Oral Answers to Questions
John Grogan Excerpts(5 years ago)
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John Grogan (Keighley) (Lab)
Edward Argar
The hon. Gentleman will be pleased to hear that that is exactly what we have done with the health infrastructure plan, which involves multi-year capital funding settlements and investment in our hospitals. I am happy to discuss separately the specific example he raises.
NHS Long-Term Plan: Implementation
John Grogan Excerpts(5 years, 4 months ago)
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Matt Hancock
My hon. Friend has raised with me before the new technology developed by Mr Lucas. A new technology such as this can be picked up by all sorts of different parts of the NHS—by different CCGs or mental health trusts—which can then use it. One of the reasons that we have brought in NHSX, which opens today, is to make sure that there is a central place to which people with a good idea for how to improve the health of the nation by using technology can go to find a way into the NHS, so that great practice and good technology can be promulgated across the NHS as quickly as possible.
John Grogan (Keighley) (Lab)
Speaking of revenue, what is the Secretary of State’s attitude to NHS trusts that set up subsidiary companies, if one of the main motives is clearly seen to be VAT avoidance, as in the case of Bradford trusts where nearly half the extra revenue of setting up a company in the first five years would be VAT-related?
Matt Hancock
If the hon. Gentleman writes to me with the specifics of the case, I will be very happy to look into it. The use of subsidiaries in the way that he described in principle has been available to NHS organisations for some time, and I am very happy to take up the case that he asked about.
Oral Answers to Questions
John Grogan Excerpts(6 years, 6 months ago)
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Steve Brine
The previous consultation in 2013 found that the evidence, as it stood at the time, was not entirely conclusive. That is still the case, which is why the Government intend to keep the policy under review. Many times in this Chamber we are given the benefit of experience north of the border as to whether a policy has been a success, but it is not always strictly spot on. Given that the policy only came in last week, it is probably premature to say that it is a success, but we will welcome the opportunity to see the evidence emerge from Scotland’s implementation of minimum unit pricing, and we will be watching very closely.
John Grogan (Keighley) (Lab)
Does the Minister agree that it is significant that major pub companies and brewers such as Greene King, Coors and Tennent’s now support minimum pricing, and that what is good for the nation’s health is good for the nation’s pubs and the promotion of sensible drinking?
Steve Brine
We want to get on and tackle all avoidable harms, including alcohol. The vast majority of our constituents enjoy a drink and have a healthy relationship with alcohol, but that is not the case for everybody. Some people can harm themselves, society and, as we have heard, their children. What is happening north of the border in Scotland is very welcome. I think that there will be an early evaluation there at the one-year point, and we will be watching that like a hawk.
John Grogan (Keighley) (Lab)
Social Care
John Grogan Excerpts(6 years, 7 months ago)
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John Grogan (Keighley) (Lab)
It is a great pleasure to follow the detailed analysis of my hon. Friend the Member for Warrington South (Faisal Rashid). As a Yorkshire MP, it is always good to follow a Member from the other side of the Pennines—it is early season yet, Mr Deputy Speaker, but particularly when Yorkshire is at the top of the county championship and Lancashire is at the bottom.
I want to take up two points directly from the seven principles that the Secretary of State outlined when he talked about the Green Paper in March. One of them is about a valued workforce, which many hon. Members have spoken about, and the other is about a sustainable funding mechanism for the future.
Every morning in the villages and towns of Airedale and Wharfedale—some of which I am lucky to represent—very early, before the commuters have got up and even thought of going into the great cities of Bradford and Leeds, another workforce have just finished their night shift and are getting the first buses and trains into those cities, where they live. They have the characteristics of the social care workforce, who number about 1.4 million in our country. They are a massive workforce. About 80% are women and 80%—the overwhelming majority—are British, with 11% coming from outside the European economic area and about 5% from within it. There is a massive turnover in the social care workforce, as Unison has illustrated, with more than one in three care workers in care homes leaving their job in the course of the year. It is higher in domiciliary care.
Members on both sides of the House have talked about valuing these workers more. They are undervalued, underpaid and in many cases undertrained. The right hon. Member for Ashford (Damian Green) and particularly my hon. Friend the Member for Leicester West (Liz Kendall) talked about building a consensus, so that in the future we value more this extremely important workforce, who look after the most vulnerable people in our society at the time they need it most.
