Tobacco and Vapes Bill

Debate between Dan Poulter and Andrea Leadsom

2nd reading
Tuesday 16th April 2024 Commons Chamber

[The Parliamentary Under-Secretary of State for Health and Social Care (Dame Andrea Leadsom)]

I want to start by thanking the many lung cancer and asthma charities, particularly ASH, for their advice, research and support. I personally pay tribute to the chief medical officer for England for his commitment to making the strongest possible case for this life-changing legislation, and to Health Ministers across the UK for their collaboration in what will be a UK-wide solution for future generations.

I was very disappointed with the hon. Member for Ilford North (Wes Streeting), who opened for the Opposition. I have said it before and I will say it again: I like the hon. Gentleman. He once said on air that that was death to his career! Why would he have said that, Madam Deputy Speaker? But I am really disappointed today, because he was not listening. My hon. Friends had some very sensible questions about consultation, and they raised very serious points about flavours for vapes and how they might help adults to quit. He was not listening; he was making party political points. In fact, he barely said anything sensible about the legislation. All he did was talk politics. I appreciate the fact that Labour Members have been whipped to support the Bill. On my side, colleagues are trusted to make their own decisions on something that has always been a matter for a free vote. [Interruption.] He sits there shouting from a sedentary position, political point-scoring yet again.

The hon. Member for Birmingham, Edgbaston (Preet Kaur Gill) raised a very serious question about stop smoking services. I can tell her that the Government have allocated £138 million a year to stop smoking, which is more than doubling. The Government’s commitment to helping adults to stop smoking is absolutely unparalleled.

I thank the hon. Member for East Renfrewshire (Kirsten Oswald) for her support for the Bill, and for the collaborative approach of the Government in Scotland in their work bringing forward this collaboration among all parts of the United Kingdom.

I pay particular tribute to my hon. Friend the Member for Winchester (Steve Brine), the Chair of the Health Committee for his excellent speech and his strong case for long-term policies that will prevent ill health and thereby reduce the pressures on the NHS, which is so important. He asked when we will see the regulations and the consultation on vaping flavours, packaging and location in stores. It is our intention to bring forward that consultation during this Parliament if at all practicable.

I thank my right hon. Friend the Member for Bromsgrove (Sir Sajid Javid) for his tribute to Dr Javed Khan for his excellent report into the terrible trap of addiction to nicotine. My right hon. Friend made the point that it is simply not a free choice, but the total opposite.

I thank the Liberal Democrats and their spokesman, the hon. Member for St Albans (Daisy Cooper), for saying that they will support the Bill on Second Reading. I am not quite sure where they are going on the smoking legislation, but I am grateful for their support on vaping. I hope to be able to reassure them during the passage of the Bill.

The case for the Bill is totally clear: cigarettes are the product that, when used as the manufacturer intends, will go on to kill two thirds of its long-term users. That makes it different from eating at McDonald’s or even drinking—what was it?—a pint of wine, which one of my colleagues was suggesting. It is very, very different. Smoking causes 70% of lung cancer cases. It causes asthma in young people. It causes stillbirths, it causes dementia, disability and early death. I will give way on that cheery note.

[Dr Dan Poulter (Central Suffolk and North Ipswich) (Con)]

I thank the Minister for giving way. I draw the attention of the House to my entry in the Register of Members’ Financial Interests as a practising NHS consultant addiction psychiatrist. Does my right hon. Friend share my concern that what we have heard from the libertarian right today is a false equivalence between alcohol and bad dietary choices, and smoking, and that moderate alcohol and moderate bad eating are very different from moderate smoking, because moderate smoking kills. It means that people live on average 10 years less and it means less healthy lives. Does she agree that this is not about libertarianism but about doing the right thing, protecting public health and protecting the next generation, and that is why we should all support the Bill?

[Dame Andrea Leadsom]

I am grateful to my hon. Friend, who makes such a powerful point and speaks with such authority. Similar points were made by my hon. Friend the Member for Sleaford and North Hykeham (Dr Johnson), who as a paediatrician spoke with great expertise on this matter. It is absolutely true: it is a false choice. It is not a freedom of choice; it is a choice to become addicted and that then removes your choice.

