Woman and Equality: North of England

Mary Kelly Foy Excerpts

Tuesday 5th November 2024 Westminster Hall

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

I beg to move,

That this House has considered inequalities faced by women in the north of England.

It is a pleasure to serve under your chairmanship, Sirusb Christopher. This debate is about the “Woman of the North” report, published in September 2024 by Health Equity North. I thank Health Equity North for the report and for their support for today’s debate, as well as all those who contributed to that vital research.

Women in the north of England face unequal challenges and inequalities in their lives and their health, compared with the rest of the country. They are more likely to work more hours for less pay and be in worse health. They are also more likely to be an unpaid carer, live in poverty and have fewer qualifications. In fact, the inequality between women living in the north of England and those in the rest of the country has grown over the past decade. It has harmed women’s quality of life and work and harmed their communities and families.

Today, I am going to debate the key findings of the research and highlight the report’s recommendations. The report does not make for easy reading. Even though the Minister, like me, will be all too aware of the impact of austerity on our communities, many of the findings will, I am sure, come as a shock, as they did for me.

I will not be able to cover everything, but I hope the debate will begin a dialogue between the Department and the contributors to this important research.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Lady for bringing this issue forward. First, there is an anomaly—there are two and a half times more self-employed men than women, with jobs and opportunities. Women have the skills and the talent, but one of the things that holds them back is childcare. It does not matter where someone is in this great United Kingdom of Great Britain and Northern Ireland: if they do not have childcare, they have nothing—they cannot get the opportunities. Last week on the TV it said that the cost of childcare for some families is as much as the mortgage. That is a massive issue.

[Mary Kelly Foy]

I could not agree more. That is why I am pleased that the Labour Government will be bringing in thousands of new nursery places and breakfast clubs, which will hopefully alleviate some of the problems of childcare. I know that childcare is an issue not just in the north of England but also in the north of Ireland.

I shall begin with employment. Employment rates for women in the north are lower than the national average of 72.2%. In my region, the north-east, the rate is just under 70%; in Yorkshire and the Humber, it is just over 70%; and in the Minister’s region, the north-west, it is just over 71%.

Disability and long-term sickness is a major issue in the north. All northern regions have levels of disability and long-term sickness higher than the national average, and considerably higher than the south-east. The report states that the resulting estimated economic cost is around £0.4 billion per annum. Compounding that is the fact that the median weekly wage for women in the north is below the national average for both full-time and part-time employment. For instance, the average weekly wage for a full-time working woman in the north-east is £569. That is much lower than the national average of £625 and considerably lower than the average weekly wage for women in London, £757. Overall, women in the north could be losing out on around £132 million a week.

In terms of education, the number of women without qualifications is higher in the north than it is in the south and the south-east. That leads to the next point about women and poverty—an issue that is worth its own debate. A higher percentage of families in the north are on universal credit than in regions in the south. In fact, the average number of families on universal credit across the north is 3% higher than in the south. The figure is even higher if London is excluded.

All 12 local authorities in the north-east have rates of absolute child poverty above the English average. By contrast, all 30 local authorities in the south-west have rates of absolute child poverty below the English average.

The north is also the region of unpaid care, with 12% of women in the north-east providing it—just under 2% higher than the national average. Health Equity North estimates that women in the north are providing around £10 billion a year in unpaid care. Harrowingly, it also estimates that, in the last decade, the life expectancy of girls born in the north of England has begun to stall and in some cases decrease. In addition, girls born in the north will not live as long in good health compared with the national average. For older women, menopause is often cited as a potential driver of change in women’s health, which makes it all the more concerning that there are regional differences in levels of hormone replacement therapy, with lower levels of HRT being prescribed in the north of England.

The picture is even more bleak when we consider pregnancy and reproductive health. We have seen the biggest increase in abortion rates between 2012 and 2021, and there has been a demonstrable relationship between austerity, the implementation of the Tory two-child limit and the increased rate of abortions. I should also add that the two-child limit itself affects over a million children in the country, and it impacts over 60,000 babies, children and young people in the north-east alone. Right now, over 25% of pregnant women in the north of England are living in the most deprived 10% of areas, with 40% of pregnant women living in the top 20% most destitute areas. Tragically, stillbirths are the highest in the most deprived communities, and highest among black African and Caribbean women living in the areas of greatest deprivation. Also, women living in poverty are at increased risk of death and depression. Subsequently, babies are at a higher risk of stillbirth, neonatal death, pre-term delivery and low birth weight.

The report also refers to smoking and pregnancy; I am glad to see that the Tobacco and Vapes Bill will receive its First Reading today. It would be good to hear from the Minister whether the Government will continue to fund the financial incentives scheme for pregnant smokers.

Women in the north of England have the highest rates of domestic violence abuse in the country, which is something that many children are exposed to. That also deserves its own debate. When we consider mental health, the report highlights that, in a cohort of over a million women aged between 16 and 65, from 2005 to 2018, the prevalence of mental illness was higher in three northern regions compared with the south of England. With severe mental illnesses, such as bipolar disorder and schizophrenia, the north-west and the north have higher prevalence rates. Lastly, the report covers the reality of marginalised women in the north, which includes a range of areas, from criminal justice to education and health, as well as issues related to homelessness and substance abuse. I do not have time to go into each point, but I encourage the Minister to read that section if he has not already, and I will either write to him about those issues or table parliamentary questions.

The report’s recommendations are spread across multiple departmental areas, so the Minister may want to follow up in writing if he prefers. One key recommendation of the “Woman of the North” report is that central Government should deliver a national health inequalities strategy—one that convenes Government Departments from across Whitehall to put health at the heart of all policies to address the wider determinants of health. Many of the policies announced in the Budget, as well as the Employment Rights Bill, will be welcome, such as uprating universal credit in line with inflation and tackling zero-hours contracts. Of course, we wait in anticipation for the child poverty taskforce strategy next year, and I sincerely hope that we will see an end to the Tory two-child limit. In addition, the report recommends that the Treasury should consider targeted support for pregnant women, as well as improving childcare. When it comes to local and regional government, which I know the Minister has experience in, the report suggests targeted support delivered to 11 to 18-year-olds through careers hubs in the areas of greatest deprivation and a higher level of the adult education budget for the north. Greater support is also required for women navigating the social security system and for social security uptake, and for women to transition back to their families and integrate into their communities after involvement in the criminal justice system.

