Oral Answers to Questions

Stephen Kinnock Excerpts

Tuesday 11th February 2025 Commons Chamber

[Munira Wilson (Twickenham) (LD)]

2. What steps his Department is taking to improve access to mental health services.

[The Minister for Care (Stephen Kinnock)]

After 14 years of Tory neglect and incompetence, we inherited a broken NHS, and nowhere is that more apparent than in our mental health services. Too many people are waiting too long to access the care they need. To fix that, we will recruit 8,500 more mental health workers; provide access to specialist mental health professionals in every school, as the hon. Member has called for; roll out Young Futures hubs in communities; and modernise the Mental Health Act 1983.

[Munira Wilson]

With the Terminally Ill Adults (End of Life) Bill being amended to include a panel that will involve psychiatrists who will determine whether a request for assisted dying should be granted, as well as a number of cross-party amendments rightly calling for the involvement of mental health professionals earlier in the process, what assessment have Ministers made of whether there is sufficient capacity in mental health services, which the Minister has just noted are overstretched, to meet those demands, and on the potential knock-on impact on both waiting times and treatments for those with mental health conditions?

[Stephen Kinnock]

The hon. Lady will know that the Government’s position on the Terminally Ill Adults (End of Life) Bill is one of neutrality. I am on the Bill Committee simply to speak about the Government’s position on the workability and operationalisation of the Bill. We look forward to seeing the amendment that will be brought forward by my hon. Friend the Member for Spen Valley (Kim Leadbeater). Any comment we make or position we take will be based on the operationalisation of that amendment, should it become part of the Bill and, ultimately, should the Bill gain Royal Assent.

[Jen Craft (Thurrock) (Lab)]

Thurrock community hospital does fantastic work on integrated care, particularly on integrated mental health care. On a visit, representatives said that what makes the hospital successful is a commitment to working across integrated care boards, the local authority and other relevant partners in the community, as well as a commitment to meeting people where they are, finding out what is important for them and working from there. Does the Minister see that model as integral to the reform of mental health care in this country? Will he join me on a visit to Thurrock community hospital to see what it does and what can be learned from how that work is undertaken?

[Stephen Kinnock]

My hon. Friend is a doughty campaigner on this issue in her constituency. She is right that the integration of services is crucial to ensuring that we get the best possible outcomes for people who are struggling with their mental health. I would be very happy to discuss with her the possibility of me visiting her constituency.

[Jeremy Hunt (Godalming and Ash) (Con)]

Is the Minister aware of the brilliant work done by Mersey Care NHS foundation trust in reducing in-patient mental health suicides to zero, which is an extraordinary achievement. Under a former Health Secretary, who may be standing not a million miles away from where I am standing now, that became an objective for all mental health in-patient units across the NHS. Will the Minister look into whether that objective still stands? If not, can it be reinstated?

[Stephen Kinnock]

I am not familiar with the detail of the case that the right hon. Gentleman mentions, but it sounds like a positive and interesting development, and I would be happy to consider it further. The Government are committed to delivering the cross-sector suicide prevention strategy for England, published in 2023. The 8,500 new mental health workers who we will recruit will be specially trained to support people at risk.

[Andrew Cooper (Mid Cheshire) (Lab)]

I am regularly contacted by constituents who are concerned that their children are not receiving the mental health care they need. Having met GPs in Winsford, I know that there are clear concerns that access to child and adolescent mental health services is being rationed to the point that it has become almost inaccessible to all but the most severe cases. Will my hon. Friend tell me what progress has been made towards our commitment to provide specialist mental health professionals in schools, ensuring that there is early intervention that prevents issues from escalating?

[Stephen Kinnock]

After the disastrous 14 years that we have had, we are facing a very serious situation in terms of mental health provision. It will take some time to get the workforce in place, but we have a clear commitment to having a specialist in every school. The appointment and training of those specialists will take some time. We are also rolling out open-access Young Futures hubs in every community. I am confident that the combination of those two interventions will get us back to having mental health services that this country can be truly proud of.

[Mr Speaker]

I call the Chair of the Health and Social Care Committee.

[Layla Moran (Oxford West and Abingdon) (LD)]

I welcome the Under-Secretary of State for Health and Social Care, the hon. Member for West Lancashire (Ashley Dalton), to her place. I look forward to working with her, as I do with other Ministers.

As the Minister for Care will know, 20% of the burden on the NHS is due to mental health, yet only 10% of the budget is allocated towards it. The mental health investment standard has been a welcome maintenance under this Government. However, the Select Committee heard from Amanda Pritchard the other day that the standard is guaranteed for only the next two years. Does the Minister agree that the standard has had a positive effect on mental health community services, and would he commit to protecting it?

[Stephen Kinnock]

The Chair of the Committee will have seen that we have made an explicit commitment to the mental health investment standard—we are absolutely committed to that. In addition, we have to drive reform in the system so that it is about not just the amount of investment going in, but how we ensure that it is working properly. I am absolutely confident that the commitment to 8,500 new specialists, the Young Futures hubs and having a mental health specialist in every school will facilitate the delivery of services in a far more effective way than is currently the case.

[Chris Vince (Harlow) (Lab/Co-op)]

I thank the Minister for his continued commitment to supporting mental health in this country. Does he also recognise that mental health involves supporting NHS frontline staff? I had the wonderful opportunity of spending time with the East of England ambulance service on Saturday morning. They work incredibly long hours and work incredibly hard. Obviously, we need to think about their mental health as well.

[Stephen Kinnock]

We in this Chamber should, whenever possible, pay tribute to the people providing those frontline services, who every day work heroically in very difficult circumstances. My hon. Friend is absolutely right about the pressures on the workforce—we are very conscious of that. We will bring forward a workforce plan in the summer, and we are working at pace to recruit the 8,500 mental health workers.

[Mr Speaker]

I call the Liberal Democrat spokesperson.

[Helen Morgan (North Shropshire) (LD)]

Last week, the Secretary of State issued a new mandate for the NHS in which a number of mental health targets were dropped. I accept that targets that drive perverse behaviours should be dropped and that some sharpened focus is necessary, but mental health waiting lists are at a record high, huge numbers of people are not at work because of poor mental health, and our young people are being let down badly by CAMHS, not least in my constituency of North Shropshire. Does the Secretary of State accept that mental health targets should be reinstated and that mental health should be treated with equal priority to physical health?

[Stephen Kinnock]

What we know about targets is that if we try to overload a system with too many targets, it causes confusion and ends up with, as the hon. Lady rightly says, perverse outcomes. We are clear that we do not want to have a system based on just making policy by press release, as was the case under the previous Government, putting out press announcements about loads more targets. It all makes for nice front-page headlines, but it does not lead to any serious delivery of the strategy that we need to deliver. I am with her on the point about focus. We are absolutely committed to mental health, as is set out in the planning guidance. It is also one of the priorities in the planning guidance, and we will continue to deliver on that priority.

[Monica Harding (Esher and Walton) (LD)]

3. What discussions he has had with the Secretary of State for Foreign, Commonwealth and Development Affairs on the UK’s leadership on global health and immunisation.

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[Harpreet Uppal (Huddersfield) (Lab)]

20. What assessment his Department has made of the adequacy of long-term funding for hospices.

[The Minister for Care (Stephen Kinnock)]

Hospices provide vital care and support for patients and their families at the most difficult time. I am very proud that this Government have provided a £100 million capital funding boost for adult and children’s hospices over this year and next. We are currently finalising the delivery mechanism for this funding, and we are pleased that Hospice UK is standing ready to distribute the money to local hospices across England. We are also providing £26 million of revenue funding for children’s hospices in England in 2025-26.

[James Naish]

While I wholeheartedly welcome the £100 million capital funding boost for hospices announced before Christmas, 17 members of staff at Nottinghamshire hospice, which is a large community-based hospice serving my constituency that provides care for family members in their own homes, have recently been told they are at risk of redundancy. Can the Minister please expand on how the Government will support organisations such as this to continue to deliver excellent care in the community?

[Stephen Kinnock]

I thank my hon. Friend for this important question, and I commend the work of hospices such as Nottinghamshire hospice in his constituency, which I know does a wonderful job for people in his area. The investment I referred to in my earlier answer will help hospices such as Nottinghamshire hospice to provide quality end-of-life care to patients and their families this year and next. It can be used to improve IT systems, make it easier for GPs and hospitals to share vital data on patients, and help to develop and improve outreach services to support people in their own homes, when needed.

[Kate Osamor]

North London Hospice in my constituency has a site in Winchmore Hill that receives one third of its funding from the NHS, with the rest coming from the generosity of the public. Many of its services, such as out-patients and wellbeing, are funded entirely by donations. While it welcomes the announcement of the £100 million in funding, what assurances can the Government provide about long-term hospice funding, given the significant delays in accessing funding from integrated care boards this year? Hospices are anxious to seek clarity about the allocation and distribution of this funding.

[Stephen Kinnock]

I thank my hon. Friend for that question. On her point about long-term funding, last week I chaired a roundtable with key stakeholders from the sector, and we were absolutely focused on developing a plan to secure the long-term sustainability of the sector. We cannot go back to the cliff edge that we have had over the last few months, primarily due to the utterly chaotic and shambolic way in which the Conservative party managed our system in the past.

[Harpreet Uppal]

I have had the privilege of witnessing at first hand the exceptional work of my local hospices, Forget Me Not children’s hospice and the Kirkwood. However, as my hon. Friends the Members for Rushcliffe (James Naish) and for Edmonton and Winchmore Hill (Kate Osamor) have stated, they are also struggling with long-term funding pressures and have had to make the difficult decision to reduce services and staff. What further work are the Government doing to ensure that hospices thrive, and to ensure that end-of-life care is included in the 10-year NHS plan?

[Stephen Kinnock]

I thank my hon. Friend for that question. One of the three shifts that the 10-year plan will deliver is shifting more healthcare out of hospitals and into the community. In the context of the plan, we are having discussions about the long-term sustainability of the palliative and end-of-life care sector, including hospices. As we develop the plan, we will be carefully considering policies in this area, with input from the public, patients, health staff and our stakeholders. As I mentioned in response to my hon. Friend the Member for Edmonton and Winchmore Hill (Kate Osamor), last week I was pleased to chair a roundtable to discuss long-term strategies for hospices to get palliative and end-of-life care, including hospices, on to a more sustainable footing after 14 years of Tory neglect and incompetence.

[Mr Peter Bedford (Mid Leicestershire) (Con)]

Leicestershire is home to some superb hospices, such as Rainbows and LOROS, both of which are set to be massively impacted by the hike in national insurance contributions. Given the important work that these hospices do, particularly for people at the end of their lives, will the Minister urge the Chancellor to reverse this pernicious tax rise?

[Stephen Kinnock]

I am once again struck by the fact that Conservative Members seem to welcome the additional investment that the Chancellor has put into our health and care service, but do not seem to have any plan or proposals at all about how the revenue should be generated for that funding. Until we get an answer to that question, we will struggle to get much further in this House, although I note that Toby Porter, the chief executive of Hospice UK, has said that the

“funding will allow hospices to continue to reach hundreds of thousands of people every year with high-quality, compassionate care. We look forward to working with the government to make sure everyone approaching the end of life gets the care and support they need”.

