Tobacco and Vapes Bill

Ashley Dalton Excerpts

Report stage
Wednesday 26th March 2025 Commons Chamber

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

I beg to move, That the clause be read a Second time.

[Madam Deputy Speaker (Judith Cummins)]

With this it will be convenient to discuss the following:

New clause 1—Review of contaminated e-liquid—

“(1) Within six months of the passage of this Act, the Secretary of State must conduct a review into the prevalence of contaminated e-liquid in England, Wales, Scotland and Northern Ireland.

(2) The review required under subsection (1), must include, but is not limited to an assessment of—

(a) the awareness of the issue of contaminated e-liquid,

(b) the extent of e-liquids found spiked with illegal substances,

(c) the measures in place to tackle the importation of contaminated e-liquid,

(d) measures used by other jurisdictions to combat the importation and prevalence of contaminated e-liquid, and

(e) options for further regulating e-liquid to limit the dangers of contamination.

(3) In conducting the review required under subsection (1), the Secretary of State may consult with whoever they see fit.

(4) The Secretary of State must report to Parliament following the conclusion of the review.

(5) The Secretary of State has the power to make regulations under this section including the power to make—

(a) offences relating to the contamination of e-liquid, including the distribution, importation, supply and merchandising or tampering of such products,

(b) offences relating to the online sale of e-liquid containing illegal substances,

(c) provisions to improve the ability to identify, test and intercept contaminated e-liquid, and

(d) provisions recommended in the review implemented by subsection (1).

(6) For the purposes of this section,

‘contaminated e-liquid’ means e-liquid which has been mixed with or includes an illegal substance.”

This new clause would require the Secretary of State to conduct a review and publish a report on the impact of contaminated e-liquid and ways to reduce its prevalence. It would give the Secretary of State the powers to make regulations in relation to curbing the harm caused by contaminated e-liquid.

New clause 2—Ban on the supply of plastic cigarette filters—

“(1) The Secretary of State must make regulations under section 140 of the Environmental Protection Act 1990 having the effect of prohibiting the supply of relevant cigarette filters or cigarettes containing relevant cigarette filters, whether by way of sale or not, in the course of a business.

(2) The notice required under section 140(6)(b) of the Environmental Protection Act 1990 in relation to the regulations mentioned in subsection (1) must be published no later than the end of the period of 12 months beginning with the day on which this Act is passed.

(3) In this section,

‘relevant cigarette filter’ means a filter which contains plastic and which is intended for use in a cigarette, whether as part of a ready made cigarette or to be used with hand rolling tobacco or other substances to be smoked in a cigarette.”

This new clause requires the Secretary of State to make regulations, within two years, which would prohibit the supply of cigarette filters which contain plastic or cigarettes containing cigarette filters which contain plastic. The regulations would be made under section 140 of the Environmental Protection Act 1990.

New clause 3—Amendment of the European Union (Withdrawal) Act 2018—

“(1) The European Union (Withdrawal) Act 2018 is amended as follows.

(2) In section 7A of the European Union (Withdrawal) Act 2018, after subsection (4), insert—

‘(4A) This section does not apply in relation to Directive 2014/40/EU of the European Parliament and of the Council of 3 April 2014 on the approximation of the laws, regulations and administrative provisions of the Member States concerning the manufacture, presentation and sale of tobacco and related products and repealing Directive 2001/37/EC.’”

This new clause asserts the primacy of the regulations made in this Bill which affect Northern Ireland in relation to the EU tobacco directive 2014/40/EU.

New clause 4—Ban on manufacture and sales of high-strength nicotine pouches—

“(1) It is an offence to manufacture a high-strength nicotine pouch.

(2) It is an offence to—

(a) sell or expose for sale a high-strength nicotine pouch, or

(b) offer or expose a high-strength nicotine pouch for sale.

(3) It is an offence for a person to have a high-strength nicotine pouch in their possession with intent to supply it to another in the course of business.

(4) In this section ‘high-strength nicotine pouch’ means a nicotine pouch that—

(a) is intended for oral use,

(b) is not intended to be inhaled,

(c) does not contain tobacco, and

(d) contains more than 20 milligrams of nicotine per pouch.

(5) It is a defence for a person charged with an offence under subsection (2) to prove that they took all reasonable steps to avoid the commission of the offence.

(6) A person who commits an offence under this section is liable—

(a) on summary conviction, to imprisonment for a term not exceeding the general limit in a magistrates’ court, or a fine, or both;

(b) on conviction on indictment, to imprisonment for a term not exceeding 2 years, or a fine, or both.”

This new clause provides for a ban on the manufacture and sale of high-strength nicotine pouches.

New clause 5—Report on sale of vaping products to facilitate child sexual exploitation—

“(1) Within six months of the passing of this Act, the Secretary of State must produce a report on—

(a) the potential prevalence of retailers with a personal or premises licence selling vaping products which facilitate child sexual exploitation; and

(b) whether licensing authorities have adequate powers to investigate retailers which may be connected to the sale of vaping products to facilitate child sexual exploitation.

(2) A copy of this report must be laid before both Houses of Parliament.

(3) In this section—

‘vaping’ has the same meaning as in Part 1 (see section 48),

‘licensing authority’ has the same meaning as in Part 1 (see section 16),

‘personal licence’ has the same meaning as in Part 1 (see section 16),

‘premises licence’ has the same meaning as in Part 1 (see section 16).”

New clause 6—Requirement for retailers of vapes in England to include age-verification technology—

“(1) The Secretary of State may make regulations making it an offence for a tobacco retailer who sells vapes on premises in England to sell vapes that do not contain approved age-gating technology.

(2) The Secretary of State may by regulations specify the requirements with which any age-gating technology must comply, which must include (but need not be limited to)—

(a) the information, including biometric information, that a user must provide to the age-gating technology in order to be able to use the vape;

(b) the steps that the age-gating technology must require the user to take in order to verify their identity and that they are aged 18 or over before first activating the vape for use;

(c) the steps which the age-gating technology must require the user to take in order to verify their identity following activation of the vape, and the frequency with, and circumstances in, which the age-gating technology must require these steps to be taken;

(d) the requirements with which the age-gating technology must comply in order to ensure the security of the information, including personal data, provided to it by users;

(e) the technical specifications which the age-gating technology must meet in order to ensure that it is compatible with vapes made by different manufacturers.

(3) The Secretary of State may by regulations under this section make further provision about requirements with which tobacco retailers must comply.

(4) In this section, ‘age-gating technology’ means technology designed to prevent the use of vaping products by persons aged under 18.

(5) Before making regulations under this section the Secretary of State must consult any persons the Secretary of State considers it appropriate to consult.

(6) Regulations under this section are subject to the affirmative resolution procedure.”

This new clause would introduce a requirement for retailers of vapes in England to include age-verification technology.

New clause 7—Requirement for retailers of vapes in Wales to include age-verification technology—

“(1) The Welsh Ministers may make regulations making it an offence for a tobacco retailer who sells vapes on premises in Wales to sell vapes that do not contain approved age-gating technology.

(2) The Welsh Ministers may by regulations specify the requirements, with which any age-gating technology must comply, which must include (but need not be limited to)—

(a) the information, including biometric information, that a user must provide to the age-gating technology in order to be able to use the vape;

(b) the steps that the age-gating technology must require the user to take in order to verify their identity and that they are aged 18 or over before first activating the vape for use;

(c) the steps which the age-gating technology must require the user to take in order to verify their identity following activation of the vape, and the frequency with, and circumstances in, which the age-gating technology must require these steps to be taken;

(d) the requirements with which the age-gating technology must comply in order to ensure the security of the information, including personal data, provided to it by users;

(e) the technical specifications which the age-gating technology must meet in order to ensure that it is compatible with vapes made by different manufacturers.

(3) The Welsh Ministers may by regulations under subsection (2) make further provision about requirements with which tobacco retailers must comply.

(4) In this section, “age-gating technology” means technology designed to prevent the use of vaping products by persons aged under 18.

(5) Before making regulations under this section the Welsh Ministers must consult any persons that the Welsh Ministers consider it appropriate to consult.

(6) Regulations under this section are subject to the affirmative resolution procedure.”

This new clause would introduce a requirement for retailers of vapes in Wales to include age-verification technology.

New clause 8—Prohibition of advertising of vaping, nicotine and heated tobacco products—

“(1) The Secretary of State must within six months of this Act being passed make provisions by regulations for the prohibition of advertising of—

(a) a vaping product; or

(b) a nicotine product; or

(c) a heated tobacco product.

(2) Before making regulations under this section the Secretary of State must consult any persons the Secretary of State considers it appropriate to consult.

(3) Regulations under this section may not be made unless a draft of the instrument has been laid before and approved by a resolution of each House of Parliament.”

This new clause commits the government to consult on proposals for prohibiting the advertising of vaping, nicotine or heated tobacco products.

New clause 9—Marketing of products to existing smokers—

“(1) The Secretary of State, or a person authorised by the Secretary of State, may make provision about the nature and inclusion of health warnings or disclaimers relating to a relevant product to ensure that the product is marketed exclusively to existing smokers as an alternative to smoking.

(2) In this section, ‘relevant product’ refers to—

(a) a vape, or

(b) a nicotine product.

(3) Compliance with this section is considered a defence to a charge in relation to an offence under Part 6.”

This new clause will allow the Secretary of State to place an additional disclaimer or warning on products.

New clause 10—Displays of products or prices in England—

“(1) The Secretary of State may by regulations impose limitations or requirements on retailers in relation to the display, in the course of business, of—

(a) relevant products in a place in England where the products are offered for sale,

(b) empty retail packaging of relevant products in a place in England where the products are offered for sale,

(c) prices of relevant products in a place in England where the products are offered for sale, or

(d) advertisements for relevant products.

(2) In subsection (1), reference to a product includes anything that represents the product.

(3) Regulations under this section—

(a) must make provision—

(i) for ensuring that an adult is able to be informed that a premises sells a related product,

(ii) for ensuring that a consenting adult is able to view the related products and information relating to them,

(iii) relating to the appropriateness of a display to ensure that it does not appeal to children, and

(iv) relating to the location of a display in a place in England where the products are offered for sale;

(b) may create offences for a failure to comply with the regulations;

(c) must provide for any offence to be punishable–

(i) on summary conviction, to imprisonment for a term not exceeding the general limit in a magistrates’ court, or a fine, or both;

(ii) on conviction or indictment, to imprisonment for a term not exceeding 2 years, or a fine, or both;

(d) are subject to public consultation;

(e) are subject to the affirmative resolution procedure.

(4) Compliance with regulations made under subsection (3) is considered a defence to a charge in relation to an offence under Part 6.

(5) For the purposes of this section—

‘consenting adult’ means an adult who has entered any licensed premises that sells nicotine, vapes, and tobacco products;

‘relevant products’ mean—

(a) tobacco products,

(b) vaping products, or

(c) nicotine products.”

This new clause will allow for the Secretary of State to restrict how vapes and nicotine products are advertised in store windows and in store, while ensuring that adult smokers are still able to determine that a premises sells a product.

New clause 12—Review of provisions—

“(1) The Secretary of State must, in consultation with the appropriate ministers in Wales, Scotland and Northern Ireland—

(a) carry out a review of the provisions for relevant products in—

(i) sections 1 to 6 (sale of tobacco etc);

(ii) sections 50 to 55 (Part 2 Sale and Distribution: Scotland: sale of tobacco etc);

(iii) sections 68 to 72 (Part 2 Sale and Distribution Northern Ireland sale of tobacco etc);

(iv) sections 90 to 93 (Product requirements etc);

(v) section 94 (Non-compliant images);

(vi) sections 101 and 102 (Matters dealt with by 2016 Regulations);

(vii) Part 6 (Advertising and Sponsorship);

(b) prepare and publish a report setting out the conclusions of the review;

(c) lay the report before Parliament.

(2) The review in subsection (1) must—

(a) set out the objectives intended to be achieved by the provisions as set out under subsection (1)(a),

(b) assess the extent to which those objectives have been achieved, and

(c) make a recommendation on whether the provisions as set out under subsection (1)(a) remain appropriate and necessary.

(3) The first review under this section must be published and laid before Parliament before the end of the period of five years beginning with the day on which the Tobacco and Vapes Act 2025 is passed.

(4) If the review recommends under subsection (2)(c) that one or more of the provisions set out under subsection (1)(a) are no longer appropriate or necessary, the Secretary of State must make arrangements for the motion mentioned in subsection (5) to be tabled in both Houses of Parliament within a period of 28 sitting days beginning immediately after the review is laid before Parliament under subsection (3).

(5) The form of the motion in subsection (4) is—

‘That the provisions of sections 1 to 6, 50 to 55, 68 to 72, 90 to 94, 101 and 102 and Part 6 (Advertising and Sponsorship) of the Tobacco and Vapes Act 2025 should expire.’

(6) If both Houses of Parliament approve the motion in the form set out in subsection (5) (or in such form as may be subsequently amended by the House to specify one or more of the provisions of sections 1 to 6, 50 to 55, 68 to 72, 90 to 94, 101 and 102 and Part 6), moved by the Secretary of State in accordance with subsection (4), the provisions specified in the motion shall expire at the end of the period of 21 days beginning with the day on which the second House approves the motion.

(7) Subsequent reports must be published at intervals not exceeding five years.

(8) In this subsection, ‘Relevant products’ refers to—

(a) tobacco products;

(b) nicotine products.”

This new clause requires a review of the necessity of provisions relating to the sale restrictions for tobacco products and nicotine products. Published every 5 years, the review could recommend that certain provisions are no longer required, and Parliament would have an opportunity to expire them.

