Tobacco and Vapes Bill

Lord Rennard Excerpts

Report stage
Tuesday 24th February 2026 Lords Chamber

[Lord Sharpe of Epsom (Con)]

My Lords, I will speak in favour of the amendments tabled by my noble friend Lord Murray of Blidworth. I will concentrate on one narrow area—one of the practical aspects of this generational ban—which, as my noble friend Lord Clarke highlighted, is the inevitable difficulty of age verification in stores. I am sure the Minister will soon argue that age verification is a well-established practice and therefore should present no particular difficulty, but the implications of the Bill in a few years’ time are profound, as my noble friend noted.

Judging the difference between an 18 year-old and a 40 year-old by eye is not especially difficult—although at this point I note that there are a number of Peers on the Government Benches who regularly claim that even that is impossible in the case of asylum seekers. But how is a shopkeeper supposed to judge the precise age of someone who is apparently 40 years old in a few years’ time? Is he 40? Is he 39? Is he 40 in 364 days? I am sure that we will soon hear the argument that the point is actually somewhat moot, because that 40 year- old born after the 1 January 2009 will have never smoked or shown any desire to smoke because of the Bill. But that is simply not a credible argument. As my noble friend Lord Murray noted, the generational ban is a de facto prohibition, and one does not need to be a dedicated student of history to know that prohibition of any kind has never worked. Indeed, it serves to make whatever is being prohibited more desirable, more glamorous and more edgy. Plenty of people will still choose to smoke.

In effect, the state will therefore be asking shopkeepers to both comply with and police the law at the same time. To put some statistics around this, the Association of Convenience Stores represents 50,000 local shops, petrol forecourt sites and independent retailers across all locations. Last year, it reported that there were 57,000 incidents of violence against people working in convenience stores. Some 87% of store workers reported verbal abuse and 44% reported hate-motivated abuse. The top three triggers of this violence epidemic were encountering shop thieves, enforcing age restriction policies and refusing to serve intoxicated customers. Does the Minister think this will get any better when the shopkeeper has to ask two middle-aged men for their passports—or, indeed, an 85 year-old for his birth certificate?

Today, I read that the British Retail Consortium has reported that there were 1,600 incidents of violence and abuse per day in shops in the year 2024-25. That is down from the previous year, but it is still a staggering number. It is welcome that the Crime and Policing Bill will make assaulting a retail worker an aggravated offence, but that is, I contend, highly unlikely to make any difference at all to the number of incidents around age verification, which are inevitable. I am sure the Minister will also refer to the increase in police numbers and neighbourhood policing officers due by 2029. That is also welcome, of course, but I note that the previous Government bequeathed more police officers than ever before in this country, and that did not have a noticeable impact. The simple fact is that this measure will inevitably cause more trouble, and the Government will be unable to do much about that. It is ludicrous to pass a law that will provoke the breaking of other laws.

My noble friend Lord Murray’s amendments would achieve the Government’s aims without causing this needless aggravation. The Government’s own impact assessment states that a one-off increase in the age of sale to 21 would be just as effective in the short term at reducing smoking rates, compared with a generational smoking ban. The Government should change tack and accept my noble friend Lord Murray’s amendments.

[Lord Rennard (Non-Afl)]

My Lords, I oppose Amendment 1 and the associated amendments tabled by the noble Lord, Lord Murray of Blidworth, because I believe wholeheartedly that a country free from the harms of tobacco would transform the public health of this nation and prevent huge amounts of human suffering. We heard from the noble Lord about the reversal of the planned policy in New Zealand, but we did not hear an explanation for that. The explanation is quite simple: there was a change of coalition parties following a general election. One of the new coalition parties feared the drop in revenue to the Government as a result of the policy being introduced and a reduction in the prevalence of tobacco smoking, which surely proves the point that that party accepted that such policies as this would be effective.

We have heard about the wonderful, kind-spirited nature of the tobacco industry in caring for young people, but not enough about the many decades of deceit, in which that industry knew full well the links between its products and lung cancer, and covered up what it knew and lied about them, as it lied about tobacco smoking of a second-hand nature. This is not an industry which we can trust for a remote second.

[Lord Clarke of Nottingham (Con)]

May I ask what evidence the noble Lord has for that? I well remember, when I was on the board of BAT, that we acknowledged the health risks. We were accused of somehow denying it, but the people with this bizarre conspiracy theory were never able to produce any examples of our denying it, because we did not, and we did not oppose warnings and labels on packages. It is just part of the mythology of the more extreme fringe of well-intentioned anti-tobacco lobbyists.

[Lord Rennard (Non-Afl)]

My Lords, with respect, I am not part of any extreme fringe, and the views I have enunciated are shared almost entirely by the medical profession in this country. For decades, the tobacco companies had evidence that tobacco was linked to lung cancer, yet they kept denying until it was proven by showing the number of people with lung cancer who smoked and the number of people with lung cancer who did not. The industry hid that as it fought tooth and nail against such things as plain packaging with many bogus arguments. This is the most deceitful industry in the world.

We have heard about the cliff edge problem, but it is one that we have now. At 17 years and 364 days, you may not buy tobacco, but you can on your 18th birthday. With these amendments, that would change to being able to buy tobacco on your 21st birthday, but not after 20 years and 364 days on this planet.

