Health (Miscellaneous Provisions) Bill: Final Stage

Part of Executive Committee Business – in the Northern Ireland Assembly at 6:15 pm on 15th March 2016.

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Photo of Simon Hamilton Simon Hamilton DUP 6:15 pm, 15th March 2016

I beg to move

That the Health (Miscellaneous Provisions) Bill [NIA 72/11-16] do now pass.

I am pleased to move the Final Stage of this Bill in the Assembly today. When I reflect on its passage, I think it is fair to say that its scope and purpose have changed quite markedly since I introduced it in the Assembly on 30 November last year. Initially, the Bill focused on two main areas. Part 1 contained provisions dealing with nicotine products that will enable the Department to make regulations prohibiting the sale of nicotine products to under-18s; to create an offence for proxy purchasing — in other words, an adult purchasing a nicotine product on behalf of a minor; to develop regulations in relation to banning the sale of e-cigarettes from vending machines, and to raise the level of fines for sales of tobacco from vending machines to a level five fine, thus ensuring fines for all underage tobacco or e-cigarette sales offences are consistent.

Part 2 of the Bill sought to amend anomalies in the Health (Miscellaneous Provisions) Act (Northern Ireland) 2008. The amendments were mainly technical in nature and sought to correct references to the various categories of people and bodies responsible for providing dental, ophthalmic and pharmaceutical services. It also amended provisions concerning charges for services provided to persons not ordinarily resident in Northern Ireland.

I move now to the provisions that seek to prohibit the sale of nicotine products, including e-cigarettes, to those under 18. The sale and use of those products has grown considerably in popularity since the ban on smoking in public places was introduced in 2007. Limited research is available on the long-term health consequences of e-cigarettes, and, while they may have a role to play in harm reduction for existing smokers, I do not wish to see non-smokers, particularly children and young people, becoming addicted to nicotine through these products.

A survey that was carried out in 2015 showed that around 13% of 11- to 18-year-olds in the UK reported that they had used an e-cigarette. That represents an increase of almost 3% from the previous year. Whilst e-cigarette manufacturers do not recommend their sale to under-18s, and some retailers impose their own age restrictions, the lack of regulatory oversight has increased the likelihood of e-cigarettes being purchased by children and young people I believe, therefore, that it is important that we protect our children, as Governments in England and Wales have chosen to do, by making e-cigarettes age-restricted products.

As the Bill progressed through its Committee scrutiny, amendments were proposed that sought to introduce a number of new provisions in the Bill and which acted as a stimulus for substantial debate. I will briefly touch on those issues. At the Bill's Consideration Stage, back in February, the Assembly agreed an amendment tabled by Sinn Féin Members to ban the use of tobacco or nicotine products in enclosed vehicles when children are present. Around 80% of second-hand smoke is invisible and odourless. That can inadvertently make people think that it is safe to smoke around others. However, evidence suggests that there are no safe levels of exposure to second-hand smoke. Research also shows that smoking in vehicles can place passengers at a greater risk of second-hand smoke exposure due to the confined internal environment. Children are more susceptible to the harmful effects of second-hand smoke than adults. That is partly because their immune system and lungs are less developed, and they breathe more rapidly and their smaller bodies can absorb more toxins.

At Further Consideration Stage, I tabled an amendment that sought to introduce a new clause. I also proposed some technical amendments, which, I believed, would strengthen the Bill and demonstrate my clear determination to tackle smoking and the dangers it poses for children. I am pleased to say that the Assembly was persuaded by the arguments setting out the merits of my new clause and my other amendments. As a result, I am convinced that we now have much tighter legislation, which will result in the more effective implementation of regulations aimed at protecting the future health of our children.

