Draft Human Medicines (Amendments Relating to Hub and Spoke Dispensing etc.) Regulations 2025

Robin Swann Excerpts

Monday 2nd June 2025 General Committees

[Robin Swann (South Antrim) (UUP)]

It is a pleasure to serve under your chairship, Mr Stuart.

The regulation of medicines is a reserved matter for England, Wales and Scotland, but a devolved matter for Northern Ireland. The amendments aim to enable the same opportunities for hub and spoke provision across the whole of the Union, and as a former Northern Ireland Health Minister, I welcome that step. When I was Minister, I published and stood over the Northern Ireland community pharmacy strategic plan 2030, which aimed to maintain and modernise systems for the safe and reliable supply of medicines and professional advice from community pharmacies.

In that regard, I have a question for the Minister. The decision has been made to enable only model 1 hub and spoke arrangements at this stage and then to revisit model 2 once the model 1 arrangements have been established. I notice that the consultation responses raise significant concerns about model 2. They outline the potential to undermine the relationship between pharmacies and patients, as well as the risks in sharing accountability for the supply of medicines and risks to patient safety. Although the spoke and hub model covers the supply of medicines, there is a danger of losing the professional advice that community pharmacists can supply to patients, which takes pressure off our health service and others. Before there is any further progress on model 2, which will be a devolved issue in Northern Ireland, will there be further engagement with the Minister of Health in Northern Ireland, the chief pharmaceutical officer and community pharmacy representative organisations?

Oral Answers to Questions

Robin Swann Excerpts

Tuesday 6th May 2025 Commons Chamber

[Stephen Kinnock]

We have, in fact, relaxed the rules on ARRS so that a mental health worker can be employed by the PCN. My hon. Friend is absolutely right that that is an important part of stepping from hospital to community, but there is more we can do on that. We continue to do whatever we can to ensure that mental health and GP surgeries are actively integrating.

[Robin Swann (South Antrim) (UUP)]

Getting It Right First Time is a clinician-led programme that leads on improvement and transformation. Can the Secretary State give reassurance that in any restructuring of NHS England, that programme will not just be continued, but expanded and still available to the devolved Administrations?

[Karin Smyth]

I am absolutely willing to give the hon. Member that commitment, and I know he worked on this programme in his previous role in Northern Ireland. It is delivering results, and we want to see results. We want to take the best to the rest of the NHS, and we absolutely want to work together across the United Kingdom to make sure that all our residents benefit from the programme.

Hospitals

Robin Swann Excerpts

Wednesday 23rd April 2025 Commons Chamber

[Robin Swann (South Antrim) (UUP)]

The motion starts by referring to “hospitals across the country”, but most of the debate today has been about England. I want to highlight the situation that has arisen from the decisions made in this House on capital investment and changes to fiscal rules, and how that affects Northern Ireland and the capital investment there.

Capital investment in the health estate in Northern Ireland has been broadly stable for the 15 years prior to 2019—until 2020 when the covid pandemic brought about increased capital investment. The long tail of the pandemic, compounded by Russia’s invasion of Ukraine, significantly disrupted global supply chains and increased construction costs. Those price increases have compounded a subsequent and very serious problem in Northern Ireland: the outcome of the two most recent Budgets, which has meant that the funding available for capital investment in Northern Ireland is now projected to be 16% lower per head of population than England for ’25-26, and therefore much lower than any assessed relative need would suggest. While I listened to the complaints of many English colleagues across the House about capital investment, in some cases I am quite envious of what they are being allocated, because it is a contrast to what we have.

Much of our health and social care capital budget is project-based. As the former Minister of Health in Northern Ireland, I am acutely aware that there is an increasing need to address the serious risks across our health and social care estate. That includes tackling its backlog maintenance liability, which currently sits at £1.4 billion. Now, as a constituency MP, I see the impact of below-needs budgets on projects in South Antrim. The new Birch Hill mental health centre is a much-needed, purpose-built facility to provide the very best environment for assessment, treatment and recovery. Yet under the budget that the Executive have provided the Department of Health, there is not enough to fund what has already been committed to, including the Executive’s flagship projects, to meet current contractual commitments, to progress projects in design or development, or to fund even limited maintenance of existing property assets.

