Building an NHS Fit for the Future

Maggie Throup Excerpts

Monday 13th November 2023 Commons Chamber

[Maggie Throup (Erewash) (Con)]

I am delighted to contribute to the debate because the Gracious Speech not only marks an historic first for His Majesty, but signals the Government’s clear commitment to focusing on the right long-term decisions to put our country on a stable footing in the face of global instability created first by covid-19 and latterly by the conflicts in Ukraine and the middle east.

When His Majesty’s grandfather, the late King George VI, made his final address to Parliament from the throne in October 1950, the Gracious Speech prepared by the then Labour Government made no mention of public health or any health-related legislation. Yet just fifteen months later—although it was never officially acknowledged—the late King, who was conservatively estimated to have smoked 40 cigarettes a day from his early teens, succumbed at the age of just 56 to the effects of two smoking-related diseases: lung cancer and cardiovascular disease. It is therefore bittersweet that, in the first King’s Speech of his reign, His Majesty announced new legislation to create a smoke-free generation by restricting the sale of tobacco so that children currently aged 14 or under can never be sold cigarettes, and restricting the sale and marketing of e-cigarettes to children. I will focus my remarks on those specific measures.

By committing to raising the age of sale for tobacco by one year, each year, making it an offence for anyone born on or after 1 January 2009 to be sold tobacco products across England, the Government will not only save countless lives, but will continue to level up areas of our country such as my Erewash constituency, where smoking rates remain unacceptably high. I take great pride in the fact that, thanks to the actions of the Conservative Government, the majority of the 1st Sawley Scouts, whom I met last Friday as part of Parliament Week, will never legally be able to buy cigarettes. When we discussed this topic, and the measures to address inappropriate vaping, there was wholehearted support from the scouts and their leaders.

I pay tribute to Dr Javed Khan for the work he has done and the role he has played in getting us to this stage on tobacco control. I was privileged to be part of the ministerial team who asked Dr Khan to dig deep into how we, as a nation, can become smoke free by 2030. One of his flagship recommendations was to raise the age of sale. To some, that may seem illiberal, but others—I am definitely in this group—would ask: “What is illiberal about protecting individuals from a killer?” Smoking remains the biggest single cause of preventable illness and death.

Shockingly, cigarettes are the only legal consumer product that will kill most users. Two out of three smokers will die from smoking unless they quit, and more than 60,000 people are killed by smoking each year. That is approximately twice the number of people who died from covid-19 between March 2021 and March 2022, yet it does not hit the headlines. Add to that the fact that in 2019, a quarter of all deaths from cancer were connected to smoking. The annual cost of smoking to society has been estimated at £17 billion, with a cost of approximately £2.4 billion to the NHS alone and more than £13 billion lost through the productivity costs of tobacco-related lost earnings, unemployment and premature death.

Achieving a smoke-free society by 2030 will not only save the NHS money; more importantly, it will save lives. Increasing the age of sale will undoubtedly be a key intervention that will make that happen. Age-of-sale policies are partly about preventing young people from gaining access to age-restricted products such as cigarettes and alcohol, but more importantly, they are about stopping the start. When smokers are asked when they started smoking, the majority say that it was in their teens. The longer we delay the ability to legally take up smoking, the fewer people will take it up, so fewer will become addicted. Let us face it: never starting to smoke is far easier than trying to quit. We have already proved in the UK that raising the age of sale leads to a reduction in smoking prevalence. Increasing the age of sale from 16 to 18 in 2007 led to a 30% reduction in smoking prevalence among 16 and 17-year-olds in England.

The last time I spoke about vaping in this place, I made a number of asks of the Government. I am delighted that I have been listened to, and that many of the measures I requested have been included in the Gracious Speech. Those asks were to regulate vape packaging, flavours and product presentation, and to enable further enforcement around the sale of vapes to children and young people. Those measures are a good start, but the message we need to put out is that vaping is an aid to quit smoking, not a recreational product. We are already hearing of children—yes, children—who have medical conditions as a result of vaping.

I believe that one way to change the way adults and children perceive vaping is to ensure that e-cigarettes are available on prescription. In October 2021, the Medicines and Healthcare products Regulatory Agency updated its guidance on licensing e-cigarettes as medicines. Being licensed would allow e-cigarettes to be available on prescription. Just over two years on, we are yet to see the first MHRA-licensed e-cigarette, so when the Secretary of State for Work and Pensions closes the debate, will he update the House on the progress made in enabling e-cigarettes to be available on prescription? That would undoubtedly put out the message that vaping is a serious way to quit smoking, not something to be consumed like sweets. That message needs to be loud and clear, because the scouts I met last Friday informed me that children in year 7 at their school were already vaping. We have no time to waste on this issue.

I will briefly mention the NHS long-term workforce plan. The focus of that plan has always been on nurses and doctors, but I want to put in a plug for other NHS workers. We need more radiologists and radiographers; we need more pathologists and biomedical scientists. Let us make sure we have all the supporting NHS staff in place that the doctors and nurses will need to conduct their business in an effective manner.

In our 2019 manifesto, we committed to levelling up, and that commitment has been reinforced by the actions of our Prime Minister and the Government he leads. Levelling up is about so much more than infrastructure; it is also about levelling up our health and our life chances. That is particularly important for my constituents in Erewash, where the prevalence of smoking—16.6%—is higher than the national average. It is estimated that the average annual spend by someone with a 20-cigarette-a-day habit is upwards of £3,000, while research recently conducted on behalf of The Daily Telegraph suggests that those under the age of 26 are spending around £2,700 a year on disposable vapes to satisfy their daily habits. Consequently, these measures should not just be considered in a health context. By becoming smoke free by 2030, the Government can lift around 2.6 million adults and 1 million children out of poverty altogether, which would represent a significant victory for our levelling-up agenda.