[Stephen Gethins (Arbroath and Broughty Ferry) (SNP)]

First, may I pay tribute to those who work in hospices? I think we can all agree that they do an astonishing job. The Minister will agree that the national insurance hike has had an impact on those who work in hospices. Can he assure me that when it comes to the Scottish Government’s funding—I acknowledge the 14 years of Tory misrule and the funding settlements that were handed down—any Barnett consequentials will be passed on in full to the devolved Administrations?

[Stephen Kinnock]

We have seen the biggest settlement in many years for our health and care system across the country. It is now up to the SNP Government in Edinburgh to absorb and deliver that funding in a way that will actually improve services in Scotland—something that we have not seen for a very long time under the misrule of the Scottish National party.

[Mr Gregory Campbell (East Londonderry) (DUP)]

The magnificent work done by those who work in hospices, including the four in Northern Ireland, needs to be reflected in the funding formula. Will the Minister undertake to discuss with ministerial colleagues the need for the Treasury to review that funding formula, particularly in relation to devolved settlements?

[Stephen Kinnock]

From the roundtable discussions, and from subsequent discussions we have been having with the sector, it is clear that we need to look at the long-term funding issue. We faced a cliff edge towards the end of last year. That is not the right way to do things. We must start getting the funding discussions moving so that, well in advance of the end of this financial year, the funding situation for the palliative and hospice sector is much clearer.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

8. What steps he is taking to reduce inequalities in healthcare.

--- Later in debate ---

[Charlotte Cane (Ely and East Cambridgeshire) (LD)]

11. What steps his Department is taking with Cabinet colleagues to increase access to assessments for special educational needs.

[The Minister for Care (Stephen Kinnock)]

Children and young people with special educational needs are waiting too long for the NHS services that they need, in large part because local authorities have been hollowed out by 14 years of austerity. We are supporting earlier intervention through the partnerships for inclusion of neurodiversity in schools—PINS—programme, which is backed by £13 million of funding. NHS England has also launched a taskforce to look at how support can be improved for people with attention deficit hyperactivity disorder. We look forward to its report later this year.

[Charlotte Cane]

Cambridgeshire has some of the lowest funding in England for GP practices and schools. Given the Government’s focus on growth for the area and the record demand for special educational needs and disabilities and young people’s mental health services, will the Minister work with colleagues across Government to ensure that high-growth areas no longer suffer lower than average funding?

[Stephen Kinnock]

Our commitment to improving SEND conditions is universal. We are looking at this from the point of view of improving provision right across the country. I am very pleased that the PINS programme is making progress. I draw the hon. Lady’s attention to the early language support for every child—ELSEC—programme, in which nine pathfinder sites over two years will provide early identification, and targeted and universal support for children with speech, language and communication needs in early years and primary school settings. We are working very closely with colleagues across the Department for Education and NHS England on that.

[Alistair Strathern (Hitchin) (Lab)]

Local authority resources are a big driver of some challenges in the SEND system, but it is clear to anyone working in it that a systemic under-prioritisation of children’s health, all too often by local NHS trusts, is a big contributing factor. Young people right across my constituency waiting for assessment and lacking support are paying the price. As part of our 10-year plan to reform the NHS, how will we ensure that children’s health is front and centre again, with much more support for people with additional needs?

[Stephen Kinnock]

I am working very closely with colleagues in the DFE on how we mainstream SEND provision more effectively, get more rapid education, health and care plans and autism diagnoses, and on a whole range of issues that require strong cross-party work. I would be happy to brief my hon. Friend on that separately.

[Joe Robertson (Isle of Wight East) (Con)]

12. What steps his Department is taking to help reach the national dementia diagnosis rate target.

--- Later in debate ---

[Catherine Atkinson (Derby North) (Lab)]

After 14 years of Conservative government, 77% of people in Derby cannot access an NHS dentist. Can the Minister tell us what caused the rot to set in and how we can fill the cavities in provision?

[The Minister for Care (Stephen Kinnock)]

I see what my hon. Friend did there, and she should brace herself as we drill down into this answer. The Conservative party is the cause of the rot: spending on NHS dentistry fell by a staggering 18% between 2010 and 2024, so it is little wonder that dentistry is on its knees. We will shortly set out plans to introduce supervised tooth brushing for three to five-year-olds in the most deprived communities, and we are working with the dental sector to implement our rescue plan.

[John Lamont (Berwickshire, Roxburgh and Selkirk) (Con)]

T6. New research from Marie Curie has found that 85% of public expenditure on people in the final year of life in Scotland is spent in hospitals and only 14% on community care. The figures are very similar for England. What work is being done to ensure a minimum standard of community treatment for people in the final year of life?

[Stephen Kinnock]

It is vital that we have a palliative and end of life care service that works and is on a sustainable footing. I have had discussions with the sector. We want to ensure that we do not have the cliff edge that we had at the end of last year. The hon. Gentleman is right to point to this, and we will report back in due course.

[Sally Jameson (Doncaster Central) (Lab/Co-op)]

The Minister will be aware that the contract uplift for dentists is facing a near 11-month delay. Can he confirm that dentists will be receiving their uplift? What will be done to make sure that they receive enough money to cover the costs of NHS dentistry?

[Stephen Kinnock]

I can reassure my hon. Friend on that point. We implemented the contract uplift on 29 January. Dentists will therefore be receiving their uplifted payments in March, backdated to 1 April 2024. For the first time in more than a decade, we have also increased payments for practices training a foundation dentist.

[Sir John Whittingdale (Maldon) (Con)]

T7. In Maldon, the number of patients per GP is already 50% above the number for England, and that will only increase with the amount of proposed house building. GPs are struggling to cope with ever increasing costs, and I have one practice still undertaking so-called collective action. Will the Government review the whole system of GP funding before it breaks down completely?

[Stephen Kinnock]

We are in negotiations about the future contract with the General Practitioners Committee England of the British Medical Association. Those negotiations are proceeding, and the right hon. Gentleman is right that we need serious reform; we will be pushing reforms through on that basis. On his point about the estate, we have a £102 million commitment on capital for the primary care estate, which I think will go some way towards reassuring him.

[Clive Lewis (Norwich South) (Lab)]

I thank my hon. Friend the Minister for all the support he has given the University of East Anglia to set up its dental school, but he will be aware that all those shiny new dentists coming out in a few years’ time will be going into the private sector, not the NHS, unless we can sort out the NHS dental contract. Can he give us any kind of timeline for when we can expect to hear an announcement on that critical factor?

[Stephen Kinnock]

I wish my hon. Friend all the best with his efforts to get that dental school up and running. As for the need for serious reform, there is no perfect payment system, but we have to get a payment system in place that makes NHS dentistry attractive—at least as attractive as doing work in the private sector. We are working at pace on that, and I will report back on that as rapidly as possible.

[Vikki Slade (Mid Dorset and North Poole) (LD)]

T10. Some 44,066 children—one in six—are waiting more than a year for medical treatment, compared with one in 100 adults. Waits are at their worst in community medicine. In Dorset, there are waits of up to two years in child development, and delays of a year are normal for child and adolescent mental health services. Fifty-three per cent of all community health referrals take more than a year. Will the Minister confirm whether the 18-week target will apply to community referrals and not just hospitals? If not, when can we expect a target, so that children are not badly affected?

--- Later in debate ---

[Josh MacAlister (Whitehaven and Workington) (Lab)]

Shortly after the election, the new Government announced £4.3 million for a new community mental health hub in Whitehaven. Unfortunately, the local mental health trust followed that decision by announcing the closure of the Yewdale ward for acute mental health services. Does the Minister agree that we need to get early intervention right before we close acute services, and will he bring together a meeting to scrutinise that decision?

[Stephen Kinnock]

Integrated care boards are responsible for providing mental health services to meet the needs of their local populations. As part of our plan for change, we will reduce delays and provide faster treatment. We are working with NHS England to transform mental health services, shift care from hospitals to local communities, and increase access to support for people across the country, including in rural areas.

[Robbie Moore (Keighley and Ilkley) (Con)]

Insomnia affects many patients, including my constituents, who are being advised by their GPs to try cognitive behavioural therapy as an alternative to medication. However, digital CBT programmes are not available on the NHS, leaving many without access to drug-free treatment. Will the Minister outline what steps the Government are taking to ensure that patients have access to digital therapies, so that more people can get access to evidence-based, drug-free support?

[Daniel Francis (Bexleyheath and Crayford) (Lab)]

The NHS South East London integrated care board provides services to my constituents, and I have discussed some ways in which we could better deliver services by redeveloping the Erith community hospital site in Northumberland Heath. Is the Minister able to provide an outline of the Government’s plan to provide capital funding for expanding community services like those at Erith hospital?

[Stephen Kinnock]

I would be delighted to meet my hon. Friend so that we can get into a bit more detail about what is happening in his constituency, but he is absolutely right to point to the need for more and better community health services. That will be at the heart of our shift from hospital to community in the 10-year plan that we are delivering.

[Steve Darling (Torbay) (LD)]

Health authorities in Devon are set to trial the relocation of a vital coronary service from Torbay to Exeter, which is 24 miles away. Will the Minister meet me and fellow south Devon MPs who have grave concerns about the impact on patient safety?

Maternal Mental Health

Stephen Kinnock Excerpts

Wednesday 5th February 2025 Westminster Hall

[The Minister for Care (Stephen Kinnock)]

It is a pleasure to serve under your chairship, Ms Furniss.

I am so grateful to my hon. Friend the Member for Aylesbury (Laura Kyrke-Smith) for securing this debate, for raising a number of important issues and for making such a powerful and moving contribution. I was very saddened to hear of the utterly heartbreaking circumstances of her friend’s passing. I offer my sincere condolences to her and to Sophie’s family and loved ones. I am also thankful to all Members for their contributions, the sheer number of which, in such a short Westminster Hall debate, illustrates the importance of this issue.

The Government take this matter extremely seriously, which is why are placing a renewed focus on mental health and suicide prevention, including for women during the perinatal period. The figures show that the challenges are sobering, and many of the issues raised today are symptomatic of an NHS that is simply not addressing needs. Perinatal mental illness affects over a quarter of new and expectant mothers and covers a wide range of conditions. Research shows that in the UK around one in three women experience traumatic births, and one in 20 women every year develop post-traumatic stress disorder after giving birth. Between 2021 and 2023, 26 women died from mental health-related causes within the six weeks following pregnancy. Over a third of maternal deaths occurring between six weeks and one year after the end of pregnancy are from suicide, drugs, alcohol or other mental health-related causes. It is unacceptable that so many women are not receiving the maternal mental health care they need, and we are determined to change that.

That is why NHS England’s three-year delivery plan for maternity and neonatal services commits to offering all women a personalised care and support plan, considering physical health, mental health and social complexities, with an updated risk assessment at every contact. Ten years ago, fewer than 15% of localities provided specialist perinatal mental health services for women with complex or severe conditions at the full level recommended in National Institute for Health and Care Excellence guidance, and more than 40% provided no service at all. Today, specialist perinatal mental health services are available in all 42 integrated care systems across England. Those services are available for women with or at risk of mental health conditions who are planning a pregnancy, are pregnant or have a baby up to two years old. That care includes increased access to evidence-based psychological therapies.

A record 62,723 women were reported to have accessed community perinatal mental health services and maternal mental health services in the 12 months to the end of November 2024. Women can be referred to services by any healthcare professional, including midwives, health visitors, GPs, hospital-based teams, mental health services and social workers. Self-referrals are accepted by some services. GPs also now deliver six to eight-week post-natal consultations that include a focus on perinatal mental health.

