Access to GP Services and NHS Dentistry

Daisy Cooper Excerpts

Tuesday 21st June 2022 Commons Chamber

[Daisy Cooper (St Albans) (LD)]

The Conservatives have been running our health and social care system into the ground for years. Covid has made an already bad situation worse, but it was already bad, and my constituents—patients and healthcare professionals—can really feel it. A constituent who is a professional chauffeur needs to provide regular medical assessment certificates to keep his job, but his GP is not doing them right now, so my team have had to work hard to make sure that his employer will not sack him.

Some of my constituents have managed to see their GPs. One has had a referral for chronic back pain, another for a diagnosis of breast cancer that needs treatment, but having had those appointments they then discovered weeks later that the referral letters were never sent. Another constituent who had a contraceptive implant has had some very severe side effects and wants to have it removed, but she cannot get an appointment. A constituent who contacted her GP to say that she was having suicidal thoughts was asked to fill out a form.

I was so concerned about these reports that I have been to visit our GP surgeries in St Albans. From the other end of the spectrum, it is incredibly shocking. The very second the phone lines open in a GP surgery, there are flashing lights on its big screen. At one minute past the time that its phone lines open, there are hundreds and hundreds of calls on the electronic board. Many of those phone calls are from very distressed callers who are in pain and very concerned. Many of the people at the counter—the receptionists at the other end of the phone—are receiving verbal abuse, and we know that GPs are receiving abuse in their surgery rooms behind closed doors as well. The BMJ suggests that violent incidents in GP surgeries have doubled in the last five years.

One of the GP surgeries in my constituency has now employed somebody on a full- time basis to do one job: to chase the local hospitals to send the letters so that the GPs can get the results that their patients need. We have heard Members across the House talk this afternoon about how fantastic it would be if we could use big data and if our constituents could become expert patients and use all the information collected on their phone, but frankly, at the moment, we are starting from a basis where we cannot even get a letter from a hospital to a GP surgery. It feels as though the entire system is creaking at the seams, and that is even before we get to the postcode lottery of the number of patients each GP has, or the length of appointments.

Members across the House have talked about the planning system and the fact that lots of new homes are often built in areas without the infrastructure to go with them. I wholeheartedly sympathise with the calls for new homes, but it seems crazy in the circumstances that clinical commissioning groups are not even statutory consultees for planning applications, for local plans or even for permitted development. It should be a priority for this Government to change that and make sure that CCGs have the right resources to respond to planning proposals.

Then we have the problems with dentists. Like many other Members use, I have constituents who have raised these problems. I have mothers with MAT-B certificates who cannot get dental treatment. I have parents whose children are developing gum disease, but they cannot get an appointment with their dentist. I have couples who have moved to St Albans and, because they have moved, cannot get an appointment with the dentist. The list goes on and on.

I have challenged the Minister before about the Government’s announcement earlier this year that they were going to give £50 million to dentists to create some emergency catch-up appointments. When the Secretary of State was challenged on this earlier this afternoon, he said that that £50 million had resulted in tens of thousands of new appointments. That was news to me. Earlier this year, I submitted a number of written parliamentary questions. I asked the Government how many dental practices had achieved the quarter 3 targets to make them eligible for this £50 million. The answer was that the Government did not hold that information centrally. I asked the Government how many expressions of interest had been received by the deadline of 3 January. The answer was that the Government did not hold that information centrally. I then asked the Government how many of those who had offered to carry out this urgent dental practice had been accepted. Again, the Government said that they did not hold that information centrally. So what has happened to that £50 million? How much of it has been drawn down?

[Maria Caulfield]

The hon. Lady will know, because she raised this in oral questions, that dentists return that data in quarters. We will have that data from the dental community by the end of June, and we will then be able to answer her questions. She knows that; she is making a political point here.

[Daisy Cooper]

I am genuinely incredibly grateful for that answer, because when I challenged the Minister on this last week I did not receive that answer. I am grateful to receive that response. I submitted a letter to the Minister—I think it was in April—and attempted to come to some drop-in events that were cancelled, so I am pleased to hear that that data will be provided by the end of June. However, my constituents in St Albans have seen absolutely zero appointments created from that money. Every dental practice has said that because of the way the funds have been set up, it has been impossible for them to apply for them. A number of other Members have raised that point.

