Points of Order

John Hayes Excerpts

Thursday 12th September 2024 Commons Chamber

[Madam Deputy Speaker (Judith Cummins)]

I remind all hon. Members that good temper and moderation are the characteristics of a good debate.

[Sir John Hayes (South Holland and The Deepings) (Con)]

On a point of order, Madam Deputy Speaker. You will recall that I have raised in the House the use of crossbows by criminals. These are lethal weapons. The previous Government added to the list of weapons that are banned, and the current Government are implementing those measures. Have you had any notice of a statement being brought to the House by Ministers to respond to the increasingly pressing cries from those who want to see crossbows added to that list of banned weapons?

[Madam Deputy Speaker]

I thank Sir John for his point of order. It is not a matter for the Chair, but I can clarify that we have not had notice of a statement.

Bill Presented

Terrorism (Protection of Premises) Bill

Presentation and First Reading (Standing Order No. 57)

Secretary Yvette Cooper, supported by the Prime Minister, Pat McFadden, Secretary Ian Murray, Secretary Jo Stevens, Lucy Powell and Dan Jarvis, presented a Bill to require persons with control of certain premises or events to take steps to reduce the vulnerability of the premises or event to, and the risk of physical harm to individuals arising from, acts of terrorism; to confer related functions on the Security Industry Authority; to limit the disclosure of information about licensed premises that is likely to be useful to a person committing or preparing an act of terrorism; and for connected purposes.

Bill read the First time; to be read a Second time Monday 7 October, and to be printed (Bill 9) with explanatory notes (Bill 9-EN).

Tobacco and Vapes Bill

John Hayes Excerpts

2nd reading
Tuesday 16th April 2024 Commons Chamber

[Victoria Atkins]

That is a brave submission from the hon. Lady, given the debate in the Chamber yesterday. I certainly will not take lectures from Labour on this legislation. We are bringing it forward because we have looked carefully at the evidence. What is more, we have tempered it so that existing adult smokers will not be affected. If the message from the Labour party is that it wants to ban smoking for adults completely, it should make that argument. We have tempered this carefully to ensure that it only deals with future generations.

[Sir John Hayes (South Holland and The Deepings) (Con)]

I commend my right hon. Friend for her approach to young people smoking, her determination to deal with illegal tobacco and her crackdown on vaping, which is a menace to young people as these things are sold like an item of confectionery. Will she accept that in doing all those things, she needs to be open minded about how the Bill can be improved? The idea of a rolling age of consent, with the consequence that someone of 35 will be able to buy tobacco but someone of 34 will not and so on, is at best a curiosity and at worst an absurdity.

[Victoria Atkins]

I am extremely grateful to my right hon. Friend and close Lincolnshire neighbour. He knows that on any piece of legislation I will always want to listen to and do business with colleagues. The principle behind this legislation is that these emerging generations will never take up smoking. That is the point.

NHS Dentistry: Recovery and Reform

John Hayes Excerpts

Wednesday 7th February 2024 Commons Chamber

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. The Secretary of State was giving an answer to a question. We do not need all this shouting. People might not agree with the answer, but you have to listen to the answer.

[Sir John Hayes (South Holland and The Deepings) (Con)]

In congratulating my right hon. Friend—my personal friend—on this welcome, excellent statement, may I ask her to forgive the ferocity with which my right hon. Friend the Member for Gainsborough (Sir Edward Leigh) and I made the case for NHS dentistry when we met her recently? In that spirit, will she ensure that some of these new dentists come to rural Lincolnshire, where we desperately need good dental care? She has today irrigated the dental desert.

[Victoria Atkins]

I give my very sincere thanks to my right hon. Friend. The House can imagine the advocacy I have received from both him and my right hon. Friend the Member for Gainsborough (Sir Edward Leigh). On reaching rural and coastal areas, as a proud Lincolnshire MP myself I wanted to bring about a set of plans that will address those underserved areas. I am delighted that the plan meets with my right hon. Friend’s approval.

NHS Dentistry

John Hayes Excerpts

Tuesday 9th January 2024 Commons Chamber

[Victoria Atkins]

The hon. Lady has raised an interesting and important point, because, of course, dentists are independent contractors to the NHS, and I have to work with the levers that are available to me. As I have said, we have already invested £1.7 billion to try to help with the recovery, and the House will, I hope, look forward to our dentistry recovery plan when it comes to other ways in which we can improve that. The important point, however, is that because those dentists are independent contractors, we must work with the profession to encourage them back to the NHS to offer the services that we all want to see.

[Sir John Hayes (South Holland and The Deepings) (Con)]

Is not the root of the problem the contracts that the NHS has with dentists? The roots of that, of course, lie with the previous Government, a Labour Government, rather as they do with the GP contracts. Does my right hon. Friend not need to revisit the genesis of this problem, as well as training more dentists here in the UK?

[Victoria Atkins]

I thank my right hon. Friend, and indeed my friend, my Lincolnshire neighbour, who knows as well as I do the pressures that we face in ensuring that our constituents receive the same quality of care that we expect across England. He was right to draw attention to the—I would argue—badly drafted contract of 2006, but he also touched on the complexity involved in finding systems that would work better.

Draft Health Education England (Transfer of Functions, Abolition and Transitional Provisions) Regulations 2023

John Hayes Excerpts

Monday 20th March 2023 General Committees

[Will Quince]

I thank my right hon. Friend for her question. She is absolutely right. I was due to visit her medical school but, unfortunately, because of illness I could not. I still very much hope to do so. She is right that we need to train more medics domestically, although we have international recruitment. We increased the number of doctors we train by 1,500—a 25% increase to 7,500 per year. I urge her to wait just a little longer for the long-term workforce plan, which will set out our requirements for the future and how we go about ensuring that we fill the places and get medics in training. I am conscious that doctors are one of those groups.

Both of my right hon. Friends talked about planning, which is very much at the heart of the regulations. Their intention is to more closely align workforce planning, which is currently the statutory function of Health Education England, with the service and financial planning responsibilities of NHS England. That will enable service, workforce and finance planning to be properly integrated in one place. Nationally and regionally, it will build on the work that has been done to develop the NHS people plan. It will also help to drive reforms in education and training further and faster so that employers can recruit the health professionals needed to provide the right care to patients in the future.

Merging Health Education England with NHS England will simplify the national system, leading the NHS to end the separate lines of accountability that exist for the two bodies. Currently, Health Education England is responsible for workforce planning, education and training, but NHS England is responsible for culture, retention, international recruitment, workforce and leadership. Uniting those functions will help us ensure a joined-up and long-term view of what our NHS workforce needs for the future.

I pay tribute to Health Education England’s leadership and staff throughout the organisation’s 10-year existence. It has played a hugely effective role in the delivery of growth in the number of health professionals trained in England. It has promoted the creation of new roles, such as nursing associates, and spearheaded reforms to professional training workforce growth; record numbers now work within our NHS. It was hugely flexible and effective during the pandemic, including by supporting the deployment of students to the frontline at critical moments.

