Covid-19 Update

Caroline Johnson Excerpts

Wednesday 8th December 2021 Commons Chamber

[Sajid Javid]

I do, of course, back any working together, whether it is of local government, the NHS or directors of public health, to help to combat this pandemic. They are doing a stellar job across the country, especially on vaccination.

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

One of the most significant harms over the last 18 months or so of restrictions has been the effect on our children and schoolchildren. I welcome the fact that instead of causing another pingdemic and having teachers and students out of school isolating, the Government have said that children will not need to isolate but will be able to use testing instead. Can my right hon. Friend confirm that that will be lateral flow testing and not PCR testing, for which they need an appointment? Can he tell us that we have enough tests if the scale of increase in cases is as he has said, and can he confirm to this House that he will resist any restrictions on schoolchildren?

[Sajid Javid]

My hon. Friend makes an important point. There is nothing more important in our society than our children. As a nation we have, like many other nations, learned a lot during the pandemic about some of the better ways to handle the concerns around the pandemic but better protect our schoolchildren. I am happy to confirm what she has said. If there is a positive case in a child, of course that individual child would isolate like anyone else, but any contacts of that child would not have to isolate. Instead, they can take lateral flow tests, not PCR tests.

Smoking Cessation: Prescription of E-cigarettes

Caroline Johnson Excerpts

Monday 1st November 2021 Commons Chamber

[Maggie Throup]

The hon. Gentleman is quite right that our goal is to help people to stop smoking completely. My heart goes out to him regarding the story about his mother. My father was a smoker and it damaged his health as well. We all have these personal stories. The evidence is clear that e-cigarettes are less harmful to health than smoking tobacco and are an effective way to help people to stop smoking, but, as the hon. Gentleman said, there is always more to be done.

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

History has shown us that an absence of evidence of long-term harm is not the same as evidence of absence of long-term harm. Indeed, in the 1940s, conventional cigarettes were considered healthy. With that in mind, how will the Minister ensure that children are protected from breathing in the vapes of e-cigarettes, prescribed or otherwise, and that their prescription by a doctor is not seen as a green light that they are healthy, encouraging uptake among teenagers?

[Maggie Throup]

My hon. Friend is right that e-cigarettes are just a gateway to stopping smoking completely. That is the ultimate goal. We want to ensure that people go from smoking to e-cigarettes, and then to no smoking at all.

NHS Dentistry: Lincolnshire

Caroline Johnson Excerpts

Wednesday 20th October 2021 Commons Chamber

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

Smiles are very important. When we smile, it makes us happier and it makes those around us happier, but unfortunately many of my constituents are struggling to smile because they have problems with their teeth and just cannot get an NHS dental appointment. That has left some of them in very significant pain and discomfort.

Many constituents have contacted me to share their experiences: people waiting years to access NHS dental care; children unable to access NHS orthodontic care, with a choice between hugely expensive private treatment and doing without; service families posted to Lincolnshire struggling to get an appointment. Figures show that just 41% of adults in Lincolnshire have accessed NHS dental care in the past two years, and less than a third of children have accessed it in the last year.

Access to specialist treatment is even more limited. Lincolnshire has gone from having three full-time consultants in orthodontics, based in Boston, Grantham and Lincoln, to just one permanent consultant two days a week, based in Lincoln. Unlike neighbouring counties in the east midlands, Lincolnshire has no specialist dental services either in paediatrics or in restorative dentistry, which means significant travel out of county for patients who require more specialist help.

It is therefore perhaps not surprising that 80% of Healthwatch complaints in Lincolnshire relate to problems with access to NHS dental services. I would like to speak about how we could improve the situation for my constituents.

[Sir John Hayes (South Holland and The Deepings) (Con)]

The circumstances are just as bad as my hon. Friend suggests. Indeed, Lincolnshire is the worst served of any midlands county, with the lowest proportion of dentists in the population. There are detrimental effects on children, as she said, and it is the poor who tend to suffer most. Finally, given her professional expertise, I wonder whether she could comment on those who have undiagnosed conditions that a visit to the dentist might reveal, notably oral cancer.

[Dr Johnson]

My right hon. Friend is a big champion for his constituents and for ensuring that they have good dental care. My hon. Friend the Member for Louth and Horncastle (Victoria Atkins), who cannot be here this evening, is also vigorously campaigning to improve access to dental care in rural areas such as her constituency, particularly in Mablethorpe, where urgent care has now been restored and where she is committed to seeing non-urgent care renewed.

