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 It is absurd that, if dentists carry out more work for their community than the outdated cap allows, they simply cannot be paid.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.

Elective Care Recovery in England

Daisy Cooper Excerpts

Monday 7th February 2022 Commons Chamber

[Edward Argar]

My hon. Friend knows of what she speaks, as a serving consultant in our NHS. She is right that investment is important but that the outcomes are what really matter. We have set out measures such as the community diagnostic hubs, which are bringing diagnostic capacity to local communities and making it more accessible. That is just one example of how we will ensure that the money delivers the required outcomes.

[Daisy Cooper (St Albans) (LD)]

Health conditions do not wait until a medic or a bed is available. They deteriorate, often very quickly, and every single one of the 6 million people on the waiting list will have to rely on their GP for extra appointments and extra treatment, and they will possibly rely on their GP to deal with severe complications. What support will there be for primary care while all these people are waiting for their planned secondary care?

[Edward Argar]

The hon. Lady makes a very important point, and I take this opportunity to put on record my gratitude to all those in general practice for the amazing work they have been doing over the past two years. Again, they are the front door to the NHS for patients and all our constituents. Last year we set out the additional funding being made available to help general practice recover from the changes that had to be made during the pandemic, and we continue to look at the system as a whole, not in its component parts. She is right that general practitioners are often the people our constituents go to if their operation is delayed or if they need additional care while waiting for an operation, so it is important that we provide support to general practice, too.

Vaccination: Condition of Deployment

Daisy Cooper Excerpts

Monday 31st January 2022 Commons Chamber

[Sajid Javid]

What I hear from my hon. Friend, and I very much agree, is that vaccines are safe and effective. They remain our most important weapon in fighting the pandemic and, as more people come forward and choose to get vaccinated, that is not only good for them but right for the rest of society, their loved ones and everyone else around them. That is especially so if the people around them—they might be in a care setting or a hospital—are more vulnerable than most of the population. The best way forward is therefore to encourage everyone now to continue to think of the vaccine in that positive, sensible way and to come forward.

[Daisy Cooper (St Albans) (LD)]

I welcome this change of tack because I, like many others, opposed the compulsory vaccination policy. However, I fear that, in the care sector, the damage has been done—there are reports that about 40,000 people have already left—and it is damaging patient safety. With the change of tack, will the Secretary of State tell us his plans to get more carers quickly into the sector? With regard to the shortage occupation list, how many carers does he hope to recruit, and by when?

[Sajid Javid]

I thank the hon. Lady for that good question. She referenced 40,000 people having left care homes as a result of vaccine as a condition of deployment, and I can give her more information on that. While there is no exact data because care homes are independent and the people who work in them are not employed directly by the state, the Department’s best estimate, which is from the industry, is that the change in workforce during the final half of last year was a fall of 19,300. We do not believe that the 40,000 number is representative—the best proxy number is 19,300. Having said that, no one would want to see anyone leaving the care home sector when, as she rightly identified, we need more people coming forward. That is why we put in place a £162.5 million retention fund before omicron, and we have added to that fund by more than £300 million during omicron. We are also supporting the sector in having the largest recruitment campaign that it has ever run.

Oral Answers to Questions

Daisy Cooper Excerpts

Tuesday 18th January 2022 Commons Chamber

[Sajid Javid]

The hon. Lady is absolutely right to raise the importance of endometriosis. She will know, I hope, that in the women’s health strategy there will be an important focus on it. Within that strategy, we have set out how we can work together to do much more.

[Daisy Cooper (St Albans) (LD)]

We know that the number of covid admissions has led to a number of people having their routine hospital treatment cancelled. Last week it was announced that that had reached a record-breaking 6 million people. When might the Government make a statement about hitting this figure and set out a plan to tackle it?

[Sajid Javid]

The hon. Lady will know that, sadly because of covid and the need for the NHS to prioritise it—rightly—we have sadly seen an increase in people waiting for elective procedures and scans. She will also know that the Government have already set out a plan to deal with that in terms of funding—the biggest catch-up fund in history, with an extra £8 billion of funding over the next three years. After tackling the most immediate need to deal with omicron, we will shortly set out in much more detail how we intend to tackle the elective backlog.

