Tobacco and Vapes Bill

Tim Loughton Excerpts

2nd reading
Tuesday 16th April 2024 Commons Chamber

[Dame Andrea Leadsom]

I am grateful to my hon. Friend, who makes such a powerful point and speaks with such authority. Similar points were made by my hon. Friend the Member for Sleaford and North Hykeham (Dr Johnson), who as a paediatrician spoke with great expertise on this matter. It is absolutely true: it is a false choice. It is not a freedom of choice; it is a choice to become addicted and that then removes your choice.

Every year, more than 100,000 children aged between 11 and 15 light their first cigarette. What they can look forward to is a life of addiction to nicotine, spending thousands of pounds a year, making perhaps 30 attempts to quit, with all the misery that involves, and then experiencing life-limiting, entirely preventable suffering. Two thirds of them will die before their time. Some 83% of people start smoking before the age of 20, which is why we need to have the guts to create the first smoke-free generation across the United Kingdom, making sure that children turning 15 or younger this year will never be legally sold tobacco. That is the single biggest intervention that we can make to improve our nation’s health. Smoking is responsible for about 80,000 deaths every year, but it would still be worth taking action if the real figure were half that, or even a tenth of it.

There is also a strong economic case for the Bill. Every year, smoking costs our country at least £17 billion, far more than the £10 billion of tax revenue that it draws in. It costs our NHS and social care system £3 billion every year, with someone admitted to hospital with a smoking-related illness almost every minute of every day, and 75,000 GP appointments every week for smoking-related problems. That is a massive and totally preventable waste of resources. For those of us on this side of the House who are trying hard to increase access to the NHS and enable more patients to see their GPs, this is a really good target on which to focus. On the positive side, creating a smoke-free generation could deliver productivity gains of nearly £2 billion within a decade, potentially reaching £16 billion by 2056, improving work prospects, boosting efficiency and driving the economic growth that we need in order to pay for the first-class public services that we all want.

I know that hon. Members who oppose the Bill are doing so with the best of intentions. They argue that adults should be free to make their own decisions, and I get that. What we are urging them to do is make their own free decision to choose to be addicted to nicotine, but that is not in fact a choice, and I urge them to look at the facts. Children start smoking because of peer pressure, and because of persistent marketing telling them that it is cool. I know from experience how hard it is, once hooked, to kick the habit. I took up smoking at the age of 14. My little sister was 12 at the time, and we used to buy 10 No. 6 and a little book of matches and —yes—smoke behind the bicycle shed, and at the bus stop on the way home from school. [Interruption.] Yes, I know: I am outing myself here.

Having taken up smoking at the age of 14, I was smoking 40 a day by the age of 20, and as a 21st birthday present to myself I gave up. But today, 40 years later—I am now 60, so do the maths—with all this talk of smoking, I still feel like a fag sometimes. That is how addictive smoking is. This is not about freedom to choose; it is about freedom from addiction.

There is another angle. Those in the tobacco industry are, of course, issuing dire warnings of unintended consequences from the raising of the age of sale. They say that it will cause an explosion in the black market. That is exactly what they said when the age of sale rose from 16 to 18, but the opposite happened: the number of illicit cigarettes consumed fell by a quarter, and at the same time smoking rates among 16 and 17-year-olds in England fell by almost a third. Raising the age of sale is a tried and tested policy, and a policy that is supported not only by a majority of retailers—which, understandably, has been mentioned by a number of Members—but by more than 70% of the British public.

[Tim Loughton (East Worthing and Shoreham) (Con)]

If I had known that my right hon. Friend was such a keen smoker, I would not have recruited her to the Conservative party at the tender age of 18 when we were at university.

I have always taken a free-choice approach to health matters, and as shadow Children’s Minister I had to lead on both the tobacco advertising ban and the public smoking ban. We were wrong to oppose them. Who would now think it remotely normal for people to be able to smoke around us in restaurants and other public places? Does my right hon. Friend not agree that in a few years’ time this measure will seem just the same as banning smoking in public places, and people will ask why we did not do it earlier?

[Dame Andrea Leadsom]

As I have said ever since I met my hon. Friend at the age of 18, he is always right. I can never disagree with him.

I want to say a few even more furious words about vaping. It is just appalling to see vapes being deliberately marketed to children at pocket-money prices and in bright colours, with fun packaging and flavours like bubble gum and berry blast, and with the vape counter right next to the sweet counter.

Parents and Carers of Infants: Support

Tim Loughton Excerpts

Tuesday 12th March 2024 Westminster Hall

[Tim Loughton (East Worthing and Shoreham) (Con)]

I came along this afternoon just to listen, not to speak. However, I have been so inspired by my Sussex colleague, my hon. Friend the Member for Hastings and Rye (Sally-Ann Hart), and equally so shocked by the revelation that the hon. Member for Strangford (Jim Shannon) does not intend to make a speech in this debate—above and beyond the mini contribution he has already made—that I will use the time available to make a few comments. I want to speak particularly in support of my hon. Friend’s Bill, which I wish well this Friday, but also in the greater context of the Best Start for Life programme that has been championed over so many years by the Minister.

