Oral Answers to Questions

Mary Kelly Foy Excerpts

Tuesday 11th July 2023 Commons Chamber

[Steve Barclay]

As my hon. Friend knows, I have already met her to discuss this scheme, and the impediment was the business plan that came forward from the local trust—further work was being done on that. She is right to highlight our capital investment more widely. This Government have committed to investing in the biggest ever hospital building programme, with more than £20 billion. That is in addition to our long-term workforce plan—the first time the NHS has done this—in which we are making a further £2.4 billion of investment.

[Mary Kelly Foy (City of Durham) (Lab)]

Is the Minister aware that the NHS North East and North Cumbria mental health and wellbeing hub is due to close this September? With mental health care in crisis in County Durham, that is an insult to the health and social care staff who desperately rely on those services. Will the Minister reverse that decision?

[Steve Barclay]

There are two issues here. One is how much investment we are prioritising towards mental health; the other is how local commissioners choose to prioritise services within those communities, and whether we try to run all of those decisions from the centre in Whitehall or embrace the 42 integrated care systems and allow them to make commissioning decisions. The bottom line is that we are spending much more on mental health, with an increase of £2.3 billion compared with the position four years ago. That is allowing us to replace 500 dormitory beds and provide 100 mental health ambulances, three new mental health hospitals, 160 projects such as crisis cafés to support accident and emergency, and £75 million to help those with mental health challenges get back into work, which is one of the best prevention measures we can take for people who are suffering with their mental health.

Smokefree 2030 Target

Mary Kelly Foy Excerpts

Tuesday 20th June 2023 Westminster Hall

[Mary Kelly Foy (City of Durham) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Sharma, and to follow my co-sponsor of this debate, the hon. Member for Harrow East (Bob Blackman). He is also the chairman of the all-party parliamentary group on smoking and health, of which I am a vice-chair. I declare that interest.

As we have heard, the measures announced by the Minister in April were a step in the right direction. However, they fell very short of the comprehensive strategy outlined by the APPG and the Khan review, and it has taken far too long—almost four years—for the Government to get going on this. In the meantime, tobacco continues to kill an estimated one person every five minutes in Britain. The deaths are disproportionately concentrated in regions such as the north-east—regions that have some of the highest rates of poverty and, in turn, the highest rates of smoking in England. In the north-east, nearly 13,000 people died prematurely from smoking between 2017 and 2019. This has an economic cost for our communities of over £100 million in healthcare costs and £64 million in social care costs. All the while, tobacco companies make record profits, leaving the taxpayer and families to pick up the pieces.

We are fortunate in the north-east to have a highly effective regional tobacco control programme—Fresh—funded by all the local authorities in the region and the local integrated care board, and it has proven successful over the years. Just yesterday, it launched a new behavioural change campaign called “Smoking Survivors”, which features two women from the north-east who have quit smoking and survived cancer. However, national funding for behavioural change campaigns such as that fell by around 90% between 2008 and 2018. Although regional activity is vital, we need strong leadership from the Government if we are to see every region be smoke free by 2030.

Like the hon. Member for Harrow East, I welcome the Minister’s recent announcement on tackling youth vaping, but why did it take so long for the Government to act? When the Health and Care Act 2022 was going through Parliament in 2021, I tabled amendments that would have given the Government powers to prohibit child-friendly branding on e-cigarette packaging and to ban the free distribution of vapes to under-18s, which, as we know, has strong cross-party support. To my amazement, not only did the Government fail to adopt my amendments, but they voted them down.

As the Minister will remember, one of Dr Khan’s must-do recommendations was raising the age of sale for tobacco beyond 18, so I was disappointed not to see that included in the April announcement. The all-party group has already urged the Government to launch a public consultation on raising the age of sale, and I urge them to do that too.

I will end with a few questions for the Minister, which probably echo what the hon. Member for Harrow East asked. Will the Minister commit to consulting on a “polluter pays” levy to raise funding for a comprehensive tobacco control strategy?

Will the Government consider measures to address the affordability, accessibility, appeal and advertising of vapes, which were recommended by ASH in its response to the Government’s call for evidence on youth vaping? Once again, I highlight the fact that big tobacco companies rigorously lobby against vaping regulations, so I would like the Minister to take note of that.

