Correction to PQ107645

Maggie Throup Excerpts

Wednesday 29th June 2022 Written Statements

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

I would like to amend a written answer that I gave to the House on 28 April 2022.

In response to written question 107645, I stated that those who are on legacy benefits and have change in status such as a new child would move to universal credit in order for their benefit claim to accommodate their change in status, and therefore will be eligible for the Healthy Start scheme. However, this information was not wholly accurate. Families on legacy benefits who have a first child move automatically to universal credit and so become eligible for the Healthy Start scheme. Families having a second or subsequent child may choose to remain on legacy benefits and, if they do, would not be eligible for Healthy Start.

[HCWS158]

Heart and Circulatory Diseases (Covid-19)

Maggie Throup Excerpts

Thursday 23rd June 2022 Commons Chamber

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

I thank the hon. Member for Strangford (Jim Shannon) for securing this important debate on heart and circulatory diseases. It is vital that we keep those serious diseases on the agenda. As he alluded to, many of us have personal reasons why that is so important. My mum had two heart attacks in her 60s, though she survived another 20 years thanks to the NHS, and my father had a debilitating stroke that took away his ability to speak and to walk independently. I also thank, as the hon. Gentleman did, the charities that support patients in their time of need and continue to support their families—a huge thank you to all those charities.

I reassure the hon. Gentleman that cardiovascular disease is a key priority for NHS England. One of the ambitions in the NHS long-term plan is to raise awareness of the symptoms of CVD and ensure early and rapid access to diagnostic tests and treatment. NHS England has a programme of work to support this ambition, which is overseen by the national clinical director for heart disease and supported by an expert advisory group of clinical professionals across the country. That work remained a priority during the height of the covid-19 pandemic. Like other hon. Members, may I take the opportunity to thank all the dedicated NHS staff who worked hard to maintain services, despite the incredible challenges presented by covid, and are now working hard to restore them? Urgent hospital cardiology services were maintained throughout the pandemic.

In February, the Department of Health and Social Care and the NHS published our delivery plan for tackling the covid-19 backlog of elective care. The plan sets out a clear vision for how the NHS will recover and expand elective services over the next three years, including for cardiology. To further reduce patient waiting times, we have committed £2.3 billion to increase the volume of diagnostic activity and roll out at least 100 community diagnostic centres by 2024-25, which will provide services to support the earlier diagnosis of cardiovascular disease, including physiological measurement tests such as echo- cardiography, electrocardiograms, pathology tests and CT and MRI scans. Some £1.5 billion is committed towards elective recovery services, to roll out new surgical hubs and to increase bed capacity and equipment. That includes surgeries and treatment for cardiovascular disease.

NHS England has also established a cardiac pathway improvement programme, which is taking an end-to-end approach to the restoration of cardiac services that will deliver improved prevention, early and accurate diagnosis, reduced waits and best practice treatment and enhanced recovery. People with heart failure will be better supported by multidisciplinary teams as part of primary care networks. Greater access to echocardiography in primary care will improve the investigation of breathlessness and the early detection of heart failure and heart valve disease.

Stroke services across England also continued to provide rehabilitation and post-acute services to stroke survivors during the pandemic. In part, that was helped by innovative methods of care delivery; clinical teams used virtual rehabilitation alongside face-to-face contact to ensure that every patient got the treatment and support that they needed, and 80% of patients reported positive or very positive experiences. However, we recognise that many people will want face-to-face rehabilitation. To that end, the NHS will deliver personalised, needs-based and goal-oriented stroke rehabilitation to every stroke survivor who needs it, in their place of residence. This will be a lifetime offer with annual reviews, recognising that a patient’s needs will change over the course of their life. The national stroke service model, which was published in May 2021, summarises the gold standard of care across the stroke pathway and advises providers and commissioners on how each element of the pathway can be improved, including how services can ensure that 90% of stroke patients receive care on a specialist stroke unit.

I would like to reassure the hon. Member for Strangford that preventing CVD from developing in the first place is a key priority. One of the aims of England’s NHS health check programme is to prevent heart disease. As the Labour spokesman, the hon. Member for Denton and Reddish (Andrew Gwynne), referred to, the programme was largely suspended between April 2020 and February 2022 as a result of the pandemic and in line with national guidance from NHS England. An estimated 2 million people will have missed out on an NHS health check as a result, of whom an estimated 500,000 would have been found to have raised blood pressure and 400,000 would have been found to be at risk of a heart attack or a stroke in the next 10 years. Data for July to September 2021 indicates that local areas had begun to recover the service, with 136 of 152 local authorities reporting some level of activity. However, the number of checks offered and delivered over the period is about 40% of what was reported prior to the pandemic.

The Office for Health Improvement and Disparities is supporting local authorities to recover the health check service, including by showcasing local delivery models that demonstrate innovative approaches to reaching people at higher risk of CVD and by working with local authorities to pilot a digital NHS health check that enables people to self-complete an NHS health check at home, including cholesterol sampling.

In addition, NHS England is working with doctors and other health professionals to support patients with heart disease through the roll-out of the NHS@Home scheme. This self-management scheme enables patients with heart disease to look after themselves in their own home. Patients will be supported to understand their medications, record daily weights and blood pressure and recognise symptoms if they deteriorate. It is anticipated that that will lead to a reduction in hospital admissions, increased quality of life and improved patient and carer knowledge of managing their condition.

Members will be aware that high blood pressure can lead to heart failure, and I am pleased that NHS England plans to increase support for people at greater risk by increasing the number of people who have access to remote blood pressure monitoring and management. That will particularly apply to people with high blood pressure who are from ethnic minority backgrounds, as well as those who are clinically extremely vulnerable, from areas of higher deprivation and aged 65 years or over. This intervention will allow people to monitor their blood pressure from home, avoiding a trip to their GP practice by communicating the results to their primary care clinician via a digital platform or phone call to the practice.

GPs also have an important part to play in reducing cardiovascular disease. The quality and outcomes framework is an annual voluntary incentive programme for GP practices in England, and it contains indicators promoting high-quality care for patients with coronary heart disease or with a diagnosis of heart failure.

For the two years of the pandemic, general practice was required to release capacity to support the pandemic response and to agree an approach to prioritising care for the most vulnerable patients. QOF was reinstated in full from 1 April 2022. That means practices will be paid based on their performance, including on the indicators relating to coronary and circulatory disease, which will ensure practices are again incentivised to deliver this care.

