Ehlers-Danlos Syndrome and Hypermobility Spectrum Disorders

Ashley Dalton Excerpts

Wednesday 22nd May 2024 Westminster Hall

[Andrew Stephenson]

That is certainly the kind of thing we would want to consider, among a whole range of things.

In the limited time available, I will try to respond to the specific points made by my hon. Friend the Member for South West Bedfordshire. At the moment, diagnosis for these conditions is based on signs and symptoms, usually by a GP. As my hon. Friend knows, NHS England recommends care for patients with non-inflammatory but painful conditions, and that should be provided in primary and community care settings. That brings care closer to home for those patients, in line with our ambition to get every patient the right care in the right place.

[Ashley Dalton (West Lancashire) (Lab)]

It is not only about being able to diagnose the condition. Constituents have got in touch with me who have been undiagnosed for more than 40 years. They say that the big issue is not necessarily the inability to get a diagnosis, but the complete lack of awareness among medical professionals, so it is not even considered as an option. Will the Minister commit to increasing awareness of this serious condition across medical services so that this can at least be considered?

[Andrew Stephenson]

The hon. Lady makes a powerful point.

When I was preparing for this debate, I looked at the last time that the issue was debated in Parliament. It was a very long time ago. I strongly pay tribute to my hon. Friend the Member for South West Bedfordshire for leading this debate. There have been others: the hon. Member for Huddersfield (Mr Sheerman), who is now in his place, raised this with me at health orals a few months back. There are parliamentarians who are pushing on this, but this is the first specific debate we have had in a while, so we all have a role to play in raising awareness. Again, I pay tribute to my hon. Friend the Member for South West Bedfordshire for securing today’s debate.

My hon. Friend made a strong case for a nationally commissioned diagnosis and treatment service. In preparation for the debate, I raised the matter with NHS England, which tells me that it does not yet feel that it has good evidence that secondary care services are more appropriate for patients with hypermobility and pain, and that if patients were placed on secondary care waiting lists, it would not necessarily be in their best interests. If clear evidence is brought together that a nationally commissioned service would benefit patients, I will be happy to forward those examples to NHS England and ensure that it looks carefully at them.

My hon. Friend also asked for a meeting between himself, campaigners and me. I am happy to commit to that. Perhaps we can talk through the evidence after that to see what the best way forward is. For now, NHS England takes the view that the majority of patients with EDS and HSD can be managed within the community.

As we know, in many cases diagnosis is challenging. In recent years, we have taken great strides in making diagnosis more effective, giving GPs and physiotherapists comprehensive toolkits developed by healthcare professionals for healthcare professionals. I thank the Royal College of General Practitioners for working hand in hand with Ehlers-Danlos Support UK to get that done.

EDS and HSD are complex, chronic conditions that are frequently associated with other comorbidities. Sufferers may require access to a range of specialists, depending on the person. Integrated care boards are responsible for many of the treatment services for patients with EDS and HSD. They have a statutory responsibility to commission services that meet the needs of people in their area and that are in line with national guidance, including guidance from the National Institute for Health and Care Excellence. As my hon. Friend the Member for South West Bedfordshire will accept, NICE is an independent body and it would be wrong for me or any other Minister to interfere in its decision making, but I know that it follows these proceedings carefully and will have heard what my hon. Friend said in the case he has made for EDS and HSD to be included in its guidelines.

My hon. Friend rightly says that people suffering with the condition should have a co-ordinated, multidisciplinary approach to diagnosis and care. That is why we are rolling out new primary care networks across the NHS in England, which are delivering more proactive, personalised and integrated care through access to multidisciplinary teams of GPs, physiotherapists, nurses, pharmacists, podiatrists, physician associates and psychiatrists. NHS England commissions some specialist services for patients with rarer forms of EDS, and a service for patients who have complex EDS is delivered by centres in Sheffield and London. The “Getting it right first time” national specialty report on rheumatology, published in September 2021, has made important recommendations for rheumatology units to work more closely with primary care and achieve the properly joined-up care that I think we all want to see.

As my hon. Friend notes, patients with the condition frequently have other comorbidities, and the Government are committed to giving every patient proper joined-up care centred around them. That is why we announced last year that we will publish a major conditions strategy. The strategy will outline our approach to tackling six groups of major health conditions that contribute to 60% of morbidity in the UK by creating a health and care system focused on prevention, and proactive and person-centred management of health conditions.