At Consideration Stage, the Assembly also agreed an amendment tabled by Sinn Féin Members that required the Department to consult about a levy on sugar-sweetened drinks. It aimed to prescribe key issues that my Department should consult on, as well as which stakeholders should be consulted. I opposed the amendment and cited a number of reasons for my opposition. For example, I believe that we need to do more to educate people about sugar before moving to legislate. There is also a lack of evidence that shows the impact on health outcomes and not just on purchasing behaviour. My concern is that a levy on sugar-sweetened drinks might simply cause people to switch to other unhealthy foods, with the result that the problem is displaced but not solved. Finally, there are arguments that such a tax is regressive and that the tax does not, by itself, combat obesity but could potentially exacerbate food poverty.

On my last point, I note that, in Mexico, a 10% tax on sugar-sweetened was implemented on 1 January 2014. More than 30% of the Mexican population is obese, and the tax was introduced to combat the growing obesity problem, not to raise revenue. In 2015, Mexico's National Institute of Public Health and the University of North Carolina carried out research, which showed that they have not seen any changes in obesity as a result of the changes in purchasing behaviour. However, the largest impact was on lower-income households, which cut their purchases of sugar-sweetened drinks by an average of 9%. That appears to highlight the potentially regressive nature of the tax and is one of the reasons why I have expressed my concerns and continue to hold those concerns.

My position is that we need to seek to educate and inform people much better about sugar-sweetened drinks. That is why, at Further Consideration Stage, I tabled an amendment that sought to remove the duty to consult on a levy on sugar-sweetened drinks and to replace it with a duty to carry out a study on a sugar-sweetened drinks levy. I also tabled an amendment seeking to extend the period within which the study must be carried out to two years after enactment. That was to reflect the complexity of the issues and to give the Department more time to commission appropriate studies and advice and to consider them fully before reporting on a study. I am pleased to say that the Assembly was persuaded again by my arguments and accepted both amendments. As a result, I am convinced that we now have a more realistic time frame in which to undertake a study, which should, in turn, provide us with more comprehensive information about how we should best move forward on the issue of a sugar-sweetened drinks levy.

At Consideration Stage, the Assembly also agreed amendments that require the Department to promote and provide information on transplantation and to provide an annual report on transplantation. It has been said many times during our debates that, in Northern Ireland, we have a tried-and-tested voluntary registration system. I also believe that our record in Northern Ireland on promoting the organ donor register speaks for itself with regard to raising awareness. I again take the opportunity, as many did during debates on the Bill, to pay tribute to the transplantation team at Belfast City Hospital and to remember that the work that it has undertaken has seen live organ donation rates in Northern Ireland rise to a level that is now the very best in Europe and also stands amongst the best in the world.

I am also aware that we have consistently been urged by clinicians, medical experts and interest groups to increase our efforts to educate the public about organ donation and enhance the existing level of awareness on that important matter. As I fully understand the motivation behind the amendments that were tabled at Consideration Stage and that now appear as clauses 15 and 16, I decided to propose a number of technical amendments at Further Consideration Stage in an attempt to ensure that the language used in the clauses is clearer and more easily understood. One of the key challenges in increasing the rate of organ donation is to convert the relatively high number of potential donors on the register to actual donations with family approval above the current average of 60%.

I am, therefore, establishing a clinical advisory group to develop a communications policy with a wide ambit to implement a programme targeted at achieving that increase. I will make available the resource to deliver this programme. That will be in addition to the promotional activities encouraging people to join the register. I will place a copy of the terms of reference for the clinical advisory group in the Assembly Library before recess. My Department will brief the Health Committee on the communications policy that is produced by the group later this year, subject to the approval of whoever is Health Minister at that time. Again, I am pleased to say that the Assembly accepted the rationale behind my amendments and was prepared to accept them.

I am grateful to all those who engaged with my Department on the Health (Miscellaneous Provisions) Bill and offered their insights and suggested amendments at the various stages of the Bill's journey through the Assembly. I express my gratitude to members of the Health Committee for their thorough scrutiny of the Bill and for the time that they took to examine the clauses and take evidence from witnesses. I am also grateful for their helpful contributions and support during the debates in the House. I am convinced that the provisions in the Health (Miscellaneous Provisions) Bill will help to make a positive and lasting difference to the health of people throughout Northern Ireland across a broad range of areas. Therefore, I encourage all Members to support the Bill.