NHS and Care Volunteer Responders Service

Baroness Coffey Excerpts

Tuesday 20th May 2025 Lords Chamber

[Baroness Merron (Lab)]

My noble friend makes an important point and I can give her that assurance. For me, volunteering provides a different type of resource. For example, Mid Yorks is advertising for trolley volunteers, ward befriending volunteers and café volunteers. It is about supporting the staff in their efforts, and supporting patients. Volunteers have always had a role, and long may that continue.

[Baroness Coffey (Con)]

My Lords, if the Minister is concerned about the use of volunteers, will she then consider the role of community first responders? Responses by volunteers are included in measuring the response times of ambulances to 999 calls. Based on her logic, she should now exclude that from response times so that we get the required transparency.

[Baroness Merron (Lab)]

This announcement does not affect transparency or services directly provided by the NHS. We are seeking to improve the volunteering offer to make it more cost-effective, and to retain, recruit and better utilise volunteers. I will look at the point the noble Baroness raises, but I emphasise my point to your Lordships’ House.

Food, Diet and Obesity Committee Report

Baroness Coffey Excerpts

Friday 28th March 2025 Lords Chamber

[Baroness Coffey (Con)]

My Lords, I declare an interest in that I worked for Mars for 12 years and I have a pension.

I am conscious that a lot of the discussion today is about food processes, not food producers, but I have spotted that the noble Baroness, Lady Batters, is speaking later, so I expect that she may cover the issue of food production.

One thing that struck me about this report is that it seems that the only way to try to get change is through regulation, taxes and strategies. I can genuinely say that, in the three different roles that I held at Cabinet level, particularly when I was at DWP, we worked with the Department of Health and Defra on the food strategy. We worked on increasing Healthy Start, and, when people asked for it to be online, we got the applications online.

This is all about how we try to develop habits and, as has already been referred to today, starting young is a key element of that. That can be in schools, but I would go further. Thinking of what the noble Baroness, Lady Brown of Silvertown said, there is a lot here for local government. That is where the health workers are and it has responsibility for planning permission, which was further strengthened last December—a key driver is not necessarily what happens at home, but what you purchase, particularly from fast food outlets. That is really where a lot of the focus should increasingly be.

To follow on from what the noble Baroness, Lady Meyer, said, I remember that, as a student, I used to go down from my halls of residence to the Berwick Street Market every Saturday at 5 am to get the cheap veg. The question is how councils can promote markets, and not just, dare I say it, the niche chichi farmers’ markets. Perhaps councils can do innovative things, such as removing business rates or similar, in order to try to get that fresh food habit as part of a regular shop, with people not just travelling to the supermarket.

One thing that the report frequently refers to is the 2021 national food strategy. I know that Henry Dimbleby was commissioned by Michael Gove to provide evidence to it. It somewhat mushroomed and went way beyond its remit and people referred to it as the “national food strategy”. I should point out that it was never adopted by the Government. However, it brought out a lot of important issues—I appreciate that Henry is not only charming but indeed passionate about this particular interest—that built on the work he had done in improving school meal standards and his other work. A strategy was produced in June 2022 and is now to be updated.

In thinking about processes, one thing your Lordships may not be aware of is the relationships that were forged, particularly during Covid, with the Food Resilience Industry Forum. Frankly, it was the partnership between government and the food processors that are being maligned that kept food on the shelves, so that people could get fed during the challenges that were faced at that time and to some extent during Ukraine a little bit later. Fast-forwarding somewhat and thinking about UPF and science, I would recommend that your Lordships read Dr Amati’s article in the Times today, which talks about this issue and the challenge of how, to be candid, the Nova classification is not just in the balance like the committee has suggested but has been discredited as being ineffective in its classifications. The Nova classification gave a starting point, which was a good thing, but it needs to evolve. That is why the important work still needs to continue. If more research could be done towards that, it would be a welcome move by the Government.

