Tackling Obesity

Preet Kaur Gill Excerpts

Tuesday 27th February 2024 Westminster Hall

[Preet Kaur Gill (Birmingham, Edgbaston) (Lab/Co-op)]

It is a pleasure to serve under your chairship, Mr Dowd. I thank the right hon. Member for Bexleyheath and Crayford (Sir David Evennett) for securing this debate. He has been a strong campaigner for tackling childhood obesity over many years, and I thank him for his remarks today.

As many colleagues have rightly highlighted, the obesity epidemic is a genuine crisis. It will be the next big public health issue that we will all be talking about in a few years. Some 60% of us are now overweight. One in four children in England are now obese by the time they leave primary school. That means that those children are five times more likely to go on to develop serious and life-limiting diet-related conditions in adulthood, such as diabetes, cardiovascular disease, liver disease and certain forms of cancer. Of course, that means more pressure on the NHS, which, as we know, is already buckling under the weight of demand after years of mismanagement by this Government. It is a disaster for the taxpayer: Frontier Economics estimates the impact of obesity to be £98 billion a year in NHS and social care costs, lost productivity, workforce inactivity and welfare payments.

I thank many Members for rightly focusing their remarks today on the poor food environments in which children are growing up, and what we as policymakers can do about that. In recent decades, action on obesity has overwhelmingly focused on measures to get people to change their behaviours without tackling the structural factors that influence them. We know that that is not enough. For example, 99.9% of us know that it is important to get our five a day, most of us can tell each other what a healthy diet looks like, and every week there seems to be some new fad diet. The bottom line is the nation’s waistline: Britain is getting fatter.

It is therefore disappointing to see the Secretary of State say that she believes the priority for preventing obesity is to give people information about nutrition with no measures to fix the food environment. It appears to be at odds with her views on tobacco, where the Government have rightly taken up measures to further protect children from tobacco harm. She does not believe that measures to inform children about the dangers of tobacco are alone sufficient to solve that issue, so why does she believe this for obesity? If giving people more information is the solution, can the Minister explain why obesity rates are twice as high in our poorest areas than the richest?

Labour believes that every community in the UK should be a healthy place for children to grow up, learn and play. Businesses need a healthy workforce to drive economic productivity and sustainable growth. It is the Government’s job to make the healthy choice the easy choice. There was a moment in 2020 when it looked like every party across the House believed this. The Government brought forward the 2020 obesity strategy, welcomed by doctors, parents and health charities, and as the right hon. Member for Bexleyheath and Crayford said, it received cross-party support.

The strategy contained evidence-based measures to begin to fix the food system by stopping our children from being bombarded with junk food adverts as part of a major commitment to halve childhood obesity by 2030. I would like to ask the Government today what has happened to that commitment, since they kicked that flagship policy into the long grass, delaying the policy for the next Government to deal with in October 2025. Are the Government still committed to halving childhood obesity by 2030, and what have they done since delaying the junk food advertising policies?

The need for action has not gone away, as we have heard today. The health of our children is in a dire state, and it is getting worse. It was once thought that it was essentially impossible for children to develop type 2 diabetes so early in life as a result of their diet, but as mentioned by the right hon. Member for Bexleyheath and Crayford, we are now seeing thousands of cases of children developing the condition, with more every year. Nearly four in 10 children with obesity are estimated to have early stage fatty liver disease, and tooth decay remains the single largest cause of hospitalisations for young children in England.

The Government assure us that the regulations on junk food advertising were delayed merely to give industry more time to prepare. If this is the case, why have the Government refused to bring out the supporting secondary legislation for these regulations, which are now months overdue? Surely the Minister agrees that it would help the industry prepare for these regulations to have this detail available to them now. Industry will want to tackle the structural drivers of ill health and be led by evidence, not ideology. That starts with delivering the measures the Government have failed to implement to protect children from junk food.

We will restrict adverts for foods high in fat, sugar and salt in favour of healthier options. We will improve children’s diets by finally implementing the 9pm watershed for junk food advertising on television and ban paid-for advertising of less healthy foods in online media. Tackling health inequalities is a central part of Labour’s health mission. We will not resort to the tired excuses that would blame families in Blackpool for having poorer health than someone in Banbury. Instead, we need to focus on making healthy food more affordable and accessible. Schools will have a role and responsibility within that, which is why our fully funded breakfast clubs in every primary school in England will serve healthy and balanced food to embed healthy habits and boost children’s concentration and development.

The Government undertook some assessments of the health impacts of the national school breakfast programme when it was running. It would be really good to hear what some of the evidence was. We heard from schools that it improved pupil behaviour, their readiness to learn, social skills and their eating habits. To conclude, I want to leave Members with a statistic to reflect just how stark this issue is. Not only are our children fatter than their peers in other European countries, but they are actually shorter than their European peers.

National HIV Testing Week

Preet Kaur Gill Excerpts

Thursday 8th February 2024 Commons Chamber

[Preet Kaur Gill (Birmingham, Edgbaston) (Lab/Co-op)]

It is a great pleasure to speak for the Opposition in this debate to mark National HIV Testing Week. We have heard great contributions today from Members on both sides of the House, and it gives me hope that we can continue to make progress on this issue in the years ahead. I thank my hon. Friend the Member for Warrington North (Charlotte Nichols), the hon. Member for Worthing West (Sir Peter Bottomley), the hon. Member for Strangford (Jim Shannon) and my hon. Friend the Member for Hammersmith (Andy Slaughter) for making powerful speeches on the enormous progress made on HIV.

Incredible advances mean that people living with HIV on effective treatment can now enjoy normal life expectancy and are no longer at risk of passing on the virus. The reality of living with HIV in the 2020s is a world away from the 1980s. As colleagues have remarked today, we might just have the chance to be the generation to make Britain the first country in the world to end new cases of HIV for good. It is an enormous credit to a generation of activists, fantastic organisations such as the Terrence Higgins Trust, many great campaigning MPs across the House and the all-party parliamentary group on HIV and AIDS that we have got to this point. More treatments have become available. Thousands of people are now living with HIV at levels undetectable or intransmissible to others, and the stigma and misinformation that the LGBT+ community suffered through the ’80s is not what it was.

For Labour’s part, we are incredibly proud of our record on HIV. It was the last Labour Government who switched spending so people could get the new drugs as they became available after 1997. We passed the Equality Act in 2010 that gave legal protections to people living with HIV. Chris Smith became the first MP to talk about living with HIV in 2005, and in 2018 my hon. Friend the Member for Brighton, Kemptown (Lloyd Russell-Moyle) was the first MP to talk about living with HIV here in the Commons. But there is much more to be done.

