Smoking Prohibition (National Health Service Premises)

John Bercow Excerpts

1st reading: House of Commons
Tuesday 29th January 2019 Commons Chamber

[Tracy Brabin (Batley and Spen) (Lab/Co-op)]

I beg to move,

That leave be given to bring in a Bill to prohibit smoking on National Health Service premises; and for connected purposes.

It is fabulous to have a full House, Mr Speaker. How marvellous.

This is a Bill that I hope is simple in its terms, can forge the support of as much of this House as possible and can bring us in line with the intentions of the Welsh and Scottish Parliaments—a Bill that would give our NHS trusts the legal back-up to ban smoking on their grounds, which I believe would be to the benefit of patients, visitors, staff, trusts and society more widely. During my contribution, I will try to convince Members of its benefits, but I am not naive. I am aware that some Members, indeed some commentators too, will have already written this off as some sort of attempted nanny state intervention that will only seek to cruelly deny unwell people the so-called pleasure of smoking a cigarette. I know I have my work cut out for me, so let us start at the beginning.

Our country has taken great steps in raising public awareness about the risks and harm of smoking. Those warnings are rightfully embedded in our education system. I doubt there are many children who would not know that smoking is linked to cancer and other life-threatening conditions. Most recently, Britain introduced plain packaging for cigarettes. Advertising by cigarette companies is also banned. This House has a history of introducing legislation to reduce the proliferation of smokers, including limits on where people can smoke. Work locations and public buildings both have bans in place. If there is a roof, you cannot spark up. You cannot smoke in cars with children. Yet, think about your last visit to a hospital, whether as a patient or a visitor. Why is it that, to reach the hospital, a place that by its very purpose should be a leading light of health and wellbeing, the chances are that you are forced to walk through great plumes of smoke to reach your location, with cigarette butts and litter filling wall-mounted bins? That scene is more than likely replicated day in, day out.

The inspiration for my Bill came from the Mid Yorkshire Hospitals NHS Trust, which serves my constituents in Batley and Spen and people across mid-Yorkshire. On a recent service visit, I was deeply concerned to hear of the havoc that smoking on the premises can cause. As I go through some of the arguments for legally outlawing smoking on NHS grounds, keep in mind that smoking is already banned on those premises and that smokers are already defying the rules of the hospital. This Bill is about putting that in legislation.

The Mid Yorkshire Hospitals NHS Trust has told me—and I have experienced this—about the unpleasant stench of smoke when people enter and exit the building. Staff face abuse when asking smokers to put out their cigarettes. The ethics of hospitals as health promoters is undermined. I also suggest that it makes the enforcement of other rules, such as bringing alcohol on to the premises, much more difficult. Smokers congregating outside the entrance cause congestion and block access for less mobile or disabled visitors, and that is significantly worse in bad weather.

If smoking is a free-for-all as soon as visitors hit the fresh air, that affects services, too. Our hard-working and over-stretched staff are asked to escort patients outside and wait with them while they smoke, and staff are taken away from duties to let patients back into the ward after smoking. Wheelchairs are difficult to find as smokers use them, and volunteers, who have given up their time, are subject to complaints from members of the public as they walk through smokers to reach the entrance. One of the trust’s neonatal wards cannot even open the windows because smoke would come in. Just think of the risk to newborn babies and patients with breathing difficulties.

In short, the case is compelling from that one trust, but we will not achieve smoke-free hospital grounds without legislation. [Interruption.]

[Mr Speaker]

Order. The hon. Lady is a distinguished actress and has a voice that projects, but it seems to me that the House is rather irreverent. What she is saying on this matter should be heard.

[Tracy Brabin]

Thank you, Mr Speaker.

A senior member of NHS staff, who will remain unnamed, said to me that we do not let alcoholics drink White Lightning, so why do we let smokers damage their recovery? Of course, the trust has not been idly waiting for legislation. It has introduced a speaker system to inform smokers where they should not be smoking, and it has even brought in a fruit and vegetable store to promote healthy eating, but sadly people smoke in front of it.

