Smokefree Future

Ian Paisley Excerpts
Thursday 11th January 2024

(2 months, 2 weeks ago)

Westminster Hall
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Ian Paisley Portrait Ian Paisley (North Antrim) (DUP)
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Thank you very much, Mr Sharma, for chairing this debate and for calling me to speak. I congratulate the hon. Member for Harrow East (Bob Blackman) on moving the debate. He regularly secures debates on this subject, and has done so very well again today. I intended to speak on the issue of vaping, which he mentioned at the end of his comments. I agree with his point about children seeing vaping as a gateway into something, and that is very serious and needs to be addressed. It will probably be the real battleground for this issue in the future.

However, I want to turn to something else. With all policies, there are unintended consequences. I have no doubt that the Government’s intention is correct, but there are undoubtedly areas that raise unintended consequences.

I first want to turn the Minister’s attention to Northern Ireland. The impact on Northern Ireland will be significant, because under the Brexit arrangements—the protocol and the Windsor framework—the sale of tobacco products in Northern Ireland is regulated not by the UK Government but by EU law. It is therefore unclear how the Government would implement a generational ban in Northern Ireland under the current regulations and laws.

As recently as April 2022, the Danish Government tried to implement a generational ban, and the European authorities blocked them on the basis that it would impact Denmark’s European neighbours. Given the situation that Northern Ireland has unfortunately been placed in by the Government under the Windsor framework, this generational ban would not be implementable in a part of the United Kingdom, so 3% of the population of the UK do not matter when it comes to this policy. That is the impact that people will see. It one of the Prime Minister’s flagship policies, but its application would be prohibited in one part of the United Kingdom. The Government need to look at that issue if they are serious about this policy, and they must comment on how they intend to fix it.

If the UK Government were to find a means of introducing a generational ban in Northern Ireland while still adhering to the Windsor framework, they would therefore show that they are able to breach the final concluded Windsor framework agreement. If they are able to breach it on this issue, all the comments we have heard in this House over the past year—“It is finished,” “It is done,” “It cannot be changed”—are therefore set aside, as that would show that it can be done.

A generational ban in Northern Ireland would create an absurd situation whereby people living in County Armagh, County Fermanagh and County Londonderry could simply drive a few miles over the border to the local convenience shop or filling station in the Republic of Ireland and purchase cigarettes there, so I do not think the Government have thought through the implications for Northern Ireland. I would be very interested to hear how they intend to pursue these issues and address these matters.

I am an officer of the all-party parliamentary group for retail crime, safe and sustainable high streets, and I think the ban will have another unintended consequence on criminality in the whole United Kingdom, not exclusively in Northern Ireland. Every single day, there are 867 violent or abusive incidents affecting retailers across the United Kingdom. Most people working in retail shops—average corner shops—get abused at some point. I got that statistic from the British Retail Consortium, so it is an accurate figure. Asian Trader carried out a survey on the generational tobacco ban in November 2023, and it found that 86% of retailers believe that a generational prohibition on the sale of tobacco will have a negative effect on their business, and 55% say that it will complicate age checks in store and will lead to violent attacks on their staff. The majority of retailers say that the only way they can enforce a generational prohibition in the long term is through mandatory ID checks. Those are not my views; they are the views of retailers.

Of course, ID checks are an enforcement nightmare. Andrew Chevis, the founder of CitizenCard, the UK’s largest provider of proof-of-age cards, said in The House magazine in November 2023,

“I have deep concerns from both a retail and enforcement perspective”

about a generation ban. His concern is, of course, for the safety of retailers. I get that. Any of us who have retail or convenience stores in our constituencies—as we all do—will be concerned about these matters.

UK retailers already suffer sky-high levels of violence and abuse, and a generational prohibition could make that worse, as retailers will have to identify young-looking customers before they are able to sell them tobacco, and they will have to be convinced. I will be very interested to see the legislation when it is printed, and I would like the Minister to confirm whether, if a retailer decides, “Oh, that person is over the age, and I can legally sell it to them,” but it turns out that that person is not over the age—they were within a generational ban threshold—it is the retailer that has committed the criminal offence and not the purchaser. That goes right the way through.

In a few years, under this generational retail ban, a person who is in their 30s and should not be buying cigarettes in the first place—but they are in their 30s and are buying them—would not actually be committing a criminal offence as an adult, but the retailer would be committing an offence for selling them. That needs to be clear: who is ultimately responsible here when adults are making adult choices? I think that that needs to be cleared up.

As I said, a survey conducted by the British Retail Consortium identified that checking for proof of age is one of the biggest triggers for violence and abuse against UK retailers. I already quoted the figure of there being 867 violent or abusive incidents occurring every day.

The Prime Minister very kindly acknowledged some of these issues, just before the recess, when I had an event in Dining Room B with the retail crime, safe and sustainable high streets APPG. He kindly indicated, from his experience of when he was a kid working in a retail shop, how these things impact detrimentally on members of staff. If the Prime Minister can see that, then I think this issue needs to be properly looked at.

The Association of Convenience Store’s crime report is published every year. Its 2023 report says that there were 759,000 incidents of verbal abuse and that 34% of verbal abuse incidents are hate-motivated. It also says that, according to retailers, 87% of convenience store colleagues reported that they had faced verbal abuse in the past year. Therefore, although I think it is an unintended consequence, creating or increasing the opportunity for that sort of abuse to take place is a consequence that the Government have to deal with. Is there a better way of doing this? Is it better, for example, for the Government to say, “You are 21 or 22. You can only buy after you become an adult, at that higher age threshold”?

Bob Blackman Portrait Bob Blackman
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The hon. Member is giving a very thoughtful speech about some of the consequences. Does he accept the fact that, when individuals go into a public house, they will now routinely be challenged and asked for proof of identity if they look young? The challenge is often whether they are over 21, although they could, of course, legally buy alcohol at the age of 18. Many public houses will not serve anyone under the age of 21. Does the hon. Member accept the fact that, because this is already in operation, the retailer should have the right to challenge people who look young so that they can make sure that they are only selling to people who are over the legal age to buy?

Ian Paisley Portrait Ian Paisley
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That is a very good point when it comes to that threshold between 17 and 21 or 22. The problem is that this generational legislation creates a conveyor belt—from 18 to 19 to 20. Eventually you will be 37 and not be allowed to buy a cigarette under the law. But, if the retailer sells it to you, whether you are a young-looking, handsome 37-year-old or an old-looking boy, you will still end up not having committed a criminal offence, even though you have, but the retailer has committed an offence for selling it to you. At that point, where do the ID checks come in?

Perhaps the intention is that there will be a time in the next five, six, seven or eight years when no one will smoke. I want to turn to that. The one issue that I have pushed hard and heavy on since becoming a Member of Parliament is the criminalisation of illicit sales of tobacco that furnish criminals’ pockets. It is that illegal crime that really worries me.

The hon. Member for Harrow East, who moved the motion today, quite rightly commented on where he thinks the level of public consumption of cigarettes is. I think that the real figure is startlingly higher, because His Majesty’s Revenue and Customs estimates that 11% of cigarette consumption and 35% of hand-rolling tobacco consumption in the UK comes from the illegal trade. People are buying it illicitly, either as stolen products or black market products that have been brought into the United Kingdom. This is happening in a huge number of areas, and it is fuelling criminal gangs.

That is the higher level. There are more people consuming tobacco than some people want to admit but, unfortunately, they are buying it illegally. The Government are not benefiting in terms of tax and legitimate manufacturers are not benefiting. In fact, the companies are disadvantaged because the product is sometimes stolen from their companies, or is a copy—a counterfeit—of their products.

The Government must decide whether they want tobacco to be supplied to UK consumers by a taxed and regulated private sector, as it currently is, or by the public sector as a medicine, which may be one way of doing it, or by the criminal sector, in the same way that cannabis is sold. Those are the choices that the Government ultimately face.

In my view, a generational prohibition will gradually hand even more of the UK tobacco market to organised criminal gangs, who use the money from tobacco smuggling to fund activities including terrorism, people smuggling, prostitution and all sorts of other things. That view is lifted from the US State Department’s 2015 report, “The Global Illicit Trade in Tobacco: A Threat to National Security”. That is why the gangs deploy such resources. When the South African Government banned the sale of tobacco during covid, illegal traders quickly stepped in. Today, 93% of tobacco sold in South Africa is illicit trade and counterfeit trade. We need to get this absolutely right or else we create a bonanza for the criminal. The sooner we do that, the better, and I am sure the Minister will consider those issues.

I do not want to criminalise shopkeepers, and I know the hon. Member for Harrow East does not want that, but that will be an unintended consequence. As people get older, it will be very difficult to judge whether they can be sold a cigarette. Shopkeepers will have to ask for ID, and we do not have ID in Great Britain. In Northern Ireland, we have a form of ID in our electoral cards, but they do not carry a date of birth, although they do show that a person is over the age of 18. That would have to be changed if they were to be used in Northern Ireland.

What are the alternatives? Many retailers and others have suggested that raising the age of sale for tobacco products to 21 would be much simpler to implement and would avoid this potential negative consequence, and the nightmare of regulation. It would be far easier to implement and enforce, and would avoid the complete takeover of the UK tobacco market by criminals. I urge the Government to consider those alternatives in pursuing this incredibly important flagship policy. For the record, I do not promote smoking, but I believe in adults making choices. We have to try to solve the real problem, not create another one.