New clause 13—Reports on roadmap to a smoke-free United Kingdom—

“(1) The Secretary of State must, on or before the relevant day and at least once every five years after that day, prepare and lay before Parliament a report setting out—

(a) how the Secretary of State expects the smoke-free target will be achieved;

(b) the steps proposed to achieve that target (which may include the setting of interim targets);

(c) an analysis of statistical data relating to the achievement of the smoke-free target.

(2) The reports must set out targets and proposed steps relating to geographical areas or categories of people in respect of which there are higher than average rates of smoking.

(3) The Secretary of State must consult the appropriate national authorities when preparing the reports.

(4) In this section—

(a) ‘appropriate national authority’ means—

(i) Welsh Ministers,

(ii) Scottish Ministers, and

(iii) Executive Ministers in Northern Ireland.

(b) ‘relevant day’ means the last day before 25 December 2026 which is a sitting day for both Houses of Parliament;

(c) ‘the smoke-free target’ means the end of the smoking of tobacco products in the United Kingdom.”

This new clause requires the Secretary of State to prepare and lay before Parliament five-yearly reports containing a roadmap to a smoke-free country including targets and specific interventions for populations with high prevalence rates.

New clause 14—Prohibition on supply of cigarette filters—

“(1) The Secretary of State must make regulations having the effect of prohibiting the supply of cigarette filters or cigarettes containing cigarette filters, whether by way of sale or not, in the course of a business.

(2) Subsections (6), (8), (9), (10), (10A), (10B), (10C) and (10D) of section 140 of the Environmental Protection Act 1990 apply to regulations under this section as they apply to regulations under those sections.

(3) The notice required under section 140(6)(b) of the Environmental Protection Act 1990 as applied by subsection (2) in relation to the regulations mentioned in subsection (1) must be published no later than the end of the period of 12 months beginning with the day on which this Act is passed.

(4) In this section, ‘cigarette filter’ means a filter which is intended for use in a cigarette, whether as part of a ready-made cigarette or to be used with hand rolling tobacco or other substances to be smoked in a cigarette.

(5) Regulations under this section are subject to the affirmative resolution procedure.”

This new clause requires the Secretary of State to make regulations which would prohibit the supply of cigarette filters or cigarettes containing cigarette filters.

New clause 15—Advertising exemptions for specialist vaping retailers—

“(1) A person does not commit an offence under any of the sections 114 to 118 in relation to an advertisement whose purpose or effect is to promote a vaping product if the advertisement—

(a) Is in a specialist vaping shop

(b) Is not visible from outside the specialist vaping shop

(c) Complies with the requirements (if any) specified by the appropriate national authority in regulations as to the inclusion of health warnings and information.

(2) Regulations under subsection (1) are subject to the negative resolution procedure.

(3) In this section—

‘appropriate national authority’ —

(a) In relation to specialist vaping shops in England, means the Secretary of State,

(b) In relation to specialist vaping shops in Wales, means Welsh Ministers,

(c) In relation to specialist vaping shops in Scotland, means Scottish Ministers, and

(d) In relation to specialist vaping shops in Northern Ireland, means the Department of Health for Northern Ireland;

‘shop’ includes a self-contained part of a shop (and, in relation to a self-contained part of a shop,

‘premises’ means that self-contained part);

‘specialist vaping shop’ means a shop selling vaping products by retail (whether or not it sells other things) more than 90% of whose sales on the premises in quest derive from the sale of vaping products and vaping accessories.

(4) For the purposes of determining whether a shop is a specialist vaping shop the sales are to be measured by the sale price—

(a) During the most recent period of 12 months for which accounts are available, or

(b) During the period for which the shop has been established, if it has not been established long enough for 12 months’ accounts to be available.”

This new clause would enable specialist vaping retailers to operate and provide free advice and consultations to smokers who are trying to find the right product for them to quit.

New clause 16—Online sale of tobacco products—

“(1) It is an offence to supply a tobacco product through an internet service, whether by way of sale or not.

(2) It is a defence for a person charged with an offence under this section to prove that they took all reasonable steps to avoid the commission of the offence.

(3) A person who commits an offence under this section is liable on summary conviction to a fine not exceeding level 4 on the standard scale.

(4) For the purposes of this section—

‘internet service’ means a service that is made available by means of the internet, even if it’s made available using a combination of the internet and an electronic communications service as defined in Section 32(2) of the Communications Act 2003.”

This new clause creates an offence of selling tobacco products online.

New clause 17—Tobacco products statutory scheme: consultation—

“(1) The Secretary of State must consult and report on the desirability of making a scheme with one or more of the following purposes—

(a) regulating, for the purposes of improving public health, the prices which may be charged by any producer or importer of tobacco products for the supply of any tobacco products,

(b) limiting the profits which may accrue to any producer or importer in connection with the manufacture or supply of tobacco products,

(c) providing for any producer or importer of tobacco products to pay to the Secretary of State an amount calculated by reference to sales or estimated sales of those products (whether on the basis of net prices, average selling prices or otherwise) to be used for the purposes of reducing smoking prevalence and improving public health.

(2) In this section—

‘importer’ in relation to tobacco products, and “tobacco products” have the meaning as in Part 5 (see section 112),

‘producer’ in relation to tobacco products, is to be construed in accordance with the meaning of ‘production’ in Part 5 (see section 112).”

This new clause would require the Secretary of State for Health and Social Care to consult on proposals for regulating the prices and profits of, and to raise funds from, tobacco manufacturers and importers.

New clause 18—Consultation on licensing regulations—

“(1) Within two months of the passing of this Act, the Secretary of State must publish draft regulations for the licensing of retail sale of tobacco products etc in England.

(2) Following the publication of the draft regulation as set out in subsection (1) the Secretary of State must publish a call for evidence seeking views on the efficacy and suitability of the draft regulations and invite the House of Commons Business and Trade Committee to scrutinise the draft regulations.

(3) After six months of the passing of this Act, the Secretary of State must lay before both Houses of Parliament a report setting out the Government’s formal response to evidence submitted in response to the call for evidence required by subsection (2) and any recommendations of the House of Commons Business and Trade Committee.

(4) The Secretary of State may not make an order under section 168(4) bringing sections 16 to 18 and Schedules 1 and 2 into force until the report specified in subsection (3) has been laid before both Houses of Parliament.”

This new clause would require the Secretary of State to publish draft regulations for the licensing of retail sale of tobacco products etc in England and ensure they receive parliamentary scrutiny.

New clause 19—Reports on illegal sale of tobacco and vaping products—

“(1) The Secretary of State must—

(a) prepare an annual report on the scale of the illegal sale and availability of tobacco and vaping products in the United Kingdom; and

(b) lay a copy of each report before both Houses of Parliament.

(2) Each report must provide details in the United Kingdom of—

(a) the estimated amount and value of illegal, counterfeit and contraband cigarettes and other tobacco products available for sale;

(b) the estimated amount and value of illegal or non-compliant vapes available for sale;

(c) the action taken to tackle the illicit trade of tobacco, tobacco products, vaping devices and vaping products; and

(d) an assessment of the impact of the illicit trade of tobacco, vapes and nicotine products on public health and safety.

(3) The first report must be laid within the period of 12 months of the passing of this Act.

(4) Each subsequent report must be laid annually beginning with the day on which the previous report was laid.”

This new clause would require that the Government produce annual reports on the rate of sale and availability of illegal tobacco and vaping products and their impact on public health and safety.

New clause 20—Age verification requirement for online sales of vaping devices and products—

“(1) A person commits an offence if the person—

(a) continues to operate an online vaping product business, and

(b) fails to operate an age verification policy in respect of online sales of vaping products and devices.

(2) An ‘age verification policy’ is a policy that steps are to be taken to establish and ensure the age of a person attempting to buy a vaping product (the ‘customer’) is not under 18 years of age.

(3) The appropriate national authority may by regulations amend the age specified in subsection (2).

(4) The appropriate national authority may publish guidance on matters relating to age verification policies, including, in particular, guidance about—

(a) steps that should be taken to establish a customer’s age,

(b) documents that may be used as evidence of a customer’s age,

(c) training that should be undertaken by the person selling vaping products,

(d) the form and content of notices that should be displayed on websites; and

(e) the form and content of records that should be maintained in relation to an age verification policy.

(5) A person guilty of an offence under subsection (1) is liable on summary conviction to a fine not exceeding level 2 on the standard scale.

(6) Regulations under subsection (3) are subject to the affirmative resolution procedure.

(7) In this section—

‘the appropriate national authority’ means—

(a) in relation to England, the Secretary of State, and

(b) in relation to Wales, the Welsh Ministers,

‘online vaping product business’ means a business involving the sale of vaping products by retail online.”

This new clause introduces a requirement on online vaping product businesses to operate an age verification policy covering steps to be taken to establish the age of persons attempting to buy vaping products online. It reflects provisions in place in Scotland.

New clause 21—Prohibition on manufacture and retail of high-capacity count vaping devices—

“(1) The Secretary of State must produce regulations relating to the design, manufacture and sale of vaping devices and products that ensure—

(a) Vaping devices must not be designed or manufactured in a way that allows refill containers, modular attachments, or third-party modifications that increase e-liquid capacity beyond the limit of 2ml per tank or pod, which includes, but is not limited to detachable extensions, multi-pod configurations, and external refill reservoirs.

(b) Any vaping device must contain a fixed, non-modifiable single-use tank or pod with a maximum capacity of 2ml.

(c) Refill e-liquid containers must be limited to a maximum of 10ml per bottle and must not be sold in forms that enable direct integration with a vaping device as an extended tank or automated refill mechanism.

(d) No manufacturer or retailer shall promote, sell, or advertise modification kits, refill systems, or accessory attachments designed to contravene the Tobacco and Related Products Regulations 2016 restrictions on vaping device capacity.

(2) A person commits an offence if they—

(a) Manufacture, import, distribute, or sell a vaping device or accessory that does not comply with the regulatory requirements set out in subsection (1).

(b) Advertise, market, or sell components that facilitate increasing a device’s effective e-liquid capacity beyond the legal limit.

(3) A person who is guilty of an offence under subsection (2)(a) shall be liable on summary conviction to a fine of £20,000 per violation or a ban on further sales within the UK market.

(4) A person who is guilty of an offence under subsection (2)(b) shall be liable on summary conviction to a fine of £10,000 per violation and may be subject to further regulatory action, including product recall or withdrawal from sale.”

This new clause would seek the introduction of regulations and new offences to prohibit the manufacture, design and retail sale of high-capacity count vaping devices.

Amendment 103, page 1, line 4, leave out clause 1.

This amendment removes the generational ban on selling tobacco products to people born on or after 1 January 2009.

Amendment 4, in clause 1, page 1, line 5, leave out

“born on or after 1 January 2009”

and insert

“under the age of 21”.

This amendment makes it an offence to sell tobacco products, herbal smoking products and cigarette papers to a person under the age of 21, rather than to people born on or after 1 January 2009.

Amendment 38, page 1, line 7, leave out “a tobacco product” and insert

“cigarettes or hand rolling tobacco within the meaning of the Standardised Packaging of Tobacco Products Regulations 2015 (S.I. 2015/829)”.

Government amendment 47.

Amendment 5, in clause 1, page 1, line 13, leave out

“shown that document was before 1 January 2009”

and insert

“showed that the purchaser was not under the age of 21”.

This amendment is linked to Amendment 4.

Government amendments 48 and 49.

Amendment 104, page 2, line 10, leave out clause 2.

This amendment is linked to Amendment 103.

Amendment 6, in clause 2, page 2, line 11, leave out “18” and insert “21”.

This amendment makes it an offence to purchase tobacco products, herbal smoking products and cigarette papers on behalf of a person under the age of 25, rather than a person born on or after 1 January 2009.

Amendment 7, page 2, line 12, leave out

“born on or after 1 January 2009”

and insert

“under the age of 21”.

This amendment is linked to Amendment 6.

Amendment 39, page 2, line 13, leave out “a tobacco product” and insert

“cigarettes or hand rolling tobacco within the meaning of the Standardised Packaging of Tobacco Products Regulations 2015 (S.I. 2015/829)”.

This amendment is linked to Amendment 38.

Amendment 8, page 2, line 18, leave out

“born on or after 1 January 2009”

and insert

“under the age of 21”.

This amendment is linked to Amendment 6.

Government amendment 50.

Amendment 105, page 3, line 3, leave out clause 5.

This amendment is linked to Amendment 103.

Amendment 9, in clause 5, page 3, line 8, leave out

“born on or after 1 January 2009”

and insert

“under the age of 21”.

This amendment is linked to Amendment 4.

Amendment 106, page 3, line 25, leave out clause 6.

This amendment is linked to Amendment 103.

Amendment 10, in clause 6, page 3, line 30, leave out

“born on or after 1 January 2009”

and insert

“under the age of 21”.

This amendment is linked to Amendment 4.

Amendment 11, page 3, line 32, leave out

“a anwyd ar neu ar ôl 1 Ionawr 2009”

and insert “dan 21 oed”.

This amendment is linked to Amendment 4.

Government amendments 51 to 59.

Amendment 1, in clause 38, page 20, line 19, leave out from “be” to the end of line and insert

“be allocated by the relevant Local Authority to public health projects.”

This amendment would direct funds from Fixed Penalty Notice fines to public health initiatives as determined by Local Authorities.

Amendment 2, page 20, line 20, leave out from “before” to the second “the” and insert

“such sums are allocated by the relevant Local Authorities”.

This amendment is consequential upon Amendment 1.

Government amendments 60 to 63.

Amendment 107, page 25, line 26, leave out clause 50.

This amendment is linked to Amendment 103.

Amendment 40, in clause 50, page 25, line 30, after “subsection (1)” insert—

“(i) for ‘a tobacco product’ substitute ‘cigarettes or hand rolling tobacco within the meaning of the Standardised Packaging of Tobacco Products Regulations 2015 (S.I. 2015/829)’, and”.

