Tobacco and Vapes Bill

Baroness Morgan of Drefelin Excerpts

Committee stage
Wednesday 26th November 2025 Grand Committee

[Baroness Hoey (Non-Afl)]

I think it will be helpful to bring the Committee very briefly up to date on what I raised. This amendment is crucial to this Bill because it is basically about whether we can implement it because of the Windsor Framework. I thought it would be helpful for noble Lords to know that four European Union countries have now put in detailed opinions to the European Commission that His Majesty’s Government now have a few months to respond to. The spokesman for the European Union said:

“It is now for the UK in respect of Northern Ireland to report on the action it proposes to take in view of the detailed opinions. The Commission will comment on that reaction”. 


I am trying to impress again that what has gone right through this Bill is the question of whether, in the end, a generational ban can be implemented in Northern Ireland. The Minister has been told again that she has to meet me. She has been told by the Attorney-General. The Attorney-General has finally written a letter to me, not via his secretary, saying that, again, he will not be commenting, even though he is the Advocate General for Northern Ireland and the Attorney-General, and that he wants a meeting where the noble Baroness, Lady Merron, will respond to all the legal points. I thought that might be helpful. I beg to move.

[The Deputy Chairman of Committees (Baroness Morgan of Drefelin) (Lab)]

The amendment has been moved. Does anyone else want to speak to it? If no one does, then we have had the debate. Does the noble Baroness wish to withdraw the amendment?

[Baroness Hoey (Non-Afl)]

Yes.

Tobacco and Vapes Bill

Baroness Morgan of Drefelin Excerpts

2nd reading
Wednesday 23rd April 2025 Lords Chamber

[Baroness Morgan of Drefelin (Lab)]

My Lords, I am delighted to participate in this Second Reading debate. I feel pretty clear about what we are trying to do here. This is a forward-looking Bill. It is about creating opportunities for the future, to have the next generations come through free from the dreadful impacts of tobacco on their lives. The Bill is about reducing the harms associated with tobacco and taking a broad view about that. I can understand why a trip to William Morris would—

[Lord Vaizey of Didcot (Con)]

Philip Morris.

[Baroness Morgan of Drefelin (Lab)]

Philip. I should not say William Morris, I rather like William Morris. I understand why such a trip would prompt these questions, which is what we are trying to do. I think the Bill is forward-looking, focused, proportionate and well balanced.

I want to talk, as the noble Baroness, Lady Thornton, did very movingly, about the impact that smoking has had on my family. I do not know whether I would define myself as a smoker. I certainly smoked when I was a rebellious teenager, but my family was terribly affected by the impact of smoking. My father was diagnosed with lung cancer when I was a teenager, which caused immense hardship for my family, propelled me and my sisters on to the free school meals list, queuing up with all the other children in the special school meal queue in the way we used to in the past. Both my parents went on to die prematurely of smoking-related cancer. It has been a terrible blight on my family and many thousands of families in this country. So, I am hugely in favour of the Bill.

I have enjoyed listening to colleagues from all sides of the House looking back at the journey we have been on to get here, the different debates we had in 2006 that looked at advertising and so on. We have come such a long way and it has been in the face of enormous opposition. To add my anecdote to the journey, when I first came into this House in 2004, smoking cigars and pipes in the Peers’ Guest Room was considered absolutely acceptable. As the day went by, you might bring a guest in and gradually the height of the smoke would descend to such a level that by about 5 pm you could not go in there without a gas mask. We have seen such an enormous amount of progress in tackling the blight of tobacco.

People think that tobacco—smoking—just affects the lungs, but I served as the chief executive of a breast cancer charity for a few decades and, over those years, I have seen the evidence building to show that smoking causes breast cancer as well as lung cancer and all the other impacts that we know about. Cancer Research UK now says that it causes around 2,200 breast cancers a year. So, we need to be mindful that evidence is unfolding all the time about the impact of smoking on our health.

We have heard that around four in 10 cancers in the UK are preventable and the biggest step forward we could take to prevent cancers would be to reduce cancers caused by smoking. We know that vaping, as we have heard, provides important assistance to those who want to quit smoking, and it is absolutely right that the Bill takes that into account. We know that a lot of the marketing and so on, as the noble Lord, Lord Stevens, so clearly demonstrated, is targeted at children.

