“The Secretary of State may by regulations require tobacco manufacturers to print health warnings on individual cigarettes and cigarette rolling papers.”—(Mary Kelly Foy.)
This new clause would give powers to the Secretary of State to require manufacturers to print health warnings on individual cigarettes.
Brought up, and read the First time.
With this it will be convenient to discuss the following:
New clause 3—Cigarette pack inserts—
“The Secretary of State may by regulations require tobacco manufacturers to display a health information message on a leaflet inserted in cigarette packaging.”
This new clause would give powers to the Secretary of State to require manufacturers to insert leaflets containing health information and information about smoking cessation services inside cigarette packaging.
New clause 4—Packaging and labelling of nicotine products—
“The Secretary of State may by regulations make provision about the retail packaging and labelling of electronic cigarettes and other novel nicotine products including requirements for health warnings and prohibition of branding elements attractive to children.”
This new clause would give powers to the Secretary of State to prohibit branding on e-cigarette packaging which is appealing to children.
New clause 5—Sale and distribution of nicotine products to children under the age of 18 years—
“(1) The Secretary of State may by regulations prohibit the free distribution of nicotine products to those aged under 18 years, and prohibit the sale of all nicotine products to those under 18.
(2) Regulations under subsection (1) must include an exception for medicines or medical devices indicated for the treatment of persons aged under 18.”
This new clause would give powers to the Secretary of State to prohibit the free distribution or sale of any consumer nicotine product to anyone under 18, while allowing the sale or distribution of nicotine replacement therapy licensed for use by under 18s.
New clause 6—Flavoured tobacco products—
“The Secretary of State may by regulations remove the limitation of the prohibition of flavours in cigarettes or tobacco products to ‘characterising’ flavours, and extend the flavour prohibition to all tobacco products as well as smoking accessories including filter papers, filters and other products designed to flavour tobacco products.”
This new clause would give powers to the Secretary of State to prohibit any flavouring in any tobacco product or smoking accessory.
New clause 8—Tobacco supplies: statutory schemes (supplementary)—
“(1) The Secretary of State may make any provision the Secretary of State considers necessary or expedient for the purpose of enabling or facilitating—
(a) the introduction of a statutory scheme under section [Tobacco supplies: Statutory schemes], or
(b) the determination of the provision to be made in a proposed statutory scheme.
(2) The provision may, in particular, require any person to whom such a scheme may apply to—
(a) record and keep information,
(b) provide information to the Secretary of State in electronic form.
(3) The Secretary of State must—
(a) store electronically the information which is submitted in accordance with subsection (2);
(b) ensure that information submitted in accordance with this provision is made publicly available on a website, taking the need to protect trade secrets duly into account.
(4) Where the Secretary of State is preparing to make or vary a statutory scheme, the Secretary of State may make any provision the Secretary of State considers necessary or expedient for transitional or transitory purposes which could be made by such a scheme.”
New clause 9—Tobacco supplies: enforcement—
“(1) Regulations may provide for a person who contravenes any provision of regulations or directions under section [Tobacco supplies: statutory schemes] to be liable to pay a penalty to the Secretary of State.
(2) The penalty may be—
(a) a single penalty not exceeding £5 million,
(b) a daily penalty not exceeding £500,000 for every day on which the contravention occurs or continues.
(3) Regulations may provide for any amount required to be paid to the Secretary of State by virtue of section [Tobacco supplies: statutory schemes] (4) or (6)(b) to be increased by an amount not exceeding 50 per cent.
(4) Regulations may provide for any amount payable to the Secretary of State by virtue of provision made under section [Tobacco supplies: statutory schemes] (3), (4), (5) or (6)(b) (including such an amount as increased under subsection (3)) to carry interest at a rate specified or referred to in the regulations.
(5) Provision may be made by regulations for conferring on manufacturers and importers a right of appeal against enforcement decisions taken in respect of them in pursuance of [Tobacco supplies: statutory schemes], [Tobacco supplies: statutory schemes (supplementary)] and this section.
(6) The provision which may be made by virtue of subsection (5) includes any provision which may be made by model provisions with respect to appeals under section 6 of the Deregulation and Contracting Out Act 1994 (c. 40), reading—
(a) the references in subsections (4) and (5) of that section to enforcement action as references to action taken to implement an enforcement decision,
(b) in subsection (5) of that section, the references to interested persons as references to any persons and the reference to any decision to take enforcement action as a reference to any enforcement decision.
(7) In subsections (5) and (6), ‘enforcement decision’ means a decision of the Secretary of State or any other person to—
(a) require a specific manufacturer or importer to provide information to him,
(b) limit, in respect of any specific manufacturer or importer, any price or profit,
(c) refuse to give approval to a price increase made by a specific manufacturer or importer,
(d) require a specific manufacturer or importer to pay any amount (including an amount by way of penalty) to the Secretary of State, and in this subsection ‘specific’ means specified in the decision.
(8) A requirement or prohibition, or a limit, under section [Tobacco supplies: statutory schemes], may only be enforced under this section and may not be relied on in any proceedings other than proceedings under this section.
(9) Subsection (8) does not apply to any action by the Secretary of State to recover as a debt any amount required to be paid to the Secretary of State under section [Tobacco supplies: statutory schemes] or this section.
(10) The Secretary of State may by order increase (or further increase) either of the sums mentioned in subsection (2).”
This new clause and NC7, NC8 and NC10 would enable the Secretary of State for Health and Social Care to regulate prices and profits of tobacco manufacturers and importers.
New clause 10—Tobacco supplies: controls: (supplementary)—
“(1) Any power conferred on the Secretary of State by section [Tobacco supplies: statutory schemes] and [Tobacco supplies: statutory schemes (supplementary)] may be exercised by—
(a) making regulations, or
(b) giving directions to a specific manufacturer or importer.
(2) Regulations under subsection (1)(a) may confer power for the Secretary of State to give directions to a specific manufacturer or importer; and in this subsection ‘specific’ means specified in the direction concerned.
(3) In this section and section [Tobacco supplies: statutory schemes] and [Tobacco supplies: statutory schemes (supplementary)] and [Tobacco supplies: enforcement]—
‘tobacco product’ means a product that can be consumed and consists, even partly, of tobacco;
‘manufacturer’ means any person who manufactures tobacco products;
‘importer’ means any person who imports tobacco products into the UK with a view to the product being supplied for consumption in the United Kingdom or through the travel retail sector, and contravention of a provision includes a failure to comply with it.”
This new clause and NC7, NC8 and NC9 would enable the Secretary of State for Health and Social Care to regulate prices and profits of tobacco manufacturers and importers.
New clause 11—Age of sale of tobacco—
“The Secretary of State must consult on raising the age of sale for tobacco from 18 to 21 within three months of the passage of this Act.”
This new clause would require the Secretary of State to consult on raising the age of sale for tobacco products to 21.
New clause 14—Implementation of Restrictions on advertising of less healthy food and drink online—
“The regulator shall put in place a mechanism for the delivery of the requirements under Part 2 of Schedule 16 which shall require that advertisers—
(a) apply media targeting filters, based on robust audience measurement data, to ensure the avoidance of children’s media or editorial content of particular appeal to children;
(b) use audience targeting tools and, where available, proprietary audience or other first-party data to further exclude children; and
(c) use campaign evaluation tools to assess audience impacts and use any learning to continually improve future targeting approaches.”
This new clause would require the regulator to put in place a three-step “filtering” process for restricting online advertising by managing the targeting of an online advertising campaign for foods that are high in fat, salt or sugar, as developed by the Committee of Advertising Practice of the Advertising Standards Authority.
New clause 15—Alcohol product labelling—
“The Secretary of State must by regulations make provision to ensure alcoholic drinks, as defined by the Department for Health and Social Care’s Low Alcohol Descriptors Guidance, published in 2018, or in future versions of that guidance, display—
(a) the Chief Medical Officers’ low risk drinking guidelines,
(b) a warning that is intended to inform the public of the danger of alcohol consumption,
(c) a warning that is intended to inform the public of the danger of alcohol consumption when pregnant,
(d) a warning that is intended to inform the public of the direct link between alcohol and cancer, and
(e) a full list of ingredients and nutritional information.”
This new clause requires the Secretary of State to introduce secondary legislation on alcohol product labelling.
New clause 16—Annual report on alcohol treatment services: assessment of outcomes—
“(1) The Secretary of State must lay before each House of Parliament at the start of each financial year a report on—
(a) the ways in which alcohol treatment providers have been supported in tackling excess mortality, alcohol related hospital admissions, and the burden of disease resulting from alcohol consumption, and
(b) the number of people identified as requiring support who are receiving treatment.
(2) Alongside the publication of the report, the Secretary of State must publish an assessment of the impact of the level of funding for alcohol treatment providers on their ability to deliver a high-quality service that enables patient choice.”
This new clause would require the Secretary of State for Health and Social Care to make an annual statement on how the funding received by alcohol treatment providers has supported their work to improve treatment and reduce harm.
New clause 17—Minimum unit price for alcohol—
“(1) The Secretary of State must by regulations make provision to ensure alcoholic drinks, as defined by the Department for Health and Social Care’s Low Alcohol Descriptors Guidance published in 2018, or in later versions of that document, are liable to a minimum unit price.
(2) The regulations must provide for the minimum unit price to be calculated by applying the formula M x S x V, where—
(a) M is the minimum unit price, expressed in pounds sterling,
(b) S is the percentage strength of the alcohol, expressed as a cardinal number, and
(c) V is the volume of the alcohol, expressed in litres.”
This new clause requires the Secretary of State to introduce secondary legislation that applies a minimum unit price to alcohol.
Amendment 14, in clause 138, page 118, line 5, after “drink)”, insert
“and section [Minimum unit price for alcohol]”.
This amendment would bring NC17 into force at the same time as section 129 and Schedule 16 (advertising of less healthy food and drink).
Amendment 3, in schedule 16, page 222, line 8, at end insert—
“(3) A brand may continue to advertise, or provide sponsorship, if the advertisement or sponsorship does not include an identifiable less healthy food and drink product.”.
This amendment makes an explicit exemption from the advertising restrictions on television programme services between 5.30 am and 9.00 pm for brand advertising and sponsorship, where there is no identifiable less healthy food and drink product.
Government amendments 31 and 32.
Amendment 11, in schedule 16, page 222, line 26, at end insert—
“(da) a drink product is ‘less healthy’ if it is an alcoholic product in accordance with the Department for Health and Social Care’s Low Alcohol Descriptors Guidance, published in 2018, or future versions of that guidance;”.
This amendment ensures that alcohol is considered a “less healthy” product and therefore liable to the watershed proposed for TV programme services.
Amendment 111, in schedule 16, page 222, line 28, leave out from “meaning” to end of line 30 and insert
“given in Section 465 of the Companies Act 2006 (Companies qualifying as medium-sized: general)”.
This amendment, and Amendments 112 and 113, aims to define companies to whom the advertising restrictions imposed by this schedule would apply as medium-sized companies within the meaning given by section 465 of the Companies Act 2006.
Government amendment 33.
Amendment 6, in schedule 16, page 222, line 38, after “unless”, insert
“a public consultation has been carried out on the proposed change to the relevant guidance, and”.
This amendment requires a public consultation to take place before any change can be made to the Nutrient Profiling Technical Guidance under which a food or drink product may be identified as “less healthy” and its advertising restricted on television programme services between 5.30 am and 9.00 pm.
Amendment 4, in schedule 16, page 223, line 4, at end insert—
“(3) A brand may continue to advertise, and provide sponsorship as a brand, if the advertisement or sponsorship does not include an identifiable less healthy food and drink product.”.
This amendment makes explicit exemptions from the advertising restrictions on on-demand programme services for brand advertising and sponsorship, where there is no identifiable less healthy food and drink product.
Government amendments 34 and 35.
Amendment 12, in schedule 16, page 223, line 24, at end insert—
“(da) a drink product is “less healthy” if it is an alcoholic product in accordance with the Department for Health and Social Care’s Low Alcohol Descriptors Guidance, published in 2018, or future versions of that guidance;”.
This amendment ensures that alcohol is considered a “less healthy” product and therefore liable to the watershed proposed for TV programme services.