There are around 4,500 people in the UK living with HIV who are undiagnosed. The earlier those people can be found and linked to care, the better their health outcomes will be and the closer we will be to stopping new transmissions. Some 44% of people diagnosed with HIV in England last year were diagnosed at a late stage. Late diagnosis rates are even higher for women, at 51%, and that means some women are diagnosed so late they are already on their death beds.

[Sir Peter Bottomley]

I am glad the hon. Lady is making the important point that women are particularly at risk of non-diagnosis. She rightly mentions some Labour people who made important contributions. We ought to remember Norman Fowler. I do not normally talk about my wife’s work, but if I may say so, when she was Secretary of State for Health, she got the insurance companies in and said, “Do not charge higher premiums, or refuse cover to, people who have taken an HIV test. That is not the way to move forward.”

--- Later in debate ---

[Preet Kaur Gill]

I thank the hon. Gentleman for his remarks, which he has now put on the record.

There were 13% fewer people tested for HIV in 2022 than in 2019. That is why we have seen cross-party support today for National HIV Testing Week. Testing is free, quick and easy. You can even test from home, and you can order a free test online; I urge colleagues to share that information with their constituents.

Turning to what the Government can do to help eradicate new transmissions of HIV, I was very pleased to see the Government finally commit to rolling out opt-out testing to all 32 areas of high HIV prevalence in England. The pilots have been a resounding success, and Labour has fully supported bringing them to other high-risk communities across England. The shadow Health Secretary, my hon. Friend the Member for Ilford North (Wes Streeting), was on the HIV Commission that first made the recommendations. Will the Minister provide an update on progress towards rolling out the programme to the 47 new hospitals? Can she provide reassurance that in the long term, opt-out testing in emergency departments will be embedded as a cornerstone of the UK’s plan to end new HIV transmissions? Receiving an HIV diagnosis can be alarming, especially if you are not expecting it, so has she considered setting aside a portion of funding to ensure that people who are diagnosed through the scheme are given support to help them to come to terms with their diagnosis? Has she made an assessment of whether opt-out testing could be rolled out to other settings in primary care?

The Minister will know that the HIV action plan included several commitments on HIV testing, including the commitment that local authority commissioners would set the standard that sexual health services would achieve a 90% testing offer rate to first-time attendees. Two years on from the publication of the plan, there has been no reporting on its progress. Will the Minister say what progress the Government have made against commitments in the HIV action plan to increase the number of people tested in sexual health services?

Finally, I want to ask the Minister about the Government’s commitment to the prevention agenda. Under the Government, we have widening health inequalities, life expectancy stalling, and a record high of 2.8 million people out of the workforce due to ill health. Any Government interested in supporting the NHS would put prevention front and centre of their agenda, but for 14 years, there has been no joined-up plan for health, and services and institutions that promote good health have been run down. This week we heard that England’s national public health agency, the Office for Health Improvement and Disparities, has been “effectively dismantled”. OHID leads on sexual and reproductive health and HIV, as well as a wide range of public health issues, ranging from tobacco to obesity and children’s health. Will the Minister explain how the Government can be committed to the prevention agenda when they are dismantling our national public health function? Will she do us the courtesy of confirming how many full-time equivalent staff have been cut from OHID, and can she explain why the Government have not had the courtesy to make a statement to Parliament on what has been reported, which sounds like quite significant cuts?

The remarkable progress on HIV has been hard won, and it puts ending new cases of HIV within reach. We have only one Parliament left to do that by 2030. I want to put on record clearly that Labour is committed to getting us over the line. That is why we would immediately get to work publishing a refreshed HIV action plan. It will not be easy, but we know what it will take. We owe it to everyone we have lost to the virus, everyone who has faced that stigma, and everyone who is living with HIV today to end new transmissions once and for all.

Pharmacy First

Preet Kaur Gill Excerpts

Wednesday 31st January 2024 Commons Chamber

[Preet Kaur Gill (Birmingham, Edgbaston) (Lab/Co-op)]

I thank the Minister for advance sight of her statement.

Let me start by paying tribute to the many organisations that have been involved in preparing for this launch and the thousands of pharmacies across the country that have embraced this initiative. Labour has long been arguing that pharmacists should play a greater role in the NHS, so we support this move.

As the Minister has said, pharmacies already do far more than just dispense repeat prescriptions and sell shampoo: they are medicine experts within the NHS; they are highly trained; they are easily accessible right across the country; and, as we saw during the pandemic, they are a highly trusted part of their communities. But their skills and knowledge are often under-utilised. Therefore, bringing more services to British high streets for patients to get treated more quickly and conveniently is absolutely right. It is why, as we announced last week, we want to bring NHS out-patient appointments closer to people through high street opticians too.

The Minister is right to say that pharmacists can take pressure off GPs. However, let us be clear: this announcement will not make up for the 1,000 pharmacies which have been closed under the Conservatives, or the 2,000 GPs that have been cut since 2015. Patients today are waiting over a month to see a GP, if they can get an appointment at all. When Labour was last in office, people could get an appointment within 48 hours.

That is the thing with this Government: they give with one hand and take with the other. Will the Minister explain what has happened to the Government’s pledge to deliver 6,000 more GPs this year and what she is doing to support community pharmacies, which are already facing a perfect storm of inflationary pressures for running costs, recruitment challenges and an unstable medicines market?

The Government press release issued today claims that patients in England will be able to get treatment for seven common conditions at their high street pharmacy from today. I would like to dig down into whether that is actually the case. Healthwatch England has warned that it will take time for pharmacists to be trained in order to provide the services that Ministers have announced, so can the Minister tell us when she will be able to guarantee that the services advertised will actually be available?

Let me also ask about IT integration. To facilitate this roll-out, pharmacists were supposed to have access to GP Connect, so that details of patient consultations would automatically be sent to general practice through the clinical IT systems. The Government have had 12 months to get that ready, but from what I am hearing this morning it is still not live. Pharmacists are telling me that they can access only a summary of GP records, that they have to use another system to input what they have prescribed, and that they then have to download that and email it across to the GP. That is cumbersome. What estimate has the Minister made of the time that will be wasted at a local level to address that issue, and how long will it take before the system is ready?

Finally, what is the Government’s plan in the longer term to integrate the increase in independent prescribers who are being trained as part of the long-term workforce plan, and does the Minister agree with us that we should be accelerating the roll-out of independent prescribing to establish a community pharmacist prescribing service covering a broad range of common conditions? That would support patients with chronic conditions, which is the big challenge facing the NHS. Does the Minister agree that community pharmacies will have an important role to play in supporting GPs in the management of long-term conditions such as hypertension and asthma and in tackling the serious issue of over-prescribing, which is responsible for thousands of avoidable hospital admissions every year?

