Tobacco and Vapes Bill

Adam Afriyie Excerpts

2nd reading
Tuesday 16th April 2024 Commons Chamber

[Mr Virendra Sharma (Ealing, Southall) (Lab)]

I support the Bill in principle, and will vote for its Second Reading later, because it is an anti-smoking measure. Smoking is the forgotten killer of our society, and the Bill contains initiatives against child vaping that I and others have been urging for some time. Let us not be in doubt: the Bill will pass, but it will pass with Labour votes, so I will direct my remarks to its shortcomings.

The Bill is late, it is slapdash and it makes several big mistakes. It seems to have more to do with the Prime Minister’s legacy than with the need for effective interventions against smoking. Disposable vapes arrived in this country and started the youth vaping epidemic during pandemic lockdowns, the last of which finished three years ago. The Prime Minister is concerned about it only now, with his time in No. 10 drawing to a close but very little to show for it. The Government were too slow and slack to get out in front of the issue. Even after three years, they do not have precise proposals for vape regulation to put before the House. As others have said, no consultations have been conducted and nobody is sure what exactly needs to be done—although we all know that something must be done. Children vaping, fake vapes, fake cigarettes that are even more harmful than real ones—these are public health disasters, but they are already illegal, so will not be deterred any more than they are now.

What does the Bill do for the 6.4 million existing smokers? Nothing. In 2019, the Government set a target of bringing prevalence down to 5% by 2030. That was a stretch target and was to be applauded—it was ambitious, but it could have been done. Instead, the Government have dropped all mention of it, and are covering their tracks and distracting us with the generational smoking ban, which will do nothing to help those who already smoke.

What we really need is relentless, thorough and inescapable enforcement, including massive boosts to the resources of trading standards, so that local councils can blast the crime gangs out of their neighbourhoods and keep them out. The fact is that most vapes sold to our children are already illegal. It is illegal for them to be sold to under-18s, to have tanks exceeding 2 ml and 600 puffs, to not carry the right warnings, and to be sold without MHRA approval. While enforcement remains feeble, the disposable ban will make little difference.

[Adam Afriyie (Windsor) (Con)]

I am listening closely to what the hon. Gentleman says because I share his passion for driving cowboys out of this industry. Does he recognise my observation that those in the industry, and particularly small shop owners, who are quite often from ethnic minority groups, are equally keen to have greater levels of enforcement because they want to drive the cowboys out as much as we do?

[Mr Sharma]

The hon. Gentleman jumps to a point that I will cover later in my remarks.

Most of the vapes being sold to our children are already illegal. While enforcement remains feeble, the disposable ban will make little difference. The Government are offering £10 million per year for three years to trading standards. That would be good if there were only 20 trading standards departments across the UK; unfortunately, there are 197, so the offer is pure tokenism. Under the generational smoking ban, the Government want to make every shop worker a target for every shopper, just to cover their own failure, Shopkeepers in my constituency are greatly concerned about the pressure this ban will place on them as retailers and on their staff. Retail workers already suffer unacceptable behaviour from customers on a daily basis, which will only get worse. Age-restricted sales are the biggest cause of violence against staff, apart from shoplifting. This ban places often disadvantaged workers at threat of risky and dangerous working environments.

Smoking is a major driver of health inequality. Disproportionate numbers of sufferers of smoking-related diseases are from more disadvantaged backgrounds. Many are dyed-in-the-wool, hardcore smokers. They should give up—they know that—but most of them are not able to do so. None of them thinks that smoking is healthy or safe, so it is urgent that wherever possible they are helped to transition to less dangerous forms of nicotine such as vaping, nicotine pouches and heated tobacco products. No one alternative suits every hardcore smoker. It is an ideologically blinkered mistake to prevent future under-age smokers—those we can never stop—from accessing relatively safer heated tobacco products. I have stated before in this House the relative benefits of HTPs. I said earlier that this Bill does nothing for existing smokers; incredibly, this provision actually makes things worse for them. A pragmatic policy would have seized the potential of all these alternatives, not just vapes, and a smoke-free 2030 could have been a reality. Instead, the Government are playing with people’s lives and making the perfect the enemy of the good.

Finally, the Bill also overlooks the highly carcinogenic scourges of paan and betel in the south Asian community. Only a targeted, community-specific intervention would have any effect in tackling those scourges—I have been drawing attention to them for years. We have waited years for primary legislation on tobacco, but it seems that our needs have again been overlooked, and south Asians will remain at the back of the queue for years to come.

I will support the Bill on Second Reading, but there is huge room for improvement. In particular, trading standards should be given the tools it needs to break the hold that illegal products already have on the market, and while we still have smokers, heated tobacco products should be removed from the generational ban as part of a broad range of less harmful alternatives. I must say that all those ethnic minority shopkeepers are concerned but supportive of this move; they believe that the ban should be in place, but that they should be supported. They feel strongly that at present, not enough support is coming from the Bill and the Government. I hope that the Government will take on board some of what I have said, and that the Bill will emerge much amended on Third Reading.

--- Later in debate ---

[Adam Afriyie (Windsor) (Con)]

I would like to point out three things at the outset. First, I used to be a smoker. I was probably one of the earliest adopters of vaping in the UK—certainly I was among them. Secondly, I am a member of the all-party parliamentary group for responsible vaping, whose chair will doubtless speak today. Thirdly, I draw Members’ attention to my declaration in the Register of Members’ Financial Interests. I chair an advisory board to a company that may or may not be doing vapes.

Here in the UK, we have been incredibly successful in our smoking cessation policies thus far. In fact, we are the envy of the world with our rates of smoking cessation. Yes, we are behind target, and yes, according to the Khan review, we might not hit the 2030 mark, but we have been incredibly successful. I have travelled around the world talking about our success. People ask how we have done it, and I explain that the industry did it: it came up with a fantastic device called a vape. Initially it was all a bit dodgy and shaky; people were mixing liquids in Manchester in their baths and it was all very complicated. We got a grip on it, now there is regulation, and provided people are vaping legally, it is safe and usable. Millions of smokers have stopped smoking by using vaping devices. It is a huge success story.

The thing that makes me smile the most is the number of children who smoke. Back in 1982, 13% of 11 to 15-year-olds—secondary-school kids—smoked. I remember it, as I was around then—many of us remember it—and everyone used to smoke behind the bike sheds. In 2003, 9% smoked, which was good progress. By 2010, only 5% of schoolchildren smoked. Today, only 1% of schoolchildren smoke. That is a record of success. It is not a huge disaster that suddenly needs a radical change of policy to resolve the issue. In my view, it merely requires upping the ante on enforcement and messaging, rather than a draconian approach.

I welcome the Bill in two ways. First, the measures on vaping are pretty strong and pretty good. Most Members would agree that we need to look at packaging so that it is not marketed to children, and we need to look at flavours. We do not need to look at the flavours themselves; I urge the Secretary of State to look at the descriptors in the relevant part of the Bill rather than the flavours themselves as a regulatory issue. It does not matter to a smoker who wishes to quit whether the flavour is called blueberry or anything else. All that matters is that the flavour exists. It does not matter if it has a reference number and a plain package. What matters is that the flavour exists—for example, mango, which was used by my hon. Friend the Member for Dewsbury (Mark Eastwood); I tended to use blueberry—to encourage smokers to shift, but it does not necessarily need to be named on the pack, which could be marketed to children.

There is another key issue on the vaping measures in the Bill. It is unbelievable, but the entire tobacco industry is ready to open its chequebook to pay for Trading Standards and enforcement. The entire vaping industry, including vaping associations and retailers, is ready to say, “We don’t want these cowboys in the industry. We want to drive them out as much as you, because they give us a bad name and it encourages nanny-state politicians to meddle and interfere, stopping us doing our lawful trade.” A vast sum of money is available from the industry to be used by the Government, hopefully directly through Trading Standards, so that Trading Standards does not just have a few million here and there but has hundreds of millions of pounds and hundreds of new staff who can do their job and drive the cowboys out of the industry, and we can ensure that we see an end to all the practices that have been mentioned today.

Bans do not work. I am not going to make a high-principled speech about freedom, but frankly bans do not work. Bhutan and Malaysia tried it, but it did not work. Australia got close to doing it with some very complicated legislation, but it did not work. Guess what? Smoking rates went up, including smoking rates among kids. New Zealand had a really good stab at it, and then said, “Nah, it’s unconstitutional and it’s probably not going to work as well.” Bans do not work, so the idea that we, in the United Kingdom, would now be at the vanguard of that is ridiculous.

For goodness’ sake, our policy as it stands is working. We just need to do it faster, make more money available for enforcement and get on with changing the descriptors to ensure fewer people are smoking, particularly our children. Nobody wants our children to smoke. Nobody wants people to die. The false argument I have heard today that anybody who does not agree with the generational ban is somehow evil and wants people to die really upsets me. We should not resort to that sort of language.

The main reason why I cannot support the Bill is the generational smoking ban. I would perfectly happily support the rest of the Bill, but I really cannot support that ban. If the Government had been bold enough to say, “Right, we are going to ban smoking below the age of 21”, I would have had huge reluctance but I would have said, “Yeah, fair enough.” Why? Because we would have been treating people the same. The Bill is making a huge constitutional change by saying that two adults will not be treated the same. It is inequality under the law. Even in Malaysia, their Attorney General said, “We can’t do that”, and they are not nearly as civilised as we are here. Several other countries have come to the same conclusion.