Finally, with health and social care, NHS England could provide additional support and investment for women’s health hubs, and health services should be supported to collect routine data on ethnicity and other key demographic data. That would help deliver better information for service development and improve our understanding of different health needs. It would also explore the ways in which the services’ work can be adapted to address health inequalities across different population groups, with examples including providing cultural sensitivity training, adopting a trauma-informed approach to care and promoting person-centred approaches.

I have been an MP since 2019 and have spoken about health inequalities ever since I was elected. Today’s debate is not pleasant, but I am genuinely hopeful that we can turn a page under a Labour Government. We have already seen positive measures, such as those in the Employment Rights Bill and the Budget. I look forward to the Minister’s reply and hope to work with him alongside Health Equity North to deliver happiness and dignity for women in the north, which is long overdue.

Oral Answers to Questions

Mary Kelly Foy Excerpts

Tuesday 15th October 2024 Commons Chamber

[Wes Streeting]

The right hon. Alan Milburn is alive, he is safe and we are treating him well.

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

October is Breast Cancer Awareness Month, and I stand here today as someone who was diagnosed, treated and cured of breast cancer this year by the amazing staff in the north-east, but not enough women are taking up their breast screening appointments. Will the Minister do more to raise awareness of, and access to, breast screening appointments, and may I urge all women to check themselves regularly?

[Andrew Gwynne]

I pay tribute to my hon. Friend for her work in this area and for setting out eloquently her own personal experiences. Of course this Government will do more to raise awareness and enable more women to access breast screening services.

Tobacco and Vapes Bill (Eighth sitting)

Mary Kelly Foy Excerpts

Committee stage
Tuesday 14th May 2024 Public Bill Committees

[Preet Kaur Gill]

I thank the hon. Member for Harrow East for raising the issue. As we know, separately from the Bill the Government are also introducing a one-off increase to tobacco duty as well as a vaping excise duty. I know that similar proposals to this one have been raised with the Government in the past, through the great work of the APPG on smoking and health. Previous Ministers expressed concerns that the proposals as previously drafted would serve to make tobacco companies pass on the cost to consumers in the shops. Undoubtedly, none of us wants any policies introduced that would come at the expense of consumers but miss their target: the tobacco giants. When it comes to addiction, we know that our most deprived communities are most likely to smoke. I am conscious of making their lives any more difficult. That said, I am certainly no proponent of any policy that would make tobacco cheap and easily available, and indeed it was a Labour Government who brought in a specific tobacco duty in the 1970s in the first place.

I understand that the revised proposal includes provisions to ensure that the Government can raise additional revenue from the enormous profits of tobacco producers, while ensuring the costs are not passed on. It is a complicated proposal that would require a team of officials within the Department of Health and Social Care to conduct market analysis, and for a tax to be set at a rate to hit those profits while regulating the prices in shops. Undoubtedly, something with as many moving parts as that would require thorough analysis and consultation, and I recognise that that is what the clause seeks to do. Given the existing levers we have available to us in tobacco duty and the focus we are trying to put on delivering a smoke-free future, I am reluctant to introduce something to the statute book that would distract from that priority. Through the Bill, there is already much consultation to be getting on with: on vapes, flavours, packaging and much more besides. I congratulate the hon. Member and the APPG on their excellent work, but this is not our priority at present.

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

We heard during our evidence session about the immense damage that is done to our health, wellbeing and the economy, costing the public finances nearly double the amount raised by tobacco taxation. We also heard about the inordinate profits of the tobacco industry and about the idea of a polluter pays levy, which could raise up to £700 million a year. I hope Members would agree that that would help to deliver the smoke-free future that we all want to see.

I am vice-chair of the APPG and we have called for this proposal for many years, and it was great to see it in Dr Khan’s recommendations. The levy is popular and feasible and, as the report from ASH shows, is supported by voters of all political persuasions and the majority of tobacco retailers.

The tobacco manufacturers have the money; they should be made to pay to end the epidemic that their products are causing for our communities. However, I understand that there is still a nervousness from the Treasury and a reluctance on both sides to accept the new clause at this time. I hope that it will continue to be explored, so that the onus is put on to big tobacco, not the taxpayer, for paying for the damage caused by these products.

[Dame Andrea Leadsom]

I also pay tribute to the all-party group, and to the work of my hon. Friend the Member for Harrow East over so many years; the effort that he has made to get us to this point really is incredible, and I commend all hon. Members who have been a big part in trying to stamp out this horrible trade and its effect on young lives in particular. I have a lot of sympathy for my hon. Friend’s request, and I hope that I can reassure him that the Government are determined to abide by the polluter pays principle, while not at this point wanting to accept an amendment that introduces a new tobacco levy, essentially because it would take years to bring into action.

The Treasury consulted on a tobacco levy in 2015 and, as set out in the consultation response, the Government’s preferred approach remains to continue with the proven and effective model of dealing with tobacco products through increases in tobacco excise and duties. As all hon. Members know, that generates up to £10 billion a year, which can support a full range of public services, including public health and the NHS. The Department of Health and Social Care will continue to work with the Treasury to assess the most effective regulatory means of making the industry pay for the undoubted and enormous harms that its products cause to our society.

Alongside the Bill, we are taking strong action to reduce the affordability of tobacco, which is an effective measure to trigger smoking cessation. The UK 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 UK comfortably meets that target, with taxes at around 80% of the selling price. The Government have also committed to a tobacco duty escalator, which increases duty by retail price index inflation plus 2%, at each Budget until the end of the current Parliament.

Data from the Office for National Statistics shows that the average price of a pack of 20 king-sized cigarettes has almost tripled in the past 15 years, from £5.37 in March 2009 to £15.66 in March 2024, and I can say that, when I took up smoking at age 14, they were about £1.50 a pack—I know I’m old, but that is an impressive escalation in the price. Cigarettes are also subject to a minimum excise tax, which sets a minimum amount of duty collected on a pack of cigarettes, discouraging manufacturers from selling cheap cigarettes by reducing the profitability of cigarettes sold at or below the minimum excise tax trigger price. The new minimum excise tax is £8.46 for a pack of 20, and applies to a pack of 20 cigarettes sold at or below £12.86.