We agree that patients should be able to go to their local pharmacy to receive some services that they currently get at GP surgeries, such as vaccinations free of charge on the NHS, allowing patients to be seen faster and freeing up GPs to see more complex cases. By bringing healthcare into the community, patients will have greater control. The NHS should be as much a neighbourhood health service as a national health service, with healthcare on the doorstep, there when it is needed—and with Labour, it will be.

[Dame Andrea Leadsom]

Well, the very first appointment under Pharmacy First happened at 8.30 this morning.

Oral Answers to Questions

Preet Kaur Gill Excerpts

Tuesday 23rd January 2024 Commons Chamber

[Mr Speaker]

I call the shadow Minister.

[Preet Kaur Gill (Birmingham, Edgbaston) (Lab/Co-op)]

I want to share with Ministers the experience of Emma from Grimsby, who said:

“NHS dentistry is a joke in the town at the moment. Thankfully I managed to get an emergency appointment in Scunthorpe (after being offered one in Doncaster originally) and I’ve now been referred to hospital to have 3 wisdom teeth removed. My dentist closed at the onset of the pandemic and I’ve not been able to register with an NHS dentist since.”

What does the Minister have to say to Emma and the millions like her who cannot get an appointment when they need one?

[Dame Andrea Leadsom]

The hon. Lady is absolutely right to point that out. Emma has my absolute sympathy and apology for the fact that since the covid pandemic we have not seen the recovery of dentistry that we would have liked. I can tell her that in July 2022 we brought in significant reforms to encourage dentists to take on more NHS patients, but we recognise the need to do more. The long-term workforce plan will increase training places and the overseas registration will improve capacity, as will the changes to dental therapists’ programmes. All those things will improve the situation, but in the meantime we will be bringing forward our recovery plan very soon, which will immediately expand the incentives to NHS dentists.

Draft Medical Devices (In Vitro Diagnostic Devices etc.) (Amendment) Regulations 2023

Preet Kaur Gill Excerpts

Tuesday 16th January 2024 General Committees

[Preet Kaur Gill (Birmingham, Edgbaston) (Lab/Co-op)]

It is a pleasure to serve under your chairship, Dame Maria.

As the Minister set out, we are considering regulations that update legislation pertaining to in vitro diagnostic devices and make supplementary provisions for the EU IVDR in Northern Ireland. The SI appears to be an innocuous measure to support the implementation of new EU regulations that came into operation in Northern Ireland in May last year. Those will continue to be applied, per the annex to the Windsor framework, but with consequential amendments to other legislation, provisions for the fees for certificates and conformity assessment, and some practical provisions for the enforcement of the new regulations.

It is of course critical that we secure continuity of supply and trade in medical devices within the United Kingdom and with the EU. The draft regulations affect a diverse range of equipment and systems to examine specimens in vitro, including things like blood grouping reagents, pregnancy test kits and hepatitis B test kits. From catching killer diseases early to preventing infections, the medtech sector makes a huge contribution to our national health service and our vibrant life sciences sector. These products are found in doctors’ surgeries, hospitals and our own homes, and we saw during the pandemic how difficult it can be to replace them when supply is disrupted.

Although the explanatory memorandum sets out that the draft regulations should affect only 19 businesses in Northern Ireland and cost less than £5 million to implement, they are still a valued part of the UK medtech ecosystem. The Opposition therefore support the regulations to secure unfettered access to the GB market for NI businesses and continuity of supply. None the less, I have a few questions for the Minister.

We welcome the fact that the previous fee structure is being retained to reduce disruption for NI operators, but will the Minister say what assessment has been made of any impact on the MHRA’s responsibilities as regulator, and assure us that it will be resourced to fulfil them? Previously, Ministers have talked about future realignment of regulations on medical devices following our departure from the EU, including consideration of alternative routes to the GB market. Will the Minister comment on the opportunities in this area? What is the timeline for the future regulatory regime that the Government want to bring into force? The Government have still not set out their proposals; is there a timeline for doing so?

It is interesting that medical devices did not receive attention in the Windsor deal. I know that some suppliers are disappointed by this, citing the complexity of navigating the current system. Is the Minister considering adding other product classes, like medical devices, to its scope? Will he also clarify the status of devices on which a conformity assessment has been performed by a UK notified body? Will it be possible to place devices bearing a CE conformity mark as well as the EU(NI) mark on the EU market? To my knowledge, no UK notified body has been appointed; when will this be dealt with and why has it been delayed?

To reiterate, we support the amendments to secure continuity of supply for the critical medtech sector. I look forward to hearing the Minister’s response.

Illegal Vapes

Preet Kaur Gill Excerpts

Tuesday 16th January 2024 Westminster Hall

[Preet Kaur Gill (Birmingham, Edgbaston) (Lab/Co-op)]

It is an honour to serve under your chairmanship, Sir Mark. I thank the hon. Member for Darlington (Peter Gibson) for securing this important debate, and the many colleagues who have made excellent points, including my hon. Friend the Member for City of Durham (Mary Kelly Foy) who is a great campaigner on this issue.

Many Members have focused their remarks on the impact of vaping on children, and they are absolutely right to do so. The Opposition recognise the value of vapes as a stop-smoking tool. They have their place. The chief medical officer put it bluntly:

“If you smoke, vaping is much safer; if you don’t smoke, don’t vape”.

But the CMO has also been blunt about the epidemic rise in youth vaping in recent years. Nicotine addiction is in no one’s interest apart from the companies that profit from it. Certainly no child should be vaping. We do not even know some of the long-term risks of the ingredients used in vapes, and certainly not when inhaled by young people whose lungs and brains are still developing.

However, I am afraid to say that the Government have been asleep at the wheel. In 2021, as we have heard, Labour voted for an amendment to the Health and Care Act 2022 to crack down on the marketing of vapes to children. Since then, as Labour has found, the number of children aged 11 to 17 who are vaping regularly has more than trebled. That is more than 140,000 British children. Meanwhile, one in five children have now tried vaping. Does the Minister regret that her Government and MPs voted against the amendment in 2021?

The issue is that it is now 2024 and we still have no legislation in place. It is bad enough that so many children are using these products, but, as other Members have said, it is even worse when we consider how many products on the market are illegal in their own right. As the chief medical officer has warned, those products can contain dangerous chemicals such as lead and nickel. Some contain nicotine when claiming they do not, or harmful tetrahydrocannabinol chemicals found in cannabis. To be clear, in most cases that amounts to a failure in enforcing existing regulations, and it really is shocking.

Last year, Inter Scientific and the BBC conducted an analysis of vapes confiscated from schoolchildren, and found that the vast majority did not meet UK product regulations and were actually illegal. In a separate analysis of 300 products seized by various trading standards around the country, they found that 88% were non-compliant with UK regulations; 23% had a nicotine strength over the legal limit; 15% contained lead, which when inhaled can damage children’s central nervous system and brain development; 100% contained nickel; and 33% contained nicotine, despite being marketed at 0%, which absurdly means that they can be sold to children. Can the Minister tell us what she will do to crack down on the influx of illegal vapes so that dangerous products are not falling into the hands of our young children?

