Oral Answers to Questions
Wendy Chamberlain Excerpts(4 days, 10 hours ago)
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Stephen Kinnock
My hon. Friend is right: we will reform the dental contract to rebuild dentistry in the long term and to increase access to NHS dental care, with a shift to focusing on prevention and the retention of NHS dentists. We continue to meet representatives from the British Dental Association and other representatives of the sector to discuss how we can best deliver our shared ambition to improve access for NHS dental patients.
Wendy Chamberlain (North East Fife) (LD)
The Secretary of State for Health and Social Care (Wes Streeting)
The leadership shown by the Chancellor has enabled her and the Government to fix the foundations of the public finances and fill the £22 billion black hole left by the previous Government. The decisions that she took meant that she was able to provide this Department with an extra £26 billion and a real-terms increase in core local government spending power by about 3.2%. That was the right decision for the right reasons in the national interest, and I am taking into consideration pressures on all parts of health and social care before making final allocations for the year ahead.
Wendy Chamberlain
In North East Fife, we have a particular issue with access to dental surgeries, especially with the recent closure of a surgery in Leven. Difficulties stem from recruitment from abroad as a result of visa changes and also simply from practices going private and coming out of the system. Obviously, the NHS is devolved in Scotland, but does the Secretary of State agree that putting staffing under further strain from increasing national insurance contributions will only make things worse for dentists? What in his conversations is he doing to ensure that dentists get the support that they need?
Wes Streeting
It is because the Chancellor took the decisions that she did in the Budget that my Department has received £26 billion to reform and improve health and social care. As I said before the general election, all parts of the United Kingdom suffered under the previous Conservative Government, which is why I am sure that Members from across Scotland will welcome the extra £1.5 billion this year and £3.4 billion next year—the biggest funding increase since devolution. I am sure that the SNP Government will welcome the increase, and they certainly have no excuses now for not acting.
Access to Primary Healthcare
Wendy Chamberlain Excerpts(1 month, 1 week ago)
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Helen Morgan
No, I will make some progress.
People do much better if they have access to continuity of care, but 8,000 more GPs are needed to deliver the rights that we laid out in our manifesto. We do not shy away from the fact that that is an ambitious objective, and we accept that it cannot be achieved through training and recruitment alone: we need to retain and incentivise our existing workforce. As I said earlier, seeing people in their communities avoids hospital admissions and saves money. Unfortunately, although the Conservatives promised us 6,000 more GPs in 2019, we ended up with 500 fewer. That is why people are so frustrated. According to the findings of research carried out by the House of Commons Library, GP funding has fallen by £350 million in real terms since 2019. As a result, not only are people struggling to gain access to basic care in their communities, but there is a postcode lottery when it comes to availability of that care.
In the area where I live, which is covered by NHS Shropshire, Telford and Wrekin, the number of fully qualified GPs fell from 280 in 2016 to 242 in 2023, despite an increased and increasingly ageing population with a much higher level of demand, while 43% of patients are waiting more than 28 days for non-urgent appointments. The Darzi report showed that the number of people waiting for long periods for appointments is rising throughout the country: it is a national issue. We know that from our own doorstep conversations.
Members might ask me, “Where are you going to get 8,000 more GPs from? That is a big number.” Apart from training new ones, we should value greatly our experienced ones. A recruitment and training programme is one idea, and, as my hon. Friend the Member for Westmorland and Lonsdale (Tim Farron) pointed out, using the dentists we have trained properly is extremely important, but we also need to focus on retention and incentivising our existing GPs, to ensure that we hold on to valuable experience and valuable patient continuity.
Let me move on from GPs to local pharmacies. Pharmacy First was a great idea of the previous Government —I am willing to give them credit—but pharmacists are under huge strain. According to the Darzi report, some 1,200 have closed since 2017, and spending under the community contract has fallen. Tomorrow I am going to visit Green End pharmacy in Whitchurch, in my constituency, which wrote to me:
“As an independent pharmacy, we’re unable to keep on absorbing costs with losses on dispensing.”
The pharmacy is struggling because it is making losses on the drugs that it gives out on prescription. Given that it is a small, independent pharmacy, it does not have a massive shop from which to make profits to subside that work.
In 2023, Community Pharmacy England warned of
“systemic pharmacy funding cuts of at least 25% in real terms since 2015.”
That has led to a postcode lottery of access, and to many pharmacies being unable to have a full-time pharmacist and relying on locums, which has led to a really poor and insecure level of service. That is impacting on people who just need to go and pick up their prescription and get on with their day.
