Oral Answers to Questions

Jim Shannon Excerpts

Tuesday 15th October 2024 Commons Chamber

[Stephen Kinnock]

My hon. Friend is right. South Yorkshire has the highest level of hospital tooth extractions in England, and I want to assure him that we will target interventions at the areas of greatest need. For example, integrated care boards have started to advertise roles through our “golden hello” scheme, which will drive recruitment of graduate dentists to areas of greatest need for three years. We have inherited a mess and we are working at pace to clear it up.

[Jim Shannon (Strangford) (DUP)]

The Minister is right to underline the issues for children, but can I remind him of the issues for those above the state pension age—which is increasing to 67, including for ladies—in particular when it comes to certain benefits, such as attendance allowance? Will he look at the contract for those who are elderly and in receipt of such benefits?

[Stephen Kinnock]

We are in a situation where a staggering 28% of the country—13 million people—have a need that is unmet by NHS dentistry. There are so many issues that we need to resolve. We are looking at the contract with the BDA and I am more than happy to look into the issue raised by the hon. Gentleman.

Sepsis Awareness

Jim Shannon Excerpts

Wednesday 9th October 2024 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

First, I thank the hon. Member for Ashfield (Lee Anderson) for raising this issue. He and I spoke this week, and his perseverance and hard work have given us a chance to make a contribution. I also commend Abbi for coming here today and for giving her personal story, which the hon. Member for Ashfield referred to. I salute her courage and bravery through all these hard times, as well as her wonderful smile, which the hon. Member for South Basildon and East Thurrock (James McMurdock) mentioned.

As the DUP’s health spokesperson, I add my voice to those of other hon. Members to raise awareness of sepsis. With superior hygiene and antibiotics available on tap, we have a tendency to think that sepsis is a disease of the past, when it clearly is not. The sad fact is that, during this one-hour debate, five people in the UK will lose their lives. This debate is to hammer home the need for people to be aware of the signs of sepsis.

My dad had sepsis in hospital a long time ago. It was a minor case, with the advantage that he healed quickly. He was right there in the hospital where the nurses were and the reaction was immediate to ensure that he survived.

Most parents are aware of the glass test for meningitis, which has been hammered home on multiple occasions. However, when I did a quick survey of my office staff—three of the five are parents and one had training from St John Ambulance—it shocked me that the only person who knew what sepsis was was the St John Ambulance volunteer; the others talked about extremities turning black, which is almost end-stage sepsis. We need to be aware of the symptoms before that, and that quick survey has pushed me into thinking that there needs to be more awareness among parents and communities as a whole. I know that the Minister will try to respond—he always does and he is assiduous in what he does.

The charity Sepsis NI said that we currently have no recovery protocols in place in Northern Ireland for sepsis, although that is not just a problem in Northern Ireland. When patients leave hospital, the fact that they may have been treated and survived does not mean that they are in any way better; in fact, most are still seriously ill and need both physical and psychological help. We still need to work on a GP and hospital after-care plan, and I hope the Minister will share some of his ideas with the Assembly back home. The situation must change, and we need a UK-wide strategy to deal with this issue across the UK.

Lastly, this statistic is a good one to put on record: the best guess for Northern Ireland is that 7,020 people will be affected by sepsis this year and 1,240 will die. If those facts do not scare us, they need to. People need to be aware of the symptoms: the fast breathing, dizziness, pale and mottled skin, high temperature and cold body. We all need to be able to call those to mind as quickly as we do with other major killers, such as meningitis.

This debate is a good step in raising awareness. I very much support my colleagues in asking for more to be done centrally, using a co-ordinated approach to raise awareness UK-wide of the killer that is sepsis. I again thank the hon. Member for Ashfield.

Maternity Services: Gloucestershire

Jim Shannon Excerpts

Wednesday 9th October 2024 Westminster Hall

[Max Wilkinson (Cheltenham) (LD)]

I beg to move,

That this House has considered maternity services in Gloucestershire.

It is a pleasure to serve under your chairmanship, Sir Christopher. The hon. Member for North Cotswolds (Sir Geoffrey Clifton-Brown) sends his apologies; he was due to be here but he is counting the votes somewhere else at the moment in an important internal election. He wanted me to start by saying that he gives his full support to the comments that I and others will make in support of maternity services in Gloucestershire, so I hope Hansard reflects that.

It is not controversial to say that NHS services across the country are struggling. One of the services that impacts all of us at least once in our lives is maternity care. This service is at the heart of women’s healthcare; it must be treated with the utmost seriousness. Pregnancy and childbirth is a special moment for families. It is a memory I cherish—obviously I was not pregnant myself. It is something to be cherished by all. But for pregnant women it can also be an extremely stressful experience. If there are failures in the system, the consequences can be dire.

Some of those consequences were laid bare in the recent “Panorama” documentary on maternity services in Gloucestershire. In that documentary we heard too many harrowing stories. Brave whistleblowers from within the system and brave mothers told their stories—one brave father told a story too. Those stories were told in the most heartbreaking terms, and will stick with me for as long as I live. Gloucestershire Hospitals NHS foundation trust apologised for those failings. It has invested in increased staffing, worked to reduce staff turnover and has made changes to leadership in maternity care. But so much more needs to be done.

The service at Gloucestershire Royal hospital was rated inadequate in 2022 and again in 2023. The findings of a further inspection earlier this year are still awaited, but a section 31 safety enforcement notice was served in May. Cheltenham’s midwife-led Aveta birth unit serves a large chunk of our county. It was closed for births in autumn 2022, some time before six of our county’s seven Members of Parliament were elected. The closure was due to a shortage of midwives. The reorganisation by the hospital’s trust was carried out to ensure that one-to-one care across Gloucestershire’s wider maternity services could be achieved. It is an entirely understandable response; nobody would want to put mothers and babies at risk.

We were told, however, that the measures were temporary. Two years down the line they are still in place, and that is not an acceptable situation for people in our county. The NHS hospital trust suggests that the Cheltenham Aveta centre will not re-open for births before April 2025. Even then, nothing seems certain. The trust states that it is committed to reopening the centre when it is safe to do so. However, the byzantine way in which the NHS sometimes works means that it is difficult to work out who will be the ultimate decision maker. Sometimes decisions on resources are made by the integrated care board rather than hospital trust staff, and that collaborative process makes it difficult to work out who must be held to account for statements that have been made in the past.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Gentleman on securing this debate. Everyone in this room will be very aware that the difficulties in Gloucestershire are unfortunately replicated in every part of the United Kingdom—certainly in my part of it. We have some of the best staff in the world in our maternity wards, and we rightly recognise the good work that they do, but they are being hampered in doing their job and caring by understaffing, budgetary restraints and an inability to get support from senior staff. I believe this needs a root-and-branch change across all the United Kingdom. Would the hon. Gentleman agree with that?

