The National Health Service

Stephen Kerr Excerpts

Wednesday 23rd October 2019 Commons Chamber

[Matt Hancock]

The hon. Gentleman raises the problem across Staffordshire. We are trying to ensure that the NHS in Staffordshire looks forward with confidence, and that includes addressing long-standing financial issues for which it has had extra support over the past few years. I pay tribute to all the NHS staff right across Staffordshire, who have done great work, especially in Stoke and Stafford, to ensure that the hospital provision there can look forward with confidence.

[Stephen Kerr (Stirling) (Con)]

My right hon. Friend was talking about spending on healthcare across the United Kingdom. Scotland has benefited due to increases in healthcare spending in England, but not all the money that comes to Scotland through the Barnett formula has been spent on healthcare. In fact, had spending increases in Scotland kept up with those in England, there would be half a billion pounds more to spend on Scotland’s NHS.

[Matt Hancock]

There speaks the voice of Scotland. As we have put record amounts of funding into the NHS in England, that funding proportionately flows through the Barnett formula to Scotland, but the Scottish Government have refused to increase NHS funding in Scotland. I wish that they would increase it as quickly as we have in England, where we have seen a faster increase in the numbers of doctors and nurses than in Scotland.

Appropriate ME Treatment

Stephen Kerr Excerpts

Thursday 24th January 2019 Commons Chamber

[Stephen Kerr (Stirling) (Con)]

I could easily say amen and sit down, but I would like to compliment the hon. Member for Glasgow North West (Carol Monaghan) on her speech.

I hope this debate and the passionate interest of colleagues from the across the House bring some encouragement to those suffering from this condition that they are not forgotten. Louise McAllan from Riverside got in touch with me last June. She tells me that ME led her to medically retire in her early 30s, that she has been too sick to leave her bed for months at a time, that she is unable to tolerate light or sound, that she cannot meet her friends and that she suffers intolerable pain. She was told by a neurologist in a major hospital that there was no such thing as ME, and she was told when she got a diagnosis that at least she did not have anything serious.

Catherine Schmitz from Stirling got in touch last May to tell me her story. For her, it is a dreadful illness that has left her signed off work for 22 years. She has balance and vision problems and sensitivity to light and noise. To get a diagnosis, she was passed around hospital departments that could look only at their own specialist areas.

Cathy Dickson from Torbrex got in touch in November 2017. Her case and the dangerous advice that she was given saw her become more ill because of doctors who had no knowledge of ME. She continues to fight for the support that she needs and deserves.

Pam Sullivan from Bridge of Allan also suffers from ME, which has left her with crippling fatigue, exhaustion, viral symptoms, muscle pain, and impaired cognitive function. Without her loving family, she would have no support at all.

I know the Minister is both compassionate and dedicated, so I hope that he will respond to the demands that we are hearing today in this debate. Treatments that harm patients should be discontinued with immediate effect. Does he appreciate the fact that ME patients cannot wait for NICE guidelines to be reviewed? I very much hope that he will agree that it is simply not acceptable that seriously ill people should be left feeling that, somehow, they are to blame for not getting better, and that if only they had a better attitude and a different mindset, they would recover.

What more will be done to provide updated professional training for GPs and other healthcare professionals properly to recognise the symptoms of ME? What more can the Department for Work and Pensions do to see that ME patients are treated fairly and that the process to which they are subject does not worsen their illness—especially in respect of how assessments are conducted? Will the Minister please reassure the House that substantially more resources will be dedicated to biomedical research so that we can understand ME and begin to reach for solutions? Minister, people need help.

NHS Whistleblowers

Stephen Kerr Excerpts

Wednesday 18th July 2018 Westminster Hall

[Dr Whitford]

I thank the hon. Gentleman for his intervention. I hope that this is just the first little step towards putting the matter on the agenda. The tragedies at Gosport brought the whole issue back. A nurse had come forward years and years ago, and could have saved hundreds of lives had she been listened to. Not being listened to is almost the least that can happen to a whistleblower, in that often they suffer detriment or reprisals and even lose their jobs.

