Health Bill [Lords]

I congratulate my hon. Friend the Member for Ilford, North (Mr. Scott) on his impassioned speech. I also thank the Secretary of State for his response to my intervention on his speech at the beginning of the debate, and apologise to him for not being able to be present for the whole of the opening speeches. It was not just the parliamentary Labour party that had other meetings to attend during the debate. I apologise to you, Madam Deputy Speaker, for the fact that I too had other things to do. Before I comment on the details of the Bill, I want to return to the point that I made in my intervention. The Secretary of State has a large in-tray, and he has demonstrated today that he is getting on top of it quickly. One of the items that he will find in it is the apparent disappearance of the community hospital development fund. I remind him that in 2005-06, when the NHS was faced with substantial deficits in trusts around the country, more than 82 community hospitals were threatened with closure. That caused a furore across the country. When he took up his post, the Secretary of State's predecessor, the right hon. Member for Kingston upon Hull, West and Hessle (Alan Johnson), sought to end the furore by magicking up a capital pot of money—some £750 million—for community hospital redevelopment. That was very welcome. The issue went away, and those campaigning to save their hospitals were then able to divert that energy to seeking to improve their community hospitals. In the first full year, close to £250 million of the funds were allocated for community hospital rebuilding. It was a three-year programme of £250 million a year, and the first year's sum was allocated. One of three threatened hospitals in my constituency, Ludlow community hospital, was in dire need of investment. It was still operating in old Victorian workhouse premises as well as having facilities that had wards closed, and therefore the property was beginning to deteriorate and decay. The community got behind it and worked hard with the local authority to put together a base-case business plan for a renovation of the hospital which, with the support of the primary care trust and the active support of the strategic health authority, turned into a bid for a significant sum for rebuilding the hospital. It was an innovative project to co-locate the hospital and the GP surgeries in the town. The bid was supported as a top priority by the West Midlands strategic health authority, or so we were told, and it went to the Department for approval. Having been encouraged to submit such a proposal, the PCT then received a letter from the SHA less than a month ago saying that the funding had been put on hold and that no more funds would be made available, and that we would have to look elsewhere if we wished to fund the project going forward. The community is determined to do so and a great deal of work is continuing, but the sudden news that no money was available after having been told that a further £500 million would be available was immensely disappointing. I sincerely hope the Secretary of State will do his utmost to find out where that money has gone and to put it back on the table, and thereby allow communities throughout the country to access it. I look forward to his fulfilling the commitment to review that decision, which he gave at the beginning of the debate. That does, of course, square with the Government's plans to bring forward public sector investment to help rejuvenate the economy from the recession, so it is in line with Treasury thinking. I want to make two points about the Bill. First, I welcome clause 33 on the investigation of complaints about privately arranged or funded adult social care, which also has resonance for my constituents. My constituency has a significantly above-average elderly population. Some 24 per cent. of my constituents are above retirement age and the proportion of over-80s rises inexorably every year as both the standards of health care and longevity increase. As a consequence, there is an increasing need for adult social care provision and many of my constituents make contributions to their provision as they come to need it. At times, of course, problems arise with the arrangements for their adult social care and therefore a proper complaints procedure is required. It is right that the Government are seeking to put in place an effective mechanism to allow for complaints to be dealt with, so that redress can be given for decisions affecting some of the most vulnerable elderly people in our community. They currently do not have much of a voice at that stage, but they will now be able to make appeals and, hopefully, secure redress where previously none existed. I look forward to seeing the detail that emerges in Committee to ensure that the system is effective, and that it is not merely window dressing so as to give a complaints procedure without teeth. Therefore, at least in principle, the proposal is to be applauded. I am less keen on the proposals for the display ban on advertising, which has taken up a lot of time. I am no advocate for the tobacco industry, although it was suggested that some Conservative Members are. I suspect that almost every Member could bring to the attention of the House heart-rending tales of relatives, friends or constituents who have suffered the effects of a lifetime of smoking. My grandfather died from lung cancer. I have never smoked in my life—I have no intention of taking it up—and I encourage my children not to do so, but I firmly believe that if we are to introduce further measures to restrict the availability of tobacco to young people, it must be done on an evidential basis. There is an illogicality in the Government's approach. They use taxation as the main means of reducing smoking in this country—I have sat through enough Finance Bills to know the arguments in favour of that. This country has the second highest price of tobacco in the EU, at £5.85 for a packet of 20; only Ireland levies more tax than we do on tobacco products. The tax that the Government generate from every sale of duty-paid tobacco is greater than the retail price in every country in the EU save Ireland and France. Taxation is, appropriately, the major mechanism used by the Government to restrict the consumption of tobacco, but many other measures have been introduced in recent years, most of which have yet to take effect. The proportion of young people taking up smoking has declined in this country year on year, which is to be applauded and welcomed. My concern is that some of the measures, in particular the display ban, will have perverse, unintended consequences and are unnecessary at this time for two reasons. The first reason relates to the evidence base, to which reference has been made, in particular by the hon. Member for North-West Leicestershire (David Taylor). He made a powerful speech, but I fear that he has not captured the essence of the evidence—it is, at best, not clear-cut. We need to see clear-cut benefits—the reduction of young people's smoking—before we embark on a display ban that will have significant ramifications for the people who will be most directly affected: the retailers, in particular the convenience store retailers, the corner shops and the confectioners, tobacconists and newsagents. Every community in our country benefits from such shops. Some 48,000 or so outlets sell tobacco, the vast majority of which are community shops that serve their local communities and happen to sell tobacco as one of their products. Such shops are typically independently owned. Some may be part of a small family-owned chain. Few of them have the capital resources to invest significantly in fulfilling the requirements of the display ban and many of them generate a substantial proportion of their turnover from the sale of tobacco products. It has been estimated that close to 12 per cent. of them—more than 2,500 shops—would go from generating profit to generating loss as a result of the proposal, and that would put close to 2,500 communities out of touch with their local shop, which provides their convenience shopping and allows them to shop within their own community. That significant potential negative of introducing a display ban has not been adequately thought through in the economic impact assessment that the Government have undertaken in examining the measures. As a result, the proposal should be put on hold. We should wait to see the impact of some of the other legislation that the Government have put through—