I have a couple of suggestions for the Government. It was good to hear from my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley) that a Labour Government would abolish 15-minute care—the idea that social care workers have to provide for the most intimate needs in 15 minutes, tick a few boxes and then rush off to the next appointment. It makes me proud to be a Labour MP that we are committed to ending that sort of thing and to paying people properly.
There are things the Government could do, and some are little things. I notice that there is an advisory council on the Green Paper. The great and the good are on that advisory council, but it would be good to have a figure from the workforce on it. I remember the Prime Minister speaking on the steps of Downing Street about involving the workforce more. Unison is a union you can do business with, and it would be good to have an additional person from the unions on that council. The Library’s list does not indicate that there is any such person on it at the moment.
If there ever was an industry crying out for a sectoral council, with the Government, the trade unions and the industry, to improve skills and the quality of the workforce, it surely is the care industry. Those are just a couple of ideas.
My hon. Friend the Member for Leicester West spoke passionately about the need to get consensus on a long-term funding model that all parties can agree on. I would stop talking about a “dementia tax”, and the bargain would be that the Conservatives would not talk about a “death tax”. We have used both those terms in the last 10 years, and I agree that they have not particularly enhanced our politics.
The letter from Members of all parties suggested raising and hypothecating national insurance. I would like to keep on the table the idea of an increase in inheritance tax, which the now Mayor of Manchester mentioned in the latter days of the Labour Government. Only 4% of people currently pay inheritance tax. It raises £5 billion. It is a potential way of achieving intergenerational fairness. A national insurance rise at the moment would hit many workers whose real incomes have been cut in recent years, so we should consider the option of raising inheritance tax. I think that many people in our society who are lucky enough to own their own home would accept that bargain—a guarantee that they could pass on the bulk of their estate to members of their family or to any good causes they wanted to support, in return for which I think they would be prepared to pay an additional inheritance tax.
The hon. Member for Central Ayrshire (Dr Whitford) reminded us that one in four of us will end our days in a care home, but of course we do not know which of us that will be. We have to face up to the fact that, under the current system, those of us who are lucky enough to own our own home would lose most of it, if we were in a care home for a prolonged period. I see that as a life tax, rather than a death tax.
Kevin Hollinrake
The hon. Gentleman talks about one in four of us ending up in a care home, but we do not know which of us that will be. Does that lead him to conclude that we should pool the risk through social insurance, as they have done very successfully in Germany, having moved in 1995 from a local authority-funded scheme to a social insurance scheme, which also has great community benefits?
John Grogan
I certainly agree that we have to pool risk, but it has to involve everyone in society, from the poor to the rich, so that whatever our circumstances we get the care we need in those days.
We heard a lot from the hon. Member for North Cornwall (Scott Mann) and other hon. Members about the potential of technology. That is a worthwhile point to make. Age UK has provided all hon. Members with the number of elderly people in our constituencies who need care. For example, in Keighley there are 3,500 long-term disabled people and 16,000 people with long-term illnesses. One way of helping them is through telemedicine from Airedale General Hospital. Even when the “beast from the east” was raging at its worst, people in Keighley, Airedale and the dales, even in remote areas, could still have tests and get treatment via broadband. That kept them out of hospital, even in the depths of winter.
This has been a great debate and I look forward to the Green Paper—may it come sooner, rather than later.
Leaving the EU: NHS
John Grogan Excerpts(6 years, 8 months ago)
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Stephen Barclay
There has been a slight reduction in nurses; the situation is more textured for clinicians as a whole. The hon. Gentleman did not touch on the fact that there are almost twice as many doctors from the rest of the world than from the EU. The NHS recruits internationally, and that will still be the case after Brexit. The Prime Minister has signalled repeatedly that the UK will be open to the brightest and best, and that will continue to be the case regardless of the deal we do.
John Grogan (Keighley) (Lab)
Looking to the future, doctors from outside the EU are currently subject to a strict regime, and at the moment the demand for sponsorship certificates showing that an NHS trust wants to employ a doctor seems to exceed the supply. Will doctors from the EU who want to come to our country post Brexit be subject to the same regime, or does the Minister envisage a different regime? What representations is he making to the Home Office about that matter as we look forward to the immigration Bill?
