Dental Care: Durham
Mary Glindon Excerpts(1 year ago)
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Mary Glindon (North Tyneside) (Lab)
I thank my hon. Friend for securing this important debate. Given that dentists are so hard pressed and are trying their best to fit in NHS patients, in light of all the problems they are facing, does she agree that they deserve our greatest respect, admiration and thanks? I am very fortunate that I have been at my dentist’s practice for 52 years, but they are struggling.
Mary Kelly Foy
I could not agree more with my hon. Friend. The dentists that I have spoken to recently all want to help NHS patients, but the way the contracts are designed, it is not worth their while, and of course they have to make a living.
I mentioned that I made a point of order yesterday regarding the Prime Minister, who has repeatedly claimed that there are “500 more dentists” in the NHS. However, following a freedom of information request, we now know that the number of dentists in the NHS fell by nearly 700 last year. The number of dentists has also fallen since the pandemic and is at its lowest level in a decade.
Diagnosing the causes of the problem is not complicated. As I mentioned at the beginning, Britain has poorer oral health than any other developed economy. The system is also dysfunctional, and practices have handed back a record £400 million-worth of funding back to the Government because they do not have the capacity to meet the required targets.
National No Smoking Day
Mary Glindon Excerpts(1 year, 2 months ago)
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Mary Glindon (North Tyneside) (Lab)
It is a pleasure to serve under your chairmanship, Mr Efford. I congratulate the hon. Member for Harrow East (Bob Blackman) on securing this debate. I hold him in high regard as a stalwart champion of the no smoking campaign. It is so sad to hear what made him into that champion. I am sure that what happened in his family has happened in many families in recent years.
I am not a smoker, but, as I have said in past debates on this subject, I was brought up in a household where both parents smoked. My mother died of breast cancer at the age of 72 and my father had a bad chest all his life. She was a Woodbine smoker, I might add. My late husband was a smoker for most of his life, from 1957—the year I was born—when he was only nine years old, and he gave up the habit on a number of occasions. Eventually, like so many smokers, he turned to vaping instead, which was a great relief to him and his pocket. How expensive smoking is for those on low incomes has already been referred to. It will come as no surprise to colleagues that I will talk about vaping as a safe alternative for those who already smoke.
One recommendation in last year’s Khan report on making smoking obsolete was about promoting vaping. Khan stated:
“The government must embrace the promotion of vaping as an effective tool to help people to quit smoking tobacco. We know vapes are not a ‘silver bullet’ nor are they totally risk-free, but the alternative”,
as has already been said, “is far worse.”
Dr Debbie Robson, a senior lecturer in tobacco harm reduction at King’s Institute of Psychiatry, Psychology and Neuroscience has said:
“The levels of exposure to cancer causing and other toxicants are drastically lower in people who vape compared with those who smoke.”
And Professor Ann McNeil, a professor of tobacco addiction at the institute, has said:
“Smoking is uniquely deadly and will kill one in two regular sustained smokers, yet around two-thirds of adult smokers, who would really benefit from switching to vaping, don’t know that vaping is less harmful”,
although evidence shows that vaping is
“unlikely to be risk-free.”
Mary Glindon
I thank my hon. Friend for that intervention. I will raise the issues he has just mentioned in my speech to reinforce what he has said.
In the past, Public Health England has stated that vaping was 95% safer than smoking tobacco, but anyone who does not already smoke should not be encouraged to take up vaping. I think we would all share that message, including those of us who champion vaping over smoking.
As a member of the all-party parliamentary group for vaping and given my interest in smoking cessation, I have worked with tobacco companies such as British American Tobacco UK and Japan Tobacco International as well as the UK Vaping Industry Association. Both the tobacco companies and the UKVIA are united in their efforts to make vaping products as safe as possible through regulation and to help prevent young people taking up vaping. I emphasise that because the companies are very conscious of the problems.
Although we acknowledge the importance of vaping in contributing to the fall in smoking since it entered the mainstream, one of the biggest concerns is products targeted to attract children and young people to start vaping. The industry is extremely concerned about rogue retailers selling e-cigarettes to minors, and are calling to increase fines for offenders to a massive amount. The UK Vaping Industry Association adheres to section 22 of the Advertising Standards Authority guide, which prevents the marketing of e-cigarettes to children. It calls for a licensing or approved retailer and distributor scheme to filter out retailers who are not applying the law, so that consumers and lawful retailers can feel confident that the vape products they purchase adhere to strict safety standards.
Given the rise of rogue traders selling vaping products to children—as well as illicit products—due to the lack of sufficient deterrents and enforcement, the industry sent an open letter to the Health Secretary with a number of recommendations, including increased penalties of at least £10,000 per instance of traders flouting the law. The Minister may be well aware of that, so I will not go into any more detail. Colleagues can look at that if they wish.
A recent press investigation into the increasing number of vaping products entering the UK market that do not comply with the tobacco and related product regulations, particularly in relation to the company ElfBar, prompted the British American Tobacco to conduct its own research. An independent, accredited laboratory carried out an analysis of ElfBar’s 600 products, which can be purchased from major UK supermarkets, including Asda, Tesco and Sainsbury’s. Shockingly, all the products tested contained significantly more than the permitted 2% of nicotine-containing e-liquid—often up to 50% or 60% more.
Following the publication of that information, a meeting was convened between the Medicines and Healthcare Products Regulatory Agency, the Office for Health Improvement and Disparities, and ElfBar last month. However, to date, no action has been taken by MHRA or Trading Standards to remove those non-compliant products from the market. The problem reinforces the industry’s call for tighter controls and fines, which I hope the Minister is considering in full.
