Tobacco and Vapes Bill (Thirteenth sitting)

Debate between Gregory Stafford and Jim Dickson

Committee stage
Tuesday 28th January 2025 Public Bill Committees

[Jim Dickson]

It is a pleasure to serve under your chairship, Mr Pritchard. Amendments 11 to 14 are intended to extend the power to local authorities in England to designate areas as smoke-free by making byelaws. Any byelaws would need to be confirmed by the Secretary of State, by virtue of section 236 of the Local Government Act 1972.What the amendments seek to do is to bring the power to extend smoke-free places to a local level, as there are already a number of local authorities that have had success with that approach.

As we know, local authorities are responsible for public health and know their communities well. Eleven councils have introduced 100% smoke-free conditions in pavement seating, including in thriving cities such as Liverpool, Manchester and Newcastle. There are many more areas where that approach could have benefits: for instance, in my Dartford constituency, we have a high street with an area where an excellent market takes place every Thursday and Saturday. It is an area not covered by smoke-free legislation, but one that in my view could greatly benefit from smoke-free areas.

[Gregory Stafford]

We may come on to this point when we discuss the substantive part of clause 136, but does the hon. Member not see any potential difficulty where there are different local authorities with different regulations on smoke-free areas? One of the beneficial simplicities in the Bill is that it applies the same rules across all areas in all the different constituent parts of the United Kingdom. What he is suggesting could potentially add a level of complexity.

[Jim Dickson]

That is indeed a good question. Consistency is clearly desirable: it is easier for the public to understand and it makes enforcement easier. However, there are councils already leading the way in that area, and it is a question of the needs of the community covered by that local authority. We know that smoking is particularly concentrated in deprived communities. Local authorities are able to understand what areas are most at risk, work with those communities and arrive at solutions hand in hand with them. We know that public spaces facilitate quit attempts, so it is a great way to do this in areas where the communities consent to that approach. I still advocate the measure as a good way forward.

Obviously I would have liked to have seen outdoor hospitality settings included in the consultation for smoke-free extensions to this Bill; however, I know that many Members at the Second Reading expressed relief that that is not in scope for England. Other Members have sought to put the areas identified by the Government on the face of the Bill to rule this out in future, but I disagree with that approach, because we need flexibility.

[Gregory Stafford]

This is a point I will raise with the Minister as well—just to forewarn him—but, whereas I entirely agree with the future-proofing of this Bill in areas such as products and advertising where the market may move on, I do not fully understand why the regulations need to be so open on public places. Public places are not going to change over the next 100 years, so why not define them on the face of the Bill?

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[Gregory Stafford]

Looking at the amendments, I can see why the hon. Member for Dartford wants to do this. There clearly could be public health benefits and, as a localist myself, I am naturally sympathetic to having local decisions made as close to people as possible. I think the point I made during the intervention stands, however: the potential for confusion among people who are potentially not from the area, or who are from the area but do not understand the local byelaws, probably makes the amendments unworkable.

My hon. Friend the shadow Minister and the hon. Member for Dartford mentioned that smoking prevalence is higher in places of social deprivation. The hon. Member seemed to be suggesting it would therefore be better to enforce regulations, or byelaws for regulations, in those areas. I can see the public health impact, but we must not ghettoise people who are from lower socio-economic backgrounds and who are more likely to smoke, as seen in the evidence. The shadow Minister makes a good point that people who do not have outside space, and who may have children and not want to smoke and vape in their properties because they are rightly worrying about their children’s health, will find that difficult if there are local byelaws in place that prevent it. I think that is especially true with women who smoke.

[Jim Dickson]

I thank the hon. Gentleman for giving way. He is making a number of very good points, but will he respond to the notion that smoke-free areas are all about making smoking less attractive and so giving people incentives to quit? Does he accept that that might give people incentives to quit and therefore be a significant public health benefit, and worth considering as part of the legislation?

[Gregory Stafford]

I completely agree that we could very easily ban tobacco and vaping for everybody at every age. That would be the biggest incentive for people to quit. The Government—I think rightly—are not doing that, because they are not looking to criminalise people who are currently addicted to tobacco and vapes. If we are allowing people to do something legally, there should be places where they can do so safely and not harm others, such as their own children. I am sympathetic to the public health argument that the hon. Gentleman makes but, in practical terms, there may be areas where this is a problem.