Stephen Barclay
Of course we are making representations to the Home Office, but the Prime Minister has signalled our commitment to attracting the brightest and best, and that will continue. What has been negotiated so far probably gives the hon. Gentleman the best signal. What the Prime Minister announced in December and what my right hon. Friend the Secretary of State for Exiting the European Union announced this week about a transition deal actually protects the rights of EU citizens. That underscores the Government’s commitment to ensuring that a positive message is sent to EU staff in the NHS.
Stephen Barclay
The hon. Lady is right to recognise the skills and talent that the Secretary of State brings to this debate as to many others. It is no coincidence that he is the second-longest serving Secretary of State for Health. It would be recognised across the House that it is a demanding job. It is to his great credit that he has been in post for such a period and that he has championed patient safety in the way that he has, which the shadow Minister has generously recognised on occasion.
The Secretary of State’s role in Government was further signalled and underscored by the Prime Minister in the recent reshuffle, when the responsibility for social care was added to the Department. As the debate has reflected, social care, and how we address it from an immigration perspective, and from a training and upskilling perspective, is one of the key legitimate areas of the Brexit debate. We are focused on that in our discussions with the Home Office and others.
The hon. Member for Motherwell and Wishaw (Marion Fellows) picked up on the need for a transition period. That point reflects the fact that the Government are listening and have responded constructively. I know from my previous role in the financial services sector in the City that there is a strong desire for a transitional period. That point was also raised by many in the healthcare sector. It is to the great credit of the Secretary of State for Exiting the European Union that those discussions have been conducted in such a constructive way. There has been a lot of doom-saying and negative commentary—“Nothing will be agreed; it won’t work.”—but he has assiduously stuck to his task. While there are some formal processes still to be completed, significant progress has been made on a transition deal, and there is reasonable consensus that it is constructive.
Several colleagues mentioned the impact of leaving Euratom. I simply remind the House that there is nothing in the Euratom treaty that prevents materials from being exported from an EU member state to countries outside the EU, nor do those materials fall into the category of so-called special fissile material, which is subject to nuclear safeguards. We very much recognise the short half-life of medical radioisotopes and the need for rapid delivery, but again there is much that can be constructively done.
The shadow Minister mentioned subsidiary companies. I do not want to incur your displeasure by straying too far from the subject of Brexit and into subsidiary companies, Mr Davies, but as the shadow Minister raised that point, I feel it is appropriate to address it. He asked what TUPE protections there will be. There are TUPE protections now and the Government have absolutely no intention to change that.
For those who sometimes suggest, as Opposition Members occasionally do, that subsidiary companies within the NHS is a form of privatisation, I merely remind the House that this legislation was passed in 2006 under a Labour Government. I was not in the House at the time, but I do not recall—this may be one for those connoisseurs of Hansard—that it was presented by Labour Ministers as a way of achieving privatisation in the NHS. Subsidiary companies are 100% owned by their parent company, which is the NHS family, so they stay very much within that.
John Grogan
Since the Minister has gone in that direction, I ask him again specifically: if it is such a good idea, would it be a good idea for NHS trusts that propose setting up subsidiary companies to publish their business plans so we can see what is happening with that public money?
Stephen Barclay
I am a former member of the Public Accounts Committee. The then Chair, the right hon. Member for Barking (Dame Margaret Hodge), would always talk about following the public pound. The National Audit Office has considerable reach in doing that.
My point is that subsidiary companies are within the NHS family. They are 100% owned by the NHS foundation trust that sets them up. They are a better vehicle than the alternative of contracting out, which gives far less grip over how services are provided. The legislation passed by a Labour Government is welcome. We should not re-write history and suggest that legislation that was fine in 2006 should suddenly be presented as privatisation.
That goes to what we sometimes see in the Brexit debate—I will bring this back to the Brexit debate, Mr Davies—in terms of a trade deal with the US. We are sometimes told that a trade deal with the US in a Brexit context is alarming and somehow a threat to the NHS, often by the same people who are very positive about the EU. When TTIP was being debated, the EU lead negotiator said TTIP was not a threat to the NHS.
Oral Answers to Questions
John Grogan Excerpts(6 years, 8 months ago)
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John Grogan (Keighley) (Lab)
With a significant amount of public money at stake, should not NHS trusts that are proposing to set up subsidiary companies publish their full business cases?
