Liver Disease and Liver Cancer: Diagnosis

Andy Carter Excerpts

Tuesday 11th October 2022 Westminster Hall

[Andy Carter (Warrington South) (Con)]

It is a great pleasure to follow the hon. Member for Strangford (Jim Shannon), and I congratulate the hon. Member for Rutherglen and Hamilton West (Margaret Ferrier) on securing the debate. It is also a pleasure to listen to the chair of the APPG on liver disease and liver cancer, the hon. Member for Caerphilly (Wayne David). I am grateful for the input he gave from Wales in particular, because it is very interesting to hear how different Administrations that have responsibility for health are tackling this issue.

I will spend the brief time I have talking about issues in the north-west of England. Similarly to my hon. Friend the Member for Totnes (Anthony Mangnall), liver disease was not an area that I was particularly familiar with until I became a Member of this House and heard from constituents, particularly families who had seen loved ones go through the terrible, very fast process of hearing about a liver disease and, sadly, passing away. I am particularly grateful to Dr Tim Cross, a constituent who is also a consultant hepatologist at the Royal Liverpool and Broadgreen University Hospitals NHS Trust. Talking to him has really helped me to understand some of the issues, and in particular some of the regional disparities that affect not only my constituents in Warrington, but people in towns and cities such as Blackpool, Manchester and Liverpool. These major centres in the north-west of England are woefully underserved when it comes to transplant facilities for tackling liver disease and liver cancer.

All those areas of the north-west record some of the highest rates of liver disease mortality, with the most recent statistics from 2020 highlighted by the British Liver Trust showing a shocking 1,838 deaths, the highest of any region in England. Per 100,000 people, that equates to 28.4 deaths. By comparison, an area such as the east of England has almost half that figure—16.1 deaths per 100,000. Over the course of 2021, the north-west saw around 10,000 admissions to hospital due to liver disease, which is by far the highest figure in the country.

As hon. Members have said, early diagnosis is fundamental to treating the disease and preventing premature deaths. The critical issue for the north-west of England is the total lack of liver transplant facilities. There is not a unit that does it. Patients are routinely travelling to Birmingham, Leeds and a further afield to be assessed for liver transplants. There is no service for an area covering 7.3 million people, including major cities such as Manchester and Liverpool. It is clear to me that one of the reasons that we have such high levels is the poor facilities in those cities in the north-west of England. My constituents are also disadvantaged because they have to spend a lot of their own money travelling to those centres to get clinical guidance—people in other areas are not having to do that. That takes a toll on the constituents who face those challenges.

In Warrington alone, 51 lives were lost due to liver disease last year. Our town’s diagnoses, hospital admissions and premature deaths far exceed the national average. When we talk about the need to level up areas of the UK, particularly in the north of England, that is not just about economic growth. Regional inequalities in healthcare need to be addressed. I am pleased that this Government see that as a priority and are tackling it, but they could address that by looking at liver disease, and liver cancer in particular.

I welcome the Government’s commitment to narrowing the gap in healthy life expectancy, but I urge the Minister to look at liver disease and see what we can do. She will be aware that there are areas of the UK that are asking for better healthcare and better hospitals. Warrington is one of the areas bidding for funding to secure a new hospital. I say to the Minister that Warrington would be a great place to have regional transplant facilities for the north-west of England, and a new facility could accommodate that. I am keen to hear the Minister’s thoughts on the additional capacity that could be released in the north-west of England to help those people in my area who are suffering from this terrible disease.

Urgent and Emergency Care

Andy Carter Excerpts

Monday 5th September 2022 Commons Chamber

[Steve Barclay]

A good example from Hull, which I visited over the summer, shows that this is not simply about money, although that is obviously a relevant factor. The hon. Lady will be familiar with the Jean Bishop integrated care centre in Hull, where the social care staff say that no one has left the service because they really enjoy working in an integrated way. The patient feedback is also extremely strong. That shows the sort of innovation we should apply across the system. I hope the hon. Lady would welcome that innovation in Hull being applied more widely.

[Andy Carter (Warrington South) (Con)]

I know that the Secretary of State is aware of the pressures that Warrington Hospital has been under through the summer, particularly the wait times. I am grateful that he intervened and spoke to the chief executive about looking at some of the issues that it was facing. Having spent some time there and having talked to staff and the management, it is clear—I agree with him—that the real issue is delayed discharge. It appears that there is a 90-bed shortage in step-down care capacity in Warrington. Will he join me in urging Bridgewater Community Healthcare NHS Trust and Warrington Borough Council to make progress on increasing that capacity, so that we can try to address some of the issues in the emergency department?