Will the Minister confirm that a consultation on raising the age of sale will be considered? Finally, will he reassure the House that a comprehensive strategy to address smoking and vaping will be delivered—if not through the tobacco control plan, as promised by his predecessors, then in the forthcoming major conditions strategy?

[Mr Virendra Sharma (in the Chair)]

I urge Members to stick to about five minutes.

Hospice Services: Support

Mary Kelly Foy Excerpts

Wednesday 14th June 2023 Westminster Hall

[Mary Kelly Foy (City of Durham) (Lab)]

I thank the hon. Member for Eastleigh (Paul Holmes) for securing this important debate. I extend my condolences to him for the loss of his manager Sue.

I start by giving my heartfelt thanks to all those who work in hospices. Ensuring that people can pass away in comfort and dignity is an extremely honourable profession, and it means a great deal to people, as we have heard. The cost of living crisis is affecting hospices up and down the country, and we need to take it seriously. Even before the cost of living crisis began, working in a hospice was challenging. The Government should not be making it harder.

The Minister should be concerned by what hospices such as the brilliant St Cuthbert’s Hospice in my constituency are saying. Inflation, for one, is a real concern. What St Cuthbert’s is receiving from the integrated care board does not even come close to either wage inflation or general inflation. It is seeing a massive rise in its energy costs, by tens of thousands of pounds. As we have heard, a care home cannot reduce its energy consumption.

The marketplace for specialist staff is currently extremely competitive. The absence of a proper workforce plan from the Government is not helping. It should be noted that despite the challenges it is facing, St Cuthbert’s Hospice continues to run at 100% satisfaction. I know the Minister will mention the £100 million announced in the spring Budget, but that falls short of what is really needed. Hospices are collectively budgeting for a deficit of more than £180 million this year.

Where is the support for energy bills? Hospices need to be able to offset their costs. After all, it does not reflect well on a society when the Government do not prioritise end of life care. Patients require the utmost dignity, and the Government should be ensuring that their dignity is prioritised.

Mental Health Treatment and Support

Mary Kelly Foy Excerpts

Wednesday 7th June 2023 Commons Chamber

[Mary Kelly Foy (City of Durham) (Lab)]

As we have heard today, England is in the midst of a mental health crisis, and that is certainly true in the north-east. I join my hon. Friends the Members for Middlesbrough (Andy McDonald) and for Darlington (Peter Gibson) in calling for an independent inquiry into the Tees, Esk and Wear Valley NHS Trust. The testimonies I have heard have shocked me. I know that I can speak only in broad terms, but they include serious cases of improper care and misdiagnosis, and of putting people on waiting lists despite their feeling suicidal.

The Care Quality Commission reports that we have seen raise concerns about risk assessments, communications and record keeping, and a lack of observation. There have also been concerns raised about the lack of beds for children, as well as poor staffing levels, high staff turnover and a lack of neurodiversity training. Horrifically, young people have even taken their lives while in the care of the trust. We owe it to them, and all those who have been harmed, to investigate what is going on within the trust. Will the Minister commit to an independent, judge-led inquiry into the trust? She can either respond to me now or I can wait for her response in her closing speech. One thing is clear: this cannot go on.

I want to highlight the crisis in children’s mental health. In my region, children spent over 1,000 hours in A&E because they were in a mental health crisis. There are over 30,000 children on waiting lists. Across England, one in six children aged five to 16 are likely to have a mental health issue. Children’s happiness and sense of wellbeing continues to decline. With mental health trusts raising the threshold of how ill under-18s must be, we have seen a quarter of a million children being denied help for their mental health. Poor mental health compounds. Left untreated, it can spiral out of control, as we have heard many times today. No one should be in a mental health crisis, let alone children. The Government must invest in children’s mental health today—no more delays and no more referrals. The Minister must allow children the happiness that they deserve.

[Madam Deputy Speaker (Dame Rosie Winterton)]

Before I call the shadow Minister, I must say that I am very disappointed that seven Opposition Members who spoke in the debate are not back in the Chamber for the wind-ups, as well as about three Government Members. I must emphasise again that it is really important for people to get back to hear what the shadow Minister has to say, as well as the Minister. I hope that message will be conveyed back to those Members who are not here. I will say it again in the hope that they are back by the time the shadow Minister has finished his speech.

