Social Care Reform

Mary Kelly Foy Excerpts

Wednesday 23rd June 2021 Commons Chamber

[Helen Whately]

I thank my hon. Friend, and I recognise the situation right now. That is one reason why we are providing £3.8 billion in grants for adult and children’s social care this financial year, which has gone up from £3.5 billion in the previous financial year. Of course, looking ahead in our reforms, we do have to make sure that the way social care is paid for is fair across the country.

[Mary Kelly Foy (City of Durham) (Lab) [V]]

I was a carer for my daughter Maria for almost 27 years, so I know the demands that carers face every single day caring for those they love. Does the Minister really believe that £67 a week carer’s allowance is a fair amount for round-the-clock care, and will this amount be raised under the Prime Minister’s “prepared” plan for social care?

[Helen Whately]

I pay tribute to the hon. Member for the hours, the love and the effort that she has put into caring herself. She knows, from her own experience, the experience of carers across the country and what it takes in time, physical effort and emotional effort.

Carer’s allowance is not intended to be somebody’s income; it is intended to support people with some of the costs of caring. It is primarily led by the Department for Work and Pensions, but I can say that I am committed to ensuring that there is support for unpaid carers and family carers, and, as I said earlier, ensuring that, as well as caring for and looking after others, those individuals should be able to have time for themselves to lead their own lives.

Tobacco Control Plan

Mary Kelly Foy Excerpts

Thursday 10th June 2021 Westminster Hall

[Mary Kelly Foy (City of Durham) (Lab)]

I beg to move,

That this House has considered recommendations for the forthcoming Tobacco Control Plan.

It is a pleasure to serve under your chairmanship, Mrs Miller. In December, the Minister confirmed to Parliament that the Government will publish a new tobacco control plan this year, setting out measures to deliver the smoke-free 2030 ambition in the 2019 prevention Green Paper. I welcome this announcement: as a former chair of the Gateshead tobacco control alliance, this issue is close to my heart. In my own area of County Durham, adult smoking prevalence is 17%, compared with 13.9% nationally, and rising to 27% among people in routine and manual occupations. Some 16.8% of mothers smoke during pregnancy, compared with 10.4% in England, and smoking in County Durham has an annual cost to society of approximately £122 million.

The Secretary of State himself stated that the “extremely challenging ambition” of a smoke-free 2030 will not be delivered by business as usual. The new report from the all-party parliamentary group on smoking and health sets out the evidence-based recommendations needed to achieve that ambition. Smoking is responsible for half the difference in life expectancy between rich and poor, and the impact is passed down through generations, with those who grow up in smoking households far more likely to become smokers. With 1,500 people dying from smoking-related diseases every week, and less than a decade to go to achieve a smoke-free 2030, there is no time to waste.

However, this will not happen without investment. That is why the key recommendation of the APPG’s report is for a smoke-free 2030 fund, requiring the tobacco industry to pay for tobacco control. This is the “polluters pay” approach that the Government committed to considering in the 2019 prevention Green Paper. As such, can the Minister assure me that the proposals put forward by the APPG on smoking and health will be considered as part of the forthcoming control plan? In particular, will the Government deliver on their commitment to consider a US-style “polluter pays” approach to fund the tobacco control measures needed to deliver a smoke-free 2030?

More investment is needed, because the huge gap in smoking prevalence between those in routine and manual occupations and those in other occupations is stubbornly persistent. Ending smoking would lift around 450,000 households out of poverty, including more than 250,000 million children and 140,000 pensioners, concentrated in the most disadvantaged parts of the country. That would not only benefit the health and wellbeing of individuals but inject money into local economies, which would show just how serious the Government are about the levelling-up agenda.

Smoking is linked to almost every indicator of disadvantage, and those indicators overlap different communities. Smokers in routine and manual occupations or who are unemployed are also more likely to live in social housing and to be diagnosed with mental health conditions. The Government have been unsuccessful so far in reducing the inequality gap in smoking and need to redouble their efforts to achieve a smoke-free 2030 for all. There is a clear need for a national strategy that targets investment and enhanced support at disadvantaged smokers.

Unfortunately, smokers from deprived communities with higher smoking rates tend to be more heavily addicted than those from more affluent areas. Analysis of Government data shows that in 2019 nearly half of England’s smokers were in routine and manual occupations or were long-term unemployed. They are just as motivated to quit as other smokers, but it is harder to succeed when smoking is more commonplace and cheap, illicit tobacco is widely available.

