Westminster Hall

Tuesday 12th November 2024 Westminster Hall

Tuesday 12 November 2024

[Martin Vickers in the Chair]

Transport Infrastructure Projects: Elizabeth Line

Tuesday 12th November 2024 Westminster Hall

09:30

[Matt Rodda (Reading Central) (Lab)]

I beg to move,

That this House has considered future transport infrastructure projects and the Elizabeth line.

It is a pleasure to serve under your chairmanship, Mr Vickers. I declare an interest as a local MP who has received donations from two rail unions, ASLEF and the National Union of Rail, Maritime and Transport Workers. Also, I am a season ticket holder and in the past was involved in the Paddington rail crash. I secured this debate to celebrate the great success of the Elizabeth line, which I travel on almost every day. I was moved by the Royal Institute of British Architects’s tribute, and its award of the Stirling prize, to the Elizabeth line—nominated for its outstanding architecture.

In today’s debate I hope we can discuss the importance of rail investment and the need for long-term planning. I hope to highlight the Elizabeth line as a national achievement and possibly a model for further investments around the country. I also hope the Minister will be able to provide further details of future investments in other parts of England. I am conscious that I am likely to talk a lot about Berkshire, my own county, and the nearby parts of London that it is so intimately connected with. Two years on is an excellent point at which to reflect on the Elizabeth line and its wonderful benefits to our community.

I hope Members will indulge me this morning, because I have to say my family banned me from going on about the Elizabeth line. I was told by my wife to stop talking about it. I am very lucky to live near London and can travel home to Reading every day —apologies to colleagues who are not able to get home in the evening—but I was admonished by my wife, who told me, “Stop going on about the Elizabeth line. I don’t want to hear any more about it.” However, she and my son and daughter all changed their tune as soon as they had benefited from it; Sarah was able to get back from a show in the west end to a cup of tea in our kitchen in Reading in 50 minutes one evening, and that stopped her ever criticising it again. Now she is as big a convert as I am to that wonderful piece of engineering.

I have my “Matt Rodda’s pub quiz” section of this speech, in which I want to mention a few fun facts about the Elizabeth line. To sum up the scale of what the country has achieved, £19 billion has been invested in this piece of railway, but it has already, in just two years, generated £42 billion of benefits to the economy. There are some 700,000 journeys a day. Every day, the equivalent of the whole population of Berkshire, a reasonably large English county, travels on the line. To put it another way, 4.8 million people travel on it every week—more than half the population of London travel on that one railway line every week. It has generated 8,000 jobs and about 55,000 homes have been built along the line. I want to mention that later in my speech, because the connection between investment in rail, the economy, jobs, housing and growth and the clustering of new industries near railway stations is a really important topic in this debate.

The Mayor of London described the line as a “game changer” for London and the surrounding area, where we have seen 8% growth year on year in passenger numbers. The best way to understand this amazing piece of railway is to ride on it and look out of the window, or to get out of the station underground and soak up what we are passing through. Getting off the mainline train at Paddington—I do not travel on the Elizabeth line all the way to Reading every day—and going on to the Elizabeth line is quite a stunning change of scene. I go into a huge box station, down two sets of escalators and into an enormous modern station, rather like being inside an airport building. It is absolutely huge, several times greater than any normal tube station, with enormous capacity built in for extra passenger numbers. Already, even on the busiest days, the line is soaking up huge numbers of people. The crowds above ground are suddenly distributed below ground and there is a train every 2.5 minutes.

I travel to Bond Street, where, wonderfully, there is a little sign that says “Trains to Reading”—something that seems completely incongruous to anybody who lives outside London. I then move swiftly on to another tube. Looking at the view coming into Reading station the other way, there is now an equally stunning sight that we would not see in many medium-sized English cities or large towns. We are starting to see a significant number of tall buildings, and all those buildings represent a rise in land values, an increase in jobs and new businesses locating near the station, creating jobs, wealth and growth through investment and infrastructure. That is driving the economy of the area and leading to significant migration into Reading from around the UK and around the world, with businesses also relocating.

I saw one example of why that relocation is taking place with my visit to the Ericsson office, in Thames Tower next to the station. This illustrates the employer’s point of view, which is important. Senior managers at Ericsson explained that they moved from a business estate in Surrey to Reading because they wanted access to a much wider pool of workers. The transport connectivity meant they could get much better access to a much wider range of people with qualifications in telecoms, electronic engineering and other related skills they needed in their business by being in Reading. Staff can connect more easily to the midlands, east to London, west to Bristol and south too. I stress that rail connectivity, and the benefits it brings to employers, as an important part of this debate.

At a local level, PepsiCo, whose office is in Green Park near the M4 motorway, is moving to Reading town centre. That movement of businesses into Reading from out-of-town industrial estates could also apply to other areas where there is due to be a significant amount of rail investment—for example on the Oxford to Cambridge line or in the north of England. I hope that is the story when investment and infrastructure are brought together.

It is also worth mentioning the huge environmental benefit. We do not have much capacity in our major towns and cities to build extra roads and getting extra road space is incredibly difficult. There are more people and more vehicles in the country, and all those vehicles on the road at the same time can cause gridlock. Rail offers the ability to generate large numbers of journeys and move huge numbers of people quickly and effectively from one place to another. That can be seen in Berkshire and west London; in fact, the section of the Elizabeth line between Reading and Hayes shows the fastest growth in passenger numbers. Interestingly, it straddles two regional boundaries, where there was previously a stopping service that was nowhere near as effective at getting people from A to B—it was not as fast or as regular—as the Elizabeth line.

[Deirdre Costigan (Ealing Southall) (Lab)]

I congratulate my hon. Friend on securing this important debate. The Elizabeth line has been a game changer for my constituency of Ealing Southall, and Southall station in particular is very well used. However, two other stations, West Ealing and Hanwell, suffer from a less frequent service than Southall, and that is in the context of increasing development, particularly in West Ealing. There are also more delays and cancellations on the line than would be expected with new rail infrastructure. Does my hon. Friend agree that not only is it important that the Elizabeth line is extended to constituencies such as his, but that the reliability and frequency of the line is improved?

[Matt Rodda]

My hon. Friend makes a good point about further enhancements and improvements to the line. I will discuss that later in my speech and I hope the Minister will also have a word to say on that.

On the wider context of the British economy and national achievements in recent years, it is fair to say that we are all proud of Great British sporting achievements, such as securing the Olympics and the performance of Team GB or our achievements in football and other major sports. I believe that the building and the growing success of the Elizabeth line are also an achievement in line with our achievements in sport or science and technology, and we ought to pay heed to that, learn from it and use it to fuel other investments, whether by learning the lessons on planning and infrastructure development or in other ways.

I also want to comment on some of the political lessons learned, on a cross-party basis: once again, it is important to focus on the crucial number of £42 billion of economic growth in just two years. That is a significant number, and we want to see more of that, not just in my region of the south-east of England, but across the country, in Wales, Scotland, Northern Ireland and the north of England.

To reflect on what went well and learn some lessons, I would like to go back a bit—you will be pleased to know, Mr Vickers, that I do not want to go right back to 1840, when the Regent’s Canal company, which was very far sighted, first talked about a cross-London route, but I will go back to the 1990s to reflect, in simple outline terms, on the things we got right and the themes that come up when we talk to the people involved. For example, I spoke to the former Member for Greenwich and Woolwich, Nick Raynsford, who was a Transport Minister. The lessons seem to be that it is important that the Government have a vision, and plan and invest for the long term. They must listen to businesses and work closely with them in deep partnership, and they must do the same with local and regional government. Both the Mayor of London and local government across the south-east were crucial to this project—the Minister may want to comment on that later.

I must thank several people, or I will never live it down. In particular, I thank MPs from Berkshire: I want to single out the former Member for Maidenhead, now Baroness May of Maidenhead, who played a very important role in this project and was an incredibly important constituency neighbour when she was in this place. I also thank Lord Sharma and other MPs from the Thames valley, including the former Labour MPs for Reading West and Slough, among others. I thank the lead members for transport on Reading Borough council, including Councillor Tony Page and Councillor John Howarth, and leaders of Reading Borough council Liz Terry, Jo Lovelock and David Sutton.

I thank the local business community, including investors from outside our immediate area who have done so much to regenerate areas near the station—for example, the team investing in Station Hill are playing a really important role—and many others, such as the two corporates that are moving into the area near the station. I would particularly like to mention Nigel Horton-Baker, who brought the business community together, and I thank the various local enterprise partnerships and chambers of commerce that cover the Thames valley.

I also highlight the importance of the business and civic community in the wider region. When the Elizabeth line was envisaged—this is a bit of a detour down a branch line, but it is very important for Berkshire—there was no guarantee that it would come to Reading. The original plan was for it to go as far west as Maidenhead, but Reading borough council built a coalition of local authorities across the three counties of Berks, Bucks and Oxon. I see that the hon. Member for Wokingham (Clive Jones) is here, and I am sure he agrees; he may want to speak about the importance of local government collegiality across the Thames valley. That cross-party group of local authorities, led by all three main UK parties, wanted Reading to be the western terminus. It was so important that they agreed and worked together. I obviously have a vested interest as the MP for Reading Central, but the idea of Reading’s being the western terminus made complete transport sense, as it is a major transport hub and a point at which the railway divides north and south, to the south coast and the midlands, and a key point at which it splays out westwards, to the far south-west, Wales and the midlands.

I am proud to be the MP for Reading Central, and it is wonderful to be able to commend the work that has been done locally. In the time that I have left, I have some questions for the Minister from me, our local business community and other stakeholders. I particularly want to explore the notion of further electrification. One of the benefits of the Elizabeth line is that it is fully electric, which saves huge amounts of money in the long run, although there is obviously an up-front cost. Under the previous Government, there was a reduction in the amount of electrification from what was originally planned. I have had requests for more north-south improvements in electrification in our area, between the south coast and Oxford. There has also been some interest in introducing more semi-fast services on the Elizabeth line—in other words, trains that do not stop at every station but move more quickly between the major stations. Some people have raised further station development.

A western rail link is an important adjunct to the arguments about the Elizabeth line. The line has created a lot of connectivity and an east-west corridor between Berkshire, Essex and Kent, but people going to Heathrow have to approach London and go out again. Many colleagues from Wales and the west country—particularly south Wales, Bristol and further west—have, with me and other colleagues, lobbied for extra connectivity that would allow people to get on a train at Cardiff or Bristol and go straight to Heathrow, reducing surface transport and pollution near the airport, and freeing up local roads. It would also bring huge flexibility for commuters working at the airport, particularly residents of Slough and west London, where many airport staff live, although some live as far away as Reading.

The other point I would like the Minister to comment on—I realise it is an ongoing discussion—is the work to smooth the transition relating to the development of Old Oak Common. I am pleased the Government are committed to investing in the link between Old Oak Common and Euston; that is an important milestone and a national priority for all of us. However, in my area, and particularly to the west of London, in Wales and the west country, there is a great deal of concern about the blockading of Paddington to allow work to take place at Old Oak Common. That starts at Christmas time, and I hope the Minister can say some reassuring words about it. I know he is interested in those matters and wants that work carried out in the smoothest way possible.

It has been a pleasure to speak this morning; I am grateful for your indulgence, Mr Vickers, in allowing me to commend some of my local government colleagues and others in the business community. I hope the Minister will be able to answer some of my questions. I also thank colleagues for attending in such large numbers and from such a wide range of political parties, and I look forward to hearing everybody’s speeches.

[Martin Vickers (in the Chair)]

I remind Members that they should bob if they wish to be called in the debate. If Members restrict themselves to speaking for about five minutes, we should be able to accommodate everyone.

09:46

[Dr Al Pinkerton (Surrey Heath) (LD)]

It is a pleasure, Mr Vickers, to serve under your chairmanship, and I extend my congratulations to the hon. Member for Reading Central (Matt Rodda) on securing this crucial debate.

I would like to focus on two pressing issues relating to the current and future state of transport infrastructure in my constituency of Surrey Heath. First, and keeping it local, there are fragmented internal transport links between towns and villages in my infrastructurally left-behind constituency. Bus services, which are vital to some of my most vulnerable constituents, including children and the elderly, are thin on the ground and poorly scheduled. As a result, many people miss rail connections, arrive late at work or school, and struggle to make hospital appointments. Residents report having to spend more than £50 to make it on time for a 9 am hospital appointment, due to the lack of a public transport option. For residents in villages such as Chobham, the problem is particularly acute. They lack any bus services at all. There is no direct bus route connecting railway stations in Sunningdale or Blackwater to key hubs such as Camberley or Frimley.

That lack of integrated public transport has made car dependency the norm in Surrey Heath. Over 56% of households own two or more cars, and 60% of trips under 10 km are made by private vehicles. That is not, I would contend, out of choice but out of necessity. There is simply no viable alternative. That dependency creates severe congestion on major roads such as the A322. If anyone listens to the traffic reports in the morning, they will have heard that letter and those numbers mentioned all too often.

With the national planning policy framework placing a 250% increase on new housing targets in Surrey Heath, that infrastructural challenge will only become more severe, but it is one that our current transport funding and planning mechanisms seem inadequate to address. If we want new homes, which we surely do, and if we want business and economic growth, we simply cannot react to transport deserts and congestion after the fact. We need to anticipate better, look ahead and think proactively.

That brings me to my second point, which concerns transport links between Surrey Heath and London. Frankly, in Surrey Heath we pray for something like the Elizabeth line. Camberley, the largest market town in my constituency, is hugely underutilised by commuters, despite being only 28 miles from the centre of the capital. Camberley station served just 789 passengers daily in 2022-23—not, I would argue, because of a lack of demand for a high-quality commuter service, but because the slow, fragmented service on offer forces residents to access the rail system from outside our borough altogether. It is a sad reality that, in 2024, the journey to central London from Camberley now takes one hour and 15 minutes, involving at least one change. That is longer than the same journey in the 1920s, a century ago.

Most residents, including me, find it more practical to drive many miles to rail stations outside Surrey Heath, such as Farnborough, Brookwood or Woking, to access the faster, more direct routes to the city. Surrey Heath’s transport system is failing its residents, keeping children out of school, and stifling local economic growth, and it is now unable to keep up with the demands placed on it by new house building targets.

Like many other infrastructurally left-behind places in the UK, Surrey Heath urgently needs investment in fast, efficient and direct rail links to London, synchronised bus schedules and better rural transport options. Those improvements have the potential to tackle congestion, lower emissions and support sustainable development, while enhancing the environment and the quality of life for residents. Just as importantly for a Government with a focus on economic growth, improved infrastructure can act as the oil in the engine of economic growth, and I hope this Government see that as an investment worth making for our shared future prosperity. Surrey Heath businesses want and deserve access to game-changing infrastructure such as the Elizabeth line, and Surrey Heath residents would, I am certain, make for hugely vocal converts and give the hon. Member for Reading Central a run for his money.

09:51

[Daniel Francis (Bexleyheath and Crayford) (Lab)]

It is an honour to serve under your chairmanship, Mr Vickers. I thank my hon. Friend the Member for Reading Central (Matt Rodda) for securing today’s debate.

I had the pleasure of serving as the cabinet member for transport in the London borough of Bexley from 2003 to 2006. During that period, the route for what was then called Crossrail was agreed. The Queen’s Speech of November 2004 confirmed that a Bill would be introduced to authorise the construction of Crossrail. Although the announcement confirmed that a southern spur would terminate at Abbey Wood rather than Ebbsfleet, people with long memories like me recall discussions at the time about terminating that spur at Canary Wharf or Custom House. I was quoted at the time, regarding the benefits for residents in Bexley, as saying:

“The most important achievement is getting Crossrail south of the river. If it had stopped at the Isle of Dogs, there would have been no benefit at all.”

My council lobbied to have that section reinstated, but it was not included in the final scheme, although the safeguarding directions for the associated land were retained.

As things stand, the southern spur of the Elizabeth line terminates at Abbey Wood station where, uniquely, the ticket office is located in the London borough of Bexley while the platforms are located in the royal borough of Greenwich. Although the station is located in the constituency of my hon. Friend the Member for Erith and Thamesmead (Ms Oppong-Asare), it is within three quarters of a mile of my constituency of Bexleyheath and Crayford. The route has therefore brought many benefits to my constituents—particularly in the western part of the constituency—providing much faster journey times through to Canary Wharf, the City, the west end and Heathrow. It has also brought benefits for my constituents interchanging at Abbey Wood via Southeastern and Thameslink services from Slade Green. Sadly, the previous Government cut the majority of direct services from Crayford to Abbey Wood, making it difficult to interchange directly. I will continue to campaign for better services by train and bus to reach Abbey Wood from Crayford.

Passengers interchanging from Slade Green and other stations to its east have to rely on less frequent services to undertake this change. There remains a strong case to extend the Elizabeth line to Ebbsfleet in order to serve residents in the thousands of new homes built there, in order to interchange with high-speed services and hopefully, in the future, with reinstated services to mainland Europe.

The Abbey Wood to Ebbsfleet corridor covers the local authorities of Bexley and Gravesham and that of my hon. Friend the Member for Dartford (Jim Dickson). The corridor has the potential to build on its existing strengths and diversify its economy, but it needs to improve transport links to make that happen. Although the corridor has large areas of underutilised brownfield sites, many sites are complex and cannot be brought forward for housing by the market alone, because of viability challenges, in part caused by poor transport connections, which limit land values. Significant evidence has been assembled to show how additional housing can be delivered by transport investment making the local area more attractive. An extension is also expected to support jobs growth due to enhanced connectivity and additional commercial floor space and through jobs to support the new population, which would support the regeneration of both Crayford and Slade Green.

The C2E Partnership was formed in 2016 as an informal group of authorities to promote an extension of the Elizabeth line beyond its planned terminus at Abbey Wood and towards Ebbsfleet. It comprises stakeholders representing local communities in the area, including the London borough of Bexley, Dartford and Gravesham borough councils, the Ebbsfleet Development Corporation, Kent county council, the Greater London Authority and the Greater North Kent Partnership. The partnership has lobbied since its inception for funding to develop scheme options. It was successful in securing funding from Government for the development of a strategic outline business case, which was submitted to the previous Government in October 2021.

Despite that, there has still not been a formal response to that business case. The project continues to form a key element of the transport strategy for growth of the London borough of Bexley, being referenced in the Bexley growth strategy and the recently adopted local plan. That is echoed in the policy documents of the wider partnership, as well as regional partners, such as the Thames Estuary Growth Board and Transport for the South East.

The partnership’s ask is for further resource to refine the options presented in the business case and identify a preferred scheme for development to detailed design, and the securing of appropriate powers for delivery. The case for such investment is considered to be stronger than ever, in the context of housing and economic development imperatives. I shall continue to call for this extension to be delivered in the years ahead. I look forward to hearing the Minister’s response.

09:55

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Member for Reading Central (Matt Rodda) on setting the scene and thank him for giving us an opportunity to participate. I want to give a Northern Ireland perspective on where we are. My method of getting here is to travel from London Heathrow or London City airport. Coming into Heathrow, I get the Elizabeth line or the Heathrow Express, depending on time. It is obviously important for us as commuters and for my constituents. I have to mention them because it is not about me; it is about the importance for them.

Thank you for giving me the chance to serve under your chairship, Mr Vickers. It is a pleasure to add some thoughts on how infrastructure can work better. Others have contributed on the real importance for their constituents. I may not have a piece of the Elizabeth line, or even a train line, in my constituency, but I am incredibly interested in connectivity throughout the United Kingdom. This time last week we had a debate on flight cancellations and connectivity. I want to give perspective on the importance of airline flight connections and of the Elizabeth line.

I can remember before the Elizabeth line was upgraded. To be fair, sometimes the service was not always dependable. That was a fact of life, so commuters would not take the Elizabeth line if they felt it would not arrive on time or be late setting off, whatever the reason. They would take the Heathrow Express instead. There were occasions when it did work well. When the new Elizabeth line came in, it was much improved. It is important to put on record our thanks for that.

There are many things to boast about in London, such as the global seat of democracy at Westminster, the royal family home of Buckingham Palace, a rich history and successful city ventures. One of the many things in favour of this envy of the world is a rail and underground system that gets travellers where they want to be quickly.

I live in the countryside, where there are no bus connections, and have a diesel vehicle as my method of transport. In the city, tube trains, especially the Elizabeth line, and the Heathrow Express, are my main ways of connecting with my job, as they are for others. Does anyone need a car in London? If I lived here, no I would not, because tube trains are so handy, once someone gets into the way of it. When I first came here, I found it quite hard to fathom how tubes worked. It is no secret that I am a country boy. Before I was an MP, I think I had come to London four times in my life. Coming to the big city was almost like a holiday, in that I was somewhere different from back home.

My point is that we get used to the tube and understand how it works and its connectivity, and the Elizabeth line is part of that. Enhanced connectivity is what everyone here wants: they want people to be able to get where they need to go in a cost-effective and timely way.

Connectivity needs to go further than the London underground; it must be everywhere in the United Kingdom. I know that is not the Minister’s responsibility, but it is tied to the connectivity of the Elizabeth line, the tube and the Heathrow Express, which is important to people like me and my constituents who come into Heathrow then into the city centre. Connectivity must relate to all parts of the infrastructure, because people fly in and then use the trains to get here.

I will give some examples that relate to my constituents. Last week, the planes from Northern Ireland to London were cancelled; we had an urgent question about it last Tuesday. I am not sure if British Airways has learned its lesson because, although it agreed to a meeting, on my way home on Thursday—guess what?—the plane was cancelled. It is at the stage where I phone the ladies in my office to say, “Will you check to make sure that the flight is on?”

If we do not have flights, and their connectivity with trains, we do not have a system that works. On behalf of all the tourists on planes from Belfast, Scotland and elsewhere in the United Kingdom, I say to the Minister: if the planes do not work, it does not really matter if the train works. It must be right for those who are coming for appointments, as the hon. Member for Surrey Heath (Dr Pinkerton) referred to, and for disabled people, with wheelchair access on the tube.

We have so much to offer as a nation—there is so much investment from other countries—but our connectivity needs to be dependable, whether that is taking the tube between Paddington and Westminster or hopping on a flight from Belfast to London and then on to the tube. We must do better and put it all together: flying and the trains.

10:02

[Jim Dickson (Dartford) (Lab)]

It is a pleasure to serve under your chairship, Mr Vickers, and I congratulate my hon. Friend the Member for Reading Central (Matt Rodda) on securing this important debate. We may be at different ends of the Elizabeth line, but we have a shared interest in getting the most out of it for our constituents.

My Dartford constituency is one of the fastest-growing communities in the country, with the population of the local authority increasing by 20% between 2011 and 2021, and likely by significantly more in the three years since 2021. Ebbsfleet in particular has grown by over 5,000 homes, with another 10,000 planned over the next decade. Yet the Elizabeth line stops at Abbey Wood, rather than reaching Ebbsfleet as was originally envisaged in the 2003 and 2004 consultations on Crossrail, as it was then known. When my hon. Friend settles down at Christmas for his Elizabeth line quiz, perhaps he could add a question: where was the intended final south-east station in the original Crossrail plans? The answer is, of course, Ebbsfleet. A quick look at the map shows the discrepancy, with services north of the river reaching all the way out to Shenfield but south of the river only as far as Abbey Wood.

I warmly welcome the fact that new residents are being attracted to live in Dartford thanks to the amazing development that is taking place, with many young families looking for comparably more affordable homes and often commuting into London. Despite not being a London constituency, we are dependent on transport links into the capital, which are crucial to economic growth in Dartford and across the Thames estuary, which could be an engine of growth for the new Labour Government.

