Tobacco and Vapes Bill

Judith Cummins Excerpts

Report stage
Wednesday 26th March 2025 Commons Chamber

[The Parliamentary Under-Secretary of State for Health and Social Care (Ashley Dalton)]

I beg to move, That the clause be read a Second time.

[Madam Deputy Speaker (Judith Cummins)]

With this it will be convenient to discuss the following:

New clause 1—Review of contaminated e-liquid—

“(1) Within six months of the passage of this Act, the Secretary of State must conduct a review into the prevalence of contaminated e-liquid in England, Wales, Scotland and Northern Ireland.

(2) The review required under subsection (1), must include, but is not limited to an assessment of—

(a) the awareness of the issue of contaminated e-liquid,

(b) the extent of e-liquids found spiked with illegal substances,

(c) the measures in place to tackle the importation of contaminated e-liquid,

(d) measures used by other jurisdictions to combat the importation and prevalence of contaminated e-liquid, and

(e) options for further regulating e-liquid to limit the dangers of contamination.

(3) In conducting the review required under subsection (1), the Secretary of State may consult with whoever they see fit.

(4) The Secretary of State must report to Parliament following the conclusion of the review.

(5) The Secretary of State has the power to make regulations under this section including the power to make—

(a) offences relating to the contamination of e-liquid, including the distribution, importation, supply and merchandising or tampering of such products,

(b) offences relating to the online sale of e-liquid containing illegal substances,

(c) provisions to improve the ability to identify, test and intercept contaminated e-liquid, and

(d) provisions recommended in the review implemented by subsection (1).

(6) For the purposes of this section,

‘contaminated e-liquid’ means e-liquid which has been mixed with or includes an illegal substance.”

This new clause would require the Secretary of State to conduct a review and publish a report on the impact of contaminated e-liquid and ways to reduce its prevalence. It would give the Secretary of State the powers to make regulations in relation to curbing the harm caused by contaminated e-liquid.

New clause 2—Ban on the supply of plastic cigarette filters—

“(1) The Secretary of State must make regulations under section 140 of the Environmental Protection Act 1990 having the effect of prohibiting the supply of relevant cigarette filters or cigarettes containing relevant cigarette filters, whether by way of sale or not, in the course of a business.

(2) The notice required under section 140(6)(b) of the Environmental Protection Act 1990 in relation to the regulations mentioned in subsection (1) must be published no later than the end of the period of 12 months beginning with the day on which this Act is passed.

(3) In this section,

‘relevant cigarette filter’ means a filter which contains plastic and which is intended for use in a cigarette, whether as part of a ready made cigarette or to be used with hand rolling tobacco or other substances to be smoked in a cigarette.”

This new clause requires the Secretary of State to make regulations, within two years, which would prohibit the supply of cigarette filters which contain plastic or cigarettes containing cigarette filters which contain plastic. The regulations would be made under section 140 of the Environmental Protection Act 1990.

New clause 3—Amendment of the European Union (Withdrawal) Act 2018—

“(1) The European Union (Withdrawal) Act 2018 is amended as follows.

(2) In section 7A of the European Union (Withdrawal) Act 2018, after subsection (4), insert—

‘(4A) This section does not apply in relation to Directive 2014/40/EU of the European Parliament and of the Council of 3 April 2014 on the approximation of the laws, regulations and administrative provisions of the Member States concerning the manufacture, presentation and sale of tobacco and related products and repealing Directive 2001/37/EC.’”

This new clause asserts the primacy of the regulations made in this Bill which affect Northern Ireland in relation to the EU tobacco directive 2014/40/EU.

New clause 4—Ban on manufacture and sales of high-strength nicotine pouches—

“(1) It is an offence to manufacture a high-strength nicotine pouch.

(2) It is an offence to—

(a) sell or expose for sale a high-strength nicotine pouch, or

(b) offer or expose a high-strength nicotine pouch for sale.

(3) It is an offence for a person to have a high-strength nicotine pouch in their possession with intent to supply it to another in the course of business.

(4) In this section ‘high-strength nicotine pouch’ means a nicotine pouch that—

(a) is intended for oral use,

(b) is not intended to be inhaled,

(c) does not contain tobacco, and

(d) contains more than 20 milligrams of nicotine per pouch.

(5) It is a defence for a person charged with an offence under subsection (2) to prove that they took all reasonable steps to avoid the commission of the offence.

(6) A person who commits an offence under this section is liable—

(a) on summary conviction, to imprisonment for a term not exceeding the general limit in a magistrates’ court, or a fine, or both;

(b) on conviction on indictment, to imprisonment for a term not exceeding 2 years, or a fine, or both.”

This new clause provides for a ban on the manufacture and sale of high-strength nicotine pouches.

New clause 5—Report on sale of vaping products to facilitate child sexual exploitation—

“(1) Within six months of the passing of this Act, the Secretary of State must produce a report on—

(a) the potential prevalence of retailers with a personal or premises licence selling vaping products which facilitate child sexual exploitation; and

(b) whether licensing authorities have adequate powers to investigate retailers which may be connected to the sale of vaping products to facilitate child sexual exploitation.

(2) A copy of this report must be laid before both Houses of Parliament.

(3) In this section—

‘vaping’ has the same meaning as in Part 1 (see section 48),

‘licensing authority’ has the same meaning as in Part 1 (see section 16),

‘personal licence’ has the same meaning as in Part 1 (see section 16),

‘premises licence’ has the same meaning as in Part 1 (see section 16).”

New clause 6—Requirement for retailers of vapes in England to include age-verification technology—

“(1) The Secretary of State may make regulations making it an offence for a tobacco retailer who sells vapes on premises in England to sell vapes that do not contain approved age-gating technology.

(2) The Secretary of State may by regulations specify the requirements with which any age-gating technology must comply, which must include (but need not be limited to)—

(a) the information, including biometric information, that a user must provide to the age-gating technology in order to be able to use the vape;

(b) the steps that the age-gating technology must require the user to take in order to verify their identity and that they are aged 18 or over before first activating the vape for use;

(c) the steps which the age-gating technology must require the user to take in order to verify their identity following activation of the vape, and the frequency with, and circumstances in, which the age-gating technology must require these steps to be taken;

(d) the requirements with which the age-gating technology must comply in order to ensure the security of the information, including personal data, provided to it by users;

(e) the technical specifications which the age-gating technology must meet in order to ensure that it is compatible with vapes made by different manufacturers.

(3) The Secretary of State may by regulations under this section make further provision about requirements with which tobacco retailers must comply.

(4) In this section, ‘age-gating technology’ means technology designed to prevent the use of vaping products by persons aged under 18.

(5) Before making regulations under this section the Secretary of State must consult any persons the Secretary of State considers it appropriate to consult.

(6) Regulations under this section are subject to the affirmative resolution procedure.”

This new clause would introduce a requirement for retailers of vapes in England to include age-verification technology.

New clause 7—Requirement for retailers of vapes in Wales to include age-verification technology—

“(1) The Welsh Ministers may make regulations making it an offence for a tobacco retailer who sells vapes on premises in Wales to sell vapes that do not contain approved age-gating technology.

(2) The Welsh Ministers may by regulations specify the requirements, with which any age-gating technology must comply, which must include (but need not be limited to)—

(a) the information, including biometric information, that a user must provide to the age-gating technology in order to be able to use the vape;

(b) the steps that the age-gating technology must require the user to take in order to verify their identity and that they are aged 18 or over before first activating the vape for use;

(c) the steps which the age-gating technology must require the user to take in order to verify their identity following activation of the vape, and the frequency with, and circumstances in, which the age-gating technology must require these steps to be taken;

(d) the requirements with which the age-gating technology must comply in order to ensure the security of the information, including personal data, provided to it by users;

(e) the technical specifications which the age-gating technology must meet in order to ensure that it is compatible with vapes made by different manufacturers.

(3) The Welsh Ministers may by regulations under subsection (2) make further provision about requirements with which tobacco retailers must comply.

(4) In this section, “age-gating technology” means technology designed to prevent the use of vaping products by persons aged under 18.

(5) Before making regulations under this section the Welsh Ministers must consult any persons that the Welsh Ministers consider it appropriate to consult.

(6) Regulations under this section are subject to the affirmative resolution procedure.”

This new clause would introduce a requirement for retailers of vapes in Wales to include age-verification technology.

New clause 8—Prohibition of advertising of vaping, nicotine and heated tobacco products—

“(1) The Secretary of State must within six months of this Act being passed make provisions by regulations for the prohibition of advertising of—

(a) a vaping product; or

(b) a nicotine product; or

(c) a heated tobacco product.

(2) Before making regulations under this section the Secretary of State must consult any persons the Secretary of State considers it appropriate to consult.

(3) Regulations under this section may not be made unless a draft of the instrument has been laid before and approved by a resolution of each House of Parliament.”

This new clause commits the government to consult on proposals for prohibiting the advertising of vaping, nicotine or heated tobacco products.

New clause 9—Marketing of products to existing smokers—

“(1) The Secretary of State, or a person authorised by the Secretary of State, may make provision about the nature and inclusion of health warnings or disclaimers relating to a relevant product to ensure that the product is marketed exclusively to existing smokers as an alternative to smoking.

(2) In this section, ‘relevant product’ refers to—

(a) a vape, or

(b) a nicotine product.

(3) Compliance with this section is considered a defence to a charge in relation to an offence under Part 6.”

This new clause will allow the Secretary of State to place an additional disclaimer or warning on products.

New clause 10—Displays of products or prices in England—

“(1) The Secretary of State may by regulations impose limitations or requirements on retailers in relation to the display, in the course of business, of—

(a) relevant products in a place in England where the products are offered for sale,

(b) empty retail packaging of relevant products in a place in England where the products are offered for sale,

(c) prices of relevant products in a place in England where the products are offered for sale, or

(d) advertisements for relevant products.

(2) In subsection (1), reference to a product includes anything that represents the product.

(3) Regulations under this section—

(a) must make provision—

(i) for ensuring that an adult is able to be informed that a premises sells a related product,

(ii) for ensuring that a consenting adult is able to view the related products and information relating to them,

(iii) relating to the appropriateness of a display to ensure that it does not appeal to children, and

(iv) relating to the location of a display in a place in England where the products are offered for sale;

(b) may create offences for a failure to comply with the regulations;

(c) must provide for any offence to be punishable–

(i) on summary conviction, to imprisonment for a term not exceeding the general limit in a magistrates’ court, or a fine, or both;

(ii) on conviction or indictment, to imprisonment for a term not exceeding 2 years, or a fine, or both;

(d) are subject to public consultation;

(e) are subject to the affirmative resolution procedure.

(4) Compliance with regulations made under subsection (3) is considered a defence to a charge in relation to an offence under Part 6.

(5) For the purposes of this section—

‘consenting adult’ means an adult who has entered any licensed premises that sells nicotine, vapes, and tobacco products;

‘relevant products’ mean—

(a) tobacco products,

(b) vaping products, or

(c) nicotine products.”

This new clause will allow for the Secretary of State to restrict how vapes and nicotine products are advertised in store windows and in store, while ensuring that adult smokers are still able to determine that a premises sells a product.

New clause 12—Review of provisions—

“(1) The Secretary of State must, in consultation with the appropriate ministers in Wales, Scotland and Northern Ireland—

(a) carry out a review of the provisions for relevant products in—

(i) sections 1 to 6 (sale of tobacco etc);

(ii) sections 50 to 55 (Part 2 Sale and Distribution: Scotland: sale of tobacco etc);

(iii) sections 68 to 72 (Part 2 Sale and Distribution Northern Ireland sale of tobacco etc);

(iv) sections 90 to 93 (Product requirements etc);

(v) section 94 (Non-compliant images);

(vi) sections 101 and 102 (Matters dealt with by 2016 Regulations);

(vii) Part 6 (Advertising and Sponsorship);

(b) prepare and publish a report setting out the conclusions of the review;

(c) lay the report before Parliament.

(2) The review in subsection (1) must—

(a) set out the objectives intended to be achieved by the provisions as set out under subsection (1)(a),

(b) assess the extent to which those objectives have been achieved, and

(c) make a recommendation on whether the provisions as set out under subsection (1)(a) remain appropriate and necessary.

(3) The first review under this section must be published and laid before Parliament before the end of the period of five years beginning with the day on which the Tobacco and Vapes Act 2025 is passed.

(4) If the review recommends under subsection (2)(c) that one or more of the provisions set out under subsection (1)(a) are no longer appropriate or necessary, the Secretary of State must make arrangements for the motion mentioned in subsection (5) to be tabled in both Houses of Parliament within a period of 28 sitting days beginning immediately after the review is laid before Parliament under subsection (3).

(5) The form of the motion in subsection (4) is—

‘That the provisions of sections 1 to 6, 50 to 55, 68 to 72, 90 to 94, 101 and 102 and Part 6 (Advertising and Sponsorship) of the Tobacco and Vapes Act 2025 should expire.’

(6) If both Houses of Parliament approve the motion in the form set out in subsection (5) (or in such form as may be subsequently amended by the House to specify one or more of the provisions of sections 1 to 6, 50 to 55, 68 to 72, 90 to 94, 101 and 102 and Part 6), moved by the Secretary of State in accordance with subsection (4), the provisions specified in the motion shall expire at the end of the period of 21 days beginning with the day on which the second House approves the motion.

(7) Subsequent reports must be published at intervals not exceeding five years.

(8) In this subsection, ‘Relevant products’ refers to—

(a) tobacco products;

(b) nicotine products.”

This new clause requires a review of the necessity of provisions relating to the sale restrictions for tobacco products and nicotine products. Published every 5 years, the review could recommend that certain provisions are no longer required, and Parliament would have an opportunity to expire them.

New clause 13—Reports on roadmap to a smoke-free United Kingdom—

“(1) The Secretary of State must, on or before the relevant day and at least once every five years after that day, prepare and lay before Parliament a report setting out—

(a) how the Secretary of State expects the smoke-free target will be achieved;

(b) the steps proposed to achieve that target (which may include the setting of interim targets);

(c) an analysis of statistical data relating to the achievement of the smoke-free target.

(2) The reports must set out targets and proposed steps relating to geographical areas or categories of people in respect of which there are higher than average rates of smoking.

(3) The Secretary of State must consult the appropriate national authorities when preparing the reports.

(4) In this section—

(a) ‘appropriate national authority’ means—

(i) Welsh Ministers,

(ii) Scottish Ministers, and

(iii) Executive Ministers in Northern Ireland.

(b) ‘relevant day’ means the last day before 25 December 2026 which is a sitting day for both Houses of Parliament;

(c) ‘the smoke-free target’ means the end of the smoking of tobacco products in the United Kingdom.”

This new clause requires the Secretary of State to prepare and lay before Parliament five-yearly reports containing a roadmap to a smoke-free country including targets and specific interventions for populations with high prevalence rates.

New clause 14—Prohibition on supply of cigarette filters—

“(1) The Secretary of State must make regulations having the effect of prohibiting the supply of cigarette filters or cigarettes containing cigarette filters, whether by way of sale or not, in the course of a business.

(2) Subsections (6), (8), (9), (10), (10A), (10B), (10C) and (10D) of section 140 of the Environmental Protection Act 1990 apply to regulations under this section as they apply to regulations under those sections.

(3) The notice required under section 140(6)(b) of the Environmental Protection Act 1990 as applied by subsection (2) in relation to the regulations mentioned in subsection (1) must be published no later than the end of the period of 12 months beginning with the day on which this Act is passed.

(4) In this section, ‘cigarette filter’ means a filter which is intended for use in a cigarette, whether as part of a ready-made cigarette or to be used with hand rolling tobacco or other substances to be smoked in a cigarette.

