Respiratory Syncytial Virus: Vaccination Programme

Lord Mott Excerpts

Tuesday 9th September 2025 Lords Chamber

[Lord Mott (Con)]

My Lords, it is an honour to follow the noble Baroness, Lady Ritchie, in this important debate this evening. Summer is only just behind us, yet I have no doubt that minds of NHS leaders will already be turning to how to deal with winter pressures. The NHS has always faced challenges in winter but, before the pandemic, only around one in 500 patients waited for more than 12 hours for emergency admission during the winter peak. Since then, the numbers have already risen sharply, with January 2025 seeing a record high of more than one in 10 patients—11.21%—waiting for more than 12 hours.

Seasonal illnesses, of which RSV is one example, have played a significant role in increasing this strain. RSV accounts for over 33,000 children under five and 24,000 adults admitted to hospital each year. That is why I welcome the decision to launch a new vaccination programme against RSV—announced by the previous Conservative Government in June 2024 and supported by the current Government since—to protect mums, their infants and older adults.

I thank the noble Baroness, Lady Ritchie, for securing this important debate today. It is hugely important, and her work has led me to take part in this debate this evening, because, for all the positives about the introduction of the new vaccination programme, we are seeing very substantial variations in take-up across different regions and ethnic and socio-economic backgrounds. For example, as already mentioned, coverage in the east of England is almost 10% lower than in the south-east, and coverage in London is even lower. I hope that the Minister will be able to update the House on what is being done to address this.

More broadly, there continues to be misinformation about vaccines and their safety, not least with wild claims being made from some political parties about vaccines over the last few days, which I will not repeat here. I am a strong defender of free speech, but misleading people can be very dangerous, and we need to ensure people have access to credible information when making decisions about their own health. I also hope the Minister can update on what more can be done to ensure patients are receiving high-quality and factual information that addresses risks and benefits, so that we can see a wider take-up of not just the RSV vaccine but vaccine programmes more widely.

In closing, it is incumbent upon us to recognise that awareness is not a passive state but a catalyst for principled action. The recent rollout of the maternal RSV immunisation programme, while a welcome development, reveals concerning disparities in uptake. As of May 2025, only 42.8% of women giving birth in England had received the RSV vaccine prior to delivery, with regional variation, and with lower figures reported in Wales. These numbers underscore the urgent need to strengthen public engagement, improve access and ensure that every infant, regardless of geography or circumstance, is afforded equitable protection. I am certain that the noble Baroness, Lady Ritchie, will continue to scrutinise, to question and, above all, to advocate; she has a new voice to support her.

Prostate Cancer

Lord Mott Excerpts

Wednesday 3rd September 2025 Lords Chamber

Asked by

[Lord Mott]

To ask His Majesty’s Government what steps they are taking to ensure that GPs proactively discuss prostate cancer with men at the highest risk; and inform them of their right to a free prostate specific antigen test.

[Lord Mott (Con)]

My Lords, around one in eight men will be diagnosed with prostate cancer at some point in their lives. In the UK, it is the most commonly diagnosed cancer in men and, sadly, it causes around 12,000 deaths a year. Even more tragically, this number includes many men who are dying needlessly due to late diagnosis. Around one in five of those diagnosed are diagnosed too late. When caught early, there is nearly a 100% survival rate—a remarkable reflection of advances in treatment—but survivability plummets to around 50% when the cancer has progressed to stage 4. Our current approach to testing and screening is falling short. That is why I have secured this debate today, and I welcome Members from across the House who have indicated that they wish to take part.

I support calls for a targeted screening programme for high-risk men. I believe that over 135 Members in the other place have expressed their support, as have many noble Lords. Importantly, so have the vast majority of GPs when surveyed, as well as many patient and campaign groups, including Prostate Cancer Research and Prostate Cancer UK, which I must thank for their support. It is also important to thank the Daily Telegraph and Daily Mail for raising awareness by taking up the campaign.

