Artificial Intelligence: Safeguarding

Lord Kamall Excerpts

Tuesday 4th November 2025 Lords Chamber

[Baroness Merron (Lab)]

My noble friend is right that this can be used for good or for ill. Of course, there are other comparisons to draw. My noble friend has not said this, but I want to make sure we keep away from the idea that AI services are escaping regulation. Many AI chatbots are certainly in scope of the Act. I also take the view that AI can actually assist us greatly in supporting those at risk and in improving health. We seek to harness that as we move from analogue to digital, as per our 10-year plan.

[Lord Kamall (Con)]

My Lords, I thank the noble Baroness, Lady Berger, for bringing up this issue and for making noble Lords aware of it. With evidence that people with mental health issues are increasingly turning to AI chatbots rather than to health providers, and rather than simply relying on the stick of the Online Safety Act, can the Minister explain what conversations her department, perhaps in conjunction with DSIT, is having with AI companies and with UKAI, the trade body, so they can come together to find a solution for safeguarding? As the noble Lord, Lord Scriven, and the noble Baroness, Lady Deech, have said, perhaps they could suggest how to deal with individuals in distress who go to these chatbots, to make sure they are signposted to appropriate services, rather than offered content that encourages them to take their own life.

[Baroness Merron (Lab)]

I certainly agree that this is the way we need to go, and discussions happen regularly with companies, as the noble Lord says. It is probably also worth saying that we have already seen some early signs of improvement in terms of protection for users from online harms, and over 6,000 services are implementing what we would regard as highly effective age assurance, which brings protection to millions of children. Of course, DSIT is monitoring and evaluating the Online Safety Act. Where evidence shows that further intervention is needed to protect children, we will not hesitate to act.

Tobacco and Vapes Bill

Lord Kamall Excerpts

Committee stage
Monday 3rd November 2025 Grand Committee

Moved by

[Lord Kamall]

32: Clause 16, page 9, line 23, at end insert—
“(5A) Draft regulations under this section must be published before the end of the period of six months from the passing of this Act.”

[Lord Kamall (Con)]

My Lords, in some ways this group will follow on from the last; some of the comments I will make now could be applied to the previous group of amendments.

Noble Lords will be aware that, as discussed in the previous group, the licensing regime the Bill sets out is complex. Many of the Bill’s provisions are yet to be determined in regulations, meaning that businesses across the country are faced with something they dread: uncertainty. Some retailers have told me they already see this on top of the double whammy of increases to employer national insurance contributions and the minimum wage, and they have had to face that doing business is more difficult, as is taking on new employees.

We all know that the large retailers have public affairs teams, legal teams and compliance teams, all helping them navigate the complexities of changes in legislation. For them, the sale of tobacco and tobacco products counts for a small proportion of their total revenue stream. However, the situation could be very different for small, family-run businesses, staffed by two, three or four people, often working from dawn to dusk—staffing the till and the counter, and sorting out bills and expenses. For many other people, just managing half this workload would be a good day’s work. Imagine, on top of all this, having to find the time to understand, and make changes to abide by, these new regulations.

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[Baroness in Waiting/Government Whip (Baroness Blake of Leeds) (Lab)]

My Lords, I thank noble Lords for the amendments in this group.

I note the comments from the noble Lord, Lord Kamall, that the noble Lord, Lord Mott, is not in his place to speak to his amendments, but I will just touch on them briefly, if I may. Basically, his amendments seek to require licensing regulations to be made within three months of the relevant provisions in the Bill coming into force. The amendments would also extend the existing retailer register in Northern Ireland. I emphasise that, of course, the Government share the noble Lord’s desire to move as quickly as possible to implement the licensing scheme. That is why we have recently launched the call for evidence on the range of issues that we have laid out, including questions on the design of the retail licensing scheme. The feedback received will be absolutely critical, and we want to get on and launch this as soon as possible. However, it is also important that the Government have sufficient time to ensure that the regulations are properly thought through. I hope that the noble Lord, Lord Mott, when he hears the discussion, will be reassured and understand that three months is not sufficient time to run a consultation, analyse the feedback received and prepare well-considered regulations. That is as much as I shall say on his amendments.

Turning to the amendments in the name of the noble Lord, Lord Kamall, I hope to give him the reassurance that he seeks, as we discussed in last week’s Committee, that I understand these particular concerns. His amendments would similarly require Ministers to publish draft regulations implementing a retail licensing scheme for England and Wales within six months of the Bill achieving Royal Assent.  The Government are committed to ensuring that those impacted by regulations and those with expertise have the opportunity to contribute their views. We want to minimise additional costs and burdens as far as possible, while ensuring that the scheme is a success and achieves our aims of supporting legitimate businesses as well as tackling those that disregard the law.  Again, the recently published call for evidence seeks input on a range of topics, including the implementation of the retail licensing scheme. As I have said, this will inform the consultation, which we will launch as soon as possible.

To respond directly to the noble Lord’s comments, our call for evidence also asks about the implementation of the scheme and how long will be required to implement the policy. We will, of course, work through the appropriate channels to ensure that businesses have the necessary guidance to implement the changes. I cannot emphasise enough that this is for all businesses, regardless of their size or the organisations that represent them. We want to make sure that we get that message out loud and clear, so that they have confidence that their views will be regarded with the same importance as all those who contribute to the policy.

I note the noble Baroness’s comments about making sure that we get this right, so we cannot be beholden to specific timeframes on the face of the Bill. We all acknowledge that this is a complex policy and, while we want to move swiftly, it is important that there is enough time to ensure that the policy is properly thought through before developing regulations. I repeat that requiring the Government to publish draft regulations before adequate consultation may risk creating a flawed policy. For the reasons that I have outlined, bringing together previous comments, I hope that the noble Lord will feel able to withdraw the amendment.

[Lord Kamall (Con)]

My Lords, I am grateful to the Minister and to all noble Lords who spoke in the debate on this group of amendments. The intention was always that these would be probing amendments; whether it was three months, as from my noble friend Lord Mott, or six months, as from us, we wanted to get some certainty and find out whether, at this stage, any thought has been given to an outline timetable. This is so that the retailers that will have to face this new licensing regime can understand the different stages—the Minister laid out some of the consultation stages—and the overall timetable. Here we are, getting towards the end of the 2025, and they are wondering, “When will this new licensing regime be in place? Will it be sometime in 2026 or in 2027?” That is the sort of outline assurance they want.

It was very helpful of the Minister to mention some of the consultation stages, but it would also be helpful if, perhaps in writing, she could give us a timetable that relates to real dates in the next two or three years—and, in doing so, avoid “in due course” or “as soon as possible”—so as to reduce the uncertainty for those retailers that will have to prepare for this measure. I also welcome the acknowledgement from the Minister of the importance of consulting small retailers—that point has already been made in our debates on previous groups—as well as her understanding of the role that these small retailers play. The burden for them is very different and disproportionate as compared to that for some of the larger retailers.

In general, we welcome the tone from the Government and understand that there must be consultation stages. However, we are asking for some sort of outline timetable in writing, if possible, on when the Government envisage the licensing regime being in place—with the usual caveats, perhaps, depending on what comes back from the consultation. Some certainty would be really welcome at this stage.

