PARLIAMENTARY DEBATES - United Kingdom Parliament

1591 Easter Adjournment
26 MARCH 2013 Easter Adjournment
1592
[Jeremy Lefroy]
There is a squeeze on emergency and acute tariffs
that started under the previous Government. I have
raised this issue before and I will continue to do so,
because unless it is addressed it will eventually result in
dangerously low levels of emergency and acute cover in
parts of the UK. It cannot be sensible for trusts that
deal in elective work to pile up surpluses while many
acute trusts, on which we all depend, struggle to cope
with mounting deficits.
It would be nice to believe that all hospital admissions
could be elective—that all work could be programmed
to fit into an ordered day—but life is not like that,
especially when we have large numbers of people living
longer, which I welcome, and then becoming ill suddenly
with acute, complex conditions. That is why I firmly
believe, as do most of my constituents, that acute district
general hospitals have an important role to play. Indeed,
if they did not exist, we would probably decide to create
them, precisely because they are the best place for the
initial treatment of the elderly with complex, acute
conditions, who could be close to home and to their
loved ones.
We do of course need to learn the lesson of Mid
Staffordshire and other places. Such district general
hospitals are usually too small to sustain many of the
specialist rotas that are needed, but the solution is not,
as is proposed for Stafford, to cram all serious emergency
and acute cases into already overstretched neighbours;
it is to work closely with those neighbouring trusts—even
become part of them—and thus enable clinicians to
work across neighbouring sites. This solution has the
merit of combining the benefits of scale with providing
care close to patients.
I met Monitor two weeks ago, and I welcome the
assurance I was given by the chief executive, Dr David
Bennett, that the trust special administrator, shortly to
be appointed, will consider options other than those
recommended, which are wholly inadequate. Monitor
has the chance to show how smaller, acute general
hospitals can not only survive but prosper under the
wing of a larger trust. If it does that, it will have done
the NHS and our country a great service.
7.19 pm
Mark Pawsey (Rugby) (Con): It is a pleasure to
follow my hon. Friend the Member for Stafford (Jeremy
Lefroy), who speaks with such authority on health
matters in his constituency.
Having set up and run a business for 25 years before
entering this place, I am always keen to meet businesses
in my constituency. Some 18 months ago I arranged to
meet a retailer with a new business called Smoke No
Smoke, run by the very entrepreneurial Jim Lacey. The
business sells e-cigarettes. On my visit I learnt about the
product. Its customers are often people seeking to give
up smoking, who have come to include a member of my
staff. It was through his contacts and visits to the shop
that I became aware of a potential EU directive that is a
particular concern to the sector. The directive could
bring the business to an end and affect many people
who are trying to stop smoking.
Most smokers know that smoking is bad for their
health. Many have wanted to quit, but quit rates are
extremely low, with only 3% to 5% of people trying to
quit managing to do so. Many have turned to e-cigarettes
as a substitute. E-cigarettes consist of an electronic
inhaler that vaporises a liquid into an aerosol mist,
simulating the act of tobacco smoking. E-cigarettes are
the same size and shape as cigarettes. They are held in
the same way and treated as cigarettes. The difference is
that while cigarette smokers smoke for the nicotine but
die from the tars and gases released by the burning of
tobacco, e-cigarettes deliver nicotine in an aerosol form
but, crucially, without the hazards that accompany
tobacco smoking. There are, of course, other ways of
getting nicotine, such as patches, gum and lozenges, and
nicotine is not harmless. However, Action on Smoking
and Health states that there is little real-world evidence
of harm from e-cigarettes. There are some trace toxicants
present, but at a much lower level than in cigarettes.
A recent article in The Economist sums up the position
very well:
“People smoke because they value the pleasure they get from
nicotine in tobacco over the long-term certainty that their health
will be damaged. So it seems rational to welcome a device that
separates the dangerous part of smoking (the tar, carbon monoxide
and smoke…) from the nicotine. And that is what an e-cigarette
does.”
The article finishes by asking rhetorically, “Who could
object?” It seems the EU can object, because it is
introducing a draft tobacco products directive, which
proposes to regulate non-tobacco nicotine-containing
products, including e-cigarettes, by classifying the vast
majority of these products as medicines. Every product
with more than 4 mg of nicotine per millilitre would
have to be reclassified. E-cigarettes come in a range of
concentrations, from zero—that is, nicotine-free—up to
48 mg per ml, with the average user choosing about
18 mg per ml. Choosing 4 mg per ml would mean a de
facto ban on such products. E-cigarettes are not medicines;
they are recreational nicotine products.
However, I do not want Members present or the
Government to take my word for it about the benefits of
this product. Let us take my constituent, Mr Preston.
He and his wife started using e-cigarettes 12 months
ago. Previously he smoked 30 a day and his wife smoked
20 a day. They had tried all cessation methods available
on the market, none of which worked. Since starting to
use e-cigarettes, neither has smoked a conventional
cigarette. Mr Preston estimates they have saved up to
£400 a month alone. He is 65 years old and tells me that
he now wakes up each morning without a heavy chest
and an immediate cough. He describes it as
“no longer waking up with that ‘bottom of the birdcage’ feeling”.
Another user said:
“After 32 years of being a smoker I love my e-cigarette and
never want to try having a cigarette again! Am on day 50 now, the
longest I’ve ever managed”.
Although I am not proclaiming that e-cigarettes are a
positively healthy alternative to conventional smoking,
I believe that the removal of the hazardous tar from
cigarettes, while still providing the nicotine that smokers
look for, means the product should be studied closely
and be saved from the forthcoming EU directive.
7.23 pm
John Hemming (Birmingham, Yardley) (LD): I refer
the House to my declaration of interest as the chairman
of the Justice for Families campaign.