NHS Winter Update

Alun Cairns Excerpts

Monday 8th January 2024 Commons Chamber

[Victoria Atkins]

That is a very fair challenge, and I will look into it, given that the hon. Gentleman has raised it.

[Alun Cairns (Vale of Glamorgan) (Con)]

The Labour party has been running the NHS in Wales for the last 27 years. The shadow Secretary of State, the hon. Member for Ilford North (Wes Streeting), highlighted that he was frustrated with waits for ambulances, GPs and operations. I politely point out to him, and to other Members, that my constituents in the Vale of Glamorgan, and people across the whole of Wales, are waiting much longer for ambulances, GPs and operations. In fact, a quarter of my constituents, and a quarter of people across the whole of Wales, are on an NHS waiting list. I advise my right hon. Friend the Secretary of State that junior doctors and GPs are also in disputes in Wales, despite the claims made by Opposition Members. I therefore ask her to show some caution before taking advice from her shadow.

[Victoria Atkins]

I will follow that advice with great enthusiasm. I have another statistic for my right hon. Friend: the Labour-run Welsh Government were hiding 45,000 patients from their A&E waiting figures in the first half of 2023, and falsely claiming that they perform better than England. If that is the blueprint for how it runs things, we should all be very worried if Labour ever again forms a UK Government.

NHS: Long-term Strategy

Alun Cairns Excerpts

Wednesday 11th January 2023 Commons Chamber

[Wes Streeting (Ilford North) (Lab)]

I beg to move,

That this House condemns the Government for failing to recognise the current crisis in the National Health Service; regrets that, as a result of Government mismanagement, hundreds of lives may be being lost every week due to the collapse of emergency care while patients are finding it impossible to get a GP appointment, ambulance or operation when they need one; calls on the Prime Minister to acknowledge the crisis and act with the necessary urgency to mitigate the impact on patients; and further calls on the Secretary of State for Health and Social Care to ensure the NHS is never in this situation again by bringing forward a long-term strategy which will end delayed hospital discharges, provide the NHS with the necessary staff to treat every patient in good time, and reform primary and community care to reduce the number of people needing hospital treatment.

I rise to support the national health service, which is going through the biggest crisis in its history, and most importantly, to defend the patients who are suffering as a direct result of 13 years of Conservative mismanagement of the NHS. This winter has shown just how high a price patients are paying: NHS staff are walking out on strike—in the case of nurses, for the first time in their history—patients are waiting entire days for an ambulance to arrive, and then days on end in A&E before they are admitted; there were 50,000 needless, preventable deaths last year, which experts have blamed on unacceptably long waiting times; and there have been hundreds of avoidable deaths every week this winter, because emergency care has collapsed.

The Secretary of State for Health and Social Care says that he disputes those figures from the Royal College of Emergency Medicine and the Office for National Statistics, but I invite him to listen to some of the stories behind the numbers. An 89-year-old fell in the bathroom and waited nine hours for an ambulance. The sepsis that caused him to fall killed him. His consultant said:

“Had I seen him within a couple of hours it could have been avoided. Maybe.”

Teresa Simpson, a 54-year-old woman from Hull, suffered a cardiac arrest and lost oxygen supply to the brain. She waited 16 hours for an ambulance, which arrived only when her husband phoned 999 a second time, after she had become lifeless. She passed away. A consultant in the north of England described a scene in a hospital waiting room this winter when a patient collapsed:

“They get CPR on the floor. I am forced to declare his time of death in front of frightened, horrified members of the public and his wife. On the floor of the waiting room. He was elderly and frail and hadn’t wanted to bother us. We had run out of trolleys and beds. In the whole hospital. This was by 10am.”

The Prime Minister refuses to describe this as a crisis.

Our motion before the House calls for a long-term plan to end delayed discharges, give the NHS the staff it needs to treat patients on time, and reform primary and community care, so that fewer people end up in hospital.

[Alun Cairns (Vale of Glamorgan) (Con)]

Will the hon. Member give way?

[Wes Streeting]

The Government do not have a plan, but perhaps the right hon. Gentleman will surprise me by telling me, against all hope and expectation, that they do.

[Alun Cairns]

Clearly, some of the statistics and cases that the hon. Member highlights are distressing and no doubt need to be investigated. The Prime Minister has rightly prioritised waiting times as one of his key commitments this year. How does the hon. Member account for the performance in Wales, which is worse than in England on all the statistics that we highlight, in spite of the Labour party having been in charge of the NHS there for more than 20 years?

[Wes Streeting]

I am grateful for the right hon. Gentleman’s intervention, because it brings me directly to the Government’s amendment to the motion, which is not a plan but a litany of excuses for the situation across the United Kingdom, including in Wales. I will run through them. By way of excuse, they say that the situation is challenging across the United Kingdom, and they are right: in Wales, the NHS is struggling; in Scotland, the NHS is struggling; and in Northern Ireland, the NHS is struggling. What do all parts of the United Kingdom have in common? Thirteen years of Conservative underfunding.

