Tobacco and Vapes Bill

Lord Kamall Excerpts

Consideration of Commons amendments and / or reasons
Monday 20th April 2026 Lords Chamber

[Lord Naseby (Con)]

My Lords, I understand the background, having been involved in the early stages of the Bill. Nevertheless, it upsets a great many people in that industry that the Government have not listened to the strong representations of the retailers and those who have knowledge of the industry. We have a situation now where we have a £200 penalty, which is huge by any yardstick, for the revised incidences. We are expecting a new Welsh Government fairly soon, and they may not be too happy with what has now been amended. However, I will say no more than that I think the time will come when the present Government and—I am sorry to say—those on my own side who believe in this idea as a whole will accept that it is totally out of date in relation to what is happening in the world. What we really need is a proper understanding of how we educate people not to take up smoking.

[Lord Kamall (Con)]

My Lords, I should be clear that, given this Motion brings forward an amendment that corrects a technical error and the Government have explained their rationale, we will not oppose it.

[Baroness Merron (Lab)]

My Lords, I again thank your Lordships’ House for its attentive scrutiny throughout the passage of the Bill. I pay tribute to the Front Benches and to noble Lords on all sides of the House.

I say to the noble Lord, Lord Naseby, that, as I have explained and his own Front Bench has confirmed, these are purely technical amendments to make this area of the Bill workable. It is a matter that had much debate. I assure the noble Lord, as I have done on a number of occasions, that we have worked closely with retailers and will continue to do so. I appreciate that he is not a supporter of the Bill, and it is on that point that I differ with him.

I urge all noble Lords to accept these amendments and note that this afternoon marks the end of the Bill’s journey through Parliament. This is a landmark Bill that will create a smoke-free generation, and it will be the biggest public health intervention in a generation. I assure all noble Lords that it will save lives. I commend it to the House.

NHS Adult Gender Identity Clinics

Lord Kamall Excerpts

Wednesday 15th April 2026 Lords Chamber

[Baroness Merron (Lab)]

It might be helpful if I speak in general terms. The Levy review highlighted multi-year waits for adult gender clinics. We recognise that waiting times are too long, and that is why we have increased the number of adult gender services from seven to 12 and we will be establishing a national waiting list. Dr Levy’s report did not make specific reference to concerns about safeguarding, and it is important to see it in that context. I emphasise once again that, where there are additional safeguarding matters, they will be dealt with on an individual basis as is right and proper.

[Lord Kamall (Con)]

My Lords, this is a highly sensitive topic, and I think we have to be very careful about how we talk about it. Evidence published in the BMJ shows a fiftyfold increase in recorded cases of gender dysphoria among children and young people between 2011 and 2021. While we should show compassion and not generalise about individuals presenting with gender dysphoria, what assessment has the Minister’s department made of the drivers for this rise in presentations? It is a sensitive issue, as I said, but are the Government assured that there are sufficient safeguards in place to ensure that the most vulnerable young adults are not irreversibly medicalised, only for some, even if just a small number, to regret it later?

[Baroness Merron (Lab)]

The noble Lord makes a number of points. Let me be quite clear that surgical interventions are only for adults—that is for those aged 18 and over. As I said in my answer to the noble Baroness, Lady Maclean, I also refer to the fact that the strong safeguards in place include, among a whole range of others, specialist assessment, access to a multidisciplinary team and assessment of capacity. These are strong safeguards, and it is right that this is the case in order to support patients to get the care that is appropriate to them and which they need.

Health and Social Care Act 2008 (Regulated Activities) (Amendment) Regulations 2026

Lord Kamall Excerpts

Wednesday 15th April 2026 Grand Committee

[Lord Addington (LD)]

My Lords, this is one of those debates where you think, “Who do I disagree with?” I am afraid that I have not disagreed with anything from anybody. As I speak for my party, it is important for me to restate that things went wrong with the treatment of the Manchester Arena disaster. We should do something about it—that would be great.