Amendment 112, in schedule 16, page 223, line 26, leave out from “meaning” to end of line 27 and insert
“given in Section 465 of the Companies Act 2006 (Companies qualifying as medium-sized: general)”.
See explanatory statement to Amendment 111.
Government amendment 36.
Amendment 7, in schedule 16, page 223, line 36, after “unless”, insert
“a public consultation has been carried out on the proposed change to the relevant guidance, and”.
This amendment requires a public consultation to take place before any change can be made to the Nutrient Profiling Technical Guidance under which a food or drink product may be identified as “less healthy” and its advertising restricted on on-demand programme services.
Amendment 106, in schedule 16, page 224, line 8, leave out “must not pay for” and insert
“must not market, sell or arrange”.
This series of connected probing amendments is intended to create parity in treatment of television and online advertising. The platform carrying the advertising, rather than those paying for advertising, would be responsible for the placing of advertisements. The wording to denote a platform mirrors that used by Ofcom in its recent regulation of Video Sharing Platforms consultation.
Amendment 110, in schedule 16, page 224, line 16, at end insert—
“(aa) in relation to advertisements placed on distributor or retailer websites which are associated with the sale of food or drink”.
This amendment aims to ensure paid-for branded HFSS product advertisements are treated as equivalent to HFSS own-brand products on retailer-owned spaces.
Government amendment 37.
Amendment 5, in schedule 16, page 224, line 26, at end insert—
“(4) A brand may continue to advertise, and provide sponsorship as a brand, if the advertisement does not include an identifiable less healthy food and drink product.”.
This amendment makes an explicit exemption from the restrictions on online advertising for brand advertising and sponsorship, where there is no identifiable less healthy food and drink product.
Government amendment 38.
Amendment 13, in schedule 16, page 225, line 10, at end insert—
“(fa) a drink product is “less healthy” if it is an alcoholic product in accordance with the Department for Health and Social Care’s Low Alcohol Descriptors Guidance, published in 2018, or future versions of that guidance;”.
This amendment ensures that alcohol is considered a “less healthy” product and therefore liable to the online ban.
Amendment 113, in schedule 16, page 225, line 12, leave out from “meaning” to end of line 14 and insert
“given in Section 465 of the Companies Act 2006 (Companies qualifying as medium-sized: general)”.
See explanatory statement to Amendment 111.
Government amendment 39.
Amendment 8, in schedule 16, page 225, line 24, after “unless”, insert
“a public consultation has been carried out on the proposed change to the relevant guidance, and”.
This amendment requires a public consultation to take place before any change can be made to the Nutrient Profiling Technical Guidance under which a food or drink product may be identified as “less healthy” and its advertising restricted online.
Amendment 107, in schedule 16, page 225, line 28, leave out “made a payment for” and insert “marketed, sold or arranged”.
See explanatory statement for Amendment 106.
Amendment 108, in schedule 16, page 225, line 30, leave out “made” and insert “received”.
See explanatory statement for Amendment 106.
Amendment 109, in schedule 16, page 227, line 3, leave out from “with” to end of line 4 and insert
“the person marketing, selling or arranging advertisements published on the internet”.
See explanatory statement for Amendment 106.
Before I address the amendments tabled in my name, I want to briefly voice my support for amendments 11 to 13 and new clauses 15 to 17, in the name of my hon. Friend Dan Carden, which call for improved regulation of alcohol marketing and labelling, for minimum unit pricing in England and for better assessment of treatment outcomes. Sadly, my hon. Friend cannot be here today, as he is with his family and his father Mike, who is receiving palliative care after many months of treatment for lung cancer. I know how important these issues are to my hon. Friend; I express my love and solidarity, and that of the whole House, at this difficult time for him and his loved ones.
Smoking is one of the biggest causes of ill health. It has a devastating impact on our population: it killed approximately the same number of people in 2019 as covid 19 in 2020, and one in every two smokers will die from smoking-related illnesses. The Government and the Opposition both support a smoke-free 2030, but without meaningful action, that ambition will be missed by seven years—or by double that number of years, in the case of the poorest in society.
Does my hon. Friend agree that Professor Marmot’s work on social and health inequalities shows that 0.5% of GDP should be spent on health inequalities such as those she describes?
I could not agree more. Michael Marmot is one of the most important health inequalities experts around.
To make matters worse, smoking rates among young adults have surged to 25% above pre-lockdown rates. However, despite the damage that missing the 2030 target would cause, there is nothing in the Bill that would help to achieve the Government’s ambition to make smoking obsolete. That is why the all-party parliamentary group on smoking and health, of which I am the vice-chair, is fighting to get the 2030 ambition back on track. I was delighted to hear the Minister say in Committee that the Government would review the APPG’s proposals as they developed their own tobacco control plan, but that plan, which was due this year and expected in July, is now likely to be delayed beyond the end of the year. If the Government are serious about creating a smoke-free England by 2030, they will implement the APPG’s recommendations as soon as possible, and the Bill provides the ideal opportunity for them to do so.
Let me quickly summarise new clause 2. It gives the Secretary of State powers to add health warnings to cigarettes and cigarette papers. The Government are reviewing the proposal, but have said that more research is needed. Health warnings such as “Smoking Kills” have been shown to be effective on billboards and tobacco packs, so why on earth would they not be effective on individual cigarettes? At least eight peer-reviewed papers have been published in the last five years showing that the measures are effective. Similarly, new clause 3 would give the Secretary of State powers to require health information messages to be inserted in cigarette packs. That has been a legal requirement in Canada since 2000, and there is substantial evidence to show that it works there. Research carried out in the UK supports its use here as well.
The hon. Lady will, of course, understand that one of our key aims must be to stop younger generations taking up smoking in the first place. Does she believe that her proposals—which I fully support—will help to achieve that key strategic aim?
The hon. Lady has said that these measures apply to England, but they will of course have an effect throughout the United Kingdom—and rightly so—contributing to our aim to bring about a smoke-free Wales as well.
Again, I could not agree more.
In Committee, the Minister said that the Department could already legislate under the Children and Families Act 2014 to require the insertion of such information messages. In that case, why do the Government not commit themselves to doing so now?
New clauses 4 to 6 address loopholes in current legislation. Now that those loopholes have been identified to the Government, they should be fixed without delay, and today we have the opportunity to do so. New clause 4 would give the Secretary of State powers to remove child-friendly branding elements from nicotine products. There are e-liquids on the market that are given sweet names, such as “gummy bears”, and that have branding that is in garish colours and features cartoon characters. Surely more evidence is not necessary to prove that such branding risks attracting children.
Is this not one of the most important of the hon. Lady’s new clauses? As people age and die—events often driven by cigarettes—or perhaps manage to give up, the tobacco companies must recruit the young, with the indefensible aim of persuading them to start smoking.
I entirely agree. Tobacco is the only legal product that kills one in two of those who use it, and most people start smoking at a young age. These new clauses are therefore extremely important, because they would tackle that problem.
The figures back up what the hon. Lady says. Two thirds of smokers in the UK start smoking under the age of 18, and over a third—39%—start under the age of 16. What she proposes will address that issue in a substantial way. We need legislation in place, and there needs to be punishment as well; that is the only way forward.
I thank the hon. Gentleman, and I will address that issue.
New clause 5 would close another loophole in the law, which allows the free distribution of e-cigarettes and other consumer nicotine products to children under 18. The Government rejected the proposal, saying that there was no evidence of a serious problem, but the Minister sympathised with the argument for preventive action. Prevention is precisely our intention. Fixing this loophole is an appropriate application of the precautionary principle.
New clause 6 would remove the limitations on the ban on flavourings in tobacco products. That ban currently applies only to characterising flavours. The new clause would extend the flavour ban to all tobacco products, as well as to smoking accessories, including filter papers, filters and other products designed to favour tobacco products. In Committee, the Minister claimed it was unclear how a ban could be enforced in practice, as it would include a ban on flavours that did not give a noticeable flavour to the product. I suggest that he seek advice from Canada on this point, where a complete ban on flavours is already in place and has been highly effective.
The new clauses on the tobacco levy would give powers to the Secretary of State to implement a “polluter pays” levy on tobacco manufacturers. The Minister dismissed this in Committee as a matter of taxation for the Treasury to consider. However, we are not proposing additional taxation. Our new clauses are modelled on the American user fee and on the pharmaceutical pricing scheme in the UK.
Does my hon. Friend agree that prevention is much better than cure, because so many adult smokers have a terrible experience when trying to give up, and it comes at a huge cost to their health?
I thank my hon. Friend for that intervention. A theme throughout these new clauses is that most people start smoking when they are children or when they are young, and most of them say that they wish they had never started. The new clauses would tackle young people’s access to tobacco-related products.
It is often vulnerable children, and often those in care, who start smoking early, so does my hon. Friend agree that it is incredible that the Government have so far said that they will not support these new clauses?
Yes, it is absolutely incredible. We have heard that a tobacco plan might be on its way, but every day that goes by without our putting these recommendations in place is another day on which someone dies of tobacco harm, and on which more young people become addicted to nicotine products.
Discussions with the Treasury on the “polluter pays” levy would not be necessary. The Food and Drug Administration administers the user fee in the United States, and the Department of Health and Social Care could and should administer such a scheme here.
New clause 11 has been revised in the light of the Government’s response to our proposal in the Committee, in which they cited the need to
“review the evidence base of increasing the age of sale to 21 in more detail”.––[Official Report, Health and Care Public Bill Committee,
They also stated the need for a public consultation. I agree that a consultation is the appropriate next step, so the new clause has been revised to require the Government to consult on raising the age of sale for tobacco from 18 to 21 within three months of the passage of this legislation.
To sum up, my new clauses address loopholes in the law. They would take incremental and obvious next steps to strengthen tobacco regulation still further, and they would provide the funding that is desperately needed to deliver the Government’s smoke-free 2030 ambition—funding that the spending review failed to deliver. When I was chair of the Gateshead tobacco control alliance, I saw the damage that smoking can do. It shortens life expectancy, increases the pressure on our health services, drives down productivity and drains wealth from our poorest communities—and for one in every two smokers, it will kill them. Eventually, the Government will have to accept that the measures proposed are necessary. The only question is how long they will wait, and how many lives will be ruined by tobacco in the meantime. I urge the Government to accept these new clauses in full.
I rise to speak in this debate to outline the case behind amendments 106 to 109 in my name, and to speak in favour of those in the names of my hon. Friends the Members for Carlisle (John Stevenson) and for North East Bedfordshire (Richard Fuller). I am also grateful from the outset for the time that my right hon. Friends the Secretaries of State for Health and Social Care and for Digital, Culture, Media and Sport have afforded me in recent weeks to discuss these matters.
First and foremost, I want to set out that in principle I am opposed to the expansion of the nanny state. I did not get into politics to tell people what they should or should not eat, or businesses how they should go about advertising their products and wares. However, I equally do not doubt for one moment that obesity is a serious health concern for this country. It is a question of the detail and the manner in which we go about tackling it as a country—principally, that we go about it through education and ensuring people are able to make choices for themselves, rather than using blunt tools that I fear will not work. As I highlighted in a Backbench Business debate on the obesity strategy some months ago, the Government’s own research shows that the measures in the Bill will reduce calorie intake among children by only 1.74 calories a day. If that is the outcome, we must seriously question the measures before us.
The amendments in my name, however, seek to rectify an unfairness that will exist if the Government push ahead with these advertising restrictions, which have businesses in my constituency very concerned. For example, farmers such as Morris of Hoggeston, who grow oats, are concerned that within the categories under the HFSS, or high in fat, sugar or salt, measures, products such as porridge and granola, which are hardly the choice of most children—certainly not my children—are in scope. We need to do something to sort that out. Great British broadcasters, both public service and fully commercial, also stand to lose some £200 million a year from the restrictions we have before us.
My amendments are about fundamental fairness, and seek to treat broadcasters the same way as online platforms. In the first place, research shows that children, who these measures are most prominently aimed at, do not watch broadcast television as much as they used to. They look more and more to YouTube, on-demand services and online; I can testify to that from my own home, where my five-year-old much prefers YouTube to watching CBeebies or other children’s television programmes, and I think that is the same for most children. [Interruption.] I am not sure what is causing amusement on the Opposition Benches.
