National Health Service

Diane Abbott Excerpts

Wednesday 21st January 2015 Commons Chamber

[Mr Burns]

First, competition was introduced on the current scale by the Blair-Brown Government, and secondly, there is nothing wrong, per se, with competition to get the best providers providing the best care for patients, so long as they keep to the sole ethos of the NHS, which is that that good care be provided free at the point of use for NHS patients. We saw that under his Government and under the Major Government, and this Government have used the private sector to ensure that patients are treated more quickly. We want them to be treated as quickly as possible, and if there is not enough capacity in the NHS, and if a private provider can provide the capacity, I see nothing wrong with that, and neither do most people in this country, if they are treated more quickly.

Returning to the walk-in centre, there were 40,000 attendances last year, 10,000 of which were by people beyond the Mid Essex CCG area. Of the remaining attendances, one third should have been self-caring or using their community pharmacy or 111, which the CCG is paying for, and another third should have been using their community pharmacy or GP, which the NHS is paying for. The CCG was therefore paying twice for the same care for the same patients, which is an utter waste of money. That money should be being used to care for more patients quicker, which is why the CCG has taken the decision it has. It is a rational decision, because the centre is failing to meet the aims it was set up for and instead ensuring that the NHS pays twice for the same patient to be treated. In place of the walk-in centre, there will now be an urgent care service at the local hospital for those people who should be going there. Sometimes, politicians have to do the right thing, regardless of political point scoring. Where it is in the interest of patients and the configuration of services, they should take the right decision, be reasonable and responsible and explain why it is the case.

In conclusion, I am delighted to see the hon. Member for Hackney North and Stoke Newington (Ms Abbott) in her place. I am fascinated to note that the nub of the motion is a call for an extra £2.5 billion for the NHS, which I am sure she strongly supports. What worries and concerns me—she may have a problem when it comes to voting at 7 o’clock tonight—is that the motion goes on to say that it is going to be

“funded by measures including a tax on properties worth over £2 million”.

Given the battle the hon. Lady had on the radio with a member—a right hon. Member— of her party from a southern Scottish constituency, I imagine that she is in turmoil, wondering how to justify that funding from that source.

[Ms Diane Abbott (Hackney North and Stoke Newington) (Lab)]

I am in no turmoil whatever. I will be walking through the Lobby with pride behind my hon. Friends. We cannot know exactly how much a mansion tax, if levied, would raise towards the national health service. What we do know is that the British people who want to save the national health service from the depredations of Government Members have to vote Labour. We have to vote for my right hon. Friend the Member for Leigh (Andy Burnham) to become Secretary of State for Health—

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. We do not need a statement; we have got the message.

A and E (Major Incidents)

Diane Abbott Excerpts

Wednesday 7th January 2015 Commons Chamber

[Mr Hunt]

I am aware that there have been particular pressures at Northwick Park hospital, but I am also aware that a plan is in place in north-west London to have weekend opening of GP surgeries to improve out-of-hospital provision. The pressures that are faced there are like those in the rest of the country—very severe. We are doing everything we can to support the hospitals in that area with our winter pressures plans.

[Ms Diane Abbott (Hackney North and Stoke Newington) (Lab)]

The Secretary of State spoke about the algorithms used by 111 call handlers. Does he appreciate that a frightened mother with a sick child is not really interested in algorithms? What she wants to know is that her child can get the medical help that they need promptly. He has told the House that he has been having meetings on this winter crisis since March. Is he not a little bit embarrassed that we now have people queuing to see their GPs first thing in the morning, ambulances queuing outside hospitals, people being treated in tents outside hospitals, and old people staying in hospital longer than they need to because there is a lack of funding and no proper co-ordination between health and social care?

[Mr Hunt]

Of course I regret any individual incidents where people do not get the care they need promptly. The hon. Lady will know that the solutions to such problems are not always things that can be done overnight. If she looks at the record of joined-up care over the past few years, she will see that this is the first Government to encourage 150 local authority areas to sit down with their local NHS and jointly plan care for the most vulnerable people in the social care system. That is a very big step forward. We are also doing nearly 1 million more operations every year across the NHS. In accident and emergency, the number of people being seen within four hours has gone up by nearly three quarters of a million since the start of this Parliament. That is real progress, but of course there are long-term issues, and we will focus on those as well.