Having said that, and having reflected on the comments from the Minister, I beg leave to withdraw the amendment in my name and that of my noble friend Lord Howe.

Amendment 32 withdrawn.

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[Baroness Walmsley (LD)]

My Lords, I have added my name to Amendment 34 in the name of my noble friend Lord Russell and Amendments 141 and 143 in the name of my noble friend Lord Rennard. I will also rehearse arguments in favour of Amendment 33 in the name of the noble Baroness, Lady Bennett of Manor Castle, for the consideration of the Committee. The noble Baroness, Lady Fox, suggested there is some confusion about why people might want to ban filters. I agree with the noble Lord, Lord Crisp, that a ban is about both public health and environmental considerations.

It has been clearly shown that filters of all kinds have no health benefits whatever. Indeed, I maintain that they are actively harmful to health, but I will come to that later. They are also very costly to public authorities and bad for wildlife and the environment. Filters have been called, by a Back-Bench Member of the government party,

“the deadliest fraud in the history of human civilisation”.—[Official Report, Commons, 26/3/25; col. 1043.]

because they were formerly advertised—when cigarette advertising was still allowed—as being safer and less harmful to health than cigarettes without filters. This lie has had a long tail because even now only 25% of people understand that they have no health benefits.

As a result of the false perception that the filter—because of its very name as pointed out by the noble Lords, Lord Young and Lord Bourne—removes some of the tar and other harmful tobacco chemicals, evidence shows that smokers of filtered cigarettes inhale deeper and more frequently. Proof that filters were invented to deceive is the fact that they were deliberately made from a white substance which turns brown when heated, adding to the illusion that they were removing some of the harmful elements from the tobacco smoke. This was deliberately to mislead the smoker.

Filters of all kinds are bad for the environment. The plastic ones in particular contain thousands of toxic substances, including microplastics and nanoplastics. They take up to 10 years to break down in the environment, releasing all these microplastics as well as the 7,000 toxic chemicals from the on average five millimetres of tobacco that remains attached to each butt. These are washed into our soils and water systems and damage marine life, other wildlife and our drinking water.

Microplastics are ubiquitous. They have been found from the top of Mount Everest to the deepest oceans. They cause cancer, including colorectal, liver, pancreatic, breast and lung cancers, and the levels of them found in human brains—causing who knows what effects—have increased by 50% since 2016, according to pathologists. Even the so-called biodegradable ones contain microplastics in the glue and in any case take a very long time to break down. I deliberately put one in my compost heap, and it was still there a year later. In any case, they, too, always have some tobacco attached. They have zero health benefit and lead to a false sense of security.

The environmental damage is also very costly. We all pay to clean them up when they are discarded through littering; as has been said, local authorities spend £40 million every year, money paid by taxpayers—you and I—which could be better spent on public health and other services. Some 86% of the public and even most smokers believe that manufacturers should switch to fully biodegradable filters rather than plastic ones, but, frankly, I think that is not enough to fix the problem, for the reasons I have outlined.

The killer fact, to coin a phrase, is that there is a strong epidemiological link between the rise in the prevalence of cigarettes containing filters and the proportionate rise of a kind of cancer called adenocarcinoma, while other lung cancers have fallen along with the reduced prevalence of smoking overall. A paper by Min-Ae Song et al published in the Journal of the National Cancer Institute in America in 2017 analysed 3,284 citations in scientific literature and internal tobacco company documents and concluded thus:

“The analysis strongly suggests that filter ventilation has contributed to the rise in lung adenocarcinomas among smokers. Thus, the FDA should consider regulating its use, up to and including a ban”.


Indeed, such a link had originally been suggested by the surgeon-general as far back as 2014. Therefore, I am inclined to support Amendment 33 in the name of the noble Baroness, Lady Bennett, but at the very least I hope the Government will accept Amendment 34 in my name and that of my noble friend Lord Russell.

On Amendments 141 and 143 in the name of my noble friend Lord Rennard, I hope the Minister will see the sense of consulting on this. Not every cigarette smoked by a child or a young person or an adult smoker comes immediately out of a packet bearing health warnings. Many children, when they start illicit smoking, share a packet among themselves and many never get to see the packet at all. That is why the principle, already accepted by successive Governments, that a health warning on the packet should accompany tobacco-containing products should apply to individual products and not just the packaging. I am aware that the Government plan to make sure that there is an insert in each packet signposting smokers to cessation services and products. This is a welcome positive measure to accompany the deterrent measures of health warnings, but it is not enough. I am sure the first thing many will do is throw away the insert and never read it, as people sometimes do with pills. They cannot throw away the paper that wraps the cigarette. That is why it would be the most effective place to put the warnings.

If you believe that the health warnings on packages work and deter, how much more effective would it be to reinforce that message every time a cigarette is removed from them? A consultation and a review of the evidence of the ban in other countries would be a good idea, and I recommend it to the Minister.

[Lord Kamall (Con)]

My Lords, I thank the noble Baronesses, Lady Bennett of Manor Castle, Lady Grey-Thompson and Lady Walmsley, and the noble Earl, Lord Russell, for introducing the amendments in their names.

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Finally, Amendments 141 and 143 tabled by the noble Lord, Lord Rennard, would require a consultation on health warnings on individual cigarettes and cigarette papers. As the noble Lord, Lord Young, said, this matter has been under consideration since 1980—a considerable period of time. The Bill restates, with some modifications, the existing power to make regulations on the features of tobacco products, including cigarette sticks. Not only this, but it goes further and extends this power to other products, including cigarette papers. Therefore, as my noble friend Lady Ramsey predicted I would say, we already have the ability to regulate the information provided on products, which would enable us to mandate health warnings in future. Driving down smoking rates among current smokers is important—

[Lord Kamall (Con)]

I am sorry to interrupt, but I asked how long the Government think they will need for evidence from Australia and Canada before they will be in a position to judge whether those health warnings have been effective. Can the Minister answer that either now or in writing? Secondly, do the Government have any evidence on what wording is most effective for health warnings? Once again, the answer could be in writing.

[Baroness Merron (Lab)]

I will gladly add to the brief points that I am going to make to the noble Lord. I was just about to turn to international comparisons. Sometimes, I feel the answer is “How long is a piece of string?” However, quite seriously, we constantly keep international comparisons under review because we are keen to learn and see. The challenge, which I will come on to, is to draw exact comparisons, for a range of reasons, including on what we are already doing.

On the point about international comparisons, it is important that we recognise that the UK already has some of the most stringent regulations in the world on tobacco packaging, which already emphasise health harms. This includes the requirement for plain packaging and graphic picture warnings on the outside of cigarette packets. As I have already referred to and noble Lords have discussed, we have announced that we will be introducing pack inserts to cigarettes and hand-rolling tobacco. I understand the motivation for these amendments, but we do not plan to introduce dissuasive cigarettes at this time. We will continue to monitor the evidence.

We are implementing many of the recommendations of the Khan review. This point was raised by the noble Lord, Lord Rennard. For example, we are majoring on the smoke-free generation policy, which is a major shift. Not only are we implementing many of these recommendations but we continue to keep them under review.

