Children’s Oral Health

Judith Cummins Excerpts

Tuesday 31st October 2017 Westminster Hall

[Judith Cummins (Bradford South) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Bone. I recently led a well-attended Adjournment debate on the growing crisis in NHS dentistry, and I was encouraged that that critical topic received such wide-spread support. I thank my hon. Friend the Member for Birmingham, Selly Oak (Steve McCabe) for securing this important debate.

I believe that momentum is building for a change in Government oral health policy. The injustices in child oral and dental health provision deserve greater prominence in debates about this country’s faltering health services. For too long, oral and dental health has been overshadowed by understandable concerns about other areas of the NHS, but addressing wider issues in our NHS should not mean that we forget to take action elsewhere. For too long, oral and dental health has been the Cinderella service of our NHS. That must end.

During my Adjournment debate, I spent considerable time setting out the growing crisis in NHS dentistry for our children and young people. I highlighted the BBC’s recent investigation, which laid bare the scale of the challenges. Shockingly, two in five of the 2,500 dental practices registered on the NHS Choices website were unwilling to accept children as new patients.

NHS treatment is so important. For our children and young people, it can be life-defining. It can be a springboard to a life marked by enduring oral health and wellbeing. It can be the bedrock of successful, healthy and prosperous lives through childhood and into old age.

The unnecessary financial cost of our children’s poor oral health to the NHS is staggering. At a time of huge pressure on our NHS, the Government are wasting a forecast £50 million each year on tooth extractions for our children and young people. The average cost of a tooth extraction is £834. Last year alone, almost 40,000 children were admitted to hospital for multiple tooth extractions, which is shocking as it is an entirely preventable condition. Sadly, that situation is getting worse and tooth extractions are up by 25% in recent years. Across the country, tooth decay is the No. 1 reason for children being admitted to hospital.

Following my Adjournment debate, I was grateful to meet the Minister. I felt that we had a constructive meeting and that there was a good chance that at least some progress would be made to improve the availability of NHS dentistry in my constituency and the surrounding areas, where the need is so clear. Three weeks on from that meeting, however, and some six months on from the conclusion of an NHS pilot in Bradford designed to improve the availability of NHS dentists to the people I represent, I am still waiting to see the official assessment of the pilot.

I asked about the report on the pilot in a recent written question, and yet it remains elusive. I suspect that the official report remains so because it confirms more than a few inconvenient truths: that the take-up of the additional NHS dentistry appointments under the pilot was overwhelming—I understand from the previous Minister that take-up was 92%, even on an unadvertised pilot—and that there is therefore overwhelming evidence that NHS dentistry provision in my constituency is abysmal and requires a huge funding uplift. Indeed, a freedom of information request submitted to the Bradford hospitals trust revealed that, in the short period of April to December 2016, 190 of our children were admitted to hospital to undergo multiple tooth extractions.

I ask the Minister again to reflect on such disturbing figures and, as I have his attention, I reiterate my request that he shares with me the official assessment of the recent pilot in Bradford as a matter of urgency. Once again, therefore—twice in a few short months—I am urging the Government to act, because each year 40,000 of our children are undergoing multiple tooth extractions in our overstretched NHS. I urge the Minister to take action; it is long overdue, and inaction is not an option. Our children and young people frankly deserve better.

Social Care

Judith Cummins Excerpts

Wednesday 25th October 2017 Commons Chamber

[Jackie Doyle-Price]

The hon. Gentleman raises an extremely important point that I am actively thinking about. He is absolutely right in the sense that providers have been following guidance that has changed. It is clear from our perspective that employers are obliged to meet their obligations under minimum wage legislation, but I am very clear on the challenge that that is giving to the sector, and we will work with it to develop a solution.

Turning to the substance of the motion, we announced in the Queen’s Speech that we will work to address the challenges of social care for our ageing population and bring forward proposals for consultation to build widespread support for future provision.

[Judith Cummins (Bradford South) (Lab)]

At least 60% of those receiving social care in the home and 70% of those in care homes are people living with dementia. The underfunding of social care has meant that the burden falls disproportionately on those people. Does the Minister agree that whatever the system of social care provided, it is unacceptable that those living with dementia, and their families, should be disproportionately affected?

