Suicide Prevention

Jim Dickson Excerpts

Thursday 11th September 2025 Commons Chamber

[Jim Dickson (Dartford) (Lab)]

I pay tribute to my hon. Friend the Member for Doncaster East and the Isle of Axholme (Lee Pitcher) for securing this debate on what I think we can all agree is a critical national public health issue. It is a timely debate given yesterday’s World Suicide Prevention Day, promoted by the wonderful Samaritans, who do so much good work, and whose badge I am proud to be wearing today.

Figures from the House of Commons Library highlight the previous long-term decline in suicides up to the year 2000 has seen some reversal in recent years, with 2023 seeing the highest number since 1999. It is right, therefore, that when the Government committed in our manifesto last year to a renewed drive to tackle the biggest killers, suicide was included. The recently published 10-year health plan sets out how the Government intend to put into practice the aim of transforming our mental health system so that support is available when people need it. I very much welcome the commitment to a cross-Government approach to suicide prevention, which mirrors the successful strategies that I have seen in my time in local government.

I have been pleased, since my election last year, to have been able to work with an excellent charity that has been mentioned by others, Gambling with Lives, to highlight the troubling link between gambling and suicide, with the Office for Health Improvement and Disparities estimating that there are up to 500 gambling-related suicides each year. I agree with both Gambling for Lives and my hon. Friend the Member for Chelsea and Fulham (Ben Coleman) that the responsibility for gambling should be transferred to the Department of Health and Social Care, and that there should be investigation of all gambling- related suicides and lessons learned from every case so that we can prevent future deaths. At present, coroners do not always correctly identify the link between gambling and suicide, and that needs to change. I hope that Ministers will give full consideration to both those calls.

Local suicide prevention strategies have a crucial role to play. In my previous life, I was cabinet member for health on Lambeth council. We launched our own local suicide prevention strategy with the aim of bringing down the numbers of suicides, which saw the council target support at the groups identified by evidence as the most at risk: older men, the LGBTQ+ community, and a range of others. We rolled out suicide prevention training to everyone, free of charge, so that all residents were able to access it, but aimed the support particularly, as others have said, at key organisations in touch with at-risk groups in the borough. The training was all about how to have effective, potentially lifesaving conversations with people in a safe way, and we saw great take-up. Crucially, the council also launched a borough-wide mental health campaign aimed at supporting people on their mental health journey and at providing advice and wellbeing information on how to access services at the right time. That period saw a decline in the number of suicides, which I hope will continue.

In my constituency, I pay tribute to the newly constituted Dartford Safe Haven—a little like the Ashford Safe Haven mentioned by my hon. Friend the Member for Ashford (Sojan Joseph)—which, working closely with GPs, provides a walk-in service, out of hours, with the crisis support that so many need. I also pay tribute to North Kent Mind, which supplements local mental health services, providing vital additional help for those with mental health support needs. Let us all commit to making suicide prevention a successful national mission.

NHS 10-Year Plan

Jim Dickson Excerpts

Thursday 3rd July 2025 Commons Chamber

[Wes Streeting]

I am so grateful to my hon. Friend for all the work she does as chair of the all-party parliamentary group, for the personal and professional experience that she brings to this House, and for the wisdom, advice and insight that she has offered to help me make better decisions. I am absolutely determined to work with families, especially those who have suffered such grave injustice at the hands of the NHS. It is a wonderful institution, but sometimes when it fails, it fails spectacularly. The culture of denial and cover-up cannot be allowed to persist, and I will work with my hon. Friend to make sure that we end it.

On neighbourhood health, it is so important that we engage with families early, especially where they may be at greater risk of complicated pregnancy or harm, because we know this is an area of grotesque health inequalities. After birth, it is really important that we have strong health visiting, and care in the community and the home that does not just consider the interests of the baby, but asks questions of the mother. How is she feeling? How is she recovering? Is her partner coping? We have to look at the whole family, and I am sure we will get it right. I am determined to get this right, and it will be in no small part thanks to my hon. Friend’s leadership and support.

[Jim Dickson (Dartford) (Lab)]

I thank the Secretary of State for both his statement and the 10-year plan. I am delighted that residents in Dartford were able to play a full part in shaping its priorities through our consultation meeting in February. They will be really pleased to see not only the additional GP appointments, but the pressure being taken off their local hospital, Darent Valley, through the provision of better and more community services. The hospital was designed with a much smaller community in mind and is now suffering the consequences. Can the Secretary of State give me an idea of the pace of the roll-out of neighbourhood health centres? We could certainly do with one in Dartford.