(5) Regulations under this section are subject to the affirmative resolution procedure.”

This new clause requires the Secretary of State to make regulations which would prohibit the supply of cigarette filters or cigarettes containing cigarette filters.

New clause 15—Advertising exemptions for specialist vaping retailers—

“(1) A person does not commit an offence under any of the sections 114 to 118 in relation to an advertisement whose purpose or effect is to promote a vaping product if the advertisement—

(a) Is in a specialist vaping shop

(b) Is not visible from outside the specialist vaping shop

(c) Complies with the requirements (if any) specified by the appropriate national authority in regulations as to the inclusion of health warnings and information.

(2) Regulations under subsection (1) are subject to the negative resolution procedure.

(3) In this section—

‘appropriate national authority’ —

(a) In relation to specialist vaping shops in England, means the Secretary of State,

(b) In relation to specialist vaping shops in Wales, means Welsh Ministers,

(c) In relation to specialist vaping shops in Scotland, means Scottish Ministers, and

(d) In relation to specialist vaping shops in Northern Ireland, means the Department of Health for Northern Ireland;

‘shop’ includes a self-contained part of a shop (and, in relation to a self-contained part of a shop,

‘premises’ means that self-contained part);

‘specialist vaping shop’ means a shop selling vaping products by retail (whether or not it sells other things) more than 90% of whose sales on the premises in quest derive from the sale of vaping products and vaping accessories.

(4) For the purposes of determining whether a shop is a specialist vaping shop the sales are to be measured by the sale price—

(a) During the most recent period of 12 months for which accounts are available, or

(b) During the period for which the shop has been established, if it has not been established long enough for 12 months’ accounts to be available.”

This new clause would enable specialist vaping retailers to operate and provide free advice and consultations to smokers who are trying to find the right product for them to quit.

New clause 16—Online sale of tobacco products—

“(1) It is an offence to supply a tobacco product through an internet service, whether by way of sale or not.

(2) It is a defence for a person charged with an offence under this section to prove that they took all reasonable steps to avoid the commission of the offence.

(3) A person who commits an offence under this section is liable on summary conviction to a fine not exceeding level 4 on the standard scale.

(4) For the purposes of this section—

‘internet service’ means a service that is made available by means of the internet, even if it’s made available using a combination of the internet and an electronic communications service as defined in Section 32(2) of the Communications Act 2003.”

This new clause creates an offence of selling tobacco products online.

New clause 17—Tobacco products statutory scheme: consultation—

“(1) The Secretary of State must consult and report on the desirability of making a scheme with one or more of the following purposes—

(a) regulating, for the purposes of improving public health, the prices which may be charged by any producer or importer of tobacco products for the supply of any tobacco products,

(b) limiting the profits which may accrue to any producer or importer in connection with the manufacture or supply of tobacco products,

(c) providing for any producer or importer of tobacco products to pay to the Secretary of State an amount calculated by reference to sales or estimated sales of those products (whether on the basis of net prices, average selling prices or otherwise) to be used for the purposes of reducing smoking prevalence and improving public health.

(2) In this section—

‘importer’ in relation to tobacco products, and “tobacco products” have the meaning as in Part 5 (see section 112),

‘producer’ in relation to tobacco products, is to be construed in accordance with the meaning of ‘production’ in Part 5 (see section 112).”

This new clause would require the Secretary of State for Health and Social Care to consult on proposals for regulating the prices and profits of, and to raise funds from, tobacco manufacturers and importers.

New clause 18—Consultation on licensing regulations—

“(1) Within two months of the passing of this Act, the Secretary of State must publish draft regulations for the licensing of retail sale of tobacco products etc in England.

(2) Following the publication of the draft regulation as set out in subsection (1) the Secretary of State must publish a call for evidence seeking views on the efficacy and suitability of the draft regulations and invite the House of Commons Business and Trade Committee to scrutinise the draft regulations.

(3) After six months of the passing of this Act, the Secretary of State must lay before both Houses of Parliament a report setting out the Government’s formal response to evidence submitted in response to the call for evidence required by subsection (2) and any recommendations of the House of Commons Business and Trade Committee.

(4) The Secretary of State may not make an order under section 168(4) bringing sections 16 to 18 and Schedules 1 and 2 into force until the report specified in subsection (3) has been laid before both Houses of Parliament.”

This new clause would require the Secretary of State to publish draft regulations for the licensing of retail sale of tobacco products etc in England and ensure they receive parliamentary scrutiny.

New clause 19—Reports on illegal sale of tobacco and vaping products—

“(1) The Secretary of State must—

(a) prepare an annual report on the scale of the illegal sale and availability of tobacco and vaping products in the United Kingdom; and

(b) lay a copy of each report before both Houses of Parliament.

(2) Each report must provide details in the United Kingdom of—

(a) the estimated amount and value of illegal, counterfeit and contraband cigarettes and other tobacco products available for sale;

(b) the estimated amount and value of illegal or non-compliant vapes available for sale;

(c) the action taken to tackle the illicit trade of tobacco, tobacco products, vaping devices and vaping products; and

(d) an assessment of the impact of the illicit trade of tobacco, vapes and nicotine products on public health and safety.

(3) The first report must be laid within the period of 12 months of the passing of this Act.

(4) Each subsequent report must be laid annually beginning with the day on which the previous report was laid.”

This new clause would require that the Government produce annual reports on the rate of sale and availability of illegal tobacco and vaping products and their impact on public health and safety.

New clause 20—Age verification requirement for online sales of vaping devices and products—

“(1) A person commits an offence if the person—

(a) continues to operate an online vaping product business, and

(b) fails to operate an age verification policy in respect of online sales of vaping products and devices.

(2) An ‘age verification policy’ is a policy that steps are to be taken to establish and ensure the age of a person attempting to buy a vaping product (the ‘customer’) is not under 18 years of age.

(3) The appropriate national authority may by regulations amend the age specified in subsection (2).

(4) The appropriate national authority may publish guidance on matters relating to age verification policies, including, in particular, guidance about—

(a) steps that should be taken to establish a customer’s age,

(b) documents that may be used as evidence of a customer’s age,

(c) training that should be undertaken by the person selling vaping products,

(d) the form and content of notices that should be displayed on websites; and

(e) the form and content of records that should be maintained in relation to an age verification policy.

(5) A person guilty of an offence under subsection (1) is liable on summary conviction to a fine not exceeding level 2 on the standard scale.

(6) Regulations under subsection (3) are subject to the affirmative resolution procedure.

(7) In this section—

‘the appropriate national authority’ means—

(a) in relation to England, the Secretary of State, and

(b) in relation to Wales, the Welsh Ministers,

‘online vaping product business’ means a business involving the sale of vaping products by retail online.”

This new clause introduces a requirement on online vaping product businesses to operate an age verification policy covering steps to be taken to establish the age of persons attempting to buy vaping products online. It reflects provisions in place in Scotland.

New clause 21—Prohibition on manufacture and retail of high-capacity count vaping devices—

“(1) The Secretary of State must produce regulations relating to the design, manufacture and sale of vaping devices and products that ensure—

(a) Vaping devices must not be designed or manufactured in a way that allows refill containers, modular attachments, or third-party modifications that increase e-liquid capacity beyond the limit of 2ml per tank or pod, which includes, but is not limited to detachable extensions, multi-pod configurations, and external refill reservoirs.

(b) Any vaping device must contain a fixed, non-modifiable single-use tank or pod with a maximum capacity of 2ml.

(c) Refill e-liquid containers must be limited to a maximum of 10ml per bottle and must not be sold in forms that enable direct integration with a vaping device as an extended tank or automated refill mechanism.

(d) No manufacturer or retailer shall promote, sell, or advertise modification kits, refill systems, or accessory attachments designed to contravene the Tobacco and Related Products Regulations 2016 restrictions on vaping device capacity.

(2) A person commits an offence if they—

(a) Manufacture, import, distribute, or sell a vaping device or accessory that does not comply with the regulatory requirements set out in subsection (1).

(b) Advertise, market, or sell components that facilitate increasing a device’s effective e-liquid capacity beyond the legal limit.

(3) A person who is guilty of an offence under subsection (2)(a) shall be liable on summary conviction to a fine of £20,000 per violation or a ban on further sales within the UK market.

(4) A person who is guilty of an offence under subsection (2)(b) shall be liable on summary conviction to a fine of £10,000 per violation and may be subject to further regulatory action, including product recall or withdrawal from sale.”

This new clause would seek the introduction of regulations and new offences to prohibit the manufacture, design and retail sale of high-capacity count vaping devices.

Amendment 103, page 1, line 4, leave out clause 1.

This amendment removes the generational ban on selling tobacco products to people born on or after 1 January 2009.

Amendment 4, in clause 1, page 1, line 5, leave out

“born on or after 1 January 2009”

and insert

“under the age of 21”.

This amendment makes it an offence to sell tobacco products, herbal smoking products and cigarette papers to a person under the age of 21, rather than to people born on or after 1 January 2009.

Amendment 38, page 1, line 7, leave out “a tobacco product” and insert

“cigarettes or hand rolling tobacco within the meaning of the Standardised Packaging of Tobacco Products Regulations 2015 (S.I. 2015/829)”.

Government amendment 47.

Amendment 5, in clause 1, page 1, line 13, leave out

“shown that document was before 1 January 2009”

and insert

“showed that the purchaser was not under the age of 21”.

This amendment is linked to Amendment 4.

Government amendments 48 and 49.

Amendment 104, page 2, line 10, leave out clause 2.

This amendment is linked to Amendment 103.

Amendment 6, in clause 2, page 2, line 11, leave out “18” and insert “21”.

This amendment makes it an offence to purchase tobacco products, herbal smoking products and cigarette papers on behalf of a person under the age of 25, rather than a person born on or after 1 January 2009.

Amendment 7, page 2, line 12, leave out

“born on or after 1 January 2009”

and insert

“under the age of 21”.

This amendment is linked to Amendment 6.

Amendment 39, page 2, line 13, leave out “a tobacco product” and insert

“cigarettes or hand rolling tobacco within the meaning of the Standardised Packaging of Tobacco Products Regulations 2015 (S.I. 2015/829)”.

This amendment is linked to Amendment 38.

Amendment 8, page 2, line 18, leave out

“born on or after 1 January 2009”

and insert

“under the age of 21”.

This amendment is linked to Amendment 6.

Government amendment 50.

Amendment 105, page 3, line 3, leave out clause 5.

This amendment is linked to Amendment 103.

Amendment 9, in clause 5, page 3, line 8, leave out

“born on or after 1 January 2009”

and insert

“under the age of 21”.

This amendment is linked to Amendment 4.

Amendment 106, page 3, line 25, leave out clause 6.

This amendment is linked to Amendment 103.

Amendment 10, in clause 6, page 3, line 30, leave out

“born on or after 1 January 2009”

and insert

“under the age of 21”.

This amendment is linked to Amendment 4.

Amendment 11, page 3, line 32, leave out

“a anwyd ar neu ar ôl 1 Ionawr 2009”

and insert “dan 21 oed”.

This amendment is linked to Amendment 4.

Government amendments 51 to 59.

Amendment 1, in clause 38, page 20, line 19, leave out from “be” to the end of line and insert

“be allocated by the relevant Local Authority to public health projects.”

This amendment would direct funds from Fixed Penalty Notice fines to public health initiatives as determined by Local Authorities.

Amendment 2, page 20, line 20, leave out from “before” to the second “the” and insert

“such sums are allocated by the relevant Local Authorities”.

This amendment is consequential upon Amendment 1.

Government amendments 60 to 63.

Amendment 107, page 25, line 26, leave out clause 50.

This amendment is linked to Amendment 103.

Amendment 40, in clause 50, page 25, line 30, after “subsection (1)” insert—

“(i) for ‘a tobacco product’ substitute ‘cigarettes or hand rolling tobacco within the meaning of the Standardised Packaging of Tobacco Products Regulations 2015 (S.I. 2015/829)’, and”.

This amendment exempts tobacco products other than cigarettes and hand rolling tobacco from the offence of selling tobacco products to a person born on or after 1 January 2009.

Amendment 12, page 25, line 30, leave out “‘born on or after 1 January 2009’” and insert “‘under the age of 21’”.

This amendment is linked to Amendment 4.

Amendment 13, page 25, line 33, leave out

“‘born on or after 1 January 2009 (“the customer) to have been born before that date”’”

and insert

“‘under the age of 21 (“the customer”) to be aged 21 or over’”.

This amendment is linked to Amendment 4.

Amendment 14, page 25, line 37, leave out

“born on or after 1 January 2009”

and insert “under 21”.

This amendment is linked to Amendment 4.

Amendment 15, page 26, line 1, leave out subsection (3).

This amendment is linked to Amendment 4.

Amendment 41, page 26, line 6, leave out “a tobacco product” and insert

“cigarettes or hand rolling tobacco within the meaning of the Standardised Packaging of Tobacco Products Regulations 2015 (S.I. 2015/829)”.

This amendment is linked to Amendment 40.

Amendment 42, page 26, line 28, after “subsection (1)” insert—

“(i) for “a tobacco product” substitute “cigarettes or hand rolling tobacco within the meaning of the Standardised Packaging of Tobacco Products Regulations 2015 (S.I. 2015/829)”, and”.

This amendment is linked to Amendment 40.

Amendment 16, page 26, line 28, leave out

“‘born on or after 1 January 2009’”

and insert

“‘under the age of 21’”.

This amendment is linked to Amendment 4.

Amendment 17, page 26, line 30, leave out

“‘born on or after 1 January 2009’”

and insert “‘under 21’”.

This amendment is linked to Amendment 4.

Amendment 18, page 26, line 33, leave out

“‘born on or after 1 January 2009’”

and insert

“‘under the age of 21’”.

This amendment is linked to Amendment 4.

Government amendment 64.

Amendment 108, page 35, line 24, leave out clause 68.

This amendment is linked to Amendment 103.

Amendment 19, page 35, line 28, leave out

“born on or after 1 January 2009”

and insert

“under the age of 21”.

This amendment is linked to Amendment 4.

Amendment 43, page 35, line 30, leave out “a tobacco product” and insert

“cigarettes or hand rolling tobacco within the meaning of the Standardised Packaging of Tobacco Products Regulations 2015 (S.I. 2015/829)”.

This amendment exempts tobacco products other than cigarettes and hand rolling tobacco from the offence of selling tobacco products to a person born on or after 1 January 2009.

Government amendment 65.

Amendment 20, page 35, line 37, leave out

“shown on that document was before 1 January 2009”

and insert

“showed that the purchaser was not under the age of 21”.

This amendment is linked to Amendment 4.

Government amendments 66 and 67.

Amendment 109, page 36, line 13, leave out clause 69.

This amendment is linked to Amendment 103.

Amendment 21, page 36, line 16, leave out

“born on or after 1 January 2009”

and insert

“under the age of 21”.

This amendment is linked to Amendment 6.

Amendment 22, page 36, line 18, leave out “18” and insert “21”.

This amendment is linked to Amendment 6.

Amendment 23, page 36, line 19, leave out

“born on or after 1 January 2009”

and insert

“under the age of 21”.

This amendment is linked to Amendment 6.

Amendment 44, page 36, line 21, leave out “a tobacco product” and insert

“cigarettes or hand rolling tobacco within the meaning of the Standardised Packaging of Tobacco Products Regulations 2015 (S.I. 2015/829)”.

This amendment is linked to Amendment 43.

Amendment 24, page 36, line 26, leave out

“born on or after 1 January 2009”

and insert

“under the age of 21”.

This amendment is linked to Amendment 6.

Government amendment 68.

