Tobacco and Vapes Bill

Lord Lansley Excerpts

Committee stage
Tuesday 11th November 2025 Grand Committee

[Lord Udny-Lister (Con)]

My Lords, I have tabled two amendments in this group, both with the intention of creating a stepped and more proportionate approach to fixed penalty notices, which I feel to be a very draconian measure in the first instance. Under the unamended drafting, the Bill would allow immediate penalties regardless of the scale or context of the offence committed. This is bad practice, contrary to the societal change that is needed if this legislation is to succeed.

Through these amendments, I want to enable enforcement authorities to apply sanctions gradually starting—this is important—with education and warnings for minor or first-time breaches. These would escalate only when non-compliance persists. This is a well-established approach of enforcement that is rooted in fairness. The goal of the Bill should be not to trap small retailers or inadvertent offenders in red tape but to encourage dialogue and corrective measures to be the mantra of our enforcement agencies. This is how you get change and compliance.

The tiered approach that I have outlined through Amendment 74 will build some much-needed credibility into the enforcement clauses of the Bill in a way that keeps the law tough when needed but ensures—this is important—that it is proportionate and, above all, fair. I beg to move the amendment.

[Lord Lansley (Con)]

My Lords, I will speak to the four amendments in this group that are in my name—Amendments 78, 86, 88 and 89. Particularly perceptive Members of our Grand Committee will remember that, when they looked at the third Marshalled List, the Minister had signed my Amendment 89. I understood at the time that she had signed it not for the same reason that I tabled it—as we discovered at the last sitting of the Committee, the Minister did not move a whole set of government amendments. We will doubtless return to those issues later.

My amendments are all of a piece. The object is to dive into Clause 38 and remove those parts that relate to money that is received through fines for licensing offences from the hands of the Consolidated Fund to put it into the hands of the local weights and measures authorities or—as we might get to, in due course—the relevant authority, which is the trading standards enforcement authority. My proposition is a terribly simple one: we should prioritise the receipt of resources not only from fixed penalty notices but from the fines imposed for licensing offences and they should be made available to local authorities with trading standards responsible for enforcement.

The background is probably well known to Members of the Grand Committee. Trading standards is operating with substantially fewer members of staff than it did a decade ago. The Local Government Association has warned that trading standards may be unable to fulfil its statutory duties and the Association of Chief Trading Standards Officers has warned of a growing gap between its statutory duties and the available resources.

Happily, today we meet with a realisation that this has not inhibited trading standards departments across the country from taking effective action together with the leadership of the National Crime Agency, which reported 2,700 premises—barber shops, vape shops and other trading establishments—operating illegally. Where vaping is concerned, which is our interest here, these are being used as a route for the sale of illegal vapes—without paying the appropriate duty or doing so in due course—including to minors, which is of particular concern for many noble Lords. There is also the employment of staff who are not properly able to work in this country.

A wide range of these issues requires enforcement. My purpose is to try to ensure that the resources that are clearly coming into the system are devoted to trading standards. We know, or at least it is estimated, that trading standards enforcement costs over the next five years will total something like £140 million. We know that the Government have provided a grant of £10 million to support trading standards. There clearly will be an income to local authorities from the fines relating to licensing to the extent that they will be able to recover their direct costs, as well as from the fixed penalty notices. We do not have an authoritative estimate of what that sum will be. If the Minister has a clear estimate of what the sums accruing to local authorities will be, it will give an opportunity to see how much of that £140 million cost over five years is likely to be met from penalties and fines.

This issue was debated in the other place and the Government, as is their wont, resisted the idea that money should be paid to local authorities from these fines, instead of being paid into the Consolidated Fund, because, as the Government put it, they did not want to create a perceived conflict of interest such that the enforcement authorities seemed to have an interest in pursuing fines. We should think of it the other way round. We want enforcement authorities to do their job properly. With these amendments, I am testing the proposition that the Government should increase the support for trading standards officers. If they find a provision that makes the revenue from fines to local authorities too much to bear, I should be supportive of a commitment by the Government—if not at this stage, then later—to assess the gap between the revenue that results from the fines and penalty notices and the costs to local authorities and to meet that gap by Exchequer grant, once they know what the Consolidated Fund revenues from these fines may be.

