Access to Primary Healthcare

Daisy Cooper Excerpts

Wednesday 16th October 2024 Commons Chamber

[Daisy Cooper (St Albans) (LD)]

The Minister may be aware that I lobbied Health and Treasury Ministers in the previous Government for the best part of a year and a half to review outdated Treasury rules that prevent GP practices that want to move from staying within a city centre—the outdated rules force them to move to ring-road locations, away from the populations they serve. Will the Minister look at this issue with fresh eyes, with her new glasses, and work with Treasury colleagues to review these outdated rules?

[Karin Smyth]

I thank the hon. Lady for her assiduous work in opposition. Looking at the capital estate is one of my favourite new responsibilities, and our commitment to a neighbourhood service means that we need to bring services together. We need to look at this across the piece, to make sure that primary care is provided where it is needed. We often hear about hard-to-reach groups, but I do not think they are that hard to reach. Frankly, services are sometimes located in the wrong area. One of our key commitments is to shift services into communities, and the neighbourhood service programme is part of that.

Just three in 10 NHS dentists are accepting new adult patients, and geographical inequalities are vast. More than 1,200 pharmacies have shut their doors for good since 2017. Again, the record speaks for itself: public satisfaction with general practice has fallen from 80% in 2009 to just 35% last year. If there is any reason why the Conservative Benches are empty, it is because dissatisfaction with access to primary care is so stark, as we learned in July’s general election.

It is absolutely clear that primary care is broken, but NHS staff working in primary care did not break it; the last Government did. They cut funding for the community pharmacy contract, they failed to incentivise enough dentists to perform NHS work, and they pursued a disastrous top-down reorganisation of the NHS, with which we are still living.

The last Government might have broken the NHS, but it is not beaten. NHS staff remain as passionate, dedicated and skilful as ever, and this Government will work in lockstep with them, their counterparts in social care and local partners across the country to fix the NHS.

NHS: Independent Investigation

Daisy Cooper Excerpts

Thursday 12th September 2024 Commons Chamber

[Mr Speaker]

I call the Liberal Democrat spokesperson.

[Daisy Cooper (St Albans) (LD)]

Much of the content of Lord Darzi’s report has been known for some years. None the less, today’s report is a scathing summary of the complete devastation that the Conservatives have wrought on our health services and on the health of our communities. We Liberal Democrats have long argued that we need to shift healthcare from hospitals to high streets, and from treatment to prevention, because doing so improves health outcomes and saves taxpayers’ money. It is a win-win.

But the report is long on diagnosis and short on prescription, so may I invite Ministers to read our fully costed manifesto to fix public health and primary care by recruiting 8,000 GPs, ending dental deserts, boosting public health grants by £1 million, implementing our five-year plan to boost cancer survival rates, and putting a mental health expert in every school?

Does the Secretary of State accept that there is an elephant in the room: social care? Will he meet me to discuss the Liberal Democrat plans for social care, starting with free personal care? This bold idea would prevent many people from going into hospital in the first place, as well as enabling them to be discharged from hospital faster. Does he accept that it is a truth universally acknowledged that we cannot fix the NHS if we do not fix social care too?

As for the dire state of our hospitals and primary care estate, well, the Conservatives have left it to fester like a wound. Will the Secretary of State give the green light to hospitals that are ready to rebuild, such as mine in west Hertfordshire? Will Ministers look to reform outdated Treasury rules that are preventing our integrated care boards and hospital trusts from spending and investing their funds in the GP practices and hospitals that we need? This Government say that they want growth. Well, health and wealth are two sides of the same coin, which is something the Conservatives do not understand. If Labour wants economic growth, fixing our health and social care must be its top priority. And it must be a priority without delay.

[Wes Streeting]

How refreshing to have constructive opposition in the Chamber. It was clear throughout the election campaign that my party and the Liberal Democrats have much in common, both in the commitments we made, which in some cases were identical, and in our shared areas of emphasis: the link between health and wealth, the importance of prevention and the importance of social care.

As the Prime Minister reiterated again this morning, we are absolutely determined to address both the short-term crisis and the long-term needs of the century in our social care system. We want to work on a cross-party basis wherever possible, so I would be delighted to meet the Liberal Democrat spokesperson.