I am delighted that as of 1 April this year, Dr Navina Evans will become the chief workforce, training and education officer in the new NHS England. Sir David Behan, the chair of Health Education England, was appointed as a non-exec director of NHS England on 1 July. Those appointments are both important, because they will ensure that there continues to be excellent national leadership of NHS education and training.

I know there will be concern in some quarters that the changes pose a risk of budgets being used for other purposes. However, we have put in place a number of measures, including ministerial oversight, to ensure that that will not be the case. I am happy to elaborate on that later if required. Very briefly, we will include objectives on the workforce within NHS England as part of the NHS England mandate. We will continue to monitor and track expenditure on education and training with, as I said, a ministerial chaired board to provide that important ministerial oversight and governance of the workforce in NHS England.

Health Education England and NHS England already work closely together to ensure that the NHS has the workforce that it needs for the future. As I said in response to the question from my right hon. Friend the Member for Chipping Barnet earlier, we have commissioned NHS England to develop that long-term workforce plan for the next five, 10 and 15 years’ time. In effect, that plan will look at the mix, the number of staff required, and the actions and reforms that will be necessary across our NHS to reduce supply gaps and—importantly—improve retention.

[Sir John Hayes (South Holland and The Deepings) (Con)]

I am sorry to have missed the beginning of the Minister’s remarks, but I want to make a case for dentistry in all this. Given that the aim of the draft regulations is to align the workforce more with local need, and that they are designed to improve care standards and workforce availability, will he look at the dental deserts such as Lincolnshire, where we cannot straight-forwardly access NHS dental care? There are more dentists in London than one could shake a stick at—there are even more than there are barbers—yet in Lincolnshire it is very hard to obtain a dentist. Would he look at that in terms of the strategic change that he has described?

[Will Quince]

I thank my right hon. Friend for his question. He is right to raise dentistry, because, as he rightly points out, there are dental deserts across the country. The Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Harborough (Neil O’Brien), is looking closely at dentistry, including workforce and supply and the use of a skill mix. Of course, it does not have to be a dentist, as others who have similar qualifications can do a lot of work that a dentist does, including on children. My hon. Friend will publish a dental plan in the coming months, and I hope that addresses my right hon. Friend’s point.

In conclusion, the merger will continue to build on Health Education England’s great work, putting education and training at the heart of service planning for the long term. The draft regulations will simplify the architecture of our NHS at national and regional level and ensure it has the workforce that it needs now and in the future. I commend the regulations to the Committee.

Covid-19 Vaccines: Safety

John Hayes Excerpts

Monday 24th October 2022 Westminster Hall

[Sir Christopher Chope (Christchurch) (Con)]

It is a pleasure to serve under your chairmanship, Sir Roger. I am, as was mentioned, the chair of the all-party parliamentary group on covid-19 vaccine damage. The group is now up and running. We had an enormously well-supported meeting in Portcullis House last Thursday. I agree with the legitimate concerns of the 100,000-plus people who signed the petition, and share their belief that the recent data relating to cardiovascular problems, which is increasing in volume, is of enough concern to warrant an inquiry on safety. As I have said, the big Hallett inquiry on covid-19 will cover a lot of this ground, but it will not report for many years. In the meantime, people are being encouraged to have more and more boosters, and they understandably want to know the impact of those boosters on their health and the risks and rewards.

As well as being chairman of the APPG, I have taken an interest in the subject for about a year, and produced a private Member’s Bill on the subject, and I hope to produce another, which will have its Second Reading next month. Coroners up and down the country have found in their reports that deaths have been caused directly by covid 19 vaccines. I have spoken to some of the bereaved; indeed, I spoke to the gentleman referred to by my hon. Friend the Member for North West Durham (Mr Holden)—the gentleman who attended our meeting on Thursday, and whose wife was a journalist in Newcastle. I have seen with my own eyes the suffering of people who are bereaved or still suffering adverse reactions.

I am sorry that my hon. Friend the Member for Carshalton and Wallington (Elliot Colburn), in introducing the debate, did not have much to say about the people who we know have suffered death or serious injury as a result of the vaccines. My hon. Friend showed himself to be rather the victim of producer capture—the producer in this case being the MHRA. He does not seem to have allowed his researches to go further than the MHRA. Has he, for example, looked at what has been happening in Germany? The Paul Ehrlich Institute is the German regulator responsible for vaccine safety. On 20 July, the institute confirmed that one in 5,000 people was seriously affected after a vaccination. That also reflected a finding that it published earlier in the year, in which the institute tried to raise the alert that one in 5,000 vaccinated people experienced a serious side effect, such as heart muscle inflammation. It said that, statistically, every 10th person must expect a severe consequence from having a course of three or four vaccines. The institute uses the World Health Organisation definition of a “serious adverse event”, meaning one that results in hospitalisation or is life-threatening or life-changing. After a course of four doses, the risk of a report to its system of a serious adverse effect is one in 1,250. That is serious information coming from the regulator of a country that is highly respected for the quality of its healthcare.

Is it not interesting that the number of adverse reports referred to the institute is far fewer than the number of adverse reports that led to the 1976 swine flu vaccine being withdrawn? Some hon. Members may recall that, in 1976, the President of the United States, Gerald Ford, was panicked by swine flu into organising a vaccination campaign. When reports emerged of suspected adverse reactions, including heart attacks and Guillain-Barré syndrome, and there were 53 reported deaths, people began to worry about the safety of the vaccine. The Government halted that mass vaccination programme in December of that year. In that case, the Government acted on far fewer adverse events than we have talked about in this debate and decided that, given the balance of risk and reward, it was too risky to continue with the vaccination programme. Let us look at the facts and not just be beholden to the MHRA. If this were a debate about the MHRA, I would have masses of material on it.

The Government seem to be in denial about the risks of these vaccines. Only this morning, the deputy chief medical officer for England was on the radio saying that the boosters were perfectly safe and effective, but they are not perfectly safe, and there is a question about whether they are effective, but that is for another debate. The fact that they are not perfectly safe has now been admitted by the Government. Indeed, the UK Health Security Agency has issued “A guide to the COVID-19 autumn booster”—you may have seen a copy of it, Sir Roger. It requests that people get another booster from their GP. Unfortunately, the cover letter from the NHS makes no reference to any risks associated with the vaccine, but if one looks at the document included in the envelope, it talks about serious side effects. It says,

“Cases of inflammation of the heart (called myocarditis or pericarditis) have been reported very rarely after both the Pfizer and Moderna COVID-19 vaccines. These cases have been seen mostly in younger men and within several days of vaccination. Most of the people affected have felt better and recovered quickly following rest and simple treatments.”

It then states:

“You should seek medical advice”.

