Social Media and Health

Bob Blackman Excerpts

Tuesday 30th April 2019 Commons Chamber

[Matt Hancock]

The hon. Lady is absolutely right that there will be an increased spend on mental health services across England—a £2.3 billion increase. It is the fastest-growing area of spend in the long-term plan. We are investing £33.9 billion in the NHS in cash terms, and the fastest proportionate rise in spend is in mental health services. That is an important part of this, although there is an awful lot that the social media companies can do to reduce the demands on those services by reducing the negative impact on mental health. The whole House can agree that the hon. Lady being alive and here, having survived measles, is another reason why it is important to get this right. It would have been the House’s loss had the measles won.

[Bob Blackman (Harrow East) (Con)]

The drop in vaccination rates is not only an annual problem but a cumulative problem, as more and more young people in society are not immunised against these childhood diseases. Can I urge my right hon. Friend not only to undertake a social media campaign to encourage parents and children to take up the vaccinations, but to target the messages so that people know where they can go to get them, how they can do it and the importance medically of doing so?

[Matt Hancock]

My hon. Friend is exactly right; in fact, that work is under way. I should have mentioned in response to the shadow Secretary of State that Public Health England has a targeted programme of positive information. We can use data and social media better to target messages at those who need them in exactly the way that he proposes. That work is in hand.

Oral Answers to Questions

Bob Blackman Excerpts

Tuesday 15th January 2019 Commons Chamber

[Stephen Hammond]

My hon. Friend and I do not always agree on everything about the EU, but numbers and statistics show that he is correct on that matter.

[Bob Blackman (Harrow East) (Con)]

Clearly, it is important as we move forward with the NHS to train more doctors and nurses. What is the Minister doing to encourage young people to start training to become nurses, doctors, and for other positions in the health service?

[Stephen Hammond]

My hon. Friend is right, and we are ensuring more routes into the nursing profession, such as nursing apprenticeships and nursing associates. We are training more GPs, and we are determined to get 5,000 extra GPs into general practice. A record 3,400 doctors have been recruited into GP training and, as part of the long-term plan, newly qualified doctors and nurses entering general practice will be offered a two-year fellowship to support them to stay there.

Leaving the EU: Tobacco Products and Public Health

Bob Blackman Excerpts

Monday 7th January 2019 Commons Chamber

[Bob Blackman (Harrow East) (Con)]

It is a pleasure to follow the hon. Member for Washington and Sunderland West (Mrs Hodgson). It is fair to say that all the changes to tobacco regulations that have been made in this House have come from the Back Benches, with pressure being put on the Government, whichever party has been in power, to make the necessary changes. It is therefore a great pleasure to see my hon. Friend the Minister and the Opposition spokesperson, who are both tremendously supportive of making the necessary changes and implementing tough regulations on tobacco products.

This is clearly one of those statutory instruments that will be required if there is no deal. In any case, once we leave the European Union we will be responsible for our own measures on tobacco enforcement. It is therefore timely that we are having this debate now, before we leave the European Union. Clearly the measures are pragmatic and will minimise the amount of work required once we leave the European Union. However, I have one or two concerns that I hope the Minister can respond to when he sums up.

The current system for notification of e-cigarettes and novel tobacco products is reasonable and minimises additional work, but products that are notified to the UK prior to leaving the EU will not require re-notification. My concern is whether such novel products will come to the fore between now and our departure date, and what the effect of having a deal would be, and therefore whether there we be another period of time in which those products could be introduced. Would we then need to review how those products are dealt with under this statutory instrument?

Secondly, on the picture warnings that we obtained from Australia, which the hon. Member for Washington and Sunderland West mentioned, one of the key issues is that people who smoke get used to cigarette packets showing messages. We need to rotate those messages and pictures so that they shock people. We want to shock people, particularly young people, to stop them smoking. The concept of rotating pictures and identifying the best images to achieve that shock factor is key. I trust that my hon. Friend the Minister will consider that and keep it under review so that we can introduce it, if needed.

