Women’s Health Strategy

Baroness Walmsley Excerpts

Thursday 23rd April 2026 Lords Chamber

[Lord Kamall (Con)]

My Lords, I thank the Minister for tabling the Statement. I am sure that the ambitions for the renewed women’s health strategy will be supported by noble Lords from all Benches. I know that the Minister recognises that women have too often felt unheard, as conditions such as endometriosis and chronic pelvic pain go underdiagnosed.

There was emphasis in the Statement on listening to women and tackling entrenched inequalities. This is, of course, welcome. We support the focus on a shift from treatment to prevention and from hospital to community, as well as the ambition to unlock the potential of digital innovation through NHS Online. I also thank the Minister for acknowledging that these initiatives build on work undertaken by previous Governments.

However, many women will judge this strategy not by its intentions and words but by whether it leads to tangible improvements in their day-to-day experience of care. All Governments announce grand strategies, but sometimes fail to deliver. While many of these individual announcements are welcome, I hope the Minister will allow me to ask for further clarity on a few points.

First, on waiting times and access to care, it is encouraging that waiting times for overall gynaecology have begun to move in the right direction, but many women are still waiting too long for diagnosis and treatment. We know what that leads to—a range of conditions, often worsening outcomes and poor quality of life. Can the Minister tell us what the department is doing to speed up the whole pathway from when the patient first presents through to treatment? How will it ensure that there is greater transparency for patients, so that they know where they are in the queue and how long they really have to wait, rather than estimates?

Secondly, the strategy rightly places an emphasis on listening to women and acting on their experiences. I am sure that noble Lords across the House share that objective. However, experience suggests that, unless you have clear structures for accountability, good intentions do not always translate into change. How will the department ensure that any feedback gathered in a patient consultation is not just perfunctory but consistently acted upon, and that it reflects a diversity of women’s experiences? There will be a range of experiences; it will not be the same for all women, especially for those who face additional barriers to being heard.

I will give your Lordships a couple of examples from my time in the department. I wonder what progress has been made. I remember when a young official came up to me and told me about her friend, a young Black lady, who had lost her baby. When they asked for the investigation and the paperwork, it had magically disappeared. How do we make sure that that sort of incident does not happen again, that there is real accountability and that there is no gaslighting, particularly for women from ethnic minority communities?

Another example comes from when I spoke to the baby loss charity Sands. Of course, we value the work that the noble Baroness, Lady Amos, is doing on maternity care. I recently received an email from a lady whom I met at Sands, which said: “For almost three years, my case was handled by the same caseworker. Of course, sometimes I questioned their competence, but at least the caseworker knew my case and they knew about things. And, despite being advised that my complaint was at its final stages, I’ve just been told that it’s been reallocated to a new case handler. Someone has to relearn the case, but has not yet been given a date for when that case will be heard”. I wonder what the Minister’s department can do to ensure that people who have suffered terribly, and are still suffering physically and emotionally from what has happened, really get the justice that they deserve.

Let us move on to patient safety and redress. The Statement refers to unacceptable experiences of women harmed in the past. As the House will be aware, the recommendations of the Hughes report were intended to provide redress for medical interventions such as the pelvic mesh, sodium valproate and hormone pregnancy tests, but many women are still waiting for some form of redress or help. Often, they are racking up bills, such as taxi bills to go to appointments, and many of them are still in pain.

When I was in the department and I was being asked the question, in the Minister’s place, I would go back to the department and ask what we are doing about this. The first answer I would be given was that I should leave it to the responsible Minister as I was the Minister responsible for technology, innovation and life sciences. When I probed again over time, I was told by one official that the Treasury does not like to write blank cheques. That is understandable—the Treasury is the guardian of the national finances. I used to ask whether anyone was doing any work on how much this would cost so that we could then present to the Treasury the cost of providing some form of redress.

The Hughes report suggested £20,000 each for mesh victims and £100,000 for sodium valproate victims. We welcome the fact that 100 of the 10,000 women who suffered from the pelvic mesh issue have received some payout from manufacturers. What about the others? I am told that many women missed out due to limitations for civil claims. What can the Minister’s department do to help those poor women who are still suffering and make sure that more women receive redress as quickly as possible? As a result of the Hughes report, we now know that it is not a blank cheque. We know that there will be negotiations between the Department of Health and the Treasury. Can the Minister update us on those discussions so we can better understand whether these women are finally going to achieve some form of justice?

Going forward, we need not only to make up for the mistakes of the past that have occurred under all Governments but to address the outstanding issues, making sure that those women who suffered are receiving long-term support and learning the lessons so that if, sadly, this ever happens again, we know how to address those issues and give the appropriate care, compassion and redress to those who suffer.

Overall, there are a number of different issues covered by the women’s health strategy. I know some noble Lords will be concerned that, although it is wonderful to have a grand, overall strategy, what about the individual interventions that we need from the departments, clinicians and others? How do we deliver on all those various issues that women suffer from to make sure that patients across the country—whatever party they support or however they feel—particularly female patients, believe that the renewed women’s health strategy will finally deliver a safe system of health for all of them and justice for those who have suffered in the past?

[Baroness Walmsley (LD)]

My Lords, I thank the Minister and I, too, welcome the women’s health strategy, as it includes many important objectives. In communities up and down the country, we have seen the devastating toll of sustained failures to invest in and deliver better women’s health. Women’s lives, families and economic productivity are damaged when they do not receive treatment in a timely way. Indeed, this also happens when menopause difficulties are ignored. This is because vital services remain understaffed and underfunded, while women and girls go without the care they need.

In 2022, we had the previous women’s health strategy, which had similar important goals to this one with similar delivery mechanisms and the same reliance on local systems to make it happen. Yet four years on, the problems remain stubbornly in place, with half a million women suffering long waits for gynaecology, patchy access to services, women reporting that they are not listened to, women not being given pain relief when they need it and serious conditions diagnosed too late. These facts must give the Government pause for thought that perhaps things need to be done differently this time.

Medical misogyny is still a perverse and unacceptable norm in the health service and that requires a culture change, which is notoriously difficult to achieve. How does the Minister’s department plan to go about it?

This strategy is being implemented when the NHS is already stretched and ICBs are facing cuts while, at the same time, taking on some of the responsibilities of the disappearing NHS England. Now we also have soaring inflation, due to Trump’s war in Iran. In this climate, can we reasonably expect the strategy to deliver meaningful change? I really hope so.

Although the issues affecting women’s health generally are numerous, the NHS failures in maternity services are the most widely reported and deeply shocking. Review after review has uncovered the same failures across the country: a failure to listen to women, a lack of time for training, inadequate staffing levels leading to staff burnout, a lack of proper assessment, poor management of risk and a failure to learn lessons when things go wrong. All this is leading to a rise in perinatal mortality, with the figures showing inequality between different groups, such as those on lower incomes and some ethnic minority groups. How will that be tackled by the strategy?

That is why the Liberal Democrats recently launched our maternity secure package to make Britain the safest place in the world to give birth. We want every maternity unit in the country brought up to a good or outstanding level of safety. That could be done by guaranteeing one-to-one midwifery and specialist doctors on every unit. Will the Minister consider incorporating these proposals into the new strategy?

On medical misinformation, many people now get their health advice online, particularly via social media. Long waits for NHS services and GP appointments are pushing people into getting their so-called information this way, but advice on those platforms does not adhere to clinical standards or guidelines, which is leading to rampant medical disinformation, with sometimes disastrous results. There is some evidence that this is a particular issue in women’s health, where gaps in scientific knowledge and public awareness are being exploited. Does the Minister have any plans to tackle that?

It is possible to fight back. In order to be helpful, we are calling for the following for the Minister’s consideration. The first is a new kitemark for health apps and digital tools that are clinically proven to help people to lead healthier lives, regulated by the GMC. The second is a big effort by the NHS, with a ring-fenced budget, to dominate the health advice social media ecosystem and algorithms, with clinically approved information in plain English. That could improve patient care and save staff time and costs. The third is a new verification requirement for any social media account claiming to be written by a medical professional.

I have a few more questions before I finish. In line with the 10-year health plan’s objective to make care more local, is the Minister confident that women in every area will benefit from a family health hub, as promised, without the threat of closure or cuts, especially in this time of reduced resources for ICBs?

How will the new system linking feedback from patients to provider funding work? Will the results for each unit be made public? Will improved staffing be funded to achieve the promise that women no longer face long waits for diagnosis for conditions such as endometriosis? Will we be able to hear from the Minister in the education department about the promised menstrual education programme to ensure that girls are better equipped to recognise the difference between healthy and unhealthy periods, and will the programme be evaluated by the girls receiving it? Finally and most importantly, will women themselves be involved in developing the implementation plans for the new measures in the strategy and coproduction of their communication with other women?

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

I thank the noble Lord and the noble Baroness on the Front Benches for their warm welcome for this renewed women’s health strategy. It represents a major shift in this country and, as the noble Lord, Lord Kamall, said, it recognises the fact that women’s voices have not been heard. It is shocking, although sadly not surprising, to know that some eight out of 10 women report not having been listened to. The noble Baroness, Lady Walmsley, talks about a culture change. The biggest culture change that we can make is to embed women’s voices into women’s healthcare, and that is exactly what we will do.

This strategy gives women and girls voice, choice and power over how they receive their healthcare. When we say that we are transforming care as part of the 10-year health plan, we mean it. I absolutely agree with the noble Lord that strategy is one thing, but delivery is another.

I was asked why this is different from the 2022 strategy. Let me first acknowledge the importance of the 2022 strategy: it was the first time we had a women’s health strategy. I spoke to the women’s health ambassador, Dame Lesley Regan, about this, and she told me that, with this renewal, we have embedded women’s healthcare in the NHS in a way that has never happened before. I have been moved and struck by the responses I have had from stakeholders, women, parliamentarians—the list goes on—because their voices were heard.

I will pick up some of the points; I am sure that a number of the points raised will come up. The matter of waiting times is key. They have improved, as the noble Lord, Lord Kamall, said—the number of patients on gynaecology waiting lists is down by over 25,000 in the same period—but there is much more to do. If I had to make just one point about this women’s health strategy, it would be that this is not the end of it but the start of the continuum of work we have been doing. How will we drive down waiting lists? I am very excited to say that, when we launch the NHS online hospital next year, we will prioritise gynaecology pathways. It is one of the limited number of pathways that there will be.

We are prioritising gynaecology for treatment in surgical hubs. We are piloting gynaecology pathways in clinical diagnostic centres, which are now in place up and down the country. We are increasing relative funding to incentivise more gynaecology procedures, as and when they are clinically appropriate. Those things are very practical and, alongside shorter waits and more convenient gynaecological care for patients, they will make that shift not only in practice but in culture.

One way in which this strategy is different from the 2022 strategy is in its considerable emphasis on measuring impact, which noble Lords have asked for. If we cannot measure something, we do not know what it is. There are three overarching measures of success: reversing the decline in healthy life expectancy, which was seen to decline in the 2010s; improving healthy life expectancy in the poorest regions to at least 61 years of age; and reducing the time that women spend in poor health, particularly for women experiencing the greatest health inequalities. That will be measured in the short, medium and longer terms. I would be happy to provide further information if required.

Women’s voices are a key focus, again in both practice and culture. We are establishing a women’s voices partnership, which means that women’s organisations, particularly those representing the more marginalised, will be able to influence national decision-making. We have described it as a direct line to Whitehall; in other words, this is not the end of the conversation. We have consulted very widely and will build on what was done with the 10-year health plan—that will continue. This has been welcomed.

In particular, we are introducing patient power payments as a trial. We will see how this goes, and I look forward to monitoring it. It will link provider funding to women’s experiences, particularly in gynaecology services, and whether a service is found wanting. The noble Lord asked about including those who are often excluded, and I absolutely agree with him. Again, culturally—to the noble Baroness’s point—women will not just have to come forward with a complaint. They will be asked, “What is your experience of care?” That is crucial. It may be that the care was excellent but the experience was terrible, and I think many of us will know about that. If that is the case, the provider will have money withheld. As I said to a former Health Minister, how do you make real change? You do it through finance, funding and systems. The money will be withheld, but it will come back into the improvement of those services. So women will not lose out, but that provider will have its feet held to the financial fire.

On the important matter of redress, we are carefully considering the work done by the Patient Safety Commissioner, and I am glad that she welcomed the women’s health strategy. I re-emphasise my deep sympathy with those who have been harmed, and I recognise the harm to those individuals and the families. We continue to look at the recommendations for redress and, as soon as we are able to make a comment, we will of course do that. In view of the time, I will just say that reducing inequalities is hard-wired throughout the women’s health strategy.