Our upcoming national vaccination service, announced by the Secretary of State in January, will bring together all the innovation, learning and good practice from the covid vaccination programme to deliver life-saving vaccinations. We are also keen for the service to offer people wider prevention services as they are jabbed, by taking the opportunity to have conversations about their health and lifestyle, to offer public health advice and impromptu health checks, and to signpost those who may need further investigation to wider NHS services. Making sure every contact with the NHS counts can help us to spot diseases such as CVD early and ensure people get the right advice and support to hopefully prevent more serious disease.

The hon. Members for Wirral West (Margaret Greenwood) and for Strangford talked about ambulance times. The number of ambulance support staff has increased by 38% since 2010. The NHS has been provided with additional funding to address the current situation, which we know is not acceptable. NHS England and NHS Improvement are providing a range of support, including targeted support and additional funding for hospitals facing the greatest delays to help with the pressures both now and in the future. NHSE and NHSI have tendered a £30 million procurement contract for an auxiliary ambulance service.



The hon. Member for Denton and Reddish talked about health disparities. He will know—I do not think he has any doubt—that I am determined to tackle this issue. It is something I am very passionate about. Very shortly, we will be publishing our health disparities White Paper. We need to tackle obesity, smoking, alcohol and drugs, because they are factors that impact on people’s health, including, disproportionately, cardiovascular disease.

[Margaret Greenwood]

I am pleased to hear the Minister’s commitment. Will she then support an increase in universal credit by £20 a week? Poverty has a huge impact on people’s physical wellbeing.

[Maggie Throup]

I think that question should be directed at the Treasury, not the Department of Health and Social Care.

If I may continue to address questions raised, I am pleased to say that our target of 50,000 more nurses is on track for 2024. My hon. Friend the Member for Meon Valley (Mrs Drummond) made the very good point that it takes quite some time to train our amazing healthcare professionals, particularly those who are highly specialised, such as in cardiology. She also highlighted the disparity in waiting times. In England, 11.6% of the population is on a waiting list, but in Labour-run Wales, as she rightly said, the figure is 21%. We have to be careful when we make comparisons and try to criticise one nation over another. Everybody is trying their utmost to get things back on track in whatever way they can, because we know that the population’s health is a priority.

[Jim Shannon]

One of the questions I asked, in a constructive manner, was about the shortage of 100 consultant cardiologists. I am mindful—this was referred to by another hon. Member—that that training can take 10 to 15 years. If the Minister does not have the answer today, I am happy for her to write to let us know.

[Maggie Throup]

The hon. Gentleman asks a specific question, so if I may, I will get back to him.

In conclusion, I hope today I have demonstrated the Government’s commitment to improve the lives of people living with heart and circulatory disease. Our commitment is there. If we can continue to make an impact on the lives of people with these conditions with better prevention, diagnostics and treatment, it will bring significant benefits to the NHS and better health outcomes for those affected. We can all agree that that really matters. Once again, I thank the hon. Member for Strangford for bringing this very important issue to the House for debate today.

High Fat, Sugar or Salt Products: Delay in Volume Price Promotion and Advertising Restrictions

Maggie Throup Excerpts

Monday 16th May 2022 Written Statements

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

The Government are delaying the implementation of the volume price promotion restrictions and the introduction of further advertising restrictions on TV and online for high fat, sugar or salt (HFSS) products by 12 months.

We are clear that the delay to volume price promotions does not impact the locations measures which will still come into force on 1 October 2022. Under these measures, less healthy products in scope will no longer be promoted in key locations, such as checkouts, store entrances, aisle ends and their online equivalents. We expect these location restrictions to be the single most impactful obesity policy at reducing children’s calorie consumption and are expected to accrue health benefits of over £57 billion and provide NHS savings of over £4 billion, over the next 25 years.

The delay to restrictions on multibuy deals will allow the Government to review and monitor the impact of the restrictions on the cost of living in light of an unprecedented global economic situation.

A delay to the advertising restrictions is necessary because a delay in the Health and Care Act 2022 receiving Royal Assent has had a consequential impact on the timetable for the regulators’ subsequent consultations and publication of final guidance, meaning it was unlikely this would be ready with sufficient time before implementation.

We have also considered the ongoing concerns from industry about having time to fully implement the final guidance, by restructuring their funding and revenue streams appropriately, and ensuring robust compliance from implementation. We therefore believe this is the best approach to balance tackling childhood obesity in a timely way, managing the unprecedented economic situation and ensuring the smooth and effective implementation of these restrictions. The advertising regulations will now come into force on 1 January 2024.

We included a power in the Health and Care Act to delay implementation of the advertising restrictions if necessary. We will be utilising this power to amend the date of implementation for the advertising restrictions by secondary legislation. The implementation of the volume price restrictions will also be amended by secondary legislation.

This Government remain committed to halving childhood obesity by 2030 and these measures and others, including last month’s new measures on calorie labelling in large restaurants, cafes and takeaways, will play their part in delivering against this ambition.

[HCWS29]

Correction to PQ1131257

Maggie Throup Excerpts

Thursday 28th April 2022 Written Statements

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

I would like to inform the House that a written answer given by the Minister for Care and Mental Health, my hon. Friend the Member for Chichester (Gillian Keegan), on 2 February 2022, UIN 113125 to the hon. Member for Central Ayrshire (Dr Whitford) was incorrect.

In the response to Question 113125, it was stated that the United Kingdom Chief Medical Officers’ low risk drinking guidelines do not include specific guidelines on consumption of alcohol by children and young people. This remains the case. However, the answer should have stated that in 2009, the then Chief Medical Officer for England published guidance on the consumption of alcohol by children and young people. A copy of the chief medical officer’s guidelines can be found at: https://www.ias.org.uk/uploads/pdf/News%20stories/doh-report-171209.pdf

No assessment has been made of the accessibility of this guidance, however the guidance document was erroneously archived from gov.uk and has now been republished at: https://www.gov.uk/government/publications/alcohol-consumption-by-children-and-young-people. The Department continues to promote the guidelines in England which apply to children and young people through online platforms such as NHS.UK and the Talk to FRANK online resource, and gov.uk. Local authorities promote these guidelines as part of their public health duties.

