Christopher Chope debates involving the Department of Health and Social Care during the 2024 Parliament

Tobacco and Vapes Bill

Christopher Chope Excerpts
2nd reading
Tuesday 26th November 2024

(1 month ago)

Commons Chamber
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Wes Streeting Portrait Wes Streeting
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I will certainly come on to the action that we are taking on vaping, and the case for it. I welcome the contribution that my hon. Friend has made in his first few months as a Member of this House. He brings enormous expertise and experience, particularly on health, which we very much value here in the Chamber.

One choice would be to continue paying an ever heavier price for failure. That is the road that we were heading down, under the previous Government. Our NHS already takes £4 for every £10 spent by the Government day to day. We are on course to go from being a nation with a national health service to a health service with a nation attached to it. It is projected that by the end of this Parliament, 4.3 million people will be on sickness benefit if we fail to act. Smoking could cause 300,000 patients to be diagnosed with cancer over the next five years, including 3,000 for whom that is the result of exposure to second-hand smoke. That is what happens if we only ever treat the symptoms of ill health. We end up spending more on the NHS than ever before, but with worse care for patients, a ballooning welfare bill due to more and more people being out of work, stagnant economic growth, and the heaviest tax burden in 70 years. In short, we will be paying more, but getting less.

Britain is like a ship with a hole. We are constantly battling to chuck enough water overboard to keep us afloat, as more and more floods in. We must break out of this cycle. Britain can break out of this cycle, but only if we are serious about tackling the causes of ill health, and shift our focus from treating the symptoms to preventing them. Plugging the hole in the ship is how we get back to growth, how we reduce the burden of taxation, and how we ensure that this Government can intrude more lightly on people’s lives.

Christopher Chope Portrait Sir Christopher Chope (Christchurch) (Con)
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The argument that the Secretary of State puts forward is essentially one for banning smoking altogether. What he said earlier was misleading; he suggested that people of a particular age group will not be able to smoke. They will not be able to buy cigarettes, but they can still smoke. They can cadge cigarettes off other people. Is this not a half-baked measure?

Wes Streeting Portrait Wes Streeting
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I am sure that the hon. Gentleman was not accusing me of misleading the House. The argument that he puts forward is used against all sorts of laws and prohibitions. Most people in this country are law-abiding citizens who follow the law. In my constituency today, there will be people dumping fridges and mattresses on street corners—fly-tipping—because they are irresponsible and not law-abiding citizens. We will not always catch them, either through closed-circuit television or local authority enforcement, but that does not mean that we should not tackle them when they do those things.

By phasing in a generational smoking ban, we are taking a measured and reasonable way of creating a smokefree country. That is the right way to proceed, and it is sensible. I know that he does not agree, but he must accept the trade-off—the choices that he is making for the Opposition. First, he is accepting that people will pay a higher price for their healthcare, either through taxes, if he still believes in the national health service, or through the cost to the individual of their healthcare. Secondly, he must concede that, through the harm caused by smoking, he is fuelling welfare dependency. My right hon. Friend the Secretary of State for Work and Pensions had a point when she said earlier that Labour is the party of work, and the Conservatives are the party of welfare. That is the logical conclusion of the hon. Gentleman’s opposition.

Maternity Services: Gloucestershire

Christopher Chope Excerpts
Wednesday 9th October 2024

(2 months, 2 weeks ago)

Westminster Hall
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Clive Jones Portrait Clive Jones (Wokingham) (LD)
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My local hospital, the Royal Berkshire hospital, is where my two children were born and many of our friends’ children were born. It has recently received an upgraded rating of good from the Care Quality Commission, and it is one of only nine organisations, out of 131, that got an upgrade to good over the last year, so I commend the Royal Berkshire leadership and staff for their diligence and dedication, and congratulate them on that result. Does my hon. Friend agree—

Christopher Chope Portrait Sir Christopher Chope (in the Chair)
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Order. Interventions should be short. If the hon. Gentleman wishes to make a speech, he can do so later. Let us hear the response to the intervention.

