Tobacco and Vapes Bill (Eighth sitting)

Angela Richardson Excerpts

Committee stage
Tuesday 14th May 2024 Public Bill Committees

[Dame Andrea Leadsom]

I am grateful to my hon. Friend the Member for Copeland for moving the new clause tabled by our hon. Friend the Member for Sleaford and North Hykeham. I think all hon. Members are keen to see much more evidence on this issue, and I absolutely share that concern. I have urgently commissioned research into the impact of vaping on both the vaper and those second-hand breathers-in. As we all heard during the public evidence sessions, and as my hon. Friend the Member for East Kilbride, Strathaven and Lesmahagow set out, we do not have the evidence. We therefore need to provide evidence-based regulation as a matter of urgency, and I absolutely assure hon. Members that that will be forthcoming.

It is certainly the case that the ban on smoking in indoor spaces has been a great public health success story since its introduction in England in 2007 and across the UK from 2006. There is no doubt that the ban has protected many adults and so many children from the harms of passive smoking; it will have saved lives.

We know that vaping is less harmful than smoking, and indeed is a very effective quit aid for adult smokers. Although I have grave concerns about whether we err too far on the side of saying “Vaping is much better than smoking,” and are therefore inadvertently saying to young people that it is fine to vape, which of course it is not, that is why we also always say, “If you don’t smoke, don’t vape, and children should never vape.”

Although smoking in a public place may be seen as a nuisance by some, and there is some evidence that it can trigger asthma attacks, in the same way that pollution or car exhaust fumes can, there is very limited evidence of the potential harms of vaping in enclosed spaces, and simply none to suggest that it is at all similar to tobacco smoking. Vapes emit vapour, not harmful tobacco smoke. Vaping does not burn tobacco or produce tar and carbon monoxide—two of the most harmful elements in tobacco smoke. Evidence of the harm from exposure to second-hand tobacco smoke is well established, and because of its carcinogenic content, there is no safe level of exposure. It is totally incomparable to vaping, where there is very little evidence to suggest that second-hand vapour is anything more than an irritant. I repeat: that is not to say that vaping is good for anyone or a good thing to try. It absolutely is not. We know it is extremely harmful to children, whose lungs and brains are still developing.

In addition, many businesses, venues and spaces have already introduced their own bans on the use of vapes where smoking is prohibited, such as on public transport, on work premises and in many restaurants and bars. In 2016, Public Health England produced guidance regarding the use of vapes in public places and workplaces, which has helped businesses to make informed decisions on their vape-free policies, but given the lack of evidence of any harm from second-hand vapour and the way that the majority of businesses, restaurants and bars self-regulate and have vape-free policies in place, as well as the fact that vaping in enclosed spaces was not raised in our call for evidence as a major issue to address youth vaping, we just do not feel that the new clause is necessary at this time.

We will of course keep this under review and continue to monitor the evidence base. As I said, I have urgently commissioned proper research into the effects in the short, medium and long terms, and I hope to make further announcements on exactly what I am doing during the Bill’s passage.

[Angela Richardson (Guildford) (Con)]

Sometimes I think that when people listening to this debate hear the words “no evidence” or “lack of evidence”, they assume that that means there is nothing at all wrong with vaping. Will my right hon. Friend make it clear to anyone listening that there is a difference between not having done sufficient studies to gain the evidence and having no evidence of any harm?

[Dame Andrea Leadsom]

Yes, I am very happy to do that. My hon. Friend is exactly right: saying that we do not have the evidence right now is not the same as saying that vaping is not harmful. As I said, the chief medical officer has said that although we can be fine consuming strawberry sherbet ice cream in our tummies, it may not be so good to inhale it. We simply do not know what the truth is. We do believe that carcinogens may be innate in some flavours, and we know that vape products can contain heavy metals in the coils. We know that there can be significant harms from vaping, especially to children. I am happy to state once again, “If you don’t smoke, don’t vape, and children should never vape.”

With those remarks, I hope that my hon. Friend the Member for Copeland will not press the new clause to a vote.

Tobacco and Vapes Bill (Third sitting)

Angela Richardson Excerpts

Committee stage
Wednesday 1st May 2024 Public Bill Committees

[Mary Kelly Foy]

Q I have seen a product that is just a plain bottle with “vape” and a number written on it, which is exactly the same flavour as the one that is clearly marketed to children with a teddy bear on it. If we get rid of that packaging and advertising, could we still use some flavours?

Professor Sir Chris Whitty: Possibly, but this Bill gives powers that allow us to vary it depending on what the industry does. That is really the point.

[Angela Richardson (Guildford) (Con)]

Q I have just looked online and found the top influencers on social media for vaping. I know the Government sometimes use influencers in order to change behaviour. Has the NHS been involved in paying influencers for vaping? Related to that, a lot of young people and children feel under pressure a certain way, and nicotine is known as an appetite suppressant. What message do you have for young people on that basis?

Professor Sir Chris Whitty: I wonder whether I can turn to Sir Gregor first, and then maybe Sir Michael.

Professor Sir Gregor Ian Smith: I am not aware of the NHS ever engaging any of these influencers, in terms of how we approach the subject of vaping. There is certainly a real danger that social media is sometimes used by younger people, and they see things that become really attractive to them in terms of lifestyle. The misinformation and disinformation that exists across those platforms can lead them to participate in activities that are potentially harmful.

