Oral Answers to Questions

Mark Pawsey Excerpts

Tuesday 23rd January 2024 Commons Chamber

[Mark Pawsey (Rugby) (Con)]

13. What steps her Department is taking to increase access to urgent and emergency care.

[The Minister for Social Care (Helen Whately)]

Almost a year ago, we published our urgent and emergency care recovery plan. The NHS has already halved the waiting times for category 2 ambulances and brought down waits in A&E. We are determined to cut NHS waits, and our plan is working.

[Mark Pawsey]

Rugby is one of the fastest growing places in the UK. While we have had additional services introduced at our local Hospital of St Cross, my constituents have insufficient accident and emergency provision. Thousands of local residents have signed my petition for doctor-led accident and emergency care at the Hospital of St Cross. I know it is a matter for the integrated care board, but will the Minister give her support? As a previous Minister, my hon. Friend the Member for Colchester (Will Quince) and the previous Secretary of State have visited in the past few months, and I invite this Minister to do likewise.

[Helen Whately]

I thank my hon. Friend for his invitation. He has been a tireless campaigner on this issue on behalf of his constituents. The future of healthcare is about getting people the care that they need, where they need it and when they need it, and Rugby is no different. New local NHS services are bringing care closer to home in his area, such as the new imaging unit at the Hospital of St Cross that opened in September.

Oral Answers to Questions

Mark Pawsey Excerpts

Tuesday 6th June 2023 Commons Chamber

The Secretary of State was asked—

[Mark Pawsey (Rugby) (Con)]

1. What assessment his Department has made of the adequacy of urgent and emergency care provision in towns with significant population growth.

[The Minister for Health and Secondary Care (Will Quince)]

Our recovery plan for urgent and emergency care provides £1 billion of additional funding for NHS capacity, alongside £250 million for capital improvement schemes up and down the country. Local integrated care boards are now responsible for working with their partners to decide how best to use that funding to improve services to meet the health needs of their changing populations, and all integrated care boards will shortly set out their plans for the next five years through a joint forward plan process.

[Mark Pawsey]

Rugby is the largest urban area within Coventry and Warwickshire that does not have its own A&E provision. In the wider region, Kettering, Shrewsbury, Redditch and Burton upon Trent all have similar or smaller populations, each with their own A&E services. Rugby is growing fast, with 12,500 homes being delivered between 2016 and 2031, when the population will exceed 135,000. Will the Minister say at what population level it will be appropriate for local health commissioners to upgrade the A&E provision at the Hospital of St Cross in Rugby?

[Will Quince]

As my hon. Friend knows, the provision of services, including accident and emergency, are a matter for local NHS commissioners and providers. I know that he regularly meets local NHS leaders about this matter and will continue to do so. I am very happy to meet him and, of course, visit. Funding for Coventry and Warwickshire Integrated Care Board has increased to over £1.6 billion this year. My hon. Friend is a huge champion for his constituents; I would be happy to meet and visit.

Vaping: Under-18s

Mark Pawsey Excerpts

Tuesday 2nd May 2023 Westminster Hall

[Dr Neil Hudson (Penrith and The Border) (Con)]

I beg to move,

That this House has considered vaping among under-18s.

It is a privilege to serve under your chairmanship, Mr Sharma, and it is great to welcome many colleagues from across the House to this important debate. I completely recognise that vaping has a vital role to play in supporting adults to give up tobacco smoking. However, vaping is a public good only if it is helping people to end addictions that they already have, not creating new ones, especially in our vulnerable young folk.

It is not an exaggeration to say that we are seeing an epidemic among our young people, which can be attributed to an increasingly popular and powerful market for disposable vapes. Action on Smoking and Health—ASH —said in its survey of 11 to 17-year-olds in Great Britain that 15.8% of 11 to 17-year-olds had tried vaping in 2022, up from 11.2% in 2021. It also said that in 2022, 7% of 11 to 17-year-olds were current users of vapes, up from 3.3% in 2021.

[Mark Pawsey (Rugby) (Con)]

It is currently illegal for young people under 18 to purchase vapes. Does my hon. Friend agree that we have a problem implementing the existing regulations, rather than anything else?

[Dr Hudson]

I completely agree, and I want to stress that key point: it is illegal to sell vapes to under-18s. I will be asking the Minister about that. I know that the Government are moving on it, and we need to address it going forward.

