Environmental Protection

Debate between Christopher Chope and Caroline Johnson

Wednesday 13th November 2024 Commons Chamber

[Sir Christopher Chope (Christchurch) (Con)]

It is a pleasure to follow my hon. Friend the Member for Sleaford and North Hykeham (Dr Johnson), who has brought a lot of knowledge to the debate.

I want to begin by referring to the hon. Member for South Dorset (Lloyd Hatton). The last time I was this close to him was early in July, before polling day, when I was standing in a pub garden overlooking Chesil beach with my good friend Richard Drax. I very much enjoyed listening to his tribute to Richard Drax, who was not only a good friend of mine, but a great servant of democracy. He contributed enormously to the successful campaign to leave the European Union, after which he was a diligent member of the European Scrutiny Committee. He was also extremely active on what was his great love: trying to ensure that we maintain strong defences in our country, and he used his military background to great effect in debates.

However, I have to tell the hon. Gentleman that he is lucky to be here. I have every confidence that, had it not been for the previous Government’s intransigence over the Bibby Stockholm, Richard Drax would still have been in this House, so it was with mixed feelings that I listened to what the hon. Gentleman had to say, but I extend a warm welcome to him. I am sure that he and I will do our best to ensure that Dorset continues to improve its provision of good-quality services to all its citizens.

Turning to the subject of the debate, it came as a bit of a disappointment that neither the Minister nor my hon. Friend the Member for Epping Forest (Dr Hudson) referred much to the unintended health consequences of outlawing disposable vapes. There is already a real problem with illegal disposable vapes—it is estimated that probably one third of vapes are illegal. Those are already bad for the environment, but what will the measures do to address that problem? Not very much, I fear. As I said, it is estimated that some 360 million disposable vapes got on to the market in the United Kingdom in 2023. I had a briefing from British American Tobacco, which highlights that 4.5 million illegal vapes were seized at the border by His Majesty’s Revenue and Customs in 2023. The gap between the 4.5 million illegal vapes seized, and the 360 million estimated to be in circulation, highlights the gravity and extent of the problem, particularly when we extrapolate into the future; the number of illegal vapes could be as high as 1 billion by 2030. That is an enormous amount of income for people engaged in black market trade, people smuggling, and other illicit activities.

[Dr Caroline Johnson]

Does my hon. Friend accept that it is quite difficult for the consumer to establish which vapes are illegal and which are not? One may have thought that going into a reputable supermarket to buy such a product was a surefire way of ensuring that it was safe, but we have heard examples of major supermarkets selling a well known brand of vapes that had more in them than was legally allowed. If we ban disposable vapes, it will become very clear: all disposable ones will be illegal.

[Sir Christopher Chope]

The information I have about the extent of illegal vapes in the marketplace comes from the Government. In their impact assessment for the Tobacco and Vapes Bill, which will be debated in the next fortnight, the Government accept that about 30% of the market is illegal, and that is where I got my figures. My hon. Friend refers to supermarkets. I am not suggesting that there is any illegal activity in supermarkets or among responsible retailers.

[Dr Johnson]

My point was that there have been examples of supermarkets unknowingly selling vapes that did not meet requirements, and it is difficult for a consumer who puts a disposable vape in each hand to identify which is allowed and which is not. As a result of the new regulations, they will be able to tell, because both will not be allowed.

[Sir Christopher Chope]

I am not sure that will help much. My hon. Friend refers to the packaging of vapes, but the number of vapes described as refillable or reusable is projected to increase exponentially over the next several years. The question I asked—I did not really get an answer from the Minister—is what the impact will be of all those refillable or reusable vapes on the environment. The same issues to do with what goes into the manufacture of vapes apply to both disposable and reusable vapes. Why would we need to have 2 billion reusable vapes being sold by 2034 if they are not being disposed of? Just because they are described as reusable does not mean that they cannot be disposed of after one use. My hon. Friend the Member for Sleaford and North Hykeham made the point that we need to be wary of how the Chinese, who are the leading manufacturers and exporters in this field, may well adapt their products to try to circumvent these regulations. In any event, what they and other manufacturers are producing is a cost on the environment, in the sense that they are using scarce resources.

