NHS Dentistry: South-west

Debate between Caroline Johnson and Stephen Kinnock

Tuesday 12th November 2024 Westminster Hall

[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.

Children’s Hospices: Funding

Debate between Caroline Johnson and Stephen Kinnock

Wednesday 30th October 2024 Westminster Hall

[Stephen Kinnock]

The right hon. Lady is absolutely right: funding that is earmarked for palliative care must go to palliative care. There is statutory guidance from the NHS, and it is vital that we continue to liaise with ICBs from the centre, to ensure that the allocated funding goes where it needs to go. If she is aware of cases in which that funding is not going where it should go, she should make representations; I am happy to receive a letter from her on the issue.

The amount of funding that each charitable hospice receives varies both within and between ICB areas. That funding will vary depending on demand in an ICB area, but will also depend on the totality and type of palliative and end of life care provision from both NHS and non-NHS services, including charitable hospices, in each ICB area. There are inequalities in access to hospice services, especially for those living in rural or socio- economically deprived areas. That is why including hospices as part of a system-wide approach is so important.

I understand that charitable hospices value their independence and autonomy, which allow them the freedom to provide services beyond the statutory offer, which is one of the wonderful parts of hospice care. That independence also gives a sense of shared purpose, in which the community cares for the hospice, and in turn the hospice cares for the community and is something to be cherished. That is indicative of the compassion that is found in hospices and communities all over the country.

In addition to ICB funding, at a national level, NHS England has supported palliative and end of life care for children and young people through the children and young people’s hospice grant, totalling £25 million in ’23-24. While ’23-24 marked the final year of the grant in its previous format, in ’24-25 NHS England continued to provide £25 million of funding for children and young people’s hospices. A prevalence-based model is used for that funding, which supports the move away from a traditional model of bed-based funding, better reflecting population needs. In ’24-25, that funding was transacted by ICBs on behalf of NHS England for the first time, rather than being centrally administered. I am aware that the shift to an ICB-transacted model for ’24-25 has not been as smooth a transition as we in the Department certainly would have hoped. We are working closely with NHS England to resolve any remaining issues with the ’24-25 funding, and to learn from what did not work so well this year.

We, alongside NHS England, absolutely recognise the importance of sustainable funding for the palliative and end of life care sector, including hospices, and we will consider the future of children’s hospice funding in the context of Budget discussions. I have absolutely heard the representations by hon. Members on both sides of the Chamber today about the need for the Government to maintain the £25-million grant, and I assure hon. Members that I am working very closely with NHS England to get that confirmed as a matter of urgency.

[Dr Johnson]

The Minister talked about maintaining the grant, but does he recognise that many hon. Members have also raised the increasing costs that hospices are facing? Will he look to not just maintain the grant but increase it?

[Stephen Kinnock]

We are certainly looking at all those issues in the round, including ensuring that the grant is sustainable and that there is a real-terms financial input to the system. We are working on that as a matter of urgency. I totally recognise and understand why the sector needs certainty and stability; it is very difficult for hospices not to be sure what is happening after this in-year position.

The 2010s were a lost decade for our health and care services, which now too often are not there when we need them. That is also true for hospice care, where we see a postcode lottery for services across the country and variation in quality and access. Hon. Members will know that we have committed to developing a 10-year plan to deliver an NHS and care system that is fit for the future, by driving three shifts in the way that care and health services are delivered.

We will be carefully considering policies, including those that impact children with palliative and end of life care needs, with input from the public, patients, health staff and our stakeholders as we develop the plan over the coming months. That engagement process was formally launched last week, and I strongly encourage the sector, including hospice providers, service providers and their families, and indeed every parliamentarian in this Chamber, to engage with that process: please go on to change.nhs.uk and make your voice heard. That will allow us to fully understand what is not working as well as it should, what the solutions are, and where the opportunities are for the future.

One of the three strategic shifts that our 10-year health plan will deliver is the Government’s determination to shift more healthcare out of hospitals and into the community. Community health teams play a vital role in supporting children and young people with complex health and care needs to live as well as possible, providing proactive care and preventing exacerbations and hospital admissions where possible. That shift from hospital to community includes our commitment to roll out neighbourhood health services to ensure that patients and their families receive personalised care in the most appropriate setting in their community, and indeed as close as possible to home. Palliative and end of life care services, including hospices, will have a major role to play in the fundamental shift from hospital to community, and in shaping that shift.

Additionally, the Department, through the National Institute for Health and Care Research, is investing £3 million in a new policy research unit in palliative and end of life care. That unit launched in January 2024 and will build the evidence base on all-age palliative and end of life care, with a specific focus on inequalities. In closing, I thank once again the hon. Member for Liverpool West Derby for securing this vital debate on children’s hospice funding. I again express my heartfelt thanks to all those who support children, young people and their loved ones when they need them most.