Max Wilkinson Portrait Max Wilkinson
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I am sure that I would agree with whatever my hon. Friend was about to say. He was making the point, I think, that it is easy to be down on our NHS and its staff. That is not the purpose of this debate at all; its purpose is to ensure that we give the support that is needed to our midwives, other NHS staff and, indeed, NHS managers, who are often maligned but, like other NHS staff, work long hours and are in it for the betterment of health services.

On a personal note, I offer my wholehearted thanks to the staff at Gloucestershire hospitals, who were there for my wife and me when our daughter was born in Gloucestershire Royal hospital in 2022. It was an important day for my family and for the country when we went into the operating theatre for the C-section: this country had no Prime Minister, and when we came out we had my daughter, Elodie, and we had Liz Truss. That is a memory that will live long for me. I particularly thank Fiona Liddle, the midwife who gave us the most care during my wife’s pregnancy, as well as all the doctors, nurses and healthcare workers who helped to make the experience so joyful for us.

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Karin Smyth Portrait The Minister for Secondary Care (Karin Smyth)
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It is a pleasure to serve under your chairmanship, Sir Christopher.

With your leave, I will start with a few words to mark Baby Loss Awareness Week. Many mums and dads across the country have suffered the heartbreak of losing a baby. Everyone deals with grief in a different way, but it has been moving to hear from parents how baby loss certificates have allowed them to process what they have gone through and have helped give them closure.

That is why this week we launched an extension to the baby loss certificate service, which is a voluntary scheme to enable parents who have experienced a pregnancy loss to record and receive a certificate to provide recognition of their loss, should they wish. Until now the service was only open to parents who had experienced a loss since 1 September 2018, but today we are removing that restriction, making the certificates available for every parent who has lost a child. We will update the House with a formal written statement shortly. The Government are committed to delivering compassionate care for women and support for parents who have suffered a baby loss. It is the right thing to do.

I think this has been a genuinely good debate. We have heard from experts—I commend the Opposition spokesperson the hon. Member for Sleaford and North Hykeham (Dr Johnson) and my hon. Friend the Member for Stroud (Dr Opher) for the work they do—and others have shared experiences. I knew that the hon. Member for Cheltenham (Max Wilkinson) would bring forward good points too, so I contacted the trust myself so that I could give the hon. Gentleman and hon. Members present my frank assessment of what is happening on the ground.

To reiterate, as of August 2024 the midwifery vacancy rate in the Gloucestershire hospitals NHS foundation trust stood at 13%—the equivalent of 32 full-time midwives. That level is high for the south-west, though roughly in line with the national average. In April 2022, the Care Quality Commission gave the trust a warning notice for the maternity service, and rated it “inadequate” a year later. In May this year, the CQC issued the section 31 notice—a severe warning that requires at minimum an immediate action and improvement plan, which, as colleagues will know, in some other settings could result in a closure. It issued that after seeing postpartum haemorrhage rates, poor foetal monitoring and high levels of agency staffing.

The hon. Member for Cheltenham and others from the area are right to be concerned. We can all agree that it is unacceptable when new mothers do not receive the highest possible standard of care. As my right hon. Friend the Secretary of State has said, we should be honest about the problems in our NHS and serious about fixing them. Maternity services are very far from where we want them to be. Childbirth should not be something that women fear or look back on with trauma. Safety is obviously paramount. As the hon. Member for Cheltenham said, it should be a special moment.

I thank the hon. Member for Thornbury and Yate (Claire Young) for sharing her experiences. I was in hospital for two weeks after having my first child, and it is a traumatic time, so the length of time she mentioned must have been very difficult. My second came out so quickly that I was in and out of hospital before we knew it. My third child, as has been mentioned, was almost delivered at home by my husband after we had chosen a home birth. He is not medically qualified, so I can tell you that the sound of the doorbell ringing for the midwives’ arrival was the best sound I have heard in my life.

