GP Funding: South-west England

Claire Young Excerpts

Wednesday 25th June 2025 Westminster Hall

[Brian Mathew (Melksham and Devizes) (LD)]

It is an honour to serve under your chairship, Dame Siobhain. I thank my hon. Friend the Member for Newton Abbot (Martin Wrigley) for securing this important and timely debate.

I will quote a GP in Melksham and Devizes who also covers part of the neighbouring constituency. He wrote in an email to me this week:

“Without a significant improvement in GP contract payments, the ICB will push us into a position where we have to reduce the hours our surgeries are open. This for us at best means closing sites 1-2 days per week to try to minimise our staff wage bill which is our largest expense. Depending on what happens in 1-2 years, one or more sites would have to close.”

[Claire Young (Thornbury and Yate) (LD)]

My hon. Friend is making a strong case for Three Shires medical practice, which has three surgeries in my constituency. Does he agree that if any of the surgeries were to close, it would be a disaster for patients because of the poor public transport links? Does he agree more generally that it is more expensive to deliver GP services in rural areas because we cannot centralise to save money without dramatically reducing patient access?

[Brian Mathew]

I totally agree with my hon. Friend.

On funding, although the general medical services baseline is around two thirds of our income, it has gone up by 7.2%, with 6% eaten up by the increases in employer national insurance contributions and the national living wage. Our other income streams—dispensing, QOF and enhanced services—have gone up very little. Our emergency section 96 one-off funding has helped us to postpone that decision, and further tightening our belts has stabilised our financial position. However, partner income remains lower than it was two years ago, and it is little more than that of salaried GPs, making reappointment difficult.

Most of the new money is tied to the primary care network, so it is centralised, or it is delivered via the additional roles reimbursement scheme, which is mainly restricted to non-GP roles such as pharmacists. There has been a scheme to allow PCNs, not practices, to employ newly qualified GPs in a temporary capacity—for example, at a central hub practice. That arrangement disadvantages rural practices, as resources are centralised towards urban centres.

At Three Shires, we have reduced our use of locums to cover GP absences by about 60%, resulting in fewer appointments overall. We have allowed retiring nurses and salaried GPs to leave without replacement, or only be partly replaced, to make savings. That has meant offering fewer appointments and greater work for remaining staff. Our patient participation group has been amazing. It formed the Friends of Three Shires, which has fundraised for new equipment, such as ECG machines and examination couches, helping to keep facilities up to scratch for patients.

The integrated care board has effectively imposed a deadline at the end of September for us to demonstrate that we can continue. Would the Minister be prepared to meet me and GPs from my constituency to hear directly from them about the stark realities of rural GP practices, so that they can help?

Covid: Fifth Anniversary

Claire Young Excerpts

Thursday 12th June 2025 Commons Chamber

[Dr Jeevun Sandher (Loughborough) (Lab)]

I thank my hon. Friend the Member for West Ham and Beckton (James Asser) for securing this debate. We have rightly spoken about those who died during the pandemic, but covid also did something else: it made it much harder for people to earn a decent living. Those who were already struggling—the low paid, the young and people in places outside London—suffered the most.

First, covid hit low-paid people in jobs such as bartending, which could be done only in person because they required complex manual movements, while those in high-paid jobs could use Zoom to reach the office. The low paid were hit and far more likely to be laid off or placed on furlough.

Secondly, the young fell behind while the wealthy baby boomers continued to pull ahead. In the two decades leading up to covid, house prices went up by 100% while wages grew by only 20%. That is why the young cannot afford homes. During the pandemic, quantitative easing, low interest rates and pensioners not spending cash meant that baby boomers started to buy homes again, and house prices are up 25% since covid began, while some 40% of 18 to 30-year-olds are living at home with mum and dad.

Thirdly, London continues to pull ahead. Zooming to work enlarges London’s effective size, while places outside the capital lose out. More and more people and economic activity are sucked into the capital. The people who already could not make ends meet are pulling away not only from mainstream parties but from this House itself. The economically insecure are 50% more likely to have stopped supporting the Labour party, but they are also leaving almost every party in this House.