The one change that Sir Robert Francis suggested to PIDA that has been made in England and Scotland is redress for discrimination regarding new employment—that is, applying for a new post within the NHS. Work is under way to introduce that in Wales as well. However, the main Act remains as it was. The first key weakness of PIDA is that it does not ensure an investigation of the whistleblower’s concern. Given the risks they take when they come forward, the detriment they may face, and the months or years of tribunals or other stages, it is crucial that the concern that made them step forward is not either overshadowed or completely ignored. I think that is their biggest frustration.

The Act most certainly does not protect whistleblowers. It describes itself as protecting whistleblowers from detriment, intimidation and reprisals, but PIDA can be used only for litigation after the detriment. Once someone has lost their job they can take their employer to an employment tribunal and attempt to have redress. The problem at that point is that the whistleblower has to prove that it was their disclosure—their coming forward and speaking up—that drove the loss of their job. Of course, employers will find all sorts of other excuses, such as, “Oh, they didn’t get on with their colleagues,” or, “They were a trouble maker,” or, “They were late for work.”

The success rate of litigation under PIDA is 3%, which is appalling, and shows how utterly weak the law is. Whistleblowers suffer further detriment while going through litigation. They know that they may face being landed with the costs. They may face bankruptcy, and stress that could go on for extended periods. Furthermore, between 2013 and 2017, people had to pay for employment tribunals. That, of course, closed that avenue off to many whistleblowers.

I make the simple case that we need a new public interest disclosure law. It should not sit inside employment law. It should not be a tweak to what we have now. We should recognise that the Public Interest Disclosure Act covers all sectors. The NHS may be one of the most common sectors to have whistleblowers, but the Act covers finance, research and business. We need a specific law.

It must be utterly clear that such disclosures are in the public interest, and that is where I disagree with the hon. Member for Stirling (Stephen Kerr), who may speak later. I do not agree with paying bounties to those who would disclose. Whether or not it creates a conflict of interest, it certainly gives the impression of doing so. It is utterly important, in the defence and protection of whistleblowers, that they can show that the only reason they have come forward is to protect patients or whoever the consumer is in their service.

[Stephen Kerr (Stirling) (Con)]

Just for clarity, I am not advocating bounties. It is one of the options to be looked at, but there are reservations about it, which I know the hon. Lady shares.

--- Later in debate ---

[Stephen Kerr (Stirling) (Con)]

It is a privilege to serve under your chairmanship, Mr Davies. I congratulate the hon. Member for Central Ayrshire (Dr Whitford) on securing this debate and on her compelling and powerful speech. I find myself agreeing wholeheartedly with what she had to say. It is a noteworthy event when Scottish Conservatives and Scottish National party Members agree unanimously, but it has happened twice today—it happened in the main Chamber, too.

I welcome the hon. Lady’s description of the work being done in NHS Scotland. She described the patient safety system, which has been in place for some time. Work on it is subject to continuous improvement, which is the correct approach. The different parts of the United Kingdom can share things with and learn from each other, and this is a good case in point.

As the hon. Lady has said, I was recently elected co-chair of the all-party parliamentary group on whistleblowing—I declare that up front. Time and again, inquiries into healthcare scandals, such as that at Gosport War Memorial Hospital, expose cases of people who spoke out to warn those who should have taken action but who were suppressed because healthcare leaders know that PIDA has no effective mechanism to address cover-ups and retaliation. The NHS continues to forensically investigate and penalise whistleblowers, while concerns go unheeded. PIDA has not changed that. It leaves patients at risk because it does not require the investigation of the whistleblower’s concerns. It is, in short, no deterrent. More than 19% of calls to Public Concern at Work and 30% to WhistleblowersUK are from the healthcare sector. Very few complaints proceed to an employment tribunal. Only 3% of claimants who make it to an employment tribunal win a PIDA claim, as has been mentioned. That is not good enough, and it is not a fair reflection of reality. Furthermore, the cost to the whistleblower can be far reaching and include complete ruination, while the institution can remain unaccountable—“It’s only taxpayers’ money”—but for a few forgettable headlines.

Inquiries into healthcare scandals such as those mentioned by the hon. Lady show that we are still not there on measures for whistleblowing. People who spoke out to warn those who should take action were suppressed, as I have said, and that happens because of the lack of an effective mechanism under PIDA. Punitive investigations and penalties are still part of the reality of life for a whistleblower. The Act does not go far enough to protect whistleblowers against that.

