NHS Backlog
Jayne Kirkham Excerpts(2 weeks, 1 day ago)
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Dr Caroline Johnson (Sleaford and North Hykeham) (Con)
Thank you, Madam Deputy Speaker—a very happy new year to you. May I also wish the grandmother of the hon. Member for Bury North (Mr Frith) a speedy recovery? I should declare an interest as a consultant practising in the NHS. My brother is a GP and I am on an orthopaedic waiting list, so I am one of the statistics.
I am looking forward to working constructively with the Government over the next year to deliver for patients across this country. The NHS has been looking after us for more than three quarters of a century. During that time, the practice of medicine has transformed. Cures have been found, and people are living longer and healthier lives. I thank all those staff who have been working in the NHS and social care across the Christmas and new year period.
We all recognise that the NHS is under pressure. We have an ageing population, patients with more complex needs and innovative, but expensive treatments. The pandemic added a huge strain to the NHS. Resources were redeployed away from elective care, and much elective care was postponed to reduce the spread of covid. For example, before the pandemic, 54 women had been waiting more than 12 months for a gynaecological appointment. By the time the pandemic was over, that number had gone from 54 to 40,000. That was replicated across other departments in hospitals across the country.
Although the NHS now treats 25% more patients than it did in 2010, waiting lists are sharply higher. We took steps as a Government to bring them down again. Those measures were working, though not as quickly as we wished. For example, the 18-month waiting list was virtually eliminated, and the 52-week list was steadily falling, despite industrial action. Meanwhile, in Wales, where Labour has been in power for more than 25 years, waiting lists continue to rise.
There is more to do, and no one is suggesting that the issues have been resolved. Waiting lists are still too high, and that is why we funded the £3.5 billion NHS productivity plan in full to upgrade IT, to expand the NHS app and to capitalise on the benefits of artificial intelligence. The Government were elected in July on the promise of a plan, but sadly the plan has still not yet been published. The Government were also elected on a promise to deliver 40,000 more appointments per week. I wish them huge success with that, but I am not optimistic. The Secretary of State has repeatedly been asked when those additional appointments will become available, but there have been no clear answers. Will the Minister please provide one, or tell us what progress has been made?
This morning we heard more about Labour’s elective reform plan. I was really pleased to hear that the Government will continue with many Conservative initiatives, which were working.
Dr Johnson
I will not, because I have a time limit.
I was pleased to hear that the Government will continue many Conservative initiatives, such as expanding the surgical hubs programme and extending the work of community diagnostic centres, but some of the other parts were a little confusing. Patients are to have a choice of where they are treated, but they already do. They are also to receive text messages to remind them of appointment times. That is great, but it is already happening. In fact, a look back through my phone revealed that the earliest text message I could find reminding me of an appointment for my child at Peterborough city hospital was sent on 28 July 2015, so this is not a new initiative. Patients are to get results online. Well, again, they already do. If the Minister has not seen that, I urge her to visit Addenbrooke’s hospital, where, via the MyChart system, patients can already log on and read their MRI or blood results or reports. Spreading good practice is to be welcomed, but it is not a revolution. It also faces significant headwinds.
The Government are to direct activity to general practice, but GPs are already rather busy and facing financial challenges caused by national insurance contributions. How will shifting pressure improve capacity? When will GPs be able to budget? Will the funding settlement be greater than their increased costs from national insurance contributions? If resources are moved to general practice, how will that deliver more secondary care appointments? One person can only do so much work. What is the Government’s plan for the workforce, which will be so key?
Of course, it is not just GPs who are affected by the national insurance contributions. The Secretary of State talked about record investment in hospices, but before Christmas the Minister was repeatedly unable to say whether that record investment would cover the rise in national insurance contributions that those same hospices are facing. Can she update the House now?
Patients are to have the choice on whether to have follow-up appointments, which will apparently reduce a million unnecessary appointments every year. Will that be a choice for patients to have a desired follow-up appointment that is not recommended by clinical staff—in which case, that could actually increase the number of appointments required—or will it be a choice not to have an appointment that a doctor or clinician has recommended? In that case, is that wise?
It is cold outside, Madam Deputy Speaker. In fact, this morning I woke up to blizzard conditions at my window. What estimate has the Minister made of the number of extra admissions that have occurred this winter for elderly patients who have been cold due to the removal of their winter fuel allowance?
NHS Dentistry: South-west
Jayne Kirkham Excerpts(2 months, 1 week ago)
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Jayne Kirkham (Truro and Falmouth) (Lab/Co-op)
I will not rehearse the numbers that Members have already given for the south-west, except to say that fewer than half the children in Cornwall have been seen by an NHS dentist in the past 12 months. That is down 13 percentage points from five years earlier. It is just getting worse and worse: people simply cannot get an NHS dentist now in the whole of Cornwall. It is impossible.
We are fortunate in that we have a new Government. We are looking at 700,000 new urgent appointments. Everybody recognises that the dental contract needs reforming, and there is a commitment to reform the contract. Obviously that will take time, so in the meantime we may need to look at what can be done locally.
In Cornwall, the commissioning of dentistry has been passed down to the integrated care board, which has done some quite innovative things. A surgery in Lostwithiel that was just about to hand back its contract went into bespoke negotiations so that the under-18s, the elderly and vulnerable people could retain their NHS dentist. There is the option, within the contract, for local ICBs to do more, to go into bespoke negotiations and maybe to salvage some things while we are waiting for the large renegotiation of the dental contract.
There are other things that I ask my hon. Friend the Minister to consider; I am sure he has done so. Could he say more about health hubs, about having more bespoke contracts and about how much power ICBs have to enter into those contracts? Will he look at things such as emergency dental vans, which I understand are a sticking plaster, but which have been used in some places?
NHS Dentistry: Rural Areas
Jayne Kirkham Excerpts(2 months, 2 weeks ago)
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Sarah Gibson
I agree with the hon. Member. The disparity is clear. As he mentioned, rural areas are being hardest hit by our broken NHS dental contract system.
Unfortunately, there does not seem to be much hope on the horizon. Denplan tells me that 90% of dentists plan to reduce their NHS commitment in the next two years and that the UK has the lowest dentist-to-population ratio in the whole of Europe. Although all dentists are dedicated to improving the nation’s health, access to NHS dental services remains a persistent challenge under the current system, particularly in rural areas.
Jayne Kirkham (Truro and Falmouth) (Lab/Co-op)
In lieu of the dental contract being renegotiated, could something not be done by the local integrated care boards that commission dentistry to make special provision for local contracts when dentists are considering giving up contracts in the short term? That could be done now, in lieu of that renegotiation.