Health and Care Bill

Debate between Edward Argar and Geraint Davies

Report stage
Monday 22nd November 2021 Commons Chamber

[Edward Argar]

I fear that I have only a few minutes left, and I have already taken a number of interventions on this. I want to conclude by covering the tobacco amendments as well, which I know that some colleagues are keen to see a response to. I apologise to the hon. Gentleman.

Less healthy food and drink products are not age restricted at the point of purchase, unlike alcohol. Finally, the 2019 and 2020 consultations on advertising restrictions for less healthy food and drink did not consult on alcohol within the restrictions, either online or on TV, so we cannot be sure of the impact these amendments would have on the industry more broadly.

Turning to tobacco in the time I have left, because I know the shadow Minister, the hon. Member for Nottingham North (Alex Norris) , has taken a close interest in the issue, I thank the hon. Member for City of Durham (Mary Kelly Foy) and others, including my hon. Friend the Member for Harrow East, who have tabled a number of amendments that seek to address the harm caused by smoking in this country. I reassure the hon. Member for City of Durham of the Government’s commitment to becoming smoke free by 2030.

We have successfully introduced many regulatory reforms over the past two decades, and the UK is a global leader in tobacco control. Our reforms include raising the age of sale from 16 to 18, the introduction of a tobacco display ban, standardised packaging and a ban on smoking in cars with children, which all place important barriers between young people and tobacco products. The Government are currently developing our new tobacco control plan, and I reassure the hon. Lady that that will reflect carefully on the APPG’s findings and report.

I am afraid I cannot be tempted to go further than the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Erewash (Maggie Throup), did in the recent Westminster Hall debate on this question, but I can reassure the hon. Member for City of Durham that we remain committed to bringing forward the tobacco control plan.

[Geraint Davies]

rose—

[Edward Argar]

Forgive me; I only have a few minutes and I want to cover the amendments from the hon. Member for City of Durham. The hon. Member for Swansea West (Geraint Davies) did manage dexterously to shoehorn air quality more broadly within the scope of these debates, and what he said will have been heard.

New clause 2, which seeks to provide powers for the Secretary of State to impose a requirement for tobacco manufacturers

“to print health warnings on individual cigarettes and cigarette rolling papers”,

is intended, as I understand from the hon. Member for City of Durham, to further strengthen our current public health messaging and encourage smokers to quit. We strongly support measures to stop people smoking, to make smoking less attractive to young people and to educate smokers of its dangers, as we have done through graphic warnings on cigarette packs.

We would need to conduct further research and build a further robust evidence base in support of any such additional measures before bringing them forward. To date, no country has introduced such a measure, so there is currently limited evidence of its impact in supporting smokers to quit. If evidence showed that the requirement would not be effective, it would not be an appropriate power to have in place.

New clause 3, also tabled by the hon. Lady, seeks to provide a power for the Secretary of State to introduce a requirement for manufacturers to insert leaflets containing health information and information about smoking cessation services into cigarette packaging. As I set out in Committee, we believe this power is unnecessary, since the Department could legislate to do that already under the Children and Families Act 2014; inserts could be required for public health messaging through amendments to the Standardised Packaging of Tobacco Products Regulations 2015. We already have in place strong graphic images and warnings of the health harms of smoking on the outside of cigarette packs. As part of the Tobacco and Related Products Regulations 2016, the address for the NHS website, which provides advice for people seeking to quit smoking, is also required on packaging.

The current SPoT regulations prohibit the use of inserts, as there was limited evidence that placing public health messaging inserts inside cigarette packages was more effective than messaging on the outside of packs. Further research would need to be undertaken to help to establish the public health benefit if we were to go further.

Turning briefly to new clause 4, I am grateful again to the hon. Lady for tabling this clause. The Government are clear that they only support the use of e-cigarettes as a tool for smokers who are trying to quit, and we strongly discourage non-smokers and young people from using them. We are committed to ensuring that our regulatory framework continues to protect young people and non-smokers from using e-cigarettes.

Current regulations include requirements on the packaging and labelling of e-cigarettes, along with restrictions on their marketing and the prohibiting of advertising on mainstream media such as TV and radio. While we strongly support measures to protect young people further from cigarettes, we believe the current regime remains appropriate and has the powers in place within it to make changes where required, although I suspect my hon. Friend the Member for Harrow East may yet be proved right when he suggests that the other place may return to this at some point.

I have outlined the many steps this Government are taking to address some of the major lifestyle challenges to our health. The Bill represents another step in the direction of preventive healthcare and building a healthier society, an aim I know we all share. I hope the House will support the amendments we have tabled at this stage to strengthen those measures.

I also want to update the House at this point, in the context of the importance of an integrated approach and how it can improve public health measures, on two steps the Secretary of State has taken today that will put NHS staff and technology at the heart of our long-term planning and allow us to take forward the integrated approach that has proved so vital during this pandemic and is so vital to public health.

[Geraint Davies]

Will the Minister give way?

[Edward Argar]

I am afraid I will not. I suspect that point will be pertinent to the debate on the first group of amendments tomorrow.

First, we intend to merge Health Education England with NHS England and NHS Improvement, putting education and training of our health workforce at the forefront of the NHS. By bringing this vital function inside the NHS, we can plan more effectively for the long term and have clear accountability for delivery.