In thinking about the needs of families, we have to remember the cost of living challenge that people face. When food inflation was rising, we had food companies admitting in private that their policies of pursuing net zero by 2030 were increasing the cost of food for families right across the country. When we challenged them about changing that while we had the national emergency, the answer was, quite simply, no. That was a concern to me, but I appreciated that trying to legislate to change that, or creating some new strategy, would simply just add to a very long list. As a consequence, going into the Department of Health as I did, I was accused of all sorts of things at the time, despite the fact that we had a series of strategies. We sat down, looked at the impact assessments for all the different bits of legislation and tried to prioritise those that would make the most difference. That is why banning buy one, get one free during a cost of living crisis was not necessary, especially when the marginal impact was so low. I hope that the updated food strategy that we will see later this year will have a systemic approach to achieving the outcomes that noble Lords seem to be seeking.

I agree with the committee on one specific recommendation: getting the Food Data Transparency Partnership to complete its work. It is one of the best things I set up when in government. It is done on a basis of trust, but it should not be delayed. I encourage the Minister to work with her colleagues to make sure that goes through.

I speak as somebody who is super-obese. Noble Lords may not believe this, but about 20 years ago, I lost 8 stone. I did that by not eating or drinking alcohol—that was pretty much it. I cannot pretend that it has stayed off—far from it. It is not a lack of desire and, as I said to the health officials when I went in, I am a classic example of failure. What has gone wrong? It was not the nutritionist who advised me to eat more carbohydrates. What was it? This is still a journey and there are many good recommendations, but I encourage the Government to focus on delivery and not on more strategies and laws that distract from getting the job done.

Food and Feed (Regulated Products) (Amendment, Revocation, Consequential and Transitional Provision) Regulations 2025

Baroness Coffey Excerpts

Monday 10th March 2025 Grand Committee

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

My Lords, these regulations were laid before the House on 29 January. This draft SI uses powers conferred by the Retained EU Law (Revocation and Reform) Act 2023 to propose two reforms to the market authorisation process for regulated food and feed products in Great Britain. The first is the removal of the requirement for certain products to be reauthorised every 10 years, and the second is to allow authorisations to come into effect following ministerial decisions and to then be published in a public register, rather than prescribed by statutory instrument. The reforms are very much related to process.

These reforms are part of this Government’s mission to kick-start economic growth by increasing investment, driving up productivity and tackling regulatory barriers—something that I know noble Lords are concerned with. The UK food industry is worth some £245 billion in consumer spending annually. It is driving innovation, particularly as the UK’s growing engineering biology sector harnesses emerging technology to produce novel foods.

Regulated products are food and feed products that require safety assessment before they can lawfully be sold. The Food Standards Agency and Food Standards Scotland carry out this assessment and provide recommendations to Ministers across Great Britain on the authorisation of products. Innovation and growth across the food sector is increasing demand for authorisations. We need proportionate regulation to support investment, while maintaining safety and consumer trust. This statutory instrument removes requirements that are unnecessary for food safety without compromising it.

On renewals, certain authorised products must currently be reauthorised every 10 years. This SI removes that requirement. Instead, safety reviews will be carried out when necessary. The service will be more efficient if regulators focus on detailed reviews of products that potentially pose risk, instead of reassessing products that have many years of safe use.

The FSA and the FSS have earned public trust through rigorous risk analysis. These reforms build upon regulators’ existing powers to request safety information. They enable an efficient approach, where the regulators respond effectively to emerging risks. I emphasise that, where necessary, approvals can be modified, suspended or revoked. Food safety will continue to be the priority.

Although steady progress is being made, it is fair to say that the FSA and the FSS are not processing as many applications as are coming in. This is causing an increasing backlog, which is of concern. There are 481 current applications; although 97 applications have been completed since 2021, the caseload is growing, not reducing. Of those 481, about 100 are renewals, with almost 500 additional renewals expected in the next three years. This has to be dealt with. While the FSA and the FSS have implemented measures to improve the service within current legislation, it is essential that the service and the system are modernised. Removing automatic assessment for renewal allows a more targeted approach.

I turn to the removal of SIs. The second part of these reforms allows authorisations to come into force following ministerial decisions and to be published in a public register, rather than being prescribed by an SI. This will enable new products to be brought to market more quickly, without, I emphasise, compromising safety. Publishing authorisations together in online registers, rather than in complex legislation, will make finding information on authorised products more accessible than currently. This aligns with other UK regulators’ authorisation processes, such as for veterinary medicines and pesticides.