The National Screening Committee is currently carrying out its review, but it seems clear to me that the introduction of MRI and new biopsy techniques, alongside the traditional PSA test, goes a long way to addressing concerns about the accuracy of a PSA test alone and the risks of the diagnostic process. The All-Party Parliamentary Group on Prostate Cancer published a report yesterday to that effect, highlighting the progress that has been made in reducing the risk of overdiagnosis and overtreatment. I hope the noble Baroness, Lady Merron, can offer an update on when this is expected to conclude and on what the Government are doing to ensure there is no further delay.

I also want to note the longer-term work, including the £42 million TRANSFORM trial, announced under the previous Government, that can further add to the evidence base and is a huge step forward; yet I have not chosen to make this the focus of today’s debate, because the issue is too urgent to wait. I want to focus on what we can do immediately to stop men dying needlessly.

Whatever the outcome of the National Screening Committee’s review, we need to change the guidance we give to GPs. At the moment, we leave it to men to proactively request a PSA test from their doctor and we actually prevent GPs from raising the issue, even with men who are at the highest risk. Men are already more likely to put off a visit to the doctor. I must admit I know this from personal experience. How realistic is it to have a system that means a man must proactively find out his risk and then chase his doctor for a prostate cancer test? It means only those who have sharp elbows or who are highly skilled at navigating the health system are getting the tests they need. It is bad enough across the board, but such an approach also entrenches health inequalities, leaving high-risk groups, particularly black men, those with family history and men in deprived areas, seriously disadvantaged.

This guidance was well intentioned when drafted, but it is now out of date. Previously, the test used could cause pain and bleeding and came with a risk of serious infection, but the introduction of MRI and new biopsy techniques has been transformational. Diagnosing prostate cancer has never been safer or more accurate. When combined with the serious consequences of late diagnosis, an update to the guidance is justified. Allowing GPs to have proactive discussions with high-risk men about their right to a free PSA test does not mean that everyone will choose to have a test; indeed, allowing doctors to have proactive conversations could help to reduce the overall proportion of over- diagnosis and overtreatment. GPs would only be proactively raising the point with those most likely to be diagnosed with aggressive cancers.

If we want to say we have a policy of informed choice, then let us make that a reality. Do not leave men to have to do their own research. Let their GPs talk them through it, let GPs guide men on the risks and benefits, and let us make the system one that does not entrench health inequalities. Will the Minister give a commitment today to revisit the guidance given to GPs through the prostate cancer risk management programme to allow them to have proactive conversations with high-risk men?

In conclusion, there is much more to do to stop men dying needlessly of prostate cancer that goes well beyond the scope of this debate, from supporting research and investing in our diagnostic infrastructure to outreach through efforts like the “Man Van” model, which recently made an appearance in Westminster, and the excellent work that has been carried out by Professor Stephen Langley at the NHS Royal Surrey cancer centre and hospital in Guildford, with a trial run by Surrey and Sussex NHS cancer alliance. I certainly hope that we have a targeted national prostate cancer screening programme once the National Screening Committee completes its review. Irrespective of the committee’s decision, we can take action today to end the absurd practice of GPs being prevented from raising prostate cancer checks with men at the highest risk. I urge the Government to take this forward without delay and I look forward to the debate and to hearing from the Minister.

Tobacco and Vapes Bill

Lord Mott Excerpts

2nd reading
Wednesday 23rd April 2025 Lords Chamber

[Lord Mott (Con)]

My Lords, I welcome the Second Reading of this important Bill. It is right that we scrutinise it carefully, and I am pleased to be following my noble friend Lord Bethell. This is a landmark piece of legislation, introduced by the previous Conservative Government, with the ambition of delivering a smoke-free 2030.

As a father of two daughters, I care deeply about the future we are building for the next generation. Protecting children from smoking and vaping is vital, but to achieve that we must ensure that the Bill is practical, enforceable and fair to those who act responsibly. My concern is that in its current form, the Bill risks harming responsible retailers and manufacturers, while driving trade into the hands of the illicit market. Many of these retailers are already under pressure from inflation and increased costs, as highlighted very clearly by my noble friend Lord Sharpe.