Dental Care: Durham

Mary Kelly Foy Excerpts

Wednesday 24th May 2023 Commons Chamber

[Mary Kelly Foy (City of Durham) (Lab)]

Vast areas of our country are increasingly described as “dental deserts”, places where not a single dental practice is accepting new NHS patients, and County Durham is one such place. We in Durham have witnessed dental services decay at an alarming rate. In my constituency today, there will be children sat in classrooms struggling to concentrate because of something as preventable as toothache. So it is hardly surprising that tooth decay is now the leading reason for children being admitted to accident and emergency in our country.

This scandal is not unique to Durham or the north-east; it is a problem everywhere. In 2023, dentistry is available on the NHS on paper but not in practice. The British Dental Association has described NHS dentistry as entering its final act. The horrifying experiences of my constituents, which I will outline, will certainly strengthen that claim, but before I turn to my constituents, let me state a chilling fact: Britain has poorer oral health than any other developed economy.

[Peter Gibson (Darlington) (Con)]

The hon. Lady raises an important point about children’s dentistry. Does she agree that prevention is better than cure? Would she welcome a return to dentistry in schools?

[Mary Kelly Foy]

Of course, prevention is better than cure, and that is one of the reasons why so many children have to go to A&E. If problems were identified and prevented in young children, there would not be the cost implication for services further down the line. In an ideal world, we would have dentists in schools.

As I said, Britain has the poorest oral healthcare among developed countries. Can the Minister honestly say that we have genuine preventive oral healthcare in our country? Over the past 13 years, dentistry has become unaffordable and unavailable for many of my constituents. Nearly 400 have contacted me in dismay at their recent experiences. I thank them for their contributions and I hope the Minister can give them some reassurance today.

My constituents know that the problem is not with the dentists themselves. They know that dentists are trying their best for their patients. The problem lies at the Government’s door. In the time that I have, I can share only a portion of the pain and suffering that my constituents have had to endure. One moved to Durham over four and a half years ago but still cannot find an NHS dentist, despite being told after a kidney transplant that it was vital that they had regular dental check-ups to monitor their health. Now they have a broken tooth and simply cannot afford to fix it.

Another constituent told me how she had to borrow money to afford a private appointment. She is now 30 weeks pregnant and exempt from dental charges, but her exemption is worthless as there are no appointments available for her. A young girl in my constituency tripped over and shattered her teeth. Her family contacted me because they could not find a dentist to help her. Luckily, after I reported the case on social media, a local dentist was kind enough to help her out, but our health system should not be based on charity. Constituents have also contacted me about do-it-yourself dentistry. In case the Minister is unaware, that is when people fit their own fillings and extract their own teeth without anaesthetic or any professional training.

I have raised the alarming experience of my constituent Ray in the Chamber before, but I do so again because his case underlines why access to dentistry should be not a luxury, but an integral part of our health system. Ray was unable to find an NHS dental appointment, so, out of utter frustration, he decided to go private. Following his appointment, Ray was diagnosed with oral cancer, for which he is now receiving treatment. As there is a cost of living crisis, we have a duty to ask, what if Ray had not been able to pay for private treatment? What if the cancer had continued to go undetected? Frankly, Ray might not be here today. It is morally wrong that Ray was put in that position. No one in my constituency —or anywhere, for that matter—should be put in that position.

Why is this happening? My visit to a dental practice in Gilesgate this week provided some of the answers. The practice has just one dentist working two days a week seeing NHS patients, and it has 10,000 patients on its books. It does not take a genius to work out why my constituents cannot see a dentist. It is clear why dentists are closing their doors to NHS patients, and it is certainly not because of a lack of demand. The problem, which the BDA has identified, is that the unreformed NHS dental contract means that dentists are pushed into the private sector to keep their practices afloat financially. As one dentist said to me:

“Every day I’m providing some treatment for nothing or at a loss—working the best I can, caring for NHS patients the best I can within the dental contract.”

He also went on to say that the Government are clearly winding down NHS dentistry in the hope that the public will accuse dentists of being greedy.

The exodus of dentists is clear for all to see—except, it seems, the Government, who continue to deny there is a crisis in NHS dentistry.

--- Later in debate ---

[Mary Glindon (North Tyneside) (Lab)]

I thank my hon. Friend for securing this important debate. Given that dentists are so hard pressed and are trying their best to fit in NHS patients, in light of all the problems they are facing, does she agree that they deserve our greatest respect, admiration and thanks? I am very fortunate that I have been at my dentist’s practice for 52 years, but they are struggling.