Directly to your question, my very strong answer to any young person thinking about using one of these products as an appetite suppressant is: please don’t. Please safeguard your health. Do not begin the potentially addictive journey of using these products. Do not do it for any reason.

Going back to the point we made earlier on, I would love to see a society where our sports organisations promote much more healthy behaviours, where we have a much better understanding of the huge variation in body image we have across our society, and where we promote the very positive and broad representation of who we are as the general public, because there is no “one size fits all” answer to who we are. We are beautiful in our diversity. Anything we can do to have a more positive representation of society across these platforms would be very beneficial.

Professor Sir Michael McBride: Believe it or not, I was a teenager once too, and I remember what it was like. Teenagers tend to push boundaries and experiment. It is all about finding yourself and your place and space in life. It is not cool to vape. It is not cool to succumb to peer pressure. Be yourself. Make sensible choices about what it is right for you. That is the message I would add to Sir Gregor’s point. We have an unfortunate situation where teenagers like to experiment and push boundaries and we have an industry that is only too willing to exploit that and market products at them with, as we heard, cartoon figures on the front, attractive colours and flavours that taste and smell nice. They are extensively marketed by opinion leaders. So don’t follow the crowd. Be yourself.

[Preet Kaur Gill]

Q We should all be concerned about the increase in the use of vapes by young children, so it is important that the Bill will ban the sale of vapes to under-18s. It will also close the loopholes for under-16s, because we know that vapes are being marketed and given out for free. That is the issue we must address. My concern with the Office for Health Improvement and Disparities being disbanded is on public health messaging. Parents and families are really concerned that some of their children are going through a number of these vapes per day or per week, and they do not know what is a safe amount.

There is a growing illicit vape market, but how would parents know what is illicit or what the Medicines and Healthcare products Regulatory Agency has notified as being compliant? Where is the public health messaging to support schools? We heard really good evidence yesterday from the union. This is my concern: where can people access support and information? We already have a generation of kids addicted to vapes that are marketed as having 0% nicotine, but we know that there is nicotine contained in them. What would you say to that?

Sir Francis Atherton: There is some messaging going on through the various Governments. In Wales we have a “No Ifs. No Butts.” programme, which tries to work at an individual level, to alert people to the dangers that we have been discussing, and with wider society, about the dangers and links between illicit tobacco and illicit vaping and organised crime. Bringing that awareness to the population is really important for those two reasons.

We work with trading standards to try to tackle the issue of illicit tobacco and vapes. It is important that we continue that. My understanding is that wherever we have been successful in reducing demand, which the Bill intends to do, the illicit supply also decreases. We would expect that to be a consequence of the Bill.

Professor Sir Chris Whitty: One of the many talking points of the cigarette industry is, “Well, any kind of downward pressure on cigarettes would lead to an increase in the illicit market.” All the evidence shows that the reverse happens. When you bring in reduced demand, the illicit market decreases.

--- Later in debate ---

[Rachael Maskell]

Q As you have just set out, we understand the harmful impact of tobacco, but I want to look at vaping. Is there any evidence of the impact on individuals who vape, or of a secondary impact, such as on triggering asthma or NHS admissions, or of an impact on admissions from the contents of vapes? We often talk about vapes, which are a delivery mechanism for substances. How should we regulate so that people understand what they are vaping, not least because it is now moving to an illicit market?

Professor Sir Stephen Powis: As I outlined earlier, the impact on the NHS of vaping at the moment is relatively small compared with the impact of smoking. Nevertheless, there is an impact, and we are seeing growing numbers. I have highlighted the number of admissions per year, but they have doubled over the past few years, so that impact is becoming apparent. For example, yellow card reporting to the MHRA is a mechanism for reporting harm, and again the number of incidents related to vaping is increasing, although still in relatively low numbers.

As I said earlier, however, what is important here is that the evidence base, although emerging, is growing. This is an opportunity for us not to get into a position where, in years to come, we regret that we did not take the steps early on to change the trajectory. Instead of seeing rising impact on the NHS—small at the moment, but with the potential to be greater—that trajectory should be changed. This is a golden opportunity for parliamentarians to step in early and to prevent further pressure building over time on the NHS, while recognising that the evidence is still emerging.

I agree with the chief medical officers you heard earlier: I do not believe that vaping is safe. It is undoubtedly safer than smoking, which is why we support its use as a means of smoking cessation, but beyond that the evidence is building that it is not safe. Unquestionably, it will have a building impact on the NHS.

[Angela Richardson]

Q My question is for Kate. I think we all fully accept that vaping is a great smoking cessation tool. About a year ago, the NHS was helping women who smoked to transfer to vaping while they were pregnant. We know that nicotine crosses through the placental barrier, and earlier you outlined the difficulties that mothers and their children have in terms of health outcomes.

How much do we know about the difference between the impacts of smoking and vaping? Thinking of the impact of vaping on babies, is vaping still an okay thing for pregnant women to be doing? Do we need to specifically address the impacts of vaping and smoking on pregnant people in the Bill?