The problem here is that we seem to have gone far too wide. As the noble Baroness, Lady Finlay, asked, how far down do you go when covering an event? For instance, for small rugby union clubs—my own sporting background—you are lucky if there are three men and a dog watching. That is your crowd, but a local cup game could have a couple of thousand. Where does that support structure kick in? That is something that all amateur sport will confront from time to time. This is merely the first opportunity for the Minister to correct these perceptions. We need to have some cut-off points, going from when it is enough simply to have a first-aider within earshot to when we need better medical support and structure. When that changes and how they interact is really what the discussion here is about.

When it comes to sport, please let us not do anything that stops sporting events happening. There is a fear that we will do so inadvertently by providing a greater bureaucratic burden on providing help. We hope that the Government will not do that. I hope that the Department of Health will not do something that will make the country intrinsically less healthy. That is really what we are looking at.

Let us look at other specialist events. This is not an interest, but I live in the village of Lambourn so, even if I did not want to be, I am very aware of things to do with equestrian sport and particularly races. Anything to do with horses is intrinsically dangerous; indeed, we have a rehabilitation centre for neck and back injuries in Lambourn. When it comes to racing, as my wife has often pointed out to me, there are not many events when an ambulance follows you down the course as you are taking part—so there are structures there. If something that organised is raising concerns—it is not because they want it to be there but because it has to be there—there might well be something worth listening to. We must make sure, when we deliver this, that we do not throw the baby out with the bathwater and that good intentions are erased out. We should go through all those things.

The Government need to start doing something to get better information out there about exactly what they are doing, where the barriers are and what will happen. A series of meetings might help—possibly with parliamentarians and certainly with larger groups—and they should get the information out quickly. It will dramatically help to let the information out in dribs and drabs—as and when they see fit as they go forward—setting out their intentions, and we will bring in stuff behind it. That way, if there is a real fault-line here, as opposed to a fear of one, we will find out. Then we can start to do something about it.

Can the Government give us something that reassures us on our worries about the extra bureaucratic burden, given that people are terrified? They are one newspaper report and a few tweets away from people having a panic about everybody being sued every time anybody gets cuts in an amateur football game. What are they doing? Where are the structures going? That is what is required here.

We all want the big events to be safer, but they will have got it wrong if they apply this to an open mic night at a pub and a Sunday league football game at the same time. We must make sure that people know where those fault-lines are. The exemption for people taking part in sports events is a no-brainer. Can we make sure that this happens and that people know about it? It is clear that they do not, at the moment, and that is a fundamental flaw in the Government’s approach.

[Lord Kamall (Con)]

My Lords, as other noble Lords were declaring their interests, I thought, “Oh, that’s good; I have no relevant interests”. But, the last time I thought that, a number of people tweeted at me for not declaring my interests, so I will bore all noble Lords with them. I am a professor of politics and international relations at St Mary’s University, Twickenham. I teach an MBA module on healthcare policy and strategy. I also work with the medical school that it is starting and have started co-operating with colleagues in the Faculty of Sport, Technology and Health Sciences. I also teach at the University of Buckingham, but I have no contact with its medical school. I just wanted to touch all the bases.

I thank the Minister for setting out these draft regulations in her usual clear manner. Obviously, they arise from the tragic events of the Manchester Arena attack and the subsequent inquiry. Like other noble Lords, my heart goes out to those who were affected; we offer our condolences to the victims and their families, some of whom are probably still in a state of bereavement. Clearly, that inquiry called for a review of healthcare provision at events, as well as clearer standards for public safety, which I think everyone who has spoken is in favour of.

Most of the people who have contacted us said that they support the principle that those attending sporting and cultural events should have access to safe, high-quality medical care—there is no disagreement there—but the question before your Lordships is one not of principle but of implementation and delivery. It is right, therefore, that the detail be scrutinised carefully.

In removing the previous exemption and requiring providers of event healthcare to register with the CQC, the SI clearly extends the CQC’s regulatory remit to a sector that is complex and, in many cases, heavily reliant on volunteers and small providers. You cannot just transplant knowledge from the hospital or mental health sectors into sports events; noble Lords have referred to the range of events that would be covered. This removal, while understandable, has given rise a number of concerns—I am sure that the Minister has heard them—among, but not limited to, small organisations and volunteer-run sports clubs. Like the noble Lord, Lord Addington, I share the concerns of the noble Lords on different Benches who have spoken. There is no disagreement here.

