Oral Answers to Questions
Lindsay Hoyle Excerpts(2 days, 17 hours ago)
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Wes Streeting
General practice is a valued part of the NHS, and GPs are a vital part of our NHS family. In fact, they are delivering more appointments than ever before, and we recognise the significant pressures they face. At the same time, we know that patients are struggling to see their GP, which is why we have invested an additional £82 million into the ARRS to recruit 1,000 more newly qualified GPs this year. This will take pressure off general practice, and we will be announcing further budget allocations in the not-too-distant future to set out what further support we will provide for general practice.
Wes Streeting
The hon. Gentleman is right. Last weekend, I was up in Middlesbrough with local Members, where we saw a great example of hospital at home delivered by the community nursing team and the community health trust. We have to do a lot more in that space to ensure we provide care closer to peoples’ homes—indeed, often in the home—keeping them out of hospital and close to home, which is better for them and better value for the taxpayer.
Dr Luke Evans (Hinckley and Bosworth) (Con)
The Royal College of General Practitioners has said the national insurance tax increase is expected to cost 2.2 million appointments. We know from answers to written questions that have been submitted that GPs, hospices and care homes are not exempt from the increases, and will not find out until April what, if any, mitigation will be put in place, so cutbacks are now being planned. Will the Secretary of State explain how his choice to tax GPs will increase GP access?
Wes Streeting
Again, we have not yet announced how we are allocating the budget for the year ahead, but I remind the Conservatives that it is thanks to the choices the Chancellor made in her Budget that she is able to invest £26 billion in health and social care. Would they cut the £26 billion this Labour Government are investing in the NHS? If not, how would they pay for it? Welcome to opposition.
Helen Morgan (North Shropshire) (LD)
Hospices provide essential care for people at the most difficult point of their life, and they are usually only partially funded by the NHS. Hospice UK says that real-terms funding has fallen by £47 million since 2022, and hospices are struggling with this hike in national insurance contributions. Hope House children’s hospice in North Shropshire estimates that it will cost £178,000. Will the Secretary of State commit to either exempting hospices from the NICs increase or ensure that they are funded to cover those additional costs?
Wes Streeting
I am grateful to the Liberal Democrat spokesperson for her question. I pay tribute to the children’s hospice in her constituency and, indeed, to Haven House children’s hospice, which serves my constituency.
Wes Streeting
And indeed your very own local hospice, Mr Speaker—I am sure that will appear on the record. I am particularly thankful for the advocacy we have received from Hospice UK and charities such as Together for Short Lives and others that are making their voices heard about the pressures on the system. I say to all hospices across the country that I am taking those pressures into account before deciding allocations for the year ahead, because I want to ensure that everyone, whatever their age, receives access to the timely and good-quality end of life care, palliative care and, of course, support for people with life-limiting conditions that all of them deserve.
The Secretary of State for Health and Social Care (Wes Streeting)
Before the election, we made it clear that investment and reform were needed in the NHS. The Chancellor announced the investment in the Budget, and since the general election we have confirmed the introduction of new league tables of NHS providers, with high-performing providers being given greater freedom over funding and flexibility. We are sending turnaround teams into struggling hospitals, giving the best performers greater freedoms over funding to modernise technology and equipment. We are creating a new college of executive and clinical leadership that will help to attract, keep and support the best NHS leaders. We are banning NHS trusts from using agencies to hire temporary entry-level workers in bands 2 and 3, such as healthcare assistants and domestic support workers. We are sending crack teams of top clinicians to areas with long waiting lists and high economic inactivity to improve the productivity of their clinics, and we are running a GP red tape challenge to slash bureaucracy. I could go on, because this is a Government who are walking the talk on NHS reform.
Tristan Osborne
I wish my right hon. Friend would go on. Irresponsible promises were made by the Opposition about capital investment in hospitals and elective surgeries across the country, including in the three Medway constituencies. Will my right hon. Friend meet me and my hon. Friends the Members for Rochester and Strood (Lauren Edwards) and for Gillingham and Rainham (Naushabah Khan) to discuss the much-needed NHS investment in our area?
Wes Streeting
I know, not least because of the mismanagement of the NHS during the last 14 years, that communities right across the country, including the hon. Gentleman’s constituents in Solihull, are struggling with poor services and crumbling estates. We would be happy to receive representations from him, but he has to level with his constituents. If he wants money to be spent in his community, he must support the investment and be honest about the fact that he supports the means of raising it. If he does not support the means of raising it, he should tell us where that investment would come from.
Mr Speaker
We have been very slow to get to topicals, so let us see if we can speed it up. Dan Tomlinson will set a good example.
Dan Tomlinson (Chipping Barnet) (Lab)
Wes Streeting
I am grateful to my hon. Friend for his question. The Royal Free hospital saved my life when I went through kidney cancer, so it holds a special place in my heart. Thanks to the Chancellor’s decision and the investment she put into the NHS at the Budget, and the reform my Department is delivering, we will deliver the change and improvement that his constituents and mine, and the rest of the country, deserve.
Edward Argar (Melton and Syston) (Con)
The Secretary of State knows that every year, irrespective of which party is in government, winter is challenging for the NHS. Possibly, it will be all the more so this year with the potential impact on older people’s health of the loss of the winter fuel allowance by many. What winter preparedness steps has he taken, like previous Governments, to increase A&E capacity and to increase the number of beds this winter, and can he say by how many?
The Minister for Secondary Care (Karin Smyth)
The Department has been working with suppliers of medicines used to treat ADHD to seek commitments from them to address the issues, expedite deliveries and boost supplies. We are working with NHS England to approve the modelling for industry and communications regarding ADHD medicine supply issues. We will continue to engage with industry to address the remaining issues as quickly as possible.
Helen Morgan (North Shropshire) (LD)
The Conservatives’ disastrous legacy on dentistry means that more than 4.4 million children have not seen a dentist in the past year. In Shropshire, dentists continue to hand back their contracts, including one in Wem in recent weeks. Will the Minister outline his plan to reverse that terrible decline and ensure that the issue is addressed in rural areas where there are dental deserts?
National Insurance Contributions: Healthcare
Lindsay Hoyle Excerpts(1 week ago)
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Alison Bennett (Mid Sussex) (LD)
The increase in employer national insurance contributions will erode the very investment in the NHS that the Budget sought to prioritise. Katie, a GP from Lindfield in Mid Sussex, wrote to me saying that the NICs increases
“serve to directly undermine access and patient care.”
The Government have promised to recruit more GPs, but hiking national insurance puts that pledge in jeopardy. Surgeries are set to see eye-watering increases in staff costs, equivalent to 26,786 appointments in West Sussex alone. GPs will have no choice but to cut services and staff numbers, and patients will pay the price.
Does the Minister agree that stronger primary care, with faster appointments and fewer people having to go to hospital, is better for both the NHS and patients? If so, will she protect services and press the Chancellor to end this GP penalty?
Karin Smyth
I respect my hon. Friend’s expertise in this area. She is right, and we understand that the pressures are real, which is why we have committed to supporting the NHS and the social care system with the additional funding that my right hon. Friend the Secretary of State for Health and Social Care secured as part of the Budget settlement.
We are also working closely with the NHS, in a new relationship, to understand its needs. That is a dynamic conversation, because we want to understand what is happening in local systems as we continue to invest in them.
