Tobacco and Vapes Bill

Robin Swann Excerpts

Consideration of Lords amendments
Monday 23rd March 2026 Commons Chamber

[Euan Stainbank (Falkirk) (Lab)]

I refer hon. Members to my entry in the Register of Members’ Financial Interests and my position as chair of the responsible vaping all-party parliamentary group, in which I succeeded my hon. Friend the Member for Newcastle upon Tyne East and Wallsend (Mary Glindon).

As a member of the Bill Committee and part of the envious generation who will precede the smokefree generation this Bill promises, I welcome its return to the House and welcome the Minister for Public Health, my hon. Friend the Member for Washington and Gateshead South (Mrs Hodgson), to her place. It cannot go without saying that we also welcome the immense contribution of her predecessor, my hon. Friend the Member for West Lancashire (Ashley Dalton), and her mammoth work in guiding the Bill through Report and Third Reading. Finally, I welcome the contributions of Members from all parts of the House to the Bill.

It is critical that the powers enabled by the extensive secondary legislation that this Bill provides for are employed with our constituents’ health at the forefront of Ministers’ minds. My primary hope is that the Bill will drastically bring down smoking-related illness and early death, which are still far too prominent among smokers in this country. It has been proven by all currently available evidence that for smokers, switching to vaping is a substantially preferable and healthier choice than continuing to smoke. To put it simply, if you do not smoke, do not vape, but if you do smoke, switching to vaping is a far preferable choice for your health. That is a message we should never tire of repeating, especially considering that four in every 10 smokers still believe that vaping is just as harmful as smoking, if not more harmful, despite the scientific and medical consensus.

As we pursue a smokefree generation for those turning 18 at the turn of the year, the Government must recommit at every opportunity—including through this Bill—to rebutting this harmful misunderstanding of the relative harm of vaping through both words and actions. Lords amendment 72 acknowledges this by providing a defence for public authorities to the offences in clause 113 on advertising that would enable the ongoing use of vapes and nicotine products for the promotion or protection of public health. I note that that defence applies only to non-branded vaping and nicotine products. When she sums up, will the Minister clarify whether the amendment would permit the use of flavoured vapes or nicotine products in pursuit of the promotion or protection of public health? The written and verbal testimony of ex-smokers across the country who have made the switch to vaping is clear that they rely on flavours to quit, to stay quitting, and to quit for good.

When we consider the use of secondary powers as part of the powers available to Ministers under the Bill, we must fairly balance the crucial public health objective of getting adult smokers to quit for good against the rising concerns about youth vaping across the country. It is the sadly too common gaudy and immediately apparent displays in shops, the ridiculous flavour descriptors and the packaging associated with illicit manufacturing and retailing that are driving youth vaping far more than the flavours themselves. We talk about the proliferation of vape shops on high streets, but it is the illicit and unregulated market that we must pursue as a priority. We certainly should not group that market with specialist retailers that pursue strong age verification, muted displays, safe storage and the ability to support smokers to quit.

On enforcement, Lords amendments 9 to 13 make necessary clarifications on the definition of an enforcement authority in England and Wales. Lords amendments 14 to 20 subsequently clarify where the responsibility to issue fixed penalty notices sits. Enforcement of this Bill will be necessary if it is to achieve its aim to crack down on illegal and illicit vape products, but we must not forget that the proliferation of the illegal vaping business is still concentrated at points of entry to the UK market. We must pursue that important objective, because we cannot prejudice public and consumer opinion against the sale of legal vapes from the regulated industry by allowing them to be displayed alongside illicit and unregulated products that we all want to see off the shelves of our local corner shops. Those are the products that are driving youth vaping, not the regulated ones. We must therefore ensure the adequate resourcing of Border Force, trading standards and local enforcement authorities. Will the Minister provide detail on how the Government will seek to achieve that within the scope of this Bill?

Lords amendments 21 and 22 to clause 38 are a welcome step. They permit relevant local enforcement authorities to retain the sums and reinvest them in connection with their enforcement functions, rather than those sums going to the national Consolidated Fund. Can the Minister clarify the purposes for which those funds can be utilised? As I understand it, they can be used only in connection with the enforcement function and not to support swap-to-stop schemes or any broader activity. I would appreciate that clarity when she winds up.

The need for enforcement against illicit retail practices has rightly become an increasingly salient issue, especially in Scotland following the tragic fire earlier this month in Glasgow. While it is important for us to state that no cause of the fire has yet been definitively established—that is rightly for the relevant authorities to investigate— will the Minister expand on how secondary legislation and associated Government action around trading standards could better enable local authorities to enforce against the illicit practices that the Bill seeks to address? How will the Government encourage retailers to drag themselves up to the best practice of specialist retailers on display, storage and age verification?

To conclude, the Bill’s primary aim to create a smokefree generation is welcome. I welcome that it will directly make that generation healthier and happier, and enable them to live far longer than those who preceded them. We must do all that, however, while enabling the millions of adult smokers in Britain to quit quicker and to get healthier.

[Robin Swann (South Antrim) (UUP)]

I welcome the Minister to her place. I worked with her predecessors when I was Health Minister in Northern Ireland, when this Bill first came about. I am sorry to disappoint the hon. Members for Windsor (Jack Rankin) and for City of Durham (Mary Kelly Foy), because this legislation started its iterations under the previous Government. Very little has changed between what was debated then and what is before us now, because it is the right thing to do. It is the common-sense thing to do for the health of the entirety of our nation.

I remember having those conversations with the then MP for South Northamptonshire, Dame Andrea Leadsom, who was passionate about what the Bill would bring about. She was receiving the same advice as I was from chief medical officers across the nation about how the cessation of smoking across generations would dramatically change not just health, but the income of many families. In respect of that four-nation approach, I seek reassurance again from the Government—I have received reassurance on this from the last Government and this Government—that the Bill will apply equally in Northern Ireland and all parts of the nation.

