Tobacco and Vapes Bill (First sitting)
Andrew Gwynne ExcerptsTuesday 7th January 2025
(1 year, 7 months ago)
Public Bill CommitteesRead Full debate Tobacco and Vapes Act 2026 View all Tobacco and Vapes Act 2026 Debates Read Hansard Text Read Debate Ministerial Extracts Amendment Paper: Public Bill Committee Amendments as at 7 January 2025 - (7 Jan 2025)
The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)
Q
Professor Sir Chris Whitty: May I take one impact that extends my previous points about outdoor smoking, and then maybe pass on to Sir Gregor and Sir Frank? For outdoor smoking, the previous Bill—the very good Bill put forward by the previous Government—did not have anything that addressed the needs of current smokers. It also did not address the needs of people exposed to smoke, despite the fact that, like over 88% of the population, they are not smokers and many of them are medically vulnerable.
The Bill allows the Government to take powers to prevent outdoor smoking, first with additional public consultation and then additional measures in Parliament. Ministers—you, Minister, have demonstrated this in the House of Commons—have indicated the areas where they intend to use these powers to reduce the risks of passive smoking. These are the areas of the greatest vulnerability: around hospitals, where some of the most medically vulnerable are highly concentrated; and around children’s playgrounds, where children are—I think everybody who does not have shares in cigarette companies would agree that exposing children to second-hand smoke is an unacceptable thing to do. That is one area where the Bill has gone further than the previous one. Maybe Sir Frank might want to add to that.
Sir Francis Atherton: In Wales, we have had smoke-free hospitals, schools and play areas since 2021, under our earlier public health legislation, and it is completely non-controversial. There are clearly issues around implementation and enforcement, particularly around hospitals, but if you go now to schools and hospitals there is no controversy whatever. So that will not make a huge amount of difference in Wales.
The one thing that will make a difference, I think, is aligning the vaping legislation with the smoking legislation. I say that because, going back to the earliest question, vape use among young people in Wales has shot up over recent years—8% of 11 to 16-year-olds regularly vape, up from 5% and a bit in 2021. It has absolutely shot up. Bringing together vaping and tobacco legislation in terms of vape-free and smoke-free places is a really important thing and one for which I have been arguing for quite some time.
Andrew Gwynne
Q
Professor Sir Gregor Ian Smith: Perhaps I can begin this answer; my colleagues may then want to come in. Alignment in this respect is really important, partly because of the clarity of message that exists to the public around about what is legally acceptable in relation to smoking and to vaping. Alignment across tobacco smoking and vape use is similarly important across the four nations.
Public health messaging is incredibly important. Having a consistent message across our four nations helps to ensure that the message is much more clearly understood and adhered to by the public. I welcome the attempts by Ministers to ensure that alignment exists within the Bill, so that as we go forward we give protection to those who do not smoke in the way that we are planning on doing with the Bill as it proceeds.
One of the most important aspects is to make sure that, although in Scotland, for instance, legislation prevents smoking within 15 metres of the likes of public places such as outside a hospital, we bring that much more closely in line with where the Welsh position is—so to the whole of the hospital grounds. Extending it to protect, as Sir Chris has said, more vulnerable places such as play parks is something I would certainly welcome in Scotland. We should do that in step across the four nations. I again emphasise that public messaging is incredibly important in making sure that we get the adherence we seek.
Andrew Gwynne
Q
Professor Sir Chris Whitty: I have already given my view that, although I have a lot of sympathy for choice and freedom arguments in many situations, tobacco addiction and second-hand smoking are not among those.
Sir Francis Atherton: If anything, choice is undermined by the addictive nature of nicotine. It is incredibly addictive. We know that now; we have known it for many years, actually. The tobacco industry has known it for many years, which is why the industry, through vaping and other means, is quite keen to have the next generation of people in our countries addicted to nicotine. Choice is completely undermined and taken away by the addictive nature of the product being marketed.
Professor Sir Gregor Ian Smith: Nicotine addiction is horrific. Nearly 9,000 people a year still die in Scotland as a result of tobacco-related health issues. Two thirds of people who begin smoking are potentially at risk of dying as a consequence of their addiction. We know that the industry targets both the younger age spectrum and vulnerable groups to sustain their industry.
If you have ever spoken to a patient with a serious tobacco-related illness such as chronic obstructive pulmonary disease, who is now suffering from the consequences of that—the limited ability to live their life—and the addictive nature of the disease, you soon begin to learn that they are filled with nothing but regret and guilt for the part that their addiction has played in the development of the disease. The stigma associated with tobacco-related disease is quite terrible for those who experience it. The basis of that is this lack of choice that they have developed as a consequence of the addictive nature of the nicotine products.
Professor Sir Chris Whitty: If I could just add a specific example from—
The Chair
Sorry, Sir Chris, but before we go further, I am trying to establish whether Sir Michael McBride has contact with us yet. If you can speak, Sir Michael, then we will know whether we have connection. It is as simple as that, really.
Professor Sir Michael McBride: Yes. The problem is not on my side, so I asked that you unlock me. I think I have now been unlocked, so perhaps I can speak.
The Chair
We will now hear evidence from Hazel Cheeseman, chief executive of Action on Smoking and Health; Sheila Duffy, chief executive of ASH Scotland; Suzanne Cass, chief executive of ASH Wales; and Naomi Thompson, health improvement manager at Cancer Focus Northern Ireland. We have until 10.55 am for this panel. I call the first Member to ask a question—the Minister.
Andrew Gwynne
Q
Hazel Cheeseman: We are all delighted to see this Bill return, and in such a strong form. There is complete consensus across the ASHs of the four nations that this is a Bill that is needed, wanted and workable.
As the chief medical officer said in the previous session, the improvements in this Bill are that there are more provisions that will assist in reducing smoking among people who are already smoking and in protecting those exposed to second-hand smoke. It also creates a comprehensive set of regulations around all tobacco and nicotine products and provides us with that future-proof—the flexibility to respond to evidence as it emerges and changes and to the market as it emerges and changes over time.
The Bill is enormously welcome for its comprehensiveness and robustness, and therefore for the opportunity to significantly reduce the uptake of smoking among the next generation and to aid people in quitting. The Minister will not mind me saying that I think there is more that the Government will need to do to accelerate that progress, in terms of investing in support for those who are already smoking and ensuring that we have the right strategy in place for that, but the Bill is a really good step in the right direction.
Andrew Gwynne
Q
Sheila Duffy: We have seen that tobacco control measures work. We have seen that they have reduced adult smoking rates over time. The points made by the chief medical officers were well made: we are looking to the generation growing up now in the UK; we are looking to protect them from addictions that so many now regret and that are claiming lives unnecessarily.
Suzanne Cass: I would add that tobacco control policies that are put in place are popular, and are really welcomed among members of the public; they are also welcomed among people who smoke. There is a huge surge of public support for tobacco control policies, and that grows—it does not diminish—as we introduce new policies; it grows, and that public support increases.
