Welfare of Doctors

Alison Bennett Excerpts

Tuesday 21st January 2025 Westminster Hall

[Peter Prinsley]

I agree that we must put resources into general practices to deal with the Government’s plan to move care from the hospital out into the community. I am sure that needs to be addressed.

The partnership model, which has served us so well, is now surely threatened as fewer young GPs are prepared to take on the responsibility or the financial risk of general practice.

[Alison Bennett (Mid Sussex) (LD)]

I thank the hon. Member for securing this important debate, which I feel could have been easily extended beyond a mere 30 minutes. On the pressure and responsibility for GPs looking to become partners, I cite the example of Silverdale practice in Burgess Hill in my constituency. In December and January, it had a problem with the sewers being blocked up, which resulted in contaminated water coming up into the surgery and car park. The point is that it has taken weeks to get support from the NHS; the pressure on those GP partners and practice managers must be huge. Does the hon. Member agree that there needs to be more support for GPs who are prepared to take on the responsibilities of a partnership?

[Peter Prinsley]

I do agree. I believe that the Government intend to do something about the somewhat terrible state of GP premises; the Health Secretary confirmed that only yesterday.

There are serious questions about the support that individual GPs receive, especially for mental health. At present, GPs rely on the NHS practitioner health service for addiction and mental health support.

Medicines and Healthcare Products Regulatory Agency

Alison Bennett Excerpts

Thursday 16th January 2025 Commons Chamber

[Alison Bennett (Mid Sussex) (LD)]

I thank the right hon. Member for Tatton (Esther McVey) for bringing forward this really important debate and for her excellent opening speech, which was very informative. In the interests of time, I will keep my remarks brief.

The Medicines and Healthcare products Regulatory Agency is tasked with vital work, and we all agree that it is there to protect and promote public health. As a number of Members have set out, it is concerning that despite the MHRA’s obvious importance, it clearly faces a number of challenges that need to be addressed. The Cumberlege review highlighted a conflict of interests, because the MHRA relies on fee income from pharmaceutical companies; as the hon. Member for Stroud (Dr Opher) said, this is a case of the agency marking its own homework. It is not a great way to set up its funding.

The hon. Member for Dewsbury and Batley (Iqbal Mohamed) made a really important point about Brexit, which is the elephant in the room. As with so many parts of our economy, Brexit caused major disruption to the pharmaceutical industry. Among other things, the loss of the prestigious European Medicines Agency from London to Amsterdam damaged trust in the UK’s pharmaceutical investment space.

[Danny Kruger]

Will the hon. Lady give way?

[Alison Bennett]

In the interests of time, I will not.

Brexit caused significant confusion for companies looking to sell products from Great Britain to Northern Ireland. It has also slowed down the time in which novel medicines and treatments can be approved for use, as pharmaceutical companies have understandably prioritised obtaining a single approval, allowing access to 27 markets via the EMA.

Meanwhile, strict affordability models imposed by the National Institute for Health and Care Excellence mean that companies face a further hurdle before their products can reach patients. Again, that diminishes the attractiveness of the UK market post Brexit. To help address this issue, the MHRA introduced the international recognition procedure a year ago to streamline the authorisation process by incorporating assessments from trusted regulatory partners worldwide, including the EMA. However, that relies on those partners having already approved the products, so UK patients will inevitably still have access to medicines later than people in other countries, including EU member states. When I met representatives of Roche Diagnostics, based in Burgess Hill in my constituency, they told me about the industry’s serious concerns that the additional GB-specific conformity checks required could be prohibitively expensive and lead to significant delays.

As things stand, the forecast is looking gloomy. My Liberal Democrat colleagues and I are committed to addressing these issues head-on, and to helping the MHRA become world leading. First, we are pushing to expand the MHRA’s capacity by halving the time for treatments to reach patients suffering from illnesses such as cancer. Secondly, we encourage the Government to fully implement the recommendations of the Cumberlege review, including on compensation, corrective surgery and psychological support for those who were failed and who suffered from faulty devices and drugs. Thirdly—this is vital—the Government should actively seek a comprehensive mutual recognition agreement with the EMA to promote faster access to new and novel medicines and medical devices. That would reduce red tape, cost and friction, providing hope for those who need access to these lifesaving and life-enhancing medicines and devices.