My final point is really a question for the hon. Gentleman: under what regulations would the local authority be enforcing such byelaws? Would it be through the penalties and enforcement activities in this Act itself —if it becomes law—or would there be some sort of fine or penalty system that the local authority could use? While there are potential fines and enforcement activities on the face of this Bill, if there were local regulations, would these be in line with what is in the Bill, or would there be some other fining system that a local authority could dream up itself?

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[Jim Dickson]

I beg to move amendment 10, in clause 136, page 77, leave out lines 26 to 29 and insert—

“(a) for subsection (1A) substitute—

‘(1A) The Secretary of State must, no later than the end of the period of 6 months beginning with the day on which the Tobacco and Vapes Act 2025 is passed, lay draft regulations to be made under this section which have the effect of providing for all enclosed vehicles to be smoke-free, other than vehicles of the type described in subsection (3).

(1B) Regulations may make provisions about the meaning of “enclosed vehicle”, which may include vehicles which are partially enclosed or enclosed (or capable of being enclosed) for some but not all of the time.’”.

This amendment requires the Secretary of State to make regulations which would extend the existing prohibition on smoking in vehicles to all enclosed vehicles except ships and hovercraft which are regulated under other legislation. The prohibition currently only applies to workplace vehicles and vehicles carrying under 18s.

Amendment 10 requires the Secretary of State to make regulations that would extend the existing prohibition on smoking in vehicles to all enclosed vehicles except ships and hovercraft, which are regulated under other legislation. As hon. Members will know, the prohibition currently applies only to workplace vehicles and vehicles carrying under-18s. The 2015 ban on smoking in cars that contained children was a really important moment in in public health. It raised awareness about the harms of second-hand smoking in enclosed spaces and protected many children from being exposed to those harms.

[Gregory Stafford]

I agree that the regulations on smoking in private vehicles with under-18s were symbolically the right thing to do. Is there evidence either that the ban was in any way enforceable, or that it had any impact on public health?

[Jim Dickson]

I thank the hon. Member for those comments; I will do my best to answer them. Compliance with the measure is still not where we would like it to be: the last survey undertaken by an independent company on behalf of Action on Smoking and Health indicates that 9% of 11 to 15-year-olds say that

“they travel in a car with someone smoking some days, most days or every day in 2024.”

The current law also does not protect those with clinical vulnerabilities. The smoke-free powers in this Bill are driven by a desire to protect people with clinical vulnerabilities from second-hand smoke. That includes pregnant women and those with asthma and lung conditions, among others. No smoker wants to harm their family, friends, pets or co-workers, so no smoker should smoke in an enclosed vehicle.

The evidence is clear: concentrations of smoke in vehicles where someone is smoking are greater than in any other small, enclosed space. If we are to be led by the evidence when extending smoke-free places, we have to consider vehicles. That would provide consistency in policy and raise awareness of the harms of second-hand smoke even further than they currently extend. It would be easier to enforce than the current law, where we have to check who else is in the vehicle, and would make the regulations on vehicles simpler and easier to understand—“It’s a straightforward ban; you can’t do it.” Finally, it is worth pointing out that it is supported by the public, with 67% of British adults saying they are in favour of an outright ban on smoking in vehicles.

[Dr Johnson]

I thank the hon. Gentleman for his clear explanation of what he wishes to achieve. I have great sympathy with it, because nobody wants to see people making their health worse by smoking in a car. However, his statistics are quite interesting. He said that 9% of children find themselves on a regular basis in a car where someone is smoking, yet the Minister has said already this morning that 11% of people smoke. Given that not all of the 11% of people who smoke have children with whom they travel in a car, that implies that the measure is pretty badly enforced and badly adhered to at the moment. He might argue that a complete ban in all vehicles would make it more uniform and easier to enforce, but I am not sure that that is the case.

I will be interested to hear from the Minister when he responds to the amendment whether he has any information or statistics on the number of prosecutions that have occurred under the current legislation. I support the legislation that prevents someone from smoking in a car with children, and I would support an extension of that to include vaping and other nicotine products. I would also support a ban on people smoking while driving; if someone is holding a lit cigarette in their hand, that will have an impact on their ability to manoeuvre the car, particularly in an emergency situation.