The industry is also aware of the concerns about single-use vapes, which offer a cost-effective and easy way for those on low incomes to quit smoking, and thus help to address health inequalities. A recent report from the Office for National Statistics showed that smoking is at an all-time low, and acknowledged the important role played by vaping in reducing those figures. A proposed ban on single-use products could put doubt into the minds of smokers and vapers about the use of e-cigarettes, and that could lead them back on to the smoking trail. It is important to point out that the UKVIA is working to ensure compliance with the waste electrical and electronic equipment directive, and is working with the industry and other bodies, including the Department for Environment, Food and Rural Affairs, to proactively look at ways to maximise the recycling and reuse of vaping products.
It has been said before that vaping is not a panacea. However, it is a way out for people who have smoked for years and cannot give up the habit. It releases them from the dangers of smoking and moves them on to something we hope is less dangerous, and a lot more risk free. I hope the Minister will look at all the considerations that need to go into the tobacco control plan, and will work with those industries so that vaping can be an effective and safe tool as an alternative to smoking in the future.
Oral Answers to Questions
Mary Glindon Excerpts(1 year, 7 months ago)
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Neil O’Brien
We are taking the action that I have just been describing in terms of direct support for households. Of course, because health is devolved, we are also helping the devolved Administrations. The Scottish Government, for example, receive £126 per person for every £100 per person of equivalent UK Government spending in England and Wales. That enables the Scottish Government to provide extra help for those in need. It is another example, on top of furlough and the energy support scheme, of how this country is strongest when we all work together constructively.
Mary Glindon (North Tyneside) (Lab)
Paul Blomfield (Sheffield Central) (Lab)
The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)
Waiting time targets for adult talking therapies were exceeded in 2021-22, with 91.1% accessing those services within six weeks and 98.6% within 18 weeks.
Mary Glindon
Young people in the north-east potentially have to wait up to three years for mental health treatment. Local Metro Radio launched Charley’s campaign to get young people more timely health support. The campaign is in memory of 12-year-old Charley Patterson, who took her own life waiting for treatment. Labour has a fully costed plan to guarantee mental health treatment within a month of referral for patients who need it. Will the Minister commit to adopting that target now?
Maria Caulfield
I thank the hon. Lady for her campaign on this issue. I am very sorry to hear of the tragic case of Charley Patterson. We recognise that, particularly with the pandemic, there has been a significant rise in mental health conditions for young people and children. We are expanding services so that an additional 345,000 children and young people can access NHS mental health support, and we are providing more support in colleges too. I am very happy to meet the hon. Lady to discuss her campaign further.
Smokefree 2030
Mary Glindon Excerpts(2 years, 1 month ago)
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Bob Blackman
I thank the hon. Member for his intervention and for the work that he has done on combatting smoking over many years. He raises the issue of smoking in pregnancy, which is the one target that the Government came closest to missing at the time of the last review. The target was 11%, and the Government just about achieved it. I am very clear that, for young women who are pregnant, we need to ensure that, if they smoke, they should be referred immediately to quitting services at the first meeting to discuss their pregnancy through the health service, and not just them but their partner as well. If both give up smoking, there is a strong chance that they will continue to not smoke. They need to understand the damage that they will do to their unborn child and the damage that they are doing to themselves. If we get to that point, it will improve the position no end. That is in the NHS plan, but for future years. I see no reason at all why that could not be introduced now. That is a management decision by the NHS, and I would ask my hon. Friend the Minister to encourage the NHS to do precisely that.
The all-party parliamentary group had an excellent meeting with the chairman of the independent review, Javed Khan. It was a very encouraging meeting, and we expect his recommendations to match the scale of the challenge, but unless his review is turned into a meaningful plan of action that is backed up by funding, it will not be worth the paper it is written on. We need new sources of funding, and the 2019 Green Paper recognised that we would need funding to end smoking, that there was pressure on budgets and that existing sources of funding were not sufficient. Three years and one pandemic later, the pressure on budgets in even greater. In its submission to me, the Local Government Association said that local authorities are paying some £75 million for quitting services overall. Clearly, they need additional funding to achieve what is required.
We are talking about disadvantaged communities, and levelling up is quite rightly a flagship policy for the Government, but there is no new funding to deliver on the bold ambitions set out in the levelling-up White Paper. The Institute of Fiscal Studies says that
“instead, departments will be expected to deliver on these missions from within the cash budgets set out in last autumn’s Spending Review. Departments and public service leaders might reasonably ask whether those plans match up to the scale of the government’s newfound ambition—particularly in the face of higher inflation.”
The levelling-up White Paper missions include narrowing the gap in healthy life expectancy between the local areas where it is highest and lowest by 2030, and increasing healthy life expectancy by five years by 2035. Smoking is responsible for half of the 10-year difference in life expectancy between the most and least disadvantaged in our society, so achieving the Government’s levelling-up mission on life expectancy will depend on delivering the smokefree 2030 ambition.
The Under-Secretary of State for Levelling Up, Housing and Communities, my hon. Friend the Member for Harborough (Neil O'Brien), has said that the Government must “floor it” when it comes to prevention and public health, but we cannot floor it unless there is gas in the tank. Gas in the tank is what we are lacking right now. Funding for public health is in a parlous state. We must face up to the fact that funding for smoking prevention has been particularly hard hit.
After the spending review was published, the Health Foundation estimated that funding for smoking cessation and tobacco control had been cut by one third since 2015. The cuts in budgets for tobacco control are the falsest of false economies. Unlike most pharmaceutical drugs, smoking cessation saves money, and with no negative side effects. The National Institute for Health and Care Excellence has estimated that, for every pound invested in smoking cessation services, £2.37 will be saved on treating smoking and smoking-related diseases, as well as increasing productivity.
