Tobacco and Vapes Bill (Sixth sitting)

Debate between Rachael Maskell and Andrea Leadsom

Committee stage
Thursday 9th May 2024 Public Bill Committees

[Dame Andrea Leadsom]

I wholeheartedly endorse almost everything I have heard. I share hon. Members’ concerns and applaud them for their commitment to solving the issue of nicotine pouches. As my hon. Friend the Member for Harrow East rightly pointed out, should the industry find a way around something in the Bill, we would have to legislate again with primary legislation. The right thing to do, therefore, is to take powers to make secondary legislation that gets on top of the issue and future-proofs us, so that right across the United Kingdom we can tackle this appalling scourge: the tobacco industry’s determination to get our children addicted.

Extraordinarily, the tobacco industry dominates the UK nicotine pouches market, and it claims to self-regulate—that is, it claims not to sell to under-18s. That is absolutely extraordinary. A recent study suggests that although nicotine pouch use is low among adults, with roughly one in 400 adults in Great Britain using them, nicotine pouches are increasingly popular with younger, largely male audiences. The Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment has identified gaps in research and flagged that the long-term health harms are not known, but use by non-smokers is likely to be associated with some adverse health effects due to the nicotine.

We all know that other nicotine products need to be clamped down on. We will not need to consult on age of sale restrictions on nicotine products; we will be able to use regulations, hopefully in this Parliament, with implementation from 2025. It is certainly our plan to consult on all of this regulation to get ahead of nicotine pouches and other nicotine products with a view to implementing the regulations in 2025.

[Rachael Maskell]

I do not know whether the Minister is aware that the strength of the nicotine in these products is excessively high—much higher than in other products—and so they rapidly bring about addiction. When the Government brought forward measures to try to educate the country about alcohol use, they did a comparison. Perhaps it would be helpful to do a comparison about the amount of nicotine that individuals are taking through a nicotine pouch, because the public would be alarmed to know that we are talking about their taking multiple factors of nicotine into their bodies.

[Dame Andrea Leadsom]

The hon. Lady is absolutely right; they vary from 2 mg to 150 mg per pouch. I imagine that that variation would make it hard to provide a complete comparison, but she is quite right that education will be a big part of the implementation.

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[Dame Andrea Leadsom]

My hon. Friend makes a good point. The Bill takes powers to bring forward the age of sale restriction, and that in itself will not require further consultation. It is my expectation that, if possible, that will be brought forward in this Parliament. However, as has been explained, if we put something in the Bill, the industry will get around it by saying, for example, “This doesn’t contain nicotine”—except it does, as we have already seen.

The other thing I want to raise with hon. Members is that clauses 61 to 63, which will grant the ability to restrict flavours, packaging and location in store, will also apply to nicotine products. Those measures are clearly designed to reduce their attractiveness to children.

[Rachael Maskell]

In response to my questions and accepting the clause as it is written, can the Minister give the Committee an assurance about when the regulations will be brought forward to ensure that products such as nicotine pouches will come within scope of the Bill?

[Dame Andrea Leadsom]

All I can say to the hon. Lady is that she has heard me, and I am determined to bring that forward as soon as possible. There are good reasons for not putting the provision on the face of the Bill, which are to do with future-proofing. I can only give her my absolute assurance that, as soon as humanly possible, I will bring the regulations forward for consultation where necessary and for implementation where not.

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[Rachael Maskell]

I want to pick up on this point as well because it is incredibly important, and we cannot put the responsibilities on to trading standards if they do not have the tools to do the job. Clearly, this is a new field and, as we have discussed throughout the Bill, new products will come out and be marketed if we do not get ahead of the curve. It is therefore important that we ensure that new testing kits are made available and that we look at how they can be brought into play.

We heard strong evidence last week about the benefits of introducing a track and trace system, which would simplify the work of trading standards. If a product has not been through that process, and there is therefore not an authoritative basis on which to say that it can be sold, it would clearly be an illicit product. If a proper track and trace process was put in place, that could aid the work of trading standards, and addressing the real challenges we are trying to deal with through these clauses would not require such extensive resourcing.

Will the Minister therefore comment on her appetite for bringing in a track and trace system for vaping and other nicotine products to get ahead of the curve? That would ensure that the illicit trade is suppressed and does not rear its ugly head and that it is as easy as possible for trading standards to uphold every part of the Bill.