The journey to being a dentist begins at university dental schools, which are heavily over-subscribed. The Government trained 21% more dentists in 2018-19 than in 2008-09. It was forward-thinking of them to increase the number of dentists; given the increase of only 7% in population, one would have expected it to result in more dental care. However, that has not happened in practice, for two reasons: partly the increase in part-time working and flexible working, but particularly the dramatic increase in the number of dentists working in the private sector as opposed to the NHS. What is the Minister doing to increase the number of dental students still further? What is she doing to ensure that they are trained particularly in areas of low provision?

I note that there is currently no university dental school in the east midlands—or in East Anglia either, in fact. It is well known that people often stay where they train; it is therefore perhaps not surprising that there are fewer dentists in Lincolnshire. Does the Minister agree that, building on the success of the Government’s investment in opening a new medical school in Lincoln to train more doctors, we should build an east midlands dental school in Lincoln, creating a centre of excellence locally for specialist services and thereby increasing the number of local dentists being trained?

There is already a precedent for opening dental schools in under-served areas: the last school was opened in Plymouth to serve a deficit in the south-west. Following the establishment of Lincoln Medical School, the addition of an adjunct dental school would be a welcome addition to Lincolnshire and the surrounding area. It would boost training and skills opportunities for young people in Lincolnshire and the wider east midlands and increase the retention of new local dentists, while helping to address access to routine NHS dental care and specialist care for patients. I also ask the Minister what efforts are being made to increase local specialist provision for paediatrics and restorative dentistry.

Following their university careers, graduates become foundation trainees, and we need to look at where we place our foundation trainers and trainees. Newly qualified dentists need to work in a foundation job to get an NHS provider number, but they can work in a private practice without one. That is something of a disincentive for people to work as NHS dentists. We also need to consider where the postgraduate training takes place. For example, there are currently six full-time training places at Grantham Hospital, just outside my constituency, but this year it has been given only two new graduates to fill those places. That is creating a reliance on temporary and overseas staff to deliver services, but it also means that there will be fewer dentists trained locally and therefore fewer dentists for the population.

Does the Minister agree that all new dentists should work their foundation year in the NHS, as doctors do, and does she agree that, given that trainees often stay where they train, the foundation places in areas of low provision should be filled first? Would she consider “golden hellos”, such as those provided in some medical specialties in areas with low provision, to attract more dentists to under-served areas?

At the heart of the issue of NHS dentists moving into the private sector is the current target-based dental contract that was introduced by the Labour Government in 2006. It was widely considered unfit for purpose even before the pandemic, which has only served to highlight its flaws, and I am aware that the Government are rightly looking to replace it. The present system effectively sets quotas on the number of patients whom a dentist can see. NHS dentists are commissioned to deliver a set number of units of dental activity—UDAs—which caps the number of dental procedures that they can perform in a given year. If they deliver over 4% more than they have been commissioned to deliver, they are not paid for the extra work; moreover, they have to bear the cost themselves of any materials used, any laboratory work, and all other overheads. That penalises dentists who treat patients in the greatest need.

The contract also penalises dentists who under-deliver on the activity that they were commissioned to deliver, perhaps owing to difficulties in filling a practice vacancy. In addition, it pays a set amount for particular types of treatment, regardless of the number of teeth that need to be treated. For example, a dentist would be paid three units of dental activity—worth an average of £75 —for one simple extraction, but would also be paid £75 for an entire course of treatment including six fillings, three extractions and a root canal treatment, which would not be enough to cover their overheads. That means that the system effectively punishes dentists for taking on new patients with high levels of dental need.

There is also—believe it or not—a huge variation in the value of UDAs. I said that the average was £75, but in fact, across England, dental practices are paid anything between £15 and £45 per unit of dental activity delivered, with an average value of £27.50. In Lincolnshire and Leicestershire, the value is between £18 and £38, with an average value of £25. For example, in Spalding, Lincolnshire—in the constituency of my right hon. Friend the Member for South Holland and The Deepings (Sir John Hayes)—two NHS practices just over a mile apart are being paid £23 and £28 per UDA respectively, a difference of more than 20% for the same work in the same town. That illustrates how dysfunctional Labour’s dental contract has become, making it more difficult for practices with lower UDA rates to recruit because they cannot pay the dentists whom they hire as much for the same work. When we compare this with private practice, where remuneration is based on actual work done, it is clear why this flawed contract has had a devastating impact on recruitment and retention among NHS dentists.

