(3 weeks, 6 days ago)
Commons ChamberMy hon. Friend is absolutely right. I am afraid that one of my first experiences of death was watching my grandmother die a very long, slow, painful death from lung cancer as a result of a life of chain smoking. That is the consequence of this cruel addiction. People who start smoking come to regret it. They struggle to stop, and I am afraid that the stolen years that they could have spent with children and grandchildren are only part of the cost. Part of my argument today, particularly to some Opposition Members, is about better use of public money and reducing the taxation burden. Other arguments, too, may have some currency with Members who might be opposed to these measures for libertarian reasons. We should not forget for a moment the impact of this cruel addiction and the harms caused by smoking on people’s quality of life, family life, and memories.
I must make progress, otherwise we will not hear from anyone else in this debate—and I think that it will be a debate.
Taking action requires a reforming Government who are unafraid to take on the orthodoxies of both the right and the left. As I said, my right hon. Friend the Work and Pensions Secretary is today proposing radical reforms to the welfare system. Earlier this month, I set out a package of reforms to drive better productivity in the NHS. Today, we are proposing the biggest public health reform in a generation: phasing out smoking for the next generation by raising the legal age at which tobacco can be sold by one year every year, so that anyone aged 15 and under today will never legally be sold cigarettes. That will phase out smoking altogether.
Almost 20 years ago, the last Labour Government introduced the ban on smoking indoors in public places, as my hon. Friend the Member for Harlow (Chris Vince) said. We heard many of the same arguments, frankly, from opponents of that measure as we hear from opponents of the Bill today. They are free to correct me if I am wrong, but I do not think that Opposition Members who oppose the Bill are also proposing scrapping the indoor smoking ban. We have political consensus on the issue because of its success. The year after the ban came into force in 2007, hospital admissions for heart attacks dropped by 1,200. Admissions for children with asthma had been rising by 5% a year before the ban. After it was introduced, admissions fell by 18% in just three years. Since 2007, smoking rates have been cut by over a third, and as our understanding of second-hand smoke grew, the ban sparked a cultural change. People no longer thought it acceptable to smoke in front of their children, and many stepped outside, even in their own homes. It is time to build on that success.
No smoker intends to cause harm to others, but that is unintentionally what they do through second-hand smoke. The harms from second-hand smoke are less than from actively smoking, but the evidence shows they are still substantial. If people can smell smoke, they are inhaling it. Smoke near schools and playgrounds exposes children to smoke. Hospitals, by definition, have high numbers of medically vulnerable people on their grounds. The Bill will allow Government to extend the ban on indoor smoking to certain outdoor settings, and we will consult on banning smoking outside schools, playgrounds and hospitals to protect children and the most vulnerable.
As we act to prevent harms from smoking, we must also tackle the rising problem of youth vaping. It has more than doubled in the last five years, and one in four 11 to 15-year-olds tried vaping last year. A new generation of children is getting hooked on nicotine, and there should be no doubt about the cause, and no illusion that this has happened by accident. On any high street in the country, we can see shop windows filled with brightly coloured packaging for vapes, with flavours like blue razz lemonade and tongue twisters sour apple. Those products are designed, made, packaged, marketed and sold deliberately to children. This industry has cynically targeted its harmful products to kids.
Action is long overdue. We promised to stamp out youth vaping in our manifesto, and the Bill delivers the change that we promised. It will close loopholes that allow vapes to be sold or given away to children, provide powers to regulate the flavours, packaging and display of vapes, and introduce on-the-spot fines of £200 for under-age sales. Just as we took action on the advertising and sponsorship of tobacco products, we will bring the law into line for vaping products, too.
I do not know whether the Secretary of State will still be in the Chamber when I talk about Spice-spiked vapes. I see a gap in the Bill: it does not talk about refills. The harmful practice of spiking vapes with Spice comes from the refills. I hope that the Government will listen to my concerns and be flexible, as they have already shown themselves to be in other places. Perhaps, during the passage of the Bill, we can include something about refills. Would he agree to that?
We want to work in a genuinely collaborative and cross-party way, and I know that is true right across the House. As I look at the Opposition Benches, including Conservative Benches, I see long-standing campaigners for action on smoking and vaping. We want to listen and engage.