[Wes Streeting]

I am grateful to my hon. Friend for his question—representation duly received. I reassure him that one of the ways we will ease the pressure valve on our hospitals is by doing more neighbourhood health. That helps to drive admission avoidance, speed up delayed discharges, and get much more effective flow of patients through hospitals. That is our commitment. We aim to roll out 40 to 50 neighbourhood health centres over the course of this Parliament, and if we can go faster, we will. I have no doubt that my hon. Friend, as a strong representative for Dartford, will make more representations to us shortly.

Mental Health Bill [Lords]

Jim Dickson Excerpts

2nd reading
Monday 19th May 2025 Commons Chamber

[Jim Dickson (Dartford) (Lab)]

I thank everyone who has taken part in the debate, from the Secretary of State onwards. It has been moving and inspiring to see the House united on the need for change. It has been particularly useful for me to benefit from the professional expertise and the personal experience of so many Members who have spoken. My hon. Friend the Member for Sittingbourne and Sheppey (Kevin McKenna), the hon. Member for Runnymede and Weybridge (Dr Spencer), my hon. Friends the Members for Ashford (Sojan Joseph) and for Thurrock (Jen Craft) and the hon. Member for St Neots and Mid Cambridgeshire (Ian Sollom) have all educated and moved me with their experience and knowledge.

It has long been known that the Mental Health Act 1983 is not fit for purpose, and I pay tribute to all the work that has been done so far, including the excellent review undertaken by Professor Sir Simon Wessely, commissioned by the former Member of Parliament for Maidenhead when she was Prime Minister. I know that the intent of the Bill both to strengthen the voice of patients and add statutory weight to their right to be involved in the planning for their care and to inform their choices about the treatment that they receive is strongly welcomed by Members on both sides of the House. Also welcome are the steps that the Government have taken since the election to start to transform mental health services with new funding—mentioned by the Secretary of State—and the plans to recruit 8,500 new mental health workers.

Before I deal with the substance of the Bill, may I ask the Minister whether, when he winds up the debate, he will be able to provide some reassurance about the future of the patient and carer race equality framework, which I believe is vital to the achievement of equality of outcome in mental health, and which I believe would be more effective as part of the Bill than simply as guidance? I know that that is the strongly held view of many of the experts by experience who have worked on PCREF.

One thing I know from my time in a previous role, when I helped to develop mental health services in Lambeth over two decades, is that a disproportionate number of people from African and Caribbean-heritage communities are detained under the Mental Health Act, as has been said by others. Figures highlighted by Mind show that rates of detention for black or black British groups are over three times those for the rest of the population. Similarly, black or black British groups are more than 10 times more likely than white groups to be subject to community treatment orders.

In Lambeth, working with organisations such as Black Thrive—set up by my great former colleague Dr Jacqui Dyer, among others, to radically change mental health services in south London and elsewhere—we showed that hearing people’s voices, early intervention, reducing stigma among African-Caribbean communities, and focusing on keeping people well via work and training provided by membership organisations, such as Mosaic Clubhouse, can prevent people from becoming ill and from tragically coming into the mental health system for the first time via the criminal justice system.

I welcome the changes in the Bill and the commitment from the Minister in the other place to improve data on outcomes and on patients’ experience of community treatment orders. Despite the passing of the Mental Health Units (Use of Force) Act 2018—otherwise known as Seni’s law—which was brought forward by my right hon. Friend the Member for Streatham and Croydon North (Steve Reed), the use of force in mental health settings remains too frequent, and that must be addressed as well.

Prevention work and intervention to address mental health needs at the earliest possible stage are critical, because if someone faces mental health problems when they are young, it can hold them back at school, damage their potential and leave them with lifelong consequences. That is why I warmly welcome the work that the Government are doing to bring vital services into schools so that they can intervene early, support pupils and help prevent conditions from becoming severe. It is really encouraging that mental health support teams should reach 100% coverage of pupils by 2029-30—the end of this Parliament.

Young people in Dartford, where I ran a well-supported engagement event last month, will absolutely welcome the introduction of Young Futures hubs in communities in England to deliver support for teenagers who are at risk of being drawn into crime or facing mental health challenges by providing open-access mental health support for children and young people in communities. I have seen that approach achieve excellent results at the Well Centre, a mental health centre run for young people in Herne Hill as part of Lambeth Together’s care partnership.