Sir Edward Leigh (Gainsborough) (Con)
We all know that a lot of the debate on assisted dying revolves around the lack of hospice places to help people pass in the best way possible. Similarly, much of the debate on the NHS is about the lack of care home spaces. Leaving aside the cross-party name-calling, may I beg the Minister to consider exempting hospices and care homes from this national insurance increase?
Mr Speaker
Order! The shadow Minister has been granted an urgent question. He asks the questions; he does not answer them from the Front Bench.
Karl Turner
Does the Minister agree that it is also disappointing that the Opposition ignore the fact that they completely disregarded and ignored social care when they were in office?
Karin Smyth
Well, I do agree with my hon. Friend. As I have said, when I became a Member of Parliament in 2015, I remember very clearly the absolute shock that I felt when the Conservatives immediately announced that they were not going to meet the commitment that they had made to implement the Care Act 2014 at that time, and we are still playing catch-up on that issue.
Oral Answers to Questions
Lindsay Hoyle Excerpts(1 month, 1 week ago)
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Stephen Kinnock
That is an extremely important question. I recognise that dementia is a huge issue that impacts on the entire country and, indeed, many Members on both sides of the House. We are absolutely committed to the research that is fundamental to addressing the problem, and our fair pay agreement is about not just pay but training and terms and conditions. We will be ramping up dementia training for our adult social care workforce.
Sir John Whittingdale (Maldon) (Con)
The Labour manifesto spoke of the need for a consensus on social care, and the Secretary of State has said that he wants to reach out across the political divide—although the message does not seem quite to have reached the Minister yet. During Health and Social Care questions in July, the Minister said that there would be announcements in the near future, but since then we have heard nothing. We are ready to talk; when will the Government be ready?
Wes Streeting
I am grateful to my hon. Friend for raising that question. When in opposition, I was delighted to spend time with a whole group of GPs from across Sheffield who showed us what primary care reform could look like. We are committed to increasing primary care as a proportion of the NHS’s budget, which will be important, and also to building exactly the kind of neighbourhood health service she describes, with more care closer to people’s homes. General practice has a key role to play in that.
Layla Moran (Oxford West and Abingdon) (LD)
What we measure is often what we end up improving, and one of the great assets of Lord Darzi’s report is the technical annex with its 330 analyses. It is incredibly useful; it is a baseline. Will the Secretary of State make sure that it is updated yearly?
Wes Streeting
That is a great constructive challenge. I am absolutely committed to transparency and to keeping that dataset updated in the way that the hon. Lady requests. We are not going to get everything right and sometimes we are not going to make progress as fast as we would like, but where that is the case we are never going to duck it or pretend that things are better than they are. The reason that we will succeed where the previous Government failed is that we are willing to face up to the challenges in the NHS rather than pretend that they do not exist.
Dr Ben Spencer (Runnymede and Weybridge) (Con)
The Prime Minister has repeatedly stressed the importance of preventing people from taking up smoking, as one of his priorities to improve the nation’s health, reduce waiting lists and lessen demand on the NHS, and we agree. The Government like to talk about the record of their first 100 days in office but, according to data from Action on Smoking and Health, 280 children under the age of 16 take up smoking in England each day. That is 28,000 children in England during the Secretary of State’s first 100 days. Why has he not yet reintroduced our Tobacco and Vapes Bill? How many children need to take up smoking before he makes this a priority?
Wes Streeting
Perhaps the shadow Minister would like to give us the figures for the entire 14 years that his party was in government. By the way, just to set the record straight, not only did I propose the measures in that Bill during an interview with The Times earlier last year, but if it was such a priority for the Opposition, why did they leave the Bill unfinished? Why had it only had its Second Reading? And why did we go into the general election with that Bill unpassed? I will tell him why: because his party was divided on the issue, and the then Prime Minister was too weak to stand up to his own right-wingers who are now calling the shots in his party. The smoking Bill will be back, it will be stronger and, unlike the previous Government, we will deliver it.
Helen Morgan (North Shropshire) (LD)
My constituent Mel Lycett has terminal cancer. After repeated visits to her GP, she was referred to a two-week urgent pathway in May. She was not diagnosed until the end of July, and she still has not started treatment. Every single target for her diagnosis and treatment was missed. That is not uncommon in Shropshire, and it is not uncommon in the rest of the country. Can the Secretary of State reassure me of what he is doing to deal with this terrible legacy left behind by the Conservative Government? How will he ensure that cancer patients are treated in a timely manner?
Seamus Logan (Aberdeenshire North and Moray East) (SNP)
I appreciate that the Secretary of State is unlikely to comment on the Chancellor’s forthcoming statement, but he and his Front-Bench colleagues have already mentioned funding issues a number of times this morning, so will he confirm that it is the policy of his Government to take steps to increase the UK’s health spending to the average of other countries in north-west Europe? That would lead to an increase of around £17 billion for the national health service and would help address some of the issues referred to by the hon. Member for Paisley and Renfrewshire South (Johanna Baxter).
Mr Speaker
Order. Questions ought to be linked to the subject being dealt with, which is access to primary care. I am sure that the hon. Gentleman meant to ask, “Will there also be funding to improve access to primary care?”, which I am sure the Minister can answer.
Andrew Gwynne
This Labour Government were elected to tackle health inequalities, fix our NHS and ensure that more people live longer, healthier lives. That will require a concerted Government effort, which is why we have the health mission board in place. My right hon. Friend the Secretary of State is making the case for investment and reform at every opportunity, but let us be clear: every single Labour Government have left the country with a better NHS than they inherited, and this Labour Government will fix our NHS once more.
Wes Streeting
My hon. Friend is absolutely right. This is about not just the necessary hospital projects, but the growth that will come through construction, getting these projects up and running and, of course, the role that the NHS plays as an economic anchor institution in communities, as some of these projects will necessarily unlock new housing sites and a local transport infrastructure. We are mindful of all of that. The most important thing is that we come forward with a timetable that is credible and a programme that is funded, and that is exactly what we will do.
Michelle Scrogham (Barrow and Furness) (Lab)
Wes Streeting
I am sorry for my hon. Friend’s constituents, and so many others who are dealing with the consequences of the Conservatives’ failure on dentistry. I would be delighted to meet him to discuss the challenges in his area.
Victoria Atkins (Louth and Horncastle) (Con)
I congratulate all nominees and winners in the NHS parliamentary awards yesterday. Their success was richly deserved, and the awards were a very good example of the House coming together to celebrate those who work so hard in our health service and social care services.
In the past five weeks, I have asked the Secretary of State 29 questions at this Dispatch Box, yet he has managed to answer only one. For the rest, he has tried to bluster his way out of his policy decisions, as we have seen this morning. Let us try again. When will be the first week in which we see delivery of his promised 40,000 more appointments?
Victoria Atkins
After 14 years of opposition—two and a half of which the Secretary of State spent on the Front Bench and travelling around the world, funded by other Governments, to look at their healthcare systems—and more than 100 days in government, the right hon. Gentleman does not even know the start date of his own flagship policy. He is no Action Man; he is Anchorman.
Let us deal with Labour’s cruel decision to slash winter fuel payments, which will add pressure not only to patients, but to the NHS. The NHS’s deputy chief operating officer—
Mr Speaker
Order. I have got a lot of people to get in. Members on both Front Benches must be quicker.
