NHS Dentistry: Rural Areas

Lee Pitcher Excerpts

Tuesday 5th November 2024 Commons Chamber

[Sarah Gibson]

I agree that a timeline for reforming the dental contract is vital; that is what I am asking for. If we lose this opportunity and our NHS dentists leave the system, we will be in an increasingly difficult place. Across Wiltshire, for those not already registered with an NHS dentist, it is absolutely impossible to get one. There is not a single practice taking on NHS patients right across the unitary authority of Wiltshire, despite its size.

[Lee Pitcher (Doncaster East and the Isle of Axholme) (Lab)]

The number of dentists is obviously extremely important, but that is just part of what goes into the equation. In rural constituencies such as mine, access to healthcare services is heavily dependent on frequent, reliable services—in particular, bus services. Does the hon. Lady agree that if people are to access dental services, we need to ensure that those reliable, frequent public services are back in place?

[Sarah Gibson]

As I am sure the hon. Member will remember, I have already mentioned the serious issue of public transport in rural areas on several occasions. I could not agree with him more.

I thank the House once again for allowing me to make the case for improved NHS dental care, and I implore the Minister and his colleagues to do the right thing by my constituents and those of the Members who have intervened, in order to support dental care, specifically in rural areas.

Oral Answers to Questions

Lee Pitcher Excerpts

Tuesday 15th October 2024 Commons Chamber

[Lee Pitcher (Doncaster East and the Isle of Axholme) (Lab)]

9. What assessment his Department has made of the effectiveness of the NHS dental contracting framework.

[The Minister for Care (Stephen Kinnock)]

I pay tribute to my hon. Friend for the excellent work he does for the people of Doncaster East and the Isle of Axholme. The scale of the problem that he points out is massive. One of the most shocking statistics I have discovered since taking up this position is that the most common reason for children aged five to nine being admitted to hospital is tooth decay. That is completely and utterly shocking—truly Dickensian. We cannot fix the matter overnight, but we are committed to reforming the dental contract and working with the British Dental Association to focus on prevention and on the retention of NHS dentists. We are also working at pace to ensure that patients can access an additional 700,000 urgent dental appointments.

[Lee Pitcher]

The horror stories I hear in my constituency are just awful: from the mum on the Isle of Axholme who could not find an NHS dentist after five years and who carries out her own treatment on her son, to a gentleman in Doncaster East whose teeth are crumbling due to illness, causing him horrendous pain, and who cannot get an appointment. The Government’s pledge to provide more emergency appointments is great, but I know that it will take time to rebuild dentistry. Can the Minister reassure me that people in my constituency will be given the priority they deserve?

[Stephen Kinnock]

My hon. Friend is right. South Yorkshire has the highest level of hospital tooth extractions in England, and I want to assure him that we will target interventions at the areas of greatest need. For example, integrated care boards have started to advertise roles through our “golden hello” scheme, which will drive recruitment of graduate dentists to areas of greatest need for three years. We have inherited a mess and we are working at pace to clear it up.

Mental Health Support

Lee Pitcher Excerpts

Thursday 10th October 2024 Westminster Hall

[Dr Spencer]

My hon. Friend is absolutely right to point out that, sadly, suicide is the No.1 cause of death among young men. My understanding, although the stats change all the time, is that below the age of 45, suicide is the No.1 cause of death among both men and women. It is absolutely right that we look at sex-specific approaches to intervention. Factors affecting health in men will be different from factors affecting health in women.

I want to go back to the social elements of mental health care, which the hon. Member for Ashford mentioned, and a smoke-free society and banning tobacco. Certainly when I was practising, 50% of tobacco was consumed by people with a severe mental illness. That raises a whole host of concerns and issues about what is happening with tobacco consumption and people with a mental disorder.

My hon. Friend the Member for Hinckley and Bosworth (Dr Evans) was absolutely right, given his experience, about something he has mentioned many times in the House: the importance of delineating mental wellbeing and mental illness. I tend to think about it in this way: we all have mental health, but we need to separate mental wellbeing from mental illness. The two are different and need different approaches, as was echoed by my right hon. Friend the Member for Salisbury (John Glen) and the new hon. Member for Stroud (Dr Opher), who gave rise to a very fertile discussion on his views on the area. The hon. Member for Leicester South (Shockat Adam), who is no longer in his place, rightly pointed out inequalities in detention and outcomes for those from minority ethnic backgrounds. That is a very important issue.

That brings me on to our record in Government over the past 14 years; there are a few things I want to pick out. One is that we set parity of esteem in law through the Health and Social Care Act 2012, which was a big step forward. We still need parity of esteem in outcomes, but nevertheless that was a very important step. We expanded access to psychological therapies and I am particularly pleased by the expansion of individual placement and support, which has been shown to help people get into work, particularly those with a chronic and enduring mental illness. We have seen more people take up maternity care, and we also invested in the mental health estate.