Naomi Thompson: In Northern Ireland, we are working towards a smoke-free Northern Ireland by 2035, and the reality is that tobacco control over the past 10 years has managed to bring things down to a stage where 2035 has potential. That is why tobacco control needs to continue. A Bill like this is just brilliant to keep that focus. If we can prevent people from starting, that will be absolutely key to making Northern Ireland, certainly, smoke-free by then.
Andrew Gwynne
Q
Suzanne Cass: As you know, ASH Wales and the Welsh Government have been at the forefront of implementing smoke-free spaces. We campaigned for smoke-free playgrounds and smoke-free school gates, both on a voluntary basis. Luckily, the foresight of the Welsh Government has made that provision legislation when it comes to hospital grounds, playgrounds, sports grounds, mental health units and a raft of other smoke- free spaces. We are obviously delighted that the Welsh Government has implemented that legislation.
The legislation has made a huge difference, in that it has allowed a platform for communication—communicating the message that it is not okay to smoke around children. There is a massive amount of public support for that messaging, and we have had the opportunity to communicate it. When it comes to smoke-free hospital grounds, a lot of us are looking at that legislation and the possibility of implementing it.
We have obviously had the legislation in place in Wales since 2021, and what we would say on the lessons learned is that there has to be a package when it comes to implementation. We cannot just legislate; we need to be looking at the support that is in hospitals for smokers to quit, we need to have trained staff and we need to have enforcement on the ground. There needs to be a whole package that comes with that legislation. That is the enormous lesson that we learned.
We implemented that legislation in 2021—in the midst of covid, which was tricky—but we have had problems around enforcement and problems around compliance. It is a very different kind of tobacco policy from that in the other smoke-free spaces. When it comes to the other smoke-free places—playgrounds, sports grounds and other areas like that—there is a lot of compliance, but when it comes to hospital grounds, you have to do a bit more of the legwork. But it is well worth it, because what comes with that is on-site hospital support for stopping smoking, and the message to everybody coming on to that site that smoking is not okay and that there is support available if you want to quit. So it comes with a whole raft of measures that support that smoke-free message.
The Chair
I call Caroline Johnson—apologies; I should have called you before the Minister.
Dr Johnson
Q
Dr Ian Walker: First, thank you very much for the opportunity to be here. I start by thanking Parliament for boldly introducing this Bill; it is genuinely world leading. I have spoken to organisations across the world that are envious of the position we find ourselves in. That is a very important question, and the answer is absolutely yes—I think this Bill will be very important in reducing the number of cancers caused by smoking tobacco. We know that there is no bigger thing we could do to actually influence that going forward for the next generation and generations thereafter.
As you have heard this morning, we know that we still have 6 million people smoking across the UK, and we know that we can expect hundreds of thousands of cases of cancer caused by smoking over the term of the next Parliament. As we move towards a truly smoke-free generation over the next 20, 30 or 40 years, we will absolutely expect to see the number of cancers caused by smoking—and, alongside that, the number of other illnesses associated with smoking—reduce.
Andrew Gwynne
Q
Dr Ian Walker: To start with smoking and cancer, the links between passive smoking and cancer, particularly lung cancer, are very clear. It is fair to say that there is less evidence around different scenarios that you might predict through this Bill, such as different outdoor environments and so on, but that is more because those studies have not necessarily been done. It is an important point to make that there is an absence of evidence, rather than evidence of absence.
You heard from the CMO of England this morning that if you can smell cigarette smoke, you are exposed to it. The direct risk, then, is linked to how long you are exposed to it, how concentrated the environment is, how close you are to it and so on. Nevertheless, passive smoking is harmful—not just for cancer, but for vulnerable people with many other conditions as well—so we are very much supportive of the introduction of smoke-free places and the ability to restrict people smoking in particular outdoor spaces.
Sarah Sleet: When it comes to people with lung conditions, second-hand smoke is incredibly important; it is a well-known, severe risk factor for people with lung conditions. About one in five of us in the UK will experience a lung condition—there are around 7 million people with asthma and about 1.6 million people living with chronic obstructive pulmonary disease. Those are two major conditions that are profoundly affected by second-hand smoking, and are clear risk factors in terms of deaths from asthma and people being hospitalised with exacerbations, so it is incredibly important that we deal with the issue of second-hand smoking. People said earlier that there is no choice about second-hand smoking, and yet it profoundly affects those with lung conditions. It is incredibly important that we ensure that we protect those vulnerable people as far as possible.
When it comes to the discussion about how far we should go in terms of smoke-free and vape-free places, we would consider going further than what has been suggested already and looking at other areas to make smoke-free. I know there has been discussion about hospitality and trying to balance the potential economic impact that has been talked about if we make the outside of hospitality places smoke-free. However, we think, given the balance between the public health impact and what we have seen with smoke-free indoor spaces and its impact on business, we could go further and should go further, there.
Andrew Gwynne
Q
Sarah Sleet: People with asthma and lung conditions are in the middle, where they are affected by both smoking and vaping. It is really important to get the balance right. Smoking is terrible—it is terrible for people with lung conditions—and we need to make sure we can drive down smoking rates as much as possible.
Vaping can play a part in helping with smoking cessation, but it should only be used for smoking cessation. People who have never smoked, and definitely children, should not be taking up vaping. We see vaping as a staging post to being completely nicotine-free. It is important to get the balance right between making vaping available for those who need smoking cessation and not encouraging people to try vaping or to keep vaping longer than they need to.
The legislation is good in allowing that flexibility for adjusting over time, as we get more evidence in. It is really important to put evaluation in place and make sure that robust evaluation does flow through over time, so we can adjust and respond to it. Traditionally—certainly in respiratory diseases—there has generally not been enough research and evaluation, so we need to correct that now.
Dr Ian Walker: First, I want to confirm that we are very much supportive of taking those powers. I think one of the real strengths of the Bill is the ability to adjust, moderate and titrate those powers and the actions that we take over time, not just as new evidence emerges, but as the tobacco industry and new products may emerge to try to circumvent the regulation that is in place. That is a really important part of the Bill.
I think the crux of the question was about what is important to consider through the consultation. From our perspective, it is important to get a balanced view on what the right actions are in this area. Of course we all agree that we want to limit, reduce and stop access for children and young people and to limit the appeal to never-smokers, while balancing that carefully against making cessation tools available to people who are trying to quit. It is important not to forget the 6 million people who are currently smokers and the long-term health implications ahead of them. We need a balance so that it is as easy as possible for those people to quit when they have chosen to do so. There will be many balancing features and balancing points of evidence that will be really important through the consultation in coming to the right outcome.
Andrew Gwynne
Q
Dr Ian Walker: Critical. Without a doubt, there is no single bigger action that you could take to reduce the cancer burden on the country. The cancer burden sits at a very personal, individual level for people getting their own diagnosis; it sits at a family level and at a friend level. It also sits at an economic level for the country and at an NHS level, in terms of the burden that smoking-related illnesses cause for the NHS.
From my perspective, this is a world-leading piece of legislation. It is absolutely an opportunity for generational change and a long-term legacy that will see our children and grandchildren never able to legally buy tobacco in the UK and never exposed to the harms that that would cause them.
