Tobacco and Vapes Bill (Eighth sitting)

Nickie Aiken Excerpts

Committee stage
Tuesday 14th May 2024 Public Bill Committees

[Preet Kaur Gill]

I thank the hon. Lady for that intervention, but as I said my greatest concern remains promotions in store and on social media, because that is where lots of young people consume this information. My view is that we need to get on with cracking down on the companies that deliberately sell these products to children in the first place.

[Nickie Aiken (Cities of London and Westminster) (Con)]

I fully support what the hon. Member for East Renfrewshire says about sports marketing and vape companies. I pay tribute to my hon. Friend the Member for Sleaford and North Hykeham for the work that she has been doing in this policy area, and I fully support what my hon. Friend the Member for Harrow East just suggested.

With this Bill, we have perhaps a once-in-a-lifetime opportunity to send a clear message to the tobacco companies. More importantly, we can say to young people, our children and parents generally, “Do not take up vaping.” Vaping has always been meant to be about stopping smoking, but sadly it has become a stand-alone product. I was shocked when I walked through my neighbourhood of Pimlico last week and saw that we now have a huge stand-alone vape shop that sells only vapes.

The new clause seeks to do the right thing, but it does not go far enough, so I ask the Minister whether we can step back, before Report, to understand what the Government can do to send a clear message about all advertising, marketing and sponsorship across the whole nation, whether it is TV or radio advertising or any form of sports sponsorship. We have to treat vapes as we treat tobacco.

[Dame Andrea Leadsom]

I thank all hon. Members for this discussion. I have to say that I agree with them. It is extraordinary that vapes are advertised and promoted in places that are seen by children. I pay tribute to the hon. Member for East Renfrewshire for her determination on this matter. She and I were discussing earlier the fact that we both know teenagers who tell us that in many cases it is not one in five vaping but more like four in five. I think that will resonate with a number of hon. Members, so we have to do everything we can.

I also pay tribute to my hon. Friend the Member for Sleaford and North Hykeham, who I believe is the only paediatrician in the House. She has done so much to seek to improve all health issues for children, but she is particularly passionate about this area. She is away on a trip with the Health and Social Care Committee, quite rightly, but I regret that she cannot be here to debate this issue. I know that she would have strong views; I have heard her speak powerfully about the need to clamp down on advertising and sponsorship.

Tobacco and Vapes Bill (Third sitting)

Nickie Aiken Excerpts

Committee stage
Wednesday 1st May 2024 Public Bill Committees

[Rachael Maskell (York Central) (Lab/Co-op)]

Q Thank you to all the CMOs. I would like to press that point a little further. Should the advertising of vapes be in alignment with that of tobacco products, for simplicity and understanding? Should the rules on where people can vape be in alignment with those for tobacco products, so not in indoor spaces or in cars transporting children? Are we missing an opportunity, in the light of the opening comments about the addiction to nicotine, to create a nicotine-free generation, as opposed to a tobacco-free generation?

Professor Sir Chris Whitty: I wonder whether Sir Michael might want to go first, and then Sir Frank.

Professor Sir Michael McBride: We have to start somewhere. What we actively want to do, at this point in time, is encourage those individuals who smoke to quit smoking. We recognise that there are nicotine replacement products other than vapes that are very effective and that individuals successfully use, but for some individuals, as has been stated already and as is outlined in the relevant NICE guidance, vapes can be effective and are safer than smoking. It is about finding the sweet spot—hence the powers to consult.

We need to get a balance to ensure that we are absolutely not creating circumstances in which vaping is attractive to young children, starts a lifetime of addiction to nicotine and is potentially a gateway to smoking tobacco, as I think your question is suggesting. But at this point in time, this is an important step to ensure that the next generation are protected from smoking tobacco. We need to support those individuals who currently smoke or are currently addicted to nicotine to gradually move away from that addiction. That includes supporting smokers who currently smoke to quit, but we are increasingly seeing individuals who wish to quit vaping and are finding it difficult.

We are at the start of a journey. As Sir Chris has said, we do not want to delay this Bill and this important step change, in terms of making very significant progress. Sir Frank, do you want to add to that?

Sir Francis Atherton: Very briefly. The principle of alignment is a positive one. Keeping it simple for the public is in the interest of messaging, as a general point. In Wales, we did try—in 2016, I think it was—to align smoke-free and vape-free public places. Personally, I think that there is merit in that, but we have to be careful, because some of the arguments are different. The arguments around smoke-free public places are based on passive smoking, but we do not have a lot of data on passive vaping; many people see it as a nuisance, but that is a very different argument. We need to be a little bit cautious about that, even though I would personally be in favour.

The important thing is to remember that we really need to keep vapes as the quit tool. Your point about moving towards a nicotine-free next generation is absolutely right; that is really what we want to do. If we can make it less acceptable and less prevalent that children take up vaping, we should move towards that. The reality is that over the last three years we have seen a tripling of vaping among our children and young people. That is just unacceptable. The measures in the Bill will help deal with that and lead us, we hope, towards the nicotine-free generation that you talk about.

[Nickie Aiken (Cities of London and Westminster) (Con)]

Q I want to go back to the vapes point. As we have all agreed and you have highlighted, vaping was, for all intents and purposes, a product to help people off tobacco, but it has become a product marketed in its own right. What are your personal and professional views on the Bill as it stands? It would stop people selling vapes to under-18s and stop members of the public or family members buying them on behalf of under-18s. Should we ban under-18s from using vapes full stop? Also, should we move vapes on to a prescription basis to ensure that they are aimed at people who want to give up smoking?

