Sudden Unexpected Death in Childhood

Debate between Caroline Johnson and John Hayes

Tuesday 24th March 2026 Westminster Hall

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

It is a pleasure to serve under your chairmanship this morning, Sir John. I declare an interest as an NHS consultant paediatrician and as a member of the Royal College of Paediatrics and Child Health. I congratulate the hon. Member for Rossendale and Darwen (Andy MacNae) on securing today’s important debate.

The death of a child is every parent’s worst nightmare. It is perhaps even more horrific when such a death happens suddenly, without warning and when no explanation can be found. I would like to convey my condolences to the family of Frankie Grogan, to Cheryl, Darren and Louis, to Nathan and Fiona, to the Rogers, Pitts and Williamson families, and to all other families grieving such a profound loss.

Childhood death is thankfully rare. However, more than 3,400 children aged nought to 17 die in England each year, and in around 40 cases the death cannot be explained. Parents are left with more questions than answers. Why has this happened? Why now? Since many cases are unwitnessed, did the child suffer? What was the cause? Could it have been prevented? Will it happen again to a sibling or a future child?

I want to focus on two questions today: how do we identify the cause of death in more cases? And how can we use that information to prevent future deaths? We can do that because we have done it before. In the 1980s, 2.35 children per 1,000 live births died within between a week and two years. That has been reduced by over 90%. The key factors were research, the Back to Sleep campaign, general safe sleeping advice and the avoidance of cigarette smoke. There is more to be done, but with the right plan, we have shown that lives can be saved.

I would first like to acknowledge some progress, including through the work of Baroness Kennedy, whose 2004 report and subsequent work with the Royal College of Pathologists and the Royal College of Paediatrics and Child Health led to the introduction in 2008 of a standard set of clinical samples, called Kennedy samples, that must be taken in the event of a sudden child or infant death. In most of the trusts I have worked in, there is now a box in each emergency department with all the samples and a list of what needs to be taken so that nothing is missed in any cases.

Child death overview panels, which were also established in 2008, are multidisciplinary panels to review the deaths of all children aged nought to 17. That process was further updated in 2018. When a child dies, all registrars must inform the child death overview panel, of which there are currently 58 in England. An expected death goes to a review meeting to look at the detail of the causes and whether it can be prevented in the future. In an unexpected death, there is an urgent joint agency response meeting including police and education, and a review meeting takes place later. All that information then feeds into the national child mortality database, set up in 2019, which is there to spot patterns and aims to prevent future deaths. It produces several reports each year with detailed guidance for Government on how deaths can be prevented.

It might be helpful to discuss an example. In December 2024, the NCMD published a report on child deaths due to asthma or anaphylaxis. I commend those who produced that report, including my medical colleague Dr Emilia Wawrzkowicz. They found that certain factors increased the risks of asthma or anaphylactic death in children, and that milk was most likely to trigger a fatal reaction. They found problems with auto-injectors that were forgotten, out of date or not with the child, or that the training had not been adequate, particularly in schools. They found issues with indoor air pollution, a failure to recognise life-threatening asthma and that children did not have asthma action plans.

Work has been done in many of those areas, which will have saved children’s lives since. My hon. Friend the Member for Rutland and Stamford (Alicia Kearns) has been promoting Benedict’s law, which hon. Members voted for just last week, to ensure that children at school are protected from anaphylaxis. Can the Minister update the House on progress in delivering the recommendations of the national child mortality database’s report? At the moment, the Government are not obliged to produce a response to the recommendations of the national child mortality database’s reports, unlike many other reports, and I think they should be. A more recent report was on the effect of consanguineous marriage on the rate of child deaths. It would be helpful to have Government responses to show that those reports are being read and acknowledged, and that the work that has been done is leading to change.

I worry about the effect of the imminent abolition of NHS England on the national child mortality database’s work. Child death overview panels do very good work in investigating each child death individually, but ICB funding cuts mean that not only bereavement staff, but investigatory staff, are being cut. The mergers of ICBs mean that local knowledge may be lost as the areas become very large. That is not in line with the statutory guidance in the Children Acts. Can the Minister update us on the Government’s plans in that area?

