Vaccination Strategy

Bob Blackman Excerpts

Wednesday 12th January 2022 Commons Chamber

[Bob Blackman (Harrow East) (Con)]

I have been a big advocate of the vaccination programme, and I got my jabs as soon as I could. Will my hon. Friend address a key issue of concern? The time gap between the different vaccines has been adjusted at various times and, as the hon. Member for Rhondda (Chris Bryant) mentioned, those who are extremely clinically vulnerable had their booster a long time ago and its effectiveness is waning. We know that Israel is already administering a fourth dose to the extremely clinically vulnerable. Will the Minister take that point to the JCVI, so that it can look specifically at the extremely clinically vulnerable and see whether they need a fourth dose?

[Maggie Throup]

Those who are clinically extremely vulnerable or immunosuppressed have already been offered a booster, so they have already received four doses. As I said earlier, at the end of last week the JCVI determined that at this stage it was not appropriate for others to have a booster or a fourth dose.

Health and Care Bill

Bob Blackman Excerpts

Report stage
Monday 22nd November 2021 Commons Chamber

[Dr Whitford]

That is the policy of the Scottish Government, and we would absolutely support the new clause if it is voted on tomorrow.

As Opposition Members have said, key to improving public health would be restoring the non-covid related public health budget in England. We cannot hide behind covid funding, because that is used up by the pandemic and does not help us with smoking, alcohol, or drug addiction. The biggest contribution the Government could make would be to abandon their plans for yet another decade of austerity. We hear the slogan all the time—levelling up—but it rings hollow after taking away £1,000 a year from the poorest families and most vulnerable households. Over the past decade, cuts to social security have caused a rise in poverty among pensioners, disabled people, and particularly children. Sir Michael Marmot was mentioned earlier, and his research was clear: poverty is the biggest single driver of ill health, and the biggest driver of poverty is Tory austerity.

[Bob Blackman (Harrow East) (Con)]

It is a pleasure to follow the hon. Member for Central Ayrshire (Dr Whitford), who brings her knowledge of the medical profession to this House on every occasion. I agreed with almost everything she had to say, apart from the last comment.

I declare my interest as chair of the all-party group on smoking and health, and I support all the new clauses tabled in the name of the hon. Member for City of Durham (Mary Kelly Foy). These comprehensive proposals are complementary and can be picked up by the Government. The new clauses were tabled in a different form in Committee. They were discussed and debated, and I think Ministers said they would take them away and have a further look. We have refined the proposals on the basis of the debate in Committee, strengthened them, and brought them back again, and they address the loopholes in current legislation. They strengthen the regulation of tobacco products still further, and they provide funding for the tobacco control measures that are so desperately needed if we are to deliver the Government’s Smokefree 2030 ambition.

We had an excellent debate in Westminster Hall last week, to which the new Under-Secretary of State for Health and Social Care (Maggie Throup) responded. Questions were posed to the Government from across the Chamber about when we will see the long-promised tobacco control plan, which is presumably due to be delivered by 31 December this year. We got no firm commitment on when we will see it, and I would like my hon. Friend the Minister to bring that forward as soon as possible. We can then measure what will happen.

The problem we have with tobacco control right now is that if we do nothing and none of these measures is introduced, the risk is that, as the hon. Member for City of Durham rightly articulated, we will miss the target by seven years. For those on low incomes and in deprived circumstances, it will be 14 years. We must consider how many people will die from smoking-related diseases as a direct result of the Government’s failure to achieve their Smokefree 2030 ambition. It is clear that we need to take further action, and I urge the Minister, who I know is a doughty campaigner for public health, to make sure that we deliver on the proposals.

My main focus is obviously on the new clauses that seek to provide funding for tobacco control. We all accept that not only can we implement measures, but we have somehow to fund them. That is critical. We must also consider raising the age of sale, as that, unfortunately, is a key proponent in encouraging young people to start smoking. The spending review failed to address the 25% real-terms cut to public health funding since 2015. Reductions in spending on tobacco control have bitten even deeper, by a third, since 2015. We need new sources of funding.

The Government promised to consider a polluter pays levy in the 2019 Prevention Green Paper, when they announced the Smokefree 2030 ambition. The all-party group on smoking and health has done the analysis, and we estimate that in the first year alone of a polluter pays levy, £700 million could be raised. That would benefit not only England, but the whole United Kingdom. It is more than twice the estimated cost of the tobacco control measures that we are proposing tonight, and that would then leave the Government with further funding to spend on other health priorities. The proposal is for a user fee, along United States lines, rather than an additional tax. Now that we have exited the European Union and can set our own rules, EU tobacco manufacturers’ profits can be controlled. They cannot pass the cost on to the consumer, but we can control their profits and use those for preventing people from smoking in the first place. It is quite justified that we should tax the manufacturers’ profits. This is the most highly addictive product that is legally available, and it kills those who use it for the purpose for which it was intended.

[Peter Dowd (Bootle) (Lab)]

The hon. Gentleman refers to public health funding since 2015, but is he aware that in 2015, it was identified that the cost to the NHS of smoking was £144.8 million in prescriptions, almost £900 million in out-patient visits, almost £900 million in hospital admissions, and a total of £2.6 billion? Is not investing in smoking cessation money well spent?