My noble friend Lady Ramsey asked about targets. Again, they will be kept under review. Unsurprisingly, our real target is delivering the Bill and designing the regulations so that they work. Some of this is also about where we can make the greatest impact in the quickest way, which is why we are focusing on the inserts rather than looking for additional things to do at this stage.

I hope that this is of some interest and reassurance to noble Lords and that they will feel able not to press their amendments.

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I look forward to hearing from the Minister how the future powers of HMRC will further reduce illicit supply and whether and how regularly this will be reviewed. I look forward to the Minister’s reply and beg to move.

[Lord Kamall (Con)]

My Lords, I will speak briefly on amendments in this group in the name of my noble friend Lord Bethell and the noble Baroness, Lady Walmsley, before turning to the amendment in my name and the name of my noble friend Lord Howe. They propose the establishment of a new licensing scheme for the distribution of tobacco, vape and nicotine products in addition to the retail licensing scheme already provided for under the Bill.

While I understand the rationale behind these amendments, I am sure it will come as no surprise that we have some concerns. My noble friend Lord Howe and I have already shared concerns about the impact of the regulatory framework of this Bill and the burden it will place on legitimate businesses, especially small retailers and distributors, which are already subject to extensive compliance requirements under existing law, and which will be beset with further regulation under the proposals outlined in the Bill.

However, we understand the underlying concerns behind these amendments about the illicit market, so we believe that they are helpful in probing the Government to understand where they believe there are enforcement gaps and whether they have evidence of gaps in enforcement at the wholesale level of the supply chain. I am, therefore, grateful to my noble friend Lord Bethell and the noble Baroness, Lady Walmsley. Our understanding is that there are concerns over enforcement in relation to illegal imports at the customs level and illicit point-of-sale activity. These amendments give noble Lords an opportunity to ask the Minister where the Government believe the enforcement gaps are, and whether they currently exist.

In addition, if the Government have identified these gaps in enforcement at the wholesale level, do they believe that they could be best tackled by having a new, separate distributor licensing scheme, or do they share concerns over creating a second, parallel system operating alongside the retail one? My noble friend Earl Howe and I are concerned that such duplication risks adding unnecessary administrative complexity for local authorities, trading standards and legitimate operators alike. We also have concerns over how these two systems would interact, and whether businesses operating both wholesale and retail functions would be required to hold multiple licences and pay multiple fees. We are interested in the views of the Minister about our concerns.

Amendment 190, in my name and that of my noble friend Earl Howe, would require the Government to prepare and publish a national illicit tobacco and vape enforcement strategy within one year of the passing of this Act. This is a probing amendment—we have suggested one year; it could be slightly longer or shorter. We believe that this is a practical proposal which chimes with the intentions and ambitions of the Government on this Bill. Indeed, it is a concern that has been raised by noble Lords on all sides of the Committee. All noble Lords are concerned about illicit sales of tobacco and vapes, wherever we sit in this Room.

While we entirely share my noble friend Lord Bethell’s concern about the rise in illicit trade, we believe that the Government need a far more comprehensive view of how products enter, move through and are sold within the United Kingdom. They must develop an overall strategy to cover the stages of the supply chain from the point of import to transportation within the UK and, ultimately, to the sale of these products on our streets and online. In short, we need a coherent and strategic plan of enforcement that gives an overview, rather than one which tries to attack certain bits. Once we have the overview, we can look at where the gaps in enforcement exist and seek to plugs those gaps.

The trade in illicit tobacco and vape products is a serious and growing concern. We have heard throughout Committee that the introduction of a generational ban and other prohibitions in this Bill may, if not properly managed, risk pushing more activity underground into the illegal market. No noble Lord wants this to happen. No one benefits from a thriving illegal market but criminals and those that seek to circumvent the law. It undermines legitimate businesses, deprives the Exchequer of revenue and exposes consumers—often young people—to unregulated and potentially dangerous products.

That is why we believe it is essential for the Government to set out clearly how they intend to meet this challenge, and to explain who will lead, how the agencies will co-ordinate, what resources will be allocated and how success will be measured. We have attempted to be careful and sensitive in drafting this amendment; it does not demand an immediate response but sets out a reasonable and deliberate timetable. It gives one year, or perhaps a bit more, for the Government to prepare, consult on and publish a coherent strategy. That would give Ministers the time to review the evidence, engage with enforcement agencies and draw together the different strands of policy that are already being developed across departments.

If this Bill is to succeed in its wider aims, it must also be accompanied by a credible and co-ordinated plan to tackle the illicit market that so often undermines those very goals. This probing amendment simply seeks to understand how the Government intend to develop a strategy to tackle the illicit market, and whether they intend to take an overall and strategic view.

[Baroness Merron (Lab)]

My Lords, I am most grateful for the contributions in this debate and for these amendments, which rightly highlight the need to take a systematic approach to the illicit market. Having said that, we do not believe them to be necessary; I will gladly set out the reasons why in my remarks.

First, I am grateful for Amendments 39 to 41, 53, 54, 58 to 62, 123 to 125, 133 to 138, 206 to 208 and 212 from the noble Lord, Lord Bethell, which were spoken to by the noble Baroness, Lady Walmsley. I am sympathetic to the aims contained in these amendments; the Government certainly share the aim of strengthening enforcement throughout the supply chain and ensuring that only legal products are on the UK market. As noble Lords are aware, the Bill provides powers for the Government to implement a licensing scheme for tobacco and vape retailers. The focus on retailers is to ensure that illicit products do not reach members of the public where they pose a risk to public health. The retail licensing scheme will enable conditions to be imposed on retailers as part of the terms for obtaining a licence. We expect all retailers to comply with the law and not sell illicit products; doing so will risk their licence being revoked.

In addition to the licensing scheme, the Bill provides powers for the Secretary of State to develop a new registration scheme for the products covered by the Bill. This will require all tobacco, vape and nicotine products to be registered before they can enter the market, meaning that wholesalers will be unable to supply illicit products to retailers as only compliant products should be available. The powers provided by the Bill also allow for the testing of products to ensure that they are what they claim to be. This will make it easier for enforcement officers to identify illicit products and to clamp down on both those who do not register products and those who seek to mislead.

The noble Baroness, Lady Walmsley, asked about spice vapes. I have a couple of points to make here. Vapes containing controlled drugs, including spice, are obviously illegal; naturally, this is a matter for the police and Border Force. I am sure that it will be understood that the regulation of controlled drugs is not a matter for this Bill. However, the measures in it will create a simpler and clearer regulatory environment, which will assist enforcement agencies in identifying and taking action against non-compliant vapes. Border Force is taking action to detect and seize supplies of vapes laced with drugs at the border and is following law enforcement to dismantle the criminal gangs that attempt to smuggle illicit commodities into the UK. It is of course worth noting that the import, production or supply of a class B drug such as spice carries a maximum sentence of up to 14 years of imprisonment, an unlimited fine or both.

