Tobacco and Vapes Bill (First sitting)

Beccy Cooper Excerpts

Committee stage
Tuesday 7th January 2025 Public Bill Committees

[Dr Zubir Ahmed (Glasgow South West) (Lab)]

I declare an interest as an NHS transplant and vascular surgeon. My wife is a lung cancer doctor.

[Dr Beccy Cooper (Worthing West) (Lab)]

I declare an interest as a public health consultant and a member of the British Medical Association.

[Sadik Al-Hassan (North Somerset) (Lab)]

I declare an interest as a practising pharmacist. [Interruption.]

--- Later in debate ---

[Gregory Stafford (Farnham and Bordon) (Con)]

Q Do you have any concerns about the impact of the Bill on vapes as a smoking cessation tool? As my hon. Friend the Member for Sleaford and North Hykeham said, vaping in children is abhorrent, and I am glad that the Bill is addressing that, but how can we ensure that, as a cessation tool, vapes remain part of the panoply of options for smokers who are trying to give up?

Professor Sir Chris Whitty: That is a very important question. I think everybody would agree on two things, and then there is a way of making sure that we get to the exact middle point of this argument.

First, as you imply, in this country—it is not universally true—there is a strong view that we should try to continue our support to allow current smokers who are finding it very difficult to get off because of their addiction, which has taken away their choice, to move to vaping as a step in the right direction. I think that is broadly accepted in this country. As I say, there are some countries where that is not accepted so, to be clear, that is not a universal view.

At the other extreme, as you imply—or state directly, actually—I think everybody would agree that the marketing of vapes to children is utterly abhorrent. I think almost everybody would agree that marketing vapes to people who are current non-smokers, given that we do not know the long-term effects of vapes because we have not had them for long enough, is a big mistake. We should not allow ourselves to get into a position where, in 20 years, we regret not having taken action on them.

The question then is: how do you get the balance? In my view, this is sometimes made more complicated than it needs to be. I think it can be very simply summarised: “If you smoke, vaping is safer; if you don’t smoke, don’t vape; and marketing to children is utterly abhorrent.” That is it, although it is sometimes made a lot more convoluted. Our view is that the Bill gets that balance right.

In general, if people’s profession is getting people who are current smokers off, they tend to be more at the pro-vaping end, because they see the dangers for current smokers. People who deal with children, such as Dr Johnson, who has taken great leadership in this area and is very much in the centre of her profession, and the Royal College of Paediatrics and Child Health take a very strong anti-vape view, because they have seen the effects on children. It is getting the balance between those two, and I think that the Bill does that.

But—and it is an important but—the Bill takes powers in this area, and that means that if we go too far in one direction or the other, there is the ability to adjust that with consultation and with parliamentary secondary legislation. That allows for the ability to move that point around if it looks as if we have not got it exactly right. It may also change over time as the evidence evolves.

[Dr Cooper]

Q My question is around inequalities. How effective or otherwise do you think the Bill will be in reducing inequalities? Are there any areas of the UK that have specific challenges related to tackling smoking prevalence that you would like to highlight?

Professor Sir Michael McBride: That is a really important question. We talked before about the blatant marketing of tobacco and vapes. There is also the preying of the industry on those more socioeconomically deprived areas.

If we look at smoking rates in those more socio- economically deprived areas, they are two to three times higher than in less socioeconomically deprived areas. If we consider the death rate from smoking-related conditions, it is twice as high. If we look at lung cancer rates, they are two and a half times as high in those areas. That is a direct consequence of the smoking incidence in more socioeconomically deprived areas. The health inequalities associated with the consumption of tobacco are significant and great.

If we look at smoking in pregnancy and all its consequences in terms of premature birth, stillbirth and low birthweight, we see that smoking among women from more socioeconomically deprived areas is four and a half times higher than among those in less socioeconomically deprived areas. The health inequalities argument and the case to be made for addressing that within the Bill is huge. This is an opportunity that we must not pass up to narrow the adverse health consequences.

Professor Sir Gregor Ian Smith: It is my very clear view that the provisions within the Bill will help us to tackle some of the inequalities associated particularly with tobacco smoking. If I look at the situation in Scotland, 26% of our lowest socioeconomic group are smokers, compared with 6% of our highest socio- economic group.

The gradient that Sir Michael has spoken about in terms of the subsequent tobacco-related disease that those groups then experience is really quite marked, whether that be cardiovascular disease or the numerous cancers associated with smoking. All of those can be addressed by trying to tackle the scourge of these tobacco companies preying on more vulnerable groups within our society, whether that be those who experience socioeconomic circumstances that are much more difficult and challenging for them, or whether that be particular groups that are more likely to experience mental health conditions.