In fact, 95% of viewing of broadcast television before the 9 pm watershed is by adults, not children, and there are already regulations in place during scheduled children’s programming. So I fear the measures in this Bill will not work, and the fundamental unfairness that I spoke of earlier is the manner in which broadcasters will be treated compared with the online platforms.
I have listened carefully to what the hon. Gentleman has said. Given that there is this disparity between the online advertiser and the broadcaster advertiser, and if we are seeking to restrict broadcasting advertisement to children so that they do not become unhealthy, would not the logic follow that we should equally restrict the online advertiser, rather than saying, “Let’s allow more of a free for all because this is more difficult to do for the online”?
I am grateful to the hon. Gentleman for his intervention. If he will let me make a little more progress, I think he will find that my amendments seek to put a harsher perspective of this on the online platforms, rather than letting anyone off anything whatsoever. I repeat that my fundamental position is one of opposition to the nanny state and restrictions, but recognising that if the Government are going to push these restrictions forward, we have to have fairness and parity across broadcast and online sectors, otherwise there will be loopholes, things will fall through the cracks and the Government will not achieve their objectives.
I certainly support the argument that my hon. Friend is putting forward. Does he feel that the Government have found themselves in a position where they feel they need to react because of the genuine obesity crisis among young people and this would seem to be the highest-profile publicity effort, but that really we should be focusing on the evidence of the case and the argument, so that we can actually have an impact on it, rather than steal the headline that might just last a couple of days?
My right hon. Friend has hit the nail on the head: if we are to tackle obesity as a country, we have to look at the most successful outcomes. Fundamentally, I believe those to be ones of education, ensuring that parents are empowered to be able to make the best decisions for their children and ensuring that people are empowered to come to the right choices for themselves. The point about these amendments is to ensure that we are not giving a green light to one side while harshly penalising another for hosting these adverts.
The nub of the point is that the broadcasters will, in effect, have to pre-clear any advertising that is put on to their platform and there will be very harsh penalties, leading right up to the point of revocation of their broadcast licence, if they fail to do this. By contrast, although the Bill puts significant restrictions on the online platforms, they are not put through that same test. They are not put through the same harsh restrictions and requirements that are broadcasters are. This is especially important when we consider recent evidence that has been put into the public domain. The Advertising Standards Authority recently drew considerable attention to the mass flouting of the rules by online influencers across many sectors. This House’s Select Committee on Work and Pensions made an important point about online regulation in a report in March this year on protecting pension savers. It said:
“Regulators appear powerless to hold online firms to account”— for online advertisements—
“in the same way they would be able to for traditional media.”
We need to bear that in mind as we consider this Bill, because if current regulations do not work in that field, I fear that the regulations on online providers proposed in this Bill will not either.
I offer these amendments as a call to those on the Treasury Bench, including the Minister for Health, my hon. Friend Edward Argar—an excellent Minister who will consider these points carefully—to rethink the practicalities of what we are saying to the broadcast and online sectors. If the Government are intent on pushing this forward, I ask them to find that parity that ensures that broadcasters are not unfairly penalised. Great British broadcasters—ITV, Channel 4, Channel Five, Sky—already produce some incredible educational programming about diet, cooking, wellbeing and lifestyle. It would be horrendous for us to cut off their lifeline of funding.
I have put my name to my hon. Friend’s amendments because I agree with the points that he makes.
It is surely vital that those responsible broadcasters should not be penalised when they are doing the right thing—and yet there is effectively a wild west on the internet, where we are simply not able to manage the issue. I recognise that the Minister will be concerned that the online harms Bill will also deal with some of these matters, but we need to find a cross-Government way of dealing with this.
My right hon. Friend is absolutely right and speaks with great experience from her time as Secretary of State at DCMS. That is the fundamental point of the amendments; it is not a complex or difficult case, but purely one of fairness and treating the different platforms—the diverse media of 2021—the same, rather than pretending that the media from the old analogue age can somehow be treated differently from those of the digital age.
Let us not cut off the lifeline that funds so many good educational programmes. Let us think again about restrictions on advertisers, move forward in a way that can enable people to make the right and healthy choices about what they and their children eat without this level of restriction, and ensure that, when restriction is brought in, it is fair.
It is a pleasure to speak for the Opposition in this first part of the debate on the Bill.
A decade ago, virtually to the day, I was a young activist taking part in marches, protests, online campaigns, letter writing campaigns, petitions and much more in opposition to what would become the Health and Social Care Act 2012. We argued that it would lead to more fragmentation, less integration, confused decision making and more privatisation and that it would not make anybody any healthier.
Despite significant opposition to the legislation, the Government pushed on. But as campaigners, we were right, weren’t we? The 2012 Act created a fragmented system that did not promote health and care integration. Performance against NHS targets, even pre-pandemic, was dismal and now it is even worse. Waiting lists have grown extraordinarily, and staff vacancies have grown to crisis proportions.
We are here today and tomorrow to consign that legislation to history—perhaps less the end of an era and more the end of an error. But the same Government who broke the system now offer a new package of reforms, and that should really scare us. These are the wrong reforms at the wrong time. There are no answers in them to the waiting times crisis, no answers to the capacity issues in accident and emergency or our ambulance services, no answers to access issues for our GPs or dentists, and no answers to the environmental factors that make a country with so many assets so unhealthy.
Yes. That was a strong theme in Committee that we on the Opposition Benches are very much against; it is likely to be a prominent theme during our discussion of upcoming amendments. Through what we are discussing now, we at least have the chance to put something in the Bill that might improve the public’s health.
My hon. Friend talked about waiting lists. Would he confirm that at the moment approximately 5.6 million people are on the waiting list and that the Government’s own projections are that that figure could rise to 13 million? What in the Bill does my hon. Friend believe can address that extraordinary situation?
My hon. Friend makes an important point. This Secretary of State must be the first in the history of the NHS who came into that important role saying that he was expecting waiting times to grow to the extent that they are. That is of course pandemic-related, but it also has a reality far beyond this extraordinary last 18 months. There are more than 125 clauses in the Bill and the Government have proposed more new clauses in Committee and on Report, but not one of them will have a meaningful impact on waiting times, so people should be really disquieted.
I have listened carefully to the hon. Member’s comments about waiting times in England and the measures that are to be introduced here. He urged disquiet; can I assume that his disquiet is even louder when he considers my constituents in Wales who have much longer waiting times?
There is a danger that the right hon. Gentleman has missed the point. The reality is that for a decade there has been historically low investment in our health service, which of course has Barnett consequentials for Wales. That is the reality and why the system is as distressed as it is. I do not think he can put that at the door of the Welsh Government.
Let me come back to public health. Over the past five years we have removed £1 billion in public health funding, which means that the challenges in respect of childhood obesity, smoking, sexual health and access to drug and alcohol services are all developing and growing. The sad thing is that such cuts make an immediate local government saving for the Treasury but create greater costs for the public purse later, never mind the impact on people’s lives. They are the falsest of false economies. For all the talk of the end of austerity, last month’s Budget did nothing to tackle that reality. Indeed, local authorities are under greater pressure and the cycle will continue.
Being smoke-free by 2030 is a major national prize, and with that I turn to new clauses 2 to 11, tabled by my hon. Friend Mary Kelly Foy. She made an excellent case and has shown tremendous leadership on this issue, in concert with Bob Blackman, through the all-party parliamentary group on smoking and health. They have given the Government a number of really good ways to improve our nation’s efforts and I hope we will hear from the Minister that they will be taken on.
Tackling smoking is a crucial part of not only improving the nation’s health but addressing health inequalities. A child born where I live, Nottingham, can expect to live seven years fewer than a child born here in Westminster. When it comes to healthy life expectancy, we can expect that difference to double. Tackling that inequality should be a core part of the business of this place. Nearly half that inequality is attributable to smoking—that is how pivotal this issue is.
Successive Governments have shown over the past 25 years that we can make inroads with public policy on smoking, but the benefits have been unevenly felt: the smoking rate among those in professional occupations is now down to just one in 10, so is well on track to meet the 2030 target, but incidence rates among those in manual or routine occupations remain a stubborn one in four, so we must now renew our efforts with that group of people who are, of course, disproportionately likely to use stop smoking services—the very services we have lost over the past decade. Of course, as my hon. Friend the Member for City of Durham said, the pandemic has posed new challenges, with a new group of people who have started smoking but would not otherwise have done so.
We have been promised a new tobacco control plan by the end of this year, but that promise looks a little less secure by the day—I hope the Minister will tell me I am wrong. We could get on with impactful interventions right away. The labelling and information interventions set out in new clauses 2 to 4 have very strong evidence bases from other countries, as my hon. Friend the Member for City of Durham said, and would be quick, easy to implement and impactful.
On new clause 4 in particular, we know that e-cigarettes and vaping are important quit aids, but we would not want them to be a gateway for children to smart smoking. We should be concerned about the 2021 YouGov research for ASH—Action on Smoking and Health—that suggests that more than 200,000 11 to 17-year-olds who had never smoked previously had tried vaping this year. As my hon. Friend the Member for City of Durham said, we must make sure that that age group does not take smoking through that route and that products are not targeted at it.
New clause 5 would tackle the bizarre loophole, which colleagues sometimes struggle to believe is true, that would allow the egregious practice whereby e-cigarettes or similar kit could be given free to someone under 18, although they cannot be sold. That is an extraordinary part of the law and I know that the Minister agrees it is daft—he said that in Committee, but also that he did not feel there was quite the evidence that it was a risk. Well, risk or not, I think the loophole should be closed, because I suspect that eventually someone will happen on it as a bright idea.
New clauses 8 and 10 are a beautiful support to any Minister who wants to improve smoking outcomes in this country, as I know this Minister does, but is conscious about the finances. This gives the Minister a chance, through a US-style polluter pays model, to fund all these interventions, including the restoration of the lost smoking cessation services in this country. He did not close the door to that in Committee when we talked about it, so I hope that he might tell us today that it is likely to form part of the new tobacco control plan. New clause 11 promotes a consultation on raising the age of sale, as we know that the older a person gets, the less likely they are to start smoking.
Let me turn to new clauses 15 to 17 and amendments 11 to 14 in the name of my hon. Friend Dan Carden. Colleagues will have been profoundly moved to hear him speak of his battle with alcoholism, and I know that his bravery has connected with people across the country. I associate myself with the remarks of my hon. Friend the Member for City of Durham regarding his entirely understandable absence from the Chamber today. With him in mind, I speak in support of those new clauses and amendments.
New clause 15 seeks to improve alcohol product labelling. This is overdue and it is popular. It is about not taking alcohol products out of people’s hands, but instead making sure that they can make an informed choice.
While an energy drink carries not only calorific information but a health warning that drinking too much can have a laxative effect, alcoholic drinks carry no calorific information and no health warning. Does the hon. Gentleman agree that that is a damning indictment of where we are in society and that a change, which the amendment could make, is needed?
I am grateful to the hon. Gentleman for that intervention. I completely agree with him. I would be the last one to police people’s consumption habits in the night-time economy for fear of being a hypocrite, but I do think that we should all have informed choice. What we have at the moment is inconsistent and unclear. We know that that frustrates people. A recent survey has shown that: 75% of people would like to know the number of units in a product; 61% would like to know the calorie information, as he mentions; and 53% would like to know the amount of sugar. We should give people the chance to have that full information to make their own decisions.
My hon. Friend will know that two thirds of people in Britain are overweight and that one in four is obese. An enormous amount of added sugar is put into processed foods that people do not know about. Men, for instance, are not supposed to have more than nine teaspoons of added sugar, and women six, which is the equivalent of a can of coke and a light yoghurt. Does he not agree that this Bill is tremendously light on the killer that sugar is, and that not only should we be labelling it, but that the Budget should tax added sugar in processed food to reduce the waiting list?
My hon. Friend will be delighted to hear that I will be coming on to the modesty of the Government’s plans for tackling obesity, but I have to finish my remarks about new clause 16.