I do not know how we have got into this state. It is so unnecessary. There are so many more important things to be doing in the world at the moment, yet now we are in this place. If this Bill somehow gets through with Labour’s support—of course, Labour always love bans; I get that and that is fine. Forgive me for being political, but it is ridiculous to have our Prime Minister, who has enough things to deal with, putting through a Bill, with Labour’s support. Why on earth do that at this stage?

[Andrew Rosindell]

I agree wholeheartedly with my hon. Friend. Surely this should be something that should evolve? As he has highlighted, the statistics show that very few young people now smoke, so we should let things gradually evolve rather than impose them. After the New Zealand example, is it not clear that a ban simply will not work?

[Adam Afriyie]

I could not agree more.

To conclude, I cannot vote for a Bill that treats adults unequally in law. The Bill creates a precedent in the United Kingdom of treating people differently—adult human beings; citizens—and of inequality under the law. I cannot support that. We are making a huge political mistake. I hope that even at this late stage we can make some amendments or change the way the legislation works. We could at least say that there is a condition—that we will bring the Bill into law, but that it can be enacted by a future Government only if smoking rates are not, for argument’s sake, below 3% by 2035. In that way we have the political win—we have got the Bill though and it is legislation—but the measures are not actually enacted.

[Several hon. Members rose—]

Smoke-free England

Adam Afriyie Excerpts

Tuesday 29th March 2022 Westminster Hall

[Adam Afriyie (Windsor) (Con)]

It is a pleasure to serve under your chairmanship for the first time, Ms Rees. I am not sure I can be as passionate as my hon. Friend the Member for Broxbourne (Sir Charles Walker), but I am convinced that we in the UK are standing on the brink of a huge opportunity to get this right in the very near future. Some 3 million people vape today, which is wonderful compared with 3 million people smoking, and approximately 6 million, maybe 7 million, continue to smoke. As my hon. Friend has pointed out, that leads to 75,000 deaths a year, or 200 people every single day. The number of people who have died from vaping is zero. So when we look at the plain stats on this, we can ask, “Do we want 200 people per day to continue to die through smoking rates continuing as they are, or do we want to have zero people dying per day?” My answer to that is pretty clear.

There is some good news, which I will come to in a moment. I have great respect for the Minister; I know she has heard these arguments many times before, and she always takes them with such grace, but I will go through a couple of negatives before I come to the positives—I am equal to my hon. Friend in my optimism for the future.

I chair the Parliamentary Office of Science and Technology, a fantastic, impartial organisation that produces science briefings for parliamentarians and their research staff. We produced a POSTnote on electronic cigarettes,. In 2013, only one in 20 people thought that vaping was as harmful as smoking. That was really encouraging, but in 2016 we observed that about one in four people thought vaping was as harmful as, if not more harmful than, smoking. We have been going backward, and today about 53% of people think that vaping is as harmful as smoking. Something is very wrong when the information flow has reversed in such a short space of time for something that was only introduced to the UK about 15 years ago, so we really need to get a handle on that problem.

There is a simple test when it comes to smoking. Lots of people say, “Oh, I like smoking. I wish we had the freedom to smoke,” and I agree entirely: you can kill yourself with your own poison, and that is fine by me. However, when a smoker is asked, “Would you like your children to smoke?” the answer is always, “Oh gosh, no. I would want them to have them the freedom to do it, but I would really rather they didn’t.” I have tried this, and it says an awful lot. It says that smokers—I was one—do not want to smoke; they stumbled into it in their youth or at a time when they thought they would be able to escape from its clutches. The truth of the matter is that nobody really wants to smoke.

With vaping, snus, and non-combustible tobacco, which may be more harmful than vaping, but is nowhere near as harmful as smoking, we have a huge opportunity to embrace newer technologies and approaches, and I know the Minister is keen to do so however she can. I agree with my hon. Friend the Member for Broxbourne that harm reduction is the key here. Why have 200 people dying per day when we could have zero dying per day? Why hold on to the idea that anything we can do to move people from smoking to vaping, snus or one of those other products should be slowed down in any way?

On balance, I am quite optimistic for the future. I am optimistic because the Minister is in her post, but also because the Javed Khan review appears to be going in the right direction. It appears to recognise that we cannot let the perfect be the enemy of the very near perfect, which vaping appears to be at this stage. Also, whether we voted remain or leave, we are now outside the strictures of the European Union and its directives. We have full autonomy and full power to head in any direction we choose, and I ask for that direction to be informed by the evidence, the data, the science, Javed Khan’s review, and what is self-evident before our very eyes—that people do not die from vaping, full stop.

I am also optimistic because we have a couple of other opportunities. We have the opportunity as a Government—the UK Government—to direct a little bit of funding at research, because there are some unanswered questions about the long-term effects of vaping and these other products. We could direct or nudge a little bit of research funding in that direction. It would not cost a fortune. A small amount could be dedicated to a longitudinal study of the outcomes. I think that such a study would put the final few sceptical academics’ minds at rest—or not, as the case may be—when we got the results.

This morning I was at a meeting on this subject with Demos, which is producing a study of this issue and some recommendations for policy. One message that came through loud and clear from the healthcare professionals was, “Give us the opportunity to try this, at least in a limited way, maybe in a limited area or perhaps just with pregnant women, because it is very clear that vaping is far better than smoking during pregnancy. Give us an opportunity, maybe in a restricted location, a particular area or with a particular demographic, to try the approach of switching people to vaping, and let’s see if that works better than trying to get them to stop smoking during pregnancy or in any other circumstances that they are in.”

There is another wonderful opportunity here. This is bizarre—absolutely bizarre—but I love to say that, bizarrely, the tobacco industry in the west is behind switching to vaping. I say to the Minister that actually the industry is ready to put its hands in its pocket and pay for a lot of this work, which is absolutely extraordinary. I think the industry recognises that its business model will not continue to succeed in the west, including in the UK, and we should be mindful that it is prepared to put its hands in its pocket to help the transition—not for altruistic reasons, of course; it will be because the industry is switching its business model more towards non-combustible and vaping products. It may also be because some of the cigarette manufacturers would like to look in the longer term at these inhaling systems as a way to deliver medicine—not smoking or vaping, but delivering all sorts of other products. The tobacco industry has a profit motive, but this is the first time that I have known it to be potentially aligned with UK policy and we should certainly take advantage of that.

I could go on for ever, but I will not do so. What I would say in summary is this: do not let the perfect be the enemy of the good. It is a really good thing to do to push in this direction. There is very little pushback from anywhere. I plead with the Government to consider the information flow as part of the judgments that they will make in the near term, because if more people today than in 2016 think that vaping is more harmful than smoking, then clearly something is very seriously wrong with the information processes.

I have a last question, which basically is: how do we get to smokers? We might think, “Oh, we don’t want to advertise these things online and on television.” Well of course not; we have to keep children and advertising to children out of the mix when it comes to these products. There is a really simple way to get to smokers though: every single smoker has to open their box of cigarettes, so have something inside the box. It is really simple and it only targets those people who continue to smoke, so let us get on with it.

Minister, thank you very much for listening. Sir Charles, thanks for calling this debate, and thank you, Ms Rees, for calling me to speak.

Medical Cannabis under Prescription: Children with Epilepsy

Adam Afriyie Excerpts

Wednesday 3rd November 2021 Westminster Hall

[Christine Jardine (Edinburgh West) (LD)]

It is a pleasure to serve under your chairmanship, Ms Bardell. The debate is a bit like groundhog day for many of us—Members will forgive the expression. We have made the arguments about the children in our constituencies, and about the pain that their families are going through, knowing that there is a drug that not only can but does help them. In my constituency, Murray Gray has been transformed from a wee boy who was constantly ill, in and out of hospital and missing school, and whose parents feared for his life almost daily, to a happy wee boy who pays football with his dad, and has been to my office and explained to me exactly what dinosaurs are—not that I am one of them.

Seeing that transformation makes me only more determined to give what support I can. For me, and I am sure for many others, the question remains: why did the Government make medicinal cannabis legal if they did not intend it to be for the benefit of these children? I am sure that they did. When the then Home Secretary made that move, I am sure that the motivation was to improve the lives of these children, so why are the Government not taking the last step to encourage the medical profession to make that happen?

[Adam Afriyie (Windsor) (Con)]

I met the father of Jorja Emerson the other day. He was literally in tears because his lovely daughter has multiple fits daily. The frustration is that the last remaining consultant who could make the prescriptions has retired. There is a real danger that some of these children will no longer have access to a drug that the Government intend them to have access to. I hope that the Minister has heard my intervention.

[Christine Jardine]

The hon. Member makes a pertinent point. This is the nub of the issue: we need consultants to be encouraged and enabled to write national health service prescriptions for these children. We have pestered the Government and will go on pestering the Government. There will be no resting place for them on this issue until we have the assurance that these children will get the help that I am sure that the Government originally intended them to have, and that is still just outwith their reach.

Medicinal Cannabis

Adam Afriyie Excerpts

Monday 6th September 2021 Commons Chamber

[Christine Jardine]

I thank the hon. Member for making an excellent point. The APPG has done astonishing work over the past few years in support of this, but yes, the Government could do so much more for those families who know what it is like to get to the end of every month, and of every prescription, and face the huge bills of which he spoke—up to £2,000 a month. The strain and financial burden of that is all on the families. Surely that is not how any of us in this place anticipated it would be or wanted it to be.

