Building an NHS Fit for the Future

Richard Foord Excerpts

Monday 13th November 2023 Commons Chamber

[Amy Callaghan]

I absolutely would like to see the same for Scotland. The Barnett consequential system in itself is quite frustrating, because we do not see the full complement we should get because of how the British Government exercise spending decisions. I would absolutely like to see a different funding structure exercised down here. The way it is spoken about is complicated in itself, and a bit of truth around that would be useful.

I have been struggling with the image of the King delivering his speech from his gilded throne while innocent people in Palestine are dying. It feels a ridiculous thing for this Parliament to have been focusing on. We are witnessing the biggest humanitarian crisis that many, if not most of us, have ever seen. It bears witness to how soulless this British Government truly are. Children are dying, refugee camps are being bombed and hospitals are being destroyed. For each second that Members throughout this House fail to call for a ceasefire, more innocent people are dying in Gaza.

Not just a humanitarian pause but a ceasefire is necessary. Riham Jafari of ActionAid Palestine so aptly described the difference between a humanitarian pause and a ceasefire:

“What use is a four-hour pause each day to hand communities bread in the morning before they are bombed in the afternoon?”

Innocent men, women and children in Palestine continue to die. I make a plea to colleagues on both sides of the House: walk through the Lobby with us on Wednesday night to vote for a ceasefire. They need you to show leadership. We need to show leadership and vote for the SNP’s common-sense humanitarian amendment to the humble address.

In preparation for this debate, I found myself reflecting on the words inscribed on the mace of the Scottish Parliament: “Wisdom, Justice, Compassion and Integrity”. The mace is not just about tradition, and it is not a bit of a pantomime like in this Parliament. In Holyrood, the mace is there to signify the relationship between the people, the Parliament and the land.

No institution better represents the link between the people and the state than our precious NHS, but being tied to this financial Union means that our NHS is suffering terribly. We have workforce shortages, medication shortages and equipment shortages—shortages, shortages, shortages. I got into politics because of the rampant health inequalities I saw in my part of the world when I took unwell as a teenager. We all know health outcomes are impacted, whether directly or indirectly, by the quality of our support network. I saw first-hand the effect of poverty on outcomes. That is why I am so proud that our SNP Scottish Government implemented the young patients family fund, which helps to prevent income from being a barrier for families being able to support a young person through ill health. Scotland is leading the way in transforming lives and outcomes with that fund.

It would have been nice to see some flickers of hope and progress woven through the King’s Speech, but given the British Government’s lack of willingness to learn from good practice elsewhere on these isles, it is relatively unsurprising not to see it. The pomp and pageantry of this place, its traditions and its reactionary main parties seem to me to be a distraction from the real work and hard conversations that neither of the two main parties want to have. Instead, we have a celebration of the dance we call debate in this place.

I will now reflect again on the words inscribed on the Mace of the Scottish Parliament. Let us take a look at each and see whether they apply to the British Government. I will start with the wisdom that is being shown—or not shown—in this place where Brexit was forced through, despite the broken promises it was built on. What has come with that wise decision endorsed by both the Government and the Labour party? We have severe medicine shortages, meaning that people are unable to access vital treatments such as attention deficit hyperactivity disorder drugs and hormone replacement therapy, as well as a shortage of staff to supply and distribute them. That oven-ready Brexit deal that the public were promised was lacking one key ingredient: wisdom. My constituents in East Dunbartonshire applied wisdom in advance when they overwhelmingly voted to remain within the European Union, but the structure of the Union meant that their voice was ignored.

Moving on to justice, where is the justice in there being so many material changes of circumstances since the 2014 referendum, while the British Government continue to deny the people of Scotland the right to choose our own future? Some might say that that is an injustice.

Moving on to compassion, there are many ways in which I could question the compassion of this place, but there is nothing more timely or truly horrific than the ongoing attacks on civilians in Gaza. We are witnessing the biggest humanitarian crisis many of us have seen in our lifetimes, and this place has rightfully expressed compassion for those killed and suffering in Israel, yet the compassion is lacking for those children in Gaza. Each day that this place fails to unite behind a ceasefire, children die. Where is the compassion for those children?

[Richard Foord (Tiverton and Honiton) (LD)]

Would the hon. Member get behind a unilateral or a bilateral ceasefire?

[Amy Callaghan]

I would get behind a ceasefire. We are talking about a ceasefire.

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[Mike Amesbury (Weaver Vale) (Lab)]

I pay tribute to our national health service and social care staff, be they in Cheshire, Merseyside or elsewhere across Britain. Of course, while many in Downing Street partied, those staff went above and beyond and sacrificed so much every day—we must not forget that; the public inquiry is certainly shining a light on it—and, importantly, they continue to do so.

It is no secret that our NHS is facing the worst crisis in history. Urgent action is needed to make our cherished healthcare system work again, but the Government provided no solution in the King’s Speech, with 21 Bills that were heavy in rhetoric but light in substance. Where was the Bill on mental health, which we have long awaited and the Government have promised time and again?

Bizarrely, after 13-plus years of failure, the Prime Minister is trying to paint himself as a vehicle of change, while recycling a failed Prime Minister from the past, whose only notable recent success was to get himself on the payroll of Greensill Capital, which came at a real human cost of 305 job losses in the Daresbury Park area of my constituency. This is a company—sorry, a failed company; a former company—that is now subject to an investigation by the Serious Fraud Office. We are still dealing with that sorry affair, yet bizarrely, that individual is now appointed to the Government. To me and my constituents, it sounds like the same old entitled Tories time and time again, with no responsibility to anybody, putting arrogance above all. It is the same old Tories—the same old Etonians—and one of them is coming back.