Victoria Atkins
After Labour’s cruel decision to slash winter fuel payments, which will add pressure to the NHS, its deputy chief operating officer warned that this winter our health service will not have the extra capacity or funding that it needs, which the Conservatives had previously provided. Why has the Secretary of State—
Mr Speaker
Order. I gave the right hon. Lady a hint to come to an end and not to carry on fully. It is unfair to Back Benchers, who I am trying to represent. I want a short answer.
Wes Streeting
The shadow Secretary of State questions the budget for this winter, but it was set by her Government. Is that finally an admission of failure on her part? Something else that we will have this winter, which we did not have last winter or the previous winter is no—
Lola McEvoy (Darlington) (Lab)
The Minister for Care (Stephen Kinnock)
By cutting mental health waiting lists and intervening earlier, we can get this country back to health and back to work. There are 2.9 million people who are economically inactive, a large proportion owing to mental health issues. Many people can be helped back into work through talking therapies. We will put a mental health professional in every school and roll out 8,500 specialists. I would be happy to meet my hon. Friend to discuss the matter further.
NHS: Independent Investigation
Lindsay Hoyle Excerpts(2 months, 1 week ago)
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Mims Davies (East Grinstead and Uckfield) (Con)
On a point of order, Mr Speaker.
Mr Speaker
How long has the hon. Member been here? Points of order come at the end—you cannot intervene in the middle of these proceedings.
I call the shadow Secretary of State.
Victoria Atkins (Louth and Horncastle) (Con)
Thank you, Mr Speaker. I thank the Secretary of State for advance notice of his statement.
The NHS belongs to us all, and we all care about it, so let us stop the political posturing and talk constructively about its future. We all know that our healthcare system faces significant pressures, as do all health systems around the world. We are living longer, and with multiple and complex conditions. We have wider societal pressures, such as the impact of social media on the development of some young minds, as well as the cost pressures of miracle drugs developed by our world-class life sciences sector for their treatment benefits, and the shock of the pandemic has had catastrophic impacts on the NHS and its productivity.
I believe there is much to be proud of in the NHS. Its dedicated staff look after 1.6 million people a day— 25% more people than in 2010. It has more doctors, more nurses and more investment that at any point in its history. It is delivering tens of millions more out-patient appointments, diagnostic tests and procedures for patients than in 2010, and we delivered the fastest roll-out of vaccinations for covid in the world, freeing our society more quickly than other countries. We have more healthcare in the community, with the opening of 160 community diagnostic centres—the largest central cash investment in MRI and CT scanning capacity in the history of the NHS—and 15 new surgical hubs; and the launch of Pharmacy First, helping to free up 10 million GP appointments for those living with more complex conditions. [Interruption.] I say to the Secretary of State that I paid him the courtesy of listening to him in silence, so I hope he will do the same for me.
Victoria Atkins
The right hon. Gentleman was chuntering from a sedentary position. We on the—[Interruption.]
Mr Speaker
Order. I want to hear the right hon. Lady, and Members’ constituents want to know what is being said. Please, let us give the same courtesies that I expected for the Secretary of State.
Victoria Atkins
Thank you, Mr Speaker.
We on the Conservative Benches never pretended that everything was fixed. We have not pretended that we have a monopoly on wisdom or that there are easy answers to the difficult challenges we face. For the NHS to thrive in its next 75 years, it needs to reform, modernise and improve productivity. That is why the Conservative Government, working with NHS England, announced the NHS productivity plan at the spring Budget to transform how the NHS works through better IT systems for frontline staff, the expansion of services on the NHS app, which is used by three out of four adults in England, and the use of new technology, including voice-activated artificial intelligence. Together, that would see productivity grow by 2% a year by the end of the decade and unlock £35 billion-worth of savings, yet the plan is not mentioned in the 163-page report. Why is such an important and forward-looking reform missing from the report, and can the right hon. Gentleman confirm that he is choosing to cancel it—yes or no?
New medicines and trials are an essential part of the productivity challenge. There is only one mention of the National Institute for Health and Care Excellence in the 163-page report. Do the Government have a strategy for life sciences and the provision of rare medicines, including cancer and dementia drugs? Why have they paused the childhood cancer taskforce?
The need for reform was also why we implemented the first ever long-term workforce plan with NHS England to train even more doctors, nurses, midwives and other healthcare staff for the future. The plan was described by the NHS CEO Amanda Pritchard as
“one of the most seminal moments in our 75-year history”,
yet it is not mentioned in today’s report. Again, why is such an important and forward-looking reform missing from the report? Is the right hon. Gentleman going to cancel the new places and forms of training, including apprenticeships, that were to be provided through that plan?
The need to modernise is why, in 2019, we announced the largest programme of hospital building in modern history: 40 new hospitals across England by 2030 [Interruption.] I would be careful if I were some Back-Bench MPs. Today, seven new hospitals have opened, the Midland Metropolitan university hospital will open at the end of the year—I imagine the Secretary of State will enjoy going to its launch—and a further 18 are in construction. We are not even halfway through the decade.
Since January 2023, it has been Labour’s plan to pause, review, delay and, presumably, possibly cancel those new hospitals. That was when it published its health mission; it is on page 6 for those who have not read it. In other words, it was always Labour’s plan to delay and possibly cancel the new hospitals, and it has nothing to do with the Chancellor’s questionable accounting since the general election.
When that was pointed out in the general election campaign, Labour candidates ran around promising voters that their new hospital or community diagnostic centre was safe with them—in Torbay, Chelsea and Fulham, Basingstoke, Watford, Bracknell, Truro, Corby and Kettering to name a few. Will the right hon. Gentleman confirm that Labour will delay those hospitals?
Mr Speaker
Order. It is difficult, but the time limit is supposed to be five minutes, and it has now been six minutes 22 seconds, so we are well over. Can you now conclude on that sentence?
Victoria Atkins
Thank you, Mr Speaker.
There is one part of Great Britain where, on almost every measure, the NHS performs the worst: Labour-run Wales. The right hon. Gentleman has compared—
Mr Speaker
Order. I am sorry; I meant that you were to conclude now, not to continue with the rest of the speech. I call the Secretary of State.
Wes Streeting
The first word that the shadow Secretary of State for Health and Social Care should have said was “sorry”. She says that she never pretended everything was fixed, and that is true, but it is about time that she admitted that it was her party that broke the NHS in the first place.
In fact, it has been a feature of debate in the House since the general election that the Opposition have taken absolutely no responsibility for the mess they left our country in, including a £22 billion black hole and the new hospitals programme that the right hon. Lady referred to, in which the timetables were a work of fiction and the money ran out in March. She knew that when she went to the country to claim that the programme was fully funded. She talks about the decisions made by NICE; that was a new Labour reform and modernisation—one that thankfully survived the last 14 years.
The right hon. Lady has endorsed the right hon. Member for Newark (Robert Jenrick) in the Conservative party leadership election. I wonder what she makes of his admission that the Conservatives failed to make the tough reforms that the NHS needed because they were afraid of what Labour might say. Is that not the most derisory excuse for 14 years of neglect?
My predecessor does not bear responsibility for everything in the Darzi report—this crisis was more than a decade in the making—but I wonder when the right hon. Lady will show some humility on behalf of her party and apologise for the mess that her Government made of our national health service. Otherwise, why should anyone trust what the Conservatives have to say ever again?