Cancer Outcomes in the UK

Baroness Walmsley Excerpts

Tuesday 21st April 2026 Grand Committee

[Baroness Walmsley (LD)]

My Lords, I am very grateful to the noble Lord, Lord Patel, for giving us the opportunity to talk about cancer today, because I am a very lucky woman: like the noble Baroness, Lady Ritchie, I am a cancer survivor. My cancer was picked up by routine screening, so I am just as much of a fan as the noble Lord, Lord Stevens, of routine screening.

I am delighted to be able to talk about the National Cancer Plan, which covers improvements in targets for prevention, diagnosis, treatment, care and research. Yet, of course, all these are underpinned by a sufficient, properly trained workforce—with ongoing CPD, since the science is constantly changing. The Government have promised the NHS workforce plan by this spring, yet, despite the sunshine outside, for the Government, spring has not yet quite sprung. Will the Minister be able to confirm when we will get it, and can she say whether it will deal with not just clinicians but technicians, and not just initial training but a reliable system of CPD to keep practitioners up to date, as the noble Baroness, Lady Watkins, has also requested?

There are many areas where efficient workforce planning is vital for achievement of not just the cancer plan but the 10-year health plan, including, as it does, moving from hospital to community, and many examples have been raised by speakers today.

A couple of hours ago, I raised an Oral Question about the issue of newly qualified midwives being without a post despite the issues of unsafe staffing levels in maternity services. In Wales, paramedic students are being told there are no posts for them in Wales when they qualify; they will have to go and work somewhere else. The number of posts for health visitors has been halved over 10 years, leading to some having enormous case loads, which were highlighted in the media this week. These are just a few examples of poor workforce planning in the general NHS workforce, but I recognise that this is not easy.

There are of course many examples of shortages in the cancer workforce, including of GPs, as the noble Baroness, Lady Gerada, just told us. They are all vital to early diagnosis, which we know leads to better outcomes. Yet the role of some groups is underestimated: last week, I went to my local dentist for a check-up; she checked me for oral cancer, and for any swellings in the lymph nodes in my neck, which might indicate cancer. Thousands of people cannot get an NHS dentist and cannot afford to pay, as I did, and therefore do not get these cancer checks, as well as having their teeth fall out. Dentists also part of the cancer workforce.

The Government plan for 28 more radiotherapy machines, which—as the noble Baroness, Lady Redfern, said—are probably enough only to replace the outdated ones. My party has proposed that the ambition should be more like 200, but we are aware that this would have to go alongside training more technicians. Is there a plan to do so across the health service?

This brings me to diagnosis and the question of investment in haematology, pathology and several other sectors which noble Lords have mentioned. Many years ago, I worked as a cytologist in the pathology lab of a major cancer hospital in Manchester. I was screening cervical smears for cancer and pre-cancer cells so that patients could have further examination and timely treatment. Since then, productivity has vastly improved with mechanisation of slide preparation and AI-assisted interpretation of samples. There is even more potential for this sort of improved productivity today, so that patients can get their results quickly and proceed to treatment. The noble Lord, Lord Kakkar, talked about the importance of doing this kind of investment when we have a cash shortage.

However, while this requires some investment, it is certainly cost-effective, as indicated by many studies. Waiting for test results is very stressful for patients—as I am sure has been experienced by several noble Lords at some points in their lives—and can be dangerous, as mentioned by the noble Baroness, Lady Redfern. Consultants need these test results to aid early diagnosis, but most areas are unfortunately well behind the targets.

Turning to prevention, there are three major areas I will mention. First, there is a long list of cancers that could be prevented by lifestyle changes. Smoking tobacco has long been the most common cause of cancer, and we are grateful to the noble Baroness, Lady Ramsey of Wall Heath, for her speech on this. Over recent years we have had legislation which has helped to reduce smoking and secondary smoking, the most recent of which was the Tobacco and Vapes Bill which finally went through your Lordships’ House yesterday. I congratulate the Minister and the Government on this legislation, which will certainly protect young people from taking up smoking and increase the opportunity for smokers who wish to quit to get help, thereby reducing their risk of getting lung and mouth cancer.

However, it is vital that community-based stop-smoking services have sufficient resources to be able to offer the full range of help. For example, most do not have the funding to afford prescriptions for the drugs which are proven to help smokers for whom other methods have failed. Vapes have proved to be a very effective quitting tool and should be widely available as such, including on prescription. However, I am pleased that the Government have taken powers to restrict the opportunity of manufacturers to attract, through advertising and marketing, children and non-smokers to start vaping, and I look forward to the regulations to put these into practice. We do not yet have enough information about any long-term dangers of vaping, especially on young and developing lungs.

The second lifestyle factor is diet. In addition to diabetes and musculoskeletal problems associated with overweight, there is a very long list of cancers caused by bad diet and obesity. In response to an inquiry in your Lordships’ House in 2024, which I had the honour to chair, the Government have put a number of our recommendations in place—thank you very much—but a great deal more needs to be done, and more quickly. The effect on the economy of the lost years of life and the lost working years due to illness caused by obesity has been well documented. It is tempting for some to suggest that it is all down to willpower, but that is not the case. We make our decisions on diet in an obesogenic environment, and many people cannot afford a healthy diet, so they are susceptible to a whole list of cancers. My committee proposed a comprehensive cross-government, long-term strategy to improve the nation’s diet.

Last year, the Government set up a national food strategy led by Defra, but we are not hearing much about it. It should cover a whole raft of government departments, so can the Minister say how her department is contributing to that? It really affects the budget of the NHS in the long term. Legislation on healthy food is undoubtedly required, and the Government will no doubt soon hear proposals for a healthy food Bill in the debate on the King’s Speech.

Having formerly worked in the area of cervical cancer, I was thrilled when a vaccine against the human papillomavirus was developed. It is offered free to teenagers as part of the school-based vaccination programme. As chair of your Lordships’ current ad hoc committee on childhood vaccination rates in England, I have heard evidence that the uptake of the HPV vaccine has fallen from 90% when it was first offered to only 72% now, and this puts the Government’s objective of eliminating cervical cancer by 2040 in great danger—the noble Baroness, Lady Nargund, mentioned that. Therefore, what is the Minister’s department doing about that, and how is she working with the Department for Education to improve the situation? I am hearing that some schools are refusing to work with the vaccination services offered to their pupils, and some find getting parental consent very time-consuming. Perhaps the Minister will write to me about that when she has spoken to her colleague.

Finally, on research, as I mentioned, vaccines have already been developed to prevent or treat cancer, and there will be more. Only yesterday, the media reported a vaccine that considerably extends the survival of patients with pancreatic cancer. This raises the question as to what the Government are doing to enable more of this sort of work and the clinical trials that are basic to it, as mentioned by the noble Baronesses, Lady Bottomley and Lady Paul. Clinical trials are absolutely vital in order to bring treatments to patients, and we need to make them easier.

I served on another of your Lordships’ committees—the Science and Technology Committee—with the noble Lord, Lord Drayson, who mentioned some of the findings of one of its most recent reports. But, in addition to the report on the difficulties of scaling up small businesses in this country, including life science businesses and other scientific businesses, the committee wrote an urgent letter to the Secretary of State for Health about the missed opportunity of attracting more researchers from the United States to come here if they are unhappy with the situation there. I am hearing that it would cost an American researcher £18,000 to come with a spouse and one child, to get visas and to pay the NHS charge in advance. This is more of a barrier than an encouragement. The committee heard that other countries are being much more opportunistic than us on this matter. Why are we lagging behind, when other countries have managed to strengthen their cancer research workforce? We need to get good people from wherever they are willing to come to us. Let us stop pussyfooting around and get on with it.

Midwives: Graduate Guarantee

Baroness Walmsley Excerpts

Tuesday 21st April 2026 Lords Chamber

Asked by

[Baroness Walmsley]

To ask His Majesty’s Government what progress they have made towards achieving the graduate guarantee for newly qualified midwives.

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

My Lords, the graduate guarantee creates additional temporary registered midwife roles and enables newly qualified midwives to apply to join the NHS workforce. This supports the transition from education to employment. Since September, over 850 of these roles have been created, backed by £8 million. This includes part-time and full-time jobs. NHS England is working closely with universities and employers to align graduate numbers with vacancies through improved workforce planning, enhanced support for students and co-ordinated local recruitment.

[Baroness Walmsley (LD)]

I thank the Minister for her Answer. The graduate guarantee is very welcome but, already, 31% of newly qualified midwives do not have a job or are on fixed-term contracts. First, how will the Government ensure that workforce planning is aligned to the number of posts available so that the skills of newly qualified cohorts are not wasted? Secondly, given the concerns about unsafe workloads in midwifery and maternity services, how will midwives have the time to discuss with their clients health issues such as diet and vaccination?

[Baroness Merron (Lab)]

On the second point, the noble Baroness is quite right: it is important that midwives have that time. That is what we anticipate will be the case—I refer her to the forthcoming workforce plan, which will improve the situation. With regard to the position that the noble Baroness describes, I agree that this needs sorting out, and I recognise the figures that she has shared. That is why we have brought in the graduate guarantee scheme—so that we can get people from their training and education into the NHS and can ensure that midwives are recruited on the basis of looking to the future rather than of the existing headcount. So we are future-proofing this.

Tobacco and Vapes Bill

Baroness Walmsley Excerpts

Report stage
Tuesday 3rd March 2026 Lords Chamber

[Baroness Merron (Lab)]

My Lords, in an earlier group I spoke about the importance of fixed penalty notices in the Bill, as they provide trading standards officers with an additional enforcement tool to bring retailers into compliance without taking up court resource. I have carefully considered the points raised by noble Lords in Committee about the proceeds of fixed penalty notices issued for licensing offences, including those made by the noble Baroness, Lady Walmsley.

I am therefore pleased to have tabled these government amendments because they will allow local authorities in England and Wales to retain all the proceeds from the £2,500 licensing fixed penalty notices for enforcement purposes, rather than having to return proceeds to the Consolidated Fund. That will enable local authorities to reinvest proceeds into strengthening the enforcement of tobacco and vape legislation—something that noble Lords have asked for.

In addition, we are investing up to £10 million of new funding in trading standards annually until 2028-29 to tackle the illicit and underage sale of tobacco and vapes, and to help to enforce the law. This funding is being used to boost the trading standards workforce by hiring 120 apprentices across England, and we will continue to provide funding to support the apprentices over the next three years as they complete their training.

Trading standards plays an essential role in ensuring compliance with tobacco and vape legislation. The enforcement provisions in the Bill, further strengthened by this amendment, will give them the tools they need to carry out that role. Proper enforcement of the law will protect the public from potential health harms and help to realise public health outcomes from policies in the Bill and other tobacco and vape legislation. For these reasons, I hope that noble Lords will feel able to support the government amendments in this group. I beg to move.

[Baroness Walmsley (LD)]

My Lords, I will speak to Amendments 66 and 68 in my name. These provide that the money collected by trading standards in small fines imposed by fixed penalty notices for offences other than those related to the licensing regulations should go towards smoking cessation services provided by the relevant local authority. The Liberal Democrats have been calling for this since the Bill was first introduced to Parliament.

--- Later in debate ---

[Lord Mawson (CB)]

My Lords, I support the amendment from the noble Lord, Lord Young. Supporting a smoke-free society is the right direction of travel, in my view, but I also worry about contact with reality.

A road map should also include the potential unintended consequences of cannabis smoking in a smoke-free country, with real targets and interventions. Walk across London and other towns and cities and smell the cannabis smoking on every street corner. People are breaking the law, with the police doing virtually nothing about it.

Cannabis has profound long-term health implications in the young. Some of us have worked in this space and have to deal with them. What are the unintended consequences of the Bill for the uptake of cannabis smoking among the next generation? I ask the Minister: what work have the Government done on the unintended consequences of this policy, and what do they plan to do about the potential uptake and increase in cannabis smoking, and the increase in illicit dealing on our streets?

[Baroness Walmsley (LD)]

My Lords, I thank the noble Lord, Lord Young, for tabling Amendment 202, to which I have added my name. It would require the Government to publish, every five years, a road map to a smoke-free country: in other words, a plan for the event rather than a review after it.

There are two essential components to achieving a smoke-free country. The first is that no one should start smoking at all. I hope that the Bill will successfully achieve that over time; the Government have shown great ambition in this area. The second component is that all current smokers are supported to quit, so that everyone stops. On this second part, the Government have been a little quieter, until recently. We have heard about the recent success of targets met for the number of pregnant women smoking at the time of delivery: I think it has gone down by half. However, the rates for other groups remain stubbornly high and we are not seeing the same targeting interventions. We need to ensure that we have this type of focus, energy and commitment with other groups, where we know that smoking rates are higher. Plans for these groups could be located in the road map being proposed.