The truth is that the Government have failed to recruit the GPs that we need. We have a retirement time bomb among our general practitioners, and we know that dentists are leaving NHS work as well. We need to see a serious plan from the Government so that everybody who needs to see a GP or a dentist can actually see one.

--- Later in debate ---

[Daisy Cooper]

Will the Minister give way?

[Maria Caulfield]

No, I will not.

We are also delivering zero tolerance to abuse through the Police, Crime, Sentencing and Courts Act 2022. Labour talk the talk, but it was those of us on the Government Benches who voted to double the maximum sentence for those who abuse our emergency care workers. Labour actually voted against giving the Bill a Third Reading. That tells us all we need to know.

With the time I have left—

Oral Answers to Questions

Daisy Cooper Excerpts

Tuesday 14th June 2022 Commons Chamber

[Maria Caulfield]

I am sure the people of Wakefield are as frustrated as I am that the Labour dental contract, put in place in 2006, is the nub of the problem. If the hon. Lady were to meet with dentists, she would hear loud and clear that the dental contract is causing the problem. [Interruption.] She might not have listened to my previous answers because she is not listening now, but we will be announcing changes before the summer recess.

[Daisy Cooper (St Albans) (LD)]

At the start of this year the Government announced £50 million to create some new dentistry appointments, but that money resulted in exactly zero new appointments in my constituency. I wrote to every single dental practice in my constituency and they said that was because the funding offer was too limited in scope and time and they were given only a week to reply.

On 25 April, I wrote to the Minister asking how many appointments had been created from this money across England and where that money had gone. I have not received an answer. Will we get one today?

[Maria Caulfield]

I am very disappointed: that £50 million of funding was for dentistry to access and be able to afford more appointments, and if local commissioners in an area did not bid for that money or ask dentists to take that money on, that is extremely disappointing—those in other parts of the country certainly did. We are putting £3 billion a year into dentistry. Local MPs have a role to play in this: if there was a problem, I would have expected the hon. Lady to have come and seen me before now to lobby for more funding for her local area.

North East Ambulance Service

Daisy Cooper Excerpts

Monday 23rd May 2022 Commons Chamber

[Maria Caulfield]

I reassure the hon. Gentleman that the police have investigated and that they did not find evidence of that. As I have said at the Dispatch Box, I will look into specific cases to be confident that no stone has been left unturned with respect to the allegations in The Sunday Times. There are measures in the Police, Crime, Sentencing and Courts Act 2022 that increase sentences for assaults on emergency workers, which we take extremely seriously.

[Daisy Cooper (St Albans) (LD)]

As far back as December last year, I wrote to the Secretary of State urging him to commission a CQC investigation of the crisis in our ambulance service, using his powers under the Health and Social Care Act 2008, because the CQC does not have powers to conduct thematic reviews itself. Since I wrote to him, we have seen scandal after scandal. In the north-east, people were told to phone a friend; in the west midlands, a patient waited more than 22 hours; in the south-west, stroke and heart attack victims are having to wait more than an hour; and in my own constituency, a cancer patient nearing the end of life had to wait almost 12 hours in agony for an ambulance to arrive. Surely it is time for the Government to stop sitting on their hands and to commission the CQC to launch a wide-ranging investigation of the crisis facing all our ambulance services.

[Maria Caulfield]

Let me reassure the hon. Lady. The CQC has been heavily involved in this case. I met representatives this morning to hear from them, and will be following that up. Moreover, an extra £55 million has been invested in the ambulance service nationally. We are aware of the pressures that the service is facing, and will do all that we can to support it.

Health and Care Bill

Daisy Cooper Excerpts

Consideration of Lords amendments
Monday 25th April 2022 Commons Chamber

[Sir Iain Duncan Smith (Chingford and Woodford Green) (Con)]

I will speak briefly to Government amendment 48A, which is in lieu of amendment 48B. Essentially, it requires the health service to ensure that it does not use products made under forced or slave labour anywhere in the world. That is a big statement by the Health Department, and one that I think we all welcome—I have certainly campaigned on this issue for some time.

