Oral Answers to Questions

Alex Norris Excerpts

Tuesday 19th April 2022 Commons Chamber

[Sajid Javid]

I understand the right hon. Lady’s point, but it is about what works on the ground. My understanding is that what is happening in her area is about a shared management team that shares best practice and tries to address challenges together, rather than any kind of formal merger.

[Alex Norris (Nottingham North) (Lab/Co-op)]

Across the country, tens of thousands of people sitting in hospital are medically fit to go home but cannot do so due to a lack of social care. The Health and Care Bill should have addressed that, but it does not. Rather than making us wait for more legislation, will the Secretary of State at least concede that local health leaders, be they in clinical commissioning groups or in integrated care systems in shadow form, should be driving this locally as a matter of urgency?

[Sajid Javid]

That is exactly what the new integrated care systems are all about. My understanding is that the hon. Gentleman sat on the Health and Care Public Bill Committee, which made it a reality.

Oral Answers to Questions

Alex Norris Excerpts

Tuesday 18th January 2022 Commons Chamber

[Gillian Keegan]

I assure my hon. Friend that this is something we take very seriously and we meet every day to discuss this issue. We are conscious of the pressures caused by omicron, and of the herculean challenges faced by health and social care providers to discharge people in a safe and timely way, particularly with outbreaks and having to manage infection prevention and control. That includes the Gloucestershire Hospitals NHS Foundation Trust, which declared a national incident on 28 December at its Gloucestershire site. But it responded brilliantly and stood down the incident nine days later. As the Secretary of State said, we have also established a national discharge taskforce, which is driving progress to bring a renewed focus on reducing discharge delays, including in Gloucestershire, and working with local government and the NHS.

[Alex Norris (Nottingham North) (Lab/Co-op)]

14. What recent assessment he has made of cancer outcomes.

[The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)]

Based on the latest available data—I am sure the hon. Gentleman will welcome this—one-year survival rates for all cancers combined are at a record high, with an increase from 63.6% to 73.9%, and the five-year survival rate for all cancers combined has increased from 45.7% to 54.6%.

[Alex Norris]

To ensure the best cancer outcomes, patients need to start treatment as soon as they can. But in the latest data the Minister addresses, the number of those who waited for more than two weeks to see a specialist set a new record high for the third month running, soaring to more than 55,000 people in November, prior to the peak of this wave. Macmillan Cancer Supports states that more than 31,000 people in England are still waiting for their first cancer treatment, which will not do. When will the Government publish a properly resourced, properly staffed national recovery plan for cancer care?

[Maria Caulfield]

I reassure the hon. Gentleman that cancer has been an absolute priority throughout this pandemic, and treatment and services have continued. I thank all those working in cancer care for making sure that has happened. Ninety-five per cent. of people started treatment within a month of diagnosis throughout the pandemic, and there have been more than 4 million urgent referrals and 960,000 people receiving cancer treatment during that time.

Draft Coronavirus Act 2020 (Early Expiry) (No.2) Regulations 2021

Alex Norris Excerpts

Tuesday 30th November 2021 General Committees

[Alex Norris (Nottingham North) (Lab/Co-op)]

It is a pleasure to start this parliamentary day just as I finished yesterday’s with you in the Chair, Mr Hosie. It is characteristic of this pandemic that we are discussing removing restrictions on the day that we will later discuss imposing other restrictions, but I am afraid that is how things move with it.

The Coronavirus Act 2020 was significant legislation. I am sure, like me, all colleagues received emails when we passed the legislation, and when we renewed it, from constituents who thought it overbearing and excessive and that it should not be renewed. I never agreed with that analysis. As the Minister said, the legislation contains important provisions relating to professional registration and people’s finances—those provisions remain crucial. However, I do not believe any right hon. or hon. Member missed the point that it was unprecedented legislation. When we were all standing for election three months prior to its introduction, I do not think any of us expected to be passing anything like it. However, extraordinary circumstances have called for extraordinary action. I always ask constituents to look beyond the endurance of the Act as an individual entity and down into the provisions, and to consider what powers have been expired. Post its renewal, the terms of the legislation are very different and much more modest in comparison with the law passed 18 months ago. If powers are not needed or are not being used, it is right that they should not lie on the statute book.

The Opposition will not divide the Committee on today’s regulations, and I hope that people across the country will welcome that some powers have been removed from the scope of the 2020 Act. Those powers include section 56 powers that relate to magistrates courts, schedule 16 and section 37 powers relating to the temporary closure of educational institutions and childcare premises. Those latter powers have not been used, and it is right that they should be turned off. Similarly, section 78 powers relating to local authority meetings are out of date and it is right that they are removed from the statute book. One of the concerns raised with me by constituents—unfounded in my opinion—relates to the powers to detain potentially infectious people. I do not believe there is any evidence that the state has used that power as a tool to be overbearing towards its subjects, nevertheless, given that that power has not been used greatly—only 10 times, and not since last October—it is right that it be expired. I hope that gives comfort to those who have concerns about the 2020 Act, and demonstrates that it is not being used in an overbearing manner.

The only provision I query is the element relating to the end of working tax credit. I and my Opposition colleagues have said that the Government have a blindspot to the financial pressures felt by people in the country. Turning off the universal credit uplift was a dreadful idea and has pushed families to the brink—our local food banks will vouch for that. The provision will cost the poorest £1,000, and I note that there is no impact assessment attached to the regulations. I keen to know from the Minister how many families will be affected by the change.

The explanatory notes probably get to the root of the Government’s misunderstanding. They note that the Act was about supporting individuals’ incomes during an unprecedented time, but the reality is that the pandemic has not shown that we need to provide temporary extra income to individuals but rather that in many cases personal income is far, far too low. That is even more apparent when set against the rising cost of living. Turning off certain support does not remove the fact that individuals will then return to living as they did before the pandemic—struggling to make ends meet and living with attendant health problems and injuries. I hope that the Minister will offer a reflection on that.

Given what we will debate later today, what consideration has the Minister given to whether powers will need to be turned back on at some point, or new powers sought? What is the Government’s current thinking on that?

Public Health

Alex Norris Excerpts

Tuesday 30th November 2021 Commons Chamber

[Alex Norris (Nottingham North) (Lab/Co-op)]

It is a pleasure to speak for the Opposition in this important debate.

The omicron variant is a sobering reminder that this pandemic is not over. We need to act with speed to bolster our defences to keep the virus at bay, and to keep each other safe throughout the difficult winter period. We on these Benches were critical of the Government’s slow response to the delta variant—slow to protect our borders, slow to act to reduce transmission in the community—so we welcome swifter action with regard to the omicron variant and, as my hon. Friend the Member for Tooting (Dr Allin-Khan) said in this place yesterday, we support the measures laid out in these two statutory instruments, one on face coverings and one on public health restrictions. It is right to be acting urgently given the seriousness of the threat, but it is sad to be debating these SIs after the fact; we need to build public confidence in whatever measures we bring in and it is always better to discuss them beforehand, rather than afterwards, to show that parliamentary scrutiny really matters.

[Mr Harper]

I am very pleased to hear the hon. Gentleman say that about parliamentary scrutiny. He will know that yesterday I asked the Government for assurances if they were to want to extend or strengthen these measures after the House has risen for the Christmas recess, as I feel that if that is the case the House should either continue sitting or be recalled. In answer to my question, the Leader of the House suggested that it would be up to the House. I therefore ask this of the hon. Gentleman speaking for the Opposition: if the Government were to bring forward strengthened measures or want to extend them after the House has risen, would the Opposition support the House being recalled so that we can debate and vote on the matters in advance, or is he prepared to give the Government a blank cheque?