[Bob Blackman]

Clearly, if we invest in public health and smoking cessation, we prevent costs in the health service later. It is estimated that most of the cost of people’s healthcare arises in the last two years of their life. Individuals who suffer from cancer or other respiratory diseases caused by smoking will cost the health service dramatic sums of money, so through cessation, we are helping the nation to be healthier and, indeed, saving money for the health service in the long run.

To quote the chief medical officer, the great majority of people who die from lung cancer

“die so that a small number of companies can make profits from the people who they have addicted in young ages, and then keep addicted to something which they know will kill them.”

The time has come to make the tobacco manufacturers pay for the damage that they do, not only to older people but to young people in particular. We need to bring forward the day when smoking is finally obsolete in this country, and I regret to say that if we do not take measures, the time before that day arrives will be lengthened quite considerably.

However, funding alone is not enough; we have to consider tough regulation. The hon. Member for Central Ayrshire mentioned that since lockdown, we have seen the smoking rate among young adults surge by 25%. In the United States, raising the age of sale from 18 to 21 reduced the smoking rate among 18 to 20-year-olds by 30%. We could do the same thing here. We talk about complementary measures; giving tobacco products away is not illegal at the moment. Just imagine—tobacco manufacturers may say, “If we give tobacco products away for free, we can encourage people to become addicted, and then they will buy them, and that will lead them on to a lifetime of smoking.” We have to break that chain of events and make sure that people do not do that.

I have a passion for ensuring that women do not smoke in pregnancy. That is one of the most stubborn measures, and we have to overcome it. Some 11% of women still smoke in pregnancy. We must give them every incentive and introduce every measure to ensure that they give up smoking, and that their partners give up smoking at the same time. That is something that I passionately support.

Our revised amendment, new clause 11, addresses the concerns that the Government raised in Committee about a review of the evidence. I hope that the Government will adopt the new clause at this stage, and then look at the evidence and consult.

People start smoking at certain key points in their life. They may take it up when they are at school and their friends are smokers and they want to be part of the team or the gang. They may take it up when they go to college or university or start a new job, when they are in a new social environment, or at a dreadful time of stress in their life. We have to make sure that they understand that if they take up smoking, they will shorten their life and cause damage to their health—and, indeed, to the health of the people around them.

[Sir Oliver Heald (North East Hertfordshire) (Con)]

I am following my hon. Friend’s argument closely. Does he agree that there is an interrelationship between the issues to do with alcohol dependency that the hon. Member for Central Ayrshire (Dr Whitford) mentioned and the issue of smoking? One of the things that comes out from the book “Alcohol Reconsidered” by Lesley Miller and Catheryn Kell-Clarke is that the science shows that alcohol reduces people’s inhibitions, and it is therefore more likely that they will smoke. If we had a culture of moderation in alcohol, we would probably do better on smoking.

[Bob Blackman]

I thank my right hon. and learned Friend for raising that point. Clearly, the fact that people can no longer smoke in public houses or restaurants has dramatically reduced the incidence of smoking. Someone has to make a deliberate decision to go outside and inflict their smoke on the outside world rather than on the people in the public house or restaurant.

We who support these amendments tabled them in Committee—we sought Government support and we debated them in Committee—and now we are debating them on Report. I understand that we may not be successful tonight, but I give fair warning that these amendments, in another form, will be tabled in the other place, and we will see what happens. We know that there is very strong support in the other place for anti-tobacco legislation. In July 2021, the Lords passed by 254 votes to 224 a motion to regret that the Government had failed to make it a requirement that smoke-free pavement licences must be 100% smoke free. That is smoking in the open air; we are talking about measures to combat smoking overall.

Finally, if we look back over the years, the measures on smoking in public places, on smoking in vehicles, on smoking when children are present and on standardised packaging of tobacco products were all led from the Back Benches. Governments of all persuasions resisted them, for various reasons. I suspect that my hon. Friend the Minister, whom I know well, may resist these measures tonight, but we on the Back Benches who are determined to improve the health of this country will continue to press on with them, and we will win eventually. It may not be tonight, but those measures will come soon. I support the measures that are proposed.

[Geraint Davies]

It is a great pleasure to follow the hon. Member for Harrow East (Bob Blackman), who gave an eloquent speech about smoking. What he did not include, and what the Minister is not considering, is the mass passive smoking from air pollution, which causes 64,000 deaths a year. I know that I am in danger of being outside the scope of the Bill, but I will make this point just briefly, because it is about public health.

Indoor and outdoor air pollution is endemic. It costs £20 billion a year. We could simply ban wood-burning stoves, which 2.5 million people have and which contribute 38% of the PM_2.5 emissions in our atmosphere. That is particularly problematic in poorer areas. I make this point partly as I chair the all-party parliamentary group on air pollution, but this is a critical public health issue, so I feel that the Department of Health and Social Care should look at it centrally, rather than leaving it to the Department for Environment, Food and Rural Affairs as an air quality issue.

I turn to the comments by the hon. Member for North East Bedfordshire (Richard Fuller), who sadly is not in his place, about free choice in advertising. Advertising is not about free choice; one would not need to advertise unless one was trying to convince somebody to do something they would not otherwise do. That is not to say that advertising is always bad—good things and bad things can be advertised—but let us be straightforward.

