Prescription Charges: Long-term Health Conditions

Andrea Leadsom Excerpts

Monday 11th March 2024 Westminster Hall

[The Parliamentary Under-Secretary of State for Health and Social Care (Dame Andrea Leadsom)]

It is a pleasure to serve under your chairmanship, Dame Maria. I am grateful to the hon. Member for Neath (Christina Rees) and the many members of the British public for raising the important issues covered in the e-petitions. I pay tribute to all members of the public who have written in with their stories. I shall set out exactly what the Government’s thinking is and what measures are in place to support people with the cost of prescription charges.

Every single one of us has constituents with long-term and chronic conditions who are suffering from financial hardship. I have a number in my own constituency of South Northamptonshire, and I have helped many get the financial support to which they are entitled. The Government are fully aware that the rise in the cost of living has been particularly severe for people who are unable to work or who have had to reduce their hours. Long-term and chronic conditions affect a person’s career opportunities and put them at a higher risk of becoming reliant on benefits to meet their basic needs.

The prescription charge, currently set at £9.65, applies to each item on a prescription form and is reviewed annually. This charge has no link to the cost of a prescribed drug or appliance, or to any of the costs associated with distribution or the dispensing service. Let me set out the extent of the exemption arrangements that are in place to provide people with free prescriptions or to limit their cost.

Eligibility for free prescriptions falls principally into three broad categories: age, income and medical condition. Some of these also provide exemption from other NHS charges, such as for dental treatment. The age-related exemptions cover all children under 16, teenagers between 16 and 18 in full-time education and all those aged 60 and over. The income-based exemptions are for those on a low income. Most are based on receipt of certain benefits, including universal credit. Help is also available through the NHS low income scheme.

With a medical exemption certificate, exemptions apply to people with medical conditions such as epilepsy, certain types of diabetes and cancer. The certificate is valid for a period of five years, exempting patients from paying for any of their prescriptions. In addition, prescriptions are also free for pregnant women and new mums with a maternity exemption certificate. As a result of all the exemptions available, 89% of all prescription items are dispensed free of charge. In addition to exemptions, we also have provisions in place to cap the total cost of prescriptions to any individual.

Our approach to exemptions is that it is not right to look at specific conditions in isolation. Someone might well consider, as has been put forward today, that their condition is particularly deserving of an exemption and that it should be added to the list of exemptions. I do have the utmost sympathy for anyone who needs regular or extensive medication, so while I must advise colleagues that the Government have no plans to extend the list of conditions that confer exemptions at this time, I do want to address some of the concerns raised by colleagues about affordability.

When the medical exemptions list was introduced, it meant that around 42% of all NHS prescription items were dispensed free of charge. Now the figure has risen to around 89% of all prescription items, and around 60% of people in England do not pay any prescription charges at all. Many people with medical conditions who are not on the list may already get free prescriptions on other grounds, because current exemptions already provide help for those on lower incomes and the most vulnerable in society. So while not everyone qualifies for free NHS prescriptions, support is available to ensure their affordability for those with greater need. Those who do pay charges are entitled to a 12-month prescription prepayment certificate, no matter how many prescriptions they need. That fixes prescription costs at £111.60 a year currently, or just over £2 a week. A prescription prepayment certificate can also be purchased to cap the cost of prescriptions for a three-month period at a cost of £31.25.

It is really important that all our constituents understand that. As Minister for Primary Care and Public Health, I get letters from people saying that their prescription costs are high and recurring, and I want people to understand that the prepayment certificate caps that cost at—I will say it again—£111.60 a year, or just over £2 a week. That annual certificate can be purchased by monthly instalments, which means that a person can have all the prescribed items they need for just over £2 a week, providing real help for someone with a long-term or chronic condition.

The NHS low income scheme provides help with prescription charges and full or partial help with other health costs. It is designed to help those on a low income who do not receive benefits that qualify them for exemption from prescription charges. As colleagues would expect, it is means-tested by comparing a person’s income with their requirements.

There is no doubt that long-term conditions place huge stresses and strains on our constituents and their loved ones. People are living longer, which is a wonderful thing, but the truth is that those extra years are not always enjoyed in good health. In England, around 26 million people have a long-term health condition that cannot be cured, but can be controlled with medication or other therapies. Some 10 million have two or more long-term conditions, and their number is expected to increase in the coming years. Caring for people with long-term conditions already accounts for over two thirds of the money we spend on health and social care in England, which was nearly £206 billion in total in 2022-23.

Long-term conditions can also mean reduced mobility, chronic pain, shrinking social networks and worse mental wellbeing. People with multiple conditions in particular are more likely to have poorer health, poorer quality of life and a higher risk of dying early. That is why we are carefully considering how to improve their outcomes in our major conditions strategy. The strategy will focus on tackling the six major conditions groups that account for 60% of ill health and early death in England: cancers, mental ill health, cardiovascular disease including stroke and diabetes, dementia, chronic respiratory diseases, and musculoskeletal disorders. We are determined to ensure that care is better centred around the patient, with more focus on prevention and a holistic approach to support.

Turning to some other ways in which the Government are providing support, we are backing people with health conditions who want to work to do so. We remain committed to bringing down the employment gap for people with long-term conditions, and we continue to support those people to start, stay and succeed in work. That is why we are increasing work coach support in job centres for people with health conditions receiving universal credit or employment support, and boosting the number of specially trained advisors in job centres offering advice and expertise.

Once we have helped people into work, our Disability Confident scheme encourages employers to think differently about health and disability and take action to address issues that employees face. We are also providing access to work grants towards the cost of working beyond standard reasonable adjustments. We do not want anybody with long-term conditions, whether one or several, to feel, “That’s it. I’m in long-term terminal decline.” We want to help people to feel that they have a future and that we can help them to get support back into the workplace to make something more of their life and to start enjoying it again.

To help with energy costs, the energy bills support scheme delivers a £400 Government discount in instalments over six months, helping no fewer than 29 million households with energy bills over winter. The energy price guarantee has been extended to April 2024, reducing typical annual household bills in Great Britain by about £3,000.

