Draft Human Medicines (Amendment etc.) (EU Exit) Regulations 2020 Draft Medical Devices (Amendment Etc.) (EU Exit) Regulations 2020

Alex Norris Excerpts

Thursday 26th November 2020 General Committees

[Alex Norris (Nottingham North) (Lab/Co-op)]

It is a pleasure to discuss these instruments under your chairship, Mr Rosindell. As the Minister says, we have had a rolling tour of them in recent weeks, but happily we seem to have a rotating supporting cast, other than the Whips, so I can just about get away with repeating some of the same arguments.

I will start, as always, by saying that we are getting very close to the final opportunity for the deal with the EU that the Government promised to finalise. I know that business desperately wants no deal to be taken off the table, and will be looking at the proceedings with interest. Perhaps the Minister will update us on the progress. I suspect that he will say it is “ongoing”, as he generally does.

As has been set out, the draft regulations amend the post-Brexit regulatory framework for medicines and medical devices respectively to implement the Northern Ireland protocol and ensure that the UK meets its related obligations under that agreement. That is, of course, a necessary step towards maintaining the UK’s obligations—necessary, critically, to ensure that people are kept safe when using medicines and medical devices.

We will not divide the Committee, but I have a few areas where I would like greater clarity. At the heart of this is patient safety, which is important to all of us; however, I think we have detected a waning in the Government’s commitment in this area in recent months. It has now been four months since Baroness Cumberlege published the independent medicines and medical devices safety review. Campaigners for that review were ignored and derided, some for many decades, but with the publication of that report they were vindicated.

We are four months on. Frankly, the Government have sat on it. Campaigners got an apology on the first day, but have been unable to get a word out of the Government since. We cannot get anything by the written question route either. It is exceptionally disappointing. I know that the Government have a lot on, but the failure even to pick up the phone to talk to those who suffered and give them an update adds insult to injury. I speak to people affected each week, and they are heartbroken by the Government’s response.

Will the Minister make a commitment that he will prod and urge his relevant colleague to consult campaigners as a matter of urgency? I honestly would not let the day finish without doing that. The hurt is really significant. Will he also commit the Government to using the remaining stages of the Medicines and Medical Devices Bill to implement the relevant recommendations? It is a perfect vehicle for us to act quickly, and we really ought to do so.

The first set of draft regulations, regarding human medicines, amend the Human Medicines (Amendment etc.) (EU Exit) Regulations 2019 and the Human Medicines and Medical Devices (Amendment etc.) (EU Exit) Regulations 2019, as the Minister said, as well as the Medicines for Human Use (Clinical Trials) (Amendment) (EU Exit) Regulations 2019. The 2019 regulations themselves amended the Human Medicines Regulations 2012, the Medicines for Human Use (Clinical Trials) Regulations 2004 and the Medicines (Products for Human Use) (Fees) Regulations 2016. They set out what the basis for the regulation of medicines and clinical trials will be in Great Britain from 1 January, and the draft regulations ensure that the 2019 regulations will remain effective at the end of the implementation period, which is, as I say, very important.

As well as making some technical amendments, the instruments will reverse some of the changes made by the 2019 regulations to limit them to Great Britain, while EU law will remain in effect in Northern Ireland, and implement policy changes to Great Britain’s regulatory regime only. As we would expect, EU marketing authorisations will now authorise sale or supply in Northern Ireland only, and UK marketing authorisations will no longer automatically apply for the whole of the UK. That often gets lost, but it is a very significant change.

I understand that the MHRA will have provision to pay regard to decisions taken by EU member states when making licensing decisions, but could the Minister explain what impact he thinks it will have on the MHRA in terms of the burden of its work when authorising products entering Great Britain? Will there be extra checks? Will there be extra pre-assessments?

Similarly I understand that, due to industry feedback, products used in clinical trials, investigational medicinal products, will no longer need to be certified by a qualified person—a QP—at both ends, which presumably would have increased the administrative burden twofold. Instead, the whole of the relevant UK manufacturer’s authorisation for import licence will simply have to ensure that any IMP has been QP certified by someone based in an approved country. There is a year before that comes into place, but could the Minister guarantee that it will not have a significant impact on the safety of the investigational products and of those using them in the trials? If so, how does he know that, and on what basis has he formed that decision?

Changes are made to a number of areas, but time is limited and I need to move on to the other draft regulations. I will conclude on this element with a slightly more general question. For absolute on-the-record clarity, can the Minister say that he is confident that the changes will not make users of medicines less safe, or leave UK businesses in a situation where they cannot compete? Those are the two points very much in play. I do not think that anybody, either in this room or in the country more generally, thinks that either of those possibilities would be a good thing, so clarity on the record about the judgment that he has made on that would be very helpful.

The draft medical devices regulations also amend the 2019 regulations to ensure that the regulatory landscape is fit for purpose at the end of the implementation period and, importantly, to keep us safe. Schedule 1 amends the principal regulations to ensure that devices placed on the Northern Ireland market meet EU legislation under the protocol. It also makes provision for persons placing devices on the market in Northern Ireland to register devices and for manufacturers of devices to appoint a UK responsible person where there is no other presence.

We talked much about the UK responsible person when considering the Medicines and Medical Devices Bill, because we know that there have been sharp practices previously. I am keen for the Minister to provide clarity and to commit to ensuring that people are not using responsible persons in name only. We know of examples of a single person, who seems to have very little connection to the businesses, being the responsible person for all manner of products, when their employment is in no way related to them. I am keen to hear any reflections on that.

The Minister discussed the UK conformity assessed marking. This is, of course, a significant moment. The assessments will be carried out by UK approved bodies, which will be converted from UK notified bodies by this instrument. What impact will that change have on the bodies and their capacity to make conformity assessments?

We support the continuation of the CE marking. That was a wise decision by the Government. I am interested to hear how the period of two and a half years was arrived at. I would like to hear an on-the-record commitment from the Government that there will be no risk to the supply of medical devices as a result of the conformity assessment.

Finally, the explanatory memorandum states:

“The MHRA will seek to minimise the legislation’s impact by providing guidance”.

Will the Minister say when that will happen and what other steps are being taken to support the MHRA in this process? The MHRA, which has always been important, is now a crucial body.

When it comes to the safety of medicines and medical devices, we are now on a high tightrope. We used to have the common eyes of the notified bodies of our EU partners looking at our products; now we will look at them alone. That is the decision that has been taken, but it means that if there is one mistake, there is no backstop. It would therefore be much appreciated if the Minister gave a sense of the capacity of the MHRA and its readiness to take on what is an absolutely crucial function.

Covid-19

Alex Norris Excerpts

Wednesday 18th November 2020 Commons Chamber

[Alex Norris (Nottingham North) (Lab/Co-op)]

I am grateful for the opportunity to open this debate for the Opposition. It is an important debate, though a solemn one: 589 deaths of our countrymen and countrywomen were reported yesterday, having perished from this virus. The total official number of deaths from covid is now more than 50,000, but the real figure is likely to be much higher. Those are big numbers, but behind each number is a person and a grieving family. All our thoughts are with them.

It is important and appreciated that the Government continue to give Government time in this place for the consideration of covid. Often—we understand this—the Government need to act swiftly to tackle the virus, but it is crucial that we get parliamentary opportunities to scrutinise their actions. I hope that we find the Government in listening mode, because we could do much to improve the current response.

In that spirit, I turn first to test and trace. Test and trace is important for two reasons: first, it is our best weapon to break the chain of transmission, and secondly, it is the part of the process that the Government have the greatest control over. Of course, the behaviour of the public is paramount, and it is critical that we guide them as best we can, but eventually it becomes a matter of personal responsibility. Test and trace, however, we have direct control of—we have control over the implementation and the commissioning.

Let us start with the good news. We recognise and welcome the overall volume of capacity developed by the Government, which the Minister talked about. That was done from scratch, and it is a very good thing indeed. However, that is as far as the good news goes, because the rest of the system is simply not delivering.

I was concerned that the Minister talked about testing but did not talk about tracing or isolation, because the system is failing, not on my terms or on political barriers put up by me or my colleagues, but on the Government’s own terms. The Prime Minister promised test results within 24 hours by the end of June. The current figure is 37.6%. That is a failure on the Government’s own terms. I hope that the Postmaster General will say when the 100% target will be reached.