Professor Sir Gregor Ian Smith: My view on the Bill as it stands is that it is a starting point for how we take this work forward. It is adequate in that sense because this is a really important area. For me, the absolute priority has to be to remove young people’s ability to access vapes and so begin the journey to nicotine addiction.

I am not in favour of criminalising the possession of these products, but I am certainly in favour of banning their sale to younger people. If we can achieve that at this stage, and, as Sir Michael said in his previous answer, if we can begin to shift the culture so that people do not start to use vapes and begin to become addicted—potentially also by using other nicotine and tobacco products—for me that will be a good job done.

If we do things that way, it will allow us to protect the useful use of vapes: where people with a lifelong addiction to tobacco can use them as way to help them stop. That is the only justification that I can see now for the way we have set this up and for continuing to use vapes in society: as a useful tool for those with a pre-existing addiction to tobacco, so that they can reduce the harm and gradually stop using tobacco—through formal cessation services, as well.

Professor Sir Chris Whitty: I agree with Sir Gregor. To reiterate, the Minister wanted to get a balance and most people would agree that criminalising people for individual possession is a step further than anyone would want and is needed. I do not think there is a clamour for that from anybody, and I think it would not help the Bill.

On prescription vapes, I would like to see those available for use at the moment. So far—I will go into the reasons for this on another occasion—no products are available that we can prescribe. We would all very much like those products to be there so that people can prescribe them. That is different from saying that they should be only on prescription; at this point, we do not even have any products to prescribe at all. If we did, that would be a very firm step in the right direction, but it depends on the industry coming forward with products.

Speaking directly to the industry, I should say that I do think there is a very important niche for prescription vapes. They would be very useful for some people, particularly those on low incomes who, for other health reasons, have free prescriptions. I encourage anyone from the industry who is listening to think seriously about bringing forward a prescription vaping product appropriate for aiding people to quit.

[Bob Blackman (Harrow East) (Con)]

Q I think the whole panel have said they are 100% behind the Bill. It is great that the whole medical fraternity is going together, but are there any tweaks that you would like to see in the Bill that could make it stronger—for example, making age verification the same in England as it is in Scotland? One of our concerns is that we have a chance to get primary legislation in only once every 10 years or so, and doing it now would be far better than waiting.

Professor Sir Chris Whitty: I have had the privilege of being more heavily involved in this Bill than the other CMOs, so I am going to ask them to answer it. My short answer is that this is a fantastic Bill. What I do not want is for the Bill to be delayed and therefore to not get through in the parliamentary time available. There is always a danger with these things, particularly when we are up against the clock, of the best being the enemy of the good. This is more than good; this is an outstanding Bill, to be clear, in terms of the Prime Minister’s bravery in putting it forward and, I think, the huge support from the general public and massive support from those working in healthcare. Really, what we want to do is get this through. I fully accept the points you are making, but that is my real concern about proposing any additions. Maybe you can start with Sir Michael, then Sir Gregor and then Sir Frank.

Professor Sir Michael McBride: I think this is a situation where perfection risks snatching victory from us. The most important thing, having looked at the Bill closely, is that this is an excellent Bill. I think we have all indicated that this is a once-in-a-generation opportunity, as your question suggests. We need to seize this opportunity. I and my colleagues fully support this Bill. I think this is a point that we will look back on five or 10 years from now and we will say that we were on the right side of history in supporting the Bill. This will make a fundamental difference to the next generation and generations to follow. Again, it is entirely consistent with the commitment in the Northern Ireland Executive to gradually phase out tobacco smoking. I fully support the Bill as it stands.

Professor Sir Gregor Ian Smith: I have nothing much more to add. In my view, this is a momentous point in time when we have the ability to really safeguard the future health of generations of people who will not be exposed to the regretful, harmful addiction to tobacco that they might have encountered. I am very satisfied with the content of the Bill as it is just now. The point Sir Michael makes about perfection being the enemy of good is a really important one. This is an opportunity that, to be honest, I really did not anticipate seeing in my career, yet here we are discussing a potential piece of legislation that will allow us to improve the health of people in our country for years and generations to come. This is an opportunity that we cannot afford to miss.

Sir Francis Atherton: There are no changes to the primary legislation that I would recommend at the moment. One thing I would say is that in Wales, we were very impressed with the Khan review, which gave us a really good steer. Many of the Khan review recommendations will be dealt with through the Bill, while a couple will not. I think the Bill as it stands has enough flexibility, particularly around vaping, to allow secondary legislation to keep up with the industry as it adapts and as it tries to find ways around the barriers to getting young people addicted to nicotine.

If I had a wish from the Khan review, it would be around the industry making a contribution to those costs I was talking earlier—the cost to the NHS—so sort of a levy on the industry to correct the damage, or a polluter pays thing, as is being introduced for the gambling industry. However, I do not think that would fit at all with the current Bill.

--- 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?

[Nickie Aiken]

Yes, rather than having them sold as they are at the moment.

Professor Hawthorne: That is an interesting question. I prescribe nicotine patches; why should I not prescribe vapes? That would be my thought.

[The Chair]

I call Dr Caroline Johnson—you have all been so kind to one another, we are now ahead of time.

Tobacco and Vapes Bill (Second sitting)

Nickie Aiken Excerpts

Committee stage
Tuesday 30th April 2024 Public Bill Committees

[Steve Tuckwell (Uxbridge and South Ruislip) (Con)]

Q The LGA has previously called for strict enforcement measures for those selling tobacco to those under-age. Do you think the Bill goes far enough in achieving that?