Essentially the hon. Member is proposing to say to someone in a parked-up vehicle, perhaps in someone’s drive, “Although you are in a private space, you are not able to smoke.” I understand what he said about no smoker wanting to hurt someone—I am sure that is true—but I cannot imagine that there is any adult smoker that does not realise that smoking in a car with children is bad for the children. I find it very difficult to believe that that would be the case. I invite him to consider whether he is trying to prevent what is a legal activity—even under this Bill, if someone is the right age—in a private space that is theirs and theirs alone?

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[Jim Dickson]

The hon. Gentleman is making his point very articulately. The idea that smoking legislation is an overreach is not new. Just about every change over the last 30 years—changes that have helped to cut very significantly the number of people affected by smoking-related diseases—has been described as an overreach. A lot of this is about public acceptability, and nearly all the polling accepts that a great majority of adults would see this not as an overreach, but as a welcome change.

[Gregory Stafford]

I do not pretend to have deep wisdom and insight into the whole population’s view on this, and I have not seen the studies the hon. Gentleman talks about, but I accept them. My concern is the need to be careful about the balance between the stated ambitions of all of us—or certainly most of us—on the Committee to reduce smoking as much as possible, and the rights confined within the Bill. If someone is legally allowed to smoke—that is, they were born prior to 1 January 2009—or is over 18 in the case of vaping, and they are in the privacy of their own vehicle without harming anybody else in said vehicle, they can do so. The hon. Gentleman’s amendment is a step too far.

[Gregory Stafford]

I have much sympathy with my hon. Friend’s point of view. I must confess, I am not clear—I am sure the hon. Member for Dartford will be able to tell us—who will enforce this regulation. If it is the police, then I agree with my hon. Friend that it is an unnecessary burden.

[Jim Dickson]

The police currently have responsibility to enforce a whole range of activities that take place within a car, such as mobile phone use. It would in no way be a new concept for the police to enforce something of this nature. If they saw someone in a car with a cigarette, they would be able to stop the car and apply a penalty as they currently do with other types of behaviour within cars.

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[Gregory Stafford]

I completely agree with the shadow Minister. I have two final points. Proposed new subsection (1B) makes reference to the meaning of an enclosed vehicle. I just want to clarify what that means. The amendment says:

“which may include vehicles which are partially enclosed or enclosed (or capable of being enclosed) for some but not all of the time.”

Is the amendment trying to capture convertible cars—someone driving with the top down on a sunny day?

[Jim Dickson]

The amendment is not intended to change the way that the current legislation relates to individual vehicles, merely the activity happening within them, and that currently permits smoking in open-top vehicles with the hood down, i.e. unenclosed. The amendment does not propose any change to that.

[Gregory Stafford]

That is a helpful clarification. Finally, in the explanatory statement, it says that enclosed vehicles account for everything “except ships and hovercraft” apparently because that is “regulated under other legislation”. Perhaps it is in a later amendment, but why did the hon. Member decide not to amend the regulations for ships and hovercraft? Is that because he is hoping to get a private Member’s Bill at some point to change whatever legislation governs hovercraft and ships—[Interruption.] My hon. Friend the shadow Minister whispers to me, “It’s further down,” so that clarifies the point for me.

Ordered, That the debate be now adjourned.—(Taiwo Owatemi.)

Hospice and Palliative Care

Debate between Gregory Stafford and Jim Dickson

Monday 13th January 2025 Commons Chamber

[Gregory Stafford (Farnham and Bordon) (Con)]

Hospices provide vital care for adults and children with life-limiting conditions, offering end of life care, pain management and bereavement support to families, but despite being this essential part of healthcare, the hospice sector has challenges due to inadequate Government funding and the taxes that they are putting on it, and to workforce shortages. That is all compounded by rising costs and economic uncertainty.