New clause 16 compels the Secretary of State to publish an annual statement about the spend and impact of alcohol treatment funding. After a decade of reduced commitment in this vital area, the Secretary of State should seek to embrace this opportunity. At the moment, national Government cannot say they are meeting their responsibility to tackle alcohol harm with the requisite financial commitment and in the right place, which should discomfort them greatly. New clause 17 would replicate in England the minimum unit pricing restrictions that we see in Scotland and Wales, and we are all watching with great interest as evidence gathers as to their impact.
Let me now turn to the amendments and new clauses relating to advertising. The Government have included a couple of elements of their obesity strategy in the Bill. As I have already said to the Minister—in Committee and upstairs in the delegated legislation Committee—I wish that they had put the entire obesity strategy in this legislation, because there are bits that could have been improved by amendment, by debate and by discussion, as we heard in the contribution of Greg Smith, and as I dare say we will in that of Richard Fuller. We should have taken that approach to the entire document, and it is sad that we did not.
On the obesity strategy itself, it is too modest and it fails to attack a major cause of obesity, which is poverty.
The hon. Gentleman is absolutely right in what he is saying. I am a type 2 diabetic and I am well aware of the issues. As I understand it, figures that have been gathered during the covid-19 pandemic showed that the number of diabetics rose by some 200,000. That tells me that, if we are going to address the issue of diabetes, we need to have a tax process in place, which I think is what the hon. Gentleman is referring to, rather than a regulation, because that is the only way that we can control diabetes.
I think that a solution might be a little from column A and a little from column B, but I am grateful to the hon. Gentleman for making that point.
We have heard about the modesty of the strategy from the hon. Member for Buckingham. The reality is that any benefits from the obesity strategy will be outstripped by losses in the nation’s health caused by the impact of the cut to universal credit. We want the strategy to succeed, but it needs to be seen in that broader category.
Obesity is an important issue, with nearly two thirds of adults carrying excess weight. Childhood obesity is also a significant issue, with one in 10 children starting primary school obese, rising to one in five by the time they leave—extraordinary at such a young age.
I thank the shadow Minister, who is making an excellent argument, and colleagues across the House for all their work on this important Bill. Does he agree that we could do an enormous amount for the health of the nation by looking holistically at the role of exercise and prescribing exercise through the national health service, including swimming—the statistics on 11-year-olds who can swim 25 metres are going backwards due to all the lessons they have missed during coronavirus—and other important sports?
Yes, I agree. I look with real sadness at the loss of exercise-on-prescription schemes that were part of the public health grant but have gone over the last decade. Similarly, on swimming, the decisions in the Budget relating to local authorities will lead to councils, which are setting their budgets as we speak, closing more leisure centres and swimming pools. We should mourn those losses, which come as a result of a weak bit of public policy.
In the Bill, the proposed watershed with regard to high fat, sugar and salt products is broadly a good thing. With that in mind, we do not oppose Government amendments 31 to 39, which are relatively modest tweaks, but we should not lose sight of the fact that we are talking about a significant proposal; I know that colleagues have interest in this. Beyond a watershed on traditional broadcast media, we will also see a complete online ban of high fat, sugar and salt advertising. This is a blunt tool in pursuit of an important goal.
New clause 14 in the name of the hon. Member for North East Bedfordshire would implement a more nuanced system, as proposed by the advertising industry itself. This is mirrored in amendments 106 to 109 in the name of the hon. Member for Buckingham. We probed this point in Committee. I was surprised then, and remain surprised, that there seems to be little interest from Ministers or the Department in even having that conversation and exploring creative alternatives. The desired benefits are non-negotiables. If there are other ways to achieve those benefits, they ought to be approached with an open mind.
I am grateful to the hon. Gentleman for mentioning my new clause. We have a number of issues potentially to put to a vote later. Given what he has said and given that the Minister was a bit hazy about this issue in Committee, would he be minded to support my new clause if it were put to a vote and the Minister did not come forward with something more robust?
The hon. Gentleman tempts me, but my problem is that I want to know that the conversations have taken place and that the proposal has been considered as an option. I would not say today that I think it is the best option, but I am surprised that that conversation has not taken place, which is why I have highlighted it. There is still time for the Minister to reconsider, and he should.
I was less persuaded by amendments 3 to 5 in the name of the hon. Member for North East Bedfordshire, which seek to permit brand advertising as long as it does not refer to an HFSS product. In many cases, the brand and product are so inexorably intertwined that it might undermine the goals and aims of the whole intervention. I do, however, support amendments 6 to 8, which refer to the nutrient profiling model—the model that is used to determine what is and is not considered to be a high fat, sugar and salt product. It is important that there is certainty and that it does not move around more than the science would say that it ought to.
We talked about this issue at length in Committee. If we are asking the industry to reformulate and change, companies ought to be able to base product decisions on the certainty that the Government will not arbitrarily change the criteria. Such companies may have made significant time, financial or infrastructure investments in a certain product and then could see the criteria change overnight. In Committee, we extracted a commitment from the Minister to a Government amendment on this matter. That was reiterated in a letter on
“introducing a Government amendment at Commons Report Stage to include a duty to consult before changing the NPM technical guidance.”
I am surprised not to see that at this point. I hope that we will get clarity from the Minister, or indeed that he is minded to accept these amendments, because this is an important development. We also want the level playing field suggested by amendments 110 to 113, so we will be listening with great interest to his reply.
This is the wrong Bill at the wrong time. It does nothing to address the real causes of ill-health in this country today. In this part of the proceedings, colleagues have given the Minister a chance to change that and I hope he is minded to take it.
It is a great pleasure to follow Alex Norris. I will speak to new clause 14 and the other amendments in my name. I am grateful for the Opposition’s support for amendments 6, 7 and 8 and for an industry-led alternative—in spirit, if not necessarily in voting. I think the hon. Gentleman, as well as many of my hon. Friends, will be wanting to hear something from the Minister to show that he has been listening to concerns that have been raised across the House.
I was surprised and delighted to see on some of my amendments the name of Dr Whitford, but she advised me that that was an error, so I am sorry that the potential amity between me and those on the Scottish National party Benches will have to wait for another day.
I am grateful to the hon. Gentleman because that has saved me from having to put a disclaimer at the start of my speech, as I was rather shocked to find my name on his amendments. I just reiterate the point made by Alex Norris. It is a concern that the names of companies, as we saw in F1 racing and other things, simply promote certain types of food and drink and you cannot separate the brand from the product.
I am grateful to the hon. Lady for making her point clear.
As the hon. Lady and other hon. Members know, my amendments relate to the ways in which the Government are seeking to restrict advertising for foods that are high in fat, sugar and salt as part of their obesity strategy. Those measures essentially ban such advertising on TV before the 9 pm watershed and ban all paid-for HFSS advertising online at any time of the day or night. My hon. Friend Greg Smith has already done a very good job in drawing out some concerns about that.
What are the concerns about what the Government are doing? First, I should mention that I have a number of important food businesses based in my constituency, including Unilever and the cereal company Jordans Dorset Ryvita, and I think everyone would be surprised to hear that products such as porridge, muesli and granola are going to be subject to these bans. All these products have ingredients such as naturally occurring oils and sugars, as well as fibre, vitamins and minerals, and because of those natural ingredients they will be caught by the Government’s definition of “HFSS”.
It is also worth considering—I was not on the Committee and I do not know if it was considered at length—the impact on food services such as takeaways and home-delivered foods. Papa John’s, which is located near me in Milton Keynes, supports hundreds of entrepreneurs and small businesses through its franchise model, and it writes to warn me:
“These would restrict our ability to invest in our businesses and our people, at a time of significant economic uncertainty for the UK economy, and would also place our franchisees, many of whom are single owner small businesses, on an unsustainable financial footing.”
I think the Government have to do a few more hard yards in support of our small businesses, and this is not a very good way of showing any support for them.
The number of diabetics, both type 1 and type 2, across the United Kingdom and the number of children with obesity is rising. Does the hon. Gentleman feel that new clause 14 cannot address the issue of those rising numbers? If it cannot, what more needs to be done?
I absolutely do not agree. The reason why the Opposition Front-Bench team are probing on this is that we are not harnessing all the talents to come up with the solution. As the hon. Member for Nottingham North said, he does not have, or want, any objection to the objective—he just feels that there may be better ways to do it. That is what my amendments are trying to create. They would introduce a better way, working with established principles and with the industry—let us face it, it has the experts in this—rather than undermining issues to do with how the Advertising Standards Authority has managed how products are advertised and rather than bulldozing through the industry, which is the current process that the Government, or this Department anyway, are proposing.
Let us just remember that this pressure on our food and drink manufacturers is part of a wider effort of social responsibility that we are putting on them. The proposal does not sit alone, but with other things, in particular around environmental protection. The Food and Drink Federation has calculated that the cost of the UK Government’s proposed environmental health policies is at least £8 billion. That is equivalent to £160 a year on household food bills that we are asking the industry to take on.
It is estimated that the introduction of this policy will cost £833 million, but the Government’s own impact assessment estimates that the benefits are likely to be in the order of only £118 million. That is a real dead loss that we will be putting, let us face it, on food bills, primarily of those in lower income brackets. Members on all sides should take a moment to consider whether this is the right time and the right process for doing that. As the Government’s own assessment shows, the actual effect on diet for those who are targeted is estimated to be 1.7 calories a day, so it is a lot of effort and cost, but not very much impact.
New clause 14 proposes an alternative that would require the regulator to implement an alternative set of increased restrictions for online, but developed through the industry by the Committee of Advertising Practice. The new clause would legislate for a three-step filtering process drawn up by the industry to appropriately manage the targeting of online ad campaigns.
Another of my amendments would introduce brand exemptions. I take a different view from the hon. Member for Central Ayrshire, who said that brands are intrinsically tied to their product. The truth of the matter is that Coca Cola is made by Coke and Coke Zero is made by Coke. Coke Zero is advertised with the word “Coke” on it. This issue is not necessarily covered by the legislation, but Coke is not tied to one thing. Brands are extraordinarily flexible in how they can assist progress in achieving some social means. The Minister should consider looking again at this area.
Finally, on the nutritional profile, the issue is consultation. I can see that the Secretary of State has tabled some amendments on that, and perhaps the Minister can talk about that. They do not seem to make the changes I would like to see, but I would be interested to hear what he has to say.
It is worrying that the Government have undermined the Advertising Standards Authority with their approach. One of the other things is targeted advertising. I am sure it has struck hon. Members here as it has me that the tech revolution of the dotcom era was 20 years ago, and two decades of technical expertise in understanding how adverts are targeted is being swept away or ignored by the Department of Health and Social Care, which would much rather have “nanny knows what’s best”. The truth of the matter is that, by harnessing technology, the Government could get a better outcome than this official ban. As my hon. Friend the Member for Buckingham said, there are plenty of other ways to do it that would be hard for advertisers to get around.
I say to the Minister that I am trying to be helpful, as always, and, to be serious, as are the Opposition. The Government have made a slight misstep by adopting a top-down, state-driven model. I say to the Minister that the path of good intentions is littered with unintended consequences. The essence of conservatism is not to use the state to bully or, as perhaps the advisers in the various Departments say in modern parlance, to nudge. It amounts to one and the same thing. The Department’s attempt to censor products such as these is profoundly un-Conservative. Our party believes in individual responsibility and that families are the foundation of society where choices and power in society most naturally lie. Nowhere is that more important than in health matters, yet these proposals extend the role of the state and undermine parental responsibilities.
The measures make the Department of Health and Social Care look like a new outpost of cancel culture that denies free speech and has a predisposition that individuals should conform to what the state determines, rather than enabling informed free choice. It is desperately sad to see them being pushed through by a Conservative Administration. I say to my colleagues on the Back Benches: when will we wake up and realise that we need a Government who support free enterprise and individual responsibility, and who understand that the way to create growth in the economy is through enabling people to make free choices, rather than expecting the state to be the answer to every problem? With that question, I will wait to listen to what the Minister has to say.