There clearly needs to be a longer-term review, so my third point is that we need to see a report by 20 May 2021, which would give us an opportunity to review all the regulations that apply not only to tobacco products but to e-cigarettes and other heated tobacco products. The Australian Government will clearly evaluate their various different initiatives, and it is fair to say that we have been at the forefront, both in Europe and across the world, in leading on tobacco control. It is therefore important that we encourage smokers to quit and prevent young people from starting to smoke.

Will my hon. Friend undertake to review the regulations regularly so that we can encourage young people and others to give up smoking and, equally, ensure that measures are in place so that people who want to give up are given help and support to do so? More importantly, we should ensure that doctors, when reviewing people’s cases, are directing those who smoke to the help and support they need in order to give up and to have better personal health.

I warmly welcome this statutory instrument, but I hope the Minister can give me some reassurance on those three points.

NHS Long-term Plan

Bob Blackman Excerpts

Monday 7th January 2019 Commons Chamber

[Matt Hancock]

As I said a moment ago, local allocations will be published in the coming days.

[Bob Blackman (Harrow East) (Con)]

One of the most effective ways of reducing avoidable deaths is to stop people smoking in the first place, and to encourage those who do smoke to give up as fast as possible. How will this plan encourage pregnant mothers, 11% of whom still smoke, to give up smoking and get their partners to give up, and how will it encourage young people not to start in the first place?

Oral Answers to Questions

Bob Blackman Excerpts

Tuesday 23rd October 2018 Commons Chamber

[Bob Blackman (Harrow East) (Con)]

T6. The recent report from the Royal College of Physicians, “Hiding in plain sight: Treating tobacco dependency in the NHS”, made clear the cost savings and health benefits there would be if doctors identified smokers and referred them to smoking cessation services, so will next month’s plan include that, particularly for pregnant women and mental health patients?

[Steve Brine]

As my hon. Friend, the chair of the all-party group on smoking and health, knows, those groups are key to delivering our tobacco control plan. We are not complacent at all; the delivery plan that was published in June sets out the actions that different agencies will take to deliver the five-year plan, and that absolutely includes mentor cessation services.

Oral Answers to Questions

Bob Blackman Excerpts

Tuesday 24th July 2018 Commons Chamber

[Steve Brine]

I probably cannot do all of that without trying Mr Speaker’s patience, but I should like to thank the right hon. Lady, who is one of my predecessors, for the work that she does through the all-party parliamentary group on children of alcoholics, and with the charity Adfam. Charities and other third sector organisations will play a key part in putting in bids to work with local authorities, as part of the £6 million. Public Health England is leading on that, and I look forward to having ongoing discussions with her and with other Members who I know have a deeply held personal interest in this matter.

[Bob Blackman (Harrow East) (Con)]

11. What steps he is taking to help reduce the rates of smoking during pregnancy.

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

Smoking rates are at their lowest ever, but we need to make more progress on tackling smoking in pregnancy, as I outlined in the general debate last Thursday. We are determined to redouble our efforts in this area, because smoking is still the biggest preventable killer in our country today.

[Bob Blackman]

I thank my hon. Friend for his answer. Smoking rates among pregnant women are still stubbornly high. What steps can he take to encourage the partners of pregnant women to give up smoking so that both partners play a part in preventing damage to the unborn child?

[Steve Brine]

My hon. Friend makes a good point, which he made in last week’s debate. Public Health England and NHS England will continue to work with local areas in our constituencies to promote evidence-based ways of identifying and supporting pregnant smokers to quit. The overall ambitions in the tobacco control plan, which I published a year ago last week, will touch the general population, which of course includes the partners of pregnant women.

Tobacco Control Plan

Bob Blackman Excerpts

Thursday 19th July 2018 Commons Chamber

[Steve Brine]

I already have and NHS England already has: we have already done so. We think that Philip Morris International’s move is totally inappropriate and totally contrary to the protocol. I do not think I could have been clearer either in the press or at the Dispatch Box today, and I thank the hon. Gentleman for giving me the chance to say so again.