I very much look forward to seeing this legislation progress through the House and become law with the support of all Members. I will support it 100% as it does so.

[Madam Deputy Speaker (Caroline Nokes)]

I call the shadow Minister.

Oral Answers to Questions

Jim Dickson Excerpts

Tuesday 6th May 2025 Commons Chamber

[Wes Streeting]

We are absolutely convinced that better use of digital tools will enable us to reduce the number of missed appointments significantly and factor in the likelihood of no-shows, so that we can reduce waste and eliminate inefficiency. I understand the case for penalties that the hon. Gentleman is making, but that is not a route we want to go down until we have made those improvements and judged how effective they have been.

[Jim Dickson (Dartford) (Lab)]

T9. Far too many promises made by the last Government—promises that care would be moved out of hospitals and into the community—turned out to be hollow. From speaking to residents in Dartford, I know that hospital and community services have struggled to keep pace with new housing developments in the constituency. I am pleased to say that later this year in Dartford we will be seeing an expansion of our state-of-the-art community diagnostic centre, taking care closer to where people live. Does the Secretary of State agree that this is the start of Labour getting on with finally delivering that big shift, and will he visit Dartford with me—

[Mr Speaker]

Order. I think Ministers have got the message. If they have not by this stage, I would be surprised. Who is answering?

Hospitals

Jim Dickson Excerpts

Wednesday 23rd April 2025 Commons Chamber

[Stephen Kinnock]

I was very pleased to see the £102 million capital investment in GP primary care. I encourage the hon. Gentleman’s ICB to look very carefully at that fund and to explore the potential that it offers. We are in conversation with colleagues in the Ministry of Housing, Communities and Local Government about ensuring that section 106 processes are working properly, so that when there are new developments, there is proper wraparound in the social infrastructure required to make them sustainable. In the space of just nine short months, we have gone from a charade based on smoke and mirrors to a programme based on serious, systematic delivery.

[Jim Dickson (Dartford) (Lab)]

The Minister is setting out very articulately what this Government are doing to clear up the mess around the hospital provision that this country needs. Does he agree that the announcement by Dartford and Gravesham NHS Trust last week that it will build a new and expanded intensive care unit at Darent Valley hospital is a big step forward for Dartford residents? It badly needs new facilities to cope with waiting lists and get them down and to cope with the rising population of the area.

[Stephen Kinnock]

My hon. Friend is a strong campaigner for his constituents. He is right that that development will be a game changer. It will be important that we keep people’s feet to the fire to deliver on what has been promised. I guarantee that he will have my full support and that of the entire ministerial team.

With your permission, Madam Deputy Speaker, I will now address the Liberal Democrat motion, beginning with its point about the cannibalising of NHS capital budgets to keep day-to-day services running. I am delighted to confirm from this Dispatch Box that this Government have drawn a line under that appalling practice, to which the Conservative party was utterly addicted. The Treasury now has new fiscal rules to prevent that from happening again; capital spending is safe in our hands.

Secondly, on reversing the so-called programme that we inherited on 4 July, I hope I have made it clear that that whole sorry mess was a work of fiction. It is not a question of reversing anything, as the Liberal Democrats say in their motion, because there was nothing to reverse. Instead, we have gone back to the drawing board, and systematically designed and built a completely new programme and a completely new approach.

Tobacco and Vapes Bill

Jim Dickson Excerpts

Report stage
Wednesday 26th March 2025 Commons Chamber

[Bob Blackman (Harrow East) (Con)]

It is a pleasure to follow the hon. Member for Newcastle upon Tyne East and Wallsend (Mary Glindon), and I congratulate her on her work on vaping and combating illegal sales. I declare my interest as the co-chair of the all-party parliamentary group for action on smoking and health for nine and a half years. I have seen the work that the Conservative Government did to combat smoking, which led to a dramatic drop, but we are not where we need to be. I commend the Minister and the Government on bringing forward the Bill, and on absorbing almost all the amendments that my colleagues and I proposed in the Bill Committee for the previous Bill to strengthen it and make it much more likely that we can achieve a smokefree England by 2030.

As has been said, the Bill will make us a world leader in tobacco control. We have always been at the forefront, but it consolidates regulation and limits the reach of the tobacco industry. We should be clear that tobacco is a uniquely lethal product that, when used as intended, kills two thirds of long-term users. Above all else, it is highly addictive and hard to quit once people are addicted. Most smokers will say that they wish that they did not smoke and had never started, and that they have had their agency removed by their addiction. By passing this legislation, we are giving choice back to young people in the future, who will avoid ever falling into that trap and the addiction that it brings.