From speaking to experts in the industry, I have heard that there has been an influx of illegal vapes into the United Kingdom in recent years. One expert I consulted said they think that around 6 million illegal vape products have flooded the UK in the last 12 to 24 months. Can the Minister comment on why the UK seems to be targeted more than many other countries, and where she thinks these products are coming from? Until now, UK regulations have largely inoculated us from public health scares such as the spate of hospitalisations from popcorn lung in the United States, but does she share my concern that if we do not get a grip on illegal products flooding our markets, we could face something similar here? Lastly, can she comment on what she has learned from the Government’s consultation about the percentage of vapes circulating in the UK that are illegal under the 2016 regulations? If it is anything like the 88% found by Inter Scientific, we have a very big problem.

A glaring issue that many have identified is enforcement. As we all know, trading standards is stretched and Border Force is evidently not stopping the import of illegal vapes in sufficient numbers. However, the Government have not made their job easy. One issue is the confusing regulations. I know that the Government have said they will act to close the loophole that means that while it is illegal to sell vapes to children, it is fine to hand them out. We have heard less from the Government on the fact that it is also currently legal to sell nicotine-free vapes to under-18s, which is of serious concern. Labour has been vocal on this issue. As I have flagged, these 0%-nicotine vapes in fact often do contain nicotine or other harmful chemicals. Will the Minister confirm that the Government will take action to ban those vapes being sold to children? It strikes me as a blatant loophole that is giving unscrupulous companies scope to hook young children on their products as a gateway to addiction. These 0%-nicotine vapes are out of the scope of the regulations, meaning they do not need to be registered with the MHRA. Will the Minister now require all manufacturers to notify vape products regardless of nicotine content to the MHRA? This would allow for a complete database of products where currently it is not possible to say which products are legal or illegal, which really undermines enforcement action.

Speaking of the MHRA, we must also recognise that the relevant authorities are not always empowered to do what is needed to crack down on those breaking the rules. It strikes me as a serious shortcoming that as long as producers complete notification requirements with the regulator, their product is allowed to go on the UK market without being tested as a whole. The MHRA—the regulator—does not have powers to test products to determine whether they are even compliant with what producers claim are in them, nor to remove notifications once published.

The fact that under this Government children are using vapes with nicotine in them is pretty scandalous, given what we know about the lack of regulations. I say that because when the producer of Elf Bars was found to be selling products that had larger tank sizes than allowed, the regulations did not provide the MHRA with the power to remove the product from the market, as the product notifications said that it was compliant. That is farcical.

This matter is a huge concern not just for me, but for most Members across the House. Will the Minister say whether she is looking at this as part of the legislation? Will she consider allowing the MHRA to use notification fees for testing and enforcement and giving it the powers to remove notifications from publication and, if necessary, take products off the market? Likewise, does she believe that Border Force has the powers that it actually needs? Will the Minister finally tackle the issue of youth vaping, as we have heard about from many Members, by doing what Labour has called for for years and banning vapes from being branded and advertised to appeal to children? We have all seen the displays in our local off licences, with flavours like gummy bear and unicorn shake, looking like colourfully packaged pick ‘n’ mix products at pocket-money prices. These really do need to be banned.

[Dr Johnson]

The hon. Lady is making some very good points about the regulations that need to be brought in to protect children. I do not think anybody thinks that the colours and flavours are not there in some ways to attract children—how many adults are going to want a unicorn milkshake-flavoured vape, whatever that tastes like? On that point specifically, would the Labour party support legislation brought in by the Government to ban all but one colour and to severely restrict the flavours available?

[Preet Kaur Gill]

What has been marketed at children, definitely, is the different flavours. However, I appreciate that adults do choose different flavours as part of their whole smoking cessation, so we need to look at the evidence in the round once we are looking at the Bill. I would be keen to hear at what the Government say on that and to look at the evidence base. We need to look at the ingredients, the make-up of colours and how we get those flavours—it is about what those ingredients actually mean. We have to ensure that we have a proper evidence base on that issue.

[Dr Johnson]

I was talking to an industry representative about the issue of flavours in particular, and he told me that when a smoker decides to quit, they often start with a tobacco-flavoured vape. When their sense of smell and taste improves because they have stopped smoking, they then no longer like the taste of the tobacco vapes, so they move on to cherry cola or some other flavour. That actually can persist their addiction. The concern about removing the flavours is that instead of stopping using the vapes, people will continue—

[Sir Mark Hendrick (in the Chair)]

Order. Interventions are meant to be short. The hon. Lady has already spoken, and we still have the Minister to come. She requires 10 minutes at least, and it is now 5.19 pm. I suggest to the Opposition spokesperson that she makes an end to her speech fairly quickly.

[Preet Kaur Gill]

The next Labour Government would come down like a ton of bricks on companies profiting at the expense of our children’s health. As part of our child-health action plan, we will crack down on companies peddling vapes to children. We will work with local councils and the NHS to ensure that they are being used as a stop-smoking aid, rather than as a new form of smoking. We will tackle health inequalities, get serious about prevention and ensure that children born in Britain today are part of the healthiest generation that ever lived. I look forward to the Minister’s response.

Smokefree Future

Preet Kaur Gill Excerpts

Thursday 11th January 2024 Westminster Hall

[Preet Kaur Gill (Birmingham, Edgbaston) (Lab/Co-op)]

It is a pleasure to serve under your chairmanship, Mr Sharma, and to speak in this important debate. It has been great to hear the large degree of consensus across the House on our ambition to secure a smoke-free future. I thank the hon. Member for Harrow East (Bob Blackman) for securing this debate and for his work with the all-party parliamentary group on smoking and health. I also welcome the new Minister to her place.

I thank my hon. Friends the Members for City of Durham (Mary Kelly Foy) and for Blaydon (Liz Twist) and the hon. Members for North Antrim (Ian Paisley) and for Strangford (Jim Shannon) for their powerful contributions on why we need a smoke-free future. They talked about the health impacts that we currently see, but also offered practical solutions.

As we have heard today, smoking is an absolute blight on the health of our society. The “Global Burden of Disease” study found that despite the fall in smoking rates in recent decades, it remains the No. 1 risk factor that causes premature deaths in England. In 2019, tobacco caused an estimated 125,000 deaths in the UK. That is one person every five minutes—a staggering statistic. On average, smokers lose 10 years of life. Not only is smoking an expensive habit, as we have heard, but it is three or four times more common in some of our most deprived communities.

