Public Health England (Porton Down)

Anna Soubry Excerpts

Wednesday 11th September 2013 Commons Chamber

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

I should like to congratulate my hon. Friend the Member for Salisbury (John Glen) on securing this debate. I also thank him for helpfully providing me and my officials with advance details of his speech. That has been of great assistance to us, because it enables us to provide answers to some of his questions and to address the many points that he has quite properly raised on behalf of the people who work at Porton and of his constituents and others who are interested in the future of the facility. I know that he is an active supporter of the work of Public Health England at Porton, and that he has worked tirelessly with Wiltshire county council and others to create a science park there. I will spend a few minutes outlining the work that Public Health England is doing on behalf of the Government to secure high-quality facilities for public health. I shall then try to respond to the points that my hon. Friend has quite properly raised.

The Government created Public Health England just a few months ago, in April 2013, with the aim of creating a national expert body charged with protecting and improving the public’s health and reducing health inequalities. The services provided at Porton are essential to the work of PHE in protecting the nation’s health and preventing disease. Porton provides some of the most specialist and high-technology microbiology facilities in the country. However, the main building at PHE Porton, as it is now known, was built 60 years ago, and the Government are committed to replacing those ageing facilities with modern state-of-the-art buildings through the submission of a revised business case some time next year.

I should add that the idea of consolidating health protection facilities on a single site to make best use of scarce skills from both Colindale and Porton is not new. What is new is the vision to develop a national centre with a much broader remit, reflecting the wider purpose of PHE to improve the public’s health and to reduce health inequalities. I understand that senior staff from PHE have met my hon. Friend about this work, as he described, and they have promised to meet him again and to engage with other interested bodies, including the county council

Let me address some of the points that my hon. Friend raised. The Government are committed to retaining some public health facilities at Porton as part of the planned science park. I know that the chief executive of Public Health England wrote a letter of support for the science park earlier this year at my hon. Friend’s request. I fully agree with my hon. Friend that it is vital to maximise the commercial potential of the services at Porton—unfortunately, that probably has not been done for some time, and the Government are absolutely committed to doing it. PHE is fully committed, too, as part of the programme on which my hon. Friend has also been briefed, and this opportunity can be grasped now. The other review is about the 15 to 20-year future for a wider range of services, currently not only at Porton, but at Colindale and elsewhere.

My hon. Friend mentions the distance between sites. The case for change that was submitted in 2011 focused on the additional benefits that can result from co-locating services on a single site. The position is not dangerous now, but there are significant opportunities for new scientific ventures and collaborations from a new national centre.

My hon. Friend asks why PHE does not simply share high-containment facilities with the Defence Science and Technology Laboratory. We need to be clear that although PHE and DSTL will continue to collaborate closely, PHE needs dedicated high-containment facilities to ensure that public health work can proceed in the event of the DSTL facilities being fully occupied. This will provide resilience if DSTL’s facilities are closed for any reason.

In conclusion, the Government have asked PHE to lead work on the creation of state-of-the-art facilities to protect the public’s health and to prevent disease. There is a well-established programme in place, overseen by the Department of Health and the Government’s Major Projects Authority.

It is really important to finish by stressing that Ministers have yet to make a final decision on how best to create future facilities for national public health science. PHE is on track to complete the business case for a ministerial decision by September 2014.

I hope that I have answered all the points so properly raised by my hon. Friend. If I have not answered any, he can be quite sure that I will respond in the normal manner by way of letter. My door is always open, and it would be a pleasure to meet him on any occasion to discuss this matter further and to provide any further assurances that I can to him and, perhaps most importantly, to the staff at Porton, who we would all agree do an outstanding job.

Question put and agreed to.

Tobacco Products (Plain Packaging)

Anna Soubry Excerpts

Tuesday 3rd September 2013 Westminster Hall

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

It is a pleasure, as ever, to serve under your chairmanship, Mr Hollobone. I echo the remarks of many speakers by congratulating my hon. Friend the Member for Harrow East (Bob Blackman)—a long-standing friend, if I may say so—on securing the debate and on his excellent speech. As he knows, I have been called many things, but I have never been called “very libertarian”, and I am still in a state of shock at that description.

I make it clear that I am no great fan or supporter of the nanny state. I do not have a particular problem with standardised packaging, because that does not relate to the nanny state. As we have heard in the many excellent speeches from Members of all parties, the issue is the protection of children, not preventing anybody from smoking or going out to buy cigarettes. It is about protecting young people from the attraction of taking up smoking.

It is important that I declare my interest. My father, a lifelong smoker, died at the age of 56 from lung cancer. I do not think that there was any doubt that that cancer was caused by his lifelong addition to tobacco—to smoking. I say with considerable shame, if I may put it that way, that until just over five years ago, I, too, was a smoker; both my brothers continue to smoke. I am not for one moment saying that if people are not or have not been smokers, they cannot engage in the debate, because that would obviously be complete nonsense, but they have to have been a smoker to understand the perverse psychology of smoking.

We know that 8 million people in this country continue to smoke and that the overwhelming majority of them want to stop. It is an admission of some weakness within us, which I think is the power of nicotine. It is often said that nicotine is more addictive even than heroin. Although I have never directly experienced heroin, when I was a criminal barrister I had enough clients to know how powerful heroin and cocaine are. Goodness me, even they would say that nicotine is a dreadful substance in its addiction. That accounts for why so many smokers, like me, found it so difficult to give up.

I want to make it clear that like so many smokers, I took up smoking before the age of 18. I accept that I sound very weak when I say—this is one of those moments where one almost wants to confess—that the power of the packet had an effect on this 17-year-old from Worksop who was working in a toy shop, which, bizarrely, sold cigarettes in those days. Younger people listening to this debate will be amazed to hear that a toy shop could sell cigarettes, but those were the days.

I have never forgotten the first time that I bought a packet of cigarettes. I deliberately chose a packet of St Moritz because they were green, gorgeous and a symbol of glamour. Do hon. Members remember the madness of those advertisements that talked of the cool fresh mountain air of menthol cigarettes? Those were the days that some of us remember because of our age. I distinctly remember the power of that package. It was the opening of the cellophane and the gold and the silver that was so powerfully important to many people who, as youngsters, took up smoking. I say that to my hon. Friend the Member for Bury North (Mr Nuttall) who says that he has never met anyone so drawn; well, he has now, because I am that person, and I am not alone by any means.

[Mark Field]

There is little doubt that if alcohol were synthesised for the first time today, or if we discovered sugar for the first time, it would be banned. The Minister has made the case about nicotine. Ideally, does she want the product banned? She talked about protecting young people. What age is she talking about? In America, for example, alcohol is banned for anyone under the age of 21. Is that the age she is considering, especially as we could outlaw both tobacco and alcohol at university when people are at an impressionable age?

[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.

[Barbara Keeley]

rose—

[Anna Soubry]

May I make some progress, because it is really important that I make the matter clear? The coalition Government have made no final decision. As I have said, we wait to see the evidence as it emerges from both Ireland and Australia. It is important to say that standardised packaging is no silver bullet. There is no simple solution to the problem of persuading both the remaining 20% of the population to give up smoking and our youngsters not to smoke.

I want to deal if I may with some of the excellent points that have been made. I, like many other Members, have talked about the power of the package. The hon. Member for Vale of Clwyd (Chris Ruane) helpfully brought in some packets. He mentioned the cigarettes that are deliberately targeted at young women. My hon. Friend the Member for Banbury (Sir Tony Baldry) asks why children, in the face of the overwhelming evidence and the health messages, take up smoking. He is right to say that we need to do more research. We know many things.

We know, for instance, the power of parents. If a child is brought up by parents who smoke, they are likely to smoke because they will see it as the norm. One of the great benefits of the legislation that was introduced by the previous Administration—I pay full credit to them for introducing that ban on smoking in open places—was that it made smoking less socially acceptable. Effectively, it turned many of us into modern-day lepers. If we wanted to smoke, we were reduced to standing outside, ostracised from our workmates, and that was a powerful reason why so many of us gave up smoking. Many of us remember with shame, as I do, sitting in restaurants thinking that we had some God-given right to smoke next to people who rightly found it deeply offensive, and who were trying to enjoy their meals. It is astonishing to look back at films and television programmes of only a few years ago to see how acceptable smoking was and how the previous Parliament changed that.