[Dame Andrea Leadsom]

This is obviously an incredibly important area of enforcement, and successful enforcement is integral to the success of this policy.

To the question from the hon. Member for Birmingham, Edgbaston about Operation Joseph, in the year before the operation—2022-23—2.1 million illicit vapes were seized by trading standards across England. In the same year, 1,199 test purchases were carried out by trading standards in England, with 27.3% resulting in an illegal sale. Those are the numbers. As the hon. Lady says, Operation Joseph has had £3 million of investment over two years, led by National Trading Standards. It conducts a range of illicit vape enforcement activities, including data collection and analysis of the scale of illegal products and under-age sales; market surveillance; under-age sales testing; court enforcement action; and upskilling of trading standards staff. A further operation—Operation CeCe —was established in January 2021 as a joint venture between National Trading Standards and His Majesty’s Revenue and Customs to tackle illicit tobacco sales.

So those individual measures are in place. As hon. Members will know, the Medicines and Healthcare products Regulatory Agency looks at the product notifications for legal products, which have to meet the compliance standards of the MHRA. It is then for trading standards to enforce, and they have had a significant increase in resources to tackle enforcement, as I have set out. I am obviously happy to write to Members with more detail should they wish.

Question put and agreed to.

Clause 19 accordingly ordered to stand part of the Bill.

Clauses 20 and 21 ordered to stand part of the Bill.

Clause 22

Power of ministers to take over enforcement functions

Question proposed, That the clause stand part of the Bill.

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[Rachael Maskell]

I rise to support my hon. Friend the Member for Birmingham, Edgbaston. I completely agree that when we set these figures, we often forget that the economy has moved on so much, and that the rise in inflation has meant that so many things cost so much more. Just £100 is a very small amount to many shops, which take their cut from these products. It is therefore essential that we move into the realms of reality, not least because the consultation advised the Government that £200 would be an appropriate starting point and would have public support.

Clause 26 says that the figure can be amended by the Secretary of State, should they choose to do so. So the amendment would not place a limit in primary legislation, but it would make this a more realistic deterrent to ensure that shopkeepers abide by the law. It is also really important to have an incentive for them to ensure that they are fully up to speed with their obligations. This change would focus their minds as regulations are introduced, as the Minister alluded to, and ensure that they keep themselves up to date, because they know that the penalty makes it worth doing that. I therefore urge the Committee to adopt my hon. Friend’s amendment. It is a simple measure that would not cause the Minister any grief as the Bill passes through its later stages.

[Dame Andrea Leadsom]

I am grateful to the hon. Member for Birmingham, Edgbaston for bringing this discussion to the Committee, and I fully appreciate the sentiment behind the amendment. I completely understand why it is attractive to raise the fixed penalty notice and make it more material to the individual, but I urge hon. Members to take into account the fact that local trading standards take a proportionate approach to tobacco and vape enforcement. The Bill proposes fixed penalty notices of £100 to enable trading standards to take swifter action by issuing on-the-spot fines, rather than needing to go through lengthy court processes. Littering, parking or under-age alcohol sales attract on-the-spot fines. The proposal in the Bill is for £100, or £50 if it is paid within two weeks. That avoids people thinking, “I can’t pay this, so you’ll have to pursue me through the courts.” That creates an incentive for these issues never to come to court, and it can clog up court time and so on. I fully appreciate the hon. Lady’s point, but this is about practicality.

I find it slightly odd that the hon. Lady says £100 is affordable but £200 is not. I would be shocked to get a £100 on-the-spot fine, and I am sure she would, too. Most retail workers would find a £100 fine to be quite devastating vis-à-vis their daily cost of living. I fully understand the sentiment behind the amendment, but £100 is in line with the precedent set by penalties for comparable offences. The fixed penalty notice for under-age alcohol sales is £90. If the penalty were raised to £200, as the amendment suggests, trading standards could issue higher on-the-spot fines, but how many of us have that kind of money on us? It would push a person into severe difficulty. As we have discussed, there is a very swift escalation—it is a “two strikes and you are out” policy—and there is the ability to take the business to task, too, so I think the current penalty is actually quite stringent.

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[Dame Andrea Leadsom]

I completely agree; the hon. Lady makes a good point. What people would see as a deterrent is an open question. I would see a £100 fine as a deterrent; I do not have £100 in my purse, so I would have to go to the cash point. I would not be keen to do that, and Members of Parliament earn quite a bit more than most retail workers. That is the truth of it. I actually think that setting the fine in line with the £90 fine for the offence of selling alcohol to someone under age is quite a material deterrent.

