Tobacco and Vapes Bill

Lord Mackinlay of Richborough Excerpts

Committee stage
Monday 27th October 2025 Grand Committee

[Lord Bethell (Con)]

My Lords, first, I declare that my wife is a non-executive director of Tesco. Secondly, I spent 10 years working at the Ministry of Sound in south London, where I came face to face with the illicit cigarette trade on a weekly basis. Christopher Upton was the name of the burly character who delivered cigarettes to the club each week; he controlled the London casual cigarette business very tightly indeed. He was a charming, if burly, individual who gave us presents at Christmas and is famous among the legal fraternity for his case, Fagomatic v HMRC, in which he argued that his shiny purple Lamborghini Countach should be deductible for VAT as a business expense, which sadly he lost in 2002. That is the face of illicit cigarette trading in the UK.

Since the days of Christopher Upton, the trade in illicit cigarettes has come down by 90%, from 15 billion sticks a year to 2 billion sticks a year. Those are the statistics that the noble Lord, Lord Bichard, rightly gave; they are different from those given by the noble Lord, Lord Scriven, which come from the KPMG report for Philip Morris, the cigarette seller, which are not figures that I feel this Committee should lean on. I can source the number, if it is helpful to noble Lords.

May I just say a word about prohibition? I have two points to make about the prohibition of cigarettes for young people. First, as the noble Baroness, Lady Fox, rightly and powerfully said, there is now a clear displacement route to vaping for anyone who wishes to take up this kind of activity. In other words, there is an alternative. Prohibitions come when there is no alternative. Secondly, I remind the Committee that, among young people, interest in smoking cigarettes has collapsed: it has gone from 23% of 18 year-olds in 2011 to 10% of 18 year-olds in 2025, and it is heading downwards. We can only encourage this move with this measure.

The amendments suggested in this group would be counterproductive and are, for that reason, extremely regrettable.

[Lord Mackinlay of Richborough (Con)]

My Lords, I support these amendments in the names of my noble friend Lord Murray and others, which concern substituting the age of 21. I do so not because I think 21 is the perfect age but because it becomes a workable solution in trying to prevent the young smoking.

I am—like many noble Lords in this Room, I suspect—a reformed smoker. It sounds like one of those AA meetings, does it not? I stopped smoking on the occurrence of my illness. I did not stop smoking because I had suddenly turned against them, morally; it is just that I now struggle to pick them up and light them. Of course, we would love to live in a world of nirvana where cigarettes and tobacco had not been invented, but I am afraid that idea is long gone; it went many hundreds of years ago.

I am sorry to say that the Bill gives this Parliament rather a bad name, because we are talking here about the complexity of age-related smoking. One needs only to look out on to today’s streets. It is pretty rare to see people smoking on the street and even rarer to see youngsters smoking on the street. As the noble Baroness, Lady Fox, and my noble friend Lord Bethell just said, 10% of youngsters smoke and, in the normal population, the number of smokers is collapsing. That is a result of cessation products, of better education and of us all, I think, being a bit more aware—if we needed to be more aware—of the dangers of smoking this smoking product, which is, by its very nature, pretty daft.

Where the public have lost us here, I think, is that they see a lot of evils on the streets of this country. They would rather we were debating banning knives on the street or banning street fentanyl, but here we are talking about banning smoking. I think people would almost laugh at us for discussing such things at length in this Parliament.

Hundreds of millions of pounds have been spent over the years on smoking cessation products via the NHS—whether patches, gums or other such things—yet the only product to have received no public subsidy, despite it being the biggest driver of reducing smoking in this country, is the vape. It has been far more successful than all those expensive products, although I share the concerns of the noble Baroness, Lady Northover, about vaping. Perversely, this is where the nanny state gets a weird outcome. We are now seeing more youngsters addicted to nicotine at a young age via a vape than I think we ever would have done had we done nothing except the usual education around how bad smoking is. We now have a generation of nicotine addicts where I do not think we would have done before.

This is not a Second Reading argument about how bad the Bill is, but we need to think carefully about the practicality of banning things. I am concerned about small shops, not so much about the trade they might lose, even though that is a factor, but the reality out there. Too often, we in Parliament try to create a nirvana but do not look at the real world. I had a decorator a few years ago and, every day on the way to my place, he was buying illicit cigarettes. He said that, on his route through the Medway towns, he knew of four shops where there were illicit cigarettes under the counter. Where is HMRC? Where are trading standards? I knew where this was going on; I even used to tell trading standards where they ought to be looking, and there was the odd raid from time to time, but it still continues.

