Osteoporosis
Debate between Wera Hobhouse and Judith Cummins(1 year ago)
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Judith Cummins
My hon. Friend makes a valuable intervention. He has been a staunch advocate for those suffering from osteoporosis and has backed the Better Bones campaign, for which I am very grateful. I agree that this issue is all about ensuring equity in access to NHS services, including FLS.
Wera Hobhouse (Bath) (LD)
I am lucky enough to represent a constituency with a fracture liaison service, which can identify 91% of fragility fractures, but other constituencies are not so lucky. Does the hon. Lady agree that a modest transformation fund would make such a big difference?
Judith Cummins
I welcome that intervention and I absolutely agree. The whole tone of the campaign and my speech will address those very issues, because it is so important that we recognise that prevention is key to tackling osteoporosis. We cannot prevent the condition unless we ensure first that people are diagnosed. Osteoporosis receives too little attention, given the scale of numbers affected by the condition: half of all women and one in five men over 50.
Reforms to NHS Dentistry
Debate between Wera Hobhouse and Judith Cummins(1 year, 6 months ago)
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Judith Cummins
My hon. Friend makes an important point. I will specifically cover access to NHS dentistry for children later in my remarks.
On the Government’s plan for a plan, experience suggests that positive change for my constituents may well be wishful thinking. My constituents are suffering and take no solace whatever from the Government’s commitment to plan for a plan for reform. The contract has been in place since 2006, and the Government have been undertaking a review of the process since 2011. After 12 years, it is still a work in progress.
Wera Hobhouse (Bath) (LD)
The British Dental Association has shown that over half of dentists have reduced their NHS work since the start of the pandemic. Official workforce data counts people, not how much NHS work they do compared with private work. Does she agree that it is important that the Government collect that data?
Judith Cummins
I absolutely agree with the hon. Member’s important remarks. Collection of data is paramount for solving the issue.
The dodging of responsibility for more than 12 years is nothing short of a disgrace. Now, we all bear witness to the human consequences of this crisis. The victims of Government negligence are—as they almost always have been—the most vulnerable people in our society. In Bradford, 98% of dentists are now closed to NHS patients. As I informed the Prime Minister just last month, 80% of practices are now refusing to accept children as new NHS patients.
The lack of access is having crushing consequences. In the financial year of 2021-22, 42,000 NHS hospital tooth extractions were carried out for 0 to 19-year-olds—an 83% rise on the previous financial year. A dental nurse has recently spoken of routinely extracting up to 10 teeth from a single child, so children are routinely losing half their teeth. This dental crisis is now ultimately a crisis of inequality. The rate of tooth extraction is more than three times higher in Yorkshire and the Humber than in the south-east of England. Children living in our country’s most deprived communities face an extraction rate three and a half times greater than those living in the most affluent areas.
In care homes for the elderly, the access crisis has been just as devastating. In 2019, 6% of care homes reported that they were unable to access NHS dental care services, but by 2022, that figure had risen more than four times to 25%—a quarter of all care homes.
As this Conservative Government continue to mull over minor reforms, they fail entire generations of people, who deserve a reasonable standard of care. No more are the cradle-to-grave principles of the NHS.
A 21st-century Britain requires a 21st-century approach. We need more than mere revision of the contract. My right hon. and learned Friend the Leader of the Opposition has spoken of the need for a new healthcare system that is just as much about prevention as about cure. It is a concrete fact that no dental treatment is stronger than protecting a healthy and original tooth, but in 2021-22 tooth decay was again the most common reason for hospital admission of children between six and 10 years old. For zero to 19-year-olds, hospital tooth extractions cost our NHS a shocking £81 million a year. In 2022, instead of children visiting the dentist on a regular basis, it cost our NHS an average of more than £700 for a single minor extraction of a child’s tooth in hospital.
We are paying for the cost of catch-up with our failure to prevent tooth decay, so prevention should be at the heart of our Government’s agenda for dental reform. We owe that to the generations of people currently being let down by the system. This country once had a strong school dental service. With the current shocking rates of tooth decay among children, now is the time to resurrect that policy as an interim prevention measure. It is not only the right thing to do but a sensible option for the country’s finances. Care homes would benefit from a dental contract that commissions stronger community dental services, as used to happen.
By using integrated care systems, upskilling care workers, and further involving local authorities, access can be increased and the pressure on dental services reduced. Prevention really is better than cure. We have a duty to ensure that taxpayers’ money is spent effectively in areas right across the country. A decade of savage cuts by the Tory Government has left long-term damage. An estimated £880 million a year is now required just to restore to 2010 levels of resources. There will be no escaping the need for more investment, but it must be thoughtful investment. One answer could be the introduction of a prevention-focused capitation-type system, where lump sums are provided to NHS dental teams to treat sections of the population.
Successful targeted investment is possible, and in 2017 I developed a project in Bradford with the former Health Minister, the hon. Member for Winchester (Steve Brine). I thank the hon. Member, who is now the Chair of the Health and Social Care Committee and who is present in the Chamber. He worked with me on the pilot scheme, which invested over £250,000 of unused clawback over three years into my constituency of Bradford South. That went straight back into local services and ensured that patients were able to access roughly 3,000 new NHS dental appointments in an area with high dental deprivation—targeting extra resources straight into an area where they were needed.