As it happens, I have a background in multinational marketing; I have been involved with PG Tips and Colgate toothpaste—good products. However, the reality is that if someone wanted to make money from a product such as a potato, which is intrinsically good for people, they could impregnate it with salt, sugar and fat, make it into the shape of a dinosaur, get a jingle and call it “Dennis’s Dinosaurs”, and make a lot of money out of that simple potato. That is the way a lot of processed foods work.

Going back to the point about diabetes and added sugar, it is important to remember that diabetes in Britain costs something like £10 billion a year. There is a compelling case for the Government to do more about added sugar, as opposed to natural sugar; obviously, we could discriminate between the two, though a lot of manufacturers will say, “Are you going to tax an apple?”. Clearly, when a child or adult can find a huge bar of chocolate in a shop for £1, we have problems, in terms of the amount of sugar we are supposed to have. Henry Dimbleby put forward a national food strategy, which is worth a read. He makes the key point that reducing the overall amount of money people have—for instance, through universal credit—has a major impact: we find that when universal credit goes down, consumption of alcohol and smoking go up.

It is important for the Department of Health and Social Care to have an idea of how the nutrition of particular natural foods can be increased through better farming. An app will be available next year that will enable people to test a carrot in their local shop. The carrot will have different levels of antioxidant, depending on how it is grown. If it is organic and not impregnated with all sorts of fertiliser and chemicals, it develops a natural resistance to pesticides and is much better for human health. The Government should, in this post-Brexit world, be actively encouraging local high-value, high-nutrition products for export and local consumption.

A whole range of public health measures that need to be moved forward are not in the strategy; but some are, such as those raised by the hon. Member for Harrow East.

Tobacco Control Plan

Bob Blackman Excerpts

Tuesday 16th November 2021 Westminster Hall

[Bob Blackman (Harrow East) (Con)]

I beg to move,

That this House has considered the delivery of a new Tobacco Control Plan.

It is a pleasure to serve under your chairmanship, Mr Bone—I believe for the first time in this place. I speak as, and declare an interest as, the chairman of the all-party parliamentary group on smoking and health. We welcomed the Government’s announcement of the new tobacco control plan, and we welcomed that it would be published this year, to deliver the Government’s smoke-free by 2030 ambition. I do not want to put any pressure on my hon. Friend the Minister, but she does not have long to achieve the first ambition. The Government’s ambition to reduce smoking rates to 5% or below, making smoking obsolete, is one that all of us in the all-party parliamentary group share. I believe that will be endorsed on an all-party basis this morning, because it is clearly a great way to ensure the health of the nation.

For me, this is deeply personal. Both of my parents died of cancer caused by smoking. My late mother was only 47 when she died of lung and throat cancer, as she was a very heavy smoker for most of her life. I do not want to see families go through what my family had to go through during those terrible days. For me, it is a lifetime ambition to ensure that people understand the risks of smoking, the damage to their health and the damage to their families.

The all-party parliamentary group is keen to support the delivery of the ambition of a smoke-free Britain, which is why, in June this year, we published a report setting out our recommendations for the tobacco control plan for England. Those recommendations were endorsed by more than 50 organisations, including the Royal College of Physicians, Cancer Research UK and the British Heart Foundation. On behalf of the APPG, I am pleased to welcome my hon. Friend the Public Health Minister to her new post, and indeed to welcome her opposite number; to put our recommendations on the record; and to give the Minister the chance to respond to those views.

The APPG has a long-term track record of acting as a critical friend to the Government on the tobacco control agenda. I am confident that this collaborative and constructive relationship will continue. Although smoking rates in my constituency are lower than the English average, there is no room for complacency. In Harrow, more than one in 10 people still smoke and smoking kills around 250 people a year. That is obviously far too many. In 2018-19, there were 1,566 smoking-attributable hospital admissions and 370 emergency admissions for chronic respiratory disease, which is caused almost entirely by smoking. That is in one constituency, so imagine what smoking does to the national health service up and down the country.

Research presented to the all-party parliamentary group shows that, on average, smokers are likely to need social care a decade earlier than non-smokers, and particularly never-smokers. Smoking-related disease and disability make it hard to carry out normal daily activities such as getting dressed, walking across a room and making a meal. Most of us take these things for granted, but we should not.

The importance of the smoke-free 2030 ambition is clear. As the Minister herself stated recently,

“tobacco continues to account for the biggest share of avoidable premature death in this country. It contributes half the difference in life expectancy between richest and poorest.”—[Official Report, 1 November 2021; Vol. 702, c. 621.]

More than 70,000 people died from smoking last year in England alone. For every person killed by smoking, at least another 30 are living with serious smoking-related illnesses.

[Dr Andrew Murrison (South West Wiltshire) (Con)]

I warmly congratulate my hon. Friend on bringing forward this debate. On the point about the 70,000 deaths, is it not important to understand that that is year after year after year? Would he set that in contrast with the awful toll we have had from covid and the terrible restrictions that we have necessarily placed upon the population of this country, and agree with me that getting rid of this horrible substance would be far less of an intrusion on people’s liberties than the sort of things we have seen over the past 18 months? Over time, that would have a far greater impact on health, wellbeing and people’s ability to go about their daily lives. It would reduce the burden on the national health service very substantially indeed, and address the health inequalities that sadly mean the life expectancy of the richest and poorest in this country are currently separated by upwards of 10 years.