When the then Home Secretary agreed that medicinal cannabis would be legal for use in the United Kingdom, I think we all believed that parents would no longer be forced to watch their children suffer, knowing that a treatment was available. What has happened since is heartbreaking. In the intervening years, they have been forced to source medication themselves, sometimes travel abroad—again at huge cost—to collect it, challenge the medical authorities and face rejection and repeated appeals for NHS prescriptions.

Surely no one in this place wants even to contemplate what it would mean to have a loved one—husband, wife, partner, brother, sister, friend or child—who had to pay for the medication they needed simply to go on with day-to-day life. Think of the diabetic without insulin or the asthmatic without an inhaler; this is no different, but it is new. With so much red tape and inflexible guidelines, too many people face being left alone, helpless and simply unable to afford life-changing treatment. In fact, since November 2018, just three NHS prescriptions have been issued for the type of medicinal cannabis that is life-transforming for these children.

Clearly, guidelines are not empowering medical professionals to do the job they want to do and provide the best possible care for their patients, knowing that they have the establishment’s support. Critics often point to the National Institute for Health and Care Excellence and say it has restricted medicinal cannabis, but only a few months ago it said that there was no ban and that prescriptions should be done on a case-by-case basis. Still parents are told that the medical profession does not have the confidence to prescribe the medication because of a lack of evidence and that clinical randomised control trials are needed. However, that will not work, because this medication does not come in a standard dosage and the balance of ingredients needs to be changed to suit individual patients. Even if medical trials did work, they would be of no use to those children who are already benefiting from medicinal cannabis. Trials would be both unethical and unsafe, because those children would have to stop taking the medicine that is working for them, perhaps for a placebo, and risk a return of life-threatening seizures.

[Adam Afriyie (Windsor) (Con)]

I thank the hon. Lady for making such a powerful presentation with great passion. Does she share my frustration—I am sure she does—that the debate around medicinal cannabis is often confused with people who just want to smoke dope and drop out? It frustrates me enormously, because people such as Murray, Karen and Jorja are all suffering from life-threatening, debilitating illnesses and we are talking about precise, prescribed medical treatments. Unless we can quickly sort out the authorisation of medical practitioners to continue to prescribe to these existing children and patients, we will be in a very dark place.

[Christine Jardine]

I could not agree more. We must address that quickly. As the hon. Gentleman said, it should not be mixed up with the scenarios he described; it is often children—adults as well—on a carefully prescribed medication that the Government have supported.

There is also the argument of there being no evidence because of the lack of clinical trials. Well, there is an abundance of observed evidence that medicinal cannabis works, so the clinical trials explanation falls short. There are also those who point to the medicine Epidiolex being available on prescription for two rare forms of childhood epilepsy, but I understand that that is less effective for many sufferers. Scientists say that the medicinal cannabis that these children need is effective for 95% of children.

--- Later in debate ---

[Sir Mike Penning (Hemel Hempstead) (Con)]

As I said earlier, is it not great that we have a couple of hours to debate this subject, which is so important to the family and loved ones of the children who have suffered so much, and we can do something about that? But is it not a crying shame that we have had this debate not just in this Chamber time and again, but in Westminster Hall as well? It was there that I responded to the debate as the police and counter-narcotics Minister, when I actually said on behalf of Her Majesty’s Government that the Government were willing to look at the prescribed medical use of cannabis for certain treatments, particularly for seizures in children with the very rare form of epilepsy that some have.

There are myriad other illnesses, which we might get to, that cannabis could help, but this is about the closed mind of some members of the medical profession—these so-called experts who took an oath to protect lives and to protect the human beings they are responsible for—who are blocking other medics. As we just heard, fewer and fewer medics are able to prescribe, frankly because in many cases they have been scared off and threatened, or are now coming close to retirement. So what will these parents do? I ask hon. Members in the House this evening what they would do if they were a parent of one of these children. God forbid.

I remember so well Hannah Deacon bringing Alfie Dingley in to see me. Alfie was having in excess of 100 seizures a week. I think the figure was actually greater than that, but that is the figure that sticks in my head. Every time he had a seizure, Hannah and her husband did not know whether he was going to come through it, because all the other medication they were giving him was not working. We have heard this story from constituents around the country, but if I may, I will just concentrate on Alfie for a second. He was given products off-label that were never designed for children to try to help him. Doctors were willing to do that with products that were never ever medicated, designed or regulated for children, but because they were off-label, GPs could write a prescription and they did that on the NHS—trying to keep him alive in that way, while in others blocking the help he could have had.

I praise the End Our Pain campaign of Peter Carroll and his team. They have worked tirelessly over the years, and I will give him a name-check because it is very important that people understand that he has never taken a penny for running such campaigns. There is all the media coverage we have had from lots of famous people, but at the end of the day it is his team who have pushed this. There is the bravery of the parents of these children—some out of desperation. But now, as hon. Members will hear in my speech, they want to make sure it does not happen to other families and other children who are desperate to make this change happen.

I made that speech in Westminster Hall with the full permission of the Home Secretary at the time, who then became the Prime Minister—my right hon. Friend the Member for Maidenhead (Mrs May)—and we started that process. The process then progressed because it was nothing to do with the Department of Health at that stage; this was a Home Office matter. I remember going to No. 10 with Alfie, and he was his usual naughty self, which was fabulous because that is how we want our young children to be to experience life. We were due to meet at No. 10 the police Minister at the time and some of the experts, and my right hon. Friend the Prime Minister came into the room, sat with Alfie and his mum and dad, and talked to them. She said, “We will do something about this: we will change the regulations and the law,” and to her credit, that is exactly what she did. With the help of the Home Secretary, who is now the Health Secretary, we changed the law.

The bit I am so upset about is that if we had not changed the law fully to move this into the Department of Health, other children would be getting the prescription that Alfie and some of the others are getting. They were not given that prescription free on the NHS by the Department of Health; they were actually given it by a committee in the Home Office. We had not moved it across through the legislation, so it was done by that committee, based on evidence that it was going to save the life of this little boy and the lives of subsequent other little boys and girls.

Then we got this impasse. The children got the prescription for free—there are not thousands of children out there; this is a really very rare condition—but when this moved across to the Department of Health, it stopped. They carried on getting their free prescriptions, but even though prescriptions were being written, they could only be written as private prescriptions, and we have heard about the cost of medication for families trying desperately, from all means, to raise the money to get this prescribed medical use of cannabis. There are different types and we could go into the different mechanisms and what is in them, but at the end of the day that is a medical or doctors’ decision, not a politicians’ decision.

Believe it or not, I had to phone the Home Secretary several times and say that there was a family at Stansted airport, at passport and customs control, who were having the medication taken away from them even though it was perfectly legal in this country to have that product. Parents had raised the money and they went to Holland—most of them went to Holland—and saw the specialist, went to the pharmacist and brought it back, and then had it taken away from them. Believe it or not, when we eventually got the authorities to agree to let them have it, they tried to charge the parents for the transport cost of moving the product back to the family. That is ignorance, a lack of knowledge, but we are beyond all that now.

We are now in this situation for the families. I spoke fairly recently to Hannah Deacon, the mother of Alfie. Alfie is what we would expect a boy of that age to be—he can ride a bike and he can have a relationship with his sister that he has never had before, and vice versa. At times he is a naughty boy; hey, that happens. Is that not what we want for our children? Yet families are still in this limbo situation of having to raise money—beg, borrow, I am not going to use the word “steal”, but all of us in the House this evening know where I am coming from; they have to desperately try to raise money. The Government could use their power to buy this product so the families would not have to pay £2,000 for it; if the Government bought the product it would be vastly cheaper as it would not cost the NHS £2,000 per prescription.

[Adam Afriyie]

My right hon. Friend is making a powerful and passionate speech, and I thank him for his work in the Home Office and in pushing this through. Does he share my frustration that in many other countries around the world, including Germany, manufacturing is coming up to speed and producing well-defined products that could be exceptionally helpful, but because of the impasse we have here among the medical profession it will prove almost impossible to introduce those products here even though, based on the evidence we have, they are perfectly safe?

[Sir Mike Penning]

We are not reinventing the wheel, as my hon. Friend says: we started this but are now lagging behind the rest of the world. The product is slightly different—the oil has different forms of THCs in it. The Minister used to be my Parliamentary Private Secretary all those years ago—how the mighty fall, and how the mighty have risen up the greasy ladder—and she is passionate about trying to help on this, but it is not about Epidiolex; it is about the particular product being prescribed actually working, and it is normally to do with the levels of THCs.

I think this problem might be to do with the terrible word “cannabis” that we use in this country. This is not anything to do with cannabis, really; I wish we could invent another name for it and just say “oil with TCHs in it”, because that would eradicate much of the fear that there is at present—and it is not just fear, it is dangerous to the argument.

--- Later in debate ---

[Crispin Blunt]

The hon. Gentleman has landed on the core of the problem: the reputational issues that we are dealing with.

We owe it to our constituents to do just a little better. We owe it to them to try to understand the evidence and create institutions that will advise our Government based on the evidence. We have a duty not to be stampeded by the popular press in a particular direction about the particular meanings of words, but we have done so for 50 years in regard to cannabis: it was shoved in schedule 1 to the regulations made under the 1971 Act, which governed the most dangerous narcotics, and we kissed goodbye to 50 years of understanding within the medical research sector of what might be possible.