This amendment exempts tobacco products other than cigarettes and hand rolling tobacco from the offence of selling tobacco products to a person born on or after 1 January 2009.

Amendment 12, page 25, line 30, leave out “‘born on or after 1 January 2009’” and insert “‘under the age of 21’”.

This amendment is linked to Amendment 4.

Amendment 13, page 25, line 33, leave out

“‘born on or after 1 January 2009 (“the customer) to have been born before that date”’”

and insert

“‘under the age of 21 (“the customer”) to be aged 21 or over’”.

This amendment is linked to Amendment 4.

Amendment 14, page 25, line 37, leave out

“born on or after 1 January 2009”

and insert “under 21”.

This amendment is linked to Amendment 4.

Amendment 15, page 26, line 1, leave out subsection (3).

This amendment is linked to Amendment 4.

Amendment 41, page 26, line 6, leave out “a tobacco product” and insert

“cigarettes or hand rolling tobacco within the meaning of the Standardised Packaging of Tobacco Products Regulations 2015 (S.I. 2015/829)”.

This amendment is linked to Amendment 40.

Amendment 42, page 26, line 28, after “subsection (1)” insert—

“(i) for “a tobacco product” substitute “cigarettes or hand rolling tobacco within the meaning of the Standardised Packaging of Tobacco Products Regulations 2015 (S.I. 2015/829)”, and”.

This amendment is linked to Amendment 40.

Amendment 16, page 26, line 28, leave out

“‘born on or after 1 January 2009’”

and insert

“‘under the age of 21’”.

This amendment is linked to Amendment 4.

Amendment 17, page 26, line 30, leave out

“‘born on or after 1 January 2009’”

and insert “‘under 21’”.

This amendment is linked to Amendment 4.

Amendment 18, page 26, line 33, leave out

“‘born on or after 1 January 2009’”

and insert

“‘under the age of 21’”.

This amendment is linked to Amendment 4.

Government amendment 64.

Amendment 108, page 35, line 24, leave out clause 68.

This amendment is linked to Amendment 103.

Amendment 19, page 35, line 28, leave out

“born on or after 1 January 2009”

and insert

“under the age of 21”.

This amendment is linked to Amendment 4.

Amendment 43, page 35, line 30, leave out “a tobacco product” and insert

“cigarettes or hand rolling tobacco within the meaning of the Standardised Packaging of Tobacco Products Regulations 2015 (S.I. 2015/829)”.

This amendment exempts tobacco products other than cigarettes and hand rolling tobacco from the offence of selling tobacco products to a person born on or after 1 January 2009.

Government amendment 65.

Amendment 20, page 35, line 37, leave out

“shown on that document was before 1 January 2009”

and insert

“showed that the purchaser was not under the age of 21”.

This amendment is linked to Amendment 4.

Government amendments 66 and 67.

Amendment 109, page 36, line 13, leave out clause 69.

This amendment is linked to Amendment 103.

Amendment 21, page 36, line 16, leave out

“born on or after 1 January 2009”

and insert

“under the age of 21”.

This amendment is linked to Amendment 6.

Amendment 22, page 36, line 18, leave out “18” and insert “21”.

This amendment is linked to Amendment 6.

Amendment 23, page 36, line 19, leave out

“born on or after 1 January 2009”

and insert

“under the age of 21”.

This amendment is linked to Amendment 6.

Amendment 44, page 36, line 21, leave out “a tobacco product” and insert

“cigarettes or hand rolling tobacco within the meaning of the Standardised Packaging of Tobacco Products Regulations 2015 (S.I. 2015/829)”.

This amendment is linked to Amendment 43.

Amendment 24, page 36, line 26, leave out

“born on or after 1 January 2009”

and insert

“under the age of 21”.

This amendment is linked to Amendment 6.

Government amendment 68.

Amendment 110, page 37, line 19, leave out clause 72.

This amendment is linked to Amendment 103.

Amendment 25, in clause 72, page 37, line 27, leave out

“born on or after 1 January 2009”

and insert

“under the age of 21”.

This amendment is linked to Amendment 4.

Government amendments 69 to 79.

Amendment 86, in clause 90, page 50, line 32, at end insert—

“(da) cigarette filters;”.

This amendment enables the Secretary of State to make provisions about the retail packaging of cigarette filters and the composition of individual products contained in an individual pack of products outlined in Clause 90(1).

Amendment 87, page 51, line 13, at end insert—

“(ja) the composition of individual products contained in an individual pack;”.

This amendment enables the Secretary of State to make provisions about the retail packaging of cigarette filters and the composition of individual products contained in an individual pack of products outlined in Clause 90(1).

Amendment 36, page 51, line 30, delete “shape” and insert “design, shape or interoperability”.

This amendment empowers ministers to regulate the design and interoperability of products in order to prohibit the sale of very high-puff count vaping devices.

Amendment 37, in clause 92, page 52, line 3, after “flavour” insert “descriptors”.

This amendment would give the Secretary of State powers to make provisions about the flavour descriptors of relevant products.

Amendment 88, in clause 110, page 60, line 35, leave out from “consult” to end of line 36 and insert

“any persons or bodies as appear to him or her representative of the interests concerned.”

This amendment would ensure that the Secretary of State has to consult all relevant parties before making regulations, rather than just those that they deem appropriate.

Government amendment 80.

Amendment 90, in clause 114, page 63, line 16, after “product,” insert

“except for the public health purpose of promoting vaping as a cessation tool for existing tobacco smokers,”.

This amendment would allow vapes to be promoted as a quit-aid/public health measure.

Amendment 46, in clause 120, page 68, line 22, at end insert—

“(ca) it is, when in relation to the advertising of vaping products or nicotine products, in a location in which it would be reasonable to expect that everyone present is aged 18 or over.”

This amendment would allow for the advertising of vaping or nicotine products within locations where it is reasonable to expect that everyone present is over 18.

Amendment 91, in clause 125, page 73, line 2, at end insert—

“(4) No offence is committed under this Part if—

(a) it is for the purposes of an interaction between a representative for the product and a member of the public, and

(b) the representative for the product has taken reasonable measures to ensure that the member of the public is aged over 18 and is an existing tobacco or nicotine user.”

This amendment will allow for vapes and nicotine products to be promoted through one-to-one interaction between individuals representing the product and adults who are already existing smokers or nicotine users.

Amendment 85, in clause 136, page 77, line 8, leave out from “smoke-free” to end of line 15 and insert

“a place in England that is—

(a) an NHS property or hospital building,

(b) a children’s playground, or

(c) a nursery, school, college or higher education premises.”

This amendment restricts the Secretary of State to only being able to designate open or unenclosed spaces outside a hospital, children’s playground, nursery, school, college or higher education premises as smoke-free areas.

Amendment 84, page 77, line 9, leave out from “place” to the end of line 12 and insert

“or description of place in England that is not smoke-free under section 2.

(1A) The place, or places falling within the description, need not be enclosed or substantially enclosed.

(1B) The Secretary of State may designate a place or description of place under this section only if they are advised by the Department for Health and Social Care's Chief Scientific Adviser that there is a significant risk that, without a designation, persons present there would be exposed to significant quantities of smoke or, if said place is—

(a) an NHS property or hospital building,

(b) a children’s playground, or

(c) a nursery, school, college or higher education premises.”

This amendment would restrict the Secretary of State to only being able to designate open or unenclosed spaces outside a hospital, children’s playground, nursery, school, college or higher education premises, or places with significant risk of second-hand smoke as smoke-free areas.

Amendment 92, page 77, line 12, at end insert—

“(1A) The Secretary of State may designate a place or description of place under this section only if, in the Secretary of State’s opinion, there is a significant risk that, without a designation, persons present there would be exposed to significant quantities of smoke.”

This amendment provides that regulations to designate places as smoke-free may only be made if the Secretary of State is satisfied that they are necessary to avoid persons being exposed to significant quantities of smoke.

Amendment 82, in clause 137, page 78, leave out lines 5 to 12.

This amendment removes the proposed power for the Secretary of State to create defences for performances. This protects the health of actors in the workplace and prevents the promotion of smoking through artistic means.

Amendment 83, page 78, leave out lines 15 to 21.

This amendment removes the proposed power for the Secretary of State to create defences for performances. This protects the health of actors in the workplace and prevents the promotion of smoking through artistic means.

Amendment 93, in clause 139, page 79, line 13, at end insert—

“(1A) The Secretary of State may designate a place or description of place under this section only if, in the Secretary of State’s opinion, there is a significant risk that, without a designation, the use of vapes may have adverse effects on the health of persons present there who are not using vapes.”

This amendment provides that regulations to designate places as vape-free may only be made if the Secretary of State is satisfied that they are necessary to avoid persons present there being exposed to adverse health effects.

Amendment 94, in clause 140, page 82, line 24, at end insert—

“(1A) The Secretary of State may designate a place or description of place under this section only if, in the Secretary of State’s opinion, there is a significant risk that, without a designation, the use of heated tobacco devices may have adverse effects on the health of persons present there who are not using heated tobacco devices.”

This amendment provides that regulations to designate places as heated tobacco-free may only be made if the Secretary of State is satisfied that they are necessary to avoid persons present there being exposed to adverse health effects.

Amendment 95, in clause 142, page 85, line 33, at end insert—

“(2A) Premises may be prescribed as no-smoking premises only if in the Scottish Ministers’ opinion there is a significant risk that, without prescribing them, persons present there would be exposed to significant quantities of smoke.”

This amendment provides that regulations to prescribe premises as smoke-free may only be made if the Scottish Ministers are satisfied that they are necessary to avoid persons being exposed to significant quantities of smoke.

Amendment 96, in clause 144, page 90, line 4, at end insert—

“(2A) Premises may be prescribed as vape-free premises only if in the Scottish Ministers’ opinion there is a significant risk that, without prescribing them, the use of vapes may have adverse effects on the health of persons present there who are not using vapes.”

This amendment provides that regulations to prescribe premises as vape-free may only be made if the Scottish Ministers are satisfied that they are necessary to avoid persons present there being exposed to a significant risk of adverse health effects.

Amendment 97, in clause 145, page 92, line 22, at end insert—

“(2A) Premises may be prescribed as heated tobacco-free premises only if in the Scottish Ministers’ opinion there is a significant risk that, without prescribing them, the use of heated tobacco devices may have adverse effects on the health of persons present there who are not using heated tobacco devices.”

This amendment provides that regulations to prescribe premises as heated tobacco-free may only be made if the Scottish Ministers are satisfied that they are necessary to avoid persons present there being exposed to a significant risk of adverse health effects.

Amendment 98, in clause 150, page 98, line 40, at end insert—

“(2A) The regulations may designate a place or vehicle as vape-free only if the Welsh Ministers are satisfied that doing so is likely to contribute towards the promotion of public health.”

This amendment provides that regulations to designate a place or vehicle as vape-free may only be made if the Welsh Ministers are satisfied that this is likely to contribute towards the promotion of public health.

Amendment 99, in clause 151, page 105, line 22, at end insert—

“(2A) The regulations may designate a place or vehicle as heated tobacco-free only if the Welsh Ministers are satisfied that doing so is likely to contribute towards the promotion of public health.”

This amendment provides that regulations to designate a place or vehicle as heated tobacco-free may only be made if the Welsh Ministers are satisfied that this is likely to contribute towards the promotion of the health of the people of Wales.

Amendment 100, in clause 153, page 108, line 25, at end insert—

“(1A) The Department may designate a place or description of place under this Article only if satisfied that, without the designation, persons present there would be likely to be exposed to significant quantities of smoke.”

This amendment provides that regulations to designate places as smoke-free may only be made if the Northern Ireland Department is satisfied that they are necessary to avoid persons being exposed to significant quantities of smoke.

Amendment 101, in clause 155, page 110, line 6, at end insert—

“(1A) The Department may designate a place or vehicle under this Article only if the Department is satisfied there is a significant risk that, without a designation, the use of vapes may have adverse effects on the health of persons present there who are not using vapes.”

This amendment provides that regulations to designate places as vape-free may only be made if the Northern Ireland Department is satisfied that they are necessary to avoid persons present there being exposed to adverse health effects.

Amendment 102, in clause 156, page 113, line 15, at end insert—

“(1A) The Department may designate a place or vehicle under this Article only if the Department is satisfied there is a significant risk that, without a designation, the use of heated tobacco devices may have adverse effects on the health of persons present there who are not using heated tobacco devices.”

This amendment provides that regulations to designate places as heated tobacco-free may only be made if the Northern Ireland Department is satisfied that they are necessary to avoid persons present there being exposed to adverse health effects.

Amendment 89, in clause 168, page 120, line 39, leave out from “force” to end of line 41 and insert

“on such a date as the Secretary of State may by regulation appoint following the consultation on licensing regulations (see section (Consultation on licensing regulations)).”

See explanatory statement for NC18.

Government amendment 81.

Amendment 26, in schedule 5, page 132, line 2, leave out

“a anwyd ar neu ar ôl 1 Ionawr 2009”

and insert “dan 21 oed”.

This amendment is linked to Amendment 4.

Amendment 27, page 132, line 7, leave out

“a anwyd ar neu ar ôl 1 Ionawr 2009”

and insert “dan 21 oed (“B”)”.

This amendment is linked to Amendment 4.

Amendment 28, page 132, line 12, leave out

“a anwyd ar neu ar ôl 1 Ionawr 2009”

and insert “dan 21 oed”.

This amendment is linked to Amendment 4.

Amendment 29, page 132, line 38, leave out

“wedi cael ei eni cyn 1 Ionawr 2009”

and insert

“yn 21 oed neu drosodd”.

This amendment is linked to Amendment 4.

Amendment 30, page 133, line 2, leave out

“wedi cael ei eni ar neu ar ôl 1 Ionawr 2009”

and insert “dan 21 oed”.

This amendment is linked to Amendment 4.