Five years ago, in 2019, the Ministry of Housing, Communities and Local Government provided funding for the C2E Partnership—an informal group of interested local authorities—to undertake a comprehensive study into options for improving transport connectivity between Abbey Wood, Ebbsfleet and Gravesend, to support new housing and employment along that growth corridor. In 2021, those options were refined to just three: first, an extension of the Elizabeth line to Northfleet, Ebbsfleet and Gravesend, sharing existing tracks with National Rail services; secondly, extending the Elizabeth line to Dartford with the construction of new tracks; or thirdly, improving the frequency of National Rail services, and a new rapid bus transit service from Abbey Wood to Ebbsfleet. Given the challenges with traffic that my constituency already experiences, I am somewhat sceptical about the third option, and there are significant challenges to sharing track with the existing National Rail services, making the first option difficult.

Unfortunately, since that narrowing of options in late 2021 when the business case was submitted to the last Conservative Government, we have seen little progress. The idea was revived earlier this year by Local London, a collection of nine local authorities in north-east and south-east London, which included it in research it commissioned on the region’s long-term transportation needs. The London borough of Bexley and my hon. Friend the Member for Bexleyheath and Crayford (Daniel Francis) are keen to see the work progress, as he so ably and articulately set out.

I urge the Minister and his colleagues across Government to look at how we can get on and finish the Elizabeth line as originally intended to grow the economy, boost productivity and improve lives across our region. That means extending it to Ebbsfleet, where the links with high-speed and international services would create an ideal interchange. That must be a priority when considering the future of the Elizabeth line.

10:06

[Clive Jones (Wokingham) (LD)]

It is a pleasure to serve under your chairmanship, Mr Vickers. I thank my fellow Berkshire MP, the hon. Member for Reading Central (Matt Rodda), because many of the trains that pass through my constituency land in his, so it is something that we need to have regular discussions about. Our constituents want us to get this right.

Wokingham is well served with choices to get to London, and many commuters take the journey every day. To provide a brief tour, residents in Winnersh and Wokingham are slowly taken by South Western Railway through a suburban route via Waterloo to the Reading line. In the north, Twyford is on the Great Western main line into Paddington, carried by the Elizabeth line and Great Western Railway. It is a blessing that all 8.8 million Londoners are merely 33 minutes away from the many beautiful villages in Wokingham.

The Elizabeth line is a great addition to London and its route through Berkshire, helping to promote a shift from private vehicles and in turn reducing carbon emissions and particulate pollution. However, Wokingham has one of the highest levels of car dependency in England, and the quality of our railways likely explains why that is the case. Our railway services are unreliable and they do not work for passengers.

I thank the House of Commons Library for the following data. Only 66.6% of GWR services arrive on time, below the UK average of 67.5%. South Western is marginally better, on 66.8%, but still below the national average. With that perspective, I must give credit to the Elizabeth line, because 81% of its services arrive on time. In addition, 4.8% of all GWR services are cancelled—again, above the national average. That might not sound too bad on the face of it, but if I forgot my house keys 4.8% of the time, I would be locked out of my house 18 days every year.

For someone travelling on a Great Western service on Monday 28 October, 55 services were cancelled and 301 trains were late. How can we expect people to travel by train if passengers are not getting to where they need to be at the right time and for a reasonable price? As the Government begin a process of nationalising the railways, we need to seriously reflect on how we got here in the first place and how we can ensure that we are never here again, because people in Wokingham will continue to use cars if trains are not working for them.

I ask the Minister this: how do the Government intend to increase the reliability of service on the Great Western main line, and will he explain the role better infrastructure plays in that? What particular attention has been given to improving the reliability and speed of the Waterloo to Reading line? When can my constituents expect genuine change from Great British Railways? Finally, I support the proposal to build a western rail link to Heathrow airport. Heathrow airport, the Thames Valley chamber of commerce, local MPs and many other organisations have backed the proposal, so Network Rail should get on and build it. Will the Minister confirm that the Secretary of State’s infrastructure review will include considering a western link to Heathrow airport, and will the Minister for Rail meet with me to discuss the proposal?

10:11

[Catherine Atkinson (Derby North) (Lab)]

I thank my hon. Friend the Member for Reading Central (Matt Rodda) for securing this key debate. I come to the debate as an interloper from the east midlands, although my constituency is not quite as far away as the hon. Member for Strangford (Jim Shannon) in Northern Ireland, who made some powerful points about the importance of connectivity.

My connection to the Elizabeth line is that its trains were built at Alstom in Derby. Derby has been building trains since 1840. The most recent order of 10 additional Elizabeth line trains to address capacity issues helped train building in Derby, which had been grinding to a halt because of a gap in train orders. I am grateful for the opportunity to speak about the importance of rail infrastructure in the mission to drive economic growth—some hon. Members may have heard me speak about it once or twice before. This debate is an opportunity for us to highlight the importance of infrastructure in bolstering not just our local economies but, in its ripples, the broader economy; in providing jobs and opportunities for skills growth; and in improving physical and social mobility.

There is a future infrastructure project that runs right through Derby: the midland main line, which is the backbone of our rail system. I have long supported plans to continue its electrification, and I was reassured by the answer from the Minister for future of roads, my hon. Friend the Member for Nottingham South (Lilian Greenwood), that the project will go ahead,

“subject to business case approvals and affordability considerations.”—[Official Report, 10 October 2024; Vol. 754, c. 438.]

The benefits are enormous: significant decarbonisation and faster and quieter trains through one of the most densely populated lines in the country.

I was recently invited to speak at an event hosted by the High Speed Rail Group, which was launching its report, “Driving Investment in Rail Infrastructure”. The report called for rail infrastructure to be viewed as

“strategic long-term investments that drive sustainable development”,

and I agree. As the Institution of Civil Engineers has said, decision making needs to give weight to the benefits of infrastructure investment.

Rail infrastructure is about more than just the tracks that the trains run on. It is the rolling stock that carries the passengers or the freight. It is about the skills of the workforce who build the tunnels, wire the overhead lines and guide multi-million—often billion—pound projects from conception to the big business case review through to line energisation. It is also about the train drivers, cleaners and ticket booth operators; the impact it has on stations and the surrounding areas; and our efforts towards decarbonisation, taking cars off our roads and cleaning our air.

The decisions we take on how money is invested , which projects go ahead and how infrastructure is put in place must be taken with a long-term view because it impacts everyone. After so many years of stop and start and boom and bust, the industry is in desperate need of stability and clarity. Investors need to feel that there is support for projects, the businesses in the supply chain need to be able to anticipate work and retain skills, and workers need to know that they have jobs for the future. That forward planning builds sustainable growth and development.

Rolling stock manufacturers such as Alstom are key examples of the need for stability. As I mentioned, Alstom builds trains in Derby and is a major employer in our city, but thousands of jobs at Alstom and in its supply chain were lost because of the production gap earlier this year, which was in part due to the HS2 delays. We had a day where 1,000 years of welding experience walked out the door.

The additional Elizabeth line trains are a huge relief. Businesses such as Alstom and other manufacturers need an ongoing pipeline of work, new train orders and network upgrades to bring the growth, jobs and skills that our country so desperately needs.

10:16

[Ann Davies (Caerfyrddin) (PC)]

Diolch yn fawr, Mr Vickers. It is a pleasure to serve under your chairmanship. Today is an important opportunity to highlight how Wales is losing out when it comes to transport, infrastructure projects and funding. To be blunt, we can only dream of having a £19 billion investment in Wales. We would love that money to come across the border. The unfair Barnett formula means that Wales is missing out on billions of pounds of transport funding. The autumn Budget announced that Wales’s Barnett comparability factor for transport had fallen yet again to 33.5%—it was 80.9% in 2015. That is due to HS2 and Network Rail being included in the calculations for Wales, which is eroding the funding available to us over time. That is not the case in other parts of the UK. Academics from Cardiff University note:

“At 95.6% Scotland and Northern Ireland continue to benefit from full Barnett population shares for transport funding that can be used for electrification, opening new lines, or to meet any other spending demand. This is a funding inequity that has long-term consequences yet continues to be ignored at the UK level”.

I remind hon. Members that the Barnett comparability factor for Wales is 33.5%, yet for Scotland and Northern Ireland it is 95.6%. Given that Wales receives roughly 5% of the spending that England does, the fall in our comparability factor means that we are now effectively receiving a third of a fifth of what is spent on transport in England. Does the Minister believe that is a fair way for Wales to be funded? The Government are set to renegotiate the fiscal framework with the Welsh Government. Will that include looking at improving Wales’s transport comparability factor?

While the erosion of Wales’s comparability factor may be new, the lack of investment is a historic problem. It is estimated that Wales has received approximately 1% to 2% of rail enhancement investment, despite the fact that the Welsh route makes up approximately 10% of the UK rail network. Professor Mark Barry of Cardiff University estimates:

“In terms of rail enhancement, in the period from 2001 through 2029…that the current constitutional arrangements have cost Wales a minimum of £3Bn in Barnett consequentials”.

Those sums could be transformational for our infrastructure in Wales. They could fund a programme of electrification and build new lines north to south, finally connecting our nation, rather than commuters having to travel hundreds of additional miles via Shrewsbury or Crewe. To add insult to injury, at the recent Budget the Chancellor announced several electrification and rail infrastructure projects across England, such as the trans-Pennine route upgrade and the Oxford-Cambridge rail, and she confirmed that High Speed 2 will end at Euston. Meanwhile, there was nothing for Wales, and no commitment of the £4 billion that we are owed for HS2.

The Welsh Labour Government have argued for the full devolution of rail; as has been noted here today, there is a strong financial case for rail infrastructure along the lines of the Scottish model, to address the broken funding for Welsh rail. What discussions have the UK Labour Government had with the Welsh Labour Government on the devolution of rail? Does the Minister agree with his Labour colleagues in Cardiff that rail should be devolved? The Government cannot continue to ignore this issue. As everyone knows, Plaid Cymru will continue to push for fair funding for our railways and the full devolution of rail for Wales. Diolch yn fawr, Cadeirydd.

10:21

[Sarah Edwards (Tamworth) (Lab)]

It is an honour to serve under your chairship, Mr Vickers. I thank my hon. Friend the Member for Reading Central (Matt Rodda) for securing such an important debate; we have heard many important points already. My constituency may not sit on the Elizabeth line, but it forms a part of that wider rail connectivity that many of us are interested in, and it makes a huge contribution to that network as well. My constituency of Tamworth is a rail hub for that connectivity, with direct trains right across the country, but much more needs to be done to improve those connections.

There have been some recent improvements. Avanti West Coast services through Tamworth and neighbouring constituencies will see some additional services added from 15 December, as well as a phased increase of hourly services that will serve the lines between Liverpool and London, which stop at Tamworth. This week, Avanti West Coast has also launched its all-electric train fleet, which is a great move towards electrification and greatly contributes to our goal to reach net zero. I welcome those improvements, but we have to do more to widen the connections from the midlands to other regions.

Many of my constituents have raised concerns about travel between Tamworth and Birmingham, including by both bus and train. Birmingham is a key connectivity point for Tamworth residents; many use it for commuting, work and leisure, but poor services have left many of my constituents frustrated. Transport projects often have a focus on distance or reach, but it is vital that we ensure that those smaller commutes are efficient, effective and reliable. I welcome the statement made by the Secretary of State for Transport yesterday and the steps that this Government took to implement a remedial plan to deal with the cross-country services, reduce their cancellations and get services back on track. That is very important to my constituents in Tamworth.

The hon. Member for Caerfyrddin (Ann Davies) just mentioned HS2, which of course goes through my constituency. It brings huge infrastructure improvement, which has been discussed already, particularly with the Elizabeth line, through both its architecture and its contribution. However, building it has plagued my constituency with traffic problems, and as many of my constituents do not feel that they will ever travel on that line, it comes with a slightly negative tinge.

However, the HS2 growth strategy, published by the Constellation Partnership covering Cheshire and Staffordshire, included ambitions for 100,000 new homes and 120,000 new jobs, all by 2040. That is spurred by the connectivity that HS2 aimed to create. It is also predicted that £6.4 billion will be contributed to the economy, so I am very interested that the Elizabeth line has contributed £42 billion in just two years since opening. That is a positive thing to potentially be looking forward to once HS2 is complete. During its construction, HS2 is expected to deliver a £10 billion economic uplift, and that is before trains even begin to run.

The Government have started to put foundations in place to support successful transport infrastructure projects. The introduction of Great British Energy will provide this country with a stable supply of clean energy, which is important as we look to the electrification of trains and other transport modes. However, there are still barriers that we need to overcome. I welcome the Minister’s thoughts on interventions that I am sure his team will be bringing forward and what contribution rail infrastructure can make to net zero.

10:25

[Mr Paul Kohler (Wimbledon) (LD)]

It is a pleasure to serve under your chairmanship, Mr Vickers. I thank the hon. Member for Reading Central (Matt Rodda) for securing this important debate.

Despite some genuine issues, it is clear that the Elizabeth line has been a tremendous success. It was an engineering marvel, and one of the biggest infrastructure projects in Europe. Crossrail dug out 42 km of new tunnels in the centre of one of the biggest cities in Europe, weaving around existing underground tunnels, cable ducts, gas pipes and other utilities. The result? Economic growth and revitalised communities along the length of the line. Since opening, 60% of employment growth in Greater London has taken place within 1 km of an Elizabeth line station, as the hon. Member for Dartford (Jim Dickson) said. The line has increased the capacity of the London underground by 10%, which is why passenger numbers on the underground have bucked the national trend by recovering to post-pandemic levels. Such success shows what happens when we are ambitious and invest in rail.

It is not just in London where the impact has been felt. As we have heard, towns in Essex and Berkshire now have direct links to central London and Heathrow, promoting investment and creating new opportunities from Reading to Romford. The construction of the Elizabeth line has also increased employment across the country. Crossrail awarded 62% of its contracts to firms outside of London, creating 55,000 new jobs, 1,000 apprenticeships and helping to keep rolling stock manufacturing in Derby, as so articulately described by the hon. Member for Derby North (Catherine Atkinson).

While the Elizabeth line shows the best of what transport infrastructure can do, it also shows some of the pitfalls. Management issues led to overspending and delays—something we have sadly become all too accustomed to with infrastructure projects in this country. In 2010, the project was forecast to cost £14.8 billion. By the end it had ballooned to £18.8 billion—clearly not in the same league as HS2, but still representing a 28% overspend. At a time when public finances are tight, it is simply not acceptable.

Like many rail projects, Crossrail showed a flexibility towards deadlines that would make even the most laid-back of my former students blush. I appreciate that rail passengers have become all too accustomed to delays, but waiting three-and-a-half years for a train is probably pushing it. As we embark on new infrastructure projects, it is vital that we understand what causes delays and cost overruns and learn lessons for the future.

In March this year, the Department for Transport and the Infrastructure and Projects Authority published their joint report into the lessons learned from Crossrail. The new Government must take heed of the recommendations to avoid another HS2. With talk of greater devolution and new public-private partnerships, the Government must take particular note of what the report says about the issues that arise from joint sponsorship of projects. Making sure that we get this right will be vital to ensuring that we build the infrastructure our country needs in years to come. The ongoing saga with HS2 has undermined public confidence in the UK’s ability to successfully complete infrastructure projects. If we are to get the full benefit of development, we must rebuild public trust and show that lessons have been learned—not just in transport, but in all infrastructure projects.

With many of our current lines at maximum capacity, we desperately need investment in our rail network to encourage rail freight, improve consumer choice and push forward the transition to net zero. We also need to replace existing infrastructure that has reached the end of its useful life. The District line in my constituency of Wimbledon is notorious for breakdowns, cancellations and delays. It needs investment urgently.

The key lesson from Crossrail is that when we invest and put spades in the ground, the impact can be transformative. Disappointingly, however, that lesson does not appear to have been fully learned by the current Government, although I suspect the Minister here today agrees with what I said in the main Chamber last week: if this Government are serious about economic growth, why did the Chancellor cut the transport budget?

Transport should be the engine of our economy. After years of neglect by the Conservative Government, the time has come to make the targeted investment that will make a difference to people’s lives. Yes, costs must be controlled—what happened with HS2, as the Secretary of State for Transport conceded in the main Chamber yesterday, is unacceptable. If we are to get this country moving again, we must learn from the Elizabeth line and give the transport network the infrastructure it needs.

10:29

[Jerome Mayhew (Broadland and Fakenham) (Con)]

It is reassuring to have a friendly, if entirely impartial, face in the Chair, Mr Vickers, surrounded as I am by Members who are my opposition. I thank the hon. Member for Reading Central (Matt Rodda) for securing the debate and for the tone in which he led it, including his generous sharing of congratulations for the work behind the creation of the Elizabeth line. There have been excellent contributions, which I will leave the Minister to highlight because that is his role and not mine.

There is lots to celebrate in our transport network, but we need to go further to increase connectivity and to react to demographic changes and changing work practices. That is something the Conservative Government tackled head-on. People may not have realised it from the tone of some of the contributions today, but over the last period more than £100 billion was invested in our railways, and under the Conservative and Conservative-led Governments some 1,265 miles of line was electrified. I will spare the blushes of the hon. Member for Reading Central, but were he to ask at his Christmas quiz how many miles were electrified under the previous 13 years of Labour Government, the answer would be not 1,265, nor even 65, but 63. There has clearly been a step in the right direction over the last decade.

There has also been investment in the midlands rail hub, Northern Powerhouse Rail and the Access for All programme—I will talk about some of those in further detail later—but we are here primarily to celebrate the Elizabeth line, which has been a huge success. It was a courageous, large-scale project that has actually delivered and continues to deliver, and I hope it will continue to deliver for many years to come, not just for the residents of London, but for the south-east more generally and for UK plc.

I mention in passing that the Elizabeth line did not have to be over time and over budget. When it was managed by the previous Conservative Mayor of London, he left it on time and on budget, and if the project no longer followed that path, perhaps we should ask Sadiq Khan about the quality of his project management. Nevertheless, the Elizabeth line has created, as the hon. Member for Reading Central said, £42 billion of economic benefit in just two years, creating 8,000 jobs and leading to the building of 55,000 homes. That is unequivocally a success story for London and the greater region.

The next project for London and the south-east is the lower Thames crossing. We have huge bottlenecks at the Dartford crossing. The previous Government had been progressing with the crossing, but the current Government have now kicked it into the long grass. That is a genuine cause for concern regarding connectivity in the south-east, and I fear that it may lead to the next step, which is cancellation. Will the Minister take this opportunity to reassure the House, and the many people who are no doubt watching this debate, that the lower Thames crossing is still very much on course and part of the Government’s projections for infrastructure development in the south-east?

It is not just in the south where the new Government are generating delay and doubt. Labour is potentially failing in the north as well, because Network North funding is now in doubt as we wait for the Government’s infrastructure strategy. People may ask themselves what the Network North funding is. Well, it is £19.8 billion of investment in Bradford’s new station, and in a mass transport transit system for Leeds and west Yorkshire; it is £12 billion of investment in stronger connections between Manchester and Liverpool; and it is £9.6 billion of investment in the midlands rail hub and in improving 50 stations in the midlands.

It is not just in rail where doubt is creeping into our infrastructure development projects, for the Government have already cancelled major road improvements in their first few months, including the A5036 Princess way scheme; the A358 Taunton to Southfields scheme; the A47 Great Yarmouth Vauxhall roundabout, close to my home; and the A1 Morpeth to Ellingham scheme. The restoring your railway programme has been cancelled. That is a terrible start in just a few months.

Is it the Minister’s intention to follow the example of his colleagues in Wales? Is it the Government’s intention to deprioritise road infrastructure? Is it the Minister’s intention to have a “no new roads” policy? It is beginning to sound like it. If that is not the policy, will he explain why that would be a bad idea, both in England and in Wales? Will he move against the imposition of 20 mph speed limits without local consultation? Will he put in place the updated guidance, which has already been drafted, on how such schemes should be introduced? It was prepared by the previous Government and is ready to go. If the Minister will not introduce it, will he explain why not?

On the record so far, St Francis of Assisi could have said—he probably did not—that Labour brings doubt where there was direction, indecision where there was investment and delay where there was dynamism. What have we got instead? We have inflation-busting pay rises with no working practice reforms to the unions. Paid for how? By debt? Yes. By increased taxes on poor pensioners? Certainly. By jacking up bus fares by 50%? That is true, too. And by delaying critical infrastructure.

The Government need to think again. This excellent debate, which I again congratulate the hon. Member for Reading Central on securing, has given the Minister the opportunity to provide clarity, to focus on transport users rather than just the unions, and to recommit to key transport infrastructure investments throughout the country.

10:37

[The Parliamentary Under-Secretary of State for Transport (Simon Lightwood)]

It is a pleasure to serve under your chairmanship, Mr Vickers. I thank all Members for their contributions to the debate, and I thank my hon. Friend the Member for Reading Central (Matt Rodda) for securing it. I appreciate the transformational impact that the full opening of the Elizabeth line has had on my hon. Friend’s constituents. The Government fully recognise the importance of investing in infrastructure to support economic growth, promote social mobility and tackle regional inequality.

The Government recently delivered to the House their first Budget, which set out significant investment in transport to support everyday journeys and address poor connectivity in towns and cities across the country. That includes capital investment, such as £485 million for Transport for London’s capital renewals programme, including funding for rolling stock on the Piccadilly and Elizabeth lines; funding of more than £650 million for local transport to ensure that transport connections improve in towns, villages and rural areas, as well as in major cities; a £500 million increase in 2025-26 compared with 2024-25, for local road maintenance; an additional £200 million for city region sustainable transport settlements, bringing local transport spending for Metro Mayors in 2025-26 to £1.3 billion; an investment of an additional £100 million in cycling and walking infrastructure in 2025-26, to support local authorities to install cycling infrastructure and upgrade pavements and paths; and over £200 million in 2025-26 to accelerate the roll-out of electric vehicle charging infrastructure.

Let me turn to the Elizabeth line. This fantastic east-west rail link through central London has revolutionised travel in the city and beyond. Since it opened in 2022, it has enabled more than 400 million passenger journeys. It has dramatically improved connectivity—particularly for areas that previously had poor accessibility—and reduced crowding and cut journey times. Indeed, it has proven so popular that, with Government support, TfL has ordered 10 additional trains. They will be produced by Alstom in Derby, with the first train scheduled to be delivered to TfL in 2026. That will not only further improve the service capability on the line, but enhance supply chain capability throughout the country.

There have also been challenges, of course. I am sure that my hon. Friend is concerned about the issues regarding the overhead electrification on the Great Western main line. I am advised that many of those failures are due to dated equipment installed in the 1990s. Network Rail plans to renew the outdated equipment during the next five years to improve reliability for passengers. Furthermore, some delivery challenges arose due to the relationship between the Department for Transport and Transport for London having grown strained at times. I am pleased to say that that has been reset under this Government, and both organisations are working together to continue to deliver the full benefit of the Elizabeth line.

The benefits of the Elizabeth line will continue to grow. My Department is working closely with the wider industry, in particular TfL, to integrate existing Elizabeth line services effectively into the new station at Old Oak Common. The interchange between High Speed 2 and Great Western main line services at Old Oak Common will provide significantly enhanced connectivity with the west of England, Cornwall and south Wales. Old Oak Common will operate as the London terminus for HS2 until construction of the link into Euston. Onward connectivity to central London will be provided via an interchange with the Elizabeth line, with journey times of about 14 minutes to Heathrow airport, 15 minutes to the west end, 20 minutes to the City and 25 minutes to Canary Wharf.

My Department is working with the rail industry to minimise disruption during the construction of Old Oak Common station. We have allocated £30 million to enable services to continue to operate during construction. That includes electrification of the “Poplars” line, which will enable Elizabeth line trains operating west of Ealing Broadway to get into their maintenance depot.

I will now reflect on some other items raised by hon. Members. I will take part in my hon. Friend’s quiz and say that the Elizabeth line is the most significant addition to London’s transport network in a generation. As I said, journey times have been slashed and new journey opportunities created, while crowding on other routes has declined. Crossrail and its supply chain have supported the equivalent of 55,000 full-time jobs across the country and have created more than 1,000 apprenticeship opportunities. Crossrail was an ambitious, multi-decade £19 billion infrastructure project to build the Elizabeth line, a new, world-class, high-frequency 73-mile railway across central London and beyond, jointly sponsored by the DFT and TfL.