Colleagues pointed to the abolition of prescription charges in the devolved Governments. Health is a devolved matter and the devolved Administrations have full discretion in how they spend their budgets, but looking at health in Labour-run Wales or the outcomes for the Scottish National party-run health service in Scotland, I am glad that this Government in England make the right decision to require those who are better off to contribute to vital NHS services in England. In 2022-23, those contributions gave about £670 million in revenue to England’s NHS—a sum equivalent to the cost of employing about 12,500 full-time nurses and health visitors for a year in 2022-23. That income helps our NHS to maintain vital and much needed services for all patients.

Personally, I support continuing to require better-off patients to contribute to their own prescription charges, while recognising that 89% of all prescription charges are no longer payable. Furthermore, we provide support to those with multiple conditions, making that affordable for them.

I thank colleagues for participating in this debate, which touches on so many of our constituents, their families, friends and carers up and down the country. I assure all colleagues and our constituents that every penny we get from prescription charges is reinvested into our NHS. We will always keep support in place for those who need it the most.

Dental Patient Charges Uplift 2024-25

Andrea Leadsom Excerpts

Thursday 7th March 2024 Written Statements

[The Parliamentary Under-Secretary of State for Health and Social Care (Dame Andrea Leadsom)]

The Department recently published our plan to recover and reform NHS dentistry, which will make dental services faster, simpler and fairer to patients and will fund around 2.5 million additional appointments (or more than 1.5 million additional courses of dental treatment). The plan sets out a number of actions that will improve access for patients, by helping the sector to recover activity more quickly, addressing underlying issues and setting out the action needed for longer-term reform of the system.

The National Health Service (Dental Charges) (Amendment) Regulations 2024 (“the Amendment Regulations”) were laid in Parliament on 1 March 2024 to increase national health service dental patient charges in England from 1 April 2024.

NHS dental patient charges provide an important revenue source for NHS dentistry and are typically uplifted on 1 April each financial year. In April 2023, the Department of Health and Social Care implemented the first dental patient charge uplift since December 2020. The economic climate at the time, along with an extended period between uplifts and increasing costs of delivering NHS dental care, meant that a higher than usual uplift of 8.5% came into force in April 2023. This allows a smaller uplift for 2024-25 without adversely affecting NHS budgets. It is important that current and future work to improve NHS dentistry is not undermined by the risk of reduced funding because of lower NHS dental patient charge revenue.

Therefore, from 1 April 2024, dental patient charges in England will increase by 4%. This means that a dental charge payable for a band 1 course of treatment will rise by £1, from £25.80 to £26.80. For a band 2 course of treatment, there will be an increase of £2.80 from £70.70 to £73.50. A band 3 course of treatment will increase by £12.30, from £306.80 to £319.10.

Details of the revised charges for 2023-24 can be found in the table below:

Oral Answers to Questions

Andrea Leadsom Excerpts

Tuesday 5th March 2024 Commons Chamber

[Paul Girvan (South Antrim) (DUP)]

11. When she plans to introduce a tobacco and vapes bill.

[The Parliamentary Under-Secretary of State for Health and Social Care (Dame Andrea Leadsom)]

The hon. Member will know that, shockingly, smoking kills 80,000 people across the UK every year, and costs society £17 billion in ill health and loss of productivity. The Government will introduce the tobacco and vapes Bill shortly. I am delighted to say that Northern Ireland Ministers announced just this morning that we will legislate for the whole of the United Kingdom.

[Paul Girvan]

I thank the Minister for that answer. I just want to say that the age-related Bill on the sale of tobacco products will create the first generation of smoke-free people in the United Kingdom. All politics is local, and it is vital that we have the same legislation in Northern Ireland. In Northern Ireland, smoking contributes to at least 1,300 smoking-related cancers per year. Some 13.9% of the people in my constituency continue to smoke, irrespective of the guidance given. I am glad to hear the Minister’s assurance on the legislation, but will the Government engage with the Northern Ireland Executive to ensure it is on their priority list?

[Dame Andrea Leadsom]

I can tell the hon. Gentleman that the Secretary of State met the Northern Ireland Health Minister just yesterday. I absolutely assure him that all parts of the United Kingdom will be included in the once-in-a-generation public health intervention that will save millions of lives.

[Bob Blackman (Harrow East) (Con)]

I urge my right hon. Friend to get on with introducing the Bill, because every single day we delay, more people die of cancer and other smoking-related diseases. Equally, in creating the first generation of people who will not be allowed to buy cigarettes or tobacco products—that is excellent—does she agree that one concern is that young people are now taking up vaping instead of smoking, and that vaping is clearly a path towards nicotine addiction?

[Dame Andrea Leadsom]

Yes. My hon. Friend raises an incredibly important point. There is no doubt that tobacco and vaping companies are now trying to recruit children, putting vapes, including many illegal vapes, next to the sweet counter with extraordinary flavours such as bubble gum and berry blast, which are clearly not designed, as was originally proposed, for adult smokers to be able to quit smoking by moving to vaping. He is absolutely right and we will bring forward this once-in-a-generation legislation shortly.

[Neale Hanvey (Kirkcaldy and Cowdenbeath) (Alba)]

12. What steps she plans to take to improve the recruitment and retention of community and district nurses.

--- Later in debate ---

[Andrew Jones (Harrogate and Knaresborough) (Con)]

T2. Thank you very much, Mr Speaker. I am talking to my local integrated care board about establishing the first centre of dental excellence in North Yorkshire, to be located in Harrogate, to build on the dental recovery plan. Does my right hon. Friend the Secretary of State agree that boosting capacity is critical to catching up from the pandemic, and that centres of dental excellence are a very good way to achieve it?

[The Parliamentary Under-Secretary of State for Health and Social Care (Dame Andrea Leadsom)]

I completely agree with my hon. Friend that we need more capacity in our dental workforce, and I know he will be a big advocate for his constituency. We set out in the first ever NHS long-term workforce plan that we will increase dentistry training places by 40% by 2031-32. Our dental recovery plan sets out many different measures to improve capacity.

[Mr Speaker]

I call the SNP spokesperson.

