Oral Answers to Questions

Neil O'Brien Excerpts

Tuesday 24th January 2023 Commons Chamber

[Gill Furniss (Sheffield, Brightside and Hillsborough) (Lab)]

20. What recent assessment he has made of the adequacy of access to NHS dentistry.

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

The Government are working to improve access. We have made initial reforms to the contract and created more unit of dental activity bands to better reflect the fair cost of work and to incentivise NHS work. We have introduced a new minimum UDA value to help sustain practices where they are low, and we are allowing dentists to deliver 110% of their UDAs for the first time to deliver more activity. Those are just the first steps; we are planning wider reforms.

[Peter Aldous]

On 20 October, the House passed a motion highlighting the continuing crisis in NHS dentistry and calling on the Government to report to the House in three months’ time on their progress in addressing this crisis. That time has now elapsed. I am grateful to the Minister for that update, but can he confirm that the Government will be producing a comprehensive strategy for the future of NHS dentistry, and can he inform the House when it will be published?

[Neil O’Brien]

It was very useful to meet my hon. Friend the other day, who is a great expert on this issue. As he knows, we are working at pace on our plans for dentistry. As well as improving the incentives to do NHS work, we are working on the workforce to make it easier for dentists to come to the UK. We laid draft secondary legislation in October to help the General Dental Council with that. We are working on our plans for a centre for dental development in Ipswich and elsewhere in the east of England, as he knows. Although we have not yet set a date to set out the next phase of our plans, my hon. Friend knows from our meeting that this is a high priority area for us and that we are working on it at pace.

[Gill Furniss]

I was contacted recently by my constituent Helen, who said:

“I don’t know what to do. I have phoned 25 dental practices today and been told the same thing each time: all we can do is put you on a 3 year waiting list.”

What does the Minister say to Helen and the thousands who, like her, cannot access an NHS dentist? When will he get a grip on this crisis?

[Neil O’Brien]

We are the first to say that the current situation is not satisfactory. That is why we invested an extra £50 million in the last quarter of last year, and it is why we are working at pace. Let us be clear: dentistry has not been right since Labour’s 2006 contract, and until we fix the fundamentals of that and the problems set up by the Opposition, we will not tackle the underlying problem.

[Rachel Maclean (Redditch) (Con)]

7. What steps his Department is taking to increase the number of NHS beds available in the Alexandra Hospital in Redditch.

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[Mr Toby Perkins (Chesterfield) (Lab)]

11. If he will make an assessment of the adequacy of GP appointment availability in (a) Chesterfield constituency, (b) Derbyshire and (c) England.

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

In November, there were 13.9% more appointments in general practice across England as a whole than in the same month before the pandemic. In Derby and Derbyshire, there were 16.6% more appointments. Our GPs are doing more than ever, and, compared with 2015-16, we are investing a fifth more in real terms. But we know that demand is unprecedented, and we are working to further support our hard-working GPs.

[Mr Perkins]

I thank the Minister for that answer. We know that there are GP appointment difficulties everywhere, but we also know that it is much more difficult in more deprived communities. Social Market Foundation research shows that GPs in more deprived communities have twice as many patients on their books than those in more affluent areas. This means that, in addition to the greater health inequalities in those communities, people are finding it very difficult to get appointments, including at the Royal Primary Care practice in Staveley. Why should patients in more deprived communities be expected to tolerate far greater difficulties in getting GP appointments than those in more affluent areas?

[Neil O’Brien]

In Derby and Derbyshire, for example, there are 495 more doctors and other patient-facing staff than in 2019. Step 1 is to have more clinicians, which we are doing through that investment. The hon. Member raises a point about Carr-Hill and the funding formula underlying general practice. There is actually heavy weighting for deprivation, and the point he raises is partly driven by the fact that older people tend not to live in the most deprived areas, and younger people tend to live in high IMD—index of multiple deprivation—areas. That is the reason for the statistic he used. Funding is rightly driven by health need, which is also heavily driven by age. We are looking at this issue, but the interpretation he is putting on it—that there is not a large weighting for deprivation—is not quite right.

[Maggie Throup (Erewash) (Con)]

In south Derbyshire there are now 133 more full-time equivalent clinical staff in general practice than in 2015. That includes nurses, physios and clinical pharmacists. What more is my hon. Friend doing to encourage more people to book an appointment with the most appropriate healthcare professional, rather than simply defaulting to booking a GP appointment?

[Neil O’Brien]

That is an excellent question. As well as having an extra 495 staff across Derby and Derbyshire, it is crucial that we use them effectively by having good triage. That is why we are getting NHS England to financially support GPs to move over to better appointment systems. That is not just better phone systems, but better triage.

[Justin Madders (Ellesmere Port and Neston) (Lab)]

T1. If he will make a statement on his departmental responsibilities.

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[Paul Holmes (Eastleigh) (Con)]

Eastleigh, Hedge End and the villages have many vibrant pharmacies, but it is disappointing that Lloyds has closed two branches in my constituency. I welcome the additional £100 million that this Government are investing in community pharmacies, but can my right hon. Friend confirm how that funding will cut NHS waiting times and, more importantly, reverse the trend of closures?

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

My hon. Friend is right. Although pharmacies are private businesses, we invest £2.5 billion in the clinical services they provide. We put in another £100 million in September so that they can provide more services. The number of community pharmacists is up by 18% since 2017, and we have introduced the pharmacy access scheme to ensure that we support pharmacies in areas where there are fewer of them. Clearly, the solution is for pharmacies to do more clinical work, take the burden off GPs and provide accessible services. That is exactly what we will keep growing.

[Mr Speaker]

I call the Scottish National party spokesperson.

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[Dr Luke Evans (Bosworth) (Con)]

I declare an interest as a GP and the immediate family of a GP and doctors. GPs are working incredibly hard in tough times. It is true that supply has gone up, but so too has demand. Change needs to happen in primary care, but one of the bedrocks is the GP partnership model. Does this Government agree?

[Neil O’Brien]

Unlike the Opposition, we do not regard GPs’ finances as murky and we do not want to go back to Labour’s policy of 1934 by trying to finish off the business that even Nye Bevan thought was too left-wing. We do not believe in nationalising GPs; we believe in the current model. [Interruption.] We do not believe that people with a problem should immediately go to hospital, driving up costs and undoing the good work of cross-party consensus in the last 30 years. A plan that was supposed to cause a splash has belly-flopped.

[Mr Speaker]

Mr O’Brien, when I move on, I expect you to move on with me. I have all these Back Benchers to get in. I do not need the rhetoric; I want to get Members in—I want to hear them, not you.

[David Linden (Glasgow East) (SNP)]

T2. The UK has the sixth largest and richest economy in the world, yet data from the Food Foundation shows that in September 2022, 9.7 million people on these islands lived in food insecurity. That kind of malnutrition does not have a good impact on the health service. When will Ministers pick up the phone or nip along the corridor to the Department for Work and Pensions and tell it to drop its punitive sanctions regime, which pushes so many people into poverty and so many problems on to the NHS?

[Neil O’Brien]

We are concerned about the exact same issues. The £900 cost of living payment for 8 million households is how we are trying to address this. It is also why we are bringing in the largest ever increase in the national living wage for 2 million workers.

[Priti Patel (Witham) (Con)]

The Secretary of State is well aware of the challenges facing Essex mental health care and the independent inquiry there into so many patients who have died. Can he tell the House and my constituents what steps he is taking to make this a statutory inquiry?

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[Anna Firth (Southend West) (Con)]

“The Future of Pharmacy” report was published yesterday and highlighted again the funding pressures on the sector, including for the brilliant Belfairs Pharmacy in Leigh-on-Sea, which asks whether the Minister will urgently consider writing off the £370 million of covid loans given to pharmacies during covid-19.

[Neil O’Brien]

We are working to increase the amount of funding going into pharmacies so that they can do more clinical services. I will look closely at the issue that my hon. Friend raises.

[Matt Western (Warwick and Leamington) (Lab)]

T7. Last week, the Government decided to mothball the covid-19 testing facility in Leamington, which will leave up to 670 people without a job. The lab reputedly cost more than £1 billion—perhaps the Minister could confirm—and when the investment was made, I was promised that it would be used for other purposes, such as pathological testing and other diagnostics. Why is that not happening?

--- Later in debate ---

[Neil O’Brien]

Absolutely; we are looking at that issue. We have already brought in a new minimum UDA value, and we would like to deliver more. We will look at measures to encourage people to work in areas with the greatest shortages.

[Jim Shannon (Strangford) (DUP)]

T8.   On World Cancer Day 2022, the then Secretary of State for Health and Social Care, the right hon. Member for Bromsgrove (Sajid Javid), announced a 10-year cancer plan to make us a world leader. Today, cancer services are buckling under immense pressure. Can the Minister confirm that the strategy will be fully resourced and will she commit to working with cancer charities to ensure that it is delivered?

Draft Health and Social Care Information Centre (Transfer of Functions, Abolition and Transitional Provisions) Regulations 2023

Neil O'Brien Excerpts

Tuesday 17th January 2023 General Committees

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

I beg to move,

That the Committee has considered the draft Health and Social Care Information Centre (Transfer of Functions, Abolition and Transitional Provisions) Regulations 2023.

It is a pleasure to serve under your chairmanship, Mrs Latham, and I hope that your throat feels better soon.

To make sure that everyone has the right version of the statutory instrument, I draw the Committee’s attention to the correction slip for the SI, which amends two points:

“Page 3, regulation 5(3)(a): omit “annual”

Page 22, regulation 63(a): “paragraph (b)” should read “paragraph (a)”.