Whenever we talk about such subjects, we hear a lot about the nanny state. As a surgeon working in A&E in general surgery, however, the difference when seatbelts, airbags and speed limits came in was night and day in how much time I spent dealing with people in operating theatres who had been involved in car crashes. Sometimes the state has to take action to protect people’s health and wellbeing.
The Bill focuses largely on reversing some of the most egregious aspects of the Health and Social Care Act 2012, which I welcome, but these measures focus on improving public health. There is no question that obesity, type 2 diabetes and other diseases associated with obesity pose not just a real threat to individual health but a threat that will overwhelm national health services in future. When I looked at the original Bill, however, I was surprised that, apart from the measures around obesity, there was little in the way of public health policy to improve and promote health, and there is also little enough about care.
It is not the national health service that delivers health. I have often said that it would be more appropriate to call it the national illness service, but who would want to work somewhere called that? The NHS spends most of its time catching people when they fall. Health comes from a decent start in life, a warm dry home, enough to eat and a decent education. Those are the things that deliver health, but there is nothing like them in the Bill.
Particularly, and surprisingly, there is nothing in the Bill on reducing harm from tobacco products and alcohol, which is why I rise to speak in support of new clauses 2 to 4, which seek to strengthen the health warnings on all tobacco products; new clauses 7 to 10, which seek to allow regulation of tobacco pricing; and particularly new clause 6, because the use of sweet flavourings to entice children and young people to take up smoking is indefensible.
I heartily commend the hon. Lady for her comments. Does she experience in her constituency, as I do in mine, that smoking cessation services are diminishing and becoming less successful? As the tobacco industry concentrates on a core group of existing addicts, it is desperate to move down the age range and encourage new addicts. That is why that element of the new clause is important.
I agree that new clause 6 is the most important of the new clauses, because tobacco companies are driven to recruit new victims—as I would have to call them, as a doctor—and they are recruiting them from young people.
Public health is devolved, so we have not had the cuts in public health funding that we have unfortunately seen in England since 2016. Therefore, we have not had the cuts to smoking cessation and sexual health services that many local authorities experienced across England when public health moved into local government.
Smoking does not just cause respiratory problems such as chronic obstructive airway disease, but affects all the blood vessels causing peripheral vascular disease, vascular dementia, strokes, heart attacks and many forms of cancer, not just lung cancer. Stopping smoking is the best favour anyone can do themselves, but many people require the very smoking cessation services that the hon. Gentleman mentioned.
I find it surprising that there was nothing in this Bill about tackling not just the health harms, but the social harms associated with alcohol abuse. Indeed, alcohol has not even been included in the definition of less healthy foods, despite that clearly being the case. There is no health argument for alcohol. I am not saying that people have to abstain, but the research many people cite about how having some alcohol is of health benefit over full abstention has all been discredited. That was because people who actually had alcoholic disease and were made to give up alcohol were put in the abstention group, and therefore brought their liver disease, their varices and everything else with them. More recent research shows that, unfortunately, alcohol does cause harm. It is only about 10 or 15 years since we learned about its association with breast cancer, my specialty as a surgeon, and with that it is absolutely the case that the more alcohol a woman drinks, the higher her risk of breast cancer.
Obviously, as the chairman of the all-party parliamentary group on alcohol harm, I know that part of the issue with treatment—I am thinking in particular of new clause 16—is the stigma behind alcohol dependency and its still being seen as a personal choice. While we need to overcome the stigma of addiction, we first need to be having a conversation about alcohol. Does the hon. Member agree that, as part of the treatment, we need to be having this conversation on a national level?
I would say that really no one who has a health problem should be stigmatised. Having dealt over 33 years in the NHS with many people who were problem drinkers, I know that the public image of someone who abuses alcohol is quite a caricature. There will be many people across this House who drink more than is healthy for them and I have met many people as patients from the middle and upper classes who had serious alcohol problems, so we should get away from the stigma and the caricature. We will not spot everyone who needs to deal with alcohol just by looking at them.
I commend the work of my hon. Friend Dan Carden in this regard. Does the hon. Lady agree with me that the whys and wherefores are all very well in this debate, but in the end the cuts to local government, which would primarily be providing services in relation to alcohol abuse, have been most disgraceful, and that is why we are seeing the huge increase in the number of people who have passed away from alcohol disease in the last couple of years following covid?
There is no question but that, after public health moved into local government—we can absolutely defend that because, as I have said, health is often delivered by things that are nothing to do with the NHS—the problem was that the budget was then cut, so the potential benefit of putting public health into local government was lost due to the cuts to services.
On alcohol not being classed as a less healthy food, with this Government I find it hard not to ask: why not, and what or who may have influenced that decision? I certainly support amendments 11 to 13 from Dan Carden, which would include alcohol, particularly the medium and high-strength alcohols, under less healthy foods, so that alcohol is covered by advertising regulations. I also support his new clause 15, which would mandate much clearer labelling of alcohol units, or whatever measure, on labels. It is no good just saying “Drink aware” or “Drink Responsibly” when the consumer has not actually been given the tools on the product to make a proper choice, such as by asking, “How much is in this?” Why not agree to use a simple, straightforward approach? A lot of public health advice is in units, so why not actually use them? People would then learn to be aware and ask, “How many units have I already drunk today?” or “How many units have I already drunk this week?”
New clause 17 calls on the UK Government to follow Scotland, and now Wales, by introducing a minimum unit price for alcohol. The UK Government have the advantage in that they can do that by setting alcohol duty based on unit, instead of on classes of drink. In every Budget we hear about a penny on a pint of beer, or so much on spirits, but why not do it by unit? It is much more accurate, and it would still allow the raising of taxation to help fund alcohol services, as well as those public services most hit by alcohol abuse, such as healthcare and policing. Under devolution the Scottish Government, and now the Welsh Government, did not have that power.
Over the past year and a half of the pandemic we have, unfortunately, seen a big increase in both smoking and alcohol consumption, as people struggled to cope with the loneliness and boredom associated with lockdowns and pandemic restrictions. However, the initial valuation of minimum unit pricing in Scotland showed that alcohol sales fell, for the first time in many years, by more than 7% in Scotland, compared with a continued rise in England and Wales. It was not possible to demonstrate a reduction in overall alcohol-associated admissions to hospital, which may include car accidents, violence and so on, but there was a drop in admissions due to alcoholic liver disease, suggesting that the policy was working. More evaluation after the pandemic will be required, but an immediate impact was an almost three-quarters drop in the sales of cheap white cider. That product is cheaper than soft drinks, and predominantly used by young—indeed, often under-age—drinkers, who purchase it, or get someone else to purchase it, so that they can drink it at home. However, that sector is literally disappearing overnight.
It will be important to review and maintain the pressure of the unit price on a regular basis, because young drinkers also drink many other products—this is the same issue as young smokers; more people are being recruited, often into problem drinking and problem products. Minimum unit pricing does not affect good wine, high-end spirits, or what is sold in a pub, but it does affect what someone can buy in a small shop to then hang out with their mates in their bedroom. Some of those products are not affected by the 50p unit price, and that must be kept under review.
I was disappointed that new clause 30, which is listed for discussion tomorrow, was not included in this group. It calls on the Government to reform the out-of-date Misuse of Drugs Act 1971, and to devolve it so to allow the devolved nations to take a public health approach to tackling drug addiction, in the same way as we take a public health approach to dealing with alcohol. Such an approach has already been demonstrated in many countries across the world, yet the Government keep sticking their head in the sand.
I am grateful to the hon. Lady for mentioning new clause 30, which I still hope against hope we might be able to discuss tomorrow. I am sure she will agree that problematic drug abuse is an illness and a social ill, not a crime, and our emphasis must be on harm reduction, treatment, and support for the problematic drug user.
As Opposition Members have said, key to improving public health would be restoring the non-covid related public health budget in England. We cannot hide behind covid funding, because that is used up by the pandemic and does not help us with smoking, alcohol, or drug addiction. The biggest contribution the Government could make would be to abandon their plans for yet another decade of austerity. We hear the slogan all the time—levelling up—but it rings hollow after taking away £1,000 a year from the poorest families and most vulnerable households. Over the past decade, cuts to social security have caused a rise in poverty among pensioners, disabled people, and particularly children. Sir Michael Marmot was mentioned earlier, and his research was clear: poverty is the biggest single driver of ill health, and the biggest driver of poverty is Tory austerity.
It is a pleasure to follow Dr Whitford, who brings her knowledge of the medical profession to this House on every occasion. I agreed with almost everything she had to say, apart from the last comment.
I declare my interest as chair of the all-party group on smoking and health, and I support all the new clauses tabled in the name of Mary Kelly Foy. These comprehensive proposals are complementary and can be picked up by the Government. The new clauses were tabled in a different form in Committee. They were discussed and debated, and I think Ministers said they would take them away and have a further look. We have refined the proposals on the basis of the debate in Committee, strengthened them, and brought them back again, and they address the loopholes in current legislation. They strengthen the regulation of tobacco products still further, and they provide funding for the tobacco control measures that are so desperately needed if we are to deliver the Government’s Smokefree 2030 ambition.
We had an excellent debate in Westminster Hall last week, to which the new Under-Secretary of State for Health and Social Care (Maggie Throup) responded. Questions were posed to the Government from across the Chamber about when we will see the long-promised tobacco control plan, which is presumably due to be delivered by
The problem we have with tobacco control right now is that if we do nothing and none of these measures is introduced, the risk is that, as the hon. Member for City of Durham rightly articulated, we will miss the target by seven years. For those on low incomes and in deprived circumstances, it will be 14 years. We must consider how many people will die from smoking-related diseases as a direct result of the Government’s failure to achieve their Smokefree 2030 ambition. It is clear that we need to take further action, and I urge the Minister, who I know is a doughty campaigner for public health, to make sure that we deliver on the proposals.
My main focus is obviously on the new clauses that seek to provide funding for tobacco control. We all accept that not only can we implement measures, but we have somehow to fund them. That is critical. We must also consider raising the age of sale, as that, unfortunately, is a key proponent in encouraging young people to start smoking. The spending review failed to address the 25% real-terms cut to public health funding since 2015. Reductions in spending on tobacco control have bitten even deeper, by a third, since 2015. We need new sources of funding.
The Government promised to consider a polluter pays levy in the 2019 Prevention Green Paper, when they announced the Smokefree 2030 ambition. The all-party group on smoking and health has done the analysis, and we estimate that in the first year alone of a polluter pays levy, £700 million could be raised. That would benefit not only England, but the whole United Kingdom. It is more than twice the estimated cost of the tobacco control measures that we are proposing tonight, and that would then leave the Government with further funding to spend on other health priorities. The proposal is for a user fee, along United States lines, rather than an additional tax. Now that we have exited the European Union and can set our own rules, EU tobacco manufacturers’ profits can be controlled. They cannot pass the cost on to the consumer, but we can control their profits and use those for preventing people from smoking in the first place. It is quite justified that we should tax the manufacturers’ profits. This is the most highly addictive product that is legally available, and it kills those who use it for the purpose for which it was intended.
The hon. Gentleman refers to public health funding since 2015, but is he aware that in 2015, it was identified that the cost to the NHS of smoking was £144.8 million in prescriptions, almost £900 million in out-patient visits, almost £900 million in hospital admissions, and a total of £2.6 billion? Is not investing in smoking cessation money well spent?
Clearly, if we invest in public health and smoking cessation, we prevent costs in the health service later. It is estimated that most of the cost of people’s healthcare arises in the last two years of their life. Individuals who suffer from cancer or other respiratory diseases caused by smoking will cost the health service dramatic sums of money, so through cessation, we are helping the nation to be healthier and, indeed, saving money for the health service in the long run.
To quote the chief medical officer, the great majority of people who die from lung cancer
“die so that a small number of companies can make profits from the people who they have addicted in young ages, and then keep addicted to something which they know will kill them.”
The time has come to make the tobacco manufacturers pay for the damage that they do, not only to older people but to young people in particular. We need to bring forward the day when smoking is finally obsolete in this country, and I regret to say that if we do not take measures, the time before that day arrives will be lengthened quite considerably.