We are going still further on tobacco tax. As announced in spring Budget 2024, there will also be an additional one-off increase for all tobacco duties, which will come into force on 1 October 2026, when the vaping duty comes into effect. From a financial perspective, that will incentivise people to continue to choose vaping over smoking once the new excise duty on vaping products comes into force. We currently do not believe that a tobacco levy would be an effective way to further protect public health or raise revenue. It would add complexity to the system and impose additional costs, and it would be unlikely to raise the amount of revenue envisaged due to the volatile nature of the tobacco market.

Tobacco and Vapes Bill (Seventh sitting)

Mary Kelly Foy Excerpts

Committee stage
Tuesday 14th May 2024 Public Bill Committees

[Kirsten Oswald]

The clause is important. We have had discussions here and listened to experts in numerous sessions, which should give us a real opportunity to pause and consider why the measure is necessary. We know the incredible damage that smoking does to far too many lives and the importance of assisting people to stop smoking. Vaping can certainly be an important and helpful part of smoking cessation—that must be acknowledged.

I find it difficult, though, to imagine that many people successfully stop smoking by using a hot pink disposable pocket-money costing vape in “candy floss unicorn” flavour. That is not what those are for nor what they are aimed at. Action to deal with flavourings, as well as names and descriptions and so on, is essential. We are more than able to deal with smoking cessation and the importance of supporting that at the same time as dealing with the harms of vaping. I would be interested if the Minister could tell us about lessons from elsewhere about how that has successfully been done.

It is important to reiterate the significant numbers of youths who vape: 7.6% of 11 to 17-year-olds currently vape. That is not those who have tried vaping. For those who have tried vaping, the numbers are significantly higher and they are absolutely targeted by marketing. Even those numbers—which, as the mother of teenagers, certainly will give me further grey hair—are partly because of the exposure to marketing. We know that wherever we are and whichever shop we go into, we see attractive displays of vapes, and the flavours are a part of those displays. More than half of young people have felt exposed to that kind of marketing in shops, and nearly a third online. The Minister will not be surprised to hear me remind the Committee that people are also exposed to the advertising when they go to watch their favourite sports teams. That is wholly unacceptable and indefensible.

I support the clause, although I think more could be done, but that will come up in our later conversations.

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

I want to speak briefly in support of the clause. I am frustrated that we would need yet more consultation when there is an awful lot of evidence to support prohibiting the tactics, branding and sweet flavourings. Indeed, that was recommended by the Khan review. I am frustrated that I tabled an amendment to this effect in 2021. If it had been passed instead of being voted down by the Government, fewer children would be addicted to nicotine now.

[Dame Andrea Leadsom]

I share the views expressed here today that we have got to stop the marketing aimed at children in the brutal and cynical way that is happening right now. Hon. Members will appreciate that the limiting of flavours is a tricky thing to achieve. Is it the name of the flavour? Is it the ingredients in the flavour? Is it a combination of the ingredients and the flavours?

Tobacco and Vapes Bill (Third sitting)

Mary Kelly Foy Excerpts

Committee stage
Wednesday 1st May 2024 Public Bill Committees

[Trudy Harrison]

Q It was more about the biological impact—how nicotine affects your body and makes it so very difficult to give up and be disciplined. It was about the biological impacts that nicotine has on the body, or the psychological impacts.

Sir Francis Atherton: As with any addictive substance, when you are deprived of it you suffer cravings and withdrawal symptoms of a sort, and that leads you to want the next hit—the next cigarette. That cycle of dependency and addiction is well known and well understood, but you would have to talk to a behavioural psychologist or a physiologist to get a more detailed answer.

Professor Sir Chris Whitty: To add to that, most smokers who are determined to quit make multiple attempts—even those who finally succeed, and many people do not succeed. As I was saying, so many people want to succeed and cannot because the addiction has a hold on their brain, essentially.

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

Q I thank the panellists for being here. I want to go back to clause 62 and the issue of vapes and flavouring. In the interest of brevity, would you say that if we ban all flavours there is a risk that some ex-smokers will be dissuaded from continuing to vape?

Professor Sir Chris Whitty: There is a surprising degree of consensus on this issue, which is sometimes difficult to pick up. We know it is useful to have in the armamentarium the ability to have some flavours to help smokers to quit, but we also know that the cigarette industry is extraordinarily good at adapting its marketing techniques to whatever leeway it is given. If Ministers do not have the power to chase down the industry’s ability to market to children using flavours, that is what it will do: it will go for multiple flavours as a way to get to children and non-smokers. That is what it has always done, so that is what it will do. This Bill gives powers to Ministers in the four nations to make sure they can restrict these products to the extent that you can make them not attractive, but attractive enough to smokers to move on. It allows the slider to be moved left or right to balance attractiveness to smokers against not making it attractive to non-smokers.

[Mary Kelly Foy]

Q I have seen a product that is just a plain bottle with “vape” and a number written on it, which is exactly the same flavour as the one that is clearly marketed to children with a teddy bear on it. If we get rid of that packaging and advertising, could we still use some flavours?

Professor Sir Chris Whitty: Possibly, but this Bill gives powers that allow us to vary it depending on what the industry does. That is really the point.

[Angela Richardson (Guildford) (Con)]

Q I have just looked online and found the top influencers on social media for vaping. I know the Government sometimes use influencers in order to change behaviour. Has the NHS been involved in paying influencers for vaping? Related to that, a lot of young people and children feel under pressure a certain way, and nicotine is known as an appetite suppressant. What message do you have for young people on that basis?

Professor Sir Chris Whitty: I wonder whether I can turn to Sir Gregor first, and then maybe Sir Michael.

Professor Sir Gregor Ian Smith: I am not aware of the NHS ever engaging any of these influencers, in terms of how we approach the subject of vaping. There is certainly a real danger that social media is sometimes used by younger people, and they see things that become really attractive to them in terms of lifestyle. The misinformation and disinformation that exists across those platforms can lead them to participate in activities that are potentially harmful.

Directly to your question, my very strong answer to any young person thinking about using one of these products as an appetite suppressant is: please don’t. Please safeguard your health. Do not begin the potentially addictive journey of using these products. Do not do it for any reason.

Going back to the point we made earlier on, I would love to see a society where our sports organisations promote much more healthy behaviours, where we have a much better understanding of the huge variation in body image we have across our society, and where we promote the very positive and broad representation of who we are as the general public, because there is no “one size fits all” answer to who we are. We are beautiful in our diversity. Anything we can do to have a more positive representation of society across these platforms would be very beneficial.

