Under-age Vaping

Andrew Gwynne Excerpts

Wednesday 12th July 2023 Commons Chamber

[Andrew Gwynne (Denton and Reddish) (Lab)]

I beg to move,

That this House is concerned that children are being inappropriately exposed to e-cigarette promotions and that under-age vaping has increased by 50% in just the last three years; condemns the Government for its failure to act to protect children by voting against the addition of measures to prohibit branding which is appealing to children on e-cigarette packaging during the passage of the Health and Care Act 2022 and for failing to bring forward the tobacco control plan that it promised by the end of 2021; and therefore calls on the Government to ban vapes from being branded and advertised to appeal to children and to work with local councils and the NHS to help ensure that e-cigarettes are being used as an aid to stop smoking, rather than as a new form of smoking.

It is a pleasure to open this debate on behalf of His Majesty’s Opposition. We are witnessing an incredibly alarming rise in under-age vaping. In many ways, the statistics speak for themselves. A recent study conducted by Action on Smoking and Health found that in the last three years alone, the number of children taking part in so-called experimental vaping has increased by 50%. That has come alongside significant growth in awareness of e-cigarette promotions, with 85% of children now conscious of e-cigarette marketing either in shops or online.

What does that promotion look like? If hon. Members walk down any high street in the country and pop into a vaping shop or off-licence, they will see it at first hand. Brightly coloured e-liquids with names such as “blue razz”, “cherry cola” or “vampire vape” line the shelves. Some liquids are even designed to imitate well-known brands. We can find “Len & Jenny’s mint Oreo cookie” alongside “pick it mix it sherbet lemons”. In fact, it really is not an exaggeration to say that some stores selling vapes resemble old fashioned sweet shops, with pretty much any flavour we can think of covered in cartoon-led packaging. Let us make no mistake, this is not packaging marketed towards adults. It is deliberately designed to appeal to children and, most concerningly, it appears to be working.

[Stella Creasy (Walthamstow) (Lab/Co-op)]

Like my hon. Friend, I have been horrified to see custard, banana, bubble gum and doughnut-flavoured vapes, clearly targeted at younger palates. They are clearly not about helping people cease smoking. One of the challenges is that we know children are increasingly moving from vaping to actual cigarettes. Does he agree that there is no case for any further delay in the Government’s work to look at how we take vapes out of the hands of young people all together? Our generation all fought so hard against Nick O’Teen; now, we have Mr Vape to deal with. Does he agree that it must be an urgent public health priority?

[Andrew Gwynne]

My hon. Friend is absolutely right. There is a place for banana, custard and even doughnuts, but that is not on a vape package. She is right that we need to close the loophole and protect children’s health. That is why we have tabled this motion.

In a recent evidence session on youth vaping, Laranya Caslin, the headteacher at St George’s Academy in Sleaford, told the Health and Social Care Committee:

“we have a significant proportion of students vaping. They vape regularly”.

The problem is so bad that St George’s has had to change smoke sensors to heat sensors, to clamp down on young people leaving the classroom to vape.

I would love that to be an isolated case, but we all know, across the House, that it is not. In Hartlepool, concerns have been raised about an increase in primary school children using vapes—that is just shocking. In Devon, schools have reported confiscating e-cigarettes from children as young as seven. Those claims seem to be reinforced by the fact that last year 15 children aged nine or under were hospitalised due to vaping, with health experts warning that the excessive use of e-cigarettes in children could be linked to lung collapse, lung bleeding and air leak. In Yorkshire and the Humber, it is estimated that 30% of secondary school students have tried vaping, which equates to around 109,000 children. It is just staggering.

[Daisy Cooper (St Albans) (LD)]

I am grateful to the shadow Minister for giving way. I have heard really shocking reports from parents and teachers in my constituency that children as young as 11 are using vapes and that one young person, at the age of 17, is now addicted. In the worst cases I am hearing, some young children are being targeted and are taking the vape apart to carry much harder drugs on the inside, which is causing an even bigger problem. Does the hon. Gentleman agree with me that we simply cannot wait any longer? We need urgent action from the Government to stop that happening.

[Andrew Gwynne]

The hon. Lady makes a powerful case. Those are precisely the reasons why we have called this debate. It should shock each and every one of us. The ease of access to e-cigarettes for children, many younger than the ages she gave as an example, just cannot be allowed. We must be doing all we can on e-cigarettes, as we did to tackle the packaging and advertising of actual cigarettes, to ensure that children are weaned off their nicotine addiction and that other children do not start vaping in the first place.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

My hon. Friend is making a very effective speech to open this debate. He quoted the figure of 30% for Yorkshire and the Humber. The figure for the north-west is 29%, which shows very little difference. Those figures are twice that for London, so it may be that some hon. Members are not aware of how bad the problem is getting. The Royal College of Paediatrics and Child Health has warned that youth vaping is fast becoming an epidemic. Worryingly, the number of children admitted to hospital as a result of vaping has almost quadrupled. Is my hon. Friend, as a fellow Greater Manchester MP, concerned about how many more children might suffer those health impacts before the Government take the action that is needed?

[Andrew Gwynne]

I am very grateful to my hon. Friend. As a Greater Manchester MP, I see the problem in my constituency and she will see it in hers. It concerns me greatly, because within our city region there are already communities that have some of the worst health inequalities. A lot of those health inequalities have been exacerbated by a higher than average prevalence of smoking. Even now, as smoking rates have declined, there are still communities in the areas we represent that have an abnormally high number of smokers. I do not want, in tackling smoking and reducing some of the health inequalities that are caused through smoking, to be storing up future problems with a new generation caused as a direct consequence of vaping or, more sinisterly, as a gateway to smoking later on in life. She is absolutely right.

[Gareth Johnson (Dartford) (Con)]

I am grateful to the shadow Minister for giving way; he is making a very good speech. No one in this country has ever been shown to have died from vaping, whereas thousands of people die each year from smoking. Yes, the emphasis should be on stopping children from gaining access to vaping and dissuading adult non-smokers from taking up vaping, but does he agree that we should not lose sight of the benefits of vaping for adult smokers in giving up smoking and therefore leading a healthier lifestyle?

[Andrew Gwynne]

The hon. Gentleman is absolutely right, and later in my speech I will discuss the fact that vaping is a really important tool to assist people who want to stop smoking—indeed, Javed Khan, in his smoke-free 2030 review, made it clear that vaping has an important role to play in that respect. We certainly do not want to throw the baby out with the bathwater, but we absolutely should be ensuring that children’s access to vapes is restricted and that the marketing of vapes is not done in way that attracts a new cohort of people who would never have smoked or vaped. While vaping is better for people than smoking, not vaping is better than vaping or smoking, and we do not want to create new problems.

[Dr Alan Whitehead (Southampton, Test) (Lab)]

I am sure my hon. Friend has seen the study by King’s College London and Action on Smoking and Health on the attraction of vaping, which concluded that among teenagers de-branding vapes had a deterrent effect on their purchasing them, whereas it had no effect on adults. Does he agree with that study and does he support action being taken along those lines?

