NHS Dentistry

Debate between George Howarth and Andrew Gwynne

Thursday 20th October 2022 Commons Chamber

[Andrew Gwynne (Denton and Reddish) (Lab)]

I thank the Backbench Business Committee for granting this important debate, and congratulate the hon. Member for Waveney (Peter Aldous) and my hon. Friend the Member for Bradford South (Judith Cummins) on having secured it. We support the motion in the form in which it has been moved; there is nothing in it that we disagree with. If some of the political arguments are removed from the debate, I think there is consensus across the House as to what the problems are and what needs to be done.

[Sir George Howarth]

I am sorry to interrupt my hon. Friend so soon. I agree with him about the motion, but I did make the point that there were some short-term measures that could, and should, be taken within the three-month period that the motion envisages before the Government report back on progress.

[Andrew Gwynne]

My right hon. Friend is absolutely right. There is no reason why the Government cannot expedite action on the issues he mentioned in his contribution and get those improvements in place.

I pay tribute to my right hon. Friend and to my hon. Friends the Members for Blackburn (Kate Hollern) and for Bootle (Peter Dowd), as well as the hon. Members for Bath (Wera Hobhouse), for Mole Valley (Sir Paul Beresford), for Berwickshire, Roxburgh and Selkirk (John Lamont), for Gloucester (Richard Graham), for Salisbury (John Glen), for North Devon (Selaine Saxby) and for Loughborough (Jane Hunt), for their contributions.

I welcome the Minister to his place. I am not sure how long he is likely to be at the Department of Health and Social Care, but I hope he is there long enough to implement some of the changes. I am all for a bit of stability in the Department. He is a good person and a good friend, and I wish him well. However, when he comes to the Dispatch Box, he will no doubt seek to deflect from the situation that has been described my Members across the Chamber by saying that we are here today because of the pandemic.

The backlog has not helped—we all acknowledge that; it goes without saying—but the Government’s spend on general dental practices in England has been cut by more than a third over the past decade, with the number of NHS dental practices in England falling by more than 1,200 in the five years prior to the pandemic. My hon. Friend the Member for Bradford South (Judith Cummins) raised that, and it cannot be ignored. It creates the regional imbalances and dental deserts we have heard about. This is not a rural-urban thing; it is a rural and urban thing, sadly. My right hon. Friend the Member for Knowsley (Sir George Howarth), the hon. Member for North Devon (Selaine Saxby) and the right hon. Member for South Holland and The Deepings (Sir John Hayes) spoke about those dental deserts, which are very real.

The Minister’s next line of defence, if I were to guess what the officials have put in his red folder, will be, “It’s all because of the dental contract.” There is some truth in that. It is 16 years since that dental contract was introduced, and it was introduced for a perfectly good reason. There was no golden age of NHS dentistry before it. There is a reason why people of my age have a mouth full of fillings and my children do not. It is not because I did not brush my teeth as much as my children do, and it is not because I ate more sweets than my children do. It is because the emphasis for paying dentists prior to the introduction of the changes was on early treatment that was perhaps not necessary—“drill and fill” is what they called it. We recognised in 2010 that the contract had not worked in the way we hoped it would, and we proposed changes. Of course, we lost that election, but after 12 years of this Government, I am afraid the line will not wash that it is solely the contract, because they have had plenty of time to make changes to that contract and have not.

We hear about the ABCD plan, and I certainly welcome the “D” in it; at least there is a recognition of dentistry. However, like my right hon. Friend the Member for Knowsley, I worry that this kind of “Sesame Street” strategy does not come close to tackling the scale of the emergency that is gripping dental care. All we have heard from the Secretary of State is sticking-plaster solutions that tiptoe around the edges while failing to address the root cause. That is apparent in the Government’s “hit and hope” approach to dentistry. The £50 million of emergency funding announced earlier this year is a prime example. As my hon. Friend the Member for Bootle said, it is a time-limited, inaccessible pot of money that has done precious little to improve access. In fact, figures obtained by the British Dental Association showed that just 17.9% of that funding was drawn down. This is indicative of a sector that has completely lost faith in the Government’s ability to act, and to be frank, I do not blame them, because when we do see action, it does not meet the scale of the crisis, and in some cases it makes things worse.

