Tobacco and Vapes Bill (Seventh sitting)

Trudy Harrison Excerpts

Committee stage
Tuesday 14th May 2024 Public Bill Committees

[Dame Andrea Leadsom]

I am genuinely grateful to hon. Members for bringing this discussion before the Committee. We all agree that with vaping, product packaging is an integral part of what we are seeking to avoid for children. As I have said before, I am on the warpath where promoting vaping to children is concerned. I want to assure all hon. Members that the reason I resist the amendments is that we already have the powers in the Bill and I want to explain how that is so.

I am sympathetic to the concerns raised. Making sure we have the right powers to tackle the appeal of vapes to children is crucial and integral. It is totally clear that the design of many vapes is targeted at children, with brightly coloured features and eye-catching designs. There is no way we will stand by while industry knowingly, deliberately and maliciously encourages children to take up addiction and use products that have been designed for adults to quit smoking. The chief medical officer has written:

“Companies trying to addict children for profit are behaving in a shameful way. Yet it is undoubtedly happening.”

That is why we are bringing forward powers to regulate product requirements as part of the Bill.

I am sympathetic to the broadening of the scope of our regulations so they cover all product and packaging features and requirements, as in amendment 21. However, the Bill already contains regulation-making powers to make provision, in relation to vaping and nicotine products, for things such as appearance, size and packaging, as well as the substances that may be included and the amount of any substance within the e-liquid, including nicotine.

[Trudy Harrison (Copeland) (Con)]

May I seek clarity that the font would be included in the category of appearance, because I have certainly seen some vaping products advertising lemon flavour and the font appears in a very stylised way that I would suggest is aimed at young children?

[Dame Andrea Leadsom]

Absolutely. The Bill does allow us great flexibility in these areas and, to clarify, this does include amending fonts and alphanumeric markings, which is the intent of amendment 26. The Bill already provides for that, just to be absolutely clear. That is why we do not need to take additional powers to amend aspects of the Tobacco and Related Products Regulations 2016, as suggested in new clause 10. The Bill already captures all the features that we may need to regulate, and allows that regulation to extend to non-nicotine vapes and other nicotine products.

Amendments 39 to 43 effectively place a duty on the Secretary of State to consult on secondary regulations. As stated in the House on Second Reading, I want to make clear my commitment to undertaking, on the vape regulations, comprehensive consultation regarding, but not limited to, packaging, product requirements, flavours and changes to the MHRA vape notification scheme. I want to make it clear to the Committee that, of course, prior to those regulations we will engage in comprehensive stakeholder discussions. For that reason, it is not necessary for a legal duty of consultation to be placed on the Secretary of State in relation to the regulation-making powers. That would result in a loss of flexibility and speed. There may be occasions when we will need to make minor changes, or quickly adapt to emerging products. Of course, in the vast majority of cases, consultation is the right and proper thing to do, but we do not need this to be stipulated in the Bill. For those reasons, I ask hon. Members to withdraw or not press their amendments.

Clauses 61 and 63 provide the Secretary of State for Health and Social Care with a power to make regulations about the retail packaging of vaping products and nicotine products and to introduce other product requirements for vaping and other nicotine products. Vaping is never recommended for children. It risks addiction and unknown long-term health impacts while their lungs and brains are still developing. We must not replace one generation addicted to nicotine with another. We know that giving up nicotine is difficult because the body has to get used to functioning without it. Withdrawal symptoms include cravings, irritability, anxiety, trouble concentrating, headaches and other mental symptoms, so I say to those children currently thinking, “A vape is going to calm me for my GCSEs” that it is going to do the exact opposite. We need to get that message across to children.

Despite the clear health advice, there has been a significant and alarming rise in the number of children vaping. Data shows that the number of young people vaping has tripled in just the last three years and now one in five children has used a vape. That is incredibly alarming and it is unacceptable. We heard, in our vaping call for evidence, that children are attracted to vapes by the brightly coloured packaging and the use of child-friendly images such as cartoons. The hon. Member for Birmingham, Edgbaston gave very good examples. Research on vape packaging has shown that reduced brand imagery can decrease the appeal to young people who have not previously smoked or vaped, and can do so without reducing the appeal of vapes to adult smokers trying to quit. To protect children from potential health harms of vaping, we must reduce the ways in which vaping appeals to them, and do so without impacting on adult smokers.

Tobacco and Vapes Bill (Eighth sitting)

Trudy Harrison Excerpts

Committee stage
Tuesday 14th May 2024 Public Bill Committees

Brought up, and read the First time.

[Trudy Harrison (Copeland) (Con)]

I beg to move, That the clause be read a Second time.

I am channelling my hon. Friend the Member for Sleaford and North Hykeham and her passionate work as a consultant paediatrician or, as she would say, the children’s doctor in the House. I regard her experience highly. As technology evolves, so do our habits. This new clause seeks parity for smoking and vaping, so that the same rules that apply to smoking in public places will also apply to vaping, thereby protecting non-vapers from exposure to harmful substances.

As the Minister put it, we know that vapes are not harmless, but we think that they are less harmful than smoking cigarettes. I acknowledge that there is a lack of evidence—we heard this in the evidence session last week—but I think there is also a lack of research into the evidence on the impacts of vaping. Could the Minister reassure us that evidence will be sought on the impacts of vaping, not just on those who are vaping but those who are in the vicinity of vaping products? We should be trying to prevent the normalisation of vaping products, particularly among children and other impressionable audiences. We have heard much about the principle of polluter pays, which I absolutely agree with, but it is equally important to prevent the pollution and avoid promoting polluting substances to the potential polluter. That was an awful lot of Ps.

[Mary Glindon (North Tyneside) (Lab)]

I thank the hon. Lady for giving way. She makes a strong argument but, on the other hand, Cancer Research says that there is no comparison between passive vaping and passive smoking. I know many former heavy smokers who have given up smoking and now vape, and that is one of the reasons why I am such an ardent supporter of vaping as opposed to smoking. It is awful for those people to have to go outside and stand with smokers. If people are not allowed to vape indoors, there should be a separate area for vapers. Does she not agree that such a situation sends out the message that vaping is dangerous when we need heavy smokers to give up smoking, and vaping is the best way for many of them to do that?