Good projects and massive potential are being lost because the Executive cannot seem to think even six months down the line, never mind one or two years. Nevertheless, Birch Hill remains high on the agenda of our Department of Health, and I hope that the Executive parties responsible for funding allocations consider the consequences of their decisions and recognise the critical need for the project. For mothers and babies in Northern Ireland, it would also provide a centre for perinatal mental health and wellbeing.

I join the hon. Member for Milton Keynes North (Chris Curtis) who said that the motions are welcome but what we would like to see is action. That action would be the certainty of having budget, and assurance that it will be a recurrent budget. I look to the words of the Secretary of State for Health, who talked about transformation in the health service and how it needs both funding and political will. I hope that following today’s debate he can get both.

Tobacco and Vapes Bill

Robin Swann Excerpts

Report stage
Wednesday 26th March 2025 Commons Chamber

[Leigh Ingham (Stafford) (Lab)]

I rise today in support of this legislation. Young people vaping is not the biggest issue that comes up in surgeries, but it is one of the biggest issues that comes up when I walk through town or visit a school, and even when I talk to young people themselves. It is an urgent crisis—not just vaping, but smoking. There are around 760 cancer deaths in the areas around Stafford, Eccleshall and the villages every year, and data suggests that in the next five years more than 1,100 of my constituents will have had lung cancer-related issues.

This legislation shows that this Labour Government care about the children of this country. We care about who they are, and who they will become; we want them to live longer, be happier, and never have the chance to pick up a £5 vape or a cheap pack of tobacco that could set them on the path of addiction for the rest of their lives.

I wish to take a moment to acknowledge the former Prime Minister, the right hon. Member for Richmond and Northallerton (Rishi Sunak), for starting a version of this Bill and bringing it forward despite significant opposition in his own party. I know that he did it out of concern for the future of the children of this country and I commend him for it.

Today, some will talk about choice when they oppose this Bill. In my work as an MP, I have spoken to people whose lives have been devastated by this addiction. I ask whether those who speak about choice truly believe that, once addiction has taken hold, a person has the same freedom of choice that they once did. This is not about taking choice away; it is about giving people freedom from addiction before it ever appears.

For me, the Bill is also about something so much deeper. It is about time—time with family and time with friends. How many of us have lost loved ones to cancer? I lost my grandfather to cancer, and my mum has had lung cancer. My mum was entirely fit at the time she was diagnosed with lung cancer—she used to do a Joe Wicks workout every morning. As she came from a place in the north where people suffer from lung-related illnesses, she was part of a pilot scheme to scan smokers and previous smokers for issues. Her cancer was caught early, while she had no symptoms. My family know how lucky we are. We were lucky that the cancer, which would have continued to grow in her body, was caught then and there. In fact, the cancer was so small that after it was taken away, she needed no further treatment; just a lobe of her lung was removed. My family could not be more grateful that she was part of that scheme, that she is still doing Joe Wicks exercises in the morning, and that she is still around to play with her grandchildren.

How many more precious moments with families will this Bill provide? That is the only question that I am here to answer. Truly, the children of the future may never know how their lives were changed by this Bill—just as I do not really know how my life was changed by the seatbelt Bill introduced years before I was born—because they will never have picked up the smoking habit in the first place. They will live longer, live healthier, and have more time with the people whom they love. Let this be the generation that ends youth addiction before it begins.

[Robin Swann (South Antrim) (UUP)]

I echo the words of the hon. and learned Member for North Antrim (Jim Allister) with regard to the importance of this Bill applying to all four nations: I want it to cover the entirety of the United Kingdom. Some 2,200 people in Northern Ireland die every year from a smoking-related illness. One in four of our cancer cases is related to smoking. The consultation carried out by the previous Government on their legislation, which was specifically about creating a smokefree generation, found that 62.5% of the UK population were supportive. In Northern Ireland, however, 79% were in favour of bringing forward this legislation.