Amendment 111, page 133, line 15, leave out paragraph 5.

This amendment is linked to Amendment 103.

Amendment 31, page 133, line 16, leave out

“born on or after 1 January 2009”

and insert

“under the age of 21”.

This amendment is linked to Amendment 4.

Amendment 32, page 133, line 21, leave out

“born on or after 1 January 2009”

and insert

“under the age of 21”.

This amendment is linked to Amendment 4.

Amendment 33, page 133, line 26, leave out

“born on or after 1 January 2009”

and insert

“under the age of 21”.

This amendment is linked to Amendment 4.

Amendment 45, page 133, line 37, at end insert—

“(1A) In this section, “tobacco products” means cigarettes or hand rolling tobacco within the meaning of the Standardised Packaging of Tobacco Products Regulations 2015 (S.I. 2015/829).”

This amendment is linked to Amendment 38.

Amendment 34, page 134, line 9, leave out

“born on or after 1 January 2009”

and insert

“under the age of 21”.

This amendment is linked to Amendment 4.

Amendment 35, page 134, line 14, leave out

“born on or after 1 January 2009”

and insert

“under the age of 21”.

This amendment is linked to Amendment 4.

[Ashley Dalton]

I would like to start by thanking all right hon. and hon. Members for their invaluable contributions during the passage of the Bill to date, and in particular, members of the Public Bill Committee for providing insight, scrutiny and debate. I am honoured to have taken on responsibility for this Bill. It is a watershed piece of legislation and the most significant public health intervention since the ban on smoking in public places in 2007. It will establish a smokefree generation by gradually ending the sale of tobacco products across the UK so that a child turning 16 this year will never be able to be legally sold tobacco, saving countless lives in the process. It will strengthen existing powers to reduce the harms of second-hand smoke in public spaces. In keeping with our manifesto commitment to the British people, it will outlaw the manipulative promotion of vapes to children to protect the next generation from becoming hooked on nicotine. Finally, it will implement robust measures to strengthen enforcement activity.

I do not need to tell anyone in this Chamber that tobacco kills—we all know that. What hon. Members may not know is just how much it kills, the rate at which it kills, and the devastation it causes for individuals, families and communities across the country. Let me remind hon. Members that tobacco kills more people than any other preventable cause of death. Around 80,000 people in the UK lose their lives to tobacco every year. It robs an average of 10 years off the life expectancy of smokers. It substantially increases the risk of many major health conditions throughout people’s lives, such as stroke, diabetes, heart disease, stillbirth, dementia and asthma. This daily tragedy continues unabated, with someone being admitted to hospital because of smoking almost every minute, day in, day out, with no end in sight.

Tobacco harms are not felt equally either. Our most disadvantaged communities suffer most, with 230,000 households living in smoking-induced poverty. In Blackpool, 17.5% of pregnant women still smoke at the time of delivery compared with 2.8% in Kensington and Chelsea. Over a quarter of people with a long-term mental health condition smoke.

Beyond the immeasurable cost to lives in the UK, the staggering economic impact of tobacco on our NHS cannot be ignored. The treatment of smoking-related diseases consumes approximately £3 billion a year of vital NHS and social care resources. The cost of smoking to our economy is even greater: £18 billion is lost in productivity every year, far outweighing the tax receipts it brings in of around £9 billion. The Bill is a vital step to break the devastating cycle of tobacco addiction and safeguard future generations from a lifetime of ill health.

But the world moves forward, and we cannot ignore the alarming rise of youth vaping. While vaping is less harmful than smoking and can be an effective quit aid for adult smokers, children should never vape. However, in the past five years, youth vaping has more than doubled. One in four 11 to 15-year-olds tried vaping in 2023, and that is no accident. It is in part due to the deliberate branding and advertisement of vapes to our children, with brightly coloured packaging and enticing sweet-like flavours—a calculated strategy to hook young people on nicotine. We cannot afford to wait to act.

I turn to the Government amendments, which seek to strengthen the Bill and ensure greater clarity. As we create the first smokefree generation and strengthen age restrictions on vapes and nicotine products, we want to support retailers in taking appropriate steps to ensure they do not sell to customers under the age of sale. New clause 11 and Government amendments 47 to 49, 51 to 53, 61, 63, 65 to 67, 69 to 71, 75, 77, 79 and 81 are a package of amendments and consequential amendments to the Bill. They seek to remove potential ambiguity for retailers regarding the use of digital identity for verifying the age of prospective customers when selling tobacco, vaping and nicotine products.

In Committee, Members raised concerns that the list of identity documents to satisfy the defence for a person charged with selling products to someone under the age of sale was limited, and queried the inclusion of other forms of physical and digital identity. These amendments remove the lists of physical ID from the Bill and instead provide powers for the Secretary of State and the Department of Health in Northern Ireland to specify in regulations the steps that may be taken to verify a customer’s age to meet the requirements for the defence. This revised approach better future-proofs the defence against developments in identification processes and provides the potential to recognise digital ID, as well as physical ID, in the context of the defence, supporting the widespread use of digital ID.

The amendments provide the opportunity for effective interaction with part 2 of the Data (Use and Access) Bill that is currently going through Parliament, which includes provisions relating to digital verification services. Digital verification services provide an opportunity to securely verify age for in-person and online sales. We will continue to work closely with the Department for Science, Innovation and Technology and other Departments when developing the regulations.

New clause 11 provides a similar power for Scottish Ministers to prescribe in regulations the steps that should be taken to establish a customer’s age as a defence to an age of sale offence. That will enable Scottish Ministers to respond to changes in technology and consumer behaviours, which may move away from the presentation of a physical document.

The last Labour Government took bold action to prohibit displays of tobacco products to protect children and young people from being enticed into addiction and to create a more supportive environment for adults seeking to quit. The Bill goes further and gives powers to limit the display of a wider range of products, including herbal smoking products, cigarette papers, vapes and nicotine products. Government amendments 56, 57, 60, 62, 74, 76, 78 and 80 will alter the powers in the Bill for England, Wales and Northern Ireland that regulate displays of products and their prices, so that they also cover tobacco-related devices. As was discussed in Committee, pipes, heated tobacco devices and bongs are currently displayed in shops and can have the effect of promoting tobacco usage. The amendments will ensure that we can make regulations to stop products that facilitate the consumption of tobacco being openly displayed by retailers.

The Bill bans the sale of vapes, nicotine products and cigarette papers from vending machines in England, Wales and Northern Ireland and restates the existing ban on tobacco vending machines. We know that vending machines are used to bypass age of sale restrictions and to undertake proxy purchases on behalf of people under the age of sale. Government amendments 50, 54, 55, 64, 68, 72 and 73 are clarifying amendments that make the scope of the prohibition on vending machines absolutely clear, as was discussed in Committee. The Government’s position is that the Protection from Tobacco (Sales from Vending Machines) (England) Regulations 2010 already apply where a customer has a coupon, receipt or token purchased elsewhere that can be redeemed at a machine. We are amending the clauses so that all machines that dispense products in connection with a sale are clearly captured by the ban.

The Bill strengthens the enforcement regime to support law-abiding retailers while taking action against those who break the rules. Along with introducing new fixed penalty notices and new powers to create a licensing system, the Bill re-enacts provisions on restricted premises orders and restricted sale orders. Those are existing measures that local authority trading standards in England and Wales can use when dealing with a retailer that persistently breaches restrictions. That ensures there is a range of tools in the enforcement armoury, so that trading standards officers can act quickly and effectively against rogue retailers.

Government amendments 58 and 59 clarify a point raised in Committee by removing a duplicative and unnecessary provision that would prevent a business or individual from operating a vending machine for the sale of tobacco, vaping or nicotine products following the issuing of a restricted premises order or a restricted sale order. Given that the Bill already prohibits the use of vending machines for tobacco, vaping or nicotine products, there is no need for restricted premises orders and restricted sale orders to expressly prohibit the use of vending machines. Together, the Government amendments will improve the implementation and enforceability of measures in the Bill to ensure the most effective protection for the public, and I commend them to the House.

Turning to the other amendments in the group, I thank hon. Members for their scrutiny of the Bill so far. When I wind up, I will try to cover the key themes that are touched on. On the amendment that seeks to undermine the smokefree generation, I am sure we will hear arguments from some hon. Members who have been listening to the tobacco industry’s arguments and myths about how people should be free to make their own choices. I would say to them that smoking kills two thirds of its users. Three quarters of people wish they had never started smoking, and the majority want to quit—that is not freedom of choice. The tobacco industry took away that choice with addiction, usually at a young age.

On smokefree places, we have been clear: in England, we intend to consult on extending smokefree outdoor places to outside schools, children’s playgrounds and hospitals, but not to outdoor hospitality settings at this time. No smoker wants to harm people, but with second-hand smoke, they do. If people can smell smoke, they are inhaling it. This is particularly important for children, pregnant women and people with pre-existing health conditions such as asthma or heart disease. The only way to stop this harm is to stop people smoking around others. While I understand hon. Members’ proposals to list specific places in the Bill or to add additional limits to the use of the powers, it is right that we consult on the detail before making regulations and have the necessary powers to protect children and vulnerable people from the harms of second-hand smoking.

I am grateful to the co-chairs of the all-party parliamentary group on smoking and health, my hon. Friend the Member for City of Durham (Mary Kelly Foy) and the hon. Member for Harrow East (Bob Blackman), for their long-standing support for the Bill. Through their amendments, they highlight the importance of retaining a focus on support for current smokers. That is why we are investing an extra £70 million for local stop smoking services this year and working to ensure that all NHS hospitals offer opt-out smoking cessation services into routine care. I hope they will be pleased that we have been able to confirm the extension of the swap to stop scheme for the coming year, with up to £90 million of funding to provide free vape starter kits for smokers to use as quit aids.

On the group of amendments relating to vape advertising, we realise that products being deliberately marketed at children is unacceptable, which is why we have included a commitment to stop vapes being branded and advertised to children. The Government are also investing £10 million of new funding for the coming year for National Trading Standards to tackle underage illicit tobacco and vapes and to boost the trading standards workforce by recruiting 80 new apprentices, providing additional boots on the ground.

[Mr Joshua Reynolds (Maidenhead) (LD)]

Trading standards are really important and obviously, therefore, so are fixed penalty notices, so will the Minister support amendment 1, which would mean that any fixed penalty notice sums will be retained by local authorities to spend on public health, thus saving the NHS money, as she mentioned earlier?

[Ashley Dalton]

As the hon. Member will know, there are already measures in the Bill that allow some of the fines to be retained—they can certainly be retained to make it cost-neutral for local authorities—but I am sure we will explore that issue later on.

The Bill contains regulation-making powers on a range of aspects of product requirements that already allow us to do many things that hon. Members seek to achieve, but I look forward to listening to the contributions to today’s debate on the wider list of amendments and to responding to the points that are made.

[Madam Deputy Speaker (Judith Cummins)]

I call the Opposition spokesperson.

--- Later in debate ---

[Mrs Brackenridge]

I am pleased to say that that will end with the Bill, which will ban vape advertising aimed at children, outlaw sales from vending machines and crack down on packaging designed to attract young eyes. Firm action to protect the health of children includes a £10 million boost for trading standards to fund more enforcement officers.

I welcome the recent announcement of the £62 million groundbreaking research to investigate the long-term health effects of vaping by tracking 100,000 young people aged eight to 18 over a decade. Unless we prevent illness, our NHS will continue to be overwhelmed, and billions of pounds will be spent addressing a problem that could have been curbed in advance. I call on the House to pass the Bill in order to protect children in Wolverhampton East and across the country.

[Ashley Dalton]

Let me begin by thanking all hon. and right hon. Members for their contributions. I will try and touch on the many amendments discussed and the key questions raised.

At the heart of the Bill is the establishment of the smokefree generation by gradually ending the sale of tobacco products across the UK. Amendments 4 to 35 tabled by the right hon. Member for East Antrim (Sammy Wilson), amendments 38 to 45 tabled by the hon. Member for Romford (Andrew Rosindell), amendments 103 to 111 tabled by the hon. Member for Clacton (Nigel Farage) and new clause 12 tabled by the right hon. Member for South Holland and The Deepings (Sir John Hayes) would remove that policy or water it down. There is no liberty or choice in addiction, however, and that is why the Government are committed to creating the world’s first smokefree generation. We have the public’s backing, with 71% of adults supporting the goal of a smokefree Britain in a YouGov poll carried out in November 2023. Raising the age of sale to 21 will not meet our ambition to make the UK smokefree.

--- Later in debate ---

[Wera Hobhouse]

I hear what the Minister is saying, but the Metropolitan police and other forces tell us that it is incredibly difficult. The Bill gives us an extra opportunity to protect young children from a terrible pathway into addiction and crime. Is it not the task of this Government to stop that?

[Ashley Dalton]

The entire Bill is about preventing addiction among our young people and preventing their move into crime. These things are already illegal and the Government believe that existing legislation will allow for them to be dealt with.

On cigarette filters, I understand hon. Members’ concerns about tobacco litter, but new clause 2, tabled by the hon. Member for Gosport (Dame Caroline Dinenage), could lead to greenwashing, improving the reputation of tobacco manufacturers while not necessarily improving environmental outcomes.

[Dame Caroline Dinenage]

That is an incredibly lazy argument. We do not care about greenwashing; greenwashing is just semantics. We care about cleaning up our beaches, cleaning up our streets and reducing the cost to local councils of cleaning up litter. It is ridiculous if the Government are going to be swayed by one lobby or another and not do the thing that is common sense and much better for our environment.

[Ashley Dalton]

I thank the hon. Member for her intervention. If I am allowed to finish, that is one of the issues and that proposal may not necessarily improve environmental outcomes. However, we consider that powers are already available to the Department for Environment, Food and Rural Affairs that enable the Government to limit the damage to the environment caused by filters, so the amendments are unnecessary.