It is worth reminding ourselves why the whole issue of getting the best start in life and encouraging, nurturing and supporting parents at the very early stages is so important. I speak as the chair of the APPG on conception to age two—first 1,001 days. We have a display of officers from that eminent group here today, which was set up by the Minister herself some years ago. Those first 1,001 days are critical because it is a period of uniquely rapid growth in toddlers’ brains. More than a million new connections are formed every second in a baby’s brain, and babies’ growing brains are shaped by their experiences, particularly the interactions they have with their parents and other caregivers. What happens during this crucial time lays the foundations for future development, not just during childhood but into adulthood. They are effectively lifelong.

There is a lot of research showing that the way in which parents interact with their baby predicts the child’s later development. In order to thrive, children absolutely must have a loving and secure relationship with at least one sensitive, nurturing caregiver who can respond to his or her needs. That is why it is so important to support parents and parent-infant relationships to give children the best start in life. A range of stress factors during pregnancy and early years can be communicated to and can impact on a baby or growing toddler.

The cost of not getting it right is considerable. Some years ago, when the Maternal Mental Health Alliance issued its flagship report, it costed maternal perinatal mental health problems at some £8.1 billion. That is what it is costing for not giving mums and dads the best support to ensure that they can bond with their children. One in six new mothers will suffer some form of perinatal mental illness, and covid certainly worsened that situation, with all the pressures on first-time parents in particular of babies born during covid, as they did not have access to some of the support networks that we took for granted until then. In addition, child neglect has been costed at something like £15 billion each year, so we are spending £23 billion-plus on the consequences of not getting it right by intervening at a stage when it could have the maximum impact for the parent and, mostly importantly, the developing and growing child.

Healthy social and emotional development in the first 1,001 days means that individuals are more likely to have improved mental and physical health outcomes from cradle to grave. It means that children can start school with the language, social and emotional skills they need to play, explore and learn, and that children and young people are better able to understand and manage their emotions and behaviours, leading to less risky and antisocial behaviour later on. It also means that children can have the skills they need to form trusting, healthy relationships.

It has been calculated that some 28% of mothers with mental health problems report having difficulties bonding with their children. Research suggests that the initial dysfunctioning of mother-baby relationships affects children’s development by impairing their psychomotor and socio-emotional development. As well as the direct impact on the child, it can have longer-term adverse effects on the parents and wider family. The onset of a maternal mental health condition can precipitate relapse or recurrence of previous mental illness. It has the potential to herald the onset of long-term mental health problems and is associated with an increased risk of maternal suicide, and we know how alarming the figures are for women who commit suicide soon after giving birth. It is important to say that this is not limited to mothers; there is also an impact on fathers. Post-natal depression has been linked with depression in fathers and high rates of family breakdown, so this is all about families and the children. That is why it is important not only that we have a range of services available in a joined-up way, but that those parents know how to access those services and whom to speak to.

I will give an example from all those many centuries ago when I was the Children’s Minister. One of the first things I did in the first summer recess was to spend a week being a social worker in Stockport. I went out with real-life social workers, without cameras, just doing their daily job. One of the first places I was taken to, with a really impressive social worker—I think they chose one of the most challenging cases they could—was a house in one of the most deprived parts of Stockport, where a young mum with three young boys from three different fathers, none of whom was on the scene, were living in absolute squalor. There were no carpets on the floor, and they were literally eating off the floor. There was nothing in the fridge, some furniture dumped at the bottom of the garden and dirty mattresses that the kids were sleeping on.

One of the children had a bad toothache—I remember it distinctly as if it were yesterday—so the social worker said to the mother, “Why haven’t you taken the child to the dentist?” because it had been going on for some time. The mother herself had had a tooth problem the day before. She had gone to the emergency dentist and had it sorted out, but she had not had the presence of mind to take the son with her. Before long, if things went on like that, those children would have ended up in care. The mother would have been absolutely beside herself—she doted on and relied on those children greatly, and the kids relied on her. For all her problems and challenges in being a decent mother, that was all she knew; she had had poor parenting herself.

What struck me was that a number of professionals had been going in and out of that house over a period of time, and virtually every time they went, she had to start her whole story again about the various problems. There was no real joined-up action where that mum and her kids were almost literally taken by the scruff of the neck to children’s support services at the local children centre, taken to the dentist, or given information and classes on nutrition and feeding and things like that. What was needed was somebody to take control of that family’s life, get them back on the straight and narrow, and join up all the services and all that information, and that just was not happening. A lot of money, time and resources were being spent on that family, and things were not getting any better. That is why the Start for Life programme, and the Bill that my hon. Friend the Member for Hastings and Rye is putting together, are all about making sure that somebody takes control of the information around a family’s requirements and needs, points them in the right direction, and takes them physically to where they need to go if necessary, so that it does not constantly start again every time the family comes into contact with yet another agency or professional service. That is why the work on the red book—digitising it, for example—is important to make sure that information is readily available to everyone having contact with families that need that sort of help.

None of this is rocket science or, frankly, new; we have been talking about it for many years. Earlier, I dug out one of the reports from the conception to age two: first 1001 days all-party parliamentary group. “Building Great Britons”, which we produced back in 2015, is now almost 10 years old. I reread the foreword, which I wrote, and we made some recommendations. I will go through those quickly to see how many have become reality and how many can still become reality with the assistance of my hon. Friend’s Bill. We also came up with two conclusions. The first was:

“We want to create children who at the end of their first 1001 days have the social and emotional resources that form a strong foundation for good citizenship.”

Tick—that is absolutely still our goal. The second conclusion was:

“Without intervention, there will be in the future, as in the past, high intergenerational transmission of disadvantage, inequality, dysfunction and child maltreatment. These self-perpetuating cycles create untold and recurring costs for society. The economic value of breaking these cycles will be enormous.”