This Government were given a mandate for change, and nowhere is that more needed than in our NHS. The report must mark the beginning of the long, hard work of change. It is the platform from which we will launch a decade of reform that will make sure that the NHS can be there for us when we need it—for us, our children and our grandchildren. It must draw a line in the sand, so that we never go back to the pain, fear and misery that the Conservative party inflicted on millions of patients.
Several hon. Members rose—
Mr Speaker
This statement will run for an hour, so please help each other. Let us try Clive Efford as a good example.
Clive Efford (Eltham and Chislehurst) (Lab)
Thank you, Mr Speaker. I will rise to the challenge.
I welcome the Secretary of State’s statement. In 2008, the previous Labour Government commissioned a report from Sir Michael Marmot on the state of society and health, and he found that there was health inequality, particularly in deprived areas. Ten years on, his second report found that health inequality had become even worse against the backdrop of an underfunded NHS. Does that not demonstrate the urgency of the need to invest in those communities under this Government? What can my right hon. Friend do to direct resources into the most deprived communities in order to turn around those health inequalities?
Wes Streeting
My hon. Friend is absolutely right that our country has stark health inequalities. It is not right that people who live in different parts of the country have such different chances of living well. A girl born in Blackpool can expect to live healthily until she is 54, whereas a girl born in Winchester can expect to live healthily until she is 66. That is why, with the Prime Minister’s mission-driven approach, we will not just get our NHS back on its feet and make sure it is fit for the future; we will also reduce the cost and burden of demand on our national health service by attacking the social determinants of ill health.
Daisy Cooper (St Albans) (LD)
Much of the content of Lord Darzi’s report has been known for some years. None the less, today’s report is a scathing summary of the complete devastation that the Conservatives have wrought on our health services and on the health of our communities. We Liberal Democrats have long argued that we need to shift healthcare from hospitals to high streets, and from treatment to prevention, because doing so improves health outcomes and saves taxpayers’ money. It is a win-win.
But the report is long on diagnosis and short on prescription, so may I invite Ministers to read our fully costed manifesto to fix public health and primary care by recruiting 8,000 GPs, ending dental deserts, boosting public health grants by £1 million, implementing our five-year plan to boost cancer survival rates, and putting a mental health expert in every school?
Does the Secretary of State accept that there is an elephant in the room: social care? Will he meet me to discuss the Liberal Democrat plans for social care, starting with free personal care? This bold idea would prevent many people from going into hospital in the first place, as well as enabling them to be discharged from hospital faster. Does he accept that it is a truth universally acknowledged that we cannot fix the NHS if we do not fix social care too?
As for the dire state of our hospitals and primary care estate, well, the Conservatives have left it to fester like a wound. Will the Secretary of State give the green light to hospitals that are ready to rebuild, such as mine in west Hertfordshire? Will Ministers look to reform outdated Treasury rules that are preventing our integrated care boards and hospital trusts from spending and investing their funds in the GP practices and hospitals that we need? This Government say that they want growth. Well, health and wealth are two sides of the same coin, which is something the Conservatives do not understand. If Labour wants economic growth, fixing our health and social care must be its top priority. And it must be a priority without delay.
Oral Answers to Questions
Lindsay Hoyle Excerpts(4 months ago)
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Wes Streeting
I welcome the hon. Member to the House—it is a rare thing to welcome new Conservative Members, and he is welcome. He is absolutely right to touch on the workforce issues in NHS dentistry, and to say that we need to incentivise dentists, on two fronts: we need them to commit to and do more work in the NHS—we are looking at a range of things in that regard—and we need to ensure that we get more dentists to the areas in which they are most needed. We will certainly support incentives to that effect.
Saqib Bhatti (Meriden and Solihull East) (Con)
I welcome the right hon. Member and his new team to their places in the Department. The shadow Secretary of State, my right hon. Friend the Member for Louth and Horncastle (Victoria Atkins), prioritised access to care, including NHS dentistry, when she was Secretary of State. The dental recovery plan that she launched announced new dental vans to provide access to care to our most rural communities and coastal communities in England. We had agreed with NHS England that the first vans would be on the road by this autumn, and I know that that timescale was welcomed by colleagues across the House. Will he confirm that dental vans will be on the road by this autumn?
Dr Ben Spencer (Runnymede and Weybridge) (Con)
May I congratulate those on the Government Front Bench on their appointments? I should declare that I am a former NHS consultant psychiatrist, my wife is an NHS doctor and I participated in the Wessely Mental Health Act review. While I no longer have a licence to practise, I may gently correct the Minister in that it is possible to provide a prescription without a diagnosis. [Laughter.]
The Opposition are pleased that the Government intend to build on the work of Conservative Governments, kick-started by the former Member for Maidenhead, to reform the Mental Health Act 1983. We will work constructively with them to make such legislation as effective, fair and compassionate as possible. With that in mind, does the Minister intend to make changes to the code of practice to the Mental Health Act now so that non-statutory changes and protections can be enacted while the Bill works its way through Parliament?
Cat Smith
Lancaster’s royal infirmary is at capacity. It is a Victorian hospital, and I am sure it was cutting-edge back then, but it is now not fit for purpose. Yesterday, the joint investment strategic committee expressed its support for the new build scheme in Lancaster, so it will soon be on the Secretary of State’s desk. Will my right hon. Friend commit to meeting me and other interested local MPs in north Lancashire to ensure that, after 14 years of chaos under the Conservatives, the Labour Government will deliver a new hospital for Lancaster?
Wes Streeting
I was about to say, Mr Speaker, that the good people of Lancaster and Wyre will be delighted to have sent my hon. Friend to Parliament, because she is second only to you in collaring me about a local hospital project—you are the holder of that record. There is a serious point: thanks to her determined efforts to collar me around the parliamentary estate, I know the particular urgency around land. A scheme will be put to me shortly, which I will consider carefully, and I will look at the programme in the round and ensure that I am able to come back to this House and to the country with promises that we can keep and that the country can afford.
Wes Streeting
Hospitals with reinforced autoclaved aerated concrete are at the top of my list of priorities. I am extremely concerned about the dire state of the NHS estate. Once again, I think that is a bit rich from Opposition Members, whose party was in government only weeks ago. They had a Prime Minister local to that hospital, and they did not do anything when they had the chance, but they should not worry—we will clean up their mess.
Dr Caroline Johnson (Sleaford and North Hykeham) (Con)
I congratulate the right hon. Gentleman on his position. I should declare that I have been working in the NHS for 23 years, currently as an NHS consultant paediatrician. I look forward to using that experience in my new role as shadow Minister of State to scrutinise the Government constructively.
Under the new hospital programme, the previous Government had already opened six hospitals to patients, with two more due to open this financial year and 18 under construction. The Government are now putting that at risk by launching a review of that work, delaying those projects, which are vital to patients across the country. Could the right hon. Member please confirm when the review will be completed?
Wes Streeting
First, I welcome the hon. Lady to her new post. I must say I preferred her much more as a Back-Bench rebel than a Front-Bench spokesperson, but I have enormous respect for her years of contribution to the NHS and the experience that she brings to this House. I always take her seriously.