[Steve Barclay]

My hon. Friend is absolutely right that a central role for the integrated care systems in future is to look at how they best use the better care fund, how we better integrate around step-down provision, and how we ensure that best practice is being followed through the delayed discharge, including regarding some of the additional pressures that Warrington faced specifically, as I know from when we spoke over the summer. He will also know that there had been additional funding for new capacity at Warrington, which strangely was not highlighted in the media coverage that I saw.

Dentist Industry and NHS Backlogs

Andy Carter Excerpts

Monday 7th February 2022 Commons Chamber

[Andy Carter (Warrington South) (Con)]

All of us at some point will suffer from toothache. We would like to think that getting treatment through the NHS would be a relatively painless thing to achieve. Indeed, most of us have grown up with the thought that a regular check-up and work when it is needed is something we can access through our local NHS dentist, but in reality the presence of an NHS dentist in towns and villages has slowly been eroding, and charges have been in place for NHS dental treatment for some time, with only a limited number of people eligible for free treatment, including young children and those on very low incomes. The likelihood of being able to find a dentist who will do the work on the NHS is becoming more and more remote. The reasons that sit behind these changes and the necessary support needed to improve access to NHS treatment is the issue I want to raise in this debate with the Minister.

I know I am not alone in receiving correspondence on this topic, but hearing from constituents in Warrington South, reading their letters and trying to help them find a dentist has led me to the conclusion that the system needs radical changes. These problems are not all as a result of the pandemic, but it is worth saying that dentists are struggling in relation to their NHS contracts at the present time because of their experiences in recent months. NHS dental statistics show that only 12 million courses of treatment were carried out by general dentists in the year 2020-21, which is down almost 79% compared with the figure for the previous year.

[Sir Peter Bottomley (Worthing West) (Con)]

The whole House will be grateful to my hon. Friend for raising an issue that matters to every Member of Parliament. Our local newspapers point out that trying to find a dentist is like trying to find a needle in a haystack. Most of us have fewer dentists than we had in 2017, and the sooner his encouragement brings about a big change in co-operation with the British Dental Association and individual dentists, the better it will be for our patients, many of whom have aching teeth.

[Andy Carter]

I thank the Father of the House for his intervention, and I agree with him—the needle in a haystack analogy is absolutely right. In my role as a local MP, I am representing both providers of dental treatment and patients who want to access that treatment. So I have tried to take time in the past couple of weeks to speak to dentists in my constituency about their experiences and how the system is operating today. Many of them have been providing NHS services for many decades.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Gentleman on bringing this debate to the Chamber, because this is an important subject, not only for him, but for all of us. Does he agree that unless we have more support for the dental industry and for affordable dental care, this will not be possible for those who are working and not entitled to help yet who are struggling with the increased cost of living? Does he further agree that there is a dental catastrophe waiting to happen in the near future if we do not do something right now?

[Andy Carter]

I absolutely agree with the hon. Gentleman. That is the purpose of this debate: to highlight to the Minister the concern that I and other Members around the country have that NHS dentistry is on the brink and that there has to be radical change.

As well as talking to dentists, I have spoken to constituents who have written to me, completed an online survey that I placed on my website or messaged me directly following publicity in local newspapers about this debate. This topic matters not only so that people can access urgent treatment for toothache. More and more studies are confirming what dentists have always argued: that tooth decay and gum disease are increasingly linked to a heightened risk of serious health problems such as stroke, heart disease and diabetes. A healthy mouth is the gateway to a healthy body. Neglecting oral health can sabotage our long-term overall health. As the hon. Gentleman indicated, this topic really does matter to many, many people.

One of the first issues I want to highlight is the challenge people face when they move house. Finding NHS treatment can be almost impossible as a new resident in a location. I wanted to say, “getting on to a surgery’s list,” but it is clear from speaking to dentists that the notion of getting on to a list does not exist anymore; there are no such things as dentists’ lists today.