What it does not state is what happens to those people who do not recover. That is what I will concentrate on in the remainder of my remarks. Those people, if they are disabled to the extent of 60% or more, may be eligible for payments under the vaccine damage payment scheme. They might get £120,000. That scheme, however, is not fit for purpose, because its description of disability does not necessarily apply to autoimmune conditions such as those suffered as a consequence of covid-19 vaccine damage. And what about all of those people who are only 59% disabled? There is no financial help for them and, even more worryingly for many, no specific medical help.

The Government refuse to provide specialist help for these vaccine victims. Although they have set up long covid clinics, vaccine victims are being ignored. I have asked parliamentary questions about this, but I have not been able to get a satisfactory answer as to why there are no clinics for those victims of vaccine damage. As a result of the Government’s behaviour, victims are increasingly telling their loved ones, neighbours and friends about their circumstances, which is leading to a much lower rate applications for booster vaccines. That is happening because the Government cannot suppress the information that ordinary people are sharing with one another, even though there is very little on this topic in the mainstream media.

Many people now would not touch a booster with a bargepole, and I include myself among them. I am not anti-vax—I had my first two vaccines—but from all that I have seen and know about this, the increase in boosters is counterproductive for many and dangerous for some. We need to take into account what is happening on the ground. People are becoming increasingly vaccine-hesitant. Large numbers of doctors and health professionals are now calling for a complete halt to the vaccination programme because the risks outweigh the benefits.

[Sir John Hayes (South Holland and The Deepings) (Con)]

The thing to understand is that there is a fundamental difference between these kinds of vaccines and vaccination per se. Vaccination per se has saved millions of lives here and elsewhere, but these vaccines are qualitatively different. Science matters, but much matters more.

[Sir Christopher Chope]

My right hon. Friend is absolutely right. In the United States, they changed the definition of a vaccine. We have always understood a vaccine to mean someone receiving into their system something containing a small element of that which they were being vaccinated against, so that their system could react against it and protect them if they were later exposed to a large amount. But unlike those old vaccines, these vaccines do not use the raw material, so in many senses it is a misnomer to describe them as vaccines at all. That information is not really out there among the public any more than the fact that the booster vaccines have not been tested on humans at all during studies; they were tested only on mice. People are being used as victims for experimentation, and that is why they are getting worried.

Finally, Oracle Films’ film, “Safe and Effective: A Second Opinion”, is available on YouTube—I make no apology for the fact that I participate in that film—and sets out a different view on the safety of these vaccines. I am not saying we should ban all covid-19 vaccines and have a complete halt. What I am saying is that there is an urgent need for the Government to get to grips with this issue before more people are duped into having vaccines that they probably do not need, that will not do them any good and that will present risks to their health.

--- Later in debate ---

[Dr Johnson]

I am referring to the covid vaccine, which has saved hundreds of thousands of lives. I take my hon. Friend’s point, but there is no evidence that those deaths were caused by the covid vaccine. Let me acknowledge and pass on my sympathies to the very small number of people for whom vaccines may not have worked as intended, and who may have suffered an adverse reaction from vaccines.

I turn to vaccine safety. All vaccines used in the UK covid-19 vaccine programme are safe. In the UK we have some of the highest safety standards in the world. The MHRA is globally recognised for high standards of quality, safety and medicines regulation. Each covid-19 vaccine candidate is assessed by teams of scientists and clinicians on a case-by-case basis. There are extensive checks and balances at every stage of vaccine development. It is only once each potential vaccine has met robust standards of effectiveness, safety and quality set by the MHRA that it will be approved for use.

It is also important to stress that the surveillance of vaccine safety and adverse reactions does not stop once a vaccine has been approved. The MHRA and the UK Health Security Agency constantly review a wide range of available data on the safety of vaccines, including UK and international reports of adverse reactions.

[Sir John Hayes]

People outside the House will not know that although the Minister has been in her job a relatively short time, she is a remarkably dedicated and diligent person. No Minister is more likely or determined than she is to get to the facts when looking at the international data. Will the Minister give the assurance that she will consider all the information available, including that international data, when she draws conclusions about the content of this debate and the cases that have been made by many of my constituents and others?

NHS Dentistry

John Hayes Excerpts

Thursday 20th October 2022 Commons Chamber

[Peter Dowd (Bootle) (Lab)]

Where are we to begin with this? We have been here before, time after time. I thank my hon. Friend the Member for Bradford South (Judith Cummins) and the hon. Member for Waveney (Peter Aldous) for bringing us this debate. We have discussed this many times and we had a debate in Westminster Hall in the summer, but nothing has really moved on. Nothing at all seems to have changed.

I want to read out part of a letter I received from a constituent, and this is typical of the problem we are facing. I have received even worse horror stories, to the extent that one local dentist told me that they may close in the next few weeks. That is typical and symptomatic of this bigger problem. My constituent said:

“I wanted to take the time to get in touch with you over my experience of getting on the books for an NHS dentist. I have had no luck and have had to have private dental visits. I have luckily not had to have any treatment as I would not be able to afford it. I have reached out to a few dental practices in the area…to be told that they are only taking on children on the NHS.”

That is typical of the experience of everyone in this Chamber. I exhort Conservative Members to stop dealing with this in the abstract, as though it is only affecting individual Members of Parliament; it is a collective issue, and it needs a thorough review and a thorough push by the Government. It is not in the abstract. The hon. Member for Salisbury (John Glen) referred to covid. I completely accept that covid had an impact on the provision of dental services—it hothoused an already challenging situation—but dental services in all our constituencies were under huge pressure before covid. Let us not pretend that covid was the be all and end all of the dental health problem.

[Sir John Hayes (South Holland and The Deepings) (Con)]

I agree with the hon. Gentleman that there are systemic problems, part of which goes back to the contracts agreed with dentists donkey’s years ago, under the Labour Government—the same applies in respect of GPs. That genesis of the problem was there, but we then face the problem of training too few dentists, which I think we do, and the problems in particular parts of the country, including, Lincolnshire, which is among the worst affected. My constituents cannot get an NHS dentist and they need to have one. That particularly applies to young people and children. He is absolutely right on this.

--- Later in debate ---

[Selaine Saxby (North Devon) (Con)]

Like other colleagues, I have spoken out many times in this House about dentists, including in the debate earlier this year. Indeed, the very first letter that I wrote as an MP back in 2019 was about the dental contract, which was brought to my attention by one of the dental practices in Barnstaple. I cannot stress the severity of the dental desert that is now Devon, with not a single NHS practice accepting new patients. Not a week goes by without correspondence from a constituent in distress. As William Shakespeare himself said in “Much Ado About Nothing”:

“For there was never yet a philosopher that could endure the toothache patiently.”

And nor should they. It really is time that something is done. I thank the current Health and Social Care Secretary for recognising dentistry within the ABCD and that there is a problem. I thank, too, the current Minister’s predecessor for at least taking some steps towards redressing the issue of the contract, which is clearly the undermining problem. However, that is a long-term solution. The steps outlined there and the training of more dentists are not going to address the current situation.