Vaccination Strategy

Daisy Cooper Excerpts

Wednesday 12th January 2022 Commons Chamber

[Maggie Throup]

My right hon. Friend makes a very good point, but I go back to the MHRA, which is globally recognised as one of the best regulators and has advised that,

“the benefits of vaccination still outweigh any risk in most individuals.”

With regards to myocarditis, to which I think he was referring as well, it is greater in those children who have been infected with covid than in those who have been jabbed. I must stress, however, that instances of both those circumstances are extremely rare. The JCVI continually reviews all the data.

[Daisy Cooper (St Albans) (LD)]

It is clear that the Government need a new strategy for driving up vaccinations among the unvaccinated. Around the country, there are practical examples of things that are working that they could roll out nationally. Will the Minister commit to looking at ideas such as vaccine tracing; the offer of an on-the-spot vaccination when somebody comes into contact with any part of the NHS; and the offer of free cabs for those who are struggling to get to a vaccination centre because of the cost or caring arrangements? Those things are working already, yet they are not being rolled out nationally.

[Maggie Throup]

I reassure the hon. Lady that many different measures are being put in place across the whole country depending on what works in different specific areas. For example, there are pop-up clinics in mosques and temples; there have been all-female clinics that help different communities; and there have been clinics in restaurants in certain parts of Bradford. There is a wide range of measures because, as she rightly indicated, there is not one solution for everybody. The fact that more than 90% of people have already had their first dose is a huge success, but the last few are the hardest to reach. That is why we are putting in place different measures to ensure that we do the right thing for individuals in different places and look at what will work for individuals across different communities.

Public Health

Daisy Cooper Excerpts

Tuesday 14th December 2021 Commons Chamber

[Daisy Cooper (St Albans) (LD)]

We all know that the NHS is facing one of the toughest winters in living memory; not only is covid a very real threat, but we are also facing a potentially tough flu season. The Liberal Democrats will be supporting the statutory instruments on face coverings and self-isolation, but let us be clear: the Government should never have scrapped the use of masks on 19 July. Their obsession with removing all precautions in one go had far more to do with party management than it did with public health. We have all made tough sacrifices throughout the pandemic, and asking people to wear masks on public transport would have been a very small ask with a very large pay-off. We also support the working from home guidance, for which we have been calling for some time.

Today we are discussing the plan B protections to reduce the spread of this disease, but there have been rumours overnight that the Government are also working on a possible plan C. It has been reported that the UK Health Security Agency has privately advised the Government that “stringent national measures” will need to be imposed by 18 December—in just four days’ time. This drip, drip of information is causing huge uncertainty and anxiety. We need clarity and we need it now. The British public are haunted by Christmas past. We know that that last-minute U-turn meant that many people ended up spending Christmas on their own last year. With just days to go, we need the Government to come clean and tell us what omicron means for Christmas this year.

We Liberal Democrats welcome the ambition of 1 million jabs a day, and we sincerely hope that it makes up for the complacency around the booster scheme over the last few months, but the way in which the target was announced, with no scrutiny and no details, was a real insult to all those who were left to scramble to pull a plan together on Monday morning. The idea that NHS staff, GPs and their staff, local authorities, the military—none of them—had been given any prior warning of the announcement is extraordinary, and highlights the Government’s complete lack of planning. The idea that those people, whom we are now asking to vaccinate millions, were an afterthought is shocking. But here we are. As always, our NHS, the GPs and their staff, local authorities, the military and volunteers are stepping up, and as a country we are grateful.

The Government still have not made a commitment this afternoon that if they bring in more protections of any kind, this House will have the opportunity to scrutinise them, so I want to get a few points on the record right now. If the Government are considering any further protections, they must support small businesses and our high streets. Hospitality businesses are experiencing unprecedented cancellation rates for this festive period, and they were experiencing them even before the latest protections were announced. Hospitality is technically allowed to stay open, but all of the mood music is telling people not to go, which is causing a huge problem. We have therefore called on the Government several times to call and convene an urgent hospitality summit in order to see what support businesses need right now.