UK Ebola Preparedness

Diane Abbott Excerpts

Monday 5th January 2015 Commons Chamber

[Mr Hunt]

I can absolutely give the hon. Gentleman that assurance. When we have decided to change protocols, they have been changed within hours, not within days.

[Ms Diane Abbott (Hackney North and Stoke Newington) (Lab)]

Pauline Cafferkey is a heroine and the thoughts of the whole House are with her and her family at this difficult time. Many people will be glad that the Secretary of State mentioned the hundreds of African health workers who have died fighting Ebola, showing extraordinary heroism and devotion to duty. Our constituents, including those linked to families in that region, will want to know that we will continue to give the region all the support we can in fighting Ebola long after it has dropped from the headlines.

[Mr Hunt]

I could not agree more with the hon. Lady. Some 382 health care workers have died of Ebola, and it is worth saying that they include not just local people from Sierra Leone, Liberia and Guinea, but people from all over Africa as well as small numbers from other parts of the world. The very least we can do is to continue to support an aid budget, which will allow them to continue to improve their local health care systems.

Tobacco Products (Standardised Packaging)

Diane Abbott Excerpts

Thursday 3rd April 2014 Commons Chamber

[Jane Ellison]

I thank my hon. Friend for his comments. Taking every possible effective measure to stop children smoking is the mark of a sensible state, not a nanny state. I do not think any Member of the House would want any extra child to take up smoking, so every Government should look clearly at any effective policy that can serve to advance the achievement of our ends in that regard. Sir Cyril devotes a significant chapter in his report to illicit tobacco products, and I urge my hon. Friend to read it. Of the arguments in that area, Sir Cyril says, “I am not convinced”.

[Ms Diane Abbott (Hackney North and Stoke Newington) (Lab)]

The House listened with care to the Minister’s statement, and the backlash from her own Back-Benchers was predictable. The medical profession and doughty campaigners such as Action on Smoking and Health will be very glad that we are making progress on this issue. Can she confirm that she will bring forward the regulations before Christmas, so that standardised packaging is a reality before the general election?

[Jane Ellison]

I welcome the hon. Lady’s response. I know that she, as a former shadow Public Health Minister, takes a great interest in this area. I want to publish the draft regulations this month, alongside the short final consultation. The timetable that the Government are contemplating once a final decision is made should allow us to introduce the measure during this Parliament.

Health Care (London)

Diane Abbott Excerpts

Wednesday 8th January 2014 Westminster Hall

[Mark Field (Cities of London and Westminster) (Con)]

It is a pleasure to serve under your chairmanship, Mrs Main. I congratulate the hon. Member for Westminster North (Ms Buck) on securing this valuable debate. Although her conclusion was perhaps a little more hyperbolic than mine would have been in the circumstances, we work closely together, along with her hon. Friend, the hon. Member for Hammersmith (Mr Slaughter), to do our best for all our constituents. Over the past year or so, as we have tried to put our constituents first, we have had concerns about elements of the negotiations on this matter.

For all the lively debate about health care provision here in the capital, there is one thing on which we can all agree, as the hon. Lady made clear in her contribution: the pressures on the national health service here in London are huge and getting bigger. They are set to increase substantially, not only because the population is ageing but because of the hypermobility and hyperdiversity of that population. In the past, that was perhaps typical of inner London alone, but it now applies to the entirety of the capital.

At times, the national health service can seem a little like a national religion, whose traditions must not be questioned under any circumstance. In my view, if one good thing has come from the terrible events in Mid Staffordshire, it is that we can perhaps start to have a more honest and less ideological debate about where the NHS is performing well, where it is letting people down and how it can better tackle the future challenges to which the hon. Member for Westminster North referred.

I have enormous respect for the Secretary of State for unashamedly refocusing the NHS around patients rather than protecting the sanctity of the system. Thankfully, the patient experience at some of our central London hospitals is, as the hon. Lady rightly pointed out, a world away from what happened in Mid Staffordshire. The diversity of population and the presence of top-flight medical schools and universities, particularly in central London, inevitably draw global talent to our local hospitals.