[Max Wilkinson]

I would. The hon. Member makes a strong case, and I will come on to some of the evidence from the Royal College of Midwives later. It has done some important studies into the stress that midwives are put under in the system.

I will move on to Stroud—the hon. Member for Stroud (Dr Opher) is in his place. In Stroud, six post-natal beds were closed around the same time as the closure to new births at the Cheltenham Aveta centre. The reason given by the trust was that the temporary closure would consolidate staffing across the county and provide a safer level of care for births across the whole of Gloucestershire. I am certain the hon. Member will have more to say on this if he is called to speak later, and I am pleased to see him here.

In our county, the 6,000 families who rely on our maternity services each year view this as a significant downgrade in service, and it is a cause of worry for a large number of families. It is clear that these services can only reopen when staffing levels improve. At the moment, the trust says it is around 13% below the staffing level required to return to the previous level of service, with Cheltenham open and the beds reopened in Stroud. However, the nature of midwifery means that quite a lot of the midwives will be off on maternity leave themselves at any one time. Indeed, I will come on to talk about the stress that midwives are under and some of its causes, which have led to a larger proportion of midwives being off for a significant period of time each year than staff in the rest of the NHS.

Research into what is driving the recruitment and retention crisis exposes the scale of the challenge we face in Gloucestershire and across the rest of the country. We are told that recruiting to a trust under a section 31 safety notice is even more challenging than it is elsewhere. Midwives who are already under significant pressure are subjected to additional strains in the form of monitoring and bureaucracy, and that can have an impact on staff morale. Of course, monitoring and bureaucracy are important when we are trying to get trusts out of safety notices; however, we cannot look past the fact that that makes it more difficult to overcome those recruitment challenges.

If that were the only barrier, it would be somewhat simpler. The Royal College of Midwives conducted a randomised survey of weekly hours worked by midwives and maternity support workers. The findings were absolutely shocking. It found that the staff surveyed reported a collective total of nearly 120,000 unpaid hours that week. That is a stark illustration of the demands placed on frontline NHS staff, who go above and beyond in a system that appears to be falling apart at the seams.

It is no wonder that the Darzi review reports that there is a high rate of sickness absence among midwives at 21.5 days a year per midwife. The most common reasons cited for absence were anxiety, stress or depression, or other psychiatric illnesses. Midwives go into the profession because of a commitment to the health of women and babies and to giving care at a critical moment, and to be part of a joyful moment in so many families’ lives. The fact that they are collectively suffering such high levels of stress tells us just how badly wrong the system has gone.

Health Services: Bridlington

Jim Shannon Excerpts

Tuesday 8th October 2024 Commons Chamber

[Charlie Dewhirst (Bridlington and The Wolds) (Con)]

I am grateful for the opportunity to debate this important subject. I thank the Minister for being here this evening, and I thank everyone I spoke to before the debate, particularly the Bridlington health forum and representatives of local NHS trusts and the integrated care board. Bridlington is not alone in needing improved access to health services, but I will seek to explain today why that has become an extremely acute problem in the town.

Constituents of mine living in and around Driffield, Hornsea, Market Weighton and the remote Wolds villages will have valid concerns about their own public services, but I hope they will forgive me for taking this opportunity to speak in depth about Bridlington and why it is in so much need of extra support. I will describe the demographic backdrop against which these issues have arisen, the challenges over supply of services, and, lastly, the need for a robust strategy to tackle the various problems faced by local people in the town.

Bridlington is a fantastic coastal resort on the edge of the rolling hills of the Wolds, and it welcomes millions of visitors every year. It is world famous for its seabird colony, and is the lobster capital of Europe. However, like many seaside towns it has significant challenges, and the demographic data is stark. It has the oldest and most deprived population in the East Riding of Yorkshire, and men living in the Bridlington South ward have a life expectancy 10 years lower than those living elsewhere in the county. Indeed, data shows that two of the three wards covering the town are the two most deprived in the county, and the other is the fifth highest of a total of 26. The age profile is equally stark. One third of the population are over 65, and that rises to 44% of residents in Bridlington North, where a significant number are over 80. Bridlington has the highest percentage of people with limiting long-term illness or disability in the York and Scarborough NHS Trust catchment area, and Bridlington residents have the highest levels of health inequality in that catchment.

The director of public health for East Riding of Yorkshire county council has said of the town:

“we have found that the inequalities are growing, they’re large and they’re serious.

In terms of length of life, quality of life and the amount of people with long term health conditions, Bridlington has got the worst levels in all of the East Riding…So this is a wake up call to do something about it.”

I certainly cannot disagree with that sentiment.

As for the supply of health services, the House will no doubt be shocked to hear that there are entire classrooms of children in Bridlington who have never seen a dentist. One patient needing emergency dental work was sent more than 60 miles to Doncaster, and in January there were 8,500 people on the waiting list for the only local NHS dentist. Many people have been forced to go private, but that is not a solution affordable to most. Will the Minister agree to look again at NHS dental contracts, so that they incentivise dentists to open practices in areas where there is such a clear and obvious shortage?

Access to primary care has seen some recent improvements, but the consolidation of GP practices from six to two has not been without its problems. Local patients still find it challenging to secure appointments at one of the two practices, but I know that GPs operating across the town have worked tirelessly to improve services in the wake of the pandemic and the shortage of local healthcare professionals. The direction of travel for secondary care, however, is not positive.

Bridlington is blessed with a fantastic hospital site, which opened in 1989. It recently enjoyed an investment of £4.7 million in 1,500 solar panels, making it one of the greenest NHS sites in the country. However, the site is chronically underused. I am not suggesting for a second that the Bridlington hospital site could be a major trauma centre or large infirmary, but it can and should be a vital community asset for health. It has the potential to be a health hub for the town, bringing together a wide array of local health services. York and Scarborough NHS trust might not be the owner of the site, but it is the provider of secondary care there. Many people in the town feel that its focus, which is naturally leaning towards North Yorkshire and not East Yorkshire, means that investment and new services are being prioritised in York, Scarborough and Malton.