The strategy will focus on the challenges, and on the changes that are needed to make the most significant difference across the six groups of major conditions. However, many of the solutions identified will be applicable beyond just those six major conditions to diseases like EDS. Aligning work across several groups of conditions for the strategy will allow us to focus on where there are similarities in approach and ensure care is better centred around the patient.

I thank my hon. Friend for bringing the matter to my attention. I also thank him and other hon. Members for their insightful contributions today. My door will always be open to him to hear how we can improve the lives of people living with EDS across the country. As I committed to earlier in the debate, I am happy to meet him and other campaigners to see how we can deliver an NHS that is faster, simpler and fairer for all.

Question put and agreed to.

Resolved,

That this House has considered the Major Conditions Strategy and people with Ehlers-Danlos syndrome and hypermobility spectrum disorders.

NHS Dentistry

Ashley Dalton Excerpts

Tuesday 9th January 2024 Commons Chamber

[Victoria Atkins]

I thank the hon. Lady, and particularly for the constructive tone of her intervention, because she is right. This is not simply about teeth health; it is also about the conditions that dentists check for—probably without anyone quite realising that they are doing so. I will take the hon. Lady up on her invitation to write to her on the figures, but that is why we are looking at health inequalities across the country and, importantly, focusing on encouraging dentists to re-register with the NHS if they have left, because it is vital for tackling much wider health conditions in addition to the pain and discomfort that tooth decay can bring.

[Ashley Dalton (West Lancashire) (Lab)]

Will the Secretary of State give way?

[Victoria Atkins]

No, I will give way to my hon. Friend the Member for North West Norfolk (James Wild) and then I will make some progress.

--- Later in debate ---

[Ashley Dalton (West Lancashire) (Lab)]

I am grateful for the opportunity to speak in this debate, because inability to gain access to an NHS dentist is an issue plaguing my constituents.

In 2024 Tory Britain, the opening of additional NHS dentistry practices is national news, with reports of people queuing on high streets just for the chance to be seen by a dentist. This is a Britain where a call to an NHS dentist to inquire about registering as a new patient is met with laughter down the phone. That is not hyperbole or hearsay: it is what I heard when I tried to register my 88-year-old mother and myself with a new NHS dentist. My dad does not need one: he had his teeth taken out for his 21st birthday, because—my hon. Friend the Member for Wallasey (Dame Angela Eagle) made this point—it was cheaper and easier. It is shocking that we seem to be back in that situation today. In 2024, it is easier to get your hands on Taylor Swift tickets than to get an NHS dental appointment.

For the benefit of the hon. Member for North Devon (Selaine Saxby), who is no longer in her place, my constituency is a rural one, and it is a beauty. However, for many of my constituents, living in a rural constituency makes accessing vital services nothing short of stress-inducing. The presence of the new Labour Members, my hon. Friends the Members for Selby and Ainsty (Keir Mather) and for Mid Bedfordshire (Alistair Strathern), would point to the idea that people in rural communities do believe that Labour has got a grip on what rural communities need; and our colleagues the candidate in Hexham, Joe Morris, and the candidate in Carlisle, Julie Minns, are also telling me that their local people, and hopefully future constituents, believe that Labour has a grip on what is needed in rural communities.

When services are not available in Burscough, in my constituency, it is not as simple as phoning the next practice down the road, or the one just over from that. It means travelling to Skelmersdale, to Southport, to Liverpool. One of my constituents has contacted every practice in our constituency and beyond, from Ormskirk to Blackpool, and is unable to register anywhere as an NHS patient—and Blackpool is 50 miles away, a four-hour round trip by public transport. Another parent in my constituency has been unable to register either of their children, both of whom have additional needs, with an NHS practice.

Another recent arrival to Skem cannot register any of his family members as an NHS patient. I took up his case with the ICB—I am sure that the hon. Member for Darlington (Peter Gibson), who is still in his place, would approve. The ICB told me the shocking truth that Government funding of NHS dentistry is only sufficient to enable around 50% of the population to access routine dental care. So where is the funding for the other half? What are the other 50% of our constituents meant to do?

[Peter Gibson]

The hon. Lady is obviously in a different ICB area from mine and I am not privy to the detail in respect of her ICB’s underspend, but it would be wonderful to know whether her ICB does in fact have an underspend.

