NHS

Debate between Wes Streeting and Victoria Atkins

Thursday 23rd May 2024 Commons Chamber

[Wes Streeting (Ilford North) (Lab)]

Let me start with a few points of genuine consensus. First, I associate myself and my party wholeheartedly with the right hon. Lady’s remarks about the hon. Member for South Thanet (Craig Mackinlay) and the extraordinary courage and strength he has shown. I greatly welcome her reassurance to victims of the contaminated blood scandal and the emphasis she placed on the cross-party commitment to continue at pace to deliver justice, whatever the outcome of the general election. I also welcome what she said about the justifiably cautious and responsible approach she is taking in relation to puberty blockers in the light of the Cass review.

That is the end of the consensus, however, because after 14 years of Conservative incompetence, neglect and vandalism, the national health service has never been in a worse state. The Government cut 2,000 GPs and now it is impossible to get an appointment. They wasted billions of pounds on top-down reorganisations, recruitment agencies and crony contracts for useless personal protective equipment instead of training the workforce the NHS needs. They forced nurses out on strike for the first time in history; and now the Prime Minister shamelessly tries to blame them for his own failures, sending the country into an election with strike action still looming. He promised to cut waiting lists; they are up to 7.5 million. Even their claim that waiting lists have fallen in the last six months has been achieved only by excluding the community figures—fiddling the figures. He promised to build 40 new hospitals and the Government have failed to build a single one. They hold people in this country in such contempt: the Conservatives think the public are so stupid that they will fall for the same recycled soggy promise all over again. Vast swathes of the country have been left without a single NHS dentist, forcing people in Britain, in 2024, to perform DIY dentistry on themselves.

After 14 years, the fundamental promise of the NHS has been broken: people can no longer be sure the NHS will be there for them when they need it. Listening to the Prime Minister’s interviews this morning, it is clear he has given up on the NHS. He has called this election with no plan to cut waiting lists, no plan to end the strikes, and no plan to reform the service. The Conservatives have taken the NHS to breaking point; if they are given five more years, they will finish the job.

This election is the country’s chance to turn the page on 14 years of failure, to end the chaos in the NHS and to rebuild our NHS. No part of our country is crying out louder for change than our health service—not just investment but reform, because if the NHS is to be there for us free at the point of use for the next 75 years, as it has been in the last, it must change. Only Labour can deliver that change.

Our damp squib of a Prime Minister is dripping into this election with a puddle not a plan. In contrast, Labour has a plan to get our NHS back on its feet and make it fit for the future. [Interruption.] Conservative Members ask what it is: give the people what they want—40,000 extra appointments a week at evenings and weekends to cut waiting lists; double the number of scanners, with AI-enabled scanners diagnosing patients faster; 700,000 emergency dental appointments and reform of the contract to rescue NHS dentistry; double medical school places and train thousands more nurses, GPs and midwives, delivering Labour’s workforce plan; bring back the family doctor so patients can see the same GP for each appointment; 8,500 mental health professionals to treat people on time, with mental health support in every school and hubs in every community, alongside landmark reform of the Mental Health Act 1983. That is Labour’s plan, and that is just the start. More than that, unlike the Conservatives, we have a record on the NHS to be proud of: a record of the shortest waiting lists and the highest patient satisfaction in history. We did it before, and we will do it again. That is why representatives of the nationalist parties in Wales and Scotland know, and even admit in private, that a Labour Government in Westminster will be a rising tide that lifts all ships across our United Kingdom.

I say to people that it is not enough to send MPs to Westminster to oppose the Conservatives; they need to send Labour MPs to replace the Conservatives. If they are given five more years, nothing will change. The chaos will continue, and the NHS crisis will get worse. As we approach this general election, be in no doubt: the only way to deliver the change our country needs is to vote Labour. I have every hope that our country will do just that.

[Victoria Atkins]

I know that the hon. Gentleman has spent a lot of time in recent days studying that infamous pledge card. It has obviously taken up a lot of space in his brain, because he seems not to have understood that not only did we settle months ago with the consultants, so they are not on strike, but we have arrived at a settlement with the specialty and specialist doctors, which is going out to ballot. He asked about junior doctors, and he has obviously missed the news that we have just entered mediation with them. We are bringing together, with the workforce plan, the progress we are making on working conditions. The Labour party does not like conversations about mediation—no, no, no —because we all know that Labour MPs are beholden to their trade union masters and have never condemned a single strike that has affected our constituents and their access to healthcare.

The hon. Gentleman asks about the new hospital programme, and I was wondering whether he would. It is, as some might say in politics, bold. I have taken the trouble—it was a lot of trouble—to read the Labour party’s health mission. One of its pledges is that one of the first steps of a Labour Government would be to pause all capital projects in the NHS. Our constituents should be clear: the Conservatives have a new hospital programme, which we are delivering; the Labour party has a no new hospital programme.