[Trudy Harrison]

I welcome that intervention, but we cannot ignore the trebling of the number of 11 to 17-year-olds who are starting to vape. However much the Minister says that people who are not smoking should not vape, and that no children should be vaping, that is not the reality in the communities that we serve. It is certainly not the reality in my Copeland community. I think the hon. Lady is saying that vaping helps us to fix the problem, but I am equally keen to prevent the problem. The rate at which young people are taking up vaping needs serious consideration, but we also need serious evidence-gathering to understand not only the harms that could be caused by those who are vaping in the vicinity of others, but nicotine addiction.

[Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (Con)]

My hon. Friend is making a very passionate speech on behalf of herself and my hon. Friend the Member for Sleaford and North Hykeham, who I am sure will be very pleased with the contribution. However, I have to say that I agree with the hon. Member for North Tyneside because the evidence that we heard strongly suggested that smoking and vaping are not commensurate. My hon. Friend the Member for Copeland is entirely right that we need further evidence, but perhaps we should be looking at evidence-based policy making so that we make the policy when we have the evidence. The best way forward would be to seek such evidence.

[Trudy Harrison]

My hon. Friend makes an excellent point. That is really what I am calling for, although it does not detract from the need to prevent the normalisation of vaping. However, I repeat the request for more in-depth research into the impacts of vaping and nicotine addiction on children.

[Preet Kaur Gill]

Most public places are already smoke free on a voluntary basis. We do not believe it is necessary or proportionate to make such a legal requirement, which would risk increasing the widespread misperception that vaping is as harmful as smoking. In the United Kingdom, vaping is already prohibited on a voluntary basis in most, if not all, places visited by children; public transport—trains, airports, planes, buses, coaches and ferries—most, if not all, sports stadiums; music venues; many hospitals or hospital grounds; restaurants and cafes, at least definitely those used widely by children; and a lot of pubs and bars. As was discussed in last week’s evidence sessions, the health harms underpinning the smoking ban are not proven for vaping, and such an approach would be hard to justify on health grounds. This would be a complicated piece of legislation to introduce, and now is not the time at which, and the Bill is not the place in which, to do so.

--- Later in debate ---

[Dame Andrea Leadsom]

Yes, I am very happy to do that. My hon. Friend is exactly right: saying that we do not have the evidence right now is not the same as saying that vaping is not harmful. As I said, the chief medical officer has said that although we can be fine consuming strawberry sherbet ice cream in our tummies, it may not be so good to inhale it. We simply do not know what the truth is. We do believe that carcinogens may be innate in some flavours, and we know that vape products can contain heavy metals in the coils. We know that there can be significant harms from vaping, especially to children. I am happy to state once again, “If you don’t smoke, don’t vape, and children should never vape.”

With those remarks, I hope that my hon. Friend the Member for Copeland will not press the new clause to a vote.

[Trudy Harrison]

There could be no better Minister to convince me of her concern for babies, children and young people. On that basis, I beg to ask leave to withdraw the motion.

Clause, by leave, withdrawn.

[The Chair]

I am flying a bit free here, but new clauses 16, 19, 20 and 22, all tabled by the hon. Member for Sleaford and North Hykeham, may have been caught by the Minister’s commitment to look deeply into the advertising issue and might therefore not be moved. However, I want to give Members the opportunity to do so if they wish.

It appears that the Minister’s reassurance has convinced the Committee.

Question proposed, That the Chair do report the Bill, as amended, to the House.

Tobacco and Vapes Bill (Third sitting)

Trudy Harrison Excerpts

Committee stage
Wednesday 1st May 2024 Public Bill Committees

[Bambos Charalambous (Enfield, Southgate) (Lab)]

Q Sir Chris, you mentioned tobacco-related diseases. I want to focus on the impact that that has on the NHS. How would the Bill help the NHS in the short term and then in the long term?

Professor Sir Chris Whitty: In the interests of brevity—the medical director of the NHS is one of your next witnesses—there would be an immediate effect on the NHS because things like asthma attacks in children would be affected almost immediately. Over time there will be a growing positive impact on the NHS as people do not prematurely become unwell with chronic diseases that are extremely difficult to treat and consume enormous resources, in addition to the much more important thing of the extraordinary impact on individuals and their families, their social life, their work life and so on. So there will be a positive and growing impact. If you look forward 30, 40, 50 years, the impact of the Bill on the NHS will be substantial, but we will start to see the effects rapidly, particularly at the paediatric end of the spectrum.

[Trudy Harrison (Copeland) (Con)]

Q Bearing in mind what the Chair just said about being brief, can the panel explain the stages of addiction—the physiological, psychological, biological impacts of addiction—and perhaps comment on the frequently heard statement that this is a free country, people should have choice and then use discipline?

Professor Sir Chris Whitty: I will reiterate my point and then hand over to Sir Frank for a longer answer. Cigarettes are a product designed to take choice away. That is the whole basis of the industry. If you are pro-choice you are anti-cigarette—absolutely, straightforwardly, no question.

Sir Francis Atherton: As I have said, nicotine is an incredibly addictive substance and it does not take long to become addicted, so it is not really a stage; it is almost instantaneous. People smoke a few cigarettes and the nicotine addiction kicks in. Obviously, it varies from person to person, but by and large it is highly addictive to young people. The younger you start, the more addictive it is, but it is addictive across the whole of the lifecycle, so nobody is immune to that addiction. Breaking that cycle of addiction and getting out of it gets you into psychological dependencies and repeated attempts to quit—the things that many smokers have been through, which cost them so much time, energy and effort, in terms of money and their personal effort and wellbeing. That is all I can say about the status of addiction. Was there anything more specific that you wanted to know?

[Trudy Harrison]

Q It was more about the biological impact—how nicotine affects your body and makes it so very difficult to give up and be disciplined. It was about the biological impacts that nicotine has on the body, or the psychological impacts.

Sir Francis Atherton: As with any addictive substance, when you are deprived of it you suffer cravings and withdrawal symptoms of a sort, and that leads you to want the next hit—the next cigarette. That cycle of dependency and addiction is well known and well understood, but you would have to talk to a behavioural psychologist or a physiologist to get a more detailed answer.