[Andrew Gwynne]

I am grateful to my hon. Friend for succinctly stating the reason for this debate. That study is very clear: for adults, the appearance of the packaging makes no difference, but children and young people are attracted to the bright colours and cartoon characters and so on. The same arguments were made about smoking and led to us moving several years ago to standardised cigarette packaging. The evidence on children vaping is now so overwhelming that Parliament must take the lead. Industry will not act without a nudge from us. We must make sure that vapes are not packaged and advertised in a way that attracts children.

In a recent article penned for The Independent, a teacher in Oxfordshire described having been:

“rostered on to control numbers of students in the toilet block in an attempt to prevent the constant vaping that goes on in there.”

She went on to describe discovering

“a stash of over 50 vapes stored above a ceiling panel in the toilets—a tactic learnt and shared on TikTok.”

Worryingly, ASH estimates that most children who vape make the purchases themselves, despite it being illegal to sell vapes to those under the age of 18.

[Tonia Antoniazzi (Gower) (Lab)]

My hon. Friend is making an excellent speech. Only yesterday, I had a call from a head of year in Gowerton School in my constituency who wanted to know why the police and social services were not acting on his reports of sales of vapes in a barber’s shop in Swansea city centre. Does my hon. Friend agree that it is up to the police, social services and trading standards to take a stand and stop the face-to-face sale of vapes to under-age children?

[Andrew Gwynne]

Absolutely. There has to be a strategy that is not just about restricting packaging and advertising. There has to be more enforcement at the local level. I have some sympathy with local government, which has had to endure massive cuts over the past 13 years, so that things such as trading standards have been cut right back to the bone, but there can be no excuse whatsoever for shops selling these products to children. Every action should be taken to prevent that and to enforce the law.

[Caroline Nokes (Romsey and Southampton North) (Con)]

The hon. Gentleman is making an interesting and important speech, but he is focusing on advertising, marketing, the bright colours and the sweet flavours, and he has not mentioned price. Price promotions are banned for tobacco, yet vapes can sometimes be bought for three for £12, which is pocket money territory.

[Andrew Gwynne]

The right hon. Lady is absolutely right. We tabled the motion because we believe that the action it calls for is something we can do quickly, but the price of vapes is also a driver, and she is right that we should look into deals whereby vapes can be bought really cheaply—as she says, with pocket money—because that would be another step to take vaping out of the reach of children and young people.

As I said, ASH estimates that most children who vape make the purchases themselves. Put simply, children are then increasingly being hooked on to addictive substances that are deliberately packaged—and, indeed, sometimes priced—to catch their eye. This affects not only their health but their education.

Who could have seen it coming? Well, not the Government, it turns out. In November 2021, my hon. Friend the Member for City of Durham (Mary Kelly Foy) tabled an amendment to the Health and Care Bill that would have given the Secretary of State the power to prohibit branding that appeals to children on e-cigarette packaging. It received cross-party support but was voted down by the Government. When the Minister stands up in a few minutes and claims that the Government are on top of the epidemic of youth vaping, I hope he will explain to the House—to Members from all parties who supported that measure—why the Government voted down that sensible amendment in 2021, and why they are still failing to do something about this acute problem now.

Sadly, this approach to public health has become all too familiar when it comes to the Conservatives. We were promised a tobacco control plan; that was binned. We were promised a health disparities White Paper; that was binned. We were promised a ban on junk food advertising to children; that was binned. Why? Because the Prime Minister is too weak to take on those on the fringes of his own party who view public health with suspicion. That is why, on the Conservatives’ watch, health inequalities have widened, and why vaping companies have been given free rein to profit off children and young people.

The next Labour Government will not allow the trend to continue, which is why in Labour’s health mission we have been clear that we will ban the packaging and marketing of vapes to children, and we will come down like a ton of bricks on those who sell vapes illegally to children.

[Caroline Ansell (Eastbourne) (Con)]

I agree with the shadow Minister that this is an increasingly serious issue that we must arrest. Does he agree that this is not just a health mission but an education mission? The surest reason why young people will now either give up and desist or not take up vaping is if they understand the harms and the risks, so the new education provision that the Government are helping to bring forward in schools, whereby children themselves will speak to their peers to communicate the risks, is a really important and welcome intervention.

[Andrew Gwynne]

Of course education has a role. When I went to secondary school, we were educated about the harms of smoking, although it did not stop a number of my peers becoming addicted to cigarettes—to nicotine and tobacco. Education has a role, then, but it does not have a full role. We only really clamped down on smoking and cut the numbers of people who smoke when we introduced regulations on smoking, including the smoking ban, which I am incredibly proud that a Labour Government introduced because it has had massive public health benefits for many people in the years since.

My hon. Friend the Member for Southampton, Test (Dr Whitehead) referred to the research conducted by King’s College London in conjunction with ASH, which suggests that the removal of child-friendly imagery and colours on e-cigarettes can reduce their appeal to children while, crucially, not discouraging their use by adult smokers to quit. This is precisely the balance that the next Labour Government want to strike, so that vapes are used exclusively as a stop-smoking tool by adults, not as a way of getting young people hooked on highly addictive substances such as nicotine. I would hope that ambition was shared on both sides of the House but, unless the Minister changes his mind at the Dispatch Box, the Government are still refusing to commit to a promotion ban. That is bizarre because, in a recent interview, the Prime Minister was asked about the marketing of vapes to children, and he said:

“It looks like they are targeted at kids, which is ridiculous.”

The Prime Minister also said:

“The marketing and the illegal sales of vapes to children is completely unacceptable and I will do everything in my power to end this practice for good.”

Apparently, everything in his power does not include banning the practice of advertising vapes in this way.

Instead, the Government have announced yet another call for evidence, further kicking into the long grass the action that academics, teachers, parents and Members on both sides of the House all agree is essential now. The Government can try all they like to feign outrage at the current situation, but it is partly because of their inaction that we find ourselves in this mess. The Department of Health and Social Care could easily have included these measures in its tobacco control plan, had it not decided to scrap that plan.

The measures are eminently sensible, and we do not need another call for evidence to tell us what we can all see in our own communities. When the Minister responds, I am sure he will point to the illicit vape enforcement squad that the Government announced back in April to enforce rules on vaping and to tackle illegal sales. The squad is obviously welcome, but a few things remain unclear. First, when will the squad start its fieldwork? In a recent answer to a written parliamentary question, the Minister admitted that it will not be until “later this year”. When specifically? We are now in July. What are parents and guardians who are concerned about their children’s vaping expected to do in the meantime?

What the Minister announced in April simply does not add up to a comprehensive tobacco control plan or a strategy for a smoke-free 2030, nor will it stop the companies that are specifically targeting vapes and e-liquids at our children. The Minister knows it and we know it, so let us drop the pretence.

The next Labour Government will end the 13 years of Tory public health neglect that have seen health inequalities widen and healthy life expectancy stall and go into reverse in some communities. In our health mission, we pledged to make this country a Marmot nation, to tackle the social inequalities that influence health and to ensure that children have the very best start possible, to give them the building blocks for a healthy life.