Tick—that absolutely applies today, as it did then. A case in point is the one I cited in Stockport, which is a textbook example of how failing to intervene properly is costing an awful lot of money.

The first recommendation was:

“Achieving the very best experience for children in their first 1001 days should be a mainstream undertaking by all political parties and a key priority for NHS England.”

I hope that the Start for Life programme, which the Minister proposed, was done with the sign-up of all the other main political parties. That is really important, because it is a long-term scheme. When there are changes of Government, it is important that one does not change everything for the sake of changing it—I was going to say, “Throw the baby out with the bathwater.” One might want a bit of rebranding or tweaking here and there, but this needs at least a decade to really take effect. I hope that the good work the Minister has done will carry over if there is a change of personnel and Government in the future.

The second recommendation was:

“Require local authorities, CCGs and Health & Wellbeing Boards to prioritise all factors leading to the development of socially and emotionally capable children at age 2, by: adopting …a ‘1001-days’ strategy”.

That is part of what the Bill proposed by my hon. Friend the Member for Hastings and Rye will impress on local authorities. Much of this is delivered through local authorities and local health professionals. It is all very well for the Government to say, “This is what needs to happen,” but it does not happen unless there is the buy-in, the infrastructure and the commitment to deliver it at the sharp end at local level.

The third recommendation was:

“National government should establish a ‘1001-days’ strategy fund to support local authorities and CCGs to make a decisive switch over the next 5 years, to a primary preventive approach”.

I think we are only part of the way on that one. The Minister may want to pick that up and explain how we can achieve that.

The fourth recommendation was:

“Hold Health & Wellbeing Boards responsible for ensuring that local authorities and CCGs demonstrate delivery of a sound primary prevention approach”,

as outlined in part 2 of our report. Again, that is what my hon. Friend’s Bill is trying to get at. We need to see commitment at a local level for local people to judge. They can do it in different ways. What might apply well in my constituency might not apply so well in my hon. Friend’s constituency, in large northern metropolitan boroughs, or in rural constituencies. It is up to local interpretation how it is best delivered, with a framework set out nationally, but with local authorities and local agencies having to describe and set out how they are going to achieve the goals and aims.

The fifth recommendation was:

“Build on the ‘Early Help’ recommendations of the Munro Review”,

which I commissioned in 2010,

“by requiring and supporting all relevant agencies in prevention to work together to prevent child maltreatment and promote secure attachment.”

As I found in office, joined-up government is an illusion. I hope that the appointment of my right hon. Friend the Minister, with a remit in several different Departments as well as Best Start for Life, achieves more of a joined-up approach in that regard.

The sixth recommendation was:

“Appoint a Minister for families and Best Start in Life with cross-departmental responsibility”,

which I hope the Minister is achieving. I hope it will survive and continue under whoever fills her shoes at some hopefully distant stage in the future.

The seventh recommendation was:

“Make joint inter-agency training on the importance of the early years for social and emotional development, for all professionals working with children and families in the early years, a priority in the ‘1001-days’ strategy.”

That is important, as I found in safeguarding. We need professionals from different bodies singing from the same song sheet. The most effective way to do that is with joint inter-agency training so that they learn about the requirements of the job sitting next to the police officer, the health visitor, the teacher, the GP, or whichever professional is involved. We do not do inter-agency joint training nearly effectively enough.

[Sally-Ann Hart]

My hon. Friend makes a valid point. Family hubs involve partnership working. I know that East Sussex family hubs partner with police, health and education, so they really do provide whole-family support.

[Tim Loughton]

That is absolutely right. We had children’s centres to an extent; we must have family hubs to a much larger extent. We need a sort of Piccadilly Circus of different professionals coming together, sharing information and nominating who will act for a particular family to make sure that the job is done and that a family in need does not fall foul of memos circulating between different professionals that never actually hit the spot. Somebody must pick it up and act on it. So many safeguarding cases end badly because somebody does not take responsibility, pick up the ball and act on it in whatever way. That is why family hubs are important.

We have all the relevant people in the same place, although hopefully going out of the family hub because most of the good things happen outside a family hub. It is not all about bricks and mortar, but where the services are targeted. The problem with children’s centres in the past, great idea though they were, was that the 15% most deprived families who would benefit most from the services offered by children’s centres tended to be those who did not access those centres. Family hubs are all about getting across thresholds where people live and go, work and shop and whatever it may be.

That was effectively the eighth recommendation. Children’s centres and youth hubs should be set up to be a melting pot of different services available.

The final recommendation was:

“Research evidence and good local area data are necessary to ensure effective changes are implemented to services. Where data and evidence are not available, these should be prioritised and supported with appropriate funding.”

I hope that as family hubs are rolled out and the Best Start for Life project becomes a reality they will start to produce the evidence we need to show that the impacts we are having on babies and their parents is life changing and dramatic. It is certainly a good investment socially and financially because hopefully we can prevent all the problems by getting in at the most appropriate time, at the earliest time.

Communication, information and all the things that my hon. Friend the Member for Hastings and Rye is endeavouring to achieve with her Bill—I wish her well with that on Friday—are all about continuing the jigsaw of the Best Start for Life, which my right hon. Friend the Minister started and which I hope will come to full fruition, because we desperately need it for so many of our children, families and babies in this country.