In addition to that request in principle to the Government, I have been looking at the impact assessment, which says in paragraph 1401:

“A new burdens assessment will be completed to assess costs to local authorities ahead of the Bill being introduced”,


particularly in relation to the enforcement of the new powers relating to vapes. I cannot find the burdens assessment—my research may be inadequate—but what does it say are the costs that need to be met by local government? That too should be something that we assess: to what extent is local government going to receive fixed penalty notices or fines that enable it to meet those costs? We do not want to be constantly adding statutory duties to local authorities without the corresponding resources.

[Baroness Bennett of Manor Castle (GP)]

My Lords, I have attached my name to Amendment 81 in the name of the noble Baroness, Lady Walmsley, from whom we have not yet heard—but that is the way the order works. I declare my position as a vice-president of the Local Government Association.

I am slightly torn because the noble Lord, Lord Lansley, has just put forward a strong case. There are indeed huge problems with the funding of trading standards. I go to a recent report in the Financial Times in which the chief executive of the Chartered Trading Standards Institute said that the underfunding of trading standards has left consumers open to rogue traders and fake goods. There is a huge problem there and, as the noble Lord said, the Government’s own impact assessment says this measure is going to increase the burden and they are already hopelessly overburdened.

However, Amendment 81 goes in a different direction, towards public health initiatives to be determined by local authorities. Either of these has a strong case. I prefer the public health case, because public health is something that I am gravely concerned about. There is a real logic to the money going from where damage is being done to public health towards dealing with damage done by illegal activity.

I talked about how much trading standards is suffering. We all know that public health in the UK is in a terribly parlous state; when we compare ourselves with other countries that we might consider similar to ourselves, we are doing much worse in public health. I suspect that the Minister will get up and say, “Yes, but in February this year we gave £200 million to public health”, but that is to go towards smoking cessation programmes —which are very relevant to the Bill—along with addiction recovery, family and school nurses, sexual health clinics, local health protection services and public health support for local NHS services, and £200 million does not sound like quite so much when I read that list out.

There is a real logic to making sure that this is not just a small drop of money going into the ocean—the Treasury—and that the money goes to where the damage has been done, to public health. Trading standards would still be better than the money going straight into the Treasury. These are simple, logical ways to make sure that we stick some plasters on to some of the crises that are affecting our communities.

--- Later in debate ---

Let me say a brief word on the new burdens assessment.

[Lord Lansley (Con)]

My Lords—ah.

[Baroness Merron (Lab)]

I thank the noble Lord for his almost intervention on that very point. I shall try to get the tense right here. As is standard government practice, a new burdens assessment will be conducted and shared with the Local Government Association. I can assure the noble Lord, Lord Lansley, that the additional net cost to local authorities in England will be considered in line with the new burdens doctrine. In summary, I hope that, for the reasons I have given—

[Lord Lansley (Con)]

None the less, the impact assessment, which I quoted, says:

“A new burdens assessment will be completed … ahead of the Bill being introduced”.


The Bill has been introduced so, clearly, the impact assessment was incorrect in that respect. I also reiterate to the Minister the request for her to say that the Government will be willing to look not only at the costs —there is an estimate of those—but at what the revenues from fixed penalty notices turn out to be, in case there is a gap between the cost of enforcement and the revenue from fixed penalty notices. Even if they continued to receive money into the Consolidated Fund, would the Government be willing to consider making additional Exchequer grants beyond the £10 million to meet any such gap?