My experience of being orphaned at 16, and finding my mother, a heavy smoker, dead in her bed as a result of hypertensive heart disease, with smoking obviously a key factor in her death, has driven me, ever since then, to support people trying to quit—that is most smokers, in my experience—and to prevent the tobacco industry promoting addiction to its lethal products. The Bill proposes a world-leading policy of which we should be proud, and we should not make it less effective, as proposed by many amendments in this group.

Raising the age at which someone can legally be sold a cigarette works in terms of reducing tobacco consumption. It may not be 100% effective, but that is not a reason to try to make it less effective. We know that raising the age of sale in England from 16 to 18 in 2007 reduced smoking rates among 16 and 17 year-olds by 30%. In the US, when the age of sale was increased from 18 to 21, the chance of a person in that age group taking up smoking fell by 39%.

The tobacco industry employs the most deceitful and dangerous lobbyists in the world. Their role is to try to protect its enormous profits and persuade more people—in particular young people—to take up the deadly habit in order to replace the 50% of its consumers whose lives are shortened by smoking tobacco.

One argument we hear from opponents of tobacco control legislation is that it represents a so-called nanny state. This is a term that I feel is really used only in the media. The phrase does not resonate with the public, who are highly supportive of tobacco control legislation. I hear laughter, but polling shows that 68% of the public support the smoke-free generation. The Chief Medical Officer has been clear that there is no freedom in addiction. Many people start smoking as children and become addicted almost immediately. Two out of three people who try just one cigarette go on to become daily smokers, and three-quarters of smokers say that they would never have started if they had the choice again.

It is also important to be clear what this policy does and does not do. The rising age of sale does not remove any current adult’s ability to buy tobacco; it simply phases in a high minimum age of purchase for future generations. That is a proportionate approach. By contrast, accepting these amendments would mean that those aged 18 to 20 who already smoke would suddenly be unable to buy tobacco legally—a far more intrusive step.

Smoking remains one of the greatest preventable burdens on our public services and our economy. It is responsible for up to 75,000 GP appointments every year. It costs the country approximately £27.6 billion in lost economic productivity. It costs the NHS almost £2 billion annually and local authorities nearly £4 billion a year in social care costs. That is money we do not have, and which could and should be spent on improving health, not managing preventable harm. The number of people—

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

My Lords, I remind the noble Lord that this is Report stage of proceedings. His speech is a bit on the long side. Can he bring his remarks to a close, please?

[Lord Rennard (Non-Afl)]

My Lords, I hear some responses from the Benches next to me who disagree with this. I hope, however, that they will consider carefully the arguments that I am making, and those that come from the Minister shortly.

[Lord Blencathra (Con)]

My Lords, unlike the noble Lord, Lord Rennard, I rise to support my noble friends’ amendments in group 1, not to defend tobacco, but to defend common sense, public safety and the livelihoods of tens of thousands of small shopkeepers who would be most harmed by a policy that looks simple on paper but is deeply dangerous in practice.

First, the burden on retailers and communities is real. Small shopkeepers already face unprecedented levels of crime and intimidation. The Bill would force them to enforce a moving legal threshold every year, placing the full weight of policing on their shoulders.

We heard an awful lot from the noble Baroness, Lady Northover, on guidance. I am listening to my noble friend Lord Sharpe of Epsom describing what the shopkeeper would have to do, and I would love to see what the Government guidance will be for that shopkeeper. When they ask, “What is your age? When were you born? Prove it.”, how on earth will the shopkeeper be able to deal with people in their 20s, 30s and 40s when trying to stay on the right side of an ever- changing law?

The implementation of a generational ban on tobacco sales will have profound, unintended consequences for shopkeepers, law enforcement and retailers—to the benefit of organised criminals—across the UK for years to come. That is not hyperbole; it is a sober description of the risks we are being asked to accept with this.

Secondly, the policy will drastically expand the illicit cigarette market and hand control to organised criminals. Everybody knows the stark evidence—even though HMRC will never admit it—that illicit tobacco loses the Treasury £3.5 billion per annum. Some 25% of all cigarettes sold are illicit and cheap, and the price differential drives consumers to illegal sources in pubs, clubs and under-the-counter sales.

This ill-conceived generational ban—admittedly, a stupid idea from the last Government—will create a permanent cohort of consumers who cannot legally buy tobacco, and where demand exists, supply will follow. That supply will be by criminal networks. Let us look briefly at Australia as a sign of what will unfold in the UK. Organised crime gangs dominate the illicit tobacco market in Australia, which has led to arson, violence and the takeover of local markets by criminal gangs.

Thirdly, enforcement capacity is already stretched to breaking point. Trading Standards and other front-line agencies have lost staff and lack the resources to police a complex, ever-changing age rule. Enforcement bodies are underfunded and under-resourced; adding a perpetual generational rule will only widen the enforcement gap and shift the burden to retailers and local communities, who will be unable to cope. When enforcement fails, the law becomes a paper shield for criminals and a real threat to honest businesses.

What is the sensible alternative? It must be setting the age at 21, as set out in my noble friend’s amendment. This is not a retreat from public health; it is a pragmatic, enforceable measure that achieves the same long-term outcome for young people while avoiding the catastrophic side-effects of a generational ban. My noble friend set out in detail from the Government’s own impact assessment how raising the age to 21 would achieve the same long-term aim.

A minimum age of 21 is clear, static and much more easily enforceable. It allows retailers to train staff once and apply a consistent rule, and it reduces the incentive for criminal markets to exploit a permanently excluded generation. It also aligns with international practice and with the Republic of Ireland’s own policy direction, reducing cross-border legal friction.