On tracing, the Government say that of those with the virus, 80% of their close contacts must be reached for the system to be effective. Last week, it was 60%. It has never been at 80%; it has bumped along, frankly, in the 50s and 60s throughout. For last week, that represents 126,000 people who ought to have self-isolated but did not, simply because they did not know that they were supposed to. Each of them is walking around unaware, working as usual, living as allowed by regulations, and in close contact with goodness knows how many people. Again, that is a failure on the Government’s own terms. Tomorrow, we will get the latest weekly figures. Do we expect performance to have reached that 80%? I do not. I raise this issue every day, whether in the Chamber, online, in the media or, frankly, to anyone who will listen. That is because the failure of the system is the root of our loss of control of this virus.

If this debate follows the patterns of previous ones, we will hear contributions from Government Back Benchers critical of the symptoms of that loss of control—damage to the economy, delayed or cancelled healthcare, restricted civil liberties. Those are all exceptionally important symptoms, but I cannot understand why we do not hear greater concerned scrutiny of the cause of the problems, which is the failing system. I hope that those Members will join us in pressing the Government to do better, not because of the politics—on this occasion, I could not care less about that, frankly—but because this is a hole beneath the water line when it comes to tackling the virus. Nothing will truly get better until this gets better.

The final weak link in the chain is about isolation. Even if all elements of the system over which the Government have direct control work flawlessly, the enterprise will fail if the person at the end of the process does not isolate when supposed to. The Prime Minister has bemoaned that issue previously, which I suspect is part of his attempts to shift the blame on to other people—'twas ever thus. In reality, however, even before the pandemic, too many people were just getting by on low wages and insecure work. People were in work but in poverty, and forced, hour by hour, to earn that poverty. Now they are being told to forego even that income in favour of sick pay. That might be the right thing to do to beat covid-19, but people do not know how to isolate and feed their family at the same time.

The Health and Social Care Secretary himself said that he could not live off statutory sick pay, and it took seven months until the £500 stipend came in. The Prime Minister thought that the stipend was weekly—it is not, and it is still not enough. Until we change the situation so that those who have least in our country, and who often work in frontline jobs where they are more likely to contract the virus, do not have to choose between the national effort and financial reality for their family, we will not get people isolating in the numbers we need.

[Tim Farron]

The hon. Gentleman is making a good point, and the 60-something-per cent. success rate of the national system is deeply regrettable. As in many other parts of the country, Cumbria public health has been far more successful, with a 97% success rate. However, because of a flaw in the system, if someone is contacted by Cumbria public health, they are not able to get the isolation grant. That is preventing many people from making the choices that they need to make to keep everybody safe, while also putting food on the table. Does he agree that the Government need to answer calls from the director of public health in Cumbria, and ensure that those who are contacted and asked to isolate by that body get that grant?

--- Later in debate ---

[Alex Norris]

The hon. Gentleman gives a concerning example that shows how the system is struggling in general. I hope that the Minister will address that issue when she winds up the debate, and I will refer more directly to local authority public health shortly.

I do not want to carp on about what is not working without providing any solutions, so I come armed with three things that Ministers could do at a stroke of their collective pens that would radically improve test and trace in short order. First, we must better use NHS lab capacity to turn tests around. I very much welcome what the Minister said about megalabs, which we have eagerly anticipated for some months. However, there has been a large gap in which we have not had that lab capacity, and we will not have it for some time yet. In the meantime, let us put our NHS lab capacity to use in getting tests turned around.

Secondly, we should give control and resources to local authorities to run the tracing operation. They know our communities and already have a local presence. They are a trusted voice and, crucially, they do this routinely. They do this already. Admittedly, that is on a smaller scale—perhaps related to an outbreak of food poisoning linked to a takeaway—but they do it effectively. Let us support them to do it fully. Thirdly, we must develop a proper package of support for those who need to isolate—that is self-evident. Those three things could be done immediately, and we would all be better off if they were.

We have seen the consequence of failure and of a test and trace system that is struggling, and that is another lockdown. This time last year we were banging on doors in the cold and the rain, and none of us supported the lockdown because we want to keep family members away from each other, or to shut businesses in our community or anybody else’s. However, the failure to break the transmission rate of the virus leads us there.

There are two important things that I wish the Government would communicate more. This is not a choice between lockdown and the economy; it is not a choice between lockdown and non-covid healthcare treatment in the NHS. We must have the lockdown for those purposes, and the longer we delay putting restrictions in place, the worse are the long-term impacts on our economy. If we do not introduce regulations to reduce the transmission of the virus, the greater are the pressures on our hospitals, and the less likely they are to be able do other treatments. Those things are not in tension; they are very much complementary.

The failures of test and trace may have led us to a lockdown, but that lockdown buys us time to sort out problems in the system. We must see progress. Lockdowns alone will not tackle or eradicate the virus, but they buy us time to put in place the things that do. We have now had two weeks of lockdown, but we have not heard about what is improving in the test and trace system, or what will be better, including in the next two weeks. Ministers really need to say this today, so we can be sure and confident that the time is being used wisely. Otherwise, when we leave lockdown, this will all recur again, something that none of us wants.

We are all very wary of Christmas. Depending on which newspaper Members read, they may have woken up yet again to see that the Government’s plans, this time regarding yuletide festivities, had been briefed out to national newspapers. Putting aside the discourtesy to the Speaker and Deputy Speakers, to all of us and to this place in general, that is all well and good, but those plans are only going to be feasible if the right efforts are put in place now and this time is used wisely.

It also ought to be stated that this lockdown is longer and more painful than it needed to be because, once again, the Government acted too slowly. The scientists told them they needed to lock down, as did we, but for two weeks the Prime Minister disregarded reality, which meant that the situation worsened. That has meant that the lockdown will be longer and harder, and also meant that we lost the benefits of the school holidays. These are mistakes that cannot be repeated in the future.

As we exit lockdown, the Government need to be honest with the British people—not in off-the-record briefings to mates in the media, but to the British people—about what will come next, both at Christmas and in the return to a tiered system. I know from our experience in Nottingham that trying to negotiate restrictions was painful, even when we wanted them at the beginning of October as our infection rates increased precipitously. We could not get the initial restrictions we wanted, because the Government were moving to the tiered system and it did not fit their timeline. We then managed to get into the tiered system at tier 2; the next day, the Government said that they wanted us to move into tier 3 and were going to call us, which they did not for a further week. Eventually, we had the painful negotiations about what that actually meant for Nottingham: we brought those restrictions in on the Friday, and by the Saturday, the national lockdown had leaked out. The system has not worked for Nottingham, so we need to know that in any return to a tiered system, the Government are going to work much more quickly and in a more agile manner. Every day wasted is a day when the virus thrives, so we need to be better upon exit.

Turning to the vaccine, we strongly welcome the Government’s efforts in this area: they were right to pre-order doses across a wide portfolio, and they were also right to back British. With our excellent research and our proud record in this area, we should be in the vanguard of it, and patriotic about our efforts to tackle this global issue. Last week, I responded on behalf of the Opposition in an excellent Westminster Hall debate on the covid-19 vaccine, secured by the hon. Member for North Herefordshire (Bill Wiggin), the day after the news broke that the Pfizer-BioNTech vaccine had achieved success in a phase 3 study. Since then, we have heard similarly positive news about the NIH-Moderna vaccine candidate, which is likely to be followed by other candidates, whether that of the University of Oxford and AstraZeneca, the candidate referenced by the Minister, or candidates developed elsewhere. I understand that overnight, there have been further promising developments for a Chinese candidate.

During that debate, colleagues and I raised the challenges and considerations that need to be addressed to make sure that this is handled and executed well. I will not repeat those contributions in the level of detail we went into then—they are on the record in Hansard for people to read. However, the theme was that we cannot repeat the slowness or logistical challenges that we saw early in the pandemic with regard to the procurement of personal protective equipment and testing: no Nottingham people being sent to Llandudno or Inverness for their healthcare this time, please, Minister.

As we have done throughout the pandemic, we on the Opposition Benches will work constructively with the Government to support viable vaccines being secured, ensure the right groups are being prioritised, develop an effective delivery programme, counter vaccine hesitancy—that is critical—and continue to support these efforts globally. A failure on any of those points will undermine the whole process, so it is absolutely crucial that we come together, and I am sure that Ministers will welcome that.