Professor Sir Michael McBride: Believe it or not, I was a teenager once too, and I remember what it was like. Teenagers tend to push boundaries and experiment. It is all about finding yourself and your place and space in life. It is not cool to vape. It is not cool to succumb to peer pressure. Be yourself. Make sensible choices about what it is right for you. That is the message I would add to Sir Gregor’s point. We have an unfortunate situation where teenagers like to experiment and push boundaries and we have an industry that is only too willing to exploit that and market products at them with, as we heard, cartoon figures on the front, attractive colours and flavours that taste and smell nice. They are extensively marketed by opinion leaders. So don’t follow the crowd. Be yourself.

--- Later in debate ---

[Mary Kelly Foy]

Q This question is particularly for Professor Hawthorne. From your experience, can you tell us what impact smoking tobacco has on our most deprived communities?

Professor Hawthorne: It is much more prevalent. There is a theory called future discounting. If you have few choices—if you do not have much money and much choice in what you eat, what you do and where you work—you do not think about your health in 20 years’ time; you think about today. Many people feel that smoking helps them get through the day, and that is what they do. It is a really difficult thing to talk to people about because some people will say to me, “I’ve just got to. I can’t get through my day otherwise.” I can say, “There are alternatives. There are other ways that we can help you get you through your day,” but you have to get them round the clock face that I was talking about, until the point comes when they say, “I’ve got to do it now.”

[Nickie Aiken]

Q Vapes—or e-cigarettes, whatever you want to call them—were introduced to help people to stop smoking. Professor Hawthorne, I would be particularly interested in your view on this, as a GP. We know that vaping has been turned into a massive industry now, but if the whole point of vapes, or e-cigarettes, is to get people to stop smoking tobacco, what is your view about vapes being prescribed?

Professor Hawthorne: Do you mean as part of a smoking cessation programme?

Tobacco and Vapes Bill (First sitting)

Mary Kelly Foy Excerpts

Committee stage
Tuesday 30th April 2024 Public Bill Committees

[Trudy Harrison (Copeland) (Con)]

Q Thank you. While the harms of vaping are becoming better understood, what do we know about the behaviours around vaping? I ask as an MP who represents the northern constituency of Copeland, where smoking levels are above the national average, where health inequalities are more prevalent, and where deprivation is also a factor. Are we seeing the same kind of mapping of deprivation in areas where people are starting to vape? Are we aware of copycat behaviour—children mimicking their parents or other people in their households—and are we starting to see some patterns in age groups starting to vape? That statistic—350 young people starting to smoke every day—is shocking. What do we know about vaping?

Dr Griffiths: Not as much as we would like. That is the headline, but I do not think it will surprise any of us to know that people follow cues in their environment. That is partly what happens around them in their social environment, but I would like to draw attention to what happens in shops and convenience stores where people buy vapes. I was looking around my local convenience store, which is not far from a school, and thinking about today. It does not take a lot to look at what is happening behind the counter and see the packaging, the marketing and the highly, brightly coloured products that are clearly labelled, named and flavoured in a way to be attractive to children, whether it be cherry cola vapes or cotton candy vapes. They are things that are deliberately sweet and targeted at children, so it causes us great concern that that will be such a huge influence on so many children. We see that playing out in prevalence. I do not know if there is anything that you would add, Sarah.

Sarah Sleet: I think you are right that there is no real evidence base around this. That research should be done and we would very much like to look at. Where smoking is very prevalent—as you say, in more deprived areas—people take cues from the people around them in terms of their behaviour. I have no doubt that look to similar cues for vaping. Are people around them smoking? Is it easy to get hold of vapes? Is it completely normalised? I think we would find a very similar pattern, but we need to get that evidence.

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

Q We have heard that this Bill covers tobacco and vaping, and we have talked quite a bit about the advertising and packaging of vapes. Do you think that we could go further in actually tackling tobacco, which is the biggest killer, around the advertising and packaging of tobacco and flavoured tobacco?

Dr Griffiths: We would welcome anything that stops people smoking or beginning to vape as a starting point for their addiction to nicotine. Given the scale of the devastation that that has on people personally as well as on our NHS in terms of cost burden and all the other impacts that it has, we fully support the Bill going through in full as it is now. If there are opportunities and support for strengthening it, I am sure that we would welcome that too.

The majority of people across the UK support the Bill and would love to see a smoke-free generation. The fact that you have 51% of retailers supporting it also speaks to how powerful a moment it is. We should do anything that we can to strengthen the Bill and prevent it from being diluted. We know that the tobacco industry will be campaigning in the opposite direction to limit any restrictions that would reduce its success, so we are really mindful of that. We urge the Committee and everyone who can to protect the Bill from dilution. It can save and improve lives. It is potentially a transformative piece of legislation.

Sarah Sleet: We asked our supporters who was in favour of the Bill. Bearing in mind that many of our supporters may still be smoking or are ex-smokers, 84% supported the Bill and really wanted to see it come through. Daily on our helplines we hear people saying, “I wish I had never taken up smoking.” They are completely addicted and find it almost impossible to get out of smoking, and their health is being slowly degraded over time. They are having to come out of the workforce and retire early and potentially face death as well.

--- Later in debate ---

[Bob Blackman]

Q You talked about the escalation whereby young people, possibly as young as 10, start by vaping and then go on to other tobacco substances. What further measures would be required, in your view? What further support would teachers need to explain the harm that young people are doing to themselves as a result of vaping and smoking?

Matthew Shanks: There are lots of campaigns that explain the harms of vaping and smoking. Sometimes people do not listen and do not engage with them. The only thing that I would say is that more people vape and smoke than take drugs, because drugs are illegal. If we are saying that tobacco is dangerous and harmful to people in our society, and our role is to protect them and educate them to see what is better, why is tobacco not illegal as well? Vaping started as an alternative to tobacco, but it is now catching on with young people. Is there a similar thing to be done with vapes? That is the view within schools on how we can help children to engage in what they should be doing at school, which is working at their education. There will be other things that have come along, but 15 years ago it was chewing gum everywhere—nicotine chewing gum was a big thing.

Patrick Roach: The reality is that schools are doing an awful lot to inform, to educate and indeed to regulate the conduct of children and young people, as well as to engage with parents and carers, but schools by themselves cannot change society. They can have a tremendous influence over wider society, but by themselves they cannot change it.