[Jackie Doyle-Price]

I invite the House to reflect on what the hon. Lady has said, because that is exactly the issue that we really need to tackle. One in 10 people face very significant costs that they have to meet from their own resources, with only 14,000 ultimately protected. She is right to point out that the vast majority of those people are suffering with dementia and Alzheimer’s. We have now reached a time when it is critical that we have a consensus on the future funding of social care so that we can address the injustice that she has very ably highlighted.

Access to NHS Dentists

Judith Cummins Excerpts

Tuesday 12th September 2017 Commons Chamber

[Judith Cummins (Bradford South) (Lab)]

In today’s NHS, the word “crisis” is sadly all too commonplace. Week in, week out, crisis grips our NHS. We see it played out across our front pages: in our money-strapped and creaking social care system, in our overflowing A&Es, and in the ever longer delays in accessing even basic procedures such as knee and hip replacements. For health professionals right across this country, it must be beyond frustrating that where the Government are concerned, it takes nothing less than a full-blown crisis before a Minister is willing to sit up and take notice.

What we see unfolding in NHS dental practices in communities right across this country is yet another crisis. The British Dental Association agrees. A BBC investigation last week revealed that of 2,500 dental practices listed on the NHS Choices website, half were not willing to accept new adult NHS patients—half of all practices.

[Paula Sherriff (Dewsbury) (Lab)]

I have raised with the Minister and his predecessors for over two years now the terrible dental services in Dewsbury, and we have not yet reached any resolution. Does my hon. Friend agree that while looking at this issue we must try to achieve a resolution for the whole of West Yorkshire?

[Judith Cummins]

Absolutely.

More disturbingly, 40% of practices were unwilling to take children as NHS patients. Millions of people each and every year are being left without access to an NHS dentist. The human cost of this crisis is huge. Families, parents and young children are suffering horrific, lifelong and extreme damage to their teeth and to their oral health. Stories of people resorting to pulling out their own teeth are increasingly commonplace. Images of young children—toddlers—with mouths full of rotten teeth are less and less of a rarity.

[Tracy Brabin (Batley and Spen) (Lab/Co-op)]

Does my hon. Friend agree that it is deeply worrying that 29% of five-year-olds in Kirklees have decayed, missing or filled teeth, and that in March 2017 NHS Digital told us that one in three children in Kirklees have not seen an NHS dentist for the past 12 months?

[Judith Cummins]

I certainly do. I thank my hon. Friend for that intervention.

The physical damage is visible—it is easily understood—but just focusing on this physical damage would be to underestimate what we are facing in this country. Much of the damage is much less visible, as it is emotional, psychological and hidden beneath the surface, with a generation hobbled by insecurity and embarrassment. At a time when mental health parity receives the personal endorsement of the Prime Minister, I despair that so many, mainly young people, are facing emotional disorders for an entirely preventable reason.

It is difficult enough for adults left with irreparable damage, but when our children and young people are left embarrassed, deeply under-confident and self-conscious, the true scale of what is happening reveals itself.

[Dr Philippa Whitford (Central Ayrshire) (SNP)]

Is not the underlying problem that there is no preventive dental contract in England? That means that people are going when they are in crisis and dentists are unwilling to take them on. England needs something like the Scottish Childsmile scheme, which takes children right through childhood.

[Judith Cummins]

I thank the hon. Lady for that intervention.

As children and young people are starting off in life, with their careers, social lives, and everything else ahead of them, they are being left damaged for entirely avoidable reasons. Sadly, identifying a crisis in our health services is not a rarity, but what we see in this crisis is that it is unfairly hitting the least affluent the hardest—those who are struggling to make ends meet, and those living in working-class areas.

The BBC interviewed a Bradford resident, Nazreen Akhtar, a mother of two children. She said it had taken her five years to find a dentist who would accept both her children.

[Imran Hussain (Bradford East) (Lab)]

My hon. Friend will be aware that in Bradford 40% of people do not have an NHS dentist. Many of them have applied unsuccessfully. Does she agree that it is unacceptable that only one in 20 practices has its doors open to new patients?

[Judith Cummins]

It is an absolute disgrace.

In the meantime, Ms Akhtar’s son had suffered chronic pain. His adult teeth had grown over the top of his milk teeth. I can only imagine the distress in having to watch your child facing chronic pain day in, day out, powerless and abandoned.