Amendment 110, page 37, line 19, leave out clause 72.

This amendment is linked to Amendment 103.

Amendment 25, in clause 72, page 37, line 27, leave out

“born on or after 1 January 2009”

and insert

“under the age of 21”.

This amendment is linked to Amendment 4.

Government amendments 69 to 79.

Amendment 86, in clause 90, page 50, line 32, at end insert—

“(da) cigarette filters;”.

This amendment enables the Secretary of State to make provisions about the retail packaging of cigarette filters and the composition of individual products contained in an individual pack of products outlined in Clause 90(1).

Amendment 87, page 51, line 13, at end insert—

“(ja) the composition of individual products contained in an individual pack;”.

This amendment enables the Secretary of State to make provisions about the retail packaging of cigarette filters and the composition of individual products contained in an individual pack of products outlined in Clause 90(1).

Amendment 36, page 51, line 30, delete “shape” and insert “design, shape or interoperability”.

This amendment empowers ministers to regulate the design and interoperability of products in order to prohibit the sale of very high-puff count vaping devices.

Amendment 37, in clause 92, page 52, line 3, after “flavour” insert “descriptors”.

This amendment would give the Secretary of State powers to make provisions about the flavour descriptors of relevant products.

Amendment 88, in clause 110, page 60, line 35, leave out from “consult” to end of line 36 and insert

“any persons or bodies as appear to him or her representative of the interests concerned.”

This amendment would ensure that the Secretary of State has to consult all relevant parties before making regulations, rather than just those that they deem appropriate.

Government amendment 80.

Amendment 90, in clause 114, page 63, line 16, after “product,” insert

“except for the public health purpose of promoting vaping as a cessation tool for existing tobacco smokers,”.

This amendment would allow vapes to be promoted as a quit-aid/public health measure.

Amendment 46, in clause 120, page 68, line 22, at end insert—

“(ca) it is, when in relation to the advertising of vaping products or nicotine products, in a location in which it would be reasonable to expect that everyone present is aged 18 or over.”

This amendment would allow for the advertising of vaping or nicotine products within locations where it is reasonable to expect that everyone present is over 18.

Amendment 91, in clause 125, page 73, line 2, at end insert—

“(4) No offence is committed under this Part if—

(a) it is for the purposes of an interaction between a representative for the product and a member of the public, and

(b) the representative for the product has taken reasonable measures to ensure that the member of the public is aged over 18 and is an existing tobacco or nicotine user.”

This amendment will allow for vapes and nicotine products to be promoted through one-to-one interaction between individuals representing the product and adults who are already existing smokers or nicotine users.

Amendment 85, in clause 136, page 77, line 8, leave out from “smoke-free” to end of line 15 and insert

“a place in England that is—

(a) an NHS property or hospital building,

(b) a children’s playground, or

(c) a nursery, school, college or higher education premises.”

This amendment restricts the Secretary of State to only being able to designate open or unenclosed spaces outside a hospital, children’s playground, nursery, school, college or higher education premises as smoke-free areas.

Amendment 84, page 77, line 9, leave out from “place” to the end of line 12 and insert

“or description of place in England that is not smoke-free under section 2.

(1A) The place, or places falling within the description, need not be enclosed or substantially enclosed.

(1B) The Secretary of State may designate a place or description of place under this section only if they are advised by the Department for Health and Social Care's Chief Scientific Adviser that there is a significant risk that, without a designation, persons present there would be exposed to significant quantities of smoke or, if said place is—

(a) an NHS property or hospital building,

(b) a children’s playground, or

(c) a nursery, school, college or higher education premises.”

This amendment would restrict the Secretary of State to only being able to designate open or unenclosed spaces outside a hospital, children’s playground, nursery, school, college or higher education premises, or places with significant risk of second-hand smoke as smoke-free areas.

Amendment 92, page 77, line 12, at end insert—

“(1A) The Secretary of State may designate a place or description of place under this section only if, in the Secretary of State’s opinion, there is a significant risk that, without a designation, persons present there would be exposed to significant quantities of smoke.”

This amendment provides that regulations to designate places as smoke-free may only be made if the Secretary of State is satisfied that they are necessary to avoid persons being exposed to significant quantities of smoke.

Amendment 82, in clause 137, page 78, leave out lines 5 to 12.

This amendment removes the proposed power for the Secretary of State to create defences for performances. This protects the health of actors in the workplace and prevents the promotion of smoking through artistic means.

Amendment 83, page 78, leave out lines 15 to 21.

This amendment removes the proposed power for the Secretary of State to create defences for performances. This protects the health of actors in the workplace and prevents the promotion of smoking through artistic means.

Amendment 93, in clause 139, page 79, line 13, at end insert—

“(1A) The Secretary of State may designate a place or description of place under this section only if, in the Secretary of State’s opinion, there is a significant risk that, without a designation, the use of vapes may have adverse effects on the health of persons present there who are not using vapes.”

This amendment provides that regulations to designate places as vape-free may only be made if the Secretary of State is satisfied that they are necessary to avoid persons present there being exposed to adverse health effects.

Amendment 94, in clause 140, page 82, line 24, at end insert—

“(1A) The Secretary of State may designate a place or description of place under this section only if, in the Secretary of State’s opinion, there is a significant risk that, without a designation, the use of heated tobacco devices may have adverse effects on the health of persons present there who are not using heated tobacco devices.”

This amendment provides that regulations to designate places as heated tobacco-free may only be made if the Secretary of State is satisfied that they are necessary to avoid persons present there being exposed to adverse health effects.

Amendment 95, in clause 142, page 85, line 33, at end insert—

“(2A) Premises may be prescribed as no-smoking premises only if in the Scottish Ministers’ opinion there is a significant risk that, without prescribing them, persons present there would be exposed to significant quantities of smoke.”

This amendment provides that regulations to prescribe premises as smoke-free may only be made if the Scottish Ministers are satisfied that they are necessary to avoid persons being exposed to significant quantities of smoke.

Amendment 96, in clause 144, page 90, line 4, at end insert—

“(2A) Premises may be prescribed as vape-free premises only if in the Scottish Ministers’ opinion there is a significant risk that, without prescribing them, the use of vapes may have adverse effects on the health of persons present there who are not using vapes.”

This amendment provides that regulations to prescribe premises as vape-free may only be made if the Scottish Ministers are satisfied that they are necessary to avoid persons present there being exposed to a significant risk of adverse health effects.

Amendment 97, in clause 145, page 92, line 22, at end insert—

“(2A) Premises may be prescribed as heated tobacco-free premises only if in the Scottish Ministers’ opinion there is a significant risk that, without prescribing them, the use of heated tobacco devices may have adverse effects on the health of persons present there who are not using heated tobacco devices.”

This amendment provides that regulations to prescribe premises as heated tobacco-free may only be made if the Scottish Ministers are satisfied that they are necessary to avoid persons present there being exposed to a significant risk of adverse health effects.

Amendment 98, in clause 150, page 98, line 40, at end insert—

“(2A) The regulations may designate a place or vehicle as vape-free only if the Welsh Ministers are satisfied that doing so is likely to contribute towards the promotion of public health.”

This amendment provides that regulations to designate a place or vehicle as vape-free may only be made if the Welsh Ministers are satisfied that this is likely to contribute towards the promotion of public health.

Amendment 99, in clause 151, page 105, line 22, at end insert—

“(2A) The regulations may designate a place or vehicle as heated tobacco-free only if the Welsh Ministers are satisfied that doing so is likely to contribute towards the promotion of public health.”

This amendment provides that regulations to designate a place or vehicle as heated tobacco-free may only be made if the Welsh Ministers are satisfied that this is likely to contribute towards the promotion of the health of the people of Wales.

Amendment 100, in clause 153, page 108, line 25, at end insert—

“(1A) The Department may designate a place or description of place under this Article only if satisfied that, without the designation, persons present there would be likely to be exposed to significant quantities of smoke.”

This amendment provides that regulations to designate places as smoke-free may only be made if the Northern Ireland Department is satisfied that they are necessary to avoid persons being exposed to significant quantities of smoke.

Amendment 101, in clause 155, page 110, line 6, at end insert—

“(1A) The Department may designate a place or vehicle under this Article only if the Department is satisfied there is a significant risk that, without a designation, the use of vapes may have adverse effects on the health of persons present there who are not using vapes.”

This amendment provides that regulations to designate places as vape-free may only be made if the Northern Ireland Department is satisfied that they are necessary to avoid persons present there being exposed to adverse health effects.

Amendment 102, in clause 156, page 113, line 15, at end insert—

“(1A) The Department may designate a place or vehicle under this Article only if the Department is satisfied there is a significant risk that, without a designation, the use of heated tobacco devices may have adverse effects on the health of persons present there who are not using heated tobacco devices.”

This amendment provides that regulations to designate places as heated tobacco-free may only be made if the Northern Ireland Department is satisfied that they are necessary to avoid persons present there being exposed to adverse health effects.

Amendment 89, in clause 168, page 120, line 39, leave out from “force” to end of line 41 and insert

“on such a date as the Secretary of State may by regulation appoint following the consultation on licensing regulations (see section (Consultation on licensing regulations)).”

See explanatory statement for NC18.

Government amendment 81.

Amendment 26, in schedule 5, page 132, line 2, leave out

“a anwyd ar neu ar ôl 1 Ionawr 2009”

and insert “dan 21 oed”.

This amendment is linked to Amendment 4.

Amendment 27, page 132, line 7, leave out

“a anwyd ar neu ar ôl 1 Ionawr 2009”

and insert “dan 21 oed (“B”)”.

This amendment is linked to Amendment 4.

Amendment 28, page 132, line 12, leave out

“a anwyd ar neu ar ôl 1 Ionawr 2009”

and insert “dan 21 oed”.

This amendment is linked to Amendment 4.

Amendment 29, page 132, line 38, leave out

“wedi cael ei eni cyn 1 Ionawr 2009”

and insert

“yn 21 oed neu drosodd”.

This amendment is linked to Amendment 4.

Amendment 30, page 133, line 2, leave out

“wedi cael ei eni ar neu ar ôl 1 Ionawr 2009”

and insert “dan 21 oed”.

This amendment is linked to Amendment 4.

Amendment 111, page 133, line 15, leave out paragraph 5.

This amendment is linked to Amendment 103.

Amendment 31, page 133, line 16, leave out

“born on or after 1 January 2009”

and insert

“under the age of 21”.

This amendment is linked to Amendment 4.

Amendment 32, page 133, line 21, leave out

“born on or after 1 January 2009”

and insert

“under the age of 21”.

This amendment is linked to Amendment 4.

Amendment 33, page 133, line 26, leave out

“born on or after 1 January 2009”

and insert

“under the age of 21”.

This amendment is linked to Amendment 4.

Amendment 45, page 133, line 37, at end insert—

“(1A) In this section, “tobacco products” means cigarettes or hand rolling tobacco within the meaning of the Standardised Packaging of Tobacco Products Regulations 2015 (S.I. 2015/829).”

This amendment is linked to Amendment 38.

Amendment 34, page 134, line 9, leave out

“born on or after 1 January 2009”

and insert

“under the age of 21”.

This amendment is linked to Amendment 4.

Amendment 35, page 134, line 14, leave out

“born on or after 1 January 2009”

and insert

“under the age of 21”.

This amendment is linked to Amendment 4.

[Ashley Dalton]

I would like to start by thanking all right hon. and hon. Members for their invaluable contributions during the passage of the Bill to date, and in particular, members of the Public Bill Committee for providing insight, scrutiny and debate. I am honoured to have taken on responsibility for this Bill. It is a watershed piece of legislation and the most significant public health intervention since the ban on smoking in public places in 2007. It will establish a smokefree generation by gradually ending the sale of tobacco products across the UK so that a child turning 16 this year will never be able to be legally sold tobacco, saving countless lives in the process. It will strengthen existing powers to reduce the harms of second-hand smoke in public spaces. In keeping with our manifesto commitment to the British people, it will outlaw the manipulative promotion of vapes to children to protect the next generation from becoming hooked on nicotine. Finally, it will implement robust measures to strengthen enforcement activity.

I do not need to tell anyone in this Chamber that tobacco kills—we all know that. What hon. Members may not know is just how much it kills, the rate at which it kills, and the devastation it causes for individuals, families and communities across the country. Let me remind hon. Members that tobacco kills more people than any other preventable cause of death. Around 80,000 people in the UK lose their lives to tobacco every year. It robs an average of 10 years off the life expectancy of smokers. It substantially increases the risk of many major health conditions throughout people’s lives, such as stroke, diabetes, heart disease, stillbirth, dementia and asthma. This daily tragedy continues unabated, with someone being admitted to hospital because of smoking almost every minute, day in, day out, with no end in sight.

Tobacco harms are not felt equally either. Our most disadvantaged communities suffer most, with 230,000 households living in smoking-induced poverty. In Blackpool, 17.5% of pregnant women still smoke at the time of delivery compared with 2.8% in Kensington and Chelsea. Over a quarter of people with a long-term mental health condition smoke.

Beyond the immeasurable cost to lives in the UK, the staggering economic impact of tobacco on our NHS cannot be ignored. The treatment of smoking-related diseases consumes approximately £3 billion a year of vital NHS and social care resources. The cost of smoking to our economy is even greater: £18 billion is lost in productivity every year, far outweighing the tax receipts it brings in of around £9 billion. The Bill is a vital step to break the devastating cycle of tobacco addiction and safeguard future generations from a lifetime of ill health.

But the world moves forward, and we cannot ignore the alarming rise of youth vaping. While vaping is less harmful than smoking and can be an effective quit aid for adult smokers, children should never vape. However, in the past five years, youth vaping has more than doubled. One in four 11 to 15-year-olds tried vaping in 2023, and that is no accident. It is in part due to the deliberate branding and advertisement of vapes to our children, with brightly coloured packaging and enticing sweet-like flavours—a calculated strategy to hook young people on nicotine. We cannot afford to wait to act.

I turn to the Government amendments, which seek to strengthen the Bill and ensure greater clarity. As we create the first smokefree generation and strengthen age restrictions on vapes and nicotine products, we want to support retailers in taking appropriate steps to ensure they do not sell to customers under the age of sale. New clause 11 and Government amendments 47 to 49, 51 to 53, 61, 63, 65 to 67, 69 to 71, 75, 77, 79 and 81 are a package of amendments and consequential amendments to the Bill. They seek to remove potential ambiguity for retailers regarding the use of digital identity for verifying the age of prospective customers when selling tobacco, vaping and nicotine products.

In Committee, Members raised concerns that the list of identity documents to satisfy the defence for a person charged with selling products to someone under the age of sale was limited, and queried the inclusion of other forms of physical and digital identity. These amendments remove the lists of physical ID from the Bill and instead provide powers for the Secretary of State and the Department of Health in Northern Ireland to specify in regulations the steps that may be taken to verify a customer’s age to meet the requirements for the defence. This revised approach better future-proofs the defence against developments in identification processes and provides the potential to recognise digital ID, as well as physical ID, in the context of the defence, supporting the widespread use of digital ID.

The amendments provide the opportunity for effective interaction with part 2 of the Data (Use and Access) Bill that is currently going through Parliament, which includes provisions relating to digital verification services. Digital verification services provide an opportunity to securely verify age for in-person and online sales. We will continue to work closely with the Department for Science, Innovation and Technology and other Departments when developing the regulations.

New clause 11 provides a similar power for Scottish Ministers to prescribe in regulations the steps that should be taken to establish a customer’s age as a defence to an age of sale offence. That will enable Scottish Ministers to respond to changes in technology and consumer behaviours, which may move away from the presentation of a physical document.