This issue is about much more than just mid-Yorkshire. I am calling for legislative support for all NHS trusts seeking to implement the Government’s smokeless NHS debate initiative, as laid out in the 2017 tobacco control plan for England. This is about more than simply installing no-smoking signs; it is about creating a culture that is in favour of quitting. I want this legislation to be part of a package that includes support to help smokers quit or abstain. They should receive encouragement to do so while on hospital grounds. Smoke-free policies should be communicated before appointments; staff should be given stop-smoking training; carers, families and visitors should have cessation advice; and, crucially, patients who smoke should be identified so they can be given support to stop. That is the whole package that I want to see implemented, but while we wait for legislation there are a number of things that I believe we should be doing now.

I gently say to NHS England that it would be welcome to see it produce guidance on smoke-free NHS policy, alongside implementation procedure. Such a step would strengthen the message to trusts that smoke-free policies are an essential part of their operation and would be a very welcome push towards a smoke-free NHS. I say this to Ministers: I am aware that the prevention Green Paper is on its way and this Bill might be the opportunity to implement that legislation.

At the start of my speech, I mentioned the Scottish and Welsh Governments. In Wales, legislation to ban smoking on hospital grounds is expected to be implemented this summer. In Scotland, legislation has been passed giving Ministers the power to designate a perimeter around hospital buildings within which smoking is prohibited. This Bill would be an example of this House taking a lead from the devolved Administrations where appropriate. We should never be shy of doing that. It is worth remembering that the smoking population inside hospitals is higher than it is among the general public and that illnesses can be a major factor in quitting. Let us support people in the first hours and days of kicking the habit.

I know that, for some Members, the provision of support will depend on cold, hard cash. They will be relieved to know that a full implementation of smoke-free policies on the Royal College of Physicians estate would deliver a net saving to the NHS of up to £60 million within one year and greater savings in the long term. Let us not lose sight of the immediate benefits. Even following diagnosis of lung cancer, people who quit have a significantly lower risk of mortality and cancer recurrence.

Although the number of smokers is reducing, it remains a serious menace in my constituency of Batley and Spen. In Kirklees, we have a higher than average number of smokers—17.1%—and in Yorkshire it is 17%. In England, the average is 14.9%. Sadly, 12.6% of pregnant women smoke at the time of delivery in Kirklees; the national average is just over 10%. According to Public Health England, between 2015 and 2017, there were 4,439 smoking-related hospital admissions in Kirklees—again, that is above average. In the same period, there were sadly 1,942 deaths attributable to smoking in Kirklees.

The need for this measure is obvious. We still have our work cut out for us. I am not saying that the Bill will magically reduce the number of smokers. Although I am aware of the hard work carried out on cessation programmes at the Mid Yorkshire Hospitals NHS Trust, we all need to do our part to make hospital grounds smoke-free, take the burden off our NHS staff and create a more pleasant experience for patients and businesses alike.

This is an incredibly simple Bill of the kind introduced in Scotland and Wales. I hope it will be implemented with ease.

Question put and agreed to.

Ordered,

That Tracy Brabin, Mary Creagh, Mrs Sharon Hodgson, Bambos Charalambous, Thelma Walker, Yasmin Qureshi, Paula Sherriff, Holly Lynch and Dr Rosena Allin-Khan present the Bill.

Tracy Brabin accordingly presented the Bill.

Bill read the First time; to be read a Second time on Friday 15 March, and to be printed (Bill 327).

Business of the House (Today)

Ordered,

That, at this day’s sitting, the Speaker shall put the questions necessary to dispose of proceedings on the motion tabled under section 13(6)(a) and 13(11)(b)(i) of the European Union (Withdrawal) Act 2018 in the name of the Prime Minister not later than 7.00pm; such questions shall include the questions on any amendments selected by the Speaker which may then be moved; the questions may be put after the moment of interruption; and Standing Order No. 16 (Proceedings under an Act or on European Union documents) and Standing Order No. 41A (Deferred divisions) shall not apply.—(Michelle Donelan.)