Mary Glindon (North Tyneside) (Lab)
I am so pleased that the hon. Gentleman’s birthday is in this month of VApril, and I congratulate him on this debate. Does he agree that the vaping industry, which is supporting harm reduction by encouraging people to turn to vaping, should get more support, and that vaping should be part of the Government’s harm-reduction strategy? Vaping is also more economical. Encouraging people away from cigarettes to vaping would be a good step in the direction of better health.
Andrew Gwynne (Denton and Reddish) (Lab)
It is a pleasure to serve under your chairmanship, Ms Nokes. I begin by thanking the hon. Member for Harrow East (Bob Blackman) for his tireless work in this area, along with my hon. Friends, and for the way he opened the debate. I also wish him a happy birthday.
Over the past 50 years, positive steps have been taken towards ending smoking, on both sides of the House. I am pleased to be here today responding to the debate on behalf of the shadow health and social care team from Her Majesty’s Opposition, because, from my point of view, it is a matter of great pride that I was in Parliament when Labour’s smoking ban was passed into law in 2006. It has become one of the defining public health achievements of the last Labour Government. The positive impact that it has had on the health of the nation is plain to see.
However, there is still much more to do, as we have heard in various speeches this morning. Smoking continues to be the leading preventable cause of ill health and mortality in England. The NHS estimates that 78,000 people in the UK die from smoking each year, with many more living with debilitating smoking-related illnesses. Smoking causes 44,000 cancer diagnoses per year, with almost 70% of all cases of lung cancers caused by smoking.
Smoking blights communities right across the country and contributes to the yawning health inequalities that we currently witness. However, smoking affects not only those who choose to do it; it affects many people around them, too. For example, a child who is exposed to second-hand or passive smoke has an increased risk of cot death, and of developing chest infections, meningitis and many other serious conditions.
The consequences of smoking are stark and affect not only our health, but our economic prosperity. My constituency of Denton and Reddish in Greater Manchester sits across the boroughs of Tameside and Stockport. Each year, smoking costs Tameside over £95 million in lost productivity and health and social care costs, and in Stockport that figure is just above £77 million. In my constituency, 22% of adults smoke, which is well above the national average of 14.5%. We will never truly level up while smoking continues to hold communities and individuals in a vice grip. We need to take robust and radical steps if we are to have any hope of reaching smokefree 2030.
Unfortunately, as we have heard in various contributions, there has been characteristic dither and delay from this Government, I am afraid to say. We were promised an updated tobacco control plan last year, but so far it has failed to materialise. The Government like to talk the talk on smoking cessation services but, as we have heard from numerous contributions, they have brutally slashed the local authority funding that allows those very services to exist.
The public health grant has been cut by £1 billion in real terms since 2015-16, and stop smoking services have suffered a funding decline of around one third over the same period, as we heard from the hon. Member for Harrow East. The Government cannot have it both ways; either they are for a smokefree 2030, and therefore they should support smoking cessation services, or they are not, in which case they should ditch the warm words. I will take the Government at face value—they want a smokefree 2030—so let us get that investment reinvested in smoking cessation services and let us restore public health funding.
I would be grateful if the Minister set out in her response a timeline for publishing the next tobacco control plan, and I want her to commit to publishing Javed Khan’s independent review into smokefree 2030 policies by no later than the end of May. Furthermore, can she outline what plans her Department has to improve access to smoking cessation services, and will she admit that stinging cuts to the public health grant have left communities such as mine, and those of many other hon. Members here today, worse off?
Yesterday, Members voted on the Government’s Health and Care Bill. The all-party parliamentary group on smoking and health set out several recommendations, as we heard from my hon. Friend the Member for Stockton North (Alex Cunningham), on how to achieve a smokefree 2030. Several of those recommendations were tabled as amendments to the Bill. Labour Members were proud to support many of those amendments and proposals, yet the Government refused to back them, much to the disappointment of health leaders and politicians across the House.
The need for a smokefree 2030 has been reinforced during the course of the pandemic. We know that during the first year of the coronavirus crisis, the number of 18 to 34-year-olds who classed themselves as smokers increased by a quarter, from 21.5% to 26.8%. That is a huge increase and one that will have a lasting negative impact on the health of people across the country, unless they are given the tools to stop smoking for good.
In short, we are falling behind. We have a smokefree 2030 ambition, but very little in the way of funding and a seeming lack of urgency from the Government to publish the tobacco control plan.
Mary Glindon
My hon. Friend is probably aware that I am an advocate for vaping. Major reports by the former Public Health England and the Royal College of Physicians have highlighted the reduced risk potential of vape products. Does he agree that the Government must address consumer misperceptions regarding the relative risk reduction of vaping compared with smoking combustible cigarettes?
Andrew Gwynne
I thank my hon. Friend for that intervention, and I think my answer will be very similar to that given by the hon. Member for Harrow East earlier. Yes, vaping has a clear role to play in reducing people’s addiction to nicotine and tobacco products, and clearly it has health benefits over smoking. However, I am increasingly concerned, partly because I see it in my own constituency—I recognise that this is only anecdotal evidence, but I see kids vaping. There is no good reason for children in Tameside or Stockport, or anywhere else in the United Kingdom, to be vaping.