However, on this one, once again I say to the Opposition that they handed over an entirely fictional timetable and an unfunded programme. The hon. Lady might not know because she was not there immediately prior to the election, but the shadow Secretary of State, who is sitting right next to her, knows exactly where the bodies are buried in the Department, where the unexploded bombs are, and exactly the degree to which this timetable and the funding were not as set out by the previous Government.
Daisy Cooper (St Albans) (LD)
I welcome the Secretary of State and his Ministers to their roles, but let me gently warn him that if he intends to run a contest on which Member can harangue him the most on crumbling hospitals, our 72 Liberal Democrat MPs say, “Challenge accepted.”
Under the Conservatives, the new hospital programme ground to a halt. We know the terrible stories of nurses running bucket rotas and all the rest. We have the worst of all worlds at the moment: trusts such as mine in west Hertfordshire are champing at the bit to get going but cannot, and are being held back. Other trusts have capital funds that they want to spend but are not allowed to because of outdated rules, and there are industry concerns that the one, top-down, centralised approach of the Conservatives could decimate competition in that industry, when we need a thriving industry to rebuild our hospitals and primary care. What is the Secretary of State’s response to that approach?
Andrew Gwynne
I welcome the hon. Gentleman back to the House, but I politely say to him that he needs to be a little bit patient. There will be some announcements in the near future on this Government’s plans for social care. He should rest assured that we on the Labour Benches understand the integration agenda. We understand the need to fix both the NHS and social care, and this Labour Government will do that.
Sir John Whittingdale (Maldon) (Con)
I congratulate the Minister and his Front-Bench colleagues on their appointments. I welcome the suggestion that the Government are considering the possibility of a royal commission on social care and intend to address the issue on a cross-party basis, but that will take time. Can the Minister therefore confirm that, as was suggested during the election campaign, the Government will take forward the Dilnot reforms, and in particular that they will introduce a cap on social care costs, as was planned by the previous Government?
Andrew Gwynne
It was, of course, the right hon. Gentleman’s Government who kicked the can down the road on these issues. They allowed the system to spend the transformation money that had been provided precisely for the purpose of the Dilnot reforms on fixing their broken national health service. He should just be a little bit patient, as we will announce our proposals for social care shortly. He should rest assured that, as I have said to him before, this Labour Government are determined to fix both the broken NHS and the broken social care system that we inherited from 14 years of Tory failure.
Daisy Cooper (St Albans) (LD)
The Liberal Democrats spoke about care a great deal during the general election campaign. At the heart of our plans was our pledge to introduce free personal care. Will Ministers please confirm whether they intend to open cross-party talks and, if so, whether free personal care will be on the table as one potential option?
Wes Streeting
I am delighted to see my hon. Friend back in the House. She campaigns relentlessly on this vital issue, and it would be very risky for me to do anything other than agree to meet her, because I share her view that progress needs to be made on it.
Victoria Atkins (Louth and Horncastle) (Con)
May I welcome the Secretary of State and his ministerial team to their places, and wish them well in their endeavours? With your indulgence, Mr Speaker, I should also place on the record my thanks to my superb team of former Ministers, to those in the private office and to officials in the Department for their hard work and support, as well as thanking the doctors, nurses and social care and health professionals with whom I have had the pleasure of working.
Now, to business. In opposition, the Secretary of State described the 35% pay rise demand by the junior doctors committee as “reasonable’. What he did not tell the public was that this single trade union demand would cost an additional £3 billion, let alone the impact on other public sector workers. Will he ask the Chancellor to raise taxes, or will she ask him to cut patient services to pay for it?
Wes Streeting
Obviously, there is a judicial review of the former Secretary of State’s decision, which I am defending. The matter is sub judice, so I will steer clear of it.
To go back to first principles, we are wholeheartedly committed to the full implementation of the Cass review, which will deliver material improvements in the wellbeing, safety and dignity of trans people of all ages. I think that is important. I want to reassure LGBT+ communities across the country, particularly the trans community, that this Government seek a very different relationship with them. I look at the rising hate crime statistics and trans people’s struggles to access healthcare, and I look at their desire to live freely, equally and with dignity. That is what we will work with them to deliver.
Mr Speaker
Order. I understand that today is a new start with Question Time, but we have to be short and speedy. That is the whole idea of oral questions, because otherwise Members are not going to get in.
Satvir Kaur (Southampton Test) (Lab)
Oral Answers to Questions
Lindsay Hoyle Excerpts(7 months ago)
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Andrew Stephenson
I would be very happy to meet my hon. Friend to discuss the issue.
Wes Streeting (Ilford North) (Lab)
Happy St George’s day, Mr Speaker.
Westminster is awash with rumours that the Prime Minister will call a July general election, presumably to avoid giving his Rwanda gimmick the time to fail. I have a very simple question for the Minister: will he repeat the pledge that the Prime Minister made last year and promise that NHS waiting lists will be lower at the time of the general election than when the Prime Minister came to office?
Dame Andrea Leadsom
It is fantastic that hard-working GPs have delivered 60 million more appointments a year than in 2019. That is a credit to their efforts. The Government have undertaken a wide range of approaches to try to reduce the administrative burden. We are focused on trying to deal with some of the issues that GPs have raised with me about the primary and secondary care interface so that they do not have to write all the fit notes and liaise with consultants. We have also spent more than £200 million on digital telephony. Importantly, the additional roles reimbursement scheme has added more than 36,000 more professional staff, from physios to pharmacists to those in GP practices, to try to support patient access.
Preet Kaur Gill (Birmingham, Edgbaston) (Lab/Co-op)
At the last general election, the Government promised to deliver 6,000 more GPs by 2024-25, but there are still 2,000 fewer GPs than in 2015. Part of the problem is that morale has plummeted in the past decade, meaning that experienced family doctors and newly qualified GPs are hanging up their stethoscopes. What does the Minister say after scrapping two GP retention schemes last month? Will she come clean today about another broken manifesto promise?
Andrew Stephenson
The hon. Member raises a very important point. Obesity is linked to many health conditions, including type 2 diabetes. We are delivering an ambitious programme of work to create a healthy environment to support people in achieving and maintaining a healthy weight. This includes restricting the placements of less healthy products in shops and online, calorie labelling on food sold in restaurants and a tax on the sugary drinks industry, which has removed the equivalent of 45,000 tonnes of sugar from soft drinks.
Victoria Atkins
My right hon. Friend makes an important point. The purpose of the levelling-up fund is to help local areas to address what they need locally, rather than respond to diktat from central London. I encourage her to work closely, as I know she will, with local agencies, the council and others making those important decisions, so that their levelling-up announcements include health, as an integral part of her mission to improve the lives of her constituents.
Andrew Gwynne (Denton and Reddish) (Lab)
Back in the real world, the record of the last Labour Government is that we increased life expectancy by three years. Under this Government, it has stalled for the first time in a century, with people in Blackpool, for example, expected to live four and a half years less than the national average. Is the Secretary of State proud of this shocking record, or will people have to wait to elect Chris Webb in Blackpool South and a Labour Government at Westminster to finally turn the tide on health inequalities?