In my quest to help residents, I have spoken to NHS England, Warrington clinical commissioning group and the regional dentists’ team. They have all pointed me to an NHS website that lists details of dentists who are accepting patients in my local area. The reality is that the website is massively out of date. In most cases, surgery information has not been updated for about two years. Despite being assured that there are dentists accepting new patients in Warrington, it is simply impossible to find them. As my hon. Friend the Member for Worthing West (Sir Peter Bottomley) indicated, it is like looking for a needle in a haystack.

On Friday, I had it confirmed by constituents I spoke to that NHS England could not provide them with the details of any dentist in Warrington, Cheshire or Merseyside who was accepting new NHS patients. They could provide details of emergency dental treatment services available in Manchester or Liverpool, but NHS England confirmed that no dentists are currently taking on new NHS patients across an area with a population of about 1.8 million people. I am afraid, Minister, that the signposting we are offering online is woeful and urgently needs to be updated.

In early January, I heard from many people living in Appleton, who had received notice from their local practice that after many years of providing NHS treatment, it would no longer be offering services through the NHS. On Friday last week, I met Paul and Paula Green, who have been patients at Appleton Park dentist surgery for many years. They are two of about 8,000 local people who received the notification that their provider was changing the way it offers services, and that the only way they could continue to get treatment at the local practice was to become part of a dental plan or to pay for their treatment. Mrs Green has been at the same surgery for about 50 years. In fact, the whole family are patients. They were suddenly informed that treatment provided by the NHS would no longer be available from the end of March. They will have to look further afield for a practice—there are no other practices in the village—and there is no guarantee that they will be taken on by any practice in Warrington, Cheshire or Merseyside.

Many of those 8,000 people will be left without an NHS dentist. Some could even be mid-treatment. They have paid their national insurance and their taxes, in many cases over many years, but now they cannot get NHS treatment. Understandably, they are pretty cross. They are cross with the dentist for making this change. They are cross with the regional NHS team. They are cross with me as their Member of Parliament. They are cross with the Government. They want to know what the Minister is going to do to help them find an NHS dentist who can look after their family’s oral health.

Myriad factors are driving practices across the country to make such moves, and I will cover a couple of the main issues that I hear when I talk to owners and senior dentists across my constituency. One of the first issues I want to discuss is the need—much like in many other sectors—to bolster and boost skills. Dental practices stand or fall based on the quality of their people, and if a dental practice cannot recruit enough good staff with the right level of training, that practice obviously has a serious problem. However, unfortunately, research suggests that this is a common problem for small and medium-sized dental practices right across the UK. Most dentists are SMEs: they are run by a senior dentist, receiving payment from the NHS to provide services through an annual contract, which I will discuss in more detail shortly.

The problem is that the UK does not seem to be producing sufficient numbers of dentists with the skills that those SMEs need. On top of that, the difficulty with dentistry is that when people graduate, they tend to work where they qualify or where they live, and they are not necessarily going to dental schools in the north of England—in fact, most of the dental schools in this country are in the south or the midlands. We are simply not training enough people in the regions who want to become dentists, who want to take on those NHS contracts, and it is not sufficient to say that we pay trained professionals well. We seem to have a lack of supply and over-demand.

What is the sector looking for? By widening access and participation in training, the Government need to create more flexible entry routes, including for overseas dentists, as well as develop training places for dental professionals right across the UK. This is not just about dentists: it is about upskilling dental technicians and dental associates by providing them with more training, so that they can provide a greater range of services. There are many vacancies for salaried dentists available in the UK—anyone who searches online can find details in pretty much every town around the country—but the problem is particularly bad in small towns and villages across the north of England, and the ability to track new entrants into NHS roles is limited, particularly when dentists working in the private sector can earn much more than they do in the NHS.

There is also an immediate need for dentists from outside the European economic area, and we should be making much more of our fantastic links to the Commonwealth countries, where there is often a surplus of trained dentists. Will the Minister look to extend the General Dental Council’s recognition of dental qualifications to schools outside the EEA? When needed, candidates could work in a provisional registration period with close supervision and training for a year before registration with the GDC is granted, a measure already used for overseas doctors by the General Medial Council, but not currently employed by dentists. I ask the Minister to look at recruitment, with a target to increase the number of UK dentist training places and incentives for NHS dentists to move to areas where there is less access to NHS provision.

