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House of Commons

Tuesday 16 December 2008

The House met at half-past Two o’clock


[Mr. Speaker in the Chair]

Business before Questions

Manchester City Council Bill [ Lords] and Bournemouth Borough Council Bill [ Lords]

Motion made,

Hon. Members: Object.

Canterbury City Council Bill, Leeds City Council Bill, Nottingham City Council Bill and Reading Borough Council Bill

Motion made,

Hon. Members: Object.

National Curriculum Tests


Oral Answers to Questions


The Secretary of State was asked—


1. Jeff Ennis (Barnsley, East and Mexborough) (Lab): What steps he plans to take to reduce the number of young people taking up smoking. [243631]

The Secretary of State for Health (Alan Johnson): Reducing smoking is a public health priority for the Government. We will bring forward legislation to remove the display of tobacco from retail environments and
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tighten requirements on vending machines. Both policies primarily aim to protect young people from smoking. Protecting young people will also be a key theme in our new tobacco control strategy.

Jeff Ennis: I thank my right hon. Friend for that very positive response. Does he recall the private Member’s Bill that I introduced in October 2005, entitled the Age of Sale of Tobacco Bill, in which I proposed to raise the age for smoking from 16 to 18? That proposal was later incorporated into the Health Bill, I am glad to say. Is he also aware that, in Barnsley, one third of all smokers under 18 buy their cigarettes illegally from what are known—for want of a better expression—as the local fag houses? The problem is so acute that Barnsley council has set up a tobacco task group to look at the issue. What more can the Government do to stop the illegal sale of tobacco to young people?

Alan Johnson: I pay tribute to my hon. Friend for his sterling work over a long period of time to get the age of sale increased to 18. He asks what more we can do. From April next year, the “three strikes and you’re out” rule will come in. If any retailer is caught selling cigarettes to under-age children three times, they will not be allowed to continue retailing. Other measures to tackle illicit tobacco are important, particularly in the context of the famous Barnsley fag houses that we are now learning about. Micro-chipping illicit cigarettes is an important development from Her Majesty’s Revenue and Customs, for example. There is a whole range of steps that should be taken, but that should not detract from the public health initiatives that we are taking in removing tobacco from the point of sale and ensuring that we take action to regulate vending machines.

John Bercow (Buckingham) (Con): I welcome the Secretary of State’s proposed legislation, which offers the prospect of real and lasting progressive change for the better. Will he tell the House what steps he is taking to enlist the services of some of our sporting icons—the Olympic gold medallists spring readily to mind—in trying to persuade young people of the dangers of smoking and the benefits of abstinence?

Alan Johnson: I thank the hon. Gentleman for his welcome for our proposals. He has raised an important point. We know that there is an issue about young people smoking. On average, 10 per cent. of 11 to 15-year-olds smoke, but almost one in five 15-year-old girls smoke. They take up smoking—as most of us did in our youth—because they see role models and people whom they admire smoking. The message from Olympians and others, which we will ensure is strongly put forward, will help in that regard. The research evidence clearly shows that the only place where tobacco can now be advertised is on point-of-sale displays and that that gives young people the impression that smoking is normal. That is what we are seeking to address with these proposals.

Mr. David Clelland (Tyne Bridge) (Lab): Regardless of the merits or otherwise of the proposals, does my right hon. Friend accept that carrying out the proposed work will involve costs to small shopkeepers? Does he have an assessment of those costs, and does he have any plans to compensate retailers for them?

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Alan Johnson: I accept that there are issues for small retailers, and of course there will be a cost. The Save Our Shop campaign is the brainchild of the Tobacco Retailers Association, which is an offshoot of the Tobacco Manufacturers Association, which represents Imperial Tobacco, Gallahers and others in the smoking industry. The campaign is estimating the cost at something like—

Mr. Clelland: Make smoking illegal, then.

Alan Johnson: This might be totally irrelevant to the question that my hon. Friend asked, but the campaign has put the cost at something like £6,000. There is no evidence whatever for that. The evidence from the countries that have introduced these measures is that there is a maximum cost of £1,000. In Canada, it was £500. The cost of putting up the displays is met by the tobacco manufacturers—by the cigarette companies themselves. We will of course offer assistance to small businesses. That is why we are saying that this measure will not be introduced for small shops until 2013. That will give us plenty of time to have a full consultation and to ensure that this will not damage those businesses.

