Tobacco and Vapes Bill

Baroness Northover Excerpts

Committee stage
Thursday 30th October 2025 Grand Committee

Moved by

[Baroness Northover]

12: After Clause 6, insert the following new Clause—
“Transparency of tobacco sales data(1) The Secretary of State must by regulations make provision requiring every manufacturer and importer of tobacco products to publish, on a quarterly basis, data relating to the sale of tobacco products in England and Wales.(2) Regulations under subsection (1) must in particular include provision requiring publication of—(a) the volume of sales of tobacco products, broken down by product type, brand and geographical region, and(b) such other information as the Secretary of State considers appropriate for the purposes of assessing tobacco consumption and its effects on public health.(3) Data published under regulations under this section must be made publicly available in a format accessible to public health authorities, local authorities, and other relevant bodies.(4) Regulations under this section are subject to the negative resolution procedure.”Member's explanatory statement
This amendment would require the Secretary of State to make regulations obliging tobacco companies to publish sales data, to improve transparency and support public health policy.

[Baroness Northover (LD)]

My Lords, Amendment 12, in my name and that of my noble friend Lady Walmsley, and Amendment 148, in my name, would require the Secretary of State to make regulations obliging tobacco manufacturers and importers to provide sales data by geographical area. Before the Minister says that there is already such a power, let me refer to Amendment 148, which seeks to change “may” to “must” for the requirement to make regulations and to publish data.

Tobacco companies collect rich data tracking the sales of their products which currently exist only to serve commercial purposes. Modelling from Cancer Research UK shows that those living in the most affluent areas of the UK should be smoke free this year, whereas those in the least affluent will not achieve that until after 2050—25 years later. That inequality has devastating consequences. Hence, there are nearly twice as many cancer cases caused by smoking in the poorest areas in England compared to the wealthiest.

Data collected by companies on sales and distributions could be used to inform public health. They could also give insights into different pricing strategies that companies use and would therefore complement a “polluter pays” levy, which I know many people rightly support. The data would also have value in setting up a new licensing system, helping local government understand the pattern of sales in its communities and make judgments about whether availability was appropriate. Trading standards would also benefit, using insights to support enforcement activity and improve the intelligence that local authorities have to assess local problems with any illicit sales and to identify upticks in illicit tobacco use.

Action on Smoking and Health, in its written evidence on the Bill, also flagged the issue of cigarillos, saying that surveys have

“recently identified that cigarillos are increasing in use among young people. With timely access to industry sales data public health agencies and researchers could have identified this trend far more quickly. These products have fewer restrictions on them than other tobacco products, something that will be addressed via the Tobacco and Vapes Bill, but lack of knowledge has inhibited swift public health response”.

Industry data have been shrouded in secrecy—what a surprise. Thank goodness that Professor Sir Richard Doll had the cancer registries to demonstrate the causal link between smoking and cancer. Since public health academics started analysing industry profits, they publish only very limited data. Mandated publication of sales data would ensure that this industry, which sells a product that kills two-thirds of long-term users, is appropriately regulated and monitored given the harms it causes. I look forward to the Minister’s response and I beg to move.

[Lord Young of Cookham (Con)]

My Lords, I agree with Amendment 12 moved by the noble Baroness, Lady Northover, but I want to speak to Amendment 192, which proposes the introduction of a levy on tobacco manufacturers.

When products cause harm, the polluter should pay. That principle was introduced by previous Conservative Governments; the landfill levy was introduced in 1996 and the soft drinks levy in 2018. After the Grenfell tragedy, we introduced the Building Safety Act to make the construction industry pay for the remediation of high-rise blocks. We should apply the same principle to tobacco.

In a report commissioned by the last Government, Javed Khan looked at three options to raise funds to implement his conclusions. He wrote:

“Introduce a ‘polluter pays’ industry levy on profits from cigarette sales, which can directly fund the full range of comprehensive measures to help us reach smokefree 2030 and make smoking obsolete. This is my preferred option … A tobacco ‘polluter pays’ levy could be introduced in the form of a charge applied as a percentage of these profits”.


It would not impact on the CPI or the cost to the consumer, and it would raise hundreds of millions of pounds.

We debated exactly that proposition on 16 March 2022, Amendment 158 to the Health and Care Bill, proposed by the noble Lord, Lord Crisp, whom I am delighted to see in his place. He said about that amendment:

“This new Clause … would require the Secretary of State for Health and Social Care to carry out a consultation about a statutory scheme for the regulation of prices and profits of tobacco manufacturers and importers. Funds raised by the scheme would be used to pay for the cost of tobacco control measures”.—[Official Report, 16/3/22; cols. 287-88.]


That is precisely what Amendment 192 proposes.

Responding to the amendment, the Minister, speaking then from the Opposition Front Bench on behalf of her party, said:

“This strikes me as wholly pragmatic; a wide-ranging consultation would undoubtedly help to strike the right balance between all the parties involved … The scheme proposed in this group of amendments would provide a well-funded and much-needed boost, and a consultation would allow this proposal to be tested, refined and shaped. I hope that the Minister will accept the opportunity of a consultation but if the will of the House is tested, these Benches will support the amendments”.—[Official Report, 16/3/22; col. 297.]


She was as good as her word: she supported the amendment, along with the Leader of her party and the Chief Whip, and the amendment was carried, later to be overturned in another place. I was therefore surprised that the noble Baroness did not add her name to this amendment when I tabled it, and I look forward to her compelling speech in its favour.

Amendment 192 would require the Government to consult on the introduction of a “polluter pays” levy. Tobacco is a uniquely addictive and lethal consumer product, and this creates a perfect storm for consumers. The tobacco industry in this country continues to be in good health, unlike its customers, and companies continue to make significant profits: an estimated £900 million per year in the UK alone, with average profit margins of around 50% compared to 10% for manufacturing margins.

There are various estimated costs to society of smoking. That from ASH is £43.7 billion a year—perhaps the Government could share their own estimate—and it is the taxpayer who picks up the tab: costs to the NHS, costs to social care, lost productivity to our economy, and higher welfare bills. A “polluter pays” levy ensures that those who can and should pay, do, and implementing it would raise up to £700 million a year.

So how would it work? The Treasury consulted on a levy in 2014 and did not proceed, but what is proposed now is quite different and, crucially, it would not allow the industry to pass costs on to the consumer and would have no impact on the RPI.

The levy model proposed by the APPG on Smoking and Health would introduce a price cap on tobacco similar to what we do with utilities. That would limit the prices to manufacturing costs plus, say, a 10% profit margin. This would be in line with other consumer products and more than generous for an industry responsible for such high levels of harm. The Government would then introduce a new levy on the industry, to be paid for from its profits.

A consultation would allow this model to be “tested and shaped”, providing a much-needed boost to public finances. The public too share our support for this proposal, with 76% of adults in England in favour of a “polluter pays” levy.

I note that the amendment from the noble Earl, Lord Russell, on this same subject proposes to put the proceeds into

“a dedicated fund held by the Department of Health and Social Care”.

I have not included such hypothecation in my own amendment, but I fully support what he seeks to do. Some £700 million a year could be used to support 2 million more smokers to quit just in this Parliament and accelerate progress towards a smoke-free future. It is likely that funds would be left over, which could be used for other public health activities, helping the Government achieve their mission of reducing the gap in life expectancy between the richest and the poorest.

This is a measured, fair and practical proposal. It would protect the consumer, prevent industry manipulation, provide much-needed funding for the Treasury, and ensure that those who profit from an addictive and lethal product made a proper contribution to repairing the damage it causes. I look forward to the Minister’s reply.

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[Baroness Merron (Lab)]

No, that is not the case. I urge the noble Baroness, Lady Northover, to withdraw her amendment.

[Baroness Northover (LD)]

My Lords, this group is about the polluter paying and responsibility across a wide range of areas. On Amendment 12, on the practice of disclosing sales data, it is already in place in the United States—full data to the Government and partial to public sources. It is also the practice in Canada, so there is precedent for that. It is not seen as an unreasonable burden, but it is a useful public health tool. It is important to know, for public health reasons, which I and others have outlined, where sales are high.

The noble Baroness, Lady Fox, referred to growth. She might want to consider the economic and growth consequences of the ill-health costs to individuals, families and the NHS and the death that results for so many consumers of tobacco products, then factor that in when she is looking at growth in the United Kingdom. Tobacco kills, which she rightly referred to. I do not need to refer her to the cancer registries—that is self-evident. It is therefore appropriate that we address this. As a former student of Marx, as she identifies herself, she will be very familiar with the notion of exploitation, particularly of the poor and already disadvantaged, to which I have referred, and the difference at the moment in outcomes between groups in terms of equality.

This is an important area. We are seeking to strengthen the Government’s arm, as is always the case when you move from “may” to “must”. We look forward to further discussions with the Minister on how best we do that. In the meantime, I beg leave to withdraw my amendment.

Amendment 12 withdrawn.

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[Earl Russell (LD)]

I am grateful for the noble Lord’s intervention. My first amendment would introduce a greater price point for entry into the market, but my second amendment is about banning little, plastic, pre-filled pods that have to go into supposedly reusable vapes and for which the manufacturers charge a premium. I would get rid of that, so that people could use a bottle to refill the vape. You would have a slightly more expensive base unit, but the daily running of that unit would be cheaper. Therefore, the savings generate over time. That is the fundamental proposition that I am putting forward.