I think the Government have to look very clearly at what is happening here, because vaping has a real role to play in helping people to wean themselves off nicotine and tobacco products, which I support. However, if we are starting to see children vaping because it is seen as the cool thing to do, as a replacement for what smoking was back in the day, then I think that is a cause of real concern that needs to be looked at. Like the hon. Member for Harrow East, I really do see the benefits of vaping, but we have to tread with caution, because we are starting to see the next generation of vapers being created. I want all children to be not just smokefree but vape-free. As I said, children have no reason to vape.
In closing, can the Minister say whether she recognises our concern about the lack of a tobacco control plan; whether she recognises the need to do more in such a short period, because we are now only eight years away from 2030; and whether she will pledge to resume public awareness campaigns about smoking and start to get really serious, as I know she wants to be, about a smokefree 2030?
Javed Khan’s independent review is exceptionally welcome, but we need to know that his recommendations will not be brushed aside. The tobacco control plan, when it comes, must contain the bold measures needed to create a healthier and more resilient nation. I give the Minister my word that the Labour party is ready and waiting to support the Government on that. We will give her the backing she needs to drive through the necessary reforms in Parliament. We cannot afford to waste more time. The clock is ticking, and as each second passes a smokefree 2030 slips further from our grip. Let us take this opportunity to redouble our efforts, with support from across the House, to make a smokefree 2030 a reality.
Smoke-free England
Mary Glindon Excerpts(2 years, 2 months ago)
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Sir Charles Walker (Broxbourne) (Con)
I beg to move,
That this House has considered progress towards a smoke-free England.
I will start by reading a couple of paragraphs from an excellent Government document published in July 2017, entitled “Towards a smoke-free generation”. I will not detain the Chair too long, but there are a few sentences that I want to read into the record. The document says:
“Over 200 deaths every day are still caused by smoking…Smoking rates have remained stubbornly higher amongst those in our society who already suffer from poorer health and other disadvantages. Smoking rates are almost three times higher amongst the lowest earners, compared to the highest earners…Smoking accounts for approximately half the difference in life expectancy between the richest and poorest in society. This injustice in the variation in smoking prevalence can be seen across England; from places where adult smoking is as low as 5% to others where smoking remains above 25%. The prevalence remains even higher in people with mental health conditions, where more than 40% of adults with a serious mental illness smoke. We want to address this. Our vision is nothing less than to create a smokefree generation…the government will provide leadership and guidance on the most effective interventions.”
There we have it: a bold statement of intent. So what does a smoke-free 2030 look like? First, it is not smoke-free. When we talk about a smoke-free 2030, we are actually talking about 5% or less of the adult population smoking—that is recognised by The Lancet. Currently, more than 14% of the adult population smoke, and it could actually be higher than 14%, because lockdown may have increased the prevalence of smoking as people turned to cigarettes as a way of releasing and relieving stress. Cancer Research UK is not optimistic about the 2030 date, which will not come as a surprise to anyone here. Its best guess is that 2037 is when we will achieve 5% or less, and I am afraid the general view is that 2037 now looks optimistic.
To put it in context, what is 200 deaths a day? That is 75,000 deaths a year and, on top of that, 500,000 admissions to hospital every year for smoking-related illnesses. Over 10 years, 750,000 people will die from smoking. That is approximately the population of Birmingham every 10 years, and 5 million people will be admitted to hospital.
The Government touch on the huge disparities in smoking between richer and less well-off areas. In some of the most deprived wards in seaside towns in the north-west, smoking rates are above 22%. In the leafy parts of Surrey, they are less than 5%—in essence, parts of Surrey have achieved smoke-free status. What does 22% versus 5% look like? That translates into about an eight-year differential in life expectancy. Of course, not all that eight-year differential will be linked to smoking but, as the Government identified in their report in 2017, about 50%—four years—of that differential will be linked to the fact that more people smoke in more deprived areas than wealthier ones.
Look, the Government have made great strides. I will not be churlish with the Minister—I would not be churlish with her, because she is a very nice woman and she is very committed to this cause, which is more important than being nice.
I understand that a pack of cigarettes now costs more than £10, although that is not something I have bought for 17 years. Some might be pushing £14, so this is becoming an expensive habit. Even at that price, 14% or more of the population are smoking. We are down to some really tough nuts to crack, if we want to reach that 5%. I remind the Government of the part of the report entitled, “Backing evidence-based innovation”:
“Despite the availability of effective medicines and treatments to support quit attempts, the majority of smokers choose to quit unassisted, by going ‘cold turkey’. This has proved to be the least effective method…The best thing a smoker can do for their health is to quit smoking. However, the evidence is increasingly clear that e-cigarettes are significantly less harmful to health than smoking tobacco. The Government will seek to support consumers in stopping smoking and adopting the use of less harmful nicotine products.”
Mary Glindon (North Tyneside) (Lab)
I congratulate the hon. Member on this Adjournment debate. He may know that I have never smoked, but I am a strong advocate of vaping. Does he agree that, if the Government are serious about reducing smoking prevalence, they must ensure that medical professionals have access to the latest evidence on e-cigarettes and are encouraged to signpost patients to appropriate guidance about harm reduction, as well as information about how to switch successfully, if they cannot quit?
Sir Charles Walker
Of course, I agree with and endorse what the hon. Lady said—on this occasion, let me call her my hon. Friend—because what we are talking about today is harm reduction.
Let me read two more sentences, from page 15 of the report, which I am sure will be of interest to the hon. Lady:
“The Government will therefore continue to evaluate critically the evidence on nicotine-delivery products, providing clear communication about what is known and unknown about the short and long-term risks of using different products relative to smoking and the absolute risk to children, non-smokers and bystanders.”