Cllr Fothergill: I have already said that we believe the amount of the fine needs to be reviewed. We believe it is right to do it by a local penalty notice, which is issued locally and can be enforced. We do not believe that £100, reduced to £50 if it is paid within 14 days, is sufficient. It will not have the effect that it needs to have and it should be reviewed.

We are also keen, as part of the Bill, for a review of whether we should be brought into line with Scotland on age verification. Scotland has very clear guidelines that legally, people have to produce identification that they are of an age to buy, and we think this is an opportunity for us to bring that in as well. There are two things where we would like to see enforcement strengthened: mandatory age verification and an increase to local penalty notices.

[Nickie Aiken (Cities of London and Westminster) (Con)]

Q I have a question for Mr Fell. Obviously the Bill will cover shisha, so I would welcome your views on shisha smoking and whether there is more we can do within the Bill or in general to tighten up shisha smoking.

Greg Fell: I would say that we need a licensing scheme for shisha smoking, and probably more education about the fact that it is a potent way to consume large amounts of tobacco really quickly and is quite damaging for people’s lungs. I am not sure what more could be achieved in the Bill, but I would like to see a licensing scheme for shisha bars. We enforce the law to its limits, but there are some limits to it.

[Bob Blackman (Harrow East) (Con)]

Q I thank you for covering the issue of age verification; I think it is important to have a similar scheme across the UK. The other issue relating to licensing is that there are potentially two ways of licensing. One is to add to the existing alcohol licensing regime, and the other is to have a separate regime for vaping and tobacco. Which would you prefer to operate if we were to introduce a licensing scheme?

Cllr Fothergill: It is not a topic that we have a policy position on, but my personal view is that it would need to be a separate scheme, because it would have separate enforcement and separate legalities within it. It needs to be very clear for trading standards what they are enforcing against, whereas alcohol is quite different. We should not mix the two just because they both need licensing. I think that they need to be separate.

--- Later in debate ---

[Dame Andrea Leadsom]

Q Thank you so much for being here and for all you do in the north-east. It is fantastic.

As you will know, rates of smoking during pregnancy in the north-east are some of the highest in the country. Do you think this legislation will help to reduce those very high numbers? The rate is somewhere in the region of 14% in the north-east.

Ailsa Rutter: We have made really good progress in the north-east in reducing maternal smoking; that has come through very good collaboration between our local maternity services and our local authorities, as well as the fantastic leadership from key people in the local maternity and neonatal system, the LMNS, and the direction from directors of public health.

As with anything, there is not one magic solution; it is about taking comprehensive measures. The tobacco age of sale increase will undoubtedly have a really positive impact on reducing maternal smoking. It needs to be coupled with important things that we must continue to do as well, so we also welcome the increased investment for stop-smoking services.

We hugely welcome—thank you—the reinvestment in the evidence-based health harms campaigns. We are thrilled that nationally you are using our fantastic “smoking survivors” TV advert featuring Sue Mountain. The role of financial incentives is also really important; we know that they have a very strong evidence base. This will have a positive impact on maternal smoking.

[Nickie Aiken]

Q If there was one thing you could add to this Bill, what would it be?

Ailsa Rutter: Gosh! There are already some fantastic elements in the Bill. The key thing for me is to make sure that we can get the Bill through—particularly the focus on tobacco. It is really good to think that there is going to be subsequent consultation on the important elements around vaping. Factoring in what colleagues said previously, we need a simple mandatory age verification scheme. That is already in place in Scotland, and I would certainly welcome its introduction in England.

[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.

Tobacco and Vapes Bill

Nickie Aiken Excerpts

2nd reading
Tuesday 16th April 2024 Commons Chamber

[Victoria Atkins]

Sadly—I say this genuinely—there is nothing inevitable about a decrease in smoking rates. Indeed, in 2020 the United States saw the first increase in tobacco sales in 20 years, and in Australia in 2022 the proportion of teenagers smoking increased for the first time in 25 years. I am reminded by a Minister that here in the United Kingdom 100,000 children and young people take up smoking every year. We must not be lulled into a sense of inevitability and security, mindful as I am of how very clever the tobacco industry is at lobbying its messages because we are threatening its business model. As Conservatives, we must take into account that this is happening today, so we must ensure we tackle it head on.

[Nickie Aiken (Cities of London and Westminster) (Con)]

I thank my right hon. Friend for giving way. She is making a very important point about young people and children smoking today. It is not just about cigarettes. Shisha smoking, in particular in Westminster, Marylebone and Edgware Road in my constituency, has become very fashionable for young people. An hour of smoking shisha equates to 100 to 200 cigarettes within an hour. Will she confirm that shisha tobacco will be included in the Bill?

[Victoria Atkins]

I thank my hon. Friend for bringing the City of Westminster right into the Chamber. There are, in fact, five times more people in England today smoking non-cigarette tobacco, which includes cigars and shisha, than there were a decade ago. Worryingly, the greatest increase is in young adults. That is why we have said that tobacco in all its forms is a harmful product, and that we therefore wish to ensure we are consistent in the policy and the messaging that this is about helping young people to stop the start.