Kate Brintworth: If we start with the evidence, as we have heard this morning there is a limited evidence base around vaping, but that does not mean we should be complacent. We know there is evidence around the transfer of chemicals and the reduction in lung capacity, which we see. As Chris said, while that is an improvement against the very, very low bar of smoking, we would see it as one step on a journey—an interim measure to being nicotine and tobacco free. On that basis, I do not think I would frame it as being okay to vape. We would see it as a tool—a means to an end—to reach the position of being nicotine and smoke free.

We will absolutely support research monitoring the impact of vaping. We cannot be complacent that it is going to be all right. However, at the moment, vaping is absolutely better than smoking, with the very well documented impacts that I have described on not just the mother but the baby and the future health of the family; we know that children born into households where smoking occurs are likely to start smoking themselves.

[Angela Richardson]

Q Can I follow up quickly? Nicotine is having an impact on babies; we heard from teachers about nicotine having an impact on young children when they are in school. Obviously, other substances are involved in tobacco smoking. Do those other substances cross through the placental barrier, or is it just the nicotine?

Kate Brintworth: It is all of it—all the elements. In some babies born to smokers, the children can almost suffer withdrawal symptoms and be jittery and restless in the neonatal period because they themselves are having to go through that withdrawal that is so difficult to enact. We also know of the numerous chemicals—arsenic, carbon monoxide—all of which are toxic to infants, so in no way would you want to distinguish out. It is a whole package of things, all of which we would like pregnant women and babies not to be exposed to.

[Mary Glindon (North Tyneside) (Lab)]

Q We hope that this really important Bill will prevent future generations from smoking. In your professional opinion, what impact can the Bill have on that stubborn figure of 6.4 million people who currently smoke? What in the Bill can help those people? It is such a high figure; when you describe the kinds of illnesses and what happens to pregnant women who smoke, it is horrifying.

Professor Sir Stephen Powis: Over time, this Bill will lead to the eradication of an addictive condition that causes the immense harm that we have described. But of course, that will occur over time, so it is also important that we continue with a range of other measures to encourage those not immediately impacted by the raising of the age of sale of tobacco products to cease smoking.

We have a number of smoking cessation programmes within the NHS, which was part of our ambition in the long-term plan for the NHS five years ago. We have been rolling out and supporting those services within hospital settings, and we should continue doing that. Of course, local authorities should also continue their work in supporting smoking cessation. Much of that is also targeted at women who are pregnant.

Part of that work is also supporting staff. Smoking rates across the 1.3 million or 1.4 million people employed within the NHS are lower than across the general public, but we nevertheless continue to see NHS staff who smoke. It tends to be in the lower pay grades within the NHS, but of course for all sorts of reasons we would like that rate to come down. Obviously there is the health benefit, but also, as you all know, smoking causes illness, illness causes absenteeism and absenteeism is a cost to the NHS. Although, as I said, we strongly support the Bill, it is important for us within NHS England and the wider NHS to continue to take other measures and put in place other programmes that will assist the public and our own staff to quit cigarettes.

Tobacco and Vapes Bill (Second sitting)

Angela Richardson Excerpts

Committee stage
Tuesday 30th April 2024 Public Bill Committees

[The Chair]

We have two minutes left. Is anyone burning to ask the last question? We have had very clear evidence and it has been an excellent session, but is anyone sitting on a question they have not yet asked?

[Angela Richardson (Guildford) (Con)]

Q Yes. Greg, I am picking up from the witnesses and evidence sessions we have had so far that there is almost an ideological feeling about vapes as a smoking cessation tool. You talked about the unintended consequences of people going back to smoking or not giving it up if we were to take a tougher line on vaping or the effects of vaping on others. I am slightly worried from a public health point of view: what if we discover that vaping is dreadful and we have taken the really strong stance of maybe not looking into it enough and giving it the urgency it needs?

Greg Fell: Again, without wanting to take the fifth amendment, that is a question for some of the experts behind me, who will give you a full view based on the science. We are 20 years into vaping now—we would probably have started to see significant amounts of vaping-related harm. Cases can always be found of somebody who has terrible lung damage as a result of vaping, but they are usually the exception rather than the rule. The comparator is always tobacco smoke: is it safer than tobacco smoke on the basis of all the science that we know, 20-odd years in? Yes, unequivocally. Is it safer than fresh air? No—hence we do not recommend that people who do not smoke start vaping. As the chief medical officer has said repeatedly, the tobacco industry marketing vapes to kids is completely unacceptable. I am happy—hand on heart, I can say that ADPH pretty much follows the line that it is a route out of tobacco smoking, as we know that smoking kills half of its customers or more. Should the science change in another 10 years, then we would change our view, but on the basis of the evidence we have now, I am happy that we have got the right position.

[The Chair]

Thank you very much, David and Greg, for an excellent session with some very clear evidence.

Examination of Witness

Ailsa Rutter gave evidence.

Tobacco and Vapes Bill (First sitting)

Angela Richardson Excerpts

Committee stage
Tuesday 30th April 2024 Public Bill Committees

[Kirsten Oswald]

Q I am grateful to you both for your comments so far. Would you say more about your thoughts on groups of people, particularly young people —this is a thing you will hear around the table—who are taking up vaping but have not previously smoked. Do the measures in the Bill go as far as you want in trying to prevent that from being the direction of travel?