Remember that that was written five years ago, so there has surely been time to do this.
What I do not understand is why the Government are so squeamish when it comes to looking at harm reduction. The hon. Member for North Tyneside talks about vaping, but there are nicotine pouches, “heat not burn” products and something called snus, which I understand is used in parts of the world. Before we cast these alternatives aside, let us remember that they reduce the harm caused to the user. There is nothing more harmful than smoking burnt, lit, combustible tobacco—nothing. Sweden has taken an enlightened approach. It has embraced science and looked at harm reduction. Smoking rates are now well below 10%, and some independent experts reckon they are nearer 7%. It looks like Sweden is going to be the first country in Europe to meet the magical 4.99% and be a smoke-free European country.
I am concerned that we are not going at this problem as hard as we should as a nation, but there is hope, which I am sure the Minister will refer to in her speech. There is the independent review of smoke-free 2030 policies, led by Mr Javed Khan OBE. The review offers reasons for optimism. In its objectives it states:
“The review will make a set of focused policy and regulatory recommendations in 2 areas, and will consider…the most impactful interventions to reduce the uptake of smoking, particularly among young people.”
It will also consider
“the top interventions to support smoking cessation, particularly in deprived areas of England where there are significant health disparities”.
That sounds like a call to arms. On outputs, the review says:
“The review will provide a far-reaching report focused on the key policy and regulatory recommendations that give the government the best chance of achieving the Smokefree 2030 ambition and addressing the health disparities associated with smoking.”
Can I make a plea to the Minister and her Department? This issue is harm reduction. It is about reducing the 75,000 deaths a year. It is about reducing the 500,000 people who go into hospital. It is not about banishing nicotine.
In a perfect world, nobody would even chew nicotine gum, but the fact is that they do. We do not live in a perfect world. People become addicted to nicotine, and it becomes part of their day. It is far better to consume it in a way that offers a much lesser chance of either shortening someone’s life or putting them in hospital. Let us use the regulatory and tax environments to differentiate harms, so that the highest harm is combustible tobacco and we can gradate the level of harm going down. We can use the tax system to signpost people to the least harmful nicotine product.
I would like to conclude by saying one thing. Levelling up has to mean reducing the disparities in people’s life expectancy. One of the greatest disparities is in those who suffer from a diagnosis of psychosis/schizophrenia. By the Government’s own reckoning, 40% of people with the diagnosis—possibly more—smoke. I know about this because I have been deeply involved in the issue of mental health since I entered Parliament 17 years ago. Smoking is often linked to the treatments used to help people with psychosis/schizophrenia—sadly often still called the chemical cosh. The treatments tend to enhance appetite, so people experience massive weight gain. They also tend to depress the person in receipt of the medications, which drives them to smoking. On average, if someone has a diagnosis of psychosis/schizophrenia, their life expectancy is reduced by 15 years—the Government say in their document that it is between 10 and 20 years. This is a real issue for so many people. This is not a “nice to have” harm reduction; it is an absolute necessity. I thank you, Ms Rees, and the Minister for allowing me to make the case for harm reduction today.
The Parliamentary Under-Secretary of State for Health and Social Care (Maggie Throup)
First, I thank my hon. Friend the Member for Broxbourne (Sir Charles Walker) for calling this important debate. I am grateful to him for his contribution and I am grateful to other Members who share the Government’s ambition for Britain to be smoke-free by 2030. My hon. Friend is correct when he says that that means 5% of people smoking, but it would still be a great achievement to get from where we are now to just 5%. The UK is a world-leader on tobacco control and we now have one of the lowest smoking rates in the world. According to my records, only 13.5% of people in the UK smoke, but that percentage is still too high. As he stated so passionately, the Government know there is still so much more to do.
We know that there are still around 6 million smokers in England and that smoking remains the single biggest cause of preventable mortality; two out of three long-term smokers will die from smoking. We also know that smoking is one of the largest drivers of health disparities and that the burden of tobacco harms is not shared equally. Smoking rates are far higher in poorer areas of the country, as my hon. Friend said, and among lower socioeconomic groups. We can see smoking rates of 23% in more deprived areas, compared with rates of 8% in wealthier ones. In addition, one in 10 pregnant women still smoke, increasing the risk of health problems for their babies. Smoking prevalence among people with long-term mental health conditions is also far too high, at over 25%.
My hon. Friend the Member for Windsor (Adam Afriyie) raised the issue of smoking during pregnancy. The decline there has not fallen in line with other groups, so we know that more needs to be done. We continue to explore options to support smoking cessation in pregnant women; those options will be set out in our tobacco control plan and they are also part of our NHS long-term plan. We know that it is not just the woman who needs support; it is her partner as well. We must continue to help those groups in all the ways we can.
What are we doing? In 2019 the Government set the bold ambition for England to be smoke-free by 2030. To support that, we have been building on the successes of our current tobacco control plan, and later this year we will publish a new plan with an even sharper focus on tackling health disparities. The new plan will set out a comprehensive package of new policy proposals and regulatory change. To help push those ambitions forward, the Government have commissioned an independent review of our tobacco control policies, led by Javed Khan, the former CEO of Barnado’s. The review will assess the most impactful interventions to help us achieve our goal of being smoke-free by 2030. I know that Javed Khan has some really ambitious ideas that I am sure my hon. Friend the Member for Broxbourne will welcome.
