Secondary Breast Cancer

Mary Kelly Foy Excerpts

Thursday 11th June 2026 Westminster Hall

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

It is a pleasure to serve under your chairmanship, Mr Betts. I am grateful to have had the opportunity to work with the hon. Member for Wokingham (Clive Jones) to secure this important debate. I thank the campaigners who work to ensure that people living with secondary breast cancer are seen, heard and supported. I am thrilled that my hon. Friend the Member for West Lancashire (Ashley Dalton), who has spoken so openly about her diagnosis, is here today: I am sure that her remarks will be invaluable.

I speak not only as a Member of Parliament, but as someone who has been through breast cancer. I was fortunate: my cancer was picked up through screening and caught early. I received timely treatment and am now cancer-free, but I am forever grateful to the teams at the QE hospital in Gateshead, the Maggie’s centre and Future Dreams for their support. Whenever I can, I encourage people to attend screening appointments and to check themselves. In fact, on 14 July I will be hosting an event alongside leading breast cancer advocates and sporting ambassadors, focusing on raising awareness of the importance of women prioritising their breast health. I would love the Minister to join us.

I know that my personal experience was not that of someone living with secondary breast cancer. For people whose cancer has spread and can be treated but not cured, time is everything. In 2026, it is unacceptable that we do not know with confidence how many people are living with secondary breast cancer. We know that around 60,000 people in the UK are living with it, but that remains just an estimate. More than a decade after data collection was made mandatory, it is still not being consistently or accurately recorded across the country, and if people are not properly counted, their needs are too easily overlooked. The NHS cannot plan the right number of specialist nurses, oncology appointments, palliative care services, mental health support services or clinical trials if the true scale of need is not known.

I welcome the work of the national disease registration service, with NHS trusts, to improve data returns on metastatic breast cancer, but I am concerned that no data has yet been published. I also welcome the Government’s commitment to the national cancer plan, to define and count recurrent cancers, starting with metastatic breast cancer, and to ensure that patients have named primary contacts, but patients need delivery now, not just commitment. The NHS must routinely capture data on not only diagnosis but treatment and support needs. That is how we can move from counting people in theory to improving the services available to them in practice.

In Durham, trust was shattered when failures were identified in breast services at County Durham and Darlington NHS foundation trust. The concerns went way beyond isolated mistakes, and patients wondered whether the care that they received was truly in line with the standards that they should expect. Patients place their lives in the hands of the system, so they deserve to know that decisions about their care are evidence- based, properly scrutinised and made through strong, multidisciplinary teams. When that trust is broken, it is difficult to rebuild. I pay tribute to those who spoke out, such as my constituent Jackie, who did so on behalf of her sorely missed daughter, Michaela, and Amelia, Cat and Nadeen, who formed the Pink Justice Network. I do also recognise the efforts of the new senior leadership team at the trust, who are working to reform services and repair patient confidence.

On access to treatments, everyone living with secondary breast cancer deserves to have access to new, effective life-extending treatments, but there are serious concerns that the way in which NICE currently assesses some drugs limits access for people living with incurable metastatic breast cancer. Campaigners have warned that since the introduction of the severity modifier, some advance cancer treatments have been disadvantaged compared with the previous system. Breast Cancer Now reports that only a minority of end-of-life treatments assessed under the new approach received the same level of priority as they would have before.

The clearest example is Enhertu, which could give people with HER2-low metastatic breast cancer more time, yet was not recommended for routine NHS use in England in 2024, as a cost-effective pricing agreement could not be reached. Since then, eligible patients have missed out, and people have asked why a life-extending treatment should be available in Scotland but not in England. The Government’s decision to increase the NICE cost-effectiveness threshold for new medicines is welcome, and I hope it will create an opportunity to reach an agreement on Enhertu. I also welcome the fact that discussions between AstraZeneca, Daiichi Sankyo, NHS England and NICE are understood to have begun. More than 50,000 people have signed a petition calling for urgent agreement on Enhertu. They are asking for something very simple: that all parties come together to find a way to give eligible patients more time.

I must also mention the work of our hospices, such as St Cuthbert’s hospice in Durham, which are supported by charities such as Marie Curie, in providing people who are living with secondary breast cancer with the services that they need. Marie Curie reports that one in three people do not receive the care and support they need at the end of life, so I welcome the fact that the Government are developing a palliative care and end-of-life care modern service framework. I hope that the framework will address the lack of support available outside of normal working hours, embed palliative care in neighbourhood health and ensure that the palliative care workforce is fit for the future.

Will the Minister set out how the Government will ensure three things: first, that secondary breast cancer data is collected and published consistently across every trust, with clear accountability for delivery; secondly, that every patient has meaningful access to a specialist named contact with the time and capacity to support them properly; and thirdly, that people living with secondary breast cancer are not left behind when life-extending treatments become available?

Secondary breast cancer is not just a diagnosis. Mothers miss milestones, daughters face uncertain futures, partners become carers and families must live with a clock that they never asked to hear ticking. We do not ask for kind words today, but for action on research, access to treatment, support and giving people more time not just to survive, but to live—because behind every diagnosis is a person who still has dreams, plans and a life worth fighting for.

[Mr Clive Betts (in the Chair)]

Order. We have four Members who want to come in, so I will issue a guideline of nine minutes each for speeches, if Members could stick to that, please.

Health Bill

Mary Kelly Foy Excerpts

2nd reading
Monday 1st June 2026 Commons Chamber

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

The NHS needs reform, not least after years of Conservative underfunding, fragmentation and neglect. I strongly support the Government’s commitment to shifting the NHS from sickness to prevention. As co-chair of the APPG on smoking and health, I was proud to support the landmark Tobacco and Vapes Act 2026, but smoking still remains one of the greatest drivers of ill health and inequality. Prevention must be built into the machinery of the NHS, and that must apply to mental health provision too. My constituency office deals with huge volumes of casework involving people waiting too long for support, families in crisis, and vulnerable people being passed between services.

On the safety and voices of patients, we have seen the devastating consequences of failures in breast cancer care at County Durham and Darlington NHS foundation trust. I pay tribute to the brave women who have spoken out after unimaginable distress. Their experience was in sharp contrast to the excellent cancer care that I received only 12 miles away at a neighbouring hospital. I hope that clause 4 of the Bill addresses the postcode lottery in quality of care.