For example, mental health is a key priority area for the Liberal Democrats. There is a dual causal relationship between smoking and mental health: if you smoke, it increases your chances of developing mental health conditions and, if you already have a mental health condition, you are more likely to smoke. Nearly half of those with a serious mental illness in England smoke, alongside a quarter of people with depression or anxiety, compared with 11.6% of the general population. High rates of smoking in this population have a disastrous impact on physical health, particularly for those with a serious mental health illness who, on average, live 15 to 20 years less than someone without. It is estimated that smoking accounts for about two-thirds of this reduced life expectancy.

The pervasive false narrative that smoking somehow alleviates mental health symptoms urgently needs to be addressed, as it creates so many challenges when we are trying to support these smokers to quit. If the Government are going to publish a strategy, a dedicated section on how they will bring down smoking rates in this group would be extremely welcome and needed. I welcome the Government’s concession that vaping vending machines should be allowed in secure adult mental health settings; this should certainly help this population to quit.

Amendment 206, tabled by the noble Lord, Lord Lansley, would require the Government to publish a review of the Bill. I welcome government Amendment 205, which does something similar but with a lot less granularity. However, would the Minister give us a little more information about where the Government will get their evidence to underpin the review? Can she assure the House that that evidence will be independent and not influenced by any lobbying or so-called evidence put before the Government by big tobacco, or anybody else who would benefit from slowing down the elimination of smoking in the UK?

The intent of this review should be to support the legislation. As several noble Lords have said, the smoke-free generation is a novel policy and we need to demonstrate the impact and evaluate implementation to encourage other countries to follow. There are also many regulations on the way, along with those from other government departments, on nicotine products. A clear analysis of how these policies will work together would be very welcome.

However, the review must not be viewed as a sunset on the smoke-free generation, and I would welcome comments from the Minister on what, at this point, we know will not be in the Government’s review. For example, the Bill’s impact assessment notes that many of the health impacts of the rising age of sale will not be seen for 10 years, so we should be mindful that this part of the Bill is playing a very long game. There may be early data that we are on the right track and the review will perhaps be able to look at compliance, retailer feedback and all the other things that the noble Baroness, Lady Fox, mentioned. I feel that much of this falls into the scope of her Amendment 207.

Finally, Amendments 91, 120, 201 and 216, tabled by the noble Baroness, Lady Hoey, raise concerns about the Bill’s implementation in Northern Ireland. I have been reassured by the Government’s response to the TRIS process, which lays out in some detail their response to the concerns raised, but, as the noble Lord, Lord Forbes of Newcastle, mentioned, the legal opinion published in the Daily Mail was commissioned by the Tobacco Manufacturers’ Association. Without seeing it, I cannot really comment other than to say it is not surprising that the industry is laying the ground for future legal challenges. It is, as we know, highly litigious and wants to chill the appetite for tobacco control globally. It all goes to show, I suppose, that if you put two lawyers into a room, you get three opinions. There are, as we have heard from the Minister on other occasions, other legal opinions out there that say that the Bill is compatible, but I leave the noble Baroness to answer for those concerns. However, I support the Government to press on with this vital public health legislation, and to plan it and review it as required.

[Earl Howe (Con)]

My Lords, this has been a very useful debate with some powerful contributions, but I should like to turn first to the amendments tabled by the noble Baroness, Lady Hoey. It was reported last week in the Times that seven EU member states have formally expressed concern that the Government’s proposed generational smoking ban might breach the Windsor Framework. The Minister said last week that the provisions of the Bill intended to apply to Northern Ireland are compatible with the United Kingdom’s obligations under the Windsor Framework. However, these external concerns plainly have not gone away.

In a previous meeting, I was grateful to the noble Baroness and her officials for discussing the Technical Regulations Information System—or TRIS—procedure in respect of liaising with the European Commission and those EU countries that have raised objections. She explained that, in the Government’s opinion, the TRIS procedure is about consultation and will not lead to any decisions that would be binding on the UK Government. Can the Minister clarify if my understanding of the Government’s position is correct in that regard? Will she also update the House on discussions with the European Commission and with representatives of member states that have raised their concerns? Can she also say whether any formal objections have been lodged through the Windsor Framework structures, including the joint committee?

In general on this issue, we see a rather polarised position, with the tobacco industry on one side and ASH and the Government on the other, so I would be grateful if the Minister could clarify whether the Government have sought or obtained any independent external legal advice on compatibility and whether they are confident that the measures would withstand a challenge in the event of infraction proceedings or dispute resolution. Following on from that, what contingency planning, if any, has been undertaken should a divergence issue arise in relation to Northern Ireland?

Let me turn to Amendments 202, 205 and 206, which relate, in their several ways, to reviewing the effects and outcomes of the Bill as an Act. I am supportive of them but especially grateful for Amendment 205, which responds to the plea put forward by a number of noble Lords in Committee that this far-reaching Bill, whose real-life effects on the health of the population must inevitably lie in the realm of uncertainty, merits close review at a point when we are in a position to assess those effects realistically. Hence, I particularly welcome subsection (2) of the new clause proposed by the amendment, which refers to assessing the impact of the Act. As my noble friend Lord Lansley argued persuasively, the review needs to drill down into the granular detail and the substance of how smokers and non-smokers are behaving in response to the implementation of the different strands of policy.

Having said that, I very much support the ideas contained in my noble friend Lord Young’s Amendment 202, for all the reasons that he gave. A review within four to seven years, as the Government have proposed, considering both economic and health outcomes and involving the devolved Governments, is a sensible safeguard as far as it goes. However, a road map and milestones, which both government and Parliament could follow and monitor along the way, would add considerable value. I am sorry that it appears that this is not an idea that the Government are willing to take further.

--- Later in debate ---

Moved by

[Baroness Walmsley]

123: Clause 89, page 50, line 17, at end insert—
“(2A) Provision made by the regulations must ensure that—(a) vaping products are sold in plain packaging;(b) vaping products are not displayed at the point of sale in the usual course of business, including promotional or marketing materials used at the point of sale, such as imagery, wording, branding, or promotional offers;(c) a person who fails to comply with the requirements imposed by the regulations under this section commits an offence and is liable to a fine not exceeding level 4 on the standard scale.(2B) In subsection (2A)—“plain packaging” means packaging that does not include branding, logos, imagery, or colours designed to make the product attractive;“point of sale” means any location within retail premises where vaping products are available for purchase.”

[Baroness Walmsley (LD)]

My Lords, Amendment 123 is in my name and that of my noble friend Lady Northover. When in Committee my noble friend tabled an amendment to prevent companies advertising vapes in a way that attracted children, the Minister’s response was that this was not necessary because advertising of vapes would be banned under the Bill except for public health purposes as a smoking cessation tool. In that case they would not be allowed to be advertised in a way that attracted children, and our amendment was therefore not necessary.

Having accepted the Minister’s point, we turned our attention to the packaging itself and point of sale display materials, because we know that the companies trying to sell vapes to people who have never smoked before will stop at nothing to hook people into nicotine addiction. That is why we have proposed that vapes must be sold in plain packaging like cigarettes and not displayed with attractive materials at point of sale. A recent UCL study showed that implementing plain packaging for vapes reduced their appeal to young people but did not affect how harmful adults perceive vapes to be compared with cigarettes. In particular, the paper noted that:

“Packaging is a primary marketing tool for vape companies”,


and that

“it is commonplace for brands to also use youth-appealing elements, such as images, cartoon characters, stylised fonts, and novel brand and flavour names on vapes and e-liquid packaging”.

We therefore felt it worth exploring the Government’s plans with regard to consultation and regulations about the packaging and point of sale of vapes. Vapes were on the market for quite a few years before the big uptick in youth vaping around 2021. That coincided with cheap, colourful, ergonomic disposables flooding the market. We need to make vapes a dull cessation tool again. Regulating packaging can and should be done quickly because vapes are being more aggressively marketed, partly through displays in stores. This is having an effect. Action on Smoking and Health’s latest youth vaping survey found that awareness of vaping promotion grew among 11 to 17 year-olds between 2022 and 2025. There was a significant increase in awareness of promotion of vapes over that period, particularly in shops: 37% in 2022 compared with 55% last year.

In 2022, 56% of 11 to 17 year-olds who were aware of vapes reported that they were exposed to some form of vape promotion. In 2022, 11% of young people who were aware of vapes reported seeing vape displays every time or most times they went into supermarkets. Last year that figure had risen to 27%, so there is a pressing need to do something about this. I accept that plain packaging and display rules for tobacco products were implemented, following consultation, through secondary legislation. I therefore ask the Minister what research has been carried out on the potential effect of plain packaging and point of sale for vapes, whether it would deter young people who do not smoke from taking up vaping and whether it has been shown that there would be any deterrent effect on adults who wish to quit by using vapes to help them to do so. Frankly, I would be very surprised if someone who wishes to quit would be deterred from buying a vape just because it was not in a shiny, colourful, attractive package on a shiny, colourful, attractive display, like the ones I currently see all over the place.

I do not support Amendments 125 and 134 tabled by the noble Lord, Lord Moylan. I felt we had a balanced debate in Committee about the role that flavours play in smoking cessation, and I was reassured by the Minister’s comments at that time. Clearly, regulation of flavour descriptors is easier to do and may give us the desired outcomes, meaning that we do not need to regulate flavours themselves. However, it is important that the Government retain the right to regulate flavours in case evidence emerges about particular flavours that require action.

On Amendment 136A tabled by the noble Lord, Lord Udny-Lister, the limit on vape size is currently 2 millilitres, but I know there are concerns regarding products that attach to vapes to increase this. I urge caution in this area. While it might seem likely that larger tanks increase consumption, there is not yet evidence of this being the case, and concerns regarding big-puff products may be unfounded. We need to find out. Indeed, the rise in youth vaping in Britain since 2020 appears to have been primarily driven by 2-millilitre, colourful, single-use vapes, not larger-capacity products. It is possible that larger-volume products could have benefits in satisfying consumer demand for longer-lasting products, reducing littering—which would be a good thing—and increasing the price point of initial purchase without unduly raising the price per puff for those using them to quit smoking. I look forward to comments from the Minister on the broad point regarding attachments. I know that both these issues were included in the recent call for evidence, so she may have some early insights for us in the light of that. I beg to move.

[Lord Moylan (Con)]

My Lords, I will speak to my Amendments 125 and 134 in this group. I am grateful to the noble Baroness, Lady Fox of Buckley, for the support that she has indicated for them. On the speech just made by the noble Baroness, Lady Walmsley, I am obviously distressed that she has been exposed needlessly to the sight of shiny vapes in her local supermarket, petrol station or whatever it is. We can sympathise with her on that, but she seems to have ignored entirely the context of Clause 89. This gives the Government the most extensive powers, at least in relation to packaging, which, as far as I can see, could very easily lead to the equivalent of plain packaging, but she made no reference to it.

My amendments would increase the powers that the Government have in Clause 89. I will first explain the rationale for what I am proposing. There is a great deal of agreement—there has been throughout Report—between the Minister and me; I hope that we can continue that in the course of this debate. We agree, crucially, on the importance of how the flavours are described and presented to the public in attracting buyers to vapes.

However, that cuts two ways. We know, on the one hand, that vapes can have what I call “flavour descriptors” on them. These are deliberately designed to appeal to children and young people in a way that we are all opposed to. We do not wish to see vapes marketed in such a way as to seduce children and young people into taking them up. When we see flavour descriptors such as “cotton candy” and “gummy bear” on the side of a vape, we can all agree that that sort of thing should have a stop put to it because we know the market that it is intended to reach. On the other hand, as I think the Minister has acknowledged, for vapes to be an effective cessation tool for adults it is important to have a range of flavours available to them. As I said, I think the Government have acknowledged that.

Where in the Bill is the power that the Government need to regulate flavour descriptors? It is the flavour descriptor—the “gummy bear”, the “cotton candy”—that the Government need a clear power to be able to eliminate. We discussed this in Committee. The Minister very kindly wrote to me afterwards and said that the Government would rely on Clause 89, which relates to retail packaging. This gives the Government a certain number of powers to make regulations concerning packaging, but it does not at any point, as far as I can see, specify the flavour descriptor that appears on the packaging as something that the Government have a direct power to regulate.

The Government may rely on Clause 89, and it may be possible that its scope could be stretched to cover their point. It would ultimately, I suppose, be a matter for the courts to decide. My Amendment 125, fairly straightforwardly, would give the Government that power explicitly. It would add to the list in Clause 89(3), currently running from paragraph (a) to paragraph (k), of the things that the Government can regulate. It would add a further thing: the flavour descriptor that appears on the packaging. I do not think the Government would necessarily want to reject this amendment. It would give them a power that could be very useful; even if they feel that they have this power already, making it explicit would make matters somewhat easier.

To complement that, there is in Clause 91, which relates to contents and flavours, a power for the Government to make regulations concerning the “flavour of relevant products”. Here I want to make a point which I made in Committee and which is of the utmost importance; I speak as somebody who uses vapes. My point is that, in practice—I say this especially for the benefit of noble Lords who do not use vapes—the flavour descriptor on the vape has almost no relationship to the flavour of the vape.