Back in May 2024, when I was a Northern Ireland Health Minister, I introduced the original legislative consent motion, which received all-party support across the Northern Ireland Assembly, and yes, as the hon. and learned Member for North Antrim has mentioned, there were concerns over the applicability of the measure owing to EU regulations and legislation. There was a concern that the law would remain undelivered in Northern Ireland. At that stage, I engaged with the then UK Government, and have now engaged with this Government to seek assurances that this lifesaving, life-changing legislation will apply equally and favourably to all parts of our United Kingdom. I look forward to the Minister being able to give me those reassurances. I have signed new clause 3, because I accepted those reassurances as Health Minister but would appreciate reinforcement in this legislation.

Much has been said about the entrapment of our young people—whether previously with regard to tobacco, or now with vaping and vaping products and how they are being marketed and presented. One of the most harrowing reports that I have read recently was regarding Alder Hey children’s hospital, which has now opened a clinic for children addicted to nicotine. They became hooked because of vaping. Twelve children between the ages of 11 and 15 have had to seek medical help to cut down and deal with their nicotine addiction. Twelve children between the ages of 11 and 15 are receiving treatment in a children’s hospital due to the evil promotion and enhancement of not just vaping but nicotine. We are looking to save money within our national health service, but we are already encouraging and enabling these young people to become addicted to a dangerous drug. We should be doing everything we can in this place for young people.

According to reports about the Alder Hey clinic, children as young as eight are vaping regularly. Some reportedly cannot get out of bed in the morning before they take their first puff. That is a disgrace. I encourage anyone in this Chamber who in any way opposes the Bill or thinks that this is not the right thing to do to seriously consider how vaping is impacting our young people across this United Kingdom.

I finish by asking the Minister to reassure this House, not just with words but with action. Can she assure those of us from Northern Ireland who have supported the legislation and worked hard to make sure that it had a four-nations approach that the guidance, support and legal enforcement in the Bill is equally applicable to us in Northern Ireland?

[Jim Dickson]

I rise to speak to new clause 14 and amendments 86 and 87. I declare an interest as vice chair of the all-party parliamentary group on smoking and health. I am also a previous smoker and a strong supporter of this legislation.

New clause 14 would introduce a ban on all filters, regardless of whether they contain plastic. I understand the environmental motivations behind new clause 2 from the hon. Member for Gosport (Dame Caroline Dinenage), but I worry that the amendment is not sufficient to address environmental concerns and could even have a damaging impact on public health. Let us start from the understanding that there are no health benefits to filters. They were developed by the tobacco industry following evidence that smoking caused lung cancer in order to give a false sense of reassurance to smokers. Filters have been dubbed

“the deadliest fraud in the history of human civilisation”.

Most filters contain single-use plastics and are a major environmental hazard, costing UK local authorities around £40 million a year to clean up. Cigarette filters are the most littered item in the world. In the UK they make up 66% of all littered items. Biodegradable alternatives may therefore feel like an attractive solution, but biodegradable filters do not eliminate environmental concerns. They have been shown to be equally toxic to marine and freshwater life when littered in our rivers and seas. They take between two and 14 years to decompose, and they often do so only in very particular conditions, such as under high temperatures. Biodegradable filters could also lead to an increase in guilt-free littering through smokers believing that discarded butts do not have an environmental impact.

However, the greatest risk of biodegradable filters is that they allow tobacco companies to continue with filter fraud and greenwashing in order to rehabilitate their reputation. The best policy, therefore, is to ban all filters. It would mean smokers smoking filterless cigarettes, which, I remind the House, are no worse for their health. It would incentivise quitting, which is the best way to tackle tobacco-related litter and pollution, and it would put people off starting smoking—something of which I am sure everyone in this Chamber would be in favour.