[Andrew Gwynne (Denton and Reddish) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Henderson.

This has been a small but perfectly formed debate. I congratulate the hon. Member for Hastings and Rye (Sally-Ann Hart) on securing not just the debate, important though that is, but a Bill. I wish her Bill well on Friday, because, as the hon. Member for East Worthing and Shoreham (Tim Loughton) rightly said, there is a degree of consensus on these issues across the House. We all understand the need for children to have the best start in life, and for parents to have wraparound support as and when they need it. Those first 1,001 days are crucial to the development of a child to ensure that they start out in life with the best chances that we can give them.

I was interested in what the hon. Member for East Worthing and Shoreham said; my ears pricked up to attention when he mentioned Stockport. Being a partly Stockport Member of Parliament, I am keen to promote it as one of the two boroughs that my parliamentary constituency sits within. Stockport children’s services are good. They provide decent support to families when they need it, and there are some challenges. Stockport is a unique borough in many ways, in that it is a microcosm of the entire United Kingdom. It has some of the richest, most prosperous parts of Greater Manchester within its boundaries, and some of the poorest parts. It is almost a perfect make-up of the country.

[Tim Loughton]

Although it was 14 years ago when I went there, I have been back since. I am delighted to confirm to the hon. Gentleman that Stockport had a fantastic children’s services department then and it has remained so, with some impressive, experienced social workers. Where I went was not in his constituency; I visited nearby, with the full compliance and support of the then Member.

[Andrew Gwynne]

I would hazard a guess that the hon. Gentleman visited Brinnington, which is just over the border. Irrespective of that, he is absolutely right to support the Best Start for Life programme, and he is right that we should not change it for the sake of it. We can tinker around at the edges, but the ethos behind it is absolutely right.

I would also hazard a guess that if this Government had their time again, they might well have done the same with the Sure Start programme, which was starting to make a big difference. I will talk very briefly about my experience of Sure Start in my constituency. I was given the privilege of opening one of a number of Sure Start centres. This one was in the Dukinfield part of my constituency, in the Tameside borough. It was attached to a primary school in the middle of a 1960s deck-access council estate. The centre had been open and providing services to the community for about six months before it had its official opening. As the guest of honour cutting the ribbon, I was introduced to a number of people who used the services within the Sure Start provision.

I was introduced to a young mum called Sarah. She was very young, and had been ostracised by her family because she had become pregnant. She had no natural support network around her. Her only existence had been the four walls of her flat in the deck-access estate. Understandably, she had become very depressed post pregnancy, and the life of her young baby was essentially sitting in front of the television while mum was in her dressing gown eating crisps. Her brilliant Sure Start worker eventually convinced mum to go to the new provision across the way, and got her out of those four walls of the flat.

Dukinfield is a very white, very working-class community. The Rive Tame, which runs through Tameside—the clue is in the name—is only very narrow, probably no wider than this room. On the opposite side of the river from Dukinfield is Ashton-under-Lyne, and that part of Ashton-under-Lyne is very heavily south Asian, with predominantly Pakistani and some Bangladeshi communities. Never the twain shall meet. That river may as well be a wide ocean. Those two communities did not mix, but this Sure Start centre was shared by both communities.

Sarah very excitedly introduced me to her best friend Ameena, who lived in Ashton. Those two would never have met but for that Sure Start provision. She said to me, “Mr Gwynne, let me introduce you to my best friend Ameena. Her daughter plays with my daughter. They’re best friends, and I go to her house. Mr Gwynne, before I came here I couldn’t boil a pan of water. She’s now teaching me to cook curry.” I just thought: Wow! Not only is it a safe space for different communities to come together by accessing support through mainstream statutory services, but they are informally helping one another. I thought that was great. If we could bottle that and spread it out, that is what we should be doing.

That is why I will always argue passionately that Sure Start was working and why I am pleased that the Minister has brought in family hubs. Although they are not yet on the scale of Sure Start, from small acorns grow great oaks. I believe that, whoever is in government, supporting the family and nurturing them in those first 1,001 days really matters. In terms of the Bill from the hon. Member for Hastings and Rye, some really simple changes can make a big difference. She mentions that for many it is not easy to access information for support and that local authorities should publish the Start for Life offer on its website.

I know we are not supposed to use props, but I draw Members’ attention to the website of Grow in Tameside, which has a page for key Tameside contacts for early years support and information. It is all there on the website, in part because early years has been a passion of Tameside Metropolitan Borough Council for a long time. In the 1980s, before it was fashionable, they had child and family centres in Tameside. Those centres were used as the evidence base for Sure Start when the Labour Government came in in 1997. The Minister made sure that Tameside was one of the pilots for the family hubs, so we have family hubs operating already in Tameside and doing great stuff. They could do more, but it is great what they do.

This is not just about statutory services but about the wider support network, whether that includes religious organisations, community organisations, the voluntary sector or others. There are lots of things going on. I am a very proud patron of Home-Start in Oldham, Stockport and Tameside. Sarah and the team there do great work. The Dad Matters team under Kieran does great work engaging with dads. They have a breastfeeding service, and they have Cascade, where people can donate toys and clothes to families who need them. That work is being done, but we need to turbocharge it. That is why Labour will always support any measure that means the best start in life for children and families.

