NHS Dentistry

John Glen Excerpts

Thursday 20th October 2022 Commons Chamber

[John Glen (Salisbury) (Con)]

I rise to speak on behalf of a number of dentists in my constituency. Nicola Jones, an oral surgeon at Salisbury District Hospital, contacted me to say that the lack of available NHS dentists is causing significant challenges in the constituency. I recognise that from my mailbox over recent weeks. I met Matthew Clover, a specialist orthodontic practitioner, in February. He took me through the challenges of the “units of dental activity” model: it does not discriminate properly when it comes to the classification of the different activities that he has to undertake.

The challenges derive primarily from the lockdown two years ago and the interruption to supply: 38 million appointments were lost. I welcome the Government intervention earlier this year to provide the additional £50 million and 350,000 additional dental appointments. I also welcome the Government’s statement in July, but this is an opportunity for the new Minister to challenge his officials and work with industry representatives to find a deeper and more enduring set of changes that address some of the ongoing challenges that have existed for a very long time.

I would not suggest that I have anything like the expertise of my hon. Friend the Member for Waveney (Peter Aldous), the hon. Member for Bradford South (Judith Cummins) or, particularly, my hon. Friend the Member for Mole Valley (Sir Paul Beresford), who has a lifetime of experience at policy level and as a practitioner. But I am aware that since 1951 there has been a model of co-payments, in which dentists act as independently contracted professionals to the NHS but also typically receive an income from private practice work as well.

[Wera Hobhouse]

The hon. Gentleman makes a very good point that, basically, private patients have been cross-financing NHS patients, but that model is no longer sustainable.

[John Glen]

I respectfully say to the hon. Lady that my mother is a resident of Bath and has received excellent service from her NHS dentist. Although I recognise this problem exists in different spots of intensity across the country, it needs a comprehensive solution.

The fundamental point is this: how can the model of rewarding dentists incentivise the maximum amount of engagement? All dentists start their professional life wanting to help people and wanting to do as much good as they can. I totally embrace what my hon. Friends the Members for Mole Valley and for Gloucester (Richard Graham) said about the need to deal with the oral health and education of young people, including how to clean their teeth at an early age. There will need to be a focus on how those practices can be embedded in a funding model that has to pay some respect to the geographic coverage of a dentist, while ensuring that each cohort of the population has access to basic dentistry.

The proposed new dental contract goes some way towards dealing with some of the challenges of the UDA model, but it probably does not go far enough. I urge the Minister to go beyond what his officials may be suggesting to him, to think radically and to take this opportunity to ask, “How can we reset after the dislocations caused by covid?” I urge him to come up with something that incentivises dentists to offer an holistic service to people of all means and to help those communities that have cold spots of dentistry supply.

I would like to make a few observations about supply and, again, my hon. Friend the Member for Mole Valley made some very good points about streamlining bureaucracy to ensure more people qualify as dentists in this country. Of course, it is right that we have ongoing quality assessments through the CQC, but that organisation’s focus, as across all industries, needs to be on where there are vulnerabilities and risks. When we think about NHS medical and dental services, I feel we are continually trying to be perfect and to remove all the risk, which sometimes has a cost because it involves using resources to fill in bureaucratic processes that might not necessarily, in most cases, give us much return.

My message to the new Minister is to build on the good start made by his predecessor in the summer, but to consider a more radical and fundamental review of the UDA funding model, to consider the volume of patients and to consider the real dynamics of the choices a dentist makes about how to maximise the number of patients they see who cannot afford to make a contribution.

I feel hopeful that the enthusiasm to provide the service I saw from my dentist in Salisbury means there will be a solution. I wish the Minister well, and I acknowledge the contribution of my hon. Friend the Member for Waveney, who showed a mastery of this subject.

Procurement of Evusheld

John Glen Excerpts

Wednesday 12th October 2022 Westminster Hall

[Daisy Cooper]

The hon. Member is absolutely right. Many people are clinically vulnerable because they have a health condition, and their physical health is getting worse, as it would when someone is stuck at home for two and a half years, but the mental health impact is also incredibly profound. We know that many of our constituents have experienced suicidal thoughts.