However, I want to briefly reference a point that my hon. Friend the Member for Bristol South (Karin Smyth) made regarding the NAO report. Again, we understand—as that report did—that the Government were having to do things that would normally take 18 months’ worth of planning in hours and days, and that comes with some efficiency trade-offs. However, we did not hear clearly enough in the Minister’s opening statement a sense that that has been reflected upon, and we did not hear what will be different in future to make sure those mistakes are not repeated.

[Karin Smyth]

I appreciate my hon. Friend having picked up on the point I made. The Minister very carefully read out a statement in reply to my question about the Government’s response to the NAO report. I am concerned that she was saying that the Government stand by what they did in that period, and do not think that the way in which those contracts and large procurement processes were handled was a problem. It may be that the Minister wants to correct the record, but if that is the case, does my hon. Friend agree that that is deeply worrying?

[Alex Norris]

I heard the point that the test had been clear that nothing wrong had been done, which, frankly, is a very low bar. I do not think anybody would say that there was nothing that happened in the early procurement phases that we would not perhaps want to change or do better later. I hope that the Paymaster General in winding up might reflect on that.

Perhaps this is the best place to say that the announcement on long covid will be very much welcomed by a lot of people, including my good friend Jo Platt who has been campaigning on this for many months, as well as living with her long covid. This is a story for lots of people up and down the country, across all our constituencies, who are living with the after-effects of this horrible virus over and over again. The act of knowing that they are being heard, as well as the 40 clinics, will be a real tonic to a great number of people, so we very much welcome that.

I turn to inequalities. At the beginning of the pandemic, we talked about the virus being a great leveller, not distinguishing between us depending on our lives, our jobs and our postcodes, but nine months on we know that to be patently untrue. Sixty per cent. of those who died were living with disabilities. Those of Bangladeshi heritage are twice as likely to die as those who are white British. Those of Chinese, Indian, Pakistani and black Caribbean ethnicities are 10% to 15% more likely to die than I am. Mortality rates in the most deprived communities are more than twice those of the least deprived communities. This pandemic has shone a light on our inequalities, whether that means the inequality in work, in housing or in income, and these inequalities have had tragic consequences for some and, in the aggregate, are catastrophic for all of us.

When we beat this virus, which together we will, what comes out of it must be a fair settlement that recognises these inequalities as bad and tackles them head-on. That is why it is already concerning to see again—of course, leaked to national newspapers—that the overseas aid budget is the first on the chopping block. In 2010, the Government chose to target those who had the least to pay for a crisis that they did not cause, and these reports are a sign that maybe this is the plan again. We will not let them repeat this in 2020. It simply would be hugely unjust.

Before I finish, I would like to take this opportunity to thank our incredible NHS and social care staff for all they have done for us. They are truly the best of Britain. Similarly, the pandemic has revealed the key workers all over our communities and all over our economy, so this week, during Respect for Shopworkers Week, I would like to say a special thank you to those working in our shops, keeping us fed, but still facing rising violence and abuse every day. The Government should take better action to protect you—the Government could, of course, adopt my private Member’s Bill and I encourage them to do so—but whether it is that or through another mechanism, we will fight for you until they do.

In conclusion, now more than ever we must stand together as a country, as families and as communities, and show once again that at a moment of national crisis, the British people always rise to the challenge, support those who need it and pull together. That involves not only recognising successes, but assertively tackling the failures that have held us back during the pandemic. If we address these, we will beat this virus.

[Mr Deputy Speaker (Mr Nigel Evans)]

We will begin with a time limit of six minutes.

Oral Answers to Questions

Alex Norris Excerpts

Tuesday 17th November 2020 Commons Chamber

[Alex Norris (Nottingham North) (Lab/Co-op)]

For cancer care, we are still dealing with the backlog from the first wave, but we are now hearing of treatments being cancelled during the second wave. Extremely vulnerable immuno-compromised cancer patients need covid-free wards and staff need regular testing. Similar backlogs to the first wave could be the difference between life and death. I ask this at every Health questions but am yet to receive a persuasive answer. What will the Government do differently in order to restore cancer services?

[Edward Argar]

I am grateful to the shadow Minister, who always asks measured and sensible questions. He is right to ask that particular question, but I am very happy for him to raise with me any specific incidents of where urgent cancer care is being cancelled in the current situation. We have worked extremely hard, as has the NHS, to ensure that treatments such as that and emergency and urgent treatment can continue. He asked what we are doing differently. We have learned a huge amount, as has the whole country, over the past six to nine months. We have increased capacity in our hospitals, which is why, with the measures that we have taken, we can continue far more surgery and far more treatments, particularly cancer treatments, than we could in the first wave.

Smokefree England: Covid-19 and PHE Abolition

Alex Norris Excerpts

Thursday 12th November 2020 Commons Chamber

[Alex Norris (Nottingham North) (Lab/Co-op)]

It is a pleasure to speak in such an important debate. I represent one of the less healthy constituencies in the country, but we could remove half of our health inequalities by being a smokefree community. That is what is at stake here. I therefore commend my hon. Friend the Member for City of Durham (Mary Kelly Foy) for securing the debate, which I understand is her first through the Backbench Business route, and congratulate her on her speech. She set out the challenge very well. The point she made about the current trajectory getting us there only by the mid-2040s was absolutely right. She also did the Minister an extraordinary favour in essentially laying down a tobacco control plan in her speech for you, Minister—sorry, Madam Deputy Speaker; I will never do that again. The Minister could clip my hon. Friend’s speech directly from Hansard and turn it into a tobacco control plan overnight. I think we are almost there, so I hope to hear positive noises from the Minister when it is his turn.

My hon. Friend the Member for Blaydon (Liz Twist) also made a strong case. I was particularly struck by the points made about smoking in pregnancy and with regard to those with mental health issues. We know from Pareto’s law that on any great journey the last 20% takes as much energy as the first 80%, and that is definitely the case with smoking cessation, so we will have to take a granular look at which groups are still disproportionately affected and target resources specifically in a way that works for them.

I was cheered when I saw the name of the hon. Member for Winchester (Steve Brine) on the call list. As he is a former public health Minister, I knew he would have an awful lot of insight to share from his time developing the previous tobacco control plan. His story certainly made me laugh. I agree with him wholeheartedly on a number of issues, particularly when he said that we should get our skates on. I agreed with his points about Public Health England, which I will expand on soon. The case for keeping everything in one place is profound and compelling; I completely agree.

The hon. Member for Strangford (Jim Shannon) seems to have perfected the art of being in multiple places at once, speaking in both Westminster Hall and here very quickly but with characteristic force and insight. I particularly liked the way he characterised this as a social justice issue, which is locked into communities. I relate to that from my home experience. I hope the Minister will address the point on e-cigarettes, which seems like a loophole that none of us would be particularly enthusiastic about.

Earlier this year, the all-party parliamentary group on smoking and health invited me to speak at a roundtable to discuss the next steps to secure the ambition, which I share with the Government, for England to be smokefree by 2030. Both the Under-Secretary of State for Health and Social Care, the hon. Member for Bury St Edmunds (Jo Churchill)—she is responding to the Westminster Hall debate—and I highlighted the importance of cross-party working if we are to deliver that ambition. I want to reiterate that sentiment today. I thank the chair of the all-party group, the hon. Member for Harrow East (Bob Blackman), for inviting me to that event and acknowledge his tireless work in this space. I think it is only the nature of proceedings that has stopped him from contributing; I have no doubt he will be watching.

As the Minister said in our exchanges relating to tobacco last Tuesday, we can all be proud of the shared record of successive Governments over the last two decades in reducing smoking. I say everything in that context. We have a high degree of consensus in wanting to be smokefree by 2030, with that ambition shared by all. That was featured in the Government’s prevention Green Paper last year, which promised to build out a comprehensive approach. It has been more than a year since the consultation on the Green Paper closed, and we are still awaiting the Government’s response and the further proposals they promised, which are expected in January. Given that each day nearly 300 children start smoking, we cannot afford further delay, so the Minister ought to lay out a commitment on the timing of that response when he has his opportunity today.

In my city of Nottingham—colleagues have drawn on their examples from around the country, so I hope they will allow me to do so as well—21% of adults smoke, compared with 14% nationally. The figure is 29% among those in routine and manual occupations. One in six mothers smoked during pregnancy, compared to one in 10 nationwide, and smoking costs the people of our city about 75 million quid, £11.5 million of which comes in the form of NHS spending, which of course is under such pressure due to covid.