Finally, we must pair any age change with stronger enforcement and support. If we raise the age to 21, we should simultaneously strengthen fixed-penalty regimes, resource trading standards and Border Force properly and invest in targeted education and cessation services. Enforcement must be credible—it is not at the moment. Everybody knows that you can get illegal cigarettes in any pub or club in the country. We need stepped penalties for repeat offenders, licensing powers that bite and better funding for the agencies that will be asked to do the work.

All of us in this House and Parliament share the aim of reducing smoking, but good ends do not justify bad, unworkable means. A generational ban risks destroying small businesses, empowering organised crime, overwhelming enforcement and creating legal chaos. A minimum legal purchasing age of 21 is a proportionate, enforceable and effective alternative that would protect public health without the catastrophic unintended consequences. If we come to a vote, I urge the House to reject the generational ban and support a measured, evidence-based approach that combines an age limit of 21 with robust enforcement and support for cessation. I support my noble friend’s amendments.

--- Later in debate ---

I welcome the Government’s amendments in this space—I think I counted 24 in the Bill—and I am very grateful for those. I am looking for some further words of reassurance from the Minister that beyond enabling powers, which we welcome, there is a clear intention from the Minister to take action. The Government taking action is where we all want to get to and, in our view, that is the best outcome on this issue.

[Lord Rennard (Non-Afl)]

My Lords, my Amendments 129 and 133 would place a duty on the Government to consult on whether health warnings should appear not just on cigarette packets or the inserts within them but on every single cigarette, by printing the warnings on the paper enclosing the dangerous tobacco. In Grand Committee, the noble Baroness, Lady Merron, whose great work on this Bill is much to be admired, said that this was something the Government could look at in future but not something they were looking at now, and that secondary legislation could provide for this in future. I ask: why not consider it now, and why not meet my request for a consultation to begin?

This idea is not new or untested. It was first endorsed by the All-Party Group on Smoking and Health in 2021, and then in the Khan review commissioned by the previous Government in 2022. Canada has already implemented this approach on cigarette papers, with demonstrable impact. Australia followed suit last April, albeit with warnings only on the filters. The evidence gathered for Health Canada examined how smokers and non-smokers responded to cigarettes carrying health warnings directly on them. The findings were striking: cigarettes displaying warnings were consistently regarded as less attractive, while those without warnings were more likely to be seen as less dangerous. In other words, the absence of a warning sends its own message—and it is the wrong one.

I strongly welcome the Government’s decision to introduce pack inserts that direct smokers towards quitting support. I argued strongly for this when we debated the Health and Care Bill. It is a positive and sensible step, but it does not address the problem that the first cigarette smoked is often offered from someone else’s packet. Warnings on individual cigarettes would get to these people in ways that pack-based measures simply do not.

This effect of warnings on individual cigarette papers has been shown to be especially pronounced among younger people. They are more likely to be offered a single cigarette in social settings, as opposed to purchasing a whole packet that already has warnings on it or may have an insert in future. Printing warnings directly on the cigarette would ensure that the health warning is present at the point of use, not just at the point of purchase. Evidence from focus groups in Scotland found that warnings on individual cigarettes were perceived by young people as embarrassing, with the consensus being that it would be very off-putting for young people.

It is sometimes disingenuously claimed that there is no need for health warnings about tobacco as the dangers of smoking are already universally understood. Action on Smoking and Health found in an analysis of its survey data that younger smokers, the very people who would benefit most from this measure, were less likely to be aware of the full risks of smoking. But awareness alone does not change behaviour. The average smoker makes 30 attempts to give up before succeeding. My amendment would help them give up every time they handle a cigarette.

More importantly, it would help prevent people smoking their very first cigarette. The evidence shows that, the greater the range of interventions we deploy, the greater our chances of preventing uptake and encouraging cessation. Different messages resonate with different people, and tobacco remains a uniquely lethal consumer product. We should be prepared to use every effective tool available to reduce the harm it causes to smokers, their families and everybody else.

Finally, I know the Minister has raised concerns about how visible the messages might be and that, in some countries where this has been implemented, they appear only on the filter. The UK could do things differently if we choose, as in Canada. It is often said that a picture is worth a thousand words. If I could display to this Chamber a picture of the effective health warnings on Canadian cigarette papers, it would be easy to see how effective they are. If the Minister cannot accept this amendment today, I hope she will say not just that this measure might be considered in future but that it will be considered now, beginning with the consultation requested.

[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.

NHS: Corridor Care

Lord Rennard Excerpts

Wednesday 4th February 2026 Lords Chamber

[Baroness Merron (Lab)]

I agree with the noble Baroness. Corridor care is perhaps one of the most visible and distressing symptoms of an NHS that the noble Lord, Lord Darzi, described as broken. We have to fix a number of the processes. I welcome that we are expanding urgent care access, for example, in primary, community and mental health settings, which will reduce demand on services. However, without publicly available data and the clinical operational standards that we are setting, the change will not be made as quickly as we would all like. There are immediate actions, as well as medium and long-term actions.

[Lord Rennard (LD)]

My Lords, my mother-in-law, Molly, is 110.

[Noble Lords]

Oh!