I am often staggered by the quality of facilities here, whether the state-of-the-art birthing unit in St Mary’s or the Royal London, the beautiful Maggie’s cancer centre at Charing Cross or the brand new oncology unit at Barts in my constituency. Only yesterday, a constituent wrote to me about his young nephew’s recent stint in hospital. He said:

“Given it seems it is ‘in vogue’ to be ‘anti-NHS’ I wanted to let you know that my recent experiences with the high dependency unit at Chelsea and Westminster Hospital”—

that hospital is outside my constituency, but obviously caters for a lot of my constituents in the south of Westminster—

“were nothing short of exemplary. I am sure that my nephew’s speedy recovery was probably all down to the standard of care he received.”

More often in my constituency, non-emergency services fail to be so patient-focused. Londoners are spoilt for choice in so many aspects of their lives, and as a result they have the idea that they should expect to get a full choice in everything. Why should they not expect a similar consumer-driven, flexible and responsive system when it comes to primary care—one that allows them swift access to a GP or provides small surgical procedures outside hospital?

We have read a lot in recent days about the number of non-emergency cases being presented at A and E departments. I think that that is in part due to the hassle factor associated with the existing GP system. With the hypermobility of population in London, many people never bother to register with a GP, and those who do all too often find that they cannot get an appointment for days or at a time that is convenient for someone with a busy working life. It is therefore often a perfectly logical decision for those people to spend a few hours in A and E, where they are at least guaranteed to be seen.

Thankfully the story is rapidly improving for my constituents. The Central London clinical commissioning group has just extended its seven-day GP opening service from three practices to five. People are able to walk in and book a same-day appointment at those practices. They do not have to be a member of the practice to use the service, and registration with their own GP will not be affected. I also know that plans are afoot to locate more GPs within hospitals in London. That type of modern and practical response really needs to be rolled out more widely.

There are problems with the health service in central London, which my colleague the hon. Member for Westminster North has so carefully outlined. My own constituency will hopefully be affected for the better by the huge changes to be brought in by the “Shaping a healthier future” programme. That programme began some five years ago to respond to the challenges of a rapidly increasing population and the variation we were seeing in the quality of acute care. It has caused most controversy in its proposals to close a number of A and E departments.

My constituents are grateful, as are the hon. Lady’s, that St Mary’s hospital in Paddington has been confirmed as one of five north-west London hospitals to provide advanced comprehensive acute care. I am assured that there is a strong business case for even greater investment on that site and exciting plans are afoot in that regard.

The Minister needs to be aware, however, that there have been issues of communication over the relocation of elective surgery, as was raised earlier. I accept much of the wisdom in the reconfiguration of services in north-west London to allow for specialist centres, rather than having hospitals that are jacks of all trades.

I accept that that is easy for me to say, given that two local hospitals in my constituency, Chelsea and Westminster and St Mary’s Paddington, are not affected, and I know that the issue is a great concern for many Members, who are hearing such concerns from many constituents. But I suspect that the perceived success or failure of any reorganisation of this sort will come down to smaller things: how well plans are communicated; how quickly alternative, out-of-hospital services are in place; and how transportation is organised for patients, many of whom are impoverished or will have to travel further and rely on public transport.

[Ms Diane Abbott (Hackney North and Stoke Newington) (Lab)]

On the acceptability of reconfiguration, we should never forget that many communities in London have a strong emotional attachment to a hospital that could have been in existence in some shape or form since the middle ages. That is why reconfiguration must go forward carefully and on a purely medical basis if it is to succeed in London.

[Mark Field]

That is right to an extent. I know that the hon. Lady spoke in a debate that I led in the House almost a decade ago on Barts, which is located in my constituency and has a special place in the hearts of many millions of Londoners—and, indeed, of people throughout the United Kingdom. The truth is that at that juncture, the private finance initiative was the only funding game in town and we all went along with it, but that £1 billion PFI has now caused major financial issues that, I am afraid, affect not just Barts but hospitals throughout the north-east of London, as the hon. Lady is well aware. We all feel a bit depressed about that knock-on effect.

We have to accept that in London, broadly speaking, we do pretty well as far as hospital care is concerned. Being absolutely candid with everyone, because I know what it is like, in central London we have a very good service, and it is partly outer London that suffers as a result. That is because of the strength of the links to which the hon. Lady rightly referred—the passion that we have for our historic hospitals—and the amount of resource that is pushed into central London because the hospitals there are teaching hospitals with consultants, former consultants and alumni who are willing to make a strong case for the existence of those hospitals. Dare I say it, that makes it easier to make the case for Barts than for a hospital out in Romford or Whipps Cross, or one in the hon. Lady’s constituency.

