Building an NHS Fit for the Future

Mary Kelly Foy Excerpts

Monday 13th November 2023 Commons Chamber

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

Last week, we heard the longest King’s Speech in years, but it had very little in it. However, there was a silver lining: the announcement that the Government will bring forward legislation to create a smokefree generation. The devil will be in the detail, of course, and this certainly does not let Ministers, past and present, off the hook on the NHS. We see that if we just look at the state of NHS dentistry, an issue I have raised, and will continue to raise, in this place. Numerous Labour and other Opposition Members have also raised it in today’s debate.

I want to focus on smoking because it may be the single largest driver of health inequalities in England. Professor Chris Whitty argues in his latest report that central and local government has a key role to play in reducing smoking. It is an issue that the overwhelming majority of medical professionals agree on, as, I hope, do the majority of MPs. I have long taken an interest in the issue; as a councillor, I held the portfolio for health and wellbeing for nearly a decade, and this included chairing our tobacco control alliance. Working together with communities and local authorities to tackle tobacco harm, I saw at first hand just how much can be achieved with a comprehensive approach that drives change, through a multitude of initiatives. So although I welcome the Government’s proposals to create a smokefree generation and to curb youth vaping, the smokefree ambition must be delivered for everyone, not just the next generation. The measures announced to date have not gone far enough, not by any measure. As I walk through certain areas of my constituency, I continue to be struck by the number of people who still smoke. More than 117,000 people have died prematurely from smoking in the north-east since 2000; it is our biggest preventable killer and it is devastating for the thousands of families whose loved ones are lost each year. It also has significant implications for our health services and economic costs for our communities. It is estimated that smoking costs County Durham almost £190 million each year, £22 million of which is spent on healthcare. So preventing ill health is key. The concept that prevention is better than cure is a pretty old-fashioned idea, but it works. After 13 years, Ministers have finally picked up on that with their smokefree announcement.

Smoking is a deadly addiction, one that can lock people into a cycle of poverty and is difficult to break out of without support. We also know that regions with the highest rates of poverty have the highest rates of smoking in England and that smoking is one of the leading drivers of health inequalities in constituencies up and down the country. Not only do men and women in the most deprived areas have shorter life expectancy overall, but they live a larger number of years suffering from ill health. So far, the Government have wasted too much time. In 2021, I tabled amendments to the Health and Care Bill to tackle smoking and youth vaping. My proposals included a levy on tobacco companies’ profits to fund stop-smoking activities; inserts in packs containing health information, with links to smoking cessation services; and a ban on tactics such as branding and sweet flavourings to market vapes to children. To my amazement, not only did the Government fail to adopt my amendments, but they voted them down. Those were common-sense proposals that enjoyed cross-party support and the backing of health campaigners. If passed then, the amendments would have been law today. Instead, the Government chose inaction. I hope that the amendments will return in whatever the Government put before the House. Since then, tobacco companies have made record profits, leaving taxpayers and their families to pick up the pieces. We cannot afford to waste any more time.

Last week, the all-party parliamentary group on smoking and health published its latest recommendations for a smokefree future. The plans called for further regulations, such as increasing the funding levied from the tobacco industry on a polluter-pays principle—a measure that could raise up to £700 million a year. The APPG report shows that the polluter-pays levy is popular, feasible and supported by voters of all political parties, as well as the majority of tobacco retailers. Tobacco manufacturers make an estimated £900 million profit in Britain each year, with an average net operating profit margin of about 50%, compared with the less than 10% average for British manufacturing. Ministers must take the APPG’s recommendations into consideration.

While the measures that the Government have announced are a step in the right direction, the devil will be in the detail. To ensure that we have the best possible legislation, I hope that the Minister will work with the APPG. We know that a strong cross-party consensus for legislative measures can make a real difference. We have seen it all before. When a Labour Government banned smoking in enclosed public places in 2007, it was a measure that had once seemed inconceivable. Now it is baffling that we did not do it earlier.

In the seven minutes I have been speaking for, at least one person has lost their life due to smoking and tobacco use, which means that as MPs we have a responsibility to stand up on this issue. As health inequalities worsen and lives remain at risk, the Government must make up for their lost time with bolder action. They must ensure that the latest Tory turbulence and the exit of yet another Health Secretary does not thwart progress. They must get on with the job.