Healthcare Provision: East of England

Daisy Cooper Excerpts

Tuesday 3rd September 2024 Westminster Hall

[Daisy Cooper (St Albans) (LD)]

It is a pleasure to serve under your chairmanship, Sir Christopher. I congratulate the hon. Member for Norwich South (Clive Lewis) on securing this important debate.

The NHS used to be the envy of the world, but it is now in crisis, and services in the east of England are no exception. We have heard many examples in the debate of where our health and care services are in crisis. There is no doubt that the new Government inherit a litany of broken promises from the previous Conservative Government; that is why we Liberal Democrats have put health and social care front and centre of our campaigning in recent months and years. It is why, on the first day after the general election, we called for an emergency Budget to give the NHS and care services the money they so desperately need, and it is why we continue to urge the Government to act with real ambition and urgency on these issues.

In a debate on healthcare in the east of England, it is hardly surprising that dentistry comes out as the No. 1 issue. Dentistry is in an appalling state across the country, and particularly in the east of England, but arguably it is one of the easiest areas to fix. Under the previous Conservative Government we ended up in an absurd position where we had children having their teeth removed and people desperate for appointments, yet we had a £400 million underspend in one financial year. We also have thousands of dentists in this country who are willing to deliver NHS work, but who cannot because the contract is so convoluted.

I ask the Minister to outline the Government’s timeline for negotiations with dentists on fixing the broken dental contract. I also have a specific request from my hon. Friend the Member for North Norfolk (Steff Aquarone), who could not be here: he asks whether it could be made faster for people who want to operate NHS services to register to do so, because there are currently delays in the system.

A number of colleagues have spoken about the challenges with ambulance waiting times. The hon. Member for Norwich South and I have spoken in debates on this before and he will know, as I do, that the East of England ambulance service has had a very troubled history. To give credit where credit is due, there have been welcome improvements in the last 18 months, but there is no doubt that there are still huge delays in ambulance response times, which are very concerning to our constituents. Would the Minister support a Bill that I tabled in the previous Parliament to introduce localised reporting on ambulance response times, so we can see response times on a postcode basis?

Thirdly, I am surprised there has not been more talk about hospitals today. We know there is a legacy from the last Government of crumbling hospitals right across our region—the hospital in King’s Lynn is one of the worst such examples in the country and is being held up by stilts. In my area in west Hertfordshire, we have West Hertfordshire teaching hospitals NHS trust and Watford general hospital is in dire need of a new hospital. It is one of the hospitals in the country that is ready to go—it has the land, it has permission, it has the plans and it just needs the green light from the Government. I urge Labour Ministers to recognise that delaying those plans does not come without a cost, because the repair bill is getting bigger and bigger.

Finally, does the Minister recognise that we need an ambitious plan of recruiting 8,000 GPs? The last Government promised 6,000 and failed to deliver them. Does she agree that we should align the primary care estates strategy with the shift to community care? Does she also agree that the Labour Government will, as part of its consultation on the national planning policy framework, make sure that infrastructure comes first, so that places such as Wixams are no longer let down by the planning system we had under the Conservatives, where people got housing without infrastructure, GPs or dentists?

Oral Answers to Questions

Daisy Cooper Excerpts

Tuesday 23rd July 2024 Commons Chamber

[Mr Speaker]

I call the Liberal Democrat spokesperson.

[Daisy Cooper (St Albans) (LD)]

I welcome the Secretary of State and his Ministers to their roles, but let me gently warn him that if he intends to run a contest on which Member can harangue him the most on crumbling hospitals, our 72 Liberal Democrat MPs say, “Challenge accepted.”

Under the Conservatives, the new hospital programme ground to a halt. We know the terrible stories of nurses running bucket rotas and all the rest. We have the worst of all worlds at the moment: trusts such as mine in west Hertfordshire are champing at the bit to get going but cannot, and are being held back. Other trusts have capital funds that they want to spend but are not allowed to because of outdated rules, and there are industry concerns that the one, top-down, centralised approach of the Conservatives could decimate competition in that industry, when we need a thriving industry to rebuild our hospitals and primary care. What is the Secretary of State’s response to that approach?