Dr Griffiths: If the Committee is minded to strengthen anything that would prohibit people from starting vaping in the first instance, where they are not doing so as a cessation tool—I hope it is really clear that we believe that, as a cessation tool, this is a product that has its place that would help thousands of smokers give up and, ideally, prevent them from losing their quality of life or, tragically, their lives; I hope that is explicitly clear—I think that could have incredible impact. What we are worried about is people using vaping as a start and an entry point to nicotine. Nicotine is so highly addictive. You see that in the number of smokers who desperately want to give up. We have spoken to such people in abundance. Anything that helps us get to that point would be welcome.

Sarah Sleet: Nicotine, we know, is as addictive as heroin and cocaine. It is a terrible addiction. However, in terms of vaping, it is going to be quite tricky to get that balancing act right. We really need to have vaping as a cessation tool. We know it is more effective than just about anything else you can have in terms of cessation. For example, when it comes to flavouring, if you make that too difficult or make it problematic for people to switch, then there is a chance that we may have a real problem in terms of stopping smoking. On the other hand, we really do not want people to be attracted into vaping who have never smoked. I understand that that bit of the legislation is in secondary legislation and can be adapted over time; I think a lot of attention is going to need to be given to how people are actually responding and how they are behaving, and then adjusting that over time.

[Angela Richardson (Guildford) (Con)]

Q You have been quite clear that even though we do not yet have the evidence to understand the impacts of vaping, it is a very important cessation tool. Do you see a world in which it could be prescribed as a cessation tool, as opposed to being available as a retail product?

Sarah Sleet: I believe that is the system in Australia—it is prescribed. I think it is a possibility. It needs to be well researched. Would it still encourage people who need to stop smoking to use it as a tool, or would it put a barrier up to using that tool? Before we move to that system, we would need some really good behavioural evidence that it is not going to be a further barrier for people. If it is not, then that could be a really good option.

[The Chair]

I am going to take the Minister at this point, and then Preet Kaur Gill.

--- Later in debate ---

[Mary Kelly Foy]

Q Following on from Bob’s question, you are in a position to educate young people about the harms of tobacco. Is there a point here about educating young people about the harms, about the unscrupulous measures that the tobacco industry takes and about the horrific products that it is making? Young people are often interested in climate change and wider issues. These industries and organisations are having an impact across the whole world. It could be something that young people are interested in—not just for their health, but for the wider impact on their local communities and across the world. If we had more funding for education, maybe with a payer levy, those types of measures could be looked at. Is there any opportunity for that type of education in schools?

Matthew Shanks: That is happening at the moment within education, in curriculums and so on, but there is a lack of messaging around vaping, its harmful effects and its cheapness compared with tobacco. Even with the teaching of the harmful effects and the messaging compared with tobacco, there are still some families who smoke and you still see celebrities smoking. You are fighting that all the time.

It is good that we are educating young children about the harmful effects of things and the need to change, and we will continue to do that. We talk about big tobacco companies, big pharma, the global environment and so on, all within the curriculum.

Patrick Roach: The reality is that we need more space in the curriculum to do all that and to make the connections between vaping, the impact on a child’s health, and how these companies are profiteering, often from the most vulnerable. The producers of vaping products, the degradation of the environment, the way products are manufactured—all of this is very rich territory.

I would like to see more by way of permission for teachers and school leaders to engage with their pupils about the real everyday concerns that young people have. There should be more scope and space in the curriculum to do that. That is not to argue against the teaching of maths, science and languages; it is about saying that we want to produce well-rounded individuals. For us, that is the purpose of education. This is an area where educators have an important role to play.

Matthew Shanks: I would just add to that by encouraging you to visit your local schools and see what they are doing.

[Angela Richardson]

Q This morning, in evidence from previous witnesses, we heard a lot about how vaping is a great smoking cessation tool, but there is not enough evidence about the harms of vaping. You have described social harms; you probably see health harms as well. You have surveyed people, and you have come to give evidence this morning. Have you been asked, outside this, for evidence of the harm from vaping to the young people you look after? Do you believe that the evidence gathering on whether vaping is harmful is going at a fast enough pace?

Matthew Shanks: No, prior to now. This is very welcome, which is why we have both given our time because this is important. There was something in the papers this morning about evidence of harms of vaping for children, but it is not the headline; it is seven or eight pages in, so people will not read it.

I absolutely think that there should be more about the harm of vaping or just the unknown. You do not know necessarily what the dangers are, so therefore why would you engage in it? We talk a lot when we are doing drug prevention with children about—apologies if this offends—where the drugs come from, what the base of them is and what they contain. In the same way, you do not know what is in a disposable vape or another type of vape, so why would you put that in your body? Those are the lessons we are talking about, so we would certainly welcome more evidence to support that.

Patrick Roach: We know, from the feedback we have had from teachers as part of the research we have done, which includes both quantitative and qualitative feedback, that children are getting ill as a result of using vaping products. That is the daily reality that school leaders and teachers have to deal with.

The more that we can systematically collect and collate that data and evidence—whether that is a child who ended up being rushed into hospital because they became very ill on the school premises or, indeed, a near miss within the school—the better we will be. But the reality is, on an everyday basis, that teachers are experiencing this and having to deal with these issues and to intervene on and support pupils who are impacted physiologically by other harms of vaping products.

