Caroline Johnson MP: speeches

Speeches

• 7 Jan 2025 · Tobacco and Vapes Bill (First sitting) · Hansard source

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  Q Smoking is a huge cause of cancers. Do you expect that this Bill will reduce the number of cases of cancer and increase the age of people who get cancer across the country? Dr Ian Walker: First, thank you very much for the opportunity to be here. I start by thanking Parliament for boldly introducing this Bill; it is genuinely world leading. I have spoken to organisations across the world that are envious of the position we find ourselves in. That is a very important question, and the answer is absolutely yes—I think this Bill will be very important in reducing the number of cancers caused by smoking tobacco. We know that there is no bigger thing we could do to actually influence that going forward for the next generation and generations thereafter. As you have heard this morning, we know that we still have 6 million people smoking across the UK, and we know that we can expect hundreds of thousands of cases of cancer caused by smoking over the term of the next Parliament. As we move towards a truly smoke-free generation over the next 20, 30 or 40 years, we will absolutely expect to see the number of cancers caused by smoking—and, alongside that, the number of other illnesses associated with smoking—reduce.

• 7 Jan 2025 · Tobacco and Vapes Bill (First sitting) · Hansard source

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  I am an NHS consultant paediatrician and a member of the Royal College of Paediatrics and Child Health.

• 7 Jan 2025 · Tobacco and Vapes Bill (First sitting) · Hansard source

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  Q How do you think the Bill will address health inequalities? We have heard that smoking is more prevalent among poorer individuals than among richer individuals. Will the Bill help address that? Sheila Duffy: We see that socioeconomic inequalities and smoking rates are closely patterned. ASH Scotland’s work with low-income communities in Scotland suggests that people regret beginning tobacco, but find it hard to move away from it. It also identified the dangers of less regulated novel products such as e-cigarettes in enticing their children and grandchildren into the kind of addiction that they themselves so regret. One of the real strengths in the Bill is the ability to bring some of these tobacco-related products into the kinds of control and regulation that we have fought so hard over decades to get for tobacco products.

• 7 Jan 2025 · Tobacco and Vapes Bill (First sitting) · Hansard source

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  Q Thank you; that is helpful. My other question is about the difference between indoor and outdoor exposure to smoke. In this country, we have had laws preventing smoking in certain indoor spaces for many years now. How does exposure to smoke inside differ from exposure to it outside? Imagine sitting next to someone smoking on a park bench and someone smoking at a neighbouring table in a restaurant—what are the comparative health risks between those two? Professor Sir Chris Whitty: I think the first thing to say is that second-hand smoke is a very serious problem. I think that is underestimated among the general public because, if I am honest, the cigarette industry has been very successful in muddying the waters on this. There are three key things that really make a difference. The first is the degree of concentration of the smoke. The second is the duration of exposure—let us say you sit next to someone for half an hour; the effect is more significant than if it had been just a couple of minutes. The third is the vulnerability of the people being exposed to it. That is one of the things that this Bill will help with. Over 88% of the population do not smoke. There are roughly 6 million smokers still. There are significantly more people in the UK, non-smokers, who have medical vulnerabilities that mean that the smoke is particularly dangerous to them, perhaps acutely. They can be exposed to smoke and have an asthma attack, and that lands them in hospital. In severe cases it could land them in a very dangerous situation. The situation may also be chronic—for example, people living with diabetes already have a disease that is going to accelerate things like cardiovascular disease. If people are smoking on top of that, it will accelerate those things still further. Although outdoor smoking is less in terms of passive smoking than indoor smoking, in most situations if you are close to someone, exposed for a long period or vulnerable, it can have very significant health impacts. In broad terms, if you can smell smoke, you are being exposed to significant amounts of smoke, and that is one of the things that the Bill is aiming to address. I would like to make one additional point: the cigarette industry has been extraordinarily good at trying to pretend that to be pro-smoking is to be pro-choice. Nothing could be further from the truth. Smoking is highly addictive. Most smokers wish they had never started and want to quit, but they are trapped by addiction. Their choice has been taken away deliberately by these companies as part of their policy. And if you are talking about second-hand smoke, indoors or outdoors, the person downwind or next door has no choice at all at any point. They are exposed to the risks with no advantages at all. If you are pro-choice, you should be firmly in favour of the principles of the Bill. Frank, do you want to add to that? Sir Francis Atherton: The only thing I would add is that there is no safe level of smoking. As Chris says, if you smell it, you are breathing it in, and there is no safe level. Obviously, indoors is worse than outdoors. The dose response is a big issue, but there is no safe level. I think that is a really important point.