[Mary Kelly Foy]

I could not agree more with my hon. Friend. The dentists that I have spoken to recently all want to help NHS patients, but the way the contracts are designed, it is not worth their while, and of course they have to make a living.

I mentioned that I made a point of order yesterday regarding the Prime Minister, who has repeatedly claimed that there are “500 more dentists” in the NHS. However, following a freedom of information request, we now know that the number of dentists in the NHS fell by nearly 700 last year. The number of dentists has also fallen since the pandemic and is at its lowest level in a decade.

Diagnosing the causes of the problem is not complicated. As I mentioned at the beginning, Britain has poorer oral health than any other developed economy. The system is also dysfunctional, and practices have handed back a record £400 million-worth of funding back to the Government because they do not have the capacity to meet the required targets.

[Mr Kevan Jones (North Durham) (Lab)]

Does my hon. Friend and neighbour agree that we have to see what the need is in each area? I contrast the current approach with when Labour were in power in Durham: we brought in new capacity where we knew that areas did not have access to NHS dentistry.

[Mary Kelly Foy]

I thank my right hon. Friend for the intervention. We all know that there is huge demand and such a lack of NHS dentists out there that it is, I guess, a question of political will whether this problem is solved or not.

The absence of oral healthcare from our national debate about the future of the NHS is alarming. Dentistry is integral to our national health and therefore must be key to the NHS. Without proper investment in preventive healthcare such as dental check-ups, we cannot quickly treat oral cancers, nor can we stem the flow of people with dental problems into our already overcrowded accident and emergency departments.

I would be grateful if the Minister responded to the following questions. First, will he ensure that dentistry is properly represented in the governance structures of the NHS? Dentistry must be at the centre of the policy-making process, not an afterthought. Secondly, will the Government publish a comprehensive national dental strategy, one that is focused on prevention and tackling health inequalities? Thirdly, will he undertake meaningful reform of the NHS dental contract, which would stem the flow of dentists out of the system? Fourthly, will he work with the BDA on the previous points?

Finally, as I have said, I raised a point of order yesterday on the Prime Minister’s claim that there are 500 extra dentists in the NHS. There are in fact 700 fewer dentists, not more. Unless I have missed something today, the Prime Minister has not corrected the record, as he is obliged to. Will the Minister finally correct the record on behalf of the Prime Minister?

I could have spoken for hours this evening, reading out the correspondence I have received from constituents. Each constituent’s experience reflects a serious failure by this Government, so I implore the Minister not to insult the intelligence of the people of Durham, but to take this opportunity to accept that there is a crisis in NHS dentistry and to commit finally to meaningful reform.

[The Parliamentary Under-Secretary of State for Health and Social Care (Neil O’Brien)]

Let me come directly to the questions asked by the hon. Member for City of Durham (Mary Kelly Foy). She called for a comprehensive dental reform plan. Yes, we will do that, and we will do it soon. She called for an overhaul of the 2006 contract. Yes, we will do that. Will we work with those at the BDA? Yes. In fact, I met them yesterday. We are keen to draw on their expertise.

I congratulate the hon. Lady on securing the time for this important debate. It is absolutely my top priority right now to work at pace to try to address the significant problems in dentistry. I am not here to say that there is no problem; I am here to try to fix the problem as quickly as possible. We could debate the figure on dental activity all day, but the bottom line is that it is not high enough and we need to get it higher. To come directly to her point about correcting the record and so on, the latest published figures show that there are 1,473 more dentists than there were in 2010—about 6.5% more.

[Mary Kelly Foy]

NHS dentists?

[Neil O’Brien]

NHS dentists, yes. Activity is definitely going up—about a fifth more patients were seen in the year ending March than in the year before that—but it is still too low. That is a point on which we absolutely agree.

We have started—only started—to reform the contract. We have introduced more bands for units of dental activity to better reflect the fair cost of work so that there is fairness for dentists, and to incentivise more NHS work. We introduced the first ever minimum UDA value to help sustain practices where UDA values are low. That has implications for under-delivery in some bits of the country.

We are for the first time allowing dentists to do 110% delivery of their UDAs so that those who want to do more NHS dentistry can do more, with a requirement to update their availability on the NHS website. We have also started the process of making it easier for dentists to come to work in the UK. Last month, we brought into force legislation enabling the General Dental Council to increase the capacity of the overseas registration exam. We are also working with local partners around the country who have various ideas about creating new centres for dental development so that, in areas that do not have a dental school, we can get more people to train and remain, and dentists flow to the bits of the country where there the need is most acute.

