Tuesday 26 April 2022
[Caroline Nokes in the Chair]
I beg to move,
That this House has considered progress towards the Government’s smokefree 2030 ambition.
It is a pleasure to serve under your chairmanship, Ms Nokes. For those who do not know, today is my birthday. What better way to celebrate my birthday than to speak in Westminster Hall? On a personal level, it is tinged with sadness, because tomorrow is the anniversary of my mother’s death. She died from smoking—officially, it was lung and throat cancer, but I am clear that smoking killed my mother. That is one of the reasons I am so passionate about ensuring that young people do not start smoking and that those who smoke give up as quickly as they can, because the medical reality is that the lungs can recover. In fact, if smokers quit at an early enough stage, even seasoned smokers who have smoked for many years will see their lungs recover.
I thank the Chairman of Ways and Means and the Backbench Business Committee, on which I sit, for granting this debate. Originally, our intention was to focus on Javed Khan’s long-awaited review. The officers of the all-party parliamentary group on smoking and health and I believed that the review’s recommendation would be published last Friday. Javed has had to delay his publication, but I hope that when we see it, it will be as radical as we believe it to be. Given the delay in publication—until the middle of May, I believe—we were left having to decide whether to proceed with this debate or wait. My view is that, given that we have the opportunity to debate this issue, and possibly even shape Javed Khan’s views and recommendations, it is better to proceed and get the answers from the Minister about where we stand on the review. I hope the Government will commit to introduce all the recommendations of Javed Khan’s review, whatever they may be, to achieve what I am sure we all in this room wish to achieve: a smokefree 2030.
The hon. Member for City of Durham (Mary Kelly Foy)—I will call her my hon. Friend—and I have co-sponsored this debate, and I am sure she will speak on many of aspects, particularly levelling up. The Government have a bold ambition, which I strongly support—I am sure we all do—to bring the end of smoking within touching distance. But it is deeply disappointing that, three years on from that being announced in the Green Paper, we do not seem to have made much progress. There is no road map to put us on the route to success. The purpose of this debate is to remind the Minister of the urgent need to deliver the bold action that was promised in the 2019 Green Paper.
The 2030 ambition was acknowledged by everyone to be extremely challenging only three years ago. We have lost three years, so it is even more challenging now. We should be clear that if we do nothing, we will not achieve that target, so there is no time to be lost. When the ambition was announced, we had 11 years; now, there is only eight. We are nowhere near achieving our ambition, particularly for our more disadvantaged communities in society, which have the highest rates of smoking.
I congratulate the hon. Member not just on jointly securing the debate but on his birthday. He talks about the harder-to-reach, socially disadvantaged communities. Does he agree that if we do not get the younger elements in particular to a smoke-free society, we will not get future generations, and the 2030 target will not be met?
I thank the hon. Member for that intervention. Clearly, people start smoking when they are young. They continue to smoke well into their later life, and it is very hard for people to give up if they have already committed to smoking cigarettes, because nicotine is the most addictive drug that we know of. Therefore, it is very hard for people to get off it once they have started, so it is far better that we prevent people from starting to smoke in the first place. At the moment, I believe that around 200 to 300 young people start smoking every day, which is why it is imperative to stop them doing so right now. Indeed, Cancer Research UK has estimated that we will have to wait until 2047 for the smoking rate in disadvantaged communities to reach 5% or less, which is the smokefree ambition.
I wish the hon. Member a happy birthday and congratulate him on securing the debate. One of the problems that we have is that some deprived communities are in larger areas where the smoking rate has actually come down, but it has remained high within those communities. We also have a high incidence of smoking in pregnancy, which causes other tremendous problems. Does the hon. Member agree that we need specific action to help people who are pregnant to quit smoking, and that we also need to tackle the whole community at the same time?
I thank the hon. Member for his intervention and for the work that he has done on combatting smoking over many years. He raises the issue of smoking in pregnancy, which is the one target that the Government came closest to missing at the time of the last review. The target was 11%, and the Government just about achieved it. I am very clear that, for young women who are pregnant, we need to ensure that, if they smoke, they should be referred immediately to quitting services at the first meeting to discuss their pregnancy through the health service, and not just them but their partner as well. If both give up smoking, there is a strong chance that they will continue to not smoke. They need to understand the damage that they will do to their unborn child and the damage that they are doing to themselves. If we get to that point, it will improve the position no end. That is in the NHS plan, but for future years. I see no reason at all why that could not be introduced now. That is a management decision by the NHS, and I would ask my hon. Friend the Minister to encourage the NHS to do precisely that.
The all-party parliamentary group had an excellent meeting with the chairman of the independent review, Javed Khan. It was a very encouraging meeting, and we expect his recommendations to match the scale of the challenge, but unless his review is turned into a meaningful plan of action that is backed up by funding, it will not be worth the paper it is written on. We need new sources of funding, and the 2019 Green Paper recognised that we would need funding to end smoking, that there was pressure on budgets and that existing sources of funding were not sufficient. Three years and one pandemic later, the pressure on budgets in even greater. In its submission to me, the Local Government Association said that local authorities are paying some £75 million for quitting services overall. Clearly, they need additional funding to achieve what is required.
We are talking about disadvantaged communities, and levelling up is quite rightly a flagship policy for the Government, but there is no new funding to deliver on the bold ambitions set out in the levelling-up White Paper. The Institute of Fiscal Studies says that
“instead, departments will be expected to deliver on these missions from within the cash budgets set out in last autumn’s Spending Review. Departments and public service leaders might reasonably ask whether those plans match up to the scale of the government’s newfound ambition—particularly in the face of higher inflation.”
The levelling-up White Paper missions include narrowing the gap in healthy life expectancy between the local areas where it is highest and lowest by 2030, and increasing healthy life expectancy by five years by 2035. Smoking is responsible for half of the 10-year difference in life expectancy between the most and least disadvantaged in our society, so achieving the Government’s levelling-up mission on life expectancy will depend on delivering the smokefree 2030 ambition.
The Under-Secretary of State for Levelling Up, Housing and Communities, my hon. Friend the Member for Harborough (Neil O'Brien), has said that the Government must “floor it” when it comes to prevention and public health, but we cannot floor it unless there is gas in the tank. Gas in the tank is what we are lacking right now. Funding for public health is in a parlous state. We must face up to the fact that funding for smoking prevention has been particularly hard hit.
After the spending review was published, the Health Foundation estimated that funding for smoking cessation and tobacco control had been cut by one third since 2015. The cuts in budgets for tobacco control are the falsest of false economies. Unlike most pharmaceutical drugs, smoking cessation saves money, and with no negative side effects. The National Institute for Health and Care Excellence has estimated that, for every pound invested in smoking cessation services, £2.37 will be saved on treating smoking and smoking-related diseases, as well as increasing productivity.
I am so pleased that the hon. Gentleman’s birthday is in this month of VApril, and I congratulate him on this debate. Does he agree that the vaping industry, which is supporting harm reduction by encouraging people to turn to vaping, should get more support, and that vaping should be part of the Government’s harm-reduction strategy? Vaping is also more economical. Encouraging people away from cigarettes to vaping would be a good step in the direction of better health.
I thank the hon. Lady for that intervention. Vaping has its purpose, which is to encourage people to quit smoking and take up vaping. I am concerned that people may take up vaping and then escalate to smoking. We do not yet have medical evidence on the long-term effects of vaping on health, so I am cautious. Clearly, it is better to vape than smoke, but let us not encourage people to take up vaping as an alternative to stopping smoking completely.
The all-party group has encouraged the “polluter pays” approach. The situation is very frustrating. The Government recognised in the Green Paper three years ago that budgets are tight and new sources of funding are needed. As recommended by the all-party parliamentary group, which I chair, the Government agreed to consider the “polluter pays” approach to funding. They also acknowledged that there were precedents, and that the approach had been taken by other countries, such as France and the USA.
Only months after the consultation closed in October 2019, the pandemic struck and put the prevention strategy on the back burner. It soon became clear that an effective prevention strategy was essential to build back better from the pandemic. It is also essential to deliver on the Conservative manifesto commitments to level up, reduce inequality and increase healthy life expectancy by five years. Those commitments are baked into the levelling-up White Paper and, the Government have said, will be enshrined in statute.
On the anniversary of the Green Paper’s publication, on 22 July 2020, the all-party group held a roundtable to examine the actions needed to deliver the smokefree ambition. The then Public Health Minister, my hon. Friend the Member for Bury St Edmunds (Jo Churchill), and her opposite number, the hon. Member for Nottingham North (Alex Norris), were the keynote speakers. The Minister gave her commitment that the Department would continue to explore further funding mechanisms with the Treasury, as had been promised in the Green Paper.
On 30 March, the former Public Health Minister, my hon. Friend the Member for Winchester (Steve Brine), challenged why the commitment to consider a “polluter pays” approach had not been fulfilled. The response at the Dispatch Box from the Health Minister, my hon. Friend the Member for Charnwood (Edward Argar), was:
“My understanding—although my recollection may fail me, so I caveat my comment with that—is that this was initially looked at that stage, but was not proceeded with.”—[Official Report, 30 March 2022; Vol. 711, c. 867.]
My hon. Friend the Member for Charnwood might like to check his recollection. The all-party group on smoking and health, following its initial recommendations, put forward detailed proposals to Government in its June 2021 report about how a “polluter pays” levy could operate. I shared a copy of the report with Health Ministers at that time and wrote to the Secretary of State in July 2021, and again in December, asking for a meeting to discuss the levy. In September, I wrote to the Chancellor about the proposals. However, to date I have not had the courtesy of a reply to any of those letters.
If the “polluter pays” levy has been seriously looked at and a decision has been taken not to proceed, that was certainly not communicated to MPs or the all-party parliamentary group. That is precisely why officers of the APPG tabled amendments to the Health and Care Bill calling for a consultation on the levy. The amendments would not have committed the Government to going ahead, but would have ensured that they fulfilled their commitment to consider a “polluter pays” approach and that our proposals get the consideration they deserve. Our amendments were carefully considered by the other place and passed by a majority of 59—the greatest defeat the Government suffered on the Health and Care Bill. However, to the great disappointment of the APPG, the Government opted to oppose our amendments when they returned to the Commons for consideration. That leaves us without a mechanism for funding the smokefree 2030 ambition, with only eight years to go.
It appears that when the noble Lords met Ministers and Treasury officials to discuss the amendments, it was the Treasury, not the Department of Health and Social Care, that objected to the proposal to consult on a levy—not to introduce one, but to consult on the principle. The Treasury has a philosophical aversion to anything that smacks of hypothecation—raising funds to be put to specific purposes. Its preference is for funds raised to go into one big pot—the Consolidated Fund, from which all Government spending flows—that it controls and allocates, thereby giving it ultimate control. However, there are already numerous exceptions where hypothecation has been justified. One is the health and social care levy, which has just come into force. Another is the pharmaceutical pricing scheme, which the Department of Health and Social Care uses to raise funds for the NHS and provides a model for how our proposals could be implemented.
The noble Lord Stevens, formerly chief executive of the NHS, pointed out that the pharmaceutical pricing scheme was put in place by a Conservative Government in 1957 and has been sustained ever since with the support of Conservative, Labour and coalition Governments. He also said—and who could disagree?—that if it is deemed appropriate to have a form of price and profit regulation for the medicines industry, which delivers products that are essential for life saving, it is not much of a stretch to think that an equivalent mechanism might be used for an industry whose products are discretionary and life-destroying. I completely agree with him on that approach.
The Government already accept the principle that the polluter should pay to fix the damage they do. The extended producer responsibility scheme, which comes into force in 2024, is another good example. It requires producers of packaging waste to pay for its collection and recycling. Lord Greenhalgh, the Housing Minister, said:
“The reality is that we cannot keep looking to the Treasury to keep bailing everybody out—we have to get the polluter to pay.”—[Official Report, House of Lords, 5 January 2022; Vol. 817, c. 566.]
I could not agree more, and that principle applies even more strongly to smoking, which, as the chief medical officer pointed out, is a deadly addiction created and marketed by companies for profit.
There were objections because we were part of the European Union, but when speaking for the Government on Report in the House of Lords, the noble Lord Howe stated:
“the tobacco industry is already required to make a significant contribution to public finances through tobacco duty, VAT and corporation tax.”—[Official Report, House of Lords, 16 March 2022; Vol. 820, c. 297.]
However—this is the key point—tobacco companies pass on the cost of tax increases to smokers, which means that it is not the tobacco industry that contributes to the public finances but ordinary smokers, who have little choice but to buy cigarettes to maintain their deadly addiction. Indeed, when HM Treasury consulted on and rejected a levy in 2015, it was on the grounds that it would add an extra tax burden to smokers. That may have been true in 2015, but it is not the case today.
In 2015, we could not prevent tobacco manufacturers from passing the costs on to consumers because we were in the European Union. We are no longer part of the European Union, and therefore by capping tobacco prices and controlling profits, the Government can ensure that tobacco manufacturers bear the full cost of the levy, helping incentivise the industry to move out of combustible products and make smoking obsolete by 2030. I can think of few better Brexit dividends than making tobacco companies pay for the damage they do.
To quote my noble Friend and fellow APPG officer Lord Young of Cookham, speaking in the other place, our proposed levy will allow the Government to
“put the financial burden firmly where it belongs, on the polluter—the tobacco manufacturer—and not the polluted—the smoker.”—[Official Report, House of Lords, 16 March 2022; Vol. 820, c. 290.]
The reality is that this levy could raise £700 million a year from the profits of the tobacco companies—money that could be applied to smoking cessation services.
There is public support for this measure. It has been endorsed by more than 70 health organisations, including Cancer Research UK, Asthma + Lung UK, the British Heart Foundation, the Royal College of Physicians and the Health Foundation. It is also supported by three quarters of the public, including those who voted Conservative in the 2019 election, with fewer than one in 10 being opposed to the levy. What could be better than introducing a tax that the public support?
If we want to achieve a smokefree 2030, it is vital that we tackle high rates of smoking among our most deprived communities, pregnant women and people with mental health conditions. As the Government have said, this will be “extremely challenging” and cannot be achieved on the cheap. Health Ministers in both Houses have said that they do not want to prejudge the review, and therefore could not accept amendments calling for a consultation on a levy. However, as I have said, that review will report very shortly—in the middle of next month—and the discussions I have had with the chairman of the review make it very clear that the measures he will be recommending will need investment, and will be radical.
Once Javed Khan has reported back to the Government, there will need to be serious consideration of how the funding to deliver the smokefree 2030 ambition can be found. That will need to be done in parallel with decisions about what interventions are needed, as interventions cost money and can be delivered only if the funding is found. Pressure on budgets has only worsened since 2019, with the covid-19 pandemic wreaking havoc on our nation’s health and on Government finances. The Government made it very clear in the spending review that there is no new money for public health, so an alternative source of funding is urgently needed. With only eight years to go before we reach 2030, the Government need to decide where that money is coming from.
The existing funds are not sufficient, and our proposals provide a new source of funding in addition to tobacco taxes. If the Government are unwilling to accept our proposals, they must come up with an alternative solution that will match the scale of their ambition. As such, my question to my hon. Friend the Minister is this: if the Javed Khan review recommends a levy, will she commit to meet with us as APPG officers and with independent experts to discuss our proposals for a “polluter pays” levy to provide the investment that is needed to deliver the Government’s smokefree ambition?
My final point is that this review also needs to look at shisha tobacco, chewing tobacco and snus. Unfortunately, those areas are completely unregulated at the moment, but are extremely damaging to people’s health. I look forward to hearing the contributions of other Members and of the Front Benchers.
It is a pleasure to serve under your chairmanship, Ms Nokes, and I wish my hon. Friend the Member for Harrow East (Bob Blackman) many happy returns. I declare an interest as a vice-chair of the APPG on smoking and health; I hope, therefore, that I can speak for a little more than six minutes, if that is okay.
The north-east is the most disadvantaged region in England, with high rates of smoking and all the harms that it brings. However, I am proud to say that in the last five years, the fastest declines in smoking rates have been in the north-east. Credit goes to our local authorities, which prioritised tackling smoking and banded together to fund Fresh—the longest-running and most effective regional tobacco control programme in the country. However, the north-east started with much higher smoking rates than the rest of England, so we have further to go to achieve a smokefree 2030.
More than 4,000 people died prematurely from smoking in our region last year, with 20 times as many suffering disease and disability caused by smoking, yet there is also an economic cost to our already disadvantaged communities. Smoking costs the north-east £685 million in lost productivity, £125 million to the NHS and £67 million in social care costs to local authorities. We simply cannot afford this strain on our economy.
When the smokefree 2030 goal was launched nearly three years ago, the Government acknowledged the scale of the challenge, admitting that it would be extremely challenging and promised bold action to finish the job. Since then, however, the Government have sat on their hands. Rather than stepping up their efforts to achieve the smokefree 2030 ambition, the Government have failed to announce a single new policy to that effect, while the £1 billion cut to public health funding since 2015 appears to be baked in.
The Minister knows that half the difference in life expectancy between the rich and the poor is due to differences in smoking rates. The Government’s lack of action threatens our ability to achieve not just the 2030 smokefree goal, but their levelling-up mission to narrow the gap in life expectancy between areas where it is highest and lowest by 2030 and to increase healthy life expectancy by five years by 2035.
Today’s debate was originally secured to discuss the recommendations of the independent review. The fact that the review was delayed made the debate even more necessary. The Secretary of State committed, when he announced the review in February, that it would report back in April. Javed Khan said he would report back on 22 April, so we were very disappointed that the Secretary of State told Parliament last week that he hoped it would be published in May, with no commitment that that would be the case. That is just the latest of many delays and missed opportunities, which we want to put on the record.
We want a commitment from the Government that they will accept no further delays in bringing forward a plan to achieve a smokefree 2030. Let us start with the Green Paper that announced the Government’s goal of a smokefree 2030, which was launched with much fanfare in July 2019. Further proposals included considering the “polluter pays” levy, which my hon. Friend the Member for Harrow East mentioned, and giving the ultimatum of making smoked tobacco obsolete by 2030. Cabinet Office guidelines say that Departments should:
“Publish responses within 12 weeks of the consultation or provide an explanation why this is not possible.”
The Green Paper consultation ended in 2019. In July 2020, on the anniversary of the Green Paper, the then public health Minister, the hon. Member for Bury St Edmunds (Jo Churchill), told the APPG that work was under way to publish the further proposals envisaged in the Green Paper, and that she was keen to work with us to explore whether the current regulatory framework was sufficient. Since then, we have heard nothing.
The lack of an outcome on the Green Paper was disappointing, so in November 2020, we held a debate urging the Government to commit to publishing a new and ambitious tobacco control plan. We were therefore delighted when the then Minister committed in December to publishing a new tobacco control plan in 2021. The APPG commissioned Action on Smoking and Health, working in collaboration with SPECTRUM, the academic public health research consortium, to provide us with a report setting out our recommendations and the measures that the Government needed to take to achieve their 2030 ambition. The then Minister attended the launch of our report, welcomed our recommendations and committed to publishing the plan by the end of 2021. We are understandably disappointed by the delay in its publication.
There were other opportunities that could have been seized but were not. The Government were legally required to review the impact of existing tobacco product regulations, including those on standardised packaging, health warnings, product standards and e-cigarette regulations. The regulations set out in law a deadline for the review to report by May 2021. To that end, the Government launched a consultation last January to assess whether the objectives were still appropriate and whether the regulations were fit for purpose. Those regulations predated the Government’s commitment to a smokefree 2030, and it was blindingly obvious that they needed to be strengthened to match the scale of the Government’s new goal.
Since the regulations came into force, it has been clear that there are serious loopholes. The menthol ban relies on subjective rather than objective measurements to determine whether the regulations are being adhered to. An investigation by the Express newspaper revealed that the industry has exploited that loophole in the law and that Britain’s biggest tobacco giant sold £1 billion-worth of cigarettes flavoured with menthol in the year after the ban came into force.
That was not the only loophole; although e-cigarettes can be sold to those aged 18 and above, it is completely legal to hand them out free to children. While the advertising, promotion and sponsorship of e-cigarettes are heavily regulated, packaging and labelling are not. That has allowed the use of sweet names for vaping products, with cartoon characters and garish colouring, all of which appeal to children. Those are clear gaps in the law that need to be fixed without further delay.
The consultation was well timed to feed into the Health and Care Bill. ASH and SPECTRUM provided the Government with detailed and well-evidenced proposals for a number of improvements that would strengthen regulations and fix those loopholes. When the outcome of the review was not published in May 2021, as was required, we hoped that the Health and Care Bill would contain the further proposals the Government had promised to bring forward. Imagine our disappointment when the Bill was introduced to Parliament last July. Although it included measures on prevention and public health, there was nothing on tobacco or smoking, despite the Government’s much-trumpeted smokefree 2030 ambition.
That is why, in Committee, I tabled a set of amendments for increased regulation on tobacco, based on the APPG’s recommendations. The amendments included requirements to consult on a “polluter pays” levy; introduce pack inserts containing quit information; put warnings on cigarettes; close loopholes in the existing regulations on menthol and e-cigarettes; and consult on raising the age of sale to 21—a measure that has been proven to reduce smoking rates in the population at large by 30%. That measure has also been shown to reduce inequalities, because it has the greatest impact on the poorest and most disadvantaged communities. Throughout the passage of the Bill, Ministers in both Houses have repeatedly said that the Government were sympathetic to our aims and amendments, and that they would be considered for the next tobacco control plan. However, the tobacco control plan has already been delayed by a year and still does not have a publication date.
If the Government had supported those amendments, we would now have the foundation in place for a comprehensive strategy to end smoking by 2030. Instead, the Government have chosen to reject the amendments and, yet again, to kick tobacco control into the long grass. Now we are waiting for the tobacco control plan. Before the plan can be published, we have to wait for Javed Khan’s independent review, which will be followed by a public health disparities White Paper in the spring, which will in turn be followed by the tobacco control plan. That will leave only seven years to deliver the smokefree 2030 goal.
Since evidence first emerged of the harms caused by tobacco in the 1950s, smoking has killed more than 10 million people in the UK, and it continues to kill hundreds more every day. Up to two thirds of those smokers die prematurely from their addiction. There is a crucial message around children: every day, 280 children start smoking—that is more than 280,000 since the smokefree 2030 ambition was launched. Smoking is highly addictive; two thirds will go on to become daily smokers. With that in mind, can the Minister assure us that the tobacco control plan to deliver the smokefree 2030 ambition will be published no later than three months after the independent review? Will she also assure us that the Queen’s Speech will include a commitment to bring forward legislation in the next Session to deliver regulatory measures essential to delivering the Government’s ultimatum to the industry to make smoked tobacco obsolete by 2030?