Let us not be naive: the fact that something is reusable does not mean it is a permanent fixture. For example, in my parents’ day, they used to smoke cigarettes through a filter that they held. Even those filters were not permanent. I remember many occasions on which my parents said that they had to get rid of the filter and replace it with another. Do not let us be naive and think that this enormously large number of reusable vape devices that are projected to be sold in 2034 will not end up in landfill.

[Dr Johnson]

I am interested to know: is my hon. Friend trying to argue that the Government should have gone further and banned all vapes, including those that can be refilled?

[Sir Christopher Chope]

I am not suggesting that; I am referring to the impact assessment. The Minister, in responding to my intervention earlier, referred to the statement made yesterday to the effect that a new magic pill will be available on the NHS to enable people to be weaned off smoking and, in particular, the nicotine effects of smoking. When bringing that forward, the Government said that the new pill would be as effective as vaping. They did not suggest it would be more effective, but as effective, thereby recognising the important role that vaping has in promoting public health.

These regulations are being brought forward on the basis of the environmental benefits that will flow from them, but let us be clear that there is little provision for enforcement. Reference has been made to the additional burden on local authorities. Paragraph 183 of the regulatory impact assessment states:

“There will be costs associated with inspection and law enforcement services to support the ban. Trading Standards Authorities (TSAs) would be best placed to enforce the ban, and work will be undertaken with LAs to establish the most effective and efficient way of enforcement.”

The impact assessment goes on to calculate that the enforcement costs will be low, because the assumption is

“as per Better Regulation guidance to assume 100% compliance by businesses.”

If we make that assumption—in my submission, it is a false one—it can lead to the acceptance of figures from the Government that no additional costs will arise from enforcing these new regulations. I think that is a load of nonsense.

[Sir Christopher Chope]

I am grateful to the hon. Gentleman for listening to the points that I have been making. They can be summed up as: smoking costs lives; vaping saves lives. Therefore, if we can encourage more people to vape rather than smoke, that is to the benefit of public health and the individuals affected, as well as assisting those who suffer as a result of secondary smoking or passive smoking. The consequence, which is accepted by the Government in their impact assessment, is that by taking these measures against single-use vapes, quite a lot of people who currently use them will go back to smoking.

Vapes have a 65% success rate in enabling people to quit smoking. The chief executive of Action on Smoking and Health said that “scare stories” about young people vaping could be causing the misconception among adult smokers that vaping is at least as risky as smoking. We know that it is not. Compliant vapes do not contain tobacco and do not produce smoke, and vape aerosols do not contain the harmful chemicals found in tobacco smoke. Why are the Government therefore proposing to introduce regulations, which, on their own figures, will result in about 26% of people going from vaping back to tobacco products?

[Dr Caroline Johnson]

My hon. Friend is referring to an important issue. I know that he is concerned about personal responsibility and people’s ability to make their own choices. The Government face something of a choice between the protection of an adult—a former smoker who is now vaping, who will be presented with a choice of going back to smoking, stopping vaping or using a reusable vape—and the protection of children. Surely the protection of children is more important, as adults are free to make their own choices about what they wish to do, as long as it is an informed choice.

[Sir Christopher Chope]

There is already vaping among children. As the hon. Member for Newcastle upon Tyne East and Wallsend (Mary Glindon) said, children cannot buy vapes and should not be using them, but if children are going to choose between vaping and smoking, it is better that they should go for vaping rather than smoking. One of the unintended consequences that may flow from the regulations is that, instead of using vaping products, an increasing number of children will go back to smoking behind the bike sheds, or whatever the modern equivalent is.

Sepsis Awareness

Debate between Christopher Chope and Caroline Johnson

Wednesday 9th October 2024 Westminster Hall

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

It is a pleasure to serve under your chairmanship, Sir Christopher. I congratulate the hon. Member for Ashfield (Lee Anderson) on securing a debate on this very important topic. I should also declare an interest as an NHS consultant paediatrician. I have cared for and continue in my work to care for people with this condition.