All our local activity has the overall goal of helping people to quit smoking and stopping others starting in the first place, so how are we doing? Here is the score card. Publications by the Office for National Statistics and NHS Digital earlier this month show that we are making progress. Since 2011, the number of adult smokers has dropped by a fifth to the lowest level since records began, and we are fully on track to achieve our 2022 ambition for adults. Among 15-year-old smokers, there is good progress, and figures published last year showed that the prevalence of smoking has reduced by a further percentage point from 8% to 7% since the publication of the plan. The number of e-cigarette users in that group is also falling. Latest figures from the ONS annual population survey reveal that smoking rates among 18 to 25-year-olds are falling faster than in any other age group. Considering that that age is when most smokers start smoking, I am particularly pleased with that.

We are also making progress on inequality. Although routine and manual workers continue to have higher smoking rates compared with the rest of the population, the gap has narrowed slightly, from 26.5% at the publication of the plan to 25.7% as reported by the ONS earlier this month. Those are achievements to celebrate. Nevertheless, I must be honest with the House and say that progress on tackling smoking in pregnancy is disappointing, and in truth the figures have barely moved in the past year.

What shall we do in year 2 of the plan? First and foremost, I am determined to redouble our efforts to support pregnant smokers to quit. That will be best for them and for their babies, and we need people to understand that. Secondly, we will use the opportunity of the Government’s investment in the NHS, which the Prime Minister announced last month, to embed prevention and cessation more firmly into the culture of the NHS. Last month, the Royal College of Physicians, which has a proud record of groundbreaking reports on tobacco, published “Hiding in Plain Sight: Treating tobacco dependence in the NHS”. That weighty report calculated that the cost of current smokers needing in-patient care is £890 million a year. It points out that smokers are 36% more likely to be admitted to hospital at some point than non-smokers, and it makes the powerful argument that smoking cessation repays the cost from year 1. I welcome that report, and I will be making that case loud and clear as we engage with NHS England on the content of the 10-year plan that the Prime Minister has asked it to produce.

Thirdly, we will continue to engage with local authorities —they are now top-tier public health authorities up and down the land in England—on promoting smoking cessation as the best evidence-based means of quitting smoking. Encouraging the NHS to do more on cessation is emphatically not about removing responsibilities from local authorities. This is about creating a whole-system approach in which addicted smokers can access the support they need to quit. Public Health England will continue to provide local councils up and down the land with facts and advice on tackling smoking—for example, it will work with sustainability and transformation partnerships, which should be leading that whole-system approach in the constituencies of all English Members.

Fourthly, as I have mentioned, we will continue to raise tobacco duty to make tobacco less affordable, while also taking action to tackle the illicit trade in tobacco. Fifthly, we will maintain a careful watch on so-called novel tobacco products. The Government are keen to use the opportunity of newer products, such as e-cigarettes, to help smokers to quit, without undermining the key message that the best thing someone can do for their health is quit completely. As I said in the Science and Technology Committee’s inquiry into this subject, we will continue to keep the harms of products such as heated tobacco products under review and continue to hold the industry to account. We have been explicit that the promotion of tobacco products is unlawful, as my recent letter to Philip Morris International makes abundantly clear—that letter was written before the one I mentioned in response to the hon. Member for Stockton North (Alex Cunningham).

Last but not least, we will continue to make the case for tobacco control internationally, building on our reputation as a leading tobacco control nation with credibility in that space. We have such credibility because our consistent work in this area goes back to the coalition Government, the previous Labour Government and the Conservative Government before them, and such consistency means that we are highly credible around the world. More than 7 million people a year across the globe die from smoking-related disease, and the UK Government can help make a dent in that toll by sharing knowledge and skills.

