Tobacco and Vapes Bill

Lord Scriven Excerpts

Committee stage
Thursday 30th October 2025 Grand Committee

[Baroness Fox of Buckley (Non-Afl)]

My Lords, I stand with some trepidation on this one, but I will give it a go. I have some reservations about this series of amendments. On Amendment 12, I have a lot of sympathy with having more transparency as a general principle, but I ask the noble Baronesses, Lady Northover and Lady Walmsley, how we would deal with having a dangerous precedent on the commercial confidentiality and sensitivities, for any company, and what can and cannot be revealed. Asking for information is one thing; mandating it is a whole different ball game. Many companies hold data close to themselves, as they are allowed to, because they are private entities. It is a legal thing to do and there are reasons, beyond malevolent ones, why that might occur.

I am particularly concerned about Amendments 192 and 194. As the noble Earl, Lord Russell, noted, tobacco companies already pay, or are responsible for, substantial duties that are collected. I am not sure that I entirely agree with the “polluter pays” principle—or, at least, it is quite complicated. It sounds virtuous, and in some instances I might well support it, but when I was reading these amendments I kept thinking, perhaps because of my left-wing, Marxist background, “Oh my God, this is a new form of legal wealth distribution by force”. It felt to me as though we were saying: “Forget economic growth. We’re just going take more from legal companies, but it’s all right because they are evil companies”.

In the words that the noble Earl, Lord Russell, used about his more specific amendments on what the money should be used for, if I may put it that way, I recognised an argument that I came across from Cancer Research. It has been very helpful in its briefings on the Bill and, in many instances, I agree with what it is putting forward. But in this instance, it said:

“At a time when funding for public health initiatives is limited, this proposal raises money without directly costing the taxpayer. Given the current economic challenges, this presents an opportunity for the Government to act decisively, should it choose to seize it”.


I kept thinking of this as a way of avoiding crises in public health, or in the NHS, by simply not resolving what should be an adequate health service for everyone while turning to private companies instead and trying to compensate for that. That is a dangerous precedent. Private companies should not let the state off the hook for what it should be doing, because those public health services should be provided by the state, regardless.

The fact that there is an economic crisis at the moment cannot just be meted out to companies that we do not like. I realise that tobacco companies have for some time been treated as especially evil, malevolent and harmful, but if you enter other debates and read the briefings of lobbying groups on other issues, you will hear similar moralistic arguments used about sugary foods, junk food, alcohol, gambling and even fossil fuels. I read a fascinating paper the other day which basically said that fossil fuels were killing us all and should be closed down, and so on. That is the kind of language being used.

I therefore worry about setting a precedent for a moralised hierarchy of legislators deciding which are the evil companies, and who gets to decide that, with a punishment then meted out. I say this because, briefly, I was a bit disturbed the other day at some mention of a report by KPMG. The data in it was dismissed as being from a report produced for Philip Morris, the tobacco company, as if that somehow closed down any possibility of a discussion—that having said that, the report could be laughed off. The idea that all you have to do is say the name of a tobacco company, and then close down valuable information, is quite dangerous.

It thought that was particularly unfair on KPMG. I am not necessarily a great fan of the big four accountancy firms, but they certainly have reputations. To write them off as being in bed with the evil Philip Morris, so that we take no notice of what they do, seemed a little unfair. If that were the case, have the Government let KPMG know that this is their view of it—especially since KPMG is a supplier to the Government, as I understand it, focusing on Civil Service training and economic matters? KPMG might have a case to answer on those things, but it should not be written off as a company because it has done some work for Philip Morris.

Neither is it appropriate for our discussions to always assume that everything a tobacco company says or does is evil because of the nature of the product. The product is harmful and contributes to cancer in many people—I know that—but if this Government believe that the tobacco companies are so uniquely evil that they are killing the population, they should have the courage of their conviction, make them illegal and ban them, not take their taxes and have it all ways.

[Lord Scriven (LD)]

My Lords, it is a great pleasure to follow the noble Baroness, Lady Fox. Normal service is probably about to be resumed. I am on a different page from her on this issue.

These amendments give me the opportunity to clarify my position on the Bill. I fear that my previous opposition to the age-escalator provision in the Bill, meaning that some adults will never be able to purchase tobacco legally, has been misrepresented by some as a general objection to any form of regulation or restriction on tobacco. I state clearly that that is not the case. That is why I support all amendments in this group—Amendments 12 and 148, tabled by my noble friend Lady Northover, Amendment 192, tabled by the noble Lord, Lord Young, and Amendment 194 in the name of my noble friend Lord Russell.

I come back to something the noble Baroness, Lady Fox, said regarding the point made by my noble friend Lady Northover about data. If this was unique, some of those issues would need to be explored further, but this is not a first. For example, the water and energy companies have to give to the regulator investment details, asset details, investment plans and details of their costs and profits. This happens without commercial sensitivities going by the way. The amendments, particularly Amendments 192 and 194, generally represent a necessary and proportionate intervention to correct a profound fiscal and health imbalance, which is weighted too heavily in favour of the tobacco industry. The tobacco industry in the UK operates with a near monopoly, as many noble Lords have said, on selling an addictive product. The market structure allows them to generate excessive profits. They extract nearly £900 million per year in profit, while contributing little in terms of corporate tax to the Exchequer.