We were then left with the situation that we faced in 2017: after my two and a half years’ experience as prisons Minister, the evidence was plain throughout the entire justice system, as it is today, that our wider drugs policy is an unqualified disaster. We have watched the frog in the pot as the temperature has risen and risen over five decades; it is now boiling over and shreds are coming off. We have the worst drugs death rate in Europe and our drugs policy has dominance over the criminal justice system, driving half of acquisitive crime in the UK. Those issues elide into the narrow issue of medicine from cannabis, but we owe it to our constituents to understand the context.

I say this to the Minister particularly: if we can get the change of approach right, there is a huge opportunity. It is not just about the magnificent campaign by End Our Pain and my right hon. Friend the Member for Hemel Hempstead for the 17 identified epileptic children and their families, although of course there are duties that we all owe to them, and they raise the question of what we would do in their position. I was in the Chamber when my right hon. Friend said that he and Frank Field would be at customs to deliver the bottles of medicine—and an absolutely splendid occasion it was, too.

It is not just about epileptic children; it is also about people with multiple sclerosis. An estimated 50,000 people in this country are growing their own medicine, at peril of a 14-year prison sentence, all to try to make themselves better. From those 50,000, there is a huge amount of research evidence, all of which is lost to the legal system: people are growing particular plants and adjusting the exact balance of the cannabis product that they produce to best use for their condition.

[Adam Afriyie]

My hon. Friend is making a powerful speech. I have chaired the Parliamentary Office of Science and Technology, and it seems to me that medicines generally arise because of people’s behaviour beforehand. People were chewing bark because they felt that it relieved pain, and now we have aspirin. I think that much of the development of medicines—very precise and targeted medicines—comes from the experience of people and what they do themselves. As my hon. Friend says, there is a body of evidence, and it is a matter of collating that evidence, but it is also a matter of the people who adopt these methods at an early stage taking on a risk for themselves, and we should use the information and evidence that we gain from that to build on the scientific knowledge that we have.

[Crispin Blunt]

I was delighted to take that intervention from my hon. Friend. He is absolutely right: this is about science and technology. It is about finding a route to a Government who can deliver policy based on evidence. We have heard very clearly why randomised controlled trials and placebos are not going to work in this case and are a completely inappropriate way of providing proof, and that there is a vast amount of observed evidence out there. What we need to do is understand the context. The case is unanswerable for these epileptic children—of course it is, and of course their treatment should be should be paid for privately if it cannot be provided by the NHS because all these barriers have appeared—but behind them sit a vast number of other people who are not being served by our system of developing drugs that will work for their conditions.

--- Later in debate ---

[Crispin Blunt]

The hon. Lady has behaved as the best of constituency MPs would. Indeed, I am sure that all of us, faced with the opportunity to help people in that way, would want to do so.

I say to my hon. Friend the Minister that, despite the legalisation in November 2018, the system remains broken. It remains broken in respect not only of cannabis but of the psychedelics. A wave of interest came into medicine as a result of cannabis; it came from North America where a significant amount of investor money was going into the new industry because people could see the opportunities that were available there. However, we could not do the research here because it was a schedule 1 drug, and hardly any universities had a schedule 1 licence to do that research. The level of oversight was far greater than that for heroin, as the hon. Member for South Antrim (Paul Girvan) said, so it is no wonder that there has been almost no research on all this down the decades.

As far as I can see from the 1960s, the psychedelics got shoved into that group as well because pop stars used them. Then, in 2008, we managed to dismiss the chairman of the Advisory Committee on the Misuse of Drugs because he had the presumption to say that riding a horse was a damn sight more dangerous than MDMA. That is what we do to the scientists who produce the evidence: we refuse to listen to the evidence because it will be politically inconvenient and subject to misrepresentation in the media. We owe our constituents way more than that, and it would be remiss of us if we do not examine this whole area on the evidence. I implore my hon. Friend the Minister to listen to it.

I have spoken about MS, and the hon. Member for South Antrim and others have referred to pain relief. As an alternative to opiate-based medicines, given all the difficulties of the opiate crisis in the United States, cannabis-based medicines offer a serious group of advantages if they can be deployed properly. Meanwhile the psychedelics still sit in schedule 1, making research incredibly difficult and expensive.

Let us consider depression, addiction and trauma. Of the veterans who have come back from their service in Afghanistan and Iraq in recent years, 7,500 have post-traumatic stress disorder, about a third of whom are beyond treatment within the current treatments available. However, the evidence is that the prescribed and overseen use of psychedelics can get to the relevant part of the brain and enable the psychotherapy to take hold and teach people to acquire the tools with which to manage and deal with their trauma. That can also work for depression and addiction. We are potentially talking about millions of people, if we enable the research to happen. Are we a country that will be on the frontline of bioscience? Are we serious? There is an opportunity for our pharmaceutical industry to get this to scale, and millions of people can be helped.

A huge cost is currently imposed on our economy by these medical conditions, so surely it makes sense to enable my hon. Friend the Under-Secretary of State for Health and Social Care, as Minister for medicines, to draw on evidence-based advice. Sitting alongside the MHRA ought to be some kind of cannabis authority, as has been done in Denmark, Holland and Germany, for Ministers to get the advice they need to be able to advance policy confidently, and it needs to be within a wider office for drug control that engages all the relevant Departments. A Department of Health and Social Care lead would be good, but a Cabinet Office lead that brings together everyone who has an interest in this area would be a fine thing, too.

[Adam Afriyie]

I thank my hon. Friend for giving way, although I do not entirely agree with all his views on the legalisation of drugs. I was shadow Minister for Science back in the day when Professor Nutt was forced to resign for making comments that were factually accurate, and the House is now very different. I feel quite optimistic today, like the hon. Member for Edinburgh West (Christine Jardine), because I sense the mood of the Chamber and the Secretary of State for Health and Social Care. If there were some mechanism to bring in the clearly available research on people who have already been using these refined substances, I think the Government and this House are in the mood to take those views on board.

[Crispin Blunt]

I largely agree with my hon. Friend, apart from on the views he imputed to me. He decided what my views are on the legalisation of drugs, but I simply want policy based on evidence.

All I will say is that the current situation is a catastrophe, not just here but around the world. It is the basic reason why we were run out of Helmand province. The farmers around Didcot were growing poppies for the legal medical morphine market, but we did not allow the farmers in Helmand to grow poppies, so they were driven into the heroin market. We then decided to go and burn their crops, reducing them to penury. And we wonder why they changed sides and were against us. We were run out of Helmand, even with 20,000 American troops coming to the aid of our soldiers.

This issue permeates the world. It is a global issue. We simply need to proceed on the basis of the evidence, so we need to create the institutions that can give us that evidence. There should be an office for drug control, promoting all the science and bioscience of which this country should be capable, within which ought to be a cannabis authority of some kind that could give the Minister and her colleagues the advice they need. The opportunity for the Department of Health and Social Care is huge, and the opportunity for the Department for Business, Energy and Industrial Strategy in sponsoring our science is enormous. The opportunity for the Treasury is not exactly minuscule either, and there is an opportunity for the Home Office to have a policy that contributes to the whole of the public interest, not just a very narrow part of it that has done so much damage. The policy of preventing things from happening has been in the lead in the drugs policy area, so this proposal is long overdue.

I beg the Minister to have this discussion with me and the think-tank I have established. I have no financial interest to declare, as I take nothing from the Conservative Drug Policy Reform Group. I set it up to give me research and scientific evidence on which to help advance these arguments. I am passionate about this issue, and it is one of the issues on which I wish to use my remaining time in public life. Having seen what I have seen as Prisons Minister and in my own experience, I know the opportunities are as great as the opportunity to end the terrible mess of our wider drugs policy. If we can grasp the science opportunity, the medical opportunity follows. There would be a huge advantage for patients in the United Kingdom.

--- Later in debate ---

[Jo Churchill]

That is true. However, people have to come forward with clinical trials designed in a way that is acceptable and gives us robust outcomes. We have discussed this and Psilocybin, and many other things, at some length in the past, and although tonight is not the time to carry that on I am sure we will do so again.

We take into account literature and evidence from other countries, and the guidelines published by the National Institute for Health and Care Excellence were developed in accordance with well-established processes based on internationally recognised and accepted standards. This ensures a systematic, transparent approach in identifying the best available international evidence within the scope of guidance at the time of the NICE evidence review. However, NICE found that current research is limited and of low quality, and that makes it difficult to assess just how effective these medicines are, and we need to make sure they are safe.

[Adam Afriyie]

I empathise with the Minister; this is tricky, because one does have to introduce medicines in a safe way according to a set formula and we have quite a good system.

I have two points. First, we were talking about prescribing to children untested or unvalidated medicines, yet in some treatments we are prescribing adult steroids to children. Will the Minister say something about that, as it seems slightly inconsistent? Secondly, there are patients, in particular children, who shortly will have no prescription whatsoever when the last specialist who can make these prescriptions retires. How are we going to cover that?

[Jo Churchill]

I am obviously very cognisant of the latter point, and my right hon. Friend the Member for Hemel Hempstead mentioned a court case. This adds to the need to find solutions to the problem. On adult steroids, that is a clinical decision by a doctor, and my hon. Friend would not expect me to comment on that, because we are dealing here with incredibly poorly children, and our heart goes out to them.

Tobacco Control Plan

Adam Afriyie Excerpts

Thursday 10th June 2021 Westminster Hall

[Adam Afriyie (Windsor) (Con)]

It is a pleasure to serve under your strong and stable chairmanship, Mrs Miller. It is a great privilege to speak in the debate, and I thank the hon. Member for City of Durham (Mary Kelly Foy) for introducing it.