[Madam Deputy Speaker]

I call the shadow Minister.

Health and Social Care: Winter Update

Alison Bennett Excerpts

Wednesday 15th January 2025 Commons Chamber

[Wes Streeting]

I am delighted to hear of the work Ros is doing as mayor to support health and care services and to take health and care to where people are. I hate hearing that there are hard-to-reach communities; there are no hard-to-reach communities. There are underserved communities and, in our determination to tackle health inequalities, to get care closer to people’s homes and indeed in people’s homes, to do earlier diagnosis and to provide faster access to treatment, we need to make sure that we take health and care services to where people are rather than expecting people to always come to us.

[Alison Bennett (Mid Sussex) (LD)]

I fear that corridor care has already become normalised and, as the Secretary of State says, it will be some time before we get back on the right path. This week there have been reports of a north London hospital advertising for dedicated corridor care nurses. I also think about my constituent who is a doctor at the Royal Sussex begging X-ray teams to give her a consultation room so she does not have to do intimate exams out in the corridor. What reassurance can the Secretary of State give the NHS workforce that things are going to get better?

[Wes Streeting]

I am really grateful to the hon. Member for raising that question and for the example she gave of the Whittington advertisement for staff specifically to deliver corridor care. I make no criticism of the trust itself in trying to make sure it has the right staff in place to deliver the best care possible in the present circumstances. It is not the fault of the Whittington that there is corridor care; it is a legacy of 14 years of Conservative failure. I would also say that my reaction to seeing that advertisement was the same as hers: it was proof that corridor care has been normalised. I want to reassure her, the House and patients across the country that this Government will not accept corridor care as normal care. We will not tolerate it as being acceptable care. We will do everything we can as fast as we can to consign corridor care to the history books and I reassure the staff working in the NHS in these intolerable conditions that we will work with them to deliver the investment and the reform needed to get the NHS back on its feet and make it fit for the future.

Health and Adult Social Care Reform

Alison Bennett Excerpts

Monday 6th January 2025 Commons Chamber

[Wes Streeting]

I thank my hon. Friend for that question. I am a proud member of Unison, and I am proud of its work to stand up for its workforce in the social care sector. She and Unison are absolutely right to argue that fair pay is essential to recruitment and retention. That is why I am delighted that the Deputy Prime Minister included fair pay agreements in the Employment Rights Bill in the first 100 days. I am looking forward to working with Unison, GMB and others to negotiate the first ever fair pay agreements for care professionals in this country.

[Alison Bennett (Mid Sussex) (LD)]

I would appreciate it if the Secretary of State could unpack a phrase in his statement. He said:

“Where we can treat working people faster, we will”.

That phrase is ripe for misinterpretation. Please could he explain what that means? Does it mean stay-at-home mums waiting for an appointment, and family carers, 26% of whom are on waiting lists?

[Wes Streeting]

It does. I was talking about the fact that working class people are often left behind in a two-tier system where those who can afford it pay to go private, and those who cannot are left behind. It is the determination of this Government to bring back to life the essential Bevanite principle of an NHS that is there for everyone when they need it: healthcare available to all on the basis of need, not on ability to pay.

Hospice Funding

Alison Bennett Excerpts

Thursday 19th December 2024 Commons Chamber

[Karin Smyth]

The hon. Gentleman asks the same question again. Through the Budget, this Government have allocated more money to the health service than the previous Government—a record announcement—and we have announced money again this morning. To govern is to choose. The last Government neither governed well nor chose to support the health sector from diagnosis to end of life; this Government have, and will continue to do so.