The Conservatives have no answers on how to save the NHS. This Government are failing millions of patients and NHS staff across the country. Waiting lists are out of control, staff are burned out, and people are literally losing their lives. Too many of our constituents are waiting longer than ever for operations, in A&E, for ambulances, and when trying to get doctors’ appointments. The system is broken; the Government broke our NHS. We only need to look at their own figures: recent statistics show that the NHS backlog has hit a record high, at 7.8 million. That backlog is 600,000 larger than when the current Prime Minister made his pledge—one of his five pledges—in January.

We on the Labour Benches know that there is a plan. There is a sizeable pot of money available from non-doms, the very people who, bizarrely, the Prime Minister seems to want to protect. It is almost as though he has a vested interest in non-doms—I cannot imagine what that might be. That money could be used to power up the frontline resources that we need to get waiting lists down. Why not adopt the Labour plan? Go and steal our plan. Let us provide 2 million more appointments by paying staff extra to work evenings and weekends, paid for by abolishing the Prime Minister’s beloved status of non-dom. Just do it—steal it! Do the right thing. Of course, that is not going to happen.

The NHS shortfall affects a number of other areas across the health landscape, especially dentistry in my constituency and throughout England. We know that 90% of dental practices in England are closed to new NHS routine patients, creating dental deserts. That is certainly true in the Halton and the Cheshire West and Chester parts of my constituency. People who have a little bit of extra money in their pockets are forced to pay for expensive payment plans in the private sector, but as has been well documented across the Chamber today, many are resorting to DIY treatment. It is an absolute scandal; it is Dickensian. In this day and age, everyone should have the right to receive dental treatment when they need it. That is a fundamental principle of the NHS—the NHS that we founded, and that we will protect and save.

Just as it is very challenging to get a doctor’s appointment, unfortunately the principle behind NHS dentistry continues to be severely undermined. I recently visited Leftwich Community Primary School, a brilliant school in my constituency with great teachers and support staff. The joint headteachers raised the desperate attempts that are made to try to get NHS dentists for pupils at the school. The teachers are going the extra mile, trying to get NHS dental appointments for children in the local community. What will the Government do to make sure there are enough dentists across England, including in Cheshire and Merseyside? Why not adopt Labour’s plan for an additional 700,000 dental appointments—quite a significant number, although it seemed to be pooh-poohed by a Minister earlier in the debate—by closing private equity loopholes? That is another costed plan—steal it! Do the right thing. Of course, the Government will not.

In my constituency, we have hospitals that badly need to be upgraded and modernised. Our bid for a new Halton campus hospital was snubbed by another Health Secretary—third time unlucky—while Leighton Hospital, which serves the Northwich part of my constituency, was successful only because it is literally falling down. It is propped up by scaffolding; it is riddled with reinforced autoclaved aerated concrete. That is how it got on the programme for the 40 new hospital builds, which of course is a work of fiction in itself. I will be asking another Secretary of State for Health and Social Care—another one was announced today; I had forgotten about that—when the people of Halton can expect to hear some good news about that desperately needed hospital rebuild.

[Richard Foord]

I was interested to hear the hon. Member mention RAAC in his speech. I have heard that there is a hospital in Harrogate that needs £20 million of repairs because of RAAC, but the Government are requiring that hospital to bid for the funding, rather than just giving it the funding. Does the hon. Member think that is right?

--- Later in debate ---

[Richard Foord (Tiverton and Honiton) (LD)]

I intend this evening to talk about rural and coastal healthcare, community hospitals, social care and NHS dentists. Right across the country, our NHS is creaking. In rural areas such as the one that I represent in Devon, many people are finding it almost impossible to get timely care. Despite that, there were almost no announcements in the King’s Speech of new legislation to support the NHS in rural areas. I really am wondering, given that I represent a corner of Devon, what was in this King’s Speech to provide for healthcare in the countryside. We often hear about acute challenges in urban areas, especially when it comes to vital services that we perhaps do not need to travel very far for, but coastal and rural areas tend to be places where older people retire to and so have a higher population of older people.

Last week Sir Chris Whitty, the chief medical officer, said that the elderly boom will be in rural, largely coastal areas. He said:

“We’ve really got to get serious about the areas of the country where ageing is happening very fast, and we’ve got to do it now...otherwise we will end up with large numbers of people leading much more dependent lives”—

that is, lives that are more dependent on the state and on taxpayers. We really need to get a grip of this. Sir Chris wrote:

“Improving quality of life in older age sometimes means less medicine”.

It might be that older people want to go to hospital, but not to intensive care. It might be that they want to have treatment, but not an operation. It seems to me that Sir Chris Whitty is encouraging us to listen to what older people want.

I held a listening exercise over the summer in which I visited 34 village and town halls, and I am certain that, more than anything else, people in my part of Devon want good community hospitals and good care close to their home. I heard that they do not want to have to travel 30 miles to the nearest acute hospital in Exeter, on a bus that can take up to 90 minutes, to see a loved one or to have an operation. Going to hospital is a huge burden for people living in rural areas like mine, where public transport is poor and declining in quality, meaning that people spend a whole day travelling to and from hospital, which is a huge undertaking for older people.

That is why community hospitals are vital. They offer bases for treatment, helping to support people in their own community. Sadly, we have been losing these centres in recent years. In my corner of Devon, we have seen the hospitals in Seaton, Honiton and Ottery St Mary suffer swingeing cuts. The cuts to the number of beds, made in 2017, were fought vocally by local people, and they are having lasting consequences.