• 7 Jan 2025 · Tobacco and Vapes Bill (First sitting) · Hansard source

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  Q I thank the witnesses for coming along; we are interested to hear what you have to say about this Bill. For some time, I have been particularly concerned about children vaping. How will the restrictions on vapes in this Bill, particularly on colours, flavours and accessibility, help to reduce their appeal and accessibility to children? Professor Sir Gregor Ian Smith: First of all, thank you to the Committee for inviting me to give evidence. I think this is an incredibly important step. I have been concerned—

• 6 Jan 2025 · NHS Backlog · Hansard source

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  I have heard the hon. Lady but will not give way, because the Deputy Speaker has been clear about the time constraints in the debate. Has the Minister made an estimate of the number of extra admissions caused by elderly people who are cold due to the removal of the winter fuel allowance, what impact that is having on hospitals, and how many elective appointments that would otherwise have occurred have been cancelled as a result? We heard the hon. Member for Bury St Edmunds and Stowmarket (Peter Prinsley) talk about his cancelled ENT list from this morning. We have had six months of a Labour Government. They have cancelled the building of 24 hospitals, they have launched a series of reviews, they have significantly increased costs on indirectly provided NHS services because of national insurance, and they have re-announced what has already been happening, in some cases for many years. I am a doctor and I am a patient, and I really want the Government to succeed in improving the NHS; we all do—we have heard too many troubling tales from our constituents and again this evening—but stating aims does not make them happen, and launching reviews and press releases is simply not enough.

• 6 Jan 2025 · NHS Backlog · Hansard source

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  I will not, because I have a time limit. I was pleased to hear that the Government will continue many Conservative initiatives, such as expanding the surgical hubs programme and extending the work of community diagnostic centres, but some of the other parts were a little confusing. Patients are to have a choice of where they are treated, but they already do. They are also to receive text messages to remind them of appointment times. That is great, but it is already happening. In fact, a look back through my phone revealed that the earliest text message I could find reminding me of an appointment for my child at Peterborough city hospital was sent on 28 July 2015, so this is not a new initiative. Patients are to get results online. Well, again, they already do. If the Minister has not seen that, I urge her to visit Addenbrooke’s hospital, where, via the MyChart system, patients can already log on and read their MRI or blood results or reports. Spreading good practice is to be welcomed, but it is not a revolution. It also faces significant headwinds. The Government are to direct activity to general practice, but GPs are already rather busy and facing financial challenges caused by national insurance contributions. How will shifting pressure improve capacity? When will GPs be able to budget? Will the funding settlement be greater than their increased costs from national insurance contributions? If resources are moved to general practice, how will that deliver more secondary care appointments? One person can only do so much work. What is the Government’s plan for the workforce, which will be so key? Of course, it is not just GPs who are affected by the national insurance contributions. The Secretary of State talked about record investment in hospices, but before Christmas the Minister was repeatedly unable to say whether that record investment would cover the rise in national insurance contributions that those same hospices are facing. Can she update the House now? Patients are to have the choice on whether to have follow-up appointments, which will apparently reduce a million unnecessary appointments every year. Will that be a choice for patients to have a desired follow-up appointment that is not recommended by clinical staff—in which case, that could actually increase the number of appointments required—or will it be a choice not to have an appointment that a doctor or clinician has recommended? In that case, is that wise? It is cold outside, Madam Deputy Speaker. In fact, this morning I woke up to blizzard conditions at my window. What estimate has the Minister made of the number of extra admissions that have occurred this winter for elderly patients who have been cold due to the removal of their winter fuel allowance?