Low-income families face a double whammy: they are unable to find local NHS dentists with open lists, and more to the point, they are unable to afford the high cost of private treatment. That double whammy has left working-class areas hardest hit. Over the past seven years, the Government’s unspoken policy has been to force dental practices to rely increasingly on patient fees, and, more insidiously, to force dental practices to rely even more on patients who pay privately. Revenue from patient charges has grown by 66% over the last decade and totalled £783 million in 2016-17. Meanwhile, direct state investment has been in steady decline.

The British Dental Association analysis also reveals that the Government have only commissioned enough dentistry to treat around half the adult population. That is an absolute disgrace.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Lady on securing this debate. Does she feel that the Minister and the Government should set aside the idea of patients per practice and set extra money aside so that more dentists can take on more patients?

[Judith Cummins]

I absolutely do.

Dental practices in working-class areas, facing spiralling overheads and a decline in their income, are struggling to stay afloat. In better-off areas, dental practices have been able to cushion themselves through extra revenue from privately paying patients. That extra income makes a difference. In working-class areas, the realities of life are hugely different. After many families have paid their rent or mortgage, covered day-to-day essentials and put food on the table, a visit to the dentist has now become one of life’s luxuries.

Research by the BDA supports that idea. Figures reveal that four in 10 patients have delayed a dental check-up because of fears about the high cost of treatment. That is understandable when we realise that the patient charge for treatment in the highest band—such as crowns or bridges—is £244.30. Working-class people, such as those in Bradford, are being hit the hardest. They have been abandoned by the Government, and they suffer failing oral health and chronic pain day in, day out. Worst of all, they are powerless to do anything about it because they find it difficult to access an NHS dentist. There is a clear human cost of poor dental health, which affects every part of a person’s day-to-day life.

The BBC spoke to a Mr Oldroyd during their investigations. Mr Oldroyd, a middle-aged man, has been trying to find an NHS dentist for four long years, during which he had suffered from chronic pain caused by his terrible tooth decay. He told reporters:

“The state of my teeth has made me depressed and I’ve literally begged to be taken on by an NHS dentist, but every time I’ve been turned away.”

Mr Oldroyd told reporters that his pain became so unbearable that, in the end, he resorted to self-extraction. He pulled out his own teeth. This is simply unthinkable. Mr Oldroyd believes that his poor dental health has contributed to him being out of work. As he puts it:

“The tops of my teeth are gone. I’m on benefits and trying to get a job, and when someone sees my teeth they just think I’m another waster.”

This crisis has been a long time in the coming. It has not crept up on the Government; it has been visible and in plain sight. The Government were put on notice when they came to power in 2010. There have been repeated warnings from dental professionals working in the sector, from within Parliament, and from the British Dental Association. All have warned that inaction is not an option, but sadly that is what we have seen.

It was not long ago that I, and many other Members, spent the afternoon right here in the Chamber in a Back-Bench business debate about health inequalities. During my remarks I set out a number of simple, uncontroversial steps that promised to improve access to NHS dentistry. First among those steps was to expedite reform of the NHS dental contract. Time and again when challenged about the reform of this contract, the Government have done little more than lay the blame at the door of the previous Labour Government. With respect, if that excuse was ever persuasive, it is now threadbare following seven years of a Conservative Government, two Conservative Prime Ministers and three general elections.

Reform of the contract is critical, as it promises to spend taxpayers’ money more effectively. The current dysfunctional contract sets quotas on patient numbers, fails to incentivise preventive work, including effective public information campaigns, and implicitly places an ever-growing reliance on dental practices to pursue private charging as a means of staying afloat. This Government are forcing dentists to make a terrible decision: either to stop providing NHS services altogether and go private, disregarding those who have less ability to pay, or to provide overstretched NHS dental treatment to their patients—or a combination of the both. That is a toxic choice for the dental profession.

Since first being elected in 2015, I have campaigned for more funding for Bradford. The city has among the worst oral health outcomes in the country, despite the hard work of local public health officials. We have received additional funding, to the credit of the previous Minister, the right hon. Member for North East Bedfordshire (Alistair Burt), but frustratingly this was only temporary. Despite my efforts, the Government still have not announced whether any permanent funding will be put in place. That is simply unacceptable. Official figures reveal that a five-year-old in Bradford is four and a half times more likely to suffer from tooth decay than a child in the Health Secretary’s constituency of South West Surrey. According to figures, a third of children in Bradford have not seen a dentist for more than two years. Children should be given a check-up every six months.