Research by the British Dental Association shows that nearly half all dentists plan to stop providing NHS services or to reduce their NHS commitment, and more than a quarter plan to move to fully private provision in the next 12 months. That has been seen in Lincolnshire, where there has been a net drop of 30 dentists providing NHS services in the year to the end of April 2021.

I am pleased that the Government have recognised the problems that this contract is creating, and are piloting alternatives. It is crucial that they deliver on their commitment to roll out new contractual arrangements by April 2022. Within the new contract, remuneration needs not only to reflect the number of dentists working in high-need areas, but to address the problems of attracting dentists to work in rural areas.

Dentists trained overseas can play an important role in filling vacancies in under-served areas. They already contribute to our NHS, and many more wish to come here, but despite the lack of NHS provision, dentists are not currently on the shortage occupation list. Moreover, it is possible for dentists from countries such as those in the EU where we recognise the equivalence of university dental qualifications to come and work here in the private sector immediately, but additional paperwork and training, with additional costs, are required for them to work in the national health service. That is a clear disincentive to working in our health service, and I would like the Minister to elaborate on what she is doing to remove bureaucratic burdens such as those that limit NHS capacity.

The covid pandemic has further exacerbated problems with access to NHS dentistry. In the spring of 2020, all routine dental care in England was necessarily paused for two months. With social distancing, gaps between treatments and decontamination between patients having been essential since then, dentists have been able to see only a fraction of their usual patient numbers. In North Kesteven alone, 22,733 NHS dental appointments were lost between April 2020 and March 2021, further adding to the unprecedented backlog.

In the short term, to address the impact of covid-19 infection prevention and control protocols limiting the number of patients who can be seen, funding for ventilation equipment could drastically reduce the time lost between seeing patients by reducing the number of times the air is changed over an hour. Currently, after each aerosol-generating procedure—which includes most courses of dental treatment including drilling—dentists are required to leave the treatment room empty for up to an hour, which dramatically lowers the number of patients they are able to treat. The experience of my constituent Emma highlights this. Her seven-year-old daughter is still waiting for a routine check-up from November 2019, and Emma is being told that the surgery is running at 50% capacity due to coronavirus prevention controls.

This fallow time can be reduced, and patient throughput increased, by installing high-capacity ventilation. However, this can cost a practice up to £10,000. England does not currently invest in ventilation for dental practices, although the devolved nations of Wales, Scotland and Northern Ireland do. Capital funding for ventilation equipment would have a transformative effect on the throughput of patients, and would in effect pay for itself through increased patient charge revenues from paying NHS patients. Could the Minister please outline what review mechanisms are in place to reduce dentists’ covid measures—particularly now that the fantastic vaccine programme this Government have put in place means that more than 90% of people have antibodies—so that dentists can increase capacity from 65% to 100%?

Lincolnshire is proud to be the home of the Royal Air Force, including RAF Cranwell, RAF Digby and RAF Barkston Heath, which are in my constituency of Sleaford and North Hykeham. Repeatedly moving location can pose particular difficulties for service families as they find themselves on lengthy dentists’ waiting lists. My constituent Karen waited five years for her and her three children to access an NHS dentist after her husband was posted to my constituency, and she is still having difficulties in securing adjustments for her disabled son. Our veterans, cared for by the Ministry of Defence during their service, often find it difficult to get an NHS dentist at the point of retirement. The Armed Forces Bill will enshrine in law the military covenant, our commitment to our brave service personnel and their families. Will the Minister outline what work she is doing to ensure that military families and veterans can access high quality NHS dental care wherever they move to, in order to meet their particular challenges of moving around frequently?

Without significant changes soon, the problems facing NHS dentistry in access and in the recruitment and retention of dentists will continue to grow. My constituents in Lincolnshire deserve to be able to see an NHS dentist, and dentists working in Lincolnshire deserve a contract that correctly rewards them for the work they do and addresses the perverse incentives that currently exist. After a decade of work on the new system, there can be no more delays. I hope the Minister can give me assurances that the Government will stick to their commitment to roll out new contractual arrangements by April 2022, so that my constituents can smile once more.