• 6 Jan 2025 · NHS Backlog · Hansard source

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  Thank you, Madam Deputy Speaker—a very happy new year to you. May I also wish the grandmother of the hon. Member for Bury North (Mr Frith) a speedy recovery? I should declare an interest as a consultant practising in the NHS. My brother is a GP and I am on an orthopaedic waiting list, so I am one of the statistics. I am looking forward to working constructively with the Government over the next year to deliver for patients across this country. The NHS has been looking after us for more than three quarters of a century. During that time, the practice of medicine has transformed. Cures have been found, and people are living longer and healthier lives. I thank all those staff who have been working in the NHS and social care across the Christmas and new year period. We all recognise that the NHS is under pressure. We have an ageing population, patients with more complex needs and innovative, but expensive treatments. The pandemic added a huge strain to the NHS. Resources were redeployed away from elective care, and much elective care was postponed to reduce the spread of covid. For example, before the pandemic, 54 women had been waiting more than 12 months for a gynaecological appointment. By the time the pandemic was over, that number had gone from 54 to 40,000. That was replicated across other departments in hospitals across the country. Although the NHS now treats 25% more patients than it did in 2010, waiting lists are sharply higher. We took steps as a Government to bring them down again. Those measures were working, though not as quickly as we wished. For example, the 18-month waiting list was virtually eliminated, and the 52-week list was steadily falling, despite industrial action. Meanwhile, in Wales, where Labour has been in power for more than 25 years, waiting lists continue to rise. There is more to do, and no one is suggesting that the issues have been resolved. Waiting lists are still too high, and that is why we funded the £3.5 billion NHS productivity plan in full to upgrade IT, to expand the NHS app and to capitalise on the benefits of artificial intelligence. The Government were elected in July on the promise of a plan, but sadly the plan has still not yet been published. The Government were also elected on a promise to deliver 40,000 more appointments per week. I wish them huge success with that, but I am not optimistic. The Secretary of State has repeatedly been asked when those additional appointments will become available, but there have been no clear answers. Will the Minister please provide one, or tell us what progress has been made? This morning we heard more about Labour’s elective reform plan. I was really pleased to hear that the Government will continue with many Conservative initiatives, which were working.

• 6 Jan 2025 · Child Sexual Exploitation and Abuse · Hansard source

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  The House has agreed this afternoon that cultural sensitivities should not get in the way of police investigations. However, it would appear that they have and they perhaps still are, and that victims have been let down and that current victims might be being failed even today. There is a specific problem with gangs of organised men, who are systematically raping and abusing young children. Within that group, there is an over-representation of men of Pakistani heritage. We need to understand why, but piecemeal investigation, town by town, will not help us to do that, will not serve the interests of victims, by ensuring they get the justice they deserve, and will not prevent future cases.

• 19 Dec 2024 · Hospice Funding · Hansard source

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  After the confusion of yesterday, I welcome the fact that further details on hospice funding have been announced, albeit by our dragging them out of the Government on the very last day of Parliament before the recess. On 30 October, the Chancellor decided to break her election promise by increasing employers national insurance contributions and reducing the threshold at which employer contributions are payable. It was later confirmed that hospices would not be exempt from the increase in costs. Now the Government have announced new funding for the sector, which they have the audacity to call “the biggest investment in a generation”. Let us be clear about what is going on: the Government are taking millions of pounds off hospices and palliative care charities, and then think those hospices and palliative care charities should be grateful when the Government give them some of that back. That is socialism at its finest. We will look more closely at the funding announced today, but despite many questions from right hon. and hon. Members, to date the Government have refused to give any clear answers on how much their tax rises will cost hospices. I will try again: will the Minister please tell us how much the Government estimate they will raise from taxing hospices more? Was an impact assessment ever produced on how hospices will be hit, and how that will affect the care that they provide? Do the Government expect the funding that they have announced today to cover the additional costs in their entirety? At the heart of this discussion are charities that provide compassionate care to terminally ill people in their final days, weeks and months. While hospices were left without information, Hospice UK reported that 300 beds have already closed, with many more closures to come. Does the Minister accept any responsibility for that? Ultimately, it is patients who will pay the price. While we welcome this update for hospices, when will the Health Secretary come forward with more details on the many other health providers who have been hit by Labour’s tax increases, including GPs, community pharmacies and dentists? Will they be expected to be similarly grateful for getting back some of the money that the Government have taken from them?

• 19 Dec 2024 · Hospice Funding · Hansard source

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  (Urgent Question): To ask the Secretary of State for Health and Social Care if he will make a statement on hospice funding.

