NHS Dentistry: Rural Areas
Adrian Ramsay Excerpts(2 weeks, 2 days ago)
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Sarah Gibson
My hon. Friend makes an interesting point that I was not aware of. From discussing this matter with dentists, it was my understanding that these days, nobody is actually registered with a dentist; they are merely allowed to come regularly, and if they do not, they are taken off that dentist’s lists. My understanding was that it is quite difficult to register, so that is an interesting point that I hope the Minister will note.
A particular concern to dental practices, and a point that Denplan made very clear to me, is that once a dental practitioner has handed in their NHS provider number, even if the dental contract is improved, they are unlikely to come back to the NHS because of the complications involved in getting that provider number reinstated. That is why we need the Government to act now, before more dentists leave the NHS. Another issue for dental practices is that when qualified dentists come over from the EU, their qualifications are valid, but they have to spend an extra year training before they are allowed to register as NHS practitioners. That is slowing down any chance of increasing our intake from our European partners.
Adrian Ramsay (Waveney Valley) (Green)
I am very grateful to the hon. Lady for securing this debate, and particularly for highlighting the added impact that the loss of dentists has in rural areas, where, if people lose their dentist, there is often no other dentist nearby. In my constituency, people frequently say that they struggle to find any dentist taking new NHS patients. She is right to highlight that the dental contract is the root cause of the issue, and to press for a clear timescale. Does she agree that by the end of this calendar year, the Government should have set out a timescale for starting crucial negotiations on the contract?
Sarah Gibson
I agree that a timeline for reforming the dental contract is vital; that is what I am asking for. If we lose this opportunity and our NHS dentists leave the system, we will be in an increasingly difficult place. Across Wiltshire, for those not already registered with an NHS dentist, it is absolutely impossible to get one. There is not a single practice taking on NHS patients right across the unitary authority of Wiltshire, despite its size.
Access to Primary Healthcare
Adrian Ramsay Excerpts(1 month ago)
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Adrian Ramsay (Waveney Valley) (Green)
On pharmacies, a new report from Healthwatch England reveals a worrying picture of pharmacy closures and reduced hours hitting older people and rural communities the hardest. NHS Norfolk and Waveney integrated care board, which covers much of my constituency, has reported the highest number of hours lost per pharmacy. Does the hon. Lady agree that we urgently need a national evaluation of pharmacy funding, including the size, role mix and distribution of the pharmacy workforce?
Helen Morgan
That is an important point. In my constituency, carers who go to pick up prescription medicines are finding that the pharmacists are not there because they are relying on locums. The pharmacy funding problem needs to be addressed as a matter of urgency, and I will say more about that later.
Growing the economy is so important that we need to get people off the waiting and referral lists and back into work. Liberal Democrats believe that people should be in control of their own lives, not “chained up” at home, unable to get out of bed, because they have no access to healthcare. They should be able to get the help that they need, when they need it, in their own homes and communities.
Let us start with GPs. The Liberal Democrat manifesto—it was well received, which is why there are so many Members sitting behind me on these Benches—called for the right to see a GP within seven days or 24 hours if the situation is urgent, and for those aged over 70 or with a chronic health condition to have access to a named GP. Those rights are extremely important. People who go to the same GP for more than 15 years have a 25% lower chance of dying than those who have seen a new GP in the last year. Primary care networks tell me that their inability to deliver continuity of care because of the shortage of GPs is one of the problems that worry them most.
NHS Performance: Darzi Investigation
Adrian Ramsay Excerpts(1 month, 2 weeks ago)
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Adrian Ramsay (Waveney Valley) (Green)
Thank you, Madam Deputy Speaker. It is a pleasure to follow the new hon. Member for Basingstoke (Luke Murphy) and hear about his pride in his constituency.
Our NHS provides amazing life-saving, dedicated care every day, but we also know that people are too often let down. Too many patients languish, often in pain, on long waiting lists. In rural constituencies such as mine, people often have to travel lengthy distances to access treatment. Lord Darzi points to systemic and chronic under-investment caused by austerity in funding and capital starvation. Resilience was stripped from the NHS before covid, and we owe it to those whose lives were lost or changed forever by the pandemic never to repeat these same mistakes and to do things differently. However, the Chancellor’s arguments about tough decisions and a black hole of £22 billion are alarmingly similar to those made by the previous Government. It is good to see the Chancellor signalling some movement on fiscal rules, and I hope this logic will apply to supporting our public services, which are a crucial investment in our future.