--- Later in debate ---

[Andrew Selous (South West Bedfordshire) (Con)]

T3. The general practice estates and technology transformation fund supported projects in my constituency and was appreciated by my local integrated care board. What evaluation has been made of it, and will it be continued?

[Dame Andrea Leadsom]

I have had a number of meetings with my hon. Friend and know that he is determined to resolve some of these long-standing issues in his constituency. I have assured him that ICBs have the freedom to increase capital for primary care in their region, so long as their plans remain within their overall capital allocation. I will certainly be happy to meet him again to talk about what more measures we can take to support his constituents.

[Rachael Maskell (York Central) (Lab/Co-op)]

T4. I held my first dental summit since the publication of the Government’s dental recovery plan, which I have to say was met with disappointment and frustration. The reason for that is that is not enough funding or flexibility, or the resolution to the contract. Will the Minister set out the timetable for when the dental contract will be resolved?

[Dame Andrea Leadsom]

I am very surprised and disappointed to hear the hon. Lady say that. We are delivering 2.5 million more appointments through the new patient premium, which started last Friday. We will have information within a month to see which dentists have taken up this generous new patient premium to ensure that many more people get access to dentistry. Not only that, but we have golden hellos to attract dentists to areas that are underserved, mobile dental vans and, importantly, a new focus on Smile4life. That is going to ensure that all babies and young children have that fabulous smile for life.

[Nigel Mills (Amber Valley) (Con)]

T5. The Pharmacy First service has proved popular in Amber Valley, but some pharmacists report confusion because the ear infection service applies only to under 18s and patients are being referred to pharmacies when they should not be. Will the Minister either extend the service to over-18s or ensure that NHS communications are clear that this service is only for children?

[Dame Andrea Leadsom]

My hon. Friend raises an important point. He will be aware that a decision was taken that ear wax removal services are better done in the community and that ear syringing can cause problems. That area is under review and I am happy to write to him to address the specific point he makes about over-18s and children.

[Dame Nia Griffith (Llanelli) (Lab)]

T7.   I absolutely agree that we should redouble our efforts to recruit and retain more home-grown carers, as the Welsh Government are doing by paying them all at least the real living wage, but in the short term we have to rely on foreign workers. From her earlier answers, it appears that the Social Care Minister is happy to deprive them of the enjoyment of their own family life, while we expect them to give our relatives loving care. Will she think again and speak to Home Office colleagues about dropping this totally inhumane ban?

--- Later in debate ---

[Christine Jardine (Edinburgh West) (LD)]

I thank the Secretary of State for her offer to help cut waiting lists in Scotland. I listened to the frankly delusional statements from the SNP Benches about the state of the NHS in Scotland. We are in dire straits and suffer the same problems, particularly about GPs and appointments disappearing. When are we going to see an improvement in appointment availability?

[Dame Andrea Leadsom]

The hon. Lady will no doubt be extremely envious of the fact that in England there are 50 million more GP appointments now every year, which is a fantastic achievement by this Government. She will want to look at what is happening in Scotland, which has some of the worst health outcomes in western Europe, and challenge SNP Ministers over drug and alcohol death rates and falls in life expectancy.

--- Later in debate ---

[Maggie Throup (Erewash) (Con)]

Given the expansion of health services through Pharmacy First, what action is my right hon. Friend the Minister taking to ensure that communities such as Sandiacre in my constituency, whose branch of Boots is due to close at the end of the month, are not left without access to such vital services?

[Dame Andrea Leadsom]

I am very happy to discuss that matter with my hon. Friend, who is a huge advocate for her constituency. It is always disappointing when a community pharmacy closes, but she will know that the launch of Pharmacy First on 31 January expanded the value and contribution of all our community pharmacies. It has been met with a £645 million investment over this year and next.

[Mr Gregory Campbell (East Londonderry) (DUP)]

On access to primary care provision, will the Secretary of State assure the House that she will liaise with Health Ministers in the devolved Departments to ensure that rural communities do not lose out because of their isolated locations?

--- Later in debate ---

[Sarah Dyke (Somerton and Frome) (LD)]

Figures obtained by the British Dental Association project that £8 million of the NHS budget in Somerset is going unspent. Will the Minister explain to my constituent, who is suffering in dental agony, why that is happening?

[Dame Andrea Leadsom]

I encourage the hon. Lady to hold her integrated care board to account. We invest more than £3 billion a year in dentistry, and our dental recovery plan means that significant money is available for NHS dentistry. It is for the integrated care board to commission those units of dental activity, which now offer more money—a minimum of £28 per UDA. I am happy to meet the hon. Lady if she finds she is not getting anywhere with her ICB.

[Anna Firth (Southend West) (Con)]

I am currently working with a brilliant local pharmacist, Fizz, to open a new NHS dental practice in Belfairs in my constituency. Premises and dentists have been lined up, but we need the ICB to commission the service. Will the Minister meet me, my local ICB and Fizz to unlock that vital service as soon as possible?

[Dame Andrea Leadsom]

I am delighted to hear about that really good news for my hon. Friend’s constituents—I know she works tirelessly for them. Of course, I will be very happy to meet her.

St Helier Hospital Improvements and New Hospital: Sutton

Andrea Leadsom Excerpts

Friday 1st March 2024 Commons Chamber

[The Parliamentary Under-Secretary of State for Health and Social Care (Dame Andrea Leadsom)]

I congratulate my hon. Friend the Member for Carshalton and Wallington (Elliot Colburn) on securing this debate. I assure him that the Department is also very excited about this project. He is a tireless campaigner for healthcare in his constituency, and I know he has advocated for this new hospital on many occasions. I am delighted that the trust has done an amazing job of decreasing backlog maintenance year on year across its sites, particularly at St Helier Hospital.

We are working closely with Epsom and St Helier University Hospitals NHS Trust on its plans for a new specialist emergency care hospital in Sutton as part of our new hospital programme. The trust is currently preparing its refreshed outline business case, supported by the new hospital programme team, to ensure that its plans are aligned with the national approach to standardisation, are deliverable and, of course, provide value for taxpayers’ money.

