NHS Dentistry: Recovery and Reform

Andy Carter Excerpts

Wednesday 7th February 2024 Commons Chamber

[Victoria Atkins]

My hon. Friend will appreciate that I get a lot of invitations, but I will do everything I can to meet him. His passion and ambition for his local area shine through, and not just in the question he asks today but in the question he asked the Prime Minister a few weeks ago. He is absolutely right: we need the General Dental Council to work with us—I think it will—to ensure that we can get more international dentists registered as quickly as possible, for the benefit of our constituents.

[Andy Carter (Warrington South) (Con)]

I welcome what the Secretary of State has said today. I also pay tribute to the ICB in Cheshire for the work that it has done to make additional appointments available in Warrington, where it has been incredibly difficult to access NHS dentistry despite there being many dentists on the high street, because so many have decided to move away from the NHS. Can she explain how the changes announced today will incentivise dentists to return to providing NHS services, so that constituents in Warrington South can get the NHS appointments they want?

[Victoria Atkins]

As I have said, dentists are independent contractors but we want to encourage them back into the NHS if they have left it, and we believe that the new patient premium and the work on the UDA are just two of the levers that we can deploy to achieve that. We also have a longer-term vision for our NHS, and through the long-term workforce plan we will be training 40% more dentists by 2031. That is real ambition and a plan for the long-term future of our country.

Building an NHS Fit for the Future

Andy Carter Excerpts

Monday 13th November 2023 Commons Chamber

[Andy Carter (Warrington South) (Con)]

As we begin the final Session of this Parliament, we do so for the first time in more than 70 years debating a King’s Speech. I am pleased that this King’s Speech lays out a comprehensive legislative programme for the forthcoming year: an ambitious set of reforms that will help boost economic growth, strengthen society and make Britain a safer and healthier place.

Having looked back at my contributions in this place over the last four years, there are a couple of Bills I want to spend time talking about, because the subjects they address have dominated what I have said. First and foremost, the subject of the debate is “Building an NHS fit for the future”. The reason I am keen to take part in the debate is because the NHS has been front and centre of my campaigning in Warrington South, before and since becoming its Member of Parliament.

Since 2019, we have seen the benefits that Government investment in our local health services is making in Warrington, including a new £5 million radiology centre at Warrington Hospital, with state-of-the-art MRI and CT scanners, and £6 million to extend the emergency department, building a new same-day emergency care unit to speed up discharge and free up capacity. Money from Warrington’s £21 million town deal has funded a new health and social care academy so that we can train people to work in our health and social care sectors in the future, and a mammography unit has boosted screening capacity.

I have named but a few projects in Warrington, but there is still much more to do. Putting in place the right health infrastructure and training more doctors, dentists and nurses is vital for the long-term future of our national health service. I regularly speak to regional NHS leaders who tell me that the extra funding the Government are putting into Warrington is making a difference to people and staff alike in Warrington. In fact, there are more doctors, nurses and staff working in GP practices and the hospital today in Warrington than there were in 2019.

However, there are two areas related to health infrastructure where we need to go further. Warrington’s status as a new town has meant its population has gone from 60,000 in the late 1960s to more than 200,000 today. When I became the MP for Warrington South, I promised to campaign for a brand new hospital for our town, not because I wanted it but because Warrington needs it. Working together with local health chiefs and local cross-party politicians, we put forward plans that would allow that to be delivered. So far we have not managed to achieve that, but there are simply not enough beds to cope with the demand, nor sufficient parking spaces for patients, visitors and staff. The facilities we have today are not fit for a town of 200,000 residents. When the Minister for Social Care, my hon. Friend the Member for Faversham and Mid Kent (Helen Whately), who was on the Front Bench earlier, came to visit in January last year, she saw for herself the challenges that we face in our A&E unit.

The other infrastructure issue I want to raise relates to the building of new GP surgeries in areas where new homes have been built. On Friday, I met with local GP Dr Jain, at the Appleton medical centre. She showed me around and, understandably, she is keen to progress from a first floor consulting suite with limited parking spaces in Appleton to a new surgery that is being funded by section 106 contributions from the local developers of all those houses that have been built. However, the process of securing an agreement to build is being delayed because of challenges in agreeing prices with the district valuer. One of my key asks for the new Secretary of State for Health and Social Care is to help unlock the funding and make progress on building the new health centres that are now urgently needed for our growing towns.