I will tell the right hon. Gentleman that, as he knows perfectly well as a Welsh Member, the reason why the Welsh NHS struggles more than England overall is the age profile of the population, the number of disabled people in Wales and the level of deprivation. The same disparities between Wales and England overall also explain the enormous health inequalities within England, which is why health outcomes in my city—in London—are so much better than in so many parts of the north or south-west of England. And you know the way to deal with that? It is genuine levelling up. But if people want a Government who tackle health inequalities so that every person in every part of the United Kingdom gets good-quality healthcare, they need to elect a Labour Government here in Westminster. That is the truth that the right hon. Gentleman does not want to admit.

I know that SNP Members will not be here today, because we are talking about England, but here is another truth that Nicola Sturgeon does not want to admit either: people in Scotland will be better off under a Labour Government too. She knows that just as well as anyone else.

When Conservative Members are not talking about other parts of the United Kingdom, they say that health pressures exist right across the world, but international pressures do not explain why the average wait for an ambulance is 14 minutes in France, while heart attack victims and stroke victims routinely wait an hour for an ambulance here in England. International pressures do not explain why it is that, over the past year, one in six UK adults had a pressing need for medical examination or treatment but could not get access. They do not explain why this is the highest figure out of 36 European countries and almost triple the EU average. Their excuses about international pressures do not explain why cancer outcomes in England are behind other comparable countries. None of that explains why the state of the NHS is as bad as it is today, but perhaps the hon. Member for Bosworth (Dr Evans), who was trying to intervene, wants to stand up and justify why it is that, after 13 years of Conservative Government, his constituents are waiting an average of an hour for a heart attack or stroke case.

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[Alun Cairns (Vale of Glamorgan) (Con)]

I must admit that I was surprised by the audacity and tone that the hon. Member for Ilford North (Wes Streeting) took when introducing such an important debate. Not one Welsh Member of Parliament from the Labour party is present. I think they may share my disappointment in the tone the Labour party is taking over this serious issue, bearing in mind the performance of the Labour party and Government in Wales in failing to deliver on the NHS. Who knows, those Members might be embarrassed or angry; maybe they are angry and embarrassed at the hon. Member for Ilford North. I hope they are certainly disappointed by the performance, waiting times and outcomes for our constituents in Wales.

Tone really does matter. This is a really important debate, and we need to consider it in the way the Secretary of State recognised the issues facing every part of the United Kingdom. The Chairman of the Health and Social Care Committee, my hon. Friend the Member for Winchester (Steve Brine), also recognised that and urged the use of responsible language. This needs to be followed through. When I have highlighted deficiencies in the NHS in Wales in the past, I have been accused of undermining the NHS or attacking NHS staff. I hope I will not be accused of that now, as that is not my objective. I am instead frustrated with the Labour Government in Wales and the outcomes my constituents are experiencing. I make this contribution in support of the NHS staff, clinicians and all the apparatus that delivers an effective and efficient health service.

Much has been said about data and waiting times, and I could go on and on about that. No matter what statistic the hon. Member for Ilford North highlights, I could trump him every time with worse performance in Wales. I am not celebrating that, because my constituents and my family experience that performance. I am disappointed by the political tone the hon. Gentleman is taking in seeking to exploit the challenges facing the NHS and its staff having come out of a global pandemic. That is something we absolutely need to recognise.

I will highlight some statistics to encapsulate the experiences of my constituents and others in Wales. After 25 years of a Labour Administration in Wales, accident and emergency times, primary care delays, cancer treatment times and waiting lists are much longer than they are in England, or than they were previously. In England, 5% of patients are waiting longer than 12 months; in Wales, 23% of patients are waiting longer than 12 months. I will not bore everyone with lots of numbers, but I will take that to the next level of statistics: 7.9% of patients in Wales are waiting longer than two years for treatment. That is why Opposition Members have to accept and recognise that this a serious debate that affects every part of the United Kingdom, Europe and beyond.

[Simon Baynes (Clwyd South) (Con)]

Does my right hon. Friend agree not only that the statistics for Wales are markedly worse than for England, but that in Wales the expenditure per head on health is 15% higher than in England?

[Alun Cairns]

My hon. Friend makes an important point. The hon. Member for Ilford North pointed to the lack of funding for the NHS in Wales, but since 2010, only the Labour Government in Wales have ever cut NHS funding—no other Government in the UK have done that. When I was the Secretary of State for Wales, we renegotiated a funding formula that the First Minister, who was the Finance Minister at the time, said was a very fair deal. That formula means that Wales receives £120 for every £100 that is spent in England, and there is a funding floor attached to it. That highlights the generosity and fairness of the settlement, bearing in mind the inequality that the hon. Member for Ilford North highlighted earlier.

In my final minute, I will comment on the strike action. Every point that the Leader of the Opposition has made about the challenges of strikes, and every criticism that has been made of the Prime Minister and Secretary of State for Health and Social Care, could equally apply to the First Minister and Health Minister in the Welsh Government. That demonstrates the complexity of the situation. The Welsh Government say that they cannot act until they have more money, but they need to remember that they are getting £120 for every £100 that is made available in England, and they have tax-varying powers. Are they saying that they want to tax the English more in order to spend more in Wales? They can vary taxes however they want—[Interruption.] They can vary taxes and that is the choice that they have to make. They decide where they spend their money. In closing—

[Mr Deputy Speaker (Mr Nigel Evans)]

Order. Sorry, time is up. We have to be fair to everybody.