The regulations are intended to transfer the statutory functions of the Health and Social Care Information Centre, which operates as NHS Digital, to NHS England, and to wind up NHS Digital. They do that in a relatively straightforward way, using the powers in the Health and Care Act 2022, which allow regulations to transfer the functions of certain bodies to others. Part 1 of the schedule amends primary legislation - chiefly the Health and Social Care Act 2012, which established NHS Digital and set out its statutory functions. Those key functions are transferred to NHS England, unless there is an equivalent function which NHS England already has, or a function is no longer needed, for example, the provisions relating to the board and governance, which will no longer be needed once NHS Digital is abolished.

There are also consequential and transitional provisions, replacing references to the NHS Digital, called the Information Centre, with NHS England in primary legislation, and part 2 of the schedule similarly amends secondary legislation.

The transfer is taking place in response to the recommendations of a November 2021 review entitled “Putting data, digital and tech at the heart of transforming the NHS”. That important review was commissioned by the Government in 2020 and conducted by Laura Wade-Gery, interim chair of NHS Digital and non-executive director of NHS England. The review’s goal was to ensure that the centre of the NHS is able to provide the right leadership and support to integrated care systems to use digital and data more effectively to deliver improved patient outcomes. It called for a realignment of the organisational responsibilities for digital transformation of the NHS, to deliver a new operating model. To achieve that, a specific recommendation was made to consolidate the functions of NHS Digital into NHS England, with an intent to merge legally once legislation enabled that, to help tackle the problem of digital remaining in its own silo and to ensure better alignment with service delivery.

The review’s recommendations were fully accepted by the Government in November 2021. The Secretary of State for Health and Social Care announced on publication of the review that NHS Digital’s functions would be transferred to NHS England as soon as legislation allowed. This SI is the legislation needed to make that happen.

We want to see the excellent work of NHS Digital continue, but we want that to happen within a single central organisation that takes responsibility for all elements of digital transformation and data. As things stand, the functions will transfer unchanged in effect. The transfer, will, however be a critical milestone in making sure our work on digital, data and technology is better aligned with service delivery and patient needs.

We will, of course, be transferring all staff and assets to NHS England at the same time via a separate transfer scheme. The transfer will reduce duplication, bringing the NHS’s national data and technology expertise together into one organisation.

We know that people recognise the value of their data in helping to improve the outcomes from the health service and from social care, but they also want to be reassured, quite rightly, that their personal data is safe. NHS Digital has been an extremely effective guardian of public data, and we will ensure that NHS England, in taking on NHS Digital’s functions, upholds the highest standards of data protection and transparency. The regulations transfer all of the existing safeguards for data, and add to them, by requiring NHS England to have regard to statutory guidance on how it protects people’s data and to report annually specifically on how it has exercised the functions being transferred to it by the SI. Those are new requirements compared with what NHS Digital had to do.

The guidance will recommend NHS England establishes processes and procedures for obtaining independent advice when exercising the transferred data functions. The arrangements for obtaining independent advice should support oversight and scrutiny of the relevant functions of NHS England’s board. NHS England will act transparently, publishing all procedures for when the Secretary of State requests data, or an outside body makes a request, and will publish details of organisations that have been allowed access to data, along with the purpose for that access and the data they have used.

People can have confidence that NHS England will uphold the highest standards of data management, including how it stores, manages, processes and allows access to data. The regulations ensure that by transferring the existing statutory framework of protections and then building on them, and I commend them to the Committee.

--- Later in debate ---

[Neil O'Brien]

Some excellent questions have been asked. My hon. Friend the Member for Amber Valley asked about the vision that the proposal is part of. It is certainly the case that there is a process of simplification of organisations, of which the transfer is another major step. The Health and Social Care Act 2022 also gave Ministers powers of direction over NHS England that did not exist before. None the less, that basic operational independence and structure still stands, so there is change but not a wholesale one compared with the 2012 arrangements.

My hon. Friend the Member for South Thanet asked a really important question about interoperability across the UK. As well as trying to promote that in the NHS, a piece of work is being done by the Department for Levelling Up, Housing and Communities and the Cabinet Office about comparability of data not just in health, but across the work of Government. I am sure that my hon. Friend would find that interesting.

The Opposition spokesman, the hon. Member for Denton and Reddish, asked who we have discussed the transfer with, and the answer is that we have discussed it with the devolved Administrations, the Information Commissioner’s Office, the National Data Guardian, medConfidential and, of course, NHS England and NHS Digital. The staff of those latter two organisations have been fully consulted and know all about the plans. In terms of the speed of the merger, the powers in the SI come into effect immediately, so that the merger can take place towards the end of the month.

I am trying to remember the hon. Gentleman’s other question—

[Andrew Gwynne]

Staff involvement.

[Neil O'Brien]

Absolutely. All the staff know about what is happening and have been consulted fully about the streamlining.

The SI will bring together NHS Digital and NHS England. It will not only preserve existing safeguards around people’s data but will establish slightly stronger ones. Effectively, it will deliver the preservation of the existing regime governing data protection as we bring the two organisations together and it will create all the efficiencies that that process will enable. I commend the regulations to the Committee.

Question put and agreed to.

Sudden Unexplained Death in Childhood

Neil O'Brien Excerpts

Tuesday 17th January 2023 Westminster Hall

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

I am grateful to my right hon. Friend the Member for Spelthorne (Kwasi Kwarteng) for securing the debate on this incredibly important issue. It is the first debate of its kind in this House and he made a number of important points, which I will address.

The first point was about raising awareness, which is something that the debate itself does. We recognise the devastation to families caused by the sudden and unexpected death of a child. Each death is a tragedy and that we are unable to offer the families an explanation for the child’s death after what will have been a long and potentially invasive process, including a coroner’s investigation, must compound the family’s confusion. For the death to be unexplained just adds to the trauma.

I thank hon. Members for some powerful speeches and interventions, including those from my hon. Friends the Members for Warrington South, for Runnymede and Weybridge (Dr Spencer), for South West Hertfordshire (Mr Mohindra), for Witney (Robert Courts) and for Keighley (Robbie Moore), and the hon. Members for Westmorland and Lonsdale (Tim Farron), for Oldham East and Saddleworth (Debbie Abrahams), for Hammersmith (Andy Slaughter) and for Lancaster and Fleetwood (Cat Smith), as well as hon. Members who have listened but not been able to speak today.

I acknowledge the advocacy work of the organisation SUDC UK, which is raising the profile of the issue and providing valuable support for families. We all share the same end goal, which is to reduce the risks of sudden unexplained death in childhood, and I welcome the contributions that have been made to today’s debate.

As has been mentioned, there has been a reduction of around 70% in the number of unexplained deaths in infancy since the early 1990s. The risk factors are well recognised and the steps that parents can take—safer sleeping practices or stopping smoking—have formed clear messages for years. We are still sponsoring more research on infancy to help reduce those risks further.

[Andy Slaughter]

The Minister mentioned sudden infant death syndrome. One of the asks that has come from both sides of the House has been whether the Department and the NHS can give the same priority to SUDC as it gives to SIDS in terms of education, research and provision of information to the public.

[Neil O'Brien]

That is exactly what we want to do. We are committed to the health service learning from child deaths. In 2019, the Government published the “Child Death Review Statutory and Operational Guidance (England)”, advising NHS trusts on how they should support, communicate with and engage with families following the death of someone in their care. Listening to bereaved families and ensuring clear communication is integral to the process, and putting clear support in place is a top priority. That guidance sets out the full process that follows the death of a child in England. It builds on the statutory requirements set out in “Working Together To Safeguard Children” and clarifies how individual professionals and organisations across all sectors involved in the child death review should contribute to reviews.

It is important that when a child dies, bereaved parents should be supported to understand the child death review process and how they are able to contribute to it. The family should be assigned a key worker to act as a single point of contact for the bereaved family, who they can turn to for information and who can signpost them to sources of support. The hon. Member for Lancaster and Fleetwood mentioned one particular, excellent way to do that.

Each local authority area has a child death overview panel that is responsible for reviewing information on all child deaths, looking for possible patterns and potential improvements in services, with the aim of preventing future deaths. This process enables us to act quickly to address local failings within the system.

The first step towards understanding the problem is to get the data. In 2018, NHS England supported the establishment of the national child mortality database to reduce preventable child mortality in England. The NCMD records comprehensive data on the circumstances of children’s deaths and is the first of its kind anywhere in the world. The child death review process aims to ensure that information regarding every child death is systematically captured and submitted to the NCMD to enable learning to prevent future deaths.

In December, the NCMD published its report into sudden and unexpected deaths in infancy and childhood. The Government are grateful to the NCMD for its important research, which is a significant step forward. Of the 204 unexpected and sudden deaths of children reviewed by child death overview panels in 2022, 32 were classified as unexplained. The report highlighted that both explained and unexplained deaths in this age group were associated with a history of convulsions, but that association still needs further research, which I will come back to later.

The NCMD provides evidence for investigation, responding to deprivation, housing and other potential risk factors, which the hon. Member for Denton and Reddish (Andrew Gwynne) asked about. Housing Ministers are already strengthening the powers of the regulator of social housing to tackle unsafe homes, and introducing a decent home standard for the private rented sector for the first time ever, which will make sure that privately rented homes are safe and decent.