I close by saying that I fully support those aspects of the Bill. I really congratulate the Government on taking seriously the terrible issues around single-use vapes. Only two weeks ago, I was in a children’s playground looking after a great-nephew. He said to me, “Do you know what? You can find a red box that can make smoke come out of your mouth—sweet smoke. It’s really great”. He is six, and he found a single-use vape in the bushes in the park and had a go on it. We do not want to see that as the norm in our society. This Bill is about the future and the kind of future that we want for our young people—I support it wholeheartedly.

Prisons: Health Services

Baroness Morgan of Drefelin Excerpts

Tuesday 14th January 2025 Lords Chamber

Asked by

[Baroness Morgan of Drefelin]

To ask His Majesty’s Government what assessment they have made of the provision of health services in prisons.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

My Lords, a full health needs assessment for every prisoner is undertaken at least every three years by NHS England, which then updates service specifications and commissions appropriate services to ensure that the health needs of offenders are being met. All 19 health service specifications for prisons and other detention environments are currently being updated to ensure that they remain fit for purpose and are expected to be published by March 2026.

[Baroness Morgan of Drefelin (Lab)]

My Lords, I thank my noble friend for her Answer. I have heard first hand, through the work of the charities the Prison Reform Trust and Revolving Doors, about the challenging and degrading experience that some prisoners have had trying to access healthcare. Does the Minister agree that there is a huge opportunity to make progress here with the development of better facilities in new prisons? Does she also agree that it be would a positive thing to include prison healthcare services in ICBs’ commissioning to ensure that people in secure settings have access to the advances and developments that are available in the community?

[Baroness Merron (Lab)]

I certainly agree with my noble friend that there are huge opportunities to improve healthcare for prisoners. On new prison design, I reassure her that all prison design will be fit for purpose because medical architects will be commissioned. That new design includes, for example, medical cells so that as many healthcare needs as possible can be met in prison. On my noble friend’s point about ICBs, it is a retained service, so it is not currently delegated to ICBs. It is the responsibility of health and justice commissioners to collaborate closely with ICBs to ensure continuity of care. The electronic referral service means that patients in prison can have access to the developments to which others in the community have access.

Puberty-suppressing Hormones

Baroness Morgan of Drefelin Excerpts

Monday 16th December 2024 Lords Chamber

[Baroness Merron (Lab)]

I very much welcome the generous and supportive comments of the noble Baroness, Lady Fox, in respect of the Secretary of State’s Statement. I am grateful for those. I note that she finds the reference to “uncapped” scary. I presented it as the way to gather the widest amount of relevant evidence, because that is a clinical trial; that is what is so important. The reason it is being done is that there is insufficient evidence and there has not been such a trial, and we need to do one for this particular situation.

In respect of meeting charities and others, the Secretary of State has been very keen to—what I would call—reset the relationship with various groups which all have different sets of thoughts on this. I have joined him in those meetings. He has also been meeting those with lived experience. We continue to do so. We have wanted to detoxify the debate, and those meetings have helped immensely. We will continue to have that listening ear.

[Baroness Morgan of Drefelin (Lab)]

My Lords, I too welcome the Statement. The tone, as we have already heard, has been absolutely right. Thinking about the clinical trial, I would like to know a little more about the timing. If we are intending to run a clinical trial that is going to be looking at efficacy and safety, it will not be an easy trial to run and it is going to take some time. It would be really welcome if the Minister could keep the House informed, which she has already promised to do.

I am particularly interested in hearing the Minister’s view on the following point. It is really important to get this clinical trial on the puberty blockers going, but we also need to understand the value and the evidence supporting all the other interventions too—the psychosocial support, the psychological support, and all the other interventions—so that it is not just this clinical trial but a broad understanding of what really helps these young people. `

[Baroness Merron (Lab)]

My noble friend is right to raise the second point. It is a whole range of interventions, and that is certainly something that we have very much in mind for consideration, for the reasons that we have heard in the Chamber this evening and the points that my noble friend makes. In respect of timings, it is a planned pathway study and that includes a clinical trial component. It is, as I said, to build evidence. I am glad to say that it remains on track to commence recruitment early in 2025, but only after there has been ethical approval. When that is granted, that is when the final study protocol will be ready, and I know that noble Lords will have a lot of interest in that. We will be issuing further updates in early 2025, and if there are any particular questions, noble Lords are very welcome to raise them with me.