I turn now to the advice of the RAPID C-19 oversight group, which has been mentioned. The Government refused to share this advice for some time, and many of us were asking for it. I was pleased to see that this advice was finally published last Thursday on 6 October. I was pretty shocked for two reasons. First, the report actually says that the group looked at real-world data and the impact on people and that data was very strong. Then it looked at the data in a non-clinical setting and decided not to roll it out. That seems absurd to me.

There is a second problem with the evidence that was published last week. It lists the evidence that the group reviewed, and it leaves out one very critical scientific study by the Francis Crick Institute—a study that I believe the Government commissioned themselves. That study was commissioned to look at the effectiveness of a different drug: sotrovimab. That report concluded that sotrovimab was effective, and the Government are using that report to justify why they continue to use sotrovimab. However, the report also concluded that Evusheld was even more effective. So why not buy Evusheld too? Perhaps the Minister can enlighten us.

On the same day the Government published this RAPID group report, The Lancet—the world’s highest-impact general medical journal—carried an article by 19 experts calling on the World Health Organisation to update its guidance on Evusheld, based on the study the Government commissioned. In the article, those experts say that Evusheld should be used for not only preventative, prophylactic use, but treatment. The UK Government are really trailing behind. Can the Minister tell us why the RAPID study ignores this vital piece of research, which they must have known about?

Many of the people we are talking about have already had five or six vaccine jabs, even though they will mount very little, if any, response. The Government say it is important that these people get those vaccines, because they say some response is better than none. Why does that same test not apply to Evusheld? Why is it being singled out and held to an impossible standard?

Let us look at what the Government are proposing, instead of following the science. Ministers have referred Evusheld to NICE for further clinical and cost-effective assessment; apparently, we might hear back in April 2023. That is another delay—another six months of isolation—even though every other covid treatment and vaccine was urgently procured before being appraised. I ask again, why is the Government’s treatment of Evusheld so inconsistent?

[John Glen (Salisbury) (Con)]

My constituent Helen Nash asked me to be here to support the case that the hon. Lady is making. She makes the key point: while the Government did a lot of great work to accelerate the availability of vaccines for the population at large, this particular cohort seems to be subject to a very different set of criteria. That is the great concern. While we must rely on clinical advice, we must also have the same situation for all people, regardless of their status.

[Daisy Cooper]

I agree with the hon. Gentleman. One of the big concerns that has not been answered by the Government so far is why their approach to this drug is so inconsistent with their approach to others. As I say, Ministers have referred Evusheld to NICE, and it is not at all clear why their treatment of it is so different.

Meanwhile, the Department of Health has proposed that immunocompromised patients have an antibody test, and that those who do not respond well enough could join an Evusheld trial. Let us be clear what that trial would mean in real life. It would require some of the people who have been shielding to stay alive for two and a half years to come out of shielding like the rest of us, but without any protection from covid vaccines, knowing that they might only be given a placebo. It would be like taking lambs to the slaughter. I would be astonished and appalled if that proposal passed anyone’s ethics test. I do not know if the Minister would support one of his loved ones taking part in such a trial, but I certainly would not. Can the Minister therefore tell us why his Department wants to take this dangerous approach instead of the approach suggested by the Drug Safety Research Unit, which has called on the Secretary of State to roll out Evusheld now, for this winter, and to run an observational study of the impact?

Another question that has arisen is whether there are problems with supply. The answer is no. AstraZeneca has dismissed that claim.

Income tax (charge)

John Glen Excerpts

Monday 16th March 2020 Commons Chamber

[David Mundell (Dumfriesshire, Clydesdale and Tweeddale) (Con)]

I am pleased to have the opportunity to speak in this debate. Harold Wilson said that a week was a long time in politics. During Brexit we found out that a week was even longer, but the Budget, only last Wednesday, seems a lifetime ago. Even when listening to the Chancellor, I still harboured hopes of a long-planned personal visit to New York this weekend, but for all the reasons we see around us that is simply not able to happen. Three weeks ago, I was in Rome for the Scotland-Italy rugby match. At that point, the talk was of difficulties in the north. No one envisaged that instead of the crowds in St Peter’s Square or outside the Colosseum there would be nobody.