To the second question asked by the hon. Member for Cheltenham, I will outline the steps the trust is taking to improve the situation. They include a new director of midwifery, an education and training midwife and a perinatal quality and governance lead. To improve retention, the new leadership has introduced a retire and return scheme and is holding monthly events for senior leadership to listen to staff and address their concerns. The trust has recruited 33 new midwifery starters since 2023, including from overseas. Ten midwives are due to start this month, with a further 10 expected in January. But there is still a gap. That is why the Aveta birthing unit and the postnatal beds at Stroud maternity will remain temporarily closed until they reach safe levels of staffing. The trust clearly felt that it could not continue those services without putting new mothers at risk, which is an impossible situation to be in.

I am pleased that the birthing unit at Stroud remains open, but the other closures have had an impact on women, their families and the local community, as has been eloquently expressed by my hon. Friend the Member for Gloucester and mentioned by my hon. Friend the Member for Thornbury and Yate. The impact goes further afield to my own city of Bristol. In addition to those measures, the trust is developing new apprenticeship schemes; building partnerships with universities, including Worcester and Oxford Brookes; and launching a midwifery attraction campaign in the autumn.

Although the trust has had positive feedback from last year’s new starters, I am pleased that it is carrying out regular assessments, as per the recommendations in the Ockenden review, to ensure that midwives have the right skills to serve the people of Gloucestershire. The turnover rate is now settling, and I know the hon. Member for Cheltenham and other colleagues will do everything they can to help convince midwives that his county is a great place to live and work. The passion for those units is very evident here today, which I am sure will be welcome to those trusts.

I know from my career in the NHS that such changes take a long time. It is too soon to make an assessment until all the new midwives have started. However, we are not waiting for the CQC to do the rounds to ensure that the picture is improving. The local maternity and neonatal systems team and the regional NHS England team are meeting with the trust on a fortnightly basis to review progress. The trust’s monthly board reports will report on progress; I know hon. Members will be watching carefully.

It is important to give the new team space to prove themselves. I am hopeful that we will see improvements in time. At a national level, whenever trusts and maternity units do not perform on our watch, we will steer them back to safer ground. That is why we are supporting Gloucestershire maternity services through the national maternity safety support programme. That means that the trust is supported by a maternity improvement adviser for midwifery and obstetrics, who helps the trust to embed the maternity improvement plan.

I know that the hon. Member for Cheltenham and others will continue to hold the trust to account, until it is delivering for women in their constituencies. I am grateful to him for obtaining this debate and giving me the chance to put the Government’s position on the record. With regard to his third question, like many trusts in this position, the trust does have the budget for establishment; it is the recruitment and retention of midwives that is the issue. Some trusts do different things with incentives; I do not know whether this trust is particularly doing that. That might be something he would wish to pick up with the trust at another time.

On more general maternity improvements, in September the CQC published a report that demonstrated how much the previous Government let down new mothers in this country. Lord Darzi’s report has shown that, despite some improvements, there is still a disgraceful inequality of outcomes for black and minority ethnic women, as we have heard again today. We will look at every recommendation in the CQC report, and if officials object to any of them, I expect to hear a very good reason why.

There is ongoing work to improve maternity and neonatal services across England. The NHS put in place a three-year delivery plan to make maternity and neonatal care safer, fairer and more tailored to every new mother’s needs.

I shall now discuss the Government’s wider ambition. Choice—which was mentioned today by my hon. Friend the Member for Stroud and the hon. Member for Thornbury and Yate—is for us absolutely a key part of maternity care. As the hon. Member for Winchester said, our NHS must listen to and work with women and families on how their care is planned and received, based on what matters to them.