[Bob Blackman (Harrow East) (Con)]

I pay tribute to the Minister’s brilliant work both since he became a Health Minister and before then. Will he comment on some of the scientific issues raised about addiction to nicotine, compared with the very harmful by-products that are a part of cigarettes, cigars and other tobacco products? Will he comment on whether it is nicotine or the by-products that are harming people’s health and causing the most damage?

[Steve Brine]

I think cigarettes cause the most damage, because of the tobacco and the nicotine. The carcinogenic properties of the former are lethal. That link was proven with the lung cancer study that started the ball rolling. I pay tribute to my hon. Friend as the chair of the all-party group for the work he has done in this area. There are a lot of things that we know and there are a lot of things that we still do not know. Some people say that I do not go far enough to promote e-cigarettes and novel products, and some people say that maybe we go too far—I mentioned Stoptober. That generally suggests to me that we are in the right place. What I would say—I think that I said it earlier—is that an awful lot of research is still needed on e-cigarettes. One Member once told me that we should make e-cigarettes free on prescription to all pregnant women. The reason I did not say, “Yes, I think that’s a good idea” is that I still think there are risks to that product. I still think that the best thing people can do is to stop chuffing on anything, whether traditional cigarettes or so-called novel products. I thank him for his intervention, and I look forward to hearing what he has to say during the debate.

--- Later in debate ---

[Mrs Hodgson]

That is important, especially when, as the Minister has acknowledged, we are in such straitened times when it comes to local authority budgets. I am sure that Fresh north-east will be very grateful for what he has said.

Sadly, other areas are not as lucky. They do not have a Fresh north-east; if only they did. Stop smoking services are roughly 300% more effective than quitting by going cold turkey, but in some places the specialist services are being decommissioned altogether. For example, in Blackpool, smoking prevalence is 22.5%, while the average for England is 15.5%, yet Blackpool Council recently decommissioned its specialist smoking cessation service, citing a number of factors including public sector budget cuts.

That example leads me to my next point. Between 2012 and 2014, the healthy life expectancy for newborn baby boys in England was the lowest in Blackpool at 55 years. Again, the shortest life expectancy among men was in Blackpool too, at 74.7 years. Interestingly, in 2014, Blackpool had the highest smoking prevalence at 26.9%. Wokingham had the lowest smoking prevalence at 9.8%, but the highest healthy life expectancy of 70.5 years. That is a 15.5 year difference between healthy life expectancies, and while there will be several factors in play in these figures, it is clear that smoking is one of the largest causes of health inequalities in England.

Some 26% of routine and manual workers now smoke, compared with 10% of those in managerial and professional jobs. This has slightly increased rather than decreased the inequality from 2016. Some 28% of adults with no formal qualifications are current smokers compared with only 8% of those with a degree. It is these people—manual workers or those from low socioeconomic backgrounds—who suffer the most when the Government cut spending to public health services. I therefore ask the Minister what steps his Department is taking to ensure that these people are reached by local smoking cessation services. What assessment has the Minister made of the impact that smoking rates have on widening health inequalities, and how does he intend to address them?

Finally, I move on to smoking in pregnancy. The Government’s ambition to reduce smoking in pregnancy to 6% or less by 2022 is laudable. In 2015-16 the rate was 10.6%. However, new data published recently showed that the rate of smoking during pregnancy in 2017-18 had increased slightly, to 10.8%. It is therefore deeply concerning that the Smoking in Pregnancy Challenge Group, which I recently met, has warned that this ambition is unlikely to be met unless urgent action is taken.

In 2010, 19,000 babies were born with a low birth weight because their mothers had smoked during pregnancy. Up to 5,000 miscarriages, 300 perinatal deaths and around 2,200 premature births each year have been attributed to smoking during pregnancy. In addition, many other children will be three times more likely to take up smoking in later life because they live in smoking households. If we are going to have a smoke-free generation in the future, the Government must take urgent action to ensure that rates of smoking in pregnancy fall. We must not forget that it will be those very babies who will become the smoke-free generation that we all hope to see.