Anything that we can continue to do to educate young people about the harms and dangers of smoking and vaping, we should continue to do. Notwithstanding this legislation, that is essential, because no legislation is going to eliminate illegality. We have to continue to strive to eradicate those behaviours wherever they manifest themselves.

What other practical measures could the Bill include? I have mentioned the way in which vape products are described. We think that something could be done there. On availability—this is potentially outwith the scope of the Bill, but it could happen through other legislation and regulation—we think that the prohibition of disposable vapes is an issue that needs to be addressed.

There is also the issue of enforcement measures. There is no point in passing legislation if it is not enforced in practice. We need to ensure that the enforcement measures are absolutely robust. The proximity to schools of any retailer selling vaping products also needs to be looked at.

[Mary Kelly Foy]

Q Following on from Bob’s question, you are in a position to educate young people about the harms of tobacco. Is there a point here about educating young people about the harms, about the unscrupulous measures that the tobacco industry takes and about the horrific products that it is making? Young people are often interested in climate change and wider issues. These industries and organisations are having an impact across the whole world. It could be something that young people are interested in—not just for their health, but for the wider impact on their local communities and across the world. If we had more funding for education, maybe with a payer levy, those types of measures could be looked at. Is there any opportunity for that type of education in schools?

Matthew Shanks: That is happening at the moment within education, in curriculums and so on, but there is a lack of messaging around vaping, its harmful effects and its cheapness compared with tobacco. Even with the teaching of the harmful effects and the messaging compared with tobacco, there are still some families who smoke and you still see celebrities smoking. You are fighting that all the time.

It is good that we are educating young children about the harmful effects of things and the need to change, and we will continue to do that. We talk about big tobacco companies, big pharma, the global environment and so on, all within the curriculum.

Patrick Roach: The reality is that we need more space in the curriculum to do all that and to make the connections between vaping, the impact on a child’s health, and how these companies are profiteering, often from the most vulnerable. The producers of vaping products, the degradation of the environment, the way products are manufactured—all of this is very rich territory.

I would like to see more by way of permission for teachers and school leaders to engage with their pupils about the real everyday concerns that young people have. There should be more scope and space in the curriculum to do that. That is not to argue against the teaching of maths, science and languages; it is about saying that we want to produce well-rounded individuals. For us, that is the purpose of education. This is an area where educators have an important role to play.

Matthew Shanks: I would just add to that by encouraging you to visit your local schools and see what they are doing.

[Angela Richardson]

Q This morning, in evidence from previous witnesses, we heard a lot about how vaping is a great smoking cessation tool, but there is not enough evidence about the harms of vaping. You have described social harms; you probably see health harms as well. You have surveyed people, and you have come to give evidence this morning. Have you been asked, outside this, for evidence of the harm from vaping to the young people you look after? Do you believe that the evidence gathering on whether vaping is harmful is going at a fast enough pace?

Matthew Shanks: No, prior to now. This is very welcome, which is why we have both given our time because this is important. There was something in the papers this morning about evidence of harms of vaping for children, but it is not the headline; it is seven or eight pages in, so people will not read it.

I absolutely think that there should be more about the harm of vaping or just the unknown. You do not know necessarily what the dangers are, so therefore why would you engage in it? We talk a lot when we are doing drug prevention with children about—apologies if this offends—where the drugs come from, what the base of them is and what they contain. In the same way, you do not know what is in a disposable vape or another type of vape, so why would you put that in your body? Those are the lessons we are talking about, so we would certainly welcome more evidence to support that.

Patrick Roach: We know, from the feedback we have had from teachers as part of the research we have done, which includes both quantitative and qualitative feedback, that children are getting ill as a result of using vaping products. That is the daily reality that school leaders and teachers have to deal with.

The more that we can systematically collect and collate that data and evidence—whether that is a child who ended up being rushed into hospital because they became very ill on the school premises or, indeed, a near miss within the school—the better we will be. But the reality is, on an everyday basis, that teachers are experiencing this and having to deal with these issues and to intervene on and support pupils who are impacted physiologically by other harms of vaping products.

Tobacco and Vapes Bill (Second sitting)

Mary Kelly Foy Excerpts

Committee stage
Tuesday 30th April 2024 Public Bill Committees

[Bob Blackman]

Q What is your view on the limitation of the number of premises that would be allowed to sell tobacco or vaping products?

Cllr Fothergill: I could not answer that one, I am afraid, but I would be happy to come back to you with a view on that.

Greg Fell: I have the same view. It is not my area of expertise so I would rather think about that one carefully.

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

Q This is a question for Greg. It would be useful for the Committee and for people watching to hear your view on the impact of smoking and tobacco on public health.

Greg Fell: It is the single biggest cause of death. There is no real question about that. It may not be in many years’ time when smoking prevalence has come down, but right here, right now, it is. No other product is available that kills more than half its users when used according to the manufacturer’s instructions. Death is often preceded by a long illness—sometimes a short illness, but often a long one—often in folk of working age. Most people who die from smoking-related illnesses die too early.

Sheffield-wise—I know my numbers locally—it is a bit north of 700 deaths a year out of 5,000 or so, so not insignificant. To give you a reference, covid killed 1,500 people over the period of the pandemic. Smoking kills 700 people every year, year on year, and that is before we get into the illnesses. Aggregated across the country, that is 80,000-odd people—a Wembley stadium-sized group of people, a non-trivial number. It is also very inequitable and led by addiction. People spend enormous amounts of money on smoking, so stopping smoking would free up that money to be spent in other ways. Smoking remains the No. 1 cause of death and it is very inequitable—almost certainly causing the largest gap in healthy life expectancy and life expectancy inequality.

[Mary Kelly Foy]

David, do you want to add anything?

Cllr Fothergill: I think Greg summed that up perfectly.

[Preet Kaur Gill]

Q Why do you support the complete ban as opposed to raising the age from 18 to 21, as many people often say? I know the Khan review has talked about not getting to a smoke-free future if we did that, but is there anything you would like to say about that?

Greg Fell: Years and years ago, the narrative was about raising the age of sale to 21, but I think the evidence has shifted. I hear from a number of stakeholders and sources that the tobacco industry is targeting its public relations at slightly older young people—the 18 to 25 age group. If you were to stop at 21, the tobacco industry would just change its marketing and you would therefore get a new target group recruited into smoking. Nobody thinks that that is a good idea, so the evidence is shifting.

