Smoking

Viscount Simon Excerpts

Monday 20th July 2020 Lords Chamber

[Lord Bethell [V]]

It is not my role to comment on the drafting of legislation in the manner that my noble friend describes. However, I resolutely repeat the Government’s commitment to a smoke-free 2030 and the tobacco control plan, both of which are absolutely essential to our tobacco policies.

[Viscount Simon (Lab)]

My Lords, no licences are required to sell deadly tobacco products and, while retailers can be prosecuted for underage sales or selling illicit tobacco, penalties are low. Over 70% of small tobacco retailers strongly support introducing a licence that could be removed if retailers break the law. Will the Government commit to consulting on the introduction of such a licence to help progress towards a smoke-free 2030?

[Lord Bethell [V]]

My Lords, I completely hear the views of retailers. No one wants to put a retailer in an awkward position and I completely understand why they would support the introduction of licensing. However, that is not currently our plan and we believe that we can get to a smoke-free 2030 without introducing onerous and expensive new regulations of the kind that the noble Viscount describes.

Smoke-free (Private Vehicles) Regulations 2015

Viscount Simon Excerpts

Tuesday 3rd February 2015 Grand Committee

[Viscount Simon (Lab)]

My Lords, the Minister knows—I suppose I should declare it as an interest—that in January 1995 I developed severe brittle asthma. On a motorway with my car windows closed, I probably will have an asthma attack if someone is smoking a cigar in another car. Children are particularly vulnerable to second-hand smoke as they have smaller lungs and breathe faster, and their immune system is not as developed as that of adults. This leaves them more open to ear and lung conditions triggered by passive smoking.

It has not been mentioned this afternoon and it is not generally known or acknowledged, but the concentration of tobacco smoke in a car with the windows half down is much higher than the amount of smoke that there used to be in pubs in the old days, and it increases to 11 times more in a stationary car with the windows closed. If parents knew of this, I suspect that they would stop smoking in their cars, but they do not know. We therefore have these regulations before us today. The Minister has given us an excellent description of how the regulations will work, and I support them.

[Lord Hunt of Kings Heath (Lab)]

My Lords, I, too, welcome the regulations. They follow on from my amendment at Report to the Children and Families Bill, which was agreed by 222 votes to 197, to ban smoking in cars when children are present. I am very proud of that amendment and I express my thanks to organisations such as ASH, the British Lung Foundation, the BMA and others who lent their support to it. I echo the tributes to the noble Lord, Lord Ribeiro, and to other noble Lords who have been campaigning on this matter for some years, including the noble Baroness, Lady Finlay, my noble friend Lord Faulkner, and the noble Baroness, Lady Tyler. My noble friend Lord Simon persuasively and eloquently illustrated the issues that we are dealing with. I am confident that these regulations, if they come to be successfully implemented, will do a lot on those issues.

My noble friend Lord Foulkes was very brave, a long time ago, to pioneer the proposal. What he had to say about the tactics and activities of the tobacco companies was a point very well taken. I welcome the Government’s decision to go ahead with standardised packaging regulations but we know that many of those companies will do their best, through representative bodies, to sabotage them—as I think they have attempted to do in Australia. We must be ever watchful about that.

I agree with the noble Baroness, Lady Tyler, that it is interesting how much public support there is for this measure. She may well have seen the work by the British Lung Foundation which has shown, in survey after survey, that a huge majority of children wanted action to be taken. We have also had the ASH poll conducted last March by YouGov, which showed that 77% of all adults—including 64% of smokers—agreed that action should be taken. Does the noble Earl agree that that shows that there is public support for measures such as this, particularly when it comes to the protection of children? I wonder whether he shares our ambition on this side of the Committee to reduce smoking prevalence to 10% by 2025 and, over the longer term, our goal that all children born in 2015 and beyond will become the first smoke-free generation in hundreds of years.

I noted that the regulations come into force on 1 October 2015. The noble Earl explained why 1 April is not appropriate but I wonder whether 1 July could not have been chosen instead. The noble Baroness, Lady Finlay, raised the experience in Wales. Is the noble Earl confident that the provisions for Wales will come in at the same time as those for England? Could he say a little more about the public marketing plan being developed by Public Health England? That very much relates to the questions asked by my noble friend Lord Foulkes about enforceability, which is so important. I am confident that a great majority of the members of the public will in fact respect the change in the law. The evidence is pretty strong on that. None the less, we need an effective public health campaign and the support of the police in being prepared to take action against those who transgress the law.

NHS: Accident and Emergency Services

Viscount Simon Excerpts

Thursday 15th January 2015 Lords Chamber

[Viscount Simon (Lab)]

My Lords, in opening the debate the right reverend Prelate mentioned people having to wait in ambulances outside A&E departments, in addition to which some patients have to wait at home for ambulances to arrive because ambulances are not available. I wonder how many patients’ conditions, when they arrive seriously ill at hospital, have worsened due to the delay.

