Mental Health In-patient Services: Improving Safety

Peter Gibson Excerpts

Wednesday 28th June 2023 Commons Chamber

[Steve Barclay]

That is an extremely good point. In fact, a key element of the primary care recovery plan looks at the handover points between secondary and primary care, which are often the cause of significant additional work within primary care. We are keen to see where we can ease those pressures, which in turn frees up our experienced GPs to do those tasks that require more time, so that is part of the primary care recovery plan. Through the rapid review and the focus on data, we are better able to identify where there are gaps or areas of duplication that take clinicians away from spending time with patients. That matters both in secondary and primary care, and it is something that the rapid review has been addressing.

[Peter Gibson (Darlington) (Con)]

I welcome my right hon. Friend’s statement and the publication of the rapid review. While Essex is rightly getting its statutory inquiry, it appears that the situation in Tees, Esk and Wear Valleys NHS Foundation Trust will merely be covered by the new powers of the Healthcare Safety Investigation Branch. Will my right hon. Friend confirm that TEWV will be covered by the HSIB review? When can families expect to hear anything from that review? Will he keep the need for a statutory inquiry into TEWV under review?

[Steve Barclay]

It will be covered by the HSIB review. On how long that will take, investigations under the predecessor body typically took around a year, which is one of the advantages of the speed at which these things can be done. I hope my hon. Friend can see from the statement today that we will follow the evidence, given the decision we have taken to put the Essex inquiry on a statutory footing, but the HSIB approach has the benefit of speed. I hope that will benefit his constituents, as we learn the lessons.

It is worth clarifying that the new body will have much greater teeth, as a result of the reforms that were passed by the House in 2022. While it is not on a statutory footing, it actually has more power than was the case in the past. That is why we think it is the right approach for learning the lessons in his constituency and more widely.

Neuroblastoma Treatment

Peter Gibson Excerpts

Thursday 15th June 2023 Commons Chamber

[Peter Gibson (Darlington) (Con)]

It is a privilege to have secured this debate on tackling neuroblastoma. I have been seeking the debate ever since I had the pleasure of meeting my constituent Mark Bell and his family at a fundraising event last year. I am pleased that Mark, Luke’s father, and, Carol, Luke’s grandmother, are able to be with us in the Gallery for the debate. I want to share with the House their story and how they came to establish their charity, the Team Luke Foundation, which is ably contributing to the battle against neuro- blastoma. I would also like to thank Solving Kids’ Cancer UK for reaching out to me in advance of the debate and sharing a briefing outlining their ideas on how we can move forward in the treatment of neuroblastoma.

The Team Luke Foundation was established as a registered charity by Mark and his wife Rebecca following the death of their inspirational eight-year-old son, Luke, who sadly died from neuroblastoma in December 2018, a mere 21 months after his original diagnosis. Luke was a typical young boy. He loved gaming, rugby, school, playing with his friends and, most of all, spending time with his mum, dad and big sister Alysha. He was incredibly active and full of energy.

I want to share an insight into Luke’s diagnosis journey, which led up to his family hearing those awful words, exactly six years ago, that his symptoms were “suggestive of cancer”. Over the preceding six months, Luke had started to have one or two unspecific viruses that seem to go around every school, at any time of the year. His symptoms amounted to a temperature, tiredness and not being that fussed about eating. They usually improved after a lie down in front of the telly, watching his favourites, but they never really bothered him.

Between October and December 2016, Luke started to look a little bit pale from time to time. Just before Christmas, his family had a trip to Kielder, in Northumberland, and the family remember occasions when Luke was a bit pale and tired, even asking for a carry one day, but it did not stop him doing a bit of ice skating, tobogganing and general mischief-making. His parents have looked back on photos of him from Christmas that year, to see whether there was something specific they might have missed, but nothing pinpointed anything that would have caused them any real worry.