I can tell the hon. Member for Surrey Heath (Dr Pinkerton) that transport will of course play a central role in our mission-led Government. We have already seen the introduction of Bills on buses and on the public ownership of our railways. We are absolutely determined to ensure that public transport is improved.

My hon. Friends the Members for Bexleyheath and Crayford (Daniel Francis) and for Dartford (Jim Dickson) asked about the extension to Ebbsfleet. Transport for London is responsible for the operation of the Elizabeth line. Currently, there are no plans to extend the line from Abbey Wood to Ebbsfleet International, although the route is still safeguarded. I have no doubt that my hon. Friends will continue to lobby TfL on that issue.

Turning to the hon. Member for Strangford (Jim Shannon), of course connectivity is critical. He will be pleased to know that work has already commenced on our integrated transport strategy, which will be an important part of our work in Government.

The hon. Member for Wokingham (Clive Jones) talked about railways. The starting gun has already been fired on reform of our railways. In fact, the Passenger Railway Services (Public Ownership) Bill was the first Bill I stood at the Government Dispatch Box to take through the House. I will ensure that the Rail Minister writes to the hon. Member about his other points.

I agree with my hon. Friend the Member for Derby North (Catherine Atkinson) that increasing infra- structure investment is a vital part of delivering on our No. 1 mission of growing the economy and creating jobs. We are serious about ending the cycle of under-investment that has plagued our infrastructure systems for more than a decade.

I will pass the comments from the hon. Member for Caerfyrddin (Ann Davies) on to the Rail Minister, but needless to say, we are looking at our infrastructure investment as part of the review.

My hon. Friend the Member for Tamworth (Sarah Edwards) mentioned net zero. As well as placing passengers at the heart of our railway, ensuring that we maximise our potential for freight will go a long way towards achieving that.

The hon. Member for Wimbledon (Mr Kohler) mentioned the overspend. Over the years, the cost for phase 1 of HS2 soared due to poor project management, inflation and poor performance from the supply chain, with a failure to deliver to budget. On 20 October, the Transport Secretary announced a series of urgent measures to control the cost of HS2 and bring that back on track.

Looking ahead, the next spending review will focus on the Government’s mission and manifesto commitments through growth and public service improvements over the long term. It is important that opportunities presented to invest in complementary infrastructure west of London are considered fully in the context of the forthcoming second phase of the spending review and the need to drive economic growth. The Government will continue to work closely with local communities, local leaders and industry to continue to deliver transport infrastructure projects that ensure that transport remains at the heart of our mission-led Government.

10:46

[Matt Rodda]

It is a pleasure to have secured today’s debate—thank you for your wise chairship, Mr Vickers. I found the positive mood and spirit in which colleagues conducted the debate wonderful and quite inspirational. It is hugely important to recognise when we do achieve something as a country, and this really was, and is, a national achievement. I just wish it could go all the way to mid-Wales and Northern Ireland—perhaps one day.

I thank the Minister—indeed, the shadow Minister hinted at this—for taking part in my Christmas quiz and repeating the key line that I hope we will all take home: this is £42 billion in just two years, so imagine what it could do over the longer term. Indeed, some of the studies on the economic benefits are yet to be fully updated, and I look forward to further benefits being discovered, including on connectivity just beyond the line. The points from my hon. Friends the Members for Dartford (Jim Dickson) and for Bexleyheath and Crayford (Daniel Francis) about the relationship to the area just beyond the Elizabeth line are well made, and indeed, places west of Reading and my area have benefited as well. I would like to thank the House again, and you Mr Vickers, for today’s opportunity to speak.

Question put and agreed to.

Resolved,

That this House has considered future transport infrastructure projects and the Elizabeth line.

10:48

Sitting suspended.

Breast Cancer: Younger Women

Tuesday 12th November 2024 Westminster Hall

09:34

[Martin Vickers (in the Chair)]

I will call Vera Hobhouse to move the motion, and I will then call the Minister to respond. There will not be an opportunity for the Member in charge to wind up, as is the convention in 30-minute debates.

[Wera Hobhouse (Bath) (LD)]

I beg to move,

That this House has considered breast cancer in younger women.

It is a pleasure to serve with you in the Chair, Mr Vickers. I thank the Minister for being here to respond.

Every woman deserves a fair chance against breast cancer, no matter her age. It is the most common type of cancer in the UK. Most women who are diagnosed are over 50, and it is therefore a disease often associated with older women, but young women are at risk, too. Breast cancer in younger women is often caught later when it is more advanced. That is because there is no routine screening and too often symptoms get dismissed as something less serious. That must change. Awareness and early detection are crucial, no matter your age.

The issue arose for me during a constituency surgery when my Bath constituent Lucy shared her story, which resonated with me because my nephew’s mother died many years ago of breast cancer aged 35. In 2021 Lucy, who was 38, had two young children and was diagnosed with primary breast cancer. She underwent a mastectomy, chemotherapy and radiotherapy before being given the all-clear. In 2024, when she was 41, a self-initiated MRI scan tragically came back showing that her cancer had returned, leading to a diagnosis of secondary breast cancer, which is currently incurable. In both cases she found it a struggle to be diagnosed.

The first time, despite her mother having had breast cancer and Lucy presenting with a lump, at least three different doctors told her that it was likely to be hormones and nothing to worry about. It was not until she requested the biopsy, which ultimately came back showing it was cancer, that the diagnosis was made. The second time she repeatedly voiced concerns about a symptom that she was experiencing, but she was repeatedly assured that it was just a side effect of the treatment. Still concerned, she approached the GP, who did some initial tests but ultimately suggested that her worries were anxiety-driven. After that appointment she came out and sobbed in her car.

Searching for peace of mind, Lucy then paid privately for a breast MRI, which tragically revealed that the cancer had returned, but by then it was too late. In both cases—first by requesting the biopsy and secondly by initiating an MRI—it was up to Lucy to fight for a diagnosis.

[Helen Grant (Maidstone and Malling) (Con)]

I congratulate the hon. Lady on securing this important debate. Because of the age restrictions in accessing NHS mammograms and the importance of early diagnosis, which she highlights, does she agree that self-awareness and self-examination in young women is critical in the battle to beat breast cancer?

[Wera Hobhouse]

The hon. Lady is absolutely right that we need to continue to raise awareness, but I am pointing out that even when young women are aware and go to a doctor, the doctor says, “Don’t worry about it.” However, I agree that we need to continue to make sure that women examine their breasts and are aware of the risks of breast cancer, even when they are young.

[Jim Shannon (Strangford) (DUP)]

I spoke to the hon. Lady yesterday. This is a massive issue for me and my constituents back home, and they bring it to my attention all the time. It was great to attend the Breast Cancer Now “Wear It Pink” event last month to raise awareness of the most common cancer in the UK. Studies have suggested that breast cancer among younger women has a more aggressive pathophysiology, correlating to poorer outcomes compared with those for breast tumours in older patients. Does the hon. Lady agree that consideration must be given to lowering the age requirement for breast screening to ensure quicker intervention for younger women?

[Wera Hobhouse]

I will come to that later in my speech, but I absolutely agree with the hon. Gentleman. We are here to make the case for earlier screening programmes for younger women, because it is becoming such an issue—the rates are increasing. It is because of Lucy’s struggle to get a diagnosis that she felt the need to speak up on behalf of the countless young people who would not question decisions made by medical professionals.

[Clive Jones (Wokingham) (LD)]

I congratulate my hon. Friend on securing this important debate. After I survived breast cancer, one of my many emotional conversations with my daughters was about having the BRCA gene. Currently, there is a postcode lottery for the availability of counselling with proper genetic guidance for those who are identified as having the gene. Does my hon. Friend agree that NHS England should ensure equitable access to information and counselling services, and that fixing the system should be a feature of the Government’s future cancer strategy?

[Wera Hobhouse]

I am sorry to hear that my hon. Friend went through a cancer diagnosis, and I am glad that he recovered. Breast cancer in men is not as well known; people do not necessarily recognise that men can develop breast cancer. Once a diagnosis is made, it is quite traumatic for the whole family. Counselling services need to be adequate, and I agree that there should not be a postcode lottery.

The description of Lucy’s story is in no way meant as an attack on the NHS. Since she was diagnosed, Lucy has received the top-class care for which the NHS is renowned, but she is not alone in having her age used against her. There are countless similar stories of women of a similar age or younger who have found it difficult to receive an initial diagnosis, with concerns often dismissed too early by doctors as hormones, anxiety or tiredness. This is by no means the doctors’ fault; they are forced to make difficult decisions about who to prioritise because of the impossible time and budget constraints that are imposed on them. That does not, however, make it acceptable.

There is a long-standing myth that breast cancer only affects older women, but there has been a global surge in cancers among the under-50s over the past three decades—sadly, the issue is not limited to breast cancer. Last year, a study found that cancer cases in under-50s worldwide are up nearly 80% in the last 30 years. More than a million under-50s are dying of cancer each year, and that figure is projected to rise by 21% by 2030.

I draw attention to the “Jess’s Law” petition, which has more than 350,000 signatures, to improve the awareness and diagnosis of cancer in young adults. It points out the struggles young adults face in getting diagnosed, even though adults aged 25 to 49 contribute around a tenth of all new cancer cases. According to Cancer Research UK, cancer rates in 25 to 39-year-olds in the UK increased by 24% between 1995 and 2019. In 2019 alone, almost 35,000 people in that age bracket were diagnosed with cancer.

The trend is especially alarming in breast cancer. Diagnoses of breast cancer have increased steadily in women under 50 over the past two decades, but in recent years the increase has been even more stark. In 2013, breast cancer cases in women under 50 topped 10,000 for the first time. To the alarm of experts, breast cancer diagnoses in women under 50 have risen by more than 2% annually over the past five years, so the trend is clearly an increase. That is deeply concerning, especially since women under 50 are nearly 40% more likely to die from breast cancer than are women over 50.

It is truly alarming that in the UK, breast cancer accounts for 43% of all cancers diagnosed in women aged 25 to 49. Despite that, we continue to wait until women are 50 or older to begin routine screening. Why are we delaying early detection when the rates of breast cancer in younger women are rising year on year? Cervical cancer screening is available to women from the age of 25, but of the top 10 cancers detected in those aged 25 to 49 in the UK, breast cancer outweighs cervical cancer by more than five times, so that discrepancy simply does not make sense. If we can screen for other cancers earlier, we should do the same for breast cancer. We all know that early detection saves lives, so we must ensure that all women, regardless of their age, have the opportunity to access lifesaving screenings.

Young women are more likely to develop aggressive forms of the disease. Breast cancer is the most common cancer in women, and it remains one of the leading causes of death in women under 50 in the UK. Unfortunately, as Lucy’s story shows, younger women often face more challenges to diagnosis. They are more likely to be diagnosed at a later stage of the disease, with larger tumours and greater lymph node involvement. Cancer in younger women is also more likely to be biologically aggressive: sub-types such as triple negative breast cancer are harder to treat and have poorer outcomes. As a result, younger women have significantly worse prognoses, with a higher risk of recurrence and death than older women. We cannot ignore that stark reality.

Premature death from breast cancer among women in their 40s accounts for the same years of life lost as those in their 50s, and substantially more than those diagnosed in their 60s. That is crucial. A death of a woman in her 40s or 50s represents not just a loss of life, but a tragic loss of potential life years.

Researchers also found an increase in the diagnosis of stages 1 and 4 tumours, which suggests that if stage 1 tumours are missed in younger women, they tend not to be found until they reach stage 4, at which point the cancer is incurable. Early detection can make all the difference. During the previous Parliament, a petition calling for funding to extend breast cancer screening to women from the age of 40 got more than 12,000 signatures. That widespread public support reflects the growing concerns about early detection.

The Government’s response was deeply disappointing. They continue to use the Marmot review as their main reference point, citing the lower risk of young women developing breast cancer and the fact that women below 50 tend to have denser breasts, reducing the accuracy of a mammogram. It is true that the risk of younger women developing breast cancer is lower, but statistics show that rates of breast cancer in women aged 25 to 49 are rising fast, and that upward trend demands urgent attention.

Although mammograms can be less effective in women with denser breast tissue, that should not limit our approach to early detection. We should continue to use modern digital mammography, but the Government should expand the use of automated breast ultrasounds. Ultrasounds are especially effective in detecting abnormalities in dense tissue that might be missed on a mammogram. The technology is not invasive; it is quick and radiation-free, and it is often used for secondary screening for women with dense breasts. Automated breast ultrasounds can detect up to 30% more cancers in women with dense breasts than mammograms alone. By embracing both mammography and ultrasound, we can significantly improve detection rates, ensuring early and more accurate diagnosis.

Last week, in the light of Sir Chris Hoy’s bravery in sharing his story about his struggle with prostate cancer, the Health Secretary asked the NHS to look at the case for lowering the screening age for prostate cancer, particularly for people with a family history of the disease. That is an important and welcome step, but we must look at extending that approach to breast cancer too. Both diseases share a significant genetic link, and a family history often increases the risk. Aligning the screening policies for prostate and breast cancers in recognition of the shared genetic risks would provide a better safety net for those affected.

Various parts of the NHS are competing for investment, but it is clear that short-term investment in this area will save money in the long term, with fewer women needing extensive long-term treatment if breast cancer is caught early. According to Breast Cancer Now, breast cancer will cost the UK economy almost £3 billion in 2024, and the annual cost could rise to £3.6 billion by 2034.

I call on the Department of Health and Social Care to review the national breast cancer screening programme to identify where changes can be made to increase capacity in the system, to ensure that, where appropriate, a woman’s initial screening appointment can happen at a lower age. I also call on the Government to investigate the merits of early optional ultrasound for women aged 30 to 49. Finally, we must educate healthcare professionals and increase resources so that younger women who seek help are always taken seriously and investigated thoroughly, and never dismissed.

It is about not just policy change, but giving people the best possible chance to fight back against cancer and live healthier, longer lives. I hope that the Minister has heard Lucy’s story and will actively look at changing the way we screen for breast cancer for good.

11:16

[The Minister for Secondary Care (Karin Smyth)]

It is a pleasure to serve under your chairmanship, Mr Vickers. I thank the hon. Member for Bath (Wera Hobhouse) for bringing this debate to the House, as well as other hon. Members for their interventions. I also pay tribute to the hon. Lady for championing the story of her constituent Lucy and others, such as Jessica Parsons, who have done so much to raise awareness. We have a powerful role as Members of Parliament, and I commend the hon. Lady for doing an excellent job.

The hon. Lady is absolutely right that awareness raising is key to catching cancer early, and the most effective way to tackle breast cancer in younger women is to encourage them to check their breasts regularly. The NHS is going through the worst crisis in its history, and this Government will turn it around so that cancer patients are diagnosed and treated on time. The investments we are making now in breast cancer treatment and research are part of our plan to make the NHS fit for the future.

Although women of any age can get breast cancer, it is much more likely to occur over the age of 50. That is why our screening programme sends women their first invitation at 50. However, I will take this opportunity to emphasise that the take-up of breast cancer screening is currently below 70%. That is worryingly low, and we are determined to change that. I make a plea to all hon. Members to help the Government achieve greater take-up of breast cancer screening in women over 50. Women need to come forward for screening.

Taken as a whole, the evidence does not support regular mammograms for women below the age of 50. Decisions on screening, including the age at which to offer it, are made by experts on the UK National Screening Committee, and those decisions are kept under review so that they continue to be based on the best available research. Ultrasound can be used as a diagnostic tool, but it is not appropriate for screening. Mammograms provide a fuller picture of the breast, and are better able to spot early signs of cancer. As the hon. Lady said, mammograms used for screening are less reliable for younger women given their denser breast tissue. Change in the screening age could mean a greater risk of false negatives, where cancer is missed, and there would also be a greater risk of false positives, which may lead to invasive testing when there is no need for it. Our approach is in line with that of most European countries, which screen women between the ages of 50 and 69.

For younger women who have a greater risk because of their family history, we offer screening using mammogram or an MRI scan. As I have said, the most effective way to tackle breast cancer in younger women is to encourage them to check their breasts regularly, and to consult their GP straight away if they have any concerns.

[Wera Hobhouse]

Lucy did that and was dismissed. Today’s debate is particularly important for awareness raising among the medical profession to ensure that women, particularly those who know about a family history of breast cancer—some do not—are not dismissed and are taken seriously.

[Karin Smyth]

The hon. Member makes a powerful point. When people come in, particularly with a family history, their relationship with their GP should be better and should take that history into account.

We know that the sooner cancer is diagnosed, the more treatment options are available, and that treatment is more likely to be effective with an early diagnosis. Primary care and GPs are essential in that pathway and I agree with the hon. Lady that we need to pay attention to the upward trend in demand. NHS England runs campaigns to increase knowledge and awareness of key symptoms, but we can all do more. Breast cancer is thankfully rare among younger women, but the more aware they are of the symptoms, the likelier they are to see their GP, and the GP will be made more aware of those trends.

I would like to take this opportunity to highlight Breast Cancer Now’s “Touch, Look, Check” advice. The NHS and the Government support this advice, and I encourage women no matter how young or old they are to check their breasts often. Breast cancer remains one of the most common cancers in England; almost 50,000 people are diagnosed each year. Instances of many types of cancer are rising among young people in this country, and we are not yet certain of the cause of that. Although breast cancer is thankfully less common in younger women, we cannot afford to be complacent and, as the hon. Lady has highlighted, we must remember the human stories behind that number—the lives disrupted, the trepidation of diagnosis and the uncertainty faced by loved ones. We can take some comfort from the fact that more women are surviving breast cancer than ever before. Between 2016 and 2020, the one-year survival rate for breast cancer was over 96%, enabled by advances in screening, treatment and care.

There is much more to be done, and I want to reassure hon. Members that it is a top priority of this Government to speed up the diagnosis and treatment of every type of cancer. On 30 October, my right hon. Friend the Chancellor restated and backed that commitment. The first Labour Budget committed £70 million for new radiotherapy treatment machines and £1.5 billion for new surgical hubs and diagnostic scanners. This investment will allow the NHS to undertake 30,000 more procedures each year, and the capacity for diagnostic tests will increase to 1.25 million. This further funding will enable us to ensure that cancer can be diagnosed or ruled out as quickly as possible, which is something we all want to see.

We also continue to pave the way in identifying the best possible testing and treatment for all types of cancer. Research is a crucial part of this. That is why the National Institute for Health and Care Research has spent £33 million on directly funding breast cancer research in the last five years. But investment alone will not be enough to tackle the problems facing the NHS; it would be like pouring water into a leaky bucket. We need investment and reform. People who work in the NHS, as I have, see first hand what is great but also what is not working—the things more money will simply not fix. As my right hon. Friend the Secretary of State has said, we need to take the best of the NHS.

We need to do more to meet the challenges presented cancer now and in the future for people of all ages. We recently launched the biggest national conversation about the future of the NHS since its birth to help to shape our 10-year plan, which will allow us to do more to prevent cancer where we can, identifying it as early and as quickly as possible and treating it with speed and precision. But we need suggestions from hon. Members on how to go further. We need to learn from the experiences of people like Lucy, which the hon. Member for Bath outlined today. I urge everyone to visit change.nhs.uk and help us build a health service fit for the future.

I thank the hon. Lady for bringing this important matter to the House and raising her constituent’s issue. I thank all hon. Members who have made such valuable contributions on this important subject. I am pleased to assure them that rebuilding our NHS and delivering world-class cancer treatment and prevention services for every person will always be a top priority for this Government.

Question put and agreed to.

11:24

Sitting suspended.

NHS Dentistry: South-west

Tuesday 12th November 2024 Westminster Hall

[Martin Vickers in the Chair]

14:30

[Richard Foord (Honiton and Sidmouth) (LD)]

I beg to move,

That this House has considered NHS dentistry in the South West.

It is a pleasure to serve under your chairship, Mr Vickers. I am grateful to the Chairman of Ways and Means to have been granted a debate on NHS dentistry in the south-west of England, which has particular problems.

I know that the new Minister will have encountered enough problems with NHS dentistry as it is, but the south-west is a special case. To illustrate: if we were to go back to 2015, 51% of adults in the south-west could see a dentist. That was also the case across England at the time, with 51% of patients who wished to see an NHS dentist having access to one. By 2024, however, that figure has declined sharply. Now, the current average across England is 40%, and in the south-west it is just 34%.

[Sarah Dyke (Glastonbury and Somerton) (LD)]

I thank my hon. Friend for securing this important debate. In Somerset, the percentage of adults who have seen a dentist has dropped by 20% over the past decade. Does my hon. Friend agree with me that we should guarantee access to an NHS dentist for everyone needing urgent and emergency care?

[Richard Foord]

That is exactly what is needed for urgent and emergency care. My hon. Friend draws attention to Somerset; the situation is bleak in Devon too. In Devon in 2015, 55% of adults were able to see a dentist, but that has since dropped to just 37% today.

I have had so much correspondence from my constituents on this subject, and the decline, as I see it, is a direct result of 14 years of Conservative neglect of our health services and of NHS dentistry in particular. I find it really troubling that the situation is affecting people in some of the most vulnerable categories, such as older people and children,

Children in Devon are missing out on crucial dental check-ups. Once upon a time, they used to have check-ups twice a year; now, it is not possible for children to be registered for NHS dentistry in many dental practices. It is therefore no surprise that tooth decay is now the leading cause of hospital admissions for five to nine-year-olds in the country. I talked to one primary school and was told that pupils are going to hospital in Bristol to have their teeth removed—often between four and 10 teeth at a time. The number of NHS dentists in Devon has dropped from 549 to 497, so the reality is that NHS dentistry is simply no longer available for all.

[Perran Moon (Camborne and Redruth) (Lab)]

I entirely accept the points that have been made about Devon and Somerset. In Camborne, Redruth and Hayle, we have some of the most deprived areas in the country. I have met people who have chosen to access dental care privately at the expense of heating their homes or eating food. This is where we are today: we are in a dental emergency across the south-west, and in Cornwall, the situation is now critical. Does the hon. Gentleman agree that we cannot wait any longer for emergency dental care across the south-west?

[Richard Foord]

The hon. Gentleman is right. We want to move NHS treatment back into primary care and away from the most critical acute care, yet it seems to me that primary care services are moving in the other direction.

[Wera Hobhouse (Bath) (LD)]

Royal United hospitals in Bath saw nearly 260 people last year with serious dental issues such as abscesses, largely because those people could not get a preventive care appointment from a dentist in their community, forcing them to go to A&E. Does my hon. Friend agree that a lack of NHS dentistry drives up costs because people go to A&E when it should only be there for emergency cases?

[Richard Foord]

I agree that emergency care should not suddenly become the routine. It is there for the most critical cases, but we have not seen that, given the drying up of NHS dentistry provision in our towns and villages.

[Sarah Gibson (Chippenham) (LD)]

Does my hon. Friend not agree that part of the problem is that we are only talking about emergencies? The Secretary of State, in his first week in the job, talked about working hard to look at preventive medicine. That should apply to dentistry as well. Does my hon. Friend not agree that we need to look at a serious timeline for reviewing the dental contract? We cannot only talk about emergencies all the time.

[Richard Foord]

My hon. Friend makes an excellent point. Prevention is clearly cheaper than dealing with the problems down the line. There is no better example than offering check-ups for children’s dentistry.

[Rachel Gilmour (Tiverton and Minehead) (LD)]

I find it absolutely shocking—I am sure my hon. Friend will agree—that the recommendations of a report published 15 years ago by the previous Health and Social Care Committee have still not been implemented.

[Richard Foord]

The hon. Member for Tiverton and Minehead has clearly done her homework. It is quite staggering that recommendations from that long ago are still not implemented.