The services are provided by multidisciplinary teams to cover every aspect of women’s health, often including a psychiatrist, nurses, mental health social workers, occupational health workers, health visitors, peer support workers and nursery nurses. The specialist perinatal mental health community workforce has almost doubled in the last five years. Furthermore, 165 mother and baby unit beds have been commissioned, 153 of which are currently operational. Mother and baby units provide in-patient care to women who experience severe mental health difficulties during and after pregnancy.

When a mother goes through the heartbreak of losing her baby, we must do everything we can to support her through bereavement. Many trusts have specialist bereavement midwives who are trained to care for and support parents and families who have suffered the loss of their baby. All trusts in England are signed up to the national bereavement care pathway, which covers a range of circumstances of baby loss, with the aim of offering every bereaved parent the high-quality, safe and sensitive care that they deserve. In October, the Government extended the baby loss certificate service to help mums and dads who go through the nightmare of a pregnancy loss.

In addition, health visiting teams are well placed to provide mental health support to new parents. They can offer assessment at each contact, appropriate interventions and referrals when necessary. Some areas have health visitors who specialise in perinatal mental health to strengthen provision for families who need it.

However, service provision can and must be made stronger. That is why we are working with partners to improve the current health visiting services, including by looking at how we can best improve support for parental mental health, and by ensuring that it is sustainable for an overstretched workforce.

This Government want every child to have the very best start in life. Last month, we announced £126 million of funding until 2026 through the family hubs and Start for Life programme. That will provide a raft of support for families with babies, from pregnancy up to the age of two. It includes funding for bespoke support for parents and carers with perinatal mental health difficulties, and for parents-infant relationships.

This Government are committed to tackling suicide, which is one of the biggest killers in this country. My hon. Friend the Member for Aylesbury makes a very good point about building awareness and good allyship in order to reduce suicide risk. The suicide prevention strategy targets pregnant women and new mothers as a priority group for additional support, so that fewer loved ones will go through the heartbreak of losing a friend or relative to suicide. More than 100 measures have been outlined in the strategy, aimed at saving lives, providing early intervention and supporting anyone going through the trauma of a crisis.

The Voluntary, Community and Social Enterprise Health and Wellbeing Alliance, managed by the Department of Health and Social Care, NHS England and the UK Health Security Agency, has sponsored a project, led by the Tommy’s and Sands Maternity Consortium, which explores experiences of perinatal suicide and self-harm and their risk factors. We have allocated funding to 79 organisations up and down the country from our £10 million suicide prevention fund over the two years to March 2025. Those organisations, many of which are grassroots and community-led, are delivering a broad and diverse range of activity that will prevent suicide and help save lives.

I have taken careful note of the four proposals that my hon. Friend the Member for Aylesbury set out clearly in her speech, and I will work with my officials to give them the detailed consideration that they deserve. Although it takes huge courage to speak out about such painful matters in public, I have always thought that that is a vital part of our public discourse, which is enriched when we bring our experiences to these debates. I again pay tribute to my hon. Friend and all hon. Members who have taken part in this debate.

Question put and agreed to.

Terminally Ill Adults (End of Life) Bill (Fourth sitting)

Stephen Kinnock Excerpts

Wednesday 29th January 2025 Public Bill Committees

[The Chair]

For the benefit of our guests, the next questioner, Stephen Kinnock, is our Health Minister.

[The Minister for Care (Stephen Kinnock)]

Q I have a specific question about the period between the legislation passing in your Parliament and the commencement of its provisions and the implementation of voluntary assisted dying. Can you say a little more about what had to be done in that period: the institutional arrangements that were needed between the Act’s passage and its commencement, and the training, capacity building and practical measures that you had to put in place? Did you do that from a standing start, so that in that 18-month period you went from having no training and no institutional set-up to being ready to take the system forward?

Dr Fellingham: Our law was passed on 19 December 2019 and came into effect on 1 July 2021. Ostensibly we had an 18-month period, but of course something fairly dramatic in health happened in 2020. Despite that, what happened at Department of Health level began first. The Department of Health set up an implementation leadership team and gathered specialists together from all across Western Australia in various different aspects. They had eight different workstreams looking at the eight different parts of the Act that they had to operationalise—the pharmacology, the substance and what that was going to look like, the doses and how it was going to be administered, the set-up of the pharmacy, and things like that. Each of those eight workstreams worked everything out at a Department of Health level.

Approximately six months before the law was enacted—on reflection, that was probably not long enough, but covid was very much complicating everything at the time—they set up a working group with the clinical leads in the various health service provider organisations. We were then tasked with taking that broad overview and turning it into a service at the point of delivery, on the understanding that we understood the nuances and expectations of the different hospitals and health systems in which we operated.

I will not lie: it was an enormous task. I leant very heavily on our wonderful Victorian colleagues who had gone first. I do not know what I would have done if I had been the first to pave the way. Subsequently, I have been able to offer that level of assistance to each of the other states and territories that have gone after Western Australia, and then of course to the UK, Scotland and Jersey, which I have been working with quite a lot. There is a wonderful international, collaborative sense of information sharing and wanting to get this right, learning from experience and not reinventing the wheel.

The vast majority of the laws that apply across the whole of Australia and New Zealand are quite similar, and they are similar to what you are planning to legislate for in the United Kingdom. A lot of fantastic groundwork has been laid already, and it can be done even in a challenging healthcare context, like covid or our resource limitations.

[Stephen Kinnock]

Thank you very much for that very comprehensive answer. Is there anything that our other guests would like to add?

Dr Mewett: As I was on the very first implementation taskforce, running blind, I probably could not add much more, except to say that it can be done. One has to focus on the readiness of practitioners, the readiness of health services, the readiness of the population and a whole range of other issues, including the pharmacy service. We have a state-wide care navigator service, which assists patients and doctors in the space. We had to set up a lot of services, and that gave us the time to do so. It was very successful and very challenging, but fortunately we did not have covid in our way.

[Danny Kruger (East Wiltshire) (Con)]

Q I am very grateful for your evidence; it is really useful. I want to state, for the record and for information, that we have before us today three professionals from Australia, all of whom support the laws in that country, and that we heard yesterday from two American doctors, who were also supportive of assisted suicide laws, even though in both countries there are many doctors who oppose what is happening. I regret that we are not hearing evidence from them, but it is very helpful to have your input.

Dr Fellingham, I was interested in your point about the distinction between the Australian model and the model in Canada and elsewhere. You are suggesting that most people who seek assisted death do so for what I think you called “existential reasons”. It is certainly not because of an absence of care, although we do see evidence of that in many countries. Can you expand on why you think it is so important that we have the terminally ill definition in the Bill, rather than recognising pain and suffering as the reason for seeking assisted dying, when I think most of the public who support a change in the law do so because they recognise that many people would naturally want to avoid pain and suffering? Yesterday, we heard from people who said that that is the right reason and that we should write that into the law. Why should we not do that?

Dr Fellingham: That is a very good question and I am grateful that you have asked it. We absolutely have to keep at front and centre that pain and suffering are primary drivers for people seeking access to relief of suffering, whether that is at the end of life or in any interaction that they have with healthcare providers. I speak to remind you that these laws apply to terminally ill people, because I feel that that is a lot easier for us to understand and get our heads around, but it does not detract from the fact that suffering can be a feature of non-terminal illnesses. There are people who can suffer terribly for very long periods of time—dementia being a clear example, but one that would be incredibly challenging to legislate for at this early stage.

What is interesting about the parallels you draw between pain and suffering is that it is a quite common conception that pain is suffering and suffering is pain, and that people seek access to relief of suffering at the end of life because it is the physical symptoms that are the most debilitating. Of course, the physical symptoms can be horrendous—pain, nausea, vomiting, anorexia; there are a multitude—but they are symptoms that we tend to be really quite good at treating. We have a whole range of medications in our palliative care spectrum that are very good at treating those physical symptoms, so it is quite rare that people prioritise those when thinking about this.

But suffering is subjective and it is context-dependent. What suffering is to me might be completely different from what it is to you, even if we are suffering from what looks to be, from the outside, the same disease. Suffering and distress—the thing that makes us human: the existential overlay of our own interaction with the world and how that is impacted by our disease process—is an incredibly personal journey and one that is extremely challenging to palliate, and it is very, very distressing for patients, their families and their practitioners if we cannot support people who are suffering at the end of life. Does that answer your question?

Speech and Language Therapy

Stephen Kinnock Excerpts

Monday 27th January 2025 Westminster Hall

[The Minister for Care (Stephen Kinnock)]

It is a pleasure to serve under your chairship, Mr Vickers. I congratulate my hon. Friend the Member for Lichfield (Dave Robertson) on introducing this important debate, and on the passionate, moving and powerful way in which he spoke, particularly about his mother. I would really like to thank him for sharing those personal experiences. I also thank every Member who has spoken today. We have heard really compelling accounts about access to speech and language therapy for both children and adults.

[Rachel Taylor (North Warwickshire and Bedworth) (Lab)]

I thank my hon. Friend the Minister for giving way, and my apologies, Mr Vickers; I had to leave earlier for a ministerial appointment.

In 2018 my father suffered a stroke, and the staff at my local hospital, the George Eliot, could not do enough for him—they were absolutely fantastic. I know that my father stayed in hospital longer than he needed because that was the only way in which he could access the speech and language therapy that he needed, as well as the help to enable him to swallow. It was fantastic to see him recovering that speech because of their intervention. As he had served for nearly 50 years as a volunteer magistrate, it is wonderful to see him now being able to challenge my ideas and give his comments on my contributions in this House.

Last week, I held a consultation event in my constituency where a dietician told me that she felt there was not enough ability for her and her team, as well as speech and language therapists, to give help in the community. She was quite excited about our ideas for virtual wards and asked me, on her behalf, to plead with the Minister to ensure that we give recognition to putting more speech and language therapy in the community. I know that my dad would have been very pleased to receive that.

[Martin Vickers (in the Chair)]

Order. Interventions should be brief— I was very generous.

[Stephen Kinnock]

I thank my hon. Friend for that wonderful example of the personal experience that so many Members on all sides of the House have of this service, which can be life-changing for so many people. I pay tribute to her father for coming through in the way that he has, and I also pay tribute to all those in the community care services. The care that he received was obviously vital and life-changing for him, and that is wonderful to hear.

My hon. Friend raises an interesting point on virtual wards. It is absolutely right that we build on the innovation and opportunities that they offer. Later in my speech I will say a word or two on the three big shifts that we will put at the heart of our 10-year plan: from hospital to community, from sickness to prevention and from analogue to digital. I think the virtual wards are a great illustration of how we can bring those three seismic shifts together to transform our health and care system. I can tell my hon. Friend that the 10-year plan is the right forum and opportunity for that, and I encourage her and all Members to get involved in that plan, which can be accessed at change.nhs.uk. Hon. Members may also wish to organise roundtables and discussion fora in their constituencies to talk exactly about the kind of innovations that we are looking to bring to the fore.

It would be remiss of me not to pay tribute to Mikey Akers; he is an outstanding young man and truly an example to us all. Of course, I also pay tribute to Chris Kamara and the whole team campaigning with such vigour and verve on this vital issue. I would of course be delighted to meet Mikey, Chris and the team at a mutually convenient time to discuss the project and how to take it forward.