Out-patient appointments are a particularly key metric, as they make up a large bulk of the interactions between the NHS and older people in Bridlington. The number of out-patient appointments at Bridlington hospital that are offered to residents in Bridlington, Driffield and the surrounding area has reduced from 46,500 in 2019-20 to just over 27,500 in 2023-24—a reduction of more than 35% in just four years. Ophthalmology appointments are down, audiology appointments are down and rheumatology appointments are down. Instead of recognising that an ageing population will result in greater demand for out-patient services locally, we are seeing these services being provided at sites away from the town.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Gentleman for bringing forward this issue. He and I knew each other long before he came to this House, as he was one of our advisers for the all-party parliamentary group for eggs, pigs and poultry. It is a real pleasure to see him in this place, and we look forward to his contributions.

The hon. Gentleman’s constituency and my constituency are very similar. He mentioned that Bridlington is a seaside resort and that he represents seaside areas, as do I. He also mentioned the fact that much of the population is over 70 years old—again, there are similarities with my constituency. Is the hon. Gentleman seeking a new rural strategy that addresses this issue in coastal areas? If he is, it is something we can all welcome.

[Charlie Dewhirst]

I thank the hon. Member for his contribution. I will come to that point shortly.

East Riding patients travelled an astonishing 2.7 million NHS miles to attend out-patient appointments in 2023-24, and two thirds of Bridlington residents attend out-patient appointments away from the town. That is not acceptable, and I will not stand by and let it continue. However, part of the problem is that local Members of Parliament have very little, if any, direct influence over the direction of our health services, which is why I am appealing to the Minister for his support. I believe that this is particularly timely.

In his recent report, Lord Darzi described the NHS as “broken”, and in the case of Bridlington he is correct. He states that:

“An ageing population is the most significant driver of increased healthcare needs since it is associated with the development of long-term conditions”

and that

“by the time people are aged 65-74, a majority will have at least one long-term condition and some 40 per cent will have two or more. By the time people are aged 75-84, this rises to nearly 60 per cent having two or more, and by the time people are aged 85 or above, 9 out of 10 will have at least one long-term condition.”

I remind the House that one third of residents in Bridlington are over 65.

Lord Darzi makes the following very pertinent observation:

“At the highest level, the NHS has had the strategic intention to shift spending from reactive care in hospitals to more proactive care in the community setting—but care has in fact moved in the other direction.”

That is very much the experience of my constituents. The report also makes it clear that “care should be more joined up, or more ‘integrated’…to reflect the fact the people living with long-term conditions”

need more support and

“a variety of different physical and mental health professionals and often rely on social care too. The frequency of their interactions with the health service means that their care is more complex and therefore requires coordination.”

Finally on this point, Lord Darzi is right to say that

“care should be delivered in the community, closer to where people live and work”,

and that

“hospitals should be reserved for specialist care. This is more convenient for patients—especially for those with long-term conditions who will need contact with the NHS more frequently.”

I would also like to refer the House to the chief medical officer’s 2021 annual report on health in coastal communities. In this insightful piece of work, Sir Chris Whitty noted:

“Given the known high rates of preventable illness in these areas, the lack of available data on the health of coastal communities has been striking whilst researching the report. Coastal communities have been long overlooked with limited research on their health and wellbeing. The focus has tended towards inner city or rural areas with too little attention given to the nation’s periphery.”

He went on to add:

“Data is rarely published at a geographical level granular enough to capture coastal outcomes, with most data only available at local authority or Clinical Commissioning Group (CCG) level. As a result, deprivation and ill health at the coast is hidden by relative affluence just inland which is lumped together.”

In conclusion, he recommended:

“Given the health and wellbeing challenges of coastal communities have more in common with one another than inland neighbours, there should be a national strategy to improve the health and wellbeing of coastal communities.”

Unfortunately, and perhaps as a result of the health service working its way through the impact of the pandemic, the report has been somewhat sidelined and the recommendations have yet to be acted upon, so what should be the solution?

We need a comprehensive strategy, bringing together all parts of the health service, that recognises the challenges and put together an immediate action plan. The Humber and North Yorkshire integrated care board is trying to address these issues, but I am concerned about exactly what its role is, or should be. Some ICBs interpret their population health duties as requiring them to act upstream of healthcare needs on the social determinants of health, where the NHS has few direct levers. Other ICBs interpret their duties as requiring them to understand and adjust healthcare services to match the needs of the population that they serve, in line with the NHS operating framework. Some interpret them as both and others as neither, preferring to focus on what they see as their traditional role of performance managing providers. Ultimately, their roles and responsibilities need to be clarified so that they can be better held to account. This is not a criticism of the performance of my local ICB, which is working hard to tackle the challenges, but I think we would all benefit from greater clarity of purpose.

In conclusion, we cannot escape what is in front of us. As one senior local authority figure commented to me:

“The health crisis in Bridlington is not a car crash waiting to happen, it is happening right now.”

My appeal to the Minister today is simple. I have no doubt that he has the very best of intentions when it comes to improving the nation’s health, but realistically many of those ambitions will take decades. If he wants to make a real difference today, will he please focus some of his Department’s collective effort on tackling the enormous health inequalities in seaside towns such as Bridlington, and will he please take the recommendations of Lord Darzi and Sir Chris Whitty and apply them to our town? We are happy to be his pilot scheme or his trailblazer.

I know that with the right energy and direction, we will not be left with a generation of children who have never seen a dentist and we will not have elderly people travelling long distances for regular routine appointments. Instead, we will have a health service to be proud of and a happier and healthier local population. I implore the Minister and his Department to work with me to ensure a better future for the brilliant people of Bridlington.

NHS Performance: Darzi Investigation

Jim Shannon Excerpts

Monday 7th October 2024 Commons Chamber

[Wes Streeting]

I am grateful to the hon. Member for her intervention. I wish that this was a challenge only in her constituency; it is a challenge right across the country. As I said to the Royal College of GPs last week, it will take time to rebuild general practice, so that it is back where we want it to be. We would be delighted to hear more from her; I will ensure that my Department makes contact, and that a Minister is in touch about the challenge in her constituency.

[Jim Shannon (Strangford) (DUP)]

I thank the Secretary of State for today’s debate. The whole House, and indeed the whole of the United Kingdom of Great Britain and Northern Ireland, wishes him well in bringing forward the changes that we wish to see. An issue that comes to my attention regularly is research and development. We hear in the press every day about new advances in treating diabetes, heart disease, cancer, Alzheimer’s, dementia and rare diseases. When we look at the bigger picture of the NHS, we see the big problems, but sometimes there are smaller issues. Will he reassure us that research and development will be encouraged?