[Lord Rennard (LD)]

I shall pass on your Lordships’ best wishes to her. Last year, she was taken ill and the ambulance took her to a Liverpool hospital in the early afternoon, but, after some tests, no bed could be found for her. She spent the rest of the day and all of the night on a trolley in a corridor. Every hour throughout the night she was moved along, deprived of sleep and the basic provisions, including food and drink, which she would have had on a ward. What are the Government now doing to tackle the problem of delayed transfer of care, which results in fewer beds being available? Does the Minister accept that this can be done only by properly resourcing adult social care?

Vaccine Health Technology Assessment

Lord Rennard Excerpts

Thursday 8th January 2026 Grand Committee

[Lord Rennard (LD)]

My Lords, some weeks ago, the noble Baroness, Lady Ritchie of Downpatrick, tabled a Written Question on this subject. With great respect to the Minister, her response was not a strong one: it merely suggested the possibility of considerations such as productivity costs being highlighted by the Joint Committee on Vaccination and Immunisation, so we are all grateful to the noble Baroness for securing this debate and enabling us to take up the issue further.

I believe that considerations such as impact on productivity and the wider economy should always be included at the heart of decision-making concerning the provision of medicines and vaccines, but there is a general problem in public policy-making, with too much short-termism and insufficient weight being applied to factors beyond simple clinical outcomes. I often argue in the House that productivity, which was discussed in the Chamber yesterday, as well as wider socio-economic considerations, should be applied more generally to decisions about procurement in the healthcare sector. We need to consider these issues in relation to the provision of assistive technology supporting people with disabilities and we need to apply them to the provision of medical equipment, such as continuous glucose monitors and insulin pumps for people with diabetes.

In many public policy areas—not just healthcare—we need real, long-term cultural change. We need much less short-termism and much less policy development based on silos that exclude the consideration of wider relevant issues. Long-term benefit analysis concerning vaccinations must cover not just costs to the NHS against improving life expectancy but the benefits of a healthier workforce, of more people paying into HMRC and of fewer people with illnesses and disabilities being more dependent on the DWP. We should also look much more at the considerable potential benefits of greater emotional well-being to both people and society as a whole.

However, first, we must think ourselves lucky to live in the United Kingdom and not in the United States, where a dangerous, ignorant and prejudiced man was appointed by President Trump to undermine sensible public health policies with his anti-vax agenda. Millions of people worldwide are at risk because of his prejudices, which contradict the scientific evidence. I hope that the Minister will assure us that the Government are doing everything they can to prevent right-wing nutters in this country—many of whom are influenced by the far right in America—spreading dangerous disinformation here about the safety and necessity of vaccination programmes. Everyone should know that vaccinations prevent millions of deaths every year from diseases such as measles, rubella, polio, flu and Covid-19. We need to educate people from an early age against the prejudice of ideologies that are hostile to vaccinations.

We also need to look carefully at the current evaluation process for new medicines and vaccines, led by NICE and the JCVI, which is built on something that is too narrow and is termed the “health sector perspective”. This approach is about managing the immediate budgets of the NHS, but it is not about the budgets of the NHS in decades to come. This approach does not look at the economic consequences of inaction. Recent research from the Office of Health Economics suggests that respiratory infections alone cost UK businesses an estimated £44 billion annually in lost productivity. This is a drain on our national prosperity; productivity should be a key factor in considering the evaluation and rolling out of vaccines.

Last year, I got my flu jab. As a person with diabetes, I also got my Covid-19 jab on the NHS. However, this year, I was told that I no longer qualified for the Covid-19 jab. I had to pay £90 to have it privately, but not everyone can do that. Failing to vaccinate as widely as we should for flu and Covid-19 costs money in many ways. I understand that the prevalence of flu this year has been very damaging to the public sector and that many people will be badly affected by this. We also need to consider the impact of vaccination programmes on educational attainment. For childhood vaccines, the current models of evaluation often miss the long-term benefits of improved school attendance and cognitive performance, which eventually translate into higher lifetime productivity.

We need to look more at the benefits of vaccines that can make other life-saving treatments, such as chemotherapy for the immunocompromised, safer and more effective. We need to be more aware of antimicrobial resistance, or AMR. Vaccines are front-line defences in this battle, reducing the need for antibiotics and thus slowing the development of resistant strains. Although the JCVI acknowledges this, it does not yet consistently capture the value in its cost-effectiveness models.

The Government’s 10-year health plan and Life Sciences Sector Plan set an ambitious target: for the UK to be one of the top three fastest places in Europe for patient access to medicines by 2030. I know that there will always be pressure within government to prioritise measures that show benefit by the time of the next election. There is always intense pressure from the Treasury to consider the implications for immediate budgets and, as we know, whichever party wins the election, the Treasury stays in power. I believe that, to establish better practice, we should look more to nations such as Sweden, which already incorporates a broader range of studied impacts, including productivity losses for both patients and carers, in its assessments. I hope that the Minister can respond positively.

Wheelchair and Community Equipment Strategy

Lord Rennard Excerpts

Thursday 11th December 2025 Lords Chamber

[Lord Rennard (LD)]

My Lords, I declare my interest as the conference chair of the National Association of Equipment Providers for the last five years. Before that, for 10 years I was director of communications for the British Healthcare Trades Association, representing manufacturers and suppliers of wheelchairs and assistive technology, upholding industry standards, promoting innovation and supporting purchasers and users through a code of practice.