I feel strongly about the matter, as does the Prime Minister. In our manifesto, we set out Labour’s mission to improve the health of the nation. We will be far better served as a country if this is a truly national mission, and if we come together in common cause for action on public health.
(11 months, 2 weeks ago)
Commons ChamberI agree. I am afraid that when it comes to serving personnel and veterans, there is a gulf between what the Government say and promise and what they do; that is not the only example.
One thing not in the Government’s amendment to Labour’s motion is a pledge to protect the NHS dentistry budget. That is odd, because the Prime Minister promised to do exactly that 18 months ago. The truth is that the Prime Minister broke that pledge in November when he gave the go-ahead for dentistry underspends to be raided, effectively waving the white flag on the future of the service. Can you believe it? Despite everything we have heard, there are dentistry underspends, and the Prime Minister thinks that other things are greater priorities than this crisis. The consequences of that decision are now being felt. The budget in some areas of the country is running out and dentists are having to stop NHS work for the remainder of the year. It is so deeply frustrating.
NHS dentists want to do more NHS work; it is the Government who are standing in their way. The Nuffield Trust’s stark report into the crisis suggested that NHS dentistry may have to be scaled back and made available only to the least well-off. Such an approach would be the end of NHS dentistry as a universal public service, yet that is exactly the approach that the Government are piloting in Cornwall. Children, the over-80s and those with specific health needs are given treatment; everyone else has to go private or go without. They will not admit it, but this is the future under the Tories: further neglect, decline and patients made to go without.
Worse still, NHS dentistry is the ghost of Christmas yet to come under the Tories. That is not partisan overreaction on our part; that is according to the lead author of the Nuffield Trust’s report. He wrote:
“For the wider health system, the lessons are troubling: without political honesty and a clear strategy, the same long-term slide from aspiration to reality could happen in other areas of primary care too.”
What has happened to NHS dentistry under the Tories is coming to the rest of the NHS if they are given another five years. That is not the continuity that the country is looking for—it is looking for change with Labour.
My Bath constituency is also described as an NHS dental desert. The only option for people is to go private. The hon. Member has already said that it is Dickensian. Does he agree that it is not just a health problem but an equalities issue that the Government fail to recognise?
I totally agree. In fact, Claire Hazelgrove, Labour’s candidate in Filton and Bradley Stoke—next-door to the forthcoming by-election—was telling me about problems in her constituency and that exact challenge of people being left without or having to go private. One patient told her that her dental practice was now only seeing private patients. That same patient cares for her 84-year-old dad with dementia, who needed a tooth removal to allow him to eat. His appointment was also cancelled. That is what is happening before our eyes.
What of those who cannot afford it? Anna Dixon, Labour’s candidate in Shipley, told me of a woman in her town who had been turned away as an NHS patient and could not afford to go private. She was struggling with pain, it was affecting her eating, and she was at her wits’ end. With the Tories, if you have not got the money, you have not got the care.
(2 years ago)
Commons ChamberMy hon. Friend is absolutely right. One reason why this country has much poorer cancer outcomes than many comparable economies is precisely because of late diagnosis. I know from my own experience how vital early diagnosis can be for good cancer outcomes. I am terrified by the fact that, within those 7 million patients waiting in the elective backlog, there will undoubtedly be cases of undiagnosed cancer and other conditions. If the NHS had eyes on the patients, they would be detected faster, patients would receive treatment much more quickly and the outcomes would be better. One of the tragedies for the NHS is that, because we do late diagnosis, we get more expensive and less effective treatment. If we could diagnose faster, patients would get better outcomes and taxpayers better value for money. That is the kind of reform to the model of care that Labour would like to see.
On diagnosis, access to GPs is also a vital part of the puzzle. Is it not terrible that the Government are not listening to GPs, who say they need a different visa system? They cannot recruit enough GPs into the system because the Government are so stuck with these immigration rules, and the Home Office does not want to change certain parts of the visa system?