--- Later in debate ---

[Maria Caulfield]

My hon. Friend makes a good point, and across Government Departments we are discussing the provision of both general practitioners and dentists for new developments. I am keen that dentistry is on a par with GP provision, because it is often an afterthought. I am keen that we push it up the agenda, and this debate helps.

[Dr Caroline Johnson]

Will dentists have a voice on care panels in the new integrated care systems?

[Maria Caulfield]

I thank my hon. Friend for that query. I am keen that dentistry has a louder voice than it does now.

As I was saying, part of this debate is about raising the profile of the issue. I reassure her that there are a number of things happening, particularly in her region. NHS England Midlands and East, which covers the east of England, is putting in place a number of initiatives, about which I wish to reassure her. Additional weekend dental sessions are going to be commissioned, to take place up to March next year. There will be additional clinical capacity to reduce waiting lists where a general anaesthetic is required, particularly for children. NHS England has also begun a procurement exercise to address the lack of orthodontic access across the region, particularly in Lincolnshire. To get us through the pandemic recovery phase, we will work closely with NHS England to ensure that that is happening as fast as possible.

In the short time available, I wish to turn to the long-term plan to address the shortfall that was there before the pandemic. We are taking up some of the suggestions that my hon. Friend has made so eloquently in this debate. The core of that is about ensuring that the NHS dental contract is renewed, because we are in a perverse situation where the contract sometimes acts as a disincentive. She made points about over-delivering or under-delivering; people can be penalised, and we can understand why dentists walk away from NHS contracts. This Government are focused on addressing that.

--- Later in debate ---

[Maria Caulfield]

I am happy to meet my hon. Friend to discuss that issue with her. She represents a coastal constituency, and this emphasises the point about where there seem to be gaps in provision.

I am pleased that we are being able to take specific action, both nationally and locally, to improve recruitment and retention, because that is key. This includes widening access to dental careers and utilising the skill mix in dental practices. It is not always the dentists who need to be used and we need to upskill some of the dental workers in dentistry too, so that we can understand the oral health needs of patients in specific communities. As part of that work, Health Education England is looking to address regional shortages by ensuring that training place numbers are better aligned with the needs of local populations and that we are targeting provision. I take the point made by my hon. Friend the Member for Sleaford and North Hykeham about a dental school and I will look at that suggestion. She rightly says that students tend to stay where they train, and we need to look at where the gaps are. The number of dental school places is increasing and we are getting more students through, but I will look at her suggestion.

I feel that I have not specifically addressed the situation in Lincolnshire as a whole, which is the subject of the debate, so let me reassure my hon. Friend that a number of measures are in place to address the issues there. We have introduced additional face-to-face weekend dental sessions from August this year through to March next year; there are dedicated urgent dental slots for 111 patients; and we are trying to address some specific local gaps in Mablethorpe by commissioning urgent NHS dental care sessions on a temporary basis. We also want to improve recruitment and retention specifically in my hon. Friend’s area. Health Education England is working in Lincolnshire to recruit newly trained dentists but should perhaps look at a dental school to support that effort even further.

My hon. Friend raised orthodontic issues, which are very important for young people’s health. NHS England Midlands and East has begun a procurement exercise to address some of the backlog. Patients with a clinical need to start treatment quickly will be contacted. I reassure the House that any patient who was referred before they turned 18 but has not yet started treatment will still get free treatment, even after their 18th birthday, because the backlogs are not their fault.

I know that I have not answered all my hon. Friend’s questions, but I hope she knows that we take this issue extremely seriously. The provision of dentistry is a complex policy area for which there is no quick solution, so I shall not make promises tonight that we cannot deliver, but we are serious about trying to address the issues. I hope I have been able to provide some reassurance that, although this issue is challenging, as the new Minister responsible for dentistry I am committed to playing my part in not only supporting the covid recovery but driving forward long-term improvements. We want to see a contract that is attractive for professionals and that ensures equality of access for all, across rural regions and coastal regions.

[Dr Caroline Johnson]

Before the Minister sits down, may I ask her to meet me later this week, or perhaps next week, to discuss further the impact on military personnel in particular?

[Maria Caulfield]

Yes, absolutely. I have not been able to address that in my speech but I am keen to meet my hon. Friend and other colleagues who have particular shortages in their areas. I want to hear what is happening on the ground and make sure, as we go forward, that the problems are addressed and we start to see improvements. I would be happy to meet my hon. Friend and other colleagues.

Question put and agreed to.