This is a social justice issue. It does impact on all communities, but not on all communities equally, and then, within this pandemic, has a compounding and knock-on effect on pandemic outcomes. The prevalence of smoking-related diseases—whether heart disease, respiratory diseases or diabetes—has undoubtedly impacted on the severity of the impact of covid on communities, especially ones like mine. Public Health England has identified these diseases as being very strongly associated with worse outcomes from covid. Of course, as we go into winter, with normal winter pressures and covid-related winter pressures, smoking puts extra pressures on our NHS. Again, there is much at stake for us.

In the covid context, I think we would all be encouraged by the rise in quit attempts and the success rates during the pandemic so far. Again, however, we know that that is not distributed equally. It tends to be older smokers in disadvantaged communities who are quitting in high numbers, not so much younger smokers. It is impossible not to think about the fact that the feeling going into a second lockdown is very different from going into the first. In the first lockdown people talked about ways in which they might improve their lives. I think I was going to re-learn French—I never did—but whether it was banana bread or committing to quit smoking, lots of people used that time very constructively. I worry about the impact of this second one, because there is definitely not the same level of optimism, if optimism is the right word. There will be people who quit six or so months ago who are feeling the pressure at this point, because quitting smoking is really hard. To those people, I think we would all send our solidarity and hope that they can keep going the course, because they are doing a brilliant thing for themselves and for their families.

I am greatly concerned by the Government’s decision to axe Public Health England in the middle of a pandemic. It seems a very odd thing to do. Certainly, without a clear plan for what the future of the health improvement work of PHE is going to be, it risks undermining the progress we have made on smoking and across all other types of health promotion issues. The success on smoking has been driven by a robust national strategy, strong regional delivery and effective, evidence-based local action. I think that is a really good model for smoking cessation and for all other areas of health improvements. I would be very keen to hear the Minister address the issue of when we are going to see an options paper for the future of PHE—I hope he will do so—but I also hope that he will commit to that model and be clear about how public health stakeholders are going to be able to contribute their views and expertise.

I am slightly surprised to have to say this, but, again, it would be good to hear a clear commitment, much in line with what the hon. Member for Winchester said, that the Government believe that this a national-level leadership role and that these functions ought to be together in one place. Whether that is in the Department, as the hon. Gentleman says, or stand alone, as they are currently, they should be in one place, taking a national lead and then providing support for the regional delivery and the effective local action. That has really worked so far, and I do not know why we would not want to do that. I would say to the Minister, as I have said to the Minister for public health—the Under-Secretary of State for Health and Social Care, the hon. Member for Bury St Edmunds—that if the Government come to a sensible place on this, we will not run political victory laps. There is no value in that to anybody. I think we just need to get it done.

It is impossible to talk about Public Health England without relating it to public health cuts, which both my hon. Friends the Members for Blaydon and for City of Durham did. I know these very well; prior to this election, I was the custodian of Nottingham’s public health budget for three years. Extraordinary cuts to local government, particularly in the poorest communities, have meant diminished public health services, but particularly smoking cessation services. After we have paid for demand-driven services such as drugs and alcohol or sexual health, there is not an awful lot left. I am not sure that the point the hon. Member for Winchester made about the public health grant ring fence is meaningful. I understood it and I agreed with it, but I think that, as a fence, it has a lot of holes. If we looked up and down the country, we would see a lot of public health spending by name that we would not necessarily consider to be public health by discipline. We need to reflect on the impact of those cuts, because they only create greater financial losses for us later, and I will come to that shortly.

Analysis by the Health Foundation shows that nearly £1 billion a year is required to reverse the real-terms per capita cuts, and that an extra £2 billion a year would be needed for adequate investment in the most deprived communities, and that is before the pandemic struck. I am very concerned that virtually all of our local authorities will have to draw up some sort of in-year budget to deal with covid costs. The promise was made by the Ministry of Housing, Communities and Local Government that those costs would be met. That is clearly now not going to happen, so, again, will those cuts come from public health budgets? That is something that we should all be very concerned about, because, as the King’s Fund characterises them, they are the falsest of false economies. The cuts have damaged not only stop smoking service provision, but all sorts of other provisions, such as health visiting, sexual health clinics and others, and they are storing up problems for our future. I hope the Minister, when he has his opportunity to speak, will confirm whether the upcoming spending review will include an uplift to the public health grant given to local authorities.

Similarly, it would be good to hear a recommitment to national level quitting campaigns, because in their heyday—2008-09—public spending in this area was in the tens of millions. It is not anymore and PHE’s budget for anti-smoking campaigns, including Stoptober, which was estimated in 2012 to have generated an additional 350,000 quit attempts in England—a fantastic figure—has fallen substantially now to £1.8 million, which is a quarter of what it was six years ago. Again, these things work. The Department clearly recognises that, and we should recognise the work that PHE did with Action on Smoking and Health during the pandemic on “Today is the Day” campaign, which was targeted at those communities where rates are the highest, including the City of Nottingham, and we are grateful for it. Therefore, those things work and I hope that we can hear a recommitment in due course.

Just to finish, how do we get to being smokefree by 2030? Following the prevention Green Paper, the Smokefree Action Coalition, which includes ASH, Cancer Research, the British Heart Foundation and the Royal College of Physicians, launched the roadmap to smokefree 2030, which is a really good read and was endorsed by all sorts of leading public health organisations and the all-party group. It also has some great recommendations that the Government should engage with, so will the Minister share his reflections on that important document? We do have to come to a position on the issue of the levy on tobacco companies. We should recognise the work that is being done by tobacco companies to reformulate to safer alternatives, but it is still a very profitable industry.

I was going to pull my punch on what I was going to say on this and leave it quite broad, but as other colleagues have been braver than me, I thought that I had better be a bit braver, too. I do not like hypothecated taxes. If we start opening the door to hypothecated taxation, we will never fund unpopular things ever again, as we will just increasingly create a tax regime that fits around that. Nevertheless, a smokefree fund is attractive and could be a way to try to improve funding for public health grant services. Therefore, again, if the Minister has a preferred way forward on that, I think that we could seek to find a political consensus on it, because we know that it would be a challenging thing to do, but it could also be a very important thing to do.

I am conscious that the sector has told us what it thinks it needs, so now it is time for us to reflect on that and that has to be through, as a matter of urgency, a new tobacco control plan. Again, I hope that we will hear from the Minister on that. There is no room now for flapping and no room for the two-year gap that we saw previously; we must get on with this because, on the current trajectory, we will not make it. I hope the Minister will commit to that as a matter of urgency.

In conclusion, this is a shared goal and it is a significant prize. There are weaknesses in our current approach that we must address now. If we do so and we act decisively, we will make one of the biggest public health breakthroughs that we have made in our nation’s history, so let us grab this moment.

Obesity: Covid-19

Alex Norris Excerpts

Tuesday 10th November 2020 Westminster Hall

[Alex Norris (Nottingham North) (Lab/Co-op)]

It is a pleasure to serve under your chairmanship, Mr Davies. I congratulate the hon. Member for Strangford (Jim Shannon) on introducing the debate and on the tone he set in doing so. The disparities between our nation and similar nations show that something different is going on in the UK, and that should, we hope, act as a call to action for all of us in seeking to do something about it.

The hon. Gentleman’s references to income and ethnicity equalities were important and well made. He was a little bashful in talking about the financial impact, but it is worth recalling that obesity is terrible for the individual and for the collective in its impact on our health service and economy. We have not only a moral but a vested interest in this.

Colleagues made excellent contributions. The hon. Member for Vale of Clwyd (Dr Davies) picked on the disparities in the impact of covid and outcomes for obese people, and in raising them the Prime Minister did a public service. The hon. Member for Strangford also mentioned social justice issues—a theme that the hon. Member for South West Bedfordshire (Andrew Selous) developed with characteristic force. We will all take away the statistic on processed food as it brought into sharp relief the difference between the UK and other countries. That should act as a wake-up call, and I hope this will be a kick-off for parliamentary debates on it.

I was glad that the hon. Member for Bath (Wera Hobhouse) referenced eating disorders. When we discuss obesity I prefer to refer to a range of healthy weight interventions. The obesity strategy might be better as a healthy weight strategy because it is only part of the picture. The hon. Lady made important points about how the different disorders are linked.

