Dr Beccy Cooper
MP for Worthing West · Labour · United Kingdom
“Its population is older than average—even though I am not older than average—frailty is increasing, multiple long-term conditions are common, emergency admissions are correspondingly higher, recruitment is harder and deprivation exists alongside affluence.”
“I thank my hon. Friend the Member for Tooting (Dr Allin-Khan) for bringing this timely and important debate to the Chamber. As we have heard, corridor care is one of the clearest signs of wider pressures across urgent and emergency care services, including rising demand, delayed discharge and constrained hospital capacity.”
“We have talked about the back door, but I really want to talk about the front door. Members will be unsurprised to hear that, as a public health doctor, I know that prevention is a corridor care policy.”
“I thank my hon. Friend for those excellent remarks, and I agree wholeheartedly. As I have said, corridor care is a symptom, and our challenge is to identify the underlying causes, rather than simply measure the symptoms.”
“Every prevented stroke, every smoking cessation intervention, every warm home, every child who grows up healthier and every patient supported earlier in the community means one less avoidable admission to an already overcrowded emergency department, such as that of my hon. Friend the Member for Tooting.”
“I agree 100%. My hon. Friend the Member for Doncaster East and the Isle of Axholme (Lee Pitcher) has already talked about his role in the water, sanitation and hygiene all-party parliamentary group. Access to water is an absolutely essential health determinant.”
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“On behalf of public health consultants and professionals, I commend the Bill to the House, and I am proud to be part of a Government and a Parliament that will bring this life-changing piece of legislation to the country.”
“I am not particularly wedded to that, but we should be laser-focused on reducing health inequalities across all populations. I therefore hope that our Government will consider having a reporting process similar to the one in new clause 13 among the changes to the national health service. In the Health and Social Care Committee this morning, we were talking about where the Office for Health Improvement and Disparities will go following the dissolution of NHS England. This is an ongoing conversation that we need to be mindful of. We need to ensure that the ongoing importance of addressing health disparities is not lost, and I think that is front and centre of the Secretary of State’s agenda in the 10-year plan.”
“In practice, that means prioritising population-level interventions that disadvantaged smokers are more sensitive to, and targeting interventions on those smokers. Having run smoking cessation services during my time as a public health consultant, I can absolutely say that it is incredibly difficult for anybody to give up smoking. We have Members who have succeeded, and who are perhaps still trying to give up. To give up smoking, a person needs to be in a place where they have the mental resilience and can put time and energy into quitting. If they are fighting all the other issues that come with the burdens of being poorer—if they are fighting for employment or trying to feed their children—it is so much harder. My hon. Friend has proposed a road map to a smokefree country, and a report to this place every five years.”
“The more disadvantaged someone is, the more likely they are to smoke, to suffer from smoking-related disease, and to suffer a premature death. Smoking-related health inequalities are not related solely to socioeconomic status. We represent different parts of the United Kingdom. The poorer health of people in the north of England is in part due to higher rates of smoking there. Smoking rates are also higher among people with a mental health condition, people in contact with the criminal justice system, looked-after children and LGBT people. We all have different types of people in our constituencies, and we should be mindful of those inequalities and the need to address them. Health inequalities will be reduced through measures that have a greater effect on smokers in higher prevalence groups.”
“Friend the Member for City of Durham (Mary Kelly Foy). The Bill will do outstanding work to enable a smokefree generation, but we also need to continue to tackle health inequalities for existing smokers. Smoking is harmful, and differences in smoking prevalence across the population translate into major differences in death rates and illness. We in this place come together from across the country and represent different constituencies. We want the best health outcomes, among many other things, for our residents. It is therefore incumbent on us to look at inequalities and where they reside, and to legislate against them where possible. Smoking is the single largest driver of health inequalities in England. It is far more common among people with lower incomes, and I am happy to discuss with any Members why that is.”
