NHS Dentistry

Debate between Lord Markham and Baroness Jolly

Monday 19th February 2024 Lords Chamber

[Lord Markham (Con)]

Yes, absolutely. That goes back to my noble friend’s point about outcomes. I know that a lot of places, if they are fortunate enough to have an NHS dentist, give you check-ups every six months as a matter of course. In fact, NICE says that if you are in good oral health you will need that only every 24 months, with the idea being that you can create more space for other people to come in, because prevention and screening are vital in all this as well.

[Baroness Jolly (LD)]

My Lords, I live in Cornwall, where there are now very few NHS dentists and many people are resorting to do-it-yourself. What plan does the Department of Health have to ensure that all in Cornwall have access to a dentist as and when needed? A kit is available from the high street for less than £10, but this does not buy any expertise or guarantee of success.

[Lord Markham (Con)]

The noble Baroness is quite correct. Cornwall is one of the areas where we piloted the mobile services. It is probably not the number one area, but it is fair to say that it is one of the main areas where we are putting in more resources for precisely that reason.

NHS: Staff Numbers

Debate between Lord Markham and Baroness Jolly

Tuesday 12th September 2023 Lords Chamber

[Lord Markham (Con)]

The noble Baroness is absolutely correct: a workforce plan needs to be backed up with the physical real estate to deliver it. As noble Lords are aware, I am responsible for the new hospitals programme, which is part of that. In primary care, much of the long-term workforce plan is all about getting upstream of the problem in terms of prevention, and clearly we need to make sure that the physical real estate is there to support that. So the next steps will be to make sure that the capital meets the long-term workforce plan.

[Baroness Jolly (LD)]

My Lords, the NHS needs more recruits, but can the Minister tell the House where there are pressing shortages that adversely affect patient care and when he anticipates that the problem will be sorted?

[Lord Markham (Con)]

As I say, the long-term workforce plan puts this on the right footing, going forward. There are big increases in the number of staff, so it is not like we have not been working hard on this area already. By any definition, 63,000 more staff over the last year is a prime example of that. So we are addressing this, but I am not going to pretend to the House that this can be done once, lightly and quickly; it is part of a long-term programme, which the long-term workforce plan is all about.

NHS: Allocation of Financial Resources

Debate between Lord Markham and Baroness Jolly

Thursday 11th May 2023 Lords Chamber

[Lord Markham (Con)]

Numbers out just this morning show that we are now at 75% of people being seen within four hours, so we are close to the 76% target. That is the best since September 2021. I am the first to admit that we want to go further, as the noble Baroness states. It is about making sure we have got the care in the right places. We are triaging to make sure that the most important cases are seen first and, as I mentioned in a previous answer, we have things such as fall services, which can avoid trips to A&E in the first place, and more primary care in place to avoid visits in the first place. That is what the primary care recovery plan is all about.

[Baroness Jolly (LD)]

My Lords, sometimes the NHS is a bit like a greedy child, always needing more. In his Question, my noble friend mentioned additional beds, extra ambulances, and recruitment and training. Will the Minister tell us what budget each of these items comes from? Will the Minister enlighten the House about this issue?

[Lord Markham (Con)]

The budgets are in the allocations for each ICB and each hospital, and within them there are specific allocations to make sure that these fundings are rooted in the place where they have the most effect. As for making sure that really does happen, it is the responsibility of each ICB to make sure it is doing that. Ministers hold them to account by each having seven ICBs to take care of and make sure that they are hitting those targets.

GP Appointments

Debate between Lord Markham and Baroness Jolly

Thursday 23rd February 2023 Lords Chamber

[Lord Markham (Con)]

Absolutely. One of the things I am very proud to be leading on the NHS side is our whole digital way of addressing access to the health service. This will be fundamental to how people make their hospital appointments and take control of their own health, so it will be the main thing that will help with the 8 am appointments, alongside the increased telephony services and everything else. Just as every walk of life is coming down to being able, at your fingertips, to make appointments and bookings and get your own records, this will also be the case with GP surgeries and I think it will fundamentally change the way that we address our whole health.