Whole genome sequencing offers an increased likelihood of finding children’s causes of death, but there is a long wait for results; it can take six months. Families are in great distress while they wait for those results, as we have heard. The Government suggest that they want to expand genome sequencing work, but it has already taken a very long time and the workforce plan has not yet been published. What are the Government doing to make sure we have the right staff and the right capacity to deliver that ambition?

Skin biopsies can be very helpful, particularly in diagnosing inborn errors of metabolism, which in children can cause illness and death, but they are not yet available everywhere. Can the Minister update the House on what is being done to roll out these tests so that, where possible, all causes can be found?

The Liberal Democrat spokesperson, the hon. Member for Mid Sussex (Alison Bennett), mentioned the fact that there are not enough pathologists. That is very important because it causes distress and delays, including to post-mortems, and it means that families have to wait much longer for results. Also, some children tragically die overseas, as happened to one of my patients relatively recently. In such cases, SUDC panels rely on being told about it and find it more difficult to investigate. Does the Minister have any comments on that?

Hon. Members talked about research. The Lullaby Trust has been doing gene sequencing on tissue samples from children who died of sudden unexplained death. In four of 20 cases, the tests were able to find evidence of infection, so there is hope that people who have been bereaved by a sudden unexplained death in the past can, with more modern techniques and retained tissue samples, discover the cause in the future. However, that will only happen if the research takes place. This research is charitably funded. We heard about the charity-funded research being done in Bristol, but the Government also need to fund research so that we get as much information as possible to prevent these deaths.

Lastly, I will talk about bereavement support. We have heard about the vital role that it plays in helping families, including siblings, in their time of grief, but I have heard about cuts to that as a result of mergers and funding changes to ICBs. In one case, a phone line has been taken away, meaning that families who want to approach bereavement support have to email and wait for a response—I can see hon. Members frowning. This is clearly not good enough, so I urge the Minister to look carefully at it and take the time to find out what is going on in each ICB regarding the commissioning of these services, so that we are not leaving families without the support they need during the most awful time they could ever experience.

What we have heard today is a call for action. We have heard a call to explain the unexplained, support families better, improve on research and, ultimately, to prevent the deaths of children.

[Sir John Hayes (in the Chair)]

In calling my long-standing friend, Mrs Hodgson, I let hon. Members know that she has agreed to leave a couple of minutes at the end for Mr MacNae to wind-up. In turn, he is about to agree to leave a couple of moments at the end for me to move the motion.

Brain Tumour Survival Rates

Debate between Caroline Johnson and John Hayes

Monday 9th February 2026 Commons Chamber

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

I thank the hon. Members for Mitcham and Morden (Dame Siobhain McDonagh) and for Witney (Charlie Maynard) for bringing forward this debate on a very important subject. The hon. Member for Mitcham and Morden talked about the people she had met who had experienced brain cancer and brain tumours. For me, this debate is about my grandfather, who sadly died of a brain tumour some years ago.

Some 12,000 people have a brain tumour diagnosed each year, and this debate is supposed to focus on how we improve the survival rates for this condition, which are very poor. It is the leading cause of cancer deaths among children and adults under 40. The five-year survival rate is poor and—unlike the rate for many other cancers over the last few years—has not really moved at all. How can we improve the survival rates for people with brain tumours? There are essentially three areas that we can look at: prevention, early diagnosis and better treatment.

On prevention, if we look on the NHS website to see how we can prevent a brain cancer or brain tumour, it talks about having a good diet and preventing obesity. These things are important, but not specific to brain cancer. It also talks about trying to avoid head injury, for example by wearing helmets. What about early diagnosis? Some people have genetic conditions, such as neurofibromatosis, Li–Fraumeni syndrome, tuberous sclerosis and Von Hippel-Lindau syndrome, that make them genetically predisposed to having tumours in their central nervous system. Those individuals can receive regular screening, which can help identify these tumours at a much earlier stage, but what about people who do not have such conditions?