Sir George Young (North-West Hampshire) (Con): I also welcome the steps taken by the Government further to reduce the damage done by smoking-related diseases, but will the Secretary of State reflect on his decision not to make progress with one proposition that achieved 98 per cent. support in the consultation exercise—namely, the proposition that tobacco products should be sold in plain packaging? That seems to have been parked for the time being by the Government. Will the Secretary of State confirm that he is not ruling out considering that matter and that there remains a strong possibility of introducing it at some point?

Alan Johnson: The right hon. Gentleman has welcomed—indeed, two Opposition Members have welcomed—the proposals, unlike the Conservative Front-Bench team. I heard the argument from the Conservative Front Bench in last week’s Queen’s Speech debate that there was no evidence base for the proposals. I have to say, however, that despite the fact that the right hon. Gentleman is quite right about the huge response in favour of plain packaging, there is no evidence base that it actually reduces the number of young children smoking. We want to keep that under review, and when there is an evidence base for it, it could well be another important measure to meet our goal, which is to reduce the number of young people smoking.

David Taylor (North-West Leicestershire) (Lab/Co-op): As the chairman of the all-party group on smoking and health, I warmly welcome the proposals. There will not be evidence on plain packaging now, as we are the first country to suggest the measure, so it needs to be piloted in some way. May I say to the Secretary of State that I was disappointed in one aspect of the announcement—the failure to abolish vending machines, which are used as the medium of sale for fewer than 1 per cent. of all cigarettes? The suggestion that we can somehow tighten up to minimise the number of young people buying from vending machines is likely to prove a dead end. The sooner we introduce the abolition, the better.

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Alan Johnson: I understand my hon. Friend’s argument. We will take a power in the proposed Bill to ban vending machines. We were persuaded during the consultation, however, that there are other measures to restrict young people’s access to vending machines without banning them. I do not think that Governments should move to banning things if there is another alternative. We were persuaded of the alternatives such as carrying out an age check before giving tokens to use in vending machines and other methods that have been used successfully to restrict access by young people. It is sane and rational to try those out first, to have the power to ban in the legislation if necessary and to move towards a ban if the other measures do not work.

Mr. Andrew Lansley (South Cambridgeshire) (Con): The Secretary of State knows that we want to proceed on the basis of evidence and he has appealed to evidence. Last Thursday, he told the House:

Well, I asked the House of Commons Library to look at the statistics from Canada and it says that the tobacco display ban was not introduced in all provinces; that it was introduced only in Manitoba and Saskatchewan; and that since the tobacco display ban was introduced, there were no statistically significant results for any reduction in the number of young people smoking in either of those provinces. Will the Secretary of State simply apologise for giving the House an inaccurate presentation of the data on Canada and will he put a note in the Library explaining his basis for the proposition that there is a proven reduction in young people smoking?

Alan Johnson: That is an extraordinary position for the Opposition Front-Bench team to take, particularly when we have produced the research from the British Heart Foundation—

Mr. Stephen O'Brien (Eddisbury) (Con): It has just been shredded.

Alan Johnson: Well, if that is shredding— [Interruption.] The hon. Gentleman should hang on before he talks about shredding things.

What Cancer Research UK’s extensive evidence shows—and it was all produced during the consultation period—is this: young people are more receptive than adults to tobacco advertising; being exposed to tobacco advertising and/or promotion increases the likelihood that a young person will take up smoking; and large displays of tobacco convey the notion that smoking is common. In Canada, 12 out of 13 provinces have introduced this legislation—and they have introduced it because there is absolute evidence, as there is in Iceland and other countries that have introduced it, that it reduces the number of young people smoking.

Norman Lamb (North Norfolk) (LD): Where else?

Alan Johnson: Thailand and the British Virgin Islands, if the hon. Gentleman wants an exhaustive list, but as my hon. Friend the Member for North-West Leicestershire (David Taylor) said, the point is this: someone has to be in the vanguard, which is why Australia and New Zealand
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are preparing to introduce such legislation. It is hugely disappointing that there is not a political consensus across the three parties, because the evidence is clear, the evidence is there.