The hon. Gentleman also talked about the ideas for the NHS—ones he could not quite remember over the weekend—and the number of appointments that Labour would bring. I think it was appointments, because when he was asked to clarify whether he meant appointment or treatments, he could not define it. I hate to break it to him, but there is a difference between an appointment and, for example, a triple heart bypass. I would love to know whether he is talking about appointments or treatments. Just to help him understand the scale of NHS England’s activities on a weekly basis, it provides 575,000 out-patient appointments a week. His pledge sounds like a big number, but the truth is that it will not even touch the sides, even when Labour has worked out where the sides are.

The hon. Gentleman also bravely talks about the Cass review, and I genuinely welcome the fact that he has thrown away his long-held principles and relied on the evidence that Dr Cass provided, but I wonder whether he ought to have a conversation with his fellow shadow Cabinet members, because they announced a policy this week that is self-identification by the back door. They want to put the responsibility for self-identification and the gender recognition certificate process on the shoulders of our GPs, when we have been clear that we want our GPs focusing on the 60 million more appointments they are making in the past year. He does not understand—[Interruption.] Forgive me, he is chuntering at me, and he needs to go away and read the Gender Recognition Act 2004, because it is a panel that looks after that process, and Labour is seeking to change that to make it a single GP.

The hon. Gentleman talks about the record of the Conservative party, and we are proud of it. I am particularly proud of the fact that we have record funding under the Government for mental and physical health. I wonder whether he is quite so proud of the record in Wales. By the way, Labour runs the NHS in Wales; I wish I had responsibility for Wales, but I only have responsibility for England.

[Wes Streeting]

How is that going?

[Victoria Atkins]

It is going better than it is in Wales. Under the Labour-run NHS in Wales, a quarter of people are on a waiting list in that part of the NHS. The number of patients waiting two years is higher in Wales than it is in England. Patients are waiting on average six weeks longer in Labour-run Wales than in England. If that performance were replicated here in England, waiting lists could be as much as six million higher. The choice is clear: unfunded Labour failure or a clear plan for a more secure future with the Conservatives.

Oral Answers to Questions

Debate between Wes Streeting and Victoria Atkins

Tuesday 23rd April 2024 Commons Chamber

[Wes Streeting (Ilford North) (Lab)]

The Health Secretary has promised that the Government will provide an extra 2.5 million dental appointments this year, but the dentistry Minister, the right hon. Member for South Northamptonshire (Dame Andrea Leadsom), says the figure has

“a high likelihood of not being reliable”.

Which one of them is wrong?

[Victoria Atkins]

I am delighted to be able to tell the hon. Gentleman that we have modelled down the ambitions, so the figure we initially provided was higher than 2.5 million appointments. That is because we are focused on delivering the dental recovery plan, rather than overpromising.

The hon. Gentleman finds it easy to call our children short and fat, but he shies away from welfare reform, calling it shameless and irresponsible. He says he is ready to stand up to middle-class lefties, but Labour has never put patients first by condemning the unions that strike. He makes glossy promises about reforming the NHS in England, yet Labour has failed completely—

[Mr Speaker]

Order. I gently say that we need to get a lot of Back Benchers in, and I am sure both sides want to do that.

[Wes Streeting]

The last Labour Government delivered the shortest waiting times and the highest patient satisfaction in history, which is a record that the right hon. Lady’s Government cannot begin to touch.

Back to dentistry, the chief dental officer says the announcement is “nowhere near enough.” The British Dental Association says:

“This ‘Recovery Plan’ is not worthy of the title.”

It also says that the recovery plan will not stop the “exodus” of dentists and will not meet the Government’s targets. Who should the public trust, and why should they trust the Health Secretary to deliver when her own adviser, her own Minister and, crucially, dentists all say that she is brushing the truth under the carpet?

[Victoria Atkins]

Again, let us bring ourselves back up to date. I know the Labour party likes looking back to the last time it found favour with the British public, but Wales is the up-to-date record of today. Labour’s lamentable record of running the NHS in Wales speaks for itself. If the hon. Gentleman is so set on reform, why on earth is he not helping his Labour colleagues in Wales to do exactly as he is promising? It is because they are empty promises, and because the hon. Gentleman and, I am afraid, the Labour party will step back from reform rather than grappling with the issues, as we are doing with our recovery plan.

Finally, on the dental recovery plan, within a month of the new patient premium being switched on, hundreds of surgeries have opened to new patients, which means that patients in the hon. Gentleman’s constituency and elsewhere are getting the care they need.