Similarly, an NHS survey in 2021 said that 9% of 11 to 15-year-olds, and 18% of 15-year-olds, had used vapes. Those are alarming statistics. ASH England also noted that the most frequently used e-cigarettes among young people are disposable vapes, with an astonishing increase from 7.7% in 2021 to 52% in 2022. Although this is not the main focus of my speech, I will point out that, quite aside from the health concerns associated with such a marked rise in the sale and consumption of disposable vapes, they are a major environmental concern, with over 1 million of them thrown away every week. It is estimated that the lithium used in those batteries equates to about 10 tonnes of lithium per year, which is equivalent to the lithium used in approximately 1,200 electric vehicle batteries.

--- Later in debate ---

[Dr Hudson]

I agree with my hon. Friend that if we can get more nuance into the advertising and labelling of vapes, that would help articulate to people the benefits of using them for the legitimate purpose of getting off tobacco smoking. It could also serve as a stern warning that young people should not take the products, because of their significant health risks. As ASH notes, 57% of e-cigarette use among 11 to 17-year-olds involves fruit flavours. Clearly and deliberately, the marketing of fruit-flavoured and trendy products is driving demand among our young people. We need to be very careful.

Aside from the nicotine, there are questions over whether the flavourings and chemicals inhaled also impact on the health risks to people who vape. For instance, in 2019 The American Journal of Physiology: Lung Cellular and Molecular Physiology reported that the flavouring chemical cinnamaldehyde was associated with decreased mucociliary clearance in the respiratory tract due to dysregulation of mitochondrial function. That presents a compelling case to treat this issue as an urgent priority and, as the hon. Member for Newport West (Ruth Jones) has said, to gather much-needed data in the area. We can then demonstrate the reality of what dangers our young people are potentially being exposed to in the long term.

As one teacher in my constituency has noted, the prevailing view seems to be that the use of such products is completely harmless. As the evidence I have mentioned suggests, however, that is very much not the case, as has also been acknowledged by health experts and, indeed, the Government.

Worse still, the potential impacts assume that the products are being sold in accordance with Government regulations. However, we have seen an increase in illicit and non-compliant trade of e-cigarettes. Checks on imports of these products find that regulations are regularly flouted, including higher numbers of puffs per vape and higher nicotine levels than those permitted. That also demonstrates that any Government action needs to remember online trading as well, not just physical sales in shops.

The Government are tackling the problem. I welcome the recent announcements by the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Harborough (Neil O’Brien), but I believe that the emerging reality of the dangerous effects that vaping may be having on our young people presents a compelling case for Government to act and move forward on the issue. His intervention on the subject last month was a welcome and major step, and a clear signal that this Government recognise the severity of the issue.

To successfully tackle a failure in any market, a holistic approach focused on both supply and demand needs to be examined. I am, therefore, heartened that that is exactly the line of travel that the Government are taking in their call for evidence on vaping plans. They are focusing not just on illegal sales, which is vital, but on what is driving up demand among our young people, such as the influence of advertising and social media. I strongly encourage those who are watching this debate, and people at large, to take part in that call for evidence, so that we can collate more data. I am thinking in particular of those who are seeing the impact at first hand, such as those involved in schools.

As I have raised with the Ministry of Justice, it is imperative that unscrupulous sellers of vapes to under-18s should feel the full force of the law if they break it. I therefore welcome the Government’s announcement of £3 million for an illicit vapes enforcement taskforce to tackle those who are illegally selling vapes to our young people, but also to look out for products that should not be on our shelves. It is an important reminder that laws are effective only if there is the determination and resources to enforce them.

To summarise, although vaping has an important part to play in supporting adults to quit tobacco smoking for good, it must not come at the cost of creating new addictions and health issues in our young people. I am very pleased that the Government recognise the severity of this issue and are acting with compassion by acting for those most vulnerable to serious harm. It must be a priority for our health policy, and in fulfilling our commitment to young people we must tackle this real threat to them and to gather information on the potential long-term effects of these products.

[Mark Pawsey]

I know that my hon. Friend is nearing the end of his remarks. Everybody in the Chamber acknowledges that the problem he has identified is that these products are getting into the hands of young people. He has already praised the work that the Government are doing, but what more should they be doing to prevent these products from getting into the hands of the wrong people?