HIV Action Plan Annual Update 2022-23

Nickie Aiken Excerpts

Tuesday 18th July 2023 Westminster Hall

[Nickie Aiken (Cities of London and Westminster) (Con)]

It is a pleasure to serve under your chairmanship, Dame Caroline. I am glad to have the opportunity to contribute to this debate on the Government’s annual update on their HIV action plan. I thank my hon. Friend the Member for West Bromwich East (Nicola Richards) for securing it.

The annual update makes it clear that progress has been made. The plan has set the stage for a transformative approach to prevention, testing, treatment and support but, as ever, there is still room for improvement, and the annual report highlights several key opportunities. First, there is scope for improving access to the HIV prevention drug PrEP, HIV testing and care for people living with HIV. As the Member of Parliament for Cities of London and Westminster, I know how important that is. Reports show that Westminster has among the highest HIV prevalence in the country: eight 15 to 59-year-olds per 1,000 are living with HIV. The action plan will change those statistics, and the Government’s investment in opt-out HIV testing and emergency departments in areas classed by the UK Health Security Agency as having a very high HIV prevalence should be highly commended.

As a result of additional funding, in St Mary’s Hospital in my constituency, three people were newly diagnosed with HIV, seven with hepatitis B and 14 with hepatitis C in the first 10 months of the Government’s programme. Those figures from the first year of the programme have been broken down by the Terrence Higgins Trust. There have been more than 2,000 positive diagnoses across London, Blackpool, Brighton and Manchester.

Now that we are in the second year of the programme, it is only right that we consider expanding opt-out testing. I understand that NHS England has costed and prepared a plan for expanding HIV testing to 41 additional A&E units in areas with a high prevalence of HIV, and I hope that will go ahead. Modelling by the Terrence Higgins Trust shows that such an expansion has serious merit in supporting the Government’s aims and ambitions.

Also important in supporting the aims of the action plan is increasing equal access to PrEP. That revolutionary drug has changed so many lives—including for many of my friends. I am proud that my constituency is home to the outstanding 56 Dean Street—the sexual health clinic that pioneered PrEP in England—which is recognised internationally for its innovation, particularly in regard to its engagement with London’s higher-risk communities. More than that, it has been a haven for so many of the LGBT+ community over the decades. I pay tribute to the outstanding staff who work there today and have worked there in the past. They have always operated without prejudice, even in the face of systemic discrimination.

Nearly 60% of people wait more than 12 weeks for their PrEP. I am glad that the annual report acknowledges the publication of the first national PrEP monitoring and evaluation framework, but there is more to do. The framework is clear in showing that there are inequalities in who is able to access PrEP; we really need to push against that. The HIV action plan includes a commitment to develop a plan to expand access to PrEP through sexual health services, but there is a case to be made to have access through GP surgeries in particular, as well as pharmacies. We need to ensure equal access to PrEP if we are to meet our 2030 commitments.

In the remaining time I have left, I would like to pay tribute to the work of the Terrence Higgins Trust. From its policy to its fundraising efforts, it is second to none in its field. In fact, I have been to visit its brilliant team in Boutique, the only Terrence Higgins Trust charity shop in the UK, which happens to be based in Pimlico in my constituency. The shop recently reached £1 million raised for charity, which is utterly amazing. I pay tribute to all the volunteers who work there. For nearly 15 years, the shop has helped the Terrence Higgins Trust to fund its hardship grant, services for people living with HIV and its campaign to end new cases by 2030. I pay huge tribute to both the shop and the Terrence Higgins Trust.

The Government’s HIV action plan is the first step in reinforcing the progress the UK has already achieved. Now Government, civil society organisations, healthcare providers, researchers and communities must continue to work together to address the global challenge. By combining our knowledge, resources and expertise, we can develop innovative solutions, advocate for policy change and create a sustainable impact that will shape the future of HIV prevention and treatment.

[Dame Caroline Dinenage (in the Chair)]

I thank all Members for keeping to time so beautifully. I call Andrew Gwynne.

New Hospital Programme and Imperial College Healthcare NHS Trust

Nickie Aiken Excerpts

Tuesday 13th June 2023 Westminster Hall

[Nickie Aiken (Cities of London and Westminster) (Con)]

Thank you, Sir Mark, it is a pleasure to serve under your chairmanship. I thank the hon. Member for Hammersmith (Andy Slaughter) for bringing forward the debate and for the points he has raised. As the Member of Parliament for the Cities of London and Westminster, I would like to focus my remarks specifically on St Mary’s Hospital in my constituency.

In September 2021, Imperial College Healthcare NHS Trust set out the need for a complete redevelopment of St Mary’s: a new 840-bed, research-led major trauma and acute teaching hospital, which would release around five acres of surplus land for wider site regeneration. As I know the Minister appreciates, that development is of huge—

[Sir Mark Hendrick (in the Chair)]

Order. The sitting is to be suspended for multiple Divisions in the Chamber. We require approximately 15 minutes for each vote. There is an issue in that there may be more than four votes. I would imagine it could possibly be an hour before we come back. Those who have put in to speak should not worry, because there will be injury time.

--- Later in debate ---

On resuming—

[Nickie Aiken]

Being the Member of Parliament for Cities of London and Westminster, I would like to focus my remarks specifically on St Mary’s Hospital, which is based in my constituency. Back in September 2021, Imperial College Healthcare NHS Trust set out the need for a complete redevelopment of St Mary’s Hospital, a new 840-bed research-led major trauma and acute teaching hospital, which would release around five acres of surplus land for wider site regeneration.