I have tabled a number of new clauses. I think that the Minister is unlikely to accept them, but I commend them to her for further consideration. New clause 17 calls on the Government to consult on the introduction of a “polluter pays” levy on the profits of the big tobacco industry. The all-party group has championed this campaign for many years. It is supported by the Khan review, which was set up by the former Member for Bromsgrove to enable a position to be reached. Almost all its recommendations are absorbed by the Bill, as they were by the previous Bill, but some are outstanding. The “polluter pays” levy is one of them. It is supported by charities, health organisations, academics and think-tanks.

Tobacco consumption costs our society greatly. The latest data from Action on Smoking and Health estimates that smoking costs society in England alone £43.7 billion a year—far more than the £6.8 billion that is raised through tobacco taxes. That includes £27.6 billion in lost economic productivity. We heard from the Chancellor and the Secretary of State for Work and Pensions about reducing the cost of the welfare state. If we can stop people smoking, they will not become unhealthy and unable to work. They will be able to get back into the workforce and pay taxes rather than be in receipt of welfare. This is an opportunity to reduce the impact on the benefit system and improve productivity right across the UK.

[Jim Dickson (Dartford) (Lab)]

I commend the hon. Gentleman on his excellent speech so far and his work over many years to reduce smoking prevalence in this country. Does he agree that the tobacco companies still make a huge margin on the tobacco that is sold, and therefore could easily afford the “polluter pays” levy that he proposes?

[Bob Blackman]

I welcome that intervention from the vice-chair of the all-party group. As we have said, smoking is not a free choice; it is an addiction peddled by an aggressive industry. I will come to some of the things that the hon. Gentleman has said.

--- Later in debate ---

[Sammy Wilson (East Antrim) (DUP)]

I want to speak to amendment 4 and the subsequent amendments in my name, and to new clause 3. It is right that where a public health issue is identified, this body should look at whether anything can be done about it through law, fiscal policy, or the other levers available to us, but we should ask ourselves, when we introduce laws, what the consequences are. Are there any unintended consequences, and how practical and enforceable are the measures? If they are unenforceable, all we do is bring the law and this place into disrepute. While some have described this Bill as well-meaning, essential, a flagship Bill, and a show of leadership, I am concerned that we have given little thought to, and had little debate about, the consequences, which are hitting us in the face. Let us be honest with ourselves: it would be good to walk away at the end of today’s sitting and say, “We have done a wonderful thing for future generations; we have introduced laws that will do away with smoking and will improve the health of the nation,” but we are ignoring the fact that we have introduced legislation that is unworkable, and to which I believe, through my amendments, there is an alternative.

[Jim Dickson]

Does the right hon. Gentleman recall that many warned before the 2007 smoking ban that it would be unenforceable, and that there would be barely any compliance with it? However, from day one, there was 97% compliance. That law has helped to drive a reduction in cancers due to secondary smoking, and a massive number of people gave up as a result of no longer being able to smoke in the pub.

[Sammy Wilson]

The hon. Member will have the answer to that if he reflects on what we are debating today. We introduced that legislation, yet here we are, revisiting the issue, because people are still smoking and health outcomes are still bad—and we have additional problems, which I will come to in a moment, namely the illegal purchase and supply of tobacco. We have tried this in the past—we have tried bans and all kinds of other measures—yet we still have the problem with us.

Let us consider the consequences. First, we are being asked to introduce legislation, the burden of which will fall on retailers, because it is at the point of purchase that the scrutiny required by the Bill, and its implementation, will have to take place. There is a question that we have not debated yet: what happens when a retailer is faced in a few years’ time with two people, one aged 29 and the other 28, both demanding tobacco? One says “I’m 29” and the other says “I’m 29 as well.” The retailer is meant to distinguish which of them he can sell tobacco to legally. That is a real, practical problem, and it places a burden on the retailer, because if he does not make the right decision, he faces a fine and the removal of his license, and that source of income for his business will be affected.

--- Later in debate ---

[Robin Swann (South Antrim) (UUP)]

I echo the words of the hon. and learned Member for North Antrim (Jim Allister) with regard to the importance of this Bill applying to all four nations: I want it to cover the entirety of the United Kingdom. Some 2,200 people in Northern Ireland die every year from a smoking-related illness. One in four of our cancer cases is related to smoking. The consultation carried out by the previous Government on their legislation, which was specifically about creating a smokefree generation, found that 62.5% of the UK population were supportive. In Northern Ireland, however, 79% were in favour of bringing forward this legislation.