All of these must be tackled; people must be assisted not to develop addictions that lead to lifelong smoking and problems with their health thereafter. I am very clearly of the view, both in terms of smoking and, it is important to say, of vaping, that the targeting of those groups that creates those inequalities within our society is something that this Bill can address.

[Sadik Al-Hassan]

Q Thank you for the evidence submissions so far. In your opinion, will the Bill’s restriction of flavours for vaping products prevent the appeal to children and ex-smokers, if they can no longer access such products?

Sir Francis Atherton: The issue of flavours and colours speaks to the issue of marketing towards children that we have been speaking about so far. I have no reason to believe that taking away colours and flavours that are appealing to children would remove vaping as a stop smoking tool. It remains an important tool in the box that we have to have alongside nicotine replacement therapy and alongside education, and it will remain an important tool to stop people smoking.

The prime aim here, of course, is to stop the marketing towards children. If you think back to when tobacco was advertised in shops, we saw big gantries in shops, and what we have seen in recent years is that we now have vape gantries in almost all our shops. Taking away that marketing opportunity towards children—the colourful and flavoursome displays—can only be of benefit to reducing childhood vaping and the nicotine dependency that comes as a consequence of that.

Professor Sir Chris Whitty: Let us be really clear about this: the vaping industry will claim it is not marketing to children while putting in flavours, colours, cartoons and placements that are clearly aimed at children. You just look at them—you do not need anything else—and you see the rates going up in children. It is very clear that the industry is doing that, and it needs to be tackled.

Professor Sir Michael McBride: If you look at products with names “gummy bear” and “rainbow surprise”, who are they actually aiming those products at? Our Public Health Agency did research with more than 7,500 children and young people in Northern Ireland, using focus groups and online surveys. Some 77% of them told us that what appealed to them about vapes was the colours and flavourings. The public consultation had the strongest and highest support for banning flavours and colourings. More than 75% of the population in Northern Ireland supported that ban. We should not delude ourselves about the exploitative marketing of those products.

In terms of next steps, it is really important that those who want to use vapes to quit smoking, as Sir Frank has said, can continue to access them. The Government undoubtedly will consult carefully on those measures to ensure that we do not—as the question is rightly exploring—restrict access or discourage individuals from using vapes to quit smoking.

--- Later in debate ---

[The Chair]

Can I just, as is my job, remind everybody that we are finishing at 10.55 am, which is in about 15 minutes or thereabouts? I have six people who wish to ask questions, so can I ask that the questions and responses are as tight as possible? Thanks.

[Dr Cooper]

Q Thank you so much to our witnesses for being here. I just want to take you back to a conversation you were having with a previous questioner about smoking cessation in hospitals. Could you give us your thoughts about vaping being available in hospitals, to allow people in hospitals who are quitting smoking, or who want to continue quitting, to continue vaping? Our CMOs talked about a smoke-free place being a vape-free place. What are your thoughts about vaping in hospitals—where it is a smoke-free place—and about access to vapes?

Suzanne Cass: In Wales, we have obviously implemented smoke-free legislation. We have seven different health boards and various approaches to that legislation when it comes to the implementation alongside vaping. When it comes to indoor spaces, there is already a huge amount of compliance with voluntary bans. People generally do not smoke in indoor spaces, so there is already that public consensus in those areas. When it comes to the outdoor spaces, there is not necessarily a consistent approach across Wales regarding smoking and vaping, which can cause confusion among the public.

I think that we need to be considering this very carefully, in terms of providing as much support to smokers as possible in these areas. We need to be considering exemptions to vape-free spaces, particularly in smoke-free spaces in hospital settings, mental health units and places where vulnerable patients who smoke are situated. That would be the message: we need to really consider those exemptions.

Sheila Duffy: In Scotland, we put medicinally therapeutic products front and centre with smoking cessation. Smoking cessation is vital, but we need to remember that there is no medicinally licensed e-cigarette product anywhere in the world, and that medicinally licensed products have a very different set-up. With e-cigarettes, you are talking about more than 30,000 different variants listed with the Medicines and Healthcare products Regulatory Agency, and four or five generations of devices, with very different health profiles.