[Rachael Maskell]

I think the Minister is making slightly the wrong comparison. A retail outlet will have a till, and that till will have money in it. Therefore, it will be the business, not the shop worker, paying the fine. She makes the point that for one person, £100 could be incredibly steep, but for someone working in a venue that sells products out of the scope of the legislation, paying £200 out of a till is not really out of the ordinary, and these businesses make extortionate profits out of these things. I wonder if she could address that point.

[Dame Andrea Leadsom]

The hon. Lady makes a good point. There is an open question as to what the right level is, but it is for trading standards to decide whether the individual member of staff or the business pays the fine. So this is a very relevant point, but it is not just about taking the money out of the till. That is not necessarily the choice that trading standards would make; the fine may well be imposed on the individual.

Tobacco and Vapes Bill (Fifth sitting)

Debate between Rachael Maskell and Andrea Leadsom

Committee stage
Thursday 9th May 2024 Public Bill Committees

[Dame Andrea Leadsom]

My hon. Friend makes an extremely good point. She will be interested to know that I have recently written to the Advertising Standards Authority to ask about how well it considers enforcement to be working, and what more it can do to enforce the already strict regulations. I am happy to share its response, when it comes, with all members of the Committee.

[Rachael Maskell]

rose—

[Kirsten Oswald]

rose—

[Dame Andrea Leadsom]

I will give way to the hon. Member for York Central and then to the hon. Member for East Renfrewshire.

[Rachael Maskell]

I am really grateful to the Minister for the work that she is doing in this area, but clearly, for vaping, there is not equality with smoking in terms of an advertising ban. For simplicity’s sake, equalising the law would make a significant difference. We often think about packaging in shops, but today, the social media space is an incredibly powerful tool that young people are exposed to on a continuous basis. Therefore, extending the advertising, promotion and sponsorship ban could have such a significant impact, and it could be legislated for simply. As we have got so accustomed to the advertising ban for tobacco products, it can simply be translated for vapes. Will the Minister look into that?

[Dame Andrea Leadsom]

With your permission, Dame Siobhain, I will take the intervention on the same subject from the hon. Member for East Renfrewshire.

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[Rachael Maskell]

I support the points that have already been made, but I will not repeat them, because they have been made eloquently.

Why is the fine in clause 4(2) only at level 3, whereas elsewhere in the legislation the fines are at level 4? We know that cigarettes being sold as single items, and packs being broken up and sold in that way, encourages people to smoke. We also know that they will be targeted at children and young people, as well as people in greater deprivation.

There are 14.5 million people in our country who are living in poverty, and there is a much higher prevalence of smoking in that population. The increase in the price of tobacco products has been a major determinant of how much people smoke and whether people smoke at all. It therefore seems perverse that the fine applied to breaking up cigarette packs is less than that applied elsewhere in the Bill, where there is a level 4 fine. Can the Minister explain the reasoning behind dropping the level of fine? Why is it not in line with the other measures in the Bill?

[Dame Andrea Leadsom]

I do not have all the answers to hon. Members’ questions. The purpose of the clause is to restate and clarify the statute book, so the answer to many of the “Why haven’t you done this or that?” questions is that the intention was to tidy up the statute book rather than address all the other potential issues that could be solved. I will certainly come back to hon. Members with the answers to their questions.

As colleagues will appreciate, there are thousands of potential add-ons to the legislation, but it is important to remember that the core purpose of the Bill is to create the smoke-free generation. On those well-made points and suggestions, I do not know whether they were considered and ruled out or whether they were not considered, but I will come back to hon. Members with answers.

Question put and agreed to.

Clause 4 accordingly ordered to stand part of the Bill.

Clause 5

Age of sale notice at point of sale: England

Question proposed, That the clause stand part of the Bill.

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[Rachael Maskell]

I am grateful to the hon. Lady for the point she made. Certainly, I did highlight that transitional benefit of moving from smoking to vaping to, hopefully, stopping altogether. However, we must also highlight that vaping is not without risk, and we need to give that serious consideration. I am just concerned that the Government are slightly light, shall I say, in terms of their concern about vaping, in order to drive down the smoking. I absolutely understand that, because smoking kills, but I just think that we could be on the “too light” side. I know that it is about balance, but I hope that we can reflect on that during the course of the Bill.