My Adjournment debate will focus on Seaton Community Hospital but, in the meantime, I will talk about two other rural health challenges: social care and dentistry. The cost of providing care at home is higher in rural areas, both to those who pay for it and to those delivering it, because they are having to drive between appointments. That is why the Liberal Democrats are calling for a carers’ minimum wage, with an additional £2 an hour boost to the minimum wage paid to carers.

The situation for dentistry in Devon is even worse. Local NHS dentists are so up against it that not a single dentist in all of Devon is taking on new NHS patients. Healthwatch England reported on seven of the NHS’s 42 subregions that are not taking new dental patients:

“Of all of these areas perhaps the worst affected is Devon, as there are currently no practices showing as taking on adult or child patients.”

This means that people are having to live in agony; having to travel huge distances to far-flung destinations—I heard one constituent say that it was recommended that they travel to Gloucester for an NHS dentist; having to pay huge sums of money that they do not have to go private; or having to perform terrible, dangerous DIY dentistry to remove their own teeth.

The Government would prefer to be silent about this issue. We have a ticking time bomb of retirement looming, and the Conservative Government have rejected Liberal Democrat calls to reform the NHS dental contract or to set out a clear plan to recruit and train the thousands of dentists that we need.

Those challenges are specific to rural communities, but today I am also talking about challenges that are specific to coastal communities. The final subject I want to cover is therefore sewage dumping, which can be damaging to health. I know people who have become sick after swimming off the east Devon coast. People should not have to risk sickness on Devon’s beautiful beaches.

There was a raw sewage spill at Sidmouth on 10 September 2022, despite the water quality report by Surfers Against Sewage finding that there had been no rain over the previous 48 hours. What did South West Water, the water company responsible, have to say? It said the spill was a “false alert” due to wildlife brushing over the sensors on the combined sewage overflow monitor. What kind of Government would set up a regulator that was prepared to accept that as an explanation? Liberal Democrats want to see water companies overhauled and reformed into public benefit companies. We need to put the health and wellbeing of local people ahead of corporate greed and shareholder profits. That will stop people getting sick and ensure that our favourite beaches remain attractive places for tourists.

I wish to close by reading out the words of David Cameron. When he retired, he talked about how he did not think he was the right person

“to try to be the captain that steers the country to its next destination.”

That can apply to the whole of this Conservative Government.

Future of the NHS

Richard Foord Excerpts

Tuesday 24th October 2023 Westminster Hall

[Richard Foord (Tiverton and Honiton) (LD)]

It is an honour to serve under your chairship, Mr Pritchard. The NHS is one of our country’s defining achievements. From the ashes of the second world war, we built a world-leading health service, delivering free care at the point of use for everyone in the country. My points today are going to focus on waiting times, dentistry and the link to social care.

In recent years, this grand vision has been steadily eroded. More and more people are struggling to get the care they need, and waiting lists continue to spiral. As of two weeks ago, 7.75 million people were on NHS waiting lists. Nearly 9,000 people in England are estimated to have been waiting more than 18 months to start their treatment, while the number of people waiting for more than a year was just under 400,000. I can think of specific examples. I represent over 75,000 people in my part of Devon, one of whom is David Crompton from near Bampton. David is a deer farmer, and he needs to be mobile to do his job. He needs a knee replacement. He wants to be useful to the economy and to society, but he has been told that it will probably be two years before he gets a knee replacement.

With cancer waiting times, the situation is little better. Every single cancer waiting time target was missed, and ambulance and A&E waiting times increased. This is a shocking situation, which will only lead to more long-term problems. We know that every day that someone waits to start treatment, or every time that someone is stuck in the back of an ambulance or an A& E department, it is because there is not a bed for them to be transferred to, which leads to worse outcomes. Then, of course, long-term health conditions can develop.

Obviously, this is not just a problem in hospitals; it is also a problem in other areas, such as primary care and social care. On primary care, the Liberal Democrats are calling for 8,000 more GPs. A very astute constituent of mine, a medicine student called Jonty Eaton-Hart, wrote to me recently. He has written a lot on rural and remote health. He pointed out that at the moment in general practice, the situation is almost similar to that of a frog being boiled in a pot, whereby there is so much pressure now on people working in general practice that at some point the frog is going to hop out of the boiling water. Retention of staff is absolutely key.

As I say, Jonty has written a lot about rural areas. In rural areas such as my corner of Devon, the very notion of NHS dentistry is another area of health that feels like some sort of vaguely recalled legend from years gone by, with people being left in agony because they cannot get an appointment. So many constituents have written to me complaining that they have to pay huge sums to travel long distances. But if people cannot travel long distances or cannot pay the large sums required for private treatment, then they have to suffer in agony.

This Conservative Government simply cannot go on as if nothing is wrong. It is plain that the dental contract needs reform, but the fact that they are not reforming it properly suggests that they simply do not care. They cannot go on pretending that somehow dentistry is available everywhere on the NHS; that is simply not the case in rural areas.

Another area that needs a major rethink is the way in which social care is integrated into our national health service. Of course, such integration has notionally happened now that we have a Department called the Department of Health and Social Care, but actually that is just rhetorical; we are not seeing proper integration of health and social care.

The Government have repeatedly shelved plans to overhaul social care and instead are content to tinker round the edges while people are unable to get the care they need. We have seen chronic workplace shortages; there are over 150,000 vacancies in adult social care. Yet the Government have repeatedly rejected Liberal Democrat proposals for a carer’s minimum wage, which would see an uplift of £2 per hour in the minimum wage paid in these crucial social care jobs.

The Liberal Democrats reckon that investing an extra £5 billion in social care will lead to savings in the NHS—not to the same level, of course, but we reckon that that would bring £3 billion in savings for the NHS. Therefore, a £5 billion investment in social care would actually involve only a net cost of £2 billion. At present, publicly funded social care is mainly financed through local government. We know that local government finances have been squeezed really hard in recent years, so we have to shift some of this burden of taxation back to Westminster.