Back in May 2024, when I was a Northern Ireland Health Minister, I introduced the original legislative consent motion, which received all-party support across the Northern Ireland Assembly, and yes, as the hon. and learned Member for North Antrim has mentioned, there were concerns over the applicability of the measure owing to EU regulations and legislation. There was a concern that the law would remain undelivered in Northern Ireland. At that stage, I engaged with the then UK Government, and have now engaged with this Government to seek assurances that this lifesaving, life-changing legislation will apply equally and favourably to all parts of our United Kingdom. I look forward to the Minister being able to give me those reassurances. I have signed new clause 3, because I accepted those reassurances as Health Minister but would appreciate reinforcement in this legislation.

Much has been said about the entrapment of our young people—whether previously with regard to tobacco, or now with vaping and vaping products and how they are being marketed and presented. One of the most harrowing reports that I have read recently was regarding Alder Hey children’s hospital, which has now opened a clinic for children addicted to nicotine. They became hooked because of vaping. Twelve children between the ages of 11 and 15 have had to seek medical help to cut down and deal with their nicotine addiction. Twelve children between the ages of 11 and 15 are receiving treatment in a children’s hospital due to the evil promotion and enhancement of not just vaping but nicotine. We are looking to save money within our national health service, but we are already encouraging and enabling these young people to become addicted to a dangerous drug. We should be doing everything we can in this place for young people.

According to reports about the Alder Hey clinic, children as young as eight are vaping regularly. Some reportedly cannot get out of bed in the morning before they take their first puff. That is a disgrace. I encourage anyone in this Chamber who in any way opposes the Bill or thinks that this is not the right thing to do to seriously consider how vaping is impacting our young people across this United Kingdom.

I finish by asking the Minister to reassure this House, not just with words but with action. Can she assure those of us from Northern Ireland who have supported the legislation and worked hard to make sure that it had a four-nations approach that the guidance, support and legal enforcement in the Bill is equally applicable to us in Northern Ireland?

[Jim Dickson]

I rise to speak to new clause 14 and amendments 86 and 87. I declare an interest as vice chair of the all-party parliamentary group on smoking and health. I am also a previous smoker and a strong supporter of this legislation.

New clause 14 would introduce a ban on all filters, regardless of whether they contain plastic. I understand the environmental motivations behind new clause 2 from the hon. Member for Gosport (Dame Caroline Dinenage), but I worry that the amendment is not sufficient to address environmental concerns and could even have a damaging impact on public health. Let us start from the understanding that there are no health benefits to filters. They were developed by the tobacco industry following evidence that smoking caused lung cancer in order to give a false sense of reassurance to smokers. Filters have been dubbed

“the deadliest fraud in the history of human civilisation”.

Most filters contain single-use plastics and are a major environmental hazard, costing UK local authorities around £40 million a year to clean up. Cigarette filters are the most littered item in the world. In the UK they make up 66% of all littered items. Biodegradable alternatives may therefore feel like an attractive solution, but biodegradable filters do not eliminate environmental concerns. They have been shown to be equally toxic to marine and freshwater life when littered in our rivers and seas. They take between two and 14 years to decompose, and they often do so only in very particular conditions, such as under high temperatures. Biodegradable filters could also lead to an increase in guilt-free littering through smokers believing that discarded butts do not have an environmental impact.

However, the greatest risk of biodegradable filters is that they allow tobacco companies to continue with filter fraud and greenwashing in order to rehabilitate their reputation. The best policy, therefore, is to ban all filters. It would mean smokers smoking filterless cigarettes, which, I remind the House, are no worse for their health. It would incentivise quitting, which is the best way to tackle tobacco-related litter and pollution, and it would put people off starting smoking—something of which I am sure everyone in this Chamber would be in favour.

Ending the sale of filters would remove the fraud being perpetrated on smokers that by using a filter they are protecting their health. We banned descriptors such as “light” and “mild”, because they gave false comfort to smokers that they were using safer products and inhibited them quitting. We should do the same again by banning filters, ensuring that those who smoke do not do so because of a belief that their cigarette is safer. Recent ASH polling showed that only 25% of the public is able to correctly identify that filters have no health benefit. The Government should be bold in addressing these misconceptions for the benefit of public health and take the opportunity of a ban to highlight the harms of tobacco.