Only last weekend, a friend, who was already registered at a dentist, told me that they had actually managed to get a dental appointment. When they got there, they were told that they needed to see the dental hygienist. They went to book an appointment and were told that there was a six-month wait to see the hygienist, who then told them that they needed to have a second appointment to do the other half of their mouth. They went to book, only to be given another six-month wait before they could see the hygienist, so it took a full year. As they said, it is a bit like cleaning the Forth bridge. This is not how our constituents’ teeth should be treated.

My concern extends to my younger constituents. The No.1 reason youngsters under 18 are admitted to hospital in my patch is linked to their teeth. At a time when our hospitals are under such duress anyway, could we not do something to help to ensure that people are able to see a dentist?

My frustration is extended by the fact that I have now managed to secure and find two separate methods for getting dentists into North Devon. Although I do not mind doing this for my constituents—indeed I welcome doing anything I can to help my constituents—I do not quite understand why it is coming down to us as individual MPs to deliver the dentistry that our constituents so desperately need.

Less than 13% of the covid catch-up funding in Devon was spent because there is no one to deliver the treatment. My NHS dentists who train up new dentists at the nearest dental schools advise that these youngsters do not wish to remain in NHS dentistry. We need to address that. Those who train to become dentists under the public purse should have to serve as NHS dentists for a certain period, but they wish to go on to do cosmetic dentistry, which pays much better. The good people of North Devon in the main are not looking for cosmetic dentistry. We are much more interested in fillings and dentures and in ensuring that our young people go on to have good-quality teeth when they get past the age of 10. I urge the Minister to push forward some of these changes, and I hope the new team remain in place long enough to do so.

We need dentists on buses or similar to get to remote rural communities and into schools, to enable every child to have the dental check-up they deserve and to provide emergency access for those people who have failed to secure a dental appointment—not because they have not tried or because of covid, but simply because there is not a dentist available to see them and many people cannot afford to pay for the treatment that they now need after waiting so long.

[Sir John Hayes]

My sons, who are now 21 and 18, have access to NHS dentistry, as I have, at the excellent Fen House dental practice in Spalding, but many of my constituents’ children do not, as my hon. Friend says. She talks about dental deserts in rural areas, and Lincolnshire is among the worst of those, with 38 dentists per 100,000 population. She is right both about young people and about the particular problems of rural areas. The Minister, for whom I have high regard, needs to give us very firm answers to those questions and a clear plan for what the Government intend to do about them. There is a plethora of private dentists, but too few NHS dentists.

[Selaine Saxby]

My right hon. Friend’s comments are wise, as always.

On international dentists, during the first lockdown, I had an Indian dentist come and meet me privately, and I forwarded that information back to the Department; apparently, there are many, many Indian dentists who would be delighted to come. We would welcome them to North Devon with open arms—indeed, we would welcome dentists from anywhere into North Devon, such is the need. I urge the Minister to look at what else can be done to speed up access for those people who are well trained internationally to come over and look at our teeth.

I will finish by reminding hon. Members how important our teeth are. I ask the Minister to do anything that can be done to help both our youngsters and those people who have struggled to see a dentist, so that we can again say that the dentist will see us now.

NHS Dentistry in England

John Hayes Excerpts

Wednesday 22nd June 2022 Westminster Hall

[Derek Thomas (St Ives) (Con)]

I beg to move,

That this House has considered NHS dentistry in England.

It is a privilege to serve under your chairmanship, Mr Stringer. I am delighted to bring this debate to Parliament and to combine it with a petition that has been signed by more than 10,000 members of the public. The petition calls for

“an independent review of the existing”

NHS dental

“contract and a radical rethink of the way in which dental services are delivered.”

We may not need an independent review to tell us that NHS dental services need a radical rethink; we all know that they do.

NHS dentistry is a huge concern for all Members here today, and the number of us present reflects what a huge concern it is for our constituents. I already had a good indication of how significant the lack of dentistry was across my constituency, but to grasp the detail and the scale of it, I posted a survey at the beginning of the year asking constituents about the problems they had faced in accessing NHS dentistry. Within a day, it had received more responses than any other survey I had run—more than surveys on bus services, post office closures, noise pollution, or whether the Cornish flag should appear on a Cornish numberplate.

The picture that came out of my survey was shocking. Nearly half of respondents had been waiting more than three years for an appointment. Tim has had temporary crowns awaiting replacement for eight years; the teeth underneath have rotted away. Robert’s solution was to wait until a tooth was

“beyond repair and intolerably painful before getting an appointment with the emergency dentist to have it extracted. Last time they removed three in one go.”

Other people tried DIY solutions. Looking up how to make temporary fillings on YouTube was commonplace. Mark pulled out his wisdom tooth himself.

Other constituents have given up completely. They do not show up on the waiting lists because they have given up on waiting. Lauren told me:

“I don’t use the right side of my mouth to chew as it’s sensitive and causes me pain but it is too difficult to get an appointment so I am having to live with it”.

Anna racked up three times her usual phone bill trying to get through to the appointments line before she gave up. One constituent comes from a family of seven, of whom only the youngest has ever seen a dentist, and only then because he went to hospital for urgent surgery; the oldest is 20. Patients who can afford to go private do so, but so do patients who cannot afford it. The fees for Anthony’s private dental care represent a tenth of his pension; that is not affordable. The fees that Megan paid to remedy just one of her abscesses equated to a month’s rent. She has just had a baby, and cannot afford to pay another two months’ rent for the other two abscesses.

The situation is particularly grave in Cornwall. Last week, NHS England and NHS Improvement presented a report to Cornwall Council showing that in 2020-21 only 24% of the dental activity commissioned in Cornwall was delivered. In 2021-22, it has increased, but only to 59%. By the end of this month, we should be returning to 100% of normal activity, but that is simply not happening in Cornwall. The total number of adults with access to an NHS dentist dropped from 188,000 in June of last year to 155,000 in December.

[Sir John Hayes (South Holland and The Deepings) (Con)]

I congratulate my hon. Friend on securing the debate. Things are clearly not as they should be in Cornwall, but in Lincolnshire they are even worse. Greater Lincolnshire has three of the four worst dental deserts in the United Kingdom, according to the Association of Dental Groups, with just 38 dentists per 100,000 people. Finding a dentist in Lincolnshire is like finding the holy grail. It is vital that we have more dentists, for the reasons my hon. Friend set out. People deserve better.

[Derek Thomas]

I completely agree. My right hon. Friend will know that in Cornwall we are very competitive; we always want to win, but I do not want to win this competition. This tragedy for both Cornish residents and his constituents highlights the fact that something needs to be done urgently. I thank him for his intervention.