As our debate today has shown, speech and language therapists work with people of all ages, providing specialist care and support. Their work takes place across a range of different settings in health, care and education. It responds to a wide range of communication needs, from those of children whose speech is slow to develop to those of older people whose ability to speak has been impaired by illness or injury, for example as a result of Alzheimer’s, a stroke or head injury. Speech and language therapists also support patients who have difficulties with eating, drinking and swallowing.

The variety of support that speech and language therapists provide means that they play a key role in a wide range of care pathways. A speech and language therapist is a core part of the multidisciplinary stroke rehabilitation team, providing long-term rehab for stroke patients. It is not just patients they support—a speech and language therapist also works with a patient’s family or carers on how best to facilitate communication and support the patient, sharing their expertise to upskill the support network of the person they are caring for.

Another example of the work of speech and language therapists is the role they play in supporting autistic people. They can offer interventions to improve communication skills where needed. For individuals who are unable to speak, speech and language therapists can design alternative communication systems.

Moreover, as part of a wider multidisciplinary team, speech and language therapists also contribute to a young person’s education, health and care plan. A therapist will carry out a detailed assessment of an individual’s speech, language and communication abilities, which will help to determine the additional support they may need to access education.

However, it is the key role that speech and language therapy plays in care and support pathways that creates complexity in funding and commissioning models for it. In some cases, full care pathways are commissioned as opposed to individual services within a particular pathway, while in some areas community health services are commissioned using block contracts. Both these things create challenges in clearly identifying specific funding streams for specific services.

Speech and language therapy is generally commissioned locally by integrated care boards and in some cases by local authorities. Funding is allocated to ICBs by NHS England. The allocations process uses a statistical formula to make geographical distribution fair and objective, so that it more clearly reflects local healthcare needs and helps to reduce health inequalities. This process is independent of Government, and NHS England takes advice on the underlying formula from the independent Advisory Committee on Resource Allocation. NHS England is also continuing to work with ICBs to develop their financial plans.

NHS planning guidance sets priorities for systems, and the Secretary of State has confirmed that this key document will be published in due course—indeed, imminently. Each ICB will then commission the services they need for their local area, taking into account their annual budget, planning guidance and the wider needs of the population they cover. Local commissioners are responsible for ensuring that their offer is tailored to the local population and that their communities are able to access the specific support they need. NHS England continues to work with ICBs to develop their financial plans, to ensure that communities can access the healthcare support they need when they need it. A complex patchwork quilt of systems and processes needs to be gone through by the people who know best about what is required in their community—those at the coalface—to deliver the care that is needed.

That said, I reassure hon. Members that the Government are committed to funding the NHS properly. We recently provided a £26 billion boost for health and social care at the Budget through the policies and choices that the Chancellor laid out. We have been clear that funding must go hand in hand with reform, and we will ensure that every penny of extra investment in the NHS is well spent.

The community health services data plan, published by NHS England last year, goes some way to improving data about community health services. The plan sets out how the NHS aims to improve the quality and relevance of data, and the timeliness of its publication. It will improve our understanding of demand and capacity across community health services, including speech and language therapy, with high-quality data to generate helpful insight to shape interventions and improvements to services.

Data and clear funding lines are not the only challenge facing speech and language services. Our children and young people are stuck on waiting lists, some for more than two years. More than 65,000 children and young people were on a waiting list for speech and language therapy in November 2024. We know that more than 23,000 have been on those waiting lists for longer than 18 weeks. That is simply too long. Waiting times for adults are not as bad as those for children and young people, but there were more than 23,000 adults on waiting lists for speech and language therapy in November 2024.

We hear a lot about the increasing demand for speech and language therapy, and about the fact that our existing workforce are struggling to meet the increase in referrals—pretty much every hon. Member said that in the debate. The reason for the increase in waiting times is multifaceted. Although services are still recovering from the pandemic, there has also been an increase in demand, and analysis from the Royal College of Speech and Language Therapists shows that demand is increasing faster than the workforce are growing.

Speech and language therapy covers a broad spectrum of support. Therapists are often dealing with complex long-term cases, requiring a resource-intensive approach to supporting their patients, and referral pathways are often complex. Those referral pathways, and the services offered, also vary regionally.

As my hon. Friends pointed out, we are coming off the back of 14 years of failure, which have led to serious workforce challenges, and the reality is that we have a mountain to climb on recruitment and retention. The speech and language degree apprenticeship is now in its third year of delivery and offers an alternative pathway to the traditional degree route into a successful career as a speech and language therapist. We think that that has had a positive impact on recruitment, but much more needs to be done. We want to remove the barriers to training in clinical roles, which is why eligible students get a non-repayable grant of £5,000 a year. Further financial support is also available for childcare, dual accommodation costs and travel, but we know that that does not go far enough.

The training and retention of our talented NHS staff are absolutely key to our mission of rebuilding a health service that is fit for the future. A central part of the 10-year plan concerns our workforce and how we ensure that we train and provide the staff, technology and infrastructure that the NHS needs to care for patients across our communities.

This summer, we will publish a refreshed long-term workforce plan to deliver the transformed health service that we will build over the next decade and that will treat patients within the 18-week constitutional standard once again. We will ensure that the NHS has the right people in the right places, with the right skills to deliver the care that patients need when they need it. We must acknowledge that tackling this will take time, but we are committed to training the staff we need to ensure that patients are cared for by the right professionals and in a timely manner.

Community health services, and speech and language therapies in particular, speak to the three seismic shifts that will drive our 10-year plan: shifting healthcare from hospitals to communities, focusing on prevention, and embracing digital care. Effective, user-centred services are invariably delivered by multidisciplinary teams that are based in the communities they serve. The early language and support for every child—ELSEC—programme provides an example of different professions coming together to support children and young people, with local authorities, schools and the health and care system working together in the community. In our view, that is a potential building block for how our neighbourhood health service should work.

Nine regional pathfinder partnerships are trialling new ways of working to better identify and support children in early years settings and primary schools. We have asked the pathfinders to consider how to make the model sustainable after the project period. The therapy assistant roles have the potential to attract individuals to train to become speech and language therapists through the apprenticeship route. The ELSEC workforce model focuses on recruiting pre-qualification speech and language therapy support workers into the workforce to improve the capacity and knowledge of staff who support children with emerging or mild to moderate speech, language and communication needs in early years and school settings.

That will be important, because we hear a lot about the challenges our workforce face in meeting the increasing demand for speech and language therapy. Across all community health services, increasing demand and workforce availability are frequently cited as the main reasons that systems are struggling to reduce waiting times and get on top of the demand. The interim programme evaluation is due to be published in February, at which point we can explore insights into the effectiveness of ELSEC delivery at a local level. Reporting data shows that therapy support teams have supported around 13,000 children so far, and just over 1,000 staff in settings have been upskilled in delivering interventions. That is an encouraging set of achievements, and I will continue to work with my ministerial colleagues and officials across my Department and the Department for Education to support this important programme.

I referred earlier to our ambition to build a neighbourhood health service. We are firmly committed to moving towards our vision for such a service, and community health services will be an essential building block of it—keeping people healthy at home and in their communities, and providing more preventive, proactive and personalised care. Later this year, we are going to trial neighbourhood health centres, which will bring together a range of services and will ensure that healthcare is closer to home and that patients receive the care they deserve.

We have heard about the importance of adequate funding and timely access to speech and language therapy services for children and adults with communication and swallowing needs. The importance of such services is not in doubt, nor is the life-changing impact that timely access to high-quality services can have, from helping a child to develop the right skills to engage with education to supporting adults to regain their ability to speak. Speech and language services are facing challenges, but sustainable, accessible and high-quality community health services are vital, and I will continue to work closely with NHS England, the Department of Health and Social Care and the Department for Education on this critical issue.

[Dave Robertson]

I place on record my thanks to all the hon. Members who have contributed to the debate, starting with the hon. Member for Meriden and Solihull East (Saqib Bhatti), who made an excellent contribution, as I think we would all expect. I congratulate him on his campaigning on this important issue. I thank my hon. Friend the Member for Wolverhampton North East (Mrs Brackenridge) for raising the story of her constituent Samantha, who I am sure will be watching the debate closely.

I thank the hon. Member for Leicester South (Shockat Adam) and my hon. Friend the Member for Hyndburn (Sarah Smith) for reminding us of the importance of supporting the next generation and all those who come after. I thank my hon. Friend the Member for Altrincham and Sale West (Mr Rand) for raising the issue of unacceptably long wait times for speech and language therapy. I thank my hon. Friend the Member for Stoke-on-Trent North (David Williams) for highlighting the caseload faced by speech and language therapists in Stoke-on-Trent and the great county of Staffordshire. I also thank my hon. Friend the Member for Dulwich and West Norwood (Helen Hayes) for discussing the need for early intervention and the remarkable impact that it can have.

I thank my hon. Friend the Member for North Warwickshire and Bedworth (Rachel Taylor) for the story of her father’s experience in speech and language therapy. I thank the Liberal Democrat spokesperson, the hon. Member for Winchester (Dr Chambers), for his excellent contribution on the need to raise awareness around aphasia, which does not necessarily get spoken about enough in the community.

I thank the hon. Member for Sleaford and North Hykeham (Dr Johnson), on behalf of His Majesty’s official Opposition, for her considered remarks and for avoiding making the issue a political football. It is really important to highlight where we do agree, because there is often more agreement than people realise in this place. By working together, we can achieve those goals.

I especially thank the Minister for Care, my hon. Friend the Member for Aberafan Maesteg (Stephen Kinnock)—did I get that right?

[Stephen Kinnock]

Not bad.

[Dave Robertson]

Mam never quite got round to teaching me the Welsh that she speaks. I thank the Minister for his kind words about her and for outlining the complicated funding scenario that currently exists for speech and language therapy, along with the Government’s desires for the future of this therapy as an example of the three shifts that the Government will introduce in the NHS, and the need for people to engage thoroughly with the NHS 10-year plan consultation as a vehicle to securing those changes.

I thank the Petitions Committee for allowing me to lead the debate. It has been a real pleasure, not least because my constituency was the fourth most supportive of the petition. Finally, on behalf of all hon. Members who have been able to contribute today, I say an enormous thanks to Mikey, without whose campaigning we would not be here discussing this issue.

Question put and agreed to.

Resolved,

That this House has considered e-petition 657935 relating to speech and language therapy.

Terminally Ill Adults (End of Life) Bill (Money)

Stephen Kinnock Excerpts

Money resolution
Wednesday 22nd January 2025 Commons Chamber

[The Minister for Care (Stephen Kinnock)]

I beg to move,

That, for the purposes of any Act resulting from the Terminally Ill Adults (End of Life) Bill, it is expedient to authorise the payment out of money provided by Parliament of:

(1) any expenditure incurred under or by virtue of the Act by the Secretary of State, and

(2) any increase attributable to the Act in the sums payable under or by virtue of any other Act out of money so provided.

The Government are of the view that the Bill is a matter for Parliament rather than the Government to decide. In order for the Public Bill Committee that is now scrutinising the Bill to consider the clause that would have spending implications, the Government must first table this money resolution. This is purely to allow the Bill to be debated in Committee, and the Government have taken the view that tabling this motion does not act against our commitment to remain neutral. Only the Government can table such motions, so tabling it allows further debate to happen. To assist that debate, the Government will also assess the impacts of the Bill, and we expect to publish the impact assessment before MPs consider the Bill on Report.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I call the shadow Minister, Dr Kieran Mullan.