I know the Minister appreciates that the development is of huge importance to the wider London area and not just my constituency. After all, St Mary’s is the major acute hospital for north-west London, providing care across a range of specialities in London, in addition to its world-leading maternity centre and 24/7 A&E department. It played a significant role in the 7/7 bombings and other major incidents over the years. It is host to the NHS’s largest biomedical research centre and through its partnership with Imperial College London, the trust continues its long legacy of translating academic discovery into better care and treatment, including making a major contribution to the management of covid-19.

I welcome the Secretary of State for Health and Social Care’s recent confirmation of Government funding for the redevelopment of St Mary’s. Though the timescales have been altered, I appreciate that the full picture is more complex and I know that work continues to complete the majority of the redevelopment as near to the original timescales as possible. I also appreciate the complexities of the programme’s schedule for building works, so I am glad to hear from discussions with Ministers that they are committed to getting the enabling works started as soon as possible. To that end, I look forward to visiting St Mary’s with the Minister responsible, Lord Markham, and the Under-Secretary of State for Levelling Up, Housing and Communities, my hon. Friend the Member for Kensington (Felicity Buchan) to discuss the case for change and the redevelopment more widely.

I pay tribute to Lord Markham and to officials at the Department of Health and Social Care, as well as to the Minister and the Secretary of State, for their communication with the trust and me throughout the process. I am currently concerned about running key clinical services while we wait for building works to commence and specifically about services being patched up to keep patient care running. As it stands, key parts of the estate date back to 1845 and most of the facilities—even the most modern bits—are at least 70 years old. That is because St Mary’s has been developed piecemeal over the decades. I am sure anyone who has visited there will agree that, when walking through the site, it is clear that the hospital is a patchwork of buildings with complex patient pathways.

As a patient of St Mary’s, having recently gone there for one of my regular mammograms, I saw that parts of the hospital are very outdated and very much in need of redevelopment. That is a product of the hospital’s history. However, the space and configuration of the buildings are making it significantly harder to respond to increasing and changing healthcare demands and opportunities. Let us not forget that the hospital was first built in the 19th century, and is now dealing with 21st-century healthcare and medical advancements.

I have heard significant concerns about the fact that the acceleration of the estate decline is impacting patient care and experience and staff working conditions. In short, the St Mary’s buildings are in a poor and declining condition, despite investment in maintenance and repairs. Taken together, the size, age and condition of the buildings make it hard to deliver the high-quality care that people expect and deserve from such a major hospital.

From speaking to Professor Tim Orchard, the chief executive of Imperial College Healthcare NHS Trust, I am confident that we will find a way to mitigate decline and enable work as soon as possible. I am assured that the trust is doing all it can to find innovative solutions to the ongoing problems. I hope the Minister can update us on the outcomes of the Department’s conversations with the trust, focusing on the progress of the enabling works.

I know the trust is accelerating its exploration of alternative funding, design and phasing approaches that will make the most of the huge potential of the land surrounding the hospital once we have a new hospital on a less sprawling footprint. That hugely expensive real estate can then be used for better redevelopment. The development of St Mary’s has the potential to do so much more for our local community and the whole of the UK science, technology, engineering and mathematics sector.

St Mary’s Hospital has been a leading provider of clinical care, education and research for 175 years. We now have an opportunity to take advantage of and invest in new technologies and other opportunities for it so that it better serves its communities and the wider health system.

National Carers Week

Nickie Aiken Excerpts

Thursday 8th June 2023 Commons Chamber

[Nickie Aiken (Cities of London and Westminster) (Con)]

I thank my hon. Friend the Member for Gosport (Dame Caroline Dinenage) for securing this debate. She is passionate about ensuring that we highlight the challenges carers face, and that we recognise the contributions they make to families and communities throughout the UK. I pay tribute to her excellent work as chairman of the all-party parliamentary group on carers.

In National Carers Week, it is only right that we reflect on and appreciate the 5.7 million carers in our country, while exploring what more we can do to support them both financially and practically. We also have to recognise that the number of carers will only increase. Life expectancy continues to increase as more people live longer with more health conditions and as children survive with conditions that, in previous generations, might have meant they never survived the womb, let alone birth—they are now living for maybe decades, and their parents have to provide most of the care.

Yesterday I was honoured to meet Age UK, the Carers Trust, Oxfam GB, the Motor Neurone Disease Association, Rethink Mental Illness and the Lewy Body Society at the National Carers Week parliamentary reception. These organisations are vital in supporting carers across the UK, and I pay tribute to their professionals and volunteers for the support they provide.

I understand, on a very personal level, the difficulties that being a carer brings. So many women, as my hon. Friend mentioned, have caring responsibilities—we know that women make up the majority of carers. Many of us are employed and keeping down jobs, and we often had our children later in life, so our caring responsibilities come at a time when our children need us, particularly as teenagers, and our parents need us because they are reaching an age at which they may have health issues. We are the sandwich generation, as is now well known. Believe me, I know it is not an easy task to juggle all these responsibilities.

I have personal experience, as I supported my mum when she was looking after my father after he was diagnosed with Alzheimer’s, and I saw the mental, physical and financial toll it took on her. What I take away from that personal experience is that caring is really, really lone, and it was particularly lonely during covid. I cannot imagine how it was for the millions of people who were isolated at home and having to look after a family member with a condition such as Alzheimer’s. The thing about Alzheimer’s is that we lose our loved one twice. We lose them as the Alzheimer’s and dementia progress, and then we lose them when they die.