However, funding alone is not enough; we have to consider tough regulation. The hon. Member for Central Ayrshire mentioned that since lockdown, we have seen the smoking rate among young adults surge by 25%. In the United States, raising the age of sale from 18 to 21 reduced the smoking rate among 18 to 20-year-olds by 30%. We could do the same thing here. We talk about complementary measures; giving tobacco products away is not illegal at the moment. Just imagine—tobacco manufacturers may say, “If we give tobacco products away for free, we can encourage people to become addicted, and then they will buy them, and that will lead them on to a lifetime of smoking.” We have to break that chain of events and make sure that people do not do that.
I have a passion for ensuring that women do not smoke in pregnancy. That is one of the most stubborn measures, and we have to overcome it. Some 11% of women still smoke in pregnancy. We must give them every incentive and introduce every measure to ensure that they give up smoking, and that their partners give up smoking at the same time. That is something that I passionately support.
Our revised amendment, new clause 11, addresses the concerns that the Government raised in Committee about a review of the evidence. I hope that the Government will adopt the new clause at this stage, and then look at the evidence and consult.
People start smoking at certain key points in their life. They may take it up when they are at school and their friends are smokers and they want to be part of the team or the gang. They may take it up when they go to college or university or start a new job, when they are in a new social environment, or at a dreadful time of stress in their life. We have to make sure that they understand that if they take up smoking, they will shorten their life and cause damage to their health—and, indeed, to the health of the people around them.
I am following my hon. Friend’s argument closely. Does he agree that there is an interrelationship between the issues to do with alcohol dependency that Dr Whitford mentioned and the issue of smoking? One of the things that comes out from the book “Alcohol Reconsidered” by Lesley Miller and Catheryn Kell-Clarke is that the science shows that alcohol reduces people’s inhibitions, and it is therefore more likely that they will smoke. If we had a culture of moderation in alcohol, we would probably do better on smoking.
I thank my right hon. and learned Friend for raising that point. Clearly, the fact that people can no longer smoke in public houses or restaurants has dramatically reduced the incidence of smoking. Someone has to make a deliberate decision to go outside and inflict their smoke on the outside world rather than on the people in the public house or restaurant.
We who support these amendments tabled them in Committee—we sought Government support and we debated them in Committee—and now we are debating them on Report. I understand that we may not be successful tonight, but I give fair warning that these amendments, in another form, will be tabled in the other place, and we will see what happens. We know that there is very strong support in the other place for anti-tobacco legislation. In July 2021, the Lords passed by 254 votes to 224 a motion to regret that the Government had failed to make it a requirement that smoke-free pavement licences must be 100% smoke free. That is smoking in the open air; we are talking about measures to combat smoking overall.
Finally, if we look back over the years, the measures on smoking in public places, on smoking in vehicles, on smoking when children are present and on standardised packaging of tobacco products were all led from the Back Benches. Governments of all persuasions resisted them, for various reasons. I suspect that my hon. Friend the Minister, whom I know well, may resist these measures tonight, but we on the Back Benches who are determined to improve the health of this country will continue to press on with them, and we will win eventually. It may not be tonight, but those measures will come soon. I support the measures that are proposed.
It is a great pleasure to follow Bob Blackman, who gave an eloquent speech about smoking. What he did not include, and what the Minister is not considering, is the mass passive smoking from air pollution, which causes 64,000 deaths a year. I know that I am in danger of being outside the scope of the Bill, but I will make this point just briefly, because it is about public health.
Indoor and outdoor air pollution is endemic. It costs £20 billion a year. We could simply ban wood-burning stoves, which 2.5 million people have and which contribute 38% of the PM2.5 emissions in our atmosphere. That is particularly problematic in poorer areas. I make this point partly as I chair the all-party parliamentary group on air pollution, but this is a critical public health issue, so I feel that the Department of Health and Social Care should look at it centrally, rather than leaving it to the Department for Environment, Food and Rural Affairs as an air quality issue.
I turn to the comments by Richard Fuller, who sadly is not in his place, about free choice in advertising. Advertising is not about free choice; one would not need to advertise unless one was trying to convince somebody to do something they would not otherwise do. That is not to say that advertising is always bad—good things and bad things can be advertised—but let us be straightforward.
As it happens, I have a background in multinational marketing; I have been involved with PG Tips and Colgate toothpaste—good products. However, the reality is that if someone wanted to make money from a product such as a potato, which is intrinsically good for people, they could impregnate it with salt, sugar and fat, make it into the shape of a dinosaur, get a jingle and call it “Dennis’s Dinosaurs”, and make a lot of money out of that simple potato. That is the way a lot of processed foods work.
Going back to the point about diabetes and added sugar, it is important to remember that diabetes in Britain costs something like £10 billion a year. There is a compelling case for the Government to do more about added sugar, as opposed to natural sugar; obviously, we could discriminate between the two, though a lot of manufacturers will say, “Are you going to tax an apple?”. Clearly, when a child or adult can find a huge bar of chocolate in a shop for £1, we have problems, in terms of the amount of sugar we are supposed to have. Henry Dimbleby put forward a national food strategy, which is worth a read. He makes the key point that reducing the overall amount of money people have—for instance, through universal credit—has a major impact: we find that when universal credit goes down, consumption of alcohol and smoking go up.
It is important for the Department of Health and Social Care to have an idea of how the nutrition of particular natural foods can be increased through better farming. An app will be available next year that will enable people to test a carrot in their local shop. The carrot will have different levels of antioxidant, depending on how it is grown. If it is organic and not impregnated with all sorts of fertiliser and chemicals, it develops a natural resistance to pesticides and is much better for human health. The Government should, in this post-Brexit world, be actively encouraging local high-value, high-nutrition products for export and local consumption.
A whole range of public health measures that need to be moved forward are not in the strategy; but some are, such as those raised by the hon. Member for Harrow East.
That is greatly appreciated, Mr Deputy Speaker.
I would like to put on record my support for amendments 11, 12 and 13, and new clauses 15 and 16. I also thank Dan Carden. We have heard why he cannot be here; I wish him well with what is going on in his family.
These much-needed amendments and new clauses are aimed at reducing alcohol harm by introducing advertising restrictions, transparent alcohol labelling and support for effective alcohol treatment. Alcohol abuse leads to many harmful things, and deserves to be called the silent killer. I am chair of the all-party parliamentary group on alcohol harm, and the group has heard in our evidence sessions the stories of those affected by alcohol. It has the potential to destroy individuals, families and wider society. Alcohol has a very public face, but it harms privately. Hospital admissions and deaths from alcohol are at record levels, and have been exacerbated by the covid-19 pandemic. Some 70 people die every day in the UK due to alcohol. Alcohol harm is a hidden health crisis that needs to be recognised.
The Bill does not go far enough to stem the rising tide of this issue. For instance, the Bill introduces restrictions on advertising for “less healthy” products, such as sugary soft drinks, but the same restrictions do not apply to adverts for alcoholic drinks, despite alcohol being linked to more than 200 health conditions, as well as having very high calorie and sugar content. There is significant evidence that children who are exposed to alcohol marketing will drink more earlier than they otherwise would. Existing laws are failing to protect children and vulnerable people. In fact, four in five 11 to 17-year-olds have seen alcohol advertising in the past month. The advertising they are exposed to builds alcoholic brand awareness and influences their perceptions of alcohol. A forthcoming report by Alcohol Health Alliance found that seven in 10 young people recognise the beer brand Guinness, including more than half of 11 to 12-year-olds. Amendments 11 to 13 would ensure that alcohol was considered a less healthy product and was therefore liable to the same proposed restrictions as sugary soft drinks when it comes to advertising on TV, on demand and online.
Awareness of the risks of alcohol is low: about 80% of people do not know the chief medical officer’s low-risk drinking guidelines of 14 units a week; only 25% are aware that alcohol can cause breast cancer; and only 20% know the calories in a large glass of wine. I need only refer you, Mr Deputy Speaker, to the Six Nations championship earlier this year—you may have a slightly better recollection of it than I do. There was alcohol-related advertising on billboards around the stadiums. There were many billboards advertising alcoholic brands. There were also drink awareness campaigns, but they were not seen, due to where those advertisements were placed. People were seeing adverts for Guinness, but not for Guinness 0.0 or for drink awareness campaigns. This is something that the Government really need to look into.
New clause 15 requires the Secretary of State to introduce secondary legislation on alcohol product labelling. Consumers have a right to know what is in their drinks to make informed choices about hat and how much they drink. However, there are currently no legal requirements for alcohol products to include health warnings, drinking guidelines, calorie information or even ingredients. Research by Alcohol Heath Alliance found that over 70% of products did not include the low-risk drinking guidelines and only 7% displayed full nutritional information, including calories. The Government's forthcoming consultation on alcohol calorie labelling is welcome. However, more needs to be done to ensure other health information is provided on labels. Many companies are already looking at e-labelling, so that anyone with a smartphone can access the information online. That is a very welcome step, but we need to do more.
Lastly, alcohol treatment services are essential to support recovery for those with alcohol dependence. Pre-pandemic, only one in five dependent drinkers was believed to be in treatment, leaving a shocking 80% lacking help. My own brother was one of those. Unfortunately, six years ago I lost him to alcohol dependency, which is why I take this matter incredibly seriously. New clause 16 requires the Secretary of State to report on the ability of alcohol treatment providers to offer support and reduce alcohol harm, and on the levels of funding required. Low levels of access to alcohol treatment are largely due to insufficient funding. Since 2012, there have been real-terms funding cuts of over £100 million—an average of 30% per service in England. Alcohol treatment is cost-effective: every £1 invested in alcohol treatment yields £3 in return, rising to £26 over 10 years. Recovery also yields powerful dividends for families affected by addiction.
In conclusion, the Bill needs to go further than it currently does to include evidence-based measures that reduce alcohol harm. I encourage Members across the House to support these much-needed amendments, so that we can tackle this silent health crisis affecting so many of our constituents.
I rise to support the amendments in my name: 110, 111, 112 and 113. I draw the attention of the House to the fact that I have a significant number of food and drink manufacturers in my constituency, and that I chair the all-party parliamentary group for food and drink manufacturing. I also support the amendments tabled by my hon. Friends the Members for North East Bedfordshire (Richard Fuller) and for Buckingham (Greg Smith), and fully support and endorse their comments.
In reality, I and many others would have preferred clause 125 and the whole of schedule 16 to have been removed from the Bill. I and I think many others are not convinced that that is really the way forward or that it will achieve very much. That view is shared by many of my colleagues, but also by many in the advertising industry and the food and drink sector. That is not because they are against the Government’s attempts to respond to the challenge of obesity, which is and should be a concern for all of us, but because their impact is likely to be so insignificant that it is disproportionate to what is proposed. We should also remember that the industry has already done a huge amount. It is incredibly innovative—reformulation, reductions in salt and sugar—and the reductions we have already seen are very significant. The industry continues to make changes and I believe it will continue to do so in the future. We should also remember that there is something called personal responsibility.
There is an opportunity, however, for compromise and improvements to schedule 16—hence the various amendments that have been tabled. I very much hope that the Government will be willing to compromise in their approach and see the benefits of the amendments that stand in my hon. Friends’ names and mine. I do not intend to detain the House for long, because my amendments are primarily technical rather than anything greater.
I tabled amendments 111, 112 and 113 because I believe that we want a food and drink manufacturing sector that is competitive and is based in the UK as much as possible. As presently drafted, the Bill exempts certain businesses, but the criteria are based on UK employee numbers. Large multinational companies could therefore be exempt if the UK element of their business has under 250 employees; conversely, a UK business with 250-plus employees would not be exempt. That has the potential to be unfair in many respects to UK businesses from a competition perspective, and could lead them to divert manufacturing abroad. A simple solution would be to take account of turnover as well as staff numbers. I have suggested using the definition in section 465 of the Companies Act 2006, which I believe would deal with the situation.
Under the Bill, paid-for branded adverts for products that are high in fat, salt or sugar would be prevented on retailer-owned spaces, but retailers would still be able to advertise equivalent HFSS own-brand products. That could distort competition directly between retailers’ and manufacturers’ products. Amendment 110 would ensure a level playing field, which in my view would be much fairer.
I hope that the Government will be receptive to my amendments—if not now, via changes introduced in the other place. In anticipation of such a compromise, I do not intend to put them to the vote.