I want to draw out one question that I have about clause 9 and giving away vapes. I certainly understand why the measures would be applied to industry, but I want to ask about public health measures that could be deployed. I recognise that the clause is about under-18s, but unfortunately, despite the current legislation, we know that many people under 18 smoke, and we obviously need to ensure that they stop and move into a safer space. The Government have been very much pressing the idea that vaping is a route out of smoking. Does the Public Health Minister see vaping as a means to help people under the age of 18 to stop smoking, or will they have no access to vapes? I would just like some clarity around that. Clearly, there are other smoking-cessation programmes and products available, but it would be useful to know the answer to that question. If vaping is to be used in that way, and clinicians are to be able in future to prescribe or indeed provide vapes for young people to stop smoking—if that was the only tool—we need to understand whether we are to have a blanket ban in the Bill. It would be very useful to understand that.

[Dame Andrea Leadsom]

Once again, I thank all hon. Members for their thoughtful and considered remarks —I really do appreciate them. Essentially, the questions are pretty much around the product notification and the availability of quit aids to under-18s. Hon. Members may not have spotted this, but the notification of vapes to the MHRA is something on which we are taking powers. There will be a further consultation on that point because it did not come under the scope of the original consultation. We will have the powers to require notification of vapes to the MHRA.

The other point that has been raised by a few colleagues is, “How do we help under-18s to stop smoking?” Under the MHRA, there is licensed nicotine replacement therapy, which is licensed for 12 to 18-year-olds. Of course, all under-18s can go to their local stop-smoking services.

To the point from the hon. Member for York Central about whether young people should be able to access vaping as a quit aid, my instinct would be, “No, absolutely not,” and I think that that would be her instinct also. However, I must slightly correct the record: it is certainly not the Government’s position that vaping is in any way safe; it is merely less harmful than smoking. I would reiterate that if you don’t smoke, don’t vape. And children should never vape, so they should not be turning to vaping, even as a quit aid. In my view, that would also be the thin end of the wedge, because people would simply say, “Well, I am only vaping because I am trying to stop smoking.” I cannot imagine that ever being a suitable way to help children to stop.

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[Dame Andrea Leadsom]

As the hon. Lady will know, the MHRA is not an enforcement body; enforcement is for trading standards. As I mentioned earlier, there will be new resources for trading standards, as well as new training and guidelines. Also, fines will go direct to local authorities, which employ enforcement officers, so there will be a huge ramping-up of enforcement on illicit vapes, non-compliant vapes and so on. That is the place for enforcement.

On the MHRA and notification of other types of vapes, there will be powers, and the consultation will take place in due course.

[Rachael Maskell]

While the Minister is doing the work on vapes, will she also look at nicotine pouches, which are incredibly concerning? We have heard that the strength of the nicotine in pouches far exceeds that in vapes. People are therefore getting a very high dose of nicotine and are sometimes not aware of the level they are getting.

[Dame Andrea Leadsom]

I am frantically looking through my pack here. Clause 10 covers nicotine pouches, so we will come on to that—[Interruption.] The Whip is saying it will be after lunch, if that is not too much of a sneaky “get out of jail” card. With the hon. Lady’s acceptance, I will defer that until later.

Question put and agreed to.

Clause 7 accordingly ordered to stand part of the Bill.

Clauses 8 and 9 ordered to stand part of the Bill.

Ordered, That further consideration be now adjourned. —(Aaron Bell.)

Tobacco and Vapes Bill (Third sitting)

Debate between Rachael Maskell and Andrea Leadsom

Committee stage
Wednesday 1st May 2024 Public Bill Committees

[Dame Andrea Leadsom]

Thank you very much. One last question: do you think the financial incentives for pregnant women and their partners would help?

Professor Turner: I think this is extremely contentious, but the evidence is that it does—sorry, you did ask me about pregnancy before. Pregnancy itself can be one of those opportunities to quit. Those parents who continue smoking—12% in Cumbria—feel terribly guilty. Anything we can do for that person, who has been addicted since she was 15 or 16, can help them to quit. There is no doubt—in Dundee, the trials have shown that, if you give mums incentives, in terms of vouchers rather than money, it helps them to quit, particularly if they are from deprived communities.

[Rachael Maskell]

Q We have already heard how addictive nicotine is, but do we have an understanding of the dosage of nicotine that people inhale through vaping versus through smoking? Secondly, are we missing an opportunity not to introduce a nicotine-free generation?