I end with a comment from the chief medical officer. He pointed out that one in five people who die from cancer will die from lung cancer, and went on,
“the reason that people like me get very concerned and upset about it is that this cancer is almost entirely caused for profit…a small number of companies make profits from the people who they have addicted in young ages and then keep addicted to something which they know will kill them.”
I congratulate the hon. Member for Harrow East (Bob Blackman) on securing this important debate and on his very persuasive speech.
I will start with some context. Hon. Members might wonder why a Welsh MP, and a Plaid one at that, is speaking in a health-related debate when health is a devolved matter. I have a long-term interest in the negative effects of smoking. Many years ago, I supported Julie Morgan, then the MP for Cardiff North, when she tried to bring in a ban on smoking in public places in Wales. Unfortunately, we were unsuccessful. The Welsh Assembly was very anxious to bring in the ban at that time, which was some years before it was actually brought in in England and Wales. We had to wait.
I am no statistician, and certainly no epidemiologist—I cannot even say the word—but I did a back-of-the-envelope sum at the time and I reckoned that, because of the delay in bringing in the ban in Wales, between 15 and 20 people such as bar staff would have contracted smoking-related illnesses that would eventually killed them. That is the argument that we made at the time: the lack of devolution cost lives.
The second point to contextualise my interest in this matter is that, some years ago, I asked Alan Milburn, the then Secretary of State for Health, about nurses’ pay. His reply, which I remember distinctly, was that it was one of the abiding
“joys of my life that I am not responsible for all things Welsh”.—[Official Report, 22 January 2002; Vol. 378, c. 739.]
Actually, health was devolved, but nurses’ pay was not. The point I am making—apart from the fact that he was wrong—is that devolution is not always particularly clearcut. In the short-term, more devolution is not really the day-to-day issue; the issue is policy divergence, not devolution.
In Wales, we see that in our early adoption of the wellbeing approach to health, which is one of the landmark policies that the Welsh Labour Government have brought in, supported by my party. In some ways, this answers the point made by the hon. Member for Harrow East about there not being cash available; this is not a cash issue—it is a policy and attitudinal issue. In Wales, we have a health—not an illness—policy, but without control over illness-creating factors such as tobacco and alcohol.
Unsurprisingly, my answer is to have fuller devolution in the short term and full powers in the long term, but if I were to pursue that point now, I am sure Ms Nokes would pull me up. For now, I will just say that the Welsh Government have the goal of being smokefree by 2030, as is the case in England. The impact on public health in Wales is frightening, as it is elsewhere—smoking is the largest single cause of avoidable early death. In 2018, around 5,600 deaths in people aged 35 or over in Wales were attributable to smoking, 16.5% of all deaths in that age group. The cost to the Welsh NHS is around £300 million per year, which is, to my mind, of itself a completely persuasive point.
The aim for England to be smokefree by 2030 was announced two years before we got around to it in Wales. However, in the meantime, Wales has taken a lead on action, having published its draft strategy and delivery plan last November. Interested hon. Members from England are still waiting for England’s tobacco control plan, and I share their concern at this delay. I would also say that this is undermining the Welsh Government’s ability to achieve their own targets, because under the current devolution settlement there are many policies that Wales cannot implement. These policies include the trailed “polluter pays” levy on tobacco manufacturers to fund tobacco control. The key tobacco controls are not devolved; they are reserved. Everything from tobacco taxes to packaging, labelling, product regulation to raising the age of sale are policies that we cannot change in Wales.
During the passage of the Health and Care Bill, I added my name to the amendment tabled by the Member for City of Durham (Mary Kelly Foy) that would have introduced tougher regulations on smoking and would certainly have benefited people in Wales. However, these measures cannot be brought in. I would formally like to state my support for raising the age of sale to 21 and putting warnings on cigarettes, advice to quit inside packs and the rest of it.
Those measures would reduce inequalities and smoking uptake. A sensible point—for me at least—is that this is not only a health issue. It is also a class issue. Clearly, it affects people on lower incomes. It is also an age issue. To conclude, I would like to ensure that the Minister is aware of all of these matters, and I ask her to commit to meeting her opposite number in Cardiff regularly to discuss how these measures can be implemented.
It is a pleasure to serve under your chairmanship, Ms Nokes. For the record, I confirm that I am vice-chair of the APPG on smoking and health.
The Minister may know that in health debates and in correspondence I spend much of my time banging on about health inequalities and the need for a new hospital in Stockton. Although we still need one, this morning I want to address another major health inequality. According to the most recent data from the Office for National Statistics, the average gross disposable income in the north-east is the lowest in the United Kingdom, at £16,995 per household—a full 43% lower than in London, where it is the highest.
Analysis of national data published by ASH has shown that the proportion of smokers living in poverty is also highest in the north-east. In our region, 42% of households containing smokers live in poverty, compared with only 17% in London. That is 112,000 north-east households. The average annual spend on tobacco per smoker is £2,000, so helping my constituents quit smoking will not only improve their health and wellbeing, but put badly needed money into their pockets. Smoking is an addiction. It is not a lifestyle choice. Smokers living in poverty tend to be the most addicted and need the most help to quit.
The Government’s arguments against the “polluter pays” levy are unconvincing. When we considered the Lords amendments to the Health and care Bill on 30 March, the Minister for Health, the hon. Member for Charnwood (Edward Argar), said that the Government
“cannot accept these Lords amendments, because the proposals would be very complex to implement, take several years to materialise and risk directing a lot of Government resource into something that we do not see as a sustainable or workable way to fund public health. This would also rightly be a matter for Her Majesty’s Treasury.”—[Official Report, 30 March 2022; Vol. 711, c. 866.]
I will address each of these arguments in turn.
First, on the Treasury, as my hon. Friend the Member for Harrow East (Bob Blackman) said, the Department of Health and Social Care already oversees a similar scheme for pharmaceuticals, put in place by health legislation that is a model for our proposals, so there is already a precedent for the Department to take the lead. It is clear that the Treasury would need to be involved, but the scheme we propose is not an additional tax. Rather, it is a pricing and profit control scheme put in place by health legislation and overseen by health Ministers.
The Minister for Health provided no evidence to justify his statement that the proposals would be “very complex to implement”, would need
“a lot of Government resource”,
and would not be a
“sustainable or workable way to fund public health.”
Indeed, evidence provided to the APPG by independent export analysts and economists demonstrates the opposite. The Department of Health and Social Care has a track record of more than 50 years of overseeing the pharmaceutical scheme. The expert analytical, finance and economic skills needed to run the tobacco levy are no different and the Department already has a team in place.
Let us not forget that the pharmaceutical market is complex. It has an enormously varied range of products, is constantly evolving and has heavy research and development costs that have to be taken into account by the analysts. More than 60 pharmaceutical manufacturers operate in the UK. Indeed, some of them are in my Stockton North constituency. Tobacco manufacturing is far simpler. Cigarettes and rolling tobacco are commodity products, cheap as chips to make. Only four manufacturers account for more than 90% of the market. Selling cigarettes is highly profitable, far more than pharmaceuticals or consumable staples. Imperial Brands sells around four in 10 cigarettes smoked in the UK and made a 71% operating profit in 2019, which is £71 in pure profit for every £100 of sales. It is not alone. The average for the big four manufacturers was 50%. By way of comparison, a 10% operating profit margin is considered average and Associated British Foods, Britain’s largest food manufacturer, made only 6% in 2021.
Clearly, some Government resource and expertise would be needed to develop a tobacco-specific scheme, but the potential returns, which would vastly outweigh the running cost, make it a no-brainer. As we have heard, £700 million a year could be raised from the four major tobacco manufacturers on sales of £14 billion, provided we could cap their profits at no more than 10%. At last, we have a Brexit dividend for the NHS, though it falls well short of the £350 million a week promised on the side of a bus not so long ago.
Market failure justifies the scheme, for this is an industry dominated by four big companies making eye-wateringly high profits from selling lethal products that kill most of their consumers. The extremely high profitability of cigarettes makes them as addictive to the companies as to the smoker. Big tobacco says it wants to turn over a new leaf and move out of cigarettes but shows no signs of doing so. Why would it? Selling cigarettes is far more profitable than any of the alternatives. The levy would provide the incentive the industry needs to deliver the Government’s ultimatum. That is a crucial function of the levy—a point Ministers seem not to have taken on board.
Lastly, the Minister for Health said it would
“take several years to materialise”.
That is not the case. The Government have already wasted three years when they could have put the scheme in place. I join my colleagues in inviting the Minister to meet the APPG officers and our independent experts to discuss our proposals. However, let me say in closing that if the levy had been implemented three years ago, we could already have invested £2 billion in smoking cessation and be well on our way to being a much healthier nation.
It is a pleasure to serve under you as Chair, Ms Nokes. I commend the hon. Member for Harrow East (Bob Blackman) and my hon. Friend the Member for City of Durham (Mary Kelly Foy) for securing today’s debate. I also wish the hon. Member for Harrow East a very happy birthday.
Smoking, as we have heard, is not a lifestyle choice. It is a lethal addiction entered into by the vast majority of smokers even before they reach adulthood. It is an addiction that is increasingly concentrated among the most disadvantaged in society, fuelled by an industry—the tobacco industry—whose behaviour must be stringently regulated if we are to achieve our smokefree 2030 ambition.
Like my hon. Friend the Member for City of Durham, my constituency of Blaydon falls under Gateshead Council in the north-east, which I regret to say is the most disadvantaged region in the country. Smoking rates in Gateshead are particularly high, bringing disease, death and disability disproportionately to my constituency. In 2019, more than 17% of adults in Gateshead smoked, compared with 15.3% for the north-east as a whole, and far higher than the average for England of 13.9%.
That higher rate of smoking translates to a lower average life expectancy. The average male life expectancy in Gateshead is eight years less than in Westminster, and five years less for women. Smoking costs the NHS in Gateshead £9.3 million, and £5.6 million to local authorities for social care costs that are entirely due to smoking and entirely preventable. Tobacco addiction has been levelling down communities across the country for decades, and will go on doing so until the Government decide to get serious about delivering the smokefree ambition—for all in society.
Smokers in Gateshead spend on average £2,000 a year on smoking. The total spend in Gateshead is £54 million, an eye-watering amount of money that goes up in smoke for no benefit to the local community. Ending smoking will significantly increase disposable income in poorer communities such as those across Gateshead, helping to grow the local economy and to improve health and wellbeing for tens of thousands of people.
In March, I was pleased to be able to attend the event in Parliament marking national No Smoking Day and to reflect on the progress that has been made in tackling smoking over the years. Also, however, the event looked at what more needs to be done. The Minister spoke passionately about the Government’s commitment to making England smokefree by 2030, and said that investment in stop smoking services would be at the heart of the forthcoming tobacco control plan.
I agree wholeheartedly. Smokers need to be motivated and supported to quit. However, the funding for stop smoking services has been cut by a third in real terms since 2015. That funding must be reinstated if the services are to play their vital role in delivering the smokefree 2030 ambition.
That is not the only area that needs extra funding to achieve a smokefree 2030. Smoking during pregnancy is the leading modifiable risk factor for poor birth outcomes, including stillbirth, miscarriage and pre-term birth. The Government’s ambition is to reduce smoking in pregnancy to 6% by 2022, but with rates at 9.6% in 2020-21, that is unlikely to be delivered.
The rate of decline in smoking during pregnancy has been higher in the north-east, and that is because we have invested in specialist interventions. We are delighted to see that initiative being rolled out across the country as part of the NHS long-term plan. Smoking during pregnancy rates remain too high, however, so the north-east has gone further by introducing voucher schemes to provide a financial incentive to pregnant smokers to quit. That is particularly powerful for women on low incomes. In South Tyneside, an area of high deprivation, the proportion of pregnant women who are recorded as being smokers at their time of delivery has dropped by a third in the three years since the scheme was put in place.
Maternal smoking cost the NHS £20 million in 2015-16, with more than 10,000 episodes of admitted patient care. Since smoking is so damaging, incentive schemes are cost-saving, with an estimated return on investment of £4 for every £1 invested. Implementing financial incentives at scale is a vital measure that needs to be part of the forthcoming tobacco control plan, which I hope to see included in the independent review—but it will need funding.
I will touch briefly on mental health. Much more investment is needed to tackle smoking among those with a mental health condition. As many as one in three smokers have a diagnosable mental health condition. The NHS long-term plan tobacco dependency treatment pathway presents a major opportunity to tackle smoking among those with serious mental illness, but many others are not in that category. We need to ensure that much more work is done on pilot projects for IAPT—improving access to psychological therapies—counselling. Counsellors are willing to deliver such support, and they should be given the opportunity to do so.
It is a pleasure to serve under your chairmanship, Ms Nokes.
I thank the hon. Members for Harrow East (Bob Blackman) and for City of Durham (Mary Kelly Foy) for securing this important debate. I well remember, as the hon. Lady will remember, that she had this debate in the main Chamber under the covid regulations. I was happy to assist in supporting her at that time, and my support is the same now.
As we turn our attention to the rebuilding of public health following the covid-19 pandemic, tackling smoking must be among our top priorities. Smoking is the leading cause of premature death, killing some 2,300 people in Northern Ireland each year—it is a devolved matter, but I think these figures are quite shocking—with 30 times as many suffering serious diseases and disabilities caused by smoking.
Ms Nokes, I have never had a wish to smoke. I can well recall the first time that I did, with my grandfather, back in the ’60s. He smoked Gallahers; there were no filters on them. I always admired my grandfather, and I said to him one day, “Granda, can I have a smoke of that cigarette?” I pestered and pestered him, and then, one day, he says, “Now, take one, and take a deep breath,” and I did. As a wee six-year-old, I was violently sick. I was green at the gills. In those days, we had—if I can say it—a po under the bed. I was sick into that, and I never had any wish, ever, to pursue the smoking of a cigarette ever since. It left a lasting impression. Maybe that is what we need to do for the young people of today. It is a bit drastic, perhaps, but none the less, it had a very sobering effect on me.
Achieving a smokefree 2030 would reduce the pressure on NHS services at a time when they are under the most severe strain in living memory. However, analysis by Cancer Research UK shows that at current rates of decline, Northern Ireland will not achieve the smokefree ambition of smoking rates of 5% or less until a decade after England—not until the late 2040s—with our most deprived populations not being smokefree until after 2050. We have really big issues to sort out in Northern Ireland regarding that.
While Northern Ireland and the devolved nations hold responsibility for our own public policies, the Government in Westminster maintain responsibility for important UK-wide policies. I therefore ask the Minister—as others have in relation to Wales—what discussions have taken place with the Northern Ireland Assembly and the Minister, Robin Swann?
There is substantial research supporting the implementation of health warnings on cigarettes and cigarette papers, and that is clearly under consideration in Canada, Australia and Scotland. Such warnings could be implemented by a simple amendment to the Standardised Packaging of Tobacco Products Regulations 2015. Tobacco manufacturers already apply print to cigarette papers, so that would be cheap and easy to implement.
Health warnings, such as “Smoking kills”, have been shown to be effective on billboards and tobacco packs, so why would they not be as effective on cigarette sticks too? Adding warnings to cigarette sticks is important because young people in particular are likely to initiate smoking with individual cigarettes rather than packs. Is that something that the Minister and the Government would be prepared to look at?
Cigarette pack inserts providing health information are not a new idea; they have been required in Canada since 2000. The health messages are effective, and research has been carried out in the UK which supports their use here too. The Government have already acknowledged in the prevention Green Paper that,
“there could be a positive role for inserts in tobacco products giving quitting advice”,
so, again, I look to the Minister for her thoughts on that.
All those measures would be cheap and easy to implement and would benefit all the UK nations. They would also support and reinforce the impact of other measures that require significant investment, such as behaviour change campaigns and stop smoking services. Although the Government opposed the introduction of the measures as amendments to the Health and Care Bill, they did leave the door open—I believe—to considering them when developing the next tobacco control plan. Does the Minister—or the Government—intend to do just that?
I have spoken before in this House about the use of licensing for tobacco retailers. In Northern Ireland, since 6 April 2016, retailers have been obliged to register with the tobacco register of Northern Ireland, with a final deadline of 1 July 2016. That built on a similar scheme already in place in Scotland, and a scheme that was due for implementation in Wales.
Since 2018, we have seen the implementation of a tracking and tracing scheme, which requires every retailer to have an economic operator identifier code. Since leaving the EU—as the hon. Member for Harrow East mentioned—the UK has established and launched its own system, with Northern Ireland operating in the UK and EU systems. That makes it easy for all nations in the UK, including England, to not just implement a retail register scheme, but go further and implement a comprehensive retail licensing scheme. If the Minister can give us some thoughts on that, I would be very pleased.
Retail licensing is the obvious back-up to the tracking and tracing of cigarettes and would help tackle the illicit trade that gives smokers access to cheap tobacco. Those who sell illegal tobacco have no compunction about selling it to children too, so the illegal trade makes it not just less likely that smokers will quit, but more likely that children will start smoking. My hon. Friend the Member for East Londonderry (Mr Campbell), who is no longer in his place, mentioned that in his intervention on the hon. Member for Harrow East.
I await with interest Javed Khan OBE’s independent review, which is due to be published shortly. I hope it will address this important issue. England remains an outlier on that important measure, which could help tackle illicit trade and protect children from tobacco. We can and must address these issues collectively, bringing knowledge from the nations we represent. I am happy to support the Minister here at Westminster in taking this matter forward and, from a Northern Ireland point of view, it is important that we address these issues together. If we do so, I am confident that we will then deliver a policy that helps not only us, but the constituents we serve.
It is a pleasure to serve under your chairmanship, Ms Nokes. I begin by thanking the hon. Member for Harrow East (Bob Blackman) for his tireless work in this area, along with my hon. Friends, and for the way he opened the debate. I also wish him a happy birthday.
Over the past 50 years, positive steps have been taken towards ending smoking, on both sides of the House. I am pleased to be here today responding to the debate on behalf of the shadow health and social care team from Her Majesty’s Opposition, because, from my point of view, it is a matter of great pride that I was in Parliament when Labour’s smoking ban was passed into law in 2006. It has become one of the defining public health achievements of the last Labour Government. The positive impact that it has had on the health of the nation is plain to see.
However, there is still much more to do, as we have heard in various speeches this morning. Smoking continues to be the leading preventable cause of ill health and mortality in England. The NHS estimates that 78,000 people in the UK die from smoking each year, with many more living with debilitating smoking-related illnesses. Smoking causes 44,000 cancer diagnoses per year, with almost 70% of all cases of lung cancers caused by smoking.
Smoking blights communities right across the country and contributes to the yawning health inequalities that we currently witness. However, smoking affects not only those who choose to do it; it affects many people around them, too. For example, a child who is exposed to second-hand or passive smoke has an increased risk of cot death, and of developing chest infections, meningitis and many other serious conditions.
The consequences of smoking are stark and affect not only our health, but our economic prosperity. My constituency of Denton and Reddish in Greater Manchester sits across the boroughs of Tameside and Stockport. Each year, smoking costs Tameside over £95 million in lost productivity and health and social care costs, and in Stockport that figure is just above £77 million. In my constituency, 22% of adults smoke, which is well above the national average of 14.5%. We will never truly level up while smoking continues to hold communities and individuals in a vice grip. We need to take robust and radical steps if we are to have any hope of reaching smokefree 2030.
Unfortunately, as we have heard in various contributions, there has been characteristic dither and delay from this Government, I am afraid to say. We were promised an updated tobacco control plan last year, but so far it has failed to materialise. The Government like to talk the talk on smoking cessation services but, as we have heard from numerous contributions, they have brutally slashed the local authority funding that allows those very services to exist.
The public health grant has been cut by £1 billion in real terms since 2015-16, and stop smoking services have suffered a funding decline of around one third over the same period, as we heard from the hon. Member for Harrow East. The Government cannot have it both ways; either they are for a smokefree 2030, and therefore they should support smoking cessation services, or they are not, in which case they should ditch the warm words. I will take the Government at face value—they want a smokefree 2030—so let us get that investment reinvested in smoking cessation services and let us restore public health funding.
I would be grateful if the Minister set out in her response a timeline for publishing the next tobacco control plan, and I want her to commit to publishing Javed Khan’s independent review into smokefree 2030 policies by no later than the end of May. Furthermore, can she outline what plans her Department has to improve access to smoking cessation services, and will she admit that stinging cuts to the public health grant have left communities such as mine, and those of many other hon. Members here today, worse off?
Yesterday, Members voted on the Government’s Health and Care Bill. The all-party parliamentary group on smoking and health set out several recommendations, as we heard from my hon. Friend the Member for Stockton North (Alex Cunningham), on how to achieve a smokefree 2030. Several of those recommendations were tabled as amendments to the Bill. Labour Members were proud to support many of those amendments and proposals, yet the Government refused to back them, much to the disappointment of health leaders and politicians across the House.
The need for a smokefree 2030 has been reinforced during the course of the pandemic. We know that during the first year of the coronavirus crisis, the number of 18 to 34-year-olds who classed themselves as smokers increased by a quarter, from 21.5% to 26.8%. That is a huge increase and one that will have a lasting negative impact on the health of people across the country, unless they are given the tools to stop smoking for good.
In short, we are falling behind. We have a smokefree 2030 ambition, but very little in the way of funding and a seeming lack of urgency from the Government to publish the tobacco control plan.
My hon. Friend is probably aware that I am an advocate for vaping. Major reports by the former Public Health England and the Royal College of Physicians have highlighted the reduced risk potential of vape products. Does he agree that the Government must address consumer misperceptions regarding the relative risk reduction of vaping compared with smoking combustible cigarettes?
I thank my hon. Friend for that intervention, and I think my answer will be very similar to that given by the hon. Member for Harrow East earlier. Yes, vaping has a clear role to play in reducing people’s addiction to nicotine and tobacco products, and clearly it has health benefits over smoking. However, I am increasingly concerned, partly because I see it in my own constituency—I recognise that this is only anecdotal evidence, but I see kids vaping. There is no good reason for children in Tameside or Stockport, or anywhere else in the United Kingdom, to be vaping.
I think the Government have to look very clearly at what is happening here, because vaping has a real role to play in helping people to wean themselves off nicotine and tobacco products, which I support. However, if we are starting to see children vaping because it is seen as the cool thing to do, as a replacement for what smoking was back in the day, then I think that is a cause of real concern that needs to be looked at. Like the hon. Member for Harrow East, I really do see the benefits of vaping, but we have to tread with caution, because we are starting to see the next generation of vapers being created. I want all children to be not just smokefree but vape-free. As I said, children have no reason to vape.
In closing, can the Minister say whether she recognises our concern about the lack of a tobacco control plan; whether she recognises the need to do more in such a short period, because we are now only eight years away from 2030; and whether she will pledge to resume public awareness campaigns about smoking and start to get really serious, as I know she wants to be, about a smokefree 2030?
