Hospice Funding

Andrew Rosindell Excerpts

Monday 22nd April 2024 Commons Chamber

[James Sunderland]

I thank my hon. Friend for his timely intervention. As we know, palliative care is privately funded and not formally funded by the NHS. It cannot be right that such an important function is funded in a hand-to-mouth way. To prove that point, Sebastian’s Action Trust is to close its Crowthorne site, the Woodlands, later this year. A sale is expected in autumn 2024, because it cannot afford the care that it is giving to so many families, so it has to rationalise its estate and move elsewhere. In my humble view, the funding for the NHS, for our hospices and for palliative care is not enough.

[Andrew Rosindell (Romford) (Con)]

My hon. Friend is making a powerful case for the hospice movement, as all colleagues have done in this debate. Does he agree that every penny that the Government give to the hospice movement takes pressure off the national health service? Hospices are doing the job that, otherwise, the NHS would have to do. Will he join me in congratulating the Saint Francis hospice in the village Havering-atte-Bower in my constituency, which was established in 1975? It has for many years served people from the London Borough of Havering and the surrounding area. It is a magnificent organisation. The hospice movement does a fantastic job for the entire country, and it is time for the Government to do more.

[James Sunderland]

I commend all the staff in the Saint Francis hospice in Havering on what they do. It sounds remarkable. We have heard so many stories this evening of hospices and palliative care providers right across the country.

The message is clear: we need more funding. We must establish better funding models. We cannot rely so much on charities and donations. We must make sure that funding is provided up front. This is a life-and-death issue. Hospices take pressure off the NHS. The facilities at Thames hospice are state of the art; we can sweat the asset an awful lot more. Perhaps the underused capacity of hospices could sometimes be hired back to the NHS.

Tobacco and Vapes Bill

Andrew Rosindell Excerpts

2nd reading
Tuesday 16th April 2024 Commons Chamber

[Sir Jake Berry (Rossendale and Darwen) (Con)]

I start my speech by saying that there are some good parts of this Bill. The banning of disposable vapes and preventing children from starting smoking or vaping is something that anyone with a brain—there are perhaps more of them on the Government Benches than on the Opposition Benches—would support. I will address my remarks to whether banning all children who are now 15 from ever smoking is the right way to stop them smoking, as well as talking about whether any Government have a mandate on removing personal liberty.

I am sorry to see the hon. Member for Ilford North (Wes Streeting) leaving his place, because I was about to address some remarks to him. It is unfortunate for the quality of debate to label someone standing up to ask whether this measure will be effective as someone who wants children to smoke. I am an ex-smoker and I do not want children to smoke; I just want to pass decent laws in this House to ensure that we can reduce the number of young people smoking. That is why, when I look at this ban, I question whether it will work.

I put it to the Secretary of State that 20% of young people say they have tried cannabis. Those are not my statistics, but those of the Office for National Statistics. That is twice as many as the number of young people who say that they have tried tobacco, I think within the past 30 days. If bans worked—cannabis is banned—no child would ever have tried cannabis. It is illegal not just for those who are 15, but for all of us, whatever age we are. I went to Aintree this weekend to enjoy the grand national. I was amazed that people were walking around at one of the most heavily policed events in the UK openly snorting cocaine. It is a class A drug, and the police were doing nothing about it. If bans worked and the police enforced them, no one is this country would take drugs. I therefore question whether banning people who are now 15 from ever starting smoke will work. To me, the answer is no.

I will move on to the mandate for any MP or any Government in this place to seek to bring in such a measure in advance of a general election. If Members go to Washington and have a look at the Korean war memorial, they will walk past thousands of names—it is an extraordinary memorial—and at the end there is a bold statement: “Freedom is not free”. All the freedoms that we enjoy in this country have not been given to us; they have been fought for. People have died to ensure that we keep those freedoms.

What we are really talking about today is removing from a group of people in our society—they may be young now, but do not forget that, at the general election after next, some will be 18 and banned from smoking, while some 19-year-old voters will be able to smoke—the right ever to have the agency to make their own decisions. If we believe in freedom, we must accept that people have to be free to make bad decisions as well as good ones. If we live in a society where the only decisions that we are free to make are those that the Government tell us we are free to make, we might as well live in a socialist society—we may as well live in Russia or China. For me, freedom means the freedom to get things wrong.

[Andrew Rosindell (Romford) (Con)]

My right hon. Friend is making some extremely valid points. Freedom with responsibility and freedom of choice are surely what the Conservative party should stand for. We can think of all kinds of reasons to ban all kinds of things, but surely the choice of the individual should be paramount. It is not for Government to dictate to individuals.