NHS Dentistry

2. Paul Holmes (Chesterfield) (LD): What recent assessment he has made of levels of access to NHS dentistry. [243632]

5. Mr. Andrew Robathan (Blaby) (Con): What his most recent assessment is of levels of access to NHS dental treatment; and if he will make a statement. [243635]

11. Andrew Stunell (Hazel Grove) (LD): What recent assessment he has made of the adequacy of levels of access to NHS dentistry. [243641]

The Parliamentary Under-Secretary of State for Health (Ann Keen): In the 24 months to the end of June 2008, 26.9 million people saw an NHS dentist. Improving access is a top priority and we have increased dental funding to more than £2 billion. In addition, last week we announced that we have set up a review to advise how we can ensure that everyone who wants to see an NHS dentist can do so. The review will be led by Professor Jimmy Steele of Newcastle university.

Paul Holmes: Over the past two years, my constituents have constantly approached me to say that their dentist has stopped doing NHS work and that, contrary to what the primary care trust website says, they cannot find a dentist in Chesterfield or Staveley who will take new patients. Yesterday, a Chesterfield dentist of 32 years’ experience told me that the current contract is the most bizarre arrangement ever devised by man. Will the Minister finally admit that the Government got the contract completely wrong, that 1.2 million fewer patients are seeing NHS dentists and that the contract needs scrapping and rewriting as quickly as possible?

Ann Keen: The British Dental Association is working very positively with us on the contract. The review that we have recently announced is to ask how we can improve access, but there is no question but that access has improved throughout the country.

Mr. Robathan: There is a question whether access has improved throughout the country. I have been telling Ministers for some time that the majority of my constituents, me and my family cannot find an NHS dentist in Leicestershire. That is the fact. Access is not better. The review announced last week is an admission of the failure of the contract. Instead of a review, how about the Government saying what they are going to do about this now to improve access to NHS dentistry.

Ann Keen: I suggest that the hon. Gentleman calm down a bit, for the sake of his own health. I am happy to advise him on how to do that. Access throughout the country and the oral health of patients throughout the country have improved. The review is assisting us to improve access. There are open lists in his constituency. That has been stated by the primary care trust.

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Andrew Stunell: The Minister will know that there are 24,000 fewer patients registered with NHS dentists in Stockport, compared with 1997. Stockport primary care trust has been offering extra sessions to try to fill the gap, but local dentists prefer to stay private, saying that the fee structure is not sufficient for them to provide a professional service under the NHS. Does she share my concern at the state of NHS dentistry in Stockport and will her review tackle the issue, whereby my patients are denied NHS treatment and, in a recession, are forced either to pay to go private or, worse still, to go without treatment altogether?

Ann Keen: The review will be guided by the principles of the NHS next stage review, ensuring that services are responsive to the needs of individual patients, that there is a strong focus on prevention as well as treatment, and that there are continuous improvements in the quality of care, especially in relation to the inequalities at the moment.

The whole House should also recognise the work that dentists have done with the contract and the improvements that have been made, such as the new treatments and the new dentists who are coming out of newly opened dental schools. I look forward to discussing the Health Committee report later this evening.

Dr. Doug Naysmith (Bristol, North-West) (Lab/Co-op): My good friend the Minister has read the recent Health Committee report on dentistry, so she will be aware that there are parts of the country where very few people have any problems accessing an NHS dentist. That is true in my area, where I serve constituents from south Gloucestershire and Bristol. We found that where commissioning is taken seriously by PCTs and they collaborate with the local dentistry profession, excellent results can be produced. What will she do to ensure that PCTs take this matter seriously and work with their dentists to commission good services?

Ann Keen: I thank my hon. Friend. The Health Committee report points out how bad things were in many parts of the country before the contract changed, and how good they are where proper commissioning takes place. That is without question. More work has to be done on commissioning and I know that Professor Steele will be looking at that matter seriously. I welcome the opportunity to share the report with the House soon.

Sir Paul Beresford (Mole Valley) (Con): I have a slight interest in this matter, as is well known. The Minister will be aware that there are 13,000 people with oral cancer at any one time in the UK. About 50 per cent. of those people will die, and the mortality rate is getting worse, not better. The key is access—and I believe, as do dentists, that the key to access is the contract. There has been an implementation group running for some time—I do not know its name because it has changed. What suggestions has it made to the Minister to change that contract to make it more desirable for dentists to work for the national health service?

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