[HCWS803]

Smokefree 2030

Maggie Throup Excerpts

Tuesday 26th April 2022 Westminster Hall

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

It is a pleasure to serve under your chairmanship, Ms Nokes. I thank my hon. Friend the Member for Harrow East (Bob Blackman) and the hon. Member for City of Durham (Mary Kelly Foy) for securing this important debate. I wish my hon. Friend a very happy birthday—it is probably one of the best birthdays he has had, given that he has started his day this way.

I am grateful to all hon. Members for their participation. We debate smokefree 2030 regularly, which indicates how important it is. We are all passionate about making England smokefree by 2030, and the devolved authorities have the same passion. The personal circumstances expressed by my hon. Friend the Member for Harrow East no doubt drive his passion, and I am sure that the personal circumstances of other hon. Members drive their passion too. I appreciate the passion and dedication shown by Members from all parties, who work together to tackle the harms caused by smoking. I am pleased to update the House on our progress towards achieving the Government’s smokefree 2030 ambition.

Over the past 20 years, through successive and progressive policies, as the hon. Member for Denton and Reddish (Andrew Gwynne) indicated, and regulatory measures, we have made progress in reducing smoking rates. Smoking prevalence in England is now 13.5%—the lowest on record. That is a fantastic public health story, but there are still nearly 6 million smokers in this country.

[Alex Cunningham]

Over the years, we have seen smoking in public places and all sorts of other things change under Labour and Conservative Governments. That reduction is a tremendous achievement, but in communities such as Stockton Town Centre ward in my constituency, smoking rates are still several times higher than that, and there are very high figures for smoking during pregnancy—way above the Government target. I hope the Minister recognises that, although we can cheer and say, “This is wonderful,” it is not wonderful in a lot of our communities.

[Maggie Throup]

I think the hon. Gentleman must have read the next page of my speech, because I was about to come on to that. He makes a really important point. As has been mentioned by the hon. Gentleman, my hon. Friend the Member for Harrow East and the hon. Member for East Londonderry (Mr Campbell), who is no longer in his place, smoking rates are far higher in poorer areas of the country, among those socioeconomic groups. We see smoking rates of 20% in more deprived areas, compared with 5% in wealthier areas, and nearly one in 10 pregnant women still smokes, which increases the risk of health problems for their baby. Smoking prevalence for people with long-term mental health conditions is over 25%, so the burden of tobacco harm is not shared equally.

We cannot let that continue, so the Government are committed to doing more. Over the past decade we have made significant steps towards making England smokefree—a bold and ambitious target that we committed to in 2019. We continue to enforce high taxation to reduce the affordability of tobacco. As part of the annual Budget process, Her Majesty’s Treasury will continue the policy of using tax to raise revenues and will encourage cessation by continuing with duty increases on tobacco products above the retail prices index. We continue to invest in local stop smoking services and our high-impact marketing campaigns such as Stoptober—I hear it is VApril this month.

Between 2010 and 2021, almost 5 million people set a quit date with stop smoking services, and 2.5 million reported quitting after four weeks. We continue to enforce a strong regulatory framework, and we have introduced policies such as smokefree legislation and standardised packaging. All these measures, and many more, have been instrumental in helping smokers to quit and protecting future generations from starting this lethal habit.

[Liz Twist]

The Minister has spoken about the great progress that has been made in 11 years, but is it not about time that we started expecting the people who caused this problem to pay for the cost of further tobacco control measures and getting people off smoking? Is it not about time that the “polluter pays” principle is adopted?

[Maggie Throup]

If I may, I will come to that later in my speech, but the hon. Lady makes a very good point.

On top of the measures, the NHS has renewed its commitment to tobacco treatment through the NHS long-term plan, delivering NHS-funded tobacco treatment services to all in-patients, pregnant women and people accessing long-term mental health and learning disability services until 2024. The Government also continue to explore ways to move smokers away from smoking and towards alternative nicotine products such as vapes, as highlighted by the hon. Member for North Tyneside (Mary Glindon). We know that the best thing a smoker can do for their health is to quit smoking altogether, but we also know how hard that can be. It remains the Government’s goal to maximise the public health opportunities presented by vapes while ensuring that such products are not appealing to young people and non-smokers. The hon. Member for Denton and Reddish made a very good point on this issue in his speech, and it requires balanced and proportionate regulation.

Despite the progress made so far, the Government acknowledge that we need to go further to achieve our ambition to be smokefree by 2030, which is why the Secretary of State for Health and Social Care asked Javed Khan OBE to lead an independent review into tobacco control in January this year. The Khan review is expected to be published next month and will make a set of recommendations to the Government. The review has two objectives. The first is to identify the most impactful interventions to reduce the uptake of smoking, particularly among young people. The second is to identify how best to support smokers to quit, especially in deprived communities and among priority groups.

Mr Khan has met hon. Members from both the all-party parliamentary group on smoking and health and the all-party parliamentary group for vaping, and he has carefully considered their views and proposals. Quite a number of members of those APPGs have expressed their approval of that route and how Javed Khan is getting into the depth of everything. Once the review is published next month, the Government will consider its recommendations, which will help inform both the upcoming health disparities White Paper and the new tobacco control plan, to be published later this year.

[Jim Shannon]

I thank the Minister for her response to this issue, and what she is saying is very positive. I am ever mindful that Northern Ireland has the highest rate of deaths due to smoking. Health is a devolved matter, and we are 10 years behind the rest of the UK on achieving our goals. What discussions could the Minister have with the Northern Ireland Assembly, and particularly with the Health Minister, Robin Swann, to enable us to catch up and achieve the goals and targets that the Minister has referred to?

[Maggie Throup]

The hon. Gentleman makes a very good point. The hon. Member for Arfon (Hywel Williams) also mentioned discussions with the devolved nations, and I am very happy to have discussions with my counterparts in the devolved health authorities.

As we have heard from my hon. Friend the Member for Harrow East and others, many in this room are supportive of a “polluter pays” levy. As they will be aware, tobacco taxation is a matter for Her Majesty’s Treasury, and the tobacco industry is already required to make a significant contribution to public finances through tobacco duty, VAT and corporation tax. As part of the development of the tobacco control plan, the Department will also continue to explore and review with the Treasury the evidence base on the best options to raise funding in support of the Government’s ambition to be smokefree by 2030. As a number of Members asked, I am happy to meet the APPG to discuss funding matters and the levy in detail, while the Khan report is being published. I have met the APPG before and am happy to continue having those meetings.