The last Labour Government took bold action to prohibit displays of tobacco products to protect children and young people from being enticed into addiction and to create a more supportive environment for adults seeking to quit. The Bill goes further and gives powers to limit the display of a wider range of products, including herbal smoking products, cigarette papers, vapes and nicotine products. Government amendments 56, 57, 60, 62, 74, 76, 78 and 80 will alter the powers in the Bill for England, Wales and Northern Ireland that regulate displays of products and their prices, so that they also cover tobacco-related devices. As was discussed in Committee, pipes, heated tobacco devices and bongs are currently displayed in shops and can have the effect of promoting tobacco usage. The amendments will ensure that we can make regulations to stop products that facilitate the consumption of tobacco being openly displayed by retailers.

The Bill bans the sale of vapes, nicotine products and cigarette papers from vending machines in England, Wales and Northern Ireland and restates the existing ban on tobacco vending machines. We know that vending machines are used to bypass age of sale restrictions and to undertake proxy purchases on behalf of people under the age of sale. Government amendments 50, 54, 55, 64, 68, 72 and 73 are clarifying amendments that make the scope of the prohibition on vending machines absolutely clear, as was discussed in Committee. The Government’s position is that the Protection from Tobacco (Sales from Vending Machines) (England) Regulations 2010 already apply where a customer has a coupon, receipt or token purchased elsewhere that can be redeemed at a machine. We are amending the clauses so that all machines that dispense products in connection with a sale are clearly captured by the ban.

The Bill strengthens the enforcement regime to support law-abiding retailers while taking action against those who break the rules. Along with introducing new fixed penalty notices and new powers to create a licensing system, the Bill re-enacts provisions on restricted premises orders and restricted sale orders. Those are existing measures that local authority trading standards in England and Wales can use when dealing with a retailer that persistently breaches restrictions. That ensures there is a range of tools in the enforcement armoury, so that trading standards officers can act quickly and effectively against rogue retailers.

Government amendments 58 and 59 clarify a point raised in Committee by removing a duplicative and unnecessary provision that would prevent a business or individual from operating a vending machine for the sale of tobacco, vaping or nicotine products following the issuing of a restricted premises order or a restricted sale order. Given that the Bill already prohibits the use of vending machines for tobacco, vaping or nicotine products, there is no need for restricted premises orders and restricted sale orders to expressly prohibit the use of vending machines. Together, the Government amendments will improve the implementation and enforceability of measures in the Bill to ensure the most effective protection for the public, and I commend them to the House.

Turning to the other amendments in the group, I thank hon. Members for their scrutiny of the Bill so far. When I wind up, I will try to cover the key themes that are touched on. On the amendment that seeks to undermine the smokefree generation, I am sure we will hear arguments from some hon. Members who have been listening to the tobacco industry’s arguments and myths about how people should be free to make their own choices. I would say to them that smoking kills two thirds of its users. Three quarters of people wish they had never started smoking, and the majority want to quit—that is not freedom of choice. The tobacco industry took away that choice with addiction, usually at a young age.

On smokefree places, we have been clear: in England, we intend to consult on extending smokefree outdoor places to outside schools, children’s playgrounds and hospitals, but not to outdoor hospitality settings at this time. No smoker wants to harm people, but with second-hand smoke, they do. If people can smell smoke, they are inhaling it. This is particularly important for children, pregnant women and people with pre-existing health conditions such as asthma or heart disease. The only way to stop this harm is to stop people smoking around others. While I understand hon. Members’ proposals to list specific places in the Bill or to add additional limits to the use of the powers, it is right that we consult on the detail before making regulations and have the necessary powers to protect children and vulnerable people from the harms of second-hand smoking.

I am grateful to the co-chairs of the all-party parliamentary group on smoking and health, my hon. Friend the Member for City of Durham (Mary Kelly Foy) and the hon. Member for Harrow East (Bob Blackman), for their long-standing support for the Bill. Through their amendments, they highlight the importance of retaining a focus on support for current smokers. That is why we are investing an extra £70 million for local stop smoking services this year and working to ensure that all NHS hospitals offer opt-out smoking cessation services into routine care. I hope they will be pleased that we have been able to confirm the extension of the swap to stop scheme for the coming year, with up to £90 million of funding to provide free vape starter kits for smokers to use as quit aids.

On the group of amendments relating to vape advertising, we realise that products being deliberately marketed at children is unacceptable, which is why we have included a commitment to stop vapes being branded and advertised to children. The Government are also investing £10 million of new funding for the coming year for National Trading Standards to tackle underage illicit tobacco and vapes and to boost the trading standards workforce by recruiting 80 new apprentices, providing additional boots on the ground.

[Ashley Dalton]

As the hon. Member will know, there are already measures in the Bill that allow some of the fines to be retained—they can certainly be retained to make it cost-neutral for local authorities—but I am sure we will explore that issue later on.

The Bill contains regulation-making powers on a range of aspects of product requirements that already allow us to do many things that hon. Members seek to achieve, but I look forward to listening to the contributions to today’s debate on the wider list of amendments and to responding to the points that are made.

[Madam Deputy Speaker (Judith Cummins)]

I call the Opposition spokesperson.

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

It is now a truth universally acknowledged that smoking is bad for one’s health. It is the leading cause of preventable death in this country, responsible for over 80,000 deaths every year. When we say that number, it is easy to allow it to trip off the tongue as another statistic without really realising just how many people it represents. For each of them—such as my Nana Burton, who was a smoker and who died of lung cancer—there is a personal story of damaged health and often an early and preventable death.

The Conservative party introduced a Bill based on a similar premise to this one in the last Parliament, although the Government have made significant changes since to the legislation, including taking a power that could be used to ban smoking and vaping in pub gardens, as well as a licensing scheme for tobacco products.

On amendment 85, while we have received repeated assurances that the Secretary of State intends to use the measures in the Bill only to improve public health, we must still examine whether the legislation is proportionate and reasonable. As far as I can see, it gives the Secretary of State enormous powers to extend the smokefree legislation to any place with minimal oversight and without needing to provide a reason. There were whispers last summer that the Government were considering banning smoking in pub gardens, before they hastily withdrew this provision in the face of public backlash. If only they would withdraw more of their policies in the face of public backlash, because perhaps then we would not be in the situation we are in now.

The Bill empowers the Secretary of State to extend smokefree and vape-free regulations to more places—essentially, to any place—with the aim of reducing exposure to second-hand smoke and promoting public health. However, on Second Reading the Government did not accept our amendment that it should apply only to places that have a provable significant risk to public health to justify such a ban. For that reason, I commend amendment 85 once again, which would restrict the Secretary of State to being able to designate only open or unenclosed spaces outside a hospital, a children’s playground, a nursery school, a college or a higher education premises as a smokefree area. Those are the areas the Secretary of State has said he wants to target, and the amendment would prevent any targeting of other areas, such as pub gardens, by the back door. While he claims that that is not his intention now, that may not remain the case for the rest of this Government’s time in office, nor indeed for any future Government. That is the risk in allowing these measures to stand, and for those reasons I encourage the House to support amendment 85.

3.15 pm

On new clause 18 and amendment 89, the new Bill also gives powers to the Secretary of State to introduce a new licensing scheme for retailers selling tobacco, vaping or nicotine products. However, we know that licensing schemes will come at a cost, to businesses and local authorities that will administer them, and in enforcement. That does not make it the wrong thing to do, but we would need to make sure that any licensing scheme is not excessively burdensome or expensive. New clause 18 and amendment 89 would therefore require the Government to consult on the new licensing scheme for tobacco sales before it came into force. That would mean that the views and impact on businesses including small businesses are heard, and ensure that councils and trading standards have the capacity to deliver such a scheme. Ultimately, there is a balance to strike between the requirements on business and public health, and a public consultation would ensure that the Government are more likely to get that balance right.

On new clause 19, another concern we have heard from those who oppose the Bill is about the impact that the legislation would have on the black market. His Majesty’s Revenue and Customs estimates that the illicit market in tobacco duty and related VAT was £2.8 billion in 2021-22, with the tobacco duty tax gap remaining broadly unchanged since 2015, while in 2023 the Chartered Trading Standards Institute estimated that a staggering one in three vape products were non-compliant. Given warnings that increasing the age requirement for tobacco products and prohibiting more vaping could expand the black market economy further, it is sensible to take precautions to tackle the issue.

--- Later in debate ---

[Preet Kaur Gill (Birmingham Edgbaston) (Lab/Co-op)]

I welcome the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for West Lancashire (Ashley Dalton), to her role. It is a great pleasure to speak in the debate and to support this genuinely world-leading piece of public health legislation, which will help to consign smoking to the history books.

Unless we act to help people to stay healthy, the rising tide of ill health in our society threatens to overwhelm our NHS. Paring back public health, as the last Government did, was the definition of penny wise, pound foolish. It is vital that we tackle the causes of ill health, not just the symptoms, so that we can save the taxpayer billions of pounds and, most importantly, save lives.

We know that prevention is better than cure. As we have heard today, smoking remains the single biggest preventable cause of ill health in our country, causing 80,000 deaths a year. It is responsible for one in four cancer deaths, and it is a factor in over 70% of lung cancer cases. In my own constituency alone, nearly 12,000 people smoke. They are more likely to leave the workforce due to ill health. Many will suffer strokes, heart attacks and conditions such as chronic obstructive pulmonary disease. On average, they will lose 10 years of life expectancy.

However, the real tragedy is how many thousands of those smokers will have started when they were children, when they did not know any better, and have simply never been able to quit. Most smokers report wishing that they had never started, which is why it is incumbent on us all to support this legislation to help stop the start. According to ASH, in my constituency alone the cost of smoking exceeds £90 million every year, including £56 million in lost productivity, £4 million drained from the NHS and £30.7 million in social care. The costs of smoking to our society are enormous, and that is why it is time to stub it out.

Even today, in 2025, hundreds of young people a day take the first drag of a habit they will never manage to kick, and will regret for the rest of their lives. I was proud to lead the Opposition’s response to the last Government’s Bill through Committee in the last Parliament and, as I said then, there is no freedom in addiction. It is a shame that the leader of the Conservative party allowed her ideology to blind her from that fact when she voted against the legislation in the last Parliament, and against this Bill in this one. Where the last Government failed to get their Tobacco and Vapes Bill over the line, this Government will get the job done.

I am proud that the Government have vastly improved on the legislation that the previous Government drew up. First, the introduction of a new licensing regime to cover tobacco and nicotine products, including vapes, is hugely welcome. That was a key recommendation of the Khan review in 2022, which the last Government largely ignored and which retailers and the public overwhelmingly support, according to surveys conducted by ASH. The status quo, where there was no requirement to obtain a licence to sell those products, is a major gap in enforcement, particularly when we consider that the sale of alcohol is licensed, while nicotine and tobacco are not.

Secondly, I am pleased that the Government are taking forward an amendment I tabled in Committee during the last Parliament, for the introduction of £200 on-the-spot fines for retailers selling products to under-age people. In 2019 to 2020, 50% of the councils that undertook test purchasing reported that cigarettes or tobacco products were sold to children who were under 18 in at least one of their premises. That proves that the current regime is not enough of a deterrent. The introduction of new on-the-spot fines, which are double the amount proposed by the previous Government, will be much easier to issue and much harder to ignore. Does the Minister agree with me that double the fine is double the deterrent?

Thirdly, I commend Ministers on the action they are taking on vapes. Under the last Government, youth vaping trebled in two years. An estimated one in three vapes on the market were illicit, and products often contained harmful chemicals, heavy metals or even drugs. Gaping loopholes were left to sit on the statute book for years, putting children at risk. The promulgation of dangerous illicit vapes in shops, schools and on our streets is a real concern. Recently, in Birmingham, trading standards officers and the police led raids on retailers under Operation Cloud, when they seized nearly £6 million-worth of illicit vapes, tobacco and drugs. One raid alone, the biggest ever in Birmingham, clawed £1 million-worth of goods out of criminals’ hands. That shows the extent of the problem of the illicit market and the incredible job that council trading standards teams do to keep the public safe.

I thank the Government for getting behind trading standards with a £10 million boost to support their work next year. In particular, I welcome the new Government’s introduction of clauses to this Bill to set up a testing regime for vapes, a proposal that I championed in the last Parliament. It is shocking that under the current rules, unlike with tobacco, there is no testing regime for vaping products. That means that dodgy products can be rubber-stamped by the British regulator and wind up on our shelves, undermining the valuable enforcement work that trading standards do to identify and seize un-notified products.

As testing of vapes marketed at young people has shown, a significant proportion of vaping products are not what they say they are. Some market themselves as 0% nicotine when they are not, leading to accidental addictions; others contain harmful substances, such as heavy metals and even anti-freeze, as evidenced by research undertaken by Inter Scientific. That is why during the last Parliament I tabled amendments that would have established a new testing regime for vapes. Unfortunately, the Conservatives voted them down. I commend Ministers for introducing powers that the previous Government snubbed. Nearly 3 million people have quit smoking using vapes. Clearly vapes have a role to play in the transition to a smokefree future, but if they are to be used as stop-smoking aids, we need confidence that the products people buy are safe, which is what routine testing would do.

Finally, I commend the Government on the amendments that have strengthened this Bill; they close the loopholes on vape vending machines and ban vape advertising, promotions and sponsorships. The new clauses will ensure that these products are kept away from the impressionable eyes of young people, so that the next generation are not simply substituting one nicotine addiction for another. There were significant holes in the last Government’s plan, and I am glad that the new Government are slamming them shut.

The health crisis facing our country has never been confined to the running of its hospital wards, doctors’ surgeries and dental practices. We are a sicker nation, and that public health challenge needs confronting. Life expectancy was extended by three and a half years over the course of the last Labour Government, but in the 14 years under the Tories, it grew by just four months. In this Bill, we see the epitome of the future-facing approach that only a Labour Government can deliver. By stopping the start and ensuring that the next generation never develop an addiction to nicotine, we can protect their health and wellbeing and protect our NHS for many years to come.

[Madam Deputy Speaker (Judith Cummins)]

I call the Liberal Democrat spokesperson.

Rare Cancers Bill

Judith Cummins Excerpts

2nd reading
Friday 14th March 2025 Commons Chamber

[Several hon. Members rose—]

[Madam Deputy Speaker (Judith Cummins)]

Before I call the first speaker, I am aware that this is a very personal debate for some Members, so please feel free to leave the Chamber if you need to. Let’s look after each other today.

Department of Health and Social Care

Judith Cummins Excerpts

Wednesday 5th March 2025 Commons Chamber

[Several hon. Members rose—]

[Madam Deputy Speaker (Judith Cummins)]

I want to try to get everybody in, so I will start with an immediate five-minute time limit.

--- Later in debate ---

[Jen Craft]

I was indeed at that Committee, and I also remember the reflection that NHS England was incredibly grateful for the amount of money that was being given. It was the highest amount of money given to any Department at the Budget, and it was much, much more than has been given in previous years.

Waiting lists have fallen for the fourth month in a row—I hope the hon. Gentleman and his colleagues will welcome that—with 160,000 fewer people waiting for treatment than when Labour took office. That includes a member of my own family, so I am very grateful to see that happening. Extending the opening hours of community diagnostic centres, such as the one set to open in my constituency this summer, will be key in catching conditions earlier.

While I welcome those measures, I would like to make the key point that funding alone is not enough to change and save how our NHS operates, and we must turbocharge the left shift to community and neighbourhood healthcare. In my constituency, it is often the front door to the NHS that lets local people down, which drives admissions to A&E when there is no available alternative. We have some of the most acute GP shortages in the country, with an average of 3,431 patients per GP. The neighbourhood health hubs promised by the previous Government have yet to be delivered. People in Tilbury, one of my most economically deprived areas, are still waiting for a long-promised facility, which currently looks like a hole in the ground, and I would welcome a discussion with the Minister about how we can work to deliver it.