[Sir John Hayes (South Holland and The Deepings) (Con)]

I apologise, Madam Deputy Speaker, for intervening despite not being here for the beginning of the debate. My hon. Friend will know that I chair the all-party parliamentary group for acquired brain injury, and I am also president of the Lincolnshire Brain Tumour Support Group—she is right about the connection between the two. Does she think it would be advisable for those who have suffered a brain injury to be screened routinely, given the correlation between an earlier brain injury and the later advent of cancer?

[Dr Johnson]

My right hon. Friend invites me to speak outside my area of expertise; I am afraid I do not know the answer to that.

Crime and Policing Bill

Debate between Caroline Johnson and John Hayes

Report stage
Tuesday 17th June 2025 Commons Chamber

[Dr Johnson]

Every jurisdiction has a democratic right to do as it chooses and I respect that, but it is a tragedy when we hear of cases where late-term abortions have not been supported by medical care or the law, and women and infants have suffered significant harm as a result.

I want to raise the case of Stuart Worby. Some people say that this issue is about protecting vulnerable women, but in this case, which was prosecuted in December 2024, a man who did not want his partner to be pregnant, when she did want to be pregnant, decided to take matters into his own hands. He asked a woman who was not pregnant to get the pills for him. He put them in a drink and gave them to his partner, inducing a miscarriage. He has rightly been put in jail for that, but the case demonstrates that there are men out there who will obtain tablets with the help of a woman. That could not have happened if women had to have an in-person appointment, because the woman arriving at the clinic to get the abortion pills on the man’s behalf would be clearly seen not to be pregnant, so would not be able to obtain the medication. My amendment seeks to protect women—women who are wrong about their gestation or who are mistaken in thinking they have had a bleed or whatever—to make sure that they have a safe termination using the right mechanisms.

[Sir John Hayes (South Holland and The Deepings) (Con)]

I am delighted to tell my hon. Friend that I, too, will be supporting her amendment. There has been a lot of talk in this place in recent weeks about coercion—in a different Bill and in a different context. The kind of coercion that she describes is a reality. It is all fine and well to have a fanciful middle-class view of the world, but as I said in respect of a different Bill, there are many wicked people doing many wicked things. The kind of coercion that she describes is the truth; it is the reality.

[Dr Johnson]

I agree with my right hon. Friend, and I shall come to coercion a little later. First, let me go back to new clause 1, which decriminalises the woman having an abortion in relation to her own pregnancy. It seems to me that what many wish to do is decriminalise abortion up until term. That is a legitimate position that some people take.

Immigration

Debate between Caroline Johnson and John Hayes

Wednesday 21st May 2025 Commons Chamber

[Sir John Hayes]

Of course Brexit and particularly free movement led to a massive influx of people. When David Blunkett, now Lord Blunkett in the other place, was Home Secretary, he estimated that as a result of free movement 13,000 people would arrive in this country. In fact, the figure was in the hundreds of thousands and when settled status was granted it turned out to be millions. So the hon. Gentleman is quite wrong about the effects of Brexit.

[Dr Caroline Johnson]

Will my right hon. Friend give way?

[Sir John Hayes]

I will not because I know others want to get in and I am already testing the Deputy Speaker’s patience.

The truth of the matter is that we need to address migration not only for the reasons I have given about population growth and the damage to social cohesion and the economy, but because unless we do so the British people will assume, and rightly so, that people here just do not get it. Well, I do, and I hope those on my Front Bench now do, and the Government need to wake up and smell the coffee pretty soon.

Solar Farms

Debate between Caroline Johnson and John Hayes

Thursday 15th May 2025 Commons Chamber

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con) [R]]

I beg to move,

That this House has considered solar farms.

I must first inform the House that my husband is a farmer and agricultural contractor.

I am very grateful to the Backbench Business Committee for allowing me time for a debate on large-scale solar farms. There are some things that Members across the House can agree on: we all want cheap and reliable energy, we all want food security and affordable food prices, and we want to live sustainably and to protect our natural surroundings. Whether or not we agree on how we should achieve those goals, I think we can at least agree that these are desirable aims, so why is the issue seemingly so controversial? It is controversial because it is doubtful that large-scale solar farms on prime agricultural land can achieve any of those aims.