We all have to face those issues. They have not arisen as a result of the reorganisation of the past three and a half years; this has been the situation in the capital for probably 40 or 50 years. I am aware that even in the latest reconfiguration there has been a sense that central London has got off slightly better than the middle portion of outer western London.

I turn to finance. There was a good outcome before Christmas for north-west London on commissioning allocations, as all of our CCGs received an uplift to offset inflation. However, I want to raise concerns about the funding formula used to determine allocation. The formula fails to take into account the needs of the large homeless population in Westminster, which places massive pressure on acute services. Rough sleepers are far more likely to attend accident and emergency; they attend six times more often than any normal member of the population. They are admitted to hospital four times more often and stay in hospital three times as long.

The formula also ignores the fact that CCGs are responsible for all attendances at urgent care centres or walk-in centres and for the costs of patients covered by reciprocal funding arrangements with other countries. Westminster welcomes more than 1 million commuters and visitors each and every day, many of whom will need health advice and care while they are here. It is important that a future funding formula recognises the impact of that on local health care services.

The proposed formula will exclude spending on community care. That cannot be correct considering the important move to provide more high-quality care at home and in the community rather than simply in hospitals. I welcome the Government’s assurances that the Advisory Council of Resource Allocation formula will not be accepted in its current state and that changes to the funding of CCGs will be fully consulted on in future.

I turn to public health spending. A draft formula for local authorities was set out in the “Healthy Lives, Healthy People” consultation, which was published on 14 June 2012 and recognised that further work was needed on adjustments for age, fixed costs and non-resident populations. However, initial modelling by London councils suggests that Westminster would have a drop of 57% in public health funding. Central London and Westminster have unique population characteristics that make it more difficult to make public health improvements. They include the age structure, with a greater focus on working age and children, and levels of mental health problems and homelessness. Those are not properly reflected in the current formula.

The formula also fails to take account of substance misuse services, many of which fall outside the pooled treatment budget, which focuses on opiates and crack treatment. It also ignores the wider health and local authority investment needed to manage the individual family and community impact of drugs and alcohol on health and well-being.

Westminster experiences a high level of population churn—I accept that many other London boroughs are in that boat—and that leads to additional demands for services, including NHS checks and other screening programmes.

--- Later in debate ---

[Andrew Gwynne (Denton and Reddish) (Lab)]

It is a pleasure to serve under your chairmanship, Mrs Main. I congratulate my hon. Friend the Member for Westminster North (Ms Buck) on securing this very important debate about health care in London. I hope that hon. Members will forgive this Mancunian for gatecrashing the debate to respond for the Opposition.

The future of health services and especially accident and emergency services across London is an important issue of genuine concern to a great many of the constituents of hon. Members present. It is definitely an issue of real significance right across our capital city. I pay tribute to all the hon. Members who today have made contributions, long and brief, on a wide variety of matters.

Let me take this opportunity to pay tribute to the staff working in the national health service for their commitment in providing a first-class service to patients in what has been a very trying period for the NHS. As we know, there have been important changes in the provision of hospital care in London. We have had “Health for North East London”, “Shaping a healthier future”, the Barnet, Enfield and Haringey clinical strategy, the trust special administrator’s review of South London Healthcare NHS Trust and the NHS in south-east London and “Better Services, Better Value” in south London, to name a few of the reconfigurations that have taken place in the capital.

My hon. Friend the Member for Westminster North is right to point to extreme financial pressures on hospital services. North-west London hospital services must accommodate a £125 million reduction in service between 2011 and 2015. The people who use hospitals in London are rightly concerned about the changes to the services on which they rely. We have heard about the proposals that will lead to the loss of accident and emergency departments at Charing Cross, Ealing, Hammersmith and Central Middlesex hospitals.

