Cigarette Packaging

Lord Foulkes of Cumnock Excerpts

Thursday 25th July 2013 Lords Chamber

[Earl Howe]

I can give the noble Baroness that assurance. She will know from her time in government how seriously the Department of Health takes its obligations in this area, not least around transparency but also minimising the extent to which officials meet representatives of the tobacco industry. I am sure that my colleagues in other departments need no reminding of their obligations as well. We do of course interact with the tobacco industry, as the framework agreement allows, but we encourage those representations to be in writing and minimise face-to-face contact.

[Lord Foulkes of Cumnock]

My Lords, has the Minister seen reports that Downing Street said yesterday that Lynton Crosby advises on strategy, not on policy. What is the difference in relation to tobacco legislation?

[Earl Howe]

I am sure that we could get into an interesting conceptual discussion about the difference between strategy and policy. The key point is that Mr Crosby has been very clear in his public statement. He has said:

“At no time have I had any conversation or discussion with or lobbied the prime minister, or indeed the health secretary or the health minister, on plain packaging or tobacco issues”.

That is very clear.

Smoking: Cigarette Packaging

Lord Foulkes of Cumnock Excerpts

Tuesday 16th July 2013 Lords Chamber

[Lord Naseby]

May I—

[Lord Foulkes of Cumnock]

My Lords—

[The Chancellor of the Duchy of Lancaster (Lord Hill of Oareford)]

We will briefly hear from my noble friend and then go over to the other side.

[Earl Howe]

My Lords, smoking rates in the UK are lower than those in many comparable western societies, but our reductions in prevalence still lag behind those in countries such as Canada and the United States, and in some Australian states. Overall prevalence is gradually coming down, but we still need to worry about smoking take-up by the young. There is no doubt that smoking is a significant cause of health inequalities in the UK.

On illicit trade, the story is quite positive. In 2000 around 21% of the UK’s cigarette market was illicit, whereas the latest estimate from HMRC for 2010-11 is that around 9% of the cigarette market is illicit. That is too much; nevertheless, we are heading in the right direction.

[Lord Foulkes of Cumnock]

Does the Minister recall that when he was a shadow Minister opposing our legislation, he regularly met Gardant Communications on behalf of Philip Morris International? May I ask him very gently: who does he think had the greatest influence on this U-turn—his friends at Gardant or Lynton Crosby?

[Earl Howe]

My Lords, I have never adopted a personal position on plain packaging; the noble Lord is wrong about that. As an opposition spokesman, yes, I did make it my business to talk to all sectors—to the tobacco companies, to ASH and to other lobby groups—to make sure that the picture I presented from the Benches on which he now sits was a balanced one. I took no personal position, nor, indeed, a position on behalf of the Conservative Party; I need to make that very clear. The decision that the Government have taken has been in no way influenced by Mr Crosby.

Health: Midwives

Lord Foulkes of Cumnock Excerpts

Monday 10th June 2013 Lords Chamber

[Earl Howe]

My Lords, as my noble friend knows, work has been going on for a number of years, including going back to the previous Government, to see whether there are viable ways of ensuring that this small group of independent midwives can obtain suitable indemnity or insurance cover. One of the difficulties we have had is the absence of information on the potential barriers to independent midwives moving to alternative governance and delivery practices in order to obtain that cover—hence the consultation I have spoken about. As I said, we are now analysing the responses. However, I do not agree that there is no way through. We know that some independent practitioners have opted for a corporate or social enterprise model as a way of gaining insurance cover. We are trying to understand what the barriers are to that among those who are resisting the idea.

[Lord Foulkes of Cumnock]

My Lords, why cannot these people just get employment as midwives within the NHS?

[Earl Howe]

My Lords, some of them already do. As I understand it, we are talking about 154 individuals as compared with 41,000 midwives on the register. If they work for the NHS, there is generally no issue; they will be covered by NHS indemnity in one way or another. The issue is if they wish to practise privately as individuals. That is the point of my noble friend’s Question.

NHS: Private Companies

Lord Foulkes of Cumnock Excerpts

Monday 11th February 2013 Lords Chamber

[Earl Howe]

My noble friend is absolutely right. Various contracts have been criticised for being too long: PFI is perhaps a good example. Other types of contract have been criticised for being too short because they do not enable providers to invest on a sufficient timescale in order to be able confidently to bid for work. I have little doubt, once again, that this is an area that Monitor will look at and make recommendations upon.

[Lord Foulkes of Cumnock]

My Lords, will the Government consider requiring companies providing services in the NHS to pay their employees at the very least the national minimum wage and preferably a living wage?

[Earl Howe]

My Lords, the national minimum wage applies across all sectors and therefore all employers need to pay heed to that, including those in the healthcare sector.

Health: Obesity

Lord Foulkes of Cumnock Excerpts

Monday 12th November 2012 Lords Chamber

[Lord McColl of Dulwich]

My Lords—

[Lord Foulkes of Cumnock]

My Lords—

[Baroness Jolly]

My Lords—

--- Later in debate ---

[Earl Howe]

I congratulate my noble friend, as ever, on his powerful advocacy in this area. He is absolutely right that NICE recognises in its guideline that dietary management, including calorie intake, is of predominant importance in battling obesity. It does, however, recognise that exercise is important. It emphasises that although an individual’s ability to be physically active may be hampered by their level of fitness, recommendations can be built up gradually. It is a balance. NICE will continue to act as a source of advice for the medical profession. It is an independent organisation, as my noble friend understands, and Ministers consciously do not interfere with its operational integrity or independence. However, we expect it to take advice and evidence from a range of clinical sources.