[Jack Rankin]

The hon. Member is right that the Bill, if it does apply, should apply to the whole United Kingdom, of which Northern Ireland is an integral part. Under the Windsor framework—the sell-out that is disgracefully named after my constituency—Northern Ireland is subject to the tobacco products directive, is it not? Is it possible, then, for the Bill to apply equally to Northern Ireland?

[Robin Swann]

That is the concern, but I point out that the Windsor framework was negotiated and implemented by the previous Government, who left Northern Ireland in this current situation. When I was in post, I received reassurances from the previous Government and from this Government. I would like to be in a place that I can take both at their word that they have done their due diligence about the applicability of this legislation, and the Minister responded to the hon. and learned Member for North Antrim (Jim Allister) on that.

--- Later in debate ---

[Jim Allister]

Name them.

[Robin Swann]

Well, it was Democratic Unionist party MPs who were prepared to oppose the Bill in this House while their MLAs supported it back in the Northern Ireland Assembly. That was a strange mixture, but that is where we are and that is where they are at this minute. I am assured that DUP MLAs support this legislation applying equally to Northern Ireland, and I think that was part of the debate in the other place with their peers. I finish by seeking reassurances from the Minister about the application of this Bill, because it is a good piece of legislation.

[Jim Dickson (Dartford) (Lab)]

It is a pleasure to have this Bill back before us today. During the many great speeches tonight, but also on Second and Third Reading, the great majority of people have agreed that we should feel proud of this world-leading piece of legislation. It will create that elusive thing: a smokefree generation in this country.

As a former smoker and as vice-chair of the all-party parliamentary group on smoking and health, I am grateful to have been able to speak regularly in the debates on this Bill, including spending many hours in the Bill Committee going through it line by line. As the hon. Member for Winchester (Dr Chambers) said, there is a feeling of veterans of the Bill gathering round to see it finally get over the line, and that is a wonderful thing.

As vice-chair of the APPG on smoking and health, I want to put on record my thanks to my hon. Friend the Member for City of Durham (Mary Kelly Foy) and the hon. Member for Harrow East (Bob Blackman) for their great work over the years leading that APPG to the point where we now have legislation that embodies the APPG’s ambitions.

Before I get into the detail, I will offer my thanks to Ministers and officials here and across the four nations of the United Kingdom for the work that they have done to create a Bill that will apply across our entire nation. I welcome the new Minister for public health, my hon. Friend the Member for Washington and Gateshead South (Mrs Hodgson), to her place. It is brilliant to have a champion for public health over many years as the new Minister. She was a very able public health spokesperson for this party while in opposition.

Just under a year ago, I tabled an amendment on Report that would have introduced a ban on all cigarette filters, regardless of whether they contain plastic. I tabled it in recognition of the fact that there are no health benefits at all to cigarette filters, despite the hon. Member for Windsor (Jack Rankin) seeming to be of the view that there are. Filters were developed by the tobacco industry following evidence that smoking caused lung cancer, in order to give a false sense of reassurance to smokers. The passage of this Bill has also seen discussions of the merits of what have been described as biodegradable filters. As Dr Bas Boots, ecologist and senior lecturer at Anglia Ruskin University—he spoke last year to the APPG on smoking and health—has said:

“All cigarette filters are harmful to the environment. Research from Anglia Ruskin shows the extent of this, with filters leaching toxic chemicals into soils and waterways causing harm to plants and animals.”

Although the Government did not accept my amendment, I am pleased to see other amendments—including Lords amendments 37 to 45—to ensure that regulatory powers in the Bill can apply to filters, and I understand from Action on Smoking and Health that if the UK were to ban filters, we would be the first country in the world to do so. I hope that the Minister, when she sums up the debate, will be able to tell us when a call for evidence related to cigarette filters will be launched.

In Committee, we discussed at length whether the changes in the Bill should extend to vape vending machines in mental health settings. I am grateful to the Government for considering that carefully and altering the Bill, via Lords amendments 3 and 4, to exempt vending machines in such settings from the overall, and very sensible, ban on them elsewhere in the light of their obvious role in helping often vulnerable people to stay smokefree.

The addition of a Government commitment, via Lords amendment 80, to review the implementation of the Bill within four to seven years is really sensible. It is important for us to look at how it is working, and to share any lessons learned with other countries that may be pursuing similar legislation—we know that a number of countries are doing so.

I also support Lords amendments 89, 90 and 91, which will ensure that a comprehensive definition of “tobacco” will apply from Royal Assent, as it should. That will end the practice of illegally marketing heated tobacco products, and will enable the Government to use powers in the Bill to specify that devices used for the consumption of tobacco cannot be promoted.

Finally, I want to reflect on the key impact of the Bill. When the age of sale restrictions for tobacco come into force on 1 January 2027, we will create a smokefree generation, with those born on or after 1 January 2009 turning 18 and never being able to purchase tobacco legally. As this century progresses, millions of UK lives will be saved, and we will genuinely be on the road to a smokefree Britain.

Medical Training (Prioritisation) Bill

Robin Swann Excerpts

2nd reading
Tuesday 27th January 2026 Commons Chamber

[Wes Streeting]

I can give the hon. Member that assurance—that is exactly what the Bill does. Madam Deputy Speaker, I cannot, however, resist the enormous temptation to say that while I welcome the support of the hon. Member and her party, I hope that her party’s position will not change now that it has adopted so many of the formerly Conservative culprits who landed us with this system in the first place. Whether it is the former Home Secretary, the right hon. and learned Member for Fareham and Waterlooville (Suella Braverman), or the former Immigration Minister, the right hon. Member for Newark (Robert Jenrick), I am afraid that Reform looks rather more like the Conservative party that the country rejected at the last election, which I am sure will not be lost on people when they go to the ballot box in May—[Interruption.] As my hon. Friend the Minister for Care says from a sedentary position, Reform UK are increasingly the teal Tories—it is certainly the most successful recycling project currently taking place in the House of Commons. Anyway, that was totally self-indulgent, and very churlish given that the hon. Member for Runcorn and Helsby (Sarah Pochin) is supporting the Bill, so I will slap myself on the wrist and get back to the serious matters at hand.