I will touch briefly on a couple of other areas mentioned in the King’s Speech that I have spoken about in the Chamber on numerous occasions, including the leasehold reform Bill. I have spoken many times on behalf of residents in Chapelford about the crucial need for changes in the law to protect those who are trapped in the leasehold system. Homes, particularly in the Chapelford area of my constituency, have been built under leasehold systems. I have been dealing with the issue on an almost daily basis since becoming the Member of Parliament for Warrington South. In common with colleagues across the House, I have constituents who face an endless array of problems with leasehold—including high service charges, and drawn-out and complicated processes to get information about the leaseholds on their homes, with people having to spend money to get that information if they are able to obtain it at all—so I welcome the leasehold and freehold Bill.

Like the hon. Member for Manchester, Withington (Jeff Smith), I am pleased to see the Media Bill, which I and colleagues on both sides of the House have been pushing for. As the chair of the all-party parliamentary media group and of the APPG on commercial radio, I have spent a lot of time looking at and working on the issue. It is hard to explain to constituents why we want to prioritise a Media Bill, but the truth is that if we do not get today’s legislation right, frankly, it will be the only such legislation we see for 20 years, and what we watch on our TVs and listen to on our radio stations will be controlled not by what happens here in Parliament, but by what happens with tech companies on the west coast of America. That is why it is so important that we get the Media Bill right.

When the last media Bill came through Parliament 20 years ago, Facebook was not around, we did not have streaming services and people listened to a radio station not through an on-demand speaker, but through a dial that they tuned. All those things have changed and we need to get the legislation right to ensure that viewers and listeners in this country are protected, and get to listen to and see public service radio and TV in the way they should.

Finally, I will briefly touch on the Government’s criminal justice agenda. As a magistrate, I know all too well how important it is to ensure that justice is seen to be done, so I very much welcome measures on proportionate sentencing and powers to compel criminals to hear their verdicts read out in court.

I do not want to take up any more time, Madam Deputy Speaker. To sum up, the King’s Speech contains a strong and promising agenda from the Government. There is lots of work to be done, and I am looking forward to another year of healthy debate and parliamentary scrutiny, so that we can get these important reforms on to the statue book over the next 12 months.

Countess of Chester Hospital Inquiry

Andy Carter Excerpts

Monday 4th September 2023 Commons Chamber

[Steve Barclay]

First of all, I pay tribute to the hon. Lady for the work she has done with the families and the staff in response to these terrible events. It is important that we reassure patients who are using the Countess of Chester Hospital now about the measures that have been put in place; that is why I wanted to bring to the House’s attention House the steps that have already been taken.

However, it was also striking in my discussions with family members that they were at pains to point out that some of the other staff they had been treated by in the Countess of Chester Hospital had been exceptional in their care. There were specific issues that raised very serious concerns, but the families were at pains to point out that there were other staff who had treated them extremely well. Indeed, as the shadow Health Secretary said, there were staff also raising concerns and ensuring that the police investigated. With NHS England colleagues, we are working closely with the Countess of Chester Hospital on next steps, but it is important that the measures we have taken provide reassurance about the quality of care that is available at Chester now.

[Andy Carter (Warrington South) (Con)]

I commend the Secretary of State on his decision to upgrade the inquiry and put it on a statutory footing, something I know many of the families wanted. I am keen to understand what steps he can take to give assurances that there is consistency in all hospitals around the UK on the freedom to speak up guardians. What steps is he taking to ensure consistency right across the NHS estate?

[Steve Barclay]

My hon. Friend raises an extremely important point. That is why in 2022 the guidance around the national freedom to speak up policy was strengthened —I mentioned the appointment in September 2022 of Henrietta Hughes as the Patient Safety Commissioner—and why significant work has been done on the quality of data, looking at the work for example of the getting it right first time teams, so that the data can be analysed more effectively to alert investigation.

Looking at the timeline, there are further lessons around, for example, who had visibility of the Royal College of Paediatrics and Child Health report and when. Clearly there are further lessons that we need to look at, but already the guidance, particularly on freedom to speak up, has been strengthened. Back in 2018 both the Public Interest Disclosure Act 1998 and alongside it the child death overview panel, which reviews all child deaths, were also strengthened.

Oral Answers

Andy Carter Excerpts

Tuesday 25th April 2023 Commons Chamber

[Steve Barclay]

We are committed to a major conditions paper, not least because many people with cancer have multiple conditions; that is why it is important that we look at these issues in the round. With the Minister for Social Care, I had a very useful roundtable with key stakeholders, including the cancer charities. The key issue is that as part of our work on cancer checks, over 320,000 more people are receiving treatment for cancer compared with last year—that is around fifth higher—and we are expanding our capacity through the diagnostic centres, the surgical hubs and the expansion of the workforce. All of that fits within the strategy we have through the major conditions paper.