The ban sets a really important norm. We can all remember walking out of a pub smelling of cigarettes. We cannot imagine that now, so continually shifting the norm changes population behaviour just by norm shifting, which is important and often underplayed. I would support the lifting lid—I think that is the right phrase.

Cllr Fothergill: I think Greg is absolutely right. At the LGA, we support the progressive lifting of the age as opposed to raising it to 21. We think that is the right way to go. It will then move through the population over a number of years rather than just being static at a single point.

--- Later in debate ---

[Trudy Harrison (Copeland) (Con)]

Q Thank you, Ailsa, for all the work that you do up north in the north-east. I represent the north-west, Cumbria, which also has higher than national average rates of mothers saying that they are smoking at the point of birth—about 12.3%. I am told by our authority in Cumbria that about 3,500 hospital admissions, 74,000 GP appointments and 80,000 sick days are caused by smoking-related illnesses. But why not just do more of what you are doing in the north-east? Do you really need this Bill to tackle the problem?

Ailsa Rutter: I think we are doing some really good work in the north-east but I absolutely think that this Bill is required. I go back to the uniquely lethal nature of tobacco smoking; that is the one key argument that we need to think about. This is guaranteed to kill. For me, this is about a societal shift.

I am really pleased with the huge shift in the north-east on the social norms of smoking. We talk to people who smoke every single day, and you have their backing because they desperately do not want their own children to fall into the same trap. As I mentioned before, this is about aspiring into the future. We are all conscious of the pressure and strain on our NHS. Think about the impact—one in four beds in the north-east and elsewhere with somebody suffering from a smoking-related condition. I think our NHS colleagues in particular really welcome this.

There is another important aspect when it comes to the economic costs. We all get the healthcare costs and we also really understand the strain on social care, but actually it is business that bears the brunt of this. That can surprise people. It is about the lost productivity and people having to retire early and dying early. I would like to think about who these people are. I have mentioned the pivotal role of Sue Mountain and the showing of her TV advert, but so many other people have come forward who sadly were diagnosed in their late 40s—women in the north-east who are desperate to tell their stories. Cathy Hunt, diagnosed with lung cancer at 49; Claire Oldfield, diagnosed with lung cancer at 49. Their real appeal to you today is to think about taking this seismic leap forward and about the leadership the UK can show globally by recognising that smoking had a beginning and a middle, and it is down to us to say that it can have an end.

[Mary Kelly Foy]

Q Thanks to Ailsa for everything that Fresh does in the north-east and for the wonderful results we have seen in the north-east, which is a very deprived area in places. I want to follow up on the question on evidence in vaping. Although there are still a few grey areas and unknowns about vapes, we know that vaping is much less harmful than tobacco. Crucially, it is a really important tool for those people who do smoke. What evidence does Fresh use to back up this argument? Do you feel there is a worry that if we focus too much in the Bill on youth vaping, we will leave behind those dependent, addicted and, very often, deprived smokers?

Ailsa Rutter: I think we are really fortunate in the UK. The UK has shown great leadership by commissioning evidence-based reviews that are completely independent of Government; we have had eight of those now since 2014. That has been incredibly important. Fresh is not complacent. We have been monitoring the evidence around the rise in vaping and how this is positioned in terms of public health for the last 20 years—since we were set up. I would strongly recommend that many of the really useful questions we have had today could be answered by looking at those systematic reviews from the Office for Health Improvement and Disparities. In particular, when people say, “We don’t know what’s in vaping,” there is a significant chapter on the constituent chemicals and so on in vaping, and the magnitude of potential harm.

I have forgotten the second bit of your question, Mary.

[Mary Kelly Foy]

It was about the use of vapes by heavily dependent smokers.

Ailsa Rutter: Yes. In the north-east, vapes have been a “game changer” for some of our heavily addicted smokers. I have permission to share with you the fantastic role that vapes have played in our biggest mental health trust, Cumbria, Northumberland, Tyne and Wear. We are talking about people who have been smoking 40 or 50 cigarettes a day, often for decades, who have really struggled to imagine that they could ever get off lethal smoking. Being able to give them something that still gives them their nicotine, but in a much purer, safer and cleaner form, has been a game changer.

Vapes are being used successfully in our drug and alcohol treatment services—on the point about alcohol, the two often go hand in hand. If we are really intent on ending smoking, we must do more on alcohol. Wearing my Balance hat—Balance is the alcohol bit—it is really important that we do not think of risk-taking behaviour in youth as just vaping. Last week, the World Health Organisation published a report that shows that across 44 countries, the UK sadly has the highest use of alcohol among 11-year-olds. I hope nobody thinks that the amount of alcohol promotion, advertising, marketing and so on is okay. I think it is quite important that we look at risk-taking behaviours in the round.

[Bob Blackman]

Q In answer to my colleague, Nickie Aiken, you raised the primary issue of age verification. We get an opportunity to change the law on tobacco and vaping only once every 10 years or so, so it is quite important that we get as much in as we can. What other improvements would you like to make to the Bill to strengthen the argument you are putting, to get people to quit smoking or not even start in the first place?

Ailsa Rutter: That is a really good point. I think it goes back to not wanting to delay the progress of the Bill. It is not necessarily for legislation, but it is important that we have a very clear communications strategy. Reflecting on previous legislation, much of the high levels of compliance we have seen in this country have come from very proactive communications in advance. We need to be really careful that the narrative does not get overly confused. It worries me enormously that too many people are staying on smoking because they are scared of even trying to switch over to a significantly less harmful product. I worry enormously about scaring people. It is absolutely right that we have evidence-based messaging to children and young people, but they are messengers who go back to their parents, and we know that it is very important that they are sending clear messages back. So, I will defer on your question about additional amendment—sorry.

--- Later in debate ---

[Dr Johnson]

Q I proposed a ten-minute rule Bill to ban disposable vapes last February, so I am delighted to see that the Government have brought in an statutory instrument to do exactly that. I am disappointed, but not surprised, to hear you say that industry is doing its best to circumnavigate the regulations before they are even brought in.

I have two questions. First, how do we ensure that the regulations are flexible enough for us to be able to stay ahead of such measures? Secondly, could you say a bit about the effect on wildlife? My hon. Friend the Member for Penrith and The Border (Dr Hudson) has talked about puppies picking these things up in their mouths and the danger they can pose if the puppies bite into them. Could you talk a bit more about the danger that they pose to wildlife when they are thrown away?