[Alex Cunningham]

Surely the Minister has not lost sight of the fact that the “polluter pays” levy is a levy and not a tax, and the Department of Health and Social Care can introduce it, as it has for the pharmaceutical industry. Will she give a further explanation of that, rather than just saying that it is a Treasury matter?

[Maggie Throup]

I fully appreciate the hon. Gentleman’s point. I enjoyed listening to his dissection of the issue, and I look forward to continuing discussions with the APPG.

The UK will continue its role as a global leader in tobacco control and remains fully committed to the World Health Organisation’s framework convention on tobacco control. The Department has received global recognition for its support of the official development assistance FCTC 2030 project over the past six years. This project helps low and middle-income countries improve their tobacco control and, ultimately, their population’s health. We will continue to support the project for a further three years under the current spending review settlement.

I turn to the questions raised during the debate. My hon. Friend the Member for Harrow East raised the point that the independent review is late. The review is on track to be published in advance of the health disparities White Paper, which it was set up to help inform, this summer. The review was originally intended to be published this month, so it is just a short delay that will not compromise the review’s impact.

The hon. Members for Stockton North (Alex Cunningham) and for Blaydon (Liz Twist) talked about smoking in pregnancy. The Department continues to explore options to support smoking cessation among pregnant women, which will be set out in our new tobacco control plan. Already, as part of the NHS long-term plan, we have made commitments for a new smokefree pregnancy pathway providing focused sessions and treatment to support expectant mothers and their partners to be smokefree. It is important that partners are involved.

The hon. Member for City of Durham mentioned the breaches of menthol regulations. The Office for Health Improvement and Disparities is investigating a range of cigarettes to determine whether the flavour is noticeable. Once that is complete, we will explore whether further action needs to be taken against companies who are in breach of the regulations.

My hon. Friend the Member for Harrow East and the hon. Member for Denton and Reddish talked about stop smoking services, which provide support to help smokers quit and are highly cost-effective. Local stop smoking services continue to offer smokers the best chance of quitting. They produce high quit rates of 59% after four weeks, and they have helped nearly 5 million people to quit since 2000. The services are a key part of the Government’s tobacco control strategy, and will remain so in the new tobacco control plan.

On any regulatory reforms the Government wish to take forward, we will review what legislative powers we have available to us, either through secondary legislation or exploring whether a Bill is required. I was asked why we rejected the tobacco amendments to the Health and Care Bill. We were grateful to Members for suggesting the amendments, which showed their strong support for tobacco control, but it is only right for my Department to fully consider the issues they raised—I am sure those issues will also be raised in Javed Khan’s report—before publishing the new tobacco control plan. We felt that was the right place for the suggestions made in debates on the Health and Care Bill.

I would like to reassure the hon. Member for Denton and Reddish that I am serious about making England smokefree by 2030, as is the Secretary of State. I thank the hon. Member for the support he and the Labour party have offered in the mission to make England smokefree. It is definitely a cross-party issue, and it is really good that we will all be able to work together.

The point about how we are supporting people with mental health conditions to cease smoking has been made a couple of times. The new universal smoking cessation offer is available through the NHS long-term plan for long-term users of specialist mental health services and people with learning disabilities. It is important that we tackle health inequalities brought about through mental health issues, and help those people to quit smoking as well.

I again thank hon. Members for securing the debate and for all their contributions to it. We have made good progress in reducing smoking rates, but the Government acknowledge that we need to go further to level up society and achieve a smokefree country by 2030. Later this year, we will publish a new tobacco control plan setting out how we will achieve our bold ambition. Working together across all parties, our mission is to make smoking a thing of the past and save future generations from the death and misery we all know it causes.

Malnutrition and the NHS

Maggie Throup Excerpts

Monday 25th April 2022 Commons Chamber

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

I congratulate the hon. Member for Linlithgow and East Falkirk (Martyn Day) on securing this important debate tonight. As he rightly said, we were expecting to be quite late, so it is good to be able to debate this matter while people might still be watching. I know that he has shown a keen interest in it, especially through his work on the Health and Social Care Committee.

Malnutrition is a common clinical health problem, affecting all ages and all health and care settings. However, it is also a complex issue and its root causes may be clinical, social or economic. I know from personal experience, and from the difficulties of those close to me, how critical it is for disease-related nutritional problems to be identified and treated early. I also appreciate how important it is for healthcare professionals to have a wide range of options available to meet each patient’s unique needs. Supplements can provide a lifeline to those already struggling with debilitating illness. Whether it was the nutritional supplement drink provided to me by a practice nurse when I could not swallow due to chicken pox, those that my mother could drink when severe breathing problems made eating a serious struggle, or the yoghurt-type products that sustained my father after his stroke, these treatments were not just life-saving; they relieved the worry of hunger at some of the most difficult times in the lives of ourselves and our loved ones.

The hon. Member has highlighted the significant cost of malnutrition in the NHS, as cited in the British Association of Parenteral and Enteral Nutrition report. The report indicates that malnutrition costs to the health and care system in the UK are estimated to be over £23 billion each year, including £19.6 billion in England, with the majority of those costs—some £15.2 billion—being in NHS secondary care settings, and around £4 billion in social care settings. It is therefore right that we hold the NHS and care services to the highest standards. It is essential that patients receive the right nutritional support to meet their needs.

We expect NHS services to be provided in line with the National Institute for Health and Care Excellence best practice guidelines. NICE has published guidance on “Nutrition support for adults: oral nutrition support, enteral tube feeding and parenteral nutrition”, which covers identifying and caring for adults who are malnourished or at risk of malnutrition in hospital, in their own home or in a care home. It offers advice on how oral, enteral tube feeding and parenteral nutrition support should be started, administered and stopped. It also aims to support healthcare professionals in identifying malnourished people and to help them to choose the most appropriate form of support. The Care Quality Commission also sets quality standards that the NHS and care settings must meet. Regulation 14 sets the quality standards for meeting nutritional and hydration needs. The standard requires that people must have their nutritional needs assessed, and food must be provided to meet those needs, including where people are prescribed nutritional supplements and/or parenteral nutrition.

We are implementing several initiatives to ensure that the highest nutritional standards are met. The Malnutrition Task Force—a partnership of Age UK, Apetito, BAPEN, Nutricia and the Royal Voluntary Service—has published a series of guides offering expert advice on the prevention of and early intervention in malnutrition in later life. These guides draw together principles of good practice to offer a framework developed to help those in a wide range of health and care settings to make the changes needed to counter malnutrition. This includes a guide for care homes on integrating good nutrition into daily practice.