“This public health Bill will stop people dying and will take away addiction to a substance—an addiction that is not a choice. For many years, there have been public health conversations about whether we should impose measures. This conversation is not new. I wonder how many of us in the House feel strongly these days about wearing seatbelts, but we do not have to go too far back to find a time when people really objected to being told to wear a seatbelt. Tobacco is undoubtedly still the leading cause of premature death and disability in the United Kingdom, as has been mentioned by my hon. Friends. Every day, around 160 people are diagnosed with cancer caused by smoking, and smoking causes at least 16 different types of cancer. I will talk primarily about new clause 13, proposed by my hon.”
“First, I should say thank you to the Minister for presenting this afternoon, and for allowing me to be on the Tobacco and Vapes Bill Committee, which was incredibly interesting. There were differing views and there was robust conversation. It is always good to listen to different views, but overall the Bill generally had cross-party support. As Conservative Members have pointed out, many Members of their party have been campaigning for this Bill for a long time. I am a public health consultant—I trained for 10 to 15 years to be one—and the precondition for public health policy is data and evidence. Opinions are interesting—they can add great colour and character to a conversation—but data and evidence will ultimately deliver better population health outcomes.”
“I thank the right hon. Gentleman for giving way. Is he making the argument that we should not address population health issues—population health interventions have seen a reduction in smoking and a reduction in health-related damage from smoking—because of the consequences of illegal tobacco? Those issues do need to be addressed, but is he saying that we should keep it legal and therefore not see a reduction?”
“As a responsible partner in the global health initiative—in our global safety, which has as much resonance for people in this country as it does for those in others—we must prioritise the things that will truly make a difference to people’s wellbeing, safety and stability. In the conference that starts tomorrow, I ask respectfully that our Ministers go forward and lead in this space; that they prioritise nutrition for growth in global health and security; and that they continue our proud history of global leadership in this area.”
“Why we should focus only on this country is beyond me, however, because whether someone lives in this country or another country, they need exactly the same things. Humans are humans wherever they live. A global initiative looking at the first 1,000 days, and concentrating on good nutrition for mothers and babies in the early days, will significantly decrease childhood stunting, wasting and developmental delay. In all our communities, we want people to grow, thrive and do well, but those things cannot happen if the basic elements of nutrition are not in place. As has been said, the UK has been a leader in this space for some years. I appreciate that there has been a cut in overseas development aid, but that does not mean that we cannot still demonstrate leadership in this space.”
“Those malnutrition needs are different, but they are malnutrition needs none the less, and we must implement those acute interventions. Alongside that is longer-term nutritional stability, which is a global conversation as well as a UK one. How do we make sure that the food we grow on this planet is sustainably grown, has the right levels of nutrition and is distributed equally? Those conversations have gone on for many years. The Nutrition for Growth conference in Paris is another opportunity to bring together people with excellent experience and try to push the conversation forward. The right hon. Member for Dumfriesshire, Clydesdale and Tweeddale mentioned maternal and child health. The first 1,000 days are critical. In the Health and Social Care Committee, we are looking specifically at the first 1,000 days in this country.”
“We all sit here as human beings, and we all have the same basic level of need. In public health, as in so many other disciplines, there is something called Maslow’s hierarchy of needs: if we cannot satisfy our basic human needs, we cannot do anything else. If we and our children are hungry, we cannot achieve any of the things we aspire to for our communities, for the people we live with or for our governance, stability and growth. We think about those foundational elements in two ways. Acute interventions have been mentioned; my hon. Friend the Member for Exeter has talked about the ready-to-use therapeutic foods and vitamin supplements that can address fundamental critical needs in so many places around the globe, including in our own country.”
“We talk a lot in this country about economic growth, but we all know that we are as much in hock to world economic factors as we are to our own national factors. As the right hon. Member for Dumfriesshire, Clydesdale and Tweeddale has said, according to the World Bank, if we invest $1 in nutrition we get $23 back into the local economy. By any account, with any economist, that is surely a no-brainer. My interest in this subject arises from the fact that I am a public health consultant. Prior to my days in this place, I worked in an NGO that has already been named, World Vision, along with the Minister. We have been in this field for quite a long time, as have many hon. Members here, and we have heard the same conversations about nutrition come up again and again.”