The Liberal Democrats are also calling for cancer patient treatment to start within two months of an urgent referral. That ought to be the case now. We are calling for an extra £4 billion to be spent over five years in this area. My right hon. Friend the Member for Kingston and Surbiton (Ed Davey) was exactly right when he said:

“Voting Conservative is bad for your health.”

LGBT+ People and Spouses: Social Care

Richard Foord Excerpts

Tuesday 12th September 2023 Westminster Hall

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

It is a pleasure to serve under your chairmanship, Sir Robert, and to respond to the debate on behalf of the shadow Health and Social Care team in my first outing as the newly appointed shadow Minister of State for Social Care. It is always good to see the Minister for Public Health in his place.

I sincerely thank my hon. Friend the Member for Dulwich and West Norwood (Helen Hayes) for securing the debate and for all her work on this important subject. Her contribution this afternoon was heartbreaking —the way in which her constituent was treated was utterly shameful. I also thank my hon. Friend the Member for York Central (Rachael Maskell) for her contribution. She ended on such a powerful poem, which speaks to so many who suffer in care home settings.

The Care Quality Commission guidance for all providers of adult social care clearly states that people using care services

“must not be discriminated against in any way and the provider must take account of protected characteristics, set out in the Equality Act 2010.”

As we have heard today and as we know from other studies, however, that is not always the case.

A survey conducted in 2017 found that 23% of open LGBT+ respondents who had been in a care home or other form of institutional care reported that being gay, trans, bisexual or lesbian, or having other protected characteristics, had a negative effect on the care that they received. Those examples are varied, but each and every one of them is concerning. Some respondents to the 2017 survey said that they felt invisible. Other responses related to use of language—for example the assumption that a partner or spouse is of the opposite sex, when that is not necessarily the case.

At their worst, the experiences of LGBT+ people in care home settings can be traumatic, as demonstrated by the story of Noel Glynn and his partner Ted Brown, who is a constituent of my hon. Friend the Member for Dulwich and West Norwood. Before he died, it is reported that Mr Glynn, who had dementia, suffered bruising across his body and had a cigarette burn on the back of his hand because of abuse from care staff. Other residents warned his partner Ted not to reveal to staff that he and Noel were a couple, saying, “That won’t be good for either of you”.

Mr Glynn and Mr Brown sued Lambeth Council, but Mr Glynn very sadly died before any compensatory payments were made. This case is beyond abhorrent. I hope the Minister will set out how it happened and what steps the Government are taking to ensure that it never happens again. The Minister will know that the Care Quality Commission does not currently consider the extent of homophobia or transphobia in inspections, despite its fundamental standards. Following this case, will the Minister look again at that guidance?

More generally, what this issue comes down to is the importance of personalised care. A report by the Women and Equalities Committee published in 2019 points to research showing that 72% of care workers do not consider sexual orientation to be relevant to one’s health needs. That same report states that

“most health and social care professionals feel under-equipped to deal with LGBT people’s needs rather than intentionally discriminating.”

The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 are clear on this subject. Regulation 9 states that people using a service should have care or treatment that is personalised specifically for them. It is important that care providers respond to the serious concerns raised by LGBT+ people and ensure that those accessing services feel respected and safe, and benefit from care that is tailored to their needs.

My questions to the Minister are as follows. Given the extraordinary shortages in adult social care staff—sitting at around 165,000—what work are he and his Department doing to protect the principle of personalised care? Further, what steps is the Department taking to monitor the experiences of LGBT+ people in social care settings? In the 2018 LGBT action plan, the Government pledged to develop best-practice guidance for monitoring and to make this openly available to the public sector. Why were these pledges not implemented? Have they simply been abandoned alongside a plethora of other Government commitments, from banning conversion therapy to tackling waiting lists? Finally, LGBT+ organisations have called for better guidelines and staff training for those working in care settings. Can the Minister outline whether the Government support these calls?

The next Labour Government will address the vacancies in social care by delivering a new deal for care workers, guaranteeing fair pay, training, terms and conditions and career progression.

[Richard Foord (Tiverton and Honiton) (LD)]

I am curious to know from the shadow Minister what fair pay in the social care sector would be. What does he think of the Liberal Democrat proposal to pitch an additional £2 per hour minimum wage for social care workers?

[Andrew Gwynne]

If the hon. Gentleman had been at the TUC conference today, he would have heard the shadow Deputy Prime Minister, my right hon. Friend the Member for Ashton-under-Lyne (Angela Rayner), outline precisely what Labour’s fair pay deal will be for the social care sector, but we need to go beyond that. We need to ensure that social care becomes a valued profession again, rather than just assuming that agency staff can fill the vacancies. We need to make sure that social care once again has parity with the rest of the healthcare system and that care workers want to work in the care sector not just because of pay, terms and conditions, but because it is a profession—which, sadly, many feel it no longer is.

We will work in partnership with users and families and develop a set of national standards based on existing minimum entitlements and legal rights, including legal rights that exist in the Equality Act 2010—a piece of legislation of which I am fiercely proud, and which the last Labour Government took through Parliament and put on the statute book. We need to make sure that all service delivery, particularly in social care, meets the ambitions and legal expectations of the Equality Act—sadly, that has let down so many LGBT+ people in the social care sector, as we have seen from the statistics in the surveys that I have cited this afternoon.