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Andrea Leadsom Portrait Dame Andrea Leadsom
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Yes, I know. You can’t believe that, can you?

Even to this day, talking about smoking all the time, I sometimes think, “Ooh a cigarette.” That is how addictive it is—40 years on and I still think, “Ooh!” It is that addictive, and that is absolutely appalling.

We have announced that we will more than double the funding to local stop smoking services across England to a total of £138 million a year, which will help around 360,000 people to quit every year. We are backing these efforts with substantial new money to support marketing campaigns. These measures are easy, common-sense and cost-effective ways to help people to kick the habit.

As colleagues will know, I am passionate about helping new mums, mums-to-be, new parents, new families and their babies, which is why I have asked officials to redouble our efforts to tackle smoking in pregnancy. Women who smoke during pregnancy are two and a half times more likely to give birth prematurely, and smoking is a significant driver of stillbirth. I want to do everything I can to spare parents the awful and heartbreaking tragedy of losing a baby, which we have heard so much about in this place only recently.

On average, just over one in 10 mums smoke at the time of delivery, but that number is as high as one in five in certain parts of the country, as some colleagues have spoken about already. We know that pregnant women who receive financial incentives are twice as likely to successfully quit throughout pregnancy compared to those who do not, so we are working to roll out a national financial incentive scheme by the end of 2024 to help all pregnant smokers and their partners to quit. This will build on our work over recent years to develop high-quality stop smoking support for pregnant women and their partners, with programmes such as the NHS long-term plan commitments on maternal smoking and the saving babies’ lives care bundle.

Thirdly, as I said at the start of my remarks, youth vaping has tripled in recent years. One in five children have now used a vape. I am especially worried about the damage being done to children’s bodies by illegal vapes, which is a growing concern for mums and dads across the country. The health advice is clear: young people and those who have never smoked should not vape. We have a duty to protect our children from underage vaping while their lungs and brains are still developing. There is not yet enough evidence on the long-term impact of vaping on young brains and lungs. I will not stand by while businesses knowingly and deliberately encourage children to use a product that is designed to help adults quit smoking. Those business do so with full knowledge that our children will become addicted to nicotine—well, not on my watch.

We have announced that we will take tough new action to reduce the appeal and availability of vapes through the tobacco and vapes Bill. In our recent public consultation, we sought views on restricting flavours, point-of-sale displays and packaging. On a visit to retail outlets in Hackney, I saw sweet counters and vape counters side by side, with the vapes in pretty packaging with cartoon characters and in little things that look like Coke cans. These vapes are not designed for 60-year-old smokers; they are designed for children, to get them addicted to nicotine.

The consultation has revealed something we already know: there are serious and justifiable environmental concerns over disposable vapes. It is a simple truth that more than 5 million disposable vapes are either littered or thrown away in general waste every week. That number has quadrupled in just the last year. Being sold at pocket-money prices, easy to use and widely available, disposable vapes are, of course, the product of choice for children. More than two thirds of current youth vapers use disposable products. We must and will take action.

Fourthly, a strong approach to enforcement is vital to ensure that our policy actually takes effect. The underage and illicit sale of tobacco, and more recently vapes, is undermining the work the Government are doing to regulate the industry and protect public health. We are cracking down on this evil and illicit trade by backing enforcement agencies including Border Force, HMRC and trading standards with £30 million extra per year. We will introduce powers in the tobacco and vapes Bill to give on-the-spot fines to tackle underage sales. I am pleased we can count on the strong support of trading standards officers right across the country.

Our public consultation closed on 6 December and we received nearly 28,000 valid responses. I am happy to assure all colleagues that we will publish our response in the coming weeks, ahead of the introduction of the tobacco and vapes Bill. I believe that our actions in this space show that the Government are willing to take tough, long-term decisions to protect our children and safeguard the health of future generations.

I will now answer some of the questions raised by hon. Members today; I thank them again for their contributions. In response to my hon. Friend the Member for Harrow East, our public consultation closed on 6 December and within the next few weeks we will publish the consultation. Of course we will then bring forward the Bill, which is, as everybody knows, a top priority for the Prime Minister.

As for the point about a polluter pays levy, the Treasury has looked at that in detail, but so far it has decided against it. I absolutely assure colleagues that I will take that point away and consider it again.

I thank the hon. Member for City of Durham for her invitation to visit her constituency, which I would be delighted to accept. She highlighted the fact that the discrepancy in life expectancy between different parts of her constituency is 50% attributable to smoking, which is a shocking figure. That is not uncommon around the country, so we need to tackle that issue.

I say gently to the hon. Member for North Antrim that when the legal age for smoking was raised, it reduced illicit tobacco sales by 25%; the evidence suggests that far from increasing criminality, raising the legal age for smoking decreases it.

The hon. Gentleman also asked a question about Northern Ireland specifically. I am pleased to tell him that in the Bill we propose to give Northern Ireland the powers to regulate in the same way as the rest of the United Kingdom. There has been a lot of consultation with the devolved Administrations and once the Stormont Assembly—which I urge him to get back up and running —is back up and running, Northern Ireland will be able to legislate to have exactly the same regime as the rest of the United Kingdom.

Ian Paisley Portrait Ian Paisley
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I do not know whether it is relevant, Mr Sharma, but for the completeness of the record I ought to have referred to my registered interests. I chair a charitable trust on employment and skills development that is named after Tom Gallaher, a leading industrialist of his age who was a tobacconist. I should just declare that on the record.

On the point that the Minister has just raised, may I ask her to go back to the Department and get advice for us? If Northern Ireland is restricted from regulating on this issue, because of our EU connection through the Windsor framework, even the Assembly would not be able to legislate on it, in the same way that the Danes were unable to do it. I really seek advice on that from the Minister.

Andrea Leadsom Portrait Dame Andrea Leadsom
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I am very happy to write to the hon. Gentleman on that point to give him absolute clarity.

I thank the hon. Member for Strangford for his contribution today. I very much enjoyed the visit that I made to his constituency, which was a long time ago—indeed, many years ago. He spoke about the importance of the four nations working together. I completely agree with him; the UK is much stronger together. I hope that in my remarks I have answered his other questions.

I also thank the hon. Member for Blaydon for her support for the Bill and for pointing out that it is vital, particularly in the north-east where smoking prevalence is higher than average in many other parts, that we really take steps to tackle the issue. I echo her expression of gratitude to local councillors, the NHS and to Fresh, the charity in her constituency, for the work that they have done to try to tackle smoking.

As I have said to the hon. Member for Birmingham, Edgbaston, I hope we can work together constructively to ensure that we introduce these changes as soon as we can.

In closing, I will quickly address the New Zealand Government’s announcement that they will no longer introduce the smoking measures that had been planned there. There have been many calls, not least from the tobacco industry—I wonder why!—for us to row back on our plans following that decision. In response to those calls, I stress that the New Zealand plans included a licensing scheme to limit quite significantly the number of retailers able to sell tobacco and plans to limit the amount of nicotine in consumer products. Our Government are introducing a smoke-free generation, by protecting future generations from the harms of smoking while leaving current adult smokers the freedom to continue smoking if they choose to do so.

Building an NHS Fit for the Future

Ian Paisley Excerpts
Monday 13th November 2023

(4 months, 2 weeks ago)

Commons Chamber
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Helen Whately Portrait The Minister for Social Care (Helen Whately)
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It is a pleasure to open this debate on behalf of His Majesty’s Government, and to have the opportunity to speak about the long-term decisions that the Government have been taking for a healthier future for our country, for our national health service, and for our social care system.

We are building our health and care system for today and for tomorrow. We are increasing the capacity of the NHS and social care systems, boosting primary care and community care, investing in diagnostics and in treatments, building our NHS workforce with the long-term workforce plan and building our social care workforce with our 10-year vision, putting people at the heart of care. We are giving people choice and control over their health and care, and investing in the facilities and technology that need to be at the forefront of care and sustainable for the long term. We are driving reforms to prevent ill health, joining up health and care in integrated care systems and delivering a shift towards prevention and proactive care, keeping people out of hospital and enabling them to live independently in their communities.

Every day since last winter, we have been planning and preparing for the challenges that lie ahead this winter. The first ever NHS long-term workforce plan underpins our plans for the future of the NHS. It will double the number of medical training places, almost double the number of adult nursing places, and expand GP and allied health professional training numbers, giving the NHS the staff it needs for the future, creating new roles, building new training pathways and delivering a huge boost in diagnostic capacity.

By the end of this year, we will have opened 160 new community diagnostic centres. That is the biggest investment in MRI and CT scanning capacity in NHS history. Community diagnostic centres will bring care closer to home, on high streets, in supermarket car parks and at football stadiums. They have already done more than 5 million tests and scans, getting patients faster diagnosis for cancer, heart disease and other life-threatening conditions. That is not all we are doing to diagnose conditions faster. The number of people receiving blood pressure checks at local pharmacies has more than doubled, reducing thousands of people’s risk of suffering a heart attack or stroke.

We are expanding primary care, too. There are now over 30,000 more primary care professionals working in GP practices than in March 2019. We will deliver 50 million more GP appointments by the end of next year and we are investing more than £200 million in tech to end the 8 am rush for GP appointments. Pharmacy First will give people another choice, giving pharmacists the power to prescribe treatments for seven common conditions, freeing up as many as 10 million GP appointments, and as we put test results on to the NHS app, that will free up GP time again.