[Alex Norris]

My predecessor as Member of Parliament for Nottingham North had a strong record on recall of Parliament in 2003 and would smite me down if I were to dismiss the right hon. Gentleman’s question out of hand. It is a hypothetical question, however, and I am not going to be drawn on that, but I will say this: when we were getting through the backlog of such SIs over the summer I said to the Minister at the time, the hon. Member for Bury St Edmunds (Jo Churchill), that I would have met at any hour at any time to get through some of them, since they were weeks and weeks delayed at some points. I have not changed my view on that.

[Karl MᶜCartney]

On that point, does the shadow Minister therefore think we should come back before Christmas, or maybe after Boxing day and before new year if the House is to be recalled?

[Alex Norris]

The hon. Gentleman’s question makes me think he has some plans to book; if he is trying to book a weekend away, he should not let me set those dates for him.

Turning to the regulations, and starting with the Health Protection (Coronavirus, Wearing of Face Coverings) (England) Regulations 2021 (S.I., 2021, No. 1340), it is right to reintroduce masks on public transport, in shops and other settings including banks, hairdressers and post offices for those who are not exempt. This measure should never have been abandoned. While mask wearing in public spaces forms part of the Government’s plan B, it was always part of the Opposition’s plan A rather than an emergency measure, as was encouraging working from home where possible.

[Rachael Maskell]

I am slightly confused by these measures, because the risks are the same in any indoor setting; whether on public transport, in a shop or in some other indoor space, the risks still exist. Can my hon. Friend tease out why there is an inconsistency in these regulations?

[Alex Norris]

My hon. Friend makes a good point that I will cover shortly. Of course the measure should apply to public transport and shops—and also to the House of Commons Chamber, but I will get to that shortly.

[Gary Sambrook (Birmingham, Northfield) (Con)]

Last night I walked past the shadow Cabinet room and there was quite a party going on inside, and I popped my head round the corner and there was a lot of drinking and shuffling going on. That is fair enough, as those are the rules at the moment—knock yourselves out, it’s nearly Christmas—but why is it okay to come into the Chamber and tell us all one thing in front of the cameras and do something completely different behind closed doors?

[Alex Norris]

If the hon. Gentleman is seeking to redress grievances as to what Labour party parties he has and has not been invited to, I am the wrong person to address those concerns to.

In order to build confidence in this issue, I ask the Minister to publish the guidance she and her colleagues have relied on that says that public transport and shops are areas of likely transmission but hospitality spaces, for example, are not. We do need to build confidence.

Anyone who has taken journeys on public transport in recent months will have seen at first hand a lack of compliance; that is of course just the Prime Minister, but beyond that all of us will have seen it on the tube and elsewhere on our commute.

[Mark Jenkinson (Workington) (Con)]

Like the hon. Gentleman, I have travelled on the tube in recent months and seen a lack of compliance, but enforcement on the tube is of course handed over to Transport for London officers. Does the hon. Gentleman think the Mayor of London should be doing more to enforce mask wearing on the tube?

[Alex Norris]

We will now start to see how effective these regulations are—they have only been going for nine and a half hours—but I will shortly address my reticence about members of staff whose primary job has not traditionally been to enforce such measures now being put in that position. That gets to the point my hon. Friend the Member for Sheffield South East (Mr Betts) was addressing.

[Mr Betts]

The issue is that enforcement is impossible when people can just claim an exemption and we are not allowed to ask, “Why have you got an exemption; can you prove it?” Does my hon. Friend agree that we should have had a system in place from the beginning where if people wanted an exemption—a medical exemption is what the Minister called it—there had to be medical confirmation that they were entitled to it because they had a medical condition that meant wearing a mask was damaging to their health?

[Alex Norris]

We are after the fact now on that, but I think we have to protect the principle that we do not expect people to wear masks if doing so is detrimental to their health. That is the right level of proportionality, but we are reliant on good faith and people not abusing that, and I would be disappointed to hear of cases such as those my hon. Friend raised.

I particularly want to raise with Ministers a point about shop workers. Our hard-working shop workers have given us so much during the last 20 months. They have kept open the vital community assets that mean we were all able to be fed and watered. In return they have faced increasing violence and abuse. It should be made very clear that they are not being asked to police this; I hope the Minister will do that and also give more detail, as colleagues clearly wish to hear it, about how enforcement will work in practice.

The largest number of infections is now in those aged under 20, with the peak at approximately 10. This is a big part of continuing transmission, yet the changing and drifting policies on masks have created confusion across schools, colleges and universities. Can the Minister confirm what the new requirements are across all settings?

[Tom Hunt (Ipswich) (Con)]

I am very pleased that compulsory mask wearing has not been extended to the hospitality sector, as that would have been deeply damaging to businesses. What is the position of Her Majesty’s Opposition on this issue, because I think I heard something slightly different just now from what I heard yesterday?

[Alex Norris]

It is hard to answer given that this is not on the face of these regulations, so I have asked the Minister to be clear about why that differentiation was made, and then all Members would be able to make a judgment as to whether that was a wise decision.

[Karl MᶜCartney]

rose—

[Alex Norris]

I have given way to the hon. Gentleman before; I do not rule out doing it again, but will not do so immediately.

On ventilation, which links in to education settings, throughout this pandemic we on these Benches have called for a radical upgrade in the ventilation of public buildings, particularly schools. We know that is not something we can just click our fingers and do; it is more expensive and time-consuming and much harder to do than asking people to wear a mask, but it is a particularly effective intervention. Some 18 months into this pandemic, can the Minister update the House on how many public buildings now have proper ventilation systems as a result of decisions taken during the pandemic?

[Dr Luke Evans (Bosworth) (Con)]

Have the Opposition done any analysis of how much it would cost to implement ventilation en masse across educational settings?

[Alex Norris]

The hon. Member goes slightly further than I did in saying that ventilation should be rolled out immediately across all schools. Of course, that would have significant financial implications. It would also, of course, be very good for British business. We are saying that, as has been clear throughout the pandemic, better ventilation in public buildings should be a significant part of building regulations in general. What I seek from the Minister is a sense that any of that, never mind all of it, has been done at all.

[Dr Murrison]

Can the shadow Minister cast his mind back to the debates we had on smoking in public places? If he is suggesting properly engineered extraction ventilation, we dismissed that during those debates—although many of us would have liked to have seen it as an alternative to an outright ban—because of the sheer engineering cost of doing it. Or is he proposing simply opening windows? What exactly is he proposing when he says we need to improve ventilation? At one extreme it is going to be murderously expensive and virtually impossible, and at the other it is simply opening the window.

[Alex Norris]

I cannot cast my mind back to that debate—I believe I had just started secondary school when it took place—but I can foresee the issues that were raised. I would not do down the idea of opening windows; that would be a good thing to do in and of itself, and I would support that. What I am saying is that there are certain places where that will work less effectively, and we ought to have some sense, certainly building by building, of what might be an effective measure. As I said, I do not think this is something that we can just click our fingers and do easily, but I would like to get a sense that we have tried to do any of it at all, and I have yet to get that. I hope the Minister will disabuse me of that.

[Dr Philippa Whitford (Central Ayrshire) (SNP)]

I raised the issue of ventilation last summer—we have known for a long time that covid is airborne—and I wrote to the Chancellor on two occasions asking him at least to remove VAT, to help businesses and public bodies that pay VAT to afford ventilation. Sticking 20% extra on the cost of a ventilation system seems quite weird in the middle of a pandemic.

[Alex Norris]

I am grateful to the hon. Member for that intervention, which gets to the root of the matter. We have been talking about ventilation for a long time. What I would really like to hear from the Minister is whether any progress whatsoever has been made in this area.