We are debating a vital issue, and the UK can be No. 1 in the world for its approach on reducing smoking and the harm it causes. I commend my hon. Friend the Member for Harrow East (Bob Blackman) for his input into the report and his earlier contribution, and my right hon. Friend the Member for Clwyd West (Mr Jones) for his apposite remarks, which I am sure the Minister took on board. I also commend the Minister herself, and the Government, for their approach. I would say that she is mistress of the brief, as we have had many conversations and interactions through correspondence, and there is no doubt that she gets all the issues to do with smoking cessation devices and the tobacco control plan.

The industry in the UK seems to be aligned with the Government’s objectives on reducing smoking, as Philip Morris, British American Tobacco and many of the other firms recognise that this is the end of the game—it is the end of smoking in the United Kingdom, even if that might not be the case in certain far eastern countries, in Africa or elsewhere. The companies accept their responsibilities, and it would be of no surprise to them—they would not be disappointed about this—that they needed to make contributions to a fund to help to secure the goal of a smoke-free Britain, which should certainly be firmly on the table.

I speak as chair of the Parliamentary Office of Science and Technology and a member of the all-party group on e-cigarettes, and it seems to me that we are in an era in which we must be driven by data and evidence. There can be no doubt that the data is completely one way on vaping devices, electronic nicotine delivery systems and all sorts of other technologies to help smoking cessation. Vaping, using an electronic device or even using snus is so much safer than smoking. Smoke is the killer; tobacco is the killer. I urge the Minister not to do what the European Union has done, or what the World Health Organisation seems to be doing, by mangling the two issues. Tobacco is one thing; smoking cessation devices, which in most cases contain nicotine, are a completely different thing, with a completely different scale of harm and risk.

I recognise that other hon. Members will talk about various recommendations from the all-party group on smoking and health, so let me briefly focus on three. Recommendation 5 says that smokers should be advised annually of their options for quitting. Reminding people that they can choose an alternative to smoking is an important step forward. If we ask any smoker—I was a smoker for a few years, some time ago—“Would you like your children to smoke?” they all say no. It is clear that no one really wants to smoke, no matter what their brain says about dopamine levels. In that scenario, I think it a good idea to remind people annually that there are alternatives. Nicotine patches are not the only alternatives. Those have some efficacy, but, to be frank, very little for the money that is paid for them. People should certainly consider vaping devices.

The second recommendation I draw to hon. Members’ attention to is No. 6, which is support for those with mental health challenges. It also says

“for those living in social housing”,

but I will broaden that slightly to those on lower incomes and in lower-paid jobs, among whom there is a far higher incidence of smoking than in the general population. There is work to be done to focus the efforts in those areas.

Recommendation 11 is also important, because there is still an ambiguity about whether vaping is a smoking cessation device or just another way of inhaling nicotine. It is clear from the evidence that it is a smoking cessation device that works, and it is twice as effective—if not more—at helping smokers to cease smoking as the other available treatments. Let us dig into the pockets of the tobacco companies—they are actually happy for their pockets to be dug into—and use that money to publish the relative health benefits of vaping, e-cigarettes and other alternatives to smoking.

Windsor is a lovely seat, and thankfully we have slightly lower smoking rates than the rest of the country, but we still have perhaps 200 or 300 people a year dying of smoking-related diseases, as well as all sorts of other challenges.

In conclusion, we are first in the world for genomics, for the vaccine roll-out, and for FinTech and financial services. Let us make this another one: let us be the first in the world to implement a tobacco control plan that completely takes on board the wonderful innovation of vaping devices, e-cigarettes and all the other technology, and let us not mangle it together in a tobacco directive.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)]

It is a pleasure to serve under your chairmanship, Mrs Miller. I congratulate the hon. Member for City of Durham (Mary Kelly Foy) and my hon. Friend the Member for Harrow East (Bob Blackman) on securing this important debate. I also thank everybody for the constructive tone in which we have discussed what is an incredibly important subject and for the acknowledgement that if we are to meet what is a very stretching target, we will all need to work together.

The hon. Member for City of Durham has highlighted the excellent work being done through the smoke-free programme in County Durham to drive rates in her area down, and I know that she fully supports that. As she alluded to, the aim is to reach 5% by 2025 through the regional tobacco control plan that Fresh drives forward, but since the launch of that in 2005, the north-east has seen a massive—47%—drop in smoking rates. I know that those rates are still above the national average, but I wanted to highlight how much I agree with that localised approach to delivery, making sure that we can focus services on those living in the local area.

I congratulate people on their successes so far, but as several right hon. and hon. Members have said, we cannot be complacent. Smoking rates at the time of delivery are among the lowest the country has ever seen, and my hon. Friend the Member for Harrow East has a relatively low rate in his area. I appreciate the passion shown through the cross-party work that has taken place to bring together these recommendations, because, as many have highlighted, one of the big challenges is the variation—across different groups in our society, but also across different regions of the country. If we are going to target those with higher incidence, we are going to have to accept that some areas will probably need more help than others.

We need to work together, and yesterday I was incredibly pleased to go to the launch of this report. I found the speech by the hon. Member for Blaydon (Liz Twist) incredibly poignant. I could not agree more: specialist cessation to help young mothers quit is so important, and the hon. Member for Jarrow (Kate Osborne) has said that it was that point in her life that was pivotal in helping her make that decision. Yesterday, we listened to a respiratory consultant who said that she ran out of her office and downstairs to speak to a young mother who was pregnant with twins, to try to get her to stop smoking. I do hope that mother was able to quit, and I assure hon. Members that this is a particular focus of mine. I have already spoken to the chief medical officer about the new Office for Health Promotion making smoking, and particularly smoking in pregnancy, a real focus. As I said yesterday, we get more bang for our buck here: not only do we help Mum but, in this case, we helped twins—that is three people—and as I have seen through some fantastic smoking cessation work in Bolton, we often get a partner, a mother, or someone who is supporting Mum to quit as well. That helps everybody to move forward.

The report and its recommendations are excellent, and I have listened with interest to the remarks made by right hon. and hon. Members today. Smoking prevalence is at an all-time low—just under 14%, and almost half the rate it was back in 2002—and it is right to celebrate where we have come to, but it is also right to say that we have a long way to go. The continued support through stop smoking services across England has been pivotal: since 1990, these services have stopped 4.7 million people smoking. That is more people quitting than the combined populations of Birmingham, Greater Manchester and Leeds, which is quite a remarkable achievement.

Smoking is linked to half a million hospital admissions each year, so the role that the NHS and charities play in helping smokers quit is also essential. The NHS long-term plan commits to supporting smokers admitted to hospital to quit, as well as pregnant smokers—pregnant mums—and their partners. It also commits to helping long-term users of specialist mental health and learning disability services, and we are ensuring that there is sufficient training, with challenge groups making sure that people get the right interventions and the right help when they intersect with these services. Funded early-implementer sites and services are also being stood up, because we cannot be complacent and we cannot wait for these timelines. I heard strongly that people want interim targets, and we will look at that in the strategy. It is important that we try to keep on track and ensure that we keep our focus on 5%.

Smoking is responsible for an estimated 75,000 deaths in England each year. That is unacceptable because it does not just affect the individual; families and everybody around them also suffer. As many hon. Members pointed out, it has a substantial financial impact on the country as well as a health and emotional impact. As my right hon. Friend the Member for Clwyd West (Mr Jones) said, we have to go at things hard if we are to see that success.

I assure everyone that we are considering alternative products in the plan in so far as they are alternatives. Ultimately, we want people to quit, but as the hon. Member for Nottingham North (Alex Norris) said just a few moments ago, the indication is that e-cigarettes, for example, are 95% better than smoking, so let us be sensible about how we take people on this journey. My hon. Friend the Member for Windsor (Adam Afriyie) will be interested to hear that, although snus is currently banned under the regulations, we are undertaking a review and will consider the evidence base.

The Government will publish the new tobacco control plan, which will set out how we achieve this, and I am pushing hard to ensure that the strategy is published as soon as possible; I am ambitious to try to publish ahead of the recess in July. However, as I am sure all right hon. and hon. Members are aware, new data on smoking prevalence will be released in July and I want to have time to ensure that the plan takes appropriate, targeted action on that data. Anecdotal evidence causes me some concern that we may have seen individuals taking up smoking. The new plan, which will expand on the success of the 2017 plan, builds momentum to support communities and groups where rates are not falling enough. As I say, I am exploring many of the issues we have covered to guarantee that the new plan will be bold enough for smoke-free 2030.

We know that reductions in smoking at a national level mask the significant health inequalities that many right hon. and hon. Members have spoken about. Smoking remains very high in certain areas of the country, particularly in deprived areas and among communities who can least afford the financial effects—as if anyone can afford the health effects. For example, prevalence in Blackpool is nearly 24%; in Richmond, it is down at 8%.

[Adam Afriyie]

I am encouraged by the Minister’s words. Will she confirm that she sees this as part of the levelling-up agenda? Given that particular regions and social groups have more of a challenge than others, it seems to me that it collides well with the Prime Minister’s levelling-up agenda, certainly in terms of health inequality.

[Jo Churchill]

Indeed I do. Actually, the levelling-up agenda and our manifesto commitment to ensure five more healthy life years must be driven by achieving the targets we have set ourselves. Smoking has such a direct correlation with other illnesses. My right hon. Friend the Member for Clwyd West mentioned his interest with Cancer Research UK, and we know about the link to cancer, but there is also a link to chronic obstructive pulmonary disease as well as other respiratory challenges and so on. As I say, a disproportionate burden is borne by those disadvantaged families and communities.