As we set out these changes, it is important to note that they will have no impact on doctors working in the armed forces, who will continue to be a priority, and neither does the Bill exclude international talent, as people will still be able to apply for roles and continue to bring new and vital skills to our NHS. The principle here is home-grown talent. It is not about where students are born; it is about where they are trained. What the Bill does is return us to the fair terms on which those home-grown medics competed before Brexit.

[Robin Swann (South Antrim) (UUP)]

I welcome the Secretary of State’s approach to the Bill, and how he has worked across all devolved Administrations. May I seek his assurance that medical students who reside in Northern Ireland, who identify as Irish and who study in an Irish institution in the Republic of Ireland will not be excluded from coming back to work in the national health service in Northern Ireland, where we very much need all the talent we can get?

[Wes Streeting]

I absolutely give the hon. Member that assurance—the Bill covers medical graduates from the UK and Ireland, for very obvious reasons. I welcome the broad support that the Bill appears to have across the House, because for the changes to benefit applicants in the current round—for posts starting this August—it must achieve Royal Assent by 5 March. Any delay will risk vacancies in August and disrupt planning in NHS trusts, which rely on their new trainees to deliver frontline care. Doctors also need sufficient time to find somewhere to live, sort childcare and arrange other aspects of their lives before their posts start. I am grateful that Parliament has agreed to expedite the Bill’s progress, and confident that we will be able to work at pace with our majority in this House, and with cross-party support in the other place.

--- Later in debate ---

[Robin Swann (South Antrim) (UUP)]

As I said earlier, I will be supporting the Bill. I thank the Secretary of State and the Minister for their engagement with the devolved institutions on the Bill’s intentions, and on expediting its progress. Its implications for Northern Ireland, and for the medical workforce spanning the islands, are crucial.

As has been discussed, the Bill introduces a UK-wide duty on providers of medical training to prioritise applicants who have graduated from medical schools in the UK or the Republic of Ireland. While health is a devolved matter in Northern Ireland, I entirely recognise that this legislation is essential to preserving a joined-up and UK-wide approach to medical training and recruitment. For too long, we have seen increasing pressures on training pathways, with locally trained graduates facing uncertainties and bottlenecks when moving from undergraduate education into foundation and specialty training. I hope very much that the Bill will ensure that those who trained in UK and Republic of Ireland systems have a clear and reliable route into employment in those same systems.

I welcome clause 4, which refers to the terms “UK medical graduate” and “the priority group”, but am concerned about the drafting of amendment 9, which was tabled by members of His Majesty’s official Opposition. If Northern Ireland were excluded from these arrangements in any way, by default, it would face an invidious choice between accepting increased competition for limited training places and withdrawing from national recruitment altogether. The latter would place a significant administrative and financial burden on local bodies, particularly the Northern Ireland Medical and Dental Training Agency, and could risk undermining long-established recruitment structures.

I welcome the fact that the Bill does not impose additional costs on health services in Northern Ireland, given that the system is under unprecedented financial strain. Instead, it simply changes the order in which applications are considered for existing programmes, and by doing so, it helps to protect the investment made in medical education. However, I seek an assurance from the Minister in connection with a graduate-entry medical school that was created at Magee College back in 2021. The first cohort of graduates came through in June 2025—69 second-degree doctors and surgeons. I hope that nothing in the Bill will hinder their progression into the workforce. I am sure that the Minister has engaged with the Northern Ireland Health Minister on ensuring that there are no impediments to that progression.

Ultimately, the Bill supports locally trained doctors and maintains the integrity of national recruitment systems. I therefore fully support it, along with its extension to Northern Ireland through the legislative consent motion process. I genuinely wish the Minister well, and commend her on the constructive approach taken to recognising Northern Ireland’s devolved competences while ensuring alignment across the entirety of the United Kingdom. However, I will support the Opposition amendment regarding the timing. In my view, this legislation is not just the right thing to do. It is the timely thing to do in order to tackle the issue of workforce recruitment, and it should not be used in any negotiations with the British Medical Association to resolve another issue out there. I seek an assurance from the Secretary of State, as other speakers have done, that the Bill will be introduced in the right manner, because it is the right thing to do.

NHS: Winter Preparedness

Robin Swann Excerpts

Monday 15th December 2025 Commons Chamber

[Wes Streeting]

Yes. The JCVI makes evidence-based recommendations, and we follow its evidence. With the best will in the world, we of course give out practical, common-sense advice, but we should not infantilise our constituents. They are perfectly capable of working out who can get together this Christmas. They really do not need Government Ministers to start issuing directions about who can get round the table for Christmas dinner and who can get together in the days after. In the exchanges we have in this House there is sometimes a degree of patronising of the British people. They really, really do not need us. They really do not need our advice on the seating plan at Christmas dinner; what they need is for NHS services to be there when they need them, and that is what the Government are focused on.

[Robin Swann (South Antrim) (UUP)]

I commend the Secretary of State for his action to try to prevent industrial action. Nye Bevan had his own challenges with the BMA.

The covid inquiry made a number of recommendations with regard to co-ordination and preparedness across all four nations. What interaction has the Secretary of State had with the devolved nations in respect of this wave of flu, RSV and access to vaccinations?

[Wes Streeting]

I speak regularly with my counterparts, and the Ministers who are either side of me this afternoon have been engaging with our counterparts in recent weeks on these issues. We have a good relationship with devolved Administrations, regardless of party or where they sit across the United Kingdom, and that is a good thing.

As for the history of Labour Governments’ interactions with the NHS, that is not lost on me. The BMA marched against the NHS. It may be the case that the BMA does not really feel it needs the NHS—the BMA will be all right regardless—but my constituents cannot afford private healthcare, let alone earn money working in it. We will do everything we can to save the NHS, get it back on its feet and ensure that it is fit for the future. It is the only NHS our country has ever had and, compared with all the alternatives, I would not give up on a publicly funded public service—owned by us and there for all of us—for anything.