[Alison Bennett (Mid Sussex) (LD)]

Some weeks before the Budget, I visited both St Catherine’s hospice and St Peter and St James hospice, which serve my constituents. I had not expected how quiet and empty those hospices were, because of the empty beds and mothballed wings that had been closed due to a lack of funding. Evidently, the funding crisis in the hospice sector was very deep before the Budget, but the Budget has only made it worse through the NIC increases. As such, I will try again: will the welcome funding announced today cover the cost of those NIC increases?

[Karin Smyth]

As Lord Darzi’s report announced, the entire sector has been under pressure and struggling since the disastrous Lansley reforms—they were part of the coalition Government—through to when we took over in July. We will fix the NHS and rebuild it to make it more sustainable and fit for the future. That includes everything from diagnosis to end of life care.

Winter Preparedness

Alison Bennett Excerpts

Wednesday 18th December 2024 Commons Chamber

[Karin Smyth]

My hon. Friend is absolutely right. Many tragedies happen over the Christmas period—my own father died on 23 December. Those staff members go above and beyond to help people at difficult times, but also at times of great joy—babies do not wait for Father Christmas, do they?—and my hon. Friend is right to commend midwives and everyone else who is working at this time. We know that maternity services are particularly stretched across most of the country. Those midwives are doing a tremendous job in keeping the system working, and doing the critically important job of supporting women at a mostly joyous but sometimes very difficult time.

[Alison Bennett (Mid Sussex) (LD)]

At the start of this week, 300 patients were ready to go home from my local NHS hospital trust in Sussex. That bears out the statistic in Lord Darzi’s report that 13% of patients are medically fit for discharge. I am really concerned that we have now reached a point with winter pressures where corridor waits are normalised, not only in A&E departments but in the case of initiatives such as continuous flow models, with corridor trolley waits being pushed into regular wards. It is unacceptable that this has become normalised. Will the Minister expand on her comments about the national care service? When will the plans be published? Will the Government work with us on a cross-party basis, and why did this work not begin sooner?

[Karin Smyth]

As I said in my statement, we have begun plans to stabilise the workforce and the employment Bill is going through the House, so I do not agree with the hon. Lady on that point. We know that it will take a long time, and we will of course be working with colleagues to ensure that we do develop that national care service.

Rare Autoimmune Rheumatic Diseases

Alison Bennett Excerpts

Tuesday 10th December 2024 Westminster Hall

[Alison Bennett (Mid Sussex) (LD)]

It is a pleasure to serve under your chairmanship, Dr Huq. I thank the hon. Member for Strangford (Jim Shannon) for bringing forward this debate on a subject that all too often does not get enough attention, but that is important and affects millions of people. I also thank the hon. Member for Bootle (Peter Dowd) for his contribution.

More than 160,000 people in the UK live with rare autoimmune rheumatic diseases. Identifying, treating and caring for those people is complex. Yesterday, my constituent Carrie told me about her experience. She suffers from a number of conditions and has done since she was diagnosed 30 years ago. Interestingly, for someone who has carried those conditions for 30 years, she considers herself fortunate to have been diagnosed with Raynaud’s and lupus at a young age, because it allowed her to start treatment early and receive consistent care. She knows from experience that early diagnosis and treatment makes a real difference, a point that has already been made by hon. Members.

While Carrie believes that she has been lucky and has received good care, she stressed that many people face years of misdiagnosis or dismissal, and poor or almost non-existent care. Those failures only exacerbate their symptoms further down the line. Sadly, one of those less fortunate than Carrie is her own mother, who lives not in Sussex but in Yorkshire, and also has multiple autoimmune conditions. Contrastingly, however, she has always been made to feel like a hypochondriac—not an unusual experience for those seeking help with rare autoimmune rheumatic diseases.

Carrie’s mother was eventually diagnosed after many unnecessary years of suffering. She suffered for longer and to a greater degree simply because no one believed her or was able to diagnose her. Carrie told me that a postcode lottery exists in the quality of care for those with these conditions. It really is down to the specific medics and practitioners who an individual meets as to how well their condition is identified and whether treatment can begin.

