Ambulance and Emergency Department Waiting Times

Duncan Baker Excerpts

Wednesday 6th July 2022 Westminster Hall

[Duncan Baker (North Norfolk) (Con)]

I thank the hon. Member for Bath (Wera Hobhouse) very much for obtaining this very important debate. The very first subject that I raised when I was a newly elected MP was the state of ambulance response times in North Norfolk. That is a particular worry for me, because up on the North Norfolk coast I have the oldest constituency demographic in the entire country, and Wells, a beautiful seaside village, has had the very dubious honour of consecutively having the worst response times. Over the last few years, whereas the category 1 responses have flatlined, the C2 and C3 response times have got worse. Constituents are coming to me almost every other day to tell me about the appalling situation that they have encountered in calling an ambulance. The worst cases are of people having strokes in the back of their car while family members are driving them to the hospital. When we hear those accounts, we get some sense of just how bad the picture is.

I agree with many of the comments made by the hon. Member, but we have to recognise that this is not a simple issue that can be solved with a single magic bullet, and it is certainly not all the fault of the ambulance service, which is working under extreme pressure. All our health systems at the moment are really buckling under the issues that have been caused by the pandemic. That is the case in social care systems, mental health care and dentistry. There are serious problems in all places at the moment.

Let us take the Norfolk and Norwich Hospital, which is my emergency department. It has the honour—I call it an honour; it is dreadful—of being the worst in the east of England. In the first 13 weeks of the year, 723 equivalent ambulance shifts were lost. The third worst performing facility for ambulance response times is the Queen Elizabeth Hospital, with 442 equivalent shifts lost. Both ED units that serve my constituency are in the top three worst facilities in the entire east of England. It is a huge problem, with hundreds upon hundreds of hours lost every single week when ambulances are queueing up outside a hospital because they cannot get patients out of the trucks and into the A&E department. Equally, the social care system is so poor that they cannot get people back into the community, with the respite that they need.

We know that there are serious issues about sickness; there are rising levels of covid. But there are other issues also. I am told that 50% of the calls that are made to the ambulance service in Norfolk are calls that simply should not have been made; they could have been for something that was not life-critical. That is coupled with ambulances pulled off the patch to go and service other areas; actually, there would be enough ambulances in North Norfolk if they were used within North Norfolk. That just adds to the problem.

However, the most pressing issue is the sheer numbers—the hundreds of hours lost every week from ambulances queueing up. The question is why, and it is a very easy answer: 95%-plus occupancy all the time is the problem. We simply cannot have the capacity in place. It is no good saying, “Well, if we just build a bigger hospital or build a bigger ED, that will solve the problem.” I do not think it will, because the problem is so multifaceted.

The hon. Member for Bath was right: transparency of data is incredibly important. But when we drill down into the information, we realise that all the issues that I have set out are working in tandem; they are all conspiring to cause the problem. In the last minute or so available to me, I want to ask what we do about it, and there are some practical suggestions that I want the Government to take really seriously.

First, the role of our community first responders should not be underestimated. We are not treating this problem seriously enough. Why on earth are we not paying community first responders, as is the case with the retained fire service? We are asking volunteers in our community, who have to be fit men and women and who, frankly, are probably not going to be people approaching their retirement age of nearly 70. Not enough people are going to be volunteering in our communities, and that is why we suffer with the numbers. If we really got some energy behind this in order to recruit these people, help them and make it economical for them to do it, we would see, I think, uptake of that. They are the first line of defence in helping to support people.

The second issue we should be looking at is rapid response vehicles. A rapid response vehicle was nearly taken away from North Norfolk, which was absolutely appalling. These vehicles offer far better economic value than ambulances. The clue is in the name—they are able to rapidly respond. They can be stationed virtually anywhere and help suffering patients while an ambulance gets to them. They are incredibly important in rural areas, so I ask the Minister to take those issues seriously.

Finally, I will be spending the first week of the forthcoming recess volunteering with the East of England Ambulance Service so that I can see at first hand the problems it faces. Those who work there are heroic people, but, my word, they need some help.