[Baroness Merron (Lab)]

The noble Lord makes an interesting point. We will of course keep these matters under review. I will certainly look again at the impact assessment and at the point made by the noble Lord; I would be happy to write to him further, if needed, once I have had a look at all of that. On his specific point, we will keep an eye on the revenue, but, again— I am not sure that this is exactly the point that the noble Lord made; perhaps I can provide that bit of cover—in our earlier discussion, the noble Baroness, Lady Walmsley, and the noble Earl, Lord Howe, both acknowledged, as I did, that we are not seeking to get enough from fixed penalty notices to fund this. That is not our intention; in fact, we all hope that the revenue will decline as this Bill becomes increasingly successful in its impact. Let us also remember why we have this Bill: to introduce a smoke-free generation and drive down the demand for consumption. That changes the whole landscape. This is literally a generational change. So I hope that noble Lords will feel able not to press their amendments.

Tobacco and Vapes Bill

Lord Lansley Excerpts

Committee stage
Monday 27th October 2025 Grand Committee

[Lord Young of Cookham (Con)]

My Lords, Amendment 9, tabled in my name, would create an offence of selling tobacco products online. This is a probing amendment.

If the generational ban policy is to be effective, or the alternative policy of an age limit of 21, there would be a clear loophole if tobacco could be bought online, as roughly 9% of sales are at the moment, without any form of age verification. Such a policy would be unusual for the UK, as there is not currently a product that is available for sale in a bricks and mortar shop that you cannot legally purchase online. However, we would by no means be the first country in the world to introduce this measure: Brazil, Mexico, Finland, France and Greece, to name a few, have all banned the sale of tobacco products via the internet, so there are some clear international precedents.

Banning the online sale of tobacco was recommended by the Khan review in 2022 and the World Health Organization, which argued that internet sales constitute

“display at points of sale”

and

“inherently involve advertising and promotion”.

Today you can look up tobacco products on any of the major supermarket websites or shopping apps and see reviews, such as:

“Quite nice for relaxing on a summers day, beside a bubbling brook perhaps or at a test match”,


as one purchaser of Pall Mall Flow Red Superkings commented. Last time I went to a test match, smoking was prohibited.

Separately from the point about the delivery of smoking products, are these the messages that we want smokers to see about such a lethal product, given that such advertising was banned on television some 60 years ago? When retailers sell tobacco products, they are not permitted to display them, yet there are pictures of products online. This seems inconsistent. Products such as heated tobacco and cigarillos have colourful packaging, as they are not captured by plain-pack laws, which seems to be a regulatory oversight. I appreciate that the Government may be doing something about this, so perhaps the Minister can give us some details—but it feels like the online world is somewhere where rules are often bent with little repercussion, and the amendment would address that.

At the moment, online sales are not heavily exploited by underage individuals attempting to circumvent the law. However, we should be mindful of that possibility in the future. If the Government are minded to resist the amendment, I hope that the Minister will explain how age verification will be secured at the point of delivery. Someone born after 2009 can order their groceries online and include tobacco, but they could not buy it in the shop. How might this be enforced without the amendment? Does the Minister plan to go down the route that we have taken for the delivery of knives? Since 2022, a retailer has to verify the age of the purchaser before he or she sells a knife and, if that knife is delivered after an online order, it has to be checked at the point of delivery. Does the Minister have that in mind for tobacco sales? Who will be responsible for ensuring the implementation of the policy if tobacco products are available online? I look forward to her reply in due course.

[Lord Lansley (Con)]

My Lords, I am grateful to my noble friend Lord Moylan for introducing this group of amendments, and I agree with his proposals relating to the mechanism by which the House looks at statutory instruments. I also agree with my noble friend Lord Young of Cookham about the desirability of further constraining online sales. However, I do not want to talk at length about those; I want to talk simply about age-verification technology and the potential that it offers.

--- Later in debate ---

In answer to the other question about engagement from officials and the department, I can confirm that officials have engaged directly with the company which was being spoken about. The issue is not just about powers but about competitive advantage. To re-emphasise, the Bill is focused on the sale of products, not the use of them.

[Lord Lansley (Con)]

Is the Minister aware of the retailers—some 3,000 of them—which have written to Ministers to make the point, which emerged in a number of noble Lords’ speeches, about how concerned retailers are about the emphasis upon them denying access to vapes? The use of age-gating technology would substantially relieve those pressures on retailers.