Stephen Barclay
The point is that trusts are 100% owned by the NHS, so any benefit accrued from the subsidiary goes to the NHS, because it is fully owned by the public sector.
NHS Wholly Owned Subsidiary Companies
John Grogan Excerpts(6 years, 8 months ago)
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Stephen Barclay
As I set out in my reply to the hon. Lady, the Department has been clear that setting up a subsidiary is not a vehicle to avoid VAT—that is not acceptable. In the autumn, we sent out guidance to make that clear. As a former Treasury Minister myself, I assure her that Treasury Ministers would take a very close interest if they felt that an abuse of VAT was taking place.
The reality is that commissioners and regulators are responsible for ensuring that NHS providers act in the best interests of patients and taxpayers. We would expect providers to work closely with their employees in any developments.
Stephen Barclay
I am conscious of the time, but I am very keen to take an intervention from the hon. Gentleman.
John Grogan
The Minister is being very generous. Clearly there is a substantial difference of view here, but would he agree that given that public money is involved, it is very much in the public interest that the business plans that the trusts are producing for the wholly owned subsidiaries are published and public, so that they can be scrutinised? In the case of the Airedale trust in my constituency, we discovered that 60% of the savings on purchasing are in VAT. Those figures should be in the public domain, so people can see what is being done with public money in their interests.
Stephen Barclay
The slightly puzzling issue here is that the savings accrued from the subsidiaries are for the benefit of the local health economy, of the trust. This is a subsidiary company 100% owned by its host trust. The more efficient the subsidiary is, the better it is at dealing with things such as its pathology—not only do we avoid samples being lost, but we run a more efficient system in a more commercial manner, which brings more money into the healthcare economy and gives the flexibility to compete effectively in the local job market for maintenance staff and others.
The benefits of those arrangements accrue to the trust that owns 100% of the subsidiary. That is why, under legislation of the previous Labour Government—correctly in my view, but clearly not in the view of the Labour Members—the local trust is empowered to empower in turn the local members of staff. That is then reflected in the staff survey, which shows a more favourable result in this trust.
Oral Answers to Questions
John Grogan Excerpts(7 years ago)
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John Grogan (Keighley) (Lab)
The Minister of State, Department of Health (Mr Philip Dunne)
Local NHS organisations are responsible for deciding the most appropriate structures they need to deliver services to their patients within available resources. Commissioners and regulators are responsible for ensuring that NHS providers act in the best interests of patients and taxpayers. A theme of the 2015 review of performance variability across NHS hospitals, undertaken by the noble Lord Carter of Coles, sought to drive efficiency through sharing administrative functions across NHS bodies in an area. A number of trusts are creating the right structures to do so. NHS Improvement is aware of 39 subsidiaries consolidated within the accounts of foundation trusts as of 31 March 2017.
John Grogan
Does the Minister share my concern that NHS trusts in Yorkshire are now lining up to follow the example of Airedale NHS Foundation Trust, which recently, behind closed doors and as part of a VAT scam, set up a subsidiary company to run many of its activities, which will not only cost the Treasury in lost tax receipts, but mean that new staff, such as hospital porters, will no longer be on NHS terms and conditions?
Mr Dunne
I can reassure the hon. Gentleman that we have no interest in allowing NHS trusts to avoid their tax responsibilities. Guidance was sent to all trusts in September to ensure that any TUPE transfers of staff would remain subject to NHS pension rules and should not be done for tax avoidance purposes.
Children’s Oral Health
John Grogan Excerpts(7 years ago)
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Steve McCabe
I absolutely agree with the hon. Lady. An education programme for young children and their parents is crucial. I want the Government to play a bigger role, but there are other approaches, too. As I have said, Simplyhealth is supporting the venture in the city of Hull and in East Riding of Yorkshire, as well as in the hon. Lady’s constituency.
A pilot programme called Starting Well is about to commence in 13 areas of England, although none of those pilots will be in Birmingham or the west midlands. I would be grateful for details of the pilot. How long will it run? How will it be evaluated? How were the 13 areas selected? It would also be useful to know exactly how the programme is being funded.