We have published a comprehensive review of hospital food and are working to implement its recommendations. Every hospital has a responsibility to provide the highest level of care for its patients, and thar includes the quality and nutritional value of the food that is served and eaten. Hospitals must comply with five mandatory food standards, including a requirement to screen patients for malnutrition and covering the nutrition and hydration needs of patients. The Government have invested in primary care networks to ensure that the NHS has the specialist staff it needs to provide in-depth assessments of patients’ nutritional requirements. Through the primary care network direct enhanced service, primary care networks have recruited hundreds of additional health and wellbeing coaches and dieticians since March 2019.

The hon. Member raised concerns about medical nutrition for people who require clinical intervention to treat or address the risk of malnutrition. As he will be aware, foods for special medical purposes are developed to feed patients who are malnourished because of specific medical conditions that make it impossible or very difficult for a patient to satisfy their nutritional needs through the consumption of other foods. These products are developed in close co-operation with healthcare professionals and must be used under medical supervision.

We are working with stakeholders, including industry and the NHS, to update the processes and guidance of the Advisory Committee on Borderline Substances to support fairer, more accurate, more consistent and faster decisions. The ACBS works to assess malnutrition products to ensure they are both clinically effective and cost-effective for the NHS. With the ACBS recommending a total of 209 products available through prescription for the management of malnutrition, the current system offers a wide choice to patients and clinicians.

The hon. Gentleman talked about the rise in the number of people diagnosed with malnutrition, the reasons for which are complex. It is likely to be partly due to improved screening and reporting and an ageing population. The issue was probably there before, but we are now identifying it more because of the NICE and CQC guidelines. The evidence also suggests that the rise in malnutrition is worse in older age groups.

The ACBS is independent of the Department of Health and Social Care and has not yet informed the Department of when it will present the outcome of its consultation. I commit to informing the hon. Gentleman as soon as we are informed. The ACBS is also responsible for advising on the prescription of borderline substances, including food for special medical purposes for use in NHS primary care. The ACBS has authorised 209 products listed on the drug tariff for the management of malnutrition, providing plenty of choice for patients.

The CQC standard on nutrition and hydration clearly sets out that people must have their nutritional needs assessed and that food must be provided to meet those needs, including where people are prescribed nutritional supplements and/or parenteral nutrition. The NICE guideline on nutrition support for adults aims to assist healthcare professionals in identifying malnourished people and choosing the most appropriate form of support. If the NHS and care homes follow the CQC and NICE guidelines, they will help to reduce the number of people in this condition and help to reduce the cost to the NHS.

To address the many complex factors around malnutrition, we need effective strategies for managing malnutrition in health and care settings. The NICE and CQC guidelines and standards clearly set out the care pathways that should be in place to ensure that patients receive the best possible nutritional care. I also agree that, where patients require specialist clinical nutritional support, we must ensure they have access to the right treatments. We will continue to work with the medical nutrition sector to ensure that the most efficacious products are available in the NHS without undue delay.

I reassure the hon. Gentleman that my Department takes malnutrition extremely seriously, and it is an issue that we are determined to continue tackling.

Question put and agreed to.

Oral Answers to Questions

Maggie Throup Excerpts

Tuesday 19th April 2022 Commons Chamber

[Ian Lavery (Wansbeck) (Lab)]

7. What steps he is taking with Cabinet colleagues to tackle the effect of poor housing conditions on health outcomes.

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

The Government are committed to tackling poor-quality housing. In the social housing White Paper, we committed to a review of the decent homes standard to test whether it is up to date and reflects current needs and expectations. The levelling-up White Paper sets out a commitment to halve levels of non-decency in all rented homes by 2030, with the biggest improvements in the poorest-performing areas. These reforms will have a positive impact on health, and we will work closely with the Department for Levelling Up, Housing and Communities to support their implementation.

[Ian Lavery]

The NHS spends a staggering £2.5 billion-plus annually on treating people with illnesses directly linked to living in cold, damp and dangerous conditions. As a consequence, severe respiratory diseases such as asthma, mesothelioma and other asbestos-related diseases are on the increase, mainly in the most deprived areas. Sadly, more and more people are dying. How does the Government’s levelling-up policy plan to tackle this increasingly urgent health issue?

[Maggie Throup]

The hon. Gentleman raises a really important issue that we are determined to tackle. Housing is one of the key determinants of health. A decent home can promote good health and protect from illness and harm. As he said, poor housing conditions have severe consequences for mental and physical health. That is why we are determined, not just through the levelling-up White Paper but through the health disparities White Paper that will be published later this year, to set out a bold ambition to reduce the gap in health outcomes and the actions that the Government will be taking to address the wider determinants of health, including the impact of poor housing on health.

[Selaine Saxby (North Devon) (Con)]

In North Devon it is not just the quality of housing that is causing health issues but the lack of availability of affordable housing and a complete collapse of the private rental sector, which is creating mental health issues among my constituents and also means that my much-loved North Devon District Hospital is struggling to recruit adequate local medical services. What steps is the Department taking to try to address these concerns?

[Maggie Throup]

My hon. Friend raises an important issue specific to her area, and other areas that attract people who go there for their holidays and are perhaps not there on a permanent basis. We are determined through our White Papers to address every health inequality, whether caused by a moving population or a static population, in the sorts of areas that the hon. Member for Wansbeck (Ian Lavery) talked about.

[Mr Toby Perkins (Chesterfield) (Lab)]

8. What recent assessment he has made of the scale of the backlog in cancer treatments in (a) Derbyshire and (b) England.

--- Later in debate ---

[Stephen Metcalfe (South Basildon and East Thurrock) (Con)]

I know from discussions with constituents that needle phobias are a real thing. Will my right hon. Friend therefore tell the House what support the Government are giving to intranasal vaccine delivery systems to ensure that the maximum number of people take up the vaccine?

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

The Department of Health and Social Care commissioned research through the National Institute for Health and Care Research, co-funded with UK Research and Innovation, for an Imperial College London study, worth £580,000, looking specifically at the safety and effectiveness of two covid-19 vaccines administered by respiratory tract. The study is ongoing, but it is in the later stages of the phase one clinical trial, and the results will be made public in due course, following peer review.

[Mr Virendra Sharma (Ealing, Southall) (Lab)]

Those providing social care often work long hours and are a real lifeline for the most vulnerable. Will the Minister act to ensure that those in social care are paid properly with a real living wage, as Citizens UK is campaigning for?