I turn to statutory instrument No. 1338 regarding self-isolation. The regulations introduce new rules for self-isolation after contact with a person who is suspected to have contracted the omicron variant of the virus, removing the exemptions to self-isolation. As we saw in the summer, this will be frustrating for those who would otherwise have been able to avoid self-isolation requirements by being vaccinated and who will now have to stay at home for the full period. However, as we wait to see how our vaccines and antivirals respond to the new variant, it is right that we prioritise caution and seek to limit community transmission as much as humanly possible. The Minister may have sensed colleagues’ eagerness to know more about this requirement. I hope that she will tell us when she thinks she is likely to have enough information about the variant to return to Parliament and say whether the Government feel that the regulations ought to remain.

There is, of course, a significant gap in the fence of these regulations. The gap has existed throughout the pandemic, and it is bewildering that we in the Opposition are still having to raise it. It relates, of course, to fixing sick pay. We have learned during the pandemic that the overwhelming majority of the British people want to do the right thing to protect themselves, their family and each other, but that falls short when they are forced to pit it against their need to feed their families. In both rate and availability, sick pay has proven insufficient to protect families against that horrendous choice.

These regulations will be weakened. They will be weakened when people ignore their symptoms and go to work, weakened when people say they are self-isolating and they are not, and weakened when people turn the app off to avoid being a close contact. Surely Ministers have learned this lesson over the last month. I am surprised that we did not hear more from the Minister about that.

The hon. Member for South Dorset (Richard Drax) raised the regulations relating to red list travel. My understanding is that we are not discussing those today because they were laid via the negative procedure, but the elements relating to testing will have an impact on SI No. 1338. Last week, we suggested that the Secretary of State should begin PCR testing for those entering the country, so I am pleased the Government have listened and included day-two PCR tests in the measures announced yesterday, but there are still holes in our defences on international travel.

I am keen to hear from the Minister how she and her colleagues reached the decision to introduce only day-two testing, and not to reintroduce pre-departure tests. I am keen to know the scientific basis behind that. We have heard many reports of private tests not being followed up, especially, perhaps, by those offering the cheapest prices. What are the Government doing to enforce this and to ensure that bringing back day-two PCR tests, which we support, is effective?

I will bring my remarks to a conclusion, because I am conscious of how many colleagues wish to speak in the debate. This is a concerning moment in the pandemic. We have learned over the last 18 months that it is vital that we act decisively at such moments. We are pleased to see these regulations come forward—indeed, in the case of mask wearing, it was premature to stop at all—but there is much more to do if we are to avoid being back here in the coming days and weeks, including working from home where possible, fixing sick pay and improving ventilation. The actions we need to take are clear. It is time for the Government to meet the moment.

Access to Salbutamol Inhalers

Alex Norris Excerpts

Monday 29th November 2021 Westminster Hall

[Alex Norris (Nottingham North) (Lab/Co-op)]

It is a pleasure to serve under your chairmanship, Mr Hosie. I am grateful for the chance to speak for the Opposition in this important debate.

I start, like others, by paying tribute to the young chef Lauren Reid, whose tragic passing last year has led to this debate. Described by her mum as

“the most amazing, kind, beautiful and caring person”,

may we turn this family’s heartache into action and look at ways we can prevent this from happening again.

I also pay tribute to Lauren’s mum, Elaine, who has been spearheading this campaign, and I send my thoughts and prayers to Lauren’s family and friends. I also send them to her colleagues. Hearing what the hon. Member for Don Valley (Nick Fletcher) said about their experience in that moment, and their efforts, I send them my solidarity, too.

Securing a debate through the petition route is a very hard thing to do—100,000 signatures is an awful lot. That speaks to the seriousness of this case, and to how strongly people feel about it. I commend those who promoted it and organised it, and all those who signed it.

The hon. Gentleman had the difficult job of opening this poignant debate, and I thought he did a very good job and made a thoughtful case. I was particularly struck by two things, which I might also speak about. The first was the context of asthma in this country, and the second was the risks in commercial kitchens, which is what, beyond the broader national messages about asthma, makes this individual case very compelling.

There were similarly thoughtful contributions from other colleagues. The hon. Member for Rutherglen and Hamilton West (Margaret Ferrier) set out just how common asthma is. It behoves us, as a national legislature, to act on behalf of that significant portion of our population. I agree with her comments against the argument that those at risk should change roles—I do not give that view much succour, either. I would not want to give up my dreams for something that a reasonable adjustment could prevent, and I would not want anybody else to do that, either.

We look forward to the upcoming debate on asthma secured by the hon. Member for Strangford (Jim Shannon), where we will be able to continue talking about some of these themes. He made very interesting points about schools, which offer an analogous example—a read-across—showing that what Elaine and her family are asking for is working somewhere else. That is very useful. Moreover, I think we all share the hon. Gentleman’s views on safeguards, because we are conscious of the risk regarding prescription drugs.

At the root of this issue is a simple argument, which is to permit the availability of salbutamol inhalers in commercial kitchens. This campaign is backed by Unichef—the chef’s union—and others, such as GMB, my trade union. They are calling for an exemption to be made, whereby commercial kitchens can be supplied with inhalers and administer them in emergencies. In their response, the Government have said that that is something that the regulator would need to approve, and if it sees a benefit a public consultation will be launched. I hope that the Minister will update us on the progress of her discussions with the licensing authority. Similarly, has she engaged with the Royal Pharmaceutical Society about the production of draft guidance once the licencing authority has finished its consideration? It would be very interesting to know what progress has been made in the period between the Government’s official response to the petition and today.

Turning to asthma more generally, 57% of healthcare professionals have had patients who have had an asthma attack or needed emergency care because, for whatever reason, they did not have their medication with them. Life happens: these are errors that any of us could make, particularly when living busy lives, and as we have heard, this is a big group of people. Some 5.4 million people in the UK are receiving treatment for asthma, leading to 41,000 hospital admissions last year due to asthma-related concerns alone, and 1,300 deaths. That is a really significant issue and it requires significant action in this place. As the hon. Member for Airdrie and Shotts (Ms Qaisar) has said, the rate of asthma deaths has increased recently, and we are an outlier relative to our neighbours, with a death rate that is 50% higher than the average in the European Union. Again, we are called upon to understand the challenges in our country and to look at what we might do differently, and this is certainly one of the things we could do differently.

As numerous hon. Members have said, the reason why the distinct setting of a commercial kitchen deserves special consideration is that it is a potentially risky environment, with triggers such as flour, fumes, heat, dust, odours and a lack of decent ventilation. It is perfectly reasonable for us to consider whether we might do better in that setting, because everybody should be safe at work and have safety nets to help them. The example in the case of schools is clear: it has been possible to make an exemption in schedule 17 to the Human Medicines Regulations 2012 to allow the sale and supply of salbutamol inhalers and EpiPens to schools for use in emergencies, so the petition is not asking for something that cannot be done.

I will make a couple of very brief points about the regulator itself. We in this country are very well served by the Medicines and Healthcare products Regulatory Agency, which will be an exceptionally important body for all of us at some point in our lives. Whatever medicine or medical device we may need, the MHRA is the regulator that tells us that it is safe for us to use, so we all rely on it. However, it is also a very busy regulator. The pace of change in that market is significant, both domestically and globally, and recently we in this place have put a significant number of new responsibilities on the MHRA through the Medicines and Medical Devices Act 2021, which received Royal Assent earlier this year. That Act was, in part, a response to our exit from the European Union and the change in the regulatory environment that arose from it. The MHRA is on a high wire and it is not overhyping it to say that it has a life-and-death job, but we are going to make a 20% cut to its staff. The MHRA’s income from the European Union has dried up so we are reducing its staff, yet we are asking it to do more, and that cannot be wise. I hope that the Minister will reflect on that and assure us that Ministers are actively looking at that decision so as to ensure that that cut does not happen, because it does not support patient safety in this country.

To conclude, it is right that we first listen to the MHRA before we act, but the petition’s proposal is reasonable and, because it has a comparative example, feasible. I hope that the Minister will address my questions and those of colleagues, and give us a sense of the conversations taking place and of the timetable, because people are watching today’s debate. I hope they will feel that we have done this really important issue justice—I think we have—but they will want to know where it goes next, so I hope we will hear that from the Minister.