[The Chair]

A very brief final question from Dr Caroline Johnson. We have to finish at 10 past 11, so I ask the witnesses to bear that in mind.

Cass Review

Angela Richardson Excerpts

Monday 15th April 2024 Commons Chamber

[Victoria Atkins]

The reason why I am able to be so robust on this issue is that I believe in it; on that, I may be different from others. The challenge that the right hon. Gentleman rightly puts forward is that we have to ensure that NHS England acts as an organisation, but also at the individual and local levels, to implement the reforms that the report recommends. I want to be fair to clinicians, medical professionals, managers and others who very much support the review. I want to support them in taking up the recommendations. What individual clinicians may or may not have done in the past will be a matter for both NHS England and the regulators going forward. The moral and professional expectation is that in future, clinicians, medical professionals and all of us will respect the evidence and the recommendations of this important report.

[Angela Richardson (Guildford) (Con)]

I would like to put on the record my thanks to Dr Hilary Cass for her thoughtful and comprehensive review. Does my right hon. Friend agree that those of us across this House who, for the past few years, have been calling for a pause on the ban on conversion therapy while we wait for Cass, because of concerns not with the L, G or B, but the T element of the ban on LGBT conversion therapy, have been completely vindicated in that call?

[Victoria Atkins]

I thank my hon. Friend sincerely for her help in raising these difficult questions and for doing so, as she has just demonstrated, in a thoughtful and careful manner. I know that she shares my concern that the children and young people at the heart of this should be our focus. We need to build the system around them, rather than them being slotted into the system, as has happened in the past.

On conversion therapy—again, I am being very mindful of the sensitivities of this—we are committed to supporting all victims of conversion practices, but we want to avoid any unintended consequences and ensure that the draft Bill takes account of the independent Cass review. That is why my Cabinet counterpart, the Minister for Women and Equalities, is leading the work in this area. We are very much considering this complex issue as part of our approach to this sensitive and important matter.

Menopause

Angela Richardson Excerpts

Thursday 9th June 2022 Westminster Hall

[Angela Richardson (Guildford) (Con)]

It is a pleasure to serve under your chairmanship, Mr Robertson, and to follow the hon. Member for Edmonton (Kate Osamor). I congratulate the hon. Member for Swansea East (Carolyn Harris) on securing the debate, on her brilliant private Member’s Bill that went through last year, and on setting up the incredibly important menopause taskforce with the Minister. I am looking forward to Menopause Monday next week, and I shall look for the invitation in my inbox. I have just checked my diary and shall try to clear it so that I can come along. The work that the hon. Lady is doing is incredibly important, because she is shining a light on something that has been swept under the carpet for a long time.

I feel lucky that I had a mother who was open and who answered the incredible number of curious questions that I had as a teenager. She is 30 years older than me, so I was 18 when she was 48, and I am nearly 48. I remember her going off to the doctor and being diagnosed with depression. This is such a perennial story, and I cannot believe that, 30 years later, we still have women being diagnosed with depression instead of perimenopause, which is what she was going through. She did not get on with the antidepressants, so she stopped taking them and went back to her old doctor—she had moved area—who prescribed her HRT. She did not get on with that either, but that was probably due to my mother’s sensitivity to changes. Throughout my life, I have not been able to cope with hormones from certain forms of birth control and such things. I have never really wanted to use them or got on with them, and I think a lot of people are sensitive to them. Because my mother did not have a very good experience with HRT, I thought, “When I get to that time of my life, I’m just going to be tough and see it through,” like we all have to do.

I loved the hon. Lady’s comment about HRT being a posh woman’s thing. It probably is, to some extent. She is absolutely right to talk about the postcode lotteries. However, the majority of women—they are busy and getting on with their lives, because they are working or have children at various different ages—put themselves last. We do not put ourselves first, and it often takes something quite significant for us to seek the medical help that we need, as we all lead busy lives.

I first experienced menopausal symptoms last summer —it was a bit before my right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes), and before the debate last October. During the summer I thought, “Have I got long covid again?” I had had covid in March 2020 and had nine months of long covid, which involved complete and utter exhaustion. I got over it and got my lung function back again, and I thought, “Why am I so tired? Why am I exhausted all the time?” Like the hon. Member for Edmonton, I thought, “Is it just this job?”

I was curious to hear my right hon. Friend talk about the HR director saying, “I don’t want anybody to know I’ve got this.” I can promise Members that, as an MP, I rely on the fact that people realise that I work hard for my constituents seven days a week. Why would I want to tell them that I am absolutely exhausted, that I am struggling to sleep at night, that I am having hot flushes, and that it takes me about five attempts to get up in the morning? That is what it was like with long covid.

The point I want to make to the Minister is that about 2 million people in the country are currently suffering from long covid. It is really important for women who are over the age of 40 and who are suffering from long covid to double-check and make sure that they are not also having to deal with perimenopause or the menopause. There could be an easy solution for them, such as taking HRT. The symptoms include brain fog and not being able to find the right words, which is a serious problem in a job like this. When your brain stops working and you are in the middle of a speech, you think, “I know what the answer is. Why can’t I find it? What’s going on?” It is due to perimenopause, and there is a good solution for it.