Similarly, new clause 14, tabled by my hon. Friend the Member for Dartford (Jim Dickson), would prohibit the supply of all cigarette filters or cigarettes containing filters, whether they contain plastic or not. Ultimately we believe that the best way to tackle filters is through the reduction of smoking rates. On bundles of tobacco products, the Bill gives the Government the powers to regulate retail packaging of tobacco products and devices, herbal smoking products and cigarette papers, as well as vaping and nicotine products. In addition, the Bill already gives the Government powers to regulate how products are packaged together in bundles, so amendments 86 and 87, also tabled by my hon. Friend, are not necessary.

Amendments 46, 90 and 91 and new clauses 8 to 10 and 15 would all undermine our promise to the electorate to stop vapes being advertised to children. We have a clear mandate, with 74% of adults in Great Britain supportive of a ban, and we will not create any exemptions that could undermine this. On amendment 90 and new clause 15, let me reassure the shadow Secretary of State and my hon. Friend the Member for Newcastle upon Tyne East and Wallsend (Mary Glindon) that the Government are not prohibiting the promotion of vapes in general as a smoking cessation tool.

Let me reassure my hon. Friends the Members for Newcastle upon Tyne East and Wallsend and for Suffolk Coastal (Jenny Riddell-Carpenter) that the Bill already provides the Government with powers to limit the amount of nicotine in a nicotine pouch, to regulate vaping products in such a way that would prohibit the sale of high puff count vaping devices, including setting tank capacity limits for devices where multiple refill tanks are attached, and to ban any other ingredient that may be harmful. The Government believe that these measures are more appropriate for secondary legislation due to the technical details that need to be captured, rather than in primary legislation as new clauses 4 and 21 would require.

On amendment 37, tabled by my hon. Friend the Member for Newcastle upon Tyne East and Wallsend, we recognise that vape flavours are a really important consideration for adult smokers seeking to quit smoking, but we also know that sweet or fruity flavours are the main flavours that appeal to children and that certain flavours and ingredients can be particularly harmful to health. We have been clear that we will carefully consider our future regulations so that we get the balance right, and this is subject to a statutory duty to consult. Similarly, I reassure my hon. Friend that amendment 88 is unnecessary. We will honour the long-established principles of good consultation when consulting on regulations under part 5 of the Bill, including in relation to who is consulted.

On new clauses 6 and 7, while the Government are committed to protecting children from the risk of harms through addiction, our approach across all products in the Bill is for age to be verified at the point of sale, not at the point of use. Mandating any age-gating technology for vapes would create harsher restrictions on vaping than smoking. That could make vapes less accessible and attractive to adult smokers wishing to quit and use vapes as a smoking cessation tool.

I recognise the concerns of the hon. Member for Harrow East (Bob Blackman) about online sales. However, it would not be proportionate to ban all online sales because that would impact on those retailers seeking to operate within the law.

As was discussed in Committee, going back to the issue of wider enforcement, new clause 18 and amendment 89 do not reflect the complex processes required to develop the licensing scheme in England and Wales. Although I am sympathetic to the shadow Secretary of State’s aims, rushing to publish draft regulations within two months of Royal Assent would risk creating flawed policy.

I pay tribute to colleagues in the Scottish Government, Welsh Government and the Northern Ireland Executive. This UK-wide Bill has been developed in partnership with them, and I thank them for their support. Our manifesto committed to resetting our relationship with the devolved Governments, and this Bill is a great success in demonstrating collaboration across Governments in improving the health of the nation.

[Jim Allister]

Since the tobacco directive applies to Northern Ireland under the protocol through section 7A of the 2018 Act and applies directly, and the directive forbids the type of proposition in this Bill, would the Minister care to explain to the House how this Bill will be applicable in Northern Ireland as long as the tobacco directive applies?

[Ashley Dalton]

This Bill has been put together, as I said, with collaboration across all the Governments and bearing in mind all the Government’s legal obligations under the law. All those things have been taken into account, and the Bill is able to be brought forward in that way. Our manifesto committed to delivering the smokefree generation, and we are working across all Governments to ensure that we deliver that, as well as honouring our international obligations. As a result, the Government do not consider new clause 3 tabled by the hon. and learned Member for North Antrim (Jim Allister) to be necessary. That is because we are content that measures drafted in the Bill that apply in relation to Northern Ireland are consistent with our obligations under the Windsor framework, and the proposed new clause would put us in breach of international law. In the drafting of the Bill, as I have stated, we have considered all its domestic and international obligations, and it is for those reasons that the Government cannot support new clause 3.

The Bill will bring about a real change by creating a smokefree generation. As we have discussed, there is no liberty or choice in addiction, and almost all smokers want to quit and two thirds wished they had never started. I started smoking at the age of 16 and decided I would stop when I was 18—I could not stop. I thought, “I know, I’ll stop when I am 21” and then it was 25, then it was when I graduated, and then it was when I had a child. At no point was I able to give up this pernicious addiction. It took a cancer diagnosis to scare me into being able to stop smoking, and I do not wish that on any of our young people.

In conclusion, many of the amendments are unnecessary because the Bill already grants the Government the power to take forward the issue through the more appropriate route of secondary legislation. This is a landmark Bill: the most significant public health intervention in a generation. It strikes the right balance on the interests of public health by being proportionate and not overly burdensome. It allows the Government to bring forward the appropriate primary and secondary legislation to ensure that we can deliver a smokefree generation that protects all our children from the addiction of tobacco, a uniquely harmful substance.

--- Later in debate ---

[Ashley Dalton]

I beg to move, That the Bill be now read the Third time.

Let me start by thanking hon. Members on both sides of the Chamber for their positive and constructive engagement today and more generally as the Bill has progressed through the House. Let me put on record my sincerest thanks to all members of the Public Bill Committee, who scrutinised the Bill extremely thoroughly and brought it to this stage.

The Bill is the next step in a long history of action on tobacco, but as the House is aware, it is not a step that this Labour Government have taken alone. I thank the right hon. Member for Richmond and Northallerton (Rishi Sunak) for his ambition to make a difference to the future of our country by championing the previous Tobacco and Vapes Bill. The Bill that we are discussing today is even stronger in its ambition to tackle smoking and youth vaping, in part thanks to the contributions and debate from MPs from all parties on these most critical of issues.

I thank the Opposition Front Benchers for their engagement with the Bill, particularly the shadow Minister, the hon. Member for Sleaford and North Hykeham (Dr Johnson), who has been a determined campaigner for action on youth vaping for a number of years. I also thank my officials in the Department for Health and Social Care and the devolved Governments, the Office of the Parliamentary Counsel, the Government Legal Department and the Clerks, whose tireless work and support on the Bill have enabled the development of this extraordinary legislation.

When this Government took office, we promised to create a smokefree generation. Today we are delivering on that promise. By creating a smokefree UK, we are investing in a healthier society for all. The Bill will tackle the concerning rise in youth vaping and reduce the immense burden that tobacco-related illnesses place on our society and our NHS. I consider it a great privilege to have overseen these last parts of scrutiny of the Bill, and I urge all right hon. and hon. Members to support it to proceed to the other place.

Oral Answers to Questions

Ashley Dalton Excerpts

Tuesday 25th March 2025 Commons Chamber

[Max Wilkinson (Cheltenham) (LD)]

5. What steps his Department is taking to improve cancer care in the west of England.

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

I know the hon. Member is acutely aware of the impact that cancer can have on families. We are committed to catching cancer earlier and treating it faster. We have achieved our manifesto pledge of 2 million extra appointments seven months early and we have invested in more surgical hubs, longer opening times, which have benefited 23 community diagnostic centres in the south-west, and new radiotherapy machines. The national cancer plan will also seek to improve every aspect of cancer care to improve patient outcomes and experiences across the country, including in the west of England.

[Max Wilkinson]

I thank the Minister for her answer. The Big Space Cancer Appeal being run by the Cheltenham and Gloucester Hospitals Charity is going on in my constituency. It is having to raise £17.5 million for a new cancer centre at Cheltenham general hospital, which is a regional cancer centre, because the previous Government did not fund it. I am proud of the fund-raising work that is being done by the hospitals charity, including by my caseworker, Mateusz, who is running two half marathons for the cause. Will the Minister meet me and Dr Sam Guglani and Dr Charles Candish to discuss how the Government might provide more support for this crucial piece of infrastructure?

[Ashley Dalton]

I commend the hon. Member’s campaign activity for improved cancer facilities. I commend, too, Mateusz’s two half-marathons. I wonder when the hon. Member will be doing his half-marathon, but I can guarantee that I will not be joining him. The fact that this sort of activity is taking place is fantastic. Local provision for healthcare is managed by the local health system. I would be delighted to meet him and local representatives as soon as diaries allow.

[Steve Yemm (Mansfield) (Lab)]

Cancer care is important for people right across the UK, particularly early diagnosis. How do the Government plan to raise cancer awareness among young people during Teenage and Young Adult Cancer Awareness Month and ensure that they are fully aware of the signs and symptoms?

[Ashley Dalton]

This is a really important issue. We have reinstated the children and young people cancer taskforce, which I visited a couple of weeks ago. We have tasked it with ensuring that children and young people are a part of its work. The Department will be marking Teenage and Young Adult Cancer Awareness Month appropriately. We encourage all children and young people to get the checks that they need and be aware of cancer symptoms.

[Kevin McKenna (Sittingbourne and Sheppey) (Lab)]

6. What steps his Department is taking to help tackle inequalities in nursing career progression.

--- Later in debate ---

[Sarah Smith (Hyndburn) (Lab)]

13. What steps he is taking to ensure special educational and disability needs are met by the NHS.

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

I commend my hon. Friend for her dedication to improving support for children in her role as the opportunity mission champion. Children with special educational needs and disabilities may access a range of NHS services, including health assessments and specialised support. All integrated care boards must have an executive lead for SEND to ensure that that work receives sufficient focus. We are working closely with the Department for Education on reforms to the SEND system.

[Sarah Smith]

As the Minister is aware, last year we faced the devastating closure of the Accrington Victoria hospital after 14 years of mismanagement by the Conservative party. I place on record my thanks to the frontline staff who have managed that transition and the operational challenges to relocate services, but sadly a fully purposed building for children with SEND had to be used to relocate clinical services. How does the Minister plan to ensure that those with SEND are at the heart of commissioning plans and service development?

[Ashley Dalton]

The system we inherited has been failing to meet the needs of children with SEND for far too long—that became clear in what happened at the Accy Vic. Through the 10-year health plan, we will consider all those policies, including those that impact on children and young people. We are working closely with the Department for Education to support the delivery of the opportunity mission. I also hosted a roundtable recently with children and young people, including those with SEND, so that they can feed directly into the 10-year plan. They will be at the heart of our thinking and planning on these issues.

[Graham Stuart (Beverley and Holderness) (Con)]

Mr Speaker, your heart would have been gladdened last week to see colleagues from across the House coming together to support my debate calling for the Down Syndrome Act 2022 to be implemented three years on. The Minister for Secondary Care said in response that Down syndrome-specific guidance would be produced, which is welcome. Will the Minister ensure that the consultation group is restricted to organisations that represent Down syndrome people only, and will she promise that, after three long years, that statutory guidance will finally be issued before the end of this calendar year?

[Ashley Dalton]

Work to develop the Down Syndrome Act statutory guidance is being taken forward as a priority, with a view to publishing it for consultation by the summer. It does involve people with Down syndrome, as part of a wider group.

--- Later in debate ---

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

I commend my hon. Friend’s constituent for her work with the Brain Tumour Charity, and I wish Lily well with her treatment. The Government have launched the brain tumour research consortium, which will support efforts to speed up the diagnosis of tumours and aid the recovery of patients, and the national cancer plan will ensure that we include brain tumour patients. We know that everyone’s cancer is as unique as they are, and this will be reflected in the plan.

[Andrew George (St Ives) (LD)]

T4. In reviewing the NHS workforce plan, will Ministers urgently review the pay and status of registered nurses, who are, after all, the backbone of the NHS? Many are now dependent on food banks, thousands are saddled with student debt, and most will expect never to rise beyond band 5, which is a maximum of £35,000 a year.

--- Later in debate ---

[Euan Stainbank (Falkirk) (Lab)]

Last year, my constituent Danielle was diagnosed with POTS—postural orthostatic tachycardia syndrome. She found herself unable to get out of bed and unable to speak for long periods. She could not receive care in Scotland. Specialist treatment does not seem to exist for POTS. What more can we do for people like Danielle, and what conversations has the Minister had with counterparts about establishing specialist treatment in Scotland?

[Ashley Dalton]

In England, it is the responsibility of local integrated care boards to work with clinicians, service users and patient groups to develop services and care pathways that are convenient and meet the needs of patients with POTS. NICE has published a clinical knowledge summary on the clinical management of blackouts and syncope, which provides advice for UK clinicians on best practice and the assessment and diagnosis of POTS.

[Charlie Dewhirst (Bridlington and The Wolds) (Con)]

I have twice invited Ministers to visit Bridlington district hospital with me to see its much-underutilised potential. In the light of the ongoing challenges faced by coastal and rural health services and the newly announced changes to integrated care boards, may I hope that it will be third time lucky, and extend that invitation once again?

--- Later in debate ---

[Tom Hayes (Bournemouth East) (Lab)]

Coastal constituencies such as mine in Bournemouth East suffer significant health inequalities. What are the Government doing to address them, and will the Minister meet me and coastal Labour MPs to address the issue?

[Ashley Dalton]

My hon. Friend is right: coastal communities face unique challenges when it comes to health inequalities. I will shortly attend the all-party group for coastal communities, where I will meet him and colleagues to discuss these issues.

