Health and Care Bill

Debate between Mary Kelly Foy and Edward Argar

Report stage
Monday 22nd November 2021 Commons Chamber

[Edward Argar]

I am afraid I will not. I suspect that point will be pertinent to the debate on the first group of amendments tomorrow.

First, we intend to merge Health Education England with NHS England and NHS Improvement, putting education and training of our health workforce at the forefront of the NHS. By bringing this vital function inside the NHS, we can plan more effectively for the long term and have clear accountability for delivery.

Secondly, we also intend to take forward the recommendations of the Wade-Gery report, which included merging NHSX and NHS Digital with NHS England and NHS Improvement, building on the huge progress made on digital transformation during the pandemic and bringing together the digital leadership of the NHS in one place. I take this opportunity to pay tribute to all our colleagues at Health Education England, NHS Digital and NHSX for their exceptional work. These changes build on that contribution and allow us to drive forward further integration and changes that will put the NHS on a firmer footing.

I hope I have reassured hon. Members of the Government’s commitment to improving public health. I urge those who have tabled amendments to consider not pressing them to a Division.

[Mary Kelly Foy]

I have listened carefully to the debate, and I beg to ask leave to withdraw the clause.

Clause, by leave, withdrawn.

New Clause 4

Packaging and labelling of nicotine products

“The Secretary of State may by regulations make provision about the retail packaging and labelling of electronic cigarettes and other novel nicotine products including requirements for health warnings and prohibition of branding elements attractive to children.”—(Mary Kelly Foy.)

This new clause would give powers to the Secretary of State to prohibit branding on e-cigarette packaging which is appealing to children.

Brought up, and read the First time.

Question put, That the clause be read a Second time.

Health and Care Bill (Twentieth sitting)

Debate between Mary Kelly Foy and Edward Argar

Committee stage
Thursday 28th October 2021 Public Bill Committees

[Edward Argar]

Except perhaps the proper conduct of proceedings.

Moving on swiftly, new clause 33 seeks to change the current flavour ban, which would of course be the context in which I was referring to proper conduct proceedings requiring proper documents to be published. The new clause seeks to change the current flavour ban, which is based on characterising flavours in cigarettes and hand-rolling tobacco, to one based on flavours for all tobacco products, as well as accessories used to flavour tobacco products.

The Government are committed to protecting the population from the harms of tobacco. Tobacco for smoking that has a detectable flavour—for example, menthol—has been changed to be more appealing to young people and easier to inhale. That can often result in a lifetime of tobacco addiction. Through the Tobacco and Related Products Regulations 2016, we have already banned characterising flavours in cigarettes and hand-rolled tobaccos. That means flavours that are noticeable before or during smoking of the product.

Again, the Government are sympathetic to the aims of the new clause, which would prohibit flavours in all tobacco products and accessories, but it is not clear how a ban on flavours would be enforced in practice, as it would include a ban on flavours that do not give a noticeable flavour to the product. Furthermore, it is not clear how this may be a better option than the current regulations, although the hon. Member for City of Durham might wish to address that point in her winding-up speech. As ever, I will reflect carefully on what she says and then discuss it with my colleague, the Public Health Minister. We are currently in the process of developing our new tobacco control plan. We are exploring, as I have said, a broad range of additional regulatory measures to support our Smokefree 2030 ambition.

New clauses 34 to 37—which, with your permission, Mr Bone, I will take in one bundle—seek to provide the Secretary of State with a power to enable the introduction of a scheme on tobacco manufacturers, limiting profitability by regulating prices. Tobacco taxation matters are, it will not surprise hon. Members to hear, a matter for Her Majesty’s Treasury. Although earlier this week I found myself answering an urgent question relating to matters pertinent to Her Majesty’s Treasury, I will not stray into its territory, beyond saying that reducing the affordability of tobacco is one of the most effective measures to trigger smoking cessation. Tax increases are particularly effective among a range of groups of smokers, and therefore this is a key tool in helping to address health disparities and health outcomes associated with smoking.