My right hon. Friend the Member for Spelthorne asked how we will improve medical education, and the report recommends consistent national training on the child death review statutory process and on sudden unexplained death in childhood. Sudden deaths of children over 12 months of age are not well understood, especially where those deaths remain unexplained. As I have outlined, child death overview panels will continue to develop their processes following the publication of the child death review statutory and operational guidance, and they will be supported by the NCMD and work with relevant professional bodies where appropriate.

We are modernising healthy child programme resources to improve available evidence for health and other professionals who work with children. This will include stronger evidence on safer sleep and sleep hygiene for older children, and NHS England is also making commitments to improve knowledge. The children and young people programme is reviewing the patient information made available, so that it is relevant and appropriate. This will involve a review of all NHS-commissioned information, including on febrile seizures. NHS England is also conducting a review of the leaflet that is handed out when a child dies, which will provide further information on sudden unexpected death in childhood.

The hon. Member for Lancaster and Fleetwood asked specifically about the NHS website. The team are reviewing the information with patient groups, so that it is appropriate.

A number of Members have quite rightly called for more research, and the report calls for further research into SUDC to better identify modifiable factors. My officials have contacted their counterparts at the University of Bristol to discuss potential research priorities, and I am happy to continue that dialogue with Members of this House and others, to scope further research priorities. Such research will help us better understand what can be prevented. The National Institute for Health and Care Research welcomes funding applications for research into any aspect of human health, including sudden unexplained death in childhood, and NHS England will be working with the NCMD to track trends in modifiable factors further. Their work will help to raise awareness across professions and identify key areas for research. My officials are also in contact with the chief nursing officer in England about any opportunities linked to the CNO’s research strategy. I look forward to hearing experts and parents’ suggestions on research, so that we all have better data on prevalence and a shared understanding of risks around gender, ethnicity and other characteristics.

Someone would have to have a heart of stone to not be moved by the contributions to today’s debate. By raising awareness and developing the understanding of modifiable factors, we can provide better information to parents and professionals, and help to reduce the risks, so that more families will not have to suffer in the same way.

[Derek Twigg (in the Chair)]

I call Kwasi Kwarteng to wind up. You have a bit more time than we originally envisaged.

NHS Dentistry: Salford and Eccles

Neil O'Brien Excerpts

Monday 19th December 2022 Commons Chamber

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

Let me start by congratulating the hon. Member for Salford and Eccles (Rebecca Long Bailey) on securing this important debate. I share her frustration and am aware that some areas in the country face serious difficulties with access to NHS dental care. She used some powerful examples, which are exactly the kinds of things that we are trying to fix.

As we recover from the pandemic, activity is going back up again and we want it to go up faster. Dentistry is an important part of the NHS. We are committed to addressing the challenges that NHS dentistry faces in some parts of the country. We are continuing to take important steps to improve access for patients. There are variations around the country, which was already an issue before the pandemic.

The specific risks from covid in dentistry, for obvious reasons given the nature of the treatment—looking down people’s throats and breathing in the same air—resulted in the need to reduce the amount of care that could be delivered, in line with infection prevention and control measures to keep patients and the workforce safe. The pandemic placed further pressure on the system. However, NHS dentistry provision has been increasing gradually and safely. I am pleased to say that NHS England asked all dental practices to return to 100% of their contracted activity in July this year. Many practices are already delivering at that level and, in some cases, beyond. I will go on to talk about delivering beyond.

To support the industry during this testing time, we took unprecedented action and provided over £1.7 billion in income protection, to ensure that NHS dentist capacity was retained and services were provided and available after the pandemic. We made an additional £50 million available for NHS dental services at the end of last year, to increase capacity in NHS dental teams. Appointments were given to those in most urgent need of dental treatment, including vulnerable groups and children. As a result of that funding, I am pleased that say that an additional 1,110 patients were seen in Salford. To support the provision of urgent care, more than 170 urgent dental care centres remain open across the country. One of those centres is in the Salford locality, as the hon. Lady knows.

Across the nation, the system is recovering and delivery of dental care is increasing. In 2021-22, 24,272 dentists performed NHS activity—an increase of 539 on the previous year. In the 12 months to 30 June this year, 5.6 million children were seen by an NHS dentist, compared with 3.9 million children in the same period the previous year. That represents a 43% increase.

[John McDonnell (Hayes and Harlington) (Lab)]

There have been reports in a number of our constituencies of almost a dental health epidemic. Can the Minister explain whether there will be targeted resources for a number of our constituencies where there is such a high level of child dental ill health?

[Neil O’Brien]

I am exploring how we can best target the places with the most acute problems. There are problems in a lot of different places, and we are thinking about that actively at the moment. I will come back to that as I make progress.

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

rose—

[Madam Deputy Speaker (Dame Rosie Winterton)]

Order. I gently say to the hon. Gentleman that if he wanted to intervene, he ought to have been here right at the beginning, because it is the hon. Lady’s Adjournment debate, and it is about Salford and Eccles? I leave it to him to decide whether he wishes to intervene.

[Neil O’Brien]

I am happy to take whatever interventions are appropriate.

We know that there are still further improvements to be made. Although I am pleased that over 75% of the patients who tried to get a dental appointment over the last two years were successful, this is not back to the level that we were seeing pre-pandemic, which was 92%. That is why in July and in our plan for patients, which the hon. Lady mentioned, we announced some improvements to the 2006 contract to ensure that patient access was improved, although I want to reassure her that we do not regard those as the end of the story; they were a stepping stone.

Those changes included: making sure that dentists were remunerated more fairly for complex work, which will improve access for patients; implementing a minimum value of £23 for each unit of dental activity, boosting incomes in the places where the UDA value is lowest; and enabling dental practices to deliver up to 110% of their contract levels, to increase activity and allow those practices that are delivering NHS care most effectively to deliver more. This effectively takes away the cap that has been in place since the 2006 contract, which the hon. Lady mentioned.

This package will increase and improve access to dental care for patients across the country. We have already taken action to implement these changes, including through regulations that came into effect on 25 November. The changes have all been decided with careful consideration, working collaboratively with the dental sector. The Department has worked with the General Dental Council on legislative proposals that will make registration processes for dental professionals qualified outside the UK more proportionate and streamlined, making the process to join the UK workforce more efficient for dentists from overseas. These changes are another way in which we are seeking to improve access for patients.

Finally, to make it easier for patients to find dentists taking on new patients, we have made it a requirement for NHS dentists to update their information on the NHS website, which has historically been out of date, but of course we are looking to go further to ensure that those appointments are there. These changes are just the beginning. They are the necessary first steps of our work to improve NHS dentistry. These are the measures that we can take immediately, and they will have a noticeable impact, but we will go further.

Looking forward into the new year, we have been working with NHS England and the sector on further changes to improve access. Our priorities for this next phase of reform include: improved access to urgent care for patients who need to see someone immediately; better access to care for new patients; and further workforce and payment reform. We aim to take the necessary steps to implement these changes next year, but I am keen to seek every opportunity to take action wherever I can, and ahead of those reforms we are also actively considering what support we can offer to help patients who do not currently have access to the dental system and those who are not attached to a practice, who have the worst access. We are also considering how the recruitment and retention of dentists can be improved, particularly in the parts of the country where the need is greater. We are also thinking further about how overseas qualified dentists can be supported to start working in the NHS more quickly.

I am strongly committed to improving our NHS dental system wherever I can for all those who need it. The hon. Lady has set out a powerful case today on why we need to go further, and we will go further. I thank her for raising this important debate, and I hope that she will be reassured that although the reforms we have made so far will make a difference, they are far from being the end of the story, and that we will continue to take action to improve access to NHS dentistry across the nation.

Question put and agreed to.

Eye Health

Neil O'Brien Excerpts

Thursday 15th December 2022 Westminster Hall

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

It is a pleasure to serve under your chairmanship, Mr Sharma. I thank the hon. Member for Strangford (Jim Shannon) for bringing forward this important debate. He has been a strong advocate for eye health for a long time. He speaks from huge knowledge and personal experience, and I listened to his speech with great interest. Given that health is a devolved matter, a lot of my response will focus on England, as he suggested. I understand that the devolved nations are facing similar challenges. We are always interested in sharing ideas and working with our counterparts, in answer to the question asked by the hon. Member for Motherwell and Wishaw (Marion Fellows).

There are 2 million people living with sight loss, and that is predicted to double to 4 million by 2050 as a result of an ageing society. Sight loss is often preventable, and that is why prevention and early detection, along with access to diagnosis and timely treatment, are key. One of the best ways to protect our sight is to have regular sight tests. The hon. Member for Strangford rightly underlined why that is so important with his powerful story about the tennis ball-sized tumour that his constituent had taken out.

When combined with early treatment, sight tests can prevent people from losing their sight. That is why we continue to fund free NHS sight tests for many, including those on income-related benefits, those aged 60 and over, and those at risk of glaucoma and diabetic retinopathy —two of the main causes of preventable sight loss. More than 12 million NHS sight tests were provided to eligible groups in 2021-22. We also provide help with the cost of glasses and contact lenses through NHS optical vouchers. Eligible groups include children and those on income-related benefits. The NHS invests over £500 million annually to provide sight tests and optical vouchers.

The risk factors for sight loss include ageing, medical conditions such as diabetes, and lifestyle factors such as smoking and obesity. We are taking action to reduce obesity and smoking. Smoking rates in England are already the lowest in history, and we remain committed to going further to be smoke free by 2030. We are working to drive down the number of people who take up smoking, and we are supporting those who wish to quit. We are also working with the food industry to ensure that it is easier for people to make healthy choices, and we are supporting adults and children living with obesity to achieve and maintain a healthier weight.