[Bob Blackman]

I could not have put it better myself. My right hon. Friend quite clearly makes the comparison between covid-19 and smoking. People cannot help catching covid, but when they smoke they make the choice as to whether they inflict life-changing circumstances on themselves.

[Sir Charles Walker (Broxbourne) (Con)]

Like my hon. Friend, I had a parent who died in their 40s from throat cancer. As we try to migrate 7 million people away from burnt tobacco, the challenge is to move them to less harmful forms of nicotine. Their addiction is to the nicotine; they crave nicotine, not the burning of tobacco. If we can make these transitions, we can reduce harm at a much quicker rate.

--- Later in debate ---

[Bob Blackman]

My hon. Friend is quite right. Nicotine is one of the most addictive drugs on the market, if not the most addictive, and perfectly legal to consume. The issue is whether someone, once addicted to nicotine, can quit. The damage is done not necessary by the nicotine, but by the delivery mechanism by which someone gets the nicotine.

Anything that reduces the risk of cancer or other related diseases has got to be good news. We can migrate people and encourage them to quit. Ideally, they give up completely. However, because it is so addictive they may need help and assistance to do that. Vaping and non-heated tobacco are ways of migrating people to safer means of delivering the nicotine they desire.

Taking up the point made by my right hon. Friend the Member for South West Wiltshire (Dr Murrison), ending smoking is essential if we are to level up the nation’s health after the pandemic. We need to reduce health inequalities between rich and poor, and increase healthy life expectancy by five years by 2035, in line with the Government’s manifesto commitments.

As well as being necessary, tobacco control measures are popular with voters for every main party, including the Conservative party, which both my hon. Friend the Minister and I represent. Results from the annual YouGov survey of over 10,000 adults in England, funded by Action on Smoking and Health, show that more than three quarters of the public support the Government’s smoke-free 2030 ambition, and eight out of 10 members of the public support Government intervention to limit smoking.

The Government have the full support of the APPG in delivering the smoke-free 2030 ambition. However, as the Government stated in the 2019 prevention Green Paper, achieving that ambition will require “bold action.” Inequalities in smoking rates have grown in recent years, not shrunk. In order to be smoke-free by 2030, we need to reduce smoking by two thirds in just a decade—we have only nine years left to achieve that—and by three quarters for smokers in routine and manual occupations. At current rates of decline, Cancer Research UK has estimated we will miss the target by seven years, and double that for the poorest in society.

There are still nearly 6 million smokers in England. We will only achieve a smoke-free 2030 by motivating more smokers to make quit attempts, using the most effective quitting aids, while also reducing the number of children and young adults who start smoking each year. With 1,500 people dying from smoking-related diseases every week and less than a decade to achieve a smoke-free 2030, there is no time to waste.

Disappointingly, with the end of the year in sight, there is still no sign of the tobacco control plan that was promised this year. My first question to my hon. Friend the Minister, therefore, is whether she can she set out a timeline for the publication of the next tobacco control plan. But the tobacco control plan is only as strong as the measures it includes. That is why the APPG was disappointed that the Government rejected the amendments to the Health and Care Bill tabled by my friend the hon. Member for City of Durham (Mary Kelly Foy), and supported by myself and other officers of the APPG, in Committee.

Those amendments would have closed the loopholes in the regulations that expose children to the insidious marketing tactics of the tobacco industry, provided funding for tobacco control and strengthened the regulation of tobacco. As it stands, the Bill fails to include a single mention of smoking or tobacco and represents a major missed opportunity to introduce key policies for achieving a smoke-free 2030. That is why we have retabled the amendments on Report. I hope the Government will look at them sympathetically, because the Bill is the ideal opportunity for them to deliver their 2019 commitment to finish the job and introduce the legislation that is needed if we are to achieve a smoke-free 2030. My second question is whether the Minister will commit to considering the adoption of tobacco amendments to the Health and Care Bill on Report.

My next area is the “polluter pays” levy. The bold action that the Government acknowledge is needed cannot be taken without investment. The Health Foundation estimates that a minimum £1 billion is needed to restore public health funding to its 2015 levels, with more needed to level up public health across the country. While there was some positive news on tobacco taxation in the recent spending review, which we welcomed, unfortunately the Government opted not to increase the public health grant to local authorities. As a consequence, we need to establish new sources of funding.

The Government promised to consider a US-style “polluter pays” levy on tobacco manufacturers in the 2019 prevention Green Paper. This scheme would mirror the approach taken in the United States, where user fee legislation raises $711 million annually from the tobacco manufacturers, with the funds then used to cover the cost of stop smoking campaigns, tobacco control policy development, implementation and enforcement.

[Ian Paisley (North Antrim) (DUP)]

I must say that I am opposed to punitive taxation policies, because I do not think they work. Does the hon. Member accept that tobacco companies already pay the Government £13 billion? An additional levy could lead—and most likely would lead, as the evidence shows—to a significant increase in criminality, because instead of paying for taxable product, people will buy smuggled product. Is that not a huge worry that he has about introducing a levy?