Professor Sir Chris Whitty: To add to that, most smokers who are determined to quit make multiple attempts—even those who finally succeed, and many people do not succeed. As I was saying, so many people want to succeed and cannot because the addiction has a hold on their brain, essentially.

[Mary Kelly Foy (City of Durham) (Lab)]

Q I thank the panellists for being here. I want to go back to clause 62 and the issue of vapes and flavouring. In the interest of brevity, would you say that if we ban all flavours there is a risk that some ex-smokers will be dissuaded from continuing to vape?

Professor Sir Chris Whitty: There is a surprising degree of consensus on this issue, which is sometimes difficult to pick up. We know it is useful to have in the armamentarium the ability to have some flavours to help smokers to quit, but we also know that the cigarette industry is extraordinarily good at adapting its marketing techniques to whatever leeway it is given. If Ministers do not have the power to chase down the industry’s ability to market to children using flavours, that is what it will do: it will go for multiple flavours as a way to get to children and non-smokers. That is what it has always done, so that is what it will do. This Bill gives powers to Ministers in the four nations to make sure they can restrict these products to the extent that you can make them not attractive, but attractive enough to smokers to move on. It allows the slider to be moved left or right to balance attractiveness to smokers against not making it attractive to non-smokers.

--- Later in debate ---

[Mary Glindon (North Tyneside) (Lab)]

Q We hope that this really important Bill will prevent future generations from smoking. In your professional opinion, what impact can the Bill have on that stubborn figure of 6.4 million people who currently smoke? What in the Bill can help those people? It is such a high figure; when you describe the kinds of illnesses and what happens to pregnant women who smoke, it is horrifying.

Professor Sir Stephen Powis: Over time, this Bill will lead to the eradication of an addictive condition that causes the immense harm that we have described. But of course, that will occur over time, so it is also important that we continue with a range of other measures to encourage those not immediately impacted by the raising of the age of sale of tobacco products to cease smoking.

We have a number of smoking cessation programmes within the NHS, which was part of our ambition in the long-term plan for the NHS five years ago. We have been rolling out and supporting those services within hospital settings, and we should continue doing that. Of course, local authorities should also continue their work in supporting smoking cessation. Much of that is also targeted at women who are pregnant.

Part of that work is also supporting staff. Smoking rates across the 1.3 million or 1.4 million people employed within the NHS are lower than across the general public, but we nevertheless continue to see NHS staff who smoke. It tends to be in the lower pay grades within the NHS, but of course for all sorts of reasons we would like that rate to come down. Obviously there is the health benefit, but also, as you all know, smoking causes illness, illness causes absenteeism and absenteeism is a cost to the NHS. Although, as I said, we strongly support the Bill, it is important for us within NHS England and the wider NHS to continue to take other measures and put in place other programmes that will assist the public and our own staff to quit cigarettes.

[Trudy Harrison]

Q Thank you both for powerfully and poignantly outlining the preventable impacts of smoking-related disease and illness on adults. I want to ask about pregnant women. In Cumbria, 12.3% of women at the point of giving birth say that they are smoking. Given the evidence-based proof, why is that still the case? I am left asking why we have we left it so long to have these conversations and bring the Bill forward.

I would like to understand the power of addiction to be able to make the point that this is a pro-choice Bill. It will give women more choice against that addiction that they are enduring at the most important point of their lives, when they are unable to make that choice for themselves.

Kate Brintworth: I absolutely agree with you. As I have said, pregnant women go to extraordinary lengths to protect themselves and their babies. They change what they eat and drink and how they behave in myriad ways to ensure that they are doing the right thing, yet it has proven very difficult to shift the figures you describe—I think nationally it is a little over 7% of women who are still smoking. That is a poignant demonstrator of just how difficult it is and how addictive nicotine is, when all women want to do is the right thing for their children. That is why all the chief nursing and midwifery officers across the four countries are united in support of the Bill, as our medical colleagues are, because we see the damage wrought across families and generations. We are 100% behind it.

Professor Sir Stephen Powis: It is important to re-emphasise the point made repeatedly by the chief medical officer for England: smoking and nicotine addiction takes away choice. When you are addicted, you do not have the choice to simply stop doing something. It is an addiction. It is a set of products that removes choice, and in removing that choice, people are killed.

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

Q I want to ask you about vaping, particularly among children and pregnant women. First, to Kate, are you aware of any research into which chemicals from vaping may be transported from the mother’s blood through the placenta and into the baby, and whether that has any effect, or is the research too early to be able to tell us that information? For Professor Stephen Powis, could you tell me what research NHS England is supporting into the effects of vaping on children?

Kate Brintworth: The information that we have so far suggests, as it does across all areas of healthcare, that vaping is safer than smoking. What we do not have is the long-term data that we have on smoking to give us the confidence to describe the harms clearly. That is something that we need to keep observing and understanding so that we can give people the best-quality information.

Professor Sir Stephen Powis: NHS England is not a primary funder of research but we are an evidence-based organisation, as I described earlier, particularly on the use of vaping for smoking cessation. We are very keen that the evidence base, particularly on vaping, is expanded. We would support research in terms of calling for it to be undertaken but also in terms of supporting the NHS as a delivery mechanism for the context in which that research is done.

We very much want to support further research because, as you know as a paediatrician, this is an area where the evidence base is emerging but there is more to do. It is not as complete as the evidence base for smoking. It is really important, even with the passage of this Bill, that that evidence base grows and that we in the NHS support the generation of further evidence where we can.

Tobacco and Vapes Bill (First sitting)

Trudy Harrison Excerpts

Committee stage
Tuesday 30th April 2024 Public Bill Committees

[Steve Tuckwell (Uxbridge and South Ruislip) (Con)]

Q Could you take us through the impact second-hand smoking has on health?