To get maternity care back on its feet, we need to train thousands more midwives as part of the NHS workforce plan, while encouraging experienced midwives to stay in the NHS. Many hon. Members, including the hon. Member for Cheltenham, spoke of recruiting midwives, with regard to morale and workload. That was also mentioned by the hon. Members for Tewkesbury (Cameron Thomas) and for Carshalton and Wallington (Bobby Dean). The NHS will deliver the people plan, giving a stronger focus to a modern, compassionate, inclusive culture, which absolutely has to be part of our forward look in the 10-year plan.

We will ensure that trusts failing on maternity care are robustly supported into rapid improvement. We are setting an explicit target to close the black and Asian maternity mortality gap. NHS England is on the right track, boosting the workforce through training, apprenticeships, postgraduate conversion, return to midwifery programmes and international recruitment. I have been clear that the Government will build on those programmes, not replace them.

Finally, I want to end by restating our unwavering commitment to maternity services across the nation, including in Gloucestershire. We are actively working to improve staffing levels and are planning for the future needs of Gloucestershire’s maternity services. I say to the constituents of the hon. Member for Cheltenham that I hear his concerns and completely understand them, and I will work with him to set this right.

The Opposition spokesperson is an assiduous writer, and I have answered a number of her letters, but if I have not responded to particular points from the previous debate before recess, I apologise, and will ensure that that happens after this debate. She has raised important questions.

In the constituency of the hon. Member for Cheltenham and in mine, women have had to bear the brunt of inaction for the past 14 years, but this Government will deliver for women, not just in the south-west but in the country as a whole.

Christopher Chope Portrait Sir Christopher Chope (in the Chair)
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I call Max Wilkinson to respond to this very well-informed debate.

Sepsis Awareness

Christopher Chope Excerpts
Wednesday 9th October 2024

(2 months, 2 weeks ago)

Westminster Hall
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James McMurdock Portrait James McMurdock (South Basildon and East Thurrock) (Reform)
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I thank my hon. Friend the Member for Ashfield (Lee Anderson) for this debate. It is hard to think of a more appropriate topic. I also thank Abbi—who has shared with us the warmest smile that I have seen in a long time—and her husband for being here; it is a privilege to meet them.

I want to take a moment to share a personal story, to show why drawing attention to this subject is one of the most appropriate things we can do as Members of Parliament. I have four young children at home. After the birth of the most recent one, my wife began to suffer some of the symptoms we have discussed today, but—very much like the hon. Member for Kingswinford and South Staffordshire (Mike Wood)—tough Brits do not easily give in to the hospital. As fate would have it, though, we had a meeting that morning with a carer who was checking on women who had recently had children. She popped round to check on the welfare of baby and mother, and although my wife and I were adamant that everything would be fine, this skilled professional spotted the symptoms immediately and demanded that we were rushed to hospital. We were there within half an hour and, within another 20 minutes, there were around a dozen doctors, nurses and support staff rushing around like maniacs. Although I cannot remember the specific number of signs, they were tenfold, fifteenfold, twentyfold what they should be in a healthy person. The staff may have saved my wife’s life in very real terms.

That is why I wanted to take this moment to recognise why this issue is extremely appropriate. The consequences of catching sepsis are minor, but the consequences of not catching it are extraordinarily severe. The difference is cheap: it is education; it is information that we can all carry with us for free, but which can potentially benefit someone’s life.

I want to take one last moment to again thank Abbi for sharing her story and my hon. Friend the Member for Ashfield for allowing us to hold this debate, and to thank the extraordinary staff at Basildon University Hospital.

Christopher Chope Portrait Sir Christopher Chope (in the Chair)
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There are two more speakers and six minutes to go, so that is three minutes each.

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Caroline Johnson Portrait Dr Caroline Johnson (Sleaford and North Hykeham) (Con)
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It is a pleasure to serve under your chairmanship, Sir Christopher. I congratulate the hon. Member for Ashfield (Lee Anderson) on securing a debate on this very important topic. I should also declare an interest as an NHS consultant paediatrician. I have cared for and continue in my work to care for people with this condition.