Some of those reforms are starting to have effects. It is good that the reforms to split band 2 have been reasonably well received, as has the 110% option. The splitting of band 2 is being used and the proportion of band 2bs is going up. As I say, activity is going up, which is encouraging, but it is not high enough and needs to be higher still. The reforms that we have talked about so far have just been a start. I am under no illusions about the significant challenges to address, not just in Durham but across the whole country.

The forthcoming dental plan will build on those initial steps to go further on improving the payment model and those initial banding changes, especially focusing on improving access for new patients, which is a particular problem. We want to consider how we address historical UDA valuations—they are stuck in time in 2006 and are, in some cases, unfair—and look fundamentally at how we make NHS work more attractive.

--- Later in debate ---

[Neil O’Brien]

My hon. Friend is quite right. Some of those disparities, which can occur from one end of the street to the other, are extremely hard to justify, hence the introduction of the minimum UDA rate and why we are looking at going further. He is completely correct. Funnily enough, as well as coming to improving access to treatment, I was just about to respond to his earlier point about prevention and his rather brilliant idea about what more we could do in schools. We are, following the conversations we have had, actively considering that.

I thank the hon. Member for City of Durham for her important work in securing this important debate.

[Mary Kelly Foy]

It feels as if the Minister is coming to the end of his speech, but I would really like him to correct the record. In my point of order yesterday, I said that the Prime Minister has on seven occasions said that there are 500 more NHS dentists, when there are in fact 700 fewer dentists. If the Minister has met the British Dental Association, it will have pointed that fact out to him. Could he please correct the record, or may I ask you, Madam Deputy Speaker, for advice on how we can encourage the Prime Minister to correct the record before the House rises tomorrow?

[Neil O’Brien]

I have already read out the statistics. I will not read them out again, and I do not think there is a need to correct the record. The statistics that the hon. Lady is drawing on are incomplete, because there is effectively a two-month lag between activity and the need to report that activity. Drawing on such incomplete information does not give the full picture, so I caution her against doing so.

First, I encourage the hon. Lady to wait for the official data in the usual way. Secondly, we are looking to improve that official data by, indeed, working with and responding to concerns raised by the BDA. I do not think that headcount is a sensible measure with the workforce. There are more people doing NHS work than there were in 2010. What we are really interested in is the total amount of activity, which is best measured by the total number of UDAs being delivered. As I have said, that total amount of activity is going up. In the last month for which we have data, it had gone up from 85% in March 2022 to about 101% in March 2023, but it is still not high enough. Although the trend is positive and dentists are doing more NHS work, the point of agreement here is that that needs to improve further.

Reforms to NHS Dentistry

Mary Kelly Foy Excerpts

Thursday 27th April 2023 Commons Chamber

[Mary Kelly Foy (City of Durham) (Lab)]

Across Durham and the whole country, dentistry is in crisis. It is a system in need of urgent reconstruction, not tinkering. To be clear, the problem has not been caused by NHS workers or dentists. It has been caused by the Conservative Government, who have ignored the concept of prevention rather than cure. Dentists have told me that the key issue is the chronic underfunding of NHS dentistry. Let us not forget that it has been subject to cuts unparalleled elsewhere in the NHS.

There is a real recruitment and retention crisis in the workforce, but the situation cannot be improved by simply recruiting more dentists. The fact is that NHS dentists are made to work in a fundamentally flawed system that does not have prevention at its heart. I fear that if NHS dentistry continues down this road, England may have an entirely private dental provision, and the facts speak to that. In August last year, the BBC showed that eight in 10 NHS practices were not taking on children as patients, nine in 10 practices were not accepting adult patients, and a third of council areas were not taking on adult NHS patients. How can we have a preventive approach if my constituents cannot get to see a dentist? In addition, tooth decay is the most common reason for A&E hospital admissions in young children. That is a disgrace.

Nothing could reflect the current crisis more than DIY dentistry. People are fitting their own fillings and extracting their own teeth without anaesthetic or professional training. This week alone, I have been contacted by eight constituents who have performed DIY dentistry. The situation is compounded by the cost of living crisis, which is blighting the lives of ordinary people. If someone needs to choose between eating and heating, they will probably not want to fork out for an expensive root canal; they will probably choose to have an extraction instead or do it themselves. This is a stark example of health inequalities.

