Organ Donation (Deemed Consent) Bill

Sandy Martin Excerpts

2nd reading: House of Commons
Friday 23rd February 2018 Commons Chamber

[Sandy Martin (Ipswich) (Lab)]

I thank my hon. Friend for bringing this Bill to the House, and I will of course support it. He mentions the modest investment in capital and resources needed to give effect to this when it has become law, but does he agree that by saving lives and making people healthy enough to play a full part in society, we will be increasing the ability of our country to succeed, and also—although this is obviously a secondary issue by comparison with the saving of life—we will be reducing the ridiculous amount of spend on just keeping people alive when they actually need organ donations?

[Mr Robinson]

I entirely agree with my hon. Friend and thank him for his intervention, but I would rather not go down the route of cost-benefit analysis; these are matters of life and death and are best left as such when we look at what we can do to save lives that we know can be saved.

--- Later in debate ---

[Dan Jarvis (Barnsley Central) (Lab)]

It is a pleasure to follow the hon. Member for North Devon (Peter Heaton-Jones), who spoke most movingly about the incredibly contribution that his constituent Keira Ball and her family have made to this process. I pay tribute to the role that he has played in bringing that to our attention. He was also right to talk about the cross-party nature of this campaign because this is Parliament at its best. This is how the public expect us to serve in this place—to work co-operatively with others in order to make really important changes.

The House faces a clear choice today. We have the opportunity to make a change that will add huge value to our country and that will undoubtedly save people’s lives. It all boils down to whether we take the opportunity to save hundreds of lives over the coming years. I very much hope that we do not miss that opportunity and that we work together to make this change.

It has been a real privilege to be a part of the campaign that has got us to this point. In particular, I pay tribute to my hon. Friend the Member for Coventry North West (Mr Robinson), who has provided real leadership through his promotion of the Bill. He and I have sat through many meetings—I have lost count of quite how many—and it is his focus and determination to lead us to this point that have meant that we have an opportunity to do something very worth while today. I also pay tribute to all the other Members who have provided such outstanding support, particularly my hon. Friends the Members for Newport West (Paul Flynn) and for Sunderland Central (Julie Elliott), and other Members—too numerous to mention—right across the House and the political spectrum who have worked together to get us to this point.

It has been mentioned before in this debate, but I also want to take this opportunity to pay tribute to Trinity Mirror. The Mirror Group has run a relentless and tireless campaign. Its contribution to this private Member’s Bill and the broader campaign has been massive. It has conducted itself in the very best traditions of a free British press. I know that I speak for all Members when I pay the organisation the largest compliment that I can. We are grateful for everything that it has done.

It is crucial today to pay tributes and to give credit where it is due. I am looking very firmly at the Minister, who has responded in the most brilliantly sensible, co-operative and constructive way. We have sat in a lot of meetings in different places over many months, and in my relatively short time in this House I have not found anybody who has been easier to deal with than she has. She has been a great pleasure to work with, and the leadership that she has shown has been instrumental in ensuring that we have the opportunity to pass this important Bill. I thank her and her officials, who have done an important job in getting us to this place. I urge all hon. Members to think of the common good and to act in a way that I firmly and passionately believe will save countless lives.

It is worth reflecting that of all the people who died in the UK last year, only about 1% died in circumstances that would have made donation possible, meaning that, even though hundreds of thousands of people across the country are registered as potential donors, only a small handful will ever be in a situation that would allow donation to take place. This is one of the main reasons why today in the UK more than 6,000 people are waiting for an organ donation and why nearly 500 people died last year while waiting. This loss of life is devastating but not inevitable.

Today we have a precious opportunity to do something about it, and we must not miss it. Moving to an opt-out system for organ donation will add thousands of names to the donor register, meaning that once the Bill is passed hundreds of lives will be saved. Let us be clear about what the Bill is not. It is not about the state taking control of people’s organs or shaming individuals into donating. If people want to opt out, that is absolutely fine, and I am hugely respectful of any decision people want to make. No questions will be asked; there will be no hard feelings. The Bill is about making it easier for those who might wish to donate to do so.