--- Later in debate ---

[Rachael Maskell (York Central) (Lab/Co-op)]

It is a pleasure to serve under your chairmanship, Mr Stringer. I thank the hon. Member for St Ives (Derek Thomas) for opening the debate and making many of the points that I intended to make. The simple fact is that we do not have time for further delay. We have four and half weeks left until the summer recess, and our constituents want answers. They want answers because they need to see a dentist but they are experiencing the deficit of NHS dentistry across the country. I would add to the list of areas mentioned that Yorkshire is also deeply affected, and my city, York, is struggling.

In 2009, Labour committed to reform the dental contract, realising that it was not going to deliver what it aspired to. The coalition Government followed in 2010 with a similar commitment, yet here we are in 2022 still making the same argument that we desperately need reform. As has already been said, this is not just something that has emerged through the pandemic; it is an issue that predates us. That is why it is essential that we have a pathway from today showing how we are going to move out of the crisis. Our constituents deserve to know what the Government’s agenda is.

Two years ago, NHS dentistry fell by 13%. Since covid-19 there has been a mass exodus in my city of York, but I realise that has also occurred across the country. Last April, NHS dentistry fell by a further 19%. It is believed that since the start of the pandemic, NHS commitments have fallen by 45%. Next year, 75% of dentists are planning to make changes and reduce their NHS commitments. Of those, some 45% say they will go fully private and 47% say they will change career or take early retirement, so if we wait another 12 months we will be in a deeper mess than we are now.

Since the start of the pandemic, we have lost 43 million dental appointments, 30 million of which were for children. In my constituency, 41% of children have not seen a dentist in the last year—they are the children who are now presenting in more acute services, requiring even more expensive interventions.

To put the situation in York into context, 9,695 UDAs were delivered in March 2021, at a time when 45% of UDAs needed to be delivered. A year later, in April 2022, 8,730 UDAs were delivered, fewer than the year before, and yet the requirement was for 95% of UDAs to be delivered. Instead of the number of my constituents accessing NHS dentistry going up when the number of UDAs that were expected to be delivered more than doubled, it has gone down. With 965 fewer UDAs, despite a doubling of the expectation, will the Minister explain how my constituents are meant to get access to services?

Fewer than half my constituents have seen a dentist in the last year. Of course, dentists have offered them private dental plans but my constituents simply cannot afford that, not least because of the cost of living crisis and the housing crisis in my city. Some travel long distances and others get nothing at all, and we know about other health inequalities that are similarly embedded.

[Sir John Hayes]

It is the least well-off people who suffer most, as the hon. Lady rightly said. Working-class people cannot afford these expensive plans. Surely the answer is that we should train more of our own dentists and make it more attractive to work for the NHS, rather than go private. My own dentist is Turkish by origin. He is a fine NHS dentist, and I could not speak more highly of him, but we cannot simply import dentists; we need to train more.

[Rachael Maskell]

The right hon. Member is absolutely right that we have to train more dentists. One reason for that is that it takes about 10 years for somebody to be fully professionally competent and able to provide the highest level of dentistry. We must not look just at what is happening now, but into the future too.

Before we get to that point, we have to look at retention and at bringing people back from private contracts and services into NHS contracts. With fewer dentists available, the toll and the mental stress felt by those who have stayed in the NHS and remained committed to it is building. Some 87% of dentists experience mental stress, and 86% have experienced abuse as a result of people being so frustrated by the time they reach the dentist’s door. The people working in dental reception areas are at the forefront of that, and I know of a practice in York that cannot recruit anyone to be on the front desk. We need significant changes to be brought forward, and that will require money and dedication.

It is not just about the contract; it is also about having a complete strategy around dentistry. I have never understood why oral health was taken outside the wider NHS, and I believe that the solution to the problems we face is to have a proper NHS dental strategy and to put the NHS dental service back into the heart of the NHS. However, while we are working on those issues, we have to look at the crisis before us.

In Parliament last week I mentioned a practice that has been fantastic at accommodating people with dental needs throughout the pandemic. I said that three dentists were leaving that practice; I was wrong—it is now four. That is the pace of people leaving the profession. We have heard about the wider consequences for oral health, and particularly oral cancers, for which a delayed diagnosis means the worst prognosis. Therefore, it is absolutely right that we see a move on this issue.

I want to raise a couple of issues about dentists waiting to come to the UK. We know that 700 dentists are waiting to sit exams. The Government have had a consultation, which has closed, and we are awaiting a response. I am sure everybody in the House would want to accelerate legislation on that, but we need to know the Government’s plan. I hope the Minister will be able to tell us about that today.

However, 700 dentists will not fill the gap. Just last week, I was speaking to Ukrainians who have come to the UK. They want to work, they want to put their skills into practice and they want to have fast-track English language training so that they are competent in terms of their language skills. They want to see their qualifications passported, so that they can get to work and practise their profession. They do not want to deskill or de-professionalise. They want to learn the clinical language that they will require, and therefore to shadow dentists getting ready for practice. However, I have not seen a strategy from the Government on how we will work with refugees who have those skills and can put them to work. Perhaps the Minister will share that in her closing remarks, because it seems such a waste of talent when many refugees absolutely want to address that local need but cannot do so.

I turn now to the future training of dentists—a point raised by the hon. Member for St Ives. I have had discussions with Hull York Medical School, which is a fabulous partnership between the two cities, and it would be prepared to help support a dental school. Of course, that would need investment, so we need proper investment for the future. To look at how that would work, I spoke to the commissioners, and there certainly is an appetite in our city to host such a school in the future. That would be helpful in bringing dentists onstream, but we also must recognise that students currently in training are struggling to get placements in the NHS. Of course, the more dentists who leave, the harder it will be to train the current cohort. Unless we see a quick increase in the number of NHS dentists, we will be in even more difficulty. That is why the urgency is there now. We must build back an NHS service for the future to ensure that we have those professionals in place.

Finally, we know that integrated care systems will be taking over the commissioning of dental services next year. My concern is that Government are waiting for that moment to act. We must see action now, because the integrated care systems will not be able to solve a problem that the national Government won’t.

Community Pharmacies

John Hayes Excerpts

Tuesday 21st June 2022 Westminster Hall

[Peter Dowd (Bootle) (Lab)]

I beg to move,

That this House has considered the future of community pharmacies.

It is a pleasure to see you in the Chair this afternoon, Sir Gary. As a member of the all-party parliamentary group on pharmacy, I am pleased to introduce the debate and glad to see so much support from Members who obviously, like me, recognise the huge value that our pharmacies bring to the NHS, patients and the public generally. I hope everyone here agrees that England’s 11,200 pharmacies play a crucial role in providing important healthcare, life-saving medicines and an increasingly wide range of clinical services to their local communities. Not only that, but as the most accessible providers of healthcare, pharmacies are key to reducing health inequalities: 89% of the population are less than a 20-minute walk from their nearest pharmacy, increasing to 99.8% in the most deprived areas, such as mine. It is fair to say that pharmacies understand their communities to a significant extent—sometimes more than the traditional health services—and as such are ideally placed to engage with the most marginalised and vulnerable groups in our communities.