Draft Mental Health Bill

Duncan Baker Excerpts

Monday 27th June 2022 Commons Chamber

[Sajid Javid]

I agree with the hon. Gentleman about cultural change. Whether we are talking about teachers or healthcare professionals, we need to make sure they have a certain level of training on autism. I am sure he knows the NHS has started rolling out a type of mandatory training on autism, and I would be happy to meet him to discuss how we can go further in the light of that report.

[Duncan Baker (North Norfolk) (Con)]

This is an enormously welcome Bill, not least in my constituency, where I have campaigned endlessly for better mental health services and for a hub at our wonderful Cromer Hospital. As Norfolk has the slowest ambulance response times and the most mental health referrals in the UK, how can we access the £7 million-worth of specialist mental health ambulance services?

[Sajid Javid]

First, I commend my hon. Friend on the work he has done. I remember meeting him to discuss this important issue, and I welcome his support for the Bill. He may know that the extra support of around £150 million announced today includes £7 million of support for mental health ambulances.

Health and Social Care Leadership Review

Duncan Baker Excerpts

Wednesday 8th June 2022 Commons Chamber

[Sajid Javid]

It was precisely because of that important point raised by my hon. Friend that when we had the recent Bill before Parliament—now the Health and Care Act 2022, thanks to the will of this House—we accepted the safe space amendment.

[Duncan Baker (North Norfolk) (Con)]

I recognise the importance of leadership and reform of the NHS. Can we now show some leadership and reform in the area of NHS dentistry? The Labour Government wrecked NHS dentistry when they brought in the contracts that have led to dentists leaving the profession in droves. When people up and down the country, including my constituents in North Norfolk, cannot see an NHS dentist, is it not about time that we reformed the rotten contracts that Labour brought in?

[Sajid Javid]

My hon. Friend is right. It is well known how the Labour Government came up with contracts with the British Dental Association that are leading to poor outcomes for millions of people across the country. We have already made some short-term changes, and we are in the process, right now, of making some longer- term strategic changes that will create all the right incentives.

North East Ambulance Service

Duncan Baker Excerpts

Monday 23rd May 2022 Commons Chamber

[Maria Caulfield]

I am very sorry to hear that and I apologise to Mrs Brocklehurst. That is not an acceptable event to have happened, and I can only imagine the pain that she was going through. I am very happy to meet him and his constituent to discuss that further because, obviously, that wait should not have happened.

[Duncan Baker (North Norfolk) (Con)]

I have tirelessly raised the issue of North Norfolk ambulance response times over and over again in this place, and there is absolutely no sign of them improving. Wells-next-the-Sea has the record of the worst response times in the entire country, which, given the elderly demographic and high number of tourists there, is not good enough. I am trying to be practical: why can the Government not fund a national programme and recruitment drive of community first responders to really help and assist our paramedics, who are completely beleaguered? Will the Minister please take that away as a serious consideration, because we cannot keep going on as we are?

[Maria Caulfield]

First responders do have an important role but they are not a substitute for paramedics. We have 3,000 paramedic graduates trained nationally per annum and we have increased our ambulance and support staff by 38%, so we are making that investment in the ambulance service.

Childhood Cancer Outcomes

Duncan Baker Excerpts

Tuesday 26th April 2022 Commons Chamber

[Duncan Baker (North Norfolk) (Con)]

A huge thank you to my hon. Friend the Member for Gosport (Dame Caroline Dinenage) for securing this debate. It is such an important debate and, as she said in her opening remarks, the number of young children who suffer with cancer is truly, truly dreadful.

This is a very important debate to me from a personal point of view, because I have friends—not just constituents, but friends—who lost a son to cancer in the last couple of years. I have spoken about Kevin and Julie Pitcher before. Their son, Benny Pitcher, lost his battle with cancer after a long and very courageous fight in my constituency. Some will remember that he was only six years old. What makes that even more pertinent for me is that I have a six-year-old as well. I can still recall, as Benny journeyed from his home to his final resting place, people lining the streets and his small coffin as it made its way past mourners. I can say, Mr Speaker, that I do not think I will ever, ever witness grief quite like that in my community.