Health and Care Bill

Alun Cairns Excerpts

Consideration of Lords amendments
Wednesday 30th March 2022 Commons Chamber

[Edward Argar]

I am grateful to the hon. Lady not only for her comments just now, but for her work on this agenda and on HSSIB over many years on various incarnations of this legislation. She has a right to gently tweak my tail that I could have listened to her in Committee and got here faster, but as she will know, occasionally it takes a little time in Government to be able to move to the compromise that often we all seek.

Turning back to the advertising restrictions, the overall policy direction has been set out effectively through last year’s Government consultation response, this proposed legislation and the debate that has taken place in both Houses.

[Alun Cairns (Vale of Glamorgan) (Con)]

Will the Minister give way?

[Edward Argar]

If I may just finish this point. I suspect my right hon. Friend may speak later on the amendments tabled by my hon. Friend the Member for Buckingham (Greg Smith).

A consultation on secondary legislation will be launched shortly and consultations on the wider guidance to the restrictions, which will support industry and provide further clarity on what to expect, are anticipated later in the year. Therefore, we do not believe there is a need to incorporate a requirement in primary legislation to specify a gap between the date of publication of guidance and implementation of the restrictions, as proposed by my hon. Friend, but I look forward to hearing his speech later. I reassure him that the Government will of course continue to work closely with industry and with him to ensure that the transition is as smooth as possible.

[Alun Cairns]

I am grateful to my hon. Friend for giving way and he pre-empts some of my comments. Does he recognise the significance of the change to the broadcasting and advertising industries? It seems to me that the amendment tabled by my hon. Friend the Member for Buckingham (Greg Smith) is very reasonable in giving 12 months minimum for the industry to prepare for such significant changes.

[Edward Argar]

I am grateful to my right hon. Friend. I know him well but I was not sure if would be able to predict exactly what he was going to say, so I am pleased that I have managed, to a degree, to pre-empt him. I recognise the impact, and that is why we believe we have struck the appropriate balance, both in terms of the time for preparation and implementation, but I will of course listen to what my hon. Friend the Member for Buckingham says when he speaks to his amendments.

Finally, amendment 79 relates to the international healthcare arrangements clause, which amends the Healthcare (European Economic Area and Switzerland Arrangements) Act 2019 to enable the Government to implement comprehensive reciprocal healthcare agreements with countries outside the EEA and Switzerland. The clause will give the devolved Governments a power to make regulations giving effect to such agreements in devolved areas of competence. This minor and technical amendment to the definition of devolved competence and the consent requirement in new section 2B(2) reflects the fact that the consent of the Secretary of State under section 8 of the Northern Ireland Act 1998 is given in relation to an Assembly Bill, rather than an Assembly Act. It has no impact on the policy intention of the clause and I hope that hon. Members on both sides of the House will be content to pass the amendment.

On Report in the other place, the Government committed to accept in principle Lords amendment 95 to change the process for regulations that give effect to healthcare agreements, so they are subject to the affirmative resolution procedure. While we continue to support the intention of the amendment, I move that this House disagrees with Lords amendment 95 and moves an amendment in lieu, Government amendment (a). This amendment achieves the same objectives, but amends the international healthcare agreements clause rather than the regulations clause for the Bill to ensure that all regulations made under the soon-to-be-named healthcare international arrangements legislation are subject to the affirmative procedure. This includes any regulations made by the devolved Governments and achieves the objectives of the Lords amendment. This conclusion has been reached following constructive engagement with noble Lords for which the Government are extremely grateful.

In addition, to make parliamentary scrutiny of our healthcare agreements even more robust, we will set out a forward look in annual reports produced under section 6 of the 2019 Act, highlighting any agreements with other countries that are under consideration. We will publish all non-legally binding agreements and their associated impact assessments. I urge the House to accept all those Lords amendments as beneficial to the public and the NHS.

Although I have sought to compromise and reach agreement on many areas, I am afraid that there are a number of Lords amendments that we urge the House to reject. First, let me deal with Lords amendments 85 to 88. I pay tribute to the work of my hon. Friend the Member for Harrow East (Bob Blackman), the chair of the all-party group on smoking and health, for its proposals to help the Government to achieve a smoke-free country by 2030. However, the Government cannot accept these Lords amendments, because the proposals would be very complex to implement, take several years to materialise and risk directing a lot of Government resource into something that we do not see as a sustainable or workable way to fund public health. This would also rightly be a matter for Her Majesty’s Treasury.

The Javed Khan review is under way and I encourage colleagues to wait patiently for that and to be guided by what emerges from it.

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[Greg Smith (Buckingham) (Con)]

I will be as quick as I can, Mr Deputy Speaker. The point underlying my amendments to Lords amendments 123 to 127 is relatively straightforward and simple. I heard what the Minister said in his opening remarks, but I feel that if we act in a way that impacts an industry—in this case, UK broadcasters—as severely as the advertising restrictions will, and we are talking about a £200 million a year loss to our great British broadcasters, it is a matter of fairness and equity that we should give them enough of a lead-in time, enough notice and enough ability to adapt, remodel their services and find a way of surviving, to put it bluntly.