--- Later in debate ---

[Baroness Walmsley (LD)]

My Lords, I thank the Minister for her response and, in particular, the words—and I hope I quote them correctly—these are areas on which we are planning to act. I reassure the noble Lord, Lord Moylan, that I looked very carefully at Clause 89, as my earlier comments in earlier debates on how they might affect specialist tobacconists might have proved to him, but I point out that it talks only about packaging and not about display materials—that appears in a different part of the Bill.

I also say to the noble Baroness, Lady Fox of Buckley, that, even if my amendment was put word for word into the Bill, it would not prevent information about the products being provided on the packaging or the display to people who wanted to buy them. That would be fine. My intention—and I know the Minister understands this—is to do everything possible to reduce the attractiveness of vaping to stop it being taken up by young children who have never smoked. Vapes are and should remain a cessation tool.

I am particularly grateful to the Minister, because we have discussed this issue outside the Chamber. She has given me what I want in that she has clarified that the Government have the powers in the Bill to regulate both packaging and display and has said the Government intend to act in these areas. I am very grateful for that. Having been given what I want, I will withdraw my amendment.

Amendment 123 withdrawn.

--- Later in debate ---

[Baroness Walmsley (LD)]

My Lords, despite the comments of the previous two speakers, I will speak to Amendment 199, the purpose of which is simple: to make every future and renewed pavement licence issued by local authorities smoke-free.

Your Lordships will recall that pavement licences first appeared during the pandemic, when indoor hospitality was restricted. They gave cafés, pubs and restaurants a lifeline. It seemed obvious that these spaces should follow the same rules as indoors: no smoking. The LGA supported this, saying that

“it sets a level playing field for hospitality venues across the country and has a public health benefit of protecting people from unwanted second-hand smoke”.

It welcomed this national policy because it stopped the stupid situation of allowing people to smoke in a pub pavement area on one side of the road but not on the other if a local authority boundary ran down the middle of the road and they had different policies. Since then, pavement licences have become a permanent fixture. However, after some lobbying from some parts of the hospitality industry, the requirement for smoke-free was removed without proper consultation of health authorities.

In 2021, this House supported an amendment from the noble Lord, Lord Faulkner of Worcester, noting the missed opportunity to make all licences smoke-free. Amendment 199 seeks to honour that vote and ensure that this health-protecting measure is applied consistently.

There is currently a requirement for some seating to be smoke-free, but the distinction means very little when you talk about a very small bit of pavement. More than 10 councils have made smoke-free a condition of obtaining a pavement licence, including Liverpool, Manchester, Newcastle, Northumberland County Council and Durham—not outstandingly liberal authorities, as far as I can tell. Feedback shows that customers and businesses welcome the change. In Liverpool, a survey of premises found that 74% of those asked expressed support for the scheme, including many smokers. Councils also aim to reduce cigarette litter with this initiative, which would make outdoor seating areas cleaner, more welcoming environments.

Second-hand smoke is harmful at any level. It worsens asthma and other respiratory conditions, and contributes to heart disease, stroke and lung cancer. Smoke-free spaces are also popular with the public. Polling from ASH shows that 59% of people support banning smoking in outdoor areas of pubs, cafés and restaurants; indeed, 40% said that they would be more likely to visit these venues if smoking were banned outside. That is more than double the number of people who say that they would go less often, debunking the idea that smoke-free means customer-free. Making outdoor areas smoke-free is not only sensible but what the public want.

I regret that this issue is not covered by the recent consultation on smoke-free places. It is a shame that the Government felt that they were not able to include hospitality in that consultation at all and that they fell into this false narrative that smoke-free is somehow an economic threat to hospitality.

Less than 12% of the population smoke, so the financial viability of the hospitality industry is clearly not dependent on the continued consumption of tobacco, including outdoors. Indoor smoke-free legislation was a far more drastic intervention, and we heard many of these arguments from those opposed then. However, a survey in 2012 of nearly 5,000 pub customers reported that more than one in five visited the pub more often than before smoke-free legislation. I do hope that the Minister will, in future, consider looking at the pilots for smoke-free pavement licences to assess the economic relationship between the hospitality sector and smoking. As prevalence continues to fall, we must be at a tipping point soon, where these spaces will naturally become smoke-free.

This brings me to Amendment 196, tabled by the noble Lord, Lord Sharpe of Epsom. I think we may disagree on the potential impact any restrictions will have on hospitality, but in any case, the Government would consult on any use of smoke-free powers as they are doing currently.

Moving on, I welcome Amendment 194A from the noble Lord, Lord Kamall, and the noble Earl, Lord Howe. There is no doubt that the public are keen to see more places where smoking and vaping are prohibited. However, this policy must be pursued not merely to cater to the things that people dislike, but also to ensure that it is addressing matters that are harmful to the public. Clearly, reducing children’s exposure to second-hand smoke passes that test. While the evidence of exposure to second-hand vapour remains unclear, I think we can agree that reducing any possible risks around children must be prioritised, following careful consultation.

In that respect, I do not support Amendments 194 and 195 from the noble Lord, Lord Udny-Lister, which would remove these powers altogether. However, there is a challenge in all of this. Given the high level of public misunderstanding about the difference in harms between vaping and smoking, as the noble Baroness, Lady Fox of Buckley, has said—and she is quite right —how do we ensure that in creating vape-free places we do not exacerbate those misconceptions? I talked to a young man the other day who asked me, “What are you doing in the House of Lords?” I explained about this Bill, and he said, “Oh, all my friends vape”. He said, “I think it is just as harmful as smoking, isn’t it?” QED. Of course it is not.

I welcome the commitment in the published consultation to treat vaping differently from smoking where it is providing support to smokers to quit. I am on the same side as the noble Baroness, Lady Fox, on that score. Will the Minister say more about how this policy will be communicated to improve public understanding that vaping is less harmful than smoking? How will any exemptions to indoor vaping regulations be used to best effect to encourage more smokers to see vaping as quitting aids?

It is disappointing to see only council-run playgrounds included in the ban on smoking in playgrounds. Why should children playing in settings not run by councils not be similarly protected? There are also other places, such as transport hubs, where the public and workers are regularly exposed to other people’s smoke, so are the Government planning to commit to look at these too?

Amendment 192A from the noble Earl, Lord Howe, is very interesting, but we do not think actors should have to smoke at work. I think it was pointed out in Committee that there are alternative products that can depict smoking for artistic purposes; in particular, I believe that the National Theatre has such a device. If it is good enough for that theatre, it is good enough for me. Moreover, Wales does not have this exemption in place, and it has not harmed Welsh theatres.

We do not think that Amendment 193 is appropriate either: most venues are vape- free anyway, and the law is just really catching up.

On Amendments 197 and 198, I do not think that heated tobacco should have special exemptions at all. Only 1% of the population use it and it is not recommended by NICE for cessation. However, I do have a couple of questions for the Minister about heated tobacco devices, because I have had a letter expressing some concern that the law is not terribly clear. The advertising offence in the Bill applies to any advert,

“whose purpose or effect is to promote … a tobacco product”.

So can the Minister confirm that heated tobacco devices—not just sticks—will be caught under this definition, as advertisement of the device might constitute promotion of the tobacco product?

I see that in Clause 132 the Government explicitly take the power to extend provisions in Part 6 to tobacco- related devices. I understand that this is to future-proof the advertising restrictions against any innovation in this space, as we know the tobacco industry is likely to use any loopholes. I ask the Minister: why are heated tobacco devices explicitly included in Clause 132? Is it because of the difficulties they have had recently with two big supermarkets advertising heated tobacco products? Is it just the devices they are advertising, or are they simply breaking the law about advertising the tobacco sticks themselves? A little clarification would be most welcome if the Minister could provide it, please.

[Baroness Merron (Lab)]

My Lords, I am grateful to noble Lords for their contributions on this last group of amendments. It may be helpful if I remind your Lordships’ House that, on 13 February, the Government published their consultation on free-from places. We are consulting on making outdoor public places, including children’s playgrounds, hospitals and schools, smoke-free and heated tobacco-free. Additionally, we are consulting on making outside playgrounds and schools vape-free.

With regard to indoor spaces that are currently smoke-free, we are consulting on also making these heated tobacco-free and vape-free. I want to emphasise—and I hear different opinions on this within your Lordships’ House—that the consultation does not consider extending these proposals to outdoor hospitality. I hope that this addresses the concerns raised under Amendments 194 and 197, tabled by the noble Lord, Lord Udny-Lister, as well as Amendment 196 from the noble Lord, Lord Sharpe.

With regard to Amendment 193 from the noble Lord, Lord Udny-Lister, the vast majority of people—around 90% of those over 16—do not currently vape. Just because someone is present in an over-18 setting does not mean that they are content to be exposed to second-hand harms. This would be of particular concern to those who are medically vulnerable, whose conditions may not always be visible.

Additionally, under the proposals put forward in the consultation, those who wish to vape would still be able to do so in outdoor hospitality settings. I should say that we have been pleased to meet various stakeholders, including UKHospitality and the British Beer and Pub Association, and we have welcomed their input.

Furthermore, a number of establishments, as I am sure we are all aware, have already introduced their own policies restricting vaping indoors. These proposals provide consistency and clarity for the public and businesses, and that is crucial if we are thinking about legislation.

I turn to the evidence. Amendments 195 and 198 in the name of the noble Lord, Lord Udny-Lister, question the need for the vape-free places and heated tobacco-free places clauses. I also refer to Amendment 194A in the name of the noble Lord, Lord Kamall.

We have already published a draft impact assessment alongside the consultation on free-from places. To the points made by the noble Earl, Lord Howe, this sets out the evidence base for the proposed policies. I encourage noble Lords to review the document, which is thorough, if they have not had the chance to do so already. I can say that we will reassess the evidence after the consultation is closed, and we will consider any additional evidence identified before deciding on final policy positions and publishing a final stage impact assessment alongside regulations.

Better Start Longitudinal Programmes

Baroness Walmsley Excerpts

Tuesday 10th February 2026 Lords Chamber

[Baroness Merron (Lab)]

It is an important point that the noble Lord raises. This is being dealt with by the Government’s proposal to have a three-month consultation, so that we get it right in terms of acknowledging the concerns and challenges of screen time for children. So, I take the point that the noble Lord has made. This is of course a matter for DSIT. I will ensure that it is aware of the noble Lord’s comments, as well as the relevant departments—my department and the Department for Education—in respect of the programme that we are talking about.

[Baroness Walmsley (LD)]

My Lords, while I welcome today’s announcement about protecting special educational needs funding, I would like to ask about support for very young children with special needs and those with physical disabilities. Parents often find it difficult to find an early-years place or childcare suitable for these special children. Can the Minister point them towards any real, properly funded, properly resourced help from people with the right training looking after these special children?

[Baroness Merron (Lab)]

I hope I can be helpful to the noble Baroness. In the Best Start for Life strategy, we committed that each Best Start Family Hub will have a children and family services practitioner to support children and families who have additional needs. I feel that this new offer will help parents to understand their child’s development and identify emerging needs sooner. Importantly, it will also support vital join-up across the services, keeping children who have particular needs at the very centre.

Under-16s Energy Drinks Ban

Baroness Walmsley Excerpts

Tuesday 10th February 2026 Lords Chamber

Asked by

[Baroness Walmsley]

To ask His Majesty’s Government when they expect to publish a timeline for legislation banning the sale of energy drinks to under-16s.

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

My Lords, we are taking decisive action on obesity, easing the strain on our NHS and creating the healthiest generation of children ever. As part of this, we will fulfil our commitment to ban the sale of high-caffeine energy drinks to children aged under 16, introducing the ban within this Parliament. Our consultation has closed. We are analysing the responses and will set out further information on our timelines in due course.

[Baroness Walmsley (LD)]

My Lords, the Government promised to ban the sale of energy drinks in this Session. The consultation has ended but we have not seen the results yet. When will the responses be published and when will the Government publish the regulations? Will the ban extend to all under-18s and all retailers, including vending machines and schools? There is still time to pass the regulations before Prorogation. Will the Government get on with it? Otherwise, it will be a promise made but a promise broken.

National Cancer Plan

Baroness Walmsley Excerpts

Monday 9th February 2026 Lords Chamber

[Earl Howe (Con)]

My Lords, I begin by welcoming the publication of the national cancer plan and make it clear we fully share the Government’s desire to tackle cancer and to succeed in the fight against a condition that has affected almost every family in the country in one way or another. The Government have set out a clear ambition in this area, and we support them in that endeavour. It is appropriate for me also to pay tribute to all those who have contributed to the development of the plan, particularly those with lived experience with cancer and those close to them. Their willingness to share their experiences with such openness—and in many cases, courage—has, I am sure, been invaluable in shaping the finished result, and they deserve our thanks and recognition.