As a Member of Parliament, I am often asked about the most difficult issue and time I have had to deal with. For me, the answer is very straightforward: the 2001 foot and mouth crisis, which affected my constituency deeply. I want to be very clear that I am not making any comparison between that disease and coronavirus. The comparison relates to the impact of an event of that scale on businesses and their continued prosperity, and on the wider community. There was also, as a report from Strathclyde University and others identified, the impact of isolation. During that period, very stringent measures were taken and many farmers had to be isolated on their own properties and could not leave. The report, two years later, made very clear the long-term consequences of isolation. We need to take those findings on board and think about them. We need to learn the lessons of such events, with measures that might come into place. I am sure those issues will be debated when we have more focused debates on coronavirus.

The businesses most affected by those circumstances were the self-employed and contractors, so we need to give those groups the maximum possible support. The hospitality industry was also very badly affected. One lesson from that experience is that small businesses need grants not loans. I remember taking part in a demonstration—I know that that will surprise you, Mr Deputy Speaker—outside the offices of Scottish Enterprise Dumfries and Galloway with colleagues in small businesses to make just that point. Grants, not loans, were needed to see them through. Rates relief is to be welcomed and I welcome the package of measures the Scottish Government have announced, but it is capped and we need to look again at whether that is appropriate.

The other big players are the banks. From my perspective, the situation that we face will be easier to deal with because it affects the whole United Kingdom, so the banks that are based outwith the south of Scotland and that are being asked to support businesses understand what is happening on the ground. We need that unity of purpose from the banks. Hon. Members who have dealt with the banks know that they always say the right thing, but doing it is something else, especially when the computer says no. We need to make sure that they follow through on their commitments, and on the positive tone that the Chancellor set in the Budget.

We need a uniformity of approach from the Government at all levels—the UK Government, the Scottish Government and local government. The underlying philosophy of all those institutions must be that we want to keep our businesses going and that we are not jobsworths who want the returns in on the exact date. That is why I welcome what the Chancellor said about VAT holidays and flexibility with Her Majesty’s Revenue and Customs. I am sure, however, that hon. Members on both sides of the House have experience of HMRC not being particularly flexible, so we need that to be followed through. That unity of purpose from government will be vital.

As has already been said in an intervention, the hospitality and tourism industry is the most vulnerable in a constituency such as mine. Often, as I found out during the foot and mouth crisis, businesses that have done well and are planning for the future are the worst hit. For example, the Gretna Green Famous Blacksmiths shop in my constituency, one of the most visited tourist attractions in Scotland, has won numerous awards for its attempts to attract Chinese visitors. A large number of Chinese visitors go to that location, but not any more—there are none. Its business model has already been seriously disrupted by these events. It is a bigger business, not a small business, but it needs help and support too, if that sector of the economy is to survive after these events.

Hotels in my constituency were already in difficulty; many, such as the Moffat House hotel, have closed. One local hotelier told me that they were facing a perfect storm of events, of which, at that stage, coronavirus was not one. I appeal directly to the Scottish Government on that issue, because the way that our business rates system in Scotland works for the hospitality industry, and particularly hotels, is still not right.

As I indicated, there are lots of lessons to learn. I hope that there is still the institutional knowledge in the Scottish Parliament and the Scottish Government to learn lessons from 2001, and that the Government can take some of those lessons on board, particularly in relation to isolation, as I said.

I welcome the Budget as a whole for Scotland, in particular the £640 million of additional funding for Scotland, which was £172 million more than the Scottish Government had anticipated. By any analysis, the Scottish Government got extra money. In my experience, they have not always welcomed, or even acknowledged, extra money—indeed, sometimes it was the wrong kind of money, even if they did acknowledge it. I hope that on this occasion, and in these circumstances, they will acknowledge the extra money.

As I said, I am pleased with what the Scottish Government have had to say about spending on business support in relation to coronavirus, but I would also like the money that is coming forward to be spent on infrastructure. Back in the ’90s, before the Scottish National party was in power, and when it held the constituency of Galloway and Upper Nithsdale, as it then was, the A75 and A76 were described as the most important forgotten roads in Scotland that needed to be substantially upgraded. Of course, since 2007 there has been an SNP, or SNP minority, Scottish Government, but that investment has not been forthcoming. I use this occasion to plead for the needs of the A75 and A76. I am sure that there is somebody in the SNP who remembers those previous commitments.