As part of the annual Budget process, the Treasury will continue the policy of using tax to raise revenues and encourage cessation through high prices on tobacco products. The tobacco industry is already required to make a contribution to public finances, through tobacco duty, VAT and corporation tax. While the Government are open to the idea of the tobacco industry providing additional funds beyond taxation, further consideration of the potential options for and impacts of a scheme, including a robust impact assessment, would be needed. We would also need to consider how such a scheme would be implemented and how it would impact the taxation requirements currently placed on the industry. Such a scheme would likely take a number of years to develop and deliver to ensure that it was effective and robust.

The Department will continue to work with Her Majesty’s Treasury to assess the most effective regulatory means of making the industry pay for the harm that its products cause to our population, to support the Government’s Smokefree 2030 ambition, including exploring a potential future levy. Our ongoing work has contributed to smoking rates falling to their lowest on record, as the hon. Member for Nottingham North said, but there is still much more work to be done to protect people from the harms of tobacco.

Finally, new clause 38 would introduce a power to introduce legislation that would increase the age of sale on tobacco from 18 to 21. We have successfully made many regulatory reforms over the past two decades, and the UK is a global leader in tobacco control. Measures include raising the age of sale from 16 to 18, a tobacco display ban, standardised packaging and a ban on smoking in cars with children, all strengthening the barrier between young people and tobacco products.

The Government remain committed to our ambition to be smoke free by 2030 and to continue to protect the population and future generations from the harms of tobacco. However, the Government would like to review the evidence base of increasing the age of sale to 21 in more detail—I am probably in the same place on that issue as the shadow Minister. We would like to further assess its full impact on public health, the costs of implementation and how it would be enforced by trading standards. We have not consulted publicly on raising the age of sale to 21 to assess public opinion and consider whether it is the right regulatory measure to take forward to protect future generations. I know it is an issue that the APPG and the Royal College of Physicians have recommended we should consider.

We are currently in the process of developing our new tobacco control plan. We will review all the proposals in that context, as well as the well-researched reports that the APPG has put forward. I suspect the hon. Member for City of Durham will still want to push us on a few of these points—if not disagreeing with the sentiment, then possibly with the speed or the timescale. I will listen very carefully to what she says. I encourage her not to press the new clauses, but I suspect I may be out of luck.

[Mary Kelly Foy]

I welcome the Government’s commitment to publishing the plan and the consideration of some of the recommendations. I hope we will see that very soon. I will not press the majority of the new clauses, but new clauses 31 and 32 are aimed at children and child public health. I do not think we can wait.

We already have examples of vaping companies handing out free vaping products to 16 and 17-year-olds. There is an example of a 17-year-old woman on a market stall. A third party company came along and offered her vaping products in return for her email address, which was suspicious enough anyway. They do not tell the young person that the products have nicotine in them. There are already such examples.

I went online this morning to see whether I could purchase vaping products. The first one that came up was called the Breakfast Club, which tastes like marshmallow-flavoured breakfast charms. It is a shot of nicotine that goes into the refill of a vaping product. The refill is 15 ml, with a space left at the top for the shot. The Breakfast Club “charms”, which come in pink and yellow, are aimed at young people. When I went to buy some, I was asked if I was over 18; I would just have to click “Yes” for it to be delivered to my door tomorrow.

There is evidence that the longer we wait, the more young people will be hooked on nicotine through vaping products. I do not think we need further evidence. How many more young people will be addicted by the time the plan is introduced? I beg to ask leave to withdraw the motion, but I will divide the Committee on new clauses 31 and 32.

Clause, by leave, withdrawn.

New Clause 31

Packaging and labelling of nicotine products

“The Secretary of State may by regulations make provision about the retail packaging and labelling of electronic cigarettes and other novel nicotine products including requirements for health warnings and prohibition of branding elements attractive to children.”—(Mary Kelly Foy.)

This new clause would give powers to the Secretary of State to prohibit branding on e-cigarette packaging which is appealing to children.

Brought up, and read the First time.

Question put, That the clause be read a Second time.

--- Later in debate ---

[Edward Argar]

I entirely agree with the hon. Lady. There is a huge number of unpaid carers who we know about, and who recognise themselves as carers, but there will be a huge number who, as she says, do not see themselves in that way. They see caring for a loved one as part of their normal life, and as what they do; they do not recognise that they are providing care.

