Queen’s Speech

Lord Ribeiro Excerpts

Monday 9th June 2014 Lords Chamber

[Lord Ribeiro (Con)]

My Lords, measures to end smoking in cars while children are present did not appear in the gracious Speech. After the large vote in favour of the measure in the Commons in February this year by 376 votes to 107, it might have been assumed that it was a done deal and a job done and that legislation would follow swiftly. Here I must declare an interest as the author of the Private Member’s Bill introduced in 2012 which proposed a ban on smoking in cars when children are present.

The Government are to be congratulated on tackling the two great obstacles in the way of reducing harm to children through smoking—that is, the introduction of plain or standard packs of cigarettes and smoking in cars. In the face of stiff opposition from the tobacco industry, the Government have shown courage and steadfastness in pursuing their strategy to reduce harm from smoking. In order to have the evidence to support their proposals, they invited Sir Cyril Chantler to undertake an independent review of standardised packaging of tobacco. It endorsed the findings of the University of Stirling in 2012 and, after careful consideration, the Public Health Minister, Jane Ellison MP, said that,

“if standardised packaging were introduced it would be very likely to have a positive impact on public health”,

and that these health benefits could include health benefits for children.

So why are we still waiting for legislation? The Government are committed to undertaking a six-week consultation on the draft regulations. There is then a bureaucratic process that involves a regulatory impact assessment, notification to the European Union, and another six months before the process is completed. We are now 11 months from a general election. Can my noble friend assure me that there will be no further delay and that we can expect legislation before the machinery of government turns its focus on to the election? One can expect continued lobbying from the tobacco industry to frustrate the proposed legislation, which has cross-party support and the overwhelming support of both Houses of Parliament. I urge the Government not to let this prize for which they have worked hard slip through their fingers, like the sands in an egg timer.

I welcome the intention to introduce legislation to stop female genital mutilation—again, a further assault on our children.

Public health is increasingly getting the recognition it deserves, and it is strange for me as a surgeon to be promoting it. However, in developing countries the burden of disease has shifted from infectious diseases to chronic conditions. The level of infectious diseases is, in fact, falling in developing countries. In an article in the Lancet on 31 May, the work of a new health group, of which I am patron, tasked with introducing essential surgery in developing countries, is featured. It has produced a film entitled “The Right to Heal”, which identifies the surgical challenges facing public health over the next 30 years. The paradigm shift to conditions that require surgery is clear: trauma and injury, burns, obstructed labour and fistulae, appendicitis, cataracts, hernia, club foot, and cleft lip and palate. These conditions affect millions of people around the globe and can all be treated by surgery.

As the millennium goals come to an end in 2015, we need a Government to lobby the World Health Organisation and the World Health Assembly to pass a resolution on the use of essential surgery. The Lancet quotes a former WHO director-general, HT Mahler, who asked for an internationally agreed list of essential surgical procedures to support primary healthcare and help countries to decide on their own lists and the related training and equipment that they would need. He concluded:

“The alternative for most people in the world is either the kind of selected essential surgery I am advocating or absolutely nothing at all”.