Covid-19 Vaccinations: 12 to 15-year-olds

Caroline Johnson Excerpts

Monday 13th September 2021 Commons Chamber

[Nadhim Zahawi]

The hon. Lady asked a number of questions that I will try to address in order. She asked about the JCVI’s remit, which was very much around what it is clinically qualified to address. That is why it advised that the CMOs needed to look at the wider impact on children specifically. There was no issue at all around shortage of vaccines, and I am confident that we have the vaccine supply that we need for both this recommendation, which we are accepting, and the booster campaign.

It was important that the JCVI took its time and looked at both first-dose and second-dose data on the rare signal around myocarditis and pericarditis. The United Kingdom has sometimes been an outlier to other nations, but on the whole we have got these decisions right because we rely on that expert clinical advice. I hope that gives reassurance to families up and down the country.

On vaccine passports, the Secretary of State for Health made it clear that we will not go ahead with vaccine certification for nightclubs or other venues. No one—certainly not on the Government side—would have moved forward with that happily. [Interruption.] If we are to have a grown-up debate, it is important for the whole House to remember that the virus is still with us and that we all want the same thing: to transition it from pandemic to endemic status so that we can have a sustainable return to normality as quickly as possible.

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

I have given many vaccines in my time, including hundreds of covid vaccines more recently, but I am not comfortable with vaccinating teenagers to prevent educational disruption. Under the current rules, no child needs to isolate if they are a contact. They do so only if they are a positive case and, for them, the maximum is eight days of schooling—and that is only if they catch coronavirus during term time. Half of children have already had it and are very unlikely to get it again. Does the Minister therefore really believe that vaccinating 3 million children to prevent an average of four days or less off school is reasonable?

[Nadhim Zahawi]

I am grateful for my hon. Friend’s important question, and I thank her for the work she has done and continues to do on the vaccination programme. All I would say to her is that I think it is important that the Government accept the final decision—the unanimous decision—of the four chief medical officers for England, Scotland, Wales and Northern Ireland, and offer the vaccine. Of course, parental consent will be sought, but it is only right that we offer the one-dose vaccine to 12 to 15-year-olds as per the advice received today.

Covid-19 Update

Caroline Johnson Excerpts

Monday 6th September 2021 Commons Chamber

[Nadhim Zahawi]

I do not disagree with the hon. Lady; I know what she is talking about. She will have seen the interim advice from the JCVI on phase 1, which is for categories 1 to 4, and phase 2, which is for categories 5 to 9—including category 6, the largest category of those people she describes. The JCVI has yet to deliver its final advice post the cov-boost study data. As we have done throughout the deployment, we will follow the JCVI advice.

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

The JCVI has assessed the known risks and benefits of the covid vaccine for 12 to 15-year-olds and has not recommended it. As the Minister said, the Health Secretary has now referred the matter to the chief medical officers so that they can look at it from a so-called “broader perspective”. Now that children are attending school, half of them have had covid already, they do not need to isolate unless they test positive and they do not need to isolate if they are merely a contact, does the Minister agree that disruption to education will now be much less severe? Furthermore, does he agree that it is not reasonable to use political decisions about schools as leverage to force vaccines on a population of children?

[Nadhim Zahawi]

I am grateful for my hon. Friend’s very thoughtful question. I can reassure her that there is no political decision making; the process that the chief medical officers are undertaking is unencumbered by any political motivation whatsoever. We will absolutely follow their advice, and the JCVI is in the room as they are deliberating. It is important to recall that the JCVI advice was that vaccination is marginally more beneficial to healthy 12 to 15-year olds than non-vaccination, but not enough to recommend a universal vaccination programme. It is also worth reminding the House that we have been vaccinating 12 to 15-year-olds who are more vulnerable to serious infection and hospitalisation, as the JCVI recommended.

Covid-19 Update

Caroline Johnson Excerpts

Monday 19th July 2021 Commons Chamber

[Nadhim Zahawi]

I am very grateful to the hon. Gentleman for his excellent question and I wish him a continued recovery. I know from the work that I have seen that it is not easy. I believe there are just over 900,000 people suffering from different forms of long covid. We have made an additional £150 million available for the NHS, both in terms of looking at long covid, and having an infrastructure to be able to deal with it and help support GPs to diagnose it.