The noble Lord makes a valid point about advertising. The better option is not to use the word “advertising” but to use the phrase “health education”. There is not enough knowledge about these products, and it would be good if people had better options to choose from.

I will also comment, very briefly, on the other amendments, which I forgot to discuss earlier. I have sympathy for Amendment 17A and for Amendment 18, which is in the names of noble Lord, Lord Moylan, and the noble Baroness, Lady Fox. These are important issues for people who are in mental health institutions or other institutions, where they are not free fully to leave or to get access to vaping products. It would be a mistake to restrict their ability to access those products.

[Baroness Northover (LD)]

My Lords, I will speak to my Amendment 28, which concerns free samples of tobacco and vaping products. I thank my noble friend Lady Walmsley for adding her support.

Although I understand that Clause 15 will take action on this issue, it is such an important matter and such a significant gap in current regulation that I wish to address it directly with my amendment. The promotion of tobacco and vaping products through the distribution of free samples is wholly unacceptable. The Tobacco Advertising and Promotion Act 2002, with which I was involved, explicitly banned that practice for tobacco. It is exactly what I saw in Africa when I was a DfID Minister, with primary age children given cigarettes as the tobacco industry saw its market decline in the West and sought to addict children in other parts of the world. If vapes were really only used for smoking cessation, why would they be so clearly targeted at children, as we have heard?

Since vapes have come on to the market, there have been multiple reports of such products being handed out to young people to get them addicted to nicotine. It is the route that my nephew, to whom I referred on Monday, and his friends, who are now unable to kick the smoking habit, arrived at cigarette smoking—via colourful vapes. It would be useful to publish the sales data, and we will see whether we have some useful data on potential upticks among children smoking as a result of vapes.

Public health campaigners have long called for the closing of the loophole that allows vapes to be given to children as part of a promotional activity. As far back as 2010, the Guardian reported that a 17 year-old had been given a free sample of BAT’s vape brand, without being told that it contained nicotine or being asked for age verification. Such promotions are often carried out by third-party marketeers at festivals, train stations and in city centres, with young, vibrant staff enticing people with their free products—but with limited explanation of the risks. Trading standards can do nothing about this, as vapes are not currently covered by existing restrictions.

My amendment came as a result of sitting on the Tube on 7 May this year and looking up and seeing the advert for Zyn that I am holding up. I know we are not supposed to use props, but this makes the point. Zyn, it says, is a “flavour you feel”. “No smoke, no vapour, no tobacco” is what that advert says in large type. Sounds benign, does it not? However, there is an asterisk to very small print that says it is derived from tobacco. Then there are the flavours: chilli guava, icy blackcurrant, citrus, black cherry, cool mint. Then it says, “Claim your free sample today”, with a double asterisk to another tiny warning and a minute warning underneath saying that it is not risk free—an understatement—that it contains nicotine, which is addictive, and that it should only be used by adults who would otherwise continue to smoke or use nicotine. Oh yes, just look at this advert. Do they put those warnings in bold colours and letters? Oh no, they do not. So do not tell me that this is not targeted at young people.

I was so angry to see that and that is why my amendment came forward. How can anyone justify seeking to draw children and young people in with an advert like that and sleep soundly at night? It is welcome that this Bill will finally address this issue, but it has taken an unacceptably long time to reach this point. The industry is, as ever, using all sorts of arguments to water this down, and we should not buy that. Young people who have never smoked should not be using vapes, as my noble friend Lord Russell has just said. Yet, 20% of 11 to 17 year-olds have tried vaping and 160,000 children at least vape daily.

I would be grateful if the Minister would confirm the following. First, will the Bill be robust enough to capture any future innovations the industry might devise? We have seen time and again how the tobacco industry exploits loopholes and adapts products to evade regulation. It is essential this practice of giving out free samples to hook young people on to addictive products ends with this Bill. Secondly, could the Minister comment on the timeframe and the reasoning behind it? I note that no further regulations are required but that the measure will come into force six months after Royal Assent. Is there any possibility that we could bring this forward? We have already waited five years for this change. I share the concern of the noble Lord, Lord Kamall, about time slipping on this. This is one of the most insidious forms of marketing, and we should crack down on it as swiftly as possible.

[Lord Young of Cookham (Con)]

My Lords, I will speak very briefly to this group of amendments. Amendment 16 is about age. My noble friend Lord Moylan said that young people are sensible. I agree with that. I think it follows from that that they are sensible enough to understand that Parliament may have prescribed different age limits for different activities, so I do not find that argument wholly conclusive but, on a more conciliatory note, I agree with what my noble friend said about Clause 12.

“A person commits an offence if the person has the management or control of premises on which a vape vending machine … is available for use”.


However, there is no provision for any exceptions.

My noble friend made a case for those mental health hospitals that have vending machines that enable patients to remain smoke free. Is it the case that, when the Bill becomes an Act, they will have to take those vape machines out and go through the whole process of licensing to be able continue to sell vaping products? Is it the case that, under Clause 16(3)

“The Secretary of State may by regulations create exceptions to the prohibition in subsection (1) or (2)”.


Is that the “get out of jail” card we need to solve the problem my noble friend rightly drew attention to?

My noble friend also touched on Amendment 17A, which relates to vaping machines in non-age-gated premises. The explanatory statement says that the amendment

“would permit the sale of vapes and other nicotine products through vending machines in only those premises that are already restricted to adults only”.

I wonder what those premises are, because younger people can go into pubs and clubs. What are these age-gated premises? I can think of nightclubs and the Chambers of the House of Lords and the House of Commons, but it would be helpful to hear in slightly more detail exactly what these exemptions might be.

I am cautious about any exemptions, because I see vaping products as a smoking-cessation tool. Allowing vaping products to be made available in pubs, clubs, restaurants, or wherever, tends more towards the recreational use of vaping, which I think we all want to downplay. I give way to the noble Baroness, who will explain what these age-gated premises are.

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[Earl Howe (Con)]

My Lords, I turn first to Amendment 16, tabled by the noble Baroness, Lady Fox, and my noble friend Lord Parkinson. The amendment raises the broad question of how, as a society, we wish to define adulthood. From that point of view, I think the amendment is a useful one. Clause 10, like much of our statute book, assumes that 18 marks the threshold of adulthood—the age at which one may also contract, serve on a jury or purchase regulated products. Yet, as my noble friend Lord Moylan argued, proposals to extend the franchise to 16 and 17 year-olds invite us to reconsider that assumption. I shall be interested to hear what the Minister has to say about the amendment.

I turn to Amendment 18, tabled by my noble friend Lord Moylan and the noble Baroness, Lady Fox. We have in Clause 12 a proposed measure that would outlaw any vending machine that dispenses vapes or nicotine products to a paying customer. The question that my noble friend and the noble Baroness have posed is whether the Government are prepared to consider any exceptions to this hard and fast prohibition. Is there not a strong case for saying that, in a smoking cessation clinic where there are adult clinical staff guiding patients through a structured programme, or in a mental health unit where staff often find themselves dealing with patients in a high state of agitation, a vending machine dispensing vapes or nicotine products not only would do no harm but could be of considerable benefit to the well-being of the individuals being treated? In those clinical environments, vapes and nicotine products are not promoted for casual use. They have a utility, and their utility lies as a means of harm reduction under clinical supervision. Let us just remind ourselves that patients admitted to mental health settings, or being treated in one, are much more likely to be smokers than other members of the general population. The noble Baroness, Lady Fox, drew attention to that. For obvious reasons, there is a deep reluctance within mental health units to permit smoking on the premises. Access to vapes, on the other hand, is a far less contentious issue, I suggest.

I would be grateful if the Minister could say why the Bill makes no provision for exceptions, even narrow ones, to the ban on vending machines. I am not contesting the proposal to ban such machines in the majority of settings, but vapes are not the same as tobacco. I have been approached by one vending machine operator that supplies machines to adult-only venues such as clubs. It asked the same question in its briefing sheet. Why is it that, in a place where anyone entering has been vetted as being an adult, they are being denied access to a vending machine? I would be grateful for the Minister’s comment on that.

Amendment 21 from the noble Earl, Lord Russell, and the noble Baroness, Lady Walmsley, raises a rather different question. I appreciate the intent behind this amendment. The goal that the noble Earl and the noble Baroness are aiming at is of course a worthy one. However, I have three problems with what they are proposing. First, if one makes vaping too expensive, law-abiding citizens who wish to quit smoking will be deterred from doing so. That is surely a risk. Secondly, smokers who may be less concerned about the lawfulness of the products that they buy will be steered towards unregulated products and/or the black market. I suggest that, under this proposal, that is simply bound to happen. Thirdly, any minimum pricing arrangement will act as a dampener on competition, and hence a dampener on innovation. A good example of such innovation is the age-gating technology that my noble friend Lord Lansley spoke about in our previous Committee session—technology built into a product or its packaging that prevents underage use. Approaches of that kind should be explored before we ever consider blunt instruments such as statutory price controls.