There has been no joined-up plan for public health for 13 years, and the British people have paid the price. That is why Labour will put a mission delivery board right at the heart of Government—one that works across the whole of Whitehall to deliver secure jobs, fair pay, adequate housing, safe streets and clean air. The next Labour Government will build on our legacy of smoking cessation and take the bold steps needed to reach a smoke-free future, a future that has drifted further and further away under this rudderless Government. We will tackle underage vaping and work alongside councils and the NHS to ensure that vapes are used exclusively as a stop-smoking aid.

In short, prevention is better than cure. We will reform our healthcare system so that it focuses relentlessly on preventing the causes of ill health in the first place. For voters, the next general election will be a crystal-clear choice: choose a Conservative Government who have undone decades of progress when it comes to public health, or choose a Labour Government who will work day in, day out to give everyone in Britain the opportunity to lead a happy, healthy and fulfilling life.

I commend our motion to the House.

--- Later in debate ---

[Andrew Gwynne]

What we are here to talk about today is advertising and packaging. I made it very clear in my contribution that the next Labour Government would act robustly on both those issues.

[Neil O’Brien]

Act robustly? I think we all want to act robustly. The shadow Minister said in his speech that he did not like banana-flavoured vapes, but would they be banned? I am happy to take an intervention if the shadow team have an answer. I do not think that we have an answer. That, ladies and gentlemen, is why we need to have evidence. We need to have an evidence-based approach, and we need to have not just the evidence about what drives these things, but clear definitions of these things on which we can actually take action. We have to be clear about what we are and are not doing within all these fields.

All I was trying to do is to demonstrate that, while we are committed to taking action—I feel very strongly about taking action on this—and while we have done a whole range of different things on this point, we need evidence to make good policy, which is why we are having a call for evidence.

Draft Tobacco and Related Products (Amendment) (Northern Ireland) Regulations 2023

Andrew Gwynne Excerpts

Tuesday 11th July 2023 General Committees

[Andrew Gwynne (Denton and Reddish) (Lab)]

It is a pleasure to see you in the Chair, Ms Harris, and to speak on the behalf of His Majesty’s Opposition.

As set out in the explanatory note, the statutory instrument means that from October this year it will be illegal in Northern Ireland to produce or sell heated tobacco products that have a characterising flavour. As the Minister set out, the change is happening because of the requirements of the Windsor framework and is being made in response to a policy change implemented by the European Union. Of course, we would prefer the Northern Ireland Assembly to be sitting, so that the Windsor framework democratic scrutiny committee could involve local representatives in the process, but we are where we are.

It is important to reiterate that heated tobacco products are very different from e-cigarettes: while e-cigarettes heat liquids or salts that typically contain nicotine, HTPs heat tobacco leaf directly, producing a nicotine aerosol that is then inhaled. Unsurprisingly, some in the tobacco industry have made the claim that HTPs are less harmful than conventional smoking, and point to a number of studies that purport to demonstrate this. However, as recent analysis by the University of Bath has shown, a majority of those studies were either affiliated with or funded by—you’ve guessed it—the tobacco industry. Conversely, the European Respiratory Society has pointed to independent research that shows that HTPs emit substantial levels of carcinogens, as well as toxic and irritant substances. Although use of these harmful products is very low in Northern Ireland, as the Minister says, they are increasingly being marketed without the requisite evidence base as a healthier alternative to smoking.

Obviously health is a devolved matter and the Minister represents public health in England, but I wish to press him on whether he plans to adopt similar legislation here so that there is parity between England and Northern Ireland. If not, why not? Have the Government made any assessment of the prevalence of heated tobacco use across the rest of the United Kingdom, and principally in England, along with the wider health implications of such use? Similarly, can the Minister outline what action his Department is taking to combat the increased marketing of such products—marketing that is often underpinned by spurious tobacco industry-backed research?

Finally, can the Minister set out how the Government will assist Northern Ireland in the implementation of the ban, especially given the possibility of illegal importation from England? It does seem odd that following the implementation of the draft regulations there will be more stringent legislation in place to clamp down on heated tobacco in Northern Ireland than in the rest of the United Kingdom. Perhaps the Government considered implementing such a ban in their tobacco control plan or in their health disparities White Paper—but we will never know, because they have both been unceremoniously binned, leaving England lagging behind on tobacco cessation, where we should be leading the way.

The next Labour Government will build on our smoking cessation legacy by taking bold, decisive action to improve public health and empower those addicted to tobacco to quit, but until then we need to see the Government drastically improving their own efforts. However, His Majesty’s Opposition fully support the draft regulations.

Oral Answers to Questions

Andrew Gwynne Excerpts

Tuesday 11th July 2023 Commons Chamber

[Mr Speaker]

I call the shadow Minister.

[Andrew Gwynne (Denton and Reddish) (Lab)]

From this complacent Minister’s replies already, one would think that health inequalities in England were improving, not widening. Last year, 11,000 people, including 312 children, were hospitalised for malnutrition in the United Kingdom. That is the highest number since comparable records began. Why are so many people in Britain going hungry under the Tories?

[Neil O’Brien]

We need to have care in discussing these subjects. Eating disorders are a sensitive subject and the statistics the hon. Gentleman is quoting are a mix of different things. I have already talked about the £3,300 of cost of living support that this Government are providing to the average UK household, with more targeted help for more vulnerable households. It is something we are seized of and are working on.

Ultra-processed Food

Andrew Gwynne Excerpts

Wednesday 21st June 2023 Westminster Hall

[Andrew Gwynne (Denton and Reddish) (Lab)]

It is good to see you in the Chair, Dr Huq. I commend the hon. Member for Stourbridge (Suzanne Webb) for securing this crucial debate and for all the work that she and others in the Chamber today are doing on this important topic. We have had a small but perfectly formed debate. I thank my hon. Friend the Member for Strangford (Jim Shannon) and the hon. Member for Stoke-on-Trent Central (Jo Gideon); the hon. Member for Erewash (Maggie Throup), who recently led for the Government on these issues and maintains a keen interest in these matters, which is good to see; and the hon. Member for Linlithgow and East Falkirk (Martyn Day), who leads on health issues for the Scottish National party. I also thank the right hon. Member for East Yorkshire (Sir Greg Knight) and the hon. Member for Glasgow North West (Carol Monaghan) for their interventions. All made crucial points.

Ultra-processed foods are defined as foods that tend to include additives and ingredients that are not typically used in home cooking. They include, but are not limited to confectionery, fried snacks and processed meats. Typically, they are produced to be convenient, quick to eat and appealing. Diets that revolve around UPFs can lead to poor health outcomes, as we have heard, and leave less room for more nutritious meals. We know that balance is essential to a healthy diet, so for most people, cutting out UPFs entirely is not a realistic option. What matters is supporting people to make informed, healthier choices and addressing the wider social determinants that influence their ability to lead a healthy, active life.

That action is important because rising obesity rates pose a profound threat to public health. I would argue that the Government have, unfortunately, responded to this threat wrongly by delaying the ban on junk food advertisements targeted at children and then scrapping the health disparities White Paper. Those are retrograde steps. Instead, the Government have announced a series of pilots, most recently built around the weight loss drug semaglutide, but the reality is that drugs of that sort, while useful for acute cases, are not long-term population-level fixes; they address the extreme end of the problem rather than the cause. My first question to the Minister is: beyond those pilots, what action are the Government taking to tackle rising obesity rates across the United Kingdom? The Government pledged to tackle childhood obesity in their 2019 general election manifesto, but cases have increased, so does the Minister recognise that more needs to be done to improve public health?