I mentioned the NHS contract earlier, and I want to move on to that topic now. One of the main points that I have heard from dentists is that urgent attention needs to be paid to the 2006 NHS dental contract. Without fail, every dentist I have spoken to has said that the current system of renumerating dentists purely on activity is simply not fit for purpose. It has received criticism from dentists; from Governments of both political persuasions; from the Health and Social Care Committee; from the chief dental officer for England and Wales; from the British Dental Association; from patient groups; from all the major providers of dentistry in the UK; and, I think, from numerous Health Ministers who want to see changes. I suspect that my hon. Friend the Minister also wants changes to be made to the dental contract.

[Nick Fletcher (Don Valley) (Con)]

A dentist in my constituency, Matt Hooper, has contacted me several times regarding this matter. He says that morale in dentistry is extremely low at this moment in time, specifically due to the contracts that my hon. Friend is discussing. Does he agree that we really need to value our dentists? When most of us are going about our day-to-day business, we do not think twice about our dentists, but when we get toothache, all of a sudden they become our best friends. We need to make sure that they are there for us.

[Andy Carter]

My hon. Friend is absolutely right: many of the dentists I have spoken to say that working with these activity targets is like being on a treadmill. It wrongly puts the focus on meeting targets, rather than delivering the sort of patient care we need to be delivered in our dentists’ surgeries.

On the back of receiving news from constituents who contacted me that a surgery in Appleton was to close, I went to see Dr Mansour Mirza, who runs Appleton Park dental surgery. He talked me through his decision to give notice to the NHS. He was handing back a contract worth hundreds of thousands of pounds which his practice had had for many years. I want to thank Dr Mirza for being so open and so frank with me about the decision that he had to take earlier this year. Providing the treatment that he is required to deliver under the contract just does not add up. It costs him more to provide the services than he is paid. No one can survive over the long term if that is the case, so it is hardly surprising that his contract, like many others around the United Kingdom, is being handed back to the NHS.

I am also grateful to David Flattery, a dentist who lives in Lymm and owns and manages a practice in Altrincham, for his insights. He says that the incentives to take on new NHS patients at his practice are slim to none, owing to the workload and the quotas that he has to meet under the “units of dental activity” system. When he explained how the system works, with units attributed to particular types of treatment, I came away scratching my head. Dentists are effectively paid the same for delivering a check-up as they are for root canal work, although one of those procedures involves a tremendous amount more work than the other. That makes little sense.

The Minister will know that UDAs simply do not work, and it is time to replace the contract with a more modern system which reflects dentistry in the 21st century. Dr Miraz told me that his private work had been subsidising the NHS contract for many years, and that despite wanting to continue, he simply could not afford to provide the NHS services that he had signed up to. Shockingly, the regional NHS team did not seem to want to find a solution: they have simply left people without access to any NHS dentist.

There is a real fear that NHS dentistry will disappear in the months and years to come. Dentists want to do the job of dentistry. It seems from what I have heard about the experience of dentists working through the pandemic that the likelihood of having payment clawed back by the NHS has grown. In the current quarter, dentists need to deliver 80% of their contracted UDAs, at a time when the prevalence of covid and the omicron variant is at its highest point in the entire pandemic, but the targets that have been set for dentists have risen during that period. If patients cancel or staff are sick and dentists cannot deliver that 80% of UDAs, the dentists lose funding, which means that they cannot pay the salaries of their staff, meet the rent, or provide future services for children or those with the lowest earnings. I believe that dentists are conscientious and caring healthcare professionals. They want to treat their patients, but they also want to be treated fairly by the NHS. Mr Flattery told me:

“If we really want to incentivise prevention, we need to see change urgently. ‘Incentives’ to just drill and fill is what the industry has been arguing against for many years.”

The latest NHS dental statistics show that in NHS Warrington clinical commissioning group, only 33.6% of child patients were seen by a dentist in the 12 months to June 2021, a fall from 54% patients the year before.

[Cherilyn Mackrory (Truro and Falmouth) (Con)]

My hon. Friend is advancing a compelling argument, and much of what he is saying rings true in Cornwall as well. One of my passions relates to childhood dentistry, or the lack of it. When we question the authorities in Cornwall, we often find that they are not entirely aware of the scale of the problem that they have. Many Cornish Members are currently conducting their own online dentistry survey.

When I was a child—I do not know whether other Members had the same experience—we used to have dental checks at school, and our parents were told if there was a problem. When I investigated, I was told that it was not necessary for a dentist to carry out the checks; a dental professional could do them, and a letter would then go home to the child’s parents. Would my hon. Friend support piloting such schemes again, particularly in deprived areas, along with preventive medicine to stop children needing to go to the dentist with serious problems in the first place?