Oral Answers to Questions

Robin Swann Excerpts

Tuesday 25th November 2025 Commons Chamber

[Dr Ahmed]

I thank my hon. Friend for all her tireless work, campaigning and advocacy on this issue for many years, particularly since the Hughes report was published in February 2024. Like me, she will be sensitive to the fact that we are coming up to the two-year anniversary of that report. It is a call to action for me and the Department to answer the questions that she has been asking for so long. I have a meeting with the Patient Safety Commissioner very shortly, and I am very happy to meet her separately when she wishes.

[Robin Swann (South Antrim) (UUP)]

The Minister will know that the Hughes report focused very much on England, but those affected by the redress scheme will be found across the entire United Kingdom. Will he ensure that he engages with Health Ministers from the devolved authorities?

[Dr Ahmed]

The hon. Gentleman can certainly be given that assurance from me, as the Minister also responsible for four-nation engagement. The Hughes report examined both the sodium valproate and pelvic mesh issues, and I know that these resonate across the four nations, particularly when it comes to licensing and regulation of medical technology. He has that assurance from me.

Cross-border Healthcare

Robin Swann Excerpts

Tuesday 4th November 2025 Westminster Hall

[Robin Swann (South Antrim) (UUP)]

It is a pleasure to serve under your chairship, Mr Dowd. I congratulate the hon. Member for Brecon, Radnor and Cwm Tawe (David Chadwick) on securing a debate on cross-border healthcare, because we in Northern Ireland know only too well that health outcomes are not, and should not be, defined by borders—whether an internal UK border or one with an entirely separate sovereign jurisdiction. Sickness does not discriminate.

In fact, as the only part of the United Kingdom to share a land boundary with another nation, the issue of cross-border healthcare is something on which every Northern Irish MP, I am sure, will have an opinion. Despite our constitutional sensitivities, I for one have absolutely no hesitation in saying that I am deeply proud of the progress we have made in cross-border healthcare in both Northern Ireland and the Republic of Ireland. The progress in recent decades has shown what can be achieved when we actually work together with a shared purpose.

I take note of what other hon. Members have said about the challenges across an internal UK border, which I believe we should not have in healthcare. Despite that, in Northern Ireland we need only to look at the success of the radiotherapy unit at our hospital in Altnagelvin, and more widely the north-west cancer centre based in Londonderry. Those services demonstrate the tangible benefits of co-operation for patients and communities from both sides of the border.

When I was Health Minister in 2021, I was pleased to come together with the Governments of Ireland and the United States of America to sign a new memorandum of understanding to reinvigorate the Ireland-Northern Ireland-US National Cancer Institute cancer consortium, which is an often forgotten and unsung part of the negotiations of the ’98 Belfast agreement. When it comes to cancer, we should leave no stone unturned. There are undoubtedly people on both sides of the border who are alive today because of that practical and sensible co-operation. By continuing to refine that service level agreement, expanding areas such as skin cancer treatment, and deepening our joint research in clinical trials, Northern Ireland will once again be strengthening cancer services and helping to advance the fight against rare and specialist cancers across the island.

The same collaborative spirit is exemplified in paediatric cardiac care. Our all-island congenital heart disease network—an issue to which my family is as close as we can be—has ensured that children with complex needs can access world-class treatment without unnecessary delay or travel. I have seen at first hand that such cross-border co-operation works. Our youngest son was eight months old when he needed his first open-heart surgery, and that was conducted at Birmingham children’s hospital. He was 10 years old when he needed his pacemaker replaced, but that was done in the children’s hospital in Dublin because of that cross-border work. We in Northern Ireland know all too well about our reliance on the working relationships that we have across borders, should that be across the UK or with our partners in the Republic of Ireland.

[Jamie Stone]

The hon. Gentleman may know that I have family living in the north, in Armagh and Antrim, and a daughter living in Donegal. What he says is absolutely correct—I can vouch for that, and it is an example for us all. When somebody is sick and we are worried about what will happen next, we do not care about lines on maps. The point I want to make is this: it strikes me that this is an easy issue for the present Government, because it need not cost lots of money. Often, we ask for stuff and there is a huge bill attached, but just knocking heads together and saying, “Get real. Get the computer system online. Talk to each other,” is doable, and it would make such a difference for people even up as far north as where I represent.

[Robin Swann]

I thank the hon. Member for raising a valid point that comes to the crux of this debate and of what has been said by every Member so far. It is about putting the “national” back in our national health service, and doing so across borders without the unnecessary bureaucracy that often comes with how we look after our patients.

There is still more to do on this issue, and no system is perfect. I know from engaging with our current Health Minister in Northern Ireland, my party colleague, that there is potential for further north-south co-operation in other specialist paediatric services that lend themselves to an all-island approach, including the hugely emotive and sensitive issue of perinatal and paediatric pathology. Northern Ireland has been without a paediatric pathologist for some time, so an all-island solution should be looked at.

As the hon. Member said, ambulances in Northern Ireland regularly cross the border in both directions to save lives. Our two ambulance services have an agreement in place to provide mutual aid, with personnel from either service able to cross the border to assist in emergencies.

I believe that the future of healthcare will be defined by the digital innovation that has been referred to, and it will be a great step forward when we can get the national health services talking to each other—it is only recently that we have been able to get our five trusts in Northern Ireland sharing digital information. The will is there if the finance and support are there on genomic medicine, workforce planning and the interoperability of electronic health records. By collaborating on the genomics of rare disease and planning jointly for a workforce that can identify and close future gaps in work, we can ensure that the entire island—and islands—benefit from technological and medical advances.

Our co-operation should not just be practical; it should actually improve outcomes. It is proof that where health is concerned, cross-border partnerships really work. I encourage the Minister to take forward the recommendations made in this debate today.