We can reshape our nation so that everyone can earn enough, but we will do it only if the Government act. For the low paid, we must invest to create good jobs and to get bills down. For the young, we must build far more homes. For the rest of the nation, we must invest outside London. We are at this moment a nation deeply divided, and the pandemic widened those divisions.

[Claire Young (Thornbury and Yate) (LD)]

Thousands of self-employed people and business owners were excluded from Government support because of the arbitrary eligibility criteria. They paid their taxes but were left unsupported during the crisis. Does the hon. Member agree that it is disappointing that those people are still struggling five years on?

[Dr Sandher]

Indeed, huge numbers of people were hit so hard during the pandemic. We agree that although support was broad, it certainly was not perfect.

On top of the suffering, the pandemic widened existing inequalities and divisions in our nation. Those who could not earn enough—the low paid, the young and people outside London—were hit the hardest. They were already turning away from us in this House; they are now turning away more quickly. We can bring them back only if we act to ensure that every single person can earn enough for a decent life, if we create a nation in which we recognise that our strength is founded in each of us doing well—a nation of unity, common purpose and connection. It is for us to build that nation, as my hon. Friend the Member for West Ham and Beckton rightly noted.

Dementia Care

Claire Young Excerpts

Tuesday 3rd June 2025 Commons Chamber

[Claire Young (Thornbury and Yate) (LD)]

Everyone deserves high-quality care when they need it—that is particularly the case for those with dementia, who often have some of the most complex needs—but the sad reality is that social care services in this country are in crisis. The disease has a huge impact not only on the patients, but on their family and friends as they struggle to care for them.

Richard wrote to me about his experience of being a full-time carer for his wife of 55 years. She has ataxia, compounded by dementia. She is losing her ability to walk or talk, write or use the phone, or follow simple instructions, and Richard has to be with her 24/7 to ensure her safety. The daily routine starts with getting his wife out of bed; transporting her to the bathroom; helping her with the toilet; getting her into the shower and then getting in the shower to shower her; helping her clean her teeth; getting her back to the bedroom to dry her hair and dress her; taking her downstairs via their self-funded stairlift; getting her into a wheelchair to transport her to the dining table for breakfast; and then taking her back to the lounge. She may sleep for a little bit, but sooner or later there will be a call for help to go to the toilet, so it is back into the wheelchair, back on the stairlift and back on the toilet. Richard will clean and dress her, and then she will go back on the stairlift, back into the wheelchair and back into the lounge, where the whole palaver will repeat after five minutes, as she has forgotten that she has already been to the toilet and cannot be convinced otherwise.

That is just one small part of a day, and it sounds relentless. Owing to a recent back injury, Richard has had to employ a carer for two mornings a week to help. He wants to care for his wife as long as he can, but one day he may have to move her to a nursing home, and that worries him. He reckons it will cost approximately £1,800 per week and rising due to the increase in national insurance, and he is now worried that in pandering to populism on immigration, the Government may make it even harder to recruit carers. He says:

“Once again, it is the least fortunate and needy of us who will bear the cost.”

Another constituent wrote:

“When my wife was first diagnosed with Alzheimer’s in 2019, we were given a couple of booklets and told to prepare for the inevitable.”

He went on to explain that for a couple of years, including during the covid lockdown, they saw no one apart from the occasional surgery visit, until a crisis in 2023 led to the community mental health team being involved. For a while, his wife got a fair amount of support, but when the mental health team deemed her stabilised, that support was withdrawn, leading to another crisis in January 2024. He is very worried that the whole cycle will play out again and again.

[Sarah Dyke (Glastonbury and Somerton) (LD)]

My hon. Friend reminds me of a conversation that I had with William, a constituent from High Ham who has been caring for his wife, who has had Alzheimer’s for many years. He has relied on the intensive dementia support team in Yeovil, but the service has recently been reorganised. As a result, it has become quite fragmented across Somerset and there is no central contact or clear structure. There are incomplete records, leaving some carers adrift. Does my hon. Friend agree that streamlining dementia care services is vital to ensure clarity and co-ordination for carers?

--- Later in debate ---

[Claire Young]

Absolutely. It is a very frightening situation for people to find themselves in. For carers who have to do all that I have described Richard having to do, having to battle their way to find the services available just adds to the problems.