By early 2017, things started to take a turn for the worse. Luke looked a bit paler and a few random symptoms started to cause some concerns. There were several conversations with Luke’s teachers about him getting more tired in class, even falling asleep in a couple of lessons. He also developed a slight limp and, from time to time, he complained of pain in his leg, and asked his dad to be carried on his shoulders for the walk to and from school.

Luke’s leg pain started to become pretty much constant, especially in the morning. He also had a visit to the local hospital after a phone call from the school one day to say that a large bump had appeared on his forehead. There was no known explanation for the bump. His family did not know until much later that it was a sign of a tumour on his skull.

In March 2017, Luke visited Center Parcs in France with his dad. Although his appetite was poor and his energy levels were low, he enjoyed the trip. On returning home, things moved quickly. An urgent visit to his GP resulted in him giving samples of blood. That was followed with a requirement to attend the local hospital for more tests. At around 2 am on the morning of 7 April 2017, his family were told the tests were “suggestive of cancer”, and Luke was taken by ambulance to the Royal Victoria Infirmary in Newcastle.

With the knowledge that it was cancer, Luke’s parents did at least feel reassured that he would be starting treatment immediately. The initial diagnosis was of acute lymphoblastic leukaemia, which had a better prognosis than many other childhood cancers, but that was then was changed to acute myeloid leukaemia, which had a much poorer survival rate. The family had to wait for further tests, and almost a week later the diagnosis was finally confirmed as high-risk neuroblastoma.

Later tests identified a particular characteristic of Luke’s cancer genes known as MYCN. This meant that he fell into the ultra-high-risk category. To add to the mix, they learned that boys and older children generally had a worse outlook. Knowing how much time had passed since their concerns were first raised with the appropriate medical professionals has added to the family’s heartbreak.

Neuroblastoma is a rare cancer that affects children. It mostly affects children under the age of five years, with fewer than 100 between the ages of 0 and 14 being diagnosed each year in the UK. Very rarely, it can develop in older children, teenagers and adults. Seventy per cent. of children with neuroblastoma survive for five years or more after being diagnosed. At present there are no known lifestyle-related or environmental causes of neuroblastoma, so it is important to remember that there is nothing that Luke or his parents could have done to prevent it.

Following his diagnosis, Luke commenced a gruelling course of treatments, including high-dose chemotherapy, extensive surgery to remove the tumour, radiotherapy, and immunotherapy. Unfortunately, routine tests in spring 2018 showed that he had relapsed. In September he was accepted on to a clinical trial, but tests as part of the trial revealed that the cancer had spread aggressively through his body. His family then received the devastating news that his cancer was terminal. Determined not to give in, Luke was accepted on to a clinical trial in Barcelona, due to start in January.

Sadly, Luke never made it to Barcelona. He passed away on 23 December 2018. He was eight years old. To lose any family member is devastating, but to have a child taken so prematurely—it is hard to imagine the pain that Luke’s family went through then, and they are still grieving today. Luke was their brown-eyed, blond-haired boy who filled their hearts with joy and made them smile every single day, and I know that he will not be forgotten. It is truly a privilege to be able to put Luke’s story on the record in the House, and to play a part in ensuring that his memory lives on.

In the wake of Luke’s death, his parents set up the Team Luke Foundation to create a legacy for him. In the words of his father Mark:

“It is very much in the spirit of his personality. Luke was very inquisitive and had a great interest in the treatment he was going through. He was also a very helpful boy, who didn’t like to see any sadness or suffering. He inspires everything we do.”

Since Luke’s illness, his parents have heard of many children who have had similar experiences of late diagnosis, Although neuroblastoma is a rare disease, the survival rate is comparatively very poor, so catching it early is key. The foundation’s aims and objectives are to make more people aware of this childhood cancer, to help parents access key services and information, to provide practical support, and to fund research to improve diagnosis and develop kinder treatments. The foundation has produced information posters for schools, which will be distributed to schools in Darlington and further afield.