I thank the hon. Member for Ealing, Southall (Mr Sharma) for making an interesting point. I assure him that we are focused on the need to make these interventions local. The local directors of public health and PHE drive plans in localities. I would like to think that we have taken, and can take, much learning from the successful local interventions of the past 18 months, such as with the vaccination programme. There are also clever uses of technology, where we have prompted people to take a vaccination. That might be interesting to look at in connection with recommendation 11, to which my hon. Friend the Member for Windsor (Adam Afriyie) alluded—I think it was him—requiring people to be prompted annually. They might look at that particular behaviour in order to modify it.

I could not agree more with the person who said that data saves lives—indeed, it does. The more we understand about the data held across the NHS, the more we can use it effectively to target interventions and to ensure that people get not only the right treatment but the right care, at the right point on their life’s journey.

In the new plan, we will ensure that we have a strong focus to drive down rates across the whole country, ensuring that they are level to where rates are the lowest, because everybody deserves to live in an area where we have targeted smoking rates and are achieving success. For too long, the harms from smoking have hit those areas that already face challenges. One in 10 babies is born to a mother who smokes. It is estimated that one in five new mothers smokes in Kingston upon Hull, compared with one in 50 in west London. It is those disparities that we need to tackle.

We must also close the gap seen among smokers with mental health conditions and smokers in routine and manual occupations. Could we be cleverer? Could we work in workplaces, for example? It is vital we continue to support interventions that make the most difference, helping people to cease smoking and encouraging them to move to less harmful products.

Covid-19

Adam Afriyie Excerpts

Monday 22nd February 2021 Commons Chamber

[Adam Afriyie (Windsor) (Con)]

I very much welcome today’s road map and the Prime Minister’s presentation and tone. Several things become self-evident. Immortality is not a policy option; that was well put today. Zero-covid is not only unachievable, but in many ways also undesirable given the history of epidemiology and the way in which viruses mutate to become ever less harmful provided they are in moderate and safe circulation.

I also welcome the timetable. Although we were not supposed to have dates, we do have some dates: they are longstop dates, they are backstop dates, they are not-before dates, but we do have some dates, which is helpful guidance for business and the rest of us. I welcome, too, the fact that the statement made it clear that restrictions will be lifted based on the data—provided it is not before the not-before dates. I also welcome the fact that any restrictions that are lifted are now seen to be irreversible. That gives a degree of certainty, albeit later than I would have hoped for, to business and society and those who care about civil liberties.

Finally, I want to say a huge thank you to the Prime Minister and to all involved for agreeing to open our schools again. That will make a huge difference to mothers, particularly single mothers, who are under pressure at home with their children, but also to the children themselves and their future mental health and education.

As for the vaccines, what a wonderful story: we are first in the world not only with vaccines, but also with genomics studies and the medicines around vaccines. We have become the world’s go-to place for vaccinations and everything surrounding them. That is incredibly positive.

I still have concerns about the hospitality sector, as the dates seem rather a long way away given the clear data already delivered in terms of hospitalisations, which are literally plummeting because the vaccines and the vaccine programme are working. I am also concerned about our care homes: yes, one visitor for somebody who is elderly and worried about things and worried about their family is really good, but we should certainly go further.

I have two questions. First, as we can believe in the vaccines—the data is clear, as is the evidence from the Medicines and Healthcare products Regulatory Agency and the real-world data—and if the vaccines are working and deaths and hospitalisations are plummeting, we must be able to accelerate this programme, not simply set it in stone based on dates which appear to some degree to be arbitrary. Secondly, why on earth are we even talking about the R rate anymore? What has the R rate got to do with anything if all the vulnerable groups are protected and serious ill health and death is being avoided?

So I welcome the statement but think we can do more.

Covid-19 Update

Adam Afriyie Excerpts

Tuesday 2nd February 2021 Commons Chamber

[Matt Hancock]

Because people in their 60s are more likely to die from covid than people who are younger.

[Adam Afriyie (Windsor) (Con)]

Our world-leading vaccines programme will mean that deaths and hospitalisations for serious ill health will fall massively—probably to normal levels by around 8 March, when the top four priority groups will have been vaccinated. I am glad to hear the Secretary of State confirm that our top priority must be to open schools first and then move on, because parents are desperate to have schools opened, teachers want schools opened, businesses want schools opened and—God bless them—even our children are desperate to have schools opened. Will my right hon. Friend confirm that schools will be the first to reopen on or before 8 March?

[Matt Hancock]

I can confirm what the Prime Minister has set out: schools will be the first in the queue for reopening. We will consider the data in the middle of this month, my right hon. Friend the Prime Minister will set out a statement after that, and we will give two weeks’ notice. Schools will not open before 8 March, and of course we will look at the data, as I set out in a previous answer.

Covid-19 Update

Adam Afriyie Excerpts

Wednesday 30th December 2020 Commons Chamber

[Matt Hancock]

The new variant of this virus makes it very difficult to control, which is why it is so important that everybody follows those public health messages. That is the challenge we are all dealing with, together, and we just have to remember that we are all on the same side in that great battle. Help is on its way, in the testing for schools, in the measures that my right hon. Friend the Education Secretary is shortly to announce and in the vaccine, which will help to protect those who are most vulnerable. Once we have got through all the clinical prioritisation, we can then move on, in general, to the under-50s. Their risk of death from covid is, thankfully, low but it is highly likely that they will still want to have a vaccine to protect themselves from this disease.

[Adam Afriyie (Windsor) (Con)]

First, I wish to commend the Secretary of State for making it clear that the vaccine will be available to all over-65s—by the end of February, we hope—as that is really important. This should be a joyous day. We have been given the gift of a free trade agreement with the EU by our Prime Minister and the gift of a new vaccine—we also have a new vaccines Minister—by our scientists and world-leading Government objectives. But the gift people really want this Christmas is to know that their jobs, livelihoods and civil liberties will be given back to them as soon as possible, so will the Secretary of State make this clear today by telling us at what point on the priority list of vaccinations he will allow restrictions to be lifted?

[Matt Hancock]

We have to remember that the vaccine is a great symbol of hope, but it is a means to an end, and the end is the lifting of restrictions and the restoration of our liberties and the freedom for us to act as we please. That is the goal of this programme: to make people safe so that we can get life back to normal and, of course, protect the NHS. On the timing, it is absolutely right, as I said in my response to my right hon. Friend the Member for Forest of Dean (Mr Harper), that the speed of roll-out can be accelerated because of the decisions announced this morning. The precise timing of that has to be determined by the manufacture, because although we can forecast that, we cannot know exactly how much will be delivered. On the question of how far down the priority list we need to go before people are safe, we will observe that as we observe the reduction—I hope—in transmission that we get, as well as the protection of individuals. So we will keep this under review, but the good news is that I am highly confident that by the spring we will be through this. It was not possible before the approval of this vaccine to say that.

Covid-19

Adam Afriyie Excerpts

Wednesday 18th November 2020 Commons Chamber

[Adam Afriyie (Windsor) (Con)]

It strikes me that, as MPs, it is our duty to make difficult decisions. We must face head-on the life and death challenges that very few people would wish to face in their daily lives. We must make contested judgments, and this debate and the response to covid is a case in point. Whether it is going to war with Iraq, which was before my time in this House, military operations in Syria or the very painful issues surrounding Brexit, we have a duty to reflect carefully and responsibly when confronted with complex challenges. It seems to me that our response to covid demands a similar level of reflection to reach our best judgments.

There are a multitude of variables involved in this decision making. Given that thousands of lives are being lost to covid, thousands of lives are being lost with covid, and thousands of lives are being lost by our response to covid, it is no easy judgment. Businesses are being forced to close across my constituency and across the country—businesses that people have spent their lives building up. Jobs and livelihoods are being wiped out. Civil liberties are certainly under threat, freedom of speech is threatened, freedom of assembly has been all but washed away in the short term, and even Parliament—even with your efforts, Mr Deputy Speaker, and the efforts of Mr Speaker—is not necessarily functioning as it should during a crisis such as this.

Looking back, I suspect hon. Members will agree that the first lockdown was absolutely the right thing to do. In March this year we were confronted with an unknown enemy: a deadly virus determined to secure its own survival by infecting as many people as possible, with sometimes fatal consequences. With incomplete information from China at the time, we did not know the fatality rate. We did not know the vectors and means of transmission, or which age groups were worst affected, or about its ability to mutate or the type of mutation that may take place. We did not have a ready treatment available for the symptoms.

That was back in March, but today we know so much more. We know that healthy children are hardly affected by the virus, and that is a godsend, considering illnesses and diseases from the past. We know now that the overwhelming majority of adults are reasonably safe: perhaps 80% will not necessarily even notice any symptoms. We know that people over the age of 65 and those with pre-existing conditions are, sadly, most likely to suffer the serious effects of the virus. We know that the virus is transmitted by touch and by being in close proximity to others, and that washing hands and maintaining social distance largely prevent transmission.

We also have far more PPE than we had when we started, thanks to the efforts of the Government. Even if we have overdone it with PPE and end up at the end of this pandemic with millions, if not billions, of pounds’ worth of spare excess PPE, that will be a good sign: it will be a sign that we prepared effectively, and it may be of use to other nations in the future.

We also know that modern treatments can halve the death rate. We know that vaccines, particularly the two new ones, can stop the illness by generating antibodies. We know that our NHS, if fully staffed, can treat those affected, provided that the inflow of patients is moderated over time.