Regional tobacco control programmes have been effective in tackling these disparities, as shown by the example of Fresh in the north-east, which is the longest-running—indeed, the only surviving—regional office of tobacco control. When Fresh was founded in 2005, smoking prevalence in the north-east was over 20% higher than the national average for England, and the disparity was growing. Since then, the north-east has seen the greatest decline in smoking prevalence of any region: smoking prevalence in the north-east is now only 10% higher than the England average. However, the regional work done in the north-east and elsewhere has been limited by cuts to the public health grant for local authorities since 2015-16. This led to the closure of the regional offices in the north-west and the south-west, and funding in the north-east has been significantly reduced. New funding streams are needed.

Smokers can successfully quit only if they are motivated to make an attempt to quit. Sustained mass multimedia behaviour change campaigns are the most impactful and cost-effective way to provide that motivation. The US Government’s “Tips From Former Smokers” campaign was funded by tobacco manufacturers through the USA’s user-free scheme, which raises $711 million annually from the tobacco industry. The Food and Drug Administration campaign led to over half a million sustained quits in three years, and it was associated with healthcare cost savings of $11,400 per lifetime quit.

Such campaigns have an immediate impact and can be targeted with precision at disadvantaged smokers, yet investment in behaviour change campaigns has fallen year on year in England. This has coincided with a significant decline in the number of adult smokers who have tried to quit. In 2008, 40% of adult smokers in England had tried to quit within the previous year; by 2018, that had fallen to just 30%. Over the same period, funding for mass media campaigns fell by over £20 million.

Behaviour change campaigns need to be targeted at key groups and communities to reduce socioeconomic inequalities. The effectiveness of national campaigns can be significantly enhanced when they are supplemented by targeted regional campaigns. Regional funding for stop-smoking behaviour change campaigns in the north and midlands would support the levelling up of some of the more deprived regions of England. These are the regions with the highest rates of smoking, combined with the lowest gross disposable household income. Supporting smokers in these regions to quit will prevent people’s hard-earned incomes from going up in smoke, lifting thousands of households out of poverty and providing a boost to local economies.

Modelling by University College London for the all-party parliamentary group on smoking and health estimates that a sustained national behaviour change campaign aimed at deprived smokers, combined with regional campaigns in the north and midlands, would result in an additional 1 million quit attempts, 179,000 successful quit attempts and 45,000 more ex-smokers in C2/DE occupations in England by 2030. The investment required is estimated to be about £28 million a year, which the tobacco manufacturers could easily afford to pay from their £900 million profits in the UK—and more than three quarters of the public want the tobacco manufacturers to pay for those measures. Does the Minister agree that targeted investment to tackle high rates of smoking among our most deprived communities is vital to delivering the Government’s levelling-up agenda?

Sadly, illicit tobacco is more accessible to children, and as it is cheaper than legally sold tobacco it reduces the incentive for adult smokers to quit. In 2018-19, the total tax revenue lost because of illicit tobacco was estimated by Her Majesty’s Revenue and Customs to be £1.9 billion. The illicit trade is heavily concentrated in the more deprived communities, contributing to higher smoking rates. Addressing that disparity requires tackling both the supply and demand for illicit tobacco in communities where it is endemic.

In the north-east, there have been dedicated multi-stranded programmes of work in place since 2007 to reduce the supply and demand as part of a broader activity to reduce smoking prevalence and improve the population’s health. Such programmes drive a strategic approach to tackling illicit tobacco at local, regional and national level. One programme was described as follows:

“an exemplar of partnership working…and…deserves to be widely disseminated”—

a recommendation supported by the National Audit Office. Unfortunately, that has not yet been possible owing to lack of funding, and the funding in the regions where it does exist is under threat because of cuts to public health budgets. Fresh and the Greater Manchester health and social care partnership have estimated that it would cost approximately £5 million annually to roll it out across England.

As the Minister said at the launch of our report, we need to get HMRC to do more to tackle illicit tobacco. Just £5 million for a highly effective regional programme is peanuts and would return far more in lost revenue than it costs. Will the Minister commit to discussing with HMRC how funding can be found for the illicit tobacco partnership to extend cover to all the regions of England to reduce the use of illicit tobacco, which is endemic in poorer communities in every part of England?

We are delighted that the Minister was able to attend the launch of the report by the APPG. I know how passionate she is about the issue. I look forward to hearing her response to our report and recommendations. I am confident that if the Government can embrace our recommendations in the forthcoming tobacco control plan, we will be well on the way to a smoke-free England by 2030.

[Mrs Maria Miller (in the Chair)]

Before I call the next speaker, I should say that I shall be moving to Front-Bench contributions at 2.35 pm. I suggest an informal five-minute time limit to enable all colleagues to make their contributions. I call Bob Blackman.

--- Later in debate ---

[Mary Kelly Foy]

I thank you, Mrs Miller, the Minister and right hon. and hon. Members for their contributions to the debate. I am so pleased that there is cross-party support. I just want to reiterate that in order to go some way towards reducing inequalities, levelling up and increasing healthy life expectancy—especially in poorer communities—we must implement this plan.

