Tobacco and Vapes Bill

Joe Robertson Excerpts

2nd reading
Tuesday 26th November 2024 Commons Chamber

[Mr Jonathan Brash (Hartlepool) (Lab)]

It is a rare thing in politics to have a moment when there is an absolute right thing to do, but consigning smoking to the history books for our children, our grandchildren and every generation that follows is one of those times. We should be under no illusion that the decision that we take today will, at some point in the future—long after we have left this place—result in a time when nobody smokes. That will be the legacy of this decision today.

I ask the House to indulge me for a moment. Let us imagine that, at that point in the future, somebody brings forward a Bill to decriminalise smoking, and the Minister, clutching their impact assessment, tells the House that it will kill only 80,000 people a year, that it will cost our NHS £3.6 billion and that 80% of the people who take it up will be under 20. Which one of us would vote for it? Which party leader would refuse to direct their troops in such a vote? Who would argue that it is freedom of choice to smoke in those circumstances? It is nonsense. The decision we are taking today is clear and it is for the good of this country.

[Joe Robertson (Isle of Wight East) (Con)]

The hon. Member talks about choice. I agree with what he has said so far, but does he agree that, when it comes to the banning of smoking for people born after 1 January 2009, there is no removal of choice in the Bill, because they cannot smoke anyway at the moment? Therefore, there is no removal of choice from those people.

[Mr Brash]

The hon. Member is completely correct in what he says, and it is the proportionate way to do it. Some of the arguments that I have heard today about freedom of choice are genuinely confusing. One Member asked earlier why we do not ban sugary foods or alcohol on that basis. I say that we have to draw the line somewhere. That is an argument for the decriminalisation of everything—cocaine, heroin, you name it, let’s go for it. No, we have to draw the line somewhere and, given the statistics around smoking, it is clear that this is the right line to draw.

I do not want to say a great deal more on this issue other than to reflect on the conversations that I have had with my children. We have been on a long journey when it comes to smoking in this country. I remember telling my children that they could eat a meal in a restaurant, and that those on the table next to them, in the smoking zone, would be smoking while they ate. They thought I was mad. I remember going to school on the bus and seeing the little cigarette holders in front of me because people used to be able to smoke on the bus. My children think that is madness. I can only hope that not long in the future children will look back and think that it was mad that we smoked at all.

I was asked about this Bill soon after I was elected by a friend, who is a parent. He knew it had fallen prior to the general election. He asked, “Will it be back?” and I said, “I am confident that it will be back.” He said, “But will it be in time?” and I said, “In time for what?” He said, “In time for her” and pointed to his teenage daughter. I am pleased to say to Mark, Kim and their daughter Bella that we are bringing it back in time and that it will make a massive difference to the lives of people in this country.

Healthcare: Hampshire

Joe Robertson Excerpts

Wednesday 20th November 2024 Commons Chamber

[Dr Chambers]

I agree with the hon. Gentleman; when there is a lack of communication with residents, decision makers and any other interested stakeholders, that is when there are difficulties, such as rumours and unnecessary anxiety. Improved communication, whether in healthcare or in any Government Department, solves a huge number of problems.

On the point made by the hon. Member for Strangford (Jim Shannon) about accessing healthcare when people live in rural areas, I have a story about Margaret, who lives just south of Winchester and who wrote to me saying that she had been given an appointment at Basingstoke for a particular type of X-ray. Her journey to Basingstoke hospital took well over an hour and involved multiple buses and a train, plus considerable walking time. Margaret has chronic obstructive pulmonary disease and gets exhausted walking long distances, and she cannot easily afford a taxi all the way from Basingstoke back to Winchester. She asked me whether people without cars were to become second-class citizens and be denied access to decent healthcare options. We have to look at individuals’ situations, and that can include needing really good public transport. The more community care we have in people’s towns and villages, the quicker they can get there from their homes.

The other side of emergency care and A&E departments is social care. We have said many times that we cannot fix the NHS without fixing social care. We know that in the Hampshire hospitals NHS foundation trust, there are between 160 and 200 people at any given point who are well enough to be discharged and more appropriately cared for in the community with social care packages, but who are currently stuck in a hospital bed and cannot be discharged. That means that patients cannot be moved out of A&E and people cannot be removed from ambulances as quickly as they could be, which means that ambulance waiting times are longer.

When I spoke to the CEO of Winchester hospital, he said that the single biggest help they could get from Government would be another 160 social care packages. Although people ask where the money will come from, we know it is more expensive to keep someone in a hospital bed than to give them a social care package. We have winter pressures coming up—indeed, winter has already started—and the CEO has told me on more than one occasion that, to help with those winter pressures, more social care packages would probably be the single biggest intervention that would make a huge difference. Local authorities struggle to afford social care packages and the NHS trusts have to fund some of those packages out of their NHS budget, which is primarily meant for treating people in hospital.