[Charlie Maynard (Witney) (LD)]

As the Secretary of State will know, in 2018, this House allocated £40 million of funding in memory of Dame Tessa Jowell, who was killed by a brain tumour. Seven years on, less than half of that money has been spent. The money is doing no good sitting in a bank, so will the Secretary of State please commit to spending that money within a decade of Dame Tessa’s death?

World Health Organisation Pandemic Accord Negotiations

Ashley Dalton Excerpts

Tuesday 18th March 2025 Written Statements

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

I would like to update the House regarding the latest round of negotiations on a legally binding international agreement on pandemic prevention, preparedness and response—the pandemic accord—at the World Health Organisation (WHO).

In March 2021, the UK joined other WHO member states in calling for a pandemic accord that would ensure the world is better prepared for any future pandemic. Negotiations on the pandemic accord have been ongoing since 2022, and member states have until the World Health Assembly in May 2025 to reach an agreement.

The pandemic accord aims to enable a better co-ordinated, global response to pandemic threats and facilitate more equitable and timely access to pandemic-related vaccines, treatments, and tests. With a future pandemic a certainty, the pandemic accord is an opportunity to better protect the UK against this threat and to deliver on the Government’s health and growth missions, including through improving pandemic prevention, promoting innovation in pandemic related research and development (R&D), and putting in place systems that can promptly respond to pandemic threats when they emerge. The UK will only sign up to a pandemic accord which is both in the national interest and protects the health of people in the UK and around the world.

Member states have reached provisional agreement on around 75% of the text, while negotiating on the principle that “nothing is agreed until everything is agreed”. Since the House was last updated in November, provisional agreement has been reached on articles covering sustainable financing for the implementation of the agreement, and R&D. During the latest round of negotiations, between 17 and 21 February, some progress was made on portions of the text covering pandemic prevention, the opening chapter of the accord (covering definitions, objectives, and principles), and pathogen access and benefit sharing (PABS). However, there is still some way to go on several issues, including on technology transfer and further areas within the pandemic prevention and PABS articles, with limited time remaining to negotiate the text. The UK Government remain committed to working with member states to reach an effective agreement.

I will continue to update the House as negotiations near conclusion.

[HCWS529]

Rare Cancers Bill

Ashley Dalton Excerpts

2nd reading
Friday 14th March 2025 Commons Chamber

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

First, let me say how sorry I was to hear that my hon. Friend the Member for Edinburgh South West (Dr Arthur) recently lost his father-in-law to glioblastoma. I congratulate him on introducing this legislation less than a year after his election. His wife and children will be immensely proud to see him in the Chamber today. He has the full support of many charities, such as Pancreatic Cancer UK, the Brain Tumour Charity and Cancer Research UK, as well as people up and down the country who have written to their MP urging them to join this debate and vote for the Bill.

I also pay tribute to all those right hon. and hon. Members who have lost loved ones and remembered them so powerfully today. I thank them for the courage that they have shown in sharing their stories. Particularly, I do not think that anyone in this Chamber or watching from the Gallery or beyond could have failed to be moved by the powerful stories from my hon. Friends the Members for Calder Valley (Josh Fenton-Glynn), for Cumbernauld and Kirkintilloch (Katrina Murray) and for Mitcham and Morden (Dame Siobhain McDonagh), to whom I give particular thanks for her tireless campaigning on glioblastoma following the untimely loss of her sister Margaret.

I also pay tribute to those who remembered their constituents. I am delighted that very soon I will be meeting my hon. Friend the Member for Hyndburn (Sarah Smith) and Lorraine to discuss Milly’s Smiles. Let me take the opportunity to add my memories of Joe Chilcott, the son of my friends Tim and Verity and sister to Ellie, who was diagnosed with a brain tumour at the age of 10. It was heartbreaking to lose him when he was just 18.

I thank all the hon. Members who have spoken today. I will seek to address as many of the issues raised as possible. There were so many stories. I recognise the people who were remembered in those stories, those in the Gallery, and the many more watching at home. They are willing the Bill to succeed. On behalf of the Government, it is my great pleasure to pledge our support for the Bill. We are undertaking fundamental reform of the NHS. People living with rare cancers must be at the heart of that change. Rare cancer patients deserve better, and the Bill gives them something that has been spoken about across the House today: new hope.

Let me begin my remarks on what the Bill will do, why we support it and our policy on rare cancers more generally. Clinical research is one of the most important ways in which we can improve healthcare, by identifying the best way to prevent, diagnose and treat cancer. The Bill will encourage the placement of clinical trials for rare cancer in England, by ensuring that the patient population can easily be contacted by researchers, streamlining the recruitment process. It will also ensure a Government review of regulations relevant to orphan drug designation, to ensure that they continue to deliver for patients. Innovations in the Bill will complement the radical actions that we are developing through the 10-year health plan and the national cancer plan to fix the NHS, on which I will expand later.

Research is a key part of this effort, which is why the Department of Health and Social Care, through the National Institute for Health and Care Research, invests more than £1.6 billion a year in health research. In 2023-24, the NIHR invested £133 million in cancer research. As we have heard, rare brain cancers such as glioblastoma have a devastating impact on people and their loved ones. That is why the NIHR announced in September 2024 a new package of funding opportunities for brain cancer research, and established in December a new national brain tumour research consortium, bringing together researchers from a wide range of different disciplines. That is in parallel with a dedicated funding call for research into wraparound care and the rehabilitation and quality of life of patients with brain tumours. We remain committed to accelerating new breakthroughs in high-quality research to drive improvement in the diagnosis, management and treatment of brain and other rare cancers, for better survival rates and patient outcomes.

The hon. Member for Esher and Walton (Monica Harding), my hon. Friend the Member for Mitcham and Morden and others asked how the £40 million promised for brain tumours has been spent. In the five years since 2018-19, the NIHR has invested £11.3 million directly in brain cancer, with a further £31.5 million to enable brain tumour research in 227 studies involving 8,500 people. The commitment remains in place. I can confirm that there is no upper limit on that funding. We are exploring additional research policy options to encourage more clinical trials in early phase research and the development of medical devices and diagnostics.

We have also talked a lot about other rare cancers, including lobular breast cancer, for which we are supporting research through the research infrastructure, including biomedical research centres. We welcome further funding applications for research on all conditions, including lobular breast cancer. We continue to consider whether abbreviated forms of breast magnetic resonance imagining —fast MRI—can detect breast cancers that are missed by screening through mammography, such as lobular and the other types of breast cancers that have been mentioned. We are also supporting the opening of 171 studies on blood cancer, providing an online registry called “Be Part of Research”, which allows users to search for and participate in studies relevant to them.

Clinical trials are a crucial part of cancer research. They provide patients with early access to groundbreaking and possibly lifesaving treatments. The measures in the Bill align strongly with our commitment to that, and aim to streamline clinical trial recruitment processes. My hon. Friend the Member for Mitcham and Morden spoke passionately about how long it takes trusts to negotiate contracts. We recognise that issue and are beginning to make progress. NHS commercial contracting has been standardised, and the national contract value review has reduced study set-up times by 36%, from 305 days to 194 days in the first 12 months’ analysis. We continue in that work.

The hon. Member for Wokingham (Clive Jones) and my hon. Friend the Member for Bootle (Peter Dowd) asked how we are working across borders. We are taking forward the most significant reform of UK clinical trial regulations in over 20 years, while maintaining robust protections and safeguarding for clinical trial participants. The MHRA already authorises cross-border clinical trials, including those conducted in the EU and on UK-based trial sites. The “Be Part of Research” programme uses information from national and international sources.

My hon. Friend the Member for Mitcham and Morden spoke so passionately—we have all commented on her passion and anger. I appreciate her frustration and share her desire for radical action. I think we can all agree that the Government’s announcement yesterday on scrapping NHS England demonstrates our willingness to be bold, take risks and do things differently.

Members raised several other matters. I will come back to them all with more detailed information on those issues, but I do not have the time to do so today. I will address the national cancer plan, however, which was raised a number of times. It is really important to fulfil our goal of transforming cancer care, and we will not just cherry-pick the most common cancers; we need a rising tide that will lift all ships. As a person who is living with an incurable cancer myself, I cannot overstate how deeply I feel the honour and responsibility of being asked to drive forward our work in creating the national cancer plan—it is my absolute honour. But while we take strides to fix cancer services, I am under no illusion that the Government or I hold all the answers, so my plea is for hon. Members to work with us and share their expertise. I ask them please to visit “Shaping the national cancer plan” on the Department’s website and to contribute evidence.

The Government are committed to making a real difference for patients with rare cancers. For those affected by this devastating disease, every discovery, every treatment and every moment matters. We will do all we can to facilitate the passage of this Bill here and in the other place.

NHS Screening and GP Registrations

Ashley Dalton Excerpts

Tuesday 11th March 2025 Written Statements

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

I would like to inform the House that yesterday, 10 March 2025, the NHS wrote to around 5,261 people who have not been invited for routine screening. This is because their general practice registration process was not completed correctly, meaning that their details were not passed to NHS screening systems. Those affected have now been added into relevant screening programmes and work is ongoing to ensure that this does not occur in the future.

The letters were posted to affected patients who are still eligible for a screening programme, or who were previously eligible for a screening programme but now exceed the programme’s upper age limit. The letter will explain what has happened and next steps, including details of the helpline that has been set up by NHS England.

Records indicate that up to 10 patients have been diagnosed with a relevant cancer and were not invited for certain screening. NHS England is writing to these patients this week. The impact on these patients is not yet known and a clinical harm assessment process will be undertaken, based on expert clinical advice. It is with deep sadness that I must report that records also indicate that around 10 people who were not invited for screening may have died from a relevant cancer. NHS England will take appropriate action in these circumstances, based on expert clinical advice.

In the summer of 2024, a small number of people contacted NHS England to say they had not been invited for screening. NHS England commissioned further investigation, which led to an issue within GP registration being identified in late December. This issue, which has continued since 2008, affected the bowel, breast and cervical cancer screening programmes, as well as abdominal aortic aneurysm screening. It did not affect the diabetic eye screening programme, or any of the antenatal or newborn screening programmes. Since then, work has been undertaken to identify the individuals affected. Where relevant, work is ongoing to assess any clinical implications of their delayed screening.

The specific problem relates to when a patient registers at a new GP practice. GP registrations returned to some GP practices by Primary Care Support England for further information or review had not been completed, or the GP practice had not sent a message to complete the patient’s registration. Incomplete registrations were not passed to the NHS screening programme IT systems and, therefore, some people had not been invited to their routine screening. Processes have been put in place to make sure that new GP registrations will be closely monitored and updated on systems as necessary.

I would like to assure the House that we will provide regular updates as we offer support to affected patients, and I would like to thank NHS staff who have worked to understand and deal with this issue.

[HCWS513]

Ambulance Response Times

Ashley Dalton Excerpts

Thursday 6th March 2025 Westminster Hall

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

It is a pleasure to serve under your chairship, Ms Jardine. I am grateful to the hon. Member for Glastonbury and Somerton (Sarah Dyke) for securing the debate. I thank all the hon. Members who have taken part, including my hon. Friends the Members for Redditch (Chris Bloore), for Ilford South (Jas Athwal) and for Wolverhampton West (Warinder Juss), and the hon. Members for West Suffolk (Nick Timothy) and for South Devon (Caroline Voaden), as well as the Liberal Democrat spokesperson, the hon. Member for North Shropshire (Helen Morgan), and the shadow Minister, the hon. Member for Sleaford and North Hykeham (Dr Johnson). I will endeavour to deal with as many issues and questions as I can. If I do miss any, will hon. Members please get in touch with me afterwards, and I will make sure they are picked up?

The hon. Member for West Suffolk mentioned the commitment made by the Secretary of State to meet him and visit his constituency, and I will ensure that that issue is raised. The parliamentary private secretary, my hon. Friend the Member for Ealing Southall (Deirdre Costigan), is here, and I am sure she will be happy to pursue a response. We will also do what we can to get a response from the Treasury for the shadow Minister.

The hon. Member for Glastonbury and Somerton and other hon. Members rightly raised constituents� experiences of long waits for an ambulance response. I put on record my deepest sympathies for the hon. Lady�s constituent Jim on the loss of his wife. As the Secretary of State has made clear, this is not the level of care that staff want for their patients, and it is not the level of care that this Government will ever accept for patients.

Lord Darzi investigated the issues facing the NHS, and his report was honest about the challenges facing the health service. Urgent and emergency care performance remains a long way from a resilient position and there is continued high demand for A&E and ambulance services, with ongoing seasonal winter pressures. For example, in December the London Ambulance Service recorded more than 121,000 incidents, the highest on record for the service. Improvement needs to happen across the urgent and emergency care pathway and through the expansion of neighbourhood health services.

Nationally, congested emergency departments reduce the productivity of ambulance services, a matter that I think almost all hon. Members raised. A huge amount of time is lost to ambulance handover delays because there is no space for patients. Having crews tied up waiting outside hospitals exacerbates poor ambulance response times. We have also seen the continued normalisation of corridor care. We will never accept patients being treated in corridors; it is unsafe and undignified. We are investing an extra �26 billion to begin turning around the NHS, and we will do all we can, as fast as we can, to consign corridor care to the history books.

Lord Darzi�s investigation into NHS performance highlighted wide variation across different parts of the country. The situation is unfair to patients and goes against the principle of a universal service. I acknowledge that there can be challenges in rural areas, where longer distances often mean that patients wait much longer for ambulances than in urban areas. I often find myself in this place with the hon. Member for Glastonbury and Somerton, and we both talk about the experience in our rural constituencies. I assure her that that is on my agenda. As she says, ambulance response times for the south-west and some other areas highlight the rurality differential.