The department’s own impact assessment acknowledges the increased costs associated with registration and ongoing compliance, but one of my concerns arose when I saw the estimate for the registration fee. It said that, for newly regulated providers, it will be between—

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[Lord Kamall (Con)]

A number of noble Lords have raised concerns, and I am going just to outline or repeat a few of them. The first is that the department’s own assessment acknowledges that the costs associated with registration and ongoing compliance are estimated, for newly regulated providers, as being between £99,400 and £994,000 per annum. They are quite accurate figures, but let me rephrase that: it could be nearly £100,000 or nearly £1 million. We know that most forecasts are wrong, but a factor of 10 is rather a wide range. I have to admit that that raises concerns about the understanding of these regulations.

But more concerning is the evidence from the Faculty of Sport and Exercise Medicine suggesting that many clinicians working in event medicine may reconsider their involvement if these regulations are implemented as proposed—as the noble Baroness, Lady Grey-Thompson, raised. As other noble Lords have said, events medical providers support the principle of these regulations but warn that they could lead to a reduction in workforce capacity, with the potential unintended consequence of reducing safety. My noble friend Lord Herbert referred to that unintended consequence.

There are also concerns that, where providers withdraw from delivering this regulated medical care, events may instead have to rely on first aid provision, as we have heard from a number of noble Lords. That falls outside the scope of CQC regulation. Well-run events such as Wimbledon, Royal Ascot, the Silverstone Grand Prix and the Glastonbury Festival currently manage most medical incidents on-site. But we could see a shift away from properly staffed medical provision, which risks increasing demand on already stretched NHS services off-site.

Stakeholders, including the Sport and Recreation Alliance, have highlighted a lack of comprehensive engagement with the sector to date. Given the unique characteristics of event medicine, it is essential that any regulatory framework be developed in close consultation with those who deliver care on the ground. However, I have been told by some medical professionals that the CQC is being selective in who it wants. I was told a similar story to that told to my noble friend Lord Markham: when three or four CMOs asked for a joint meeting, the CQC person refused and insisted that they wanted to meet only one of the CMOs. When I hear this, frankly, it gives me no confidence in the CQC or its consultation process. Let me be clear: I do not use those words lightly, but the CQC should be doing proper consultation and not refusing meetings.

I recognise the efforts by the previous and the current Government and the CQC to fix its previously poor reputation. Last year, in the mental health debates, these Benches supported the Government in resisting the appointment of a separate mental health commissioner, because we agreed that the mental health part of the CQC was getting its house in order. Indeed, I met today with some people from the CQC on transitional care, and I was very impressed with them.

However, when I am told that for this regulation the CQC suggested that an additional 36 organisations would require registration, compared to an estimated 25,000 in the survey by the Faculty of Sport and Exercise Medicine, this, as my noble friends Lord Lansley and Lord Markham, and the noble Baroness, Lady Grey- Thompson, said, demonstrates a massive gap in understanding that needs to be addressed. Once again, I am sorry when I say this, but it gives the impression of the CQC being out of its depth.

I am sorry if that is not exactly the ringing endorsement that the Minister was hoping for, but I also know that she has been willing in the past to meet to discuss legislation, and we have worked constructively together in the time we have both been on our respective Front Benches. So, in that constructive spirit, I will make three suggestions, which in fact touch upon those that that were made by other noble Lords.

First, we need to see meaningful CQC engagement with sector representatives, our national governing boards, the chief medical officers in sports groups, the Faculty of Sport and Exercise Medicine and the Faculty of Pre-Hospital Care to ensure that any inspection framework is sector-specific and not simply lifted from the hospital sector. Imposing a CQC regulatory framework suitable for hospitals is inappropriate for pop-up clinics at park runs, cycle races or pitch-side at rugby. Let us be frank: the CQC does not have any existing knowledge of working in these sectors at that level, and it should be listening rather than seeking to impose.

Secondly, we should consider expanding the current employer/employee CQC exemption to athletes, performers and officials whose healthcare providers meet strict occupational health standards regardless of the patient’s contractual arrangement, as other noble Lords suggested.