However, it is not only my hon. Friends who are concerned about the future of A and E departments in London; local authorities are, too. Local authorities such as Ealing have voiced their concerns about the downgrading of their A and E services. As we have heard from my hon. Friend the Member for Hammersmith (Mr Slaughter), A and E facilities that both the Prime Minister and the Secretary of State had promised to save across north-west London and elsewhere in the capital will be closing. I hope very much that the meeting between the Secretary of State and the hon. Members who represent Ealing and Hammersmith can be reconvened as requested.

Of course, all this is in direct contradiction to what the Prime Minister said during the general election, when he promised to halt the closures of hospitals, accident and emergency departments and maternity units. Why does the Minister think that there is such widespread concern about the lack of leadership in the health service in London at a time when the NHS is dealing with unnecessary upheaval?

Frankly, it was a disastrous decision on the part of the Government to spend billions of pounds on an unnecessary top-down reorganisation, which has led to a loss of financial grip in the NHS. Now, more than 6,000 nursing posts have been lost, waiting lists are getting longer and we are seeing the return of patients on trolleys in corridors. Indeed, we are now seeing A and Es not just in London but across the country facing a winter crisis after an unprecedented summer A and E crisis. At the same time, local authorities are having a huge cut to their social care budgets. More and more elderly people are therefore ending up in A and E, because there is no one at home to care for them, adding even more pressure to a pressured system.

Labour Members warned Ministers repeatedly during the passage of the Bill that became the Health and Social Care Act 2012 that the legislation would lead to the break-up of the NHS. The public rightly expect to have easy access to health services, and Ministers have a heavy responsibility to show leadership and to act to prevent people’s lives being put at risk. Ministers must also tell the House today what action they propose to take to ensure that London’s growing population will continue to have good access to hospital and other health service provision in their local areas. Those points were made eloquently by a number of hon. Members, but I have to mention my hon. Friend the Member for West Ham (Lyn Brown) in relation to Newham.

Of course, Labour Members do not oppose all the changes to local health services. Surely, it is right that hospitals and services evolve and change. However, it must be change based on good clinical reasons and not just financial necessity.

[Ms Abbott]

Does my hon. Friend agree that the issue in London is not just provision for its size of population, but the extreme diversity and complexity of the population? It is a very mobile population. There are large numbers of refugees and asylum seekers, and London has the largest lesbian, gay, bisexual and transgender community in the country. That is what people have to pay attention to if they are reconfiguring services.

[Andrew Gwynne]

My hon. Friend is right. London is a global city. It has people coming in from all over the world, not just from elsewhere in the United Kingdom. It is a diverse city. It is an exciting, vibrant city—I am probably over-egging it for a Mancunian, but it is a great place. Those complexities are what makes London fantastic, but they are also what makes delivering health services a real challenge.

To make the change work, there must be clarity and partnership. Everyone must understand what is being proposed and how the decisions are to be taken. That brings me on to the issue of Lewisham and clause 118 of the Care Bill. We saw in Lewisham the power of an effective campaign in the face of unpopular change to health services and what that can achieve.

I pay tribute to the Lewisham MPs and to the campaigners, who fought tirelessly for their local hospital. The proposal to close their A and E department was rightly met by a strong local campaign, which included protest marches and a successful legal challenge to the closure. Indeed, the Court of Appeal ruled that the Health Secretary did not have the power to implement the cuts at Lewisham hospital. If only he had listened to my hon. Friends in Lewisham—they had been arguing that beforehand.

Clause 118 should give very real concern to all hon. Members in the debate, because in future it will give carte blanche to the Secretary of State and the Department of Health to reconfigure services right across the country as they sought to in Lewisham, disfranchising the communities that have spoken out very loudly across London against some of the changes. Labour Members are rightly concerned about that measure and we will be opposing it during the next stages of proceedings on the Care Bill.

In conclusion, I pay tribute to my hon. Friend the Member for Westminster North and to all my right hon. and hon. Friends who have taken part in the debate. Hospital services are very important to the capital. We must make sure that there is proper strategic planning across London, not the piecemeal approach to reconfigurations of services that we have seen, so that the complexities in health needs—including mental health, which my hon. Friend the Member for Hampstead and Kilburn (Glenda Jackson) mentioned—are taken on board fully for the betterment of people living in London.