[Caroline Voaden (South Devon) (LD)]

Lord Darzi said in his review of the NHS that

“urgent action is needed to develop a contract that balances activity and prevention, is attractive to dentists and rewards those dentists who practise in less served areas”

such as mine in South Devon, where not a single dentist is taking on NHS patients any more. Would my hon. Friend agree that we urgently need a timeline for this work to be done?

[Richard Foord]

Yes, I think so. My hon. Friend is right to point to some of the recommendations in the Darzi report. I was encouraged to see reference to neighbourhood hubs, where perhaps we can have delivery of primary care, such as NHS dentistry, nearer to the constituents we represent.

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Gentleman for securing this debate. Does the hon. Member not agree that the story in the south-west is being replicated across all of the United Kingdom of Great Britain and Northern Ireland? He may not be aware of a survey of almost 300 dentists in Northern Ireland that found that almost nine in 10 intend to reduce or end their health service commitments in the coming year. That could be the end of NHS dentistry. Is he experiencing the same thing in the south-west? If he is, Government must really grasp this issue, and, as the hon. Member for South Devon (Caroline Voaden) said , get it done.

[Richard Foord]

I am glad that the hon. Member for Strangford made that point, because I did not know about the situation in Northern Ireland. It sounds like some regions of the UK are not getting the attention that they require when it comes to NHS dentistry.

I want to share the story of two of my constituents, Mike and Shirley. I have received correspondence from them and many other residents, such as Martin Loveridge, who has had a similar experience. Mike and Shirley are hard-working people. Mike is almost 75 and retired after more than 50 years in horticultural work. Shirley, aged nearly 70, is still taking on part-time cleaning work to make ends meet. In 2023, their dentist in Sidmouth finally went private, driven away by the broken dental contract that we have heard described. The impact of that shift has been devastating.

Shirley developed a dental abscess. Anyone who has had a dental abscess will know what excruciating pain it can involve. Years ago, Shirley suffered from a similar infection, which led to sepsis. This time, instead of receiving urgent care from the NHS, Shirley faced the following choice: either wait in pain or go private. Plainly, this incident is a stand-out case, given that it was crucial that she received NHS treatment for sepsis, but typically, it would cost them £1,200 in dental fees—a sum that is simply unaffordable for people in Mike and Shirley’s position. Mike has not seen a dentist since May 2022 because he simply cannot afford it. Mike and Shirley tried to get NHS dentistry—they went to NHS England, Healthwatch Devon and the complaints department of the Devon NHS—and they had people admitting to them the dire state of the system, but they were offered no real solution. They spent hours on “Find a dentist”, an NHS website just for that purpose, but they were referred to a clinic that was 80 miles away, an impossible journey for them.

[Max Wilkinson (Cheltenham) (LD)]

I thank my hon. Friend for securing this important debate. Cheltenham, similarly, is a dental desert. My residents often find themselves referred out of our region and into the midlands for treatment, to places as far away as Malvern, if they are not lucky enough to get somewhere in the constituency of the hon. Member for Gloucester (Alex McIntyre). Does my hon. Friend agree that that is simply wrong and unacceptable? Will he join me in thanking community campaigners in Gloucestershire, including Councillor Paul Hodgkinson, the health lead for the Lib Dems on Gloucestershire county council, who are trying to fight this at the local level?

[Richard Foord]

My hon. Friend is right to draw attention to community campaigners, but frankly it should not require grassroots organisations to self-organise and mobilise; as representatives and as Government, we should be able to provide that in this, the sixth richest economy in the world.

[Carla Denyer (Bristol Central) (Green)]

I thank the hon. Member for arranging this debate and for his forbearance on the incredible number of interventions. Does he agree that to solve this problem once and for all, and not just deal with the emergency situations that have been mentioned, the Government need to move towards a model similar to that for GPs, in which dentists are reimbursed for their work and rewarded for caring for patients and taking a more preventive approach?

[Richard Foord]

Dentists need to be rewarded under an NHS dental contract that recognises that not everyone has the same ability to pay. Frankly, if a little money were invested early in preventive measures, some of our constituents would not cost the system nearly so much later.

At a Westminster roundtable on dentistry last year, it was made plain that the issue was about not so much a shortage of dentists, but a need to attract private practising dentists to NHS work. Many dentists, even those who would ideally prefer to work within the NHS, avoid NHS work or leave it, because the current system is not fit for purpose.

On Remembrance Sunday, I was talking to a couple near the war memorial in Sidmouth. They were both veterans. Between them, they had served for 62 years, and they were unable to get NHS dental appointments. They felt that they had dedicated their lives to public service and this was how the state was rewarding them.

[Clive Jones (Wokingham) (LD)]

I thank my hon. Friend for securing this important debate. I am sure that the issues in the south-west are similar to, and as challenging as, those in Wokingham in Berkshire. Commons Library data states that only 32.6% of children in Wokingham have seen a dentist in the past two years, compared with a 40.3% figure for the whole of England. Both figures show the Conservative party legacy of rotten teeth, fillings and agony. Arborfield and Swallowfield in my constituency are without dedicated dentists. That simply is not good enough. Does he agree that NHS primary care needs to be properly funded?

[Richard Foord]

I am appalled to hear about those examples from my hon. Friend. The really disappointing thing is that some of the expense of secondary care could be avoided with a little more investment upstream in primary care.

There is a clear disparity between the work that dentists do in the NHS and in private practice. There is so much more emphasis in private practice on preventive care. We need to see that same level of preventive work happening in the NHS.

At an Adjournment debate last week in the main Chamber, it struck me that although many of us were there seeking to draw attention to NHS dentistry, not a single Conservative MP attended. I thank the Minister in the new Government for showing more commitment to NHS dentistry than the last administration, yet we have further to go. The Government prioritised the NHS in the Budget, allocating it an additional £25.7 billion. However, we needed more reference to dentistry in the Budget. The Labour party’s manifesto talked about a dental rescue plan that would provide 700,000 more appointments and, most critically, focus on the retention of dentists in the NHS. We urgently need that.

We urgently need a dental rescue package to bring dentists back to the NHS, particularly in the south-west, where we have a dental training school in Plymouth. We understand that dentists, once trained, often stay where they went to university, so we need more dentists to be attracted to the south-west and to stay once they are there.

[Dan Aldridge (Weston-super-Mare) (Lab)]

It is important to look at the role of public health in local government as well. Better Health North Somerset has a great programme led by Catherine Wheatley that is all about promoting oral health, which the hon. Gentleman mentioned, in early years and for children and young people. One thing I have noticed is that what works and good practice is not often shared between integrated care boards across local areas. With the strength of feeling here, demonstrated by the amount of south-west MPs that have attended this debate, there is a real opportunity for us to collaborate and share what works. That would be really useful.

[Richard Foord]

I agree. One way in which we can share best practice is by thinking about not only training places, but the recognition of qualifications. After the UK’s exit from the European Union, we saw a breakdown in the number of EU dentists wanting to stay or being attracted here. With fewer eastern European dentists, in the south-west of England, for example, we need to look again at dental qualifications and whether there are some dentist qualifications we might recognise that might make it more attractive to be a practising dentist in the UK.

The rural south-west of England needs to be able to expect the same level of NHS dentistry provision that we see in urban areas across the country. Will the Minister commit to the reform of NHS dentistry so that constituents such as Mike and Shirley do not have to go into the red or forfeit heating their homes to get dental care that avoids them going to acute hospitals such as the Royal Devon and Exeter hospital at Exeter?

[Martin Vickers (in the Chair)]

I remind Members that if they wish to speak, they should bob. If they could limit their contributions to an absolute maximum of four minutes, we will probably get everyone in. But it is going to be a squeeze, particularly if there are too many interventions.

14:48

[Tom Hayes (Bournemouth East) (Lab)]

My constituent Jonathon Carr-Brown recently went to his dentist for a routine check-up. Dr King seated him in the dentist’s chair, as he had done many times before, and felt his throat, as he had done many times before. Unlike those other times, Dr King found something: he found a lump. After that visit to Bournemouth dental centre and further investigations, a tumour was identified.

I saw Jonathon at the weekend. He had just completed a course of chemotherapy, because his dentist had helped to spot cancer. He was doing well: he was a little tired following his treatment, but he was not too tired to talk passionately about the importance of dentistry within our wider healthcare and about how more lives could be saved with the right changes by our Labour Government.

Jonathon’s story shows the potential of so many things, including co-location, the promise of innovation and the possibilities of integration. Imagine if Jonathon had been able to go up the corridor to get diagnosed even faster and receive the right kind of support even faster. Jonathon’s story shows the power of prevention. There are so many people in Bournemouth East who are struggling to get the routine appointments that could spot problems and fix them sooner.

Of course we need more appointments and of course we need more workers, but we also need a rethink of who does what. In my constituency, as elsewhere, I know the potential for local hygienists and therapists to use the full scope of their practice, and indeed for Bournemouth to pilot a new model of therapy-led practices, with dentists covering only the work that sits outside scope.

I would welcome investment in the training and development of an oral health team who could learn by doing, providing clinical and preventive services to people who need them. Right now, Health Sciences University in Boscombe could help to increase local people’s access to oral health care by training even more professionals for the future and getting support to people who need it, bringing down the waiting list while also training people up and particularly providing outreach in areas of deprivation.

There are so many areas of policy that we could focus on. I would love to talk at length about the reform of the dental contract, but in the hope that colleagues will do so, I will focus instead on the importance of empowering people by giving them accurate and clear information about NHS dentistry.

The NHS app and the nhs.uk website are managed by NHS Digital and the NHS Business Services Authority—I said “NHS” quite a lot there. It is the responsibility of NHS contractors to update for their specific provision. That means that there is no kind of oversight or meaningful guarantee of accuracy of information.

In April, before the general election, my team rang around all the surgeries in Bournemouth that were offering spaces to new NHS patients. They discovered that many had not updated their details, sometimes for years. Since then, there have been a small number of updates, perhaps prompted by my team’s calls. However, most of the surgeries that were recently showing as not having updated their details were private. They were only offering private appointments and seemed baffled to be rung by somebody looking for NHS care.

It is not just that time-poor people who are desperate for dental care might be accessing incorrect information. It struck me and my team that people could be ringing surgeries listed on NHS platforms for NHS care—they are not listed as private dental providers. When those people are unable to access NHS care, they may be so desperate for any kind of care that they will buy into private dental provision.

When we checked it out with the NHS, it had no way of determining whether patients commit to private dental provision, or what service members of the public may be offered. We were told that although so many private surgeries were not listed as private on the website and digital platforms, the NHS could not comment on the advertising of private dental providers. In April, under the Conservative Government, we discovered that there were no new NHS places available in a dental surgery in Bournemouth. Things have improved slightly since then, but only slightly.

We need to improve the accuracy of the information that we provide to our public by putting in place the right mechanisms. We need to strengthen our digital platforms to ensure that citizens can book appointments, get personalised notifications to book routine check-ups and compare waiting times and patient satisfaction scores.

Lastly, we need a digital health record as a single source of truth about someone’s health. That information is fragmented across pharmacies, GP surgeries, dental practices, hospitals and people’s phones. How much better would it be to bring that information together so that someone’s medical record is in hand and complete when they are seen? That would allow them to be seen by the right person at the right time in the right setting.

Our NHS was founded on the principle that health should not depend on wealth. However, people who can pay are paying. The use of private healthcare will continue to rocket, perhaps even through unintended encouragement on NHS platforms, unless we co-locate, innovate and integrate.

A healthy population will unlock a stronger Britain. I look forward to supporting the Government in their efforts to change our NHS and our NHS dentistry, so that they can survive and serve our public.

14:53

[Anna Sabine (Frome and East Somerset) (LD)]

I thank my hon. Friend the Member for Honiton and Sidmouth (Richard Foord) for securing the debate. As the MP for a rural constituency in Somerset, I do not need to repeat the well-known fact that the south-west is one of the worst dental deserts in England.

As a mum, and as someone who received excellent dental care as a child because my grandad was a dentist, I particularly worry about the effects on children. With such a scarcity of NHS practices accepting new patients and with the rising cost of living, working families simply cannot afford to go private. More often than not, that means that parents have to unwillingly forfeit their children’s health.

This is a topic that people care about up and down the country. The regular emails I receive about it from my Frome and East Somerset constituents normally describe the same regrettable situation: they cannot get a space, there is no room anywhere in the vicinity and they are forced to go to hospital. However, one recent casework email was particularly stark: it was from a retired man and his wife who have recently become kinship carers for their two grandchildren following the sudden death of their daughter. Although one child had “luckily” already started orthodontic treatment prior to their mum’s death, the grandparents cannot find a single NHS practice that will onboard the other child. They receive the state pension and one child benefit. Luck should never be a factor in the question of children’s health, let alone set two siblings apart. NHS dentistry should be there to level the playing field and give access to all, regardless of background or family set-up.

I know from having met local dentists and national dentist groups that the growing consensus is that there are two reasons why there are so few spaces in NHS dental practice. One reason is budget; the other is the availability of NHS dentists, many of whom are leaving the NHS or leaving dentistry altogether because of low morale and stress. Recruitment is already difficult, but retainment is even more so. NHS dentistry has been chronically underfunded. The UK spends the smallest proportion of its health budget on dentistry of any European nation, and England spends almost half less per head than other parts of the UK.

Just as working families in the south-west are struggling with the rising cost of living, high inflation, energy costs and the cost of everyday household items, so are NHS dental practices. The chronic underfunding has coincided with rising overheads. Most notably, the rise in employer’s national insurance contributions announced in the Budget will have a severe impact on NHS dental practices, which are already on their knees. That tax rise will significantly affect health and care services for patients. The Liberal Democrats fear that it will only make the crisis in our NHS and social care sector even worse.

We have urged the Chancellor of the Exchequer to urgently rethink the rise in employer’s national insurance contributions, either by cancelling it for all employers or at the very least by exempting those employers that provide vital health and care services, including GP services, dentists, social care providers and pharmacies. Without that exemption, the health and care crisis will only worsen and regional disparity will widen. Children in the south-west region will depend on good fortune. Parents will feel helpless and will be forced to make sacrifices. It risks setting apart and setting back thousands of children.

14:56

[Jayne Kirkham (Truro and Falmouth) (Lab/Co-op)]

I will not rehearse the numbers that Members have already given for the south-west, except to say that fewer than half the children in Cornwall have been seen by an NHS dentist in the past 12 months. That is down 13 percentage points from five years earlier. It is just getting worse and worse: people simply cannot get an NHS dentist now in the whole of Cornwall. It is impossible.

We are fortunate in that we have a new Government. We are looking at 700,000 new urgent appointments. Everybody recognises that the dental contract needs reforming, and there is a commitment to reform the contract. Obviously that will take time, so in the meantime we may need to look at what can be done locally.

In Cornwall, the commissioning of dentistry has been passed down to the integrated care board, which has done some quite innovative things. A surgery in Lostwithiel that was just about to hand back its contract went into bespoke negotiations so that the under-18s, the elderly and vulnerable people could retain their NHS dentist. There is the option, within the contract, for local ICBs to do more, to go into bespoke negotiations and maybe to salvage some things while we are waiting for the large renegotiation of the dental contract.

There are other things that I ask my hon. Friend the Minister to consider; I am sure he has done so. Could he say more about health hubs, about having more bespoke contracts and about how much power ICBs have to enter into those contracts? Will he look at things such as emergency dental vans, which I understand are a sticking plaster, but which have been used in some places?

14:58

[Vikki Slade (Mid Dorset and North Poole) (LD)]

It is a pleasure to serve under your chairmanship, Mr Vickers. It is interesting that the hon. Member for Truro and Falmouth (Jayne Kirkham) mentions dental vans: we were due to have one in Dorset, but I heard from my local NHS dentist in Corfe Mullen that they were seriously concerned about the prospect. They were worried that if they took it out to their rural community, there would be mayhem and frustration on the part of people who had not seen a dentist in so long. They were actually in fear for their staff, so they decided not to take the dental van. They also noted that it was 2.4 times more expensive than operating a practice, so they decided that they would invest the practice’s extra money in an additional graduate dentist. I met her a few weeks ago: her name is also Vicky. I am really excited about the work she could do, particularly in children’s health, but the decision to increase national insurance without exempting dentists means that the equivalent of half her salary will now go on additional national insurance for the staff within the practice. That is jeopardising the opportunity for practices like Corfe Mullen dental surgery to take on such staff.

It is interesting that dental care was available on the NHS from its inception. The original advert for the NHS stated that it would provide

“all medical, dental and nursing care”

for everyone—

“rich or poor, man, woman or child”.

I am sure Beveridge and Bevan would turn in their graves if they thought that adults were pulling out their own teeth and children were being hospitalised for tooth extraction. It has already been said that fewer than a third of adults in the south-west are receiving dental care. When we describe it as a desert, we are not talking about our wonderful beaches. It is genuinely a dental desert.

I find it hard because NHS Dorset has told us that it had a £9 million underspend in the last year, yet people are spending hours on the phone, begging for help. I am pleased that our ICB has approved an increase in the price of the unit of dental activity, but why is that being delayed until next year, and why are we not going further? Why is it that our hospital can find the money to go to a private hospital and sort out all the knee replacements, but our dentists cannot be brought online to deal with urgent cases? I ask the Minister to instruct ICBs across the south-west and beyond to ringfence the underspend in dental budgets, so that it cannot be used to plug the gap elsewhere in the service while people are struggling.

Katie in Bearwood told me that she will lose her front tooth if she does not get help soon. She wakes up every day with blood on her pillow and all over her teeth. The pain is so unbearable that it has her in tears, and she has lost two stone in weight as she can barely eat. She cannot get a referral to hospital without paying to see a private dentist. She is ashamed to go out in public. She said that she will have to pay £1,000 in private costs before she can be seen, but nobody will give her a loan. Zoe in Wimborne told me it has been nine years since she has seen a dentist, and that she is close to using the old-fashioned method of string and a door. It is absolutely ridiculous. It cannot be allowed to carry on.

I cannot not talk about the children in our area. It is wonderful that the Government are bringing in supervised toothbrushing, but what is the point if children then cannot see a dentist? I was mortified in 2022 when I took a foster child who had come to live with me to my dentist, because I had assumed that, as with GP practices, looked-after children would automatically be added to a family’s NHS practice. How wrong I was. We did not realise, so we insisted on telling the dentist that they had to see this child. He was 11 years old and he had seven teeth gone already. He needed those teeth replacing for his future and for his smile. If we cannot do it for the adults, we must at the very least do it for our children, especially our looked-after children.

15:03

[Steve Race (Exeter) (Lab)]

I am here to speak on behalf of Exeter residents about the parlous state of NHS dentistry in our city after 14 years of the Tory Government, who allowed NHS dentistry to fall into complete disrepair.

We have heard that the south-west is one of the most notorious dental deserts, but most troubling is the proportion of children who get to see a dentist. In Devon, it has dropped by a fifth, from about 61% of children in 2016 to 47% in 2024, well below the English average of 55%. The reality is truly shocking. Across the country, tooth decay is now the No. 1 reason why children are admitted to hospital, and more than 40,000 children in 2021-22 had teeth removed at hospitals across the UK. That is the case in Exeter too. The Royal Devon University Healthcare NHS foundation trust states in its annual accounts that tooth decay is still the most common reason for hospital admission in children aged between six and 10 years old. According to the oral health survey of five-year-old children, more than a fifth of children in Exeter—22%—have tooth decay by the time they are five.

I talked to one of my local primary schools in preparation for this debate, to get the views of its staff. They said that they know of multiple children who have had teeth removed due to a lack of dentistry and then had to miss school. Some children have joined reception with all of their teeth brown or blackened stumps. Children are missing school due to being in agony from toothache and having no dentist, and many families—and indeed teachers—are unable to find an NHS dentist that will take them on. It is truly shocking, and, as with many things, our primary schools do what they can to pick up the slack. This primary school already teaches children how to brush their teeth, and they do so each day in reception. Exeter’s NHS dentist crisis is not just having a detrimental impact on people’s teeth and health; it is having a detrimental impact on children’s education and on our economy. It is also having a detrimental impact on our local A&E department, which is already stretched to capacity. Tooth decay forced 740 patients to attend the emergency department between April 2022 and March 2023, according to NHS Digital data.

Comparing NHS regions, those in the south-west and south-east were least likely to have an NHS dentist and most likely to have a private one. Given that the cost of simply being accepted on to a private dentistry register can be upwards of £70 a month for a small family, before treatments are added in, this is clearly a cost of living issue for many.

As referenced already, the NHS dental budget across the south-west is underspent by more than £86 million in the financial year 2023-24. That is not due to any lack of demand, of course, but largely due to dental practices being unable to work under the current NHS contract, which simply does not cover the cost of treatment. We are asking dentists to deliver NHS services at a loss, which is clearly unsustainable.

Instead of seeking to provide flexibility in the dental contract, as I know some integrated care systems do across the country, Devon ICB simply reallocates that dental funding elsewhere in the budget, despite the fact that it is supposed to be ringfenced. That is causing us further issues in Devon, as the BDA informs me that dentists are leaving the NHS in droves. In Devon, we saw a 9% drop in the number of NHS dentists last year alone.

My residents welcome the Labour Government’s pledge to provide an extra 700,000 urgent dentists’ appointments and to reform the NHS dental contract, as part of a package of measures to rescue NHS dentistry. I know the Department is working at pace to roll out those extra, urgent dental appointments, and to pave the way for a new reformed dental contract.

I met the chair of the BDA recently to talk about Exeter specifically; he stressed that NHS dentists, who are stung by the many broken promises from the previous Government, need the Labour Government to deliver meaningful change, including a clear timeline for negotiations. I know the Government treat NHS dentistry extremely seriously—the Health Secretary made the BDA the first organisation he met after the election—and I was pleased to hear the Prime Minister say recently at Prime Minister’s questions that he would work as quickly as possible to end the current crisis. Given what I know and what we have heard today, for my constituents in Exeter that change cannot come soon enough.

15:07

[Rebecca Smith (South West Devon) (Con)]

It is a pleasure to serve under your chairmanship, Mr Vickers. I congratulate the hon. Member for Honiton and Sidmouth (Richard Foord) on securing this vital debate about NHS dentistry in the south-west.

My constituents know the issues with access to NHS dentists only too well. Since 2020, the number of dentists in the county has fallen from 549 to 497. That means that each remaining dentist must see almost 300 additional patients a year. It is clear that we have a significant shortage of dentists in Devon. Only 34.7% of adults in the county have seen a dentist in the past year, compared with 55% 10 years ago. As we also heard from the hon. Member for Exeter (Steve Race), very few children are seeing dentists: 46.6% of children in Devon in the past year, compared with 61% in 2016.

For those who live in or around Ivybridge in my constituency, there are currently only two dental practices within a 10-mile radius accepting new patients. That only gets worse for the more rural and coastal communities, and the statistics are not good for the communities within the Plymouth boundary. I am aware that an anomaly in Devon is that there is actually a waiting list for NHS dentists.

At one recent meeting with local senior health officials, it was pointed out that Devon’s waiting list is unusual, perhaps even unique. We have 60,000 people on that list, believing they are entitled to an NHS dentist, when, as was discussed at the same meeting and I was led to believe on the day, the existing NHS contract was designed to serve only 55% of the adult population. The assumption was that others would access dental care privately.

I am not making a judgment about whether that is right or wrong; I am just stating the fact that most people do not understand that. The dental system was set up to be more like that for opticians than GPs at the time. The issues we currently face in Devon have in many ways gone beyond those points’ being particularly relevant, but it is worth reflecting how important it is to be honest with people, as we make changes, to ensure they understand what the impact of those changes might be for them.