One of the biggest concerns raised by Winchester residents is the potential removal of consultant-led maternity services at Winchester hospital. That means that if a woman were to haemorrhage or require an emergency C-section during labour, she would need to be transferred. To put that into perspective, in April 2024, 22.7% of births were performed via emergency C-section at Winchester hospital. It is clear that surgical interventions are not an unusual eventuality, but something that will affect more than one in five mothers.

An emergency transfer in such a situation would inevitably put the lives of some women and babies at serious risk and, tragically, some could be lost. A constituent wrote to me about her daughter, who had recently haemorrhaged badly after giving birth to a baby who was in a breech position. The blood transfusion and lifesaving surgery to remove her placenta needed to happen within minutes, and it is unthinkable what would have happened had there been no consultants on hand. As someone who has performed many emergency caesareans—on animals rather than on humans—I know that time is of the essence, and anything that delays surgical intervention can make a huge difference, not just to whether the person and the baby survive but to whether the baby has potential brain damage and other life-changing complications.

As the Liberal Democrat mental health spokesperson, I see this debate as a chance to highlight how desperately we need more resources put into mental health, alongside a more holistic approach to treatment. When speaking to residents in Winchester, one of the most common concerns is the difficulty in accessing mental healthcare, and that is especially true for parents who are struggling to access mental healthcare for their children.

I spoke to a constituent near Swanmore who was struggling to access the mental healthcare and support they needed for their child who was anorexic and had an eating disorder. They had been informed that their child had to reach a lower BMI to qualify for the threshold to get treatment, because resources are so stretched. That would not be considered even remotely acceptable for any other disease. A person with cancer would never be told that they needed to reach stage 4 before they qualified for treatment. We know that outcomes with delayed treatment for mental and physical health disorders, of which eating disorders are a combination of both, will be much less successful and much less cost-effective, requiring longer and less successful treatment the longer that the condition is left. I urge the Minister to look with particular concern at the mental health of young people and children. Delays in mental health treatment for anyone can be catastrophic, but a three-year delay for someone who is only 13, 14, or 15 is a huge chunk of their life.

As part of that, we urgently need to invest in primary care. Failing to address this will only place greater pressure on our already overstretched hospitals. I have spoken to people who have spent extended amounts of time in hospital beds, because they cannot get the mental healthcare that they need.

Similarly, the lack of NHS dentists often forces patients to turn up to hospital, sometimes needing a general anaesthetic, to sort out tooth root abscesses, which costs more than providing NHS dental care. It seems as though all the dentists I speak to say that their current contract for performing NHS care is not fit for purpose. I urge the Minister to look at this as an urgent priority, because so many people are not receiving the dental care that they need. It seems as though this whole issue will not be resolved until the NHS contract is looked at.

The other issue that affects people getting healthcare in their communities, especially around Hampshire, Winchester and the Meon Valley, relates to struggling pharmacies. The situation for pharmacies seems to be very similar to that of the dentists in that their arrangement with the Government for providing prescription services does not seem to be fit for purpose. It seems to be costing pharmacies money to provide prescription drugs, and they are telling me that their businesses are no longer viable. The more pharmacies that we lose, the further people will have to travel to not only collect drugs, but get medical advice and vaccines.

In conclusion, I wish to pay tribute to NHS staff. I imagine that they dread the winter coming up. Every year, it is a stress for them. Every year, they are overworked. And every year, we know that both clinical and non-clinical staff will work longer hours than they are contracted to do. I know that they will be bracing themselves right now. They will be busier, and they will be putting themselves at risk from getting things such as flu, covid and the other respiratory diseases that we see in the winter. One thing that we can all do, both as the public and the Government, is to encourage everyone to get vaccinated ahead of these winter pressures. Anything we can do to prevent a trip to hospital will make their job easier and make it less likely that they will get sick.

[Joe Robertson (Isle of Wight East) (Con)]

The hon. Gentleman speaks eloquently on a wide range of healthcare challenges in Hampshire. Does he agree that our shared integrated care board for Hampshire and the Isle of Wight must do all that it can to make the best of the situation, particularly in relation to NHS dentistry and funding for hospices across Hampshire and the Isle of Wight?

[Dr Chambers]

The hon. Member makes a good point about hospices in particular. Only about a third of hospice funding is provided by the Government. It is a hugely emotive subject, which affects not only the people in the hospice but the whole family, who are trying to care for a loved one who often has only weeks or months left to go. We have two hospices in Winchester, one of which is a children’s hospice, Naomi House. Some of the most moving visits I have ever done have been to hospices, where the staff and patients are incredibly brave. We have a debate coming up on assisted dying. We will really have to look at palliative and hospice care and how it is funded, and how we make it sustainable and fit for purpose. I thank him for that important intervention.

Many constituents write to tell me about the excellent care that they receive in hospitals, and how much they appreciate the hard work of NHS staff. A Winchester resident called Owen wrote to tell me that he honestly does not believe that he would be alive today were it not for Winchester hospital. Owen sadly suffers from a brain tumour in the pituitary gland, and has needed many emergency treatments. Owen lives five minutes from the hospital and has managed to have lifesaving treatment there on multiple occasions.