First, how good are solar panels? In principle, solar energy is green, but the reality is murkier. The journey of a solar panel, from raw materials to installation, is far from carbon neutral. The production process demands substantial energy, often sourced from fossil fuels. It requires the mining of silver and zinc. It requires energy to produce the intense heat needed to melt quartz for polysilicon, and the transportation of components and finished panels across vast distances by diesel-powered trucks, trains and ships. What happens when the panels reach the end of their lifespan? Recycling should be the obvious answer, yet they are notoriously difficult to recycle. A constituent of mine who dedicated their master’s research to this issue found that most solar panels, once they finish their lifecycle, cannot currently be effectively recycled.

Solar energy is not morally clean either. Most solar panels sold in the UK—an astonishing 97%—contain materials sourced from places where there are concerns about forced labour. Baroness May of Maidenhead, the former Prime Minister, did so much to champion the cause of combating modern slavery during her tenure, and we must not be complicit in human rights abuses in business supply chains. The Government’s decision to U-turn yesterday on the Lords message on the Great British Energy Bill is welcome, but it is shameful that it came only after so much pressure.

Even if the challenges with production, transportation and recycling could be resolved, there are concerns about whether solar energy is the right option for the UK’s energy production at all. Solar energy is most effective in sunny places, where there is high demand for energy when it is sunny. But in the UK the highest energy demand occurs when it is cold and dark. That means energy must be stored, leading to the need for large battery storage systems, which bring their own problems—we would require another debate just to discuss those. In fact, the UK is ranked as second to last on a list of 240 countries in terms of its suitability for photovoltaic electricity production.

[Sir John Hayes (South Holland and The Deepings) (Con)]

There is a further point about suitability. My hon. Friend, as a Lincolnshire MP, will know that our county produces a hugely disproportionate amount of the nation’s food. Compromising food production puts food security at risk, because the solar farms, which are industrial developments, use up land that could otherwise feed the nation.

[Dr Johnson]

My right hon. Friend is of course right, as usual, and I will address that point in more detail later in my speech.

Even if we could resolve all those production, recycling and transportation issues, and so accept that solar is viable for the UK, ground-mounted solar projects are not the right approach. Panels installed so far are relatively inefficient. Despite a currently installed capacity of 17.8 GW, the total output last year was less than 10% of that.

Our current approach is also centred around technology that is outdated. If Members can cast their minds back to 1984, when the first Apple Mac computers were put on the market, and then look today at the present advances in technology, they will see that technology has evolved at a rapid pace. Solar panels planned for fields today are already being superseded by cleaner, more efficient technology that does not need farmland. Researchers in Japan are developing next-generation panels made from iodine. They are flexible and 20 times thinner than existing panels. They would make it realistic to build solar installations on urban infrastructure such as stadiums, airports and office buildings.

--- Later in debate ---

[Dr Johnson]

rose—

[Sir John Hayes]

rose—

[Tony Vaughan]

I will not take any further interventions at this stage. [Interruption.] Members will hear what I come on to say.

We have a decommissioned nuclear power station in Folkestone and Hythe, and I strongly believe that it should be brought back for energy generation. The site has the right location, with proximity to the grid, and a local skills base for these technologies, such as advanced modular reactors. I am grateful to Lord Hunt, the Minister responsible for nuclear energy, for his continued engagement on this issue, but I urge the Government to move faster to create the conditions for advanced modular reactors and other new technologies to become a reality.

On solar, Folkestone and Hythe must play our part in delivering the Government’s clean energy mission, but it should not come at the expense of the fundamental character and beauty of the rural community. People visit Romney Marsh for its tranquillity and beautiful landscapes. We must take our fair share of solar developments to support the Government’s clean energy mission, but covering a large area of Romney Marsh with multiple developments will affect the character of the area. One of the projects would occupy 2.3 square miles of countryside, and there are four more in the pipeline. It is entirely consistent to support the Government’s mission and accept our fair share while saying that there need to be principled limitations and a reasonable amount of development. That is the right position to take.

Solar farms need to be evenly spread across the country. The clean energy mission is a national endeavour, and we cannot have one community in Romney Marsh facing it on their own. [Interruption.] If any hon. Members want to intervene and make legitimate points, they are free to do so.