If everyone quit tomorrow, it is estimated that that could lift 1 million children out of poverty. That is to say nothing of the impact on the economy. Not only is it another cost to our NHS, but Action on Smoking and Health has estimated that smoking costs the United Kingdom £32 billion in lost productivity through lost earnings, unemployment and early deaths, and another £15 billion in social care costs. The evidence is overwhelming that for the future of the NHS, the economy and the health and wellbeing of the country, smoking is bad for Britain.

As Primary Care and Public Health Minister, I will drive a prevention agenda forward. The agenda has received many warm words from Conservative MPs and Ministers in the abstract, but very little by way of action over the past 14 years. We in Labour have set ourselves a clear mission to reduce the number of lives lost to the biggest killers. Realising a smoke-free future will be integral to that.

Smoking, of course, is the leading cause of cancer in the United Kingdom. It is strongly linked to cardiovascular disease, which is highly preventable, yet causes one in four deaths in the United Kingdom. Some 15,000 deaths from heart and circulatory diseases can be attributed to smoking every single year, so Labour has set clear targets on both cancer and cardiovascular disease. We will improve cancer survival rates by hitting NHS cancer waiting time and early diagnosis targets within five years so that no patient waits longer than they should, and we will reduce deaths from heart disease and stroke by a quarter within 10 years. Building a smoke-free future will be key to that to help more people make that journey.

We welcomed the Khan review when it was published in 2022, and we were pleased to see some of the recommendations taken forward. I will not use this debate to discuss the Government’s smoke-free generation legislation. We shall await their response to the consultation when it is published—perhaps the Minister can today share the timeline for that. To be clear, the Opposition support phasing out smoking over time, and we encourage the Government to get on with it.

When we proposed phasing out smoking, some Conservatives attacked us. The hon. Member for Blackpool South (Scott Benton), who cannot take part in the debate today, called it “health fascism’’ and

“an attack on ordinary people and their culture”.

I ask those Members what freedom they think there is in addiction. Is it in the average 10 years of life lost by smokers compared with non-smokers? Or the millions of children growing up with parents who smoke? It is a shame that the Prime Minister has failed to convince his MPs of the argument for the reforms and is calling a free vote. But he can rest assured that Labour will vote to see this through.

As Members have highlighted today, the legislation cannot be a substitute for smoking cessation services and other public health measures. Two thirds of adult smokers started before the age of 18; the legislation will come too late for them. Adults who have smoked for years and have not managed to kick the habit need help, too. Does the Minister share my concern that local government funding for “stop smoking” services and tobacco control has fallen by 45% since 2015? Has she assessed the impact of that against the 2030 ambition? Can she provide an update on when the major conditions strategy will be published?

One of the clearest cases to do more on smoking is the impact on children. There has been good progress in recent decades to bring down maternal smoking, but there is more to do. Last year, 9% of mothers were smokers at the time of delivery—still some 50% above the Government’s 6% target. At the current rate of progress, we will not hit that goal until 2032. That is why, as part of Labour’s child health action plan, which was launched today, we would make sure that all hospital trusts integrated opt-out smoking cessation interventions into routine care, with a named lead on smoking cessation, meaning that parents would have all the support they needed to quit and every interaction with the NHS actually encouraged quitting.

Children born to households that smoke are more likely to be born with heart defects, born underweight, or grow up to be smokers themselves—if they grow up at all. Smoking in pregnancy doubles the likelihood of stillbirth. It increases the risk of pre-term birth and miscarriage, and trebles the risk of sudden infant death syndrome. The health of Britain’s children should be non-negotiable. For my part, I want to ensure that children born in Britain today are part of the healthiest generation to have ever lived. But to do that, children deserve a smoke-free start. Can the Minister tell us what she is doing to ensure that every expecting mother is offered the smoking cessation support they need, and that partners, as we heard from the hon. Member for Harrow East, are also encouraged to quit?

For far too long, public health has been either an afterthought or a battleground on which to have ideological arguments. Strategies have been announced and binned in short order, health inequalities have widened, and the long-term crisis in the NHS has deepened. But, just as the last Labour Government delivered one of the most significant public health interventions in history in the smoking ban, the next Labour Government will grasp the smoke-free challenge. We will get serious about prevention, deliver equitable access to smoking cessation services, and take on tobacco companies that profit at the expense of public health. As part of our child health action plan, Labour will make sure that Britain’s children get the happy and healthy start in life that they deserve.

Recently, a school in my constituency had to apologise after handing out a leaflet to a child suggesting smoking as a self-help measure—absolutely shocking and bizarre. That is why Labour has decided to legislate to make tobacco companies include information in tobacco products that dispels the myth that smoking reduces stress and anxiety, and to crack down on businesses marketing vapes to children. We will ensure that the incremental ban on smoking comes into force so that the next generation are not addicted to tobacco. The last Labour Government led the way in tackling smoking, and the next one will do so again.

NHS Dentistry

Preet Kaur Gill Excerpts

Tuesday 9th January 2024 Commons Chamber

[Preet Kaur Gill (Birmingham, Edgbaston) (Lab/Co-op)]

I start by expressing my thanks to Members across the House for their many powerful contributions this afternoon. They include my hon. Friends the Members for Stockport (Navendu Mishra), for Weaver Vale (Mike Amesbury), for Wakefield (Simon Lightwood), for Birmingham, Erdington (Mrs Hamilton), for City of Durham (Mary Kelly Foy), for Easington (Grahame Morris), for Leeds North West (Alex Sobel), for Selby and Ainsty (Keir Mather), for West Lancashire (Ashley Dalton), for Tamworth (Sarah Edwards), for Mid Bedfordshire (Alistair Strathern), and for Lewisham East (Janet Daby). They all spoke forcefully about the struggles of their constituents to find an NHS dentist. That is far too common, as we have heard today. Recently I was contacted by a constituent whose daughter was told she would have to wait four years for an appointment to get braces. She is 13 now and will be 18 by the time that she is seen. That is not acceptable.

Let me also thank my hon. Friends the Members for Bradford South (Judith Cummins), for Sheffield, Brightside and Hillsborough (Gill Furniss), for Brighton, Kemptown (Lloyd Russell-Moyle), for Stretford and Urmston (Andrew Western), and for Kingston upon Hull West and Hessle (Emma Hardy) for raising the issue of DIY dentistry. Recent polling has found that around one in 10 adults has attempted some form of DIY dentistry. No one should be forced to pull out their own teeth with pliers. That is Victorian healthcare in Britain in 2024. The British Dental Association survey found that more than half of dentists in England have reduced their NHS commitment in the past few years, and almost half are considering either a change of career, early retirement or turning fully private. I hope that this is a wake-up call for Ministers. All of this paints a bleak picture, Mr Deputy Speaker. The Nuffield Trust described it as a “widespread crisis”, bringing NHS dentistry to its “most perilous point” in its 75-year history. That is why we are debating this motion today. Without urgent action, we are looking at the end of NHS dentistry as we know it.