I decided in August last year—thankfully, we were on recess—that I could not wait any longer. I needed to go and see a doctor, and I did the research. I am lucky: I am able to spend time googling. I am looking up things all the time, and I found Dr Alex Standring at the Surrey Park Clinic, who had put together a whole load of informative videos about symptoms and what women were going through. I got in touch with her and managed to get myself a prescription, and the change was immediate. Almost within two weeks, I felt like a different person.

I came into this place thinking, “I don’t want to be boxed in talking about women’s issues. I’ve got to talk about the economy, defence, justice and big meaty things”, but we have to speak our truth and talk about what we are going through. As women, we have powerful voices in this place. We ask women to stand for Parliament, and it is quite often at this time in their life that they are ready to make that sort of contribution, yet they might come in and find themselves suffering with perimenopausal symptoms, and then probably from impostor syndrome—“What am I doing here? I don’t belong here. I can’t do this job.” We absolutely can do this job, and we need more women to come into this place. We have hit the prime of our life. Quite often, women have had their children—or they may not have had children, but they are at a point in their career when they should absolutely be humming. It is such a shame to see so many women step back from what they can potentially be in the workplace and in everything they are doing because these awful symptoms of perimenopause and menopause come along. Many role models have been mentioned, and I just wanted to say that Sophie, Countess of Wessex, is also doing a brilliant job in raising awareness.

My colleagues have already mentioned asks of Government in their speeches, so I will not repeat them, but it is important that we keep talking about this issue and raising awareness. I am pleased that steps seem to be being taken on a more regular basis, due to the one- woman campaign machine that is the hon. Member for Swansea East, as well as the Chair of the Women and Equalities Committee, my right hon. Friend the Member for Romsey and Southampton North, keeping these things at the forefront of everyone’s mind. I thank all Members present for their indulgence, because it is important that we are able to tell our stories and talk about what we have experienced. I also thank the Minister for her tireless work behind the scenes; it is not always easy.

Health and Social Care

Angela Richardson Excerpts

Friday 3rd December 2021 Commons Chamber

[Edward Argar]

I can reassure the hon. Gentleman that it is not him who is looking a little old or worn around the edges. I understand the point he makes, and he and I have met about this particular issue, which goes back to what counts against capital allocations in terms of accounting. He tempts me to change Treasury rules; I fear that could be career-limiting, as I am not a Treasury Minister, but I will continue to talk to him and work with him to see whether we can find a way to allow the project to proceed.

[Angela Richardson (Guildford) (Con)]

I am reassured to see that applications to study nursing and midwifery have risen by 21% this year alone. Having recently joined my midwives on their March with Midwives up the high street in Guildford, I know that midwives urgently need their numbers boosted. Will my hon. Friend confirm that we remain on track to deliver 50,000 more nurses by the end of this Parliament, as we promised in our manifesto?

[Edward Argar]

I can confirm that my hon. Friend is absolutely right in her assessment of the progress that we are making.

Menopause (Support and Services) Bill

Angela Richardson Excerpts

2nd reading
Friday 29th October 2021 Commons Chamber

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

It is always a privilege to be in this Chamber to support the work of the hon. Member for Swansea East (Carolyn Harris). It is just over a week since we last debated the menopause in the Chamber, and I always say that in Parliament we should pick not just our battles but our allies. It is a pleasure to campaign, to hold a revolution and to be a warrior alongside her.

The reality is that all women will go through the menopause, but not all women will suffer symptoms. Only about 80% suffer symptoms and HRT—a brilliant, wonderful solution to some of those symptoms—does not work for everyone, and the same type of HRT does not work for every woman. That is why it is often a case of trial and error, going through many prescriptions to find the form of HRT that works for each woman and resolves their symptoms. We have to address the costs because women will be bearing the burden of prescription after prescription until they find the solution for them.

We have heard a little this morning about education, but no one has yet paid tribute to the brilliant work of my right hon. Friend the Member for East Hampshire (Damian Hinds), who made sure that, as part of personal, social, health and economic education, girls are not just taught about periods, not getting pregnant and contraception but are taught about what might happen when those periods stop. Of course, it is not just a matter for girls. Their male classmates and colleagues, their fathers and brothers, also need to be part of this discussion.

As we have heard repeatedly, there is too little knowledge in schools and in the workplace. I regard this place as a workplace and, until very recently, it was heavily male- dominated, but we are clawing it back, sometimes just one seat at a time. I pay tribute to the work of one of the foremost menopause warriors, Anne Milton, the predecessor of my hon. Friend the Member for Guildford (Angela Richardson). As Deputy Chief Whip, Anne Milton played the crucial pastoral, human resources role of helping many of us with conversations on all sorts of weird and wonderful health issues. It helped that she was previously a nurse, but she was an evangelist for HRT. When I spoke to her about it yesterday, she said, “Just go and get yourself a prescription, because this will solve those hot flushes at night and the fact you wake up in a puddle of sweat.” I still tried to say, “No, I’m sure that’s just my insistence on sleeping under a 13.5 tog duvet.” Apparently not.