Most of the comparisons are made with the toxins in tobacco, but there are different additional toxins in e-cigarettes, and there is new research—for example, AI modelling—on the impacts of heating some of the chemicals in e-cigarettes to vapour point, where they produce highly toxic outcomes. We need to bear that in mind. We also need to look at the research on air quality, because e-cigarettes conclusively contain the kind of particulates that we worry about for air quality and that cause harm to health. I think that that is an issue arguing for vape-free spaces.

In Scotland, we are supporting people to quit smoking in whatever way works for them—we are supporting individuals—but we are actively recommending only medicinally licensed products, because they have that context of appropriate use, safety and quality control, which e-cigarettes do not have.

[Sarah Bool]

Q I want to follow up on that point, because clause 12 of the Bill will actually include a ban on vending machines for vaping, but I know that there have been mental health trusts that have said that, actually, they would call for those to be exempted. Is that one of the exemptions that you would perhaps go for, and actually allow those vending machines in hospitals?

Suzanne Cass: Absolutely. I think we need to consider the vulnerable smoker at the heart of this and how they are managing to abstain from that addiction. It comes back to that addiction all the time. With smoking, nicotine is such an addictive substance that it is very difficult just to tell somebody that they cannot do it. You need to give them the right support, as well as the support that they want. When it comes to choice, that is where we need to be looking at what their choices are and how they choose to move away from that deadly tobacco use.

Hazel Cheeseman: On the mental health settings, we have done a lot of work in England with mental health trusts, and vending machines have been one way in which they have been facilitating access to vapes in quite a large number of mental health trusts. It is certainly something that we would be interested in looking at, because it will make it a bit more challenging for them to implement smoke-free policies in mental health settings if the vending machine rule applies across the NHS estate.

Also, going back to Dr Cooper’s question, in mental health settings and those places with vulnerable smokers, vapes have been really important in England in facilitating. We do not have legislation in relation to smoke-free grounds in England, but obviously it is the policy across the NHS estate that they are smoke free. Allowing vaping, particularly in those mental health settings, has been very facilitative of creating smoke-free grounds and supporting those people to maintain their smoke- free status as they move out of mental health settings as well.

Sheila Duffy: Scotland already has a ban on e-cigarettes in vending machines and has had for some years.

Tobacco and Vapes Bill

Beccy Cooper Excerpts

2nd reading
Tuesday 26th November 2024 Commons Chamber

[Edward Argar]

I am grateful to the hon. Gentleman for most of what he just said. I will address precisely his point in a few paragraphs, but I say to him that my party brought forward legislation in March, which was debated in April, that did not have the mission-creep that I fear the Secretary of State is demonstrating with clause 136 and various other measures in this proposed legislation.

I must also challenge the Government on how they anticipate this measure being enforced. Will members of the public be encouraged to call the police if they see a parent smoking in a prohibited place? If there are no children in a park or playground, will it still be prohibited?

Concerns are also raised by the new licensing and registration schemes. While it is right that we had planned to expand the existing notification scheme to include non-nicotine vapes and nicotine products involved in the supply chain, this Bill goes a number of steps further. The Secretary of State will be able to create a new licensing regime for retailers for tobacco, vaping and nicotine products. Over 70% of convenience stores selling vapes and tobacco products are independent shops. How will they fare and how will they be assisted with the layers of added bureaucracy and cost that will be associated with the Bill? Do local authorities, which are already under pressure, have the capacity and additional funding allocated to administer such a licensing scheme in their areas?

Again, my fear is that we are unable to make a fully informed decision about the impact because the regulations will be set out only after the Bill has passed. The impact assessment states:

“A more restrictive licensing scheme would be expected to have a greater impact on public health and a greater economic impact on businesses.”

However, we simply do not know if that is what the Secretary of State has in mind or what the regulations will look like. Likewise, there is no detail on the impacts of a new registration scheme for all tobacco, vaping, nicotine and herbal products, as well as tobacco-related devices.

In the few months that the Government have been in office, they have sadly shown that they are not particularly a friend of business and have broken a number of their pre- election promises. Although I have confidence in the Secretary of State as an individual and as a right hon. Member of this House, I ask him to forgive the cynicism of those on the Opposition Benches over any attempted reassurances from the Government that they will take businesses’ concerns into account as they consult on their plans.

To the point made by the hon. Member for Bracknell (Peter Swallow), if a Division is called, in line with the precedent set last time this will be a free vote; each Conservative Member may vote as they choose. The Bill, as I have said, comes from a good intention to keep the population healthy, to ease costs for the NHS and to prevent children from taking up addictive habits that may follow them for the rest of their lives. I support those objectives, but I call on the Minister for public health, when he winds up, to give the reassurances I seek and roll back the additional measures that have been put in place, over and above what we were proposing.