We need to look at what the evidence may be about whether adult smokers who wish to quit by using vapes would be at all deterred by the age-gating technology. To that extent, what worries me is that we may conclude, either through international experience or pilot schemes in this country, that they are not deterred at all. Then suddenly we do not have access to a technology that would deal with illicit sales and proxy purchasing, which the point-of-sale restrictions will not bite upon. I worry that we should have the powers available.

[Baroness Merron (Lab)]

I understand the point the noble Lord makes. I believe I said that it potentially risks making vapes less accessible. I know that that is not a view that he shares. I also agree that, where there is evidence, we need to be focused on it in the measures we are taking. But the position I have outlined is the case. I will reflect on the comments that he and other noble Lords have made, which I have heard very well. I understand the concerns of retailers and I am very aware of them; that is why we continue to work so closely with their trade associations to overcome difficulties. We do not want retailers to be put in a position where they cannot do the job that they want to do. We will continue in our work in that way.

With that, I hope the noble Lord will feel about to withdraw his amendment.

NHS and Social Care: Joint Working

Lord Lansley Excerpts

Thursday 26th June 2025 Lords Chamber

[Baroness Merron (Lab)]

The noble Baroness raises a practical and realistic point that many care workers speak about. She will know that we are implementing a new fair pay agreement that, for the first time ever, will reflect what people actually do. Also, for the first time, there will be a universal career structure for adult social care that supports care workers. The approach that the Government are now taking shows a line of movement that takes seriously the pay, terms and conditions of care workers. I should also add that the noble Baroness, Lady Casey, will have free range to decide how she wishes to conduct her review of social care. Perhaps the noble Baroness, Lady Watkins, will ensure that she speaks to the noble Baroness, Lady Casey, about that.

[Lord Lansley (Con)]

My Lords, does the Minister agree that sometimes the most effective integration of care is around the decisions and choices of the care recipient themselves? To that purpose, would she agree that the NHS should be pursuing personal health budgets that can be combined with direct payments from social care entitlements, so that recipients of care can design their care, which will sometimes include the appointment of staff who are able to meet both purposes?

[Baroness Merron (Lab)]

I certainly agree with the noble Lord about the importance of the individual needs of the person at the centre. For too long—and part of this is a lack of integration—the needs of the person who receives, wants and needs that care and support have not been at the front. On his suggestion, I would just counsel waiting for the 10-year plan. It may not do exactly what the noble Lord says, but it will set out a way forward on how we will resolve such matters. I am sure that he will participate in further discussions about how we can get to the place that we all want.

Tobacco and Vapes Bill

Lord Lansley Excerpts

2nd reading
Wednesday 23rd April 2025 Lords Chamber

[Lord Lansley (Con)]

My Lords, I am very glad to follow the noble Baroness, Lady Thornton, and indeed to join her in saying how important it is that this is a further step in the process of strengthening our tobacco control regime and that we should do that on a cross-party basis. I agree with her that we should certainly put this, as I think the Front-Bench speeches did, in the context of a range of measures over a substantial period of time.

I was part of the health team—with my noble friend Lord Howe and, indeed, the noble Baroness, Lady Northover—back in 2010, when in the coalition Government we took the measures to which the noble Baroness, Lady Thornton, just referred and implemented those regulations. My noble friend Lord Howe was quite right to stress the importance of understanding how such powers are to be used, and in the passage of this legislation I hope we will understand very well and, if necessary, challenge the powers that are to be given and how they are going to be used, all the while, I hope, as my noble friend Lord Howe was doing, supporting the principles and trying to ensure that they are carried through with effective enforcement and a lack of unintended consequences.

We had supported the 2006 ban on smoking in public places from the Front Bench, but gave, as I think the Labour Party did at the time, a free vote on that measure, which helped, I think, to ensure that it was pursued without some of the complex exemptions which the Government were considering. I think that led us to the conclusion that, where some of these public health measures are concerned, as Horatio Nelson said, the boldest measures are the safest, and we were bold in 2010. As the noble Baroness, Lady Thornton, said, that boldness was very rapidly proved successful, so I think we may once again be bold. We set out, after 2010, with the ban on vending machine sales, the display ban and the consultation, which I initiated, on standardised packaging that was completed in 2015. All of this was very much focused on trying to ensure that we did not have a constant re-creation of a cohort of young people who went on to spend much of their lives trying and failing to quit smoking. The reduction of the initiation of smoking is a central part of this.