Although that was never meant to be a long-term solution, it proved that targeted investment is possible. Where there is a will, there is a way. With a staggering 10% of this year’s £3 billion national budget for NHS dentistry set to be returned, the system is clearly broken. Taxpayers’ money is returned not because people are not desperate for NHS dentists, but because the Government continue to push an underfunded and unworkable system. They lack the will to act and to find a way forward to protect dental health in this country. Now is the time to put “national” back into NHS dentistry.
The Government may once again list the challenges that stand in the way of re-establishing a truly universal dental care system. We are in a time of extraordinary change, with unprecedented cost of living crises, war on the European continent, and a society impacted by a deadly virus. Our health system is undoubtedly challenged, but 80 years ago the Conservative-Labour coalition Government published a guiding principle of NHS dental reform, just as this country fought for its very freedom and independence. In Sir William Beveridge’s own words:
“A revolutionary moment in the world’s history is a time for revolutions, not for patching.”
It is time for real change, not empty promises. This is the time for a Government dedicated to acting in the public good, to revitalise and resurrect NHS dentistry once again, ending the shoddy record of this Government’s patching of our NHS dental services.
Planning
Debate between Wera Hobhouse and Judith Cummins(3 years, 4 months ago)
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Judith Cummins (in the Chair)
Please sit down. That is not a point of order.
Christopher Pincher
I am grateful, Mrs Cummins, for that ruling. I am conscious that I probably have only about six minutes left in which to conclude my remarks, to allow my hon. Friend the Member for Isle of Wight time to sum up the debate.
A number of Members have raised the issue of infrastructure. We all know that when we build homes, those homes need the requisite infrastructure to support them: the GP clinics, the parks, the schools, the roads and the roundabouts. We want to make sure that we have a system that provides those things when they are needed and not way down the line. We do not believe that the present system—a mixture of section 106 agreements and community infrastructure levy payments—meets that requirement.
Indeed, 80% of local authorities tell us that section 106 does not work for them. It is loaded in favour of developers, especially the bigger guns, and often means that infrastructure comes late or not at all. If it does appear to be coming, it is often negotiated away in a manner that local authorities and local communities do not want. That is why we have proposed an infrastructure levy, which will provide up front the infrastructure that local communities want and need. We will make sure that, in doing so, we deliver just as much affordable housing as is delivered in the present system.
My hon. Friend the Member for North Devon (Selaine Saxby) made the very important point about the challenge that some rural communities face. I am open to considering ways in which we can help local people to remain living close to where they come from or where they work. One of the initiatives that we have announced is the first homes initiative, paid for through developer contributions, which will ensure that local people will be able to buy, at a discount of at least 30%, a home in their local community. Those homes will be covenanted, in perpetuity, to ensure that when or if they are sold on, the buyers, who will be local people—they could be key workers—will also buy at 30% at least below the then local market rate. However, I am open to hearing from colleagues about what other opportunities there may be to encourage local people to stay close to their communities.
My hon. Friend the Member for Isle of Wight also raised the issue of neighbourhood plans. I am very keen that we build, and bake, neighbourhood plans into the new planning system. They can be very effective and engaging. The trouble is that there are fewer of them the further north—or further into urban areas—we go, so in our planning reforms we are looking at ways to ensure that more neighbourhood plans are produced across the country so that additional housing is identified, with good designs and local infrastructure, to support those communities.
My hon. Friend also mentioned the importance of recycling. We have already made it very clear—in our national planning policy statements, and in the national planning policy framework—that brownfield ought to come first. We have backed that up with fiscal spending to ensure that we are paying for remediation in and around our country. Some £400 million was made available last year for the remediation of brownfield sites in mayoral combined authorities, with a further £100 million made available by the Chancellor in the latest Budget. We are determined to put brownfield first.
In our permitted development rights reforms—I know some colleagues are not so very keen on those—we also encourage the development of redundant sites, or shops that are no longer viable, in towns and city centres. That means we are building homes in the places where people need them, which takes the weight off the transport infrastructure as they are close to GP clinics and other services that people want and need. We are addressing that issue of recycling, too.
In the short time that I have left, I will speak about build-out. The shadow Minister, the hon. Member for Brentford and Isleworth (Ruth Cadbury), talked about a ten-minute rule Bill. I would suggest that it is a “ten-minute thought” Bill, because we do not really know from their proposals how the Opposition would deal with issues like gaming or whether they would help and support small and medium-sized enterprises, rather than making the system more difficult for them. We do not know whether they are proposing that the timetable system should relate to the permissions granted or the building commencement date.
However, we are keen to ensure that we find sensible mechanisms to encourage the build-out of permissions where they exist. We have heard what people have said, both across this Chamber and in response to the consultation, and we are determined to ensure that, where appropriate, permissions are built out rapidly.
Wera Hobhouse
On a point of order, Mrs Cummins. I want to put on the record the fact that the Minister gave this Chamber incorrect information. Bath and North East Somerset Council has a fully updated local plan in place. It is going through a partial revision and is halfway through the terms of its current plan. But while the partial revision is taking place, the local plan is fully updated.
Judith Cummins (in the Chair)
The Minister is here and your point of order is now on the record.