We would also ensure that our commitment to raise standards right across the sector is upheld by requiring all care providers to demonstrate financial sustainability and, crucially for this debate, to deliver high quality care for service users before they are allowed to receive contracts from local authorities, making sure that local authorities commission care providers who are capable of delivering the care that people need at the standard we should expect. That would result in more personalised and ultimately higher-quality care for all individuals.

In 2023 people who are lesbian, gay, bisexual, trans and others should not feel ostracised by a system that is there to support them. They should not feel ignored and that their personal needs are not being met. Ultimately, they should not feel the need to hide the fact that they are gay, lesbian, bisexual, trans or other. I hope that the Minister will agree with me that we can get to work on delivering that higher standard of care for all service users. The testimony that we have heard today from my hon. Friend the Member for Dulwich and West Norwood should stand as that end point. Never again should somebody from the LGBT+ community be treated as we have heard. “Never again” should be more than a slogan. It should be deeds.

Under-age Vaping

Richard Foord Excerpts

Wednesday 12th July 2023 Commons Chamber

[Richard Foord (Tiverton and Honiton) (LD)]

I join Members from across the House in expressing concern about the way in which vaping is marketed to, and taken up by, children.

We have heard that vaping is a useful tool to help people to quit smoking, and that it is safer than smoking tobacco and cuts down the chances of developing conditions such as cancer. However, the Liberal Democrats are deeply concerned by the rise and prevalence of single-use disposable vapes, which are explicitly targeted at young people, be it through the use of brightly coloured advertisements, a range of playful colours or their placement near the front of supermarkets. We must ensure that young people do not become addicted to those products, and that vapes do not become a gateway to smoking. I am grateful to the right hon. Member for Romsey and Southampton North (Caroline Nokes), who, during her excellent speech, referred to the location of vape bars in supermarkets. I will expand on that point by talking a little about my own experience of it.

A few months ago, a parent of a student at Tiverton High School in Devon reached out to me as he was deeply concerned by the rise in the theft of vapes from our local Morrisons supermarket, which is just a short walk from Tiverton High School, making it easily accessible before and after school, and perhaps during lunch breaks. I visited the store and found that the vape stand was indeed right next to the shop entrance, offering a range of single-use disposable vapes. My staff spoke to the staff at the store, and it emerged that that spot was, yes, chosen by the vendor. The vendor specifically insisted on the vape stand being at the front of the shop in that way, and paid extra for it. As is the case in other supermarkets, the security team were not regularly stationed by the front of the shop, so it seemed ludicrous to me and my team that those products were placed so close to the door and left unprotected.

We took up the cause and campaigned with community representatives, including those from Tiverton High School, and spoke with staff from Morrisons to get that changed. After a short investigation, the store offered first to have a security guard stand next to the vape stand, but clearly, that was not enough. I am pleased to say that, after a lot of pressure, the vapes are now kept safely behind security doors, which are locked during school opening and closing periods on weekdays, meaning that vapes can be bought only from the kiosk.

That is very welcome news. I thank and pay tribute to Frazer Gould, from my part of Devon, who raised this issue with me. I do not think it should take a constituent lobbying a Member of Parliament, and that Member of Parliament getting directly involved, to ensure that those addictive products are not left openly accessible to young people.

[Kirsten Oswald]

The hon. Member is making an excellent speech. It is very helpful of him to point out the constructive actions of his constituent in this regard, although he is correct to say that it is we who should act. We should appreciate all the constituents of ours who are very focused on this, including my constituent Laura Young, who has done so much work to try to get vapes off our streets.

[Richard Foord]

I am grateful to the hon. Member. I also pay tribute to other constituents of mine: many of the young people who attend Tiverton High School. I do not want to mischaracterise them as people who are only out to steal vape bars from the supermarket at lunch times. I have been to that school several times, and there are some brilliant pupils there. Many of them are aware of the risks of becoming addicted to vape bars.

The campaigners, the high school and my team have worked with Morrisons and we have got that arrangement in place, but that is clearly just one arrangement with one supermarket. What we definitely need to do is think about single-use vape bars in the round. It is clear that we need to ban the sale of single-use disposable vapes, clamp down on the appealing packaging and the advertising of those products, and ensure that the shameless vaping companies cannot get our children hooked on those addictive devices.

Defibrillators: Public Access

Richard Foord Excerpts

Tuesday 4th July 2023 Westminster Hall

[Richard Foord (Tiverton and Honiton) (LD)]

I pay tribute to the hon. Member for Erith and Thamesmead (Abena Oppong-Asare), who set out some moving thoughts about the importance of altruism and caring for other people in their moment of need, and about how the Government can perhaps help communities to enable individuals to help other people.

I want to pay particular attention to two aspects of best practice in my constituency and in broader east Devon, and I will close with one ask of the Government. The two examples of great ideas relate to Devon Air Ambulance Trust and Axe Valley Runners club. I met Devon Air Ambulance Trust here in Parliament last winter. The trust let me know that it is running CPR training and training on how to use a defibrillator. It invited me along to Sidmouth rugby club to get some training on CPR and how to use a defibrillator. It was great, because I had not done much of that sort of training since being a Scout as a young lad. It was brilliant to see how much progress has been made in resuscitation and how much more can be achieved these days with technology that we did not have in the 1980s and 1990s.

The Devon Air Ambulance Trust has a “Help with all your Heart” campaign, which seeks the best possible outcomes for patients who suffer a cardiac arrest. Part of the objective is to provide more of the equipment, as well as trying to train people such as myself in how to use it. The trust has put AEDs outside its charity shops on high streets, and it is working with town councils in east Devon to enable better access to AEDs.