I absolutely agree with all those who are trying to nail the falsehood in two important parts of this argument about standardised packaging. The first is whether it is plain. I concede that one of the great failings of this debate is to explain what we mean by “standardised”. That goes back to the point that was inaccurately made by my hon. Friend the Member for Bury North. I never said that packaging would be glamorous or glitzy, but that, as I think my hon. Friend the Member for Harrow East also tried to say, under the regulation and legislation holograms can be put on standardised packaging—not to be attractive but as part of the argument against the claim that anybody will be able to counterfeit it.

Far from being a counterfeiter’s charter and dream, standardised packaging is a counterfeiter’s nightmare. I wish that I had with me some of the packets that have been produced by Australia. If we had them, Members would see that they are far from plain. On the contrary, they have colour in them, but they have the standardisation, which takes away this incredibly powerful marketing tool and the attraction for young people.

[Barbara Keeley]

On the point about waiting for the evidence, it is not 20% of people who smoke in Salford but 25%, and much more in some areas, and it is 1,000 children. As we wait, 1,000 children every year will start smoking in Salford. Why are we waiting?

[Anna Soubry]

I think I have explained why we have waited. My understanding of the statistics is that it is 20%, but it differs in different parts of the country. I also want to make the point that the Government have not stepped away from taking action against the harmful effects of tobacco. We have a tobacco control plan for England that sets out our national ambitions and our comprehensive evidence-based strategy of national and local actions to achieve them, including high-profile marketing campaigns. Our Stoptober campaign, which was hugely successful last year and which we will be running again this year, provided help and assistance to smokers, the majority of whom want to quit.

I also want to pay tribute to local authorities, which now have responsibility for public health. I have met members and representatives from councils in the north-east who are doing some terrific work persuading people to stop smoking or not to take it up, and that shows good local action.

As ever, the clock is against me, but I hope that I have made the Government’s position absolutely clear. I congratulate again everybody who has spoken in this debate. My own views are clear, but it is right to wait to see the evidence. I assure Members that the wise words from so many different parties today will be taken back to the Government and will be listened to. It is to be hoped that in due time, standardised packaging will be introduced.

Brain Tumours in Children

Anna Soubry Excerpts

Tuesday 3rd September 2013 Westminster Hall

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

It is a pleasure, as ever, to serve under your chairmanship, Mr Sheridan. I have been called some bizarre things today. I was called “very libertarian” in a debate in this Chamber this morning, and I have been called something else this afternoon. I think it is a compliment, but in any event I will take it as such.

I begin by congratulating my hon. Friend the Member for Esher and Walton (Mr Raab) on securing this important debate. As I have said on many occasions, the clock is always against us. I look around and I see the faces of Members who have been engaged not just in similar debates but, most importantly, in some of the meetings and in the all-party group on brain tumours, with which we have all been involved for some time.

I pay tribute to my hon. Friend the Member for Brentford and Isleworth (Mary Macleod). She and I had a very good meeting with some of her constituents on brain tumours in adults, and many of the problems of diagnosis are also experienced by adults who suffer from this unpleasant, horrible and often fatal disease. I also pay tribute to my hon. Friend the Member for Cannock Chase (Mr Burley) and Trudy’s Trust. Some of us were at the launch of Trudy’s Trust with Mr Speaker.

I also pay tribute to my hon. Friend the Member for Castle Point (Rebecca Harris) and the Danny Green Fund. We hear today of yet another tragedy that has occurred, but some good comes out of every evil. One of the good things that comes out, especially when a child dies from a brain tumour, is the great power of a family to leave a legacy and make a great tribute to that child. There is nothing worse than the loss of a child—it is every parent’s nightmare—but to be able to turn that awful situation into something good, and to use that power to great effect, is something that we see in many instances. Today we have heard about just some of them, and there are others.

[Sir Gerald Howarth (Aldershot) (Con)]

I, too, congratulate my hon. Friend the Member for Esher and Walton (Mr Raab) on securing this debate, because HeadSmart is based in my constituency. Will my hon. Friend, the Minister pay tribute to Neil and Angela Dickson? Their daughter Samantha died of a brain tumour and they have done fantastic work, not only to produce the kind of initiatives that have been mentioned by several hon. Members today, but to raise funds that have contributed to research that has produced results that have enabled the causes of brain tumours to be identified in part. Neil and Angela Dickson deserve many congratulations on what they have achieved.

[Anna Soubry]

I am more than happy to add my grateful thanks for the work of Neil and Angela Dickson, and the work of all those who support them. There are many such examples, and funds are often raised for research and to support families or other bits of work.

As my hon. Friend the Member for South West Bedfordshire (Andrew Selous) said, money that goes into research often has the most powerful results. I pay tribute to Headcase cancer trust in my constituency, as I am very much aware of the great work that continues to be needed on brain cancer, which is a pernicious and horrible disease that affects people of all ages, but it seems somehow to be particularly cruel and wicked when it is inflicted on children.

There are a few things that I want to mention before moving on to some of the substantive points raised by my hon. Friend the Member for Esher and Walton. We recognise that we need to do more to bring cancer survival rates up to the level of the best in the world—survival rates have been languishing in the wrong place for too long—so we have an outcome strategy that sets out our ambition to halve the gap between England’s survival rates and those of the best in Europe through saving an additional 5,000 lives every year by 2014-15. We know that the earlier a cancer is diagnosed, the greater the scope for curative treatment, and our strategy therefore prioritises addressing late diagnosis. To support that, we have £450 million over four years going into early diagnosis, which is part of the £750 million of additional funding from the Government for addressing cancer over the spending period. That funding will do much great work that I am happy to identify in a letter to my hon. Friend.

On direct GP access to diagnostic tests, my hon. Friend the Member for Hexham (Guy Opperman) made a good point about having someone within each clinical commissioning group who knows about not only brain cancers and brain tumours but other similar afflictions. As he rightly identifies, when a child has a headache, or when an adult has some other complaint and they are not sure what it is, there could be a more specialist GP who can say, “Maybe this is the sort of case that we need to scan swiftly,” or, “Maybe it needs some other treatment.” That is a very good point, but we need GPs to recognise symptoms that could be indicative of cancer and, where appropriate, to refer patients to more specialist care.

The National Institute for Health and Clinical Excellence has published referral guidelines for suspected cancers, including a section on children, to help GPs and primary care professionals identify children with suspected cancer. The Department of Health published guidance in April 2012 on the best practice for what we call “referral pathways” for GPs.

When GPs suspect a brain tumour, they are able urgently to refer patients for special care using the two-week urgent referral pathway, and I have been helpfully supplied with some figures that I hope will give comfort and encouragement. Some 95.5% of patients were seen by a specialist within two weeks of an urgent GP referral for suspected cancer—that is for all cancers—in the first quarter of 2013-14, and 96.4% of patients urgently referred by their GP for suspected brain or central nervous system tumours were seen by a specialist within the two-week period. In the first quarter of 2013-14, 96.4% of patients in England urgently referred by their GP for a suspected children’s cancer were seen by a specialist within the two-week period. I think those are good figures, but of course we can always do better.

[James Duddridge]

Will the Minister give way?

[Anna Soubry]

Briefly, yes.

[James Duddridge]

Those are the figures for being seen by a consultant, but are there figures for when surgery actually takes place? Will the Minister provide us with those figures after the debate?

[Anna Soubry]

I do not believe I have those figures in front of me, but I am more than happy to provide them to everyone who has taken part in the debate. My official is indicating that we have the figures, and it is not a problem for me to give them to my hon. Friend.

NHS England now monitors the use of key diagnostic tests through the diagnostic imaging dataset, and the latest available provisional data for the period from April 2012 to March 2013 show that 28,995 tests—which is about a quarter of all tests—that may have been used to diagnose or discount cancer were requested by GPs under direct access arrangements.