I support the introduction of the retail licensing scheme. Reputable retailers have been calling for a scheme like this for years. Licensing will help distinguish responsible businesses from those that sell illegally. We know from ASH that nearly half of underage vapers buy their products from retailers, and the Chartered Trading Standards Institute says that around a third of vaping products in the UK are non-compliant. A proper licensing scheme will help enforcement and protect children, but there is no implementation date in the Bill. Without enforcement, this legislation will not succeed. Trading Standards Wales has already raised concerns about the risk of the expanding illicit market. I will support amendments to strengthen and accelerate the delivery of the retail licensing scheme. Responsible retailers must be supported, and those that break the rules must be held to account.

Another urgent issue is the rise of “mega puff”, or carousel, vape devices. These are being marketed as reusable, but in reality they are often thrown away after the coil burns out, as mentioned by other noble Lords. These devices are cheaper per puff, contain more liquid and plastic, and are proving popular with young people. Material Focus estimates that 3 million of these “big puff” devices are sold every week, and nearly half are sold to 16 to 34 year-olds. If we do not act now, this loophole will undermine the disposable vape ban coming into force in June. The Government must be empowered to remove these products and prevent future redesigns that bend the rules.

I find myself in the unique place, as mentioned earlier by my noble friend Lord Lancaster, of agreeing not only with him but with the noble Baroness, Lady Bennett of Manor Castle. While the Bill rightly focuses on reducing the health harms of tobacco and vaping, we must also recognise the significant environmental damage caused by cigarette litter. Cigarette butts are made of a synthetic plastic. Each cigarette butt contains around two straws’ worth of plastic. Globally, around 6 trillion cigarettes are smoked each year, of which 4.5 trillion are littered. Even here in the UK, an estimated 3.9 million cigarette butts are discarded every day.

These butts are not just unsightly; they pose a real threat to wildlife, pollute waterways and are expensive for local authorities to clean up. Each plastic cigarette filter can take up to 10 years to break down into microplastics—tiny particles that now pollute every corner of our planet, from the summit of Mount Everest to the deepest parts of the ocean. Microplastics are now found in our food, our water and even the air we breathe. The scale of this problem is growing. According to the Marine Conservation Society, the amount of plastic waste found on UK beaches rose by 9.5% in 2024, compared with the previous year. As we look to shape a smoke-free generation, we must also address the long-term environmental consequences of tobacco use. I urge the Government to consider measures to reduce cigarette filter pollution as part of this legislation.

I have focused on two areas that are critical to the success of the Bill. We must support enforcement and close dangerous loopholes so that the legislation achieves what it sets out to do. Above all, we must protect our children and reduce smoking-related harm. I look forward to hearing the Minister’s response and working with colleagues to ensure that the Bill delivers a truly smoke-free generation.

New Hospital Programme Review

Lord Mott Excerpts

Tuesday 28th January 2025 Lords Chamber

[Lord Mott (Con)]

My Lords, I welcome the £102 million that the Minister referred to for the upgrade to GP estates. May I ask how many of those will be in Cambridgeshire? Has any assessment been made of the pressure that the upgrade of those GP estates will take off the NHS? The Minister said that often people cannot get a GP appointment and therefore tend to go to A&E. Has any assessment been made of how much pressure will be taken off and, more importantly, the quality of care given to people who are able to go to their local GP instead of having often to go to A&E?

[Baroness Merron (Lab)]

While I cannot answer exactly on Cambridgeshire, which the noble Lord raises, I can say that the department and NHS England are working with integrated care boards to ensure that there is a priority on high-impact projects where investment will unlock all the things we are all looking for, which are significant productivity gains and additional usable space from existing buildings. Of course, ICBs are responsible for that. I perhaps should also make the point that this is the first dedicated national capital fund for primary care since 2020. The noble Lord rightly quoted me back about the benefits of investing in GP practice. We are probably all familiar with that. There have been a number of reviews, including, of course, the independent review of the noble Lord, Lord Darzi, which spoke to the point about the need for capital investment in primary care.