A new initiative by the British Society of Paediatric Dentistry, “Dental Check by One”, is seeking to raise awareness of the importance of getting young children to attend the dentist from an early age. It is supported by organisations across the dental professions. I am pleased to report that it is due to launch in Birmingham tomorrow, despite some torturous negotiations about funding. It seems likely that funding issues will prevent it from being implemented by other regional NHS teams.
What else might be done? Has any consideration been given to proposals from the Faculty of Dental Surgery to use school breakfast clubs to deliver supervised tooth brushing sessions? Analysis by Public Health England has suggested that if public health professionals such as health visitors are involved in supporting oral health improvement programmes, that can lead to significant improvements and long-term savings. Health professionals who have regular contact with children, such as midwives, health visitors, school nurses, pharmacists and early years practitioners, are all ideally placed to help identify children who may be at risk of tooth decay.
Equally, dentists look at all the soft tissues in the mouth and are often able to help identify a number of conditions, from diabetes and Crohn’s disease to oral cancer. According to recent figures on dental attendance, 42% of children aged 0 to 17 did not visit an NHS dentist in the 12 months to 31 March 2017.
John Grogan (Keighley) (Lab)
Does my hon. Friend share my concern that a cursory review of the NHS Choices website yesterday showed that there are many areas of the country, including Keighley, where there is no advertising at all of dentists who are available to take on new children as patients? Might one answer to the age-old problem of poorer areas having fewer dentists be an expansion of salaried dentists in the NHS?
Steve McCabe
There is certainly an issue with access to dentists in some areas, although it is probably also true that some parents need to realise that visiting the dentist is free for children. There is certainly a question about how we incentivise dentists and provide better coverage.
As I was saying, 42% of children did not see an NHS dentist in the 12 months to 31 March 2017; in Birmingham, that figure is 47%. The Faculty of Dental Surgery has reported that, in the same 12 months, 80% of children aged between one and two did not see a dentist, but official advice recommends that children begin dental check-ups as soon as their first teeth come through, which is usually at around six months.
We may need to reconsider certain elements of existing dental contracts to see if we can better incentivise some dentists to pursue a preventative dental strategy with children. At present, three visits for fluoride treatment equal one unit of dental activity, which is roughly worth about £60 to the dentist. Perhaps we should look at that again. I am sure that both the Minister and local authority public health officials will be keen to remind me about money if I urge greater activity, but I remind hon. Members that parliamentary questions have revealed a clawback of £95 million through undelivered units of dental activity in 2013-14, rising by 36% to £129 million in 2016-17.
Dentistry remains a highly siloed service in the NHS and has been largely neglected from future NHS plans, such as the five year forward view and sustainability and transformation plans. As I have said, education programmes and regular visits to the dentist are needed if we are to begin to tackle the problem, but we also need action to tackle sugar consumption.
There are question marks over how likely the soft drinks industry is to meet the targets agreed under the voluntary reformulation programme. Earlier this year, the Food and Drink Federation announced that it was unlikely to comply with the optional 20% reduction in sugar content by 2020. It has also been revealed that it will be March 2018 before we even know whether the industry has achieved the first target of a 5% reduction by August of this year.
We desperately need to make significant progress towards reducing the amount of sugar in soft drinks and other products. The Government need to look again at their obesity strategy. As luck will have it, it is Sugar Awareness Week. What better time could there be for the Government to seriously consider the suggestion of the Local Government Association and others that we introduce teaspoon labelling on the front of high-sugar products? We should certainly look at advertising, and consider a ban on two-for-one offers and other price promotions on high-sugar products.
Childhood tooth decay is a problem that affects millions of children. It can be extremely painful and it often results in costly tooth extractions under general anaesthetic. Addressing tooth decay is not complicated; we know what works, and the actions I have outlined today could make a real difference. I hope that the Minister will consider those arguments, and that he is in a position to tell us that the Government are considering a series of preventative measures so that good oral health can be enjoyed by all our children.
Tobacco Control Plan
John Grogan Excerpts(7 years, 1 month ago)
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Steve Brine
I will look at that point; as ever, my hon. Friend makes a pertinent point from the Back Benches—where I do not think he will be forever, I might add. [Interruption.] It is evidently not my decision.
I have given the relevant figures, and we are now considered by independent experts to have the best tobacco control measures in Europe. We published the new plan this year to build on that success, but there is no room for patting ourselves on the back in this game, and we still have a huge amount to do.