The FSA and the FSS provide scientific scrutiny through expert staff and independent scientific advisory committees. They provide safety assessments, risk management advice and recommendations for ministerial decisions. This process aligns with internationally recognised principles. The FSA and the FSS will publish risk assessments and authorisations, in line with their commitments to transparency. The statutory obligation to consult will not change, and authorisations will continue to be subject to public scrutiny.

I assure noble Lords that there has been extensive engagement with industry and consumer groups, including through public consultation. The reforms have received substantial support. The Secondary Legislation Scrutiny Committee was reassured by the FSA’s responses to questions raised during scrutiny. I have responded to those primary areas of focus in this opening speech.

These reforms prioritise efficiency and safety, focusing resources on innovative products. I hope noble Lords will feel able to support these reforms, which will create a service which manages risk in a proportionate fashion, without compromising our high food and feed safety standards. I beg to move.

[Baroness Coffey (Con)]

My Lords, I welcome these regulations, on several grounds. First, as the Minister mentioned, this is a deregulatory approach. There cannot be many regulations deemed to be deregulatory that have 104 pages, but 70 of those pages deal with revocations of existing legislation. That is to be welcomed.

I completely support that this will be a risk-based approach. I am conscious that consultations are ongoing on products being considered by the FSA under this approach. I am conscious that some may be concerned about removing the need for separate secondary legislation, which is a hangover from our days in the European Union, but this is perfectly routine.

I have a couple of questions for the Minister. First, I am conscious that the Food Standards Agency is a non-ministerial department, with the DHSC leading on this in government and in Parliament. Can she confirm whether DHSC Ministers will be making these decisions or whether it will be open to Defra Ministers?

Secondly, an issue that arose during the passage of what is now the precision breeding Act was concern that the devolved Administrations would be reluctant to have any GMO in products sold in their countries. The purpose of the United Kingdom Internal Market Act and the non-discrimination principle was to make sure that, where something had been given the go-ahead in England, say, it could be sold anywhere across the United Kingdom, respectful of the devolved Administrations but nevertheless giving consumers that choice. Will the UK Government fully assert the non-discrimination principle in the sale of future products? As I said, I support these regulations.

[Baroness McIntosh of Pickering (Con)]

My Lords, I support the comments made by my noble friend and concur entirely. I congratulate the Minister on bringing forward this streamlining and deregulatory process. However, I share some of the concerns put forward by the Secondary Legislation Scrutiny Committee.

My noble friend talked about GMO. I am personally very wary of GMO products: I would like to know if I were eating such a product or if such feedstuff was being fed to an animal that I may go on to eat. Can the Minister assure me that the removal of the renewals process will not lead to any information affecting the suitability of validation methods for GMOs being overlooked? Put simply, can the public and consumers rest assured that the processes that have been followed hitherto will be followed? How can the public be made aware of those processes and know that that is the case?

NHS Dentistry: Recovery and Reform

Baroness Coffey Excerpts

Wednesday 7th February 2024 Commons Chamber

[Victoria Atkins]

The advice and guidance to dentists will be going out today, while the new patient premium that I have told the House about will come in from March—it is weeks away.

[Dr Thérèse Coffey (Suffolk Coastal) (Con)]

I thank my right hon. Friend the Secretary of State for an excellent statement and an excellent plan. It is exactly what patients in Suffolk have been waiting to hear—the rural payment, the bonus there and the mobile service. I am conscious that many dentists have chosen not to have more patients, and they might blame the contract—this, that or the other. That is why I welcome her plan about potentially tying in graduates to the NHS. My hon. Friend the Member for Mole Valley (Sir Paul Beresford) has already referred to the General Dental Council, which, in my view, has not taken full advantage of the regulations that came into force last March. Will the Secretary of State also look at the NHS’s own rules that further restrict the rapid supply of dentists into the NHS for our constituents?