Simultaneously, the societal costs of smoking are vast, as the noble Lord, Lord Young, and my noble friend Lord Russell identified, with the NHS bearing the immediate cost of approximately £1.8 billion per year. The current system places the entire tax burden on the consumer and the taxpayer, while the manufacturer enjoys excessive returns. That is not only a moral wrong but an economic failure that government has a duty to correct.

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I assure noble Lords that we will consult on these requirements as we develop the necessary regulations. The noble Earl, Lord Howe, and other noble Lords may be aware that, as I referred to on our first day in Committee, the Government launched a technical call for evidence on 8 October; that included questions on registration and what information businesses may need to provide. I emphasise that it is the first stage in the process. I encourage the noble Baroness and other noble Lords to engage in that process in order to ensure that their views are considered. We think that it is best to wait until after the consultation has concluded to decide what information will be required to be provided by relevant producers and importers.

[Lord Scriven (LD)]

That is an important point. When will the consultation end? Will we have its results before we are asked to give this Bill its Third Reading?

[Baroness Merron (Lab)]

I will gladly come back to the points that the noble Lord has just made, if he will allow me. In the meantime, there is no doubt as to the intention and ambition of each of the amendments before us, but it is the Government’s view that they either are unnecessary, due to existing powers, or would risk introducing complexity and unintended consequences; they would not do the job that I know we all want them to do. Once again, I assure noble Lords that we remain committed to reducing smoking, to improving public health and to ensuring transparency around the tobacco industry’s activities.

In so doing—this is perhaps the overall point of this group—I can say that the answer to the question from the noble Lord, Lord Scriven, it is 3 December 2025 on which we can set that date for the call for evidence to close. What I am trying to say to noble Lords is that that is very soon. In answer to the noble Lord’s concerns about how long these things might take—

[Lord Scriven (LD)]

My question to the Minister was slightly different. It was not about when the consultation will close. It was about whether we would have the results and the Government’s view before Third Reading. That is the critical question—not, “When will the consultation close?”

[Baroness Merron (Lab)]

The noble Lord will be glad to know that I am reminded of what I should know already: matters in relation to the dates for Third Reading are matters for business managers. It will also depend on how much progress we make.

Tobacco and Vapes Bill

Lord Scriven Excerpts

Committee stage
Monday 27th October 2025 Grand Committee

[Lord Bourne of Aberystwyth (Con)]

My Lords, I will speak briefly on this group of amendments, which are regrettable, in my view. The previous Prime Minister, Rishi Sunak, is to be applauded for what he did, as are the previous Government and this Government. This measure should be nothing to do with party politics.

Interestingly, this is a measure on health, but the proponents of the amendments have not so far mentioned the word “health”. We have heard many arguments, some of which I understand—I will address them briefly in a minute—but, in essence, this is a health measure and we have our own Health Minister, quite rightly, responding to this set of amendments. It is her measure and the Government’s measure. This is a health measure and we should not shy away from the fact that it will save lives.

Those proposing the amendments said they were in favour of bringing in restrictions—there is an age limit now—but they did not say that to me when they were proposing this. It did not sound like that. When I was preparing for this debate, I looked at this set of amendments and, at the back of my mind, I was vaguely reminded of something. I remembered what it was—and they will not like this comparison, so forgive me. It was when Jeremy Corbyn was supposedly in favour of Remain and went around giving speeches on it. Similarly, this proposal seems very half-hearted.

At the core of the current legislation is an age limit. This alters only the way that the age limit applies. The suggestion, in its hyperbole, is that we are going to face a Wild West of people opposing this and so on. Perhaps we need more resources on enforcement, and we certainly need to put in resources to anticipate what small businesses will be doing, but do not forget that this will be a gradual ban; it will not happen overnight. We also need to spend money on cessation services. All of that comes up in a later group of amendments.

These amendments address something outstanding that the Government are doing, which the previous Government were committed to. We should not shy away from it. We can improve this legislation, but this set of amendments would drive a coach and horses through what is necessary.

[Lord Scriven (LD)]

My Lords, I find myself in difficulty in this debate. As many noble Lords will know, my party will have a free vote on the generational ban if any amendments are pushed on it. At Second Reading, I made my view about it very clear. I reaffirm my commitment to the aim of the Bill to reduce smoking and have a healthier nation, which is a crucial public health objective, and I support greater regulation that helps people quit and prevents addiction. I say that as somebody who saw both parents die of smoking-related illness, so I understand the effect that it has.

My worry about the Bill, and the reason I support the amendment in the name of the noble Lord, Lord Murray, is the assumption that by banning something, demand will automatically go. It will not go; it will just be shifted to a different market: the black market. That is what will happen; evidence throughout history always shows that. The question is: will the Bill therefore be enforceable to the shift in demand to different markets?

At Second Reading, I raised the issue of proxy demand. Where people are legally able to buy, how on earth will trading standards and the police be able to police every single household in this country, where adults will share tobacco and cigarettes? That is what will happen. I ask the Minister directly whether it will be legal if someone in England who is not able to buy tobacco because they are deemed below the age threshold goes to Jersey, buys tobacco, brings it back and smokes it. Will they be deemed to be carrying out an illegal activity in the UK? Where we had booze runs in previous generations, will we have ciggie runs for this generation? It is a real question.

If somebody goes to France, buys cigarettes and then gives them to somebody back in the UK who is not deemed able to buy them in the UK, will the fact that they have bought them in France but given them to somebody in the UK be an illegal act? Smoking will not be illegal; it is the buying, so if somebody buys in a foreign country, will that be deemed illegal? These are really important questions. The whole enforcement of this relies on those kinds of questions being asked. I do not know the answers, so I ask these genuine questions.