Every year, more than 100,000 children aged between 11 and 15 light their first cigarette. What they can look forward to is a life of addiction to nicotine, spending thousands of pounds a year, making perhaps 30 attempts to quit, with all the misery that involves, and then experiencing life-limiting, entirely preventable suffering. Two thirds of them will die before their time. Some 83% of people start smoking before the age of 20, which is why we need to have the guts to create the first smoke-free generation across the United Kingdom, making sure that children turning 15 or younger this year will never be legally sold tobacco. That is the single biggest intervention that we can make to improve our nation’s health. Smoking is responsible for about 80,000 deaths every year, but it would still be worth taking action if the real figure were half that, or even a tenth of it.

There is also a strong economic case for the Bill. Every year, smoking costs our country at least £17 billion, far more than the £10 billion of tax revenue that it draws in. It costs our NHS and social care system £3 billion every year, with someone admitted to hospital with a smoking-related illness almost every minute of every day, and 75,000 GP appointments every week for smoking-related problems. That is a massive and totally preventable waste of resources. For those of us on this side of the House who are trying hard to increase access to the NHS and enable more patients to see their GPs, this is a really good target on which to focus. On the positive side, creating a smoke-free generation could deliver productivity gains of nearly £2 billion within a decade, potentially reaching £16 billion by 2056, improving work prospects, boosting efficiency and driving the economic growth that we need in order to pay for the first-class public services that we all want.

I know that hon. Members who oppose the Bill are doing so with the best of intentions. They argue that adults should be free to make their own decisions, and I get that. What we are urging them to do is make their own free decision to choose to be addicted to nicotine, but that is not in fact a choice, and I urge them to look at the facts. Children start smoking because of peer pressure, and because of persistent marketing telling them that it is cool. I know from experience how hard it is, once hooked, to kick the habit. I took up smoking at the age of 14. My little sister was 12 at the time, and we used to buy 10 No. 6 and a little book of matches and —yes—smoke behind the bicycle shed, and at the bus stop on the way home from school. [Interruption.] Yes, I know: I am outing myself here.

Having taken up smoking at the age of 14, I was smoking 40 a day by the age of 20, and as a 21st birthday present to myself I gave up. But today, 40 years later—I am now 60, so do the maths—with all this talk of smoking, I still feel like a fag sometimes. That is how addictive smoking is. This is not about freedom to choose; it is about freedom from addiction.

There is another angle. Those in the tobacco industry are, of course, issuing dire warnings of unintended consequences from the raising of the age of sale. They say that it will cause an explosion in the black market. That is exactly what they said when the age of sale rose from 16 to 18, but the opposite happened: the number of illicit cigarettes consumed fell by a quarter, and at the same time smoking rates among 16 and 17-year-olds in England fell by almost a third. Raising the age of sale is a tried and tested policy, and a policy that is supported not only by a majority of retailers—which, understandably, has been mentioned by a number of Members—but by more than 70% of the British public.

Leaving the EU: the Rural Economy

Debate between Dan Poulter and Andrea Leadsom

Tuesday 17th January 2017 Commons Chamber

[Andrea Leadsom]

I do recognise the hon. Gentleman’s point, and it is something I continue to look closely at in my Department. I will keep him up to date with progress on it.

Leaving the EU will give us the chance to develop policies for the rural economy that are bespoke to the needs of this country rather than the different approaches and circumstances of 28 different member states. As Secretary of State, I have made very clear my two long-term ambitions: first, to make a resounding success of our world-leading food, farming and fisheries industry—producing more, selling more and exporting more of our great British food; and, secondly, to become the first generation to leave the environment in a better state than we found it in. These ambitions look far beyond tomorrow; they are about long-lasting change and real reform. They form the bedrock of a balanced approach to policy, and the success of one is integral to the success of the other.

[Dr Daniel Poulter (Central Suffolk and North Ipswich) (Con)]

My right hon. Friend will be aware that one of the difficulties the agricultural sector faces under current EU legislation is with honest food labelling. Some food sold as British in this country is not, under EU regulations, necessarily grown in Britain—it may well have been grown or farmed a long way overseas. One real opportunity on leaving the European Union is that we can have honest food labelling so that we know that food is genuinely grown, farmed and produced in this country.