Laura Young: Of course. On the regulations, I think that we have to think creatively and innovatively about some of the workarounds that might be being used. We are already seeing charging ports just being popped on the bottom. Of course, that might mean that the battery can be recharged a few extra times, but if it cannot be refilled with the solution, it is still, in practice, a single-use item and will have to be thrown away eventually.

The issue is about ensuring that we look at the builds and make sure that they are modular and that the circular-economy principles that we want to achieve are set in stone. I think that that means working as best as possible with the retailers and the manufacturers—although that will be really difficult—and looking to other initiatives, whether that is single-use plastics bans or treaties on plastic, one of which has just come to an end globally, to see what we can do.

I will tell you a story about the wildlife. A wildlife photographer, a birdwatcher, was taking some images of a marine bird doing a very normal activity, which was picking up a shellfish—what looked like a razorfish—and dropping it from a height to smash it open to get some delicious dinner. But after this young gull had failed multiple times, this photographer realised that, unfortunately, what it was actually picking up and dropping was a disposable vape. We are seeing not only domestic animals, such as cats and dogs and things that we love as pets, getting hold of disposable vapes and potentially breaking them open, but actual wildlife being impacted—picking them up, thinking they are shells on the beach, and trying to eat what is inside them.

That is just from the very short time that we have been paying attention and looking out for this, and from keen birdwatchers capturing it, so we know that there will be extensive wildlife impacts. We are only now scrambling around to try to find more evidence, but we know that it is already happening, and that that is just one example. The photographs are on Twitter, if anyone did want to go and find them. It is sad, but it is definitely the reality of what we are seeing.

[Mary Kelly Foy]

Q Just a very quick question: would you agree that this is symptomatic of the throwaway society that we live in? We have disposable vapes, plastic toys with happy meals and toasters—all small appliances that do not last long enough. They are all thrown away and are damaging the environment. I know that, in Durham, all sorts of electronic devices are thrown in the river, and that is interfering with wildlife.

[The Chair]

It is a fair question; it is not within scope of the Bill, but it is a fair question.

Laura Young: Yes, absolutely. Just last week, I and other leading scientists from across the UK published a piece in Science, the science magazine: a letter about disposable technology, using vapes as an example—the first in a wave of disposable, cheap tech that is having an impact—and about the need for a global effort to tackle this. That is absolutely a hot topic right now; if we do not get a grapple on it now and use vapes as an example of how to tackle it, we will just continue to see disposable electronics, which are all jam-packed full of things that we need for other devices for a green economy.

Illegal Vapes

Mary Kelly Foy Excerpts

Tuesday 16th January 2024 Westminster Hall

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

I thank the hon. Member for Darlington (Peter Gibson) for securing this afternoon’s debate. I am sure he knows that I have been discussing this issue and campaigning against the sale and use of illegal vapes throughout this Parliament, and I am sure he is aware that I tabled several amendments to the Health and Social Care Bill in 2021, when it was in Committee. I understand that the hon. Member was not a member of that Public Bill Committee, but he must share my frustration with his party on this issue. The Tory Whips instructed Conservative Members to vote down my amendments in 2021—amendments that were very similar to the proposals in the King’s Speech last November. If my amendments had been voted for, it is fair to argue that fewer people—particularly young people—would be addicted to nicotine, and that as a result the tenor of this debate would be different.

“What ifs” aside, we need to see robust regulation and enforcement at local level. My constituency needs that, and I am shocked at the extent of illicit, non-compliant and even untraceable vaping products in my constituency. Over 6,000 illicit vapes were seized last year across County Durham, with three prosecutions linked to under-age sales and illicit vapes. I express my thanks to The Northern Echo for its investigation into that.

Although I welcome the Government’s announcement of an illicit vapes enforcement squad, we are now nine months on from that announcement, and unregulated and potentially dangerous products continue to fly off the shelves. All the while, the tobacco industry is making profits off the back of youth vaping rates. Cuts to trading standards have not helped, either. Trading standards workers in Durham are at full capacity, so when will they receive something from the £30 million that was announced in October to help them do their job?

We need the Government to be bold. We need to stop rogue vape traders in their tracks, and we must ensure that the sale of illicit vape products does not deter smokers from switching to vaping. I welcome any Member’s raising the issue of the use and sale of illegal vapes. Like the hon. Gentleman, I was pleased to be part of a rare example of cross-party unity in The Northern Echo but, at the end of the day, what matters in this place is how we vote on policies. If an issue similar to that posed by the Health and Social Care Act 2022 arises in the future, I hope that the hon. Gentleman and Members who are about to contribute to the debate will put their constituents before their party Whips.

Smokefree Future

Mary Kelly Foy Excerpts

Thursday 11th January 2024 Westminster Hall

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

It is a pleasure to serve under your chairmanship, Mr Sharma. I thank the hon. Member for Harrow East (Bob Blackman) for securing the debate, and I declare my interest as a vice-chair of the APPG on smoking and health.

The Government’s announcement of their smoke-free generation policy was welcome after several years of inaction on tobacco from successive Conservative Governments, which have left us playing catch-up to achieve the Smokefree 2030 ambition. Indeed, regulations to protect children from taking up vaping and smoking in the first place would already be in the law today if the Government had accepted my amendments to the Health and Care Bill three years ago. Nevertheless, I welcome the commitment to curb youth vaping with tighter rules around packaging and promotion. The right balance needs to be struck to ensure that vapes are used only by adults who want to quit smoking.

In the north-east, the most disadvantaged place in England, we know better than most that smoking is not only the greatest cause of preventable deaths, but responsible for half the difference in life expectancy between the most and least advantaged in society. Smoking rates are a clear expression of the health inequalities that divide our country. That is why my colleagues and I show up time and again to demand that real and bold action be taken to make smoking history. Children of parents who smoke are three times more likely to take up smoking themselves, more likely to suffer significant income loss and more likely to live a shorter life.

It is high time to break the mould. The Government now need to make the best use of the additional funding that they have attached to the smoke-free generation policy. The Fresh tobacco control programme in my own region is a long-standing example of how budgets can be pooled and partners can work together to bring about positive results. I would be delighted to welcome the Minister to Durham and the north-east to learn more about the work of Fresh, which has been so crucial in reducing smoking rates far more rapidly than the national average.