I would like to thank Abbi for coming today. It was an honour to meet earlier today and to hear her story from her MP, which highlighted both the difficulties she faced in getting good immediate care for sepsis and the consequences of that. I commend her for the bravery she has shown in coming today and for raising this issue for the benefit of other people. This debate will increase awareness, which is a very positive thing.

I remember sitting in the Chamber earlier this year when the former hon. Member for South Thanet re-entered Parliament to a standing ovation—an exceptionally rare occurrence in the House of Commons. It is truly humbling to reflect on the journey that he has been through in such a short space of time. Little over a year ago, he had no outward signs of sepsis at all. He has now become one of the most well-known advocates for people with it. His case brought renewed attention to this disease, which kills nearly 50,000 people in the UK every year. As the hon. Member for Ashfield said, that is around the same number of people who die from bowel, breast and prostate cancer combined.

The case of our former colleague speaks to not only a remarkable recovery but the suddenness with which sepsis can utterly change someone’s life. As many people have said today, early identification is vital. Under the previous Government, awareness of sepsis improved significantly, as did the clinical recognition of symptoms, screening rates and the administration of antibiotic treatment, but there is much more to do.

I want to commend the UK Sepsis Trust and other public campaigners who played a significant role in improving awareness among the general public. A recent YouGov survey showed that the UK has high levels of public awareness compared with other countries. Will the Minister say what steps the Government will take to work with NHS England and patient groups such as the UK Sepsis Trust to raise public awareness, so that people can more easily identify the signs of sepsis? I have also asked this of another Minister, but have not yet received an answer. The Chancellor said that she was cutting the communications budget—can the Minister confirm that those cuts will not affect the important public health messaging for campaigns like this? It is important that we do not cut budgets that will save people’s lives and, indeed, save the NHS money. It is also important to raise awareness not just across the general public, but among health professionals, including medical staff in both hospitals and communities.

The national early warning score has been introduced and is being rolled out, along with the sepsis six, which was developed with the UK Sepsis Trust. The six—oxygen, cultures, antibiotics, fluids, lactate management and urinary output monitoring—must all be carried out within the first hour. Has the Minister established how well those measures are being rolled out across the UK, and what is he doing to ensure that is being done effectively? The National Institute for Health and Care Excellence updated its guidance earlier this year. Will the Minister update the House on how effectively that guidance has been implemented across the UK? Martha’s rule was introduced before the election; the rule relates to the ability for people to get a second opinion from another health professional if they remain concerned about their loved one or themselves. Will the Minister update the House on the work the NHS is doing to roll that out, too?

Research is the cornerstone of transforming sepsis care, and the last Government invested more than £1 billion through the National Institute for Health and Care Research. It is important that we research the causes of and treatment for sepsis, but we must also research new antibiotics, because we are starting to see antibiotic resistance to infections. If we do not invest in antibiotic research, new antibiotics will not be developed—we are essentially asking people to develop a drug to be kept on the shelf for when we need it, and there is no money in that, so it will not get commercial take-up. It is therefore important that the Government invest in that.

The UK Sepsis Trust is calling on the Government to publish data on the sepsis care pathway so that we can see where it is performing well and where it is performing less well. I urge the Government to do that. It would be helpful if the Minister could confirm today that they will do so.

As we close the debate, let us remember what we are fighting for. Sepsis takes the lives of 50,000 people every year. It strikes suddenly and often without warning, as Lord Mackinlay’s case reminds us so powerfully. Early identification and rapid treatment are the keys to saving lives; we have made strides, and awareness is growing, but we must do more. We must continue to improve recognition, strengthen control and push forward with life-saving initiatives. I urge the Government today not just to maintain their commitment but to strengthen it by partnering with NHS England, publishing more data, researching the causes of sepsis and ensuring we can fight this disease together.