[Wes Streeting]

I welcome the hon. Lady back to her place. We worked constructively on the Opposition Benches together and, regardless of the size of the Government’s majority, we intend to work constructively with her on this side of the election, too. By extension, I congratulate her colleagues on their election. I have discovered that I have 72 new pen pals, all sitting there on the Liberal Democrat Benches, and they have been writing to me about a whole manner of projects. My colleagues and I will get back to them.

The hon. Lady is right that this is not just about the new hospitals programme, important though that is; the condition of the whole NHS estate is poor. In fact, backlog maintenance, the direct cost of bringing the estate into compliance with mandatory fire safety requirements and statutory safety legislation, currently stands at £11.6 billion. That is the legacy of the last Conservative Government.

--- Later in debate ---

[Mr Speaker]

I call the Liberal Democrat spokesperson.

[Daisy Cooper (St Albans) (LD)]

The Liberal Democrats spoke about care a great deal during the general election campaign. At the heart of our plans was our pledge to introduce free personal care. Will Ministers please confirm whether they intend to open cross-party talks and, if so, whether free personal care will be on the table as one potential option?

Oral Answers to Questions

Daisy Cooper Excerpts

Tuesday 23rd April 2024 Commons Chamber

[Andrew Stephenson]

We are working to improve radiotherapy services across the NHS, and I would be happy to meet my hon. Friend to discuss that in more detail.

[Daisy Cooper (St Albans) (LD)]

West Hertfordshire Hospital Trust is at the front of the queue for the new hospital programme. We have the land, planning permission, building design, political and staff support, and enabling works are under way. But, like many other trusts around the country, the hospital trust is being asked to submit business case after business case. Will the Secretary of State clarify whether those delays are down to bureaucracy and the new hospital programme, or are they deliberate delaying tactics by a Government who do not want to release funds to hospitals before the general election?

[Victoria Atkins]

Normally, a Secretary of State would appear at the Dispatch Box after a question like that and say, “I refer the hon. Member to the answer I gave earlier.” On this occasion I will refer her to the question from my hon. Friend the Member for Watford (Dean Russell). He has just set out the business case for Watford General, which is great news, and I hope she will join him and me in welcoming that new hospital when it is open.

Tobacco and Vapes Bill

Daisy Cooper Excerpts

2nd reading
Tuesday 16th April 2024 Commons Chamber

[Daisy Cooper (St Albans) (LD)]

First, I want to put on record my thanks to the public health Minister the right hon. Member for South Northamptonshire (Dame Andrea Leadsom) and the chief medical officer Sir Chris Whitty, who spent time answering my questions and those of some of my colleagues. It was a very collegiate exercise and I am grateful to the right hon. Lady. It would be good to see more of that.

The Government proposals on vapes are an absolute no-brainer and are consistent with Liberal Democrat party policy that was adopted at our conference last year, including the ban on single-use vapes on environmental grounds. Parents and teachers in St Albans are particularly concerned about the insidious marketing of vapes to young people: the colours, flavours and packaging are designed to appeal to children. Earlier in the debate the shadow Secretary of State, the hon. Member for Ilford North (Wes Streeting) talked about children gathering in toilets, desperate to use their vapes. I am aware, unfortunately, of one example in my constituency where children have gathered in toilets not just to use the vapes but to take them apart to use as containers for smuggling in more dangerous substances, thereby using the vapes as a new gateway drug. I therefore entirely support the Government’s proposals on the regulation of vapes.

The question of a so-called smoking ban on those aged 15 and younger, stopping them being sold cigarettes, is not so straightforward, however. For Liberal Democrats there will be a free vote on this Bill; there are some good liberal arguments to be made both for and against it. I will be supporting the measures in the Bill, but some of my colleagues have remaining liberal and practical concerns. For example, in 30 years’ time how does somebody prove they are 46 and not 45 without a driver’s licence or a passport? How can we prevent abuse at retailers, too? I hope the Government will be providing more reassurances to colleagues on these issues.

[Sammy Wilson (East Antrim) (DUP)]

Does the hon. Member accept that that difficulty puts the onus on the retailer, who is meant to distinguish between a 45-year-old and a 46-year-old, and if they do not do that or they do so incorrectly, they could find themselves faced with a fine? Is that fair?