I pay huge tribute to HeadSmart, and of course I welcome its “Be brain tumour aware” campaign and the collaboration between the Brain Tumour Charity, the children’s brain tumour research centre at the university of Nottingham—to which I admit I have a bias, being a Nottinghamshire MP—and the Royal College of Paediatrics and Child Health. I have written to HeadSmart offering encouragement and advising that it could apply to the voluntary sector investment programme for funds to raise awareness of HeadSmart cards in schools. I will continue to work with those great and wonderful charities, and I look forward to seeing them inform the development of our nationally led campaigns.

My hon. Friend the Member for Esher and Walton directly challenges me to take action, and I shall tell him what I will do. I might not completely agree with all that he proposes, but I am more than happy to speak to my colleagues at Public Health England—cancer screening is an obvious priority for Public Health England—about how we can best advance HeadSmart cards in schools. As he knows, of course, public health is now devolved to local authority level. And as he also knows, we are a Government who believe in localism, and therefore it is not for Ministers to tell people what to do, however much we might want to at times.

The idea advanced by my hon. Friend the Member for Brentford and Isleworth is very good. A great deal of work can be done by local MPs. Of course, hon. Members might not know about this, but we can talk afterwards about how we can alert our colleagues throughout the House to what can be done. A letter from a local Member of Parliament to their director of public health, or to the chair of their health and wellbeing board, will frankly have more weight than any letter from me.

[Andrew Selous]

As my hon. Friend the Member for Esher and Walton (Mr Raab) has said, local authorities are already writing to schools and putting stuff in the post. If MPs do that too, it will cost the public purse. It strikes me that that already happens, and cheaply.

[Anna Soubry]

I do not agree. I do not know about my hon. Friend, but I write to all my schools. In truth, I do not have that many schools, so there are not that many letters. A letter from a Member of Parliament to all their schools and to their health and wellbeing board could be very powerful. I am more than happy to talk to my colleagues in the Department for Education, but I am not sure that a letter to cabinet members will have any weight.

[Mr Raab]

Will the Minister give way?

[Anna Soubry]

I am going to run out of time. Unless my hon. Friend is very quick, I do not see how I can respond.

[Mr Raab]

I thank the Minister for giving way. The whole point of this debate is to try to get central Government to co-ordinate with local government. We are not talking about forcing local government, but we are talking about urging local government to do something through its internal mail system. Will she give that further consideration and perhaps meet me and the HeadSmart campaign?

[Anna Soubry]

Yes. That is a brilliant idea, and I am more than happy to do it, especially as I have only six seconds left. Seriously, though, between us all we can find a way to ensure that we all get what we want.

Question put and agreed to.

Public Health (Local Authorities)

Anna Soubry Excerpts

Thursday 18th July 2013 Written Statements

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

We have today laid before Parliament “Government Response to the House of Commons Communities and Local Government Committee Eighth Report of Session 2012-13: The Role of Local Authorities in Health Issues” (Cm 8638).

The Government are grateful to the Committee for its constructive and positive report, and for the opportunity it provides to set out our position and expectations on some key issues in greater depth.

I am grateful to the Department for Communities and Local Government and the Department for Work and Pensions for their contribution to this report, and commend to the House the increasingly broad base for thinking and action on public health across Government.

Copies of the Government response are available to hon. Members from the Vote Office and to noble Lords from the Printed Paper Office.

Organ Transplants

Anna Soubry Excerpts

Wednesday 17th July 2013 Commons Chamber

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

Let me begin by congratulating the hon. Member for Stretford and Urmston (Kate Green) on securing this debate, raising this important issue, and enabling us to discuss it for this very short period. It is not really a debate but a number of questions quite properly asked, no doubt many of which I will not answer, through no unwillingness on my part but because, as I always say, the usual rules apply. However, all questions will be answered, if not by me tonight then certainly by way of a letter. I thank the hon. Member for Strangford (Jim Shannon) for his helpful and interesting contribution. He has been good enough to provide me with a clipping. I believe that it is about kidney transplants and kidney donations, and I will make further inquiries.

As you will know and understand, Mr Deputy Speaker, this matter has come up by way of the fact that hon. Lady, as she explained, has a constituent, Natalie McCusker, who has had a lung transplant. We are all delighted that she was able to have that lung transplant.

As we know, the donation of organs is sometimes from a living source, to put it in crude terms. There are many examples of people who have made the most amazing sacrifices, often within families, to supply a kidney to a loved one so that they can live. There is, of course, the whole additional subject of what happens on death and the wishes of somebody in relation to their organs, and the absolutely amazing difference that that generosity after life can make to people. No doubt Natalie is a very fine example of that, and no doubt she and her family are profoundly grateful to the person who had the good sense to indicate that they were willing that on their death their organs would be donated. Then there is the great and often very emotional matter of the family deciding that they are all content for this to happen. There is nothing worse than when someone is taken from us when they die. It is very difficult for anyone in the medical profession—we have nurses who are specially trained in this—to approach the family in those profoundly difficult times and discuss the possibility of organ donation. The work of those nurses and other medical professionals is one of the reasons we have seen an increase in organ donation.

We all know the benefits of transplants and know that we need to do more to increase the number of organs donated. That would give many more people the opportunity to benefit from a transplant that could save their life or significantly improve the quality of their life. About 8,000 people are listed on the national transplant list waiting for a transplant. Many more could be listed if more donated organs were available for transplant. Many people wait months and years for a phone call telling them that a suitable organ has been donated and calling them in for a transplant. I am aware through my work as a Minister of some of those families and their anguish as they literally sit around waiting for that phone call, especially when it is a child who so desperately needs the transplant to, in effect, save or improve the quality of their life. For some, that phone call never comes and about three people—adults and children—die every day waiting for a transplant that could have saved their lives.

Given that the number of people needing organ transplants in the United Kingdom is greater than the number of donor organs available, there has to be a system to ensure that patients are treated equitably and that donated organs are allocated in a fair and unbiased way. Allocation is based on the patient’s need and the importance of achieving the closest possible match between donor and recipient, which is often very difficult.

All patients waiting for transplants are registered on the national transplant database. Rules for allocating organs are determined by the medical profession in consultation with other health professionals in health departments and specialist solid organ advisory groups. The blood group, age and size of both the donor and the recipient are all taken into account to ensure the best possible match for each patient, and the cardiothoracic advisory group is currently looking at improving the allocation of donated lungs to help to ensure equity and better outcomes for patients.

At present, lungs are allocated to the transplant centre based on the location of the donor, as the hon. Member for Stretford and Urmston said. The transplant centre will decide whether or not to accept the lungs and will select the most appropriate recipient. NHS Blood and Transplant is working with transplant centres to consider whether the current allocation system can be improved. It is considering whether it would be worth while implementing a national allocation scheme offering lungs and other organs nationally, rather than by centre. Other models are also being considered. NHS Blood and Transplant monitors the current allocation system closely to ensure that there is equity of access across the UK, and a recent analysis showed no statistical differences in outcomes across the UK in relation to lung transplant centres.

[Kate Green]

I appreciate that the Minister may not immediately know the answer to this, but does the equity of outcome apply not just to survival rates, but to waiting times?

[Anna Soubry]

As the hon. Lady has anticipated, I do not have the answer to that question in my brief, but I will make sure that she receives a proper answer.

Over the past five years, we have been strengthening the donation infrastructure by implementing the 14 recommendations of the organ donation taskforce, which were published in 2008. Is it not nice that in this sort of debate we can pay tribute to another Government of a different political persuasion? We are all united on this issue; it is not a party political issue and it is always a pleasure to take part in these sorts of debates.

The number of donor co-ordinators across the United Kingdom has nearly doubled. They are working closely with intensive care clinicians and families to identify potential donors and obtain consent. As I have said, it is difficult work but, goodness me, what a difference it can make when it is successful.

We have appointed clinical leads and established donation committees and chairmen in all trusts. This has driven improvement in hospitals, optimising the potential for organ donation. I am delighted that we have achieved an increase of 50% in organ donor rates and of 30% in transplant rates over the past five years, helping many more people to have the transplant that they so desperately need. We need to do more, however, to enable many more people like Natalie to receive the organ transplant that in many circumstances will save or enhance their life.