Sadik Al-Hassan
Q
Sarah Sleet: As I said earlier, the research evidence around vaping harms is currently very poor. There has not been enough. It takes a long time to build up evidence of things that are generally very progressive rather than having an immediate impact, so we will have to wait. We need to put that in place, and we are going to have to wait to get that evidence back.
We have had anecdotal reports from our beneficiaries and those who contact the organisation about places—particularly in closed spaces, but sometimes outside—where there is a concentration of vaping. It is that classic thing where you go through a door and suddenly everybody around you is vaping immediately outside it. We get reports that that exacerbates people’s asthma and sometimes their COPD, but they are anecdotal. We really need the evidence base to support what is happening.
Dr Ian Walker: The only thing that I would add specifically from a cancer perspective is that although there is very little long-term evidence, because the products have not been around long enough and the cumulative effects have not been seen yet, what we do know, based on the current evidence, is that vapes are far less harmful than cigarettes. You heard the advice earlier that if you smoke it is better to vape or take other nicotine products, but if you do not smoke you should not vape, because we do not know yet what the long-term effects will be. In particular, we are very light on evidence on what the impact of vaping will be on bystanders.
Oral Answers to Questions
Andrew Gwynne Excerpts(1 year, 7 months ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)
I thank my hon. Friend for his question and for his campaigning on this important issue—and indeed for speaking so honestly about his own experiences during his time in this House. An additional £267 million has been invested this year to improve the quality and capacity of drug and alcohol treatment and recovery. We are committed to correcting the years of disinvestment in treatment and recovery services and ensuring that people can access the support they need.
Dan Carden
The Minister has done it for me, but I alert colleagues to my interests in this area.
Last month, the Advertising Standards Authority ruled against seven companies posing as treatment providers or impartial advice services or for failing to make clear their role in earning commission when they were in fact brokers—and I can tell the Minister that many more such companies escaped that ruling. They are able to mislead families while taking cuts of up to 40% of fees being paid directly to treatment providers. Frankly, they have been able to run the sector like a racket. Can we make sure that this ruling by the Advertising Standards Authority is the start of something new, where we can seek to regulate practices properly, and will the Minister meet me and interested parties?
Andrew Gwynne
Attempting to exploit people with addictions is reprehensible. Free drug and alcohol treatment is available in every part of the country and I urge anyone who is struggling right now to visit the NHS addiction website. The Care Quality Commission has said that it could take legal action against companies misusing its logo, and Google has said it would remove search listings from these companies. I am more than happy to meet my hon. Friend to see what more we can do to stop this outrageous activity.
Jess Brown-Fuller (Chichester) (LD)
Social prescribing is one of the primary care services provided for drug and alcohol addiction, and it also supports the Government’s aim of moving from cure to prevention, which is why I was shocked to hear that a primary care network in my constituency is reviewing its social prescribing offering across the Chichester district and proposing to remove it entirely. Does the Minister agree that social prescribing is a key pillar of our primary care services, and does the money used need to be ringfenced to protect that service across the country?
Andrew Gwynne
Social prescribing is one of the tools, and it is an important one in addressing public health concerns in each of our constituencies. This Government are committed to ensuring that we get those shifts from sickness to prevention. We will be ensuring that local areas have public health funding in reasonable time. We are about to announce, in due course, this year’s allocations. We need to make sure that local systems maximise the use of their money, and that certainly includes social prescribing.
Rachael Maskell (York Central) (Lab/Co-op)
In 2022, there were more than 10,000 deaths from alcohol use. We know that more than 600,000 people have an alcohol dependency. We need to focus not just on treatment services and their funding, but on prevention. The last Government failed to bring forward a timely alcohol strategy. Will the Minister update the House on what he is doing to ensure that we are tackling this massive situation in our communities?
Andrew Gwynne
My hon. Friend raises an important point. As part of the Government’s health mission, we are producing a five-point plan for prevention, and alcohol harms is one of those areas. I hope to be able to update her and the House in due course on the actions we will be taking to drive down the prevalence of alcohol harms and other addictions, because they are costing lives and causing misery in communities. That is why this Government are determined to tackle these public health problems.
Jim Shannon (Strangford) (DUP)
I thank the Minister for his answers. While there are community addiction services for those over the age of 18, worryingly, across this great United Kingdom, those under the age of 18 are succumbing to alcohol addiction, too. There does not seem to be any provision for them. May I ask the Minister genuinely and helpfully what provision there will be for those under the age of 18, because addiction problems are rising among the younger generation?
Andrew Gwynne
The hon. Gentleman raises an important point. This Government are committed to having the healthiest generation of children ever. That means we will have a concerted effort on a whole range of health issues that determine the health and wellbeing of young people, which will hopefully ensure that they become healthy adults as a consequence. Alcohol harms are certainly one of the considerations we will be looking at.
Elaine Stewart (Ayr, Carrick and Cumnock) (Lab)
Pippa Heylings (South Cambridgeshire) (LD)
The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)
We believe that every child deserves the best start in life. Due to the challenging fiscal context, we are initially prioritising family hubs and Start for Life funding to areas of high deprivation. We will consider the case for extension to South Cambridgeshire in future financial years.
Pippa Heylings
We know how important the best start in life is for opportunities for all. Only half upper-tier local authorities currently receive prioritised Start for Life and family hub funding—78 do not. In South Cambridgeshire, officers are doing huge work to provide support and signposting without dedicated funding, which means that babies, young parents and young families do not receive the full benefits. Will the Minister commit, in the next spending review, to extending these services across the whole of England?
Andrew Gwynne
Local authorities were pre-selected using the income deprivation affecting children index average rank scores, with a rural and urban weighting applied. Tackling child inequalities in health and outcomes is crucial. As resources allow, it is the ambition of the Government to ensure that Start for Life services reach every child.
Gregory Stafford (Farnham and Bordon) (Con)
The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)
Let me start by commending the hon. Gentleman for his fundraising efforts to fight cancer in Surrey and his support for the Brain Tumour Charity. We are committed to ensuring that people with brain tumours have access to more effective treatments and excellent care through, for instance, our national cancer plan, and we will give more details shortly.
Gregory Stafford
I thank the Minister for his answer, and for his googling of my background! Early detection is essential in ensuring that brain tumours do not fall further behind other cancers in priority. Will the Minister update us on the Government’s progress to ensure that screening is prioritised?
Andrew Gwynne
We absolutely want to ensure early detection of these cancers, and I recently met representatives of the Brain Tumour Charity to discuss how we can roll that out. The Government are investing an awful lot of money in tackling cancers, but there is a great deal more that we can do on brain cancer.
Calum Miller (Bicester and Woodstock) (LD)
Adam Jogee (Newcastle-under-Lyme) (Lab)
The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)
In September the Secretary of State and I met the families of people who had suffered harm following the covid-19 vaccination, including my hon. Friend’s constituent Sheila Ward, and they raised the need for reform of the vaccination damage scheme. We listened closely to their descriptions of what they had been through and agreed to look at a number of options, noting that cross-cutting Government decisions might be necessary. We are also working with the NHS Business Services Authority to improve claimants’ experiences of the scheme, and to ensure that claims are processed quickly.