If there are further restrictions, we must also look after people’s mental health. We need supported isolation, not lone self-isolation. There must be financial and practical support for those with caring duties and for those who live alone—and for our schools. Our children have suffered so much. It was months ago that the Liberal Democrats called on the Government to ensure that there was an air purifier in every single classroom in England, but we are still nowhere near that.

Finally, for all these measures to work, there must be trust in the Government. With that in mind, what we need now from the Prime Minister and his Cabinet is the truth. Will the Government come clean about Christmas, or will we see another last-minute U-turn that ruins the Christmas holiday and is too late to alleviate pressure on the NHS? I sincerely hope that it is the first.

Covid-19 Update

Daisy Cooper Excerpts

Monday 13th December 2021 Commons Chamber

[Sajid Javid]

I am not aware of any plans for any further restrictions. As I told the House from this Dispatch Box last week, we are focused on the regulations that are coming before the House and will be subject to the will of the House. We will see if they are approved.

My right hon. Friend asked for an assurance, and I will take that back to my right hon. Friend the Prime Minister.

[Daisy Cooper (St Albans) (LD)]

Eighteen weeks ago, on 9 August, I asked the Government what assessment they had made of using community pharmacies. The response, in full, said:

“No assessment has been made.”

Nine weeks ago, on 22 October, I asked the Government whether covid-secure transport would be available, so that the clinically extremely vulnerable could go for their booster jab appointments. The Government said they had made no assessment.

Six weeks ago, I asked the Government for guidance to the clinically extremely vulnerable. I asked them to sort out the confusion between third primary doses and booster jabs, and two weeks ago, on the same day that the British Medical Journal published data showing that omicron is more transmissible, I asked the Government whether they will renew contact-tracing funding for local authorities. A week later, they said they were still assessing it.

Will the Secretary of State apologise for the shocking levels of complacency in rolling out the booster programme over the past four months? And will he now apologise to all the patients who will have their treatment cancelled as a result of these new announcements?

[Sajid Javid]

No, I will not apologise for speeding up the booster programme to protect the health of the British public, and I will not apologise for asking the NHS to make it a priority. If the hon. Lady believes we should not be vaccinating people in this country, why does she not just say so?

Adult Social Care

Daisy Cooper Excerpts

Wednesday 1st December 2021 Commons Chamber

[Gillian Keegan]

I thank my hon. Friend for all her work in this area. Obviously, I have just come in at the end of the journey and many, many people have been working on this issue for many, many years. They should all take credit for that work and for reaching this point. She has my firm commitment that the Government are absolutely committed to fixing social care. As I said, we cannot level up without fixing social care, and of course we all have a vested interest in having a very good social care system.

[Daisy Cooper (St Albans) (LD)]

This statement is incredibly thin. It feels as though the Government are trying to fiddle with the light bulbs on the Titanic as it is starting to go down. We have an enormous crisis, where people who need care cannot get it and end up going into ambulances, ambulances are now queueing up outside hospitals, and hospitals cannot discharge patients back into their homes or the community because the care is not there. The statement and the White Paper do not address the fundamental problem of fragmentation and integration. The Minister has already accepted that this is now just a first step. Will she be clear with us today on when she will bring forward concrete proposals for how to tackle the problem of fragmentation and integration between the NHS and care?

[Gillian Keegan]

The hon. Lady is absolutely right that the complexity is broad. We have always anticipated that we would have winter challenges to deal with. With the global pandemic, there is a backlog of all kinds of things that people need—diagnosis, operations, electives and so on—plus all the other challenges such as winter flu and new variants of covid, which are still here. That is why we have specifically put a winter plan in place; we have also set out hundreds of millions of pounds of extra funding to look specifically at the winter challenges and the discharge process. It is not easy, because of the absolute growth in demand. We knew that it was always going to be challenging, and we regularly monitor and measure it with our NHS colleagues.

The hon. Lady mentions a fundamental pillar: the integration of health and social care. That will be subject to another White Paper, which will come early next year and will have more details about integration. She is absolutely right that it is another solid foundation on which social care reform will stand.