Finally, I turn to Amendment 28, tabled by the noble Baronesses, Lady Northover and Lady Walmsley, which would prohibit the provision of free tobacco or vaping products through the course of business. Again, I completely understand and respect the motivation behind that proposal, but we should ask some questions about it. In the case of tobacco products, I am absolutely on the same wavelength as the noble Baronesses; at the same time, it would be helpful to know how much of a problem this now is.

First, is it not already illegal? If not, and if free samples of cigarettes, say, are being supplied by the manufacturers or importers to wholesalers or retailers, that sounds like an expensive exercise, bearing in mind the need for them to account to HMRC for the relevant tobacco duty, which I do not think they can avoid. What can the Minister tell us about that?

Secondly, on free samples of vapes, I listened carefully to the noble Baroness, Lady Northover, but I venture to say that different considerations apply to vapes compared to tobacco. My noble friend Lord Moylan was absolutely right: vapes are not in the same league of harm as tobacco products. They are also a smoking cessation tool. I would be the first to agree that free vapes should not be handed out to children. That is a given—

[Baroness Northover (LD)]

The advert I have here says that the samples they are giving out are actually derived from tobacco. Even though it says, “No smoke, no vape and no tobacco”, the advert states that the samples are derived from tobacco. My reference is therefore to tobacco products—that is the link there—but I also emphasise the point about nicotine.

[Earl Howe (Con)]

If it is a tobacco product, I take the point, but I thought that the noble Baroness was also arguing about handing out free vapes. Making it illegal for a shopkeeper to supply an adult with a regulated vaping product as a free sample feels very much like an unreasonable restraint of trade. If someone enters a shop to buy cigarettes—let us say he is a smoker—and the shopkeeper offers him a free vape, what exactly is wrong with that, as long as the regulations are adhered to? Do we really want to criminalise that kind of free supply? I am afraid that I am not convinced.

The Bill already imposes a series of significant new obligations and compliance costs on legitimate businesses. The restrictions contained in Clauses 13 to 15 alone are substantial and will likely require many retailers to make complex and costly adjustments. To introduce further constraints and prohibitions, as well as a substantial potential liability, however well-intentioned, has to be thought about very carefully before we go down that path.

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[Earl Howe (Con)]

To pick up on that, I ask the Minister to clarify the issue that was left slightly in the air earlier about the derivation of nicotine. While nicotine can be synthetically produced, it is derived from tobacco, but the point made by definition in the Bill is that a vaping product is a distinct product from a tobacco product. So the advertisement seen by the noble Baroness, Lady Northover, which I agree is highly regrettable, may be accurate in saying that the product is derived from tobacco but is not a tobacco product. Is that correct?

[Baroness Northover (LD)]

Can I comment on that? It has been very instructive to learn all about this subject. I could see a discussion occurring between the noble Earl and his noble friend but most nicotine is, in fact, derived from tobacco. This fits with what the advert I have here says, which is that the product advertised is derived from tobacco but does not contain tobacco leaf. Whether it is misleading for it to say, “No tobacco”, is another matter, but, clearly, dancing on the head of a pin is not very helpful here.

[Earl Howe (Con)]

I respectfully disagree. It is helpful to dance on the head of a pin if we can distinguish “tobacco” from “tobacco product” and, again, distinguish a tobacco product from a vaping product. The Bill does that.

[Baroness Northover (LD)]

I disagree that we can necessarily distinguish between nicotine and a tobacco product, given that most nicotine products are derived from tobacco and are, therefore, tobacco products. However, the key thing here is that nicotine is being targeted at children, who often then graduate to smoking cigarettes. So you have not only an addiction but a potential route into the problem that we have worked on together for many years: reducing smoking, especially among the young, for all the reasons we know about.

[Lord Patel (CB)]

May I join the argument? The noble Earl is quite right: there is a synthetic nicotine product, which is manufactured chemically. So you can have nicotine that is not a tobacco product. However, as far as we know, most of the nicotine used in vapes is derived from tobacco.

By the way, I want to come back, slightly tongue-in-cheek, on the noble Earl’s question about where it comes from. Of course, I was hoping that he would say, “From tomatoes, potatoes, nightshade and some other plants”, from which you can also get small amounts of nicotine.

Tobacco and Vapes Bill

Baroness Northover Excerpts

Committee stage
Monday 27th October 2025 Grand Committee

[Lord Bichard (CB)]

My Lords, I declare an interest as chair of the National Trading Standards Board. In that capacity, I make one or two points that I made in the Bill Committee and at Second Reading, as they may be helpful in the context of this debate on these early amendments and because trading standards professionals will of course be on the front line in enforcing this legislation. It is therefore important to know whether they are confident about it. By the way, I regret suggestions that trading standards is in some way being ineffective at the moment. It has certainly been starved of resources, but I cannot think of a profession that has found new ways of using its resources more effectively better than trading standards. I once again pay tribute to the work that it does—in no way is it ineffective.

What it currently feels about this Bill is quite interesting. In saying these few words, let me say that I have spoken to the Chartered Trading Standards Institute and it is content with what I am about to say. The first point is that, in a recent survey of all trading standards staff, 80% of professionals supported this Bill and felt that it provides a good balance between the strategy that people have to get off smoking and protecting, in particular, younger people. They believe quite strongly that the provisions in this Bill can be enforced. They feel very positive about what I would call the “one date policy” because it will avoid retailers having to check several dates on ID every year; there will be just one date for them to focus on. It will also avoid—this has not been mentioned yet—people who are currently able to buy cigarettes having that right taken away from them. That is a flashpoint for retailers; I take very seriously the point that has been made about the threat that retailers are working under.

Trading standards also points to the fact that people often say that increased regulation and increased costs cause the illicit market to boom. There is no real evidence for that—certainly not in this country. I am not a smoker, but the cost of cigarettes has increased from £1 for 20 in 1987 to £16 or £17 for 20 in 2025; that has already been mentioned. Yet the market for illegal cigarettes reduced from 15 billion sticks sold to 2 billion sticks sold in the same period; actually, that was from 2000 to 2025. So the impact of regulation and price increases has not, at least in this country, been to increase the illicit market; that market is under control.

The other two points that the professionals make are, first, that they believe that the retail licensing in the Bill will actually improve standards in the retail landscape and, therefore, they support that as well. Where do they have doubts? They want resources, of course; everyone always does. Is the fixed penalty notice a sufficient sanction? Perhaps, but perhaps not; it depends on the circumstances, I think, and it will need to be kept under review.

I am trying to paint a picture here of a group of professionals who are under huge pressure, who have great commitment to their work and who actually support most of the provisions in this Bill.

[Baroness Northover (LD)]

My Lords, most of the amendments here may seem limited in scope but, as we have heard, they have in fact been set down to seek both to delay and to water down this Bill.

This weekend, my daughter and I visited my 24 year-old nephew where he is currently studying. As we walked along, he rolled cigarettes. I mentioned to him that I would be involved in the Tobacco and Vapes Bill today and that the aim was to create a smoke-free generation. He stopped in his tracks, turned to me and said, “Just get this passed now”. He then said, “I never want my son, if I ever have one, ever to take up smoking”. He told me that, several weeks earlier, he had given up vaping. He told me how difficult he found it. He hopes he can keep to it, despite repeatedly seeking to give up both vaping and smoking. He started among his peers in his teens, at the age of 14. He has not managed to kick the habit thus far. No one else in his family smokes. He fully knows the risks. No amount of warning on packets can deter the urge that he has. Try as he might, he just cannot kick the habit.

We know how addictive this is, which is why it is vital to stop the habit starting among the young. My nephew’s desire in his teens to do what all his friends were doing led him to smoking via highly attractive vapes, which is precisely what the industry knows. It is also precisely why this legislation, brought forward after the Khan review and then by former Prime Minister Rishi Sunak, is so visionary. We must deliver this, yet many of these amendments seek to undermine it. The industry is very adept at working on opposition, as has been the case over so many years.

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[Baroness Northover (LD)]

My Lords, I shall speak to Amendments 24 and 25 in this group. They were tabled by the noble Lord, Lord Davies of Brixton, who is unfortunately unwell today; I am speaking at his request.

These amendments would apply mandatory age-verification procedures for the sale of tobacco, vapes and non-medicinal nicotine products across England and Wales. Such provisions are in line with the provisions set out for Scotland in the Bill. Also in this group are the amendments in the names of the noble Lords, Lord Lansley, and the noble Viscount, Lord Hanworth, about which we have just heard. The amendments in the name of the noble Lord, Lord Davies, are, in his view, different.

First, they would apply to all tobacco products and not just vaping devices, as the amendments in the name of the noble Lord, Lord Lansley, would. Secondly, they would require decisive action on the policy to be applied for age verification, rather than an evidence review. The amendments do not prescribe specific methods for age verification; they simply state that age verification would be required.

Since these amendments were tabled and debated in the other place, the Government have announced plans for digital ID cards. This Bill defines “identification” in a broad way to make space for the option of digital ID—it is understood that that option will be used for alcohol sales soon—but it is separate from any kind of mandate on such forms of ID.