As well as the new measures in the Bill, there are already policies in place to manage products through the supply chain. The noble Lord, Lord Kamall, asked questions and made important points about the role of HMRC. For tobacco, HMRC already operates the tobacco “track and trace” system, which tracks the movement of all tobacco products, whether manufactured in or imported into the UK, through the supply chain all the way up to retail.

Also, the vaping products duty will come into force on 1 October next year, taxing vaping liquids at 22p per millilitre. To support the implementation of the duty, HMRC is introducing a range of measures, such as a duty stamps scheme to support the identification of non-duty-paid products, as well as investment in more than 300 additional enforcement officers. Vaping duty stamps will be in a hybrid digital and physical format, which will allow product tracing and authentication. Together, these schemes will better support a compliant market and weed out illicit products, as we all seek to do.

I am grateful to the noble Lord, Lord Kamall, for tabling Amendment 190, which seeks to publish a strategy to deal with illicit tobacco and vapes. I understand the concerns that have been raised regarding illicit sales, but this amendment is unnecessary given that the Government already publish a strategy on illicit tobacco sales.

Tobacco and Vapes Bill

Lord Kamall Excerpts

Committee stage
Thursday 30th October 2025 Grand Committee

Moved by

[Lord Kamall]

13: After Clause 9, insert the following new Clause—
“Ban on manufacture of high-strength oral nicotine products (1) It is an offence to manufacture a high-strength oral nicotine product. (2) In this section “high-strength oral nicotine product” means a nicotine product that—(a) is intended for oral use,(b) is not intended to be inhaled or chewed, and(c) contains more than 20 milligrams of nicotine per portion.(3) A person who commits an offence under this section is liable—(a) on summary conviction, to imprisonment for a term not exceeding the general limit in a magistrates’ court, or a fine, or both;(b) on conviction on indictment, to imprisonment for a term not exceeding 2 years, or a fine, or both.”Member's explanatory statement
This amendment bans the manufacture of nicotine pouches containing more than 20mg of nicotine.

[Lord Kamall (Con)]

My Lords, I speak to the group of amendments in my name and that of my noble friend Lord Howe, supported by the noble Baroness, Lady Grey-Thompson, to whom I am grateful. Together, these amendments seek to prohibit the manufacture, sale and supply of high-strength oral nicotine products—those containing more than 20 milligrams of nicotine per portion—and empower HMRC officers to seize and detain such products before they reach consumers.

The reason for these probing amendments can be summarised by a BBC article in July which told the story of Finn, a 17 year-old who started using nicotine pouches after getting bored of vaping. What began as curiosity quickly became addiction. He described how he and his friends would use pouches so strong—some claiming to contain 150 milligrams of nicotine each—that they would vomit or become physically immobilised. At school, he hid them under his lip, until one day he turned “bright green” in class and had to run out of the room. His mouth, he said, was “shredded to bits”.

This is not an isolated case. Recent data suggests that use among 16 to 24 year-olds has risen sharply in recent years, a deeply worrying trend. These pouches come in bright tins, flavoured with mango ice or bubble gum, and are marketed as clean, safe, and discreet. In reality, some of these products are many times stronger than a cigarette and far more addictive. This is a form of nicotine ingestion which is socially acceptable and often unnoticeable. Children can and do consume these products, sometimes even in class.

The point is not that nicotine pouches have no legitimate role at all. For adult smokers trying to quit, properly regulated products can have a place as part of the harm reduction strategy and a pathway off smoking. Although the Minister knows that my classical, liberal views mean that I am generally against banning things I do not like, what we have at present is the sale of nicotine products that are so strong that dentists have reported that they can burn gums, cause lesions and even expose the roots of teeth.

For these reasons, more reputable manufacturers already limit their products to under 20 milligrams per pouch. They also want a market that encourages and rewards responsible production, and which acts against rogue operators flooding the market with dangerously high-strength pouches. These probing amendments suggest a possible, sensible and enforceable ceiling that would align with good industry practice and give clarity to both regulators and retailers.

However, prohibiting the manufacture and sale of these products is only part of the solution. Unless enforcement agencies have the statutory power to act, those prohibitions risk becoming little more than words on a page. That is why our amendment to Clause 88 proposes that HMRC officers should be explicitly empowered to seize and detain high-strength nicotine pouches, preventing them entering the market in the first place. I know that the Government have indicated that they recognise the need for action in this area; this amendment probes the Government on how they intend to address concerns over these high-nicotine products.

Do the Government think that we should rely on downstream enforcement after these products have already reached young people? That is my first question for the Minister. My second question is: do the Government agree with the sentiment of the amendment on the need to address this issue at the border, where these goods are entering the country in large quantities, especially by giving HMRC the clear legal authority to do so? Thirdly, do the Government see the need for immediate action, or will they require a series of future consultations? Finally—I know that I am asking a lot of questions—do the Government believe that it is more effective to have a firm and immediate statutory assurance in this Bill, in order both to allow these products to be controlled and to give enforcement agencies the clarity that they need to act?

These amendments can be seen an opportunity to protect people, in particular young people, before they become addicted instead of punishing them afterwards. It is about ensuring that, if these products are so dangerous, they should not be able simply to be bought over the counter or ordered online. I recognise that all tobacco products may to some extent be classified as dangerous—or, at the very least, as not good for you— but the products at which these probing amendments are aimed are particularly dangerous. I am, therefore, interested in the Minister’s answers; in the Government’s position on high-nicotine pouches; and in how the Government intend to address the concerns here, as exemplified by Finn’s story. I beg to move.

[Baroness Grey-Thompson (CB)]

My Lords, I shall speak on Amendments 13 to 15. I apologise for not adding my name to Amendments 139 and 140, but I strongly support them.

I added my name to this group of amendments because I did not know an awful lot about oral nicotine. I was talking to a group of university students about my strong dislike of vaping. They introduced me to the subject and told me—they were at several different universities—that many university students use vapes almost continuously for lots of different reasons.

A lot of my concerns are around the impact on young people. Growing up, I remember the TV adverts that showed all the damage that smoking would do to your lungs, with images such as the pouring out of a glass of tar, but I am not sure that young people necessarily understand the impact that vaping will have on them. I am concerned about the high levels of nicotine in these products, but I am also concerned about the potential for vaping to lead to addiction and cardiovascular issues such as increased blood pressure.

I have read the same report as the noble Lord, Lord Kamall. It mentions young people talking about using vapes until they vomit. The report talks about a young man, Finn, using vapes and says that they immobilise the individual—especially when they use two or three in one go—which is not at all the intended consequence of them. Finn goes on to say:

“You feel this burning sensation against your gums, and then you get the hit”.


As the noble Lord, Lord Kamall, said, these products have impacts on oral health, including gum disease and gum recession. Vaping is also linked to an increased risk of certain cancers, such as oral, pancreatic and oesophageal cancers. It can also have, potentially, a negative effect on adolescent brain development.

My problem with these products is that they are so easy to hide. The fact that children in school are able to use these products should be cause for concern, because young people are talking about sweating, salivating and struggling to concentrate. These products that should not be anywhere around young people. There is also a lot of discussion about how they can be used as a gateway to vaping or smoking. There is a lot of debate around how vaping and smoking are meant to be helping each other, but I have concerns about that as well.