Thirdly, although I understand that the Secondary Legislation Scrutiny Committee has raised concerns about the time taken to bring forward these regulations, given that the CQC is not exactly inspiring confidence from those who organise sports and other events, could the Government possibly ask the CQC to wait until the event healthcare standard being led by the Faculty of Pre-Hospital Care has been published? In addition, if and when it becomes apparent that the CQC has indeed underestimated the size of this and the cost to the sector, would they be prepared to perhaps extend that December 27 deadline, if appropriate?

However, really to emphasise the point that the Government are listening, I know we have asked for individual meetings, but a much better suggestion would be a round table with interested noble Lords, with the relevant Minister from the department—obviously we would love to have the noble Baroness, Lady Merron, there as we always enjoy her consultations— and the CQC, so it can stop being selective about who it speaks with and can actually listen to CMOs and other medical experts from across the sector. They are not doing this to score points; none of us is doing this for that reason. We agree with the principle, and we want this to work, whichever party and whichever Bench we work on, but we are concerned that the CQC’s approach will lead to the unintended consequence of the withdrawal of appropriate medical provision at these services.

It is quite clear that all noble Lords support the goal of improving public safety at events. All noble Lords have heard the concerns from public events medical experts, and all noble Lords hope that the Minister has listened to their concerns and will agree to the modest requests they have made in today’s debate.

[Baroness Merron (Lab)]

My Lords, I am most grateful for the debate today. I will make a few general points.

I very much welcome the points and the concerns that noble Lords have been willing to outline. I also want to acknowledge that I have heard the understanding of why we are doing this. I know that we all understand the intent, and I understand the numerous questions— I make that as a comment, not as any criticism—trying to understand the workability. I very much welcome them. What I take from this debate and what I will share with Minister Ahmed as the Minister for Patient Safety is that clearly there is considerable concern. To refer to what the noble Lord, Lord Addington, said about fault lines, I think this is about fear of fault lines, but even fear of fault lines is fear enough, so I absolutely take that point.

Let me say at the outset that, if noble Lords had not asked for it, I would have suggested having a round table for interested Peers. It will indeed include officials from the department and the CQC. Ministerially, because it is Peers, I would want to be there in any case. I am sure that Minister Ahmed would want to be there too, but my anxiety is to get on with the meeting, so I will happily have a discussion with him, but I certainly want to be there. If noble Lords remain concerned about a lot of the points, we can tease them out there.

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[Lord Kamall (Con)]

I can add to that. What is the process for notifying those who will come under this regulation? That would be helpful to know as well.

[Baroness Finlay of Llandaff (CB)]

If I may add to the list of questions, I think it might be helpful for the Minister to explain how the decisions over the size relate to the Purple Guide that the Health and Safety Executive produced, because I understand from page 114 of volume 2 of the Manchester Arena inquiry report that the Purple Guide for an event of that size set things out quite clearly, but was not adhered to at all. I have a slight concern from the responses that we have had that we may have two completely separate things going on. The Minister may not be able to answer that now, but it would be helpful in this meeting that we are all anticipating if there is a cross-reference to the Purple Guide and if the discussions could include how that would impact and be used by the CQC in regulating.

Migraine Care: 10-year Health Plan

Lord Kamall Excerpts

Monday 23rd March 2026 Lords Chamber

[Baroness Merron (Lab)]

As I know my noble friend is well aware, the eligibility criteria are set independently by NICE. They are based on clinical evidence and cost-effectiveness, rather than being set by Ministers. However, it is worth saying that the introduction of oral CGRPs, which do not require specialist initiation, will significantly widen access through primary care and reduce the bottlenecks in the system. We are very keen that people can access effective drugs, and I take on board the point my noble friend made.

[Lord Kamall (Con)]

My Lords, I thank the noble Lord for the Question, because although many people think that migraines are just bad headaches, they are in fact a distinct, complex neurological condition. They are responsible for 43 million lost working days each year and are estimated to cost the UK economy up to £4.4 billion. The Minister rightly talked about calcitonin gene-related peptide therapies, but apparently only about 29% of trusts allow access to CGRPs. I welcome what the Minister said about increased access via primary care, but I note that these drugs prevent migraines by targeting a molecule involved in pain transmission. What specific steps is the Minister’s department taking to increase access to these treatments in addition to the primary care initiatives?