[Several hon. Members rose—]

Oral Answers to Questions

Robin Swann Excerpts

Tuesday 22nd July 2025 Commons Chamber

[Wes Streeting]

That sounds like another bid for a neighbourhood health centre in the right hon. Gentleman’s constituency, but I am sure that local commissioners will be delighted to hear the case he has made, given the experience that he brings to bear.

[Robin Swann (South Antrim) (UUP)]

13. What assessment he has made of the potential impact of industrial action on NHS services.

[The Secretary of State for Health and Social Care (Wes Streeting)]

Before this Government came to office, strikes were crippling the NHS. Costs ran to £1.7 billion in just one year, and patients saw 1.5 million appointments rescheduled. Strikes this week are not inevitable, and I sincerely hope that the British Medical Association will postpone this action in order to continue the constructive talks that my team and I have had with its representatives in recent days. Our priority is to keep patients safe regardless, and we will do everything we can to mitigate the impact on them and the disruption that will follow should these totally unnecessary and avoidable strikes go ahead.

[Robin Swann]

In a previous role, I found that health workers took industrial action only in extreme circumstances, so I agree with the Secretary of State that if the strikes can be prevented, they should be. During previous resident doctors’ strikes, elective or scheduled procedures were usually postponed, or planned to be postponed, to free up senior doctors to cover their work, but I note that the chief executive of NHS England has instructed hospitals to continue those procedures. Has the Secretary of State made any assessment of the impact that would have not just on patients but on the staff who would have to remain?

[Wes Streeting]

The approach we are taking is different from that taken during previous periods of strike action. NHS leaders have made it clear to me that those earlier strikes caused much wider harm than had previously been realised. There is no reason why planned care—appointments relating to cancer, for example, as well as other conditions—should be treated as being less important than, or playing second fiddle to, other NHS services. That is why the chief executive of NHS England has written to NHS leaders asking them to keep routine operations going to the fullest extent possible, as well as continuing priority treatments. It will be for local leaders to determine what is possible given staffing levels, which is why it is so important for resident doctors to engage with their employers about their determination—or not—to turn up at work this week, and why I must again spell out the serious consequences for patients should these avoidable and unnecessary strikes go ahead.

Resident Doctors: Industrial Action

Robin Swann Excerpts

Thursday 10th July 2025 Commons Chamber

[Madam Deputy Speaker (Caroline Nokes)]

I remind hon. Members and the Secretary of State that we have an important statement to come, as well as two Backbench Business debates. May we have short questions and shorter answers?

[Robin Swann (South Antrim) (UUP)]

I agree with the Secretary of State when he tells the BMA resident doctors that they will never have another Secretary of State as sympathetic to their legitimate complaints— I recognise that, having worked with five of his predecessors. My experience tells me that what happens here with the BMA often filters through to the devolved nations. What engagement has he had with his counterparts on the proposed industrial action so that there can be a combined resolution and message to the BMA?

[Wes Streeting]

I reassure the hon. Gentleman that I will obviously engage with my counterparts in the devolved Administrations. While health is a devolved matter, the decisions that we take in this place, and what is going on in the English health system, have a bearing on other health systems, and vice versa.

I am almost tempted to call back the right hon. Member for North East Cambridgeshire (Steve Barclay), who is still a Member of this House, to remind the BMA what it went up against twice before; indeed, I could call back any of my Conservative predecessors to remind the BMA that the grass is not greener on the other side of this House. It currently has a Secretary of State who has shown through actions, not just words, a willingness to work together, and I hope that it rediscovers the spirit of partnership that we had last year.

Rare Cancers Bill

Robin Swann Excerpts

Committee stage
Wednesday 2nd July 2025 Public Bill Committees

[Dr Scott Arthur (Edinburgh South West) (Lab)]

It is a pleasure to serve under your chairship, Mr Stuart. I was happy with the unanimous cross-party support that the Bill received on Second Reading and look forward to examining it in detail today.

The term “rare cancer” might imply that this is a relatively niche issue that is unlikely to have an impact on many of us, but the reality is that 47% of cancers diagnosed in the UK fall within the “rare and less common” category, and they account for 55% of all cancer deaths. That second statistic is partly due to the survival rate—five out of six less survivable cancers are also rare cancers—but survivability is not just a function of the aggressiveness of the cancer. It also depends on the treatment options available, and for less survivable cancers the options are limited. They receive a mere fraction—roughly 16%—of the funding that more survivable cancers receive.

At this point, I should clarify that I have had some contact with a charity that represents younger people. It is the case that the Bill covers younger people and that all childhood cancers are rare.

The situation is unlikely to change without Government intervention. Markets encourage pharmaceutical companies to prioritise the highest return on investment. Inevitably, that favours the development of drugs with the largest potential patient pools. When a company does pursue taking a rare cancer drug to market, having to access a limited patient pool can make the creation of sufficiently robust studies and trials a struggle.

The Bill is an attempt to intervene on behalf of patients and their families, and to enable pharmaceutical companies and the Government to re-evaluate the strategies for funding, research and finding treatments. It has been drafted carefully in consultation with a wide range of cancer charities—I am pleased to see a few of them represented in the Public Gallery—and expert bodies. The Bill reflects the solutions that scientists, doctors and those with lived experience think are necessary.

In practical terms, by passing this legislation we can, first, remove the barriers to participation in potentially lifesaving clinical trials; secondly, drive investment in under-resourced yet vital drugs and treatments; and thirdly, enhance connectivity between various organisations and individuals working to find cures. That last one is an incredibly important point. I have attended many meetings of the all-party parliamentary group on brain tumours, chaired by my hon. Friend the Member for Mitcham and Morden; we often we see that those connections are not being made, and we all lose as a result.

Clause 1 will enable regulations to be made that compel the Secretary of State for Health and Social Care to conduct a review of the marketing authorisations for orphan medicinal products for the diagnosis, prevention or treatment of cancer, and to prepare and publish a report setting out the conclusions of that review. I have never been a great fan of the term orphan drugs, which refers to drugs for rare conditions. The clause provides that the review process will specifically consider the regulatory approaches adopted in other countries. That will help to avoid research and patients in this country losing out.