The phrase that I underlined from the speech of the hon. Member for Stoke-on-Trent Central (Jo Gideon) was that the public mood has changed in recent months. It has, and we must take this opportunity, but a delicate balance must be struck. You, Mr Davies, have spoken publicly about the need not to moralise, and you and I have had that conversation in the context of gambling. People switch off if we wag our finger and say that they should be as virtuous as we are. We do not, however, do our people a service if we are blind to the challenges that our environments and our lifestyles are creating for us. We must find the balance between not wagging our fingers and being assertive enough to say when things are not working and are not right. The time when the public mood is changing is a good moment to do so.

I liked the emphasis that the right hon. Member for Romsey and Southampton North (Caroline Nokes) gave to wellbeing. I do not think that is too new age for us to latch on to. It would be a really good outcome of the covid settlement, as people have made this extraordinary national sacrifice, to have public services, an economy and a general environment that points towards wellbeing for all of us. We should all be interested in that.

In my community, in 1920, poverty manifested itself in malnutrition. We have all seen the pictures of rake-thin children. In 2020, it is the opposite. A third of our children leave school overweight or living with obesity. In the adult population, two thirds of us are above a healthy weight and half of those are living with obesity. That is a challenge of exceptional scale. It is a population-level public health challenge. That behoves us to act. We know that obesity is a risk factor for heart disease, type 2 diabetes, some cancers and covid-19, as hon. Members have said. This is a good moment to tackle a national crisis.

My party has had interest in this matter for some time. Members may recall that our former deputy leader, Tom Watson, who is no longer of this parish, took on this issue personally during the last Parliament. His journey was incredible and I know people have taken great interest in it. He is a great ambassador.

We are glad to see the obesity strategy. I am happy to say publicly, as I have said in the media, that we support the Government in their efforts. We want to see the strategy actually implemented, so we do not get bogged down in consultations for ever and things do not actually happen. Rather than pushing the Minister on the substance of the strategy, I will push her on making it happen. There are arguments to broaden it out to a healthy-weight strategy and bring in greater emphasis on mental health, but at the moment I will take what we have.

Yesterday, the Minister replied to my written parliamentary question on this issue. It is clear that there is no new money for this and it is within the public envelope. I will talk about public health cuts shortly. The reality is that there have been diminished resources for this over the past few years. The impact of covid-19 on public finances means that resources are likely to diminish further. We should question whether we are geared up to meet such a significant challenge.

One reason why it is expensive and hard to tackle obesity centres on the complexity of the issue. It is about not just food, but childhood experiences, education, income and mental health, as well as poverty, in which I have a direct interest as the representative of one of the poorest communities in the country. We know that in communities such as mine, children are twice as likely to be obese as children who live in better-off places. Those children are no different. It is not because our burgers are any bigger or our sugary drinks any more sugary in Nottingham. There is nothing in the waters. Those environmental factors in our community push children and young people towards obesity. It is fine and right to talk about personal choice, but we have to understand that there are structural, social and economic inequalities in our country that close down choices, limit opportunities and push very difficult life outcomes on to our young people.

This is a challenge for the Government. This Administration and previous Governments in the past decade have not taken a long view on this—an investment view, rather than a finances view. Short-term decision making will cause greater problems. Public health cuts are a shining example of that. The migration of public health to local authorities is a good thing and one of the few aspects of the Health and Social Care Act 2012 that is likely to remain much longer. However, cuts to local authorities have meant a diminution or repurposing of those services.

I know from three years of leading in Nottingham on our public health grant that once we have paid for drug and alcohol services and sexual health services, which are demand-led services, there is not a lot left for smoking cessation, which really works, or for early life-course interventions, which are spectacularly effective. Unhealthy weight barely gets a look in. Across the country, we have seen the complete loss of any supported cooking programmes or those sorts of things that pull down the myth that cooking and eating healthily is hard or time-consuming.

That is thing that frustrates me. If I could get one message across to my neighbours, it would be that with a little bit of planning, it could be cheaper for them to eat healthily and it could be better for them, too. We have lost that, because we have lost the support through the public health grant. Covid makes everything harder because all of our local authorities—I am talking about England specifically; I apologise to Scottish colleagues—are looking at their finances. The “don’t worry, we’ll meet all your covid expenses” promise will not be honoured—that is clear by now—so there will be in-year cuts, and they will come from the places that they came from in the past, because they cannot come from children’s or adult’s social care, but from things that are seen as discretionary That is bad for individuals and our communities, and it is dreadful for all of us collectively because it will create much greater expense further down the line.

I will reference briefly free school meals. When I wrote this speech at the weekend, events had not moved on. Again, that was a prime example of understanding the cost but not the value of something really significant. Research by the Nuffield Foundation found that the provision of free school meals leads to a fall in obesity rates. I have gone public on this: I have no more interest than you, Mr Davies, in moving to a point where the Government feed children routinely. However, we need to understand that it is partly a good thing. When we have children at school, it is good because we educate them, but we can do many other good things around health and exercise, and we should not miss those opportunities.

Before I finish I want to make a quick point about Public Health England. I still think it is a very odd thing—one of the oddest things that has happened in an exceptionally odd year—that during this pandemic the Secretary of State for Health and Social Care would want to abolish Public Health England. It is an important ring-holder body for our obesity efforts as a country. I understand the disease and infection control points, but the Secretary of State wants his organisation, so he will have it. To an extent, I will not contest that space but, for the remaining functions of Public Health England, which are vital whether it is around obesity, smoking or drugs and alcohol, I really hope the Minister will give us a sense of what the plan is. I have asked parliamentary questions, so I know the consultation is coming soon, but we do not have long if it is to be up and running by April. I hope we have a soft landing. I will commit publicly to making no political capital out of it. We will all be relieved and will move on and never mention it again. That would be in all of our interests.

The hon. Member for South West Bedfordshire said the real theme to take away from this is a combined national effort. I really like that. We can find a high level of political consensus on this really easily. As the hon. Member for Stoke-on-Trent Central said, there is a public interest. Industry is falling over itself at the moment to tell us about the good things that it is doing. That is great. We should welcome that and encourage it. If we come together, resource it properly and see the long-term benefits of it, we can make a significant difference. It will make the country much healthier, more robust in many ways, and we will all be better for it.

Covid-19 Vaccine

Alex Norris Excerpts

Tuesday 10th November 2020 Westminster Hall

[Alex Norris (Nottingham North) (Lab/Co-op)]

It is a pleasure to serve under your chairship for the first time, Mr Dowd. I am grateful to the hon. Member for North Herefordshire (Bill Wiggin) for initiating today’s debate on this topic. Timing is everything in politics, and his is clearly spot-on. Similarly, a rare political skill is the ability to make the complex comprehendible, and he really did that in his setting out of the debate. I do not know who is watching, but I did plug this debate when I was on Sky News at lunchtime, so I hope a few people are, because that was the best explanation that I have heard, and certainly the best one that can be distilled into about 15 minutes, of just how rigorous the process is. I hope people will take from that explanation the reassurance that although we are keen for the vaccine to succeed, there is a rigorous process. It has not been retrofitted to fit the vaccination’s journey, so we should have some confidence in that.

To reflect on the two Back-Bench contributions, when the hon. Member for Strangford (Jim Shannon) referred to it being bit of good news, = he was speaking for all of us. He mentioned the groups that will be prioritised, and I think there will be a high level of consensus on that. Hopefully, it is something that we will settle on very quickly. I was cheered by the hon. Member for Henley (John Howell), who talked about the Council of Europe and the World Health Organisation, because those are exactly the sorts of fora that we need to engage with to get an equitable distribution around the world. It is hard for all of us; this is why political consensus is so important. It is hard for us to tell our constituents why we feel there needs to be a global distribution when people are so desperate to get their lives back to normal, but we know there is both a moral and a pragmatic obligation to do that. The organisations that the hon. Gentleman talked about are exactly the places for those conversations.

On the politics of this, it is really important that we do not mess around or be mischievous with the idea of the vaccine. There is a big public conversation about this. Any look of doubt from us would be magnified significantly. As community leaders, we have a responsibility to say that we trust the process. The outcome is whatever the outcome is, but the process itself is a proper one that we trust. That is certainly what hon. Members will see from the Opposition.

Yesterday’s news on the progress and the efficacy of the vaccine will have cheered all of us. I know that the Government are on record with regard to doses from that particular provider, but when we add in the AstraZeneca-University of Oxford one and the Moderna one, might the Minister be able to tell us how many pre-orders have been put in place for the vaccinations? That would help us to gauge the scale. I know the Government have laid the pitch for the roll-out through the changes to the human medicines regulations, and significant changes were made, including giving the Medicines and Healthcare Products Regulatory Agency the powers to grant temporary authorisation pending the granting of a licence.