A ban on filters is an opportunity to protect the environment and secure health benefits. The impact of any ban should be maximised by a strong communications campaign to educate smokers and the wider public about filter fraud.

Briefly, amendments 86 and 87 flag the need for the Government to consider the matter of the sale of bundles of tobacco papers and filters, which could be seen as smoking starter kits. Some supermarkets offer these bundles at only a small cost above the price of the tobacco alone. They are convenient and cost-saving for smokers. That undermines the public health motivation for increasing the price of tobacco products.

NHS England Update

Jim Dickson Excerpts

Thursday 13th March 2025 Commons Chamber

[Wes Streeting]

NHS dentistry is in a terrible state and, in fact, in many parts of the country it barely exists. There are lots of reasons for that, and it is a source of constant astonishment to me that the dentistry budget was underspent year after year despite that situation. The Minister for Care is working with the British Dental Association to reform the contract. I know that Members are frustrated at the pace, and so am I. We are trying to clear an enormous challenge; it is not going to be easy, but we are committed to working with the profession. We are rolling out the 700,000 urgent dentist appointments and supervised toothbrushing, as we promised and as the BDA has welcomed, but we have a lot more to do. That requires working with the profession—not simply tinkering with the system as it is, but fundamentally rethinking it and how we rebuild it into an NHS dentistry service that we can be proud of.

[Jim Dickson (Dartford) (Lab)]

I welcome the statement, particularly the commitment to ensure that as much money in the NHS as possible is spent on the frontline, where it can really affect patient outcomes. Nowhere is that more needed than in my constituency of Dartford, which is the fastest growing town in the UK. That extra population is imposing a huge strain on our local district general hospital at Darent Valley, despite the excellent efforts of the staff there. Could the Secretary of State outline how the changes will support the shift we need to see from services being delivered in the hospital to the community, thereby relieving the strain on hospitals like Darent Valley?

[Wes Streeting]

The frustrating thing is that we are delivering the wrong care in the wrong place at the wrong time, which is delivering poorer outcomes for patients and poorer value for taxpayers. People cannot get a GP appointment, for example, which might cost the NHS £40, and then they end up in accident and emergency, which could cost £400. If people cannot find a bed for a delayed discharge and rehabilitation outside of hospital, they end up stuck in a hospital bed, wasting away at greater cost. In fact, when I was up in Carlisle earlier this year, such intermediate care was being offered by a local social care provider, commissioned by the NHS, at half the cost and of a much better quality than the hospital bed that patients had been discharged from. That shift to the community is about delivering better outcomes for patients and better value for taxpayers, and that will be reflected in our 10-year plan.

HIV Testing Week

Jim Dickson Excerpts

Thursday 13th February 2025 Westminster Hall

[Jim Dickson (Dartford) (Lab)]

It is a pleasure to serve under your chairship, Dr Allin-Khan. I pay tribute to the right hon. Member for Dumfriesshire, Clydesdale and Tweeddale (David Mundell) for securing this important debate and for his excellent speech.

We are here because of the work done by the excellence Terrence Higgins Trust, which, with the Department of Health and Social Care, runs the vital National HIV Testing Week campaign. It provides a vital staging post towards the goal, which we all share, of ending new HIV infections by 2030. This week, as the right hon. Member said, anyone can order a free postal HIV test, and I encourage anyone listening to do so. I was pleased to be able to take a test myself just next door, on Tuesday, at the excellent event run by the Terrence Higgins Trust.

I welcome the goal set by the last Government to end new HIV cases by 2030, and I am pleased that the new Labour Government have commissioned a new HIV action plan for England, which is expected to be published in the summer, to make that a real prospect as we approach 2030. As I am sure other hon. Members will agree, if we are to meet this ambitious target, it is crucial that we find the estimated 4,700 living with undiagnosed HIV in England, as well as those across the UK, and ensure that they are getting the lifesaving treatment they need and cannot inadvertently pass on the infection. It is clear that that will happen only through testing.

In my previous life as cabinet member for health in Lambeth, we worked very closely with the Elton John AIDS Foundation to introduce the world’s first social impact bond focused on bringing people living with HIV into care. We worked with a coalition of third-sector organisations across the three boroughs of Lambeth, Southwark and Lewisham to ensure that health settings earned outcome-based payments each time they identified someone either newly diagnosed with HIV or someone who had stopped treatment, and linked them back into care. Our brilliant GPs across the three boroughs carried out opt-out testing to accompany this set of changes. The results were dramatic: over three years, more than 265,000 people received HIV testing, and more than 460 south Londoners living with HIV entered treatment. More than 200 people received a new HIV diagnosis and attended their first treatment, and 250 who had stopped treatment returned to care.