“I thank the right hon. Member for Dumfriesshire, Clydesdale and Tweeddale (David Mundell) for organising the debate. So much has been covered already, and I do not want to reiterate or repeat it unnecessarily, but I want to draw attention to some key statistics around the fact that nutrition is a core issue, both for health and for global security. According to the stats from the World Food Programme on global security—they have been cited, but they are worth citing again—a 1% increase in food insecurity leads to a 2% increase in migration. If we think about geopolitical stability and all the issues that we currently talk about, a 2% increase in migration because of a 1% increase in food insecurity makes no sense in the world today. We need to do everything we can to mitigate that. Similarly, nutrition is a global growth issue.”
“Drug-resistant infections have been rising in Ukraine and remain a challenge in treating wounded soldiers and getting them back to the frontline. Such infections have also spread outside Ukraine and into Europe. In the context of conflict, what steps are the Minister and the Department taking to ensure that antimicrobial resistance is appropriately considered in the national security strategy?”
“I thank the Secretary of State for her statement. Welfare reform must ensure that incentivising people into work does not produce unintended health consequences, not least by generating fear and uncertainty, as she rightly points out. Does she agree that we need to address the health inequity issues that are delaying treatment of mental illness, and our underlying public health and inequality issues? Welfare reform and NHS transformation must complement each other, to make sure that no one is left behind.”
“There is an urgent need to transform the health and social care system. In doing so, we have a superb opportunity to look at innovative models of integrated and accessible “neighbourhood health” maternity services, delivered alongside hospital care. Finally, I welcome the recommendations of the APPG on birth trauma for a national maternity improvement strategy and a maternity commissioner to drive improved outcomes and rebuild our services.”
“In our hospital in Worthing, the maternity services are staffed by hard-working, capable healthcare professionals who want to get on with the job they have trained for. They are as frustrated and saddened as the rest of us when processes, equipment, staffing levels and governance are simply inadequate for the provision of excellent healthcare. Our Government have pledged to recruit and train thousands more midwives, which is to be warmly welcomed. The forthcoming 10-year plan for the NHS is an opportunity to address the underlying problems of a deskilled and demoralised workforce, which impact maternity services. We must take action to improve midwife training and retention, address the numbers of qualified medical staff on maternity wards, improve patient voice and bring a relentless focus to safety and compassion.”
“As a public health professional, it saddens me to say this, but the NHS Confederation reports that the UK stands out as the country with the largest female health gap in the G20 and the 12th largest globally, with women spending three more years in ill health and disability compared with men. Those systemic failings underpin the poor outcomes and health inequalities that we see in maternity care. [ Official Report, 22 July 2025; Vol. 771, c. 6WC.] (Correction) As a public health doctor, I have worked in and led health teams, and as the proud MP for Worthing West, I have heard from dedicated staff across our local services. I understand that systemic issues fail staff as well as patients.”
“Closing the black and Asian maternal mortality gap and tackling profound health inequalities such as those is rightly a priority for this Labour Government, and it is the reason I went into politics. Poor outcomes exist, too, for the most vulnerable and marginalised women, such as refugees, LGBTQ+ women, prisoners, those who have been through the care system and those who have experienced domestic violence or sexual abuse. All of them are more likely to experience poorer maternity care and the resultant trauma. Poor standards in maternity services are part of a wider picture of a healthcare system that has not prioritised women’s reproductive health. The Women and Equalities Committee highlights that gynaecological care waiting lists have grown faster than lists in any other specialty in recent years.”
“In the past year, the number of maternity services in England receiving ratings of inadequate or requires improvement from the CQC increased from 54% to 67%. Of the 131 maternity services inspected from August 2022 to December 2023, only 4% were rated outstanding, and not one was rated outstanding for safety. In that context, we see stagnating progress on improving stillbirth and maternal mortality rates not seen in the UK for over 20 years. As we have heard, black women are almost three times as likely, and Asian women almost twice as likely, as white women to die during birth or post-natally. Maternal mortality rates for women from the most socioeconomically deprived areas are twice those for women from the least deprived areas.”