In the great sweep of this health legislation, on which there are agreements and disagreements across the board, that may not seem to be something that will directly affect our lives, but in truth it will resonate beyond our shores. It is already resonating among the Uyghur, who have found themselves under distinct pressure, with husbands often separated from wives and families broken apart for forced labour thousands of miles away from their homes. This measure will speak to them; it is, in a way, a sign that Governments in the free world are taking up this real cause and recognising that it is intolerable for us to turn a blind eye and buy equipment, clothing and so on simply because it is cheaper and helps our cost balance. I do not believe that it will in the end; the trade-off between cost and the human rights of those who have suffered so much under the heel of those totalitarian states is an abysmal one.

Child labour is used in rare-earth mines; when we use those rare-earth materials for the manufacture of our computers, we turn a blind eye to it. When slave labour is used in the Xinjiang region to produce the cotton and the cloth for our personal protective equipment, making it quicker and easier to get, we turn a blind eye to it. It is not just done there; it is done in many countries around the world because it is easier and cheaper, and we tolerate it. I therefore welcome that my right hon. Friend the Secretary of State and the Ministers have tabled the amendment. It will speak volumes to those who are oppressed. It will say to them, “The free world has not forgotten you.” I am certain that in due course the rest of this Government will do the same, and other Governments will then follow suit. I congratulate us for making the right decision.

[Daisy Cooper (St Albans) (LD)]

I will speak to the workforce amendment and the amendment on the social care cap.

The Lords have compromised on the workforce amendment—they have now asked for projections every three years instead of every two, and they no longer require independent verification of the projections—so it is deeply disappointing that the Government have not moved to meet them halfway, especially when outside the Government there is so much cross-party consensus that the amendment is badly needed. I know from my constituency of St Albans, as I am sure many Members know from theirs, that our NHS and care staff are burnt out. They are understaffed and overworked. Those people, who continue to turn up every single day, need to know that the cavalry is coming, and without this workforce amendment, they simply will not.

There have been worrying reports that NHS trusts have been silenced when they have tried to talk about the numbers of staff that they need to recruit, so will the Minister address this question in his response: if the Government will not produce workforce planning numbers, will they at least commit to not interfere with or silence any part of the NHS or care sector that decides that it wants to produce its own workforce projections? I look forward to hearing the Minister’s assurances on that point.

When it comes to the social care cap, Ministers have stated time and again that their changes would save the Treasury £900 million a year by 2027-28, but that saving comes at the expense of people with fewer assets and savings, including those who will have been paying five years of increased national insurance contributions, which were put in place partly to fund these care reforms. The Government continue to say that that improves on the current situation, but they conveniently ignore that it is much worse than their original proposal. The social care cap provision does nothing to generate more care; it does nothing to give protections to unpaid carers, who are often on lower incomes but save the Government millions of pounds; and it does nothing to help the social care workforce. I know from my constituency that hospitality, the NHS and social care are all fighting for the same people, and nothing in the Bill will help to improve that situation.

[Peter Aldous (Waveney) (Con)]

I am grateful to have a few minutes to say a few words on the cap on care costs and on workforce planning.

With regard to the care cap, it is important to congratulate the Government on tackling a problem—or attempting to defuse a ticking time bomb—that all their predecessors shied away from. However, there is concern that the proposals are a rushed tag-on to a Bill that was designed for a different purpose: the integration of health and social care and the setting up of integrated care systems. I accept that there is a clear correlation, but the legislation that addresses the problem of people being forced to sell their homes to pay for their care should have been considered and scrutinised separately and carefully, with the objective of putting in place a system that has political consensus and will stand the test of time. That is what the Dilnot proposals and the Care Act 2014 achieved, and they should be the foundation stone on which we build this new system.

My concerns are twofold. First, clause 140 is extremely unfair to those with limited assets and modest incomes. The changes may save the Government hundreds of millions of pounds, but they do so at the expense of those on low incomes and those who live in parts of the country where house values are lower, such as Lowestoft in my constituency. Secondly, there is a worry that working-age adults with disabilities will be unfairly penalised, hence the introduction by the other place of a provision to address it. I acknowledge the Government’s worries about the cost implication of that additional provision, but that iniquity needs to be addressed.