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Returning to the issue of protecting young people, our commitment is to act swiftly and responsibly, which is why we have already launched the comprehensive call for evidence to better understand the available evidence. It would be extremely problematic if we were categoric at this stage and then found, in a very changing landscape, new potential harms that we would not be able to deal with in the appropriate way. For the reasons I have outlined, I hope that I have reassured noble Lords that we are taking this exceptionally seriously and that the noble Lord will feel able to withdraw his amendment.

[Lord Kamall (Con)]

My Lords, I am grateful to all noble Lords who have spoken in this debate; I welcome their thoughtful discussion and the important points that a number of them made. As I said earlier, this was a difficult group for me to put into words, in moving this amendment, because, as many noble Lords will know, I tend to take a classical, liberal perspective on many things and I do not like banning things.

The intention of the amendments in this group was to probe the Government on whether they believe that action to address these products, which have such high levels of nicotine that they lead to consumers vomiting, is required sooner rather than later; dentists also warn that these products physically burn gums, cause lesions and expose the roots of teeth. In probing the Government, the intention was to set clear, enforceable limits rather than pursuing an outright ban.

These probing amendments were aimed at achieving a balance between taking dangerous products off the market when they are easily obtained by young people and allowing properly regulated, lower-strength products to continue to help people come off smoking. However, one of the advantages of probing amendments is that you are able to test your argument and to hear other arguments—either those in favour, which reinforce your view, or those that challenge your view.

I am grateful to the noble Lord, Lord Patel, and the noble Baronesses, Lady Watkins and Lady Finlay, for raising their concerns about pouches. That is an important point. We should understand whether the Government believe that nicotine pouches can play a role and that they are an effective pathway off smoking. Given that vaping is probably seen as the thing that the Government would promote most as a pathway off tobacco, that would be a very interesting conversation to have.

I am also grateful to the noble Baroness, Lady Fox, because she made some interesting points in sharing the evidence from, I believe, Cancer UK. She also posed some questions. What are we trying to achieve here? Are we trying to address the harms of tobacco or are we trying to tackle addiction? Should we be tackling addiction or harm? These are important points. What is more harmful? That seems to be the debate in this Room: we agree that tobacco is harmful, but how harmful is nicotine? That needs to come out a bit more, perhaps, as we debate the Bill more.

I am grateful to the Minister for answering directly some of the questions that I put to the Government. That was really important. Having listened to the Minister, and to the many noble Lords who challenged the intentions behind these probing amendments, I beg leave to withdraw my amendment.

Amendment 13 withdrawn.

--- Later in debate ---

[Lord Patel (CB)]

May I join the argument? The noble Earl is quite right: there is a synthetic nicotine product, which is manufactured chemically. So you can have nicotine that is not a tobacco product. However, as far as we know, most of the nicotine used in vapes is derived from tobacco.

By the way, I want to come back, slightly tongue-in-cheek, on the noble Earl’s question about where it comes from. Of course, I was hoping that he would say, “From tomatoes, potatoes, nightshade and some other plants”, from which you can also get small amounts of nicotine.

[Lord Kamall (Con)]

My Lords, if we take the logic of the noble Baroness’s argument about nicotine being derived from tobacco, does that drive a coach and horses through the distinction between tobacco products and vaping products? Wherever you stand on this argument, are we now arguing that vaping products are, in fact, tobacco products because the nicotine in them is derived from tobacco? We all have to clarify this, whichever side of the argument we are on.

[Baroness Merron (Lab)]

I fear to tread here—I will be brief. The Bill distinguishes between tobacco products, nicotine products and vaping products. They are separate products. I emphasise the point that I made earlier: vapes are not risk-free, although they are less harmful than smoking. They do not involve burning tobacco, which releases tar and carbon monoxide. However, I must say, having heard the range of debate, I feel that it would be very helpful for me to write to noble Lords with further clarity on these points.

--- Later in debate ---

Moved by

[Lord Kamall]

26: Clause 13, page 7, line 12, leave out from first “consult” to end and insert “and take into consideration the view of—
(a) retailers of relevant products or their representatives, and(b) any other person the Secretary of State considers it appropriate to consult.”

[Lord Kamall (Con)]

My Lords, this group of amendments in my name and that of my noble friend Lord Howe are probing the Government, in one way or another, on the question of consultation. What we seek to do is quite simple in many ways: to recognise that the impact of the Bill is not just on big tobacco, as many noble Lords have said; it will impact some vaping companies, not all of which are big tobacco. It is really important that we make that distinction. Some tobacco companies have vaping divisions. In fact, I have asked tobacco companies: when these Bills go through, what will you do and where will you diversify? It is very interesting to hear some of their answers, which I would be happy to share at some other stage.

The other thing we need to understand is that this will impact retailers, some of which are specialists and some of which sell other products but this is part of their income stream. We want to make sure that we get the balance right.



What we really want is to understand the nature of the consultation. Which voices with experience are being listened to? Which retailers are being listened to? On manufacturers, I want to be slightly careful, because I have had some conversations since these amendments were laid. In fact, I have been told by some people that we should not ask the manufacturers, particularly big tobacco, for their views. I have also been told that some companies do not want to be consulted, because that would be seen to be diluting the result of that consultation. Given that these are probing amendments, I will be a little careful about which manufacturers should be consulted and which should not.

--- Later in debate ---

I confirm that we have already started this engagement. On licensing and some of the Part 5 powers, such as registration and product requirements, we have launched a call for evidence. Those with evidence to share can contribute now and we will consider their feedback prior to consulting on specific proposals. We will publish a consultation on our proposals for display regulations shortly. With those comments, I hope that I have given the reassurance sought and that the noble Lord therefore feels able to withdraw his amendment.

[Lord Kamall (Con)]

I thank noble Lords who have contributed to this debate, and the Minister for her response. With these probing amendments, we were trying to make sure that the consultation was as wide as possible. We completely understand the WHO requirements, but we sometimes worry about some of the more specialist cigar manufacturers, which are not big tobacco but much smaller specialist organisations.

I seek some clarity from the Government at this point. Are they saying that the WHO guidelines mean that they cannot speak to these small, specialist manufacturers? We understand not consulting the big Philip Morris Internationals of this world, and others, but is it the Government’s understanding that they cannot speak to the small specialist cigar manufacturers because WHO guidelines preclude them from doing so? Or are they saying that they can speak to those small manufacturers?

Clarification on that from the Minister would be welcome. Is she able to give an answer, or shall I witter on a bit and hope that the officials can give her an answer in that time? I will do that; I am trying to be helpful. That clarity is essential. I am not asking that they call in the likes of the big firms, such as BAT and Philip Morris, every time they want to do a consultation; we know what their business models are. This really is about the small specialist manufacturers who feel that they are excluded and lumped in with big tobacco all the time. Their demographic is very different. It is an ageing demographic; perhaps literally a dying demographic —who knows?

The newspaper that came to see me told me that its readership was not consulted even though their trade associations claimed that everything was fine. Therefore, we need to understand those nuances. In my experience, I have seen some trade associations claiming to represent a wider membership than they do. They are not the ones who are damaged.