Down Syndrome Bill

Alex Norris Excerpts

Friday 26th November 2021 Commons Chamber

[Alex Norris (Nottingham North) (Lab/Co-op)]

I am grateful for the opportunity to speak for the Opposition on this very important Bill. I commend the right hon. Member for North Somerset (Dr Fox) for using his precious private Member’s Bill slot on this important matter, and I understand this is his first success in the ballot in 29 years, so roll on 2050 for the next one.

The right hon. Gentleman said plenty that will have moved people who are watching as well as Members in the Chamber, particularly the comment that I will reflect on now and over the weekend, too. This Bill is not about a condition: it is about people, and it is not about charity; it is about empowerment. That really struck me, and it is important.

We have heard that 47,000 people in this country, across every nation, region and constituency, are living with Down’s syndrome. They are people with hopes and dreams, who love and are loved, and they have a right to live full lives and to reach their potential. The right hon. Gentleman is taking a major step in that direction with this Bill.

We have had brilliant contributions from colleagues on both sides of the House, and I will try to group them into themes. As this Bill is human rights legislation, as the hon. Members for North Antrim (Ian Paisley) and for Stourbridge (Suzanne Webb) and my hon. Friend the Member for Hackney South and Shoreditch (Dame Meg Hillier) said, I share the enthusiasm of the hon. Members for Dunfermline and West Fife (Douglas Chapman) and for Berwickshire, Roxburgh and Selkirk (John Lamont) that there should be a four-nations approach in the years to come.

There were moving contributions from the hon. Members for Broxbourne (Sir Charles Walker), for Meon Valley (Mrs Drummond), for Buckingham (Greg Smith), for Carshalton and Wallington (Elliot Colburn) and for Don Valley (Nick Fletcher), who brought the debate to life by raising constituency cases. We can throw around the statistics about tens of thousands of people, but each one of them is an individual with different needs, different hopes and different dreams, and they should be treated in that way.

Alongside the 47,000 people, there are tens of thousands of families—mums, dads, sisters, brothers and cousins—who I know will have listened to the debate. My family is one of those tens of thousands, so I am especially grateful to the right hon. Member for North Somerset for giving us the opportunity to take a leap forward in the support available for people living with Down’s syndrome.

I was born in 1984, when life expectancy for a person with Down’s syndrome was about 25; it is now into the 60s. People with Down’s syndrome have basically gained a year every year for my entire life, which is wonderful and it shows the advances we can make when we prioritise the human rather than the condition, and when we are ambitious for everybody and do not define people by the challenges they live with. We know that, with appropriate support, people with Down’s syndrome can thrive at school, can work, can marry and can live full lives. We have to take every opportunity to remove all the barriers, to tackle stigma and to tackle the poverty of ambition that hold back progress in this area, and this Bill is a perfect opportunity to do so.

I note that the right hon. Gentleman has secured Government support for the Bill, so its passage is likely to be smooth. Clause 1(1) provides for the Secretary of State to publish guidance to relevant authorities to make sure they meet the needs of people with Down’s syndrome, which is a powerful tool and I look forward to hearing from the Minister about what she envisages being part of that.

Under clause 1(3) there is an expectation that the Secretary of State will consult. As other colleagues have said, that is important. It must start with individuals with lived experience, so they can tell us what change they need in their lives and what challenges they have had to negotiate. It must also apply to their families—the hon. Member for Carshalton and Wallington talked about it being a battle, which is a common theme in the stories of the families who I have spoken to and who we have heard about today. Beyond that, it is crucial that Ministers talk to clinicians, commissioners and decision makers. I am sure that the Minister will not want to be prescriptive about a consultation today, but she might set out some of its broader themes.

The schedule to the Bill highlights four areas in which the right hon. Member for North Somerset is seeking guidance to be made. I will touch on them briefly in turn. On the national health service, it is vital that healthcare services are responsive to and ambitious for people living with Down’s syndrome so that they get world-class healthcare. We can be proud of the progress made over the last few decades, but we must make sure that we are as ambitious about mental health as we are about physical health and that the progress in physical health can be matched in mental health. I hope that the Minister reflects on that in her closing remarks.

The Bill also references clinical commissioning groups. The Health and Care Bill is going through this place—we debated its remaining stages on Monday and Tuesday—so the commissioning landscape will change. Can the Minister tell us how the language will change to reflect the fact that the Bills are progressing at the same time?

[Kerry McCarthy (Bristol East) (Lab)]

To return to what my hon. Friend said about mental health concerns, when people with disabilities and conditions such as Down’s experience mental health problems that are not necessarily connected to their condition, treatment can be more difficult and it can be difficult to identify that they are developing mental health problems. Perhaps it is more a point for the Minister, but I hope that we can bear that in mind when we are looking at how we treat people with Down’s.

[Alex Norris]

I am grateful for that intervention. Members on both sides of the House share a commitment and an ambition to make significant advances in the mental health of the British people. We know that there are barriers for people with the most profound physical health conditions because, traditionally, we have not looked beyond those conditions to evaluate the mental health aspect. I hope that the Bill is a good opportunity to do that.

On housing, we know that with the right support, people with Down’s syndrome can live semi-independently, so we must make sure that the right type of housing, sensitive to need, is available and distributed across the country. Has the Minister made a baseline assessment of where we are and what we might need to do better?

Hon. Members have made important points about education. At the risk of repeating more of what the hon. Member for Carshalton and Wallington said, the points about education, health and care plans were well made and I hope that they were heard. I took from his contribution that they cannot be pro forma exercises; they must be individual exercises that meet individual needs. That is the purpose of having them.

Linked to that, on employment, only 6% of people with a learning disability in this country are in employment. We should aspire to do much better. Work gives purpose, independence and dignity, and is part of the collective investment that we make in each other. Our ambition is for everybody to be in work who can be, irrespective of their challenges. We need a full strategic plan on the active steps that we can take to show employers the benefits of hiring staff with learning disabilities and the support that can be offered to help to facilitate that. It is important to understand that it is a win-win because, as global studies show, workplaces hiring employees who live with Down’s syndrome are happy and productive.

The right hon. Member for North Somerset made the point about redress, which is an important and live conversation in this country. To read across, if I may, to the Cumberlege report and the impact of sodium valproate and Primodos on children who are born having been exposed to them, those families still cannot get redress—in many cases, many decades later—without an expensive, long and hard pursuit in the courts. That system is not working. The report recommended that a redress system be set up to avoid that, which has not happened as the Government have not accepted the recommendation. It should not be happening to them and it should not happen here, so I hope that, through the Bill, we can do better for people living with Down’s syndrome and for others.

[Dr Fox]

There is, of course, a great carrot for the Government in producing a workable redress system, which is that, if it is not fixed in this Chamber, it may be fixed in the other place. One way or another, however, I assure the hon. Gentleman that it will be fixed.

[Alex Norris]

I am very grateful to the right hon. Gentleman for that, although I am not sure that it was a carrot as much as a stick. However, I know that noble Lords will be taking the same interest in the Health and Care Bill, and I absolutely share his confidence in that sense.

To finish, I look forward to seeing this Bill in its next stages, and we want gains to be made in the four areas in the schedule to the Bill. I would make the very important concluding point that, particularly in relation to local authorities, social care is distressed and under-invested in in this country, so if there are new responsibilities, there must be new investment to come with that. We will continue to make such points at future stages. This requires Government commitment, and it is good that we are hearing that today, but also the resources to sit behind it, and I hope we hear that, too.