Victoria Atkins
As the hon. Lady will know—she saw the statistics published very recently—we are in fact treating more people at earlier stages of their cancer. I want to take on her point about gynaecological waits, because that is important. We are spending more than £8 billion in this spending review period on additional elective activity, and investing in additional capacity, including community diagnostic centres and surgical hubs, many of which provide gynaecological tests and procedures. She may have missed it, but the latest published management information for March shows that the longest waits for gynaecology services have reduced by nearly 95% since their peak in September 2021. Of course there is more to do, but we are making progress. I thank all the doctors and teams who are involved in that important work.
Preet Kaur Gill (Birmingham, Edgbaston) (Lab/Co-op)
Today, we have seen alarming figures pointing to the systematic de-prioritisation of women’s health, with 600,000 women in England waiting for gynaecological treatment, 33,000 women waiting more than a year, and under two thirds of eligible women screened for breast cancer in the last three years. Will the Secretary of State come clean and admit that under this Government, women’s health has become an afterthought?
Victoria Atkins
I dispute the 17-year figure, as it can vary across innovations. The figure is contested, but my hon. Friend raises an important point. We have a plan to prioritise the acceleration of patient access, thereby ensuring safe, effective and innovative medical technology for patients and the NHS. Our ambition is backed by funding, and we are reforming the medical technology regulatory framework, introducing the innovative devices access pathway pilot and launching frameworks to increase the availability of innovative products for the sake of patients across England and the United Kingdom.
Victoria Atkins
I am delighted to be able to tell the hon. Gentleman that we have modelled down the ambitions, so the figure we initially provided was higher than 2.5 million appointments. That is because we are focused on delivering the dental recovery plan, rather than overpromising.
The hon. Gentleman finds it easy to call our children short and fat, but he shies away from welfare reform, calling it shameless and irresponsible. He says he is ready to stand up to middle-class lefties, but Labour has never put patients first by condemning the unions that strike. He makes glossy promises about reforming the NHS in England, yet Labour has failed completely—
Mr Speaker
Order. I gently say that we need to get a lot of Back Benchers in, and I am sure both sides want to do that.
Wes Streeting
The last Labour Government delivered the shortest waiting times and the highest patient satisfaction in history, which is a record that the right hon. Lady’s Government cannot begin to touch.
Back to dentistry, the chief dental officer says the announcement is “nowhere near enough.” The British Dental Association says:
“This ‘Recovery Plan’ is not worthy of the title.”
It also says that the recovery plan will not stop the “exodus” of dentists and will not meet the Government’s targets. Who should the public trust, and why should they trust the Health Secretary to deliver when her own adviser, her own Minister and, crucially, dentists all say that she is brushing the truth under the carpet?
Victoria Atkins
I thank my right hon. Friend for raising that matter. I understand that a consultation was conducted locally and that more than 5,000 local people and staff responded. Their feedback will be analysed by an independent research agency, which will produce a report for the Mid and South Essex ICB, and a meeting is due to take place in public in July. I will, of course, continue to take an interest in this matter.
Kirsty Blackman (Aberdeen North) (SNP)
The recent announcements on fit note reform are just the latest in a long string of attacks on the most vulnerable people in society. Sick and disabled people are being vilified, when, as the Joseph Rowntree Foundation points out, almost two thirds of those living in destitution live with a chronic health condition or a disability. The UK Government are continuing their track record in failing, and making life more difficult for, disabled people. Does the Secretary of State understand how much more difficult these changes will make people’s lives?
Victoria Atkins
We switched on our fully funded dental recovery plan, in case the hon. Gentleman was not listening carefully earlier, on 1 March. Nearly 500 more practices in England are accepting new adult patients than at the end of January, and even more will do so under the dental recovery plan. We have plans to bring in new dental vans to help our most isolated communities. We are also bringing in the Smile4Life programme for children, because prevention must be a critical part of our dental recovery plan.
Oral Answers to Questions
Lindsay Hoyle Excerpts(8 months, 3 weeks ago)
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Helen Whately
The hon. Gentleman is absolutely right to talk about the whole health system. One thing we are doing as part of our work on urgent and emergency care is preventing people from being admitted to hospital unnecessarily, or from being brought to A&E in the first place. Primary care is part of that. In our investment in expanding medical school places, we are particularly encouraging medical schools, such as the new Kent and Canterbury Medical School near me, to train students to work more outside hospitals, including in primary care.
Helen Whately
I work closely with colleagues in the Department for Work and Pensions on the recruitment of people looking for jobs in social care, and I will raise that point with my colleague in the Department.
Andrew Gwynne (Denton and Reddish) (Lab)
It was the Minister’s party that promised to fix the crisis in social care “once and for all”. With vacancy rates almost three times above the national average and turnover rates for new staff at more than 45%, it is clear that the Government failed. Labour’s plan for a national care service with clear standards for providers and a new deal for staff will give social care the fundamental reset it needs. The Government have done it with our workforce plan, and they have half-heartedly tried it with dentistry. Does the Minister want to copy our homework once again?
Helen Whately
Let us be honest, Labour has no plan for social care. Whatever the shadow Minister says, it is unfunded. There is no funding committed to it and it is not meaningful. Those of us on the Conservative side of the House are reforming adult social care. We not only have a plan, but it is in progress.
Amy Callaghan (East Dunbartonshire) (SNP)
I have asked the Secretary of State a number of times how she intends to recruit and retain social care staff, particularly with the visa changes coming into effect next Monday, stopping those from overseas coming to fill skills gaps from bringing their spouse or dependants with them. I ask again: how does the Secretary of State intend to improve the recruitment and retention of staff in the social care sector while her colleagues effectively work to undermine her?
Andrew Stephenson
Significant investment is going in to reduce both general wait times and cancer wait times. More patients on the cancer pathway have been seen than ever before; nearly 220,000 patients were seen last December following an urgent GP referral for suspected cancer, representing 117% of December 2019 levels. We continue to keep this under review and continue to strive to make the system go faster and reduce the elective backlog.
Abena Oppong-Asare (Erith and Thamesmead) (Lab)
NHS figures from December show that the number of women waiting for gynaecological treatment reached another record high of nearly 600,000. That number has tripled since 2012. A Labour Government will cut NHS waiting lists in England by funding 2 million more appointments a year. What can the Minister say to the women waiting urgently for treatment?
Victoria Atkins
Again, it is for integrated care boards to assess the needs of their area. If there are concerns about access to primary care, we are keen to give them the autonomy to make decisions about how they spend their budget. We have set expectations of integrated care boards in a couple of respects—in particular, we expect them to use the money that we have provided for dental care and we have set clear expectations that integrated care boards will introduce at least one women’s health hub in their area this year.
Steve Brine (Winchester) (Con)
While we are talking about the recovery of primary care and the Secretary of State is at the Dispatch Box, the recovering access plan released last May talked about high-quality online consultation, text messaging services and online booking tools. They were due in July, but that became August and then December, and I understand that it has now been delayed indefinitely due to a claim made against NHS England in what is a £300 million project. That delay is hitting access to primary care. Will the Secretary of State update the House?
Victoria Atkins
I will ask the relevant Minister to write to the hon. Lady.
Wes Streeting (Ilford North) (Lab)
The simple fact is that the Conservatives have been in power for 14 years, and general practice has never been in a worse state. Despite slogging their guts out, GPs are struggling because this Government have cut 2,000 GPs since 2015, making it even harder for patients to get an appointment. Given that, why has the Government decided that the NHS needs what the Institute for Fiscal Studies has described as the biggest funding cut since the 1970s?