On workforce planning, there is a staffing crisis both in the NHS, where there are 110,000 full-time equivalent vacancies, and in social care, where there are another 100,000 vacancies, high staff turnover and very limited respite for unpaid and family carers. Those deficiencies cascade through the health and care system, creating bed-blocking in hospitals and impeding the efforts made to reduce waiting lists. There is an urgent need for strategic planning to address this crisis. There is concern that framework 15 is not working because of inadequacies in the collection of data, lack of assessment of workforce numbers, and unresponsiveness to societal shifts.

Since we last considered the issue last month, the other place has sought to address the Government’s concerns and, as we have heard, has made reasonable concessions. There is a crisis that must be addressed, and I hope that at this very late stage the Government will accept this reasonable amendment, so that we can get on with this much-needed work.

Health and Care Bill

Daisy Cooper Excerpts

Consideration of Lords amendments
Wednesday 30th March 2022 Commons Chamber

[Jeremy Hunt]

It is absolutely the case. We need something like this because, as I know—I will do my self-reflection now—when a Health Secretary negotiates a spending settlement with the Chancellor, the number of doctors they are going to have in 10 or 15 years’ time is quite low down their list of priorities because they are thinking about immediate pressures. So we need something that deals with that market failure. I did set up five new medical schools and was proud to do so, but I do not know whether that was enough. That is why we need something to make sure that we never have to worry, whoever the Government and the Health Secretary are, that this fundamental thing that is vital for the future of the NHS for all of us is always properly looked after.

Let me conclude by remembering what we were discussing this morning in the Ockenden review. We talked about the agonies faced by families. We did not talk enough about the agonies faced by doctors, midwives and nurses who find themselves responsible for the death of a child—it is psychologically incredibly devastating for them. We need to be able to look them in the eye and say, “The No. 1 thing in the Ockenden review that came out was that staffing shortfalls can make a difference. We understand that.” They know and we know that there is no silver bullet; this cannot be solved overnight. It takes seven years to train a doctor, 10 years to train a GP and three or four years to train a nurse or a midwife. No one is expecting a solution tomorrow, but we do at least have a responsibility to look each and every one of those people, who worked so hard for us in the pandemic, in the eye and say, “We do not have a solution right away but we really and truly are training enough for the future.”

[Daisy Cooper (St Albans) (LD)]

The Minister made a valiant effort to dissuade some of us from supporting Lords amendment 29—the workforce amendment—but I suspect he knows he is not kidding anybody.

We have learned today that public satisfaction with the NHS is at its lowest level since 1997. We should not underestimate the blow that that news will deliver to the health and care workers who turn up, do an amazing job, and go above and beyond every single day. To say that that news is dispiriting is an understatement. It is important that those workers know that the public, and every Member of this House, loves our NHS; it is just that we want it to work a bit better. It is hardly surprising that people’s biggest frustrations are waiting times, a lack of proper funding and staff shortages. Those things are the fault not of health and care workers but of this Tory Government, who are driving our health and care services into the ground.

Cancer Research UK says that without the workforce amendment the Bill will fail to address the biggest barrier to the achievement of world-class cancer outcomes in the UK: the staffing shortages and pressures. The King’s Fund has said that the health and care workforce crisis will be the key rate-limiting factor in the reduction of the NHS elective care backlog. The workforce amendment may not be a silver bullet, but it is the closest thing to one, which makes it all the more frustrating that the Government will not accept it. As I suspect the Minister knows, the Government’s objections just do not stand up to scrutiny.

As the right hon. Member for South West Surrey (Jeremy Hunt) said, framework 15 simply sets out the number of staff the Government think they can afford, rather than the number of staff we actually need. I urge the Minister to think about what message that sends to my constituent, who is a newly qualified midwife. She wrote to me just a couple of months ago and said:

“I am extremely concerned about the crisis in maternity care. This isn’t caused by Covid-19—the systemic failings have been crippling the service for a generation—but the pandemic has made a bad situation worse.”