Covid-19 Update

Alex Norris Excerpts

Friday 26th November 2021 Commons Chamber

[The Secretary of State for Health and Social Care (Sajid Javid)]

With permission, I would like to update the House on covid-19. Before I begin, I wish the shadow Secretary of State, the right hon. Member for Leicester South (Jonathan Ashworth), well as he recovers from covid-19.

Over the past 48 hours, a small number of cases of a new variant have been detected on our international genomic database. I want to reassure the House that there are no detected cases of this variant in the UK at this time, but this new variant is of huge international concern. The World Health Organisation has called a special meeting this morning, and that meeting is taking place right now. I want to update the House on what we know so far, why we are concerned and the action that we are taking, although I must stress that this is a fast-moving situation and there remains a high degree of uncertainty.

The sequence of this variant, currently called B.1.1.529, was first uploaded by Hong Kong from a case of someone travelling from South Africa. The UK was the first country to identify the potential threat of this new variant and to alert international partners. Further cases have been identified in South Africa and Botswana, and it is highly likely that it has now spread to other countries. Yesterday, the South African Government held a press conference where they provided an update on what they know so far. I want to put on the record my thanks to South Africa not only for its rigorous scientific response but for the openness and transparency with which it has acted, much as we did here in the United Kingdom when we first detected what is now known as the alpha variant.

We are concerned that this new variant may pose substantial risk to public health. The variant has an unusually large number of mutations. Yesterday, the UK Health Security Agency classified B.1.1.529 as a new variant under investigation, and the variant technical group has designated it as a variant under investigation with very high priority. It is the only variant with this designation, making it higher priority than beta. It shares many of the features of the alpha, beta and delta variants. Early indications show that this variant may be more transmissible than the delta variant, and current vaccines may be less effective against it. It may also impact the effectiveness of one of our major treatments, Ronapreve.

We are also worried about the rise in cases in countries in southern Africa, especially as these populations should have significant natural immunity. In South Africa in particular, there has been exponential growth, with cases increasing fourfold over the last two weeks. In Gauteng province, which includes Johannesburg and Pretoria, some 80% of cases, when tested with a PCR test, have shown something known as the S-gene drop-out, which we associate with this variant. While we do not yet know definitively whether the exponential growth in South Africa is directly associated with this new variant, this PCR test analysis does indicate that there could be many more cases of this new variant than just those that have been sequenced so far.

Even as we continue to learn more about this new variant, one of the lessons of this pandemic has been that we must move quickly and at the earliest possible moment. The UK remains in a strong position. We have made tremendous gains as a result of the decisions that we took over the summer and the initial success of our booster programme, but we are heading into winter and our booster programme is still ongoing so we must act with caution. We are therefore taking the following steps. Yesterday, I announced that from midday today, we are placing six countries in southern Africa on the travel red list. These countries are: South Africa, Botswana, Lesotho, Eswatini, Namibia and Zimbabwe.

Anyone who is not a UK or Irish resident who has been in one of these countries in the past 10 days will be denied entry into England. UK and Irish residents arriving from these countries from 4 am on Sunday will enter hotel quarantine. Anyone arriving before those dates should take PCR tests on day 2 and day 8, even if they are vaccinated, and isolate at home along with the rest of their household. If you have arrived from any of these countries in the past 10 days, NHS Test and Trace will be contacting you and asking you to take PCR tests, but please, do not wait to be contacted; you should take PCR tests right away. We have been working closely with the devolved Administrations on this, and they will be aligning their response. In recent hours, Israel has also taken similar precautions.

I wish to stress that we are working quickly and with a high degree of uncertainty. We are continuing to make assessments, including about those countries with strong travel links to South Africa, and we are working with our international partners, including South Africa and the European Union, to ensure an aligned response. This variant is a reminder for us all that this pandemic is far from over. We must continue to act with caution and do all we can to keep this virus at bay, including, once you are eligible, getting your booster shot. We have already given more than 16 million booster shots. The booster jab was already important before we knew about this variant, but now it could not be more important. Please, if you are eligible, get your booster shot. Do not delay.

We have made great progress against this virus—progress that we are determined to hold on to. This Government will continue to do whatever is necessary to keep us safe, and we all have our part to play. I commend this statement to the House.

[Alex Norris (Nottingham North) (Lab/Co-op)]

I thank the Secretary of State for advance sight of his statement and for his kind words about the shadow Secretary of State, my right hon. Friend the Member for Leicester South (Jonathan Ashworth), which we all share on this side of the House.

We have been critical of the Government in the past for taking too long to protect our borders from new variants, particularly when delta was left to run free, so we are glad to see swift action today. Adding these countries to the red list is the right call and we support it. Can the Secretary of State explain why these specific countries have been added, and not the wider group where cases of this variant have been detected? Is the addition of further countries under active consideration over the coming days? Perhaps in the meantime, we might at least require PCR tests on arrival, rather than lateral flow tests, for countries not on the red list that have cases.

As the Secretary of State says, we have made great strides in getting people vaccinated in this country, but we have always warned that no one will be safe until everyone is safe. It is regrettable that when we offered plans to the Government earlier around the global expansion of vaccination, they were not taken up. Today’s news reflects a failure of the global community to distribute the vaccine, with just 5.5% of people in low-income countries being vaccinated. Can the Secretary of State tell us about the work he will be doing with his counterparts in affected countries to ensure they have the vaccines and infrastructure to deliver them? Can he give us an assurance that our cuts to aid that we made in this country will not affect that? Does he share our regret that we had to destroy 600,000 expired doses of the vaccine in August? What are we doing to ensure that our stockpiles get to other countries that need them?

I turn to testing. Earlier this month capacity went down significantly, with members of the public reporting that their local centres had closed. Will the Secretary of State reassure us that testing will still be an integral part of our approach? Will he take this opportunity to refute the rumours that Test and Trace will be scaled down further?

This is also a reminder that we need to go further and faster with vaccination at home. Children’s vaccination rates remain low. The progress on the booster is of course welcome, but we know that to get there by Christmas we need to go even quicker. There are huge pockets of the country where significant numbers of people remain unvaccinated—40% of people in Nottingham, 38% in Wandsworth and 30% in Bolton, for example. The message the Secretary of State had for those people today was very important.

This is a reminder that covid has not gone away. Will the Secretary of State make commitments to fix sick pay, which is still necessary 19 months on? Will he go further to ensure that public buildings, schools and businesses have the support they need? Surely, we must now revisit cost-free measures, such as mask-wearing in public spaces.

To conclude, this is a sobering reminder of the challenges the pandemic brings. We must meet this moment as we have throughout the last 19 months: by pulling together and looking out for each other, and in that British spirit of doing what must be done.

[Sajid Javid]

I am pleased to respond to the shadow Minister. His first question was on the six countries we have decided to put on the red list from midday today. We are going primarily by where the new variant has been detected at this point. It has been confirmed in two countries in southern Africa: South Africa and Botswana. We included the four other countries in southern Africa I mentioned earlier as a precaution. The shadow Minister will not be surprised to know that we are keeping this under review and that there are very live discussions going on around whether and when we should add further countries. We will not hesitate to act if we need to do so.

On vaccine donations to developing countries, the shadow Minister is absolutely right about the importance of that. He will know that the UK has, for a country of its size, done far more than any other country in the world, with over 30 million donations already. We are absolutely committed to our 100 million target and will continue to work bilaterally with countries, but also through the COVAX alliance, to get out more vaccines to the developing world.

Testing remains a hugely important part of our response to the pandemic. It is playing an incredibly important role and that will continue for as long as is necessary.

Lastly, vaccinations are of course the primary form of defence in our country. In one sense, we are fortunate with such a high level of vaccination. Over 80% of people over the age of 12 have been double vaccinated and 88% at least are single vaccinated—one of the highest rates in the world—but we need to go further and even faster. It is great news that our booster programme, at over 16 million jabs across the UK, is the most successful in Europe—now, I believe, over 26% of the population over the age of 12—but we want more and more people to come forward as soon as they are eligible. I cannot stress the importance of that enough. Today, as the hon. Gentleman said at the end of his remarks, is a sober reminder that we are still fighting this pandemic and we can all play a part.