[Bob Blackman]

I will come to some of these issues in a few moments, if the hon. Gentleman will be patient and let me build the case. Obviously, it has been estimated by ASH that the funding needed for a comprehensive tobacco control plan to deliver a smoke-free 2030 would cost around £266 million for England and £315 million in total for the UK. A levy could raise around £700 million from the tobacco manufacturers, to be spent on tobacco control and other public health initiatives. The devolved Governments would also have the ability to opt into the scheme, should they so wish.

Such a scheme is more than justified in response to market failure that allows an industry, whose products kill consumers when used as intended, to make exorbitant profits. While net operating profits for most consumer staples, such as food, beverages and household goods, stands at 12% to 20%, Imperial Brands in the UK enjoyed net operating profits of 71% in 2019. That is £71 in profit for every £100 in sales. In 2018, it is estimated that tobacco manufacturers made over £900 million in profits in the UK alone.

[Sir Charles Walker]

The hon. Member for North Antrim (Ian Paisley) makes an interesting point about taxation. Would it be possible for politicians, with all their imagination, to use the taxation system to encourage cigarette and tobacco companies to transition their products away from combustible tobacco to less dangerous nicotine-delivery mechanisms?

[Bob Blackman]

My hon. Friend makes a good point; clearly, research could be undertaken to establish how we could use the taxation system to transition people in that way. I personally welcome the escalators that have been put on tobacco products and continued by the Chancellor.

Despite the enormous profitability for those companies, major tobacco manufacturers pay very little profit tax in the UK. That probably reflects their global engagement in diverse and elaborate tax avoidance strategies, which allowed Imperial Brands to lower its UK corporate tax bill by an estimated £1.8 billion over the past 10 years, and British American Tobacco to reduce its bill by an estimated £760 million over the same period. Public support is strong for such a measure, with 77% of the public supporting making tobacco manufacturers pay a levy or licence fee to the Government for measures to help smokers quit and to prevent young people from taking up smoking, and just 6% opposing it.

The covid-19 pandemic has put huge pressure on public finances, and there is a desperate need for bold, properly funded policies to level up public health after the pandemic. Our recommendations on the “polluter pays” approach are backed up by a much more detailed policy paper on how this would work, which we commend to the Minister and her officials. Will the Minister commit that the recommendations for a “polluter pays” mechanism will be included in any consideration of how the tobacco control plan should be funded?

My last major point is about raising the age of sale. If England is to be smoke-free by 2030, we need to prevent people from starting smoking at the most susceptible ages—when they are adolescents and young adults. Two thirds of those who try smoking go on to become regular smokers, only a third of whom succeed in quitting during their lifetime. Experimentation is rare after the age of 21. Therefore, the more we can do to prevent exposure and access to tobacco before that age, the more young people we can stop from becoming hooked into this deadly addiction.

Raising the age of sale from 16 to 18 was associated with a 30% reduction in smokers aged 16 and 17 in England, as was increasing the age of sale to 21 in the United States among 18 to 20-year-olds. University College London estimates that increasing the legal age of sale from 18 to 21 would immediately result in 95,000 fewer smokers aged 18 to 20 in 2022, and an additional 77,000 fewer smokers over the long term, to 2030. That would reduce smoking prevalence among 18 to 20-year-olds to 2%, compared to 9.6% without the intervention. It would be simple and inexpensive to introduce, as ongoing enforcement costs are already factored into the existing age regulations. This is the regulatory measure that would have the biggest impact on reducing smoking prevalence among young adults.

Compared to non-smokers aged 18 to 20, smokers in this age group are more likely to be from lower socioeconomic backgrounds. As such, the effect in increasing the age of sale would be particularly beneficial in poorer and more disadvantaged communities. It could also have knock-on benefits. Smoking during pregnancy, for example, is concentrated among young, disadvantaged mothers, and whether a woman smokes during pregnancy is significantly affected by her wider environment. Discouraging experimentation and the uptake of smoking among young, disadvantaged people would prevent smoking in young women who may go on to become pregnant, as well as their male partners, friends and family members. That then reduces the likelihood that young women and their children will be exposed to toxic second-hand smoke during, or indeed after, pregnancy.

In keeping with the current age of sale legislation, raising the age to 21 is not about criminalising those under that age, but about making it much more difficult for them to get hold of tobacco. Increasing the age of sale is supported by a majority of the adult population, with 63% in favour and just 15% opposed. The support is consistent among Conservative, Labour and Liberal Democrat voters—I do not have figures for the Democratic Unionist party. That is also true for those aged 18 to 24, among whom 54% support the measure and just 24% oppose, and for 11 to 18-year-olds, of whom 59% support and 14% oppose.

Given the strength of the evidence and the public consensus that this is the right thing to do, I and other members of the all-party parliamentary group urge the Government to launch a public consultation on raising the age of sale. It is particularly important to encourage children and young adults, who will be most affected by the policy, to participate.

Experience of smoke-free law implementation in England in 2007 showed that a public consultation can help raise awareness and bolster compliance with legislation. For example, 98% of all premises and vehicles inspected in the first nine months after the law was implemented complied fully with the legislation, and 81% of business decision makers thought the law was a good idea.

When the Government rejected the amendment to the Health and Care Bill that would have provided the power to raise the age of sale to 21 by regulation, they said that they would like to review the evidence base for increasing the age of sale to 21 in more detail. That seems to me and others a very good idea. The best way to do that would be by carrying out a consultation, which is what we are calling for in the revised amendment on Report. I urge the Minister not to wait for the debate but to give her support to the consultation now.