The noble Lord, Lord Davies, wishes to point out that the successful implementation of the policy in this Bill will require a consistent, practical and enforceable approach to age verification. In his view, this should be in the Bill. He points out that, in Scotland, there is already legal underpinning to the Challenge 25 policy; the Bill adapts this for the rising age of sale. However, there is no such legal basis in England and Wales. These amendments would remove this inconsistency by extending such an underpinning to England and Wales; he feels that it should also be extended to Northern Ireland, although that is not covered in the amendments currently tabled.

The noble Lord, Lord Davies, is, therefore, seeking to provide across Great Britain consistency, clarity for both retailers and consumers, and protection for retailers who, as other noble Lords mentioned earlier, might be on the front line in implementing the policy and finding the challenges in that. He points out that, if age verification is a legal requirement, retailers can say, “It’s not me. It’s the law”, rather than shouldering the burden of difficult conversations with customers.

The Bill already creates an offence for retailers who sell tobacco to those born in or after 2009. The defence in law is that all reasonable steps were taken to ensure that the law was being followed. The noble Lord, Lord Davies, points out that this does not mean that retailers will be required to ask every customer for ID from 2027 onwards if, as in Scotland, the age of sale is obviously such that they do not need to proceed with an ID. He says that these amendments have the backing of retailers themselves. Polling shows that 83% of retailers in England support mandatory verification for under-25s, rising to 91% in Scotland where it is already law, and it provides them with clarity, protection and reassurance. The noble Lord also says that public support is equally strong, with 72% of adults in Great Britain favouring this approach.

This is not just about future generations; it is also about tackling a current problem. Despite the ban on sales to under-18s, data shows that around half of the young people who vape are buying them in shops. In fact, the noble Lord, Lord Lansley, said that the figure is actually higher than that. The amendment would make it clear to retailers that ID is required for not just tobacco but vapes and non-medicinal nicotine products. The Bill already allows flexibility; regulations can specify a wide range of acceptable forms of identification, including digital ID, as is already being introduced for alcohol sales.

The noble Lord, Lord Davies, is acutely aware that the enforceability of this part of the Bill has been raised. He hopes that his amendments provide a practical solution that is a proportionate measure. Given that he could not be here, it seemed important to me that his amendments were spoken to so that the Minister can address these issues. I look forward to her response and I am sure the noble Lord, Lord Davies, will be very interested as well.

[Lord Bourne of Aberystwyth (Con)]

My Lords, I support the amendments proposed by my noble friend Lord Moylan on having the affirmative resolution procedure for statutory instruments. That seems wholly sensible.

On age verification, I strongly support the amendment proposed by my noble friend Lord Young of Cookham. Dealing with online sales is a real issue. We have the overseas experience of countries such as France, Mexico, Brazil and so on to look at, but this seems a neat solution to what could otherwise become a very real problem.

On the amendment proposed by my noble friend Lord Lansley, considerable work has been done on age gating in relation to vaping sales and, as he said, those who are vaping strongly support having some kind of process. We have the system being developed by IKE Tech in the USA, currently awaiting FDA approval, which provides a very neat and quick method of age verification via a smartphone app. It will enable adults to remain protected—it will take them only 90 seconds for the initial process and six seconds for every subsequent vape, so it will not take long. That seems a very sensible way of proceeding and I am interested to hear what the Minister has to say on that.

In relation to what the noble Viscount, Lord Hanworth, and the noble Baroness, Lady Northover, said about what the noble Lord, Lord Davies of Brixton, would have said, there is certainly an issue to be looked at. I strongly support looking at what has been working in Scotland. It seems sensible to look at what they have been doing, learn from their experience and follow it where appropriate. Again, I will be interested to hear what the Minister has to say on that issue.

--- Later in debate ---

[Baroness Northover (LD)]

My Lords, I will speak to Amendment 199 in my name, which complements Amendment 193, which was so effectively introduced by the noble Lord, Lord Young, and which I have also signed.

Amendment 199 would require the Government to publish and fund a comprehensive communications plan for the smoke-free generation policy. We have referred to the wealth of experience among us when it comes to implementing tobacco control measures: a number of those who are taking part in today’s discussion were involved in the 2007 smoke-free legislation, the subsequent rise in the age of sale and the introduction of plain packaging in 2016. We worked across parties. There are valuable lessons to be learned from how those policies were implemented.

The 2007 campaign for smoke-free indoor public places was, in many ways, the gold standard for large-scale public health communication. Its clear and consistent message—needed, wanted and workable—underpinned every aspect of that campaign. Early identification of those at risk of non-compliance ensured smooth implementation and effective enforcement. Government-led TV adverts made it absolutely clear that it was the Government, not the hospitality sector, who were informing the public of the changes. Venues and public spaces were equipped with the resources, signage and materials that they needed well in advance of implementation. The result was 98% compliance from day one. Public support was strong and the legislation was practically self-enforcing. Even the noble Lords who put what I see as the weakening amendments at the beginning of this debate said how well that had gone.

Crucially, the debate surrounding that policy also raised awareness of the harms of smoking and led to an increase in people’s attempts to seek to quit smoking. That is precisely the outcome we should be aiming for with this legislation. Although the rising age of sale will apply only to those born in or after 2009, this policy presents a significant opportunity to raise the profile of smoking-cessation services and to invite everyone to be part of this smoke-free generation.

I have tabled this amendment to ensure that the Government publish a clear and ambitious communications plan to achieve that. At its heart must be strong public health messaging, which is inclusive, evidence based and backed by a dedicated budget. Next year’s October campaign, which seeks to encourage smokers to stop, should be led by the Department of Health, sending a clear message that every smoker can join a smoke-free future. Now, this annual campaign is led by stakeholders, with little input from the department. This should change.

The communications around the disposable vapes ban were clearly ineffective. That was a Defra policy, but it published guidance only for businesses; there was nothing at all for the healthcare settings that use these products in smoking cessation. The Government will need to do better. I am sure that the Chief Medical Officer is aware of that, not least through his experience of Covid. There are in this Committee various people, not all on the same side, who have a lot of public affairs experience. I would love them to put their minds and experience to this; that would be really worth while.

A well-structured plan would also ensure that retailers are engaged early on, provided with concise materials, signage and briefing materials and supported to play their crucial role in this policy’s success. Engagement should be broad, involving local authorities, trading standards, the NHS and higher and further education. Such proactive collaboration would, as in 2007, reduce the need for enforcement by fostering widespread understanding and voluntary compliance. Obviously, such a communications plan needs robust monitoring, evaluation and engagement. Some noble Lords have already expressed concern about the novel nature of this policy; I hope this proposal demonstrates how the Government can provide reassurance through clarity, transparency and careful planning. The UK has a vibrant creative sector. Let us harness that in an ambitious and effective public information campaign, as happened with the 2007 ban on smoking in public places.

[Baroness in Waiting/Government Whip (Baroness Blake of Leeds) (Lab)]

My Lords, we are running out of time. If we want to finish the group, we will have to finish by 8 pm—otherwise, we will have to break midway through. It is up to noble Lords whether they want to keep their comments to a minimum so that we can finish this group.

Tobacco and Vapes Bill

Baroness Northover Excerpts

2nd reading
Wednesday 23rd April 2025 Lords Chamber

[Baroness Northover (LD)]

My Lords, I too thank the noble Baroness for setting out this Bill so clearly. Most of the provisions were introduced by Rishi Sunak when he was Prime Minister and it is excellent that they are now being taken forward by the current Government. We have a long tradition of cross-party working to reduce tobacco harms and I am delighted to follow the noble Earl, Lord Howe, who has a long history as a committed member of that group, although he is always aware of the variety of views on his own Benches.

When I first came into this House in 2000—I was a health spokesperson and, much later on, deputised for the noble Earl, Lord Howe, in the coalition—there were a number of people who took the industry briefings, sometimes unaware that these were what they were. Front groups, lobby groups, commercial groups led to be anxious when this was not merited, think tanks, and now social media, were all active. They resisted all kinds of tobacco controls that we now take for granted. The ban on smoking in public places, for example, was castigated as being nanny-state, anti-libertarian, about to destroy all sorts of institutions, disproportionate and so on. Many later said that it felt wrong when they encountered smoking in public places in other countries. And so we moved forward, step by step.

Opponents of action dropped in number, almost to a single voice, although I think the opponents have grown in number now. The industry had for so long denied that it knew what Professor Sir Richard Doll proved through research with the cancer registries—that smoking caused cancer and killed.

It is essential to consider public health and how we best protect children from developing an addiction that is likely to blight their life and their health. The noble Baroness mentioned stillbirths, cancer, heart disease and dementia. Passive smoking, too, causes significant harm. Most smokers wish that they had never started. Tobacco kills about two-thirds of its long-term users.

As the Chief Medical Officer points out, the industry first makes addicts of people; then they are trapped and the industry frames “It can’t be taken away” as freedom of choice. Many ingenious arguments are used to combat changes. I was a development Minister and I saw how the industry gave out cigarettes to build new markets in developing countries as they were squeezed elsewhere.

Of course, people will point to challenges—as we have just heard—in the yearly increase in age. If in a few years the age limit is, say, 35, an 18 year-old will not easily pass as that. So we should focus on the main aim and seek ways to help deliver this. As was said the other day by a former Conservative Minister, “Don’t let the perfect be the enemy of the good”. Of course there is push-back; there always is.