It is a less attractive habit to quote oneself, but back in March 2012, as Secretary of State, I said:

“My objective is to achieve smoke-free communities”.


That was over 13 years ago now. It was pretty controversial at the time, but I think it is now much less controversial and much more of a widely shared objective. The question was always how to achieve it, and I reinforce the credit to Prime Minister Sunak and my friend the then Secretary of State Sajid Javid for asking Dr Javed Khan, in his review back in 2022, to propose that bold step of an incremental rise in the age bar on cigarette sales. I very much support that, because it was not clear how we were going to achieve it and I think this now shows us the path to achieving it.

I support the Bill. I want to look at it constructively to ensure that it delivers what we are aiming for, including such practical measures as securing that trading standards officers have the powers and resources needed to secure compliance. Many noble Lords will talk about why we need to achieve this. From my point of view, it is not just that so many smokers suffer so much from their addiction to cigarette smoking; it is how it contributes so dramatically in society to the inequalities between parts of the country. We have to reduce those.

I have one point on vaping: I hope we will also look to take an evidence-led approach, think about what the long-term consequences may be and give ourselves the powers to respond to that over time rather than necessarily making all the judgments that we need to make now. I hope we will look at how we can make the enforcement procedures more effective as well. With all those thoughts yet to come, I very much support the Bill.

Community Pharmacy Closures

Lord Lansley Excerpts

Tuesday 28th January 2025 Lords Chamber

[Lord Lansley (Con)]

Further to that important point, will the Government guide ICBs to commission additional services from pharmacies? They have often not been commissioned with a sustainable funding model. Dispensing is not enough. They can provide important preventive services and minor illness services. However, they need the commissioning revenue to enable them to sustain their position.

[Baroness Merron (Lab)]

That point is understood, which is why I thought it important to bring to your Lordships’ House the announcement in the media release from my ministerial colleague Stephen Kinnock. As I mentioned in answer to an earlier question, integrated care boards have a role to play. They should—in fact, they are required to—have regard to the pharmaceutical needs assessment conducted every three years by local authorities. That ought to identify where there are gaps and allow consideration of how to fill any such gaps.

Health and Adult Social Care Reform

Lord Lansley Excerpts

Tuesday 7th January 2025 Lords Chamber

[Baroness Merron (Lab)]

As the House knows, my noble friend is a great campaigner on this issue. I can certainly assure her that the review will include exploring the needs of the 4.7 million unpaid carers who effectively hold the adult social care system together. On the point about the care workforce, we are already improving career pathways by expanding the national career structure, including new role categories. The suggestions my noble friend makes about a seamless service are quite right. We are a long way from that, but I hope we will be able to get to it, and the workforce will be key in that.

[Lord Lansley (Con)]

My Lords, may I tell the Minister that the Statement is not an accurate representation of what happened in 2009-10? More importantly, it is now over 13 years since Andrew Dilnot produced his report, and there have been many promises to implement it that have not been kept. There should be no further delay. The Minister should acknowledge that if there is further delay in implementing a social care cap on costs, many thousands more people will face the catastrophic loss of their life savings and earnings as a consequence of meeting those costs. Until we implement the cap on social care costs, we will not know whether it will deliver a market in providing insurance against long-term care costs, which in itself would make a significant contribution towards meeting some of the costs of social care in the future.

[Baroness Merron (Lab)]

I understand the wish of many, myself included, for more urgent action. However, the reality is that acting in haste will not solve the problem, not least because of the depth of the difficulties we are looking at. The noble Lord is right that many promises have been made—a number by his own Government—but not fulfilled regarding what should happen on the cap. I reiterate the point I made earlier: while I appreciate that there are Members of your Lordships’ House who believe that Dilnot is the answer, it deals with just one aspect, and that is not what we need. As my noble friend just said, we need a comprehensive look at creating a more joined-up service that will work around people, rather than focusing on institutions or one particular problem.