Turning to the medical conditions that lead to sight loss, diabetic retinopathy—a common complication of diabetes—is a potentially sight-threatening condition. The diabetic retinopathy screening programme now provides screening to over 80% of those living with diabetes annually. Between 2010 and 2019-20, the number of adults aged between 16 and 64 who are registered annually as visually impaired due to diabetic retinopathy has fallen by 20%, meaning that it is no longer the main cause of sight loss in adults of working age. The screening programme has played a major role in that.

[Jim Shannon]

I thank the Minister for his helpful response. The target of providing retinopathy screening to 80% of those living with diabetes has been achieved. Are there any plans to try to reach the other 20%? I am diabetic. I had my retinopathy test about four weeks ago; I get it every year. I know the encouragement and confidence that testing gives people once they know they are okay. Are there any ideas for how we can get to the other 20%?

[Neil O'Brien]

Absolutely. As the hon. Gentleman says, we are keen to constantly drive that rate up, and we can talk more offline about the different things that we can potentially do to drive it up even further. The healthy child programme recommends eye examinations at birth, six weeks and age two, and school vision screening is also recommended for reception-age children.

The hon. Member for Strangford raised a question about a special school, which I will address specifically. The NHS long-term plan made a commitment to ensure that children and young people with a learning disability, autism or both who are in special residential schools have access to sight tests. NHS England’s proof of concept programme has been testing an NHS sight-testing model in both day and residential schools, and it is currently evaluating its proof of concept as part of programme development, which we expect to conclude towards the start of 2023. The evaluation will then inform decisions about the scope, funding and delivery of any future sight-testing model. I reassure the hon. Gentleman that, at present, absolutely no decisions have been made; we are waiting for the evidence that that programme is generating.

I turn to secondary care. Once an issue with eye health is detected, it is vital that individuals have access to timely diagnosis and any necessary treatment. The NHS continued to prioritise those with urgent eye care needs throughout covid-19. However, we acknowledge the impact that the pandemic has had on our ophthalmology services, as it has had on other care pathways. Our fantastic NHS eye care teams are working hard to increase capacity and provide care as quickly as possible. We have set ambitious targets to recover services through the elective recovery plan, supported by more than £8 billion over the next two years, in addition to the £2 billion elective recovery fund and the £700 million targeted investment fund announced last year.

[Marsha De Cordova (Battersea) (Lab)]

Will the Minister give way?

[Neil O'Brien]

I give way with pleasure to the hon. Lady, who has been hot-footing it from a funeral to attend the debate. I will seamlessly fill in, so she can catch her breath. I congratulate her on making it here.

[Marsha De Cordova]

I honestly thank the Minister for giving way. I have just got here from the funeral of a dear friend, Roger Lewis, who, as a totally blind man, was also a strong advocate for a national plan for eye care in England and the devolved nations. I congratulate my dear and honourable friend, the hon. Member for Strangford (Jim Shannon), on securing this very important debate.

As many Members will know, I currently have a Bill calling for a national strategy for eye health in England. We need to ensure that eye care provision is joined up across England to reduce avoidable sight loss but also, more importantly, to end the fragmentation of services. Is the Minister willing to meet me to discuss some of the provisions in the Bill, to ensure that we can create an eye care pathway that ensures that nobody who is losing their sight—or has already lost it—will go through the pathway without the right support and timely treatment?

[Neil O'Brien]

I am grateful for the hon. Lady’s intervention, and I will be happy to meet her. It sounds like there is an important connection between where she has just been and this debate. I am extremely happy to meet her to talk about that.

I will continue setting out our strategy. I have already talked about screening in primary care, and I was setting out the sums of money that we are investing—the £8 billion plus the £2 billion—in elective recovery following the pandemic. NHS England has been supporting NHS trusts to increase capacity in surgical hubs, and the independent sector has also been used to increase the delivery of cataract surgery, in particular. In 2021-22, nearly half a million cataract procedures were provided on the NHS, which is actually more than before the pandemic, so that is recovering.

Beyond recovering from the pandemic and looking to the future, hospital eye care services are facing increasing demand. As a number of hon. Members have pointed out, ophthalmology is already the busiest out-patient speciality, and the predictions are that the demand for services will increase by 30% to 40% over the next 20 years as the result of an ageing society.

To help address these challenges, NHS England’s transformation programme is looking at how technology could allow more patients to be managed in the community and supported virtually through image sharing with specialists in NHS trusts. Current pilots for cataracts and glaucoma are allowing primary care practices to care for these patients and refer only those who need to be seen by specialists. The learning from these pilots will feed into any possible future service model. That could allow us to use the primary care workforce to alleviate some of the secondary care pressures.

I am delighted that the NHSE has appointed the first national clinical director for eye care, Louisa Wickham, who will oversee this work programme. I am aware that the APPG on eye health and visual impairment has called for there to be one Minister responsible for primary and secondary care services. I can confirm that my portfolio covers both those areas, so I will be taking an active interest in the development of that transformation programme and strategy.

A number of hon. Members have raised questions about the workforce, and we acknowledge that there are challenges across the system, including in ophthalmology. NHS England is developing a long-term workforce plan that will consider the number of staff and roles required and will set out the actions and reforms needed to improve workforce supply and retention. We have already invested in growing the ophthalmology workforce with more training places in 2022, but there is more to do. We are also improving training for existing staff so that they can work at the top of their licence.

Research is an area that the hon. Member for Strangford is interested in, and I was extremely sorry to hear from the hon. Member for Tooting (Dr Allin-Khan) about her keratoconus. That is one area where, fortunately, research and new treatments are coming online, so research is hugely important. While we have effective treatments, particularly for macular disease, we absolutely cannot rest on our laurels because medicine continues to evolve. We recognise that research and innovation are crucial to driving improvements in clinical care and improved outcomes for people living with sight-threatening conditions. The £5 billion investment in health-related research and development announced in the 2021 spending review reflects the Government’s commitment to supporting research into the most pressing challenges of our time, including sight loss.

Over the past five financial years, the National Institute for Health and Care Research has invested more than £100 million in funding and support for eye conditions research, and many of the studies focus specifically on sight loss. The NIHR Moorfields Biomedical Research Centre has recently been awarded £20 million from the NIHR for another five years of vision research, allowing it to continue its mission of preserving sight and driving equity through innovation. Through the NIHR, England, Scotland, Wales and Northern Ireland work together on a range of research topics, and the devolved Administrations co-fund several research programmes.

To assess how well interventions are achieving their intended aims, it is important that we track their impact, which hon. Members have mentioned. The public health outcomes framework’s preventable sight loss indicator tracks the rate of sight loss per 100,000 population for three of the most common causes of preventable sight loss: age-related macular degeneration, glaucoma and diabetic retinopathy.

We are making progress. The indicator shows the impact that the new treatments have had on the rate of sight loss due to age-related macular degeneration. Despite an ageing population, the rate of sight loss in 2019-20 was 105.4 cases per 100,000, down from 114 per 100,000 in 2015-16, so there has been an improvement on macular degeneration. The open availability of this data provides a valuable resource for integrated care boards to draw on in identifying what is needed in their areas and for local democratic accountability for any variation in performance against public health outcomes.

[Jim Shannon]

The answers are very helpful. One thing that all three Members referred to was the waiting list, and those who lose their eyesight just because they have been on a waiting list for diagnosis, examination and investigation. I know the pandemic created lots of problems in relation to the waiting list. Does the Department intend to have a strategy that will reduce the number of people on waiting lists to ensure that those waiting for a diagnosis retain their eyesight?

--- Later in debate ---

[Neil O’Brien]

I mentioned earlier that one of the main goals of the huge £8 billion plus £2 billion investment is in elective recovery because, as the hon. Gentleman said, the pandemic has had a huge impact. We have already cleared the number of people waiting for two years. The next milestone is to clear those waiting 18 months and then to work through the plan and bring down the numbers using that additional money over time, reducing those waiting the longest first and then steadily reducing the number of people waiting in total.

I acknowledge the importance of good vision throughout life, and especially as we get older. I hope that what I have outlined today provides some reassurance that we acknowledge the ongoing challenges faced by eye care services and are taking action to address them.

Advertising Restrictions on Less Healthy Food: Delay in Implementation

Neil O'Brien Excerpts

Friday 9th December 2022 Written Statements

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

The Government are delaying the implementation of the introduction of further advertising restrictions on TV and online for less healthy food and drink products until 1 October 2025.

Due to a delay to Royal Assent of the Health and Care Act 2022, and recognition that industry needs more time to prepare for the restrictions, in May 2022, Government announced a year delay to the implementation of these restrictions to 1 January 2024.

However feedback from industry and the regulators is now clear that there is insufficient time to prepare for implementation on the previously announced date of 1 January 2024.

This is because ahead of implementation there are a number of steps that need to be taken including: a Government consultation on draft regulations that are required to set out the details of the advertising restrictions, such as the definition of product categories in scope of the advertising restrictions and the definition of the exemptions for small and medium enterprises, audio only content and services connected to regulated radio; the subsequent making of such regulations; a consultation from the statutory regulator (Ofcom) on the designation of a frontline regulator; the possible designation of a frontline regulator by Ofcom; and publication of guidance to support business compliance with advertising restrictions, following consultation on such guidance from the frontline regulator.

Through discussions with key stakeholders it is clear that this process cannot be delivered by January 2024.