• 5 Dec 2024 · Cumberlege Review: Pelvic Mesh · Hansard source

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  It is a pleasure to serve under your chairmanship, Mr Stringer. I congratulate the hon. Member for Harlow (Chris Vince) on securing this important debate. I draw Members’ attention to my entry in the register of interests, as I am a practising NHS consultant, although in paediatrics rather than in any form of gynaecological surgery. I begin by expressing my heartfelt sympathies to the women affected by injuries from pelvic mesh and, indeed, mesh in other sites, as we have heard about. Mesh is a surgical material and technically, therefore, a medical device, which was implanted in thousands of women to treat organ prolapse and urinary incontinence. However, in many cases, as we have heard today, it has caused serious long-term effects, including chronic pain, infections, organ perforation and, in some cases, permanent disability, which continues even after the mesh has been removed. The exact number of affected women is still not known. Some have estimated the number to be 10,000, and today we have heard an estimate of 40,000. However, it is clear that it is a very large number of women. I echo the hon. Member for Chesham and Amersham (Sarah Green) in thanking Baroness Cumberlege, the Conservative peer who published the independent medicines and medical devices safety review in 2020. The review panel spoke to more than 700 women and their families from across the country. The document is exceptionally comprehensive, and it puts patients’ and families’ views at the heart of the review. Their experiences make for harrowing reading. The women speak of lives damaged, families put under immense strain, relationships destroyed, careers broken, financial ruin and chronic pain. Last week, I spoke to a woman who is suffering after having had such mesh put in. Following the surgery, the skin never healed because of a low-level infection. That lady faces awful difficulties. The mesh is visible through the skin, from the surface. It is incredibly difficult to remove. Indeed, she has not been able to find a surgeon who is willing to even try to remove it, so she suffers in the house, unable to go out and experiencing infection after infection, an increasing number of which are resistant to some antibiotics. She knows that without the mesh removal, her prognosis is poor. It is an awful situation to be in, as I am sure the Minister will agree. I know he will be doing his best to try to help. Our healthcare system has to learn from those it has failed, such as that lady, and ensure that patients are put at the front and centre of healthcare so that this cannot happen again. The Minister needs to focus on two things: how we help those affected by the mesh scandal, and how we prevent similar incidents with medical devices that we do not yet know the harms of, or that may not yet have been invented. People should not have to pay privately for treatment to rectify things that the NHS has done wrong. When someone has had a mesh put in and the mesh needs removing, the NHS should pay for that care. If the NHS cannot provide it, the NHS and the Minister must find a way of funding that care, provided by whoever can provide it, so that women are not financially out of pocket to the tune of tens of thousands of pounds for something that is not their fault. The nine centres have been set up, and that is a good thing; they have been set up with a full multidisciplinary approach, which is also good. However, as we have heard, the outcomes are not 100% good in all cases. Surely it is intuitive that women should not have to see the same surgeon again. They should not be forced to make that explicit. It should be automatic, unless they want to see the same surgeon; it should be an opt-in system. I urge the Minister to look at what the centres do. They provide help for women who have had pelvic mesh repair, but there are people suffering with mesh problems who have had mesh put into other places, for example near the rectum or in the abdominal wall. That may be women, but it may also be men, and they may suffer quite significant problems as a result. They need a centre, or several centres, of people who can support them and ensure that their mesh is removed, or their treatment needs are met, to stop the suffering they are experiencing. We need a balance between ensuring that a similar scandal does not happen again and that long-term effects are picked up, and not restricting people’s access to new and innovative good treatments. In this place, we often have debates on treatments that are widely available, but not necessarily available here yet. We want to make good treatments available here quickly, but we need a robust system to identify problems as quickly as possible. Part of that system includes the Medical Devices (Post-market Surveillance Requirements) (Amendment) (Great Britain) Regulations 2024, on which the hon. Member for Harlow, the Minister and others were recently involved in debate. When that statutory instrument was discussed in the Lords, the noble Lord Cryer said that the Government intended to introduce implant cards, and that the SI was part of a wider review of the regulation of medical devices that would be carried out in due course. Will the Minister give us some information on what that will entail? What are his thoughts on the process, and when will it happen? People need these things quickly. I recognise the work that my right hon. Friend the Member for Wetherby and Easingwold (Sir Alec Shelbrooke) has done over a long time on many topics affecting women’s health, including the menopause and other concerns, and I congratulate him on that work. He represents female constituents very effectively. He talked about the fact that when surgeons inserted pelvic mesh, they often thought that it was the right thing to do. Only over time did it turn out not to be the panacea that it had been thought to be. I remember in my medical training being told that a good surgeon is not just a surgeon who can operate well; the best surgeons are those who know when they should not be operating. It is very sad to hear that for many of the women, treatments that did not involve surgery could have been done instead, and that would have meant that those women did not suffer in the way they have done. I highlight the point made by the hon. Member for Shipley (Anna Dixon) and my right hon. Friend the Member for New Forest East (Sir Julian Lewis) on the importance of research. When we are trying to resolve the problems caused by the mesh, we need to know that we are doing that in the most effective way. We need someone to look at the clinical outcomes and ask what we are doing, whether we are doing it in the best way and what other options might be available. This problem is not limited to the United Kingdom. What is being done elsewhere? Are there international comparators that do this better, and can we emulate what they are doing? What we need from the Minister is rapid action to address the problems faced by women who have had this mesh put in. We need him to assure us that he is doing what he can to introduce proportionate regulations that will ensure that any other devices in use and in circulation across the United Kingdom do what they are supposed to do, and do not do any harm.