Wendy Chamberlain (North East Fife) (LD)
The NHS is devolved in Scotland, but the UK Government have responsibility for continuity of supply of medications. I have constituents with attention deficit hyperactivity disorder who have been waiting for up to a year to secure that continuity of supply. Does my hon. Friend agree that we need to see more action from the Government, who should be proactive in that regard?
Helen Morgan
That is a really important point. A lot of people in my constituency have contacted me for help with drugs—for example, to deal with ADHD. People need to be able to access important medication readily.
We must not forget the dentistry element of primary care. A generation of children are at risk of poor oral health because of the mess in which dentistry has been left by the previous Government. Tooth decay is the biggest cause of children being admitted to hospital, with over 100,000 admitted since 2018. That is totally unacceptable. Some 4.4. million children have not been seen by an NHS dentist in the last year, according to the House of Commons Library.
Dentistry is really important for children—they have to keep their teeth for the rest of their lives—but this issue affects adults too. My constituent Ron Kelly, who is 62, is disabled and lives in Market Drayton. Members who have been around a while might know that it is not easy to catch a bus to anywhere from Market Drayton. He has not been able to find a dentist since 2019, and my caseworkers have rung every NHS dentist in our constituency. None of them is taking on new patients, so even if he was able to use the bus, he would not be able to find an NHS dentist in North Shropshire at the moment.
Office for National Statistics data released last week shows that, in the midlands, 99% of people who do not have an NHS dentist, and who are trying to find an appointment, cannot access one—99%! It is just unbelievable in a modern country in the 21st century.
Unpaid Carers
Wendy Chamberlain Excerpts(2 months, 3 weeks ago)
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Wendy Chamberlain (North East Fife) (LD)
Thank you, Madam Deputy Speaker. It is great to be back, and to see you in the Chair. I congratulate you on your new position.
Caring or being cared for is an almost universal experience. Almost everybody will find themselves being an unpaid carer for their loved ones at some point in their life, or being cared for by loved ones. Who among us does not know somebody who is helping an elderly parent, or supporting a family member with a long-term illness? As new MPs will come to learn, almost every week here, we have an opportunity to learn about and mark a national awareness day for a different devastating illness. For every person suffering from those illnesses, there will inevitably be a family member—unseen—supporting and caring for them.
According to the recent census, there are 5.7 million unpaid carers in England and Wales, but those are just the people who recognise themselves as such. In 2022, Carers UK research estimated that there were up to 10.6 million unpaid carers. Whichever figure we use, that is a huge number, and the figure is growing. According to very recent research published by the Joseph Rowntree Foundation, by 2035 there will be an 11% increase in the number of unpaid carers, and as degenerative conditions, including chronic degenerative conditions, become more prevalent, the amount of care that carers do is predicted to go up; it is expected that ever more will provide more than 35 hours of care each week.
The Government should care about carers, not just because that is the right thing to do, and not even because unpaid carers are in homes across every constituency in the UK, but because we need them. Unpaid carers are absolutely vital to our economy and our society.
Jim Shannon (Strangford) (DUP)
I commend the hon. Lady for bringing this debate forward. The House is fuller than usual for this Adjournment debate, which indicates the importance of the issue. Every one of us knows people who are carers. I care for my brother, who had a big accident 20 years ago, and I understand what it means to be a carer and to be available at all times, as others do. Does the hon. Lady agree that respite for carers is an essential component of support, and that inability to access respite care will push many into making the unwanted decision to give up caring and instead institutionalise the people they care for, due to the unbearable pressure on their mental health?
Wendy Chamberlain
I am grateful to the hon. Member for that intervention. He is absolutely right, and as he and I know, having served in the last Parliament, during covid the lack of respite care was a critical factor for many carers. It is clear that we all need to do more in that area.
We were talking about how vital carers are to our economy and society. The economic value of unpaid care is £162 billion a year in England and Wales, £13.1 billion in Scotland and £5.8 billion in Northern Ireland. We know the country’s finances have been left in a ruinous state by the last Government, and that the social care system is already stretched to breaking point. We must also know that we cannot take the contribution of unpaid carers for granted, so I hope that the Minister will take tonight as an opportunity to show that the Government do care about unpaid carers.