[Victoria Atkins]

I thank my right hon. Friend for all the work she did on dentistry in the Department. I am conscious that many people have contributed to this plan; I am grateful to her and others. Again, I hear the observations on the General Dental Council, and will ensure that the GDC hears them as well. That is a fair challenge to the NHS. Colleagues will see that the plan is co-signed by NHS England, which shares our ambition to deliver those 2.5 million more appointments and set up the future of NHS dentistry for our country.

Pharmacy First

Baroness Coffey Excerpts

Wednesday 31st January 2024 Commons Chamber

[Dame Andrea Leadsom]

Oh, was it 8.31? I thank the Secretary of State. When will the services be available? I should think that many more are taking place already.

I am afraid that, while welcoming this, the hon. Lady is being a little pusillanimous with her praise. A lot of her suggestions, as she will know, are simply not true: already, well over 2,000 new GPs and tens of thousands of nurses are working in our NHS. Many thousands of additional practice staff are working in GP practices, and, as she will know, our brilliant GPs have made 50 million more appointments available each year ahead of the target in our manifesto. Good on them. They are doing an amazing job, and Pharmacy First will ease the ever-increasing burden on them.

The hon. Lady talks about technology. I am pleased to tell her that ensuring that the technology was in place was key in deciding when we could go live. There is a very short window in which some systems will have elements of manual intervention, but only for a few weeks. The whole system will be fully automated and will provide the ability to inquire into GP records and to swap advice, which is important for pharmacists to deliver the excellent service that they are already delivering.

Finally, the hon. Lady will know that community pharmacists have for some time now been delivering blood pressure checks, which in some cases are truly lifesaving. This is amazing patient access and patient convenience. The Labour party should, for once, simply praise it and be glad that the Government have stuck to our plan and got on with it.

[Dr Thérèse Coffey (Suffolk Coastal) (Con)]

I am so pleased to hear today’s announcement that we are delivering. It was one of the key things in our plan for patients that I wanted to ensure happened. In particular, many Members of this House, current and past, have had infections and, as a consequence of not dealing with them, have ended up in hospital. This is the sort of sensible approach that, frankly, met some resistance during my time in the Department, with worries about over-prescribing. It is about treating pharmacists like proper professionals and, most important, providing quicker access to necessary care, which patients will now properly enjoy.

[Dame Andrea Leadsom]

May I say a huge thank you to my right hon. Friend for her contribution to kicking this project off? I feel very fortunate to be at the Dispatch Box on the day we launch it, because many others were involved in setting it up. She rightly highlights some of the problems with spotting things such as sepsis infections, which pharmacists are trained to spot. They really can be the first line of defence. Being able to walk in off the high street to see a pharmacist is incredibly valuable to us all.

Draft Anaesthesia Associates and Physician Associates Order 2024

Baroness Coffey Excerpts

Wednesday 17th January 2024 General Committees

[Dr Thérèse Coffey (Suffolk Coastal) (Con)]

It is a pleasure to serve under your chairmanship, Dame Caroline. This may surprise Members, but I am not a member of the Committee. However, I care about this issue. I believe that the expansion in the number of associates is fully in the interests of patients. By virtue of this Order in Council—which has also been put forward by Scottish Government Ministers—there will be a necessary and rightful route by which physician associates and anaesthesia associates can be regulated by the General Medical Council, with all its professional elements. There will be a curriculum, continuous professional development, and a variety of other things that we expect of other professionals in the NHS and the wider health services.

This may all sound a bit odd. Why do we not just get more people to become doctors? The Government, however, have already addressed that, through the expansion in medical school places that is to happen. I will tell the Committee a personal story, through which I saw the issues at first hand. I will not pretend otherwise: when I was, for a brief time, Secretary of State for Health and Social Care, this event reinforced the reasons why I was keen to see this move make the progress that it is making.

About 18 months ago, Parliament was busy with a potential change in leadership, although Prime Minister Boris Johnson was still in post. I suffered an infection and went to a hospital in London, where I waited more than nine hours to see a doctor. I went home without any treatment, and then re-presented myself at a different London hospital, where I got the treatment that I needed within a much shorter time. This meant that I attended my last Cabinet meeting by phone from an NHS hospital bed.