Mid Staffordshire NHS Foundation Trust

Diane Abbott Excerpts

Tuesday 19th November 2013 Commons Chamber

[Mr Hunt]

The biggest assurance that patients will have is that the definition of success as regards how the system views a hospital will be the same as patients’ definition of success. They want to go somewhere that treats them promptly and safely and with decent, compassionate care. That has not been how the system has judged the success of a hospital or its chief executive or board. That is why it is such a profound change to have a new chief inspector and Ofsted-style ratings. I think this will make a big difference, but I do not want to underestimate how big a challenge it is and how long a process it will be fully to make the transformation we need.

[Ms Diane Abbott (Hackney North and Stoke Newington) (Lab)]

The Secretary of State will be aware of people’s disappointment that there is still no proper system of regulation for health care assistants. Does he understand that many members of the public feel that one of the problems with general standards of care in the health service may have been the push—under a Labour Government—for an all-graduate nursing profession? There is a strongly held view among members of the public that that has led to elevating taking exams and inputting data on a computer over providing basic levels of care, which is what they really value in a nurse.

[Hon. Members]

Hear, hear.

Changes to Health Services in London

Diane Abbott Excerpts

Wednesday 30th October 2013 Commons Chamber

[Ms Diane Abbott (Hackney North and Stoke Newington) (Lab)]

The whole House knows that all the medical directors in the hospitals involved in north-west London support the reconfiguration. Does the Secretary of State really understand the importance of bringing ordinary people with him? Londoners are especially cautious about these reconfigurations because of the historic problems with access to GPs and the many excluded communities for whom A and E is their primary care, and because these institutions are often major employers in their area and people identify with them. Does he realise that unless he brings ordinary people and patients with him on these reconfigurations, Londoners will continue to fight them and, as in the case of Lewisham, they will continue to win?

[Mr Hunt]

Apart from the very last sentence, I actually agree with what the hon. Lady says. It is important to carry the public with us in these reconfigurations. Governments of both parties have struggled to do that in these difficult reconfigurations, which is why the new structures that we have introduced will put doctors in the front line to argue for changes. It is not just the medical directors of trusts supporting them, but the CCG leaders, who are all local GPs, making that case. That is why there is much stronger support for these changes. All the elected representatives on the local councils, apart from Ealing, supported these changes, and that is a very big change from what we have seen previously. I agree with the hon. Lady: we need to do more work and it is very important to carry people with us.

Tobacco Products (Plain Packaging)

Diane Abbott Excerpts

Tuesday 3rd September 2013 Westminster Hall

[Ms Diane Abbott (Hackney North and Stoke Newington) (Lab)]

I thank the hon. Member for Harrow East (Bob Blackman) for making possible this important debate at this stage in the Parliament. I also thank you, Mr Hollobone, for your exemplary chairing, which has allowed everyone who wanted to speak to do so.

In my brief remarks, I want to deal with the bogus point that doing anything about cigarette packaging necessarily affects how we treat alcohol and fatty foods, and to talk about the importance of protecting children and local leadership. I first want to congratulate my hon. Friends the Members for Blaenau Gwent (Nick Smith),for Stockton North (Alex Cunningham) and for Worsley and Eccles South (Barbara Keeley) on their excellent speeches, as well as my colleague, my hon. Friend the Member for Vale of Clwyd (Chris Ruane), for his helpful visual aids, which enabled us all to focus on what the debate is about in practice. I found the contribution from the hon. Member for Banbury (Sir Tony Baldry) quite moving. For me, the image of a child on his father’s ward with all those men dying from lung cancer, a type of cancer in which people drown, was particularly vivid and moving.

First and foremost, I will deal with the bogus idea that we can compare the packaging of cigarettes with that of sweet or fatty foods, alcohol and so on. If people consume alcohol and packaged sugary or fatty goods in the quantities indicated on the packaging—all packaged goods now have information about calories and what proportion of people’s diets should be made up of particular food groups, and all alcohol packaging tells people the advisable level of consumption—the effect on health is marginal. If they consume tobacco in the way manufacturers indicate, half of lifelong smokers will die—no ifs, no buts. Tobacco is the only legal substance for which, if consumed as indicated, half of consumers will die. In relation to packaging, that makes tobacco a wholly different case from alcohol and sugary and fatty foods. In my view, it is a dishonest argument to try to make that comparison.

[Mark Field]

Will the hon. Lady give way?

[Ms Abbott]

I am afraid that I cannot.