Ending the sale of filters would remove the fraud being perpetrated on smokers that by using a filter they are protecting their health. We banned descriptors such as “light” and “mild”, because they gave false comfort to smokers that they were using safer products and inhibited them quitting. We should do the same again by banning filters, ensuring that those who smoke do not do so because of a belief that their cigarette is safer. Recent ASH polling showed that only 25% of the public is able to correctly identify that filters have no health benefit. The Government should be bold in addressing these misconceptions for the benefit of public health and take the opportunity of a ban to highlight the harms of tobacco.

A ban on filters is an opportunity to protect the environment and secure health benefits. The impact of any ban should be maximised by a strong communications campaign to educate smokers and the wider public about filter fraud.

Briefly, amendments 86 and 87 flag the need for the Government to consider the matter of the sale of bundles of tobacco papers and filters, which could be seen as smoking starter kits. Some supermarkets offer these bundles at only a small cost above the price of the tobacco alone. They are convenient and cost-saving for smokers. That undermines the public health motivation for increasing the price of tobacco products.

Oral Answers to Questions

Robin Swann Excerpts

Tuesday 11th February 2025 Commons Chamber

[Karin Smyth]

No.

[Robin Swann (South Antrim) (UUP)]

14. What steps he is taking to help devolved Administrations reduce waiting lists.

[The Secretary of State for Health and Social Care (Wes Streeting)]

I was delighted to work closely with the hon. Gentleman when he was Minister for Health for Northern Ireland, and I am delighted to work with his successor. I have met regularly with my counterparts in Northern Ireland, Scotland and Wales since I took up office. The Chancellor’s recent Budget meant a massive £26 billion-a-year boost for the health and social care services; thanks to the Barnett consequentials, the devolved Administrations will benefit from a major increase in their budgets—the biggest since devolution began.

[Robin Swann]

I thank the Secretary of State for his answer. Just over a year ago, the former Health Secretary wrote to counterparts in the devolved Administrations to offer patients from Wales and Scotland who were experiencing lengthy waits the option of treatment by providers in England. The offer was declined, as it was seen as a political stunt. Would the Secretary of State consider reviewing that offer, but this time including Northern Ireland, so that his call to offer the best of the NHS to the rest of the NHS can be shared across the entire nation?

[Wes Streeting]

I am absolutely committed to our working across the whole of the United Kingdom of Great Britain and Northern Ireland on cross-border working and co-operation, where we can. I have had constructive conversations, particularly with my counterpart in Wales, to that effect, and I would be delighted to work with my counterpart in Northern Ireland in the same spirit. Despite our differing views on the future of the United Kingdom, I have had equally constructive discussions with my counterpart in Scotland, although he may not thank me for mentioning it.

Maternal Mental Health

Robin Swann Excerpts

Wednesday 5th February 2025 Westminster Hall

[Laura Kyrke-Smith]

I agree with the hon. Member; that support is needed, and I will come on to that.

The causes of these mental health challenges are really varied. Some people will have past experiences of mental health problems or difficult childhood experiences. Some will struggle after a traumatic birth. Some will be experiencing stressful living conditions. Some evidence suggests there are biological or hormonal factors, and some people are at higher risk than others: young mums face particular risks, with post-natal depression up to twice as prevalent in teenage mothers compared with those aged 20 or over, and data suggests that post-natal depression and anxiety are 13% higher in black and other ethnic minority mothers than in white mothers.

People’s experiences of mental health are also really varied, ranging from mild to moderate conditions such as low self-esteem, anxiety and depression to more serious conditions including post-traumatic stress disorder and post-partum psychosis. While most people find a way through, perinatal mental health can be incredibly serious, as it was for Sophie.

[Robin Swann (South Antrim) (UUP)]

I thank the hon. Member for bringing this very important issue to the House. With regard to perinatal support, does she agree that it is very important we have those professional teams in place, and that we get the additional value that comes from a physical mother and baby unit, where specialist support can be given to not just the mother and child but the family as well?