Mr Speaker
Order. May I remind Members not to walk past when the Minister is replying to a question? Please have regard for each other; this sets a bad example.
I call the shadow Secretary of State.
Andrew Gwynne
My hon. Friend raises a really important point. NHS England is due to complete a stocktake of long covid services throughout England at the end of this month. That will provide an accurate in-depth overview of not only long covid services but ME/CFS—myalgic encephalomyelitis/chronic fatigue syndrome—services. The stocktake will provide a comprehensive and accurate national picture, identify key challenges and make strategic recommendations for future service improvement, development and assurance.
Rosie Duffield (Canterbury) (Ind)
Mike Martin (Tunbridge Wells) (LD)
Becky’s son Will was a normal, happy teenager until he suffered multiple covid infections. His mother tried to find out what was wrong with him, but she found that there were no paediatric long covid care services in Kent. Will the Minister update the House on whether Kent, with a population of 2 million, will ever get a paediatric long covid service?
Andrew Gwynne
I am very sorry to hear about the hon. Gentleman’s constituent. I know at first hand how complex and debilitating long covid can be. As I mentioned in an earlier answer, there is a stocktake taking place, which should show where there are deficiencies, but let me be clear: I want to ensure that there are good services for people suffering with long covid in every part of England.
Health and Social Care
Andrew Gwynne Excerpts(1 year, 7 months ago)
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Andrew Gwynne
For MSK conditions such as rheumatoid arthritis, early diagnosis is the key to preventing joint damage and improving quality of life. The Government are investing £1.5 billion in capital funding in 2025-26 for new surgical hubs and diagnostic scanners, to build capacity for over 30,000 additional procedures and over 1.25 million diagnostic tests as they come online.
[Official Report, 17 December 2024; Vol. 759, c. 68WH.]
Written correction submitted by the Under-Secretary of State for Health and Social Care, the hon. Member for Gorton and Denton (Andrew Gwynne):
Andrew Gwynne
The Government are investing £1.5 billion in capital funding in 2025-26, including for new surgical hubs and diagnostic scanners, to build capacity for over 30,000 additional procedures and over 1.25 million diagnostic tests as they come online.
Musculoskeletal Conditions
Andrew Gwynne Excerpts(1 year, 8 months ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)
It is a pleasure to serve under your chairmanship, Mr Efford. I thank my hon. Friend the Member for Dudley (Sonia Kumar) for securing this really important debate, and for bringing her professional expertise to the House. I also thank my hon. Friend the Member for Morecambe and Lunesdale (Lizzi Collinge), who showed that she can think on the spot and turn an intervention into a short speech.
It is important that we acknowledge just how significant the impact of musculoskeletal conditions can be on both individuals and their loved ones. Poor MSK health can severely impact every aspect of a person’s life. It also has a significant impact on the NHS and the wider economy. Pain, stiffness and limited movement all affect quality of life and independence, including the ability to work. MSK conditions are the leading cause of years lived with disability in England. They are responsible for up to 30% of GP consultations, and MSK community services have the longest waiting lists of all community services in England, as of September this year. MSK conditions are also one of the leading causes of sickness absence, with approximately 23.4 million working days lost due to MSK conditions in 2022 in the UK.
That is why the Government are committed to improving care for the 17 million people living with MSK conditions in England, and ensuring that they receive support and access to the latest treatments. Improving health and work outcomes for people living with MSK conditions also forms a key part of the Government’s missions to build an NHS fit for the future, and to kickstart economic growth.
Turning first to the health mission, my Department recently announced plans to develop a 10-year NHS plan. It will consider what actions are needed to improve patient access and reduce waiting times. It will set out a bold agenda to deliver the three big shifts needed. Those are moving healthcare from the hospital to the community, from analogue to digital, and from treatment to prevention. We recognise that there is much more we can do to support earlier diagnosis and management for people with MSK conditions, and the need for timely and comprehensive care that starts at home. We know that many people with MSK conditions can be diagnosed and well managed in the community, which is why we are making a start by exploring how best to support MSK primary and community service improvement, helping to give MSK conditions greater parity with other conditions.
I will certainly take away the suggestions made by my hon. Friend the Member for Dudley on physiotherapists, AHPs more generally, and other issues. They could play a vital and important role in getting the better outcomes we want to see. She spoke rightly about how we deal with children. The Government want to create the healthiest generation of children ever. We must ensure that we have the services to diagnose bone conditions at an earlier stage and get children the appropriate treatment.
My hon. Friend also talked about communities that are difficult to reach. I have a row with my officials because I do not accept that any community is difficult to reach—we have just not tried hard enough. It is precisely the kind of suggestions that she set out that will ensure, on a whole range of health conditions including MSK, that we do better at identifying where those people and health inequalities are, and get access to services into the places where those people are so we can get them on to the treatment pathways.
With NHS England, we are considering a range of options to identify the most effective ways of improving the quality of and access to the fracture liaison service model, and the interventions that that model provides. For MSK conditions such as rheumatoid arthritis, early diagnosis is the key to preventing joint damage and improving quality of life. The Government are investing £1.5 billion in capital funding in 2025-26 for new surgical hubs and diagnostic scanners, to build capacity for over 30,000 additional procedures and over 1.25 million diagnostic tests as they come online.
I turn now to the growth mission. The “Get Britain Working” White Paper highlighted the issue of spiralling economic inactivity, with 2.8 million people, which is equivalent to the population of Greater Manchester, being locked out of work because of long-term sickness. Tackling economic inactivity caused by ill health will play an important part in realising our ambition of having an 80% employment rate.
To support that ambition, the Further Faster 20 scheme will be delivered by NHS England’s Getting It Right First Time programme. Further Faster 20 will operate in 20 areas of the country that have high levels of economic inactivity, with the aim of reducing waiting times and enabling people to return to work. Actions will include improving secondary care interfaces with primary and community services.
We will also launch a set of place-based trailblazers in eight areas in England and Wales to run during 2025-26. These trailblazers will be at the forefront of developing joined-up approaches to support people with work, health and skills. Three trailblazer areas will be funded to become health and growth accelerator sites, in order to build evidence of the impact of targeted action on the main health conditions driving economic inactivity, and I assure the House that those conditions include MSK conditions.
I also say to my hon. Friend the Member for Dudley that I am more than happy to meet her to discuss these issues further. If we can squeeze it in somewhere in my diary, I am also more than happy to visit the fracture liaison services in her area.
I want to reassure my hon. Friend the Member for Morecambe and Lunesdale that we take very seriously the impact of MSK conditions on the NHS workforce itself. As part of our workforce planning, we need to get better at identifying NHS employees who have MSK conditions and ensure that we provide them with the appropriate support, so that they can carry on working in our health and care systems.
To conclude, once again I thank my hon. Friend the Member for Dudley for securing this important debate. I hope that she is reassured by some of the measures I have outlined today. In addition, I will take on board the very important points she made about how we can do better on those issues and ensure that they are fed back through my team to those working up our policies on fracture liaison and MSK more generally.