My final question for the Minister is this: will she give a commitment to conducting a consultation on raising the age of sale from 18 to 21 within three months of Royal Assent of the Health and Care Bill? That brings me to my conclusion, Mr Bone. I welcome the opportunity to have this debate and look forward to contributions from right hon. and hon Members and the replies from the Front Benchers.

--- Later in debate ---

[Bob Blackman]

I thank my hon. Friend the Minister for her reply. I also thank the Opposition Front-Bench spokesperson for his strong support. I thank every colleague who has participated in the debate. We all share the same view: smoking must be eliminated and we must get to a smoke-free 2030. All the advancements in legislation on this subject have come from the Back Benches, and they will continue to come from the Back Benches. If the Government refuse to act, we will continue to press further.

In answer to the hon. Member for North Antrim (Ian Paisley), the “polluter pays” principle is key. When we raise tobacco tax at the point of delivery, the individual who smokes pays, but if we continue to tax the profits, we can pass the benefits on in terms of prevention. I thank colleagues for their contributions today. We have had a very good debate. No doubt the debate will continue, on both the Health and Care Bill and other measures.

Question put and agreed to.

Resolved,

That this House has considered the delivery of the Tobacco Control Plan.

Smoking Cessation: Prescription of E-cigarettes

Bob Blackman Excerpts

Monday 1st November 2021 Commons Chamber

[Maggie Throup]

There will be officials at COP9. It is a very important meeting. The UK’s approach to e-cigarettes has been and always will be pragmatic and evidence-based. I am sure that will be the message they put forward at COP9.

[Bob Blackman (Harrow East) (Con)]

I declare an interest as chair of the all-party parliamentary group on smoking and health. Clearly the best way of ceasing smoking is to stop altogether. I welcome the fact that this proposal was originally contained in the last tobacco control plan in 2017, so I congratulate my hon. Friend on her prompt action on assuming the job. We will get an opportunity to debate the tobacco control plan on 16 November in Westminster Hall, and I trust she will reply to that debate. Will this particular proposal be targeted at the extreme smokers—the people who are hardened smokers and smoke a lot—and pregnant women to encourage them to give up?

[Maggie Throup]

I thank my hon. Friend for his question. I am looking forward to our debate in a couple of weeks’ time. As I mentioned earlier, the NHS already has measures in place through the long-term plan to help those who are pregnant to stop smoking. That is important. Should e-cigarettes be licensed as a medicinal product, it will be a gateway for those smokers to stop smoking through that method and hopefully stop smoking completely.

Health and Care Bill

Bob Blackman Excerpts

2nd reading
Wednesday 14th July 2021 Commons Chamber

[Bob Blackman (Harrow East) (Con)]

I strongly support the Bill. However, although it contains strong measures to combat obesity, there is none to tackle smoking, which is the leading cause of preventable premature death, including cancer. I declare an interest as chairman of the all-party group on smoking and health. The report we proposed suggested that we implement the “polluter pays” levy that the Government promised to consider two years ago. The Bill is the ideal opportunity to introduce such a levy. Analysis by Cancer Research UK shows that we will not achieve the Government’s aim of a smoke-free England until 2035—the Government target is 2030, so years later—in our poorest communities, so there is no time to waste. We must get on with the job.

In the Government’s recent paper on public health, they accepted that they have a responsibility not only to help people improve their own health, but to go further when it comes to industries that are based on addictions such as smoking. The Bill is the ideal opportunity, and I urge the Government to consider the recommendations laid out by the all-party group and table them as amendments in Committee, so that we tackle the most deadly addiction in our society.

We need to combat not only smoking rates but the long-standing, unacceptable health inequalities that exist across the country. The plan needs to be comprehensive, but it will not be effective without sufficient additional and sustainable funding. A smoke-free 2030 fund, using the industry to pay for it, but without industry interference, could pay for the comprehensive measures that we need to reach that ambitious target across all socioeconomic groups.

On the plan to combat obesity, there is a measure that will be harmful to many of our media companies, but it will not hit some of the social media and online companies. That runs the risk of having a two-stage process. Perhaps we could consider having limits at weekends to limit the impact of junk food advertising on TV when our young people are watching.

Overall, however, this is a good Bill. We should support it, and we should support our national health service that has brought it before us today.

Tobacco Control Plan

Bob Blackman Excerpts

Thursday 10th June 2021 Westminster Hall

[Bob Blackman (Harrow East) (Con) [V]]

It is a pleasure to serve under your chairmanship, Mrs Miller. I am the co-sponsor of the motion, so I crave your indulgence slightly because I have a rather longer speech than five minutes will allow. It is a pleasure to follow my co-sponsor, the hon. Member for City of Durham (Mary Kelly Foy). I chair the all-party parliamentary group on smoking and health, which published the report on the tobacco control plan yesterday.

