Tobacco and Vapes Bill

Debate between Lord Kamall and Lord Young of Cookham

Report stage
Tuesday 24th February 2026 Lords Chamber

[Lord Young of Cookham (Con)]

My Lords, I have added my name to two amendments in this group. Before coming to those, I will say a word about Amendment 77 from the noble Baroness, Lady Bennett, which I was initially attracted to. Like many other noble Lords, I went to a presentation by ASH, where we listened to health experts explain that filters do not prevent anything noxious reaching the lungs. On the contrary, they have ingredients in them that might be damaging. Far worse, because of the filter, smokers inhale more than they would have done had there not been one, as they think it is safe. It may be that the 25 government amendments achieve in a rather roundabout way what the noble Baroness seeks to do in Amendment 77. We will listen with interest to the Minister when she speaks to her amendments.

Amendment 133 was ably spoken to by the noble Lord, Lord Rennard. As I have said before, when I was a Health Minister in 1979, I tried to get the tobacco industry to adopt putting a warning on cigarettes and it declined on the grounds that ink was carcinogenic. This was not an argument I found very persuasive. Here we are, nearly 50 years later, still discussing something that at the time was world-beating, although I understand that I have now been overtaken by Canada.

Amendment 204, spoken to by the noble Earl, Lord Russell, sits rather uneasily in this group, which is otherwise about filters, in that it is about the tobacco levy. I want to make a number of points. First, previously the Government ruled this out on the grounds that they consulted on a levy model in 2014. Indeed they did, but this is a very different model from that which they consulted on. Crucially, in the one they consulted on, the levy would have been passed on to the consumer, with all the impact on RPI or CPI. This model has been constructed to avoid that; it would control the price that tobacco can be sold for, leading to very different outcomes from the model consulted on by the Treasury, and would not allow tobacco companies to pass the costs on to consumers as they do at the moment. It would raise revenue. One estimate has been £5 billion. Even if it is a fraction of that, it is money well worth having.

The scheme would not be complex to administer. As the noble Earl said, there are only four manufacturers. The department already operates the PPRS, controlling medicine prices, with far more manufacturers than are involved in tobacco. Crucially, the Khan review, already referred to, which was initiated by Sajid Javid when he was Health Secretary, pointed out that the Government were not going to hit their then target of a smoke-free England by 2030. It recommended the levy—this was an independent review commissioned by the last Conservative Government—and reinvesting the money in media campaigns targeted at those elements of the population who were still smoking.

Finally, I know that the Minister will not mind me reminding her of what she said when a similar amendment was debated in 2022 and passed in your Lordships’ House by 213 to 154. She knows what I am going to say; she supported and voted for that amendment, saying that it would

“provide a well-funded and much-needed boost, and a consultation would allow this proposal to be tested, refined and shaped”.—[Official Report, 16/3/22; col. 297.]

Well, that is what we are asking for today. She did not persuade me in Committee when she gave the reasons why she had changed her mind. Perhaps she can have another go this evening and explain why she will now urge the House to reject what she thought was a good idea four years ago.

[Lord Kamall (Con)]

My Lords, since this is the first time I have spoken on Report, I declare my interest as a professor of politics and international relations at St Mary’s University, Twickenham, where I teach an MBA module on healthcare policy and strategy. I also work with the Vinson Centre for the Public Understanding of Economics and Entrepreneurship at the University of Buckingham, and we sometimes run seminars on evidence behind public health policy.

NHS Dental Services

Debate between Lord Kamall and Lord Young of Cookham

Tuesday 24th May 2022 Lords Chamber

[Lord Young of Cookham]

To ask Her Majesty’s Government what plans they have to improve access to NHS dental services.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)]

The Government are working with NHS England and the British Dental Association to reform the current NHS dental system and to improve access for patients, tackling the challenges of the pandemic. We have also provided an extra £50 million for additional activity and patient appointments. We are working to return quickly to pre-pandemic levels of activity. For this quarter, a new activity threshold for NHS dentists has been set at 95% to increase patient access.

[Lord Young of Cookham (Con)]

I am grateful to my noble friend, but with 86% of NHS dentists closed to new patients, do we still have a national dental service? The current dental contract was deemed unfit for purpose 14 years ago by the Health Select Committee in another place. Will my noble friend, as a matter of urgency, introduce a new dental contract which reverses the decline in NHS dentistry? As his fellow Minister has said,

“there is a shortage … not of dentists but of dentists taking on NHS work.”—[Official Report, Commons, 19/4/22; col. 7.]

Will my noble friend negotiate a contract with private dentists in the meantime to address the NHS backlog?

[Lord Kamall (Con)]

I half-thank my noble friend for giving me advance notice of one of his questions. I will try to answer that one. Many dentists who provide NHS treatment also already work in a private care capacity, and all dentists who provide NHS care must be registered on the performers list. The NHS uses the list to ensure high quality and safety standards in NHS dentistry.

On the UDA and negotiations, NHS England is in conversations with the BDA concerning both short-term changes and longer-term changes given the concerns that have existed since they were introduced in 2006.

NHS Mental Health Patients in Private Hospitals

Debate between Lord Kamall and Lord Young of Cookham

Thursday 28th April 2022 Lords Chamber

[Lord Kamall (Con)]

I thank the noble Baroness for the question and for repeating the fact that you can find problems in the independent sector and in NHS providers. What is really important is that we are looking at the HEE workforce plan as well as the NHS workforce plan, while working with trusts at the local level and other providers of care to ensure that we have the most appropriate staff levels to meet local conditions.

[Lord Young of Cookham (Con)]

My Lords, if the £2 billion which the NHS is paying to the private sector is enabling vulnerable mental health patients to get high-quality care, is this not to be welcomed as it takes pressure off the NHS?