[Wes Streeting]

I strongly agree. Although health is devolved, I look forward to working constructively and closely with Governments right across the United Kingdom of Great Britain and Northern Ireland, because every part of the health system in every part of the UK is going through challenges. We are determined to do that. [Interruption.] I think the hon. Member wants to come in again.

[Jim Shannon]

National Institute for Health and Care Excellence recommendations go from here to Northern Ireland, and then we endorse them; if we do not get them from here to start with, we cannot make people better. That is the point that I was trying to make.

[Wes Streeting]

The hon. Member’s point is taken.

The NHS stands at a fork in the road. There is a choice before us, and the parties represented in the House have different opinions on the best way forward. The first option is for the NHS to continue on its current path—to head down the road to ruin, on a mismanaged decline, with a status quo so poor that patients are forced to raid their savings to go private, and with the worst yet to come, because many Opposition Members believe that all patients should have to put their hands in their pockets when they fall ill. Reform UK has openly stated that it wants to change the funding model and replace it with an insurance-based system, and plenty in the Conservative party want to head in the same direction, chasing Reform UK down the hard-right rabbit hole.

--- Later in debate ---

[Victoria Atkins (Louth and Horncastle) (Con)]

On this, the first anniversary of Hamas’s horrific attack on Israel, our thoughts are with Israel, the victims of that horrific attack and their loved ones, and with all those who are trying to rescue the hostages, get aid where it is needed and bring peace to the region.

Day 95 of this fumbling Labour Government, and yet another general debate to talk about a report that we talked about three weeks ago. That seems to be the golden—or Gray—thread running through this Government: lots of talk, but where is the action? If the Secretary of State for Health and Social Care wanted to make a meaningful contribution to the nation’s health, why did he not bring forward the Second Reading of the Tobacco And Vapes Bill this evening, to help our children and bring about the first smokefree generation? That Bill is ready to go; why are the Government not?

The right hon. Gentleman could have provided an update to the House on the 40,000 more appointments that he promised many times during the campaign, which the latest answer from his Minister to a written parliamentary question suggests is nowhere near happening. It is perhaps about as likely as the Prime Minister paying for his own glasses. The right hon. Gentleman could have set out the steps that his Department is taking to prepare the NHS for winter. In the spring, I asked the system to start planning for this winter. How many beds, ambulances and care packages has he put into the system to prepare it for winter? He could have set out the terms of the royal commission on social care. We in the Conservative party stand ready to help on that royal commission, because we believe in constructive opposition, yet we have heard nothing from this Government. The right hon. Gentleman could have launched the much-hyped 10-year plan, which he promised before the election was “oven-ready”, but appears to be in the deep freeze. How many more Government resets will there be before that 10-year plan is launched?

Instead, in their first 95 days, this Labour Government have talked down the economy and the NHS, stopped new hospitals from being built, scrapped NHS productivity improvements, overseen GPs entering industrial action, been exposed in a health cronyism scandal, and opened a dispute with hundreds of thousands of nurses and midwives. They seek to justify all of that with the Darzi report. That report, from a former Labour Health Minister, has sunk as quickly as it was briefed out. It looks backwards, but not far enough to mark the last Labour Government’s policy and operational failures. If this Government are serious about reforming the NHS—and I genuinely hope they are—they and the Secretary of State need to transition quickly from opposing to governing.

[Jim Shannon (Strangford) (DUP)]

Will the right hon. Lady give way?

[Victoria Atkins]

I will finish this point. That transition must begin with the language that the Secretary of State is choosing to use about the NHS. Interestingly, we have heard a little bit of nuance for the first time tonight, perhaps because health leaders are raising concerns that his “broken” narrative is damaging public confidence and will lead to people not coming forward for care, as was reported on the day that the right hon. Gentleman gave his speech to conference. That narrative is hurting the morale of staff who are working tirelessly for their patients. As the confected doom and gloom of the new Chancellor damages business confidence, so too does the Health Secretary’s relentlessly negative language risk consequences in real life.

Let me say what the Health Secretary refuses to acknowledge: the NHS is here for us and is ready to help. Its dedicated staff look after 1.6 million people per day, a 25% increase from the days of the last Labour Government. That is why I am always a little concerned whenever the right hon. Gentleman harks back so far; I do not think he has quite understood the change in capacity and scale of the national health service since we inherited it from the last Labour Government. The majority of those 1.6 million people will receive good care. [Interruption.] These are just facts, but I know the Health Secretary finds them difficult to receive.

--- Later in debate ---

[Victoria Atkins]

First, I am very sorry to hear that. Again, the way we were trying to deal with the enormous increase we have seen in mental ill health across our country was first of all to boost mental health services for children and young people. Indeed, the hon. Member may not be aware of this, but we rolled out mental health support teams across nearly 45% of schools. We wanted to complete that to 100% of schools by the end of the decade, and I very much hope that the Secretary of State will be taking up that policy and delivering it.

The hon. Member for Bournemouth East (Tom Hayes) might know that there seems to have been a real increase in eating disorders since the pandemic. We know, for example, that the impact of social media sites, and the algorithms that sit behind them, can lead people who are already feeling very vulnerable into even darker places. So when the Secretary of State says that there should be a cross-Government piece of work, I very much agree with him—I hope he will achieve that through his mission board. But we really have to look at how we as a society can deal with some of these causes, because I do not think anyone is happy with seeing such a huge increase in anxiety and mental ill health among our young people since the pandemic.

[Jim Shannon]

One of the things that came up at our party conference some time ago was a recommendation from the British Medical Association and the General Medical Council to encourage medical students into local trusts by paying their fees, which would pay for itself given the cost of locum doctors in each of our health trusts. Would the shadow Secretary of State support that, and would she in turn encourage the Government to do likewise?

[Victoria Atkins]

I hope the hon. Gentleman knows by now that when he makes a suggestion, I will take it away. He will appreciate that, as part of a constructive Opposition, I want to look carefully at the ramifications—both the intended and unintended consequences—of policies suggested in the Chamber, but that sounds very interesting. I thank him for his contribution, as always.