[Sir Jake Berry]

My hon. Friend is quite right. That is the legal position under the law in this country if we have capacity, no matter how bad the decisions we make. Constituents have contacted me about elderly relatives who are making poor financial decisions, but because they have capacity they are free to make those decisions, albeit bad ones in some cases.

--- Later in debate ---

[Craig Whittaker (Calder Valley) (Con)]

Everyone would like to see a cessation of smoking. People stopping for good, let alone starting at an early age, would bring long-term health benefits to the nation as a whole. Sadly, the problem is that this Bill will not be the vehicle to achieve such an ambition. It is a Bill written by non-smokers for smokers, and it is so out of touch with the cause that they want to cure that it will miss its target by a very long shot. First of all, the Bill does not ban smoking; it only stops the sale of tobacco to 18-year-olds if they turn 15 this year. We heard today from the Secretary of State that 100,000 children already start smoking every year. The sale of tobacco is already banned for those children.

The Bill is based on the premise that children today still ask their mate’s older brother to buy them some cigarettes from the corner shop, like they did back in the 1980s. They do not. The vast majority of regular smokers today only ever buy their cigarettes from the corner shop when they have run out of illicitly bought cigarettes. If people do not believe me, they should pop into any pub in the UK and ask the smokers whether they buy tax-paid cigarettes from the supermarket and the corner shop. I guarantee that the vast majority do not. In every community there are avenues to buy illicit cigarettes at a fraction of the average price of £15 for a pack of 20 cigarettes from the corner shop.

A recent poll of 12,000 adult smokers found that the illegal tobacco market remains resilient in the UK in spite of the number of overall smokers declining year on year. On that basis alone, the illicit market is increasing. The study found that 76% of those 12,000 smokers bought tobacco in the last year that had not been subject to UK tax, with nearly one in two smokers having no objection to buying non-UK-duty-paid tobacco from family, friends, colleagues or shops. The poll also revealed that 9% of smokers who buy tobacco through social media or websites advertising cheap tobacco do so at least once a month.

Evidence from around the world shows that when we put further restrictions on people, smugglers and gangs take over where the Government have left the market. South Africa banned the sale of tobacco during the pandemic and it is now struggling with the gangs and smugglers who cover 93% of the market there. In Australia, as mentioned earlier, there has been a rise in the number of young people smoking, and retailers there have been fire-bombed when corner shops have refused to stock illicit tobacco. Children do not buy £15 packets of cigarettes either; they buy illicit tobacco from the same sources in the community—the smugglers and gangs.

The Secretary of State said that the Bill allocates £30 million to trading standards. That is a drop in the ocean. Trading standards is not just a sick department; it needs life support to come anywhere near to achieving the task it already needs to achieve. That £30 million still leaves it with a shortfall of £78 million on its budget in 2009. Spending on trading standards in 2009 was £213 million. This year it was frozen at £102.5 million, and between 2009 and 2016 the number of trading standards officers fell by 56%. The Chartered Trading Standards Institute has warned that cuts have created a “postcode lottery” of provision and called for an urgent review of how trading standards are resourced.

[Andrew Rosindell]

My right hon. Friend is making some extremely important points. He seems to be saying that, however laudable and well intentioned the Bill is, it is impractical and unenforceable because there is insufficient funding for trading standards to make it happen in reality.

[Craig Whittaker]

That is exactly what I am saying. The Government’s aim to create a generation of smoke-free people as time progresses just will not work. It is not working now when it is already banned for those 100,000 young people who take up smoking every year. In 2021, trading standards seized just over £7.8 million in illicit tobacco. This is from the UK Government’s own guesstimate that illicit tobacco accounts for more than 16% of the market, resulting in a loss of £2.8 billion—billion, not million—in tax and duty.

We have heard that the Bill is based on the New Zealand model. New Zealand does not have an illicit tobacco problem like we do here in the UK. It is 2,500 miles away from the nearest big trader, Australia; the UK is 23 miles away from the continent. The two countries cannot be compared. The New Zealand model has now failed, and it has performed a U-turn, as we have heard. Instead, the New Zealand Government continue to support initiatives to provide people with practical tools and support to help them to quit, including by ensuring the provision of effective services to stop smoking, providing access to alternative products to help smoking cessation, and promoting social media marketing campaigns to stop smoking and vaping.

