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.

Tobacco and Vapes Bill

Robin Swann Excerpts

2nd reading
Tuesday 26th November 2024 Commons Chamber

[Wes Streeting]

I am grateful to my hon. Friend for that intervention, not least because of the expertise that he brings to the House as a clinician. We are well served by his expertise in debates on the health of the nation.

Opposite me sit many opponents of the Bill and of the Government’s prevention agenda. I acknowledge that their opposition is based on genuine, sincere beliefs about the limits of government and the size of the state, but I appeal to them by saying that the Bill is in the national interest and, ironically, in their ideological interest.

[Robin Swann (South Antrim) (UUP)]

I thank the Secretary of State for making a number of times the point that this is a truly national Bill that applies across the United Kingdom. I thank him for including Northern Ireland, Scotland and Wales in the measures. When we in this place consider measures to promote health, we should do so equally for the entirety of the United Kingdom.

[Wes Streeting]

That is a very helpful intervention because it gives me the opportunity to say thank you to my counterparts in Wales, Scotland and Northern Ireland. This is a genuinely four-nations Bill, and through it, we have an opportunity to create a smokefree generation in every corner of our country.

I say to people who have an ideological objection to the Bill that if they believe in lower taxes, as they say they do, and in maintaining a national health service, as they say they do, they cannot duck this simple equation: an ageing population plus a sicker society equals more spending on the NHS, paid through higher taxes. The Bill is just one measure, but it will make a significant difference to the health of our society, and to the balance of that equation.

The question that opponents of the Bill must answer is this: if they want our health and care services to continue having to spend £3 billion every year on the symptoms of smoking, are they willing to accept that that means higher taxes or higher healthcare charges for their constituents? Are they happy for their constituents to shoulder the welfare bill for smokers falling out of the workforce? Those are the consequences of what we are voting on today. Higher taxes and higher welfare are not the Labour way.

There are arguments about liberty from those who oppose based on libertarian belief. They say that the state should not deny individuals the choice to smoke if they want to, but three quarters of smokers want to stop and wish they had never started. It takes a smoker an average of 30 attempts to quit before they manage it. By definition, an addict is not free; there is no choice, no liberty and no freedom in addiction. Nor is choice afforded to anyone inhaling second-hand smoke. Tobacco is not only highly addictive but uniquely harmful. Yes, some smokers can quit, but most who want to cannot. Those who have help to quit are three times more likely to succeed. That is why the Government are, as I said, investing £70 million in smoking cessation services—an investment that will pay for itself several times over—but prevention is better than cure, and that is why we are taking action, through the Bill, to stop the start.

In conclusion, this Bill marks the start of a decade in which we will shift the focus of healthcare from treatment to prevention; take serious action on not just smoking, but obesity; reform the NHS, so that it catches problems earlier and gives patients the tools that they need to stay out of hospital; harness the revolution taking place in life sciences; and fundamentally transform the NHS, so that it predicts illness and prevents it from ever taking hold. That is the future available to us, and it is the future we must realise if we are going to put our welfare system, health service and public finances on a sustainable footing. It starts with this Bill. Smokers are more likely to need NHS services, be admitted to hospital, drop out of the workforce and on to welfare, and need social care years earlier than if they did not smoke. By taking the measures set out in the Bill, we are putting the UK on the road to becoming smokefree, building a healthier, wealthier nation with a health service fit for the future and leading the world as we do so. I commend this Bill to the House.

--- Later in debate ---

[Dr Beccy Cooper (Worthing West) (Lab)]

It is a privilege to take part in this debate and to hear the broad consensus across the House on this excellent Bill. We have come a long way since the 2004 White Paper proposed a smoking ban in almost all public places in England and Wales. Smoking on public transport and in workplaces now feels inconceivable thanks to decades of work by campaigners and public health professionals and bold action from Government.

As a public health consultant, I pay special tribute to my public health colleagues who have worked so tirelessly in this area, from the seminal 1956 research undertaken by Sir Richard Doll and team that first established the link between smoking and lung cancer—something we take for granted today—through to the smoking cessation advisers who work daily to help people combat this destructive addiction.

Mark Twain is reported to have said:

“Giving up smoking is the easiest thing in the world…I’ve done it thousands of times.”

In my career to date I have been fortunate enough to undertake smoking cessation training and I can testify to the incredible amount of hard work and determination that both the quitter and the adviser put in to overcome the nicotine receptors that demand to be fed. This is an addiction, not a choice.

So it is better by far not to start this destructive habit in the first place. Currently, every day about 350 young adults still start smoking and about 160 people are diagnosed with cancer caused by smoking. Smoking is still the leading cause of premature death and disability in the UK, and is responsible for half the difference in healthy life expectancy between rich and poor. Other Members have talked about the appalling health inequalities in this country and how the Bill will really contribute to reducing them.