Tobacco and Vapes Bill

Debate between Wes Streeting and Victoria Atkins

2nd reading
Tuesday 16th April 2024 Commons Chamber

[Wes Streeting]

I do not know whether there is a problem with the speaker system in here, because this is the second time I have had an intervention after answering the question. I have already said that the Government have consulted on measures to clamp down, and I am absolutely not against the Government talking to people who, like the hon. Lady, have used vaping as a smoking cessation tool. In fact, I fully support the point she is making, which is that vaping can be a really effective tool to help smokers to quit smoking. I am in favour of that; that is good for health. If the Government want to talk to and engage with people who vape as part of the passage of this Bill, that is absolutely fine. What I am not in favour of is tying the Secretary of State’s hands when she wants to do more, and more quickly, to prevent children becoming addicted to nicotine.

[Victoria Atkins]

Just to be clear, we will consult on this. It is a simple question that requires a simple answer: will Labour consult further?

[Wes Streeting]

Mr Deputy Speaker, we are now in this parallel universe where the Secretary of State is asking me, the shadow Secretary of State, whether I am going to consult on her Bill. Now, I am willing to help her out, but if she wants me to sit on that side of the Chamber and run the Department of Health and Social Care, I am ready and willing, but we need a general election to do that. I do not understand—this is just extraordinary. I feel like I am living in a parallel universe this afternoon. It was bad enough when the former Prime Minister, the right hon. Member for South West Norfolk, walked in with her book and her fan club, and now we have the absurd spectacle of the Secretary of State asking me whether I will run the consultation on her Bill. This is extraordinary. I will allow her to correct the record and save her blushes.

[Victoria Atkins]

The hon. Gentleman is not listening. He has been asked repeatedly whether he supports the concept of a consultation on vaping in order to ensure that these regulations are drawn up properly. He is not listening. He refuses to answer the question. We on this side of the House are clear: we want to get this right and we will consult. I am simply asking whether he will answer the questions that he has been asked.

[Wes Streeting]

Honestly, Mr Deputy Speaker, you just can’t help some people. I am trying to help the Secretary of State out and defend her against her own side, and now, to curry favour with them, she has turned on me. Now I know what it is like being in the Conservative party. This is like a 1922 committee meeting—absolutely absurd.

For the final time, let me just explain the situation we find ourselves in today. The Secretary of State is currently in government. This is her Bill. She is taking it through Parliament. She is perfectly able to run a consultation. I will support her in running a consultation, if that is the support she needs. [Interruption.] I am so pleased. If only I had known it was that easy. If all she needed was a bit of moral support from me to run the consultation, then you go, comrade—don’t you worry; I have got your back, and it is absolutely fine.

I am trying to be helpful to the Secretary of State this afternoon, but I just have to say to her that I am not sure that the best way to persuade her colleagues was to invoke the great cigar chomper, Winston Churchill. Some have estimated that Churchill went through 160,000 cigars in his time. Indeed, on one occasion, at a lunch with the then King of Saudi Arabia, Churchill was told that no smoking or drinking would be permitted in the royal presence. He responded:

“If it was the religion of His Majesty to deprive himself of smoking and alcohol, I must point out that my rule of life prescribed as an absolutely sacred rite smoking cigars and also the drinking of alcohol before, after and, if need be, during all meals and in the intervals between them.”

I appreciate the Health Secretary’s efforts, but I fear that Lord Soames was probably on to something when he said that his grandfather certainly would not have approved of this Bill.

Just before any Conservative Members decide to wage yet another culture war and accuse me of talking down one of Britain’s greatest Prime Ministers, I would just add to the historical record that it was thanks to the Labour party that it was Winston Churchill, not Lord Halifax, who became the leader of our country at a crucial time, and thank goodness that he did. Nevertheless, I do commend the Secretary of State on a good effort—she was close, but no cigar. Anyway, let us go back to the economic arguments of the Bill.

Cass Review

Debate between Wes Streeting and Victoria Atkins

Monday 15th April 2024 Commons Chamber

[Wes Streeting (Ilford North) (Lab)]

I thank the Secretary of State for advance sight of her statement and, even more importantly, Dr Hilary Cass and her team for the thoughtful and thorough way in which they have undertaken their work. Dr Cass has navigated the complexities and sensitivities of the subject with academic rigour, providing an evidence-led framework for children to receive the best possible healthcare. I also pay tribute to journalists such as Hannah Barnes and the whistleblowers who together helped to shine a light on what was going on at the Tavistock clinic.

At the heart of the complexity around this issue are two things that are true simultaneously. There are trans adults in this country who have followed a medical pathway and who say that, for all the pain and difficulty that involved, it was not just life-affirming; it was lifesaving. There are also people in this country who followed a medical pathway but who say it was a disaster that ruined their lives irreversibly, and they ask how anyone could have let that happen. For the sake of all those children, young people and now adults—but particularly those being referred into gender identity services today—we have a duty to get this right.