On 11 July, NHS Blood and Transplant published the new UK strategy for organ donation and transplantation. “Taking Organ Transplantation to 2020” sets the agenda for increasing organ donation and transplant rates to world-class standards over the next seven years by aiming to improve consent rates to organ donation to more than 80%—they are currently 57%—and transplant more organs and increase the number of people receiving an organ. The strategy calls for a revolution in public attitudes and behaviours, and emphasises the importance of individuals and families agreeing to donation. That important work needs to take place irrespective of someone’s background, ethnicity, religion, faith or whatever else. We need to ensure that more people in all parts of society sign up to donate their organs and that we are able to persuade people’s families to allow their organs to be donated upon death.

[Jim Shannon]

The Welsh Assembly has recently taken a decision on organ donation, which is a positive step. Is it the intention to consider having that system in England, because that might help the hon. Member for Stretford and Urmston (Kate Green) in her quest?

[Anna Soubry]

The Welsh Government have introduced legislation under which people will have to opt out. We need to work with the Welsh Government to ensure that that system works, because there are concerns about the effect it will have across the United Kingdom when one country has people opting out as opposed to opting in, as in the rest of the United Kingdom.

The independent organ donation taskforce examined the case for moving to an opt-out system in 2008 and its recommendation was against such a system. Spain had an opt-out system, but I think that it has now rejected it. In any event, it no longer has an opt-out system. I know that because I had a conversation with Spain’s Health Minister at a recent EU conference, as one does at such events, where people learn from each other, which is extremely useful. Spain has one of the highest uptake levels for organ donation and there is an awful lot that we can learn from it.

When people apply for a driving licence, they can now tick a box to sign up for organ donation. That has its value. I think we should take every opportunity to encourage people to donate. However, if people are applying for a driving licence, there will be a tendency to skip that box because they want to get on with filling in the form.

I will be quite frank. When I got this job, ITV ran an excellent campaign for about a week in which it encouraged its viewers to sign up to be donors. I suddenly realised that I did not have a donor card. I was informed by my brilliant officials that I did not need a donor card and that all I needed to do was go online. I went online and signed up extremely easily and quickly. I was highly impressed by that system. I would not have known about it if ITV had not run that campaign. There are many opportunities to encourage and positively enable people to sign up and donate.

I will keep an open mind on the opt-out system. We will look at what happens in Wales. We may well have a great deal to learn from it. It may be that that system, which the Welsh Government have great hopes for, will be successful and that, in looking at it, we will form a different view. It is important to keep all one’s options open.

As I was saying, NHS Blood and Transplant announced its new strategy on 11 July. It has a new chair who is full of vigour and who I am sure will do an extremely good job.

In conclusion, transplantation offers many people the opportunity of life and enhances the lives of many others. I am delighted that Natalie has had that opportunity and we all wish her a long, happy and healthy life. We have made significant progress over the past five years and we must thank all the families of donors for agreeing to or supporting donation and giving the gift of life at such a terrible time in their own lives. We want to build on that progress and increase our donation and transplantation rates up to 2020 to match the world-class performance in many other countries. There is no reason why we cannot do as well as the Spanish or even better. We will continue to monitor the procedures in the United Kingdom for the selection and allocation of organs, and to consider whether changes to the allocation of organs need to be made to ensure equity of access for all people on the national waiting list.

I hope that the hon. Member for Stretford and Urmston, whom I congratulate again on securing this debate, has been heartened by the points that I have made. If there are any questions that I have not answered, I will of course write to her, unless she wants to make a quick intervention before I finish. She seems content and I am grateful for that.

Question put and agreed to.

Managing Risk in the NHS

Anna Soubry Excerpts

Wednesday 17th July 2013 Commons Chamber

[Andy Burnham]

This is debate is about the NHS in England, and if the hon. Gentleman has concerns about the NHS in Wales, why does he not have a word with his right hon. Friend the Chancellor of the Exchequer and get a better deal for the Welsh Assembly so that a bit more money could be put back into the Welsh national health service?

As I was saying, the Government have put staff morale at rock bottom, and where are the promised benefits of this reorganisation? Clinical commissioning groups are not, as we were promised, the powerhouse of the new NHS; they are embryonic at best and anonymous at worst. Members of all parties, I am sure, write letters to CCGs that get passed to NHS England, which then either does not provide a proper answer or passes them on again. [Interruption.] I hear the public health Minister saying it is dreadful that Members do not get proper answers. When my hon. Friend the Member for Easington (Grahame M. Morris) wrote to her about cancer services in his constituency, she also brushed it off to NHS England. Is this proper accountability? No.

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

rose—

[Andy Burnham]

I hope the Minister is going to deliver some accountability now.

--- Later in debate ---

[Anna Soubry]

Will the right hon. Gentleman please agree and accept that I have not only answered his letters, but met him on at least one occasion? It is right under the new system for such letters to go to NHS England, but that does not stop me making representations. We have introduced a much better system than we used to have under his Administration.

[Andy Burnham]

We have just heard it; this is what the NHS has been reduced to. The Minister has to make representations to NHS England about cancer services of all things. My goodness, if Ministers are not responsible for cancer services, what are they responsible for? Who is making the decisions and who is responsible for what? Even now, confusion reigns.

What precisely is the role of the Secretary of State in this new world? He has cast himself in a new role as a detached commentator on the sidelines, magnifying all of the NHS’s failings and accepting none of the responsibility to fix them. I assume that that is all for NHS England, too. With the NHS already laid low by cuts and reorganisation, the Secretary of State has opened up a new front on staff: nurses repeatedly blamed for not caring enough; hospitals blamed for coasting, as I have said; GPs blamed for causing the A and E crisis. Everything is someone else’s fault.

Then we get to this weekend. The Keogh report rightly exposed poor care standards, which should never be tolerated; we support action to tackle to them. The report, however, exposed something else, too—a Government who are now actively spinning against the NHS for which they are responsible, generating misleading or, in Sir Bruce’s words, “reckless” headlines about 14 already troubled hospitals. What chance do they have of improving when the man supposedly in charge is actively doing them down?

HFEA and HTA (Government Response)

Anna Soubry Excerpts

Wednesday 17th July 2013 Written Statements

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

The Department of Health is today publishing Government response to the independent report, “Review of the Human Fertilisation & Embryology Authority and the Human Tissue Authority” by Justin McCracken.

On 25 January 2013 I announced to the House that, following a consultation carried out in 2012 on proposals to transfer functions from the Human Fertilisation and Embryology Authority (HFEA) and the Human Tissue Authority (HTA), I had commissioned an independent review of both bodies which would also give serious consideration to their merger. This review was conducted by Justin McCracken, the then chief executive of the Health Protection Agency, between January and April 2013 following which he reported to me and the Minister for the Cabinet Office.

We have now considered Mr McCracken’s report in detail and have taken careful note of his conclusion that the current arrangements deliver generally effective regulation and achieve high levels of public and professional confidence. We have also closely examined his finding that there is little overlap in the activities of the two bodies and his conclusion that greater efficiency is to be gained from reducing the burden of regulation than from structural reform. The review recognises that there is scope for improvement in the ways the bodies operate, and that efficiencies can be achieved by way of a review of human tissue legislation. There are 18 recommendations in total to help achieve a reduction in the burden of regulation. Most of the recommendations are aimed at the HFEA and HTA and we will work with them to ensure they are implemented.

The report recommends that the Government review human tissue legislation. We recognise the importance of that and understand that there will be particular sensitivities around such an undertaking but believe that the evidence presented in the McCracken report is persuasive. We are committed to safeguarding the principles of the Human Tissue Act (and the requirements of EU legislation) but believe that after nearly a decade in force, a review of this legislation is timely. We aim to produce a consultation document in this financial year.

The Department, therefore, accepts Mr McCracken’s recommendations in total, and will work closely with the HFEA and HTA as they implement those recommendations for them.

In conclusion, we believe that implementation will bring about increased efficiency and effectiveness of the regulators while maintaining public and professional confidence in these sensitive and complex areas.

A copy of the Government response to the report of the independent review of the Human Fertilisation and Embryology Authority and the Human Tissue Authority by Justin McCracken along with a copy of the independent report, “Review of the Human Fertilisation & Embryology Authority and the Human Tissue Authority” have been placed in the Library. Copies are available to hon. Members from the Vote Office and to noble Lords from the Printed Paper Office.