Healthcare: Carshalton and Wallington

Maggie Throup Excerpts

Wednesday 30th March 2022 Westminster Hall

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

It is a pleasure to serve under your chairmanship, Ms Rees. I congratulate my hon. Friend the Member for Carshalton and Wallington (Elliot Colburn) on bringing forward this important debate and on his commitment to tackling the range of health and social care issues that affect his constituents. A new hospital for Epsom and St Helier University Hospitals NHS Trust is part of our plans to build 40 new hospitals by 2030—the biggest hospital building programme in a generation.

The new hospital programme team is working closely with all schemes in the programme on how and when new hospitals will be built across the decade. I thank my hon. Friend for his praise and support for the new hospital programme. He campaigns tirelessly for his constituents, despite local opposition on purely political grounds. I assure him that we remain fully committed to the delivery of a new hospital for Epsom and St Helier University Hospitals NHS Trust to deliver improved local health outcomes.

The new hospitals will transform the way we deliver healthcare infrastructure for the NHS, prioritising sustainability, digital technology and the latest construction methods. This will result in outdated infrastructure being replaced by facilities for staff and patients—in his constituency and across the country—that are on the cutting edge of modern technology, innovation and sustainability. As my hon. Friend said, we can learn lessons from the covid pandemic to ensure that we future-proof our infrastructure.

The trust and the programme are working closely together on options for a new specialist emergency care hospital at the Sutton site, while general acute services remain in the current Epsom and St Helier hospitals. The programme team is in regular and ongoing discussion with the trust regarding the development of their plans, in line with the overall programme approach for delivery. This includes working closely on the trust’s expectations for the build and ensuring that those are in line with the financial envelope across the whole programme. The individual allocation for the scheme will be determined only once the respective full business case has been reviewed and agreed.

To date, the new hospital programme has approved over £31 million in public dividend capital allocation to the trust for a variety of works related to the scheme. This includes fees for design works, enabling funding for the construction of a multi-storey car park as part of the scheme, and a contribution towards the costs of a new electronic patient record system. Further allocations to the scheme will be decided through the proper process as the scheme is progressed.

The new hospital programme is working collaboratively with trusts across the programme to ensure that their plans get the most from available funding, while avoiding repetition of work and ensuring that the principles of repeatable deign, modern methods of construction and net carbon zero are met. This will maximise the potential benefits of a programmatic approach to the scheme, resulting in the best possible value for money to the taxpayer and improved health outcomes for local constituents.

I will briefly talk more widely about the ambitions of the new hospital programme and our wider investment in our nation’s hospital infrastructure. The Government have been doing incredibly ambitious work, providing substantial capital investment to support the biggest hospital building programme in a generation. On 2 October 2020, an initial £3.7 billion of funding was confirmed to support the delivery of 40 new hospitals, with a further eight schemes invited to bid for future funding to deliver 48 hospitals by 2030.

I am pleased that six of the hospitals in the programme are already in construction, including the Royal United Hospital Bath, which is the first of the 40 new hospitals to begin construction. In addition, on 19 August 2021, the Secretary of State opened the Northern Centre for Cancer Care, the first of the eight hospitals confirmed by the previous Government that now form part of the new hospital programme.

This hospital building programme is in addition to significant upgrades to over 70 hospitals, worth £1.7 billion, and a wider programme of capital investment. The commitment to fund a programme of new hospitals is an exciting opportunity to build the next generation of intelligent healthcare facilities, as well as to embed a long-term capability for future capital investments within the NHS.

While this major scheme gets under way, we are supporting Epsom and St Helier University Hospitals NHS Trust with other capital investments, including £6.1 million for the expansion of the emergency department and same-day emergency care unit at St Helier Hospital and the extension of waiting room space and mental health cubicles at Epsom hospital; £7.4 million for the relocation of services from the New Epsom and Ewell Cottage Hospital to Epsom General Hospital; and £11.6 million to eradicate the backlog in maintenance across the estate. I take this opportunity to acknowledge the amazing contribution our health and care staff have made during the pandemic—none more so than those serving the constituency of my hon. Friend.

In conclusion, I pay tribute to my hon. Friend for all the work he is doing to support the new hospital scheme for Epsom and St Helier University Hospitals NHS Trust. My Department and I look forward to continuing to work closely with him, and we are happy to arrange a meeting with him and his colleagues, and to work with the trust, as these important and ambitious plans continue to develop and come to fruition, and as they deliver improved healthcare outcomes in Carshalton and Wallington and the surrounding area.

Question put and agreed to.

Civil Proceedings

Maggie Throup Excerpts

Tuesday 29th March 2022 Commons Chamber

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

I beg to move,

That the Coronavirus Act 2020 (Delay in Expiry: Inquests, Courts and Tribunals, and Statutory Sick Pay) (England and Wales and Northern Ireland) Regulations 2022 (SI, 2022, No. 362), dated 23 March 2022, a copy of which was laid before this House on 23 March, be approved.

[Madam Deputy Speaker]

With this it will be convenient to discuss the following motion on the Coronavirus Act 2020 (Review of Temporary Provisions) (No.4):

That the temporary provisions of the Coronavirus Act 2020 should not yet expire.

[Maggie Throup]

Throughout the pandemic, the Government have done everything in our power to protect the lives and livelihoods of people across the country .The Coronavirus Act has been a vital tool, allowing us to do that. Last week marks two years since the Act gained Royal Assent and the automatic expiry date for its temporary provisions. This is an opportunity to reflect on the progress we have made in our fight against covid-19 and on how the Act has supported us in that fight, as well as in encouraging important innovations in some of our public services, which we want to take forward.

First, I come to the support the Act has given us. It was an extraordinary piece of legislation for an extraordinary time in this country’s history, giving us the powers we needed to keep the country safe, and the economy and public services open at the time of need. It helped us to bolster the health and social care workforce by suspending rules in the NHS pension schemes for England and Wales, and allowing the creation of temporary registers enabling recently retired NHS and social care staff to return to the workforce and play their part. Almost 15,000 nurses, midwives and, in England, nursing associates joined these temporary registers to help deal with the impact of the pandemic, as well as more than 10,000 paramedics, operating department practitioners and other professionals, and about 6,500 social workers.