Now I come to vaping. If the industry had provided vapes simply as a means to enable people to stop smoking, that would have been fine. But it did not. It made vapes attractive to young people, with flavours and bright covers. It targeted them with nicotine levels that got them hooked. Vapes should never have been sold to those who do not smoke. I have seen this with close young relatives. It is cool to use vapes. You see this on the bus, at the school gates, everywhere. We have a difficult balance here of allowing vapes as smoking cessation but doing our best to prevent the take-up among children.

I welcome the Government’s proposals that branding on vapes that might appeal to children should be banned, that free vapes should never be handed out to children, and that vape contents and flavours should be controlled and displays regulated. We have to do our best to ensure that the Bill is as watertight as possible, given the industry’s inventiveness. I understand why the Government have sought flexibility, given the history of foot-dragging in every instance of tobacco control. I understand their frustration.

I am glad that the Government wish to extend smoke-free arrangements in public places. Working cross-party, we had secured in the pandemic that pubs and restaurants should be smoke-free outside, as they were inside, but the industry was effective at pushing back on that—not through the Department of Health, but through the local government department. I hope we can make further progress here.

There is no doubt now about the harm that tobacco causes to users and those around them. We know the cost to the NHS and the economy. We know that most smokers wish that they had never started. I therefore strongly support this Second Reading.

Smoking: Public Places

Baroness Northover Excerpts

Tuesday 3rd September 2024 Lords Chamber

[Lord Geddes (Con)]

My Lords—

[Baroness Northover (LD)]

My Lords—

[Lord Hayward (Con)]

My Lords—

--- Later in debate ---

[Baroness Northover (LD)]

My Lords, I urge the Government—it sounds like the door is open—to resist the siren voices which so often have accompanied efforts to protect the public from tobacco smoke, including the theoretical risk to pubs, as we have just heard. It is a joy to be in public places which are now smoke-free. Does the Minister agree that, now that restaurants and pubs have pavement licences, those areas too should, like the interiors, be smoke-free?

[Baroness Merron (Lab)]

I am glad that the noble Baroness welcomes the direction of travel. As regards the specifics that she seeks, those will be forthcoming in the very near future. However, it is important to remind ourselves that the tobacco industry, for example, was very vociferous in its opposition to indoor smoke-free legislation and argued that it would be disastrous for hospitality, but, as I mentioned, it had almost no impact, and in some sectors it had a positive impact. As my noble friend said earlier, the response of the public, the way they approach this matter and their understanding are also crucial.

Health and Care Bill

Baroness Northover Excerpts

Lords Hansard - Part 2 & Report stage
Thursday 3rd March 2022 Lords Chamber

[Lord Hunt of Kings Heath (Lab)]

My Lords, it is a great honour for my two amendments to be grouped with that in the names of the noble Lords, Lord Alton and Lord Blencathra. As the noble Lord has discussed the supply chain, I should declare my interest as president of the Health Care Supply Association, although I am not speaking on its behalf when it comes to my strongly supporting his amendment, which sets the context for my own two amendments.

We debated this issue very fully in Committee. I think that the House believes strongly that the commercial exploitation of body parts in all forms is unethical and unsavoury. When it is combined with mass killing by an authoritarian state, we cannot stand by and do nothing. In 2019, the China Tribunal, led by Sir Geoffrey Nice QC, stated:

“The Tribunal’s members are certain—unanimously, and sure beyond reasonable doubt—that in China forced organ harvesting from prisoners of conscience has been practiced for a substantial period of time involving a very substantial number of victims.”


In June this year, 12 UN special procedure experts raised the issue of forced organ harvesting with the Chinese Government in response to credible information that Falun Gong practitioners, Uighurs, Tibetans, Muslims and Christians had been killed for their organs in China.

Currently, human tissue legislation covers organ transplantation within the UK, where we have a very ethical approach, but it does not cover British citizens travelling abroad for transplants, and British taxpayers’ money will pay for anti-rejection medication regardless of where the organ was sourced or whether it was forcibly harvested from prisoners of conscience.

I shall not repeat all that I said in Committee, but I have had a helpful meeting with Ministers for which I thank them. In that meeting and in subsequent meetings, the Minister was concerned that my amendment in relation to organ tourism would penalise vulnerable people seeking to pay for a transplant. I have thought about that carefully, but, in the end—and the noble Baroness, Lady Kennedy, expressed so well why this Bill is highly appropriate for these kind of amendments—we have to draw a line in the sand. That is particularly so today, in the horrific circumstances that we meet. We have to draw a line in the sand and send out a powerful message globally that we will not support these abhorrent practices in any way.

My Amendment 162 comes later, but I shall seek the opinion of the House at that time.

[Baroness Northover (LD)]

The noble Lord, Lord Hunt, has very effectively introduced the amendments to which I have put my name, Amendments 162 and 173, and I wish briefly to express the support of these Benches for those. We also support Amendment 108, to which my noble friend Lady Brinton has put her name.

As noble Lords know, we have been inching forward on these matters with Ministers, and I welcome that forward movement. I note, however, recent warnings from Ministers that, for example, there are “opportunity costs” in implementing these measures, as ensuring that proper standards are enforced requires effort and potential cost. I understand that. Nevertheless, we cannot allow ourselves to become complicit in any way in organ tourism where the source of those organs is forced or where selling the organ is to address appalling poverty.

Some say that this trade may be declining in and from China. If so, that is welcome and might reflect international pressure, not least on the Chinese medical profession. It is not clear that those involved in the China Tribunal and the Uyghur Tribunal would agree that it is declining.

Even if we were to accept that, and Ministers seemed to indicate that they thought that might be the case, we are also hearing now of an increase in the selling of organs in Afghanistan because of the dire situation there. There have been recent reports of journalists seeing the scars of those who have sold their kidneys. That is a terrible indictment of our walking away from Afghanistan and failing to address the appalling conditions that we have left there. How can we regard such potential “donors” as being anything other than the most extremely vulnerable? How can you put that up against the vulnerable who may need to have donations?

As for the bodies exhibitions, we have discussed before how distasteful they are—but then we realise with horror exactly where these bodies seem to have been sourced: among other things, from Chinese prisons. We should never have condoned that, turning a blind eye. I agree with the noble Baroness, Lady Thornton, who argued in Committee that they should simply be banned. There is no reason whatever to agree to their continuation.

I now hear that the Government may argue—and this is incredibly familiar—that these amendments are flawed. As the noble Earl knows, often Ministers are given briefs that say, “This is a flawed amendment, so turn it back.” I am very familiar with them. In those circumstances, the best thing is for your Lordships to pass these amendments, because Ministers know, or should know, that the essence is extremely clear, and with government lawyers we can work out how best to sort out any unintended consequences. I hope that I do not hear anything about these amendments being flawed—and I say that to the Box. I therefore commend them to your Lordships.

[Baroness Finlay of Llandaff (CB)]

My Lords, I support all the amendments in this group, and I shall speak specifically and briefly to Amendments 162 and 173.

These amendments are updates to the Human Tissue Act, which was born out of public outrage following the Alder Hey scandal, when over 100,000 organs, body parts and entire bodies of foetuses and stillborn babies were stored in NHS facilities. The body parts of dead patients, including children, were removed without consent. Today, the Human Tissue Authority’s guiding principles, as set out in its code of practice, are consent, dignity, quality, honesty and openness. These principles should not only reflect how human tissue sourced from within our own nation is treated, we must treat human tissue and organs with the same principles when sourced overseas.

In China, as has been said, there is substantial evidence of Falun Gong practitioners and Uighurs—as well as some evidence of Tibetans and house Christians—being killed on demand for their organs. Blood is taken off them for tissue-typing at the time when they were taken into custody, often with no idea why they were taken into custody at all, other than that they belong to one of those groups. There is no consent, no dignity and no transparency.

On 7 December last year, the British Medical Association released a statement on the abuse of Uighurs in China, expressing

“grave concern regarding the situation in China and the continuing abuse of the Uyghur population of the country as well as other minorities.”

It went on to state:

“We are particularly alarmed by the reports of organ harvesting, forced birth prevention, and the use of genomics data for racial profiling.”


It urged

“the UK government and international actors to exert pressure on the Chinese government to cease its inhumane actions towards the Uyghurs”.

If we do not pass amendments as laid before the House today, we will be complicit with these practices, because we will be looking at them with Nelson’s eye, with all the evidence that we have that they are going on.

On Amendment 173, on the exhibition of whole bodies using a plastinated technique, I suggest that there is no transparency whatever. Any attempt to claim that there has been consent is extremely suspect, because consent is very easily falsified. I went to one of these exhibitions because I thought you ought to go and see what you are criticising. This was not an anatomical, educational experience but a visual display of plastinated bodies in all kinds of different poses. But the one that horrified me the most was a pregnant woman, quite advanced in her pregnancy and with the foetus in her womb, which had been plastinated. I do not believe that that woman would have given consent for plastination. That raised real questions as to why such an advanced foetus was in the womb of a dead woman without something there explaining the nature of her death, the cause of death and the circumstances in which she had decided to consent to such a procedure.