Oral Answers to Questions

Tim Loughton Excerpts

Tuesday 11th July 2023 Commons Chamber

[Will Quince]

Should the UK Government wish to accept an IHR amendment, changes to domestic law to reflect proposed obligations may indeed be required. The Government would therefore prepare draft legislation and bring it before Parliament in the usual way. Let me repeat that in all circumstances, the sovereignty of the UK Parliament would remain unchanged and the UK would retain control of any future decisions around national public health measures.

[Tim Loughton (East Worthing and Shoreham) (Con)]

19. If he will publish the results of the consultation on giving powers to coroners to investigate stillbirths.

[The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)]

The consultation on giving powers to coroners to investigate stillbirths received 334 responses, including from bereaved parents, charities, the Chief Coroner, clinicians and a range of other organisations.

[Tim Loughton]

Mr Speaker, you are very familiar with the problems over the implementation of my Civil Partnerships, Marriages and Deaths (Registration etc) Act 2019, which passed this House in February 2019. Section 4 remains incomplete. The consultation was completed in June 2019. Mr Speaker, you are aware that I made six attempts to get a meeting with the Minister and a Justice Minister. Eventually, I got it in March, after the Leader of the House intervened. Four months on, I have heard nothing and the consultation remains unpublished. What will it take to get this legislation, which everyone wants and which was passed unanimously, into law?

[Maria Caulfield]

I thank my hon. Friend for his work in this space and I apologise for the delay in publishing the consultation. I met him along with a Justice Minister, and I assure him that we hope to publish it very soon.

Covid Pandemic: Testing of Care Home Residents

Tim Loughton Excerpts

Wednesday 1st March 2023 Commons Chamber

[Helen Whately]

It is difficult for me as a Minister to see WhatsApp messages from me in the pages of a newspaper. If the hon. Lady has read those, she will have seen that I was seeking a test for a member of my family and that I used exactly the same test app as everybody else to try to access a test that was needed.

[Tim Loughton (East Worthing and Shoreham) (Con)]

I seem to recall that two years ago, when there was a limited supply of testing equipment, there were all sorts of calls for certain groups to be prioritised. There were also urgent calls for available beds in hospitals to be freed up to cope with the likely surge in cases. In hindsight, some of those priorities may have been wrong, but at the time it was an urgent situation. Will my hon. Friend confirm that exactly the same set of priorities about access to testing prevailed in Wales, and it took the Welsh Government two weeks longer to mandate testing for care home residents in Wales than it did in England? Why are we not seeing equal outrage from the Opposition about that?

[Helen Whately]

My hon. Friend makes an important point about the challenges that were faced around the world in handling the pandemic, and very conspicuously for us across the UK. Decisions were having to be taken in Scotland, Wales and Northern Ireland as well as here in England. Had Opposition Members been in our position, in government, and having to make these difficult decisions, I am sure that they, like us, would have strained every sinew and done their very best to make the best possible decisions in a situation of limited information.

NHS: Long-term Strategy

Tim Loughton Excerpts

Wednesday 11th January 2023 Commons Chamber

[Wes Streeting]

I wholeheartedly agree. We hear this time and again. When patients are struggling to get access, and experiencing appalling delays in accident and emergency, they do not blame the staff. They know that the staff of the NHS are busting a gut, but those staff are suffering in the same way as patients because of 13 years of Conservative mismanagement. The only part of the Government’s amendment that I agree with is the part that praises NHS staff. Why is the Secretary of State’s Prime Minister bringing in his “sack the nurses” Bill next week? How many nurses will he sack? How many paramedics or junior doctors will he sack? The only people who need the sack are this Government—[Interruption.] Perhaps the hon. Member for East Worthing and Shoreham (Tim Loughton) agrees.

[Tim Loughton (East Worthing and Shoreham) (Con)]

When the last Labour Government left power, they were spending 8% of GDP on the NHS. Last year that figure was 10.6%, which is average for the EU nations. Why did the last Labour Government so chronically underfund the NHS?

[Wes Streeting]

The hon. Gentleman has got some brass neck. I have already given him figures showing that per capita funding increased by 5% under the last Labour Government—[Interruption.] And as for GDP, perhaps he should look at growth figures and ask why the economy is so much smaller than it would have been if we had had a Labour Government managing the economy well. That is the truth; it is a simple fact. If not, perhaps he wants to explain how his Government will put more money into the NHS, but I did not hear that commitment.

Baby Loss and Safe Staffing in Maternity Care

Tim Loughton Excerpts

Tuesday 25th October 2022 Westminster Hall

[Tim Loughton (East Worthing and Shoreham) (Con)]

I could not, and I certainly do not, seek to compete with the personal testimonies of my hon. Friends the Members for Hartlepool (Jill Mortimer) and for Hexham (Guy Opperman). As Members know, I have been around for a while in this place. We sit through many harrowing and poignant debates, but none has been more emotional and more emotive than those that we have traditionally had to commemorate Baby Loss Awareness Week, and today is another example of that. I pay particular tribute to my hon. Friend the Member for Hartlepool for securing the debate, and to our colleagues for bravely coming forward with their personal testimonies, which make this problem so real. Understanding it is so important for our constituents.

I was lucky with my three children. I did not have to go through the traumas that we have heard about, but so many people do. Despite all the terrible news that we have heard recently, it is worth noting that maternity services in this country are still safe and that the infant mortality rate has fallen to a historic low. However, we are still 19th out of 28 European countries for mortality rates. The ethnic and regional variations in this country are still a disgrace, and those infant mortality rates do not take account of stillbirths. There are 13 stillbirths a day. No doubt lockdown has made the situation worse.