Motion lapsed (Standing Order No. 10(6)).

A Plan for the NHS and Social Care

Mary Kelly Foy Excerpts

Wednesday 19th May 2021 Commons Chamber

[Mary Kelly Foy (City of Durham) (Lab) [V]]

I must admit that I greatly enjoyed the Health Secretary appearing to argue that our health and care sectors need to recover after a decade of Tory government—I could not agree more. The covid-19 pandemic has served to expose the damage done by Tory austerity and privatisation to our NHS and social care sectors. They are understaffed and underfunded, while existing staff are overworked and underpaid. However, unlike the Health Secretary, I do not think that further privatisation is the answer, even if he and his pals are already drooling at the thought of selling off the NHS to every Tom, Dick and Tory donor.

It is clear that our health and social care sectors are in crisis. Before the pandemic, there were over 100,000 NHS vacancies, while a quarter of staff were more likely to leave than in the year before. The Government’s plan to address that is to give NHS staff another real-terms pay cut. Added to that, there are an estimated 112,000 social care staff vacancies. Again, with zero-hours contracts and median pay of just £8.50 an hour, I do not think there is any great mystery behind that shortage. However, the social care crisis goes beyond staffing. Age UK estimates that there are 1.5 million older people not receiving the social care support they need. Councils have had their budgets slashed by nearly 50% on average since the Tories came to power, with around £8 billion taken out of social care budgets since 2010, so is it any surprise?

We desperately need a plan for social care that relieves the pressure on unpaid carers and widens access to adult social care where it is needed, yet the Government appear clueless. This crisis requires a dynamic Government: a Government who are ready to accept the ideological failures of austerity and privatisation, who are willing to invest in publicly-run health and social care services, and who reward the workers who staff them. Instead, the promised plan for social care is still missing, private healthcare firms are being welcomed with open arms, and workers face pay cuts and poverty wages.

The Health Secretary speaks about the prevention agenda, but the main cause of ill health is not obesity alone; it is poverty. He can talk about levelling up, building back better and the rest of their buzzword bingo, but until the Government address insecure work, low wages and welfare reform, health inequalities will continue to grow. The Government need to wake up to the health and social care crisis, because the effects are already being felt by real people—the people this Government promised to help.

Health and Social Care Update

Mary Kelly Foy Excerpts

Thursday 18th March 2021 Commons Chamber

[Matt Hancock]

Yes. We did fund the science from the start, and we worked collegiately to make that happen. I can confirm that there is no impact on the road map timetable from the news on supply, because we remain on track in terms of the targets that we have set out.

[Mary Kelly Foy (City of Durham) (Lab) [V]]

If there are indeed issues with vaccine supply, it does not make sense that countless manufacturers across the world are unable to produce covid-19 vaccines, treatments, diagnostics and other health technologies because of intellectual property restrictions and pharmaceutical monopolies that prevent open technology sharing. Will the Government now commit to supporting a waiver of covid-19-related patents at the World Trade Organisation, or is artificially limiting vaccine supply official Government policy?

[Matt Hancock]

I am very happy to provide the hon. Lady with a briefing, because she should be very proud of her country. AstraZeneca is providing the Oxford vaccine free of charge—it is not charging for any intellectual property rights—right around the world. That is not true, as she implies, for all the vaccine companies, but she should be really, really proud of ours.

Maternal Mental Health

Mary Kelly Foy Excerpts

Wednesday 10th March 2021 Westminster Hall

[Mary Kelly Foy (City of Durham) (Lab) [V]]

I thank the hon. Member for Richmond Park (Sarah Olney) for introducing this debate. I declare an interest as co-chair of the all-party parliamentary group on cerebral palsy

Maternal mental health has been one of the hidden impacts of the pandemic. Being a new mam is a special time for any woman. However, it can also be overwhelming and generally challenging. In normal times, many women receive support from their family and friends, who are there to offer invaluable guidance. However, for the past year, the public health restrictions needed to tackle covid-19 have meant that many women have had to make this journey on their own.

I had my first child, Maria, at 21. The advice from my mam was crucial in spotting the missed stages in her early development, which enabled her cerebral palsy diagnosis to come much sooner than it otherwise would have. I cannot put into words how valuable her support was following such heart-rending news. It was thanks to my family and friends that I felt confident enough to go on and have two more children.

It strikes me that if Maria had been born during this pandemic, the personal support I received from my mam and health visitors would have been much more limited. My heart truly goes out to those who have become mothers during the pandemic. I cannot imagine the impact that isolation is having on their mental health. I worry that sadly some may choose not to extend their families in future.