[Ashley Dalton]

I thank the hon. Gentleman for leading up conveniently to my next point. The issue is that the ICB is actually bringing back more money than ever before from our dentists, and the local NHS dentist in Burscough is telling me that that is because they cannot recruit dentists or hygienists or other dental professionals in order to meet their target. They would love to do it; they cannot. The hon. Member for Darlington also talked about choice, but it is no choice when the only choice is private or nowt—and that is what my constituents are looking at.

If only the problem stopped at dentistry. The inability to access a dentist and regular check-ups leads to people having to visit their GP for knock-on health issues, or they are in so much pain that they are forced to end up at an already stretched A&E. Under this Government, the state of NHS dentistry services has ended up as dismal. A member of the public who contacted Healthwatch Lancashire recently, reported that they were in so much pain that they were feeling suicidal.

The public know that they cannot trust the Tories with NHS dentistry, and the alternative with Labour is clear. Prevention is by far the most effective way to improve patient outcomes across the NHS, and there is no better way to prevent than to educate. We have heard that a Labour Government will introduce supervised toothbrushing in schools for three to five-year-olds, giving children the best chance to avoid tooth decay altogether; 700,000 more urgent appointments for the most serious treatments such as fillings and root canals; and will incentivise dentists to work in areas where they are needed most. That is music to the ears of residents in rural areas such as mine. Even better than that, it is all paid for, by ensuring that the people who make Britain their home pay their taxes here, abolishing the non-dom tax status once and for all.

Toothache is nothing compared with the hurt of another five years of this Government’s inaction on dentistry. It is time they called a general election to make way for a Government with a plan to fix our nation’s teeth.

Oral Answers to Questions

Ashley Dalton Excerpts

Tuesday 5th December 2023 Commons Chamber

[Ashley Dalton (West Lancashire) (Lab)]

With your indulgence, Madam Deputy Speaker, I welcome the Secretary of State and the new members of her Front-Bench team to their roles. I am honoured myself to stand at the Dispatch Box today for the first time on behalf of the shadow Secretary of State for Health, my hon. Friend the Member for Ilford North (Wes Streeting), who is currently in Australia exploring international best practice in healthcare.

Talking of best practice, on this Government’s watch, people with suspected breast cancer are not getting it. The two-week target from GP referral to a first consultant appointment for breast cancer has not been met since March 2020. I know from my own experience of breast cancer that the waiting is terrifying, wondering whether it has been left too late and the cancer has become incurable. How much longer will patients have to wait before the Government can meet their own targets and deliver the timely care that patients need and deserve?

[Victoria Atkins]

I genuinely thank the hon. Lady for her warm welcome, and indeed I welcome her to her first outing at the Dispatch Box. As she was describing where the hon. Member for Ilford North (Wes Streeting) is, I had images of “I’m a Celebrity… Get Me Out of Here!” Sadly for citizens in Wales, they are experiencing what it is like to live under a healthcare system run by Labour, and they might fully agree with that sentiment.

The hon. Lady raises the important issue of breast cancer, and the NHS has an ambition to diagnose 75% of cancers as stages 1 or 2 by 2028. In January last year we provided £10 million of funding for 28 new breast screening units and nearly 60 life-saving upgrades to services in the areas where they are most needed, because we understand our constituents’ concerns and also their determination that we continue to improve cancer survival rates.

[Ashley Dalton]

Unfortunately, the reality is that cancer referrals have only got worse with the Conservatives in government. In September 2023, only 74% of urgent cancer referrals to a consultant met that two-week target. That is the second-lowest rate for two-week referrals since 2009. When can the public expect this performance to improve?

[Victoria Atkins]

We have in fact made progress by delivering record numbers of urgent cancer checks, and levels of first treatments following an urgent cancer referral have been consistently above pre-pandemic levels, with activity in September standing at 108% of pre-pandemic levels on a per working day basis.

NHS Workforce Expansion

Ashley Dalton Excerpts

Tuesday 28th February 2023 Commons Chamber

[Aaron Bell]

When Labour left office, more than 20,000 people were waiting over a year for elective treatment. Before the pandemic—this was not acknowledged properly—the number of people waiting more than 52 weeks for elective treatment had fallen by 95% in England, to just over 1,000. Those are the statistics. The hon. Gentleman can argue with them if he likes, but they are there in black and white.