[Andy Carter]

My hon. Friend raises an interesting point. I spent Friday afternoon with a GP practice in Warrington South and heard from the doctor there about the work that is now undertaken by nurse practitioners in the surgery and in the community. It seems sensible to me to upskill dental nurses to become dental nurse practitioners who can work in the community, and in schools in particular, to try to give guidance to parents to support families and to ensure that children’s dental health is a priority.

My hon. Friend identifies issues in child oral health. If we are not careful, we will store up an incredible problem for the future. We need to see it as a priority. The notion of having a six-month check-up has gone, for many good reasons, but many children are not seeing a dentist over a 12 month or even two-year period. We need to think carefully about that, so I absolutely support her point.

According to the NHS workforce study, 147 fewer dentists are working in the NHS in the north-west than in the previous year. In Warrington, there are 64 dentists per 100,000 of the population and we are seeing considerable falls on previous years.

In the long term, root and branch reforms need to be instigated in the dentistry sector. I hope that the Minister can explain what steps the Government are taking to increase training places in the north of England. I ask her to instigate a national recruitment drive to increase the number of people going to university to study dentistry and to introduce incentives for dentists to relocate to areas such as Warrington and to work in smaller practices where they provide an incredible service to local communities.

I ask the Minister about the new dental contract too. As I mentioned, I think most of the underlying problems in NHS dentistry spring from the fact that the current contract, which dates back to 2006, is not fit for purpose. It is inadequate and does not reflect the needs of dentists and their patients today. I hope that she can explain what steps she will take to bring forward a new contract and how she can work with dentists, patient groups and other interested parties around the country to ensure that the contract reflects what dentists and their patients need for the next decade. Does the Minister agree that we must break the idea of units of dental activity and ensure that NHS dentistry is available to all those who need it, as well as prioritising preventive care?

Finally, what can she say to my constituents, such as Paul and Paula Green, who have paid their national insurance contributions and paid their taxes but who, because of where they live in Warrington, can no longer get access to NHS treatment because nobody wants to provide a service through an NHS contract? I thank the Minister and look forward to hearing her reply.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)]

I congratulate my hon. Friend the Member for Warrington South (Andy Carter) on securing the debate and on raising such an important issue. I answered another Monday Adjournment debate on dentistry recently, and on Thursday there will be another debate on it in Westminster Hall, so it is obviously a significant issue for many hon. Members across the House. I also thank my hon. Friends the Members for Clacton (Giles Watling) and for Isle of Wight (Bob Seely) for raising issues on behalf of their constituents.

I am not going to stand here and say that there is not an issue around dentistry, because there absolutely is —it has been significantly affected by the pandemic. I will touch first on the short-term problems that the pandemic has created for dentistry and for patients, before going on to the longer-term problems around the contract, which my hon. Friend the Member for Warrington South raised and which have existed for a significant time.

A significant backlog has been created during covid. The majority of dental procedures are aerosol-generating, so covid creates a significant risk both for patients and for dental teams. When the lockdown measures initially came into force, only urgent dental procedures were allowed to go ahead. It was not until 8 June 2020 that non-urgent procedures were allowed, and only 20% of normal activity was allowed to go ahead at the time because of infection control measures. Even at that stage, we could see that a significant amount of work was backing up.

For most of last year, dental teams were allowed only up to 40% of normal activity. It was not until the end of last year that they could go up to 65%, and just around Christmas time that they were able to go up to 85% of normal activity. Even today, they are still not allowed to go back to 100% of normal activity, simply because infection control measures make it important that space, intervals between patients and cleaning between patients continue. Even with dentists working at pace and as hard as they can, a backlog is still accumulating nearly every day because those measures are in place.

[Andy Carter]

I thank the Minister for setting out very clearly how dentists have come back to operate in their surgeries. As she mentions and as I said in my speech, dentists were asked just before Christmas to deliver 85% of the UDAs for the three-month period from January to March. A number of small dentistry practices operating with one or two people are saying that we have increased the amount that they are required to deliver in order to be paid, at a time when covid is at its highest with the most infections ever. If a staff member, dentist or patient is unable to attend, the risk that the dentist will not be able to deliver is very significant, which means that they could be financially penalised. Does the Minister understand that the way the contract has been set up can really work against the current timeframe?

