Health Bill [Lords]

The Department is considering a broader review of tobacco control policy later this year. We will be able to provide the right hon. Gentleman with a fuller answer then. I agree with the shadow Secretary of State that vending machines are an important part of the debate—we need to have that debate—but it is also important to act proportionately and to ensure that we consider the legitimate needs of small businesses when making any changes. To give retailers time to prepare, the point-of-sale provisions will not come into force until October 2011 for larger businesses and 2013 for smaller shops. I hope that that responds to the concerns raised by the hon. Member for The Wrekin (Mark Pritchard). That will allow smaller retailers time to adjust, refit their shops when their old displays are due to be replaced anyway and limit as far as possible additional costs. The Bill will also create powers to control the sale of cigarettes to children and young people through vending machines. Cigarette machines represent 1 per cent. of the overall cigarette market, but 17 per cent. of 11 to 15-year-olds describe them as their usual source of tobacco. Initially, we will introduce stricter controls to ensure that only adults can purchase cigarettes through vending machines, but if those restrictions fail to stop underage sales we will consider banning vending machines outright. In conclusion, the NHS is both transformed and transforming as an institution. This journey of reform has seen our priorities evolve over time. There have been three phases of reform. In the wake of the 2000 NHS plan, when the focus was on building capacity and driving up core standards, we needed the discipline and focus that centrally agreed targets confer. Following that, the focus rightly switched from numbers to process, as we took steps to introduce greater diversity and flexibility into the system, pushing power down to local organisations and enabling the NHS to look outwards to the communities it serves rather than upwards to Whitehall. Now, with Ara Darzi's "Next Stage Review" and this Bill, we are opening up a third era of reform for the NHS, one that is focused on people—patients and staff—and that empowers clinicians and staff as the driving force of reform. It will all be backed by an NHS constitution, securing the values and principles of our national health service for future generations. I commend the Bill to the House.