Seventeen months ago, while he was losing a leadership election to the right hon. Member for South West Norfolk (Elizabeth Truss), the Prime Minister pledged to “restore” NHS dentistry. I thought the Prime Minister might have learned his lesson about five-point pledge cards by now, but I remind the House what he promised: ringfenced funding; frontline retention; strengthened prevention; and contract reform. Yet hardly any of that has been delivered. There are fewer NHS dentists now than when he took charge, and they are doing less NHS work. There has been no national roll-out of a supervised toothbrushing scheme to promote healthy habits among children, despite cavities being the top reason they are admitted to hospital. As the Health and Social Care Committee has said, changes to the dental contract

“constitute tweaks rather than anything close to ‘reform’.”

The recovery plan, promised last April, is nowhere to be seen. The Government’s one big idea so far has been to tweak the dental activity contract to allow practices to deliver 10% more NHS work but, having listened to today’s debate, I do not think that a fraction of practices upping their workload by 10% will actually cut it—talk about toothless—and it certainly will not without the money to fund it. We have heard some laboured explanations from the Secretary of State about how local dentistry budgets can be ringfenced, yet simultaneously ICBs have been told that they can raid those same budgets to balance their bottom lines.

Let me raise a specific example. Last week, it was reported that one integrated care board in the west midlands has instructed practices that they will no longer receive funding to deliver the extra 10% of NHS work that was promised. Labour’s candidate in Newcastle-under-Lyme, Adam Jogee, told me that people were already struggling to access basic dentistry as many dentists are not accepting new patients. ICBs are supposed to improve access locally, better integrate services and address inequalities. For one practice in Birmingham, the decision means that from next month the money for it to see NHS patients will run out for the rest of the financial year. The U-turn means that dentists who want to do more NHS work simply cannot. That is bonkers!

It is not just happening in the west midlands: throughout the country there are more examples of care boards cutting back funding for dentistry. Eight out of 10 practices are not taking on new NHS patients, and people are pulling out not just their hair but their own teeth, because they cannot get an appointment. One local dentist in Birmingham said:

“The system is on the verge of collapse—and the only stakeholder that will eventually lose out is the patient.”

That is not restoring NHS dentistry; that is another broken promise. Does the Minister know how many other ICBs are withdrawing funding? Have the Government even made an assessment of the U-turn’s impact on thousands of people who cannot get an appointment with an NHS dentist? Do they know how much scheduled dental activity will be lost under the revised financial plans of ICBs?

As we have heard today, the consequences for patients are shocking, particularly for children and the most vulnerable. Tooth decay is the No. 1 reason for hospital admissions among children aged six to 10. Tens of thousands of children are left in pain for months, if not years, waiting for procedures. They face difficulties learning, eating and sleeping. It is particularly grim when we consider that children from the most deprived areas are three times more likely to have hospital extractions than their peers.

How can the Government hope to level up opportunity for every child in Britain when some are in too much pain even to concentrate at school? Sixty thousand school days were lost to this problem last year. That is why our plan includes rolling out a national supervised toothbrushing scheme that targets the most deprived 20% of children, embedding good habits. It is recognition that prevention is better than cure. It will cost £9 million per year, which is dwarfed by the estimated £51 million that it cost for child tooth extractions in hospital in the latest year. Labour actually understands good economics—that dealing with issues early saves cases worsening and ending up in secondary care, which puts pressure on hospitals and costs the taxpayer far more.

While the Government have been rolling back their ambitions, Labour will ramp ours up. Our motion proposes giving dental practices extra money to run urgent care programmes to give people access to timely acute care, which they simply cannot get right now. We will fund an extra 700,000 urgent appointments a year from revenues generated by abolishing the non-doms tax status. Not only is that costed, but it is deliverable and doable, because dental practices have the capacity to deliver; the issue is that they do not have a Government with a plan that gives them the certainty they need. Our constituents need dental appointments far more than the wealthy need tax breaks.

I am grateful to colleagues who have raised the issue of the dental activity contract. They are right that it is no longer fit for purpose, and I think that Ministers know that—despite having pledged to reform it 14 years ago, which they have clearly failed to do. Do they share my concern that without wider reform to tackle retention issues in NHS dentistry, recruitment alone will be like trying to fill a leaky bucket?

In the meantime, NHS dentistry is dying a slow death. I was shocked to read about a pilot scheme in Cornwall in which only children and the most vulnerable are being seen on the NHS. At one practice, 4,500 patients were kicked off the books and told either to go private or to find another dentist. This is what we can expect under five more years of the Conservatives: dentistry for the few and everyone else left to sink or swim. We in the Labour party will never accept that.

NHS dentistry is an issue that crosses party lines and is as desperate in many Conservative constituencies as it is in Labour ones. We have good data on dentistry practices self-reporting whether they can take on new NHS patients. In Milton Keynes North, 12 out of 12 practices are not accepting any new adult patients, and in Bassetlaw, 10 out of 10 surgeries are not accepting new adult patients and seven in 10 are not accepting anyone at all. In Louth and Horncastle, the Health Secretary’s own constituency, not a single practice is accepting new adult patients. That is a big constituency; imagine how far someone living on the coast would have to travel to get an appointment. I heard it is about 21 miles to the nearest dentist. Is her message to constituents just to get on their bike? Or will she back our proposal today for a targeted recruitment scheme to train up new dentists in left-behind areas?

The crisis in NHS dentistry is urgent and cannot be ignored any longer. The Government need to drop the spin and accept the facts. In the short term, services need to be put on a sustainable footing, and in the long term we need deeper reform to ensure that everyone who needs an appointment can get one. I urge Members across the House to do right by their constituents today and vote for Labour’s motion to rescue NHS dentistry from further decay.

International Health Regulations 2005

Preet Kaur Gill Excerpts

Monday 18th December 2023 Westminster Hall

[Preet Kaur Gill (Birmingham, Edgbaston) (Lab/Co-op)]

It is a pleasure to serve under your chairship, Sir George, on this debate responding to the e-petition 635904, which relates to the International Health Regulations 2005. It is wonderful to see so many of the public in attendance.

I thank my hon. Friend the Member for Lancaster and Fleetwood (Cat Smith), who is Chair of the Petitions Committee, for opening the debate. I also thank the right hon. Members for Wokingham (John Redwood) and for Rayleigh and Wickford (Mr Francois) and the hon. Members for Shipley (Philip Davies), for North West Leicestershire (Andrew Bridgen), for Devizes (Danny Kruger) and for Christchurch (Sir Christopher Chope) for their contributions. I was in the debate responding to a similar petition regarding the draft treaty on pandemic prevention, preparedness and response in April; I hope hon. Members who were also in that debate will forgive me for retreading some similar ground.