Alcohol Harm

Alex Norris Excerpts

Thursday 25th November 2021 Commons Chamber

[Alex Norris (Nottingham North) (Lab/Co-op)]

It is a pleasure to speak in this important debate and to follow such powerful contributions by colleagues. I commend in particular the hon. Member for St Ives (Derek Thomas) on securing the debate and on the way in which he led it. He said he wanted to start a new conversation. That was an elegant way to put it and is a good challenge to us all; we should all work in that spirit, and his efforts in the commission and in Parliament more generally reflect that.

I was particularly grateful to hear the hon. Gentleman mention foetal alcohol spectrum disorder. That is a hidden harm in society; we are scratching the surface of our understanding of the profound challenges it poses for individuals and society at large. I hope the Minister will give a commitment in her speech to a national prevalence study on it, as the sector is calling for; that would be an incredible thing for a public health Minister to pick up. That fits in neatly with what the hon. Member for North Norfolk (Duncan Baker) said about investing in services that are proven to work. That is important, particularly in relation to work with our local authorities, which I will refer to shortly. Gathering evidence on conditions such as FASD would help us build services that could be very impactful.

The contribution from my right hon. Friend the Member for Birmingham, Hodge Hill (Liam Byrne) was exceptionally moving, and his candour and the vulnerability with which he spoke will have touched those watching the debate and given people permission to speak out themselves. I congratulate him on the work he has done, and the work my right hon. Friend the Member for Leicester South (Jonathan Ashworth), the shadow Secretary of State, has done in this area is also genuinely transformative, changing societal perceptions and giving people permission to speak. I felt very lucky to have been sat here to hear the contribution of my right hon. Friend the Member for Birmingham, Hodge Hill.

My right hon. Friend spoke movingly as well for my hon. Friend the Member for Liverpool, Walton (Dan Carden). We have missed him today, for entirely understandable reasons today. He and I have been friends for a very long time—from long before we were elected here a few years ago—and he and his family are in the thoughts and prayers of me and my family, and I am sure they are also in the hearts of all hon. and right hon. Members. His courage, too, in speaking out as he has done has given others permission to do the same.

Every day in our country 70 people die from alcohol-related causes. Alcohol is a powerful drug that has a wide range of effects on the human body, and the impact goes far beyond just individual health: it meaningful both for the health and wellbeing of the person concerned and for their family and the community they live in. Alcohol is linked to 200 different diseases and injuries, including heart disease, liver disease and stroke, and costs the NHS £3.5 billion every year. Alcohol is now the leading risk factor for ill health, early mortality and disability for those in my age bracket of 15 to 49. There are over 1 million hospital admissions related to alcohol each year and, as with many public health issues, they are disproportionately reflected in the poorest communities; a third of all alcohol-specific deaths are in the most deprived 20% of communities.

In my city of Nottingham our hospital admissions entering the pandemic in 2017-18 were 25,000, an all-time high, and the pandemic will only have turbocharged that. We know that in 2020 a record high of nearly 7,000 people died from diseases that are a direct consequence of alcohol, up 20% on the year before. That is a staggering change. In 2020-21, 126 million extra litres of alcohol were sold, and the heaviest drinkers increased their buying by 14%. That is a really significant change in behaviour from what was already a very challenging baseline.

As I say, alcohol harm does not just affect the individual; it harms families, too. Alcohol harm is associated with violence and domestic abuse. While alcohol use is never the sole reason for domestic abuse, the World Health Organisation estimates that roughly 55% of perpetrators were drinking alcohol prior to an assault. As we have heard today, alcohol is also a major factor in child maltreatment, with Department for Education statistics showing that parental alcohol use was a factor in 16% of child-in-need cases.

We feel the harm more widely, too, with crime and antisocial behaviour, traffic collisions and unemployment. As colleagues will know, I have been campaigning for a number of years on violence and abuse against retail workers; again, alcohol is an anchor factor in that type of abuse. Drink-driving causes almost 9,000 casualties and 260 deaths a year. That is an awful lot of empty places at the table this Christmas, and a lot of hearts broken.

Good treatment services are our way, as a society and as a Parliament, to respond to the harm in our society, but even prior to the pandemic, only one in five dependent drinkers were believed to be in treatment. We must do much better than that. I think we can be much more ambitious. The hon. Member for St Ives mentioned the significant proportion of dependent drinkers in his constituency who are not in treatment—and, as he said, his constituency actually outperforms the national average.

That takes us, as we are often taken in Thursday debates about public health, back to the public health grant and our cuts to it over the last decade, which have been a cost efficiency but, as a value proposition, poor public policy. Between 2016 and 2018, more than two thirds of local authorities in England cut their alcohol treatment budgets, with 17 imposing cuts of more than half. Those cuts are part of the reason why dependent drinkers are often unable to get support. St Mungo’s estimates that funding cuts meant that 12,000 fewer rough sleepers accessed support in 2018-19 than if funding had remained at 2010 levels. Of course, as I say, covid will have exaggerated that even further.

Due to these resource cuts, alcohol treatment providers have reduced their offer to try to make sure that they can see as many people as possible. Currently, there are just six NHS in-patient detox units operating in the entirety of the UK, with fewer than 100 beds in total. A lack of outreach services means that those with complex needs are missing out, and a reduction in capacity means that those at lower levels of drinking, where treatment could be really impactful as an early intervention, are missing out too. We are not investing properly in those services, but we need to.

I look forward to hearing what the Minister has to say. I hope that she will address the point about the public health grant and what more can be done to restore what we have lost. As I say, there may have been a short-term cost saving on a financial line in the Budget, but in reality the cost—in human terms, of course, but also in cash terms to the rest of the health service—far dwarfs whatever has been saved. I hope that we can look at that and restore it as a matter of urgency.

Before closing, I want to revisit the point about labelling on alcohol products that I and my right hon. and hon. Friends pressed during proceedings on the Health and Care Bill. I will not reiterate the arguments, which I had the chance to make at length, but it is safe to say that we on the Opposition Benches are impatient for consistent, high-quality information to be available. It is about informed choice; we know that that is what consumers want, too. The settled will of the House, as established during proceedings on the Bill, is to let industry continue its efforts through self-organisation, and it is doubtless true that significant progress has been made in this area in recent years, so we will watch that with great interest. I hope that those in industry who are least willing to make this important change do not see Monday’s vote as a defeat of the concept of labelling itself but, rather, see that they are being given time and space to sort it themselves. If they do not, we will return to the issue.

In conclusion—I want to give the Minister plenty of time to address the comments that colleagues have made—the point about a strategy is well made. Now is the time to pull the efforts together under one roof so that they can be measured, understood and action-planned together—I think that is a good call. The funding that sits beneath them must be restored to its 2010 level. This is a significant harm for the individual and for our communities. I have no doubt that there is a cross-party commitment to attack this issue, and those are ways to do that.

Oral Answers to Questions

Alex Norris Excerpts

Tuesday 23rd November 2021 Commons Chamber

[Sajid Javid]

My hon. Friend, as always, make an important point. I thank his constituents for their excellent response to the national roll-out of the vaccination programme, and for playing their part in that. I have heard what he has said very clearly. We want to make access to vaccination as easy and convenient as possible. I will speak to the NHS to see what more can be done.

[Alex Norris (Nottingham North) (Lab/Co-op)]

The vaccination programme has lost momentum over the summer and autumn. To ensure that everyone who is eligible gets their booster jab by Christmas, we need to be vaccinating half a million people a day, but we are currently not near that figure. We need to reboot the national effort in Shipley and beyond—[Interruption.] Always just for you, Mr Speaker. We need to be mobilising retired medics, and using pop-up clinics and of course our nation’s pharmacies, which are crying out to help. Will the Secretary of State commit to that, and confirm by which day the 500,000 person target will be met?