I was grateful for the time that the Minister gave me with her and the deputy chief medical officer to talk about those changes, but when will there be a parliamentary opportunity to do so? We need to demonstrate that we have scrutinised this properly because the public want to know that we are talking about these things to the fullest extent. That would also allow us to address the point about immunity from civil liberty that the manufacturers and healthcare professionals are seeking, which is not surprising, but there are important and significant qualifiers around that not extending to sufficiently serious breaches. Will the Minister explain what a sufficiently serious breach would look like, or when we might have an occasion to talk about that further?

On vaccine hesitancy, it seems there are distinct phases. We have the anti-vax movement, which is about the substance of vaccinations to an extent, but it also about a broad range of other things. As our constituency mailbags will reflect, there is also a group of people who are hesitant, which is entirely understandable. They want to know that any vaccination, whichever one it is, is a safe one, but it is telling that last year the WHO had vaccine hesitancy in its top 10 threats to global health—up there with a future pandemic. That is something that we need to be aware of. We know that such speculation and the stuff that moves online at an incredible pace can really damage the process. For example, in Denmark in 2013 there were false claims from a documentary about the HPV vaccine, which led to a decline in uptake among some of the cohorts from levels of around 90%. Similarly, between 2014 and 2017 in Ireland, vocal attacks on the HPV vaccine from the anti-vaccine lobby led to a drop in take-up from 70% to 50%. These things matter. One thing that best counters them is proactive, positive health promotion campaigns. I am keen to hear whether the Government plan to talk about these things to educate the population ahead of time, but, again, it something that we all need to buy into, share and push out on a cross-party basis.

An area where I think there might be a little more room for divergence is delivery. We do not know what the future holds for the vaccine or when things will pop up, but it is reasonable to say that we expect one, and we know the scale of our population, so we have no reason not to have significant plans. When the Health Secretary was pushed on it this afternoon, he said that there were plans, but he was less forthcoming on what they were. I am keen for more detail. Whether it was PPE at the early stage of the pandemic or test and trace, frankly, throughout it, such big-scale planning and logistical exercises have not gone flawlessly. Qualifications could be made when they were being done for the first time, but we cannot repeat those mistakes now that we are, I hope, learning from what has happened.

Again, the Health Secretary has talked quite a bit today in the media and the Chamber about the importance of general practice. As I understand it, the BMA’s GP committee, NHS Improvement and NHS England have agreed an enhanced service for general practice to lead this process. That is good. People will want to see this delivered through the NHS rather than a private company, whether because they believe in its efficiency, as I certainly do, or whether in general they think that will reflect best in the population. That is a wise thing to do.

I understand that it is optional for practices to sign up, so may I get more detail from the Minister on that? If take-up is not good enough, will an alteration be considered? I also want to understand what assessment has been made about GPs’ capacity and workload. As I understand it, the programme requires participants to deliver at least 975 vaccinations over a seven-day period from each designated site—that will require 12-hour days seven days a week, including bank holidays. GPs are already busy, so I am keen to know about what assessments have been made about prioritisation.

I do not have enough time to talk about this properly, but I turn finally to the point made clearly by the hon. Members for Henley and for North Herefordshire: we have to come to an equitable settlement globally, too, and to play a leading role in global organisations as we do so.

[Peter Dowd (in the Chair)]

There will be multiple votes in the Chamber shortly. I call the Minister to speak.

Exiting the European Union

Alex Norris Excerpts

Wednesday 4th November 2020 Commons Chamber

[Alex Norris (Nottingham North) (Lab/Co-op)]

There are many great trios and trilogies—we think of the Marx Brothers, the Lord of the Rings or Ali and Frazier, culminating in the “Thrilla in Manila”. This week the Minister and I have had our own trilogy of debates—two upstairs and now one, the main event, in the main Chamber—on three statutory instruments that are pretty much identical, but with different names. I do not see many people from those Committees in the Chamber, so as well as being able to recycle my gags, I can recycle some of my points of substance; I am sure the Minister will forgive me.

These are technical, Brexit-related amendments, but they are also of life-saving importance. They refer to the safety and quality of blood and blood components, organs, tissues, cells and reproductive cells for treating patients. Among other technical changes, they will allow current regulators in these areas to continue as the competent authorities in relation to the EU for Northern Ireland. That is, of course, essential in both legislative and practical terms, so we will not be dividing on these regulations. It is vital that this and the rest of the protocol is implemented in good time. I asked the Minister for this on Monday and Tuesday, but, with fewer than 60 days to go, it is really important to put on the record his assurance that the rest of the protocol will be implemented in time.

The UK legislation for the safety and quality of blood organs, tissues and cells is, of course, based on European law. The European Union (Withdrawal) Act 2018 ensures that the EU-derived domestic legislation will continue to have an effect after the end of the transition period. In 2019, this House introduced regulations to ensure that UK legislation in this area could function effectively after the transition period. However, Northern Ireland will remain subject to relevant EU laws as a result of the protocol on Ireland and Northern Ireland, so today these four statutory instruments amend those regulations and allow Northern Ireland to meet European law. This seems to be an area where divergence would not be of great interest across Great Britain and Northern Ireland, so it would be helpful to have some assurance from the Government—again, I have raised this twice this week—that there are no grand plans for significant divergence in this area. Similarly, I wonder whether I might press the Minister on how these regulations will relate to the Medicines and Medical Devices Bill. During the Commons stages of the Bill, we pushed a human tissue amendment to stop unwillingly harvested materials from entering the UK. Clearly, these regulations will have a bearing on underpinning that amendment. We were not able to make much progress in this place, but I am happy to say that, this week, the Government Minister in the other place, during the Lords stages, has indicated a willingness to try to come to a common agreement on this. If we can find such cross-party support in the other place, will the Minister make a commitment to look at this with an open mind?

The OneBlood establishment in Northern Ireland, the Northern Ireland Blood Transfusion Service at Belfast City Hospital, will of course be able to continue to receive blood and blood components from similar establishments across the UK, but when this happens, Great Britain will be treated as a third country—as it will be. When the Minister was on his feet, I think he said that there would be no great frictions there, but I would like to understand that in practical terms and to have full assurances that there will not be a delay in the use of blood products and that patients will not be injured in waiting to receive them. I think that is something that requires a categorical assurance.

Regarding organs for transplant, we know that the NHS Blood and Transplant service will continue to be responsible for organ donation and retrieval in the UK. Between April 2019 and March 2020, 32 organs from deceased donors moved from Great Britain to Northern Ireland and 126 organs moved from Northern Ireland to Great Britain. Organs will continue moving from Great Britain to Northern Ireland, but, as before, Northern Ireland-based establishments will now be treated in Great Britain as a non-EU member for these purposes, so we need a firm commitment on the record that this will not, as I say, hinder our ability to move those organs. Clearly, there is a significant need for such an assurance as this is likely to continue on a significant scale.

The Human Tissue Authority says that human tissue establishments will need to vary their licences in order to continue their activities post-transition. This includes establishments that intend to import or export tissues and cells as the starting material for the manufacture of an advanced therapy medicinal product. That is extremely important, so what variance does the Minister foresee? Will there be delays? How will it happen? I wonder what consultation he has perhaps had with such centres.

I wish to make a final point on fertilisation and embryology. What disruption is expected to patient treatment as clinics adapt during the transition period? Can the Minister say what proactive support is being offered to those clinics to limit the impact on patients?

All of this would be much easier if we had a deal arranged. When these regulations were laid in 2019, my predecessor as shadow public health Minister, my hon. Friend the Member for Washington and Sunderland West (Mrs Hodgson), was saying then that there really was not much time to get a deal done, and that was 18 months ago. We have burned through those 18 months and are down to the last two, so, again, we would like a clear commitment from the Minister today that every effort is being made to reach a good deal for ourselves and for our partners, because that is what the British people were promised, and that is what the British people expect. In doing so, we need to make sure that disruption to such important things as those we have been discussing today can be avoided.

Draft Tobacco Products and Nicotine Inhaling Products (Amendment) (EU Exit) Regulations 2020

Alex Norris Excerpts

Tuesday 3rd November 2020 General Committees

[Alex Norris (Nottingham North) (Lab/Co-op)]

It is a pleasure to serve under your chairship, Mr Mundell, for the first time. As the Minister said, we discussed similar regulations yesterday, and we are heading for a third bout in our series tomorrow, which is proving so juicy that it will held in the main Chamber. So something for everyone.