The second organisation that is doing great stuff in my part of Devon is Axe Valley Runners club. Earlier this week, as covered by the Midweek Herald newspaper, the club did a “defib dash”. A defib dash is a bit like orienteering, for those who know what that is. The idea is that the runners go off in groups with a map to find a number of defibrillators. They go on various routes, competing against one another, to see who can get back to the beginning having found the most defibrillators. They ran around Seaton, Axmouth, Beer, Colyton and Colyford, covering a big chunk of the Tiverton and Honiton constituency. I pay particular tribute to Heather Simmons, Claire Warner and Sarah and Ronnie Whelan, who deserve credit for that novel and creative idea.

My third and final point is the ask. It would not be necessary for community groups to come up with these fantastic initiatives if there was better understanding of where defibrillators are and how to use them. The hon. Member for Erith and Thamesmead has mentioned the Complete The Circuit campaign being run by the Express. The absence of a complete register of AEDs is a particular issue for rural areas such as my part of Devon. We think that there are 70,000 AEDs on the national register, but our understanding is that there are between 100,000 and 200,000 AEDs in existence. We are, therefore, nowhere near having a good idea of where defibrillators are located. This is an important issue. If someone comes across somebody who has had a cardiac arrest, one of the first things that the ambulance service will do when they call 999 is direct them to the nearest AED. In a rural area such as mine, however, the service might think that the nearest AED is miles away, without knowing that there is one just a few hundred metres away from the incident. As the Express has said, we need to Complete The Circuit. We need a full and proper record of where AEDs are located.

I am a Liberal Democrat and we do not really believe in intervening in matters in which the state need not get involved. In this instance, however, I have been racking my brains for reasons why the Government might not want to legislate or intervene to require community groups to register AEDs on a national database. I have asked the chairman of Sidmouth Town Council and other community groups about the arguments against having a comprehensive register of AEDs, but I have not yet heard a sound argument why we should not require everyone who, through the kindness of their heart, buys an AED to register it so that the ambulance service can direct people to all available AEDs.

In summary, fantastic work is being done outside the House by community groups, but we need a central register and it has to be as comprehensive as possible.

--- Later in debate ---

[Will Quince]

I have not been the Schools Minister for many months, but I will gladly ensure that the relevant Minister—or I, having accessed that information—gets it to the hon. Lady.

I remember that a key point in the design of the scheme—this touches on a point made by many hon. Members—was that providing an AED, in and of itself, is not enough. Accompanying the roll-out, we wanted to ensure that there were awareness videos about how easy it is to use an AED. We want teachers, as part of their training and in the staffroom, and pupils in assemblies to see how easy an AED is to use. In a rolling way, we hoped to create a new generation of young people who are confident in their use. As AEDs become more prevalent across communities, that can only be a good thing.

I think it was the hon. Member for Plymouth, Sutton and Devonport (Luke Pollard) who asked about CPR and first aid training. As a Back Bencher, I campaigned to have first aid included on the curriculum. The Schools Minister at the time was not very happy about that—not because he was against having it on the curriculum, but because the curriculum was already very full—but we did manage to get it included. It is important that we upskill young people so they have the confidence to act in the unlikely but possible event that they encounter someone in cardiac arrest.

The question about vandalism of defibrillators is a fair one. I had not given it any thought, but I will certainly have a conversation with my counterparts in the Home Office and the Ministry of Justice and see if there is any scope to take further action in that area.

Turning to The Circuit, I would certainly like to recognise the incredibly important work that charities do in ensuring that the public have access to defibrillators. The British Heart Foundation, in partnership with Resuscitation Council UK, the Association of Ambulance Chief Executives and of course the national health service, set up The Circuit, which is the national defibrillator network database that provides information on where defibrillators are located.

I heard the point that the hon. Member for Tiverton and Honiton (Richard Foord) made about legislation, which I have some concerns about. At the moment, registration is entirely voluntary, so nobody is forced to register their defibrillator with The Circuit. However, registration enables the emergency services and community first responders to locate the nearest publicly accessible external defibrillator when they are treating someone suffering from an out-of-hospital sudden cardiac arrest. In those crucial moments after a cardiac arrest, we know that locating an AED quickly will help save lives.

[Richard Foord]

What are the arguments against making registration compulsory?

[Will Quince]

That is a question that I had not previously been asked. The danger of legislating in an area like this is that often there are consequences of legislation. One consequence would be that all existing defibrillators were registered as part of The Circuit, and that comes with a tick—that is a merit. However, having created legislation and having worked in Government Departments where legislation has been drafted on numerous occasions, I know that there are invariably and inevitably also negative unintended consequences that need to be considered and thought through.

For example, would registration discourage communities from taking a defibrillator? Would it discourage businesses like the one to which the hon. Member for Plymouth, Sutton and Devonport referred from putting one in their shop? We have to think through that kind of thing. What kind of pressure does it put on those organisations? Would it discourage people? If we are going to create legislation, what are the implications of not registering? Will there be a criminal sanction or a civil one? These are all things we would have to work through, and that is why legislating on something like this is complex. We have to remember that most defibrillators are bought by community groups, although in this particular case the Government support them. We would be placing a legal requirement on them for something that they are purchasing through goodwill, for philanthropic or altruistic reasons.

We have just got to be careful. I am not saying that we should not consider it, but it is not quite as simple as saying, “Let’s legislate,” and thinking that that will address the problem. What we need to do, and are doing, is to encourage as many people as possible to register because of the benefits of registration.

Lung Cancer Screening

Richard Foord Excerpts

Monday 26th June 2023 Commons Chamber

[Steve Barclay]

As part of expanding our capacity, we are doing both: we are expanding the diagnostic capacity—my hon. Friend is right to highlight that investment in Barnsley, as elsewhere—and boosting the surgical capacity through the expansion of our surgical hubs. In addition, we are looking at the patient pathway and identifying bottlenecks and how we design them out, given the additional capacity that is going into the system. So she is right to highlight the investment that is going in, alongside which we need to look at the patient journey and how we expedite that. The bottom line is that we are treating far more patients, the vast majority of whom—more than nine in 10—are getting treatment within a month.