I would like to thank Abbi for coming today. It was an honour to meet earlier today and to hear her story from her MP, which highlighted both the difficulties she faced in getting good immediate care for sepsis and the consequences of that. I commend her for the bravery she has shown in coming today and for raising this issue for the benefit of other people. This debate will increase awareness, which is a very positive thing.

I remember sitting in the Chamber earlier this year when the former hon. Member for South Thanet re-entered Parliament to a standing ovation—an exceptionally rare occurrence in the House of Commons. It is truly humbling to reflect on the journey that he has been through in such a short space of time. Little over a year ago, he had no outward signs of sepsis at all. He has now become one of the most well-known advocates for people with it. His case brought renewed attention to this disease, which kills nearly 50,000 people in the UK every year. As the hon. Member for Ashfield said, that is around the same number of people who die from bowel, breast and prostate cancer combined.

The case of our former colleague speaks to not only a remarkable recovery but the suddenness with which sepsis can utterly change someone’s life. As many people have said today, early identification is vital. Under the previous Government, awareness of sepsis improved significantly, as did the clinical recognition of symptoms, screening rates and the administration of antibiotic treatment, but there is much more to do.

I want to commend the UK Sepsis Trust and other public campaigners who played a significant role in improving awareness among the general public. A recent YouGov survey showed that the UK has high levels of public awareness compared with other countries. Will the Minister say what steps the Government will take to work with NHS England and patient groups such as the UK Sepsis Trust to raise public awareness, so that people can more easily identify the signs of sepsis? I have also asked this of another Minister, but have not yet received an answer. The Chancellor said that she was cutting the communications budget—can the Minister confirm that those cuts will not affect the important public health messaging for campaigns like this? It is important that we do not cut budgets that will save people’s lives and, indeed, save the NHS money. It is also important to raise awareness not just across the general public, but among health professionals, including medical staff in both hospitals and communities.

The national early warning score has been introduced and is being rolled out, along with the sepsis six, which was developed with the UK Sepsis Trust. The six—oxygen, cultures, antibiotics, fluids, lactate management and urinary output monitoring—must all be carried out within the first hour. Has the Minister established how well those measures are being rolled out across the UK, and what is he doing to ensure that is being done effectively? The National Institute for Health and Care Excellence updated its guidance earlier this year. Will the Minister update the House on how effectively that guidance has been implemented across the UK? Martha’s rule was introduced before the election; the rule relates to the ability for people to get a second opinion from another health professional if they remain concerned about their loved one or themselves. Will the Minister update the House on the work the NHS is doing to roll that out, too?

Research is the cornerstone of transforming sepsis care, and the last Government invested more than £1 billion through the National Institute for Health and Care Research. It is important that we research the causes of and treatment for sepsis, but we must also research new antibiotics, because we are starting to see antibiotic resistance to infections. If we do not invest in antibiotic research, new antibiotics will not be developed—we are essentially asking people to develop a drug to be kept on the shelf for when we need it, and there is no money in that, so it will not get commercial take-up. It is therefore important that the Government invest in that.

The UK Sepsis Trust is calling on the Government to publish data on the sepsis care pathway so that we can see where it is performing well and where it is performing less well. I urge the Government to do that. It would be helpful if the Minister could confirm today that they will do so.

As we close the debate, let us remember what we are fighting for. Sepsis takes the lives of 50,000 people every year. It strikes suddenly and often without warning, as Lord Mackinlay’s case reminds us so powerfully. Early identification and rapid treatment are the keys to saving lives; we have made strides, and awareness is growing, but we must do more. We must continue to improve recognition, strengthen control and push forward with life-saving initiatives. I urge the Government today not just to maintain their commitment but to strengthen it by partnering with NHS England, publishing more data, researching the causes of sepsis and ensuring we can fight this disease together.