The covid pandemic was one of the most surreal and seismic events of our lifetimes. Hundreds of thousands of people died here in the United Kingdom and millions more were extremely ill. There are perhaps two million people still living restricted lives, who are now in their fourth year of shielding because they are clinically vulnerable to the virus—we should not forget them. As our economy and public services still recover, it is vital that we learn lessons and take steps to strengthen our resilience for the future, and I hope that the inquiry taking place at the moment will be a valuable resource in that respect. Our NHS was badly prepared, the Government’s handling of public health measures was chaotic, and we jumped in and out of lockdowns. Some measures, such as guidance issued to care homes and eat out to help out, were raised as concerns by Members of this House, including myself.

As we discuss the petition, we must recognise the international dimension of the pandemic, too. Deadly infectious diseases do not respect borders. It is therefore squarely in our interests to co-operate with other nations and support efforts to co-ordinate the global public health response. The lesson of the pandemic was that no one is safe until everyone is safe, so it is clear that global co-operation on pandemics and biological threats needs to be strengthened. Labour absolutely supports the principle of legally binding international health regulations that define the obligations of countries in handling pandemic-level threats. That is critical to our national health security.

The international health regulations under discussion have of course existed in various forms since the 1960s. The latest iteration came into force in 2007. As they stand, the regulations obligate the 196 state parties to develop national core public health capacities for the detection, assessment, control and reporting of public health events. At some international ports, airports and ground crossings, they require parties to notify the WHO of serious diseases with risk of international spread. They set some of the human rights and other protections for any of us travelling abroad—protection of personal health data, for example. Those requirements are hardly controversial, apart from the fact that they were not on their own sufficient to prevent the spread of covid-19 around the world. That is why we think they must be strengthened. Climate change and globalisation mean that biological threats are only becoming more common, and future pandemics could be deadlier than covid-19. If another epidemic strikes with that same infectious potential, we must ensure that we are better prepared.

The subject of debate today is how amendments to the international health regulations and the pandemic accord under negotiation at the World Health Organisation might actually impact the United Kingdom’s public health policy in the future. Earlier I mentioned some of the measures taken by the UK Government during the pandemic, ranging from interventions like eat out to help out to the three national lockdowns. The variety of those policies and how they compare with some of the other 195 countries who are also signed up to the international health regulations shows that the UK and other countries were able to exercise considerable discretion in their domestic responses to the pandemic.

It is important to emphasise this fact: the e-petition we are discussing asks for Parliament to vote on amendments to the IHR, which are being negotiated alongside the draft text of the pandemic accord that we debated here in April. It raises concern that Parliament has not voted on an amendment to which the UK Government agreed and that was adopted at the World Health Assembly last year. That is a process-related amendment under article 59 of the international health regulations, which reduces the time for future amendments to come into force to 12 months. Of course, until any such future amendments are agreed, it will have no impact on the United Kingdom.

In any case, the principles that protect our national sovereignty will remain. The democratically elected Government are responsible for negotiating, signing, ratifying, amending and withdrawing from international treaties under their prerogative powers. Any legislation, if necessary to implement the regulations, would have to go through the proper parliamentary process. No international treaty can, by itself, change United Kingdom law. As for the future amendment, it makes sense that, as the only international treaty on infectious diseases, changes to the IHR are considered alongside the draft text for the pandemic accord. Of course, as negotiations are still under way, nothing is agreed until everything is agreed.

[Mr Francois]

If what the hon. Lady says is true, why has Parliament just spent two weeks arguing about Rwanda? Can I ask her a direct question? She has heard many concerns expressed from the Conservative Benches about these proposed amendments. With the exception of the hon. Member for Lancaster and Fleetwood (Cat Smith), who introduced the debate, not a single Labour Back Bencher has even been present, let alone contributed. Here is the question: would a future Labour Government be minded to accept the spirit of those amendments to the WHO treaty or to oppose them? Our position is very clear. What is the hon. Lady’s?

[Sir George Howarth (in the Chair)]

Order. I understand that feelings are running high and people have areas that they want to explore, but I hope that any further interventions are brief.

[Preet Kaur Gill]

We all know that Rwanda is just a gimmick by this Government, and I think that I have already set out my position very clearly. I will continue to make my remarks so that the Government are absolutely clear as to where we stand on this issue.

I am pleased that the zero draft highlighted that states must retain sovereignty, and that the implementation of the regulations

“shall be with the full respect for the dignity, human rights and fundamental freedoms of persons”.

I ask the Minister to take this opportunity to update us on the progress being made in negotiations over the amendments and the draft text. Can he reassure our constituents that the Government would not sign up to anything that would compromise the UK’s ability to take domestic decisions on national public health measures?

[John Redwood]

I do not understand the hon. Lady’s argument. This amendment to the regulations would mean that the WHO could decide that there was a health crisis in our country, whether we thought there was or not. It could then tell us how we had to handle it in far more detail than its advisory work during the covid crisis—it would be mandatory. What does she not understand about that and why does she not disagree with it? [Interruption.]

--- Later in debate ---

[Sir George Howarth (in the Chair)]

Order. I say to those in the Public Gallery that I know that there are strong feelings and that they have come here with a great deal of interest in the subject, but they need to be quiet. It is not an occasion for applause or shouting out. I would be grateful if people respected that. Thank you.

[Preet Kaur Gill]

I think that I have made my position really clear, hence my question to the Minister. Our constituents want reassurance that the Government would not sign up to anything that would compromise our ability to take domestic decisions on national public health measures. Nothing has been agreed. Today is an opportunity to hear from the Minister about how those negotiations are going forward and what amendments have been accepted. I also want to hear from the Minister.

[Mr Francois]

On that point, will the hon. Lady give way?

[Preet Kaur Gill]

I am not taking any more interventions. The reality is that although the pandemic is over now, the threat is not over. We must never leave our country with such a soft underbelly again. We strongly support efforts to strengthen the international legal framework to prevent, protect against, control and respond to cross-border health threats. It is squarely in our interests and integral to our security to encourage other countries to commit to do the same.

Draft Health Care Services (Provider Selection Regime) Regulations 2023

Preet Kaur Gill Excerpts

Tuesday 28th November 2023 General Committees

[Preet Kaur Gill (Birmingham, Edgbaston) (Lab/Co-op)]

It is a pleasure to serve under your chairship, Mr. Efford. I begin by reflecting on the story of these regulations. That goes back to the David Cameron era of reforms that came into force with the Health and Social Care Act 2012. Those flagship Conservative reforms turned the concept of competition into the organising principle in our NHS. They turned competition from one of the ways that the NHS was meant to operate into pretty much the only way to run the NHS. As that Bill went through Parliament, Labour argued that relevant authorities should have the flexibility to award contracts. We warned against excessive private involvement in the NHS and said that the marketisation of the NHS would act as a barrier to integration—which is crucial for our ageing population, who often have multiple conditions—and would ultimately lead to a worse service for patients. We were vindicated.