I also worry about trading standards. I heard what the noble Lord said about trading standards, but I declare an interest as vice-president of the Local Government Association. Trading standards officers and organisations I speak to are very happy with what is being proposed but raise great questions about how enforcement will be carried out. They welcome the extra £30 million over the next five years but make it very clear that, in their view, three times that amount will be required to effectively enforce this. They also worry about rolling age verification, particularly as this goes into the future—distinguishing between a 30 year-old and a 31 year-old, as the noble Lord, Lord Murray, said. There will be a rolling issue of enforcement.

Finally, I made clear my fundamental philosophical issue at Second Reading and I shall not dwell on it today. The illicit trade already accounts for one in four cigarette sales. That is according to figures in Civil Service World. They are not HMRC figures. The Civil Service World article stated that, historically and to date, HMRC still underestimates the illegal trade and suggested that it is more like one in four sales. My view is that, by moving demand, we will move more of this into the illicit trade and therefore the enforcement will be even more.

I come back to my central point. Legislation in itself is useless if it cannot be enforced and I have no idea how proxy buying will be enforced in individual homes. People may say that they are not buying for somebody but then pass it on. I therefore believe that the Bill will not create the smoke-free generation that some want by having a generational ban. A cut-off point of an age, followed through with better regulation and better smoking cessation policy, with money paid by the tobacco industry for those things—there are amendments further down that we will come to on that—will be more effective than this view that a generational ban will magically stop the demand and stop younger people smoking throughout their lives.

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[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

My Lords, I am most grateful for the amendments and also the contributions today. As we know, this group of amendments seeks to change or to place conditions on our smoke-free generation policy. As the noble Lord, Lord Young, and the noble Earl, Lord Howe, both observed, this group is very much at the core of the Bill and I understand the amount of interest that we have had today.

Let me say at the outset that there are a number of areas raised by noble Lords that I will return to in much greater detail, including, as the noble Baroness, Lady Walmsley, to: verification and retailers in group two; illicit sales and licensing in group 13; tobacco products that are in scope in group 16; and vaping, which is in groups five and six. I look forward to the detail of those debates when we get to them.

Perhaps I could say that I am grateful for the supportive comments on this Bill, which, as we have been reminded throughout, was introduced under the previous Government. Credit goes to them for doing so, in particular for the commitment that was shown by the former Prime Minister, the right honourable Rishi Sunak. I am therefore grateful to my noble friend Lady Carberry, the noble Baroness, Lady Northover, and the noble Lord, Lord Bourne, who helpfully reminded us all that this is a health Bill, and that is what we are here to consider. I also thank the noble Lords, Lord Bethell and Lord Young, and the noble Baroness, Lady Walmsley, all of whom have been supportive of the smoke-free generation principle and have emphasised to the Committee today the amount of public support for that and its role in stopping the cycle of addiction.

I will start with the amendments tabled by the noble Lord, Lord Murray of Blidworth, which propose changing the age of sale and proxy purchasing offences. These amendments would make it an offence to sell tobacco products, herbal smoking products or cigarette papers to a person under the age of 21. They would also make it an offence to buy or attempt to buy these products on behalf of anyone under the age of 21.

I am also grateful for the points that were just made by the noble Earl, Lord Howe, on this group of amendments. I cannot fail to emphasise that smoking is indeed the number one preventable cause of death, disability and ill health. It is unique in its harm, because it claims the lives of around 80,000 people a year in the UK, it causes one in four of all cancer deaths in England and up to two-thirds of deaths in current smokers can be attributed to smoking. I am sure that, over the years, noble Lords have heard the Chief Medical Officer’s opinion of the contribution that smoking makes, and that there is no safe level of smoking.

To the point raised by the noble Baroness, Lady Fox, who spoke about restrictions on adults’ individual autonomy, three-quarters of people who smoke wish that they had never started smoking. The majority want to quit and we want to help them. In my view, smoking is not about freedom of choice; I believe that the tobacco industry takes that choice away through addiction, particularly at a young age. In my view and that of a number of noble Lords whom I have heard speak, there is no liberty if we are speaking of addiction.

Almost every minute, someone is admitted to hospital because of smoking and up to 75,000 GP appointments can be attributed to smoking every single month. There is, as has been referred to, an economic cost. It is estimated to cost our society more than £21 billion a year in England alone, including £3 billion a year in costs to our health and care service. This is far from insignificant.

That is why this Government has made a commitment to create a smoke-free generation, so that anyone born on or after 1 January 2009 will never be legally sold tobacco products. I recall the noble Lords, Lord Scriven and Lord Mackinlay, making a particular reference to the potential contribution of people bringing tobacco back from abroad, but the noble Baroness, Lady Fox, and the noble Lords, Lord Murray and Lord Strathcarron, talked about the Bill prohibiting smoking. Let me make it clear: the smoke-free generation policy is not about criminalising people who smoke. It will not be an offence to possess or consume tobacco, regardless of your age. I can tell the noble Lords, Lord Scriven and Lord Mackinlay, that we are not imposing new restrictions on bringing tobacco back into this country.

I agree with my noble friend Lady Carberry. It is my belief—it is not just a belief, in fact; it is based on experience—that, if we raise the age of sale to 21, to which this group of amendments refers, the tobacco industry will simply change its business model and target older adults; a number of noble Lords referred to this. It will not meet our ambition of a smoke-free UK.