My personal interest in this began as a teenager pushing my mother in a second-hand wheelchair bought through an advert in the Liverpool Echo. There was no assessment, training or support in the 1970s. Much has improved in the 50 years since, yet the Wheelchair Alliance report in December 2023 showed that wheelchair provision varied widely. It said:

“Wheelchair users … in some areas receive an excellent service whereas users in other areas may experience significant delays, inappropriately tailored equipment, a lack of training and/or slow response to breakdowns”.


The report also showed how high-quality provision can improve lives and deliver financial benefits. Wheelchairs are not just medical devices; they are gateways to independence, inclusion, work, education and activity.

Poor provision restricts life chances, limits employment and can harm the health of carers. Pressures in wheelchair services are mirrored across community equipment—from hoists and specialist beds to bathing aids and home adaptations. The problems are systemic, not just localised. The APPG for Access to Disability Equipment found that delays are driven by staff shortages, particularly of occupational therapists; supply chain and recycling constraints; and wide inconsistencies between local authorities. At the root of this crisis are weak oversight and blurred accountability between local authorities and integrated care boards, driving wide regional variation. Provision is fragmented and inconsistent, so I also hope that the Government will now drive forward a national strategy with clear structures for provision.

I agree with the Wheelchair Alliance that all integrated care boards must adopt the quality framework for wheelchair provision and the model service specification when commissioning services. I also support the call by the APPG for Access to Disability Equipment for a dedicated national strategy for community equipment, alongside a dedicated DHSC Minister to oversee delivery. This would ensure that needs are appropriately and fairly met everywhere. I welcome the Government’s wheelchair quality framework, but it does not go nearly far enough. I also welcome increased use of personalised budgets, but providers and users really need to understand these budgets to ensure real choice and best provision, giving users more control over their daily lives.

Fundamentally, what we need to address is balancing the costs of the provision of wheelchairs and community equipment with long-term benefits, including preventing accidents, reducing the need for healthcare intervention in future and enabling people with disabilities to work, pay taxes and reduce their dependency on benefits, while at the same time significantly increasing emotional well-being for many families.

NHS: Wheelchair Services

Lord Rennard Excerpts

Monday 24th November 2025 Lords Chamber

[Baroness Merron (Lab)]

The provision of the right type of wheelchair is crucial, but we also need to expand care options to boost independent living at home. We have done that in part through an additional £172 million for the disabled facilities grant, which goes hand in hand with people being able to live at home. This could enable around 15,600 extra home adaptations. Introducing care technology standards for those who are using wheelchairs and those who are not will also enable proper care standards and independent living.

[Lord Rennard (LD)]

My Lords, I declare an interest as the conference chair of the National Association of Equipment Providers. As a teenager, I pushed my mother everywhere in a wheelchair; we had to buy it second hand through the Liverpool Echo. Wheelchair provisions have improved greatly since then, but how can the Government work with the Wheelchair Alliance and with trade associations to ensure that retailers have skilled clinical staff who are trained to undertake assessments and prescribe appropriate wheelchairs and other forms of assistive technology?

[Baroness Merron (Lab)]

The points that the noble Lord has raised are crucial—not least that, as I alluded to earlier, one type of wheelchair does not suit everybody. That is why I am keen to see the results of the Wheelchair Quality Framework, which, as I mentioned to my noble friend, was published in April. That sets out quality standards and statutory requirements, including offering personalised wheelchair budgets, which would assist in the circumstances that the noble Lord describes.

Tobacco and Vapes Bill

Lord Rennard Excerpts

Committee stage
Monday 3rd November 2025 Grand Committee

[Earl Russell (LD)]

My Lords, I will speak to my Amendment 34 in this group, which is on cigarette filters and health warnings. I thank the noble Baroness, Lady Grey-Thompson, and my noble friend Lady Walmsley for their support. This amendment would require the Secretary of State to make provision

“prohibiting the manufacture, supply, or sale of … plastic filters intended for use in cigarettes, and … cigarettes containing plastic filters”

through regulations that must be laid before Parliament

“no later than the end of the period of six months beginning with the day on which this Act is passed”.

This amendment is required. It is a practical, necessary and long-overdue measure that I hope to show enjoys widespread public support. Implementing it would strengthen our commitment to environmental sustainability and corporate responsibility while having minimal impacts on those who choose to smoke cigarettes with filters.

As we heard from the noble Baroness, Lady Bennett, discarded cigarette filters are one of the most common and prevalent forms of public litter. It has been estimated that 90% of all cigarettes smoked in the world contain non-biodegradable filter tips and that, in the UK, some 3.9 million cigarette butts are discarded daily. On a constituency basis, that is 6,000 cigarette butts, or 2.2 million thrown away each year. Every year, billions of cigarette butts are discarded across the UK, which is a staggering amount.

As they degrade very slowly, they release microplastics and many harmful chemicals, which are a danger to nature and to aquatic life in particular. Only one in four smokers even realise that filters are not biodegradable; most assume that they already are. Eighty-six per cent of adults support this change in the law, including 77% of the smokers asked. Cigarette butts are a bit like ants. The power of their pollution is caused by their very small nature, their frequency and the fact that they are discarded so widely. It is very difficult to clear them up, even if we wanted to.

As we have heard, they are made from cellulose acetate—a non-biodegradable form of plastic—and take up to an estimated 10 to 15 years to break down in the natural environment. I question one figure from the noble Baroness, Lady Bennett, which seemed to be for plastic filters, not biodegradable filters. I do not recognise the figure she gave. Yet, despite this harm, plastic filters continue to be widely used. This and other Governments have made progress on banning other forms of everyday plastic pollution, but no progress has been made here. For these reasons, regulatory action is now required. Fortunately, perfectly workable alternative solutions are available and are widely recognised within the industry as being fit for purpose and working with manufacturing processes.