Gender Incongruence: Puberty Suppressing Hormones

Debate between Caroline Johnson and John Hayes

Wednesday 30th April 2025 Westminster Hall

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

It is a pleasure to serve under your chairmanship, Ms Lewell. I start by making a declaration of interest as an NHS consultant paediatrician and a member of the Royal College of Paediatrics and Child Health. My work in the NHS at times involves looking after children who may have gender dysphoria, although it is not specifically for that purpose. I congratulate my hon. Friend the Member for Reigate (Rebecca Paul) on securing this important debate, and on her excellent speech.

Hippocrates’ dictum, “first do no harm”—although it does not actually appear in the Hippocratic oath—captures a core medical ethic, and is an important guiding principle in policymaking. When it comes to children and young people expressing gender dysphoria, we must take a compassionate but firmly evidence-based approach. The causes of gender incongruence are not fully understood, but they are likely to be multifactorial and influenced by both biological and social factors. It is of huge concern that diagnoses of gender dysphoria have risen over fiftyfold, and that vulnerable and same-sex attracted children are over-represented.

There are legitimate licensed uses for puberty blockers, such as in cases of children who enter puberty very young, and in the treatment of certain malignancies. However, using puberty blockers for young people with gender dysphoria represents a significantly different context, both medically and ethically. With most children with gender dysphoria, symptoms resolve without treatment, with many finding that the natural process of puberty leads to a resolution to their distress.

The Gender Identity Development Service began trialling puberty blockers for adolescents with gender dysphoria back in 2011. Preliminary findings in 2015-16 showed no psychological benefit from the treatment and, alarmingly, a deterioration of wellbeing in some children, particularly some girls. The Cass review, published last year, showed that there is insufficient evidence on the long-term effects of using puberty blockers to treat gender incongruence. I ask the Minister: why does the planned trial not look at long-term outcomes?

The Cass review made the risks of these drugs explicit. Puberty blockers can seriously compromise bone density and can lead to adverse long-term neurodevelopmental effects. As for the purported benefits, the review added that,

“no changes in gender dysphoria or body satisfaction were demonstrated.”

The often repeated justification that blockers are for “time to think” was not supported by the evidence, with concern that they may instead alter the developmental trajectory of psychosexual and gender identity.

In May 2024, the last Government passed emergency legislation to temporarily ban puberty blockers for new treatments of gender dysphoria. The current Government have renewed that order twice, continuing restrictions until the end of this year. However, that does not affect cross-sex hormones. Does the Minister plan to commission research on the outcome of masculinising and feminising hormones on young people? Do the Government plan to extend the ban to cross-sex hormones in the fullness of time?

We heard in February that the NHS has announced plans to start offering puberty blockers as part of a clinical trial. There are questions about this trial. Given that most children’s symptoms will resolve anyway, and that the Cass review clearly states there is no method of proving in advance which children will have improved symptomatology and which will not, the trial will be essentially treating a whole cohort of healthy children with drugs to see the effect on the around 15% whose symptoms may not resolve in adulthood. Former Tavistock clinicians, including David Bell, have said that they would not refer patients to the clinical trial.

The Government are taking direct control of NHS England, so it is now the Secretary of State’s responsibility to ensure that any such trial is properly conducted. The gold standard for a medical trial is the double-blind randomised controlled trial. Will the Minister confirm that if the trial goes ahead there will be a control sample? The trial still requires ethical approval from the Health Research Authority. Will the Minister provide an update on when that decision is expected, clarify how the Government are ensuring the impartiality and safety of the decision-makers, and clarify whether provisions are in place to pause or suspend the trial if safety concerns arise?

[Sir John Hayes]

Might my hon. Friend add to her list of questions and ask about the experience of other countries that have looked at these matters? For those countries that have used alternatives to having children in trials, how effective have such alternatives been?

[Dr Johnson]

My right hon. Friend raises important questions that I hope the Minister will answer. It is important to look at the data that we already have. That was the next part of my speech—my right hon. Friend is, as usual, reading my mind.