We have listened carefully to the concerns raised by advertisers, broadcasters and regulators about the importance of having sufficient time with these documents to fully prepare and restructure their advertising. We also recognise that businesses need time to reformulate their products. This is why we have decided to delay implementation of this policy until 1 October 2025.

Parliament included a power in the Health and Care Act to delay implementation of the advertising restrictions if necessary. We will be utilising this power to amend the date of implementation for the advertising restrictions by secondary legislation, which we are laying today.

To illustrate our commitment to this policy, we are also launching a consultation on the definitions included in secondary legislation, to provide detail to that included in the Health and Care Act. This consultation will run for 16 weeks, until 31 March 2023.

This consultation will not be inviting opinions on the policy or looking to deviate from anything announced in the consultation response in June 2021—it will be to confirm the clarity of the definitions used and that the text in the secondary legislation is fit for purpose.

Addressing obesity remains a priority for the Government. Having a fit and healthy population is essential for a thriving economy and we remain committed to helping people live healthier lives.

New regulations on out of home calorie labelling for food sold in large businesses including restaurants, cafes and takeaways came into force in April 2022 and restrictions on the promotion by location of products high in fat, salt or sugar came into force in October 2022.

[HCW433]

Government PPE Contracts

Neil O'Brien Excerpts

Tuesday 6th December 2022 Commons Chamber

[Dawn Butler (Brent Central) (Lab)]

I have a few points for the Minister of State, Department of Health and Social Care, the hon. Member for Colchester (Will Quince), who is no longer in his place. The National Audit Office did not have all the paperwork it needed to give a full and correct report. Therefore, when the Minister kept quoting the National Audit Office saying that due diligence was done on all companies, that is not correct. Also, the NHS published weekly consumption data during the pandemic, so the question is: how on earth did we come to buy five times more PPE than we actually needed? It makes no sense. There is a lot of evidence and paperwork on the Good Law Project website, just for the Minister’s reference.

The coronavirus pandemic has been a nightmare for everyone. It was a time of national pain and loss, and for some it was unspeakable. People lost loved ones, as I did, and it was also financially damaging for the country. It is absolutely shocking and unforgivable that some people saw this crisis as an opportunity to seriously line their own pockets, making money out of the misery we all went through. Let us be clear: this money is not free money. This money comes from working people through taxation, and the Government have been pickpocketing the working class to fund the lifestyle of the rich.

We still do not know the true extent of the misuse of public money, and that is why this motion is important. Even though I and many others have been asking questions for three years, what comes back from the Government is really quite sparse. We are having to piece together the information, and that is not good enough from a Government. They need to be transparent and honest, and the public deserve to know who was given public funds, how many had links to the Conservatives and what they were paid for. I often ask, “What were they paid for? What kind of PPE? How many, and how many did we receive?” The Minister never comes back with that information, so if the Minister has the facts and figures, broken down for each company, I would appreciate if he put that in the Library. According to the Minister last week, some companies were paid for PPE even though we had enough PPE in stock. I said, “Was that deliberate?” and he said yes. I think that is really quite strange—if we have enough PPE, why are you giving people more PPE?

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

The hon. Member claims that we bought five times too much PPE. This is not the case. We did have 20% excess capacity against a worst-case scenario that, thankfully, did not materialise. But just to be clear to her, it is not the case, as she keeps saying, that we bought five times too much PPE. That is simply not the case.

[Dawn Butler]

I thank the Minister for that intervention. So can he just clarify: if the NHS was given weekly stats on how much PPE was needed, how come there is so much PPE in storage, which is costing £750,000 a day to store? Does the Minister want to come back? Oh, the Minister of State has walked in at the right time.

[Neil O’Brien]

The Minister of State did actually give the House some updated figures on that point. It is not the £750,000 figure the hon. Member just quoted. On this point, it is not the case that we bought five times too much PPE. She keeps saying that. It is not the case.

[Dawn Butler]

I suppose the facts will reveal themselves when the Minister shows us all the paperwork, leaves it in the Library and then we can go through the facts, the stats and the figures together. I look forward to that. We heard earlier today—[Interruption.] The Ministers are going through some figures now. I really think that, to resolve all of this, and to not even have this debate and conversation, they should put all the paperwork in the Library, we can all go through it together and that is what is needed.

--- Later in debate ---

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

To make sure that I get to them, I want to respond to some of the important points made by Back-Bench Members at the start of my remarks. The hon. Member for Kingston upon Hull East (Karl Turner), who is sadly no longer in his place, mentioned Arco not getting a contract. My understanding is that it did get a contract, so we should resolve what is correct.

The hon. Member for Argyll and Bute (Brendan O’Hara) mentioned the two different contracts for PPE Medpro, and it is important to be clear that one of those contracts was delivered—the PPE was delivered and that was fine—and one did not, and that is the one we are taking enforcement action on. With all these contracts, we are just as keen as everybody else to make sure that we get good value for money for taxpayers and we enforce whenever things have not been delivered.

The hon. Member for Blaenau Gwent (Nick Smith) called for the publication of details of companies that were in the high-priority group and then got contracts, which is something that happened in November 2021. I slightly disagree with one point that the hon. Member for Bradford West (Naz Shah) made: the argument that we should not have had any contracts with firms that had not previously been PPE suppliers. Of course lots of new firms were coming into the market, and part of our drive to get more UK supply relied on that very point.

[Nick Smith]

rose—

[Neil O’Brien]

I am just going to complete my tour of people’s contributions.

The hon. Member for Brent Central (Dawn Butler) said that we should donate and reuse PPE, and I am pleased to tell her that that is precisely what we are doing. The hon. Member for Edinburgh West (Christine Jardine) said that we are in the middle of a major cost of living issue, and she is absolutely correct. That is why we are spending £55 billion on energy support, why we have the £900 payment for 8 million poorer households and why we are raising the national living wage to a record level—that is worth about £1,600 for a full-time worker.

The hon. Members for Blackburn (Kate Hollern) and for Llanelli (Dame Nia Griffith)—

[Several hon. Members rose—]

[Neil O’Brien]

I will give way, but I am trying to respond to everyone’s points first. If Members can hold on, we will get there.

As I was saying, those two Members both made the point that we wanted to get more UK producers making PPE. The Minister of State, Department of Health and Social Care, my hon. Friend the Member for Colchester (Will Quince), has already made the point that we have gone from 1% of FFP3 masks being made in the UK to 75%. I should also mention our work with Moderna to get more development and production of vaccines happening in the UK as part of that exciting deal.

The hon. Member for Glenrothes (Peter Grant) said that one potential supplier had been incandescent with rage because they did not get a contract. That is the system working. People were being turned down for contracts; 90% of those who went through the—[Laughter.] Madam Deputy Speaker, I am desperately trying to respond to all the points. [Interruption.]

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. Give the Minister a chance to respond to all the questions. I have tried to give enough time for that, so let him get on with it.

[Neil O’Brien]

Thank you, Madam Deputy Speaker. I am keen to reply to them. The hon. Gentleman said that only 3%—

[Peter Grant]

rose—

[Neil O’Brien]

I am literally responding to the hon. Gentleman. He talked about only 3% not being reusable and implied that some of the other things were only fit for servicing a car. To be clear, some of these things have a different clinical use. For example, the NHS tends to use and wants to use aprons on a roll when there is the choice, where we have a normal PPE market. What we do therefore is use the flat-pack ones that we had and donate them to care homes. Self-assembly visors are not preferred in the NHS because they take a bit of time to assemble, so we give them to dentists and the like.

We have heard two different uses of the words “writing off” in this debate, and it is important to be clear about the difference between these two things. Some people talk about “writing off” for things that are not usable, and only 3% of what was purchased is in that category. Then there is a different accounting use of “writing off”, which is something we have to do; we bought a load of PPE because we needed it in the middle of the pandemic and it was more expensive at that time—it was worth more then than it is now. That is the accounting meaning of “writing off”. Let us be clear about those two different uses.

[Several hon. Members rose—]

[Neil O’Brien]

There are so many questions that I do not know who to give way to, but I think I should start with the hon. Member for Blaenau Gwent.

[Nick Smith]

I thank the Minister for giving way. He attributed comments to me that I did not make, and I just want to put that on the record. I do have a question for him: does he accept that excessive profits have been made on the back of some of these PPE contracts?

[Neil O’Brien]

I am about to explain the due process that we went through and the incredibly forensic work that our civil servants did. Just to be clear—again, for the benefit of the House—Ministers did not make decisions on contracts. Officials, as usual, made the decisions on contracts. I will talk more about the process that we went through in the very short time that we have remaining.

During the dark days of the pandemic, we had a collective approach that saw hundreds of millions of life-saving vaccine doses delivered, the largest testing infrastructure in Europe established from a standing start and the distribution of tens of millions of items of PPE. It was a uniquely complex challenge even in normal times, but a particular challenge when the entire world was trying to get these goods. [Interruption.] Opposition Members might want to have the courtesy to listen to the answers of the questions that they have asked—a strange approach.

We delivered 20 billion items to the frontline and to our broader workforce—we are still in fact delivering 5 million items a months. That was enough to deliver a response to a worst-case scenario, which, fortunately, did not emerge. That is why we have that 20% excess stock that I mentioned earlier. It is simply not the case, as one hon. Member mentioned, that we had five times too much PPE. However, let us remember the context. It was the former Leader of the Opposition, the right hon. Member for Islington North (Jeremy Corbyn), who said that it was a “matter of safety” and of patients’ safety. We agreed, which is why we acted. It was the shadow Health Secretary who said:

“Our NHS and social care staff deserve the very best protective clothing…and they urgently need…it.”