Javed Khan’s independent review is exceptionally welcome, but we need to know that his recommendations will not be brushed aside. The tobacco control plan, when it comes, must contain the bold measures needed to create a healthier and more resilient nation. I give the Minister my word that the Labour party is ready and waiting to support the Government on that. We will give her the backing she needs to drive through the necessary reforms in Parliament. We cannot afford to waste more time. The clock is ticking, and as each second passes a smokefree 2030 slips further from our grip. Let us take this opportunity to redouble our efforts, with support from across the House, to make a smokefree 2030 a reality.
It is a pleasure to serve under your chairmanship, Ms Nokes. I thank my hon. Friend the Member for Harrow East (Bob Blackman) and the hon. Member for City of Durham (Mary Kelly Foy) for securing this important debate. I wish my hon. Friend a very happy birthday—it is probably one of the best birthdays he has had, given that he has started his day this way.
I am grateful to all hon. Members for their participation. We debate smokefree 2030 regularly, which indicates how important it is. We are all passionate about making England smokefree by 2030, and the devolved authorities have the same passion. The personal circumstances expressed by my hon. Friend the Member for Harrow East no doubt drive his passion, and I am sure that the personal circumstances of other hon. Members drive their passion too. I appreciate the passion and dedication shown by Members from all parties, who work together to tackle the harms caused by smoking. I am pleased to update the House on our progress towards achieving the Government’s smokefree 2030 ambition.
Over the past 20 years, through successive and progressive policies, as the hon. Member for Denton and Reddish (Andrew Gwynne) indicated, and regulatory measures, we have made progress in reducing smoking rates. Smoking prevalence in England is now 13.5%—the lowest on record. That is a fantastic public health story, but there are still nearly 6 million smokers in this country.
Over the years, we have seen smoking in public places and all sorts of other things change under Labour and Conservative Governments. That reduction is a tremendous achievement, but in communities such as Stockton Town Centre ward in my constituency, smoking rates are still several times higher than that, and there are very high figures for smoking during pregnancy—way above the Government target. I hope the Minister recognises that, although we can cheer and say, “This is wonderful,” it is not wonderful in a lot of our communities.
I think the hon. Gentleman must have read the next page of my speech, because I was about to come on to that. He makes a really important point. As has been mentioned by the hon. Gentleman, my hon. Friend the Member for Harrow East and the hon. Member for East Londonderry (Mr Campbell), who is no longer in his place, smoking rates are far higher in poorer areas of the country, among those socioeconomic groups. We see smoking rates of 20% in more deprived areas, compared with 5% in wealthier areas, and nearly one in 10 pregnant women still smokes, which increases the risk of health problems for their baby. Smoking prevalence for people with long-term mental health conditions is over 25%, so the burden of tobacco harm is not shared equally.
We cannot let that continue, so the Government are committed to doing more. Over the past decade we have made significant steps towards making England smokefree—a bold and ambitious target that we committed to in 2019. We continue to enforce high taxation to reduce the affordability of tobacco. As part of the annual Budget process, Her Majesty’s Treasury will continue the policy of using tax to raise revenues and will encourage cessation by continuing with duty increases on tobacco products above the retail prices index. We continue to invest in local stop smoking services and our high-impact marketing campaigns such as Stoptober—I hear it is VApril this month.
Between 2010 and 2021, almost 5 million people set a quit date with stop smoking services, and 2.5 million reported quitting after four weeks. We continue to enforce a strong regulatory framework, and we have introduced policies such as smokefree legislation and standardised packaging. All these measures, and many more, have been instrumental in helping smokers to quit and protecting future generations from starting this lethal habit.
The Minister has spoken about the great progress that has been made in 11 years, but is it not about time that we started expecting the people who caused this problem to pay for the cost of further tobacco control measures and getting people off smoking? Is it not about time that the “polluter pays” principle is adopted?
If I may, I will come to that later in my speech, but the hon. Lady makes a very good point.
On top of the measures, the NHS has renewed its commitment to tobacco treatment through the NHS long-term plan, delivering NHS-funded tobacco treatment services to all in-patients, pregnant women and people accessing long-term mental health and learning disability services until 2024. The Government also continue to explore ways to move smokers away from smoking and towards alternative nicotine products such as vapes, as highlighted by the hon. Member for North Tyneside (Mary Glindon). We know that the best thing a smoker can do for their health is to quit smoking altogether, but we also know how hard that can be. It remains the Government’s goal to maximise the public health opportunities presented by vapes while ensuring that such products are not appealing to young people and non-smokers. The hon. Member for Denton and Reddish made a very good point on this issue in his speech, and it requires balanced and proportionate regulation.
Despite the progress made so far, the Government acknowledge that we need to go further to achieve our ambition to be smokefree by 2030, which is why the Secretary of State for Health and Social Care asked Javed Khan OBE to lead an independent review into tobacco control in January this year. The Khan review is expected to be published next month and will make a set of recommendations to the Government. The review has two objectives. The first is to identify the most impactful interventions to reduce the uptake of smoking, particularly among young people. The second is to identify how best to support smokers to quit, especially in deprived communities and among priority groups.
Mr Khan has met hon. Members from both the all-party parliamentary group on smoking and health and the all-party parliamentary group for vaping, and he has carefully considered their views and proposals. Quite a number of members of those APPGs have expressed their approval of that route and how Javed Khan is getting into the depth of everything. Once the review is published next month, the Government will consider its recommendations, which will help inform both the upcoming health disparities White Paper and the new tobacco control plan, to be published later this year.
I thank the Minister for her response to this issue, and what she is saying is very positive. I am ever mindful that Northern Ireland has the highest rate of deaths due to smoking. Health is a devolved matter, and we are 10 years behind the rest of the UK on achieving our goals. What discussions could the Minister have with the Northern Ireland Assembly, and particularly with the Health Minister, Robin Swann, to enable us to catch up and achieve the goals and targets that the Minister has referred to?
The hon. Gentleman makes a very good point. The hon. Member for Arfon (Hywel Williams) also mentioned discussions with the devolved nations, and I am very happy to have discussions with my counterparts in the devolved health authorities.
As we have heard from my hon. Friend the Member for Harrow East and others, many in this room are supportive of a “polluter pays” levy. As they will be aware, tobacco taxation is a matter for Her Majesty’s Treasury, and the tobacco industry is already required to make a significant contribution to public finances through tobacco duty, VAT and corporation tax. As part of the development of the tobacco control plan, the Department will also continue to explore and review with the Treasury the evidence base on the best options to raise funding in support of the Government’s ambition to be smokefree by 2030. As a number of Members asked, I am happy to meet the APPG to discuss funding matters and the levy in detail, while the Khan report is being published. I have met the APPG before and am happy to continue having those meetings.
Surely the Minister has not lost sight of the fact that the “polluter pays” levy is a levy and not a tax, and the Department of Health and Social Care can introduce it, as it has for the pharmaceutical industry. Will she give a further explanation of that, rather than just saying that it is a Treasury matter?
I fully appreciate the hon. Gentleman’s point. I enjoyed listening to his dissection of the issue, and I look forward to continuing discussions with the APPG.
The UK will continue its role as a global leader in tobacco control and remains fully committed to the World Health Organisation’s framework convention on tobacco control. The Department has received global recognition for its support of the official development assistance FCTC 2030 project over the past six years. This project helps low and middle-income countries improve their tobacco control and, ultimately, their population’s health. We will continue to support the project for a further three years under the current spending review settlement.
I turn to the questions raised during the debate. My hon. Friend the Member for Harrow East raised the point that the independent review is late. The review is on track to be published in advance of the health disparities White Paper, which it was set up to help inform, this summer. The review was originally intended to be published this month, so it is just a short delay that will not compromise the review’s impact.
The hon. Members for Stockton North (Alex Cunningham) and for Blaydon (Liz Twist) talked about smoking in pregnancy. The Department continues to explore options to support smoking cessation among pregnant women, which will be set out in our new tobacco control plan. Already, as part of the NHS long-term plan, we have made commitments for a new smokefree pregnancy pathway providing focused sessions and treatment to support expectant mothers and their partners to be smokefree. It is important that partners are involved.
The hon. Member for City of Durham mentioned the breaches of menthol regulations. The Office for Health Improvement and Disparities is investigating a range of cigarettes to determine whether the flavour is noticeable. Once that is complete, we will explore whether further action needs to be taken against companies who are in breach of the regulations.
My hon. Friend the Member for Harrow East and the hon. Member for Denton and Reddish talked about stop smoking services, which provide support to help smokers quit and are highly cost-effective. Local stop smoking services continue to offer smokers the best chance of quitting. They produce high quit rates of 59% after four weeks, and they have helped nearly 5 million people to quit since 2000. The services are a key part of the Government’s tobacco control strategy, and will remain so in the new tobacco control plan.
On any regulatory reforms the Government wish to take forward, we will review what legislative powers we have available to us, either through secondary legislation or exploring whether a Bill is required. I was asked why we rejected the tobacco amendments to the Health and Care Bill. We were grateful to Members for suggesting the amendments, which showed their strong support for tobacco control, but it is only right for my Department to fully consider the issues they raised—I am sure those issues will also be raised in Javed Khan’s report—before publishing the new tobacco control plan. We felt that was the right place for the suggestions made in debates on the Health and Care Bill.
I would like to reassure the hon. Member for Denton and Reddish that I am serious about making England smokefree by 2030, as is the Secretary of State. I thank the hon. Member for the support he and the Labour party have offered in the mission to make England smokefree. It is definitely a cross-party issue, and it is really good that we will all be able to work together.
The point about how we are supporting people with mental health conditions to cease smoking has been made a couple of times. The new universal smoking cessation offer is available through the NHS long-term plan for long-term users of specialist mental health services and people with learning disabilities. It is important that we tackle health inequalities brought about through mental health issues, and help those people to quit smoking as well.
I again thank hon. Members for securing the debate and for all their contributions to it. We have made good progress in reducing smoking rates, but the Government acknowledge that we need to go further to level up society and achieve a smokefree country by 2030. Later this year, we will publish a new tobacco control plan setting out how we will achieve our bold ambition. Working together across all parties, our mission is to make smoking a thing of the past and save future generations from the death and misery we all know it causes.
I thank everyone who has contributed to the debate, including the Front Benchers, and I thank my hon. Friend the Minister for her commitment, which we all share. We have to remember, however, that Professor Sir Richard Peto has pointed out that smoking has killed nearly 8 million people over the past 50 years in the UK alone. That is 400 a day, every day—far more than have died under covid. It is obviously something that can be prevented, but more importantly even than that, 2 million more people are expected to die over the next 20 years unless we get smoking rates down.
We all support the Javed Khan review, and we are looking forward to it. I understand that it is going to be published on 17 May. I can inform my hon. Friend the Minister that we will be calling for another debate on its recommendations and looking forward to a commitment from the Government that they will be implemented. However, the most important thing is that all those recommendations, whether they are on raising the age of sale, more tobacco control or licensing—we could go through all the options—will cost money to implement, which is why today we have concentrated on the levy.
I return to the central point that I made at the beginning of the debate: the difference between a levy and taxation that is imposed on the tobacco companies is that the companies just pass the costs of taxation on to the consumer, so they suffer no consequences whatsoever from it. Those companies would not be allowed to pass a levy on to the consumer; they would have to pay it out of their profits, making their product that kills people less profitable. Until we get to that stage, we are not going to have the money in the health service that is required to stop smoking—to encourage people to quit, and to encourage young people not to start. That is why we have concentrated on the levy today. I look forward to helping my hon. Friend the Minister in her arguments with the Treasury, if that is what we need to do to achieve that goal.
Question put and agreed to.
That this House has considered progress towards the Government’s smokefree 2030 ambition.
Future of Small Cities Following Covid-19
I beg to move,
That this House has considered the future of small cities following the covid-19 outbreak.
It is a pleasure to serve with you in the Chair, Ms Nokes. Let me start by saying that the pandemic clearly is not over—this debate is very much looking ahead. I am grateful for the opportunity to raise a huge subject, about small cities in general. I have a particular interest in Cambridge, my own small city, and in the future of the community that I represent and in which I live.
There are many things that could be said on this topic. I am conscious that it is a short debate and there are other Members who want to make a contribution. I therefore offer a warning to any watchers or readers: be aware that this will be a very narrow account, dealing particularly with issues of work and innovation. There is much more to be said on a whole range of issues, such as housing, fairness, mental health, transport, environmental sustainability, and air and water quality, but for today only, I will just touch on many of those issues.
The stimulus for this debate is the report by Cambridge Ahead entitled, “A New Era for the Cambridge Economy”. I pay tribute to the many Cambridge thinkers who have started the ball rolling on this discussion as we think about the world beyond the pandemic. I will mention in particular Jane Paterson-Todd and her team, Metro Dynamics, who were the lead authors, and the chair, Dr David Cleevely—there were many others.
The report sits in a wider framework. I have long felt that our goal as leaders should be to make Cambridge the best small city in the world. For me, when we are seeking to understand what that might look like, the idea of one city fair for all must be at its heart—social justice is essential. I am delighted that that runs as a golden thread throughout the report.
That goal will inevitably be delivered through the work of local leaders. I will name just a few: Councillor Anna Smith, the city council leader; Councillor Katie Thornburrow on the local plan; and Dr Nik Johnson, the Mayor of Cambridgeshire and Peterborough. I have named some of my Labour colleagues, but I well appreciate the work of many others within and beyond local government. Future success will only be achieved in partnership; I look to the Government, and the Department in particular, to work with us to find constructive ways forward.
Let me turn to some lessons from the pandemic. A leitmotif for many of us was, “You’re on mute!”—I think many of us will remember that for years to come—but the report picked up on many more things. When it was launched a few weeks ago, I could not help noticing that it was picked up in the national media, by the Daily Mail and The Times, and it was almost as if the only issue was whether people should go back to the workplace—that is an ongoing conversation in Government, as I understand it.
However, those reports missed the core point of the report; frankly, the paradigm has shifted and the world has changed. The question is how to adapt and turn that change to our advantage. Let us be clear that for many workers in Cambridge and elsewhere, there is no choice. The street cleaners, the cabbies, the bus drivers, the hospitality workers, the cleaners, the health workers, the lab workers, the manufacturing workers and many people in schools and universities did not have a choice—all those people had to be in their workplace all the way through the pandemic and will continue to be there.
The knowledge economy is different. In some ways, historically, Cambridge has evolved in a unique way to foster networking. Those who are familiar with the college system will know that it has its pluses and minuses, but one of the great bonuses is the sense of people being together and meeting in human-sized communities. When one looks at the way the science parks, innovation centres and networking organisations, such as Cambridge Network, Cambridge Ahead and Cambridge Angels, have grown up, along with many of the consultancies that have emerged in Cambridge, one can see that it is key that those opportunities for people to meet and discuss continue as they have in the past.
David Cleevely talks passionately about what he calls the serendipity of the chance meetings that so often lead to breakthrough ideas. I have lost count of the number of people who have told me they were padlocking their bicycles in Cambridge and a chance conversation led to an investment opportunity, a discussion or a new idea. Those moments—in other places they are the water-cooler moments; in Cambridge, they are the bike-locking moments—are crucial.
The report argues that policy makers need to understand how these changes will work for city economies, so that we can respond positively and take advantage of them. Our places must not only be resilient to the shocks of the future but evolve, adapt and mature through the process, taking the opportunity to do things better than they were done before. To achieve that, we must be on the front foot and experiment to help us understand what new demands we need to make of our cities, and how resources could and should provide for all.
Cambridge Ahead is a business-led and academic membership organisation. It has been looking at the structural changes that have occurred in Cambridge during and after the pandemic, looking at internationally competitive companies, and bringing together world-leading thinkers to identify the impacts of the pandemic and the opportunities it might present. Clearly, the report was produced through the lens of Cambridge, but I believe much can be learned for other great small cities across the UK. Cambridge Ahead concluded that the UK is on a new path and that the changes we are seeing are substantially changing the city’s dynamics in a number of ways. I will touch on three points.
First, transport patterns have altered. It is pretty clear that private vehicles are still being used in preference to public transport. Public transport numbers have recovered, but not to pre-covid levels. The timing of people’s journeys has also shifted. That offers both a threat and an opportunity. There is a danger of gridlock, frankly, but if we can spread the peaks and understand that road spaces are a precious commodity, there is an opportunity to do something differently—to develop active travel in a city the size of Cambridge. There is a genuine opportunity to shift to things such as electric bikes—I am a passionate user of an electric bike myself; they are ideal for small cities such as Cambridge—and reliable, affordable mass transit into and out of the city to make sure that those outside the city are not disadvantaged.
This is a time of real opportunity, but to realise it, we have to resolve the vexed issue of financing such a transition. I make no apology for referring the Minister to my very first speech in this place, back in 2015. Perhaps slightly unusually in a first speech, I talked about tax increment financing and how close Cambridge had come to securing a truly innovative deal a few years earlier, until the dead hand of the Treasury descended, as it so often does. It is time for the Government to look at that again.
Secondly, the demand for space is changing. Perhaps counterintuitively, demand for office space in Cambridge continues to grow, even though not everyone is back. The report details why that is: people want to maintain a space, and with social distancing and so on, we do not necessarily have people back together in quite the same way. At the same time, people are also working from home. The report concludes that it looks as if we are going to settle back at somewhere between three and four days a week in the office for most people, meaning one and a half days working at home.
That means that people are working in places that were never originally designed as workplaces, which raises some real challenges, not least the need to develop far more neighbourhoods—or quarters, as one might call them—with services nearby. Academics are talking widely about the 15-minute city. We need to do that and find a way to create it. We also need green spaces for people to be able to enjoy those new workplaces. That is a very big planning issue and there are many ways to address it, but I gently suggest—this might be slightly controversial at home—that for Cambridge, where many of our green spaces are locked behind college walls, sharing that space more equitably with citizens of our city should be high on the list for those who have the opportunity to make these decisions.
The hon. Member is making an excellent speech. As he said, I am a neighbour of his; I am the MP for the bit of Cambridge that is not in his constituency. I pay tribute to Cambridge Ahead, which does excellent work—this is an excellent report.
The hon. Member makes a lot of interesting points about the changing nature of Cambridge. I just want to highlight a couple of other things. You mentioned quite a range of workers who could not work from home, but I do not think you included laboratory workers. A lot of those who work for life sciences companies, particularly in my constituency, have to go into laboratories to work, and they often stayed there throughout the pandemic. You mentioned the shortage of office space—
I am sorry, Ms Nokes. The hon. Member mentioned the shortage of office space, but there is also a shortage of wet lab space that is constraining a lot of companies. Perhaps he is going to come to this, but the changing nature of the high street is also very important, not only in Cambridge but in some of the villages in my constituency, particularly because people are doing more online shopping and there is a changing demand. The report is excellent, and I pay tribute to its authors.
I am grateful for those contributions—they are all important. I mentioned lab workers in passing at the beginning, but the hon. Gentleman is absolutely right. The Cambridge economy is perhaps slightly different from other parts of the country, but many of these lessons, particularly those relating to reinventing the high street, will be key. The report picks up on the fact that a number of companies are looking at setting up work spaces in other areas, not necessarily in the city centre, so it is likely that there will be a different pattern to the way in which people work in future.
The third and final point that I will pull out from the report—this is, inevitably, a brief summary of a long, complicated report—is that the biggest thing for innovation in Cambridge is, as I have already hinted, how networks work and may change. New working patterns affect the frequency and manner in which we interact with people. There are generally many benefits to homeworking. At the document’s launch there was a discussion about our need—I think we can all appreciate this—for places where we are not being constantly interrupted and where we can think and work through ideas. Homeworking provides an opportunity for such a productive space, and it can clearly boost people’s quality of life.
However—and this is key for innovation—we still need to create moments of value where people come together. The report describes that as making “serendipitous encounters” happen—in other places, that could be the water cooler moment—which has been key to Cambridge’s success. Many people over many years have asked why Cambridge has done so well. This is one of the key understandings that we have learned over the years. We have to ensure that, in the transition to different working patterns, we do not lose that. To be frank, that is important not only for Cambridge. Cambridge is a key, significant driver not just of the regional economy but of the wider UK economy, so it is very important to the Government.
That is a brief summary of a much longer argument, but lessons can be pulled out for other small cities, too. Cambridge has a proud tradition of innovation and we could be an ideal test bed for new approaches. Our economy continues to grow and there are opportunities to observe, measure, experiment and learn. That will require selecting projects to monitor proactively, publish data and test ideas, so that other cities can benefit and share in the experience, with an emphasis on generating societal benefit for every community.
We are asking Government to work with Cambridge and perhaps other like-minded cities to take the work forward to the next step. I hope the Government will follow up on this discussion and agree to meet us to discuss the creation of what might be called a multi-disciplinary test bed: a framework for implementing experiments and studies, covering health, education, climate, retail, town and city centre offers, transport, housing, business models and the evolution of office and industrial space. Cities across the UK have different characteristics and face different challenges, and they will want to experiment in different ways. Of course, an experimental approach is not without risks. Some experiments will fail, but the vital thing is to have the mechanisms to monitor and learn.
In conclusion, our cities have changed substantially and will continue to do so. There will be no return to the way things were, so let us take action together to take advantage of these changes and give our cities the resilience they need to face the future.
Thank you, Ms Nokes. I am grateful for the opportunity to speak very briefly about the future of small cities. The key thing is that historically small cities have lost out from consolidation and regionalisation by both Government and the private sector.
Big cities have the advantages of size, but small cities such as Gloucester have an enormous amount to contribute. We have fantastic cathedrals and great sports clubs such as Gloucester Rugby. We are highly rated by the Centre for Cities research on patent applications and digital connectivity, and we have all sorts of diversity, including a primary school with more than 50 nationalities. All of that can lead to very vibrant cities.
The Government’s role is to help us achieve our goal to be the greenest small city—converting our recycling centre such that it will be able to produce solar, wind and hydrogen: green energy made in Gloucester—and to enable us to realise our dream of becoming the cyber-city and cyber-county, and also the nuclear county, with nuclear fusion bids, as well as a bid to host Great British Railways and all sorts of activity on the cyber front.
Will the Minister continue to be flexible on the best structure for local government? Our city council is important to us. Will he ensure that local government is given sensible funding to guard against cyber-attacks and hacking from Russia, and will he continue the great work on the levelling-up fund? We in turn will deliver one of Britain’s most exciting small cities and a model for others.
It is a pleasure to serve under your chairmanship, Ms Nokes. I congratulate the hon. Member for Cambridge (Daniel Zeichner) on securing a debate on an issue that matters to so many communities across this country. The future prospects of small cities and our future support for them are real, tangible things that people in this country care deeply about. I commend him for his ongoing interest and convicti-on.