The second hospital was quicker to deal with my situation, because it had a wider range of medical professionals, including a physician associate, who was able to do a lot of the work on the appropriate treatment, although of course that still needed sign-off by the doctor. Instead of patients waiting for hours for that one doctor, the hospital was using a full range of NHS professionals to the extent of their abilities. That is a sensible, practical way to ensure that patient care and safety is absolutely paramount.

Not all hospital trusts have associates, nor are they necessarily planning to have them, but I would strongly recommend that they do. When I think about the number of operations that could be happening, I really welcome the expansion of anaesthesia associates. The anaesthetist will be a key part of that, but imagine one anaesthetist helping with three operations at one time, along with appropriately trained and regulated anaesthesia associates. That is an approach that modernises the NHS’s capacity and capability to treat as many patients as possible.

In the past, there has been resistance to Pharmacy Direct, which is about to be launched, expanding the number of things that pharmacists can do. There has also been resistance to expanding what nurses can do without a doctor’s sign-off. There will be plenty of situations where people in community hospitals say, “Ah, yes, you’ve come in. We will try to treat that in the minor injuries unit, but we don’t have a prescribing nurse here, so you’ve got to either wait, or go to the doctor to get a prescription.” The modern NHS has to think about those situations, and be careful in how it deploys staff. This Order in Council is a key element of that. It brings associates into the same professional regulatory body and inspection regime as doctors—of course, people will know that there are other regulators for different professions.

I felt strongly about coming along to the Committee to support this order and see it progress. For me, patient safety will always be paramount, but I see this as a professional step forward, and I look forward to the change happening right across the United Kingdom.

NHS Winter Update

Baroness Coffey Excerpts

Monday 8th January 2024 Commons Chamber

[Victoria Atkins]

I thank the hon. Lady for re-emphasising the critical timing of the strike actions and the impact it has on patients. We know that winter is difficult. It is not just difficult for our healthcare system. Around the world, when cold winter strikes, it has physiological impacts on people with underlying health conditions. We also have a rise in infectious conditions, too. As she will appreciate, that is precisely why, on the advice of clinicians, we brought forward the flu and covid vaccination programme to try to protect the most vulnerable in our society. But again, the timing of the strikes is so very cynical, because their impact and tail will, I am sorry to say, have consequences beyond tomorrow’s stop date.

[Dr Thérèse Coffey (Suffolk Coastal) (Con)]

I was really concerned when my right hon. Friend mentioned the number of requests made to the BMA for certain duties in hospitals and that only two had been responded to positively. That is really concerning for patients. Contrast that with the behaviour of Nick Hulme, the acting chief executive at Norfolk and Norwich University Hospital, who has transformed its A&E in terms of waiting times. We need to promote such leaders, but we also need to unreservedly condemn the actions of the BMA junior doctors committee and get the strikes over and done with.

[Victoria Atkins]

I thank my right hon. Friend for her work in the Department. She knows only too well the difference an inspirational leader can make to a local NHS trust, and at regional or national level. Managers who are good and committed to their local area, who work with their clinicians and other healthcare staff to try to look after patients all year round, have been put under the most enormous pressure over the last few weeks because of the strikes. I thank every single one of them for doing what they can to safeguard patient safety. As I say, I trust their judgment. If they have put patient safety mitigations in, it is because they consider, in their professional judgment, that they are needed.

Health

Baroness Coffey Excerpts

Monday 9th June 2014 Commons Chamber

[Andy Burnham]

I will move on to that point. Whenever there is a problem, we are told, “Speak to NHS England.” I am afraid that is not good enough. Up and down the country we are seeing services closed without adequate consultation. NHS walk-in centres continue to be closed, piling more pressure on A and E departments. It is just not good enough. We have seen top-down changes driven through, and the hospital closure clause is on the books, so sadly this will continue. It will only change when we have a Labour Government back in control—a Government committed to putting the public and patient voice at the very heart of the NHS.