The clause sets a timeframe for the publication of the report, namely within three years of the Bill being passed. We consulted broadly on that three-year point. We obviously all want to see progress on this issue as quickly as possible, but we have to balance that against the need for the review to be authoritative and impactful. That is where the three-year duration comes from, but I recognise that some people want it to move faster. A review of best practice at international level should surface a variety of effective strategies that the Government could consider implementing to drive pharmaceutical industry investment into lifesaving research and treatments.

Clause 2 will enable regulations to be made that will encourage the Secretary of State to facilitate, or otherwise promote, research into rare cancers. The clause will specify that the Secretary of State must ensure that arrangements are in place that will, first, enable potential participants in clinical trials to be identified and contacted, and secondly, ensure that a person—to be known as the national speciality lead for rare cancers—is appointed to promote and facilitate research into rare cancers. That person will hold an advisory and facilitatory role, offering input on the design and planning of research, as well as building collaborative networks between key bodies and individuals. Appointing a specific individual to hold that role will provide a structure for greater accountability and a more strategic approach for the delivery of rare cancer research across different organisations.

Clause 3 will enable regulations to be made that will facilitate data sharing in the context of contacting and identifying potential participants in clinical trials that are focused on orphan medicinal products for the diagnosis, prevention and/or treatment of rare cancers. The clause does not authorise the processing of information that would contravene existing data protection legislation. The twin benefits to enhanced data sharing are a greater access to clinical trials for patients, which could be lifesaving, and more higher-quality trials taking place in the UK as a result of a larger potential participant population for researchers.

Clause 4 explains the territorial extent of the various clauses. Clauses 2 and 3 will extend to England and Wales only, while the remainder of the Bill extends to England, Wales, Scotland and Northern Ireland. Where the Bill does not extend to the entirety of the UK, we have been assured by the devolved Governments, which were consulted during the Bill’s formulation—I thank Department of Health and Social Care colleagues for that—that they will work alongside us to achieve the policy goals it outlines within the context of their unique legal landscapes. In that regard, I acknowledge the work of the hon. Member for South Antrim to ensure that Northern Ireland generally, and his constituents specifically, benefit from the Bill.

Clause 5 will provide for commencement, which will occur two months after the Bill is passed, and clause 6 provides the short title for the Bill.

I hope the Bill has real impact, because so many people in the charity sector and elsewhere are working so hard to raise often small amounts of money, which they hope will have a big impact. I hope the Bill amplifies their work and helps it to go further. I look forward to Committee members’ contributions to the discussion of this important Bill, and I commend the clauses to the Committee.

[Robin Swann (South Antrim) (UUP)]

It is a pleasure to serve under your chairship, Mr Stuart. I thank and congratulate the hon. Member for Edinburgh South West on bringing forward this private Member’s Bill, which will have life-changing effects for many individuals across the entirety of the United Kingdom. I applaud him for it, because I know some of the driving reasons behind him doing that.

I have a couple of points to make about the Bill. I am fully supportive of it, but I note the geographical challenge it brings. The Northern Ireland Assembly passed a legislative consent motion for clause 1 on Monday, so we are already stepping into line for this legislation. Much of the relevant work was discussed in the Northern Ireland cancer strategy, which was published in 2022 when I was Minister of Health there. It looked at our specific challenges with regard to research and clinical trials. At that point, cancer charities highlighted that only 15% of cancer patients in Northern Ireland are offered the opportunity to take part in cancer trials, compared with 31% across the rest of the UK. I hope the Bill increases awareness among Northern Ireland patients and cancer sufferers, and their families, of what is out there and their ability to take part.

The other concern often raised by some of my Northern Ireland colleagues—you are aware of this, Mr Stuart—is the EU implications. I can state that novel treatments do not fall under the scope of the EU, so hopefully any medication, treatment or supply that comes forward will be equally accessible and applicable to the entirety of Northern Ireland. The only difficulty and challenge we have in progressing the Bill’s other provisions is the legislation that allows Northern Ireland to use secondary data for cancer registries. I am aware that the current Health Minister in Northern Ireland, who is my party colleague, has a one-clause Bill ready to move forward to rectify that.

I wanted to make that small contribution in support of the work done by the hon. Member for Edinburgh South West in bringing forward the Bill. It has been a pleasure to serve on this Committee.

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

It is a pleasure to serve under your chairmanship, Mr Stuart. I congratulate the hon. Member for Edinburgh South West on bringing forward this very important piece of legislation. I declare an interest as a consultant paediatrician who has looked after a number of children with rare conditions such as teratoma, rhabdomyosarcoma, Wilms’ tumour and retinoblastoma, to name but a few.

One of the issues with rare cancers, which transposes to rare diseases in general, is that they are often diagnosed late, because people do not recognise that they have symptoms of a rare disease and their health professionals are not as familiar with them because they are rare. The presentation and diagnosis are then late and, as such, the treatment is more difficult. That is compounded further because there has been less research on those topics, so it is not clear what the best treatment for those conditions is. On top of that, the patient may have to travel very long distances to see a specialist who is familiar with the condition, adding both logistical difficulty and cost to that patient’s care.

Some steps are in place to try to improve the situation. The orphan drug regime gives market exclusivity for 10 years, and it provides for lower and refunded fees from the Medicines and Healthcare products Regulatory Agency for the services it provides. Nevertheless, it can still be non-commercially advantageous to put money into developing a drug that is going to be used on no more than a handful of people, however beneficial it is for the individuals concerned.