[Sajid Javid]

I know that the hon. Gentleman sees it as his job always to be negative about the Government, although on the vaccination programme he and his colleagues have so far been very co-operative across the House. We should not talk down our world-successful vaccination programme, because we have delivered more than 15 million booster vaccines across the UK to 26% of the population over the age of 12—the most successful booster vaccination programme in the whole of Europe.

Health and Care Bill

Alex Norris Excerpts

Report stage
Monday 22nd November 2021 Commons Chamber

[Greg Smith]

My right hon. Friend is absolutely right and speaks with great experience from her time as Secretary of State at DCMS. That is the fundamental point of the amendments; it is not a complex or difficult case, but purely one of fairness and treating the different platforms—the diverse media of 2021—the same, rather than pretending that the media from the old analogue age can somehow be treated differently from those of the digital age.

Let us not cut off the lifeline that funds so many good educational programmes. Let us think again about restrictions on advertisers, move forward in a way that can enable people to make the right and healthy choices about what they and their children eat without this level of restriction, and ensure that, when restriction is brought in, it is fair.

[Alex Norris (Nottingham North) (Lab/Co-op)]

It is a pleasure to speak for the Opposition in this first part of the debate on the Bill.

A decade ago, virtually to the day, I was a young activist taking part in marches, protests, online campaigns, letter writing campaigns, petitions and much more in opposition to what would become the Health and Social Care Act 2012. We argued that it would lead to more fragmentation, less integration, confused decision making and more privatisation and that it would not make anybody any healthier.

Despite significant opposition to the legislation, the Government pushed on. But as campaigners, we were right, weren’t we? The 2012 Act created a fragmented system that did not promote health and care integration. Performance against NHS targets, even pre-pandemic, was dismal and now it is even worse. Waiting lists have grown extraordinarily, and staff vacancies have grown to crisis proportions.

We are here today and tomorrow to consign that legislation to history—perhaps less the end of an era and more the end of an error. But the same Government who broke the system now offer a new package of reforms, and that should really scare us. These are the wrong reforms at the wrong time. There are no answers in them to the waiting times crisis, no answers to the capacity issues in accident and emergency or our ambulance services, no answers to access issues for our GPs or dentists, and no answers to the environmental factors that make a country with so many assets so unhealthy.

[Mike Amesbury (Weaver Vale) (Lab)]

Does the shadow Minister agree that the Bill gives the green light to private profit making companies sitting on integrated care organisations?

[Alex Norris]

Yes. That was a strong theme in Committee that we on the Opposition Benches are very much against; it is likely to be a prominent theme during our discussion of upcoming amendments. Through what we are discussing now, we at least have the chance to put something in the Bill that might improve the public’s health.

[Barry Gardiner]

My hon. Friend talked about waiting lists. Would he confirm that at the moment approximately 5.6 million people are on the waiting list and that the Government’s own projections are that that figure could rise to 13 million? What in the Bill does my hon. Friend believe can address that extraordinary situation?

[Alex Norris]

My hon. Friend makes an important point. This Secretary of State must be the first in the history of the NHS who came into that important role saying that he was expecting waiting times to grow to the extent that they are. That is of course pandemic-related, but it also has a reality far beyond this extraordinary last 18 months. There are more than 125 clauses in the Bill and the Government have proposed more new clauses in Committee and on Report, but not one of them will have a meaningful impact on waiting times, so people should be really disquieted.

[Alun Cairns]

I have listened carefully to the hon. Member’s comments about waiting times in England and the measures that are to be introduced here. He urged disquiet; can I assume that his disquiet is even louder when he considers my constituents in Wales who have much longer waiting times?

[Alex Norris]

There is a danger that the right hon. Gentleman has missed the point. The reality is that for a decade there has been historically low investment in our health service, which of course has Barnett consequentials for Wales. That is the reality and why the system is as distressed as it is. I do not think he can put that at the door of the Welsh Government.

Let me come back to public health. Over the past five years we have removed £1 billion in public health funding, which means that the challenges in respect of childhood obesity, smoking, sexual health and access to drug and alcohol services are all developing and growing. The sad thing is that such cuts make an immediate local government saving for the Treasury but create greater costs for the public purse later, never mind the impact on people’s lives. They are the falsest of false economies. For all the talk of the end of austerity, last month’s Budget did nothing to tackle that reality. Indeed, local authorities are under greater pressure and the cycle will continue.

Being smoke-free by 2030 is a major national prize, and with that I turn to new clauses 2 to 11, tabled by my hon. Friend the Member for City of Durham (Mary Kelly Foy). She made an excellent case and has shown tremendous leadership on this issue, in concert with the hon. Member for Harrow East (Bob Blackman), through the all-party parliamentary group on smoking and health. They have given the Government a number of really good ways to improve our nation’s efforts and I hope we will hear from the Minister that they will be taken on.

Tackling smoking is a crucial part of not only improving the nation’s health but addressing health inequalities. A child born where I live, Nottingham, can expect to live seven years fewer than a child born here in Westminster. When it comes to healthy life expectancy, we can expect that difference to double. Tackling that inequality should be a core part of the business of this place. Nearly half that inequality is attributable to smoking—that is how pivotal this issue is.

Successive Governments have shown over the past 25 years that we can make inroads with public policy on smoking, but the benefits have been unevenly felt: the smoking rate among those in professional occupations is now down to just one in 10, so is well on track to meet the 2030 target, but incidence rates among those in manual or routine occupations remain a stubborn one in four, so we must now renew our efforts with that group of people who are, of course, disproportionately likely to use stop smoking services—the very services we have lost over the past decade. Of course, as my hon. Friend the Member for City of Durham said, the pandemic has posed new challenges, with a new group of people who have started smoking but would not otherwise have done so.

We have been promised a new tobacco control plan by the end of this year, but that promise looks a little less secure by the day—I hope the Minister will tell me I am wrong. We could get on with impactful interventions right away. The labelling and information interventions set out in new clauses 2 to 4 have very strong evidence bases from other countries, as my hon. Friend the Member for City of Durham said, and would be quick, easy to implement and impactful.

On new clause 4 in particular, we know that e-cigarettes and vaping are important quit aids, but we would not want them to be a gateway for children to smart smoking. We should be concerned about the 2021 YouGov research for ASH—Action on Smoking and Health—that suggests that more than 200,000 11 to 17-year-olds who had never smoked previously had tried vaping this year. As my hon. Friend the Member for City of Durham said, we must make sure that that age group does not take smoking through that route and that products are not targeted at it.

New clause 5 would tackle the bizarre loophole, which colleagues sometimes struggle to believe is true, that would allow the egregious practice whereby e-cigarettes or similar kit could be given free to someone under 18, although they cannot be sold. That is an extraordinary part of the law and I know that the Minister agrees it is daft—he said that in Committee, but also that he did not feel there was quite the evidence that it was a risk. Well, risk or not, I think the loophole should be closed, because I suspect that eventually someone will happen on it as a bright idea.

New clauses 8 and 10 are a beautiful support to any Minister who wants to improve smoking outcomes in this country, as I know this Minister does, but is conscious about the finances. This gives the Minister a chance, through a US-style polluter pays model, to fund all these interventions, including the restoration of the lost smoking cessation services in this country. He did not close the door to that in Committee when we talked about it, so I hope that he might tell us today that it is likely to form part of the new tobacco control plan. New clause 11 promotes a consultation on raising the age of sale, as we know that the older a person gets, the less likely they are to start smoking.