I think of a husband who lost his wife and two sisters who lost their mam after tragic failings in what should have been routine care. Their fight for justice continues. The Bill must not weaken independent scrutiny or make it harder to raise the alarm when things go wrong.

I briefly raise dentistry; as co-chair of the dentistry and oral health APPG, I know that access to NHS dentistry is one of the clearest examples of where the system is failing constituents. Dentistry is public health, and Ministers must explain how ICBs will be held accountable for NHS dental care.

Finally, on the single patient record, there is real potential for better joined-up care, but patients must have confidence that their information is safe, confidential and used in their interest. That means safeguards on NHS data, including the role of private technology companies such as Palantir, and transparency around access by private providers and consultant partnerships, including limited liability partnerships. The point of reform is not to move boxes around Whitehall; it is to ensure that when people in County Durham and across the country need care, they can access it, trust it and be listened to.

Tobacco and Vapes Bill

Mary Kelly Foy Excerpts

Consideration of Lords amendments
Monday 23rd March 2026 Commons Chamber

[Dr Luke Evans (Hinckley and Bosworth) (Con)]

I welcome the new Minister to her place; she is stepping in and taking the Bill through this stage, like a technical finishing substitute. I, too, have been substituted for my hon. Friend the Member for Sleaford and North Hykeham (Dr Johnson), who spent a huge amount of time going through the Bill in Committee. I place my thanks to her on the record. Because of what she did, I have not had to do it, which has been a relief.

Eradicating smoking among young people is a public health priority. There may be differences in how we would achieve that, but the objective is shared by Members across the House, and we will not divide the House on the Bill tonight. There has been important common ground. As my colleague Lord Kamall said in the other place, smoking is harmful, vaping is less harmful than smoking, and not vaping is better than vaping. I think we can all agree that those principles should guide this legislation.

Those principles underpinned the Bill introduced by the previous Government. Since then, it has expanded, and at times it risks losing focus on its central aim of reducing smoking, particularly among young people. The Opposition have been concerned, for example, about measures that have placed additional burdens on hospitality and retail, and about restrictions on vaping that could undermine its role as a quitting tool for adult smokers. I therefore welcome the changes made in the House of Lords and the Government’s acceptance of them.

Further, the exemption of the adult mental health in-patient setting from the ban on vapes vending machines is a sensible and compassionate decision. Ministers were right to respond to concerns raised by peers, including my colleague Lord Moylan, and mental health charities, and we welcome the changes to clause 12. It is also right that local authorities will be able to retain proceeds from fixed penalty notices to support enforcement under the amendments to clause 39.

However, the Bill marks not the end of the process, but simply the end of the beginning. Key questions remain, including about the regulation of flavours and descriptors, advertising, and the designation of vape-free places. Those decisions will pretty much determine whether the Bill works in practice. It is therefore essential that the Government proceed in a way that is proportionate, enforceable and sustainable. We have already seen the importance of that balance. I welcome the decision to drop proposals to extend restrictions in pub gardens, which would have placed further strain on the hospitality sector. However, Ministers should take note. Restrictions should be targeted at areas where there is a clear and significant risk to public health. Possible considerations include restrictions outside schools and playgrounds, and I gently ask the Minister to reflect that approach as further regulations are developed.

The Lords also strengthened the Secretary of State’s powers in relation to cigarette filters, enabling more effective regulation of components that contribute to environmental harm. In addition, a series of technical amendments were agreed to, aimed at clarifying definitions, improving compliance mechanisms and ensuring that secondary legislation is subject to the appropriate level of parliamentary scrutiny. For example, Lords amendment 1, relating to age verification regulations under clause 1, requires the affirmative procedure to be used, increasing oversight of a core part of the Bill. Those are sensible improvements that reflect the spirit of constructive scrutiny.

A key and central issue raised throughout the passage of the Bill has been the risk of unintended consequences, and particularly the growth of the illicit market. Whether we are for the Bill or against it, one concern unites us all: the black market. If regulation is too restrictive or poorly enforced, it will drive consumers away from the legal market and into illegal supply, which would undermine both public health and enforcement. The Opposition proposed an annual report on illicit tobacco and vaping activity, which the Government rejected. Given the concerns raised throughout the passage of the Bill, I would be grateful if the Minister could set out clearly how the Government will monitor and respond to changes in the illicit market.

We support the broad objectives of the Bill, but we will be watching closely. Its success depends not on its intentions, but on its delivery. When it was first introduced, I spoke about my experience as a junior doctor on a respiratory ward—my first hospital job. I saw patients struggling for breath, families in distress, and moments when, despite everything, there was little more that could be done. The true test of the Bill is simple: in years ahead, fewer families should have to experience the same pain, suffering and despair. Let us hope this works.

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

I declare an interest: I am proud to be the co-chair of the all-party parliamentary group on smoking and health. I am pleased that the Bill has returned from the Lords with minimal amendments. All the amendments before us are either Government amendments or have Government support, so I hope that the Bill can achieve Royal Assent as soon as possible. I understand that the amendments put forward today by the Secretary of State are simply to correct drafting errors, so I assume that they will need only brief consideration by the Lords.

I am proud that the Bill will become law under a Labour Government. I hope that this Government will be remembered as the one that began the end of smoking in this country. In a few decades’ time, I hope that people, particularly young people, will look back on smoking with disbelief, and will say, “Can you believe that selling tobacco, a lethal product, with the aim of getting us hooked, was ever allowed?”

Before coming to this place, I was a councillor in Gateshead council, where I held the public health portfolio from 2009 to 2019, and I chaired the Gateshead Tobacco Alliance. Tackling smoking was a central part of my work during that time, and it continues to be so today, because it remains the single biggest driver of health inequality in communities like mine and across the north-east.

In areas of high deprivation, smoking is not just a public health issue, but a deeply entrenched inequality. It is far more common in disadvantaged communities, where people are more likely to start smoking younger, find it harder to quit, and suffer the worst health outcomes as a result. That means higher rates of cancer, heart disease and respiratory illness, and lives cut tragically short. I have seen that reality at first hand over many years, and it is why action like that set out in the Bill is so important.

We should remember that tobacco is the single most harmful commercial product on sale in the world. It is sold for profit, while killing around two thirds of its long-term users and generating enormous returns for the companies that manufacture it. It is highly addictive, and many who start smoking wish they never had. Over 80,000 people die in this country every year because of it, and if it was introduced today, it is unthinkable that it would ever be permitted.

