Tobacco and Vapes Bill

Baroness Ritchie of Downpatrick Excerpts

2nd reading
Wednesday 23rd April 2025 Lords Chamber

[Baroness Ritchie of Downpatrick (Lab)]

My Lords, I welcome this legislation and am grateful to my noble friend the Minister for outlining the rationale for the Bill. I support the principles, which I believe we should all embrace. We have had a very interesting debate this evening, ebbing and flowing between those who totally embrace those principles and the libertarians who have certain reservations. I think people are generally united on the viewpoint that there should be some way to deal with smoking and the side-effects of smoking and vaping.

I am also grateful to Asthma + Lung UK and the BMA for their briefings. I come with a personal testimony as well. Both my late mum and my late cousin had lung cancer. Neither of them smoked, but they were exposed to passive smoking because in all public arenas—some 40, 30, 20 and even 15 years ago—there was a lot of public smoking.

As this legislation extends to all of the UK, I want to give a Northern Ireland-specific viewpoint. This legislation was given consent by the Northern Ireland Assembly on 10 February. To ensure that the legislation is meaningful and given its best chance, I urge my noble friend the Minister to encourage the Minister for Health in Northern Ireland to introduce lung screening. It does not exist on a scheduled basis in Northern Ireland but is vital, as it can look for a cancer or other lung-related disease in a person long before they have developed all the various symptoms. There is growing evidence supporting the benefits of early detection. Although screening and research projects are under way, a fully funded and implemented programme has yet to be established. I therefore urge my noble friend to make contact with the Northern Ireland Minister, urging him to move from thinking about the issue to actually doing something about it. I have talked to consultant oncologists who deal specifically with lung cancer in Northern Ireland and they urgently want to see this lung screening implemented, because they believe that if it is implemented, they can deal with the disease in patients before it has reached such an advanced stage, when they have restricted means of dealing with it.

The statistics are there as evidence. Around 2,400 people die every year in Northern Ireland as a result of smoking-related conditions, and there are around 35,000 smoking-related hospital admissions in Northern Ireland annually. I join my friends from Northern Ireland, the noble Lords, Lord Weir and Lord Dodds, in asking to ensure that the enforcement measures in the Bill are made effective and capable of implementation, because in Clause 81 it is up to district councils. There are 11 district councils in Northern Ireland, and I would like to think that they were all on the same page and did not operate a variety of implementation enforcement schemes. It is important that the legislation is sufficiently mandatory to ensure that happens, because we want to eradicate disease and to ensure that everybody is on the same page and that the impact of smoking and of using tobacco and vapes is mitigated.

Finally, I ask that drastic funding cuts for smoking cessation services be reversed. Also like my friends from Northern Ireland, I suggest that not only enforcement but other measures to do with money laundering must be ensured. There must be work between all the law enforcement agencies, the Department of Health and Social Care and the Department of Health in Northern Ireland to ensure that it does not happen. If people can purchase vapes and tobacco under the counter or by some other means, that will not help in dealing with disease eradication in the various cancers and emphysemas that are prevalent in Northern Ireland.

Pharmacy Opening Hours

Baroness Ritchie of Downpatrick Excerpts

Thursday 20th March 2025 Lords Chamber

[Baroness Merron (Lab)]

I appreciate the noble Baroness’s views. Indeed, community pharmacies in England are dispensing around 1.1 billion NHS medicines with a value of over £10 billion each year. Prescribing is of course a clinical decision. We are nevertheless keeping an eye on the situation, of course. What matters is that people seek help, and I am very glad to say that pharmacies are playing an increasing role in the availability of assistance, so people do not always have to go to GPs, particularly for some of the more common conditions.

[Baroness Ritchie of Downpatrick (Lab)]

My Lords, does my noble friend agree that community pharmacies play a vital role in addressing NHS waiting lists through the administration of the vaccination programme—whether it is influenza or the Covid-19 vaccine—and thereby contribute to the reduction in the waiting lists that are faced by many hospitals throughout the UK? Will all efforts be made by government to ensure that the challenges faced by community pharmacies at present will be resolved in the near future?