I am proud that my party has already committed to establishing at the heart of the next Labour Government a mission delivery board that will ensure that all Departments with an influence over the social determinants of health work in tandem to reduce inequalities and to ensure that health is part of all Government policies. The work will not stop there, though. Under the next Labour Government, every child will benefit from fully funded breakfast clubs and a broad and balanced national curriculum containing a wide range of physical activities. We will end the promotion of junk food targeted at children by implementing the ad ban which the current Government should have introduced—the watershed about which the hon. Member for Stourbridge spoke so passionately. We know that poverty is a key driver of obesity, so we will work tirelessly to tackle child poverty and to ensure that families can afford to feed their children and keep them well.

This is Labour’s vision—positive, ambitious and led by what works—but we cannot afford to wait until the next general election for action on obesity, so I hope that the Minister accepts that more needs to be done and that he will set out how the Government will develop their strategy to tackle obesity, reduce health inequalities and improve access to good, affordable food now. The Labour party stands ready to support him in this action, but it must come sooner rather than later.

Smokefree 2030 Target

Andrew Gwynne Excerpts

Tuesday 20th June 2023 Westminster Hall

[Andrew Gwynne (Denton and Reddish) (Lab)]

It is a pleasure to see you in the Chair, Mr Sharma. At 9.30 am, it would have been a pleasure to see anybody in the Chair. I place on the record my thanks to you and Mr Evans for stepping into the vacancy. I congratulate the hon. Member for Harrow East (Bob Blackman) and my hon. Friend the Member for City of Durham (Mary Kelly Foy) on securing this important debate and on their tireless work on this issue. When we create a smoke-free England—the consensus here today is for a smoke-free Britain—it will be in no small part thanks to their tremendous efforts and campaigning.

I also pay tribute to my hon. Friends the Members for Birmingham, Erdington (Mrs Hamilton) and for Blaydon (Liz Twist), and the hon. Members for Southport (Damien Moore), for Strangford (Jim Shannon) and for Arfon (Hywel Williams), as well as the hon. Member for Linlithgow and East Falkirk (Martyn Day), who leads for the Scottish National party on health issues. There is consensus across the Chamber on where we need to go.

In 2019, the Government committed themselves to a Smokefree 2030. As Members across the House will be aware, that means a smoking prevalence of around 5% of the population. The commitment was welcomed across the House, and for good reason: despite significant progress in driving down smoking rates over the past 40 years, smoking, as we have heard today, is still the biggest cause of cancer and death in the United Kingdom. Smoking causes around 150 cancer cases every day, and smoking tobacco kills one person every five minutes.

Those deaths are made all the more tragic by the fact that they are avoidable. By creating a smoke-free England, we would empower people to live happier, longer and healthier lives, and substantially reduce pressure on our NHS, as Cancer Research UK estimates that up to 75,000 GP appointments could be freed up each year if we put an end to smoking. That would all come alongside substantial economic benefits, as smoking costs the public finances an estimated £20.6 billion. The argument for a smoke-free future is overwhelming. We just need to get there.

In a recent response to a written question I tabled, the Minister stated that his Department is “confident” that it is

“on course to achieve…Smokefree 2030,”

but Cancer Research UK estimates that the Government are, as we heard from the hon. Member for Harrow East, on track to miss their Smokefree 2030 target by around nine years. Smoking cessation services have faced cuts of 45% since 2015-16, and in some of the most deprived areas of England, smoking rates are increasing, not decreasing.

That increase is incredibly concerning, and it risks exacerbating health inequalities that are already widening, in some cases at an alarming rate. Therefore, I would be grateful if the Minister explained why his Department is so confident that the 2030 target will be met, and where the Government’s modelling is, as well as why it differs from that of Cancer Research UK.

The announcements the Minister made in April were undoubtedly welcome, but they do not seem to me to be ambitious enough or wide-ranging enough to get us back on track. If that is the case, and if we are to miss the 2030 target, the Department of Health and Social Care needs to fess up and say how it plans to keep its pledge. The truth is that the foot has been taken off the pedal with regard to Smokefree 2030. The Government wasted precious time, and unless they act swiftly the target will be beyond reach. I do not want that. I want the Minister to succeed in achieving the target, and I do not think anybody in the Chamber wants us to miss it.

We need action, so I will press the Minister on a few key points. First, will he confirm whether the Government plan to announce any further measures to tackle smoking prevalence, or whether the April announcement is intended to replace the tobacco control plan and the health disparities White Paper?

Secondly, the April announcement referred to an updated strategy to tackle illicit sales and imports of tobacco due to be released at some point this year. There is a backlog of reports to be published sometime this year. We would like this one to be at the front of the queue, not the back. Will the Minister update Members on where the work has got to and when we can expect publication of the strategy?

Thirdly, the Minister will no doubt be aware that Cancer Research UK and ASH have made several recommendations to the Government, most notably on an increase in the age of sale and a “polluter pays” tobacco levy. I would be interested to hear what recent assessment he has made of those proposals and whether they will inform his Department’s work moving forward.

Finally, cross-Government guidance on protecting public policy from the vested interests of the tobacco industry was published yesterday. That is a step in the right direction, but will the Minister set out how the guidance will be disseminated to all branches of Government, given that it is cross-departmental?

The last Labour Government had a proud history of taking bold action to drive down smoking prevalence. We implemented the indoor smoking ban and took action to tackle cigarette advertising, and we are still feeling the benefits of those policies to this day. We want to continue that legacy and, indeed, the measures that were brought in more recently. That is why creating a smoke-free England within a smoke-free United Kingdom will be an absolute priority for the next Labour Government.

Our recent health mission launch set out the first steps of our road map to a smoke-free Britain. They include making all hospital trusts integrate opt-out smoking cessation interventions into routine care and expecting every trust to have a named lead on smoking cessation, so that every single clinical consultation counts towards health improvement. We would legislate to require all tobacco companies to dispel the myth that smoking reduces stress and anxiety. We would also ban vapes from being advertised to children and instead work with councils and the NHS to ensure that vapes are being used to stop smoking—full stop.

That is just the start of our road map to a smoke-free United Kingdom. The next Labour Government wholeheartedly believe in a smoke-free future, and we will not shy away from taking the bold steps that are needed to protect and improve public health. Until then, we are ready to work constructively and across party lines to build a smoke-free England within a smoke-free United Kingdom. I look forward to hearing how the Government plan to get us back on track.

Cancer Medicines: Appraisals

Andrew Gwynne Excerpts

Tuesday 13th June 2023 Westminster Hall

[Andrew Gwynne (Denton and Reddish) (Lab)]

It is a pleasure, as ever, to serve under your chairmanship, Mrs Harris, and to respond to this debate on behalf of the shadow Health and Social Care team.

I begin by congratulating the hon. Member for Strangford (Jim Shannon), who I call my hon. Friend, on securing this important debate, and I thank him for his tireless work campaigning on such issues.

