The NHS

Lord Faulkner of Worcester Excerpts

Thursday 5th July 2018 Lords Chamber

[Lord Faulkner of Worcester (Lab)]

My Lords, like every other speaker I am delighted to congratulate my noble friend Lord Darzi on the brilliant way that he introduced the debate. I thank him for the hundreds—probably thousands—of lives he has saved during his very distinguished career as a surgeon. My contribution will focus on why treating tobacco dependency must be embedded throughout the plan that NHS England has committed to delivering in return for the additional £20 billion it has been allocated. The evidence for this is set out in a major new report published just last week by the Royal College of Physicians. I declare an interest as a long-standing officer of the All-Party Group on Smoking and Health.

Helping smokers quit is not just about prevention. It improves treatment outcomes and helps poorer people in particular to live longer. Take lung cancer. Currently, at diagnosis one-third of lung cancer patients still smoke and their average life expectancy is nearly doubled if they quit, yet fewer than a quarter get advice to quit from their GP and only 13% are prescribed stop smoking medications. Helping to quit smoking costs hundreds of pounds and has a similar impact on life expectancy as the latest lung cancer drugs, which cost tens of thousands of pounds per course of treatment. So why are lung cancer patients not being given the help to quit that they need?

Tobacco dependency treatment is cheap and saves the NHS money. The RCP has calculated that if all smokers were provided with help to quit the NHS could save £60 million annually in hospital admission costs and A&E attendances alone from year one onwards. This includes the cost of the treatment, which is only £182 per quitter. By freeing up beds and saving money, it would ensure the additional £20 billion can be used more cost effectively.

We need only look to Greater Manchester, where the CURE programme will start to deliver treatment for all smokers from September, to see the potential gains. Manchester has almost 53,000 hospital admissions of active smokers every year. Smokers are admitted with cancer, heart disease, mental health conditions, HIV/AIDS—the list goes on. It has been calculated that providing patients with tobacco dependency treatment will save the equivalent of 250 additional beds per day. This will help to tackle the winter bed crisis in Manchester. Smokers are five times more likely to have micro-biologically confirmed influenza. When combined with other smoking-related respiratory diseases, such as chronic obstructive pulmonary disease, this can lead to their admission to hospital at the worst time of the year.

Supporting smokers to quit will also deliver improved maternity outcomes. Every year, maternal smoking in the UK causes 5,000 miscarriages, 300 perinatal deaths and 2,200 premature births. Younger mothers in disadvantaged circumstances who have never worked are more likely to smoke throughout their pregnancy. These are the immediate savings; the benefits in the longer term are even greater, as current smoking costs hospitals almost £1 billion a year, most of which is avoidable.

It is not that smokers do not want to quit—over 60% say that they do—but our hospitals are not providing the help that the most addicted need if they are to succeed. Will the Minister ensure that NHS England takes into account the evidence and recommendations set out in the recent RCP report on treating tobacco dependency as it develops the new plan for the NHS?