She said:

“I am being harmed, my clients are being harmed. Staff are being harmed. For every 30 newly qualified midwives, 29 are leaving. Parents are reporting bullying and coercion. Threats are being used to ensure compliance. Unnecessary medical interventions are at epidemic levels. Trauma—amongst parents and midwives—is rife.”

She said that “concerns are being missed” and interventions “made too late”, and that the reason was “staffing problems.” If that is not a wake-up call, I do not know what is.

I wish briefly to express my concern about the powers the Bill will give the Secretary of State. At best, the change will create a bureaucratic nightmare; at worst, it will lead to meddling and the politicisation of the day-to-day running of the NHS. The Government have tried to argue that the pandemic showed the need for Ministers to have more powers, but we know that during the pandemic the Secretary of State had powers over PPE and test and trace, both of which issues were handled extremely badly. The NHS’s operational independence is critical, but it will be undone by the introduction of the Henry VIII powers in the Bill, so Liberal Democrats will oppose them.

Finally, I congratulate the right hon. Member for Chingford and Woodford Green (Sir Iain Duncan Smith) on his impassioned speech. I agree with him wholeheartedly that we have a duty as a nation and as a society to ensure that the goods used in our publicly owned NHS are not tainted by modern slavery or linked to the behaviours that may lead to genocide.

[Derek Thomas (St Ives) (Con)]

I rise to speak in support of Lords amendment 29, in the context of those who suffer brain tumours. I wish to take a moment to reflect on the fact that Tom Parker, a member of The Wanted who had done so much work to raise awareness of brain tumours and who worked with the all-party parliamentary group on brain tumours, which I chair, died today of his brain tumour. I wish to take a moment to remember him, his family and the two young ones he has left behind.

As I say, I chair the APPG on brain tumours, so I wish to discuss the need for Lords amendment 29 in that context. As we have heard, there is currently no data on how many healthcare staff the country needs, but we know that staff are overstretched. As we heard from my right hon. Friend the Member for South West Surrey (Jeremy Hunt), £6.2 billion was spent on locums in the financial year 2019-20 to plug the gaps. The NHS and social care will never be able to keep up with demand without regular assessment of the numbers needed. As we know, the Government have so far dismissed this workforce planning amendment on the basis that the Department of Health and Social Care has commissioned a long-term strategic framework. We have heard already this evening why that is not good enough, although I am extremely aware of how much the Minister is engaged in, and concerned about, this workforce subject, and he has been generous with his time in talking to colleagues about what the Government hope to do.

--- Later in debate ---

[Daisy Cooper]

I would like to start by talking about carers and safe discharge. I welcome the Government’s concession on this point. It is a pleasure to follow the hon. Member for Gosport (Dame Caroline Dinenage), who talked so eloquently about the fact that unpaid carers are often, in effect, invisible. She is seeking a number of assurances from the Minister, and I wonder if I might add another.

The Minister will be aware that on Report I tabled an amendment calling for a new NHS duty to recognise and identify unpaid carers who come into contact with the NHS so that their health and wellbeing could be taken into account when decisions are made concerning the health and care of the person or the people for whom they care. The amendment now before us is not as strong as that. In fact, it is not as strong as the Lords amendment. I welcome the Government’s concession on this, but I wonder whether the Minister might provide some assurances that the nub of my amendment at an earlier stage could, for example, be included in some of the ICB guidance. It is important that carers are consulted but also important that their health and wellbeing is taken into account when decisions are made about those for whom they care.

I have a couple of thoughts on the social care cap. First, it is a really terrible way to come up with policy to change a policy halfway through a Bill, because it starves important policies of public debate and parliamentary scrutiny. It is a very bad habit. We have seen it with other Bills, such as the Building Safety Bill—a national scandal that I have spoken about many times. This is a bad way of making law. It is important that the Government do not fall into bad habits.

The other point is on broken promises. The Prime Minister stood on the steps of No. 10 and pledged to

“fix the crisis in social care once and for all”.