The national cancer plan sets out a number of significant commitments, including improving early diagnosis, restoring performance against cancer waiting time standards, accelerating the set-up of clinical trials and rolling out targeted lung screening nationally. It also places a strong emphasis on modernising services through technology and innovation.

These are all laudable aims and, indeed, Cancer Research UK has said that there is “much to welcome” in the plan. However, it has also rightly noted that delivery, funding and accountability will ultimately determine whether patients see real change. It is easy to put ambitious plans down on paper, but what matter in the end are clear delivery milestones and accountability. In that respect, this plan echoes many of the ambitions of the 10-year NHS plan, which was strong on aspiration but lighter on detail about how improvements would be delivered on the ground. My first question is, therefore, straightforward. When will the Government publish clear, fully funded milestones setting out how and when patients can expect to see tangible improvements over the next year or two?

It is also clear that the success of the plan will depend on having a sufficient workforce of cancer nurses, radiographers, pathologists and oncologists to deliver its aims. Can the Minister say whether we will shortly see a fully funded long-term workforce plan to support the staffing required to expand diagnostic and treatment capacity, not just in NHS trust settings but within neighbourhood health centres? In particular, can the Government explain clearly who will staff these services and how they will be funded? Blood Cancer UK has highlighted the importance of ensuring that blood cancers are properly recognised in workforce and service planning, and that patients receive consistent support from the point of diagnosis, including access to a named healthcare professional. Staff also need to know that they will be supported in delivering this plan, given current strains on capacity. In that context, we hear anecdotally of the difficulties involved in ensuring that staffing by doctors is adequate in all parts of the country. Some doctors, especially doctors in training, make up their minds that they will not be sent to work in an area that is not to their liking, perhaps because it would locate them far from friends and family. Will the welcome announcement of more training places in rural areas be enough to get sufficient doctors working in those areas?

Alongside the important question of staffing levels sits the Government’s ambition to invest in up-to-date capital equipment and cutting-edge technology. Investment in this often expensive technology is best and most efficiently met through capital budgets managed centrally. That leads me to a question about accountability for delivery, and where such accountability will lie. With the planned absorption of NHS England into the department, can the Minister give a sense of how the national cancer plan as a whole will be steered and monitored, not only centrally but regionally?

One specific aspect of the plan that I would like to welcome is the dedicated chapter for children, teenagers and young adults. This has been described by the Teenage Cancer Trust as a crucial step and an important acknowledgement that teenagers and young people deserve care designed around them and not as an afterthought. The work that the Government have done in recognising this is welcome. One point that the Teenage Cancer Trust has made particularly clearly is the importance of involving young people at the policy development stage. Can the Minister set out how young people with cancer were engaged in the development of this plan and how their voices were reflected in its content? Looking ahead, what steps will the Government take to ensure this becomes an ongoing process: listening to young people with cancer and systematically taking their feedback into account as the plan is implemented and reviewed?

Another point that charities and campaigners have consistently emphasised is the importance of clearly distinguishing between children and young people. The needs and challenges facing a three year-old child are self-evidently different from those of a 17 year-old young person, and it is important that this distinction is properly recognised in both policy and practice. I would therefore be grateful if the Minister could set out for the House how these different groups within the broader category of children and young people are engaged with. In particular, it would be helpful to understand how mental health support is tailored to different age groups and how the impact of a cancer diagnosis at different stages of a young person’s educational journey is reflected in their treatment and support pathways. If the noble Baroness could confirm that this distinction is one which the Government actively make and which will be taken into account in future policy development, I should be most grateful.

Let me conclude by reiterating my support for this plan and for the ambitions it sets out. In particular, there are some welcome and promising commitments around improving access to clinical trials and speeding up diagnosis. As the Minister knows, we need to do better in both those areas, and we share the Government’s ambitions to do so. For our part, we will continue to play our role in opposition by scrutinising delivery closely to ensure that ambition is matched by action and that the Government’s very laudable commitments translate into tangible improvement on the ground for patients.

[Baroness Walmsley (LD)]

My Lords, from these Benches, we very much welcome the national cancer plan and support its ambitions—and it is very ambitious. Many organisations and committees have called for an integrated, long-term plan, so it is very good that the Government have listened and, in particular, have taken note of the views of patients and their families—the people with lived experience of all these problems. However, may I reiterate Cancer Research UK’s response to the plan? It said:

“The key question that patients and their loved ones will ask, however, is how quickly will they see progress in cancer survival and outcomes? The improvements they are waiting for will depend on how this plan translates into delivery. Funding must match the ambition of what has been promised, or the NHS will struggle to expand its diagnostic capacity or introduce innovation at scale. And clear leadership and accountability are also crucial”.


Many of those points have also been mentioned by the noble Earl, Lord Howe, just now.

We know that outcomes in England have lagged behind comparable countries for decades, so it is positive to see improving cancer survival at the centre of the plan. However, it is going to be tough to achieve and will require much faster progress than what we have heard so far indicates. The key, of course, is improved diagnosis at an early stage, so I welcome the renewed commitment to earlier diagnosis and to meeting all cancer waiting time targets by 2029. It is outrageous that 92% of trusts do not reach the target for starting treatment. I welcome the full rollout of lung screening by 2030 and increasing the sensitivity of the tests used in bowel screening by 2028. However, what about breast screening? There have been problems in some parts of the country in getting that done. Can the Minister say whether these plans will be fully resourced? There is no point in doing the screening and tests unless an expert is there to interpret them. There are bold promises, but will they be matched with the resources and training required?

The plan talks about AI tools and liquid biopsy tests, which could certainly hold real potential for increasing productivity. However, before they are introduced, they must be robustly tested so that only safe and effective innovations reach patients and those that do not work can be dropped.

While there is a focus on diagnosis and treatment, I was pleased to see that the plan includes a commitment to increase action on lifestyle factors which we know cause cancer. Smoking tobacco, being overweight or obese, alcohol and UV exposure still cause many cancers that could be prevented. Fortunately, the Tobacco and Vapes Bill should certainly have a positive effect over the coming years in stopping people smoking in the first place. It is also positive to see action to strengthen protections on sunbed use and measures to drive HPV vaccination uptake, particularly in underserved groups. The new ad hoc committee on childhood vaccine rates is, I hope, going to contribute to that.

More action is needed to drive the shift from sickness to prevention, which is one of the Government’s core objectives in their 10-year health plan. There is still more to do to help millions of existing smokers quit smoking and to prevent someone becoming overweight or obese in the first place. Tightening regulation on alcohol through introducing minimum unit pricing, as implemented in Scotland and Wales, was a missed opportunity. Will the Government reconsider?

Rare cancers make up about 24% of cancers diagnosed in the UK and the EU every year. This includes cancers of children and young people, because they are less likely to suffer from the cancers caused by the lifestyle issues I have just mentioned. This is where research comes in, and the ability to implement research findings into the NHS. It is a sad fact that the NHS has been slow in the past to implement new cutting-edge treatments, so it is welcome that the plan has some important commitments in that respect. However, as with other aspects of the plan, the devil is in the detail.

The focus on ending delays in cancer treatment is a step forward, but funding 28 new radiotherapy machines is not enough when the treatment is so cost-effective and successful. We need to end the radiotherapy deserts. Will the Minister extend her ambition to the 200 extra radiotherapy machines that the Liberal Democrats have proposed? Another 28 will probably only replace the old machines that need to be replaced anyway—it will not take us forward. Can the Minister tell us about the plan to train the operatives for these new machines? Resources, training and accountability are at the heart of this. We have not had a lot of detail yet, so I look forward to getting more.

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

My Lords, I am grateful for the warm welcome from both Front Benches for the national cancer plan. This is a moment when we transform our cancer care and we make it personalised—we wrap it around the person instead of expecting it to be the other way around. The 62-day treatment standard has not been met since 2015, and outcomes, as we have talked about a lot in this Chamber, continue to lag behind those of comparable countries. That is what has driven us to this point to ensure that, by 2035, three in four people diagnosed with cancer will be alive five years later, whereas at present, the figure is three in five. That represents 320,000 more lives saved, with all the effects on their friends, families and communities, as well as themselves. That will be the fastest improvement in cancer survival this country has ever seen.

I will try to deal with some of the Front-Bench questions. I agree with much of what has been raised, including the recognition of all those, including those with lived experience, who contributed to what is, in my view and experience, a very bold 10-year strategy that actually sets out how we will do this. Both the noble Earl, Lord Howe, and the noble Baroness, Lady Walmsley, asked about clear milestones. I am glad to say that those are set out at the end of each chapter, with dates and the responsible organisations for all key actions and commitments.

The noble Earl raised the workforce plan. It will be published in the spring and will set out guidance—this goes to the point raised by the noble Baroness—not just on expanding numbers but on ensuring that staff are properly trained and supported. This will require a multidisciplinary team approach. We will use training directly as a lever to prioritise training places in trusts, often in the rural and coastal areas that the noble Earl asked about, as it is indeed the case that vacancy rates are higher and performance is lower. Training doctors of course takes time, but this is about long-term sustainable change and about turning around the whole of the cancer pathway. It is the exact opposite of us tinkering here and there. We are working with the royal colleges to boost the numbers of doctors specialising in clinical and medical oncology.

The noble Earl asked about bringing NHS England into the department. I see that as a great opportunity. Within the plan, we have set out a reformed national cancer board. It will be comprised of cancer experts, and it will be accountable—this is so important, as the noble Baroness said—for the overall delivery of the plan. Regionally, we will keep and strengthen the role of cancer alliances, which will work hand in glove with NHS regions to deliver cancer improvements.

The noble Earl asked how young people are being engaged. We worked with the Children and Young People Cancer Taskforce to ensure their voices were heard through its patient experience panel. Importantly, we will appoint a lead for children and young people with cancer to be part of the revamped national cancer board. We want their voices to continue to be heard. We definitely recognise the distinction between children and young people; they have different needs. For example, the plan highlights the importance of play for children, as well as the role of youth support co-ordinators in providing educational, emotional and fertility support for teenagers and young people. I agree with the noble Earl that cancer has a profound psychological impact on all patients and those supporting them. The plan sets out how that support must be standardised for children and young people, including the provision of longer-term support.

The noble Baroness asked about improving early diagnosis. We are providing £2.3 billion of investment in diagnostics to deliver 9.5 million additional tests by 2029 across screening and symptomatic diagnosis. The noble Baroness asked about seeing change; I say go to a community diagnostic centre. That epitomises where we are going with our National Health Service. We will also spend more than £650 million to complete the rollout of lung cancer screening by 2030, which is one of the things that can make the biggest difference in more disadvantaged areas, as well in prevention.

On radiotherapy machines, the responsibility lies at a local level. We expect local systems to continue to invest in new machines to meet the ambitious targets. Through the spending review, providers have been allocated with £15 billion in operational capital for local priorities and £5 billion to support a return to constitutional standards, including for radiotherapy machines.

Baby Milk Powder: Cereulide

Baroness Walmsley Excerpts

Wednesday 4th February 2026 Lords Chamber

[Baroness Merron (Lab)]

As ever, the noble Lord has put things better than I did. I understand the point he is making. The FSA’s role, certainly in the incident response, includes chasing supply chains to identify any additional potential products and businesses. I certainly agree that it is very important to stem any difficulty. But, as it is a live incident, the only point I would make, as I said to the noble Baroness, is that the focus is very much on managing the situation. Therefore, there has not been the opportunity to look into the detail that I agree it needs. That will happen, as it always does, in an incident such as this.

[Baroness Walmsley (LD)]

My Lords, is the Minister aware that it took Nestlé four weeks from its first notification of contamination to the Dutch Government to initiate the first product recall on 5 January, following further tests? Does she agree that there should be independent testing, rather than relying on in-house testing by the formula producers? Does she agree that that independent testing should be triggered, at the very least, at the first whiff of any possible contamination?

[Baroness Merron (Lab)]

In my preparation for this Question, which is an important one, I asked a similar question to officials, particularly those from the FSA, and they assured me that testing shows we are meeting the right standards. They also made the point that this is all covered by the Food Safety Act. In their opinion, they have the tools to do the job. I am not aware that there has been something wrong in the management of this live incident, but I am aware that the FSA and the UK Health Security Agency are liaising very closely with the manufacturers to establish the root cause of the possible presence of this toxin. But I can also reassure your Lordships’ House that it is confined to certain batches. That is the information that is going out.