The wider public appreciate the easy accessibility of pharmacies, which by their very nature are located at the heart of every community throughout the country. Throughout the pandemic, not only did community pharmacies remain open and continue to offer their full range of services, but they played a huge role in the vaccination programme, delivering an astonishing 24 million jabs. They also distributed some 27.6 million covid lateral flow tests and initiated a pandemic delivery service that ensured that 6 million vulnerable patients could access their medicine.

I think I am correct in saying that all Members present today would like to put on record their thanks and express their appreciation for all pharmacists, pharmacy dispensers, pharmacy technicians, medicines counter assistants, delivery drivers and administrative teams, who worked so hard during that difficult time to maintain the public’s access to the pharmaceutical services that they relied on. We, and the whole country, owe them a debt of gratitude. But we must also recognise that it is not just about thanking staff; it is also about recognising that the conditions they work in are crucial to the maintenance of a good service, whether a member of staff works in a larger or a smaller pharmacy provider.

[Sir John Hayes (South Holland and The Deepings) (Con)]

I congratulate the hon. Gentleman on securing the debate. The point he is making appears to be twofold: first, as well as responding to need, pharmacies can have a role in preventive medicine; and secondly, we now need to shout louder about that. Pharmacies did a heroic job during the pandemic and they continue to do so, but I am not sure that everyone knows as much as he clearly does about what we can do with and at a community pharmacy, and this debate serves the purpose of telling them.

[Peter Dowd]

The right hon. Gentleman makes a really valid point, and I will talk about some of that later. We have to recognise that, despite pharmacists trying to help people, they sometimes got dreadful abuse. We have to help them and protect them from abuse. That is part of addressing their working conditions. Vacancies in the sector are not caused simply by a shortage of pharmacists. It is also about which part of the space pharmacists work in. In other words, if I were a pharmacist, I would ask, “Do I like the conditions, pay and terms of my work?” If the answer is no, people move on.

Pharmacies are not just a shop; they are a healthcare setting and should be treated as such. They are a crucial part of the NHS ecosystem. I suspect that that is why a pharmacist needs to be on site all the time—this is not just a shop operating within a transactional context. Aside from covid, pharmacies are doing an incredible amount of work for their local communities every single day. In the most recent flu season, in 2021, pharmacies mobilised to deliver the biggest flu vaccination campaign on record, administering 4.85 million doses—over 2 million doses more than in the previous flu season, representing a 75% year-on-year increase.

The recently commissioned NHS blood pressure check service has already meant that 100,000 people have had their blood pressure checked in a pharmacy. Anecdotally, pharmacy representatives say they are already hearing that these checks have picked up cases of extremely high blood pressure in patients, who have then been referred on for treatment. This is a very highly valued healthcare intervention, which will save the NHS money in the long run, because it is cheaper to prevent disease than it is to treat it. More than that, however, I am convinced that these interventions will save lives.

Those two services on their own demonstrate pharmacy at its best. PwC estimates that the sector contributes around £3 billion in net value to society as a whole, and it works every day to improve the health and wellbeing of our local communities and our constituents. That is surely why we have the NHS in the first place.

What is the current financial health of the sector? It is no exaggeration to say that the community pharmacy network is under huge strain and that pharmacy staff and businesses are coming under increasing and, indeed, unsustainable pressure. Pharmacy funding is currently flat, with the total available funding envelope fixed at £2.592 billion. In practice, the Pharmaceutical Services Negotiating Committee reports that this means that real-terms funding is decreasing year on year, as inflationary pressures, rising business costs and increasing workload are not taken into account in that funding deal. Despite all that, many pharmacies have remained open, albeit under extremely difficult economic conditions.

However, the PSNC says that some businesses are reaching the limits of what is possible in terms of remaining viable, and that is already having an impact on patients. A recent survey on pharmacy pressures, conducted by the PSNC, found that 90% of pharmacy businesses are now unable to spend as much time with patients as they did before. Perhaps more worryingly, 92% of respondents said that patients were beginning to be negatively affected by the current pressures on their pharmacy. Despite pharmacies being a significant part of the NHS family—on average, at least 90% of their income comes from the NHS—pharmacy funding has not received the annual funding growth of 3.4% per annum that the rest of the NHS has been afforded.

Those in the sector feel that it is time to put things right. Indeed, the PSNC recently submitted a funding bid to the Department, making the case for extraordinary economic circumstances to be taken into account. When the Minister responds to the debate, I hope she will update Members on whether a funding increase will be granted to the sector.

The PSNC also estimates that the sector has had to make efficiency savings of between 37% and 50% in order to manage the funding squeeze and to keep providing the services it is contracted to deliver, but how much more pressure should we expect it to operate under? Do we want a bare-bones network that delivers only the very basics for patients, or do we want a vibrant, innovative sector that is constantly looking to the future to find new ways of working and providing a personalised and consistently high-quality service for patients, and that is fully integrated with other areas of healthcare and able to be consistently relied on in the future, as millions of people relied on it during the pandemic? Members can certainly guess what my preference is.

One thing is for certain: maintaining the status quo is not an option. So what does the future of community pharmacy look like? I would like to see pharmacies evolve into the go-to healthcare settings for help with minor ailments. There is no need for otherwise healthy patients with minor conditions to continue to see their GP. The truth is that they can get the same expert advice from their local pharmacist, who can exercise their clinical judgment and sometimes even prescribe medicines or offer an over-the-counter treatment at half the cost to the NHS. Indeed, the PSNC estimates that if this policy was rolled out nationwide, the NHS could save a staggering £640 million.

What is more, there would perhaps be no need for people to queue in a waiting room or to visit multiple locations. Pharmacies could be a single go-to place for diagnosing, advising on and supplying medicines for the treatment of minor ailments. As we all know from when we go abroad, that system works in Europe and much of the developed world, so why not here? It would be potentially game-changing for the future of pharmacy and more widely for primary care. I hope the Minister will comment on what plans, if any, the Government have to commission a service of that nature.

Aside from minor ailments, pharmacies are well placed to deliver much of the prevention agenda set out in the NHS long-term plan. They could and should be at the forefront of promoting and supporting self-care. Future services could include a national emergency contraception service, or even the treatment of minor injuries. Pharmacies could also offer help and support to manage long-term conditions. For instance, they could offer a whole host of valuable services for supporting patients with asthma, such as an inhaler technique service or annual asthma reviews. Community pharmacies could do even more than they already do to review patients’ medication and ensure that it is being taken appropriately. That is all extremely important, from a patient perspective.

For the population that is otherwise healthy, pharmacies could play an increased role in promoting health and wellbeing, and in preventing and reducing further healthcare demand in the first place. After all, healthy people do not often visit hospitals or GPs, but they probably pass by pharmacies on the high street regularly. I certainly do. Pharmacies could conduct NHS health checks with enhanced patient follow-up, and they could use personalised wellbeing plans to help people to make healthy lifestyle choices. Pharmacies could also replicate their success with the flu and covid vaccination programmes by expanding into the provision of others such as the shingles and pneumococcal vaccine and NHS travel vaccinations.