[Maria Caulfield]

I absolutely have a lot of sympathy for dentists. It is due to their and their teams’ hard work that, since December 2020, urgent care is back to pre-pandemic levels. I reassure my hon. Friend that when we were at 20%, 40% and 65%, dentists were getting paid 100% of their contract value; it is only since the Christmas period, when we went to 85%, that they have not been paid the full 100%. Throughout most of the pandemic, even though they were seeing fewer patients than their contract allowed because of infection control measures, they were getting 100% of their contract value.

[Andy Carter]

I understand what the Minister says. The way dentists are paid is not that dissimilar to the way MPs are paid: they get a chunk of money and have to pay their rent and pay their staff, as they have had to do all the way through the period. If they get to the point where they are required to deliver 85%, but where covid and the infection levels mean that they cannot physically deliver it because they are not there, they still have all those outgoings—they still have to meet their contractual requirements to pay the rent and pay their staff. That is the issue that I think many dentists are very concerned about.

[Maria Caulfield]

I take my hon. Friend’s point of view, but during the pandemic there has been significant support that many other sectors did not get. That is not to detract from the problems that dentists are facing, however, and no one is a bigger supporter of dentists than I.

I will just move on to some of the other points that my hon. Friend raised. We are not up to 100% of pre-pandemic activity simply because of covid, and that is taking a toll on access to NHS dentistry. A number of patients have waited and waited during the pandemic and now need urgent care, and we are seeing that reflected in A&E attendance and in surgical elective lists, because patients have got to a stage where they need surgery to rectify some of their problems.

I fully take on board many of the issues that have been raised in the debate this evening, but I reassure colleagues that we are trying to support dentistry as much as possible. NHS England is providing local commissioners with help and support to direct patients to where there is availability. It may have been my hon. Friend who mentioned this, but dentists have been asked recently to update their information on the NHS website that records where NHS dentists are, so that we can direct patients to those surgeries that are taking patients. Dentists have also been asked to operate a cancellation list, so that, should someone pull out, the next person on the list is proactively contacted to be offered that appointment. It is difficult for patients to navigate the system and find out where NHS dentists are.

Members may be aware—I hope they are—that just a few days ago, a one-off additional £50 million was secured for NHS dental services, the first pot of money that they have received in a long time. It is specifically focused on this financial year, so it has to be spent by April. It is targeted at those NHS dental teams to ask them what availability they have in increasing capacity, so that those waiting for treatment can start to access some of it. My hon. Friend’s area in the north-west has been allocated £7.3 million to be spent by April. NHS England is working at pace with local commissioners to deliver that and to try to tackle some of the backlog.

The difference between that funding and the contract is that the rates of pay are significantly different, and we are seeing huge uptake from dentists who are keen to do NHS work when they are rewarded accordingly. That additional £50 million will secure up to 350,000 additional dental appointments and will be targeted at those in most urgent need of dental treatments, whether it is oral pain, disease or infections, to help them get the care they need. Children, who a couple of Members mentioned, are being prioritised, as are other vulnerable groups. We are seeing some take-up of that offer, and I hope that shortly we will be able to update colleagues on where exactly that take-up has happened and the difference it has made in accessing NHS dental provision.

I will move on to some of the longer-term dental issues, which have been eloquently set out this evening.

Health and Social Care

Andy Carter Excerpts

Friday 3rd December 2021 Commons Chamber

[Edward Argar]

It would be easy to commit the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Lewes (Maria Caulfield), to a visit because she is not here. Equally, I am conscious that East Leake is just up the road from my constituency, so it may be that my hon. Friend gets me instead. I will certainly look into that visit.

[Andy Carter (Warrington South) (Con)]

Following the point made by the hon. Member for Weaver Vale (Mike Amesbury), the greatest challenge that we face to recovery from covid in Warrington is that our hospital is too small. Warrington trust recently submitted a bid for a new purpose-built hospital. Will my hon. Friend assure me that, in the new year, he will look favourably on Warrington?

[Edward Argar]

My hon. Friend, along with many right hon. and hon. Members, is doing his bit to push the cause of his local hospital investment bid. As I said to the hon. Member for Weaver Vale (Mike Amesbury), I commend that, but it would be wrong for me to be drawn while the process is still under way.