Victoria Atkins
I thank my hon. Friend for supporting our dental recovery plan. Indeed, he is one of many colleagues who campaigned hard for it. I am pleased to inform him that dental activity, as measured by courses of treatment, has increased by 15% on the previous year in his local integrated care board area, and our plan will support further increases to dental access through some 2.5 million additional appointments across the country, including in his constituency. The first measure, namely new patient premiums, went live on Friday, and we hope to have the results very soon.
Wes Streeting (Ilford North) (Lab)
With a general election in the air, I welcome what the Secretary of State has said about baby loss certificates and Martha’s rule—there is genuine cross-party agreement on this. I also thank her for advance notice of today’s important written ministerial statement.
However, with a general election in the air and given the Secretary of State’s principled, vocal and consistent opposition to funding the NHS by abolishing the non-dom tax status, on a scale of one to 10—one being utterly shameless and 10 being highly embarrassed—how red-faced will she be when the Chancellor adopts Labour’s policy tomorrow?
Victoria Atkins
The Leader of the Opposition is a former barrister, and barristers like to rely on evidence, so let me give some evidence on what the Labour-run NHS in Wales looks like. People are almost twice as likely to be waiting for treatment under the Labour-run Welsh NHS—21.3% of people in Wales are waiting for hospital treatment after a consultant referral, compared with 12.8% in England. Patients in Labour-run Wales are, on average, waiting five weeks longer for NHS treatment than patients in England, and the number of patients in Wales who are escaping to seek treatment in England has increased by 40% in two years. But don’t worry, folks, according to the Leader of the Opposition this is the blueprint—
Mr Speaker
Order. I remind everyone that these are topical questions. It is about the many Members I need to get in, rather than the ping-pong over the Dispatch Box. Let us move on to Andrew Jones as a good example.
Andrew Jones (Harrogate and Knaresborough) (Con)
The Parliamentary Under-Secretary of State for Health and Social Care (Dame Andrea Leadsom)
I completely agree with my hon. Friend that we need more capacity in our dental workforce, and I know he will be a big advocate for his constituency. We set out in the first ever NHS long-term workforce plan that we will increase dentistry training places by 40% by 2031-32. Our dental recovery plan sets out many different measures to improve capacity.
Amy Callaghan (East Dunbartonshire) (SNP)
Later this month I will be 10 years cancer free, having survived melanoma first as a teenager and again in my early 20s. Can the Secretary of State look me in the eye and guarantee that she is doing all she can to prevent others from getting the same diagnosis ?
NHS Dentistry: Recovery and Reform
Lindsay Hoyle Excerpts(9 months, 2 weeks ago)
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Wes Streeting (Ilford North) (Lab)
I wholeheartedly associate myself and my party with the Secretary of State’s remarks on sending our best wishes to His Majesty the King. Having gone through a cancer diagnosis myself, I particularly send best wishes to his family, for whom a diagnosis is often more difficult than for the person receiving it.
Also in the generous spirit in which we have begun, may I thank the Health and Social Care Secretary for accidentally e-mailing me her entire plan yesterday? That goes above and beyond the courtesy that we normally expect. I look forward to receiving her party’s election manifesto any day now—but of course we will have to write ours first to give her party some inspiration.
After 14 years of Conservative Government, NHS dentistry is in decay. Eight in 10 dentists are not taking on new patients, and in the south-west of England the figure is 99%. One in 10 people has been forced to attempt DIY dentistry—Dickensian conditions!—because they cannot see an NHS dentist, and they cannot afford to go private. [Interruption.]
Mr Speaker
Order. Mr Baker, I am sorry, but I don’t want any more heckling from you; you did a little bit earlier. I wanted everybody to listen to the Secretary of State, and I expect them to do the same for the shadow Secretary of State.
Wes Streeting
Don’t worry, Mr Speaker: I will come back to the Parliamentary Private Secretary shortly. Tooth decay is the No.1 reason for children aged six to 10 being admitted to hospital. Unbelievably, there have been reports of Ukrainian refugees booking dentist appointments back home and returning for treatment, because it is easier to fly to a war-torn country than it is to see an NHS dentist in England. Well, at least one Government policy is getting flights off the ground—and it is certainly not the Government’s Rwanda scheme failure.
Let us look at the human consequences of this Conservative tragedy. Labour’s candidate in Great Yarmouth, Keir Cozens, told me about Jeanette, a young woman in her 30s who has struggled with gum and mouth problems all her life. She used to be able to get treatment; now she cannot find an NHS dentist in all of Norfolk to take her. She cannot afford to go private. It hurts to smile, it hurts to laugh, and the pain is so great that Jeanette does not go out anymore. Just this week, she resorted to trying to remove her tooth herself. That is not right for anyone of any age, but Jeanette should be in the prime of her life. Will the Secretary of State apologise to Jeanette and the millions like her for what the Conservatives have done to NHS dentistry?
After 14 years of neglect, cuts and incompetence, the Government have today announced a policy of more appointments, recruiting dentists to the areas most in need and toothbrushing for children. It sounds awfully familiar. They are adopting much of Labour’s rescue plan for dentistry. Does that not show that the Conservatives are out of ideas of their own, and are looking to Labour to fix the mess they have made? I say: next time Conservative Ministers say that Labour does not have a plan, or that Labour’s plan is not credible, don’t believe a word of it.
There are some differences between our two parties’ approaches. Labour is pledging an extra 700,000 urgent and emergency appointments, which are additional to the appointments announced today. Can the Health Secretary confirm that the Government’s plan does not provide any additional emergency support? Labour proposed supervised early-years toothbrushing, and Conservative MPs accused it of being “nanny state”. Does the Health Secretary stand by that label, or does she now support children under five being supported in brushing their teeth?
The key difference is that we recognise that our plan is a rescue plan, and that to put NHS dentistry back on its feet, immediate reform of the dental contract is needed. Without that, the Government’s plan is doomed to fail. Do not just take my word for it; the British Dental Association has said that the plan will not stop the exodus of dentists from the NHS, will not provide a dentist for every patient who needs one, and will not put an end to this crisis.
I come to the Parliamentary Private Secretary, the hon. Member for North Norfolk (Duncan Baker), and the miserable script that the Whips are spreading out on the Table. If Labour’s contract is to blame, why have the Government not reformed it in 14 years, and why are they not reforming it now? In 2010, the Conservatives promised in their election manifesto to reform the dental contract. They are bringing back not just Lord Cameron, but his broken promises. People have been desperately trying to get dental care for years, but there was nothing from the Conservative party. Now that we are in an election year, the Conservatives are trying to kick the can down the road, and are scrambling for a plan. They only discover their heart when they fear in their heart for their political futures, and the consequences have been seen: queues around the block in Bristol.
Finally, the Secretary of State is promising reform after 2025 and after the next general election. Who is she trying to kid? After 2025, the Conservatives will be gone, and if they are not, NHS dentistry will be. How many more chances do they expect? How many more broken promises will there be? We had 2010, 2015, 2017 and 2019. Their time is up, and it is time for Labour to deliver the change that this country needs.