The pandemic has particularly affected those whose babies have received neonatal care, with more than 90% of parents who responded to a Bliss survey saying that they felt more isolated due to having a baby in neonatal care during the pandemic, and 70% saying that their mental health was negatively impacted as a result of their experience. The situation has not been helped by the fact that Bliss research also found that psychological support for parents experiencing neonatal care was inconsistent at best. Around half the parents said they were not offered mental health support during or after this care.

The impact of negative maternal mental health goes beyond the parent and is not limited to the short term. As we have heard, the first 18 to 24 months of a baby’s life are critical in their development, and the stress and trauma of poor maternal mental health has the potential severely to impact a child’s life chances.

In parts of the north-east, where my constituency is located, existing health inequalities mean that some children begin their lives with inferior life chances to those from less deprived regions. We simply cannot afford to place further obstacles in the way of their development and risk losing a whole generation. As a result of the pandemic, we are facing a potential mental health crisis in Britain and maternal mental health is significant.

It is unreasonable to suggest that, as a society, we could experience a collective trauma on this scale without it impacting on mental health. Inevitably, that will be challenging, especially when the existing foundations of mental health care in the country are already weak. It was therefore incredibly disappointing that health services were absent from the Chancellor’s Budget last week. He could do with learning that the damage to public health from the pandemic will not fix itself.

It seems fitting that the debate is happening in the week in which International Women’s Day falls. Not only have women consistently stepped up to the plate during the pandemic, with little to no reward, but they have shown resilience in coping with one of life’s toughest challenges—becoming a mam. We owe it to the women in our constituencies to have the best mental health support out there, for what is undoubtedly one of the most beautiful yet challenging life experiences they will face.

Covid-19

Mary Kelly Foy Excerpts

Monday 14th December 2020 Commons Chamber

[Mary Kelly Foy (City of Durham) (Lab)]

With the Health Secretary’s announcement today, there will rightly be a lot of focus on the spread of covid-19 in the UK and the questions it raises about the effectiveness of the Government’s tier system, as my hon. Friend the Member for Kingston upon Hull West and Hessle (Emma Hardy) pointed out powerfully. However, I want to use the debate to raise the impact of covid-19 across the world. Last week, the People’s Vaccine Alliance—a collection of organisations including Oxfam, Global Justice Now and Amnesty International—called for the pharmaceutical companies that are developing covid-19 vaccines to share their information and to waive their intellectual property rights to all vaccines, tests and treatments until the threat of the virus has abated. To do so would massively increase the global supply of vaccine doses and save countless lives. Now is not the time to put profit before people, and I would like to make clear my support for this proposal.

Through an analysis of data collected by Airfinity, the People’s Vaccine Alliance has highlighted the dangers that an unequitable distribution of coronavirus vaccine poses. Its work has revealed that 67 of the world’s poorest countries will be able to vaccinate only one in 10 of their population. In contrast, wealthier countries have acquired enough doses to vaccinate their population three times over, while Canada could potentially vaccinate its population of five times over. All in all, the most well-off states that make up just 14% of the world’s population have bought 53% of the doses of vaccines most likely to be successful. It is so disheartening, and arguably dangerous, that 96% of Pfizer’s doses have been acquired by wealthy nations. While it is welcome that 64% of the Oxford AstraZeneca vaccine has been made available to developing nations, it will still only be enough for 18% of the world’s population. This is clearly not right.

Covid-19 has, sadly, shone a spotlight on the susceptibility to ill health of those in the most deprived communities, as well as the disproportionate impact of coronavirus on the world’s poorest. In the UK, those in our most deprived communities have been about twice as likely to die as those in the least deprived. With this in mind, it cannot be right that the wealthiest countries have enough doses to vaccinate more than their entire population while the most impoverished nations are unable even to vaccinate their healthcare workers and their most vulnerable. In times of crisis, it is easy to panic and to look after our own, but the reactionary response is rarely the best one. In the UK, we are no more deserving of the lifeline that a vaccine offers than any other nation. In order to uphold our human rights obligations, we must ensure that there is equal access to vaccines across the world. However, an equal sharing of vaccine resources is not just morally correct, it is also beneficial to the UK. As the director of Frontline AIDS said:

“This pandemic is a global problem that requires a global solution. The global economy will continue to suffer so long as much of the world does not have access to a vaccine.”

As a country, we cannot look to end this crisis simply by eliminating the virus within our own borders, because for as long as it exists, public health will be at risk and economies will be weakened.

I remind this House of our obligation, as a wealthy country, to the rest of the world. I urge nations from around the world to reject the pull of vaccine nationalism and to consider the world’s most vulnerable. To those who say, “We must put British interests first”, I say that beating this virus and reducing global poverty is a British interest. We must remember that when it comes to covid-19, none of us are safe until all of us are safe.