Health: Quad-demic

Baroness Morgan of Drefelin Excerpts

Tuesday 10th December 2024 Lords Chamber

Asked by

[Baroness Morgan of Drefelin]

To ask His Majesty’s Government what steps they are taking to reduce the impact of a potential “quad-demic”, involving high prevalence of influenza, respiratory syncytial virus, COVID-19 and norovirus, following the warning of Professor Sir Stephen Powis, the NHS national medical director.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

My Lords, levels of hospital admissions due to flu and norovirus are higher, while Covid hospitalisation rates are lower and RSV hospitalisation rates are about the same as the same time last year. The impact of these infectious diseases can be reduced through our annual vaccination programmes for flu and Covid-19, as well as the new year-round vaccination programme for RSV, and by observing good hygiene measures. Some 16.6 million flu vaccinations, 9.3 million Covid-19 vaccinations and 1.2 million RSV vaccinations have been delivered so far this winter.

[Baroness Morgan of Drefelin (Lab)]

My Lords, I thank my noble friend the Minister for that comprehensive Answer. I have to say that “quad-demic” was a new phrase for me and so I was very keen to understand what the Minister made of the announcements from the NHS national medical director, Sir Stephen Powis. From my point of view, it is vital that we learn the lessons of the last pandemic and I know a huge amount of work is being done to understand the implications of the recommendations from Module 1 of the inquiry. But, as I understand it from Sir Stephen’s announcement, the uptake of NHS vaccine programmes is much lower than last year, so I am concerned for us to be reassured that if uptake does not improve in the run-up to Christmas, we are ready and we have learned the lessons from last time and we will not panic and start making foolish decisions about PPE acquisition, for example.

[Baroness Merron (Lab)]

We are absolutely committed to learning the lessons from Covid in order to build resilience. The recommendations of the independent review of procurement by Nigel Boardman have already been implemented and a Covid Counter-Fraud Commissioner has already been appointed to scrutinise contracts to learn the lessons and recover money for taxpayers. Professor Sir Stephen Powis, who I have spoken to about this, was not suggesting that there is a pandemic but more that four infectious diseases are coalescing to create a situation and that vaccination is crucial. His comments were a call to the public to get vaccinated, which I also endorse.

NHS: Breast Screening Programme

Baroness Morgan of Drefelin Excerpts

Tuesday 3rd September 2024 Lords Chamber

Asked by

[Baroness Morgan of Drefelin]

To ask His Majesty’s Government what assessment they have made of the take-up of the NHS breast screening programme.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

Breast cancer survival rates have improved by 41% since the mid-1970s and 86% of women survive their cancer beyond five years. I pay tribute to NHS staff and to my noble friend Lady Morgan for making such a contribution to these improvements. Take-up of breast screening is just below 70%, and NHS England has developed a national uptake improvement plan, including expanding access to screening, reducing inequalities, improving IT systems and ensuring that communications are inclusive and accessible to all.

[Baroness Morgan of Drefelin (Lab)]

I thank my noble friend for that very kind and generous Answer. As we know, screening uptake has been in decline for more than 10 years now. There is no NHS region that has met its 70% minimum standards since 2019-20. Importantly, uptake for women on their first invite is really worrying. Will the Minister commit to keep feet to the fire on this issue, and work closely with the department and NHS England to press down on any potential complacency because breast cancer outcomes have improved so much? Screening is a simple way to stop women dying of breast cancer, and it is not rocket science. Please can we do all we can to improve uptake?

[Baroness Merron (Lab)]

My noble friend makes a very clear and definite point about the link between breast screening and outcomes. I certainly can give her the assurance that we will continue to seek to drive up rates of breast cancer screening. It is important to say that the reason for the take-up not improving as one might have hoped since Covid is multifactored and complex, as I am sure she understands. We all know that research shows that women are more likely to attend breast screening if it is in a unit that is easy to get to, if it is convenient, and if we can help women to get over the problems of fear of the test, awkwardness or embarrassment. I give my noble friend the assurance that the NHS is working on understanding all that, and all that will be in collaboration with charities and key stakeholders.