[Sandy Martin]

Mention has been made of religiously inclined Jewish people in this country. Some people will feel uncomfortable about the concept of donation. Does my hon. Friend agree that people from various religious traditions—not just one—might feel uncomfortable about this and that it is entirely right to give them the opportunity to opt out, if they wish to do so?

[Dan Jarvis]

I wholeheartedly agree with my hon. Friend. He makes an incredibly important point. This is absolutely not about shaming anybody into doing anything they do not want to do. If anybody, for whatever reason, decides they do not wish to be part of the scheme, they have the right to opt out. It is incredibly important that we be clear about that.

It is also worth reflecting on the point made by my right hon. Friend the Member for Leeds Central (Hilary Benn): the current system requires people to take the time to discuss this most serious and difficult matter with their loved ones in order to reach a judgment about whether, in the event of some tragedy occurring, they would want their organs to be donated. It is incredibly important, if people feel they can have that conversation with their loved ones, that they do so, but we understand that people lead busy lives, and many of us will be guilty of not having had these conversations and of putting these tasks on hold.

I believe, however, that we can no longer afford to ignore this issue. It is a matter of life and death for thousands of people around the country, which is why we must increase the number of people on our donor register and make sure we save as many lives as we can and that no more people die waiting for a transplant simply because a potential donor was not able to sign up.

Hospital Car Parking Charges

Sandy Martin Excerpts

Thursday 1st February 2018 Commons Chamber

[Robert Halfon]

I am very proud to have worked with my hon. Friend on the FairFuelUK campaign to keep fuel duty low. The point he has just made is very broad, so if he could wait a few minutes, I hope to be able to address the concerns that he has expressed.

I mentioned earlier that, in 2014, the Government had offered guidelines on concessions for patients and visitors. I welcomed that, as it was a sign that the Government were aware of the extortionate costs facing hospital users, but the problem with the guidance is that none of it is mandatory. In fact, the guidance encourages the postcode lottery. The guidelines state that charges should be reasonable for the area. Trusts are free to set their own fees, which means that patients and staff living in London and the south-east are charged the most. I have asked the Government on a number of occasions what constitutes a reasonable charge, and I consistently receive responses along the following lines: first, that hospital car parking charges are a matter for individual NHS trusts; secondly, that local NHS trusts are expected to follow the published guidance; and thirdly, that the Department of Health and Social Care has not discussed car parking charges with local NHS trusts.

[Sandy Martin (Ipswich) (Lab)]

Will the right hon. Gentleman give way?

[Robert Halfon]

I will give way one last time, as I want to be fair to Mr Deputy Speaker who spoke to me before the debate started.

[Sandy Martin]

Does the right hon. Gentleman accept that the national health service is not best placed for administering car parks, and that if we take car parking charges away from it we should also take away the whole provision of car parking from it and ensure that it does not lose out financially as a result?

[Robert Halfon]

The hon. Gentleman raises an important point. The crucial thing is that the NHS does not lose out financially. I think that that is the substance of what he is saying.

Sadly, the guidance is superficial. I have been unable to work out what constitutes a reasonable charge. The Government are not able or willing to keep local trusts in check. Since 2013, the campaign to scrap hospital car parking charges has gained speed, with more and more leading UK charities and associations representing drivers carrying out research into the negative effects of the charges on different groups of patients and drivers.

The sick and vulnerable are disproportionately hit by the charges, particularly those with long-term or severe illnesses who require repeated or lengthy stays in hospital. Research has shown that cancer patients and parents of premature babies face the greatest financial consequences. CLIC Sargent, a wonderful charity supporting young people with cancer, found that families were paying an average of £37 in car parking charges every month, with some families paying up to £10 per day. It also says that more than one in four parents of a child with cancer—29%—are not offered a reduction in parking costs by their NHS trust.