We know that half of lifetime smokers will die from smoking, that it remains the largest preventable cause of cancer, that it causes one in four deaths from cancer and eight in 10 deaths from lung cancer, and that smoking is the biggest cause of health inequality. That is what makes tobacco packaging different and makes the measures so important.

On children, the key to the debate is not whether a change in packaging would make established smokers alter their habits, but the attraction that packaging holds for children. The question is one of child protection: although adults can make their decision about smoking, society has a responsibility, which some speakers have ignored, to protect children. Even Members who do not accept that must agree that we have a responsibility to bear down on the millions of pounds a year that it costs the NHS to deal with the consequences of smoking.

We have seen important local leadership on smoking. A lot can be done locally, which is why it is so important to move public health to local authorities. I want to name the leader of Newcastle city council, Nick Forbes, and Fresh North East for their innovatory work.

This is one of those issues on which what is done upstream—Government measures—has the most impact. In the lifetimes of everyone in the Chamber, levels of smoking have gone down, and attitudes to smoking have changed. When I was a child, people smoked on the television, in films, in meetings and in offices, none of which is now acceptable. That shows what we can do in public health with a mix of moral suasion and legislation, but there is more to be done, and I believe that the packaging measure is the last brick in the wall.

It is important to make the point that we are discussing UK packaging. As part of my role as shadow public health Minister, I have been to Europe—to Brussels and so on—to talk about the issue. In Brussels, people are clear that one reason why the tobacco industry is so exercised about packaging is not profits in the UK, but the example that UK legislation would set to the rest of the world, including the huge markets in China and Africa. What is at stake is not a marginal decrease in profit here; it is the big problem of profits forgone in the huge markets elsewhere. That is why it is so important for us in Parliament to set the right example—not just for the health of British people or because of the costs to the health service, but for the rest of the world.

In closing, I congratulate such organisations as Cancer Research UK and Action on Smoking and Health that have been ceaseless in bringing the facts before the public and MPs. We know that the issues are difficult and that the Government face the money and power of big tobacco. To be candid, that is why my Government in the end allowed a free vote. If this debate can get one important thing rolling, it should be pressure on the Government at the highest level to allow Parliament to discuss the question: let us debate and decide. The health of Britain’s children and the general population depends on it and the spiralling cost of the NHS depends on it, as does the health of people all over the world, to whom we can set an example with exemplary legislation on cigarette packaging.

Oral Answers to Questions

Diane Abbott Excerpts

Tuesday 16th July 2013 Commons Chamber

[Anna Soubry]

I am rather disappointed at that question from my hon. Friend. I can assure him that the Government take all these issues very seriously. I am proud of our emerging record on public health, but as I say, we have yet to make a decision, because, quite properly, we want to see what happens in Australia, and of course we are also waiting to see what happens elsewhere, notably in Ireland, where the Irish Government intend to introduce this policy. It might or might not be successful.

[Ms Diane Abbott (Hackney North and Stoke Newington) (Lab)]

The Minister says, quite correctly, that the best legislation is based on evidence, but should it not also be untainted by the activities of lobbyists? She will be aware that Department of Health officials met Philip Morris Ltd at the end of January this year, but although minutes of meetings with other tobacco companies that occurred at the same time have been released, the Department insists that the minutes of the meeting with Philip Morris have yet to be finalised. Is it not the truth that the Government are trying to cover their tracks over their relationship with Lynton Crosby and his clients and that when it comes to the decision effectively to drop plain packaging for this Parliament, all roads lead back to No. 10 and Lynton Crosby?

[Anna Soubry]

I have just seen a piece of straw flying over, which the hon. Lady attempts to clutch at. [Interruption.] “Clutching at straws”—it is a bit lost on the Opposition, but that is more a sign of their difficulties than ours. The minutes of the meeting with that tobacco company have been published this morning. The reason for the delay—I very much hope the hon. Lady is not suggesting for one moment that my officials have been in any way dishonest—is because unfortunately the tobacco company did not agree the minutes, and there was some to-ing and fro-ing. I really wish she would not subscribe to conspiracy theories where they do not exist.

Tobacco Packaging

Diane Abbott Excerpts

Friday 12th July 2013 Commons Chamber

[Ms Diane Abbott (Hackney North and Stoke Newington) (Lab)]

(Urgent Question): To ask the Secretary of State for Health if he will make a statement on the Government’s response to the consultation on standardised packaging of tobacco products.