[Baroness Merron (Lab)]

We very much recognise the concerns that people may face unnecessary hurdles when trying to access CGRP treatments. NHS England is working with integrated care boards to ensure that the pathways being followed are consistent and timely. It would perhaps be helpful for me to mention some of the national tools, such as NHS RightCare’s headache and migraine toolkit and the Getting It Right First Time recommendations; they also speak to the clearer referral rates that the noble Lord called for and reduce variation. We want people to receive appropriate treatments; we do not want them to be delayed.

Unpaid Carers: Patient Hospital Discharge

Lord Kamall Excerpts

Thursday 19th March 2026 Lords Chamber

[Baroness Merron (Lab)]

My noble friend makes exactly the right points. We certainly recognise the vital role that unpaid carers play in supporting those who are to be discharged. Decisions about staffing and the approach—I emphasise that a multidisciplinary approach is clearly needed here—are a matter for local areas, but I can say in addition that there is a regular cross-government meeting, which is really important when it comes to joining up the approach, that looks at providing unpaid carers with the recognition and support that they need, as my noble friend said. We are also working towards publishing a cross-government action plan later this year. So in this area, including the LGA work, the kind of approach that my noble friend talks about will certainly be considered.

[Lord Kamall (Con)]

My Lords, I thank the noble Baroness, Lady Pitkeathley, for being a tireless champion of unpaid carers over many years and successive Governments. She quite rightly pointed out that Carers UK found that only 14% of unpaid carers were asked about their ability and willingness to provide care before hospital discharge. I want to follow up on the previous question from the noble Baroness, Lady Andrews. One of the problems faced by successive Governments is that trusts and what were previously CCGs and are now ICBs are very bad at learning from other parts of the system that do things well. For example, Northumbria has been known to have a really good discharge system: it embeds co-ordinators and works out how to get that discharge going. How can the Minister’s department improve learning across the system where there is good practice, take that best practice and appropriately transplant it into other areas so that we can really tackle this problem once and for all?

[Baroness Merron (Lab)]

The whole system needs to do better, as the noble Lord outlines. It will be helpful that we are also looking at commissioning research in this area to look at best practice, as well as barriers and solutions, regarding the involvement of unpaid carers—I think that has been somewhat overlooked, if I am to be honest with your Lordships’ House. We have regional teams that have issued very practical toolkits to help hospitals implement their legal duties; we should remember that there are legal duties in this response. In addition, that is why we are involving the LGA’s better care fund support programme, as I said, as well as seeking to publish a cross-government action plan. These will be steps in the right direction, but I very much acknowledge that we do not start in a good place.

GP Contract

Lord Kamall Excerpts

Tuesday 17th March 2026 Lords Chamber

These ideas were not cooked up by someone sat behind a desk in Whitehall. What is happening is that we are taking the best of the NHS to the rest of the NHS, working with pioneering practices that have been doing these things for a long time. Today we can see that our policies are working, and after years of decline in general practice, we are getting the front door back on its hinges. Patient satisfaction with general practice is finally moving in the right direction. According to the Office for National Statistics, almost 77% of people described contacting their GP as easy in January this year, up from just 60%, where it was languishing in July 2024. I know that when he gets up, the honourable Member for Hinckley and Bosworth, Dr Evans, will hugely welcome, as will his honourable friends, the progress that we are making”.

[Lord Kamall (Con)]

My Lords, I am grateful to the Government for this repeat. The Minister in the other place pointed to 1.3 million referrals being diverted through something called “advice and guidance”. This means that GPs must seek input from a specialist before making a referral, but some professional bodies have warned that this mandatory approach will risk creating barriers to patients accessing specialist care and may compromise patients’ safety if they are not referred in a timely manner. To address these concerns, can the Minister set out what clinical safeguards are in place where a GP believes a patient needs to be referred directly to a specialist but is instead referred to go through this advice and guidance process? If a patient comes to harm as a result of any delay due to not being referred directly to a specialist, who will bear responsibility for that decision and how will accountability be determined?