Benny’s cancer was an aggressive type of childhood cancer that forms in the brainstem, called diffuse intrinsic pontine glioma. At present, there is still a 0% chance of fighting that cancer and being able to survive. In over 50 years, we have made little progress in changing that. I find that just astonishing. If we can find a cure for covid-19 within nine months, why on earth have we not improved the life chances of children with childhood cancers in 50 years? Cancer continues to be the leading cause of death by disease in young children and young people. It is clear from every speech we have heard today that more must be done. It is essential that we drive more research into the biology of cancers if we are to stand any chance whatever of eradicating them.

I want to sum up by making a very important point about the families of young children who suffer with cancer. We have heard a lot today about those families having a proper emotional support network around them. Kevin, Benny’s father, is an inspiration to all those who meet him in North Norfolk. He alone has raised thousands upon thousands of pounds for children’s charities, so that other parents do not have to suffer quite as much as the Pitcher family did. Together, we are in the process of setting up a charity called Benny’s Battalion to help those families. I want to say on the record today that Benny’s name and his memory will never die—far from it. It is on days like this that it lives on.

Queen Elizabeth Hospital, King’s Lynn

Duncan Baker Excerpts

Wednesday 23rd March 2022 Westminster Hall

[James Wild (North West Norfolk) (Con)]

I beg to move,

That this House has considered quality of care and the estate at the Queen Elizabeth Hospital, King’s Lynn.

It is a pleasure to serve under your chairmanship, Mr Hosie. I am grateful to Mr Speaker for granting this important debate, which gives me the opportunity to highlight the significant improvements at Queen Elizabeth Hospital, while once again making the compelling case for it to be one of the new hospital schemes that the Government have committed to building. I also want to recognise the close interest that my hon. Friend the Minister has taken in QEH and to thank him for the many meetings and discussions we have had about it so far. Of course, I also encourage him to back the bid.

QEH serves 330,000 people across Norfolk, Lincolnshire and Cambridgeshire, providing a comprehensive range of specialist, acute and community-based services. It is a busy hospital, with 55,000 in-patient admissions, a quarter of a million out-patient appointments and 70,000 emergency department admissions last year. However, QEH has suffered from poor Care Quality Commission ratings and an historic lack of investment, and has therefore been in special measures for some time. However, under the leadership of Caroline Shaw, the chief executive, and the chairman, Steve Barnett—who is moving on shortly, having done a lot of good work—things have changed.

In the last three years, there have been significant improvements in care. However, you do not have to take my word for it, Mr Hosie; that was the verdict of the CQC’s report a month ago. The core services it inspected—medicine, urgent and emergency care, and critical care—were all rated good overall. Indeed, critical care was recognised as having outstanding elements in many areas. That means that QEH is now rated good in three domains: caring, well led and effective. The CQC found that

“Staff provided good care and treatment…treated patients with compassion and kindness, respected their privacy and dignity, took account of…individual needs…and made it easy for people to give feedback.”

The report shows how far QEH has come. As a result, the Care Quality Commission’s chief inspector of hospitals has recommended that QEH come out of special measures, which is very welcome for the area.

It is frankly remarkable that all this has been achieved during a period when covid posed such huge challenges to QEH and other hospitals, and to other parts of the health and social care sector. This has not happened by luck; it is due to the leadership, hard work and commitment of all the staff at QEH. I have seen that dedication at first hand when I have met doctors, nurses, the infection control teams, the porters and all the others who make up the hospital during my regular visits. I commend them for all that they have achieved in the report. As the CQC said, staff were

“passionate about…providing the best possible care for patients”,

and leaders understood

“the priorities and issues the trust faced”

and were

“visible and approachable…for patients and staff.”

Clearly further improvements are required, as the hospital recognises, but it is important that we acknowledge the huge step forward that has been taken, as reflected in the report.