[Baroness Merron (Lab)]

I certainly agree with my noble friend’s point. I hope that she has noticed my enthusiasm for the role that pharmacies play. The introduction of Pharmacy First was a tremendous contribution to some common-sense approaches so that people who have common conditions can more immediately access services. Many of us will have experienced that. As I have said, we will conclude matters shortly and look forward to making the decision about future funding known ASAP.

Autism and Learning Disabilities: Hospital Detention

Baroness Ritchie of Downpatrick Excerpts

Tuesday 11th March 2025 Lords Chamber

[Baroness Merron (Lab)]

Regrettably, that person’s experience is not a lone example. That is why, for example, the Mental Health Bill will limit the scope to detain people with a learning disability and autistic people, so that they can be detained under Section 2(3) only if they have a co-occurring mental disorder that requires hospital treatment. That is key because, in the times that we are talking about, people were detained just because of autism or a learning disability. That is not acceptable.

[Baroness Ritchie of Downpatrick (Lab)]

My Lords, I welcome my noble friend the Minister and advise her that your Lordships’ House has a specialist committee that is dealing with the review of the Autism Act 2009. I encourage my noble friend and her ministerial colleagues, both in health and social care and in education, to undertake a review of that Act to ensure that it is fit for purpose, for the needs of autistic people.

[Baroness Merron (Lab)]

I am very grateful to the committee for its work and I am certainly looking forward to its report. The Government will respond to that report within two months. It is indeed vital work that is being undertaken.

Musculoskeletal Health: Chiropractors

Baroness Ritchie of Downpatrick Excerpts

Wednesday 26th February 2025 Lords Chamber

Asked by

[Baroness Ritchie of Downpatrick]

To ask His Majesty’s Government whether they plan to incorporate a role for chiropractors in national musculoskeletal health prevention strategies.

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

My Lords, improving health outcomes for over 17 million people in England with musculoskeletal conditions forms a key part of this Government’s commitment to build an NHS for the future. Healthcare professionals play a vital prevention role in supporting people to self-manage their conditions. NHS England does not commission chiropractic care nationally. However, ICBs have their own clinical or commissioning policies and so may commission a limited amount of such treatment, based on the needs of the local population.

[Baroness Ritchie of Downpatrick (Lab)]

I thank my noble friend for her Answer. I say initially that I am someone who avails periodically of chiropractic services. Will my noble friend the Minister, along with her ministerial colleagues in the Department of Health and Social Care, review the allied health professions list to include chiropractors working within the NHS to deal with musculoskeletal conditions, which in turn could alleviate the burdens on an already overburdened NHS? Could this also be included in the national health plan, which I hope will be published shortly?

[Baroness Merron (Lab)]

I recognise the importance of mitigating the long-term burdens of MSK conditions, which are considerable, and the role that healthcare professionals, including allied healthcare professionals, can play in supporting not just prevention but early detection and the management of conditions. I know that chiropractic care is appreciated in a number of cases, including that of my noble friend. However, clinical evidence from systemic reviews does not support national commissioning of chiropractic treatment, as I mentioned, although ICBs can commission these services. To the point on the 10-year plan—a report on that is expected in the spring, as my noble friend referred to—I place on record that I am grateful to the British Chiropractic Association, the Arthritis and Musculoskeletal Alliance, Versus Arthritis and the Royal Osteoporosis Society for ensuring that the voices of the MSK community have been well heard in the consultation.

Care Homes: Safety Ratings

Baroness Ritchie of Downpatrick Excerpts

Wednesday 5th February 2025 Lords Chamber

[Baroness Merron (Lab)]

I agree that public confidence is absolutely crucial. That is why honesty is very important and why the Secretary of State accepted in full the recommendations of Dr Dash’s review into the CQC, which was published in October. In addition to new executive leadership, a recruitment process is under way for new non-executive leadership, including the chair, which is very important. I agree with the noble Baroness on the importance of the patient voice, because that will lead to greater confidence. There is a long road to go down, but I am absolutely confident that we are well on the way.

