NHS Dentistry: South-west

Chris Bloore Excerpts

Tuesday 12th November 2024 Westminster Hall

[Dr Opher]

Yes, but that is even more shocking, is it not?

There are also disincentives in the contract for dentists to take on new NHS patients. When we look into it, there are all sorts of other things. For example, a dentist cannot provide urgent NHS dentistry unless they have used up their quota of UDAs, which are issued to dentists at the start of the year. The whole system is crazy, which is why there has been such a massive saving. As we have heard, dentists are leaving the profession, and it is clear that we are not training enough. I accept what the hon. Member for South West Devon (Rebecca Smith) said about how dentists are trained and where they are likely to end up working, because that is incredibly important.

As to solutions, we must have prevention. Dentistry is exceptional because dental treatment is preventive in its own right, so as soon as NHS dentistry is stripped away, there are immediately problems. We also have to make sure that young people’s diet is better. Dentist Cerri Mellish and I have developed a project in our area. Cerri sees young pre-school children who are under five. She has a quick look in their gobs and if there are signs of decay, they are whipped out and the children are given treatment. If there are any other signs of problems, she can give them fluoride enamel. These types of innovative solutions are really important.

One thing that happened with the pandemic was that NHS dentists stopped registering new patients. The pandemic started in 2020, so almost all pre-school children are likely not to be registered with a dentist, which is a real disaster. We should remember that two thirds of general anaesthetics used for children are used for dental reasons, and a general anaesthetic is not without risk.

[Chris Bloore (Redditch) (Lab)]

I congratulate the hon. Member for Honiton and Sidmouth (Richard Foord) on securing this important debate. I apologise for being an interloper from the west midlands, but it such an important debate that I want to add some thoughts.

My hon. Friend has hit on an important point. As the father of a toddler, I struggle every day to ensure that he brushes his teeth. The gap in the number of registrations since covid is creating a generation of children who are not used to going to the dentist. We have to reverse that trend; otherwise, we will have huge problems as a society, having to treat teenagers and adults with severe dental problems who have never been to the dentist.

[Dr Opher]

That is absolutely true. Simple things such as dental brushing schemes, which we introduced in the Stroud area before the election, are essential. Those sorts of things are often laughed at, but they are probably the most important thing we do as a Government.

One other quick win relates to urgent care. The Gloucestershire ICB, particularly in the Stroud area, was able to pay more for the units of dental activity and allowed all NHS dentists to do urgent care. In that way, some of the £86 million that the hon. Member for Honiton and Sidmouth (Richard Foord) talked about was spent. We were able to quadruple the number of urgent appointments.

We can do that kind of work on a smaller scale, but I suggest that we need to do things step-wise. We must get the prevention in place and start doing urgent dental care, and when we have enough money we can do more. It is all very well talking about fantastic NHS dentistry, but we need the funding for it and we need the taxes to pay for it. As a Government, we are responsible for that. In the long term, we need to look to universal NHS dentistry in this country.

World Stroke Day

Chris Bloore Excerpts

Tuesday 29th October 2024 Commons Chamber

[Sarah Dyke]

I thank the hon. Member for the intervention. He makes a strong point.

Our health and social care services are likely failing the 14,159 registered stroke survivors in Somerset at some stage in the system, but there is reason to be optimistic. If the Government put stroke at the heart of our health and social care system, each and every part of the system will be stronger and deliver better outcomes for everyone—not just stroke survivors.

Leaving aside the human cost, there is also an economic cost, as strokes lead to an avoidable £1.6 billion annual loss of productivity. I recently spoke to Garry, who works in Somerset and had a stroke in his 30s. He told me that he could have been back to work after nine months if he had had access to life-after-stroke care. Instead, he spent five years recovering, during which time he had to rely on the benefits system. At the start of the debate, I said that stroke is preventable, treatable and recoverable. If that is true—I know that it is—why are people like Garry forced to waste years in the prime of their life learning how to recover from strokes themselves?

[Chris Bloore (Redditch) (Lab)]

The hon. Lady is making an important point. Our clinical profession does an incredible job of saving many people who suffer from a stroke, but the rehabilitation work that follows surviving a stroke—the ability to get back into work, build emotional confidence and rebuild relationships—is so important. As she was detailing, too many people who survive strokes have to wait for years to get on with their lives, including their work, friendships and relationships.