Before I reach the main point I wish to make today, I will briefly mention two challenges we face in Devon: how we train dentists and how NHS contracts are awarded. Devon is fortunate to have an outstanding dental school at the University of Plymouth. When it opened, many believed it would provide the city and the region beyond with a ready supply of new dentists to help us tackle our dental shortage. The school, however, is so successful that it is incredibly difficult to secure a place to study there, which has an impact on local people’s being able to study at home and perhaps stay after graduation.

Equally, I have been informed by an expert on dental training that the way we train dentists makes it very difficult for people to stay where they have studied. Currently, the system almost forces the non-local dentists—the ones that might be coming down from the midlands —to go back to where they came from, rather than staying in the south-west if they want to. I urge the Minister to look into what more can be done to ensure that students can more easily stay where they have studied; at the moment, even if a dental student falls in love with Devon, it is very difficult for them to stay and help us to solve our problems.

Secondly, I am concerned about the lack of flexibility in the awarding of new NHS contracts at a time when we are in desperate need of more dentists. I was contacted about a year ago by a dentist seeking to open a practice in my constituency, who was told by the ICB that the window for applications had closed. That may have been the case but, given that we are in such dire need of dentists, perhaps an exception could have been made.

That leads me, finally, to my main point. In the last 12 months, 876 people attended the emergency department at Derriford hospital for a dental reason. Of those, 18% were under the age of 20 and 82% were over 20. That is an average of 2.4 people per day having to resort to using the emergency department to access dental care. Of these patients, 77 were then admitted for treatment. That is why we need to see the stalled review into funding for Derriford hospital’s urgent and emergency care facility, because it is part of the bigger picture of how we provide dental care across the south-west. If we free up emergency, we have more capacity to look after the region more fully.

15:12

[Alex McIntyre (Gloucester) (Lab)]

It is an honour to serve under your chairmanship, Mr Vickers. I extend my congratulations to the hon. Member for Honiton and Sidmouth (Richard Foord) on securing this important debate on NHS dentistry in the south-west.

NHS dentistry stands at a critical crossroads, facing the most challenging period in its history. A recent report from the Nuffield Trust described the threat to NHS dentistry as “existential”. Under the previous Conservative Government, NHS dentistry was put under immense strain, with only enough dentists to serve half the population and a severe shortage of investment. The Tories left Britain with one of the smallest dentistry budgets across Europe. At the start of the year, a staggering 13 million people were unable to access NHS dental care, which is more than three times as many as before the pandemic. Tragically, 7% of adults have resorted to the most desperate of measures: performing DIY dentistry, including pulling out their own teeth.

In the south-west, and particularly in my Gloucester constituency, the situation is deeply concerning. The region is one of the worst dental deserts in the country, as we have heard today, with just over a third of adults in the south-west having seen an NHS dentist in the last two years. In some cases, people are waiting up to four years for an appointment. The effects on children are particularly shocking. In the south-west, only one in two children was seen by an NHS dentist in the last year—well below the national average. That is a disgrace. We see an increasing number of children suffering from tooth decay, to the point that the most common reason for hospital admissions among children aged five to nine is to have their teeth removed due to rot.

In my constituency of Gloucester, two in five constituents are facing significant delays in accessing dental treatment, with many unable to see an NHS dentist at all. I heard some of these challenges first hand on a visit to the Bupa surgery on Painswick Road in my constituency. Sadly, Gloucester falls below the national and south-west averages for children and adults seen by a dentist, and has one of the lowest numbers of dentists in England. Families across Gloucester are suffering.

Plans are afoot to change that, and I have had positive early discussions with the ICB and the University of Gloucestershire about their plans to establish a new dental hub at the university’s new campus in the city centre, which is very exciting for my city. I am also aware that we need long-term change and investment from the Government to ensure that we meet the current challenges in NHS dentistry and reverse the worrying finding that 60% of NHS dentists in England have considered leaving the profession.

That is why I am proud to support the Government’s plan to fix NHS dentistry to deal with the immediate crisis. The Government have committed to providing 700,000 additional urgent dental appointments to tackle the backlog and to provide immediate relief to those suffering in my constituency. I look forward to the Minister’s update on that in his closing remarks. I know that the Labour Government are committed to providing the necessary investment and reform to ensure that our dental services are fit for the future, but these measures are desperately needed in Gloucester and across the south-west.

15:15

[Mr Gideon Amos (Taunton and Wellington) (LD)]

It is a pleasure to serve under your chairmanship, Mr Vickers. I congratulate my hon. Friend the Member for Honiton and Sidmouth (Richard Foord) on leading a genuinely important debate. I also congratulate my hon. Friends the Members for Glastonbury and Somerton (Sarah Dyke), for Frome and East Somerset (Anna Sabine), for Bath (Wera Hobhouse), for Tiverton and Minehead (Rachel Gilmour), for South Devon (Caroline Voaden), for Chippenham (Sarah Gibson), for Wokingham (Clive Jones) and for Mid Dorset and North Poole (Vikki Slade)—to mention but a few. I also thank Government Members for their contributions to this important debate.

Nearly three years ago, in 2022, long before I was a Member of Parliament, I launched a survey of dental provision for the NHS in my Taunton and Wellington constituency. It showed that fewer than half of people there had access to an NHS dentist. Nearly three years on things have, incredibly, got worse. There are 64,000 children in the county who did not see a dentist last year. That puts Somerset in the worst-hit 5% of local authorities in the country.

As has been mentioned, access to NHS dentists in Somerset has fallen from more than half of people back in 2015 to less than a third—32%—this year. Over half the constituents who contacted me did have an NHS dentist but were then told it was going private, so they lost it. That decline has been consistent. My constituents are having to travel out of county and, as I said in the Chamber a couple of weeks ago, one of my constituents, a stage 3 cancer sufferer, is having to use her savings to pay for dental treatment that she is entitled to for free on the national health service.

Taunton and Wellington has many of the same problems as other areas of the country, in particular the terrible state of the dental contract, which is at the root of much of this issue. I have met the BDA chair, as have Government Members, and it definitely wants a timescale for the negotiation of the new dental contract. I hope the Minister will give a clear timetable for the negotiations so that we can have a new contract, which is what is needed to unblock this situation. If we are to train and equip the profession for the future, which we need to do, we have to end the uncertainty that is exacerbating the drain from the profession and the retention crisis we have seen over the past few years. It is vital that that uncertainty comes to an end.

Uncertainty hits in other ways as well. For example, we all want more housing built—certainly, those on the Liberal Democrat Benches do, and I know that Government Members do too—and we want new housing developments to be infrastructure-led, with GP surgeries and dental surgeries. Developers could contribute to those surgeries, but what would be the point in building them if they are to lie empty, unstaffed by the dentists we need? Will the Minister consider whether ICBs can be required to support the finding of dentists to staff those facilities, when they are provided?

I put on the record the fact there was a huge £11 million underspend in Somerset last year. Children, pregnant women and cancer sufferers are all being denied free treatment and £11 million is sitting in the coffers—it is a scandal. I hope the Minister will consider ensuring that that money is ringfenced year on year, so that it is ultimately spent on the patients who need treatment.

I urge the Minister both to give a timetable for the negotiation of the new contract and to safeguard the underspends so that the money can be used to help patients in Taunton and Wellington, in Somerset and in the south-west as a whole.

15:19

[Dr Simon Opher (Stroud) (Lab)]

Thank you, Mr Vickers, for chairing this essential debate about dentistry in the south-west. My mailbox is full of people complaining about the lack of NHS dentistry, and we have heard all the horror stories. As a GP, I see people staggering into my surgery holding their face. I know no more about teeth than anyone else here, but we GPs have to try to treat them with painkillers and antibiotics, because there is nothing else available. We must change that.

Let me quickly talk through the dental contract; I then have a couple of positive stories, which will perhaps stimulate the Minister in respect of what could lie ahead. As has been said, the current dental contract nationally has an £86 million underspend, which is absolute madness, but it is because the contract is incredibly restricted and restrictive. The funding for units of dental activity is very poor.

[Richard Foord]

The £86 million underspend relates to the south-west in particular.

[Dr Opher]

Yes, but that is even more shocking, is it not?

There are also disincentives in the contract for dentists to take on new NHS patients. When we look into it, there are all sorts of other things. For example, a dentist cannot provide urgent NHS dentistry unless they have used up their quota of UDAs, which are issued to dentists at the start of the year. The whole system is crazy, which is why there has been such a massive saving. As we have heard, dentists are leaving the profession, and it is clear that we are not training enough. I accept what the hon. Member for South West Devon (Rebecca Smith) said about how dentists are trained and where they are likely to end up working, because that is incredibly important.

As to solutions, we must have prevention. Dentistry is exceptional because dental treatment is preventive in its own right, so as soon as NHS dentistry is stripped away, there are immediately problems. We also have to make sure that young people’s diet is better. Dentist Cerri Mellish and I have developed a project in our area. Cerri sees young pre-school children who are under five. She has a quick look in their gobs and if there are signs of decay, they are whipped out and the children are given treatment. If there are any other signs of problems, she can give them fluoride enamel. These types of innovative solutions are really important.

One thing that happened with the pandemic was that NHS dentists stopped registering new patients. The pandemic started in 2020, so almost all pre-school children are likely not to be registered with a dentist, which is a real disaster. We should remember that two thirds of general anaesthetics used for children are used for dental reasons, and a general anaesthetic is not without risk.

[Chris Bloore (Redditch) (Lab)]

I congratulate the hon. Member for Honiton and Sidmouth (Richard Foord) on securing this important debate. I apologise for being an interloper from the west midlands, but it such an important debate that I want to add some thoughts.

My hon. Friend has hit on an important point. As the father of a toddler, I struggle every day to ensure that he brushes his teeth. The gap in the number of registrations since covid is creating a generation of children who are not used to going to the dentist. We have to reverse that trend; otherwise, we will have huge problems as a society, having to treat teenagers and adults with severe dental problems who have never been to the dentist.

[Dr Opher]

That is absolutely true. Simple things such as dental brushing schemes, which we introduced in the Stroud area before the election, are essential. Those sorts of things are often laughed at, but they are probably the most important thing we do as a Government.

One other quick win relates to urgent care. The Gloucestershire ICB, particularly in the Stroud area, was able to pay more for the units of dental activity and allowed all NHS dentists to do urgent care. In that way, some of the £86 million that the hon. Member for Honiton and Sidmouth (Richard Foord) talked about was spent. We were able to quadruple the number of urgent appointments.

We can do that kind of work on a smaller scale, but I suggest that we need to do things step-wise. We must get the prevention in place and start doing urgent dental care, and when we have enough money we can do more. It is all very well talking about fantastic NHS dentistry, but we need the funding for it and we need the taxes to pay for it. As a Government, we are responsible for that. In the long term, we need to look to universal NHS dentistry in this country.

15:24

[Steve Darling (Torbay) (LD)]

I thank you, Mr Vickers, for ably chairing the debate, and my hon. Friend the Member for Honiton and Sidmouth (Richard Foord) for securing it.

I represent Torbay, which is sadly a dental desert. We have more than 2,200 people on our waiting list, desperate to receive support from a dentist. I fear that is just a shadow of the reality of the need there, because people think that it is a forlorn hope to be able to register for a dentist. More than half the adults of Torbay have not seen a dentist in the past two years. More than a third of children have not seen a dentist in the past year. This is a cocktail of severe dangers for the health of communities across the United Kingdom.

I have spoken to a number of residents since being elected, and I want to share a couple of examples of how the situation is impacting on real people. One of them told me that she was halfway through treatment to resolve challenges in her mouth when her dentist withdrew, leaving her with a job half done. She still suffers with pain and is upset about her dentistry needs.

Another resident, Kirstie, tells me that she suffers with a condition that means she is highly likely to develop mouth cancer. She is meant to receive three-monthly checks yet, as she has no NHS dentist and cannot afford a private practice dentist, she is having to go without. That is resulting in severe depression and her having to medicate for those depression issues. That is not where the United Kingdom should be.

Coastal and rural communities face real challenges in dentistry. When we look at the national picture, urban areas tend to be rich in dentists; our far-flung areas are much more challenged. I am delighted that we are looking at about 700,000 new emergency appointments, but how many of those will happen in Torbay? On the renegotiation of the dentists’ contract, how will we be able to take account of rurality and coastal issues as part of the mix?

15:27

[Claire Young (Thornbury and Yate) (LD)]

I thank my hon. Friend the Member for Honiton and Sidmouth (Richard Foord) for securing the debate.

Last year, a staggering 58% of children in south Gloucestershire were not seen by an NHS dentist, despite the NHS recommending that under-18s see a dentist at least once a year. When we talk to dentists, however, that is not surprising. As we emerged from the pandemic, one local dentist stopped NHS work for all, including children. When I spoke to those at the practice, they were clear that the contract was at fault, but they also explained that they would have liked to continue NHS dentistry for children but NHS England in the south-west was not supportive.

The last Conservative Government failed to fix the broken contract, and the new Government have yet to show that they grasp the scale of the challenge. We are calling for an emergency rescue plan, including the use of the underspends that have been referred to today to boost the number of appointments.

I will mention a couple of examples from my inbox. The first I alluded to recently in the Adjournment debate on rural NHS dentistry led by my hon. Friend the Member for Chippenham (Sarah Gibson). A constituent who had to retire from his job due to health and mobility issues is entitled to free NHS dentistry, yet he was unable to find treatment anywhere near where he lives. Facing a dental emergency, he ended up having to seek private treatment, because of the pain he was in. He struggled to afford it, but felt he had no choice.

Later, my constituent experienced another painful dental issue. This time, when he contacted the NHS, he was told that there was provision but, because he was now registered, it was unavailable to him; it was available only to unregistered patients. As a result, he had to pay £95 for a small temporary filling at a private practice. He was then told he was not entitled to be enrolled as an NHS patient, as he was registered as a private patient with the practice. I hope the Minister will agree to look into that situation to ensure that everyone can get the care they need.

Another issue I will draw attention to is people missing appointments. A constituent of mine got in touch to complain that, although he is one of the lucky ones in the area who is still able to access dental treatment on the NHS, he was shocked to see a sign saying that 39 people had missed their appointment last month. Staff confirmed that that was the number of people who missed appointments at the practice with no warning or formal cancellation—and that is just one practice. They also said that number was actually quite low, and that it was regularly much higher.

Because those missed appointments were no-shows, not cancellations, the slots could not be offered to other people desperately in need. That resulted in the equivalent of more than eight days of lost work. That brings us back to the question of the contract and how we can make sure that dentists are rewarded for their time, because it adds to the problem of them not being remunerated in a way that enables them to continue NHS work. It is also a question of making the best use of limited resources. I welcome the Minister’s thoughts on how to ensure that happens.

Over 12 million people were unable to access NHS dental care last year. That is more than one in four adults in England, and three times as many people as before the pandemic. I echo the comments made by my hon. Friend the Member for Torbay (Steve Darling) about the challenges, particularly in rural areas, and look forward to hearing the Minister’s comments on that. We have been warning about the issues for years, yet there has been little decisive action to address the crisis. The British Dental Association has been pushing hard to get the Government to ditch the current failed dental contract and instead move to a more prevention-focused, patient-centred system that rewards dentists for improving the overall health of the communities they serve.

In short, I welcome the warm words from the Government on dentistry, but we need more than words; we need action. I urge this Government not to kick the can down the road as the previous Government did.

15:31

[Alison Bennett (Mid Sussex) (LD)]

It is a pleasure to serve under your chairmanship, Mr Vickers. I thank my hon. Friend the Member for Honiton and Sidmouth (Richard Foord) for securing this debate. The strength of the contributions by south-west Members from all parts of the House show how important this issue is for everyone in the region. I thank my hon. Friend for making the debate about the south-west. I grew up in Gloucestershire, and my dentistry as a child began in Tewkesbury. The comment by the hon. Member for Stroud (Dr Opher) that dental treatment is preventive in its own right was helpful. Indeed, thanks to the insistence of my mother, Christine, on my going to the dentist twice a year, I never got a filling until I was into my 40s. I thank her for that.

While I welcome the Government’s injection of funds into the NHS as a whole, we must be clear that dentistry should not be forgotten. That is why I, along with many of my Liberal Democrat colleagues, have today written to the Chancellor of the Exchequer to ask her to reconsider the proposed increases in employer national insurance contributions in the case of various healthcare providers, including the dentistry sector and those providing NHS dentistry. Commenting on that letter, the British Dental Association said that the changes, should they go ahead, will inevitably punish patients.

Before coming to this debate, I had meetings with the National Care Forum and the children’s hospice charity Together for Short Lives. In all those forums, grave concerns have been raised about the impact of the increase in employer national insurance contributions on the work that providers do, and the potential cuts to the number of people they employ and the services they offer. I ask the Minister to urge his team in the Department of Health and Social Care to reconsider and to press the Treasury to rethink the increase, or at least look at finding some form of dispensation.

As hon. Members have said, tooth decay is the most common reason for hospital admission in children between the ages of six and 10. Thanks to a freedom of information request commissioned by the Liberal Democrats, we know that over 100,000 children have been admitted to hospital with rotting teeth since 2018. That is shameful, yet also entirely preventable. That is what makes it so tragic.

Our failures stretch across the full breadth of age groups. Last year, a poll commissioned by the Liberal Democrats revealed that a shocking one in five people who fail to get an NHS appointment turn to DIY dentistry. Indeed, during the general election, I knocked on the door of somebody who told me that he had pulled his own teeth out. It is simply Victorian that that has happened to dentistry in our country in 2024. The Darzi review found that

“only about 30 and 40 per cent of NHS dental practices are accepting new child and adult registrations respectively.”

To me, and I think to everyone here, the fact that our dentistry system is in a position where people feel the need to pull out their own teeth is appalling.

The south-west is feeling the full force of the crisis, having lost more than 100 dentists last year alone. However, the issue is not limited to the south-west. Only one of the 13 dentists in my constituency of Mid Sussex is accepting children as NHS patients, and none is accepting adults. Using data from the House of Commons Library, it is estimated that 44% of children in West Sussex did not see a dentist in the year to March 2024.

My Liberal Democrat colleagues and I are calling for three things and we have a plan to make them happen. First, we need guaranteed access to an NHS dentist for everyone who needs urgent and emergency care. Secondly, we need guaranteed access to free NHS check-ups for those already eligible: children, new mothers, those who are pregnant and those on low incomes. Thirdly, we need guaranteed appointments for all those who need a dental check before commencing surgery, chemotherapy or a transplant.

The first thing that we can do to achieve those vital baselines in dental care is to deliver a dental rescue package, including investing in extra dental appointments, fixing the broken NHS dental contract and using flexible commissioning to meet patient needs. Secondly, we need to ensure that a proper workforce plan for health and social care, including projections for dentists and dental staff, is written into law. Thirdly, we would reverse the previous Government’s cuts to public health grants to support preventive dental healthcare. We must tackle the root causes of the oral health catastrophe in the south-west by focusing on investment in prevention. In doing so, we can put an end to the suffering of so many children and adults, take away the need for DIY dentistry and provide some much-needed respite for the NHS system as a whole.

15:37

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

It is a pleasure to serve under your chairmanship, Mr Vickers. I congratulate the hon. Member for Honiton and Sidmouth (Richard Foord) on securing a debate on this important subject, starting at the significant time of two-thirty—I thought that was particularly skilled of him. [Laughter.] I thought you would like that one, Mr Vickers.

Nobody should have painful teeth and nobody should have difficulty accessing an NHS dentist. Lincolnshire, which is home to my constituency, suffers similar challenges with access to NHS dentistry; indeed, I led an Adjournment debate on the topic in October 2021. It has been pointed out that the number of dentists is not the issue; in fact, we have more dentists per capita than we did 10 years ago. Rather, dentists are either in the wrong place—concentrated in urban rather than rural and coastal areas—or they do not perform NHS work, for a variety of reasons. That leads to the underspend that has been described.

There has been some progress, with 500 more practices accepting NHS patients as a result of the dental recovery plan, and 6 million more dental treatment processes completed in 2023 than in 2021-22. One thing that helped with that was the patient premium for new patients, who are more likely than repeat patients to have a problem with their teeth that requires treatment. They are also more expensive for dentists to treat, so the current contract disincentivises the seeing of new patients. The patient premium is funded until April 2025. Will the Minister say whether he plans to continue it beyond that date? Another help has been the golden hello of up to £20,000 for dentists working in underserved areas, including the south-west, the midlands and East Anglia. Will the Minister say whether that scheme will continue?

A number of hon. Members have mentioned a long-term workforce plan. There are already additional dental training places in the south-west, but, as my hon. Friend the Member for South West Devon (Rebecca Smith) pointed out, there can be challenges in the way the training is organised, which means that people do not stay in the local area—although more do stay than if they had been trained elsewhere. Will the Minister look in detail at the problems my hon. Friend raised?

Ultimately, we have more dentists than ever before, but private dentistry is much more lucrative than NHS dentistry, and the NHS contract is complicated, offers disincentives and needs reform. The previous Government began reforming the 2006 contract by increasing the UDA rate to £28 as a minimum. The Labour party had a manifesto promise to negotiate with the BDA. Will the Minister confirm if negotiations have started and, if they have not, when he expects them to start?

[Tom Hayes]

I have just been rereading the 2010 Conservative manifesto—a delightful read. On page 47, it promises full dental contract reform. I then looked at comments by Conservative Ministers in 2024, when they promised to “consider” dental contract reform. Can the hon. Lady explain why no meaningful reform happened over those 14 years of Conservative government?

[Dr Johnson]

It is unfair to say that there was no meaningful reform. There was reform, but it has not been enough to ensure that everyone gets a dental appointment, and we need further negotiation and reform. We can relitigate the election, but the Labour party won a majority for this term and it needs to use it to do what it promised. One of those things is reforming the contract, and that is why I am asking the Minister to tell us whether he has entered negotiations to do so.

One thing the Government have done—this was brought up by the hon. Members for Mid Dorset and North Poole (Vikki Slade) and for Mid Sussex (Alison Bennett)—is increase national insurance contributions and lower the thresholds at which they are paid, which presents a challenge for dentists across the country. I know the BDA has written to the Chancellor to ask for an exemption, and I wonder whether the Minister can comment on that. I have tabled a number of written questions, and the answers I have received have been less than satisfactory; they are really not proper answers at all. The Government do not seem to have worked out how much they intend to mitigate the increase in national insurance contributions, for whom they might do so, or how much it might cost. That is clearly a great worry.

The Health Service Journal published a leaked letter suggesting that the cost of the 700,000 extra appointments —and presumably, in many cases, the national insurance contributions—will have to be found within the current budget. The Department of Health and Social Care has suggested that the letter was never sent and therefore may be inaccurate. Will the Minister put on the record the reality of the situation? Will the funding be expected to come from the current budget, or will there be extra money—and, if so, how much?

The Minister has said himself that water fluoridation is safe and effective and reduces tooth decay, so will he be adding fluoride to our water? He said in answer to a parliamentary question that he would do so “in due course”. Will he tell us what that means and how quickly he expects to do it? The Government have talked the talk on prevention; now they need to take action.

The previous Government conducted a consultation on whether newly qualified dentists could be tied into working for the NHS for a period of time. What is the Government’s assessment of that consultation, and what do they intend to do about the issue? Supervised toothbrushing is an interesting plan, but what about children of other ages? What is being done to encourage parents to take responsibility for ensuring that their children’s teeth are cleaned?

Armed forces families move around the country a huge amount, and our forces do an excellent job keeping us safe. The Conservative Government brought in the armed forces covenant to protect our armed forces and their families. What plans does the Minister have to ensure that families can access NHS dental care as they move around the country, and that they do not have to wait for a place only to not get one, and then move again and have the same problem?

I think it was the hon. Member for Honiton and Sidmouth who brought up international dentists. An international dentist with equivalent qualifications can work in the UK privately, but they need to go through an additional process to work for the NHS and be on the performers list, which is unnecessarily complicated. What will the Minister do to ensure that, if a dentist is able to practise privately in the UK, they can also practise on the NHS—or does he think that is not the right thing to do?