[Andy Carter (Warrington South) (Con)]

St Rocco’s Hospice in Warrington provides invaluable palliative and end-of-life care for families. However, the charities that run hospices around the UK are finding it incredibly difficult to raise funds. Will the Minister give us an assurance that she is working very closely with the sector to ensure that those services continue to be provided?

[Helen Whately]

My hon. Friend makes a really important point about the very important work that hospices do in our communities, and I fully support hospices as a sector. The funding for hospices generally comes through the NHS and the local integrated care boards that commission the services they provide, as well as, of course, from their own fundraising efforts. I am speaking to NHS England about the support it provides to hospices, because I am very keen to make sure that they get the support that they need.

Junior Doctors’ Strikes

Andy Carter Excerpts

Thursday 30th March 2023 Commons Chamber

[Steve Barclay]

First, there is absolutely no traducing going on. In my last answer, I praised the junior doctors and recognised the fact that they have faced huge pressure from the pandemic, which is why we stand ready to work with them. Some on the BMA junior doctors committee have a different agenda, but we stand ready to work very constructively with that committee. The hon. Gentleman suggested that I drop the precondition. It is not I who set the precondition; it is the junior doctors committee that did so. I remind the House that it includes restoration to 2008 levels of all elements of pay, not just basic pay; parking fees and exam fees; and “radical” reform of the Review Body on Doctors’ and Dentists’ Remuneration. It is the junior doctors committee that set those preconditions, not the Government.

[Andy Carter (Warrington South) (Con)]

I commend my right hon. Friend for the way in which he and his team have worked to find solutions with other trade unions, particularly the nurses. None the less, the 96-hour walkout is a significant period of disruption. Can he confirm that he is doing everything he can to ensure that those needing urgent healthcare in Warrington will be able to access it despite the industrial action by the BMA?

[Steve Barclay]

I thank my hon. Friend for his question. Yes, the Department is working very closely with colleagues in NHS England and across the NHS to mitigate as best we can the impact of the junior doctors’ strike. He is right that we had meaningful and constructive talks with the staff council representing “Agenda for Change” staff. I am very pleased that, as a result of the constructive engagement we had, the NHS staff council was able to recommend that pay award to its members. He is right that that points to the constructive approach that we have taken. We stand ready to have that constructive engagement with junior doctors, recognising the real pressures that the profession has been under. We will mitigate as best we can, but, given the timing over the Easter period, obviously, there is a risk in terms of patient harm. We will do all we can to mitigate that.

Urgent and Emergency Care Recovery Plan

Andy Carter Excerpts

Monday 30th January 2023 Commons Chamber

[Steve Barclay]

I am delighted that, thanks to my hon. Friend’s assiduous campaigning, he has secured his diagnostic centre, and that he assures me he will get it operational in one of the fastest times seen by any area. We are bringing forward our workforce plan, and as I set out, we have 2,500 more nurses this year compared with last year. We are on track for our manifesto commitment of an extra 50,000 nurses, with more than 30,000 recruited already.

[Andy Carter (Warrington South) (Con)]

May I take my right hon. Friend back to the response he gave to the hon. Member for Weaver Vale (Mike Amesbury) about Warrington Hospital? That A&E unit is incredibly under pressure. Over the weekend nurses talked to me about the 120 patients currently waiting to be discharged, which is putting intolerable pressure on that unit. My right hon. Friend said that he was not particularly familiar with those issues, but perhaps I can invite him to Warrington to see the pressure. While he is there, perhaps he will also look at the Health and Social Care Academy, which was set up by the local college to try to address the shortage in social care. A great level of innovation seems to be happening there, and I am sure he would like to see Warrington for himself.

[Steve Barclay]

That last question gives me a beautiful opportunity to correct an earlier answer regarding the constituency of my hon. Friend. He knows I am familiar with this issue, because I remember calling him at about half past 10 one evening to discuss his A&E when some particular issues had come to the attention of the media. I am familiar with the pressures on his hospital—[Interruption.] I was just placing the constituency of the hon. Member for Weaver Vale (Mike Amesbury) vis-à-vis that of my hon. Friend. Now clarified on place, I am familiar with the fact that that hospital is under pressure. I know the Minister of State is due to visit, and I am sure she will look forward to meeting both the hon. Gentleman and my hon. Friend.