In the same breath in this legislation, we have some ridiculous statements about snus, a Scandinavian product that probably has its place in taking people out of smoking by an alternative supply of nicotine. We are seriously going to have potentially two years’ imprisonment for the selling of snus, yet while illicit cigarettes are banned, or just not legal to be sold, on every street in every town across this country we have illegal, illicit tobacco being sold. To then overlay further a load of new regulation, hoping that it will be enforced, is, frankly, for the birds.

I will take the whole moving-age argument a bit further. We discussed the ages of 31 and 30. I pay tribute to the noble Lord, Lord Scriven, for saying what he said, which was absolutely right. I take that a bit further. A 70 year-old and a 71 year-old are living next door. The 71 year-old is going to have a very busy shopping list when he pops down to the Co-op in 2080 when he is buying cigarettes for the 70 year-old. To think that the trader is having to ask for some sort of ID, from someone who is obviously of a reasonable age, to buy cigarettes is, frankly, lunacy. That is why I support the age limit of 21 in preference to doing nothing at all.

I also have some sympathy for Amendment 16 in the names of the noble Lord, Lord Parkinson, and the noble Baroness, Lady Fox. If we are seriously considering youngsters being able to vote at 16 then why not have 16, or whatever that voting age is, as a sensible measure for doing lots of things? We do not think that 16 year-olds should be using a sunbed, but we suddenly think they should be voting.

I know that this measure was introduced, or thought about, by the outgoing Government and the previous Prime Minister, Rishi Sunak; we had discussions about this very Bill when he came to visit me in—in hospital. I nearly said “in prison”; it felt like that after six months. I gave my thoughts to him quite graphically: “Yes, it begins with a B, Prime Minister”.

There is an international dimension to this, which has been picked up on by a few speakers this afternoon. What will we do with Easyjet when you have the 18 year-old traveller coming back from Malaga or Majorca? I can only imagine, because they will be in international airspace, their complete ability to buy a carton of cigarettes on Easyjet or Ryanair or whatever other plane they are coming on, or at Malaga airport or at Dubai Airport. They will be able to bring them into the country and smoke them.

What will we do about the very real, seemingly invisible, border between the Republic of Ireland and Northern Ireland that has been discussed by my noble friend Lord Murray? Will the 18 year-olds living just over the border in Northern Ireland hop over to the tobacconist, literally just over the border, to satisfy their wishes? This just becomes within the realms of lunacy.

We have to look at what has happened elsewhere in the world. In Australia, we have seen an explosion of turf wars and an increase in illicit tobacco. There are two “illicits”: there is completely made-up tobacco, which is potentially truly dangerous, or the merely untaxed tobacco that has been imported to the UK but is the genuine product. There is huge money involved, and wherever there is big money there are turf wars, violence and problems.

It is too late to stop this legislation. I think it is daft, and we really should be addressing more pressing issues in this nation. The age limit of 21 is at least enforceable and has clarity. I have every confidence that the years of smoking in this country, because of the measures of education, peer pressure and the way we are not allowed to smoke in pubs, are being reduced almost to single figures and a diminishing number. On that basis, my noble friend Lord Murray and those amendments have my full support.

Terminally Ill Adults (End of Life) Bill

Lord Mackinlay of Richborough Excerpts

2nd reading
Friday 19th September 2025 Lords Chamber

[Lord Mackinlay of Richborough (Con)]

My Lords, I will present five bases of rejection to the Bill. The first is the evolution of the Bill in the other place, which we can hardly call Parliament at its best. It was deemed to be a Private Member’s Bill, but I am sorry to say that I think we are being fooled here; it is quite obviously a government Bill in disguise. The noble and learned Lord, Lord Falconer of Thoroton, indicated this last week in his fine speech, when he referred to the Civil Service assistance he had had to date, which is more than unusual for any Private Member’s Bill.

From the start, Committee in the other place was stilted in its composition, and many respected institutions that will be operating in the space of the Bill were denied their opportunity for input. What worried me more than anything else were the joyous, tear-flecked celebrations by some parliamentarians of the passing of the Bill in the Commons; it is a Bill of death. I found that quite bizarre and chilling. I should not be surprised, however, as many of the same people are jubilant about the opportunity to home-conduct abortions up to full term without sanction. I celebrate life rather than death.