[Laura Kyrke-Smith]

I agree: mother and baby units are vital.

For women in the period from six weeks after giving birth to one year after giving birth, the leading cause of death is suicide. While I want to speak more widely today, I want us to be very conscious of that extreme end of the risks that women face. Despite the potential seriousness, the stigma around these problems is huge. Some 70% of women will hide or underplay maternal mental health difficulties, and in turn, they will never get the support they need.

National Cancer Plan

Robin Swann Excerpts

Tuesday 4th February 2025 Commons Chamber

[Andrew Gwynne]

My hon. Friend makes some really important points. The need to get people scanned more quickly, and to get results to consultants, is in part why we now have extra capacity through community diagnostic centres, where there are extra facilities for scans. She is absolutely right to raise the issue of where AI and emerging technologies may take us, which will almost certainly lead to faster identification of cancers.

[Robin Swann (South Antrim) (UUP)]

I thank the Minister for making his statement on World Cancer Day, and I do not doubt his sincerity on this issue. On 22 March 2022, the then Northern Ireland Health Minister launched a 10-year cancer strategy and funding plan. It was co-designed, co-produced and co-chaired by Professor Charlotte McArdle, the then chief nursing officer, and Ivan McMinn, the then chair of Cancer Focus NI. The strategy looked to adopt a regional approach, to create smoother pathways and to adopt successful innovations. It had 58 action points and was costed at £145 million per year for 10 years, but it has not really made any progress since the fall of the Northern Ireland Executive. The Minister has said that he is developing a national cancer plan. Will he meet me and the current Northern Ireland Health Minister to ensure that the work that was developed is not lost but is built into what can be a truly successful national cancer plan if we do it right?

Welfare of Doctors

Robin Swann Excerpts

Tuesday 21st January 2025 Westminster Hall

[Peter Prinsley]

I do agree. I believe that the Government intend to do something about the somewhat terrible state of GP premises; the Health Secretary confirmed that only yesterday.

There are serious questions about the support that individual GPs receive, especially for mental health. At present, GPs rely on the NHS practitioner health service for addiction and mental health support.

[Robin Swann (South Antrim) (UUP)]

We should not be looking to the old saying “Physician, heal thyself” within our national health service. It is critical that the practitioner health service should be available across all parts of the United Kingdom; the hon. Member may not be aware that it is not currently available in Northern Ireland. Would he encourage the Government to work with the Northern Ireland Executive to ensure that all our health professionals get the same standard of care that they want to give their patients?

[Peter Prinsley]

I was not aware that the practitioner health service was not available in Northern Ireland; I certainly agree that it ought to be.

The practitioner health service was designed to be used by only 0.5% of GPs, but in fact it is accessed by 10 times that number. Ensuring that such services are fully funded will be important. There is alcohol and drug abuse, loneliness, depression, insomnia, anxiety and, sadly, suicide—including two of those who I graduated with from Sheffield, both in their very first year of medicine; and two doctors, a psychiatrist and a neurosurgeon, from my own road in Norwich. One of my own trainees was rescued at the last minute from a very serious attempt. All doctors know of this problem, but few speak of it.

Last week, I informed the House of my former student who described the terrible flashbacks and post-traumatic stress disorder of the young clinical intensive therapy unit staff who witnessed 40 or 50 covid admissions die at a hospital in Yorkshire, and the complete lack of support they received. Many are reluctant to seek help and do not know where to turn. Itinerant junior doctors not registered with GPs are known to self-medicate. We simply cannot leave them on their own.

In conclusion, I will respectfully make some suggestions, which have little or no cost implications. In making them, I am thinking especially of our resident doctors. They include to provide identified mentors, not simply people called educational supervisors; simplified contracts, transferable across trusts and between hospitals; clear, early information for doctors about what they will be paid and their rotas, timetables and holidays; hot food at night, and places to rest and sleep; to cover exam fees and make examinations fair and achievable; and to provide parking at the hospital and, crucially, a GP for every doctor and simple access to mental health support.