What has emerged in the Cass review is a scandal. It is a scandal that children and young people are waiting far too long—often years—for care while their wellbeing deteriorates and their childhood slips away. It is scandalous that medical interventions have been made on the basis of shaky evidence. It is scandalous that, despite all that, some NHS providers refused to co-operate with Dr Cass’s review. Perhaps the worst scandal of all is that the toxicity of this discussion means that people have felt silenced, and it required investigative journalism to prompt the review to take place. This particularly vulnerable group of children and young people are at the wrong end of all the statistics for mental ill health, suicide and self-harm. There is no doubt that they have been very badly let down, so we owe it to them to approach this discussion with the same care and sensitivity with which Dr Cass undertook her review.

Parts of the report will sound familiar to anyone acquainted with the NHS today. Children and young people face unacceptably long waiting lists and are unable to get the mental health support and assessments they require, and services face significant staff shortages, with a lack of workforce planning driving all of that. As with so many parts of the NHS today, the report paints a picture of a service unable to cope with demand. Dr Cass is clear that care must be personal and holistic. Will the Secretary of State set out how she plans to cut waiting times for assessments for mental health and neurodevelopmental conditions?

Waiting lists are so bad in some cases that children are passing into adulthood before they have had their first appointment with gender identity services, leaving them facing a cliff edge. Cass recommends follow-through services up to the age of 25 to ensure continuity of care. Will the Secretary of State indicate how long she thinks it will take to establish those services?

Labour welcomed the decision by NHS England last month to stop the routine prescription of puberty blockers to under-18s. The loophole that exists for private providers risks sparking a black market. The Secretary of State has said that she expects private clinics to follow the report’s recommendations to follow the evidence. I underline our support for her expectations on compliance. Can she give an indication of whether she thinks that further regulation may be needed to ensure adequate enforcement of the recommendations?

The refusal of adult gender services to share data on the long-term experience of patients is inexcusable—as the Secretary of State said, it is deplorable. The data does not belong to them; it belongs to the NHS and, crucially, to patients. I welcome their coming forward now, but how was this allowed to happen, and what accountability does she think would be appropriate?

This report must provide a watershed moment for the NHS’s gender identity services. Children’s healthcare should always be led by evidence and be in the best interests of children’s welfare. Dr Cass’s report has provided the basis on which to go forward. The report must also provide a watershed moment for the way in which our society and our politics discuss this issue. There are children, young people and adults—including trans children, young people and adults—in this country who are desperately worried and frightened by the toxicity of this debate. There are healthcare professionals who are scared to do their job and make their views known. Dr Cass said that

“toxic, ideological and polarised public debate has made the work of the Review significantly harder”

and it will hamper the research that is essential to finding a way forward.

Even in a general election year, there is surely one issue on which we can down tools and work together: the pursuit of the healthcare of vulnerable people. I pay tribute to the right hon. Member for Bromsgrove (Sir Sajid Javid). We had many scraps across the Dispatch Box, but for his role in commissioning this review he deserves our thanks and respect. I hope to work constructively with the Health Secretary to put children’s health and wellbeing above the political fray.

[Victoria Atkins]

I welcome all those who have changed their minds about this critical issue. In order to move forward and get on with the vital work that Dr Cass recommends, we need more people to face up to the truth, no matter how uncomfortable that makes them feel. I hope the hon. Gentleman has the humility to understand that the ideology that he and his colleagues espoused was part of the problem. He talked about the culture and the toxicity of the debate. Does he understand the hurt that he caused to people when he told them to “just get over it”? Does he know that when he and his friends on the left spent the last decade crying, “Culture wars,” when legitimate concerns were raised created an atmosphere of intimidation, with the impact on the workforce that he rightly described? People were scared or worried to go into it.

Does the hon. Gentleman now have the good grace to apologise to those who have been maligned in public life—including his own female colleagues—and for the chilling effect that this has had on clinicians, journalists and campaigners who were trying to raise the alarm? I say that because I want to believe the hon. Gentleman when he says that he has turned a corner on this issue. We have to start with a new page, for the sake not just of the children and young people we are looking after but of their families, many of whom will be watching this, living with the consequences of the ideology and secrecy, wondering how on earth the hon. Gentleman talks about general elections when, every single minute and day, their children have to live with treatment that can never be reversed.