Tobacco and Vapes Bill

Baroness Walmsley Excerpts

Committee stage
Wednesday 26th November 2025 Grand Committee

[Baroness Bennett of Manor Castle (GP)]

My Lords, I rise briefly to address a couple of these amendments in a broad sense. Amendments 182 and 187 would ensure that all schools and colleges were vape-free and would require them to proactively implement policies as such. I draw here on my own experience from the Learn with the Lords scheme. I had a shadow from that scheme here in Parliament—a young woman of about 16 or so. She had been with me for about an hour when she said to me, in tones of total desperation, “I need a vape”. I confess that that is not something within my personal experience, and I am not entirely sure about where I took her, although it seemed an appropriate place and I did my best. But I think that we have to acknowledge that schools, colleges and other similar institutions will encounter people who have started vaping and are experiencing great difficulties with addiction to that vaping. I would want to keep it so that the school can make its own decisions on what is best for its own situation and its community, rather than trying to apply a blanket ban. We know what the ideal would be, but we have to think about the reality for head teachers and others who have to deal with that practical situation.

I also want to speak against Amendment 182A, which would allow vaping products in places where it is reasonable to expect that everyone present is over 18. I should declare another interest here. I must admit that I really do not enjoy walking down the street and getting a face-full of vaping fumes through no choice of my own. Many of the pubs, clubs and bars that are likely to be in this situation are already voluntarily vape-free. We do not want to force them to change the circumstances of what works for their patrons.

[Baroness Walmsley (LD)]

My Lords, I shall start with Amendment 182A tabled by the noble Lord, Lord Howard of Rising, which replaces his withdrawn Amendment 180A. It seeks to specify that vaping should be allowed in locations where it is “reasonable to expect” that only people over 18 congregate. I believe this would limit the Government’s response under their powers in the Bill if future evidence emerged that action would be desirable. Given that parts of the Bill seek to limit any action that opens the way to under-18 vaping and to discourage those aged 18 to 24 from vaping, except as a smoking cessation tool, this amendment would appear to be in opposition to that objective, which I share.

I have commented before that many young people slip undetected into over-18 places—the noble Lord, Lord Kamall, has just accepted that that does happen now and then—so the amendment could undermine the Bill’s objective, which could be why the noble Lord has reworded it. However, many indoor settings already voluntarily designate their premises vape-free, and they may do so because many non-smokers find vaping as well as cigarette smoke offensive because of the smell. I am sure they would not have done that if it were bad for business. Any change in this situation would require further consultation, so perhaps that is what the Minister might say.

Going back to the beginning of the group, Amendments 181 and 184, tabled by the noble Lord, Lord Kamall, seek to restrict the Government’s ability to act in future to three specific locations. I am glad that the noble Lord did not specify that hospitals should be designated vape-free, because vaping may be a valuable quit-smoking aid to patients. However, it does not seem to me that these places need to be specified in the Bill. There is going to be a lot more consultation, and I hope that evidence will come from the call for evidence.

Amendments 182 and 187, in the name of the noble Lord, Lord Udny-Lister, are unnecessary as schools already have the power to ban students bringing vapes on to their premises as they cannot have been obtained legally if the students are under 18. However, it is sad that many of them either do not do so or find it hard to enforce their ban, if they have one, for the reasons the noble Baroness, Lady Bennett of Manor Castle, has just mentioned. One has to have sympathy with young people who have managed to be hooked on nicotine so badly that they have to say, “I need a vape”, as she put it. I hope that schools in particular, where the pupils are under 18, will see it as their duty to discourage vaping among their pupils. In support of that, I would be sorry to see staff vaping on the premises because it is a very bad example.

There is a major problem with young people buying unlicensed vapes, some of which have been adulterated with THC or the drug spice, which is a dangerous development. The latter is particularly addictive and harmful, so I hope that schools would be active and vigilant on this matter. However, I think the Minister may tell us that more consultation is taking place on this issue, so I am content to wait for that.

I support the principle of Amendment 183, from the noble Lord, Lord Kamall, which would prohibit the Government designating mental health trusts as vape-free. We must recognise the use of vaping in mental health and smoking cessation, alongside treatment, so the trusts should be able to make their own decisions about vaping on their premises. I very much hope that the Minister will reassure us that the Government do not have any intention of designating mental health trusts as vape-free areas. For all those reasons, and those given in previous debates, I would not support removing Clause 138 from the Bill. The public strongly support their opportunity to go into vape-free places, and many businesses have understood that already.

--- Later in debate ---

[Baroness Bennett of Manor Castle (GP)]

My Lords, I will speak very briefly against all the amendments in this group. I respectfully disagree with the noble Lord, Lord Howard of Rising, about our understanding of heated tobacco products. I am drawing here, as I have been throughout Committee, on the excellent briefings from Action on Smoking and Health. I note its conclusion, that there is not currently good-quality evidence on the health harms of heated tobacco devices or their efficacy as a smoking cessation tool. Therefore, in that context, we need to be very cautious of the potential health impacts. The Bill as it stands is in the right place.

[Baroness Walmsley (LD)]

My Lords, I agree with the noble Baroness. In Amendment 184A, the noble Lord, Lord Howard of Rising, seeks to exclude heated tobacco from the smoke-free generation objective of the Bill, to allow it in places where everyone is over 18. For this reason, and because of my lack of confidence that any location can be sure it is really only used by over 18s, I cannot support this amendment.

In Amendment 185, the noble Lord, Lord Udny-Lister, seeks to exempt heated tobacco from being banned in uncovered hospitality areas, which parallels an earlier amendment about vaping. As smoking gradually declines, the Government may very well seek to make further restrictions, as the public will almost certainly become used to the lack of nicotine products in their environments, and they may rather like that situation. Therefore, the Government must be free to use their powers in the Bill to respond to the public’s changing attitudes on these issues.

Removing Clause 139 would prevent the Government from designating heated tobacco-free places at all. Many businesses have done this already, and any evidence that these products are being used as smoking cessation tools is likely to decrease over the years as the number of smokers decreases. That would therefore not be a good reason to prevent the Government from acting if they saw fit.

--- Later in debate ---

[Lord Stevens of Birmingham (CB)]

My Lords, I hesitate to interject at this late stage of Committee, but I just respond to the noble Baroness, Lady Fox, who had concerns that many of the organisations giving evidence previously on the retail question were from health-related charities, and I declare my own non-pecuniary interest as chairman of Cancer Research UK.

I just inject a note of caution about relying too heavily on some of the trade associations for the small retailers that she describes, given that they have some financial vested interests. The organisation that she cited, I noticed on their website, has received a sponsorship support from Japan Tobacco International. Another major retail association declares on its website that it has received funding from Philip Morris, Japan Tobacco, Imperial Tobacco and British American Tobacco. Therefore, notwithstanding the need to consult retailers directly, I think that some of these trade associations may have a conflict of interest.

[Baroness Walmsley (LD)]

My Lords, I agree with the noble Earl, Lord Howe, about how important it is that retailers of all kinds feel supported as we move into the transition to a smoke-free generation. Those who operate legally and who will obtain a licence to operate under the new rules will want to see the Government doing everything that they can to attack the illicit trade that undermines the profits of law-abiding businesses.

They also need protection from the wave of shoplifting, which the noble Earl, Lord Howe, talked about, which eats into their profits and sometimes puts them in physical danger. It is quite possible that progress towards gradually raising the age below which the retailers may not sell tobacco products could exacerbate this situation unless action is taken. Age verification could be seen as a problem or a solution. However, the need for age verification is already quite common and it falls upon the consumer, not the retailer. I have to verify my own age when I buy a senior railcard to use on the train, although my grey hair means that I am not challenged when I want to buy a bottle of wine. However, the fact remains that, when I have alcohol in my basket at the checkout, a member of staff is entitled to verify that I am over 18—in fact, they take one look, and they click on the terminal. They do not ask for my birth certificate, but of course they might if I looked under 18, which I do not.

However, the situation will soon change for young people only a year apart in age. Having said that, young people are already quite used to having to verify that they are over 18 when buying a drink or a packet of cigarettes or vapes. What do they do now? They use a digital age-verification tool already, and some bars issue their own card once they have verified the age of their regular customers. It therefore would not be unreasonable, and would be helpful to the retailers, if a range of age-verification mechanisms could be available to customers who would then have to show one of them in order to protect the retailers from inadvertently committing an offence. They have to show that they are over 18 now, so why not that they are 19 a year after Royal Assent or 20 the year after that?

It may be a very good idea for the Government to carry out more research on this and publish a strategy, as the noble Earl, Lord Howe, has proposed in Amendment 188. But the public are not the only ones who need guidance and information about the law well before it comes into operation; how much more important is it for retailers? We have already debated my noble friend Lady Northover’s amendment about the need for a communications strategy, so I am not sure how much Amendment 191 would add to that, but it is a useful probe.

Like the noble Baroness, Lady Bennett of Manor Castle, I do not support Amendment 200A from the noble Lord, Lord Howard of Rising. I do not see why taxpayers should foot the bill for creating age-verification mechanisms. I suspect that individual customers will obtain their own digital age-verification mechanism and that inventive companies will produce them and make them readily available. Of course, the vape manufacturers may also produce age-gated products, so perhaps it should be the tobacco industry that foots the bill because of its very large profit margins. I look forward to hearing the Minister’s views on this issue.

[Baroness Fox of Buckley (Non-Afl)]

If the Committee will allow me, I want to come back on the point about retail organisations. I am more than happy to acknowledge that all sorts of organisations are not quite as independent as they seem. In fact, many health charities over the years feel more like Astroturfed organisations, because most of their money comes from government, one way or another. All I am pointing out is that the idea of a kind of neutral body of representative organisations is something that could be queried.

It is fair enough about trade associations, but my general point—rather than trying to imply that there is something dodgy about the associations I mentioned because of any association with tobacco—is that tens of thousands of small retailers are tearing their hair out about the implications of this legislation. That is reflected in a wide range of ways, not just by briefings I have had from trade associations, of which I have not actually had very many. I have investigated this myself; I have talked to quite a number of them and met others, and I have read around. That is why doing research for a piece of legislation matters.

There is a danger of saying, “We can’t talk to the trade associations for small convenience stores, because the ones we know of have some association with or get some funding from big tobacco”, but maybe that is because they are often sidelined and ignored by other organisations, and they should not be. The Government could actually take them seriously and not have them treated as though they were a kind of pariah one can ignore. These are the small players; this is your local corner shop. How do they get a voice here? I thought I would try to give them a voice, and it is not appropriate to imply that somehow giving them a voice is something to do with representing big tobacco. It is completely unrelated to the general point I was making and, as I have pointed out, organisations such as ASH get their funding from somewhere. That is not necessarily big tobacco, but it is big government.

[Baroness Walmsley (LD)]

Having said that, does the noble Baroness agree that it would be unfortunate to see any organisations fearmongering among small businesses that already have a lot of concerns, and a lot to face when this Bill comes into operation?

[Baroness Fox of Buckley (Non-Afl)]

It would also seem that misrepresenting them in the pages of the Grocer by saying that they absolutely love this legislation is the opposite of fearmongering. That is called misinformation; it is illegitimate and not fair. I do not think any fearmongering needed to happen. As it goes, the Government recognise that small retailers are under pressure, which is why they are trying to bring in legislation so that there will be a special offence if you assault or attack a retail worker. I always hoped the law would do that anyway and that we would not need an extra law, so it makes me nervous that we would do it.

That is not because of fearmongering but because on the ground, in small shops up and down high streets throughout the land, things are pretty grim. The BBC report I recently mentioned about the illegal shops that are springing up was also an indication that a lot of these small shops are saying, “We don’t even mind being licensed. We don’t want to be part of a world that’s ignored”. All I am saying is that they have not had consultation with the Government; they do not know how to do it, and they cannot afford the big bucks—perhaps they get a bit of sponsorship, I do not know—but somebody should listen to them. They should go out and talk to them; go round with a billboard and just chat to them. I am suggesting that we do not pass this legislation without having a chat with them. I get annoyed when people say that we have already consulted retail, yet nobody has had a chat with the people who will be really affected by this.

--- Later in debate ---

[Baroness Hoey (Non-Afl)]

My Lords, I add my support for this amendment, which seems very sensible. When we have an amendment in the names of both the noble Lord, Lord Lansley, and the noble Baroness, Lady Fox, we should all be looking at it very seriously indeed.

I have never smoked and never vaped but I remember, when vaping started, being absolutely delighted because it got rid of the smell of smoke whenever you went to places. There was a general feeling that vaping was better than smoking. I still feel that very strongly, but I accept that there is no evidence to tell us what is going to happen in the long term. I also think that things change; there is more research going on in all sorts of areas to do with vaping, and it just seems sensible that we have some form of expert panel.

I very much accept what the noble Baroness, Lady Fox, said about the word “experts”. We need to look carefully at who would be the experts on this but, as the noble Lord, Lord Lansley, said, this might be something on which there could be discussion before Report so that there is agreement on the kinds of expert that we want. What we do not want is for them all to come from the same aspect of research in a particular academic area. As we come to the end of this Bill, I really do think that the Minister should see this as something that she could accept and which would be very sensible.