Across the world, there has been a move to work on these issues. The World Health Organization supports a ban on non-biodegradable cigarettes as part of the global plastics treaty and the EU is also looking at these matters. If the Government accept this amendment, the UK could become the first country in the world to pass legislation on these matters. Biodegradable cigarette filters made from natural fibres such as paper, hemp or bamboo would degrade much more quickly and cause far less harm. They would eliminate unnecessary plastic waste and give people the option of having a filter on a cigarette if they want one.

I do not argue that filters in any shape or form make cigarettes healthier to smoke; they clearly do not. I know that tobacco companies have falsely put them forward in this way in the past. However, they make smoking more pleasant for those who want to smoke. If an alternative exists that would deal with the plastic pollution, we should not unnecessarily ban these items. My amendment is about trying to find a way between having the plastic pollution we see now and a complete ban.

Turning to the amendment from the noble Baroness, Lady Bennett, I suggest that banning filters would not resolve the problem because people will continue to smoke. They will smoke cigarettes without filters. They will dispose of the butts of those cigarettes without filters on the ground. Indeed, in many cases, they will end up burning their fingers and dropping them in places they do not want to, which could become an increased cause of wildfires, which are becoming an ever more prevalent problem. The litter will still exist and the nicotine in the cigarette butts will still exist. I do not buy the argument that removing filters would improve health outcomes in any way at all. I find it hard to see that a cigarette without a filter is in any way healthier than a cigarette with a filter. It may not make any difference, but I certainly cannot see how it can be argued to be in any way better.

My amendment is well argued and supported. I am open to working with the Government around the timelines that I would put in place. It might be that the Government feel that those timelines are too short. On reflection, maybe I should have allowed for a bit more time for it to take place.

[Lord Rennard (LD)]

My Lords, Amendments 141 and 143 would require the Government to consult on introducing health warnings on each individual cigarette by printing them on the cigarette papers. These amendments are necessary because the Government have not yet committed to consulting about these warnings, let alone insisting on them, as I believe that they should.

Warnings on individual cigarettes, also known as dissuasive cigarettes, were recommended by the APPG on Smoking and Health in 2021 and in The Khan Review—Making Smoking Obsolete in 2022. The Government should take heed of Dr Javed Khan’s report in particular, which was commissioned by the previous Government to examine how we could get to our smoke-free target by 2030. Canada has already seen remarkable success with this approach and Australia has just followed suit with regulations coming into effect in July this year.

Research commissioned by Health Canada into the appeal and attractiveness of cigarettes with health warnings showed that these cigarettes were perceived as less appealing than cigarettes without health warnings. The converse is, of course, also true. Cigarettes that did not have health warnings on were viewed as being less harmful. The impact was particularly notable among young people, who reported that when they were offered single cigarettes in social situations, they were not exposed to the warnings on the cigarette pack. With warnings visible on every cigarette, this would no longer be the case. Cigarettes may not be able to be sold individually, but they certainly can be handed out individually to others at parties and social events.

It is very welcome that the Government are introducing pack inserts, for which I have long argued and which signpost smokers to quitting information inside the packets. But I find it ironic that it is the tobacco industry, which of course shortens the lives of half its customers, that warns that there may be dangers from the ink printed on the cigarette papers. These papers would, of course, be printed with non-toxic ink and would discourage people from taking up this habit, which proves fatal and damaging to so many people.

We do not want to make smoking any more harmful. We want fewer people to take up the habit, and we want to help the majority of smokers, who are struggling to quit as most are. So, I urge the Minister to consider this additional complementary and necessary measure. It may help those people who need to be deterred from accepting a cigarette offered from someone else’s packet and who may then begin a habit that shortens the lives of half the people who take up that invitation to become a smoker.

Some people, particularly those in the tobacco industry, still suggest that, at this point, we all know all about the harms of smoking. However, the evidence is clear: the more strategies we use to inform consumers, the more chance we have of preventing people starting smoking or of helping people quit, as most smokers try to do repeatedly. My late noble friend Lord Ashdown frequently told me that he gave up smoking three times a day. He found it, as most smokers do, highly addictive and very hard to give up. We need to know that what is compelling for one potential smoker may not be workable for another smoker. So, given how lethal tobacco is, we need to use every tool at our disposal to deter smoking and to help people quit.

Respiratory Syncytial Virus: Vaccination Programme

Lord Rennard Excerpts

Tuesday 9th September 2025 Lords Chamber

[Lord Rennard (LD)]

My Lords, I, too, congratulate the noble Baroness, Lady Ritchie of Downpatrick, on securing this important debate. We have heard from her about the need to ensure that all infants receive an equitable offer of protection from the respiratory syncytial virus, and that the maternal RSV vaccination programme is fairly new, having been introduced in Scotland in August 2024 and in England in September 2024. It is important now, therefore, to monitor its uptake in detail and to assess the protection that it gives.

We are grateful, therefore, to the UK Health Security Agency—UKHSA—for the monitoring undertaken so far, which has already provided vital insights. From this, we are encouraged to see that the level of vaccine uptake has increased, month on month, since its first implementation. For England, the UKHSA’s first annual report on the programme, published in July, showed that 42.8% of all women who had given birth in the six months after 1 September had received an RSV vaccine prior to delivery. Progress is being made, because, for the month of April alone, the figure reached 54%, with most regions showing a pattern of increasing monthly uptake.