I remember looking after my father for a week in August 2021, when my mum had a week of respite care. It was one of the hardest things I have done in a long, long time. I was trying to juggle my parliamentary work at the same time. Thank goodness for test cricket and the Hundred, because my father was an avid cricket fan all his life. When I was looking after him, we had the India test during the day and the Hundred in the evening, so that kept me sane. I do not know how the amazing carers across the country cope.

Because of my own experience, and because of speaking to so many carers across the Cities of London and Westminster, I was proud to support the Carer’s Leave Act 2023, which was introduced by the hon. Member for North East Fife (Wendy Chamberlain). I was delighted to sit on the Public Bill Committee, and I congratulate her on the Act receiving Royal Assent. It will make such a difference, as it means unpaid carers will now be entitled to at least five extra days off a year, helping more carers to stay in employment. According to Carers UK, 600 people a day leave work due to care duties, and the Act recognises that those people need the flexibility to take time off work for their loved ones.

In 2020, more than 7 million people in employment had the added responsibility of unpaid caregiving. Of course, those combined work and care responsibilities can lead to people getting very little rest, which explains why 71% of carers report having poor physical or mental wellbeing, according to the Mental Health Foundation. That is why I fully support the Government’s “Next steps to put People at the Heart of Care” report, which includes a £25 million funding package for unpaid carers, although I would obviously like to see that funding increase.

We must also remember that many carers are too young to be employed. I take this moment to recognise the role played by young carers, of whom there are approximately 800,000 across the UK, which is a staggering number. These children—they are often very young children —and young adults embody compassion, responsibility and maturity beyond their years. On average, young carers devote around 17 hours a week to their caring duties, according to Carers UK. Just imagine the sacrifices they make. Their selfless acts of love go unnoticed by many.

I was first exposed to this issue when I worked at the Children’s Society and was responsible for publicising a report on the lifetime effects of being a child carer. The report’s findings remain with me, because being a young carer has not only an immediate effect but a long-term effect on things like education, attainment and even personal and social confidence. I remember speaking to people who had taken part in the report—they were men and women in their 30s and 40s—and they still lived with what they called the shame of not being able to take friends home because they were embarrassed about what might be at home if their mum, as it usually was, had mental health issues, or of not being able to go to birthday parties or be proper teenagers with their friends because of their caring responsibilities. It has a lifetime effect on people’s confidence and life chances.

That being said, I am proud of the Government’s work to support young carers. Obviously there can always be more help, but through the extension of education, health and care plans to 19 to 25-year-olds, for example, thousands of families across the country have seen increased support.

I, like many Members in the House today, have spoken of the incredible sacrifice made by so many unpaid carers, whether financially or personally, but in National Carers Week we must not forget the professional care sector. We often speak about NHS doctors and nurses, who are so important, but the value of social care sector workers cannot be overestimated. I take this opportunity to thank our professional carers who support our loved ones in care settings and in their own homes. I saw that directly in how the outstanding carers looked after my father with such respect, love and devotion at the Bellavista care home in Cardiff bay before he passed away last year. My mum was a hairdresser working in care homes and day centres, and I used to help her in the summer holidays, so I saw the vital respite care that the Ely day centre in Cardiff gave to so many families.

Across the country, we see fine examples of sacrifice, love and selflessness every day, which is why it is so important that we have such debates—again, I thank my hon. Friend the Member for Gosport for securing it—to recognise and thank the carers, and particularly the unpaid carers, across the UK. It is also why I fully support the Government’s new support for carers such as the 2023-24 better care fund, with £327 million earmarked to support local authority health and care services, including providing carers with advice, support, short breaks and respite services. It is so vital to ensure that we provide respite for carers.

I know at first hand how important this extra funding will be. When I was a council leader, approximately 40% of our annual budget was spent on adult social care, so we need to continue funding councils in this vital work. I also note what my hon. Friend said about the need to undertake care assessments a lot quicker and in a much more caring way. I hope the Minister has taken note of that comment, too.

[John Howell (Henley) (Con)]

I hear what my hon. Friend said about young carers. Does she recognise that there is a problem in identifying all young carers and that we must do more to identify all those who are providing that care service but going totally unnoticed in society?

[Nickie Aiken]

I thank my hon. Friend for his intervention and completely agree with him on that. Part of the problem, particularly for young carers, is that they are embarrassed, but they may also think that they could be taken into care—I fear for them on that. They think that because they are having to look after a parent, a social worker and local authority will perceive that they cannot cope. That is the last thing that any family needs to think about. When I was the children’s services lead at Westminster City Council, I did a lot of work with young carers and we had an amazing support network in Westminster for young carers. They can be so young—as young as eight or nine—and it is therefore important that we identify them. We must also give them and their parents assurances that this is not about taking them away, but about giving the children and the parents the support they need.

I am also glad to see that the Minister is due to hold a cross-Government roundtable with other Ministers to make sure that carers’ needs are recognised not just in social care, but in every aspect of their lives. That is a theme we have discussed today. This is about not just the daily grind of caring—the responsibilities and the tiredness—but the financial and other help that is needed.

Making sure that carers are recognised in health, social care and education is a priority, along with helping people to recognise themselves as carers so that they can tap into local carers networks and apply for the financial support that is available. That will be crucial for carers across the UK. That is why I look forward to continuing my work with the Government to ensure that all adult unpaid carers and young carers across not only the two cities of London and Westminster, but the whole country, are supported financially, emotionally and physically. We owe them all a huge debt.