[Dr Hudson]

I look forward to hearing from the Minister what he and the Government are going to do. Calling for evidence and having a taskforce is a good starting point, but I think that is just a staging post. We need to do more by tackling the advertising and making sure that the labelling is sufficient. The health warnings on cigarette packets are quite alarming now, and tobacco products are kept behind closed cabinets in outlets. We need to be moving in that direction, so that vapes are not like sweeties on shelves for our young kids. That is the real issue: they are appealing, colourful and fruit-flavoured products, and people think, “Do you know what? I’d like to have a try of this.” That is where people are slipping into this problem.

I fear that our young people face a public health ticking timebomb, and we as a Parliament and as a society must address it as a priority. I welcome colleagues’ interventions today, and I look forward to hearing more from the Minister about what steps the Government are going to take to tackle this very important issue.

--- Later in debate ---

[Neil O'Brien]

Absolutely, and I hope people will put in evidence on that. I will touch in a moment on something else we are doing. In the speech I mentioned, I announced the new specialised illicit vaping flying squad, a team to tackle under-age vape sales and illicit products that young people are accessing. It will hold companies to account and enforce rules.

My hon. Friend the Member for Rugby (Mark Pawsey), the chair of the all-party parliamentary group for vaping (e-cigarettes), said that we must enforce the rules, and he is absolutely right. That is why we are providing £3 million in new funding to Trading Standards, which will help share knowledge and intelligence around the country. The squad will undertake test purchasing, so that we find out who is selling to young people. It will disrupt illicit supply, and will also do work on organised crime gangs. It will remove illegal products, not just from our shelves but at our borders. It will undertake more testing to ensure compliance with our rules, bolstering the capacity of Trading Standards. Companies that fail to comply with the law will be held accountable.

It is important that we teach young people about the risks of vaping. That is why we have published new content on the potential risks of vaping for young people on the FRANK and Better Health websites. We have also provided extra input into educational resources produced by partners, including the PSHE Association.

[Mark Pawsey]

The Government has an objective to be smoke-free by 2030—that is, to get down to 5% of people smoking. Is the Minister concerned that if we continue to talk about the dangers and harms that may be associated with vaping, we are in grave danger of providing a disincentive for smokers to switch to a much safer alternative?

[Neil O'Brien]

My hon. Friend has pre-empted my next paragraph almost perfectly. I was about to say that although we want to ensure that children do not take up vaping, vaping can play an important part in achieving our ambition of a smoke-free England by 2030. Vaping is a double-edged sword. On the one hand, we do not want children to develop an addiction to any substance at a young age, but on the other, it is substantially less harmful than smoking, as my hon. Friend the Member for Dartford (Gareth Johnson) said. It is 95% safer than smoking.

Urgent and Emergency Care Recovery Plan

Mark Pawsey Excerpts

Monday 30th January 2023 Commons Chamber

[Steve Barclay]

I do not think it has been hiding. Flu seasons are not uncommon in the NHS and come round on a periodic basis, and that is why we anticipated it through the flu vaccine. On the hon. Gentleman’s wider point, it is also recognised that as a consequence of covid some resistance to flu may have been lowered, but we have had flu pressures on the NHS in past years.

[Mark Pawsey (Rugby) (Con)]

Would the Secretary of State consider more use of existing urgent care centres, such as that at St Cross in Rugby? Our nearest full A&E is 12 miles away at University Hospitals Coventry and Warwickshire NHS Trust, in Coventry, which means that 83% of my constituents are more than 15 minutes’ drive from an A&E. The hospital at Coventry serves a population of 600,000, which is twice the national average. Does he agree that extending provision at St Cross would go a long way towards reducing pressure at the hospital in Coventry?

[Steve Barclay]

My hon. Friend is right that not every patient accessing an emergency department needs a tier 1 A&E facility. This is about right place, right treatment for the patient, and making better use of urgent care centres. How those centres can better triage patients who can be treated there is a key part of the plan we have set out.

NHS Winter Pressures

Mark Pawsey Excerpts

Monday 9th January 2023 Commons Chamber

[Mark Pawsey (Rugby) (Con)]

Does the Secretary of State agree that many of those who will need to be admitted to hospital in the coming weeks will have reason to welcome the fact that this Government, unlike the Labour party, do not have a prejudice against making use of facilities from within the independent sector?