We still have 7.3 million smokers. That exerts a huge impact on our communities and our NHS. Tobacco use is the biggest contributor to cancer, accounting for more than one in four UK cancer deaths, and nearly a fifth of all cancer cases in this country. Research by the Independent Cancer Taskforce reported that up to two thirds of long-term smokers will die as a result of smoking if they do not quit. We have heard from a number of Members across the House about people whom they have loved and lost, and they are not statistics; they are people’s mothers and fathers, and sons and daughters, who have been lost to cancer. Cancer is not contracted through smoking alone, of course, although it accounts for a huge part of the cancer rate. We must remember that 200 people die every day due to smoking; I think every Member will join me in saying I want us to do better than that.
The plan sets our interim ambitions en route to that goal. Over the next five years we want to reduce the prevalence of adult smokers to 12%. In answer to my hon. Friend the Member for Harrow East (Bob Blackman), I would like to go lower than that, but that is the current figure in the plan. It is not necessarily an end-point, however, and it is not an end in itself. We should also remember the prevalence of 15-year-olds who regularly smoke. We want to get that down to 3%, and the prevalence of pregnant smokers—which so many Members have mentioned today—down to 6%. We want to reduce the burning injustice—a number of Members have used that term today— that sees some of the poorest in our society die on average nine years earlier than the richest, so we will focus, as the plan says, on people in routine and manual occupations.
We want to focus on other groups particularly affected by smoking, such as people with mental health conditions and those in prisons. The hon. Member for Stockton South (Dr Williams) rightly spoke about that being part of a wider poverty reduction programme. That has to be central to the plan, which is not just owned by the Department of Health and me. It is a cross-governmental plan and everything that we do should be part of that aim to reduce poverty. That is why the Prime Minister said what she did. I guess that the hon. Gentleman does not agree with everything she said, but surely he must agree with her words on the steps of Downing Street about poverty reduction.
John Grogan (Keighley) (Lab)
The statistics in some of our cities are much higher than in others. In my city of Bradford, the Minister will know that the figure for smoking prevalence is about 22%. Public health is so important; does he recognise the importance of giving more resources to public health and councils, which have experienced significant cuts in recent years?
Steve Brine
I simply say to the hon. Gentleman, who has not been present for the debate, that that point has been made. I also point out that we are giving £16 billion of ring-fenced public health spending to councils in England, which is significant. However, I shall come back to his point if he will bear with me.
To achieve the ambitions in the plan, we need to recognise that smoking is increasingly prevalent in particular groups in society and in particular areas. That is why we need to shift the emphasis from national to local action, and support smokers, particularly in disadvantaged groups, to quit. Now is not the time for more legislation—we have done that bit. I do not rule it out forever, but successive Governments have done that part. Now is the time to redouble our efforts to focus on our top priority groups such as pregnant women, young people and people with mental illnesses. We must focus on the people and areas with the greatest need.
Let me give an example. Yesterday, we published the two-years-on plan from the national cancer taskforce, which looks at the cancer strategy. It is full of good case studies. One that especially struck me was the Manchester lung cancer project, whereby we screen people arriving at supermarkets in certain parts of Manchester. That has led to improved cancer detection and outcomes for the local community that are quite staggering. Why do that in Manchester and not in Hampshire—in Winchester in my constituency? That is because there is a high prevalence of lung cancer driven by smoking in the Greater Manchester area. I visited Macmillan’s headquarters in London and sat and listened to some callers on their support line. I asked about regional disparities and they said that when they got calls from that part of England, they were about lung cancer, and that is no coincidence.
The example I gave is a policy response from the Greater Manchester authority, led by Andy Burnham, formerly of this parish, who has already put in place a plan that will mean 115,000 fewer smokers by 2021. I pay tribute to Andy, with whom I worked a lot in the House through my chairmanship of the all-party parliamentary group on breast cancer. I know that he has been greatly affected by that, and he is great partner for us on this matter. That is exactly the kind of thing we meant when we said in the tobacco control plan that we wanted local areas to develop their own local strategies.
There are many other good schemes locally—for example, the Fresh programme operates in a dozen local authorities in the north-east. I wonder whether the hon. Member for North Tyneside (Mary Glindon) is aware of it. She made an excellent personal speech, and I congratulate her on managing not to turn into a smoker, given the family background that she described. All the evidence suggests that children who grow up in families where the parents smoke go on to do so. The hon. Lady clearly knows something that we do not.