Sudden Unexplained Death in Childhood

Andy Carter Excerpts

Tuesday 17th January 2023 Westminster Hall

[Kwasi Kwarteng]

I am very pleased to join the hon. Lady in raising the profile of the condition. This category of death has never really gathered the attention it deserves. As far as I know, this is the first time it has been debated on the Floor of the House in this Parliament.

[Andy Carter (Warrington South) (Con)]

I pay tribute to my constituents, the Grogan family, in particular Sarah, a teacher at Cobbs Infant School in Appleton. She has been in touch with me to tell me about her experience with Frankie, her little boy, who died at the age of three. Sarah has helped to inform medical professionals, including GPs, through the videos she has made. I have learned a tremendous amount from her, and I am sure my right hon. Friend will join me in paying tribute to her for her work on this important topic.

[Kwasi Kwarteng]

I am delighted that my hon. Friend has made that contribution. I must press on to the end of my remarks and look forward to what other hon. Members have to say on this sensitive, moving and tragic subject. The silver lining is that we will be able to make more progress in the years ahead.

It is vital to get on the record an undertaking from the Minister and his Department to encourage consistent medical education and training—there is currently very little—to help prioritise research into this category of death. Our urgent, immediate request is an undertaking to increase public information about this tragic phenomenon. How will the Minister help to prioritise scientific research to better understand this phenomenon, and to work out ways we can prevent and reduce the tragic deaths such as those experienced among many of our friends and wider communities?

I have written to the chief executive of the NHS to ask for more and better public information. The website should be updated. I urge the Minister to engage with NHS officials and managers through a commonly agreed platform, on which we can progress.

The initial response to this debate has been incredibly heartwarming and impressive. In the last few days, dozens and dozens of people have written in. They have outlined their experiences and told us about their own tragedies and their families, which have been torn apart and devastated by this phenomenon. It would be invidious of me to talk about those responses individually, but common themes run through all the submissions in this overwhelming response—in all the evidence we have accumulated in the last few days.

The thing that comes out most tragically and vividly to me is the sense of utter bewilderment about the cause of death. Many of us in our lives have dealt with personal tragedy and the passing of loved ones. In most of those instances, we have understood the nature of the illness, and there has been a degree of timing and ability to adjust to an appalling series of events. But let us imagine the death of a child who has all of his or her life in front of them and it is suddenly ended. If we can imagine that for one of our own children, we get a sense of how tragic and difficult that occurrence is. I commend the many people here who have gone through that heart-wrenching experience, who have had the courage to reach out to come and speak to MPs, and who work incredibly hard to make sure this goes further up the agenda.

The other principal thing that I have noticed is that there is not only bewilderment and the initial horror and confusion around the event, but a marked degree of ignorance about this phenomenon among the wider public. People do not know about this. We used to read and hear about what was called cot death, which was technically applied to children under the age of one, but, for the age group between one and four and for older children, there was not even a word or a phrase to describe what happens. If this debate can start a wider conversation about SUDC, I will feel that we have done a bit of our job. This is not the end; this is just the beginning of a wider debate on a deeply tragic occurrence.

Finally, because we do not have much time, I want to thank Nikki Speed, the chief executive officer of SUDC UK, who is here, and Julia and Christian Rogers for bringing this important subject to my attention and enabling us to have a wider debate. As I have said, I think it is the first time that this has been discussed, certainly in my experience as an MP of 12 years, in these precincts. I hope we can continue to work together to find adequate solutions and improve outcomes for people in this country.

We have had successes on the phenomenon of cot death—we made huge strides with that—and it is vital now that we turn our attention and expertise to SUDC. I thank Members from across the House who have listened with real respect not to me, but to the gravity of the debate. I am very interested to hear what my hon. Friend the Minister will say in response to our speeches.

NHS Winter Pressures

Andy Carter Excerpts

Monday 9th January 2023 Commons Chamber

[Steve Barclay]

My hon. Friend is right to point to the real pressures at Kettering which, as he says, I have visited. Not only am I keen to see it get its fair share, but I know that he will absolutely champion it through his good offices to ensure that that is the case, as he always does. He also raises an important point that the pressure of an ageing population is not universally distributed but is more intense in certain areas than others. Again, in our scrutiny of the data, I am keen to look at how that plays out in the variation in performance between trusts because, as I said, 15 trusts account for 56% of ambulance handover delays and there is significant variation across the NHS. Understanding what is driving that, such as different ageing profiles between different areas, is a key part of our recovery plans.