[Steve Barclay]

I agree; I think that it is important that we maximise capacity in the independent sector. That is what we are committed to doing, and I very much agree with my hon. Friend.

Ambulance Pressures

Mark Pawsey Excerpts

Monday 18th July 2022 Commons Chamber

[Steve Barclay]

I know the hon. Gentleman is co-chairing, with the Minister for Care and Mental Health, a strategy board looking at these issues, and I would be very keen to explore that with him in due course. There is an opportunity—not just from a health perspective, but from a levelling up perspective—to look at the pockets where there are gaps in the way he sets out, and to see how we can get better coverage geographically as well as address the very real health needs he identifies.

[Mark Pawsey (Rugby) (Con)]

My constituents attribute the deteriorating response times in Rugby to the decision of the West Midlands ambulance service to close our community ambulance station at the Hospital of St Cross—a decision taken without reference to doctors, councillors, residents or the local MP. Does the Secretary of State agree that decisions of that nature should be made only after consultation and with the support of local stakeholders?

[Steve Barclay]

I do not know the specific circumstances of the case my hon. Friend highlights, but in general good consultation and engagement with stakeholders will of course lead to better and more informed decision making. Where decisions have been taken and the outcomes proceed in a sub-optimal way, I know from my knowledge of my hon. Friend that he will make such a case in the strongest terms.

Hospital of St Cross: Accident and Emergency

Mark Pawsey Excerpts

Thursday 9th June 2022 Commons Chamber

[Mark Pawsey (Rugby) (Con)]

It is a great pleasure to see the Minister in his place. It is a particular pleasure to have been granted this debate on health provision in Rugby—one of the most important issues for my constituents, because my predecessor and father, Jim Pawsey, held such a debate concerning the Hospital of St Cross in Rugby 25 years ago. Much has changed in the intervening period, but the hospital remains as dear to Rugby residents’ hearts now as it was then. In particular, I want to talk about the provision of accident and emergency care at the Hospital of St Cross. In the course of my speech, I will first set out the current facilities available to Rugby residents, and then go on to make the case for improved and increased provision.

The urgency of today’s debate arises because of the increasing number of cases of concern being brought to my attention by my constituents. They are currently directed to the University Hospitals Coventry & Warwickshire site at Walsgrave in Coventry, 12 miles away. One constituent told me that when he needed to visit A&E, it took 22 hours for his condition to be fully assessed due to the very high number of patients waiting for treatment. He suggested, as I will today, that to help to alleviate pressure in Coventry, the Hospital of St Cross should be used more widely.

Another constituent told me that they were taken to University Hospital by ambulance one evening after suffering heart palpitations. Although the ambulance arrived at their home within 45 minutes, once they arrived at the hospital it took an hour to be taken into the care of the hospital because of the queue of ambulances waiting to discharge their patients. My constituent told me that the care they went on to receive at the hospital was good. That is a recurring theme throughout all the cases that have been brought to me: the care, once it is received, is excellent, but it is taking far too long to access it.

According to the history of the hospital written by the Rugby local history group, the importance of timely emergency care was the catalyst for the foundation of the Hospital of St Cross. In 1882, an engineer on the railway running through Rugby had a serious accident and his leg had to be swiftly amputated. At that time, victims of such accidents were normally taken by rail to either Birmingham or Northampton, but on this occasion, there was not time. The engineer’s leg was amputated on a bed in a small hospital on Castle Street in Rugby because there was not an operating table. Sadly, the amputation was not enough to save the young man’s life. When Mrs Elizabeth Wood heard of the engineer’s fate, she presented the hospital with an operating table, and subsequently, the land for the new hospital. The Hospital of St Cross remains 140 years later. The hospital today offers a number of high-quality specialist services, including orthopaedic and ophthalmic procedures and the recently added haematology service.

In respect of emergency care, there is a minor injury and minor illness unit, which is a nurse-led service for patients over the age of five. Rugby residents can attend for small wounds, animal stings, some sports injuries, minor injuries or suspected broken bones. X-rays, blood tests and a pharmacy are available, but, significantly, for anything complex or for a serious injury, residents must travel to Coventry.