When it comes to what pharmacies can do to improve patient outcomes, the possibilities are endless. I know at first hand that, given the capacity and a good working environment, pharmacists and their teams are ready and willing to take on and promote all those new services, but that has to be put into the context of wider deliverability. Let me use one example. Amanda Pritchard, the NHS chief executive, recently announced funding for high street pharmacies to identify signs of early cancer, and for subsequent referrals and follow-up by clinical radiologists. That is a good initiative. Nonetheless, as Anne Brontë wrote,

“there is always a ‘but’ in this imperfect world”.

Workforce and equipment issues are obstacles to a successful roll-out, given that the radiology system is already under pressure. What about an audit and a replacement programme for our increasingly outdated and, in some cases, obsolete imaging equipment? There are no plans to tackle the annual 7% increase in complex imaging demand and no plan to meet the workforce demand, with a 30% shortfall in clinical consultant radiologists. That figure is going up, and there are backlog issues.

The only question is whether the Government will now enable the community pharmacy sector to fulfil its potential by supporting the range of possible services, and by providing it with appropriate support and funding. I sincerely hope that the answer will be yes.

--- Later in debate ---

[Sir John Hayes (South Holland and The Deepings) (Con)]

I will be mercifully brief, given the overture you have just offered the whole gathering, Sir Gary.

I want to do three things. The first is to endorse the comments of the hon. Member for Bootle (Peter Dowd) about the significance of community pharmacies. As I said in my brief intervention, that was drawn into sharp focus during the covid pandemic, when people began to realise quite the extent to which pharmacies and pharmacists are among the unsung heroes of the NHS. They provide services that are both proactive, in preventive medicine, and also reactive. They are often the first port of call when people seek medical advice.

The second point I want to make is that we should be saying much more about pharmacies. Indeed, it is important that we do, so that people know they can access those services. The point about celebrating the role of community pharmacists is not just to congratulate them on all they do, although that is worthy in and of itself, but to spread the word and evangelise about what they do to people who are not taking advantage of those services. I think particularly of the preventive services that the hon. Gentleman highlighted, which deal with things such as diabetes and blood pressure. We must ensure that there is early detection and diagnosis of conditions, so that people can be referred to other elements of the NHS and dealt with promptly. These are all aspects of the role of pharmacies, which deserve to be better known for the good that they can do.

My third and final point is informed by my visit to Holbeach community pharmacy, where I met staff in anticipation of the consideration of these matters, which I know the House takes seriously. Last week, I also met a pharmacist to discuss what more can be done. As the Government’s long-term health plan says, NHS England and the Government need to work together to see how the advantages of community pharmacies can be cemented and expanded. In saying that, I offer a word of warning: we should not see pharmacies as an alternative to GP services. We are having a debate in the main Chamber—almost as we speak—on those pressures, and I do not think that any of us would want to say that pharmacies should replace GP services. There is an overlap, but they are distinct aspects of healthcare. I know the Minister will want to reflect on that, and perhaps she could comment on it today. That is my caveat, but it is none the less important that the Government and NHS England look at how the services provided by community pharmacies can be cemented and built on.

The secret of this debate, if I may put it that way, can be expressed in two words: “pharmacies” and “community”. These pharmacies must be sufficiently accessible and plentiful—particularly in areas such as the ones that you and I represent, Sir Gary—so that people can gain all the benefits I have described, as close to home as is reasonable. There has been a trend in public services during my lifetime, including my political lifetime, towards centralisation and obliging people to travel further for the things they need to service their wellbeing. It needs to be reversed by the Government, who need to think much harder and more clearly about this issue. We need public services to be accessible to those who need them. That is particularly salient for the most vulnerable of our constituents, who find travelling more challenging.

Let us have more community pharmacies, more distributed services and more cottage hospitals—more things happening within communities. Community is the second part of what the hon. Gentleman has drawn to our attention today. It is the lifeblood of a healthy society that services the wellbeing of all, thereby adding to the common good.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)]

It is a pleasure to serve under your chairmanship, Sir Gary. I thank the hon. Member for Bootle (Peter Dowd) for securing this debate. He is pushing at an open door, as I am a huge supporter of community pharmacists.

The evangelising of my right hon. Friend the Member for South Holland and The Deepings (Sir John Hayes) is definitely working. Community pharmacies are front and centre of the changes we want when developing primary care. Of course, they are already a central part of the NHS, delivering vital primary care services at the heart of every community throughout the country and ensuring that patients have timely access to medicine. That is one of the lesser elements of the services we have talked about, but it is an important element that keeps patients well and out of hospital, enables them to get discharged safely and prevents readmission.

Community pharmacies are offering more services and they are accessible to all. They are key in providing self-care support, thereby allowing individuals to manage their own healthcare needs and, in turn, increasing capacity for the NHS overall. Community pharmacists are an easily accessible and trusted part of the NHS: a team of highly skilled, qualified, experienced healthcare professionals. There are more than 11,000 community pharmacies across England, 80% of which are around a 20-minute walk from most people’s homes. I am committed to making the best possible use of their resources and talent.

As many Members said, we saw the clear difference that community pharmacies made during the covid pandemic. They stepped up to implement a medicines delivery service for shielding and isolating patients. They implemented Pharmacy Collect, making lateral flow tests widely available to the public. At the height of the vaccination programme there were more than 1,500 community pharmacy-led covid vaccination centres. There is no doubt that they stepped up to the mark and showcased what they could offer.

We have a clear vision for community pharmacy. In 2019, we agreed the landmark five-year deal, the community pharmacy contractual framework, which commits to £2.592 billion of funding for the sector. It also sets out a joint vision for the Government, NHS England and the Pharmaceutical Services Negotiating Committee for how pharmacy services will support the delivery of the NHS long-term plan. We are in negotiations for year 4 of that deal, so I am limited in what I can say about the funding, but I can reassure Members that the PSNC is negotiating hard and we want to work with it to expand services. Obviously, it is keen for funding to be attached.

[Sir John Hayes]

It is vital that, as the Minister described, the service is integrated. GPs must continue to offer out-of-hours services, weekend services and, most salient of all, face-to-face encounters with their patients. Services do a great job but that does not mean that GPs should not do all those things.

[Maria Caulfield]

Absolutely—it is not an either/or situation. We have enough capacity and patients to expand community pharmacy services, but that does not mean that we do not also need to support GPs and other primary care providers.

I thank the team at the Department of Health and Social Care; often, their work is not recognised, but they are working hard to develop some of the services that we have talked about. The community pharmacy consultation service went live in November. Patients can dial 111 and be directed to a community pharmacist for help with minor ailments or medication. We have extended that to GP surgeries, so now a receptionist can make an appointment at the local pharmacist for minor illness consultations.

