Healthcare: Hampshire

Jim Shannon Excerpts

Wednesday 20th November 2024 Commons Chamber

[Dr Chambers]

We never opposed a new hospital—that was something the Conservatives were saying about us. We support a new hospital, we want a new hospital, and we want modern healthcare services in Hampshire. However, we were very concerned that the proposed location of the new hospital is not suitable when we look at how healthcare is delivered throughout Hampshire. Sites just north of Winchester were identified as suitable; when we look at a map of Hampshire, it is clear that those proposed locations would be much more suitable for people throughout Hampshire, including those in the hon. Gentleman’s constituency, to reach emergency services.

Our current A&E department, like other A&E departments, is hugely busy, especially as we head into winter. We know that many people attend A&E because they cannot get the primary care they need. Up to 20% of people who turn up at A&E are there because they cannot get a doctor’s appointment. People who are in a mental health crisis—many are often already on a waiting list—are going to A&E. They take up a huge amount of time and staff resources, often needing 15 to 18 hours of constant monitoring before they can be taken to a place of safety. We also have people turning up with dental issues because they cannot access an NHS dentist.

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Gentleman for securing the debate. While there are other hon. Members in the Chamber know the issues well, does he agree that the ability to bring healthcare into communities is vital, particularly for people in isolated communities who cannot hop on a bus every 15 or 20 minutes, or even every hour, to get to their appointments? Some areas simply cannot have centralised care or a new hospital; they do need localised facilities. If the hon. Gentleman is asking for that, then he is asking for the right thing.

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[Andrew Gwynne]

I hear loud and clear what Conservative Members say about the leadership of their ICB. I hope that the ICB management will obtain a copy of today’s Hansard and read not only those comments, but the Minister’s reply. I expect them to make decisions in a timely fashion, so that there is some certainty for the local population about the new make-up of health and care services in that area—not just for the sake of patients and the local population, but staff. As we redesign services and change towards more preventive, community-focused care, some parts may become obsolete, and it is absolutely crucial that we take the workforce, as well as the population, on that journey of change in services. I very much hope that the hon. Gentleman’s ICB leadership will have heard the message from the Minister at the Dispatch Box, which is that they really need to crack on, make a decision, communicate it and work with Members of Parliament, the public and staff on whichever changes they propose.

I return to primary and community care. As I said, our manifesto commits to moving towards a neighbourhood health service, with more care delivered in local communities, so that problems are spotted earlier. We will bring back the family doctor by incentivising GPs to see the same patient, so that ongoing or complex conditions are dealt with effectively. In doing so, we will improve continuity of care, which is associated with better health outcomes for patients, and our plan will guarantee a face-to-face appointment for all those who want one; we will deliver a modern booking system that will end the 8 am scramble. That is crucial in improving access to general practice.

The hon. Member for Winchester rightly raised the huge problems with dentistry in his area, which are not that uncommon across the whole country. I do not believe that the previous Government’s dentistry recovery plan went far enough; too many people were still struggling to find an NHS appointment. We are working to ensure that patients can start to access additional urgent dental appointments as soon as possible, and we will target the areas that need the most—the so-called dental deserts. Integrated care boards have started to advertise posts through the golden hello scheme. This recruitment incentive will see up to 240 dentists receive payments of £20,000 to work in the areas that need them most for three years. The common reason why children aged five to nine are admitted to hospital—this is absolutely shocking in the year 2024—is tooth decay. We will work with local authorities to introduce supervised toothbrushing for three to five-year-olds in the most deprived communities. These programmes are proven to reduce tooth decay and boost good practice at home.

To rebuild dentistry in the long term, we will reform the dental contract with the sector, with a shift to focusing on prevention and the retention of NHS dentists. To be fair, this has been an issue for all Governments, going back to the Labour Government who introduced the dental contract. They did so for the right reasons, but in 2010, we recognised that the dental contract was not working in the way we envisaged, and that it had to change. It is shocking that 14 years have passed since then with no real action having been taken—we are determined to fix that. At the same time, we will not wait to make improvements to the system to increase access and incentivise the workforce to deliver more NHS care. We are continuing to meet the British Dental Association and other representatives of the dental sector to discuss how we can best deliver our shared ambition of improving access for NHS dental patients.