That is also one of the ways that this Government are giving patients more choice and control. Just as we are going to give people more choice in where they are treated when they are referred by their GP for specialist care, we have committed to giving patients a choice between by five providers so that they are treated based on what matters to them—be that shorter waiting times, seeing a particular doctor or getting care closer to home. We have given patients who are waiting more than 40 weeks the right to request treatment elsewhere, making better use of available capacity across the NHS and bringing in more capacity from the independent sector.

On patient choice, there is a clear dividing line between the Government and the Opposition. The Leader of the Opposition calls the Welsh Government the blueprint for what Labour would do in power, yet in Wales, under a Labour Government, there is no legal right to patient choice, and patients there wait on average five weeks longer for treatment than in England. We know where Labour’s plans would lead. We just need to look at its Welsh blueprint: less choice for patients, longer waiting lists and more bureaucracy for doctors and nurses who just want to get on with the job.

Before the most disruptive industrial action in NHS history stalled progress, we were reducing the longest waits. Last summer we hit our target to eliminate two-year waits for planned operations. This June we had virtually eliminated waits longer than 18 months. We are spending more than £8 billion between 2022 and 2025 to increase elective activity, including opening over 140 new surgical hubs to deliver 2 million more operations. We are investing almost £6 billion in beds, equipment and technology, and this year we started preparing the NHS for winter sooner than ever before.

Back in January, we published our recovery plan for urgent and emergency care, setting clear targets to improve A&E waiting and ambulance response times and using £1 billion of dedicated funding to provide 5,000 more permanent staff beds and 800 new ambulances. We are seeing results. In October, average category 2 ambulance response times were more than 90 minutes faster than in the same month last year. Delayed discharges have been coming down and we have brought forward flu and covid vaccinations, protecting the most vulnerable from illness this winter and reducing the likelihood that they will need hospital treatment.

A strong social care sector is also vital this winter and into the future. That is why we have made up to £8 billion available over this year and next to boost adult social care across the country. This is enabling local authorities to buy more care packages and help more patients to leave hospital on time, together with 10,000 “hospital at home” beds which mean that patients can receive their care where they are most comfortable, recovering in their own homes with support from secondary care when they need it. Through social prescribing, thousands of people up and down the country are benefiting from activities such as reading circles, choir groups, walking and football. We are driving reforms to the intermediate and proactive care framework, which sets out how local systems should support adults who need support after discharge, freeing up hospital capacity for those who need it most and giving people more care as they need it—in their community, away from A&E and out of hospital.

We are rolling out technology that will give patients life-saving treatments now and in the future. By the end of the year, every stroke network in England will have AI technology that can examine brain scans an hour faster, cutting stroke patients’ risk of suffering long-term consequences by as much as two thirds. What is more, almost half of NHS acute trusts have won a share of £21 million to invest in AI, accelerating the analysis of X-rays and CT scans for suspected lung cancer patients. That will save radiologists’ time, boost efficiency and cut waiting times. For the long-term, we are investing a further £100 million to use AI to unlock treatments for diseases that are incurable today, be they novel treatments for dementia or vaccines for cancer.

Ian Paisley Portrait Ian Paisley (North Antrim) (DUP)
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Can the Minister say something about the availability of new and specialist drugs that the National Institute for Health and Care Excellence is not recommending? Will an effort be made to make these specialist drugs, which in many instances are effectively regarded as miracle cures, available for cystic fibrosis and cancer treatments, for example?

Helen Whately Portrait Helen Whately
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I understand what the hon. Gentleman is saying, and I know how strongly families and patients feel about this. It is not for me, as a Minister, to step on the independence of NICE, which has a remit to take those decisions. I am sure that the new Secretary of State for Health and Social Care, my hon. Friend the Member for Louth and Horncastle (Victoria Atkins), and other Ministers in the Department will continue to listen to the concerns of families about access to those treatments.

If we want to fully embrace preventive care, we must tackle the single biggest preventable cause of ill health, disability and death, which is smoking. Unlike drinking alcohol or eating fatty, salty or sugary foods, there is no safe level of smoking. It causes almost one hospital admission every minute, one in four cancer deaths and 64,000 deaths a year.

Four in five smokers start by the time they are 20, so the best thing we can do is to stop young people smoking in the first place. That is why this Government will automatically raise the smoking age by one year every year, so anyone who is 14 or younger today will never be able to buy tobacco legally. Increasing the smoking age works. When it rose to 18, smoking rates dropped by almost a third in that age group. Restricting choice is never easy, but this time it is the right thing to do. Existing smokers will not be affected, but the next generation will be smoke-free, saving thousands of lives, reducing pressure on the NHS and building a brighter future for our children.

Cancer Care

Ian Paisley Excerpts
Tuesday 14th March 2023

(1 year ago)

Westminster Hall
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Ian Paisley Portrait Ian Paisley (in the Chair)
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I call the Opposition spokesperson, Feryal Clark.

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Ian Paisley Portrait Ian Paisley (in the Chair)
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Before I call Nicola Richards to wind up, I want to offer my personal condolences from the Chair. I thank and commend you for touching on the matter. To all of us—or most of us—our mother is the most precious person in our life. Thank you for the way in which you introduced the debate.

Ambulance and Emergency Department Waiting Times

Ian Paisley Excerpts
Wednesday 6th July 2022

(1 year, 8 months ago)

Westminster Hall
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Wera Hobhouse Portrait Wera Hobhouse
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Thank you, Mr Stringer. I think every one of us has such stories from the doorstep. Almost everybody knows of a loved one or a friend who has waited an unacceptably long time. That is why it is so important that we get the urgent review that Liberal Democrats have been calling for.

We are calling for a formal inquiry. The Government need to fund thousands of extra beds to stop handover delays in A&E so that ambulances can get back on the road as soon as possible. Will the Minister comment on a formal inquiry into the crisis?

Ian Paisley Portrait Ian Paisley (North Antrim) (DUP)
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Fifty per cent. of the entire Northern Ireland budget is spent on the health service, which is a higher proportion than in the rest of the UK. But this is not just about the money. Does the hon. Member agree that it is about how the money is spent and managed, and that that is critical to any review?

Wera Hobhouse Portrait Wera Hobhouse
- Hansard - - - Excerpts

Indeed. Not everything is always about money; it is also about proper management. At the heart of it all is transparency. We need to have the figures and to understand what the problems are. I echo the Royal College of Emergency Medicine: unless we have transparency, we cannot get to the bottom of the problem.

The Royal College of Emergency Medicine has already stated that A&E departments are not confident they will cope this winter. The Government simply cannot ignore this looming crisis on top of the existing challenges we face. They are running the NHS into the ground. With A&E wait times measured in hours instead of minutes, people are no longer confident that they can get urgent medical help when they need it. The Government need to start working with NHS staff to draw up a robust plan now to tackle the crisis in ambulance waiting times and emergency care, and start delivering. Thousands of lives depend on it.

Cancer Care: Young Adults

Ian Paisley Excerpts
Wednesday 8th June 2022

(1 year, 9 months ago)

Westminster Hall
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Ian Paisley Portrait Ian Paisley (in the Chair)
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I will call the Member to move the motion and the Minister to respond. There will not be an opportunity for the Member in charge to wind up, unfortunately, because this is a 30-minute debate and that is the convention. I understand that several Members have indicated to the Member moving the motion that they intend to make an intervention, and she has very kindly agreed to allow that.

Julie Marson Portrait Julie Marson (Hertford and Stortford) (Con)
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I beg to move,

That this House has considered cancer care for young adults.

It is a pleasure to serve under your chairmanship, Mr Paisley. Normally I would say that it is a pleasure to be here in Westminster Hall speaking on a particular issue but, of course, it is not a pleasure today. I wish I was not here raising the issue of cancer in young adults.

It is an issue that is horrible to confront and contemplate, but what I feel is nothing compared with what Simon and Andrea Brady feel. Every day they have to confront the reality of what happened to their daughter Jessica, who tragically passed away on 20 December 2020, aged just 27. They are here today because of Jess. I am here because of Jess. My right hon. and learned Friend the Member for North East Hertfordshire (Sir Oliver Heald) is here because of Jess, and the Minister is here because of Jess—I thank them both for that.

I pay tribute to Simon and Andrea. They are utterly determined in the face of their terrible loss to effect change in Jess’s name. I hope I can do justice to them and to Jess in supporting their call for that meaningful change. We are asking for Jess’s law—a practical change designed to save lives. Jess’s law would be that after the third contact with a GP surgery about a condition or symptom, a case should be elevated for review. After five contacts, it should be red-flagged and set procedures and guidelines should be followed, including a referral to a specialist.

We are clear that this should not be a tokenistic exercise, such as a simple, inconclusive blood test with the patient given an all-clear. The investigations need to be thorough and conclusive to make a real difference and to save lives.

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Julie Marson Portrait Julie Marson
- Hansard - - - Excerpts

I very much welcome the hon. Lady’s intervention. She is absolutely right. Her work to raise awareness of ovarian and breast cancer is all part of that hugely important process. I lost a dear friend to ovarian cancer, and it is a very difficult and unspecific thing to diagnose, or even for someone to realise that they might have the relevant symptoms. Breast cancer we have made a lot of progress with, and we have to keep that up. There are different cancers, with different symptoms, and awareness of the range of symptoms and how those might impact on different people is key to early diagnosis, to self-diagnosis so that people say, “Let’s go to a GP now”, and to get that GP to take things forward to identify the real underlying issue. I thank the hon. Lady.