Let me turn to new clauses 15 to 17 and amendments 11 to 14 in the name of my hon. Friend the Member for Liverpool, Walton (Dan Carden). Colleagues will have been profoundly moved to hear him speak of his battle with alcoholism, and I know that his bravery has connected with people across the country. I associate myself with the remarks of my hon. Friend the Member for City of Durham regarding his entirely understandable absence from the Chamber today. With him in mind, I speak in support of those new clauses and amendments.

New clause 15 seeks to improve alcohol product labelling. This is overdue and it is popular. It is about not taking alcohol products out of people’s hands, but instead making sure that they can make an informed choice.

[Christian Wakeford (Bury South) (Con)]

While an energy drink carries not only calorific information but a health warning that drinking too much can have a laxative effect, alcoholic drinks carry no calorific information and no health warning. Does the hon. Gentleman agree that that is a damning indictment of where we are in society and that a change, which the amendment could make, is needed?

[Alex Norris]

I am grateful to the hon. Gentleman for that intervention. I completely agree with him. I would be the last one to police people’s consumption habits in the night-time economy for fear of being a hypocrite, but I do think that we should all have informed choice. What we have at the moment is inconsistent and unclear. We know that that frustrates people. A recent survey has shown that: 75% of people would like to know the number of units in a product; 61% would like to know the calorie information, as he mentions; and 53% would like to know the amount of sugar. We should give people the chance to have that full information to make their own decisions.

[Geraint Davies (Swansea West) (Lab/Co-op)]

My hon. Friend will know that two thirds of people in Britain are overweight and that one in four is obese. An enormous amount of added sugar is put into processed foods that people do not know about. Men, for instance, are not supposed to have more than nine teaspoons of added sugar, and women six, which is the equivalent of a can of coke and a light yoghurt. Does he not agree that this Bill is tremendously light on the killer that sugar is, and that not only should we be labelling it, but that the Budget should tax added sugar in processed food to reduce the waiting list?

[Alex Norris]

My hon. Friend will be delighted to hear that I will be coming on to the modesty of the Government’s plans for tackling obesity, but I have to finish my remarks about new clause 16.

New clause 16 compels the Secretary of State to publish an annual statement about the spend and impact of alcohol treatment funding. After a decade of reduced commitment in this vital area, the Secretary of State should seek to embrace this opportunity. At the moment, national Government cannot say they are meeting their responsibility to tackle alcohol harm with the requisite financial commitment and in the right place, which should discomfort them greatly. New clause 17 would replicate in England the minimum unit pricing restrictions that we see in Scotland and Wales, and we are all watching with great interest as evidence gathers as to their impact.

Let me now turn to the amendments and new clauses relating to advertising. The Government have included a couple of elements of their obesity strategy in the Bill. As I have already said to the Minister—in Committee and upstairs in the delegated legislation Committee—I wish that they had put the entire obesity strategy in this legislation, because there are bits that could have been improved by amendment, by debate and by discussion, as we heard in the contribution of the hon. Member for Buckingham (Greg Smith), and as I dare say we will in that of the hon. Member for North East Bedfordshire (Richard Fuller). We should have taken that approach to the entire document, and it is sad that we did not.

On the obesity strategy itself, it is too modest and it fails to attack a major cause of obesity, which is poverty.

[Jim Shannon]

The hon. Gentleman is absolutely right in what he is saying. I am a type 2 diabetic and I am well aware of the issues. As I understand it, figures that have been gathered during the covid-19 pandemic showed that the number of diabetics rose by some 200,000. That tells me that, if we are going to address the issue of diabetes, we need to have a tax process in place, which I think is what the hon. Gentleman is referring to, rather than a regulation, because that is the only way that we can control diabetes.

[Alex Norris]

I think that a solution might be a little from column A and a little from column B, but I am grateful to the hon. Gentleman for making that point.

We have heard about the modesty of the strategy from the hon. Member for Buckingham. The reality is that any benefits from the obesity strategy will be outstripped by losses in the nation’s health caused by the impact of the cut to universal credit. We want the strategy to succeed, but it needs to be seen in that broader category.

Obesity is an important issue, with nearly two thirds of adults carrying excess weight. Childhood obesity is also a significant issue, with one in 10 children starting primary school obese, rising to one in five by the time they leave—extraordinary at such a young age.

[Catherine West]

I thank the shadow Minister, who is making an excellent argument, and colleagues across the House for all their work on this important Bill. Does he agree that we could do an enormous amount for the health of the nation by looking holistically at the role of exercise and prescribing exercise through the national health service, including swimming—the statistics on 11-year-olds who can swim 25 metres are going backwards due to all the lessons they have missed during coronavirus—and other important sports?

[Alex Norris]

Yes, I agree. I look with real sadness at the loss of exercise-on-prescription schemes that were part of the public health grant but have gone over the last decade. Similarly, on swimming, the decisions in the Budget relating to local authorities will lead to councils, which are setting their budgets as we speak, closing more leisure centres and swimming pools. We should mourn those losses, which come as a result of a weak bit of public policy.

In the Bill, the proposed watershed with regard to high fat, sugar and salt products is broadly a good thing. With that in mind, we do not oppose Government amendments 31 to 39, which are relatively modest tweaks, but we should not lose sight of the fact that we are talking about a significant proposal; I know that colleagues have interest in this. Beyond a watershed on traditional broadcast media, we will also see a complete online ban of high fat, sugar and salt advertising. This is a blunt tool in pursuit of an important goal.

New clause 14 in the name of the hon. Member for North East Bedfordshire would implement a more nuanced system, as proposed by the advertising industry itself. This is mirrored in amendments 106 to 109 in the name of the hon. Member for Buckingham. We probed this point in Committee. I was surprised then, and remain surprised, that there seems to be little interest from Ministers or the Department in even having that conversation and exploring creative alternatives. The desired benefits are non-negotiables. If there are other ways to achieve those benefits, they ought to be approached with an open mind.

[Richard Fuller (North East Bedfordshire) (Con)]

I am grateful to the hon. Gentleman for mentioning my new clause. We have a number of issues potentially to put to a vote later. Given what he has said and given that the Minister was a bit hazy about this issue in Committee, would he be minded to support my new clause if it were put to a vote and the Minister did not come forward with something more robust?

[Alex Norris]

The hon. Gentleman tempts me, but my problem is that I want to know that the conversations have taken place and that the proposal has been considered as an option. I would not say today that I think it is the best option, but I am surprised that that conversation has not taken place, which is why I have highlighted it. There is still time for the Minister to reconsider, and he should.

I was less persuaded by amendments 3 to 5 in the name of the hon. Member for North East Bedfordshire, which seek to permit brand advertising as long as it does not refer to an HFSS product. In many cases, the brand and product are so inexorably intertwined that it might undermine the goals and aims of the whole intervention. I do, however, support amendments 6 to 8, which refer to the nutrient profiling model—the model that is used to determine what is and is not considered to be a high fat, sugar and salt product. It is important that there is certainty and that it does not move around more than the science would say that it ought to.

We talked about this issue at length in Committee. If we are asking the industry to reformulate and change, companies ought to be able to base product decisions on the certainty that the Government will not arbitrarily change the criteria. Such companies may have made significant time, financial or infrastructure investments in a certain product and then could see the criteria change overnight. In Committee, we extracted a commitment from the Minister to a Government amendment on this matter. That was reiterated in a letter on 13 November, when the Minister wrote to Committee members and committed to

“introducing a Government amendment at Commons Report Stage to include a duty to consult before changing the NPM technical guidance.”

I am surprised not to see that at this point. I hope that we will get clarity from the Minister, or indeed that he is minded to accept these amendments, because this is an important development. We also want the level playing field suggested by amendments 110 to 113, so we will be listening with great interest to his reply.

This is the wrong Bill at the wrong time. It does nothing to address the real causes of ill-health in this country today. In this part of the proceedings, colleagues have given the Minister a chance to change that and I hope he is minded to take it.