Oral Answers to Questions

Anna Soubry Excerpts

Tuesday 16th July 2013 Commons Chamber

[Cathy Jamieson (Kilmarnock and Loudoun) (Lab/Co-op)]

1. If he will bring forward legislative proposals on standardised packaging of tobacco products.

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

The Government’s policy remains unchanged. We are waiting to see how the legislation recently introduced in Australia pans out before deciding whether to follow.

[Cathy Jamieson]

Given some of the public health Minister’s previous pronouncements, some of us could be forgiven for thinking that the Government’s policy has changed. Will she advise the House, therefore, on who overruled her support for this policy? Was it the Prime Minister, the Health Secretary or Lynton Crosby?

[Anna Soubry]

Unfortunately, the hon. Lady has not listened to my last answer or, indeed, to my statement on Friday. The Government’s policy remains unchanged. We are waiting to see the evidence before making a decision. I take the very firm view that the best legislation is based on good evidence.

[Mr David Nuttall (Bury North) (Con)]

Of course, there are those of us who believe it is up to the individual to take personal responsibility for their own health and who entirely support the Government’s decision not to have any extension of the nanny state. Does the Minister agree that, before we introduce any new laws on tobacco, we ought to enforce more strictly the existing laws on not selling cigarettes to children?

[Anna Soubry]

My hon. Friend makes a number of excellent points with which I agree, save for one: with great respect, standardised packaging would not be an extension of the nanny state, because it would not impinge on anybody’s freedom or right not only to buy cigarettes, but to smoke them. It is all about ensuring that the package is not attractive, especially to young people, who are at risk of taking up smoking.

[Ian Austin (Dudley North) (Lab)]

18. Earlier this year, I met young people from Dudley who set up the Kick Ash project campaigning for plain packaging. They showed me evidence from research that plain packaging would stop young people smoking in the first place, which is something every MP ought to be committed to trying to do. If the Government reject plain packaging, will those young people be right to conclude that the Government take the advice of big tobacco companies and their wealthy lobbyists more seriously than the views of young people in Dudley?

[Anna Soubry]

First, I pay tribute to Kick Ash. I am more than happy to meet those youngsters; they seem to be doing a very good job. Secondly, we are not in anybody’s pocket. I am sure the hon. Gentleman can say he is not in the pocket of any trade unions either. This is an important decision, but we have not made it yet; we are waiting to see how things develop in Australia, and as I say, good laws are based on good, sound evidence. That is the way forward.

[John Pugh (Southport) (LD)]

Is the high evidential threshold being set for the plain packaging proposals to be applied across Government legislation or only where lobbyists are involved?

[Anna Soubry]

I am rather disappointed at that question from my hon. Friend. I can assure him that the Government take all these issues very seriously. I am proud of our emerging record on public health, but as I say, we have yet to make a decision, because, quite properly, we want to see what happens in Australia, and of course we are also waiting to see what happens elsewhere, notably in Ireland, where the Irish Government intend to introduce this policy. It might or might not be successful.

[Ms Diane Abbott (Hackney North and Stoke Newington) (Lab)]

The Minister says, quite correctly, that the best legislation is based on evidence, but should it not also be untainted by the activities of lobbyists? She will be aware that Department of Health officials met Philip Morris Ltd at the end of January this year, but although minutes of meetings with other tobacco companies that occurred at the same time have been released, the Department insists that the minutes of the meeting with Philip Morris have yet to be finalised. Is it not the truth that the Government are trying to cover their tracks over their relationship with Lynton Crosby and his clients and that when it comes to the decision effectively to drop plain packaging for this Parliament, all roads lead back to No. 10 and Lynton Crosby?

[Anna Soubry]

I have just seen a piece of straw flying over, which the hon. Lady attempts to clutch at. [Interruption.] “Clutching at straws”—it is a bit lost on the Opposition, but that is more a sign of their difficulties than ours. The minutes of the meeting with that tobacco company have been published this morning. The reason for the delay—I very much hope the hon. Lady is not suggesting for one moment that my officials have been in any way dishonest—is because unfortunately the tobacco company did not agree the minutes, and there was some to-ing and fro-ing. I really wish she would not subscribe to conspiracy theories where they do not exist.

[Stephen Timms (East Ham) (Lab)]

2. What recent assessment he has made of the effects on NHS services of changes in local authority spending on adult social care.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

I pay tribute to the work done on this issue by my hon. Friend, as well as by my hon. Friends the Members for Broxbourne (Mr Walker), for Croydon Central (Gavin Barwell), for Loughborough (Nicky Morgan) and many others. They have done a huge amount to remove the taboo associated with mental health. We are funding the “Time to Change” campaign, with up to £16 million being put in from 2011 to 2015. The programme works to support and empower people to talk about their mental health problems and to tackle the discrimination that so many of them face. It includes for the first time a tailored programme of work for children and young people.

[Bob Stewart]

How confident is my hon. Friend that general practitioners are able to make rapid assessments of potential mental health problems, particularly clinical depression, when patients present themselves perhaps for other non-related matters?

[Anna Soubry]

We know that a third of GP appointments are mental health-related, so GPs have a lot of experience in tackling mental illness. We also know, however, that it is not covered extensively in GP training, which is why the Royal College of General Practitioners has identified improved care for people with mental health problems as a training priority—this is to be welcomed—through its enhanced GP training programme.

[Mr Andrew Love (Edmonton) (Lab/Co-op)]

Yet mental health spending has been cut over the last two years and we find ourselves in a position where four in 10 mental health trusts do not have safe levels of staffing. What is the Minister going to do about the funding and the staffing levels in our mental health services?

[Anna Soubry]

Of course, the overall health budget will be rising by some £12 billion by 2015, and in relation to mental health, I have to say that I am exceptionally proud of this Government for making mental health such a priority, notably through the mandate. I think we are to be congratulated on at last recognising how important mental health is. In our view, it underpins almost all public health matters and so many of the troubles and conditions that people present to GP surgeries. Therefore, I think we are doing an extremely good job on this subject.

[Valerie Vaz (Walsall South) (Lab)]

4. What plans he has to implement the recommendation of the Francis report on safe staffing levels.

--- Later in debate ---

[Jason McCartney (Colne Valley) (Con)]

5. Whether the new review of children’s heart surgery units will cover adult as well as paediatric cardiac surgery.

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

I am informed by NHS England that it will include adult surgery in its review of care for people with congenital heart disease.

[Jason McCartney]

Can NHS England assure us that a clear link will be shown between the feedback from patients, the public and stakeholders and the final configuration of services in the review of the Leeds children’s heart surgery unit?

[Anna Soubry]

Let me first pay tribute to the work my hon. Friend continues to do in support of his hospital and his children’s heart unit. NHS England has told me that individuals and patient organisations have all been encouraged to engage with and contribute to the local review process. The feedback received will be used to help to inform the outcome of the review of children’s heart surgery at Leeds.

[Mr Henry Bellingham (North West Norfolk) (Con)]

6. What plans he has to meet the acting chief executive of the East of England ambulance trust to discuss that trust’s recovery plan.

--- Later in debate ---

[Caroline Lucas (Brighton, Pavilion) (Green)]

10. If he will take steps to ensure that people affected by muscle- wasting conditions in the South East Coast NHS area are adequately supported after September 2013; and if he will make a statement.

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

NHS England commissions some elements of neurological services through specialist services commissioning arrangements, while clinical commissioning groups commission general neurological services. I am informed that the Muscular Dystrophy Campaign and the Surrey and Sussex area team are considering funding the care pathway adviser post for a further six months.

[Caroline Lucas]

I thank the Minister for her answer, but an exploration just for the potential of a mere six months’ reprieve is not good enough. As things stand, for people with muscular dystrophy and their families in the South East Coast region, from September, that is set to be the only part of the country without access to a local care and support advocate. Therefore, will the Minister agree to meet me as a matter of urgency to discuss what can be done to ensure long-term funding for that vital post, which sufferers and their families want to see continue?

[Anna Soubry]

The simple answer is absolutely yes. My hon. Friend the Member for North Thanet (Sir Roger Gale) has also raised this matter through parliamentary questions and the like. I am more than happy to have that meeting.