[Andrea Leadsom]

I share my hon. Friend’s concerns. This is something we have improved on greatly through voluntary and compulsory schemes for labelling, and we continue to look at that, particularly as we leave the EU, so he is right.

That brings me to the mechanics of our departure from the EU. The great repeal Bill will transpose the body of EU legislation into UK law. We will then be able to change or amend it, as UK law, at our leisure. We will soon be publishing a Green Paper consulting on a framework for our 25-year plan for the environment. This will help to inform our decisions, better connect current and future generations to the environment, and ensure that investment is directed to where it will have the biggest impact on the environment. I am sure all hon. Members will agree that our constituents want clean beaches, clean air, clean water, good soil and healthy biodiversity, whether we are a member of the EU or not, and I can assure hon. Members of my full commitment to that.

Oral Answers to Questions

Debate between Dan Poulter and Andrea Leadsom

Tuesday 22nd October 2013 Commons Chamber

[Dr Poulter]

The hon. Gentleman is right to highlight the fact that local commissioners have a duty to ensure adequate community health care provision. I hope that that is an issue that he will take up with them. If he would like help in that fight, I am happy for him to come and meet me, and to bring in the local commissioners to talk this through, as it is important that we have enough community nurses to provide good care in communities and local commissioners need to listen to that.

[Andrea Leadsom (South Northamptonshire) (Con)]

T6. Can my hon. Friend update the House on what he is doing to support the earliest relationships of new families through early years intervention? Specifically, will he support the cross-party “1,001 Critical Days” manifesto?

[Dr Poulter]

I pay tribute to the work that my hon. Friend has done on the early years, and there are many good things in that manifesto. That is why we are investing in an additional 4,200 health visitors by 2015 and why we are supporting the most vulnerable families by increasing to 16,000 the number of families that will be supported by family nurses by 2015. A lot of investment is going into early years, which pays back to the Exchequer and gives much better care to families, too.

EU Working Time Directive (NHS)

Debate between Dan Poulter and Andrea Leadsom

Thursday 26th April 2012 Westminster Hall

[Dr Daniel Poulter (Central Suffolk and North Ipswich) (Con)]

It is a great pleasure to speak under your chairmanship, Mr Brady. I pay tribute to my hon. Friend the Member for Bristol North West (Charlotte Leslie) for securing this debate on an important issue in medicine and in improving front-line patient care that affects every MP’s constituents, whatever the constituency. I also pay tribute to the hon. Member for North Antrim (Ian Paisley) for a real tour de force in his speech just now. In my contribution to the debate, I will touch briefly on some of the points that he made, but I will try to expand on some of the points made by my hon. Friend.

My hon. Friend made a couple of very good points. Early in her speech, she pointed out the effect of the European working time directive, saying that it has effectively taken 4,000 doctors out of circulation. Effectively, therefore, hospitals throughout the country have to recruit an extra 4,000 doctors as a direct consequence of the EWTD. That is a huge financial burden, but it is something that hospitals have effectively had to do in many cases and in many specialities in a very quick fashion—indeed, almost overnight. That has been very difficult to do.

Many hospital services in many parts of the country, particularly the more remote rural areas, are reliant on locum doctors, who are often not necessarily trained in Britain—not that that is a bad thing, because a huge contribution is made to the NHS by overseas workers. However, as has been very publicly highlighted by the Dr Daniel Ubani case, some overseas doctors are not necessarily familiar with the British medical system.

The failings of the EWTD and its implementation go further than just increasing the strain on doctors and the loss of continuity of care for patients. They relate to the way that hospitals have been forced to deal with the shortfall in their rotas and the problem of how they will look after their patients and to the fact that the system that is used to employ locum doctors is not fit for purpose. The General Medical Council and the British Medical Association are looking into those matters. Nevertheless, the failings of the EWTD have exposed a very important issue, and patients are suffering.