In a debate shortly before the general election was called, the then shadow Minister for care, who is now a Minister, the hon. Member for Gorton and Denton (Andrew Gwynne), committed Labour to developing a new carers strategy if it formed the next Government:
“There will be a carers strategy under the next Labour Government, because we value the vital work our carers do. It will be a cross-Government strategy with the Department for Work and Pensions, Department for Education and the future of work review all feeding into it along with the Department of Health and Social Care. There is a brighter future for those living with dementia and their families and carers. Labour will deliver it.”
Given that promise, I hope that the Minister can understand why I and many whom I have spoken to in the care third sector were disappointed that unpaid carers were not mentioned at all in the Labour manifesto. At the same point in the speech I just referred to, the then shadow Minister said that unpaid carers
“will be at the heart of Labour’s plans in Government.” —[Official Report, 16 May 2024; Vol. 750, c. 228WH.]
I hope the Minister will take tonight’s debate as an opportunity to make that case.
Tom Gordon (Harrogate and Knaresborough) (LD)
I thank my hon. Friend for bringing forward this Adjournment debate, and of course for the work she did before this parliamentary Session on what is now the Carer’s Leave Act 2023. One of the reasons why I became involved in politics is that the day before I started my master’s degree, my mum was diagnosed with breast cancer. I studied my degree part-time over two years to look after her and my little sister, who was just five. Looking back, it is clear that I was filling the role of a carer, but I did not identify as one. That is a key point to note if we are to have a carers strategy. A recent Carers Trust survey found that 73% of those who provide or have provided unpaid care do not identify as unpaid carers. Does my hon. Friend agree that a national carers strategy should prioritise the identification of carers across all sectors?
Madam Deputy Speaker (Ms Ghani)
Order. This is an Adjournment debate and interventions must be super-short.
Wendy Chamberlain
I am grateful to my hon. Friend. It demonstrates how prevalent caring is in our society when we have Members who have direct experience of it. Identification of carers, or people identifying themselves as carers, is a key issue that any strategy should address.
The then shadow Minister was right that we need a cross-Government strategy. This is not a new idea, because we have had such strategies before; the last one was drawn up all the way back in 2008, but the problems that unpaid carers face have not gone away. Unpaid carers are significantly more likely to be in poverty than the rest of the population. The most recent data available from the Department for Work and Pensions—the 2023 family resources survey—shows that just under a third of households in receipt of carer’s allowance are food insecure, compared with 10% of households as a whole. That is a huge difference.
To assess food insecurity, the survey asks the respondent whether in the past 30 days: they have has eaten less than they felt they should because of lack of funds; they have been hungry, but not eaten due to lack of funds; or they have lost weight due to not enough money for food. It also asks whether they or someone in their household has gone without eating for an entire day because they lack money for food. Further, the survey found that 13.3% of households in receipt of carer’s allowance—that is just more than one in every eight—had used a food bank in the previous 12 months, compared with just 3% of households overall.
Anna Dixon (Shipley) (Lab)
I commend the hon. Lady for her work to ensure that the millions of unpaid carers in the UK are both valued and supported. As has already been mentioned, I commend her for successfully bringing forward her private Member’s Bill, the Carer’s Leave Act 2023. Under that Act, carers have an entitlement to a week of unpaid leave. Does she agree that further action is needed to ensure that those carers juggling work and care can continue to stay in employment, avoiding the poverty trap that she describes?
Wendy Chamberlain
I absolutely agree with the hon. Member. My party’s policy is that carer’s leave should be paid. At the moment, we are formalising a system that already worked for people in asking for time off unpaid with the employer’s agreement, and potentially not taking sickness or annual leave. They are not getting remunerated for taking that leave, and I am cognisant of that.
Going back to my evidence on food banks, the research from the sector aligns with that survey data. The Joseph Rowntree Foundation’s 2024 report on UK poverty found that 29% of carers live in poverty. More than half of the carers who responded to the Carers Trust adult carer survey in 2022 said that they are struggling to make ends meet as a result of those caring responsibilities. As the hon. Member just said, one of the main reasons for unpaid carers being in poverty is that it is difficult to stay in work as a carer, especially full-time work.
Carla Lockhart (Upper Bann) (DUP)
I commend the hon. Member for securing this excellent debate. Across the United Kingdom, some 60% of carers are women, with many having to give up employment, reduce their hours or take a less qualified job. Does she agree that needs to be a top priority when the Government are looking at this issue?
Wendy Chamberlain
Yes, I absolutely agree. When we think about pension inequality, we know that women are more likely to be caring and so are unlikely to be able to build up a full pension entitlement, which compounds the poverty that the hon. Member describes.