The Bill provides little guidance or support on cessation to those who already smoke. I myself was one of the 6.4 million smokers here in the UK, but I stopped smoking just over a year ago. I found very little help or support from the Government, despite all the hype around what is being done. In fact, I tried virtually every product on the market to give up smoking—even hypnosis—and the only one that eventually made me give up was heated tobacco. That product, however, is not included in the Bill as a cessation tool. Instead, its sale to young people is to be banned. Even the Kiwis recognised what a great cessation tool it is and did not include it in their ban. Instead, they put it in their arsenal of tools and recognised its benefits for cessation. In Japan, where 18.6 million people smoke, 25% of ex-smokers quit using heated tobacco, and Japan is already seeing the health benefits through its health system.

Similarly, more than half of the ex-smokers in the country with the lowest smoking rate in the world, Sweden, have quit using something called snus, which is already banned here in the UK. Ironically, the Government have put all their eggs into the vaping scene for cessation but 30% of those people who vape still smoke cigarettes. Not only that, but although Public Health England refers to alternative nicotine delivery devices, such as vaping products, the Bill does not include heated tobacco, which is delivered via just such a device.

To summarise, the Bill is not cut out for the Government’s ambitions. It follows a failed model that was devised in New Zealand, which does not have the UK’s issue with illicit tobacco. We will depend on a morsel of cash going to an incredibly stretched trading standards, which is operating on a budget that is half what it was 15 years ago, to police and enforce the policies in the Bill. The legislation underestimates the scale of the illicit tobacco trade already in the UK and will promote it even more in future. It also fails to promote cessation to the current 6.4 million smokers in the UK, and fails to recognise the many more products for people to use to quit that are better than cigarettes, such as heated tobacco. It fails on every level.

Finally, if the Government, and indeed this House, were serious about stopping people smoking, why not just set an arbitrary date in the future when smoking, in respect of either partaking or selling, will be banned completely? That will give us time for serious investment in cessation and will also give a serious amount of time to invest in stopping the illegal gangs and smugglers.

--- Later in debate ---

[Adam Afriyie (Windsor) (Con)]

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

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

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

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

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

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

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

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

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

[Andrew Rosindell]

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

[Adam Afriyie]

I could not agree more.

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

Cumberlege Report

Andrew Rosindell Excerpts

Thursday 3rd February 2022 Westminster Hall

[Andrew Rosindell (in the Chair)]

Before we begin, I remind hon. Members to observe social distancing and to wear masks.

[Alec Shelbrooke (Elmet and Rothwell) (Con)]

I beg to move,

That this House has considered the Cumberlege Report.

It is a pleasure to serve under your chairmanship, Mr Rosindell. I have secured a debate about fulfilling the recommendations of the Cumberlege report because I do not feel that we are making enough progress. We had a debate on the Floor of the House in July and a written ministerial statement on 21 July. To stay in order, Mr Rosindell, I will only say that the Minister’s answer to the debate and the written ministerial statement were disappointing, in many ways. In my opening remarks, I will seek to address why I believe that to be the case and, fundamentally, ask for certain updates. We are talking about people whose lives have been destroyed. Many hon. and right hon. Members will bring their own examples about various parts of the report, whether they are about Primodos, sodium valproate or mesh, but I will focus my comments on mesh.

I will not spend too much time going over the examples I gave during the debate in July, which can be looked up in Hansard, but I will say that people were given an operation that many did not need, which many were convinced that they should have. Some people did not even know it had happened to them. It took many years for the problems that arose to become apparent, and so those people have effectively been dismissed.

Like many Members, I have constituents who have had their lives stopped, especially women, although I will mention how the issue affects men as well. One constituent, who I have mentioned before, was a physiotherapist in her 40s who had had a child. She had mild incontinence after giving birth and was told to have the mesh implant, which she went ahead and did. Her entire life has been destroyed by that. Trying to remove it was described to her as being like “trying to take hair out of chewing gum”. We should consider that image when we think about the difficulty of the operation. We must not forget that the NHS did this, and the NHS has a responsibility to deal with it. I will make that point several times.

I have been contacted by a lady who is a constituent of my hon. Friend the Member for Thornbury and Yate (Luke Hall). Her name is Paula Goss and both she and he have given me permission to talk about her case. She set up Rectopexy Mesh Victims and Support in March 2019 after she was unable to find much research or information about the meshes that she had had put in. The group now has over 1,100 members, as well as members who have sacrocolpopexy vaginal mesh and hernia mesh. She is the ambassador and advocate for rectopexy and hernia mesh on the Mesh UK Charitable Trust, which has a further 2,000 members.