I was talking about A and E and the reorganisation. We know that Ministers were explicitly warned about an A and E recruitment crisis by the College of Emergency Medicine a couple of years ago, but they said they were too absorbed with the reorganisation to listen or act. That brings me to the nub of the matter before the House: the root cause of the deterioration in the NHS is that reorganisation, which nobody wanted and nobody voted for. It threw the service into chaos just when it needed stability. As we warned, it has damaged standards of patient care. Four years ago the Government inherited a self-confident and successful NHS, with the lowest ever waiting times and the highest ever public satisfaction. Since then it has been destabilised, demoralised and reduced to an uncertain organisation that is increasingly fearful of the future.

[Dr Thérèse Coffey (Suffolk Coastal) (Con)]

The right hon. Gentleman refers to cuts in funding. The only cuts in funding that we have seen in this country have been in the NHS in Wales. With regard to patient satisfaction, I can assure him that the targets left behind by the previous Labour Government did nothing to satisfy patients who were left on the ground by ambulance services because they had already gone past the eight or 19-minute limit. I am afraid that the focus on targets, rather than patients, is something that this Government have had to address.

[Andy Burnham]

I think that it would behove Government Members to have a bit more self-reflection and humility. The hon. Lady was not a Member of the House at the time, but she may recall that before 1997 people used to spend years on NHS waiting lists, and some never came off them. Over Labour’s 13 years in government we saw waiting lists come down, and down, and down, to the point that, when we left office, they were at their lowest ever level. I am not claiming that the NHS was perfect and did everything right, but it had the highest ever level of public satisfaction. We must have done something right. A bit of balance and accuracy in this debate is just what the NHS needs.

Ambulance Resources and Response Times

Baroness Coffey Excerpts

Wednesday 14th May 2014 Westminster Hall

[Mr Wright]

My hon. Friend makes an important point. How can an ambulance service plan for the next five years if it faces annual commissioning rounds? That does not work and does not provide long-term sustainability.

The North East Ambulance Service, which, like other ambulance services, has received a flat cash offer from the Government over the course of this Parliament, has been required to cut £4.83 million from its budget for 2012-13, which is some 5% in real terms, and another £4.35 million for 2013-14. Unison estimates that real cuts of about 20% to 25% have been made to ambulance services so far over this Parliament. Those cuts, coupled with rising demand, are having a detrimental impact on the quality of ambulance service that people receive.

[Dr Thérèse Coffey (Suffolk Coastal) (Con)]

Will the hon. Gentleman give way?

[Mr Wright]

If the hon. Lady will allow me to continue for a moment, what I am about to say is relevant to her area. Response times, especially for the most life-threatening emergency cases, are getting worse. In March 2012, 75.5% of emergency calls in England were responded to within eight minutes. In March 2014, in the latest figures available, that had gone down to 74.7%, with seven of the 11 ambulance trusts, including the North East Ambulance Service, seeing a deterioration in performance. The East of England Ambulance Service saw the proportion of emergency calls responded to within eight minutes fall from 76.2% to 62.4%. That is simply unacceptable, and the hon. Lady will want to respond to it.

[Dr Coffey]

I congratulate the hon. Gentleman on securing the debate. I agree that this is a depressingly familiar situation, but I do praise Anthony Marsh, the new chief executive of the East of England Ambulance Service. I recognise the hon. Gentleman’s points, but what is the North East Ambulance Service’s board doing? MPs in the east of England campaigned and successfully managed to get rid of the entire board.

[Mr Wright]

As a north-east collective, we work closely to ensure that our constituents get the best possible services.

Let me move on to average response times. In the north-east, the average response time increased from five minutes and 16 seconds in 2011 to five minutes and 48 seconds last year. The east of England saw a 90-second increase in response times. Only one ambulance trust actually reduced the average emergency response time. Those figures reinforce what the senior management from the North East Ambulance Service confirmed at Mr Gouldburn’s inquest, namely that ambulance services do not have the resources to meet demand, that it is a national problem and that response times are suffering as a result. There has been an admission from a senior manager in the ambulance service that resources are not keeping up with demand. Response times, in particular for more serous cases, are deteriorating and lives are being threatened, if not tragically lost. Will the Minister therefore pledge this afternoon to provide more resources to ambulance services in Hartlepool, the north-east and across England to meet rising demand?