Macmillan Cancer Support mirrors that sentiment, saying that cancer patients in England are paying extortionate hospital car parking charges. Bliss is another very special charity for families with premature babies. Although some babies stay in the neonatal unit only for a few days, some parents will have to pay more than £250 if their baby stays in the neonatal unit for eight weeks. The charity says that many parents cannot even afford to go to see their premature baby because of the cost of hospital car parking.

I have a quote from the charity, Headway, which really sums up the whole debate. Headway does an incredible amount of work with brain injury. This is what it said:

“Recently, we supported a family who had spent more than £1,500 in parking charges in only 15 weeks. They needed to be at the bedside of their son who was fighting for his life after sustaining brain injury. What parent wouldn’t want to be there, day and night? Yet they were faced with a huge bill. These charges are driving families into debt and despair at a time when they already have more than enough to cope with.”

Kidney Care, another charity, told me that dialysis patients have to go to hospital three times a week, and each appointment takes four hours, with the average cost of four hours of parking estimated to be £3.28. Members can imagine how the costs stack up. The right hon. Member for Kingston and Surbiton (Sir Edward Davey) mentioned disabled car parking. It is extraordinary that, despite the Government guidance, almost half of hospitals inexplicably charge disabled drivers. They do not go to hospital out of choice. It is harder for them to use public transport, yet they have to pay significant charges. Even the hospitals that allow free parking attach a lot of conditions to that provision. Scope, the charity supporting disabled people, shares the sentiment, widely noting that disabled people

“have on average £108,000 fewer savings and assets than non-disabled people”.

It is not just charities that do valuable work. The RAC and FairFuelUK have also supported the campaign to scrap hospital car parking charges. I have worked with Howard Cox at FairFuelUK for a number of years in order to freeze fuel duty. The organisation held a poll last year with almost 9,000 respondents, 95.5% of whom wanted hospital parking scrapped or set at a maximum of £1. The RAC carried out a serious survey of more than 1,000 motorists. Two thirds of them named hospitals as the location where they most disliked having to pay for parking, and 41% said that the Government should scrap hospital parking charges immediately. It is clear that support is growing for the campaign to scrap hospital car parking charges, not only from the charities representing the most vulnerable—often with long-term and life-threatening illnesses—but from the two major organisations representing millions of motorists in the United Kingdom.

The support for an end to hospital car parking for patients and their visitors is clear, but we must not forget our incredibly hard-working NHS staff, some of whom are charged to go to work. Other public sector workers such as police officers and teachers are, for the most part, rightly able to park for free on their work premises, whether at a police station or a school. The Government guidance suggests that concessions should be available to all hospital staff—nurses, porters, cleaners, occupational therapists and doctors—working shifts that make public transport use difficult, but so much of the hospital workforce cannot rely on public transport to get to work.

Let us take the example of a hospital worker living in Pocklington in Yorkshire. He or she would either have to make the 15-mile drive to work at York Hospital and pay £2 to park during the shift, or spend more than an hour on two buses to get to work. If staff are working shifts at unsociable hours—as, of course, many do in the health service—they have no choice but to use hospital car parks.

Although all hospitals seem to offer a discounted parking scheme based on pay band or salary, or by allocating a limited number of discounted staff spaces, NHS staff are charged to work unsociable hours. The hon. Member for Kingston upon Hull West and Hessle (Emma Hardy) was told by hospital staff that they cannot afford the charges at hospital car parks, so they have to park on unlit nearby streets, which leaves them vulnerable when leaving the workplace at night.

Interestingly, staff car parking charges are a nuisance not just for hard-working NHS staff, but for residents too. I was recently contacted by a resident of Scarborough. This person was delighted to hear of the campaign, but came from a rather different angle. Staff park in the residential roads around Scarborough General Hospital to avoid being charged to go to work. The influx of cars every day means that driveways are blocked, there is more traffic on the road and residents are unable to go about their daily business.