Those improvements have been made despite the decaying and ageing buildings that staff and patients have to experience and operate in. As my hon. Friend the Minister knows, QEH is one of the best-buy hospitals and has major issues with reinforced autoclaved aerated concrete planks—which I think we should refer to as RAAC planks for the rest of the debate—which are structurally deficient. The hospital was built with a 30-year design life, but it is now in its 42nd year. Some 79% of hospital estate buildings have RAAC planks, and I am sorry to say that it is the most propped hospital in the country, with 470 steel and timber supports across 56 parts of the hospital.

Being in a ward or another part of the hospital, surrounded by props holding up the roof, is a poor experience for patients. It makes it harder for staff to care for them. It is not something that we should accept, and we do not. This is a serious situation, and the trust’s risk register has a red rating for direct risk to life and the safety of patients, visitors and staff, due to the potentially catastrophic risk of failure of the roof structure. Last year, the critical care unit had to close for some weeks due to precisely those safety issues. The urgent need for a new hospital, and the strength of that case, is underlined by the fact that over a third of all reported RAAC issues in the east of England were at QEH in the last year.

I know that my hon. Friend recognises the seriousness of the situation, and the £20.6 million of emergency capital funding that he approved last year is very welcome. That is making a difference: a new endoscopy unit is taking shape to modernise facilities, and to create space to enable installation of fail-safe roof supports. In addition, there is £3 million of funding for a west Norfolk eye centre, which along with other projects, including digital, means that QEH is currently delivering a more than £30 million capital programme.

[Duncan Baker (North Norfolk) (Con)]

I thank my hon. Friend for giving way and for securing this incredibly important debate. It is a very poor situation to have a hospital in Norfolk in this position, when it clearly needs a rebuild. I thank my hon. Friend for everything he has done; we would not be in this position without his tireless work to raise this matter with the Secretary of State. May I raise one point? We have three hospitals in Norfolk. We want a new hospital at QEH. That will benefit not just his constituents, but those all over Norfolk, particularly in my constituency of North Norfolk, who will also use its fantastic services when it is rebuilt.

[James Wild]

I am grateful to my hon. Friend for his support and words. He is absolutely right; I think his constituency has the oldest average age in the country, and that poses particular needs. My constituency and that of my hon. Friend the Member for Broadland (Jerome Mayhew), who has joined to support the debate, also have challenges, so we need to ensure that the care is in place. There is also a lot of planned housing growth in the area. The demand is strong across our constituencies, and in Lincolnshire and Cambridgeshire, which is why it is important to show the strength of support for the hospital across Norfolk and beyond.

When compared with the turnover, the level of capital programme is significant, and it is important to acknowledge that the programme is being managed well. QEH has submitted a further bid for £18 million for an orthopaedic centre, as part of the funding to tackle the backlog. Given that it is the area with one of the longest waiting lists for QEH, I strongly endorse that bid, and encourage the Minister to approve it when it comes to his desk. Seeing is believing. When the Secretary of State visits QEH—which he has agreed to and I hope will happen soon—he will see those improvements, but he will also see the props and the very real need for investment. My hon. Friend the Member for North Norfolk (Duncan Baker) will be able to join him on that occasion or another, as he will be very welcome.

As well as the structural issues, the hospital has outgrown its footprint. The emergency department sees 70,000 patients a year—more than double what it was designed for. The layout of the hospital does not meet modern care pathways, with too few consulting rooms, and wards well below the recommended size.

--- Later in debate ---

[Edward Argar]

As my hon. Friend knows, each region will feed in its views about which of the schemes and bids in its area are the highest priority. Without prejudging that assessment process, I hope I can reassure him that one factor that I know he considers to be of significant importance—RAAC—will be considered. Patient safety and the safety of the buildings will be a factor in the analysis of which bids should go forward to the long list, but I do not want to go further than that at this point, however much he may charmingly seek to tempt me to do so.

Elective recovery is an area of real focus for the Department and for the whole Government, and I am aware that covid-19 has placed an unprecedented strain on routine and planned care, with waiting lists in England reaching a record high, at just over 6 million in January 2022. I understand that 19,366 of those patients are waiting for treatment at the Queen Elizabeth Hospital.