“I thank the hon. Member for Chichester (Jess Brown-Fuller) for calling this debate. As neighbouring parliamentarians on the south coast, we are both passionate champions of the health of our residents and want the best healthcare provision for all, and that includes maternity services. Unfortunately, despite numerous reviews, plans and strategies, too many maternity services remain shockingly, stubbornly poor, as the hon. Member pointed out. Successive investigations into high-profile failures have described a pattern of dysfunctional and even dangerous cultures, with a failure to listen to families and missed opportunities to address known issues. As a result, too many mothers and babies have experienced substandard care and unacceptably poor outcomes.”
“The Government’s devolution plans are a welcome progressive development to shift power and resources from Whitehall to our communities. There are discussions now about the process and the realisation of benefits for our communities. Will the Prime Minister assure my residents in Worthing West, and those in all constituencies starting priority devolution programmes, that Sussex devolution will give us meaningful control of our local priorities, including housing, transport and social care?”
“Does my hon. Friend agree with my perspective as a public health doctor that there is a need for population-level interventions? There is ample evidence of a need for stronger policy and regulatory controls that protect public health and wellbeing and prevent harm. Gambling is not simply a cultural pastime for people or a leisure facility; it is an addiction and it needs to be addressed appropriately.”
“Therefore, leaving this issue open to allow that debate to continue within our political sphere is absolutely fair and proportionate.”
“This is an interesting debate, and I want to add some thoughts from a public health point of view. There is a balance to be struck in Government between supporting the hospitality industry and making sure that we are being fair and proportionate and encouraging businesses. We should also be mindful of public health evidence about passive smoking in an area—for instance, outside a pub where there are multiple people and some are passive smoking. It is clear that the Government, the current Secretary of State and our Minister have taken the proportionate response that the law will not extend to public spaces with hospitality. We should be mindful, however, that history does play out in public health and that people’s attitudes about what is acceptable does change.”
“The hon. Gentleman raises a fair point. I am perhaps a public health consultant first and foremost and a politician second, but I do appreciate that in politics, we have to find fairness and balance and support people in their businesses, as well as being mindful of their health. As a public health consultant, I am looking at people’s health first and foremost, but I think this is the right place in Government to have this sort of legislation and this debate, so I am supportive of what is in the Bill. It is for people like me to make the argument that passive smoking outside hospitality, for example, is not the way forward, but as a politician, I absolutely appreciate that I have to be mindful of businesses. I therefore maintain that the proposals are balanced, but I take the hon.”
“Gentleman is absolutely right that, in the case of smoking, using vapes is much more preferable for a person’s health, but in terms of smoking cessation, as clinicians and advisers, we need to be careful in how we apply clinical norms, and that is relevant here.”
“I want to add something to what the hon. Gentleman is saying, which is interesting and relevant, about smoking cessation services and how they currently work. I have run and managed smoking cessation services. As it stands, when a smoking cessation adviser is talking to a person who wants to stop smoking, they discuss nicotine patches, gum and whatever other options may be available. They do not promote vapes or actively say that they are an option. The reason for that is the public health evidence. In public health, we apply the precautionary principle, by and large, where we think that there may well be harms ensuing from using a particular product, but the evidence is not yet sufficient. The hon.”
“There may not be incontrovertible evidence about gambling, but there are undoubtedly health harms from gambling that we need to look at as we move forward.”
“From a public health point of view, I just point out to the hon. Member that we are basing this Bill on evidence and therefore we are looking at the evidence of tobacco harm, which I think we agree on. There is incontrovertible evidence; tobacco is undoubtedly harmful. People should not start smoking tobacco, and we should assist those who come forward to stop. In relation to vaping, I go back to a previous comment I made, about the precautionary principle. There is evidence on vaping; there do appear to be some harms associated with vaping. There is not sufficient evidence right now for it to be incontrovertible, but it would be irresponsible not to adopt the precautionary principle that we use in public health. In relation to gambling, I just urge caution—again, on the evidence.”
“I thank the Minister for those comments. How will he ensure that tackling health inequalities is baked into public service reforms, devolution agreements and local growth plans?”
“What does the hon. Member think happens currently? On various issues, there is obviously enforcement across the board, including tobacco control, and the Crown Estate has to comply. How would this extension of that enforcement differ from what happens now at Windsor or any other Crown Estate?”