My constituent says that mental health services are the Cinderella of the NHS. There is a lack of staff and resources, and such services need more financial support so that they do not abandon people the minute they think they can get away with it.

A number of Members have highlighted the importance of voluntary initiatives, and I would like to take this opportunity to thank all those in my constituency, including Time 4 Carers, the memory cafés in Yate and Thornbury, and the Charfield memory group. However, voluntary initiatives are not enough to provide the support that dementia patients and their carers need.

The cross-party commission on social care is welcome, but unpaid carers such as my constituents cannot wait three years—they need a fair deal now. That means respite breaks, so that they do not get to breaking point and can carry on caring for their loved ones, as they want to. It means ongoing support from health services, regular check-ins and not being abandoned when the immediate crisis is over, and it means having the confidence that when they do need to turn to paid carers, those carers will be available, they will have dementia training, and cost will not be a barrier to using them.

[Several hon. Members rose—]

Access to NHS Dentistry

Claire Young Excerpts

Thursday 22nd May 2025 Commons Chamber

[Claire Young (Thornbury and Yate) (LD)]

I thank the hon. Member for Great Grimsby and Cleethorpes (Melanie Onn) for introducing this debate.

Thornbury and Yate is a dental desert. According to a recent newspaper report, not a single dentist in Thornbury and Yate is taking on new NHS patients for the third year in a row, leaving people having to travel long distances for care, or forced to pay for private treatment. I am sure, as a fellow south-west MP, the Minister will be as concerned as I am to hear that in September 2024 the NHS dental activity delivery rate was lowest in the south-west, at 61.6%, compared to the highest in London, at 94.7%. Not surprisingly, in the south-west, around one in every 460 people had to be taken to A&E with a dental problem in 2023-24. That was substantially higher than in London, where the figure was only one in every 860 people. The area covered by the NHS Bristol, North Somerset and South Gloucestershire integrated care board is the worst of all worlds, with fewer dentists, adjusted for population size, and lower dental activity delivery rates alongside higher numbers of A&E visits with dental problems.

I want to highlight two cases that show the impact that is having on vulnerable people. One constituent wrote:

“Despite contacting more than a dozen dental practices in and around South Gloucestershire and Bristol, I have been told by every single surgery that no NHS appointments are available. However, I have been offered private appointments if I am willing to pay…The situation is even more distressing as my wife is currently pregnant and requires urgent dental care, which is crucial for her health and that of our unborn child. Pregnant women are entitled to free NHS dental care, yet this right is rendered meaningless when no NHS appointments are available.”

Another constituent wrote to me: a cancer patient who needed major dental treatment ahead of intense radiotherapy. Bristol dental hospital advised them they would need lifelong follow-up care, but during covid that treatment was stopped and they were discharged back to their NHS dentist. Soon after—surprise, surprise—the practice ceased to provide NHS dentistry and they could not find another, so they were forced to pay for their essential treatment.

[Charlie Maynard (Witney) (LD)]

There seems to be a consensus across the House that the NHS dental contract is broken. That is the consensus across the country as well, including in my constituency. If there is one thing we can get out of the debate today, it is a timeline to which the Government will commit to fixing the situation and to bringing legislation before the House. Does my hon. Friend agree that would be of benefit?

[Claire Young]

I do. We also need solutions for people like my constituent in the meantime; they have already had to pay £1,400 for treatment and they face another £2,000-worth of work to be able to eat normally. That is a stiff fee when you are reliant on personal independence payment and your spouse’s pension. My constituent feels that they have nowhere to turn.

To sum up, patients like my constituents deserve access to an NHS dentist. We need an emergency scheme to guarantee access to free NHS dental check-ups for those already eligible: children; new mothers; those who, like my constituent’s wife, are pregnant; and those on low incomes. We need a dental rescue package that brings dentists back into the NHS from the private sector by fixing the dental contract and using flexible commissioning to meet patients’ needs in the meantime.