If you will permit me, Madam Deputy Speaker, I will list the signs to spot cancer in children: headaches; vision issues; sudden or persistent weight loss; changes in skin complexion; unexplained bumps, lumps or bruising; recurring high temperatures and night sweats; frequent tiredness and low energy levels; persistent or intermittent pain; and aching limbs and limping.

I am fully supportive of Team Luke’s work, and want to praise it unreservedly for keeping Luke’s memory alive and for the important work it is doing to tackle this awful cancer. A number of my colleagues have raised neuroblastoma during this Parliament. Last year my hon. Friend the Member for South Cambridgeshire (Anthony Browne) and my right hon. Friend the Member for Tonbridge and Malling (Tom Tugendhat) both shared powerful stories about children in their constituencies who had suffered with neuroblastoma, during a debate on childhood cancer outcomes. I was also very sad to hear that the hon. Member for Batley and Spen (Kim Leadbeater), who sadly could not attend this debate, has a constituent whose daughter died from neuroblastoma earlier this month. She has written to the Prime Minister to encourage him to do all he can to pioneer new treatments for this awful disease. I want to add my voice to that call. Will the Minister press our right hon. Friend the Prime Minister to respond to the points that the hon. Lady has made?

Luke, like many children, was taken too soon by the awful disease that is cancer. I want to thank the Minister for listening, and end by leaving him with these questions. Will he work with me and other across the House to speed up and improve the diagnosis of neuroblastoma? Will he do all he can to increase the pace of research into treatments that are more effective at treating neuroblastoma? And will he do all he can to ensure that his Department does all it can to raise awareness of neuroblastoma?

Hospice Services: Support

Peter Gibson Excerpts

Wednesday 14th June 2023 Westminster Hall

[Peter Gibson (Darlington) (Con)]

I congratulate my hon. Friend the Member for Eastleigh (Paul Holmes) on securing this important debate, and I extend my condolences to him on the loss of his office manager. I draw the attention of the Chamber to my entry in the Register of Members’ Financial Interests, particularly as a trustee of North Yorkshire Hospice Care, and to my co-chairmanship of the APPG on hospice and end of life care. I put on record my thanks to everybody in our hospices—the nurses, the doctors, the trustees, the volunteers and the fundraisers—for all that they do.

As my hon. Friend mentioned, the APPG recently published a report entitled “The Lasting Impact of COVID-19 on Death, Dying and Bereavement”. I know that the Minister has received a copy of that report, because I personally handed it to her. One of the key points in it was about sustainability of funding for end of life care and bereavement services, and about the need for funding to them to provide their care confidently, commissioning for the years ahead, not just the year ahead.

I recently convened a meeting of all the MPs and hospices in the Tees valley, and there is a very sad picture. In Darlington, St Teresa’s Hospice is posting a £541,000 deficit this year. Teesside Hospice is posting a deficit of £400,000 this year, and Alice House Hospice in Hartlepool has had to close a unit. It does not have to be this way. Ask anyone where they want to die; they will tell you that they want to die at home, surrounded by their loved ones. Our hospices provide support to enable that to happen. Given a choice between a hospital and a hospice, people will choose a hospice.

We know that deaths in hospital are costly, blocking beds and often giving people a less than good death. I want to see everyone have access to a good death, and I want the NHS to save money and unblock beds. That can be achieved with proper commissioning and support for palliative care, as required by the Health and Care Act 2022, not just in Darlington, Teesside or North Yorkshire, but right across the country. We would not, in this day and age, fund maternity care by running bake sales, skydiving or wing-walking, but it seems perfectly acceptable to many that that is how we should fund palliative care. It is not right and it is not fair, and the time for dealing with it is now.

UK hospices are budgeting for a deficit of £186 million this year. Our integrated care boards must step up to the plate, commissioning and paying for the hospice care that their community needs and, at the same time, safeguarding these institutions that are so integral to our communities, saving the NHS money and reducing bed blocking. It really has the potential to be a win-win situation. I implore the Minister to do everything in her power to get this sorted, once and for all.