• 4 Dec 2024 · Farming and Inheritance Tax · Hansard source

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  As a farmer’s wife, I understand the emotional impact that my right hon. Friend sets out so clearly. This is about not only the farmers who will be affected but all the farmers who know that they might be affected. This is a tax on tragedy, and no one knows if it will befall them.

• 3 Dec 2024 · UK Supply Chains: Uyghur Forced Labour · Hansard source

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  My constituents are angry that this Government want to cover Lincolnshire’s beautiful countryside with solar panels, ruining the landscape and damaging food security, but they are particularly horrified to hear that many of those solar panels could be produced using slave labour. The Minister has talked about increased import controls as a way of preventing that. When does he plan to introduce them, and what are the further measures that he alluded to?

• 3 Dec 2024 · Topical Questions · Hansard source

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  T2. Air ambulance charities deliver life-saving treatment to people every single day, yet they are under threat from the Chancellor’s rise in national insurance and taxes. The Lincolnshire & Nottinghamshire Air Ambulance alone will need to find another £70,000 just to pay the national insurance rises. Two weeks ago, local right hon. and hon. Members and I wrote to the Chancellor on this matter, but we have not yet had a reply. I ask her now: will she exempt these vital charities, so that they can continue their vital, life-saving work?

• 27 Nov 2024 · World AIDS Day · Hansard source

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  It is a pleasure to serve under your chairmanship, Sir Mark. As we mark World AIDS Day, we are called to reflect on the progress that we have made, on the challenges that remain and on the road ahead in our collective fight against HIV and the stigma so often associated with it, especially in the past. The UK has much to be proud of in that effort. Through the introduction of an HIV action plan, we set ambitious goals, such as an 80% reduction in new HIV infections by 2025. Remarkably, we achieved the UNAIDS 95-95-95 target back in 2020: 95% of individuals were living with HIV diagnosed, or presumed to be living with it diagnosed; 99% of them were on treatment; and 97% were achieving good viral suppression. Those figures reflect the dedication of our healthcare professionals and the effectiveness of our public health strategies. When diagnosed early, people with HIV in the UK can now expect a relatively normal life expectancy. The disease is no longer the death sentence it once was. The hon. Member for Uxbridge and South Ruislip (Danny Beales) spoke about that. Sadly, that is not the case worldwide. My right hon. Friend the Member for Dumfriesshire, Clydesdale and Tweeddale (David Mundell) highlighted the starkness of the global picture. Last year, AIDS-related illnesses claimed as many lives as did the sum total of all wars, homicides and natural disasters that ravaged our planet. In parts of southern Africa, in countries such as Botswana and Zimbabwe, more than one fifth of the adult population live with HIV. Such figures remind us that the global fight against AIDS is far from over. Troublingly, within our own borders, we are starting to witness a reversal of hard-won gains. A long and steady decline of HIV rates in the UK has suddenly and sharply risen in recent years. HIV diagnoses in England doubled from roughly 3,000 to a little more than 6,000 between 2020 and 2023, unfortunately reversing more than a decade of progress and throwing the Government’s goal to end HIV transmission by 2030 into some jeopardy. We must focus on what is driving that resurgence. One key factor is a worrying trend identified by the World Health Organisation: a decline in condom use, especially in younger populations. Between 2014 and 2022, a survey of nearly 250,000 adolescents across Europe found that only 61% of sexually active young men and 48% of young women in England reported using a condom during their last sexual encounter. The hon. Member for Uxbridge and South Ruislip talked about the success of PrEP, its greater availability and how it is an important tool in preventing HIV infections. It has undoubtedly saved lives. The Minister therefore has a complex challenge in how he will continue to promote lifesaving interventions such as PrEP while reinforcing the importance of safe practices such as the use of condoms. I am interested in the Minister’s plans to achieve that. Another part of the answer is an effective testing strategy. As the hon. Member for Uxbridge and South Ruislip said—to quote more of his speech—it is about testing, testing, testing. I know that the Labour party like to have the same word three times in a row. Successive Governments have been working very hard to reduce stigma and normalise HIV testing through campaigns such as the “I Test” programme, which helped to normalise HIV testing as something routine and beneficial, both for the individual concerned and wider society. Such campaigns have largely been targeted at communities with a higher HIV presence. The Conservative Government introduced opt-out testing, which has had a significant impact and is now available in 34 emergency departments across the country. It has identified hundreds of people who were previously undiagnosed or had been lost and followed up with treatment of HIV and hepatitis B and C. The identification of those cases helps the individual concerned and also helps to reduce transmission among the wider population. What plans do the Government have to expand the testing into more areas of the country and into A&Es across the country so that we can find out what other undiagnosed cases might be out there? Between 2019 and 2021, the estimated number of undiagnosed cases in England declined, but opt-out testing has suggested that there are more cases than we realise. Does the Minister have plans to re-estimate the number of cases of undiagnosed HIV that may be out in the community waiting to be treated? When one studies the statistics of new HIV diagnoses, it is clear that there has been a rise driven more recently by the migration of individuals who are HIV positive. I wonder what considerations the Minister has given to HIV testing for this population, and what plans he has to target measures to reduce HIV within that group. Finally, I want to talk about education, which has been and remains a key pillar in protecting young people from HIV and AIDS and reducing the stigma associated with testing and living with HIV. We must recognise the extent to which the pandemic disrupted health outreach programmes and traditional learning, leaving many young people without access to vital information. It is important that young people feel comfortable seeking advice and accessing resources. I would like to take a moment to acknowledge the tireless work of organisations such as the Terrence Higgins Trust, the National AIDS Trust and local sexual health clinics, who have continued to provide lifesaving services under incredibly difficult circumstances. However, those organisations cannot tackle the crisis alone. Indeed, with the Government’s new Budget, they face high charges for national insurance contributions. The Terrence Higgins Trust employs more than 200 people. What conversations has the Minister had with the Treasury about exempting such charities from paying national insurance on their employees so that they can continue their good and lifesaving work, rather than just paying more tax into this Government? We need to ensure that those charities have the funding and resources to expand their outreach, particularly in underserved and high-risk communities. On this World AIDS Day, let us reaffirm our commitment to ending this epidemic. Let us celebrate the progress we have made while recognising that there is still much work to be done. Let us ensure that future generations can live in a world that is free from the shadow of AIDS.