“In conclusion, we need to ensure that we in this place are legislating to make good nutrition an easy choice for all and that we are curating a healthy leptogenic environment. In that way, we will ensure that we are enabling healthy choices for all our residents and reducing obesity to a slim, historical footnote as we move forward into a healthier future for everyone.”
“That is a great step forward, but we need to be mindful of how much investment the major brands of high-fat, high-sugar and high-salt foods put into advertising. In digital advertising alone, that figure was £87.5 million. Food organisations do not put money into things if they do not make profit from them. Profit essentially remains their bottom line, not our waistlines. These are systemic issues, but we do not need to reinvent the wheel. We need to implement the wide-ranging recommendations of the national food strategy. The last Government missed that opportunity, but as we move forward with this Government, let us look at those recommendations, many of which have been mentioned in the House this evening. They include introducing a sugar and salt reformulation tax and expanding the Healthy Start scheme.”
“If people feeding their children across the country this week on a budget are faced with two different options, and one is cheaper and will fill their children’s stomachs, the odds are that they are likely to take that option, and there is no judgment in that at all. It is on us to make healthy food much more accessible and affordable for people. On attractiveness, how attractive is healthy food? We have heard this evening about the marketing and branding of ultra-processed, high-fat, high-sugar, high-salt food. It is fantastic that our Labour Government and our Minister for Public Health and Prevention, my hon. Friend the Member for Gorton and Denton (Andrew Gwynne) have taken the step to ban junk food advertisements before the watershed.”
“On accessibility, how easy is it to buy nutritious food? We have heard Members across the House talking about their constituencies, their residents, food deserts and how for some people, when they go into a shop, the choice is not from an array of vegetables, fruits, decent carbohydrates and decent proteins, but from processed, often cheap, quite filling, nutritionally poor food. That is not making healthy food accessible. On affordability, we have heard several times from different Members that healthy food—this is worth repeating—on average is more than twice as expensive per calorie as less healthy options.”
“We might reflect on our own environment, Madam Deputy Speaker—whether it is an obesogenic or leptogenic environment. I wonder how many of us have managed to have dinner yet this evening, and how we are feeling. That is something for the Modernisation Committee to reflect on. To achieve a leptogenic environment we need to look at measures that create a functioning food system. As we have heard, we need to work with our farmers and food producers to produce a skilled food sector and a vibrant food economy. For our food system to allow us all to enjoy healthy food—again, we have heard this before—we need to ensure that it is accessible, affordable and attractive. We are visual creatures: what we see really influences us and our choices, and, boy, do the food organisations and the food companies know that.”
“We are literally eating ourselves into our sick beds, from diabetes to heart attacks, from liver disease to cancer; as we have heard, this is the second most preventable cause, after tobacco, of cancer. I have spoken before in the House, and will continue to do so, about creating conditions for people to thrive and to make healthy choices. Today, as so many hon. Members have highlighted, we live in an obesogenic environment—an environment that promotes unhealthy eating and does not make it easy to undertake regular exercise. A less familiar term is the opposite of that, and perhaps Hansard has never heard it: a leptogenic environment promotes healthy food choices and encourages physical activity. The comments on housing and on fair pay for good work were about a leptogenic environment.”
“Friend the Member for Ilford South (Jas Athwal) mentioned, there are different levels of BMI for different ethnicities, and also it can be a limited metric. The House might be aware of the case of a female Olympic bodybuilder being classed as obese. We need to be careful about BMI and what we are saying to people— children or adults—when we see their BMI. This is about taking health in the round, and looking at what we eat, not what we look like. There is no debate about the evidence of obesity’s cost to our population’s health and our health system. We have heard the figures from multiple Members across the House, and £6.5 billion annually to the national health service is no small figure.”
“Many great points have been made and I do not intend to repeat them, but I would like to stress a couple of things, starting with an interesting observation about the term “obesity”. It carries with it a certain load and stigma, which as a female I very much recognise. I want to put on record that this is not about fat-shaming; this is not about how people look or how society tells us we should look. This is about our health; this is about being well and feeling well and being able to live well and thrive. I also want to put on record something about body mass index. This is a slightly controversial subject in my area at the moment. It is a useful tool, as people have said, but as my hon.”