As we have heard, the geographic, ethnic and socioeconomic disparities affecting access to NHS dentistry are becoming starker by the day. What does the new Health and Social Care Secretary do in response to that problem? She scraps the health disparities White Paper. It is beyond bizarre that in the face of such overwhelming evidence, the Government will not even consider possible solutions—let alone implement them.

I fully support what the hon. Member for Waveney and other hon. Members on both sides of the House have said about education. Dentistry in schools, a prevention strategy and an emphasis on good oral health is absolutely crucial. We would support the Government in implementing that—hopefully sooner rather than later. The consensus and mood is there to get that done, so I hope the Minister will take that up and get going on that opportunity.

As for many issues facing our NHS, much of the problem with NHS dentistry can be traced back to one thing: workforce. Several hon. Members raised that point. Any hope of an NHS recovery must be underpinned by a comprehensive workforce strategy. Where is that strategy? Was it accidentally shredded with the mini-Budget? I am sure the Minister will hail the fact that NHS stats show an increase of 539 dentists practising in 2021-22, compared with the year before. When we drill down beneath the surface, however, there is not much to be positive about.

Those stats are rendered worthless by the fact that a dentist performing a single check-up on the NHS in a 12-month period is weighted the same as one with a full cohort of NHS patients. BDA survey data shows that for every dentist leaving the NHS altogether, a further 10 are significantly reducing their NHS commitment. No matter how much Ministers might try to fudge the numbers, they simply do not add up. We cannot afford more bluff and bluster. We need action, which the Opposition will support.

The outgoing Prime Minister said that dentistry was in her top three priorities for her first 90 days. That now seems rather optimistic given that she is Liz of 44 days, but we really want the Government to act on that commitment. Can we have an update on how things are going?

The Labour party will fund one of the biggest NHS workforce extensions in NHS history. We will double the number of district nurses qualifying every year, train more than 5,000 new health visitors and create an additional 10,000 nursing placements every year. We will fund this transformative expansion by abolishing non-dom tax status. We will give dentistry the staff, equipment and modern technology it needs to get patients seen on time. Labour has a plan. Where on earth is the Government’s?

Disability Equality Training (Taxi and Private Hire Vehicle Drivers) Bill

Debate between George Howarth and Andrew Gwynne

2nd reading: House of Commons
Friday 18th November 2016 Commons Chamber

[Andrew Gwynne]

Absolutely. I thank the hon. Gentleman for sponsoring my Bill; his support is greatly appreciated. He is absolutely right to suggest that there is a lot more on the enforcement side that local authorities could and should be doing. At the moment, taxi licence holders who are brought before the licensing panel can plead ignorance and say that they did not appreciate that this was the law. However, if they have to have training as part of their licence requirements in the first place, or as part of their renewal requirements, they will no longer have that excuse.

[Mr George Howarth (Knowsley) (Lab)]

Does my hon. Friend agree that, welcome though it is that local authorities are taking more seriously their responsibilities for training and enforcement, the only way to guarantee that people get the respect they deserve and that taxi drivers abide by the law is to put this requirement on to a statutory footing?

[Andrew Gwynne]

I absolutely agree. Best practice is in place in many areas across the country, but unless there is a statutory requirement for training as part of the licensing regime, we will never be able to weed out any bad practice that still exists.

The Economy and Work

Debate between George Howarth and Andrew Gwynne

Thursday 26th May 2016 Commons Chamber

[Mr George Howarth (Knowsley) (Lab)]

I begin by thanking the Chancellor for the £5 million he earmarked in the Budget for Shakespeare North. May I press him a little further and ask him to waive the VAT on the construction costs?

I want to talk today about the link between poverty, economic progress and education. Before doing so, however, I should perhaps say a word about my position on the EU referendum. In the previous referendum, in 1975, I chaired the “Huyton says no” campaign. That merry band of naysayers was a fairly eclectic group consisting of Labour party Young Socialists, the Communist party of Great Britain and two Tories who ran a ballroom dancing academy. Fortunately, the people of Huyton sensibly listened to our local MP at the time, Harold Wilson, and voted to stay in.