The Bill as originally drafted had 16 Henry VIII clauses; that has now grown to 42, including many that will allow ministerial powers and secondary legislation to create criminal sanctions. Noble Lords will be aware that this is just not right in legislation; this should not happen without great cause, to create criminal sanctions by secondary legislation. It is usually widely condemned.

My second objection is the reality of what we have seen in other jurisdictions, where we have seen a loosening throughout—whether that be in Australia, Canada or most certainly Belgium. The noble and learned Lord, Lord Falconer, predicted last week that only 1% of deaths would be through legalised suicide within 10 years. That does not fit very well with Australia’s 3% and Canada’s just under 5%. In all jurisdictions, “I don’t want to be a burden” has become bigger and bigger. In Belgium, children as young as nine are being euthanised under similar legislation—let me repeat that: in Belgium, children aged nine are being euthanised. I have grave concerns about the human rights industry in this country, where whatever happens in Parliament gets overturned through judicial activism. I am absolutely sure that this would be watered down to death on the state on demand in due course. That is my great fear.

My third grave concern is inheritance. I am professionally trained and licensed to do probate work through the Institute of Chartered Accountants; believe me, post-death battles over inheritance can get very ugly. I am fearful of the coercion of the elderly and the vulnerable. It is so obvious.

Fourthly, I am worried about the six-month time limit. We have a similar thing in the DWP for end-of-life PIP, where you have to have an assessment that you may live for only up to 12 months. The reality is very different: the average is over two years, and very commonly people live for three when the assessment was just a year. Are we really going to terminate lives earlier than may be the case? The noble Lord, Lord Forsyth of Drumlean, gave a fine speech last week: a personal account of his father. What he is looking for, and what I would be looking for, is that very end-of-life solution where things can be put right, the making a person comfortable, that we know happens, sort of, today. If that is the bit that needs codification into legislation, that is fine; we should be considering that.

Fifthly and finally, I am concerned that we want to embed an option for death within the NHS, where its modus operandi should be for life and for doing its bit, obviously, when palliative care is needed. To have this as an option is very dangerous. I would like to see—if we have to have this at all—a separation, because unfortunately the NHS would have skin in the game in terms of costs and staff problems. This is an unwholesome Bill, and I will oppose it.

Prosthetics for Amputees

Lord Mackinlay of Richborough Excerpts

Thursday 1st May 2025 Grand Committee

Asked by

[Lord Mackinlay of Richborough]

To ask His Majesty’s Government what steps they are taking to ensure that amputees receive appropriate prosthetics at an appropriate time.

[Lord Mackinlay of Richborough (Con)]

My Lords, I have declarations to make. These are TASKA hands, and they are on long-term loan from Steeper Group. Similar, Steeper Group paid for me to attend a prosthetics conference in France just a couple of weeks ago. As ever, we owe thanks to our library facilities—both the House of Commons Library and, this time, the House of Lords Library, which provided some data for this debate.

Some 55,000 to 60,000 people attending UK clinics have some form of limb loss. We are not entirely sure of the figure. The NHS is a great organisation for collecting a lot of data, but it has not quite managed to collect the data on why people have lost their limbs, which is a little remarkable. There are a number of reasons why people may not be fully limbed or may have suffered limb loss after they were born. There are congenital reasons, obviously: people may not have fully functioning limbs. Indeed, not having limbs at all can be a feature. The examples of limb loss that we are more familiar with, of course, are those caused by trauma, such as car accidents or injuries at work.

I always ask why Leeds seem to be a centre for the whole prosthetic and limb loss industry, if there is such a thing. Leeds hospital is at the forefront of hand transplants. Of course, that is because of the industrial past of that part of the world; we may have a greater population in the south-east, but we do not have those types of industrial accident at quite the same level.

Of course, we see a huge expansion in limb loss during wartime. We saw that during the Afghan and Iraqi wars, with IEDs and mines, which are certainly good at one thing: taking limbs off very effectively. The Ukraine war, though, has come up with some new reasons for limb loss. Some 80,000 soldiers in Ukraine have lost limbs—one can only guess that, in Russia, it is a similar amount—but there is a new dynamic of antimicrobial resistance. If you get a limb injury, it should not kill you; it should just pass. However, because we have an increased amount of resistance, that can lead to limb damage and loss. Then there is the use of field tourniquets, where the urgent decision of saving life, not limbs, is taken; the limbs then die and have to be taken off.

The classic cause is diabetes; it is one of the main reasons for limb loss. When I was in my clinic, the amputee rehabilitation unit just over the river in Kennington, the classic example was that of older men who had lost limbs to diabetes—not living as well as they should, shall we say. You can also lose limbs with cancer.