Rugby residents were bitterly disappointed in 1997 when the A&E service at St Cross was downgraded as part of a wider move away from the district general hospital model and towards a higher concentration of specialists at a smaller number of sites. At the time, serious concerns had surfaced about the quality of some of the clinical services, which resulted in the board of the Rugby NHS trust agreeing to merge with Walsgrave Hospitals NHS trust in February 1997.

The royal colleges were invited to make reports on the services. The Royal College of Surgeons noted that Rugby’s catchment area was not at that time—that is the significant bit: it was not then—large enough to provide sufficient opportunities for clinicians to maintain their skills and deliver a safe service. A further justification was that, as medical science advanced, the days of the general surgeon had ended while the required number of support staff and the cost of complex equipment had increased.

Since that 1997 decision, the population served by the Hospital of St Cross has changed substantially. The local authority in Rugby has always been pro-growth. I have been very keen to see the many housing developments in Rugby in recent years, simply because we need to meet the challenge of enabling the next generation to own their own home and because we welcome the additional footfall for our town centre at a time when high streets face stiff competition from online retailers.

Between 2001 and 2011, the population of the Rugby borough grew from 85,000 to 100,000. I expect the 2021 census data to indicate similar or greater growth than that. Rugby is one of the fastest growing places in the UK and has an ambitious local plan that expects an additional 12,500 new homes by 2031. Accordingly, we can expect a population rise of about 30,000 people.

As part of the new developments, we have seen new roads and new schools. The people of Rugby also rightly expect to see a commensurate increase in the health services provided. There are plans for increased primary care provision. Whitehall medical practice has recently expanded and there will be additional provision in Houlton—a new housing area of Rugby—and the south-west development area, which should relieve the pressure on existing GP practices.

However, over recent years it has become clear from constituency cases brought to me and from discussions on the doorstep that Rugby residents are increasingly concerned about the provision of accident and emergency care and the impact of population increases on services. Most treatment is provided at Coventry, which is about 20 minutes’ drive from Rugby on a good day, and realistically at least half an hour’s drive for most Rugby residents. I understand from information provided by the Library that 83% of my constituents live more than 15 minutes’ drive from a major accident and emergency department.

--- Later in debate ---

[Mark Pawsey]

That figure is higher than in 84% of constituencies across England. The travel time is compounded by residents’ uncertainty and lack of clarity about what constitutes a minor injury or illness and whether their need can be met in Rugby or requires travel to Coventry. I frequently hear accounts of residents attending St Cross only to be immediately directed to University Hospital in Coventry. On occasion, I hear about residents who have travelled to Coventry for a very simple matter that could have been dealt with at St Cross.

In response to broader concerns about health provision in Rugby, last autumn I carried out a survey on my website asking about accident and emergency care in Rugby. I very much thank the people of Rugby for their outstanding response: nearly 3,000 residents took the time to have their say. That is an outstanding number for such a survey, and it sends a very clear message to local health decision makers about what Rugby residents want. The key points are that 98.5% of respondents believe that Rugby should have its own accident and emergency department, and 93% believe that Rugby does not currently have adequate accident and emergency care provision.

My survey builds on the work that the Coventry and Warwickshire clinical commissioning group carried out over the summer of 2021, covering all of Warwickshire. That survey had 922 respondents, which is rather fewer than the 3,000 who responded to my survey, but about 600 of those 922 people were Rugby residents. My constituents’ hugely disproportionate participation shows their strength of feeling.

Given the large number of responses, I am pretty confident that the results of my survey were representative of the views of Rugby people more broadly. It is clear that my constituents believe that our town, particularly given its growth, is currently underserved with A&E provision. After conducting my survey, I met Professor Andrew Hardy, the chief executive of University Hospitals Coventry and Warwickshire NHS Trust. He agreed about the high volume and the unanimous response, which I hope the Minister will acknowledge in his remarks.

One issue for the accident and emergency department at UHCW is that it is very large. It has to be, because according to the Library, most accident and emergency departments serve a population of at least 200,000—the average is 320,000—but the accident and emergency department of University Hospital in Coventry serves a population of about 600,000, nearly double the national average.

It is my contention that if we improve the offer at the Hospital of St Cross, pressure on the University Hospital site in Coventry could be alleviated and waiting times could reduce. Of those residents who completed my survey, 52.7% said they had waited more than four hours for treatment on their most recent visit to Coventry.