Oral Answers to Questions

Debate between Wes Streeting and Victoria Atkins

Tuesday 5th March 2024 Commons Chamber

[Wes Streeting (Ilford North) (Lab)]

The simple fact is that the Conservatives have been in power for 14 years, and general practice has never been in a worse state. Despite slogging their guts out, GPs are struggling because this Government have cut 2,000 GPs since 2015, making it even harder for patients to get an appointment. Given that, why has the Government decided that the NHS needs what the Institute for Fiscal Studies has described as the biggest funding cut since the 1970s?

[Victoria Atkins]

It has been a very long time since Labour were in government, but even the hon. Gentleman knows that Ministers will never comment on fiscal events the day before they occur. Let me introduce some facts into his analysis. We have now delivered on our manifesto commitment for 50 million more general practice appointments per year, with 363.8 million booked in the last 12 months. That compares with 312 million deliveredin the 12 months to December 2019. [Interruption.] If the hon. Gentleman stopped shouting, perhaps he would be able to hear me. About 62,000 more appointments were delivered per working day last December, excluding covid vaccinations. We have our primary care recovery plan, and it is working. Of course there is more to do, but even the hon. Gentleman would not be so churlish as to deny those extra 50 million appointments.

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[Wes Streeting (Ilford North) (Lab)]

With a general election in the air, I welcome what the Secretary of State has said about baby loss certificates and Martha’s rule—there is genuine cross-party agreement on this. I also thank her for advance notice of today’s important written ministerial statement.

However, with a general election in the air and given the Secretary of State’s principled, vocal and consistent opposition to funding the NHS by abolishing the non-dom tax status, on a scale of one to 10—one being utterly shameless and 10 being highly embarrassed—how red-faced will she be when the Chancellor adopts Labour’s policy tomorrow?

[Victoria Atkins]

One of the joys of being at the Government Dispatch Box is that not only do we have to deal with very serious matters, such as I have just set out, but we get to have a knockabout on the Labour party’s electioneering. The hon. Gentleman will know the Conservatives’ proud record on funding our NHS since 2010. I invite him to wait for tomorrow’s Budget to see what more this Conservative Government are doing to support our constituents, and to help our economy grow for a bright future.

[Wes Streeting]

The Under-Secretary of State for Health and Social Care, the hon. Member for Lewes (Maria Caulfield), has said that the policy will be

“as much use as an ashtray on a motorbike.”—[Official Report, 28 February 2023; Vol. 728, c. 710.]

As she speeds down the A23 back to Lewes, to defend her constituency against the Liberal Democrats, how on earth will she feel with all those embers of the Conservatives’ 14-year record blowing in her face?

Is it not now clear that, with the Government having adopted Labour’s workforce plan, Labour’s dentistry recruitment plan and now Labour’s NHS funding plan, when it comes to a record to be proud of, and when it comes to finding the answers, only Labour can deliver an NHS that is fit for the future?

[Victoria Atkins]

The Leader of the Opposition is a former barrister, and barristers like to rely on evidence, so let me give some evidence on what the Labour-run NHS in Wales looks like. People are almost twice as likely to be waiting for treatment under the Labour-run Welsh NHS—21.3% of people in Wales are waiting for hospital treatment after a consultant referral, compared with 12.8% in England. Patients in Labour-run Wales are, on average, waiting five weeks longer for NHS treatment than patients in England, and the number of patients in Wales who are escaping to seek treatment in England has increased by 40% in two years. But don’t worry, folks, according to the Leader of the Opposition this is the blueprint—

NHS Dentistry: Recovery and Reform

Debate between Wes Streeting and Victoria Atkins

Wednesday 7th February 2024 Commons Chamber

[Wes Streeting]

Don’t worry, Mr Speaker: I will come back to the Parliamentary Private Secretary shortly. Tooth decay is the No.1 reason for children aged six to 10 being admitted to hospital. Unbelievably, there have been reports of Ukrainian refugees booking dentist appointments back home and returning for treatment, because it is easier to fly to a war-torn country than it is to see an NHS dentist in England. Well, at least one Government policy is getting flights off the ground—and it is certainly not the Government’s Rwanda scheme failure.

Let us look at the human consequences of this Conservative tragedy. Labour’s candidate in Great Yarmouth, Keir Cozens, told me about Jeanette, a young woman in her 30s who has struggled with gum and mouth problems all her life. She used to be able to get treatment; now she cannot find an NHS dentist in all of Norfolk to take her. She cannot afford to go private. It hurts to smile, it hurts to laugh, and the pain is so great that Jeanette does not go out anymore. Just this week, she resorted to trying to remove her tooth herself. That is not right for anyone of any age, but Jeanette should be in the prime of her life. Will the Secretary of State apologise to Jeanette and the millions like her for what the Conservatives have done to NHS dentistry?