The record funding uplift for general practice, with £889 million of investment, is again welcome news, but it highlights the fundamental tension between tackling the crisis in acute care and driving the vital left shift to community care that will be fundamental in turning the tide on the NHS. We must not lose sight of the goal of creating a healthier population in order to reduce pressure on acute services in this country, creating better, healthier lives and delivering the right care at the right time that puts the focus on the individual.

Thurrock community hospital in my constituency delivers excellent integrated community care that brings together social workers from the local authority and NHS staff to meet people where they are, intervening early and reducing pressures on acute care. That is partly thanks to a real partnership between the local authority and the integrated care board, and it has removed the need to focus on which public body benefits and which public body pays. I have to point out that our local authority has one of the lowest spends on adult social care, partly due to measures such as this.

The real focus is on how to deliver for individual patients—what do patients need and how do they get to that place? I welcome the bold move in the recent planning guidance to drastically reduce the strict targets placed on integrated care boards, allowing more of this work to take place by giving ICBs independence to make decisions that are relevant to their local population. However, I have heard from ICBs, including mine, that there is a risk that a focus on the elective care target may draw attention away from prevention.

I would like to point out the removal from the planning guidance of the targets for annual health checks for people with learning disabilities. That community historically has been under-represented and has not had its health needs fully met. This population dies younger and does not access preventive care at the point at which it would be most beneficial for them. Blanket prevention measures do not cover such populations. People in this community need specific intervention that allows them to access the healthcare that they need, when they need it. While a blanket annual health check is not necessarily the right way forward, it is absolutely critical that historically overlooked groups who are not served as well as others by our healthcare system are not overlooked when we shift to community and prevention work.

I very much welcome the strong investment that the Government are making in our NHS; it is vital in order to turn the NHS around and ensure that it is there for generations to come. I would welcome the Minister’s thoughts on how we can incentivise prevention as well as providing acute care.

[Madam Deputy Speaker (Judith Cummins)]

I call the Chair of the Select Committee.

--- Later in debate ---

[Several hon. Members rose—]

[Madam Deputy Speaker (Judith Cummins)]

I will start with an immediate four-minute time limit.

--- Later in debate ---

[Several hon. Members rose—]

[Madam Deputy Speaker (Judith Cummins)]

Order. Before I call the next speaker, Members may wish to know that, given the time remaining for this debate and the number of Members who wish to speak, I will be unable to get everybody in, even with a four-minute time limit.

--- Later in debate ---

[Seamus Logan (Aberdeenshire North and Moray East) (SNP)]

I commend the hon. Member for North Cotswolds (Sir Geoffrey Clifton-Brown) for introducing the debate, and I pay tribute to the retiring interim chief executive of NHS Grampian, Adam Coldwells, an outstanding public servant who will be sadly missed when he departs his post.

The revised departmental expenditure limit for the Department of Health and Social Care in England sees an overall increase in the estimates of around £10 billion, and I want to comment on how that affects Scotland generally and my constituency in particular. Lest we get giddy about the numbers, let us think about where that expenditure might be going: salaries and wages, price increases—particularly for fuel and food—and certainly more taxes. It is a new definition of the circular economy as I understand it.

Let us also consider how the changes affect our partners in the enterprise of health and social care. GPs, hospices and charities are already facing huge financial pressures from rising energy costs, staff retention issues and labour shortages. Staff morale is already low and will be further impacted by funding cuts to the vital services they provide, as money is diverted to meet rising costs. Then along comes the increase in employer national insurance contributions for those partners. When we look across the border into England, we see additional GP contract funding of close to £1 billion, which will cushion much of those additional national insurance costs.

Let me share a local example from Aberdeenshire council, on which I was an elected member for more than two years. The cost to the council of the additional NIC changes is about £11 million. The council’s estimated allocation from the Scottish Government to mitigate those additional costs is around £5.5 million. The difference is stark and cannot simply be written off as a Scottish Government responsibility. Indeed, as Wes Streeting constantly reminds us, all roads lead to Westminster when it comes to funding. Our joint enterprise partners, such as GPs and third sector organisations such as Marie Curie—I see Members are wearing a daffodil today—or Chest Heart & Stroke Scotland, and local GP surgeries in places like Longhaven and Cruden Bay, are paying the price.

Turning to hospices, the Minister for Care, Stephen Kinnock, stated that there will be no additional Barnett consequentials—

[Madam Deputy Speaker (Judith Cummins)]

Order. I remind the hon. Gentleman to refer to Members not by name but by constituency.

[Seamus Logan]

Thank you, Madam Deputy Speaker.

There will be no additional Barnett consequentials arising for Scotland for hospices. The Scottish Government are investing an additional £4 million in the hospice sector, but that wider sector faces a £2.5 million bill from the additional employer national insurance contributions. A flat exemption would mean that they would not have to pay that cost.

Perhaps also not evident from the estimates are the eye watering costs of agency staff, which is felt no less in Scotland, partly because of the regressive immigration policies of the last Government, which are now pursued by this Government. We have asked for those powers to be devolved to Scotland, but if Ministers cannot do that, there is an alternative approach—that has already been pointed out by the right hon. Member for Salisbury (John Glen). The Royal College of Radiologists tells us that workforce shortfalls in radiology are around 30%, and around 15% in oncology. It states that the most urgent task facing the NHS is to manage its workforce crisis by investing in an increase of 150 radiology training places and 45 clinical oncology training places, rather than relying on outsourcing and international recruitment. Of course training has costs, and it is every bit as expensive in Scotland as it is here.

In conclusion, through the Minister I say this to the Treasury: do not treat Scottish citizens as if they live in some vassal state; they are taxpayers too. Rather than expecting us to give you thanks, just get your chequebook out because of the pressures that I have listed.

--- Later in debate ---

[Sarah Bool]

I will make some progress.

That key relationship and contact between a GP and their patient was reinforced by the Public Accounts Committee report on NHS financial stability, published in January, which concluded that a reallocation of funds was needed to focus attention from sickness to prevention.

I am a massive advocate of prevention. Many hon. Members will know that I talk about being a type 1 diabetic; if they have not heard me talking about it, they may have heard one of my sensors going off for a low blood sugar. There is so much we could do in preventative measures in the treatment of diabetes. Treatments can be expensive as an initial outlay, but they will solve many long-term problems. We cannot prevent type 1 diabetes, but we could have earlier testing in children, for example, so that we could avoid them being diagnosed when in a state of diabetic ketoacidosis, which can be fatal. Families could be prepared and ready, and children could avoid hospitalisation, saving costs to the NHS while also saving lives.

We can also ensure access to technology that can avoid huge complications. Poor blood sugar control can result in loss of eyesight and limbs, alongside heart and other conditions. Making continuous glucose monitors and even insulin pumps available across the country can significantly help the patient and, again, in the long term save the NHS money. At the moment there is a very unfair postcode lottery, so I ask the Minister to consider ways to tip the funding balance, to ensure both prevention and community care measures are properly funded.

Finally, any reforms to the NHS must consider the computer operating systems in place. Many of my constituents must go out of the constituency for their hospital care, be it to Northampton general hospital, the John Radcliffe hospital, Horton general hospital, Milton Keynes university hospital or Kettering general hospital, but all those trusts operate on different systems, with the result that my constituents often cannot have their scans or medical notes shared easily. That is frustrating for residents, and potentially fatal. One resident noted that his wife was nearly given a drug that she was allergic to, because her notes had not been able to be shared correctly—it was only his presence that saved her.

We must ensure that money is spent to look at that and to change the systems, which my hon. Friend the Member for North Cotswolds (Sir Geoffrey Clifton-Brown) has explained very conclusively. We owe it to our constituents to work across the House to better our healthcare and to support the fantastic work of our doctors and nurses.

[Madam Deputy Speaker (Judith Cummins)]

I will start to call Front-Bench speakers at 3.15 pm.

[Alex McIntyre (Gloucester) (Lab)]

In my last career, prior to entering this House, I was incredibly proud to represent our NHS and other healthcare providers, and I will continue to fight for our NHS now that I sit here as an MP. I saw at first hand the impact that Tory mismanagement had on our NHS, which breached one of the fundamental principles of medical ethics: “first, do no harm”.

I saw that at first hand this week in my constituency when I visited Gloucestershire Royal hospital. I also met with Gloucestershire ICB this morning, and earlier this year I visited the surgery in Tuffley. The challenges that they face will not surprise anyone in this House, as they were set out in stark terms in the Darzi report, and they are replicated across the country in many constituencies—maintenance backlogs, lengthy ambulance waiting times, recruitment challenges and an ageing and sicker population. What struck me most about my visits this week was the resilience of our NHS staff, who are committed to people in our county and in my city of Gloucester.

What a difference a Labour Government are making with more investment in our NHS. Waiting lists locally are already coming down, and patients are now able to access emergency dental treatment, rather than pulling their teeth out at home. We have more midwives and dentists and a new GP contract that will help to bring back the family doctor. That is what we can do in eight months—imagine the impact that we could have if we had 14 years, as the Conservative party did.

From a personal perspective, I have seen how important that work is. I used to joke on the doorstep that I should be a poster boy for why prevention is better than cure—it will not surprise Members that I may have a few extra pounds that I could afford to lose. Sadly, the prevention piece came too late for me; I was diagnosed with type 2 diabetes earlier this year. The treatment I have received since then has been phenomenal. I am now on the path to remission programme—available in Gloucestershire, but not across the country—which has already brought my blood sugar levels down and helped me to lose 3½ stone. [Hon. Members: “Hear, hear!”] Thank you very much. It will help countless others across Gloucestershire and across the country. As we move to prevention work, it is so important that we also look at public health measures around diabetes; I echo the comments made by the hon. Member for South Northamptonshire (Sarah Bool).

I also thank all the staff who looked after my little boy last year when he was really sick. We need to ensure that when we look at investment in our NHS, we prioritise maternity services and services for the youngest in our society to ensure they get the healthcare they need.

We have talked about British values a lot in this place over the last few months. When people ask me what makes me proud to be British, I point them to our NHS—a system without comparison in the world that means that everyone can access healthcare, regardless of their wealth. I know that Reform Members are not in their places today, but they say that all options are on the table. I would like the Minister to make it clear in her remarks that standing against our NHS and its principles—being there for everyone, regardless of their wealth—is the opposite of being patriotic and that their options are not on the table.

I welcome the record investment in our NHS and the shift from analogue to digital and from cure to prevention. I would also welcome the Minister’s comments on how we can ensure that we deliver on the people’s priorities in Gloucester.

[Madam Deputy Speaker (Judith Cummins)]

I call the Liberal Democrat spokesperson.

--- Later in debate ---

[Helen Morgan]

I fundamentally agree. There are many such instances, and I chose that one because I spoke to the providers there recently.

I will come on to community pharmacy, because I am particularly concerned about pharmacies, which are a key pillar of care in the community, dispensing prescriptions and providing over-the-counter medicines and advice. Critically, they also provide Pharmacy First, but they are closing at an alarming rate. Analysis by the National Pharmacy Association predicts that another 1,000 pharmacies will close—900 of them by the end of 2027—if the current rate of closures continues. That is because of a 40% real-terms cut in their funding since 2015.

In fact, community pharmacies are essentially subsidising the NHS by making a loss on many of the prescription drugs that they dispense. In a few weeks’ time, in April, they will be clobbered by not only the NICs hike, but the increase in business rates, which will affect high street retailers. Shamefully, they have not even had their funding rates for the current financial year confirmed—the one that ends in three weeks’ time.

Pharmacy First, the flagship plan to move care into the community, has not had its funding confirmed beyond the first week of April this year, which is in just a few weeks’ time, according to the National Pharmacy Association. In her remarks, will the Minister confirm the future of Pharmacy First? Is there a funded plan to deliver that service? What steps are being taken to keep our community pharmacies in business? If we want to see care in the community, it is essential that we support them.

I want to mention dentistry. In Shropshire, Telford and Wrekin, the number of NHS dentists fell by 12.3% from 2019-20 to 2023-24. Many of my constituents cannot access a dentist, and the Government have committed to improving the situation, so can the Minister confirm when the negotiations on the new dental contract will begin?

The crisis that the social care system faces is daunting, not least because of the additional national insurance hike that will take place in a couple of weeks’ time. Last week, caring organisations launched an unprecedented day of action, with thousands of people marching on Westminster to highlight the precarious state of the organisations that provide care. The Darzi review found that people waiting to access social care account for 13% of NHS hospital beds. We all understand the urgency of tackling social care, but the cross-party talks collapsed last week—they have not started. There is no date for a new meeting, and there are no published terms of reference. We think that 2028 is far too late to resolve this problem, so can the Government urgently reinstate those talks and act now to deal with the social care crisis?

Before I conclude, I will talk about mental health. As Lord Darzi has said,

“There is a fundamental problem in the distribution of resources between mental health and physical health. Mental health accounts for more than 20 per cent of the disease burden but less than 10 per cent of NHS expenditure. This is not new. But the combination of chronic underspending with low productivity results in a treatment gap that affects nearly every family and all communities across the country.”

He is dead right. By April 2024, about 1 million people were on a waiting list for NHS mental health services, of whom 340,000 were children. My casework is full of children who wait months and months for the diagnosis and treatment that they need. The Government have removed the targets for mental health waiting lists; I urge them to reinstate those targets, so that we have parity between mental and physical health in our health service.

I am very conscious of time, so in conclusion, I will just reiterate our asks. Those are to ensure that social care talks start immediately; to deal with the problems with pharmacies; and to make sure that mental health and social care receive parity.

[Madam Deputy Speaker (Judith Cummins)]

I call the shadow Minister.

New Hospital Programme Review

Judith Cummins Excerpts

Monday 20th January 2025 Commons Chamber

[The Secretary of State for Health and Social Care (Wes Streeting)]

With permission, Mr Speaker, I would like to make a statement on the new hospital programme.

Of all the damage that the Conservative party did during their time in office—the broken public finances, the broken economy, the broken NHS—perhaps the most egregious was the broken trust between the British people and their Government, not just through their scandals or by breaking the rules they imposed on the rest of the country, but by making promises that they never intended to keep.

In 2019, the Conservatives told the British people that they would build 40 new hospitals over the coming decade, but there were never 40 new schemes and many of them were extensions or refurbishments. Put simply, they were not all new, some of them were not hospitals, and there were not 40 of them. Five years passed, start dates were delayed, spades remained out of the ground, and it became clear the announcement was a work of fiction.

Yet what did the Conservative party manifesto at last year’s general election say on the matter? It said:

“We will invest in more and better facilities, continuing to deliver 40 new hospitals by 2030”.

They repeated the promise even though the Department of Health and Social Care was putting contracts out to tender for hospital building that ran until 2035. They repeated that commitment even after the National Audit Office found that the Government

“will not now deliver 40 new hospitals by 2030.”

They repeated it even though the Government’s own infrastructure watchdog deemed it to be “unachievable.” No one thought that the promise would be met, yet the Conservative party made it anyway time and again.

Despite knowing this, when I walked into the Department of Health and Social Care on 5 July, what I discovered shocked me. The scheme was not just years behind schedule; the money provided by the previous Government was due to run out in March, just weeks from today. On 25 May 2023, the then Health and Social Care Secretary, the right hon. Member for North East Cambridgeshire (Steve Barclay), stood at this Dispatch Box and told the House:

“Today’s announcement confirms more than £20 billion of investment”.—[Official Report, 25 May 2023; Vol. 733, c. 480.]