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

Will the hon. Lady give way?

[Judith Cummins]

I am really sorry; I cannot give way because of the time.

One of the most shocking figures reveals that the number of children admitted to hospital for tooth extractions has risen by a quarter over the past four years. Some may think that tooth extraction is simply a part of growing up—a rite of passage for children. Some may recount their own personal memories of visiting the dentist. If anyone still holds that sentimental view, they should pause for a moment and rethink. The tooth extractions I am speaking of, which have gone up by a quarter in the last four years, mostly involve a general anaesthetic. A recent freedom of information request to Bradford hospitals sets out the scale of the crisis. In the short period from April to December 2016, 190 children were admitted to hospital to undergo a tooth extraction under general anaesthetic. What was also shocking about this request was the hospital’s admission that those figures were not available prior to April 2016. The hospital did not consider that the procedure warranted reporting.

[Dr Whitford]

Will the hon. Lady give way?

[Judith Cummins]

I am sorry, I do not have time.

One core theme that emerges time and again, as borne out by Bradford hospitals’ admission, is that the Government are paralysed by inaction when it comes to oral health and NHS dentistry. They are indifferent towards even the simple task of requiring a countrywide collection of the most basic statistics on how many children are being subjected to the dangers of general anaesthetic. Time and again, the only sensible conclusion that can be drawn is that this Government are paralysed by inaction. Oral health and dentistry services truly are the Cinderella service of our NHS.

Across our country, tooth decay remains the leading reason for hospital admissions among young children, despite being almost completely preventable. The Government should be ashamed of the fact that almost 40,000 children were admitted to hospital to have multiple teeth extracted under a general anaesthetic because of tooth decay in the last year alone. On the Department of Health’s own figures, the average cost of a tooth extraction is £834. Overall, the NHS is calculated to have wasted more than £50 million on tooth extractions. This crisis is wasting the NHS millions upon millions of pounds each and every year in tooth extractions for our children. As the saying goes, prevention is better than cure. That was never truer than in oral and dental health. The Government should be ashamed of the fact that, on their watch, tooth extractions are up by 25%. It is beyond doubt that that £50 million would be better spent on prevention activities. Spending the money in that way would free up scarce NHS time and limited beds, while saving tens of thousands of our children from the trauma of hospital admission and general anaesthesia.

I want to touch upon the real scandal at the heart of those 40,000 hospital admissions. NHS dental treatment is free for our children and young people. Every child and young person should be receiving good quality NHS dental treatment, but recent figures published by the Royal College of Surgeons faculty of dental surgery reveal that 42% of children did not visit an NHS dentist in the year prior to 30 June 2017, and a staggering 80% of children between the ages of one and two did not visit a dentist at all. That may perplex some Members. Why are so many of our children and young people not receiving the treatment that they are freely entitled to access under our NHS? A recent survey published by the BDA reveals the truth. The survey found that 25% of parents did not know that routine dental check-ups were free for their children. More to the point, seven in 10 parents were not aware that treatment for their children would also be free of charge.

In theory and in name, we operate an NHS dental system for our children and young people—one that is based on need, not on ability to pay. It is free at the point of need and free at the point of delivery. In reality, however, when seven in 10 parents are not aware that treatment for their children is free; and when, on the ground, 40% of NHS dentists are unwilling to take on children as new NHS patients, I ask this question: can we really say with any certainty that we continue to operate a free NHS dental system for our children in this country? Is it not true that, following seven years of inaction, the Government have, de facto, displaced our NHS dental system with a burgeoning private system?

Although the working class are, beyond doubt, being hit the hardest, the crisis in dentistry transcends social class, ethnicity and age. Although the people in my home city of Bradford are being hit hard by the lack of access to an NHS dentist, evidence from the profession, patients and the British dental association makes it clear that the crisis is a national one, which is hitting all areas of this country. Therefore, I ask the Government to get on with dental contract reform and, more broadly, to bring forward a coherent strategy to tackle the inadequacies and inequalities I have set out this evening. Indifference is not an option; Government need to act now to stop this crisis.