Secondly, we also intend to take forward the recommendations of the Wade-Gery report, which included merging NHSX and NHS Digital with NHS England and NHS Improvement, building on the huge progress made on digital transformation during the pandemic and bringing together the digital leadership of the NHS in one place. I take this opportunity to pay tribute to all our colleagues at Health Education England, NHS Digital and NHSX for their exceptional work. These changes build on that contribution and allow us to drive forward further integration and changes that will put the NHS on a firmer footing.

I hope I have reassured hon. Members of the Government’s commitment to improving public health. I urge those who have tabled amendments to consider not pressing them to a Division.

--- Later in debate ---

[Edward Argar]

I entirely understand the point the hon. Gentleman is making. I think he was careful, shall we say, given some litigation that may be going on, not to mention anything specific, but I know what he is talking about. We believe that our amendment will prevent private companies—whatever services they were providing for the NHS—with a significant private interest in this, or their lobbyists, from being able to sit on ICBs. The hon. Member for Bristol South (Karin Smyth) raised the need for transparency in Committee a number of times, and I suspect we may return to that point. We believe that the current transparency requirements on CCGs that will be carried across are sufficient to ensure transparency and public access to the information they need.

[Geraint Davies]

rose—

[Edward Argar]

I am afraid I am about to conclude. I suspect that the hon. Gentleman will come back in with a speech and I will endeavour to pick up on that in the wind-ups.

There are a number of similar amendments, such as amendment 101 in the names of the hon. Members for Wirral West (Margaret Greenwood) and for Brighton, Pavilion (Caroline Lucas). I hope they might feel, to some degree, reassured by our amendment and the intent behind it, but that is obviously for them to say. We believe that the Government’s amendment puts beyond doubt what we believe was already entirely clear but were determined to put beyond doubt—that ICBs will not and cannot be controlled in any way by the private sector, as NHS-accountable bodies guided by the NHS constitution and with NHS values at their heart. These principles, I believe, irrespective of other debates we may have this evening, command respect from both sides of this place. I therefore commend the amendments to the House.

Income tax (charge)

Debate between Edward Argar and Geraint Davies

Monday 16th March 2020 Commons Chamber

[Edward Argar]

I hear what the hon. Gentleman says. As ever, he is a vocal champion for his constituents and his hospital. I say very gently that recent events have slightly impacted on my ability to schedule as many meetings as I might wish, but I remain committed to meeting him and talking to him about that particular project.

We want the new hospitals to be fully equipped with the very best modern technology, with touch screens, not clipboards, and systems that talk to each other. We also want them to be fully integrated with other local NHS organisations. But this is just the start, and we will follow this work up with multi-year capital funding through the spending review to be announced later this year.

[Geraint Davies (Swansea West) (Lab/Co-op)]

Is the Minister looking to divide up hospitals—new ones and, indeed, the existing ones—into coronavirus and non-coronavirus, with people wearing protective suits in coronavirus sections? China has been building a number of hospitals within weeks specifically to deal with this problem, so will the Minister refocus the programme he is outlining and bring it forward to address the coronavirus crisis?

[Edward Argar]

I suspect that Chinese building regulations and similar are possibly a little different from the processes in this country when it comes to speed, but the hon. Gentleman makes a good point. These hospitals, though, will be built for the future of our country—for the next 10, 20 and 30 years. He alludes to an important point and one that I was touching on in my speech, which is that we should ensure that our new buildings are adaptable and can be adapted to the changing needs of medical emergencies and the long-term demographic trends in this country. On that front, yes, we are building hospitals that are fit for the future, whatever that future may throw at us. But the issue he is raising is perhaps a little more short term than the length of time it will take us to build some of these hospitals.

Let me turn to people—the 1.4 million-strong team who make up the most dedicated workforce in the world. What is the one thing most NHS staff would change if they could change one thing? What is the best present we could give our nation’s nurses? [Interruption.] I will not be led astray by the Opposition. The answer is more nurses—more nurses to share the burden of rising demand, and more nurses bringing their compassion and determination to their work in the NHS. Over the next five years, we will deliver 50,000 more nurses for our NHS. We will do so by retaining and returning existing NHS staff, and by recruiting more nurses from abroad, but crucially by attracting more young people into the profession in the first place. The Budget delivers that by providing new non-repayable maintenance grants for nursing students of at least £5,000 a year for every undergraduate and postgraduate nursing student on a pre-registration course at an English university, with more for students with childcare costs or in disciplines such as mental health where the need is greatest. More than 35,000 students are expected to benefit.

In the coming months, the British people will have even more reason than usual to give thanks to our nation’s nurses, and we will work to repay them by making the NHS the country’s best employer—more supportive, more inclusive and more concerned with the wellbeing of staff as well as patients, an NHS that cares for its carers. We will set out how in our landmark NHS people plan.

We will also tackle the taper problem in doctors’ pensions, which has caused too many senior doctors to turn down work that the NHS needs them to do. Thanks to action in the Budget and the work of the Economic Secretary to the Treasury, from April the taxable pay threshold will rise from £110,000 to £200,000. That will take up to 96% of GPs and up to 98% of NHS consultants out of the scope of the taper based on their NHS income. I am particularly grateful to my hon. Friend for his work on delivering that.

Turning to staff in primary care, the Budget funds 6,000 more doctors and 6,000 more primary care professionals in general practice, on top of the 20,000 primary care professionals already announced. Why? It is because we want every NHS professional working at the very top of their skills register; because there are brilliant physios, pharmacists and healthcare assistants who can offer great treatment and advice for people seeking primary care; and because we can improve patient access to the NHS while freeing up GPs for those who need them most.