Dr Griffiths: It has a huge impact, and thanks to some of the previous legislation there have been some improvements that we can measure and track with great certainty. Second-hand smoke is undoubtedly a cause of cardiovascular disease, and for those people unfortunate enough to be exposed to it, it is a serious issue. Just over 15 years ago, there was a study that looked at coronary heart disease and cardiovascular disease in men. It showed a significant uplift for those exposed to second-hand smoke on a regular basis that was roughly the equivalent in risk of smoking nine cigarettes a day. So there is a very clear basis for saying that second-hand smoke causes heart and circulatory disease.

Sarah Sleet: I would add the legislation on smoking in closed places—there was of course the legislation back in 2015 about children and smoking in cars—was based on very good evidence and was introduced for very good reasons. It proved to be a popular measure. Second-hand smoke in this context as well is an important additional factor to consider in terms of the harms balanced against the need to restrict these particular products.

[Trudy Harrison (Copeland) (Con)]

Q Thank you. While the harms of vaping are becoming better understood, what do we know about the behaviours around vaping? I ask as an MP who represents the northern constituency of Copeland, where smoking levels are above the national average, where health inequalities are more prevalent, and where deprivation is also a factor. Are we seeing the same kind of mapping of deprivation in areas where people are starting to vape? Are we aware of copycat behaviour—children mimicking their parents or other people in their households—and are we starting to see some patterns in age groups starting to vape? That statistic—350 young people starting to smoke every day—is shocking. What do we know about vaping?

Dr Griffiths: Not as much as we would like. That is the headline, but I do not think it will surprise any of us to know that people follow cues in their environment. That is partly what happens around them in their social environment, but I would like to draw attention to what happens in shops and convenience stores where people buy vapes. I was looking around my local convenience store, which is not far from a school, and thinking about today. It does not take a lot to look at what is happening behind the counter and see the packaging, the marketing and the highly, brightly coloured products that are clearly labelled, named and flavoured in a way to be attractive to children, whether it be cherry cola vapes or cotton candy vapes. They are things that are deliberately sweet and targeted at children, so it causes us great concern that that will be such a huge influence on so many children. We see that playing out in prevalence. I do not know if there is anything that you would add, Sarah.

Sarah Sleet: I think you are right that there is no real evidence base around this. That research should be done and we would very much like to look at. Where smoking is very prevalent—as you say, in more deprived areas—people take cues from the people around them in terms of their behaviour. I have no doubt that look to similar cues for vaping. Are people around them smoking? Is it easy to get hold of vapes? Is it completely normalised? I think we would find a very similar pattern, but we need to get that evidence.

[Mary Kelly Foy (City of Durham) (Lab)]

Q We have heard that this Bill covers tobacco and vaping, and we have talked quite a bit about the advertising and packaging of vapes. Do you think that we could go further in actually tackling tobacco, which is the biggest killer, around the advertising and packaging of tobacco and flavoured tobacco?

Dr Griffiths: We would welcome anything that stops people smoking or beginning to vape as a starting point for their addiction to nicotine. Given the scale of the devastation that that has on people personally as well as on our NHS in terms of cost burden and all the other impacts that it has, we fully support the Bill going through in full as it is now. If there are opportunities and support for strengthening it, I am sure that we would welcome that too.

The majority of people across the UK support the Bill and would love to see a smoke-free generation. The fact that you have 51% of retailers supporting it also speaks to how powerful a moment it is. We should do anything that we can to strengthen the Bill and prevent it from being diluted. We know that the tobacco industry will be campaigning in the opposite direction to limit any restrictions that would reduce its success, so we are really mindful of that. We urge the Committee and everyone who can to protect the Bill from dilution. It can save and improve lives. It is potentially a transformative piece of legislation.

Sarah Sleet: We asked our supporters who was in favour of the Bill. Bearing in mind that many of our supporters may still be smoking or are ex-smokers, 84% supported the Bill and really wanted to see it come through. Daily on our helplines we hear people saying, “I wish I had never taken up smoking.” They are completely addicted and find it almost impossible to get out of smoking, and their health is being slowly degraded over time. They are having to come out of the workforce and retire early and potentially face death as well.

Tobacco and Vapes Bill (Second sitting)

Trudy Harrison Excerpts

Committee stage
Tuesday 30th April 2024 Public Bill Committees

[Nickie Aiken]

Q If there was one thing you could add to this Bill, what would it be?

Ailsa Rutter: Gosh! There are already some fantastic elements in the Bill. The key thing for me is to make sure that we can get the Bill through—particularly the focus on tobacco. It is really good to think that there is going to be subsequent consultation on the important elements around vaping. Factoring in what colleagues said previously, we need a simple mandatory age verification scheme. That is already in place in Scotland, and I would certainly welcome its introduction in England.

[Trudy Harrison (Copeland) (Con)]

Q Thank you, Ailsa, for all the work that you do up north in the north-east. I represent the north-west, Cumbria, which also has higher than national average rates of mothers saying that they are smoking at the point of birth—about 12.3%. I am told by our authority in Cumbria that about 3,500 hospital admissions, 74,000 GP appointments and 80,000 sick days are caused by smoking-related illnesses. But why not just do more of what you are doing in the north-east? Do you really need this Bill to tackle the problem?

Ailsa Rutter: I think we are doing some really good work in the north-east but I absolutely think that this Bill is required. I go back to the uniquely lethal nature of tobacco smoking; that is the one key argument that we need to think about. This is guaranteed to kill. For me, this is about a societal shift.

I am really pleased with the huge shift in the north-east on the social norms of smoking. We talk to people who smoke every single day, and you have their backing because they desperately do not want their own children to fall into the same trap. As I mentioned before, this is about aspiring into the future. We are all conscious of the pressure and strain on our NHS. Think about the impact—one in four beds in the north-east and elsewhere with somebody suffering from a smoking-related condition. I think our NHS colleagues in particular really welcome this.

There is another important aspect when it comes to the economic costs. We all get the healthcare costs and we also really understand the strain on social care, but actually it is business that bears the brunt of this. That can surprise people. It is about the lost productivity and people having to retire early and dying early. I would like to think about who these people are. I have mentioned the pivotal role of Sue Mountain and the showing of her TV advert, but so many other people have come forward who sadly were diagnosed in their late 40s—women in the north-east who are desperate to tell their stories. Cathy Hunt, diagnosed with lung cancer at 49; Claire Oldfield, diagnosed with lung cancer at 49. Their real appeal to you today is to think about taking this seismic leap forward and about the leadership the UK can show globally by recognising that smoking had a beginning and a middle, and it is down to us to say that it can have an end.