It almost goes without saying that covid-19 changed the world as we knew it. I cannot think of any part of the country that went untouched. Although the virus was a doomsday event for the businesses that make up our high streets, its effects—the hon. Gentleman has highlighted this in the past—were not evenly distributed. For places such as university cities and tourism hotspots, the effects of the virus were particularly profound. The issues created by the shutdown of local economies and the temporary closure of high streets were massively exacerbated by having fewer students and tourists in the city. For cities such as Cambridge, Oxford or York, whose populations always swell in size during normal times, the loss of revenue was especially damaging. I know that the hon. Gentleman will have felt that pain acutely, as Cambridge usually attracts more than 8 million visitors a year, bringing in about £800 million and accounting for nearly a quarter of all employment in the city.
I firmly believe that the Government, thanks to the support from the Treasury, did everything possible to support cities and places to weather the storm. That included billions of pounds of covid loans, furlough support and money to local authorities to support their communities. Those economic lifelines helped to keep businesses going, keep people in jobs and, most importantly, keep people safe from the virus. But it is right, with covid almost, I hope, in the rear-view mirror, that we look beyond the pandemic and at the wider economic geography of this country.
Although the virus was a generational event, we do not need to be economists to recognise that wider issues plaguing many of our small cities and towns have long predated the pandemic, including a lack of opportunities and good-quality jobs, and life prospects diminished by areas being overlooked and undervalued. Places across the country with proud histories have seen generation after generation leave the area in search of a brighter future that did not feel was possible where they were.
We need only to look at the high streets in some of the small cities dotted around the UK to see that they have been taken for granted for too long. Even places such as Cambridge, which draws millions of tourists and thousands of students, and places with a rich cultural heritage have at times been like a jet plane powered by only one of its engines. It does not have to be that way.
The Government party stood on a manifesto that promised to end the status quo, delivering policies and plans to usher in new opportunities across the country. That means reviving the fortunes and transforming some of our much loved cities, big and small, creating vibrant places and communities where people want to live and work.
In February we launched, in our levelling-up White Paper, our blueprint for how we get there. It outlines a huge number of measures designed to close gaps in health, education and wealth between regions, and inequalities that disfigure this country, including those in the east of England. It draws together policies on education, transport, housing, research and development and many other areas of Government spending. It is a plan that sets out a clear, targeted and measurable approach to breathing fresh life into our cities and improving the lives of people across the UK.
People want to see buzzing high streets. My hon. Friend the Member for South Cambridgeshire (Anthony Browne) is right to raise the changing nature of many of our high streets and how we can tackle that. People want thriving local businesses and to see their children in good schools. They also want money to be invested back into things that strengthen the social fabric locally —from renovating the local theatre or museum, to constructing a neighbourhood community centre and preserving a centuries-old pub.
We believe that with the right approach—an approach that takes a long view and focuses on policies such as regeneration and proper devolution to local leaders—the results can be more money in the pockets of those people who need it most, more high-skilled jobs and more new investment attracted to an area.
May I draw the Minister’s attention to one aspect of Gloucester’s success with the levelling-up fund, which is the first ever conversion in this country of a department store into a university teaching campus? It will open in September 2023 and I hope he will have the chance to visit it one day. That is also an opportunity for other cities.
That is exactly the sort of innovation that we want to see in towns and cities all over the country, where people locally know what is best for their communities and of the existing opportunities, such as an empty building or area in need of redevelopment. Such local decision making will be key to ensuring that we maximise the potential for local communities. I thank my hon. Friend for raising that.
I also emphasise, as I have many times in the past, the moral imperative to level up the country. Levelling up is not about an arbitrary divide that starts just to the north of the Watford gap, and nor is it about a London versus everyone else divide; it is about breathing new life into, and offering a more prosperous future to, neglected areas across the country that have for years felt forgotten by Westminster. I assure every Member present that those places in the east—Cambridge, Peterborough, Luton, Bury St Edmunds—and those further afield, such as Gloucester, are just as central to our levelling-up ambitions as Sunderland, Darlington and Grimsby.
The hon. Member for Cambridge has said that while slogans come and go, we need a proper regional policy. I could not agree more. For our strategy to work, it has to be more than a slogan; it has to be something that people can really see and feel where they live. One of the central pillars, therefore, is regeneration, and I am delighted with the progress that we are making on that front. The towns fund of more than £3.6 billion is helping to create jobs and to build more resilient local communities and economies. Our investment of £2.4 billion through the town deals for 101 towns across England is giving them the tools they need to boost their local economy.
Hon. Members will have seen at first hand how that funding is supporting regeneration in the east of England. The region has received more than £287 million through our towns fund for several projects to support growth, regenerate public spaces, as the hon. Member for Cambridge mentioned, and improve transport. A fantastic example is the city of Peterborough, which will benefit from a range of new cultural facilities in the city centre, including a lakeside activity centre and the creation of new pedestrian links to improve access to the riverside and its green spaces, alongside the brand-new university opening its doors for the first time later this year. That is levelling up in action, and is just one of hundreds of examples.
We are soon to open the next round of our £4.8 billion levelling-up fund, and I encourage all smaller cities to get their bids in and to secure investment that will help to deliver on local priorities for the people they serve.
I was literally about to come on to the hon. Member’s point. For me and the Department, regeneration has a fundamental role to play in the levelling-up agenda. By bringing together the vast experience that exists in our private sector businesses, local authorities, developers and local communities, we can create vibrant cities and restore people’s pride in the places where they live.
The hon. Member mentioned the Cambridge Ahead report, and I loved his comment that his ambition is for Cambridge to be the best small city in the world. The Government are clear that, as I have said, levelling up means levelling up all over the country—and that, of course, includes Cambridge. He will understand that certain points he raised on education and transport are not in my Department’s remit. None the less, the values he raised from the report sound like they could be of value to our Department’s levelling-up mission. I particularly welcome the report’s recommendations for a more resilient city with well-designed, inclusive spaces. That will be a key element of some of the work we will be doing in the forthcoming months. I will ensure that this report is reviewed and taken into consideration by my Department as we consider the next steps from the levelling-up White Paper. More importantly, I am more than happy to ensure that officials meet people in Cambridge to discuss the report further.
I want to touch on another central theme of our levelling-up plans, and that is devolution. As part of our diagnosis of the challenges that areas are facing, we recognise that low-paid, low-productivity work is largely concentrated in areas that are disconnected from much bigger cities. We believe that one of the principal solutions should be levelling up by devolving down, with a proper revolution in how we approach local democracy—one that replicates some of the extraordinary successes that have come from the introduction of metro Mayors in places such as Teesside and the west midlands. We believe that that is a winning formula for giving back control to areas over their own destiny.
That kind of devolution is what will propel us beyond what Michael Heseltine termed “the traditional Whitehall solution” of
“throwing money at individual identified problems”.
Our approach will embody the Heseltine approach to devolution, where the focus is not based on north, south, east and west, but on devolving power to cities and devolving to towns. For the east of England, that process has already begun, with Norfolk and Suffolk among the first wave of areas being invited to discuss county deals.
I will finish by thanking the hon. Member for championing the cause of small cities and bringing the debate to us today. I hope I have laid out our vision for how we offer these places a positive vision for the post-covid era, with policies and initiatives that meet the urgent needs of the moment. Individually these policies would do little to transform the fortunes of any given place, but taken together our levelling-up plans, with new hospitals, new county deals, new 4G infrastructure investment and new powers for local leaders have the potential to lift up every single city and strengthen its social fabric.
Local government and local institutions worked with national Government throughout the pandemic to support people through one of the most challenging periods in the history of this country. We did that in the spirit of collaboration and with a desire to protect people from a deadly virus. I am certain that if we work together and apply the same spirit and zeal that we showed in that moment to levelling up our country, we can deliver on the things that matter to people. I know that all hon. Members present share the motivations behind that agenda, even if we may sometimes disagree on the precise means of getting there, and I look forward to working hand in hand with hon. Members present and on all sides of the political divide to make that a reality.
Question put and agreed to.
Future of Rail
[Sir Charles Walker in the Chair]
There are a lot of colleagues present. Some are on the speaking list and others are not. If you are hoping to get on the speaking list, I do not think you will have much success, but if Members keep their interventions short, there might be extra space. There will be three votes in about 10 to 15 minutes, and I shall suspend the sitting for 35 minutes to account for them.
I beg to move,
That this House has considered the future of rail.
It is a pleasure to serve with you in the Chair, Sir Charles. On 27 September 1825, as Stephenson’s Locomotion powered its way up out of Shildon towards Stockton, the eyes of the world marvelled at the height of British engineering. As we prepare for rail’s bicentenary against the backdrop of a different set of challenges, the excellence of British engineering can once again capture the imagination of what can be achieved and ignite a new transport revolution.
Sitting suspended for Divisions in the House.
Today, I will set out why consolidation and intersection with other forms of transport and energy technologies is essential if Britain is once again to lead the transport revolution, and why it is vital that the Government invest in this unique global rail supercluster for rail’s bicentenary. I am ambitious for rail and I am ambitious for Britain.
It will not be lost on anyone in this debate that York is where that revolution will occur. After all, York made the railways and the railways made York. The partnership between York University and Leeds University centres the future of digital and advanced rail, including the Institute for High Speed Rail and System Integration at Leeds University, bringing together the very best of transport, academia and digital technologies with the 13 leading rail education providers in the region, including the Institute of Technology at York College, which I visited recently.
We love our steam trains; whether it is the Mallard or the Flying Scotsman that fills people with greatest pride, our rail heritage is a natural draw for anyone across the network. Today, York has over 100 rail companies, which are at the forefront of engineering, operations, software development, timetabling and planning, providing over 5,500 of York’s top jobs and 9,500 jobs in the surrounding region, and consolidating York’s rail cluster, which is the largest outside London and now eager to take us forward once more.
I thank the right hon. Gentleman for his intervention. Where else can Great British Railways locate itself but in York if it is to level up the whole country? That really must be the argument we make.
The York Rail Innovation Community already oversees the intersection of rail businesses and innovations, enabling the northern rail economy to generate over £42 billion, according to the University of Leeds. It draws on the University of York’s Institute for Safe Autonomy, bringing new technologies and robotics together, and opening up a new conversation for the future of rail and the future of transportation, and modernising how we think about rail and transport. The institute’s £12 million programme leads global research to provide industry, regulators and researchers with guidance on assuring and regulating robotics and autonomous systems, including those on rail. York’s work is setting global standards and ensuring that such systems are safe.
Taking the search for answers into applied testbeds, such as the advanced rail test facilities, widens possibilities and the collaborations between York, Leeds, Sheffield, Huddersfield and Hull. This is not just a rail cluster, but a transport cluster. Interlink that with the new headquarters of Active Travel England, and we will have end-to-end connectivity and endless possibilities. Now that the Government are seeing such enthusiasm for BioYorkshire, Yorkshire’s green new deal and advancing a new generation of fuels, including links to the Teesside and Humber energy clusters, even more future technologies open up, with new innovations between transport and energy clusters.
The electric vehicle revolution is too slow, too expensive, with too little infrastructure and too few people engaged, and it is not sustainable enough. We need travelling by train to be competitive with travelling by road. Pricing matters. Rail advancement will be far more efficient, faster, cleaner and greener, if we are to decarbonise and claim the climate dividend to keep the target of 1.5 degrees alive. That must be our bicentenary challenge.
As a nation, there are significant challenges we need to address. Post pandemic, the trains need to see patronage restored and advanced, better timetabling and intermodal end-to-end connectivity, not least connectivity from main lines to improved branch lines, to consolidate opportunity. The very best industry expertise across the railways in York is ready to rise to the challenge. With fuel prices escalating, the Government must seize the moment to achieve a sustained and sustainable modal shift.
Although the integrated rail plan came as a bitter blow to us in Yorkshire, centring Great British Railways’ future on driving up patronage, accessibility, connectivity and reliability across the towns and cities of our region will address some of the Williams-Shapps plans. I know other colleagues will reinforce the point and urge the door not to be closed on our ambition.
I congratulate my hon. Friend on securing this important debate. Entire sections of the transport infrastructure, especially in the north, are just not up to the job. A good example is the Hull to Selby route. We have been begging and pleading for years for that rail line to be electrified. Does my hon. Friend agree that it is about time the Government got their finger out?
My hon. Friend is making an excellent speech. The problem in the north is much greater, because most of the north suffers from the situation identified by my hon. Friend the Member for Kingston upon Hull East (Karl Turner); we lose the economic benefits that would be brought by electrification. If the Government are serious in their levelling-up rhetoric, the people of the north need to see that. The Government need to take action.
My hon. Friend is right. I know his frustrations for Bradford, and the opportunity he wants to bring to his constituents and his city through greater connectivity.
The reason for this debate is to lift the sights of the Minister beyond York and Yorkshire, and beyond even our railway nation. The UK could once again take pride of place in marketing the very best in railway planning, operations and engineering globally. If we are looking for a reason for global Britain, the operational and engineering expertise grown in our rail cluster in York, mixing the intermodal intersections with the next generation of energy, could be globally marketable and transformative. Already students from 120 countries study in Yorkshire. Global companies already understand the power of what is happening in York. Bosch has just made a significant investment in the city, building partnerships and integrating with other high-tech initiatives. The Government must invest if we are to move forward over the next 200 years of rail.
York also stables the Network Rail trackside repair fleet. My recent visit to Holgate engineering works showed me how the most advanced trackside safety developments are being integrated into the fleet, with robotics, digital and high-end scanning equipment filling these yellow mechanical engines. That will give the UK the reputation for having the safest railway anywhere in the world. Again, that will be priceless when exporting our safety capability.
York’s Rail Operating Centre—the largest in the UK—has tech that mirrors that of a spaceship. Every inch of the network is mapped live, overseen and monitored across a series a sophisticated digital tools, which enhances rail operations. It is preparing us for the future, playing a key role in plans to introduce the next generation of digital signalling on the east coast and beyond. Network Rail’s training centre for professional development is already in the city and helping to take this revolution forward, with more than 1,000 Network Rail staff already working in York.
Every time I meet York’s engineers, excitement for the next development greets me. My thinking is transformed, my mind left marvelling. This is what we can do when we build a sustained rail cluster. When the network’s guiding mind is anchored and embedded in the midst of such developments, and the sparks of each rail entrepreneur are joined together, the future of our rail is set ablaze. That is why I am calling for investment for the rail bicentenary. The Minister will see its return.
As for freight—perhaps the most challenging but neglected area of the network—investment in innovation has never been more needed. High Speed 2 and Northern Powerhouse Rail were partially about freeing up track for freight. That argument got lost as the debate turned to speed and costs. Our freight capability is woeful. Now coal remains in the ground, and while the likes of Drax see biofuels slowly chug their way from Liverpool docks to Selby, investment is urgently needed to drive freight forward.
I thank my hon. Friend for her speech. She mentioned the port of Liverpool; trading goods through the port of Liverpool has expanded dramatically, but it has put far more freight into lorries in an area with some of the worst air quality in the country. The Government’s answer is to build another road, which will increase roadside emissions and go through a much-loved country park. Through her, may I make a plea to the Minister that it be reconsidered and that rail be seen as the option not just to address those short-term challenges, but because the long-term success of our freight transport depends on massive investment in rail?
To harness the opportunity provided by the bicentenary of British Rail, investment in the freight industry will be the gamechanger for our logistics and transport.
Those living in Kent are constantly reminded of the challenges of road haulage. However, the last couple of years have exposed the risks that the logistics industry is facing. Short-term fixes do not address the twin challenges of climate and workforce. As motorways turn into motels, a modal shift from road to rail for freight must be a priority. Cutting emissions, addressing the skills shortage and moving goods reliably is not only good for the climate, but better for business, which can become more dependable, meeting just-in-time demands that are essential in logistics. Moving goods from road to rail must be the rail cluster’s bicentenary challenge and the Minister’s focus. If we get the engineering, logistics, planning and operations right on freight, we can be confident of export demand for another product from global Britain: not just capability, but know-how, too. That is the prize for the industry.
The brilliant minds that serve our industry are the people who, at the height of the pandemic, got on our trains, repaired our tracks and advanced the network. Some, such as Belly Mujinga, gave their lives. We truly honour our transport workers and their unions—ASLEF, the National Union of Rail, Maritime and Transport Workers, the Transport Salaried Staffs’ Association and Unite—who have worked tirelessly to keep staff and us safe, and to keep people in work.
We have difficult months ahead, but the Government must guarantee job security and good wages as staff work to rebuild the future of the industry to be even better than before. We need to enable all—from the station porter and train cleaner, to ticket office staff, trackside engineers, operators, designers, controllers, electricians and train drivers—to know that they are valued in our rail family, as they keep us safe and take our industry forward. Although consolidation of York’s rail cluster will level up our city, address the low-wage economy and accelerate inward investment for York and the region, it is what York’s rail cluster can deliver for levelling up across the whole country that excites our city the most. We believe that can be achieved only if Great British Railways is anchored in York and if investment in the sector’s research and development powers that opportunity.
York has the very best of our rail past and present, but in politics we cannot change the past; it is the future that is placed in our hands. I look at the girls and boys in my city, who are all mesmerised by our rail story. The National Rail Museum’s new galleries will give them the first taste of rail engineering and spark their ambition to be the planners, operators and engineers of the future as they embark on their science, technology, engineering and maths journey. Our collective ambition will realise the potential power of York’s rail intersectional clusters to deliver the very best rail future—all delivered on the site of the old British Rail carriage works, adjacent to just about the best-connected station in the country.
Great British Railways will be no add-on in York; it will anchor Britain’s rail future, ignite Britain’s rail ambition and deliver the next chapter of our Great British Railways revolution like no other place can. The bicentenary of rail gives the Minister the opportunity to invest in the future of passenger and freight. That will be the pride of my city, and that is our offer to the future of rail.
It is always a pleasure to serve under your chairmanship, Sir Charles.
I congratulate the hon. Member for York Central (Rachael Maskell) on securing this debate. She spoke very well about why the headquarters of Great British Railways should be located in York, and about the opportunities that transport investment delivers for levelling up and decarbonising for the future. I want to support that argument.
Lots of Members will put forward the case for their areas. Some of those cases are, quite frankly, a bit on the thin side. I understand why they are doing it, but I believe that the correct way to approach this question is to look at the criteria that the decision makers in this competition have set.
Let me start by suggesting what the challenges for rail are, and how they influence what Great British Railways needs. The rail industry is a huge success. The pre-pandemic data, which I use for obvious reasons, tells us that it had 1.8 billion passenger journeys per year and 140,000-plus services per week—more than ever before. The question for Ministers and the industry is how to cope with the growth. The answer has been, through a variety of mechanisms, to increase capacity with new lines, improve existing lines, and provide new rolling stock and better signalling. The pandemic has clearly changed things, and it is too early to see how the trends will settle, but we can see that demand is returning already, although the commuting sector is still weak. The long-term problems have not gone away, and Great British Railways will need to address them.
The Government have published six criteria for judging the bids, and a critical element is the opportunity for Great British Railways. That is the third of the listed criteria, and I will focus on it for a few moments. It is against that criterion that York emerges head and shoulders above the others as the strongest bid. The question is: how do we deliver the future? The digital signalling, the planning of line enhancements, the new systems of power to drive the industry as the sector decarbonises, the expertise, the skills, the wider rail ecosystem with companies based in York and beyond in Yorkshire, the partnerships with academic institutions—they are all in place in York now, ready to be expanded and play a greater role.
Let me give one small example. The UK has been developing a series of rail operating centres—12 in total—that will control all the country’s signalling. They have been operating for some years and have taken on more services over time. York hosts one now, and it is in fact the largest of them all. It was part of a Network Rail campus, and it includes a workforce development centre, so York is already at the heart of the digital rail future.
The other criteria against which the bids will be judged are again met by the qualities of York: connectivity north-south and east-west is excellent; it is centrally located, half way between London and Edinburgh; the railway heritage is obviously second to none; and it hosts one of the major rail museums of the world. I know that the Science Museum Group has already made an important representation to the Minister in the bid process in favour of York. Public support has been demonstrated by the work undertaken locally by political representatives, not least in this debate. York is Yorkshire’s choice.
The hon. Member for York Central did not mention that in Yorkshire we are famous for liking value. [Interruption.] That is not really a joke, but a truth. We are famous for liking value, and with the York Central development we have an enterprise zone, with much of the land already in Network Rail ownership, so there is a ready-made value solution.
The last criterion is levelling up. Some of the most left-behind communities in the country are within a short journey time from York. The halo effect, building upon the current cluster, would have the positive effect of providing opportunity across these communities. Looking at the criteria as a whole and seeing what York can deliver, I see the York bid as being head and shoulders above the others, which is why I support it. I am grateful for the opportunity to share my views this afternoon and to support this bid.
It is a pleasure to serve under your chairship, Sir Charles, and to take part in this debate. I congratulate my good friend, my hon. Friend the Member for York Central (Rachael Maskell), on securing the debate.
We hear a lot from the Government about the decarbonisation agenda, and it is important to highlight that we can cut congestion on the road, as well as noise and air pollution, by investing in good quality public transport across the country. My constituency of Stockport is in Greater Manchester, and unfortunately the rail capacity through Stockport is currently insufficient to operate any extra services. The rail network around Stockport and south Manchester is among the most congested in the country. The Government have to address that issue to ensure that decades of under-investment is reversed and that people in my constituency and across Greater Manchester get good quality public transport options.
I associate myself with the comments that my hon. Friend the Member for York Central made about transport workers and transport unions. They do a really good job in difficult circumstances. The pandemic has not been easy for any of us, but people in that sector do a very important job with long hours and low pay, and we are grateful to them.
Two businesses based in my constituency provide services to the rail industry: Sella Controls, in Manor ward, which I visited last year, and Lundy Projects, a few minutes’ walk from my constituency office, which I visited only a few days ago. Rail electrification has to go far beyond the Government’s current ambition. Lundy Projects is a specialist company that focuses on signalling and electrification. I want to see more skilled, well-paid, unionised jobs in my constituency, and the Government should come forward with investment.
In Manchester, Mayor Andy Burnham is doing a very good job with the Bee Network, which integrates walking, cycling, trams and buses into integrated systems similar to those in London. It is a long time coming, because people in my constituency in Greater Manchester have suffered from a disintegrated public transport system at very high cost, so bus franchising is a good move. I will not go into that too much because we are here to talk about trains. We all love trains, so I will stick to trains rather than going on about buses.
I will come to a conclusion in just over a minute, but I thank two groups in my constituency: the Friends of Heaton Chapel Station, who visited me last week in the Palace of Westminster and who I was pleased to give a tour to, and the Friends of Davenport Station. The platforms at both stations lack tactile safety tiles, which is a serious issue. Unfortunately, we recently had a fatality on the railway network. The Government must come up with a timetable to ensure that all train stations have that provision, so that people with disabilities or visual impairments are not injured.