Similarly, the Bill makes proxy purchasing an offence such that anyone over the age of 18 cannot legally purchase tobacco products on behalf of someone born on or after 1 January 2009. The noble Lord, Lord Scriven, and the noble Earl, Lord Howe, asked important questions about the handling of proxy purchasing. I have explained clearly what the offence is and who would be responsible for it. This is about protecting children from the harms of smoking. I reiterate that tobacco is uniquely harmful. As I have said, there is no safe level of smoking; I emphasise that, to my knowledge, no other consumer product is killing two-thirds of its users.

[Lord Scriven (LD)]

I just want to pursue the issue of proxy purchasing abroad. My question was not about whether people will be able to buy tobacco abroad or whether duty-free limits will cease. My question was: if somebody buys cigarettes in a jurisdiction outside the UK and, when they come back, gives one of them to someone who is not legally entitled to buy them here, will that be an illegal act for the UK citizen who has bought that product abroad?

[Baroness Merron (Lab)]

The purchasing referred to is within our jurisdiction.

That gives me an opportunity to make a general but important point. This is about changing culture and practice. It is not about everything staying the same. This is not just a message but a practice in terms of what is acceptable and what is not. All noble Lords have seen changes over the years, as I did when I was the Public Health Minister in the previous Labour Government, which have meant that we can speak about this Bill, as we are doing today, in a way that I do not think would have been possible just a few years ago. Tobacco is a deadly addiction, and preventing children starting to smoke is undoubtedly the easiest way to reduce smoking rates. We have to be bold and brave on this, which is why we are committed to creating a smoke-free generation.

My noble friend Lady Carberry mentioned the impact assessment. Modelling shows that creating a smoke-free generation is expected to help reduce smoking rates among 14 to 30 year-olds to near zero by 2050. That is a prize worth having, in my view. Over the next 50 years, it will save tens of thousands of lives, as well as many years lived in ill health with misery, discomfort and pain; it will also avoid up to 130,000 cases of lung cancer, stroke and heart disease. As I say, all of these are, I believe, prizes worth having.

On the impact assessment, a number of noble Lords said that an “age 21” policy would have just the same impact as a smoke-free generation policy. That is not true. We are aware that the tobacco industry has been telling parliamentarians this. I must say, again, that it is incorrect. The published modelling considered different scenarios for the impact of the smoke-free generation policy; it did not model the impact of raising the age of sale to 21. I believe that we have a responsibility to protect future generations from becoming addicted to nicotine; to break the cycle of addiction and disadvantage; and to allow people the chance to live healthier lives.

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The noble Lord, Lord Scriven, mentioned an article in Civil Service World that referred to a particular percentage of cigarettes being illicit. I understand that that article was written by Philip Morris Ltd; I will, therefore, leave noble Lords to make their own decisions on it.

[Lord Scriven (LD)]

The Minister must be clear that the report was done by KPMG; it was commissioned by Philip Morris Ltd, but it was not written by that organisation.

[Baroness Merron (Lab)]

I am happy to accept that clarification, but the point that I am driving is still being driven.

I now move on to Amendments 5 and 205 in the name of the noble Lord, Lord Moylan, which seek to introduce an interim age of sale of 21 at Royal Assent, before the smoke-free generation provisions come into force. Although I appreciate the noble Lord’s ambition in seeking to raise the age of sale for relevant products, which we are discussing, it is my view that these amendments are not necessary; indeed, they would distract from our ambitions. Let me explain why.

Under this Bill, the smoke-free generation will come into force in 2027 when people born on or after 1 January 2009 turn 18. Subject to timetabling, these amendments would mean that any interim age of sale proposed by the noble Lord would be in place for only a year or less. Retailers and enforcement agencies—they are, as many noble Lords have acknowledged, absolutely key to the success of this measure—would not be provided with any time to prepare for the increase to 21. I do not feel, therefore, that a measure such as this one would be helpful; indeed, it would divert resources.

The important matter of communication to the public came up in the debate. The noble Lord’s amendments would confuse all such communications if a different regime were to apply for such a short time.

The noble Lords, Lord Strathcarron and Lord Mackinlay—as well as other noble Lords—referred to the situation in Australia. Let me say this in response: we are not aware of any evidence for the illicit market in Australia being the result of a change in the age of sale. In fact, I am advised that Australia has not changed its age of sale since 1998. I say this to noble Lords: the UK is highly regarded for its robust, comprehensive approach to tackling illicit tobacco. Despite what the tobacco industry may say, implementing tobacco controls does not lead to an increase in the illicit market.

MBRRACE-UK Report 2025

Lord Scriven Excerpts

Thursday 23rd October 2025 Lords Chamber

[Baroness Merron (Lab)]

I can give that assurance in respect of services across the country. The independent maternity and neonatal investigation will act at pace. It is an independent investigation and will be chaired by the noble Baroness, Lady Amos. In addition, the Secretary of State, Wes Streeting, is showing how high a priority it is for us to provide urgent action on this by chairing the maternity and neonatal task force himself. These projects will work at pace to bring about the change we need to see.

[Lord Scriven (LD)]

My Lords, I am pleased to hear the Minister say that this is urgent. While waiting for the review to take place, the report called for improved interagency working. While the Government are waiting for that review, are there any specific changes to information sharing and co-ordinated care pathways between maternity services, social services, specialist domestic abuse services and other statutory agencies that the Government will ask to be implemented on an interim basis, to ensure that as many women as possible live?