It is important that information is available so that people can make informed decisions and that support is available for those who choose to stop smoking. Adult individuals are best placed to make decisions about their own lives, but we recognise that the same is not true for children. I look forward to the responses from the Minister for public health, which I hope will be constructive. I welcome the Secretary of State’s offer to be collaborative and constructive in his approach to the legislation.

[Dr Beccy Cooper (Worthing West) (Lab)]

Will the shadow Secretary of State give way?

[Edward Argar]

I will briefly, because I have one sentence to go.

[Dr Cooper]

I thank the shadow Secretary of State. As a public health doctor, I am delighted to hear him speak so freely, openly and positively about all the great things that this legislation will bring, but I remain unclear whether he will be voting in support of this generation-defining public health Bill this evening.

[Edward Argar]

That will depend on whether the Minister for public health gives the promises I seek that he will withdraw a number of the measures that the Government have added to the Bill. I am grateful to my hon. Friend the Member for Sleaford and North Hykeham (Dr Johnson), who will take the Bill through Committee on behalf of the Opposition, and I know that she looks forward to constructive and collaborative engagement with the Minister. I hope he can offer reassurances when he gets up to the Dispatch Box in a few hours’ time.

--- Later in debate ---

[Dr Beccy Cooper (Worthing West) (Lab)]

It is a privilege to take part in this debate and to hear the broad consensus across the House on this excellent Bill. We have come a long way since the 2004 White Paper proposed a smoking ban in almost all public places in England and Wales. Smoking on public transport and in workplaces now feels inconceivable thanks to decades of work by campaigners and public health professionals and bold action from Government.

As a public health consultant, I pay special tribute to my public health colleagues who have worked so tirelessly in this area, from the seminal 1956 research undertaken by Sir Richard Doll and team that first established the link between smoking and lung cancer—something we take for granted today—through to the smoking cessation advisers who work daily to help people combat this destructive addiction.

Mark Twain is reported to have said:

“Giving up smoking is the easiest thing in the world…I’ve done it thousands of times.”

In my career to date I have been fortunate enough to undertake smoking cessation training and I can testify to the incredible amount of hard work and determination that both the quitter and the adviser put in to overcome the nicotine receptors that demand to be fed. This is an addiction, not a choice.

So it is better by far not to start this destructive habit in the first place. Currently, every day about 350 young adults still start smoking and about 160 people are diagnosed with cancer caused by smoking. Smoking is still the leading cause of premature death and disability in the UK, and is responsible for half the difference in healthy life expectancy between rich and poor. Other Members have talked about the appalling health inequalities in this country and how the Bill will really contribute to reducing them.

So it is right that this Bill will phase out the sale of tobacco and create a smokefree generation. Already ever fewer people smoke, and this legislation will increase the rate of decline. By increasing the age of sale by one year every year we can expect smoking rates among 14 to 30-year-olds to reach zero by 2050. As a mum of two young sons, I greatly welcome that.

I welcome, too, the increased powers to tackle vaping in the Government’s Bill. Vaping can be an effective aid for adult smokers to quit, but much tougher measures are needed to regulate products designed to appeal to young people. As ASH puts it:

“Vaping is an adult quitting aid, not a children’s toy.”

The chief medical officer further underlines this by stating:

“If you smoke, vaping is much safer; if you don’t smoke, don’t vape; marketing vapes to children is utterly unacceptable.”

This Bill will give the Government far greater control over the marketing and design of vapes and the flexibility to adjust regulations in the future if the market or evidence changes.

[Robin Swann]

Does the hon. Member agree that that is also why it is important that we control vending machine sales?

--- Later in debate ---

[Dr Cooper]

I wholeheartedly agree. Vending machines are often forgotten, but they are used for sales and marketing, and sometimes in ways we do not understand.

[Wera Hobhouse]

We should also look at online sales. A lot of young people purchase products online. May I ask the Minister what the Bill says about that?

[Dr Cooper]

I do not disagree. The Bill will give the Government far greater control over the marketing side of vapes and the flexibility to adjust regulations in the future. Life evolves outside this Chamber, and we need to be able to evolve with it flexibly.