[Mary Kelly Foy]

Q Thanks to Ailsa for everything that Fresh does in the north-east and for the wonderful results we have seen in the north-east, which is a very deprived area in places. I want to follow up on the question on evidence in vaping. Although there are still a few grey areas and unknowns about vapes, we know that vaping is much less harmful than tobacco. Crucially, it is a really important tool for those people who do smoke. What evidence does Fresh use to back up this argument? Do you feel there is a worry that if we focus too much in the Bill on youth vaping, we will leave behind those dependent, addicted and, very often, deprived smokers?

Ailsa Rutter: I think we are really fortunate in the UK. The UK has shown great leadership by commissioning evidence-based reviews that are completely independent of Government; we have had eight of those now since 2014. That has been incredibly important. Fresh is not complacent. We have been monitoring the evidence around the rise in vaping and how this is positioned in terms of public health for the last 20 years—since we were set up. I would strongly recommend that many of the really useful questions we have had today could be answered by looking at those systematic reviews from the Office for Health Improvement and Disparities. In particular, when people say, “We don’t know what’s in vaping,” there is a significant chapter on the constituent chemicals and so on in vaping, and the magnitude of potential harm.

I have forgotten the second bit of your question, Mary.

--- Later in debate ---

[Kirsten Oswald]

Q I do not know if others have had this experience, but I am aware that I am increasingly being advertised at online by products that, although I am not really sure what they are, are certainly connected or proximate to tobacco or vapes. That leads me to wonder whether there are any tobacco, vaping or other connected or related products that are not covered by this Bill, which you think perhaps should be.

Kate Pike: I think the Bill is really good at closing some of those loopholes. It will include an age restriction on 0% nicotine vapes, for example. There are other nicotine products, such as the little nicotine pouches. The popular term is, I think, snus, but we know that snus is already banned in this country. The enabling regulations to put a regulatory framework around products like that will be really helpful. These industries are very innovative, so we just need to make sure that we are keeping up with our regulation. I think that the enabling regulation powers will enable us to keep up with new products, but it is continually little steps, and regulation chasing after innovation. We would like it to be the other way round, really.

[Trudy Harrison]

Q You are both very effectively articulating the complexity of your programme of work within trading standards, but 2027 seems like a terribly long timeframe. Given what we know about nicotine addiction and the outcomes, is it the right timeframe, and what will you need to be doing in that timeframe to achieve the deadline?

John Herriman: I think this is all about strategic resourcing. As I have already articulated, the profession has had a significant cut in resources over the last decade or so. Actually, we now have to go into a phase where we are rebuilding the capacity. We can do this; we know that we can enforce regulations, because we have seen that we can do it successfully within the world of tobacco. It is now about what we are doing as a profession to start building back that capacity. We are taking some new steps: for example, there are now apprenticeship schemes running in England, both at level 6 and level 4, and we are supporting the level 4 apprenticeships in Scotland and Wales.

One of the things that I think is really good about the Bill, and the work that DHSC and other Departments have been doing, is the taking of a strategic view. We have to build this capacity gradually—fairly swiftly, actually—into trading standards, but we also have to be clear on expectations with businesses, so that they know what is coming and we can therefore make sure that we are moving at the same sort of pace. By taking that strategic approach, it allows us to build the capacity at the right level and make sure we have trading standards officers who are qualified—it can sometimes take two to three years to train somebody as a fully-qualified trading standards officer. That way, we have a sustainable platform to make sure that the legislation can be enforced. Essentially, that is what we are seeing here. We have not seen this level of strategic approach to resourcing and tackling a problem in many other areas, so it is quite welcome.

[Preet Kaur Gill]

Q You mentioned that trading standards has faced huge amounts of cuts, with many telling us that in some places there is not even a single trading standards officer. The enabling regulation and the powers within that will be really important, especially when making it clear what trading standards officers must look for when they go into a shop, how vapes are being marketed, and so on. The Government have already consulted on that. Do you think the Government should release that information now, so that they can work with you and do the preparatory work? What kind of timescales do you think there should be? We heard today from ASH that there is some evidence—for example, from Canada—around descriptors that we could already put in the Bill, or that we could implement immediately—why should we wait? Would it have been helpful to have some of that consultation around the enabling regulations already there?

John Herriman: The Bill itself is helpful in that it has enabling regulations within it. It is about a phased approach. We cannot turn a switch overnight: we have to build it up gradually. We will need to do a lot of training—and not just training, but recruitment of new apprentices, students and trainees into local authorities, as well as doing the business education part, alongside that—and move in a very structured way. The worst thing that could happen is that we have the regulations, we have the law in place, but cannot enforce it. That would mean that it became ineffective. It is about having a phased approach, and the Bill does that quite nicely. It fits within where trading standards is as a profession. We need to build back that capacity over time. We are still waiting to hear the outcome of the discussions on funding, which are happening at the moment.

--- Later in debate ---

[Preet Kaur Gill]

Q What impact do you think the Bill will have on improving the environmental outcomes?

Laura Young: I think the regulations and how those are designed will be crucial. I know there will be follow-up legislation mopping up other parts of the issues, with disposable vapes hopefully being banned, but it is important that we look at the design. How we get the most circular economy version of vapes is crucial: limiting as much as possible single-use plastic, looking at how we can make them modular, making sure we do not just shove a charging port at the bottom and hope for the best, but actually looking at how they can be circular by design.

On design, it is also important that we are beginning to see vapes that are legal—there are the illegal ones, which are to one side—that I believe are getting around existing legislation in terms of capacity. You now see ones that have different cartridges, so it is almost like the pens that you had where you could switch between the inks. You can now do that with vapes that are being sold legally. They are getting over the limits because they are saying, “This isn’t one big cartridge. This is four small ones.” We are already seeing the industry innovating in a negative way to get around the legislation, so we need to make sure that that does not happen when we bring in environmental topics as well as all the other ones for public health.