In January, the South Western Ambulance Service�s average response for category 2 emergency incidents, which include strokes and heart attacks, was 51 minutes and 45 seconds, which is 26 minutes longer than the best-performing ambulance trust in England. The NHS constitutional standard for category 2 average response times is 18 minutes, and no ambulance trust in England has met that target since the pandemic. This cannot go on. Prioritising patient safety will always be the Government�s and the NHS�s main focus. We are committed to getting A&E waiting times and ambulance response times back to NHS constitutional standards.

The independent review of ambulance trust culture was published in February 2024. Its recommendations included addressing workforce pressures. NHS England is working closely with ambulance trusts to implement those recommendations. We have made some significant investments in the ambulance workforce, and the number of NHS ambulance staff has grown by 9% compared with last year, but we recognise that there is much more to do on retention and wellbeing for ambulance staff. That is something that we will continue to work on.

We cannot keep plugging the gaps. There is a need for more fundamental reform. We have been clear that there are no quick fixes and that to turn things around will take investment and reform. We have provided the highest real-terms capital budget for the NHS since before 2010. We announced an extra �22.6 billion in day-to-day health spending and an additional �3.1 billion further capital investment over two years. That extra investment will be accompanied by fundamental reform, of which ambulance services.

In January, the Government published �Road to recovery: the government�s 2025 mandate to NHS England�, which clearly sets out delivery instructions for the NHS through the prioritisation of the five key objectives aimed at driving reform in the NHS. Improving A&E and ambulance service performance was also one of a small number of prioritised objectives in the Government�s mandate to NHS England to specifically start to address the current challenges facing urgent and emergency care.

In turn, NHS England�s planning guidance for this year includes the target to improve average category 2 ambulance response times to no more than 30 minutes across 2025-26. The guidance also sets out a range of key actions for the NHS to deliver in the same timeframe, focused on reducing avoidable ambulance dispatches and conveyances and reducing hospital handover delays.

[Helen Morgan]

Will the Minister pick up on the point about social care? Inability to admit to hospital is a key point in the handover delay problem, and the social care talks are a key measure in solving it.

[Ashley Dalton]

The hon. Member will be delighted to know that I am coming to that point next.

We are working on reducing delays and getting hospital handovers back to within 15 minutes, ensuring that no handover between hospital and ambulance services takes longer than 45 minutes. We want to improve the range and co-ordination of services to avoid unnecessary ambulance conveyances, including through improving access to urgent community response and hospital at home services, and continuing to build on ambulance services and the great work that they do to increase the hear and treat rates so that people can be advised on what they can do and what services they can access that might mean they do not need that ambulance. We will also be driving consistency and commissioning practices across England for ambulance services. I will say a little more about the rurality element in a moment.

We are taking the first steps in the reform and improvements that we want to see in services, and we will shortly set out further plans in the urgent and emergency care services plan. We know that there is no solution for ambulances that does not include tackling the challenges facing adult social care. Health and care services need to be more joined up.

Today, there are approximately 12,000 patients in hospital beds who have no criteria to reside. They do not need to be there but cannot be discharged for reasons of capacity. Over the last month, on average, 276 of the patients with no criteria to reside were in the Somerset integrated board area. That is why the Government are making available up to �3.7 billion of additional funding for local authorities that provide social care. We are funding more home adaptations through the disabled facilities grant this year and next, so that people�s homes can be safer, reducing the risk of their needing an ambulance. We are reforming the better care fund to ensure that the pooled NHS and local authority funding spent on social care contributes to wider efforts to reduce emergency admissions and delayed discharges.

[Dr Caroline Johnson]

Social care is clearly very important, but what assessment has the Department made of the effect of national insurance contributions on social care provision as a whole?

[Ashley Dalton]

The hon. Member will be aware, because we have discussed the matter many times in Westminster Hall and the main Chamber, that the funding has been made available to the statutory sector bodies for employer national insurance contributions for public sector pay, and the negotiations for the delivery of commissioned services locally and within the NHS will take place locally. I am sure that we will be able to point her to some more detail on that issue, which has been discussed at length by colleagues.

We have announced the largest ever increase in the carer�s allowance earnings limit since the benefit was introduced in 1976. It is worth approximately �2,000 a year for unpaid carers. We are also introducing fair pay agreements to empower worker representatives, employers and others to negotiate pay and terms and conditions in a responsible manner. That will help to address the recruitment and retention crisis in the sector. It is not all about ENICs; it is about making sure that our social care service is resourced in order to make sure that social carers are recognised for the powerful and important work that they do. We have appointed Louise Casey to help to build a national consensus on the long-term solution for social care.

The social care cross-party talks, to which the Liberal Democrat spokesperson referred, have not been called off; they have been merely delayed. As I told her in the Chamber just yesterday, it is very much about making sure that we have the right people in the room and that they can attend. It is our intention for the talks to go ahead very soon. They have not been called off; they have been merely postponed.

Of course, we need further reform. We are bringing it forward through the 10-year plan this spring to accompany the additional investment in the NHS. The Government will publish that plan for radical reform in the NHS, with those three big reform shifts: from hospital to community, from analogue to digital and from sickness to prevention. The reforms will support putting the NHS on a sustainable footing so that it can tackle the problems of today and of the future.

The shadow Minister asked about the configuration of ambulance services. As I am sure she is aware, decisions on service configuration must be made by those who are experts in delivering it.

We have also talked about the key issues of rurality. A range of adjustments are made in the core ICB allocations formula to account for the fact that the costs of providing healthcare may vary between rural and urban areas. Some of the differences, such as the tendency for rural populations to be older, are naturally captured within the formula. We continue to review the formula for the impact of the characteristics of local areas, such as rural, urban and coastal, in the development programme.

I encourage all hon. Members to raise these matters with their local ICBs, which are responsible for commissioning the right configuration of local services. The NHS has increased the availability of local data on ambulance response times performance, with category 2 ambulance performance now published at ICB level, which has increased the transparency of the important data. I encourage hon. Members to use that data to direct conversations with their ICBs.

We have also talked about air ambulances. I am sure that all hon. Members recognise the contribution that they make, as the Government do. The Government support the long-standing independent air ambulance charities model for the successful operation of helicopter emergency medical services in England, which gives the sector the independence to raise funds through commercial activity and sponsorship from corporate partners. The NHS continues to support air ambulance services, including through thorough training and the provision of NHS clinicians.

Communities right across the country, including the constituents of the hon. Member for Glastonbury and Somerton, are struggling with poor services and crumbling NHS estates. We are putting record capital into the NHS. We will bring down ambulance response times. We will get waiting lists back down to what they were in 2010. It will take time, but we will deliver an NHS and a national care service that provide people with the care they need, when and where they need it.

Covid-19 Vaccination

Ashley Dalton Excerpts

Thursday 6th March 2025 Written Statements

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

His Majesty�s Government (HMG) is committed to protecting people most vulnerable to covid-19 through vaccination as guided by the independent Joint Committee on Vaccination and Immunisation (JCVI).

On 13 November 2024, the JCVI published advice on the covid-19 vaccination programme for spring 2025, autumn 2025 and spring 2026. On 12 December 2024 the Government accepted their advice that a covid-19 vaccine should be offered in spring 2025 to those in the population most vulnerable to serious outcomes from covid-19 and who are therefore most likely to benefit from vaccination.

Vaccination will therefore be offered in England in spring 2025 to:

adults aged 75 years and over;

residents in a care home for older adults;

individuals aged six months and over who are immunosuppressed, as defined in tables 3 and 4 of the covid-19 chapter of the UK Health Security Agency (UKHSA) green book on immunisation against infectious disease.

The Government are considering the JCVI�s advice for autumn 2025 and spring 2026 programmes and will respond in due course.

The vaccines that will be supplied for the spring 2025 programme are the Moderna mRNA (Spikevax) vaccine and Pfizer-BioNTech mRNA (Comirnaty) vaccine.

Notification of liabilities

I am now updating the House on the liabilities HMG has taken on in relation to further vaccine deployment via this statement and accompanying departmental minute laid in Parliament containing a description of the liability undertaken.

The covid-19 vaccines to be used in spring 2025 were pre-procured as part of HMG�s pandemic emergency response. As part of the contractual arrangements with covid-19 vaccine producers for these vaccines, provision of an indemnity was required in order to enter into supply agreements. This only applies to vaccines purchased as part of the pandemic emergency response.

The agreement to provide indemnity with deployment of further doses increases the contingent liability of the covid-19 vaccination programme.

I will update the House in a similar manner as appropriate, as and when any future decisions impact the contingent liability of the covid-19 vaccination programme.

[HCWS505]

Plasma for Medicines Programme

Ashley Dalton Excerpts

Thursday 6th March 2025 Written Statements

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

My noble Friend the Parliamentary Under-Secretary of State for Patient Safety, Women's Health and Mental Health (Baroness Merron) has made the following written statement:

I am pleased to inform the House that the first patients in England have now received life-saving plasma derived medicines made from UK donor plasma for the first time in over 25 years. This will boost self-sufficiency and reduce reliance on imports from abroad.

Blood plasma medicines are critical for approximately 17,000 NHS patients who rely on them to treat immune deficiencies and rare disorders. They are also essential in emergency medicine, particularly during childbirth and trauma care.

Using UK donor plasma was banned in 1998. This followed concerns about a potentially increased risk of plasma recipients acquiring the brain disease variant Creutzfeldt-Jakob disease due to UK plasma donors being exposed to bovine spongiform encephalopathy (sometimes referred to colloquially as mad cow disease) prions from infected cattle. The NHS has relied solely on imported plasma medicines since then.

The ban was lifted in 2021 following a review by the Medicines and Healthcare products Regulatory Agency and the Commission on Human Medicines. The plasma for medicines programme was set up in 2021 by the Department of Health and Social Care as a tripartite programme between the DHSC, NHS Blood and Transplant and NHS England. Since April 2021, NHSBT has re-established its plasma collection programme and collected 500,000 litres of plasma medicine. Following a successful procurement exercise by NHSE, Octapharma was appointed to fractionate the plasma into component parts (including albumin) and made into medicines. Shipments of UK donor plasma began in summer 2024.

This collaboration, along with the generosity of blood donors, means that the first patients in England are now benefiting from these medications. The devolved Governments in Scotland, Wales and Northern Ireland are already actively engaged in the programme, with similar benefits expected in the near future.

This development is a milestone to deliver the Government�s growth mission, and reflects excellent strategic collaboration between NHSBT and NHSE. This is a further step to establishing strategic self-sufficiency in critical medicines and reducing exposure to international markets, with the global plasma medicines industry expected to rise by $15 billion (2023) to $45 billion by 2027. In England, we expect 25% self-sufficiency on immunoglobulin by the end of 2025, growing to 30-35% by 2031, and 80% self-sufficiency in albumin.

DHSC will continue to work with NHSBT, NHSE and the devolved Governments to consider the next steps for self-sufficiency in the supply of plasma medicines.

[HCWS506]

Department of Health and Social Care

Ashley Dalton Excerpts

Wednesday 5th March 2025 Commons Chamber

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

Let me begin by thanking the Chair of the Public Accounts Committee, the hon. Member for North Cotswolds (Sir Geoffrey Clifton-Brown), for opening the debate. As a Public Accounts Committee alumna, it is my pleasure to have my first outing at the Dispatch Box for this debate.

I also thank all other colleagues for taking part. The number of right hon. and hon. Members who have contributed today speaks to the significant interest in our health and social care services not only in this House but in the country. The wide range of issues raised shows how broad and overarching our NHS and social care services are. I will try to cover as many of those issues as I can, and if I miss anything, I will happily pick it up with hon. Members afterwards. I will also attempt to respond to all hon. Members who have spoken, but if I miss anyone, I hope they will forgive me, because we have had so many contributions.

The Chair of the Public Accounts Committee, as well as the hon. Member for St Ives (Andrew George), my hon. Friends the Member for Poole (Neil Duncan-Jordan) and for Sheffield South East (Mr Betts) and many other Members, talked about social care. Productivity was a key point mentioned by the Chair of the Public Accounts Committee, as well as by the right hon. Member for Salisbury (John Glen), the hon. Member for Farnham and Bordon (Gregory Stafford) and my hon. Friend the Member for Barking (Nesil Caliskan). Prevention in public health was raised by many Members—as the Minister responsible for those areas, I am delighted to discuss that.

My hon. Friend the Member for Uxbridge and South Ruislip (Danny Beales) talked about dentistry, and shifts were mentioned by many hon. Members. My hon. Friend the Member for Barking talked about the work not only of public health but of local government, and the role of ICBs. It was great to hear my hon. Friend the Member for Gloucester (Alex McIntyre) talk about his pride in the NHS. This Government will always stand by our NHS and will always keep it free at the point of use.

In her autumn Budget, the Chancellor took the necessary decisions to put our NHS on the road to recovery, with an increase of more than £22.5 billion in day-to-day health spending and over £3 billion more in the capital budget over this year and the next. Thanks to her, we are taking the first steps towards fixing the foundations of our NHS and making it fit for the future. I say to the shadow Minister that yes, this will make a difference, because it is not just about the money but about making the right choices.

[Gregory Stafford]

Will the Minister give way?

[Ashley Dalton]

I will, but very briefly, because we have very little time.

[Gregory Stafford]

I thank the Minister, and welcome her to her place. This, I think, is the fundamental point that Conservatives are making. We all accept that we want to see a shift from acute hospital provision to social care, but when the Chancellor’s Budget does not reflect that and when the national insurance rises hit the social care end of the spectrum, how can the public have faith that what the Minister says is anything more than rhetoric?

[Ashley Dalton]

I am coming to all of that.

Since coming into office, the Government have made choices. We have ended the resident doctors strike. We have published our elective reform plan, which will cut maximum waiting times from 18 months today to 18 weeks by the end of this Parliament. We have introduced investment and reform in general practice to fix the front door to the NHS and bring back the family doctor. We have started to get waiting lists falling, and we have kept the promise in our manifesto to deliver an extra 2 million appointments in our first year, a target that we have actually smashed in the first seven months. Anyone who thinks the Chancellor was wrong to make the necessary decisions and trade-offs must explain what they would cut from that list. Anyone who thinks they could have achieved everything we have done in less than a year without the autumn Budget is living in cloud cuckoo land.