Christopher Chope Portrait Sir Christopher Chope (in the Chair)
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I thank the Front Benchers for sticking to their five minutes, which means the Minister now has 10 minutes; there will hopefully also be a couple of minutes for the proposer to reply.

Healthcare Provision: East of England

Christopher Chope Excerpts
Tuesday 3rd September 2024

(3 months, 3 weeks ago)

Westminster Hall
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Clive Lewis Portrait Clive Lewis
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I thank the hon. Gentleman for his interesting question. I am not happy with the removal of the winter fuel payment—of course I am not—and I do not think anyone on this side of the House will be happy with it, but I also understand that there are two points in the year when you support your Government: the King’s Speech and the Budget. I am not looking to break that, but like many of my colleagues I have severe concerns about the impact this proposal will have on people’s health and wellbeing and on their pockets. I have every confidence that my Government will put in place the best possible response to the £22-billion hole left by Conservative Members. I just do not think that the removal of the winter fuel allowance is necessarily the right way forward, but we shall see what happens in the days and weeks ahead. My question to the Minister is this: does she believe—this almost pre-empts the question asked by the hon. Member for Broadland and Fakenham (Jerome Mayhew)—that the cut to winter fuel payments will improve the situation in terms of fuel poverty and its impact on health?

Another example is financial insecurity. Age UK Norwich told us that 35% of Norwich wards fall within the top 10% of the most deprived areas in England. There has been a 35% rise in food bank use in the city, fuel poverty is at nearly 16%, and 68% of Age UK Norwich inquiries are about money, debt or bills.

Another example is poor housing and malnutrition. We have quite extreme malnutrition in Norwich. Norfolk has the highest malnutrition rate in England; malnutrition affects one in five people in Norfolk and Waveney. Jade Hunter, the headteacher of West Earlham infant and nursery school, told The Guardian:

“We do get a lot of bad chests because they’re in damp homes that are maybe mouldy, and we get a lot of sickness and diarrhoea because the quality of the food they’re eating isn’t great”.

She told me that one way teachers know children are hungry is that they chew their pens and chew sand. That shows that they are not being given what they need to thrive at school.

Before I conclude to allow others to contribute, I would like to ask the Minister some more questions. We know there will be a Government review of NHS England structures. There is an incomprehensible patchwork of bodies covering different geographical areas, including the Norfolk and Suffolk NHS foundation trust, the East of England ambulance service, the NHS Norfolk and Waveney integrated care board—the list goes on. Are there plans to simplify those structures and make those bodies more accountable? I understand that NHS reorganisations and reforms are not always popular, particularly with staff, but I wanted to ask that question.

Secondly, before the general election, all Norfolk MPs called for an undergraduate dental school to be established at the University of East Anglia. With my hon. Friend the Member for Norwich North (Alice Macdonald) and many others across the region, I have been working on that proposal, so will the Minister tell us whether there has been any news or developments? Such a school will be critical to beginning to end the dental desert in Norfolk and Waveney—dentist provision in Suffolk is in almost as bad a state.

Finally, I campaigned for mental health before I was an MP, I and continue to do so to this day, despite the difficulties. Despite the past 15 years of so-called change and reform in our local mental health service, it is still arguably the worst in the country. Will there be a statutory public inquiry into the systemic failure of mental health services in Norfolk and Suffolk? This scandal—this slow-motion disaster—has gone on too long, disrupted and ruined too many lives, led to people dying unnecessarily, and caused much grief. People need answers, and if we are to learn lessons from what has happened in the past 15 years, we need an independent public inquiry to get to the bottom of these issues.

Christopher Chope Portrait Sir Christopher Chope (in the Chair)
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Before I call the next speaker, let me say that about 10 people have indicated that they wish to speak. The winding-up speeches will start just before 10.40 am. I believe in self-regulation, so I hope people will contain themselves so that their speeches meet the overall need.