Other Members have mentioned fluoride varnish. Does the Minister have a plan to ensure that young children have access to that treatment? Finally, the Secretary of State for Wales has said that Labour will “take inspiration from Wales”. Given that dental activity is at 58% of pre-pandemic levels in Wales, compared with 85% in England, and that 93% of practices in Wales—a greater proportion than in the rest of the UK—are not taking on new adult NHS patients, will the Minister reassure us that that is definitely not the case?

15:39

[The Minister for Care (Stephen Kinnock)]

It is a real pleasure to serve under your chairship, Mr Vickers. I congratulate the hon. Member for Honiton and Sidmouth (Richard Foord) on securing this very important debate on NHS dentistry in the south-west.

My right hon. Friend the Secretary of State has said that this Government will be honest about the problems facing the NHS and equally serious about tackling them. The truth is that we are very far from where we want and need to be. Lord Darzi’s report laid bare the true extent of the challenges facing our health service, including NHS dentistry. Even he, with his years of experience, was shocked by what he discovered.

I pay tribute to all the hon. Members from across the House—too many to name in the short time available to me—for helping to highlight and elucidate their concerns. In many ways, those reflected what Lord Darzi set out, but we have also heard today some heartbreaking examples of the experiences our constituents are having. Colleagues across the House have brought those to life today.

Lord Darzi’s report is vital because it gives us the frank assessment we needed to face the challenges honestly. Lord Darzi is clear that rescuing NHS dentistry will not happen overnight, but we will not wait to make improvements to the current system, to increase access and to incentivise the workforce to deliver more NHS care.

We inherited a broken NHS dentistry system. It is truly shameful and nothing short of Dickensian that the most frequent reason for children of between five and nine years old to be admitted to hospital is to have their rotten teeth removed. That is, frankly, disgraceful. Those are the sort of challenges that we need to face.

Some 13 million people in England have an unmet need for NHS dentistry. That is 28% of our country. It is absurd that people cannot access NHS dentistry when each year the budget is underspent—in recent years, that has been to the tune of hundreds of millions of pounds-worth of care going undelivered. That is why we need to reform the dentistry contract.

In NHS Devon integrated care board, which includes the constituency of the hon. Member for Honiton and Sidmouth, 34% of adults were seen by an NHS dentist in the 24 months to March 2024, compared with an average of 40% in England. In 2023-24, there were 40 dentists per 100,000 of the population, whereas the national average, across all integrated care boards, was 50 in the same year.

We acknowledge that there are areas of the country that are experiencing recruitment and retention issues—including many rural areas, where the challenges in accessing NHS dentistry are exacerbated. As Lord Darzi said, we have enough dentists and dental care professionals at an aggregated national level; the problem is that not enough of them are doing NHS work in the right parts of the country, where they are most needed.

The mountain that we have to climb is daunting, but this Government are not daunted and we are working at pace. Take for example the golden hello scheme, which will see up to 240 dentists receiving payments of £20,000 to work in those areas that need them most for three years. ICBs have already started to advertise those posts through that scheme. Nationally, there have been 624 expressions of interest and 292 of those have since been approved. Thirty-eight posts are now being advertised with the incentive payment included. Or take our rescue plan, which will help to get NHS dentistry back on its feet by providing 700,000 additional urgent appointments as rapidly as possible.

We know that rescuing NHS dentistry means acknowledging that we need more dentists doing NHS work and we know from survey data that morale among NHS dentists is low. We must turn that around. This Government will do all we can to make NHS dentistry an attractive proposition. Strengthening the workforce is key to our ambitions, but for years the NHS has been facing chronic workforce shortages and we have to be honest that bringing in the staff we need will take time.

We are committed to reforming the dentistry contract to make NHS work more attractive, boost retention and deliver a shift to prevention. There are no perfect payment models, and careful consideration needs to be given to any potential changes to the complex dental system, so that we deliver genuine improvements for patients and the profession. We are continuing to work with the British Dental Association and other representatives of the dental sector to deliver our shared ambition to improve access to treatment for NHS dental patients.

The Secretary of State met with the BDA on his first day in office, and I engage with it regularly, including at a meeting earlier this month. I share the BDA’s desire for a timeline for negotiations, but we have had to wait for the Budget and the ensuing discussions with the Treasury to initiate and conclude those discussions.

[Mr Amos]

Is the Minister able to say when the timeline for those negotiations will be available?

[Stephen Kinnock]

As the hon. Gentleman will understand, we are in a sequence: we have the Budget, then the complex negotiations around the spending review. We cannot engage in meaningful, formal discussions and negotiations until we are clear on what exactly the financial envelope is. We are working at pace on that. However, we have been meeting informally to sketch it out, so I would say that the scope of the negotiations is agreed. The formal negotiations will really start only once we have the detailed budget in place.

We will listen to the sector and learn from the best practice to improve our workforce and deliver more care. For example, the integrated care boards in the south-west are applying their delegated powers to increase the availability of NHS dentistry across the region through other targeted recruitment and retention activities. That includes work on a regional level to attract new applicants through increased access to postgraduate bursaries, exploring the potential for apprenticeships and supporting international dental graduates.

There are two dental schools in the south-west: Bristol Dental School, and Peninsula Dental School in Plymouth. I recently had the pleasure of visiting Bristol Dental School and seeing the excellent work that they are doing there, training the next generation of dental professionals, supporting NHS provision by treating local patients, and reaching underserved populations through outreach programmes. I also know that Peninsula Dental School, which first took on students in 2007, is doing the same for Plymouth and its surrounding areas.

I would also like to pay tribute to Patricia Miller of NHS Dorset, Lesley Haig of the Health Sciences University and council leader Millie Earl for working so constructively with my hon. Friend the Member for Bournemouth East (Tom Hayes) on improving oral health in his constituency.

A number of hon. Members have rightly highlighted the importance of prevention, and we are working around the clock to end the appalling tooth decay that is blighting our children. We will work with local authorities and the NHS to introduce supervised toothbrushing for three to five-year-olds in our most deprived communities, getting them into healthy habits for life and protecting their teeth from decay. We will set out plans in due course, but it is clear that to maximise our return on investment, we need to be targeting those plans at children in the most disadvantaged communities. In addition to that scheme, the measures that we are taking to reduce sugar consumption will also have a positive effect on improving children’s oral health.

Separate from the national schemes, I was pleased to note that NHS Devon integrated care board has committed £900,000 per annum for three years to support further cohorts of children for supervised toothbrushing, fluoride varnish and Open Wide Step Inside, with a new fluoride varnish scheme due to go live in September 2025. Open Wide Step Inside is a local scheme in which a dental outreach team, run by the Peninsula Dental Social Enterprise, goes into schools to deliver 45-minute oral health education lessons across Devon and Cornwall. It is a truly commendable scheme.

The steps we take in NHS dentistry will feed into the wider work we are doing to fix our broken NHS. We have committed to three strategic shifts: from hospital to community, from sickness to prevention and from analogue to digital. Our 10-year plan will set out how we deliver those shifts to ensure that the NHS is fit for the future.

[Dr Johnson]

The Minister has iterated the problem, and he has spoken warm words about listening, talking and working with people. However, he has said little that is concrete, except about things that were happening already, either locally or as a result of the previous Government. With a minute left to answer all the questions he has been asked, can he commit to answering in writing those he does not have time to answer in the remaining minutes?

[Stephen Kinnock]

The first thing I will say is that I am not going to take any lectures from any Conservative Member about the state of our dental system. What brass neck we see from that party, both in the Chamber and in this place—lecturing us, given the disgraceful state of our NHS and the fact that the biggest cause of five to nine-year-olds going to hospital is to have their rotten teeth removed! I will not be taking any lectures on that from the Conservative party. Of course, I am more than happy to answer the hon. Lady’s detailed questions, many of which I feel I have already answered in my preceding comments. I will not take any more interventions from her because I need to finish shortly.

Our 10-year plan will set out how we deliver these shifts to ensure the NHS is fit for the future. To develop the plan, we must have a meaningful conversation with the public and those who work in the health system. We are going to conduct a range of engagement activities, bringing in views from the public, the health and care workforce, national and local stakeholders, system leaders and parliamentarians. I urge hon. Members from across the House to please get involved in this consultation—the largest in the history of the NHS—at change.nhs.uk. I urge them to make their voices heard in their constituencies, through the deliberative events.

[Vikki Slade]

I have been on to the survey, and it is incredibly limited. It would be helpful if there were a way for the public to be encouraged to introduce more freeform responses.

[Stephen Kinnock]

I am slightly surprised to hear that. The presentation I received on the portal showed there was a clear channel through to having a more discursive engagement with the platform. I will take that feedback away and, through officials, will come back to the hon. Lady on that point.

I thank the hon. Member for Honiton and Sidmouth once again for bringing the issue of dentistry in the south-west to this debate. On 4 July, we inherited a profoundly challenging fiscal position, but I can assure him that we remain committed to tackling the immediate crisis facing NHS dentistry, and that we are taking steps to make delivery more efficient through long-term reform.

To recap, we are committed to providing 700,000 more urgent dental appointments, delivering the golden hello scheme to recruit more dentists in areas of greatest need, bringing in preventive measures to improve our children’s oral health and negotiating long-term contract reforms to make NHS dentistry more attractive. Those steps will help tackle the place-based disparities commonly seen in dentistry, and ensure that everyone who needs to access NHS dentistry can get it, including in the south-west.

Our NHS dentistry is broken after 14 years of Tory neglect and incompetence, but it is not beaten. In 1945, it fell to Clement Attlee’s Labour Government to create a health system for the 20th century. Now, 79 years later, it falls to this Government to clear up the mess we have inherited, to get NHS dentistry back on its feet and to build an NHS dentistry service fit for the 21st century. That is what we shall do.

15:58

[Richard Foord]

I acknowledge what the Minister said about the Conservative Government’s legacy for NHS dentistry, which is apparent for us all to see. The Health Service Journal revealed last month that in Devon and Cornwall, the wait for an NHS dental appointment for a new patient is 1,441 days—almost four years. Many of my constituents cannot wait that long. I hope the Minister has heard not only the examples of pain and suffering set out today but some of the prescriptions proposed by the Liberal Democrat spokesperson and other MPs from across the west country.

Question put and agreed to.

Resolved,

That this House has considered NHS dentistry in the South West.

Tackling Image-based Abuse

Tuesday 12th November 2024 Westminster Hall

16:00

[Kirith Entwistle (Bolton North East) (Lab)]

I beg to move,

That this House has considered the matter of tackling image-based abuse.

It is a pleasure to serve under your chairship, Mr Vickers. I declare an interest as a member of the Women and Equalities Committee. I am bringing this motion before the House to maintain the steady pressure from campaigners and parliamentarians on an issue that is both urgent and often neglected: image-based sexual abuse, which is a form of violence that overwhelmingly affects women and girls.

Today, I aim to shed light on where our legislation on image-based sexual abuse is falling short and to propose three reforms that this Labour Government can deliver. This will build on the fine work conducted by Members across the House—including the Minister for safeguarding and violence against women and girls, my hon. Friend the Member for Birmingham Yardley (Jess Phillips); Madam Deputy Speaker, the right hon. Member for Romsey and Southampton North (Caroline Nokes); the hon. Member for Gosport (Dame Caroline Dinenage) and current and previous members of the Women and Equalities Committee—as well as Members of the other place.

Image-based sexual abuse encompasses a wide range of violations, from digitally altered images such as deepfakes to invasive acts such as upskirting, downblousing and so-called revenge porn. In an increasingly digital world, this abuse—this violence—is an escalating crisis.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Lady. This is a massive issue in my constituency, and that is why we are all here to support her. The Safeguarding Board for Northern Ireland has revealed that 96% of deepfakes surveyed online were non-consensual pornographic materials, and 70% of targets were private individuals’ photos that had been harvested from social media. Does she agree that more must be done in schools to make young people aware of the dangers and risks that come with sharing private content online?

[Kirith Entwistle]

Yes, that is an important point. It goes to show the extent and the seriousness of the issue.

Drawing on two powerful accounts that have profoundly shaped my own perspective, I will highlight the three glaring flaws that we must confront. The first is the failure to ensure the permanent removal of abusive content, which leaves survivors chained to their trauma. The second is the weak regulatory enforcement that allows platforms to shrug off their responsibilities. The third is the lack of civil remedies for survivors, a lifeline that we know to be critical to restoring dignity, control and hope.

I will not have the space today to discuss how we can prevent online violence against women and girls by embedding it into the relationships, sex and health education curriculum, to which the hon. Member for Strangford (Jim Shannon) alluded, or how proceeds from the digital services tax and Ofcom fines could sustainably fund lifesaving support services for victims. However, those issues loom large in the debate.

I am grateful that the Minister for victims, my hon. Friend the Member for Pontypridd (Alex Davies-Jones), is present. I look forward to hearing how tackling image-based abuse aligns with this Government’s unprecedented commitment to halving violence against women and girls. I also hope to hear from the Secretary of State for Science, Innovation and Technology on these issues. In the UK, we face an escalating crisis of image-based sexual abuse. Every week, new victims emerge and women and girls lose their right to control their most intimate images.

[Luke Myer (Middlesbrough South and East Cleveland) (Lab)]

So many young women are having their life destroyed by the proliferation of deepfakes and AI-enabled images. Does my hon. Friend agree that the Bill introduced by Baroness Owen—the Non-Consensual Sexually Explicit Images and Videos (Offences) Bill—would go some way towards addressing the issue, and that the Government should look favourably on it?

[Kirith Entwistle]

My hon. Friend raises an important point. I will come on to that important Bill. I know that Baroness Owen has already done a great deal of work on the issue.

In 2023 alone, the Revenge Porn Helpline reported nearly 19,000 cases of abuse, a staggering increase from just 1,600 cases in 2019. Deepfake-related abuse has surged by 400% since 2017, with over 99% of these vile creations targeting women and girls. The numbers are shocking, but they are more than statistics. Behind each one is a life and a human story—another innocent person whose confidence, relationships and sense of safety is shattered. Survivors often describe their experience as digital rape, a term that captures the intensely personal and profoundly scarring nature of this violation.

Just two weeks ago, the escalating crisis hit home in my constituency of Bolton North East with the case of Hugh Nelson, who was sentenced at Bolton Crown court to 18 years in prison for creating and distributing depraved sexual images using artificial intelligence. Detective Chief Inspector Jen Tattersall of Greater Manchester police described Nelson as

“an extremely dangerous man who thought he could get away with what he was doing by using modern technology.”

Yet Nelson’s sentencing is something of an exception. Too many perpetrators remain beyond the reach of justice, shielded by gaps in our legal framework. This reality raises a question: has our response truly kept pace with the escalating scale of this crisis? Are we really doing all we can to support victims and survivors?

[Jo Platt (Leigh and Atherton) (Lab/Co-op)]

My hon. Friend is making an excellent case on this important subject. I was deeply shocked to learn from Refuge that, in some cases, reports of intimate image abuse are not being taken seriously by the police force. Does my hon. Friend agree that it is essential for police officers to receive consistent, comprehensive training on internet image abuse so that they understand how the law can further protect women and girls?

[Kirith Entwistle]

Yes, training would be exceptionally valuable in combating the issue. I look forward to hearing what the Minister has to say.

[Rachel Taylor (North Warwickshire and Bedworth) (Lab)]

I thank my hon. Friend for bringing the issue to Westminster’s attention and giving us the opportunity to debate it. I place on the record my interest as another member of the Women and Equalities Committee.

We must also do better to protect male victims who reach out to the Revenge Porn Helpline. It is time we prioritised victims. We must not let technology develop without the necessary safeguards to protect us all from harm. I was alarmed to hear last week that online platforms do not take images down while they are reviewing their harmfulness; that practice simply exacerbates the harm that victims face. It is vital we ensure that image-based abuse does not get lost in the excitement of this Government’s new, packed legislative agenda. It is time that the legislation recognised adult non-consensual intimate images as illegal content, in the same way that abusive images of children are so considered. The Online Safety Act 2023—

[Martin Vickers (in the Chair)]

Order. Interventions are supposed to be short. May I ask the hon. Member to conclude hers?

[Rachel Taylor]

My apologies, Mr Vickers.

[Kirith Entwistle]

My hon. Friend raises an important point. We should absolutely be putting victims at the heart of any legislation on this topic.

I do not believe that in their 14 years the previous Government did anywhere near enough to tackle the issue. I can already see the Labour Government taking decisive steps to change the answer to the question of whether we are doing enough. I welcome the Government’s manifesto commitment to ban the creation of sexually explicit deepfakes, an essential step in safeguarding women and girls from malicious technology. I am encouraged by the collaborative work under way among the Department for Science, Innovation and Technology, the Home Office and the Ministry of Justice to identify a legislative vehicle to ensure that those who create these images without consent are held accountable. I am also pleased that new changes to the Online Safety Act will make image-based abuse a priority offence.

Although those are positive steps, they represent only modest progress. As experts such as End Violence Against Women and the #NotYourPorn campaign have pointed out, sharing intimate images without consent was already prioritised under the Online Safety Act. So far, the changes under this Government have been merely administrative and merely incremental. Having listened to survivors of image-based abuse, I urge the Minister to agree that this is no time for incremental change.

Georgia Harrison is a courageous campaigner who shared her story with the Women and Equalities Committee. Georgia’s images were distributed without her consent, leading to years of harassment, scrutiny and anguish. Even after her abuser was convicted, Georgia continued to see her images circulate online—a haunting reminder that, as she has stated, her life will never be the same again.

Another survivor is “Jodie”, who bravely spoke to the BBC about the trauma of being deepfaked by someone she once considered her best friend. Jodie discovered that images from her private Instagram account had been overlaid on pornographic material and posted across Reddit and other forums, with users invited to rate her body. Jodie endured this abuse for five years. She recalls:

“I felt alone. The emotional toll was enormous. There were points I was crying so much I burst the blood vessels in my eyes. I couldn’t sleep and when I did, I had nightmares.”

In Jodie’s case, the perpetrator was asking others to create explicit images of her, revealing a shameful grey area in our current legislation. That is why Jodie, along with campaign partners the End Violence Against Women coalition, Glamour and #NotYourPorn, is calling for an image-based abuse law.

Speaking as a mother, I cannot imagine having my child endure such horror. I am grateful that Baroness Owen of Alderley Edge has introduced a private Member’s Bill in the other place to address this gap. She has done a great deal of work on the issue, keeping victims like Georgia and Jodie at the heart of her Bill.

Georgia and Jodie’s experiences underscore three critical flaws in the Online Safety Act. The first is the glaring failure to criminalise abusive images themselves. Georgia’s story illustrates this brutal oversight: despite her abuser’s conviction, the absence of a stay-down provision allows her images still to circulate online, forcing her to relive the trauma with each resurfacing. To quote Professor Clare McGlynn,

“every day these images remain online is another day of extreme suffering for victims.”

Survivors deserve certainty that once their abuse is addressed, it is addressed permanently.

A second flaw in the Act is its reliance on Ofcom, whose current enforcement powers lack the agility and speed needed for an online world in which, if one website is blocked, another can appear instantly. Initiatives such as the StopNCII.org campaign have revealed how social media platforms consistently outmanoeuvre Ofcom. This is effectively leaving tech giants to determine whether supporting survivors like Georgia serves their profit-driven interests. To close the enforcement gaps, I stand with the End Violence Against Women coalition, Glitch and others in calling for a national online abuse commission —a dedicated body to champion the rights of victims and survivors of online abuse.

Finally, our legislation fails survivors by denying them accessible civil remedies—such as immediate take-downs and compensation for emotional harm—outside the criminal process. For survivors such as Jodie who have endured years of abuse, the inability to seek swift relief without a lengthy, retraumatising trial is a devastating gap. Creating a statutory civil offence for image-based abuse would not only empower survivors to seek redress directly against perpetrators and platforms, but give them that all-important second chance. The Minister will know that organisations such as South West Grid for Learning and the UK Safer Internet Centre consider civil remedies as much-needed lifelines for survivors. I wholeheartedly agree.

Today, through Georgia and Jodie’s stories, we have seen the devastating cost of our inaction on the escalating, ever-evolving crisis of image-based abuse. For too long, our legislation has had three glaring deficiencies: the absence of a stay-down provision, the lack of an online abuse commission and the unavailability of civil remedies.

Returning to my earlier questions, I want to be able to tell survivors that this Government are doing everything possible to support them. I want to reassure them that our Ministers are responding in real time to the scale and urgency of the crisis. With every day we delay, more women and girls are thrust into cycles of harm without the protections that they urgently need and deserve. I look forward to hearing from the Minister exactly how we will deliver this assurance. I would also be grateful if I could discuss the matter further with the Secretary of State for Science, Innovation and Technology at the earliest opportunity.

Let us not wait another day to act. Survivors need real action, not just incremental change. We owe it to Georgia, Jodie and all those who have suffered.

16:15

[Dame Caroline Dinenage (Gosport) (Con)]

It is a great pleasure to serve under your chairmanship, Mr Vickers. I thank the hon. Member for Bolton North East (Kirith Entwistle) for tabling such an important debate, and she made some really powerful points.

I declare an interest: being very elderly, at one stage I was the Minister for Women and Equalities, and I was responsible for bringing forward the Revenge Porn Helpline. When that legislation came through, I was hopeful that that vital resource would be something temporary, and that one day it would be abolished because we did not need it any more. In actual fact, quite the opposite is true: it is busier than ever. As the hon. Member for Bolton North East said, it is catching some terrible perpetrators of the most horrific online abuse.

I was also the Minister for Digital and Culture who held the baton for a couple of years on the Online Safety Act 2023. I hope that legislation will offer more protection for the victims of this humiliating crime, which, as we know, disproportionately affects women. But technology moves so fast. I am concerned that, despite the protections in the Act and the Revenge Porn Helpline, the emergence of deepfakes in particular has opened up a new front in the war on women—I say that because 99% of pornographic images and deepfakes are of women. Literally tens of millions of deepfake images are being produced every year, most of them sexual, as the hon. Member for Bolton North East said.

The fact that the use of nudification apps and the creation of ultra-realistic deepfake porn for private use is still legal, and worse, becoming more popular, is a war on women’s autonomy. It is a war on our dignity, and a war on our identity. The creation of these unpleasant sexual or nude deepfakes serves to push us out of those spaces and to undermine and silence us, both online and offline. We must do everything we can to stand against it.

I am sure the Minister agrees that we owe a debt to my noble Friend Baroness Owen of Alderley Edge for her work to legislate in this area. She encountered some hate of her own when she was appointed to the other place—she was too young and too female—but her very presence there indicates exactly why we need young women in both Houses to stand up against these injustices and bring them to the fore. I hope the Minister will do everything in her power to see my noble Friend’s fantastic Bill become law.

16:18

[The Parliamentary Under-Secretary of State for Justice (Alex Davies-Jones)]

I thank my hon. Friend the Member for Bolton North East (Kirith Entwistle) for securing a debate on this very important subject. I look forward to discussing it with her and other members of the Women and Equalities Committee later this month.

This Government are absolutely committed to tackling violence against women and girls, and to restoring trust so that victims know that the justice system sees them, hears them and takes them seriously. In our election manifesto, we promised to make tackling violence against women and girls a political priority—finally, after years of neglect—with a pledge to halve violence against women and girls over the next decade. It is an ambitious target, but I believe we can do it.

Tackling online abuse is crucial. As outlined so eloquently by my hon. Friend the Member for Bolton North East, the statistics are clear, but behind them are real people—real victims. Many of us will have experienced it ourselves, or know friends or family who have. Women have the right to feel safe in every space, online and offline. The rise in intimate image abuse is utterly devastating for victims, but it also spreads misogyny on social media, which can develop into potentially dangerous relationships offline. It is truly an abhorrent crime, which is why the Government are determined to act. It will not be easy and we are just at the start, but we will use all the tools available to us to tackle it.