The plans for the new specialist emergency care hospital will include a new major emergency department, acute medicine, emergency surgery, critical care for intensive monitoring and paediatric care, as well as both midwife-led and consultant-led birth units. However, 85% of care will still be delivered at Epsom Hospital and St Helier Hospital.

[Elliot Colburn]

I could kick myself for forgetting to mention that we have not only those incredible services but a brand-new working partnership between the Royal Marsden, an incredible cancer hospital that we are very lucky to have in Sutton, and the specialist emergency care hospital. We can provide more and improved services for cancer patients with the two trusts working closely together.

[Dame Andrea Leadsom]

I am grateful to my hon. Friend for highlighting the importance of working across specialties to deliver the best possible care.

I am delighted that the trust continues to work collaboratively with the programme on developing designs for its new hospital scheme, following our national approach to standardisation, Hospital 2.0, through which we will see the most benefits from economies of scale and efficiencies.

The scheme had received more than £23 million in development funding by the end of the 2022-23 financial year. This funding has supported the trust’s activities to prepare for main construction, including the vacation of blocks at St Helier ready for demolition, and a new electronic patient record system that will be implemented next year. In the current financial year, we have released over £1 million in fees to support the trust to develop its business case for early works to prepare the site for main construction.

Part of the funding is for a programme of demolition and groundworks to prepare the Sutton site, which we expect will start later this year, as well as to ensure that vital utilities are available at the new site, including power upgrades and junction improvements. I assure my hon. Friend that Ministers are committed to keeping him updated as further funding is released.

I am pleased to note that the trust has received additional funding from national programmes in recent years, including £7.3 million allocated for the relocation of services from the new Epsom and Ewell cottage hospital and The Poplars to Epsom General Hospital. The construction is complete and has been patient ready since August 2023. The trust previously received £6.1 million for A&E upgrade works at both Epsom Hospital and St Helier Hospital, to improve flows through the emergency departments by increasing A&E capacity and capability.

I take this opportunity to provide a general update on the new hospital programme and the ambitious work it has been undertaking. I am very pleased that four of our new hospitals are now open to patients: the Northern Centre for Cancer Care; the Royal Liverpool Hospital; stage 1 of the Louisa Martindale, also known as the 3Ts Hospital, in Brighton; and the Northgate and Ferndene Hospitals in Northumberland. A further four hospitals are expected to be opened by the end of the next financial year: the Salford Royal major trauma centre, Dyson Cancer Centre, the National Rehabilitation Centre and Midland Metropolitan University Hospital. A further 18 hospitals are either in construction or have early construction activity well under way or completed to prepare their sites. That includes surveys and crucial work on non-clinical infrastructure, such as energy centres, demolition and car parking. The programme will deliver facilities that are at the cutting edge of modern technology, and we are engaging with clinical staff to ensure we are providing them with a better working environment, enabling increased efficiency, promoting staff wellbeing and improving retention.

I thank my hon. Friend for his continued engagement on his new hospital scheme. I know that my ministerial colleague with responsibility for the programme, Lord Markham, is arranging to meet him and other colleagues to discuss the new hospital plans in more detail. I appreciate how tirelessly he campaigns for his constituents, and I assure him that we are committed to delivering the new hospital for Epsom and St Helier University Hospitals NHS Trust by 2030.

Question put and agreed to.

Tackling Obesity

Andrea Leadsom Excerpts

Tuesday 27th February 2024 Westminster Hall

[The Parliamentary Under-Secretary of State for Health and Social Care (Dame Andrea Leadsom)]

I congratulate my right hon. Friend the Member for Bexleyheath and Crayford (Sir David Evennett) on raising this important issue. I thank all hon. Members for their contributions. There is no doubt that this country faces an obesity challenge. I am reassured by the contributions from everybody that none of us underestimate the scale of the task ahead.

As others have said, two thirds of adults in this country are overweight or living with obesity, increasing their risk of many serious diseases. Tackling it head on is not just the right thing for patients but makes good economic sense too. Obesity-related conditions cost our NHS £6.5 billion directly every year and the cost to wider society is a staggering £57 billion. As my right hon. Friend the Member for Bexleyheath and Crayford said, some estimates put it at over £90 billion.

My great passion is for giving every baby the best start for life. There is no doubt that prevention is not only kinder but much cheaper than cure. Food given to babies and young children helps establish food preferences at an early age, so it is vital that we build healthy eating patterns as soon as possible.

Nearly one in 10 children starting primary school are already living with obesity, doubling to nearly one in five by the time they leave. Growing numbers of children with excess weight are, as hon. Members have said, developing health conditions once rarely seen in childhood such as high blood pressure. Every child needs an environment that helps them to thrive and reach their full potential. Of course, that is easier said than done. There is no single solution, no magic bullet to solve the problem. That is why we are delivering an ambitious programme with four strands: first, we are supporting families to make healthier choices through more advice and better information. That starts at the very beginning of life with our national breastfeeding helpline for parents who need support. The Start for Life website is a rich source of helpful advice.

We are backing family hubs with £300 million so that new mums and dads have the best advice, including on children’s nutrition, with one-stop shops across England. Weaning is a critical time for establishing healthy eating, so we are working on voluntary industry guidelines to reduce levels of sugar and salt in commercial food and drink aimed at children up to 36 months. We have begun a four-week period of engaging with industry to make sure we get that right.

For older children, families and adults, we provide a range of materials, tools and apps to encourage eating better and moving more. That can all be found on our Better Health website. I encourage all hon. Members to recommend it to their constituents.

I am proud of action that we have taken to mandate calorie labelling on websites and delivery apps for all large restaurants, cafés and takeaways. We have prohibited the promotion of less healthy products at key selling locations to help people stave off impulse buys, because we all know that people are not making those choices consciously. They are unconscious choices being hugely promoted by incredibly strong advertising and marketing. We know it can be very challenging for some families to make healthier choices, so we are investing over £200 million a year on three health food schemes: healthy start, the nursery milk scheme and the school fruit and vegetable scheme.

Secondly, we are promoting more physical activity, which helps people maintain a healthier weight. The Government are investing over £600 million in school sports over the next two years via the PE and sport premium and School Games Organiser network so that children can get more active. We also have the Couch to 5K and Active 10 apps to promote everyone getting more active.