Obviously coronavirus is significantly affecting today’s debate, and rightly so, because it is the issue that most affects our constituents at the moment, but I want to highlight one other issue on which I wrote to the Chancellor ahead of the Budget, together with 15 Conservative colleagues, the Association of Convenience Stores and the British Retail Consortium: access to cash. It is a big issue; in a crisis, many people like to have some cash available, so that they have flexibility in how they approach difficult circumstances. There is a crisis in access to cash, and it affects large rural constituencies such as mine in particular, but also many other communities.

Some of the most deprived communities in our country bear the hardest impact. I had not realised until relatively recently that the average withdrawal from a cash machine is around £10 or £20. A fee of up to £3 to take £10 out of a cash machine is a very significant mark-up. A report has indicated that about 8 million people in our country are not ready to cope with a cashless society. A cashless society may come; indeed, when I travel from my constituency to central London, I feel that central London is, in many ways, a cashless society—in which there are, ironically, hundreds of cash machines. We need to do something about this issue. I welcome the Chancellor’s promise in his statement to legislate to secure the long-term future of cash, but it is very important that the steps that he takes are the right ones.

[The Economic Secretary to the Treasury (John Glen)]

indicated assent.

[David Mundell]

I am pleased to see the Minister nodding; I hope that he will nod when I say that those steps should include reversing the arbitrary cuts to the LINK interchange rates paid by banks to fund the network; exempting free-to-use ATMs from business rates; and recognising that ATMs are the only infrastructure through which we can guarantee national access to cash. Of course, cashback at convenience stores and other places has a role to play, but it is very important that we have a sustainably funded network of cash machines throughout the whole country, given the many branch closures we have seen in our constituencies—particularly Royal Bank of Scotland branch closures in Scotland.

I agree with the hon. Member for Ellesmere Port and Neston (Justin Madders). The consequences of these events—such as the foot and mouth crisis that afflicted much of the south of Scotland 20 years ago—go on for years. They do not just end when someone declares that the crisis is over. They go on for a long, long time for the businesses, individuals and communities that have been affected. We do not just pledge support to those individuals and communities today; we pledge it to see them all the way through the consequences. I think that that will mean revisiting some of what was announced in the Budget and some of what was announced by the Scottish Government, and if that is necessary, so be it.

Young People’s Mental Health

John Glen Excerpts

Thursday 27th October 2016 Commons Chamber

[Andrew Bingham]

Exactly. I mentioned this to Martha and Lucy and they did not know what SWALK was. I can tell my hon. Friend that it stands for “Sealed with a loving kiss”. Those days are long gone. Now everything is done via social media. It is out in the open for everyone to see and it is also there forever. The SWALK letter is read. If it is not reciprocated, it is thrown away; if it is reciprocated, it is replied to. On social media, it remains there forever.

That brings with it perils and pressures. Relationships, appearance, fashion, style—all are analysed in the public glare. Relationships, attitudes and opinions once shared privately between friends are now put out for the world to see, with every comment seemingly soliciting a further comment or response and the rhetoric growing from that. With, for example, chat groups on applications such as WhatsApp, it is very easy for what could be seen as a little verbal leg-pulling or teasing to take on a sinister complexion. We increasingly hear stories of cyber-bullying and the posting of revenge pictures. I am sure all of us in this House have at one time or another been on the receiving end of comments online that we would see as offensive or upsetting. However, for a teenager, maybe uncertain, vulnerable or lacking in confidence, such remarks can have a shattering effect on their self-confidence and in turn their mental state.

Let us look at the media in general. The modern media seem to present all young people in reality programmes such as “Made in Chelsea” as perfectly formed human beings, which puts pressure on so many young people to be absolutely perfect. The slightest imperfection, perceived or otherwise, can become a major issue. We hear a lot about body image, too, and young people’s attitude towards it. Again, the desire to be perfect crops up, so when a perceived imperfection is not only remarked on but ridiculed via social media, it can be amplified and re-tweeted, when “likes”, “unlikes” and “comments” can become very cruel, particularly to uncertain and vulnerable teenagers. This can severely damage the self-esteem and mental health of a young person.