--- Later in debate ---

[Helen Whately]

I will not commit to getting involved in a specific conversation between a hospice and an ICB. That would not be the right thing for me to do as a Minister. The hon. Gentleman and I have had several conversations over the years that I have been a Minister, so he will not be surprised to hear that I have been seeking transparency about the extent to which the funding has or has not gone to hospices. I have been seeking data on whether the rates being paid to hospices have or have not gone up so that we have transparency about the extent to which the funding that has gone to integrated care boards to support with inflation is getting through to the services that need support.

[Peter Gibson]

Although I acknowledge and appreciate everything the Government did to support hospices during covid, it is simply not the case that every ICB across the country is passing the right amount of money to the hospices from which it commissions services. Will the Minister commit to publishing information about which ICBs are stepping up to the plate and fulfilling their statutory obligations, and which are not?

[Helen Whately]

I commit to continuing to dig into getting visibility on the extent to which extra funding is going through to hospices. Of course, there is a balance to be struck when giving integrated care boards the freedom to do what we want them to do, which is to understand fully the needs for care in their populations, and make good decisions about how they fund care for their populations. None of us believes that a Minister in Westminster has the answers about what should happen and exactly how funding should be distributed in every single one of our communities. I will continue to get that visibility, because it is important that we know the extent to which our hospices are getting support for the extra financial pressures that we have been discussing.

Dental Care: Durham

Peter Gibson Excerpts

Wednesday 24th May 2023 Commons Chamber

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

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

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

[Peter Gibson (Darlington) (Con)]

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

[Mary Kelly Foy]

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

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

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

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

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

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

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

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

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

--- Later in debate ---

[Peter Gibson]

I thank the Minister for his engagement with me on dentistry in my constituency, and I welcome the reforms that he is talking about, but as he has just mentioned UDAs, could he say something about the disparity of UDA rates across a region? That disparity means that a large practice can concentrate its efforts in areas with higher UDA rates rather than in areas with lower UDA rates.

[Neil O’Brien]

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

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

Hospital Provision: Tees Valley

Peter Gibson Excerpts

Tuesday 28th March 2023 Westminster Hall

[Jill Mortimer]

I need to make some progress.

The first plan that Julie and I favoured was an upgrade and return of services to Hartlepool, new diagnostic hubs in Hartlepool and Stockton, and a new hospital closer to the A19 in Hartlepool, which would be the major trauma centre. This was a bold new model. It would allow people to access diagnostic and out-patient facilities very locally and to travel to the true central point of all the communities in the Tees Valley for major procedures in a state-of-the-art new facility. Sadly, with the huge pull on public funds created by the pandemic, the war in Ukraine and the rising cost of living, it has become clear that that project will not be possible in the near future.

Undeterred, Julie and I returned to the drawing board with a plan to upgrade Hartlepool further and maximise the return of services to that site. I mentioned that there is not enough capacity for the significant volume of elective surgical procedures in Tees Valley NHS sites. The upgrade at Hartlepool, with a proposed 40% increase in operating theatres, would address that lack of resources and increase capacity to perform those elective procedures in a new centre of excellence. That would be alongside a new, much-needed primary care hub and a community hub, which would enable patients to be fully rehabilitated before being discharged. That would free up hospital beds on wards.

I also point out to the Minister that, like most things that I inherited in my constituency, hospital services had not been championed by predecessor Labour MPs for too long.

[Peter Gibson (Darlington) (Con)]

My hon. Friend is a fantastic champion for Hartlepool and is doing incredible work to secure the hospital. Representing as she does the former lands of Mandelson, Milburn, Mowlam and Blair—all who are here today represent such places—does she agree that there is very little to show in our region for their years in office, save for costly PFI deals?

[Jill Mortimer]

I totally agree with my hon. Friend. The fact that we are here now is the proof of the pudding; people got tired of being ignored by Labour MPs who took the heartlands for granted.

[Peter Gibson]

They took the north for granted for years.