NHS: Independent Investigation

Jim Shannon Excerpts

Thursday 12th September 2024 Commons Chamber

[Wes Streeting]

I am delighted to see my hon. Friend in her place. She is absolutely right. I feel really sorry for NHS staff for what they have been put through over more than a decade of mismanagement and political incompetence, and we will work with them to clean up the mess. She establishes exactly the right test, which is whether we would want our loved ones to be treated in our local health and care services, and whether we would have confidence that, in every case, on every occasion and in every interaction, they would have access to the best-quality care. The truth is that we do not have that certainty, and too often it feels like chance. That is why we will always put the patient voice, the patient interest and the patient experience at the heart of our reform and modernisation programme.

[Jim Shannon (Strangford) (DUP)]

I thank the Secretary of State for the honesty in his statement, and for his contact with the regional Minister responsible at the Northern Ireland Assembly. Those are the first actions of a Secretary of State who, I suggest, does not run away from issues but takes them head on. I congratulate him on that.

I appreciate the terminology used in the report, which outlines the seriousness of conditions in the NHS but also highlights the fact that the vital signs are still strong. Will the Secretary of State outline how he intends to address the fact that the NHS in devolved regions is in an arguably worse condition? Will he confirm that the review will incorporate Northern Ireland and will he ensure that the findings, new practices and standards will be in place for Northern Ireland, along with increased funding in a new funding formula?

[Wes Streeting]

I thank the hon. Gentleman for what he said; coming from him, that means a great deal to me. I reassure him that I am committed to working with Ministers in all devolved Administrations to improve health outcomes for everyone in every part of our United Kingdom. I know that the system is particularly pressed in Northern Ireland and I will do whatever I can, working with Ministers in Northern Ireland, to help that situation and create the rising tide that lifts all ships right across the UK.

Medicines

Jim Shannon Excerpts

Monday 9th September 2024 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

I thank all those who have made maiden speeches and valuable contributions today. As the Democratic Unionist party’s health spokesperson, it is important that I speak on this issue to provide, as I always do, a Northern Ireland perspective for the Minister, the shadow Minister and all others who have spoken. The experience in Northern Ireland mirrors that in the rest of the United Kingdom. I add my support for what the Minister has brought forward—nobody in the Chamber is unable to see the benefits.

As Members will be aware, naloxone is a life-changer. The DUP has consistently supported the administration of naloxone by the Police Service of Northern Ireland and the ambulance service. The legislation before us will extend that remit to further professions and staff, as well as confirm necessary rules around storage and training. I have talked to colleagues and friends back home about this issue. They were clear that we need to address it, and the provisions are a method of doing just that.

The figures around opioid-related death in Northern Ireland are absolutely heartbreaking: 154 drug-related deaths were registered in 2022. Although that represents a reduction of 59 from the 213 drug-related deaths registered in 2021, I think we can all agree that that is simply too many deaths. We must do whatever we can do reduce that number and the impact on all those families who wish something was available to save lives. Since 2012, deaths from drug-related causes have risen by 98% in Northern Ireland, They have gone from 110 to a peak of 218 in 2020, and to 213 in 2021. The 2022 total of 154 represents a 40% increase on the number of drug deaths registered a decade ago. All those figures show a worrying trend.

My constituency gained new territory from South Down in the boundary changes prior to the last election. Drug-related activity there is incredibly worrying, and I am taking up those issues with community representatives and the PSNI. Of the 154 drug-related deaths registered in Northern Ireland in 2022, over two thirds were of men. If we look at the number of deaths by age, the 25-to-34 and 35-to-44 age groups accounted together for 56% of all drug-related deaths in 2022. Each year, over half of drug-related deaths involve an opioid. In the years from 2020 to 2022, the death certificates for an average of 118 drug-related deaths mentioned an opioid.

The Minister mentioned homelessness. The provincial press back home—I think it was a newsletter that I read before I left this morning—mentions an increase in the number of homeless people in Northern Ireland. We have never before experienced such figures in all these years. The Minister is right to underline that issue, because it is not just happening in London, Birmingham, Manchester, Newcastle, Glasgow or Cardiff; it is happening everywhere. It is happening in Northern Ireland. The numbers of people looking for properties and accommodation in my constituency are at some of the highest levels I have ever seen, in all my years as an elected representative—as a councillor, as a Member of the Northern Ireland Assembly and latterly as a Member of Parliament.

The need for the appropriate use and storage of this medication, which can bring people back from the brink and hopefully give them a chance of a normal life, is all too clear. I also ask the Minister to outline whether, within the legislative process, there is any protection for public health staff. That is very important; I say that respectfully, because I know how important it is for the staff I speak to back home that they receive protection from legal liability for the administration of naloxone. We need to ensure that staff do not fear stepping in and that they fully understand that their intentions to do good in the circumstances will come with a cloak of protection. I ask that for the sake of the people I represent; I know that the hon. Member for South Antrim (Robin Swann) will speak shortly, with his vast knowledge of health issues, and will probably reiterate the same point.

It is a terrible thing to understand, but whenever I speak to medical personnel, they say that there must be no hesitancy about stepping forward for fear of repercussions. Many people wait to see whether someone else will step forward—not because they lack confidence in their ability or because of a mentality that they are off the clock and about to go home, but because of a deep fear that if their help is not successful, they will face repercussions. The situation needs to be clarified for the workers allowed to administer the drug, who must always be protected while administering it.

I very much welcome the Minister’s proposals, and I look forward to the House’s endorsement of the draft regulations. There has been magnanimous support for them from the shadow Minister and the hon. Member for Carshalton and Wallington (Bobby Dean), as I am sure there will be from the hon. Member for South Antrim and from other Members who contribute. This is the right thing to do. Let’s do it. I look forward to the Minister’s response.

--- Later in debate ---

[Karin Smyth]

This evening, I am standing in for my hon. Friend the public health Minister, who could not be here. I might offer to stand in again, such has been the rare outbreak of unanimity across this House. I know from my own experience in the sector that that is often the case with public health measures, as so much work is done in the background, and there is broad agreement on the need for prevention and the great work that has been done before. I thank Members, particularly the Opposition spokespeople, for their support this evening and their comments, which are testament to the work done by officials and by the previous Administration to get us to this point. The consultation was very well received.