Health and Care Bill

Baroness Northover Excerpts

Lords Hansard - Part 1 & Committee stage
Monday 31st January 2022 Lords Chamber

[Lord Hunt of Kings Heath (Lab)]

My Lords, I hope that I do not slow us down again after the provocative words of the noble Baroness, Lady Chisholm, but I am going to talk about access to dental treatment and fluoridation. Although the House is somewhat empty, I expect that as the debate goes on it might fill up a little.

We had an Oral Question this afternoon about dentistry, and I do not want to repeat everything that was said then. I have enjoyed debating dental issues with the Minister, the noble Earl, Lord Howe, for many years. He will know that there is widespread concern about the lack of access to dentistry. At Oral Questions the Minister, the noble Lord, Lord Kamall, referred to the £50 million that had been provided, but I am afraid that the 350,000 treatments that it will pay for are a drop in the ocean compared with the 38 million patient treatments that have been lost as a result of the pandemic.

Many people are finding accessing dentistry almost impossible at the moment. The Minister referred earlier today to people being able to use the access centres, and to the 111 service, but I am afraid that it has broken down in many parts of the country. One is led to the conclusion that dentistry issues are not a priority. Many adults and children are suffering in pain because of their lack of access. The Government must focus on this and develop a proper strategy. I pay tribute to Healthwatch for its work in this area—it has had a lot of interest from members of the public—and to the BDA for its briefings.

Treatment is one thing, prevention is another. Here, I must remind the Committee of my presidency of the British Fluoridation Society. This brings me to effective preventive measures. I welcome Clauses 147 and 148. Unfortunately, the noble Lord, Lord Scriven, is not here to hear me say this, but essentially, giving this responsibility to local authorities has proved to be a failure. Not one local fluoridation scheme has gone through under the auspices of local authority leadership, and we must conclude that leaving it to local authorities is likely to mean that we will not see fluoridation developed in any part of the country.

So this is a national issue and it is right that the Secretary State should take over responsibility; it is also right to acknowledge that, in September last year, the four Chief Medical Officers stated:

“As with all things in medicine and public health there is a balance of risk and benefit.”


We have certainly learned that in the last two years. As they said:

“There is unquestionably an issue with tooth decay in the UK and an entrenched inequality which needs to be addressed. Fluoridation of water can reduce this common problem … On balance, there is strong scientific evidence that water fluoridation is an effective public health intervention for reducing the prevalence of tooth decay and improving dental health equality across the UK. It should be seen as a complementary strategy, not a substitute for other effective methods of increasing fluoride use.”


I think that is a very wise assessment of the situation. The effectiveness of fluoridation of water supplies to improve oral health has been evident for many decades. Some communities such as my own—Birmingham—have taken advantage and, as a result, we generally enjoy good overall oral health, but progress in spreading these benefits has been very slow. The transfer to local government, I am afraid, did not work.

So I strongly support the thrust of these clauses; in fact, they are the two most welcome clauses in the whole Bill. The question, however, is whether they will bite, and this is what lies behind my amendments. Amendment 260 concerns the consultation process. I do not think I have got the wording in quite the right place—frankly, trying to find my way through the Water Act and changes to it over the last 20 years or so proved beyond me—but the intent is to ask: if there is to be consultation about schemes, please can we move away from the local consultations that have to be gone through at the moment? They are an absolute nightmare. They bring out opposition from national bodies that causes mayhem in the locality.

The issue is not the practicalities of the scheme but about going back over the principle. The very fact that the Government have brought these clauses has decided the principle of the benefit of fluoridation. If there is to be a consultation, for goodness’ sake, let us have just one instead of the myriad local consultations that have obviously got in the way of progress in the past.

My Amendment 261 is part probing. Currently, the Bill gives the Secretary State power to make regulations to require a public body to meet the costs to the Secretary of State in relation to fluoridation schemes. I would be interested to hear from the Minister the reasons and circumstances under which they would be used. My concern would be that asking too hard a subvention of local bodies might inhibit the progress of fluoridation schemes. Amendment 262 requires the Secretary of State to ensure that a programme for implementing water fluoridation schemes is established within 12 months of the Bill being passed. I would like to see a report every three years, laid before Parliament by the Secretary of State, on the progress made in implementing new water fluoridation schemes. The basic purpose would be to ensure that the Government get on with this, establishing more schemes and spreading the benefits across the entire community as soon as possible. I beg to move, and hope that I have met the noble Baroness’s test.

[Baroness Northover (LD)]

My Lords, I will speak in support of Amendments 260, 261 and 262 in the name of the noble Lord, Lord Hunt, on water fluoridation.

The NHS rightly prides itself on being evidence-based. Nevertheless, when Ara Darzi became health Minister, he was concerned that, in a number of areas such as the treatment of diabetes, there was not a full assessment of regular outcomes, as opposed to the fantastic clinical trials on new treatments for specific diseases. Hence, he introduced his atlas of outcomes. It showed, for example, absolutely unacceptable different outcomes for diabetes if you lived in Cornwall—where you were more likely to lose a leg—compared with Essex. There were serious lessons to be drawn from that, which needed to be applied in other areas, too.

Health and Care Bill

Baroness Northover Excerpts

Lords Hansard - Part 2 & Committee stage
Thursday 13th January 2022 Lords Chamber

[Lord Stevens of Birmingham (CB)]

My Lords, it is a great privilege to follow the noble Baroness, Lady Hayman, and support all the amendments in this group in her name. I speak particularly to Amendments 201 and 210 which, as she said, refer specifically to using the purchasing power of the NHS to drive this agenda. Given how brilliantly she has set out the case, I shall be extremely concise.

There are two evidence-based reasons why these amendments are important. The first, as the noble Baroness said, is because the health consequences of the environmental crisis are increasingly clear. The Royal Society and the Academy of Medical Sciences laid all of those out. Whether on heat-related deaths, the disruption to care through climate emergencies, the increased risk of vector-borne infectious diseases, or the fact that up to a third of preventable asthma cases may be linked to the consequences of air pollution, the health case for action is clear. The second evidence-based reason, again as we have just heard, is that unfortunately healthcare itself is not blameless. It is part of the problem as well as part of a solution. By one estimate, if all the health systems in the world were their own country, they would be the fifth-largest greenhouse gas emitter on the planet. Therefore, the NHS must get its act together, given that it contributes 4% to 5% of our country’s emissions.

Those are the two evidence-based reasons. The NHS has stepped up in the way that the noble Baroness has set out. An expert panel led by the brilliant Dr Nick Watts made it the first health service in the world to charter a practical blueprint to net zero, but to do that, we must recognise that only about 28% of the carbon footprint of the NHS arises directly from care being provided. Another 10 percentage points are associated with travel on the part of patients, staff and visitors, but 62% of the carbon footprint arises from the supply chain—the medicines, the devices, the anaesthetic gases, the asthma inhalers, that the NHS uses, which it procures from 80,000-plus suppliers.

I am grateful to the noble Lord, Lord Prior of Brampton, and the noble Baronesses, Lady Young of Old Scone and Lady Hayman, for their support of my Amendments 201 and 210. Their purpose is simply to harness the £150 billion of purchasing power that will flow through either the new NHS payment system or the procurement rules to achieve the two evidence-based rationales that we have been discussing.

[Baroness Northover (LD)]

My Lords, this is my first foray into this Bill. I have a sense of déjà vu, having deputised for the noble Earl, Lord Howe, on the 2012 Bill. Despite our absolute confidence at the time, it seems that some things need to be tweaked and rectified, though I now find myself on this side and the noble Earl on the other.

From these Benches, I support these amendments. The noble Baroness, Lady Hayman, put it very effectively. Climate change needs to run through to the very foundations of the Bill, as does addressing the health inequalities which were the subject of the previous debate. We have had such a long-standing debate about them over the years.

As the noble Baroness has said, at the moment, the UK is taking the lead internationally on combatting climate change through COP 26 and in the year after. We have been urging the world to take urgent, deep-rooted action if the enormously damaging effects of climate change are to be tackled and reversed. We know that the poorest will be hardest hit and can already see that effect, but no part of the globe will be spared. We can already see this as well.

As the noble Lord, Lord Stevens, said, we also know the effects on human health worldwide. We can see them already in developed countries: we saw the effect of that heat dome in Canada and the deaths that resulted from it. We know that climate change might have played a part in seeding the pandemic from which we have suffered during the last two years. We know all that. We also know that we cannot lead internationally without addressing climate change nationally. I pay tribute to the staff supporting Peers for the Planet, a group of which I am a member, for making sure that we address climate change at every stage, in every Bill.

We are rightly proud of the NHS. It is the major employer in the United Kingdom. The health and social care of our ageing population will play an ever more important role in our lives. It is therefore right that, in the Bill, as in every other area of life, tackling climate change must run as a thread through all we do. The Climate Change Committee makes this clear. It is not something for only Defra or the COP team. It requires fundamental change in everything we do and the scrutiny of every area of life.

The NHS has already made strides forward. Here, I pay tribute to the noble Lord, Lord Stevens, in making sure that that was the case. At COP 26, the NHS made a commitment to net zero. As we have heard, 14 other countries followed the NHS’s lead. More than 50 countries, representing more than a third of global healthcare emissions, have committed to developing sustainable, low-carbon health systems. This is incredibly encouraging. It is also encouraging that, at COP 26, a new international platform was set up—to be hosted in partnership with NHS England and the WHO—to bring together those in the healthcare systems, so that people can learn from each other.