The Act also helped the Government to offer unprecedented economic support and to help people and businesses at a time when so many businesses faced disruption. That includes the coronavirus job retention scheme, also known as furlough, which has supported 11.7 million jobs.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

Will the Minister comment on the figures released by the Office for National Statistics today, which state that men and women living in the most deprived parts of the country were five and six times more likely to die from covid than those in the least deprived areas? What can she say about the adequacy of the regulations for those people?

--- Later in debate ---

[Maggie Throup]

It has been clear throughout the pandemic that people living in areas of deprivation and different ethnic minorities have been impacted more than others. We are committed to addressing that, which is why we will launch a health disparities White Paper shortly that will look at all the different issues.

[Jeremy Corbyn (Islington North) (Ind)]

Following on from the point that was just made by my hon. Friend the Member for Oldham East and Saddleworth (Debbie Abrahams), the Minister must be aware of the massive effect of the whole coronavirus process on mental health, particularly among young people—even among children in primary school. Are the Government committed to putting the necessary resources into the hardest-hit communities where the mental health crisis is at its worst?

[Maggie Throup]

The right hon. Gentleman makes a very good point. We know that the pandemic has had a mental health impact not just on children and young people, but on people of all ages. That is why it is important that we are now living with covid and getting our lives back to normal, which is one way of helping restore that normality that we are so desperate to get back to.

The Government helped businesses at a time when many faced disruption, including through the coronavirus job retention scheme. We have also supported the self-employment income support scheme, which paid out more than £28 billion to nearly 3 million self-employed people and was one of the most generous schemes for the self-employed in the world.

[Jim Shannon (Strangford) (DUP)]

The legislation covers England, Wales and Northern Ireland. Will the Minister reassure me that full consultation has taken place with the Health Minister and the Economy Minister in Northern Ireland to ensure that what she is mentioning is endorsed by the Northern Ireland Assembly?

[Maggie Throup]

I shall come shortly to the specific parts of the extension that are relevant to Northern Ireland. I am sure that the hon. Gentleman will appreciate that we have had ongoing conversations with the devolved Administrations throughout the whole two years.

The Coronavirus Act 2020 also helped to ease the burden on frontline staff in our critical public services. For example, provisions in the Act have helped the courts and tribunal system to keep functioning throughout the pandemic by allowing thousands of hearings to take place remotely.

[Mr Toby Perkins (Chesterfield) (Lab)]

The Minister has now turned to the subject I wanted to ask her about. She talks about our courts, but the reality is that they are in a terrible position. We are up to a record 708 days for the average time it takes to prosecute suspected criminals. The longer those delays go on, the more victims wait. No party can seriously claim to be tough on crime while allowing victims to be left waiting and allowing criminals to spend 708 days before they are prosecuted. Will the Minister apologise to those people who are waiting and tell us that the Government have some kind of strategy to address that appalling record backlog?

--- Later in debate ---

[Maggie Throup]

I was about to come on to why we have tabled this statutory instrument today, but I can reassure the hon. Gentleman that the backlog is now falling. The Ministry of Justice’s spending review settlement has put £500 million into addressing the issue.

Currently, more than 11,000 hearings take place each week using remote technology across 3,200 virtual courtrooms. The Act has allowed the courts to deal promptly and safely with proceedings, avoiding unnecessary social contact and travel and keeping justice going while upholding the principle of open justice. That shows how the Act has not just offered support at a time of emergency but has driven modernisation of important services that we want to take forward. We are looking to replicate several of those powers in other primary legislation.

We have always said that we would not keep these measures in place for a day longer than needed. When the Act was introduced, the temporary provisions within it were given a two-year lifespan so that we could make sure that those powers would be in force only for as long as they were necessary and proportionate to respond to the pandemic. Since the Act was first introduced, we have made huge progress in our fight against the virus thanks to a national vaccination programme that has now put more than 140 million doses in arms.

The scientific protection that we have built up, together with our greater understanding of the virus, has shifted the odds. Our fight against the virus is not over, but our living with covid plan showed how we can now take a different approach, protecting ourselves without restricting our freedoms. To do that, we are moving away from legal curbs towards an approach based on personal responsibility and public health guidance where we trust people to take the right decision for those around them. As we have built up greater defences against the virus, we have been able to suspend or expire early more and more temporary provisions from the Act and the vast majority of temporary non-devolved provisions are now expired. Only five temporary non-devolved provisions remain in force and they would be extended by the regulations.

I will now set out the detail of the regulations. Four of the provisions relate to taking forward innovations in the justice system until we make them permanent by other means. Section 30 of the Act removes the obligation for coroners to hold inquests with a jury when covid-19 is suspected to be the cause of death. Subject to parliamentary approval, that will be made permanent in the spring through the Judicial Review and Courts Bill.

Sections 53 to 55 enable participation in court and tribunal hearings to take place remotely by video or audio links, which will be made permanent this summer through the Police, Crime, Sentencing and Courts Bill. Again, that will be subject to parliamentary approval.

Covid has meant that a backlog of cases has built up in our justice system. Those provisions are helping courts to work more quickly through that backlog. They are therefore crucial to court recovery and it is vital that the powers are not allowed to lapse. A maximum six-month extension to those provisions in the Act is important to enable a smooth transition and avoid disruption to service before the primary legislation comes into force. The provisions will be expired once the new primary legislation is in place.

The regulations also extend section 43 of the Act on statutory sick pay in Northern Ireland for a period of six months. That enables the continuation of statutory sick pay to be paid from day one for absences related to covid-19 in Northern Ireland. Although statutory sick pay is a transferred matter in Northern Ireland, section 43 confers on the Secretary of State the power to make regulations in respect of Northern Ireland. As a result, the UK Government are asking for section 43 to be extended on the formal request of the Department for Communities in Northern Ireland.

I take this opportunity to note an addendum in the 12th two-monthly report on the Act, which was published on 24 March. It is regrettable that there was an omission of status updates for two temporary provisions in previous reports on the Act. Those are sections 42 and 43, which relate to provision of statutory sick pay and extend to Northern Ireland only. My Department apologises for the omission and welcomes the opportunity to correct it. The addendum provides information about the status of those provisions over the course of the pandemic. I reassure the House that the reporting omission has not had an impact on the policy relating to those provisions.

I thank hon. Members from all parties for the valuable scrutiny they have provided as we have debated the Act over the past two years. I am pleased to come before the House today with the vast majority of the temporary provisions in the Act having expired. That shows our commitment to removing powers that are no longer necessary, but also shows how far we have come since the Act was introduced.