The third measure is supporting those already overweight or obese to achieve and maintain a healthier weight. We have delivered a free NHS weight loss app, and local authorities are funding local weight loss services from their public health grants. The NHS provides a digital weight management programme and many specialist services. We are now exploring ways to increase access to the newest weight loss drugs for more people who are eligible.

Fourthly—a really critical point, as lots of right hon. and hon. Members have raised—is our work with the food industry itself. Sadly, there has been a long-term trend towards producing and marketing foods high in calories, saturated fat, salt and sugar—a race to the bottom. We will reverse that trend. Our soft drinks industry levy has already made huge strides in bringing down the sugar content of soft drinks by almost half between 2015 and 2020, removing a staggering 46,000 tonnes of sugar. Our voluntary reformulation programme requires all sectors of industry to reduce levels of sugar, calories and salt in the everyday food and drink that people buy. If we can see this through, consumers will have many fewer calories in their diet without them having to consciously change what they eat.

Although the salt and sugar reduction programmes have brought some progress, there is much more to be done. The calorie reduction progress report published this month showed little change in calorie levels between 2017 and 2021. I have asked industry to meet the reduction targets for calories and sugar by the end of 2025. We will leave no stone unturned if they do not live up to our expectations.

I am pleased to assure the House and my hon. Friend the Member for Erewash (Maggie Throup) that we remain committed to introducing further advertising restrictions to reduce the marketing of less healthy foods to children. We will also bring in restrictions on volume price promotions, such as three for the price of two, on less healthy foods in October next year, and we will back local government in using its powers to support a healthy local food environment.

Obesity is a significant challenge, not just in the UK but globally. We all have our part to play. I have personally been engaging with industry throughout my career, from the Treasury, to the then Department for Business, Energy and Industrial Strategy, to the Department for the Environment, Food and Rural Affairs. Business people say they want a brighter future for all our children. I plan to make sure that they deliver on that.

Health and Social Care

Andrea Leadsom Excerpts

Friday 23rd February 2024 Ministerial Corrections

[Paul Bristow (Peterborough) (Con)]

For new patients, accessing an NHS dentist in Peterborough is almost impossible. Should a new medical centre wish to establish a new NHS dental practice, doing so would require flexibility in units of dental activity rates and the ability to recruit dentists from overseas. Would the Minister give that effort her enthusiastic support and encourage NHS bosses to do the same?

[Dame Andrea Leadsom]

My hon. Friend is pushing against an open door. He may be aware that in 2023 we made some legislative changes to give the General Dental Council more flexibility to expand the registration options open to international dentists, tripling the capacity of three sittings of the overseas registration exam from August 2023 and increasing the number of sittings for the part 2 exam in 2024 from three to four.

[Official Report, 23 January 2024, Vol. 744, c. 133.]

Letter of correction from the Under-Secretary of State for Health and Social Care, the right hon. Member for South Northamptonshire (Dame Andrea Leadsom):

An error has been identified in my response to my hon. Friend the Member for Peterborough (Paul Bristow).

The correct information should have been:

[Dame Andrea Leadsom]

My hon. Friend is pushing against an open door. He may be aware that in 2023 we made some legislative changes to give the General Dental Council more flexibility to expand the registration options open to international dentists. The GDC has tripled the capacity of three sittings of part 1 of the overseas registration exam from August 2023 and increased the number of sittings for the part 2 exam in 2024 from three to four.

Heart and Circulatory Diseases: Premature Deaths

Andrea Leadsom Excerpts

Thursday 22nd February 2024 Commons Chamber

[The Parliamentary Under-Secretary of State for Health and Social Care (Dame Andrea Leadsom)]

First, may I congratulate my hon. Friend the Member for Watford (Dean Russell), and say how pleased we all are to see him fighting fit and in his place? I also say to the right hon. Member for Alyn and Deeside (Mark Tami) that we wish his son absolutely all the best and a speedy return to full health, and to the hon. Member for East Dunbartonshire (Amy Callaghan)—who has had so many health problems of her own—that we all wish her very well and a full recovery. Some very good contributions have been made to today’s debate. I would just like to mention a very, very dear friend of mine who died of a sudden cardiac arrest very unexpectedly aged 55. It was a tragedy for his young family, so I really do understand—thankfully not personally, but through very close friends—how terrible this is.

I will write to the hon. Member for North West Leicestershire (Andrew Bridgen) and my hon. Friends the Members for Shipley (Philip Davies) and Christchurch (Sir Christopher Chope) about the statistics. I do not have any information today; I wanted to focus on the Government’s strategy for preventing cardiovascular disease, but I will write to them. As ever, I thank the hon. Member for Strangford (Jim Shannon) for his thoughtful remarks, and say to him that I have already been in contact with the Minister in Northern Ireland about the smoking Bill. Meeting with him will be one of my early priorities.

My hon. Friend the Member for Watford is a vocal supporter of the British Heart Foundation. On behalf of the Government, I thank the BHF for all the incredible work it has done throughout Heart Month, including introducing online CPR training that takes just 15 minutes to complete—15 minutes that could genuinely save a life. I also pay tribute to the many other charities that work tirelessly to support people at risk of, or living with, cardiovascular disease.

Over the last decade, the Government have taken significant action to prevent cardiovascular disease and its causes. Just over 10 years ago, we launched the NHS health check, which is our CVD prevention programme. Health checks play a key role in preventing heart disease, stroke, type 2 diabetes, and some cases of dementia and kidney disease. The numbers show that, through health checks, people have a lower likelihood of being admitted to hospital for CVD and type 2 diabetes, and for all causes of death one, three and five years after attending a check. So far, well over 10 million checks have been delivered, and data shows more people are receiving checks than before the pandemic. We are now investing £17 million in the creation of a digital NHS health check.