I welcome the sentiment behind the noble Baroness’s response. I had a conversation with the Minister only yesterday about a particular organisation not feeling that it had been consulted. Immediately, she said, “Let’s meet with that organisation”, so I recognise the sentiment. However, I would like that clarification now if it is available.

[Baroness Blake of Leeds (Lab)]

We require all those with links, direct or otherwise, to the tobacco industry to disclose them when answering consultations. I hope that is the clarification that the noble Lord requires.

[Lord Kamall (Con)]

Just to understand, they can be consulted—that sounds reasonable; I do not think anyone would say otherwise. It is important that they do not hide where they are from.

If there are organisations that have written to me about this in the past and I have had conversations with them, I am sure that the Minister will be open to having conversations where appropriate. With those reassurances, I beg leave to withdraw the amendment.

Amendment 26 withdrawn.

--- Later in debate ---

[Baroness Blake of Leeds (Lab)]

I am at the mercy of the Committee, but we have some more time and the ability to go on until 5.15 pm. If noble Lords agree, we have one more group to do to get to the target. Shall we continue?

[Lord Kamall (Con)]

My Lords, my noble friend Lord Mott is not here to move Amendment 29 and has obviously not sent a substitute to speak on his behalf. What is the procedure from here?

[The Deputy Chairman of Committees (Lord Haskel) (Lab)]

I suggest that the Committee adjourns.

Human Medicines (Authorisation by Pharmacists and Supervision by Pharmacy Technicians) Order 2025

Lord Kamall Excerpts

Tuesday 21st October 2025 Grand Committee

[Lord Scriven (LD)]

My Lords, as the noble Baroness said, the changes are enabling and not mandatory, yet the risk of financial exploitation of the regulations is real. Pharmacies are already funded below cost for dispensing, and my concern, mirrored by many in the sector, is that the department or NHS England may interpret this regulatory freedom as an automatic justification to reduce dispensing fees based on the assumption of a cheaper skill mix that may be automatically adopted. Any such reduction would threaten further the financial viability of community pharmacies, particularly small independent ones, risking closures and access issues.

The third issue is the ambiguity of supply “at or from” a pharmacy. Some in the sector feel that the proposed change to allow the supply of medicines at or from a pharmacy, while intended to cover home deliveries, introduces ambiguity. This phrase is viewed by some as a potential gateway to unsupervised remote supply models, such as unstaffed collection lockers in remote locations. The Government must emphatically stamp out any interpretation that undermines the fundamental principle that a pharmacist’s professional clinical input or availability is the bedrock of safe supply.

To ensure that we implement this modernisation safely and successfully, I ask the Minister for clear answers on these three points. On professional assurance, what guarantee can the Minister give to individual pharmacies that the new GPhC standards will explicitly address the concern over minimum competency and mandatory continual professional development, and that the accountability split is clear before the main authorisation provisions come into force?

On financial stability, can the Minister offer an unequivocal commitment that NHS England and the department will not use the new skill mix freedoms as a mechanism to unilaterally reduce the dispensing fees paid within the community pharmacy contractual framework?

On the safety of supply, given the sector-wide apprehension, will the Minister commit to publishing restrictive statutory guidance that clearly defines “supply at or from” a pharmacy to rule out any future implementation of unsupervised off-site collection points for pharmacy and prescription-only medicines?

This is a reform that will have good outcomes if implemented correctly. The move forward for progress must address the potential risks, ensuring support for the entire pharmacy team and financial stability for dispensing as well as, crucially, protecting patient safety and access to local dispensing community pharmacy.

[Lord Kamall (Con)]

My Lords, I also thank the Minister for the way she introduced this SI. I begin by also thanking the thousands of pharmacists and pharmacy technicians who deliver vital services to patients every day in both the community and hospital settings— I can see that your Lordships all agree with that.

From these Benches we support the principle behind this statutory instrument. As the Minister said, in many ways it is common sense. It reflects the evolution of community pharmacy practice, which has changed significantly since the original 1933 Act was introduced—a time when pharmacists still routinely compounded medicines by hand. Over the years, that role has evolved and medicines are now largely pre-packaged and supplied via global supply chains. Pharmacists increasingly play a critical role in delivering NHS services, from vaccinations to blood pressure checks, emergency medications and, of course, Pharmacy First consultations—which many noble Lords agree with. Given the Government’s priorities on moving from hospital to the community, they also play a vital role here.

This legislation rightly seeks to release capacity, allowing pharmacists to spend more time with patients, and it allows pharmacist technicians to take on more responsibility in line with training and regulation. As the noble Baronesses, Lady Hollins and Lady Bennett, said, there were concerns about the technicians and the differential in training level, and taking that on. In some ways, that takes us back to the physician and anaesthetist associates debate. Although the noble Baroness, Lady Bennett, and I were on different sides in that debate, I think that we would all agree that it was not right that those who were not qualified were taking on the role of those who were more qualified and taking on roles above their qualifications. What can the Minister say about that, given the experience of anaesthetist and physician associates? We welcomed that. Some of them were being asked to do roles for which they were not qualified. How do we make sure that pharmacist technicians are not repeating that?

Healthcare Provision: Inequalities

Lord Kamall Excerpts

Monday 20th October 2025 Lords Chamber

[Baroness Merron (Lab)]

We have discussed national insurance contributions a number of times in your Lordships’ House, and I can only repeat the previous assurance, given not just by me but by other Ministers: that in making the decision, the Chancellor took into account not just the funding available—for example, in the Department of Health and Social Care, which was notable and welcome—but the impact.

In respect of rural areas, the national approach to inform action to improve equality in healthcare does define groups, including those in rural and coastal communities, so I can assure the noble Baroness that this issue does get the attention she seeks.

[Lord Kamall (Con)]

My Lords, to address inequalities we need better data. We have heard from noble Lords about granular data in some areas, but in many areas we still need to collect data and publish it in a much more granular manner, based on region, ethnicity and income, but also other measures. What are the Government doing to improve the collection of data, and particularly its granularity, so that we can address these inequalities?

[Baroness Merron (Lab)]

I agree with the noble Lord about the importance of data. We have discussed this a number of times in respect of racial inequalities. But it is not just about data; it is also about the use of digital services. We must ensure that those in the most deprived areas are not excluded because of their inability to deal with digital aspects. As the noble Lord knows, moving from analogue to digital is another core part of what we are doing. I assure him that we are improving data collection and its availability and use.

HIV: Testing and Medical Care

Lord Kamall Excerpts

Monday 20th October 2025 Lords Chamber

[Baroness Merron (Lab)]

We are currently in the process of reviewing existing mechanisms as well as options for improving retention and re-engagement in care for people who live with HIV. This is a crucial part of the new HIV action plan, for which we will not be waiting very long. The noble Baroness makes an important point: there are all sorts of reasons for disengagement from care. It can be due to complex mental and physical needs but also the fear of stigma, as she referred to, particularly in the most vulnerable population groups, which means that they are disproportionately challenged. However, I assure her and your Lordships’ House that the plan will take account of that. Indeed, the 10-year health plan already makes that commitment.