My hon. Friend also said that medicine is a profession and a vocation; I know that, too, and I obviously speak from personal experience. Medicine is not about clocking on and clocking off. It is about looking after patients effectively, whenever that may be. The result of introducing the EWTD has been to encourage hospitals, through fear of litigation, to encourage doctors to have a clocking-on and clocking-off culture. That is wrong; it is against the duties of the doctor, as laid down by the GMC; it is against what medical professionals want to do, because they care about their patients; and it is actually bad for patient care, for all the reasons that were outlined earlier by my hon. Friend.

My hon. Friend said that we do not want to go back to the bad old days of 100-hour weeks. I worked those 100-hour weeks, and I am sure that the other medical doctors who are in Westminster Hall today did so, too. It was certainly not ideal to work 100-hour weeks; it was not good for patient care. However, the point that was made earlier is that there is actually a happy compromise between doctors working a rota pattern—one that allows for training, continuity of care and proper treatment of patients—and ensuring that doctors have proper rest and are in a fit state to look after their patients. That happy compromise can be achieved. As has been highlighted already in speeches and interventions, it has been achieved in many countries within the European Union, and we should be able to achieve it effectively in this country, too.

The point that has been highlighted is that the previous Government dressed up the introduction of these reforms in the idea that they would be better for doctors with families and better for doctors’ training. In fact, neither of those things have actually come to pass. Doctors’ training has suffered as a result of the introduction of the EWTD in this country. Doctors do not get enough on-the-hour time with patients, and because many hospitals are forced into looking at service provision—in other words, having enough doctors on the ground as a direct consequence of the EWTD—the time allocated for junior doctors to receive proper training has been reduced massively. Given the rigid nature of the rotas introduced under the EWTD, they are often less family-friendly than rotas were in the past when doctors were asked to work more hours than now.

My hon. Friend highlighted the increased rates of sickness, particularly among physicians but also in other specialities where—quite rightly—an increasingly high proportion of women are entering the medical profession. In many cases, the reason why those women are finding things difficult and taking time off work is that they are unable to meet the demands of looking after their family properly. The fixed rotas are damaging to family life. My hon. Friend has made some excellent points.

I will now talk about a few other issues that are important to highlight in this debate. The Minister is working hard on our behalf to address the EWTD issue, by raising it in Europe for the Government and ensuring that we can put right what the previous Government got wrong. The issue of locum doctors goes to the heart of out-of-hours care. Many hon. Members, particularly those of us with more rural constituencies, have experienced the previous Government’s reforms of out-of-hours care by GPs. Thanks to those reforms, we now have a system that is not fit for purpose. We have locum companies running local out-of-hours care on the basis of care models that are, in many respects, not fit for purpose. Many locum companies often employ out-of-area doctors who do not understand local patients to run those services.

[Andrea Leadsom (South Northamptonshire) (Con)]

I am grateful to my hon. Friend for giving me the opportunity to make my point. Does he agree that there is also a great concern about the fact that other European legislation means that the GMC cannot systematically check locum doctors’ ability to speak English and communicate with their patients and that that is also putting patients’ health at risk?

[Dr Poulter]

My hon. Friend makes a very good point and the issue that I was just raising—that of locums and out-of-hours care—ties in very well with it, because those checks and balances very much occur in the sector of locum work. To fill staff vacancies in GP rotas in primary care and in hospital rotas, doctors are often rushed in at short notice from locum firms, even though we have not necessarily got the proper checks that would be in place when doctors are working in hospitals.

As I have said, doctors from overseas make a huge and valuable contribution to the NHS, but they do so when they have been familiarised with the British medical system and they are embedded in our hospitals up and down the country. However, there is a real danger: when we have an over-reliance on locums, which is a direct consequence of the EWTD, the problems that my hon. Friend has highlighted occur, and that has damaging effects for patients.

The key issue for me in this debate is the continuity of care. The point has already been made in interventions that bad things happen to patients at weekends and out of hours, because there are fewer doctors, nurses and members of staff working in the hospital. If we have a system in place whereby doctors are clocking on and clocking off and they are encouraged to do so because hospitals are worried about the dangers of litigation and that encourages the handover of information to another professional because people think, “I’ve finished now; it’s not my job anymore,” that will encourage bad things to happen out of hours.