NHS: Treatment of Children from Other Countries

Lord Lansley Excerpts

Thursday 21st November 2024 Lords Chamber

[Baroness Merron (Lab)]

I will certainly ensure that officials take up the suggestion of the noble Baroness to explore possibilities.

[Lord Lansley (Con)]

My Lords, one of the reasons why people are envious of the NHS is because we are able to do things through the NHS which are not necessarily able to be supported in other countries by private medical insurance, and we have the benefit here of some of the finest clinicians in the world. That is something I am sure the Minister will want to focus on when she meets Professor Jeelani. There will doubtless be very specific ways in which he and his team might be helped, but could she bear in mind the fundamental principle that only about one in three million babies is in this condition and they have no hope other than to be treated by his excellent team? That is a responsibility, regardless of residence and those definitions, that we probably take on board through the NHS.

[Baroness Merron (Lab)]

I understand the point that the noble Lord makes and am sympathetic to it. He will also understand the need to ensure not only that we have the expertise here and use it correctly, but that the payment is in place so that the areas of excellence can also meet the requirements of other demands on them, including the reduction of waiting lists. He knows that it is a very delicate balance and that is why it is right that this is a trust-based approach, but I will certainly bear that in mind when I meet the professor.

Cancer: Older People

Lord Lansley Excerpts

Tuesday 19th November 2024 Lords Chamber

[Baroness Merron (Lab)]

I thank my noble friend for her confidence, and I will do my best. Decisions on screening, including the age ranges at which they operate, are made by the UK National Screening Committee. They have an upper and a lower age limit, which are based on evidence and kept under review. Current evidence does not support making changes to these ages. For breast screening, for example, self-referral is available for those over the age of 71 and for bowel screening it is available for those over 75. I confirm to her that this is all evidence-based, and we always keep an eye on the continuing evidence.

[Lord Lansley (Con)]

My Lords, I declare an interest in that I am a happy statistic of having survived more than five years after cancer treatment. But I know that I am not alone and that many others of the near 2 million cancer survivors have chronic conditions resulting either from cancer or from its treatment. Will the cancer strategy recognise and offer support to the many cancer survivors who have continuing chronic conditions resulting from their cancer?

[Baroness Merron (Lab)]

I am glad that the noble Lord is, as he describes himself, a happy statistic. We are all grateful for that. I certainly share the view that there are a number of ongoing chronic conditions and impacts on other aspects, such as people’s mental health. The cancer strategy needs to look at this in its development, and I am grateful to him for highlighting it.

NHS: Independent Investigation

Lord Lansley Excerpts

Tuesday 8th October 2024 Lords Chamber

[Baroness Merron (Lab)]

I am sorry to hear of the circumstance that the noble Baroness raises. I agree with her about the pressure on GPs who, of course, are working harder than ever. We know, not just through the Darzi report but through much evidence, that discharge into the community has to take place at the right time and with the right support, and that is not the case at present. I will certainly take up the specific thing the noble Baroness asks for and look into it in far greater detail, because this is clearly a practice, as she described, that is not supporting patients or GPs but working against them.

[Lord Lansley (Con)]

A wholly different report could have been written based on the underpinning evidence. To that extent, the report may call itself independent but it was not objective. If the Minister subscribes to some of the hyperbolic criticisms of the 2012 Act, can she then explain how the NHS in Labour-run Wales—where the 2012 Act had no effect whatever—performed worse on almost every measure of performance? She said that output was what matters. Can she therefore confirm that productivity in the NHS rose after 2010, relative to the preceding period, up until the pandemic? Can she actually agree that it is outcomes that matter most? Will she say that the Government will maintain the progress that needs to be made in making the NHS accountable to the NHS outcomes framework that we established a decade ago?