Mental Health Bill [Lords]

Claire Young Excerpts

2nd reading
Monday 19th May 2025 Commons Chamber

[Dr Simon Opher (Stroud) (Lab)]

I am delighted to speak about this new Mental Health Bill. It follows up on the Mental Health Act 1983, which is as old as our Secretary of State, as we heard. What I have heard throughout the debate is that mental health affects us all in some way. It touches all of us, whether personally or through people we know really well.

I welcome the greater protections under the Bill, especially for people with learning disabilities. I also welcome early intervention, the stress on out-of-hospital care and the idea of advance choice. People who have repeated psychoses know exactly what they want when they are well. When they become ill, they can become paranoid about their family and their friends, and they are not rational. That is one of the reasons why sometimes they need to be detained under the Mental Health Act. If they have an advance choice document, they can at least say what they would like while they are in a normal state of mind. That is important, and I look forward to that measure.

I like the fact that police stations are being removed as a place of safety. I am concerned about how sections 135 and 136 of the Mental Health Act are being used. I notice that there are some schemes in which mental health workers go out with the police and work together with them, and that is crucial. A close relative of mine became extremely unwell, though it was not quite as awful as what happened to the hon. Member for St Neots and Mid Cambridgeshire (Ian Sollom). First, they were sectioned in an A&E department, and then no bed could be found for 48 hours for this poor relative of mine. The heroic nurses and consultants had to look after someone who was acutely psychotic. That simply is not is not tolerable in our system. We need to find a place quickly for people who are mentally ill, and we have to make sure that they get the best treatment, so that they can get better quickly, while protecting the rest of the NHS.

This close relative of mine was moved to a bed 140 miles away from her family. We must ensure that we get more sufficient beds and more local provision. I know that will take time, and that mental health provision is not in a good state, but I hope that with this legislation and our new Labour Government, we can change that, so that people do not have to travel out of area for mental health provision.

I am impressed by the idea of crisis hubs. I have worked with the Stroud crisis team for many years as a GP, and I have always felt that, given a bit more strength and a bit more resource, they could keep a lot of people out of hospital and from being sectioned, but they need that resource. They also need close working with consultant psychiatrists.

[Claire Young (Thornbury and Yate) (LD)]

One of my constituents waited more than eight hours in a mental health crisis for 111 to get back to them, in which time their mental health deteriorated. Previously, they accessed a dedicated local support line, which gave them prompt access to professional support. Does the hon. Member agree that prompt access to support in a crisis is vital to reducing the need for the greater degrees of intervention covered by this Bill?

[Dr Opher]

That is certainly true, but we need to be careful, because part of the issue is the resources for mental health, rather than the Mental Health Act. We must not blur the two. The current Government are putting 8,500 mental health workers into the system, and I am delighted about that. Hopefully, it will prevent the waits for mental health assessments that people are having to put up with.

I want to say something about “appropriate medical treatment” and “therapeutic benefit”, to which the Bill refers. Some 8.7 million people in this country are on antidepressants, and about 25% of those people are trying to get off them. The harm that these drugs can do includes an increased risk of suicide when people are first going on to them and when they are coming off them, as we have seen in a couple of recent, tragic cases. They can also cause fairly long-term sexual dysfunction. I am asking the Medicines and Healthcare products Regulatory Agency to put proper warnings on its leaflets, and I am also asking for a special service to help people come off antidepressants, because doing so is extremely difficult and most GPs are not particularly well informed about the best ways of doing it. It has to be done extremely slowly.

My hon. Friend the Member for Whitehaven and Workington (Josh MacAlister) talked about ADHD and autism, and what should be done about neurodiversity. I feel that we should be extremely careful in mental health services not to over-medicate people with so-called neurodiversity, and I look forward to speaking to my hon. Friend about that. I had to nip out of the Chamber for half an hour earlier, to talk to the head of a neurodiversity taskforce which will report in July. What I think it needs to do is bring about a much more supportive service rather than going straight for medication, which is what seems to happen when people are referred to private psychiatric clinics. At present, the level of Ritalin-like substances with which people with ADHD are treated has increased by a factor of 500%—and, interestingly, that increase has occurred in social class 1 rather than social class 5. There is something here that we need to get a grip on: we need to provide proper services for people with ADHD.