I have to say that the statistics for Hampshire and Isle of Wight integrated care board make sorry reading. Only 36% of adults were seen by an NHS dentist in the 24 months to June 2024, compared with 40.3% across England, and 54% of children were seen by an NHS dentist in the 12 months to June 2024, compared with 56% across England. In 2023-24, there were 46 dentists for every 100,000 people in the hon. Gentleman’s trust, whereas the national average across all ICBs in the same year was just under 50 dentists, and in 2024, the general practice patient survey success rate for getting an NHS dental appointment in the past two years in the Hampshire and Isle of Wight ICB area was 72%, compared with 76% nationally. They are not great statistics nationwide, but they are certainly not brilliant in the ICB of hon. Members present, and we look for real improvements there.

Turning to the pharmacy sector, we want to take pressure off GPs by increasing the services offered in community pharmacies. There is so much more that our pharmacists could and should be doing to deliver basic healthcare services on the high street and in the community, as part of the shift from hospital to community. That would free up thousands of GP appointments in cases where people do not really need to see a general practitioner for their condition. We are committed to looking at how we can further expand the role of pharmacies and better use the clinical skills of pharmacists as more become independent prescribers—that is where the potential gets really exciting. Now that the budget for Government has been set, we will resume our consultation with Community Pharmacy England shortly. I hope Members will understand that I am unable to say more until that consultation has concluded. Suffice it to say that Pharmacy First and community pharmacies have a huge role to play in improving health outcomes in the community.

[Jim Shannon]

In my former role as an Assembly Member back home, we had a very close relationship with pharmacies. The consultation process that the Minister is outlining for England would be very much welcomed in Northern Ireland, so can I ask the Minister a favour? When that consultation concludes, will he share his findings with the Northern Ireland Assembly, and particularly with the Minister in Northern Ireland? What the Minister is hoping to achieve is what we would also like to achieve.

[Andrew Gwynne]

The hon. Gentleman raises an important point. No part of the United Kingdom holds a monopoly on wisdom, and if we are doing something good or if there is innovation in one part of the United Kingdom, it is incumbent on Health Ministers across the devolved Administrations and here in Whitehall to share best practice—to work together and, where possible, take a four-nation approach. I hope I can reassure the hon. Gentleman that since this new Labour Government came into power, we have really tried to reset our relationships with the devolved Administrations and with the various Ministers. I have had several meetings with Mike Nesbitt on a range of health issues that appertain to the whole United Kingdom on which we want to ensure there is consistency of approach. I am more than happy to communicate further with Mike Nesbitt and colleagues in the Northern Ireland Executive on how we reform our health and social care services in England to see whether things can be taken by them in Northern Ireland. Vice versa, if there are good ideas from Northern Ireland, I am more than happy to consider them in how we transform NHS services in England.

The hon. Member for Winchester mentioned social care, and he is right to raise winter resilience. I have spoken about fixing the front door to the NHS through primary care reforms. We also have a serious job to do to fix the back door and ensure that patient flows through the system are not held up because of a lack of social care. On winter resilience, I hope he will understand that we are working to ensure that there are no crises and that we tackle the issues of social care. Getting beds in appropriate places is a key part of our plan.

In the long term, there are no quick fixes. The Dilnot reforms were announced by the previous Government, but it is fair to say that, when we came into office, we found that the money apparently set aside for the Dilnot reforms had already been spent on other NHS pressures. Laudable though it may have been to spend that money to try to get waiting times and waiting lists down and to fix some of the problems that that Government had created, it left us with a bit of a social care issue, given that the reform money had gone, had disappeared and was no longer there to be spent.

Over the next decade, this Government are committed to building consensus on the long-term reform needed to create a national care service based on consistent national standards, including engaging across the parties. It is good to see the shadow Secretary of State, the right hon. Member for Melton and Syston (Edward Argar), in his place, and I am sure he will be very willing to work with us, as indeed will the Liberal Democrats. We genuinely want to make sure that we get cross-party consensus on the future of our adult social care, so that we can finally grasp this nettle once and for all, and to fix it without it becoming such a contentious issue, as it became, sadly, in 2010 and 2017. Neither of the two main parties has a good story to tell on this, because we have both shamefully used it as a political football from time to time. It is now appropriate that we set aside those politics and get on with fixing social care. I hope that, in due course, we will be able to move forward on that agenda.

I assure the hon. Member for Winchester that we are acutely aware of the problems with mental health services. We both agree that waiting lists are unacceptably high. Indeed, the people of Hampshire and most of England are not getting the mental health care they deserve. He has spoken previously about Lord Darzi’s report, which has shone a searing spotlight on the waiting lists that young people face, in particular. I am immensely proud that this Government are intent on tackling the issue head on, with specialist mental health professionals in every school in England. That is our aim. These NHS-funded mental health support teams in schools and colleges will work with young people and parents to manage mental health difficulties and to develop a whole-school approach to positive mental health and wellbeing.