So it is right that this Bill will phase out the sale of tobacco and create a smokefree generation. Already ever fewer people smoke, and this legislation will increase the rate of decline. By increasing the age of sale by one year every year we can expect smoking rates among 14 to 30-year-olds to reach zero by 2050. As a mum of two young sons, I greatly welcome that.

I welcome, too, the increased powers to tackle vaping in the Government’s Bill. Vaping can be an effective aid for adult smokers to quit, but much tougher measures are needed to regulate products designed to appeal to young people. As ASH puts it:

“Vaping is an adult quitting aid, not a children’s toy.”

The chief medical officer further underlines this by stating:

“If you smoke, vaping is much safer; if you don’t smoke, don’t vape; marketing vapes to children is utterly unacceptable.”

This Bill will give the Government far greater control over the marketing and design of vapes and the flexibility to adjust regulations in the future if the market or evidence changes.

[Robin Swann]

Does the hon. Member agree that that is also why it is important that we control vending machine sales?

--- Later in debate ---

[Robin Swann (South Antrim) (UUP)]

I noticed from the opening comments that the Opposition have a free vote on the legislation, as do the Lib Dems. I assure the Minister that the Ulster Unionist party group in this House is 100% behind the Bill, which means: I am.

I sincerely hope it is second time lucky for the Bill. Prior to getting elected to this House, I was the Minister of Health in Northern Ireland in the re-established Assembly when it came back in February 2024. The Bill was then going through this House. Despite hugely challenging pressures, there was a much appreciated latitude from the public health Minister, Andrea Leadsom, who worked with the devolved Administrations to ensure that the Bill had a four-nations approach. I thank the Government for continuing that approach. As the hon. Member for Aberdeenshire North and Moray East (Seamus Logan) described happening in Scotland, a legislative consent motion went through the Northern Ireland Assembly. More importantly, it received the full support of the four parties in the Northern Ireland Executive.

It was only right and proper that the profound public health benefits be extended to Northern Ireland. Like Scotland, Northern Ireland was included in the UK-wide consultation exercise, which closed in December 2023. There was particularly strong support for the measures from the people back home. The consultation received a proportionately higher response rate from the Northern Ireland population than the UK-wide population. While 62.5% of UK respondents were in favour of an ambitious smokefree generation proposal, the Northern Ireland figure stood at 79%. That was by far the greatest support from among the UK regions. Support was also much higher in Northern Ireland for a range of other proposals, such as restricting vape flavourings and displays.

Some of the flavours that attract children have been mentioned. There is also a move towards flavours, labels and names that appeal to older age groups. We now have “Brain Freeze” and “Killer Kustard.” The producers are moving on from young people who are already addicted to early teens, and are making sure that their addictions embed. It is important that this Bill addresses that.

While I am glad of the support that many of the measures have received across Northern Ireland, we need to remain mindful of the fact that if passed, the Bill will be a literal lifesaver for decades to come. Tobacco use is a leading cause of health inequalities in Northern Ireland. It is a tragedy, but an avoidable one, that the lung cancer incidence rate in the most deprived areas of Northern Ireland is about two and a half times the rate in the least deprived areas. A recent health inequalities report from the Department of Health in Northern Ireland showed that the gap between the healthy life expectancy of women in the most deprived areas and those of women in the least deprived stood at 14.2 years—not months, but years. That differential will be dealt with by this Bill and others like it. Moreover, smoking rates in the most deprived areas are typically almost three times higher than the rate in the least deprived. I therefore fully support any and all efforts to dissuade people, especially young people, from taking up the habit in the first place.

This Bill goes even further than the one that fell before the last general election. I will be honest and admit that at the time, I was hugely frustrated that the previous Bill was not given the time to succeed, and I feared that a once-in-a-generation chance to do something transformative might have been missed. Looking at the Bill now, however, I am pleased to see that, rather than potential being lost, it has the potential to be even more impactful, given all its enhancements. Mike Nesbitt, my successor as Minister of Health and the leader of my party, has been able to use the little extra time to consider the licensing provisions carefully. While Northern Ireland’s tobacco retailers register is a helpful enforcement tool, it has limitations, and a new licensing regime would be another significant step forward for my constituents.

I acknowledge that, like its predecessor, this Bill is complicated by our somewhat messy post-Brexit arrangements, but I take reassurance from this Government and the last Government on that, because surely they cannot both be wrong.

Sepsis Awareness

Robin Swann Excerpts

Wednesday 9th October 2024 Westminster Hall

[Robin Swann (South Antrim) (UUP)]

I thank the hon. Member for Ashfield (Lee Anderson) for moving the motion and for speaking about not just the political side but the personal side of this debate, through the story of Abbi. I congratulate her on her bravery and on being here to hear the debate.

In reflecting on what the hon. Member said, what I will say to the Minister is that although we talk so much about health being devolved to the other nations, at times we have to take a step back and see what our national health service can do at that national level. The hon. Member’s ask for a sepsis awareness campaign is surely something that our public health agencies, health trusts, Ministers and Departments across this United Kingdom can take on and look at on a four-nations basis. Sepsis affects everybody and every region equally, so that is something that we can do. I thank the hon. Member for raising the issue here today.