There is also a large, often unidentified, number of child carers. They care for their parents, grandparents and others, but they will not think of it in that way. They just think they are doing their bit to look after mum or dad, or granny or grandad. The hon. Lady is right to highlight the need for all of us—both in government and other Members—to make it as clear as possible that these people are carers and should be able to access support and help. There is support and help available, but people need to understand that they are in that category and are entitled to it. That is a long answer to basically say that I entirely agree with the hon. Lady.

We are not convinced that the provisions of new clause 39 are appropriate for the ICB, as a similar duty to that in the new clause is already held by and imposed on local authorities, so it risks causing duplication. The local authority will be part of the ICB and of the ICP, so we feel that the issue is captured.

Carers already have a legal right to an assessment of their needs from their local authority. Local authorities have a legal duty to meet needs identified through a carer’s assessment where the carer is deemed eligible. In 2019-20—the latest figures I have to hand—376,000 unpaid carers in England were assessed, reviewed, and/or supported. However, the number may well be a lot higher than that figure, which goes to the point made by the hon. Member for Central Ayrshire.

We continue to work closely with stakeholders, care organisations and the wider sector to support carers. We will work with care users, providers and other partners to co-develop more detail on our plans for the reform of adult social care. We will publish further detail of our plans for reform in a White Paper later this year, building of course on the strong foundations of integration we are setting in this legislation. The shadow Minister, the hon. Member for Ellesmere Port and Neston, would have been disappointed or concerned about me if I had not said that, and would have wondered what was going on.

New clause 40 introduces a definition of carer that includes—this goes to the point to which I have just responded—young carers, parent carers and adult carers. It seeks to bring clarity and to ensure that all carers, regardless of their age or their relationship with the person they care for, benefit from the measures in the Bill related to carers. The circumstances and needs of every unpaid carer are unique. Unpaid carers make a vital contribution to the lives of those they care for, and I know that every member of this Committee would want to put on record a tribute to them. It is important that we continue to work to understand carers’ needs and how to best support them, while reflecting the diversity of carers.

I have already discussed the measures in the Bill designed to promote the involvement of carers. “Carers” in this context should include anyone, child or adult, who cares, unpaid, for a friend or family member who, due to a lifelong condition, frailty, illness, disability, serious injury, mental health condition or even addiction, cannot cope without their support. In seeking clarity and inclusion, it is important that we do not inadvertently exclude groups of carers. The legislation as drafted is based on an everyday use of the term “carer”, and this allows for flexibility and the inclusion of all who provide unpaid care, in any shape or form, to a loved one or friend.

I appreciate, and to a large extent share, the shadow Minister’s intention of strengthening the legislation and seeking to bring clarity, so that those who are entitled to support know it, and can claim what they are entitled to. I want to reassure members of the Committee that we have today heard the concerns expressed about carers. I will take that away and carefully consider the issues, and see if we can continue to address them through the wider work of the Department on carers, and our ongoing discussions with organisations, many of which we deal with as constituency MPs, week in and week out, on their work in our constituencies.

For these reasons, I encourage the hon. Member for Ellesmere Port and Neston to consider not pressing his new clauses to a Division, but I look forward to hearing from him.

[Mary Kelly Foy]

For those who do not know, I should say that I was a carer for my severely disabled daughter for 27 years. Maria died six years ago; she suffered with cerebral palsy. I was very fortunate to be in a local authority that recognised the need for respite for carers. I was lucky enough to have a very generous package of six weeks, and that allowed me to engage with public life, have a social life and just recharge my batteries. However, other local authorities do not give such generous packages; it is a postcode lottery. When carers can no longer look after their loved one and that person has to be placed in social care, the cost to the public purse is huge.

On young carers, the issue is not just the caring role of young children. My children were classed as young carers, and the package they had was to enable them to enjoy social activities with other young people. They felt very left out of normal activities, because I was spending most of my time looking after Maria. It is very important that carers recognise that there is help out there, and help has to be consistent. As we know, local authorities have had their budgets cut massively, so what was once perhaps a gold star service for carers is down to a much lesser service.

A lot of carers I knew did not think they were carers and did not really want anything from the state. They said, “We’re just doing it because this is our loved one, and this is what we need to do.” However, the needs, health and wellbeing of unpaid carers are so important if we want them to continue doing the fantastic job that they do.