Health and Social Care

Judith Cummins Excerpts

Monday 27th February 2017 Commons Chamber

[Judith Cummins (Bradford South) (Lab)]

It is a pleasure to follow my hon. Friend the Member for Bristol South (Karin Smyth). We are here to debate the financial sustainability of the health and adult social care sectors. Although health and adult social care are almost inseparable, I will focus on adult social care for brevity’s sake.

Although the acute care and adult social care sectors face similar unprecedented pressures, adult social care is different in one important way. Unlike the NHS, which has the ear of the Chancellor and the Treasury, adult social care certainly does not. All the evidence in recent months has served only to confirm that. The Chancellor’s decision not to make one extra penny of new money available in his autumn statement was met with almost universal criticism from across the health and local government sectors, and his recent decision to introduce the adult social care precept is damning evidence that a desperately outdated view of funding remains strong in the Treasury.

Adult social care is delivered locally by local authorities, so the Chancellor views its funding as a locally devolved issue. The Government’s decision to pass the blame to local councils and to underfund adult social care is nothing short of moral cowardice. They are deliberately underfunding adult social care in my home city of Bradford.

What is most desperate is the Government’s abandonment of the hundreds of thousands of older and vulnerable people who are reliant on vital adult social care services, day in, day out. We are talking not about hypotheticals but about the care happening today, right now. Real people are struggling to get by in my constituency of Bradford South. Bradford is a relatively young city; nevertheless, the number of people in Bradford over the age of 65 has grown substantially. Between 2012 and 2015, an extra 4,500 people were living in the district, and the number of people in Bradford with complex physical disabilities has grown by 400.

My local council, Bradford Council, agreed its budget last Thursday. Like many others, it had the task of agreeing swingeing cuts to scores of community services. In recent years, it has reduced its budget by more than £218 million, and a further £82 million in cuts will have to be made by 2020. Adult social care, as the biggest service overseen by Bradford Council, faces the lion’s share of the looming budget cuts. A further £19 million of cuts will fall on the city’s adult social care sector. The Government are washing their hands of any responsibility. By 2020, the revenue support grant, which is the primary source of central Government funding to Bradford Council, will drop to zero—zilch; absolutely nothing.

The Government’s half-baked answer is the adult social care precept. In the next two years, the precept is expected to raise an extra £6.6 million in Bradford, but that extra money is dwarfed by the huge cuts to Bradford Council’s revenue support grant. More to the point, the extra £6.6 million is not even enough to meet the increased cost of adult social care that will flow from the Government’s so-called national living wage. Because of the unprecedented increase in demand, such bruising budget cuts are only the tip of the funding shortfall. It is expected that the cost of supporting increasing numbers of older people, coupled with larger numbers of working-age people living with disabilities, will mean Bradford Council will have to shoulder an extra £1.5 million, each and every year.

[Maggie Throup]

Will the hon. Lady give way?

[Judith Cummins]

I am nearly at the end of my remarks, and the hon. Lady has had her turn to speak.

What is beyond doubt is that the Chancellor must act in the upcoming Budget. He faces his greatest test in this Parliament. I hope that he and his Government do not disappoint. Time will tell.

Reducing Health Inequality

Judith Cummins Excerpts

Thursday 24th November 2016 Commons Chamber

[Judith Cummins (Bradford South) (Lab)]

Thank you, Mr Deputy Speaker, for calling me to speak in this important and, in my opinion, overdue debate. I thank the Chair of the Health Committee, the hon. Member for Totnes (Dr Wollaston), for initiating it, and I thank the Backbench Business Committee for allowing time for it.

I want to focus on an area of health inequality that receives disproportionately less funding than most others and, sadly, far less attention from Ministers than it is due. I am, of course, talking about dental and oral health inequality. Most people, when asked to describe what health inequality looks like in this country, would cite difficulties in seeing a GP, long waiting lists for treatment for common ailments, and the rationing of licensed drugs for those suffering from treatable diseases. I could, of course, go on. Most, however, would not immediately cite dental and oral health, although inequality in that area is just as widespread throughout the country as the many other important inequalities that Members have rightly highlighted today.

Let me underline my point by sharing with the House some unsettling figures that have caused me, as a Bradford Member, more than a few sleepless nights. Official figures reveal that five-year-old children in Bradford are four and a half times more likely to suffer from tooth decay than their peers in the Health Secretary’s constituency of South West Surrey. The number of children admitted to hospital for tooth extractions—they usually require a general anaesthetic—has risen by a quarter over the past four years. Shockingly, during the past year 667 children in Bradford alone have spent time in hospital for that entirely avoidable reason.