I realise that hospital parking charges can be a source of income for hospitals. They are certainly a goldmine for some private companies, but the Government have previously stated:

“Providing free car parking at NHS hospitals would result in some £200 million per year being taken from clinical care budgets to make up the shortfall.”

I have a number of things to say about that. When considered in the content of the £120 billion-plus to be spent on running the NHS, the figure of £200 million is put into perspective. Going on the assumption that free hospital car parking would cost £200 million a year, I think that there are a number of funding options that would not leave hospitals out of pocket or affect clinical care budgets. The Government themselves have published a report saying that better procurement in national health service hospitals would bring in more than £1 billion a year. I am just asking for £200 million to scrap hospital car parking charges.

The Department of Health financial accounts for 2016-17 suggest that the Department underspent its revenue budget by £563 million, which is about 0.5% of the total budget. Could some of this money not go towards covering the parking costs of patients and hospital staff? It might also be time to look at other areas of government where we spend a significant amount of money and look at reallocating the very small amount of that money—£200 million—that it would take to scrap hospital car parking charges.

Another concern, raised by my hon. Friend the Member for Solihull (Julian Knight), is that free parking at hospitals would be exploited by shoppers. However, this could easily be solved by using parking tokens validated by ward staff. Some NHS hospitals in England do the right thing and provide free parking, including Northamptonshire Healthcare NHS Foundation Trust and Leicestershire Partnership NHS Trust. That shows that it is possible to deliver free parking for patients, visitors and staff while discouraging abuse of the system with tokens or barriers. Having contacted hospitals in Scotland and Wales directly, I know that there are numerous parking solutions to ensure that free parking is not exploited. Alongside the abolition of hospital car parking charges, a system could be introduced whereby a ticket or token is presented to ward staff at the beginning of the visit and validated at the end.

It is time to end the hospital car parking rip-off once and for all. The NHS is supposed to be free at point of access. It was never envisaged that people with cars would have to pay on top of their taxation for the national health service, yet patients and visitors are charged for access to vital services. That causes a huge amount of stress to many. It affects the most vulnerable: parents with sick children, patients suffering from long- term illnesses, and staff without access to public transport. These charges are a cause of major social injustice. Clearly, the Government guidance is not working. I urge the Government to look into the most efficient way to scrap hospital car parking charges and bring an end to this stealth tax on drivers once and for all.

Mental Health Provision: Children and Young People

Sandy Martin Excerpts

Tuesday 12th December 2017 Commons Chamber

[Luciana Berger]

I thank the hon. Gentleman for his intervention. We have heard from many Members on both sides of the House about families having to travel hundreds of miles to access treatment. Just last week, I heard of one young person being sent to Scotland to access in-patient treatment for eating disorders, because there was not a bed available for her in England. In certain parts of the country, it is certainly the case that people have to cross boundaries and to go north and south to access services, in a way that we would not accept if this was for physical health services.

Given this growing and what I can only describe as desperate demand for services for young people, I and many others eagerly awaited the Green Paper. I have read it many times, but it was—and I hate to say this—a disappointment. I believe that Ministers have failed to meet the scale of the challenge. The £300 million outlined for mental health support in schools sounds really impressive—until we read the detail and we realise that Ministers aim to reach just a fifth of schools over the next six years, with eight out of 10 schools remaining without the extra support until 2029. It really is a drop in the ocean. Ministers intend to roll out services over the next decade as though there was no urgency or imperative for action. I hardly need to point out that this means that most eight-year-olds today will see no benefit from these proposals throughout their entire childhood and adolescence.

[Sandy Martin (Ipswich) (Lab)]

I thank my hon. Friend for bringing this important issue to the House. Does she share my concern about the waiting times between referral for treatment and the start of treatment? Does she agree that much self-harm and, indeed, suicide of young people takes place during that waiting period? Does she believe, as I do, that while four weeks would be an improvement on most of the waiting times that our children and young people have had to face up until now, that maximum wait needs to be upped to until actual treatment and not just until the assessment for treatment?