[Jill Mortimer]

Exactly. The Minister might be surprised to learn that the trust has not received significant capital investment to improve its services since its initial construction more than 50 years ago, while neighbouring trusts have received funding more recently. That results in a significantly lower per capita spend for the population served by the trust—around £60 per head in the region, compared with neighbouring trusts that receive more than 11 times that amount, at £680 per head. I am sure I do not need to point out to him that positive change means productivity and prosperity. Those things are limited by a high local prevalence of chronic disease.

Our local population has a higher prevalence of 17 out of 21 chronic conditions recorded on the quality and outcomes framework in 2020-21. Both long-term and temporary sickness are cited as the main reason for unemployment in Hartlepool; at 33%, that is higher than the national rate of 25%, suggesting that poor health outcomes are the main driver of unemployment in the region and underlining the significant need for a return of good health services locally.

[Peter Gibson]

I am grateful to my hon. Friend for giving way once again; she is being incredibly generous with her time. We were all elected on a mission to level up, and levelling up is about delivering on those health outcomes. Does she agree that levelling up health inequalities in the north-east is a key part of why we are here?

[Jill Mortimer]

Absolutely. It is incredibly important because, without levelling up health disparities, we cannot get growth or productivity, so it is very important to make sure that we have a happy, healthy population.

The historic lack of prosperity means that a disproportionately high percentage of the local population is in the lowest 10% for deprivation in England, based on the index of multiple deprivation. That puts Hartlepool in the bottom 10 of 147 local authorities nationally. High levels of deprivation also contribute to the fact that life expectancy in Hartlepool and throughout the Tees Valley is considerably lower than the national average in the most deprived areas.

It is the lack of prosperity and the deprivation that I was elected to fight. The people of Hartlepool voted for me to bring positive change. They wanted an MP who finally listened and did something about it. I will not rest until we get the local health services that we deserve and have been so cruelly deprived of. We have been ignored for too long. Will the Minister commit to meeting Julie Gillon and me to discuss the matter further?

Oral Answers to Questions

Peter Gibson Excerpts

Tuesday 6th December 2022 Commons Chamber

[Peter Gibson (Darlington) (Con)]

9. What plans he has to reduce health inequalities.

[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.

Oral Answers to Questions

Peter Gibson Excerpts

Tuesday 1st November 2022 Commons Chamber

[Peter Gibson (Darlington) (Con)]

Following a recent unannounced inspection by the Care Quality Commission, some services at Tees, Esk and Wear Valleys mental health trust have improved, but the trust’s overall rating remains “requires improvement.” Can my right hon. Friend assure me and my constituents in Darlington that his Department will keep a laser-like focus on the trust and that he will do everything in his power to ensure the trust carries out the improvements that are so desperately needed?

[Maria Caulfield]

I thank my hon. Friend for raising this important issue. I understand he recently wrote to the Secretary of State, and we will respond shortly. NHS England and the North East and North Cumbria integrated care board have commissioned an intensive support team review of the trust, and I will keep him updated. He is right to make sure that we keep this high on the agenda.

Liver Disease and Liver Cancer: Diagnosis

Peter Gibson Excerpts

Tuesday 11th October 2022 Westminster Hall

[Peter Gibson (Darlington) (Con)]

It is a pleasure to serve under your chairmanship, Mr Betts. I congratulate the hon. Member for Rutherglen and Hamilton West (Margaret Ferrier) on securing this debate. I also welcome the Minister, my hon. Friend the Member for Sleaford and North Hykeham (Dr Johnson), to her place. I wish her every success in her new role. I have known her for over 30 years, and I have every confidence that she will be a thoughtful, listening Minister in a Department where she has professional experience and expertise.