The pivotal role that general practice doctors play in diagnosing patients early cannot be overstated. People—our sons, daughters, mothers, fathers, family, friends and neighbours across the board, regardless of age, race, sex or any characteristic—are equally deserving of diagnostic testing and referral. Patients must be accorded the time, space and physical contact to voice their concerns when presenting with recurrent and progressively aggressive symptoms. Listening and acting are key.

I know that the Minister is listening. We have met and discussed the issue, and her own experience in the nursing profession gives her great empathy and insight. I look forward to hearing her response in a moment. I also take this opportunity to thank my right hon. Friend the Secretary of State for Health and Social Care, who is arranging to meet Mr and Mrs Brady to discuss Jessica’s experience, what we can learn from it and how we might be able to implement Jess’s law.

I am also grateful to all those who have contributed today, in particular my right hon. and learned Friend the Member for North East Hertfordshire, who stands shoulder to shoulder with the Brady family. Finally, but most importantly, I reiterate my thanks to and deepest sympathy for Simon and Andrea Brady and their family. We do not want to hear tragic stories such as Jess’s—not because we do not care, but precisely because we do.

To conclude, I will repeat a detail of Jess’s story that I think illustrates the high regard in which she was held. On the day of her funeral, a satellite that she helped to design was launched into space from Cape Canaveral. It was inscribed with the words, “Thank you, Jess!” In honour of Jessica Brady, let us implement Jess’s law, so that other young adults who face the trauma of cancer in future can also say, “Thank you, Jess.”

Ian Paisley Portrait Ian Paisley (in the Chair)
- Hansard - -

Before I call the Minister, I too want to acknowledge the presence of Simon and Andrea Brady in the Public Gallery.

Childhood Cancer Outcomes

Ian Paisley Excerpts
Tuesday 26th April 2022

(1 year, 11 months ago)

Commons Chamber
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Ian Paisley Portrait Ian Paisley (North Antrim) (DUP)
- Parliament Live - Hansard - -

I congratulate the hon. Member for Gosport (Dame Caroline Dinenage) on how she introduced this debate today. Many Members who have already spoken have become the voice for the voiceless in this debate. It is probably what Parliament should be for—to cry out for those who are most vulnerable, most needy and most deserving, yet do not have a voice.

Like many, I want to be the voice for one of my voiceless constituents today; I want to speak for Jake Oliver. Jake is four. He is currently in the haematology ward of the Royal Victoria Hospital for sick children, being looked after by some of the most magnificent staff in cancer services who deal with young people and children in particular.

Jake’s mum wrote to me, saying that she wanted me to speak in this debate because

“I honestly wouldn’t wish on any parent/family what we have been through in the past 19 months and continue to go through daily…Jake being so unwell and not getting a diagnosis quicker! 8 awful weeks before we knew he had cancer and at the age of 4. It breaks my heart to think my boy was so sick and didn’t know what was going on in his wee body…It took a further 6/7 days to stabilise him in hospital before we could begin biopsies….4 years old and he was basically being suffocated by a large mass surrounding his heart and lungs, cutting off his blood and air supply.”

I think we will hear many messages today from hospital beds and people’s homes about their little ones and how they need care. It is important that we recognise that every single effort has to be made to help these young people. Early diagnosis is clearly a key point.

Cat Smith Portrait Cat Smith (Lancaster and Fleetwood) (Lab)
- Hansard - - - Excerpts

It strikes me that I have had a similar piece of correspondence from my constituents about their three-year-old son Alfie, who is undergoing treatment for leukaemia. Does the hon. Gentleman agree that awareness among GPs would go a long way to ensuring that these young people—my three-year-old constituent, and his four-year-old constituent—get treatment sooner that is perhaps less aggressive?

Ian Paisley Portrait Ian Paisley
- Hansard - -

If Jake could speak today, he would say “Hear, hear!” to what the hon. Lady has just said, because early diagnosis has been key. As other hon. Members have said, waiting several months before the GP was able to get the child to A&E and then have them diagnosed is not appropriate. It is not the GP’s fault. More money has to be put into research. There has to be more awareness, more skills training and more discovery research done, so that these problems do not arise again and again. As the right hon. Member for Alyn and Deeside (Mark Tami) said earlier about his own little kid, if there had been greater awareness at the GP level, these things could have been avoided and we would have at least had an early diagnosis and earlier treatment.

The fragmented experience that many young people and their families are going through must be addressed. We have heard already from hon. Members on both sides of the House that the fragmented service is not good enough. Jake will not take the excuse that some of those issues had to be set aside because of covid. He will not accept that excuse and his parents will not accept that excuse—and rightly so. They will not accept the excuse that there are not enough resources and enough money being made available.

Some hon. Members will not like me making this point, but I will make it: we spend more on abortion services than on childhood cancer research. Hon. Members should think about that and the weight of that. Surely we should be putting resources into childhood cancer research to save the most vulnerable lives that are already with us. That is where the effort should be made.

I agree with the points and statement of the hon. Member for Gosport and with the strategy that we must outline and deliver urgently. Let us not have another debate in a few years’ time about the issue. Let us have a celebration that we have done something—that we have directed those resources, changed lives, and had the ability to encourage the research. Let us bring together the experts who we know are already out there so that little boys such as Jake and the little girls who have been mentioned know that the treatment will be made available and that the research will result in their lives being saved, so we will see a difference. Let us give Jake and other children across this kingdom a chance.

Abortion Services Commissioning: Northern Ireland

Ian Paisley Excerpts
Tuesday 14th December 2021

(2 years, 3 months ago)

Westminster Hall
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Ian Paisley Portrait Ian Paisley (North Antrim) (DUP)
- Hansard - -

Thank you, Mr Pritchard, it is an honour to serve under your chairmanship. I congratulate the hon. Member for Pontypridd (Alex Davies-Jones) on bringing the matter to the attention of the House. She is absolutely right that this is a narrow debate on a narrow set of issues. It is not, therefore, about women’s rights, despite the fact that what we have heard today has been padded out with a lot of comments about women’s rights.

It is not, unfortunately, about the rights of the unborn child, whom we should pause to consider, because no one ever speaks up for them. No one ever speaks up for that beating heart in a mother’s womb; no one ever gives voice to that. Today is not about that, unfortunately. Today is about the narrow confines of the rule of law, and where law should properly made.

I am aghast at the irony of today’s debate. We have had a lot of comment about this being the rightful place to make these laws, and how it is not a contradiction to stand as a Member from another devolved region and say that the devolved Assembly in Northern Ireland has no right to make those laws and regulations. When that region is currently in court on these very matters, trying to shape the laws of Northern Ireland, it is the most abhorrent contradiction for this place to try to grasp that power back, and the Assembly in Northern Ireland is on this very day debating some of the issues that pertain to this matter. The irony is not lost on anyone, except the unborn.

Scott Benton Portrait Scott Benton (Blackpool South) (Con)
- Hansard - - - Excerpts

I thank my hon. Friend for giving way; he is a great champion for the life of the unborn child, as are all his DUP colleagues. Does he share my concern that the regulations violate the terms of the Northern Ireland Act 1998 and fundamentally dishonour the devolution settlement? That point is particularly appropriate now that Stormont has been restored.

Ian Paisley Portrait Ian Paisley
- Hansard - -

That was a telling point and absolutely right and proper. Yes, this does dishonour and betray the devolution settlement. There are no two ways about; that is the only want it cuts. When powers are devolved to one region and then it is decided that it is not doing things the way we like, so the powers should be taken back, that is not lost on anyone.

We are not allowed to make up facts in this debate. The myth has been projected today that the majority of people in Northern Ireland agree to and with the most liberal abortion laws in any other part of the United Kingdom. Given that that has never been tested, that statement is erroneous and not factual. Any time the Assembly has voted on such matters over the years, it has taken the other view. Whenever this House has voted on it, the representatives from Northern Ireland who attend this place were divided, but the majority voted against the new regulations as outlined.

We cannot make up the facts and pretend that, because one or two Members support this, all Northern Ireland supports it. That is a myth and one that has to be challenged. Talk to any section of society in Northern Ireland, in the tribal way that Northern Ireland is often caricatured—talk to members of the Roman Catholic faith, members of the Protestant faith, members of no faith—and one will find that the weight of opinion is solidly for the rights of the unborn child. That is the socially conservative society that Northern Ireland actually is.

Carla Lockhart Portrait Carla Lockhart (Upper Bann) (DUP)
- Hansard - - - Excerpts

My hon. Friend makes a valid point. Some 80% of respondents to the consultation on the imposition of the legislation did not want it imposed on Northern Ireland, which completely dispels the myth that the majority of people in Northern Ireland are pro-abortion. In fact, they are pro-life.

Ian Paisley Portrait Ian Paisley
- Hansard - -

I do not need to make the point, because my hon. Friend has just made it so exceptionally well.

When the regulations were first set in train in July 2019, it was argued in this Parliament that Parliament was duty-bound to pass the amendment that became section 9 because Northern Ireland, it was stated, was in violation of its international human rights obligations under the convention on the elimination of all forms of discrimination against women and the recommendations of the 2018 CEDAW Committee report on Northern Ireland.

However, when ones drills down into that report, the explanatory memorandum to the Abortion (Northern Ireland) Regulations 2021 acknowledges the fact, which the Government now confirm, that paragraphs 85 and 86 of the CEDAW Committee report, which the House rested upon when it made its case in 2019, do not constitute legally binding international obligations. Constantly, those arguing for these liberal laws hang their hat on the false premise that it was an international obligation, when it was no such thing. That myth needs to be dispelled. We should not base our laws upon a lie, and that is what has happened. That is why people are so agitated about what the Government did.