I want to focus briefly on stillbirth. Stillbirth is 15 times more common than cot death. I concentrate on it, because I have been campaigning on it for many years. My Civil Partnerships, Marriages, Deaths (Registration etc) Act 2019 became law in February 2019. Two of its clauses have taken effect; two have not, and those two are to do with stillbirth. I should not have to discuss this today, because those clauses should have taken effect. My Act gave powers to the Secretary of State for Justice to amend the Coroners and Justice Act 2009 so that coroners had the power to investigate stillbirths. They do not have those powers, because coroners can only investigate the body of a deceased person and a stillbirth is not designated as a deceased person. That is a technical, historical situation.

My hon. Friend the Member for Hexham talked about some infant deaths being described as stillbirths. Given those occurrences, rare though they may be, we have heard stories and The Daily Telegraph ran a campaign recently showing that this issue is still a problem. Given the scandals of East Kent, Shrewsbury and Telford, and Morecambe Bay, we need more than ever the reassurance that the coroner has the ability, if he or she chooses, in a limited number of cases, to investigate whether a stillbirth was a result of mismanagement or incompetence or whatever. Parents need that reassurance, and we could all learn from such cases. This measure must come into force, three and a half years after the legislation that enabled it to do so.

My Act included another clause, which was about recognising stillbirths that take place before 24 weeks but are not designated as ever happening. A panel was set up to look at that back in 2018. I was a member of that panel. It has still not reported; no conclusions have come forward. The Act made it necessary for those conclusions to come forward. Could we at last get on with this important legislation? We all agreed that it was necessary and it was passed unanimously through this Parliament.

East Kent Maternity Services: Independent Investigation

Tim Loughton Excerpts

Thursday 20th October 2022 Commons Chamber

[Dr Johnson]

From a wider perspective, the Government have a target of reducing stillbirths and neonatal deaths across the country and that, obviously, includes women of colour.

[Tim Loughton (East Worthing and Shoreham) (Con)]

What was particularly shocking about the report, coming hard on the heels of Shrewsbury and Morecambe Bay, was the culture of cover-up that it revealed, the lack of empathy—extraordinarily—among staff and the fact that it took parents and grandparents such as Derek Richford to campaign to get the exposé. Does the Minister agree that, given that liveborn children were described as being stillborn so coroners could not investigate, it underlines yet again the need for my Civil Partnerships, Marriages and Deaths (Registration etc) Act 2019, which was passed by the House three and a half years ago and gives powers to coroners to investigate stillbirths, to come into force at last? Will she go and speak to the Justice Secretary and liaise between the Departments to get that measure enacted straightaway to give some confidence to those parents who have been through these terrible experiences?

[Dr Johnson]

I understand my hon. Friend’s passion in this area. I am happy to meet him to discuss it further.

Ambulance Pressures

Tim Loughton Excerpts

Monday 18th July 2022 Commons Chamber

[Steve Barclay]

The hon. Lady brings great practical insight on these issues from her profession as a nurse. The point she raises, as did my right hon. Friend the Member for South West Surrey (Jeremy Hunt), is absolutely right—delayed discharge has long been a key issue. That is why we have made the tough decisions we have on national insurance and why we brought forward the changes on integrated care boards. It is an area of common ground across the House that we need to work better to address delayed discharge, which blocks the pipe and, in turn, delays ambulance handovers and causes problems at an earlier stage. It is a key issue. I have set out a number of practical measures that we are taking, and further work is ongoing.

[Tim Loughton (East Worthing and Shoreham) (Con)]

On Friday afternoon, I spent a shift with the A&E staff at the fantastic Worthing Hospital, which is clearly being impacted, in particular, by older people affected by the heat. The staff said to me—the Chairman of the Health Committee mentioned this—that more than 15% of the beds are being occupied by people medically fit to be discharged. They also said that a huge amount of their time is being taken up by people with mental health problems, including those being brought in by the police, most inappropriately. What more can be done to make sure that people with mental illness are being looked after away from A&E departments, as is far more appropriate, and to speed up the process of freeing up those beds?

[Steve Barclay]

My hon. Friend is absolutely right on mental health and where a patient is violent, as I saw for myself on my visit to Bedford, for example, that can be unsettling for A&E. I am happy to have further conversations with him on what measures can be taken. The fact is there is no single intervention in this space; it is a question of looking at the integrated approach. That is what the call for evidence is about. Also key is understanding the data and seeing where it can better target action on areas such as mental health that can have a disproportionate impact.

Mental Health Act 1983: Detention of People with Autism and other Lifelong Conditions

Tim Loughton Excerpts

Thursday 20th January 2022 Commons Chamber

[Sir Robert Buckland]

My hon. Friend is absolutely right about the waste of resources that I am afraid underlies much of this. I shall come to some of the figures, which are pretty shocking. He is right to highlight the levy that is being introduced in April. It is imperative that the £12 billion that we are told is being earmarked as part of the £36 billion to be raised from the levy is actually used on social care.

The worry we all have is that the money will be eaten up by spending on the health backlog, and that there will be no audit trail at all to make it possible to ensure that it is, in effect, ring-fenced and used in social care. I put that big challenge to Ministers. The Health Secretary knows my strong view; I was writing about it in the national media on Sunday. We have to really laser in on these issues.