[Baroness Walmsley (LD)]

My Lords, I thank the noble Lord, Lord Lansley, for Amendment 197 and the noble Baroness, Lady Fox of Buckley, for the robust debates that we have had during Committee; I thank the Minister and all noble Lords for that. I want to say just one thing in response to something that the noble Baroness, Lady Fox, just said. There is something wrong with vaping in the very limited circumstances when it hooks a 12 year-old on to something very addictive, which may last for the rest of their life—the noble Baroness did concede that point.

I turn to the amendment. The noble Lord, Lord Lansley, recognises that evidence and public opinion are likely to move forward as the measures in this Bill are implemented over a period of time. While the harms of smoking tobacco are well researched and evidenced, the impact or benefits of vapes and other nicotine products as smoking cessation tools are not yet so well evidenced. Besides, we can expect innovation in this area as the tobacco companies try to protect their profits. We must keep up with that. As the noble Lord, Lord Young of Cookham, just mentioned, Public Health England used to publish regular reviews on the impacts of vaping, but this has not continued; in any case, the reviews need to be a bit wider than vaping because we do not know what products are coming down the track.

The noble Lord is asking for an independent expert panel. I would certainly expect the Government continually to provide evidence themselves as they put the wide powers in this Bill into operation. However, just as the independent Climate Change Committee is well trusted in respect of the advice it gives to the Government, based on a wide range of scientific evidence—the Government benefit from that—so an expert advisory committee on the future implementation of the new regime for nicotine and vaping products, quite independent of the tobacco and vapes industry, would add to the Government’s confidence and to public confidence.

I do not want to predict what the findings of such an expert panel would be, but its deliberations could be very helpful when the operation of the Bill is reviewed at any point in future, as suggested by my noble friend Lord Russell in his Amendment 195. The noble Earl, Lord Howe, suggested a five-year review. However, it will be very important that its deliberations and advice to the Government are totally transparent. If that were not the case, it would not command the respect of the public, the research community or anybody else. I am sure that that is the noble Lord’s intention. This idea is well worth consideration by the Minister. I am sure that there will be more discussions about it, perhaps offline, and I look forward to her reply.

[Earl Howe (Con)]

My Lords, the Committee will be grateful to my noble friend, with his considerable experience in health policy, for the clear and cogent way in which he introduced his amendment. I am very supportive of the principles behind the amendment, as it seeks to ensure that decisions taken after the passage of the Bill are informed by robust, independent evidence and that Parliament is equipped with the relevant and authoritative information it needs to provide proper oversight of the regime for vaping and nicotine products, information that is constantly updated as the body of evidence evolves.

Critically, this principle applies equally to the Government. Proposed new subsection (5) in the amendment would require Ministers, when making regulations under the Act, to have regard to the proposed panel’s reports and recommendations. That is a sensible idea. My noble friend Lord Young of Cookham was right to remind us that there has for some time been a gap in the public health mechanisms regarding the production of such reports. If we were to recreate a mechanism of the kind suggested, the regulatory frame- work would evolve in response to the realities of science and the market rather than outdated information.

It is also important to recognise, as the amendment implicitly does, that although our primary concern here is health, regulation in this space cannot be viewed in isolation from the wider economy. When sales of currently legal products are restricted or prohibited, this inevitably impacts businesses, consumers and, sometimes, wider society, and those economic effects can themselves have unintended consequences for public health and people’s lives. There is also plenty of evidence of unintended consequences and the effectiveness of previous episodes of prohibition. The risk of a rise in consumption of illicit products is an obvious example, as is misinformation propounded on social media. The Government should make and review decisions with as clear a view as possible about those sorts of trade-offs.

For those reasons, I hope the Government will take on board the very sensible suggestion contained in this amendment.

Tobacco and Vapes Bill

Baroness Walmsley Excerpts

Committee stage
Monday 17th November 2025 Grand Committee

[Baroness Walmsley (LD)]

My Lords, we cannot support these amendments, I am afraid.

I want to make a couple of comments on the points made by the noble Lord, Lord Moylan. The scenarios that he outlined would be against common sense and I really hope that, when the regulations come before us, they adhere to common sense and take account of the sorts of scenario that he suggested. I certainly think that, with the Bill as it stands, if the noble Lord had decided to give up smoking after the Bill—rather than before, as I understand he already has done—by being of age, in that I think he probably is over 18, he would be able, once the Bill becomes law, to go into a shop and buy vapes to help him give up smoking. So, I do not share his fears; let us put it that way.

I agree with the comments from the noble Baroness, Lady Bennett of Manor Castle, about the egregious nature of some of the advertising. In my own experience, in the high street of my local village, the whole window of one of the local shops is covered with advertisements for vapes, which are very clearly aimed at children: there is no question about it. Of course, the regulations must be carefully drafted to make sure of the objective we all share: making sure that adults who are of age and who wish to stop smoking can do so with the help of vapes.

I turn to the specific amendments in this group. In Amendments 160 to 166 and 173, the noble Lord, Lord Udny-Lister, seeks to exclude vapes and nicotine products from the prohibition on publishing and advertising. We do not believe that these products should be marketed to the general public; there are already provisions allowing them to be promoted as a cessation tool, which is what they are supposed to be in the first place, with a reasonable range of flavours correctly advertised.

Amendment 172 would require both a call for evidence and consultation before the introduction of marketing restrictions on vaping and heated tobacco products. These would delay the Bill—there is no question about it—and would, therefore, delay what the Bill is trying to do, which is combat the uptake of these products by young people. In any case, consulting with the manufacturers in this way may very well contravene Article 5.3 of the FCTC, which we debated last week.

Amendment 173A is not necessary, as we have already been assured both that consultation will take place and that the available evidence will be considered.

Finally, Amendment 174 from the noble Lord, Lord Kamall, is not necessary because Clause 132(2) already states:

“Before making regulations … the Secretary of State must consult any persons the Secretary of State considers it appropriate to consult”.


That should cover the noble Lord’s concern.

I have a question for the Minister about the consultation. This morning, I met a mother whose teenage daughter took up vaping at school and now cannot get off the habit. The mother did everything a good mother should do, because the child was quite upset about it; she was so hooked on nicotine that she could not give it up. She went to the GP. She went to the stop smoking services. She went to the pharmacist. She went to a drop-in. She then tried to buy 0% vapes but could not find them in any shop. Eventually, she persuaded a local shop to stock a small number of 0% nicotine vapes, so that the child could continue the behavioural habit without the nicotine—and without standing out from her peers, all of whom vaped behind the bike sheds, as far as I understand it.

It is important. It harks back to an amendment that we discussed last week about the NICE guidelines for stop vaping services. The Government need to make it clear that 0% vapes are and should be available as part of the cessation tools for people who do not just want to give up smoking tobacco but want to get off nicotine as well. That public health service—I do not call it an industry, as the noble Baroness, Lady Fox, does—should be available to young people.

In the real world, they are vaping. We do not know how harmful it is to them, but I strongly suspect that it is. It is certainly highly addictive. It takes all their pocket money and who knows what else. Very often, they get their vapes from illicit sources, which brings them in contact with people they should not be in contact with. So I would like to know from the Minister whether the consultation will take that sort of thing into account.

[Earl Howe (Con)]

My Lords, I hope I was right in believing that it was implicit in the noble Baroness’s remarks that she felt that 0% vapes should be an exception to the advertising rule.

[Baroness Walmsley (LD)]

Just to clarify, yes.

[Earl Howe (Con)]

That is helpful. These amendments once again bring us back to the issue of proportionality. The first thing to say, and I hope that no Member of the Committee will disagree with me, is that we have to be very careful when legislating on vapes and nicotine products, lest we inadvertently discourage their use by those who need them for smoking cessation purposes.

That leads to me to make a point similar to that made by my noble friend Lord Moylan. Sending the message that there are harsh criminal penalties associated with advertising these products or having anything to do with the advertising process plays right into the false narrative, which a lot of people now believe, that vapes and nicotine products—but especially vapes—are as harmful to human health as tobacco smoking. Used irresponsibly, vapes can cause addiction to nicotine and, in that sense, are bad for you. However, when responsibly used as a means of quitting smoking, they are not bad for you. We should tread carefully when purporting to put them on a par with tobacco products and herbal smoking products, as the Bill does in Clauses 113 to 118.

There are 6 million tobacco smokers in this country whom the Government rightly want to help to quit. But those who go through that process know that it is not as easy as simply putting down the cigarette and walking away. Having a safer, accessible and—dare I say—pleasant alternative to turn to is often what makes it bearable for those suffering from cold turkey.

Vaping and nicotine products are those safer alternatives to smoking. They do not possess the same chemicals and tar found in tobacco, and the poisonous chemicals in tobacco smoke are absent. Despite this consensus, 53% of the public believe that vapes are just as bad, while 40% believe that nicotine causes most smoking-related cancer. What do the Government say to those people when they place equal bans on the advertising of tobacco, nicotine and vapes alike? I do not think that they convince them that one of those options is better.

Amendment 173A, in the name of my noble friend Lord Howard of Rising, and Amendment 174 in my own name, would require the Secretary of State, before imposing a ban on the advertising of vapes and nicotine products or a ban on vape and nicotine companies acting as sponsors, to assess the impact of those bans on likely rates of smoking cessation and the impact on producers, retailers and, indeed, consumers. The free market has played a large part in the threefold reduction in smoking over the past 20 years through the natural growth of tobacco alternatives. The result is that we now have a vaping industry worth over £3 billion, a large part of it with standards and codes of practice, and a rapidly growing nicotine products industry.

I believe that we should welcome that, because it has facilitated the decline in smoking rates and, at the same time, contributed to the economy. I am the first to concede that there are bad-faith actors out there. No one on these Benches would argue against a ban on products or advertising targeted at children, but that is a very different thing from a ban on all advertisements of vaping and nicotine products in any circumstances.

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[Baroness Bennett of Manor Castle (GP)]

My Lords, I will address just two amendments in this group. The first is Amendment 171 in the name of the noble Baroness, Lady Northover, who powerfully and clearly introduced it as a probing amendment to the Government while very handily timing her intervention to remind me that it is in this group and that I have attached my name to it. I thank the noble Baroness for that.

We might say that there are different sides in this Committee, but everyone has agreed that adult smokers need to be able to get the information they need that this is an effective way to stop smoking. That is what this amendment does, and I do not think I need to say anymore on that.

I want to address briefly Amendment 172A in the name of the noble Lord, Lord Udny-Lister, which is about restrictions on brand sharing. It is important to highlight why this amendment should not be part of the Bill. The process of brand stretching or brand sharing is something that we have seen the tobacco companies doing a great deal of. Mysteriously, expensive leather jackets, fancy sunglasses or even stationery suddenly start to bear various branding aspects—I will get to what those aspects are in a second—that just happen to echo that of a certain form of cigarettes. Governments very often find themselves playing a whack-a-mole game: if you try to ban this, then something slightly different appears and so on.

I particularly want to highlight the guidelines for implementation of Article 13 of the WHO Framework Convention on Tobacco Control because this amendment very clearly goes against what that says. It notes that there needs to be an effective ban on all forms of tobacco advertising, promotion and sponsorship. I think it is worth quoting this because it highlights the ways in which the WHO is trying to catch everything because it has to try to catch everything:

“Promotional effects, both direct and indirect, may be brought about by the use of words, designs, images, sounds and colours, including brand names … or schemes of colours associated with tobacco products, manufacturers or importers, or by the use of a part or parts of words, designs, images and colours”.


The Government need all the powers they can possibly have to stop the merchants of death sneaking round into little gaps in the legislation.

[Baroness Walmsley (LD)]

My Lords, I support my noble friend Lady Northover’s Amendment 171 in this group, along with the noble Baroness, Lady Bennett of Manor Castle. My noble friend has highlighted many egregious examples of the sort of advertising that the Bill needs to avoid through careful drafting. Her suggestion is explicit that advertising must not appeal to children, non-smokers or indeed anyone for whom these products are not intended, while ensuring that their core purpose as smoking cessation products is not impeded.

Amendment 171 would tighten up the wording of the Bill to achieve the Government’s intention. It would also future-proof it. We debated, on Amendments 195 and 196 from my noble friend Lord Russell, the need for reviews in the future, to give everyone the confidence that the Government will at least keep pace with—or preferably get ahead of—developments. We should include in those reviews any clever advertising and marketing intended to get round the Bill, as well as product development and emerging evidence of harms. Frankly, if the industry does not like it, it has only itself to blame because of its blatant and highly successful campaign to lure children to use its products.