[Trudy Harrison]

Q You have expertly explained the concerns around plastic pollution from vapes, but what do we know so far about the impacts on nature and biodiversity from cigarette butts? Also, are you aware of any concerns about the air pollution risks on biodiversity from cigarettes?

Laura Young: This may be something that has gone under the radar: the No. 1 item littered is cigarette butts, particularly when you look by number. They have a huge environmental impact, particularly because plastic is inside the filters, and the filter is the butt that is let behind. Although there has been a lot of campaigning around the environmental impact of vapes, there have been amazing efforts to raise awareness of the environmental issues around tobacco by organisations like ASH Scotland and the Marine Conservation Society, one of which I know has already given evidence.

Globally, we also need to look at this as a huge industry. Of course, kind of like any other industry, they need to be looking at their footprint and their sustainability measures. We know of course that air pollution is absolutely key to the conversation, and that has an impact as well on wildlife and biodiversity. Neither tobacco or nicotine products, such as vaping, are good for the environment; they are very harmful to the environment. We are just beginning to see those harms with disposable vapes in particular, but we know that cigarette butts have had a longstanding impact on the environment. They are also just a nightmare to collect. They are so small and so problematic. On beaches, you will see them as much as you see sand. We definitely need a lot more action across both those sectors.

[Mary Glindon]

Q The concerns about the environment are important, but the other issue about banning the use is that it sends out a message that vapes may not be safe. I know a lot of vaping companies are trying their best to see how vapes can be disposed of safely. They have these new vapes where they are disposable, but they are not single use. Do you think there could be any alternative to a ban? Do you think a ban might deter people from giving up smoking because they think that because vapes are banned, they are not good for you? It is a complicated discussion to have about what should be done. Do you want to comment on some of the things I have said?

Laura Young: Absolutely. The first thing to remember is that vaping is not good for you. It is slightly better than smoking, but let us definitely not push the message that it is good for you.

On disposables, that is something I got to see first hand just last week. Only one place in Scotland has the capacity to recycle disposable vapes or any vapes at all. From watching that process, it takes an individual staff member with personal protective equipment under a ventilation hood—if you remember chemistry from when you were at school—pulling them apart manually with pliers. They separate the parts of the vape out and put lots of it to the side because it cannot be recycled, and they take away things like the battery, covering it in this special type of tape to ensure that it does not combust and burn, because of course lithium is very explosive. The whole process of recycling one vape takes over a minute for one member of staff. It is a huge cost, and it is not an economically viable piece of WEEE—waste electronical and electronic equipment—to recycle.

We know that only a tiny number of vapes are actually being recycled. If all five million a week that are currently being thrown away in the UK were sent to recycling centres, it would be a huge cost to local authorities, which often are the ones collecting them, and it would take a lot of infrastructure and people hours to process them.

I will just say that nobody wants to ban things—I certainly do not want to ban things. Nobody started by saying, “Here, these seem like a bit of an issue. Should we ban them?” We actually went through the process of asking all the questions that you and many others have asked. What are the solutions? What can we do? How can we raise awareness?

Unfortunately, with an item that is just so damaging and dangerous and is the complete opposite of a circular economy, which is what we are trying to achieve, they just cannot exist. Disposable electronic devices should not exist, and that is really important. It is our job—the rest of us—to ensure that the public health messaging comes across clearly, which is, “One of the main reasons we are banning these is the environmental impact and youth access, but we still want to help adult smokers quit smoking and move to really just breathing fresh air. We want to move them completely away from tobacco and nicotine products.”

Services for People with Autism

Trudy Harrison Excerpts

Thursday 21st March 2019 Commons Chamber

[Trudy Harrison (Copeland) (Con)]

It is a pleasure to follow my hon. Friend the Member for Torbay (Kevin Foster), who made many powerful points. I commend my right hon. Friend the Member for Chesham and Amersham (Dame Cheryl Gillan) for securing this important debate ahead of World Autism Week and thank my hon. Friend the Member for Bexhill and Battle (Huw Merriman) for his outstanding representation of her in the Chamber today. I also commend the all-party group report, “Autism and Education 2017”, which was written in partnership with the National Autistic Society.

I am a member of the Education Committee, which is also looking into the needs of children and young people with special educational needs and disabilities. The autism APPG’s report contained some shocking statistics. The one that really upset me was that fewer than half of the children and young people on the autism spectrum going to school say that they are happy. It says that a lack of understanding from their peers and their teachers is the main reason for such unhappiness. The thought of any child or young person not looking forward to their day at school is, to me, so incredibly sad and utterly avoidable. We need better understanding and a co-ordinated resourced approach.

[John Woodcock (Barrow and Furness) (Ind)]

I do not wish to take up much of the House’s time, but has the hon. Lady had a chance to meet my constituent, Deborah Brownson, who has created extraordinary facilities through the online autism plan to help parents and children who are facing difficulties? If she has not met her, she should and join the campaign to get Government support for what Deborah is doing.

--- Later in debate ---

[Trudy Harrison]

I thank the hon. Gentleman for his intervention. I have not met Deborah, but I absolutely look forward to doing so. May I task him with connecting us?

Almost immediately after I was elected to this House two years ago, calls for my assistance arrived from families living with autism. They have told me about living with the daily fight for support, for a diagnosis, for professional advice, for an education and health care plan, for the necessary resources to actually carry out the recommendations in the plan, for reasonable adjustments in school and for flexible working arrangements with parents’ employers. As one of the many parents who responded to my call for information ahead of this debate said, “Everything is a fight. To get help is a fight and to find anything that you are entitled to is a fight.” Each family I met said the same thing over and over again. Families talk of the agonising wait for a diagnosis, in the hope that a diagnosis will bring some certainty and a joined-up forward plan but, all too often, it does not.

We in Copeland live in a rural and remote community, so one may have expected self-sustaining groups to form to support each other; it is what we do. Groups such Shine for Autism, Autism Around the Combe, the West Cumbrian Autism Society and the award-winning Sellafield Site Autism Support Network have been formed out of absolute desperation and in recognition of the fact that so many people are living with autism and these groups could make a real difference. And they do. I pay tribute to all the volunteers and parents who selflessly support others. The resilience and concept of helping each other make me so incredibly proud of my community, but it is not fair or right, or sustainable in the long term, because the parents I speak to say that they are “at the end of their tether.”