[Daisy Cooper]

Colleagues across the House have genuine concerns about that point. I know from engagements in my constituency that a number of retailers already suffer attacks when challenging people wishing to buy other age-related products, so I hope the Government will offer reassurances about what they intend to do to tackle that.

As I have said, I will be supporting the measures in this Bill, but coming to that decision was a bit of a journey for me. My first reaction on hearing of the Bill before it was published was indignation, because the measures are just a drop in the ocean in terms of what is needed to tackle cancer. One in two of us will get cancer at some point, yet the Government have missed their targets to provide fast cancer treatment every year since 2015 and have dropped their 10-year cancer plan. What we need is research in rare cancers, outdated cancer scanners updated, cancer nurses and efforts to tackle waiting times. It would perhaps have been better if the measures in this Bill had been a single clause in a much broader Bill. To be honest, I am frustrated that so much energy is going into this Bill, which could be described as low-hanging fruit, rather than into producing a much more ambitious plan to tackle cancer more broadly. We need to see more ambition in this area.

My second reaction was the raising of my liberal hackles. Liberals are not libertarians; we do not object to all bans. Liberals support bans as a last resort, but not as a first lever. The situation here is frustrating, however: it is a bit rich that the Government are bringing this Bill forward when they have simultaneously been slashing public health budgets, including for smoking cessation programmes, since 2015. Even with the new money the Government have put into smoking cessation programmes, the funds still fall far short of 2015 levels. We also know that smoking rates among young people have dropped very quickly; they are now down to 1% and continue to drop.

Liberals do sometimes back bans when a particular product or practice causes excessive harm, and that is why I have decided to back this ban. Fundamentally, I asked myself a simple question: is this going to help reduce the overwhelming harm caused by the significantly dangerous and addictive practice of smoking? The answer is yes, it is. We know that smoking is dangerous and highly addictive. We know that smoking is the UK’s biggest preventable killer, causing around one in four cancer deaths, including 64,000 in England alone. We know that 75,000 GP appointments each month are taken up by smoking-related illness. We know that smoking costs the economy £17 billion a year through smoking-related lost earnings, unemployment and early death. We know that it comes at enormous cost to our NHS, and we know that smoking rates in pregnancy vary hugely, with as many as 20% of pregnant women smoking in some parts of the country, increasing the chance of stillbirth by almost 50%. That is an incredibly stark health inequality.

Some people have suggested it could be contradictory for a liberal to support a ban on tobacco for 15-year-olds and younger while wanting to legalise cannabis, but let me say to them that they are wrong. It is entirely consistent for a liberal to want to make harmful products illegal—harmful products such as nicotine in cigarettes, skunk and products with high THC levels that can cause psychosis—while simultaneously wanting to have a legal regulated market for less harmful products such as vapes for nicotine and cannabis products with low and regulated THC levels.

In conclusion, do I think this measure is the first or best thing that the Government should be doing to tackle cancer? No. Do I think this measure is particularly ambitious? No. But do I think it is a useful step that will help us to tackle the dangerous health impacts of smoking addiction, to improve population health and to take pressure off the NHS? Personally, I do.

[Madam Deputy Speaker (Dame Rosie Winterton)]

I remind colleagues to stick to the guidance of seven minutes, because otherwise I will have to impose a time limit, and it might not be seven minutes, which would be annoying for everybody.

Oral Answers to Questions

Daisy Cooper Excerpts

Tuesday 5th March 2024 Commons Chamber

[Daisy Cooper (St Albans) (LD)]

I have been corresponding with the Primary Care Minister, the right hon. Member for South Northamptonshire (Dame Andrea Leadsom), and her predecessors about urgently needing to protect general practice locations in city centres from outdated Treasury rules that potentially force them to move to ring-road locations. The Minister’s latest reply suggested that the ICB could use capital funding to pay for new premises, but my ICB claims that that is against the rules. Would she and her officials please urgently meet me and my local ICB to bottom out what the rules are and urgently protect our city centre GP locations?

[Victoria Atkins]

I will ask the relevant Minister to write to the hon. Lady.