The truth is that no funding had been set aside for future years; the money simply was not there. This was a programme built on the shaky foundation of false hope.

If I was shocked by what I discovered, patients ought to be furious—not just because the promises made to them were never going to be kept, but because they can see when they go into hospital how badly the health service needs new buildings. The NHS is quite literally crumbling. Lord Darzi’s independent investigation found that the NHS was starved of capital investment by the previous Government. Its outdated estate has hit productivity, with services disrupted at 13 hospitals every day during 2022-23. I have visited hospitals where the roof has fallen in and where pipes regularly leak and even freeze over in winter. The Conservatives literally did not fix the roof when the sun was shining.

On Thursday, the Infrastructure and Projects Authority published its annual report for 2023-24. Its assessment of the new hospital programme read:

“There are major issues with project definition, schedule, budget, quality and/or benefits delivery, which at this stage do not appear to be manageable or resolvable. The project may need re-scoping and/or its overall viability reassessed.”

That is what this Government have done.

Our review of the new hospital programme and the announcement I am making today will do two things: first, it will put the programme on a firm footing with sustainable funding, so that all the projects can be delivered; and, secondly, it will give patients an honest, realistic and deliverable timetable that they can believe in. This Labour Government are rebuilding our NHS, and as we do so, we will also rebuild trust in politics.

The seven hospitals built wholly or mostly from reinforced autoclaved aerated concrete—RAAC—were outside the scope of the review. These will be rebuilt at pace to protect people’s safety. Also out of scope were the hospitals already under construction or with an approved business case, where building works have continued without delay.

Working closely with my right hon. Friend the Chief Secretary to the Treasury, we have secured five-year waves of investment, backed by £15 billion of investment over consecutive waves, averaging £3 billion a year. That funding is in addition to the £1 billion that the Chancellor announced at the Budget to tackle dangerous RAAC and the backlog of critical maintenance, repairs and upgrades across the NHS estate. It is also in addition to the £1.5 billion we are investing in new surgical hubs, diagnostic scanners and beds. Together, it forms part of the £13.6 billion of capital investment announced at the Budget, which is the largest capital investment in our national health service since Labour was last in office.

I will now set out the new timetable. Projects in wave zero are already in the advanced stages of development and will be completed within the next three years. These are: the Bamburgh unit, phase 3 of the care environment development and re-provision, or CEDAR programme; the national rehabilitation centre in Nottinghamshire; Oriel eye hospital; Royal Bournemouth hospital; St Ann’s hospital; Alumhurst Road children’s mental health unit; and Dorset county hospital.

Wave 1 schemes will begin construction between 2025 and 2030. These include the seven RAAC hospitals: Leighton hospital; West Suffolk hospital; Frimley Park hospital; Hinchingbrooke hospital; Queen Elizabeth hospital; James Paget hospital; and Airedale general hospital. The other wave 1 schemes are: Poole hospital, Milton Keynes hospital; the 3Ts hospital—trauma, tertiary and training—in Brighton; the women and children’s hospital, Cornwall; Derriford emergency care hospital; Cambridge cancer research hospital; Shotley Bridge community hospital; North Manchester general hospital; and Hillingdon hospital.

Wave 2 schemes will now begin main construction between 2030 and 2035. They are: Leicester general hospital and Leicester royal infirmary; Watford general hospital, the specialist and emergency care hospital in Sutton; Kettering general hospital; Leeds general infirmary; Musgrove Park hospital; Princess Alexandra hospital; Torbay hospital; and Whipps Cross hospital, where I should declare an interest, as it serves my constituency.

Wave 3 includes nine schemes that will start construction between 2035 and 2039: St Mary’s hospital in London; Charing Cross hospital and Hammersmith hospital; North Devon district hospital; Eastbourne district general hospital, Conquest hospital and Bexhill hospital; Hampshire hospitals; Royal Berkshire hospital; Royal Preston hospital; the Royal Lancaster infirmary; and the Queen’s medical centre and Nottingham city hospital.

Following this statement, further details of the hospital building programme will be published on my Department’s website and a copy of the report will be placed in the House of Commons Library. In addition, the Minister for Secondary Care will hold meetings tomorrow, to which MPs of all parties are invited, to answer any further questions about these projects.

To ensure that every penny of taxpayers’ money is well spent and every hospital is delivered as quickly as possible, we will shortly launch a new framework for the construction of the new schemes. This will be a different way of contracting by working in partnership with industry to mitigate cost, schedule and delivery risks and saving money through a standardised design approach. That will speed up the process of opening new hospitals and provide a foundation for a collaborative supply-chain partnership. We will also appoint a programme delivery partner in the coming weeks to support the delivery of crucial hospital infrastructure across the country and provide programme, project and commercial expertise.

I know that patients in some parts of the country will be disappointed by this new timetable—they are right to be. They were led up the garden path by three Conservative Prime Ministers, all promising hospitals with no credible plan for funding to deliver them, and by Conservative MPs, who stood on a manifesto promise they knew could never be kept. We will not treat the British people with the same contempt. We will never play fast and loose with the public’s trust.

The plan that we have laid out today is honest, funded and can actually be delivered. It is a serious, credible plan to build the hospitals that our NHS needs. It is part of the biggest capital investment that the NHS has seen since Labour was last in office, delivering not just more hospitals but new surgical hubs, community diagnostic centres, AI-enabled scanners, radiotherapy machines, modern technology, new mental health crisis centres and upgrades to hundreds of GP estates. It will take time, but this Labour Government are determined to rebuild our NHS and rebuild trust in politics. I commend this statement to the House.

[Madam Deputy Speaker (Judith Cummins)]

I call the shadow Secretary of State.

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[Wes Streeting]

My hon. Friend is absolutely right: I think that will be a unique representation this afternoon. I can already hear the vultures swooping, looking for that capital allocation and slot in the pipeline. She has made the case repeatedly, forcefully and with conviction that these services should remain in a community with high levels of deprivation and high need. I know that the Minister for Secondary Care, my hon. Friend the Member for Bristol South (Karin Smyth), has already committed to meeting her, and we are very happy to have those conversations with her.

[Madam Deputy Speaker (Judith Cummins)]

I call the Liberal Democrat spokesperson.

[Dr Danny Chambers (Winchester) (LD)]

In Hampshire and across the country in 2019 and 2024, Conservative MPs stood on the promise of delivering new hospitals, including one for Hampshire. However, it turned out that there was never any funding for that, and that those were just false promises to try to get votes. I have fought tirelessly to save and improve Winchester’s A&E and consultant-led maternity unit. With the announcement that construction of a proposed new hospital in Hampshire will not even start until between 2037 and 2039, we absolutely need to ensure that the current services are invested in and improved so that they remain fit for purpose.

Given that the new hospital programme is delayed, it is more urgent than ever to increase capacity by fixing social care, so that those who are well enough to leave hospital can be cared for in the community, thus freeing up beds immediately. We cannot endure both insufficient social care packages and crumbling hospitals. Given this delay to the new hospital programme, will the Secretary of State commit to prioritising more social care packages now, rather than waiting three years for a review to be complete?

Although the Health Secretary is not responsible for the state of the NHS or the state of the economy, which the Government inherited, the new hospital programme was seen as part of the solution to the crisis in the NHS, and people across the sector have warned that delaying the programme will only mean more treatments cancelled and more money wasted plugging holes in hospital buildings that are no longer fit for purpose. We are therefore concerned that one of the biggest announcements to affect the NHS over the next few years is coming out right now, during Donald Trump’s inauguration, because it will not get the media attention it deserves. Liberal Democrats therefore urge the Health Secretary to promise to release a full impact assessment on how the delays to the new hospital programme will affect patients and NHS staff.

--- Later in debate ---

[Wes Streeting]

First, I thank my hon. Friend for his strong representations on behalf of his constituents, not just since his election, but before it. Between the by-election and his election to this place, he did not give up; he continued to fight for his community.

I stood outside Hillingdon hospital, having had a good look around at the state of the hospital and the plans for the reconstruction of the site. I am delighted to have kept my promise and this Government’s promise, so that construction at Hillingdon hospital will begin in 2027-28. My hon. Friend is quite right to say that his predecessor and his predecessor’s predecessor made claims about Hillingdon hospital that were not true. This Government will not make those mistakes. We will keep our promise. What we have set out for all schemes in the new hospital programme is a credible, realistic, funded timetable that this Government, for as long as there is a Labour Government, will actually deliver.

[Madam Deputy Speaker (Judith Cummins)]

I call the Father of the House.

[Sir Edward Leigh (Gainsborough) (Con)]

Will the Secretary of State forgive me if I give the House a few seconds’ respite from the blame game by trying to make a positive suggestion? Everyone accepts that the real problem facing our hospitals is the number of frail and elderly people who do not need to be in hospital and should be in some sort of care facility. Does the Secretary of State agree that while building brand-new, all-singing, all-dancing hospitals is very expensive, there is a future for smaller cottage hospitals such as the one in Gainsborough and a case for opening other facilities so we can move elderly, frail people out of those big hospitals into a caring environment and free up space?

--- Later in debate ---

[Several hon. Members rose—]

[Madam Deputy Speaker (Judith Cummins)]

Order. Members will have seen how many people are on their feet wanting to ask the Secretary of State a question. Could I ask Members please to try to keep their questions and answers quite short? I want to try to get everybody in, if at all possible.

[Graham Stringer (Blackley and Middleton South) (Lab)]

My right hon. Friend’s statement stands in sharp contrast to that made on 25 May 2023 by the previous Secretary of State, when he completely forgot to put in his statement, both written and verbal, North Manchester general hospital. I am pleased that North Manchester general hospital is today in the first wave, but I would be grateful if my right hon. Friend could spell out in detail when the work will continue, because in one of the areas of the country with the worst health outcomes, it is not only a hospital scheme; it is an urban regeneration scheme, and some work has started. Will that work be allowed to continue? Can he give me some details, please?

--- Later in debate ---

[Several hon. Members rose—]

[Madam Deputy Speaker (Judith Cummins)]

Order. I plan to run this statement until 6 o’clock, so I ask Members to please help each other out by keeping their questions and answers short.

[Rosie Wrighting (Kettering) (Lab)]

My predecessor told my constituents that the work on Kettering general hospital was ready to go. It is shameful that, in reality, the Conservatives had no credible plan, and the money was going to run out in March this year. Does the Secretary of State agree that people in Kettering are right to be angry at the previous Government for breaking their promises, and can he reassure my constituents that they will see a realistic, deliverable timeframe for the rebuild of our hospital?

Health and Social Care: Winter Update

Judith Cummins Excerpts

Wednesday 15th January 2025 Commons Chamber

[The Secretary of State for Health and Social Care (Wes Streeting)]

With permission, Madam Deputy Speaker, I would like to make a statement on winter pressures.

I start by saying that my thoughts, and I am sure the thoughts of the whole House, are with the nurse who was stabbed in a horrific attack at Royal Oldham hospital on Saturday. Nurses are the backbone of our NHS. They should be able to care for their patients without fear of abuse or violence. As she goes through treatment for her injuries, we pray for her speedy and full recovery and that she will be left to recover in peace.

I want to thank our NHS and social care staff for their remarkable effort, stamina and care in the most challenging of circumstances. Over the past few weeks, I have seen at first hand that staff are doing their level best in hospitals and care homes across our country—in the south-west, Essex, London, South Yorkshire and the north-west. Even when patients are left waiting far longer than they should be, and in conditions they should never be made to endure, they are still at pains to stress that the staff are doing their best.

I said on day one in this job that I would never gloss over problems in the health service and I would not pretend that everything is going well when it is not. The experience of patients this winter is unacceptable. I visited one A&E department over Christmas where I was told on the way in that I was lucky as I had come on a quiet day. Yet, as I walked through the hospital, I saw patients on trolleys lining the corridors where they were being treated, without the dignity or safety they should expect as a minimum. I saw frail elderly people on beds in the emergency department, many with dementia, crying out in pain and confusion because, ultimately, they were in the wrong place for their care needs. That was supposedly a good day.

The King’s Fund has said:

“The NHS is facing a toxic cocktail of pressures this winter”,

and it is right. Fourteen years of under-investment and a lack of effective reform have combined with a tidal wave of rising pressures. This has been the busiest year on record for our ambulance and accident and emergency services. We have had severe cold snaps, with temperatures as low as minus 15° in some parts of England. There are 5,100 patients in hospital beds with flu—more than three times the number at this point last year. Alongside the impact on patients, the rise in respiratory infections saw 53,000 NHS staff forced off work sick in the first week of the year. The result has been patients let down by ambulances that do not arrive on time, A&E departments that leave them waiting 12 hours or more, and the continued normalisation of corridor care. This is not the level of care staff want for their patients, and it is not the level of care this Government will ever accept for patients.

I said coming into this winter that 14 years of failure cannot be turned around in six months. It will take time to fix our broken NHS. Since July, we have done everything we can to prepare the NHS for winter. Following four months of silence from the previous Government, I called the British Medical Association on day one, met it in week one, and within three weeks negotiated a deal to end the junior doctors’ strike with a new deal for resident doctors. For the first winter in three years, staff are on the frontline, not the picket line. The Chancellor made immediate in-year investment in the NHS to fill the black hole we inherited and prevent us from having to cut back on services.

We have introduced the respiratory syncytial virus vaccine, and more than a million people and counting are protected against that virus. In total, 29 million vaccines have been delivered for flu, covid-19 and RSV, and more patients are protected against flu than at this stage last winter. If anyone is yet to get themselves vaccinated, it is not too late to protect themselves, their family and the NHS. They can check if they are eligible and book through their local GP or pharmacy.

We are working hand in hand with NHS England and care leaders, and I continue to meet regularly with senior leaders in social care, NHS England and the UK Health Security Agency. We have an excellent national operations centre running seven days a week. Its data allows us to zoom in—not just on individual hospitals but on individual patient waiting times—to respond in real time to spikes in pressures, and to manage threats as they emerge. The NHS is now using critical incidents proactively to focus minds and get the system responding to de-escalate and steer back to safer waters. I am happy to report that there is currently one live critical incident, down from 24 last week.

However, I do not pretend that that is good enough. It will take time to get back to the standards that patients deserve, but it can be done. That will require a big shift in the focus of healthcare—out of the hospital and into the community—to free up beds for emergency patients and to prevent people from having to call an ambulance or go to A&E in the first place. That is the reform agenda that the Government are enacting.

In recent weeks, we have announced steps to begin rebuilding general practice, and immediate and long-term action in social care. When we came into office, we inherited a situation in which qualified GPs could not get a job, while patients could not get a GP. That is why, within weeks, I found just shy of £100 million to recruit 1,000 more GPs by April. We have recruited hundreds of GPs to the frontline already, and we will recruit hundreds more in the months to come. We have announced an extra £889 million in funding for general practice, which is the biggest funding uplift in years, alongside a package of reforms to bust bureaucracy, slash unnecessary targets and give GPs more time to spend with their patients—our first step towards bringing back the family doctor.

Ten days ago, I visited a care home in Carlisle that was offering intermediate step-down care for NHS hospitals. It was able to give patients en suite bathroom facilities in care homes, with rehab, all at half the price it was costing the taxpayer to keep patients in a hospital bed up the road. That is better for patients and less expensive for taxpayers. Yet there are 12,000 patients in hospital beds today who do not need to be there but cannot be discharged because appropriate care is not available. That is why the Government are making up to £3.7 billion of extra funding available for local authorities that provide social care. It is why we are delivering an extra 7,800 home adaptations through the disabled facilities grant this year and next year. It is why we have delivered the biggest increase in carer’s allowance since the 1970s, worth an extra £2,300 to family carers. It is why are introducing fair-pay agreements to tackle the 131,000 vacancies in social care. And it is why we have appointed Baroness Louise Casey to help build a national consensus on the long-term solutions for social care.

