I congratulate Bob Blackman on securing this important debate and on his very persuasive speech.
I will start with some context. Hon. Members might wonder why a Welsh MP, and a Plaid one at that, is speaking in a health-related debate when health is a devolved matter. I have a long-term interest in the negative effects of smoking. Many years ago, I supported Julie Morgan, then the MP for Cardiff North, when she tried to bring in a ban on smoking in public places in Wales. Unfortunately, we were unsuccessful. The Welsh Assembly was very anxious to bring in the ban at that time, which was some years before it was actually brought in in England and Wales. We had to wait.
I am no statistician, and certainly no epidemiologist—I cannot even say the word—but I did a back-of-the-envelope sum at the time and I reckoned that, because of the delay in bringing in the ban in Wales, between 15 and 20 people such as bar staff would have contracted smoking-related illnesses that would eventually killed them. That is the argument that we made at the time: the lack of devolution cost lives.
The second point to contextualise my interest in this matter is that, some years ago, I asked Alan Milburn, the then Secretary of State for Health, about nurses’ pay. His reply, which I remember distinctly, was that it was one of the abiding
“joys of my life that I am not responsible for all things Welsh”.—[Official Report,
Actually, health was devolved, but nurses’ pay was not. The point I am making—apart from the fact that he was wrong—is that devolution is not always particularly clearcut. In the short-term, more devolution is not really the day-to-day issue; the issue is policy divergence, not devolution.
In Wales, we see that in our early adoption of the wellbeing approach to health, which is one of the landmark policies that the Welsh Labour Government have brought in, supported by my party. In some ways, this answers the point made by the hon. Member for Harrow East about there not being cash available; this is not a cash issue—it is a policy and attitudinal issue. In Wales, we have a health—not an illness—policy, but without control over illness-creating factors such as tobacco and alcohol.
Unsurprisingly, my answer is to have fuller devolution in the short term and full powers in the long term, but if I were to pursue that point now, I am sure Ms Nokes would pull me up. For now, I will just say that the Welsh Government have the goal of being smokefree by 2030, as is the case in England. The impact on public health in Wales is frightening, as it is elsewhere—smoking is the largest single cause of avoidable early death. In 2018, around 5,600 deaths in people aged 35 or over in Wales were attributable to smoking, 16.5% of all deaths in that age group. The cost to the Welsh NHS is around £300 million per year, which is, to my mind, of itself a completely persuasive point.
The aim for England to be smokefree by 2030 was announced two years before we got around to it in Wales. However, in the meantime, Wales has taken a lead on action, having published its draft strategy and delivery plan last November. Interested hon. Members from England are still waiting for England’s tobacco control plan, and I share their concern at this delay. I would also say that this is undermining the Welsh Government’s ability to achieve their own targets, because under the current devolution settlement there are many policies that Wales cannot implement. These policies include the trailed “polluter pays” levy on tobacco manufacturers to fund tobacco control. The key tobacco controls are not devolved; they are reserved. Everything from tobacco taxes to packaging, labelling, product regulation to raising the age of sale are policies that we cannot change in Wales.
During the passage of the Health and Care Bill, I added my name to the amendment tabled by Mary Kelly Foy that would have introduced tougher regulations on smoking and would certainly have benefited people in Wales. However, these measures cannot be brought in. I would formally like to state my support for raising the age of sale to 21 and putting warnings on cigarettes, advice to quit inside packs and the rest of it.
Those measures would reduce inequalities and smoking uptake. A sensible point—for me at least—is that this is not only a health issue. It is also a class issue. Clearly, it affects people on lower incomes. It is also an age issue. To conclude, I would like to ensure that the Minister is aware of all of these matters, and I ask her to commit to meeting her opposite number in Cardiff regularly to discuss how these measures can be implemented.