Our consumer society is another issue. As we see with mobile phones, clothing and computers, everywhere we look there is a thirst for the latest, the best, the biggest, the fastest and the shiniest, while anything less than the optimum is seen as a problem. This is another issue that ratchets up the mental pressure on young people. I am not saying that a young person’s not having the latest iPhone will lead to mental health problems, but I am saying is that if someone is vulnerable and has low self-esteem, this sort of thing can work to enhance those insecurities and push someone into the territory that we are discussing today.

We need to remember, too, that all these pressures—I have mentioned only a few—are impacting on young people at a time when their minds, brains and characters are still growing and forming. As we get older, we form our minds and personalities, and we develop our own resilience to many of these outside pressures.

[John Glen (Salisbury) (Con)]

My hon. Friend is putting forward a pertinent case and providing an accurate analysis of the pressures on our teenagers. Does he agree that it is important to recognise that we need an integrated solution, which requires education and NHS response, so that schools can get in very early and start tackling some of the behaviours that lead to poor mental health outcomes?

[Andrew Bingham]

My hon. Friend is absolutely right, and his point about the need for a whole school approach is acknowledged in the conclusion of the report. It states that when children leave school, they should be conversant with all the issues around mental health, which the hon. Member for Dulwich and West Norwood also mentioned in her speech. As I was saying, as we get older, we develop our own resilience, but in young people that development is not complete. That is the issue that we need to be aware of, and it is where schools need to play a part in helping to develop that resilience.

As we know, a stigma is attached to mental health—and nowhere more so than with young people. No young person wishes to admit to it for fear of being labelled, and people often are labelled in this society. Parents are similarly affected, so this leads to a situation of potential denial—I am not sure that “denial” is exactly the right word—which further exacerbates the problem. There seems to be a lack of willingness to say, or a fear of saying, “Look, I have a problem, and I need some help.” There should be no stigma attached to any young person admitting that they are struggling with certain issues, and neither should there be any barrier to parents making a similar plea.

Young people should have somewhere to go to ask for help—the report mentions a counsellor—without fear of ridicule. They should not be judged or labelled either by their peers or by society. Parents can be the strongest help and support for any young person, and we should look to families and family support units as well. We need to enable parents to play as full a part as they can. A young person who is getting some help at 15 can find on turning 16 that they are suddenly deemed to be an adult and their parents can be almost excluded from playing a full part. An attentive parent who is trying to help can face being told, “We can’t discuss this with you, because your girl or boy is now 16.” We should look to see whether there is a way around that problem.

In conclusion, I would like to thank Lucy Boardman and Martha Banks Thompson for their help. They have given me an insight into the world of the modern teenager and into how 21st-century pressures impact on their lives in a way that did not impact on my life as a teenager or that of many other Members here today. It was a very illuminating and educational experience for me, and I pay tribute to both of them for their candour and their honesty. As I have said, talking about these issues freely takes a lot. Many of my remarks today have come as a result of their contribution.

I say gently to the Minister that we must not in any way fall into the trap of dismissing mental health issues in the young as mere growing pains. This is a serious matter. I know she understands, but let us recognise that to provide the help needed, it needs to be not only readily and easily available, but available for as long as it is needed for each person according to their individual needs.

Health Service Medical Supplies (Costs) Bill

John Glen Excerpts

2nd reading: House of Commons & Programme motion: House of Commons
Monday 24th October 2016 Commons Chamber

[Mr Hunt]

It will deal with some of those concerns, and we will listen to all the concerns raised by hon. Members during the progress of the Bill. On the particular issue the hon. Gentleman raises, the CMA is already investigating the behaviour of pharmaceutical companies in certain situations, but it has become clear to us that there is a particularly unethical and unacceptable practice of drugs companies getting control of generic drugs for which they command a monopoly position and then hiking the prices. There was one product whose price increased by 12,000% between 2008 and 2016, and if the price had stayed the same as before the increase, the NHS would have spent £58 million less. The Government’s conclusion is that the simplest and quickest way to sort this out is through new legislation, but I will happily take the hon. Gentleman’s other concerns offline and look into them further.

[John Glen (Salisbury) (Con)]

I welcome the provisions of the Bill that will close a loophole and deal with terrible examples of where the NHS is in effect exploited, but can my right hon. Friend point to the future in light of the suggestion that the drugs bill will increase to £20 billion by 2020—a much more significant increase than can be afforded under the projected expenditure in the NHS? What bigger measures need to be put in place for us to deal substantively with that bigger problem?