Leicester provides great examples of innovative stop smoking services, and the right hon. Member for Rother Valley mentioned Leicester and namechecked the council officer, who I suspect will keep that Hansard report. Well done to Leicester.
I recognise that hon. Members are concerned about local stop smoking services, but as I said in response to an intervention, we have a £16 billion ring-fenced public health budget. The Government believe that local authorities are best placed to make decisions on how the services should be prioritised to meet the needs of their populations. That is why I gave the example from Manchester. I am many things, but I am not best placed to decide what works in Leicester or Manchester; locally elected politicians are best placed.
The Government will continue to publish data that help local people hold those locally elected leaders to account. That is a crucial part of the plan. Public Health England, for which I am responsible, will continue to offer support to local authorities to help them develop their local approaches in the most cost-effective and evidence-based way. As Minister, I will continue to be a passionate advocate for evidence-based tobacco control plan policy making. It is an integral part of my mission to reduce the toll of preventable cancers.
I want to say something about the Government’s approach to e-cigarettes, which almost every Member who spoke mentioned. The new control plan commits to monitoring the safety, uptake, impact and effectiveness of e-cigarettes and so-called novel tobacco products. We must find a better term than that. The plan charges Public Health England with the responsibility of including messages about the relative safety of e-cigarettes in their quit smoking campaigns. I am pleased to say that that is already under way and that PHE’s current Stoptober campaign, for the first time, highlights e-cigarettes among the array of tools that smokers can use to improve their chances of quitting successfully.
As we like to say during Stoptober, there has never been a better time to quit. I will leave to my right hon. Friend the Chancellor the several Budget submissions around e-cigarettes. The suggestion of my hon. Friend the Member for Colchester (Will Quince) of providing free e-cigarettes to pregnant women who are smokers is certainly worthy of consideration. I noted that the hon. Member for North Tyneside is not necessarily a fan of changes to e-cigarette levies, so it is fair to say that we so not have unanimity across the House on that. PHE is already preparing its new year quitting campaign, which is rolled out in January each year, and it will reprise the hard-hitting messages that we have seen on our televisions. It is through consistent messaging that we can hope to reverse the harmful, mistaken and increasingly widespread belief that vaping is no safer than smoking. It clearly is.
The right hon. Member for Rother Valley made an excellent speech, touching on health inequalities and how smoking disproportionately hits the poorest in society. There is huge variation in the figures for pregnant women, with smoking rates of between 2.3% in London and—to correct the record—28.1% in Blackpool. He also made an excellent point about dentists and oral health. PHE-commissioned training will continue to ensure that local authorities have access to the training they need to provide effective help to quit and the information they need to work with patients. He chairs the all-party parliamentary group on pharmacy—I think we will be meeting soon—so he would say this, but he spoke about pharmacists and healthy living pharmacies, which have been particularly good. He referred to Government research, and PHE is committed to reviewing the evidence on e-cigarettes on an annual basis, and is working closely with Cancer Research UK and the UK Centre for Tobacco and Alcohol Studies to deliver a forum to ensure that we continue to have that strong evidence base.
I think I need to wind up by 3 o’clock, Madam Deputy Speaker. Is that right? [Interruption.] “Well by,” she says. Okay, let me conclude by thanking everyone who has spoken today. I particularly enjoyed the speech of my hon. Friend the Member for Chippenham (Michelle Donelan). It was hypnotic in many ways but very good, and I noted her Budget submission. As usual, I thank my hon. Friend the Member for Harrow, although I suspect that his berating me on this subject will not have started and ended today. The hon. Member for Ipswich (Sandy Martin) made a consistent point about local authority pension schemes, and it must be for local authorities to make such decisions and then answer to members of the scheme, their elected members and, of course, the residents who elect them and get to make such decisions every day.
In closing, I appreciate the many challenges and I appreciate the support that the House has given to tobacco control legislation over many years. It is now up to us to provide a national lead and to support our local authorities and ensure that they carry through what is in the plan. I thank my friend the right hon. Member for Rother Valley for introducing today’s debate and ensuring that tobacco control is no longer a partisan issue; this is now about the tobacco control plan.