We agreed. It was the current shadow Chancellor who called for a

“national effort which leaves no stone unturned”.

That is exactly what we did. [Interruption.]

[Madam Deputy Speaker (Dame Eleanor Laing)]

Stop shouting!

[Neil O’Brien]

What did the hon. Member for Brent Central say there? [Interruption.] No, she does not want to repeat it.

Let me be clear, Madam Deputy Speaker: at every point in the procurement process, the process is rightly run by our brilliant commercial professionals. Ministers are not involved in the procurement process; Ministers are not involved in the value of contracts. Ministers are not involved in the scope of contracts, and Ministers are not involved in the length of contracts. That is something echoed by the National Audit Office, whose report concluded that the Ministers had properly declared their interests and that there was

“no evidence of their involvement in procurement decisions or contract management”.

The role of Ministers was exactly what we would expect. Approaches from suppliers were passed on to civil servants for an independent assessment. Let us again look at the scale of the effort: 19,000 companies made offers, around 430 were processed through the high-priority group, and only 12% of those resulted in a contract for 51 firms. That group was primarily about managing the many, many requests that were coming in to Ministers from people across the House and from people across the country who were desperate to help with that national challenge of getting more PPE, and there had to be a way of dealing with them. To be clear, due diligence was carried out on every single company, financial accountability sat with a senior civil servant, all procurement decisions were taken by civil servants, and a team of more than 400 civil servants processed referrals and undertook due diligence checks. It was a huge operation run by the civil service, and I thank them for their work in getting our NHS the PPE that it needed.

Let me be clear, I will not stand here and say that there are not any lessons to be learned; of course there are. But we should be clear about what those lessons are. Despite the global race to get PPE, only 3% of the materials sourced were fit for purpose, but we have built more resilient supply chains. We are implementing the recommendations of the Boardman review of pandemic procurement in full. I have mentioned the growth of UK procurement of face masks and of vaccines.

In closing, I wish to thank all of those who have been involved in this important conversation. We should be rightly proud of what was achieved during those dark and difficult days at the start of the pandemic, operating in conditions of considerable uncertainty. We were in a situation where, literally, there was gazumping going on. If people did not turn up with the cash, things were removed that they had bought from the warehouses. That was the global race that we were in to source these things. The 400-strong team of civil servants who led this process did a remarkable job from a standing start of sourcing the goods that we needed.

During this debate, we have heard a number of deliberate obfuscations of the different things that Ministers and officials do. To be clear, all of these decisions went through an eight-stage forensic process that was run entirely by officials and it did not get anyone a contract to go into this high-priority group. It was simply about managing the sheer number of bids for contracts that were coming in to people across this House. At the time, although memories are very short and the barracking on this continued—

[Sir Alan Campbell (Tynemouth) (Lab)]

claimed to move the closure (Standing Order No. 36).

Question put forthwith, That the Question be now put.

Question agreed to.

Main Question accordingly put and agreed to.

Oral Answers to Questions

Neil O'Brien Excerpts

Tuesday 6th December 2022 Commons Chamber

[Scott Benton (Blackpool South) (Con)]

8. What progress he is making on negotiating a new NHS dental contract.

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

In July, we made some initial changes to the reformed system to support NHS dentistry. We have invested an extra £50 million, reformed the contract to create more UDA—unit of dental activity—bands to better reflect the fair cost of work, and introduced a minimum UDA to help practices where the levels are low, allowing dentists to deliver 110% of their UDAs to provide more treatment. The number of dentists doing NHS work last year was up 2.3% but we are working on plans to go further.

[Scott Benton]

The changes made to the dental contract last week were a step in the right direction, but they fall some way short of the holistic reform required to help the estimated 25,000 of my constituents who do not yet have an NHS dentist. Will the Minister consider a change whereby the NHS funds subsidies to underprivileged areas such as Blackpool, thereby allowing NHS practice to offer a greater financial incentive to attract new dentists into those areas?

[Neil O’Brien]

Absolutely; my hon. Friend and I have talked about this. We are looking urgently at payment models and measures to address areas that are struggling to attract the right workforce. The commissioning of dentistry will be coming down to a more accountable local level in April, and we need to build on that.

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

My constituents in Durham have told me tales of DIY dentistry, missing teeth, children in pain and the unfairness of only being able to access dental care if they can afford it. Things should not be this way. The British Dental Association does not accept that the Government’s new plans go far enough to halt the decay in NHS dentistry provision. Will the Minister tell me when the Government will put in adequate funding and reform so that people in Durham can get the dental care that they need and deserve?

[Neil O’Brien]

As well as increasing the number of dentists doing NHS work and the amount of work being done, we are taking further steps to look to the longer term and build NHS dentistry. The number of dental school places is up from 810 in 2019 to 970 in 2021, but of course we want to go further. We are making it easier for dentists to come to the UK to practise. In fact, we laid draft secondary legislation on 11 October to give the General Dental Council more flexibility to do that. Around the country, plans are advancing for centres for dental development to provide not only additional dentists but hygienists and other nurses.

[Mary Robinson (Cheadle) (Con)]

18. What plans he has to reduce health inequalities.

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

We are taking action on public health across the board. The £3 billion that we are investing in the drugs strategy will create an extra 50,000 places in drug treatment. We have doubled the duty on cigarettes since 2010 and brought in a minimum excise tax. We now have the lowest smoking rate on record and will go further. The £300 million that we are investing in Start for Life means new or expanded family hubs in 75 local authorities. We are taking action right across Government, from the £55 billion that we are investing in energy support to the measures that we are taking through at the moment to crack down on non-decent housing.

[Peter Gibson]

Levelling up is not just about jobs and infrastructure; it is about healthcare too, and dentistry is a key part of that. However, Darlington faces the potential closure of its surgery, which serves 7,000 patients, because the current system of NHS dentistry makes the business case for that surgery unviable. What will my hon. Friend do to ensure that we level up dental services so that my constituents can get the services that they need?

[Neil O’Brien]

My hon. Friend and I have discussed this, and we are due to meet again shortly. I repeat my offer to speak both to that practice and to local partners so that we can tackle this crucial problem.

[Mary Robinson]

Research by the University of Manchester adds to the significant body of evidence showing that addressing disparities in healthcare is key to levelling up. Inequalities have resulted in a 30% productivity gap in the north, which can be attributed to poorer health. Will my hon. Friend outline how the Government are working to address this and to ensure that residents of the north are not at a health and care disadvantage?

[Neil O’Brien]

I saw that important report, and we have to tackle the problem from both the health end and the economic end. Spending on health in the north grew from £36.5 billion in 2018-19 to £52.6 billion in 2020, so there is significant investment in health and preventing ill health in the north. Economic activity stops people sliding into a cycle of ill health and worklessness, and we are working jointly with the Department for Work and Pensions to roll out more disability employment advisers in jobcentres. The underlying key is to tackle and prevent ill health, hence the £3 billion drug strategy and the measures on smoking, energy and housing.

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

I will give the Minister a good example of health inequality. Until quite recently, we had a perfectly good consultant-led maternity service based in Caithness. Following the Scottish Government’s rubber-stamping decisions, pregnant mothers now have to make a 200-mile return journey to Inverness to give birth. That glaring inequality is despicable. I hope His Majesty’s Government will share best practice with the Scottish Government on tackling this problem.

[Neil O’Brien]

I am always keen to work constructively with the Scottish Government. This sounds like a serious problem. My right hon. Friend the Secretary of State set out how we are using our health and capital spend more efficiently, and unfortunately this is an example of where it is not happening in Caithness.

[Helen Morgan (North Shropshire) (LD)]

It is well documented that people in rural areas have worse health outcomes than people in urban areas. One driver is that the most vulnerable people lack access to the services they need. Will the Minister consider working with his colleagues in the Department for Transport to figure out how the most vulnerable people can access the healthcare they need?

[Neil O’Brien]

We are rolling out community diagnostic centres to bring services closer to those who need them, and we are investing in 21,200 extra people working in general practice to make sure that rural services, as well as services in the rest of the country, are improved.

[Mr Speaker]

I call the shadow Minister.

[Andrew Gwynne (Denton and Reddish) (Lab)]

In 2019, the Tories promised to extend healthy life expectancy by five years, but on this they are failing. In the last year, the health disparities White Paper has disappeared, the tobacco control plan has been delayed and they have chickened out on implementing the obesity strategy because the Prime Minister is too cowardly to stand up to his Back Benchers. Health inequalities are widening as a consequence. Does the Minister plan to revive any of these strategies, or have the Conservatives completely given up on prevention?

[Neil O’Brien]

I have already talked about some of the things we are doing to crack on with improving public health and narrowing inequalities, but I will add some more. We are driving up blood donations from shortage groups and vaccine uptake in areas with the lowest uptake. I mentioned the extra £900 million for drug treatment, taking the total to £3 billion over three years. I will not repeat all the things I mentioned but, across the board, we are working at pace to improve public health and narrow health inequalities.

[Margaret Ferrier (Rutherglen and Hamilton West) (Ind)]

10. What steps his Department is taking to improve survival rates from sudden cardiac arrest.

--- Later in debate ---

[Sir Greg Knight (East Yorkshire) (Con)]

13. What recent steps his Department has taken to increase the number of dentists working in the NHS.

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

As well as making it more attractive to practise in the NHS, the number of dental school places is up from 810 in 2019 to 970 in 2021, making it easier for qualified dentists to come to the UK. We are putting through secondary legislation on that and encouraging new centres for dental development.