She had rectopexy mesh in 2014 as she was unable to clear her bowels. She was ill-informed by the now dismissed surgeon, who, as she found out from her notes, inserted three meshes—in the bowel, vagina and posterior. She says:

“All mesh types don’t necessarily show complications straightaway. My Pre mesh insertion issues started again around 9 months after the op, in which I was passed from pillar to post by all medical professionals saying my issues were the menopause or in my head. This went on from 2015 until September 2018 when I was admitted to hospital with a blocked bowel and bladder and had to have enemas and catheters, still they would not connect this to the mesh, upon doing a CT scan at this time they also found a large ovarian tumour, it was then discussed by my gynae oncologist at the BRI and Southmead NBT to do a joint op to remove the tumour and the mesh, due to the incompetence and lack of mesh removal experience at Southmead I ended up having the ovarian tumour removal in January 2019. Thankfully, after testing it was a large benign fibroma, following up with Southmead they then stated that they wouldn’t remove my mesh but would do an op to give me a permanent stoma—again, brushed aside and fobbed off, I sought a second opinion in London privately, whilst we are by no means rich, you can’t put a price on your health...I had to pay £32,000 for my removal, it took over 10 hours and they could not get all of it…two protacks in particular sit very close to the bifurcation of the inferior vena cava on the left and the common iliac on the right. Pre mesh removal I was found to have a heart murmur and I suffered pericarditis quite a few times. My histology on my meshes showed that I was not a candidate for polypropylene and should not have this inserted again…When I discovered I had hernias again I was neglected by the local hospital who at first refused to do a scan, saying I must have an ulcer. it was thanks to my private mesh removal surgeon who contacted my GP and insisted that I was referred for a CT which then clearly showed two large incisional hernias.

The consultant at Southmead stated he would only fix my hernias with polypropylene mesh. After I told him that I couldn’t have that, there was no option but to again look down the private route. Thankfully, my colorectal mesh removal surgeon was able to do this and a date was set for 6 January 2020. However, my hernia started to strangulate and I was luckily rushed to London by my husband, and had this op done on 28 November 2019. This cost £43,000.

This operation was by far the toughest and took a long time to get over, due to ending up with a seroma and now a hiatus hernia due to the trauma to my abdomen.

My journey has not been, and is still not, plain sailing, but I am one of thousands.

Whilst vaginal mesh gets a lot of coverage, ours does not. Rectopexy affects men, women and children…All three main types of mesh need to be included and talked about—bowel mesh, vaginal mesh…sacrocolpopexy and colporrhaphy vaginal mesh and hernia mesh...One of our rectopexy mesh ladies found out that the surgeon who put mesh in also removed her ovary without consent, she sadly committed suicide due to this event.

One of our rectopexy patients was just 15 when she had her mesh inserted. She’s early 20s now and now suffers complications and doesn’t even know if she will ever be able to have children.

We have other ladies in their 20s and early 30s suffering, who may not be able to have children.

We have many rectopexy bowel men on our sites who feel they have nowhere to go and no one who will listen to them.

This is the same for all hernia mesh victims too.

There are many real victims’ journeys that need to be listened to and taken seriously.”

That is what the report did, and why it was so appreciated by the victims, as they were finally being taken seriously. That is where the report’s value lies. Today, I once again push for it to be implemented in full as far as possible, and for recommendation 3 about redress, recommendation 4 and recommendation 5 to be reconsidered.

Recommendation 1 was for an apology. That apology was received in July 2020, given by the Government, but, as good as it was, their actions depend on whether they can justify what they are doing on recommendation 9. Recommendation 2 is:

“The appointment of a Patient Safety Commissioner who would be an independent public leader with a statutory responsibility. The Commissioner would champion the value of listening to patients and promoting users’ perspectives in seeking improvements to patient safety around the use of medicines and medical devices.”

The Government accept recommendation 2, and I ask the Minister for the latest update on that appointment. On 2 December last year, in the other place, the noble Baroness Cumberlege asked Her Majesty’s Government

“when the process to appoint the Patient Safety Commissioner will commence; and when they expect the Commissioner to be in post.”

In response, the noble Baroness Chisholm of Owlpen said:

“My Lords, we are making good progress towards appointing the first patient safety commissioner for England. We expect the appointment of the postholder by spring 2022.”—[Official Report, House of Lords, 2 December 2021; Vol. 816, c. 1443.]

As I said, I would like an update on where we are in that process.

Recommendation 3 is that:

“A new independent Redress Agency for those harmed by medicines and medical devices should be created based on models operating effectively in other countries. The Redress Agency will administer decisions using a non-adversarial process with determinations based on avoidable harm looking at systemic failings, rather than blaming individuals.”

The Government do not accept recommendation 3. As set out in the Government’s statement,

“We have no current plans for a redress agency…We do not believe it is necessary to create a new agency for redress as it is already possible for the Government and others to provide redress for specific issues where that is considered necessary. Neither do we believe that creating an agency would succeed in making products safer as the report suggests, or that grouping existing redress schemes through a single front door would add value for harmed patients.”—[Official Report, 21 July 2021; Vol. 699, c. 72WS.]