We need to avoid the trap of cutting short-term costs, such as by not investing in social care, which has ended up costing the state so much more money in the long run. We need a comprehensive plan to give people adequate local healthcare throughout their lives, and escape the endless cycle of crisis after crisis. We know that winter is coming this year, and coming next year. What are we doing to ensure that we will not have an NHS crisis in Hampshire next winter as well?

Income Tax (Charge)

Joe Robertson Excerpts

Tuesday 5th November 2024 Commons Chamber

[Joe Robertson (Isle of Wight East) (Con)]

This is not a Budget for growth. On the Treasury’s own figures, growth will decline from 2% next year for the rest of the decade. On the OBR’s analysis, this Budget is inflationary. It is not on small businesses that the responsibility should land. Small businesses employ people. Small and medium-sized businesses drive the UK economy. If we tax them, we tax growth. If we tax their greatest assets—the people who work for them—then we take away employment opportunities for hard-working people.

I will talk more substantively about the dire impact of the Budget on health and social care, including health and social care providers that are not part of the NHS. The increase in employer’s national insurance contributions will cause great difficulty and hardship for GP practices; charities, including hospices; dentists; pharmacies, which are crucial providers of health services; and social care providers. Those organisations, charities and businesses thought that they might have a friend in a Labour Government, but I assure Government Members that they do not feel as though the Labour Government are a friend right now. I have been speaking to those in GP practices in my constituency on the Isle of Wight. One said:

“Our increase in tax from this Budget is the equivalent of the salary of a practice nurse. There will be no new practice nurse for us.”

[Graham Stuart]

Does my hon. Friend agree that no one would think less of the Government if they listened to these arguments, heard the message and changed? For instance, there is the message about social care being hit by £2.5 billion of extra costs. The £600 million that has been given to local authorities will not cover those costs. If the Government simply listened and changed, people would think much better of them, and we would have a social care system that supported the NHS, rather than one that stops the NHS being able to do what it needs to do.

[Joe Robertson]

I agree with my right hon. Friend. In fact, there has been one common theme running through this debate: GP practices, charities such as hospices, dentists, pharmacists and social care providers are all being taxed by this Government. At a time when they need Government most, these providers find increased pressure on their ability to employ and provide services to the British people. There would be no shame if the Labour Government were to do something about this gross problem with their own Budget.

Moving on to social care, the Secretary of State for Health and Social Care said that there would be no more money for the NHS without reform, yet the Chancellor provides £22 billion for day-to-day spending unattached to reform. She and the Secretary of State are giving the equivalent of just 2.5%—£600 million—of that £22 billion for social care. That is a tiny fraction, yet the biggest reform that our NHS needs is fairer funding for social care. Money would be better spent on relieving the pressure on hospitals, and getting people out of hospital beds who do not need or want to be there, but who have nowhere safe to go to. Through this Budget, social care providers not only face the full burden of increased national insurance contributions, as employers, but receive a small fraction of the funding that the NHS receives. I urge the Government to go back to the drawing board and provide for our GPs, dentistry, pharmacies, hospices and social care.

Oral Answers to Questions

Joe Robertson Excerpts

Tuesday 23rd July 2024 Commons Chamber

[Wes Streeting]

I am grateful to the hon. Member for her question and congratulate her on her re-election to the House. She is right to point to the detrimental impact that the Conservatives’ failure is having on people’s lives. In fact, in 1948, when the national health service was founded, Nye Bevan received a letter from a woman who had worked her entire life in the Lancashire cotton mills about how the dentistry she was given by the national health service had given her dignity and the freedom to associate in any company. What a tragedy that 76 years later, the Conservative party has squandered and destroyed that legacy to the point where people are suffering not just pain and agony, but the indignity of being unable to find a job and unable to socialise in polite company because they are ashamed of the state of their rotting teeth.

The hon. Member is absolutely right: Lord Darzi is conducting a review on the state of the NHS, and it will report in September. That is not preventing us from making progress, talking to the BDA and working within the Department and across the sector to get those 700,000 appointments up and running as a matter of urgency. I look forward to reporting the progress to her and other right hon. and hon. Members.

[Joe Robertson (Isle of Wight East) (Con)]

As the right hon. Gentleman is aware, there is a particular shortage of NHS dentists in coastal and rural communities such as mine on the Isle of Wight. Will he therefore commit to the previous Government’s plan for 240 golden hellos for newly qualified dentists by the end of the year to address that issue?

[Wes Streeting]

I welcome the hon. Member to the House—it is a rare thing to welcome new Conservative Members, and he is welcome. He is absolutely right to touch on the workforce issues in NHS dentistry, and to say that we need to incentivise dentists, on two fronts: we need them to commit to and do more work in the NHS—we are looking at a range of things in that regard—and we need to ensure that we get more dentists to the areas in which they are most needed. We will certainly support incentives to that effect.