I welcome the Bill, but wish to make a couple of points. First, in principle it is best that trials are first broached with the patient by a member of their healthcare team. Of course, a member of any given healthcare team—I speak as one myself—will never be aware of all the trials available to all patients at any one time. I welcome the Lord O’Shaughnessy review—commissioned by the last Government and accepted by the current one—which talks about getting a consensus on how best patients can be informed of trials. I wonder whether we should have a system in which patients opt out of not the trial itself but being asked about trials. At the outset, they could be asked, “Would you like to receive information on trials—yes or no?”, so that more people can be aware of how they can contribute. When people are diagnosed with something rare, they often want to contribute to helping others who will come after them.

Will the Minister tell us more about the national cancer plan, which was consulted on earlier this year? I welcome the fact that the children and young people cancer taskforce, which was paused, is being reinstituted. Also, how will the Bill apply to repurposed drugs? Sometimes new medicines are developed for a particular condition, but we often find that medicines can be reformulated and used in a different way to provide a different form of treatment to help individuals with a different condition. How will that apply in respect of both the measures in the Bill and the O’Shaughnessy review?

As a paediatrician, I am very pleased that the Bill applies to children. Overall, I think the Bill is great. It offers hope for many in the future. Will the Minister say something about other rare conditions? As well as rare cancers, people get other rare conditions, and they are affected by the same challenges with research and treatment, and by delays in diagnosis and travel.

Overall, doctors are able to save people’s lives, and improve people’s lives, one at a time, but Parliament and research offer the opportunity to do that on a much bigger scale. I am very grateful to the hon. Member for Edinburgh South West for what he is doing today.

Access to GPs

Robin Swann Excerpts

Monday 23rd June 2025 Commons Chamber

[Alex Easton]

I thank the hon. Member for his intervention and I totally agree with everything he said. People across Northern Ireland are not able to see their GP as much as those in other parts of the UK. That is leading to big frustrations for our constituents. The lack of support and funding for GPs is adding to the frustration that is felt across the board.

[Robin Swann (South Antrim) (UUP)]

This is a debate about GP access across the United Kingdom, but one issue in Northern Ireland is GPs’ ability to access indemnity insurance, whereas in England and Wales there is a Government-provided scheme. Does the hon. Member agree that if the Government worked with the Department of Health in Northern Ireland to allow our GPs to access that indemnity insurance scheme on a national level, it would ease some of the burden on our GPs?

[Alex Easton]

I agree, and perhaps the Minister will take that point on board in looking at how we can improve our GP services.

One of the significant challenges across the UK is the shortage of GPs, which inevitably leads to longer waiting times and, unfortunately, sometimes to a compromised quality of care.

--- Later in debate ---

[Stephen Kinnock]

We have to have a mixture of access channels. The telephone is very important, as is being able to turn up in person, but we also need to shift more to online booking. I am really pleased that the new contract that we have with GPs is based on an £889 million investment that came with a lot of strings attached around reform. One of those strings is that every GP surgery—in England, at least—must have online booking facilities by 1 October. I hope that will improve access, and will make more space in the reception process for people who cannot use the internet.

We have to ensure that we get the balance right. That is why, as I mentioned, we took decisive action in October 2024. We invested £82 million in the additional roles reimbursement scheme, which was a targeted move to strengthen our frontline services and ease the pressure on practices across the country. That funding has directly supported the recruitment of over 1,700 GPs across England. Those GPs are now in place, helping to increase appointment availability and—most importantly—improving care for thousands of patients who have been struggling to get the help they need when they need it. We have also seen a rise in the number of GPs employed directly by practices over the past 12 months, which is a positive sign that general practice is stabilising and beginning to rebuild capacity on the ground. Together, these developments are making it easier for patients to access care and for practices to deliver it.

[Robin Swann]

As the hon. Member for North Down (Alex Easton) mentioned, there are contracts that have been handed back to the Department. We have people coming forward who want to be GPs, but it is getting harder to find those partners who want to run and manage practices. Does the Minister agree that in any training scheme and any course that comes forward, that side of general practice—how to run a business and how to run a practice—needs to be reinforced in training? There are people who want to be GPs and medics, but we need that skills mix, too.

[Stephen Kinnock]

The hon. Member speaks with great knowledge and expertise in this area, so I am pleased that he is here for this debate. He is right that it is about the skills mix. Many GPs really enjoy the management, administration and leadership role at partnership level. He raises an interesting and important point about the training for that. My impression is that many go into managing a practice having just learned on the job and gone through the process in an ad hoc way. Perhaps training is a matter for further discussion with the Royal College of General Practitioners. It is also about learning to run a business. Could we look at that in respect of universities and MBAs or whatever it might be, given that business administration is an important part of the equation?

I also wanted to say a word about bureaucracy. Too much red tape is holding GPs back. On 4 October, the Secretary of State launched the red tape challenge, with a clear goal to identify and eliminate unnecessary administrative burdens, freeing up GPs to see more patients and focus on delivering high-quality care. Improving access is not just about cutting bureaucracy; it is also about transforming how care is delivered. That is why we have committed to moving towards a neighbourhood health service. That model of care will bring a range of services together, breaking down barriers and silos between services and streamlining support for patients. That integrated approach will mean that patients are seen sooner by the right person in the right setting.

We will require all practices to ensure that patients can go online to request an appointment at any point during core opening hours. That is about not just adding a digital option, but transforming how general practice works for the modern world. By making online access standard, we are giving patients more control and greater flexibility over how they engage with their GP. It will mean no longer having to call at 8 am sharp or waiting in a phone queue. That is especially important for those juggling work, childcare or other responsibilities. This change also helps those who prefer to call or go to the surgery in person; by enabling more people to use online routes, we reduce pressure on phone lines and reception desks, meaning shorter waits and faster service for everyone.

We are also taking action to improve access for those who need it most by incentivising better continuity of care, particularly for patients with chronic or complex conditions. They benefit significantly from seeing the same practitioner over time. Continuity does not just improve the patient experience; it improves outcomes. When patients see a familiar clinician, issues are identified earlier, care is more personalised and time is not lost repeating history or re-explaining symptoms. Our manifesto pledge is to bring back the family doctor, and that is what we will do.