Finally, to revert to what my noble friend and the noble Lord, Lord Scriven, rightly asked about, in the last decade the 10-year plan has been something that the NHS owned. There was the five-year forward view in 2014 and the 10-year plan in 2019, and now in 2024 the NHS should own the refresh of the 10-year plan, but I do not think that is going to be the case. Can the Minister explain why the Government are taking that earned autonomy away from the NHS?

[Baroness Merron (Lab)]

I do not recognise the description of taking autonomy away; I appreciate that that is the noble Lord’s opinion. The National Health Service is so key to not just our health and well-being but the economic health of this country. In my opinion, it is something of a backbone of the country. It is right that the Government have made this an absolute priority and have commissioned a very honest report—I hear his criticisms of the report; they are not ones that I share—and that the Government are held accountable. That does not mean taking away autonomy from the NHS. I accept the noble Lord’s point that it is outcomes that matter, and perhaps I should have put that better because by output I mean things not just being done but actually being effective. I thank him for that point.

On frameworks and meeting obligations, one of the points made not just in the Darzi report but elsewhere is on how many of the standards are not being met. We will return to a number of the standards to ensure that people can feel that they know what they are going to get and within what timeframe, and that that will be absolutely possible. We are interested only in what works. We are not interested in scoring points; we are interested in improving the health and well-being of the nation, and I hope noble Lords will want to join with that.

Covid-19 Inquiry

Lord Lansley Excerpts

Tuesday 3rd September 2024 Lords Chamber

[Lord Lansley (Con)]

My Lords, I am very pleased to contribute to this debate and to follow the noble Baroness, Lady Thornton. One should never underestimate the importance of the Official Opposition in securing the role of good government. I am slightly hoping that the noble Baroness, Lady Merron, will recall that I was the shadow Secretary of State for Health when she was Minister of State for Public Health during the swine flu pandemic. I give credit to her and to the then Secretary of State, Andy Burnham—and indeed to Alan Johnson previously—because they were always very open. She will know that it was one of the things I was very interested in before the 2010 election. I asked specifically for an evaluation by the Health Protection Agency of the containment phase of the response to the swine flu pandemic. Although people might imagine that we did not do this, we were looking carefully at what the potential for containment of an influenza epidemic looked like and how we might do more in that respect.

I should declare an interest: I was Secretary of State between 2010 and 2012. In that context I was, strictly speaking, the author of the 2011 pandemic influenza preparedness plan. I am not going to go on at length about it, but I have my personal criticisms of the way the inquiry has been conducted, which I hope can be remedied in part by the government response which the Minister said will be coming in the months ahead. It is very important for the Government to ensure that any flaws in the inquiry report are themselves challenged, because the inquiry may have been prone to groupthink as well, by imagining that there were certain conclusions that it was bound to reach and then aiming for them.

My problem with the process is that, as a number of noble Lords have said, there is criticism of flaws in the 2011 preparedness plan. The inquiry did not ask me for evidence. It did not invite me to give oral evidence or ask me for written evidence. Notwithstanding that, it then chose to send me a rule 13 letter, making what were not specific individual criticisms but generalised criticisms of Secretaries of State over a period that included me. I then had three weeks in which to send it what were pages and pages of corrections, some of which it took on board, and others it did not. Although I will not go through them in detail, there are things the report says about the period running up to the 2011 pandemic influenza preparedness plan and the use of it which are absolutely wrong. It is not fair for it to say that we should have looked at other emerging infectious diseases in the same way that we looked at avian influenza.

I was responding, and I knew it, to the national risk register. It said that H5N1 was going to have a very high mortality rate when it was transmitted to humans, and therefore was immensely dangerous. If it were to mutate to the point at which it would be readily transmissible between people, we would be facing a pandemic on at least the scale of Spanish flu. I was very focused on that, because that is what the risk assessments told me to do. Let us not leave aside the central importance of looking at risk and understanding the various components of the risks that we face. To be fair, the national risk register and the risk assessments took account of other emerging infectious diseases—hence the establishment of NERVTAG.