NHS Blood and Transplant Service: Blood Stocks

Baroness Morgan of Drefelin Excerpts

Tuesday 30th July 2024 Lords Chamber

[Baroness Merron (Lab)]

The lessons-learned exercise started from day one—we are not waiting for the end of the alert. The approach that has been taken is to increase the number of appointment slots available, to launch new and innovative campaigns, and to seek to reduce the use of O-negative blood. On all these levels, there has been a tremendous response from the public and clinicians, and from all stocks. Even if we put the cyberattack to one side, it is certainly the case that collections of blood have been lower in recent months due to the impact of sporting events, bank holidays and the weather. All of these would have been manageable; it is the cyberattack that tipped the service over—by that I mean “over” to the point where it is now.

[Baroness Morgan of Drefelin (Lab)]

My Lords, I am delighted that my noble friend is looking at resilience with respect to the supply of universal O-group blood. Is she concerned that it could be indicative of the pressure that pathology services have been under for many years? If we see cyberattacks, we obviously have to be resilient to those, but we also need to be resilient in the strength of the pathology services across our NHS, so that when you have unusual happenings such as this, there is some back-up. Will she consider that when she looks at the resilience question?

[Baroness Merron (Lab)]

I thank my noble friend. That is a very important point and I will consider it in our deliberations. It is worth saying on resilience that work was already in place—for example, new centres are planned to be opened in Brixton and Brighton. I make that point not just because of expanding capacity but because the location of them will widen the range of donors. We absolutely need to continue. That is why I have asked the chief executive and the chair to come back to me with their plans to make us even more resilient.

National Institute for Health and Care Excellence

Baroness Morgan of Drefelin Excerpts

Monday 23rd May 2022 Lords Chamber

Asked by

[Baroness Morgan of Drefelin]

To ask Her Majesty’s Government what steps they are taking to address capacity issues in the National Institute for Health and Care Excellence.

[Baroness Morgan of Drefelin (CB)]

I beg leave to ask the Question standing in my name on the Order Paper and, in so doing, I declare an interest as chief executive of the research and care charity Breast Cancer Now.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)]

A key priority for NICE this year is to increase the flexibility and capacity of its technology appraisal programmes through a more proportionate approach to assessments that will enable it to continue to consistently deliver timely guidance on new medicines. From April 2023, NICE aims to expand its capacity for technology appraisals by 20% to respond to increasing numbers of new medicines.

[Baroness Morgan of Drefelin (CB)]

I thank the Minister for his Answer and for writing to me on this. NICE does a really important job in our health system and I pay tribute to it for that. However, one thing that I have observed recently is that, in some of the more tricky technology appraisals, sometimes you have a first rejection, then another committee meeting, then possibly another reappraisal. This puts a huge amount of stress on patients, often at the end of life, when they are really worrying about whether they will have access to the treatments under review. Is there anything more that the Government can do to help ease the passage of these interim access agreements that patients can have?

[Lord Kamall (Con)]

I am sure that the noble Baroness appreciates that this was a new process, because of the Orbis trial. In some ways, NICE was not exactly prepared for that. NICE has learned from that lesson and 100% of its guidelines are issued within 90 days of licensing. It has learned the lesson but, sadly, there was a confluence of factors: one was Orbis and the other was that the committee meeting regarding recommendations ran over because there were a number of other cancer drugs that it was trying to look at. It has put this on the agenda for the next meeting.

Mental Health Services for Rough Sleepers

Baroness Morgan of Drefelin Excerpts

Monday 21st March 2022 Lords Chamber

Asked by

[Baroness Morgan of Drefelin]

To ask Her Majesty’s Government what assessment they have made of the effectiveness of the £30 million programme to provide specialist mental health services for people sleeping rough, as detailed in the NHS Long Term Plan; and what plans they have to publish an evaluation of the outcomes of that programme.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)]

This Government are committed to ending rough sleeping by the end of this Parliament. The long-term plan set a target of 20 high-need areas to receive new specialist mental health provision for people sleeping rough by 2023-24. In fact, the NHS has exceeded that target, with 23 sites. There are plans to share learning from these sites to identify the key successes and effective approaches, and NHS England plans to undertake a formal evaluation before the end of the programme.

--- Later in debate ---

[Baroness Morgan of Drefelin (CB)]

I thank the Minister for that Answer and look forward very much to the publication of that work. We know that common mental health conditions are twice as high among people who have experienced homelessness, and psychosis is 15 times as high. Obviously, I commend the Government’s commitment to end rough sleeping. Does the Minister know what figure has been settled on for the number of people sleeping rough with specialist mental health services needs? If one has been settled on, is that the criterion that will be used to review progress with the NHS long-term plan when that is refreshed?