I was interested by the comment from the right hon. Member for Godalming and Ash (Sir Jeremy Hunt) about families. When it comes to mental health, families are crucial, and I would like to adapt the Bill slightly to make them much more central and responsible. The concept of a family could be extended to certain other people whom a person, when well, could nominate, but families are the crux in a lot of psychiatric care. Their input must be valued, and they must be involved.

This is a very good Bill, and it is about time we had it. I support all its greater protections, and I believe that it will reduce the number of compulsory detainments.

National Cancer Plan

Claire Young Excerpts

Tuesday 4th February 2025 Commons Chamber

[Andrew Gwynne]

I am grateful to my hon. Friend for being a member of the Committee for that Bill, which ended its business last Thursday. The hon. Members for Sleaford and North Hykeham (Dr Johnson), and for Farnham and Bordon (Gregory Stafford), who are sitting on the Opposition Front Bench, were also members of that Committee. My hon. Friend is absolutely right, because the Bill will stop the conveyor belt that the tobacco industry has used to its advantage for decades. We are saying that we will not allow any more children and young people to become addicted to nicotine and tobacco, which, as he says, kills two out of every three users. It is uniquely the most harmful product, and we are making the next generation smoke-free for a reason.

[Claire Young (Thornbury and Yate) (LD)]

One of my constituents waited two years from the onset of severe symptoms to receive a cancer diagnosis, and another 10 weeks to have the type of cancer identified, at which point it was incurable. One of the key failings in this case seems to be the disconnect between her reporting the symptoms to her GP and getting the right referral to the hospital, despite her having a previous history of breast cancer. What promises can the Minister make on improving the co-ordination between different parts of the NHS to make sure that people like my constituent do not fall through the cracks in the future?

[Andrew Gwynne]

That kind of experience is unacceptable, and the purpose of our plan is to demand better of the NHS and the system more widely when it comes to cancer outcomes. Nobody should have the kind of experience that the hon. Lady’s constituent had, which is why we will drive better outcomes through better treatment and earlier diagnosis, and make sure that the whole NHS is joined up in the process—a key part of the national cancer plan.

Oral Answers to Questions

Claire Young Excerpts

Tuesday 7th January 2025 Commons Chamber

[The Minister for Care (Stephen Kinnock)]

We are making a priority of resuming consultations with the sector to stabilise community pharmacy. Pharmacy First has built on existing services to increase the clinical scope. The conditions treated under Pharmacy First vary across the UK, and the NHS will keep this under review.

[Claire Young (Thornbury and Yate) (LD)]

T3. When we think of social care, we often think of those who are older, but at a recent advice surgery I met the mother of a 20-year-old with complex needs that local services are unable to meet, so the only option that would allow him to engage with his peers is residential care further afield, taking him away from his family. Will the Minister meet with me, my constituent and his mother to discuss how we ensure that those with complex needs are properly supported?

[Stephen Kinnock]

I am sure the hon. Lady will welcome the fact that we have found an £86 million uplift for the disabled facilities grant, but on the specific question she raises, I would be happy to meet her and discuss that further.

Community Pharmacies: Devon and the South-west

Claire Young Excerpts

Tuesday 17th December 2024 Westminster Hall

[Rachel Gilmour]

I thank my hon. Friend for his not particularly concise, but erudite, intervention.

I will turn briefly to the funding model of pharmacies. Some 90% of a pharmacy’s income is derived directly from NHS funding, but when it comes to how that funding is allocated, the system is broken. Community pharmacies across the UK dispense more than 1.1 billion items a year and deal with shortage issues on a daily basis. The Department of Health and Social Care sets reimbursement prices in our system, but due to the reimbursement prices being so low and pharmacies being unable to compete on the international stage, the global market is now a safer bet for pharmaceutical companies than the UK. That means that people in the UK sometimes are not able to get the right medication due to shortages and that even when the DHSC puts together a price concession and allows for a greater reimbursement rate to allow UK pharmacies to compete for those life-aiding medications, there are extraordinary pressures on the NHS and the taxpayer. The realities of the funding model mean that community pharmacies are trying to push up water uphill using tools riddled with holes—in other words, sieves.