This Government are right to legislate for a smokefree generation, because there is a fundamental imbalance at the heart of this issue. Companies are making vast profits from a product that drives disease, kills two in three of their customers, deepens inequality and places huge costs on our NHS and wider society. We know how important it is to work towards a truly smokefree future, and to drive smoking rates down to as close to zero as possible.

In the north-east, we have a clear declaration for a smokefree future, endorsed by all directors of public health, our integrated care boards, Fresh, all 12 local councils and all 10 local hospital trusts. That kind of whole-system commitment is vital, not just for improving health but for tackling poverty, supporting a more productive region and preventing the premature loss of loved ones to smoking-related disease. That work is already delivering results. In County Durham, smoking rates have nearly halved over the last decade, reflecting a sustained effort across prevention and support to help people quit. However, rates remain higher in some communities, so we cannot afford to lose focus now.

I am equally pleased about the strong cross-party support for the Bill. We saw that clearly in debates in the other place. The APPG on smoking and health is a great cross-party effort, which I am proud to co-chair with the hon. Member for Harrow East (Bob Blackman).

There is much to welcome in the amendments. In particular, amendment 80, which requires the Government to review the Act, is an important addition that strengthens the Bill. To be clear, it is not a sunset clause, nor is it a test of whether the smokefree generation policy has succeeded in its health aims—the impact assessment makes it clear that we are playing the long game—but rather it will assess how smoothly implementation has progressed and what burdens, if any, have fallen on retailers. I am confident that it will report positively, and that it will encourage other countries to follow our lead. I note that a similar private Member’s Bill is before the French Parliament, which I hope reassures colleagues about the policy’s compatibility with EU law.

--- Later in debate ---

[Mary Glindon (Newcastle upon Tyne East and Wallsend) (Lab)]

I commend my hon. Friend for all her work as part of the APPG on smoking and health and in her former role as a councillor. Does she find it as shocking as I do that four in 10 adult smokers in this country believe vaping to be as harmful or more harmful than smoking, when it is one of the most effective tools to help people quit?

[Mary Kelly Foy]

I totally agree with my hon. Friend. We must keep in mind the fact that it is smoking that causes harm and death, not vaping, which can be a very successful cessation tool. I hope that the Bill will continue to push that.

Powers in the Bill cover marketing, display, packaging and product design, as well as flavours and their descriptions. However, there is a crucial balance to strike: reducing youth appeal without limiting access or effectiveness for those using the products to quit smoking. We must keep the harms of smoking firmly at the forefront of our minds.

A review after four to seven years feels appropriate to assess how the regulations are affecting usage and the market, and whether we are striking the right balance. This should be considered alongside the disposable vape ban and the forthcoming vape excise tax. I would welcome reassurance today that the review will place the harms of smoking and the needs of smokers at its centre.

Many of the other amendments are technical in nature. I welcome the comprehensive definition of tobacco coming into force on Royal Assent, through Lords amendments 89, 90 and 91, as there is no need for a transition period. The exemption for vape-vending machines in Lords amendments 3 and 4 is also welcome, as others have noted, because we must ensure that vulnerable smokers are supported as much as possible to quit.

As my hon. Friend the Member for Washington and Gateshead South (Mrs Hodgson) has recently taken up her role, I welcome her to her position as Minister for Public Health. I look forward to working with her as this Bill, soon to be an Act, progresses, so that we can continue our work, and hopefully set out a road map for a totally smokefree country and to look again at introducing a polluter pays levy.

Finally, as someone who has spent many years advocating for a smokefree future, free of death and disease from tobacco, I know from speaking and listening to many people affected by smoking just how much the public want and need this action. We have already shifted the social norms around smoking and now, thanks to the work of organisations such as Action on Smoking and Health and Fresh, and the work of colleagues across the two Houses, a smokefree future is now possible. That is truly something to celebrate.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I call the Liberal Democrat spokesperson.

Palliative Care

Mary Kelly Foy Excerpts

Thursday 5th March 2026 Commons Chamber

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

Palliative and end-of-life care is one of the clearest tests of a health and care system. It is about whether people can live their final months, weeks or days with dignity, comfort and choice, and whether families are supported, rather than left to cope alone. It should never be a lottery, yet too often people still experience palliative care as something that arrives too late in a crisis and only after families have reached breaking point. Referrals are delayed, honest conversations are postponed and advance care plans are created at the point when somebody is already too unwell to meaningfully shape them. Families describe repeating the same story to multiple professionals, not knowing who to call at 10 pm on a Sunday evening, and watching distress escalate because there is no rapid response available. That is not what a compassionate system looks like.

I will make three substantive points. First, we must confront the reality of variation and fragmentation. Access to specialist palliative care, hospice-at-home services and community nursing support still vary widely between integrated care boards. In some areas, there is a reliable 24/7 advice line and rapid response within hours. In others, support is limited, particularly out of hours, and families are told to ring 111 or attend A&E.

Funding arrangements contribute to that variation. Adult hospices, which provide extraordinary care, still rely heavily on charitable fundraising, alongside NHS funding. The balance differs significantly between areas, which creates instability and inequity. Hospices such as St Cuthbert’s hospice in Durham do remarkable work supporting patients and families across our community, but like many hospices it remains heavily dependent on charitable fundraising. St Cuthbert’s has recently had to make difficult decisions, including on redundancies and reducing dementia services, as funding pressures grow. At the same time, much of the Government’s announced support has been directed towards buildings and capital investment, at a time when hospices and organisations such as Hospice UK have repeatedly warned that the real pressure is on staffing and day-to-day service delivery. If we are serious about reducing health inequalities, we cannot accept such stark differences in something as fundamental as end-of-life care.

Secondly, palliative care is not simply about the last days of life; it is about quality of life from the point of diagnosis of a life-limiting condition. Early specialist input can provide for symptom control, reduce unplanned hospital admissions and help people to make informed choices about where and how they wish to be cared for. That is why I welcome the emphasis in the NHS 10-year plan on shifting care away from hospitals and into the community, because for many people facing serious illness, the most compassionate and effective care is delivered at home or close to home, supported by community teams.