[Luciana Berger]

My hon. Friend pre-empts a question that I was going to ask of the Minister, because it is not clear whether the pilot that the Government are going to introduce is based on a four-week waiting time for assessment or a four-week waiting time for treatment. Those two things are very different. In many parts of the country, young people will sometimes have an immediate assessment but then have to wait weeks, if not months, to actually access the treatment that they need.

Vaping

Sandy Martin Excerpts

Wednesday 1st November 2017 Westminster Hall

[Gareth Johnson]

Importantly, over the last 20 or 30 years we have moved away from the James Dean image of smoking. For many people, it is no longer seen as being cool, although it was when I was growing up; it was somehow seen as being acceptable. An increasing number of people look to vaping rather than smelly tobacco, if I can put it that way. It is increasingly recognised that there is huge problem with smoking.

Unfortunately, statistics show that more and more people are viewing vaping as more dangerous than smoking. Vaping is clearly a lot safer than smoking tobacco, but unfortunately the public perception is different from the facts presented by reputable organisations. Some 7 million people smoke in England alone, and some 8 million people do so across the whole UK, so potentially a large number of people can benefit from vaping. Although we have spoken briefly about smoking, my approach is not at all nannying. If an adult wants to smoke, that is their choice; I do not seek to lecture people on their tobacco use. It is an individual choice, but it needs to be an informed choice. We should therefore not obstruct people who want to access smoking cessation products, and vaping forms an important part of that.

I do not claim that vaping is risk-free; indeed, I would urge anybody who does not smoke not to take up vaping. There are risks, and it is unnecessary for non-smokers to take them. I also urge that our approach to vaping be evidence-based. When the Government make decisions on issues that affect vaping, they should base them on the best evidence available. Vaping should not be treated in the same way as tobacco simply because the term “e-cigarettes” has been adopted to describe vaping products.

We also need to be open-minded and objective about the pros and cons of vaping. Our views may change as more research is carried out, and that is fine. We may, over time, become more negative or more positive about vaping, but that should always be based on the facts available and not on a general dislike of smoking.

I am not a medical man at all, and I certainly do not claim to be an expert on health issues, so I have looked at what reputable organisations have to say about vaping. It makes incredibly interesting reading. For example, Cancer Research UK has said:

“the evidence so far shows that e-cigarettes are far safer”

than tobacco, even in the long term. It also says that

“Growing evidence shows e-cigarettes are helping people stop smoking”.

That is a pretty clear position. The British Heart Foundation has also looked into vaping and said:

“e-cigarettes are not harm-free.”

It has said:

“We would not advise non-smokers to take up e-cigarettes, but they can be a useful tool for harm reduction and to stop smoking.”

It also points out that long-term studies are, of course, not available just yet. That point is frequently brought up in this debate: because of the relative newness of vaping, we do not have the long-term studies that many people want to see. As I say, we need to be open-minded about vaping, but we should not turn our backs on the opportunities that it offers simply because we do not have long-term studies. It would be wrong for us not to engage with vaping for the next 50 years while we wait for long-term studies to be carried out. The opportunities are in front of us today.

[Sandy Martin (Ipswich) (Lab)]

Is the hon. Gentleman aware of the first major study on whether vaping helps pregnant smokers to quit, which is being led by Professor Hajek of Queen Mary University of London, working in conjunction with Barts and the London School of Medicine and Dentistry? Does he accept that although there are apparent health benefits to switching to vaping if people are otherwise unable to give up smoking traditional cigarettes, it would be sensible to wait for the report to be published in three years’ time before making major interventions that might encourage pregnant women to start vaping when they are not already smoking?

[Gareth Johnson]

I am not aware of that report, but I think there is an inherent problem with pregnant women today having to wait three years to make that decision. My gut feeling is that the best approach would of course be for pregnant women not to smoke anything at all—not to smoke any tobacco products, and not to vape. I am not qualified to say whether it is beneficial for pregnant women to vape instead of smoking if they are unable to give up tobacco, so I would not want to comment on the report the hon. Gentleman mentions, but it throws up interesting questions. That is why I believe that this whole debate should be based on facts and evidence, rather than on an instinctive dislike of tobacco products that leads to lumping vaping in with them.