Regrettably, since my survey was conducted last autumn, the pressures on accident and emergency departments have only increased; I am sure the Minister will acknowledge that. The minutes of the University Hospitals NHS Trust February board meeting noted that the hospital’s occupancy had been over 97% since August 2021, with full hospital protocol occurring in September and early November. However, I was pleased to note that there is an ongoing focus within the trust on using some of the capacity that exists in Rugby to assist the flow in Coventry. It is my contention, and that of my constituents, that the Hospital of St Cross could be used rather more to relieve the pressure.

The concerns of Rugby residents have been compounded by the closure of Rugby community ambulance station in October of last year, along with a number of other ambulance stations across the west midlands. That was a unilateral decision by West Midlands Ambulance Service University NHS Foundation Trust, which has been opposed by me and by other west midlands MPs. There was no consultation with residents. I was not notified, nor were my parliamentary colleagues: we read about the decision in the press.

It is a simple and regrettable fact that the closure of the community ambulance service in Rugby makes it less likely that there will be an ambulance in Rugby. I believe that if we had ambulances coming to Rugby with patients seeking accident and emergency care, there would be a greater likelihood of an ambulance in the vicinity, and ambulance response times would improve for Rugby residents because ambulances would have a reason to be in Rugby. West Midlands ambulance service says that its service is delivered by people, not buildings, and that the single biggest factor that it faces is handover delays at hospitals. This is a national problem, as the Minister will acknowledge, but, as I have said, if ambulances could come to the Hospital of St Cross rather than going straight to Coventry, there would be a greater likelihood of an ambulance in Rugby able to deal with calls from local residents.

In my survey, I asked Rugby residents this question: if they could change one thing about the NHS locally, what would it be? The vast majority said that they would like to see better accident and emergency provision in Rugby. Others noted difficulties arising from their circumstances. The key theme was the challenge posed by the journey to University Hospital in Coventry. Many residents noted that it was particularly difficult without a car, and that those without cars, who might have had to wait a long time at A&E—until late evening—often ended up returning home in a taxi and paying a large fare that they could ill afford.

I have heard from many constituents about the lack of accident and emergency provision for children under five. One parent wrote:

“My son who is 3 has had 3 fits in the last year and each time we have had to travel to University Hospital”.

Another wrote:

“I have two small children and it terrifies me that I will have to travel so far if they needed emergency care”.

Among the responses from my constituents were a number of heartbreaking accounts, but none was more heartbreaking than an account of an issue that arose in January this year, when my constituent Jamie Rees died of a sudden cardiac arrest. The ambulance that attended the scene had to travel from University Hospital, and given that time lag it had no realistic chance of meeting the category 1 response time, which would have saved Jamie’s life. Jamie’s family have organised an extraordinarily powerful campaign, known as “Our Jay”, to raise more than £10,000 for externally mounted defibrillators. What was so frustrating for the family was the fact that a nearby defibrillator that could have saved Jamie’s life was locked inside a nearby school, which was very sad. There was no externally mounted defibrillator. One reason for people’s unwillingness to provide them is that from time to time they are subject to vandalism and theft.

Jamie’s family have also rightly asked questions of the emergency services, particularly about the impact of the closure of the community ambulance station in Rugby in October. Quite reasonably, they were really bothered about the length of time it took for an ambulance to attend. Jamie’s parents were full of praise for the amazing staff who cared for Jamie, but they rightly point to the importance of that care being accessible at the time it is needed. We know that people in Rugby want to see improved local accident and emergency provision, and I very much hope to have the opportunity to demonstrate this need for an extension to the A&E provision in Rugby when the Secretary of State comes to visit Rugby and St Cross in the near future, which he has kindly committed to do.

Our role as Members of Parliament is to represent the concerns of our constituents here in this place and to seek redress when it is needed. In Rugby, for my constituents, there is no greater issue right now than health provision, and I would not be doing my job as their representative if I was not doing all I could to make sure that that need is met. The Government have quite reasonably asked that towns such as Rugby do their bit to provide the housing that the people of this country need, and Rugby is proudly meeting that challenge. All we ask is that the Government and local health commissioners also do their bit to provide the healthcare that the people of Rugby need and are asking for.