This fight is resulting in relationship breakdowns and mental ill health conditions, and in parents having to reduce their hours, or having to give up work altogether because of the lack of childcare for families with autistic children. Autistic children are three times more likely to be excluded from school for a fixed period than children who do not have any special educational needs and, with just 16% of autistic adults in full-time work, the UK is missing out on talent and much-needed skills. Child and adolescent mental health services came up time and again as being a critical but under-resourced source of help in Copeland and across Cumbria. Too many children and young people are being left without education, mental health support or any reassurance of a plan.

My right hon. Friend the Member for Chesham and Amersham introduced the Bill that became the Autism Act in 2009, and 10 years on it is time to recognise the calls for training for school staff, for reasonable adjustments in schools and for guidance and resources for local authorities to provide the full range of educational provision and support. I am delighted that the Academy for Autism will be opening in West Cumbria in September and that the outstanding Mayfield specialist school in Whitehaven will move into its brand-new facility later this year, too.

The Department for Education increased the total high needs budget across England from £5 billion to just under £6 billion in 2018, and funding is set to rise above £6 billion in 2019-20, so there has been much progress, but I urge the Minister to consider a different approach in rural and remote areas, as we are missing out, our children are missing out and the country will miss out on the abundance of talent and skills, which are so desperately needed. My call to the Minister is: please help me to find a way to better help these dedicated groups in the vital work they do.

Organ Donation (Deemed Consent) Bill

Trudy Harrison Excerpts

3rd reading: House of Commons & Report stage: House of Commons
Friday 26th October 2018 Commons Chamber

[Trudy Harrison (Copeland) (Con)]

This private Member’s Bill has my full support. It was introduced by the hon. Member for Coventry North West (Mr Robinson) and inspired by the Daily Mirror campaign to find an organ donor for a little boy from Cheshire, Max Johnson, whom we have heard so much about this afternoon from the hon. Member for Barnsley Central (Dan Jarvis) and many others.

In preparing for this debate, I was saddened to learn of just how many people lose their lives due to the lack of a suitable donor. In adopting this Bill, England would have a similar system to Wales, essentially an opt-out system where consent would be presumed unless otherwise stated.

There is already overwhelming public support for organ donation. According to the NHS Blood and Transplant website, over 80% of adults in England say they would definitely donate or would consider donating their organs, but only 37% of the UK population have registered as a donor on the NHS organ donor register.

While the then nine-year-old Max was the inspiring story behind the Daily Mirror campaign, at any one time there are more than 6,000 people waiting to have life-saving transplants. I spoke to one such person, a chap in my local West Cumberland Hospital, during his dialysis treatment in our new renal unit just last month. There are still many desperately sad accounts of lives being lost, with families destroyed and children without their parents.

The Johnson family spent almost eight months on a transplant ward; they said it was a “rollercoaster” of a year, sometimes worrying that their son’s weight might have dropped too low to continue on the transplant list. After 196 days of waiting, a tragically fatal car crash resulted in a suitable heart donation from a little girl, Keira Ball. I echo the comments of the hon. Member for Barnsley Central, and of my hon. Friend the Member for North Devon (Peter Heaton-Jones) in his emotional speech, in expressing admiration for Keira’s family.

Being a mum of four daughters myself, I was devastated to learn of other accounts, particularly that of Jade Gulliver’s sister. Jade, a mum to two little boys, died at just 27 while waiting for a liver transplant. She had viral hepatitis. Her sister said:

“You hear about transplants on the telly, but you never expect it to happen to someone you know. She kept getting sicker and sicker. I can’t explain what it was like—waiting every day for a phone call that never came. We take the boys to the bench we have in Jade’s memory for birthdays and anniversaries and we show them pictures.”

Jade’s sister went on:

“I will be the first to admit, before this tragedy, I also was almost ignorant to organ donation. Now I want to do everything in my power to prevent this from happening, so that no more families have to go through what our family has been through, and is still going through.”

It is not at all difficult to opt in. In fact, while preparing for my speech last night I decided that, in order to speak with any conviction and to be in an honest position to encourage the country to take the decision to donate, I at least needed to ensure that I had joined the register, so that is exactly what I did. But what dawned on me at that time, working late in my office here in Parliament and enjoying a mug of coffee and looking forward to getting back up to Cumbria to see my family and friends at the weekend, was how relatively relaxed I felt about making a decision that could only come into effect after my death. Online, I made a choice to donate all the bits of me that could ever be useful, and was rewarded for my choice by being informed that my decision could improve or save up to nine lives. I could instead have individually chosen my heart, lungs, kidney, liver, corneas, pancreas, tissue or small bowel, or any combination of them.

After I had registered, the website encouraged me to take three next steps to make clear my decision to my loved ones. It gave me advice on how to introduce the conversation, how to explain that my decision could improve or even save a life and how to tell them why and how I had arrived at my decision. I have had this conversation many times at home; it is a popular topic around our kitchen table with my four daughters. Personally, I have a positive outlook on life and understand that the only certainty in life is death, but it is a much more difficult to have that conversation with my husband. We are all different. One thing is sure: if the worst had happened, and if my daughters and husband, or my mum and dad, had been forced to make that decision shortly after my sudden death, it would have been very difficult for them.

For me, last night, registering was a simple choice, made without any doubt in my mind, but it is important to note that of the 500,000 deaths each year in this country, only around 5,000 people die in circumstances, or from conditions, that mean their organs could be considered for transplantation. I am sure the Minister will agree that the Bill will significantly improve the chances of finding a suitable donor for the 6,100-plus people currently waiting for that phone call to tell them of a suitable donor who could improve or save their life. It is a tragedy that three people will die today because of the lack of a donor.

