the needs of an individual pupil?

[Alex Cunningham]

The then Minister did indeed say that a detention had to be reasonable, but a teacher who does not know that the young person is a carer cannot take that into consideration. That is all the more reason why we need such provision. It is also interesting to note that young carers aged between 16 and 18 years are twice as likely as their peers to not be in education, employment or training—a so-called NEET.

We are a long way from being perfect in the borough of Stockton-on-Tees—although we are very close to it on many issues—but I am proud to say that the borough council is very much leading the way on issues associated with young carers. The council has a young carers strategy, which has been in place since 2009. The aim is to ensure that services work together and share information to identify and support families to avoid young people becoming established in inappropriate caring roles, and to ensure that schools have in place procedures and policies that offer flexible and additional support to young carers, such as provision for personal tutors and access to the local young carers project. Stockton borough council and NHS Stockton-on-Tees are also developing a joint carers and young carers strategy, which will enable carers to be involved in planning care packages and designing local care services, and to fulfil their educational and employment potential.

Many other councils and health authorities are also doing innovative and exciting things to identify and support young carers—and carers generally—but many are not. They need the guidance in the Bill to fulfil the needs of one of the most vulnerable groups of young people in our society. We are all well aware of the immense challenges facing young carers, but we cannot help them if we cannot identify them. Again, that is why the Bill is so important to enable and ensure that support is provided.

As I set out at the start of my speech, the Government can send a signal to local authorities today—demonstrating that they believe that there has to be proper identification of young carers, universal protection for them and the right to quality services—by allowing the Bill to progress to Committee for further discussion and development. Even though the Government are developing their own legislation on carers, including young carers, in different Bills, they will disappoint a large community of people, along with their supporters, if they do not do so. Young carers give up a lot to be carers. They miss out on comforts and freedoms that the rest of us take for granted. They often give up their time and their social lives; indeed, they give up their childhoods. Their focus is on the loved ones they care for. That is why we have to remember to focus on them and move the Bill forward today.

Business of the House

Alex Cunningham Excerpts

Thursday 6th September 2012 Commons Chamber

[Mr Lansley]

I am conscious that, in my new privileged position, I stand at a constitutional juxtaposition between the legislature and the Executive. One of the last things I would want to do, on my first occasion at the Dispatch Box, would be to trespass on the relationship between the legislature, the Executive and the judiciary, and in particular on the independence of the judiciary, so I will avoid commenting on that. However, my hon. Friend’s observations are on the record.

[Alex Cunningham (Stockton North) (Lab)]

Yesterday, 500 Teessiders, many of them from my constituency, lost their jobs with Direct Line, which is part of the state-owned RBS Group, not long after apparently having been cajoled into signing new contracts. That means that their redundancy payments will be considerably less; they will lose thousands of pounds as well as their jobs. I am sure that the Leader of the House will agree that such actions are abhorrent, and that the managers must be held to account. Does he know whether the Business Secretary plans to make a statement on the decisions of this state-owned business, and would the Leader of the House allow a debate on the issue?

[Mr Lansley]

I share the hon. Gentleman’s view, as I am sure all Members do, that the prospect of losing one’s job can be difficult and that we should all sympathise and do everything we can to help. Indeed, the Government will do everything they can to help, and Governments have done a great deal in the north-east. For example, the Deputy Prime Minister and the Chancellor were there recently to see how new investment was going to the north-east as a result of the enterprise zones. I confess that I was in the House only for the latter part of Business, Innovation and Skills questions, so I do not know whether the hon. Gentleman was able to raise this matter then. That would have been a good opportunity to do so.