I do not accept that it is already possible to provide redress where necessary, because my inbox, and I am sure those of several right hon. and hon. Members, suggests that that is simply not true. It is too vague and takes too long. When I talk about recommendation five, I will discuss where that issue comes to a head.

I come back to my point, which is that the NHS did this to people. I have said it before and I say it again: the problem is very similar to the thalidomide scandal. Eventually we got justice for thalidomide victims. People are just being fobbed off—I have many examples—and that is exactly what happened with thalidomide. Mr Rosindell, can you imagine living an active life, as we all do, and the NHS recommending something that means that you can no longer take part in what you were doing? Imagine being physically and mentally restricted and unable to fulfil your life’s ambitions. A full quango might not need to be set up, but at the very least we need a ring-fenced department in the NHS to bring those areas together.

Smoke-free Society by 2030

Andrew Rosindell Excerpts

Tuesday 23rd March 2021 Westminster Hall

[Andrew Rosindell (in the Chair)]

I remind hon. Members that there have been some changes to normal practice in order to support the new hybrid arrangements. I remind hon. Members participating virtually that they are visible at all times to each other and to us here in the Boothroyd Room. If Members attending virtually have any technical problems, they should email the Westminster Hall Clerks. Members attending physically should clean their spaces before they use them and as they leave the room.

[Mr David Jones (Clwyd West) (Con) [V]]

I beg to move,

That this House has considered reduced-risk smoking products and proposals for a smoke-free society by 2030.

It is a pleasure to serve under your chairmanship, Mr Rosindell, albeit from such a long distance. I am pleased to see the Minister there too. At the outset, I declare my interest as an honorary life fellow of Cancer Research UK.

This is not the first occasion on which I have raised the need to pursue the goal of a smoke-free society. I raised it previously in a Westminster Hall debate in 2019. I continue to pursue this issue because the ills of smoking continue to persist and they will continue to trouble our society for many years to come unless we take action now.

Today, I speak with hope. This year, we have an opportunity that we must embrace. Our exit from the European Union has provided us with the opportunity to take control of our own policy to improve public health, to contribute to the Government’s levelling-up agenda and to enhance the United Kingdom’s reputation as a world leader on tobacco harm reduction. The Minister’s Department is currently reviewing the regulations that have in recent years transposed the EU’s tobacco products directive into UK law and the Minister has committed to producing a new tobacco control plan this summer. I hope that in her remarks today she will set out what progress the Department has made in the process and confirm the plan’s anticipated publication date.

Since the last Westminster Hall debate that I secured on this issue in June 2019, the Government have committed to delivering a smoke-free society by 2030. There is no time to waste, and nor should we waste the opportunities that we have this year. The needs of the 7 million people in the UK who, sadly, still smoke must remain at the forefront of our minds. If my right hon. Friend the Chancellor is listening, I am sure he will be pleased to hear, especially in these difficult times, that nothing I propose this morning will require any expenditure by Her Majesty’s Treasury.

It should, of course, go without saying that smoking kills. While the number of people who smoke has fallen in recent years, the problem is still real, and it is a problem that reflects inequalities. We might not all see it in our constituencies, but there are large parts of the country where smoking rates remain troublingly high. The health costs of tobacco consumption fall disproportionately on the poor, ethnic minorities and those suffering from mental health conditions. Disadvantaged communities across the country are being left behind and the inequalities gap is getting worse.

In addition, statistics from the Office for National Statistics show that intention to quit has gone down almost year on year since 2015. Analysis by Cancer Research UK indicates that the Government are not on track to meet the new smoke-free 2030 target. In fact, its modelling predicts that adult smoking prevalence in England will not reach 5% until 2037. The pace of change needs to be around 40% faster than projected to deliver the ambitious target, so now is the time to act. It is time to make use of our newly restored policy making freedoms to make a difference with the forthcoming tobacco control plan.

The Minister’s predecessor closed the last Westminster Hall debate on this issue by saying:

“We will continue to be driven by the evidence.”—[Official Report, 26 June 2019; Vol. 662, c. 335WH.]

I am sure that approach is something that the Minister will be happy to endorse now, and it is something that I believe will set us on the right course to make the difference. Making a difference starts, first, with understanding that the fundamental problem with smoking is the smoke—the combustion. Acknowledging that should be the core principle under which we regulate. While it will always remain the case that smokers should aim to quit completely, if they are unable to do so, there are now many non-combustible alternatives that they can try, which will be less harmful to them.