I am proud of the work done across local government in the fight against HIV/AIDS. In Lambeth, for instance, the council has led London boroughs on commissioning of the London HIV prevention programme. We were in the forefront of the successful campaign to get PrEP provided free on the NHS for all those who needed it, and the council continues to jointly commission, with our neighbouring boroughs, work with marginalised groups to reduce stigma and thereby increase awareness of HIV and the need to take tests.

I support the Government’s aim of ending new HIV cases in England by 2030, supplemented, it needs to be said, by the Mayor of London’s great work in ensuring that the capital is a fast-track city. However, that date is only five years away and, like the right hon. Member for Dumfriesshire, Clydesdale and Tweeddale, I worry that without a dramatic increase in testing, we will not get there. I was pleased therefore that last month the Government announced an expansion of the number of hospitals carrying out HIV opt-out testing, including Darent Valley hospital in Dartford, in my constituency. I welcome the service that will be made available to my residents as a result.

I hope that the new HIV plan for England, expected this summer, will build on that expansion and bring the increase in opt-out testing we need to find all those unknowingly living with HIV. The incredibly welcome 5.4% increase in the public health grant for 2024-25—that is £200 million, which is the biggest increase for many years—will strengthen this work, alongside so many other areas in which we need to tackle health inequalities.

I would like to end by paying tribute to all the charities working so hard to tackle this issue, including but not limited to the Terrence Higgins Trust, the Elton John AIDS Foundation and the National AIDS Trust.

National Cancer Plan

Jim Dickson Excerpts

Tuesday 4th February 2025 Commons Chamber

[Andrew Gwynne]

I congratulate the hon. Lady’s step-mum on ringing that bell, which is great news. The hon. Lady is absolutely right to raise the issue of inconsistency when it comes to the levels of service that different patients get. That will obviously be a major factor in the national cancer plan going forward, to ensure that all people diagnosed with cancer have the same levels of treatment and the same opportunities to survive.

[Jim Dickson (Dartford) (Lab)]

I warmly welcome the Minister’s statement. He will know as well as anybody else in this Chamber that smoking causes one in four cancers in this country, and that two out of three people who smoke will die as a result. He is assiduously moving the Tobacco and Vapes Bill through Parliament. Can he set out the likely effect that the Bill will have on those shocking statistics?

[Andrew Gwynne]

I am grateful to my hon. Friend for being a member of the Committee for that Bill, which ended its business last Thursday. The hon. Members for Sleaford and North Hykeham (Dr Johnson), and for Farnham and Bordon (Gregory Stafford), who are sitting on the Opposition Front Bench, were also members of that Committee. My hon. Friend is absolutely right, because the Bill will stop the conveyor belt that the tobacco industry has used to its advantage for decades. We are saying that we will not allow any more children and young people to become addicted to nicotine and tobacco, which, as he says, kills two out of every three users. It is uniquely the most harmful product, and we are making the next generation smoke-free for a reason.

Tobacco and Vapes Bill (Thirteenth sitting)

Jim Dickson Excerpts

Committee stage
Tuesday 28th January 2025 Public Bill Committees

[Andrew Gwynne]

I am very happy to answer the question posed by the shadow Minister. It is a simple answer: we need clause 133 to avoid loopholes. Otherwise, newer products such as heated tobacco—and those products that have not even been developed yet—are in scope of the restrictions, but devices used alongside them could still be used to promote tobacco consumption.

Question put and agreed to.

Clause 133 accordingly ordered to stand part of the Bill.

Clauses 134 and 135 ordered to stand part of the Bill.

Clause 136

Addition of smoke-free places in England

[Jim Dickson (Dartford) (Lab)]

I beg to move amendmentusb 11, in clause 136, page 77, line 8, after “regulations” insert

“and a local authority may (as respects its area) make byelaws”.

This amendment would extend the power to designate areas as smoke-free to certain local authorities, by making byelaws. Any byelaws so made would need to be confirmed by the Secretary of State by virtue of section 236 of the Local Government Act 1972.

[The Chair]

With this it will be convenient to discuss the following:

Amendment 12, in clause 136, page 77, line 14, after “regulations” insert “or byelaws”.