[Lord Kamall (Con)]

I should remind noble Lords that the noble Baroness said that she was not against private provision out of principle. Private provision can be very helpful and has always worked with the NHS, ever since it was founded. If we think about responders—for example, the impact of lockdown on many people—we have seen an increase in mental health needs. What do you do to increase the provision of mental health services? Do you wait for a new NHS hospital to be built? No—if there is a private provider out there, or an independent provider that can provide those services, you engage them. That is why the NHS and the independent sector, working together, is a really important partnership.

Mental Health Services for Rough Sleepers

Debate between Lord Kamall and Lord Young of Cookham

Monday 21st March 2022 Lords Chamber

[Lord Kamall (Con)]

The noble Baroness makes the very important point that a number of people who are homeless suffer from alcoholism and alcohol abuse—and indeed drug abuse. For some of these people, the issues they are suffering from are often interrelated. Therefore, in the joined-up thinking we are looking at, charities, civil society organisations and the NHS are making sure that we treat the various symptoms in an integrated way.

[Lord Young of Cookham (Con)]

My Lords, given the success of the Everyone In campaign, through which 15,000 rough sleepers were given accommodation to protect them from Covid, does my noble friend agree that that progress must be maintained? Given that many rough sleepers have mental health issues, can my noble friend say whether the specialist funding for mental health services for rough sleepers will be extended beyond the next two years?

[Lord Kamall (Con)]

I thank my noble friend for raising that important point. The new rough sleeping strategy from the Department for Levelling Up, Housing and Communities will set out how departments will work together to end rough sleeping. This will build on the recent success to which my noble friend refers to ensure that rough sleeping is prevented in the first instance and responded to when it occurs. We are going to work closely with the Department for Levelling Up, Housing and Communities and other departments, as well the voluntary and social enterprise sector and others, to make sure that we are all joined up.

Care Workers: Professional Register

Debate between Lord Kamall and Lord Young of Cookham

Monday 10th January 2022 Lords Chamber

[Lord Young of Cookham]

To ask Her Majesty’s Government what plans they have to introduce a professional register for care workers.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)]

We will invest at least £500 million in the social care workforce over the next three years. The major investment includes the introduction of a digital care workforce hub. This hub will help identify people working in social care and provide them with access to resources to help them in their careers. It will also include a skills passport to provide staff with a permanent record of their training and development over their career.

[Lord Young of Cookham (Con)]

My Lords, I am grateful for that reply. In his letter to us today on NHS resilience, the Secretary of State says:

“Social care is vital for our success in managing Covid-19, working as part of a single system with the NHS.”


We all agree that we need to integrate the NHS and social care and provide a high-quality, seamless service to users, but as long as those in the social care profession are seen as the undervalued poor relations of those in the health sector, such integration is going to be very difficult. Scotland, Wales and Northern Ireland have already introduced a registration scheme, offering professional skills and better working conditions for those in social care and making it a more attractive career profession. When will England do the same?

[Lord Kamall (Con)]

As my noble friend rightly points out, the devolved Administrations have registers in place in Scotland, Wales and Northern Ireland and they have taken a phased approach over the years to registers of staff working in a variety of roles across social care, because of the complexity of the sector. This is why our first priority is to embed a knowledge and skills framework to clearly understand the current layout of the workforce and the skills required in their roles and to look at potential pathways before we consider mandatory regulation.

Public Health Grant to Local Authorities

Debate between Lord Kamall and Lord Young of Cookham

Tuesday 2nd November 2021 Lords Chamber

[Lord Kamall (Con)]

As noble Lords will know, the Chancellor has confirmed additional spend for public health, and the public health grant will be maintained in real terms over the spending review period, enabling local authorities to invest in prevention and front-line services such as child health visits. There will also be continued funding of £100 million per year over the period to tackle obesity in adults and children, as well as investment in a new start for life offer for families, with an additional £66 million in 2024-25. We know and recognise the importance of public health. At the same time, the NHS is committed to rebalancing between public health, prevention and therapeutics.

[Lord Young of Cookham (Con)]

Has my noble friend seen analysis by the University of York showing that expenditure on public health is three to four times more effective in terms of health outcomes than investment in the NHS? Will he take steps to ensure that we now invest in the resilience of the public health network to ensure that we are better placed for any future pandemics?

[Lord Kamall (Con)]

I thank my noble friend for that very important question. We continually assess our preparedness plans for infectious disease outbreaks and pandemics to ensure that they remain as robust as possible. This assessment includes, as appropriate, incorporating lessons learned from exercises that test the readiness of our plans and from our experience in responding to pandemics, disease outbreaks and other types of incident in the UK. The UK Health Security Agency will be dedicated to ensuring that we are protected from all future threats, including pandemics.

Social Care

Debate between Lord Kamall and Lord Young of Cookham

Wednesday 27th October 2021 Lords Chamber

[Lord Kamall (Con)]

I thank the right reverend Prelate for that question. I am not able to answer it directly now, but I will send an answer.

[Lord Young of Cookham (Con)]

My Lords, further to the question from the right reverend Prelate, I understand the concern that the proceeds from the ring-fenced levy may not be enough to relieve all the pressure on social care. So will the Minister encourage the NHS trusts, which are receiving the bulk of the extra funds, to use Section 75 of the National Health Service Act 2006 to commission social care, thereby taking some of the pressure off local authorities?

[Lord Kamall (Con)]

I thank my noble friend for that suggestion, and I will take it back. What we have to remember about the way social care is funded is that, in reality, it is mostly private providers that provide social care, and these are funded by private and state-funded patients. Quite often, we find it is private patients who cross-subsidise state-funded patients. I will take the question from my noble friend back and send an answer.