Today we are setting out our supplementary estimates to the House. Funding will help the NHS to deliver 40,000 extra elective appointments a week, and to make progress on reducing the number of patients who wait longer than 18 weeks between referral and consultant-led treatment. We will publish our departmental budgets for the next financial year in the spring through phase 2 of the spending review.

[Ben Coleman]

Will my hon. Friend give way?

[Layla Moran]

Will the Minister give way?

[Ashley Dalton]

I will give way very briefly.

[Layla Moran]

The Minister will have noted, on page 53 of the estimates, a £1 billion decrease in capital spending in the departmental accounts. Will that be explained, and can the Minister explain now how new hospitals constitute day-to-day spending?

[Ashley Dalton]

I will be coming to that, but I thank the hon. Lady for raising it.

We have talked about productivity, an issue that has been raised by many Members including the Chair of the Public Accounts Committee. I am delighted that Members on both sides of the House, including Conservative Members, have now recognised and accepted the value of the Darzi report, which this Government commissioned.

We are committed to meeting a 2% productivity target by 2025-26. To help us to achieve that, there is a £2 billion investment in NHS technology, allocated to freeing up staff time, ensuring that trusts adopt electronic patient records—we have heard a great deal about old-fashioned paper today—and enhancing cyber-security measures, while also improving patient access to services via the NHS. The current measures of health productivity data do not capture all the outputs and outcomes adequately, and NHS England is working with the Office for National Statistics and the University of York to refine those metrics. Reform is at the heart of our 10-year plan.

We are rebuilding our capital-starved NHS through £1.6 billion of national capital funding in 2025-26, which will help us to achieve constitutional standards. The money will help to deliver more than 30,000 additional procedures and more than 1.25 million diagnostic tests as they come online through investment in new surgical hubs and diagnostic scanners, new beds across the estate, and a £70 million investment in new radiotherapy machines to improve cancer treatment. Questions have been asked about the shift from capital to revenue. Some of investment has met historic need, including capital funding for technology and new hospitals programmes, but because of the nature of the funding it needed to be defined as revenue. It is still being spent on those programmes. The autumn Budget included a commitment to ban shifting from capital to revenue, and I can confirm that no shifts of that nature have taken place since then. I will now give way.

[Ben Coleman]

I am most grateful to the Minister for giving way to me and not to an Opposition Member this time, splendid though they are.

The Minister probably shared my great disappointment when the last Government put no money into the new hospital programme and threw Charing Cross hospital, in my constituency, out of the programme. May I share with her my delight that the Government have put Charing Cross back into the programme and are funding it, with a timetable that the last Government failed to deliver?

[Ashley Dalton]

Everyone knows that the previous Government’s promise of 40 new hospitals was a fiction: there were not 40, they were not new, and many of them were not even hospitals. We have put the programme on a firm footing with sustainable funding, so all those projects will actually be delivered.

In response to the Chair of the Health and Social Care Committee, the hon. Member for Oxford West and Abingdon (Layla Moran), I am more than happy to work with the Committee to clarify the funding for NHS providers. I understand that there is already quite of lot of information in the public domain, and I am more than happy to have that conversation with her.

On financial levers and incentivising prevention, the 10-year health plan is really the driver of all our shifts—from analogue to digital, from hospital to community, and from sickness to prevention. It will set out how we achieve transformational change. As part of that, the plan’s working groups are looking at how payment mechanisms, funding flows and contracting will need to change to build a health system that is fit for the future.

On ENICs, we have been here before. The Government will provide support to Departments for additional ENICs for public sector employees, and commissioned services are all subject to local negotiation with providers.

I want to move on to public health, in which I take a particular interest. I agree with hon. Members on the importance of public health investment. In 2025-26, through the public health grant and the 100% retained business rates arrangements for local authorities in Greater Manchester, we are increasing funding to £3.858 billion—a 5.4% cash increase, and 3% in real terms. It is a priority for this Government to confirm future year allocations as early as possible, and we will seek to do that. It is a priority of mine.

We have talked a lot about social care. Louise Casey commands great respect across political parties, the Government and the NHS, which is why she will lead the independent commission on adult social care as part of our critical first steps towards delivering a national care service. She will begin her work in April, drawing on people who need care and their families, staff, politicians, and the public, private and third sectors to inform the recommendations on how we rebuild adult social care.

[Anna Dixon]

I welcome the Minister to her place and congratulate her on her new role. On building a national care service and the Casey review, will she reassure me and other Members of the House that there will be a first-phase report in 2026 to inform the spending review, and that we will have action sooner than the 2028 final report?

[Ashley Dalton]

I can confirm that, as has already been stated, those interim reports will take place, with a view to informing spending reviews.

I want to pick up on the point made by the hon. Member for North Shropshire (Helen Morgan) about the cross-party talks. My right hon. Friend the Secretary of State wrote to colleagues from all the UK-wide parties to invite them to joint cross-party talks in February. Not everybody was able to take part—a significant number of people were not—and we think it is really important to have a wide range of views at such talks. We have taken the decision to reschedule them, but we will make sure that they take place. We are seeking to reorganise those talks at the earliest opportunity, and I can confirm that the intention is to go ahead with them.

We have committed to look at how we can further expand the role of pharmacies and better utilise the clinical skills of pharmacists, and we have now resumed our consultation with Community Pharmacy England regarding the funding arrangements for 2024-25 and 2025-26. I am unable to say any more on that until the consultation has finished.

To wrap up, we are undertaking the largest capital investment in our national health service since Labour was last in office, but if we are to deliver our promises to the British people, we must deliver faster improvement than even the last Labour Government achieved. Investment and reform are what we promised before the election, and investment and reform are what we are delivering. We will ensure that the NHS is there for people when they need it; we will tackle the big killers, such as cancer; and we will create a fairer Britain, where everyone lives well for longer, while making sure that every penny of taxpayer money is well spent. I commend the estimates to the House.

Type 1 Diabetes and Disordered Eating Services

Ashley Dalton Excerpts

Wednesday 5th March 2025 Commons Chamber

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

I thank my hon. Friend the Member for Cannock Chase (Josh Newbury) for securing the debate and all hon. Members who have contributed. The hon. Member for Strangford (Jim Shannon), who appears to be quickly making an exit but remains in his place, spoke about mental health. The hon. Member for South Northamptonshire (Sarah Bool) spoke about destigmatisation for disordered eating and for type 1 diabetes. By sharing her diagnosis in this place, she is making a huge contribution towards destigmatisation, and I thank her for that. My hon. Friend the Member for Gloucester (Alex McIntyre) shared his family’s story, which is heartbreaking and shows the impact that these issues have on people. My hon. Friend the Member for Worcester (Tom Collins) talked about technological advancement and support.

As my hon. Friend the Member for Cannock Chase outlined in his remarks, type 1 diabetes and disordered eating—T1DE—is not a widely known condition, yet it potentially affects up to a third of people with type 1 diabetes. People with T1DE find themselves trapped in a battle between needing to control their diabetes with insulin and trying to control their weight in an unhealthy way. It is a vicious cycle. People with T1DE experience increased ill health and, sadly, an increased chance of early death. Studies have shown that people with T1DE who restrict insulin have a mortality rate more than three times higher than those who do not.

We should pay tribute to the diabetes charities that are doing so much for people living with diabetes across the UK and tackling this problem head on, such as Beat, which has dedicated helplines for people struggling with this condition; Breakthrough T1D, which funds international research to cure, treat and prevent type 1 diabetes and its complications; and Diabetes UK, which does a fantastic job of articulating the community’s needs to Government.

[Tom Gordon (Harrogate and Knaresborough) (LD)]

I congratulate my friend, the hon. Member for Cannock Chase (Josh Newbury), on securing this debate. As was mentioned, I used to work for the type 1 diabetes charity JDRF, as it was then—it is now Breakthrough T1D. We used to regularly have meetings with Ministers in the Department of Health and Social Care. One of the key things that I and, I am sure, Members across the House would like to see is the new Government taking up the recommendations of the report by Theresa May and Sir George Howarth. Will the Minister agree to meet the APPG for diabetes to talk about how those recommendations can be implemented?

[Ashley Dalton]

I am more than happy to meet the APPG to discuss those matters.

I was really moved to read Lynsey’s story on the Diabetes UK website. One thing that really stood out to me was her experience of turning 18 and moving to an adult clinic. She said:

“I became a number in a system, rather than a patient. Every time I went, I saw a different team, and would have to explain my entire medical history. It felt like it wasn’t worth my time, and I certainly wasn’t going to have a conversation about what was going on with people I didn’t know.”

After just a few appointments, Lynsey stopped going. T1DE cuts across diabetes and mental healthcare, and Lynsey’s interactions with the NHS show that we must never treat patients like interchangeable statistics, bouncing around a cold system that does not seem to care for them. Instead, each patient should benefit from a unique, joined-up approach.

To its credit, NHS England has recognised that there is an unmet need for better treatment of T1DE. As my hon. Friend the Member for Cannock Chase has recognised, it has begun piloting type 1 diabetes and disordered eating services, two of which came online in 2019. The aim of those pilots was to develop the evidence base around how best to manage T1DE by testing an integrated pathway, which means that patients such as Lynsey would not be obliged to recount their medical history on every visit. In the past five years, NHS England has expanded on the original pilots, with funding extended for five T1DE pilot sites until March 2026 to ensure that there are sufficient patient numbers for us to get a full picture of what is happening on the ground. I thank my hon. Friend for his contribution to those pilots.

While those pilots are gathering evidence, NHS England is looking carefully at the findings, with a view to developing a future national strategy. Each of the five new pilot areas is submitting quarterly data to the evaluation, and it intends to publish its analysis of the data by September.

[Jim Shannon]

I thank the Minister for her comprehensive and helpful response. I first came to this House in 2010, and in 2015 a diabetes plan for the whole of the United Kingdom came out of Westminster for all the regions together, but that came to an end. I had always asked and hoped for that plan to come together again. Will she consider having a diabetes plan for all of the United Kingdom of Great Britain and Northern Ireland working together, because I understand that in Northern Ireland we have the highest number of type 1 diabetics anywhere in the United Kingdom?

[Ashley Dalton]

As I am sure the hon. Member knows, health is obviously a devolved matter. However, I am more than happy to look at the issues he has raised and come back to him.

The data from the pilot areas will also be shared with all the integrated care boards, so that we can build up the case for more investment in T1DE from ICB budgets while looking at ways in which NHS England can support ICBs in commissioning their services.

While those pilot sites are doing critical work, the NHS is supporting people with diabetes to live well. Central to that is making sure that patients have access to annual reviews that cover eight processes recommended by the National Institute for Health and Care Excellence. We know that people who attend annual diabetes reviews have much better outcomes for emergency hospital admissions, amputations, retinopathy and mortality. That is why it is right that the NHS is investing £14.5 million over the next two years, supporting up to 140,000 people between the ages of 18 and 39 to receive additional tailored health checks by healthcare staff. That support will include vital support to break down any stigma associated with diabetes while helping those people to manage their condition, from blood sugar level control and weight management to minimising the risk of heart disease.

As has been touched on, technology plays a critical role in helping people with diabetes to live healthier lives, and there is great potential to do the same for people with T1DE. NICE has made positive recommendations on offering real-time continuous glucose monitoring and hybrid closed loop technology to adults and children with type 1 and type 2 diabetes, meaning that those treatments are now offered on the NHS. Over two thirds of people with type 1 diabetes currently use glucose monitoring to help manage their condition, and following NICE’s recommendations on hybrid closed loop systems, NHS England has developed a five-year national strategy that began in April last year. I know that five years will seem like a long time to many of those young people struggling with this condition here and now, but the NHS does need an implementation period to ensure we have all the right people with the right skills within specialist adult services. We cannot compromise an inch on safety, and NHS trusts should only ever provide hybrid closed loop if specialist trained clinical staff, experienced in using insulin pumps and continuous glucose monitors, are in place.

[Tom Collins]

I can speak from personal experience about the power of hybrid closed loop systems and the safety they present from day one, compared with the conventional treatment using injections. I encourage the Minister to explore every way possible—using collective peer forums or any other vehicles that can be imagined—to accelerate the deployment of hybrid closed loop technology as fast as we possibly can.

[Ashley Dalton]

I thank my hon. Friend for that intervention, and for sharing his lived experience. I am more than happy to consider his suggestions and discuss them further.

Finally, I will touch on the encouraging work of the early surveillance for autoimmune diabetes—ELSA—programme. Type 1 diabetes is not preventable, but the sooner we reach people, the sooner we can care for them. ELSA is a children’s screening programme that can detect type 1 diabetes through a simple fingerstick blood test by looking for four antibodies associated with a higher risk of developing diabetes. ELSA launched in November 2022, and over 20,000 children have already taken part. The study has made a huge effort to screen all of those children by February, and we are still waiting to hear whether that ambitious target has been reached. I would be pleased to keep my hon. Friend the Member for Cannock Chase and the House updated on that programme.

It is clear that T1DE is a serious and often overlooked condition that requires a more integrated and compassionate approach to care. The work being done through NHS pilot programmes, investment in diabetes management, and advances in technology all represent meaningful progress, but there is still much more to do. It is vital that we continue to build on the evidence gathered through these initiatives to ensure that people with T1DE receive the tailored, consistent and supportive care they deserve. No patient should feel like a number in the system, or be forced to navigate a fragmented approach to their health. By working together through Government, the NHS and charities, we can ensure that people with T1DE receive the right support at the right time. I look forward to working with my hon. Friend to get this done.

Question put and agreed to.