[Sir Greg Knight]

Is the Minister aware that there is a particular problem in Bridlington in my constituency, where an increasing number of residents are finding it not just difficult to access NHS dental care, but impossible to do so? Recently, a dental practice in the town has closed. Will he agree to meet me on this matter to see what can be done to resolve the issue, hopefully sooner rather than later?

[Neil O’Brien]

Of course, I would be keen to meet to try to address those issues and to build on the work that we are doing nationally.

[Rachael Maskell (York Central) (Lab/Co-op)]

York has had a dental desert for years. It is six years now to see an NHS dentist and the Government have made no change to improve that situation, or to bring more NHS centres into my area. In March, dentistry will be moving into integrated care systems and integrated care boards. How are they going to solve the problem?

[Neil O’Brien]

One problem has been that having large, remote regional commissioning for dentistry has meant that it is more unlikely that specific local problems will be picked up. That is why we are taking the step that the hon. Member has described. She is now complaining about it, even though it is a measure to get more local accountability over the way that services are commissioned.

[Michael Fabricant (Lichfield) (Con)]

14. What recent discussions he has had with the Secretary of State for Education on increasing the number of university places for medical students; and if he will make a statement.

--- Later in debate ---

[Mary Robinson (Cheadle) (Con)]

T2. At 1 o’clock today, patient safety expert Dr Bill Kirkup will be speaking to MPs at the all-party parliamentary group for whistleblowing, to which all colleagues are invited. It is a timely meeting following last week’s “Newsnight” programme, which highlighted yet another NHS trust where a culture of fear left staff unable to speak up on patient safety concerns. It is clear change is needed. Does my hon. Friend agree that supporting whistleblowers in the NHS is crucial to patient safety?

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

My hon. Friend is so right. I praise her work with the APPG and I know many colleagues will want to attend. Whistleblowers can save lives and improve healthcare, as I have seen in my own constituency, and she is right to be pressing on this matter.

[Mr Speaker]

I call the shadow Secretary of State.

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[Bob Blackman (Harrow East) (Con)]

T4. There have been several changes of Ministers, as we know, but officials have carried on working through these changes, so can we know on what day, date and time the long-promised and overdue tobacco control plan will finally be published?

[Neil O’Brien]

Whatever format our next steps forward are set out in, we will be pushing forward very quickly and aggressively on this. This year, we are putting £35 million into the NHS to support our services for everyone who goes in to stop smoking. We have doubled duty on cigarettes and brought in a minimum excise tax. Women who are pregnant now routinely get a carbon monoxide test. National campaigns such as Stoptober have now helped 2.1 million people to quit smoking. We are also supporting a future medically licensed vaping product as a quitting aid. We will be pressing forward at the greatest speed.

[Mr Speaker]

I call the SNP spokesperson.

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[Alexander Stafford (Rother Valley) (Con)]

T7. Several GP practices in Rother Valley, such as Swallownest Health Centre, operate a policy of having to ring the doctor’s surgery at 8 am for an appointment. Residents find themselves being placed 50th or 60th in the queue, and are then told that no appointment is available and to call back the next day. This is clearly an unacceptable way to offer appointments. What steps are my hon. Friends taking to stop the current failed booking system and instead guarantee a system of pre-booked appointments at all GP surgeries?

[Neil O’Brien]

That is something that we are working on very actively. As well as financially supporting GPs to roll out new and better ways of managing their appointments, we are looking at what criteria we expect from GPs. We already set out some moves in our summer action plan, but we will be looking further at preventing the lamentable situation my hon. Friend describes of people being asked to ring back or being held in long phone queues. That is not acceptable.

[Karl Turner (Kingston upon Hull East) (Lab)]

T3.   The public are not daft. They know that the backlogs in the NHS existed well before the pandemic, they know that the NHS was already on its knees, and they know that it was this Tory Government who brought it to its knees. So why do the Government not take up Labour’s policy of scrapping non-dom status, use the £3.6 billion to train nurses, doctors and midwives, and get the NHS back on its feet? People in east Hull want nurses, not non-doms.

--- Later in debate ---

[Dr Rupa Huq (Ealing Central and Acton) (Ind)]

In a case that is sadly all too typical, a GP in Ealing, who has seen their patient list go up from 3,000 to 9,000 in the last decade, had plans approved for expansion, but NHS estates now will not cough up. What are the Government doing to support doctors in inadequate premises who cannot increase their patient lists to expand and modernise in the current climate?

[Neil O’Brien]

The total activity done by GPs was about 7% up in October compared with the previous year. We are actively looking at the way that capital works and the contributions of section 106 and the local integrated care board, to ensure that, as well as having those 2,300 extra doctors and 21,000 extra staff, GPs also have good facilities to work in.

[Robert Courts (Witney) (Con)]

Access to dentistry is an acute issue for West Oxfordshire. Can Ministers explain what they are doing to help rural areas such as mine, and can we meet to discuss it further?

[Neil O’Brien]

I have mentioned the fact that the number of NHS dentists was up 2% to 2.3% last year, as well as the extra £50 million and the reforms we have made to the contract, but we will go further. We want to address those areas, and particularly rural areas, where more provision is urgently needed.

[Patricia Gibson (North Ayrshire and Arran) (SNP)]

The chair of the Royal College of General Practitioners has expressed concerns about patients with chronic conditions such as asthma, diabetes and even serious mental health conditions refusing sick notes because they cannot afford time off work. What discussions has the Secretary of State had with Cabinet colleagues about the adequacy of statutory sick pay during this cost of living crisis?

World AIDS Day

Neil O'Brien Excerpts

Thursday 1st December 2022 Commons Chamber

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

Let me start by congratulating all Members from across the House who have taken part in what has been an incredibly informative and high quality debate. Let me join others in congratulating the hon. Member for Brighton, Kemptown (Lloyd Russell-Moyle), on a speech that mixed huge personal experience and knowledge, years of advocacy and successful campaigning, and a huge number of insights.

I undertake to look at numerous issues raised by the hon. Member, but to pick just a few, he asked about: the bureaucratic barriers stopping syphilis testing from being added to the opt-out testing that we already do for HIV and hepatitis B and C; some of the risks around the shift to online clinics; people on PrEP being tested regularly; and the promising experiment by the Terrence Higgins Trust with saliva testing for HIV. He raised a number of other points, including the important issue about patent waivers. There was a huge amount in his speech to take away and look at.

The same is true of other hon. Members. My right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes) made hugely important points about women and girls, and gave some incredibly striking and harrowing statistics. She made important points about the barriers to testing, particularly among minority groups. We can learn from the way that we are tackling that problem in other fields, including in covid vaccination work.

The hon. Member for Strangford (Jim Shannon) gave us insights on what is happening in Northern Ireland, such as the role of the Public Health Agency there and what it is doing on PrEP. He talked about the role of the church in his constituency and the connection between Swaziland and Strangford, which might surprise outsiders. He talked of the work of the Positive Life charity in Northern Ireland, which I commend.

My hon. Friend the Member for West Bromwich East (Nicola Richards) spoke powerfully about her constituents’ experiences of stigma. She made the important point that, as a high prevalence area, it should be considered for the expansion of opt-out testing. A similar point was made by the hon. Member for Slough (Mr Dhesi) and my hon. Friend the Member for Heywood and Middleton (Chris Clarkson). I join my hon. Friend in commending the work of Middleton Health Centre.

The hon. Member for Coatbridge, Chryston and Bellshill (Steven Bonnar) talked about some important lessons that we can learn. We are keen to learn across the UK about the rollout of PrEP in Scotland. On the roll-out of our world-leading vaccination campaign against mpox—one of many issues raised by the hon. Member for Denton and Reddish (Andrew Gwynne) in his speech—we are talking to that relatively small number of clinics that have had to deliver the huge majority of the campaign about its impact financially and on their day-to-day work.

World AIDS Day is an invitation to underline our commitment to tackling HIV, to show our support for people living with HIV and to remember those we have lost to AIDS. I am proud of how far we have come: from the stigma and the sidelining of the past, which a number of Members have mentioned, to where we are today thanks to collaborative efforts and the commitment of the Government, together with HIV patients, their friends and family, campaigners, medics, researchers and the health and care system at all levels.

Today, when diagnosed early and with access to antiretroviral therapy, most people living with HIV in England can expect a near-normal life expectancy. People diagnosed with HIV can expect to receive world-class, free and open-access HIV care. That has been a result of our collective and collaborative partnerships. However, despite successes, HIV has not gone away. There is still more that we should do. That is why last year, this Government published their commitment to end new HIV transmissions in England by 2030 through the HIV action plan. That plan is the cornerstone of our approach in England to drive forward progress and achieve our bold ambitions.

We have come far in the first year since its publication. The UK met the UNAIDS 95-95-95 targets for the first time in 2020: 95% of HIV-positive individuals were diagnosed; 99% of those diagnosed were receiving treatment; and 97% of those receiving treatment were being virally suppressed. I am pleased that the number of people being newly diagnosed with HIV in England continues to fall. The latest data on HIV diagnoses shows that 2,955 people were diagnosed with HIV in England in 2021—a 33% decline compared with 2019, when the Government first made their commitment to end all new HIV transmissions in England by 2030. We are conscious of the need to avoid flatlining or slowing the pace in any way. We are still understanding the impact of the covid pandemic and the things that happened during that period, but there has been progress.