Elective Care Recovery in England

Mark Pawsey Excerpts

Monday 7th February 2022 Commons Chamber

[Edward Argar]

I am grateful to the hon. Gentleman for his willingness to share with the House his personal experience in respect of his mother. I think that in doing so he probably speaks for a number of Members of this House, and certainly a number of our constituents. He said it is important that we focus on cancer, and he is absolutely right. Clinical prioritisation will be a key part of how we address bringing the waiting lists down, because it is right that we focus on the illnesses and diseases where the longer the delay, the greater the risk of not making a full recovery or of a negative outcome. He is right to highlight the focus on cancer as on certain other key areas. On his final point, I do not share that view. I believe it is right that we get this plan right so that it delivers the outcomes we need. As I have said to a number of hon. and right hon. Members, I do not believe that the plan is a necessary precursor for getting on with taking a number of steps, as we have done as a Government, to start to bring the waiting lists down.

[Mark Pawsey (Rugby) (Con)]

Does the Minister agree that there must be an important role in this programme for smaller hospitals such as St Cross in Rugby, where on a recent visit I saw some brand new operating theatres providing important extra local capacity?

[Edward Argar]

I am grateful to my hon. Friend for his shout-out for his local hospital. He is absolutely right: we need to utilise the resources and the capacity of the whole system, and this is the approach we are adopting. Often, the debate can focus on the large, acute district general hospitals, but he is absolutely right that smaller hospitals, community hospitals and indeed community facilities all have a part to play in helping to tackle this waiting list.

Covid-19 Update

Mark Pawsey Excerpts

Friday 26th November 2021 Commons Chamber

[Sajid Javid]

I understand that this is difficult news, whether for the sports teams or the thousands of British tourists and others who currently find themselves in South Africa, Botswana or any of these countries, but I hope that many will understand. Indeed, I have had messages today from people who are in South Africa, saying that this has made their life a bit more difficult when it comes to getting back home, but they fully understand and support the action that has been taken.

The hon. Member asked what could be done to try to get the team back before the deadline. The answer is nothing; we will not do anything to help them get back before the deadline, because for anyone who is in South Africa, the best thing to do is to come back after 4 am on Sunday and go into hotel quarantine.

[Mark Pawsey (Rugby) (Con)]

I commend the Secretary of State for the extremely prompt action that he is taking to protect our citizens. Although these are early days—he has spoken about the uncertainty and said that we do not know enough about the new variant—does he have any assessment of the length of time for which the measures that he has announced might be necessary?

[Sajid Javid]

That is a good question, but such is the uncertainty around the variant and the rate at which it seems to be spreading that I am afraid that it is not possible to put a timeline on this action.

Tobacco Control Plan

Mark Pawsey Excerpts

Tuesday 16th November 2021 Westminster Hall

[Mark Pawsey (Rugby) (Con)]

It is a pleasure to serve under your chairmanship, Mr Bone. I join the hon. Member for City of Durham (Mary Kelly Foy) in congratulating my hon. Friend the Member for Harrow East (Bob Blackman), as the chairman of the all-party parliamentary group on smoking and health, on securing an important debate, and I compliment his outstanding record in the subject area of smoking cessation. As he will know, I chair a separate APPG—the all-party parliamentary group for vaping—which I established in 2014. I do not vape, have never smoked and have no personal interest in vaping, but I set up the APPG after meeting with a proprietor of a small business in my Rugby constituency, who was concerned that impending legislation from the EU—the tobacco products directive—might mean that his customers would not have access to a product that had enabled many of them to finally stop smoking.

Another reason for getting involved was that a member of staff in my office had tried every mechanism available to him—patches and other routes—to quit smoking, but the only thing that had worked was vaping. Since setting up the APPG for vaping, we have heard from many members of the public about the benefits of vaping in enabling them to stop smoking, and the support that has been given to that position by Public Health England’s assertion in 2015 that vaping was 95% safer than smoking combustible tobacco.