He also promised that no one would have to sell their home to pay for care. He has now broken both those promises, because this Bill does not fix the social care crisis and it does continue to see people facing the prospect of losing their home to fund care costs. Quite frankly, it is appalling that the Government are arguing that they cannot afford to accept this amendment when the savings that are going to be generated for the Treasury come off the backs of the poorest people in our society. The Government really should think again.

[Steve Brine]

I have sat through all this debate and taken issue with the Government in some places and supported them in others. I am going to take issue with them on amendment 51. It is always hard to take issue with this Minister, but I seem to have done it twice already today. My hon. Friend the Member for Gosport (Dame Caroline Dinenage) and I did not compare notes but seem to have exactly the same comments, which suggests that this is an important amendment.

I want to make a few points about young carers in Hampshire and nationally who have been in touch with me about amendment 51. The amendment that we are being asked to strike out says at paragraph (5)(b) that

“a ‘carer’ means any person, including any child under the age of 18”.

It does not say that in the Minister’s amendment in lieu, but I have heard what he has said today and I hope that it will be heard clearly, because what is said at the Dispatch Box matters a great deal. The Minister in the Lords said on Report that there will be statutory guidance that hospitals “must have regard to” and that that is a sufficient measure for carers. Again, I hear that, but what is said at the Dispatch Box in the Lords matters as well. As young carers have said to me, ahead of today, this is not the same as primary legislative rights and it can be withdrawn or changed at the stroke of a Minister’s pen, intentionally or unintentionally. It does not mean the same for carers and young carers in the daily operation of the system. I would suggest that very few carers, especially young carers, have the energy, the means or the knowledge to go to judicial review if their rights are not followed.

When the Minister winds up, I beg him once again to make it absolutely crystal clear that his amendment in lieu does the same as the Lords amendment that he is asking us to strike out, because young carers, in particular, want and need that reassurance. Other than that, it is a good amendment that is worthy of our support, but I just want to hear a little bit more from my excellent Minister—and now that I have flattered him he cannot deny me.

Civil Proceedings

Daisy Cooper Excerpts

Tuesday 29th March 2022 Commons Chamber

[Daisy Cooper (St Albans) (LD)]

I, too, put on record my enormous thanks to all the health and social care workers as well as the many unpaid carers—who have demonstrated extraordinary public service over the last couple of years, and also on a daily basis, day in day out—for the instances of love, care and medical attention for the thousands of people who have recovered, but also the 165,000 who did not.

Two years ago, in March 2020, the Liberal Democrats recognised the seriousness of the emergency. We worked constructively with the Government, along with other Opposition parties, to introduce this emergency legislation. In the course of time it became clear that some of the provisions were indeed necessary to tackle the impact of the pandemic, such as enabling the emergency registration of nurses and other healthcare workers, and allowing people to receive statutory sick pay. However, many of the powers in the 2020 Act have serious implications for people’s wellbeing and for their rights and freedoms, such as the relaxation of duties on local authorities to assess and meet people’s care needs, the extra powers for police and immigration officers to detain people, and the powers to restrict or ban events and gatherings.

This is the third time that the Act has come up for renewal. We are glad that the Government have retired many of the most controversial provisions. However, I ask the Minister whether the Department of Health and Social Care will work with the Cabinet Office to review the use of emergency legislation over the last couple of years, because we must not end up in this situation again. It is vital that we as a House ensure that there are safeguards in place to guard against the assumption that this or any future Government may use emergency legislation outside of an emergency.

Although the emergency legislation is effectively being retired bit by bit—we have just six months left—I share the concerns of a number of colleagues about the creeping complacency that has shown its face in the Department of Health and Social Care, particularly towards some of our most vulnerable residents, the immunocompromised. Other colleagues have talked about the importance of free covid tests, clear guidance and sick pay. The Government have talked very much about taking a vaccine-led approach, yet they are falling down in that approach when it comes to the immunocompromised.

There is a life-saving drug, Evusheld, the trials for which have shown that it can reduce the chances of developing symptomatic covid-19 among immunocompromised patients by 77% after three months and 83% after six months. I ask every Member of the House to take a second to put themselves in the shoes of immuno-compromised people. Two years ago, the Prime Minister wrote to every person in this country and asked them to stay at home. Those who are immunocompromised or immunosuppressed have never left. Many of them are still in lockdown. They cannot benefit from the vaccines that the rest of us have enjoyed. For them, the decision of whether to go back to work or just to the shops is a life or death decision. It is a huge health inequality in our country that all of us can benefit from vaccines but those who cannot are not being given access to this life-saving drug.