Last month, my father should have celebrated his 80th birthday. Instead, his life was cut short by liver and pancreatic cancer. He died at 47—the age I am now—exactly six weeks to the day from being diagnosed. Looking back on the events of his passing in 1990, I would have assumed that things had improved. Advances in screening, treatment and diagnosis surely must have led to a very changed picture. However, in preparing for today’s debate, I have sadly learned that things do not look better. The British Liver Trust reports that there were around 200,000 deaths from liver disease in 1990, and in 2018 that figure had risen to almost 400,000.

In the north, the picture is quite bleak. It has the highest levels of liver disease, the highest admissions and the highest deaths. Liver disease is the second biggest cause of premature mortality and lost working years of life. We have seen a 400% increase in deaths from liver disease over just the last two generations. Liver cancer has seen the second fastest increase in incidence of any cancer in the UK, and the fastest increase in mortality rates over the past decade of any cancer for both men and women. Liver cancer mortality rates have more than doubled since the 1970s. I am reliably informed by the British Liver Trust that, sadly, the mortality rate in Darlington is the worst in the north-east, at 46 deaths per 100,000. Those are the worst results of any constituency in the north-east, which in itself is the worst in the country.

Those figures are not worrying or troubling; they are shocking. That is why I am pleased that we are having this debate. It is essential that the Government focus on tackling the causes of liver disease and cancer, so that we can prevent further families from losing a loved one prematurely.

As we know, liver disease is largely preventable, however symptoms often do not present until the damage is irreversible, making early diagnosis difficult but key to tackling disease. We know that liver disease deaths are higher in more deprived areas and are increased by higher levels of alcohol harm and obesity. When we talk about levelling up—improving our roads and railways, improving our homes and hospitals—we must not forget, and indeed must have a keen focus on, the health mission element of our levelling-up goals: to narrow the gap in healthy life expectancy and increase healthy life expectancy by five years.

The British Liver Trust’s “Make early diagnosis of liver disease routine” campaign in Parliament earlier this year was welcome, as are the Government’s efforts to improve diagnosis times and make testing more readily available. The evidence from this debate, however, is clear: we need to go much further and much faster to have a real impact on the dreadful mortality figures.

As I said at the beginning, I know that the Minister is someone who listens and who will have listened closely to the debate. I know too that, as someone who was born in the north-east, she will share my concerns about those families robbed of their fathers or mothers too early. She will want to do all that she can to reduce those losses in the future. I look forward to her response to the debate.

[Mr Clive Betts (in the Chair)]

Those Members who were listening intently to what I said earlier will have noticed that I tried to extend the debate by a further half hour, although we do have to start the wind-ups at about quarter past. For guidance, that gives about five minutes for each speech.

NHS Dentistry in England

Peter Gibson Excerpts

Wednesday 22nd June 2022 Westminster Hall

[Peter Gibson (Darlington) (Con)]

It is a pleasure to serve under your chairmanship, Mr Stringer, and to follow the hon. Member for York Central (Rachael Maskell). I am pleased to report that my own dentist is in the hon. Lady’s constituency, and I have had excellent service from them for the past 25 years.

I congratulate my hon. Friend the Member for St Ives (Derek Thomas) on securing the debate. As we have heard, many Members across the House have had significant correspondence on this issue from constituents. Since the start of the year, I have been contacted by 26 constituents raising their difficulties in obtaining access to NHS dentistry. I therefore welcome the opportunity to discuss this important issue.

The problem of access to NHS dental services has sometimes been put down to a lack of adequate staff numbers. Across the Tees Valley CCG area over the last 11 years, the number of dentists carrying out NHS activity has remained static, at around 330. Moreover, issues with access to care have undoubtedly been compounded by the pandemic, with waiting times increasing significantly due to the infection control measures that were required to keep services going. However, those are not the main issues.

Instead, we must look at the shortcomings in the current system of dental contracts, which was introduced by Labour in 2006. Under that system, a dental provider agrees to provide a set number of units of dental activity from April until the following March, and the annual contract value is paid in 12 monthly instalments. Those units are not related to numbers of patients or the extent of the work that needs to be performed, and similar rates are paid for taking out one tooth or doing one filling and for doing extensive dental work.