• 27 Nov 2024 · Draft Human Medicines (Amendment) (Modular Manufacture and Point of Care) Regulations 2024 · Hansard source

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  It is a pleasure to serve under your chairmanship, Mr Betts. I will be brief. The Opposition note that the draft regulations are a response to a Conservative Government-launched consultation, more than 91% of respondents to which were supportive. As Conservatives, we welcome innovation and want to support UK patients getting early access to new and innovative treatments. I urge the Government to ensure that funding and hospital resources are available so that patients can benefit from them, and that businesses are structured so that they can use UK hospitals to innovate.

• 26 Nov 2024 · Draft Medical Devices (Post-market Surveillance Requirements) (Amendment) (Great Britain) Regulations 2024 · Hansard source

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  It is a pleasure to serve under your chairmanship, Mr Efford. I think we all understand the context of the IMMDS review. Having spoken on Sunday afternoon to a lady who is suffering having had a mesh put in—the skin has never healed over the top and she is facing difficulties—I fully understand the reasons for the regulations. We all want safety; we all want the equipment that doctors like me use to be safe. We also all want support for the science and technology sector, and we all want people in the UK to have early access to the very best new medical devices. As such, the importance of the regulations is not just that they are there and they are strong, but that they are proportionate and effective in their aims. I have a few questions in regard to that. First, the MHRA will be sent lots of data—reports on 3 million medical devices at one, two and three-year intervals, depending on the type of device. Is the MHRA required to look at that data, or to check whether manufacturers are required to produce these reports, or even to check that manufacturers have produced these reports? If it does have such a requirement, does the MHRA have the resources to look at all this extra data and to review it? If it does not have such a requirement, what is the point? The cost estimate in the impact assessment talked about £310 million over 10 years, but for 3 million devices that does not seem particularly high. Six months is being given for these regulations to become legally enforced. Is that long enough for businesses to prepare and for the MHRA to get ready to look at this? How much of this cost will be passed to the NHS, and how much has the NHS budgeted for such costs? How will the NHS comply with the legal requirement to get patient experience data? The Minister talked about the importance of getting patient experience data where appropriate, so what will the exemptions be? If someone was having a Guedel Airway put in, they would probably be unconscious and might not be aware of how effective the device was—if they woke up it would probably be more effective than if they did not, I suppose, but it is quite difficult. Confidentiality is also an issue. If a medical device like a new hip is being put into somebody, will the Government provide information to manufacturers on who has got their hips, or is the manufacturer expected to guess? Or is the NHS expected to act as a go-between, and if so, how will that work in practice? The regulations are also a bit of a burden on small businesses. I notice the Government have made the decision, as evidenced in the impact assessment, to include all small businesses—even micro-businesses—under these regulations. Has the Minister considered whether that will incentivise businesses to set up elsewhere, in Europe or overseas, reducing UK innovation and reducing the likelihood that manufacturers will apply for a UK Conformity Assessed mark because there is more regulation in the UK than elsewhere? Will that delay access to new devices for our patients in this country? In particular, the “similar devices outside of GB” requirement requires even the smallest businesses to find out similar devices’ safety, around the globe. That is possibly something that a large multinational corporation could do, but a micro-business in, perhaps, Oxford or elsewhere would find it difficult to find all that information. The cost proportional to the business will be extremely high, which will reduce the number of new people entering the market. Overall, the Government have the right intention to provide for patient safety. However, the longer period that safety has to be viewed over and the additional regulation compared to the European Union mean that, once again, the Government have chosen to take an EU regulation and gold-plate it, to the detriment of Britain, and ultimately potentially that of patients.