I therefore ask the Minister not only to respond to the point about how we deal with emergency legislation in future, but to confirm on record today that the Government intend to place an order for this drug, and to do so within days not weeks, because, now that it has approval from the European Medicines Agency, the window within which there is still manufacturing capacity and the UK can place an order is shrinking fast. Although it is vital that the legislation that we have used during the pandemic comes to an end slowly—in six months hopefully it will all be retired—many people are still living in lockdown because of covid, so I would ask the Minister to respond to those points.

Oral Answers to Questions

Daisy Cooper Excerpts

Tuesday 1st March 2022 Commons Chamber

[The Parliamentary Under-Secretary of State for Health and Social Care (Maggie Throup)]

As we clearly stated, the decision has been made to end the temporary approval, which means that face-to-face consultations and taking the first pill in a healthcare setting returns to England from 30 August 2022. As I said earlier, all healthcare services are kept under review as evidence and information emerge.

[Daisy Cooper (St Albans) (LD)]

Since the NHS was created, it has been governed by the principle that services are free at the point of use, and, of course, the Secretary of State has a duty to protect that. Many of my constituents want to know whether the Government’s decision to start charging for covid tests marks a departure from that founding principle.

[Sajid Javid]

Clearly, that is one of the most important principles of the NHS and it will not change. It is right, though, that when we look at living with covid, we target testing on those who are most vulnerable or who are in vulnerable settings. That is the right, proportionate and balanced approach.

Access to NHS Dentistry

Daisy Cooper Excerpts

Thursday 10th February 2022 Westminster Hall

[Daisy Cooper (St Albans) (LD)]

I, too, congratulate the hon. Members for Waveney (Peter Aldous) and for Bradford South (Judith Cummins) on securing this well-attended and important debate.

I want to relay some of the desperate accounts that have come from my constituents. One moved to St Alban’s with his fiancée in November 2020—15 months ago. They needed dental care and tried eight NHS dental practices in the area, but not one could add them even to the waiting list. They have checked with the practices every single month for the past 15 months and still no joy. My constituent’s fiancée has now registered with some student dentists at a hospital in London. She is desperate to get some treatment. The good news is that she is on the waiting list; the bad news is that it is still a very long waiting list.

Another constituent, a mother, has a very young daughter. The mother has spent two and a half years trying to get her daughter an appointment with a dentist. She wrote that she was surprised that NHS practices do not even have an obligation to take in children, especially when they have a dental issue. She herself has gum disease, which got worse during her pregnancy. She has had to spend all her savings and money to go private.

Another person who has been trying for ages to get a dentist appointment rang the NHS phone number, which tells people to call it if they cannot get an appointment. All the people there did was to search the websites for her, which she had already done. Their only advice was that she should wait until she was in agony and then call NHS 111. What kind of advice is that? It is unfair and counterproductive, and it costs the taxpayer more.

The local dentistry committee in Hertfordshire wrote to me. It had written to NHS England, along with the dental committees of Bedfordshire and Milton Keynes. They were begging for the payment system to be reformed. It is absurd that, if dentists carry out more work for their community than the outdated cap allows, they simply cannot be paid. That is an absolutely absurd system. Dentists are unable to provide the care that their patients need. The units of dental activity skew the dental system. It is now more attractive for practices to deal with less complex patients: in many cases, they are paid the same flat rate for such treatments as they would for helping those with higher needs.

The Local Dental Committees confederation has sent its plans to the Government and to many MPs, saying that the system has to be reformed. I sincerely hope the Minister will give us a better answer than the one I was given to my written parliamentary question earlier today, which simply confirmed that the system was being reviewed along with lots of other options. We need to hear more positive noises from the Minister this afternoon.