Also, I pay tribute to my hon. Friend the Member for Mitcham and Morden (Siobhain McDonagh) for the powerful case that she put to the Minister in respect of brain tumours generally and specifically the glioblastoma manifesto. I very much hope that the Minister is able to take up her challenge, because the inequalities in outcomes that she laid out are unacceptable. In the year 2023, we should not be looking at a situation in which there have been zero improvements in life expectancy from cancers such as glioblastoma since 2005-06 when we have seen dramatic improvements in the other areas that she mentioned. We owe it to Baroness McDonagh—Margaret McDonagh—and to others such as Tessa Jowell to ensure that we see improvements in this area, too.

As for the hon. Member for Chatham and Aylesford (Tracey Crouch), she said herself that she has been on the cancer treadmill, and it is lovely to see her back in her place and up to her old usual tricks. We welcome her.

[Tracey Crouch]

I just want to say that I was never not in my place; I was fortunate enough to go through cancer treatment during covid, when we were all working under a hybrid procedure. Actually, that experience has helped to form some of the contributions that I have made to the Procedure Committee about how we in this place support people who are going through significant illnesses.

[Andrew Gwynne]

Absolutely—the virtual Parliament hid a multitude of sins. I know that as somebody who struggled with long covid through that period. Many people would not have known just how ill I was, because I just appeared on a screen. However, it is nice to see the hon. Lady in person; I should put it like that. And she was entirely right to say that cancer touches us all, which is why we can all cite personal experiences of it. I lost my mum to ovarian cancer when I was 19; she was just 50. I lost my dad last year to rectal cancer. I am not alone; we all have people, including close family members and friends, who we have lost to cancer.

I also pay tribute to the hon. Member for Midlothian (Owen Thompson), who responded on behalf of the SNP, for his contribution to the debate and to the right hon. Member for Dwyfor Meirionnydd (Liz Saville Roberts), for her intervention.

I am sure that I speak for everybody from all parties in the House when I say that ensuring that patients have quick access to the most innovative and effective treatments is an absolute priority. This country has a proud history of medical innovation, a reputation that we should try not only to protect but to enhance, as we have already heard today.

We are talking today about the appraisal process for cancer patients, which, as we have also heard, has changed markedly over recent years in several areas. We have seen increased focus on targeted treatments and immunotherapies, as well as reform of the cancer drugs fund in 2016, a move that was taken to improve people’s access to cancer drugs while allowing NICE to collate more information on potential areas of clinical uncertainty.

In a recent report, the Association of the British Pharmaceutical Industry highlighted that 78% of medicines have been able to exit the cancer drugs fund with a positive recommendation, with most of them spending about two and a half years in the CDF process. It also recognised improvements as a result of the relaunched CDF, but raised concerns that the CDF has

“perhaps been overly relied upon”

in order to

“delay making routine recommendations.”

It states that

“a new balance may need to be struck between NICE and manufacturers in considering which treatments should enter the CDF to resolve genuine uncertainty surrounding long-term clinical outcomes and for how long.”

Given that NICE recently set out specific circumstances when committees may be able to accept a higher degree of uncertainty in routine commissioning decisions, can the Minister set out whether his Department has assessed the ABPI’s findings and whether more can be done to improve access to innovative treatments for patients via routine commissioning? That links to a wider point that I wish to raise on clinical research and trials.

Clinical trials provide an opportunity for the NHS, businesses and brilliant researchers to work together for the benefit of everyone. Unfortunately, however, in recent years the UK trials industry has collapsed. The number of commercial trials in the United Kingdom decreased by 41% between 2017 and 2021. Worryingly, the UK has dropped from fourth to 10th in the global rankings, behind Spain, France and Italy. Of most concern is that in 2020-21, the NHS lost £447 million in revenue due to a drop-off in clinical commercial trial activity. Those figures should seriously worry the Minister. They risk putting patients at a disadvantage for all kinds of innovative treatments, including cancer medicines.

In Labour’s recent health mission, we committed to putting Britain right at the front of the queue for new medicines and vaccines. Alongside our pledge to spend 3% of GDP on research and development across the public and private sectors, we want our clinical trials to be more competitive, efficient and accessible. Making those ambitions a reality means tackling unnecessary bureaucracy in how trials are set up and reducing the administrative burden on everyone involved in the clinical trial, including the NHS. Will the Minister set out how his Government plan to reverse the drop-off in clinical research and trials—a drop-off that is costing our NHS financially and clinically?

Finally, I want to touch on the issue of patient access to innovative medicines, including for cancer patients. In 2021, in its “Life Sciences Vision”, the Government committed to identifying and addressing “unwarranted variation” in the uptake of innovative medicines. But in February this year, in the innovation scorecard commissioned on behalf of the Department of Health and Social Care, it was found that a number of areas were still falling short of the NICE recommended levels of new medicine uptake.

Will the Minister provide an update on what work he is doing to improve regional variation in uptake of innovative medicines so that no matter where someone lives, they can access the treatment they need when they need it. Will he also commit to improving the data collected as part of the innovation scorecard to include information on cancer medicines so that we can meaningfully assess uptake and isolate areas for improvement where necessary? That is something that the life sciences sector has called for, so I would welcome more information on that from the Minister.

In conclusion, Labour is wholly committed to ensuring that cancer patients in this country receive access to the very best medicine and care. That means ensuring that appraisals for cancer medicines remain fit for purpose and adapt in line with evolving technologies and scientific advancements. It also means turbocharging clinical trials and tackling the unacceptable gaps in access to cutting-edge treatment. In his response, I hope that the Minister will meet the ambition set out by the Labour party and that we can work together towards making Britain a world leader in cancer care and treatment, because we owe it to all those people on the treadmill right now.

Mental Health Treatment and Support

Andrew Gwynne Excerpts

Wednesday 7th June 2023 Commons Chamber

[Andrew Gwynne (Denton and Reddish) (Lab)]

It is a pleasure to close the debate on behalf of the shadow health and social care team.

We have had a thorough debate and we have heard some heartbreaking, harrowing and concerning things during its course. The amendment that the Minister has put down in response to the motion is reminiscent of “Alice Through the Looking Glass”, because it does not bear any relationship to people’s lived experiences of the mental health system in England or the contributions made by Members from both sides of the House to the debate.

I pay tribute to all who have spoken today. There have been some incredible speeches. We heard from the hon. Members for Watford (Dean Russell) and for Penrith and The Border (Dr Hudson), from the right hon. Member for Chelmsford (Vicky Ford), and from the hon. Members for Runnymede and Weybridge (Dr Spencer), for Penistone and Stockbridge (Miriam Candidates), for Newcastle-under-Lyme (Aaron Bell), for Devizes (Danny Kruger), for St Albans (Daisy Cooper), and for Oxford West and Abingdon (Layla Moran).