[Lord Kamall (Con)]

My Lords, does the Minister agree that routine opt-out HIV testing—offering HIV tests to all patients in healthcare settings, such as emergency departments, unless they specifically decline—has proved highly effective, having identified over 1,000 cases of HIV that may well have gone undetected otherwise? Do the Government have any plans to extend this approach beyond the current pilot projects?

[Baroness Merron (Lab)]

I certainly agree that giving people who are attending an emergency department a blood test as part of a routine examination—unless they opt out—has assisted very much in engaging people in care and in identification. We have 79 emergency departments in the programme and they are making a substantial contribution. We will continue to assess where it is successful and how we can extend the success into areas that are not currently benefiting.

Terminally Ill Adults (End of Life) Bill

Lord Kamall Excerpts

2nd reading
Friday 19th September 2025 Lords Chamber

[Baroness Berger (Lab)]

My Lords, I have spoken already about how my experience as a Member in the other place has made me very concerned about this Bill, and more determined that it must not be a cause of further harm to vulnerable people. Many unanswered questions about the Bill before us have been raised during the course of this important debate. This is why I have tabled the amendment and the following Motion to hold a Select Committee before Committee of the whole House begins.

This is a significant and complex piece of legislation by any definition. It demands a process that can withstand the weight, but it is clear that there are serious shortcomings, as both the Constitution Committee and the Delegated Powers and Regulatory Reform Committee noted in their reports last week. Indeed, I am concerned that the legislative process is being asked to compensate for the absence of robust policy-making before the Bill was published: no comprehensive review; no public consultation or prior engagement with professionals and other stakeholders; no Green Paper or White Paper, which we would have seen had it been a government Bill—I understand the case made for why it is not a government Bill, but that has diminished what is before us today; and no published analysis of international experiences. Instead, Parliament has been asked to grapple with questions about implementation, safeguards and NHS implications without this groundwork, which we would usually turn to for a law change of this magnitude.

Back in March, Jill Rutter of the Institute for Government—which is neutral on the principle of assisted dying—said:

“We’re expecting Commons scrutiny to do far too much—things it simply can’t do … Commons scrutiny is being left to solve a whole range of problems it isn’t equipped to deal with”.


We have seen the dropping of key but expensive safeguards, such as the review by a High Court judge, and whole new clauses and schedules introduced to replace them with very little opportunity for thorough scrutiny.

It was a clear pattern in the other place that when significant concerns were raised that had not been anticipated, the response was often to add another delegated power. There are now, as we know, 42 delegated powers contained within the Bill: 42 areas where government will work out the detail later, with Parliament largely excluded from the conversation. The result is a Bill that is today substantially different from when the Bill Committee in the other place took evidence in January this year, but now with less clarity.

I do not wish to detain the House any longer than is necessary, but I have been asked many questions on the process about what is before us, which I will seek to address. My amendment ensures that we can have some evidence, expertise and insight on the Bill before us today. We need this information before we commence line-by-line scrutiny.

Noble Lords will have received a letter setting out a condensed list of witnesses that I and other supporters believe this House must hear from, including my noble and learned friend Lord Falconer of Thoroton and those who will bear the responsibility for delivering the Bill, should it pass, and setting out how they would use their delegated powers. These witnesses are to include the Secretary of State for Health and Social Care, the chief executive of NHS England, the Secretary of State for Justice and the Chief Secretary to the Treasury.

We must also take evidence from the professional bodies whose members will be asked to carry out the functions that the Bill sets out: the Royal College of Psychiatrists, the Royal College of Physicians, the Royal College of General Practitioners, the British Association of Social Workers and the Law Society.

We are, of course, not able to hear from serving members of the judiciary, but may hear from the former Chief Coroner of England, Thomas Teague KC, and Sir James Munby, President of the Family Division of the High Court. We must also ensure that we understand the impact of the Bill on our hospices and care homes, through Hospice UK, the Association for Palliative Medicine and Care England.

A previous suggestion of a Select Committee in parallel, alongside a Committee of the whole House, would not achieve—

[Lord Kamall (Con)]

I apologise, I do not want to detain the House any longer than is necessary. Just to clarify, will all the evidence before the Select Committee be published?

[Baroness Berger (Lab)]

I am very grateful for the intervention, and I was just about to come on to that, but I will answer that now. The answer is yes, absolutely. The intention is that all the evidence accumulated and amassed during that time will be published for everyone in the House to interrogate and consider in advance of us going into Committee of the whole House. To confirm, this Select Committee cannot take place in parallel in order that we can receive evidence on vital parts of the Bill before we go into debate, so that we are not in the unenviable position of knowing what is wrong with the Bill but being unable to amend it.

My Motion provides that a Select Committee would be intended as a focused piece of work, hearing vital expert oral evidence, as I have just set out, rather than it being a more time-intensive open exercise. It may report by simply publishing that evidence before we go into Committee of the whole House, in order to inform our detailed consideration of the Bill. As I understand it from the clerks, the revised timetable allows the committee to hold six meetings over three weeks, with two panels of witnesses on each of the days, to begin the week commencing 20 October and allowing it to conclude by 7 November. The revised timetable ensures that the Bill can progress to its next stage and maintain the opportunity for four sitting Fridays before Christmas.

We have, over the past two Fridays, shown the determination of your Lordships’ House to discuss the Bill in a considered and constructive way, and it is my strongest hope that we can continue to do that. If my amendment is accepted, I do not intend to speak on the Motion that will follow, which contains the detail that I have just set out. I am grateful to my noble and learned friend Lord Falconer of Thoroton—

Genome Screening: Newborn Infants

Lord Kamall Excerpts

Thursday 18th September 2025 Lords Chamber

[Baroness Merron (Lab)]

I am grateful to the noble Lord and will be very pleased to write to him on that specific. Part of this work in the programme we are referring to is on treatable diseases. For example, the Generation Study covers hereditary fructose intolerance, which means that babies would not be able to ingest fructose normally. By identifying it, we can then recommend removing fructose from their daily diet, which is a way of overcoming that condition. So, by spotting the condition early, we can take action. As the noble Lord says, there are indeed a number of areas in which further work needs to be done, but I would be very glad to write to him on the detail.

[Lord Kamall (Con)]

My Lords, while genome screening of newborns is welcome and could be an important part of the prevention agenda, it raises a number of ethical issues. I will focus on just one: at what stage do you tell someone who has a high probability of getting a medical condition, say in their 40s or 50s, about the probability or even certainty of developing that condition, without causing undue distress or even premature treatment? Can the Minister briefly tell noble Lords about the conversations that are going on in the department about these ethical issues, perhaps with the medical profession, and perhaps write in more detail later?

[Baroness Merron (Lab)]

As I mentioned to the noble Lord, Lord Kakkar, the matter of ethics is crucial in this development. It might help if I restated— I absolutely understand the noble Lord’s point—that that is why the Generation Study, which is directed at newborns, is for treatable conditions that may develop in the first five years of life, not later on. I understand why that would be of concern, and similarly of concern to my noble friend Lord Winston, so I hope that assurance will be helpful.