Covid-19 Vaccine Roll-out

Mary Kelly Foy Excerpts

Tuesday 8th December 2020 Commons Chamber

[Matt Hancock]

The UK has put more money into the international search for a vaccine, and the distribution of a vaccine to the countries that otherwise would not be able to afford it, than any other state of any size, and we should be very proud of that. The way that we have managed the Oxford-AstraZeneca vaccine is to ensure that it is available on a not-for-profit basis, essentially, worldwide. We have taken this approach because, to put it exactly as my hon. Friend did, nobody is safe until everybody is safe. This is a global pandemic and we need to address it globally. That is the only fundamental way to solve this for the long term. In the short term, what we all need to do is keep following the rules.

[Mary Kelly Foy (City of Durham) (Lab)]

The vaccine is indeed welcome news, but until it is fully rolled out, the north-east will continue to be harmed by the lack of economic support that accompanies tier 3 restrictions. The Health Secretary stated that the restrictions were based on

“cases among the over-60s; the rate at which cases are rising or falling; the positivity rate; and the pressures on the local NHS.”—[Official Report, 26 November 2020; Vol. 684, c. 1000.]

Can he therefore tell me precisely what level these figures will have to be at for the north-east to be moved into tier 2?

[Matt Hancock]

We consider all those figures, and because we consider them alongside special factors such as whether there is an outbreak, we do not put a specific figure on that, as the hon. Lady well knows. But what we have done is put in more economic support than almost any other country in the world, as the International Monetary Fund has recognised. We have tried as best we possibly can to support people through what has been an incredibly difficult year. We have not been able to save every job, but with the economic measures of support for business and the furlough scheme in place, we have put in very significant support. But the best support that people in the north-east, and elsewhere in the country, can have until this vaccine is rolled out is to continue to follow the restrictions that are necessary and then, if they get the call from the NHS, take that vaccine.

Smokefree England: Covid-19 and PHE Abolition

Mary Kelly Foy Excerpts

Thursday 12th November 2020 Commons Chamber

[Mary Kelly Foy (City of Durham) (Lab)]

I beg to move,

That this House welcomes the Government’s ambition for England to be smokefree by 2030; notes the increasing disparities in smoking rates between the richest and poorest in society; further notes the effect of the covid-19 outbreak and the opportunities and risks provided by the reorganisation of public health on the UK’s ability to achieve this ambition; and calls on the Government to set out the further steps it plans to take to deliver a smokefree England by 2030.

I thank the Backbench Business Committee for granting this debate. I am also grateful to every Member who has given up their time to speak, especially the hon. Member for Strangford (Jim Shannon), who I believe has already had two questions and a speech today—and I suspect that he still has an Adjournment debate ahead of him.

This debate is on an issue that is close to my heart. I must declare an interest as a former chair of the Gateshead tobacco control alliance. As the prevention Green Paper acknowledged, achieving the smokefree 2030 ambition will be challenging, especially in deprived communities where smoking rates are higher. On current progress, Cancer Research UK estimates that these communities will not reach the 5% ambition until the mid-2040s. This is simply not acceptable. Indeed, in County Durham, adult smoking prevalence is 17% compared with 13.9% nationally. This rises to 27% among people in routine and manual occupations. On top of that, 16.8% of mothers smoked during pregnancy compared with 10.4% in England.

Smokers in the north-east lose around £600 million because of unemployment and reduced income due to smoking. For working smokers, weekly earnings are on average 6.8% lower than for non-smokers, equivalent to £1,424 less per smoker annually—and this, of course, was prior to covid-19, which is disproportionately harming the health of local economies of already disadvantaged areas. Helping smokers to quit will benefit not just their health and wellbeing but their incomes, helping to level up disadvantaged communities. Smoking is also responsible for half the difference in life expectancy between the rich and the poor. For every person who dies from smoking, another 30 are suffering from serious smoking-related diseases. Disturbingly, every week in England, almost 2,000 children take up smoking, two thirds of whom will go on to become regular smokers.

With 1,500 people dying from smoking-related diseases every week, there is no time to waste. The tobacco control plan published in 2017 was for five years, which comes to an end in 2022. It has already been overtaken by events and is no longer fit for purpose in the light of the ambition for England to be smokefree by 2030, the decision to abolish Public Health England, and the Government’s manifesto commitments to increase healthy life expectancy by five years by 2035 while narrowing inequalities. If a new tobacco control plan is to be put in place in a timely manner, it needs to be in development now. The Minister may remember that the last plan was published two years after its predecessor ran out of time. We need bold announcements from the Government on tough new measures, along the lines set out in the “Roadmap to a smokefree 2030”, which has been endorsed by the all-party group on smoking and health, if we are to achieve a smokefree 2030. Will the Minister confirm whether the Government are developing a new tobacco control plan, and if not consider doing so urgently? Will he further commit to publishing a new tobacco control plan in 2021, setting out concrete measures for delivering on the smokefree 2030 ambition?