There are four stations in my constituency, but the main Stockport station on the mainline to Birmingham, London and Manchester, is not in a good shape. Platforms often flood, the roof leaks and the lift is often broken, which makes staff members’ lives difficult as well as creating discomfort and inconvenience for passengers. We need a significant capital investment in the station, so I hope the Minister will address those issues at Stockport train station.
Finally, the Greek Street bridge has come to the end of its life and needs to be replaced. We need a new bridge that will safeguard the future of the Metrolink tram system coming into Stockport, which provides better integration with Manchester and wider areas. I could go on, but I will leave it there, Sir Charles. I hope the Minister will address these issues.
It is a pleasure to speak in this debate, Sir Charles. I thank the hon. Member for York Central (Rachael Maskell) for bringing forward this important debate. I will confine my remarks to supporting York’s bid, as others have, for the Great British Rail headquarters. My constituency is a little further north of York, but will nevertheless form part of the new York city region, which we are all very excited about in our neck of the woods. We will see an elected mayor for the region in 2024. Economic development is a key part of that role and what elected mayors are all about.
I am a little parochial in making my arguments, of course. Other people will obviously make their very good cases for other places, be it Derby, Darlington or wherever else, but I feel that York is the best option. I have been keen to support other cases for other investments in other parts of Yorkshire and further afield. I am very keen for us to look again at Northern Powerhouse Rail having a proper independent line between Leeds and Bradford through to Manchester. That would transform the economy in Bradford.
I am very happy to support the cases of other areas where they make sense, but the York case makes so much sense. It makes sense primarily, as the hon. Member for York Central said, in terms of the proven economic effect, called the cluster effect, which is huge. We only have to look down the road at the City of London to see how important the cluster effect is for economics. It works on the basis of three important fundamentals: it enhances productivity and brings forward innovation, and a huge amount of new business is created in the supply chain and direct supply into the particular cluster.
It is very important that, when we talk about moving jobs out of London and potentially into our regions, we do not put them just anywhere, so that we can say we are levelling up and distributing those jobs around. We have to put them in the right place, because after all, as my hon. Friend the Member for Harrogate and Knaresborough (Andrew Jones) said, we need to make sure that the money spent represents good value.
The cluster effect will mean there is enhanced value by putting these jobs near to other jobs and other businesses that specialise in those areas, so that we get the productivity benefit. Clearly, if people can walk across a street to talk to somebody about a certain innovation, or if they work together on an innovation, that is hugely important. The businesses that are created are on wonderful sites, such as the brownfield sites of York central, which is a wonderful opportunity for an entire city and region.
Some 5,500 people work in the rail industry in York: engineers and skilled people, clearly consultants and people involved in the new digital world of rail. Some 10% of UK workforce work in York, so it is pretty compelling. Again, the heritage has been mentioned by others. People recognise York as the nation’s capital when it comes to rail, and we are of course proud to host the wonderful National Railway Museum.
The city is hugely well connected. It is connected directly to one third of UK stations. The wonderful thing is that when the public across Yorkshire were asked the best place to put the headquarters of Great British Rail, six out of 10 said it should be York—three times the number that said any other location. Let us support the #yestoyork campaign and make sure the headquarters of Great British Rail come to York.
Ealing and Acton would not be here without the railways. Both have stations underground, overground—not wombling free—east, west, south, broadway, common, central. They are in “that there London”, so people might be thinking, “You’re all right, Jack,” but I want to counter this misperception that has grown up around the Government’s levelling up rhetoric. It is in the suburbs of London that we feel this most acutely. Our trains are full and getting fuller, fares are rising faster than wages, and west London, the sub-region with Heathrow, is a key driver of our national economy, but it needs transport fit for purpose, not just to and from central London but between the suburban bits.
An obvious solution would be breathing life into the old Beeching line, the west London orbital. There is Ealing, the centre of west London, and to the north Brent Cross, with lots of jobs, and to the south, Brentford, but good luck to anyone trying to get between any of those three. There is the super-development opportunity area of Old Oak, which has promised 24,000 dwellings and jobs, jobs, jobs. Again, this proposal could link them all, but there is no chance in sight, because the Government will not commit long-term funding to TfL.
Instead, we have the ignominious situation of cap-in-hand, eleventh-hour settlements, being marched to the top of the hill and down again. We are pretty much the only capital city on earth—I am not counting Singapore—where there is no central Government subsidy. We need reliability, predictability and all those things. When the current Prime Minister was Mayor of London, he was bequeathed a load of goodies from his Labour predecessor: the bikes that bear his name, the TfL rail Overground—it used to be quite scary when it was the Silverlink; it is brilliant now—the DLR extension and bus investment. But for Sadiq Khan—bless his cotton socks—the cupboard is bare.
I congratulate the hon. Member for York Central (Rachael Maskell) on securing the debate. I have been listening intently to what the hon. Member for Ealing Central and Acton (Dr Huq) said about the finances for TfL. Does she agree that if the National Union of Rail, Maritime and Transport did not strike so often in London and bring the whole of London to a standstill, the TfL finances might be in a better position?
The hon. Gentleman is falling into the Tory trope of union bashing. I am a proud trade unionist, and the unions are there to better the conditions of their members. We do not want exploitation, do we? Is he going to be shoving kids up chimneys next? I fear the track he is going down. This issue is a bit of a smoke screen. We need long-term funding and a dependable model for London, which we used to have. Every other London Mayor had that, but in 2016 George Osborne suddenly cut the support grant. I think that had something to do with the complexion of City Hall, but—[Interruption.] I am not going to give way, because I do not get any extra time.
With covid giving way to a cost of living crisis, what did we see from the Chancellor? A cut in fuel duty and a 3.8% rise in fares, and I am not counting that gimmicky video—that thing, whatever it was—about the 1% of journeys where someone can get a cheap fare, going to the right place on the right day. That is not going to affect any of my constituents.
Meanwhile, we can only marvel at what they are doing outre-Manche in the rest of Europe. Look at Austria’s climate ticket. In Germany, there is a €9 a month regional transport ticket. In this country, no one between 25 and 65, which is probably most of the people here, is eligible for a national railcard, which is available elsewhere. I urge the Minister to look at something like that.
In conclusion, the future of rail should include projects that complete vaguely on time. I have an Oyster card holder that says, “Crossrail—new for 2018”. Ha! The future of rail would have considerate construction. HS2 goes through my seat and has made life a misery for the residents of Wells House Road, NW10. The future of rail would also have a visionary Government that could think long term, rather than say, “It’s all Sadiq Khan’s fault,” any time a London MP stands up to say anything, when we know that our London Mayor is doing a fantastic job against the odds. The country cannot be levelled up by levelling down London. The new Piccadilly line trains, due in 2025, are being built in Yorkshire. Level up London and the whole country benefits. Let us get Ealing, Acton and Chiswick back on the rails. Now that’s what I really call levelling up.
Thank you for calling me, Sir Charles. Well, with three minutes I will just get to the point, if I may.
I appreciate the comments of the hon. Member for Ealing Central and Acton (Dr Huq). I should just say that the RMT does not quite agree with her about the London Mayor. I respectfully make that point, because the RMT has itself said that it is the London Mayor who is causing the logjam, and ultimately that has a considerable impact on the finances available. I represent a constituency that I am afraid has a three-hourly train service frequency, and when I see Transport for London getting such considerable amounts of money, it is a matter of great concern to me. That is money going to support the good people of London, rather than to support the Heart of Wessex line. I know that my hon. Friend the Minister is well aware of my strong views on that point.
I will move on to the future of rail. I spent 20 years working for the railways before being elected to Parliament. I am not sure whether there are any Opposition Members present who used to be members of the RMT. I was once a member and should give it a big shout-out for its policy briefing, which was very interesting and for which I am grateful. The railways are very important for the future of this country. I appreciate that lots of people have strong views on where the new GB Railways HQ should be, although personally I do not think that will make much of a difference to the future capability of the railway; what will make an enormous difference is where the Government look to invest. The Government have supported the railway to the tune of £14 billion during the worst time of the pandemic. They have kept thousands of people in jobs, and they have done so to ensure that the future of our railways is extremely good and supports the future of our country.
It is really important that we also consider the wider things that the railways have to change going forward. The railways have been marvellous in lots of ways, but the fact that it can take 12 months to change a timetable is not acceptable in the current day and age. Why is it that we have a timetable that is the same on a Monday as it is on a Friday, when we know that the demands are very different? There are fundamental changes that need to happen in order for our railways to excel.
I am conscious of time and am grateful for the opportunity to speak in this debate. As a final point, it is really important that we remember it is not all about the cities; it is about connecting the rural areas as well—areas such as West Dorset and other parts of the country that would greatly benefit from that in the future.
It is a pleasure to see you in the Chair, Sir Charles. I thank my hon. Friend the Member for York Central (Rachael Maskell) for introducing the debate. I am also pleased to see my hon. Friend the Member for City of Chester (Christian Matheson) here, because I want to talk about the journeys that we used to take together when we were first elected in 2015. Those hourly direct services from Chester to London have all gone during the pandemic and are yet to return. I understand that we are due to get some back next month, but not all of them will be restored. I have to ask the Minister, why are we waiting longer than everyone else to get a lesser service restored? Who is accountable for that decision? Will we ever get back to what we had before? What evidence are those decisions based on?
Those questions are important because the Department is also planning to award a new 10-year franchise to run the line later in the year. How can decisions be properly made on future service provision when the service is not yet back to pre-pandemic levels? What evidence base will the Department be working on for that decision? There needs to be a crystal-clear commitment that the new franchise will restore hourly direct services from Chester to London. I would like the Minister, when she responds, to say that is exactly what will happen. If she cannot do that, will she at least meet me and my hon. Friend the Member for City of Chester to discuss what we would like to see in the new 10-year deal?
We cannot continue to have decisions made about our rail services without reference to Members in this place and our communities. I have suggested to Avanti already that if it does not want to run the service at the previous level, it should not only not bid on the current franchise but give the current one up. I am due to meet Avanti on Friday, and I will be interested to hear what it has to say. In the meantime, I hope that we have the Department’s support in restoring services to pre-pandemic levels.
Perhaps when I meet Avanti I will be told that it has been unable to restore services because of a lack of demand. Of course, if it does not put the services on, we do not know what the demand is. It may be the case that a huge increase in home working as a result of the pandemic has affected travel patterns, but I would not be surprised if there were other issues at play. If there is a feeling that businesses are using rail less, perhaps the answer may lie in the eye-watering costs attached to such travel.
Let us look at journeys of a similar distance between cities in England, Germany and France: Chester to London is 165 miles; Hamburg to Berlin is 159 miles; and Calais to Paris is 147 miles. The cost of a single rail ticket for the morning to arrive by 9 am for each of those journeys tells its own story: Hamburg to Berlin is £26; Calais to Paris is £39; and Chester to London is £155. Travelling from Chester to London costs nearly six times more than a similar journey in Germany and nearly four times more than a similar journey in France. In fact, I can get to Sharm el-Sheikh in Egypt or to Tel Aviv in Israel for less money than it costs me to get to London by train before 9 am, so I can actually get to another continent for less money. Therefore, if we are going to do something about rail travel in future, let us make it affordable for everyone.
It is an honour to serve under your chairmanship, Sir Charles. I congratulate the hon. Member for York Central (Rachael Maskell) on securing the debate.
This debate is about the future of rail, but understandably the question on everyone’s mind at the moment is which of our towns or cities will be given the huge honour of hosting the public body tasked with delivering that future. Right hon. and hon. Members will not be surprised to hear that I very much support what the hon. Member for York Central has set out, and what my hon. Friends the Members for Harrogate and Knaresborough (Andrew Jones) and for Thirsk and Malton (Kevin Hollinrake) have set out. There is also support from other north Yorkshire MPs.
Members have previously heard me set out at length why I think York is the best site for Great British Railways, but in the short time available I will briefly reiterate what I consider to be the main points in support of York’s strong case. First, there are York’s existing Network Rail facilities, strong connectivity and rail heritage, as well as the availability of a range of convenient city-centre sites. That last point has already been touched on, but the York central site stands out proud in terms of what it can deliver. It is also shovel-ready—it is ready to go—and that must add huge weight to York’s bid.
Secondly, York has a skilled workforce, which accounts for over 10% of the national rail industry’s workforce, and it is also situated at the centre of the north-east Yorkshire rail cluster, which is the largest in the UK.
Thirdly, York has leading status in training and innovation, which has been driven by local businesses, colleges and universities. I could add so much more to this point, but I cannot do so in the brief time available, although I know that other Members have already touched on it.
Fourthly, York’s position at the heart of the UK rail network makes it an ideal national administrative base. Moreover, York would potentially contribute to the Government’s goals of strengthening the Union and levelling up in the north of England, based on York’s strong links to Scotland, the north-east, Manchester and all parts of Yorkshire.
Yorkshire and, in particular, York have not only a proud rail history but a vital role to play in the future, by leading the way in developing new technologies and providing new skills that will revolutionise rail travel in York. For me, the case for York’s bid is absolutely overwhelming, and I am proud to be supporting it here today. I am also proud to support Members from across our region in supporting York’s case, and I very much look forward to learning how the Government will take this matter forward.
It is a pleasure to serve under your chairmanship, Sir Charles, and I thank my hon. Friend the Member for York Central (Rachael Maskell) for securing this important debate.
It has been a year since East West Rail gave the devastating news to my constituents that their homes and land were at risk, but it was only this week that they have received letters from EWR to inform them that they “may be” affected or “probably” will be affected by the scheme. The letters arrived after months of pushing for them from my office and from councillors in the impacted wards, during which time we pleaded with EWR and the DFT to be much more open and honest about where my residents stand and what their options are, whatever the outcome of the scheme.
Communications from the Government and EWR—whether on the consultation or on answering the many questions my constituents have about the project, such as its environmental impact—have been deplorable from day one. Both the Government and EWR have been happy to allow local representatives, who have no real influence on or knowledge of the plans, to take the flak and try to fill a void where their information and transparency should have been.
The consultation response, which was due in March, has been delayed, so we are still none the wiser; we cannot even be sure whether the project will go ahead. I do not know why the Government will still not commit to electrifying the line from day one, given their net zero targets.
I want to explain the cost of dither and delay for my constituents. Residents have written to me in distress at being in limbo. One describes her home as feeling like a prison. People cannot make plans. They do not know whether to make home improvements, or whether they will even have a home. They fear the loss of their community. Many worry that they may not be able to move house. This situation is taking its toll on people’s mental health and wellbeing.
The uncertainty cannot go on. The Government are now in the process of reviewing the strategic and economic case. In my view, the only thing the Government are assessing is whether they will risk running a train line through the Tory shires before the next general election. If the Government are minded to U-turn on their plans, I urge them to level up with the public about what is going on. What I see is East West Rail forging ahead with meetings and mailouts, and a Government in reverse.
If the Department for Transport is to proceed with the investment, it needs to bring the proposals forward immediately, so that the public understand what they are dealing with. The Rail Minister will be aware that I was broadly in favour of the fantastic connectivity and investment opportunities that a green rail link between Oxford and Cambridge would bring to the people of Bedford, but not at any cost.
It is a pleasure to serve under your chairship, Sir Charles. I congratulate my hon. Friend the Member for York Central (Rachael Maskell) on securing today’s debate. I agree that rail and our wider public transport network are essential to tackling the climate crisis and meeting our net zero commitment, but we do not have a Government willing to drive a transformative strategy that encourages more people to travel by train.
In the midst of a cost of living crisis, the Government decided to increase rail fares by a brutal 3.8%. Average fares have now risen by 48.9% more than in 2010—that is twice as fast as wages. In my constituency of Luton South, that means commuters to London now pay £4,717 for a season ticket, an increase of 46% since 2010. The Government’s short-term “Great British Rail Sale” does not scratch the surface of tackling the broken system of overpriced fares. A flash sale is not a strategy. My constituents and our country have suffered 12 years of rail mismanagement and under-investment.
I am here to say, again, that Luton station is not fit for purpose. The patching up of roof leaks, licks of paint and basic renovations are not sufficient to provide people in Luton with the modern-day train station they deserve. Accessibility remains a major issue. Disabled and elderly people and young families are marginalised, as there are no lifts to four out of five platforms.
The long-awaited Access for All funding for lifts at the station is welcome, although I understand that works will not be completed until early 2024. Luton needs a comprehensive station revamp in line with our town’s modern 21st century ambitions. Will the Minister explain whether additional capital funding will be allocated to redeveloping town train stations such as Luton as part of the Government delivering on their levelling-up commitments?
I echo the comments of my hon. Friend the Member for York Central on the importance of rail unions. Long-term rail reform must have the interests of rail workers at its heart. I send my solidarity to RMT members who are opposing pay freezes, threats to their jobs and attacks on their terms and conditions. Staff are not being properly rewarded. Commuters are not getting value for money and the public are not getting a plan that helps tackle the climate crisis.
It does not have to be this way. For every pound spent on rail, £2.50 is generated for the wider economy. There are European comparisons, too, with cheaper journeys, punctual trains and publicly-owned railways. European state-owned companies are making profits delivering our rail services. Essentially, British taxpayers are subsidising European countries’ rail services. That is absurd. We know the benefits that UK-owned East Coast and London North Eastern Railway have delivered to the Treasury. Reform of rail cannot come soon enough. We need accessible, affordable and better connected railways that work for passengers, our community and rail workers.
It is a pleasure to appear before you, Sir Charles. I thank my hon. Friend the Member for York Central (Rachael Maskell) for introducing this debate on the future of rail. I say, “What future?”
Many of the problems with rail can be traced back to 1993, when British Rail was privatised into more than 100 separate companies under the Conservative Government. It was supposed to bring greater efficiency and innovation. Instead, it brought fragmentation, confusion and extortionate fare increases.
In 2018, the Government finally admitted that privatisation was not working when the east coast franchise collapsed and was taken into public ownership. It is now making profit. Instead of doing the right thing, putting passengers before profit, and bringing our rail franchises back into full public ownership, the Government are now proposing a joint system under which taxpayers will continue to pay hundreds of millions of pounds in profit to rail companies to run the network. It is unacceptable.
For years I have had constituents write to me about the impact of daily overcrowded trains and infrequent, unreliable train services. They have lost jobs, missed lectures and medical appointments, and in some cases have been sanctioned by the Department for Work and Pensions for arriving late to their appointment. The cost to commuters has grown by 50% in the past 12 years of Tory government, and Transport for London is now facing a 40% loss of its core funding.
In January, a report was published on behalf of the Minister’s Department that said that only major Government funding would solve the accessibility problems at stations across the country. One of the rail operators interviewed said that 60% of stations lacked step-free access from street level to the platforms. Just last month, elderly constituents from Farnworth in my constituency were returning from a holiday and took a train from Manchester airport to Bolton with heavy luggage. When they got to Bolton, the station lift was not working. What were they supposed to do? Another woman behind them was carrying a pram.
We know from reports that ticket offices are set to close across the country. That will impact those who need face-to-face services, such as the elderly, the disabled, pregnant women and other people. What will happen to them, especially if trains are not running at night?
We were told that there was going to be an integrated plan on infrastructure for the north, which was then scrapped. For a whole year, I sat on the High Speed Rail (London - West Midlands) Bill Committee. We had seven sessions a week. HS2 will run from London to Birmingham, and we were told that there would be a continuation of the line to Manchester and Leeds, but that integrated rail plan has now been scrapped. It is wrong. We need transport infrastructure in the north. We also need proper train services connecting the east and west along the M62 corridor—
If William Gladstone, when he was Prime Minister in the 1880s, had organised a debate such as this on the future of the railways and came back today, I imagine he would be shocked. The UK was the great industrial powerhouse, and he would have expected the railways to have improved. However, as the Transport Committee found when it looked at regional railways, the timetables are slower than they were in Gladstone’s time.
There are three primary reasons for that. First, the over-application of public sector borrowing requirements starved the railways of investment for decades. Secondly, as my hon. Friend the Member for Bolton South East (Yasmin Qureshi) said, there was the privatisation of the railways. The railways were under-sold—the National Audit Office recognised that they had been massively sold at a loss. They were then prey to unregulated rolling stock companies, which hired trains at massive profits. Thirdly, Railtrack—the people running the railways—decided it was a property company, not a railway company, and killed people. That is what privatisation did.
Now the Government are showing some faith in the future, and we are going back to a similar structure to British Rail, but we need integration. The hon. Member for West Dorset (Chris Loder) said that we could have different timetables every day of the week. Privatisation meant that when people sat down to work out timetables, there were about five times as many people as there were under British Rail. It was inefficient.
I have three quick points. We need investment in the pinch points in the rail system. In Manchester’s case, we need platforms 14 and 15 at Piccadilly station, which would help the whole of the north of England. We need HS2. My hon. Friend the Member for Bolton South East correctly pointed out that HS2 should benefit the whole of the north of England. In fact, it should go to Scotland. HS2 should be the backbone of our rail system.
Finally, a point that everybody else has made, although it is not necessarily about the future of the railways: the site of the Manchester Exchange Station in Salford, which had the longest platform in the world, going to Victoria Station, should be the home of GBR. This was the home of the first scheduled passenger rail service between Manchester and Liverpool.
I congratulate my hon. Friend the Member for York Central (Rachael Maskell) on securing this important debate.
The climate emergency really does require that we change the way we travel. Radical and urgent action is needed, as well as a transformative plan to switch to more sustainable forms of transport and at the same time create new and innovative jobs for our workforce. As in other parts of the country, rail plays a pivotal role in Wales as a public transport network, with millions of passengers dependent on rail for commuting and leisure. It is a critical asset and must have a greater role in Wales if it is to achieve an integrated, intersectional, accessible, affordable, efficient and sustainable transport system that meets the needs of the present while protecting the ability of future generations to meet their own needs. The Welsh Government have set out an ambitious vision for transport in Wales, as set out in their strategy, Llwybr Newydd.
As in other parts of the country, Wales faces many challenges—similar challenges to the rest of the United Kingdom. When he was Cabinet Secretary for Economy and Transport, Ken Skates, Member of the Senedd, said that rail delivery in Wales was “complex, fragmented and underfunded.” In Wales, the rail service continues to suffer from infrequent services, unreliable infrastructure and indirect routes. Only last year the Welsh Affairs Committee, on which I sit, published a report on rail in Wales that exposed a raft of issues: performance issues, poor service experience, inadequate stations, the cost, infrequency, accessibility and low standards. There is an urgent need for the network in Wales, as in the rest of the UK, to be upgraded.