--- Later in debate ---

[The Minister for Care (Stephen Kinnock)]

I thank Members for their continued contribution to the debate. The Government are of the view that the Bill is an issue of conscience for individual parliamentarians and it is rightly a matter for Parliament, not the Government, to decide. The money resolution allows the Bill to be debated in Committee, where its detail will continue to be scrutinised. As I have said, the Government will also be assessing the impact of the Bill and we expect to publish an impact assessment before MPs consider the Bill on Report. I therefore commend the money resolution to the House.

Question put and agreed to.

[Jim Shannon (Strangford) (DUP)]

On a point of order, Madam Deputy Speaker. The right hon. Member for North West Hampshire (Kit Malthouse) made a comment that I feel impinged upon my integrity. I have spoken to the right hon. Gentleman and he knows what I am referring to. I underlined and highlighted that the Terminally Ill Adults (End of Life) Bill Committee went into private session; some 15 Members, who support the Bill, voted for the private session and nine Members, who oppose the Bill, voted against the private session. The record must be corrected about what the right hon. Gentleman said about the comments I made about that. Facts are facts; they matter to me, as does my integrity.

Auditory Verbal Therapy

Stephen Kinnock Excerpts

Tuesday 21st January 2025 Westminster Hall

[The Minister for Care (Stephen Kinnock)]

It is a great pleasure to serve under your chairship, Mr Western. I thank my hon. Friend the Member for Washington and Gateshead South (Mrs Hodgson) for securing this vitally important debate, and for her powerful and moving contribution to our discussion.

I would also like to break with protocol and welcome Sam to Parliament today. He is clearly a remarkable young man, and an inspiration to us all—thank you for being here, Sam. Like the shadow Minister, the hon. Member for Hinckley and Bosworth (Dr Evans), I thank hon. Members for their excellent contributions today. We have had a range of contributions, including from the shadow Minister, and from the hon. Members for North Shropshire (Helen Morgan) and for Strangford (Jim Shannon), and my hon. Friends the Members for Bury North (Mr Frith), for Bolton North East (Kirith Entwistle), for Derby South (Baggy Shanker) and for Bolton South and Walkden (Yasmin Qureshi). I think that may be all, but huge apologies if I have missed anybody. All their contributions were excellent and very well put.

My hon. Friend the Member for Washington and Gateshead South has done so much work to champion the interests of children with special educational needs and disabilities, including non-hearing children. I know that she also has an excellent partnership with Auditory Verbal UK, which I welcome to Parliament today. I would, of course, be happy to meet its representatives to follow up on all the points made in this debate.

This Government are committed to raising the healthiest generation of children ever. We will deliver on this ambition through the health and opportunity missions, and through the Government’s child poverty strategy. This is not about silos, with each Department delivering one part of a puzzle that does not fit together properly; this is about systemic, holistic change, and ensuring that we join up analysis, expertise and delivery across Government. Our mission-driven Government will drive long-lasting and sustainable change for children now and in the future. We will break down barriers to opportunity and ensure that every child has the best start in life. This includes all children and young people with special educational needs and disabilities, including non-hearing children.

We know that developing early communication skills is a key foundation for life, and there are serious knock-on consequences when that development is delayed. That is why we are committed to improving access to early interventions so that every child can find their voice. With the right support, children with hearing loss can develop effective communication skills, live fulfilling lives and enjoy the same opportunities as everyone else. The Government recognise the importance of the earliest days of an infant’s life. There is strong evidence that the 1,001 days from conception to the age of two set the foundations for our cognitive, emotional and physical development. That is why we are giving a £126 million boost for families to give every child the best start in life.

Thousands of families across England will be able to access family hubs, which will act as a one-stop shop for help with infant feeding advice, parenting classes and perinatal mental health support, among other things. Figures from the National Deaf Children’s Society show that there were more than 45,000 deaf children and young people in the UK in 2023. Between one and two babies in every 1,000 are born with permanent hearing loss in one or both ears. This number increases to about one in every 100 for babies who have spent more than 48 hours in intensive care. Early and effective support is crucial for these children and their families. Permanent hearing loss can significantly affect a baby’s development, so early and effective support is crucial for these children and their families.

It is vital that we intervene at birth. The NHS newborn hearing screening programme—the NHSP—aims to find babies who have hearing loss as early as possible so that the right support and advice can be offered right from the start. As we all know, language is linked to social, emotional and learning outcomes. From birth through to childhood, children and young people with hearing loss might need a range of therapies, such as speech, language and auditory verbal therapy. However, as we have heard today, those children are not always receiving the support that they need.

We recognise the important role of auditory verbal therapy as one of the therapies that can be useful for children with hearing loss. NHS audiology services, including the provision of therapies for children with hearing loss, are locally commissioned, and responsibility for meeting the needs of children with hearing loss lies with local NHS commissioners, because local systems are best placed to meet the needs of their own communities.

After 14 years of Tory neglect, incompetence and austerity, our NHS and care service are on their knees, but this Government are committed to properly funding the NHS, and we recently provided a £26 billion boost for health and social care in the autumn Budget. NHS England is responsible for determining allocations of financial resources. Each ICB will then commission the services they need for their local area, taking into account their annual budget, planning guidance and the wider needs of the population they cover. NHS England is supporting integrated care boards to make informed decisions about the provision of audiology services so they can provide consistent, high-quality and integrated care to non-hearing children.

In July 2016, NHS England published “Commissioning Services for People with Hearing Loss: A framework for clinical commissioning groups”. The framework supports NHS ICBs to make informed decisions to address inequalities in access and outcomes between hearing services.

[Mr Frith]

Does the Minister agree that, for all the good intentions of ICBs, our healthcare system is atomised, but that if they were to take instruction from guidance provided nationally, the pillar-to-post experience of a lot of families seeking auditory verbal therapy would end? Will he commit to updating the nine-year-old guidance to ICBs, or at least acknowledge that it needs updating, with a national pilot that proves the efficacy of AVT for families seeking that intervention?

[Stephen Kinnock]

My hon. Friend will know that one of the constant challenges in the system is getting the right balance between empowering those operating at the coalface—those who are close to the communities and know them best—to ensure they are delivering the best possible services, and ensuring consistency and coherence, both strategic and operational, across the entire system. It is safe to say that we are not always getting that balance right. One of the key objectives of the 10-year planning process that we are going through will be to address the so-called postcode lottery—variation between regions—across the whole range of health and care. Without that cross-cutting strategic look at the system, it will not be possible to get the balance right. I absolutely take the point, but one thing I will say is that we are crystal clear when we issue guidance to ICBs that they must take that guidance into account, and their performance is monitored on that basis.

[Mrs Hodgson]

Am I right in thinking, from what the Minister has just said, that he will issue revised guidance following today’s debate? Am I right that the Government, having given an extra £26 billion to local areas, will give them guidance that they should be looking to commission these services on a much bigger scale, so that we have more than 33 AVT therapists?

[Stephen Kinnock]

I can certainly tell my hon. Friend that this is a very dynamic situation. A system never stands still. For a system to work, we have to be constantly reviewing its performance and whether it is delivering to its objectives. I believe that the 10-year plan that we are producing will absolutely lead to a radical rewiring of the way our health and care system works. It will be driven by three big shifts: from hospital to community, from sickness to prevention, and from analogue to digital.

There is no doubt at all that where there are therapies and treatments that are working—that are clearly delivering big results, and value for money for the taxpayer—it is right that we give those priority in the way that we deliver. It is clear that AVT has huge potential, and it appears to have unexplored potential. I cannot pre-empt today how this is all going to pan out in terms of the system and the reforms that we are looking to push forward, but I can assure my hon. Friend that we are committed to innovating and to building a system that is fit for the future.

In 2019, with input from the National Deaf Children’s Society, NHS England produced a guide for commissioners and providers who support children and young people with hearing loss. The guide provides practical advice on ensuring that non-hearing children receive the support they need. Auditory verbal therapy is one type of therapy to support children with hearing loss, and it is important that local commissioners know their population and have the discretion to decide how best to meet its needs. When it comes to commissioning and providing services for children with hearing loss, we have been crystal clear with ICBs and NHS trusts that they must take the relevant guidelines into account.

We recognise the real need to improve access to therapies for all children who need them, including children with hearing loss. In recent years, in very difficult circumstances, the NHS has increased the number of speech and language therapists working in the service, but we know that more needs to be done. That is why the Government are committed to fixing the NHS and building a service that is fit for the future, with the workforce it needs to get patients seen on time.

[Dr Luke Evans]

The Minister rightly points out the need to try to deal with the postcode lottery and to ensure that there are reviews and sharing of best practice, but may I draw him back to my comments about guidelines? One thing he could do is ask NICE to look at the current evidence and consider what national guidance should be in place. ICBs have the right to choose what kind of treatment they think works best, and they will be driven by the clinical evidence and clinical guidelines; if there are no clinical guidelines, they will simply make their own decisions. Will the Minister commit to doing that?

[Stephen Kinnock]

The hon. Gentleman will know that NICE has a prioritisation board, and ultimately that is the decision-making process for prioritising guidelines and the entire operating framework for what falls under NICE’s remit. This is something that absolutely should be on the radar, and of course we are constantly in conversation with NICE about its prioritisation, but it is important that it takes an objective clinical stance on the question.

We have committed to develop a 10-year plan to deliver a national health service that is fit for the future. The engagement process has been launched. As we work to develop and finalise the plan, I encourage those concerned about the availability of services to support children with hearing loss, including auditory verbal therapy, to engage with that process to allow us to fully understand what is not working, as well as what should be working better and the potential solutions. I encourage all hon. Members present to go to change.nhs.uk to make their voice heard.

This summer, we will publish a refreshed long-term workforce plan to deliver the transformed health service we will need to build over the next decade to treat patients on time and deliver far better patient outcomes. We are also in the process of commissioning research to understand the gaps between the supply and demand of different therapy types for children and young people with special educational needs and disabilities. That will help us to understand the demand for speech and language therapists and inform effective workforce planning.

[Helen Morgan]

I am pleased to hear that the Government have increased the number of speech and language therapists, which is so important for young people who are struggling to achieve their potential in an educational setting, but will the Minister address the specific point on commissioning by local authorities? Often, they are so strapped for cash that they are effectively trying to limit demand.

[Stephen Kinnock]

Commissioning is led by ICBs. It is important that ICBs have open channels of communication with local government. We in the Department of Health and Social Care have close contact and engagement with colleagues in the Ministry of Housing, Communities and Local Government, and it is important that that relationship and interaction feeds down through the entire system, but the leading organisations on commissioning are the ICBs.

A number of colleagues raised the question of a pilot scheme to identify how our existing workforce can work differently. The early language and support for every child programme is an excellent example of different professions coming together to support children and young people—local authorities, schools, and the health and care system working together in the community to support our children and young people. The ELSEC workforce model focuses on recruiting pre-qualification speech and language therapy support workers into the workforce to improve the capacity and knowledge of staff who support children with emerging or mild to moderate speech, language and communication needs in early years and school settings.

Nine regional pathfinder partnerships are trialling new ways of working to better identify and support children in early years settings and primary schools. We have asked pathfinders to consider how to make the model sustainable after the project period. The therapy assistant roles have the potential to attract individuals to train to become speech and language therapists through the apprenticeship route. I understand that Auditory Verbal UK is progressing a National Institute for Health and Care Research grant application to support a pilot, and I would welcome an update from AVUK about how that is going when we get the chance to meet.