Why does this matter? As the noble Baroness, Lady Hayman, has said, the healthcare sector is responsible for almost 5% of global emissions. Of course, public health is assisted by tackling climate change. Although we pay tribute to what the NHS has managed to do so far—and it is ahead of its requirements under the Climate Change Act—we need to make sure that this is built in and sustained for the future. This is what these amendments are about. Progress is being made, but we need to ensure that it is locked in and does not necessarily depend simply on who is leading these organisations at any particular time.

The noble Baroness, Lady Hayman, has explained how her first amendment affects the overarching structure within NHS England. The other amendments put in place the necessary pragmatic steps to make sure that this is addressed. Thus, we have identified individuals for these particular responsibilities. This is obviously of key importance.

It is fundamental that, in addressing climate change, we do not just see this as hosting a major meeting or siloed in one department—whether Defra or BEIS. I am a member of the Select Committee on the Environment and Climate Change. When our committee asked the different departments to report on what they were doing in advance of COP what came back to us, in many regards, was a kind of surprise that they were relevant to it. They felt that it was something for Defra, for BEIS in particular, or for the COP unit. They did not see it as their responsibility. Some of the responses were superficial in the extreme. That is why it is important to make sure that we mainstream this issue, and this is another opportunity to do so. I strongly support the amendments that the noble Baroness, Lady Hayman, and others have tabled.

[Baroness Bennett of Manor Castle (GP)]

My Lords, it may not surprise your Lordships’ House that as a Green Peer, I rise to offer my full support to all these amendments. I also declare my involvement with Peers for the Planet.

In introducing this group so comprehensively and, I would say, brilliantly, the noble Baroness, Lady Hayman, said it was just important as the group that we were discussing previously, which addressed inequalities in issues such as smoking and alcohol and their impacts on health. I would actually go further and say that the two groups are intimately related, in that when someone arrives at the NHS needing treatment for an illness or a disease, at a point where their environment and society, often, has failed and has created or amplified that disease, the NHS then has to deal with the problems created by society and that environment. We need a systems-thinking approach to health—not just “Here’s a disease” or “Here’s a limb or an organ with a problem” —that considers the whole person. I say in passing that I regret that I was not able to take part in that earlier group due to my being unable to be here at the start.

I am not going to run through all the amendments, which have been very well covered, but they go all the way from the duty of the NHS to have regard to climate and the environment, right down to the detail of procurement. I particularly commend the noble Lord, Lord Stevens. We would like to see the Government take control of procurement more broadly to improve our society. The Preston model comes to mind here.

I want to address the climate side of this issue, and then I am mostly going to talk about the environmental side, which has not been discussed much yet; I want to add something different rather than repeat. However, I have to highlight the fact that we are talking about 5% of UK climate emissions and 40% of public service emissions.

We really have to think about the interrelationship of environment and health. We know that heatwaves have huge impacts, particularly on the health of older people. They can be a significant cause of death among older people, and as long as the NHS contributes to climate change, there is a disastrous cycle there. Also, some 10% of London hospitals are at risk of river flooding. I have not been able to find figures for the country as a whole, but I am sure that will be true for many other hospitals too.

While preparing for today’s debate, I looked at the Medicines and Medical Devices Act, which we debated last year. It is a little unfortunate that, as I look around the Chamber today, practically no one is present who attended those debates. That Act was a huge missed opportunity. It requires that when the appropriate authorities are approving veterinary medicines, they must have regard to their environmental impacts. I moved an amendment—but lost the vote—that would have applied the same judgment to human medicines. This point applies particularly to antibiotic resistance. I am not going to repeat everything I said in Committee on 26 October, but it is all there. The management of antibiotic resistance is a huge issue that the NHS needs to do a great deal more on, as do all global health systems.

I want to focus on some other aspects of the environmental impacts of the NHS today, particularly in light of the report by the Environmental Audit Committee in the other place on the state of our rivers. The Bloomberg Green newsletter going around the world today has the following headline:

“English Rivers Join Europe’s Most Noxious with Chemical Cocktail”.


That report notes, as have many others, that:

“No river … received a clean bill of health for chemical contamination.”

--- Later in debate ---

[The Parliamentary Under Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)]

I thank the noble Lord, Lord Stevens, for the amendments and the noble Baroness, Lady Hayman, for her opening remarks. I also thank the noble Baroness for her suggestion yesterday that it might make my life a lot easier if I just accepted amendments. I understand that advice, having just gone through a two-hour debate on the previous group.

A number of noble Lords referred to how these amendments relate to our previous debate on inequalities. I point out that that is sometimes not quite in the way that we would expect. We might think there is a direct connection, but sometimes the green agenda can be seen to be for those who can afford it—as I explained before, for the white, middle-class, patronising people who tell immigrant working-class communities what to do and push up their costs. Anti-car policies push up costs for those in rural areas, and there are higher fuel costs as we replace gas boilers with potentially more expensive heat pumps. We have to be aware of those issues. In the long term, I am optimistic. I look forward to the day when we have solar power and wind power, with storage capacity, which will reduce costs.

[Baroness Northover (LD)]

Will the Minister look at this globally and recognise that the poorest are affected the worst? When he talks about those in poverty, he should think globally.

[Lord Kamall (Con)]

I accept that point, but I also accept that, sometimes, one can be patronised, and I do not accept being patronised as I was in the earlier debate. One day, there will be cheaper fuel, and we can look forward to it, but we have to make sure that the transition along the way is not seen to push up costs for working people, because we all feel passionately about this green agenda.

Organ Tourism and Cadavers on Display Bill [HL]

Baroness Northover Excerpts

2nd reading
Friday 16th July 2021 Lords Chamber

[Baroness Northover (LD)]

My Lords, I too commend the noble Lord, Lord Hunt of Kings Heath, for his pursuit of these issues. He has introduced his Bill brilliantly, as ever, cogently and comprehensively. It is a real privilege to follow him and such leading medical practitioners as the noble Lord, Lord Ribeiro, and the noble Baroness, Lady Finlay.

I had long been appalled by the body exhibitions, which just seemed macabre, but as with many it never occurred to me that the bodies might not have been willingly donated for that purpose, as for medical science. It is appalling to think that these were likely to have been the bodies of Chinese prisoners, and absolutely sickening that money was made from them and that visitors to exhibitions unwittingly colluded. This Bill would put an end to that in the UK, as it has been ended elsewhere.

The Bill also addresses organ harvesting. In this case, often desperate people may travel abroad to undergo organ transplants without thinking or knowing of where these organs are sourced. I recall with shock one current Minister who, clearly out of lack of knowledge, praised China for the number and speed of its organ transplants. Given her strong personal faith, had she known then that praise would never have been expressed. We now know so much more: that beyond reasonable doubt, organs have been forcibly extracted from prisoners and others in China, killing the victim in the process. The harvested organs are sold for transplantation.

The China Tribunal, chaired by Sir Geoffrey Nice, released its full report in March 2020 and the judgment concluded that forced organ harvesting had been committed for years throughout China on a significant scale, and that Falun Gong practitioners were probably the main source of organ supply. It also concluded that, in relation to the Uighurs, there was evidence of medical testing on a scale that could allow them, among other uses, to become an “organ bank”. It concluded:

“Commission of Crimes Against Humanity against the Falun Gong and Uyghurs has been proved beyond reasonable doubt”.


As the noble Lord, Lord Hunt, mentioned, UN human rights experts have called on China to respond to the allegations of organ harvesting and to allow independent monitoring by international human rights mechanisms. That has not happened. Sir Geoffrey Nice is now chairing the Uighur tribunal and we await its conclusions with huge concern. In June this year, during the first set of hearings, further evidence of forced organ harvesting from Uighur victims has already been heard. This is a horrific crime and the treatment of the Uighurs has been classed by the US, for example, as genocide. The Bill takes actions to make sure that we are not complicit in these crimes.

I noted the very welcome support of the noble Baroness, Lady Penn, for action in this regard during the passage of the medical devices Bill. Things were moved forward, and I thank her and the Government for that. We are all therefore agreed, and I urge the Government to accept the Bill, work with the noble Lord, Lord Hunt, on any changes needed to make it as effective as possible and make sure it goes on to the statute book with immediate effect. We surely owe that to the victims of such appalling exploitation.

Medicines and Medical Devices Bill

Baroness Northover Excerpts

Report stage & Report stage (Hansard): House of Lords & Report: 1st sitting & Report: 1st sitting: House of Lords
Tuesday 12th January 2021 Lords Chamber

Today, we welcome wholeheartedly what the Government have done and the very important signals that are now being sent to the rest of the world. Like other noble Lords, I thank all those involved most sincerely.

[Baroness Northover (LD) [V]]

My Lords, praise will be ringing in Ministers’ ears from the first group of amendments, concerning the patient commissioner, in the name of the noble Baroness, Lady Cumberlege. There is praise again for listening on this issue.