Covid-19: Government Response

Andy Carter Excerpts

Thursday 21st October 2021 Commons Chamber

[Andy Carter (Warrington South) (Con)]

When I speak to my constituents I sense there is an element of uncertainty as to exactly who is entitled to a booster vaccination. May I ask the Minister to be really clear for my constituents in Warrington: who is eligible and how can they check?

[Maggie Throup]

I thank my hon. Friend for that question. It is really important to make sure that people understand that, if they had their second jab six months ago, plus one week to allow for a bit of admin, they are eligible. They may get a text or a letter from the NHS, but if they do not, they can go online or phone 119 to book their jab.

Social Care Reform

Andy Carter Excerpts

Wednesday 23rd June 2021 Commons Chamber

[Helen Whately]

I hope the hon. Lady will forgive me if I am not drawn on specific models of funding or paying for care, but the Government and I recognise that we have on the one hand the challenge of catastrophic costs and the problems some people face of having to sell their home to pay for their care, which many Members have mentioned already today, but also we have the other part of the system, which is those who receive care funded by the state. Many of them are of working age, as well as there being older people. She is right: in our social care reform, we need to look across the breadth of the system.

[Andy Carter (Warrington South) (Con)]

I thank the Minister for her responses to the questions so far. As part of Warrington’s £22 million town deal, the town is launching an innovative social care academy, in partnership with Warrington & Vale Royal College, to tackle the shortage of trained carers, so that residents in my constituency receive the best quality care. Does she agree that initiatives such as that, which address an identified skills gap, will mean that both care homes and in-home care in Warrington will have tailored and targeted support? Would she like to come to see the academy when it is up and running?

[Helen Whately]

My hon. Friend outlines a fantastic example: that is a really good use of town deal funding by Warrington. The academy—there are examples around the country—does an important thing in raising the profile of the social care workforce and developing their skills, which are so important. I absolutely support this initiative and, as and when the time is right, I would be delighted to visit.

Obesity Strategy 2020

Andy Carter Excerpts

Thursday 27th May 2021 Commons Chamber

[Andy Carter (Warrington South) (Con)]

It is a pleasure to follow the hon. Member for Strangford (Jim Shannon). I congratulate my hon. Friend the Member for South West Bedfordshire (Andrew Selous) on securing the debate.

There is no doubt that tackling obesity is one of the greatest long-term health challenges this country faces. Weight loss is an incredibly difficult challenge for so many people. I spent the first few months of this year on an enforced walking programme and managed to lose a stone in weight. Coming back to Westminster, I am afraid I can already feel it piling back on, but that personal responsibility that my right hon. Friend the Member for Forest of Dean (Mr Harper) talked about earlier is so critical.

One reason I wanted to speak in this debate is that children in the most deprived parts of the country are more than twice as likely to be obese as their peers who live in wealthier areas. That is sowing the seeds of adult disease and health inequalities in early childhood. We do need an urgent strategy so I welcome many of the measures the Minister talked about earlier.

I think we all agree on the need to address issues around obesity. How we tackle it is what we need to debate and what we are debating today. I heard the Minister say that there is no silver bullet and I think she is absolutely right on that. However, I am afraid there are some bullets that can have wide-ranging impacts, some of them unintended. As a number of hon. Friends have raised, one proposal is a TV and digital advertising ban. While some suggestions appear straightforward, I think this is a very complicated issue. The Minister herself said that if advertising did not work, the companies concerned wouldn’t do it. She is absolutely right on that, but there is significant evidence to suggest that introducing a ban will not deliver the necessary beneficial impacts she wants and could have significant outcomes on the public good. The Government’s own evidence, as we have heard, shows that the reductions in calorific intake will be negligible—about 1.7 calories a day. I think it was referred to earlier as a Smartie; I would refer to it as a Tic Tac. It really is not a significant amount of calories on a daily basis. My call to the Minister, therefore, is to encourage further investment in education in this area.

I want to mention in particular the impact that a reduction in advertising or an ad ban would have on public service broadcasters such as ITV and Channel 4. Some data I have seen suggests that about £200 million a year would be taken out of that sector, which is almost three times the amount the broadcaster spends on regional news each year. Regional news is something we all benefit from. It is incredibly important and the impact on public service broadcasting would be significant. My drive is to encourage broadcasters to put more emphasis on the campaigns they have been working on recently, such as the “Eat them to Defeat Them” campaign to increase the amount of vegetables in shopping baskets—around 500 million child-sized portions because of joined-up thinking between broadcasters and retailers, and something that children want to get involved with.