[Maggie Throup]

As someone who was born in Bradford, I can proudly say that, even at my age, I have only one filling. As with obesity, dental problems are often due to a lack of parental responsibility as well as environmental factors.

--- Later in debate ---

[Judith Cummins]

That is an interesting point. I shall deal with some of those issues later in my speech.

According to the latest figures, 32% of children in Bradford—nearly a third—have not seen a dentist for more than two years. Ideally, as Members will know, children should be given a check-up every six months.

Dental and oral health has been and continues to be the Cinderella of health service provision. It is seen as being “nice to have”—to be tackled once the good ship NHS has returned to calmer waters—and due for its much-needed extra funding only when the financial black holes elsewhere in the NHS have been plugged. Such inequality in dental and oral health is plain wrong. It is an unspoken injustice in today’s society, and the task of tackling it cannot and should not be kicked down the road like the proverbial can year after year.

Tooth decay is an almost entirely preventable disease. It is a scandal, without exaggeration, that tooth decay is the No. 1 reason for hospital admissions of children between the ages of five and nine. It is a scandal not only because it causes our children needless pain and suffering, but because, in this time of austerity, it wastes countless millions in NHS resources. However, its impact goes much deeper than that.

In an increasingly globalised and competitive world in which our children are expected to succeed at school, improve their skills and excel in internationally benchmarked exams, they all need to be healthy and energised to face the school day. Too often, however, pain arising from poor oral and dental health hinders their school readiness, impairs their nutrition and growth, and cripples their ability to thrive, develop and socialise with each other. A recent survey sadly confirmed that more than a quarter of our young people feel too embarrassed to smile or laugh due to the condition of their teeth. For our teenagers, the injustice is no less when they need to succeed and make their way in a competitive job market.

[Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

In my constituency, I can tell the extent of someone’s poverty by the state of their teeth, so not only is there the issue of decay, but this is about not having the money to be able to get the necessary treatment—perhaps cosmetic treatment—which can then lead to embarrassment and a loss of confidence.

[Judith Cummins]

I thank my hon. Friend for making that valid and important point.

Disproportionate levels of poor oral and dental health, predominantly in deprived, low-income areas such as those in Bradford, hamper these young people from forging their careers. Survey after survey confirms that young people who suffer from poor dental and oral health face poorer job prospects. Dental and oral health plays, rightly or wrongly, an important part in selling ourselves in today’s competitive job market.

I have set out the depressing scale of the challenge, but what can we do—or, perhaps more accurately, what can and should this Government be doing—to tackle this scandalous health inequality? As I highlighted to the former Prime Minister Mr Cameron, when I challenged him about this inequality in my constituency and city, there are some simple steps that can be taken. The first of them is due to be implemented in the foreseeable future: a tax on sugary drinks. Although the Government’s final proposal was very much weaker than it should have been, it was nevertheless very much a welcome step in the right direction.

The Royal College of Surgeons faculty of dental surgery, a professional body that sees dental inequalities first hand in its day-to-day work, suggests a number of low-cost, easily deliverable measures that could readily be adopted by Government: tightening restrictions on advertising high-sugar products on television, for example by restricting advertisements before the 9 pm watershed; limiting price promotions in supermarkets for high-sugar foods and drinks, and excluding these products from point-of-sale locations such as checkouts and counters; and, most sensibly, limiting the availability of high-sugar foods and drinks in our school system.

Perhaps the most important measure that the Government could implement, as highlighted by the British Dental Association, would be to expedite changes to the current dental contract. Critical changes are long overdue, the first of which would be to incentivise preventive work through the contract. The second, and most important, would be to incentivise the dental profession to establish new practices in deprived areas. Such areas desperately need practices as people there typically face the least availability.

In my constituency, despite need being so high, there is a shameful shortfall of NHS dentist appointments. Very few NHS dentists have open lists, meaning that most people in search of dental treatment simply give up, and those who are determined end up finding a dentist outside the city boundaries. Surely that is not right. I understand that the Government hope to begin rolling out a reformed dental contract from 2018-19 onwards, but that simply is not soon enough.