Thirdly, there are practical steps that the Government can and should take. We need a clear, fully articulated national strategy for palliative and end-of-life care, with measurable standards and transparent reporting. Every area should be required to demonstrate that it provides equitable access to specialist advice, rapid response and co-ordinated care planning, so that the ambitions set out in the 10-year plan to strengthen community-based care are genuinely realised for people at the end of life. We should move towards a model where every part of the country has guaranteed 24/7 access to specialist palliative care advice, backed by community capacity to respond quickly when symptoms escalate.

Workforce is central. Generalist staff in primary care, acute hospitals, community services and social care must feel confident in recognising when someone is deteriorating, in managing pain and other distressing symptoms, and in initiating compassionate conversations. That requires investment, training and protected time, not simply guidance on paper. We must also recognise that hospice and social care services rely on the contributions of migrant workers. Recent changes to visa rules and the right to remain are making recruitment and retention even more difficult, at a time when these services are already under immense pressure.

We must not forget the strain on hospice care for children, as the right hon. Member for New Forest East (Sir Julian Lewis) said. Provision in this area remains uneven, and the stakes are extraordinarily high. Recent campaigning on Hugh’s law has also highlighted the importance of ensuring that families caring for seriously ill children are properly supported and not left navigating complicated systems while dealing with unimaginable circumstances.

Debates on assisted dying are now taking place in this Parliament. I am clear in my opposition to that proposal. I believe that the foundation of a compassionate society must be strong, universal access to high-quality palliative care and end-of-life care. When people are properly supported, when pain is managed, when families are helped and when the highest standard of care is available close to home, the fear and desperation that often drive these debates are significantly reduced. If assisted dying were to become available on the NHS, it would raise important questions that are already being asked by professionals in palliative care and across the health system about our priorities for healthcare. Access to compassionate and properly resourced end-of-life care should never become the secondary option. I ask the Minister to set out how the Government will reduce the postcode variation, strengthen community and out-of-hours provision, provide stable funding frameworks—particularly for hospices—and ensure that workforce development is prioritised.

This is not an abstract policy area. It is about whether, at the most vulnerable point in someone’s life, the system is fragmented and reactive or calm, co-ordinated and compassionate. We owe it to patients and their families to get this right.

Defibrillators

Mary Kelly Foy Excerpts

Tuesday 2nd September 2025 Westminster Hall

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

I thank my colleague and neighbour, my hon. Friend the Member for Bishop Auckland (Sam Rushworth), for securing this important debate.

Nearly half the postcodes in my constituency are not within easy reach of a defibrillator. That is not just a statistic, as we have heard; it is the difference between life and death. We know that when a defibrillator is used within three to five minutes of cardiac arrest, survival chances rise from just 8% to more than 70%, yet too often communities in Durham are left without timely access. This inequality is compounded by cost. Community groups, sports clubs and small businesses fundraising for devices face average VAT bills of £500 per defib. That is an unnecessary barrier to saving lives, so I join colleagues in urging the Government to look at abolishing the so-called heart restart tax.

One organisation that has done magnificent work in helping to get defibs into key locations across our region is Rotary North East, which has installed more than 100, including in Durham city centre. The work it does, particularly the work of my constituent Tom Sharples, has genuinely saved lives in the north east. Not only has Tom worked to roll out defibs across the region, in conjunction with our brilliant police community support officers for Brandon and Brancepeth, Paul and Dan, but he has invested his time in delivering training sessions for young people in those communities.

Following the harrowing scenes during the 2020 Euros, when Christian Eriksen suffered a cardiac arrest on the pitch, I became determined to improve lifesaving equipment. I supported the roll-out of CPR training for young people across my constituency.

In 2021, I led a campaign that helped bring about a change in Football Association policy. Since then, all new FA-funded facilities must have a defibrillator as standard. That was an important step forward, but it is only part of the solution. Every day, 80 to 90 people die from cardiac arrest outside hospital, and many of those lives could have been saved. Wider availability of defibs would save lives, reduce pressure on our ambulance service and prevent the devastating long-term impact of brain injury and loss that follows so many of these cases. I urge the Government to act to close the defibrillator gap, end the postcode lottery and give every community, including mine in the City of Durham, the fair access that they deserve.

Tobacco and Vapes Bill

Mary Kelly Foy Excerpts

Report stage & 3rd reading
Wednesday 26th March 2025 Commons Chamber

[Helen Morgan (North Shropshire) (LD)]

I thank the Minister for her opening remarks and add my broad support for the improvements that the Government have made to the Bill. I will restrict my comments mainly to amendments 1 and 2, which have been tabled in my name and the names of my hon. Friends the Members for Winchester (Dr Chambers), for Eastleigh (Liz Jarvis), for Chichester (Jess Brown-Fuller) and for Mid Sussex (Alison Bennett). I will also comment on new clause 1, tabled by my hon. Friend the Member for Bath (Wera Hobhouse), to which I have added my name.

Amendments 1 and 2 would direct the moneys raised from fixed penalty notices to public health initiatives chosen by the relevant local authority. The Liberal Democrats agree with the Secretary of State and the Government that prevention is better than sickness and cure, and that public health initiatives are crucial in making those key shifts in healthcare that we all hope to achieve. The Secretary of State hopes to create a smokefree generation for those born after 1 January 2009, but there will be existing smokers who may well wish to stop, and who may need help from a public health initiative or a smoking cessation programme to do so. The Conservatives cut public health budgets by a quarter since 2015, meaning that fewer people have had help to quit. That is not what anybody hopes to achieve through this legislation or, more broadly, the reforms to the NHS.

Research by University College London showed that in parts of England, smoking rates have begun to rise again, and they have been flatlining as a whole since 2020. Between 2020 and 2024, the rates rose by 10% in southern England and fell by 9.7% in the north. Overall, an estimated 7.5 million adults in England are smokers. UCL concluded that the disparity between north and south reflected the concentration of dedicated tobacco control programmes in northern regions and their positive impact, and their relative absence in the south. As the shadow Minister, the hon. Member for Sleaford and North Hykeham (Dr Johnson), mentioned, there is also evidence of significant black market activity in the United Kingdom. Cessation activities have therefore become even more important to deprive the criminal gangs involved of funds, and to ensure that people are free of their grip. Given the impact of public health initiatives, I sincerely urge the Government to accept Liberal Democrat amendment 1, and consequential amendment 2, which are in line with the Government’s objectives, and would improve health and save taxpayers money in the long run.