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

The Minister is aware of my reservations about asking children to be vaccinated where it may provide only very marginal benefit to them, but this relies on the importance of informed consent and people being given all the right information. Can he confirm, first, that where children with medical conditions are being offered the vaccine, the risk posed to that child from a serious effect from covid is greater than the risk to that child posed by any vaccine? Can he also confirm that, where children are being asked to be vaccinated to protect an adult who may be vulnerable for whatever reason, those parents, carers and the child will be provided with the absolute—not relative—risk reduction for those individuals they are being asked to be vaccinated for?

[Nadhim Zahawi]

My hon. Friend’s question is an excellent one. She has participated in the vaccination programme—she is one of the heroes I stand on the shoulders of—and she has done work in Sleaford and North Hykeham. I absolutely confirm to her that the JCVI advice is very specific on the conditions of young people who will be eligible to receive the vaccine to protect them from covid and, of course, those adults who are also vulnerable to it. That is why I talked in my statement about the NHS being in contact with those families to be able to advise them and then facilitate vaccination in a place and at a time convenient for them.

Oral Answers to Questions

Caroline Johnson Excerpts

Tuesday 13th July 2021 Commons Chamber

[Sajid Javid]

As I said in response to an earlier question, this is a huge priority for the Government and, again, I am pleased that the hon. Lady has raised the issue. It is an issue for her constituents and for constituents throughout the country. She referred to the research by Cancer Research UK. I am afraid that it is right: there are thousands of people who did not come forward. We can understand why, so let me say this again as it is so important: for anyone concerned, please do come forward. We have provided additional funding—more than £1 billion—for more diagnostics and we will continue to provide additional support.

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con) [V]]

  In vitro fertilisation treatment is a lifeline for many people desperate to conceive. My constituent Sarah Barker dreams of being a mother, but sadly suffers from an infertility problem. Sarah is being refused IVF treatment on the grounds that her partner already has a daughter from a previous relationship. Her petition to stop denying women fertility treatment for this reason has already reached almost 13,000 signatures. Does my hon. Friend agree that treatment for infertility should be available based on the medical needs of the women involved, and not affected by the partner that she has fallen in love with having a child from a previous relationship?

[The Minister for Care (Helen Whately)]

I thank my hon. Friend for raising this question and the situation of her constituent. What I can say is that we expect clinical commissioning groups to commission fertility services in line with National Institute for Health and Care Excellence guidelines, so that there is equitable access across England. We are aware of some variations in access, and we are looking at how we can address that. Very specifically, CCGs should not be using criteria outside that NICE fertility guidance.

Obesity Strategy 2020

Caroline Johnson Excerpts

Thursday 27th May 2021 Commons Chamber

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

Helping people to achieve and maintain a healthy weight is one of the most important things we can do to improve our nation’s health. As a consultant paediatrician, I have seen at first hand a worrying rise in obesity among our children and the health complications that come with it. I remember in my practice seeing a nine-year-old heavier than I was at seven months pregnant. I saw a young teenager weighing more than 120 kg—that is more than 19 stone. I saw many children with significant obesity-related health problems.

As other Members have said, the trend is increasing. One in three children leaving primary school are already overweight and one in five are leaving with obesity. This trend is further exacerbated in the most deprived areas of this country, where children are twice as likely to be obese as their peers in the richest areas. This is tragically setting up far too many young people for a lifetime of health complications, from diabetes to mental health, as well as reinforcing health inequalities.

In my experience as a doctor, the patients I see want to maintain a healthy weight but find it challenging to do so—and it is challenging, perhaps not surprisingly given the food environment in which we live. In particular, eating out has gone from an occasional treat to a regular feature of our social lives, but we have very little information on how many calories are in the food offered. This is important because on average meals out contain more than twice as many calories as those prepared at home. Accordingly, I welcome the Government’s proposal to introduce calorie labelling on menus, because it will empower people and give them the chance to make the healthy choices that they want to make. Nutritional information is already available on the food and drinks that we buy in supermarkets; expanding the practice to larger restaurants and cafés will help customers to make more informed decisions when they eat out. The evidence shows that calorie labelling on menus can reduce the number of calories consumed by about 8% and, indeed, that it leads to the development of healthier menus.

Although I welcome the push for reformulation to reduce the sugar and calorie content of food, I am worried that in their efforts to reduce the calories on menus, food producers and establishments may make greater use of artificial sweeteners. Research has shown that the mismatch between the sweet taste and few calories provided by artificial sweeteners can confuse the body’s systems and lead to hunger cravings that result in the consumption of an even greater number of calories overall. We need to be careful to ensure that our efforts to reduce calories do not unintentionally create the opposite effect with artificial sweeteners.