I have some questions for the Minister. When will the Government adopt a preventive approach to health and social care, particularly to dentistry? When will the Government provide NHS dentistry with the funding it desperately needs? Has the Department had meetings recently with the Treasury to discuss funding? When will the Government work with the British Dental Association to reform the current dental contract, to stop the exodus of staff from the NHS?

In 1948, Labour recognised that it was vital to integrate dentistry within the NHS and that oral health is not an optional luxury but integral to our national health and key to the NHS. How we tackle it must therefore be a priority, not an afterthought. Only a Labour Government can save dentistry from the rot and decay that has set in under the Tories’ watch.

Oral Answers

Mary Kelly Foy Excerpts

Tuesday 25th April 2023 Commons Chamber

[Neil O’Brien]

I pay tribute to my hon. Friend’s work as chair of the all-party parliamentary group for vaping. He is right; as well as the measures I mentioned, we have updated the guidance on Talk to FRANK, to illustrate for young people the dangers of consuming lots of nicotine.

[Mary Kelly Foy (City of Durham) (Lab)]

In 2021, the Government rejected my amendment to the Health and Care Bill to tackle smoking and youth vaping. England is now set to miss the Smokefree 2030 target by at least seven years, and countless children are now addicted to vapes. I welcome the U-turn, but what steps has the Minister taken to make up that lost time?

[Neil O’Brien]

We are taking action across the board on smoking. I think we are in agreement on what has to be done. That is why we recently announced that we are giving vaping kits to a million smokers to help them swap to stop. We are also bringing in new health incentives for all pregnant women so that we can help them stop—that is based on good local evidence. We are taking preventative action, and I think the hon. Lady and I both want the same thing.

NHS Strikes

Mary Kelly Foy Excerpts

Monday 17th April 2023 Commons Chamber

[Steve Barclay]

I do agree with my hon. Friend. If that demand were agreed to, it would mean some junior doctors receiving a pay rise of over £20,000. We need to find a balance, with a fair and reasonable settlement for NHS staff, recognising the huge pressure from the pandemic and the backlogs it has caused, while at the same time bringing inflation down, because that matters not just to NHS staff, but to all working people who are impacted by inflation.

[Mary Kelly Foy (City of Durham) (Lab)]

The BMA has made it crystal clear that it is willing to enter into negotiations, so will the Secretary of State commit right now to asking ACAS to negotiate and mediate? If not, why not?

National No Smoking Day

Mary Kelly Foy Excerpts

Thursday 9th March 2023 Westminster Hall

[Mary Kelly Foy (City of Durham) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Efford. I congratulate the hon. Member for Harrow East (Bob Blackman) on securing this really important debate to mark national No Smoking Day. For the record, I am vice-chair of the APPG on smoking and health and was Gateshead Council’s cabinet lead on public health for 10 years, so I am passionate about making smoking history. It is telling that a number of Members present are from the north-east, and we will be reiterating the same messages.

The last tobacco control plan expired at the end of last year, and we are still waiting for the response from the Government to Javed Khan’s independent review on tobacco control. While we wait, thousands of people are getting sick and dying from smoking-related illnesses that are wholly preventable. Since 2000, more than 113,000 people in the north-east have died from smoking, and one person is admitted to hospital in the UK every minute due to smoking.

Although there is rightly a lot of discussion about smoking being the No. 1 cause of cancer, it is important to recognise the host of life-threatening and life-altering illnesses caused by smoking, including COPD, heart disease, dementia, stroke and diabetes. I am therefore delighted that this year’s No Smoking Day campaign is shining a light on the link between smoking and brain health. Smoking has been identified as one of the 12 risk factors that, if eliminated, could collectively prevent or delay up to 40% of dementia cases. Alzheimer’s Research UK found that dementia is the most feared health condition for people over the age of 55. However, only one in five people who smoke in the north-east are aware that smoking raises the risk of dementia. It is therefore vital to get that message out there. It is great that Fresh’s radio ad on this issue is estimated to reach more than 670,000 people in the north-east. I am proud that the north-east has been a trailblazer on this issue, with local authorities across the region working together to fund Fresh, which is a highly effective tobacco control programme. It has nearly halved the smoking rate in the north-east since it was set up. I am pleased to hear that Fresh will once again be funded by all 12 local authorities in the region.