I support the comments of the Opposition spokesperson, the hon. Member for Runnymede and Weybridge (Dr Spencer), about recognising World Suicide Prevention Day. Suicide, particularly among men, is something that has affected most families—most of us, I think—and it has certainly affected many people in this House, so the hon. Member is right to raise those issues. He asked about training, and I can confirm that training and data reporting requirements will be attached to this measure. That training will be required to meet some broad objectives, including the safe administration of naloxone, safe storage, and how to train someone else to handle and administer it safely. Training on its use is already well established in most parts of the country alongside naloxone provision, and each product has its own established training set out by the manufacturer. I have heard the professional points that the hon. Member has raised, and if he has any further requirements, my hon. Friend the public health Minister would be happy to write to him.

Other excellent points were made about keeping this issue under review, which we absolutely will be doing. The hon. Member for Brighton Pavilion (Siân Berry) made her points well, and they are now on the record. The Government will be looking to work on our prevention strategy across all Departments—including the Ministry of Justice, the Home Office, the Ministry of Housing, Communities and Local Government, the Department for Work and Pensions, and the Department for Education—to ensure that we take a preventive, public health-led approach to this issue. I also thank the hon. Member for South Antrim (Robin Swann), who has brought his expertise in Northern Ireland into this House for this debate. I am sure this issue will come back before the House in the future.

[Jim Shannon]

In my contribution I asked a question—which the hon. Member for South Antrim (Robin Swann) has reminded me of—about ensuring that medical staff who have the expertise to administer naloxone, but do so outside of their job, are covered and that there is no comeback against them. Could the Minister answer that question?

[Karin Smyth]

I understand that there are some concerns about that issue, and we will make sure that the hon. Member receives a full answer from my hon. Friend the public health Minister.

In short, these changes will widen access to life-saving medicine. I am sure hon. Members will agree that any death from an illicit drug is tragic and preventable, so I am pleased that we are taking this step and that we have the support of the House this evening for reducing drug-related deaths. On that basis, I hope hon. Members will join me in supporting these important regulatory changes, which I commend to the House.

Question put and agreed to.

Resolved,

That the draft Human Medicines (Amendments Relating to Naloxone and Transfers of Functions) Regulations 2024, which were laid before this House on 29 July, be approved.

Government Policy on Health

Jim Shannon Excerpts

Monday 9th September 2024 Commons Chamber

[Wes Streeting]

I am grateful to my hon. Friend for his question. We know that the NHS is broken, and is going through the worst crisis in history. We will shortly hear from the noble Lord Darzi about the outcome of his investigation into the true state of our national health service, but against that bleak backdrop of political failure are stories across the country of triumph against the odds, and of some outstanding public servants doing extraordinary things, showing what the future of our health and care services could look like with a Government on their side. I am pleased that such a Government is here—this Labour Government—and I would be delighted to hear more about my hon. Friend’s constituency.

[Jim Shannon (Strangford) (DUP)]

I wish the Secretary of State all the best in his new role, and in the task that he has taken on. With great respect to my Conservative colleagues, the downfall of the Tory Government was due in part to the fact that people did not trust the background politics behind closed doors. I want the Government to succeed, as do most people in this House. Stability and direction are much needed, but that can happen only with openness, transparency and a desire to put nation before party. How can the Secretary of State assure us that this Government will do things differently, and that policy will be proposed by those with know-how, and passed with scrutiny in this place, not simply due to pressure from lobby groups?

[Wes Streeting]

I strongly agree with the hon. Member. In the short time that I have been in post, I have been delighted to have had virtual meetings with the current Northern Ireland Minister of Health, as well as with his predecessor, the hon. Member for South Antrim (Robin Swann), who now sits over there on the Opposition Benches—I am delighted to see him in his place.

Ministerial meetings attended by third parties are declared in our quarterly transparency publication. People will want to lobby and influence Government, and Members of Parliament, all the time. Members of Parliament regularly receive correspondence—let alone the deluge of advice that we receive in government. The important thing is that Ministers take decisions on the basis of the best possible advice available, that they weigh up carefully the evidence and arguments in a fair and proper way, and that advisers may advise but Ministers ultimately decide.

This Government are aware of the deep crisis in trust in our politics. That is why, on his very first day, the Prime Minister talked outside Downing Street about restoring Government to service. It is why it should be no surprise whatsoever that many people who have given outstanding public service to this country, such as my right honourable friend Alan Milburn—and the same is true of Patricia Hewitt, Alan Johnson, my noble Friend Lord Reed, the Mayor of Greater Manchester and many more—want to roll up their sleeves and help the Government. They can see the state that the Conservative party left our country in, and are willing once again to roll their sleeves up to get our country back on its feet, turn the situation around and ensure that everyone in our country can look forward to the future with optimism and hope after 14 years of abysmal failure.

Preventable Baby Loss

Jim Shannon Excerpts

Wednesday 4th September 2024 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to follow the hon. Member for Morecambe and Lunesdale (Lizzi Collinge) and to hear her contribution as well. In particular, I thank the hon. Member for Ashfield (Lee Anderson) for setting the scene, as he often does, with a passion and an understanding of his constituents that we all see, and for describing the examples of his constituents who have suffered in this way. He did it with sensitivity, because it is a very sensitive debate. As a father and a grandfather, my thoughts are with those who have faced and are living through baby loss; there are many who have. I say “living through” because I know that it is not something to get over as such.

I could give many examples, but I will give just one. The hon. Member for Ashfield said that every family has been touched, and he was right. My mother has had a number of miscarriages, as has my sister and Naomi in my office, so the issue of baby loss resonates with us all.

There was a lady I greatly admired. Her name was Agnes Thomas. She is dead and gone, but she was 4-foot-nothing. There wasn’t much of her, but she was definitely a whirlwind. I remember her coming to see me. She took care of her 105-year-old mother—and that is the age her mother was when she passed away. Agnes had a very ill husband, and she had minimal help from anyone. Within a few months of her passing away, her mother and her husband died too. She was the centre of that home and one of the strongest women that I have ever known—apart from my own mother, of course, who at 93 is equally strong. However, underneath all that undeniable strength was also a lady that, in her 80s, came to the office to see whether she could find out where her stillborn son—

[Helen Morgan (North Shropshire) (LD)]

The hon. Gentleman is making a powerful speech. It is good to hear the story of Agnes, and I hope that he will agree with me that sympathising with our constituents who have suffered such awful circumstances and telling their stories in Parliament is a good way to ensure that they are heard in the future.

[Jim Shannon]

I thank the hon. Lady for that. The story of Agnes’s son is this: her stillborn son was born sleeping in the early ’70s and was buried. Agnes came to see me over 50 years later.