Therefore, dental providers effectively end up being paid less money for more work, with it not being financially viable to provide NHS dental services. That results in providers not taking on NHS patients, or sometimes handing back NHS contracts and concentrating on private dental care. Furthermore, the nature of the employment of many associates—who are retained on a decreasing percentage share of the income they generate—further reduces the incentive for those coming up through the profession to remain doing NHS work. I understand from the Minister that the British Dental Association and NHS England are in discussions to reform the contract. I wish those negotiations well for the sake of all our constituents.

I would also like to focus on the fact that the main causes of tooth loss are decay and gum disease. Prevention is definitely better than cure. Improved dental hygiene gives a better chance of keeping teeth for life. I hope that any changes to the NHS contract include a shift to focus more on prevention and pre-emptive care in order to reduce demand for routine and urgent dental care.

I firmly believe we need a far greater focus on education in dental care. Early years foundation stage is a child’s first experience with oral health impacting on the rest of their life. Setting good dental hygiene standards and practices early on often leads to far less need for care in later life. Schools should do more to emphasise good dental health, and dentists should do more to educate parents on how they can set high standards for their children and on the vital role they play in normalising dental visits, putting their children at ease with the dentist, as a person they can trust.

I welcome the steps the Government have taken to try to deal with the backlog of NHS dental care, including the provision of £50 million to provide up to 350,000 additional dental appointments in England. It is welcome that that funding was targeted at those groups most in need of dental treatment, with children and people with learning disabilities, autism or severe mental health problems being prioritised. But I fear that that is not enough to ensure that everyone who needs to be seen can be.

This is a hugely important issue in Darlington, and one we cannot afford to get wrong. It is essential that those in the most need of care and those in the most deprived areas are prioritised. The current system is simply not working in that regard. I trust that the Minister has listened closely to the points I have raised, and recognises the importance of expediting the reform of NHS dentistry contracts and of focusing on preventive care, so that we can create a system that works for all.

Health and Care Bill

Peter Gibson Excerpts

Consideration of Lords amendments
Wednesday 30th March 2022 Commons Chamber

[Peter Gibson (Darlington) (Con)]

I believe that everyone should have high-quality, personalised palliative care, and that is why I am speaking in favour of Lords amendment 12 on palliative care. I wholeheartedly welcome the benefits that this Bill can bring to those in need of that care. I must mention the tireless campaigning of Baroness Finlay, as referenced by the Minister in his opening statement, and Hospice UK, which acts as the secretariat for the all-party parliamentary group on hospice and end of life care, of which I am a co-chair along with Baroness Finlay. Without their campaigning, we would not have been able to welcome this step forward. I should also declare my interest as a trustee of a hospice, and I draw the House’s attention to my entry in the Register of Members’ Financial Interests.

On the day of the publication of the Ockenden report and our discussion of good births, it is time that we started to talk about good deaths, too. There is far more that we need to do to ensure that hospices and palliative care providers have the tools they need to achieve this, and Lords amendment 12 certainly moves us forward. We need to ensure that the impact of the measures in this Bill are maximised. The Bill specifies appropriate palliative care, but we should expand on this to ensure that a fair minimum standard of care is provided. We should be providing statutory guidance to integrated care boards on the commissioning of palliative care, ensuring that the new requirements are clear. That point was ably raised by my hon. Friend the Member for North Warwickshire (Craig Tracey).

Funding certainty for hospices is essential. Certainty can enable them to better plan, support the needs of their local community and give commissioning boards confidence in relying on them as an integral part of local services. Certainty of funding will allow hospices to invest, innovate and integrate with the NHS and care system. Before the pandemic, adult hospices on average received 34% of their funding from Government, with some receiving little or none. Hospice funding came primarily from charitable donations, with the sector needing to raise £3.1 million every day. The pandemic saw donations, retail sales and fundraising activities fall dramatically, at the same time as an increase in service delivery. I want to put on record my thanks to the Government for the support that was given to all our hospices during the pandemic—and, in particular, to St Teresa’s in Darlington—but we need to see some certainty of funding for our hospices to deliver on this promise.