Physical infrastructure has also been mentioned by hon. Members. Our new £102 million primary care utilisation and modernisation fund will create additional clinical space in more than 1,000 GP practices across England. This investment will deliver more appointments and improve patient care.

Terminally Ill Adults (End of Life) Bill

Robin Swann Excerpts

Report stage
Friday 13th June 2025 Commons Chamber

[Robin Swann (South Antrim) (UUP)]

I rise to speak in support of amendment (a) to amendment 77, which is in my name. I should also refer to my entry in the Register of Members’ Financial Interests about my involvement with the Royal College of Psychiatrists.

New clause 13, we are told, is a replacement for clause 34; I hope that Members have taken the time to compare the two. New clause 13 contains even more powers than clause 34. It follows the trend of this Bill: instead of more detail being added, more powers are added. It seems to me that the line is, “There are some issues that we’ll sort out later,” but that this place will not be involved in that “later”. What is particularly concerning is that the powers that the Bill creates contain no explicit limit or guiding principle by which they are to be exercised. Nor do we have the benefit of a policy paper from the Secretary of State saying how he intends to exercise those powers or how his successors will.

I believe that the provisions relating to “approved substances”—clause 25 and new clause 13—face a real problem. As Dr Greg Lawton, a barrister and pharmacist, told the Committee in written evidence, the lethal substances intended to end life are not medicinal products within the meaning of the Human Medicines Regulations 2012. That definition is itself derived from EU law, which states that

“the term ‘medicinal product’…must be interpreted as not covering substances whose effects merely modify physiological functions and which are not such as to entail immediate or long term beneficial effects for human health.”

That creates the real problem: if the substances are not medicinal products, why does the Bill provide that pharmacists are to be involved in their preparation and why would doctors be supplying them? New clause 13(4) seeks to get around the problem by giving the power to the Secretary of State to amend the Human Medicines Regulations 2012 so that the substances fit in. The impact assessment tells us that the Government have no plans to conduct or rely on the sort of scientific studies normally done for drug approvals or for the MHRA to be involved.

[Sadik Al-Hassan]

As a pharmacist, I should say that the drugs to be used for assisted dying are commonly used in pharmacy now. It would be obvious for pharmacies to supply those drugs in some way, shape or form. I accept the hon. Member’s point about medicines being used, but he will, I hope, accept my point: how would the same studies used to approve treatments be used to approve their use for death?

[Robin Swann]

I think the hon. Gentleman said in an earlier intervention that those medicines would then be used off licence, to the risk of the prescribing doctor and the person using them. That is where the risk falls back on the individual rather than being covered by anything in the Bill. That is where my regret comes.

I understand the need to treat the substances as medicinal products in England and Wales if it is the will of the House to change the law here; what I cannot understand is why the law should change the situation for the rest of the United Kingdom. That is the basis of my amendment to amendment 77. The House is not voting for assisted dying in Northern Ireland, so it has no locus to change the definition of a medicinal product in Northern Ireland in order to accommodate this Bill, which we have been told applies to England and Wales only. Or is it the intention of the Bill’s sponsor or those behind her to extend it to Northern Ireland at a later date, using some of the Henry VIII regulations in it?

There is a further issue in Northern Ireland. We are still in part subject to EU law, and I would be interested to know whether the Government have considered that aspect. Can the Minister really change, by ministerial diktat, EU law in Northern Ireland when it comes to the use of these substances? If so, why is he not being granted such power in other areas of significance to Northern Ireland? Why only this? Why has so much Government time previously been spent on medicine regulation and supply for Northern Ireland? Why did the right hon. Member for Melton and Syston (Edward Argar), as the Minister of State for Health, and I, as the Minister of Health in Northern Ireland, spend so much time on that? To that extent, I ask the hon. Member for Spen Valley (Kim Leadbeater) and the Minister: what engagement has there been with the Department of Health in Northern Ireland or the chief pharmaceutical officer for Northern Ireland? Or is this another part of the Bill that is being put in to meet the promoter’s needs without any background or engagement?

In conclusion, the application of those provisions to Northern Ireland also has implications for the conscience protection. If, as a result of regulations made under those provisions, pharmacists in Northern Ireland are required to be involved in the manufacture or preparation of such substances, they will not have the benefit of the conscience clause, as that clause has not been extended to Northern Ireland. I therefore oppose the extension of those provisions to Northern Ireland and Scotland. I will also oppose amendment 77 and ask hon. Members to support amendment (a) to amendment 77 in my name.

[Blair McDougall (East Renfrewshire) (Lab)]

I rise to speak in support of amendment 15, which is tabled in my name. I will minimise my comments to maximise the time available to other hon. Members.

Owing to the widespread unease among NHS practitioners and the growing number of concerned voices about the Bill’s shortcomings, if it is passed by the House—I still hope that it will not be—it is likely that assisted deaths will take place away from the public sector. Indeed, the Bill does not prevent assisted deaths from being outsourced to private companies, and there is no definition of what “reasonable remuneration” means in return for helping to end someone’s life. My amendment seeks to ensure that providers publish annually the number of people to whom they have provided those services, the costs of doing so, and the revenues received in return.

Many hon. Members will be guided by their religion when they vote on these issues. Although I deeply respect that, I am not a person of faith. If there is a booming baritone voice appealing to my conscience, it is not that of God, but that of Nye Bevan, who was concerned about the commodification of care. In his time, the worry was about the role of the market in extending life. Today, my concern is about the potential role of the market in ending it.

Throughout the Bill’s passage, we have discussed different kinds of coercion by individuals on the lives of people whose protection is entrusted to us. As a Labour MP, I do not think that we can have this debate without addressing the economic coercion experienced by the vulnerable in our society. As someone who has sat beside a bed and prayed for mercy, I genuinely understand the attraction of arguments around freedom of choice, but arguing for that as a fundamental principle in isolation, without also acknowledging the economic, social and cultural context in which people make such choices, is not a Labour approach to the issue.