I have spoken before in the House about the fact that I do not agree with the nanny state and telling advertisers what they can and cannot advertise. The Lords amendments that we are considering, and my amendments to them, are very much about the implementation of a policy, and about giving British broadcasters—public service and fully commercial ones alike—a fighting chance. It would be much fairer to give broadcasters at least a year to comply from the point at which Ofcom publishes its guidance and puts it in the public domain. Broadcasters and advertisers will have to go through a lot of processes once this Bill receives Royal Assent, and that cuts the time that they have to put in place new policies, compliance checks and mechanisms to comply with the legislation. Two months on from Royal Assent, Ofcom will not even have got its statutory powers in this regard, and so will not even be able to start work with the Advertising Standards Authority and other bodies on the detail, and the ways and means of implementation.

[Alun Cairns]

I strongly support the amendments that my hon. Friend has tabled. Does he agree that the definition of some of the products, and the work that needs to be done, needs to undergo significant consultation, because of the way in which the efficacy, strength and merits of the policy will be judged?

[Greg Smith]

I am grateful to my right hon. Friend for that point, as the argument that I am making is very much that these things take time. Two months on from Royal Assent, Ofcom gets its statutory powers. Only then can it start the consultation, and the work of defining the restrictions on advertising that come under the broad categories in the Bill. Let us assume that two months on from Royal Assent is some time in the next couple of months. There would then be 10-week or perhaps three-month consultations to get the detail right, for a go-live date of 1 January 2023. That does not give our broadcasters sufficient time to put in place their processes, remodel their whole service, and find a way of working when they are so many hundreds of millions of pounds down on their operating models.

Elective Care Recovery in England

Alun Cairns Excerpts

Monday 7th February 2022 Commons Chamber

[Edward Argar]

The hon. Lady makes an important point. Orthopaedic surgery, for want of a better way of putting it, is a hugely important part of the planned care and surgery that the NHS does. Although it does not have a direct impact on someone’s life chances in the same way that oncology does, it certainly affects their quality of life and their ability to enjoy it. I hope that I can give her some good news: I believe that I am due to meet Versus Arthritis, with which I have spoken in the past, later this week to discuss its work in this space and its ideas on how we can incorporate that in our work.

[Alun Cairns (Vale of Glamorgan) (Con)]

One in nine people in England are on a waiting list, which is clearly too high. I take confidence from my hon. Friend’s statement and the constructive tone with which he is responding. The figure in Wales is one in five. Does he share my disappointment and dismay at the tone that has been taken by the shadow Front-Bench team in particular, when waiting times in Wales are much longer and the number of people waiting is much higher?

[Edward Argar]

My right hon. Friend makes an important point, which was made by my hon. Friend the Member for Bridgend (Dr Wallis) earlier. I am sure that the shadow Secretary of State will be asking his colleague in the Welsh Government where their plan is.

Covid-19 Update

Alun Cairns Excerpts

Monday 13th December 2021 Commons Chamber

[Sajid Javid]

It absolutely is. Work on this is being led by Lucy Chappell, in particular, in my Department and the UKHSA. One of the central focuses of her work has been to encourage more pregnant women to come forward and take up the offer of the vaccine. As the hon. Lady says, sadly, when we look at the data on pregnant women who are going into hospital because of covid infections, we see that almost all of them are unvaccinated.

[Alun Cairns (Vale of Glamorgan) (Con)]

I pay tribute to my right hon. Friend for the speed and efficiency with which he, the Government and the NHS are rolling out the booster programme. Does he share my concern that the roll-out of the programme is somewhat slower in Wales? There is no access to walk-in centres, no online booking system and the local health boards are depending on Royal Mail when the postal system is under the greatest pressure because of Christmas and because of staff off with covid. Will he agree to share the expertise and capacity that the UK Government have built up in the most positive way with the devolved Administrations—specifically with the Welsh Government —so that my constituents can receive the same access as his?

[Sajid Javid]

I very much agree: the omicron emergency is UK-wide and all parts of the UK should respond by increasing whatever they are doing on the booster programme further. I think that that view is shared throughout the UK. We will provide more support to Wales, Northern Ireland and Scotland to make sure that they can increase their booster programmes.

Covid-19 Update

Alun Cairns Excerpts

Monday 29th November 2021 Commons Chamber

[Alun Cairns (Vale of Glamorgan) (Con)]

I congratulate my right hon. Friend on taking swift and efficient action in relation to the additional protections that are necessary, but when he reviews, as more data becomes available, the wearing of face masks and the additional restrictions that he has introduced, will he consider real-life scenarios? He has heard the calls from Opposition Members for mask wearing and working from home. Is he aware that in Wales those measures have been in place since the summer, yet infection rates are still much higher?

[Sajid Javid]

My right hon. Friend is right to raise the difference between Wales and England in the approach taken. I feel—like him, I think—that we have taken the right approach to face masks. I welcome his support today.

Health and Care Bill

Alun Cairns Excerpts

Report stage
Monday 22nd November 2021 Commons Chamber

[Greg Smith]

I am grateful to the hon. Gentleman for his intervention. If he will let me make a little more progress, I think he will find that my amendments seek to put a harsher perspective of this on the online platforms, rather than letting anyone off anything whatsoever. I repeat that my fundamental position is one of opposition to the nanny state and restrictions, but recognising that if the Government are going to push these restrictions forward, we have to have fairness and parity across broadcast and online sectors, otherwise there will be loopholes, things will fall through the cracks and the Government will not achieve their objectives.