Until recently St John Ambulance could provide a rapid response to patients where and when required, thus keeping conventional ambulances free for other work. It could also provide immediate life-saving intervention in more serious incidents where ambulances were delayed in reaching the patient and when it was nearer. It was able to use blue lights and sirens. It could also use motorcycle units when required, in addition to which motorcycles were used to transport emergency equipment, medicines or other parts very urgently.

However, following a judgment handed down in the Court of Appeal last March, all response services not involving a conventional ambulance have ceased. The judgment has also applied to many other operating response cars, support vehicles, emergency equipment tenders and the like. Consequently, they can no longer exceed speed limits, go through red lights or do anything else that they used to do under an exemption. A special order under Section 44 of the Road Traffic Act 1988 refers to the use of sirens and lights. It runs from 6 June 2014 until 5 June 2016 and permits vehicles constructed for medical response emergencies that are not emergency vehicles to operate within the meaning of the various vehicle lighting and construction regulations. A list has been provided of the ambulance services covered that are associated with NHS trusts.

As St John Ambulance vehicles are appropriately constructed, I wonder why they have not been included in the list. Is there any possibility of this being amended? It also has very robust driver training standards and compliance. St John Ambulance used to be very useful and very helpful to the accident and emergency services and it still could be if the exemptions that it and other like-minded organisations used to have for vehicles used “for ambulance purposes” were restored.

Children and Families Bill

Viscount Simon Excerpts

Wednesday 29th January 2014 Lords Chamber

[Baroness Howe of Idlicote (CB)]

My Lords, I very much support the aims behind Amendment 62, and indeed an awful lot of what the noble Lord, Lord Hunt, said about doing something really firm to prevent smoking in cars when children are present. This amendment certainly seems a sensible and straightforward way to ensure that all children have a healthy start in life, without the harmful influence of tobacco smoke in their young and still developing bodies.

We have heard that opponents of the proposed ban on smoking in cars have argued that legislation on activity in private vehicles would constitute an invasion of people’s private space. The noble Earl, Lord Howe, even said in Committee on this amendment that although smoke-free public spaces legislation has proven to be extremely successful in reducing people’s exposure to second-hand smoke,

“it does not automatically follow from that that it is right to extend the scope of legislation to cover private cars”.—[Official Report, 20/11/13; col. GC 412.]

However, in the case of child protection, this may not be such a stretch of the imagination. My noble friend Lady Howarth absolutely spelt out that the issue of child protection is a perfect example of this distinction playing a secondary consideration to the well-being and health of the child. Children are protected by the law from abuse and neglect wherever they are.

I have heard about the impact that tobacco smoke has on the health of children. We have all heard about it. Their bodies are still developing and they are much more likely to be affected by smoke-related illnesses than their adult counterparts. A Royal College of Physicians report estimated that smoking around children causes more than 20,000 cases of lower respiratory tract infection; 120,00 cases of middle-ear disease; at least 22,000 new cases of wheeze and asthma; 200 cases of bacterial meningitis; and 40 sudden infant deaths—one in five of all SIDs.

We know that only a proportion of people continue to smoke around children, so the level of illness in children due to second-hand smoke is staggering. It would be difficult to impose such a law on the home—we have heard this already—but we can do something about children's exposure to smoke in cars. We also know that tobacco smoke pollution levels in vehicles can be 23 times greater than in a house. I am talking, of course, about a car with a roof on it. Moreover, when a child is strapped into the car, they do not have a choice about leaving the room—a choice possible, at least for some children, in their home—when adults are smoking.

More needs to be done to protect children from avoidable harm, whether this harm takes place in private vehicles or in public spaces. Moreover, there is also a precedent for banning smoking in vehicles. Cars are already recognised as potentially dangerous spaces for second-hand smoke exposure due to their confined spaces. This is why smoking has already been banned in all vehicles used for the purpose of work in the UK since July 2007. It is surely astounding that we cannot do something effective to protect children as well. There are no restrictions on smoking in private vehicles with children present. I believe fully that this needs to change.

[Viscount Simon (Lab)]

My Lords, the greater majority of people live in smoke-free homes, not because of the law, but because it is no longer acceptable to smoke in the home of a non-smoker. Equally, most smokers no longer allow smoking in their cars when children are present.

It is absolutely correct to protect children from second-hand smoke, but it is wrong to think that it is children who are most at risk from its catastrophic consequences. While it is estimated that there are 1 million children with asthma, adults with asthma outnumber them by four to one—and I am one of them. While open windows in cars have been mentioned by a couple of noble Lords, I would have an asthma attack on the motorway with my windows closed if there was someone smoking a cigar at some time somewhere ahead. Also, the greatest risk from second-hand smoke is to those with a pre-existing heart condition.