I also want to question the assessment process used to screen calls and prioritise response times. Given Mr Gouldburn’s history of heart problems, his age and the fact that he had recently undergone surgery and had seen the doctor that same day, why on earth was he not prioritised as an emergency case and provided with an eight-minute response time? Why did it take seven calls to escalate the case to an emergency? The Minister must accept that that is simply unacceptable. Is there pressure from the Government to downgrade the priority of emergency calls due to inadequate resources?

This week, I received a letter from the Health Minister Earl Howe stating in response to Mr Gouldburn’s case that

“the 999 call was triaged correctly, although some of the questioning could have been better.”

Why was it not better? Why is the questioning not relevant and efficient in every case? The constituent whose father had kidney problems said to me:

“Phone assessments should be changed. In each assessment they asked me did dad have a rash and could he put his chin on his chest! Words like kidney failure and potassium should be taken note of. Because I’m not a rude person I didn’t react angrily, but wish I had because dad could have died. We realise that there is a shortage of ambulances and this can’t go on. We are a rich country. Shortages of ambulances are something you read about in poor countries. It shouldn’t be happening here.”

Assessment and prioritisation seem to be failing and the right questions are not being asked during initial screening. What will the Minister do to address that?

The third issue is that ambulances were delayed because of a problem in admitting patients to North Durham hospital due to a lack of available beds. That seems to show both a lack of joined-up thinking on hospital admissions and the fact that ambulance and NHS resources are hanging by a thread. Is it really acceptable, as seems to have happened in Mr Gouldburn’s case, that because of a delay at a single hospital in County Durham due to insufficient beds, the whole ambulance service for the north-east, or certainly the south of the region, grinds to a halt? The Minister surely cannot find that acceptable. Are resources being spread so thinly that services are not being provided to my constituents?

Hospital services in my area have gone through dramatic changes in the past few years, as my hon. Friend the Member for Easington (Grahame M. Morris) knows all too well. Hartlepool’s A and E closed in August 2011, much to the town’s concern, on the grounds of clinical safety and the specialisation and centralisation of appropriate medical skills. There is a mismatch between the Momentum programme of centralising services and the Government’s failure either to commit to funding a new hospital or to provide resources to reinstate services at the existing Hartlepool hospital. If there are fewer A and Es across the country and ambulances have to travel greater distances to a smaller number of centres, will that not increase the handover and turnaround times of patients between the ambulance service and hospital staff? Ambulance crews—my hon. Friend the Member for Middlesbrough South and East Cleveland (Tom Blenkinsop) has been strong on this—are queuing up outside fewer hospitals, making handover and turnaround times worse. Does that not reduce the amount of time for which ambulance staff can be in a position to respond to emergency calls?

Tobacco Products (Standardised Packaging)

Baroness Coffey Excerpts

Thursday 3rd April 2014 Commons Chamber

[Jane Ellison]

I thank my hon. Friend for his support. There is a significant chapter about illicit trade in the report and there are reflections on the Australian experience throughout it. If the Government’s final decision is to move ahead, we will look to glean everything we can from the Australian experience.

[Dr Thérèse Coffey (Suffolk Coastal) (Con)]

In November 2009, the right hon. Member for Leigh (Andy Burnham) wrote in a letter to the right hon. Member for Dulwich and West Norwood (Dame Tessa Jowell) that

“no studies have shown that introducing plain packaging of tobacco would cut the number of young people smoking or enable people who want to quit, to do so.”

I would be grateful to hear, because not all of us have had a chance to read the report, what additional studies have led Sir Cyril and my hon. Friend to reach the conclusion that she has set out today?

[Jane Ellison]

When my hon. Friend has a chance to look at the report, she will see that there have been a number of new reports in recent years. Sir Cyril commissioned an independent academic review that considered not just the Stirling review, which looked at more than 37 academic reviews on the subject, but the supplement to that, which was published in 2013. He concluded that the reviews were very robust. Much of his report is devoted to a scientific and forensic examination of the methodology used in those reviews. I commend it to her.