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

As the noble Lord said, we have seen 1.3 million people diverted since April 2025. Otherwise, they would have been added to the electives waiting list, in clinical terms, unnecessarily. The main thing I can say to the noble Lord on advice and guidance is that I think the figures speak for themselves. That is why we are embedding it into the core contract. We are recognising it as routine practice. It provides more predictable funding and removes annual sign-ups. More generally, I must emphasise to the noble Lord that it does not take away a GP’s right to refer. That remains a matter of clinical judgment and, as in all things, clinical judgment will rule the day.

NHS: In-house Software Capabilities

Lord Kamall Excerpts

Monday 16th March 2026 Lords Chamber

[Baroness Merron (Lab)]

Cyber attacks across our whole government are extremely concerning, and that is why we have built resilience. On health and social care specifically, I can assure the noble Lord that, in 2025-26, we invested £75 million across health and social care; that built on the £375 million invested since 2017. When I had responsibility for the blood transfusion service, my own experience was that, where there was a cyber attack, we had the systems in place.

[Lord Kamall (Con)]

My Lords, there is always a very difficult balance between keeping something in-house or outsourcing it, and we should not forget the national programme for IT in the NHS in the early 2000s, which ended up costing between £10 billion and £20 billion. My question is on the company Palantir. The Minister will be aware that there are a range of views on Palantir. Some say that it is the best software available and that no one can match it; others say that they are worried that it will lock the NHS in long-term and scrape data for other uses. What specific measures have NHS England and the department put in place so that, in the event that the Palantir contract is not renewed, the healthcare system will be able to move seamlessly to another supplier?

[Baroness Merron (Lab)]

That seamless movement is an important point generally, but the federated data platform does not centralise or sell patient data. Data remains firmly under NHS control, and access is strictly governed. It is fully auditable and used only for approved patient benefit and NHS benefit. Palantir operates strictly under the instruction of NHS England and it does not, as I said, own or control NHS data. That access is tightly governed. In response to the earlier question, I note that the federated data platform to which the noble Lord refers is cyber resilient and subject to rigorous contractual, legal and information governance controls.

NHS: Heart Valve Disease

Lord Kamall Excerpts

Thursday 12th March 2026 Lords Chamber

[Baroness Merron (Lab)]

The noble Lord is right to make the point that innovation research is one part of it, but it is actually its implementation that matters. However, the faster and more frequent detection of cardiovascular conditions is the key thing and training is certainly a part of that.

[Lord Kamall (Con)]

My Lords, I am grateful to the Minister for giving me time for this question. She will be aware that studies analysed in around 155,000 diagnoses of aortic stenosis in England have found that women were significantly less likely to be referred to specialists and far less likely to receive valve replacement. This also applies to patients from deprived areas and in some ethnic minority groups. What assessment have the Government made of these disparities and what action are the noble Baroness’s department and NHS England taking to ensure that patients have access to heart valve treatment regardless of their gender, ethnicity or where they live?

[Baroness Merron (Lab)]

The noble Lord is quite right: women are underdiagnosed, they are undertreated and some ethnic minority groups face poorer access. That is why I very much welcome the fact that, in the framework to which I referred, dealing with inequalities will be absolutely key. Research, in which we are partnering with the British Heart Foundation, will focus on tackling inequalities in higher-risk groups as well as unequal cardiovascular disease outcomes. Inequalities and tackling them will be at the heart of all our acceleration of progress as well as our research.

Tobacco and Vapes Bill

Lord Kamall Excerpts

3rd reading
Monday 9th March 2026 Lords Chamber

[Baroness Merron (Lab)]

My Lords, it has been a privilege to take this landmark Bill through your Lordships’ House. Smoking is the number one preventable cause of death, disability and ill health and tobacco claims around 80,000 lives every year. While tobacco remains the greatest threat, this legislation is about protecting future generations from the harms of not only tobacco but nicotine addiction.