The current target is to reduce smoking in pregnancy to 6% or less by 2022. If that is achieved, it could mean around 30,000 fewer women smoking during pregnancy, leading to between 45 and 73 fewer stillborn babies, 11 to 25 fewer neonatal deaths, seven to 11 fewer sudden infant deaths, 482 to 796 fewer pre-term babies, and 1,455 to 2,407 fewer babies born at a low birth weight. That is something to aim for, but it will only happen if the Government take urgent steps to reduce the number of women smoking during pregnancy.

[Bob Blackman]

On behalf of the all-party group on smoking and health, I thank the hon. Lady for speaking at the launch of our recent report. Does she agree that we must encourage not only pregnant women to give up, but their partners, too, so that pregnant women no longer have to face the challenge of not only being deprived of smoking, but of seeing their partner smoke in front of them? This should be a partnership for both parties.

[Mrs Hodgson]

That is a very pertinent point. We all know the damage of passive smoking. It is all well and good if the mother gives up smoking—that will definitely help her and the baby during pregnancy—but if smoking is still going on in the household, the children will still be growing up in an environment of passive smoking. I thank the hon. Gentleman for making that important point and for his excellent work as chair of the all-party group.

I welcomed what the Minister said about tackling smoking in pregnancy, but will he also tell us how he will target work to encourage younger women and women from more disadvantaged backgrounds to give up smoking during pregnancy? Teenage mothers are nearly four times as likely to smoke before or during pregnancy than those aged 35 and over. Young mothers are less likely to quit before or during pregnancy, and only 38% of mothers under the age of 20 did so, compared with 58% of mothers aged 35 or above. It is clear that the Government need to tackle smoking in pregnancy, and smoking in childhood, as a matter of urgency to achieve their ambition of a smoke-free generation.

The Minister and his Department have a huge challenge on their hands if they are to meet the ambitious targets set out in the tobacco control plan. I still welcome the plan as the right thing to do, as I am sure the Minister does. Anything that is worth doing is going to be hard. We have four years to go before the target date, and the Minister must now look at how the Government can properly fund smoking cessation services to drive down smoking rates and support those who need extra help to stop smoking. I look forward to the remainder of the debate and the Minister’s closing remarks.

[Bob Blackman (Harrow East) (Con)]

It is a pleasure to follow the hon. Member for Washington and Sunderland West (Mrs Hodgson), who has done excellent work already in her shadowing role. I know that she was also at the forefront of this debate before shadowing these matters. Equally, I pay tribute once again to the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Winchester (Steve Brine), who set a precedent for future public health Ministers when, at his first outing at the Dispatch Box, he agreed to publish the long-awaited tobacco control plan. We should remember that it had been delayed for a year before it was published last year at the behest of my hon. Friend, probably much to the consternation of his officials.

I also want to pay tribute to the Minister’s predecessors, particularly the former Member for Battersea, Jane Ellison, who did a brilliant job of advancing many of the controls on tobacco that we now have in such a way as to ensure that they were delivered. I remember taking on the first debate on this subject in Westminster Hall, at which many of my colleagues were present. I think it was in September 2013, and it was the first debate after we came back from the summer recess. It took place at 9.30 in the morning, and I feared that I would have an hour and a half to fill by explaining why we should have standardised packaging for tobacco products. I have to say that both major parties were opposed to that idea at the time, but we were able to convince them otherwise and we changed the policy. That measure has now been enacted, which demonstrates the power that we on the Back Benches can have to change policy in a good way.

I must gently chide the Government, however, for taking over our Back-Bench debate. This means that we cannot pass the resolution that we wanted to pass today to encourage the Government not only to adopt smoking cessation policies but to resource them properly, to ensure that the plan is delivered. We understand that we are now having this general debate, however.