Medicine is a brilliant career—satisfying, interesting and rewarding. Let us look after the doctors who look after us.

Hospice and Palliative Care

Robin Swann Excerpts

Monday 13th January 2025 Commons Chamber

[Robin Swann (South Antrim) (UUP)]

I thank the hon. Member for Wimbledon (Mr Kohler) for bringing this important debate to the House tonight. I congratulate him, but it is unfortunate that it was not held in Government time, because this issue was raised on a number of occasions during the debate on assisted dying.

The debate has highlighted the importance of the discussion around palliative care. The All Ireland Institute of Hospice and Palliative Care conducted a recent study of 500 people in Northern Ireland, which indicated that more than one in three think that they only had days to live if their doctor or healthcare professional talked to them about palliative care, and more than one in four would feel that their doctor was giving up on them if they talked about referring them to palliative care. This debate and the previous debates that we have had raise the importance of these discussions with family and the wider community. Work has been done in Northern Ireland on conversations about advanced care planning, where families, health professionals and all parts of the society are involved in those open conversations.

Much has been said about the fundraising model for hospices and palliative care providers, and it is no different in Northern Ireland. We talk about the need for a funding model, but the Department of Health and the entire health service in Northern Ireland have been relying on year-on-year budgets since 2016. That puts stress not only on our national health service, but on palliative care providers, hospices, GPs and community pharmacies. There is a desire from the rest of health and social care in Northern Ireland to see a recurrent, guaranteed budget that we could use to make those transformation decisions.

I pay tribute to the hospices and palliative care providers in Northern Ireland, especially the people who work in them. Much has been said today about funding care models, how they are managed and all the rest of it, but often we forget that at the heart of every care package, every delivery, every door that is knocked and opened and every cup of tea that is made for someone in one of those conditions are those healthcare professionals. They have the strength and the ability to move on to the next patient and family, to give them the same level of dedicated professional support.

Finally, I pay tribute to the staff in the Macmillan specialist palliative care unit in Antrim area hospital. I had the honour and privilege of visiting them many times as Health Minister in Northern Ireland, but especially when they were providing support and care to Shirley Smyth almost this time last year—a fantastic supporter and grandmother of one of my councillors, and a fantastic lady.

Puberty-suppressing Hormones

Robin Swann Excerpts

Wednesday 11th December 2024 Commons Chamber

[Wes Streeting]

The trial will be uncapped, and I reassure the hon. Member and the House that all NIHR-commissioned research must go through robust scientific and ethical approval processes, both of which can influence final study design. In terms of the design of this trial, ethics is an integral part of the trial’s approval.

[Robin Swann (South Antrim) (UUP)]

I thank the Secretary of State for his statement, which I welcome, both in its tone and the approach taken. I welcome that this indefinite ban will include Northern Ireland. I thank the Secretary of State and his predecessor for the collaborative approach they have taken with the Minister of Health in Northern Ireland. It is important for the House to note that the ban in Northern Ireland was supported by all the Northern Ireland Executive parties. In his statement, the Secretary of State talks about being able

“to restrict the sale or supply of puberty blockers…through a prescription issued by…a prescriber registered outside the United Kingdom.”

What steps will he take to close all those loopholes and avenues that would allow these drugs to be prescribed, recommended or supplied by online suppliers for under-18s?

[Wes Streeting]

The challenge that the hon. Member mentions relates not just to these drugs, but goes more generally, too, and it is something we are looking at closely. More broadly, I want to acknowledge the first part of his question. I am grateful, not just to my counterpart Mike Nesbitt in the Northern Ireland Executive, but to the First Minister, the Deputy First Minister and all parties involved in the Northern Ireland Executive for the collaborative way and the spirit in which they have engaged in discussion about this issue for Northern Ireland, and also for their willingness to work in partnership with the UK Government. That is to their credit and to the benefit of all citizens across every part of the United Kingdom.