The British Lung Foundation has also commented on vaping:

“Given half of long-term smokers die as a result of their habit, using vaping to help someone quit smoking could literally save their life.”

The British Lung Foundation is also clear that vaping should not be seen as a permanent alternative to smoking or promoted to non-smokers, but nor should it be banned in public in the way that smoking is.

Public Health England famously—or famously in the vaping world—said clearly that it believes vaping to be 95% safer than smoking tobacco. The Royal College of Physicians and Action on Smoking and Health have chipped in with similar comments, so there is plenty of evidence that such products have potential, but they have to be judged on their own merits and should not be in the shadow of tobacco products. That is why, in my view, the EU tobacco products directive was wrong to incorporate vaping, which should have been dealt with separately.

That ludicrous approach is illustrated in the regulations that companies have to follow. If someone buys a vaping machine, the machine has to have a warning on it that it contains nicotine. The one I have here, which was sent out by a company called Totally Wicked, says,

“This product contains nicotine which is a highly addictive substance”.

They all have to comply with that requirement. The silly thing is, of course, that the machine does not contain nicotine—but it says it does, because it has to as a consequence of the EU directive. It contains nicotine only when e-liquid is added to the product; it is not included in the product. Companies have to put a caveat at the bottom of the product to say that the statement is not true, so that they do not get prosecuted under the Trade Descriptions Act 1968. That is one illustration of the ludicrous nature of an approach that lumps vaping products in with tobacco products, and that expects vaping organisations to act in exactly the same way as those involving tobacco.

The EU directive also imposes a requirement to sell e-liquid only in small quantities with a maximum of 20 mg of nicotine, which I understand some heavy smokers find insufficient. I do not want to turn this into a Brexit debate—we have enough of those taking place in the House of Commons at the moment; there are plenty on today and tomorrow, if anybody is interested—but we have to recognise that there is an opportunity after Brexit to depart from some regulations, where appropriate. I ask the Minister to put March 2019 in his diary, so that he can consider which of the regulations can be looked at again, are unnecessary or can be altered.

The rules on advertising are also inconsistent. An advert on a bus is fine, but an advert in a magazine or newspaper is not. The trouble is that it sends out a mixed message, which helps neither the public nor the industry and adds to the problem whereby increasing members of the public believe that vaping is potentially more harmful than smoking tobacco. That ultimately stops the benefits that do seem to exist, according to people far more qualified in the medical field than me.

Most people agree that there is a necessity for more evidence, and I am pleased that the Select Committee on Science and Technology is about to carry out an inquiry on vaping, which aims to collate the available information and give recommendations. I hope that it will look at studies on the health implications and give its view on which studies are the most and least credible. The public should not have to rely purely on whichever report is given the greatest prominence in the press. The inquiry will be important, but what is ultimately needed is more fully independent assessments of the health considerations around vaping.

The Government have launched a tobacco control plan, which I am sure the Minister will mention. I welcome the aim in that plan to reduce the number of people smoking in the UK, and it is to be welcomed that the usefulness of vaping is recognised in the plan.

To conclude, although vaping is not risk-free, it has been found to be a useful tool for millions of people who want to stop smoking. It should therefore be given the recognition it deserves. It has huge potential to save lives. I therefore ask the Minister to meet the vaping industry as soon as his diary allows, to discuss how vaping can be best utilised.

--- Later in debate ---

[Sandy Martin (Ipswich) (Lab)]

I was only going to intervene today, but there are other things that I wish to say. Thank you for calling me to speak, Mr Howarth.

The hon. Member for Dartford (Gareth Johnson) said that vaping is the most successful way to stop smoking. I absolutely and fully support his contention that vaping is a valuable way of persuading people who have failed to give up smoking through other methods, and I support any attempt to use vaping to crack the hard nut of breaking addiction to nicotine. When he sums up, however, will he confirm that vaping induces a certain degree of nicotine addiction if there is nicotine in the substance that is vaped?