We were delighted when my hon. Friend the Minister set out the need for a new control plan last December, and we commissioned Action on Smoking and Health and SPECTRUM, a widely acknowledged scientific research consortium, to put together a report for us on what needed to be done and why. The importance of the ambition is very clear: the chief medical officer, Professor Chris Whitty, recently said that smoking is likely to have killed more people in Britain than the covid-19 pandemic, with more than 70,000 people dying from smoking last year in England alone—and for every person killed by smoking, another 30 live with the serious consequences of smoking-related illnesses. Ending smoking is essential if we are to reduce health inequalities between rich and poor, level up the nation and increase healthy life expectancy by five years, in line with the Government’s manifesto commitments.

The smoking rate in my Harrow East constituency is lower than average for England, but there is no room for complacency. More than one in 10 of my constituents smoke, and smoking kills 250 of my constituents every year. In 2018, there were 1,566 smoking-attributable hospital admissions in Harrow alone. Research shows that smokers are likely to need social care a decade earlier than non-smokers because of the impact of smoking-related diseases and disability.

Inequalities in smoking have grown, not shrunk, in recent years. To be smoke free by 2030, we need to reduce smoking by two thirds in only a decade, and by three quarters for smokers in routine and manual occupations. Cancer Research UK has said that, at current rates of decline, we will miss the target by seven years, and by double that for the poorest in society, because there are still 6 million smokers in England. We will achieve a smoke-free 2030 only by motivating more smokers to attempt to quit using the most effective quitting aids, while reducing the number of children and young adults who start smoking.

It is right that the Government brought forward the ambition of the prevention Green Paper, and we need to ensure that bold action is implemented, with appropriate investment. The Health Foundation estimates that a minimum of £1.2 billion is needed to restore public health funding to 2015 levels, and that a further £2.6 billion is needed to level up public health across the country.

The APPG’s view is that when it comes to ending smoking, the industry that makes excess profits from the sale of tobacco should pay, as it does in the US. The US’s user fee legislation raises $711 million annually from the tobacco industry; a similar approach could be introduced in the UK, with a statutory smoke-free 2030 fund imposing a targeted tobacco manufacturer profit cap and utility-style price controls in order to raise funds from the industry through a charge-based mechanism on sales volumes. It would not apply just to tobacco, because obviously this is about incentivising the industry to deliver on making smoking obsolete by 2030. It is quite clear that this is more than demonstrated by the market failure that has happened, and we need to get on with it. Will the Minister commit that the APPG recommendations for a “polluter pays” approach will be considered as a funding mechanism for the forthcoming tobacco control plan?

We also need to look at raising the age at which young people can buy cigarettes. Clearly, young people who start smoking continue to smoke into adulthood, so one of the areas that we have explored is raising the age of sale. It was raised from 16 to 18, which produced a 30% reduction in smokers aged 16 to 17 years old. It would be helpful if we could get to a position whereby 18 to 20-year-olds were prevented from smoking, so will the Minister commit to conducting a consultation on raising the age of sale from 18 to 21 and to coming to a decision about whether to go ahead by the end of 2021?

We have been a leader in the tobacco control plan, but obviously the position is that we have set the record. Now that we are free from the European Union, we can make decisions on our own. Will the Minister investigate extending Official Development Assistance funding for the FCTC 2030 project for a further five years?

Finally, the Minister is the lead for the World Health Organisation’s FCTC in the Department of Health and Social Care, so will she commit to provide the leadership in other Government Departments and public authorities that we need to fulfil their legal obligations to prevent tobacco policy from being influenced by the tobacco industry?

I have been able to touch on only four of the recommendations that we have made, and there are 12 in the report. I urge all Members to read the full report and the recommendations. The recommendations are supported not just by the APPG, but by leading health organisations too numerous for me to mention. There is good evidence that the recommendations will work in synergy to drive down smoking rates, and the forthcoming tobacco control plan offers the perfect opportunity to put them in place. I commend our recommendations to the House, and look forward to the reply of my hon. Friend the Minister.

Covid-19 Update

Bob Blackman Excerpts

Monday 7th June 2021 Commons Chamber

[Matt Hancock]

We are explicit about that. I appreciate what the hon. Lady said about the importance of data and data saving lives, and I agree with her about the importance of trust and bringing people with you. In fact, a large majority of those in the NHS are now actively enthusiastic about using data better. I very much hope we can keep it that way, not least because everybody has now seen the importance of using data to manage a crisis. One of the reasons for the vaccine success—why it has been rolled out so effectively—is that the data architecture that underpins the vaccine roll-out is extremely effective, and I pay tribute to the people who built it.

[Bob Blackman (Harrow East) (Con) [V]]

In Harrow, because of the delta variant, we have surge testing in our schools: 13,000 young people have been tested at school and 12,000 relatives at home. This weekend, 3,280 vaccinations took place because we had two new pop-up vaccination centres for 18-year-olds and over. Will my right hon. Friend join me in congratulating the entire team who have made this massive project, so diligently followed, to enable people to be safe in Harrow, but will he also consider having further pop-up clinics for 18-year-olds so that we can get everyone vaccinated as soon as possible?

[Matt Hancock]

I pay tribute to the team at Harrow, and especially for the testing expansion. My hon. Friend said that there were 13,000 pupils and 12,000 of their relatives, and that includes me, because one of my children goes to school in the Harrow area. We got our PCR tests at home, we sat around the kitchen table and we all did them together, and I am glad to say they were all negative. This showed me—I felt like a mystery shopper —how effective this surge testing can be in making sure that we tackle these problems. We have seen that surge testing can work. We saw it in south London, where it worked. We have seen it in Bolton, where the case rate has come down. It has been used in Hounslow. It has been used in other specific areas, and I am glad it is now under way in Harrow to try to keep this under control.