For whistleblowers, the cost of bringing a PIDA claim often exceeds £100,000 and they often find themselves on trial, as has been said. They suffer from retaliation and financial ruin. In the health service, as in so many sectors, institutions use attrition to wear down whistleblowers and can bring to bear uncapped resources and lawyers who use strategies to exhaust their funds, wearing them down mentally as well as financially and into submission. Whistleblowers are left without any money or resources, with their professional reputation undermined and their health impaired.

When a whistleblower acts, it is from a sense of duty to the public and to their vocation. In the case of health, that is in pursuit of patient wellbeing. When institutions react, it is often with an attitude of legalistic defence rather than in the spirit of embracing the opportunity to improve, or to right a wrong. Take the case of Dr Raj Mattu who exposed the preventable death of patients. After a fight of more than 10 years—this case may have been the one referred to by the hon. Member for Coventry South (Mr Cunningham), but I did not catch the name he used—Dr Mattu’s case was upheld by a judge. It had cost taxpayers anywhere between £6 million and £22 million, according to various estimates. Furthermore, Dr Mattu had been a leading cardiologist but now, at the age of 59, he is having to retrain. That is a waste of talent, and he was someone who did the right thing and has been proven to have done the right thing. A vast amount of money was spent to defend a legal position and to fight against a whistleblower, instead of being used to right the wrongs that Dr Mattu identified—all because a route of legal challenge was followed.

The main upshot of such cases is to channel NHS funds to firms of employment lawyers. That cannot be right at any time, because resources are always scarce. The case for legal reform is evident. The APPG will gather evidence to support changes to the law, which is what is required. Our objective is to bring together Members on both sides of the House, including those with different views on the finer details, to continually highlight the issue of whistleblowing and what happens to those who have the integrity and courage to act. The objective is to build consensus on certain issues and, we hope, to draw sufficient attention from Members across the House to achieve that change in the law.

We need to look closely at the idea of an independent investigatory authority, as has been discussed—I completely support what the hon. Member for Central Ayrshire said in that regard. We must also look at having independent and transparent investigations, and at the provision of arbitration, which has also been mentioned. We need to keep the law under review and up to date—it is 20 years since this law was looked at in any detail, and that is a long time—because the landscape changes, loopholes become apparent and new legal strategies can be deployed to shut down whistleblowers. Most of all, we need to look at the issue of protection for whistleblowers. Our job in this place is to formulate law, and we should do so to give genuine whistleblowers the protections they need. They may need financial help, and their professional reputations will almost certainly need protection. Most importantly of all, however, they need to know that we as legislators have their back through not only our words but our actions.

I hope that this important and valuable debate will continue. I also hope that the Minister will suggest that the Government have taken heed of the need for improvements to be made to the way in which whistle- blowers are treated, because we still have a long way to go.

ME: Treatment and Research

Stephen Kerr Excerpts

Thursday 21st June 2018 Westminster Hall

[Stephen Kerr (Stirling) (Con)]

It is a pleasure to serve under your chairmanship, Mr Rosindell. I pay tribute to the hon. Member for Glasgow North West (Carol Monaghan) for this campaign, which she is doing a superb job of leading. I cannot remember the name of the academic who wrote to her reproaching her for the stance she has taken in the campaign, but I say to her, I think on behalf of us all, that she is doing exactly what an MP should be doing, and shame on anyone who says otherwise.

I specifically compliment the hon. Lady on her presence at the recent Edinburgh event with the hashtag #MillionsMissing—a global day of action. The purpose of that event was to raise awareness, to highlight the need for support for ME sufferers, and to call for investment in healthcare and biomedical research, which is an excellent summary of the purpose of today’s debate. As has been mentioned, every participant in that event was invited to bring a pair of shoes, but what touched me deeply in the event publicity was that those pairs of shoes symbolised the millions of patients who are missing from their lives because of this devastating disease. The phrase “missing from their lives” deeply touched me.

I rise to speak just for a few minutes to highlight the experience of those who are affected by ME. As my hon. Friend the Member for Cheltenham (Alex Chalk) said, their evidence is compelling and should be a primary consideration. It has been upsetting for me to hear how many people, including those in the medical profession, are unaware, or lack a detailed understanding, of ME. Many persist in believing that the disease is some form of mental illness or neurological disorder. A constituent in Stirling told me that as recently as 2011 they were told, “There is no such thing as ME,” after collapsing at work. She has since been diagnosed with severe ME.