From visiting emergency departments, monitoring the performance of the NHS over this winter and noting the variation in performance across the country, I know that we can clearly get our ambulance and A&E services working better. Before the spring, we will set out the lessons learned from this winter and the improvements that we will put in place ahead of next winter.

Finally, let me be clear on corridor care, which became normalised in NHS hospitals under the previous Government: I will never accept or tolerate patients being treated in corridors. It is unsafe, undignified and a cruel consequence of 14 years of failure on the NHS, and I am determined to consign it to the history books. I cannot and will not promise that patients will not be treated in corridors next year. It will take time to undo the damage that has been done to our NHS, but that is this Government’s ambition.

Annual winter pressures should not automatically lead to an annual winter crisis—indeed, there were no annual winter crises by the end of the previous Labour Government. That is why this Government are investing an extra £26 billion in our health and care services, and undertaking the fundamental reform that both services need. That will take time, but we will deliver an NHS and a national care service that provide people with care where and when they need it. I commend this statement to the House.

[Madam Deputy Speaker (Judith Cummins)]

I call the shadow Secretary of State.

--- Later in debate ---

[Wes Streeting]

I wholeheartedly agree with my hon. Friend, and thank her for the work she has been doing this winter on the NHS frontline, providing support to her colleagues at her local hospital—literally rolling her sleeves up and looking after people. She is absolutely right that we need an urgent and emergency care plan to make sure we see continued year-on-year improvements. I can reassure my hon. Friend that that plan is already being written; we are learning the lessons from this winter in order to apply them next winter. As I should have said to the shadow Secretary of State, the right hon. Member for Melton and Syston (Edward Argar), I took the same approach when I was shadow Secretary of State: the very first meetings I held on winter planning were ahead of the general election in access talks with the Department. The first briefing I received on winter preparation was on my first day in office. Throughout the past six months heading into winter, I continued to talk to staff in the Department, NHS England and social care leaders to ensure that we were as well prepared for this winter as we could be. Right now, we are learning the lessons to prepare for next winter.

[Madam Deputy Speaker (Judith Cummins)]

I call the Liberal Democrat spokesperson.

[Helen Morgan (North Shropshire) (LD)]

I associate myself with the comments of the Secretary of State and the shadow Secretary of State regarding the abhorrent attack in Oldham.

The pressure on our hospitals this winter brutally demonstrates the scale of action needed after years of Conservative neglect of the NHS. Across England last month, 71% of A&E patients were seen within four hours, but that statistic varies wildly depending on where one happens to live. At Shrewsbury and Telford emergency departments last month, ambulances had to wait an average of over two hours to hand over their patients. Just 50% of patients were seen within four hours, and nearly 1,500 patients were left stuck on a trolley for more than 12 hours.

Statistics like these often fail to have much impact now, because we have heard them so regularly—particularly since winter crises have become normalised—but it is very important that we consider who is behind them. It is patients such as my constituent Emma, who having been diagnosed with sepsis spent 48 hours in a fit-to-sit area and then 12 hours on a trolley in an X-ray corridor before finally being admitted, alongside a horrifying delay in the medication required to deal with her life-threatening condition. Yet we often have to wait weeks for data that fully explains what is happening in our hospitals, and no official data is collected about the number of critical incidents. This leaves patients potentially ill-informed, and it makes scrutiny and support in this place, in particular, difficult to provide.

Will the Secretary of State commit to introducing faster and more detailed reporting about the live state of play in our emergency departments, including the number of critical incidents and the temporary escalation spaces, and give a timeline for reporting that information? Will he publish information that shows the impact that delays are having—for example, by looking at the number of deaths in emergency departments—and will he act on the long-term Liberal Democrat request to publish localised data on ambulance delays so that support is provided in areas, such as Shropshire, where it is most needed?

--- Later in debate ---

[Wes Streeting]

I thank my hon. Friend for that question. The conditions she describes at her local hospital are truly shocking. As I have said, and this is often quoted by the SNP, all roads lead to Westminster, and I am happy to report that up that road from Westminster to Holyrood lies a record uplift in funding for the Scottish Government. They have no excuses for inaction. They need to grip the crisis in the NHS in Scotland, as we are here. The difference, as my hon. Friend states, is that they have a record of 18 years that they cannot defend, and I hope people will consider that record very carefully when they decide who should govern in Scotland at the next set of Scottish elections.

[Madam Deputy Speaker (Judith Cummins)]

I call the Chair of the Health and Social Care Committee.

[Layla Moran (Oxford West and Abingdon) (LD)]

May I press the Secretary of State on that data point? It is not just the Liberal Democrats making these representations; the Royal College of Nursing, the Royal College of Physicians, the Royal College of Emergency Medicine, HealthWatch, the British Medical Association, Age UK and many others also want the data. This matters, because the situation causes moral injury to staff and compromises patient safety—and the problem is not just corridor care; it encroaches on to other wards. Will the Secretary of State commit to releasing that data before the NHS England board meeting on 4 February? In addition, what assessment has he made of the impact of this winter on less urgent care, and on elective waiting lists?

[Several hon. Members rose—]

[Madam Deputy Speaker (Judith Cummins)]

Order. Members will be aware that we have pressure on time today, so I will finish this statement at around 3.15 pm.

[Rachael Maskell (York Central) (Lab/Co-op)]

Triaging patients into virtual wards will not only protect the front door of the NHS, but be far better for patients. What is the Secretary of State doing to hold integrated care boards to account and ensure that they are putting money into primary care, as opposed to where everyone always looks, which is secondary care?

--- Later in debate ---

[Several hon. Members rose—]

[Madam Deputy Speaker (Judith Cummins)]

May I ask Members to keep their questions and answers sharp, please?

[Mrs Sharon Hodgson (Washington and Gateshead South) (Lab)]

Under the last Conservative Government, strikes cost the taxpayer millions of pounds and 1.5 million appointments were cancelled, so may I thank the Secretary of State sincerely for making it his day one priority to sort that out? He called the junior doctors and found a deal within three weeks, ending the strikes. All of us across the House thank him for sorting that out. For the first winter in three years, staff will be on the frontline, not the picket line, as the Secretary of State so rightly said. Does he agree that that is just one example of what Labour Governments do in office? We always have a laser focus on making the NHS better, unlike the Conservatives, who seem to have a laser focus on making it fail.

Hospice and Palliative Care

Judith Cummins Excerpts

Monday 13th January 2025 Commons Chamber

[Several hon. Members rose—]

[Madam Deputy Speaker (Judith Cummins)]

Order. Members will see that we have some pressure on time this evening, and I want to get everyone in. Before I call the next speaker, I suggest an informal four-minute time limit.

NHS Backlog

Judith Cummins Excerpts

Monday 6th January 2025 Commons Chamber

[Several hon. Members rose—]

[Madam Deputy Speaker (Judith Cummins)]

Order. I am now imposing an immediate four-minute time limit, to try to get everyone in.

--- Later in debate ---

[Josh Fenton-Glynn]

In fact, the better care fund works best in West Yorkshire when it works to hasten people’s journey out of hospital, and that sounds like a very good example.

In my own local hospital trust, the figure for people on the transfer of care list is even higher: 20% of beds are taken up by people who could be treated at home. That is almost 150 patients in hospital rather than getting social care where they need to be. Even well-run trusts are finding the wait for transfer of care too great, proving again that we cannot fix our health service without fixing 14 years of Tory mismanagement or without fixing social care.

In closing, while this Government face problems not of our own creation, we must still learn from what has gone before. In this regard, I absolutely welcome the announcement on progress in social care today, but I gently express to the Minister, as I did to the Health Secretary at his Committee appearance, that we need to see action on the ground solving our social care crisis earlier than 2028. In 2023, the National Audit Office told us that nearly four in 10 directors of adult social services were worried about meeting their statutory obligations. On top of that, we have a provider crisis because of this instability. The electorate gave this Government a term of five years to take bold steps to reverse the crisis in our NHS. They rejected the previous Government because they wasted each of their terms over 14 years of failure to enact a solution on social care, leaving people in hospital instead of being able to receive care among family and friends. I look forward to this Government acting on that mandate.

[Madam Deputy Speaker (Judith Cummins)]

Order. We will start the Front-Bench the Front-Bench speeches at 9.35 pm, so our very last Back-Bench speaker is Ellie Chowns.

[Ellie Chowns (North Herefordshire) (Green)]

Thank you, Madam Deputy Speaker. I would like to thank the hon. Member for North Shropshire (Helen Morgan) for securing this debate on the vital area of NHS backlogs, which is of great importance to me and my constituents. We are short of time so I will not talk, as I wished to, about the need to tackle the crisis in social care and the need to invest heavily in public health. I will focus my comments on responding to the Government’s announcement today on elective care.

I hope the Minister will be able to respond in a moment to some of the questions I want to pose, because it is one thing to use spare capacity in the private sector to tackle the absolute crisis we have with waiting lists and backlogs—I can understand that as an emergency measure—but it is quite another to propose in effect long-term outsourcing from the NHS to private providers. To be honest, I fear that today’s announcement could essentially be a form of creeping back-door privatisation of aspects of NHS care, and specifically those in which is easiest for private sector providers to make a profit. We only have to look at PFI to understand the dangers of that approach.

I have read today’s partnership agreement between the NHS and the independent sector, and I am afraid I find it the opposite of reassuring. I will briefly canter through some of the reasons why. Section 2 indicates that the Government do envisage increased private provision of both surgical and diagnostic services.

There is some text in section 3 about trying to seek assurance that those private providers will not essentially cherry-pick the most attractive, easy and profitable patients. However, all it says is that the independent sector will review its patient criteria; there are no teeth there.

There is nothing in section 4 about measures to protect the NHS from the risk of private providers making excessive profits from the services they provide. We have recently heard in this Chamber cases of that happening in the social care sector and the children’s social care centre. Is there not a real risk that that could also happen in the healthcare sector if this is not actioned?

Finally, there is nothing in section 5 to address the risk of transferring services to private providers leading to leaching of staff from the NHS services into the private sector. How can we be guaranteed that there is not going to be excessive competition in a workforce that is already extremely stretched?

For the Green party and myself, the profit motive has no place in our NHS. I hope the Minister will provide assurances that the NHS will continue to be publicly owned and publicly run for public benefit, and that the concerns I have highlighted will be addressed so that the agreement between the NHS and the independent sector has teeth.

[Madam Deputy Speaker (Judith Cummins)]

I now call the Liberal Democrats spokesperson, Jess Brown-Fuller.

[Jess Brown-Fuller (Chichester) (LD)]

I thank my hon. Friend the Member for North Shropshire (Helen Morgan) for introducing this important debate on our first day back after Christmas. I also thank all hon. Members from across the House who have contributed to the debate, and specifically the hon. Members for Runnymede and Weybridge (Dr Spencer), for Ashford (Sojan Joseph) and for Bury St Edmunds and Stowmarket (Peter Prinsley), who always bring really valuable contributions because of their background and current professions; it is very much appreciated when talking about the NHS.

My hon. Friend the Member for North Shropshire highlighted in her opening remarks that backlogs are not just about NHS waiting lists, but that there are also problems with mental health backlogs, handover delays, A&E waits, poor access to dentistry, GP appointments, cancer treatment waiting times and staff that are being driven from the NHS because they cannot provide the care they want to give.

Our healthcare system remains the No. 1 issue that I am contacted about. It is not unreasonable for my constituents and people across the country to expect to receive the care they need when and where they need it. I doubt there are many people who have not been affected or know somebody who has been affected by NHS backlogs. Indeed my dad struggled for months to get a face-to-face GP appointment for what he believed was a return of a hiatus hernia. By the time he saw his GP and was referred, the oesophageal cancer that he had was so progressed that palliative care was the only option for him and he passed away shortly after being diagnosed in 2021.

When I asked my constituents to get in touch with examples of personal experiences of the NHS backlogs, I was inundated with emails from people across Chichester, and I will share some of those with the House.

I have Jane, who was at high risk of bowel cancer due to living with ulcerative colitis. She is meant to see her consultant every six months but has not had an appointment since 2019, despite her GP trying on her behalf on multiple occasions. She has no idea if the polyps discovered in 2017 have turned cancerous and is living in constant fear of her health deteriorating further.

Ian got in touch after waiting over a year to receive a scan after he experienced extreme chest pain. The scan revealed heart disease, but the lack of any follow-up appointments has left him anxious and uncertain about his health.

I will also mention a good friend of mine, Rylee, who noticed irregular bruising and a physical change on the back of their leg in 2021 and was finding it harder to walk. After visiting the GP, who sent an urgent referral to the hospital, Rylee waited for months only to discover when chasing the hospital that the referral had gone to the wrong place. They then got added to the waiting list and were told the wait would be between 40 and 50 weeks. We are four years on from the initial changes to Rylee’s leg, and they are finally being treated by leading specialists as Rylee can no longer walk unaided. Amputation of their leg is now being considered. If Rylee had been seen within the expected window of an urgent referral, they would not be facing the prospect of losing their leg in their mid-20s.

These are just a few examples of what is a much larger picture of the NHS, with caring and compassionate staff working within it who are overstretched and overburdened and, as my hon. Friend the Member for North Shropshire said, who cannot provide the care they desperately want to because of a system that cannot meet the demand.

The Liberal Democrats recognise that this is an inherited problem; indeed, the key NHS waiting times standards have not been met for some years. The number of patients waiting longer than four hours in A&E rose consistently between 2015 and 2020. The 62-day waiting time for standard cancer treatment has not been met in recent years, and the consultant-led treatment target in England of 18 weeks has not been met in 2016.

The last Conservative Government left emergency care in a deep crisis. The Darzi review stated that 800 working days were lost every day to handover delays in 2024. Last winter, ambulances across England collectively spent a total of 112 years waiting outside hospitals to hand patients over. In 2024, more than 1 million patients faced waits of more than 12 hours in A&E. The Liberal Democrats welcome new investment in the NHS, but instead of spending money firefighting crisis after crisis, we would invest to save taxpayers’ money in the long run. We would do that by investing in the front door and the back door: in primary care, with GPs and dentists, and by reforming social care.

Some of my constituents would like it noted that they will not be counted on any statistics regarding backlogs, because they cannot get a GP appointment to even get on the backlog list. That is why the Liberal Democrats are calling for everyone to have the right to see their GP within seven days, or 24 hours if it is urgent, with a 24/7 booking system to end the 8 am phone-call lottery to get an appointment. We would also ensure that everybody over the age of 70 and those with a long-term condition have access to a named GP.

We would fix the back door and address the social care crisis now, rather than spending another three years commissioning a report that will find out what we already know: social care is in urgent need of reform. The Darzi review showed that inadequate social care accounts for 13% of hospital bed occupancy, meaning that people who desperately want to get home cannot because of the lack of social care packages available and that others deteriorate at home, because they cannot access the social care they need. In the past year, more than half of all requests for social care were unsuccessful. We would strengthen our emergency services to reduce excessive handover delays by increasing the number of staffed hospital beds and calling for a qualified clinician in every A&E waiting room to ensure that any deteriorating conditions are picked up on to prevent tragic avoidable incidents.

I once again thank the hon. Friend the Member for North Shropshire for bringing forward this incredibly important debate, and I thank those Members who contributed to a conversation that matters to my constituents in Chichester and to people across the country.

[Madam Deputy Speaker (Judith Cummins)]

I call the shadow Minister.