[Baroness Jolly (LD)]

My Lords, part of the problem is where there is no mobile phone signal. People who live or who have homes in Cornwall will identify with that. Does the Minister have any idea what proportion of patients find accessing their GP difficult? What advice has been given to practitioners on resolving the issue? In rural areas such as Cornwall and Northumberland, there are poor bus services, if any. Getting home can mean a really long wait—sometimes half a day if there are only two buses a day. What advice would the Minister give to the GP and to the patient?

[Lord Markham (Con)]

First, my understanding is that the vast majority of homes in Cornwall have broadband, to which your mobile phone will of course connect. That is where people will be making appointments from. They can use digital to do that. Secondly, we are rapidly increasing the number of doctors’ appointments. We made a pledge to increase the number of appointments by 50 million. To date, we have increased them by 36 million—11% up since 2019. So we are making more appointments available. Do we want to do more? Absolutely. Are we going to publish a primary care plan shortly to show how we will address those additional needs? Yes.

Bread and Flour Regulations 1988

Debate between Lord Markham and Baroness Jolly

Tuesday 7th February 2023 Lords Chamber

[Lord Markham (Con)]

Yes, that is my understanding. One of the aspects that has taken time is getting the devolved Administrations on board and the complications of the Northern Ireland situation with the EU.

[Baroness Jolly (LD)]

My Lords, many countries put folic acid into bread to prevent neural tube defects. When it was added to flours in Australia, the number of these defects reduced by 14%. More folic acid in more bread products could save 800 babies a year in the UK from developing birth defects such as spina bifida. The Minister gave your Lordships positive news, but when can we expect it to bear fruit?

[Lord Markham (Con)]

As mentioned, there is a process that we are going through. As I said in my first Answer, we will be laying the legislation early in 2024, but it is happening. More importantly, in the meantime a lot of the industry are voluntarily adopting it.

NHS Winter Pressures

Debate between Lord Markham and Baroness Jolly

Tuesday 10th January 2023 Lords Chamber

[Lord Markham (Con)]

I have said before in this Chamber —and I will say it again—that we should be learning all lessons. I like to think that, three months into my role, I am learning some of those lessons. The noble Baroness will see that we have taken some backwards steps on the use of the independent sector, which, again, was pioneered 15 or 20 years ago, but hopefully we will move forward again. I unashamedly say that we can learn from those things. I have spoken to some colleagues from the noble Baroness’s side of the House, and will continue to, because I will adopt anything that works, and I agree that payment by results is one of those things. We can speak after these questions; my door is definitely open on those matters.

[Baroness Jolly (LD)]

My Lords, I have the privilege to chair the NHS national community nursing plan clinical reference group. We meet on a regular basis and look at how community nurses can keep people out of hospital and get people home from hospital. We have heard very little about that today. Can I have five or 10 minutes with the Minister at some stage to bring him up to speed on the work that is going on?

[Lord Markham (Con)]

As with my answer to the previous question, I look forward to that meeting and learning everything we can. I will repeat the statistics on that subject that struck me most: of those 13,000 people who are fit to be discharged, we think that only 3% need to be in social care in the long term; 97% could be at home, which is the best and most cost-effective place for them. We need to ensure that the support is in place to ensure that that option exists.

NHS Dental Contract

Debate between Lord Markham and Baroness Jolly

Thursday 1st December 2022 Lords Chamber

[Lord Markham (Con)]

I will need to write to give the exact number. From memory, it is not a big number at the moment—less than 10%—but I will confirm that. That is why I was pleased that we agreed the measures the other day, so that we can expand that. Evidence shows that in areas where water is fluoridated—again, I am speaking from memory and I will confirm it in writing—tooth decay declines by as much as 20%, so it does work.

[Baroness Jolly (LD)]

What advice does the Minister give to people in Cornwall for whom the nearest NHS dentist is 50 miles away but there is no public transport from the local town to the practice?

[Lord Markham (Con)]

I am aware of some of the dental deserts. Some 700 urgent care centres have been set up to try to cater for such cases, and they have seen 4 million people. In total, there were about 26 million treatments last year. About 75% of patients who wanted to get an appointment were able to. Clearly, that leaves 25% who were not. We need to work further on that, including in Cornwall.