Those successes have been underpinned by clear national leadership and strengthened partnership working. I am grateful to Professor Kevin Fenton, the Government’s chief adviser on HIV, who has been chairing the HIV action plan implementation steering group, involving the key partners in the delivery of the HIV action plan, including local government, the NHS, and our voluntary and community sector. The steering group has met quarterly throughout the year to monitor progress on our commitments and ensure that appropriate action was taken to keep us moving forward with our objectives. Within the remit of the group, they have established specific task and finish groups focusing on key priority areas for action, such as improving equity and access to HIV drug prevention—PrEP—and addressing workforce challenges, among others.

We are also thankful for the work of the UK Health Security Agency, which excels as a world-class leader running high-quality data collection and surveillance systems to help us to better understand and address the challenges on HIV. Those have enabled us to truly understand developments, emerging issues and where we can have the greatest impact with our prevention efforts, and add to our growing repertoire of world-leading British innovation, systems and technology.

Of course, none of this could have been possible without the brilliant efforts of our local government, NHS and voluntary and community sector partners to deliver the highest-quality healthcare tailored to the needs of their local populations. We know through their work that different areas face different challenges, and we remain committed to helping level up outcomes for the whole population across the country.

A key priority, therefore, of the Government’s approach is to ensure that all under-served populations benefit equally from improvements in HIV outcomes. A range of important suggestions have been made in this debate about how to go further. The approach includes scaling up our prevention efforts and increasing access to PrEP. We have already invested £33 million to roll out PrEP access across sexual health services over the past two years. PrEP is now being commissioned as a routine service through the public health grant.

In delivering against these commitments, UKHSA has now developed and published a monitoring and evaluation framework to support local authorities, sexual health services and other key stakeholders to inform continuous service development in PrEP commissioning and delivery, using the existing available data. I am sure many of the people involved in delivery of those services will have followed this debate with great interest and noted some of the challenges posed by different hon. Members.

[Lloyd Russell-Moyle]

One of the problems is that the Department does not collate data on the average wait times for sexual health clinics or the availability of stocks for PrEP appointments in those clinics. Without that data, we rely on voluntary organisations to make freedom of information requests and report periodically. Having a baseline set from the Department would make a big difference and help us to understand areas that are struggling to roll out PrEP versus areas that maybe are not. Is that something the Minister could take back to the Department? I understand why in the past we have been nervous about publishing data on sexual health issues, but now is the time when we can be a bit more open about that and maybe publish that data, or collate it if that is not already done, so we can start to target our actions.

[Neil O'Brien]

That is certainly something I will take away and look at. As the hon. Gentleman points out, there are a number of challenges in doing that and in unpicking the activities of sexual health services on different diseases, and he has already alluded to some of the risks. However, I will certainly undertake to go away and look at that important point.

We know there is still more to do to improve PrEP access for key groups and we are in the process of developing a plan for provision of PrEP in settings beyond sexual and reproductive health services, to help us to reach those who are underrepresented—something a number of hon. Members have called for. Our efforts are also focused on scaling and improving testing levels in targeted, high-risk populations, including in black African communities, to be able to reach those 4,500 individuals who we believe are living with HIV but unaware of their status.

As part of implementation of the action plan, NHS England is investing £20 million over the next three years to expand opt-out HIV testing in A&E departments in the local authority areas across the country with the highest prevalence of HIV and across the whole of London. As a number of hon. Members have pointed out, it is a proven effective way to identify new HIV cases, as it promotes testing on admission to hospital of anyone who has not previously been diagnosed with HIV, therefore rapidly helping to identify the virus. Some 33 A&E departments are now live, delivering that important initiative.

We also took the opportunity to link the initiative to the hepatitis C elimination programme, backed by a further £6.85 million, to provide hepatitis B and C testing as well. As several hon. Members alluded to, NHSE published its report on the first 100 days yesterday, describing the progress, challenges, results and learning from the first period of this initiative.

Those very early findings show the benefits of the approach: more than 200,000 HIV tests were conducted over just the first 100 days of opt-out testing across London, Manchester, Salford, Blackpool and Brighton, which meant that more than 600 people were identified with a previously unknown blood-borne virus. Of those, 128 people were newly identified as living with HIV and an additional 65 people living with HIV who were previously diagnosed but were not under the care of an HIV clinic were also identified.

This approach is important to ensure everyone living with HIV can access testing and rapid linkage to treatment and care, allowing them to live a long and healthy life. Moreover, 325 people were newly identified with hepatitis B and 153 people were newly identified with chronic hepatitis C virus; a further 50 were found who had disengaged from care for both diseases and seven people were identified who had previously cleared the hepatitis C virus.

We will be considering the initial evidence from the first year of testing alongside the data on progress towards our ambitions to decide how and whether we further expand this programme. We are in the very early days of evidence on this, but I must say that evidence is extremely encouraging. I hear what hon. Members across the House are calling for, given the success of that programme in its first 100 days, but we need further evidence as it develops.

We redoubled our efforts to increase HIV testing throughout the country during National HIV Testing Week, which took place in February this year. Results are promising: 30% of the almost 25,000 users who ordered an HIV and syphilis self-sampling kit during the campaign had never tested before, and a majority of the campaign’s target audiences reported having taken some kind of preventative action as a result of the campaign.

We know there is still more we need to do to achieve our ambitions. The HIV action plan monitoring and evaluation framework developed by UKHSA, published today, will explore in detail the inequalities and gaps in HIV prevention, testing and care and other indicators of the progress required to achieve our shared ambitions and will help inform our progress. Our actions continue to be closely monitored by the HIV action plan implementation steering group, which includes key delivery partners such as local government, the NHS and the voluntary and community sector, to ensure we remain on track to meet the 2025 and 2030 objectives. The Secretary of State will report annually to Parliament on progress towards our objectives.

World Aids Day gives us the chance to reflect on progress and challenges, being accountable for what we have done over the past year and where we need to continue improving. But, most importantly, it gives us the possibility of coming together to restate our collective commitment to continue working together to end new HIV transmissions in England by 2030 and to finish the race.

Draft Food and Feed (Miscellaneous Amendments) Regulations 2022

Neil O'Brien Excerpts

Monday 28th November 2022 General Committees

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

I beg to move,

That the Committee has considered the draft Food and Feed (Miscellaneous Amendments) Regulations 2022.

It is a pleasure to serve under your chairmanship, Mr Sharma. The statutory instrument is made under powers in the European Union (Withdrawal) Act 2018. It follows on from the previous EU exit instruments in the field of food and feed safety made since 2019. The Government’s priority is to ensure that we continue to maintain the same high standards of food and feed safety and consumer protection that we have established. The principal changes introduced by the instrument will ensure that national and GB-wide legislation continues to operate effectively following the UK’s exit from the EU.

The purpose of the instrument is to amend national England regulations in the fields of articles in contact with food, extraction solvents and animal feed to remove cross-references to European Union directives and correct other EU exit-related inoperabilities. The instrument also addresses a range of remaining deficiencies in retained direct EU legislation in the field of food and feed safety and hygiene, to ensure the continued operability of that legislation after exiting the EU.

The instrument will also address inoperabilities that have arisen as a consequence of previous deficiency amendments made pursuant to the European Union (Withdrawal) Act 2018. It will extend the tolerance period of three withdrawn genetically modified organisms for a further three years until 31 December 2025, to align with the correction of a deficiency in retained EU regulation 619/2011. It will provide for a time-limited transitional period for edible insects specific to Great Britain. This will permit qualifying edible insects to remain on the market in GB after 31 December 2023, while applications for novel food authorisation are considered by the appropriate authority.

Let me be clear that the instrument does not introduce any changes that will impact the day-to-day operation of food or feed businesses. Nor does it introduce any new regulatory burden. The essence of the existing legislation is unchanged.

It is important to note that the devolved Governments have some shared and devolved legislative responsibilities in relation to food law. Both Scotland and Wales have provided their consent for the instrument. Amendments introduced by the instrument do not apply to Northern Ireland. In accordance with the Northern Ireland protocol, EU regulations will continue to apply; however, the Northern Ireland Department of Health has been briefed. We have engaged positively with the devolved Governments throughout the development of the instrument, and their ongoing engagement has been warmly welcomed.

I reassure hon. Members that the overarching aim of the draft regulations is simply to provide continuity for businesses and ensure that high standards of safety and quality for food and feed regulation continue across the UK. They do not affect the essence of existing legislation. Having effective and functional law in this area is key to ensuring that high standards of food and feed safety are continued. I ask hon. Members to support the amendments proposed in the instrument, to ensure the continuation of effective food and feed safety and public health controls. I commend the draft regulations to the Committee.

--- Later in debate ---

[Neil O’Brien]

To take some of the important questions raised by the Opposition in reverse order, the hon. Member for Cambridge is right that there are no substantive changes on edible insects. It is already the case that the pictograph does not need to be used; only the “do not eat” wording is mandatory. A consultation was carried out to allow stakeholders to consider the proposal to remove the requirement to use the pictograph. We shared the consultation widely and did not receive any responses on that particular point, although we will of course review the implementation of the change to ensure that there are no negative impacts.

On the original point raised by the hon. Member, this is indeed a technical SI. The legislation as it stands is workable. He was right that the point is that, although relying on cross-references to lists in EU directives is legal and operable, an issue arises if any further amendments would require the creation of a separate list in domestic regulations. We would then have two lists, which would run the risk of creating confusion. That is the core of what the SI is about, and on that basis I commend it to the Committee.

Question put and agreed to.