We welcome the work that AVUK is doing to upskill health professionals to deliver auditory verbal therapy. On the point made by the shadow Minister, the hon. Member for Hinckley and Bosworth, there are as yet no NICE guidelines on hearing loss in children, and NICE has not made any recommendations on AVT specifically. Decisions on the need for guidelines on new topics and updates to existing guidance are made by NICE’s prioritisation board, in line with NICE’s published common prioritisation framework. I understand that NHS England met with AVUK and discussed the need for more high-level research evidence for the intervention and the need to develop evaluations of impact. I am pleased that AVUK has been invited to join the chief scientific officer’s audiology stakeholder group, where it will contribute to decision making.

We recognise the impact on the lives of children of timely access to high-quality services, including different therapies to help children to develop the right skills to engage with education. The Government’s ambition is that all children and young people with SEND or in alternative provision receive the right support to succeed in their education and as they move into adult life. We will strengthen accountability on mainstream settings to be inclusive, including through the work of Ofsted, by supporting the mainstream workforce to increase their SEND expertise and by encouraging schools to set up resourced provision or SEN units to increase capacity in mainstream schools. That work forms part of the Government’s opportunity mission, which will break the unfair link between background and opportunity, starting with giving every child, including those with SEND, the best possible start in life. We will work with the sector, as essential and valued partners, to deliver our shared mission and restore parents’ trust.

I again thank my hon. Friend the Member for Washington and Gateshead South for securing this debate and sharing her insight on the vital issue of early interventions for non-hearing children. We recognise the importance of such services and the life-changing impact they can have on the lives of children. We are committed to ensuring that all children receive the support they need to live healthy, fulfilling lives. I will continue to work closely with NHS England and the Department for Education as we strain every sinew to deliver on those commitments.

Hospice and Palliative Care

Stephen Kinnock Excerpts

Monday 13th January 2025 Commons Chamber

[The Minister for Care (Stephen Kinnock)]

I pay tribute to the hon. Member for Wimbledon (Mr Kohler) for securing the debate and making such a powerful and thoughtful opening speech. I thank hon. Members from across the House—there are too many to list. It would be impossible to capture the richness of the contributions made. Something like 28 Back-Bench Members made speeches—I am sure Madam Deputy Speaker will correct me if my numbers are not quite right. It was an excellent debate, and I thank everybody for their contribution. I thank all those who work or volunteer in the hospice and palliative care sector for the deeply compassionate care and support that they provide to patients, families and loved ones when they need it most.

This Government are committed to building a society in which every person receives high-quality, compassionate care, from diagnosis through to the end of life. We will shift more care out of hospitals and into the community, to ensure that patients and their families receive personalised care in the most appropriate setting. Palliative and end of life care services, including hospices, will have a vital role to play in that shift. The reality is that we have a mountain to climb. Our health and care services are on their knees, but this Government will strain every sinew to build them, and to create a health and care system that is once again fit for the future.

In England, integrated care boards are responsible for the commissioning of palliative and end of life care services to meet the needs of their local population. To support ICBs in that duty, NHS England has published statutory guidance and service specifications. While the majority of palliative and end of life care is provided by NHS staff and services, we recognise the vital part that voluntary sector organisations, including hospices, play in providing support to people at end of life, as well as to their loved ones.

Most hospices are charitable, independent organisations that receive some statutory funding for providing NHS services. The amount of funding each charitable hospice receives varies both within and between ICB areas. The variation is dependent on demand in the area, and on the totality and type of palliative and end of life care provision from NHS and non-NHS services, including charitable hospices, within each ICB footprint.

We understand the financial pressures that hospices have been facing, which is why last month I was truly proud that this Government announced the biggest investment in hospices in England in a generation. It will ensure that hospices in England can continue to deliver the highest-quality care possible for patients and their families and loved ones.

[Danny Kruger]

I also welcome that, and congratulate the Minister on getting that money out of the Treasury, but will he acknowledge that there is a difference between capital and revenue? Hospices urgently need support for their day-to-day running costs, not just more money to support the capital. They also need capital support, but that is less crucial.

[Stephen Kinnock]

I take the hon. Gentleman’s point, but hospices face a range of pressures. The capital expenditure injection that we have provided will help them in the round. Clearly, anything that helps a hospice with its budget in the round, be it capital or revenue, will help the hospice.

We are supporting the hospice sector through a £100 million capital funding boost for adult and children’s hospices, to ensure that they have the best physical environment for care. There is also £26 million in revenue funding to support children and young people’s hospices. The £100 million in capital funding will deliver much-needed improvements—from refurbishments to overhauling IT systems and better facilities for patients and visitors—during the remainder of 2024-25 and throughout 2025-26. The investment will help hospices to improve their buildings, equipment and accommodation, so that patients continue to receive the best care possible.

Hospices for children and young people will receive a further £26 million in revenue funding for ’25-26 through what was known until recently as the children’s hospice grant. That investment demonstrates the Government’s recognition of the importance of integrating services to improve the treatment that patients receive. Furthermore, through our plans for neighbourhood health centres, we will drive the shift of care from hospitals to the community, which will bring together palliative care services, including hospices and community care services, so that people have the best access to treatment through joined-up services.

[Warinder Juss]

Money is not always the only solution, so will my hon. Friend confirm how the commission on palliative care that the Government announced last month will improve end of life care?

[Stephen Kinnock]

The Government announced a commission on the future of adult social care. A separate commission was announced by my hon. Friend the Member for York Central (Rachael Maskell) on palliative care. We will certainly monitor the findings of that commission very closely.

We will set out details of the funding allocation and distribution mechanisms for both funding streams in the coming weeks.

[Jim Shannon]

In my contribution, I made the House aware that the Northern Ireland hospice has to cut its beds from seven to six for five days of the week, and at the weekend, there are only three. The Minister knows that I respect him greatly. It is all very well to have capital money available, but there has to be money to run the system and provide beds. Otherwise, we can buy beds, but might not be able to keep them and run a service. There must be something seriously wrong with what he is putting forward.

[Stephen Kinnock]

As I said in a previous answer, hospices face a range of pressures that financial contributions from the Government will help to ease. The funding will, of course, have a knock-on impact on hospices budgets in the round.

In spite of the record-breaking package that we have announced, we are certainly not complacent. There is more work to be done, and through the National Institute for Health and Care Research, the Department is investing £3 million in a policy research unit on palliative and end of life care. The unit launched in January 2024 and is building the evidence base that will inform our long-term strategy. A number of hon. Members requested a long-term strategy and plan, which is sorely missing after 14 years of Conservative neglect and incompetence. I agree that we need a long-term plan, and assure Members that conversations are taking place between my officials and NHS England. The research needs to be based on evidence and facts, which the unit will help us to get.

[Dr Ben Spencer]

It is important that this debate is not a political ding-dong, and I really appreciate the tone that all Members, including the Minister, have taken. On evidence and facts, will he look into the impact of the national insurance contribution rises on hospice care and provision, how many hospices are running a deficit, and how many will likely go into deficit as a result of his policies?

[Stephen Kinnock]

The hon. Gentleman will not be surprised to know that I have a section in my speech on employer national insurance contributions. I will get to it.

A number of colleagues raised concerns about regional variations. Facts and evidence are very important in that context. To address that issue, NHS England has developed a palliative and end of life care dashboard, which brings together all the relevant local data in one place. The dashboard helps commissioners to understand the palliative and end of life care needs of their local population, enabling ICBs to put plans in place to address, and track the improvement of, health inequalities, and to ensure that funding is distributed fairly, based on prevalence.

[Gregory Stafford]

Will the Minister give way?

[Stephen Kinnock]

I will, but I have to finish at 9.58 pm, so there is only about five minutes left of my contribution.

[Gregory Stafford]

It is generous of the Minister to give way, so I shall be brief. Would funding continue to be produced through ICBs, or will the system be funded centrally?

[Stephen Kinnock]

That is precisely the topic of conversation for officials in my Department and NHS England, who are looking at this issue in the round and deciding how we will work. We need a system that empowers ICBs to deliver at the coalface, but we also need accountability from the centre to ensure that things are delivered. Getting the balance right is never easy, as I am sure the hon. Gentleman will understand; that is what we are trying to navigate.

Alongside NHS England, my officials and I will continue to proactively engage with our stakeholders, including the voluntary sector and independent hospices, to understand the issues that they face. In fact, I will meet the major hospices and palliative care stakeholders, including Hospice UK, early next month to discuss potential solutions for longer-term sector sustainability. That will inform our 10-year health plan.

[Munira Wilson]

On the children’s hospice grant, will the Minister confirm that it will be ringfenced, and that it will go beyond the one-year settlement?

[Stephen Kinnock]

Again, that is on the agenda for discussion with officials. Having inherited a disastrous situation, we are using 2025-26 to stabilise and to try to enable the sector to survive. The hon. Lady will understand that as well as doing that, we are looking at long-term reform solutions, but when we came into power on 4 July, it was one minute to midnight, and we had to rescue the sector. That is what we are doing, and we will look at the long-term issues in due course.

A number of Members have raised the concern around employers’ national insurance contributions. Since we came to office in July, we have been completely focused on repairing the catastrophic legacy of 14 years of Conservative neglect and incompetence. The first step was to fix the foundations of the public finances at the autumn Budget, and that enabled the spending review settlement of a £22.6 billion increase in resource spending for our health and care system. Our approach to ENIC exemptions has been consistent with the Office for National Statistics definition and the approach taken by previous Governments. It does not include an exemption for independent contractors, including charities like hospices, although December’s record funding announcement was a clear recognition of our commitment to financially supporting this vital sector more broadly.

I ask Opposition Members from all parties who luxuriate in criticising the means by which we have raised the record funding for hospices what they would do. How would they have raised the £22 billion that our autumn Budget delivered? Which taxes would they raise? Which public services would they cut? Answer comes there none. The Government recognise the need to protect the smallest businesses and charities, such as hospices, which is why we have more than doubled the employment allowance to £10,500, meaning that more than half of businesses and charities with ENIC liabilities either gain or see no change next year.

While the debate is not about assisted dying, I want to say a word on the matter. My hon. Friend the Member for Spen Valley (Kim Leadbeater) put forward her Bill, and it has received its Second Reading. It is vital that our approach to end of life care and patient choice is holistic and driven by an in-depth understanding of patient need.

I thank everybody across the House for this excellent debate. Actions speak louder than words. This Government have acted to deliver the biggest financial contribution to hospices in a generation.

Oral Answers to Questions

Stephen Kinnock Excerpts

Tuesday 7th January 2025 Commons Chamber

[Charlie Dewhirst (Bridlington and The Wolds) (Con)]

2. What assessment he has made of the potential impact of the increase to employer national insurance contributions on social care.

[The Minister for Care (Stephen Kinnock)]

This Government will never shy away from taking the choices necessary to fix the public finances and rebuild our public services. It is thanks to those choices that we are able to invest an additional £3.7 billion in 2025-26 in local authorities that provide social care. We are also delivering the biggest uplift to the carer’s allowance since the 1970s, an £86 million uplift to the disabled facilities grant, and a fair pay agreement for care workers.