I want to focus on three priorities for Wales. Again, these apply to the rest of the UK. First is bringing rail back into public ownership. In 2020, the Welsh Government decided to take the Wales and Borders rail franchise into public ownership in order to protect services, safeguard jobs and deliver infrastructure improvements, particularly in light of the ongoing challenges associated with covid. Second is fully devolved rail in Wales. In the words of the Welsh Government:
“Rail devolution is essential for us to deliver the comprehensive, integrated, and efficient transport network needed across Wales”.
Finally, we need a fair funding settlement to improve rail networks in Wales. HS2 should be reclassified as an England-only project. That would provide Wales, through the Barnett formula, with around £5 billion—not million—to spend on rail infrastructure in Wales. We are taking a llwybr newydd—a new path. We have set out a new way of thinking that places people and climate at the centre of our transport system so that we can deliver a transport system for the whole of Wales, but we need action by Westminster as well, and action needs to happen now. Diolch yn fawr.
I hear you, Sir Charles. It is a privilege to serve under your chairmanship. I congratulate the hon. Member for York Central (Rachael Maskell) on securing this important debate. She set the scene very well and spoke proudly—quite rightly—about York’s magnificent railway heritage. She spoke about modal shift, including freight—a point that was echoed by the hon. Members for Sefton Central (Bill Esterson) and for Luton South (Rachel Hopkins), who, along with many other Members, brought up pricing.
Decarbonisation was mentioned. The hon. Member for Stockport (Navendu Mishra) mentioned that the Government are not electrifying the track quickly enough. I completely agree and I will come to that in my speech. The hon. Member for Bedford (Mohammad Yasin) mentioned East West Rail using diesel on its trains. The hon. Member for Cynon Valley (Beth Winter)—apologies for my pronunciation—mentioned decarbonisation and HS2 with regard to Wales, and the fact that Wales gets no Barnett money, but Scotland gets 100% Barnett. It is a point I have raised before.
Connectivity and capacity were issues mentioned by the hon. Members for Kingston upon Hull East (Karl Turner), for Bradford East (Imran Hussain), for Ealing Central and Acton (Dr Huq), for West Dorset (Chris Loder)—who is my comrade on the Transport Committee—and for Ellesmere Port and Neston (Justin Madders). This debate became about the location of GBR’s headquarters. Many strong cases were made for York, not least by the hon. Member for York Central and the hon. Members for Harrogate and Knaresborough (Andrew Jones), for Thirsk and Malton (Kevin Hollinrake) and for York Outer (Julian Sturdy). If I have missed any hon. Members, I do apologise. It is a very good case that they made, but it is one that I cannot support, because there are six Scottish bidders—Dundee, Edinburgh, Fife, Motherwell, Perth and Stirling—and I am not choosing one of them either.
The hon. Member for York Central finished her contribution with a tribute to all our public transport staff for the work they did to keep us moving through the pandemic. It is a tribute I very much echo. Despite the significant impact of the covid pandemic, I believe that the future of rail is bright and green. I believe also that the future of rail is in public ownership. I think it is a policy that both the hon. Members for Bolton South East (Yasmin Qureshi) and for Blackley and Broughton (Graham Stringer) would also support.
I want to talk about the future of rail in Scotland. The future of rail in England and Wales is a little more debatable. The action by the Scottish Government to take ScotRail back into public control just under four weeks ago should be a template for railways elsewhere. Public ownership is a fresh start for the railways in Scotland. Already we can see innovation in the shape of the spring fare deals that far exceeded DFT’s plans. If the issue is about tempting travellers to use rail on a national and transformational basis, it should be up to Government to set the priorities of our railways and, more widely, set out how those priorities integrate with other modes of transport.
It is disappointing that the Williams review ruled out real public ownership, instead opting for operating concessions. It is a real missed opportunity to begin revitalising rail services in England and across borders. The chance to provide real accountability within the system has been missed. Instead, the DFT has settled for a halfway house, where blame continues to be placed on operators where expedient. Meanwhile, the real direction of travel is set by GBR and the DFT.
I know that the team at the top of GBR are leaders in the industry. The Transport Committee recently heard Andrew Haines give evidence, and we were impressed by his track record, knowledge and genuine enthusiasm for building a railway fit for the future. However, all the talent in the world will struggle against a structure that is not fit for purpose from the start. I worry that behind the glossy reports that the Secretary of State likes to show off on his bookshelves whenever he appears on the TV, the new GBR will simply be a rebranding of Network Rail, with some of the DFT and Office of Rail and Road’s current functions.
There also must be an appetite for real change right across the industry from those who hold the purse strings, and the signs from the DFT and Treasury are not good. We have a ludicrous situation where ScotRail is paying over double the amount of track access charges that Northern Rail is liable for—£340 million versus £150 million—while running only slightly fewer services by distance travelled.
Indeed, ScotRail pays the third-highest total access charges of any train operator in Britain. That might be worthwhile if that funding gave Scotland the kind of railway of the future that people and passengers in Scotland are looking for, but even with that kind of expenditure, Transport Scotland and the Scottish Government had to plough in an additional £630 million in capital and infrastructure investment in 2020-21, in line with the Scottish Government’s plans for decarbonisation of our passenger rail services by 2035. That is £1 billion toward track and infrastructure every year, funnelled to Network Rail and under its command, while Network Rail remains out of devolved control and reports to the DFT and the Office of Rail and Road.
As things stand, GBR will take over control of infrastructure in Scotland in the same way that Network Rail controls it. That is a missed opportunity to do the sensible thing and fully devolve responsibility and control of the entire rail network to the Scottish Parliament. Already ScotRail and Network Rail work closely together as part of the ScotRail Alliance. Full devolution would strengthen that alliance and finish the work of fully integrating track and train that started in 2005 with the transfer of franchising and services to Holyrood. We will have a situation whereby a publicly owned train company will have to negotiate with the publicly owned network operator, whose primary job will be dealing with private concession operators that are running services on behalf of the Government-owned GBR. Inevitably, the culture and institutional knowledge of GBR will skew towards that needed to deal with the private operators rather than a publicly owned company. Full devolution of Network Rail in Scotland, before it ends up under the auspices of GBR, will avoid that happening. Given the inevitability of all transport in Scotland coming under the control of the Scottish Parliament once we are independent, it would be real planning for the long-term future, but that future has to be cleaner and greener.
Scotland’s rail decarbonisation target of 2035 is hugely ambitious. It is 15 years ahead of DFT’s target for England. Hundreds of miles of our network run through areas of extremely low population, and maintaining and improving them over time is technically challenging. At this stage, full electrification of such routes would be disproportionate to passenger numbers, but in the longer term we should be looking to invest in these railways in the same way that Norway has electrified many of its rural routes. However, the development of alternative fuel trains, such as the zero-emission train developed under Transport Scotland and fuelled by hydrogen fuel cells, along with battery electric solutions, shows that no corner of our rail network will be untouched by the zero-carbon revolution that is not just desirable but critical for the future of our society and the planet.
That all said, our track record—apologies for the pun—on rail electrification since devolution has been excellent. Over the last 20 years or so, Scotland has electrified track at more than twice the rate that DFT has in England, which has resulted in a 44% increase in routes electrified since devolution, compared with just 17% across Britain as a whole. Moreover, this rolling programme of investment, which has been much lauded not just by me but by the industry, has resulted in far lower costs, with electrification costs 50% higher per single track kilometre in England than in Scotland, and there is a target to lower the cost to around half of the current English electrification cost.
In Scotland, we already have the Edinburgh-Falkirk electrification scheme, with the Shotts line, Paisley canal and Alloa all seeing the wires go up. Future projects will connect East Kilbride and Barrhead to the electric railway, and some lines have been reinstated after the short-sighted closures of decades past, including the Borders railway—a huge success story, as passenger numbers hugely exceed expectations. The Levenmouth link is currently under construction.
It pays to invest, to give certainty and to allow decisions to be made closer to the local people, communities and businesses that they affect. The fact that it took devolution for Scotland to get on and start our decarbonisation journey should be a red flag for the Government, and it makes an indisputable case for full devolution of rail. By the end, if there is one, of what has so far been a two-decade-long process—a process, incidentally, that was ignored by Westminster when it had control of rail in Scotland, but which has been driven forward by all political parties in Scotland, bar the Conservatives—we will have a railway that is fully fit for the future.
I want the future to include constructive relationships with GBR and the Department for Transport across borders—not just in Scotland but in Wales—but I fear that the overriding urge to centralise and the inability to let go, even when it makes very little sense not to do so, will mean that we still have the same outdated and outmoded structures of railway governance that have dragged the industry down over recent years. That cannot be allowed to happen, and if the Minister takes on board one thing from today, I hope it is that the new GBR cannot follow the centralising model that has been a dead hand preventing the devolved Administrations and many areas of England from taking the decisions that best support their priorities. Decisions on investment and growth are best taken by those on the ground, not by a DFT trying to extend its reach across the UK. That needs a real transfer of power to national Parliaments and regional authorities, and I hope that the future plans for rail mean that that task can be completed sooner rather than later.
It is a pleasure to be taking part in this crucial debate, and I thank my hon. Friend the Member for York Central (Rachael Maskell) for securing it. As my predecessor in this role, she certainly has superb knowledge in this field. I also applaud her for being an amazing champion of her constituents, and for her dedication in supporting York in its bid to be the new headquarters for Great British Railways. Indeed, there was a lot of harmony in the room when the hon. Members for Harrogate and Knaresborough (Andrew Jones), for Thirsk and Malton (Kevin Hollinrake) and for York Outer (Julian Sturdy) all supported York’s bid because of the city’s global rail cluster and digital technology firms, which contribute immensely to UK rail innovation. I applaud them all for their dedication, and I am sure that York will be a very strong candidate. Indeed, as a nation we must ensure that we increase exports of such cutting-edge technologies to other parts of the world.
We cannot debate the future of rail without considering its past. Understanding first where rail has come from in the past decade is crucial in understanding where it is going in the next. As the phrase goes, “Those who cannot remember the past are condemned to repeat it”, which we definitely do not want for our railways. The 2010s can only be described as a disastrous decade for rail, with fares rising twice as fast as wages, as my hon. Friend the Member for Luton South (Rachel Hopkins) eloquently highlighted, cuts to rail services up and down our country, a network unlikely to be decarbonised and net zero by 2050, and a consistently vague communications approach for future development and investment in rail. Despite the Tory rhetoric of investment and expansion, the Government’s actions speak far louder than their words.
Passengers travelling by rail today compared to 12 years ago are paying twice as much for a lot less. Year on year, rail fares have ballooned, increasing by 49% since 2010, while wages across the UK have stalled, with weekly median earnings increasing by just 23% since 2010, all while incomes are being squeezed by a pressing cost of living crisis. How do this Government expect people to be able to keep up with these brutal hikes? Increasing passenger numbers while simultaneously pricing them out does not seem like the most robust strategy from the Government.
The Government solution appears to be the “Great British Rail Sale”, touted to offer huge savings on many off-peak intercity routes, but Labour findings suggest that these discounts will be applied to a mere 1% of all journeys taken, as my hon. Friend the Member for Ealing Central and Acton (Dr Huq) eloquently explained. Perhaps we are being far too generous, Sir Charles, as even the Tory press are running stories that only 0.66% of journeys will be discounted. This is nothing more than a gimmick, and rail staff, unions and passengers know that all too well. No wonder it has been called the “Great British Rail Fail”.
Short-term sales and political gimmicks should not be the future of our railways, but a permanent, affordable, efficient and green network should be. Given the steep cost of travelling on our railways, passengers would be expected to experience an equally steep improvement in services. Sadly, that has not been the case. This Government are imposing cuts of 10% on operators, threatening jobs across the network and reducing network capacity.
Furthermore, industry anxiety about omicron, used as a front to permanently reduced timetables, seems to have materialised, with 19,000 pre-pandemic services yet to return, as my hon. Friend the Member for Ellesmere Port and Neston (Justin Madders) eloquently explained when he talked about services to and from Chester. In areas of the south-west, there is a distinct lack of services, as the hon. Member for West Dorset (Chris Loder), who has considerable experience in the rail industry, highlighted. It is evident to me that while the Tories might talk up the bright future of rail, all I can see is managed decline. Will the Minister tell us what plans the Government have to bring back these lost services and provide passengers with a future in which rail travel is better value for money?
A key part of rail’s future, and of all of our futures, is the climate crisis, but Government failures on rail are a pattern, with an equally poor record on electrification, despite increased climate change awareness during the last decade. This is the view not just of the Labour party but of industry professionals and stakeholders with whom I have had several meetings. The Railway Industry Association’s 2021 report, entitled “Why Rail Electrification?”, puts forward the case for a rolling plan of electrification, which is necessary for network decarbonisation, adding that that is how the UK will reach its net zero targets.
I can see several Members want to get in and normally I would be well up for taking interventions, but Sir Charles has intimated the lack of time. I apologise to Members on both sides, but I have only a few minutes.
Despite Conservative boasts in the Chamber about the record on electrification, the facts show that there is absolutely nothing to be proud about. The Government have reneged on plans to electrify east-west rail, as my hon. Friend the Member for Bedford (Mohammad Yasin) highlighted. According to Network Rail, 13,000 single track kilometres of rail or 88% of the total network should be electrified by 2050. However, between 2010 and March 2020, just 1,786 kilometres of rail track were electrified, meaning that only an additional 5,358 kilometres would be electrified by 2050. At the current rate, the Government will not get even halfway to their net zero target on electrification.
Perhaps the Minister will clarify this point, rather than just harking back a couple of decades to the days of the last Labour Government. How will this Government reach net zero targets on our rail network? We all know that the last Labour Government invested billions to modernise the old inefficient rolling stock. That is what their priority was. The priority now should be to tackle the climate crisis and electrify.
Part of the issue with the Government’s approach to the future of our railway infrastructure is its lack of detail, specificity and long-term commitment to investment. The devil is in the detail. Much to the dismay of the rail industry, the “Rail Network Enhancements Pipeline”, the document providing the detail on infrastructure delivery, which the Government have told the House will be published annually, is a mere 900 days out of date.
Oh, it’s coming—only 900 days late, severely hindering industry players’ investment in their skills and technology and making future infrastructure programmes even more expensive and slower to deliver. Given the unheeded warnings regarding the enhancement pipeline, including a plethora of my own written parliamentary questions on this subject, perhaps the Minister will enlighten us today as to when the updated document will finally appear.
Then, of course, there is the distinct lack of accessibility, as ably highlighted by my hon. Friend the Member for Stockport (Navendu Mishra). I appreciate that the Minister has only recently taken on the rail brief, but considering the Government’s decade of rail mismanagement, what prospects are there for a promising future in rail under this Government? No doubt, the Ministers today will extol the virtues of Great British Railways as their innovative solution to revolutionise the railways and herald a bright future, but despite consisting of 113 pages, last year’s Williams-Schapps plan for rail lacked the detail necessary for the industry to understand its day-to-day operations.
As the barrister and legal commentator Max Hardy recently tweeted:
“A car journey costs the same if it’s planned 6 minutes ahead or 6 months ahead...If trains are not competing on price, comfort or convenience, what is the point of them?”
We need devolution and integration of our public transport, as was ably highlighted by my hon. Friends the Members for Cynon Valley (Beth Winter) and for Blackley and Broughton (Graham Stringer)—and, indeed, my hon. Friend the Member for Bolton South East (Yasmin Qureshi), who explained why the fragmentation and privatisation of the rail industry has ensured that there is such a disastrous impact on our railways. I hope that the Government will look back into taking the railways back into public ownership, so that we put people before profit.
It is a privilege to respond to this debate under your chairmanship, Sir Charles. I start by thanking the hon. Member for York Central (Rachael Maskell) for securing this important debate on the future of the railways, and all hon. Members who have made contributions today.
As some hon. Members will know, the railways are close to my heart: both my paternal grandfathers worked on the railways, one in Wensleydale in North Yorkshire—for those who are not Yorkshire colleagues—and the other in County Durham. My dad was actually born in a railway cottage, so I like to think that I have a little railway heritage or railway stock in my blood.
I understand the importance of the industry and the magnificent railway heritage of this country. There is a lot to respond to in this debate. I will respond to as much as I can. It has been a very broad debate—a good debate—but there are some specific points that I want to cover, particularly the point about GBR HQ, which I will come to shortly.
The Government are committed to securing the heritage of our railways, now and in the future. Although I cannot comment today on specifics of the initiative in York, our plans for the future of rail will benefit the UK as a whole.
I will start with the Williams-Shapps plan for rail. The case for change has long been clear, and the need to move away from a model that delivered multiple franchise failures, falling passenger satisfaction, a timetable collapse, spiralling costs and a one in three chance of delays across the network. That is why we commissioned Keith Williams in 2018 to carry out the first root and branch review of the rail industry in a generation. Keith and his team identified six key problems facing our railways; I am sure hon. Members will be familiar with some of them.
The rail sector too often loses sight of its customers, both passengers and freight. It is missing opportunities to meet the needs of the communities it serves. It is fragmented, and accountabilities are not always clear. It lacks clear, strategic direction. It needs to become more productive and tackle long-term costs. It struggles to innovate and adapt.
The pandemic has only exacerbated those problems, with revenues down and costs up. The Government rightly stepped in with emergency financial support, from the start of the pandemic to the end of the previous financial year, spending almost £14 billion funding on passenger services. I also recognise the work of the industry in keeping services going through the pandemic. But that support cannot be open-ended and the need for change is greater than ever.
Hon. Members will be aware that the Williams-Shapps plan for rail, published in May 2021, set out the path towards a truly passenger-focused railway, underpinned by new contracts that prioritise punctual and reliable services, the rapid delivery of a ticketing revolution with new flexible and convenient tickets, and long-term proposals to build a modern, green and accessible rail network. We are confident that our ambitious programme for reform will address the problems that Keith identified and support recovery from the pandemic. To that end, we are now well on the way to the biggest transformation of the railways in three decades.
Central to our vision is the establishment of a new rail body, Great British Railways, which will provide a single familiar brand and strong unified leadership across the rail network. Once established, GBR will be responsible for delivering better value and flexible fares, and the punctual and reliable services that passengers deserve. Bringing ownership of the infrastructure, fares, timetables and planning of the network under one roof, it will bring today’s fragmented railways under a single point of operational accountability, ensuring that the focus is delivering for passengers and freight customers and encouraging integration across the system as a whole.
GBR will be a new organisation with a commercial mindset and strong customer focus. It will also have a different culture to the current infrastructure owner, Network Rail, and different incentives from the beginning. It will also be accountable to Ministers, ensuring that its focus is on providing value for the taxpayer, enabling innovation and delivering for passengers and freight customers.
I am grateful for what the Minister is saying about the GB focus and the new thing coming. Will she look at the European examples that I mentioned? As a member of the Select Committee on Digital, Culture, Media and Sport, I know that tourism is a big thing in this country. It is worrying that people land in London and cannot get to Manchester without its costing a three-figure sum. Can the Minister sort that out, too?
The hon. Lady is demonstrating the need for a railway system that is not fragmented, and highlighting the importance of the rail industry, not just for commuters and travel to work, but for the tourism sector and leisure.
Private businesses have always played a big role on the railway, originally as its creators, then as providers of passenger and freight serves, and suppliers and partners to Network Rail. Privatisation has been a success story for the rail network, with passenger numbers doubling in the 25 years before the pandemic, and passengers travelling more safely. [Interruption.] Some hon. Members might not like that, but numbers have doubled in 25 years. The private sector has invested billions into new, modern trains and the upgrading of stations.
Our reforms are about simplification—
It would be helpful to remind this debate of what has happened in our railways over the past few years. After decades of decline, we reached the point where we had only 760 million passenger journeys per year. The situation transformed, under privatisation, to 1.8 billion passenger journeys a year. I think the Minister should continue her history lesson to the Opposition Members, who really haven’t got a clue.
I am grateful to my hon. Friend for the intervention. Let me continue, because he does make some very important points on the private sector. GBR will harness the very best of the private sector—innovation, an unrelenting focus on quality, and outstanding customer service—and fuse it with a single guiding mind, empowered to drive benefits and efficiencies across the system as a whole.
I will quickly touch on some of the points raised by hon. Members. A number spoke of reform; I want to be absolutely clear that we are committed to workforce reform, which will make the railways financially and operationally sustainable for the future, to deliver in the ways that passengers want, and provide greater opportunities and more flexible roles for employees.
We talked about GBR; we also have the GBR transition team in place. While transformation on this scale cannot happen overnight, the Government and the sector are committed to ensuring that benefits for passengers and freight customers are brought forward as quickly as possible. Since our plan for rail, we have set up the GBR transition team, fulfilling the plan for rail’s commitment to start interim arrangements immediately.
The hon. Member for York Central referenced her bid for York to be the GBR HQ, as did others—my hon. Friends the Members for Thirsk and Malton (Kevin Hollinrake), for York Outer (Julian Sturdy) and for Harrogate and Knaresborough (Andrew Jones). GBRTT is currently overseeing the competition to select the national HQ for GBR, which is to be based outside of London, ensuring that skilled jobs, investment and economic benefits are delivered nationwide and in line with this Government’s historic commitment to levelling up across the nation.
I am pleased to say that we have received an amazing 42 applications—an incredibly positive response to the recent expression of interest phase. Obviously, there was one for York, and six others were mentioned by the hon. Member for Paisley and Renfrewshire North (Gavin Newlands). I am conscious of time, and I know that there have been other debates on GBR’s possible HQ locations, but I do commend the hon. Member for York Central for her tireless advocacy of York in the past.
I want to quickly touch on other points in the time that I have. On RNEP, please be patient; we will be coming forward with that in due course. There were very specific requests from the hon. Member for Ellesmere Port and Neston (Justin Madders) around services, new franchising, and a request for a meeting. I am happy to pick that up after the debate.
Various points were raised around accessibility and tactiles by a number of colleagues. That is something that I feel is very important, and we are absolutely committed to increasing the tactiles to 100%, and Network Rail has received an initial £10 million to install tactiles.
Thank you, Sir Charles. I thank all hon. Members for their participation in today’s debate. We truly have debated the future of rail. It has been outstanding, with all of the contributions mentioning safety, stations, staffing and local services, as we try to grapple with the real challenges ahead of us around connectivity and the climate. Of course, centred in that is the opportunity that Great British Railways will bring to our network, to our country and to our future.
I trust that, in today’s debate, not only was the case for York made so strongly, but also the plea to look to the next 200 years of our railways, using the bicentenary for real investment in our rail cluster, to ensure that we truly can be global Britain once more on our railways.
Women’s Elite Sport: Prize Money
I beg to move,
That this House has considered prize money in women’s elite sport.
It is a pleasure, as ever, Sir Charles, to speak under your chairmanship. I am grateful to the Speaker for granting this debate on such an important subject at a critical time for women’s sport.