NHS Dentistry: Recovery and Reform

Daisy Cooper Excerpts

Wednesday 7th February 2024 Commons Chamber

[Victoria Atkins]

Very much so, and that will be primarily through the patient premium, which will mean that from next month dentists will be able to turn their signs from “closed” to “open” for NHS patients. We wanted to use levers that could be deployed immediately in order to help our constituents.

[Daisy Cooper (St Albans) (LD)]

It is estimated that more than 12 million people are waiting for dental treatment, but the Government’s announcement says that it will help just 1 million. The Government’s underspend last year was £400 million, and it is expected to be the same this year, but only £200 million has been announced. This plan is a drop in the ocean. In St Albans, my dentists are desperate to provide NHS care, and my constituents are desperate to see a dentist. At the heart of the problem is the broken contract. Will the Government take up the Liberal Democrats’ plan to reform the contract and provide guaranteed access to an NHS dentist for everybody needing urgent and emergency care?

[Victoria Atkins]

I heartily recommend the recovery plan to the hon. Lady, because it offers 2.5 million more appointments and has a long-term ambition for the prevention of tooth decay in children. In addition, it has that long-turn vision about increasing training places for our dental professionals by 40% by 2031.

Pharmacy First

Daisy Cooper Excerpts

Wednesday 31st January 2024 Commons Chamber

[Dame Andrea Leadsom]

My hon. Friend raises an important point. Pharmacists will keep their community pharmacy open for up to 72 hours a week in most cases, and up to 100 hours in some cases, which means there is weekend accessibility. We keep this under review, but the availability is very good.

[Daisy Cooper (St Albans) (LD)]

The Liberal Democrats have long supported calls for Pharmacy First, and the National Pharmacy Association, based in my St Albans constituency, has been calling for it since at least 2017. This is a welcome move, but it is long overdue. The Minister will be aware that there have been almost 700 permanent pharmacy closures since 2015, and the Company Chemists Association now estimates that eight pharmacies a week are closing, including one in my constituency. What steps is she taking to make sure there are no more closures this week, next week and every other week this year?

[Dame Andrea Leadsom]

The hon. Lady might remember that the Liberal Democrats were in government for a good part of that period. She talks about pharmacy closures, and we see pharmacies opening and closing. There has been a small number of net closures, but we are very well served across England and we keep a close eye on that. Pharmacy First is a new boost to community pharmacies across England.

NHS Winter Update

Daisy Cooper Excerpts

Monday 8th January 2024 Commons Chamber

[Victoria Atkins]

First, I sincerely thank my hon. Friend. I was in contact with her over the weekend when she had come off a very long shift in emergency care, looking after patients locally. I have nothing but admiration for her and the many, many other people who stepped in at short notice to cover urgent and emergency care in our NHS during the strikes. On minimum service levels, she will know that we have already introduced them for ambulance services—something that was opposed by the Labour party—but we have just closed the consultation on minimum service levels in hospitals and we are, of course, carefully analysing the responses. Again, the point that 40—four zero—patient safety mitigations were made by NHS leaders yet only two were granted by the BMA, is very, very worrying when it comes to how seriously the BMA is taking concerns about patient safety.

[Daisy Cooper (St Albans) (LD)]

A few weeks before Christmas, NHS bosses were here in Parliament briefing MPs that, notwithstanding their preparation for the winter crisis, the one thing that would push them to the brink would be a rise in respiratory illness. Now here we are: cases of flu, covid, RSV—respiratory syncytial virus —and whooping cough are all rising rapidly. A strong public health intervention by the Government could have prevented that from happening. When will the Government get serious about public health interventions such as vaccine uptake, air filtration and protecting the immune compromised to stop people getting so ill so often for so long?

[Victoria Atkins]

I thank the hon. Lady for re-emphasising the critical timing of the strike actions and the impact it has on patients. We know that winter is difficult. It is not just difficult for our healthcare system. Around the world, when cold winter strikes, it has physiological impacts on people with underlying health conditions. We also have a rise in infectious conditions, too. As she will appreciate, that is precisely why, on the advice of clinicians, we brought forward the flu and covid vaccination programme to try to protect the most vulnerable in our society. But again, the timing of the strikes is so very cynical, because their impact and tail will, I am sorry to say, have consequences beyond tomorrow’s stop date.