We can see from data that the tiered local approach is having an impact. Data that we have seen over the past week or two is to do not with the current lockdown but with the previous regional measures. That is a good thing, because we can see that we can control this virus to some degree.

Of course, there is still much more that we do not know. That is why we will be forced to make a judgment at the end of this month, but that judgment must be an informed judgment. I very much welcome the Government’s commitment to giving Parliament a say on future restrictions and regulations. I also welcome the Prime Minister’s desire to try to avoid restrictions in future, if it is considered safe to do so, and I very much welcome the Minister’s comments earlier about the progress we have made in tackling the disease so far and our prospects to do so in the not-too-distant future.

To move forward I believe we need to recognise the costs of the restrictions in addition to the benefits of future restrictions. I urge the Government to do three things. First, I ask them to prepare a clear cost-benefit analysis of any future proposed regulations, in terms of both the health and the economic costs and benefits in the short and the long term. Clearly, the two are intricately connected, but it is very important that MPs in this House—the decision makers—have clear sight of the overall costs and benefits.

Secondly, I ask the Government to ensure that the latest data is available from the NHS on hospitalisations, intensive care unit beds and their occupancy, and death rates from all causes, very carefully categorised, perhaps against a five-year baseline. This summer we have seen that the modelling can, let’s face it, get a bit out of control and, on occasion, be more like conjecture than reality. When we make the decision at the end of this month, it is important that we are in a better position to see the real data and perhaps to reflect on it ourselves.

Thirdly, I urge the Government—

[Mr Deputy Speaker (Mr Nigel Evans)]

Order. I am terribly sorry, but the six minutes are up. I know that before I call you, Mr Hanvey, you will be conscious of the time constraints on other people.

Health Protection (Coronavirus, Restrictions) (England) (No.3) Regulations 2020

Adam Afriyie Excerpts

Monday 7th September 2020 General Committees

[Justin Madders]

It is not a question of ambition; it is a question of trusting local government and giving it the resources to do the job that it is clearly the most suited, out of everyone in the country, to do. We absolutely can learn from other countries. There are many examples around the world of how different approaches have produced different results.

It is also worth noting that the fines under this regulation for an initial offence are pretty small. Although there is a multiplier effect, a business might decide that it is worth pursuing its activities until the fines reach a level at which that is no longer economic. We will have to see how that works in practice. As we have seen with other coronavirus regulations, the Government have stepped in to increase the fines through statutory instruments, so perhaps that will happen again if we see a problem with this regulation as well.

As I understand it, there is no statutory review clause for the regulations, so they will not even be reviewed at regular intervals. How can that be right? These are new and far-reaching regulations with potentially massive resource implications for local authorities. Although we know that any directions made by local authorities under the powers in this instrument must themselves be reviewed every seven days—a sensible measure that we support—any local restrictions must also have a clear evidence base and rationale behind them, and should be regularly reviewed. That in itself is resource-intensive activity and is not the same as the Government undertaking a detailed and thorough review of whether the regulations themselves are proportionate and effective. Will the Minister commit to reviewing the regulations in due course? Will she commit to producing impact assessments and publishing them alongside such reviews? Most important, will she commit to bringing any future regulations to the House before they come into force?

I do not intend to go into the details of each regulation within the instrument, but as the regulations have been in place for approaching two months now, I want to discuss the issues that local authorities have experienced in implementing them and in the general approach to interactions with local authorities, as it is vital that the Government listen and take urgent steps to learn from their mistakes—and mistakes have been made. As we know, the Government were too slow to act in Leicester, and its local authorities have raised ongoing concerns about the way the Government have handled the situation there. It is widely believed that if Leicester had been able to access the testing data much sooner—I will come back to the wider issues with testing data later— it could have avoided a lockdown, but that did not happen.

The situation in Leicester was flagged in Government on 8 June, but another 10 days passed before the Health Secretary announced that Leicester had a problem, and it was not until 30 June that Leicester went into lockdown for two weeks. Following that, although the lockdown was extended for another two weeks in mid-July, it was not until the end of July, following ongoing pressure from Members, that the Government announced additional funding for Leicester businesses. As we know, Leicester was the first place to go into a local lockdown, but a month later, when areas in the north of England—in Greater Manchester, Lancashire and West Yorkshire—were placed into local lockdown on 30 July, it was clear at that point that lessons had not been learned. Again, the Government’s communication was chaotic and caused widespread confusion and anxiety.

The Government announced new restrictions on 30 July, the eve of Eid, less than three hours before the rules came into force. Understandably, Greater Manchester’s Mayor and deputy Mayor, along with council leaders, raised concerns about how the changes were announced by the Government. It is not acceptable to announce local restrictions late at night on Twitter, just hours before they are due to come into place. The public deserve clear and timely communication of changes and decisions that affect the everyday life of individuals, families and businesses. Importantly, there needs to be transparency about the reasons and thresholds for introducing and easing local restrictions. It is not fair to leave local areas in the dark. I hope we can avoid a repeat of that approach, although it is noted that the powers of the Secretary of State under regulation 3(5) do not require him to consult with a local authority before giving a direction. Perhaps the Minister will provide some assurances on that point.

There is an issue not only with powers being exercised centrally, but with information. Local directors of public health and local authority leaders have been asking for access to detailed data since the launch of test and trace at the end of May. Starting from July, councils were given access to weekly postcode data for their area, but it only showed positive test results and did not contain granular data on where people live or work, and was often out of date by the time it arrived. Data on local outbreaks needs not only to be shared in a timely way, but to be comprehensive and include information such as addresses, workplaces and ethnicity, which still is not routinely being shared. I hope the Minister will outline in her response what is being done to ensure that those vital details are being shared with local authorities to help them to tackle infection rates. The powers in the regulations will not be effective unless local authorities have the information in the first place to act on them.

Additionally, local authorities are concerned that the centralised Government test and trace operation has failed to reach many of the most vulnerable residents, leading to a number of councils setting up their own localised test and trace systems. That is the biggest vote of no confidence in the privatised national system of test and trace that the Government set up. Perhaps the Government heard those criticisms, because on 14 August they announced they would assign dedicated teams of contact tracers to more than 10 local authorities, after trials in Leicester, Luton, and Blackburn with Darwen. Will the Minister update us on when they expect those teams to be up and running?

It is vital that the scope of restrictions under these regulations and other laws is easily understood by local people. That is key to maintaining the public buy-in and trust that is needed for restrictions to be effective. They must also make sense. As a group of Manchester MPs highlighted in a letter to the Health Secretary on 18 August, the scope of local restrictions must make sense for local communities: where people go to work or school, socialise and shop are all important considerations, as people tend not to organise their lives around geographical administrative boundaries.

Communication also matters. Clear public health messaging is more vital than ever at this time. That is particularly so when different areas are subject to different measures. Tougher measures have been introduced in Bolton this weekend, as the infection rate has risen to 99 cases per 100,000 per week—the highest in England. The restrictions include not mixing with other households in any setting, indoors or outdoors. Those are different from some of the other restrictions in Greater Manchester.

Clear messaging matters. For example, just last week the borough found itself in what the Mayor of Greater Manchester described as a “completely unsustainable position” in which the Government planned to release restrictions despite a rising number of cases. That was, of course, before an 11th-hour U-turn. I empathise with the Mayor. Restrictions are hard enough to explain to the public without their being introduced in such a completely illogical way.

That is why it is vital that each local area must have a clear plan in place detailing steps to take in the event of an increase in cases. Those restrictions must be easily understood by local people. Telling people that they can go to the pub but not visit their family is a message that is hard to explain in public health terms and risks damaging public trust. That is why it is vital to ensure that restrictions are effective. I understand that people in Leicester, for example, are still being told they are not allowed to meet other people in their own back gardens, yet they can meet people in a pub. I should like the Minister to set out—in writing if she cannot respond now—the public health reason for that distinction.

Where councils are on the Government’s watchlist and there is a clear and imminent public health ground to take action, I think it is fair to say they feel they can take enforcement action under the regulations. However, where there is not an increase in covid cases, councils are less certain whether they can take action. It would assist them if there were a clearer steer from Government on the circumstances in which is acceptable to use the regulations. There is no accompanying guidance to the regulations to advise councils on the factors that they should consider when contemplating action. That is also an important issue for any business that might be affected by a council decision. After all, what use is the ability to challenge a decision in the magistrates court if there is no detail on the basis on which that can be done?

If a local authority were concerned that, unless a premises took account of the need to socially distance customers, the situation would lead to an increase in the spread of covid-19, would that be enough for it to take enforcement action under the regulations? Is that the baseline for action? What factors may a magistrates court take into account when considering an appeal against such a decision? I would not expect local businesses to have access to the epidemiological data that might lead to such a decision, but is the impact on a business’s viability a relevant factor? What would the timescale be for a magistrates court to hear such an appeal? It is no good having a hearing on the issue months after the event. The business might have gone bust in the meantime.

The one positive from debating the regulations so long after they were introduced is the fact that we have the opportunity to look in a little more detail at how they have worked in practice. I am grateful that the Minister has said that already 61 directions have been issued under the regulations. Can she confirm, for each of those directions, whether the Secretary of State was notified as soon as possible, and within 24 hours of the issuing of the direction, as per the guidance? I understand that one direction was appealed to the Secretary of State, and representations were made. What was the timescale for that? It would be useful for individuals who might be affected to know the timescales for decisions. How many fines have been issued under the regulations to date, for breaches of the directions issued by local authorities?