The reduction in smoking in this country over the past 20 years is one of the best possible advertisements for health education and smoking prevention measures. The number of people who have managed to give up smoking is fantastic. I gave up in 2013 and have not touched a cigarette since. I gave up lots of times before that, but when I gave up in 2013 it was conclusive. I have never used any substitution products, because the problem for me was breaking the addiction to nicotine, rather than to the smoke itself. Now that I have broken my addiction to nicotine, I have absolutely no intention of going back to any form of smoking product.

I believe that there is an issue with the nicotine addiction element of vaping. I look forward to seeing all of the studies, including that of pregnant women.

[Gareth Johnson]

The hon. Gentleman is absolutely right that nicotine is an addictive substance. There is no doubt that if someone stops smoking and moves on to vaping, their addiction continues. One of the benefits of vaping is that the substances can have a reduced amount of nicotine or no nicotine at all, which some vapers have found useful when they want to overcome their addiction to nicotine.

[Sandy Martin]

I fully accept that and I thank the hon. Gentleman for that intervention. Vaping is clearly a valuable tool in the attempt to reduce further the number of people who smoke, but I urge caution. Health education measures that enable and encourage people who are hard-nut smokers to move on to vaping should be fully supported, but we should wait until the studies report before introducing measures that make it easier for people who do not already smoke to start vaping.

Tobacco Control Plan

Sandy Martin Excerpts

Thursday 19th October 2017 Commons Chamber

[Sandy Martin (Ipswich) (Lab)]

I am concerned about the damage that smoking does to my constituents. Almost 15% of the population of Suffolk smoke. More than 7,500 admissions to Suffolk hospitals every year are attributable to smoking. Those who do not quit will have roughly a one in two chance of dying prematurely from smoking-related diseases.

The tobacco industry is deliberately producing products that it knows will kill its customers. While the market for cigarettes is mercifully in decline in the UK and other rich countries around the world, it is still growing in low-income countries, where the industry regularly uses tactics that would be illegal in this country, including the deliberate sale and marketing of cigarettes to young people and children. As a result, more than 7 million people die from the consequences of tobacco use each year. Almost four fifths of the world’s 1 billion smokers now live in low and middle-income countries. Money spent on tobacco is money not spent on other household needs. In Kenya and Bangladesh, tobacco cultivation has replaced food crops, leading to local food insecurity. In Malawi, at least 78,000 children are forced to work in tobacco fields, preventing most of them from attending school. Tobacco growing around the world is responsible for a loss of biodiversity, land pollution due to the use of pesticides, soil degradation, deforestation and water pollution. The result of all that deeply destructive and irresponsible activity is that the four major tobacco manufacturers are some of the most profitable businesses on earth.

It is impossible to hold an ethical investment in a tobacco company. To invest in tobacco is to seek to make money from environmental destruction, social exploitation, disease and premature death. That is increasingly understood by investors, because last year AXA, one of the world’s largest insurers and a major part of the Ipswich economy, divested more than $2 billion of tobacco industry assets. I welcome its decision. Tobacco-free investment policies have also been announced by AP4, one of the most influential pension funds in Sweden; Medibank, the largest health insurer in Australia; Fonds de Réserve pour les Retraites, France’s public pension fund; the Irish sovereign investment fund; and CalPERS, the largest public pension fund in the USA. So far in 2017, tobacco-free investment decisions have been made by AMP Capital, Bank of New Zealand, SCOR, PME, ACTIAM and Aviva, the largest insurer in the UK. In addition, ABN AMRO, the global bank, will cease lending to tobacco manufacturers. Those very welcome individual decisions now constitute a clear trend.

In that context, it is increasingly absurd that large investments in tobacco are still held by local authority pension funds across the United Kingdom. There is a fundamental contradiction between the local authorities’ public health responsibilities and their investments in tobacco, which actively promote the biggest public health problem confronting this country.