Carrie’s Raynaud’s is particularly debilitating in winter. She told me that more awareness of the issues around the conditions and how symptoms can be alleviated is vital. Often, solutions can be as simple as helping with buying things such as thermal gloves or socks.

Another major challenge has been the impact of her autoimmune conditions on her teeth, particularly with the Sjögren’s that she suffers from. Carrie has spent thousands and thousands of pounds on private dental care over the years—the only option as NHS treatment was not available. Despite that money, Carrie now thinks that it is not long until she will have very few teeth left.

Carrie thinks that the current system is disjointed, with her dentist not understanding the issues surrounding her conditions, and her rheumatologist likewise not understanding the impact her conditions have on her dental health. She believes that a more co-ordinated, multidisciplinary approach to treating the conditions would help. It is clear from my conversation with Carrie that we simply must do better on this issue.

We must tackle the postcode lottery, exemplified by Carrie and her mother at opposite ends of the country; build a more joined-up system; and take rare autoimmune rheumatic diseases seriously so that we can start diagnosing earlier and more consistently. While the problems seem daunting, I believe that by collaborating—for example, with organisations such as RAIRDA—we can find solutions to the problems that Carrie told me about.

It is already Liberal Democrat policy to ensure that everyone with long-term health conditions has access to a named GP. We must also do better on dentistry, both generally, by sorting out the NHS contract and ensuring that we have a proper workforce plan for dentistry, and specifically, for people with those rare diseases that have a massive impact on dental health. As well as having access to a named GP, the Liberal Democrats are campaigning for the Medicines and Healthcare products Regulatory Agency to have greater capacity, which would help to speed up the process by which new treatments reach patients—a potential game changer for those suffering with such conditions.

We need change so that we can help the people living with those complex, long-term and debilitating conditions. The diseases may be complex, but I believe the solutions need not be. I am encouraged by the words of hon. Members today, and together, we can effect the change that Carrie, her mother and so many others need and deserve.

[Dr Rupa Huq (in the Chair)]

I call the shadow Minister, the hon. Member for Hinckley and Bosworth (Dr Evans), to speak for His Majesty’s loyal Opposition.

Infected Blood Inquiry

Alison Bennett Excerpts

Tuesday 19th November 2024 Commons Chamber

[Nick Thomas-Symonds]

The Infected Blood Compensation Authority has operational independence. The Government have stewardship over the amount of money allocated. As my hon. Friend will appreciate, the £11.8 billion is a huge and substantial commitment. I do not pretend for a moment that any amount of money can actually provide recompense for the scale of the injustice, but at the same time it is an indication of the commitment—from the Prime Minister, the Chancellor and across the Government—to deliver justice.

In saying that, I should say that I am grateful for the work and co-operation of hon. Members across the House. In particular, I once again thank my predecessor as Paymaster General, the right hon. Member for Salisbury (John Glen), for his efforts in government. As I indicated in the debate last week, I look forward to continuing to work in that spirit with the new shadow Paymaster General, the right hon. Member for Basildon and Billericay (Mr Holden), on this hugely important issue. I also thank my ministerial colleague, my right hon. Friend the Member for Kingston upon Hull North and Cottingham (Dame Diana Johnson), and the former Member for Worthing West. Their tireless campaigning and representation of the community’s interests over so many years has been invaluable.

Much progress has been made in responding to Sir Brian’s report, but much more remains to be done. I will set out the Government’s fuller response to the recommendations to the House in line with the timetable Sir Brian set out, but I hope in the course of this debate to assure right hon. and hon. Members, and most importantly those in the community, that we have listened, we have learned and we are taking long overdue action.

The inquiry’s report is persistent in uncovering the truth, unshakeable in its honesty and damning, frankly, in its criticisms. It is absolutely clear that fundamental responsibilities of patient safety in healthcare were repeatedly ignored, and that

“what happened would not have happened if safety of the patient had been paramount throughout.”