--- Later in debate ---

[Karin Smyth]

I would like to, but I am afraid I need to adhere to the time limit.

In closing, on Second Reading of the National Health Service Act 1946, Nye Bevan warned us against following abstract principles that work on paper but not in the real world. This Government are interested only in what works, and we know we must do things differently, because the backlog began to build before the pandemic. NHS constitutional standards have not been met for more than a decade. Whatever the last Government were doing, it was not working. That is why our elective reform plans will do things differently, giving patients more choice and more control over their treatment, making greater use of technology—including the NHS app—to give patients the convenience of a seven-day diagnostic service.

In response to the hon. Member for North Herefordshire (Ellie Chowns), we will use private sector capacity to help—supporting patients is what matters. As the party that founded the NHS, we will always be committed to a publicly funded NHS that is free at the point of use. We are going hell for leather to get waiting lists down, rebuild our NHS and ensure that it is there for us when we need it once again. None of this will happen overnight, but we are not asking to be judged by our promises; we will be judged by our results, and we are determined to succeed.

[Madam Deputy Speaker (Judith Cummins)]

I call Helen Morgan to wind up quickly.

Puberty-suppressing Hormones

Judith Cummins Excerpts

Wednesday 11th December 2024 Commons Chamber

[The Secretary of State for Health and Social Care (Wes Streeting)]

With permission, Madam Deputy Speaker, I shall make a statement on puberty blockers.

At the outset, I wish to make clear the principles that drive the Government’s approach to this issue. First, children’s healthcare must always be led by evidence. Medicines prescribed to young people should always be proven to be safe and effective. Secondly, evidence-led, effective and safe healthcare must be provided to all who need it, when they need it. Thirdly, this Government believe in the dignity, worth and equality of every citizen, and recognise that trans people too often feel unsafe, unrecognised and unheard, and that must change. None of these simple ambitions has been achieved in recent years. Medicine has been provided with insufficient evidence, and young people have been left to go without the support and care that they need. This Government are determined to change that.

The Cass review made it clear that there is not enough evidence about the long-term effects of using puberty blockers to treat gender incongruence to know whether they are safe or beneficial. That evidence should have been established before they were ever prescribed for that purpose. It is a scandal that medicine was given to vulnerable young children, without proof that it was safe or effective, or that it had gone through the rigorous safeguards of a clinical trial.

Following the Cass review, the NHS ceased the routine use of puberty blockers to treat gender incongruence in children. In May, the previous Government issued an emergency order to extend these restrictions to the private sector. In Opposition, my party and I, as shadow Health and Social Care Secretary, supported those decisions. Since coming into office, I have renewed this order twice, continuing restrictions until the end of this year. That was done jointly with the Health Minister in Northern Ireland, and I updated the House via a written statement.

While the temporary ban was in place, I asked the Commission on Human Medicines to look at the current environment for prescribing puberty blockers, and we launched a targeted consultation. The commission is an independent body, made up of leading clinicians and epidemiologists, that advises on medicine safety. It took evidence directly from clinical experts, consultant paediatric endocrinologists and patient representatives, including representatives of trans people, young people and their families. After thoroughly examining all the available evidence, it has concluded that prescribing puberty blockers to children for the purposes of treating gender dysphoria, in the current prescribing environment, represents “an unacceptable safety risk”. Of particular concern to the commission was whether these children and their families were provided with enough time and information to give their full and informed consent. The commission found that children had received prescriptions after filling out online questionnaires and having one brief Zoom call with prescribers from outside the UK.

Consequently, the commission has recommended that the Government extend the banning order indefinitely, until a safe prescribing environment can be established for these medicines. On the basis of those findings, I am acting on the commission’s advice and putting in place an indefinite order to restrict the sale or supply of puberty blockers to under-18s through a prescription issued by either a private UK prescriber, or a prescriber registered outside the UK. This is on the advice of expert clinicians, the independent Commission on Human Medicines—advice based on the best available evidence—and follows the cautionary and careful approach recommended by Dr Cass. The legislation will be updated today, and will be reviewed in 2027, when there will be an updated assessment of the safety of the prescribing environment for these medicines.

We are working to grow a thorough evidence base for puberty blockers. The National Institute for Health and Care Research is working closely with NHS England to establish a clinical trial on puberty-supressing hormones. The NIHR is now contracting the team that will deliver the study and is working tirelessly towards recruiting the first patients by spring. The trial is the first of its kind the world over. It will help us better understand the effects of puberty-suppressing hormones on young people, providing the robust evidence required.

The Cass review also made clear recommendations to the Government and NHS England on improving healthcare services for children with gender dysphoria. I will now provide an update on the progress made. NHS England has published its implementation plan, which will transform its services. It has also published a new services specification, to ensure that children and young people experiencing gender incongruence have an appointment with a paediatrician or mental health professional before being referred to specialist services. Dr Cass was clear on the need for the model of care to change and take account of children and young people’s holistic needs.

Since April, NHS England has opened three new gender identity services—in the north-west, in London and in Bristol—with a fourth expected in the east of England by the spring. That puts us on track to open services in every region by 2026. These services offer a fundamentally different clinical model. They bring together clinical experts in paediatrics, neurodiversity and mental health, so that care can be tailored to patients’ needs. At first, the new services were prioritising patients registered with the old Gender Identity Development Service, but I am delighted to report that the north-west and Bristol services are now taking patients off the general waiting list.

On the waiting list, Dr Cass’s review painted a picture of a service unable to cope with demand. Children and young people face unacceptably long waits for care, with some children passing into adulthood before their first appointment, leaving them facing a dangerous cliff edge. I am pleased to tell the House that NHS England is working with potential partner organisations to explore establishing a much-needed follow through service for 17 to 25-year-olds, as Dr Cass recommended. Young people’s distress or needs do not vanish when they turn 18, and neither should their healthcare.

We do not yet know the risks of stopping pubertal hormones at this critical life stage. That is the basis on which I am making decisions. I am treading cautiously in this area because the safety of children must come first. There are some who have called on the Government not to go ahead with the clinical trial recommended by Dr Cass. Others on the opposite side of the debate want the Government to ignore the recommendations of the independent expert Commission on Human Medicines. We are taking a different approach. The decisions that we take will always be based on the evidence and the advice of clinicians, not on politics or political pressure.

Finally, there are many young people in this country who are desperately worried and frightened by the toxicity of this debate. This has not been helped by some highly irresponsible public statements, which threatened to put vulnerable young people at risk. In the past few months, I have met young trans people, who either have been, may be, or will be affected by the decisions that I and my predecessor have taken. I have listened to their concerns, fears and anxieties, and I want to talk directly to them. I know it is not easy being a trans kid in our country today. The trans community is at the wrong end of all the statistics for mental ill health, self-harm and suicide. I cannot pretend to know what that is like, but I do know what it is like to feel that you have to bury a secret about yourself, to be afraid of who you are, to be bullied for it, and then to have the liberating experience of coming out. I know it will not feel like it, based on the decisions that I am taking today, but I really do care about this, and so does this Government.

I am determined to improve the quality of care and access to healthcare for all trans people. I am convinced that the full implementation of the Cass review will deliver material improvements in the wellbeing, safety and dignity of trans people of all ages, and the Government will work with them to help them live freely, equally and with the dignity that everyone in our country deserves. I commend this statement to the House.

[Madam Deputy Speaker (Judith Cummins)]

I call the shadow Secretary of State.

--- Later in debate ---

[Wes Streeting]

I can certainly give my hon. Friend that assurance. Better-quality evidence is critical if the NHS is to provide reliable and transparent information and advice to support children and young people, and their parents and carers, in making potentially life-changing decisions. That is why we support the setting up of the study into the potential benefits and harms of puberty-supressing hormones as a treatment option. The study team’s application for funding is going through all the usual review and approval stages ahead of set-up—including peer review, consideration by the National Institute for Health and Care Research funding committee, and ethical approval processes. We want the trial to begin recruiting participants in spring 2025. I am confident in the robust, appropriate and ethical way in which the trial is being established.

[Madam Deputy Speaker (Judith Cummins)]

I call the Liberal Democrat spokesperson.

[Helen Morgan (North Shropshire) (LD)]

I thank the Secretary of State not only for the content of his statement, but for its tone and his recognition of the importance of such a tone in this place. For too long, children and young people who are struggling with their gender identity have been badly let down by low standards of care, exceptionally long waiting lists and an increasingly toxic public debate.

Before GIDS closed, more than 5,000 young people were stuck on the list for an appointment and waited, on average, almost three years for their first appointment. For teenagers going through what is often an incredibly difficult experience, three years must feel like an eternity, so change is desperately needed.

The Liberal Democrats have long pushed to ensure that children and young people can access the high-quality healthcare that they deserve. We welcome the NHS move to create multiple new regional centres, but those centres must get up and running as quickly as possible. Will the Secretary of State outline what steps the Government are taking to ensure that happens in every region, and will he give a timetable for that work? Tackling waiting lists and improving access to care must be priorities.

I understand why today’s news is causing fear and anxiety for some young trans people and their families, who have been badly let down for so many years—not least those I have met in my constituency, who have highlighted the catastrophic mental health impacts of the situation. It is crucial that these sorts of decisions are made by expert clinicians based on the best possible evidence. Will the Secretary of State publish all the evidence behind his decision, including the results of the consultation, to give those families confidence that this is the right move for them?

We welcome the announcement of a clinical trial. We need the NHS to build up the evidence base as quickly as possible, and the Government to provide certainty that they will follow evidence and expert advice on behalf of those children.

Tobacco and Vapes Bill

Judith Cummins Excerpts

2nd reading
Tuesday 26th November 2024 Commons Chamber

[Mary Kelly Foy (City of Durham) (Lab)]

I declare an interest as the co-chair of the all-party parliamentary group on smoking and health. Just over a year ago, I welcomed the previous Government’s Tobacco and Vapes Bill. As the House may know, I have called for a smokefree generation for many years. I was not best pleased when the Conservatives voted down my amendments to the Health and Social Care Bill in 2021. Those amendments called for a ban on flavours and packaging targeted at children, which the shadow Secretary of State has just brought to the House’s attention. If they had not been voted down, we would already have regulations to protect children from smoking and vaping.

I join the Secretary of State in congratulating the former Prime Minister, the right hon. Member for Richmond and Northallerton (Rishi Sunak) on bringing the Smoking and Vapes Bill forward, but it was regrettable that the previous Government did not fast-track it in the wash-up before the general election. Nevertheless, I am grateful to the Labour Government for bringing this Bill forward. It is stronger than the previous legislation, and it responds to many of the issues that I and others raised in Committee with the previous Bill.

The comprehensive regulation of all vaping and nicotine products is important for addressing the concerns that vaping has become too widespread among young people. I strongly support regulations to reduce the appeal of such products, but we must ensure that the regulations are enforceable, robust and fit for purpose. My first of many questions to the Minister is this: will he confirm that a detailed policy paper will be forthcoming, setting out the policy objectives on vaping and how the new regulations will deliver against the objectives?

The Labour manifesto made a bold commitment on halving the gap in healthy life expectancy between the richest and poorest regions in England. Tobacco control is the best way to close the gap. We cannot say it enough: the range of diseases that smoking causes is extraordinary, from stillbirths and asthma in children to heart disease, stroke, dementia in old age, poor mental health and many cancers.

It will never cease to amaze me that there are people in this place who are happy to be lobbied by the tobacco companies—including, I am guessing, the shadow Secretary of State—some of whom we have heard from already, knowing full well the damage caused to individuals, families and communities, as well as to our health services. That includes communities such as mine in the north-east of England, where smoking is still the key driver of health inequalities and has been the cause of 26% of all deaths in the last 50 years and the cause of 125,000 deaths since 2020.

In my constituency of City of Durham, smoking costs us over £95 million a year, and more than £3 million is spent on healthcare. In County Durham, smoking costs us over £500 million a year, and over £21 million is spent on healthcare. In the north-east, the cost is over £2 billion, with healthcare costs at over £93 million. Nationally, smoking is still the greatest cause of preventable death, still the leading cause of premature death and disability, and still responsible for half the difference in healthy life expectancy between the rich and poor. That is why I have asked time and again in this Chamber for action.

It is a tragedy when we consider the further health implications. According to Cancer Research UK, the most deprived communities will not be smokefree until 2050. I urge the Government to restate their intention to publish a road map to a smokefree country and outline how support will be targeted at those who most need to quit. Smoking is also directly and indirectly linked to poor mental health. Nearly 40% of those who have a severe mental health problem smoke, and smoking accounts for two thirds of the reduction in life expectancy among that group.

I want to touch on the “polluter pays” levy. The Darzi review found that our health service is in real trouble. The Secretary of State is right that to rebalance supply and demand in our healthcare system, we need a major shift from sickness to prevention. The Khan review and the all-party parliamentary group on smoking and health have advocated for a “polluter pays” levy, which could raise £700 million a year to create a smokefree fund. That would ensure that the tobacco companies—not the public—pay for the harm that they inflict. Will the Minister consider that approach to fund the work needed to reduce smoking across society and to protect the NHS?

I should add that public health initiatives to tackle smoking are remarkably good value for money and that failing to fund efforts to tackle smoking is a false economy. Initiatives such as Fresh—the north-east’s tobacco control programme—have led the way in tackling smoking in our region. Fresh and others could provide best practice for the Department.

The Minister will know that the UK Government are party to the World Health Organisation framework convention on tobacco control. Article 5.3 seeks to protect policymaking from industry influence, but we have already seen that influence even at this stage of the Bill. Will the Minister confirm that the Government will live up to their obligations under the FCTC and commit to protecting the Bill from industry influence throughout its parliamentary process and the following regulations?

I am proud to vote for a Bill that will improve people’s lives and extinguish the injustice that smoking causes to individuals and society. Smoking is never about choice, and it is pathetic that some Members have argued that this is an issue of freedom; it is absolutely nothing of the sort. Tobacco companies target children and young people. Smoking is an addiction, and the only free choice is that first cigarette. When someone is in hospital, struggling to breathe because of smoking-induced lung cancer, where is their freedom? Today, we have the opportunity to give people the freedom to live healthy lives, free from disease and the inequalities that smoking causes.

[Madam Deputy Speaker (Judith Cummins)]

I call the Liberal Democrat spokesperson.

--- Later in debate ---

[Several hon. Members rose—]

[Madam Deputy Speaker (Judith Cummins)]

After the next speech, I will impose a six-minute time limit.

Infected Blood Inquiry

Judith Cummins Excerpts

Tuesday 19th November 2024 Commons Chamber

[John McDonnell (Hayes and Harlington) (Ind)]

On a point of order, Madam Deputy Speaker. I apologise for raising a point of order out of sequence, and I will explain why I am doing so. It relates to the case of Mr Alaa Abd el-Fattah and a point of order that I raised over a week ago. Some Members may recall that he is a British citizen who was imprisoned for his human rights campaigning in Egypt. He has served his sentence of five years and should have been released in September, but was not. His mother, a well-known academic at Cairo University, has been on hunger strike for 50 days. Anyone who has had any experience of hunger strikes knows that this is a critical period.

A number of us wrote to the Foreign Secretary over 10 days ago about this case, urging him to make further representations to the Egyptian Administration to secure Mr el-Fattah’s release. As of close of play today, we have not received a response. Through you, Madam Deputy Speaker, could I urge the Foreign Secretary to respond and, more importantly, take action? I am now fearful for the life of Laila, Mr el-Fattah’s mother, because as I said, the hunger strike has entered its 50th day.

[Madam Deputy Speaker (Judith Cummins)]

The very serious matter raised by the right hon. Member is not one for the Chair, but he has placed his concerns on the record in the hearing of the Foreign Office.