Although it is great to see that work happening locally, it is vital that it is supported by much more investment at a national level. It is shocking that England is on track to miss the smoke free 2030 ambition by nine years, while projections by Cancer Research UK suggest that it will take a further 20 years to get smoking down to 5% in England’s poorest communities. The north-east is the most disadvantaged region in England. With that come high rates of smoking, which means there is further for us to go to become smoke free. The fact that smoking rates are disproportionately high among deprived communities highlights the fact that smoking is one of the leading drivers of health inequalities in our society. As we have heard, smoking during pregnancy is five times more common in the most deprived communities than in the least deprived. In County Durham, 704 women a year are smokers when they give birth, while 41,233 children live in households with adults who smoke. That not only has severe health consequences for children living in deprived areas, but increases fourfold their chance of taking up smoking and remaining a smoker in adulthood.

As well as having a shorter life expectancy overall, men and women in the most deprived areas also suffer from ill health for more of their lives. The levelling-up White Paper identified addressing health inequalities as a priority, yet little has been done so far. The Government’s lack of action and their delay in responding to the Khan review threaten our ability not just to achieve the 2030 smoke free goal but to level up. They must take action now and look urgently to implement the recommendations in the report from the APPG on smoking and health and in the Khan review to tackle the prevalence of long-term illness in areas of deprivation.

We all know that smoking is our biggest preventable killer and, as we have just heard, it is devastating for the thousands of families who lose loved ones each year. It also has significant implications for our economy, our local authorities and our health service. It is estimated that smoking costs County Durham £211.9 million each year, £26 million of which is spent on healthcare. Preventing ill health is key, and it is clear that effective Government action on the issue would relieve the significant pressure that smoking places on our health and social care services. There is no time to waste when we consider that our NHS is in crisis as resources are stretched to the absolute limit.

We must also ensure that smokers have the best chance of success when they attempt to quit, whether that is through support from local stop smoking services or access to alternatives. At the same time, we must prevent children and young people from taking up smoking in the first place, reduce the demand for and supply of illegal tobacco, and support further enforcement around illicit tobacco.

Four years ago, the Government set out their ambition for England to become smoke free by 2030. In April 2022, I asked the Government to ensure that the tobacco control plan would deliver their ambition and that it would be published no later than three months after the Khan review. Here we are, nearly 12 months on, and I am still asking the same question and we are still waiting for action. The chair of the Durham health and wellbeing board even wrote to the Secretary of State about the Khan review, but she received a non-committal response. With that in mind, will the Minister tell us when he plans to publish the tobacco control plan and what the Government intend to commit to on the back of the Khan review? Every day that we wait, too many people are dying needlessly.

[Clive Efford (in the Chair)]

Absolutely impeccable. Thank you very much—you have made it very easy to chair.

NHS: Long-term Strategy

Mary Kelly Foy Excerpts

Wednesday 11th January 2023 Commons Chamber

[Mary Kelly Foy (City of Durham) (Lab)]

Let us be clear: the NHS crisis did not begin with covid. It is the culmination of 13 years of failure and neglect by the Conservative party. Nye Bevan described the creation of the NHS as

“the most civilised step any country has ever taken”.

After hearing the horrifying testimonies today of delayed ambulances and operations, it is clear that we have taken a giant and shameful step backwards. Our overworked and underpaid healthcare staff are telling us that with more than 100,000 vacancies in the NHS, safe and timely care can no longer be guaranteed. Underfunding is causing delays, and delays have real-life consequences on people’s lives, as I know only too well.

In 1989, a decade into an earlier Conservative Administration, my daughter was born 10 weeks premature. She needed a ventilator before she could breathe on her own. The local hospital did not have one, and neither did any of the surrounding hospitals. Eventually, one was found 30 miles away, and Maria was born three hours later by emergency C-section. As a consequence she suffered brain damage, and lived her life with severe cerebral palsy. No parent should face such an agonising delay today, but the harsh reality is that there are no guarantees.

Decisions made in this place have life-changing impacts on the people we represent, and under the watch of the Tories, the words “NHS” and “crisis” have again become synonymous. Today, ambulance workers from the Unison and GMB unions have been forced to strike in order to protest against the underfunding of the service, and the dangerous disfunction it has created. People are dying needlessly. Labour has a clear plan to train a new generation of doctors, nurses and midwives, and to have meaningful negotiations to end the strikes.