Amendment 84, which is also in my name, is very similar to the Opposition’s amendment 85. It would restrict the ability of the Secretary of State to unreasonably designate a place as a smokefree area. If they do not mind me saying so, the Conservatives have been a bit sloppy in drafting their amendment, because they have managed to remove protections in existing law for areas where there is a significant risk of second-hand smoke in smokefree areas. The Liberal Democrats’ amendment 84 has an added safeguard: if the chief scientific officer—that is not easy for me to say—advises that there is a significant risk of second-hand smoke, an area can be designated as smokefree. The amendment also retains mention of the areas that the Secretary of State has indicated that he will designate as smokefree, including NHS premises, schools, educational establishments and children’s playgrounds.

The Secretary of State has indicated that he will not designate other areas as smokefree, particularly if it would have a detrimental impact on our already struggling hospitality industry and much-loved village pubs. We take him at his word on that commitment, but I hope that the Minister can imagine a future in which a different Secretary of State is less inclined to honour a promise made by someone else at the Dispatch Box. It is right and in good order that in that scenario, Parliament should get a vote on the change of heart. I urge the Government to consider this amendment carefully and ensure that the legislation matches the promises made at the Dispatch Box.

New clause 1, which I have also added my name to, would require the Secretary of State to review and report back on the presence of contaminated vapes, and to find ways to reduce their prevalence. My hon. Friend the Member for Bath has campaigned on this issue following findings by the University of Bath that one in six vapes in English schools contained the drug Spice, which can have serious side effects in children, including cardiac arrest. It seems reasonable that the Department of Health and Social Care and the Secretary of State should try to find a way of addressing that issue.

I intend to push amendments 1 and 2 to a vote to ensure that there is additional funding for public health measures. I very much hope that hon. and right hon. Members will support me in this common-sense move to improve public health.

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

I begin by declaring an interest as the co-chair of the all-party parliamentary group on smoking and health. I will speak to my amendments and one or two others.

The Tobacco and Vapes Bill is world-leading health legislation that will create the first smokefree generation, protecting children and young people from the harms of smoking. In the City of Durham alone, some 5,500 children start smoking each year. Most of them will go on to wish that they had never started. This Bill will end that. It will stop the start and ensure that every child has a smokefree future. Recent data from UCL has shown that the rates of smoking are falling fastest in the north-east. This can at least partly be attributed to hard work and amazing regional programmes such as Fresh, which works so hard to tackle inequalities in our region. The same data also shows that progress is not guaranteed; in some areas, smoking rates appear to be increasing. The case for action is clear.

New clause 13, in my name, would put a duty on the Secretary of State to publish a road map to a smokefree country every five years. It was a Labour Government who introduced the first-ever smoking strategy in 1998, “Smoking Kills”. It is 2025, and smoking still kills. This world-leading Bill is to be celebrated for many reasons, but the rising age of sale will not impact the 6 million people who are currently smoking in the UK. Smoking is not spread equally across our society; the most affluent 10% are set to become smokefree this year. However, at the current rate, the most deprived will not achieve that until 2050. It is vital that the Government ensure that no one is left behind as we create a smokefree future. Having a clear plan for achieving that, and targets for reducing smoking not only for the whole population, but for pregnant women, those struggling with their mental health and those in occupations with high rates of smoking, will save lives. Will the Minister meet the all-party parliamentary group following the publication of our report to discuss how we can turbocharge reductions in smoking and create the smokefree generation?

New clause 19, tabled by the Conservatives, would require the Secretary of State to publish reports on the illicit market. Let us be clear that His Majesty’s Revenue and Customs already publishes annual data with a detailed analysis of the illicit market, so it is difficult to see what the Department of Health and Social Care could do in addition. There are no additional data sources available that would yield any different results.

Finally, amendments 82 and 83 would remove the exemption for performers. Since 2007, it has been against the law to smoke inside. However, that does not apply to actors smoking in performances for artistic reasons. There is a play on in London’s west end that tells the story of the American oil lobbyist and master strategist Don Pearlman. Don Pearlman was a heavy smoker who died from complications arising from lung cancer. The actor playing the lead role smokes on stage. The exemption should be removed, because actors deserve to have their health protected at work as much as everyone else. Audiences and other actors also deserve to be protected from second-hand smoke. Performances at the National Theatre already require that smoking in performances be substituted for vaping or other alternatives. There is no reason why all performances should not follow suit.

Amendments 85 and 86 deal with smokefree extensions. I know that there will be further consultation and debate on the regulations creating extensions to smokefree places and vape-free areas, but can the Minister confirm that there will be exemptions if it is shown that the use of vapes in certain settings aids smoking cessation efforts? I am thinking of, for example, mental health settings. The Mental Health and Smoking Partnership has pointed out that vapes are a valuable tool in such settings to help patients quit. Will the Minister undertake to visit a mental health trust to hear directly about people’s experiences? It is vital that we all work with trusts to provide clear guidance on how to navigate these changes. Particular attention must be paid to how the policies in the Bill, and those that will come into effect after it, such as the disposable vapes ban in June, will interact with each other.

Today’s funding announcement is welcome, but we have gone down to the wire, given that the funding was due to end at the end of this month. Can we be reassured that, following the spending review, services can expect consistent, long-term funding that will allow them to plan their activities and hire staff on longer contracts?

The Bill presents us with a historic opportunity to transform public health in this country, and, after working tirelessly on it for more than a decade, I am proud to support it. However, we must remain vigilant to ensure that no one is left behind. All aspects of the Bill, from the smoking cessation measures to protections for workers in the arts, must be fully realised if we are to create a truly smokefree generation.

[Dame Caroline Dinenage (Gosport) (Con)]

I think you may agree, Madam Deputy Speaker, that the longer we spend in this job, the more we realise that almost nothing is ever straightforward. Even the best intentions nearly always have unintended consequences, and there is absolutely no doubt that smoking, and specifically smoking tobacco, has done untold damage in my constituency and continues to do so. The health of my constituents has suffered as a result of the well-documented effects of regular smoking, and, moreover, smoking is a driver of social and economic inequality. Smokers earn, on average, 7% less than non-smokers. I could not believe that statistic when I first read it, but when I thought about it, I realised that it made complete sense. Those who take more time off work because of the inevitable ill-health effects of smoking, those who spend more of their disposable income on tobacco, and those who develop a dependency on a drug such as nicotine will obviously experience, over time, an impact on their earnings. Smoking is like an extra tax on the most disadvantaged communities, and I can see why this Government have maintained the last Government’s ambition to phase it out.