• 26 Nov 2024 · Draft Medical Devices (Post-market Surveillance Requirements) (Amendment) (Great Britain) Regulations 2024 · Hansard source

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  The Minister is saying that more regulation will encourage innovation. I am not sure I agree with that premise, but does he accept that these new regulations will lead to a higher regulatory burden on people wanting to set up medtech companies in the UK than in the EU or elsewhere?

• 26 Nov 2024 · Draft Medical Devices (Post-market Surveillance Requirements) (Amendment) (Great Britain) Regulations 2024 · Hansard source

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  Parts of the UK are working to EU regulations, but does the Minister recognise that the statutory instrument he is bringing forward will introduce into the whole of the UK market, regulations that are not currently present in either the UK or EU markets?

• 26 Nov 2024 · Tobacco and Vapes Bill · Hansard source

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  Prevention is better than cure. As we have heard, smoking is a cause of many premature deaths and much serious ill health. That was why the previous Government introduced legislation to tackle it and restrict access to tobacco purchases for those born after 1 January 2009. This Bill builds on many measures in the previous one. As we have heard, this is a Bill of two parts: tobacco and vapes. Those two parts have been received differently, a bit like Marmite and chocolate spread—part controversial, part pretty universally liked. The section on smoking and tobacco has proved to be a bit like Marmite—some people have liked it. My hon. Friend the Member for Harrow East (Bob Blackman) spoke eloquently of his passion for stop-smoking measures, his successful campaigning, and the previous Government’s success in reducing rates of smoking. My hon. Friend the Member for North Dorset (Simon Hoare) spoke eloquently about the balance between libertarianism and choice, and the need for order, societal norms and the protection of others in society. The hon. Member for City of Durham (Mary Kelly Foy) spoke about the dangers of smoking and the difficulties and challenges for people trying to quit. On the other hand, other Members expressed concern about the Bill. The hon. Member for Lewes (James MacCleary) talked about how the Secretary of State might use powers relating to outside places where people may smoke. The hon. Member for Newbury (Mr Dillon) shared his concerns about how measures on the age of sale will work in practice. Those will indeed be clunky measures for shopkeepers to try to enforce, and will have an effect on the cohort of individuals who are just either side of the threshold, who will require ID throughout their lives. The hon. and learned Member for North Antrim (Jim Allister) spoke about how that measure will work in Northern Ireland, and although he received some assurances from the Minister, I am not sure that they were completely effective. Although I confess that I do not like Marmite, it is a free vote this evening for Conservative Members, and I will support the Bill. The Secretary of State said in opening that 350 young people will start smoking today, most of whom will regret it, so why was 1 January 2009 chosen? I appreciate that that was the date in the previous Bill, but why did he choose it for his Bill too? Let me move on to the area of chocolate spread—the part of the Bill on vaping. I think it was universally welcomed, and was supported by the hon. Members for Newcastle upon Tyne East and Wallsend (Mary Glindon) and for North Shropshire (Helen Morgan) among others. It includes measures to tackle vaping among children, on which I have personally campaigned. As others have said, the chief medical officer has been clear that for someone who smokes, vaping may be better, but if they do not smoke, they should not vape. As a Member of Parliament and a children’s doctor, I have been increasingly concerned about the sharp increase in children addicted to vaping and, more recently, to other nicotine products such as pouches. Schoolteachers have reported that children are unable to concentrate, or even complete a whole lesson, without visiting the bathroom to vape.