Preventing the next generation from starting to smoke is not enough. There are 6.4 million adult smokers who need support to quit. The additional funding being provided to stop smoking services is vital, but we cannot ignore the threat to NHS provision of tobacco dependence treatments for in-patients, mental health patients and pregnant smokers. In November, the Health Service Journal revealed that NHS trusts were being told that they could raid these budgets to fund urgent and emergency care. At a time when the roll-out of those programmes has already been cut and is well behind schedule in many areas, the Government pay lip service to the need for prevention if we are to reduce pressure on our NHS. It is yet again a Cinderella service, trumped by the need to do more to treat those who are already sick.

What is more, funding for financial incentives to support pregnant smokers to quit and for the Swap to Stop vape campaign is only guaranteed for two years. We need a long-term and sustained commitment to protect our most vulnerable from the harms of tobacco smoke, including unborn babies. I hope the Minister can ensure that those schemes will be funded for at least the full five years needed.

While the measures announced by the Government, which the APPG and Action on Smoking and Health have long called for, will have an important impact, they are not enough to achieve the Smokefree 2030 target of a maximum 5% smoking rate. We need further action. Of course, more action means more funding, which is where the APPG’s recommendation of a “polluter pays” levy on tobacco manufacturers comes in.

As always, more money is needed if we are serious about a smoke-free future. Why, then, are we not seriously considering making the polluter, the tobacco industry, pay to address the damage that its products are inflicting on our communities? The industry makes vast profits in Britain every year. Why is it not being made to pay, instead of the taxpayer? As the APPG report makes clear, a levy on the industry would raise the funding necessary to achieve a smoke-free future for all, not just the most advantaged.

Ahead of the spring Budget, will the Minister commit to discussing the APPG’s proposal of a “polluter pays” levy on tobacco manufacturers? Would she discuss this with Ministers responsible for tobacco policy in His Majesty’s Treasury? As health inequalities worsen and lives remain at risk, the Government must make up for their lost time with bolder action. They must make the polluter pay.

NHS Dentistry

Mary Kelly Foy Excerpts

Tuesday 9th January 2024 Commons Chamber

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

It was music to my ears when my hon. Friend the Member for Ilford North (Wes Streeting) announced that a Labour Government will introduce 700,000 extra appointments each year, get more dentists into the communities such as mine that need them the most and ensure that everybody who needs an NHS dentist can get one, because I am fed up with the state of NHS dentistry. I am fed up that my constituents cannot get an appointment, fed up that people in Durham have resorted to DIY dentistry and fed up that Tory Governments have sat on their hands for over 13 years.

To be clear, NHS dentists are not to blame for the crisis. We know they are trying their best. It is Ministers on the Benches opposite who are to blame, and they cannot say they have not been told. I have raised this important issue for the last two years and other Members have done so for so much longer. Last May, I raised, as a point of order, that the Prime Minister may have made several inaccurate statements regarding the number of NHS dentists. For instance, in Prime Minister’s questions on 3 May, he stated that

“there are more than 500 more dentists working in the NHS this year than last year.”—[Official Report, 3 May 2023; Vol. 732, c. 111.]

However, a freedom of information request obtained by the British Dental Association threw the Prime Minister’s comments into doubt. According to the FOI response, the number of dentists is in fact down by 695 compared with the previous year, and there were fewer dentists undertaking NHS work than before the pandemic, bringing the workforce down to levels not seen since 2012-13. Unsurprisingly, the Government did not correct the record, and that says it all.

Everyone knows that NHS dentistry is in crisis—our constituents tell us regularly—but the Government continue with their “It’s all fine” attempt at message discipline. Why do they not just accept that vast areas of our country are now described as dental deserts and do something about it? I hoped that the Chancellor would have offered something—just anything—for NHS dentistry in the autumn statement, but dentistry was not mentioned in the Chancellor’s speech or the policy report. Not a penny was put forward, even though the Government announced a recovery plan in April last year. That recovery plan, as we have heard, still has not been published. Even worse, perhaps, was the sinister announcement, confirmed in the answer to a written question I tabled in November, that the Government would withdraw free dental care for the long-term sick.

Last year, I led an Adjournment debate on one such dental desert—my constituency, City of Durham—and I want to repeat what my constituents shared with me so that Ministers know what people are going through. One constituent told me that they had moved to Durham four and a half years ago, but could not find an NHS dentist. They were told that, after a kidney transplant, it was vital they had regular dental check-ups to monitor their health, but then they broke their tooth and could not afford to fix it. Another constituent told me she had to borrow money to afford a private appointment; after becoming pregnant, the exemption she got from dental charges was worthless because there were no appointments available. A young girl from my constituency tripped over and shattered her teeth, and her family could not find a dentist to help her. It was only after I reported the case on social media that a local dentist kindly offered their assistance. Another was unable to find an NHS dental appointment, so out of frustration decided to go private. Following that, they were diagnosed with oral cancer.

Why is this happening? A visit to a dental practice in my constituency provided some answers. The practice had just one dentist working two days a week seeing NHS patients and it had 10,000 patients on its books. In the north-east, almost 97% of surgeries are not accepting new adult patients. It does not take a genius to work out why my constituents cannot see a dentist.

The situation nationally is diabolical. Rotten teeth is the No. 1 reason why children aged between six and 10 are admitted to hospital, with an average of 169 children undergoing tooth extractions every working day. It is clear that a preventive approach to healthcare has eroded in Britain. Fundamentally, this is because of austerity. For over 13 years, the Government have hollowed out our welfare state.

[Peter Gibson]

The hon. Lady and I share the same integrated care board. If this is to do with austerity, why has she not engaged with our local ICB to ask it about the underspend and the provision in her constituency?

[Mary Kelly Foy]

I do speak to the ICB whenever I need to and it has told me, as I am about to say, that our welfare state, of which the NHS is a part, has been hollowed out. The system is wrong. Austerity has caused these problems: it is not the pandemic; it happened many years before then.

Supporters of austerity often say they do not want to burden future generations with debt, but austerity and preventive healthcare are incompatible; we cannot have both. The healthcare problems this Government have caused our constituents—issues that could have been prevented with funding and investment—will now be more expensive to resolve down the line. Conservative Members have saddled future generations with poorer health, poorer opportunities and ultimately a poorer country, and it is time for them to go.