[Lord Kamall (Con)]

I thank the noble Baroness for her Question and for her continued conversations with me on a number of different health-related issues; I am learning quite a lot from those. I understand that the data will be collected at some point, and I hope that that will be done regularly. If the noble Baroness will allow me, I write to her with more details, but I know that the top-level answer to that question is that we are about to get the data.

Health and Care Bill

Baroness Morgan of Drefelin Excerpts

Lords Hansard - Part 1 & Report stage
Tuesday 1st March 2022 Lords Chamber

I again thank the Government and remind them that, tragically, the average age of death of people experiencing homelessness remains at 46 years for a man and 43 years for a woman.

[Baroness Morgan of Drefelin (CB)]

My Lords, I do not want to detain the House for too long, as there is an awful lot of business to think about on Report. However, as I put my name to Amendments 63, 65 and 67, tabled by the noble Baroness, I want to press the Minister on the question of data.

I am advised, as I am sure others are, by really experienced charities, which say that one of the real challenges here, which will be a challenge for the ICSs when they are trying to do a great job in terms of compliance on disparities, is that the data on inclusion health populations is very incomplete. While there have been efforts to collect data on housing status, for example, that has been relatively incomplete and unsuccessful. So what I want to hear from the Minister is how we can be sure that through the development of this commitment to tackling health inequalities with an evidence-based approach, populations such as the inclusion health population are not invisible because the data is so difficult to collect. Is this something that the forthcoming White Paper could pick up? Will it focus on how the health system leaders will get the tools that they need to do a really great job for these populations, who have such complex needs and who really draw on the health service, A&E, et cetera, in a very intense way? There is such potential to make real progress, whether it is in the interests of people coming out of care, sex workers who are really challenged, or homeless people. We are all only a few steps away from that, are we not? So I would be interested to hear from the Minister whether that drive to collect comprehensive data to inform this work can be channelled in some way through a forthcoming policy initiative.

[Baroness Walmsley (LD)]

My Lords, from these Benches I thank the Minister and the whole Front-Bench team for the way they have engaged with the House on the issue of doing something really serious about addressing health inequalities.

Many of us put down amendments in Committee: dealing with inequalities was dotted all over the Bill. We even suggested that perhaps we needed a quadruple aim—an additional aim. The Government have taken a different but none the less effective approach, and I really welcome the fact that dealing with health inequalities has been made integral to the first two aims of the triple aim.

The Government have done two things that I particularly welcome. The noble Lord, Lord Kakkar, mentioned the engagement of the noble Lord, Lord Patel, with the Bill team on making sure that data can be collected. Without collecting the data, you cannot analyse or take action on addressing health inequalities.

The second thing, which the Minister mentioned in his introduction, is government Amendment 21, which is about the experience of people in the health service. He mentioned that the experience of people from an Asian background can sometimes be poor. I can give him an example of where that has been the case. My daughter has a friend, an Asian gentleman, who had a very painful physical injury. Very unusually, although his physical problems have now healed, he has been left with a mental scar because of his experience with the health service. This is very unusual, but he was not treated with compassion or respect. Indeed, it was more like discrimination—so I really welcomed what the Minister said about the importance of the experience of people from all demographics and ethnic backgrounds in the health service. It is vital.

I turn to the amendments from the noble Baroness, Lady Armstrong. Like all noble Lords, I have been watching the television recently, looking at the pain that the poor people of Ukraine are going through and seeing children, mothers and whole families huddled in cold, damp cellars. Some of them are taking several days to drive to the border to go to a country that will welcome them, perhaps with even more open arms than we do. It occurred to me that those people, when all this is over—and let us hope it will be over very soon—will probably be suffering from mental and physical illness. It also then occurred to me that there are people in this country who have poor-quality housing, insecure housing or no housing at all. When you put those things together, it is not surprising to realise that such people will be suffering from more serious and more frequent physical and mental ill-health than the rest of us who are in good-quality, secure housing. So the noble Baroness has hit on some very important issues about health inclusion communities and about the importance of housing to making health, and we support what she has to say.

I end by sincerely thanking all three Ministers and the Bill team for the way they have addressed this issue of health inequalities, and I really look forward to it making a real difference in future.