[Alun Cairns (Vale of Glamorgan) (Con)]

I certainly support the argument that my hon. Friend is putting forward. Does he feel that the Government have found themselves in a position where they feel they need to react because of the genuine obesity crisis among young people and this would seem to be the highest-profile publicity effort, but that really we should be focusing on the evidence of the case and the argument, so that we can actually have an impact on it, rather than steal the headline that might just last a couple of days?

[Greg Smith]

My right hon. Friend has hit the nail on the head: if we are to tackle obesity as a country, we have to look at the most successful outcomes. Fundamentally, I believe those to be ones of education, ensuring that parents are empowered to be able to make the best decisions for their children and ensuring that people are empowered to come to the right choices for themselves. The point about these amendments is to ensure that we are not giving a green light to one side while harshly penalising another for hosting these adverts.

The nub of the point is that the broadcasters will, in effect, have to pre-clear any advertising that is put on to their platform and there will be very harsh penalties, leading right up to the point of revocation of their broadcast licence, if they fail to do this. By contrast, although the Bill puts significant restrictions on the online platforms, they are not put through that same test. They are not put through the same harsh restrictions and requirements that are broadcasters are. This is especially important when we consider recent evidence that has been put into the public domain. The Advertising Standards Authority recently drew considerable attention to the mass flouting of the rules by online influencers across many sectors. This House’s Select Committee on Work and Pensions made an important point about online regulation in a report in March this year on protecting pension savers. It said:

“Regulators appear powerless to hold online firms to account”—

for online advertisements—

“in the same way they would be able to for traditional media.”

We need to bear that in mind as we consider this Bill, because if current regulations do not work in that field, I fear that the regulations on online providers proposed in this Bill will not either.

I offer these amendments as a call to those on the Treasury Bench, including the Minister for Health, my hon. Friend the Member for Charnwood (Edward Argar)—an excellent Minister who will consider these points carefully—to rethink the practicalities of what we are saying to the broadcast and online sectors. If the Government are intent on pushing this forward, I ask them to find that parity that ensures that broadcasters are not unfairly penalised. Great British broadcasters—ITV, Channel 4, Channel Five, Sky—already produce some incredible educational programming about diet, cooking, wellbeing and lifestyle. It would be horrendous for us to cut off their lifeline of funding.

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[Alun Cairns]

I have listened carefully to the hon. Member’s comments about waiting times in England and the measures that are to be introduced here. He urged disquiet; can I assume that his disquiet is even louder when he considers my constituents in Wales who have much longer waiting times?

[Alex Norris]

There is a danger that the right hon. Gentleman has missed the point. The reality is that for a decade there has been historically low investment in our health service, which of course has Barnett consequentials for Wales. That is the reality and why the system is as distressed as it is. I do not think he can put that at the door of the Welsh Government.

Let me come back to public health. Over the past five years we have removed £1 billion in public health funding, which means that the challenges in respect of childhood obesity, smoking, sexual health and access to drug and alcohol services are all developing and growing. The sad thing is that such cuts make an immediate local government saving for the Treasury but create greater costs for the public purse later, never mind the impact on people’s lives. They are the falsest of false economies. For all the talk of the end of austerity, last month’s Budget did nothing to tackle that reality. Indeed, local authorities are under greater pressure and the cycle will continue.

Being smoke-free by 2030 is a major national prize, and with that I turn to new clauses 2 to 11, tabled by my hon. Friend the Member for City of Durham (Mary Kelly Foy). She made an excellent case and has shown tremendous leadership on this issue, in concert with the hon. Member for Harrow East (Bob Blackman), through the all-party parliamentary group on smoking and health. They have given the Government a number of really good ways to improve our nation’s efforts and I hope we will hear from the Minister that they will be taken on.

Tackling smoking is a crucial part of not only improving the nation’s health but addressing health inequalities. A child born where I live, Nottingham, can expect to live seven years fewer than a child born here in Westminster. When it comes to healthy life expectancy, we can expect that difference to double. Tackling that inequality should be a core part of the business of this place. Nearly half that inequality is attributable to smoking—that is how pivotal this issue is.

Successive Governments have shown over the past 25 years that we can make inroads with public policy on smoking, but the benefits have been unevenly felt: the smoking rate among those in professional occupations is now down to just one in 10, so is well on track to meet the 2030 target, but incidence rates among those in manual or routine occupations remain a stubborn one in four, so we must now renew our efforts with that group of people who are, of course, disproportionately likely to use stop smoking services—the very services we have lost over the past decade. Of course, as my hon. Friend the Member for City of Durham said, the pandemic has posed new challenges, with a new group of people who have started smoking but would not otherwise have done so.

We have been promised a new tobacco control plan by the end of this year, but that promise looks a little less secure by the day—I hope the Minister will tell me I am wrong. We could get on with impactful interventions right away. The labelling and information interventions set out in new clauses 2 to 4 have very strong evidence bases from other countries, as my hon. Friend the Member for City of Durham said, and would be quick, easy to implement and impactful.