[Charlie Dewhirst]

The increase in employer national insurance contributions comes at a time when we simply cannot afford to lose any more provision from care providers. Age UK estimates that 2 million people aged 65 and over already have unmet care and support needs. What assessment has the Minister made of the potential increase in unmet care needs as a result of the increase to employer national insurance contributions?

[Stephen Kinnock]

There is a pattern here. The Conservatives welcome the additional investment in health and care but oppose the choices that we have made to raise the revenue. They need to tell us which services they would cut or which taxes they would raise instead.

[Mr Speaker]

I call the Liberal Democrat spokesperson.

[Helen Morgan (North Shropshire) (LD)]

Coverage Care, a not-for-profit adult social care provider in North Shropshire that operates 11 care homes and employs around 1,000 local staff, has been in touch to say that it expects the impact of the increase in national insurance contributions to be £840,000 in the first full year of implementation. Given that there are huge numbers of vacancies across adult social care in North Shropshire, will the Secretary of State consider exempting social care providers from the national insurance increase? Otherwise we are putting money into social care with one hand and taking it away with the other.

[Stephen Kinnock]

I refer the hon. Lady to my previous answer on the very substantial funding that we are providing to local authorities, which of course are key to the adult social care system. However, funding must always be married with reform. We have brought forward a packed programme of reform—from data sharing and empowering care workers to take on basic healthcare to promoting better use of care technologies—and in the spirit of cross-party collaboration that we believe is absolutely vital and urgent in this area, I gently encourage her to see those reforms as the first step towards rebuilding our care service and making it fit for the future.

--- Later in debate ---

[Gideon Amos (Taunton and Wellington) (LD)]

20. What steps his Department is taking to improve access to mental health services.

[The Minister for Care (Stephen Kinnock)]

As Lord Darzi’s independent investigation found, around 1 million people are waiting to access mental health services in England. This Government will fix our broken mental health services by recruiting 8,500 more mental health workers, providing access to specialist mental health professionals in every school and rolling out young futures hubs in every community.

[Tom Gordon]

In my constituency of Harrogate and Knaresborough we have heard harrowing stories from people who have tried to reach out and get access to mental health services before they reach crisis point. Often, people end up facing months-long if not years-long waiting lists. When all too often they reach a crisis point, they end up having to access services as far away as Newcastle or Manchester. What are the Government doing to make sure that we can root local community mental health facilities in communities such as Harrogate and Knaresborough?

[Stephen Kinnock]

In addition to the measures that I just set out, in the Budget the Chancellor made funding available to expand talking therapies to 380,000 extra patients. We have a £26 million capital investment scheme for mental health crisis centres and, as always with this Government, investment goes with reform. We are finally reforming the Mental Health Act—that was first talked about when Theresa May was in 10 Downing Street. This Government are rolling up their sleeves and getting on with the job.

[Gideon Amos]

Taunton and Wellington is a trailblazer in taking mental health from hospital to community and from sickness to prevention. The trust is the first in the country to merge mental health with the hospital trust. Will the Minister meet the trust and me to understand how successful that programme is, and to discuss the much needed maternity and paediatric unit at Musgrove Park hospital?

[Stephen Kinnock]

It sounds like there is some interesting, dynamic and innovative work going on in the areas that the hon. Gentleman mentioned. I would be happy to meet him to discuss it further.

[Peter Prinsley (Bury St Edmunds and Stowmarket) (Lab)]

I have just been visited by my former medical student, a young doctor in Yorkshire working in an intensive therapy unit, who told me that 40 of the 50 patients who were admitted with covid died. Many healthcare workers are suffering from flashbacks and post-traumatic stress disorder. What measures will the Government take to look after the mental health of the healthcare workers who so bravely helped us during the covid pandemic?

[Stephen Kinnock]

My hon. Friend raises an important point, which provides an opportunity for us all to reflect on the incredible work of those working in our health service; they are, in many ways, heroes, and we should absolutely acknowledge that fact. We need to explore the point he has raised—we could meet to discuss it further, or I would be happy to write to him.

[Anna Dixon (Shipley) (Lab)]

In England, more than 200,000 people were waiting for an autism assessment in September 2024. In my constituency, some adults have waited more than two years for an autism assessment, and one child has been waiting eight years—and is still waiting—to receive support from child and adolescent mental health services. These delays have a profound impact on people’s lives. Will the Minister commit to the mental health investment standard and ensure that as the Government reduce waiting times, they do so for both physical and mental health services for young people and adults?

[Stephen Kinnock]

We remain absolutely committed to the mental health investment standard. We have prioritised the expansion of NHS talking therapies and individual placement and support schemes, and provided £26 million of capital funding to open new mental health centres. However, we are not complacent on this issue. My hon. Friend spoke about autism assessments, which is a red light that is flashing on my dashboard. I would be happy to discuss that further with her.

[Sir Desmond Swayne (New Forest West) (Con)]

11. Whether his Department plans to improve integration of counsellors and psychotherapists into the mental health workforce.

[The Minister for Care (Stephen Kinnock)]

Counsellors and psychotherapists form an integral part of the NHS mental health workforce, delivering support to people with mental ill health across a range of settings in services for both children and young people and adults. We will publish a refreshed NHS long-term workforce plan to ensure that the NHS has the right people in the right places with the right skills to deliver the care that patients need.

[Sir Desmond Swayne]

Is there a plan to maintain service provision where psychotherapists and counsellors operating in the charity sector have been hit by eye-watering cost increases as a consequence of the national insurance increase?

[Stephen Kinnock]

As I have said in answers to previous questions, and as my right hon. Friend the Secretary of State has said, there is something of a pattern emerging here: Opposition Members say that they welcome the investment the Government have made, but oppose the revenue-raising measures and refuse to set out whether they would increase taxes or cut services. I still have not heard an answer on that from those Members.

--- Later in debate ---

[Mr Speaker]

Can Members please remember that these are topical questions?

[The Minister for Care (Stephen Kinnock)]

We are making a priority of resuming consultations with the sector to stabilise community pharmacy. Pharmacy First has built on existing services to increase the clinical scope. The conditions treated under Pharmacy First vary across the UK, and the NHS will keep this under review.

[Claire Young (Thornbury and Yate) (LD)]

T3. When we think of social care, we often think of those who are older, but at a recent advice surgery I met the mother of a 20-year-old with complex needs that local services are unable to meet, so the only option that would allow him to engage with his peers is residential care further afield, taking him away from his family. Will the Minister meet with me, my constituent and his mother to discuss how we ensure that those with complex needs are properly supported?

[Stephen Kinnock]

I am sure the hon. Lady will welcome the fact that we have found an £86 million uplift for the disabled facilities grant, but on the specific question she raises, I would be happy to meet her and discuss that further.

[Jo Platt (Leigh and Atherton) (Lab/Co-op)]

T6. Groups such as Action for ME and Long Covid Support tirelessly advocate for improved care for over 2 million people living in the UK. How will the Minister ensure that NHS reforms deliver timely diagnosis, effective treatment and long-term support for those affected?

--- Later in debate ---

[Natasha Irons (Croydon East) (Lab)]

T7. The Family Dental Practice in my constituency has faced significant challenges caused by dental contracts introduced by the previous Government. The pilot scheme it took part in caused long-lasting operational financial damages to the practice. How will the Secretary of State support such practices, and will he consider measures such as rebasing the unit of dental activity targets to help them overcome these challenges?

[Stephen Kinnock]

My hon. Friend is absolutely right: the NHS dental contract simply is not working. We are working with the sector to reform the contract, with a shift to focusing on prevention and the retention of NHS dentists. We will deliver on our pledge to provide 700,000 more urgent dental appointments at the earliest possible opportunity, targeting areas that need them most.

[Tim Farron (Westmorland and Lonsdale) (LD)]

One in five social care jobs in Cumbria are currently unfilled, and the consequences are unbearable for those who are vulnerable; indeed, they are causing pressure on the rest of the NHS. Will the Secretary of State look carefully at the specific needs of rural communities such as ours, where it is so much harder to recruit and retain social care workers?

--- Later in debate ---

[Mr Richard Quigley (Isle of Wight West) (Lab)]

T10. The Isle of Wight does not just have a problem with its ferries, as the House would expect; we also have a huge problem with dentistry. We are a true dental desert. However, the size of our community means that we are an ideal place to try new approaches to dentistry, especially for children. Will the Minister meet me to discuss those approaches and improve dentistry on the island?

[Stephen Kinnock]

My hon. Friend is absolutely right to describe the Isle of Wight as a dental desert. That is perhaps one of the reasons why the good people of that island elected a Labour Member for the first time in history. Our ambition is to make sure that everyone who needs a dentist can get one. Sadly, 28% of adults in England—13 million people—have an unmet need for NHS dentistry. I would be glad to meet my hon. Friend to learn more about how the experience of the Isle of Wight can improve services nationally.

[Rishi Sunak (Richmond and Northallerton) (Con)]

Prostate cancer is the most common cancer in men, yet it has no national screening programme. We worked on this issue in government, and I thank the Secretary of State for taking an interest in this area. Will he join me in commending Prostate Cancer Research’s excellent new report and urge his team to consider the findings, not least on increasing screening of at-risk groups so that we can not just save the NHS money but, more importantly, save thousands of lives?

[Deirdre Costigan (Ealing Southall) (Lab)]

The last Government treated mental health as a Cinderella service, with my constituents waiting days in A&E to be admitted to hospital mental health wards. The Solace Centre in Ealing Southall provides help and support in the community for those with mental health problems, at a fraction of the cost of a hospital stay. How does the Minister intend to move more mental health services from hospital to the community, and to create more great services like the Solace Centre?

[Stephen Kinnock]

I thank my hon. Friend for her excellent question. She is right that it is vital to move services from hospital to community. The Chancellor made funding available for 380,000 more talking therapies for patients and put in place a £26 million capital investment scheme for mental health crisis centres. A lot of work has been done, but there is a lot more still to do.

[Vikki Slade (Mid Dorset and North Poole) (LD)]

Will the Secretary of State confirm what is being done to ensure that patients with rare and complex conditions, such as functional neurologic disorder and achalasia, can access consistent and co-ordinated care, including referrals to the multidisciplinary teams they need for the different symptoms they experience?

Community Pharmacies: Devon and the South-west

Stephen Kinnock Excerpts

Tuesday 17th December 2024 Westminster Hall

[The Minister for Care (Stephen Kinnock)]

It is a real pleasure to serve under your chairship, Mr Betts. I thank the hon. Member for Tiverton and Minehead (Rachel Gilmour) for ensuring that this really important debate can take place today. I start by acknowledging and paying tribute to the outstanding work of community pharmacy teams in Devon, the south-west and right across the country. I have heard so many examples, showing just how many patients and communities rely on pharmacy services, and the lengths to which they go to deliver care. I thank them for their professionalism, hard work and dedication in providing excellent standards of patient care.

It is a credit to them that surveys show that nine in 10 people who visit pharmacies feel positive about the experience. Community pharmacies are often the most accessible part of our NHS, allowing people to access professional healthcare advice right there on the high street. They are also vital in supporting rural communities and people living in remote locations. Furthermore, as community pharmacies provide more clinical services, they help to relieve pressure in other areas of the NHS. That includes freeing up GP appointments, preventing hospital admissions and reducing overall pressure on secondary care.