The horror of Winterbourne View is still seared into my mind 11 years on, together with other instances of abuse. But in general, we are not in this position because of malice or hostility towards people with autism or a learning disability; we are here because of indifference, frankly. It is all too easy to make the assumption that because the person has been detained for their own safety, the letter of the law has been followed and the clinicians have given their opinion, that will just have to do. That really is not good enough in this day and age.

Recent news coverage of the cases of Tony Hickmott and Patient A has brought these issues into stark relief. I will briefly mention Mr Hickmott’s case, which was highlighted by the media just before Christmas. Ongoing legal proceedings mean that I must limit my remarks, but I read reports that this gentleman has been detained for more than 20 years under this system—nearly half his entire life. That is deeply distressing for his family and should be of grave concern to the rest of us.

Patient A’s case was reported in The Sunday Times just after new year, the result of some excellent investigative journalism. He has been confined for over four years so far in a secure apartment at the Priory Hospital Cheadle Royal. That apartment—I use the word advisedly—is the size of a large living room. He is monitored by CCTV. His food and medication are passed through a hatch. He is now 24 years of age. The story of his life leading up to this incarceration is heartbreaking in itself but also emblematic of failure. The interventions made exacerbated his existing anxiety, creating a descending spiral of deterioration in his health that has resulted in over-medication, more restrictions and even poorer mental and physical health. We are spending money on harming people rather than saving them.

[Tim Loughton (East Worthing and Shoreham) (Con)]

It is so good to have my right hon. and learned Friend on the Back Benches in some respects; he is such a champion of this cause and is making a very important contribution. Does he agree that it is a completely false economy not to be thinking smarter, and lazy not to be able to let people out of NHS facilities where there may be better community facilities and better working with the families? It would, of course, mean a much better life for the person involved as well. The chemical cosh that he just referred to and the use of restraint, which in some places is disproportionate, is a sign of failure, and that the person is not being looked after appropriately. That is what needs to change.

I should have declared my entry in the Register of Members’ Financial Interests at the beginning of this intervention.

[Sir Robert Buckland]

My hon. Friend, who has long experience of this matter, having served with distinction as Children’s Minister and as a long-standing campaigner on these issues, makes a hugely important point about the chemical cosh that is medication. I think he and I agree that we are not here to single out or criticise many dedicated care staff and NHS workers who do their very best to care for and support in-patients. They deserve our thanks; they are doing the day-to-day work. I am talking about the system that allows this to happen—that allows, in effect, a standing reproach to us all. This is 2022, not 1922.

There are two strands to the approach that we need. First, as the hon. Member for Strangford (Jim Shannon) said, earlier and better interventions are needed to prevent cases spiralling into crisis in the first place. Secondly, better community-based alternatives to the continued detention of in-patients are needed. It is my firm belief that with the better commissioning of community support, the need for recourse to detention would inevitably fall. That would create a virtuous—rather than vicious—circle, which would benefit all.

There is not only a social, health or moral price being paid for this failure, but a financial one. In 2015 the National Audit Office estimated that, in the year 2012-13, the NHS spent £557 million on in-patient services for people with learning disabilities whose behaviour could be challenging. More than half a billion pounds was spent on services that harm people, and that figure is from nearly 10 years ago. The cost now will be considerably more. That speaks volumes about the failure of the present system.

Although the Mental Health Act was reformed in 1983, it is, in essence, a replication of a regime that was created under the Mental Health Act 1959. That is a 60-year-old framework; to say that it is out of date understates the argument.

Public Health

Tim Loughton Excerpts

Tuesday 14th December 2021 Commons Chamber

[Caroline Lucas (Brighton, Pavilion) (Green)]

I have just come from a meeting of the all-party parliamentary group on coronavirus. We were given a shocking set of presentations, about which the hon. Member for Oxford West and Abingdon (Layla Moran) will say more shortly.

I want to bring three key messages from that meeting of scientists and NHS professionals. The NHS is already beyond full stretch, and some said that it was at breaking point. They pointed out that we are not South Africa, which started its omicron wave from a low level of cases. We are starting it on top of a rising number of delta cases, so we have to get transmission rates down now. The focus on vaccinations alone, although they are vital, will not be enough. We have to focus on a range of other measures such as ventilation in schools, as other hon. Members have mentioned, and the big issue of limiting social contact.

We need to be honest and to have consistent and clear messaging about the need to reduce social contact. There is a direct relationship between the number of contacts that we have and the spread of infection. Giving guidance to work from home while still giving the green light to Christmas parties is, as the professor of primary care in Oxford suggests, akin to giving people advice to wash their hands after a meal but not after going to the toilet. We are all dreading the prospect of not seeing loved ones again at Christmas, but that is exactly the direction in which we are heading unless the Government show some leadership and tell us the unwelcome truth that we might not like to hear.

[Tim Loughton (East Worthing and Shoreham) (Con)]

The hon. Lady and I share a hospital trust. She will know that that hospital is being overwhelmed at the moment not by covid cases or covid pressure but by cases of non-covid illness that have been neglected during lockdown and by the inability to release people who are medically fit for discharge. Is it not correct that, as it stands, those are the real pressures on the health service, not a torrent of covid cases coming in?