We also heard from my hon. Friend the Member for Hemsworth (Jon Trickett), my hon. Friend the Member for Bermondsey and Old Southwark (Neil Coyle), who made an extremely powerful contribution, and my hon. Friends the Members for Chesterfield (Mr Perkins), for Batley and Spen (Kim Leadbeater), for West Ham (Ms Brown)—I ask the Minister not to forget her request for a meeting; she is certainly someone to whom it is difficult to say no—for Oldham East and Saddleworth (Debbie Abrahams), for Leeds North West (Alex Sobel), for Sheffield, Hallam (Olivia Blake), for Birmingham, Erdington (Mrs Hamilton), for Halifax (Holly Lynch), for Kingston upon Hull West and Hessle (Emma Hardy), for Wakefield (Simon Lightwood), for Luton South (Rachel Hopkins), for St Helens South and Whiston (Ms Rimmer), for Salford and Eccles (Rebecca Long Bailey) and for Blaydon (Liz Twist). Finally, we heard from my hon. Friend the Member for City of Durham (Mary Kelly Foy); I remind the Minister that she would like a response to her request for an inquiry into issues in her local area.

We are facing a mental health emergency in this country—

[Vicky Ford]

The hon. Gentleman has said that the Government’s amendment bears no relation to the reality of what people are seeing. In my speech I mentioned the creation of a brand-new facility for patients in mid-Essex, which means that people in crisis are not spending many hours in A&E but are going to a bespoke 24/7 centre. That is the sort of provision that I want to support, and it is mentioned in the Government amendment but not in the Opposition motion.

[Andrew Gwynne]

Of course we need facilities in every part of England, but the fact is that after 13 years, too many parts of England are falling behind. We know that the mental health crisis in this country has become worse on the watch of the right hon. Lady’s Government, and she should have a little contrition about the state of mental health services in England.

[Vicky Ford]

rose—

[Andrew Gwynne]

I will not give way. We have heard enough from the right hon. Lady, supporting her “Through the Looking-Glass” amendment which bears no relation to the reality.

As we have heard today, people who require mental health support, no matter where they live—except in the right hon. Lady’s part of England—will be confronted by a system that is buckling under the pressure of 13 years of Tory mismanagement, neglect and incompetence. The right hon. Lady shakes her head, but the figures speak for themselves. Last year, patients suffering with mental health issues waited more than 5.4 million hours in accident and emergency departments. There are 400,000 children currently waiting for mental health treatment, and 1.2 million people are waiting for community mental health care, with some patients being forced to travel more than 300 miles because there are no beds in their local area. My hon. Friend the Member for Hemsworth spoke powerfully about that. The Resolution Foundation has found that, of the 185,000 young people who are unable to work, nearly two thirds cite mental ill health as the reason. Suicide is now the leading cause of death in adults under 34, with about 18 people losing their lives every single day. As the cost of living crisis has worsened, we have also seen a knock-on effect on addiction and rehabilitation. Drug-related deaths are at a record high, and last year there were 9,641 deaths in the UK from alcohol misuse, a 27% increase on the year before.

Make no mistake: the emergency in mental health has become a public health crisis, and we need to see action. Our motion calls on the Government to adopt Labour’s plan to recruit 8,500 mental health staff to expand access to treatment, to provide specialist mental health support in every school, and to establish open-access mental health hubs for children and young people. That would be paid for by the closing of tax loopholes, because politics is about priorities, and Labour’s priority is to ensure that those who need mental health support have access to it in all parts of the country. Our priority is to build a Britain where patients start receiving appropriate treatment within a month of referral. I hope that those on the Government Benches will demonstrate that they share these priorities by voting for Labour’s motion today.

Staffing is just one part of the equation. Like any public health issue, addressing mental health requires a holistic approach that recognises its complex nature. That is why Labour has committed to a whole-Government plan to improve outcomes for people with mental health needs and to address the social determinants that drive mental ill health for many people. Our mental health can be influenced by a multitude of different things. Secure jobs, fair pay and good housing are all building blocks for a healthy life, physically and mentally, and unless we improve people’s lives in the round, positive change will remain out of reach.

It is for this reason that the next Labour Government will focus as much on prevention as we do on treatment. We will pioneer a transformative cross-departmental agenda with a mission delivery board at the heart of the Government ensuring that all Departments work to improve the wider determinants of health. We will boost capacity in mental and public health teams so that people can get the support they need before presenting at A&E or turning to substance abuse. We will also encourage the integrated care systems to identify opportunities to join up services within the community. Our aim will be for more patients to have one point of contact for appointments with a range of professionals and services. This neighbourhood team will include the family doctor, carers, health visitors, social prescribers and mental health specialists.

Our vision is to turn the national health service into a neighbourhood health service with the patient right at the heart of it. The benefits of this kind of work will travel far beyond improving the lives of individuals suffering from mental ill health. For instance, in my own region of the north-west of England there were over 140,000 calls to 999 from people in a mental health crisis last year, and in my own constituency local people spent over 6,500 hours waiting in A&E for mental health treatment. If we were to help people before they reached these crisis points, we would drastically reduce pressure on the wider health system and thereby improve patient outcomes right across the board.

The same is true of wider economic productivity. As we have heard in the debate, the Mental Health Foundation and the London School of Economics have estimated that poor mental health costs the British economy £117 billion a year. That is a phenomenal amount of money and a huge loss to our country’s economic power. Improving mental health outcomes is therefore not just a moral imperative—although it is certainly that—but a practical one, and one that is essential if we want the United Kingdom to prosper, as I hope and believe we all do. That is what we come to this House for. We want to leave our country in a better shape for our children than it has been for ourselves.

That brings me again to the motion. All Members of the House have the opportunity today to support a fully funded plan to improve mental health treatment. Those on the Government Benches can choose to put party politics first, but that will not change the fact that this Government have failed people on mental health. No matter what amendments they put before us, that does not change people’s real, lived experiences or the experiences of Members on both sides of the House who deal with the impact of mental ill health in their constituency casework. The system is crumbling and more of the same will just not cut it, so I am enormously proud to be supporting Labour’s motion today and I would strongly urge Members on both sides of the House to back it. It is time to give those suffering from mental ill health the treatment and support they deserve, and I commend our motion to the House.

[Madam Deputy Speaker (Dame Rosie Winterton)]

I reiterate for those who were not here that it is incredibly important that people get back in good time to hear the Opposition wind-up as well as the Government wind-up—that includes Ministers. I would expect anybody who was not here at the beginning of the Opposition wind-up, some of whom are still not here, to write to Mr Speaker to apologise. I take it that people will do that.

Oral Answers to Questions

Andrew Gwynne Excerpts

Tuesday 6th June 2023 Commons Chamber

[Mr Speaker]

I call the shadow Minister.

[Andrew Gwynne (Denton and Reddish) (Lab)]

As my hon. Friend the Member for Rhondda (Sir Chris Bryant) pointed out, the brutal truth is that the Tories have consistently missed England’s cancer treatment target since 2013. Last year, 66,000 cancer patients waited more than two months for their first treatment following an urgent GP referral, and the UK now has the worst cancer survival rate in the G7. Labour will give the NHS the staff, the technology and the reform it needs, and we make no apologies for expecting cancer waiting times and diagnosis targets to be met once again. That is our mission. Why is theirs so unambitious?