On new clause 4 in particular, we know that e-cigarettes and vaping are important quit aids, but we would not want them to be a gateway for children to smart smoking. We should be concerned about the 2021 YouGov research for ASH—Action on Smoking and Health—that suggests that more than 200,000 11 to 17-year-olds who had never smoked previously had tried vaping this year. As my hon. Friend the Member for City of Durham said, we must make sure that that age group does not take smoking through that route and that products are not targeted at it.

New clause 5 would tackle the bizarre loophole, which colleagues sometimes struggle to believe is true, that would allow the egregious practice whereby e-cigarettes or similar kit could be given free to someone under 18, although they cannot be sold. That is an extraordinary part of the law and I know that the Minister agrees it is daft—he said that in Committee, but also that he did not feel there was quite the evidence that it was a risk. Well, risk or not, I think the loophole should be closed, because I suspect that eventually someone will happen on it as a bright idea.

New clauses 8 and 10 are a beautiful support to any Minister who wants to improve smoking outcomes in this country, as I know this Minister does, but is conscious about the finances. This gives the Minister a chance, through a US-style polluter pays model, to fund all these interventions, including the restoration of the lost smoking cessation services in this country. He did not close the door to that in Committee when we talked about it, so I hope that he might tell us today that it is likely to form part of the new tobacco control plan. New clause 11 promotes a consultation on raising the age of sale, as we know that the older a person gets, the less likely they are to start smoking.

Let me turn to new clauses 15 to 17 and amendments 11 to 14 in the name of my hon. Friend the Member for Liverpool, Walton (Dan Carden). Colleagues will have been profoundly moved to hear him speak of his battle with alcoholism, and I know that his bravery has connected with people across the country. I associate myself with the remarks of my hon. Friend the Member for City of Durham regarding his entirely understandable absence from the Chamber today. With him in mind, I speak in support of those new clauses and amendments.

New clause 15 seeks to improve alcohol product labelling. This is overdue and it is popular. It is about not taking alcohol products out of people’s hands, but instead making sure that they can make an informed choice.

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[Edward Argar]

I am grateful to my right hon. Friend. It has been a while since he intervened while I was at the Dispatch Box, so this has been a pleasure. I have never seen him as in any way a puritan; I suspect that he is rather more a cavalier in his approach to life.

My hon. Friend the Member for North East Bedfordshire has also tabled amendments to schedule 16 which would insert in the Bill an exemption from the advertising restrictions for brand advertising. I am grateful to him, but I can reassure him that the Bill already delivers that exemption, and I therefore believe that his amendments are not necessary to achieve the effect that he seeks. We made that clear in the consultation response published in June this year, and in speeches made in Committee.

My hon. Friend has also tabled new clause 14. As I am sure he and other Members are aware, the Government consulted on different approaches for restricting online advertising in 2019, and considered alternatives submitted through the consultation process. However, it was felt that the alternatives, including the proposal from the Committee of Advertising Practice to use a self-regulatory mechanism based on targeting, were sufficiently similar to the policy options previously consulted on. These were not sufficient to meet the objective of the policy, namely to protect children from advertisements for less-healthy food and drink.

[Alun Cairns]

Does the Minister accept that there is a significant inconsistency between the approach to television broadcasters and the approach to those who use social media and online provision, and that a consistent approach would help? Does he also accept that a considerable array of views has been expressed by those seeking to help him to develop the Bill in a positive way, and will he maintain an open mind as it passes through the other place to establish whether it can be refined to achieve some of these objectives?

[Edward Argar]

I hope I can reassure my right hon. Friend, and other Members, that I always seek to maintain an open mind, and always seek to reflect carefully on the contributions made by Members. I will turn shortly to the challenges posed by television, which is essentially a linear broadcasting medium, in comparison with those posed by online broadcasting. I am conscious that I must conclude my speech before 7 pm.

There is evidence to suggest that the targeting of online adverts does not account for the use of shared devices and profiles between parents and children, the communal viewing of content or false reporting of children’s ages. This, combined with concerns about the accuracy of interest-based targeting and other behavioural data as a way of guessing a user’s age and a lack of transparency and reporting data online, shows why the Government believe that we need to introduce strong advertising restrictions online. Any alternative proposals would therefore need to meet a high bar in terms of protecting children online, and we consider alternatives that rely on a targeting approach to be—currently—potentially insufficient to meet the policy objectives.

Amendments 106 to 109 are relevant to the point that my right hon. Friend has just made. I am grateful to my hon. Friend the Member for Buckingham (Greg Smith) for raising these matters. His amendments mean that liability for online advertisements found to be in breach of the restrictions included in the Bill would shift to become the responsibility of the platforms rather than the advertisers, which some may see as providing parity with the enforcement mechanisms for broadcast television.

During the 2020 consultation, we considered whether other actors in the online advertising sphere should have responsibility for breaches, alongside those of advertisers. However, we concluded that this was not the right place to consider that broader issue.

The online advertising ecosystem is complex and dynamic. The scale and speed of advertising online, as well as the personalised nature of advertising and the lack of transparency in this system, makes it difficult for platforms to have control over what is placed on them. The approach that we are taking in the Bill best aligns with the current enforcement frameworks across TV, online and on-demand programme services advertising, and is familiar to industry. It will ensure that there is limited confusion for broadcasters, platforms or advertisers, as the liable parties for less-healthy food and drink product advertising breaches will be the same as those for any other advertising breaches. The Government intend to consider this issue as part of the wider online advertising programme, on which the Department for Digital, Culture, Media and Sport will consult in the coming months.