I finish by asking a simple question: is it just and equitable that five-year-old children in Bradford, my home city, are four and a half times more likely to suffer from tooth decay than their peers in the South West Surrey constituency of the Health Secretary? I hope that the House agrees that the answer is no.

Dementia and Alzheimer’s Disease

Judith Cummins Excerpts

Tuesday 12th April 2016 Westminster Hall

[Judith Cummins (Bradford South) (Lab)]

Thank you, Mr Stringer, for allowing me the opportunity to speak in this very important debate. It is a pleasure to serve under your chairmanship.

I congratulate the hon. Member for Strangford (Jim Shannon) on securing the debate. I also congratulate the Bradford District Care NHS Foundation Trust on winning a national gold award for its work in the state-of-the-art dementia assessment unit at Lynfield Mount hospital.

The 850,000 people living with dementia today deserve to be properly supported to live dignified lives, but worryingly an Alzheimer’s Society poll found that 90% of people suffering from dementia felt that the support they received after diagnosis was inadequate, and 73% of GPs—the medical practitioners who arguably are on the front line in managing dementia in our communities—believe that our health and social care system is confusing for people with dementia and, importantly, their carers. As a society, we need to support dementia sufferers soon after diagnosis, so that they are properly prepared to manage their symptoms, especially as the symptoms will worsen as the illness progresses. They are best placed to plan and prepare their affairs, but they must be helped to do that. At present, those suffering from dementia are not properly supported by the Government.

As a society, we should also be supporting the legion of selfless carers across the country, who contribute £11.6 billion to the UK economy each year through that unpaid caring. Often, carers feel unsupported and isolated. We must ask ourselves as a society whether it is fair that those carers, contributing £11.6 billion in unpaid service each year, are allowed to feel unsupported and isolated.

That prompts the question: what more should the Government be doing? We are fortunate that there is no need to reinvent the wheel. An initiative run by the Alzheimer’s Society is already being piloted in communities. The carer information and support programme is aimed at family members and friends after a relative has been diagnosed with dementia. It involves attending information sessions in a group environment. The Prime Minister’s commitment, as shown by the “Prime Minister’s challenge on dementia 2020”, is commendable, and I am happy to place on the record my support, but the target date of 2019-20 is simply not ambitious enough. I therefore call on the Minister to commit in her remarks to exploring what extra funding can be made available now, not in 2019-20, to support the roll-out of the carer information and support programme to communities across our country.

National Minimum Wage: Care Sector

Judith Cummins Excerpts

Wednesday 23rd March 2016 Westminster Hall

[Judith Cummins (Bradford South) (Lab)]

It is an honour to serve under your chairmanship, Mr Rosindell. I, too, thank my hon. Friend the Member for Sheffield Central (Paul Blomfield) for securing this important debate.

As has been spelt out in the Budget debates over the past few days, the Tory Government’s stated goal is to make work pay, so I will spend a few moments examining their record, given that we are considering the 1.5 million care workers who day in, day out, do noble work caring for our elderly and disabled population.

A March 2014 National Audit Office report found that an astonishing 220,000 home care workers are paid less than the national minimum wage. The main reason that so many care workers fail to receive the national minimum wage is that, despite resounding court judgments declaring this practice illegal, hundreds of thousands of workers are still not paid for the time they spend travelling between visits. They are, disturbingly, only paid for the time that they spend with their clients. That would be unacceptable in any other line of work, but, quite wrongly, it is still common practice in the care industry. As a matter of decency, care companies should meet the amount that Parliament has legislated for as the minimum that workers should receive in their pay packet. Each and every worker should not fear that, at the end of the working week, their employer has short-changed them. The national minimum wage is simply not happening in our care industry, and that is a national scandal.

The Tory Government need to step up and take action to ensure fairness in our care sector. Thankfully, under the national minimum wage legislation brought in under a Labour Government, the Tory Government have inherited the necessary powers to take much needed and long-overdue action. To be specific, under section 12 of the National Minimum Wage Act, care providers as employers can be required to supply a written statement to each care worker, in which they should clearly set out the amount that the worker is being paid, the hours worked, and how that means that the employer is not short-changing them. With that in mind, I ask the Minister to commit to exploring the potential for introducing regulations under section 12.

At present, the work of many hundreds of thousands of care workers simply does not pay. They are still not guaranteed a national minimum wage. They are simply being short-changed, and that scandal must not continue.