[Sarah Dyke]

I wholeheartedly agree, and that is exactly the point that I was making.

Research from the Stroke Association shows that the NHS faces £1,300 of additional pressure for each person like Garry who does not receive life-after-stroke care, due to avoidable secondary strokes and other health complications. It is an injustice for stroke survivors who are suffering longer than they need to, for the taxpayer who could be paying less, and for the friends and families who often have no choice but to become unpaid carers to support stroke survivors, as my mum did for my dad after he suffered a stroke.

Unpaid carers currently bear 62% of the cost of prevalent strokes, with the NHS and social care bearing only a distant 9% and 22% respectively. Unpaid carers do a remarkable, important and often invisible job, and the Government must ensure they have access to the support that they need, including paid carer’s leave and a statutory guarantee of regular respite breaks.

There are not many easy answers when it comes to stroke. Constituents across Glastonbury and Somerton have written to me almost every month since my re-election because they are concerned about the closure of Yeovil district hospital hyper-acute services. It is right that steps are being taken to address the fact that 60% of people who arrive at hospitals do not get into a stroke unit quickly enough, so services are being reconfigured to provide patients with cutting-edge care in Dorchester or Taunton.

By concentrating hyper-acute services, wards can process patients more quickly, which is so important when caring for patients suffering from a stroke. After critical care has been provided, patients will be moved back to services closer to their home, such as Yeovil, so that family and friends will be able to visit their loved ones there rather than in critical care further away. I can understand why people are scared of potentially having to travel further in an emergency when response times are so poor. In fact, with an average response time of 42 minutes and 50 seconds, people in Somerset wait longer for an ambulance than anywhere else in England. For every minute a stroke is left untreated, nearly 2 million brain cells die, so fast ambulance response times are necessary for getting stroke patients lifesaving, disability-reducing treatments in time.

This is especially important for those living in rural locations, such as Glastonbury and Somerton, who may need to travel further for treatment. Liberal Democrat analysis has revealed that waits for life-threatening calls are 45% longer in rural areas than in urban ones. The average handover time for a category 2 ambulance call in Somerset has risen to over an hour, despite the ongoing 18-minute target, which results in ambulance crew being able to see only two or three patients per shift. The Government could lower these ambulance response times by increasing the number of staffed hospital beds, and ensuring our social care system is resourced well enough to allow people to recover outside hospital. We know that a matter of minutes can make all the difference in emergencies, so it is heartbreaking that ambulance delays are worsening and stroke victims are being left for hours for help to arrive.

I am inspired by the stroke quality improvement for rehabilitation project, which has helped over half the stroke survivors who were previously being failed by services in Somerset. The pilot has ensured that survivors have access to personalised and face-to-face support to help them with behavioural changes and re-entering work. Despite its success in preventing secondary strokes, and thus saving the health and social care system a great deal of money, the pilot is unlikely to receive funding from April next year, and 250 patients in Somerset face the prospect of losing access to good-quality life-after-stroke support.

I am particularly worried about stroke survivors in Glastonbury and Somerton, and elsewhere in Somerset, who will instead have to rely on Yeovil district hospital if this happens, as Yeovil district hospital provides only the minimum level of occupational therapy, physiotherapy, and speech and language therapy a week to less than half as many patients as the national average. There is a future where we no longer need to have a World Stroke Day, and that is what I am looking for—a future without a World Stroke Day.

Innovations such as the use of artificial intelligence in diagnosis could revolutionise recovery prospects for stroke patients, and preventive programmes could limit the impact stroke has on working-age people. We saw stroke mortality halved in just 10 years when stroke was prioritised in 2000, so progress can be made. If we are to reach that future, though, we must start by ringfencing budgets to enable the NHS to adopt innovative digital tools, invest in new technologies and develop a digital strategy.

This Government have already begun to make some progress with the Darzi report, which showed that the NHS is on its knees after years of mismanagement by the Conservatives, but we must ensure that stroke remains a top priority in their health mission.