[Sir Christopher Chope (in the Chair)]

I thank the Front Benchers for sticking to their five minutes, which means the Minister now has 10 minutes; there will hopefully also be a couple of minutes for the proposer to reply.

Covid-19 Vaccines: Safety

Debate between Christopher Chope and Caroline Johnson

Monday 24th October 2022 Westminster Hall

[Dr Johnson]

I thank my right hon. Friend for his kind words. I will, of course, look at all the evidence. He is aware of my experience as a clinician and he knows that I will look at the evidence-based medical process.

As part of the surveillance into currently used medicines and vaccines, the MHRA continues to review all the suspected adverse drug reaction reports—known as the yellow card reports—relating to covid vaccines, which right hon. and hon. Members have mentioned. Through the MHRA yellow card scheme, members of the public and healthcare professionals can report any suspected side effects. A comprehensive surveillance strategy alerts us to any unforeseen adverse reactions to the vaccine, to enable us to act swiftly when required.

In April 2021, we quickly responded to reports of extremely rare cases of concurrent thrombosis and thrombocytopenia following vaccination with the first dose of AstraZeneca. At that point, the Joint Committee on Vaccination and Immunisation advised that adults under 30 without underlying health issues should be offered an alternative vaccine to the AstraZeneca if one was available. That was later extended in May 2021 to adults under 40 without underlying health issues. The MHRA, as my hon. Friend the Member for North West Leicestershire (Andrew Bridgen) said, has undertaken a thorough review of UK reports of thrombosis and thrombocytopenia. While the estimated incident rate has increased over time as awareness of the condition increases across the healthcare system, the number of cases remains extremely low, given that more than 49 million doses of AstraZeneca covid-19 vaccine have been administered.

A number of colleagues asked about myocarditis. There is no evidence that people are at an increased risk of cardiac arrest in the days and weeks following the vaccine. The risk of getting myocarditis or pericarditis after the vaccine remains very low. A large study of 4 million vaccinated people in Denmark, published in the British Medical Journal, found that there were no deaths or diagnoses of heart failure in people who were diagnosed with myocarditis or pericarditis after being vaccinated.

In the highest-risk group, those aged 18 to 29, until the end of September this year there were 29 cases for every million second Pfizer doses and 68 cases for every million second Moderna doses given in the UK. The risk is much lower after a booster dose, and in other age groups the risk is lower still. However, it is worth remembering that catching covid-19 can significantly increase the risk of cardiac arrest and death, and the risk of developing myocarditis. There are an estimated 1,500 cases of myocarditis per million patients with covid—far greater than the risk of myocarditis following vaccination.

Let me turn now to some of the questions that have been asked. My hon. Friend the Member for Carshalton and Wallington asked about the inquiry and how people would be able to contribute to it. It will listen to and consider carefully the experiences of bereaved families and others who have suffered loss as a result of the pandemic. It will not consider individual cases; instead, listening to such accounts will inform its understanding of the impact of the pandemic and the response, and any lessons to be learned. Individuals will be able to engage through the inquiry’s listening exercise and the details of that will be brought forward in due course.

My hon. Friend the Member for Christchurch (Sir Christopher Chope) asked about informed consent. Indeed, I think that he produced the leaflet that provides the information that allows people to understand that the JCVI has recommended the vaccine because on balance it is beneficial to people; it is more likely to be of benefit to them than harm. Equally, however, each individual will be provided with information about the vaccine, as they are with all medical treatments, so that they know the benefits they can expect and the risk of side effects, however small, as well as what they are. As I say, he produced an example in the debate of a leaflet containing such information. What is important is that people are aware of the benefits and risks and can make informed decisions. Vaccination is not compulsory, but we are aware that it is of great benefit to the population and to individuals at risk of covid.

[Sir Christopher Chope]

What happens if somebody suffers a 50% disability as a result of having the vaccine, through an adverse reaction, or an unusual event? What do the Government do to help that person? They do not provide any compensation, or any special help through the health service, or a clinic, so what do they do?