Secondly, making a difference means that we cannot take our foot off the pedal in introducing further barriers to cigarettes and other combustible tobacco products. I am not generally an advocate for high taxes, but I can see the benefit of using taxation to increase the price gap between combustible and non-combustible products. We must do more to secure our borders to ensure that smugglers from abroad do not profit from health inequalities here.

Thirdly, and most importantly, making a difference means helping smokers who cannot quit smoking to change to something that is less harmful for them than cigarettes—products that are not combustible. The forthcoming tobacco control plan gives us the opportunity to take a fresh look at the new products and innovations in the UK, as well as those that we could have now that we have left the European Union. To make the most of that range of products in a sensible and controlled way calls for the creation of a new, reduced-risk smoking products category, to provide a robust regulatory framework.

It is important that products be regulated and controlled to ensure that they are used in the right way, but they will not be sufficiently effective if we do not get the information about them out to smokers. We have made great progress on tobacco harm reduction over recent years, but both those elements—regulation and information—should be addressed if we are to give ourselves the best chance of reaching the smoke-free 2030 goal.

We have seen great results from e-cigarettes, and Public Health England recently found that in every region of England quit rates involving a vaping product were higher than those for any other method. However, while they have worked for many smokers, e-cigarettes are not a panacea. In fact, nearly half the smokers in Britain have tried vaping, but did not continue. Now the number of vapers is falling, which should be a cause for concern for us all.

There are two measures that the Government can take to address the issue. The first concerns communications. Existing communications are not cutting through. When it published its annual vaping report last month, PHE said:

“Thousands more could have quit except for unfounded safety fears about e-cigarettes.”

Does the Minister agree that we could do better at communicating directly and clearly to smokers the harm reduction benefits of e-cigarettes and, indeed, all reduced-risk alternatives? The Government could, for example, allow the use of cigarette pack inserts or even online communications as ways to reach smokers directly.

The second measure concerns the nicotine level in e-cigarettes. The EU imposed a seemingly arbitrary 20 mg per ml limit on e-cigarettes, under its directive. The fact is that many smokers do not find that sufficiently satisfying to lead them to make a permanent switch away from combustible cigarettes. Now that we have the freedom to do so, we should look at setting our own limit at a level that would make the products more effective.

E-cigarettes will, however, never be the answer for all smokers. Nicotine pouches, which have been on sale in the UK for only a year or so, have rapidly grown in popularity. Around 100,000 people already use them. I understand that a reason for that is the success of point-of-sale advertising and the ability to advertise online. At present the products are not regulated beyond our general consumer protection laws, so they could benefit from being part of a sensible framework.

The use of heated tobacco in the UK continues to grow. Sales increased by 270% in the past year alone. The benefit is that there is still tobacco in the product, but it is not combustible. As I mentioned in the previous debate, 70% of heated tobacco users give up smoking altogether, but at the moment smokers cannot hear about those products, as they can hear about others. That is where smokers could benefit even more from receiving the targeted information that I mentioned earlier, online or from shopkeepers.

Finally, snus is another tobacco product and is currently not legal in the UK owing to a ban imposed by the EU. In Scandinavian countries such as Sweden, which are exempt from the EU ban, the availability of snus has had an enormous positive impact on smoking levels. Lifting the ban would show that our policy is driven by evidence, making the UK the true global leader in tobacco harm reduction. If all these smoke-free products were part of the controlled framework, with the same regulations, we would give smokers the best possible chance of moving away from cigarettes and we would give the country as a whole the best possible chance of achieving a smoke-free 2030.

Before concluding, I must touch on the opportunities that Brexit offers us in tobacco harm reduction. Every two years, we send officials from the Minister’s Department to the conference of parties to the World Health Organisation’s framework convention on tobacco control, a body that has taken positions that run completely counter to our own. Worryingly, just last month the WHO proposed a ban on vaping. The Minister will undoubtedly have noted the remarks of Clive Bates, an expert and the former director of the anti-smoking group Action on Smoking and Health, who said that that proposal was “irresponsible and bizarre”.

When we have attended the COP before, we have had to conform to the views of the EU grouping. This year, we will be attending, albeit perhaps only virtually, in our own right. This is the opportunity that I urge the Minister to consider. We have a strong story to tell on tobacco harm reduction at home, and we now have the freedom and ability to embrace bold, innovative new policies, such as those I have suggested this morning; so will we simply go along to get along at the COP, or will we do what is right by taking a bold and progressive stance in favour of tobacco harm reduction and proudly defend our own domestic position? I believe there is much that the world can learn from our approach, and I therefore urge the Minister to make the tobacco control plan one that will help us to deliver a smoke-free 2030, and one that we can showcase to the world later this year.