The argument that I want to advance today takes its inspiration—fittingly, in the centenary year of his birth—from Harold Wilson’s “white heat of technology” speech. Key to his argument in 1963 was that we needed to adapt to changing economic realities by embracing the challenges presented in science and technology. It also included an element about the importance of education as a pathway out of poverty. My argument is that we now face a similar challenge. How do we compete in a rapidly changing global economy? Do we, as some international corporations would suggest, adopt zero-hours contracts and other insecure forms of employment, or do we incentivise innovation and educate and train our workforce to take advantage of the opportunities that innovation creates? The first option is, in my view, a self-defeating race to the bottom.

However, we have to face up to some uncomfortable truths, one of which is the decline in manufacturing in the UK. In 1972, 32% of the UK’s GDP came from manufacturing. By 1997, that percentage was down to 14.5%, and by 2013 it had dropped further to 10.4%. The economic levers available to the Chancellor and the Government need to be remorselessly focused on creating incentives for innovation, using not only the taxation system but the export guarantee system and everything else available to ensure that the opportunities that exist in the world are brought within the reach of our country.

We also need to talk about education. We have serious problems with education in Knowsley. I do not want to go into too much detail, but we have a serious problem of under-attainment at GCSE level.

[Andrew Gwynne]

I just wonder how many secondary schools in Knowsley are academies.

[Mr Howarth]

That is the point. Out of the six secondary schools in Knowsley, four are already academies, so that is clearly not the solution to the problems we face. My own belief is that we need to start from scratch and completely rebuild the education system. Nothing should be protected from proper scrutiny or from modernisation. The curriculum, the public examination system, educational institutions and even the underlying philosophy behind education need rigorous questioning and frankly need to be radically redesigned to meet the real challenges that we face in the world. If we do not do that, areas such as Knowsley will continue to lag behind. We can, however, make bigger and bolder choices to meet the challenges and harness innovation and education as the twin engines of tackling inequality, deprivation and the random economic effects associated with where people live. Surely there is only one choice, and that choice must be progress.

Contaminated Blood

Debate between George Howarth and Andrew Gwynne

Tuesday 12th April 2016 Commons Chamber

[Andrew Gwynne (Denton and Reddish) (Lab)]

I start by paying tribute to the 21 hon. and right hon. Members who have today provided a strong voice for the victims of contaminated blood. In particular, I pay tribute to my hon. Friend the Member for Kingston upon Hull North (Diana Johnson), who has been tireless in her pursuit of justice. I remember her forceful arguments when she asked an urgent question on the subject about a year ago, to which my right hon. Friend the Member for Leigh (Andy Burnham) responded on the Opposition’s behalf, and when she asked her urgent question in December, to which I responded for the Opposition. She does real credit to the cause of those who are suffering as a result of this scandal. We must never ever forget the personal tragedies behind scandals such as this one, and I want to pay tribute to the families who have travelled down here today to listen to the debate. They deserve their day in Parliament, and I hope that the Minister will carefully consider the points that have been raised by all Members and by the families of the victims.

[Mr George Howarth (Knowsley) (Lab)]

I apologise for not being here throughout the debate; I was chairing a Committee elsewhere in the building. Would my hon. Friend accept that one of the defining characteristics of the modern world is that we have an expectation that an individual, a company or a Government will accept responsibility when things go wrong, and that they will accept the consequences of taking that responsibility? Does he agree that it is high time the Government accepted responsibility in this case?

[Andrew Gwynne]

My right hon. Friend is absolutely right, and I will come on to that point later. We owe it to the victims and their families to find some kind of justice for them.

I am not frequently on the same side as the editorial line taken by the Sunday Express, but I congratulate that newspaper on its tireless campaign for justice. This scandal has seen families torn apart through death and illness caused by the negligence of public bodies. I am willing to accept that, over the years, the response of Governments of all colours has just not been good enough. When the consultation was published in January, I was clear that while no amount of money could ever make up for the impact that this tragedy has had on people’s lives, the victims deserved some form of justice. We have three days until the consultation closes and I want to use my remarks to push the Minister on four points relating to the current proposals.

First, in the 1970s and 1980s, around 7,500 people were infected with hepatitis C or HIV as a result of this scandal. Many of those people were being treated for haemophilia. The viruses have had a devastating impact on their lives and those of their families, not least through loss of earnings and the cost of treatment. The failure of successive Governments to accept liability for this issue means that many of the victims have lost financial security through no fault of their own.