In fact, we are looking at every opportunity to prevent CVD throughout the course of a person’s life. Two years ago, the NHS published its CVD prevention recovery plan, setting out four high-impact areas for every part of the health service to focus on risk factor detection and management. This began by rolling out blood pressure checks in high street pharmacies and helping people measure blood pressure at home, and we are now helping thousands more people detect hypertension earlier. Our forthcoming major conditions strategy will focus on prevention throughout the life course, which is essential in creating a more sustainable NHS. It aims to improve care and health outcomes for those living with multiple conditions and an increasingly complex set of needs.

We are tackling salt, sugar and calories through the voluntary reduction and reformulation programme. Working with industry, we have already delivered reductions of up to 20% in some foods. The second pillar of our prevention plan is smoking cessation. I am proud to be part of a Government who will introduce the ground- breaking smokefree generation, so that children aged 15 and younger will never legally be sold cigarettes. This will be the most significant public health intervention in a generation.

I now turn to managing risk factors. Once we have diagnosed hypertension, it is vital that we properly manage it, and we are doing more than ever before. Among those under the age of 80 with GP-recorded hypertension, 170,000 more people had their condition managed to safe levels by March 2023 compared with the same month in 2020. The NHS has set hypertension management as a key priority, investing over £3 million to bring CVD leadership roles within every integrated care board.

We recognise that outcomes are often worse in different parts of the country, and understanding why variations occur is critical so that the NHS can take the right action. I support it in its launch of CVDPREVENT, a national primary care audit, which will provide data to highlight gaps in diagnosis, identify inequalities and find room for improvement. I am confident that the programme will help integrated care systems make real change in their areas.

A heart attack is a medical emergency, and recognising the symptoms can be a matter of life or death. People’s chances of surviving a heart attack are far greater if they seek care as soon as possible. In August last year, the NHS launched a lifesaving campaign, helping people to recognise the common signs of a heart attack that are often dismissed or ignored, and to seek help by calling 999. I absolutely applaud my hon. Friend for raising his specific symptoms in this Chamber so that others can understand more about what to look out for. Of those who reach hospital early to receive treatment, about nine in 10 survive a heart attack, compared with only seven in 10 of those who do not. That is why raising public awareness is so critical. To improve survival rates for out-of-hospital cardiac arrest cases, the Government have announced a new £1 million fund to expand defibrillator access in the community. We have already delivered over 700 defibrillators towards an estimated total of 1,000.

We are also taking huge strides in making our NHS simpler by providing for patients at home, because we know that patients prefer to avoid hospital if they can be safely supported in their own homes. The NHS programme “managing heart failure @home” is pioneering this approach, and addressing health inequalities as a key aim. Thanks to record funding, we are rolling out up to 160 community diagnostic centres, which will provide echocardiography services by March 2025, and I am pleased to update the House that 153 CDCs are live at this time.

[Amy Callaghan]

Will the Minister join me in congratulating East Dunbartonshire Council on its good work in getting so many community defibrillators for use across East Dunbartonshire ?

[Dame Andrea Leadsom]

Absolutely. I am happy to do that, and I would encourage all local authorities across the country to make best use of the funds that are available to them.

Let me turn to mental health and counselling services. As my hon. Friend the Member for Watford discussed, surviving a heart attack can have significant psychological impacts on individuals and their families, and I am grateful to him for sharing his own experience so powerfully. Integrating NHS talking therapies with physical health services can provide better support to people with combined physical and mental health needs, including people with cardiovascular disease.

[Mark Tami]

The right hon. Lady is making an important point. This should not be a bolt-on. It should be part and parcel of the treatment. We tend to address the physical side of the illness, open the door and away we go, and we do not ask people about some of the issues that they are struggling to cope with.

[Dame Andrea Leadsom]

I completely agree with the right hon. Gentleman. As part of the NHS long-term plan, all integrated care boards are expected to expand services locally by commissioning NHS talking therapies services integrated into physical healthcare pathways. I encourage anyone experiencing symptoms of depression, anxiety or post-traumatic stress disorder, even a long time after the event, to reach out to their GP or NHS talking therapies for support.

To conclude, I thank my hon. Friend for raising such an important issue. Across the House we all share the ambition to bring down premature deaths from heart and circulatory disease. Specifically, this Government aim to prevent 150,000 heart attacks, strokes and dementia cases in the next five years. Prevention is not only kinder but so much cheaper than cure.

National HIV Testing Week

Andrea Leadsom Excerpts

Thursday 8th February 2024 Commons Chamber

[The Parliamentary Under-Secretary of State for Health and Social Care (Dame Andrea Leadsom)]

I congratulate my right hon. Friend the Member for Dumfriesshire, Clydesdale and Tweeddale (David Mundell) and the hon. Member for Warrington North (Charlotte Nichols) on securing this important debate. My right hon. Friend has been called away to his constituency today, but I am grateful to both him and the hon. Lady for their strong advocacy for National HIV Testing Week.

I pay tribute to all the other Members who have contributed today: my hon. Friend the Member for Worthing West (Sir Peter Bottomley), the hon. Members for Hammersmith (Andy Slaughter), for Strangford (Jim Shannon), and for East Dunbartonshire (Amy Callaghan), and the shadow Minister, the hon. Member for Birmingham, Edgbaston (Preet Kaur Gill). It is clear that there is cross-party consensus on the need to challenge ourselves to meet our ambition of no new HIV transmissions by 2030, and I am sure that we can do that if we stick together on this subject. I listened carefully to all Members’ speeches, and I will try to answer all the questions that were asked.

Let me begin by saying how grateful I am to everyone who has taken part in in National HIV Testing Week, especially all those who have been tested in Portcullis House thanks to the work of the excellent Terrence Higgins Trust. I also commend the work of other charities, including the National AIDS Trust, Tackle HIV, LGBT Foundation, George House Trust and many others supporting families up and down the country—and I salute the work of the all-party parliamentary group on HIV and AIDS.