I am grateful for this evening’s debate. More than once during the passage of the Bill, I have put on the record the Government’s commitment to improving and protecting the public’s health and have paid tribute to the hard work and dedication of our NHS and public health professionals in rising to the greatest infectious disease challenge of modern times. I would again like to put on the record those important points, with which I know Opposition Front Benchers agree.
Our commitment to public health is clear in the Bill, in the proposals set out in the Government’s recently published plan for health and care, “Build Back Better”, and in our wider programme of public health reform. A focus on the prevention of avoidable diseases is a central principle in delivering a sustainable NHS and in levelling up health outcomes across the country.
Childhood obesity is one of the biggest health challenges that this nation faces. The latest data from the national childhood measurement programme revealed that approximately 40% of children leaving primary school in England were overweight or living with obesity.
The Minister is being generous in allowing interventions. Is the Bill silent on the challenge around prescriptions for exercise? In an earlier intervention, I mentioned the impact of school swimming. Unfortunately, we are going backwards: fewer 11-year-olds can swim 25 metres—that is just an example. On childhood obesity, we need to address both: not just diet, but exercise.
I am grateful to the hon. Lady, with whom I worked in London local government many moons ago on issues not dissimilar to those that we are debating. The Bill focuses on diet and the obesity that it causes, but she is right to highlight that exercise and a healthy lifestyle also play a key role in tackling obesity. We do not believe that the Bill is the right place to put that role into legislation, but I join in the sentiment underpinning what the hon. Lady says. Schools, local authorities and health bodies need to consider the issue in the round.
Nearly two thirds of adults—64%—are also overweight or living with obesity. I am grateful to my hon. Friend Richard Fuller for gently tempting me to respond to his points about the nanny state, but I would argue that it is not being a nanny state to look out for the health of our citizens. Yes, it is about giving advice and giving people the information to make informed judgments, but it is also about putting in place a proportionate framework in legislation.
As with the speech of my hon. Friend Bob Blackman, I did not agree with everything that Dr Whitford said, particularly her concluding comments, but I listened carefully to her comments about seatbelts. She said that she, as a clinician, saw the impact that legislation on that public health and public safety measure had on reducing injuries.
I wondered what I was about to have bowled at me there, but my hon. Friend is absolutely right. I entirely agree that a huge amount of progress has been made; we believe that we need to go further with our proposals, but he is right to highlight that progress. He is also right to highlight the relevance of the central role of personal responsibility and the decisions that we and our families all take.
To meet the ambition of halving childhood obesity by 2030, it is imperative that we reduce children’s exposure to less healthy food and drink product advertising on TV and online. We want to ensure that the media our children engage with the most promote a healthy diet. The Bill therefore contains provisions to restrict the advertising of less healthy food and drink products on TV, in on-demand programme services and online.
The Minister has just mentioned seatbelts, and earlier he talked about alcohol and cigarette smoking, but this is about porridge and muesli. There is a sense that there is no end to what the Department of Health and Social Care feels is its responsibility to legislate on for what people should be able to do for themselves and their family. My point is that this is overreach by the state, as well as perhaps being the incorrect process for achieving the Government’s aims.
I know my hon. Friend well and entirely understand the perspective that he brings, but I would argue as a counterpoint that the Bill strikes a proportionate balance, in the same vein as with seatbelts and other issues. Alongside personal choice and giving people the information to make choices, I believe that it is a proportionate and balanced approach—not the thin end of the wedge, as he might suggest, although perhaps I am characterising his words unfairly.
May I make a little more progress? I have more to say on obesity, so my right hon. Friend should not worry.
We held two consultations, the first in 2019 and the second in 2020, which have informed our policy on introducing further restrictions to the advertising of less healthy food and drink products. I welcome the devolved Administrations’ engagement and support for the policy, which is being brought forward UK-wide. The UK Government have engaged with them extensively on the matter since early 2021; I put on the record my gratitude for the spirit in which they have approached it.
I happen to agree that there is a question of proportionality on the alleged nanny state issues, but does my hon. Friend agree that where an issue is contentious—such as the fluoridation of water supplies, which has been contentious over many years in this House—it should be properly debated before the state takes control of it, not just tucked away at the end of a very long Bill? That causes me concern.
I take my right hon. Friend’s point, but I would argue that we are placing the matter before the House in a Bill that has been debated and has gone through its stages, including one of the longest Committee stages of a Bill in my time in this House. There is, or was, the opportunity for Members to table amendments on Report on the aspect that he mentions, and I suspect that it will be extensively debated in the other place as well. I take his point, but I would argue that we have provided sufficient time and have brought the issue to the House in that way.
Would the Minister be as surprised as I was to know that quite a lot of Members of this House are completely unaware that that provision has been added at the end of the Bill?
All I would say—without in any way implying any criticism of right hon. or hon. Members—is that soon after I entered the House I was a member of the Procedure Committee for a year, and one of the first pieces of advice I was given was to read the legislation and go through it in its entirety. I recognise that this is a long and complex piece of legislation, but I would make that point.
Telecommunications and internet services are reserved matters. The UK Government are clear about the fact that the primary purpose of provisions on the advertising of less-healthy food and drink for TV and internet services is to regulate content on reserved media, and on that basis the policy is reserved. The purpose is not incidental. Therefore, the provisions do not fall within the competence of the devolved legislatures or engage the legislative consent process. While the Scottish and Welsh Governments have agreed with our policy ambitions, they disagree with our legal assessment, and thus far we have had to agree to disagree on this matter, but we have had extensive engagement, and I suspect that we will continue to do so. I see that the hon. Member for Central Ayrshire is in her place, and while she is present I would like to thank both Governments for their engagement and offer my assurances that it will continue as we implement the policy for the benefit of citizens across the UK.
I am grateful to my hon. Friend the Member for North East Bedfordshire for his amendments 6 to 8, which would require the Secretary of State to conduct a public consultation before any changes could be made to the relevant guidance, the nutrient profiling model, in which I know the shadow Minister, Justin Madders, takes a particular interest. The principle and importance of the amendments is recognised, but we fear that, as drafted, they may create a number of unintended consequences. When consultation exercises need to reach a diverse audience, several approaches may be appropriate. For example, words such as “public” may be interpreted in a number of ways in different contexts, and would risk rendering the legislation insufficiently clear. However, as I confirmed in Committee, the Government have now tabled their own amendments to ensure that a requirement for the Secretary of State to consult before making any changes to the relevant guidance appears in the Bill.
Let me now turn to amendments 31, 33, 34, 36, 38 and 39, tabled in the name of my right hon. Friend the Secretary of State. These new amendments to schedule 16 will insert a requirement for the Secretary of State to consult persons whom he or she considers relevant before any changes can be made to the use of the technical guidance known as the nutrient profile model. This applies to the restrictions on less-healthy food and drink advertising outlined in the Communications Act 2003. An amendment has been made to each of the TV, on-demand programming services and online sections, ensuring that all parts of the policy are covered by this new duty to consult before changing the NPM.
The less-healthy food and drink advertising restrictions outlined in schedule 16 use a two-step approach to determine whether a product is “less healthy” and therefore within the scope of the policy. First the products need to fall into one of the categories identified as significant contributors to childhood obesity; then the product needs to be classed as “less healthy” in accordance with the relevant guidance. That guidance is the Nutrient Profiling Technical Guidance of January 2011, which sets out the requirements of the existing nutrient profiling model of 2004-05. The Secretary of State has the power to make regulations to change the meaning of “the relevant guidance” in the future, for example if the guidance needs to be materially modified to reflect changes in nutritional advice on what constitutes “more” or “less” healthy or an alternative model is developed.
This power is subject to the affirmative procedure, ensuring that there will be clear parliamentary scrutiny at the point at which any changes are brought forward.
Although, as Members may know, over the past few years work has been under way to update the NPM in line with updated dietary recommendations, it is not our current intention to apply it to the less-healthy food and drink advertising restrictions policy that the House is now debating. We made it clear throughout the 2019 and 2020 consultations that if we wanted to use the updated NPM in the future, we would first need to consult and invite views from interested stakeholders.
I appreciate the concerns that Members have raised, and would like to reassure them, the House and, indeed, industry. These technical amendments will not change the policy intent of the original provisions. I hope that they will address the valid concerns that my hon. Friend the Member for North East Bedfordshire has understandably raised today, and I hope that he and colleagues across the House will be able to support them in place of his amendments.
It was my hon. Friend the Member for North East Bedfordshire who inspired my intervention. I just want the Government to make it clear that they are not contributing to a strange paradox which seems to prevail in modern society, that of being simultaneously more puritanical and more prurient. We are prurient in that we let the tech giants corrupt our children in all kinds of ways, and puritanical in that we are censorious about the jokes people tell, the language they use, and how much ice cream—or indeed Christmas cake—they eat.
I am grateful to my right hon. Friend. It has been a while since he intervened while I was at the Dispatch Box, so this has been a pleasure. I have never seen him as in any way a puritan; I suspect that he is rather more a cavalier in his approach to life.
My hon. Friend the Member for North East Bedfordshire has also tabled amendments to schedule 16 which would insert in the Bill an exemption from the advertising restrictions for brand advertising. I am grateful to him, but I can reassure him that the Bill already delivers that exemption, and I therefore believe that his amendments are not necessary to achieve the effect that he seeks. We made that clear in the consultation response published in June this year, and in speeches made in Committee.
My hon. Friend has also tabled new clause 14. As I am sure he and other Members are aware, the Government consulted on different approaches for restricting online advertising in 2019, and considered alternatives submitted through the consultation process. However, it was felt that the alternatives, including the proposal from the Committee of Advertising Practice to use a self-regulatory mechanism based on targeting, were sufficiently similar to the policy options previously consulted on. These were not sufficient to meet the objective of the policy, namely to protect children from advertisements for less-healthy food and drink.
Does the Minister accept that there is a significant inconsistency between the approach to television broadcasters and the approach to those who use social media and online provision, and that a consistent approach would help? Does he also accept that a considerable array of views has been expressed by those seeking to help him to develop the Bill in a positive way, and will he maintain an open mind as it passes through the other place to establish whether it can be refined to achieve some of these objectives?
I hope I can reassure my right hon. Friend, and other Members, that I always seek to maintain an open mind, and always seek to reflect carefully on the contributions made by Members. I will turn shortly to the challenges posed by television, which is essentially a linear broadcasting medium, in comparison with those posed by online broadcasting. I am conscious that I must conclude my speech before 7 pm.
There is evidence to suggest that the targeting of online adverts does not account for the use of shared devices and profiles between parents and children, the communal viewing of content or false reporting of children’s ages. This, combined with concerns about the accuracy of interest-based targeting and other behavioural data as a way of guessing a user’s age and a lack of transparency and reporting data online, shows why the Government believe that we need to introduce strong advertising restrictions online. Any alternative proposals would therefore need to meet a high bar in terms of protecting children online, and we consider alternatives that rely on a targeting approach to be—currently—potentially insufficient to meet the policy objectives.
Amendments 106 to 109 are relevant to the point that my right hon. Friend has just made. I am grateful to my hon. Friend Greg Smith for raising these matters. His amendments mean that liability for online advertisements found to be in breach of the restrictions included in the Bill would shift to become the responsibility of the platforms rather than the advertisers, which some may see as providing parity with the enforcement mechanisms for broadcast television.
During the 2020 consultation, we considered whether other actors in the online advertising sphere should have responsibility for breaches, alongside those of advertisers. However, we concluded that this was not the right place to consider that broader issue.
The online advertising ecosystem is complex and dynamic. The scale and speed of advertising online, as well as the personalised nature of advertising and the lack of transparency in this system, makes it difficult for platforms to have control over what is placed on them. The approach that we are taking in the Bill best aligns with the current enforcement frameworks across TV, online and on-demand programme services advertising, and is familiar to industry. It will ensure that there is limited confusion for broadcasters, platforms or advertisers, as the liable parties for less-healthy food and drink product advertising breaches will be the same as those for any other advertising breaches. The Government intend to consider this issue as part of the wider online advertising programme, on which the Department for Digital, Culture, Media and Sport will consult in the coming months.