Given that these drugs have been used on hundreds of patients at GIDS alone, why not look at that data, rather than conduct new experiments on further children? Despite the last Government legislating to ensure that data could be made available for research, several NHS trusts refused to participate fully in the Cass review. What are the Government doing to retrieve that data and to ensure that NHS trusts, which are now more directly controlled by the Government, comply with data-sharing requirements in the future? If the trial does go ahead, how will the Secretary of State ensure the genuine impartiality of those conducting the trial so that we can rely on the results?

In conclusion, this debate is about the wellbeing of young people. Gender-questioning children are not solely defined by their gender incongruence and gender-related distress; they are whole individuals. They deserve holistic care and the same rigorous evidence-based care as any other young patient.

Tobacco and Vapes Bill

Debate between Caroline Johnson and John Hayes

Report stage
Wednesday 26th March 2025 Commons Chamber

[Dr Johnson]

That is certainly a significant possibility, and that is the reason for moving the amendment, as my hon. Friend will understand.

Illegal products can include smuggled and counterfeit cigarettes, vapes with nicotine levels way above the legal limits, and products containing illegal and potentially dangerous ingredients. They can be more harmful and may not include the appropriate labelling requirements and health warnings that genuine products have to carry. Regardless of whether colleagues support or oppose this Bill as a whole, I am sure we all agree that a black market is unacceptable. We have therefore put forward an amendment that would require the Government to produce annual reports on the rate of sale and availability of illegal tobacco and vaping products and their impact on public health and safety.

[Sir John Hayes (South Holland and The Deepings) (Con)]

My hon. Friend has rightly taken a fierce line on illegal tobacco sales in Lincolnshire. Does she acknowledge that those illegal tobacco sales are often linked to serious and organised crime? The shops that sell them are often linked to money laundering—and are usually foreign owned, by the way—and the damage they do is extreme. Will she join me in urging further action by Government to support trading standards and the local police, who are doing such a fine job in trying to clamp down on this industrial-scale crime?

[Dr Johnson]

As is usually the case, I find myself agreeing with my right hon. Friend, and that is of course why we have tabled the amendment: it will give us the evidence that we and the enforcement authorities require to make sure that the black market is reduced.

Accessibility of Radiotherapy

Debate between Caroline Johnson and John Hayes

Tuesday 4th February 2025 Westminster Hall

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

It is a great pleasure to serve under your chairmanship this afternoon, Sir John.

As we discuss the future of radiotherapy services, it is essential that we acknowledge the vital role our radiographers, medical physicists and oncologists play, along with all the nursing staff and others, in the delivery of care.

The professionals are the backbone of any successful radiotherapy service, and without them progress is impossible. However, it is clear that Governments have faced significant challenges in both staffing and infrastructure. I will take this opportunity to scrutinise the current state of radiotherapy services and the plans to address those concerns. The demand for radiotherapy has increased substantially in recent years, driven primarily by one factor: our ageing population, and the fact that as we grow older our chances of being diagnosed with cancer increase significantly. However, radiotherapy is and remains one of the most cost-effective treatments available within the NHS. Previous Governments recognised that fact, and between 2016 and 2021 they invested £162 million to enable the replacement or upgrade of approximately 100 radiotherapy machines.

Since April 2022, the responsibility for investing in new machines has sat with local integrated care boards in England, supported by the 2021spending review, which set aside money for the purpose. As hon. Members have said, to keep up with increasing demand and the need for cutting-edge care, there must be significant sustained investment in radiotherapy services. Radiotherapy is one of the most technologically advanced areas of healthcare, so it is incumbent on us to keep up with the latest scientific developments.

It is welcome that the Government have announced £70 million for new radiotherapy machines, but Radiotherapy UK has said that that is not enough and has suggested that the Government invest five times that amount to upgrade out-of-date machines. I would appreciate clarification on that point. The Government have consistently stated in written answers that funding for new radiotherapy machines will be allocated by ICBs using criteria set by NHS England, but how will they monitor the upgrading of the machines across ICB areas to ensure that that takes place and to prevent the postcode lottery that Members have described? Furthermore, NHS England has confirmed that it will give high-performing local systems greater freedom around capital spending. Will such freedoms include capital retention, which can be used to invest in new radiotherapy equipment?