Obesity Strategy 2020

Alun Cairns Excerpts

Thursday 27th May 2021 Commons Chamber

[Alun Cairns (Vale of Glamorgan) (Con)]

Thank you for inviting me to contribute to this extremely important debate, Mr Deputy Speaker. I pay tribute to my hon. Friend the Member for South West Bedfordshire (Andrew Selous) for securing the debate, and to the way in which the Minister and the Opposition spokesman have contributed so far. Obesity rates are too high, without question, and the long-term consequences include a range of diseases: covid, which has already been mentioned, dementia, cancer, diabetes, heart disease, liver disease and so many more. The need to tackle obesity therefore goes without saying.

The challenge of obesity and its consequences among young children naturally has a very long tail. Introducing policies to meet the childhood obesity challenge naturally requires an understanding of the complexity of the causes if we are to have a real impact on the effect. Diet is obviously central to what we need influence, but it is not the full story. Contributing to the make-up of the diet there will be a series of complexities, and there needs to be clarity around the content of food products. I pay tribute to the work that the Government are doing and what they have committed to do in the Queen’s Speech, and to the work that has been done on labelling and on the sugar tax, which has contributed to a reduction in sugar in fizzy drinks and other products.

Knowledge and skills are important, including, for example, on the availability of fresh vegetables. Fruit and vegetables are obviously important, as is knowing how to cook. Standards and approaches in schools are also difficult. We need education in schools and among parents, who are also central to tackling childhood obesity. Lifestyle is an issue. The slower lifestyle through the lockdown period has enabled many people to address their own weight, but others have not done so. All of these issues naturally have complexities associated with them. Exercise is clearly also an issue, as well as eating disorders, which have been highlighted. I am trying to highlight the complexity of all that we need to face.

With these points in mind, I ask the Minister to consider the cause and effect directly, as well as the focus that has been given to the advertising industry and the marketing of food products, to establish whether it will have the desired impact. Whatever action we take, we must be sure that it will make a difference. There have been calls for many years for a television advertising ban. I can remember it being discussed in Cabinet and being resisted because the evidence was unconvincing. We need to consider that, although there is a call for a television advertising ban, habits have changed. Very few children these days watch television in the way that we might have done when we were younger, and that demonstrates the further complexity of the debate. Displacement is another issue. Advertising is more likely to move online, and I think all Governments recognise the challenge of tackling advertising online. Finding a solution is much more complicated when dealing with things online, as we have seen from the example of Governments struggling to tackle adult content online being accessed by children.

In the very limited time I have, I want to ask the Minister to look at the consequences, both positive and negative, and to question whether one will outweigh the other. I ask her to engage with the industry to see whether a solution can be found in which the industry itself, including broadcasters and online advertisers, can support the Government’s aims.

--- Later in debate ---

[Mr Mark Harper (Forest of Dean) (Con)]

As I said in my interventions on the Minister, I very much support the Government’s objective. A situation in which 36% of adults in England are overweight and 28% are obese is not good, and there are many health consequences of it, but my view is that, fundamentally, we need, first, to enable people to understand whether they are overweight or obese. That might sound like a foolish thing to say, but there is some evidence that people do not recognise whether they or those around them are overweight or obese, and are not very good at working that out.

Secondly, we need to make people understand the health consequences of being overweight or obese. The Minister talked about incentives. The real incentive that people should have is that they want to be healthier. Unless individuals themselves want to be healthier and move towards a healthy weight, it seems to me that we will not get very far.

Frankly, getting to a healthy weight means having a healthy diet. It does not mean going on a diet and then going back to unhealthy eating; it means changing diet permanently. In many cases, it means making not dramatic changes but small changes that people stick to, such as reducing portion sizes. It is about reducing treats and things we like, not getting rid of them. When I eat, I like all the bad things, but I have become better as I have got older—I have needed to—and now I am a bit more controlled about how many times I have them. I watch the size of my portions, because as I have got older, I have had to watch what I eat.

It seems to me that it is about diet, not about individual foods. As my hon. Friend the Member for Buckingham (Greg Smith) said, demonising individual foods is not a very successful strategy. There are plenty of things that I like that would individually be very unhealthy, but I just do not eat them very often. That is where we need to get to: people need to understand what a healthy weight is, understand the health consequences and want to get there themselves.

I have a couple of questions for the Minister. She spoke about the evidence for out-of-home labelling. The impact assessment is a rather weighty document of 76 pages, but one of the things that I learned as a Minister is that it is worth plodding through such documents. There is lots of useful information in it, but I did not find any compelling evidence that introducing out-of-home calorie labelling would have any significant impact on the quantity of calories that people consume. Given the concerns that the hon. Member for Bath (Wera Hobhouse) and the charity Beat have rightly set out about those with eating disorders, the case for its successful impact is not very compelling. There is quite a lot of concern that it will not be helpful, so I think the Government ought to think again about their approach.