Britain is a world leader in tobacco control, having driven down smoking rates by 60% since the start of this century. However, the Government’s decision to abolish Public Health England without a clear plan for the future risks undermining this hard-won progress. The success in tobacco control has been driven by combining national population level interventions with comprehensive actions at regional and local levels.

The national function is currently provided by a combination of the Department of Health and Social Care and Public Health England; what is crucial is not where the function sits, but that it has protected funding and continues to exist. Furthermore, while inequalities in smoking rates remain, where regional tobacco control programmes have been in place there has been a significantly higher rate of decline. Regional programmes, such as those led by Fresh in the north-east, provide an effective bridge between national and local activity and between local authorities and the NHS. The Government must publish a clear plan setting out the future of Public Health England’s health improvement and wider functions; that is crucial if we are to achieve the Government’s interlocking pledges not just to achieve a smokefree 2030, but to increase disability-free life years, reduce inequalities, improve mental health and reduce obesity and alcohol harm.

The covid-19 pandemic makes action to reduce smoking prevalence all the more urgent. Chronic diseases such as cardiovascular disease, respiratory diseases and diabetes account for about 89% of all deaths in the UK and are also linked to higher rates of mortality from covid-19. A robust and sustainable approach to health improvement is vital if we are to tackle the leading causes of chronic diseases, namely smoking, obesity and alcohol and drug abuse.

However, the impact of smoking is not limited to the UK. It is estimated that at least 8 million deaths around the world every year are linked to tobacco, more than for AIDS, tuberculosis and malaria combined. Over 80% of the more than 1 billion smokers in the world live in low and middle-income countries. In addition to the human cost, the impact on already overstretched health care systems puts a heavy economic burden on those countries, adding to the difficulties LMICs face in recovering from the global pandemic.

That is why we can all be proud that the UK, as a global leader in tobacco control, is providing funding via Official Development Assistance to support implementation of the framework convention on tobacco control in low and middle-income countries. The funding was £15 million over five years for the World Health Organisation’s FCTC 2030 project to support low and middle-income countries to implement tobacco control measures. The FCTC 2030 project has been very well regarded; however, funding is due to come to an end. Extending this funding will accelerate progress in ending the global tobacco epidemic, support FCTC 2030 beneficiary countries to recover from covid-19 domestically, and as the UK leaves the EU maintain our position and as a global leader on tobacco control.

This is a matter of development funding so it requires broader support than just from the Department of Health and Social Care, but the Minister’s support for the proposal would greatly facilitate the likelihood of success. Will the Minister therefore commit to supporting extending the UK’s funding for the FCTC 2030 project beyond 2021?

Aside from our international commitments, it is important that there is a focus within the UK at regional and local authority level. Smokers from deprived communities with higher smoking rates tend to be more heavily addicted than those from more affluent communities. Deprived smokers are just as motivated to quit as other smokers, but it is harder to succeed when people are more addicted, when smoking is more commonplace and when cheap, illicit tobacco is widely available.

Regional tobacco control programmes have been effective in tackling these disparities, as shown most clearly by the example of Fresh in the north-east, which is the longest-running and only surviving regional office for tobacco control. When Fresh was founded in 2005, smoking prevalence in the north-east was much higher than the average for England, at 29% compared with 24%, and the disparity was growing. Since then, the north-east has seen the greatest decline in smoking prevalence of any region, and smoking prevalence is now only a little higher than the England average. Smoking rates have also fallen faster among routine and manual workers in the north-east compared with in England as a whole. As a result, although the differential between routine and manual and professional workers declined in the north-east between 2012 and 2017, it has increased in England as a whole. The success and value of Fresh’s work is clear, and I commend it for its vital work in the region.

After the public health grant to local authorities was cut in 2015-16, the funding provided by local authorities for regional offices in the north-west and south-west was cut completely. Even in the north-east, funding has been significantly reduced. New funding streams are therefore needed. In addition, there are stop smoking services that act as a highly effective and cost-effective way of supporting smokers to quit. However, there is a stark inequity in the local authority offer to smokers across England. In some areas, stop smoking services have been scaled down or decommissioned altogether, whereas elsewhere local authorities have sustained or developed their services.

An Action on Smoking and Health and Cancer Research UK report published in January looked at the state of local stop smoking support and found that among the local authorities that still had a budget for stop smoking services, 35% had cut that budget between 2018-19 and 2019-20. That was the fifth successive year in which more than a third of local authorities had cut their stop smoking service budgets. Financial pressures caused by the cuts to public health funding and the wider pressures on local government finances are the major reason for that. The public health grant, which funds local authority tobacco control, has been cut by around a fifth in real terms since 2015-16, falling from £4 billion in ’15-16 to £3.2 billion now.