I believe that two points should be integral to the treatment of vaping in the forthcoming tobacco control plan. First, there is the recognition of relative risk and harm reduction products, which was mentioned by my hon. Friend the Member for Broxbourne (Sir Charles Walker). Secondly, there is the fundamental importance of distinguishing between combustible tobacco, which we all know and have heard in the debate already is extremely harmful, and the far less harmful non-combustible alternatives that are available. The new plan should continue on the progressive path that the UK has forged over the last few years by continuing to recognise the importance of reduced-risk products in reducing smoking prevalence in our country. It is absolutely essential that we do not conflate smoking combustible tobacco with vaping. That position is not helped by the fact that we regularly see in public places signs telling people that smoking is not permitted and nor is vaping. Signage and messages such as that are putting it in people’s minds that there is an equivalent harm between smoking and vaping, when we know that is not the case. They are entirely separate activities and should be treated as such.

It was concerning to read through some of the documents from the recently concluded framework convention on tobacco control COP9 meeting and see a concerted effort by some to treat vaping as smoking. The hon. Member for City of Durham mentioned that concern. We should push back against such messages at all costs. Earlier, and by contrast, it has been pleasing to see the Government acknowledge the importance of vaping. They did so in the 2017 tobacco control plan and I believe the case for vaping has increased since that time. Of the estimated 3.3 million vapers in the UK, 1.8 million are ex-smokers and the balance are smokers who also vape. We need to recognise that category of people, who reduce their exposure to tobacco by continuing to smoke from time to time but who also use vaping as an alternative device. If we assume that when they are vaping they might otherwise be smoking, their use of vaping products at that time helps their health.

Vaping has played a significant role in recent years in reducing smoking prevalence. If the Government are serious about their 2019 commitment to getting smoke-free by 2030, the role of vaping should be reinforced and supported through the new tobacco control plan. However, as we have heard, we know that approximately 7 million people continue to smoke in the UK and we need to do all that we can to help the many people who have tried to move from cigarettes to safer, reduced-risk products, as my hon. Friend the Member for Broxbourne said.

Over the past year the APPG for vaping has conducted two inquiries, with two reports, which I know the Minister has seen. The first focused on the UK’s position at the recent COP9 and the second analysed the opportunities available for tobacco harm reduction policies post Brexit. I thank the Minister for her receipt of our reports and for meeting the members of the APPG ahead of COP9 last week. I know that all Members, not just the members of APPGs, will be interested to hear from the Minister some of her thoughts on the outcome of COP9. She will, I know, acknowledge the delay in publishing the tobacco control plan that we expected this summer, as mentioned by my hon. Friend the Member for Harrow East. Can the Minister confirm that the post-implementation review into tobacco-related products will be published beforehand, as recommended by the APPG in its most recent report? I hope that she can also confirm that the new plan will not be published prior to the publication of Office for National Statistics data for 2021 on smoking prevalence. We understand that that was something that her predecessor intimated.

The APPG’s expert recommendations on how we can achieve a smoke-free 2030 can embrace the ideas to help eliminate smoking, tackle inequalities and help level up and strengthen consumer confidence in vaping by tackling some of the misinformation that is currently prevalent. Our report called for the tobacco control plan to ensure that we meet our 2030 smoke-free target by setting out a clear plan to achieve it, embracing the concept of tobacco harm reduction and, as mentioned previously, ensuring that the post-implementation review of the tobacco and related products regulations is published ahead of time. It is imperative that the evidence gathered through the process is properly considered, transparently disclosed and used to best effect before we set out our new policy direction under the new tobacco control plan. The new plan should be used as an opportunity to introduce a multi-category approach that, as we heard earlier, encourages switching to less harmful alternatives when a smoker is unable or unlikely to quit entirely. As we have heard, we know that it is the process of combustion that carries the harm in cigarettes, so we need to fully analyse all the non-combustible reduced-risk products available on the market and align our regulations for all of these products—as has been advocated for by the Royal College of Surgeons.

Finally, we should use the new tobacco control plan as an opportunity for the UK to cement its place as the world leader in tobacco harm reduction. I have been on calls with representatives of other countries; we have a lead in this area that other countries look to and it is important that we maintain that. I know the Minister will agree that that means allowing sensible communication on the benefit of vaping, rather than banning their promotion and looking at the transposed EU tobacco products directive. That way, we can make sure that they are fit for purpose for our more progressive approach to tobacco control and harm reduction. By making these changes we will give ourselves a real chance to reach our smoke-free 2030 target. Without bold leadership—which I know the Minister will provide us with—there is a danger that we will miss that target; as a consequence, we will miss the opportunity to help those 7 million people who still smoke get off tobacco for good.