The hon. Member for Pontypridd is right: everyone is entitled to their own opinions on these serious, weighty and emotional matters; however, they and the Government are not entitled to make a pretence that the law was an international obligation that had to be followed when it was no such thing. The Government have now changed their former line of reasoning, arguing that it is the 2019 Act rather than the CEDAW recommendations that requires them to force Stormont to implement the Abortion (Northern Ireland) Regulations 2020 and the 2021 regulations. If ever something has been made perverse, it is the way in which the law is now being argued for.

It is plainly an untenable situation, where non-binding recommendations have been misrepresented to create a binding Act that removes any obligation to and any protection that the unborn child heretofore had. In doing so, the Government leave Northern Ireland in a straitjacket on one of the most sensitive issues that it could ever consider. The UK Government should not have imposed the same law on Northern Ireland that the UN Committee on the Rights of Persons with Disabilities has criticised in respect of the United Kingdom. That committee expressed its concern

“about perceptions in society that stigmatize persons with disabilities…and about the termination of pregnancy at any stage on the basis of fetal impairment.”

By allowing for abortion up to birth—think of it—in cases of non-foetal disabilities such as Down’s syndrome, cleft lip and club foot, the regulations are deeply offensive to the values of Northern Irish people and their politicians.

The House is currently considering a private Member’s Bill that the Government have given fair wind to, introduced by the right hon. Member for North Somerset (Dr Fox), on the rights of children with disabilities. I am honoured to be the secondary sponsor of that Bill. On the one hand, Parliament is trying to introduce laws to protect children with Down’s syndrome, to honour them and to give them their place in society. At the same time, this House says, “Destroy that Down’s syndrome child.” That is what is perverse and wrong, and it is why people are so agitated.

We shall see evidence of that in the latest progress of the Severe Fetal Impairment Abortion (Amendment) Bill, which is being debated as we speak in Stormont. There is a myth that a majority of Northern Ireland politicians are for these liberal laws, when, in fact, the only vote that has taken place in the legislative Assembly since these laws were introduced was on a law to amend them and to remove some of the most horrible liberal policies that affect the unborn. That point, and that sense of irony, is not lost on us.

I welcome the fact of this debate. I also welcome the fact that the Opposition are not here in force today. I think that is surprising, because the Opposition have made a habit of trying to push these matters on to Northern Ireland. I think that, perhaps, under their leader the penny is starting to drop that they cannot keep interfering in the devolution process. They cannot keep saying on the one issue—the Protocol—that they cannot get involved in a debate because they are defending the Belfast agreement, and then the next day come into this place and say, “We want to interfere in the Belfast agreement, set its issues aside, and interfere in a piece of legislation in Northern Ireland.” They cannot have it both ways—that is the message that we send out. This House cannot have it both ways, because that would be obscene and it would be wrong.

Today, I proudly proclaim my defence of, and give my voice to, the unborn. The unborn have a right to life. It is not a health issue to remove the life of an unborn child. It is a moral issue, and this House should have the moral compass to do what is right.

--- Later in debate ---
Tonia Antoniazzi Portrait Tonia Antoniazzi (Gower) (Lab)
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It is a pleasure to serve under your chairship, Mr Pritchard. I congratulate my hon. Friend the Member for Pontypridd (Alex Davies-Jones) on securing this timely debate on the commissioning of abortion services in Northern Ireland. I am proud of her work, as my predecessor, for women and girls in Northern Ireland. I will endeavour to do all that I can to support them.

At the beginning of my parliamentary career, I worked as Parliamentary Private Secretary to the shadow Northern Ireland team and was a member of the Women and Equalities Committee. This afforded me the opportunities to work with colleagues in Northern Ireland and to have a greater insight into the inequality of women in Northern Ireland compared with the rest of the UK. I had the opportunity to meet the hon. Member for Belfast South (Claire Hanna) before she was in this place. I remember the conversation well. She spoke today about compassion and learning and that this issue is a journey. I think we all understand what a journey it is for women in Northern Ireland.

Being part of the Women and Equalities Committee when it did the report on abortion law in Northern Ireland gave me an in-depth view of the change that was needed to move forward. I pay tribute to all the organisations and politicians who spoke to us. Moreover, I pay tribute to the women who shared their deeply personal experiences with us as well.

The standpoint of the Labour Front Bench is that these women should have the right to make an informed choice. Any woman who suffers a loss or makes a decision to end a pregnancy should have support services available to them. I was very dismayed to hear that there is an 80% increase in need, and limited funding means that women have got up to a six month waiting list for support. How can this be acceptable in 2021?

I have listened to all of the speakers in today’s debate. It is important that we all understand and are respectful of each other’s views. I was brought up a Roman Catholic and my father was the deputy head of a Roman Catholic school. I had that one-sided view of the right to life. However, as a woman and having been in education for 20 years, I have seen at first hand the pain that girls and women have had to go through. That is why those services are so important. As my hon. Friend the Member for Pontypridd outlined at the start, this is not a debate about the mechanics of devolution; it is a debate about the rights and the duty of this Parliament to uphold the rights of citizens across the United Kingdom. The law is clear: we need to get on with delivering those services.

The hon. Member for North Antrim (Ian Paisley) and the hon. Member for Strangford (Jim Shannon) talked about the views of the people in Northern Ireland. I want to draw their attention to an Amnesty International poll, done by an independent research company in 2020, which

“demonstrates an overwhelming demand for change to Northern Ireland’s draconian abortion laws.”

It is important that we are fair, just and transparent about the data that is out there on the views of people in Northern Ireland.

As my hon. Friend the Member for Pontypridd explained in her excellent speech, the changes to abortion laws extended abortion rights to the women of Northern Ireland. They were made in line with the recommendations of the UN Committee on the Elimination of Discrimination against Women and affording women in Northern Ireland those rights was about aligning abortion policy across the United Kingdom. It was a key moment for us, but little has changed since March 2020 for women in Northern Ireland. This is the title of the debate, and the lack of the commissioning of abortion services in Northern Ireland is having a direct impact on women.

The debate is about the rights of women in Northern Ireland and their right to access basic reproductive healthcare without needless barriers. It is about their right to clear, accurate and impartial advice and guidance about their healthcare choices. There is a worrying lack of impartial guidance, if any guidance at all, on a woman’s right to choice when she finds out she is pregnant. The GP should be women’s first port of call and they do not always get the advice they need there. When women turn to the internet and google abortion services in Northern Ireland, they are led to services that put in delaying tactics, making it impossible for them to terminate their pregnancy if they wish to. It also forces more and more women to purchase abortion pills online. We should not be in that situation. Fortunately, those women are not living in fear of prosecution now when they use that service.

Ian Paisley Portrait Ian Paisley
- Hansard - -

Will the hon. Lady give way?

Tonia Antoniazzi Portrait Tonia Antoniazzi
- Hansard - - - Excerpts

Unfortunately, I need the time.

The lack of commissioning means that Informing Choices NI has had to withdraw its central access point and BPAS has had to come in to support it as well. Women have a right to have high-quality access services as early as possible and as late as necessary and those rights are currently denied to women because of the inaction of the Northern Ireland Executive, the Department of Health in Northern Ireland and the Secretary of State. It has been nearly two years since those essential services should have been made routinely available in Northern Ireland, but as colleagues have said, the reality for many women is that the change in legislation might as well not have happened.

The lack of funding or a commissioning framework has led to piecemeal service provision, with women’s access dictated by their postcode. Women in the Western Health and Social Care Trust area have had not access to services in nine months and they cannot go to another trust to access services, having to pay nearly €500 privately to go to Ireland or to England and access pills online if it is not too late. What should be a service for all becomes a service for a lucky few: those who can take a hit to their income, take a day off work or travel the hours to access healthcare. That is not fair. The impact of covid has also been felt in service provision and in the travel restrictions.

The reality for women in Northern Ireland is that access to basic healthcare rights is in no way guaranteed. Will the Minister and the Secretary of State for Northern Ireland meet me to discuss an immediate way in which the Government can address the current crisis for women in Northern Ireland? What additional measures will the Executive put in place, especially in light of the new covid variant omicron, to ensure that the provision will be extended and maintained into the new year?

I look forward to hearing what the Minister has to say, because this is a very important issue for women and girls in Northern Ireland.

Maria Caulfield Portrait The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)
- Hansard - - - Excerpts

I am grateful to the hon. Member for Pontypridd (Alex Davies-Jones) for securing the debate. The Northern Ireland Office Ministers regret that they are unable to be here today, but I am sure they welcome the opportunity to have this debate and hear the wide-ranging views on abortion in Northern Ireland. It is an extremely emotive and sensitive subject and it is important that we have that debate in this place.

It is now more than two years since the Northern Ireland (Executive Formation etc) Act 2019 was passed, where Parliament stepped in and decided that women in Northern Ireland should have access to the same healthcare rights as women in England, Scotland and Wales. Even though the law was changed two years ago, it is true that services have not been commissioned in full.

The Northern Ireland (Executive Formation etc) Act placed a duty on the Secretary of State for Northern Ireland to ensure that abortion services which meet the recommendations are put in place and implemented. He has a legal duty to uphold that. As we have heard today, it is true that women have to access abortion in the rest of Great Britain, even though early medical abortion is available in four of the five trusts in Northern Ireland and BPAS has stepped in to provide an interim referral service for women and girls on a temporary basis.