[Mr Hunt]

My hon. Friend is right in that we see demand for NHS services, which includes treatment and drugs, increasing by a total of around £30 billion over the next five-year period, which is a huge amount and certainly more than we as a country can afford without changing practice. That is why we are implementing a very challenging series of efficiency reforms designed to make sure that we can afford to continue current levels of NHS service on the £10 billion increase this Government are putting in. Part of that is indeed measures such as those in this Bill to control the drugs bill. My hon. Friend is also right that going forward over the next 25, rather than five, years we will be seeing the bigger issue of the accelerating pace of innovation in science. That provides great opportunities for the NHS, but potentially great pressures for the budget, and I am sure we will continue to discuss those issues extensively in this House.

NHS Sustainability and Transformation Plans

John Glen Excerpts

Wednesday 14th September 2016 Commons Chamber

[Richard Fuller]

I very much appreciate the hon. Lady’s question, because it gets to my point. I am actually quite sceptical about what consultation means. She might not know that Bedford has been through a review process for our acute services. I was trying to measure the length of that process in terms of Members of Parliament for Corby: it preceded Louise Mensch becoming Member of Parliament, carried on through the whole period of Andy Sawford being Member of Parliament, and is now taking up the time of my hon. Friend the Member for Corby (Tom Pursglove). We do not involve Corby any more; it is now just Bedford and Milton Keynes. That process included consultation and participation, with the NHS saying that it wanted to listen to people. It consulted them, yes. Did it listen to them? No. It was the NHS’s own process. It ticked all the boxes, but it was a complete and utter disgrace to local accountability.

I do not have distrust of Pauline Philip, chief executive officer and leader of our STP, and I do not need to know everything. I want to know that our local authorities are having their voice heard in the process just as much as our local CCG, as they are our representatives. I feel relatively comfortable that the process will lead to options that are more acceptable to the population, because it involves local authorities as well as the NHS. We should, however, expect the outcomes of the process to be highly varied around the country. Some will be correct and acceptable, and will go forward. Others will be controversial, and others will be downright wrong. We should not curse this whole process across the country, because it achieves a difference in outcome in different parts of the country. We should be prepared to look at each on its own merits and judge them accordingly.

[John Glen (Salisbury) (Con)]

Is there not a real challenge to reconcile the reticence to change and adapt with the clear imperative to have new technologies and new ways of doing things that can offer a step change, which are often resisted? Consultation will not necessarily deal with that.

[Richard Fuller]

My hon. Friend is right. I come back to the central part of what is different about STPs: they involve local authorities. On issues such as mental health and care in the community, that voice will be heard much more clearly. Our local authorities represent our local people—that is their interest. Their voice will make a substantial difference.

I have two brief final points about Bedford to which the Minister can perhaps reply. First, our CCG is under legal direction. Will that affect local decision making? Secondly, our CCG set up a joint committee with Milton Keynes to review acute services. Is he in a position to assure me that that joint CCG will not take any part whatever in the decision processes when the result of the STP is reached?

Defending Public Services

John Glen Excerpts

Monday 23rd May 2016 Commons Chamber

[John Glen (Salisbury) (Con)]

It is a pleasure to follow the hon. Member for Huddersfield (Mr Sheerman). Having listened carefully to his remarks, I would take issue with his assertion that many on the Government Benches are fully committed to the notion that private sector is always good and public sector is always bad. That is not my approach. I wanted to speak in this the third day of the debate on the Queen’s Speech because I think that the delivery of quality public services is critical to what we deliver to our constituents, and it is really important that we have an open mind about how we deliver those services effectively. The biggest employer in my constituency, Salisbury hospital, is from the public sector. It has just gone through the rigours of a Care Quality Commission inspection, and I am grateful to Professor Sir Michael Richards for his constructive observations around that and the way to move forward.