After 14 years of neglect, cuts and incompetence, the Government have today announced a policy of more appointments, recruiting dentists to the areas most in need and toothbrushing for children. It sounds awfully familiar. They are adopting much of Labour’s rescue plan for dentistry. Does that not show that the Conservatives are out of ideas of their own, and are looking to Labour to fix the mess they have made? I say: next time Conservative Ministers say that Labour does not have a plan, or that Labour’s plan is not credible, don’t believe a word of it.

There are some differences between our two parties’ approaches. Labour is pledging an extra 700,000 urgent and emergency appointments, which are additional to the appointments announced today. Can the Health Secretary confirm that the Government’s plan does not provide any additional emergency support? Labour proposed supervised early-years toothbrushing, and Conservative MPs accused it of being “nanny state”. Does the Health Secretary stand by that label, or does she now support children under five being supported in brushing their teeth?

The key difference is that we recognise that our plan is a rescue plan, and that to put NHS dentistry back on its feet, immediate reform of the dental contract is needed. Without that, the Government’s plan is doomed to fail. Do not just take my word for it; the British Dental Association has said that the plan will not stop the exodus of dentists from the NHS, will not provide a dentist for every patient who needs one, and will not put an end to this crisis.

I come to the Parliamentary Private Secretary, the hon. Member for North Norfolk (Duncan Baker), and the miserable script that the Whips are spreading out on the Table. If Labour’s contract is to blame, why have the Government not reformed it in 14 years, and why are they not reforming it now? In 2010, the Conservatives promised in their election manifesto to reform the dental contract. They are bringing back not just Lord Cameron, but his broken promises. People have been desperately trying to get dental care for years, but there was nothing from the Conservative party. Now that we are in an election year, the Conservatives are trying to kick the can down the road, and are scrambling for a plan. They only discover their heart when they fear in their heart for their political futures, and the consequences have been seen: queues around the block in Bristol.

Finally, the Secretary of State is promising reform after 2025 and after the next general election. Who is she trying to kid? After 2025, the Conservatives will be gone, and if they are not, NHS dentistry will be. How many more chances do they expect? How many more broken promises will there be? We had 2010, 2015, 2017 and 2019. Their time is up, and it is time for Labour to deliver the change that this country needs.

[Victoria Atkins]

I tried to help the hon. Gentleman by giving him an advance copy of my speech yesterday, yet that was his speech. This Government are focused on delivering for patients. Perhaps I can help him understand the difference between the Opposition’s proposals and the Government’s fully funded dental recovery plan. The Opposition’s ambitions reach only as far as 700,000 more appointments. Our plan will provide more than three times that number of appointments across the country—that is 2.5 million, to help him with his maths. We are offering golden hellos to 240 dentists who will work in hard-to-reach and under-served areas; their proposals cover only 200. They have no plan for training more dentists; we set out in the long-term workforce plan last year, and again in the dental recovery plan, that we will increase training places for dentists by 40% by 2031.

Then we have the centrepiece of the Opposition’s proposals: making teachers swap their textbooks for toothbrushes—an idea that is hated by teachers and that patronises parents. We believe that most parents do a great job of looking after their children. I know that the Labour party does not agree with that; the hon. Gentleman called our children short and fat on a media round. We believe that most parents do a great job, and that is why we support pregnant mums-to-be, and support parents in family hubs and nurseries. We will not wait until reception class, by which time children have already got their teeth.

I want to dwell on the experience of anybody living under Labour in Labour-run Wales. Health services in Wales are devolved, and the Leader of the Opposition has called Wales “the blueprint” for how the Opposition will run our health system. Welsh Labour has the highest proportion of NHS dental practices not accepting new adult patients, and the joint highest proportion of those not accepting new child patients. In Wales, 93% of NHS dental practices are not accepting new adult patients. That is a higher figure than for any other nation in the UK. Some 86% of practices there are not accepting new child patients, which is the joint highest figure with Northern Ireland. Our plan is fully funded, but how will Labour pay for its plan? By using the magical money tree. The list of policies funded by the non-dom policy is as long as my arm. In 2022, it promised to fund a workforce plan. Last September, it became breakfast club meals. By October, it morphed into 2 million appointments and scanning equipment. By Christmas, it was funding a dentistry plan. It is the same old Labour: it has no plan.

NHS Dentistry

Debate between Wes Streeting and Victoria Atkins

Tuesday 9th January 2024 Commons Chamber

[Victoria Atkins]

I thank my right hon. Friend, and indeed my friend, my Lincolnshire neighbour, who knows as well as I do the pressures that we face in ensuring that our constituents receive the same quality of care that we expect across England. He was right to draw attention to the—I would argue—badly drafted contract of 2006, but he also touched on the complexity involved in finding systems that would work better.