The objective of Amendment 57BB, therefore, must not be simply to protect children but rather to further change public attitudes and behaviour so that people no longer smoke in cars carrying any passenger. Just as the law focused on workplaces had a great effect on smoking at home, it is hoped that this amendment will reduce the harm caused to non-smokers of all ages.

As it is the noble Earl’s birthday today, I hope he will accept this amendment.

[Lord Naseby (Con)]

My Lords, I want to make it clear that I have no interest to declare on this Bill. I have never smoked and I have no investments in any tobacco company. However, it remains a fact that 20% of our nation smokes. That 20% expects someone at least to speak up for the implications for it of any legislation that we in Parliament propose.

Perhaps surprisingly, the first dimension of the amendment that I draw to the House’s attention is a constitutional one. I think many noble Lords will know that in another place I was Chairman of Ways and Means, and there one had to be very careful about constitutional innovations—I shall put it like that. This amendment is a constitutional innovation. Leaving aside the detail about the standard packaging for a moment, the broad framework of the amendment defines what the regulation is to be and says that the Secretary of State, not Parliament down at the other end, may make those regulations. We need to be quite clear about this. The amendment goes on to say, in new subsection (12):

“The Secretary of State must”—

not “may”—

“obtain the consent of the Scottish Ministers … the consent of the Welsh Ministers”,

and,

“the consent of the Office of the First Minister … in Northern Ireland”.

What it does not say is that the regulation needs to receive the consent of the House of Commons in the United Kingdom. Noble Lords may be very comfortable with that in relation to standard packaging, but I wonder whether they would be equally comfortable if it directly involved other packaged goods industries. One has in mind the sugar industry, the alcohol industry and the fizzy drinks industry, and there must be myriad others that interest groups outside would lobby to have contained or indeed restricted. I just put that on the record because it is a novel dimension to our constitution that I would like to have studied in a little more detail rather than have it sneaked in, if I may put it that way, in this Bill.

Smoking

Viscount Simon Excerpts

Thursday 8th September 2011 Lords Chamber

[Earl Howe]

My Lords, we are going to publish a tobacco marketing plan later this year which will lay out precisely what we propose to do at a local level. It is our intention to support local efforts to raise awareness and use the insights that we know about from behavioural science to influence positive changes in behaviour, including around the social norms of not smoking when children are present. Voluntary local initiatives are already working. There is a very good example of that in Lincolnshire at the moment. We want to roll out more programmes like that.

[Viscount Simon]

My Lords, legislation already exists to ban smoking in commercial vehicles and in company cars because of the road safety aspects and also, presumably, because of health. Would it not be easy to ban smoking in all vehicles?

[Earl Howe]

My Lords, as I indicated earlier, we certainly have not ruled out the possibility of legislation, but we need to be sure about the evidence that legislation will have a greater beneficial effect than voluntary action on its own. It is a case of balancing the pros and cons. We have touched upon the enforcement issue and I do not think that that will go away, but on the other hand, the benefits of legislation in other jurisdictions may turn out to be compelling.

Healthcare

Viscount Simon Excerpts

Thursday 28th October 2010 Lords Chamber

[Viscount Simon]

My Lords, it is interesting that numerous professional societies which deal with chronic illness have concerns about potential inequalities of commissioning, the lack of involvement of specialists in commissioning and the potential fragmentation of services that an expansion of the internal market would generate. However, I have been made aware by the British Thoracic Society of its separate anxiety, which relates to the apparent lack of prioritisation for patients with long-term lung disease. The previous Government, at the instigation of the chief medical officer and the Department of Health, spent four years developing a national strategy for COPD and asthma that went out to public consultation earlier this year. The accompanying economic impact assessment made it absolutely clear that good-quality, integrated, community care for people with COPD would improve care and save about £1 billion over 10 years.

There is no mention of this in the White Paper, and there is general concern that it has been dropped on ideological grounds. The assessment of services on markers of quality is admirable where it exists, but it is likely to focus on what can be easily measured, such as cancer rates, heart disease, et cetera, not on what needs to be measured—such as the impact of chronic lung disease. I should declare that I have severe allergic brittle asthma and can get very ill within a few seconds, and that I was a member of the Select Committee considering the provision of allergy services.

The European Union, under the Belgian presidency, has adopted chronic respiratory disease as one of two priorities presented to the Council of Ministers in Brussels last week. It would be a shame if England were not to promote recommendations for improvement in costs and quality of care by integrated working. Numerous societies would like the national strategy to be implemented, and I hope that the noble Earl will be able to address that concern.

I am aware that there is a new allergy clinic in the Midlands, but there are still insufficient trained allergists for the demand throughout the country. Patients with allergic conditions are sometimes given inappropriate treatment by other, non-allergy-trained doctors. I hope that the noble Earl will also address that concern without delay.