[Lee Anderson]

The hon. Gentleman is making a very passionate speech, and I think everybody in Westminster Hall can tell how impassioned he is. He tells a very touching story. Does he agree that it does not matter how long ago baby loss occurred—it will always stay with the family?

[Jim Shannon]

I am sorry for being emotional. I know that I should not be. I thank the hon. Gentleman for giving me a chance to recover some of my composure.

Agnes came in tears to ask where the Royal Victoria hospital had buried her son. It meant something to her, even though it was 50 years later—that wee small lady, standing in my office telling me her story, which was breaking her heart 50 years later.

The loss of a baby is life-changing, and my thoughts are with those families who have been mentioned in this debate. There will be others. Other hon. Members will speak, and they will tell the same story with the very same emotion, compassion, understanding and that realness that the hon. Member for Ashfield compounded in such a fantastic way in his introduction.

The fact that baby loss can be preventable makes the outcome that bit more difficult to accept. Sands is a phenomenal charity, and it has given the following statistics. I always give a Northern Ireland perspective simply because I feel it adds to the debate, but it also tells us that the things happening here are no different for us back home. The stillbirth rate declined 17.7% in Northern Ireland between 2010 and 2022. However, comparing the rate over a three-year average shows a smaller reduction of 10.1%. My goodness! Though it is decreasing, it is still there with a vengeance. The neonatal mortality rate has been higher in Northern Ireland than in any other UK nation since 2013. It is equally bad wherever it is, but I am just making the point that Northern Ireland has examples of it that are above the rate anywhere else.

[Carla Lockhart (Upper Bann) (DUP)]

I thank my hon. Friend for his powerful speech. This is certainly a debate that resonates with me on a very personal level, but I want to make mention of a little boy called Teddy from my constituency of Upper Bann, who died from sudden infant death syndrome. He will be forever seven weeks old. Does my hon. Friend agree that we need better wraparound services, particularly in our hospitals, with rooms made available for families who find themselves in these most tragic circumstances? There should be support, counselling and help right through their grief journey.

[Jim Shannon]

I thank my hon. Friend and colleague for that intervention. What she says is absolutely true.

I tend to be emotional at the best of times, but whenever someone loses someone, particularly at that time, it resonates with everyone. It is a time when people want to wrap their arms around them, because it is the right thing to do. At the same time, there has to be someone outside. The hon. Member for Ashfield gave some examples where—with respect—people were just sent home when they needed someone. That is so sad. I feel that there should be a greater role for churches and ministers to help and, as best they can, to give succour and support physically, emotionally and mentally. Those are things that we have probably all tried to do.

Unlike stillbirths and neonatal deaths, the total number of miscarriages and miscarriage rates are not reported in Northern Ireland. That needs to change. It is a matter for us back home and not the Minister’s responsibility, because health is devolved, but I do feel that we need to do better. I still feel that the aims in the mainland should be replicated. I know that the Minister is sitting in for another Minister who cannot be here, but maybe it could be conveyed to the responsible Minister that we should look at an overall strategy for the whole United Kingdom of Great Britain and Northern Ireland.

Although there is an ambition in England to halve the 2010 rates of stillbirth, neonatal death, pre-term birth, maternal death and brain injury by 2025, there is no equivalent ambition in Northern Ireland. There really needs to be one; that is one thing that I would love to see. Sands states:

“The Northern Ireland Executive must commit to reducing pregnancy loss and baby deaths and eliminating inequalities. Any future targets must have a clear and agreed baseline to measure progress against.”

It is not just about having a goal; it is about having a goal that means something. With respect, we can have words until the cows come home, but they mean nothing unless they turn into action. Sands further states:

“These targets should be the driving force behind a programme of policy activity, with funding and resources to meet them.”

I agree. The ambition of this debate is to highlight the need for funding and resources, highlight the issue, make people aware and give an outlet to those who have suffered so painfully and who will carry that burden with them all their life. That is what I too am advocating, not simply for England but throughout the whole United Kingdom.

We have midwives who regularly find themselves staying after handover, as they are understaffed. We find exhausted junior doctors being left with full maternity wards while their SOs catch up on the never-ending paperwork. We have cleaning staff telling us that they do not have time to do all they need to clear rooms of infections. All those things are a matter of funding, and they are all UK-wide.

In all parts of this great nation, these are matters of life and death. The death of just one little baby that did not need to happen—we all have examples in mind today—is a tragedy. The number of babies who have died needlessly is not just a tragedy, but a catastrophe. We need to change it. With that in mind, I congratulate the hon. Member for Ashfield on giving us all an opportunity to participate in this debate in a small way, but with united force. Politics aside, we are here as MPs on behalf of our constituents, and we will all say the same thing: the loss of a baby is devastating to a family. If we can do something, we must. Let us support staff and, by doing so, support the health of our mothers and their children.

Healthcare Provision: East of England

Jim Shannon Excerpts

Tuesday 3rd September 2024 Westminster Hall

[Clive Lewis]

On the hon. Gentleman’s first point, yes, successive Governments have presided over the NHS, but with differing intentions. Until the mid-1970s, say, there was a broad consensus—I will come on to this—on what the welfare state was and how it operated. That has changed substantially in the past 60 years. The implementation of different policies by different Governments, including Conservative ones, has not always been in the best interests of the NHS. On enterprise, yes, a secure welfare state, good social security and the ability to give people good health—the NHS has been integral to that—have implications for our economy, as I have already pointed out.

I am sure I am not the first or the last to suspect a direct connection between the rise of angry and anti-democratic right-wing politics and the demise of the NHS’s ability to look after us all effectively. The sheer far-reaching impact of the NHS and its crisis cannot be underestimated. One needs only to look at the US, where free universal healthcare does not exist, as the hon. Member for Mid Norfolk (George Freeman) just mentioned, to see the state of politics, crime, drug addiction and social breakdown there. The free market in healthcare provision and medicines has led to a country with one of the least efficient and most high-cost healthcare systems in the western world, and where millions are hooked on drugs that are as heavily advertised as if they were cans of coke. Let us not indulge too much in English exceptionalism, though. We need only to look at dentistry and adult social care in this country to see what happens to healthcare provision that is, to all intents and purposes, privatised or well on its way to being so—the consequences of which I hope colleagues will discuss later in the debate.