In February, the NHS published the “Delivery plan for tackling the COVID-19 backlog of elective care”, which set out a clear vision for how the NHS will recover and expand elective services over the next three years. That delivery plan commits to eradicate waits of longer than a year for elective care by March 2025. Within that, by July 2022, no one will wait longer than two years, and we will aim to eliminate waits of over 18 months by April 2023 and of over 65 weeks by March 2024.

To support elective recovery specifically, the Department plans to spend more than £8 billion from 2022-23 to 2024-25, in addition to the £2 billion elective recovery fund and £700 million targeted investment fund already made available this year to help drive up and protect elective activity. Taken together, this funding could deliver the equivalent of around 9 million more checks, scans and procedures, and will mean that the NHS in England can aim to deliver around 30% more elective activity by 2024-25 than it was delivering before the pandemic.

In highlighting the extra resources that we are putting into our NHS, it is vital to understand that this is not about the inputs; it is about the outcomes for patients and how those resources are used wisely to deliver improved patient outcomes and improved experiences for patients, with shorter waits. With regard to what is needed to achieve those outcomes, a significant part of that funding will be invested in staff, in terms of both capacity and skills.

I understand that an orthopaedic unit bid for about £18 million has been submitted by my hon. Friend’s local hospital trust. That is in the context of the £5.9 billion elective recovery funding, and the £1.5 billion from that for capacity and social hub improvements. Those bids will be carefully considered. They will need to meet the recommendations arising from the pilots that took place in London and the getting it right first time review, but I certainly look forward to considering the bid from my hon. Friend’s trust in due course.

[Duncan Baker]

Does the Minister know that the Queen Elizabeth Hospital was named after the Queen Mother? As it is Queen Elizabeth’s platinum jubilee this year, does he agree that it would be a fitting tribute to give the green light to rebuilding a hospital that is named after her mother?

[Edward Argar]

My hon. Friend is even more dextrous than our hon. Friend the Member for North West Norfolk in seeking to tempt me into an indiscretion or a prejudgment of the application process and consideration. I hear what he says and he makes his point eloquently, but I will not be drawn while that analysis and assessment of the bids is under way.

Ambulance services, like other emergency care services in the NHS, have come under significant pressure, as hon. Members will know. In February 2022, the service answered over 764,000 calls to 999—an increase of 13% on the number of calls in the same month before the pandemic. High levels of demand on the emergency care system, alongside the need for infection prevention and control measures, has resulted in higher instances of delays in the handover of ambulance patients to A&E in some areas.

I reassure hon. Members that significant support is in place for acute trusts, to help address handover delays. NHS England and Improvement and its regional teams are working with local systems—in this case, with the Queen Elizabeth Hospital in the constituency of my hon. Friend the Member for North West Norfolk—to improve their patient handover processes, helping ambulances get swiftly back on the road. Ministers are in regular contact with NHSEI on the performance of the emergency care system, including the ambulance service and accident and emergency departments.

In conclusion, I once again pay tribute to my hon. Friend the Member for North West Norfolk and all my hon. Friends who have spoken in this brief but very important debate for the work that they are doing to champion the Queen Elizabeth Hospital, King’s Lynn. As I say, his constituents are incredibly lucky to have such a champion of their cause, of healthcare in his constituency, and of investment in his local hospital, and I look forward to continuing working with him to ensure that the quality of healthcare his constituents receive is the best the NHS can provide. I note his very kind offer, which has been reiterated to me, to visit him in sunny Norfolk—as I suspect it will be in the coming months—to see his local hospital. If I am able to do so, I will be delighted to visit.

Question put and agreed to.

Access to NHS Dentistry

Duncan Baker Excerpts

Thursday 10th February 2022 Westminster Hall

[Peter Aldous]

I am very grateful that the hon. Gentleman intervened on me, because Birmingham is the model of how to do this. As a Birmingham MP, it is right that he highlights that, and I thank him for it.