I welcome the many Bills in the Queen’s Speech that seek to address the biggest issues facing our nation, both now and under all Governments: how we create the conditions where the most vulnerable can be helped on to a better pathway. I was genuinely shocked and saddened when listening to the response from the Leader of the Opposition last week, when he said:

“Apparently, it is all about instability, addiction and debt—all things that can be blamed on individuals about whom Governments like to moralise… Poverty and inequality are collective failures of our society as a whole, not individual failures.”—[Official Report, 18 May 2016; Vol. 611, c. 16.]

I agree that it is a failure of society as a whole that people in our communities must endure complex, ongoing problems, but it is not about labelling society collectively or people individually as failures, and it certainly is not about moralising; it is about a credible analysis of the diversity of individuals’ problems, recognising that it is incumbent on Government to deliver a customisation, adaptation and reformulation of public service delivery if they are sustainably to meet the needs of our communities. It is naive to say that a financial measure of poverty, by itself, is likely to provoke a meaningful recognition of the complexity of poverty.

I want to make some observations about several of the proposed Bills, but three themes will emerge as I contemplate them. The first is about the need to innovate in public service delivery and the second is about the need to integrate. Going back to my opening remark, it is not about public versus private; it is about recognising that sometimes we need to innovate and integrate good public services, bringing in new ideas and providers able to improve how we have done things to date. The third important element is about timeframes. I vividly remember, in my six years’ service as a magistrate, seeing individuals come back again and again before the court for crimes related to the same underlying problems—typically addictions—in their lives. On average, it takes people seven attempts at rehabilitation to overcome some of those addictions. There is no one template for delivering those sorts of services. That is why we need to be careful, when we frame the legislation, to put in place reasonable measures of what success looks like and to show an understanding of the complexity of the lives of the people we are trying to help.

My enthusiasm for the children and social work Bill is infused with a strong conviction that the Government are absolutely right to look at looked-after children and care leavers, who experience some of the worst outcomes, in terms of life trajectory, of any in our society. It is important, however, that innovation is examined. In local authorities near me and across the country, we are beginning to look at schemes, such as those run by Safe Families for Children, where trustworthy families are engaged to look after children when underlying issues need to be dealt with in families. I recognise that the pathway to securing the engagement of safe families for children obviously necessitates more work in order to complete the process of safeguarding, but this is an example of where innovation and integration with existing public sector provision—in this case, within local authorities —can deliver enhanced outcomes.

On all the Bills, we need to look at how health, education and social services can work better together, so that the payback is significant. I remember, three or four years ago, being asked to visit a residential centre in Devon, with the Amber Foundation, which was working with young adults leaving the criminal justice system and in grave danger of not finding their way—often they were without family support and, being low-skilled, finding it difficult to get into employment, and typically they had been engaged in the criminal justice system previously. I hope that when we come to consider the proposed legislation, we will find room to enfranchise groups such as the Amber Foundation into the delivery of services. It is through commitment over time that those individuals are able to find a sustainable trajectory into independent living. We need to be honest and real about the challenges that those individuals face. I welcome the overdue reform of adoption. I have seen too many cases in which the evaluation stresses reasons why not, while in the meantime too much time passes and the individuals are left behind.

I welcome the education for all Bill, and there is particular enthusiasm in my constituency for the fair funding formula. Wiltshire is the third worst funded local authority, and that has a significant impact on the ability of schools to plan their budgets going forward. It is critical at the moment in the formation of a multi-academy trust, because trying to anticipate what the uplift will be is significant in giving assurance to governors as they come together.

When we look at options facing young people at 18-plus, it is important to be clear about the integration of the great macro-policy goal of having 3 million new apprenticeships with enabling children from difficult backgrounds to get on to a pathway that will deliver the skills and employment opportunities that they crave.

The prisons and courts reform Bill is also very welcome. The emphasis on rehabilitation to reduce reoffending is wholly necessary. Importantly, it will introduce new boards with external experts and emphasise prisoner education and the necessity to have a pathway to employment.

Finally, there is the digital economy Bill, and this is a massive issue for rural Wiltshire. I have campaigned on it for many years. We must have a reliable plan for the last 5% in particular. The universal service obligation must have meaning and teeth in ways that my constituents and those across rural England can fully understand.

I finish where I started. I have no ideological objection to the integration of innovative ways of delivering public services. I hope that this Government will continue to have ambition and will measure their success in a way that allows further developments to take place so that we can meaningfully address the conditions of the poorest in our society with solutions that give them dignity and the justice that they deserve.