[Caroline Lucas]

That may well be the case now, but I do not see why that is an argument against needing to get coronavirus cases down. If transmission rates go up on the trajectory that we are being told they will, we can be sure that there will be massive pressure on our hospitals and NHS trusts. I do not disagree with the hon. Gentleman’s point, but it is not a criticism of my argument. It is precisely because of the multiple pressures on our hospital system that we need to get transmission rates of omicron and delta down. That is why I want the Government to get rid of the disincentives that are built into the system and that stop people being able to self-isolate when they need to. Why do we still not have better sick pay for self-isolation? Why do we not have better support for our businesses? If there is going to be reduced social contact, as there needs to be, we know that has an impact, particularly on the hospitality sector.

We need VAT reductions to be extended beyond April, when they are due to end. We need businesses to be offered grants to help them through the next difficult weeks and to be given flexibility on paying back covid loans. My constituency is already feeling the impact of omicron, and the hospitality sector is extremely worried. Why can we not tell it, for example, that there will be extended and expanded business relief, with the Government ensuring that local councils do not lose even more funding? There should also be a proper support scheme for the self-employed who, as we know, play such a key part in our economy but were utterly left out of previous support mechanisms.

I regret that the Government have given MPs less than 24 hours to analyse the statutory instruments before us. Frankly, they have not advanced the scientific case for them. A Public Administration and Constitutional Affairs Committee inquiry earlier this year concluded that the Government had not made a robust case for vaccine passports, and I have not heard anything today that has persuaded me otherwise.

Although I recognise the civil liberty arguments on the measures, with which I have sympathy, my bigger concern comes from the strong body of evidence on the impact of vaccine passports on vaccination rates. That evidence makes it clear that, although they can accelerate take-up rates among those inclined towards vaccination, they also entrench opposition among those who are hesitant.

As Professor Stephen Reicher has said, people not getting vaccinated is not a cognitive problem—it is not that they do not understand the issues—but a social problem. People are not getting vaccinated because of a lack of trust, and trying to force them into it, either through vaccine passports or through mandatory vaccinations in some settings, compounds that mistrust, as does berating them or “othering” them. If we want more people to be vaccinated—and believe me, I absolutely do—that is the bottom line, but we have to build the sense that vaccination is being done for the community, not to it. It is for the common good. Behavioural science clearly indicates that coercion undermines the relationships we need to build and the respect we must show one another in order to increase vaccination rates, and we do everyone a massive disservice by ignoring that science.

I want to end by saying a few words about the wider global situation that we face. It is supremely reckless to have so catastrophically neglected vaccination in poorer countries, and it is extremely reckless of our Government to refuse to support the waiver on trade-related aspects of intellectual property rights at the World Trade Organisation. As Winnie Byanyima, executive director of UNAIDS, has said,

“Omicron is with us because we have failed to vaccinate the world.”

The Government should absolutely be changing their position on that TRIPS waiver: they should not be blocking it. The virus will be with us for years and years to come, and it will mutate into other viruses and variants unless we treat this as a global crisis, not just a crisis here at home. I beg the Government to look at the evidence, to look at what works, and to move forward on that basis.

--- Later in debate ---

[Tim Loughton (East Worthing and Shoreham) (Con)]

It is difficult to follow Buttons, but I will try. Yesterday I was asked in an interview whether I was plotting to revolt, and indeed I have seen my name on various lists of rebels today. Let me make it clear that I have not been plotting, I am not rebelling and I am certainly not revolting. What I am doing, in three minutes, is trying to scrutinise a really important piece of legislation affecting all our constituents—a duty that Labour Members seem to have completely abrogated by giving the Government a blank cheque here today. They have been here only in single figures for most of this debate.

What have we learned during this pandemic? We have learned that vaccines work and that they are our best defence. We have also learned that disproportionate measures have consequences. Closing schools has led to a tsunami of mental health implications for many of our children. We have also learned that when we are presented with evidence-lite and a shortage of data, some of the predicted outcomes do not happen. We have learned how brilliant the NHS is, but there have been consequences in the form of non-covid deaths as well. Covid is not the only killer. We have also learned the difference between modelling and forecasts. Modelling predicted more than 100,000 daily infections back in September, but it turned out to be nothing like that figure. Let us not confuse modelling with accurate forecasts and predictions. We have also learned about mission creep. Perhaps we saw that on Sunday. We are learning to manage risk and realising that we cannot eliminate it. Soon we are going to have the pi, rho, sigma and tau variants. We cannot head for the hills with knee-jerk emergency measures every time a new variant comes along.

To scrutinise these measures and to be prepared to vote against some of them is not to be ideological; it is to do our job. I am pragmatic. I am quite relaxed on masks. I have been wearing masks in shops and on public transport because I think that is a respectful thing to do. It gives assurance to people who are scared to come out, so I am not going to oppose that measure. The measures on self-isolation are of course progressive, but I will vote against covid passports, which are a key part of plan B. I appreciate that they are not vaccine passports, but that is the Government’s plan C, and that is what I fear. It is passport creep. We have already heard about passports for pubs and other venues. However much we want to get people vaccinated, we do not want a society where we ask for papers and deprive people of their liberty.

I will certainly vote against mandatory vaccinations for the NHS. It was crazy to do it for care workers, of whom we probably lost 40,000. There are 1.5 million people working in the national health service. It is wrong to mandate medical procedures, but it is pragmatically stupid when we will lose so many people who we need to help to fight the infection at the sharp end. I am afraid we will lose many more with that measure. We need to base our decisions on science, the holistic impact and what is proportionate and fair, and these measures are not.