The noble Baroness, Lady Penn, had the task, in the first instance, of rebutting the original amendment. I, for one, asked her to read the China Tribunal report to get a strong sense of the horrendous problem that was part of the context for this amendment. You could see that she was listening, and subsequent engagement has been very useful, as the noble Baroness, Lady Finlay and the noble Lord, Lord Hunt, have said. I am glad that the ministerial team has responded. It comes on the day that the Foreign Secretary has made a Statement in the Commons that focuses on human violations against the Uighurs.

I pay tribute to the noble Lord, Lord Hunt, for consistently, and with great political skill, taking forward this issue, as he has done on the scandal of the “Real Bodies” exhibitions. I also pay tribute to the others who have worked in this area, including the noble Baroness, Lady Finlay, and the noble Lords, Lord Ribeiro and Lord Alton. This is a terrible problem and one that it would be easy to turn away from, but those noble Lords simply do not do so.

We need to make further progress across this area, and I am sure this will be taken forward. Forced organ harvesting, which according to the China Tribunal has happened on a mass scale in China, is a horrific crime. Organs are removed from living victims by doctors in state-run hospitals for transplantation, inevitably killing the victim in the process.

As the noble Lord, Lord Hunt, said, the China Tribunal concluded that many victims were Falun Gong practitioners. A brutal and systematic crackdown on Falun Gong was initiated in 1999, with the Chinese leadership ordering their eradication. Many disappeared without trace, which was when China’s organ transplant trade rapidly increased. As we now recognise, in recent years there has been a similar crackdown on the ethnic-minority Uighurs. They have been put into re-education camps and have endured forced labour, brainwashing, rape and torture. The China Tribunal stated:

“In regard to the Uyghurs, the Tribunal had evidence of medical testing on a scale that could allow them, amongst other uses, to become an ‘organ bank’.”


Our amendment aims to ensure that no human tissue or cells that have been sourced from victims of organ harvesting can be used in human medicines or enter the UK medical supply chain. This is the first time the United Kingdom Government will enact legislation in this area, and we must hope that it sends a strong and clear message internationally. Thus far, as the noble Lord, Lord Hunt, said, it is enabling, but the Government will know that many will be monitoring this area. We need to see those regulations in place.

I note the weakness of the HTA assessment of the “Real Bodies” exhibition, on which I am sure the noble Lord, Lord Alton, will expand, and its acceptance of what it was told, seemingly at face value. The noble Baroness, Lady Finlay, also, rightly, pointed to this. The amendment that we are agreeing today will help move things forward. I am grateful to the Government and their lawyers for working on this, although, clearly, we will all need to be vigilant and there is still much to do.

[Lord Ribeiro (Con) [V]]

My Lords, like the noble Lords who have spoken before me, I thank the Minister and the Government for accepting our amendment. I believe it sends a powerful message, not only to China but to other countries such as Pakistan and India, to which I referred in my speech of 28 October in Committee. In discussion with the Foreign Office, through the noble Lord, Lord Ahmad, we were reassured that the diplomatic strategy would be to continue lobbying as many countries as possible on the issue of human rights and the immoral practice of forced organ harvesting. With the noble Baroness, Lady Finlay, we undertook to raise awareness with the British Medical Association and the surgical royal colleges.

It is worth noting the World Health Organization’s Guiding Principles on Human Cell, Tissue and Organ Transplantation. Any programme such as the kidney pairing exchange, which makes it possible to utilise kidneys that are biologically incompatible between patients and their genetically or emotionally related donors, must follow and respect the WHO’s Guiding Principles of practice, particularly principles 3 and 5, which are worth quoting.

Principle 3 says:

“Live donations are acceptable when the donor’s informed and voluntary consent is obtained, when professional care of donors is ensured and follow-up is well organized, and when selection criteria for donors are scrupulously applied and monitored. Live donors should be informed of the probable risks, benefits and consequences of donation in a complete and understandable fashion; they should be legally competent and capable of weighing the information; and they should be acting willingly, free of any undue influence or coercion.”


Principle 5 states:

“Cells, tissues and organs should only be donated freely, without any monetary payment or other reward of monetary value. Purchasing, or offering to purchase, cells, tissues or organs for transplantation, or their sale by living persons or by the next of kin for deceased persons, should be banned.”


In 2017, the World Health Assembly supported a concept of financial neutrality to protect vulnerable people from being exploited. That is the essence of what this amendment achieves, and I am grateful to the Government and to the noble Lord, Lord Bethell, and the noble Baroness, Lady Penn, for endorsing it. I hope that they will maintain their pressure on the WHO to end these practices.

Medicines and Medical Devices Bill

Baroness Northover Excerpts

Committee stage & Committee: 3rd sitting (Hansard) & Committee: 3rd sitting (Hansard): House of Lords
Wednesday 28th October 2020 Grand Committee

[Lord Sheikh (Con) [V]]

My Lords, I fully support Amendment 24. The issue of organ harvesting was raised in the other place and at Second Reading by me and other noble Lords. The ability to use human tissue in medicines and transplants saves many lives and is a great achievement of modern science. However, we need to make sure that the way human tissue is obtained and used is completely ethical. At the moment, we do not have legislation that properly stops organs that have been obtained forcibly or without proper consent from entering the UK. That is completely unacceptable.

We should be greatly concerned about the treatment of Muslim Uighurs and Falun Gong in China. The detention and persecution of these innocent people is a crime against humanity. Millions are suffering in inhumane conditions. They are tortured and a great many have been murdered. Last year, the China Tribunal, chaired by Sir Geoffrey Nice QC, concluded that forced organ harvesting in China had been practised for a substantial time, involving a substantial number of victims. The tribunal also found that Muslim Uighurs were used as an organ bank.

The British Medical Journal found that 99% of studies that looked at organ transplants in China did not report whether the organs used were donated with consent. This is unacceptable and a disturbing violation of human rights. It is also illegal. Furthermore, The Economics of Organ Harvesting in China report found that large profits had been made from organ harvesting.

I appreciate that although the companies, including British ones, may not be directly involved with organ harvesting, they could be part of a wider system that provides devices, drugs, materials and know-how for transplantation. Sir Geoffrey Nice QC also stated that anyone interacting with the People’s Republic of China was interacting with a criminal state. If we do not have proper checks on human tissue entering the UK, we risk being complicit in this crime.

Organ harvesting is not limited to China. There are gangs and traffickers all over the world that exploit vulnerable people to obtain organs without any proper aftercare. This coercion is also illegal and must be stopped. Through this amendment we can prevent this happening and close the gaps in our existing legislation. For instance, the Human Tissue Act 2004 has strict consent and documentation requirements for tissue in the UK, but does not enforce the same standards for imported tissue. Instead, it advises only that the same standards should be applied. Although the human tissue regulations 2007 ensure that there is proper documentation and tracking from donor to recipient, they request details on how consent was obtained and look into whether the donation was voluntary or unpaid or not with consent at all. This means that there is no legislation against importing organs that have been obtained involuntarily and without consent.

We must accept this amendment so we can make better regulations that uphold human rights and values. By including the ability to make provisions about the origin and treatment of human tissue used in developing and manufacturing medicines, this amendment means that we can make regulations if there are any concerns as to whether consent has been given. This amendment would require that informed, unforced and properly documented consent must be given for all tissue entering the United Kingdom. At present we do not have appropriate safeguards against forced organ harvesting or human tissue. Innocent people are tortured and killed while businesses and some Governments have made a profit.

This amendment is an opportunity to take a proper stand against organ harvesting and to have a statutory commitment. Through this amendment we can ensure that all human tissue imports are ethical. During Second Reading, my noble friend Lord Bethell stated that the idea that any British companies profit from these trades is abhorrent. This is an abhorrent practice. We must put a stop to it and therefore we need to pass this amendment. I emphasise that it is our moral duty to do so.

[Baroness Northover (LD) [V]]

I am very pleased to have added my name to Amendment 24. The noble Lord, Lord Hunt of Kings Heath, is to be commended for his determination on this issue. Given his previous service as a Health Minister as well as his career-long engagement at different levels of the NHS, no one can say that he does not have a good grasp of all the implications of his amendments. As he made clear, this amendment gives the power to the Government to take action in this area. It closes a gap between what is expected in terms of the origins and uses of human tissue in the UK and that which may be brought in from overseas.

As we have heard, the Human Bodies exhibitions were able to slip through this gap. It cannot be said that no problem can be envisaged. The noble Lord, Lord Alton, laid out the potentially horrendous origins of those bodies. Like the noble Lord, Lord Hunt, the noble Lord, Lord Alton, has been determined and assiduous in pursuing such cases and he is remarkable in his ability to never pass by on the other side. He made a powerful and passionate contribution here as usual.

--- Later in debate ---

[The Deputy Chairman of Committees (Lord Lexden) (Con)]

My Lords, I have received a request to speak after the Minister from the noble Baroness, Lady Northover, whom I now call.

[Baroness Northover (LD) [V]]

Can the Minister tell me whether she has read the China Tribunal report in preparation for this amendment, as I asked when I was speaking to it? If she has not, will she agree to do so before Report, especially to help inform her since she may come forward with her own amendment, as I hope she is indicating?

[Baroness Penn (Con)]

My apologies to the noble Baroness, Lady Northover. I have read the findings of the report and will agree to read the full report ahead of any further meetings that we have.