[Lord Foulkes of Cumnock]

My Lords—

[Baroness Jolly]

My Lords—

[Lord McNally]

I suggest we hear from the noble Lord, Lord Foulkes.

[Lord Foulkes of Cumnock]

My Lords, I, too, have an interest to declare; I think it is fairly obvious if you look at me. That is why I want to ask a serious question of the Minister. Will he say to medical practitioners and others that it does not help to be critical and condemnatory of those of us who are obese? It is important to give information and encouragement. Otherwise, there can be complications and people can end up with depression and other illnesses, so it is very important to give encouragement. I am glad to say that that is why I have been able to lose more than a stone in the past month.

[Earl Howe]

Not for the first time, the noble Lord is an example to us all. I agree with the point he makes about the way in which doctors engage with their patients on this often sensitive subject. That is why the previous Government very commendably put in place a suite of resources to guide GPs in this area. Those have since been supplemented by electronic training modules on the identification and management of obesity and supporting behaviour change in patients. NICE has produced a clinical guideline to supplement its advice on obesity and exercise to guide clinicians on exactly how they approach this topic.

NHS: Health Tourism

Lord Foulkes of Cumnock Excerpts

Monday 28th May 2012 Lords Chamber

[Earl Howe]

The rules are complex, depending on whether the person is from the European Union, where certain rules apply, or from other parts of the world. There is no mandatory requirement for people to carry health insurance unless there is a transparent medical need when they enter the country. For example, a heavily pregnant woman might be asked to produce proof that she could pay for treatment if giving birth was likely. There are clear rules for NHS trusts where a patient who is chargeable presents. The trust must seek either to secure payment before treatment or to bill the person immediately afterwards.

[Lord Foulkes of Cumnock]

My Lords, in answer to the question asked by the noble Lord, Lord Roberts of Llandudno, the Minister rightly described the situation as it currently is. Is the Department of Health doing any study into the disaster that would happen in terms of healthcare between Scotland and England if Scotland were to separate from the rest of the United Kingdom? If it is not doing a study, why not?

[Earl Howe]

My Lords, were that situation to occur, the issues arising from it would be little different from the issues today in that health is already devolved. However, I cannot speculate on whether there would be a different policy on immigration in Scotland compared to south of the border as we are really not in that territory yet.

Health: Clinical Commissioning Groups

Lord Foulkes of Cumnock Excerpts

Thursday 26th April 2012 Lords Chamber

[Earl Howe]

The noble Baroness makes an extremely important point, which is why we have laid great stress on training and ensuring that the NHS Commissioning Board will develop appropriate guidance on procurement, avoiding conflicts of interests and avoiding unfair competition entering the arena.

[Lord Foulkes of Cumnock]

My Lords, what is the estimated extra cost of all this extra bureaucracy?

[Earl Howe]

My Lords, I do not accept that it is extra bureaucracy. Conflicts of interest arise in all walks of life and have to be managed. I do not think that issuing guidance represents extra bureaucracy.

National Institute for Health and Clinical Excellence

Lord Foulkes of Cumnock Excerpts

Wednesday 14th December 2011 Lords Chamber

[Earl Howe]

My Lords, part of the objective of the growth strategy is to break down some of the barriers that undoubtedly exist to pharmaceutical companies conducting clinical trials in this country. There have been unwelcome delays in the system and we are putting in place several measures to get rid of them, which in turn should encourage pharmaceutical companies to view the UK as the platform of choice for clinical research.

[Lord Foulkes of Cumnock]

My Lords, has the Minister thought—

Health: Funding

Lord Foulkes of Cumnock Excerpts

Tuesday 1st November 2011 Lords Chamber

[Lord Foulkes of Cumnock]

Did I catch the Minister’s first answer right—did he say that it would be the new head of commissioning who would have this responsibility? Am I right in saying that this is the professor who was described by MPs as not having the experience necessary and not understanding the job of head of commissioning, and who was only approved by the committee in the House of Commons on the casting vote of the chairman? Is this the guy who is going to be responsible?

[Earl Howe]

My Lords, the chief executive-designate of the NHS Commissioning Board is Sir David Nicholson, who is currently chief executive of the NHS. He is not the gentleman to whom the noble Lord referred. He currently runs the NHS. Professor Malcolm Grant, to whom I think the noble Lord was referring, will be chairman of the NHS Commissioning Board Authority, in a non-executive capacity.

Smoking

Lord Foulkes of Cumnock Excerpts

Thursday 8th September 2011 Lords Chamber

[Earl Howe]

My Lords, I did not see that report, but what the noble Lord says disturbs me. I think we all want to see an increase in adoption rates and we do not want to see potentially good adopters turned aside for what may appear to be trivial reasons.

[Lord Foulkes of Cumnock]

My Lords, I moved Private Member’s legislation in the other place in the early 1980s and got nowhere on it. Only when legislation was moved was there a real reduction—a complete ban—on smoking in public places and only through legislation can effective action be achieved. Is it not also the case that smokers lighting up cigarettes in cars are dangerous in terms of road safety? That is an extra reason for doing it. Will the Minister therefore stop pussy-footing around and saying that this can be achieved voluntarily, when we all know that it can only really, successfully and effectively, be achieved through legislation?

[Earl Howe]

My Lords, I do not agree with the noble Lord’s analysis. It is true that, on current evidence, the legislation is having a beneficial effect; I would not dissent from that. However, we know that voluntary behaviour change is eminently possible. It would explain why, between 1996 and 2007 when the legislation came in, secondhand smoking exposure in children in England declined by 70 per cent. That was driven by not only the evidence but also awareness campaigns and increased awareness in the lead-up to the legislation. Therefore, voluntary action can have a beneficial and marked effect.