[Duncan Baker (North Norfolk) (Con)]

As I will set out in my speech, my father was an NHS dentist for 23 years. He trained a long time ago in Manchester, and he told me that the advent of sugary foods and drinks had had an enormously detrimental effect on children’s teeth over the years. The one thing we can do to solve that problem is fluoridation of our waterstream. It has made such a difference, and I thank the hon. Member for Birmingham, Perry Barr (Mr Mahmood) for raising that point.

[Peter Aldous]

I am grateful to my hon. Friend for re-emphasising that.

--- Later in debate ---

[Duncan Baker (North Norfolk) (Con)]

I echo other hon. Members in thanking my hon. Friend the Member for Waveney (Peter Aldous) and the hon. Member for Bradford South (Judith Cummins) for bringing this debate forward. My hon. Friend is a good friend and has been a real champion in bringing these debates to this Chamber and other places on many occasions, and I thank him for all the work he has done.

As I said in my intervention, I might have a bit of a vested interest in this topic given that my father was an NHS dentist for 34 years. As a retired dentist, he is probably sitting at home with a cup of tea watching this debate, so I shall try to say some nice things about him. He worked in the constituency of my hon. Friend the Member for Broadland (Jerome Mayhew), who is my neighbour in north Norfolk. The facts from when he retired 10 years ago are still prevalent today. In fact, it is arguable that the problems he encountered back then are now even worse. That is a sad state of affairs.

It is fair to say that we have a crisis in dentistry—-we certainly do in my constituency. Not a week goes by when I do not receive casework from people who are in pain or who simply cannot get an appointment with an NHS dentist and cannot afford to go private.

There are acute problems in certain parts of the country. We have heard from hon. Members from all over the country today, but the south-west and East Anglia are well known to have some of the worst problems. The fact is, we simply cannot get dentists to come and work in some of these rural locations.

The Minister wants to have answers, not always problem, and I would echo my hon. Friend the Member for North West Norfolk (James Wild), who said that a dental training college in our part of the country would be very worth while. Alongside the Norwich Medical School, such a college would create jobs and opportunities and filter those into our part of the country. There is nowhere in the east of England to train dentists at the moment. We are crying out for some kind of provision to help us. Why can we not make it a requirement for newly qualified NHS dentists to have to do a year of training in an area of high need before they pass with flying colours?

I also echo what was said by my hon. Friend the Member for South West Bedfordshire (Andrew Selous). He is absolutely right: it is not simply that we cannot get dentists into the country or that we are not training enough. Many will call for dentists to be trained or imported from other countries to ease the crisis, but the truth is that we do not simply have a shortage. Of course, we can make it easier for dentists coming across from India to have their qualifications recognised so that they can perform their work straightaway. We do need to streamline that process. However, that is not at the heart of the issue.

The simple facts are that the General Dental Council found that almost 2,000 more dentists are registered now than in 2018. The problem is that those dentists—just like my father, who retired 10 years ago—have simply had enough and do not want to work in the NHS any more. We have to establish why that is and address that as a key problem.

Of course, we could talk about many different areas. My hon. Friend the Member for Waveney listed five, and I will not go over those again. I will focus on one issue that we have heard a lot about today. I am not going to apologise for calling it the dreadful UDA contract. It was bad a decade ago and it is still bad today.

Almost 1,000 dentists quit the NHS in the last year alone, and the motivation to do so, as has been said, is not purely financial. Those dentists, like my father, are doctors; they care about patients’ health. They want to spend time with their patients and treat them properly. The bureaucracy of getting points for giving out prizes is not the right way to deal with people. Dentists are not being treated with care. They do not want to be chasing these dental activity targets—that is highly stressful and demoralising. The delays in the contract reforms are leading to their motivation plummeting and going through the floor. That is why they are turning away. The lack of urgency in helping them is the real root cause of the problem.