[Margot James (Stourbridge) (Con)]

11. What steps he is taking to improve the care of vulnerable older people.

--- Later in debate ---

[Heidi Alexander (Lewisham East) (Lab)]

12. What recent progress his Department has made on negotiations with acute providers on the capital and revenue costs of implementing the recommendations of the special administrator of the South London Healthcare NHS Trust.

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

Decisions on funding for each individual hospital are being worked through as part of the implementation planning process, in collaboration with the Department, to ensure value for money for the taxpayer. Decisions need to ensure that capacity is available in the right place and that quality and safety are maintained.

[Heidi Alexander]

Is it true that King’s College hospital wants £109 million in capital funding alone to cover changes at the Denmark Hill site and at the Princess Royal hospital, given that in January the Secretary of State announced £73 million of additional investment for all the other hospitals in south-east London to deal with displaced patients from Lewisham? Will the Minister explain where the money is coming from? Will she also tell us whether all this will be centrally funded, or whether local commissioners will be asked to pick up the tab?

[Anna Soubry]

What I can say is that it will be centrally funded, but as to the other detail in the hon. Lady’s question, I will have to write to her with those answers. As ever, my door is open and I am more than happy to meet her to discuss it further.

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op)]

13. What plans he has to increase the management capability of doctors elected to clinical commissioning groups.

--- Later in debate ---

[Keith Vaz (Leicester East) (Lab)]

T4. Will the Secretary of State join me in congratulating Abbey primary school on becoming the first “silver star” school in Leicester for banning sugary drinks and for promoting healthy eating and exercise? Does he agree that this is the best way of preventing diabetes and obesity in later life?

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

Absolutely. I would be delighted to come along and visit the school. May I give full credit to the right hon. Gentleman for his campaign and to the Silver Star charity, which does great work? That is why it is so right that we put public health back in local authorities, where it should always have been and where it was, historically. This sort of local action is very much the way forward, so I congratulate the school and the right hon. Gentleman again.

[Andrew George (St Ives) (LD)]

Further to the question raised by the hon. Member for Walsall South (Valerie Vaz), I have met the Under-Secretary of State for Health, my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter) regarding safe staffing levels and I provided a substantial file of evidence on behalf of the Florence Nightingale Foundation in support of its 1:8 registered nurse to patient ratio. What part of that evidence are Ministers unconvinced by?

--- Later in debate ---

[Tessa Munt (Wells) (LD)]

The Secretary of State will be aware of the case of Nadejah, the face of the Teenage Cancer Trust, who at the age of 23 has been refused the CyberKnife cancer treatment that could save her life. Her mother Michelle is here today. Will he intervene so that this young woman gets the treatment that her consultant, Professor Hochhauser, recommends, and will he meet Nadejah’s mother and me so that we can work together to unblock the funding so that she can get the treatment she so desperately needs?

[Anna Soubry]

I am more than happy to meet the hon. Lady and the family but, as she knows, this is a treatment that we have talked about endlessly, and we have had many meetings, which I am more than happy to continue to have with her.

[Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

Since 2010, thousands of NHS staff have left the NHS with big, fat redundancy cheques, only to go through the revolving door and get new jobs in the NHS, often months later. Will the Secretary of State tell us how much has been spent on redundancy payments and whether he regrets that waste of NHS money?

Tobacco Packaging

Anna Soubry Excerpts

Friday 12th July 2013 Commons Chamber

[Ms Diane Abbott (Hackney North and Stoke Newington) (Lab)]

(Urgent Question): To ask the Secretary of State for Health if he will make a statement on the Government’s response to the consultation on standardised packaging of tobacco products.

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

The Government’s policy remains unchanged. The Government have today published a summary report on the consultation on the standardised packaging of tobacco products. The consultation was undertaken last year between April and August with the agreement of the devolved Administrations on a UK-wide basis. The summary report is available in the Library.

The standardised packaging of tobacco refers to measures that may be taken to restrict or end the use of logos, colours, brand images or promotional information on packaging. Any brand or product names would be displayed in a standard colour and typeface. The consultation was intended to explore views on whether standardised tobacco packaging would reduce the appeal of tobacco products to consumers, increase the effectiveness of health warnings on the packaging of tobacco products, reduce the ability of tobacco packaging to mislead consumers about the harmful effects of smoking and have a positive effect on smoking-related attitude, beliefs, intentions and behaviours, particularly among children and young people. To inform responses to the consultation and subsequent policy making, the Department commissioned a systematic review of evidence on standardised packaging. I am grateful to the academics who undertook the review at the university of Stirling, university of Nottingham and the Institute of Education. It is being published alongside the consultation document.

More than 668,000 responses to the consultation were received and the views expressed were highly polarised. Strong views were put forward on both sides of the debate and a range of organisations generated campaigns and petitions. Of those who provided detailed feedback, some 53% were in favour of standardised packaging while 43% thought the Government should do nothing about tobacco packaging. Having carefully considered those differing views, the Government have decided to wait until the emerging impact of the decision in Australia can be measured before we make a final decision.

Only one country, Australia, has adopted the policy, which it introduced on 1 December last year. New Zealand and the Republic of Ireland have announced that they intend to follow suit. We intend to wait, so we can benefit from the experience of countries such as Australia that have introduced standardised packaging. In the meantime, I want to promote wider public debate about whether we should introduce standardised packaging in this country, including in this House as well as in the media.

[Ms Abbott]

Mr Speaker, you would have to have a heart of stone not to feel sorry for the hon. Lady, who has been forced to be the face of this humiliating policy U-turn. Once again, the Government have tried to slip out an important policy statement by means of a written statement on a Friday, hoping to avoid parliamentary scrutiny. Once again, the Government have completely lost their way on public health and caved into big business. Today, the health of the nation is being sacrificed to the interests of big tobacco.

The Minister has conceded that the Government’s systematic review found that standard packaging would make smoking less attractive to young people. The Minister will have read the letter signed by 160 specialist consultants and professors calling on the Government not to enact this U-turn. The Minister might have heard the former Health Secretary, the right hon. Member for South Cambridgeshire (Mr Lansley), say:

“The evidence is clear that packaging helps to recruit smokers, so it makes sense…having less attractive packaging. It’s wrong that children are being attracted to smoke by glitzy designs on packets…children should be protected from the start.”

The Minister might even remember what she had to say—that she had been “personally persuaded” of the case for standardised plain packaging. The Opposition have to ask what happened. We suspect that Lynton Crosby happened.

Every single medical stakeholder, every campaigner on tobacco harm and every member of the public who is concerned about the fact that half of all lifetime smokers will die prematurely from their habit and that hundreds of children start smoking every day will be appalled at this decision. It bears no relationship to the evidence and people will die. Will the Minister tell the House whose decision it was to slip out the announcement on a sitting day by means of a written statement? Who was involved in making the decision and can she confirm that Lynton Crosby had no involvement whatsoever in today’s decision?

There can be no greater responsibility on Government than the heath of the nation. Every single Health Minister has declared their personal support for standard plain packaging and the Minister should be ashamed to have been dragged to the House today to set out this disgraceful U-turn.

[Anna Soubry]

May I apologise, Mr Speaker, for the fact that apparently I have been speaking far too quietly for perhaps the first time in my life? The hon. Lady clearly did not hear what I said, and I will repeat it. We have not made a decision. We have decided to wait, quite properly, to see the evidence as it emerges from Australia. I make it very clear that there is no change in the policy of this Government. Forgive me, Mr Speaker, but the Order Paper is quite clear—I see it before me—and states that there will be the publication in the Library today of a written statement on the matter of standardised packaging. I just heard a whole load of nonsense going up in smoke.

[Sir Peter Bottomley (Worthing West) (Con)]

When I was responsible for reducing drink-driving, I was told that we had to increase the penalties, lower the limit and increase the policing. Drink-driving deaths have come down by three quarters in the past 30 years. The reduction of smoking among men from 82% to about 20% mainly happened before we started throwing the law at everything. People smoke because they take it up as teenagers, and we say they are too young to smoke. We ought to say that only children take it up and to make it as unlikely as people picking their nose in public.