There are many distressing stories about the treatment of people suffering from ME. Another of my constituents was told repeatedly by different doctors that her ME was a psychological problem, and was referred on multiple occasions for psychological assessments. It took her two and a half years to get a proper ME diagnosis.

[Carol Monaghan]

Does the hon. Gentleman share my concern about the aspect of “medically unexplained symptoms” diverting ME down the psychological path?

[Stephen Kerr]

I absolutely agree, and I thank the hon. Lady for her intervention.

I cannot speak too highly of Helen Hyland, a constituent of mine, who has done so much to raise awareness of the condition across the UK in her role within the ME Association. She has also done so much to educate me as her Member of Parliament about this disease. Soon after my election as the Member of Parliament for Stirling, Helen reached out to inform me of what I could do to help the campaign. I am grateful that my office and I have been able to work with her to highlight ME to GPs in Stirling. I am not sure how they have responded to a letter from their Member of Parliament advising them to be careful about how they diagnose those who have the symptoms of ME; I am sure that is a different story.

Helen has been involved with the ME Association since her husband took his own life, a year after being diagnosed with ME. The way she told her children, who were very small at the time, of her husband’s passing outlines how hard ME is to cope with. She said:

“Imagine a Dr Who monster getting inside and taking over Daddy’s head and body. The harder Daddy fights, the harder the monster fights back. The monster always wins”.

For people with ME and those around them, the diagnosis is crucially important. To be told that they have a medically recognised condition is validation for them, yet there is still so little known about this illness. There is no easy way of diagnosing it, no clear treatment, and no known cure. That has to change. Along with many others, I will continue to support the ME Association and any campaign that pledges itself to combating ME.

I will now turn to the first-hand account of a lady called Jules Smith, who wrote to me and asked me to make her voice heard in this afternoon’s debate. I will do that because her story, as touching as it is, is not her story alone, but the story of many others. She wrote to me:

“For over ten years I was a therapist and devoted my life to helping others as best I could.

I first became ill about 8 years ago but kept going and put it down to general aches and pains. I finally had to give up what I loved in November 2016 with a final diagnosis of severe ME in May 2017.

I’ve been to psychology to be told it’s all in my head, pain management to be told to push through the pain and physiotherapy who told me my muscles were so weak there was nothing they could do!

I’ve been on so many prescribed medications and vitamins; last year I was taking in excess of 22 tablets a day and yet I would still crash.

I am 90% house and bed bound and my GP has exhausted all avenues for me therefore—as I was told—‘you must try and manage your illness as best you can.’

I had been told that graded exercise therapy would help me starting off by stretching then low impact sports like walking. I’m an ex-runner who was capable of running a 10k every week so I was familiar with pushing through the pain barrier and grading my exercise but it has made me more severe. I feel like my life is just wasting away; I get all my prescription medications on repeat, I get a telephone appointment with my GP every once in a while, and that’s it!

My husband works long shifts with the Scottish Prison Service and I’m home alone for at least 10 hours a day; sometimes I have to crawl on my hands and knees to get to the bathroom and I can go days on end without being able to bathe or shower as I’m just too exhausted to move!

I feel like so many others that we are just left to rot; I feel like my mental health is now suffering as I become more and more isolated from society and there’s no one to help me and many others just like me.

I am severely fatigued to the point that I cannot stand upright otherwise I get so dizzy I’m about to faint. I also have severe laboured breathing but there’s nothing recommended but rest and resting doesn’t cure ME.

I don’t wallow in self-pity. I spend what time I can online being an advocate for Action for ME and Millions Missing Scotland and whenever I can, I offer support to other members of the social media groups I am in and share my stories and experiences.

I have a devoted and caring husband who does everything he physically can to look after me but it’s tough when I’m home alone for so long with no care.

I try to do what I can to keep my spirits up but on days when I crash for no reason and I can’t watch TV, or read a book, I have to have my curtains drawn and be in a darkroom. Sometimes I even need soft silicone earplugs to block out any noise as I get cognitive dysfunction too!

This is not living Stephen this is just existing!”

I thank Jules for allowing me to share her story in the debate. I am grateful and feel privileged that I was allowed to let her voice be heard today in Parliament.