More needs to be done to prevent young people from taking up smoking and to protect our future generations from its devastating harms. More also needs to be done to support current smokers to quit, especially in deprived communities and among the priority groups. Smoking, and the grip it has on our society, must become a thing of the past. I am confident that the Khan review will give us the focus and political support to do so. I encourage all hon. Members to contribute to the review so that we can hear as wide a range of views as possible. We are open to bold new ideas about how to reach our smoke-free ambitions. Hon. Members have talked about the role of reduced-risk products. The Government are supportive of smokers using less harmful nicotine delivery systems to quit or switch away from the most harmful form—combustible tobacco.
Mary Glindon
This week is the beginning of VApril, which is a campaign run by the industry to support smokers who are looking to quit. Would the Minister support efforts to encourage adult smokers to quit by speaking with local authority stop smoking services, this month in particular, and highlight the role of e-cigarettes in reducing harm?
Maggie Throup
The hon. Lady—I will call her my hon. Friend—speaks passionately about vaping, and we have had those conversations before. We know and acknowledge that reduced-risk products are not risk-free, but vaping is a way to help people stop smoking and it has been proven to be effective. We must continue to ensure that the products do not appeal to young people and non-smokers—that is really important. However, we need to get the message out that vaping is an effective way to stop smoking. Balanced and proportionate regulation is required as we shift to different products. We have an innovative and varied nicotine market in the UK, as has been mentioned; vapes are by far the most popular alternative source of nicotine, but there are also patches, gums and, more recently, nicotine pouches.
We want to see more smokers using vapes to quit, which I know is in line with the wishes of the hon. Member for North Tyneside (Mary Glindon). She mentioned earlier the possibility of vaping and e-cigarettes being available on prescription, and the Secretary of State has spoken of his desire to see those products routinely prescribed by the NHS. That is something that we need to move forward with. My hon. Friend the Member for Windsor raised the important issue of the perception of vaping and how it has changed. That is something I will take away and consider.
Health Inequalities: Office for Health Improvement and Disparities
Mary Glindon Excerpts(2 years, 4 months ago)
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Mary Glindon (North Tyneside) (Lab)
It is an honour to serve under your chairmanship, Mr Twigg. I congratulate my hon. Friend the Member for Bootle (Peter Dowd) on an excellent, well-researched speech and on securing this important debate.
Before turning to the exact subject of the debate, as vice-chair of the all-party parliamentary group for vaping, I want to reflect on the role of the predecessor body of the Office for Health Improvement and Disparities. Public Health England sought to be a practical institution, with evidence and pragmatism at the heart of its approach to public life. I want to pay particular attention to its work on tobacco harm reduction, which I have witnessed not only as a member of the APPG but personally. Since 2015, across seven evidence reviews, PHE reports on the role that e-cigarettes can play in a healthier society have captured the ethos of the organisation in its entirety.
The first report was a landmark publication for the vaping industry. It concluded—I hope that everyone in this House heeds this fact when reflecting on reducing inequalities born from smoking cigarettes—that vaping is “95% less harmful” than tobacco. In its report, PHE went on to look favourably on e-cigarettes, while others have sought only to fuel misinformation, risking lives by claiming vaping and smoking to be one and the same. They are not. It is because of that evidence-based endorsement of vaping that millions of smokers across England and—dare I say it?—across the world, who have exhausted all other routes trying to quit smoking, have a fighting chance with an incredibly successful product that is helping smokers to quit.
Smoking is perhaps one of the biggest contributors to inequality in our society, causing considerable damage to private and public health, and it has a high impact on physical and mental health. It is an expensive and addictive habit, particularly for those most disadvantaged in our society, where smoking prevalence is highest. Vaping is less expensive and is an effective way to stop smoking. It is therefore critical that the Office for Health Improvement and Disparities recognises the role of vaping, picks up the torch left by Public Health England and continues to be a stalwart champion of tobacco harm reduction.
This could not be more important as we continue to wait for the Department of Health and Social Care to publish, first, its review of the Tobacco and Related Products Regulations 2016—that review is now eight months late—and secondly, its new tobacco control plan, which is also late and nowhere to be seen. The APPG for vaping’s door is always open to the Minister, and I know that leading bodies such as the UK Vaping Industry Association would welcome the chance to work with Government to secure a future in which the health benefits of switching from smoking to vaping are fully realised. The UKVIA has industry-led solutions to many of the remaining concerns that prevent people from finally making the switch to vaping. Those solutions include the guidance it produced on introducing restrictions on packaging and branding. I support that paper, and can share it with the Minister if she wishes.
The UK is seen by many across the world as a world leader in tobacco harm reduction, with countries, smokers and vapers looking to the UK for guidance in this space. That reputation should not be compromised by the loss of institutional knowledge during the transfer of resource from Public Health England to OHID, and it should not come at the cost of a Government Department delaying publications once again. If the Government are serious about levelling up and wish to support endeavours to improve people’s lives, they must ensure that OHID adopts the same evidence-based approach as its predecessor to finding solutions for life-debilitating problems.
I once again express my gratitude to my hon. Friend the Member for Bootle for having secured this debate. I hope that in responding, the Minister can provide clarity about the timeline for responding to the TRPR review and for the publication of the new tobacco control plan. I also hope that she agrees that the OHID must remain independent, with its institutional knowledge protected.
Medical Cannabis: Alleviation of Health Conditions
Mary Glindon Excerpts(2 years, 7 months ago)
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Mary Glindon (North Tyneside) (Lab)
It is an honour to follow the hon. Member for Edinburgh West (Christine Jardine). I congratulate the hon. Member for Inverclyde (Ronnie Cowan) on securing this debate, which, as everyone has said, is yet another debate on the same issue. Three years on from when we had such hope, it is disappointing that we find ourselves still here.