[Andy Carter (Warrington South) (Con)]

I spent Friday morning at Warrington Hospital to see the challenges that A&E department staff are facing. One senior clinician said to me that it was the busiest he had seen it in 30 years. The entire hospital was full—there were no beds—and last Monday, 90 people were waiting in A&E to be admitted to a bed. The Secretary of State knows that I am waiting for an announcement on whether a new hospital can be funded in Warrington, and I am keen to hear when that announcement will come, but can he reassure my constituents that the funding announced today will support the staff in Warrington Hospital and the social care staff in Warrington and ensure that the pressures that they are facing will be addressed immediately?

[Steve Barclay]

Yes, I can; that is the whole purpose of the announcement. Although my hon. Friend campaigns assiduously for the new hospital, he will concede that, regardless of the decision, that would take time. To his point about the hospital being full, there is an immediate challenge about how we get additional capacity into the emergency department so that it can operate more effectively, because if there are too many people, that impedes an emergency department’s ability to operate effectively. There is also a challenge about how we address the wider occupancy in the hospital as a whole, because that is at the core of getting flow into the system. That is the essence of the feedback that we have listened to and taken on board from the clinical community —as he did on Friday—particularly within emergency departments. Today’s announcement speaks to the exact issue that he raises.

Oral Answers to Questions

Andy Carter Excerpts

Tuesday 6th December 2022 Commons Chamber

[Steve Barclay]

Again, that ignores both the pressure of time at the start of the pandemic and the fact that there was international competition, with companies competing for scarce resources. It is also the case that although more than 19,000 companies were offering PPE, only 2,600 passed initial due diligence checks.

[Andy Carter (Warrington South) (Con)]

2. What steps his Department is taking to increase hospital bed capacity.

[The Minister of State, Department of Health and Social Care (Will Quince)]

To support operational resilience, the NHS has set out plans to increase hospital bed capacity by the equivalent of at least 7,000 general and acute beds during the winter. That is alongside £500 million of funding to support quick, safe discharge from hospital and free up capacity, and £1.5 billion of targeted investment funding for new surgical hubs, increasing bed capacity and equipment for elective care recovery.

[Andy Carter]

I am grateful for the Minister’s response. Over the last 20 years, Warrington has had among the highest level of new houses built in the north-west of England, but our healthcare infrastructure has not kept pace. We desperately need a new hospital. Our accident and emergency is at breaking point, we do not have enough beds and there is nowhere for those visiting to park their cars. In 2021, my NHS trust submitted a bid to the Department of Health and Social Care for a new hospital. Will he update us on where we are with that process?

[Will Quince]

I thank my hon. Friend, who has been a long-standing advocate for a new general hospital for Warrington. The expression of interest from the trust has been received. We are currently in the process of reviewing expressions of interest for the eight new hospitals and aim to announce a final decision by the end of the year. I recently met him to hear about the plans, and the people of Warrington could not have a greater champion than him.

Oral Answers to Questions

Andy Carter Excerpts

Tuesday 1st November 2022 Commons Chamber

[Will Quince]

I thank my right hon. Friend for her question and I look forward to visiting Norfolk and Norwich University Hospital as soon as possible. She rightly raises cancer referrals. Cancer referrals from GPs are now at 127% of pre-pandemic levels. Cancer treatment levels are at over 107% of pre-pandemic levels, with nine out of 10 people starting treatment within a month. However, as she rightly points out, there is variance across the country and, where trusts have more challenging statistics, we need to address them.

[Andy Carter (Warrington South) (Con)]

9. What steps he is taking to help move patients who no longer need acute care from hospitals into social care settings.

[The Minister of State, Department of Health and Social Care (Helen Whately)]

When a patient no longer needs acute hospital care, they are usually better off outside hospital and that frees up their bed for somebody else. Delayed discharges are nothing new, but they have been getting worse in part because of the shortage of social care. That is why the Government have announced £500 million to speed up discharges from hospital into social care this winter.

[Andy Carter]

Warrington is at least 90 beds short in terms of step-down care. A local hospital has too many long-term patients who simply cannot be discharged because there is nowhere for them to go. I am told there is capital funding available. We have two local NHS trusts, a local authority and the integrated care board, which is no longer in Warrington but now in Liverpool, but no action is being taken. Will the Minister come to Warrington to meet local NHS leaders and me, so we can secure access for patients who are spending too long in acute hospital care?

[Helen Whately]

My hon. Friend is absolutely right about patients spending too long in acute care in his own hospital. We know this is affecting other people around the country. I am very happy to meet him and I would very much like to visit his hospital and speak to his NHS, the local authority and other stakeholders to ensure we can improve the situation.