Public Health

Andrew Rosindell Excerpts

Wednesday 6th January 2021 Commons Chamber

[Andrew Rosindell (Romford) (Con)]

In 2017, the World Health Organisation’s pandemic influenza risk management guidance emphasised that any emergency measures should be necessary, reasonable and proportional. I fear that the measures we are being asked to vote for today are none of those. I was elected to represent my constituents in Romford, and I pay tribute to them for their resilience throughout this pandemic, but I cannot justify such a fundamental assault on their liberties and livelihoods. Removing people’s most fundamental rights and freedoms and confining them to their homes is a political decision. Those of us who are elected must judge not just the impact of the virus but the impact on our constituents’ livelihoods, businesses, jobs, education, homes and physical and mental health.

We are constantly told by the governing, scientific and media class that we must shut down our country and that people must surrender their most basic rights and freedoms in order to save lives, yet those countries that have followed strict lockdown strategies have not all been successful in achieving that aim. There is no Member of this House who does not want to save lives. From the bottom of my heart, I thank the NHS personnel at Queen’s Hospital in Romford, who have done a magnificent job in saving lives and caring for the sick. But there has to be a balance and proportionality to these decisions, considering the long-term consequences for the lives of the people we represent. I fear the impact of these shutdowns on those who run small businesses; on the 50,000 Britons with undiagnosed cancer, as estimated by Macmillan Cancer Support; on the elderly who have been cut off from their loved ones in the last years of their lives; on children from the poorest backgrounds who will fall behind as a result of schools closing; and on the victims of increased domestic violence and suicide.

The scientific advisers will never need to account for the effects of lockdown on our constituents, but we will. The shutdown that we are voting on today and the effects of these measures, while well intended, may, I fear, do more damage to the lives of the British people in the long term than the pandemic itself. I believe a complete rethink of this policy must now take place. Our country cannot go on like this.

Covid-19 Response

Andrew Rosindell Excerpts

Monday 18th May 2020 Commons Chamber

[Matt Hancock]

I have looked at this proposal and it is clear that primary legislation is not needed, because the Data Protection Act will do the job.

[Andrew Rosindell (Romford) (Con)]

I thank the Secretary of State for his unstinting dedication to protecting the health of our nation during this crisis. First, will he update the House on when the roll-out for antibody tests will be revealed, so that we can start to get back to normality? Secondly, in last Friday’s statement, he spoke about the reform of health and social care. When will the Government bring forward a lasting care funding solution to stop people in constituencies such as Romford from being forced to sell their family homes to fund long-term care?

[Matt Hancock]

I think the whole country celebrated when there was the announcement last week that antibody testing that fits the bill and does the job had been approved by our Porton Down labs. We are in the closing stages of commercial negotiations to ensure that those tests are widely available, and I will let my hon. Friend know just as soon as I can when that roll-out will be, but I do not want to prejudice the commercial negotiations, which I am sure he will understand.

On the second point, I strongly agree with my hon. Friend that this crisis has demonstrated just how important social care reform is, just how important social care is and how we must maintain the benefits and improvements in delivery and working practice that happened because of the crisis and happened through the heat of the crisis. We must maintain and strengthen that close working relationship. The financial changes that we put through have proved very effective at bringing the two systems closer together, but there is much, much more to do.

Eating Disorders Awareness Week

Andrew Rosindell Excerpts

Thursday 5th March 2020 Westminster Hall

[Ms Dorries]

Absolutely. On training for GPs, I take the hon. Lady’s point exactly. The NICE guidelines are incredibly clear, in terms of the Hope Virgo campaign and taking BMI, weight and other things into consideration. The NICE guidelines are clear, and it is up to the clinical commissioning groups to ensure that GPs and others do not take weight as a consideration. Tim Kendall is all over this and is working on it. We want GPs and others to abide by what are already very strict NICE guidelines. We have the guidelines; we just need the medical profession to implement them, but I had an idea when the hon. Lady asked her question. We are talking about training for GPs with the General Medical Council and we will continue to hold conversations about that, and I am sure that NHS England is doing exactly the same thing, but there are quicker ways to get information through to GPs.

When I was a nurse and I was training, it was the Nursing Times that informed us, on a weekly basis, of what was new in treatments and operative procedures. For GPs, it is Pulse and other magazines that they receive. I think that there might be a quicker way into GPs’ surgeries to alert them to the fact that the NICE guidelines are not being applied by GPs or by clinical commissioning groups. I think that there may be more inventive ways around that. Yes, training GPs absolutely is important; it is important to include this issue in the GP training programme, but in terms of getting a message through to GPs now, I think that we need to look at a more innovative way of doing that.