I am going to speak yet again about one of my constituents, a very brave and formidable woman who is known to many in the House, because she has been courageously campaigning for the medical use of cannabis by highlighting the problems she has faced in recent years to access the drug Bedrocan. Lara Smith is a wife and the mother of three children. She was a paediatric nurse and a county fencing coach before her health deteriorated because of cervical and lumbar spondylosis. For over 20 years, she has had 35 different medications, as well as a number of operations for her condition. Unfortunately, she has been left with permanent nerve damage, limited mobility and a constant, annoying and debilitating tremor in her right hand. Her quality of life has been completely impaired. That is not just because of her medical condition, but because of the awful side effects of the drugs she has been prescribed over all those years. This has meant that Lara was not able to be the full-time mother that she wanted to be to her daughters and son.
Fortunately, Lara’s pain management consultant in the north-east prescribed Bedrocan, and the transformation was such that she was able to come off all the other medications. Her young family said that they felt they had their mam back. The downside was that for a time, Lara could access the drug only by travelling to a Dutch pharmacy to collect it on a private prescription. I have said it before, so I will not go into it again, but she made that arduous journey every three months, bearing in mind the pain she was in. She had to notify full details of her prescription and her travel to Border Force each time. The costs of the medication and travel were very expensive for her family, but they thought that the sacrifice was worthwhile, because of the difference the drug made to Lara.
A couple of years ago, I was successful in raising the issue at Prime Minister’s questions. I received a response from the appropriate Minister at the time, who said that
“there should be no barriers to patients getting access to the appropriately prescribed medicine. The Department of Health and Social Care…has been working closely with suppliers and NHS procurement pharmacists to ensure that prescribed CBPM are available when needed.”
If only that were the case.
Fortunately, Lara no longer has to travel to Holland for her drugs—they are prescribed on a private prescription—but her consultant has unfortunately been unsuccessful in obtaining an individual funding request for her, which is a great disappointment to us all. That is because unfortunately the Northumbria trust—it is a well-respected and well-known trust in many ways, and I always support our trust for a lot of the good things it does, but I am rather frustrated in this instance—followed guidelines that do not advocate the use of cannabinoids, citing a lack of evidence for effective pain relief, because of the difference in the trials put forward to prescribe the drugs, and we have already heard about that issue. On that score, there has been no progress. Perhaps the biggest irony of all is that the trust advocates and allows the prescription of synthetic cannabinoids. For Lara’s drug, a synthetic cannabinoid is £588 a month and unfortunately leaves her quite ill; she pays £100 less for her private prescription. Such a state of affairs seems ludicrous.
There is nothing much I can add to what has been said today. All the speeches are always passionate, and Members speak with such knowledge on the subject—knowledge that has had to be acquired over all the years there has been the fight to win the case. I know that the new Minister, having worked with her on all-party parliamentary groups, is compassionate and knowledgeable, so we put great hope in her that we will see some progress after today’s debate and the other debates that have gone before. I wish her the best of luck in taking this forward, and I am sure she knows we are all behind her. We hope there will be change for the adults and children whose quality of life needs to be improved and can easily be improved if some changes are made in law.
Smoking Cessation: Prescription of E-cigarettes
Mary Glindon Excerpts(2 years, 7 months ago)
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Maggie Throup
My hon. Friend is right that e-cigarettes are just a gateway to stopping smoking completely. That is the ultimate goal. We want to ensure that people go from smoking to e-cigarettes, and then to no smoking at all.
Mary Glindon (North Tyneside) (Lab)
COP9 is due to start next week and, as yet, the Government have not announced their delegation. Will the Minister therefore please tell us who the delegates might be and what their approach will be to COP9, given that the World Health Organisation is completely against vaping?
Maggie Throup
There will be officials at COP9. It is a very important meeting. The UK’s approach to e-cigarettes has been and always will be pragmatic and evidence-based. I am sure that will be the message they put forward at COP9.
Dame Carol Black’s Independent Review of Drugs Report
Mary Glindon Excerpts(2 years, 7 months ago)
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Mary Glindon (North Tyneside) (Lab)
It is an honour to serve under your chairmanship, Ms Fovargue. I congratulate my hon. Friend the Member for Liverpool, Walton (Dan Carden) on securing the debate, and on the way that he spoke with great knowledge and passion. I declare my interest as co-chair of the drugs, alcohol and justice cross-party parliamentary group. In that capacity it was my privilege to introduce Professor Dame Carol Black to address our group the week after she published her report. My co-chair, Lord Ramsbotham, has repeatedly asked in the other place when the Government will establish the long-awaited royal commission on the criminal justice system. I hope the Minister may have some news on that for us.
Dame Carol’s report recommended earlier interventions for offenders to divert them away from the criminal justice system, particularly prison. Providing people with pathways into treatment, rather than into the criminal justice system, seems an eminently sensible approach because, as Dame Carol observed:
“Rarely are prison sentences a restorative experience.”
Over a third of prison places in England and Wales are taken up because of drug-related offences.
I pay tribute to the pioneering work of the late Ron Hogg, who, as Durham’s police and crime commissioner, introduced a successful checkpoint scheme. We have since heard of other excellent diversion schemes, such as those developed in the West Midlands and in Thames Valley—we desperately need more like them. I am glad that Ron’s successor, Joy Allen, along with Dorset PCC Dave Sidwick, is leading the PCCs’ work on addiction. I am sure the Minister will join me in welcoming their dedication to helping people towards a safer and healthier future.