I also have a question about the soft drinks industry levy. The levy has been successful in reducing the amount of sugar consumed; in my constituency, Suntory Beverage & Food Great Britain and Ireland, which produces Lucozade, Ribena and Orangina, has led the industry in taking more than 50% of sugar out of its products. It has also invested £13 million in new machinery at its Forest of Dean plant to produce those products—I was very proud to launch the new production line. However, although we have reduced the amount of sugar consumed, I have seen no evidence that we have therefore reduced the quantity of calories consumed or made any impact as a result.

[Alun Cairns]

My right hon. Friend is making a very effective, cogent argument. Does he agree that because there is a will to come up with a solution that will have an impact, there is a danger that unless we take account of all the evidence, including his points about the impact of the sugar tax, we might well feel better for doing something, but not quite achieve what we set out to achieve?

[Mr Harper]

That is right. I am very keen that we look at the evidence. I can see that through reformulation we have led the industry—the company that makes Lucozade and Ribena has been successful in doing that—but the real question is whether that has reduced the number of calories consumed, both by adults and by children, and had any impact on the number of people who are overweight or obese. It has clearly been successful in reducing the quantity of sugar consumed, but as my hon. Friend the Member for Buckingham said, sugar in itself is not a bad thing; people need to consume a certain amount of sugar to have a healthy diet. My worry is that we have reduced the amount of sugar in these products, but that will not actually make any difference to whether people have a healthy diet.

All these measures need to be tested. The point that I was making to the Minister earlier is that I do not want us to introduce them, wait nine years until 2030, and then say, “Goodness, it hasn’t worked.” I absolutely accept the Minister’s point that national targets may not make sense, but we need to look, at a local level, at whether the measures are successful. If they are not working, we need to change them and look at what the evidence suggests would be more successful in getting people to a healthy weight so that we all lead a healthier lifestyle.

Covid-19 Update

Alun Cairns Excerpts

Monday 5th October 2020 Commons Chamber

[Matt Hancock]

The hon. Lady makes a really important case. First, as she implies, we obviously have to put the testing capacity into the areas with the biggest outbreaks to tackle those outbreaks. I think everybody understands that. At the same time, we have to increase testing capacity, and we are doing that. But thirdly, if an area has lower testing than another area, we have to make sure that we take that into account when we look at how serious the problem is. We do that in two ways. The first is the positivity rate—what proportion of tests come through positive—and the second is the survey data, particularly the Office for National Statistics survey, which shows that rates in London are higher than in some parts of the rest of the country, such as the south-west, the south-east and East Anglia, but not as high as in the midlands and the north of England, or indeed in Scotland, Wales and Northern Ireland. We have to look at the surveys and the positivity, as well as the basic case rate.

[Alun Cairns (Vale of Glamorgan) (Con)]

I recognise my right hon. Friend’s focus, attention and efforts in responding to the ever-changing covid situation. Does he recognise that there are currently myriad different forms of restrictions across different parts of the country and that can become confusing? What consideration has he given to simplifying the approach to the restrictions? In doing so, would he ensure that any simplification applies to every part of the UK?

[Matt Hancock]

The short answer is yes. The proposals that we are working through and that I will bring to this House are to have a more simplified approach to the local action that we took. We have shared that approach with the devolved Administrations. Indeed, I have discussed it with Vaughan Gething, my opposite number in Wales. It is the sort of approach that would simplify matters further were it undertaken across the UK, but that is a decision for the Welsh Government in Wales, and for the other devolved Administrations, because public health decisions are devolved. I urge the Welsh Government to continue working with us. I urge my right hon. Friend, who is a very strong voice in Wales, to try to persuade the Welsh Government to take that sort of approach across the whole of the Principality.

Oral Answers to Questions

Alun Cairns Excerpts

Tuesday 1st September 2020 Commons Chamber

[Edward Argar]

My hon. Friend quite rightly raises the Diana, Princess of Wales Hospital in Grimsby. He has raised it with me before, and I give him that commitment.

[Alun Cairns (Vale of Glamorgan) (Con)]

What steps his Department is taking to reduce obesity rates.

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

The Prime Minister is clear that we must care for the health of our population. In July, we published the ambitious strategy to empower adults and children to live healthier lives, taking forward actions from the previous three chapters of the childhood obesity plan and laying out a series of initiatives. It sets out an overarching campaign to reduce obesity and has measures to get the nation fitter—to protect, importantly, against covid-19, to protect the NHS, but most importantly, to improve individuals’ health and wellbeing and quality of life.

[Alun Cairns]

There is strong support for the Government’s ambition to reduce obesity among children and young people, in particular. There are many calls for advertising bans for broadcasters for high salt and sugar content, for example, but those are not as straightforward as is suggested, because there is the risk of driving advertising online, which is far more targeted and, as some believe, might be much more effective in communicating the message to attract people to buy those products. Does the Minister recognise that this is a complex picture that needs lots of analysis before clear policies are decided upon?

[Jo Churchill]

I thank my right hon. Friend for that question. I know that as a keen marathon runner, he has a keen interest in us all keeping fit. I could not agree with him more: our children’s online watching is considerably greater than their watching of terrestrial television, and that is precisely why we have included a consultation in the online space to ensure that we have fully considered all the impacts that he just mentioned before we move forward and any changes to advertising restrictions before they are introduced.