Women and girls who require surgical abortions and post-10 week abortions still have to travel to Britain. The only way for the legal obligations to be met is through local commissioning. The Secretary of State has been clear with the Northern Ireland Department of Health and the Northern Ireland Executive about the commissioning of abortion services that are consistent with the regulations passed in 2019. Despite continuous engagement by the Secretary of State, he remains frustrated that progress is not being made.

As a result of the ongoing delay in commissioning services specifically by the Department of Health and the Northern Ireland Executive, Members will be aware that in July this year, the Secretary of State issued a direction to the Northern Ireland Department of Health, the Minister of Health, and the Health and Social Care Board to commission and make abortion services available by no later than 31 March 2022.

Ian Paisley Portrait Ian Paisley
- Hansard - -

I thank the Minister for giving way because that point is absolutely vital. By the Secretary of State recommending to the Minister in Northern Ireland that he commission these services, is that not an acceptance that these services are devolved matters? Conversely, matters that are reserved, such as the protocol, can be debated here—and posed and changed here—if that is the Government’s position. If the Government’s position is that this matter is devolved, it should remain devolved.

Maria Caulfield Portrait Maria Caulfield
- Hansard - - - Excerpts

I thank the hon. Member. I was going to come on to the point he raised in his remarks, but will touch on it now, if I may. Health is a devolved matter and that is very much recognised. It was frustrating. It was a free vote, and he knows how I voted and I would do the same today. However, at the time, there was no functioning Assembly. This Parliament had to make decisions, not just on this issue, but other issues such as budgetary matters. As a member of the Northern Ireland Affairs Committee at the time, I remember making the case to MLAs that this was why it was so important to get the Assembly up and running, because decisions were made in this place that did not reflect and respect devolution. Decisions were having to be made in this place on devolved matters.

Fibrodysplasia Ossificans Progressiva

Ian Paisley Excerpts
Monday 6th December 2021

(2 years, 3 months ago)

Westminster Hall
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Ian Paisley Portrait Ian Paisley (North Antrim) (DUP)
- Hansard - -

Thank you, Sir Roger, for calling me to speak in this debate. I add my congratulations to the mover of the motion on the petition today, the hon. Member for Carshalton and Wallington (Elliot Colburn). I am grateful that we all have an opportunity to speak about this rare disease and how it affects some of our constituents.

It is absolutely amazing that we are actually having this debate, when we consider how rare this disease is. That says something about the temerity of and strength of feeling among those who are in FOP Friends, those who suffer from the condition and those in our society who are just genuinely concerned about it. This matter weighed so heavily upon them that it had to be brought to the House. When I consider that one in a million or one in 2 million may have this condition, it is amazing that they have been able to lobby, cajole, persuade and encourage people to sign this petition and get it to the Floor of the House. That fact should not just be left on its own. It should not be underestimated just how significant an effort has been made by so few. It is important.

My constituency has, I think, the largest petitioning group in Northern Ireland—658 petitioners—and across every constituency in Northern Ireland between 100 and 200 constituents did this, yet in Northern Ireland there are known to be only two cases. That says something about the power of lobbying, and it puts a great onus on Members of this House that our communities have felt so strongly that this matter has to be debated even though it affects a very small section of our society. That is what Parliament is about: helping the most vulnerable; helping those who are left behind and can be forgotten. It is absolutely certain that without this debate, FOP would hardly have been heard of. It would have been discussed among those who had a genuine interest in it, or a connection with someone who has the condition or with their family, but to debate it on the Floor of the House is incredibly important—indeed, it is a landmark, and it is important to say so.

Each Member who has spoken so far has mentioned an individual who they have known, and I have been contacted by Lucy Fretwell and Zoe, her sister, who both have this condition. It is incredibly rare that one sister would have this condition, but both do. They wrote to me to say that FOP

“only affects one in a million people. Unfortunately, FOP has affected my sister and I and we have been diagnosed with the disease. Zoe and I have been living with it for 30 years. We are the only two people in Northern Ireland that suffer from FOP.”

She was so concerned that this matter must be debated, and she implored Members to be in this debate, so it is a privilege for me to speak for Zoe and Lucy today.

Mike Penning Portrait Sir Mike Penning
- Hansard - - - Excerpts

Part of this debate is about the fact that we do not really know how many people have this condition. I have referred to the misdiagnoses that we have seen—we can google them. People have had amputations in other countries because they thought this condition was cancerous, and the amputation made it worse. If we had better diagnosis and better expertise and knowledge out there, I think the figures would be much higher in the province.

Ian Paisley Portrait Ian Paisley
- Hansard - -

The right hon. Gentleman is absolutely right: it is only through awareness that we know this condition is probably much broader and deeper in our society. Those few who have been diagnosed are obviously encouraged and energised to write to us and lobby about it, but he is absolutely right that they are only the tip of the iceberg. Those people know about the condition, but many others do not. I for one do not believe that over 3,000 people from Northern Ireland petitioned us on this matter because of two people. There are many more across our society, but we have to look at the facts that are in front of us and relay them to the House.

I will make one other point in today’s debate, which is that the Government have a framework for dealing with rare diseases. That UK framework is critically important, because it commands the Government to do two things: help patients and increase awareness. Today, we are doing the second part of that. We are increasing awareness by having this debate and encouraging the Government to be more active and respond on these matters. Increasing awareness is vitally important, but when it comes to helping patients, no Member of this House can do anything about that. It is the Government who can do something about it by doing what these petitioners ask for: directing resources into research into this rare disease, making sure that that research not only is dedicated and focused, but hopefully leads to outcomes.

If there is any country in the world that should be proud of what medical research delivers, it has to be this nation. Look at what we have delivered over the past two years through targeted, effective research. If that is what we can do under emergency conditions, what more could we do if there were some targeted research and resources directed at this condition?

Like many others, I implore the Government to listen to the pleas of Lucy, Zoe and the many thousands of others who we are aware of. I encourage the Government to respond positively to this petition.

Tobacco Control Plan

Ian Paisley Excerpts
Tuesday 16th November 2021

(2 years, 4 months ago)

Westminster Hall
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Bob Blackman Portrait Bob Blackman
- Hansard - - - Excerpts

My hon. Friend is quite right. Nicotine is one of the most addictive drugs on the market, if not the most addictive, and perfectly legal to consume. The issue is whether someone, once addicted to nicotine, can quit. The damage is done not necessary by the nicotine, but by the delivery mechanism by which someone gets the nicotine.

Anything that reduces the risk of cancer or other related diseases has got to be good news. We can migrate people and encourage them to quit. Ideally, they give up completely. However, because it is so addictive they may need help and assistance to do that. Vaping and non-heated tobacco are ways of migrating people to safer means of delivering the nicotine they desire.

Taking up the point made by my right hon. Friend the Member for South West Wiltshire (Dr Murrison), ending smoking is essential if we are to level up the nation’s health after the pandemic. We need to reduce health inequalities between rich and poor, and increase healthy life expectancy by five years by 2035, in line with the Government’s manifesto commitments.

As well as being necessary, tobacco control measures are popular with voters for every main party, including the Conservative party, which both my hon. Friend the Minister and I represent. Results from the annual YouGov survey of over 10,000 adults in England, funded by Action on Smoking and Health, show that more than three quarters of the public support the Government’s smoke-free 2030 ambition, and eight out of 10 members of the public support Government intervention to limit smoking.

The Government have the full support of the APPG in delivering the smoke-free 2030 ambition. However, as the Government stated in the 2019 prevention Green Paper, achieving that ambition will require “bold action.” Inequalities in smoking rates have grown in recent years, not shrunk. In order to be smoke-free by 2030, we need to reduce smoking by two thirds in just a decade—we have only nine years left to achieve that—and by three quarters for smokers in routine and manual occupations. At current rates of decline, Cancer Research UK has estimated we will miss the target by seven years, and double that for the poorest in society.

There are still nearly 6 million smokers in England. We will only achieve a smoke-free 2030 by motivating more smokers to make quit attempts, using the most effective quitting aids, while also reducing the number of children and young adults who start smoking each year. With 1,500 people dying from smoking-related diseases every week and less than a decade to achieve a smoke-free 2030, there is no time to waste.

Disappointingly, with the end of the year in sight, there is still no sign of the tobacco control plan that was promised this year. My first question to my hon. Friend the Minister, therefore, is whether she can she set out a timeline for the publication of the next tobacco control plan. But the tobacco control plan is only as strong as the measures it includes. That is why the APPG was disappointed that the Government rejected the amendments to the Health and Care Bill tabled by my friend the hon. Member for City of Durham (Mary Kelly Foy), and supported by myself and other officers of the APPG, in Committee.

Those amendments would have closed the loopholes in the regulations that expose children to the insidious marketing tactics of the tobacco industry, provided funding for tobacco control and strengthened the regulation of tobacco. As it stands, the Bill fails to include a single mention of smoking or tobacco and represents a major missed opportunity to introduce key policies for achieving a smoke-free 2030. That is why we have retabled the amendments on Report. I hope the Government will look at them sympathetically, because the Bill is the ideal opportunity for them to deliver their 2019 commitment to finish the job and introduce the legislation that is needed if we are to achieve a smoke-free 2030. My second question is whether the Minister will commit to considering the adoption of tobacco amendments to the Health and Care Bill on Report.