The culture of wilful ignorance runs through the report, and continued to proliferate as the scandal developed. It speaks to Governments across decades and a state more focused on discharging its functions, whatever the risk and whatever the cost. The report chronicles suffering of almost unimaginable scale: thousands of people died prematurely and continue to die every week; lives completely shattered; evidence destroyed; victims undermined; families devastated; and children used as objects of research.

It is a truly horrifying injustice.

However, Sir Brian’s report goes much further. He lays bare the institutional defensiveness that existed within the Government, and indeed the civil service, which led to the truth being hidden for so long, compounding the pain and the injustice. Sir Brian highlights

“the consequences of civil servants and ministers adopting lines to take without sufficient reflection, when they were inaccurate, partial when they should have been qualified, had no proper evidential foundation…or made unrealistic claims that treatment had been the best it could be.”

These actions are the very antithesis of public service, and that is why I know there is such collective determination to learn the right lessons and to act on them.

There is so much that can be said about the volumes of evidence that Sir Brian has uncovered, and I know that during this debate many Members will raise vital issues, but let me be absolutely clear: the report details utterly unacceptable failings on a chilling scale, and this Government will do everything in their power to address them. Through acting on these lessons, we must ensure that all those who have suffered, and those who have campaigned, have not done so in vain.

Let me now turn to the 12 recommendations that the inquiry made in its report. First, I will touch briefly on the progress that has already been made. I know that Members on both sides of the House are keen to hear the details of what the Government intend to do in response. The recommendations are wide-ranging, and are being given full consideration. As I have said, I will provide an update to Parliament by the end of the year against each and every one of those recommendations.

I will begin with compensation. I have already updated the House on a number of occasions on the progress that is being made. I am grateful to Members on both sides of the House for their contributions to the debate on the regulations that we have made to establish the Infected Blood Compensation Authority and the core route for compensation for infected people, but I am also grateful, crucially, for the support there has been throughout the House to ensure that the delivery of compensation is not delayed in any way by Parliament.

[Alison Bennett (Mid Sussex) (LD)]

What assurances can be offered that the Infected Blood Compensation Authority has sufficient staffing and resources at its disposal to meet expectations of the swift payments promised by the Government?

[Nick Thomas-Symonds]

I can assure the hon. Lady that the Government will ensure that the authority has the support it needs. I expect it to be making the first payments to infected people by the end of the year, and to start making payments to affected people next year. Further regulations will be required for people who are affected, but that will not disturb the timetable that I have set out. I intend the second set of regulations to be in force by 31 March next year. More than £1 billion has already been paid out in interim compensation, and the Government have opened applications for interim payments of £100,000 to the estates of deceased people who were infected with contaminated blood or blood products and have not yet been recognised.

National Insurance Contributions: Healthcare

Alison Bennett Excerpts

Thursday 14th November 2024 Commons Chamber

[Mr Speaker]

I call the Liberal Democrat spokesperson.

[Alison Bennett (Mid Sussex) (LD)]

The increase in employer national insurance contributions will erode the very investment in the NHS that the Budget sought to prioritise. Katie, a GP from Lindfield in Mid Sussex, wrote to me saying that the NICs increases

“serve to directly undermine access and patient care.”

The Government have promised to recruit more GPs, but hiking national insurance puts that pledge in jeopardy. Surgeries are set to see eye-watering increases in staff costs, equivalent to 26,786 appointments in West Sussex alone. GPs will have no choice but to cut services and staff numbers, and patients will pay the price.

Does the Minister agree that stronger primary care, with faster appointments and fewer people having to go to hospital, is better for both the NHS and patients? If so, will she protect services and press the Chancellor to end this GP penalty?

[Karin Smyth]

The hon. Lady makes an excellent point about the importance of GPs and primary care to the wider sector. Immediately after taking office this summer, we freed up the system to employ 1,000 extra GPs through the additional roles reimbursement scheme—which the previous Government refused to implement—because we recognised the need for that extra capacity. We will be talking to general practice as part of the contract reforms over the next few months, following the normal process, to determine allocations for next year.