[Steve Barclay]

We are making significant progress. The hon. Gentleman specifically mentions GP referrals, and there were more than 11,000 urgent GP referrals for suspected cancer per working day in March 2023, compared with just under 9,500 in March 2019, so we are seeing more patients.

Let me give an indication of how we are innovating on cancer. We have doubled the number of community lung trucks, which means the detection of lung cancer at stages 1 and 2 is up by a third in areas with the highest smoking rates. In the most deprived areas, we are detecting cancer much sooner, and survival rates are, in turn, showing a marked improvement.

NHS Dentists: South-West England

Andrew Gwynne Excerpts

Wednesday 24th May 2023 Westminster Hall

[Andrew Gwynne (Denton and Reddish) (Lab)]

It is a pleasure to serve under your chairmanship, Ms Elliott. I thank the hon. Member for West Dorset (Chris Loder) for securing this really important debate and for the work that he does locally and here in Westminster to raise awareness of the issue. We have had a good, full debate. I thank my hon. Friends the Members for Bristol East (Kerry McCarthy) and for Plymouth, Sutton and Devonport (Luke Pollard) for their contributions, as well as the hon. Members for Torbay (Kevin Foster), for South Dorset (Richard Drax), for Newton Abbot (Anne Marie Morris), for Poole (Sir Robert Syms), for St Ives (Derek Thomas), for Bath (Wera Hobhouse), for Tiverton and Honiton (Richard Foord), and for Westmorland and Lonsdale (Tim Farron). That stretches the geography to the limits, but the hon. Member for Westmorland and Lonsdale has raised some very important points on behalf of his constituents and rural communities across England, not just in Cumbria.

Last week I responded to a debate on behalf of the shadow Health and Social Care team on dental services, but it was about the east of England. A couple of weeks before that I responded to a Backbench Business debate on NHS dentistry in the main Chamber. I do not raise those debates today to fill you in on my diary commitments over the past few weeks, Ms Elliott, but to highlight the strength of feeling across the House about the crisis we are currently experiencing in dental care.

We are all hearing from constituents who cannot access care, about parents trying to get their children seen and, in the most extreme cases, as we have heard today, patients attempting to perform dental treatments on themselves or on loved ones. So-called dentistry deserts are not being eradicated. Instead, they are multiplying, not least of all in the south-west, as we have heard today.

Last summer it was reported that out of 465 dentists across the south-west, just seven were accepting new patients. Indeed, we have heard more up-to-date statistics from Members during this debate. The number of NHS dentists practising across the south-west has fallen by more than 200, and in areas such as Exeter the current wait to get an NHS dentist is now two years. Behind the statistics are human beings who just want to be seen and to be treated, and we owe it to them to act. So my points to the Minister today will be familiar to him, and I fear that I will keep having to make them time and again until we see the Government’s dental plan.

My first point relates to the dental contract. As I have said before, it was the Labour Government who introduced the dental contract, but by the 2010 general election they had recognised that the contract needed to be substantially reformed. That was in our manifesto. The then Conservative Opposition agreed and it was in their election manifesto, too. The Government have been in power now for 13 years and change has moved at a glacial pace. In his response to the debate last week, the Minister said that he was under

“no illusion that there are significant challenges to address”,—[Official Report, 16 May 2023; Vol. 732, c. 353WH.]

but that those would be tackled in a forthcoming dental plan. Given the urgency of the situation, can the Minister provide an update on the development of the plan and when we can expect publication?

The hon. Member for West Dorset highlighted issues with unit costs being disincentives, and that was followed by other Members during this debate. It is true that dental costs have to be looked at on a per-unit basis because there are perverse incentives, but it would also be wrong to pretend that before the dental contract was introduced, there was a golden age of NHS dentistry. As I said last week, there is a reason why I have a mouthful of fillings and my children do not. It is not because I ate more sweets and did not brush my teeth as well as my children, but because of the then even more perverse incentives for dentists to drill and fill. They were paid for every filling that they put in so that people ended up with a mouthful of fillings whether they were needed or not. We need to strike a balance so that we get the public health needs and patients’ needs as well as a financial package that works for dentists to make a living.

On a similar note, can the Minister update us on the workforce plan? We have heard about that from hon. Members across the House today. We know that it has been produced and that it is on the Secretary of State’s desk. It is particularly pertinent, given that it was revealed earlier this week that the number of active NHS dentists in England is now at its lowest level in a decade, in spite of rising demand and in direct contradiction to claims made by the Prime Minister in Parliament.

Given that net Government spend on general dental practices in England has been cut by more than a third in the past decade and the number of NHS dental practices in England has fallen by more than 1,200, it is of little comfort to patients waiting in abject pain and misery to hear the Government say that a plan is coming. We urgently need to see the workforce plan published and implemented and reforms put in place that work for both patients and staff.

Labour knows we need to change if we are to secure the future of NHS dentistry. We want the NHS to become as much of a neighbourhood health service as it is a national health service. To do that, we will encourage joined-up services in the community that include dentistry. We want to see health professionals such as dentists working with family doctors as part of a neighbourhood team. That will not only help people get access to more care on their doorstep but prevent oral health problems before they become acute. It will also dismantle the two-tier system that has been allowed to develop, where those who can afford to pay receive treatment and those who cannot are left languishing. That is being further compounded by the way the cost of living crisis means some families are unable to afford even basic hygiene products. We are witnessing health inequalities widen in real time as a result, and that must not be allowed to continue.

What does the Minister plan to do to tackle oral health disparities and prioritise prevention? Will that work be part of his dental plan? I am sure this will not be the last dental debate I take part in on behalf of the shadow Health and Social Care team, but I sincerely hope that the next time I am face to face with the Minister in Westminster Hall or the main Chamber, we will have seen some long overdue progress.

It has been demonstrated during today’s debate that this need not be a partisan issue. It is in all our constituents’ interests that the Government crack on now and get improvements to dental care. We all want better dental care for our constituents and, as I said in the last debate and probably the one before that, addressing this crisis cannot wait until we have had a general election. In that vein and in closing, I urge the Minister to recognise that fact and get on with the job.

Cost of Living: Healthy Start Scheme

Andrew Gwynne Excerpts

Tuesday 23rd May 2023 Westminster Hall

[Andrew Gwynne (Denton and Reddish) (Lab)]

As ever, it is a pleasure, Mr Twigg, to serve under your chairmanship.

I begin by thanking my hon. Friend the Member for Stretford and Urmston (Andrew Western) for securing this debate and for the fantastic work that he is doing in raising awareness of this issue.

It has been a small but perfectly formed debate, with the hon. Member for Strangford (Jim Shannon) contributing to it. He always comes to Westminster Hall full of knowledge and willing to share the Northern Ireland perspective. We are always grateful for that, because we can learn a lot from different parts of the United Kingdom and it is really important that voices from different parts of the United Kingdom are raised in these debates, even though primarily these debates, when they relate to health, relate to health issues in England only. Nevertheless, we are the United Kingdom Parliament and it is really important to know what is happening in other parts of the country where there are devolved Governments.