[Baroness Merron (Lab)]

It is important to say that we are not waiting for the results of investigations or task forces in order to take action. A number of projects are already in train and making a difference. For example, we are rolling out maternal mental health services and specialist perinatal mental health services in every area across the country. I will give one example to address the point that the noble Lord raised. A single patient record will ensure that maternity teams have all the information they need about previous consultations. That will be of great assistance in improving safety and efficiency.

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[Lord Scriven (LD)]

While we are talking about Leeds, can the Minister explain, following on from the previous question on leadership, how the former chief executive of the Leeds Teaching Hospitals, who was in post at the time that this was happening, can then go on to become the chief executive of the CQC? Do recruitment processes need to be looked at, particularly for chief execs who have been leading failing services such as the ones in Leeds?

[Baroness Merron (Lab)]

I note what the noble Lord says and will take his comments back to the Secretary of State.

Human Medicines (Authorisation by Pharmacists and Supervision by Pharmacy Technicians) Order 2025

Lord Scriven Excerpts

Tuesday 21st October 2025 Grand Committee

[Baroness Bennett of Manor Castle (GP)]

My Lords, I thank the Minister for her very clear introduction of this SI. It is a pleasure to follow the noble Baronesses, Lady Hollins and Lady Ritchie, and to say, perhaps counterintuitively, that I agree with both of them. It is very clear that there are arguments for steps forward because of the way in which circumstances and technology have changed: there is an argument for reform. But the questions put by the noble Baroness, Lady Hollins, are very important and we have to put those into context.

I note that a survey put out in August by the National Pharmacy Association and Community Pharmacy England said that 63% of pharmacies could close in the next year and only 6% of pharmacies were profitable. Only 25% of pharmacies are independent; the rest are either corporate or supermarket-owned pharmacies.

The concerns are obvious when we are talking about that last group. There is a risk of seeing one pharmacist having effective control and providing authorisation to a large number of pharmacy technicians where there might be corporate structures that put a large amount of pressure on financial returns rather than ensuring absolute safety and the controls that are needed. So we need to understand this SI in that context. Obviously, in some ways that is what is driving the SI, but we also need to think about the controls and where there is huge financial pressure on independence. A majority of prescriptions now come through giant corporate companies with very distant methods of control.

My second question is on timing. I note that on 1 October the General Pharmaceutical Council opened its consultation on overhauling the pharmacy technician training framework, including plans to move study from level 3 to level 4. It rather feels that we have just opened a consultation on changing the training, yet here we are bringing in regulations that almost seem to be assuming that that training has already been stepped up. Would it not be a better idea to step up and overhaul the training and then bring in the different regulations? The consultation suggests there is a very clear understanding that there is a need to improve the training of pharmacy technicians.

My final set of questions has to go back to physician and anaesthesia associates and the Leng review. I would like to understand how this SI fits within the broader framework of regulation of all the medical professions. I note, looking back over the history of this, that we go back to 2014 and the Law Commission recommendations about the regulation of a new single legal framework for health and care professionals. Under the previous Government we had consultations in 2017, 2019 and 2021, all of them in this space. So far as I have been able to discover, they did not seem to cover physician technicians: certainly not in much detail. This whole physician and anaesthesia associates débâcle, I have to say, was supposed to be part of a whole process of looking at all stages of medical regulation right across the board. How does this SI fit within that framework?

Finally, I have to note that, in the Chamber on 16 July, I was told that the Government would be delivering an implementation plan for the Leng review in the autumn. I have noticed that quite a lot of leaves seem to be changing their colour at the moment. I know that the government definition of “autumn” can be quite extended, but perhaps the noble Baroness could update us on when we can expect to see that implementation plan.

[Lord Scriven (LD)]

My Lords, it is a pleasure to follow the noble Baroness, Lady Bennett. In fact, it is a pleasure to follow all noble Baronesses who have spoken and to be the first Baron to speak in this debate. A bit like the noble Baroness, Lady Bennett, I counterintuitively support quite a lot of what has been said, even though some of it is quite contradictory and does prompt questions, even though the generality is supported.

I also thank the Minister for outlining in a clear and understandable way the order before the Committee. In my role as vice-chair of the APPG on Pharmacy, I have been able to speak not only to a number of organisational groups but to individual pharmacists to understand some of the differences of opinion within the sector.

This is without doubt a pivotal moment, marking a significant shift in pharmacy regulation. I offer the Government our general support for the core principle of modernising an outdated legal framework to unlock clinical capacity. As the noble Baroness, Lady Ritchie, pointed out, for far too long—in fact, since 1933—regulations have been rigid, forcing highly qualified pharmacists to oversee tasks that can be safely and competently managed by other registered professionals.

This order, by introducing the concept of authorisation and delegation to pharmacy technicians, corrects this historical anomaly. The benefits are clear; it empowers pharmacists to fully embrace clinical roles: prescribing, consulting and administering services, probably as part of the new neighbourhood health services that the 10-year plan suggests. It validates the expertise of pharmacy technicians, providing them with greater autonomy, particularly in complex environments like hospital aseptic facilities. It introduces, to use the Minister’s phrase, common sense measures of allowing trained staff members to hand out pre-checked, bagged medicines in the pharmacist’s temporary absence, ending needless patient delays.

However, the consultation process responses, which saw over 5,000 replies, revealed a sector divided. Although professional bodies and pharmacy technicians largely welcomed the proposals, we must not ignore the fact that many individual pharmacists expressed profound concern, as quite rightly highlighted by the noble Baroness, Lady Hollins. It is here in the detail and the perceived risk that we must focus our scrutiny. Indeed, while welcoming the statutory instrument, there could be some unintended consequences. The issues raised are not frivolous; they are structural and require ministerial assurance.