Let me put that into some kind of context. In the Norfolk and Waveney CCG area, which also covers the constituency of my hon. Friend the Member for Waveney, we lost 40 NHS dentists between 2018-19 and 2020-21—a 9% drop in just two years. If we carry on at that rate, we will be in an absolutely shocking predicament. We therefore need to make a decision, and I heard what my hon. Friend the Member for North East Bedfordshire (Richard Fuller) said earlier. However, NHS dentistry is not free—that is a myth. We need to make a decision: either we will continue with this decline, effectively privatising dentistry and sending it down the opticians route, or we need to urgently get on and reform the dentistry provisions in the contracts we keep talking about. There is a simple reason why: we cannot do this to our children, our elderly, our vulnerable and people on low incomes. They are the ones who need access to good dentistry, and it is not acceptable in the 21st century, and in a modern country, that they cannot get help and support from this service.

Less than 25% of children in Norfolk saw an NHS dentist in the year to June 2021, and that is significantly lower than the national average of 33%. Imagine if it was your child who had excruciating pain and could not get to see a dentist. That goes back to what I said earlier: this is a particular problem in East Anglia.

I know that the Minister is keen on reforming the system and that negotiations are under way, but I urge her to grab this issue with huge vigour. The number of Members sitting here this afternoon—on a Thursday, and when we are waiting to get away for the recess—shows just how important this is for so many of our constituents up and down the country.

--- Later in debate ---

[Duncan Baker]

And a good golf course.

[Jerome Mayhew]

It also has a good golf course—I thank my hon. Friend and neighbour. It is genuinely a really gorgeous town, so why is it that it cannot attract anyone to take on the NHS dentistry contract that is available? As my hon. Friends have pointed out, one of the reasons is that we have no training facility—not just in Norfolk or Suffolk, or even in Cambridgeshire or Bedfordshire; the nearest is in London. People have to go up to Birmingham or to London.

When we are trying to persuade young dentists to set out on their professional life in a certain place, moving to a rural or small town is not automatically attractive to them. We have to encourage people via training, and we know from our experience with the medical provision at the University of East Anglia and the Norfolk medical training in Norwich that someone is much more likely to stick around afterwards in the place where they train, because they have established relationships, they have contacts in the community—and, frankly, they know what great places Fakenham and other parts of Broadland are. One of the primary reasons I wanted to speak today was to encourage the Minister to consider the provision of a dental training facility in the east of England.

I will leave it to others who are much more professional than I am to comment on how we properly reform the 2006 NHS contract, save for saying that we need to treat dentists with respect. It is not all about money; it is about how we treat people. And please can we have some training in Norfolk?

Elective Care Recovery in England

Duncan Baker Excerpts

Monday 7th February 2022 Commons Chamber

[Edward Argar]

My hon. Friend is exactly right in what she says. The whole purpose of these community diagnostic hubs is to bring cutting-edge diagnostic facilities to the heart of our towns, our rural communities, our seaside communities and our cities to make it much easier for people to access the diagnostic tests they need.

[Duncan Baker (North Norfolk) (Con)]

Cromer Hospital is the jewel in the crown of our hospital facilities in North Norfolk, but as my hon. Friend will know, it is 25 miles from the nearest main hospital, the Norfolk and Norwich, and I have many older residents. Will he meet me to discuss the viability of an urgent treatment centre? That would not only be a huge benefit to my demographic, but would go hand in hand with tackling the elective backlog.

Alcohol Harm

Duncan Baker Excerpts

Thursday 25th November 2021 Commons Chamber

[Duncan Baker (North Norfolk) (Con)]

I am honoured to make a contribution to the debate. In particular, I thank the hon. Member for Liverpool, Walton (Dan Carden), who cannot be here and of whom we will be thinking, and my hon. Friend the Member for St Ives (Derek Thomas) for helping to bring the debate to the House.

Before I go any further, let me say that the previous speech was probably one of the most moving contributions I have heard in the House. I say to the right hon. Member for Birmingham, Hodge Hill (Liam Byrne) that his father would be immensely proud of what he has said this afternoon. I commend the bravery with which he stood up and spoke movingly about his personal experiences. Even though I do not know him, I am incredibly moved to have heard what he said, and I thank him.