NHS Long-Term Plan

Stephen Kerr Excerpts

Monday 18th June 2018 Commons Chamber

[Mr Hunt]

I am very happy to tell the hon. Gentleman that all this money will materialise, because this is a Government that keep their promises. If he is so worried about the Brexit dividend, he should be speaking not to me but to his own leader, who said that he wants to

“use funds returned from Brussels after Brexit to invest in our public services”.

Have a word with him!

[Stephen Kerr (Stirling) (Con)]

I also welcome the statement from the Secretary of State, but I note that it relates to health spending in England only. Will my right hon. Friend spell out what this means for Scotland in particular, thanks to the Barnett consequentials, and how can we ensure that the additional funds provided to the Scottish Government are spent on the NHS in Scotland, which has not always happened in the past?

[Mr Hunt]

My hon. Friend is right to raise that question, because under the Barnett consequentials, for every £1 per head additional for the NHS in England, there will be £1 per head available for the NHS in Scotland. The Scottish National party has chosen to invest only 84p of every £1, which is why people in Scotland are 30% more likely to wait too long for their elective care in Scotland. That is a choice made by the SNP in Scotland and I hope that it will do it differently this time.

NHS Winter Crisis

Stephen Kerr Excerpts

Wednesday 10th January 2018 Commons Chamber

[Dr Philippa Whitford (Central Ayrshire) (SNP)]

Like others across the House, I thank all staff in all four UK systems, who, as the Secretary of State has said, have gone above and beyond the call of duty to focus on their patients, and I do not think any debate we have in here is intended to upset or insult any of them.

Before the hon. Member for Ludlow (Mr Dunne) perhaps leaves the Chamber, I want to thank him for his service as a Minister of State for Health, whom I often met across the Chamber, but I also want to correct a comment he made in answer to my question on Monday. He claimed that the number of patients waiting longer than 12 hours in A&E in England was half the level of that in Scotland.

Naturally, I would have expected the Minister to know all the stats and what they mean: in England data are only published for the percentage of patients who meet, or do not meet, the four-hour target. There is no publication of data on eight hours or 12 hours. The clock restarts for patients who require admissions, and that is defined as from the decision to admit until they get a bed and is known as trolley waits. So 48,000 patients waited over four hours on a trolley after their four-hour wait in A&E to get a bed, and the 109 he was referring to had waited over 12 hours on a trolley for a bed after the four or five hours they had waited in A&E. Therefore, it was utterly incorrect to compare that with the Scottish data, where we have a single clock from when the patient starts right through until they get to where they need to go. I simply want to clarify that while the hon. Gentleman is in the Chamber.

[Stephen Kerr (Stirling) (Con)]

I know that comparing England and Scotland is one of the pastimes that Scottish National party Members like to engage in—it is a fascination for them—but the reality is that in my constituency of Stirling, served by the excellent NHS Forth Valley in Larbert, only 57% of patients were seen within four hours in the last week of last year because we have a flu epidemic in Scotland, as they do in England, and that should be acknowledged.

[Dr Whitford]

If the hon. Gentleman gives me a little longer, he will find that I intend to talk about the flu epidemic, but before he gets too celebratory he might want to wait until tomorrow when we will have comparable data, because while in Scotland the data are published every week, in England they are published only every month. I am glad, however, that we no longer wait six weeks after the end of a month, which is 10 weeks after the start of it, but get it a fortnight later. So that will be available tomorrow, and then he can compare hospital trusts in England with hospitals in Scotland to his heart’s content. I would have thought that, as someone who celebrates the United Kingdom, he might want to praise the fact that Scotland has led the entire UK since March 2015 on emergency admissions and A&E.

Having corrected that, all of us recognise that this is a particularly tough winter because there has been an outbreak of flu on top of a bad freeze. I point out to those who think the worst is past that the flu season lasts until March and at the moment this is an outbreak, not an epidemic, but it comes on top of underlying pressures, and across the four nations this has involved staff having to go above and beyond the call of duty.

Whether it was how Public Health England said it or how the media reacted to it, this business of stating in public that the flu vaccination does not work is unfortunate and irresponsible. The flu vaccination recipe is planned by the World Health Organisation at the beginning of each year. It will already be working on next year’s flu. It does not have a crystal ball and people who have what we in the medical profession call a retrospectoscope should recognise that that tool was not available at the time when the decisions were made. Producing vaccine is a biological process that takes months, so the decision is made in March for the northern hemisphere, and all the companies produce to that recipe. Headlines in Scotland implying that the Scottish Government popped down to Boots and took the wrong vaccine off the shelf are therefore facile, and that also encourages people not to bother.