However, the cause that is of great interest to me is sepsis. The trouble with sepsis is that you often lose limbs in pairs. You do not lose just one: both go at once, whether that is two legs or two arms. If you are really lucky and get the quad, you lose all four, like me. The provision of legs is somewhat easier. I am very lucky in that mine were lost below the knee, so I have knees; that makes life incredibly different. The NHS has been good at bringing forward microprocessor-controlled prosthetic knees, which are known as MPKs. They have been widely provided for some years, and people get on well with them. They have become standard kit.

So NHS provision, particularly on legs, is okay once it is on track. However, it is one of extreme delay. I can tell you the story of the legs that I am on. They are private legs. Thankfully, I have been able to get them. I am 10 months on from a cast and still have not got a leg that fits on the NHS. If I had not been able to get these privately, I would have been in a wheelchair for the last 10 months, with mental health issues, unable to go to work and probably suffering severe muscle wasting.

We have a problem in our clinics. The age profile is poor; it is old. It is not an industry that youngsters feel enthused to enter. The pay is not great, and although it may not be much more, if any more, in the private sector, that sector is growing and there is a feeling there of greater reward, greater ability to do your craft and better morale.

We have university provision for prosthetics. The two primary ones are those in Salford and Strathclyde. Within clinics that I have been to there has often been someone shadowing from their university course. However, the drop-out rates are appalling. We can look even further to the technicians, who make the sockets. It is all very well having a great prosthetist for the mould, but you need a technician. The drop-out rate there is even worse and the pay truly dire—often little better than minimum wage. As a country, we concern ourselves with how NHS provision is, particularly regarding our nurses. We have done a lot to try to improve nurse morale and nurse pay, but we have not had that same focus on the problems facing prosthetists and technicians.

This country used to have transferrable old skills. I come from north Kent and the Medway towns. I attend the Medway NHS clinic. In days of old, you would have had those transferrable skills from, say, the dockyard, which closed in 1983. In fact, they would have been greater skills of knocking stuff up in fibreglass, wood and whatever else. This would have also been true in parts of the country with car industries that have, perhaps, now gone. Those craft industries were very good at providing technicians for making prosthetics, but those days are gone.

Noble Lords can imagine my frustration that we still use those old ways, which work, of a plaster cast that is prised off and manufactured manually by a skilled artisan, yet we are short of those skilled artisans. Staff are the limitation. I hear all the time, “We’re short of staff”. There are new CAD techniques to direct 3D printing. I talk to various private companies that do NHS provision, such as Steeper Group, which I mentioned, and which is supporting me. Opcare is another. Those companies are still using those old techniques. I am trying to encourage them, if they have a shortage of people, to take people out of the system as far as they can.

If you lose one arm, you might get away with it. However, you could call losing two something of a catastrophe. I am a quadruple amputee. My worry is that we will see more people like me. My sepsis was very severe, and I was lucky to live, but years ago, if you had severe sepsis, you would simply have died. Now, with a greater understanding, greater knowledge and better drugs, you will get survivors, in states such as mine or that are even worse, yet the system is not preparing itself for keeping people alive. If you are going to keep people alive, let us try to get them on a pathway to recovery.

My experience of upper limbs is really poor. In the brief time I have, I will tell the Committee the story. One is that I was given a pair of what I can only call William the Conqueror-designed arms, with a rubber end. If you have one arm, you might get away with it, but being given two of those was the lowest part of my rehabilitation. You are then told, “Within a few months we might think about body-powered hooks”, which are straps around your shoulders—I would not be able to put them on by myself, of course, as I have two limbs missing—and you use your shoulder to open and close them. They are circa 1790. You then progress to a 1950s-style myoelectric. You have to use that for a year before you can be considered for what I have now, which people with two arms missing need at the earliest possible stage.

We have to go through those hoops. Those early hoops are paid for by the local NHS trust; my hands are paid for by NHS England. My experience was to attempt to make a discretionary appeal, as my condition is as bad as it is, to NHS England. It said, “After 10 months of trials, surely we can just get going with NHS-provided multifunctional hands”. The answer from NHS England was no, so I am very pleased to see the end of NHS England because we have to do better.

I have a final few words. If you go into A&E with a wound on your arm, the staff do not reach for a 1920s hot bread poultice; they give you up-to-date drugs, topical solutions and antibiotics. So please stop giving out pre-Victorian prosthetics.