I declare my interest as chair of the all-party parliamentary group on smoking and health. We could go through the history of the progress that has been made, and the speeches from the Front Benches have shown us where we are today. I want to take us back to 1974, when I was sitting my A-levels. My late parents were both very heavy smokers. In those days, half the men in this country smoked, as did more than 40% of the women. It is hard to imagine, but in many ways it was considered healthy to smoke; it was somehow considered to be good for our lungs. Sadly, both my parents died five years later of cancer, so for me this is not only a health issue but a personal one. I do not want to see other people going through what my family had to go through as a result of using tobacco products in the way that they are intended to be used.

Smoking rates have dropped remarkably. As has been mentioned, the number of adult smokers has dropped from 7.7 million in 2011 to 6.1 million in 2017. The difficulty with figures, however, is that, as the population increases, we have to go harder and further to reduce the number of people smoking. Smoking-related diseases are the leading cause of preventable death, with 80,000 people a year dying as a result of tobacco products. In Harrow, part of which I have the honour of representing, we still have 14,000 smokers, which is difficult to understand given the encouragement to quit and all the health issues, and the cost to public services is estimated to be £37.9 million a year in just one London borough, out of 32, that has about 250,000 adults. It is clear that we need further action.

The good news is that the UK is one of the leading countries in the implementation of tobacco control policies. We are recognised as a leader in the implementation of the World Health Organisation’s framework convention on tobacco control, and I want to remind the House of article 5.3, which states:

“In setting and implementing their public health policies with respect to tobacco control, Parties shall act to protect these policies from commercial and other vested interests of the tobacco industry in accordance with national law.”

The guidelines on implementing article 5.3 have been agreed by the UK and advise Governments not to enter into any partnerships, whether they be non-binding or non-enforceable, or agreements with the tobacco industry, not to accept voluntary contributions from the tobacco industry, not to accept tobacco-industry-drafted legislation or policy or voluntary codes for legally enforceable measures, not to participate in corporate social responsibility or related schemes funded by the tobacco industry, and not to permit tobacco industry representation on Government tobacco control bodies.

Former MP Paul Burstow, my predecessor as chair of the all-party parliamentary group on smoking and health, is now the chair of the Tavistock and Portman NHS Foundation Trust and co-chair of the Mental Health and Smoking Partnership. He wrote to the Minister about the letter sent by Philip Morris International, and I am pleased that the Minister has taken up the issue straight away. The company, which manufactures Marlboro cigarettes, wrote to say that it is

“keen to work with NHS Trusts and Foundations to see if we can support the NHS in helping its employees to stop smoking”.

I do not usually promote this publication, but an article in The Guardian today quotes me, Paul Burstow and the Minister making it clear that we do not want any interference from Philip Morris and that that company should not avoid its responsibilities under the code. I am delighted that the Minister has completely rejected the position of Philip Morris, which also states that it has

“written to the heads of all the NHS Foundations and Trusts in England, all Clinical Commissioning Groups, Simon Stevens, and the Secretary of State for Health and Social Care”

about the issue.

Most local authorities in England have signed up to the local government declaration on tobacco control, which is a public statement of the councils’ commitment to reduce the harm caused by tobacco. The declaration commits signatories to

“protect our tobacco control work from the commercial and vested interests of the tobacco industry by not accepting any partnerships”

and so on. However, local government officers have reported continuing efforts by the tobacco industry to engage with local authorities over tobacco control issues including, but not limited to, the illicit trade. We must be clear that the industry’s involvement is not required and not welcome.

I am delighted that, on 1 November 2017, the Minister made a clear statement in this House on the Government’s position, and I am delighted that will continue. I welcome his comments, both in his opening speech and in his letter. What else can he do to make sure that local authorities, the NHS and any other interested parties do not get sucked into this offer from Philip Morris?

On the risks we run, as the hon. Member for Washington and Sunderland West said, one of the problems is that the plan and the targets might not be met. We have to encourage everyone to get to that point. The reality is that smoking rates among young people have started to level out. There is a risk that we will not hit those targets. The target to get smoking rates down to 5% or less by 2022 is good, but I would like to see it at 0%—no one smoking. We could then say that we have achieved what we wished to achieve.