What needs to change? The Association of Dental Groups has made some recommendations on workforce. Some Members have alluded to those recommendations—the “six to fix”. The association talked, first, about the need for more training places here in the UK, which I am sure we all support. Secondly, it called for—some Members have not referenced this—the recognition of EU national dentists to be extended beyond the end of this year, when it will otherwise run out. Thirdly, the association has called for the UK to look at recruiting from countries that have a surplus of high-skilled dentists. Unfortunately, it appears to be news to some Members in the Chamber that we were always able to recruit from some of those countries, and it did not require Brexit to be able to do so.

I would like to put three questions to the Minister. First, when will my constituents be able to see a dentist? Secondly, when will this absurd payment system be scrapped and reformed? Thirdly, when will there be a workforce strategy so that dental deserts, which we have heard so much about, become a thing of the past and this Dickensian system of years-long waiting is finally brought to an end?

Integration White Paper

Daisy Cooper Excerpts

Wednesday 9th February 2022 Commons Chamber

[Edward Argar]

I am grateful to my right hon. Friend in this respect. Discharge of people from hospital safely, either into a care home setting or back to their own home with support, is vital not only for their own health outcomes but for the flow of patients through our acute hospitals to enable A&Es and other parts of the system to function effectively. Through the national discharge taskforce and through the work we have done throughout the pandemic, we are bringing together acute hospitals and local authorities, and we have made huge strides together within localities in improving this and learning lessons. This White Paper sets out a way in which they can be embedded to ensure that they continue to deliver long-lasting benefits.

[Daisy Cooper (St Albans) (LD)]

My constituent Lynn is a powerful and loving advocate for her husband Andy, but she is at her wits’ end because she has to repeat the same information time and time again to nurses, consultants, dementia specialists, carers and the Department for Work and Pensions. When will the White Paper make her life a little bit easier? Despite her frustrations, she knows that all those professionals are working incredibly hard, but there just are not enough of them. How can it be that the Minister has said in this statement that he wants integrated care systems to have a joint health and care workforce plan, but he is still refusing to put that commitment to a workforce strategy into the Health and Care Bill?

[Edward Argar]

I am grateful to the hon. Lady for her comments and for highlighting the situation Lynn and Andy find themselves in. What we seek to do, through what I said about care records, is exactly what she and I think they would wish to see, which is to reduce the number of unnecessary or duplicative interactions with the system.

She touches on workforce. I set out in my remarks earlier that since 2010, under this Government, there have been over 30,000 more doctors and 38,000 more nurses. In just the past year, we have seen a huge increase in the number of nurses—I think 11,000—and an increase of about 5,000 doctors. We continue to grow the workforce and we are already working to do so. My right hon. Friend the Member for South West Surrey (Jeremy Hunt), who is no longer in his place, set a lot of that in motion. We have also commissioned from Health Education England and NHS England, now that we have announced their merger, the long-term 10-year workforce strategy, which I look forward to with interest.

Elective Treatment

Daisy Cooper Excerpts

Tuesday 8th February 2022 Commons Chamber

[Sajid Javid]

My hon. Friend speaks with great experience and raises a really important issue. The short answer is yes. We have fantastic doctors throughout the NHS and more in training in medical schools than ever before, but we should also focus on retaining talent throughout the NHS. I assure him that that work has already begun.

[Daisy Cooper (St Albans) (LD)]

I am shocked that some Government Members are trying to pat each other on the back, because right now my heart is breaking for all those constituents who have emailed me to tell me that they are in fear and in pain, and what they have just heard is that that may continue for years to come. The Secretary of States talks about new tech, new hubs and new scanners, but without people to operate them they may be of limited use. Where is the plan to fill the almost 100,000 NHS vacancies?

[Sajid Javid]

The hon. Lady, like other hon. Members, is absolutely right to raise the importance of workforce. To deliver on this plan, of course we need to do so much more to keep increasing the workforce and make sure all the skills we need are there. Just last week, I believe, the NHS published that it has more doctors, nurses and clinicians than ever before; 40,000 people have joined the NHS over the last two years, including many more doctors and nurses. Also, as I mentioned, I have asked the NHS, with HEE, which will become part of the NHS, to come up with a long-term plan. We look forward to that plan and will invest in it.