Alongside the measures in this Bill, this Government have made important commitments to integrating smoking cessation into routine care and ensuring that the most disadvantaged groups are not left behind as we move towards a smokefree Britain. When I was undertaking my training in public health, a director of public health told me that our profession is where medicine meets politics—I am not sure how he would feel about me going into politics, but there we go. In this Bill, I am delighted to see the evidence and data provided by my profession working in synergy with this Government’s policy development to bring forward a Bill that will allow our young people to enjoy healthier futures and allow us all to live in a healthier environment. I thank all Members across the House for their work on this issue, and I offer my wholehearted support for the Bill.

Oral Answers to Questions

Beccy Cooper Excerpts

Tuesday 19th November 2024 Commons Chamber

[Wes Streeting]

We have not yet announced allocations for general practice for the year ahead, and we are taking into account all the pressures that general practice is under.

[Dr Beccy Cooper (Worthing West) (Lab)]

T10. The renewed focus on prevention in our health system is welcome, but under the previous Government, the public health grant that facilitates much of that work was cut by 28%. Has the Minister, in partnership with the Treasury, considered when we might be able to address that public health funding issue, which is essential to enabling progress in prevention?

[Andrew Gwynne]

We will confirm the 2025-26 local authority public health grant allocations in due course. Local government plays a critical role in delivering the Government’s health mission and driving action on the prevention of ill health. We are committed to working in partnership with local government to tackle the wider determinants of ill health.

Income Tax (Charge)

Beccy Cooper Excerpts

Tuesday 5th November 2024 Commons Chamber

[Dr Beccy Cooper (Worthing West) (Lab)]

A healthy economy means healthy people, but let us not forget that, conversely, healthy people are the backbone of a healthy economy. This Budget is working its way through some very difficult circumstances and dealing with problems that have been ignored for far too long. Problems in our economy have had an adverse effect on the health of the people we are here to serve, so I am heartened to see that this Budget is aware of the need not only to get the financial engine room running again, but to rebuild the foundations of good health for this country.

This Budget rightly prioritises the NHS, with vital capital investment and increased spending. I know that many of my constituents and those across the country will welcome the announcement of funding for mental health crisis centres, providing services that are so desperately needed. That will go some way towards taking the pressure off our A&E departments.

I would like to highlight a couple of the investments made beyond our NHS that are so vital for our health. I am delighted to see investment in giving all children the best start in life, with spending on early years and family services rising to £8 billion. The £30 million expansion of breakfast clubs will ensure that children start their days with a meal and positive social time. I have seen how much value is added when the catering is integrated into a school’s wider vision for health, wellbeing and pastoral care.

I am also encouraged to see that the debilitating cuts to local government funding in recent years have finally stopped, and that a plan has been put in place to support essential providers of frontline services in continuing their vital work. As well as the 3.2% real-terms increase in local authority core spending power, the additional £500 million going into the affordable homes programme will kick-start an increase in decent, affordable social housing and finally begin to address some of the unacceptable emergency accommodation that our constituents find themselves in while waiting far too long on our housing waiting lists.

As we move forward and build on the healthy economic foundations outlined in this Budget, I look forward to considering the reforms that will be needed for social care. The £600 million grant funding for it is a good starting point for the necessary work to come. Similarly, the public health grants in local government must be protected and funded properly in order for us to move sustainably from treatment to prevention. We know that our public services and NHS cannot be fixed overnight, but I congratulate the Chancellor on delivering a Budget that has given us a firm marker of intention and direction. The measure of our collective health and wellbeing is not GDP per capita alone. We can rebuild the services that we need to lead healthy and productive lives, and with this Labour Government, we will all thrive.

Access to Primary Healthcare

Beccy Cooper Excerpts

Wednesday 16th October 2024 Commons Chamber

[Mr James Frith (Bury North) (Lab)]

Some of us newly elected or returning MPs have only just got our accommodation and offices sorted out, so I commend the Government on the speed with which they have got surgeons back to work, resolved the doctors’ strike, reviewed and assessed the crisis and made announcements for a decade of national renewal. They have also affirmed the view that our NHS should be treated not as a shrine or beyond question, but as something that must be returned to deep service to our country and play its part as a health and economic public service.

Lord Darzi’s review for the Government highlights the critical issues in the NHS and the state we are in, and particularly the underfunding of primary care. It has been neglected in favour of a creeping trend towards hospital services, under the failed principle of leaving it late—the crisis mode setting that applied across our public services under the last Government. By design, people ended up in A&E because of a failure to plan for GP and primary care, with 16% fewer GPs than other high-income countries. The review also points out significant health inequalities, with deprived areas historically receiving insufficient resources. In Bury North, child poverty is up to 43%, densely concentrated in just three of our nine wards. Life expectancy for those living in Bury North ranges enormously: the difference in life expectancy between North Manor and East Ward is five years for women and nearly seven years for men.