My next area is the “polluter pays” levy. The bold action that the Government acknowledge is needed cannot be taken without investment. The Health Foundation estimates that a minimum £1 billion is needed to restore public health funding to its 2015 levels, with more needed to level up public health across the country. While there was some positive news on tobacco taxation in the recent spending review, which we welcomed, unfortunately the Government opted not to increase the public health grant to local authorities. As a consequence, we need to establish new sources of funding.

The Government promised to consider a US-style “polluter pays” levy on tobacco manufacturers in the 2019 prevention Green Paper. This scheme would mirror the approach taken in the United States, where user fee legislation raises $711 million annually from the tobacco manufacturers, with the funds then used to cover the cost of stop smoking campaigns, tobacco control policy development, implementation and enforcement.

Ian Paisley Portrait Ian Paisley (North Antrim) (DUP)
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I must say that I am opposed to punitive taxation policies, because I do not think they work. Does the hon. Member accept that tobacco companies already pay the Government £13 billion? An additional levy could lead—and most likely would lead, as the evidence shows—to a significant increase in criminality, because instead of paying for taxable product, people will buy smuggled product. Is that not a huge worry that he has about introducing a levy?

Bob Blackman Portrait Bob Blackman
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I will come to some of these issues in a few moments, if the hon. Gentleman will be patient and let me build the case. Obviously, it has been estimated by ASH that the funding needed for a comprehensive tobacco control plan to deliver a smoke-free 2030 would cost around £266 million for England and £315 million in total for the UK. A levy could raise around £700 million from the tobacco manufacturers, to be spent on tobacco control and other public health initiatives. The devolved Governments would also have the ability to opt into the scheme, should they so wish.

Such a scheme is more than justified in response to market failure that allows an industry, whose products kill consumers when used as intended, to make exorbitant profits. While net operating profits for most consumer staples, such as food, beverages and household goods, stands at 12% to 20%, Imperial Brands in the UK enjoyed net operating profits of 71% in 2019. That is £71 in profit for every £100 in sales. In 2018, it is estimated that tobacco manufacturers made over £900 million in profits in the UK alone.

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Ian Paisley Portrait Ian Paisley (North Antrim) (DUP)
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I declare an interest as the chair of The Gallaher Trust, which was set up half a dozen years ago in the wake of the closure of tobacco production in Northern Ireland. It was named after Tom Gallaher, a huge industrialist in Northern Ireland who created tens of thousands of jobs. Although the charity has absolutely nothing to do with the promotion, sale or development of tobacco—it is a skills development charity, of which I am an honorary and unremunerated chairman—I think it is important to put my interest on record, because of the association that people may draw from that.

I congratulate the hon. Member for Harrow East (Bob Blackman) on securing the debate. He has presented the arguments in the way that he always does, very persuasively. It is important that we have had a very good, healthy debate. It has showed that we are probably all on the same page. We want to get to the same finish line, but there are differences in nuance and in how we get there. I think it is important that we explore those differences and we try to get there in the best, most efficient and effective way.

Any tobacco control plan must be evidence-based, not based on emotions. Evidence is key. Innovations to support quitting smoking are crucial to the plan. We have heard something of the detail from the hon. Member for Rugby (Mark Pawsey) and others who are very keen that we develop innovation to ensure a systematic quitting of smoking. The evidence shows that high punitive taxation policies simply do not work. For someone growing up in a deprived society, whose parents have low wages, and where cigarettes—a lawful product in the local shops—are nearly £15 a pack, the temptation to purchase a pack for a fiver from someone round the local pub is huge and significant. The real thrust of any tobacco control plan must go hand in hand with a plan that addresses criminality. Aside from one or two vague mentions of criminality, that is what is absent from the plan.

We have to focus on criminality. We can tax this product until it squeaks even more, but unless we address the criminality that lies behind illegal product and illegal product sales across the United Kingdom, I am afraid that consumption rates will stay at a very high, stubborn level. I do not believe that there are fewer than 10 million smokers in the United Kingdom. I think that anyone who believes that is in cloud cuckoo land. Walk down any street in this city and count the first 100 people. I would say that in excess of 20 people on average are smoking. That is a rudimentary calculation. In other places it is considerably higher—in night culture, for instance. Let us face the fact that smoking consumption is probably at a much higher rate than the figures suggest. Therefore, all the punitive taxation policies that have been adopted by the United Kingdom—and they are the highest in the world—are not addressing the stubborn fact that people are continuing to smoke.

Let us pivot and get on to other counteracting measures. Where do those other measures rest? I believe there is a role for partnership with experts. Three things need to be done. We need to explore, develop and ensure that new products are brought to the market expeditiously. We need to engage a huge amount of effort in education, especially for young people and women. We need to make sure there is adequate, sensible and robust enforcement against criminality.

As has been mentioned today, there is a full range of new products already on the market to ensure that less harmful products are available to smokers, helping them to reduce their habit and get away from smoking. I applaud companies that have created e-cigarettes, nicotine patches, heated products and vaping, to encourage people away from the very harmful addiction to tobacco and nicotine. Those less harmful alternatives must be pursued and we must encourage their use, not discourage it. Indeed, the points that were made earlier regarding misinformation about those products should be addressed sensibly by central Government. There must be co-operation with responsible companies that want to make their lawful product and pay tax on it. That co-operation should allow research and development to happen, to enable them to get away from manufacturing the single product that they currently produce.

Some mention has been made today of the levy, and it was suggested that there should be a new levy on tobacco manufacturing companies. As I said earlier, we in the United Kingdom pay the highest taxes in the world on a pack of cigarettes—I think that 90% of what we pay for cigarettes goes to the Government—but that high tax has not solved the problem by reducing consumption. What happens is that people are driven towards buying unlawful products, thinking that that is a harmless activity. Many people who purchase cheap cigarettes think that they come over from mainland Europe in a white van and do no one any harm, but of course most of those products are illegally made. They are not made by the tobacco companies. What is inside those products is beyond tobacco and therefore, incredibly, they are even more harmful than cigarettes. People do not necessarily realise it, but selling those products is a huge and significant crime in our kingdom.

In the last number of years, over £1 billion-worth of illicit cigarettes have been sold in the United Kingdom. This is not a problem exclusive to Northern Ireland; in fact, we are the minority. This is a multi-million pound problem across the whole United Kingdom, and we have to get to grips with it as soon as we can. That multi-million pound crime syndicate needs to be broken up and destroyed.

Regarding taxation, in 2019-20 tobacco alone accounted for £11.25 billion of the Government’s revenues. However, if we set against that the criminal sales of tobacco, we see that the Government lost almost £3 billion in tobacco revenue. There is a huge gap that could be made up. On the point about a levy, if there was proper enforcement against the criminals, an extra £3 billion would be available—legitimately raised from legitimate sales—for things such as the promotion of education, research and development. Imposing another levy on the tobacco companies is lazy and would not address the problem of crime; indeed, that problem would continue to grow. Until we face up to that, we will keep coming back to this House—year in and year out, decade in and decade out—and inflating taxation but seeing consumption remain stubbornly high.

Let us address the real issue of properly attacking the criminals. In 2020, HMRC gathered an additional £1.4 billion through its border control activities. That was an untapped source of new revenue, which came about largely as a result of Brexit and having more control of our borders, but also because of the pandemic and the inability to travel to and from the continent to bring illegal products in. The Government were able to raise revenue under those circumstances. With a little bit of ingenuity, they could continue to raise that additional £1.4 billion in previously untapped sources by clamping down on gangs and gathering the revenue that the public are entitled to have gathered on their behalf; that is something that HMRC should do proudly.

As Members know, there is a £10,000 on-the-spot fine for criminals engaged in evasion of tax on tobacco. People might say that that is a very high fine, but it is not. A case of illicit cigarettes is worth hundreds of thousands of pounds in illicit sales to a criminal, and a van full is worth over £1 million. Why is the on-the-spot fine not something like £50,000 or £100,000, in view of the sums that the criminals make? For every van that HMRC captures, at least 20 or 30 get through, so let us make sure that we have proper enforcement. The high price of a pack of cigarettes simply encourages people, especially those with less disposable income, to purchase illicit products.

I understand the point that was made about the age limit, but if we are going to change the age limit for smoking, we have to look at the whole panoply of age limits across the United Kingdom—for alcohol consumption, driving, betting and smoking. It would be incredibly difficult to enforce different age limits rather than having a standardised one. If a 20-year-old tells a shopkeeper that they are 21 and they want to buy a pack of cigarettes, that would be incredibly difficult to enforce. Shopkeepers already find it hard to tell an 18-year-old from a 14-year-old in some circumstances.

Let us make sure that we have a standardised age for sales rather than different ages for different products. I do not think the Government are looking at that point, but it will no doubt gather momentum, because it seems to be an easy solution. None of these easy solutions work. Hard attacks against criminal enterprises are where we will make a significant difference.

We need to avoid the danger of virtue signalling—I am not saying any of that has gone on today; we have had a good, positive and practical debate—and move towards evidence-based solutions, including by encouraging companies to make less harmful product available to the public, by enforcing and controlling the legitimate enterprises of business and by ensuring that criminals are not allowed to get away with their multibillion-pound criminal enterprise. Otherwise, we should really go the whole hog and ban tobacco altogether in the United Kingdom. To achieve some of the goals that have been set out, that is where this debate has to be taken. It is not being taken there at present, but we need to get real on this.