We already have falling vaccination rates in childhood vaccination and in flu. We should be pointing out that multiple flu viruses are circulating. While all the talk in the media is of Australian flu, in Scotland that is about a quarter of the strains that are circulating.

One of the issues with flu is that it happens in cold weather, and in Scotland we get the coldest weather in the United Kingdom, so we have double the rate of flu that there is down here in England. We also had a worse freeze, and are continuing to have a worse freeze. So when the data come out tomorrow, I think we will see that Scotland will still lead the UK. We will not be performing to the level we want. We have not met the 95% target for emergency departments since August, but England has not met them since 2015 and, sadly, Wales has not met them since 2008. So this is a challenge across the board, but Scotland has been more resilient. I call on all MPs to encourage staff and other people to get a flu vaccination, because this will continue until March and it is still absolutely worth doing.

The Secretary of State often talks as if the problems in A&E are due to people who should not be there. If we talk to anyone who works in A&E, they will say that, by and large, that is not the case. With people getting fractured ankles and fractured wrists on the ice, A&Es will have been very busy with having people carted in and X-rayed, and what we call in Scotland getting a stookie put on before they go home. That is all going to take time, but anyone who works in A&E would say that the key issue is frail, sick people, often with multiple conditions, and whether they fractured their hip falling on the ice or have a respiratory problem secondary to flu, they need a bed and the issue in England is that there are not enough beds.

Tobacco Control Plan

Stephen Kerr Excerpts

Thursday 19th October 2017 Commons Chamber

[Stephen Kerr (Stirling) (Con)]

With your kind permission, Madam Deputy Speaker, as a Scottish MP I hope to make a short contribution to the debate on a tobacco control plan for England. I shall make some reference to the situation in Scotland, to highlight the cost of smoking in human suffering and death, as well as the cost impact on public health budgets and the overall economy. I welcome the debate on this vitally important matter and congratulate the right hon. Member for Rother Valley (Sir Kevin Barron) on securing it. I also applaud the Backbench Business Committee for granting the time.

The tobacco control plan builds on the successes of the previous control plan, established by the coalition Government, and aims to herald a smoke-free generation—I say that while recognising that much yet needs to be done. I wholeheartedly support the principle of preventative spending on early intervention, which can prevent negative health outcomes later in life. I also welcome the investment in tackling ill health and recognise that it has the potential to save a significant amount of public spending in the long term and can help to reduce health inequalities. I do not underestimate the power of addiction. For that reason, I feel that where there is a will to stop smoking we should do everything possible to help people to help themselves.

I welcome recent falls in the number of adults who smoke in England and Scotland, and the number of children exposed to second-hand smoke. However, smoking rates in Scotland are still higher than in England, and we must be prepared to do much more to reduce this figure. Currently in Scotland, tobacco use is linked to 10,000 deaths a year.

On e-cigarettes, I am a firm supporter of having a robust regulatory framework, which ensures all devices are safe and acknowledges their potential use in smoking-cessation programmes. I welcome the fact that earlier this year the Scottish Parliament voted to ban the sale of e-cigarettes to under-18s and to limit advertising, moves I fully support because they will protect the health of our young people.

On the tobacco control plan for England, I acknowledge that the previous plan reduced adult smoking rates in England from 20.1% to 15.5%. That is indeed progress. I also applaud the ambition in the plan to reduce adult smoking rates from 15.5% to 12% or less by 2022. It is welcome that the plan is supported by the British Heart Foundation, which recognises it as an important tool in reducing the rate of strokes and heart disease. I compliment the Government on the fact that the World Health Organisation has designated England as one of the best places in the world to give up smoking. The strategy is based on a joined-up approach between the NHS, the Department of Health and local government. That can only be good, too.