It has been estimated that 20 million appointments in general practice alone do not require a GP—that does not mean we do not need GPs—and pharmacists can look after those conditions. The introduction of the scheme has been slightly slower than we would have liked, so there is work being done to help to overcome some of the barriers to referrals, because once they see their community pharmacists, patients have a positive experience.

In addition, the discharge medicines service enables hospitals to refer discharge patients to community pharmacists for support with their medicine. The evaluation of this service indicates that for every 23 consultations, one readmission is prevented. Where patients are readmitted, their stays are reduced by six days on average, which I think we can all agree is of huge value. We also have the blood pressure check service, which enables people with high blood pressure to be managed by their local community pharmacist, offering blood pressure checks.

We also have the stop smoking service to enable patients who started their stop smoking journey in hospital to continue with a community pharmacist, and we are looking at developing the role of community pharmacy teams, because it is not just the pharmacist who has clinical knowledge and skills. We are working in a number of areas to upskill the whole community pharmacy team so that they can deliver more and use their skills in a better way.

As has been mentioned, we now have NHS Direct cancer referrals, which community pharmacists will be able to take. Just to reassure the hon. Member for Bootle, we have 160 community diagnostic centres, which will be increasing the capacity to do some of those diagnostic tests, and we have already had 1 million visits to those centres. We are not just expecting pharmacists to refer into existing services; we are expanding the routes for diagnosis as well.

My hon. Friend the Member for Southend West (Anna Firth) beautifully told the story of Ask for ANI. It is so vital that a woman can go into a pharmacist, just say those few words and get help—they might not be able to go to a GP practice, because sometimes the help they are asking for might be more obvious.

We also have the minor ailments service, which is being rolled out throughout the country, so pharmacies are delivering more and more. The hon. Member for Coatbridge, Chryston and Bellshill (Steven Bonnar) knows that I am a pharmacy first supporter. I hate to admit it, but Scotland has taken the lead in that, although we are not afraid to learn lessons if that means learning from what Scotland has done.

On the Fuller stocktake and the future of primary care, just to reassure colleagues, we are not just looking at how general practice looks in the future; community pharmacy will also play a key part in that model. With the integrated care system set to go live on 1 July, we are working with those who will be making commissioning decisions in local communities to set out how that future will look.

We are considering all options for community pharmacy and how we build on the progress we have already made. It is important to say that although we have made progress, there is a lot more that can be done. We are developing new standards for the initial education and training of pharmacists, which are set to be implemented shortly, so that from 2026 all newly qualified pharmacists will be able to be independent prescribers—an essential skill that will help to deliver and develop the service further. For those who are not currently prescribers but would like to be, Health Education England is supporting the existing pharmacy workforce to undertake the required training and upskilling, and £15.9 million of funding support has been made available.

We are also looking at the use of patient group directions, because pharmacists have specifically asked for that, so there are a number of measures in place. We are listening to the community pharmacy community, and where we can make changes quickly and easily, we will.

Just to touch on the issue of violence, I want to be really clear that there is zero tolerance for abuse and violence against community pharmacists—and, indeed, against all primary care staff, whether receptionists, GPs or community pharmacists themselves. I also want to put on the record our thanks to the hon. Member for Coventry North West (Taiwo Owatemi) for her work in the NHS as a pharmacist and the experience she has brought to this debate. I reassure hon. Members that we are on a clear journey and we will be supporting community pharmacy going forward.

Cystic Fibrosis: Prescription Charge Exemption

John Hayes Excerpts

Wednesday 2nd February 2022 Westminster Hall

[Sir John Hayes (South Holland and The Deepings) (Con)]

I had not intended to contribute to this debate, Mr Sharma. As you know, because I gave you written notice, I could not be here at the outset and I cannot stay for the end, and it is not conventional to contribute on that basis, so I am grateful for your indulgence in allowing me to do so. I decided to contribute only when I heard the superb speech of my hon. Friend the Member for Ashfield (Lee Anderson), which was both moving and informed by the most intimate personal experience. Sometimes in this place, that inspires us to contribute, and I will briefly say why.

Long before Bob Russell was invented, in the dim and distant past, and before my 19 consecutive years as a Front Bencher, I was a bright-eyed, bushy-tailed Back Bencher, fortunate in the late 1990s to come up in the ballot for private Members' Bills. It was the only private Member’s Bill I have ever had—we cannot have one as Front Benchers, and I have not had one since. I chose to introduce a Bill to do exactly what my hon. Friend the Member for Blackpool North and Cleveleys (Paul Maynard) has requested today, which is to remove prescription charges for those suffering from cystic fibrosis. I did so, believing all that has been said in this debate by all who have contributed.

I went to see the then Labour Minister, a nice man in the House of Lords—Lord Hunt—who was a good, diligent Minister. He gave me a fair hearing as I put the case with all the vehemence but reason that has typified this debate. Unfortunately, I was not able to persuade him, and subsequent Health Ministers have remained unpersuaded. I put the case because I have a personal story too, but it is a story with a less happy ending than that told by my hon. Friend the Member for Ashfield. I had a close friend who suffered from cystic fibrosis, and her experience catalysed my commitment to try to do something about it.

My friend was a very young woman who worked for me when she contracted cystic fibrosis. She had two lung transplants at the Freeman Hospital, in the days when they were an extreme rarity—very few single lung transplants had been done in the early 1990s. She survived them both and did well, got married and had a baby. Later, she was due to be the godmother to my youngest son, who is now 17 years of age. When I asked her to do it, she said, “You know I won’t be around for his 21st birthday.” Sadly, she was not even around for his christening because, as my hon. Friend the Member for Ashfield said, people who have transplants are always likely to die of something other than the condition that originally provoked the transplant. My friend died of cancer in Derbyshire Royal Infirmary when my son was a tiny baby and the day after I had been to see her with the infant in my arms.

Jane, my dear friend, made me know how important this cause is, and made me understand why my hon. Friend the Member for Blackpool North and Cleveleys (Paul Maynard) has done us a great service in bringing it before this Chamber and to the Minister’s attention. Having been a Minister many times—I am sorry to put my hon. Friend the Minister in this position, because he is a personal friend as well as being an hon. Friend—I know that if he were to say today in this debate, “We are going to do this,” it would happen, because in the great scheme of things it is not a huge decision for the Government. But, my goodness, it is an immense one for people such as the wife of my hon. Friend the Member for Ashfield and my late, dear friend. For that reason, I say to the Minister that he should stand up now and say that the Government will consider this or, better still, that they will do it. He would be remembered forever as the Minister who responded to a Westminster Hall debate on the basis of the strength of a cross-party argument that had such weight and substance—such vehemence expressed on behalf of those who suffer—that it persuaded him to act immediately. I hope that he might at least commit to considering this again, because it is a just and worthy cause. So many people would celebrate a small step for the Government, but a huge step for them.

[Mr Virendra Sharma (in the Chair)]

It was the right decision to let you come in. Thank you very much for your contribution.