The foresight of the 1945 Labour Government cannot be underestimated. When the NHS was launched in 1948, it was done in tandem with the advent of the welfare state, because Beveridge, Keynes and Bevan understood the three pillars necessary for a healthy nation. The first pillar—the NHS—would be there for people if they became sick, but it was the second and third pillars that meant the NHS would not be overburdened. They would work in tandem with it to prevent sickness.

The second pillar was, of course, the welfare state, providing a network of social institutions that would protect citizens from the market risks associated with unemployment, accidents and old age. The third pillar was an economic system that prioritised full employment in secure, well-paid, unionised jobs—a system that sought to reduce all forms of inequality, from wealth to health.

Over the last 60 years, the three pillars have been systematically smashed. The second and third pillars are in tatters, while the first—the NHS—is wobbling precariously. It is testament to the enduring nature of the national healthcare system that it has managed to survive as an almost solitary pillar for as long as it has. If a Labour Government are truly to fix the foundations of our broken healthcare system, they must acknowledge the nature of the three-pillar foundation, and acknowledge that the NHS cannot be fixed if we do not rebuild and replace the other two pillars as well.

The situation in the east of England—from dentistry deserts to sky-rocketing rates of mental health referrals and some of the worst ambulance waiting times in the country—is beyond one malfunctioning organisation. Norwich and the wider region are experiencing a systemic crisis that is institutional, social and economic. Healthcare reforms such as devolution to the integrated care boards have become about devolving who gets to wield the axe to make savings—known to many people as cuts. I will give an example. Our ICB in the east of England, part of NHS Norfolk and Waveney, has been told by national health bosses to cut its running costs by 30% by 2026. My first question to the Minister is: how will our Government deliver improved healthcare outcomes while simultaneously implementing the previous Government’s frankly destructive cuts?

We know that vast areas such as dentistry and social care are largely privatised, with spiralling costs, and that undermines the NHS’s central commitment to care being free at the point of use. Tendrils of the crisis extend into social care. It is often said that if social care is cut, the NHS bleeds too. Norfolk county council acknowledges a crisis in social care. With soaring demand and struggles to recruit staff, there is a backlog of hundreds of vulnerable people waiting to get their care needs assessed, and care providers fold on a regular basis. My second question to the Minister, then, is: what news can she give us on the last Government’s unimplemented cap on care costs? Is it being implemented, as the Secretary of State implied during the general election campaign, or being dropped? If it is dropped, what plans are there to help those facing ruin given their complex care needs?

One consequence of the situation in Norfolk is that there are regularly hundreds of hospital patients who are medically fit to leave but unable to be discharged. It is clear that our healthcare system is struggling to respond to today’s crisis, but it is also unprepared for the challenges of the future. East Anglia is the UK region most at risk from early climate impacts, and there is clear evidence of the link between climate breakdown and ill health. For example, from 2022 to 2023 the number of flood reports in Norfolk doubled, and stretches of Norwich are predicted to flood year after year. Victims of flooding in the UK are nine times more likely to experience long-term mental health issues, and flooding is linked to a greater instance of respiratory diseases because of dampness.

Prevention is better than cure—it is about treating the causes, not just symptom alleviation. We know that the Prime Minister is keen on the so-called preventive state and we have seen some early policy announcements, so my third question is: will the Minister elaborate on what that will look like? What does healthcare provision that prioritises prevention look like in the east of England?

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Gentleman for bringing this issue forward. I know the debate is about the issues particular to his constituency, but they are ones apparent to all of us across the United Kingdom of Great Britain and Northern Ireland. First, does he understand and perhaps agree that the Minister and Government could look at pharmacies having a bigger role in treating minor ailments? Secondly, there is the issue of how people, particularly elderly people, can access GP appointments regularly. Thirdly, when it comes to cataract surgery there is a postcode lottery across the whole United Kingdom. If people get the surgery early, it stops them losing their sight. Is the hon. Gentleman experiencing issues in his constituency similar to those in mine?

[Clive Lewis]

I thank the hon. Gentleman for his input, and his points were well made. When researching this debate, I probably spent more time working out what I did not have time to say than what I could actually put into the debate, so I have tried to do a broad overview. Many of the issues the hon. Gentleman raised are also of concern in my Norwich South constituency and across the eastern region. I am sure that during the debate many of those issues will be raised and dealt with in more detail.

Our Government have said they are a Government of service, but a legitimate fourth question that I ask the Minister is: in service of whom and to what end? It is clear to many that the interests of big business, of big tech and data companies and of private finance do not always sit well with the public interest, particularly when it comes to health. There are areas where they do, but there are also areas where they do not. We know with whom the last Government sided; whom will ours back when push comes to shove—big business, big tech, the finance industry or Joe public?

I want to briefly provide a snapshot of the scale of the crisis in the eastern region. Ambulance response times in the east of England are significantly worse than those in the rest of England. In 2023, response times for category 1 cases—that is, severe cases—were nearly 12 minutes in East Anglia, while the national target is seven minutes. They were nearly the worst on record. The Care Quality Commission, now under inquiry and investigation itself for its capability to do its job, has described Norwich university hospital as the

“worst in the East of England”

for ambulance handover times.

Referrals to mental health services increased by 18% between 2018 and 2020. Compared with the rest of England, Norwich and Norfolk have higher rates of self-harm, death by suicide and mental health issues among young people, as well as more self-diagnosed mental health issues generally. Our mental health trust—Norfolk and Suffolk NHS foundation trust—is notorious for being the worst in the country, and I do not think that can be said enough.

Norwich is a dental desert. In July, the Secretary of State branded Norwich North the “Sahara of dental deserts”. That is a rather romantic notion, but it is a desert where people pull their own teeth out in this burgeoning phenomenon of a do-it-yourself dentistry industry. Indeed, some of my Ukrainian constituents have told me that they find it preferable to dodge Russian missiles and artillery to use Ukrainian dentists. Ukraine arguably has a better dental system in the middle of a prolonged war. That is unsurprising given that in the east we have one NHS dentist—no, it is not even one NHS dentist; it is one dentist—per 2,600 people. Just picture that in your head: one dentist with their tools with 2,600 people queued up. That is what it feels like to many of my constituents.

For the second year running, no dental practices are accepting NHS patients. Norfolk children under five have some of the worst tooth decay in the entire country. Thousands of people have had to go to hospitals in Norwich and Norfolk for abscesses that should have been prevented. The list goes on and on. I am sure that many of my colleagues from the eastern region will also outline some of the issues and stories that they know are taking place on a daily basis, and that have been for many years now.