The World Health Organisation estimates that, every year, some 3 million people around the world die due to the harmful use of alcohol. That accounts for a staggering 5.3% of all deaths. In England and Wales alone, there were 7,423 alcohol-related deaths in 2020, which, shockingly, was a rise of 19.6% from 2019. Based on those statistics, it is absolutely the case that alcohol remains an alarming and clear problem, not just around the world but in this country.

As we have heard, alcohol misuse can have many effects, from causing death and disability to fostering and exacerbating mental health and behavioural disorders. Health consequences aside, its harmful use can bring with it many socioeconomic losses to individuals and wider society. It is therefore paramount that we address alcohol misuse and work collaboratively to mitigate that sad and perennial problem in our society.

Tackling alcohol misuse will require a multi-pronged approach and an essential part of that is investing in programmes that address alcohol harm. I know that the Government continue to work on that and I am sure that we will hear more about that from the Minister. We must invest in bodies such as NHS England and Improvement, whose programmes have a long history and a deep understanding of how to help with the issue.

In my research for the debate, I was pleased to learn that £27 million has been invested to establish alcohol harm teams in hospitals that will provide specialist support where needed; that £80 million has been allocated for substance-misuse treatment in 2021-22; and that there is a further £90 million for medically managed in-patient detoxification units. That spending will come in, in addition to local authorities’ funding for substance misuse treatment, through the public health grant. From what we have heard, that is welcome. More must be done, but things are being done.

I am a firm believer that through investing in such programmes, alongside strengthening the capacity for local authorities to help to co-ordinate community action and bring knowledge and expertise to the table, we can begin to make a difference. I do not think there is a quick fix or single solution to something that is very damaging for society, but we want the Government to take more approaches to deal seriously with the issue. They are taking action, engaging with campaign groups, and investing in services and communities, which is the only way really to begin to target the harmful effects of alcohol misuse.

Health and Care Bill

Duncan Baker Excerpts

Report stage
Tuesday 23rd November 2021 Commons Chamber

[Peter Dowd (Bootle) (Lab)]

Yesterday, regrettably, the Minister did not respond to my exhortations on self-care in his summing up, although to be fair it did not take Sherlock Holmes to work out that he had his mind occupied with more contentious issues. New clause 13 gives him the opportunity to formalise the role of self-care by introducing a national self-care strategy that is more than just a footnote or passing reference in the NHS plan. The new clause would ensure that the Secretary of State for Health and Social Care publishes a national care strategy, to integrate self-care for minor ailments into the national health system. Surveys by the Proprietary Association of Great Britain have shown that people have been more amenable to seeking health advice that is outwith the GP practice, the walk-in centre or accident and emergency. Why not build upon that behavioural change? As shown during the pandemic, self-care is a crucial element of our healthcare system and it reduces the strain on GPs and A&E, so that those with more serious conditions can be treated with greater efficiency.

As the NHS seeks to recover from the most recent waves of the pandemic, there will be a unique opportunity to integrate self-care behaviours into the NHS and people’s lives. So by developing and implementing a national care strategy, the Government can ensure that a vision for self-care is realised whereby individuals understand and are willing to practise self-care, knowing how to take care of themselves and where to go when they are feeling unwell. The system will also be supportive of self-care, with pharmacy being much more embedded into the primary care pathway. What is there not to like in this new clause?

Finally, may I mention new clause 18, on the Secretary of State’s duty to report on access to NHS dentistry and to which I am a signatory. Dentistry is a vital component in people’s health. It is not just about teeth; it is about overall health. It can be the first port of call for many people whose symptoms may appear to be related to their teeth but may in fact be symptomatic of another disease, such as oral cancer. So let us make sure that dentistry gets the recognition it deserve—

[Duncan Baker (North Norfolk) (Con)]

Will the hon. Gentleman give way?

[Peter Dowd]

I am afraid that I do not have time. Let the Secretary of State report on access to NHS dentistry and give it a seat at the table on integrated care boards and partnerships, along with other health professionals. In conclusion, these proposals are about a comprehensive national care strategy that will help both patients and the NHS, and giving dentistry the attention that it deserves. Those are the areas we need to focus our attention on. They need a bit of tender loving care.