The issue of prize money in women’s sport featured quite prominently in a debate on women’s football that I led in this Chamber back in January, and it is great to see the Minister announce that there is to be a review into women’s football, as recommended in the fan-led review, the call for which I and many colleagues echoed in that debate. I am sure that the issue of prize money will be included in that. Taken alongside the news that the Women’s EURO taking place in England this summer and the women’s World Cup will be added to the listed events regime, it is a great time for women to be involved in sport. The Minister said in the previous debate that the Government were minded to agree to that change in the regime, so I am very glad that that has now been confirmed. Visibility is vital and I think that will go a long way towards improving women’s sport.
One of the other issues raised by colleagues in the debate was the difference in FA cup prize money that the women’s teams received in comparison with the men’s. At the time of the debate, the women’s competition received 2% of the total prize money received by the men. I am sure most people would be shocked by that. Even if we take into account the fact that around double the number of teams play in the men’s competition, the disparity was huge.
It was therefore extremely welcome that the FA announced two days after the debate that it was to raise the prize money for the women’s game tenfold. The final figure of rewards for the women’s FA cup is still only 20% of what the men get, but this is good progress and I must pay tribute to the FA for its swift action in increasing support for the women’s competition. The FA has already noted that the distribution of that money will be disproportionately directed towards the early stages of the competition, which will go a long way in supporting clubs that need that extra funding, given that some made a loss on their FA cup games in the past and many had to be crowdfunded in order to fulfil games in the event that they progressed further than their budget predicted. The FA has done some incredible work in growing the women’s game, and the increase in the women’s FA cup prize money will help put the money where the game needs it most.
While I start with the good news, I intend this debate to be on wider issues of equality in sport, not just football. I have long taken a keen interest in equal pay in sport, and given the work done by the Telegraph women’s sports team on the new Close The Gap campaign, I believe now is the right time to bring the matter forward. I must thank Anna Kessel, Jeremy Wilson, Molly McElwee, Fiona Tomas and Tom Garry for all their research on this area and their work in bringing the issue to light. The campaign was launched a few weeks ago with the support of incredible sports icons, including Dame Laura Kenny, Steph Houghton and Ian Wright, and it seeks to highlight the massive disparity in prize money awarded to men and women in elite sports, both in the UK and abroad. Jessica Ennis-Hill, who wrote in support of the campaign, said:
“We all tell our children that everyone is equal. I always say to my daughter, ‘Girls can do anything,’ and she says, ‘and boys can too!’ But one day they will go out into the big wide world and they will realise, ‘No, this isn’t actually equal, there is a big discrepancy.’”
Does my hon. Friend agree that financial support for young women’s teams, which sets the scene for later years, feeds into the very issue of inequity that she is talking about, and that funding for young women’s and girls’ football teams is crucial to setting the cultural scene?
Absolutely—and, as I have said, not just in football; this debate is happening across sport more widely. Unfortunately, that is where we are with sport.
Jessica Ennis-Hill went on to say:
“Many of us know the story of how tennis made huge strides around equal prize money, with Billie Jean King and Venus Williams, and others, lobbying for change, but you do not hear much about the discrepancies in other sports. It tends to go under the radar. Unless you are a diehard sports fan most of us probably are not aware how different the prize money scales are across different events. It is only when you take the time to delve into it, and look at the numbers. Then you cannot help but think it is just ridiculous.”
So let us look at the numbers. The men’s European championship in football, which was held in this country last year, saw the men awarded a total prize pot of some £335 million. The women’s European championship, which will be held in this country this year, will see women receive a total prize pot of £13.4 million. The champions league, which of course we do not solely host but many of our clubs play in, offers a £1.6 billion prize fund to the men, but just £20 million to the women.
Snooker is a sport that historically women have been allowed to play, but without equal access to facilities in venues such as working men’s clubs, and therefore they have struggled to gain access to it. Snooker’s world championship winner is awarded a £500,000 prize, but the winner of the women-only competition receives just £5,000.
In cricket, the International Cricket Council’s one-day international World cup for men, which was held in England and Wales in 2019, awards just over £7.5 million. The women’s competition, which was held in New Zealand this year, awarded only a third of that—£2.6 million—although I understand that the ICC is working towards making the situation more equitable.
Without going into too many more numbers, as I am sure people will get the picture from those snapshots, I will offer as a final example rugby union, the sport that I really enjoy—watching, not playing. Although it was difficult to get any finite data on the Six Nations, I understand that the tournament says it does not award prize money but instead awards the participating teams a tenth of its annual revenue from the men’s tournament—that is reportedly around £16 million, although, as I said, exact numbers are unclear—relative to performance. There is no such distribution of revenue in the women’s tournament. Jessica Ennis-Hill said in her article on the campaign for equality:
“At last year’s women’s Six Nations…some teams had to manage without sanitary bins, fresh kit, or even hot showers—it is a hard pill to swallow being underpaid compared to your male compatriots.”
At a global level, World Rugby says that it does not do prize money, but there is a “participation grant” in the men’s World cup, which is awarded depending on performance, whereas the women get a “preparation grant”.
I could go on. In golf, women consistently get much less money than men; in tennis, there have been some famous successes, but around the world the situation is still variable; and in cycling, the men’s Tour de France offers a prize pot of almost £2 million to men and just over a tenth of that to women.
The numbers are important because they paint a picture and they show an attitude. First, it is about respect. To reach the levels in elite sport that these athletes reach takes extreme dedication; it takes many hours of practice, energy and commitment to get to the pinnacle of a particular sport. Yet the nature of unequal prize money means that the effort of one person is valued so much more than that of another—in some instances, 10 times or even 20 times more. If we consider the situation purely on the basis of respect, then it is demonstrably unfair.
Secondly, it is about sport being a livelihood and something that athletes can commit time to, in order to take them to the top of the game. Whether that is a world cup, a world championship or the Olympics, it takes time and costs money. When the prize money for even the few who win is not enough for them to commit to an effective and long-lasting training programme in order to sustain high levels of performance, what of those who place lower down but work just as hard? That is part of the reason why there are far fewer female athletes, and why so many more female athletes need second jobs outside their sport—any possible hard-fought win does not provide enough to sustain the process full time. As Jessica Ennis-Hill writes,
“in some sports prize money is an essential part of our income, rather than a cash bonus.”
This takes me to my third point—the wider benefit to the sport of providing a more evenly financially rewarding playing field. The ability for an athlete to make their sport their full-time job is of benefit not only to them, but to the sport’s future. By giving more time to the sport, they are able not only to raise their game and compete on a larger stage for more reward, but to raise the game of those around them and those who train with them. They are able to spend more time in training facilities, learning from the best and passing on what they know to those who are following in their footsteps. And they are able to inspire more young boys and girls to get involved, and perhaps be future champions themselves.
Many of the organisations that I have mentioned will talk about their investment in women’s sport and the money that they put in elsewhere, but the issue of prize money is symbolic as much as anything else. One of the key metrics that they often refer to is commercial revenue; they say that the women do not bring in as much money. But we simply must place that in the context of women being banned for so long from playing different sports—they were banned for 50 years from playing football—of the unequal access to facilities, and of the attitude towards women playing sport that still exists today, as researchers at the University of Leicester reported earlier this year. That has had an effect on the commercial revenues available to people, especially as the visibility of women’s sport still suffers from historical inequalities.
There has been progress in this area. It is clear that women’s sport is getting more coverage than ever. That is testament to those at the BBC, under the incredible leadership of Barbara Slater, and at Sky, for example. There are brand-new deals on women’s sport, and there is the greater exposure that many women who play elite sport receive today. But ultimately, as the organisation Women in Sport notes, women’s sport still accounts for only about 10% of total sports coverage, and when we flick through the sports pages of newspapers, we still have to look much more closely to find women’s sport. There are many excellent journalists out there who are doing all they can to bring attention to women’s sport—not least those whom I mentioned earlier—but there is still so much more to do.
The lack of general coverage and the historical context in which elite sportswomen have operated contribute to the arguments about lower commercial revenue. I know that many of the organisations will point to commitments to raise their game, but it would be wrong not to take this opportunity to say that more can always be done. Above all, this is about a fairer distribution, about respect, and about ensuring that children and young people have the chance to see people like them competing at the highest levels of their sport and to think, “That could be me, too.” I therefore ask the Minister what plans he has to work with governing bodies towards a fairer deal for women’s sport and how he will go about continuing the huge growth that we have seen in women’s sport in the last decade.
I will end with a quote from Steph Houghton, the former Lionesses captain, whom we are extremely proud of in my city of Sunderland; she is a former Sunderland player who grew up in the city. She said this in support of the campaign:
“The prize money in women’s sport to reward and acknowledge personal and team achievements continues to fall incredibly short. Football clubs and sponsors are increasing investment into the sport more than ever before, but prize money seems to have a glass ceiling that needs to be broken. Let’s work together to #CloseTheGap.”
We have seen cracks in the glass ceiling. I am with Steph—let’s break it.
It is, as always, a pleasure to serve under your chairmanship, Sir Charles. I thank the hon. Member for Sunderland Central (Julie Elliott) for securing time for this important debate today. Let us just hope that we can have the same success rate in delivering the things that she has asked for as we were able to achieve in the last debate. We were only half-joking when we said outside the Chamber that I should just stand up, say that I agree with everything the hon. Lady says, and then sit down. This is one of those cases in point, so I will try not to repeat too many of the points that she raised, but she raised such important points and I genuinely do agree with everything she said. I am also signed up to the campaign.
The hon. Lady was right to name-check all the people who have campaigned with her on this issue for so long, including journalists, sportspeople and people in this House. I give credit to her, because I know this is a topic she has been campaigning on for some time.
I am absolutely committed to supporting women’s sport at every opportunity, which means pushing for greater participation, more commercial opportunities and increased visibility of women’s sport in the media. We should do all we can to ensure women’s sport is treated equally to men’s at all levels, including in areas such as prize money. With that in mind, I would like to set out some of the progress that has been made and the challenges that remain. I will try not to repeat exactly what the hon. Lady said, but it is important to get all this on the record.
I agree that it is vital that women and men are recognised and paid equally for their achievements. I welcome the recent launch of the Telegraph’s Close the Gap campaign calling for fairer prize money in women’s sport—a campaign that I know the hon. Lady and many others have supported, as I do. In a bumper year for sport this year, with the women’s Euros, the rugby league World cup and the Commonwealth games in the UK, I am keen for all sports bodies to look at what more can be done to redress existing imbalances. As the hon. Lady mentioned, we are seeing progress, but we need to see more.
In January, it was announced that the FA will increase prize money for the winners of the women’s FA cup from next season—the hon. Lady gave it due credit for that—and professional female footballers in England are to benefit from maternity and long-term sickness cover in a landmark change to their contracts. It is remarkable to be saying that in this day and age and that it happened just this year. Yesterday, I was pleased to announce that the Government will be launching an in-depth review of domestic women’s football this summer to examine issues affecting the game at elite and grassroots level.
In cricket, last year, the £600,000 total prize pool for The Hundred was split evenly between the men’s and women’s competitions. As the hon. Lady mentioned, tennis is a great example to other sports; it has offered equal prize money in all four majors since 2007. The International Triathlon Union leads the way, having paid equal prize money to men and women in every race for every year since its inception in 1989, more than a decade before triathlon became an Olympic sport.
We know there is still a lot more to do. In September 2021, UEFA announced that it would double the women’s Euro 2022 prize money, but it is still a fraction of the prize money of the men’s competition. The 16 qualifying teams for the women’s Euros will share a pot of €16 million, but the 2021 men’s Euros saw a total prize pot of €371 million. I thought that either I or the hon. Lady had the numbers wrong, but she quoted pounds and I am quoting euros. The currency does not matter—the gap is still huge.
Of course, it is often argued that differing rates of pay for sportsmen and sportswomen is largely down to women’s sport not having the profile or media coverage of men’s sport over the years, but that is changing. Sponsorship and media coverage go hand in hand. If women’s sport does not have the media coverage, sponsors often do not see it as commercially attractive.
Record sponsorship deals have been struck with women’s sports leagues, such as Barclays’ sponsorship of the women’s super league, the premier women’s football league in England. Barclays will also be investing more than £30 million in women’s and girls’ football from 2022 to 2025, doubling its existing investment and becoming the first title sponsor of the FA women’s championship. The media profile of women’s sport is continuing to rise with new and innovative broadcasting deals being struck, such as DAZN’s four-year partnership with YouTube for the women’s champions league.
We have been working to improve the diversity of the listed events regime, first by adding the Paralympic games to the list in 2020. In addition, I was pleased to announce yesterday that the FIFA women’s World cup and the UEFA women’s European championships have been added to group A of the listed events regime, as the hon. Lady pleaded for in January. That will ensure that those tournaments continue to be available to as wide an audience as possible. Research conducted recently by the Women’s Sport Trust shows that almost 33 million people watched women’s domestic sport in 2021, with The Hundred and the women’s super league bringing in 11 million new viewers to women’s events, but we want to continue to push for greater change and strive for more equality and inclusivity in sport.
That is why in May 2021 I set up a women’s sport working group with key sector partners to explore some of these challenges and identify opportunities in women’s sport. Since May, we have held four meetings of the group, which have focused on participation, visibility, commercial investment and major events. We want to continue to use these meetings to bring value to and challenge all aspects of women’s sport. They are not just talking shops; we have some very powerful and influential people in those groups, and we will see, and have already seen, some action.
The hon. Lady asked what I can do. I regularly meet governing bodies of multiple sports—football and beyond. The topic of women’s pay and prize money comes up all the time, and I assure her that I raise it at every opportunity. Although we always get warm words, as she perhaps gets in the conversations that she and the Digital, Culture, Media and Sport Committee have, we want to see action following on from that. I assure her that I will raise this issue at every opportunity.
The 2022 sporting calendar presents some great opportunities to demonstrate our commitment to women’s sport. At the rugby league World cup this year, female and wheelchair athletes will receive equal participation fees and will get prize money for the first time in the tournament’s history. I was delighted to see the news last week that all the Lionesses games at the women’s Euros this summer have now sold out, and a record attendance for any women’s football match is expected at the final. It is not true, therefore, that there is no interest in women’s sport; those figures show that that is not the case.
There are lots of reasons to be optimistic about women’s sport, but work remains to be done, as the hon. Lady said. I want to leave hon. Members in no doubt that I am personally committed to doing everything to raise the profile of women’s sport, women’s pay and prize money.
Question put and agreed to.
National Strategy for Self-Care
I beg to move,
That this House has considered the potential merits of a national strategy for self-care.
As ever, Sir Charles, I am pleased to have this debate with you in the Chair. In October 2019, I chaired a roundtable event on self-care, which involved healthcare professionals, pharmacists and other experts. It was organized by the consumer healthcare association the Proprietary Association of Great Britain, and following the event we produced a report that the Minister, or at least the Minister who was supposed to be here—the Under-Secretary of State for Health and Social Care, the hon. Member for Lewes (Maria Caulfield)—is aware of. I am indebted to PAGB, the Juvenile Diabetes Research Foundation and Diabetes UK for the briefing they have provided for this debate.
It might be helpful if I define what I mean by self-care. Essentially, it is about the actions individuals take for themselves, on behalf of others or with others to develop, protect or maintain their health. It can be summarised as a spectrum that includes the promotion of everyday wellbeing, taking care of self-treatable conditions, and the management of long-term conditions. It is important, however, to point out that self-care is not no care. Those who need medical support on a more traditional basis should be entitled to that type of care.
The covid-19 pandemic has revealed the important role that self-care can play in reducing the burden on GPs and hospital A&E departments, so that those with the most serious ailments can be treated with greater urgency. Prior to the pandemic, it is estimated that 18 million GP appointments and 3.7 million A&E visits were for minor ailments, including a blocked nose, dandruff and travel sickness, at an estimated cost of £1.5 billion annually. A survey of frontline healthcare professionals carried out by the self-care academic research unit at Imperial College in 2021 indicated that 95% of those who responded felt that self-care was important during the pandemic, compared with 55% pre-pandemic. However, a further survey carried out by PAGB later in 2021 found that the percentage of members of the public saying that they were more likely to self-care had fallen from 69% in 2020 to 55%, which illustrates that the trend in that direction has reversed.
My key point in this debate is to highlight the necessity for a new national strategy for self-care. The previous such strategy, “Self-care—A Real Choice”, was published in 2005. Since then there have been many new developments and the case for a new strategy has been more clearly recognised.
Before I move on to describe what the elements of a new strategy might be, I will use the example of those with diabetes to illustrate how self-care can work well. Other conditions could also serve to make that point, but, to avoid taking up too much time, I will use this single example. JDRF has pointed out that 79% of the management of type 1 diabetes is carried out by the individual with the condition, often with the help and support of their families and carers. That makes type 1 diabetes a case study in how to successfully promote self-management. JDRF also draws attention to the need to invest in technology as a crucial benefit to the long-term sustainability of the NHS post-covid.
JDRF’s 2021 report, “Covid and Beyond”, concluded that people with type 1 diabetes who had access to relevant technologies felt more confident in managing their diabetes in the absence of routine NHS care and support. The charity Diabetes UK points out that diabetes is
“the fastest growing health crisis of our time”,
with the equivalent of one in 14 people—that is 4.9 million in total—living with the condition, and that it accounts for 10% of the NHS budget—that is a staggering figure—80% of which is spent on treating largely preventable conditions.
Diabetes UK draws attention to the fact that, to live well with diabetes, avoid complications and successfully self-manage diabetes, those living with the condition require five things: first, access to education about diabetes and how to manage it; secondly, emotional and psychological support, which is increasingly important; thirdly, access to technology to support self-management; fourthly, access to weight-management support when needed, and I will say more about that in a moment; and finally, facilitated peer support.
Typically, those with diabetes spend about three hours a year with their doctor, nurse or consultant, and a staggering 8,757 hours managing the condition themselves. As Diabetes UK points out:
“Managing diabetes day-to-day can be difficult. This is why it’s important people have the knowledge and skills to manage their diabetes so they can live well and avoid complications.”
I appreciate what the right hon. Gentleman is saying and I understand that he has spoken to my constituent Scott Craig. Does he agree that there needs to be awareness of the risks, and training for people who are self-managing and for their families? I understand that my constituent’s husband’s device failed, leading to his untimely death. Does the right hon. Gentleman agree that there needs to be greater awareness of how these devices work and what people need to do should things go wrong?
As the hon. Lady is aware, I spoke to her constituent about that point earlier today. She makes a good point and I agree with her, and I would add that it is important that those who use technology are properly trained in how to use it best. The devices need to be reliable, so that technology can provide effective help with these conditions.
Those with type 1 diabetes who also struggle with eating disorders experience problems if they omit to take their insulin in order to lose weight. I know that you are familiar with this issue, Sir Charles. The right hon. Member for Maidenhead (Mrs May) and I will shortly carry out an inquiry into this growing problem, with the support of JDRF. We hope to point to how self-care can play an important role in dealing with this worrying trend. Hon. Members may be aware that there is a storyline in the soap opera “Coronation Street” that covers this subject. It has not yet concluded, but it offers a helpful perspective of how the problem has arisen, what it is and what the dreadful consequences can be.
I will refer to the recommendations from the report following the roundtable I chaired in October 2019. First, the Department of Health and Social Care should develop a national self-care strategy. Secondly, NHS England and Improvement should explore the implementation of self-care recommendation prescriptions, to support clinicians to discuss self-care with patients and refer them towards it. Thirdly, primary care networks should consider ways to improve self-care in local populations as part of the development of the network across the local health system. Fourthly, NHS England and Improvement should enable community pharmacists to refer people directly to other healthcare professionals. That has become even more apparent during the covid-19 pandemic.
The fifth recommendation is that NHS England and Improvement should support moves towards community pharmacists being granted read and write access, to give them full integration and interoperability of IT systems as part of local health and care records partnerships, and promote national support for such data-sharing agreements. That would unlock the door to a hugely increased, positive role for community pharmacies. Sixthly, the Government and royal colleges should include in the healthcare professional curriculum and the national curriculum self-care modules that can be delivered sustainably by schools. Finally, NHSX should explore technologies that could be used to promote self-care and manage demand on the NHS.
Before concluding, I would be grateful if the Minister, or his colleague, could consider some questions. It is not necessary for them to be answered today; theyj could respond by letter if that would be more effective. First, will the Minister undertake to look closely at the recommendations for a new self-care strategy? Secondly, will he give consideration to the report’s seven recommendations, which I referred to earlier? Thirdly, will he agree to meet a representative group of healthcare professionals, other interested parties and me to discuss potential ways forward? Finally, will he meet diabetes charities, the right hon. Member for Maidenhead and me to discuss the relevance of the two conditions—it is often overlooked that type 1 and type 2 diabetes are two distinct conditions—and to explore how the condition can serve as an example for self-care management? I look forward to the Minister’s response.
It is a pleasure to be under your stewardship, Sir Charles. I thank my right hon. Friend the Member for Knowsley (Sir George Howarth) for securing the debate.
We all know that people have self-cared in one fashion or another for thousands of years. Personally, I think that self-care starts with mental health, which can often be forgotten in strategies. The old Hippocratic approach was to be in a good frame of mind: a healthy mind produces a healthy body, and that is as pertinent today as it was more than 2,000 years ago. A self-care strategy should take a holistic approach that covers lifestyle, diet, as my right hon. Friend has said, and exercise, and a person’s state of employment is also a factor. They must all be taken into account by strategies dealing with self-care, because this is about not just people’s physical health, but their social and economic health.
On the point made by the hon. Member for Glasgow Central (Alison Thewliss) about self-care, I do not think that self-care means self-isolation as far as healthcare is concerned. It is about sharing care. It is also important that people use the healthcare system responsibly. Some referrals to GPs and hospitals could be considered inappropriate—I think my right hon. Friend the Member for Knowsley touched on that—with people turning up and putting a strain on the system. We have a personal responsibility to ensure that the health service is used in the most appropriate way. That is not to dissuade people or tell them not to go to the GP, but it is a factor that must be taken into account. There must be a system that assists in self-care so that people feel empowered and, crucially, safe, as the hon. Member for Glasgow Central referred to, when making decisions about self-care.
We have also got to take into account those people who cannot self-care and need support from family or carers who are, in effect, proxy self-carers, if I may use that phrase. A strategy must also include a safety net for people who are not in a position to self-care as much as they would like.
The World Health Organisation has an excellent prospectus on self-care. It straddles many different cultures and countries, but broadly talks about self-management, the use of self-testing and, importantly, self-awareness, which goes back to one or two of my earlier points.
I welcome the 2019 clinical consensus statement on self-care, which sets out seven recommendations, as touched on by my right hon. Friend the Member for Knowsley. More recently, “Realising the potential: Developing a blueprint for a self-care strategy for England” sets out nine themes.