Professor Hawthorne: I am not a nicotine expert, but my understanding is that there is a risk from vaping, but it is about 5% of the risk from smoking. That is the best I can do in comparing the two. When I talk to patients about stopping smoking, vaping is one of the things we talk about as an alternative, with a view to eventually stopping vaping as well. Of course, there are all the other products: we use patches and chewing gum—all the usual things. It is difficult to quantify exactly how much less dangerous vaping is than smoking.

Professor Turner: Just to supplement that, as a user—if that is the right word—or a customer buying a vape, you can select the dose you want. There are doses that are equivalent to cigarettes and doses that you can wean yourself down on.

You asked whether we would be missing an opportunity if we do not introduce a smoke-free generation. I think we would absolutely be missing an opportunity. If we look back, the legislation on smoke-free public spaces across the UK was landmark. We all remember the days when you went on a plane and there was a smoking bit up front and a non-smoking bit at the back. If we were to go back and say there would be no smoking areas, we would think, “Wow, that would be transformational.” We have come on a journey, and the legislation has been part of it. I see a smoke-free generation as the logical next step, and I really think we have to take it.

Tobacco and Vapes Bill (Second sitting)

Debate between Rachael Maskell and Andrea Leadsom

Committee stage
Tuesday 30th April 2024 Public Bill Committees

[Dame Andrea Leadsom]

Q You have already said that you do not think the penalties are high enough, but do you think that the enforcement rules as they are, with the proposals to change the packaging, move the location of vapes and so on, will make it easier or harder to enforce? Do you think that enforcement officers will have sufficient time to train and gear up to meet the challenge of the legislation?

Cllr Fothergill: Specifically on vaping, we support the move to plain packaging, moving them away from the counter and restricting flavours—we support all those things. I have to say that we recognise the role of vaping in helping people to give up smoking, but where children and younger people are involved, we want to move the vapes away and make them less accessible. Trading standards will enforce that, as long as there are clear definitions of what can be sold, where it can be sold and who it can be sold to. A lot of the work that they do is evidence-led, so they will work on people who are giving them tip-offs or where they are seeing that there is a trend in an area where those products are being sold. As long as we are resourced and we recognise that a lot of that evidence-led work is required, it is entirely achievable.

Greg Fell: I have a fairly similar view. Largely, trading standards do this work now. The easier and simpler we can make it, and the more we make sure that it is resourced appropriately, the better, but they largely do this job now pretty well.

[Rachael Maskell (York Central) (Lab/Co-op)]

Q My question is for Greg Fell. The clarity and simplicity of knowing where you can smoke has meant that the universal principle of that bar has largely been applied, but it has not applied to vaping to date. Given that vapes contain not just nicotine but cannabis, Spice and other illicit substances, should the same restrictions be applied to vaping?

Greg Fell: Hopefully only illegal vapes contain cannabis or Spice, and not legally produced ones—I sincerely hope that is the case. I have mixed views on vaping in public. I think that Prof McNeill will talk later this afternoon. It is worth reading her evidence review for the Office for Health Improvement and Disparities, which has a whole chapter on the passive inhalation of vapes. The ADPH does not have an official position on the passive inhalation of vapes, but my personal view is that in open spaces I am not too worried about it. In enclosed spaces, I might be, particularly for people who have pre-existing respiratory conditions, but I do not think that the evidence supports it being as big an issue as people think. However, that is definitely a question for Prof McNeill, who is the expert on such matters.

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[Dame Andrea Leadsom]

Q It is clear to me, having done a visit with enforcement officers, that some so-called specialist vape shops and some newsagents just have the vapes next to the sweets. It is a free-for-all: you get your bubble gum and your vape there. Is that problematic? Will this legislation mean that enforcement officers shut them down? Will there be enough powers and resources to ensure that this can no longer happen?

Kate Pike: The Bill will have enabling regulations on vapes, with powers and criminal sanctions. That is good, but the specifics around where the vapes are positioned in store will be down to the next stage. We get calls all the time from people saying, “There’s a shop in my area called Toys and Vapes—do something about it!” There is actually no legislation that we can use to tackle that.

If you do not want the vapes next to the sweets, legislate for it. We will enforce what it says in the legislation, but we cannot make it up. People are always saying, “That’s not right,” but we cannot enforce morals. We can only enforce the law, so get it in there. If you do not want the vapes there, for very good reasons, give us legislation and we can enforce it.