To conclude, one issue that has concerned me greatly relates to press reports suggesting that the ad ban will not be introduced across all platforms. It could be that it is just on TV platforms, rather than online platforms such as YouTube. That is a recipe for disaster, because the money currently spent on TV channels that generate wealth for this country will simply go overseas to the US.

Covid-19

Andy Carter Excerpts

Tuesday 25th May 2021 Commons Chamber

[Nadhim Zahawi]

I am glad the hon. Member will get his jab when the call comes. We are obviously working with a number of manufacturers, who are looking at different delivery technologies for vaccines in the future. It is still some way off, I am afraid. At the moment, the needle dominates the vaccination deployment technologies, but I know that a number of manufacturers are working on other ways of delivering vaccines, including through pills.

[Andy Carter (Warrington South) (Con)]

Seventy per cent of my constituents have now had one vaccine. I am sure the Minister will join me in congratulating and thanking all those people in Warrington who have played such an important part in this incredible vaccination programme. As he will know, vaccines are one part of the solution. Can he give us an update on drugs and research into treatment for those who find themselves in hospital suffering from covid?

[Nadhim Zahawi]

I join my hon. Friend in thanking the local team for going above and beyond, and, as I said earlier, it is all about that spirit of Dunkirk and the coming together of the nation to deliver the vaccination programme. A couple of weeks ago, the Prime Minister announced the therapeutics taskforce, which is moving at pace to identify therapeutics and antivirals to help people who, for whatever reason, cannot be vaccinated and to give us a greater arsenal in our armoury against this pandemic.

Covid-19

Andy Carter Excerpts

Monday 22nd February 2021 Commons Chamber

[Andy Carter (Warrington South) (Con) [V]]

Thank you for bringing me in, Mr Deputy Speaker. It is a pleasure to follow my hon. Friend the Member for Ipswich (Tom Hunt).

I suspect that for most parents listening to the Prime Minister’s announcement earlier, the news that all children will be back in school from 8 March is very welcome—not because we have had too much of the little cherubs appearing midway through Zoom calls, but because the best place for children to be is in school with their friends, socialising and learning. Having listened to my son’s virtual lessons over the past few weeks, I suspect that most teachers will also be delighted to have children back in one place, focused on the lesson and not distracted by whatever else is going on in their bedrooms.

I pay particular tribute to the hugely professional teachers who have adapted to a blended Teams and Zoom world through ever-changing circumstances. The ongoing uncertainty has created significant anxiety for young people, with particular pressure for those due to take exams this year and next. The focus on catch-up and support funding for mental health is now critical, and I request that the Secretary of State for Education allows flexibility in the way that schools deliver those programmes.

It would be remiss of me not to mention the efforts of mums and dads across Warrington who have been home-schooling while also working and doing all the other things that are necessary for life to continue.

I welcome the news that the Chancellor will address support for businesses in the Budget next week. I make one specific request: extend the business rates holiday for eligible small businesses.

Finally, the incredible vaccination programme both here in Warrington and throughout the UK has meant that we can have some certainty around a route out of lockdown. Having visited four of the five vaccination centres in Warrington over the last few weeks—

[Mr Deputy Speaker (Mr Nigel Evans)]

Sorry, Andy. It was short but sweet.

Vaccine Roll-out

Andy Carter Excerpts

Thursday 21st January 2021 Commons Chamber

[Matt Hancock]

Let us see what we can do.

[Andy Carter (Warrington South) (Con) [V]]

I know that the Secretary of State will want to join me in praising the response of GPs, NHS and care staff and volunteers in Warrington, who, working at the two community hubs in the town, will have vaccinated, by the end of tomorrow, around 17,000 people from this area. Looking forward, can he tell the House what plans he has to open 24-hour vaccination centres in the north-west, so that anyone who, say, works shifts or has caring responsibilities can access a vaccination at a time when they might be available?

[Matt Hancock]

Absolutely. We will pilot that approach and see how much demand there is for overnight vaccination. As my hon. Friend says, it could be particularly appropriate for shift workers, and of course the NHS runs shifts in every hospital because of the need to care for patients overnight, so that is a very important point that he raises. Let me also say how glad I am that we have been able to open the Imaan pharmacy in Bewsey in Warrington, further expanding the vaccine roll-out in his area.