We clearly have to encourage young people not to start smoking. As has been said, more than 350 young people a day take up smoking, and 60% of them go on to smoke for the rest of their life. The huge risk is that those people will fuel the tobacco industry for the future.

There is therefore a case for further control measures, including increased funding for the initiatives, and new legislation. Although it is not appropriate to allow the tobacco manufacturers to make voluntary contributions, if they are offering to give money to the NHS and to local authorities as part of so-called corporate social responsibility, the industry clearly has money to pay for the measures we need to control tobacco and to mitigate the harm it causes, so let us make the tobacco manufacturers pay.

At a time when public sector budgets are under pressure both at national and local level, the tobacco manufacturers, if they have money, should pay an increasing share of the cost of control, as an application of the “polluter pays” principle. That is the clear recommendation of the all-party parliamentary group, and I trust my hon. Friend the Minister will therefore advance that recommendation to the Chancellor.

[Steve Brine]

Consider it advanced. Time will be limited for the wind-ups, so I will address the point about young people. Earlier this week, I held a roundtable in the Department of Health with a number of charities working on drug policy and with reformed drug takers. One gentleman said to me, “The trouble was that I really enjoyed taking drugs. What I didn’t enjoy was the outcome of taking drugs.”

I have heard young people say that they really enjoy smoking but that they do not enjoy the outcome. We should welcome today’s statement by the Secretary of State for Education on the new work that will be done in schools on health and relationships education. Specifically, health education can help young people to understand the health consequences of smoking, even if they might enjoy the process of smoking.

[Bob Blackman]

I thank my hon. Friend for his intervention, and I completely agree that health education is an appropriate way to consider the issue.

There is a model in the United States that we could introduce. The Family Smoking Prevention and Tobacco Control Act of 2009 gives the US Food and Drug Administration the power to regulate the tobacco industry, funded through what is called a user fee on manufacturers. The total amount to be raised is set out in legislation and apportioned to manufacturers on the basis of their share of the US tobacco product market. I ask the Minister to look at that US legislation as a way of introducing such a model.

The major recurring costs of tobacco control, and they are important, are mass media campaigns to discourage uptake and to encourage quitting. An approach such as the one in the US would: raise hundreds of millions of pounds a year from the tobacco industry; help to protect the business of legitimate retailers who obey the tobacco control legislation; help to protect Government tax revenues—at the moment, the excise tax raised £9.9 billion in 2016-17, but the loss on illicit tobacco was estimated to be £2.4 billion; pay for the mass media campaigns to discourage smoking, which we desperately need; and provide a source of revenue to local authorities, which could help to fund local tobacco control measures, including enforcement activity and the provision of support to smokers seeking to quit. Funding for trading standards has fallen substantially in recent years, from £213 million in 2010 to only £124 million in 2016, and the National Audit Office estimates that the number of full-time staff has reduced by 56% in seven years. So there are fewer people to enforce the rules that we want to see enforced. Such an approach could also support regional partnerships working to tackle illicit tobacco. The success of that has been shown in the north-east and north-west, which have concerted multi-agency enforcement activity and effective, evidence-based measures to reduce demand. So it is clear that we can deliver on this.

Polling conducted for ASH—Action on Smoking and Health—asked respondents how strongly they would support measures requiring tobacco manufacturers to pay a levy or licence fee to help encourage people to quit and prevent young people from starting to smoke. The net support for that was 71%, with only 9% opposing. So the Minister should impress on the Chancellor the need for this and the benefit of doing it.

One key issue that I wish to emphasise above all else is the need for mass media campaigns to shock people into realising how desperate smoking is and how damaging it is to health. There is nothing like seeing those sorts of mass campaigns for encouraging people to realise that they are responsible for their health. The analysis of these campaigns has shown that they are very effective but that they have declined in recent years. Public spending on such campaigns in the UK peaked in 2008-09 at £23.38 million, but now that has fallen dramatically, to only £1.5 million in 2016-17. Clearly, we need to encourage local authorities and the Department of Health and Social Care to use the opportunity to shock people so that they understand the damage they are doing. I therefore ask the Minister to look at mass media campaigns and ensure that they are used as part of the strategy.