The Bill seeks to improve and save lives, but it also seeks to take out some of the decision making at a time when families are suffering the worst possible ordeal of losing a loved one. There are nearly 25 million people on the NHS organ donor register, and such high rates of voluntary donation should be applauded, but I realise that there will be people who, for a range of religious or other reasons, do not want to become full or even partial donors. That choice must be respected. I hope that the Minister can reassure the House that opting out will be possible under the Bill. We know that the numbers of registrations have significantly increased following public awareness campaigns—I hope that this afternoon’s debate will result in such an increase—but that is still not enough to prevent the unnecessary deaths of an average of three people each and every day. Thousands of lives are needlessly being lost, and in thinking of all those who continue to suffer and the inevitable devastation for their family and friends, and in the belief that the Bill will save and improve so many lives, I will be supporting it through its parliamentary stages. I hope that colleagues across the House will do the same.

Oral Answers to Questions

Trudy Harrison Excerpts

Tuesday 19th December 2017 Commons Chamber

[Mr Steve Reed (Croydon North) (Lab/Co-op)]

15. What assessment he has made of the adequacy of access to mental health services for children and young people.

[Trudy Harrison (Copeland) (Con)]

17. What steps he is taking to improve the provision of mental health services for children and young people.

[Christopher Pincher (Tamworth) (Con)]

21. What steps he is taking to improve mental health provision for children and young people.

--- Later in debate ---

[Jackie Doyle-Price]

We are approaching Christmas, and the hon. Gentleman is quite right to highlight the fact that it can often be the moment of greatest crisis for people with mental health issues. I was with the Samaritans yesterday to commend it for all its work—it is obviously a good pathway to help—but, absolutely, we will speak with YoungMinds.

[Trudy Harrison]

“Jesse Evans—Autism Adventures” highlights the daily challenges faced by families living with autism, who are supported by self-sustaining groups such as Autism around the Combe. Will the Minister explain how the recent announcement of a multimillion pound development at West Cumberland Hospital will help those families?

[Jackie Doyle-Price]

My hon. Friend highlights the great synergy between those health services that the Government can provide, on which people obviously rely, and self-help, which is very important, as well as the help that people can give each other when they share their experiences. I commend the work of Jesse Evans and his “Autism Adventures” blog, which is extremely positive and educational.

NHS Pay

Trudy Harrison Excerpts

Wednesday 13th September 2017 Commons Chamber

[Trudy Harrison (Copeland) (Con)]

I am grateful for the opportunity to speak in this debate. West Cumberland Hospital in my constituency has faced significant challenges over many decades in recruiting and retaining enough doctors and nurses. It was because of those challenges that our midwifery unit was under threat of losing 24-hour, seven-day-a-week consultant-led maternity care. In a rural area such as mine, abundant with farms—I am proud to support the National Farmers Union’s Back British Farming Day today—that could mean a two-hour journey on a single-carriageway road up to Carlisle hospital, often being held up by slow-moving vehicles. Having been through four childbirths myself, I simply cannot agree that having to travel an extra 40 miles is an acceptable modern-day service, especially if the mother experiences complications.

I was pleased that the Minister of State, Department of Health, my hon. Friend the Member for Ludlow (Mr Dunne), came to West Cumberland Hospital to see the challenges for himself, and that the Secretary of State came to the hospital in Carlisle, Cumberland Infirmary, to hear for himself the concerns of clinicians. Not one mentioned the 1% pay cap, but concerns were expressed about morale, recruitment and retention, and how to ensure that enough doctors and nurses join the health sector. In my role on the Education Committee, I look forward to considering how we can recruit doctors and nurses through technical and academic routes. I am really pleased by the huge investment that has been made in our hospital and our NHS trust.

[Dr Whitford]

The hon. Lady mentioned recruiting doctors and nurses through a technical route. Do she or the Government really propose that route into medicine, without a degree?

[Trudy Harrison]

I thank the hon. Lady; I should have been clearer in saying that I support technical and academic routes into all employment in the health sector, because I understand that it is a team effort.

Over the past seven years, more than £90 million has been spent on the brand-new hospital in Whitehaven—more investment than ever before. I am delighted that we have been awarded more than £40 million of extra capital investment to refurbish and rebuild parts of the hospital estate, to bring it up to date and improve the experience of patients and staff. The funding will help to deliver faster diagnosis of conditions including cancer, easier access to mental health services and an expansion of our A&E department, leading to shorter waiting times for operations and more services in GP surgeries. There has been huge progress in improving patient care, and the funding will help to secure the highest-quality, most compassionate patient care anywhere in the world. Some £30 million of new funding will be invested across south Cumbria to modernise mental health facilities and improve A&E facilities at our hospitals, and nearly £10 million of the new capital funding has been earmarked for modernising mental health in-patient services.

Ensuring that we have a full complement of doctors, nurses and other staff on wards is essential. We simply cannot run wards without the appropriate staff. Our public sector workers, including nurses and other healthcare staff, are some of the most talented and hard-working people in the UK. Like everyone else, they deserve to have fulfilling jobs that are fairly rewarded in their take-home pay. We now have 12,000 more nurses working in our hospital wards than we did under the Labour Government, and retaining hard-working nurses and doctors is vital to maintain the service that we all appreciate. I am pleased that yesterday the Treasury decided to remove the 1% pay cap across the board.

One point I would like to draw attention to is the need to assist our talented, highly qualified medical clinicians to be able to do what they are trained to do and experienced in practising. From speaking to midwives both at my local hospital and elsewhere in our trust, I know that they are regularly spending up to three hours of their eight-hour shifts ploughing through administration work, stuck at a computer screen, rather than being out on the wards doing the work that they are trained to do—assisting mothers in labour and delivering children safely. I ask Ministers to look at innovative ways in which our trained staff can use the skills that they have.

It is the 42-year record low unemployment rate and our seven-year track record on deficit reduction that have made the end to the pay freeze possible.

[Sir Oliver Heald (North East Hertfordshire) (Con)]

Does my hon. Friend agree that with the Labour years having led to far less recruitment and training of nurses and doctors than the country needed, we are now in an international labour market for those important workers? It is therefore important that pay rates are high enough to attract them to this country.

[Trudy Harrison]

Indeed; I thank my right hon. and learned Friend for that intervention.

I end by commending the Treasury for yesterday’s decision to remove the 1% pay cap.