[Richard Foord (Tiverton and Honiton) (LD)]

We know that 28% of victims of lung cancer have not smoked and do not smoke. My mum was one such victim. She died having contracted lung cancer and having not smoked before. But we were lucky in my family that she was diagnosed early. So, on behalf of the Liberal Democrats, I really welcome today’s announcement. However, on behalf of people in Devon whom I represent, I ask why only 40% of the people who are diagnosed will be subject to screening by 2025? Why do we have to wait until 2030 for the screening to be widespread and available to all?

[Steve Barclay]

First, may I express regret about the hon. Gentleman’s own family experience of this condition? On the roll-out programme, we need to build that capacity and to do so in a sustainable way—that point has been raised by Members across the House. We are following the science in targeting those communities that are most deprived; they have the highest prevalence of smoking. Of course we will look at evidence of other risk factors, which colleagues across the House have highlighted, but it is important that we roll this programme out in a sustainable way. What is clear, however, is that it is making progress and it is welcome that so many communities want the programme to be rolled out to their area as soon as possible.

NHS Dentists: South-West England

Richard Foord Excerpts

Wednesday 24th May 2023 Westminster Hall

[Richard Foord (Tiverton and Honiton) (LD)]

I am grateful to serve under your chairmanship, Ms Elliott, and to follow the hon. Member for South Dorset (Richard Drax), who made some excellent points that get to the heart of why the Government are failing us on NHS dentistry. I will follow him by using some examples and giving a voice to some of the constituents in my part of Devon who have written to me to appeal for help.

Chrissy Evans from Seaton wrote:

“I don’t understand why there has been no effort to address the problem of thousands of British children without free access to a dentist…We have tried all the dentists in our area and none are taking on new patients unless they are private.”

John Mason from Branscombe received an email advising him that his check-up was booked, only to be telephoned by the practice in Sidmouth a few weeks later. He wrote:

“I had been an NHS patient in Sidmouth for many years. I was telephoned by the practice”,

which told him that his options were to become a private patient, to try to find another dentist, or to call NHS Devon if he needed emergency treatment.

A woman from Honiton, who I do not have permission to name, has had dental issues since 2011. She wrote to me:

“I have been trying to sort this since 2011, I believe now I am considered too old to matter. I cannot eat, I don’t wish to be seen trying. I hide my face when possible. I don’t smile, I avoid friends and family, my speech is affected, this has ruined my life for the past 12 years and consumes my every thought.”

Finally, Edward Roberts from Tiverton puts it very plainly:

“The situation which prevails is unacceptable but no one in Government seems to be concerned about it.”

People are living in pain. The examples I have just given are a small snapshot of the heart-rending emails that I have received about people’s dental misery. As we have heard already, many in the west country do not have access to an NHS dentist. A survey by the British Dental Association in March laid bare the challenges we face. It found that across the south-west, nearly three in five dentists reported having reduced their NHS commitment by an average of 30%, but a staggering 75% also reported their intention to further reduce the amount of NHS work they undertake this year.

Why is this happening? Because the NHS work that dentists take on simply does not pay enough to be viable. Many NHS dentists are simply overwhelmed by the soaring costs of their work and, on this trajectory, the problem is only going to get worse. The BDA reports that 49% of south-west dentists say that they are likely to go fully private, with 41% likely to change career or seek early retirement. Fifteen per cent say that they will move abroad. Unless the Government take swift action now to start to address the situation, we could see NHS dentistry effectively disappear within a decade.

It is pretty infuriating to see the Government’s lack of recognition of the issue. Ministers at the Dispatch Box should not hide behind the outrageous claim, which I and others will have heard, that the Government have reformed the NHS contract. They have not. In July 2022, they simply paid dentists for a few more units of dental activity—for example, a dentist who is treating a mouth full of teeth that need repair will get paid the same as somebody who is treating a mouth that needs three teeth worked on. Instead, the Government should engage constructively with dentists and overhaul the NHS contract to compensate sufficiently for dental work carried out on the people who need it. Unless those steps are taken, people will continue to suffer in pain. Dentistry should not be only for those fortunate enough to win the postcode lottery.

I hope to hear from the Minister some unequivocal plans to reform the NHS dental contract, and I am curious to know what steps the Government will take to address the crumbling state of NHS dental services—I hope that they will include some measures that my Liberal Democrat colleagues and I have been calling for over many years. Above all else, I want some honesty from this Conservative Government: either reform the NHS dental contract properly, or simply admit that an NHS dental service for our constituents in the west country is a thing of the past that this Government are not willing to prioritise.

NHS Strikes

Richard Foord Excerpts

Monday 6th February 2023 Commons Chamber

[Will Quince]

I completely agree with my hon. Friend. Ensuring that we support the mental health and wellbeing of NHS staff and that working conditions and working environments are the best they can possibly be is how we can attract and retain the best. Measures such as wellbeing champions, training for line managers, occupational health services and flexible working are very important, but the key to this is having conversations with the unions, because they are the representatives, ambassadors and advocates. That is why I very much hope they will engage in the pay review body process and continue to have those conversations with me, not just about pay, but about how we can improve working conditions and working environments and reduce the bureaucracy that makes the job so difficult.