Analysis by the King’s Fund in 2018 found that wider tobacco control and stop smoking services were among the biggest losers in planned budget cuts and that these cuts have been accompanied by a 38% decline in the number of smokers setting quit dates at stop smoking services since 2015. Among pregnant women, the number setting quit dates has fallen by a fifth. This is one of the many failures of austerity, so will the Minister confirm that the Government will reverse the cuts made to local public health budgets to ensure that local authorities can play their part in delivering a smokefree 2030?

We must also recognise the value of social marketing campaigns, which have immediate impact, can be targeted with precision at disadvantaged smokers and can be highly cost-effective if carried out at a regional and national level. Such campaigns play a particularly important role in motivating smokers to try to quit. In 2016, Fresh worked with Smoke Free Yorkshire and the Humber to implement a hard-hitting quit smoking campaign aimed at raising smokers’ awareness of the links between smoking and 16 types of cancer and to trigger quit attempts, reaching millions of people. It is now thought to have been among the most successful quit campaigns to have ever been run in England in terms of awareness, attitudes and actions taken, with around 10% of people who saw it making a quit attempt—that is around 72,000 smokers. However, this regional activity is threatened by local authority budget cuts, which led to the decommissioning of the regional offices in the north-west and south-west. A smokefree 2030 fund imposed on the tobacco industry, as proposed in the Green Paper consultation, would provide vital funding for national and regional anti-smoking mass media campaigns.

Another important regional issue is the impact of illicit tobacco, which is concentrated in poorer communities. Cheap and illicit tobacco provides easier access to tobacco for children and reduces the incentive for adults to quit. In 2009, Fresh, along with colleagues in the north-west and Yorkshire and the Humber, established the North of England Tackling Illicit Tobacco for Better Health programme, originally with pump priming from a Department of Health grant. The aim was to increase the health of the population by reducing smoking prevalence; reducing the availability of illicit tobacco, therefore keeping real tobacco prices high; developing infrastructure to aid information sharing, identification of illicit markets and enforcement action; reducing the demand for illicit tobacco through campaigns raising awareness of the issue; engaging with relevant health and community workers; and finally, regularly monitoring smokers’ attitudes and behaviour to measure the effectiveness of the programme.

Between 2009 and 2019, the illicit market share declined by a third in the north-east from 15% to 10%, and enforcement was enhanced. That compares with the national market share of illicit tobacco in 2018-19 and of manufactured cigarettes, with a share of 34% for hand-rolled tobacco. Elements of the original north of England programme have been sustained by Fresh in the north-east, including insight-led demand reduction programmes. Fresh now leads the national Illicit Tobacco Partnership, supported by ASH and other partners. However, the 2013 National Audit Office recommendation that this approach be rolled out nationally has not yet been adopted, while essential regional activity to tackle illicit tobacco and reduce smoking among children and young people has been put at risk by cuts to public health grants since 2015-16. Does the Minister agree that regional activity to get illicit tobacco off our streets should be sustainably funded?

Finally, I would like to raise the regulation review. While we await the Government’s response to the prevention Green Paper consultation, I hope the Minister can tell us what has happened to the Government’s response to the consultation on the Nicotine Inhaling Products (Age of Sale and Proxy Purchasing) Regulations 2015, which closed in September last year. A response to that consultation was due last December, and almost a year on, there has been no word from the Government about when it will be published. The Government are also required to review the Tobacco and Related Products Regulations 2016 and the Standardised Packaging of Tobacco Products Regulations 2015 by May 2021. They should set out the timetable for the consultation process for both sets of regulations as soon as possible. We are therefore awaiting the Government’s response to two consultations and the launch of two more, which need to be reported by the end of the financial year. Can the Minister confirm when the Government will deliver on all four of those?

I recognise that I have posed a lot of questions, and I thank the Minister and the House for their time. However, those are questions that need to be asked and answered if we are to achieve the smokefree 2030 ambition that is shared right across the House.

--- Later in debate ---

[Mary Kelly Foy]

I thank every Member for their contribution to this important debate: my hon. Friend the Member for Blaydon (Liz Twist), the hon. Members for Winchester (Steve Brine) and for Strangford (Jim Shannon), my hon. Friend the Member for Nottingham North (Alex Norris) and the Minister. I am glad that there is consensus across the House on the need to reach the target of a smokefree England by 2030. If I may, Madam Deputy Speaker, I would like to thank Deborah Arnott from ASH and Ailsa Rutter from Fresh who have been a continued source of support and knowledge in all things smoking-harm related.