On money being diverted and ring-fenced, I think that the hon. Lady knows that the money from the £2.3 billion that goes to the CCGs is ring-fenced for mental health services only. They are not allowed to siphon it off and use it for anything else. We have our own queries as to whether some are doing that, and I know that NHS England, because I raised this with it the last time I met it, is doing an evaluation of clinical commissioning groups and having a look and checking that that money, which is ring-fenced, is spent only on—

[Andrew Rosindell (in the Chair)]

Order. Could I ask whether the Minister intends to give the proposer of the motion his usual two minutes to wind up the debate?

[Ms Dorries]

I think that the right hon. Gentleman, if he wants to talk to me at any time, knows that he can catch me anywhere. I will now give way to him.

[Andrew Rosindell (in the Chair)]

I thank the Minister and call Sir George Howarth.

Oral Answers to Questions

Andrew Rosindell Excerpts

Tuesday 29th October 2019 Commons Chamber

[Mr Speaker]

Yes, speak for Romford. Well done.

[Andrew Rosindell (Romford) (Con)]

13. What progress his Department has made on providing NHS services seven days a week.

[The Parliamentary Under-Secretary of State for Health and Social Care (Ms Nadine Dorries)]

Everyone now has easier and more convenient access to GP services, including appointments in the evenings and at weekends. There are also substantial improvement programmes in place related to seven-day hospital services set out in the NHS long-term plan, including hospitals with major A&E departments providing same-day emergency care services 12 hours a day, seven days a week, by the end of 2019-20.

[Andrew Rosindell]

I thank the Minister for her reply, but I am increasingly concerned that my constituents in Romford often have to wait three weeks or even longer for routine appointments with their GPs. What action are the Government taking to ensure that such long waiting times are reduced and preferably eliminated altogether?

[Ms Dorries]

I thank my hon. Friend for that question. Just over 40% of all booked appointments take place on the same day with GPs. However, it is important to recognise that many patients will be appropriately booking ahead as part of the ongoing plan for long-term conditions. The new GP contract will see billions of pounds in extra investment for improved access to GPs, expanded services at local practices and longer appointments for patients who need them. NHS England is working with stakeholders and is undertaking a national review of access to general practice services.

Acquired Brain Injury

Andrew Rosindell Excerpts

Tuesday 2nd July 2019 Westminster Hall

[Several hon. Members rose—]

[Andrew Rosindell (in the Chair)]

I am sorry to have to inform Members that there will now have to be a time limit. Five Members wish to speak, so unfortunately the time limit will be around four minutes.

ME: Treatment and Research

Andrew Rosindell Excerpts

Thursday 21st June 2018 Westminster Hall

[Sir Edward Davey]

The hon. Gentleman is absolutely right, and it is good that he is here to champion that centre. He makes the point I wish to make to the Minister: a pipeline of research proposals is likely to come about not only from the centre in Norwich, but no doubt as offshoots from research elsewhere—particularly the United States, which is beginning to get its act together on the research side. There is a pipeline, and I urge the Minister to anticipate that, to talk to the research councils and to say with his colleagues, “We will be ready and we will have the funds ready so that when the research proposals come through”—as I am confident they will—“we will back them.” Then we can start making progress. I say to the Minister, please, not to wait to see whether they come through before he dedicates the money and starts pressurising the research councils, because we know that process can take too long. People have already waited too long.

I will conclude my remarks by underlining two points touched on by the hon. Member for Glasgow North West. The first is the need for respect for patients. Sometimes it seems, from the stories I have read, that some in the medical profession—I say some—do not respect patients. They make comments that it is all in people’s minds and that they are making it up. That is no way to talk to adults. A constituent of mine who has been suffering from ME, who I talked to last night, recently went to see her consultant. The consultant said in terms, “All ME people are crazy, except you.” That did not make her feel very happy. I am afraid that type of view among senior medical people is not acceptable, and I hope Ministers will make it clear that they expect patients not to be treated like that.

That links to my final point, on the need to train doctors. We need better guidance and better training so they understand that situation. In that light, I am worried that we are seeing some pressure to reclassify ME. That is sending a dangerous signal, and I hope the Minister will say that the Government are questioning that reclassification and putting it on hold. Otherwise, the training for doctors will not happen, the respect for patients will not happen and we will not see the change that our constituents demand. I look forward to the Minister’s remarks and to the contributions of other hon. Members.

[Andrew Rosindell (in the Chair)]

As a lot of colleagues wish to speak in the debate, I ask that everyone keep their remarks within about eight or 10 minutes each, if that is possible. For the benefit of the Minister and the Opposition spokesmen, I hope to be able to start the winding-up speeches at 4 o’clock.