I hope that my hon. Friend recognises that MSK is a priority for this Government. I absolutely recognise that we must go further, but today I will close by reaffirming this Government’s commitment to supporting the millions of people in the UK living with an MSK condition, to ensure that they receive the support they need, including improved diagnosis and management, and to ensure that we drive down waiting times and waiting lists, identify conditions earlier, get people into treatment as quickly as possible, and have the happier, healthier and more prosperous country that we have all been elected to this place to help deliver, which would be the consequence of having a healthier, happier workforce and a healthier and happier population.
Question put and agreed to.
Commercial Research Delivery Centres
Andrew Gwynne Excerpts(1 year, 8 months ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)
My noble Friend the Under-Secretary of State for Health and Social Care, Baroness Merron, has made the following written statement:
Today, I am pleased to announce an ambitious expansion of commercial clinical research capabilities across the four nations of the UK through the establishment of 20 new commercial research delivery centres.
The CRDC programme will be funded across the UK by the voluntary scheme for branded medicines pricing, access and growth investment programme and, in part, by the Department of Health and Social Care through the National Institute for Health and Care Research in England. The VPAG Investment programme, a unique joint public-private partnership between the UK Government and the pharmaceutical industry agreed as part of the 2024 VPAG Scheme, aims to boost economic growth and the global competitiveness of the UK’s life sciences sector. This network of CRDCs is the first clinical trial infrastructure to receive funding from the VPAG investment programme to accelerate access to new medicines and vaccines to patients, through research.
Funding is being allocated to NHS organisations across all four UK nations, reinforcing the pan-UK commitment to research. The CRDCs cover the length and breadth of the UK from the Sussex coast to Aberdeen, including coverage across Wales and Northern Ireland, ensuring a truly UK presence. They will act as hubs for pioneering approaches in commercial clinical research delivery with a dedicated workforce and facilities and streamlined and efficient trial set-up to support industry trials. The CRDCs will enhance the UK’s competitiveness on the global health research stage and make it a destination of choice for life sciences innovation, supporting both the health and growth missions set by Government.
In a significant step forward, the CRDCs will bring clinical trials beyond large hospital trusts and into smaller hospital community settings and primary care. This will make research participation easier for people across our communities, including those currently underserved by research, ensuring that everyone can have access to new treatment through cutting-edge medical research.
Aligned with the UK Government’s missions to build a healthcare system fit for the future and kickstart economic growth, the CRDCs bring enhanced resource and infrastructure across the NHS, by growing research capacity and creating opportunities for collaboration with industry partners to trial new treatments. They will contribute to the strength and vitality of our life sciences sector, creating opportunities for growth and collaboration across the UK. This significant investment in commercial research delivery is a powerful signal of the UK’s commitment to the life sciences and it contributes to advancements in patient care to improve health outcomes for people across the UK.
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Clinical Trials Regulations
Andrew Gwynne Excerpts(1 year, 8 months ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)
My noble friend the Under-Secretary of State for Health and Social Care, Baroness Merron, has made the following written statement:
I am pleased to announce that the Medicines for Human Use (Clinical Trials) (Amendment) Regulations 2024 have been laid before Parliament today. When approved by Parliament, this legislation will represent the most significant reform of UK clinical trials regulation in over 20 years, addressing the sector's need for a more efficient and adaptable regulatory framework, while safeguarding the wellbeing of trial participants. It will establish a proportionate, streamlined, flexible and effective clinical research environment, placing patients at the heart of the process and strengthening the UK’s position as a global leader for innovative clinical trials.
Clinical trials are essential for the safe development of medicinal products, allowing innovators to rigorously evaluate their products in healthy volunteers and patients. Through this, clinical trials provide a route for bringing pioneering new treatments directly to patients, serving as a crucial step in healthcare innovation. This legislation will play a vital role in transforming the environment for running clinical trials in the UK.
Modernising the regulatory framework will strengthen the UK’s standing as a prime destination for conducting groundbreaking, safe clinical trials. This supports the recommendations of the Lord O’Shaughnessy review, making the UK more attractive for commercial clinical trials and increasing opportunities for UK patients to have early access to innovative treatments that could improve or even save lives. These reforms will also help the NHS conduct trials more efficiently, fostering research that improves methods for preventing, diagnosing, and treating a wide range of conditions. Ultimately, this will expand patient access to new therapies and reinforce the NHS’s reputation as a world-leading platform for health and life sciences research.
The revised legislation aims to reduce unnecessary administrative burdens on trial sponsors while keeping participant safety at the forefront. By removing overly prescriptive elements, the legislation will introduce greater flexibility and risk-proportionality, reflecting the evolving nature of clinical trial design and the innovative treatments they investigate.
These reforms will:
Create a proportionate and flexible regulatory environment—the new legislation will empower researchers to take more risk appropriate approaches to trials, meaning the regulatory requirements will be more flexible to match the risk that a trial presents.
Cement the UK as a leading destination for international trials—the new legislation will introduce more streamlined and efficient application processes, making it easier to apply for trials in the UK but without compromising on safety standards. A combined regulatory and research ethics review will be brought into legislation and approval timelines will be internationally competitive.
Move away from a one-size-fits-all approach, to be responsive to innovation—the new legislation has been drafted to ensure it is as future-proof as possible and is responsive to different types of trials and innovative ways of carrying out trials. Guidance will be used for specific details, rather than granular and duplicative requirements in legislation.
Ensure patients and their safety are at the focus of all clinical trials and supported by greater transparency bring the benefits of clinical trials to everyone—the new legislation will ensure increased public transparency about trials, including a requirement for registration on a public database and sharing of trials results with participants.
The reforms were developed by the Medicines and Healthcare products Regulatory Agency and the Health Research Authority through a series of stakeholder workshops, seeking the views of a wide range of organisations and individuals from across the clinical research sector, including patient representatives. A public consultation took place in January to March 2022, to which over 2,000 responses were received, and the Government response was published in March 2023.
The regulations, along with the associated explanatory memorandum and de minimis assessment, an analysis of the impact of the reforms on business, will be published on gov.uk today.
[HCWS310]
Rare Autoimmune Rheumatic Diseases
Andrew Gwynne Excerpts(1 year, 8 months ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)
It is a pleasure to serve under your chairmanship, Dr Huq. I thank the hon. Member for Strangford (Jim Shannon)—I want to call him an hon. Friend because he is a friend, but convention dictates that I must call him an hon. Member—and I welcome the fact that he cares so much about health-related issues. I now see him more than I see my wife, because he is always in debates about a whole range of health conditions, and he brings so much passion to those debates. Importantly, he highlights rare diseases. I thank him for the way he made his case this morning, and for speaking about Zoi’s experience. When we humanise these things, we make them all the more impactful.
I thank my hon. Friend the Member for Bootle (Peter Dowd) for his contributions, and I thank the Liberal Democrat spokesperson, the hon. Member for Mid Sussex (Alison Bennett), for humanising the issue through Carrie’s story; that is crucial. The shadow Minister, the hon. Member for Hinckley and Bosworth (Dr Evans), brings his professional experience to this debate, and that cannot be underestimated. I confess that I am not a medical professional, but in health debates it is important to listen to the expertise of those who work in the sector and on the frontline. I thank him genuinely for the way he has approached the debate. This is not a party political, knockabout debate; it is something on which we all want to see progress. The beauty of Westminster Hall is that we can leave the knockabout to the main Chamber, and in this room we can get into the detail of important subjects that are often overlooked. I pay tribute to those who are affected by rare disease, including rare autoimmune rheumatic diseases, and to their families.