Tobacco and Vapes Bill (Fifteenth sitting)

Mary Kelly Foy Excerpts

Committee stage
Thursday 30th January 2025 Public Bill Committees

[Andrew Gwynne]

Clause 160 and schedule 21 provide further general consequential amendments relating to this Bill. The specific amendments to existing legislation are set out in the schedule. Those amendments help the provisions in the Bill to function effectively within the existing legislative framework. This is a standard supplementary clause that enables the legislation to function as intended following the Bill’s introduction.

The shadow Minister refers to different aspects of legislation. Many of the clauses that we have already debated bring together existing tobacco control legislation in one place, so the consequential powers that we are seeking through this clause will make sure that the existing legislation set out in the schedule will be amended, to ensure the smooth running of the legislation. I therefore commend the clause and schedule to the Committee.

Question put and agreed to.

Clause 160 accordingly ordered to stand part of the Bill.

Schedule 21 agreed to.

New Clause 2

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).”—(Mary Kelly Foy.)

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.

Brought up, and read the First time.

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

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

I will not be pushing this new clause to a vote; nevertheless, I think it is a policy that the Minister should take into consideration. New clause 2 would require the Secretary of State for Health and Social Care to consult on a “polluter pays” levy. The Minister will know that I and members of the all-party parliamentary group on smoking and health have campaigned for this for some time. It was also recommended in the Khan review in 2022 and, more recently, by the Institute for Public Policy Research’s commission on health and prosperity.

Action on Smoking and Health estimates that smoking costs England more than £43 billion a year. That is more than £27 billion in productivity costs, nearly £14 billion in social care costs and more than £1.8 billion in NHS costs—and much more. A “polluter pays” levy on tobacco manufacturers could raise around £700 million a year, with that money coming from tobacco companies’ profits, not raised from consumers.

A levy of this kind would provide sustainable funding for tobacco control and could be given to organisations such as Fresh, the tobacco control programme in the north-east, which does such vital work in ensuring that no one gets left behind as we move to a smoke-free future. In fact, all the Government’s programmes on tobacco, including mass media campaigns, incentives for pregnant women and support for smokers with mental health problems, could be funded many times over, with cash to spare that could go to other public health initiatives.

This would be subject to consultation, but the model proposed by Action on Smoking and Health would cap the wholesale price of tobacco, similarly to how we cap the prices of essential utilities and hence limit profits. The big four tobacco companies account for 95% of UK sales and make excessive profits selling a highly addictive product that kills two in three long-term users when used as intended by the manufacturer. Tobacco manufacturers make an estimated £900 million in profit per year in the UK, with an average net operating profit margin of about 50%. For context, the average profit margin for UK manufacturing is 10%.

There is widespread public support for this measure: 79% of adults in Great Britain would support a levy on the tobacco industry, with only 5% opposed. I hope the Government will seriously consider this, because it would complement the intentions of the Bill.

[Dr Johnson]

I am interested by this new clause. Tax is applied to some products that the Government would like us to consume less of, to make them more expensive so that we consume less of them, and that has been the case with tobacco for some time.

Looking at the current levels of tobacco duty, we see that tax on cigarettes is 16.5% of the retail price of £6.69 for a pack of 20, which is quite a substantial proportion of the cost. Cigars are taxed at £4.17 on a 10 gram cigar, and there is 14.3% tax on a £30 packet of hand-rolling tobacco.

The Government introduced an escalator for further increases in tobacco taxation in their autumn Budget. In addition, they have introduced a tax on vaping products, which will help to take them out of the reach of pocket money. Personally, I have been quite concerned about the fact that vaping products are so cheap that children can easily buy a vape with pocket money, and if they are potentially about to get caught, they can discard it without worrying and then buy another one. A tax on vaping products is, therefore, a welcome initiative.

However, as I understand it, the Government make £8.8 billion per year from tobacco taxation—I am sure the Minister will correct me if that figure is wrong—and it is in the gift of the Chancellor to increase these taxes if she wants to. She is quite good at increasing taxes, so I am sure she knows that that is the case.

As I understand it, the hon. Member for City of Durham proposes that the tax on these products should automatically go towards improving the health—including the public health—of the nation, as opposed to going into general funds. In practice, the Government are already free to spend the money that they receive from tobacco and vape taxation on the health service. They certainly already spend more on the health service than they receive in tobacco taxes. It is a choice. To govern is to choose, and they are choosing how they wish to spend the taxes they raise.

The new clause proposes

“limiting the profits which may accrue to any producer or importer”.

Presumably, that would require some sort of open-book system, and I am not quite sure how the hon. Lady thinks that would work. This level of regulation of the market would require quite detailed open-book working. Perhaps she would like to explain why she thinks that is necessary, when the Government already have in their remit the levers of taxation specifically for these products.

[Mary Kelly Foy]

The difference is that the tax would not come from the consumers. This would be a tax on the big four tobacco companies, rather than raising taxes from consumers. We know that consumers of these products are already likely to come from deprived backgrounds. In addition to raising revenue, the measure would allow us to impose much tighter controls on the prices of tobacco products. That would disincentivise the tobacco industry from creating so much profit from their products.

Although the Chancellor can use taxes for whatever purpose, this measure would be a tax on those companies whose product, as we know, kills one in two of the people who use it. Just raising taxes in the way that the hon. Lady describes would be an extra burden on the consumers who we are trying to help quit tobacco.

[Dr Johnson]

I thank the hon. Lady for her explanation, which was really helpful. I am grateful that she, as a Labour MP, understands that a tax on business will be passed on to the consumer, because it seems that the Chancellor does not. Perhaps the hon. Lady should apply for a new job.

The hon. Lady is right that if taxes are applied to a business, the business will pass them on to the consumer. The only way to avoid that is through price control. Nevertheless, I do not think that makes price control a desirable thing for the Government to interfere with. That level of regulation would go too far, and other measures in the Bill already seek to restrict and disincentivise smoking in so many different ways. I hope that they will be effective and that there will be no need for such onerous regulation.

--- Later in debate ---

As the Minister has often said, tobacco sales are declining, so perhaps the new clause would not be as effective as it needs to be in the long term, although I see the principle behind it. I am also concerned that if we put on caps or try to close down the market, we may end up with poorer quality, illicit-market tobacco. I am trying to think about the wider implications. Perhaps the hon. Lady wants to say something further in that regard.