[Matt Western (Warwick and Leamington) (Lab)]

The rumble in the jungle.

[Alex Norris]

Quite. I made that joke yesterday.

[Matt Western]

If only I had been there.

[Alex Norris]

Exactly; that’s what all they all said. It is a challenge not to repeat the content, especially not my gags, although some points may bear repeating. The regulations were the subject of very good exchanges in the other place yesterday, which as well as covering the minutiae of the subject also addressed important points about general tobacco control. I may refer to those exchanges briefly, but first I should like to echo what my predecessor, my hon. Friend the Member for Washington and Sunderland West (Mrs Hodgson), said 18 months ago when debating the 2019 regulations. She outlined how dangerous it was that so much planning was needed for a no-deal scenario, and yet there was so little clarity on a no deal at that point. She warned that with 18 months to go, it was far too close to the deadline not to know where we were going. Well, we are now 60 days away, and we still know very little more. That is concerning: the Government need to get the deal that was promised to the British people, otherwise there will be significant disruption.

As the Minister said, the 2020 regulations amend the 2019 regulations, and implement the Northern Ireland protocol of the withdrawal agreement to ensure that the UK meets its obligations on tobacco control policy under that agreement. They will ensure consistency between the requirements relating to tobacco products placed on the market before and after the end of the implementation period, change the fees payable by producers when reporting information about their products in order to account for such amendments in Northern Ireland and ensure that tobacco control legislation continues to work effectively at the end of the implementation period. To that end, I will not be forcing a Division on the SI, because we do not want to render the nation’s tobacco control policies ineffective. However, I want some reassurance on the Northern Ireland aspects and the smoke-free agenda generally.

As per the withdrawal agreement, Northern Ireland is obliged to rely on specific EU rules, but looking at the bigger picture, time is running out for the Government to implement the remaining elements of the protocol. Any update on when that is likely to happen would be helpful, because proper implementation is vital to the protection of the Good Friday agreement.

Whatever happens in terms of these regulations, and our exit from the EU, that must not slow down our journey towards smoking cessation. I live in and represent one of the most challenged communities on health inequalities in the UK, and half of our health inequality is smoking based. We could remove half of health inequalities at a stroke by achieving that smoke-free goal. To me, that is an absolute priority project for Government. If they want to talk about levelling up, smoke cessation is perhaps the best thing that could be done to achieve that. The Minister made an accurate, well-expressed point about the cross-party record on declining smoking rates in the past couple of decades, and we should all be proud of that. However, smoking still remains the biggest preventable cause of cancer and death. There is an awful human cost, as well as the treatment costs of £2.4 billion each year – cutting smoking represents a really big prize to us.

It was interesting to note the Cancer Research UK report, ‘Making Conversation Count’, which set out the health and economic benefits of improving smoking cessation support in UK general practice. It is worth a read, and I would be interested in the Minister’s reflections on it. Before I draw attention to couple of the report’s highlights, I want to make a broader point about smoking cessation.

Local authorities have been under exceptional financial challenges for a decade. We could have a big political conversation about the necessity or otherwise of that, but I am less interested in that today. What we know for sure, however, is that those challenges have led to a diminution in smoking cessation services. Those services are strongly evidence-backed, and save us money in the long run. It is the falsest of false economies that hard-pressed local authorities are having to make. That matters today, beyond the fact that in itself it is a bad thing, because as councils deal with the impact of covid—it is clear that the total cost to each and everyone of our local authorities will not be met by central Government and that that initial promise will not be met—they will have to make difficult decisions. I know that in Nottingham, and I suspect this will happen across the country, we will see in-year budgets. They are horrendous not least because to try to get a 12-month saving from a six-month budget means that councils have to cut twice as much. Councils can try to finesse reserves, but they are in short supply. I am very concerned, and I hope that the Department are keeping a watchful eye on the aggregate impact on smoking cessation services in this country. If we lose them, we will face significant challenges. I sense that I am in danger of my comments being ruled out of the scope of the regulations. Am I?

[The Chair]

Possibly; I am sure that you will return right back to the regulations.

[Alex Norris]

I am on the edge; I am coming back to the substance of the regulations, and how important it is that we do not weaken our approach to the smoke- free agenda. The Cancer Research UK report is worth reading. The target of being smoke-free by 2030 is equivalent to less than 5% of adults still smoking, which could prevent more than 400,000 smoking-related diseases, 90,000 premature deaths and 10 billion quids-worth of smoking-related health care costs. The price for us is significant.

To pivot back to the regulations, I want to refer particularly to the ban on tobacco products with characterising flavours. Those regulations came into force five months ago, but those products are still being produced and made available for sale. I understand that the Minister’s Department has instructed an investigation into that, which is welcome, but my sources tell me—I would love to be told that I am wrong, because I think it is extraordinary—that actually we waiting for the European Commission to make a decision on the matter. Does that mean that it is now Government policy that when we come to these regulations, and others, it is likely that we will wait for the EU to act and then we will take mirror action? If so, we will have lost our voice in that institution, just to wait to mirror it daily. I do not think that was what people were enthusiastic for, and certainly was not sold as a benefit of leaving the EU. I would be grateful to receive a commitment from the Minister that that is not so.

We will be in a much stronger position once we have a deal, and it is worrying that we are considering these regulations at a time of such uncertainty, when we still do not know whether a deal will be reached. The regulations before us underpin and are fundamental to the bigger prize of smoking cessation by 2030. I know that the Minister is committed to pushing us towards that, and I mirror that by saying that I am committed to reaching that target when we are in government in the latter half of the decade.

Draft Nutrition (Amendment etc.) (EU Exit) Regulations 2020

Alex Norris Excerpts

Monday 2nd November 2020 General Committees

[Alex Norris (Nottingham North) (Lab/Co-op)]

It is a pleasure to serve with you in the Chair, Ms Nokes. When I saw this SI come through, just before recess, my heart leapt a little to be considering secondary legislation not related to covid. Then I realised that it was related to Brexit and my happiness disappeared just as quickly as it had arrived.

When my predecessor, my hon. Friend the Member for Washington and Sunderland West (Mrs Hodgson), addressed the original regulations that we are amending, she began with a caveat on the danger of a no-deal scenario, and the danger that the Government were running out of time. It is incredible, and quite startling, that 18 months later we have no greater clarity. In many ways, the world seems an entirely different place. This Parliament certainly seems an entirely different place than it was 18 months ago; however, the issue is still there. This time last year, the Government were making very clear and un-caveated promises, which many hon. Members were elected on, about an oven-ready deal. They ought to, and must, deliver on that.

I am grateful to the Minister for his letter in recent days seeking our support on this issue, and I can confirm that we do not intend to divide the Committee. As he said, he and I are on this travelling tour. I believe we have secondary legislation to consider on Monday, Tuesday and Wednesday this week—a trilogy befitting Ali and Frazier, I would say. I do not think that the final one is in Manila, but I believe it is in the Chamber. It will be box office, but hopefully not £15 to watch.

As the Minister set out, it is important to make these regulations, and to change the references to the UK that there were under EU law to reference Great Britain instead. The Department of Health in Northern Ireland will not have the same functions transferred to it as the rest of the UK. The amendments will ensure that EU law continues to apply in Northern Ireland and the EU-retained law in England, Scotland and Wales will therefore be effective. I must say, again, that that breaks a spectacular number of Government commitments that we have heard in the Chamber on the treatment of Northern Ireland. I know that public interest has moved on, that we are upstairs, and that no one is watching, but frankly if any Government Members are really satisfied with that scenario and think that it is reputable and honourable way of doing things, frankly I disagree. That is no commentary at all on the Minister. He is an excellent Minister, who I hold in high regard, but this is extraordinary and really disappointing. Nevertheless, for us not to support these regulations today would render the regulations as a whole ineffective and would not be in the interests of the nation, so I will just pick up a couple of issues that I hope he can cover.

As per the European Union (Withdrawal Agreement) Act 2020, as we know, Northern Ireland is obliged to align with specific EU rules. Looking at the bigger picture, time is running out for the Government to implement the remaining elements of the protocol, which comes into force in less than 60 days. Proper implementation is vital for the protection of the Good Friday agreement, so could the Minister update us on progress with the rest?