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

The Government’s policy remains unchanged. The Government have today published a summary report on the consultation on the standardised packaging of tobacco products. The consultation was undertaken last year between April and August with the agreement of the devolved Administrations on a UK-wide basis. The summary report is available in the Library.

The standardised packaging of tobacco refers to measures that may be taken to restrict or end the use of logos, colours, brand images or promotional information on packaging. Any brand or product names would be displayed in a standard colour and typeface. The consultation was intended to explore views on whether standardised tobacco packaging would reduce the appeal of tobacco products to consumers, increase the effectiveness of health warnings on the packaging of tobacco products, reduce the ability of tobacco packaging to mislead consumers about the harmful effects of smoking and have a positive effect on smoking-related attitude, beliefs, intentions and behaviours, particularly among children and young people. To inform responses to the consultation and subsequent policy making, the Department commissioned a systematic review of evidence on standardised packaging. I am grateful to the academics who undertook the review at the university of Stirling, university of Nottingham and the Institute of Education. It is being published alongside the consultation document.

More than 668,000 responses to the consultation were received and the views expressed were highly polarised. Strong views were put forward on both sides of the debate and a range of organisations generated campaigns and petitions. Of those who provided detailed feedback, some 53% were in favour of standardised packaging while 43% thought the Government should do nothing about tobacco packaging. Having carefully considered those differing views, the Government have decided to wait until the emerging impact of the decision in Australia can be measured before we make a final decision.

Only one country, Australia, has adopted the policy, which it introduced on 1 December last year. New Zealand and the Republic of Ireland have announced that they intend to follow suit. We intend to wait, so we can benefit from the experience of countries such as Australia that have introduced standardised packaging. In the meantime, I want to promote wider public debate about whether we should introduce standardised packaging in this country, including in this House as well as in the media.

[Ms Abbott]

Mr Speaker, you would have to have a heart of stone not to feel sorry for the hon. Lady, who has been forced to be the face of this humiliating policy U-turn. Once again, the Government have tried to slip out an important policy statement by means of a written statement on a Friday, hoping to avoid parliamentary scrutiny. Once again, the Government have completely lost their way on public health and caved into big business. Today, the health of the nation is being sacrificed to the interests of big tobacco.

The Minister has conceded that the Government’s systematic review found that standard packaging would make smoking less attractive to young people. The Minister will have read the letter signed by 160 specialist consultants and professors calling on the Government not to enact this U-turn. The Minister might have heard the former Health Secretary, the right hon. Member for South Cambridgeshire (Mr Lansley), say:

“The evidence is clear that packaging helps to recruit smokers, so it makes sense…having less attractive packaging. It’s wrong that children are being attracted to smoke by glitzy designs on packets…children should be protected from the start.”

The Minister might even remember what she had to say—that she had been “personally persuaded” of the case for standardised plain packaging. The Opposition have to ask what happened. We suspect that Lynton Crosby happened.

Every single medical stakeholder, every campaigner on tobacco harm and every member of the public who is concerned about the fact that half of all lifetime smokers will die prematurely from their habit and that hundreds of children start smoking every day will be appalled at this decision. It bears no relationship to the evidence and people will die. Will the Minister tell the House whose decision it was to slip out the announcement on a sitting day by means of a written statement? Who was involved in making the decision and can she confirm that Lynton Crosby had no involvement whatsoever in today’s decision?

There can be no greater responsibility on Government than the heath of the nation. Every single Health Minister has declared their personal support for standard plain packaging and the Minister should be ashamed to have been dragged to the House today to set out this disgraceful U-turn.

[Anna Soubry]

May I apologise, Mr Speaker, for the fact that apparently I have been speaking far too quietly for perhaps the first time in my life? The hon. Lady clearly did not hear what I said, and I will repeat it. We have not made a decision. We have decided to wait, quite properly, to see the evidence as it emerges from Australia. I make it very clear that there is no change in the policy of this Government. Forgive me, Mr Speaker, but the Order Paper is quite clear—I see it before me—and states that there will be the publication in the Library today of a written statement on the matter of standardised packaging. I just heard a whole load of nonsense going up in smoke.