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Adrian Ramsay Portrait Adrian Ramsay
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I totally agree with the hon. Member’s point. I have had family experiences in recent months that have shown me, starkly and at first hand, just how much we need to address the crisis in social care and the lack of integration with the health service.

I want to highlight that on the Norfolk-Suffolk border, in towns such as Eye and Diss, people are 20 miles from the nearest big hospital in Norwich, Bury St Edmunds or Ipswich—and in towns such as Halesworth, which does not have a local community hospital at all, people are even further away. I ask the Minister to consider what support can be given to rural hospitals to provide more services, and particularly to encourage cross-county border working in the health services that will enable us to look at how services can be provided in a way that benefits communities straddling the county border, as they do around Diss and Eye in my constituency.

Secondly, is no surprise that we have heard about dentistry from nearly every hon. Member who has spoken in this debate. We have the Sahara of dental deserts in the east. In the winter, I conducted a survey of residents in Waveney Valley to which more than 800 people responded. A quarter had given up on dentistry treatment altogether because of lack of NHS provision, others were driving long distances to access a dentist and some had even pulled out their own teeth. That is just not tolerable in the 21st century.

I welcome the Government’s commitment to reforming the dental contract. From my discussions with dentists and dental organisations such as the British Dental Association, it is clear that reform of the dental contracts is the root cause of the big exodus of dentists from the NHS. Dentists are not being paid appropriately for the work they do. Can the Minister set out the timescale for reviewing that contract? Health organisations have told me that for every effort they put in to getting new dentists into the NHS, dentists are leaving at a greater rate. We must address the root cause of the problem.

Thirdly, I want to highlight optometry. I received correspondence from an optometrist in Norfolk concerned about the lack of post-operative aftercare, particularly for operations such as cataract surgeries. They highlight that private companies are operating services of that kind and then discharging members to the community without aftercare, which is having a knock-on effect on A&E. Can the Minister ensure that, where private companies provide such services, the proper aftercare is also provided? Will she commit to looking at whether that highlights the problem of relying on private companies, which might seek to cut corners in the name of profit, to provide services?

To conclude, our rural services, particularly in market towns and villages, are severely affected by the decline in health services. Whether it is dentistry or a lack of local hospital services, we need urgent action and I would welcome the Minister’s addressing my specific points.

Christopher Chope Portrait Sir Christopher Chope (in the Chair)
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Mohammad Yasin, you have one minute.

Mohammad Yasin Portrait Mohammad Yasin (Bedford) (Lab)
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Thank you, Sir Christopher. You said you would surprise me, and you really did. It is a pleasure to serve under your chairmanship.

Like those in many other areas, Bedford’s residents are suffering when it comes to GP and dentist appointments. One of the reasons my constituents are struggling is that we have shortages of GPs. We are trying to recruit from other countries, but we need local GPs. I am pleased that the Government have pledged to train more GPs locally.

Data from the 2021 census showed that the populations in each of the local authority areas covered by the Bedfordshire, Luton and Milton Keynes integrated care board grew much faster than average, ranging from a 10.9% increase in Luton to 17.7% in Bedford. The population in England only grew by 6.6% in that period—

Christopher Chope Portrait Sir Christopher Chope (in the Chair)
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Order. I am afraid I have to call the hon. Gentleman to order because we have run out of time. I am sorry that a lot of people will not be able to give their speeches.

I try to promote self-regulation, but it is worth reminding ourselves that paragraph 7 of the “Rules of behaviour and courtesies in the House of Commons” says that even if time limits are not imposed, Members

“should speak with reasonable brevity and be mindful of others. Brevity in debate will give other Members a greater opportunity to speak and increase…chances of being called early”,

on the next occasion on which a Member seeks to speak. I read that out as this is the first Westminster Hall debate of this Parliamentary Session. It is important that Members take into account that although I would prefer not to have to impose time limits, people then have to regulate themselves.