Finally, I wish to discuss an area that needs greater emphasis in the Government’s strategy to tackle obesity: education. As other Members have mentioned, education is really important in tackling obesity. Today’s greater prevalence of eating out is partly because of an increase in disposable income and convenience. We also know that cooking skills at home are just not what they once were. Education has a significant part to play by instilling healthy habits in young people and showing them not just what is healthy but how to make it, so that by the time they leave school they have good kitchen-safety skills and can cook simple, healthy and nutritious meals. I hope that when she responds to the debate the Minister will have time to elaborate further on the Government’s intentions in regard to education in this policy area.

Covid-19 Update

Caroline Johnson Excerpts

Thursday 15th October 2020 Commons Chamber

[Matt Hancock]

Yes, I do think more action is needed, and that is why we are taking it today.

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

The Prime Minister has been very clear on the risk of obesity for those who get coronavirus, in that people who are obese have a more severe disease course than those who are slimmer. In tier 3 areas, however, many gyms are being closed and many sporting activities are being restricted. What are the Secretary of State and the Department doing to ensure that we can encourage activity among people in those areas? Perhaps we could have a work out to help out scheme, with free online activities targeted to each age group and each physical ability.

[Matt Hancock]

I love the idea of work out to help out. It is undoubtedly true, from the science that I have seen, that obesity contributes to a worse impact for those who catch coronavirus. This is something the Prime Minister has spoken about with great passion, and it is something we want to tackle, so I will absolutely look into that idea. I would also say that we have changed the proposals for people who are shielding, even in the highest risk, tier 3 areas, who should always be clear that outdoor exercise is a good thing.

Oral Answers to Questions

Caroline Johnson Excerpts

Tuesday 6th October 2020 Commons Chamber

[Matt Hancock]

Yes, absolutely. I think we agree right across the House on the importance of this agenda. The first and most important part of it is to bear down on the long waits, because the longer that people wait, the more dangerous cancer can become. That is happening, and we also have to make sure we bring the referrals forward, because we do not want to have fewer people referred for the diagnostics. At the same time, we are expanding the diagnostics that are available, both in hospitals and increasingly in community hubs, which are safer from a covid point of view and, for the long term, will mean that diagnostic centres for things such as cancer can perhaps be on a high street or in the places where people live, so that they do not necessarily have to go to a big, acute hospital to get the diagnostics part of the pathway done.

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

What steps he is taking to ensure that patients with illnesses other than covid-19 can access the treatments and procedures that their diagnosis requires.

[The Minister for Health (Edward Argar)]

It is vital that non-covid treatments are restored as quickly and safely as possible. That is what the NHS is doing. It is working to have them restored, by October, to around 90% of last year’s levels.

[Dr Johnson]

Thankfully, children are relatively robust in the face of coronavirus. However, children’s services, like other hospital services, were understandably reduced during the pandemic. What is my hon. Friend doing to ensure that paediatric services are now 100% up and running and will not be affected by a future wave of the pandemic? What is he doing to support NHS trusts in dealing with the backlog of appointments delayed by the coronavirus?

[Edward Argar]

I pay tribute to my hon. Friend for her service to her constituents both as their MP and as a paediatric clinician. She is right to raise this important issue. Restoration guidance has already been published by NHS England and NHS Improvement, setting out a framework to fully restore services in this area, which I agree is vital. I would be very happy to meet her to discuss this further.

--- Later in debate ---

[Matt Hancock]

I pay tribute to the group that the hon. Lady mentions. I have put a huge amount of effort into supporting social prescribing, including with funding, and I encourage her CCG to engage with such bodies to make sure that we can get funding to support them on the frontline.

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

  At the start of this pandemic, in the first lockdown, abortion services were relaxed to allow women to enable them to access the service from home, but I am particularly worried about the effect that has had on those women who are particularly vulnerable, subject to abuse or in coercive relationships. Now that we know that the risk to women of childbearing age from attending a face-to-face appointment is extremely low, what assessment has my right hon. Friend made of the ongoing need to continue in this way?

[Matt Hancock]

The Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Bury St Edmunds (Jo Churchill) has committed to consult on the subject to make sure we get to the right outcome.