As we heard from the Minister, the regulations give the Secretary of State the power to require a local authority to make or revoke a direction, after consulting the chief medical officer or a deputy chief medical officer. I heard from the Minister that the Secretary of State has so far not given any such direction, and I hope that we can move forward, in the sense that local authorities use the power when the Secretary of State considers it appropriate. I should be grateful for more detail regarding the dialogue and processes that should happen before the Secretary of State issues such a direction. Will the Minister also explain how this set of regulations interacts with Government guidance and other legislative regimes? We are hearing from councils that they are struggling to understand that, and it would be helpful for them to have a clear set of guidelines about when the directions apply and how they interact with other restrictions.

What is the role of Members of Parliament in terms of these regulations, particularly in respect of introducing and easing restrictions? There is nothing in the regulations that requires a Member of Parliament to be consulted, but we have heard many outbursts in the media from hon. Members about their concerns about restrictions in their local areas. Will the Minister confirm that there will be an opportunity for all hon. Members, including Opposition Members, to make representations directly to the Department should consideration be given to issuing directions in their area?

A story appeared in The Observer yesterday about a report apparently prepared by Public Health England that stated that the national lockdown in parts of the north of England had little effect on the level of infections. The story says that when comparing other English regions, the study says:

“Each region has experienced its own epidemic journey with the north peaking later and the North West, Yorkshire and Humber and East Midlands failing to return to a near zero Covid status even during lockdown, unlike the other regions which have been able to return to a near pre-Covid state.”

It also questions why anyone should expect fresh local lockdowns to work in these areas now, and asks:

“If we accept the premise that in some areas the infection is now endemic - how does this change our strategy? If these areas were not able to attain near zero-Covid status during full lockdown, how realistic is it that we can expect current restriction escalations to work?”

Given the content of today’s regulations, I can only assume that the view expressed in that report is not shared by the Department. Can the Minister shed any light on the report and what assessment the Department has made of the effectiveness to date of the powers given to local authorities under these regulations? It is important that we clear that up.

Let us talk about what is not in these regulations, as well as what is in them. Perhaps the most glaring omission is financial support for those affected. The Government cannot continue to turn a blind eye to the devastating economic impact of these restrictions. They must acknowledge the economic consequences of putting certain areas or businesses back into lockdown. There are still no clear plans in place to provide targeted economic support to areas of the country that are forced to increase restrictions or become subject to local lockdowns. A tailored approach to support businesses and employment in affected areas is needed, and that must take local circumstances into account and include adequate support for those who need to self-isolate. Effective local lockdowns depend on people self-isolating when they are supposed to. We have been warning for months that the Government need to ensure that people who need to self-isolate can afford to do the right thing, but once again the Government have been too slow to recognise the problem.

The Government recently announced plans to address the issue, but that will unfortunately apply only to a limited number of areas with high rates of covid-19, meaning that only one in eight workers will be covered by the scheme. That does not make sense when the instruction to self-isolate applies to everyone in the country. If the Government accept that additional support is needed for people to self-isolate in some areas, then they should accept that it is needed everywhere. Everyone should get the support they need to self-isolate, and there is no logical reason why such a distinction is being made.

In any event, £13 a day does not go anywhere near far enough to support the lowest earners who need to self-isolate. Even the Health Secretary must agree with that, given that he has previously said that statutory sick pay in the UK is not enough to live on. Can the Minister explain how the Government have arrived at a solution that offers only some people a level of support that the Secretary of State has already acknowledged is not enough? It is not acceptable that so far into the pandemic the Government do not have a strategy on that. The Government were eventually forced to provide support in Leicester, but they have been unclear about whether they would do the same in other areas. Individuals and businesses deserve clarity and support.

And what about schools? We know that missing school is bad for child development and widens existing inequalities. Indeed, the Education Policy Institute report published at the end of last month found that the attainment gap between disadvantaged pupils and their peers has actually stopped closing for the first time in a decade. With many schools returning last week, and more set to return this week, we have been clear that keeping schools open should be prioritised in the event of local restrictions being introduced to ensure that children’s education is not disrupted again. Will the Minister provide clarity on what steps the Government will take to prioritise schools in the event of local restrictions being introduced? What plans are there to ensure the continuation of education should exceptional circumstances mean that some children cannot attend school in person?

To come back to test and trace, without a vaccine, getting an effective test, track and isolate system is the only way to safely reopen society. It is vital to minimise the need to introduce wide-ranging local restrictions wherever possible and to effectively manage local outbreaks where they occur. Right now, however, the Government’s approach is failing and people have lost confidence in the system. With cases on the increase and the Government pushing for everyone to return to work, it is more important than ever that test and trace is working to its full potential, yet we hear of new issues with it almost every day.

The Government seem to have completely taken their eye off the ball when it comes to ensuring that tests are readily available and quickly administered. The latest figures are not encouraging. The percentage of people reached by the system decreased again last week, with the proportion of close contacts of people who tested positive for covid-19 being reached through the test and trace programme at its lowest level since the system was launched—down from 77.1% in the previous week to just 69.4%. The number of cases handled online or by call centres is even lower, at just 59.8%—a staggering 37% lower than the 97.3% of contacts reached by local health protection teams.

It is also taking longer for people to get their results. Although an improvement on the previous week, only 49.3% of tests taken at regional test sites, and 59.9% taken at mobile testing units, received their test results within 24 hours. The number of satellite tests and home tests receiving a result within 48 hours fell to just 8.1% and 17.6% respectively. Home testing kits and satellite test centres both saw an increase in the median time taken from taking a test to receiving the results, with satellite test centres increasing from 65 hours to 76 hours, and home testing kits increasing from 76 hours to 86 hours.

There are also still issues with capacity. More than 100,000 tests lie unused every day, yet at the end of last month, England and Scotland ran out of home testing kits. Last week we heard that, once again, there are clearly problems with the testing infrastructure as people across the country are being sent hundreds of miles away for testing appointments. In spite of all that, the Government seem determined to reward the private sector companies, which are still not reaching more than half the contacts of those who test positive, by renewing their contracts.

These are unprecedented times and it was always going to be challenging, but surely we can do better than that. The Government’s own scientific experts have been clear. We need tests to be done quickly. We were promised a 24-hour turnaround for test results by the end of June, but it is now September and the numbers are still nowhere near that.

[Adam Afriyie (Windsor) (Con)]

Would the hon. Gentleman draw my attention to which particular regulation in the instrument he is referring to? I am not quite sure how that fits with the regulations we are discussing.

[Justin Madders]

Of course the regulations do not deal with test and trace, but it is clear that, unless we have an effective test and trace system, local lockdowns will not be successful and we will not beat the virus.

We know that the NHS and social care face significant pressure in winter months, which is likely to be further exacerbated by covid-19 this year. We do not want to head into a winter disaster with a second wave of covid-19 over us. We are far from where we need to be. We need to deliver routine testing in care homes and for NHS staff, and to prioritise airports and other frontline workers. We need contact tracing and testing to work properly and to be led by local teams that understand their local areas.

Although we support the introduction of local restrictions where they are needed to curb the spread of covid-19, and as a consequence we will not seek to divide the Committee, those restrictions must be complemented by adequate resources for the local authorities tasked with implementing and monitoring those restrictions, and proper financial support for those individuals and businesses affected by the restrictions. The Government were too slow into lockdown, too slow to protect our care homes and too slow to provide our key workers with protective equipment. We cannot afford for them to be too slow in getting these local lockdown restrictions right. I repeat the plea that resources must follow these responsibilities or we risk them being ineffective and creating economic damage across the board.

[Adam Afriyie]

I rise to speak briefly. I welcome you to the Chair, Ms Ali. I will make one observation and ask one question of the Minister. The observation is that, as the local MP for Windsor, I have been incredibly impressed by how quickly local authorities have responded. My hon. Friend the Member for Bracknell and I have been on the telephone with Bracknell Forest Council on a biweekly basis. I have been on the telephone with the former Prime Minister, my right hon. Friend the Member for Maidenhead (Mrs May), and the Royal Borough of Windsor and Maidenhead. I also observe that Slough, which is not a Conservative-held council, was incredibly quick to respond. What strikes me most is the grip they have on what is going on in local areas. I therefore welcome the putting right of the missing regulatory framework to enable local authorities to continue to function in that way.

First, to give a brief example of how that works, for the numbers of pupils in local schools, the local authorities—the royal borough in particular—helped out by being able to produce all those statistics quickly for the reports to central Government. Secondly, with a small outbreak in the Bracknell Forest area, the local authority and the local resilience forum knew in detail within 48 hours exactly who, where, when and how these things were contracted.

If anything, I have heard from local authorities that a bit of a frustration has been that they have been unable to act more quickly and, in a way, unable to be instructed to act more quickly. They were holding that data locally and responding locally. I have to say that they have been doing a really good job.

My question for the Minister is to get some clarity. I think she was referring to upper-tier local authorities. I am not an expert on local authorities, so will she clarify whether that means that all individual local authorities may be able to act within this remit, or is there a definition of upper-tier local authorities that excludes some authorities?

Another frustration of the local authorities that I work with is that, although they may have been able to ask to close an entire area, street, particular business complex or retail park, they have been unable to take action in individual premises or more specific areas. I wonder whether the regulations cover such areas, so that local authorities may drill down in more detail and be more responsive than they have been able to be up until now. With that, I conclude my remarks and very much welcome the regulations.