For far too long, however, Governments have failed to recognise the essential role of community pharmacies in safeguarding the nation’s health. On 4 July, we inherited a system that has been starved of funding, with a 28% cut in funding in real terms. In many ways, it is on its knees, with far too many closures happening across the country. Lord Darzi’s report laid bare the true extent of the challenges facing our health service. Even he, with all his years of experience, was truly shocked by what he discovered. His report was vital, because it gave us a frank assessment—a diagnosis—so that we can face the problems honestly and properly. It will take a decade of national renewal, lasting reform and a long-term plan to save our NHS. We have committed to three key shifts: from hospital to community, from analogue to digital, and from sickness to prevention. Our 10-year plan will set out how we will deliver these shifts to ensure that the NHS is fit for the future.

To develop the plan, we must have a meaningful conversation with the country and those who work in the system. We are therefore conducting a comprehensive range of engagement activities, bringing in views from the public, the health and care workforce, national and local stakeholders, system leaders and parliamentarians. I urge Members, their constituents, and staff across health and social care to tell us what is working and what needs to change. They should visit change.nhs.uk and make their voice heard.

The Government are committed to restoring the NHS to its founding promise that it will be there for all of us and our constituents when we need it. However, as identified by Lord Darzi’s review, primary care is under massive pressure and in crisis. I recognise that it is a really challenging environment for colleagues in all parts of the NHS, including in community pharmacy, but we remain resolute and determined to fix this situation.

Pharmacies are based in, and are a key part of, the communities that they serve. They are ideally placed to help to tackle inequalities and to increase the reach of and access to NHS services. This includes delivering a range of health advice and support services, helping to relieve pressure on and improve access to the wider NHS. Community pharmacies are a vital part of our NHS that must be recognised in the development of the Government’s 10-year plan. They are central to the three big shifts in healthcare that I outlined earlier. I know that pharmacies can and should play an even greater role in providing healthcare on the high street. This will be imperative if we are to deliver across the Government’s mission—not just on the health mission, but on growth and opportunity.

A healthy society and workforce are pre-conditions for prosperity and growth. We have a staggering 2.9 million people who want to work, but are unable to do so because they have been failed by our health and care system for the last 14 years. Community pharmacy has a pivotal role to play in getting our economy back on its feet and fit for the future, whether that is by identifying those with risk factors for disease such as high blood pressure, or ensuring that people can access and use their medicines to best effect. As a Government, we are fully committed to working with the sector to achieve what we all want: a community pharmacy service that is fit for the future.

I am keen to unlock the potential of the whole pharmacy team. We want pharmacists to be providing new and impactful clinical services, including our future pharmacies prescribing service. We want pharmacy technicians to have more responsibility in supporting the pharmacists, to help people to deliver the best possible health outcomes.

Every day, pharmacy teams facilitate the safe supply of medicines to patients, enabling them to manage health conditions as part of their daily lives in Devon, the south-west and right across the country. They also provide vital advice on prescriptions, over-the-counter medicines and minor ailments. But pharmacies do not just dispense medicines and offer advice. They do much more. They positively impact patients’ health and support the wider NHS by providing a wide range of clinical services. Many offer blood pressure checks, flu or covid-19 vaccinations, contraception consultations and many more locally commissioned services.

[Dr Evans]

The Minister is espousing brilliantly what community pharmacies do. That all comes under a contractual framework, and one of the key things that pharmacies are asking for is when the negotiations will start and what the terms of reference will be. Will the Minister address that point?

[Stephen Kinnock]

I thank the shadow Minister for that intervention. I am as frustrated as everybody else about the delay. The reason for the delay is that the negotiations did not get over the line before the general election. The general election came, and we have spent a lot of time now clearing up the disastrous mess that the previous Government made of the system. I can say that we are now very focused on getting these negotiations started early in the new year. I know that hon. Members across the House will be very interested in that, in terms of the contractual framework, the medicines margin and all of the funding. We have a statutory duty to consult with the sector before we can make any announcement, but we are confident that we will start the negotiations early in the new year.

We supported Pharmacy First in opposition, and we will build on that programme in the future. We look to create an independent prescribing service, where prescribing is an integral part of the services delivered by community pharmacies. We are also doing a lot of work on the IT infrastructure to make sure that the sector can more easily prescribe and refer through better IT. That is an important part of our shift from analogue to digital. We need pharmacies delivering services that help patients to access advice, prevention and treatment more easily—services that help people to make best use of the medicines they are prescribed and that ease some of the pressures in general practice and across parts of the NHS.

There are more than 10,000 pharmacies in England. They are busy dispensing medicines, offering advice and providing these services. Patients across the country can also choose to access around 400 distance-selling pharmacies that deliver medicines to patients’ homes free of charge. They play a vital role in reaching the most isolated members of our society.

I am very keen to ensure that the hon. Member for Tiverton and Minehead has a minute at the end of the debate to sum up. In the short time I have, I want to say a couple of words about her constituency, where there are 15 pharmacies. We are aware of the closure of one pharmacy in her constituency since 2017 and that the local population instead get their medicines from the neighbouring dispensing GP. I also note that, according to the latest data, there are 203 pharmacies in Devon; across the south-west, there are 916. Where closures have occurred across the south-west, the ICBs are working through the process of approving applications from new contractors. Some applications have already been granted. Following approval, the new pharmacy contractor has 12 to 15 months in which to open a pharmacy, so the ICBs are also working with GP practices and other contractors to minimise any temporary disruption for patients.

Community pharmacies are a vital part of the NHS and communities across our country. The Government are committed to supporting them now and into the future. I look forward to working with pharmacists across the country and hon. Members across this House as we progress our plans to embrace the skills, knowledge and expertise in pharmacy teams.

Dental Healthcare: East Anglia

Stephen Kinnock Excerpts

Wednesday 11th December 2024 Westminster Hall

[The Minister for Care (Stephen Kinnock)]

It is a pleasure to serve under your chairship, Mr Dowd. I thank the hon. Member for Broadland and Fakenham (Jerome Mayhew) for securing this vital debate on dental healthcare provision in East Anglia, and I thank hon. Members on both sides of the House for their important interventions.

The debate follows hot on the heels of a debate on 3 September that my hon. Friend the Member for Norwich South (Clive Lewis) led on healthcare provision in the east of England. We know that huge swathes of the region are dental deserts. These areas are facing great pressures from challenges in the recruitment and retention of dentists, leaving patients struggling to access the NHS dental treatments that they need. As has been pointed out, it is a scandal—frankly, it is Dickensian—that the No. 1 reason for children aged five to nine to be admitted to hospital in our country in 2024 is to have rotten teeth removed.

Norfolk and Waveney integrated care board had 31.5 dentists per 100,000 of the population in 2023-24, which is the lowest number in England. That is why I have met with colleagues from the east of England, including the hon. Member for Broadland and Fakenham, to discuss the specific challenges in the region and to discuss the University of East Anglia’s plans to open a dental school. The UEA’s proposal to begin training dental students is very welcome news. As I said to all the colleagues I met recently, and to the hon. Gentleman at oral questions last month, the Government strongly encourage the UEA to continue its progress towards establishing a dental school by submitting its bid to the General Dental Council as rapidly as possible.

The independent Office for Students is another key player. It has statutory responsibility for allocating funded training places to dental schools. As the hon. Gentleman has pointed out, the OfS is independent from the Government. I cannot make specific commitments about allocating additional training places for future years, because to do so would be to cut across the independence of the OfS. The OfS makes decisions based on its own assessments, following guidance issued by Government. What I can say to the hon. Gentleman is that our guidance is influential, but I cannot guarantee its outcome.

The guidance for the 2026 academic year will be published in due course. Provided that the UEA meets those requirements, it would absolutely be considered for Government-funded dental training places. That would certainly help to retain local dentists in East Anglia. As a Member for a rural constituency, I absolutely understand how important that is to the hon. Gentleman and to the many other hon. Members present who represent his part of the country.

We also need a clear-headed diagnosis of where we are. It is beyond doubt that NHS dentistry was left in an appalling state of disrepair by the previous Government. As the Prime Minister said last week, the precious contract between the state and the British people has been broken. He rightly said that our public services are

“in crisis, unable to perform their basic functions”

and that they are

“unable to provide the timely care and dignity that Britain relies on”.

Almost five years on from the beginning of the pandemic, NHS dentistry has still not recovered to pre-pandemic levels. Only 40% of adults were seen by an NHS dentist in the 24 months to June this year, down from almost 50% before the pandemic. Although 34 million courses of dental treatment were delivered in England in 2023-24, that is down from almost 40 million courses five years ago. As I say, it is disgraceful that having rotten teeth removed is the single most common cause of hospital admissions for children aged five to nine, causing them untold pain and suffering and affecting their ability to sleep, speak and socialise.

On the subject of the general state of dentistry, I thank the National Audit Office for its recent investigation of the previous Government’s dental recovery plan. Its report lays out in black and white something that was already apparent to millions of people across the length and breadth of our country: the dental recovery plan that we inherited did not go far enough. We are reflecting on every line of the NAO report as part of our efforts to rebuild dentistry, get it back on its feet and make it fit to serve people of all ages. We have launched the largest ever national conversation to inform our 10-year plan to reform the NHS, and our workforce will play a central role, because they are key to unlocking improvements across our communities.

The golden hello scheme offers dentists £20,000 to work in underserved areas of the country for three years. The recruitment process is well under way, with posts being filled by dentists in those areas as we speak. As of 7 November, 64 posts had been advertised. Our manifesto pledged 700,000 more urgent dental appointments, and we are working to ensure that patients can start to access them as soon as possible. They will be targeted at the areas that need them most.

Strengthening the workforce is key to our ambitions, but for years dentistry has faced chronic workforce shortages. We have to be honest that bringing in the staff we need will take time. To rebuild dentistry in the long term and increase access to NHS dental care, we will reform the dental contract with a shift to focusing on prevention and the retention of NHS dentists. There are no perfect payment systems, and careful consideration needs to be given to any potential changes to the complex dental system, so that we deliver a system that is better for patients and the profession.

[Adrian Ramsay]

I thank the Minister for reiterating the Government’s commitment to reforming the dental contract. Please will he set out a timescale for that work commencing?

[Stephen Kinnock]

I was just going to say that we are continuing to meet the British Dental Association and other representatives of the dental sector to discuss how we can best deliver our shared ambition to improve access for NHS dental patients. We are working on this as a matter of urgency. I cannot give a specific timeframe, but it is a top priority for the Department.

[Charlotte Cane (Ely and East Cambridgeshire) (LD)]

I understand that the Government have inherited a big problem, but the situation is urgent. I have a constituent who has heart problems, so his oral health is really important to him. He cannot get an NHS dentist, so constituencies such as Ely and East Cambridgeshire need urgent action.

[Stephen Kinnock]

I share the hon. Lady’s belief that we need urgency and focus. We have a big mountain to climb, but we have to crack on. I completely take her point about the need for urgency.

We need to ensure that the process to register a dentist in the UK is as efficient and fast as possible, while retaining robust safeguards for patient protection. The Department regularly engages with the General Dental Council to understand what it is doing to improve the waiting times for the overseas registration exam. Earlier this year, the Department ran a consultation on introducing a further piece of legislation to give the GDC powers to provisionally register overseas qualified dentists, which will help to address some of the workforce challenges.

In summary, this is an immense challenge. There are no quick fixes or easy answers, but we will choose change, not because it is easy but because it is what we have to do. We have to do the hard yards, and I look forward to working with the hon. Member for Broadland and Fakenham and other colleagues to deliver what is needed.

Question put and agreed to.