• 26 Nov 2024 · Tobacco and Vapes Bill · Hansard source

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  The challenge is that if we were to ban it altogether, we could risk criminalising people who were already addicted to tobacco products—adults who had made that choice. That is the reason why both present and past Governments put forward a measure to increase the age gradually, but I understand the points that have been made about the difficulties for shopkeepers and others in enforcing it over time. I return to vaping. Doctors report a growing body of evidence suggesting that children may be having difficulty in school and suffering health problems as a result of vaping. A report from Healthwatch said that 31% of the more than 4,000 under-18s it surveyed were regularly vaping. Nicotine is a powerfully addictive product. Young people are particularly susceptible to it, so it is very important that we protect children from vaping and other nicotine products. After all, vaping is an adult activity; it is apparently designed to help smokers quit. While the industry may argue that the flavours and colours are enjoyed by adults—and they may well be—I struggle to understand why adults would want a vape flavoured like a unicorn milkshake, whatever a unicorn’s milk tastes like. The Healthwatch survey showed that fruit flavours are very popular with children, and the same has been repeated by various teaching unions, the British Medical Association, of which I am a member, Cancer Research UK and even a Government report from last year. I also do not see why an adult stop-smoking device needs to be disguised in the form of a highlighter pen, which could perhaps be hidden in a child’s pencil case, or created in the shape of a children’s cartoon character. Enticing and luring children into a lifetime of unwanted and potentially harmful addiction is immoral. The Secretary of State is taking powers to regulate the flavours, colours and packaging of vapes, but how will he ensure that he stays one step ahead of an industry whose income depends on a new generation of addicts? He has taken quite extensive powers, which I know is of concern to some hon. and right hon. Members, but how and when does he intend to use them? What support will be given to children who are already addicted to vaping to help them quit? Finally, while this is a free vote issue, I am pleased on a personal level to see some of the proposals that I put forward on the last Bill being incorporated into this one, particularly on the sponsorship and advertising of vending machines. Whatever our views on this Bill, it is a bold piece of legislation of good intention. It aims to improve the health of our nation and of our children in particular and to reduce smoking and prevent nicotine addiction in the young. It is not clear whether it will work, but we have to hope, for the health of all of us and our children, that it does.

• 19 Nov 2024 · Point of Order · Hansard source

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  On a point of order, Mr Speaker. I seek your guidance about how this House can obtain answers from the Government, particularly the Department of Health and Social Care. On Budget day I tabled a question asking what the changes to national insurance contributions would cost the NHS both directly and indirectly. On 4 November I got a holding answer, and on 11 November I was given an answer that did not answer the question. On 8 November I tabled a question to break it down into small pieces. Last night I received yet another holding answer. We have had very little clarity from the Minister this morning. Are we truly supposed to believe that, three weeks after their own Budget, which the Government took almost four months to prepare, they do not know or cannot quantify its effects? [ Interruption. ] Surely, it is a discourtesy not to provide the House with an answer to a written question, and incompetent not to know the answers—

• 19 Nov 2024 · Point of Order · Hansard source

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  Could you please advise me, Mr Speaker, on how to get to the truth, so that this House and my constituents can understand the magnitude of the effect of these national insurance contribution changes on the NHS?

• 19 Nov 2024 · Health and Care Staffing Costs: Employer NI Contributions · Hansard source

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  The right hon. Member speaks of ducking questions, but it is worrying that three weeks after the Budget he still does not know, or will not tell the House, how much it will cost the NHS. Of course, changes to national insurance contributions affect not just the NHS directly, but suppliers, contractors, charities and other NHS care providers. I know you are a great supporter of your local air ambulance service, Mr Speaker, as I am of the Lincs & Notts air ambulance, which now needs to raise £70,000 extra just to fund this Government’s ill-advised changes to NICs. That £70,000 is a lot of cakes to sell, cars to wash and fun runs to complete, and that is just one example of pressures placed on lifesaving services right across the country. Will the Minister confirm that he will meet the Chancellor, explain the disastrous effects of the policy and insist that she reverses it?