[Wes Streeting]

rose—

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[Victoria Atkins]

I cannot wait to reach the part of my speech that will deal with the hon. Gentleman’s suggestions, but first I will allow him to intervene, because I enjoy this back and forth.

[Wes Streeting]

So do I. The Secretary of State is far more entertaining than her predecessor. Given that she is painting a picture of improvement, how does she explain the story in The Times which revealed that NHS dentistry activity is now falling in 2023-24 compared with 2022-23? Is it not the case that things are going backwards rather than forwards? How does the Secretary of State explain that, and when are we going to see her plan?

[Victoria Atkins]

I am grateful to the hon. Gentleman for raising that point, because according to the latest statistics available to me, 18.1 million adults were seen by an NHS dentist in the 24 months up to 30 June 2023. That is an increase of 10%, and what does it mean in reality? It means that over 1.7 million more adults were seen than in the previous year. I know that we are all concerned about the health of children; some 6.4 million children were seen by an NHS dentist in the 12 months up to 30 June 2023, an increase of 14%, which means, in real terms, an increase of 800,000 on the previous year.

I accept, of course, that there is more to do, and we will be setting that out in our dental recovery plan shortly, but this is not just about big numbers. [Interruption.] The hon. Gentleman asks when “shortly” will be. As he knows full well, “shortly” is a little shorter than “in due course” and a little longer than “imminently”.

We have introduced several simple and effective measures to improve the nation’s dental health. The Health and Care Act 2022 made it simpler to expand water fluoridation schemes, because raising the fluoride level to 1 mg per litre is a straightforward way to prevent tooth decay. It has proved effective in parts of England as well as Canada, the United States, Ireland and Australia, and the chief medical officer has concluded that there is “strong scientific evidence” that water fluoridation can drive down the “prevalence of tooth decay”.

--- Later in debate ---

[Victoria Atkins]

I am going to plough on, I am afraid.

Earlier, Labour Front Benchers—perhaps not understanding that they were doing so—set out the philosophical difference between our two parties on how to grow the economy. As our economy grows, we on the Conservative side of the House want to attract the best and the brightest from around the world to work in our NHS, in our tech sector, in our life sciences industry, in our movie industry—hon. Members may know that it filmed “Barbie” this year—and in many other thriving industries. Labour, however, apparently wants to shut the door by taxing such people on earnings they make outside the UK. I speak, of course, of non-domiciled tax status.

If I may correct the hon. Member for Ilford North, because I appreciate that he has not spent any time on the Front Bench, last year alone non-domiciled taxpayers paid £8 billion in UK taxes on their UK earnings. That is equivalent to more than 230,000 nurses. Labour wants to put that at risk and put the UK at a disadvantage in the highly paid, highly competitive, highly mobile international labour market. This really is yet another branch of the magic money tree that Labour has always been looking for, to which they apparently want to add £28 billion a year of taxes or increased borrowing and increased inflation.

How they want to spend this money is interesting as well, because in 2022 Labour promised that their non-domiciled taxation would fund a workforce plan. Last September, it became breakfast club meals. Then, by October, it had morphed into 2 million hospital appointments and MRI and CT scanners. Now, apparently, it is funding a dentistry plan. One wonders how all these magic branches on the magic money tree will add up to all the promises made so far.

[Wes Streeting]

Will the right hon. Lady give way?

[Victoria Atkins]

I will resist, but only because I am going to ask the hon. Gentleman to intervene in a moment—he should be careful what he wishes for. I also notice that he talked about reform of the dental contract but did not give any detail. Government is not as easy as selling a book. It cannot be cut and pasted from Wikipedia, as some on the Labour Front Bench seem to like to do. It is about being clear on what you would do differently. Now, Labour in Wales is of course running the Welsh NHS. They do like to do things differently. People there are almost twice as likely to be waiting for health treatment as in England.

[Victoria Atkins]

I thank my hon. Friend, who represents a Welsh constituency. The chair of the British Dental Association wrote to the Labour Welsh Government to complain about their plan and, I understand, used words such as “toxic mix of underinvestment” and “untested targets.” The picture in Wales, if it is the Leader of the Opposition’s blueprint, is perhaps not as convincing as the shadow Health Secretary would have us believe.

The fundamental difference between the current systems in England and Labour-run Wales is that Wales has a capitated list system for dentistry. I am willing to give way so that the shadow Health Secretary can clarify whether he wants to bring in that system.

[Wes Streeting]

I cannot believe that is meant to be the right hon. Lady’s big “Gotcha.” She cannot even tell us when she will bring forward her plan, let alone what is in it. They have had 14 years to come up with a plan. This is absolutely astonishing. As much as I enjoy these partisan knockabouts at the Dispatch Box, the sight of the Health Secretary giggling and laughing at her own jokes will be of small comfort to people who are literally pulling out their own teeth.