I am aware that, at the minute, a significant amount of public health focus is directed at tackling the coronavirus pandemic, and rightly so. However, I hope that this debate serves as a reminder that there remain significant health inequalities in society. In our most deprived communities, these inequalities pose a grave risk to the health of countless people. While this has been exacerbated by the pandemic, without action the threat to our most vulnerable communities will only become more grave. It is vital, therefore, that the issues raised today are addressed. As the hon. Member for Strangford (Jim Shannon) highlighted, tackling and addressing health inequalities is a matter of urgency.

Question put and agreed to.

Resolved,

That this House welcomes the Government’s ambition for England to be smokefree by 2030; notes the increasing disparities in smoking rates between the richest and poorest in society; further notes the effect of the covid-19 outbreak and the opportunities and risks provided by the reorganisation of public health on the UK’s ability to achieve this ambition; and calls on the Government to set out the further steps it plans to take to deliver a smokefree England by 2030.

Covid-19 Update

Mary Kelly Foy Excerpts

Tuesday 10th November 2020 Commons Chamber

[Mary Kelly Foy (City of Durham) (Lab)]

We know that those in the most deprived areas are around twice as likely to die from covid-19 as those in the least deprived areas. We also know that the most deprived people in society are less likely to take up the vaccine and health services, so will the Secretary of State tell me what plans he has made to ensure a high take-up of any covid-19 vaccine among the most deprived and if he will consider setting an inequalities target for this?

[Matt Hancock]

We are of course concerned about that and will put in enormous efforts to try to ensure that the take-up of the vaccine is as equal as possible. The starting principle is that we will roll out the vaccine according to clinical need across the whole UK, across all four nations, working of course through the devolved NHSs, which are going to be critical to actually delivering the vaccine in the devolved nations. But the procurement of this vaccine is a UK programme—we have been working very closely together—and in terms of the roll-out among deprived communities and harder-to-reach communities, we have a particular emphasis on trying to make sure that we get as equal a roll-out as possible. The starting point must be clinical need.

Covid-19

Mary Kelly Foy Excerpts

Monday 2nd November 2020 Commons Chamber

[Mary Kelly Foy (City of Durham) (Lab)]

The situation we are facing is farcical, quite frankly. Before recess, the Prime Minister stood at the Dispatch Box and mocked the Leader of the Opposition for calling for a two-week circuit-break lockdown over half term, yet, because of the Prime Minister’s usual dither and delay, we now face a lockdown that will last at least a month. It is not good enough. Although every community must do their bit, the blame for this lockdown must lie squarely at the feet of the Government.

I want to raise a number of crucial points that my constituents have contacted me about. The first is the way the Government have approached this pandemic geographically. When the tier system was introduced to try to slow the spread of the virus, the north was hit the hardest. In Durham and the wider north-east, communities responded to the threat of greater restrictions by working together and following the rules, which resulted in a steady drop in cases, yet now that the infection rate is rising in the south, the Prime Minister has announced a national lockdown. It betrays the Government’s attitude to those in the north that a regionalised approach was taken only when it did not impact the south.

On top of that, when large parts of the north were placed in tier 3, we were told that furloughed workers deserved only 67% of their wage, yet now that the south is in lockdown, that has risen to 80%. Although, obviously, I support that rise, it certainly reveals a lot about this Government’s attitude to the north: out of sight, out of mind.

Secondly, given the concerns of education unions, it would be wrong if I did not touch on the issue of schools. Today, a constituent contacted me to say that her child is 16 and lives with heart failure. If she were an adult, she would be able to work from home, as someone who is extremely vulnerable. Instead, she must go to school, where coronavirus infections are common. Countless pupils and educational staff will be in similar positions. Every teacher, child and parent wants schools to remain open if possible, yet the National Education Union and the University and College Union tell us that schools and colleges are not fully safe right now. The Government must urgently make the necessary changes to fix that. Schools need to stay open, but only if they are safe. No one should have to go into a workplace that is not safe.

Finally, I feel it necessary to mention the impact of gym closures, especially for women. Gyms act as relatively safe spaces for women to exercise, and many simply cannot do so outdoors in the dark with the same confidence or security. As we all know, exercise plays a vital role in people’s mental and physical wellbeing. While people will accept the closure of gyms, sports facilities and grassroots sport in the short term, the Government must urgently detail how such environments can be covid-secure, and must support them in their efforts to operate safely and stay open.

It frustrates me to have to give this speech today. This Government have had seven months to respond to the pandemic. They have failed on testing, failed on track and trace, and failed to support workers and businesses properly. Because of the Government’s incompetence, we are virtually back to where we were in March. No one has demanded perfection, and I understand the complications, but it is not unrealistic to call for competence and to expect the Government to learn from their mistakes. I urge the Government to use this month to get a grip on the virus. It is time to stop handing out jobs and contracts to their pals, and focus instead on their actual duty—protecting public health and reviving the economy—because the public and this House are fast losing patience.