Department of Health and Social Care

Debate between Sarah Bool and Gregory Stafford

Wednesday 5th March 2025 Commons Chamber

[Sarah Bool (South Northamptonshire) (Con)]

The Government came into office making all the right noises about tackling waiting lists and delivering a better healthcare service, which all our constituents want to see. However, since their election, I am concerned that Ministers are giving out more money—about £22.6 billion —for the day-to-day running of the NHS, without plans about how that may be spent to reform our health service, make it more efficient and support priority areas, such as dentistry, general practice or hospice care.

The Government are seemingly giving with one hand but taking with the other. No one should overestimate the impact of the increase of the employer national insurance contribution on our GP surgeries. Both Towcester and Brackley medical centres in my constituency have said that that increase will cost at least £40,000 to £50,000 and may result in redundancies, stopping the growth of their practices. Our surgeries are not here to make profit, but to deliver care, and attacks like this make care unsustainable.

The Darzi report said:

“The NHS budget is not being spent where it should be—too great a share is being spent in hospitals, too little in the community, and productivity is too low.”

[Gregory Stafford]

I agree entirely with what my hon. Friend says, but has she seen anything from this Government that suggests that there will be a significant shift from acute care in hospitals to community care, despite the rhetoric that we have heard from the Government Benches?

[Sarah Bool]

I concur that I have not seen anything, which is why today’s debate is so important. My GPs tell me that more attention needs to be given to GP practices: they are the praetorian guard who can ultimately protect the NHS. Access to timely appointments is crucial, as is rebuilding the key relationship and contact between a GP and their patient.

Tobacco and Vapes Bill (Thirteenth sitting)

Debate between Sarah Bool and Gregory Stafford

Committee stage
Tuesday 28th January 2025 Public Bill Committees

[Gregory Stafford]

I completely agree that we could very easily ban tobacco and vaping for everybody at every age. That would be the biggest incentive for people to quit. The Government—I think rightly—are not doing that, because they are not looking to criminalise people who are currently addicted to tobacco and vapes. If we are allowing people to do something legally, there should be places where they can do so safely and not harm others, such as their own children. I am sympathetic to the public health argument that the hon. Gentleman makes but, in practical terms, there may be areas where this is a problem.

My final point is really a question for the hon. Gentleman: under what regulations would the local authority be enforcing such byelaws? Would it be through the penalties and enforcement activities in this Act itself —if it becomes law—or would there be some sort of fine or penalty system that the local authority could use? While there are potential fines and enforcement activities on the face of this Bill, if there were local regulations, would these be in line with what is in the Bill, or would there be some other fining system that a local authority could dream up itself?

[Sarah Bool (South Northamptonshire) (Con)]

Taking on board what you said, Mr Pritchard, I just want to build on the point that my hon. Friend made about enforcement—I always talk about enforcement in practice. I want to know how rules will be advertised between different jurisdictions. I think we will end up spending an inordinate amount of money on trying to run a campaign that could have been better spent on helping with smoking cessation or on more practical measures.

Tobacco and Vapes Bill (Seventh sitting)

Debate between Sarah Bool and Gregory Stafford

Committee stage
Thursday 16th January 2025 Public Bill Committees

[Gregory Stafford]

My hon. Friend is making an interesting point. What does she think about the idea of having a single licence? If a shop—for example, a small convenience store—is selling alcohol, tobacco, where it is still permitted under the regulation, and vapes for those over 18, would a single regulatory process and licensing scheme be more efficient and more beneficial both to the customer and the retailer?

[Sarah Bool]

My hon. Friend makes a valid point. We do not want the introduction of this legislation to lead to any overburdening. We do not want the smaller convenience stores that are trying to operate to be challenged and put out of business. We want this to be a very practical measure so I agree that would be something to look into. I wonder whether the Minister might offer any further thoughts on that.

Tobacco and Vapes Bill (Sixth sitting)

Debate between Sarah Bool and Gregory Stafford

Committee stage
Tuesday 14th January 2025 Public Bill Committees

[Sarah Bool]

Absolutely. Unlike my hon. Friend, I am not a medical professional, but I wholeheartedly agree that it is a self-perpetuating cycle, and we need to stop it as soon as possible to protect children.

[Gregory Stafford]

It is a pleasure to serve under your chairmanship, Sir Roger. I want to make two points about this part of the Bill. First, I support new clause 10, in the name of my hon. Friend the Member for Sleaford and North Hykeham. It is essential that we close off all avenues for children to purchase vapes. In the Bill, the Government have done a very good job of dealing with physical retailers, but there is a gap in relation to online retailers. I hope the Minister is minded to support the new clause, either when we come to a vote on it in a few moments, or by inserting something similar into the Bill on Report to ensure we close off online retailers.

In my opinion, online retailers are more dangerous than physical shops. A child—especially a very young child—has to depart from their guardian or their adult to go and buy something in a shop, whereas they can purchase products online on their phone or computer in the comfort of their own home, and it is very difficult for a parent or a senior person in their family to spot that. We know that that is where a number of children and young people are getting these products, so we have to close off that avenue.