[Dr Beccy Cooper (Worthing West) (Lab)]

Public health interventions cost only a quarter of the amount that clinical interventions do to add an extra year to life expectancy, so does my hon. Friend agree that the reduction of the public health grant was an appalling false economy and should be restored, as soon as finances allow, to at least 2015-16 levels of funding?

[Mr Frith]

My colleague makes a valid point; I defer to her knowledge of the public health system.

The distance of a mile or so has a huge impact for the men and women living in east Bury. I urge those carrying out the Government review to see how, in constituencies like mine, specific interventions could address those deep health inequalities and identify the work we need to do to resolve that impoverishment in densely populated areas and that ingrained health inequality. I urge the Government also to adopt multidisciplinary care models and shift care closer to home to address these issues—a sentiment that I know Ministers share.

Taking a wider view, the funding formulas are outdated and an update is long overdue. That update should take into account the weight of funding pressures for areas such as mine, with a mix of economic and demographic inequality, including the fact that so much of the revenue that our local authority raises is immediately swallowed up by adult care and the disastrous special educational needs system—a symptom of the crisis mode mentality under the previous Government.

The Government have wasted no time, investing £82 million to recruit a thousand newly qualified GPs and addressing the dental care crisis with 700,000 urgent dental appointments. The Government also aim to expand the role of pharmacies—a measure I hugely welcome—to reduce the burden on our GP and hospital care, and crucially also for those living with chronic illness or conditions. A boost to the engagement patients can have with health decision makers via the NHS app and an improved trusted status for healthcare professionals will boost this too and reduce the bureaucracy in our caring system.

There is a well known saying in good hospitals, “The best hospitals keep people out of them and get people out of them.” This principle strikes at the heart of what has gone wrong in recent years. The problems in A&E, emergency services and waiting times stem from a failure over the past 14 years to design by this doctrine. The key to resolving those issues lies in primary care—preventing people from needing hospital services in the first place and enabling faster discharges when they do. That is where the focus must be.

--- Later in debate ---

[Dr Beccy Cooper (Worthing West) (Lab)]

The Darzi review has effectively shone a spotlight on the key issues that GPs and all in the healthcare profession have experienced over the past 14 years. It rightly highlights the detrimental impact of austerity and the increased pressure that the pandemic put on an already stressed service. It also draws attention to the ongoing excellent work that is being done by NHS staff across the country in spite of, rather than because of, the facilities, systems and processes that are not fit for purpose and must now undergo intelligent reform. Primary care is an essential part of our health system. It is where prevention meets treatment, and GPs can effectively undertake secondary prevention to keep people well for longer—for example, people with chronic conditions such as diabetes and hypertension.

As a public health consultant, I want to fight for our GPs and make sure that they have the resources they need, and I want to highlight three things today. I often speak to the Royal College of General Practitioners, and we are in sync on these three things. The first is the long-term workforce plan. It is due for review next year. It has been underfunded in previous times, and we have to look at the modelling that is in the workforce plan now. If we are moving from a hospital model to a community model, we have to look at the rate of increase that we expect in our GP service. It currently stands at 4% for GPs and 49% for hospital consultants. This is in no way to denigrate my colleagues who are hospital consultants—they are incredibly important—but we need to review this workforce plan. I know that the Public Accounts Committee was looking at this issue prior to the election. As a new member of the Health and Social Care Committee, I will encourage the continuation of that work.

Secondly, we spoke earlier about a mixed model of GP provision and how that will work. In my constituency, the Worthing integrated care centre is due to open very soon. It is part of a neighbourhood model, where GPs will work with other healthcare professionals to provide a holistic wraparound service. As has been demonstrated in this Chamber today, there are already partner practices that are working effectively. This is about the interaction between neighbourhood hubs and those partner practices. It is pragmatic politics to get those to work, and work well, for our GP colleagues.

Finally, we have talked about the national retention strategy. GPs are currently leaving in their droves, and even though many people are coming forward as GP trainees, it has been said in this Chamber that we must ensure that we retain our GP colleagues. This issue is particularly acute in deprived areas. As a public health consultant, I know that health inequalities are one of the major issues in this country. In order to address that, and to ensure that prevention is writ large for those areas of health inequality, we must make sure that we are retaining our GP colleagues in those areas.