The work of patient organisations such as RAIRDA is vital in raising awareness and campaigning to improve the lives of people who are living with rare diseases, and I thank those who dedicate their lives to this community. It is important to make the point that although rare diseases are individually rare, they are collectively common. One in 17 people will be affected by a rare condition over their lifetime. People living with rare diseases may face additional challenges in accessing health and social care. As the hon. Member for Mid Sussex said, this applies to a whole range of health services, including dentistry, and I hope that the Minister responsible for dentistry will pick that up. I will ensure that he receives her comments, because dentistry is often overlooked when it comes to people with rare conditions.
We are committed to improving the lives of people who are living with rare conditions. As the hon. Member for Strangford mentions, the UK rare diseases framework outlines four priorities to achieve this aim: helping patients to get a final diagnosis faster; increasing awareness of rare diseases among healthcare professionals; bettering co-ordination of care; and improving access to specialist care, treatments and drugs. Rare diseases are a priority for the Government. In England, we publish a rare diseases action plan annually, which details the specific steps we are taking to meet the shared priorities of the framework. Each action has an owner, desired outcomes and detail about how we will measure and report on progress. This Government are committed to delivering on the priorities framework, and we are working to publish the next England action plan in early 2025.
The UK rare diseases framework comes to an end in 2026, and I know that the rare disease community would like the policy to continue, to maintain the momentum and progress made over the lifetime of the previous framework. It is UK-wide and agreed across the devolved nations, and I am more than happy to discuss it further with colleagues in Wales and Scotland and, for the hon. Member for Strangford, with Mike Nesbitt, the Health Minister in Northern Ireland. I am the UK Health Minister with responsibility for engagement with the devolved Administrations when it comes to health and social care; indeed, we have a meeting with them and with the Secretary of State tomorrow to discuss a whole range of subjects. I am more than happy to discuss this issue further with colleagues to see if we can maintain four-nation co-ordination in this area. I believe that if we can do so, we should. I give the hon. Member for Strangford my commitment that I will take the matter up with the devolved Health Ministers to see if we can continue the four-nation approach.
In England, I am committed to working towards the four priorities of the framework, which were identified through the 2019 national conversation on rare diseases. Alongside the evaluation of England’s rare disease action plans commissioned through NIHR, the Department will undertake engagement next year to inform future policy decisions. The Government are committed to providing the best diagnosis and care for rare diseases, as set out in the UK rare diseases framework. Good diagnosis should be timely and accurate, and I know that people living with rare diseases often face journeys that are years long—diagnostic odysseys—before they receive an answer.
As the shadow Minister set out, many health professionals are involved in a patient’s journey, from those in specialist testing and genetic screening to GPs and primary care professionals. Raising awareness of rare conditions among those professionals is one way in which we can help to speed up diagnosis. I know that every experience of living with a rare disease is unique, and, with more than 7,000 identified rare diseases, we focus on addressing shared challenges across all rare diseases.
Although the increasing use of genetic testing is an groundbreaking tool in diagnosis, many conditions, including rare rheumatic autoimmune diseases, do not have an identified genetic component, so it is important that overall awareness, diagnostics and quality of care continue to serve all people living with rare conditions. NHS England is working to improve awareness of rare diseases among healthcare professionals, including those in primary care, through the NHS England genomics education programme, which includes non-genetic rare diseases. The GEP provides education and training to support the specialist and wider workforce to diagnose rare conditions early and to know how to deliver the best possible care for patients and families—the shadow Minister mentioned that. Working with partners such as Medics 4 Rare Diseases, the GEP has created genomic notes for clinicians, GeNotes, an innovative digital educational resource for healthcare professionals. The GEP works to provide information to GPs where and when they need it—for example, by presenting at primary care educational events, producing blended learning modules for GP trainees or ensuring regular reviews of the curriculum of the Royal College of General Practitioners.
The shadow Minister rightly mentioned research. I reassure him that the Department of Health and Social Care—this started on the previous Government’s watch, and we rightly are continuing the progress—supports research into rare diseases through the NIHR. The NIHR is the nation’s largest funder of health and care research, and it welcomes funding applications for research into any aspect of human health, including rare diseases. The usual practice of the NIHR and other research funders is not to ringfence funds for expenditure on particular topics. The “Rare Diseases Research Landscape Project Report” described investment of almost £630 million from MRC and NIHR programmes in rare disease research over five years. We are now working with the rare diseases community to further understand the gaps and the priorities, and to get them into those research pathways so that we can, we hope, fill the gaps.
As many rare diseases are chronic and affect multiple body systems, those living with rare disease face complex condition management, and interact with many specialists and providers of health and social care. That can include travelling across the country to access highly specialised care from experts. All of that can add up to a significant emotional and physical burden, and deepens existing inequalities. Co-ordination of care is essential to ensure that care is effectively managed, that the burden on patients and their carers is minimised and that healthcare professionals are working together to provide the best possible joined-up and high-quality care.
Last year, we hosted a workshop with RAIRDA to explore how best to support people living with “non-genetic” rare diseases. That highlighted the importance of specialised networks of care in delivering high-quality care at value for money. As we heard from the hon. Member for Strangford, networks, such as the Eastern Network for Rare Autoimmune Disease, are an example of best practice. I encourage integrated care boards to consider similar models across the whole country for types of rare diseases. I am more than happy to look closely at how we can seek to spread that best practice across the country, across different rare disease types and across ICBs, because patients with rare conditions deserve the same quality, safety and efficacy in medicines as other patients with more common conditions.
NICE, the MHRA and NHS England are working to understand and to address challenges preventing treatments for rare conditions from reaching patients who need them. I take on board precisely the points that the shadow Minister raises about the new drugs, how we ensure faster access and how we create the environment whereby clinical trials are more readily available in the United Kingdom. I want to assure Members that that is a central part not just of our health mission but of the Government’s economic mission, because we want the United Kingdom to be a base for investment in life sciences, in medtech and in access to clinical trials, so that our patients win as well as our economy. We have to ensure that safety is foremost in our deliberations. Safety is paramount, and we must ensure, in whatever regulatory regime that we have to encourage the life sciences, medtech and data industries into the UK, that safety is never compromised. I take on board fully the comments made by the shadow Minister.
NICE has also been working with RAIRDA to create a quality standard for rare diseases. That will find commonalities across the more than 7,000 identified rare diseases to develop standards that will drive quality improvement across multiple rare disease groups. Although the majority of rare diseases are genetic, others, such as rare autoimmune rheumatic diseases, do not yet have an identified genetic cause, as I said. A study by Genetic Alliance UK suggests that such conditions often have higher prevalence, impacting on a significant number of people, so it is important that both genetic and non-genetic conditions are considered.