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Maggie Throup Portrait Maggie Throup
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I could not agree more with my hon. Friend. The burden of tobacco harms is not shared equally: smoking rates are far higher in poorer areas of the country, and among the lowest socioeconomic groups. Alongside the tragedy created by illness and early deaths, the NHS bears the heavy financial burden of £2.5 billion every year from smoking. In 2019-20, smoking was responsible for nearly half a million hospital admissions and around 64,000 deaths.

The Government have set the bold ambition for England to be smoke free by 2030. To support that ambition, we have been building on the successes of our current tobacco control plan. We will soon publish a new plan with an even sharper focus on tackling health disparities. That new plan will form a vital part of the Government’s levelling-up agenda and will set out a comprehensive package of new policy proposals and regulatory changes, to enable us to meet our smoke-free 2030 ambition.

We are, of course, carefully considering the recommendations of the all-party parliamentary group on smoking and health. Our new tobacco control plan will look to further strengthen our regulatory framework. We are exploring various regulatory proposals, including those put forward as amendments to the Health and Care Bill. We will conduct further research and build a robust evidence base in support of such measures, and will include the strongest proposals in the new plan.

One continuing concern is that one in 10 pregnant women are still smokers at the time of delivery, which is something that the Government are determined to tackle. The maternity transformation programme contains some important measures, and we have made a commitment under our NHS long-term plan that pregnant mothers and their partners will be offered NHS-funded treatment to help them to quit. I know that issue is close to the heart of my hon. Friend the Member for Harrow East. Our new plan will continue to have a strong focus on pregnancy and will encourage more innovation and new approaches to help mothers to quit.

The evidence is clear that e-cigarettes are less harmful to health than smoking. It remains the goal of the Government to maximise the opportunities presented by e-cigarettes to reduce smoking while managing any risks. Our regulatory framework enables smokers to use e-cigarettes to help them to quit, but we do not want to encourage non-smokers and young people to take up those products. In the current tobacco control plan we have actioned the MHRA to help bring medicinal e-cigarettes to the UK market. On 29 October, the MHRA published updated guidance to encourage manufacturers to do so.

Stop-smoking services remain at the heart of our tobacco control strategy, producing high quit rates of 59% after four weeks. Since 2000, they have helped nearly 5 million people to quit. We have protected the public health grant over the course of the spending review, to ensure that local authorities can continue to invest in stop-smoking services and campaigns specific to their areas. We will continue to support local authorities to prioritise those services.

The UK has been recognised as a global leader in tobacco control. We are proud to be a member of the World Health Organisation framework convention on tobacco control. My officials played an active role in the ninth conference of the parties—COP9—last week, and reaffirmed our commitment to deal with the global tobacco pandemic. It was a robust meeting, with more people attending than ever. In my video statement to COP9, I set out the UK commitment to having comprehensive tobacco control policies, including a strong regulatory framework for e-cigarettes. Our commitment to the WHO FCTC is further demonstrated through the overseas development funding we contribute to the FCTC 2030 project, which is now entering its sixth year. That project directly supports the implementation of the WHO FCTC in 31 low and middle-income countries, helping to reduce the burden of death and disease from tobacco.

I will now address some of the issues raised by right hon. and hon. Members. My right hon. Friend the Member for South West Wiltshire (Dr Murrison) talked about restrictions imposed during covid. Covid has highlighted the health disparities across the country. Our ambition to be smoke free by 2030 will play a major role in tackling those disparities. I would like to reassure my hon. Friend the Member for Harrow East that I am conscious of the urgency of the publication of the tobacco control plan. However, I am determined that the plan will have robust and effective measures. He also highlighted measures that the APPG would like to see included. Along with my officials, I am looking carefully at each measure put forward.

Tobacco taxation was raised by my hon. Friends the Members for Harrow East and for Broxbourne (Sir Charles Walker), as well as the hon. Member for North Antrim (Ian Paisley). That is a matter for Her Majesty’s Treasury. However, the Department continues to work with HMT to assess the most effective regulatory means to support the Government’s smoke-free 2030 ambition, which includes exploring a potential future levy.

Ian Paisley Portrait Ian Paisley
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Will the Minister give way?

Maggie Throup Portrait Maggie Throup
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I am a bit short of time.

On raising the age from 18 to 21, we know how important the period between the ages of 18 and 21 is for those who may experiment with tobacco. We will include a focus on protecting young people and adults from the harms of tobacco within our tobacco control plan. As I have already indicated, I am ambitious for our new plan.

On the Health and Care Bill, at this stage we do not feel that it is the right Bill for the suggested measures without a full assessment. Members should rest assured that they will be fully considered as the tobacco control plan is finalised.

The hon. Member for City of Durham (Mary Kelly Foy) and my hon. Friend the Member for Rugby (Mark Pawsey) asked about the post-implementation reviews. The Department will publish its response in the coming months. I make no excuse for the delay. We had more than 5,000 responses to that review, and that was coupled with the pressures that my Department has experienced on covid-19. I reassure colleagues that it is on our agenda and we will publish in due course.

The hon. Member for City of Durham also asked about the investigations into menthol. The Office for Health Improvement and Disparities is investigating a range of cigarettes to determine if the flavour of menthol is noticeable. Once that study is complete, we will explore whether further action is needed against companies that have breached regulations.

My hon. Friend the Member for Rugby asked a number of questions. I understand that the ONS will publish smoking prevalence data for 2020 next month.

As I have already said, COP9 was one of the best attended conferences of the parties so far. I understand that there was a real buzz and an appetite to address the harms from tobacco and implement the framework convention on tobacco control, which I am sure will be welcomed by everybody in the room.

My hon. Friends the Members for Rugby and for Northampton South (Andrew Lewer) spoke about e-cigarettes. The Government are clear that we only support the use of e-cigarettes as a tool for smokers who are trying to quit, not as a route for people to take up smoking by another means. Our approach to e-cigarettes has been and will remain pragmatic and evidence-based.

My hon. Friend the Member for Northampton South talked about the environment that those who are attempting to quit find themselves in. Vaping is not covered by the smoke-free legislation. It is down to individual businesses to determine how they consider the guidelines.

I extend my thanks to hon. Members for their participation in today’s debate. It has been very constructive and there is clearly cross-party support. I reiterate the Government’s commitment to a smoke-free 2030. As we build back better from the pandemic, our aim is to make smoking truly a thing of the past and level up society.

Tobacco Control Plan

Ian Paisley Excerpts
Thursday 10th June 2021

(2 years, 9 months ago)

Westminster Hall
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Ian Paisley Portrait Ian Paisley (North Antrim) (DUP) [V]
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It is an honour to serve under your chairmanship, Mrs Miller, and lovely to see you in the Chair. I refer Members to my registered interests. I am the chairman of the Gallaher charitable trust, which was formed after the closure of a tobacco company in Northern Ireland.

Let me turn to the subject of the debate. Facts are stubborn things. We all appreciate that, and we must ensure that any actions we take to address facts are based on evidence. I am a non-smoker. I do not encourage people to smoke. I do not want people to smoke, and I recognise the impact that smoking has on people’s lives, but like many substances, tobacco is a lawful product, and I will not tell other adults what they should do or not do with lawful products.

Tobacco is one of the most highly regulated products and the most highly taxed product in the UK—about 90% of the cost of an average packet of cigarettes is taxation. That tax disadvantages poorer households in my constituency and across this country than the most affluent. The UK tax regime is designed to control tobacco and the sale of tobacco, but it has had the opposite impact. It has driven up the price of the product and encouraged smuggling of illicit product. Many people have made the wrong choice to purchase that illegal product. Therefore, under the current mechanism, everyone is a loser. It is not working.

On 2 June—just nine days ago—the Northern Ireland Border Force, at the real border in Northern Ireland, which is the land border, seized 4.4 tonnes of illegal tobacco, which, if sold, would have stolen from you, Mrs Miller, and me and our taxpaying constituents £7.24 million in unpaid duty. Tobacco control measures ought not to be about trophy taxation or gimmicks, but should be primarily about reducing consumption by good education and good enforcement, and secondly about minimising crime by directing resources to the tackling of criminality associated with activities related to illegal tobacco.

None of the control measures addresses that issue seriously. Government policy has failed to do that, and I believe that today’s proposals fail to do it. Instead, they are about unnecessary tax and minor tinkering such as putting another written warning on the cigarette stick. When the cigarette is in a person’s mouth, it is too late to put such a warning to them.

HMRC already generates £11.8 billion in tax on tobacco, yet it loses almost £2 billion in revenue annually in illegal sales of tobacco product. That is because the control plan is one-dimensional and, frankly, stupid. It does not work. Since 2000, tobacco smuggling has stolen from you, Mrs Miller, and me and our taxpaying constituents a revenue loss of—wait for it—£47.2 billion. That has been stolen from us by tobacco smugglers. Surely we can have a plan that, instead of punitively taxing a lawful product more, lets consumers see that money being spent on tackling this international, multibillion-pound crime of racketeering. Imagine a control plan that, over the next 10 years, would deliver £40 billion in revenue to hon. Members’ constituencies. Imagine what we could do for hospitals, schools and the defence budget. Imagine what we could do with the overseas aid budget.

I want the Government to be creative and to stand up to people who say, “Just put on more tax,” because clearly that does not work. Frankly, the control plan will not save one life from the effects of smoking, will not stop one smoker from smoking, and will not stop one smuggler from bringing in illegal products. If the Government want, unintentionally, to fill the pockets of organised crime gangs, undermine legitimate businesses and ruin small shops throughout the country, they should stick with the plan, but they should not be smug about it, because the plan is not working.