In fact, in my own constituency, we have a new mental health hospital. The Abraham Cowley Unit is being rebuilt, which will provide world-class care for people living in my patch. Perhaps most important of all, given the conversation that we have had today, is the decrease in in-patient and out-patient suicide that we have seen over the years. Of course, I recognise that there are a variety of factors driving that but we should be pleased that things are moving in the right direction on suicides, although there is more to be done.

Today is World Mental Health day and it is a very broad topic, but in my time I would like to focus specifically on one area that, as it certainly was in my former career, is often neglected—psychosis. It particularly affects people suffering from schizophrenia or bipolar affective disorder. It can be a very disabling illness and has been responsible for quite a degree of disability and health concern in the UK. Often debates such as these, and debates in the media, do not focus on psychosis and I think a big part of that comes from the stigma attached to it. People who work in the sector, and those with expertise here, will know that it is an area of great need both in terms of community mental health teams and in-patient settings. The hon. Member for Stroud was absolutely right and I am glad he pointed this out: the 10 to 15 years of life lost following a diagnosis of psychosis is something that we have to fix.

I believe that we also need to improve access to treatments such as clozapine, which is an excellent treatment for schizophrenia. I am pleased to have previously worked with Clozapine Support Group UK in its campaign to try to get more access to clozapine for people for whom it is indicated. We have also seen the reform of the Mental Health Act 1983, which the former Prime Minister Theresa May kicked off with the Wessely review. I was part of the working groups on the Wessely review, particularly looking at helping with the tribunal system, and I was on the pre-legislative scrutiny committee as well. How we look after people detained for treatment in the absence of consent is very important, and I am pleased that this Government have committed to take forward the work on reviewing that Act.

I thank everyone who works in the care and treatment of people with mental illness. As we have heard today, that is a very broad sector; it is not only people who work in the NHS but those who work in the third sector in a variety of organisations and institutions. That is very important work.

[Lee Pitcher (Doncaster East and the Isle of Axholme) (Lab)]

Will the hon. Member give way?

[Dr Spencer]

Very briefly—I have only a couple of minutes left.

[Lee Pitcher]

My cousin died from suicide two years ago. We have talked about a lot of facts and figures today, and we have talked a bit about heart, but I can absolutely tell the hon. Member that a family never recovers from that. My auntie and uncle will never recover from the fact that they lost their child before they themselves went.

All a person can do in that situation is put their energy into something positive, and that is about how to help people going forwards. One of the big things is absolutely those charities that support people, such as the Jackson Hope Foundation. I have gone along and spoken there myself even this last Friday, and I talked about some of my experiences in Parliament really openly and freely. It is a safe place. There are 16 men there talking unbelievably openly about how they feel, and it makes such a difference. I want to ensure that going forwards, whatever we do, learning from those groups feeds into our plans and strategies because it makes all the difference to people.

[Dr Spencer]

I thank the hon. Gentleman for sharing something so personal in his intervention, and for sharing his experience of the impact of suicide. Many Members have shared personal experience in this debate. That is very important.

I am mindful that there will be people in the Gallery or watching at home who may be affected by the topics we are discussing, and I take a moment to point out that there are a variety of services to help people in their recovery, if one can call it that, after a loved one has tragically died from suicide, or to help people who are in crisis, such as local crisis services, the Samaritans or Mind. There is a variety of third sector and charity helplines that can help. Men’s Sheds is one organisation I know of that is very helpful. I am really pleased that the hon. Gentleman raised this issue.

I will finish with a few questions for the Minister. The Government do not have a mental health care and treatment strategy or a psychosis strategy and, following an answer to a written parliamentary question I tabled, I understand that there are no plans for a mental ill health strategy to be brought in. Given today’s debate, I wonder whether the Minister will reconsider that position. What are the Government’s plans on taking forward our suicide prevention strategy, or a specific psychosis or mental ill health strategy—however he wants to cut the cloth?

Secondly, when does he expect the Mental Health Bill to have its First Reading in this place? All Members are going to want to extensively debate and scrutinise that Bill. When does he expect it to come forward? What is his appraisal of the challenges that the Bill needs to answer when it comes to the interaction between the Mental Health Act 1983 and the Mental Capacity Act 2005 and the deprivation of liberty safeguards? What about the MM case on deprivation of liberty in the context of a restricted patient in the community, and the interaction with the Children’s Act 1989 on when children can choose a nominated representative? I realise he may not have the answers to that immediately, but I would be grateful if he could write to me. Community mental health teams are the core of psychiatric teams in the community and our psychiatric care and treatment service. What is his plan to support them?

Finally, what is his appraisal of integrated care systems and their commissioning of mental health services? The hon. Member for Hastings and Rye (Helena Dollimore) mentioned the challenges with her ICS. What is the Minister’s appraisal of that commissioning and how integrated care systems can be held to account to make sure that is being delivered?