[Mary Kelly Foy]

The new clause would be a game changer. One of the questions was whether the measure might later be applied to other areas—I presume that the hon. Member means taxing the big alcohol and gambling companies—but tobacco is a uniquely lethal and addictive product, so in this case the intervention is justified. She makes a good and compelling point, but I think the Government’s overall health strategy is to shift from sickness to prevention, which will require looking at all habits and supporting people to live healthier lives in healthy environments.

[Dr Johnson]

I have been listening carefully to the hon. Lady. Does she have a price for tobacco products in mind? Governments of different colours have increased tobacco duty a bit at a time, presumably to nudge behaviour. If we do not increase it enough, we do not have the desired effect, but if we increase it too much and too fast, we potentially drive people into illicit-market tobacco. We heard from the chief medical officer about the difficulties people have in giving up cigarettes because of the profoundly addictive nature of nicotine, so if we were to increase the prices too quickly, we could end up making life difficult for people who are poor and addicted to nicotine, without the necessary support in place. If the prices are going to go up to somewhere in the middle, how is that different from taxation?

[Mary Kelly Foy]

The new clause asks for a consultation, so a lot of issues would need to be worked through with the Chancellor. However, the tobacco companies make exorbitant profits from a product that kills the folk to they sell it to, so I am sure that the shadow Minister would agree that that means we should use some of their profits to pay for the damage being done.

[Dr Johnson]

I certainly agree that it is immoral to sell products that they know are addictive, are dangerous and kill people.

[Andrew Gwynne]

I am grateful to my hon. Friend the Member for City of Durham for tabling the new clause, because it allows us to have a debate about a really important matter. As has been discussed, the new clause would require the Secretary of State for Health and Social Care to consult and report on a scheme to regulate and to raise funds from the prices and profits of tobacco manufacturers and importers.

Duty on tobacco raises around £8.8 billion a year. The Government’s preferred approach is to continue with a proven and effective model of dealing with tobacco products through increases in tobacco excise and through duties. This generates finances that can support a full range of public services, including public health and the NHS, as well as smoking cessation services. We believe the proposed scheme would be complex to implement and might take several years to materialise.

Alongside the Bill, we are taking strong action to reduce the affordability of tobacco, which is an effective measure to trigger smoking cessation. The United Kingdom already has some of the highest tobacco taxes in the world. The World Health Organisation recommends that total taxes on tobacco are at least 75% of the retail price on typical cigarettes. The United Kingdom comfortably meets this target, with taxes at around 80% of selling price.

As announced at the autumn Budget 2024, duty rates on all tobacco products were increased in line with the tobacco duty escalator by 2% above retail price index inflation. The duty rate on hand-rolling tobacco was increased by a third of 10%, to 12% above RPI inflation, to reduce the gap with duty on cigarettes. Those changes came into effect on 30 October 2024.

Cigarettes are also subject to minimum excise tax, which sets a minimum amount of duty collected on a pack of cigarettes. That discourages manufacturers from selling cheap cigarettes, as it reduces the profitability of cigarettes sold at or below minimum excise tax trigger prices. The new minimum excise tax is £8.93 for a pack of 20, and it applies to cigarettes sold at or below £13.59 for a pack of 20.

We are still going further on tobacco tax. As announced in the autumn Budget, there will be an additional one-off increase for all tobacco duties. That will come into force on 1 October 2026, when the vaping duty comes into effect. From a financial perspective, that will maintain the incentive for smokers to switch to vaping once the new excise duty on vaping products comes into force.

On one last technical note, His Majesty’s Treasury can consult on tobacco taxation and fiscal policy at any time, so that does not need to be set out in the Bill. For those reasons, I ask my hon. Friend the Member for City of Durham to withdraw her new clause.

[Mary Kelly Foy]

I beg to ask leave to withdraw the motion.

Clause, by leave, withdrawn.

New Clause 4

Ban on supply of 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 6 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.”—(Dr Caroline Johnson.)

This new clause requires the Secretary of State to make regulations 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.

Brought up, and read the First time.

[Dr Johnson]

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

I am sorry that the hon. Member for Dartford is not here to discuss his important new clause 4, which is about a ban on cigarette filters. I asked the Minister why cigarette filters were not included in clause 1, along with cigarette papers and tobacco products. Cigarette filters have a health effect, but it is not necessarily the effect that most people think. Filters were first introduced in the 1950s in response to mounting scientific evidence highlighting the dangers of smoking. The tobacco industry seized upon the opportunity to present the filter as a way to make cigarettes safer. It claimed that they reduced the inhalation of harmful substances such as nicotine, tar and other toxicants.

The early filters were made of cork, which is the origin of the cork pattern that can still be seen on many cigarettes. By the end of the 1950s, sales of cigarettes with filters had surged to more than 40% of the market, and by 1965, more than 60% of cigarettes were manufactured with filters. Alongside that shift, the marketing of light and mild cigarettes with ventilated filters further enhanced the illusion—and it is an illusion—of reduced harm, making smoking appear to customers more palatable, and to some extent reducing customer awareness of the risks involved.

There were some early studies that appeared to support the tobacco industry’s claims. Filter tip cigarettes at that time were thought to be associated with lower rates of lung cancer and mortality, compared with their unfiltered counterparts. However, when comprehensive and rigorous studies were completed over time, the initial findings were disproven. Subsequent epidemiological data revealed that both ventilated and non-ventilated filter tip cigarettes were just as harmful as unfiltered cigarettes. In fact, the incidence of lung adenocarcinoma—a type of lung cancer that has increasingly replaced the more prevalent squamous cell carcinoma—has risen significantly in recent decades. The rise in adenocarcinomas is believed to be linked to the use of ventilated filters, as they affect smoking behaviour and the combustion of the product.

One of the key reasons why filter tip cigarettes fail to reduce the risk of lung cancer and other diseases is the changes they cause in smoking behaviour. When cigarette filters were introduced, they altered the way people smoked. For example, smokers began taking longer and deeper puffs, increasing their exposure to harmful chemicals in the smoke. Such behaviours may have upset the potential benefits that some individuals thought filters might have in reducing the toxic smoke inhaled.