I am grateful for that intervention. We are in the worst of all worlds on immigration and the NHS. The Government try to have it both ways. They talk tough on rhetoric, so we end up with a very bureaucratic, ineffective and costly system, but because they fail to invest in our own homegrown talent, they are over-reliant on immigration from other countries, including those who desperately need their own doctors and nurses. I do not think it is good enough, after 12 years of Conservative Government, that we are turning away bright potential doctors, nurses and allied health professionals because the Government cannot be bothered to pull their finger out and train our own homegrown talent. We need to see improvement, so we that can draw the best international talent and make the system smooth, efficient and effective, but it is also crucial that we train our own homegrown talent.
Turning to more of the Conservatives’ excuses—we have heard the excuses of the pandemic—let us now look at the excuse they are planning to deploy this winter. There is no denying that this winter could be the most challenging the NHS has ever faced. The Royal College of Nursing, for the first time in its more than 100-year history, is planning to undertake strike action. Just this lunchtime we got strike dates from Unison, the GMB union and Unite the Union. That raises the question: why are the Government not even trying to stop the strikes in the NHS from going ahead? Surely, when the NHS already lacks the staff it needs to treat patients on time, the Government ought to be pulling out all the stops, getting around the table and negotiating to stop industrial action? So why aren’t they?
The Secretary of State said in Health questions earlier that his door is open—as if we can just sort of wander in off the street into the Department of Health and Social Care, where there will be a cup of tea and a biscuit waiting, and he will be just waiting for the negotiations. That is not how this works. Everyone knows that is not how it works. He had a nice little meeting with unions after the summer, after Labour complained that we had not seen a meeting between a Secretary of State and the unions since the right hon. Member for Bromsgrove (Sajid Javid). Goodness me, we have had three Secretaries of State since then—and two of them are the Secretary of State on the Front Bench today. Why on earth are they not sitting around the table and conducting serious negotiations? I will tell you why, Mr Deputy Speaker: they know that patients are going to suffer this winter and they do not have a plan to fix it, so instead of acting to improve care for patients and accept responsibility, they want to use nurses as a scapegoat in the hope that they avoid the blame. We can see it coming a mile off. It is a disgusting plan, it is dangerous and it will not work.
If I am wrong, perhaps Conservative Members could explain why the Government are not trying to prevent the strikes from going ahead. Perhaps they could explain why the Secretary of State ignored all requests from the health unions for meetings and conversations this summer while the ballot was under way. Perhaps they could explain what the Government’s plan for the NHS is this winter. Perhaps they could explain why a Government source told The Times newspaper that
“Ministers plan to wait for public sentiment to turn against striking nurses as the toll of disruption mounts”.
They said the quiet bit out loud and they gave the game away.
What else would explain the unedifying and embarrassing spectacle of the chair of the Conservative party going on national television to accuse nurses of doing the bidding of Vladimir Putin? I should not have to make this point, but nurses are not traitors to this country. They bust a gut day in, day out to look after all of us. We clapped them during the pandemic and now the nurses are clapped out. They are overworked, overstretched and undervalued by this Government. Let me say to the chairman of the Conservative party that he would speak with greater authority on what is in Britain’s national interests if he did his patriotic duty in his own tax affairs.
When it comes to sending a message to Vladimir Putin, why does the burden consistently fall on the working people in Britain? Why is it that NHS staff must make huge sacrifices because of the invasion of Ukraine, yet people who live in Britain but do not pay their fair share of taxes here do not have to lift a finger? When it comes to paying the bills, the first and last resort of this Conservative Government is always to pick the pockets of working people, yet the enormous wealth of tens of thousands of non-doms is left untouched. They may blame covid, they may blame health professionals, they may even blame the weather, but it is 12 years of Conservative mismanagement and under-investment that has left the NHS without the doctors, nurses and staff it needs, and patients are paying the price.
I am sure every Member of this House, indeed everyone in the country, knows someone who has been let down when they needed healthcare in recent months. They all say the same thing: the NHS staff were brilliant, but there simply are not enough of them. There is no NHS without the people to run it, yet today there are more vacancies in the NHS than ever before: 9,000 empty doctor posts, 47,000 empty nursing posts, and midwives leaving faster than they can be recruited. There are 4,600 fewer GPs than there were a decade ago, and the right hon. Member for Bromsgrove admitted last year that the Government are set to break their manifesto promise to recruit them back.