This amendment is associated with amendment 11.

Amendment 13, in clause 136, page 77, line 16, after “regulations” insert “or byelaws”.

This amendment is associated with amendment 11.

Amendment 14, in clause 136, page 77, at the end of line 24, insert—

“(5) Before making byelaws under this section the local authority must consult any persons the local authority considers it appropriate to consult.

(6) In this section,

‘local authority’ means a county council in England, a district council, a London borough council, the Common Council of the City of London in its capacity as a local authority, the Council of the Isles of Scilly, a combined authority or a combined country authority.”

This amendment is associated with amendment 11.

[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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[Jim Dickson]

Certainly, public spaces are not going to change, but smoking prevalence is; it may be that as, a result of declines in smoking prevalence, the public acceptance of smoke-free areas may change. I am sure that the Minister will have a useful contribution to make in response to the hon. Gentleman’s point when he speaks. There is a discussion to be had.

I would be particularly interested to look at the data and modelling and the customer feedback that suggests that hospitality venues are economically dependent on the consumption of tobacco. As we have discussed, currently only 11% of the population smoke—granted, if we are talking about nightlife, that prevalence may be higher, but I certainly believe that families should be able to enjoy eating outside in the summer without being exposed to the risk of second-hand smoke. We have seen that smoke-free pavement licences are popular with businesses and with the public, particularly families with children.

Giving local authorities a say in how smoke-free laws are applied will align with the commitment in the recent English Devolution White Paper to shift any power

“away from Whitehall and into the hands of those who know their communities best”.

It is critical that local authorities consult fully on any measures, and particularly closely with the hospitality industry. As I say, there is a possibility that that industry, in specific parts of local authorities where the consultation takes place, may actually agree and feel that this is a sensible step. It is important that local authorities get this right with the right consultation, but they should have the powers to do it.

[The Chair]

I remind Members that we are at this point talking about amendments, so any comments should be restricted to those amendments. We can talk about the generalities of the clause later in the debate. It is always helpful to have a reminder of that—for myself as well.

[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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[Sarah Bool]

I absolutely agree, and my hon. Friend makes a powerful point. I would like us to consider this issue when we look at whether to take these proposals any further. I cannot see how we can ensure in practice that everyone knows what is happening without there being a national campaign.

[Jim Dickson]

Perhaps I can try to answer a couple of the questions from the hon. Lady and other hon. Members. If a byelaw were enacted, it would need to be well publicised, and there would need to be signage. Clearly, it would be impossible for a local authority to enforce a byelaw against which the defence was, “We had no knowledge of the fact that there was a byelaw.” Therefore, doing those things would be very important, and that would obviously be part of the consultation. The local authority would also have to set out a plan, and it would ultimately have to be approved by the Secretary of State, who I am sure would ensure that it was adequate. In terms of the penalties, the local authority has the power to set out its own penalties, but only within the quite tight legal framework set out in the Local Government Act. It would be for the local authority in this instance to define the level of penalty and what was proportionate.

[Sarah Bool]

I thank the hon. Member for clarifying that point. Many Members would prefer that local councils were dealing with potholes rather than advertising those different spaces, but I thank him for his amendment and his proposal.

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[Andrew Gwynne]

Obviously, if a local authority introduces byelaws, as the City of Manchester has done in respect of pavement licensing, it is for that local authority to ensure that those byelaws are adhered to. Of course, in that case, the weights and measures authority is the City of Manchester, so I suppose that makes it easier.

These powers are already being used. Local authorities are already designating areas, whether it is for pavement licences, public space protection orders or just deeming that land within their own responsibility is smoke-free. We do not believe that the amendments are necessary. I kindly ask my hon. Friend the Member for Dartford to withdraw them.

[Jim Dickson]

The Minister has given a very comprehensive response. I suspect that the suggestion that this might be a way forward might come up in the consultation when that happens in the coming months. For the moment, I beg to ask leave to withdraw the amendment.

[The Chair]

Mary Kelly Foy, did you want to speak?

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Division 25

Ayes: 4

Noes: 8

[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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As the shadow Minister said, if the Bill passes, smoking will not be illegal; smoking, and likewise vaping, will be illegal for certain people of a certain age. As I said previously, I support the ambitions of the Bill, but this is a massive overreach. If a person is legally allowed to smoke in their own home on their own—or indeed with others—then if they are in their own vehicle and their smoking is harming nobody other than themselves, I do not see that we should make that illegal.

[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.)