[Dr Johnson]

My hon. Friend is talking about the vaccine damage payment scheme, which has been running since 1979 and provides a payment of up to £120,000—a tax-free lump sum, a one-off payment—for people who have been severely damaged by vaccines, on the balance of probabilities, which is determined when people apply. That does not prejudice any claim that they may have in a legal sense and they can still pursue a civil claim should they wish to do so. It has been asked whether there should be a separate scheme for covid, but of course it is right that all vaccines are treated in a similar fashion.

My hon. Friend the Member for Devizes (Danny Kruger) asked a few questions. He asked about the terms of reference of the inquiry being a matter for the chair, which indeed they are. He also asked whether I would commit the chair of the MHRA to meet specific people, but that is not for me to decide; it is up to the chair. My hon. Friend’s other question was about children’s vaccines. He is aware of my thoughts on that: it is important when we vaccinate children that the vaccines are of benefit to the child themselves. I am aware that when the vaccine was approved that was the decision made by all four chief medical officers and it is very important that the Government listen to and take medical advice. Since then, some things have changed. Natural immunity is more widespread and school disruption is no longer an issue. I understand that very shortly, at its next meeting, the JCVI will consider whether children’s vaccines should continue to be recommended, on the basis of the current situation. I think it is right that medical research is reviewed regularly as it becomes available and is taken into account.

The position of the MHRA remains that for most people the benefits of the covid-19 vaccine continue to outweigh the risks. The surveillance strategy is working, as we have discussed. We are able to respond quickly to ensure safe administration of all covid vaccines. I reiterate that the public should be very confident that all tests are completed to the very highest standards and that vaccines are safe.

Despite the progress we have made, we must not become complacent.

--- Later in debate ---

[Sir Christopher Chope]

Would the Minister be willing to address the all-party parliamentary group on covid-19 vaccine damage in a private meeting, so that she can hear at first hand some of the concerns that members have?

[Dr Johnson]

I thank my hon. Friend for that question. He will be aware of events today and I will at least have to see whether I remain in post before I potentially commit somebody else to such an event.

As I was saying, despite the progress we have made, we must not become complacent. We cannot risk an increase in serious illness, hospitalisations and deaths from covid. The UKHSA estimates that vaccinations had averted up to 128,000 deaths and 262,000 hospitalisations by the end of September 2021, and many more since then.

We must do everything in our power to protect those who are most vulnerable to the virus and keep pressure off the NHS in a tough winter period. Viruses such as covid-19 spread much more easily in winter when we socialise indoors. To protect those most at risk and help to reduce pressure on the NHS, we are delivering an autumn booster dose to those who are most in need of an extra layer of protection. Even if someone has had all of their jabs so far, and perhaps had covid too, they might still need an autumn booster to strengthen their protection. I encourage everyone who is eligible to come forward for their covid booster and seasonal flu jab today. To encourage vaccination against covid and flu and boost uptake, the NHS is making every effort to make it as convenient as possible for individuals to take up the offer, including offering both covid and flu vaccines at the same time, where possible, to reduce the number of appointments needed. Our NHS staff and volunteers are pulling out all the stops to deliver the next phase of the covid vaccine programme at speed once again, with more than 3,000 sites up and down the country involved.

The NHS was the first healthcare system in the world to deliver a covid-19 vaccine outside clinical trials, and it is now the first to deliver the new, variant-busting vaccine. Bivalent vaccines target two different strains of covid-19. They will give us a broader immunity and therefore potentially improve protection against variants of the virus. Whatever vaccine people receive in the autumn booster programme, they can be assured that it remains effective in preventing severe disease against all current variants and any potential future variants.

As I draw to a close, I thank my hon. Friend the Member for Carshalton and Wallington for bringing this important debate to the House at such an important time. The Government have already commissioned a public inquiry into the pandemic, and covid vaccines will be reviewed as part of that inquiry. There are no plans for an inquiry solely on vaccine safety. We face a tough winter ahead, and collectively we must do everything we can to protect those who are most vulnerable and to reduce pressure on the NHS. I encourage everyone who is eligible to step forward for their covid and flu vaccines as soon as they are able.