Finally, let me say that my area now has a large number of people from the European Union who have chosen to come here to live in this country. If we go to many eastern European countries, we see people smoking everywhere; these places do not have the tobacco control that we have in this country. Those people need to be reached to encourage them to give up smoking and ensure they look after their own health. It is those people we have to reach out to fully. I look forward to other contributions from right hon. and hon. Members, and I am sure that the Minister will reply in suitable fashion.

Medicines and Medical Devices Safety Review

Bob Blackman Excerpts

Wednesday 21st February 2018 Commons Chamber

[Mr Hunt]

I hear what the right hon. Lady is saying. The reason it was important to ask whether there was a causal link was that it has an implication for the compensation to which people might be entitled, but I would like to reassure her that Baroness Cumberlege will have the freedom to look at all the issues that she has raised.

[Bob Blackman (Harrow East) (Con)]

The pharmaceutical companies have consistently refused to accept a causal link between sodium valproate and autism. My right hon. Friend has now set out measures to warn people about this in the future, but that does not compensate the victims. What attempts is he going to make to ensure that victims are fully compensated for the dreadful impacts on the lives of their children?

[Mr Hunt]

In this country, the compensation system works through the courts. There are times when the NHS is liable and there are times when the drugs companies are liable. I hope that Baroness Cumberlege’s work will take us closer to understanding where the liability actually lies, so that we can give relief to the families who have suffered for too long.

King’s College Hospital Foundation Trust

Bob Blackman Excerpts

Tuesday 12th December 2017 Commons Chamber

[Mr Dunne]

I am afraid that the hon. Gentleman was not referring to the urgent question. We are talking about what has happened at King’s over the past few days, rather than what is happening in Scotland.

[Bob Blackman (Harrow East) (Con)]

My local hospital trust, based on Northwick Park Hospital, has had to make some very difficult decisions to make itself more efficient and to reduce its deficit, and it has done so under excellent leadership. Does my hon. Friend know whether decisions were taken at King’s to keep to the deficit target? Were efficiencies made, and how effective were they?

[Mr Dunne]

What is particularly disappointing about King’s is that it does have a cost improvement programme, but regrettably, it has not been able to keep to it. It is particularly surprising that, as recently as October, the senior leadership team indicated that they were on track to meet their deficit, which palpably, as we now realise, was not the case.

Hormone Pregnancy Tests

Bob Blackman Excerpts

Thursday 16th November 2017 Commons Chamber

[Steve Brine]

First, may I correct myself? I might have said that the expert working group met “companies”, not “families”. If I said “companies”, I wish to correct the record.

I agree with the hon. Lady that the notice the families were given was not good enough. I and my colleague in the other place have made that crystal clear. Some notice was given to Mrs Lyon on Friday last week that there was likely to be an event on Wednesday, but that was not confirmed until Monday, so that was the notice the family got, and I do not think that is good enough; I have made that very clear.

On the hon. Lady and the hon. Member for Bolton South East (Yasmin Qureshi), who chairs the all-party group, being locked out of the press conference, I cannot imagine how that happened, and again I have sympathy on that. I expect the MHRA to look into that and explain that to me, because, while we may disagree, I can see how that merely feeds the conspiracy theory that some have around this subject.

[Bob Blackman (Harrow East) (Con)]

My hon. Friend is clearly struggling to defend this position. I urge him to look at the scope of this review and all the evidence that was presented to it, as all the evidence that was available should be looked at and looked at again. Without that, many people across this country will not be satisfied that justice has been done.

[Steve Brine]

With respect, I do not think I am struggling at all; I am just setting out a very clear position. Ministers are confident in the report and the review process. I say again that this was a comprehensive independent scientific review of all available evidence by experts across the expert working group who have a broad range of specialisms.