I wish to highlight three major areas of risk. The first one is patient safety, training and accountability. The core objection from many pharmacists relates to the level of initial education and training required by pharmacy technicians to take on these new autonomous roles. As the noble Baroness, Lady Bennett, pointed out, the consultation has just started. It ends on 24 December. It will not pick up pace until at least early 2026, and then there will be the training, the qualifications for the training and the accountability for the training. Are the Minister and the Government convinced that there is enough time to roll out not just the training but to assure its quality before technicians are allowed to do this?

The noble Baroness, Lady Hollins, has really highlighted the problems that could come around with vague authorisation. If a pharmacist gives a general or oral authorisation without clearly defining the scope, conditions and limitations for the technician, it could lead to confusion and mistakes, particularly concerning high-risk medicines. I was going to ask similar questions to the noble Baroness, Lady Hollins, but I will leave those to one side.

There also is, potentially, an accountability gap. While the order notes that a pharmacist’s failure to have a

“due regard to patient safety”,

may lead to professional misconduct, establishing clear accountability when a technician makes an accuracy error under general supervision could be challenging for regulatory bodies. There is a contradiction there that needs to be understood.

Also, on dispensing queries, the new rule allowing a sale supply of ready dispensed products in the pharmacist’s absence creates a challenge. For example, will a shop assistant who has been there for one day and works in the pharmacy be allowed to do this? It does say “any member”, so I am pleased that the Minister is shaking her head. I seek reassurance on that particular point.

What if a patient has a question about the medicine? The person carrying out the transaction must know when they are qualified to answer and, crucially, when they must stop the transaction. How will this be addressed and understood by all concerned? The safety mitigation is reliant on the General Pharmaceutical Council-strengthened guidance and rules—work that is still pending, as we have heard. We must ensure that this guidance provides absolute clarity on the minimum competence standards required for authorisation and, crucially, that the professional indemnity cover for those roles is appropriate for the new scope of the responsibility.

Secondly, on the risk of undervaluing dispensing services, as the Minister said, the changes are enabling and not mandatory, yet the risk of financial exploitation is real. Pharmacies are already funded below cost for dispensing. My concern mirrored—

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[Lord Scriven (LD)]

My Lords, as the noble Baroness said, the changes are enabling and not mandatory, yet the risk of financial exploitation of the regulations is real. Pharmacies are already funded below cost for dispensing, and my concern, mirrored by many in the sector, is that the department or NHS England may interpret this regulatory freedom as an automatic justification to reduce dispensing fees based on the assumption of a cheaper skill mix that may be automatically adopted. Any such reduction would threaten further the financial viability of community pharmacies, particularly small independent ones, risking closures and access issues.

The third issue is the ambiguity of supply “at or from” a pharmacy. Some in the sector feel that the proposed change to allow the supply of medicines at or from a pharmacy, while intended to cover home deliveries, introduces ambiguity. This phrase is viewed by some as a potential gateway to unsupervised remote supply models, such as unstaffed collection lockers in remote locations. The Government must emphatically stamp out any interpretation that undermines the fundamental principle that a pharmacist’s professional clinical input or availability is the bedrock of safe supply.

To ensure that we implement this modernisation safely and successfully, I ask the Minister for clear answers on these three points. On professional assurance, what guarantee can the Minister give to individual pharmacies that the new GPhC standards will explicitly address the concern over minimum competency and mandatory continual professional development, and that the accountability split is clear before the main authorisation provisions come into force?

On financial stability, can the Minister offer an unequivocal commitment that NHS England and the department will not use the new skill mix freedoms as a mechanism to unilaterally reduce the dispensing fees paid within the community pharmacy contractual framework?

On the safety of supply, given the sector-wide apprehension, will the Minister commit to publishing restrictive statutory guidance that clearly defines “supply at or from” a pharmacy to rule out any future implementation of unsupervised off-site collection points for pharmacy and prescription-only medicines?

This is a reform that will have good outcomes if implemented correctly. The move forward for progress must address the potential risks, ensuring support for the entire pharmacy team and financial stability for dispensing as well as, crucially, protecting patient safety and access to local dispensing community pharmacy.

[Lord Kamall (Con)]

My Lords, I also thank the Minister for the way she introduced this SI. I begin by also thanking the thousands of pharmacists and pharmacy technicians who deliver vital services to patients every day in both the community and hospital settings— I can see that your Lordships all agree with that.

From these Benches we support the principle behind this statutory instrument. As the Minister said, in many ways it is common sense. It reflects the evolution of community pharmacy practice, which has changed significantly since the original 1933 Act was introduced—a time when pharmacists still routinely compounded medicines by hand. Over the years, that role has evolved and medicines are now largely pre-packaged and supplied via global supply chains. Pharmacists increasingly play a critical role in delivering NHS services, from vaccinations to blood pressure checks, emergency medications and, of course, Pharmacy First consultations—which many noble Lords agree with. Given the Government’s priorities on moving from hospital to the community, they also play a vital role here.