My second point is about a more fundamental issue with the clause itself. My hon. Friend the shadow Minister has said this quite extensively, but it bears repeating so that we get some answers from the Minister. It does not seem obvious why the Government decided to ban vapes for anyone under the age of 18, whereas for other tobacco products it is for anyone born on or after 1 January 2009. I completely accept that vapes can be used as a smoking cessation tool; it is important that they are used in that way.

When we come on to vending machines, there are medical settings in which people require some form of intervention to help to stop smoking, and we should be looking at that. However, it is not beyond the wit of the Bill’s drafting to apply 1 January 2009 to tobacco products, and then to create an exemption specifically for smoking cessation. I want to understand why the Minister has decided to make this distinction. Does he not see the potential risks in doing so? Hopefully, we all want people not to be addicted to any products that are harmful to them, but both retailers and consumers, when faced with two sets of rules for very similar products, could become confused and accidently fall foul of the law. Because of that confusion, the law might not be enforced as the Minister would like it to be. I very much hope the Minister addresses those two points in his closing remarks on these clauses.

--- Later in debate ---

[Sarah Bool]

This amendment states:

“The offence set out in subsection (1) does not apply to vending machines that are located within specialised mental health units that provide care for mental health patients.”

I tabled this amendment on the basis of the evidence provided to us. I put on record that the Committee received a letter by Peter Terry, a

“Smoke Free lead in a large Mental Health Trust in the North West of England”.

In his letter, he says,

“As you may be aware the success of hospitals and Trusts becoming smokefree environments (especially Mental Health units) is particularly challenging. Mental Health service users due to their conditions have little or no motivation to stop smoking. On the units of my trust the prevalence of smoking is consistently between 70-77%.”

He goes on to say:

“To ensure we allow service users who are hospitalized a safer way to manage their nicotine addiction...my Trust would require Vending machines. These would allow service users to purchase a closed pod system device, which is a lot less harmful than tobacco smoking. On admission they would be offered either free NRT products or to purchase a vape as described above.”

He is asking that we make an exemption.

The exemption was also supported in another submission from the Cambridgeshire and Peterborough NHS foundation trust. Ben Kingsbury, the tobacco dependency lead in that trust, wrote to express his concerns over the ban on the sale of vapes from vending machines. He indicated that his trust had installed vending machines back in May 2024

“to ensure that vapes are available to staff and patients at all times.”

He stated:

“Since installation of the vending machines in our Trust we have had over 2400 individual vends. Each vend represents a staff or service user making a positive decision to improve their health. 2400 individual vends in just 6 months represents a saving to the Trust of around £12,000.”

He argued:

“Removing the machines will reduce patients’ independence in buying their own devices while in hospital and will have a financial implication to our Trust, as wards would be expected to fund more vapes.”

He was also concerned that

“a lack of vape provision on our Trust premises may result in patients returning to smoking”,

which I am sure we all agree we do not wish to be the result. He also asked that we consider the financial implications, as well as health and wellbeing of service users, by implementing the exemption.

We can all empathise with those who are admitted to mental health units. They may have difficult and complex conditions that they need to work through, and coping with a potential addiction may be too much for them. There may be a logic to listen to the voices of the experts—especially if we end up having smoke-free places around hospitals and how that will work out—asking us to allow a mechanism to help someone with smoking cessation.

The Minister himself has just said that vaping can be good to help someone quit, but if they do not have access to a vape they may face difficulties such as cravings, anxiety, trouble concentrating and all the other elements that go with it, including potentially going back to smoking tobacco in its pure form. Taking away the option from those in mental health units will only make their recovery harder, longer and more expensive for the NHS. I heartedly commend to all members of the Committee that we all consider this amendment thoroughly, to ensure that we are not doing additional harm by taking an aggressive approach in this regard.

[Gregory Stafford]

I thank my hon. Friend the Member for South Northamptonshire for moving the amendment. One thing we have seen across the debate thus far, and indeed during oral evidence, is that we have been led by the evidence—the Minister has clearly said that. The evidence that my hon. Friend has provided is from medical experts. These are not vape peddlers or people from the industry, or people who want to make a quick buck out of those who are addicted to nicotine. These are health professionals who are trying to ensure that there is a balance between what is absolutely right—we do not want to see people vaping—and the reality of the situation in medical settings, especially in mental health settings, where the ability for patients to have a certain amount of autonomy is often vital to their mental recovery.

My hon. Friend also made the valid point that if we remove smoking and tobacco products from in and around hospitals, which is a suggestion in the Bill that I think I support, we must ensure that those who are addicted—and we accept that it is an addiction—are dealt with appropriately. Obviously, in most regular acute trusts, that would be dealt with through a nicotine patch, but for mental health services, as I said, the requirement for autonomy should sometimes outweigh the functional nature of a nicotine patch. Indeed, my understanding is that nicotine patches do not work for everyone, because some of the addiction is in the holding as well as the imbibing.

I welcome the Minister’s response. As I have said to him on previous amendments, even if he is not happy with the precise wording my hon. Friend the Member for South Northamptonshire has put forward, I hope that he can bring in some kind of exemption on Report, so that the medical professionals who have written to us are satisfied that their concerns have been heard?