The hon. Member for Glasgow Central (Alison Thewliss) speaks so well on these issues. She obviously has her role as the chair of the all-party parliamentary group on infant feeding and inequalities, and with the work that she does with that APPG she has got really stuck into the matters that we are considering today in real depth and detail. But she also brings a fresh perspective to these debates, as does the hon. Member for Strangford. We learn more from her about what is happening within Scotland through the Scottish Government, and it is important that across the United Kingdom Parliament we hear such examples and that we learn from best practice in different parts of the United Kingdom, so as to make better policy here in Westminster.

My hon. Friend the Member for Stretford and Urmston was absolutely right to raise the issues that he did in this debate, because Healthy Start is an essential scheme that ensures that there is a nutritional safety net for pregnant women, parents and children under the age of four in low-income families. It allows parents—in theory —to buy healthy foods such as fruit and milk, as well as to access free vitamins. However, in the context of the cost of living crisis—so eloquently set out by my hon. Friend—families are undoubtedly finding it increasingly difficult to get what they need. Analysis from the British Pregnancy Advisory Service shows that, although the benefit itself has not changed since 2021, the price of infant formula—as we have heard from the hon. Member for Glasgow Central and from my hon. Friend the Member for Stretford and Urmston—has increased substantially since then. The cheapest brands have increased in price by a phenomenal 22%, which is just unfathomable, in that short space of time.

As we have also heard, huge concerns have been raised about the uptake of the vouchers themselves, particularly following the switch from paper vouchers to a prepaid card system. Healthy Start scheme data for January 2023 shows that up to 37% of eligible families with young children are currently missing out on the scheme. That cannot be acceptable, either. A huge proportion of the people who desperately need that support—or they would not be eligible for it—are missing out.

In an answer on 13 February to a written question tabled by my hon. Friend the Member for Stretford and Urmston, the Minister responded:

“While there are no current plans to increase the value of Healthy Start, this is kept under continuous review.”

With that in mind, I would be grateful if the Minister could update us on whether there have been any recent discussions regarding the value of the scheme and whether it is still his Department’s position that no increase in value is forthcoming. If that is the case, can the Minister set out what assessment his Department has made of the impact of inflationary price rises on low-income households, and what reassurances he can provide to all Members here today that families are not being priced out of essential goods on this Government’s watch?

Similarly, I will press the Minister on the uptake of the scheme. The Government’s target for uptake is 75%, but as I mentioned earlier, we are currently sitting at about 63%. A quick trawl of written questions shows that the Minister has been responding to concerns raised by Members on this issue with a boilerplate response—namely, that the NHS Business Services Authority promotes the Healthy Start scheme through its digital channels and has created free tools to help stakeholders to promote the scheme locally. That answer suggests to me that the Government are not particularly concerned about missing their own target. That is not acceptable. I remind the Minister that there is very little point in setting a target if they are not going to do their utmost to meet it. We all know that the NHSBSA promotes this scheme, but something is clearly not working if uptake is as low as it is. What additional action is the Minister planning to take to increase uptake so that all families who are eligible are not just able to access the scheme but do access it?

It would be remiss of me if I did not raise the problem of child health inequalities, which are widening at an alarming rate. At our mission launch on Monday, Labour committed to a children’s health plan that would give every child a healthy start in life. That includes our pledge to establish fully-funded healthy breakfast clubs across England and restrict adverts for foods high in fat, sugar and salt. We would oversee the retrofitting of 19 million homes in England, to keep families warm. We would reform universal credit. And we would pass a clean air Act, to protect our children from the serious respiratory illnesses caused by pollution. It is an ambitious agenda that would proactively tackle child poverty and ensure families could afford to feed their children and keep them well. Over the last 13 years, the UK’s progress on infant and child mortality has stalled, and we now have much worse rates compared with other developed countries. We must see a concerted effort from the Minister to tackle that. More of the same will just not cut it. What exactly is the Government’s plan to meet the scale of the crisis in child poverty and ill health?

All children deserve to lead long, happy and healthy lives, irrespective of where they grow up and which part of the United Kingdom they live in. That means ensuring that in England the Healthy Start scheme works, and that we do everything we can to tackle child poverty across the country. I strongly urge the Minister to better engage with campaigners on the issue and work proactively with Members on all sides of the House to ensure that the Healthy Start scheme is fit for purpose.

--- Later in debate ---

[Neil O'Brien]

If I can just complete the thought, the total cost of living support that the Government have provided is worth more than £94 billion across 2022-23 and 2023-24. That is, on average, more than £3,300 per UK household. It is one of the most generous support packages for the cost of living anywhere in Europe.

I turn to the critical role that the Healthy Start scheme plays in supporting hundreds of thousands of lower-income families across the country. Eating a healthy, balanced diet, in line with “The Eatwell Guide”, can help to prevent diet-related disease. It ensures that we get the right energy and nutrients needed for good health and to maintain a healthy weight throughout life. The Healthy Start scheme is one way that the Government continue to target nutritional support at the families who need it most, which is increasingly important in view of the cost of living.

Healthy Start is a passported benefit, one of a range of additional sources of help and support that the Government provide to families on benefits and tax credits. It is a statutory scheme that helps to encourage a healthy diet for pregnant women, babies and young children under four from lower-income households. Women who are at least 10 weeks pregnant and families with a child under four years old are eligible for the scheme if they claim: income support; income-based jobseeker’s allowance; child tax credit, if they have an annual family income of £16,190 or less; universal credit, if they have a family take-home pay of £408 or less a month; or pension credit. Pregnant women on income-related employment and support allowance are also eligible for the scheme.

Anyone under 18 who is pregnant is eligible for Healthy Start, regardless of whether they receive benefits. Following the birth of their child, they must meet the benefit criteria to continue receiving Healthy Start. The scheme offers financial support towards buying fresh, frozen or tinned fruit and vegetables, fresh, dried and tinned pulses, plain cow’s milk and infant formula. Beneficiaries are also eligible for free Healthy Start vitamins.

In April 2021, as has been mentioned, we increased the value of Healthy Start by 37%, from £3.10 per week to £4.25 per week. Unlike the Scottish Government’s scheme, which is for the under-threes, Healthy Start is for the under-fours. Pregnant women and children aged over one and under four each receive £4.25 a week, and children aged under one each receive £8.50 a week—twice as much. For a family with a six-month-old and a three-year-old, that is £12.75 a week to help towards buying nutritious foods. That comes on top of the benefits and all the other measures, such as the increase in the national living wage, that I mentioned.

[Andrew Gwynne]

I am grateful to the Minister for rattling off the sums. To go back to the point that the hon. Member for Glasgow Central (Alison Thewliss) made about the Healthy Start grant and why the Government chose not to uprate it, will he share with the House what the cost to the Exchequer would have been to uprate it? That must have been part of their deliberations as to why not to do it. What is the cost?

[Neil O'Brien]

We have chosen to spend over £3,300 per UK household, on average, on the cost of living support. Putting that into the schemes that are available and targeted at people with low incomes, and indeed at the entire population, is the choice that we have made. To reiterate my earlier point, and since the hon. Member says that I am rattling off the figures, it is worth stressing that we have invested £3,300 per household—a colossal sum of money. That is unprecedented. There has never been a cost of living intervention anywhere of that magnitude, so that must be an important part of the discussion about Healthy Start.