The presence of a filter, especially those with ventilation, changed the combustion of the cigarette itself. That led to a greater exposure in smokers to tobacco-specific nitrosamines, which are potent carcinogens and a major contributor to lung cancer. The filtering process did not remove those harmful substances, and in some cases may even have enhanced their presence in the smoke that smokers inhaled.

Another concerning aspect of modern cigarette filters is the material from which they are made. The most common material used is cellulose acetate—a synthetic plastic that, when inhaled, can contribute to respiratory issues. The fibres and microplastics from filters can embed in the lungs, potentially leading to long-term damage. Although that material can be effective in filtering out some particles, it does not remove gases of low molecular weight, such as carbon monoxide, which are also harmful to health.

Despite cigarette filters being marketed as a safer option, their widespread use over the past 60 years has had little effect on reducing the health risk of smoking. In fact, it may have contributed to a decrease in public awareness about the dangers of smoking, and may have led to more people becoming addicted to smoking without fully understanding the risks involved.

I note that new clause 4 suggests that the Environmental Protection Act 1990 should be used to ban the supply of cigarette filters, because they have a significant environmental impact. Roughly 4.5 trillion cigarette filters are disposed of annually, making them the most littered man-made waste item in the world and accounting for roughly a third of all litter found in coastal and urban clean-ups. Despite their small size, the sheer volume of discarded cigarette butts would fill almost 50,000 shipping containers every single year, and that is expected to increase by 50% in 2025.

Tobacco and Vapes Bill (Sixteenth sitting)

Mary Kelly Foy Excerpts

Committee stage
Thursday 30th January 2025 Public Bill Committees

[Andrew Gwynne]

This is a remarkable moment in parliamentary history, because we have got the Tobacco and Vapes Bill through Committee. I thank you, Mr Pritchard, as well as Sir Roger, Sir Mark and Mr Dowd, for your diligent chairing. Please pass on the whole Committee’s appreciation for the way in which you have kept us going throughout.

I thank all Members on both sides of the Committee for the role that they have played, particularly as many are new Members. It has been a baptism of fire for some of them, but I hope that they have found the experience of amending, scrutinising and debating a really important piece of legislation to be of benefit. New Members should be assured that their Whips have already noted that this will be their first Committee of many.

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

I wonder whether the Minister will allow me to indulge in a history lesson of my own, as that seems to have been the order of the day for most of the Committee’s sitting days. While I am overjoyed that the Bill is one step closer to becoming law, I must make the Committee aware of a previous smoking ban introduced in the 16th century by Pope Urban VII. During his short period as pope—it lasted 13 days—he went like the clappers to bring in a smoking ban, before he snuffed it. That ban was taken further by Pope Urban VIII, who banned snuff and threatened to excommunicate anyone smoking it, chewing it or sniffing it in or anywhere near a church. I only wish that the hon. Member for Windsor was in his place to realise that the Bill is positively liberal compared to the papal bulls of those popes.

[The Chair]

May I say that that was completely within scope? [Laughter.]

Tobacco and Vapes Bill (Thirteenth sitting)

Mary Kelly Foy Excerpts

Committee stage
Tuesday 28th January 2025 Public Bill Committees

[The Chair]

Mary Kelly Foy, did you want to speak?

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

indicated dissent.

[The Chair]

No. Okay. That is fantastic. No problem. [Interruption.] I mean it is fantastic and we can hear you on another clause or amendment, just to be clear.

Amendment, by leave, withdrawn.

Tobacco and Vapes Bill (Fourteenth sitting)

Mary Kelly Foy Excerpts

Committee stage
Tuesday 28th January 2025 Public Bill Committees

[Andrew Gwynne]

I certainly do not think the hon. Gentleman is putting pernickety arguments, as he put it. They are important points. He and the shadow Minister are allowing me to provide clarification, hopefully, on some of the concerns, which I would argue are unfounded, and to clarify the extent to which the powers in the Bill would be used by Ministers in England. Of course, it is for my counterparts in Scotland, Wales and Northern Ireland to clarify at future stages how they would seek to use the powers that the Bill confers on them.

As we have discussed at length, the fact that the powers are so broad means that we can respond to evolving evidence at a later stage, particularly when there are clear harms to children and vulnerable people. It allows us then to get on and make the necessary changes. That is consistent with the Bill as a whole, which gives us the legal framework for tobacco control and measures on vapes.

The shadow Minister mentioned hospitals. She is right to point to the evidence we heard on the first day of Committee about compliance with the existing measures in Wales. Ministers in the Department of Health and Social Care are rightly concerned about that in England. We are engaging with counterparts in Wales to understand what worked, what did not work and how we can mitigate the things that are not working as well as they could be when we consult on the measures that we wish to introduce in England, should the Bill get Royal Assent.

The answers to that and other questions about what a children’s playground is and what areas around a hospital would apply are down to the details that will be presented for consultation when His Majesty’s Government advance the proposals on outdoor spaces in England. The right place for us to have that discussion is when I bring forward the consultation and say, “This is what the Government consider to be the scope of children’s playgrounds, the scope of outside a school and the scope of outside a hospital setting.” We can debate whether those are the right or wrong definitions. We can put it out to consultation. We can draw on the experiences of other parts of the United Kingdom that already have measures in place. We can then refine our proposals if need be and introduce the secondary legislation.

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

I totally agree that we need a consultation—that is the beauty of gauging the public interest—but the issue around smoking in public places, and particularly play yards, is about not just second-hand smoke, but de-normalising exposure to smoking. The less that our children see adults smoking, the less chance they will have of thinking it is normal and becoming addicted. We need a comprehensive package to bring in the future smoke-free policy. We have evidence to show that the public, in the main, are in favour of a smoke-free generation, and I am sure that they would police the ban around playgrounds when there are children there. If people are not meant to smoke there, the issue will be policed—possibly by the public.

[Andrew Gwynne]

My hon. Friend, who has done so much work in this area over such a long period of time, is absolutely right. I will come to some of the enforcement arguments. Our primary aim is to tackle passive second-hand smoking, but it is important that smoking is not so obviously prevalent in areas where children are present —for example, around children’s playgrounds and outside schools. It is not just that the issue of second-hand passive smoking is important—although it is—it is about the clear statement that smoking around children really should be something for the history books. That is why we have removed the public health test from the 2006 Act. Children’s playgrounds probably would not fall within the scope of that test, but it is a clear priority of the Government to remove the prevalence of smoking around children.