We should be much more aware of the risk of the next pandemic—we may be in it. The scale of the impact of antimicrobial resistance on global population and mortality could potentially be worse than the Covid-19 pandemic. We know that many emerging infectious diseases are zoonoses, and we may see in them characteristics that we do not recognise from either influenza or coronaviruses; it may be something completely different, and the vectors of transmission may be completely different.

I do not want to go on about it at length, but I want to talk about the idea that, in 2011, we should have had a pandemic plan that looked at other potential pandemics. It would not have changed the outcome in 2020. Why? Because when you look at the 2011 pandemic preparedness plan, you find that many of the potential countermeasures were either not considered or the evidence base we were presented with and on which Ministers were working said that they would not work.

The evidence base said that respirators and face masks were right for preventing transmission by a person but that they were probably not going to be effective in the population as a whole. We may now conclude that that was wrong, but that was the advice we were given at the time. The advice given at the time was that school closure should have been a limited measure, devoted to specific high-impact areas and events. That may have been wrong, but it was the advice given at the time. The advice given at the time was that we stood no chance of containing a pandemic by controlling access to airports.

If somebody had come along, by some mystery, and told us in 2011 that we were going to be presented with a coronavirus pandemic of the scale that we subsequently encountered, many of the measures that we deployed—including lockdowns, which were not recommended in relation to pandemic influenza—would not have been recommended. The pandemic plan may have been a pandemic plan for some other virus, but it would not necessarily have been any different from that which was prepared for pandemic influenza.

Therefore, there are two key points when it comes to what our preparedness should look like. The first is understanding at the earliest possible moment what a new virus or infectious disease actually looks like. How is it transmitted and by what means? What is the incubation period? What are the clinical characteristics? In 2011, the idea that we could be presented with something with a long incubation period and asymptomatic transmission was not contemplated, and so the idea that in 2011 we would have understood this and prepared for it is fanciful.

The point that the inquiry looks at but does not really focus on is the second key part of preparedness: making the country resilient by making people and our public health system more resilient. I put in parentheses that the public health White Paper of December 2010, establishing Public Health England, did so on the basis that its budget would increase at the same rate as the NHS budget. In 2015, this was trashed by the Treasury. Unfortunately, I think Secretary of State Hunt let that happen. You can look at the evidence to the inquiry from Duncan Selbie, former chief executive of Public Health England, to see the serious adverse consequences that resulted from the £200 million cut in that year and in subsequent years to the public health budget.

Not only that, but we must understand that, around the world, some populations were more resilient because they were less unequal. Equality matters. The coalition Government had this as an explicit objective of our policy, and I personally very much subscribe to it. Our public health needs us to be much more equal and for disadvantage to be actively challenged. That is why I supported Michael Marmot in the latter part of his further inquiries.

I encourage the Minister, in the work that will be done in government, not simply to respond to this module —and, as the noble Baroness, Lady Thornton, rightly said, to later modules—with what the present Labour Administration think or thought at the time but to challenge some of the things that the inquiry says if it is conducting itself on a basis which is not a reasonable one for us to have worked on in the past. To make conclusions that are unjustified seems to be a bad way of reviewing the evidence and thinking for the future.

Finally, when the inquiry moves on to later stages, I hope it will return to the question of what was done in 2016 on Exercise Cygnus and after it. If we are going to do better in future, having plans is critical. As von Clausewitz would have said, having plans will never stand contact with reality but having no plan gets you nowhere. It is important to have plans and to expose those plans to serious scrutiny, including by Ministers, as well as officials, and to follow up on those plans.

Everything tells me that the 2011 preparedness plan was not the problem. The problem, as Sally Davies said in evidence to the inquiry, was that it was not reviewed, updated and properly looked at in 2016 as it should have been. After Exercise Cygnus, there should have been a new and additional preparedness plan related to what we had then understood to be different threats from MERS and SARS. That did not happen. The follow-up to Exercise Cygnus did not happen as it should have. Having these exercises, preparing the scenarios and following up on them is absolutely critical to our overall preparedness, as is reforming our ability to influence the public health of this country.