[Claire Young (Thornbury and Yate) (LD)]

Does my hon. Friend agree that in addition to the issues with the cost of drugs, the funding model for providing all the other services that pharmacies are expected to provide, including the Pharmacy First approach to avoiding GP appointments, needs addressing?

[Rachel Gilmour]

I will come on to Pharmacy First at the end of the debate, because I see it as the solution, rather than the problem.

The sector is trying its hardest, but without a fundamental overhaul of the system these NHS services, which are much-needed by patients and the public, may fall by the wayside into one of the following pits. There are the hours lost. When the money is not there, pharmacies cannot operate. As we see in many areas across the south-west and the UK, including in Tiverton and Minehead, hundreds of hours have been lost to temporary closures of pharmacies. According to the Company Chemists’ Association, pharmacies across the south-west have cut opening hours to the tune of 130,400 hours over just more than a year and a half by reducing their opening hours. According to Community Pharmacy England, from October 2021 to May 2024, in my constituency alone, more than 520 hours of pharmacy time were lost due to temporary pharmacy closures.

Although pharmacies operate all the services that I mentioned in the first part of my speech—and more, but I do not have time to go through them all—the closures take a toll on the GPs and A&E staff who might be someone’s next port of call if they cannot see their pharmacist. They take a toll on the NHS 111 line if the individual calls in, and they take a toll on the people who might not have any other free time in that day to take care of their health needs. Those lost hours add up. When pharmacies cannot provide those appointments or other services, it leads to bottlenecks elsewhere in the system.

Over the first three months of Pharmacy First, to which I will come shortly, pharmacies took 234 appointments out of the GP system simply by offering consultations for the seven applicable conditions. Pharmacies have fantastic potential to relieve pressure and provide new ways for people to access medical services, receive advice and so much more. Pharmacies cannot fulfil their potential if they are closed. The prospect of local pharmacies closing really does scare people. In a recent poll, 83% of respondents reported that they would be concerned about their local pharmacy closing. Data shows that closures are disproportionately taking place in the most deprived areas, with 50% of the pharmacy closures recorded in areas in the lowest three deciles of deprivation.

NHS Dentistry: South-west

Claire Young Excerpts

Tuesday 12th November 2024 Westminster Hall

[Claire Young (Thornbury and Yate) (LD)]

I thank my hon. Friend the Member for Honiton and Sidmouth (Richard Foord) for securing the debate.

Last year, a staggering 58% of children in south Gloucestershire were not seen by an NHS dentist, despite the NHS recommending that under-18s see a dentist at least once a year. When we talk to dentists, however, that is not surprising. As we emerged from the pandemic, one local dentist stopped NHS work for all, including children. When I spoke to those at the practice, they were clear that the contract was at fault, but they also explained that they would have liked to continue NHS dentistry for children but NHS England in the south-west was not supportive.

The last Conservative Government failed to fix the broken contract, and the new Government have yet to show that they grasp the scale of the challenge. We are calling for an emergency rescue plan, including the use of the underspends that have been referred to today to boost the number of appointments.

I will mention a couple of examples from my inbox. The first I alluded to recently in the Adjournment debate on rural NHS dentistry led by my hon. Friend the Member for Chippenham (Sarah Gibson). A constituent who had to retire from his job due to health and mobility issues is entitled to free NHS dentistry, yet he was unable to find treatment anywhere near where he lives. Facing a dental emergency, he ended up having to seek private treatment, because of the pain he was in. He struggled to afford it, but felt he had no choice.

Later, my constituent experienced another painful dental issue. This time, when he contacted the NHS, he was told that there was provision but, because he was now registered, it was unavailable to him; it was available only to unregistered patients. As a result, he had to pay £95 for a small temporary filling at a private practice. He was then told he was not entitled to be enrolled as an NHS patient, as he was registered as a private patient with the practice. I hope the Minister will agree to look into that situation to ensure that everyone can get the care they need.

Another issue I will draw attention to is people missing appointments. A constituent of mine got in touch to complain that, although he is one of the lucky ones in the area who is still able to access dental treatment on the NHS, he was shocked to see a sign saying that 39 people had missed their appointment last month. Staff confirmed that that was the number of people who missed appointments at the practice with no warning or formal cancellation—and that is just one practice. They also said that number was actually quite low, and that it was regularly much higher.