I am pleased that the Government accept Lords amendment 12. It is an important step forward for hospices and palliative care, and I welcome it.

[Kevin Hollinrake (Thirsk and Malton) (Con)]

It is a pleasure to speak after my hon. Friend the Member for Darlington (Peter Gibson). He made some very strong points in his speech with which I absolutely concur. I want to speak to Lords amendment 80, and his constituency—I know it pretty well, having been there and spent a bit of time there prior to the last election—is the kind that will be affected by it. The Government’s decision is to resist that Lords amendment, which I cannot support. In my view, this is a classic policy for levelling down, not levelling up.

The Minister is absolutely right—both Ministers involved in this Bill are good friends of mine, and I do not want to make their lives more difficult in any shape or form—when he says that the policy across the board is a significant improvement on anything we have had before. That is absolutely right. He said that in his speech, and I agree with it, but I do not agree with him when he says that it is fair. I do not believe it is fair, and that must be the basic criterion on which we judge any proposals, not least these.

I think everybody, including the Minister, accepts that it is quite clear that a £900 million transfer is happening here, which was introduced just as the Bill went on to Report stage. That is a direct transfer of £900 million from household wealth to somewhere else. That is what it is: a transfer of assets—household wealth—to healthcare, the Treasury or wherever else it is going, because that is the way that council contributions are used when it comes to the speed at which somebody reaches the cap.

I could live with that, if we were trying to make the system more affordable, as the Minister says—if the burden was going to fall equally on everyone’s shoulders in different parts of the country. It also true to say that most people will not be affected, because only people on very long care journeys tend to be affected badly, but there are quite a few of them: according to the Department’s own figures, about 6,000 a year—10 people per constituency—would be affected in this way, and most of them have dementia. We know that there are 900,000 people with dementia in the UK today; according to the Alzheimer’s Society, there will be 1.6 million by 2040; and 70% of care home residents are dementia sufferers, and they are the sort of people who will suffer because of the changes. They have very long care journeys, and they move out of their house so it becomes one of the assets that we take into account when assessing how much people contribute to the care cap.

The Minister says we are making these changes to make the system sustainable. Well, okay, make it sustainable, but make it fair too. I do not believe that this is fair. I know I am comparing this with a system that never existed—my hon. Friend is right to say that—but one was proposed in which the council contributions would count in calculations of people’s contribution to the care cap. That is the change we have made—the specific measure to make the system more sustainable is that change, and that affects people with limited assets and wealth. We are balancing this on the shoulders of people with fewer assets and less wealth, and on certain areas as well, as people in some of the regions in the north that we represent tend to have fewer assets and less wealth.

Particularly affected are people who have wealth or assets worth between £75,000 and £150,000. The research provided by the Alzheimer’s Society is clear: under the Dilnot proposals, about 50% of people living with dementia benefited fully from the care cap—they reached the care cap. That was true across all the wealth quintiles—it was very fair. This is not. Only 13% of people in the least wealthy quintile will reach the cap, whereas 28% of the most wealthy will. Such huge disparity cannot be right, yet that is the change that we have made. That £900 million has been found from people with less wealth. That cannot be right, nor is it consistent with levelling up. Look at how different regions are affected: only 13% of people in the north-east reach the cap whereas 29% of people in the south-east do so. Previously, in almost every part of the country, about 50% of people did so. The cap was not as generous, but it was very fair across different wealth quintiles and different regions of the country. I cannot see how this is fair.

Instead of each of us having 10 people in our constituency affected, some will have more and those representing wealthy constituencies will have fewer. I and other Members representing the north-east will have more constituents affected by this change and less generously treated because of it. For that reason, and because in my view it levels down, I cannot support the Government and will vote against them this evening on Lords amendment 80.