--- Later in debate ---

[Anna Soubry]

I am very grateful for those comments. My hon. Friend is quite right that prevalence is now at about 20%, which is better than in many other countries. There is a very good debate to be had about whether we should take legislative action or change social attitudes. That is why I am so proud of our “Stoptober” campaign and the fact that we have had up to half a million hits on our website. Half a million quitting packs have been given out. It is a subtle combination of many factors. If only there were one silver bullet—but unfortunately there is not.

[Kate Green (Stretford and Urmston) (Lab)]

When the Minister publishes the analysis of the Australian experience, will she also publish an evidenced analysis of the number of avoidable deaths and illnesses that have resulted from the delay?

[Anna Soubry]

Well, I could say that the hon. Lady’s party, when it was in government, had 13 years to introduce such legislation. Indeed, I am more than happy to say that. If it was so simple to introduce standardised packaging, why did Labour not do it? It is not as simple as they now try to make out. Most importantly, I believe, Mr Speaker—and I do speak as a lawyer—you always want good legislation that is evidence-based. That is why I am more than content to support a delay, while we wait to see the evidence as it emerges from Australia.

[Philip Davies (Shipley) (Con)]

I congratulate the Government on this decision. The Minister will recall that the last time I raised this subject in the House, she told me that I would see the light, and I am delighted that she and the Government are the ones who have seen the light on this issue. She cherry-picked some numbers of people in favour of and against standardised packaging from the consultation. Could she tell us the figures from the full 688,000 responses? How many of those were in favour and how many against?

[Anna Soubry]

Forgive me; I do not have that information at my fingertips. I am more than happy to supply it to my hon. Friend by way of a letter, or any other mechanism.

The position I have set out is what we now need, and if there is a criticism that I would make, it is that we went to consultation first. All good legislation needs a good, healthy debate, followed by, perhaps, wider consultation. We now need to have that debate, and I am very happy to lead it.

[Chris Williamson (Derby North) (Lab)]

Does this not represent a shameful capitulation to the merchants of death who want to recruit more children to smoke, who will go to an early grave as a consequence? Can the Minister therefore confirm to the House whether or not Lynton Crosby has had any conversations at all with any Health Minister on this issue?

[Anna Soubry]

I can assure the hon. Gentleman that Mr Crosby has not had any conversation with any Health Minister on this issue. This really is a complete red herring. I can also inform him that I am very proud of the fact that we have banned cigarette vending machines, which will mean that people under the age of 18 in particular no longer have access to cigarettes by virtue of that site of sale, and I am also pleased that by 2015, we shall be ensuring that the ban on displays of cigarettes, which are currently banned in supermarkets without the provision of shutters, will be extended to smaller shops.

[Mr Mark Williams (Ceredigion) (LD)]

One hundred and fifty thousand youngsters are estimated to have taken up smoking since the end of the Government’s consultation, so the time scale is important. Can the Minister reiterate her assurance that this is not being kicked into the long grass, albeit in the outback, as we fear it may well be?

[Anna Soubry]

As I have explained, there has been no change of policy at all. What we have decided to do, based on the consultation, but most importantly based on what the Australian Government have done, is to look at that evidence as it emerges. I have spoken to the Australian high commissioner—[Hon. Members: “Oh!”] Hon. Members on the one hand claim that this is serious—

[Mr Speaker]

Order. Let us try to lower the decibel level. Questions should be heard with courtesy, which, to be fair, I think they have been, and the answers must be heard with courtesy.

[Anna Soubry]

I think this is important. I also spoke with one of the leading experts who have been involved in the legislation in Australia, and I was quite surprised that even after about three or four months, they could not give me a picture of any emerging evidence. That is why we need this time. I believe all good legislation should be based on firm, good strong evidence.

[Andrew Selous (South West Bedfordshire) (Con)]

I am all for evidence-based policy making, not least from Australia—I declare an interest in being half Australian myself—but the Minister will be aware that my step-sister died of lung cancer at the age of 49, leaving four children. The Minister was kind enough to meet her late husband, whose children have set up the Deborah Hutton campaign to do work, particularly with young people, to prevent them from taking up smoking through innovative use of film and suchlike. What are the Government doing to prevent young people—particularly girls, whose lungs are more severely damaged by smoking—from taking up smoking?

[Anna Soubry]

I am grateful to my hon. Friend, and it was a great honour to meet members of his family. My own father died, after a lifetime as a heavy smoker, from lung cancer, so we are all well aware of the health risks. My hon. Friend makes the good point about what we are doing specifically to stop children from taking up the habit. I have explained about vending machines. Of course, there is also an EU directive; although it may not find a great deal of favour with some Members on my side of the House, it is a very good directive. Work began on it only a few weeks ago, which will mean, for example, that we will not—[Interruption.] The hon. Member for Streatham (Mr Umunna) is chuntering, Mr Speaker, and it is not always very helpful, as I know.

[Mr Speaker]

Order. So the hon. Lady knows. Was she perchance speaking as a practitioner?

--- Later in debate ---

[Anna Soubry]

If I were in court, I think I would have to plead guilty to that one, Mr Speaker. In all seriousness—it is a very serious point—one of the things in the EU directive that we specifically looked at was the percentage of the package that should contain health warnings. It is now going up to 65%. There will be no flavourings. Again, this is very important in tobacco products. All this is designed for the next generation.

It is really important to add this: standardised packaging was about making cigarette smoking unattractive to young people. It is the next generation; that is the fundamental aim. That is why it is really important, even for those who use that aim to argue in favour of standardised packaging, that we find out what the evidence is in Australia, which is doing it. That is why my hon. Friend is right to say that good, evidence-based legislation is always the best.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

I am proud that the Labour Government in 2006 gave a free vote on the legislation for smoke-free workplaces. That was an important step forward. Perhaps the Minister should be thinking in those terms now, because today’s decision to take no action will really disappoint the 190 health organisations, including the royal medical colleges and the World Health Organisation, that have supported the move to standardise packaging on tobacco products. Will they not now be drawing the conclusion that the Government, as my hon. Friend the Member for Hackney North and Stoke Newington (Ms Abbott) has said, have given in to vested interests and entirely lost their way on public health?

[Anna Soubry]

I do not give in to pressure from anybody, and neither does anybody else in my Department or indeed in my Government. We have taken a decision to wait for the emerging evidence from Australia, and that is the right thing to do.

[Jacob Rees-Mogg (North East Somerset) (Con)]

May I welcome the wise statement made by my hon. Friend today, and remind her that it is often the case that parties in opposition are all in favour of freedom, and when they get into government they are suddenly in favour of the nanny state?

[Jacob Rees-Mogg]

I did indeed; I was very fortunate. [Laughter.] It is a pity some Opposition Members did not, but never mind.

When liberties are removed, it should always be done, as my hon. Friend says, on the basis of evidence, because freedom is very precious, and the state does not have the right to interfere willy-nilly.

[Anna Soubry]

I agree that the state does not have a right to interfere willy-nilly, but of course standardised packaging does not prevent anybody from buying cigarettes or inhibit their right to smoke cigarettes if that is their choice, so with respect to my hon. Friend, this is not a nanny state argument at all. The packaging would be affected, but people would remain free, as ever, to buy cigarettes and to smoke them.

[Ian Paisley (North Antrim) (DUP)]

I, too, congratulate the Government on their courageous and brave decision to do the right thing, and I would encourage the Minister to keep on changing in this matter. She has protected 1,000 jobs directly in my constituency today as a result of this, and for that I am truly grateful. But may I also say that with clarion certainty today, we now have a statement from the Government that policy in this area will be based on evidence, not emotion. That is incredibly important, in order that we can get to sensible decisions. On that basis, turning to the tobacco directive, will the Minister now agree for her officials to meet me and industry representatives who employ people in my constituency, given that the Minister’s Department has already met with Ms Linda McAvan, the MEP and reporter, on the tobacco directive, because it is only fair that we have proper, full, evidence-based debate on this matter?