I understand that pension fund trustees have a duty to run their funds to secure strong returns for beneficiaries. Local authority workers depend on sound investments for their pensions. Case law has now made it clear that local authority pension fund trustees may consider non-financial factors when setting investment strategies, provided that any restrictions they place on investment as a result of such consideration do not significantly affect financial returns. But how immoral does an investment have to be before the financial returns no longer trump the moral question?

[Iain Stewart (Milton Keynes South) (Con)]

The hon. Gentleman is making a powerful argument, but will he consider the fact that many tobacco manufacturers are actively investing in non-tobacco products, which may change their whole future investment strategy? In the light of that fact, should not investors—pension funds and so on—look at that long-term development of such businesses rather than their current position?

[Sandy Martin]

I thank the hon. Gentleman for his intervention, but I do not agree with him. If a company is producing something that is detrimental to the whole world, the best approach is to disinvest from it.

How bad does an investment have to be before its financial returns no longer trump the moral question? Are there no factors that could lead a pension fund to divest on moral grounds alone? Such factors could—and in my view should—include the UK’s treaty obligations. For example, article 5.3 of the framework convention on tobacco control, to which the UK is of course a party, states:

“In setting and implementing their public health policies with respect to tobacco control, Parties shall act to protect these policies from commercial and other vested interests of the tobacco industry in accordance with national law.”

Guidelines for the implementation of article 5.3 were agreed back in November 2008 at the third conference of the parties to the convention. Recommendation 4.7 states:

“Government institutions and their bodies should not have any financial interest in the tobacco industry, unless they are responsible for managing a Party’s ownership interest in a State-owned tobacco industry.”

I am delighted that the UK has no state-owned tobacco industry, but the level of public investment in private tobacco firms in this country flies in the face of the convention.

As leader of the opposition at Suffolk County Council—before I was elected to this august House—I brought forward a motion proposing that the county’s pension fund should disinvest from tobacco funds. The motion was passed unanimously. The pension fund committee then commissioned legal opinion on how to divest, but the opinion was that the committee could not legally do so.

Does the Minister believe that our local authorities should also invest in, say, pornography—a very profitable business I am led to believe? Profit should not be the only consideration for pension fund investment. We can and must do better, and responsible disinvestment by local authority and public sector pension funds is the right place to start. This is an issue on which the public health Minister could usefully engage, and I hope he will make a commitment to do so when he replies to the debate.

Oral Answers to Questions

Sandy Martin Excerpts

Tuesday 4th July 2017 Commons Chamber

[Steve Brine]

Clinical commissioning groups have a statutory responsibility to consult the public, and Members of Parliament have a key role in ensuring that members of the public engage with those consultations, as I do in my area. I will be following the hon. Lady’s case closely, and she is welcome to come and see me about it if she likes.

[Sandy Martin (Ipswich) (Lab)]

10. When the Government plan to publish a tobacco control plan.

[The Parliamentary Under-Secretary of State for Health (Steve Brine)]

The UK is a world leader in tobacco control, and we will publish a new tobacco control plan shortly, building on our success. That plan will set out new national ambitions to further reduce smoking prevalence, particularly among disadvantaged groups.

[Sandy Martin]

I need to declare an interest as a Suffolk county councillor. Given the health responsibilities of local government, will the Minister tell the House what can be done to deal with the situation in which the actuarial advice from local government and other public sector pension schemes is that they are not at liberty to disinvest from tobacco stocks?

[Steve Brine]

I will have to look into the exact point that the hon. Gentleman raises, but I should like to welcome him to his place. I worked closely with his predecessor, and the hon. Gentleman has a tough act to follow. When we publish the tobacco control plan, there will be clear local tobacco plans as part of it. We in the Government can give the best evidence of what works, but we need to recognise what is needed in each local area. I know that he has specific needs in his local area in relation to tackling this issue.