National Health Service Regulations

Lord Kamall Excerpts

Tuesday 16th September 2025 Lords Chamber

[Lord Kamall (Con)]

My Lords, as the Minister will know, the 2025 amendments to the regulations made several key changes, one of which was to keep online consultation talks open during surgery hours. While these Benches welcome the shift from analogue to digital, we understand that the National Pensioners Convention estimates that between 500,000 and 700,000 older people would not be able to access either the online consultation tool or patient records, either because they are not online or because they struggle to navigate apps and websites. Can the Minister update the House about what her department is doing to work with GPs and, in fact, the whole system of health and care, to make sure that that small minority of people who are not digitally literate, including older people, are not locked out of receiving health and social care?

[Baroness Merron (Lab)]

The noble Lord makes an important point. There is absolutely no intention that people will be disadvantaged in any way. This is about equalising access, which means keeping all forms of access open. That may be online, but it will also be possible to deal with things in person and on the phone. Obviously, if we can take pressure off phone access, or personal access, through the use of online, that will assist the group to which the noble Lord referred.

Respiratory Syncytial Virus: Vaccination Programme

Lord Kamall Excerpts

Tuesday 9th September 2025 Lords Chamber

[Lord Kamall (Con)]

My Lords, I thank the noble Baroness, Lady Ritchie of Downpatrick, for securing this debate today on RSV, particularly on vaccines for children. I pay tribute to her for continuously raising awareness of RSV. As she reminded me, when I was a Minister she raised it a number of times and continues to raise it. That shows how important it is and the vital role she plays.

As we know, RSV, alongside flu and Covid, is a leading cause of serious respiratory illnesses. Before the rollout of the vaccination programme, it was responsible for more than 10,000 hospital admissions and 4,000 deaths each year among adults aged over 75. The noble Baroness reminded us that it poses a danger in early childhood, with, as other noble Lords have said, over 30,000 hospitalisations and up to 30 deaths each year among children under five. One of the reasons that children are especially at risk is due to their developing smaller airways, which makes them particularly susceptible to bronchiolitis, a condition in which the lungs become inflamed during the fight against infection. We also know that RSV is perhaps more widespread than is commonly known and can seriously affect the most vulnerable people in our society.

I welcome the opportunity that this debate allows us in taking the time to speak about RSV and to ask the Government about the steps they are taking to prevent it as much as possible and to treat it. The previous and current Governments and the many health professionals are to be congratulated on the fact that RSV vaccine coverage has been rising steadily. It is good news that, among eligible older adults in England, the vaccine uptake has risen from 23% in September 2024 to around 63% by the end of June 2025. Similarly, as others have said, maternal vaccination has followed a similar trajectory, so that among mothers who gave birth in March 2025, 55% have been vaccinated. I know noble Lords have given out various statistics today.

The challenge now, as the noble Baroness has identified, is how to increase this coverage further. We know that the vaccination works; a recent study, looking at data from 14 hospitals in England up to March 2025, found that vaccination reduced the chances of hospital admissions with RSV infection by 82%. It is important that we repeat some of these statistics so people recognise that vaccines work. More relevant to today’s debate is that the estimated reduction in RSV risk was 58% for infants whose mothers were vaccinated at any time before delivery. It is sometimes easy to quote statistics and figures and see who has the best or the more up-to-date statistics, but sometimes we forget the human element. It is clear that taking the RSV vaccine protects us, our friends and our loved ones from harm and hospitalisation, and we should not forget that.

Despite that good news, though, as with other conditions, there are substantial disparities in how effective these measures have been in the population data, as my noble friend Lord Mott, the noble Lord, Lord Rennard, and indeed the noble Baroness, Lady Ritchie, said. As we have seen, recent data from the UKHSA showed that the uptake of the RSV vaccine for pregnant women in London was about 44%, compared to a figure of 65% in the south-west. We have heard from other noble Lords that members of the “Black or Black British—Caribbean” ethnic community are substantially less likely to be vaccinated than the highest uptake. Interestingly, ethnically Chinese people are the most vaccinated group, but in the “Black or Black British—Caribbean” cohort the coverage reported by the UKHSA earlier this year was only 28%.

We saw that the uptake of RSV vaccine for pregnant women in some of the UK’s largest ethnic groups is also quite low, with white British people at 62% and British Indian people at 56%. This data shows that, while many people have been vaccinated against RSV and the numbers have certainly increased, there are many communities where vaccination levels remain low. Clearly more needs to be done.

When I met the Caribbean and African Health Network last week, it explained some of the factors behind vaccine hesitancy within their communities. Sometimes it stems from a lack of trust of the organisations promoting vaccines, as well as a lack of culturally and linguistically appropriate information. We also know, as other noble Lords have said, about misinformation about the harms that could be caused by vaccines, spread via social media but also by politicians in some parts of the political spectrum.

Noble Lords will recall that we had to tackle vaccine hesitancy under the Covid programme. We found that asking local community organisations—people in the communities, especially faith communities, who knew the people we were trying to reach—to take the lead helped to build trust, but it did not always solve the problem. It is very easy to point to one success story. Indeed, in at least one case, there were certain churches that were actually discouraging their congregations from being vaccinated. That just shows how granular we have to be in reaching those communities and trying to understand some of those barriers.

So, while noble Lords may extol the benefits of vaccination programmes for RSV, Covid, HPV and MMR, there is clearly more work to be done in reaching out to individuals in the communities where uptake is low. We need to understand their concerns and the barriers that they feel they face, and we need to understand how we can tap into the power of trusted local community organisations to ensure that as many people as possible benefit from RSV and other vaccines.

The noble Baroness, Lady Ritchie of Downpatrick, stressed the importance of vaccinating infants, but we need to reach the children via their parents and the communities in which they live. I am sure that noble Lords across the House share the ambition to break down barriers of access and build trust in communities, and to make sure more people are protected against RSV.

When we returned after the short break, the Minister said she missed a number of questions from noble Lords across the House, so, as in any debate, I want to make sure that I help her in that respect. I have questions but, if the Minister cannot answer now, perhaps she will write to us. What specific steps are her department and organisations such as the Office for Health Improvement and Disparities and the UKHSA taking to address these disparities in RSV vaccine uptake, not only regionally but also ethnically? What initiatives are there to increase uptake in those ethnic communities where vaccination levels are particularly low? What has worked and what has not?

Is the Minister able to share some good stories where specific programmes to tackle vaccine hesitancy have actually showed some success? How can that best practice be rolled out to other communities in other parts of the country? I think the noble Baroness, Lady Ritchie of Downpatrick, asked about disaggregated data—what disaggregated data is available on RSV vaccine uptake? If it is not yet available, will the Minister look at or perhaps commit to publishing regular disaggregated data on RSV vaccine uptake by region, ethnicity and socioeconomic group so that Parliament and the public can track progress in ensuring equity of access? I am sure the noble Baroness, Lady Ritchie of Downpatrick, would appreciate such disaggregated data, as all noble Lords would.

I once again thank the noble Baroness, Lady Ritchie of Downpatrick, for securing this debate today and for the opportunity it has afforded the full Benches to discuss this important issue. Your Lordships recognise that the Minister takes this issue seriously, so we look forward to the responses.