One of the most pressing issues is the need for a comprehensive long-term strategic plan for radiotherapy from the Government. The absence of such a plan hinders the ability to think strategically about the future of cancer care and to make the necessary investment to meet growing demand. I am glad that today, World Cancer Day, the Government have committed to produce a new cancer plan. We are told that it will include details about how outcomes for cancer patients, including waiting times, will be improved. Will the Minister indicate whether it will provide specifics on the roll-out of radiotherapy machines in the short, medium and long term?

In response to a written question last month, the Minister clarified:

“NHS England does not hold any data on the effectiveness of radiotherapy machines relative to the number of doses that they deliver.”

Hon. Members have said that newer machines will be able to deliver more doses more quickly. I would be interested to know whether the Department has any plans to collect such data.

Of course, any strategic plan should focus not just on the machines, but on the people who operate them—the radiotherapy workforce. What steps are the Government taking to improve the recruitment and retention of the radiotherapy workforce?

In a written question, the hon. Member for Westmorland and Lonsdale asked the Government whether they had consulted or planned to consult with clinical experts, the radiotherapy industry, patients or charities about how best to allocate the funds announced in the Budget for the new radiotherapy machines. The Minister responded by saying:

“The Department has no plans to consult on this matter”,

and reiterated that the funding would be allocated using NHS England criteria. The Minister today announced the plan to produce a cancer strategy. Will that include radiotherapy? Will he commit to working with Radiotherapy UK and providers to improve access to radiotherapy treatment where it is currently lacking?

The hon. Member for Westmorland and Lonsdale (Tim Farron) made a very compelling case about long journeys. He spoke about a service in his constituency, and there are others that are similarly affected. We know that earlier treatment affects survival rates. I asked the Minister a question in the main Chamber earlier about the 62-day target, and I did not hear him answer. Will he confirm that he intends to stick to the Health Secretary’s previous commitment to reaching the 62-day target by the end of this Parliament?

In addition to Government investment, the private sector plays a role in ensuring the future success of radiotherapy services. The NHS has signed a significant partnership agreement with the independent sector to increase capacity for diagnostic and elective procedures, which will help to reduce waiting times, but it is not clear whether that agreement includes treatment equipment such as radiotherapy machines. Will the Minister confirm whether the Government will work with the independent sector to upgrade equipment such as radiotherapy machines? A partnership that includes capital investment in radiotherapy equipment could ease the burden on the NHS and speed up access to treatment for patients.

I know the Minister is hugely motivated to do all he can to improve cancer care, as we all are. This debate should have helped to give him a steer on how that can be achieved.

[Sir John Hayes (in the Chair)]

I ask the Minister to leave a few moments for Mr Farron to say a final word of wind-up, and Mr Farron, in turn, to leave me a few moments to put the question.

Tobacco and Vapes Bill

Debate between Caroline Johnson and John Hayes

2nd reading
Tuesday 26th November 2024 Commons Chamber

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

Prevention is better than cure. As we have heard, smoking is a cause of many premature deaths and much serious ill health. That was why the previous Government introduced legislation to tackle it and restrict access to tobacco purchases for those born after 1 January 2009. This Bill builds on many measures in the previous one.

As we have heard, this is a Bill of two parts: tobacco and vapes. Those two parts have been received differently, a bit like Marmite and chocolate spread—part controversial, part pretty universally liked. The section on smoking and tobacco has proved to be a bit like Marmite—some people have liked it. My hon. Friend the Member for Harrow East (Bob Blackman) spoke eloquently of his passion for stop-smoking measures, his successful campaigning, and the previous Government’s success in reducing rates of smoking. My hon. Friend the Member for North Dorset (Simon Hoare) spoke eloquently about the balance between libertarianism and choice, and the need for order, societal norms and the protection of others in society. The hon. Member for City of Durham (Mary Kelly Foy) spoke about the dangers of smoking and the difficulties and challenges for people trying to quit.