[Several hon. Members rose—]

Menopause

Nickie Aiken Excerpts

Thursday 9th June 2022 Westminster Hall

[Nickie Aiken (Cities of London and Westminster) (Con)]

It is a pleasure to serve under your chairmanship, Mr Robertson. I want to start by congratulating my dear friend, the hon. Member for Swansea East (Carolyn Harris), on securing this debate and on all her brilliant work highlighting the importance of speaking about the menopause. I am very proud to be a vice chair of the APPG on menopause, which she chairs. We have done some brilliant work together and will continue to do so. We have finally lifted the lid off the menopause jar—the genie is out of the bottle. I could refer to other sayings, but it is important that finally we are ensuring this is no longer a taboo subject where we whisper, “the change”.

The issue crosses over every demographic—from royalty, including the Countess of Wessex, all the way through. I was fascinated to hear the hon. Member for Swansea East refer to it as a “posh” issue. That is so depressing, but she is absolutely right that some women feel that HRT products and help and support are available only if they are posh and can demand them. She is right that in the cost of living challenge we are now living through, too many women will be putting food on the table for their children rather than spending £18 on the vital HRT products that they need.

I welcomed the Minister and the Secretary of State for Health’s support for the private Member’s Bill promoted by the hon. Member for Swansea East. They agreed to her proposals, but it is disappointing that we have to wait until April 2023, given that there are women in England who are desperately waiting for an annual prescription.

It was interesting to listen to the hon. Member for Belfast South (Claire Hanna). The issue applies to all four nations, and it is a shame that England is still the poor relation of the four. She reminded me of a close friend of mine who lives in Northern Ireland and is a constituent of the hon. Member for Strangford (Jim Shannon). She was telling me a few weeks ago of all the symptoms she had. She had been to her GP in Northern Ireland and he was suggesting antidepressants. I begged her and said, “Please, you are 51. You are going through the menopause. Go back to that GP and demand.” She did, and now she is on HRT. She is an educated woman who has been to university and has a high-profile job, but she still has to beg her GP to take her seriously. That is unacceptable. There is more to do to ensure that GPs across the four nations have the right advice and training.

I want to highlight Pausitivity, an organisation I know very well and whose posters I have previously mentioned in the Chamber. I wrote to the Minister recently and I hope she will respond positively. We need to support Pausitivity’s Know Your Menopause campaign. Its leaflets are a signpost for women and highlight symptoms, so that they can go back to their GPs and demand support and help.

[Caroline Nokes]

My hon. Friend makes an important point about Pausitivity. Claire Hattrick from Hampshire has published a whole book about self-help. There is a brilliant case for the Department of Health and Social Care to consider making small funding streams available to ensure that the work of all those smaller, regional self-help and campaign groups can be disseminated much more widely. All of us have friends, like my hon. Friend’s friend in Northern Ireland, who have not had the confidence, knowledge or expertise to go to their GP and say, “This is what I have got. Please can I have?” We need to spread the information. Perhaps DHSC should look at how it can fund that.

[Nickie Aiken]

My right hon. Friend is absolutely right. I wrote in my letter to the Minister that we need to support organisations such as Pausitivity so that women can use them as a signpost. Its posters are brilliant. They are in Urdu, Punjabi, French, Dutch, German, English and also, as the hon. Member for Swansea East will be delighted to know, Cymraeg. Let us support women from all walks of life, and let us also support families.

This morning I went to talk to a group of year 10 pupils at Pimlico Academy. They asked me what I was doing this afternoon and I said that I would be speaking in the menopause debate. I said, “It is really important that you guys, aged 15—boys and girls—are aware.” I said to the girls, “PMT and periods are tough enough, but you wait: the menopause is something to really know about. You have to know for your mums who are going through it, or are about to go through it, and for your grandmothers and your aunties. It is really important that you know about the menopause so that you can support them and so that you know that when they are screaming at you, there is probably a reason for it. It is not because of you, but because they are probably having a really tough time because they haven’t slept for five days, they feel like they are having an out-of-body experience, they do not feel themselves and then they take that out on their families.” It is really important that husbands, partners, brothers and fathers also understand what women are going through.

We have come a long way. The Government have been listening. I know that the Minister takes a lead on this issue and I absolutely welcome the Government’s real emphasis on it, but we still have issues with a shortage of HRT products. When I went to get my prescription a few months ago, I was told that I could not have my Oestrogel because it is not in supply at the moment. I was really worried. I have one bottle left and am squeezing every single ounce of it. I hope to God that it will be back in when I go back to the GP next week. I urge the Minister to do all she can to make sure that the products get back on the shelves. I fear for my Chief Whip and my Whip if I do not get my HRT product. I am just putting that out there to the Minister—you have been warned.

More seriously, there is so much more that we have to do on education and for businesses. I am extremely proud that this week the Cabinet Office—the Minister was also at this event—became the largest organisation to sign the menopause workplace pledge. More than 1,000 organisations have now done so. That is a start, and it is amazing. The Government are actually taking the lead, but as many have said here today, including my right hon. Friend the Member for Romsey and Southampton North, there is much more that each Government Department can do—like not working in silos. We know that when Governments work in silos, nothing gets done. There has to be a holistic approach. Let us get this done.

It is very important to ensure that women are aware of the symptoms of menopause, but also that they can be symptoms of other conditions. I have recently been diagnosed with hypothyroidism and Hashimoto’s, and the symptoms are very much related to the menopause. Although I may have been going through the menopause, I wonder whether the vast majority of my issues over the past two or three years were because of my thyroid problem. I am now on thyroxine, and it is changing my life, but women need to understand that their symptoms might not just be from the menopause. GPs have to understand that, too. Again, I would like there to be more information and for GPs to have a better understanding of those issues.