[Richard Foord (Tiverton and Honiton) (LD)]

It is now clearly established that the workforce crisis in the NHS is mirrored by vacancies in adult social care. There are more than 165,000 vacancies in social care, up by 52% in a year. The Liberal Democrats are calling for a carers’ minimum wage of £12.42 per hour from April; will the Minister support a £2 per hour uplift in that minimum wage for care workers by doubling the tax on the profits of online gambling companies?

[Will Quince]

The hon. Gentleman got a plug in for his policy there, but I am not entirely sure how relevant it is to this statement. On NHS staffing, we have 10,500 more nurses and 4,800 more doctors than last year. But I know adult social care represents one of the biggest challenges for our NHS, and it puts pressure on the rest of the system. That is why in the autumn statement the Chancellor put in place £7.5 billion, the largest ever investment in adult social care.

NHS Industrial Action: Government Preparations

Richard Foord Excerpts

Monday 12th December 2022 Commons Chamber

[Will Quince]

I am not one to cast aspersions on the shadow Secretary of State, other than to say that I and the Secretary of State refuse to play politics with this issue. This is all about patient safety and ensuring that if industrial action goes ahead—[Interruption.] The shadow Secretary of State again shouts “Negotiate” from a sedentary position, but he knows that we have an independent pay review body, process and mechanism. It is important that we respect that.

[Richard Foord (Tiverton and Honiton) (LD)]

We simply cannot afford to lose any more nurses and valued NHS staff. We already have huge workforce shortages—40,000 nurses resigned last year and there are more than 130,000 vacancies across the NHS—so cancelling Christmas for members of the armed forces will not fix these problems. Will the Minister explain how paying nurses insufficiently and drafting in military personnel over Christmas serves to attract new recruits to the NHS and the armed forces?

[Will Quince]

That is a bizarre question, because the only reason we have to put in a MACA—military aid to civil authorities—request is that the unions have called strike action over Christmas. As the hon. Member asks about recruitment and retention, let me cover off that issue. As I have set out, we are committed to publishing a comprehensive workforce strategy, which will be independently verified; we have set out new pension flexibilities; we have already recruited about 29,000 more nurses and are on track to meet our 50,000 target; and we plan to boost international recruitment. However, I hope that the hon. Member agrees—in the interests not only of our armed forces, many of whom will have to cancel their Christmas leave, but of patient safety—that we do not want industrial action to take place. I urge the unions to meet us to discuss a way forward.

Cancer Services

Richard Foord Excerpts

Thursday 8th December 2022 Commons Chamber

[Steve Brine]

I think that is right. The public are clear on this. I get that there are different views across this House and that there are those who disagree with much of the work that my hon. Friend and I did in government to push some of those measures on preventing obesity. I could agree with them, but then we would both be wrong. At the end of the day, obesity is a driver of diabetes, and obesity is a driver of certain cancers. We must take that seriously. Next year, the Select Committee will be doing a huge piece of work on prevention, and we will be returning to that. I hope that Ministers are aware of that.

The recognition of the importance of health in the levelling-up White Paper is welcome, but without specific actions to address health disparities, this agenda will be at risk, so it is vital that the Government take up the prevention agenda again to stop people developing cancer in the first place. I hope the Minister will have some good news for us on that front, and I recommend that she returns to the prevention Green Paper that we published back in 2019, which contains lots of helpful ideas in that respect.

[Richard Foord (Tiverton and Honiton) (LD)]

On that point about health disparities and levelling up, I want to draw attention to the Royal Devon University Healthcare NHS Foundation Trust, which serves my constituency. The staff who work there do a fantastic job of cancer diagnosis but, given that the target for the number of people seeing a cancer specialist within two weeks is 93%, it is tragic that only fewer than 60% of people who are served by that trust see a cancer specialist within two weeks of a referral. Does the hon. Member agree that we need to level across, as well as level up, and think about health disparities across the country?

[Steve Brine]

Yes, of course. I hate the term, but this should not be a postcode lottery. We do have integrated care systems and cancer networks, and good, strong, experienced MPs should be driving those local health economies to ensure that they level themselves up and make use of what is there in the system to deliver as well for their population as other parts of the country do. There could be a lot more sharing among us of how we use that ability as Members of Parliament to drive our systems. I do it in my area, and I am sure the hon. Member does it in his. I thank him for his intervention.

There are issues of variation affecting cancer specifically, such as proper screening uptake among certain groups, lower referral rates for some cancers and in certain areas, and higher rates of less survivable cancers among more deprived groups. We called for NHS England and the Office for Health Improvement and Disparities to produce an action plan for addressing disparities in cancer and for the much talked about 10-year cancer plan to include a specific action schedule for rarer and less survivable cancers. That remains, for us, a vital aspect of improving cancer services, and we hope that the long-term cancer plan—should one arrive—makes that part of its work.

Last month, NHS England made it clear to us that it was focusing on delivering the NHS long-term plan for cancer. In many ways, that emphasis on delivery is welcome. The programmes being implemented as part of that work are positive, and I have covered some of them today, but recent research from the International Cancer Benchmarking Partnership has shown that national cancer plans are worth far more than the paper they are written on. The ICBP found that the countries that have made the biggest improvements in cancer since 1995 are those that have ambitious, detailed and costed plans for improving cancer services that are open to scrutiny by those whose job it is to do that—namely, us. Denmark and England used to be at the bottom of the league table for cancer, but thanks to consistent national cancer plans with associated long-term investment, the Danes have made rapid improvements, and they now leave us lagging behind.

In conclusion, the Health and Social Care Committee’s report on cancer services found that there are many areas where the Government and the NHS are doing really good work and using the unique benefits of our national health service, but there are too many other areas where we can go further and faster to improve cancer services and outcomes. I hope the Minister will confirm that the Government intend to do so through the promised 10-year cancer plan.