As I said, it is interesting to see the lack of contrition about the state of the NHS in Wales, which is a complete mess. I will refer to that in detail later, but only yesterday the NHS Board in North Wales was put into special measures for a second time. I accept that there are challenges everywhere—in Scotland, Wales and England. Indeed, if we look at the comparisons across the continent, we can see that these challenges are international in nature, because everybody is recovering from covid, but I believe that this Government are tackling the challenges, and the workforce challenges, head on.

[Ashley Dalton (West Lancashire) (Lab)]

I am really glad that you have consistently raised the issue of covid. Could you suggest why it is that services such as the overnight children’s A&E at Southport and Ormskirk Hospital in my constituency, which was closed, allegedly due to covid restrictions, still remains closed to this day?

[Mr Deputy Speaker (Sir Roger Gale)]

Order. I gently say to the hon. Lady that expression is through the Chair. This is a mistake that even those who have been here quite a while make. It is “the hon. Member”, not “you”.

[Ashley Dalton]

Thank you, Mr Deputy Speaker.

[Aaron Bell]

I welcome the hon. Lady to her place and congratulate her on her recent election. I believe that her predecessor, Rosie Cooper, is now responsible for the issue that she has just raised, so perhaps she will have some luck if she speaks to her about that—[Interruption.] Have I got that wrong? I do apologise. By the way, I would like to pay tribute to Rosie Cooper, because I did not have the chance to do so when she left. She handled herself with great dignity in the face of some very unacceptable circumstances, and I pay tribute to her. I see several by-election victors on the Opposition Benches and I congratulate them all. I cannot speak exactly to the hon. Lady’s NHS trust. I am sure that if she writes the Minister or speaks to the NHS trust directly, she might get some answers as to what is going on in Southport, but if she will forgive me, I represent North Staffordshire.

Before I detail the work that the Government are doing, I would like to praise the work of everybody in the NHS—as the Opposition Front Benchers did—and particularly those in North Staffordshire who working in our hospitals and GP surgeries, our health visitors and clinical staff, and those who support those people. It has been a difficult winter—after a difficult few years—with covid and flu peaking simultaneously in December. I am pleased to report that the most recent figures from the integrated care board for Stoke and Staffordshire show that ambulance handovers hugely improved in February, compared with where they were in January, which was unacceptable, as I said in the House at the time. There has been an 8% increase in primary care appointments, compared with a year ago, with 73% delivered face to face—higher than the national average—and waiting times for surgery are falling, including for cancer treatment at the Royal Stoke Hospital. I pay tribute to everybody working at the coalface in the NHS, because I know what difficult work it is and we are all extremely grateful.

Turning to NHS workforce expansion, this Conservative Government are strengthening the NHS workforce. In hospitals we have 5,000 more doctors and 10,500 more nurses compared with October 2021. Compared with 2010, when the last Labour Government left office, we have 37,000 more doctors and 45,000 more nurses in our hospitals. We are also building up the workforce in primary care, recruiting 26,000 more primary care staff by March 2024—a target that is on track, unlike the target in Scotland. In Newcastle-under-Lyme, the number of doctors, nurses and other clinical staff based in GP surgeries has increased by 46% since September 2019. That is 55 additional full-time equivalent people. So we are seeing a growth in Newcastle-under-Lyme as well.

Workforce expansion is also about retention, as the Minister said. Times are tough for everybody, given what Putin’s war in Ukraine has done to inflation, but we have always prioritised NHS workers, especially those earning the least. A million workers received at least an additional £1,400 in their pay packets in the last year, and we accepted the independent pay review in full. During covid in 2021, we protected healthcare workers, giving them a pay rise during a wider public sector pay freeze and when private sector wages were falling. The full-time basic salary of a newly qualified junior nurse at the bottom of band 5 is now over £27,000, and experienced nurses or midwives at the top of band 6 are earning £40,588. On top of that, they get excellent pension provision, so we are looking after our NHS staff by paying them and retaining them.

More generally, we are also increasing the number of beds across the hospital estate. A new ward with 28 beds recently opened at the Royal Stoke University Hospital, but I know Tracy Bullock wants more, and I will speak to the Minister about that. We will need more beds for next winter, because the Royal Stoke is under incredible pressure, not least because of the burden of the New Labour private finance initiative contract that costs them a fortune to maintain. A previous Health Secretary ranked the worst 10 PFI contracts, and I believe that we were 11th or 12th at the time. The hospital has to live with that burden, and I raise it again with the Minister today; we want what went wrong before to be put right.