A 2019 Carers UK report on the difficulties of juggling unpaid care with employment found that around 600 people a day are giving up work. A snapshot from the family resources survey I referred to earlier showed that 22% of adult informal carers were retired and 25% were economically inactive. I am proud to acknowledge that since then we have hopefully seen some improvement in the ability of carers to balance work and caring, having passed my Carer’s Leave Act in 2023, giving employment rights for the very first time to unpaid carers. However, I know from the work that I have done that that is not enough.
One of the reasons for this debate is because there is a Minister in the Department responsible for unpaid carers. The DWP sees the impact of families living in poverty. The Treasury is in charge of the overall picture, but the Department for Business and Trade has responsibility for employment practices. I want to highlight the need, which the Government previously recognised, for cross-Government working on supporting unpaid carers. The one thing that the DWP is responsible for that could help unpaid carers—I would be grateful if the Minister took this away—is carer’s leave. As the Minister knows, I could give a whole speech on how that benefit needs reforming, which would help rather than hinder unpaid carers, but I accept that is not his remit.
Sorcha Eastwood (Lagan Valley) (Alliance)
I appreciate the hon. Member bringing this matter to the House. We can see clearly from the cross-party representation in the Chamber that it matters to everybody. Many in those roles are actually young people. Whenever we are talking about employment rights and workers’ rights, it is important that we remember young people, and particularly young carers, who may be care-experienced on top of that. Does she have an opinion on that?
Wendy Chamberlain
I am grateful to the hon. Member. I will be saying a bit about young carers, but carer’s allowance, which I am talking about at the moment, does need reform. My understanding, from speaking to colleagues, is that young people undertaking T-levels are potentially losing out on carer’s allowance because of the number of hours they are required to do. I am sure that that oversight needs to be corrected.
When unpaid carers are told that they can work only 13 hours a week at the national minimum wage—the number of hours keeps going down because of how the calculations are made—without losing their benefits, when they are left struggling because carer’s allowance provides the lowest level of benefits of its kind, and when systems are set up so that unpaid carers find themselves thousands of pounds in debt from inadvertent overpayments, that inevitably has an impact on their own health and ability to provide care to their loved ones.
The resilience of our ageing population is also very much in the remit of the Department of Health and Social Care. We know that pensioner poverty is deeply linked to health outcomes and the demand for NHS services during the cold winter months. We also know that providing care during someone’s working years means missing out on vital opportunities to save for retirement, leading to a much higher prevalence of poverty among unpaid carers.
I appreciate that the Minister can control pensions, but I want to mention another thing outwith his remit: education. Being a young carer is more uncommon than being an adult carer, but the impact over that person’s whole life is so much greater, as my hon. Friend the Member for Harrogate and Knaresborough (Tom Gordon) said.
Richard Foord (Honiton and Sidmouth) (LD)
Does my hon. Friend agree that one other Department that might be quite interested in a cross-Government strategy is the Treasury? My constituent Amanda had a civil penalty applied on the basis that she misrepresented her earnings, which has made her frightened to go back to work or to work more hours. Does my hon. Friend agree that it is damaging to the economy if we have people not going out to work?
Wendy Chamberlain
I agree with my hon. Friend. If the Government’s aim is to grow the economy, they must, in addition to other measures, be targeting those people who are economically inactive not because they cannot work as a result of their skills, knowledge or capacity, but because their caring responsibilities prevent them from doing so.
I am conscious of your direction, Madam Deputy Speaker, so if the House allows I intend not to take any further interventions. Otherwise, I will not get through the remarks that I want to make.
I want to mention Fife Young Carers, which supports 207 young people in North East Fife, and about 1,300 overall across Fife. Some of those carers are as young as five years old. Caring for a loved one as a child has a significant impact on their education. In the last Parliament, the all-party parliamentary group on young carers and young adult carers carried out an inquiry that found that young carers are missing on average 27 days of school each year and are 38% less likely to go to university than their peers. We know that how children do in school has a vital long-term impact on their future employment—indeed, the Education Secretary was talking about that the other day—and just about everything in their future. The position of young carers gives us a clear example of how the lack of an overarching strategy fails unpaid carers.
Earlier this year, I wanted to question the then Government over the exclusion of young carers from carer’s allowance, building on a question asked by the hon. Member for Slough (Mr Dhesi). The reason that the DWP gave me was that supposedly young carers in education can rely on educational grants for support. I therefore asked the Department for Education about support for young carers. It turns out that there is no specific support for them because they are not considered to be part of a vulnerable group. It means that the DWP can abandon financial support of young carers to the Department for Education, which seems to think that young carers can rely on their parents for income. That shows what happens and how support for arguably an incredibly vulnerable group can get lost without overall leadership.