To conclude, being in politics can be very difficult. We have so many arguments, and there is so much that can divide us, but women’s health—particularly issues such as the menopause—unites us. We can see Northern Irish, Scottish, Welsh and English MPs here today in support of getting more help for the menopause. That is what makes it great to be a Member of Parliament—we can come together and join forces to ensure that we support women and men in all walks of life. The menopause revolution has only just begun. It is only the start, but I am sure that, working together, we will ensure that women have the products and support they need to carry on with their lives. The menopause is a change. It is the midpoint in our lives. It should never be the end of women’s lives. I feel that I am just beginning my life.

--- Later in debate ---

[Carolyn Harris]

Thank you, Mr Robertson. I will not take the hour that is left for my summing up, although I could start all over again.

I want to make just a few points. First, I thank everybody for being here and for sharing their personal stories—I am looking in a certain direction. I know it is painful and hard, but when people in this place talk about their personal experiences, it makes us look like what we are—real people with real lives and real feelings—to the outside world. That gives confidence to women out there who are thinking that nobody cares and nobody is listening. Unless we talk to those women, we will not know how they feel. When Nicola Sturgeon appears on “Loose Women” and talks about her menopause, it is inspirational for women right across the UK. When a certain Jim Shannon gets a shout-out as a menopause ambassador on “Loose Women”, it gives confidence to women across the UK that we politicians are listening.

The celebrities who are coming in on Monday are really nervous about coming to Westminster. They think they are coming into a world where they are expected to perform in a particular way, and that we will all be looking at them and thinking, “What do you know about politics?” Through the work they have done, they have proved that they may do politics better than we do, and that they have used their platform to change actually things, without making it party political, which we try not to do on this subject. They are using their platform to share really important messages and really personal stories, in an industry where, traditionally, nobody wants to admit to being a certain age or to potentially being menopausal, because they would be seen as getting on a bit. I really want to thank them.

One thing that it is really important to say is that I would like to see the Davina effect enshrined in legislation—perhaps we can have a show of hands on that—because Davina McCall has played a huge role. I do not think any of us could really have done what we have done without Davina’s documentaries and the work she has done.

[Nickie Aiken]

On that point, rather than having the Davina McCall effect, perhaps we should all write to whomever we are meant to write to, to ask whether Davina McCall should become a Dame.

Special Educational Needs and Children’s Mental Health Services

Nickie Aiken Excerpts

Wednesday 9th February 2022 Westminster Hall

[Nickie Aiken (Cities of London and Westminster) (Con)]

It is a pleasure to serve under your chairmanship, Ms Fovargue. I thank my hon. Friend the Member for Newbury (Laura Farris) for bringing forward this important debate.

I do not think we realise the crisis that our children face on mental health. It is hard growing up—we all remember growing up—but our young people face an even more traumatic time following the pandemic. I truly believe that our children and young people have been badly affected by the pandemic and also by social media—we did not have social media, growing up, with that extra, 24/7 pressure.

On educational attainment, I have a 17-year-old daughter going through A-levels and a 15-year-old son going through GCSEs, and I can speak with authority about just how much pressure they are under. However, I cannot imagine how families cope with all the extra pressure when that is compounded by a special educational need.

I want to speak about people’s actual experiences in schools. I recently spoke to the head of a Westminster secondary school, who is a very experienced teacher. She said that she has never, in her 20-plus years as a teacher, known such a crisis in the mental health of young people and particularly teenagers. The pandemic has obviously compounded that, but we are now seeing far more anxiety, self-harming and suicidal thoughts. That is what she explained to me. The pressure that that head and her staff are under—to help and support the young people going through these things—has created even more of a burden for them. They are taking advantage of the Mind counsellors and the extra help that the Government are providing, but it simply is not enough.

There seems to be a disconnect between the Department for Education and the Department of Health and Social Care, because there is no one Minister taking control, and I ask the Minister to really consider that point. We cannot just leave it to schools to try to navigate special educational needs and support for families. We must make sure that there is one place for teachers to go for that support. There is such pressure on budgets now in schools. The head I spoke to told me how much they were now spending on extra support for pupils, which comes out of the general budget. I plead with the Minister to try to secure more funding for this issue from the Department for Education.

In Children’s Mental Health Week, I pay tribute to the local authorities in my constituency. This week, Westminster launched a trial of a keyring, which will reach 4,000 young people. They simply scan a QR code to take them to a special hub, which will give them the advice and support they need. That is the kind of practical help we need to give our children, but this is also about getting the funding that our schools need, to ensure that our young people have the future they deserve.

Covid-19 Update

Nickie Aiken Excerpts

Wednesday 8th December 2021 Commons Chamber

[Sajid Javid]

I am pleased that the hon. Lady welcomes these measures, which will certainly help to slow down the growth of omicron. I will look at the measure that she referred to.

[Nickie Aiken (Cities of London and Westminster) (Con)]

First, I thank my right hon. Friend for coming to the House to make this statement this evening and showing this place the respect that it deserves and expects. The hospitality sector has had a huge hit over the past 18 months because of the covid pandemic. In the past two weeks, following the omicron travel restrictions, we have seen a 25% cancellation rate in bars, restaurants and hotels in central London. Can he give assurances that whatever measures the Government introduce in the short term really will be short term, and that we will be able to get back to normal as soon as possible to support the hospitality sector?