The NHS that the Government inherited from Labour in 2010 was judged by the Commonwealth Fund as the best and—crucially, when we consider the regulations—one of the most efficient healthcare systems in the world. A decade on, the NHS is in the middle of the worst crisis in its history, with the highest waiting times and lowest patient satisfaction. It has been left without the staff, equipment or modern technology needed to ensure that patients can be treated on time, and it has slid down the international rankings to the middle of the pack. Competition may have been the watchword of the Government’s NHS reforms, but in reality, the only competition it meant was a race to the bottom. Even the current Chancellor admitted that the reforms led to ridiculous fragmentation, wasteful bureaucracy and a worse service for patients.

The new provider selection regime is an opportunity to correct a decade-long mistake, and to move the NHS away from competitive retendering by default and towards the emphasis on collaboration and integration that Labour called for all along. I will not go so far as to call this another case of the Government pinching our ideas, given what a long struggle it has been to get to this point, but it is a chance to draw a line under a failed Conservative experiment. That is why I and the Opposition will support the new regime today.

The new regulations are an extension of the Health and Care Act 2022. As the Minister outlined, they are intended to provide relevant authorities with greater flexibility to award contracts, and they set out the key criteria that they must take into account when choosing the process to follow. More people now live with multiple long-term conditions and need support from several different services at the same time, so it is vital that services have the flexibility to work together more effectively and provide joined-up, co-ordinated care that meets their needs.

The Government were previously wedded to outsourcing services to private companies and to the flawed notion that financial competition drives up clinical quality, when in reality it has been a barrier to integration. That undermined the NHS in the years before the pandemic, but then we saw a new scandal emerge and staggering levels of waste and cronyism, represented most potently by the infamous VIP lane for covid contracts. A recent report by Transparency International UK stated that a fifth of covid contracts awarded by the Government contained red flags indicating possible corruption. An analysis by The New York Times found that roughly half of the 1,200 contracts it analysed, worth some £17 billion, went to companies run by friends and associates of Conservative party politicians.

I raise that issue because it highlights just how important it is that we get these regulations right. The rampant reliance on outsourcing and the waste and cronyism we have seen under this Government need to come to an end. Labour is clear that every penny of the public’s money should be spent wisely. That does not mean endless financial competition, and certainly not any more opaque backroom deals. We recognise that the independent sector has a role to play in the NHS if a service cannot be provided by a public body, because the capability or capacity is not there. Labour will always put patients first, which is why in the short term we will use spare capacity in the independent sector to treat NHS patients and bring waiting lists down as we reform and strengthen NHS-delivered services and capacity for the future.

I turn to the specifics of the regulations. I welcome the increased emphasis on provider quality and patient outcomes in the new provider selection regime. It is right that providers will be evaluated not only on their capacity to deliver services, but on their track record of achieving positive results for patients. That change should foster a culture of continuous improvement among healthcare providers. Does the Minister agree that authorities should engage with service users to accurately assess and develop services to meet their communities’ needs? Will he say why no such stipulation is included in the regulations?

The emphasis on quality and outcomes, and the inclusion of transparent performance metrics and patient feedback, are also welcome. Transparency is key to avoiding the cronyism that we saw during the pandemic. Will the Minister address the concern raised by the NHS Support Federation and others that prior notice of how commissioners plan to award a contract is reduced under the new regulations? Only in the most suitable provider process and the competitive process will the public know of the commissioner’s intentions to begin the decision-making process, meaning that many decisions will take place with no notice to the public. Does that not risk disempowering patients?

The Opposition also support the recognition of the value of providing continuity of care, allowing commissioners to prioritise providers providing good quality care over time instead of having to resort to competitive retendering by default. I know that that flexibility will be welcomed by commissioners right across the NHS, which is reflected in the 70% support among respondents to the consultation. Does the Minister agree that with this flexibility must come greater accountability, and that quality data will be critical to that?

My hon. Friend the Member for Ilford North (Wes Streeting) recently set out Labour’s plans to make sure that people can see how their local providers are performing and the progress being made towards our targets to empower patients and put their experience at the centre of the service. Does the Minister not agree that the NHS should be accountable to the many, not just the well-informed few, and that this is a critical aspect of the culture shift we need to drive innovation and continuous improvement?

The aspect of the new regulations with perhaps the greatest potential is the flexibility to innovate that they provide to commissioners. Last week, I had the pleasure of meeting Professor Sam Everington, the former chair of the Tower Hamlets clinical commissioning group and a GP at the Bromley by Bow Centre, which has been doing groundbreaking work with its multidisciplinary team providing community-based care. Professor Everington told me, for example, how one local doctor, sick of seeing young boys turning up on his operating table with stab wounds, set up a charity to follow up those admissions and help those boys to prevent further knife crime. They reduced repeat hospital admissions from 30% to 1%.

These partnerships are game-changing, but they do not happen enough and they have not been consistently incentivised by the current model. Can the Minister say how the new regulations will encourage integrated care systems to consider a diversity of providers, including voluntary and community sector organisations, to play a role in delivering innovative health and care services? Where is the Government strategy to ensure that, where innovation is working at a local level, the right incentives and resources are there to ensure that it is adopted elsewhere, bringing the best of the NHS to the rest of the NHS?

Can the Minister explain why it has taken so long to bring these regulations forward? The Health and Care Act received Royal Assent 19 months ago. In the meantime, these regulations have suffered several disruptive delays, leaving commissioners and providers alike in limbo, creating uncertainty and undoubtedly increasing costs for the taxpayer. What support are the DHSC and NHSE providing to commissioners in integrated care boards, trusts and other relevant authorities to ensure that these regulations are implemented quickly and smoothly? Can the Minister say how his Department will ensure that the regulations are monitored and reviewed, especially so that commissioners are supported in knowing which procurement process to follow, and when? Does he know what progress NHSE has made to establish the independent oversight panel to resolve complaints on choice and procurement issues? That will be critical to managing disputes and reducing the cost to the taxpayer from cases going to judicial review.

I note that a job advert for the role of chair of the provider selection regime review panel has just closed. Part of their role will be to recruit and review panel members and to establish and maintain its process. Can the Minister confirm that this will be ready for when the regulations come into force? Can he assure me that there will be no risk of corporate capture of this panel leading to conflict of interest?

The Opposition support the new provider selection regime as a break from the failed reforms of the last decade. As more people are living with multiple long-term conditions and need support from several different services at the same time, it is vital that services have the flexibility to work together and provide joined-up, co-ordinated care. If implemented successfully, we hope that the new regime will simplify health procurement, saving time and money. I look forward to the Minister’s response.