NHS Dentistry: South-west

Alison Bennett Excerpts

Tuesday 12th November 2024 Westminster Hall

[Alison Bennett (Mid Sussex) (LD)]

It is a pleasure to serve under your chairmanship, Mr Vickers. I thank my hon. Friend the Member for Honiton and Sidmouth (Richard Foord) for securing this debate. The strength of the contributions by south-west Members from all parts of the House show how important this issue is for everyone in the region. I thank my hon. Friend for making the debate about the south-west. I grew up in Gloucestershire, and my dentistry as a child began in Tewkesbury. The comment by the hon. Member for Stroud (Dr Opher) that dental treatment is preventive in its own right was helpful. Indeed, thanks to the insistence of my mother, Christine, on my going to the dentist twice a year, I never got a filling until I was into my 40s. I thank her for that.

While I welcome the Government’s injection of funds into the NHS as a whole, we must be clear that dentistry should not be forgotten. That is why I, along with many of my Liberal Democrat colleagues, have today written to the Chancellor of the Exchequer to ask her to reconsider the proposed increases in employer national insurance contributions in the case of various healthcare providers, including the dentistry sector and those providing NHS dentistry. Commenting on that letter, the British Dental Association said that the changes, should they go ahead, will inevitably punish patients.

Before coming to this debate, I had meetings with the National Care Forum and the children’s hospice charity Together for Short Lives. In all those forums, grave concerns have been raised about the impact of the increase in employer national insurance contributions on the work that providers do, and the potential cuts to the number of people they employ and the services they offer. I ask the Minister to urge his team in the Department of Health and Social Care to reconsider and to press the Treasury to rethink the increase, or at least look at finding some form of dispensation.

As hon. Members have said, tooth decay is the most common reason for hospital admission in children between the ages of six and 10. Thanks to a freedom of information request commissioned by the Liberal Democrats, we know that over 100,000 children have been admitted to hospital with rotting teeth since 2018. That is shameful, yet also entirely preventable. That is what makes it so tragic.

Our failures stretch across the full breadth of age groups. Last year, a poll commissioned by the Liberal Democrats revealed that a shocking one in five people who fail to get an NHS appointment turn to DIY dentistry. Indeed, during the general election, I knocked on the door of somebody who told me that he had pulled his own teeth out. It is simply Victorian that that has happened to dentistry in our country in 2024. The Darzi review found that

“only about 30 and 40 per cent of NHS dental practices are accepting new child and adult registrations respectively.”

To me, and I think to everyone here, the fact that our dentistry system is in a position where people feel the need to pull out their own teeth is appalling.

The south-west is feeling the full force of the crisis, having lost more than 100 dentists last year alone. However, the issue is not limited to the south-west. Only one of the 13 dentists in my constituency of Mid Sussex is accepting children as NHS patients, and none is accepting adults. Using data from the House of Commons Library, it is estimated that 44% of children in West Sussex did not see a dentist in the year to March 2024.

My Liberal Democrat colleagues and I are calling for three things and we have a plan to make them happen. First, we need guaranteed access to an NHS dentist for everyone who needs urgent and emergency care. Secondly, we need guaranteed access to free NHS check-ups for those already eligible: children, new mothers, those who are pregnant and those on low incomes. Thirdly, we need guaranteed appointments for all those who need a dental check before commencing surgery, chemotherapy or a transplant.

The first thing that we can do to achieve those vital baselines in dental care is to deliver a dental rescue package, including investing in extra dental appointments, fixing the broken NHS dental contract and using flexible commissioning to meet patient needs. Secondly, we need to ensure that a proper workforce plan for health and social care, including projections for dentists and dental staff, is written into law. Thirdly, we would reverse the previous Government’s cuts to public health grants to support preventive dental healthcare. We must tackle the root causes of the oral health catastrophe in the south-west by focusing on investment in prevention. In doing so, we can put an end to the suffering of so many children and adults, take away the need for DIY dentistry and provide some much-needed respite for the NHS system as a whole.