I vividly remember being brutally asked by GB News, “What are your menopause symptoms?” I recoiled a little from the question, which I thought was a bit rude. And then I thought, no, I have to talk about it. I regard it as my duty to talk about it so that younger women know, whether it is brain fog, anxiety, hot flushes or night sweats, this is all normal and it can be addressed.

[Angela Richardson (Guildford) (Con)]

I had that conversation with my predecessor, the right hon. Anne Milton, quite a few years ago, and she completely changed my mind about HRT. My mother and aunt had to go through this 30 years before me—I am now 47—and they had difficult reactions to HRT. My aunt died from cancer that, anecdotally, was blamed on HRT.

It was Anne Milton who said to me, in a frank conversation, “This is what women need to live good lives.” I pay tribute to her for having the courage to have that conversation with me, and I pay tribute to my right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes) for the courage she shows in talking about it, too.

[Caroline Nokes]

My hon. Friend has made the point—lead good lives—and that is what we want to do, whether it is at home or at work.

Something in particular has struck me during Menopause Awareness Month. I have spoken to many employers about the menopause workplace pledge, and have talked to members of organisations in the City of London about what they can do to support women. According to a survey carried out by the Fawcett Society, 50% of women working in financial services were not taking on additional responsibilities because they were worried about their menopause symptoms, while 25% were considering leaving work. Women at the height of their careers are potentially losing them, and not providing those brilliant female role models to which we all need to aspire in order to progress in our careers.

I make no criticism of my right hon. Friend the Member for Pudsey (Stuart Andrew), the current Deputy Chief Whip, but I issue a plea to all those in the Whips Office: make sure you have good, strong women in there who can provide advice when it is needed. I pay tribute to Claire Hattrick, who lives in Hampshire and runs the clipboardclaire.com website, providing impartial, informed advice for women when they are going through the menopause. Many of us simply do not know what the symptoms are. We do not understand them, and we do not know where to turn. Claire and many like her across the country provide that advice, free of charge and independently, giving us all hope that the symptoms can be dealt with.

Bills such as this mean that we will debate the issue on the Floor of the House as well as in the wider country. It is about having the conversations, about making sure that we understand, and, most of all, about joining the hon. Member for Swansea East and ensuring that we are all warriors and allies, and that we are going to bring about change.

Baby Loss Awareness Week

Angela Richardson Excerpts

Thursday 23rd September 2021 Commons Chamber

[Angela Richardson (Guildford) (Con)]

What an honour it is to follow my good friend, the Member for Bracknell (James Sunderland). I pay tribute to him for his openness and honesty today. I think we need more of that in this House. I thank my hon. Friend the Member for Truro and Falmouth (Cherilyn Mackrory) for securing the debate and bravely sharing again her story about Lily, and for her tireless work on the all-party parliamentary group on baby loss. Sometimes we end up in these things, but it is what we make of them that counts. In her speech, and in her answers to interventions, it was clear that she really knows her stuff. So I commend her. I also thank my constituents who wrote to me last year after my contribution to the debate and this year asking me to be here today.

This is an opportunity for us to talk about our shared humanity and our shared stories right across the whole Chamber. It is something that affects us all. I have always found that being open in discussing a sensitive subject is a good thing. It encourages others to open up and talk about things. However, as I was preparing for the debate today, I knew why I do not talk about these things sometimes. There is a real physical reaction to bringing those memories back to the forefront of your mind. Your eyes prick with tears, it becomes difficult to swallow and you wonder if you are going to be able to get the words out and speak. We have seen, in contributions across the Chamber, that we are all in that position. Even as I was writing my speech today and writing notes, I could feel that physical reaction to things that happened a long, long time ago.

As I was looking up statistics, as we do in this place, I realised that I am a statistic on a piece of paper—quite an awkward thing to be sometimes. I want to focus my comments on the mental health side of baby loss. On stillbirth and mental health, Tommy’s, a great charity and resource, has stated that women who have suffered stillbirth or neonatal death are more likely to have anxiety and depression afterwards. One study in the US of 800 women showed that women who had stillbirth were twice as likely to have depression, compared with those who had live births. That effect had actually increased when they were studied again two years later, showing that stillbirth has a long-term effect on mental health. Another study of 609 women who had experienced stillbirth or neonatal death showed that women who had loss were four times more likely to have depression and seven times more likely to have post-traumatic stress disorder. In my speech last year, I talked about flashbacks. They catch you by surprise and come at the most unexpected times. Something will trigger one, bringing those physical sensations right to the forefront.

I wanted to talk a little about my story. I have schoolfriends who had to give birth to babies who no longer had a heartbeat and, on the anniversary each year, watch the photos go up on Facebook. It is wonderful that they are able to celebrate—that is probably the wrong word—to recognise that child and that their friends share that with them, even though it is very difficult to look at those photos. I had a very good schoolfriend who, like my hon. Friend the Member for Truro and Falmouth, at 20 weeks found out in a scan that the amniotic fluid was disappearing and that her baby was being crushed slowly in the womb. She had to make the decision to terminate the pregnancy because the baby would never have survived. Because she was such a good friend, I lived that with her.