I welcome the ambition of the plan to reduce the number of 15-year-olds who regularly smoke from 8% to 3% or less; reduce the smoking rates among adults in England to 12% or less; reduce the inequality gap in smoking prevalence between those in lower paid, routine and manual occupations, and those in higher paid professional and managerial occupations; and reduce the prevalence of smoking in pregnancy from 10.7% to 6% or less. I also applaud making all mental health in-patient service sites smoke-free by 2018, as was mentioned by my hon. Friend the Member for Witney (Robert Courts). It has been a source of frustration for me for many years, as I am sure it has been for other Members, to visit hospitals for various reasons and find people congregated around the entrances, often having been escorted there by health workers who I am sure would prefer to be doing more productive things. I also welcome the ambition of permitting innovative technologies than minimise the risk of harm and maximise the availability of safer alternatives to smoking.

I hope we all support the idea of creating a smoke-free generation without any reservation. Effectively enforcing existing legislation on proxy purchasing and standardised packaging to reduce the uptake of smoking among young people is a very noble objective. Supporting pregnant smokers to quit, which will undoubtedly increase the life prospects of children yet unborn, and reviewing the sanctions for retailers who consistently break the law designated to protect young people from smoking, is welcome. As the right hon. Member for Rother Valley mentioned in his opening speech, in 2016 it was estimated that 2 million people had used e-cigarettes and had completely stopped smoking—that must be very good news—while at the time a further 470,000 were using them as an aid to quit.

In 2013, the Scottish Government introduced a five-year tobacco control strategy entitled “Creating a Tobacco-free Generation”. It set the target to reduce smoking prevalence in Scotland to 5% or less by 2034—again, a very ambitious and welcome target. The strategy set out a range of measures to support young people to choose not to smoke, to protect children and all people from second-hand smoke, and to continue to support those who do smoke to quit. Actions taken by the Scottish Parliament in recent years to control tobacco, and to limit and tackle the harm caused by tobacco, include legislation to prohibit smoking in public places, which came into effect in March 2006; raising the age of sale for tobacco from 16 to 18 in 2007; implementation of a tobacco retail register in 2011; a ban on self-service sales from vending machines in 2013; and the introduction of a tobacco display ban in shops from 2013.

I turn now to the impact of smoking. According to Scottish Government statistics, tobacco use in Scotland is associated with more than 10,000 deaths and about 128,000 hospital admissions every year. According to the Office for National Statistics, smoking prevalence in Scotland among over-16s was 17.7% in 2016—an estimated 942,644 smokers—compared with the UK-wide smoking prevalence of 15.8%. Smoking prevalence in Scotland fell between 2003 and 2013 but has remained fairly static since. Some 35% of adults in the most-deprived quintile of the Scottish index of multiple deprivation smoke compared with 11% in the least-deprived quintile.

According to ASH Scotland, on average lifelong smokers die about 10 years sooner than non-smokers. The estimated cost to the NHS in Scotland alone is £323 million. According to the Scottish Public Health Observatory, for every 1 percentage point by which smoking prevalence is reduced, the NHS could save £13.4 million. One last set of numbers underlines the cost of smoking: ASH Scotland estimates that smoking costs Scotland around £1.1 billion annually, including £271 million in healthcare costs, £692 million in productivity losses due to active smoking, £60 million in productivity losses due to passive smoking, £34 million in clearing smoking-related litter and £12 million in fires caused by smoking in commercial properties.

[Colleen Fletcher (Coventry North East) (Lab)]

As an ex-smoker who went cold turkey many years ago, I agree with most of what has been said. Like many others, however, I come from a family where parents and grandparents smoked. I welcome all measures to help people to stop smoking. Does the hon. Gentleman agree that we need more investment in prevention, not least through public health budgets, but that those are now in the hands of local authorities, the cuts to which have been abominable over the years? Does he agree that more money needs to be invested in public health?

[Stephen Kerr]

I note in the plan the £16 billion commitment to funding public health programmes, in conjunction with local authorities in England, which is surely welcome news.

[Bob Blackman]

Just to reiterate, although it is local authorities that spend the money to help people give up smoking, which is warmly welcome, the savings go directly to the health service, and so the money is not recycled back to those helping people to stop smoking to meet the considerable expense incurred.

[Stephen Kerr]

I thank my hon. Friend for his intervention and his moving and impactful contribution earlier.

Behind the numbers on lives and costs, there is above all else the human suffering and the suffering of the families who lose family members to this terrible disease. I welcome any and all efforts to help people across the UK stop smoking.