Let me set out some of the work we are doing right now. First, it is vital that our criminal law is equipped to deal effectively with this behaviour. A range of criminal offences tackle intimate image abuse, whether online or offline. That includes offences of voyeurism and sharing or threatening to share intimate images without consent. However, the current law has developed in piecemeal fashion, with new offences introduced over many years to address different forms of offending. The result is a patchwork of offences with known gaps in protection for victims. For example, while it is currently an offence to share a deepfake of an intimate image without consent, it is not an offence to make one. That is why the Government’s manifesto included a commitment to ban the creation of degrading and harmful sexually explicit deepfakes. This is not porn; this is abuse. We are looking at options to swiftly deliver that commitment in this Session of Parliament. We will consider what further legislative measures may be needed to strengthen the law in this area.

While intimate image abuse rightly has serious criminal consequences, we also need to tackle the prevalence of such content online. That is why, on 12 September, we laid before the House a statutory instrument to add the new criminal offences of sharing or threatening to share intimate images to the list of priority offences under the Online Safety Act. This strengthens the duties on providers to prioritise tackling intimate image abuse under the Act by holding them responsible for stopping the spread.

[Victoria Collins (Harpenden and Berkhamsted) (LD)]

Strengthening those duties is key. As the hon. Member for Bolton North East (Kirith Entwistle) mentioned, Ofcom does not have the teeth it needs. Would the Minister agree that Ofcom needs to use its codes of practice to push social media companies to be more innovative to tackle the issue at the source?

[Alex Davies-Jones]

The hon. Lady makes a very good point; she has pre-empted my next sentence. As I have said, this is a start. Ofcom’s codes of practice are being developed and will give it the tools to go after the platforms, but there is nothing stopping the platforms taking decisive action now. They do not need to wait for Ofcom to have the powers available to make them act. They could remove this imagery now; there is nothing making them wait. Other things could be done to take that further by building safety into design, which I know the Secretary of State for Science, Innovation and Technology is looking at very carefully.

Ofcom is working on the illegal harms codes of practice, which will take effect next year, and already working with the tech companies to ensure that the Online Safety Act is implemented quickly and effectively. Firms will also need to start risk assessing for that illegal content by the end of this year. Ofcom will have robust enforcement powers available to use against the companies that fail to fulfil their duties. It will be able to issue enforcement decisions that may include fines of up to £18 million or 10% of qualifying global revenue in the relevant year—whichever is higher. The Online Safety Act also means that when users report illegal intimate image abuse content to the platforms, they will be required to have systems and processes in place to remove the content.

It is important that the police respond robustly to such crimes. We have heard the importance of that today. In our manifesto, we committed to strengthening police training on violence against women and girls. We must ensure that all victims of VAWG have a positive experience when dealing with the police. That is essential to increased reporting of these crimes and delivery of better outcomes for victims. We will work closely with the College of Policing and the National Police Chiefs’ Council to improve and strengthen training for officers. This is a start, but I am clear that it is not the be-all and end-all of tackling intimate image abuse. We can and must do more. If we want to see true and lasting change, we need a culture shift. I have said this before and I will keep saying it: we need everyone, especially men, to play their part in slowly but surely, bit by bit, wearing away outdated views and misogyny to ensure women are safe, wherever they are.

[Chris Bloore (Redditch) (Lab)]

I echo that point. When we see this abuse on social media, hear of it in discussions in our constituencies and, in particular, hear from young men—this horrifies me—about the number of men sharing these images, we have to challenge it. We must be strong on that and do more.

[Alex Davies-Jones]

I could not agree more. This is about all of us playing our part and saying that we will not stand for it—we will not be passive bystanders and we will challenge these views to tackle it. It will not happen overnight. It will take time, but I believe we can do it. Women deserve to feel safe, whether that is online or out in the physical world. Men who abuse, harass and discriminate should have nowhere to hide.

[Charlotte Nichols (Warrington North) (Lab)]

I thank the Minister for her work on this policy so far, which is among the most meaningful things that has happened since we came into office, particularly the removal of the intent provisions. We have seen too many women unable to get justice because of a technicality, including a horrific case in my constituency that the Minister is well aware of. We are talking a lot about the online space today, so can she clarify that, where intimate image abuse is part of the commission of an offline offence of voyeurism or rape, for example, that will factor into the work that she is doing?

[Alex Davies-Jones]

I am well aware of the horrific case in my hon. Friend’s constituency. I am pleased that we have been able to go further on intent versus consent with some of these crimes. The right to banter should not trump the right to feel safe; I have said that before in this place and I will say it again. Women have the right to feel safe everywhere and we are looking at all offences in that regard, but it will take a whole system effort. My colleagues and I across Government know that, and that is why we are working together to get to the root causes of violence and misogyny to create the lasting change that we all want and need to see.

Finally, we need to ensure that when someone has been the victim of intimate image abuse, they get the support that they need and know that they as victims and survivors have done nothing wrong. A key part of that is the invaluable work of victim support organisations such as the intimate image abuse helpline, which is funded by Government and was set up by the hon. Member for Gosport (Dame Caroline Dinenage). Not only do these services provide high quality support and advice to victims of intimate image abuse, but they work with law enforcement and others to improve the response to these awful crimes. Representatives from the helpline recently gave evidence to the Women and Equalities Committee on this very issue, and I am grateful to them for all that they do to support victims. Their work is more valuable and more needed than ever.

[Charlotte Nichols]

I thank the Minister for giving way a second time—she is being very generous. Just to clarify, non-contact offences, including intimate image abuse, are not currently covered in the criminal injuries compensation framework. Could conversations be had with her ministerial colleagues about providing financial support for victims to access things such as therapy, which my hon. Friend the Member for Bolton North East (Kirith Entwistle) brought up as a really important feature of the debate?

[Alex Davies-Jones]

I was about to come on to therapy, support services and other things that the Ministry of Justice funds to support victims and survivors. My hon. Friend the Member for Bolton North East mentioned redress, and compensation can be made available from the perpetrators directly through the civil courts. That has been pursued previously, and it is available to victims and survivors to get the redress that they need by claiming that compensation.

On victim support, the Ministry of Justice funds many other services to help victims cope and recover from the impact of crime. For example, we have the rape and sexual abuse support fund, which supports more than 60 specialist support organisations. As others have mentioned, we also have Refuge, which the Government fund to deliver a specific tech abuse function. It has been at the forefront of the response to tech abuse. We also provide police and crime commissioners with annual grant funding to commission local, practical, emotional and therapeutic support services for victims of all crime types, not just intimate image abuse.

The Victims and Prisoners Act 2024 will aim to improve support to victims of sexual abuse, including intimate image abuse, by placing a duty on local commissioners to collaborate when commissioning support services so that victims and survivors get the support that they actually need. That brings me back to the key point: collaboration, with everyone pulling together and playing their part. That is what we need if we are going to truly see a shift. Again, I thank my hon. Friend the Member for Bolton North East for securing the debate and I thank everyone for coming and showing support. It really is important that we have good representation in Parliament. We are absolutely committed to tackling violence against women and girls, as are this Government, and we are just at the start of it.

Question put and agreed to.

School Transport: Northumberland

Tuesday 12th November 2024 Westminster Hall

[Carolyn Harris in the Chair]

16:30

[Carolyn Harris (in the Chair)]

Before I call the hon. Member for Hexham to move the motion, I inform Members that the parliamentary digital communications team will be conducting secondary filming during the debate.

[Joe Morris (Hexham) (Lab)]

I beg to move,

That this House has considered school transport in Northumberland.

It is an honour to serve under your chairship, Mrs Harris.

In Westminster Hall today, I am delighted to see Members who share my concerns about school transport, not just in my constituency but across the county. I place on the record my thanks to organisations such as Contact, Adapt North East and local schools, in particular Queen Elizabeth high school, for their valuable contributions. The future of school transport is a pressing and increasingly concerning issue affecting my constituents —parents, students and teachers—in Hexham and in Northumberland more broadly.

I grew up in Hexham. I was fortunate enough to have been educated at Sele first school, Hexham middle school and Queen Elizabeth high school. I am, and always will be, incredibly grateful to my teachers for the valuable education that I received. In particular, I mention Tony Webster, my former headteacher at QE—he filmed a video supporting me during the general election campaign—for his constant support and mentorship.

Meeting students and teachers across my constituency—from Queen Elizabeth high school to Longhorsley St Helen’s Church of England first school and back to Sele first school, where I went a few weeks ago—has provided valuable insight into the issues affecting our local schools, and school transport in Northumberland is raised again and again.

During my maiden speech, I said:

“a great state education has the ability to change lives and to lift and change entire areas. I want every child in the constituency to have access to the kind of education that I was lucky enough to get.”—[Official Report, 19 July 2024; Vol. 752, c. 347.]

That is my motivation to secure this debate. Ensuring that every child in Northumberland gets the best education is a commitment that I share with my hon. Friend the Member for North Northumberland (David Smith), and with my hon. Friends the Members for Blyth and Ashington (Ian Lavery) and for Cramlington and Killingworth (Emma Foody), who cannot join us today.

Home-to-school transport is an integral part of our education system in Britain. It ensures that no child of compulsory school age is prevented from accessing education by a lack of, or the cost of, transport.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Gentleman for securing this debate. He is right to bring up the issue of school transport, especially in rural areas. We should never deplete services that children rely on to get to school; instead, we should increase their accessibility. I had a meeting with my Translink bus service and the education authority, and we were able to sort out some of the problems with rural transport. Does he agree that more needs to be done for bus services, especially in rural areas where transport is already limited, to ensure that kids’ education does not falter as a result of bus service issues? That is what could happen.

[Joe Morris]

I thank the hon. Member for his intervention and for his attendance. I think he has attended every Westminster Hall debate that I have spoken in. I completely share his assessment. The provision of appropriate bus routes is important, and it comes up in my casework. I have spoken to families in villages such as West Woodburn, where they allegedly have a choice of school, but the only available routes go to one single school.

[Sarah Dyke (Glastonbury and Somerton) (LD)]

I thank the hon. Member for securing this important debate. I recently spoke to a constituent, Sara, who lives just outside Bruton in my constituency. She told me of her frustration that her daughter cannot catch the school bus that literally stops at the end of her farm track and goes to the local school. Instead, the council insists that she must drive her daughter or get a taxi to a different school, which is further away. Does he agree that our existing home-to-school transport legislation is too rigid? It is stifling local authorities’ ability to make common-sense judgments.

[Joe Morris]

As constituency MPs, we all hear the frustrations of parents, teachers and students, who, because of school transport provision, are often hit with lateness marks or are forced to attend schools that they would rather not attend, as the hon. Lady said. It is something that we need to address properly, considering all the solutions in the round to ensure that we can provide great education to every child. I know from looking at my inbox that the 685 bus in Hexham is regularly full and delayed by up to 40 minutes. When people rely on commercial bus routes to get to school, it becomes an additional barrier to attendance. That is damaging to children’s educational attainment and future prospects, simply because buses cannot always be relied on.

I spoke in the rural affairs debate in the main Chamber yesterday. Too often, people in rural communities pay more and get less. The previous Government, and other Governments before them, have allowed that to sail through without challenge. When we talk about rural-proofing our policies, it is essential that we look at things through the prism of how they affect some of our most isolated communities.

Fourteen years of Conservative austerity and neglect broke the very foundations of Britain and our education system, and took hope away from our young people, who have been let down and overlooked. I am extremely proud of our new Labour Government’s commitment to increasing funding for schools, to putting our younger people first and to ensuring that every child receives a world-class education. Parents want the best for their child’s education; they want their children to learn in a safe and secure environment where they feel part of the community and supported in their educational development. No child should be restricted from that because of inaccessibility.

I am proud to have secured this debate, and to be a voice for students and parents as we champion school transport in our local community. As Members— particularly the hon. Member for Westmorland and Lonsdale (Tim Farron)—do not tire of hearing, I represent England’s largest constituency; I am delighted to see the silver and bronze medallists here today. The rural landscape has a considerable impact on school transport services. The reality of rural roads means that, despite having relatively short journeys, children are regularly late for the start of the school day. Children’s education is suffering, and more transport vehicles and a reassessment of transport routes could make considerable headway in reducing the number of pupils who are late for school.

I have had one constituent raise the fact that delays to school transport mean that her daughter regularly receives late marks at school. Despite the fact that her daughter is a 14-minute journey from school and is collected at 7.45 am, she does not get to school until after 9 am. That is a case of a student’s education suffering from a lack of adequate school transport services. As the early grid for learning report outlined, missing 15 minutes of school per day equates to 2 weeks’ absence a year, and that is equivalent to missing 55 lessons a year. Being late negatively impacts a child’s education and contributes to a loss of learning.

Home-to-school transport is often available only through the local authority, along with the additional support offered by parents and carers. Across the Hexham constituency and the Northumberland county council area in general, the provision of local bus and train services is unreliable—I have already mentioned the 685 bus—and not regular enough for young people to access when travelling to or from school.

I am pleased to see that North East Mayor Kim McGuiness has launched a consultation on the north-east local transport plan. That plan will cover five areas that are necessary for my constituents to be able to access a public transport system that is fit for all our communities, not just those in centralised areas. Those five areas are: journey planning and customer support; ticketing and fares; expanding infrastructure and making it more resilient; enhancing safety, especially for women and girls; and improving links between different modes of transport. There is a clear delivery plan that has outlined and established targets for 2040, setting the path for overcoming the current challenges and creating a more efficient and resilient transport network for the future of the north-east. That will make considerable headway in helping my constituents access education and training opportunities, as well as work and social opportunities more broadly.

The system on offer in Northumberland provides inconsistent results for families when they are allocated school transport places. One of my constituents, who is a resident in the far north of the constituency, contacted me to say that his daughter has obtained a free transport place but his son has not. As a result, he has to drive his son 170 miles a week, alongside the bus that takes his daughter to the same school. That is not just illogical, but vaguely Kafkaesque. It has environmental implications, in addition to educational ones, and it places a financial and administrative burden on a family who already qualify for free transport provision. I am sure the Minister will agree that we need to support the families in my Hexham constituency and families across Northumberland, ensuring that the provision of school transport is consistent for siblings within the same family. We cannot allow administration to provide inconsistent results for families.

In my constituency, I am often asked questions about school catchment areas. I was on a call with Northumberland county council on the train down here, and I was informed that one of the school catchment areas in my constituency is larger than the area contained by the M25. Unsurprisingly, I get quite a lot of incoming casework on this. Many students who are outside catchment areas and ineligible for school transport services require commercial public transport to get to school. That is particularly common in constituencies such as mine, and those of my hon. Friend the Member for North Northumberland or the hon. Member for Westmorland and Lonsdale. Villages and towns such as Haydon Bridge, Bardon Mill and Haltwhistle, as well as settlements such as Falstone, Greenhaugh and Kielder, have considerable numbers of students who travel to Hexham middle school and Queen Elizabeth high school, which sits in the Tyne valley at the centre of my constituency. Such places are deemed to be outside the catchment area for those schools, but the safety of students travelling to and from school in Northumberland should be a priority. Those children should feel safe travelling to school, and parents should be reassured about their safety.

A constituent has shared a deeply concerning story about the 685 bus breaking down on the side of the A69, with children being required to stand on the side of the A69—one of the busy roads running through the constituency—without any police presence or safety measures in place. I am sure that the Minister is aware of the growing concerns over that road. Since 2019, there have been 191 crashes on it between Hexham and Carlisle, with 44 of them being deemed serious by the police and six people losing their lives. When I heard about children standing on the side of the A69, I was deeply concerned. They should not be in that position.

Constituents frequently mention the delays to the 685 bus service, which affect children getting to and from school. Despite petitions by parents to change the service from a single-decker to a double-decker bus—that was raised with the previous Conservative MP—no action was taken to resolve the issue. Constituents have said that their children have had to wait for more than an hour for the next bus service to collect them, because of a lack of space in addition to delays to the service. We need to work collaboratively with local bus companies and local councils to ensure that the safety of our students is protected as they journey to and from school.

I will briefly mention transport for children with special educational needs and disabilities. I know that the Minister and the Government agree that SEND needs urgent attention, as has been demonstrated by the devastating consequences of the previous Government’s actions. In Northumberland at present, there are 407 routes transporting 1,738 pupils and their escorts. In six years, the number of children in Northumberland requiring an education, care and health plan has doubled, from 1,679 in 2017 to 3,369 in 2023. The figure is still rising, and the failure of the last Government to adequately provide for children with SEND is a damning indictment of that Government and indeed the Conservative party.

Children with educational needs and disabilities often have to travel further to schools, not through choice but just to get the education that meets their needs. My constituency surgeries are often attended by families who have to travel from the far west of my constituency to the coast of Northumberland—a journey that does not take a small amount of time. In large rural areas such as mine, the need for children to travel such extremely long distances isolates them from their local communities and friendships, and it ultimately undermines their potential to have a local support network.

I was contacted by a parent who travels from Prudhoe to Berwick every day, which is a three-hour round trip, to ensure that their child receives the support they need. We must ensure that parents feel supported as we look to reform the SEND framework. One of the things I am most proud of in the autumn Budget is the £1 billion uplift in SEND education and the prioritisation of improving SEND education nationally. I am hopeful for the future of SEND education and will always support the Minister and the Government in their commitment to it.

I want to acknowledge the work of Kim McGuinness on her Kids Go Free initiative, and her commitment to improving public transport services for young people across our region. That initiative offers free transport to children during school holidays, reducing travel costs for families, promoting sustainable public transport and encouraging families to explore the wonderful region that is the north-east—I draw attention to my Westminster Hall debate next week on improving tourism in Northumberland, at which I look forward to seeing the hon. Member for Strangford (Jim Shannon). It is a positive step in the right direction in terms of improving transport services in the region. Through that collaboration and co-operation we will increase prosperity and make a real difference to the lives of young people.

I am sure Members present can agree that every child in Britain deserves an accessible and safe education. Moreover, every parent should feel safe and secure in the knowledge that their children are receiving support. Children deserve to have a safe and sustainable passage to school, to arrive on time and to access an education that is appropriate for their learning requirements. For my constituents in Hexham and for people across Northumberland, school transport is jeopardising that promise. With rural geography, inconsistency in allocating school transport places, problems with catchment areas, and journey delays, the very premise of that principle is being jeopardised.

I am proud that this Government are putting students and young people at the heart of the agenda, following the neglect of the previous Conservative Government. I am sure Members can agree that more can always be done to ensure that our young people access the educational support they need and deserve. Providing clearer guidance on transport provision for children will minimise confusion for local families. Giving more attention to the eligibility of SEND children will make a considerable difference to many of my constituents across Hexham.

I know that the Minister and the Secretary of State are committed to finding long-term solutions for education, school transport and SEND education. I hope the Minister will consider how, in the vast rural communities that make up my constituency, having greater provision for SEND students closer to their homes would minimise journeys and go a long way to dealing with the central issues we are debating. Everyone deserves the opportunity to access education, and we cannot allow a lack of access to appropriate school transport to jeopardise that.

16:47

[David Smith (North Northumberland) (Lab)]

I am absolutely delighted to speak in this debate alongside my hon. Friend the Member for Hexham (Joe Morris), and I am delighted that he secured it. The lack of accessible transport options to Northumberland secondary schools, in particular, may not attract national attention, but it affects children, young people and parents in my constituency much more directly than almost anything else we discuss in Parliament. In North Northumberland, it is now common in villages such as Pegswood for an 11-year-old to spend up to two hours a day on four different buses making the round trip to school and back. When we factor that in for SEND students, as my hon. Friend said, parents face a collective nightmare.

One constituent recently wrote to me—I have changed the name of their daughter—to say:

“We are currently having issues with school transport for our daughter who is autistic. Northumberland County Council have rejected our appeal for alternative provision. Sarah is no longer attending school, due to a number of issues, the first being transport. We are now homeschooling Sarah.”

That issue is repeated over and over again in my mailbox.

There are two reasons why it matters so much. The first, which I have just highlighted, is the most obvious: the cost and strain on parents is totally antithetical to the ideal of the state school. Families are spending hundreds of pounds a year making sure that their child gets to school, worrying the whole time about their safety, as we heard. Our state school system should not rely on significant private expenditure to meet basic educational needs. In fact, it was designed to do the very opposite.

Secondly, school transport is a pinch point in terms of a wider range of northern rural inequalities in education and transport, and deservedly reinforces the idea that places such as Northumberland have been left behind and ignored over the years by the powers that be. There have been repeated failures across the county in the way that our schools, roads and rail are run, and school transport exposes them all, pointing to a much wider range of issues.

How did we get here? North Northumberland has too few schools, and in some areas that is leading to huge pressures. The nearest secondary school to Pegswood, the village I mentioned, is in Ashington—Ashington Academy—which is a 20-minute bus journey away. However, Ashington is oversubscribed, so students are often sent to Cramlington instead. If parents cannot drop them off, there is a range of ways to get there, of which the quickest takes 41 minutes and involves a train. The season ticket for that train costs £1,120 a year, so most take the cheaper option—a bus journey. Actually, it is two bus journeys, which take up to an hour and a quarter and will cost at least £960 a year, according to the very confusing and unhelpful Arriva website. This very afternoon, teenagers from Pegswood who finished school in Cramlington at 3 o’clock will only just be getting home, having taken four buses on a £1,000 ticket. Commutes like that are happening in towns all over North Northumberland, from towns and villages such as Belford, Wooler, Rothbury and Amble. We heard from my hon. Friend the Member for Hexham about the state of some rural roads and about how that often makes journeys more challenging.

Nowhere is this issue more visible than with SEND schooling. Like my hon. Friend the Member, I welcome the Government’s commitment to spend £1 billion pounds more on SEND next year. North Northumberland has three SEND schools and they do a remarkable job supporting the flourishing of young people with more complex needs. However, the nearest school might not necessarily be the best option, which can require pupils to spend over an hour in a taxi or bus to get there—we heard about the hour-and-a-half journey in each direction that some have to make in my hon. Friend’s constituency. Parents are increasingly resigned to the notion that having a child with more complex needs will require spending large amounts of money and time travelling to school.

The Education Act 1944—I am sure hon. Members did not expect me to bring that up in this debate—established modern secondary schools and came into being because,

“when poorer children were offered free places”

—at grammar schools, as they then were—

“parents often had to turn them down owing to the extra costs involved.”

Free state schools were instead set up to cater to all needs and incomes, but my constituents seem to have ended up trapped in a new system that promises equal and free schooling, but includes submerged and unexpected costs that put family finances under strain.

On the wider issues, the school transport issue has not emerged in isolation but is evidence of a wider series of pressures on public services across the county. First, the education system is struggling in various guises in some parts of Northumberland. The town of Berwick, in my constituency, is extremely reliant on its one state secondary school to nurture the necessary skills and qualifications for the town’s economy, so when the school struggles, the town struggles. A 2017 report said:

“Berwick is one of Northumberland’s most deprived towns. It has a vulnerable economy characterised by poor quality job opportunities, part time working, low wages and very limited education facilities.”

North Northumberland’s further education is in a poor way too, and 16 to 18-year-olds who want to take up a vocational course have to travel miles out of the constituency and at great expense. Another constituent recently got in touch about this very issue, saying:

“I have been made aware of a colleague’s 16 year-old daughter who undertook an apprenticeship across the border in Scotland in July. She lives in Berwick and was catching a bus to and from work. However, after just a few weeks, Border Buses removed the morning bus. Emma”—

whose name I have changed—

“is now relying on taxis to get her to her apprenticeship in the morning. This is costing her family, who are not in a position to afford this, £150 a week. Emma is a vulnerable young woman who has endured a difficult time at school and yet is thriving in her apprenticeship, but this is now at risk.”