We should remember the way in which heroic NHS staff stepped up to care for people living and dying with HIV and AIDS in the 1980s, at a time when AIDS was a terrifying new disease that spared no one. It was to honour their legacy, and to complete the work that our NHS began 40 years ago, that this Government made a bold and ambitious commitment in 2019 to end new transmissions in England by 2030. To that end, we published the first, groundbreaking national HIV action plan just over two years ago. Testing is one of the plan’s central pillars, and I am proud to say that we have been making huge strides, setting an example to the rest of the world to follow. Last year the UK ranked first in the European combined sexual and reproductive health rights ranking atlas 2020 to 2023, in front of 43 other countries, and the UK Health Security Agency has confirmed that for the third time in a row, England achieved or exceeded the UN’s 95-95-95 targets. That means that 95% of people with HIV are being diagnosed, 98% of those diagnosed are being treated, and 98% of those receiving treatment are unable to pass on the condition.

However, while we have made excellent progress, we are not complacent, and we will not be satisfied until the number of transmissions is brought to zero. We have therefore put National HIV Testing Week at the heart of our efforts, year on year. We know that tailored and targeted campaigns are the most effective, so we have increased the number of tests and widened the scope of our campaign, ensuring that our messaging reflects and appeals to the different groups whom we are trying to reach. We are undertaking ever greater efforts to reach those who have been missed before and have become disengaged from the process. Last year we introduced the option of self-testing, with near-instant results at home, to give people more choice and more control over their testing, and this year we are partnering with local businesses to offer tests in places that regularly serve people from, for example, the black African community, who we know are less likely to want to go for a test.

These efforts have brought results. Since we launched the HIV action plan, we have sent out nearly 100,000 tests and received more than 300 reactive results, allowing us to immediately begin the process of getting vital treatment to those who need it. So far this year, the figures show that more than 4,000 self-sampling and self-testing kits have been ordered and nearly 500 results have been reported, nine of them reactive. Our campaign’s message is simple: “I test”—not “eye test”! I am pleased to tell the House that, like the hon. Member for East Dunbartonshire, I tested this week, so I can say from experience that testing is quick, easy, confidential and free. I engaged in a good bit of banter with my fellow Health Ministers as we undertook our testing together, so ours was not very confidential, but it was done through choice, and we were demonstrating how easy it is to do. Everyone should test. It takes two minutes, so I say: please do it.

Our most recent figures show that although new HIV diagnosis rates are steadily decreasing, they sadly remain disproportionately higher among gay men, bisexual men and other men who have sex with men, as well as heterosexual people from the black African community. Similarly, disparity can be found in testing: despite huge progress and record testing rates among gay men, lower levels of testing persist among black African and hetero- sexual groups.

NHS England has invested £20 million to deliver opt-out HIV testing in emergency departments in areas of extremely high HIV prevalence to ensure that people who need it receive the right treatment as early as possible. Anyone having blood taken in A&E in those centres has been automatically—with the potential to opt out—tested for blood-borne viruses, which means that people who would not have been reached via any other testing route have been diagnosed. This saves the NHS millions of pounds, relieves pressure on the service, and helps to address inequalities in testing. In under two years, the programme has already proved value for money by diagnosing more than 4,000 people with blood-borne viruses including HIV, hepatitis B and hepatitis C. The National Institute for Health and Care Research is investing an additional £20 million to find out how we might go further, faster, in tackling HIV rates in the additional 47 sites of high HIV prevalence across England.

[Andy Slaughter]

That may be a good initiative, but it is limited by time, geography, and the type of institution offering the test. Are the Government committed to going further, and spreading opt-out testing to other health facilities and other parts of the country?

--- Later in debate ---

[Dame Andrea Leadsom]

As I just mentioned, there is an additional £20 million for the National Institute for Health and Care Research. As well as delivering the opt-out testing in 47 centres, it will deliver a live dashboard showing the effectiveness of this type of testing. That is in addition to self-testing, which people can do at home or at a testing centre. It is particularly important to note that the public health grant is used in local authority areas, so that authorities can make their own attempts to reach out and identify those who should be tested.

[Jim Shannon]

We in the House may want to reach out further and bring about more testing. Has the Minister been able to explore the possibility of extending this programme to Northern Ireland, Scotland and Wales? This is something that we should all pursue vigorously, and we can do that better if we do it collectively.

[Dame Andrea Leadsom]

I completely agree. We would like to see this being done around the world. The UK is, I believe, the third biggest donor to the Global Fund to Fight AIDS, Tuberculosis and Malaria, which seeks to eradicate those diseases and to which we have donated £5.5 billion, so our interest is in eradicating those diseases throughout the world. Closer to home, the hon. Gentleman is absolutely right: that crucial part of the United Kingdom, Northern Ireland, should also be supported and helped to roll out this testing, and that will be possible now that the Northern Ireland Assembly has been re-established, which I am delighted about.

Of course, there is still much more to be done to smash the stigma attached to HIV testing and treatment. I pay particular tribute to Becky from Sheffield and Akhona from Leeds for coming forward recently and telling their stories to the BBC. They are setting an example for people up and down the country who should come forward for testing or treatment, and we are backing their efforts to spread awareness by funding HIV Prevention England’s HIV stigma symposium in March at the International Convention Centre in Birmingham. The event will bring together community experts, activists, healthcare professionals and affected people to discuss the impact of HIV stigma and look at effective stigma-reduction strategies. I am sure that it will generate promising stigma-reduction solutions, and I will listen carefully to its recommendations. I am pleased that HIV Prevention England is focusing its efforts on giving a platform to speakers from underserved areas.

Of course, HIV prevention goes beyond testing. The use of pre-exposure prophylaxis, commonly known as PrEP, is an important part of combination HIV prevention. It has been called a “miracle drug” that prevents HIV-negative people from acquiring the virus, and it is a vital tool in our battle to end new HIV transmissions by 2030. Oral PrEP has been routinely available in specialist sexual health services since 2020.

However, we recognise that certain groups have challenges in accessing the PrEP they need. That is why we have developed a PrEP road map with colleagues from Government, local authorities, professional bodies and the voluntary and community sectors, and it will be published on 15 February.

[Andy Slaughter]

At the moment, because it can be accessed only through sexual health clinics, the average wait to access PrEP is more than 12 weeks. Sexual health clinics have seen about a 30% real-terms funding cut over the last few years, so will the Minister either increase the resources available to clinics or increase the number of outlets, such as pharmacies, from which PrEP can be obtained? That is where the logjam is occurring.