However, as we have heard, there were significant differences in uptake in different commissioning regions and among different ethnic groups. For the month of April this year, the UKHSA reported that the highest coverage of the vaccine was in the south-east of England, at 63.4%, while the London commissioning region reported the lowest level of coverage, at 44.8%. For the Midlands, the coverage was 51.3%. The variation across ethnic groups was much wider. The “Other ethnic groups—Chinese” category showed the highest coverage, at 70.6%, while the “Black or Black British—Caribbean” category reported the lowest level of coverage, at just 25.6%. Greater efforts must therefore be made to improve take-up of the vaccine, and they must be targeted effectively.

Will the Minister let us know more about how the Government will help to address the disparity in coverage by region and ethnicity? The figure for “Black or Black British—Caribbean” is alarmingly low. Can the Minister tell us whether any research has been undertaken to see if there is a difference between the point in pregnancy at which people of different ethnicities present themselves to GPs or midwives? What may be the cultural differences or barriers relating to access? Is there an issue about less time being available for a working mother as opposed to one not in employment? The vaccination is most effective when offered around the 28-week antenatal appointment, or within a few weeks of this, to provide babies with the best protection for their first six months of life. Those who present late may be less protected even if they ultimately receive the jab.

I am aware that the UKHSA is planning further investigations. Can we know whether such crucial questions are being looked into? We know that the Parliamentary Under-Secretary of State for Public Health and Prevention, Ashley Dalton, has stated that UKHSA monitoring is a “key tool”. She promised that an update to the UKHSA’s immunisation equity strategy is “forthcoming” to ensure equitable access, but could we possibly know when? Meanwhile, the production of RSV antenatal vaccine information leaflets in over 30 languages and in various formats is a very positive step.

Significant issues about the vaccination rollout have been raised by the Royal College of Midwives. Clare Livingstone of the RCN noted in January that midwives had more work to do to respond to concerns and questions around vaccinations. She acknowledged that it was not always possible for midwives to provide all the information, reassurance and support needed, often due to lack of time to discuss each vaccine in detail. The RCM has suggested that there are more challenges about these issues in some regions than in others. We need to know if that is because of staff vacancies, which may vary by region, or because of the number of patients on each midwife’s list, or both factors, as these issues are obviously connected.

There is an urgent need to recruit more midwives. Some midwives have raised concerns about workforce capacity and training availability. Some maternity services face considerable challenges in implementation, and they are being required to send women to their GPs instead. The Royal College’s previous calls about having the right staff in the right place, with the right education and training, must be heeded. Training materials, including webinars for midwives and patient-facing publications, have been made available in collaboration with the UKHSA and NHS England. Will these now be updated in the light of the questions that are being asked over the first year of the programme?

We need to know if there is any link between hesitation about having the RSV jab and hesitation about having other jabs, such as the Covid and MMR vaccinations. Much seriously damaging misinformation has been circulated about vaccinations, including very recently, and we all, in responsible parties, need to help to counter it.

Eligibility for the RSV vaccination is an issue. NHS England has acted on the recommendation of the Joint Committee on Vaccination and Immunisation. This was based on safety, efficacy, cost and how many people of different groups become really ill with the virus. Initially, the programme is for pregnant women, preferably around the 28th week for maximum efficacy, and for older people aged between 75 and 80. A recent study in The Lancet Child & Adolescent Health journal has shown the maternal RSV vaccination to be 58% effective in preventing hospitalisation of infants. This figure, as we heard, increases to 72% if mothers were vaccinated more than 14 days before delivery. The UKHSA confirms that this evidence clearly shows that the RSV vaccine for pregnant women is highly effective.

However, the criteria for older people, currently set at the ages of between 75 and 80, appears to many people to be arbitrary and questions are being asked about it. Ministers have said that the JCVI will be monitoring the current criteria alongside evidence of serious infections among those not currently eligible. Can the Minister please say when the joint committee’s next investigation will be published? Will it be considering the case of people who are immune-suppressed and who may therefore be at greater risk of serious illness if they catch the virus?

Prostate Cancer

Lord Rennard Excerpts

Wednesday 3rd September 2025 Lords Chamber

[Lord Rennard (LD)]

My Lords, many men and their families should be grateful to the noble Lord, Lord Mott, for this debate, which will increase the profile of prostate cancer and illustrates the need for screening.

We have heard moving stories about prostate cancer. I have very strong and close relationships with friends from my university days some 45 years ago. Several male members of this group now have personal experience of prostate cancer. Thanks to screening, early diagnosis and the latest treatments, most of them are okay. But one close friend, who is my age, has advanced stage 4 prostate cancer. The very latest and experimental treatments are helping to keep him going for a few more years than we dared hope. He was unlucky, because he had screening but the disease developed rapidly in between screenings.

The experience of my male friends means that I ask for a PSA test now when I can, sometimes when I have other blood tests concerned with diabetes. But we have heard how some GPs are discouraged from discussing this threat with some of those at highest risk. The risks are highest with black men and those with a family history of the disease. Those from the most deprived backgrounds are almost a third more likely to be diagnosed with late-stage incurable prostate cancer.