Putting wellbeing at the heart of what we do should help us navigate how we support the NHS. Bad planning, poor housing, weak transport and divisive social policies have a huge impact on health outcomes, for example. So I welcome the Secretary of State’s comments and he has been bullish about reform, but he has not been specific about exactly what he means by private sector involvement in the delivery of NHS services. There are real reasons to keep delivery of the NHS public, and not to outsource it to private providers. The Secretary of State has made statements about using the private sector to reduce waiting lists, but he has not explained whether he considers this to be a short-term plan while the NHS is being rebuilt, or a permanent policy. Lord Darzi’s diagnosis was helpful and the emphasis on prevention is hugely welcome, but to deliver it we require bold action and investment.
Healthcare Provision: East of England
Adrian Ramsay Excerpts(2 months, 2 weeks ago)
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Adrian Ramsay (Waveney Valley) (Green)
I thank the hon. Member for Norwich South (Clive Lewis) for securing this crucial debate. Our region is rural and many Members have talked about the decline in health services in rural areas. I want to talk about some issues that particularly affect my constituents in Waveney Valley, which straddles the Norfolk-Suffolk border.
Whether it is the long waiting lists for surgery, long delays in getting assessments for mental health or the difficulty in accessing a GP or a dentist, we have seen a decline in our health services and it is becoming harder and harder for people in our villages and market towns to access them. At the Budget in a few weeks’ time, I very much hope the Government will look at all options for increasing funding to the NHS, including being willing to ask the very richest in society to pay a little more in tax—modestly more—in a way that could enable us to get the funding needed to keep pace with demand.
I want to raise three specific issues on the decline of rural health services that particularly affect my constituency. I would appreciate it if the Minister addressed them in summing up the debate. The first is the lack of hospital services in rural constituencies, which others have already referred to. For example, Hartismere hospital in Eye is a wonderful building that has had a lot of investment, but lacks the services that the local population, particularly older people and people without a car, would really like to be able to make more use of.
The League of Friends at the hospital showed me round the excellent facilities a couple of weeks ago. The hospital runs a range of clinics that people really value. However, both the league and local doctors would like to see facilities such as an X-ray scanning unit, the return of a community consultant, particularly in services for older people, and a GP walk-in surgery. Will the Minister consider how hospitals in rural areas, such as Hartismere hospital in Eye, can be given the resources and support to provide a greater range of services?
Victoria Collins (Harpenden and Berkhamsted) (LD)
The hon. Member talks about hospital services, especially for the more elderly in society. Will he join me in calling for more cross-party talks on social care, which is often the back door to the support that a lot of people who go into hospital need?
Adrian Ramsay
I totally agree with the hon. Member’s point. I have had family experiences in recent months that have shown me, starkly and at first hand, just how much we need to address the crisis in social care and the lack of integration with the health service.
I want to highlight that on the Norfolk-Suffolk border, in towns such as Eye and Diss, people are 20 miles from the nearest big hospital in Norwich, Bury St Edmunds or Ipswich—and in towns such as Halesworth, which does not have a local community hospital at all, people are even further away. I ask the Minister to consider what support can be given to rural hospitals to provide more services, and particularly to encourage cross-county border working in the health services that will enable us to look at how services can be provided in a way that benefits communities straddling the county border, as they do around Diss and Eye in my constituency.
Secondly, is no surprise that we have heard about dentistry from nearly every hon. Member who has spoken in this debate. We have the Sahara of dental deserts in the east. In the winter, I conducted a survey of residents in Waveney Valley to which more than 800 people responded. A quarter had given up on dentistry treatment altogether because of lack of NHS provision, others were driving long distances to access a dentist and some had even pulled out their own teeth. That is just not tolerable in the 21st century.
I welcome the Government’s commitment to reforming the dental contract. From my discussions with dentists and dental organisations such as the British Dental Association, it is clear that reform of the dental contracts is the root cause of the big exodus of dentists from the NHS. Dentists are not being paid appropriately for the work they do. Can the Minister set out the timescale for reviewing that contract? Health organisations have told me that for every effort they put in to getting new dentists into the NHS, dentists are leaving at a greater rate. We must address the root cause of the problem.
Thirdly, I want to highlight optometry. I received correspondence from an optometrist in Norfolk concerned about the lack of post-operative aftercare, particularly for operations such as cataract surgeries. They highlight that private companies are operating services of that kind and then discharging members to the community without aftercare, which is having a knock-on effect on A&E. Can the Minister ensure that, where private companies provide such services, the proper aftercare is also provided? Will she commit to looking at whether that highlights the problem of relying on private companies, which might seek to cut corners in the name of profit, to provide services?
To conclude, our rural services, particularly in market towns and villages, are severely affected by the decline in health services. Whether it is dentistry or a lack of local hospital services, we need urgent action and I would welcome the Minister’s addressing my specific points.