I extend my thanks to noble Lords who have contributed from right across the House: in particular, on the Front Benches, the noble Lord, Lord Kamall, the noble Earls, Lord Howe and Lord Russell, and the noble Baroness, Lady Walmsley. My thanks go also to the Secretary of State for his leadership and support and to former Minister Ashley Dalton MP, who advanced this Bill to your Lordships’ House.

I also want to pay tribute, as many of us do, to former Prime Minister the right honourable Rishi Sunak for his ambition for a smoke-free generation. I also thank the Chief Medical Officer, Sir Chris Whitty, for his expertise and unwavering focus, and all the officials who have played a crucial role, including the Bill team, policy teams, analysts, the Bill’s senior responsible owners, my private office and the Government Legal Department and the Office of the Parliamentary Counsel for their invaluable contributions.

Finally, I pay tribute to Ministers and officials from the devolved Governments for their collaborative approach. This is genuinely a four-nations Bill which will ensure that we create a smoke-free generation and tackle youth vaping in every corner of our country. I beg to move.

[Lord Kamall (Con)]

My Lords, we have now reached the conclusion of what many will see as a landmark Bill. I thank all noble Lords who have contributed throughout the various stages of its journey through your Lordships’ House, which began with its introduction as long ago as March last year. From these and other Benches, we heard a range of views on its various proposals and on the Bill itself. For some, it goes too far. For others, it does not go far enough. However, among all the disagreements, there were three points that I think noble Lords can agree on. First, smoking is bad for your health. Secondly, current evidence shows that vaping is less harmful than smoking tobacco. Thirdly, not vaping is healthier than vaping.

Beyond that, our debates covered a number of issues, from the evidence base to how to make vapes an attractive alternative to adults who wish to quit smoking while not appealing to children, as well as matters of individual liberty. We also debated the illicit sale of tobacco, the treatment of specialist retailers, cigarette filters, the compatibility of the Bill with the Windsor Framework and the enforcement of a regulatory regime of considerable complexity. We also probed the Government on the evidence behind some of the proposals, for example on the relative harm of heated tobacco compared with combustible tobacco for smokers who have tried vapes but did not like them, so reverted to cigarettes.

While we did not always agree, I thank the Minister and her officials for meeting my noble friend Lord Howe and me throughout the passage of the Bill. I particularly thank her for the concessions made: we particularly welcome the amendment permitting vape vending machines in secure mental health settings. These are vulnerable people in restricted environments for whom access to cessation aids is not a luxury but a genuine health need and it was right that the Bill was amended accordingly.

Independent Commission on Adult Social Care

Lord Kamall Excerpts

Monday 9th March 2026 Lords Chamber

[Baroness Merron (Lab)]

Yes, indeed. We have three core foundations in place in our government objectives for adult social care, one of which is—to the point made by the noble Lord—strengthening the join-up between health services and social care services, because people need to experience more integrated, person-centred care. I am glad that the noble Lord welcomes the immediate actions, set out by the noble Baroness, Lady Casey, that the Government must take on adult safeguarding, dementia and motor neurone disease. We are not wasting any time in taking those recommendations forward.

[Lord Kamall (Con)]

My Lords, picking up on the points made by the noble Baroness, Lady Pitkeathley, and the noble Lords, Lord Young and Lord Laming, when we were in government, we published a White Paper on an integrated national health and care service, to be available for patients from birth to their later years. When the new Government were elected, as was their prerogative, the Secretary of State talked about creating a separate national care service, but we have heard little since. Can the Minister tell your Lordships’ House whether we will have to wait until the next stage of the Casey commission, in 2028, to get any further details at all, especially on how it will work in tandem with our healthcare system, or can we expect any clues or hints before then?

[Baroness Merron (Lab)]

The noble Lord does not have to wait because, in addition to the work by the noble Baroness, Lady Casey, which, as I have said, is independent, she has set out immediate recommendations, which we are working on. We have already made commitments on the disabled facilities grant for housing, so that people can stay in their own homes. We have announced a £500 million investment in the first ever fair pay agreement, and we are uplifting social care allowances to support disabled people more than they ever have been. Those are just some examples, and I would be very happy to direct the noble Lord to other ways in which we are already taking action.