[Baroness Ritchie of Downpatrick (Lab)]

My Lords, organisations such as the Medical Defence Union report that new healthcare providers are facing severe delays registering with the Care Quality Commission. These delays are slowing down the process of registering new patients to access services. Can my noble friend the Minister outline what discussions the Government have had, or will have, with the Care Quality Commission to resolve this issue?

[Baroness Merron (Lab)]

I assure my noble friend that the department has discussions with the CQC at fortnightly meetings. Those discussions are about performance, including clearing the backlog of registration of new providers, and this will continue in order to make the necessary improvements that my noble friend seeks.

Health: Quad-demic

Baroness Ritchie of Downpatrick Excerpts

Tuesday 10th December 2024 Lords Chamber

[Baroness Merron (Lab)]

I must be honest: I cannot explain here the exact reasons why NHS staff are not taking it up, but I assure the noble Lord, as I have assured other noble Lords, that our focus is on getting vaccination rates up. That is why the national medical director made the comments that he did, as well as assuring me that we are not nearing a pandemic.

[Baroness Ritchie of Downpatrick (Lab)]

My Lords, undoubtedly the vaccination programme has had an important influence and impact on our National Health Service as well as our economy. What further vaccines and vaccination programmes will be accelerated on to the national immunisation programme this year and in further financial years?

[Baroness Merron (Lab)]

My noble friend has campaigned tirelessly for the vaccine rollout in respect of RSV, for which I thank her, and I know that many others would wish to thank her for that too. With regard to the other vaccines about which my noble friend asked, we will continue to work with the JCVI and, as there are further developments, I will update your Lordships’ House.

Fracture Liaison Services

Baroness Ritchie of Downpatrick Excerpts

Wednesday 4th December 2024 Lords Chamber

[Baroness Ritchie of Downpatrick (Lab)]

My Lords, I begin by thanking the noble Lord, Lord Black of Brentwood, for securing this vital debate. I welcome my noble friend the Minister to the Front Bench and declare an interest as a breast cancer survivor who is osteopaenic and therefore required to avail of bone density examinations in Northern Ireland, where there is excellent provision of fracture liaison services and where research has shown that there is 100% coverage. I hope that my experience and those of many people in Northern Ireland will be helpful to my noble friend in seeing the benefit of such service provision to many people, particularly those in the older cohort of the population.

We have seen encouraging signs in recent weeks that the Government are ready to act decisively on bold, proven ideas. There is a growing appetite for initiatives that will tackle ill health, reduce pressures on the NHS and keep people in work. Fracture liaison services, as we all know, are a perfect example across all three: a gold-standard, internationally recognised intervention that was invented here in Britain and has been adopted across the world. Yet, unfortunately, around half the trusts in England still lack access to this life-changing service.

We now have six integrated care boards across England that are ready to take action. These ICBs have done the groundwork, mapping pathways, securing local support and developing clear plans to establish high-quality fracture liaison services, so I ask my noble friend when they will be able to do that. Crucially, there is a clear road map to take us from these early adopters to full national coverage by 2030. With a phased rollout approach, we can learn from these trailblazers and build momentum over the coming years. What is needed now is targeted pump-priming funding to bridge the short 18 to 24-month period before fracture liaison services become cost-saving—an approach that has already proven successful in Wales, as pointed out by the noble Baroness, Lady Bull.

It is not just the ICBs that are ready to act. Across the country, there is a coalition of support poised to make universal FLS a reality. A shadow national implementation steering group has convened to support the Government in making FLS one of its early successes in prevention—a true example of a Darzi reform in action. Its members include the Royal College of Physicians and the Royal College of GPs, as well as Age UK and several other expert societies: pooled expertise to help the Government make quick progress.

What we need now is a clear plan setting out how these services will be delivered by 2030 or even sooner. The groundwork has been done, the support is in place and the opportunity is here; let us not waste it. By acting now, the Government can turn their ambition into reality, saving lives, easing NHS pressures and strengthening the economy. Acting together, along with the Government, we should take this opportunity and make it happen. I look forward to the Minister’s response outlining how that will happen.