Dietary Advice and Childhood Obesity Strategy

John Glen Excerpts

Monday 23rd May 2016 Commons Chamber

[John Glen (Salisbury) (Con)]

I welcome the Government’s words on the national child obesity strategy and the necessity of making sure that it is authoritative when it is published. However, in the light of today’s unhelpful reports, is not the real point that it is absolutely critical that that strategy deals with many of the myths out there and is truly authoritative and conclusive in the advice that it relays?

[Alistair Burt]

My hon. Friend is absolutely right—that is important. The strategy has been awaited, and if it is to do the job we all want it to do, it should deal with the myths and concerns that have been raised, and do so in a proper evidential manner.

Junior Doctors Contract

John Glen Excerpts

Thursday 19th May 2016 Commons Chamber

[Mr Hunt]

I know that that is a view that some colleagues share. Doctors have obligations even now under the Medical Act 1983 not to take action that would harm patients, and under their responsibilities to the General Medical Council; they have to be aware of those. What I hope is that that question simply does not arise again. We are now having constructive discussions with the BMA; I think that is the way forward and I hope that neither I nor any future Health Secretary has to go through what has happened in the past 10 months.

[John Glen (Salisbury) (Con)]

I applaud the tone and content of the Secretary of State’s remarks. I think this agreement will go down as a breakthrough in the NHS. It has been very uncomfortable to engage in dialogue with constituents who are junior doctors, who have felt aggrieved, so I particularly welcome the way my right hon. Friend has been able to look at non-contractual issues. I urge him to give serious consideration to the outcome of the Bailey review so that progress can be made on morale and the wider issues that have been raised.

[Mr Hunt]

I finish by saying that I completely agree with my hon. Friend. It has been a very sad dispute for all of us, because we all recognise that junior doctors are the backbone of the NHS; they work extremely hard and they often work the most weekends already. That we now have an agreement is a brilliant step forward. We all have constituents who work hard for the NHS. They are people we value, so dialogue, negotiation and constructive discussion must always be the way forward.

NHS Bursaries

John Glen Excerpts

Wednesday 4th May 2016 Commons Chamber

[Ben Gummer]

I do believe that. The Opposition were wrong back in 2010, and had we followed their advice, fewer people from disadvantaged backgrounds—precisely the people Labour was elected to represent and support—would be going to university. As a result of our taking forward brave proposals, in the teeth of much opposition, we have done more for the prospects of people from disadvantaged backgrounds than any Government dealing with this matter since higher education was reformed after the second world war.

I come now, I am afraid, to the motion tabled by the hon. Member for Lewisham East. It implicitly accepts that we have made progress. The fact that it is so anaemic in offering an alternative makes it clear that there is no alternative suggestion that she thinks would achieve the aims that she and I want: an increase in the number of students going into nursing and training, and of those coming from a diverse background. It also implies that she accepts, like me, that workforce planning over the last 10, 15, 20, 30 or 40 years has failed. I can say that, whereas she is not willing to, because everything we are doing now to correct workforce numbers—for example, the 5,000 additional GPs my right hon. Friend the Health Secretary fought the last election campaign on and will be delivering in the next few years—is the result of poor commissioning decisions made not under the coalition Government, or even in the latter years of the Labour Government, but under Governments 20 and 30 years ago.

The failure to predict the number of GPs needed, and the number and types of other professionals needed, lands us perpetually in this perverse situation where we are not accepting British students on to training courses at British universities and, as a result, are not creating the numbers of domestically trained nurses we need. In response to the inadequacies in care uncovered as a result of the Mid Staffordshire NHS Foundation Trust scandal and the failure of the Labour Government to provide the number of nurses needed in hospitals across the country, we are having to import nurses from abroad and to fill nurse places with expensive agency posts. That is something we are putting right now.

[John Glen (Salisbury) (Con)]

One of the main pieces of feedback I have had from Salisbury NHS Foundation Trust is its frustration at the reliance on agency nurses, so I welcome the Government’s moves, because they will open up supply and reduce that reliance and the significant additional costs we have seen over the last few years.

[Ben Gummer]

It is precisely to help my hon. Friend’s hospital that we are introducing these reforms.