In the current climate there are huge stresses on the health service and on people’s mental health and, subsequently, their physical health, partly because of covid and partly because of their individual social and economic circumstances. A care strategy must take into account societal movement and those social and economic factors that impinge on people’s health, so that, in helping people to self-care, we must also have a net in place to ensure that that self-care is safe.
I will call the shadow Minister shortly. There is usually a five-minute limit for the Opposition spokesperson, but as we have quite a long time left, if the hon. Lady would like to speak for longer, she can do so, although she is under no obligation to do that. I am sure the Minister would not mind either.
Yes, indeed. Having sat opposite the Minister in Committee and when ping-ponging with Lords amendments, I am sure I can dredge up an awful lot to talk about for a very long time, but I will not do that. That would be unfair, although we might have another opportunity to do that tomorrow.
It is a pleasure serve under your chairmanship, Sir Charles, and I congratulate my right hon. Friend the Member for Knowsley (Sir George Howarth) on securing this debate. There are not many hon. Members here, but that belies the fact that this subject is of interest to an awful lot of people. As my hon. Friend the Member for Bootle (Peter Dowd) outlined, it covers not only physical health but mental health, and deserves time to be discussed.
As my right hon. Friend the Member for Knowsley said, self-care refers to long-term conditions and preventive health measures. It is an important component for healthy living. We all need to be clear that self-care is not passing responsibility that should be with professionals to the individual, or that we are using self-care to prop up our increasingly underfunded health and social care systems. We need to look at self-care in a positive sense, as has been discussed, as empowering people and patients to know and understand their own bodies and their own physical and mental health, but also to know how to manage the many things that life throws at us all along the way, and to do that from a young age.
Self-care is about lifestyle choices, but also about better awareness of symptoms and when it is important to seek professional advice. Our professional systems should be set up with that in mind, starting with empowering people and not telling them all the time what they should be doing or expecting them to be at the end of a professional opinion. There are many examples, but with cancer symptoms, early diagnosis is crucial and we know that can be a matter of life and death. We also need to understand when an ailment can be treated by someone themselves, and when to do that, or by talking to community pharmacists, as has been mentioned and which I will say more about as I go on.
My right hon. Friend the Member for Knowsley talked eloquently and from experience about diabetes, which is an important area. We know how many people have diabetes, what a huge area it is for the health service and how important education and self-management strategies are for people with diabetes. Before the pandemic, I worked a lot with Diabetes UK in my constituency and across Bristol, as I did in my previous life as a health service manager, to support those important local groups of people coming together. Those groups support individuals, share professional information and empower people very well. We all look forward to the results of my right hon. Friend’s work with the right hon. Member for Maidenhead (Mrs May). We wish them well and offer our support for that work in any way we can.
My area, like many other constituencies, has high levels of health inequality. I recognise the importance of improving health literacy as a way of supporting people to help them tackle some of those health inequalities themselves.
As the Minister would expect me to say, after a decade of Tory mismanagement of the NHS, with long waiting lists before the pandemic and staff shortages, record numbers of people are waiting for care. Self-care is essential for the future sustainability of the NHS. Through empowering people to take control of minor ailments, we can focus NHS resources on those who need them most.
Does my hon. Friend agree that organisations such as those in the voluntary, community and faith sector have been absolutely fantastic in supporting people over the last two years and have enabled them to self-care as part of their healthy lifestyle, at a time when the NHS has been under huge stress?
I absolutely agree. The pandemic has been a terrible time for most of us, but it has provided the opportunity to look at, and to trial in real time, different ways of working with and helping people. A lot of third-sector organisations have been able to use technology, particularly in rural areas, so that people no longer have to travel to centres if they do not want to. Such organisations have been supporting people to use more online communication methods, and people have been coming together in more localised settings and been supported in a different way.
From my many years in the health service, I know that getting online appointments organised and, as the hon. Gentleman has heard me say before, managing things—for example, dermatology—using online services was a really hard task. We have now gone through that process and need to learn the lessons from the pandemic. It is a unique opportunity to promote self-care as an essential part of healthy living. We have heard from my right hon. Friend the Member for Knowsley about the numbers involved. People are keen to take this opportunity to promote self-care and improve our understanding of, and confidence in, our own health, so that people can access the right service at the right time, and we ensure that our highly professional health service and specialist services are well used.
I would like to mention local pharmacies in my constituency of Bristol South. Bedminster pharmacy has been commended several times—it has the most commended pharmacy team in the United Kingdom—by national awards. I echo the points that have been made about pharmacies, which are often overlooked by other professional organisations. Some primary care services in different parts of the country are better than others at working together across the piece. I certainly hope that is a feature of the new integrated care systems, which have a huge opportunity to support pharmacies properly so that they can do their day-to-day work.
My hon. Friend makes a good point about community pharmacies and the potential they offer. Does she agree that in the past the potential of community pharmacies has been underused, just as the capacity of GP and A&E services has been overused? It is not just about sloughing off the responsibility to somebody else; it is a matter of using the expertise that already exists.
Absolutely. I refer back to one of my favourite pieces of legislation, the Health and Social Care Act 2012; one of the many terrible things that that Act did was to demote the role of pharmacists in local communities and affect the support they were given by primary care trusts. In my area, we had a huge team supporting pharmacies who were very much part of that local community offer. I hope that the integrated care systems recognise that that was a mistake. We have lost a decade and really should be working much more closely together. Pharmacies exist in most areas and are easy for local people to access. They can give people confidence to look after themselves and the literacy that I mentioned.
It is vital that people receive a consistent message about self-care when they look at NHS services online, call 111, or visit a GP or local pharmacist, and that requires local systems to work together. A national self-care strategy would help to embed consistency across the country. As has been mentioned, self-care is a continuum that covers adopting healthy lifestyle choices and managing long-term health conditions, be they mental or physical. We must ensure that health literacy and targeted actions to tackle health inequalities take account of the systemic barriers in place for many people who wish to live a healthier lifestyle, particularly given the rising cost of living. I look forward to hearing from the Minister about how the Government’s upcoming White Paper on health inequalities will consider the issue.
We need to remember that self-care is for everyone at all stages of life. Educating children through programmes in school is an important part of that. As I said earlier, the confidence to manage our own health with appropriate support is as important for someone in a care home as it is for a parent looking after a new baby or for children growing up, particularly those growing up with long-term conditions.
Empowering and enabling us all to take charge of our health, be that through using digital interventions, improving health literacy or providing greater support for self-care, is important not only for the long-term sustainability of the health and care service, but for patients. We must ensure that the system does not inadvertently disempower people or result in gaps in the care pathway. I very much look forward to hearing the Minister’s thoughts on this.
It is always a pleasure to serve under your chairmanship, Sir Charles, and a particular pleasure to serve opposite the hon. Member for Bristol South (Karin Smyth), the shadow Minister. We spent many happy days in Committee on the Health and Care Bill, even if we were not in full agreement. The Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Lewes (Maria Caulfield), within whose portfolio this would normally sit, has just been answering a debate in the Chamber, which is why I am responding to this debate.
I will endeavour to do justice to the very important points that the right hon. Member for Knowsley (Sir George Howarth) raised in his speech. I will do something, which, even within my own portfolio, would cause my officials to wince—and I suspect that the same may happen given that this falls within somebody else’s portfolio—which is that, notwithstanding the wonderfully well written notes that my officials have provided me with, I may well say what I think on this subject and respond to the specific points that have been raised in the course of this debate. This could be career limiting, but we will see.
The right hon. Member made a powerful speech. Essentially, the way in which he illustrated through the prism of a particular condition of diabetes a number of the points that could be applied more broadly across the spectrum of self-care was particularly helpful to hon. Members. Although we may not have a huge quantity of hon. Members in this Chamber today, what we do have is quality, judging by the contributions that we have heard.
The right hon. Member is absolutely right, as is the shadow Minister, that, in talking about self-care, we must be very clear that we do not see it as an alternative—an either/or—to medically qualified support or other forms of support. The two parts of the system should work hand in hand. Indeed, I see it as a continuum. I have seen the work done by PAGB, the Self-Care Forum and others on that self-care continuum. We start at one end with education, which I will turn to in a moment. The pure end of self-care is around diet, daily calorie intake, and the simple lifestyle changes that can make a big difference to our own health and the risk of our contracting illnesses or diseases. Those lifestyle and dietary factors may not be for everyone given the nature of particular conditions, but, by and large, are within the control of the vast majority of us.
At the other end of that continuum, we have things such as major trauma, or treatment for illnesses such as cancer or cardiac conditions where medical care, and often hospital-based care is essential. Then there is that space in the middle around self-treatable conditions. There are the minor ailments where people might be able to self-care, but where, as the hon. Member for Bristol South put it very well, some might need some confidence or advice to be able to do so.
There is also the management of acute conditions and long-term conditions, which, I suspect, will entail a degree of professionally qualified medical care, but, equally, a degree of self-care based on that advice as well. We have that spectrum—that continuum—and it is important that we view it in that way. The ability to turn to the right type of support at the right time is crucial to maximising the benefits and opportunities for individuals in self-care.
Through the pandemic, we have seen the opportunities to innovate. They were opportunities forced on us by the circumstances in a dreadful situation, but, none the less, there have been ideas and innovations that have come out of that pandemic. We have seen also the consequences of demand within our healthcare system, particularly at GP practices, at accident and emergency, and at urgent treatment centres. Notwithstanding the record investment by this Government in our NHS, and notwithstanding the record numbers of staff in the NHS, we do see pressures. An effective and proportionate self-care approach that people feel confident in can play a key part in helping to manage the pressures, where people go to the most appropriate point to be treated.
Empowerment is key—people understanding and being educated in their choices and the implications of their choices, through public health messaging. There is a telling statistic, although it may be a little out of date—I was discussing this with some officials earlier this week: 43% of the population do not feel fully confident in understanding health information conveyed in words. The figure leaps to 61% of people who do not feel fully confident in understanding information about their own health and their choices when the information contains words and numbers. That signifies that there is a lot more work for us to do.
I am encouraged by the first part of the Minister’s speech that he gets this, as I was by the response of my hon. Friend the Member for Bristol South (Karin Smyth) on the Front Bench. The Minister is right that people who have long-term conditions—or, for that matter, the general population—need to understand better what they can do for themselves. It is not always obvious to people what they can do. It is also important—I referred to the recommendations—that medical practitioners understand these issues in their initial training and that they are kept up to date on the potential. Otherwise, people are operating in a fog, without understanding the potential. I am sure the Minister will agree that those things are important.
I entirely agree that for health professionals, having up-to-date and refreshed knowledge is hugely important. In my current role and my previous role at the Ministry of Justice, I have looked at this point when considering domestic abuse and domestic violence. GP practice staff are often the first people to get an indication that something is wrong—not necessarily because a patient presents saying so, but because of the nature of their injuries or what they present with. Up-to-date knowledge across a range of areas is hugely important.
The hon. Member for Bristol South is right that education cannot start too early for forming good habits, and that, through school and beyond, it is important to educate people about the choices they make and the impact of those choices. That is not the so-called nanny state; it is about people being given the information to make an informed and educated choice for themselves and the benefit of their health. Another key element is confidence. People need information, but they also need to be confident to take a decision on that basis and to know where to go if they are not sure. I will turn to community pharmacies in a moment.
There are two other broad points to highlight—mental and emotional health—which the hon. Member for Bootle (Peter Dowd) quite rightly highlighted. I hope that all of us in this place agree, and that it is understood more broadly in society, that we cannot look at physical health in isolation. All elements interact with and impact on each other. We need to be fully cognisant of that and of the broader determinants of health and health inequalities, be they social, economic or health factors. There are a whole range of impacts on individuals and their overall health.
We need to ensure that people have access not only to information, but to the technology and kit to be able to manage their condition. During the pandemic, virtual wards have become more prevalent. For example, there are pieces of kit that monitor oxygen levels in blood and report back to the GP to give an early indication. That is just one example of how technology can assist, and it expanded rapidly of necessity.
I will turn to the recommendations in the report, speak a little about community pharmacies, which have quite rightly been highlighted, and then turn to the request of the right hon. Member for Knowsley for a meeting—always an easy point to respond to when one is not the Minister responsible. It is always nice to be able to commit other colleagues to meetings, but I will also address the issues in my own right.
I hear what the right hon. Member for Knowsley says about the need for a specific strategy, but I would sound a slight note of caution. It is often the case that the first call in a particular area of policy is, “We need a strategy around this”, and I am slightly cautious about having a multiplicity of strategies without bringing together a whole range of actions. That may be a point that the right hon. Gentleman wishes to raise with my hon. Friend the Member for Lewes, who I will commit to meeting him in a moment.
On that specific recommendation, self-care is an integral part of the NHS long-term plan, which we are looking at at the moment in the light of the experiences and impacts of covid, and the community pharmacy contractual framework—the five-year deal running to 2024. For that reason, I merely sound a note of caution about an additional national strategy, because over the past two and a half—almost three—years, what I have often seen in the Department of Health is a strategy for a particular issue or area of care that does not always interact with other elements of the system or take into account just how complex that landscape is. The right hon. Member for Knowsley is aware of that point from his many years in this House, but I merely sound a slight note of caution.
The Minister is making an important point. However, I am sure he also recognises that there are already lots of things out there in the care continuum he spoke about: the health literacy toolkit, the e-learning programme on health literacy from Health Education England, the health literacy support hub, guidance on physical health and mental wellbeing in schools, the community pharmacy contractual framework to which he referred, modules on self-care for minor ailments and successful self-care, and so on. Part of a strategy, if that is what we want to call it, is trying to bring all those things together. On top of that, does the Minister agree that in the plan, so to speak—the “Realising the Potential” document—there is a reference to how
“There should be a cultural shift among healthcare professionals, towards wellbeing and away from the biomedical model of care”?
It is about trying to fit those things together in a coherent strategy, if that is what we want to call it.
The hon. Gentleman is seeking to find a way through some of these points in his typically dexterous way. Suggesting “a strategy, if that is what we want to call it”, leaves open the option for my hon. Friend the Member for Lewes to consider other ways in which the same thing might be achieved. I do not want to prejudge the conclusion that she will come to, but I will ensure that she receives a transcript of this debate.
I hear what the Minister says. To be honest, I am not overly fussed about what we call it. My concern is that the Government—and, for that matter, the rest of us—are able to draw on the experience of patients, clinicians, and all those in the healthcare system to examine how we can do things better. If the Minister wants to call it something else, I am not here to have a row with him about that; I am here to try to make some progress.
I am grateful to the right hon. Gentleman for that typically courteous intervention. A lot of what we are seeking to do in this area comes back to the refresh of the NHS long-term plan, which will have to happen in the context of what we have seen during the pandemic. The hon. Member for Bristol South highlighted the health inequalities White Paper, which will come forward in due course. There is a genuine opportunity to use that White Paper to draw a number of these elements together.
I am conscious that the right hon. Member for Knowsley had six other key recommendations, which I will address briefly. I will say a little bit about community pharmacy before I turn to meetings. He raised the issue of building on the successful community pharmacist consultation service, and exploring additional pathways to access that service through the implementation of self-care recommendation prescriptions to support GPs and other professionals to appropriately refer patients to self-care. Rather than taking the issue of community pharmacy separately, I will address it in response to this point, because that is probably the neatest way to do so.
I fully recognise the value of community pharmacy, and the hon. Member for Bristol South also rightly highlighted its importance. My first official engagement when I took on this job in 2019 was to attend, in lieu of the Pharmacy Minister at the time, my hon. Friend the Member for Bury St Edmunds (Jo Churchill), the Pharmacy Business Awards ceremony, which recognised community pharmacies that had done amazing work in their communities, such as the one the hon. Member for Bristol South highlighted.
As constituency Members of Parliament, we all know the depth of expertise and local knowledge that our community pharmacies bring to the communities they serve, and we know just how well regarded they are by our constituents as friendly, accessible sources of advice. Constituents do not have to be there first thing in the morning, and they do not have to make an appointment. They can stroll in and talk to a pharmacist who can give them genuinely helpful advice, without having to wait. I put on record my gratitude, and I suspect that of all hon. Members, to community pharmacies.
We are increasing our potential to expand the Community Pharmacist Consultation Service to urgent treatment centres and A&E departments. It has already taken just shy of 184,000 referrals from GPs, which, as hon. Members have suggested, is of benefit to our general practitioners, who can better manage their workload, given that some people do not need to see a GP. We are promoting the uptake of that service and incentivising its use through the GP contractual arrangements. Negotiations with the PSNC on what community pharmacy will deliver in 2022-23 as part of the five-year deal are ongoing, and hon. Members would not expect me to prejudge those negotiations. As soon as they conclude, we will announce the arrangements so that Members can consider and scrutinise them as they see fit.
The right hon. Member for Knowsley talked about primary care networks. I know the value of primary care networks. My own GP in Leicestershire is actively involved in the PCN. We saw their potential to do amazing things during the pandemic when they supported our communities with the vaccination programme and in a whole range of ways. He is right to highlight their potential to consider ways to improve self-care in their local populations as part of their network development. I hope that the soon-to-be-statutorily-constituted ICSs and ICBs will also take that very seriously, obviously subject to the other place and their deliberations later this evening.
I know from my own GP, who I regularly speak to, that many local health systems are proactively exploring upstream prevention initiatives across the health and care system and looking for further partnership opportunities to support people to improve their overall health and care outcomes. Clinical commissioning groups—soon to be ICSs—and NHSEI regionally also have the option to commission a local minor ailments service in addition to CPCSs. I hope they will explore those options as they go forward—particularly ICSs.
The fourth recommendation was that NHSEI should enable community pharmacists to refer people directly to other healthcare professionals where self-care is not appropriate, enhancing the role of pharmacists as a first port of call for healthcare advice. I entirely agree with that. There is an educational point as well in making people aware that they can go to their pharmacists. Equally, all community pharmacists are required under the terms of service to signpost people to other health and social care providers and support organisations as appropriate. There is, I suspect, more we can do in that space, but I think we have an extraordinary resource there at our disposal. NHSEI is accelerating efforts to enable community pharmacists to populate medical records and give them full integration into operability of IT systems as part of LHCR partnerships and national support for data sharing.
Data and the sharing of data in this space is, as all hon. Members know, a vexed and complicated subject, but when got right, it holds incredible potential for improving health outcomes and care. NHSX is leading the Government’s plans that will see the development of interoperable NHS IT systems that integrate health and care records, while of course considering issues that the hon. Member for Bristol South brought up in Committee when we were discussing similar matters—issues such as patient consent and data security.
We are very clear in our view that community pharmacy must play an enhanced role in the healthcare of our country, and it is our responsibility and NHS England’s responsibility to help support that. The right hon. Member for Knowsley made two final recommendations about meetings. The Government should promote a system-wide approach to improving health literacy, including working with royal colleges to include self-care modules in healthcare professionals’ training curricula and continuous professional development. I touched on that point in my response to his intervention. I have had many helpful and positive meetings with the royal colleges. I seek to meet them regularly—perhaps not as regularly as I would like, given the pressure of business in this place at times—because they have a depth of knowledge that is incomparable and incredibly useful.
Public Health England, when it was around, undertook a programme of work to improve health literacy across the country, and the Office for Health Improvement and Disparities will continue to work on that issue. The pharmacy integration programme will deliver a further almost £16 million-worth of post-registration training. That investment will equip pharmacy teams across primary care so that they are better prepared to support wider integrated healthcare delivery and expand their role in providing clinical care to patients. A pharmacist independent prescriber can provide autonomously for any condition within their clinical competence, with the exception of certain controlled drugs, particularly for the treatment of addiction. To become an independent prescriber, pharmacists must complete additional qualifications, which last typically six months, before they can prescribe.
In 2021, the General Pharmaceutical Council introduced new professional standards for initial education and training to ensure that the next generation of pharmacists is equipped with essential clinical skills. A key theme running through all the contributions today is that, when a resource is used, there can still be an untapped element of it that can be better utilised to provide support, alongside education, self-care and all the things we can do as individuals, to provide confidence and professional expertise.
NHSX should evaluate the use of technologies that have been developed during the covid-19 pandemic, and develop them to cover a wider range of minor ailments to promote self-care and manage demand on the NHS. I alluded to one example that we are working on. The Department is working with NHS Digital and NHS England and Improvement to encourage innovation and enable new approaches and organisations to support services and collaborate effectively.
I hope that, as someone whose policy area this is not, I have addressed at least in outline some of the right hon. Gentleman’s key recommendations. He made specific requests about meetings. I am always wary about that, because I have discovered that when I have meetings with my right hon. Friend the Member for Maidenhead (Mrs May) and you, Sir Charles, I come out having agreed to something or changed the direction of a policy, after being persuaded by both of you. I know that the right hon. Member for Knowsley is equally persuasive. With that in mind, I am happy to ask the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Lewes, to arrange to meet the right hon. Gentleman, my right hon. Friend the Member for Maidenhead and you, Sir Charles, to discuss this issue more broadly.
The right hon. Member for Knowsley also asked for a meeting with Diabetes UK and the relevant Minister. I will certainly pass that on to the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Lewes. In the context of the elective recovery work and my work with the NHS more broadly, I have met a number of charities in the course of developing the elective recovery plan and since we published it. I am always happy to meet charities and other organisations that do so much not only to educate people and campaign on issues, but sometimes to press us in particular directions. They always do so with good intentions and to support people. In that context, I have also met trade unions and other bodies, because I believe that a collaborative approach in this space is useful. I will pass the request on to the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Lewes, but if the right hon. Member for Knowsley feels that this could also fall within the ambit of elective recovery or of my role as Minister sponsoring the NHS long-term plan, I will of course, framed in that way, also be happy to meet Diabetes UK—I have met many charities in recent months.
If that does not provide the right hon. Gentleman with immediate agreement on what he called on the Government to do, I hope it provides him with some reassurance of just how seriously we take this issue and the recognition of just how important self-care is for each of us as individuals, for our constituents, for our healthcare system and indeed for this country. And I am very grateful to him for bringing the matter before the House today.
Thank you, Sir Charles, for calling me to sum up.
First, I thank everybody who has taken part in this debate: my hon. Friend the Member for Bootle (Peter Dowd), the hon. Member for Glasgow Central (Alison Thewliss), my hon. Friend the Member for Bristol South (Karin Smyth), who is the shadow Minister, and the Minister himself. As I had hoped it would be, it has been a constructive debate. Although the Minister did not quite go as far as agreeing with me on every single point that I made, he showed a degree of understanding and presented what he had to say as constructively as everybody else’s contribution was. He was unfailingly polite, although I have learned through bitter experience that Ministers can be unfailingly polite and then go away and forget all about the matter that has just been discussed. However, I am sure that will not be the case now.
I am grateful and I see this debate not as the end of a process but as its beginning, and I am pleased that the Minister has nodded in agreement with that comment. And believe me, we will take up his offer of various meetings to progress these matters, including with your good self, Sir Charles.