I am grateful to the Minister for that commitment to consider the points in my amendments, and with that commitment in place, I will not seek to push them to vote. However, may I ask him, as he makes these considerations along with colleagues in the DCMS, to ensure that broadcasters are fully consulted so that they can point out the loopholes that any online provisions could throw up?
I am grateful for my hon. Friend’s confirmation that he does not intend to press his amendments to a Division, and I will ensure that his point will be heard not only in the Department of Health and Social Care but in DCMS as well.
I am grateful to my hon. Friend John Stevenson for his amendments 111 to 113 and for bringing this debate before the House. I would like to reassure him that small and medium-sized enterprises—businesses with 249 employees or fewer—that pay to advertise less healthy food and drink products that they manufacture and/or sell will be exempt from the less healthy food and drink restrictions and can continue to advertise. The definition of SMEs will be provided in secondary legislation and not on the face of the Bill, which will enable Ministers to act promptly in future years if new or emerging evidence suggests that amendments are needed. We will conduct a short consultation as soon as possible on the SME definition to be included in the draft regulations. The Government want to ensure consistency with other definitions for size of business that have been used for other obesity policies, such as the out-of-home calorie labelling policy, to create a level playing field. Our preferred definition, therefore, is a standard definition used by Government across other policies.
On the point about an industry-led alternative, on which the Minister has kindly made some comments today, I think that this discussion will continue, particularly when the Bill is considered in the other place, so would he be prepared to meet me so that I can continue to make representations about certain improvements that could be made?
I am certainly happy to commit that either I, as the Bill Minister, or the relevant policy Minister will meet my hon. Friend to discuss his views in this space.
Amendment 110 would ensure that advertisements placed on distributor or retailer websites are out of scope of the less healthy food and drink advertising restrictions. Again, I am grateful to my hon. Friend the Member for Carlisle for tabling the amendment, and I would seek to reassure him that the Government’s intention is to ensure that restrictions are proportionate to the scale of the problem. It is not our intention to prohibit the sale of less healthy food and drink products on the internet. Our aim is to reduce children’s exposure to advertisements of less healthy food and drink products, which is why the restrictions are being applied only to paid-for advertising online—namely, where an advertiser pays by monetary or other reciprocal means for the placement of adverts online.
We appreciate that there will be consumers who seek less healthy food and drink products, which is why this restriction applies only to paid-for advertising, and companies will be able to continue to use owned media in the same way as they do now. The restrictions will not apply to spaces online where full editorial control and ownership apply, such as a brand’s own blog, website or social media page. This means that retailers are able to continue promoting their own products on their own website, as this would not be covered by the restrictions.
I shall turn briefly to Government amendments 32, 35 and 37, tabled in the name of the Secretary of State for Health and Social Care. Amendments 32 and 35 will amend the definition of an advertisement placed on television and on-demand programme services to ensure that sponsorship credits around programmes and sponsorship announcements respectively are included for the purpose of this Bill. Members will be aware that sponsorship announcements and sponsorship credits are required so that viewers know which product is sponsoring any particular programme. Although these are not routinely considered to be advertisements in other contexts, the Government’s view is that they could reasonably be considered to be advertising less healthy food and drink products for the purposes of the Bill’s restrictions.
Amendments 32 and 35 will therefore clarify the status of those announcements, in effect to prohibit identifiable less healthy food and drink products from sponsoring programmes before the watershed, in line with the Government’s original policy aims. Amendment 37, meanwhile, will make it clear that UK businesses producing online advertisements intended to be accessed principally by audiences outside the UK fall in scope of the exemption and will not be in breach of the less healthy food and drink advertising restrictions set out in the Bill. This amendment is needed to ensure that the legislation aligns with the Government’s policy intention to exempt advertisements made to be viewed outside the UK. We are confident that the likely frontline regulator already has a clear remit and tests in place that should allow it to apply this exemption effectively.
I shall now turn to the amendments relating to alcohol. I join the shadow Minister and put on record my tribute to the bravery of Dan Carden, who has spoken so openly about the challenges he has faced, and to my hon. Friend Christian Wakeford for talking about his familial experiences. I am grateful to both of them for their bravery in doing that in a public place in this House.
As with meeting the challenge presented by obesity, this Government are committed to supporting the most vulnerable who are at risk from alcohol misuse, and we have an existing agenda for tackling alcohol-related harms. As part of the NHS long-term plan, we have invested £27 million in an ambitious programme to establish or improve specialist alcohol care teams in the 25% of hospitals with the highest rates of alcohol-dependence-related admissions. This is expected to prevent 50,000 admissions over five years. We have also made the largest increase in substance misuse treatment funding for 15 years, with £80 million of new investment in 2021-22.
I reiterate the comment I made earlier that the best way to treat alcohol addiction and dependency is to treat it like a mental health illness, because that is what it is. The best way to do that is to remove the stigma and put more money into mental health, but in trying to overcome the stigma, we need to ensure that there is parity between mental and physical health. If we treat the mental health issue, we treat the alcohol issue. We cannot do one without the other. Will the Minister commit today to going some way towards doing that and to putting more money into mental health to deal with this?
I am grateful to my hon. Friend. He will know that this Government have continued not only to highlight and promote parity of esteem between mental and physical health but to increase the funding available to mental health, reflecting that reality on the ground. He is right to highlight that issue.
We have announced a comprehensive set of reforms to alcohol duty in this year’s Budget which, taken with the steps we have put in place on a public health basis, have put in place a strong regime to tackle the consequences of alcohol misuse. We do not feel that this Bill is the place to legislate further on this issue but, as I have said, I am none the less grateful to the hon. Member for Liverpool, Walton for his amendments and for this opportunity to debate them.
On amendments 11, 12 and 13, this Bill would introduce a 9 pm TV watershed for less healthy food and drink products and a restriction on paid-for advertising of less healthy food and drink online. Those amendments, tabled by the hon. Member for Liverpool, Walton, would expand the definition of a less healthy product to include alcohol. This would have the effect of making alcohol advertising liable to the watershed proposed for TV programme services and the online restriction on paid-for advertising.
I reassure the hon. Gentleman, through Opposition Members, that the Government have existing measures in place to protect children and young people from alcohol advertising through the alcohol advertising code. Material in the broadcast code and the non-broadcast code relating to the advertising and marketing of alcohol products is already robust, recognising the social imperative of ensuring that alcohol advertising is responsible and, in particular, that children and young people are suitably protected. If new evidence emerges that clearly highlights major problems with the existing codes, the Advertising Standards Authority has a duty to revisit the codes and take appropriate action. Furthermore, the Government introduced additional restrictions last year on alcohol advertising on on-demand programme services, through amendments to the Communications Act 2003.
Clause 129 and schedule 16 are aimed at reducing the exposure of children to less healthy food and drink advertising and the impact of such advertising on child obesity. Less healthy food and drink products—
I fear that I have only a few minutes left, and I have already taken a number of interventions on this. I want to conclude by covering the tobacco amendments as well, which I know that some colleagues are keen to see a response to. I apologise to the hon. Gentleman.
Less healthy food and drink products are not age restricted at the point of purchase, unlike alcohol. Finally, the 2019 and 2020 consultations on advertising restrictions for less healthy food and drink did not consult on alcohol within the restrictions, either online or on TV, so we cannot be sure of the impact these amendments would have on the industry more broadly.
Turning to tobacco in the time I have left, because I know the shadow Minister, Alex Norris , has taken a close interest in the issue, I thank Mary Kelly Foy and others, including my hon. Friend the Member for Harrow East, who have tabled a number of amendments that seek to address the harm caused by smoking in this country. I reassure the hon. Member for City of Durham of the Government’s commitment to becoming smoke free by 2030.
We have successfully introduced many regulatory reforms over the past two decades, and the UK is a global leader in tobacco control. Our reforms include raising the age of sale from 16 to 18, the introduction of a tobacco display ban, standardised packaging and a ban on smoking in cars with children, which all place important barriers between young people and tobacco products. The Government are currently developing our new tobacco control plan, and I reassure the hon. Lady that that will reflect carefully on the APPG’s findings and report.
I am afraid I cannot be tempted to go further than the Under-Secretary of State for Health and Social Care, my hon. Friend Maggie Throup, did in the recent Westminster Hall debate on this question, but I can reassure the hon. Member for City of Durham that we remain committed to bringing forward the tobacco control plan.
Forgive me; I only have a few minutes and I want to cover the amendments from Geraint Davies did manage dexterously to shoehorn air quality more broadly within the scope of these debates, and what he said will have been heard.
“to print health warnings on individual cigarettes and cigarette rolling papers”,
is intended, as I understand from the hon. Member for City of Durham, to further strengthen our current public health messaging and encourage smokers to quit. We strongly support measures to stop people smoking, to make smoking less attractive to young people and to educate smokers of its dangers, as we have done through graphic warnings on cigarette packs.
We would need to conduct further research and build a further robust evidence base in support of any such additional measures before bringing them forward. To date, no country has introduced such a measure, so there is currently limited evidence of its impact in supporting smokers to quit. If evidence showed that the requirement would not be effective, it would not be an appropriate power to have in place.
New clause 3, also tabled by the hon. Lady, seeks to provide a power for the Secretary of State to introduce a requirement for manufacturers to insert leaflets containing health information and information about smoking cessation services into cigarette packaging. As I set out in Committee, we believe this power is unnecessary, since the Department could legislate to do that already under the Children and Families Act 2014; inserts could be required for public health messaging through amendments to the Standardised Packaging of Tobacco Products Regulations 2015. We already have in place strong graphic images and warnings of the health harms of smoking on the outside of cigarette packs. As part of the Tobacco and Related Products Regulations 2016, the address for the NHS website, which provides advice for people seeking to quit smoking, is also required on packaging.
The current SPoT regulations prohibit the use of inserts, as there was limited evidence that placing public health messaging inserts inside cigarette packages was more effective than messaging on the outside of packs. Further research would need to be undertaken to help to establish the public health benefit if we were to go further.
Turning briefly to new clause 4, I am grateful again to the hon. Lady for tabling this clause. The Government are clear that they only support the use of e-cigarettes as a tool for smokers who are trying to quit, and we strongly discourage non-smokers and young people from using them. We are committed to ensuring that our regulatory framework continues to protect young people and non-smokers from using e-cigarettes.
Current regulations include requirements on the packaging and labelling of e-cigarettes, along with restrictions on their marketing and the prohibiting of advertising on mainstream media such as TV and radio. While we strongly support measures to protect young people further from cigarettes, we believe the current regime remains appropriate and has the powers in place within it to make changes where required, although I suspect my hon. Friend the Member for Harrow East may yet be proved right when he suggests that the other place may return to this at some point.
I have outlined the many steps this Government are taking to address some of the major lifestyle challenges to our health. The Bill represents another step in the direction of preventive healthcare and building a healthier society, an aim I know we all share. I hope the House will support the amendments we have tabled at this stage to strengthen those measures.
I also want to update the House at this point, in the context of the importance of an integrated approach and how it can improve public health measures, on two steps the Secretary of State has taken today that will put NHS staff and technology at the heart of our long-term planning and allow us to take forward the integrated approach that has proved so vital during this pandemic and is so vital to public health.
I am afraid I will not. I suspect that point will be pertinent to the debate on the first group of amendments tomorrow.
First, we intend to merge Health Education England with NHS England and NHS Improvement, putting education and training of our health workforce at the forefront of the NHS. By bringing this vital function inside the NHS, we can plan more effectively for the long term and have clear accountability for delivery.
Secondly, we also intend to take forward the recommendations of the Wade-Gery report, which included merging NHSX and NHS Digital with NHS England and NHS Improvement, building on the huge progress made on digital transformation during the pandemic and bringing together the digital leadership of the NHS in one place. I take this opportunity to pay tribute to all our colleagues at Health Education England, NHS Digital and NHSX for their exceptional work. These changes build on that contribution and allow us to drive forward further integration and changes that will put the NHS on a firmer footing.
I hope I have reassured hon. Members of the Government’s commitment to improving public health. I urge those who have tabled amendments to consider not pressing them to a Division.