Because those missed appointments were no-shows, not cancellations, the slots could not be offered to other people desperately in need. That resulted in the equivalent of more than eight days of lost work. That brings us back to the question of the contract and how we can make sure that dentists are rewarded for their time, because it adds to the problem of them not being remunerated in a way that enables them to continue NHS work. It is also a question of making the best use of limited resources. I welcome the Minister’s thoughts on how to ensure that happens.

Over 12 million people were unable to access NHS dental care last year. That is more than one in four adults in England, and three times as many people as before the pandemic. I echo the comments made by my hon. Friend the Member for Torbay (Steve Darling) about the challenges, particularly in rural areas, and look forward to hearing the Minister’s comments on that. We have been warning about the issues for years, yet there has been little decisive action to address the crisis. The British Dental Association has been pushing hard to get the Government to ditch the current failed dental contract and instead move to a more prevention-focused, patient-centred system that rewards dentists for improving the overall health of the communities they serve.

In short, I welcome the warm words from the Government on dentistry, but we need more than words; we need action. I urge this Government not to kick the can down the road as the previous Government did.

Income Tax (Charge)

Claire Young Excerpts

Tuesday 5th November 2024 Commons Chamber

[Claire Young (Thornbury and Yate) (LD)]

While this Budget has some welcome measures, including adopting Liberal Democrat proposals on increasing the earnings limit for carer’s allowance, others raise serious concerns. The previous Conservative Government left our NHS on its knees. People in Thornbury and Yate are fed up with struggling to get a GP appointment or register with an NHS dentist, so I will be holding the Government to account to ensure that the extra funding actually delivers for patients.

On that note, I am deeply concerned about the knock-on impacts of raising employer’s national insurance contributions on those parts of the system that are not in the public sector. GPs and pharmacists play a vital role in preventive health and in detecting serious problems early, yet because many are privately run businesses, they will be left footing a huge new tax bill. I have been contacted by several concerned local GP surgeries. One told me that as it had a large number of part-time workers who were previously exempt but will now be eligible, the national insurance increase alone will wipe 2.5% off its top-line budget. Another told me:

“This change will have a significant financial impact on general practices, including my own, and can only serve to directly undermine access and patient care”.

[Mr Adnan Hussain (Blackburn) (Ind)]

Blackburn has the third highest number of patients per GP. Does the Member agree that, despite the ringfencing of the funding that GP surgeries get, the increase in national insurance will essentially reduce the number of available appointments at GP surgeries?

--- Later in debate ---

[Claire Young]

That is exactly the point that my local GP was trying to make, and I am not clear from the Secretary of State’s earlier remarks whether this will be addressed.

Similarly, the majority of social care providers are privately run companies. They play a huge part in reducing pressure on hospitals, and raising employer’s national insurance will deal a hammer blow to struggling providers. That is why I urge the Government to think again and provide them with the same support they have provided for publicly owned NHS services. They should instead look to raise the money needed by reversing Conservative tax cuts for the big banks, or by asking the social media giants to pay their fair share. I was disappointed that the Budget made little or no reference to social care, and I urge Ministers to start cross-party talks on social care now.

The other area that I want to touch on is flooding. I draw the House’s attention to the letter I sent ahead of the Budget about the need to support local authorities to prevent and respond to flooding. My Thornbury and Yate constituency recently endured 50% of its annual rainfall in just one month. The council has had to respond to that within its already overstretched budget. While I welcome the funding for flood resilience projects, it needs to be recognised that years of underfunding under the last Government have left councils struggling to maintain their infrastructure to prevent surface water flooding.

Given more time, I would like to cover other topics, including the concern that the additional SEND funding will barely touch the sides, the impacts on farmers, bus users and small businesses, and the ongoing financial crisis in local government. Instead, I will conclude by noting that the unintended consequences lurking in this Budget put at risk much-needed improvements to our public services. I hope the Government will think again and make the right decisions now for the long term, including fixing social care and delivering long-term infrastructure improvements.