We know that labelling, specifically, is a critical concern for food and drink manufacturers in Great Britain and Northern Ireland. As has been outlined, we will have different trading rules in Great Britain and Northern Ireland on 1 January, and there is a real risk that labelling used in Britain will no longer be legally recognised in Northern Ireland or on the continent. I seek assurance on the record from the Minister that that will not be the case, because that would be a significant concern.

I recognise what the Minister has said about stakeholders, but trading bodies have warned throughout the process that unless they get guidance in time they will not be able to prepare. As well as meeting their expectations on frictionless trade, will we also be able to meet their expectations on timeliness and being able to act and prepare?

I do not want to rehash the arguments over the United Kingdom Internal Market Bill, because that is the settled will of the House, but the point must still be made about the negotiation tactics, the threats to breach laws, the breaking of promises made in general elections and the tone that that will set in any future regulatory conversations we have at the Joint Committee if business is to get that certainty. Again, we must be responsible in the way we negotiate with our partners, because we are going to have to work with them in January, February and for centuries to come. We might be leaving the EU, but we are certainly not leaving the continent of Europe. Could the Minister give us an assurance that the protocol will be implemented urgently, so that the businesses that are asking us will have that reassurance?

In the previous airing of the original regulations, my predecessor in this role, my hon. Friend the Member for Washington and Sunderland West, raised her concerns over the impact on businesses, as some respondents to the consultations on the regulations had raised them and thought there was an underestimation of the burden of submitting health claims. The Minister has said today that there will be no burden, so I would like to just ensure that I have heard that right: no extra forms, no online forms, no virtual forms and everything basically the same on 1 January as it was on 31 December. That would be an important and welcome commitment.

I conclude by asking for an update on the preparedness of the UK Nutrition and Health Claims Committee and the relationship it will have with the European Food Safety Authority, whatever the outcome of ongoing negotiations. That is in our interests. There is one other thing; perhaps it is not an issue for today, but it is important and we have never quite been able to tease it out in the getting on for three-and-a-half years that I have been in this place. Throughout that time we have always wanted to know what is behind the curtain on divergence of regulations, so I urge the Minister to take this moment to tell us. We will have the chance to have different labels from Northern Ireland: why might we wish to do that and, if so, what will that be used for?

I repeat what I began with: this is all a lot easier when no deal is removed from the table, because it takes away the damaging uncertainty, focuses efforts and dials down the rhetoric. I hope we can see that and I hope the Minister can address some of the concerns I have raised.

Public Health

Alex Norris Excerpts

Wednesday 7th October 2020 Commons Chamber

[Alex Norris (Nottingham North) (Lab/Co-op)]

In recent weeks, Ministers and Opposition Front Benchers have met upstairs in Committee to discuss such covid-related statutory instruments. It is welcome that we are debating this in the main Chamber because it means that local Members of Parliament can scrutinise them also. With that in mind, I do not intend to speak for long and I will probably limit the interventions I take—one thing I know is not to disappoint a roomful of colleagues who want to talk about their community.

I will start with the good news. I have been critical throughout the pandemic about the time that it has taken between a statutory instrument being brought into effect, and it being debated. In one case there was a lag of nine and a half weeks. It makes a nonsense of parliamentary scrutiny if we rubber stamp measures months after they have come into effect. We must have a timely say, so that the British public can have confidence, and as the Minister said, this statutory instrument is just four days old—that is the good news.

The bad news is that SI 2020/1074 amends SI 2020/1010, which came into force on 18 September, although it is not to be debated until Monday. We are discussing amendments to secondary legislation, even though we are yet to discuss that secondary legislation. I am keen to hear from the Minister why things have happened in that order. Is it possible that the other SI is more controversial and is to be hidden upstairs and discussed after the fact? We have followed events over the past hour or so on the controversial SI on the curfew. That seems to have been pulled from upstairs entirely because it is coming downstairs. What on earth is going on? I hope the Minister can tell us so that we do not have to find out through anonymous briefings yet again. This is a reflection of rather chaotic, rather than competent, leadership.

I suspect that the Government are doing this to head off division in their own ranks, once again putting the interests of the Conservative party ahead of the interests of the country. I say gently to would-be rebels—I say this at every opportunity—that if they do not like the delegated powers in the Coronavirus Act 2020, they should wait to see the ones in the Brexit-related legislation. For example, as drafted, the Medicines and Medical Devices Bill will hand to the same Secretary of State virtually unfettered powers over our entire medicines regime in this country. I hope that when the time comes, Members will be as keen and proactive to ensure that those powers are used in an appropriate way as they have been with these secondary powers.

The Opposition do not oppose the substance of SI 2020/1074. We know that as infection rates increase, so will restrictions. In this case, Liverpool city region, Warrington, Hartlepool and Middlesbrough are being added to those areas where mixing indoors is barred, which is an inevitable part of rising infection rates. We in Nottingham are awaiting that same call this week.

[Ben Bradley]

The hon. Gentleman mentioned Nottingham and as a fellow Nottinghamshire MP I am interested in his views. A few minutes ago, my hon. Friend the Member for Redcar (Jacob Young) mentioned the granular and localised nature of those lockdown areas and being able to pick the areas where this is most effective. My constituents in Mansfield, with one seventh of the rate of transmission in Nottinghamshire, are faced with lockdown measures linked to that outbreak. Does the hon. Gentleman agree that it is important in those areas to consider local data, and not to impose additional restrictions on people where that might not be appropriate?

[Alex Norris]

I am grateful for that intervention and I share that view. I have seen the hon. Gentleman’s tweet this afternoon in which he is very clear about that. Like me, he will have followed local Nottinghamshire data closely, and there should be close consultation with hon. Members, and with leaders such as the Mayor of Mansfield, and the leader of Nottinghamshire County Council. A one-size-fits-all approach is not the best route scientifically, and it will also breed local discontent and mean that people might be less inclined to follow it. So I support the hon. Gentleman in that venture.

Although rising restrictions are an inevitable part of rising infection rates, there is nothing inevitable about the loss of control of this virus. The Government promised us a world-class test and trace system, but rather than building on tried and tested local options in local government, they pursued a big national private contract. It was a triumph for dogma at a time when we need evidence-based leadership, and of course it has been a debacle.

The Government had a chance to fix this at a time when infection rates were relatively low, but they failed to do so. They have now lost control of the virus entirely, and our people will lose freedoms as a result. Yesterday, I saw a Minister blame the British people for rising infection rates. I thought that was extraordinary. Our constituents have made incredible sacrifices over the last several months; they do not deserve to have the Government thumb their nose at them for it.

Frankly, the Government can deflect as much as they want, but it will not wash. I would like to hear from the Minister today what they are doing to get this right and when it is going to happen. No more being sent hundreds of miles for tests, no more delayed results, no more lost spreadsheets. Drop the ludicrous defence of the indefensible. Let us stop pretending it is all okay when it is obviously not.

I have debated a number of these statutory instruments, and it is striking that every one of them has related to the north or the midlands. Rather than levelling up, we risk entrenching the north-south divide in this country. It is no longer reasonable to say, either, that these are going to be short, sharp interventions.

[Graham Stringer (Blackley and Broughton) (Lab)]

My hon. Friend mentions that many of these lockdowns have been in the north of England and the midlands. Does he agree that the figures for Chorley, Wyre, Lancaster, Oadby and Wigston, Wolverhampton, and West Lancashire, where there is lockdown, hardly vary from those in areas where there is no lockdown that have Conservative MPs, such as Barrow, Darlington, Craven and Newark? It reeks of political bias rather than objective decision making.

[Alex Norris]

I am grateful for that intervention, and I am about to make a related point. There seems to be no direction for when an area might exit restrictions or, indeed, what it might need to do in order to do so. The Minister started by saying that the Government are following the best epidemiological guidance, but it is unclear, as my hon. Friend mentions, why some areas are in lockdown despite having lower infection rates than others that are not. Again, that breeds cynicism and frustration.

It is also true that these restrictions ought to be accompanied by greater economic support, as well as much clearer communication. Perhaps the Minister could be a trailblazer and do what the Prime Minister was unable to do by saying what a local community needs to do to exit lockdown and, in the meantime, what precisely is likely to be done to support it.

In conclusion, we do not oppose these restrictions, but we strongly oppose the incompetence that has led us here. British people have missed births, weddings and funerals to fight this virus. Now, more people will not even be able to go and see their parents or their grandchildren, because the Government have not got a grip. No wonder their patience is running so thin.