Approximately 3.5 million people in the UK live with a rare condition, and addressing shared challenges across all conditions will be central to this Government’s approach. In addition, shared challenges across the health and social care system are often exacerbated for people living with rare diseases, such as access to mental health support—something else that the hon. Member for Mid Sussex mentioned. A central mission of this Government is to build a health and care system fit for the future.
The hon. Member for Strangford referred to our 10-year health plan. I reassure the House that that is intended to focus on the three shifts needed to deliver a modern NHS—not just fixing our NHS, but making it fit for the future, for the next 10, 20 or 30 years, putting it on a modernised footing as well as fixing the fundamentals. The three shifts are moving from hospital to community, from analogue to digital and from sickness to prevention. Those shifts offer opportunities to improve time to diagnosis and care for people living with rare diseases. Many highly specialised services for rare diseases must be delivered in hospitals to ensure the high standards of expert care that we want to see, but we can improve co-ordination of care to deliver better treatments closer to where people live, where possible. While many rare diseases are not preventable, early diagnosis can lead to interventions that improve health outcomes.
On the point made by the shadow Minister about community diagnostic centres, the Government’s commitment is to continue that programme. Indeed, I have seen the benefits of it myself—I got to open the new CDC at Crownpoint in Denton in my constituency in July. It is already having a game-changing impact on the local community, giving faster diagnosis and getting people into treatment more quickly, with better outcomes and better patient experiences for those who access the facilities.
The 10-year plan will ensure a better health service for everyone, regardless of condition or service area. On 21 October, we launched a national conversation on the future of the NHS, inviting views from across the country on how to deliver a health service fit for the future. Patients, staff and organisations can make themselves heard by logging on to the online portal, change.nhs.uk. I encourage hon. Members to do the same and to encourage their constituents to do likewise, if they have not done so already.
Unmet need remains, however, for people living with rare diseases, including rare autoimmune rheumatic conditions. I reaffirm that I am deeply committed, as is this Government, to working across the health and care system and with the rare disease community to address that need.
Finally, on workforce, the hon. Member for Strangford and other Members asked if the goal of the Government is to ensure that a patient gets the treatment, and that we get that treatment with the workforce we have. Getting that right workforce will be key. I reassure Members that the goal of the Government is to ensure that the patient, as they deserve, gets all the help that the NHS can offer in treatment, care and support.
The 10-year health plan will deliver those three big shifts on hospitals to community, analogue to digital, and sickness to prevention. To support delivery of the plan, the Secretary of State has confirmed that next summer we will refresh the NHS long-term workforce plan. That will help to ensure that the NHS has the right people in the right places with the right skills to deliver the care that patients need when they need it, not just today but in the future. The shifts we want to see in the delivery of healthcare will require us to rethink the kind of workforce we need in 10 years’ time.
Dr Luke Evans
I am grateful to the Minister for acknowledging the workforce, and for looking at the workforce plan. I was aware of the Health Secretary’s plan to revisit this, and the Minister talks about it being done next year. Does he have a timescale for how long the review will take? The danger, especially in healthcare, is that modernisation happens so quickly that, by the time we review something, it is already out of date and needs another review. This is always a chicken-and-egg situation. I would be grateful for a timescale.
Andrew Gwynne
We will refresh it next summer, and the Department is already beginning to think about whether this is what the shifts are intended to bring about, and whether these are the outcomes we want to see as a result of those shifts. If we are to have a neighbourhood health service that delivers much more in a community setting, how do we ensure we have the right skills and the right workforce to deliver that?
Particularly with the shift from analogue to digital, we will need a lot more tech-savvy clinicians, too. How do we build in some of the massive advances in artificial intelligence into medical devices and medical technology? We will be doing that concurrently with the 10-year plan to make sure that the workforce plan refresh is ready to go. This will allow us to embed the future, not just today’s practices, into the training and recruitment processes for the immediate future. The refresh will begin next summer, but it is a chicken-and-egg situation. We need to work out what the future of the NHS will look like, and then we have to ensure that we have the skills to meet that ambition—not just for today, but for the future.
In closing, I again thank my friend, the hon. Member for Strangford, for raising such an important matter, and I thank the rare diseases community for their continued and constructive engagement with the Government to help bring about meaningful change. I hope I have reassured the hon. Gentleman both on cross-UK working—and I take up his challenge to try to get colleagues across the devolved Administrations to agree to continue a UK-wide approach—and on my specific responsibility here in England. We will take forward the four areas identified in the UK plan. We will have a new plan for England, and we will seek to make the significant progress that I believe all Members of this House want to see happen.
I am more than happy to work collegiately with Members across the House, whose role is to scrutinise the Government, to hold our feet to the coals and to make sure we do what is in the plan at the best speed and pace for people living with these conditions. I also accept that I am not the sole fount of all wisdom in this area.
Andrew Gwynne
I know the shadow Minister is surprised by that. Genuinely, whatever people bring to the table, whether it is personal experience, professional expertise or their constituents’ stories, we need to share that knowledge so that we can improve how we deliver the outcomes we want to see for people living with rare diseases. I stand willing and ready to work with hon. Members across the House, and indeed with organisations that champion this area, so we can get the best outcomes that people deserve.
Cumberlege Review: Pelvic Mesh
Andrew Gwynne Excerpts(1 year, 8 months ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)
It is a pleasure to serve under your chairmanship, Mr Stringer. I congratulate my hon. Friend the Member for Harlow (Chris Vince) on securing such an important debate on pelvic mesh and the independent medicines and medical devices safety review, also referred to as the Cumberlege review. We are all privileged to see the noble Lady Baroness Cumberlege in the Public Gallery. We thank her sincerely for the work that she has done over a number of years on women’s health, and on this issue in particular. I also thank my hon. Friend for the opportunity to contribute to this vital debate.
I am responding today on behalf of Baroness Merron, who leads on women’s health and patient safety in the Department of Health and Social Care. I will try to address as many as I can of the issues that right hon. and hon. Members have raised in this debate. If for any reason I do not get round to addressing something, I will ensure that Baroness Merron, as the Minister responsible, writes to Members.
This debate came about because of a meeting between my hon. Friend the Member for Harlow and one of his constituents, Debbie. As we have heard, Debbie described undergoing a failed procedure to remove vaginal mesh, which has caused her severe pain. She has remained in constant pain since the operation, and I express my deepest sympathy to her for her ongoing experience. It should never have happened.
My predecessor as a Minister, Nadine Dorries, placed on the record in 2020 the previous Government’s apology. We are a new Government, so I take this opportunity to make the same apology today on behalf of His Majesty’s Government elected on 4 July. This should not have happened, and I say to every single person it has happened to that we are sorry and we have a duty to put things right. That is what this Government will seek to do, and at pace.
This Government will build a system that listens, hears and acts with speed, compassion and proportionality. Complications from vaginal mesh can be devastating and have included severe and chronic pain, recurrent infections, reduced mobility, sexual difficulties and psychological impacts. It can be hard to imagine the avoidable suffering that many women have endured and the damage that has been inflicted on their lives. It is unacceptable that concerns raised by women were not listened to and that women were left to suffer alone. It is vital that we acknowledge those failures and ensure that the mistakes of the past are not repeated.