Before I became a Member of Parliament, I have to confess that I had, perhaps fortunately, very little contact with the hospice sector, despite having worked in health and social care for the majority of my career and being a local government councillor for 17 years. During the election campaign, I was invited to the Shooting Star children’s hospice, which has been mentioned by numerous Members across the House. I visited Christopher’s, which is its in-house care facility in Guildford. I think it is actually in the constituency of my right hon. Friend the Member for Godalming and Ash (Jeremy Hunt)—I am sure that the hon. Member for Guildford (Zöe Franklin) will correct me if I am wrong. There I saw the true meaning of selfless day-to-day acts of kindness and care, with people looking after some of the most vulnerable children and their families. They are the absolute exemplar of people providing dying well.

I also have the Phyllis Tuckwell hospice in my constituency, which is currently going through a multimillion-pound rebuild funded by donations from people who have either used or care for our hospice in Farnham. When it is open—hopefully by the end of the year—it will provide 18 new palliative care beds alongside rehabilitation and services for the families as well, along with therapy sessions. Both are shining examples of what dying well should look like.

As other hon. Members have mentioned, the one good thing to come out of the assisted dying debate has been a much greater focus in this House, and indeed across the country, on what it means to die well. I echo some of the comments we have heard: let us get palliative care and hospice care right first, before we start thinking about whether or not we should be allowing people to kill themselves.

Despite the Government’s announcement just after Christmas, which I would be churlish not to welcome, the reality is that adult hospices and children’s hospices are almost totally reliant on charitable donations. The rest comes through the integrated care boards and, as the hon. Member for Scarborough and Whitby (Alison Hume) just mentioned, it is a complete postcode lottery.

I am grateful to the hon. Member for Wimbledon (Mr Kohler) for securing the debate, and he mentioned the significant variation in per person funding depending on where they are in the country and at which hospice they are being treated. The children’s hospice sector is the starkest example, with some places funding just under £30 a head, whereas others fund over £500 a head. This inequity in care clearly leaves some families worse off.

The Government really have not made it easy for the hospice sector. It is still not clear to me that the Health Secretary and the Department of Health had any clue that the national insurance contribution changes were coming down the line. If they were aware, had they allocated this funding beforehand? Was this in their plan, or have they been scrabbling to try to make up the difference since they heard this announcement? Despite asking questions, I have not heard an answer.

We also have not heard whether the Government will cover the costs of the national insurance contribution rise. My personal view is that they must, because the hospice sector, alongside so much of the care sector, is vital not just to the people who use it, but to the wider health economy. Underfunding and taking money from hospice care will have a significant cost impact on other parts of the health service.

[Jim Dickson (Dartford) (Lab)]

The hon. Member seems to welcome the additional £100 million for the hospice sector and, indeed, the additional investment in the NHS that have come out of the Budget, but he seems not to welcome the way in which that revenue is being raised. How would his party raise the revenue needed for the NHS and the hospice sector?

[Gregory Stafford]

Well, the simple fact is that what the hon. Members and his Front-Bench team are doing is ensuring that the NHS is worse off, because raising the money will have a greater impact on the rest of the service. [Interruption.] The Minister for Care is shouting at me from the Front Bench, and I am sure that, in his response to the debate, he can outline whether he and his team knew about the national insurance contribution rises and whether they planned for them.

The other part of this is the workforce, who have been touched on briefly. There is a real shortage of qualified healthcare professionals. Vacancy rates for hospice nurses have risen to nearly 19%, and the corollary is that staff morale is low. Again, the Government need to make sure that the long-term workforce plan that they and the NHS are rolling out includes how we will ensure that hospice staff are part of the long-term funding. Hospice UK has warned, seriously, that without urgent action, some, indeed many, hospices may be forced to close their doors in the next 12 months.

I have some requests of the Government. First, as the hon. Member for Birmingham Erdington (Paulette Hamilton) said, we need them to commit to a long-term sustainable funding model for hospices. That is not to say that hospices should be brought into the central NHS—I personally believe that the innovation of the hospice sector is down to its independence from the NHS—but they need multi-year funding to understand where they stand.

Secondly, as has been mentioned, we need to scrap the postcode lottery that comes from the integrated care boards. Some kind of ringfenced funding, particularly for children’s hospice grants, would prevent a lot of the delays and inequities in the service. As I said, we need to make sure that hospice staff are integrated into the NHS long-term workforce plan and are paid in parity with similar NHS roles.