On Amendment 161A, from the noble Lord, Lord Udny-Lister, about the removal of “reason to suspect”—

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[Baroness Walmsley (LD)]

My Lords, as I was saying, on Amendment 161A, tabled by the noble Lord, Lord Udny-Lister, about the removal of,

“or has reason to suspect”,

in Clause 114(1)(b), we believe this phrase is commonly used and therefore there is no need to remove it.

On Amendment 161B on possible disparities between penalties in different devolved nations, we look forward to the Minister’s response. Although consistency is usually desirable, there may be unintended consequences, which the Minister knows about, because different situations prevail in different parts of the country.

We support the intention of the noble Lord, Lord Kamall, in his Amendment 167 because it is important that vapes can be promoted as a cessation tool. However, as I understand it, the Bill prohibits the advertising of vapes by businesses only, which means that public health organisations, GPs and hospitals treating patients suffering from smoking-related diseases could promote them as a quitting aid. As I understand it, the prohibition does not cover products licensed as medicines, so they can continue to be promoted.

Having said all that, I hope that the Minister can assure us that clear guidance compatible with the Bill’s intentions will be provided by the Advertising Standards Authority so as not to hinder public health settings while preventing commercial advertising, which has had such an egregious effect on the level of awareness of these products among children, who do not need them to quit smoking.

With Amendment 168, the noble Lord, Lord Moylan, would allow vapes to be promoted in what we might call adults-only places. Leaving aside the fact that, as we know, many younger people slip into these places, promotion there would give the impression that these products are for recreational use, which is not their purpose. Anyone going to a nightclub who is trying to quit smoking but fears they may be tempted to have a cigarette when they have had a few drinks and their resistance is lowered would certainly equip themselves with their vapes before going out.

We do not think Amendment 168A in the name of the noble Lord, Lord Howard of Rising, is necessary as the Bill already allows public health authorities to promote heated tobacco and other things as quitting aids.

Amendment 169 in the name of the noble Lord, Lord Kamall, raises an interesting issue that we think could be explored. There may be a case for some limited arrangements for display or promotion by specialist retailers, but this should be done very carefully to avoid ensnaring young people inappropriately. I think the Bill allows specialist vape shops to operate, and they could display material provided by public health authorities.

Amendment 170 is not necessary as there is no prohibition in the Bill of specialist retailers putting information on their website.

Regarding Amendment 170A in the name of the noble Lord, Lord Howard of Rising, I think about my local corner shop, which has illuminated signs inside and a shop window plastered with enticing advertisements for sweet-flavoured vapes. I hope the Minister will resist this very broad exemption.

Finally, we think that Amendment 172A in the name of the noble Lord, Lord Udny-Lister, on brand sharing is far too broad and would, in the end, apply to all brand sharing. I know from my work on food advertising how widely brand logos, colours and images can be recognised by the public. Who does not know that burgers and chips are being sold when they see the golden arches of McDonald’s, or that chocolate bars are being advertised when they see the colour purple and the words Dairy Milk? You need to be very careful when regulating brands, so I hope the Minister will resist that one, too.

[Earl Howe (Con)]

My Lords, in this group of amendments we have seen a logical continuation of our debate on the previous group, since in their various ways these amendments pose the question of what are the appropriate constraints to place around products that are of considerably less concern in a health context than tobacco products. We are back in the realm of deciding what is proportionate and how to secure better clarity and consistency in the operation of the Bill’s advertising and design provisions.

Although he has not been here to speak to it, my noble friend Lord Udny-Lister’s Amendment 161A struck me as a point worth raising. It would protect designers and creative professionals from being criminally liable based on mere suspicion or indirect association because it would work to raise the threshold of proof of intent. One could imagine that in some cases it could be difficult to prove that someone designing an advertisement had reason to suspect that it would be published. In any event, is it right that someone who has been asked by their employer to design a vape advertisement should be criminalised because they know or believe it may be used in some context? I am afraid that the word “draconian” comes to mind.

On my noble friend’s Amendment 161B a very similar thought came to mind. Are the Government really saying that the offence of designing an advertisement for a vape merits a prison sentence? There are mixed messages coming out of the Government at the moment. How should the sentencing provisions in this part of the Bill be read alongside the provisions of the Government’s Sentencing Bill? What is the overall message? The Sentencing Bill will require almost all sentences of less than 12 months to be suspended. On the one hand, the Government are creating imprisonable offences, and on the other, they are saying that people should not actually go to prison, even if they are sentenced to it. At the very least, the Minister needs to explain to the Committee why the sentence on summary conviction is to be different in Scotland than in Northern Ireland, which might have been a point my noble friend Lord Udny-Lister would have made.

Turning to my Amendment 167 and the very well worded amendment, if I may say so, from the Liberal Democrats, the underlying purpose of each is the same, which is to urge the Government to regulate, rather than ban, vape advertisements so that in narrow clinical contexts, such as smoking cessation clinics, they can be deployed for public health purposes. Amendment 168A in the name of my noble friend Lord Howard of Rising has a very similar purpose.

In Amendment 169 I am asking the Government to consider a further exemption for advertisements located discretely in specialist vaping shops. Why not allow that? As my noble friend Lord Moylan has asked in his Amendment 170, why prohibit such specialist shops providing information online subject to suitable age-gating checks? That in turn raises a further question from my noble friend in his Amendment 168. In adult-only environments, why should displaying an advertisement for a vaping product be against the law given that, as we need to keep reminding ourselves, vapes are and will remain legally available for purchase by anyone aged 18 or over? Why are the Government treating vape advertising in exactly the same way as tobacco advertising? What is the justification? Amendment 170A from my noble friend Lord Howard asks that question in a different form. Why should we not allow factual product information to be provided at point of sale in an age-restricted area in suitably licensed premises?

Finally, Amendment 172A from my noble friend Lord Udny-Lister would prevent overreach. It would ensure that brand restrictions target only genuine attempts to promote nicotine or tobacco, not completely unrelated products such as clothing or other merchandise. I think my noble friend has identified an issue that requires clarification from the Government, and I would welcome the Minister’s comments.

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[Baroness Bennett of Manor Castle (GP)]

My Lords, we have not yet heard from the noble Baroness, Lady Walmsley, but I will speak briefly in opposition to the amendments just introduced by the noble Lord, Lord Kamall, particularly Amendments 175 and 179. I start from the point of view that the powers to extend smoke-free places in England, were Amendment 175 to pass, would be less than the powers in the devolved nations. As smoking prevalence continues to fall, there will clearly be an ongoing open discussion that appraises the evidence on smoke-free extensions and how best to protect public health and workers’ rights.

In August 2024, the Government indicated—well, apparently it was leaked—that they were going to extend these powers when bringing back the Bill. There was then a backlash, the Government U-turned and said that the consultation would focus only on schools, playgrounds and hospitals. That is disappointing, but we do not want to close down the opportunities and options for the future that would be available from this Bill.

Think about some of the other places that might be high-priority areas in the future, such as beaches. Very often, we experience big problems with litter and there are lots of small children on beaches. People have an expectation of fresh air there; that is one of the reasons why they go to the seaside. There are other places where exposure to second-hand cigarette smoke is particularly high. One example is transport hubs, but we can all think of other places where there are real issues and where we might want to keep the possibility of further extension open.

Finally, our medical understanding of the impacts of so-called passive smoking and second-hand cigarette smoke is growing and increasing all the time, and heading in only one direction. I note, for example, that just in the last week a major veterinary provider told pet owners to be aware of the impacts of passive cigarette smoke and vaping on pets. Our understanding of the impacts in this kind of area just keeps growing and growing, so we should not close down the possibilities in the Bill.

[Baroness Walmsley (LD)]

My Lords, I will speak first to my Amendment 176. As the noble Lord, Lord Kamall, said, his Amendment 178 does something very similar. As I have often said, policy should be based on evidence, so this amendment seeks to tease out exactly what evidence the Government plan to use when designating a new area as smoke-free.

The Government have already said that their consultation on further smoke-free areas will focus on schools, playgrounds and hospitals. It is fairly clear that areas in and close to schools should be smoke-free, in the same way that local authorities now have powers to prevent the opening of new fast-food outlets near schools because of the health dangers of much of their sales.

However, some playgrounds are very large and it is possible that a parent waiting on a bench for a child, well away from the play equipment, may want to smoke a cigarette—if they are of legal age, of course. Although it would set a bad example, it would be hard to understand the level of risk to the children playing; it would depend how far away they are. As for hospitals, many of them have already designated their grounds as smoke-free, although it has been hard to enforce. Many of us will have seen people smoking outside St Thomas’ Hospital, underneath the “No smoking” sign. Many hospitals have distinct outdoor smoking shelters. The matter is complicated, which is why my amendment probes the Government on the criteria they will use.

On the other hand, Amendments 175 and 179 seek to specify in the Bill the areas that can be designated as smoke-free. This could restrict the Government from acting in other areas in future. Obviously, we want the same rules in all parts of the UK, to save confusion. There are several reasons why the Government should not be limited in this way, and they must bear in mind the different circumstances that prevail in different areas. For example, as the noble Baroness, Lady Bennett, mentioned, there are many children on beaches, and discarded cigarettes are a real litter problem, according to coastal local authorities. As she said, transport hubs may also come into focus, because of the crowded conditions in many of them, especially at certain times of the day such as rush hour. We think the Government need flexibility on this issue. Indeed, somebody might be more affected by second-hand smoke in a transport hub than at the far side of a very large playground, which is why I would like to see an evidence test.

We do not support Amendment 177 in the name of the noble Lord, Lord Udny-Lister, as the Government may want to restrict smoking in uncovered hospitality areas in the future. However, if they do so they will have to explain the reasons why, and we could debate it then. The fact is that the prohibition on smoking in indoor hospitality venues has proved very popular with customers and landlords alike and has certainly not had a damaging effect on footfall or expansion of the sector. The same might apply to uncovered hospitality areas in the future, if they are considered for the ban.

[Baroness Merron (Lab)]

My Lords, as we have heard, all the amendments in this group seek to limit the powers in the Bill to make additional places smoke-free in England. On Amendment 176, tabled by the noble Baroness, Lady Walmsley, we know that passive smoking, whether indoors or outdoors, poses a risk to health. The rule of thumb is: if you can smell cigarette smoke, you are inhaling it. This is particularly important for children, pregnant women and those with pre-existing health conditions such as asthma or heart disease, which may not be visible to the smoker.

However, despite these well-known and very well-evidenced harms, trying to ascribe specific harms to locations is somewhat challenging, as this debate shows. For example, as the noble Baroness, Lady Walmsley, mentioned, in a large children’s play area it is difficult to evidence that exposure to second-hand smoke has caused a specific harm in a specific place. I can assure noble Lords that we are extremely mindful of this. Therefore, the test referred to in the amendment is overly restrictive, technically very difficult to do and not necessary, given the extensive evidence of harm to vulnerable people. It would also likely lead to a scenario in which we are unable to protect the most vulnerable in society from the harms of second-hand smoke.

Similarly, on Amendment 178, tabled by the noble Lord, Lord Kamall, as I mentioned, we know the harms of passive smoking. There is strong indirect evidence but, as I said, it can be difficult to demonstrate this evidence in specific locations. Again, this restrictive test would prevent areas where there are harms of second-hand smoke to children and medically vulnerable people from becoming smoke-free. Furthermore, as this amendment would apply in England only, it would leave England with more restrictive smoke-free provisions than the devolved nations. 

Amendments 175 and 179 were tabled by the noble Lord, Lord Kamall. As we have made clear but I would like to reiterate, in England we plan to consult on extending smoke-free places as and when. In the first instance, it would be to the outdoor areas of schools and early years settings, children’s playgrounds and healthcare settings. I can assure the noble Lord, Lord Kamall, and the noble Baroness, Lady Walmsley, that all proposed smoke-free locations will be subject to consultation both now and into the future and that regulations will be subject to the affirmative procedure. We will be guided by public health advice. The noble Baroness, Lady Bennett, rightly observed that the powers within the Bill allow us to respond to evolving evidence at a later time, particularly where there is evidence of clear harms to children and vulnerable people.

On Amendment 177 tabled by the noble Lord, Lord Udny-Lister, we have made it very clear—I am glad to take the opportunity to do so again, not least because the noble Lord, Lord Kamall, raised this—that outdoor hospitality settings will not be in scope of the consultation on smoke-free places. We fully recognise the balance that is needed to protect the most vulnerable as well as ensure that businesses are not financially impacted. We are confident that we have the balance right in deciding the places, which I have already outlined, on which we plan to consult.

However, the powers in the Bill, as has been observed, allow for additional places to be designated smoke-free in the future, subject to further consultation and parliamentary debate. The landscape may change significantly on tobacco legislation, as it has done over the years. Evidence and attitudes may also shift, again as we have seen over the years, so it is sensible to ensure that the Bill is future-proofed and can respond to evolving evidence. I therefore ask the noble Lord to withdraw this amendment.