Dame Carol understands that addiction is a chronic health condition, arising as people try to cope with trauma and other issues. Her report rightly condemned the current situation as intolerable. Drug-related deaths are at record levels, the impact of drug-related harms in many places is getting worse and the worst affected areas are those with greatest deprivation. I am sad to say that the highest rate of drug misuse deaths in 2020 was once again in the north-east, which according to the ONS has had the highest rate of drug misuse for the past eight years, with a significantly higher rate than other regions of England and over three times the rate of London.
We know drug treatment has seen years of disinvestment. Some services have seen budgets nearly halved as funding has been redirected to other local government priorities. There has been an absence of political leadership and financial commitment to address the concerns of the sector, with very clear and obvious consequences. A range of treatment providers welcome Dame Carol’s review, fully endorse her recommendations for a whole system approach and told our group they were keen to seize this unique opportunity to rebuild and renew our treatment and recovery system. Jon Murray, an executive director at With You told us:
“This review represents a potentially defining moment in the course of drug treatment in the UK.”
Yasmin Batliwala, chair of the Westminster Drug Project said:
“This report has the potential to be a game changer!”
Karen Tyrell, executive director at Humankind added:
“Dame Carol Black has provided the map needed to get the sector back on course and we urge the government to employ their moral compass, invest accordingly and help us turn this ship around.”
For far too long, piecemeal investment through path- finders and pilot schemes failed to provide the stability for providers to develop the long-term plans, and recruit and retain the high-quality staff, that are needed to meet the ambitions laid out in the review. As recommended, ringfenced funding is essential for the sector to build and maintain a resilient support system for the hundreds of thousands of people who so desperately need and deserve those services. I sincerely hope that the Government will act on all of Dame Carol’s recommendations.
Tobacco Control Plan
Mary Glindon Excerpts(2 years, 11 months ago)
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Mary Glindon (North Tyneside) (Lab)
It is an honour to serve under your chairmanship, Mrs Miller. I thank my hon. Friend the Member for City of Durham (Mary Kelly Foy) for having secured this important debate and speaking so eloquently, especially as the Department of Health and Social Care is looking to publish a new tobacco control plan later this year. The forthcoming plan is an enormous opportunity for the Government to cement the UK as a global leader in tobacco harm reduction. Having left the European Union, the Government must—alongside the post-implementation review of the tobacco and related products regulations—set a clear direction for reducing smoking prevalence and improving public health.
However, if the Government are to achieve their ambition for a smoke-free society by 2030, their forthcoming tobacco control plan must champion the less harmful alternatives to combustible tobacco. In particular, a significant and growing body of scientific evidence shows vaping to be the most effective alternative for adult smokers looking to quit smoking. In their blueprint for better regulation, the UK Vaping Industry Association made a series of recommendations to the Department of Health for consideration when reviewing the tobacco and related products regulations—a process that is already underway. These recommendations, many of which I support, can also be applied to the Government’s tobacco control plan.
The first recommendation involves effectively tackling the increasing levels of misinformation, as well as the increasing misperception of the relative harm of e-cigarettes versus combustible tobacco. Action on Smoking and Health data suggests that millions of smokers—more than half of the 6.9 million remaining in the UK—could now be dissuaded from exploring switching to e-cigarettes because of incorrect views or confusion about the harm of e-cigarettes. To combat increasing misinformation, the UKVIA recommends that the Department of Health launch an effective communication strategy. This should include the introduction of approved health claims and switching messages that can be displayed on vape device and e-liquid packaging alongside nicotine health warnings, a proposal similar to those explored by the Governments of Canada and New Zealand.
In addition, it is important that medical professionals at local stop smoking services are sufficiently supported, with clinicians signposted to the latest clinical guidance and evidence on e-cigarettes. An evidence-based approach to smoking cessation must be adopted consistently by local stop smoking services to support patients in their harm reduction journey. This is critical, considering the upcoming trials in NHS A&E departments. The forthcoming tobacco control plan should also make provisions for a review of the regulation of nicotine in e-cigarettes, to better understand the role nicotine plays in allowing e-cigarettes to be a satisfying alternative for adult smokers wishing to make the switch away from smoking. For them to compete with combustible cigarettes and provide a satisfactory alternative for those looking to switch, they must provide a comparably satisfying nicotine experience. It is the toxic by-products of combustion, not the nicotine, that are responsible for smoking-related death and disease.
Understanding the alternatives to combustible cigarettes and making a clear distinction between smoking and vaping is critical to our smoke-free ambitions and changing misconceptions. Our all-party parliamentary group for vaping made several recommendations in our report on vaping in workplaces and public places. These are endorsed by the UKVIA and, if implemented, would support adult smokers in their transition to less harmful alternatives and give those who have already made the switch the best chance of sticking at it. I can provide the Minister with a copy of that report, if she so wishes. My late husband Ray is an example of such a switcher: having smoked from the age of nine with a couple of interludes, he made the switch to vaping several years ago, and was never separated from what he called his “pipe”. I might add that he did not die of a smoking-related illness.
Finally, I turn to another opportunity to enact the meaningful regulatory change to support smoking cessation. The Government are currently considering the submissions made to the consultation on the review of the Tobacco and Related Products Regulations 2016. Like many others, I eagerly await the publication of the Department’s response, which has already been delayed from May 2021 until later this year. It is hoped that the Department of Health and Social Care will continue to take an evidence-based approach to the regulations and listen to the experts. The TRPR review can help shape the UK’s approach to tobacco harm reduction considerably and can significantly support the next tobacco control plan. I look forward to the Government’s response to the tobacco and related products regulations review and the publication of the tobacco control plan. I hope that they make the most of these unique opportunities to support adult smokers in their transition to a less harmful alternative.