Yet more Government Departments have a role in the health and wellbeing of unpaid carers. According to Carers UK’s 2023 state of caring report, 50% of unpaid carers are lonely and 58% of carers had to cut down on their hobbies and leisure activities. Caring for a loved one should not mean being isolated from your own support networks or having to give up the things that bring meaning and joy, but clearly it does for many, either because they cannot find the time in the day for themselves between work—if they can stay in it—and caring, or because often they simply cannot afford to participate any more. This is the moment for the Ministry of Housing, Communities and Local Government to get involved, with its overarching responsibility for leisure and the services provided at local level. I am talking about respite breaks, which the hon. Member for Strangford (Jim Shannon) mentioned, support services, and access to local leisure facilities. A cross-Government strategy could also engage the Scotland, Wales and Northern Ireland Offices, and ensure that similar priorities are discussed in intergovernmental meetings with the devolved nations.
There are many root causes and solutions to the problems faced by unpaid carers, and they span all Government Departments. The Minister is here as the Minister for Care, but I hope that he is also aware of the impact of all the cross-Government issues that I have set out on the health of unpaid carers. I am sure that he has learned much in recent weeks. Last year’s “State of Caring” report on health found that 82% of unpaid carers said that the impact of caring on their physical and mental health would be a challenge. It found a significant impact on mental health, with 79% saying that they were stressed or anxious and 49% saying that they were depressed. It is therefore no surprise that research carried out by Dr O’Dwyer at the University of Birmingham has found that unpaid carers are a group at high risk of suicide. That is particularly true for parent carers of children with a long-term illness or disability. Of the participants in her study, 41% of unpaid carers had thought about killing themselves.
It is clear that we need vital preventive healthcare for unpaid carers, but clearly that is not in the remit just of the Department of Health and Social Care. Again, I reiterate why we need a cross-Government strategy. I appreciate that even if a strategy were announced this evening, it would not just be in place overnight—it could not be and it should not be. Its goals need to be co-designed with unpaid carers and the organisations that represent them. It needs organisation, buy-in and leadership. For it to work and take meaningful action, it ought to be sponsored at the highest level of Government and engage all the Departments that I have mentioned. It needs ringfenced funding. It will not surprise the House that I have mentioned funding. The last strategy was supported by £255 million in funding. That may sound like a big figure when we keep being told that difficult decisions have to be made, but it is nothing compared with the economic value of unpaid care, which, as I have said, amounts to £190 billion per year.
I do not want to pre-empt the goals of the strategy—they need to be designed with unpaid carers themselves—but a first priority should be, as my hon. Friend the Member for Harrogate and Knaresborough said, the proper identification of unpaid carers. Unpaid carers may not recognise themselves as such or know what support services are available to them. Professionals and organisations play a vital role in identifying them, through GPs, hospitals, local authorities, workplaces and educational settings. A national carer’s strategy will provide leadership and strategic direction. It will put the needs of unpaid carers at the highest level of Government. Morally, practically and politically, it is the right thing for the Government to do.
I do not particularly like the title of this debate on the Order Paper. The word “potential” was inserted to keep me in line with the rules on neutrality in debate titles. It makes it sounds like the merits of the strategy are arguable, which clearly they are not. I chose to read “potential” in a different way: a national carer’s strategy has an abundance of potential to create improvements that have not yet been realised. I look forward to hearing the Minister’s remarks.
Oral Answers to Questions
Wendy Chamberlain Excerpts(4 months ago)
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Wes Streeting
I would be delighted to do that. As my hon. Friend knows, we visited Specsavers during the election campaign. There are lots of high street opticians, and they can make a real difference to cutting the backlog. The Conservatives should have gone to Specsavers, and this Government will.
Wendy Chamberlain (North East Fife) (LD)
My constituents have struggled to get pre-diagnosis ADHD and autism support for their young daughters. We cannot diagnose children at a very young age, but that does not mean that families do not need help. Can the Minister confirm what engagement he will have with support organisations such as the National Autistic Society to ensure that best practice means that families are not struggling for support?
Stephen Kinnock
I welcome the hon. Lady to her place. She raises a vital issue. We have a plan for improving mental health services, including 8,500 more mental health workers. Autism is, of course, a vital part of that, and I will be more than happy to meet her to discuss further how we might be able to take it forward.