[Victoria Atkins]

Just to cut through all the froth, the hon. Gentleman has not, in fact, answered my invitation. Does he wish to have a capitated list system, as they have in Wales, or does he have other plans? Could he please answer?

[Wes Streeting]

Like any responsible Government, we would consult the dentistry profession, the BDA, and come up with a serious programme for dentistry reform. If the right hon. Lady wants to ask me questions and have me answer them, the Government should call a general election and I will happily oblige.

[Victoria Atkins]

Again, cutting through the froth, the hon. Gentleman called this debate and has not set out his plan. He knows full well that this is an Opposition day debate and I am responding to Labour’s motion by moving an amendment. He has no plan on dentistry. When I asked him to clarify whether he will follow the capitated system in Wales, he declined to answer. I assume that is because he knows we tested a prototype system based on the Welsh capitation approach here in England, and the results were clear. It worsened access and widened oral health inequalities.

The hon. Gentleman quoted the Nuffield Trust, placing great emphasis on it, in his opening speech. As he agrees so much with the Nuffield Trust’s report, does he also agree with its former chief executive who said that his ideas on general practice represent

“an out of date view”

and “will cost a fortune”?

It is becoming increasingly clear that the Labour party’s approach to our NHS is empty words about reform followed by the phrase “funded by non-doms.” We are very lucky in this country—on this side of the House we consider ourselves blessed—to have incredible dentists working across the NHS.

Here are some facts for Opposition Members. There are now 1,352 more dentists working in the NHS than 14 years ago, thanks to the stewardship of this Conservative Government. I thank them and their colleagues for everything they do, and we are backing them to build a brighter future for NHS dentistry by taking concrete steps to improve recruitment and retention. That is why our long-term workforce plan, the first in NHS history, will expand dentistry training places by 40%, providing more than 1,100 places by 2031, which will be the highest level on record under any Government.

Over the same period, this Government’s plan will also increase training places for dental therapists and hygiene professionals to more than 500. The importance of the long-term workforce plan to dentistry’s future was recognised across the sector, and Professor Kirsty Hill, who chairs the Dental Schools Council, backed our plan:

“Expansion is a significant and positive development, and we commend the government for recognising the importance of increasing dental hygiene and dental therapist positions. These roles play a vital role in enhancing capacity and improving care.”

NHS Winter Update

Debate between Wes Streeting and Victoria Atkins

Monday 8th January 2024 Commons Chamber

[Wes Streeting]

Patients are sick and tired of waiting—waiting for ambulances, waiting for a GP appointment, waiting for their operation and waiting for a general election that cannot come soon enough. Why do the Conservatives not get out of the way and let Labour fix the mess they have made?

[Victoria Atkins]

I welcome the hon. Gentleman back from his world tour promoting his book. It is very nice to meet him for the first time across the Dispatch Box. While he was away in sunnier climes, he may have missed what is actually happening in Wales, which interestingly has been described by the Leader of the Opposition as the “blueprint” for how Labour will run the NHS, were it ever to come into government. Interestingly, in the Labour-run Welsh NHS, people are almost twice as likely to be waiting for treatment, and they are waiting an average of five weeks longer for NHS treatment under Labour in Wales than they do in England. Indeed, the number of patients in Wales seeking treatment in England has increased by 40% in two years because of the experiences that people are having in Wales.

I will just correct the hon. Gentleman on a couple of other things, too. Just to help him understand, we are delivering the 800 new ambulances—those are new ambulances—at pace at the request of the NHS, just as we are putting in 5,000 extra beds in hospitals across England, because we understand the point about capacity and we want to help the NHS look after people in a timely and efficient manner.

I will also just correct him again on the doctors in training point. I am surprised he has come on to that at this point, but had he spoken to his friends in the BMA, he would have understood that that is the phrase that the BMA is using. It has passed a motion to stop using the phrase “junior doctors”. [Interruption.] Yes, the BMA passed a motion. The hon. Gentleman referred to doctors, but he perhaps does not understand the complexities of contractual negotiations. The phrasing is used to denote those professionals who are still on formal training pathways who are not specialty doctors or consultants. That terminology has been agreed with the BMA.

In terms of the strikes themselves, I note—I know that those sat behind me on the Government Benches noted it, too—that the hon. Gentleman did not condemn the strikes. I am happy to give way, if he would like to confirm whether he condemns the strikes. Unfortunately, he has missed his chance to do so, but I suspect that everybody, including the patients at home waiting for appointments, will see the Labour shadow Minister’s failure to condemn these strikes. That is because, in line with public sector strikes more generally, the Labour movement will always prioritise union harmony over patient safety. That is not what we as Conservatives do; we will always put patient safety first.