“I echo earlier comments by thanking all Members who have contributed to this debate. As a new Member, it has been heartening to hear so much agreement across the House and so many colleagues putting their evidence, enthusiasm and opinions into finding a solution to this epidemic. I thank my hon. Friend the Member for Stroud (Dr Opher) for introducing this debate. Unlike my hon. Friend, who has a medical degree and has become a GP, I took my medical degree and went into public health. I am a public health consultant and that is why I am here. It has been fantastic to hear everybody in this House talk in such resoundingly positive public health terms. It is past time for us to address this issue.”
“I have quick and pragmatic point about the different uses of cigarette papers. I am a mum and a saxophone player myself, and I suggest that other materials can be used in the place of cigarette papers. I appreciate the debate, but I do not think this is about a pragmatic use.”
“I just wanted to clarify something with the hon. Lady, because she is talking about the size of the signs in Wales, under clause 6, I think. Clause 6(4) says: “The notice must comply with any requirements set out in regulations made by the Welsh Ministers”. I presume that that is the response that she is looking for: the Welsh Ministers will absolutely be able to decide on the size of the signs.”
“I thank my hon. Friend for making the arguments on vending machines. From a public health consultant point of view, I have listened and think there is a reasonable debate to be had. I am convinced by the arguments that my hon. Friend the Minister has given, but I would ask that following the debate the conversation continues as the Bill progresses and that the Department of Health and Social Care continues to have these conversations.”
“I thank the hon. Member for the points he is making, which add to the interest of the debate, and I have listened with interest. I declare an interest as a public health consultant, and if the hon. Member is not interested in the greater moral argument, I would encourage him to look at my discipline and the 50 years of evidence and data we have collected since Sir Richard Doll first identified the fact that lung cancer had a causality with smoking. Data and evidence build this great Government and this great country. I ask the hon. Gentleman to please not accept the moralistic or paternalistic arguments: this is a solid Bill, built on 50 years of evidence.”
“All of those can be addressed by trying to tackle the scourge of these tobacco companies preying on more vulnerable groups within our society, whether that be those who experience socioeconomic circumstances that are much more difficult and challenging for them, or whether that be particular groups that are more likely to experience mental health conditions. All of these must be tackled; people must be assisted not to develop addictions that lead to lifelong smoking and problems with their health thereafter. I am very clearly of the view, both in terms of smoking and, it is important to say, of vaping, that the targeting of those groups that creates those inequalities within our society is something that this Bill can address.”
“Professor Sir Gregor Ian Smith: It is my very clear view that the provisions within the Bill will help us to tackle some of the inequalities associated particularly with tobacco smoking. If I look at the situation in Scotland, 26% of our lowest socioeconomic group are smokers, compared with 6% of our highest socio- economic group. The gradient that Sir Michael has spoken about in terms of the subsequent tobacco-related disease that those groups then experience is really quite marked, whether that be cardiovascular disease or the numerous cancers associated with smoking.”
“That is a direct consequence of the smoking incidence in more socioeconomically deprived areas. The health inequalities associated with the consumption of tobacco are significant and great. If we look at smoking in pregnancy and all its consequences in terms of premature birth, stillbirth and low birthweight, we see that smoking among women from more socioeconomically deprived areas is four and a half times higher than among those in less socioeconomically deprived areas. The health inequalities argument and the case to be made for addressing that within the Bill is huge. This is an opportunity that we must not pass up to narrow the adverse health consequences.”
“Q My question is around inequalities. How effective or otherwise do you think the Bill will be in reducing inequalities? Are there any areas of the UK that have specific challenges related to tackling smoking prevalence that you would like to highlight? Professor Sir Michael McBride: That is a really important question. We talked before about the blatant marketing of tobacco and vapes. There is also the preying of the industry on those more socioeconomically deprived areas. If we look at smoking rates in those more socio- economically deprived areas, they are two to three times higher than in less socioeconomically deprived areas. If we consider the death rate from smoking-related conditions, it is twice as high. If we look at lung cancer rates, they are two and a half times as high in those areas.”