The PSA screening test is not perfect by any means. We need, as and when we can, to move to saliva/spit tests. We need to use AI with blood and urine tests and use multi-parametric MRI. But in the meantime, it seems that we should get GPs to proactively offer PSA testing to men at high risk. It will save lives, and I hope that people are listening.

Diabetes: 10-Year Health Plan

Lord Rennard Excerpts

Thursday 26th June 2025 Lords Chamber

[Baroness Merron (Lab)]

The noble Lord is quite right in his observations, which play to the point of the NHS that we want to see not just now but in the future. Noble Lords may have heard the announcement earlier this week that the Government are committing the necessary funding to screen babies early in their lives through the use of genomics, in order to, as the noble Lord said, identify underlying conditions that can be dealt with early on. There are some that cannot be prevented, but if they are diagnosed and anticipated, their management will be much better.

[Lord Rennard (LD)]

My Lords, continuous glucose monitoring and Mounjaro have helped me to come off insulin after 20 years of daily injections and have greatly improved my diabetic control. Such innovations are undoubtedly a cost saving to the NHS in the long run. Does the Minister think we are looking far enough into the future when we consider the cost-benefit analysis of their use? How can NHS spending plans take into account their long-term benefits to the economy by keeping people in work and getting many people back to work?

[Baroness Merron (Lab)]

The noble Lord, Lord Rennard, knows that it is always good that we hear about his own experience, because he epitomises the changes that are possible. I believe there is an understanding—not least because, as noble Lords will know, the Chancellor very recently gave the department a settlement that was, in large part, because of not just immediate need but looking to the future and the kind of NHS that is fit for the future we will see identified in the 10-year plan when it is published. Technology is certainly a huge part of that, which is why CGM and the hybrid closed loop system—the latter of which began to be rolled out in April 2024—are so important. There have been huge advances and they will be part of that NHS of the future that we seek to build.

Cardiovascular Illnesses

Lord Rennard Excerpts

Thursday 12th June 2025 Grand Committee

[Lord Rennard (LD)]

My Lords, we are all grateful to the noble Lord, Lord Booth, for arranging this Question for Short Debate on cardiovascular disease and for sharing his emotional and personal experience. The statistics about cardiovascular disease paint a stark picture of a health crisis that demands urgent and comprehensive attention. My thanks go to the British Heart Foundation, the Stroke Association, Diabetes UK and the House of Lords Library for excellent briefings.

The facts are that every day in the UK 240 individuals wake up to the catastrophic reality of a stroke. Stroke remains the fourth-leading cause of death in our nation and a primary cause of disability. Every three minutes, a family loses a loved one to cardiovascular disease and CVD causes more than a quarter of all deaths in the UK.

However, nearly nine out of 10 strokes are preventable, often associated with modifiable risk factors such as high blood pressure, smoking and physical inactivity. High blood pressure alone is the largest risk factor for stroke, contributing to 50% of all strokes. The number of people living with diabetes, or pre-diabetes, now exceeds 12 million in the UK, equivalent to one in five adults. Their risk of death from CVD is 4.2 times higher than for those without diabetes. Each week, diabetes leads to 812 strokes and 568 heart attacks. It is therefore vital that we optimise the detection and management of high-risk conditions such as high blood pressure, atrial fibrillation and high cholesterol.

As part of that, we need strongly to support the measures in the Tobacco and Vapes Bill to further reduce the prevalence of smoking in this country, as we have done through successful regulatory measures over the past few decades. We need to support the reduction of other modifiable risk factors, including drinking alcohol to excess and obesity. The measures put forward by the House of Lords Select Committee on Food, Diet and Obesity, which was chaired by my noble friend Lady Walmsley, need to be given much more respect by the Government than has so far been the case.

The current system for health checks, such as NHS Health Check, has the potential to screen for conditions such as diabetes, but more needs to be done to expand those checks, particularly to those at highest risk, including individuals under 40. It remains alarming that millions of people with diabetes are missing essential health checks annually which are crucial for detecting and preventing serious long-term complications.

Beyond prevention, we need to consider many issues concerning treatment and care. There is still a critical lack of imaging capability for diagnostic testing, all of which delays patients’ access to specialist stroke units and time-sensitive treatments such as thrombectomy.

We need to ensure 24/7 access to acute stroke treatments, including thrombectomy and thrombolysis, through pre-hospital video triage and access to specialist stroke units. We need a dedicated plan to drive action to address CVD and its risk factors. I know that the Government have committed to a 25% reduction in deaths from CVD and stroke by 2035 but, to achieve this, we need steps to reduce disability.

Scientific research and innovation are the basis of progress in this field. The British Heart Foundation, a leader in cardiovascular science, funds more than half of independent cardiovascular research in the UK. It has powered advances that have nearly halved the number of people who die each year from cardiovascular disease. We are in an era of immense scientific opportunity, with revolutionary advances in areas such as artificial intelligence, genomics and regenerative medicine. BHF-funded scientists are already using AI to better predict heart attack or stroke risk.

For those who have suffered a stroke, prioritising and investing in rehabilitation, in line with national guidelines, is critical to prevent recurrent strokes, as one in four survivors will experience another one within five years. Every stroke survivor should be offered a six-month post-stroke review to tailor recovery plans. Beyond this, we must continue to inspire the nation to learn CPR and continue to ensure greater provision of public-access defibrillators, as survival rates for out-of-hospital cardiac arrests are significantly higher in countries where bystander CPR is more prevalent. We must address the basic glaring issues of health inequalities in order to address these problems.