I was Health Minister in Northern Ireland for three and a half years and, looking back, sepsis was not an issue that was high on our agenda—or even my agenda—at that time. There is a realisation from the stories that we have heard today, including those of Abbi, the hon. Member for Ashfield and the hon. Member for Kingswinford and South Staffordshire (Mike Wood), that brings home the seriousness of it. I looked back to see what had been done in Northern Ireland on raising awareness of sepsis. In 2019, Unison ran an awareness campaign in Northern Ireland for its members and, in 2020, the South Eastern health and social care trust—one of our five geographical health trusts— ran a campaign, but I could find nothing done centrally or pushed out by our public health agency. There is so much more we can do.

I found one positive thing: a piece of work was published last month by Sepsis Research FEAT and the James Lind Alliance, in which they identify the top 10 research priorities that could shape the future of sepsis treatment and care, with the goal of saving tens of thousands of lives each year, as well as addressing the financial implications that the hon. Member for Ashfield talked about. Those top 10 priorities address critical questions, including how to improve the accuracy and speed of diagnosis, which has been mentioned today; exploring alternatives to antibiotics; and investigating the long-term effects of sepsis, which is now referred to as post-sepsis syndrome because of the after-effects of having that illness. As a life-threatening condition that can affect anyone, sepsis often progresses rapidly, leading to death or life-altering consequences for survivors, with post-traumatic stress disorder even being identified in previous sufferers.

I mention that research because it was co-led by a professor from Queen’s University Belfast. It suggests that work on sepsis can be brought forward, so I encourage the Minister to look at that research, which was published last month and also involved professors from Cambridge and Edinburgh. The Minister can take that work forward after this debate, but he should also engage with his ministerial counterparts across the United Kingdom and follow the hon. Member’s appeal for UK-wide awareness of sepsis and what can be done to prevent it. In closing, I congratulate Abbi once again for being here to put a personal face on a very challenging condition. Hopefully, today’s debate will have a positive outcome.

NHS Performance: Darzi Investigation

Robin Swann Excerpts

Monday 7th October 2024 Commons Chamber

[Robin Swann (South Antrim) (UUP)]

Chapter 5 of Lord Darzi’s report is about where and how the money should be spent. I know from previous experience that there is a lot of money that can be spent in the national health service, but does the Secretary of State agree that we have to invest to save? We cannot simply move about the money that we currently have in the health service. Investment is needed to allow us to go into the greater detail that Lord Darzi talks about in respect of moving from analogue to digital and from primary care back into the community. That needs investment; it cannot be done simply with the budget that is there.

[Wes Streeting]

I strongly agree with the former Minister. I will take that as a representation for the forthcoming Budget and spending review, and ensure that his comments are sent straight to my right hon. Friends the Chancellor and the Chief Secretary to the Treasury. Without pre-empting future fiscal events, we have been clear for some time that it is investment and reform that deliver results. That is how the last Labour Government delivered the shortest waiting times and the highest patient satisfaction in history. If people are in any doubt about what investment minus reform does, they need only look at what Darzi says about our hospitals: after 2019, lots of resource was poured in, particularly in relation to staffing, but productivity fell. It is investment and reform that deliver results, and this Labour Government will deliver both.

Medicines

Robin Swann Excerpts

Monday 9th September 2024 Commons Chamber

[Robin Swann (South Antrim) (UUP)]

I thank the Minister for bringing this statutory instrument to the House. As I think all hon. Members have said, naloxone has proven itself time and again to be the lifesaving drug that reverses the effect of a devastating opioid overdose. That is especially important because opioid-related deaths now make up the largest proportion of deaths from drug misuse across the UK; in Northern Ireland, as the hon. Member for Strangford (Jim Shannon) said, they represent over 50%.

The purpose of these amendments, which I fully supported when I was Minister of Health in Northern Ireland, is to increase the number of services, professionals and organisations that can supply naloxone without prescription or even a written instruction. In June 2021, when I was in post in my Department, the then Government agreed to a UK-wide public consultation on the proposed changes to the Human Medicines Regulations 2012, which sought views on the viability of proposals to widen access to naloxone by expanding the list of services and individuals who can give it out without a prescription or a written instruction.

I support the contribution from the hon. Member for Brighton Pavilion (Siân Berry). We need to keep the matter continually under review, with additional training to ensure that we can get naloxone into as many people’s hands as possible, so that it can be administered at the right point at the right time.

I thought at the time, and I still think today, that these changes are not just perfectly sensible; they are a small legislative step that will have big, real and life-changing consequences. I am glad to see that they have received support across the House. Thankfully, the consultation indicated strong support for each of the proposals, including from those who responded solely from the Northern Ireland perspective. The evidence is clear: countless lives have been saved as a result of naloxone. I am confident that today’s changes will help to prevent more people who use drugs from sadly losing their lives to that use.