[Anna Soubry]

The hon. Gentleman knows that he and I do not agree on this matter. Of course, we have not made a decision; that is the whole point. We are waiting to see the evidence as it emerges from Australia before we make a decision. I am more than happy to meet him again, as I have done in the past, but I can tell him: I am not going to meet those whose business is to trade and to manufacture tobacco. It is bad; it is horrible stuff. It kills people. It does great damage to people’s health.

[Mr Christopher Chope (Christchurch) (Con)]

I draw attention to my entry in the Register of Members’ Financial Interests.

I congratulate my hon. Friend on her indecision. I also draw to her attention the fact that there does not seem to be any evidence that the sale and availability of illegal drugs in plain packages has reduced their attractiveness to young people.

[Anna Soubry]

I could speak for a very long time about illegal drugs and how we make them less attractive to young people. We know, for sure, that we need a subtle mixture of different measures that persuade young people not to take substances that are harmful to them. I am more than happy to have that conversation with my hon. Friend.

[Valerie Vaz (Walsall South) (Lab)]

Apart from vending machines, what public health initiatives is the Minister going to undertake immediately to stop 570 children a day taking up smoking?

[Anna Soubry]

We have a number of measures. For example, we have some of the toughest tax and duty measures in relation to tobacco. The “Stoptober” campaign was phenomenally successful last year. We have a TV campaign that is encouraging people not to smoke in cars, for example, as well as our other continuing work. With public health being devolved back to where it always should have been—to local authorities—a number of authorities, notably up in north-east England, have taken grave measures to tackle smoking by educating young people, in particular. This is all good work that will continue through Public Health England.

[Penny Mordaunt (Portsmouth North) (Con)]

I can see the merits of standardised packaging. Companies have invested heavily in equipment to produce complex packet designs in order to make counterfeiting harder. Does the Minister agree that if standardised packaging is adopted, whatever the future designs are, the packaging should still be sufficiently complex and difficult to forge? These are just the sort of issues that she and her Department must now look at in depth.

[Anna Soubry]

Absolutely. One of the problems in this debate is that unfortunately it has been called plain packaging. It is far from plain. As, in effect, the Government would be in control of what goes on to the cigarette packet, there is provision to make it as complicated as possible, with a variety of colours, watermarks, holograms and so on. Far from being a counterfeiter’s dream, it would be a counterfeiter’s nightmare.

[Ann McKechin (Glasgow North) (Lab)]

The Minister said that this is a joint consultation with the devolved authorities. Can she confirm whether Scottish Government Ministers were happy to hit the pause button for an undefined time period?

[Anna Soubry]

I have been very pleased to have a number of discussions with colleagues north of the border and in Wales. It is a pleasure, as always, to continue to work with them.

[Mr Peter Bone (Wellingborough) (Con)]

I draw the House’s attention to an interest in the register.

I congratulate the courageous Minister on making this decision. She has led from the front and done completely the right thing in having an evidence-based decision. The shadow Minister’s attack on her was completely unfounded. This Minister would never do something against her principles; if she thought it was wrong, she would resign. Is not this exactly the way Government should be: evidence-based rather than rushing through things?

[Anna Soubry]

I agree.

[Mr Kevan Jones (North Durham) (Lab)]

It is a first for this Government to determine policy by waiting to see what the Australians do. What time period will there be for the consultation? Has the Minister’s position on this issue, and that of her colleague the Under-Secretary of State for Health, the hon. Member for Central Suffolk and North Ipswich (Dr Poulter), changed?

[Anna Soubry]

I have absolutely no problem whatsoever with waiting to see what happens with the introduction of the legislation in Australia. The hon. Gentleman knows that the aim of standardised packaging is to dissuade young people from taking it up.

[Mr Jones]

How long?

[Anna Soubry]

I am answering the hon. Gentleman’s first question first, after which I will move on to the next one. That is the aim of the introduction of standardised packaging. If a good experiment is up and running that will produce evidence, what could be a more sensible thing for Government to do? As to the length of time, I cannot answer that question, because we have to wait and see the evidence as it emerges. I thought that we might see some sort of change quite quickly in Australia, but we have not seen it yet; I am surprised about that. I am afraid it is a case of “How long is a piece of string?” We have to wait and see how the evidence emerges.

[Richard Burden (Birmingham, Northfield) (Lab)]

The Government’s own review found a solid case for standardised packaging, and the Minister says that she is personally persuaded of that case. The Government’s consultation finished not far short of a year ago, and now she says that their position has not changed. Does that mean that their position was always just to wait and see whether anybody else did it before making a decision? If not, what on earth was the point of the consultation and the statements she has made up until today?

[Anna Soubry]

I appreciate that the hon. Gentleman may have a problem with this, but we have had, and continue to have, an open mind. I have no difficulty with that. We had a consultation that closed in August last year. The Australians passed their legislation and it came into effect in December last year. It is absolutely right and reasonable to see the evidence as it emerges from Australia before making a final decision. That strikes me as responsible, grown-up government.

[Karl Turner (Kingston upon Hull East) (Lab)]

When did the Minister last speak to Lynton Crosby?

[Anna Soubry]

I think it would have been in 2004.

[Mark Durkan (Foyle) (SDLP)]

Like other Members, I regret that the Government have flinched on this. However, I welcome the fact that the Minister still clearly refutes the fallacy that standardised graphic packaging with markers would in any way aid smuggling or counterfeiters. Will the pause mode that the Government have now moved into still allow them to work with their Irish counterparts, perhaps moving on a synchronised basis in relation to these measures to make sure that this move happens throughout these islands?

[Anna Soubry]

I am very grateful for those comments. I know that the Republic’s Minister for Health is a firm advocate of standardised packaging. In fact, I think that if he could he would go even further and make tobacco illegal. I hope that he will not mind me saying that in public, but I believe it is his view. It is an absolute pleasure to work with him. We learn from each other. At the various European Union Health Ministers’ meetings we exchange ideas and experiences. That is why—I keep saying it, but it is absolutely right—we must wait and see the evidence as it emerges from Australia.

[Ian Paisley (North Antrim) (DUP)]

On a point of order, Mr Speaker. How can I correct what I consider to be misleading information? How can it be the case that the Government have not met representatives of the tobacco industry when I have accompanied them to meet the Government every year since I have been a Member of Parliament and the previous Member of Parliament for North Antrim has accompanied them to meet the Government for the past 30 years? Can that be corrected in some way, because I believe that it was misleading the House to assert that there would be no such meeting?

--- Later in debate ---

[Mr Speaker]

I am grateful to the hon. Gentleman for his point of order. My understanding was that the Minister was asked whether she would meet representatives of the tobacco industry and she indicated that she did not intend to do so. I do not think that she was making any wider claim about what had happened with other Ministers or on previous occasions; she was simply signalling that it was not her intention to meet them. If the Minister wants to speak, she is welcome to do so.

[Anna Soubry]

I will write to the hon. Gentleman.

[Mr Speaker]

I think the position is now clear; the Minister has kindly committed to write to the hon. Gentleman.

Informal Health Council

Anna Soubry Excerpts

Friday 12th July 2013 Written Statements

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

EU Health Ministers met in Vilnius, in Lithuania, on 8 and 9 July. I represented the UK. The agenda included discussions on sustainability of health systems, mental health and well-being of older people, and of smoking prevention in youth.

The meeting began with a discussion on sustainable health systems, with emphasis placed by the presidency on the need to reduce health inequalities. There was broad agreement that innovation in technology is an important tool in making healthcare more efficient and affordable.

For the UK, I stressed that while the EU can add value to member states work on the three major life choices of smoking, obesity, and alcohol, it is important that the principle of subsidiarity is respected. I noted the important recent progress on the tobacco products directive, which crucially allows member states to go beyond the requirements of the directive where this is essential for public health.

Many member states highlighted the importance of member states collaborating to learn from each other.

There was also a discussion on the mental health and well-being of older populations, during which I stressed the equal importance of mental and physical health, and the UK work on dementia.

The second day included discussions on smoking prevention in youth, focusing on nicotine containing products and on the marketing of tobacco.

The meeting concluded with an AOB item on differential pricing of medicines in member states. A variety of different views were expressed but the UK and a number of other member states opposed the launching of any new EU initiative on the pricing of medicines as this is a matter of member state competence, while recognising the common issues faced by member states, particularly in relation to rare diseases.