Cancer: Older People

Baroness Ritchie of Downpatrick Excerpts

Tuesday 19th November 2024 Lords Chamber

Asked by

[Baroness Ritchie of Downpatrick]

To ask His Majesty’s Government what steps they are taking to ensure a UK-wide approach to improving outcomes for older people with cancer.

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

My Lords, sadly, the risk of developing cancer increases as a person gets older. Health is a devolved matter, as your Lordships’ House will know, and the department is working with the NHS in England to improve outcomes for people of all ages with cancer. On my noble friend’s specific point, we are working to bring England in line with other nations by delivering a new national cancer strategy next year following the publication of the 10-year health plan.

[Baroness Ritchie of Downpatrick (Lab)]

I thank my noble friend for her Answer. I am sure she is aware that the UK’s cancer burden is projected to rise by around one-third by 2040, and 60% of those cancer diagnoses are expected to be among those aged 70 and above. Yet there is evidence that older people’s cancer care is not always provided to the level that it should be. Therefore, what assurances can she give me of actions the Government will take as part of the forthcoming cancer plan and the 10-year NHS plan to address these health inequalities in cancer care and treatment throughout the UK?

[Baroness Merron (Lab)]

My noble friend is quite right that the incidence of cancer is expected to rise across the UK, especially in older people. I agree that older people can face specific barriers when accessing care. Following on from the independent review by the noble Lord, Lord Darzi, I assure my noble friend that the 10-year health plan and the subsequent cancer strategy for England, both to be published next year, will help us do more to prevent cancer, identify it early and treat people quickly. They will have regard to older people.

Type 2 Diabetes: Continuous Glucose Monitors

Baroness Ritchie of Downpatrick Excerpts

Tuesday 19th November 2024 Lords Chamber

[Baroness Merron (Lab)]

I must confess that is something that I will need to look into—it may be with my ministerial colleagues in the Department for Transport. But I will look into it, and I will be pleased to write to the noble Baroness.

[Baroness Ritchie of Downpatrick (Lab)]

My Lords, as part of ongoing research, would my noble friend talk to her ministerial colleagues about possible research that is required into the causes of type 1 diabetes, and if more updated research could therefore provide new types of technologies and treatment? There is no particular cure at this moment in time, and people live with it on a daily basis, hour by hour.

[Baroness Merron (Lab)]

Through the National Institute for Health and Care Research, £206 million was awarded to diabetes research in the last five years through its research programme. The NIHR and Diabetes UK have developed a joint strategy which will inform diabetes research in the UK. I hope that can get us to the place that my noble friend refers to.

NHS Hospitals: Apheresis

Baroness Ritchie of Downpatrick Excerpts

Wednesday 9th October 2024 Lords Chamber

Asked by

[Baroness Ritchie of Downpatrick]

To ask His Majesty’s Government what steps they are taking to support increasing apheresis capacity in NHS hospitals in England.

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

The Government are aware of the issues around apheresis capacity within the National Health Service impacting patient services, including stem cell donations. A departmentally led working group met for the first time last month to examine existing apheresis capacity and to develop solutions, and it will report in the spring. This working group includes members of the UK stem cell register, health professionals and service providers, and it aims to develop an evidence base by which strategic decisions around capacity can be established.

[Baroness Ritchie of Downpatrick (Lab)]

My Lords, I thank my noble friend Lady Merron for her very helpful reply. Only last month I chaired a round table in your Lordships’ House on apheresis capacity. Therefore, given the rapid developments in cell and gene therapies and related international regulation over the last few years, what plans do the Government have to update legislation governing the use of substance of human origin and the development of advanced therapeutical medicinal products to better utilise modern technologies such as apheresis platforms?

[Baroness Merron (Lab)]

I am grateful to my noble friend for her work in this regard. I certainly share the view that there have been very rapid developments in cell and gene therapies over the past few years, and there is tremendous potential for these therapies to address the root cause of diseases and to offer life-changing outcomes for patients. So, we are working with devolved Governments and with key stakeholders to review the EU standards and requirements, and to consider our approach in light of the changes introduced by the EU SoHO regulations, which will take account of innovation within the sector.