This legislation rightly seeks to release capacity, allowing pharmacists to spend more time with patients, and it allows pharmacist technicians to take on more responsibility in line with training and regulation. As the noble Baronesses, Lady Hollins and Lady Bennett, said, there were concerns about the technicians and the differential in training level, and taking that on. In some ways, that takes us back to the physician and anaesthetist associates debate. Although the noble Baroness, Lady Bennett, and I were on different sides in that debate, I think that we would all agree that it was not right that those who were not qualified were taking on the role of those who were more qualified and taking on roles above their qualifications. What can the Minister say about that, given the experience of anaesthetist and physician associates? We welcomed that. Some of them were being asked to do roles for which they were not qualified. How do we make sure that pharmacist technicians are not repeating that?

--- Later in debate ---

[Baroness Merron (Lab)]

It is important to keep all matters under review—and I would want more than that—because we need to see how things are going. Certainly, the monitoring will continue. However, I would counsel a bit of caution: increases may not be directly related. As the noble Baroness well knows, it is always a complex situation, but certainly monitoring will continue. We will want to see how these reforms are working.

On training, I say to the noble Lord, Lord Scriven, that initial education training is assured by the regulator. Post-qualification training is a responsibility of NHS England. No pharmacy technician should be acting outside of their competency, and pharmacists have the responsibility that I outlined of ensuring that they are delegating tasks appropriately.

On accuracy errors, which the noble Lord, Lord Scriven, raised, pharmacists and pharmacy technicians remain professionally accountable for their actions. There is no change to that. On the question from the noble Lord, Lord Scriven, about a patient having a question about their medication, the pharmacy technician, or the other professional handing out the medication, will be trained to refer this back to the pharmacist. So, again, that assurance can be given.

I make reference to pharmacy funding because the noble Lord, Lord Scriven, raised it. We have been quite clear that funding community pharmacy is a priority. The new community pharmacy contractual framework, which has been secured by this Government, is the first step in rebuilding community pharmacy as part of our plan for change. There is a £3.1 billion deal; it is the largest uplift in the funding of any part of the National Health Service, which shows, I believe, our commitment to supporting community pharmacy and building a service that is fit for the future.

[Lord Scriven (LD)]

I know that the sector welcomes the commitment from the Government to the uplift—that is not in doubt—but that fact is that, even with the uplift, dispensing fees are still below cost. The question was quite specific, because it is causing a bit of worry in the sector: can the Minister assure the sector that, because this measure is enabling and not mandatory, the Government will not use a skill-mix change as a way of trying to reduce dispensing costs?

[Baroness Merron (Lab)]

I will be pleased to write to the noble Lord in greater detail, if he will allow that, because his question raises a whole range of points, and I would like to be accurate in my response to him.

I move on to the points made by the noble Lord, Lord Kamall, about the transition period. I hope that it is helpful for me to say that, following the approval of the Privy Council and royal approval, provisions on handing out checked and bagged prescriptions in the absence of a pharmacist will apply, as I mentioned earlier, some 28 days later. The other measures will be brought into force after a one-year transition period, which will be enacted by an Order in Council to be agreed with the Privy Council. This will allow time for the professional regulations and guidance that are absolutely crucial to making this work to be updated; we cannot do this without that time.

Noble Lords have made extremely helpful and important points today. I know that there is more work to be done to ensure that the sector is fit for the future so that we can deliver the change described in the 10-year health plan. I am grateful for noble Lords’ support for innovating and modernising the regulatory framework, because pharmacy services must be sustainable, deliver quality services and deliver the outstanding patient care that we all deserve. I thank noble Lords for their contributions and questions.

HIV: Testing and Medical Care

Lord Scriven Excerpts

Monday 20th October 2025 Lords Chamber

[Baroness Merron (Lab)]

I certainly can assure my noble friend that, in our discussions with the devolved Governments, we highlight this area and will continue to do so.

[Lord Scriven (LD)]

My Lords, I have a question about regional variations. Some 37% of all community tests were carried out in London in 2023, but only 1.1% in the north-east. What action will the Government take to deal with this regional variation?

[Baroness Merron (Lab)]

The UKHSA supports local areas to improve delivery, not least through data monitoring and reporting, which is vital. Without commenting on specifics, I will say that there will be variation because of incidence and the needs of local populations. We account for this in our funding and direction. What really matters is equality of access and outcome, which will remain a real focus of the plan that I look forward to presenting to your Lordships’ House.

Healthcare Provision: Inequalities

Lord Scriven Excerpts

Monday 20th October 2025 Lords Chamber

[Baroness Merron (Lab)]

I can indeed give that assurance, and I am grateful to my noble friend Lady Brown for her voice on the matter of women’s poor hysteroscopy experiences. These are unacceptable and part of a wider issue of women’s pain being normalised. Women must be given the opportunity to discuss pain relief with a clinician before the procedure. While I am glad to say that updated guidelines from the Royal College of Obstetricians and Gynaecologists do emphasise minimising pain, it is clear that more action is needed. I assure my noble friend that we are updating the Women’s Health Strategy for England to address what I believe is a wider issue, and to improve the experiences of women across the country.

[Lord Scriven (LD)]

My Lords, clinical evidence has established that poor health care directly contributes to the current 22-year life expectancy gap between people with learning disabilities and the general population. Why is this unacceptable inequality simply becoming a grim statistic that the Government continue to pay millions of pounds to measure, but are reluctant to take statutory measures to end?

[Baroness Merron (Lab)]

It is an unacceptable situation, as the noble Lord says. However, I refer him to the national approach, which will inform action in communities, including for people with a learning disability and those who are autistic. The Core20PLUS5 informs the reduction of healthcare inequalities among a range of groups; and, extremely importantly, it supports NHS organisations in identifying who might be at risk of poorer experiences, and in addressing this. I agree with the noble Lord that this must include those with a learning disability and those who are autistic.