I assure the right hon. Member for Wetherby and Easingwold (Sir Alec Shelbrooke) that the 10-year health plan that the Government are consulting on will ensure a better health service for everyone, regardless of their condition or service area. A core part of the development of the 10-year plan, including its approach to women’s health, will be an extensive engagement exercise with the public, NHS staff and stakeholders.
We have heard about the nine specialist mesh centres that NHS England has established across England. The intention behind them is that every woman, in every region, who experiences mesh-related complications receives the appropriate support.
I hear the message of my hon. Friend the Member for Shipley (Anna Dixon) that more needs to be done on accessibility, outcomes and listening to women. I agree, and I will take that message back to Baroness Merron.
I share the concerns of the right hon. Member for Wetherby and Easingwold—I thank him for his support on this—about the battles and challenges that lie ahead to get the system right. The Government will consider how we build on existing provision in a sensitive way that meets the needs of the women. At the heart of all we do to try to put things right is addressing the needs of the women involved, and their families, who have been so dramatically affected by what went so tragically wrong.
Each mesh centre is led by a multidisciplinary team that comprises urology, gynaecology and colorectal consultants, in addition to nurses who specialise in a range of things that I am unable to pronounce, and in urology and incontinence, which I can pronounce. Patients also have access to other healthcare professionals, including psychologists, occupational therapists and pelvic floor specialists, to help with pain management.
I recognise the trauma that women have experienced and the vital need to exercise patient choice. That is especially true for women who are rightly concerned about being treated by a surgeon who previously operated on them. I hope that things have moved on since the answer that the right hon. Member for New Forest East (Sir Julian Lewis) received, but I will ensure that what Members have said, with the sincerity and the strength of feeling, is communicated back to Baroness Merron. I agree with the right hon. Gentleman that the process set out in that written ministerial answer is not acceptable. Yes, women have the right to choose treatment from another surgeon, but I actually agree with the shadow Minister that there should be an automatic assumption that their treatment should be done by somebody who did not operate on them previously, unless that woman does not mind. That is a stress and a trauma for many women, and we have to think about their rights.
I also recognise that there is a need to support GPs’ knowledge and understanding of pelvic mesh so that they can identify the symptoms of mesh complications and refer patients on to the appropriate services. I do not want any woman to be in the position of my hon. Friend the Member for Washington and Gateshead South (Mrs Hodgson), or any other woman who has had her body tampered with in the most inappropriate way, when the procedure was not even necessary, and has suffered lifelong complications as a result. We have to move on at pace.
Following Baroness Cumberlege’s recommendations in 2018, the national pause on mesh remains in place for the use of vaginally inserted mesh to treat prolapse and the use of retropubic suburethral mesh sling to treat stress urinary incontinence. That means that mesh can be used only in exceptional cases where clinicians are of the opinion that there is a clinical urgency and no suitable alternative exists. NHS England continues to monitor progress on the conditions associated with the national pause and will only make changes to it linked to clinical advice and following consultation with a wide range of stakeholders, including patients, professional bodies and NHS organisations.
The Cumberlege review made nine recommendations, and the then Government accepted seven. Of those seven, four have been delivered, including the appointment of Dr Henrietta Hughes as the first Patient Safety Commissioner in England, the establishment of nine specialist mesh centres across England and the establishment of a patient reference group. Through our ongoing work, the Government are committed to delivering on the remaining three recommendations.
On redress, I will mention briefly the recommendation set out in the Hughes report, which was published in February. I first thank the Patient Safety Commissioner, Dr Henrietta Hughes, for her commitment to improving patient safety. Although the Government are not yet in a position to comment on the recommendations, I assure Members that we are considering the wide range of work set out in the report. I agree with the hon. Member for Eastleigh (Liz Jarvis) that the previous Government were too slow on that. It is a priority for this Government. We are working at pace, and we remain focused on making meaningful progress. This is a complex area of work, involving several Departments, but we are committed to providing an update at the earliest opportunity. I have heard the desire for urgency today, and I hope that we can make the progress that Members want to see.
I am afraid that I have left my hon. Friend the Member for Harlow 30 seconds to sum up, but I hope we have made some progress.
Food and Drink Advertising Restrictions
Andrew Gwynne Excerpts(1 year, 8 months ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)
This Government are committed to creating the healthiest generation of children ever, and today we are taking another step towards achieving that goal.
Further to my statement on 12 September 2024, I wish to inform the House that today the Government will lay before Parliament the Advertising (Less Healthy Food Definitions and Exemptions) Regulations 2024 and an explanatory memorandum. This legislation enacts the provisions set out in the Health and Care Act 2022, which amended the Communications Act 2003, for a 9 pm watershed on the advertising of less healthy food or drink on television and a 24-hour restriction on paid-for advertising of these products online. Alongside laying the regulations, the Government are publishing a response to the technical consultation held between September and October 2024 on how the advertising restrictions apply to internet protocol television (IPTV) services, which deliver TV and advertising live over the internet. The consultation response confirms that IPTV services regulated by Ofcom will be subject to the broadcast restrictions (9 pm watershed), in the same way as other Ofcom-regulated TV and on-demand programme services, and we have clarified this in the final regulations. The Government are also publishing guidance for industry on the food or drink categories in scope of the advertising restrictions to support their preparation for implementation.
Following previous policy consultations and the Government’s response on 12 September 2024 to the consultation on the draft secondary legislation, the legislation and guidance published today provide businesses with further certainty in terms of the products, businesses and services in scope of the restrictions as well as practical guidance on their application, so that they can continue to prepare ahead of the restrictions coming into force on 1 October 2025. We will continue to engage with stakeholders during this period.
This delivers on our manifesto commitment to implement the junk food advertising restrictions without further delay, and in doing so we expect to remove 7.2 billion calories from UK children’s diets per year and reduce the number of children living with obesity by 20,000.
Obesity is the second biggest preventable cause of cancer and costs the UK health service more than £11 billion each year. By taking preventative action now, the Government will begin fixing the foundations of good health and protecting the next generation so that it can become the healthiest ever.
The Government’s response to the IPTV consultation and guidance on food or drink products in scope of the restrictions will be published on gov.uk shortly.
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Health and Social Care
Andrew Gwynne Excerpts(1 year, 8 months ago)
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Andrew Gwynne
…We will still encourage adult smokers to switch to vaping through Swap to Stop in England, and I am delighted that localities have asked for over half a million starter kits so far. On advertising regulations, of course the consultation will take place after Royal Assent, but I hope that I can assure the hon. Member for Harrow East that we will take away his point about ensuring that the NHS can still advertise Swap to Stop under those regulations.
[Official Report, 26 November 2024; Vol. 757, c. 736.]
Written correction submitted by the Under-Secretary of State for Health and Social Care, the hon. Member for Gorton and Denton (Andrew Gwynne):
Andrew Gwynne
…We will still encourage adult smokers to switch to vaping through Swap to Stop in England, and I am delighted that localities have asked for over half a million starter kits so far. On vape regulations, of course the consultation will take place after Royal Assent, but I hope that I can assure the hon. Member for Harrow East that we will take away his point about ensuring that the NHS can still promote Swap to Stop under those regulations.