[Rachael Maskell]

Q My big concern is the illicit trade around vapes. What further measures would be helpful in the legislation to enable you to do your job? Vapes are clearly a delivery mechanism. We have particularly focused on lung health; I am more concerned about the use of vapes for synthetic drugs, which are available in my community and, I am sure, elsewhere. What more can be done to ensure that we do not see the growth of illicit vapes on our street corners or in our shops?

Kate Pike: Illegal drugs are not a trading standards issue. If drugs are consumed via vape or by injection or rolled up in a roll-up, that is not our issue; that is a police issue. We can only enforce the law around the products where the enforcement is given to trading standards. We have no role whatsoever in illegal drugs in vapes. But there is a huge amount of enforcement around illegal drugs in this country, with the police, and the public health approach, about ensuring that people do not use illegal drugs. However they consume them, it is really important that they are on board—

Oral Answers to Questions

Debate between Rachael Maskell and Andrea Leadsom

Tuesday 5th March 2024 Commons Chamber

[Dame Andrea Leadsom]

I have had a number of meetings with my hon. Friend and know that he is determined to resolve some of these long-standing issues in his constituency. I have assured him that ICBs have the freedom to increase capital for primary care in their region, so long as their plans remain within their overall capital allocation. I will certainly be happy to meet him again to talk about what more measures we can take to support his constituents.

[Rachael Maskell (York Central) (Lab/Co-op)]

T4. I held my first dental summit since the publication of the Government’s dental recovery plan, which I have to say was met with disappointment and frustration. The reason for that is that is not enough funding or flexibility, or the resolution to the contract. Will the Minister set out the timetable for when the dental contract will be resolved?

[Dame Andrea Leadsom]

I am very surprised and disappointed to hear the hon. Lady say that. We are delivering 2.5 million more appointments through the new patient premium, which started last Friday. We will have information within a month to see which dentists have taken up this generous new patient premium to ensure that many more people get access to dentistry. Not only that, but we have golden hellos to attract dentists to areas that are underserved, mobile dental vans and, importantly, a new focus on Smile4life. That is going to ensure that all babies and young children have that fabulous smile for life.

Oral Answers to Questions

Debate between Rachael Maskell and Andrea Leadsom

Tuesday 23rd January 2024 Commons Chamber

[Rachael Maskell (York Central) (Lab/Co-op)]

18. What progress she has made on introducing a dentistry recovery plan.

[The Parliamentary Under-Secretary of State for Health and Social Care (Dame Andrea Leadsom)]

I am determined to ensure that everybody who needs NHS dental care can receive it. We have already implemented a package of reforms to improve access and provide fairer remuneration for dentists. That has had an effect, with 1.7 million more adults being seen, 800,000 more children being seen and a 23% increase in NHS activity in the past year. We know we need to do much more, and our dentistry recovery plan will be published shortly, setting out a big package of change.

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[Dame Andrea Leadsom]

As my hon. Friend will know, this is a local matter, and it is for his ICB to determine whether it wishes to support the excellent pilot proposal for overseas dental students in Clacton. At the same time, it needs to ensure that its actions are compliant with current legislation and within the delegation agreement with NHS England. I have just written to my hon. Friend about that, and my letter should address his concerns, but of course I would be happy to see him again if he has any further questions.

[Rachael Maskell]

We were promised “before the summer”, we were promised “after the summer”, we were promised “before Christmas”, we were promised “soon” and now we have been promised “shortly”. The reality is that Labour has a plan and the Government have not. In York, we cannot get an NHS dentist either. Blossom Family Dental Care is just handing back its contract. My constituents have nowhere to go. What is the Minister going to do to ensure that my constituents can access NHS dentistry?

[Dame Andrea Leadsom]

As I said to the hon. Member for Oxford West and Abingdon (Layla Moran), I absolutely understand the challenge for some people. The situation has improved over the last year. Since the covid pandemic, where almost every dentist had to stop working altogether, we have not seen the recovery we want. We are putting in plans—not a paper ambition like the one Labour has put forward, but significant reforms that will enable many more people to be seen by NHS dentists. I say gently to the hon. Member for York Central (Rachael Maskell) that a recent Health Service Journal article states that Humber and North Yorkshire ICB

“have indicated in board papers that dentistry funding will be squeezed to help them balance their books.”

I encourage her to talk to her ICB about that too.