Suicide Reduction

Lord Scriven Excerpts

Monday 8th September 2025 Lords Chamber

[Baroness Merron (Lab)]

The noble Baroness is quite right to speak as she has done. The suicide prevention strategy and the seven priority groups it identifies does include autistic people. As the noble Baroness will know, I think that is particularly key and I will certainly be pleased to look out for the report to which she refers.

[Lord Scriven (LD)]

My Lords, first, I welcome the Minister back to her place and wish her rudimentary health in the future.

Internationally, a co-ordinated government approach, as the noble Baroness said, is a proven factor in reducing suicide. She said moments ago that two-thirds of people who commit suicide are not actually involved in mental health services. In light of international practice, where the best success rates are when co-ordination is dealt with not by one department but across government, would the Government look at potentially moving this to the Cabinet Office, rather than it being led purely by the Department of Health?

[Baroness Merron (Lab)]

I thank the noble Lord for his warm welcome back to the Dispatch Box in full health. The noble Lord makes an interesting suggestion. I will be co-ordinating a cross-government suicide prevention approach. It is the case, as the noble Lord alludes to, that this cannot be solved by DHSC alone. However, it is where it is placed presently and I assure him of the cross-government commitment we are making, and also how that will be developed so that it is much more meaningful than it is at present.

Diabetes: 10-Year Health Plan

Lord Scriven Excerpts

Thursday 26th June 2025 Lords Chamber

[Baroness Merron (Lab)]

Fracture liaison services do an incredible job. I refer the noble Baroness to the words of the Secretary of State—I will not quote them because I do not have them to hand and there is nothing worse than misquoting somebody, particularly the Secretary of State—who has made his intentions quite clear on fracture liaison services. We certainly appreciate their value and the need to make that kind of provision available across the country.

[Lord Scriven (LD)]

With regard to what the Minister said about the DNA database of children with diabetes and other conditions, what are the mechanisms in place if a child, at the time they reach Gillick competence, no longer wishes to have their data on that DNA database? Will there be mechanisms so that the child can at that point withdraw their data and prevent it being used?

[Baroness Merron (Lab)]

All the usual provisions will apply, but, as we develop the system, all that detail will be confirmed. I will ensure that the point the noble Lord raises is fed into that consideration.

NHS: Private Equity

Lord Scriven Excerpts

Wednesday 25th June 2025 Lords Chamber

[Baroness Merron (Lab)]

I am grateful to the noble Lord for his suggestion. This was another area I raised with officials who have been in contact with Assura and the proposed new company, Primary Health Properties plc. The implication, I believe—I am sure the noble Lord will happily correct me outside the Chamber if this is not the case—is that somehow the Government should take on this responsibility. This would be a significant cost because the Government would have to offer in excess of the £1.79 billion currently offered by PHP and, in addition, take over £2 billion of debt raised against the properties which is secured against future rental income streams. I hope that gives some idea of the scale. There is also no strategic imperative. I understand the concerns, but the market is currently delivering, and it is expected to continue to do so.

[Lord Scriven (LD)]

My Lords, this raises a wider question regarding the NHS primary care estate. Will the Government look seriously at implementing new controls and transparent pricing benchmarks to prevent overseas investors not just imposing exploitative rents but producing punitive dilapidations, which is where they will make their money when they return the estate to the public sector?

[Baroness Merron (Lab)]

The noble Lord raises an important point. I assure him that rent and service charges continue to be set in line with the original terms if there is a change of owner. Whatever the ownership, properties occupied by GPs are required to be professionally valued by the district valuer. The service advises commissioners on whether levels of rent are value for money and align with market rents in a particular area. The other thing I might add, which I mentioned in answer to an earlier question about the mixed model of the general practice estate, is that nearly half of them are in any case GP-owned and 26% are GP leasehold. We do not currently see a problem in the way the noble Lord describes, but if there are particular examples to follow up, I am very happy to do so.

Perinatal Mental Health

Lord Scriven Excerpts

Wednesday 25th June 2025 Lords Chamber

[Baroness Merron (Lab)]

The noble Baroness raises a very important point, particularly on voices not being heard. I am sure she heard the announcement on maternity safety made by the Secretary of State on Monday. He highlighted the issue of women’s voices and that women are so often not listened to. That is particularly the case among the minority ethnic groups the noble Baroness referred to. I assure her that that is taken into account. I am glad to say that there are record numbers of women accessing community perinatal mental health services. On the point raised, that is why it is for local areas to serve their local communities in the way she describes.

[Lord Scriven (LD)]

My Lords, given the £8.1 billion annual cost of untreated perinatal mental illness, will the Government mandate a ring-fenced, inflation-proof budget for perinatal mental health services within ICBs to ensure sustainable long-term investment, rather than relying purely on discretionary funding?

[Baroness Merron (Lab)]

I do not share the view that it is discretionary funding, not least because what matters are the outputs, which are, as I described, that a record nearly 65,000 women accessed a specialist community perinatal mental health service or maternal mental health service in the 12 months to April 2025. That gives some idea of the scale—that is a 95% increase compared with four years earlier. So the output is absolutely there. Was it ever the case that all needs were met? No, it was not, even before the change to the planning guidance and the ring-fencing. I emphasise again that this Government’s whole approach is to ensure that local communities are properly served. That is why ICBs can make decisions about how they provide what I regard as first-rate services.