North Northumberland’s GCSE and apprenticeship levels keep pace with the rest of the country, but A-Levels and higher education qualifications are behind the England and Wales average, and that will be in part because of the inaccessibility of further and higher education. However, those pressures are also evidence of a public transport system that is not up to the job.

North Northumberland residents are right to be sceptical about local bus services, considering that Arriva, the largest provider, is owned by an American equity investment fund based in Miami, which is hardly ideal for a public service. In fact, from 2017 to 2022, the distance travelled by bus services in Northumberland fell by over a third—one of the highest reductions for any authority in the north-east.

It is for that reason that, like my hon. Friend, I am delighted that the Mayor of the North East, Kim McGuinness, has started the process of bringing buses back under public control so that we know that they go where they are needed and not just on the routes that make the most money. Having spoken to the Mayor of the North East about that, I know that one reason she is keen to do that is the positive impact it would have on rural services.

Meanwhile, local train services are increasingly sidelined in favour of London to Edinburgh links on the east coast main line that squeeze stopping services from the timetable. Cost-benefit calculations designed to extract value do not favour rural areas, which need targeted public investment and intentional support. Poor transport is a contributing factor to low rural productivity.

As my hon. Friend the Member for Hexham said, all of this is the natural end point of 14 years of a real-terms education spending freeze, with reduced school capital spending; of 14 years of neglect of public transport that let franchising diminish the value of rail travel and bus companies be driven by international investors; and of 14 years of letting economic liberalism expose rural communities to economies of scale that make post offices, banks and other essential services non-viable. It is not by accident that hundreds of schoolchildren cannot go to schools in their own communities—it is the consequence of the policies of the last Government.

However, the work of change has begun locally and nationally. I am working with Berwick stakeholders to rethink our vision of what an outstanding education system could look like, with a campus model and associated further education facilities having the potential to transform education in the town and even the town itself. I am fully supportive of the campaign by the South East Northumberland Rail User Group to introduce a regular stopping service up the east coast main line that serves local residents and opens up the region to inward investment. I welcome the £1 billion committed by the Government to local transport, with another £650 million towards transport and buses in towns, villages and rural areas.

The difference between a Labour and a Conservative Government is that when we see communities facing economic disadvantage and inequality, we have no issue putting our money where our mouth is and making sure that where someone starts in life or where they live does not determine the opportunities they can pursue.

16:57

[Tim Farron (Westmorland and Lonsdale) (LD)]

It is an absolute joy to serve under your guidance, Mrs Harris. I pay tribute to the hon. Member for Hexham (Joe Morris), who is becoming almost as much of a regular in this place as our recently departed friend the hon. Member for Strangford (Jim Shannon). As he rightly set out, he, I and the hon. Member for North Northumberland (David Smith) are the big three—we represent the three largest constituencies in England. The hon. Members for Hexham and for North Northumberland made really great points, not just on behalf of their constituents in Northumberland, but on an issue that is of huge significance across the country, particularly in rural communities such as mine.

The hon. Member for Hexham talked about rural communities paying more and getting less. Sadly, that is absolutely how things are. About a year ago, the Rural Services Network calculated that if a single region was created from rural England and compared to the geographical regions of England, it would be comfortably the poorest. Although the depiction of rural life is often full of a bucolic, ideal, wonderful and high quality of life—of course rural places are beautiful, and we are proud to live in them—poverty is undoubtedly real, and the cost of transport and the distance people have to travel to get to the services they need are a major driver of that.

As the hon. Members for Hexham and for North Northumberland set out, one issue we face in rural communities is that, with huge catchment areas, the divide between two school catchments can be incredibly blurred. Someone may well be sending their child to the nearest school, but it may technically not be the one in catchment, so they are left having to pay a significant amount for their child to go to that school. As the hon. Member for Hexham rightly pointed out, people often find that one of their children can get a bus to school but that the other cannot. That is definitely the case in parts of my constituency.

This problem is exacerbated by the reduction in the number of small village schools over the last few decades. In my constituency I have at least three schools with fewer than 20 children and three schools that have closed in the last few years as well—in Ravenstonedale, Satterthwaite and Heversham. The communities around those schools are now, and have been for a generation in some cases, forced to make alternative arrangements. That has largely come about because of the growth in second home ownership, unchecked, in many communities in the lakes and dales, which has gobbled up the homes available for a full-time permanent population. Without that, where are the children coming from? Where are affordable houses being built to replace those second homes? There are some, but nowhere near enough. It is all part of the fabric of rural life, which comes under enormous pressure. The community’s school is at risk and may go, and bus services are lost, along with the post office, as mentioned by the hon. Member for North Northumberland.

The patchwork of rural life under such strain is often maintained by decent public transport links, if they exist, but they are often lacking in rural communities. I will come back to the debate about £2 and £3 bus fares. It is hugely regrettable that the Government have increased that cap on bus fares. As I often say, any bus fare cap is of no use if there is no bus to use it on.

It is important to look at this issue seriously, and I am grateful to the hon. Member for Hexham for bringing it forward. One reason a child might not be sent to the nearest school is that that child has special educational needs. That may be formalised, and I have some figures on that. We have seen a 24% increase in the number of children travelling to special schools in the past five years. We have seen the number of EHCPs increase from 105,000 in 2015 to 230,000 across the country in 2023.

The County Councils Network estimates that by 2027 spending on special needs transport will have trebled over a decade to a vast total of £1.1 billion. Many children do not have an EHCP because there is an incredible backlog, and there are people who have special needs who are not formally assessed. Nevertheless, parents will send those children to the schools more able to cope with them and provide the best quality of education. If that is not in catchment and the child does not have an EHCP, parents pay for that themselves. Many parents in my communities are struggling as a result. They cannot afford it but, for the sake of their children, they do it.

The use of taxis over the past five years to get children with special educational needs to school has gone up by 36%. The school and the local authority between them bear the cost of that. It is encouraging to hear the new Government talk about special educational needs and try to focus on this as a crisis to be fixed. The Liberal Democrats believe strongly that there should be a national body for special educational needs, with additional support for local authorities and schools to fund provision. We should not be in the situation where those schools that do the right thing by children with special educational needs are penalised for doing so, and end up losing staff as a consequence of paying the costs of those children they have rightly taken on and supported.

I will talk about the communities across the Pennines in Westmorland and Furness. We have historic spend factors that account for 28% of our high-needs allocation and which do not reflect the changes in demand and the costs incurred in the past six years. Historical spend factors mean that Westmorland and Furness is funded 45% less than other high-cost authorities, and the impact is felt by children across our communities.

It is worth bearing in mind that Northumberland and Cumbria have very high visitor numbers. Although we do not pay for the education of visitors, we do pay for lots of other services that visitors use when visiting Northumberland national park, the lakes and the Yorkshire dales. There are 20 million visitors to Cumbria in the average year. That costs the local authority, and there is nothing in the funding formula to recognise that, to ensure that we do not dip into money that might otherwise be spent on education, in order to prop up other services, because we have all those visitors and do not have the money to pay for and support them.

When talking about school transport, we should pay attention to the plight of young people over 16. I am deeply concerned, along with others who represent rural constituencies, that although we rightly have young people continuing their education beyond 16, as is mandatory, we do not support or fund them to get to those places of education. It is probably quite straightforward in an urban area, where people could just walk to their nearest sixth form, but students at Kendal college are coming from right across Westmorland and north Lancashire, travelling maybe 40 or 50 miles in one direction to get there each day.

The sixth forms at the Queen Katherine school and Kirkbie Kendal school also take young people from far outside Kendal. At the Lakes school in Troutbeck Bridge, people travel from Grasmere, Ambleside, Windermere and the likes to get there. Dallam school takes children from the rest of south Cumbria and north Lancashire. There is also Ullswater community college. Kirkby Stephen and Appleby sixth forms are really small and in wonderful schools, and young people travel there at great cost to themselves and their parents. A student might find their brother in year 9 has his place at school funded, but they may have to pay £700 or £800 a year for the privilege. As a result, young people are choosing not to go into further education and take A-levels; they are choosing other routes instead, because they simply cannot afford to do so. That is why this issue is so important. I am delighted that the hon. Member for Hexham has managed to secure this debate, because it is of great significance to all of us who represent rural communities.

17:05

[Neil O'Brien (Harborough, Oadby and Wigston) (Con)]

It is a pleasure to serve with you chairing, Mrs Harris. I congratulate the hon. Member for Hexham (Joe Morris) on securing this hugely important debate. This is an important subject to talk about, and there have been really good contributions from multiple Members. I declare an interest in Northumberland, as it is where I got married, in Wooler near Rothbury, which has already been mentioned. I have a great appreciation for Northumberland as a county. If I am not in the constituencies of the hon. Members for Hexham or for North Northumberland (David Smith) in the summer, I am normally in the constituency of the hon. Member for Westmorland and Lonsdale (Tim Farron), so they are all places for which I have a lot of love.

I will recap the story a little. Last year, we announced an extra £500 million of funding for local government for adult and children’s social care, particularly to reduce the pressure on other areas of children’s services, such as home-to-school transport. It was part of our wider strategy for children’s social care reform and allocated to things such as expanding family help, targeted early intervention and all those things. It was part of a wider settlement for local government last year, which was another above-inflation settlement. Local government absolutely was squeezed in the coalition years, when we were clearing up the large deficit after the financial crisis, as the Institute for Fiscal Studies has pointed out, but funding per person in 2024-25 is set to be 10% higher in real terms per person than in 2019-20, with bigger increases for the most deprived councils. It is worth recognising that what happened over the last Parliament is not the same as what happened in the period 2010-2015, when there were real-terms increases per person for local government.

I mention that because the local government financial settlement for next year is now looming; I guess that we should expect it some time in the next month. Perhaps the Minister will tell us when it is coming. I have a couple of specific questions that I hope she will be able to answer, as they are relevant to this debate. What will the total cost to local government be of the national insurance increase announced in the Budget? What will the cost of the national insurance increase be specifically to home school transport? Will local authorities be compensated for those costs?

We know that one of the recurring issues with the national insurance increase is who will be compensated. Public services that are not part of the public sector are not included in the protection. For example, GPs are up in arms about the enormous bills that they all face, and there are similar issues for nurseries, which are extremely concerned. The university sector has already learned that the entirety of the increase paid for by the breaking of the tuition fees promise will pay for the breaking of the promise on national insurance, so one broken promise will pay for another. All the gains that it thought it was going to get from the tuition fees increase are being entirely wiped out and eaten up by the cost of the national insurance increase, so real-terms funding for universities will go down. Those issues very much apply to home-to-school transport, a public service provided by people outside the public sector. Will the Minister tell us whether they will be fully compensated for that? I hope she will be able to give us that assurance.

We have touched on some of the wider issues in which this issue is situated. The hon. Member for Westmorland and Lonsdale has mentioned this, but I was really sad to see the end of the “get around for £2” scheme, which we introduced and extended to the end of 2024. I know from my own community that it has particularly benefited people in rural areas, so I am sad to see that it has gone and there is effectively a 50% increase in the cost of a lot of journeys on buses. That is a real shame, because I felt we were making progress on buses. I was involved in the Bus Services Act 2017, which gave mayoral combined authorities the power to introduce into other areas of the country the kind of franchising that London has enjoyed for a long time.

It was sad to see the scrapping of the dualling of the A1 through Northumberland. Land and houses had been bought up to allow for the work, which makes it even worse. I was astonished to see that in the Budget, although there was lots of capital for other things, including the different things that the right hon. Member for Doncaster North (Ed Miliband) wants to do on net zero, there was an overall reduction in capital transport spending. I was really surprised by that. I do not really understand what the logic was.

[David Smith]

I have a simple question: would the hon. Gentleman agree that the last Government had 14 years to dual the A1 and did not manage to do so?

[Neil O'Brien]

We had finally got there. We had bought the land and the houses, and the thing was about to happen. Somehow, the new Government snatched defeat from the jaws of victory, which is desperately sad. We will have to agree to disagree on that.

We have talked a bit about SEND funding in the round. The high needs block spending grew 70% between 2018-19 and 2024-25, so we put a lot more money into it. Hon. Members might say that is still not enough, and I would totally understand where they are coming from, but the demand is exploding upwards. I know that the Minister will be thinking equally about the causes of that and what she can do about it—not just meeting the need, but trying to understand the root causes and reduce the need for these services. There was a very large increase in that high needs block SEND spending.

A couple of hon. Members mentioned that one of the ways to solve the issue is not to look at the transport but to look at the schools. This is a long-term obsession of mine. I had a Westminster Hall debate not so long ago about this very issue. Since 1980, the number of small schools with fewer than 200 pupils had roughly halved, from 11,464 to 5,406, by 2018. That is a long-term trend. Since 2000, rural schools—those in villages and hamlets—have been twice as likely to shut. When they have shut, the typical walk time to the nearest school has been about 52 minutes. That long-term trend, which has occurred under Governments of all three of the main parties, has posed all sorts of challenges for rural areas.

To try to arrest that trend, we brought in the lump sum within the national funding formula, which is about 60% of the total funding. It is a hugely important part of the funding and I look forward to hon. Members championing it. We must think about how we keep village and rural schools, which are such an important part of rural communities, going. That is not just because they make life simpler and the whole transport issue simpler, but because they are at the heart of rural communities. The hon. Member for Westmorland and Lonsdale talked about a 36% increase in taxis. We need to think about how we can attack the underlying causes of the need. I am sure that the Minister will be thinking about this.

I will end where I started by congratulating, in an honest way, the hon. Member for Hexham on securing this debate. It is hugely important. He made a super-important point about siblings being treated differently, which seems like absolute craziness. I am sure that we all agree that we ought to tackle that, but there are opportunities to address these issues, particularly through the local government funding formula. Government Ministers will stand up in a few weeks’ time and give us the numbers for how much local government is getting, but those in local government will want to know what is happening to their costs and for which of the services they provide, such as home-to-school transport, they will get compensation on the national insurance increase, because otherwise they will not know whether they are really ahead or behind.

17:13

[The Minister for School Standards (Catherine McKinnell)]

It is an honour to serve under you as Chair today, Mrs Harris. I congratulate my hon. Friend the Member for Hexham (Joe Morris) on securing the debate today on this very important subject. I know how hard he works to represent the constituents of Hexham and how passionate he is about access to the best education possible for the children in his rural constituency. I am very familiar with my hon. Friend’s constituency, having lived there, spent most of my holidays there, and represented parts of it for 14 years leading up to the last general election. It is a truly beautiful and blessed part of Britain, but I totally understand that it is not without its challenges. He is rightly here today raising them and ensuring that he can deliver change for his constituents.

The Department’s home-to-school travel policy aims to make sure that no child is prevented from accessing education by a lack of transport. As my hon. Friend will know, local authorities are required to arrange free travel for children of compulsory school age who attend their nearest school but cannot walk there because of the distance, because they have special educational needs, a disability or a mobility problem, or because the route is not safe.

There are additional rights to free travel for low-income households, so that they can exercise school choice, but local authorities are struggling to fulfil those duties for all eligible children and the costs of doing so have risen sharply in recent years. All local authorities are looking for ways to deliver that service efficiently and cost-effectively. In 2023, Northumberland county council conducted a comprehensive review of home-to-school travel, which made wide-ranging recommendations that are being implemented.

There are several reasons for the steep increase in the cost of home-to-school travel in recent years, such as fuel price inflation and a shortage of drivers, passenger assistants and transport operators. Those things have pushed up costs, but most of the increase can be attributed to challenges in the school system itself that have built up over many years, specifically the way the school system currently educates children with additional needs. My hon. Friend the Member for Hexham raised that in his speech. More children have education, health and care plans and more of those children travel long distances to a school that can meet their needs. As well as their journeys being longer, which is more expensive in itself, that also reduces the opportunity for economies of scale. Fewer children are likely to take each route, so more vehicles are required.

We want more children and young people to receive the support they need to thrive in their local mainstream setting, which will reduce the need for them to travel a long way to access specialist placements. Many mainstream settings already deliver specialist provision locally, including through resource provision and special educational needs units, but there will always be a place in the system for special schools, which are required by children with the most complex needs.

The Department supports local authorities to provide suitable school places for children and young people with SEND through annual high needs capital funding. It can be used to deliver new places in mainstream and special schools as well as in specialist settings and to improve the accessibility and suitability of existing buildings. We will set out plans for future high needs capital funding in due course.

Making sure that more children can be educated in their local community will reduce pressure on home-to-school travel over time. We want to work with the sector to ensure our approach to SEND reform is planned and delivered with parents, schools, councils and expert staff, who we know go above and beyond to support children. There are no quick fixes. Fixing the SEND system is a key priority for this Department and a vital part of our opportunity mission, but it will take time. We will work with the sector as essential and valued partners to ensure our approach to SEND is fully planned and delivered with parents, schools and councils.

For many children with SEND, learning to travel independently is an important part of preparing to lead an independent and fulfilling adult life. Independent travel training is a tailored programme to help children with SEND to learn to travel independently, for example by public transport or walking. My hon. Friend the Member for North Northumberland (David Smith) highlighted the length of the journeys that some children in Northumberland face. Local authorities should offer independent travel training to children with SEND who are eligible for free travel to school and who think they could successfully complete the programme. Many parents are anxious about their child’s ability to travel independently, and the child may also be worried about it, so it is important that local authorities support families to help them to understand the benefits of being able to travel independently, which will build their confidence.

We are also aware of significant concerns around home-to-school travel for children in temporary accommodation. We understand that when a child has to move to temporary accommodation—for example, as a result of homelessness or fleeing a difficult situation—they will benefit from the continuity of remaining at their current school, with familiar teachers and friends. However, they might not be eligible for free travel to school—for example, if there are other school places that are nearer, between their school and their temporary accommodation.

Local authorities have a discretionary power to arrange free home-to-school travel for children, even if they are not eligible. We know there is incredible pressure on local authority home-to-school travel budgets, but we encourage local authorities to exercise that discretion whenever they can for children who are vulnerable.

In the Budget, we announced an additional £233 million for tackling all forms of homelessness, taking the total spending on reducing homelessness to nearly £1 billion in 2025-26. That will be directed at supporting people into secure and stable housing, and at supporting children. We recognise that there are similar pressures on local authorities providing transport support to post-16 students, and the cost and availability of public transport can be a real issue, as my hon. Friend also pointed out.

Nevertheless, it is a responsibility of local authorities to put in place transport arrangements to help young people aged 16 to 19 to access education or training, as well as for people aged 19 to 24 who have special educational needs, using funds that they have available locally. Most local authorities do offer some form of subsidised transport, and it is combined with the 16 to 19 bursary. It is intended to provide financial support to students from the lowest-income households. For example, in the constituency of Hexham, Northumberland county council offers free transport to young people from low-income backgrounds and those on EHCPs. However, I appreciate the concerns that my hon. Friend the Member for Hexham has outlined today.

The vast majority of central Government funding for home-to-school transport and post-16 transport goes through the local government finance settlement, administered by the Ministry of Housing, Communities and Local Government. We recognise the challenges local authorities face as the demand for their critical services continues to rise. We have listened to voices across the sector, and we prioritise local government funding. In the Budget, we announced £1.3 billion of new grant funding in 2025-26 for local government to deliver core services, which, together with the local income from council tax and business rates, will provide a real-terms increase in core spending power of around 3.2%. I appreciate the concerns the shadow Minister raised, but the amounts and the way they will be administered will be announced in due course—the announcement is due this month.

[Neil O’Brien]

I am grateful for the Minister’s answer. I am keen to understand whether local authorities will be compensated, not just for the direct costs to their own staff of the increased national insurance payments, but for the costs of services that they buy in, such as home-to-school transport. Will that also be fully compensated?

[Catherine McKinnell]

All those details are being worked through and will be announced in due course. I appreciate the hon. Member’s keenness to have advance sight of the statement—it is coming, and it will set out all of the detail.

In addition, local government in England is expected to receive about £1.1 billion of new funding in 2025-26 through the implementation of the extended producer responsibility for packaging scheme. Hon. Members might wonder what that has to do with transport, but it will shift the burden for managing household packaging waste from local authorities to the producers who supply and import the packaging. That will create additional revenue for local authorities to channel towards vital services such as public transport.

The Government are committed to reforming public services and the local government funding system, while providing as much certainty as possible. It is important that we deliver that reform in partnership with local government, and my ministerial colleagues will be setting out more detail shortly.

The Department routinely collects data on local authorities’ expenditure on home-to-school travel, and we understand the increasing financial pressures that they face. However, as things stand, the Government have not collected data on the actual travel being arranged, even fundamental information such as the number of pupils receiving free home-to-school travel, the transporting of siblings—as my hon. Friend the Member for Hexham highlighted—and information on catchment areas. I am determined, given the concerns that he and other hon. Members have raised, that we improve our data on the subject so that local authorities can benchmark themselves against similar authorities and learn from one another, and so that central and local government have the robust evidence to inform decision making on those issues. We will be writing to local authorities in the coming days, setting out our plans to ask them to provide data on travel that they arrange for children and young people to get to school and post-16 providers. It will be voluntary at first, but I hope local authorities will see the benefit of the data collection and share the requested data that they hold.

Another big issue that we know we must tackle is school absence. If children are not in school, they cannot benefit from their education. Thanks to the efforts of the sector, more children are in school in 2023-24 compared with the previous year, but 1.6 million children are still persistently absent, and that is a major challenge. We know that some children, particularly those with additional needs, face additional barriers to attendance, so we have to work to tackle those issues. We know that schools need to take a support-first approach and ensure that they have an attendance champion and policy and that they work with local authorities. Clearly, transport to school is a big part of that jigsaw.

Public transport clearly has an important role to play. Good local bus services are an essential part of thriving communities, providing access to education and other services. Outside of London, buses were deregulated in 1985. They now largely run on a commercial basis, and my hon. Friend the Member for North Northumberland pointed out some of the challenges that that can present. The Government have pledged to fix that, and the Bus Services Bill announced in the King’s Speech will put the power of local buses into the hands of local leaders. I know the North East Mayor Kim McGuinness is working to improve bus routes and has committed to repairing our broken bus system in the north-east.

I thank my hon. Friend the Member for Hexham again for bringing the matter forward and all those who have made contributions to the debate. It is an issue that many people rightly feel passionately about. I acknowledge the challenges that far too many families face when seeking to get the right support for their children. By fixing our broken SEND system, by transforming our education system so that more children can access an inclusive, high-quality education locally and by fixing our broken transport system, we can truly make this change.

17:27

[Joe Morris]

I thank the Minister for her response and thank her ministerial team, the other Ministers in her Department and the Secretary of State for their continued proactive engagement with me and other rural MPs. For the first time we have a Government that truly get the challenges of rural Britain, aided in no small part by the new Labour intake.

I do not want to finish the debate with a political point; I want to finish with the words of some of my constituents. One of my constituents wrote to me saying that she has a daughter who travels from Stocksfield to Prudhoe community high school, which is a wonderful school that I look forward to visiting. The only way to get there is to walk 2.9 miles along a busy road, and that would be unsafe. That was one of the many emails that led to me requesting this debate. The son of a constituent had to move school due to bullying and sadly does not qualify for school transport. That is the reason why I brought the debate: those stories that make up portions of my constituency surgeries that bring me here every day to fight the corner of my constituents.

I hope people across my constituency feel that we have given voice to their concerns. I hope those at County Hall who have the power to intervene or look again at certain cases are watching and take notice. It is a privilege to represent the people of the Hexham constituency, whether that is Throckley and Callerton, ably represented by my hon. Friend the Member for Newcastle upon Tyne North (Catherine McKinnell) for many years, or the Northumberland part.

I thank all Members from across the House for their contributions, particularly the hon. Member for Strangford (Jim Shannon), who sent me a wonderful note, and the hon. Member for Westmorland and Lonsdale (Tim Farron), who paid me a wonderful compliment by comparing me to the hon. Member for Strangford.

Question put and agreed to.

Resolved,

That this House has considered school transport in Northumberland.

17:29

Sitting adjourned.