On the other hand, other Members expressed concern about the Bill. The hon. Member for Lewes (James MacCleary) talked about how the Secretary of State might use powers relating to outside places where people may smoke. The hon. Member for Newbury (Mr Dillon) shared his concerns about how measures on the age of sale will work in practice. Those will indeed be clunky measures for shopkeepers to try to enforce, and will have an effect on the cohort of individuals who are just either side of the threshold, who will require ID throughout their lives. The hon. and learned Member for North Antrim (Jim Allister) spoke about how that measure will work in Northern Ireland, and although he received some assurances from the Minister, I am not sure that they were completely effective.

Although I confess that I do not like Marmite, it is a free vote this evening for Conservative Members, and I will support the Bill. The Secretary of State said in opening that 350 young people will start smoking today, most of whom will regret it, so why was 1 January 2009 chosen? I appreciate that that was the date in the previous Bill, but why did he choose it for his Bill too?

Let me move on to the area of chocolate spread—the part of the Bill on vaping. I think it was universally welcomed, and was supported by the hon. Members for Newcastle upon Tyne East and Wallsend (Mary Glindon) and for North Shropshire (Helen Morgan) among others. It includes measures to tackle vaping among children, on which I have personally campaigned. As others have said, the chief medical officer has been clear that for someone who smokes, vaping may be better, but if they do not smoke, they should not vape. As a Member of Parliament and a children’s doctor, I have been increasingly concerned about the sharp increase in children addicted to vaping and, more recently, to other nicotine products such as pouches. Schoolteachers have reported that children are unable to concentrate, or even complete a whole lesson, without visiting the bathroom to vape.

[Sir John Hayes]

I very rarely disagree with my hon. Friend. She is of course right about vaping, the effect that it has on children and the difficulty that schools have in managing it, as headteachers will no doubt have told Members across the House, but can she really go into the Division Lobby to support the Bill with this nonsense about age? The idea that someone aged 30 could smoke and someone aged 29 could not, and the idea that that could be policed or managed in any practical way, is just nonsensical. It was daft when the last Government introduced it, and it is daft now this Government have done so.

[Dr Johnson]

The challenge is that if we were to ban it altogether, we could risk criminalising people who were already addicted to tobacco products—adults who had made that choice. That is the reason why both present and past Governments put forward a measure to increase the age gradually, but I understand the points that have been made about the difficulties for shopkeepers and others in enforcing it over time.

I return to vaping. Doctors report a growing body of evidence suggesting that children may be having difficulty in school and suffering health problems as a result of vaping. A report from Healthwatch said that 31% of the more than 4,000 under-18s it surveyed were regularly vaping. Nicotine is a powerfully addictive product. Young people are particularly susceptible to it, so it is very important that we protect children from vaping and other nicotine products. After all, vaping is an adult activity; it is apparently designed to help smokers quit. While the industry may argue that the flavours and colours are enjoyed by adults—and they may well be—I struggle to understand why adults would want a vape flavoured like a unicorn milkshake, whatever a unicorn’s milk tastes like. The Healthwatch survey showed that fruit flavours are very popular with children, and the same has been repeated by various teaching unions, the British Medical Association, of which I am a member, Cancer Research UK and even a Government report from last year. I also do not see why an adult stop-smoking device needs to be disguised in the form of a highlighter pen, which could perhaps be hidden in a child’s pencil case, or created in the shape of a children’s cartoon character. Enticing and luring children into a lifetime of unwanted and potentially harmful addiction is immoral.

The Secretary of State is taking powers to regulate the flavours, colours and packaging of vapes, but how will he ensure that he stays one step ahead of an industry whose income depends on a new generation of addicts? He has taken quite extensive powers, which I know is of concern to some hon. and right hon. Members, but how and when does he intend to use them? What support will be given to children who are already addicted to vaping to help them quit?

Finally, while this is a free vote issue, I am pleased on a personal level to see some of the proposals that I put forward on the last Bill being incorporated into this one, particularly on the sponsorship and advertising of vending machines. Whatever our views on this Bill, it is a bold piece of legislation of good intention. It aims to improve the health of our nation and of our children in particular and to reduce smoking and prevent nicotine addiction in the young. It is not clear whether it will work, but we have to hope, for the health of all of us and our children, that it does.