Last year, I talked about the three miscarriages I had in a row. Life was wonderful and fine and we managed to have our first child. I am one of those people who is very lucky in that I am incredibly fertile—I am sure my husband wishes I was not quite so fertile—and we were able to fall pregnant very easily. I talked about the fact that we had contracted a horrible SARS-like illness back in 2003 and that, in the following year, I had three back-to-back miscarriages. I think it says something about my character that I was so driven to have another baby that I would have a miscarriage and then two weeks later in the cycle I would ovulate and fall pregnant. That happened three times in a row, so I suffered the loss of a baby and then was pregnant again two weeks later. That happened three times. When we fell pregnant with our second child—he was my rainbow baby—I had been pregnant for 18 months. I think there were a lot of missed opportunities to pick up on the fact that I was having mental health problems, both perinatal and postnatal. Towards the latter stages of my pregnancy with him, I was absolutely desperate to give birth. I almost could not cope with being pregnant any more. It was very difficult looking after a toddler as well.

After I gave birth the second time, the same thing happened to me as the first time: I had retained placenta, I haemorrhaged and I had to be returned to hospital to have blood transfusions and IV antibiotics. The first time, I had my baby with me; the second time I didn’t have my baby with me, because I couldn’t—I just had to get better, and I needed to leave him to be looked after by my mum. As many in this House know, my second baby is on the autism spectrum.

[Nickie Aiken]

Does my hon. Friend agree that it is so important to understand the mental health issues that can surround pregnancies and can occur soon after birth? We need a better understanding of that.

[Angela Richardson]

I could not agree more. By the time I had got to my third baby, they realised that they needed to do more to make sure that postnatally I was in a much better position. In the debate last year, I talked about one of the babies I lost, in the second trimester; I asked for a test to be done, but the hospital did not do it. They just sent the foetus to the incinerator, and they had to apologise for it. I was left wondering for a long time what I had done wrong.

With my son, who is on the autism spectrum, I had post-natal depression and I did not take him to hospital with me. I spent years feeling guilty, because that is what happens to us as mums: we feel guilty for everything and we spend years making things up to our children. That is one of the things that I think we really need to address in looking after the mental health of mums, because it impacts not just on our children, but on their siblings, on our husbands and on family members who are not even in the same country as us.

[Lia Nici]

I commend my hon. Friend for talking so openly about her experiences. We talk about statistics and about how one in four pregnancies do not end in the way that we would like, but when we talk and when we look at items in the media, there is constant pressure on women—specifically women, although there is pressure on men as well. We are expected to be superwomen, we are expected to be super-mums and we are expected to be perfect, when actually we are all fallible human beings and we all need help.

We need to make sure that we talk about it. When I told friends that I had lost babies, I was shocked that it had affected virtually everybody—I would be surprised if it is not well over 90% of people who have experienced this. We need to talk openly with each other, make sure that we look after parents as well as children, before pregnancy but also after pregnancy, and make sure that it is not something that is shameful. Quite often, women will not talk about trying for babies, because they are worried about what their employer will do or say and it is a very private thing anyway.

It is also about the time afterwards. This is probably the one taboo left that we really do not talk about, because we feel like failures. Does my hon. Friend agree that we need to continue to fight for this and make sure that people do not feel that they are a failure when things do not always go right?

[Angela Richardson]

I thank my hon. Friend for her intervention and for giving me a bit of time to compose myself. I agree with her.

My hon. Friend commented about our having to be superwomen and have everything together. I did not get the help that I needed because I spent so long trying to be tough. It was months and months after I had given birth to my second baby before I even went to see a doctor, but I know that the midwife who was visiting me after I had given birth was concerned because she had been with me after my first delivery as well. I think she knew that I was not quite right. That is what I mean about missed opportunities: there were lots of points where people could have picked things up and I would not have got to quite the state that I was in.

What I want to do is encourage people who are watching today. Sands is a wonderful stillbirth and neonatal death charity. Its website has such a host of information that people can use to get the support that they need.

Last year, I said to those who have suffered baby loss: please be patient with yourself and be kind to yourself. It is really hard to do—if you are driven, like I am, with the relentless desire to have a family, it is really difficult to stop. I was given very good advice to give my body and mind time to rest and recover, and I did not listen. I say to anybody out there who is listening today: please listen to my story. I hope that it will give you some insight and some food for thought.

I thank everybody who has participated today. I do hope that the Minister will take away those thoughts and comments about how we can better support women and their families with mental health.

Covid-19 Update

Angela Richardson Excerpts

Tuesday 14th September 2021 Commons Chamber

[Sajid Javid]

This year, we have already planned to spend an additional £34 billion on both the NHS and care homes, helping to pay for additional measures such as infection controls and some additional staffing costs. We keep that under constant review.

[Angela Richardson (Guildford) (Con)]

I echo the comments my constituency neighbour and the Chair of the Health Committee, my right hon. Friend the Member for South West Surrey (Jeremy Hunt) made in raising concerns about mental health. I am dealing at the moment with a constituent who has been sectioned under the Mental Health Act, but there were no beds in Surrey and she has had to be moved to Kent. Would my right hon. Friend the Secretary of State look at increasing capacity in the most severe cases so that families do not have to undertake such a journey in what is already a difficult set of circumstances for them?

[Sajid Javid]

My hon. Friend is right to raise that. It is a very difficult situation, as of course I think everyone in this House understands. It is one of the reasons we are increasing capacity—there is new funding and support—and it remains a priority.