Let me finish by thanking the health and care staff and all key workers who have worked so tirelessly throughout the pandemic as well as the British people for the extraordinary efforts they have made. The pandemic is not over, but we have made huge strides in our fight against the virus, which is why we can take these steps. I commend the regulations to the House.

Smoke-free England

Maggie Throup Excerpts

Tuesday 29th March 2022 Westminster Hall

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

First, I thank my hon. Friend the Member for Broxbourne (Sir Charles Walker) for calling this important debate. I am grateful to him for his contribution and I am grateful to other Members who share the Government’s ambition for Britain to be smoke-free by 2030. My hon. Friend is correct when he says that that means 5% of people smoking, but it would still be a great achievement to get from where we are now to just 5%. The UK is a world-leader on tobacco control and we now have one of the lowest smoking rates in the world. According to my records, only 13.5% of people in the UK smoke, but that percentage is still too high. As he stated so passionately, the Government know there is still so much more to do.

We know that there are still around 6 million smokers in England and that smoking remains the single biggest cause of preventable mortality; two out of three long-term smokers will die from smoking. We also know that smoking is one of the largest drivers of health disparities and that the burden of tobacco harms is not shared equally. Smoking rates are far higher in poorer areas of the country, as my hon. Friend said, and among lower socioeconomic groups. We can see smoking rates of 23% in more deprived areas, compared with rates of 8% in wealthier ones. In addition, one in 10 pregnant women still smoke, increasing the risk of health problems for their babies. Smoking prevalence among people with long-term mental health conditions is also far too high, at over 25%.

My hon. Friend the Member for Windsor (Adam Afriyie) raised the issue of smoking during pregnancy. The decline there has not fallen in line with other groups, so we know that more needs to be done. We continue to explore options to support smoking cessation in pregnant women; those options will be set out in our tobacco control plan and they are also part of our NHS long-term plan. We know that it is not just the woman who needs support; it is her partner as well. We must continue to help those groups in all the ways we can.

What are we doing? In 2019 the Government set the bold ambition for England to be smoke-free by 2030. To support that, we have been building on the successes of our current tobacco control plan, and later this year we will publish a new plan with an even sharper focus on tackling health disparities. The new plan will set out a comprehensive package of new policy proposals and regulatory change. To help push those ambitions forward, the Government have commissioned an independent review of our tobacco control policies, led by Javed Khan, the former CEO of Barnado’s. The review will assess the most impactful interventions to help us achieve our goal of being smoke-free by 2030. I know that Javed Khan has some really ambitious ideas that I am sure my hon. Friend the Member for Broxbourne will welcome.

More needs to be done to prevent young people from taking up smoking and to protect our future generations from its devastating harms. More also needs to be done to support current smokers to quit, especially in deprived communities and among the priority groups. Smoking, and the grip it has on our society, must become a thing of the past. I am confident that the Khan review will give us the focus and political support to do so. I encourage all hon. Members to contribute to the review so that we can hear as wide a range of views as possible. We are open to bold new ideas about how to reach our smoke-free ambitions. Hon. Members have talked about the role of reduced-risk products. The Government are supportive of smokers using less harmful nicotine delivery systems to quit or switch away from the most harmful form—combustible tobacco.

[Mary Glindon]

This week is the beginning of VApril, which is a campaign run by the industry to support smokers who are looking to quit. Would the Minister support efforts to encourage adult smokers to quit by speaking with local authority stop smoking services, this month in particular, and highlight the role of e-cigarettes in reducing harm?

[Maggie Throup]

The hon. Lady—I will call her my hon. Friend—speaks passionately about vaping, and we have had those conversations before. We know and acknowledge that reduced-risk products are not risk-free, but vaping is a way to help people stop smoking and it has been proven to be effective. We must continue to ensure that the products do not appeal to young people and non-smokers—that is really important. However, we need to get the message out that vaping is an effective way to stop smoking. Balanced and proportionate regulation is required as we shift to different products. We have an innovative and varied nicotine market in the UK, as has been mentioned; vapes are by far the most popular alternative source of nicotine, but there are also patches, gums and, more recently, nicotine pouches.

We want to see more smokers using vapes to quit, which I know is in line with the wishes of the hon. Member for North Tyneside (Mary Glindon). She mentioned earlier the possibility of vaping and e-cigarettes being available on prescription, and the Secretary of State has spoken of his desire to see those products routinely prescribed by the NHS. That is something that we need to move forward with. My hon. Friend the Member for Windsor raised the important issue of the perception of vaping and how it has changed. That is something I will take away and consider.

[Ben Bradley (Mansfield) (Con)]

The Minister talks about the range of alternative products, such as vapes, “heat not burn” and other things that already exist, and about the statistics on people’s perceptions of the health impacts of those products. We know that those products are less harmful, so does she agree with what my hon. Friend the Member for Windsor (Adam Afriyie) said about the importance of getting that information our to people—even if it is as simple as a slip of paper in a cigarette packet? I like to think that a Conservative Government, rather than seeking to ban things, could empower people to make that choice through information. We could certainly do more to get that information out there.

[Maggie Throup]

My hon. Friend is quite right. It is important that we communicate the other ways people can stop smoking and, as the hon. Member for North Tyneside said, do so in such a powerful way. As Members of Parliament, we all have a role in getting those messages out, and I am sure that everybody in this room will be doing their bit in VApril to get that message through to the public. It is about messaging and about people understanding the impact smoking has, not just on their lives but on other people’s lives as well.

I am also aware of the desire to bring snus to the UK market to give smokers further choice of less harmful alternatives. Considering the range of alternative nicotine products that can be accessed by smokers, the Government are not currently minded to introduce a new tobacco product to the UK market. Current alternative products such as nicotine pouches deliver nicotine in an identical way to snus but do not contain any tobacco. We will continue to consider the evidence around snus and we welcome additional non-tobacco reduced-risk products to the UK market.

I thank my hon. Friend the Member for Broxbourne again for calling this important debate and for hon. Members’ interesting contributions to the discussion. We have packed a lot into 30 minutes. I hope to be able to tell the House more in the coming months about the specific policies that will deliver our ambitious agenda for a smoke-free England. The end is in sight through a sustained and multi-pronged approach. I hope we can look forward to a future for our children without the death and misery that is caused by smoking.

Question put and agreed to.