[Dame Andrea Leadsom]

As I have just said, we have developed a PrEP road map precisely to increase access to PrEP, and its report will be published in a few days’ time. I encourage the hon. Gentleman to look at that report. I thank everyone who played their part in drafting the road map, working tirelessly towards our 2030 goal of zero new transmissions.

I also thank all our partners for supporting the promotion of HIV testing through National HIV Testing Week, our sexual health summer campaigns, the roll-out of PrEP throughout the country, the introduction of opt-out testing, the development of a PrEP access and equity road map; and so much else besides.

These results would not have been possible without Kevin Fenton, the Government’s chief adviser on HIV and chair of the HIV action plan implementation steering group. His bold leadership has brought together partners across the health landscape towards our shared goals, and I pay particular tribute to him.

So many of us have a part to play as we reach the endgame of ending new HIV transmissions in England by 2030. I reiterate my sincere thanks to all colleagues who have shared their stories, advice and experiences to support our efforts for so long. I hope that today’s debate will inspire thousands of people to do the right thing and take an HIV test.

Public Health Grant: Local Authority Allocations 2024-25

Andrea Leadsom Excerpts

Monday 5th February 2024 Written Statements

[The Parliamentary Under-Secretary of State for Health and Social Care (Dame Andrea Leadsom)]

Today I am publishing the Public Health Grant allocations to local authorities in England for 2024-25.

Funding for local government’s health responsibilities is an essential element of our commitment to investing in preventing ill health, promoting healthier lives and addressing health disparities, and an important complement to our investment in both health and social care.

In 2024-25, we are increasing funding through the Public Health Grant and the pilot of 100% retained business rate funding for local authorities in Greater Manchester to £3.603 billion.

The allocations I am announcing today are part of a wider package of investment in public health services. From 2024-25 we are investing an additional £70 million per year to support local authority-led stop smoking services—nearly doubling current spend on these services—in support of our commitment to deliver a smoke-free generation. This further supplements targeted DHSC allocations to local authorities over the spending review period of £516 million to improve drug and alcohol addiction treatment and recovery, and £170 million to improve the Start for Life services.

This overall package will deliver a real-terms increase of more than 4% over the two years 2023-24 and 2024-25 in DHSC funding allocated for local authority public health functions over the spending review period, enabling local authorities to invest in the prevention of ill health and in essential frontline services.

The 2024-25 Public Health Grant will continue to be subject to conditions, including a ring-fence requiring local authorities to use the grant exclusively for public health activity.

Full details of the Public Health Grant allocations to local authorities for 2024-25 can be found on www.gov.uk. This information has been communicated to local authorities in a Local Authority Circular.

Attachments can be viewed online at:

http://www.parliament.uk/business/publications/written-questions-answers-statements/written-statement/Commons/2024-02-05/HCWS239/.

[HCWS239]

Pharmacy First

Andrea Leadsom Excerpts

Wednesday 31st January 2024 Written Statements

[The Parliamentary Under-Secretary of State for Health and Social Care (Dame Andrea Leadsom)]

Following constructive consultation with Community Pharmacy England, I am very pleased to inform the House that on 31 January, the Pharmacy First service will be launched in community pharmacies in England.

Pharmacy First was announced in May 2023 in the delivery plan for recovering access to primary care. This made significant new funding available for community pharmacies to deliver Pharmacy First and to deliver more blood pressure checks and contraception consultations. The new and expanded services will release around 10 million appointments in general practice per year once scaled. We want to do everything we can to support our GPs in supporting patients with higher acuity conditions—a job they do so well. Making use of the clinical skills in community pharmacy does just that.

Four in five people in England can reach a community pharmacy within a 20-minute walk and there are twice as many pharmacies in the most deprived communities. Our vision is to support community pharmacists to evolve further into a more clinically focused role, with members of the public able to take full advantage of their skills and capabilities. Pharmacy’s role has been increasing in recent years. In 2019 we set out how we would work to embed and integrate community pharmacy into the NHS, delivering more clinical services and making them the first port of call for many minor illnesses. We had already made good progress, for example:

General practice, NHS111 and urgent and emergency care (UEC) can now refer patients to community pharmacies for advice and treatment for minor illnesses, and NHS111 and UEC can also refer for urgent medicines supply. Over 3.4 million referrals have been made through these routes to date.

We expanded the new medicine service which supports over 200,000 people a month when they start new medicines and we introduced the discharge medicine service which supports 8,000 patients a month who have had their medicines changed following a visit to hospital, reducing medication errors and readmissions.

Over 9,000 pharmacies have delivered over 2 million blood pressure checks since October 2021, allowing those with high blood pressure to be identified and referred for onward management. The delivery plan has made funding available for 2.5 million additional checks. It is estimated this could prevent over 1,350 cardiovascular events such as heart attacks and strokes in the first full year of service, and could lead to savings of around £13 million across primary, secondary and social care.

We introduced a contraception service in April 2023 to enable community pharmacists to manage oral contraception on the basis of an existing prescription and in December 2023 this service was expanded so that pharmacists can now also initiate oral contraception. The delivery plan has made more funding available for this service so that up to half a million women will be able to access oral contraception through their pharmacy.

Pharmacy First will go further, building on this success and enabling pharmacists to supply prescription-only medicines, including antibiotics and antivirals where clinically appropriate, to treat seven common health conditions without the need to visit a GP. The seven conditions are sinusitis, sore throat, earache, infected insect bite, impetigo, shingles, and uncomplicated urinary tract infections in women. Patients will be able to walk into a pharmacy if they have symptoms or may be referred to a community pharmacy by a GP or NHS111. Ninety-four per cent of pharmacies have signed up to deliver Pharmacy First from 31 January 2024.



The investment in Pharmacy First will also deliver significant upgrades in the digital infrastructure in community pharmacy. This will streamline referrals to and from other NHS services, provide additional access to relevant clinical information from the GP record, and share structured updates quickly and efficiently following a pharmacy consultation back into the GP patient record.

Pharmacy First is the next step on the journey to make the best possible use of the knowledge and expertise of community pharmacists and their teams, improving patient access to care.

[HCWS232]