Covid-19 Update

Bob Blackman Excerpts

Monday 17th May 2021 Commons Chamber

[Mr Deputy Speaker (Mr Nigel Evans)]

I do aim to try to take everybody, so can we have concise questions—and concise answers, Secretary of State?

[Bob Blackman (Harrow East) (Con) [V]]

My right hon. Friend will be aware that London has a younger cohort and is full of communities from across the world, but many are hesitant because of the activities of pharmaceutical companies in the countries of their origin. Will he look at aspects of control to ensure that those communities can get the vaccine they choose to take, rather than attempting to force them to take vaccines they are extremely reluctant to take?

[Matt Hancock]

We have had a principle of saying that they come forward for the vaccine and get the vaccine that is there on the day, but of course we have nuanced that because of the changes in the clinical advice on the AstraZeneca vaccine. As we reach further and further into those who need encouragement to come forward, so we are willing to look at more and more creative solutions to tackle people’s hesitancy. As it happens, I was in Brent central mosque last week at Eid. It was absolutely wonderful to see the work they have done to make sure that people of all faiths and none can come forward. For many Muslim people it means that in Brent they can go forward to somewhere where they are very comfortable being vaccinated. It was brilliant, frankly, to see teams working in the mosque to vaccinate people of all backgrounds. The imam was vaccinated by someone with the support of a member of the Jewish community with me looking on, all organised by a Hindu administrator. It was modern Britain at its best. They have done thousands of vaccines and they have done great work. I know it is that sort of approach that my hon. Friend is looking for. If we can do more on the specifics of which vaccine, I am very happy to look at that. [Interruption.]

Covid-19 Update

Bob Blackman Excerpts

Monday 19th April 2021 Commons Chamber

[Matt Hancock]

I certainly agree with the hon. Lady on her final point, on international collaboration and working together, which, along with the Foreign Secretary and the Prime Minister, we are working incredibly hard on. We are using the UK’s presidency of the G7 and the enthusiasm of the new Administration in Washington to try to drive international collaboration, in particular collaboration among like-minded democracies in favour of an open and transparent, science-led response to pandemics. I hope that she will concur with that approach.

On the new variants of concern, it is important when looking at the numbers to distinguish between community spread and spread connected to travel. By taking the action that I have just announced to put India on the red list, we are restricting yet further the likelihood of incursion from India of somebody with a new variant. However, the majority of the cases that we have seen already in this country have been picked up by the testing that we have in place now for every single passenger entering this country. That is a sign of the system working, and it is now being strengthened.

[Bob Blackman (Harrow East) (Con) [V]]

I am delighted to say that I have had my second dose of the Oxford AstraZeneca vaccine and, so far, no ill effects. In Harrow, we have had surge testing because we have had a relatively small number of cases of the South African variant discovered. Literally thousands of people have been tested, but one of the most frustrating things is that these tests then have to be sent off and there appears to be an extremely long turnaround time before we get the results. What can the Secretary of State do to speed up getting the results of these tests? Otherwise, people will not be aware of whether they have the variant or whether they should take particular actions.

[Matt Hancock]

My hon. Friend is absolutely right to raise this important issue. I know that this is an important announcement for him and his constituents, representing as he does a significant number of constituents from the Indian diaspora. We have managed to reduce somewhat the turnaround time for the sequencing of positive tests, but we are also introducing a new type of test that can detect not just whether someone is positive but whether they have one of the known variants without having to go through a full sequence. That can give us a snapshot much, much faster—within a matter of hours—of whether a positive result has one of the known variants, before sending it off to sequencing so that we can see any new variant that we do not know about. We are introducing that technology. It is starting in the Lighthouse lab testing facility in Glasgow and we are rolling it out across the system. It is an important tool to make sure that we can get the turnaround time of spotting the variants down faster.

Covid-19: Government’s Publication of Contracts

Bob Blackman Excerpts

Tuesday 9th March 2021 Commons Chamber

[Edward Argar]

As part of the answer to her question, I refer the hon. Lady to the answer that I gave to the hon. Member for Strangford (Jim Shannon). In response to the rest of her question, the honest answer is that we are undertaking a stocktake and an audit. It is that which is required to assess whether any stockpiles are not fit for purpose or do not meet requirements, or to check what was and was not delivered and make sure that every order was fully fulfilled. We have been very clear that, as part of that audit, that stocktake, we will pursue with any who did not meet the requirements or did not supply the goods the recouping of that money for the public purse.

[Bob Blackman (Harrow East) (Con) [V]]

Last year, the shadow Chancellor of the Duchy of Lancaster wrote:

“We need Government to strain every sinew and utilise untapped resources in UK manufacturing, to deliver essential equipment to frontline workers. This must be a national effort which leaves no stone unturned.”

Can my hon. Friend say that the Government have done what she wanted and have delivered for the people of this country?

[Edward Argar]

I would argue that that is exactly what the Government have done. The hon. Member for Leeds West (Rachel Reeves) and I do not always agree, but I agreed with her then and I agree with what she wrote then now.