Victoria Atkins
I tried to help the hon. Gentleman by giving him an advance copy of my speech yesterday, yet that was his speech. This Government are focused on delivering for patients. Perhaps I can help him understand the difference between the Opposition’s proposals and the Government’s fully funded dental recovery plan. The Opposition’s ambitions reach only as far as 700,000 more appointments. Our plan will provide more than three times that number of appointments across the country—that is 2.5 million, to help him with his maths. We are offering golden hellos to 240 dentists who will work in hard-to-reach and under-served areas; their proposals cover only 200. They have no plan for training more dentists; we set out in the long-term workforce plan last year, and again in the dental recovery plan, that we will increase training places for dentists by 40% by 2031.
Then we have the centrepiece of the Opposition’s proposals: making teachers swap their textbooks for toothbrushes—an idea that is hated by teachers and that patronises parents. We believe that most parents do a great job of looking after their children. I know that the Labour party does not agree with that; the hon. Gentleman called our children short and fat on a media round. We believe that most parents do a great job, and that is why we support pregnant mums-to-be, and support parents in family hubs and nurseries. We will not wait until reception class, by which time children have already got their teeth.
I want to dwell on the experience of anybody living under Labour in Labour-run Wales. Health services in Wales are devolved, and the Leader of the Opposition has called Wales “the blueprint” for how the Opposition will run our health system. Welsh Labour has the highest proportion of NHS dental practices not accepting new adult patients, and the joint highest proportion of those not accepting new child patients. In Wales, 93% of NHS dental practices are not accepting new adult patients. That is a higher figure than for any other nation in the UK. Some 86% of practices there are not accepting new child patients, which is the joint highest figure with Northern Ireland. Our plan is fully funded, but how will Labour pay for its plan? By using the magical money tree. The list of policies funded by the non-dom policy is as long as my arm. In 2022, it promised to fund a workforce plan. Last September, it became breakfast club meals. By October, it morphed into 2 million appointments and scanning equipment. By Christmas, it was funding a dentistry plan. It is the same old Labour: it has no plan.
Sir Peter Bottomley (Worthing West) (Con)
The House enjoyed the words of the Opposition spokesman, the hon. Member for Ilford North (Wes Streeting), although I am not sure how many he wrote himself; some may have seemed rather familiar to anyone who read Matthew Parris this morning on going to Ukraine to have a filling fixed.
In West Sussex, in Worthing and Arun, we want the same situation found in parts of London, where dentists have a sign saying, “New NHS patients welcome”. Has the Secretary of State been working with the British Dental Association and the General Dental Council to bring forward registrations, to get incentives right, and to make sure that dentists are no longer told, “You can’t serve any more patients because you will go above your limits”? Can she confirm that we are taking limits off, so that dentists, especially the young ones, can do as much work as they can, and can help as many patients as possible, so that we can get back to the situation that we were in before Labour changed the rules about 20 years ago?
Steve Brine (Winchester) (Con)
I welcome the plan. Recovery and reform is right, and the Select Committee will study the plan carefully. The dental Minister, my right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom), has already been invited to come before us, so that we can talk it through with her to see whether it reflects our aforementioned report on the subject. The golden hellos, the toothbrushing for pre-schoolers—as long as the workforce can handle it—and the mobile vans are good, but even a day longer of a contract focused on units of dental activity is a problem. Can the Secretary of State say how she plans to entice professionals into returning to NHS dentistry? So many have left, and that is key.
Oral Answers to Questions
Lindsay Hoyle Excerpts(10 months ago)
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Mr Sheerman
I have turned over a new leaf, Mr Speaker.
May I urge the Secretary of State to take this issue very seriously, to direct much more social media at young people and to get into schools the message about the real damage that can be done to the entire life of a child if the mother is drinking alcohol during pregnancy?
Dame Andrea Leadsom
My hon. Friend is pushing against an open door. He may be aware that in 2023 we made some legislative changes to give the General Dental Council more flexibility to expand the registration options open to international dentists, tripling the capacity of three sittings of the overseas registration exam from August 2023 and increasing the number of sittings for the part 2 exam in 2024 from three to four. That will create an additional 1,300 places overall for overseas dentists aiming to work in the UK. We will also be bringing forward measures to enable dental therapists to work at the top of their training, which will expand the capacity. He is right that reform of the UDA is also required and we will be bringing forward our plans shortly.
Preet Kaur Gill (Birmingham, Edgbaston) (Lab/Co-op)
I want to share with Ministers the experience of Emma from Grimsby, who said:
“NHS dentistry is a joke in the town at the moment. Thankfully I managed to get an emergency appointment in Scunthorpe (after being offered one in Doncaster originally) and I’ve now been referred to hospital to have 3 wisdom teeth removed. My dentist closed at the onset of the pandemic and I’ve not been able to register with an NHS dentist since.”
What does the Minister have to say to Emma and the millions like her who cannot get an appointment when they need one?
Victoria Atkins
I am sure that the hon. Gentleman is a fair man, and that, being so, he will point out to his constituents, when they call him with their issues, that ambulance response times for category 2 emergency incidents in his local area have in fact been over 30 minutes faster than last year. However, we accept of course that this is a two-year plan and will take time to meet our full ambitions. Interestingly, the latest figures show that we have provided £6.9 million from the community diagnostic centres fund for the development of a community diagnostic centre at Wakefield. Presumably he welcomes that Conservative innovation.
Victoria Atkins
My hon. Friend is right to point out that we are in the final few hours of the consultants’ ballot on the pay reform programme that we have offered the British Medical Association. I very much hope that consultants will feel able to support that programme, because it is about bringing together the frankly quite bureaucratic system that they have to deal with at the moment, so that they are assessed in a shorter time with less bother and paperwork, while respecting their need to train and keep up their education and supporting professional activities commitments. I hope that they will agree with us on that. As I have said to the junior doctors committee from this Dispatch Box, should they return with reasonable expectations, we will, of course, reopen negotiations.
Karin Smyth (Bristol South) (Lab)
The Secretary of State has said that preparation for winter started last January, but 54% of A&E departments were still rated inadequate or needing improvement in December, exacerbating the winter crisis. What will she do differently this year to ensure that we do not have another winter crisis in 2024-25?
Victoria Atkins
Again, the plan that we laid out last year is having a real impact at local level on the services being deployed through our accident and emergency services. We have seen discharge rates improving, for example. We appreciate that there can be local differences, but the importance that we put on maintaining that flow through hospitals is critical to ensuring that the waiting lists and waiting times that the hon. Lady describes are reduced. However, I gently remind the Labour party that it has been running the NHS in Wales for some time now, and it is a great shame that the good people of Wales—[Interruption.] The good people of Wales are waiting longer for their treatment—[Interruption.] They are almost twice as likely—
Mr Speaker
Order. I am a little bothered, because we have a long way to go on the Order Paper. I call the SNP spokesperson.
Amy Callaghan (East Dunbartonshire) (SNP)
We cannot discuss winter pressures in the NHS without acknowledging workforce shortages. The Secretary of State is having to contend with new immigration policies from her Cabinet colleagues that prevent dependants from coming to the UK, meaning that we are asking people to come and care for our loved ones while they leave behind theirs. I imagine that she is frustrated that that is now another barrier to recruiting staff to our health and care sectors. Has she expressed those frustrations to her Cabinet colleagues?
Helen Whately
I am actually really shocked by the way the hon. Member referred to the care workforce, with terms like “It is all blah”—very shocking. I am determined that care workers should get the recognition they deserve. We have a 10-year plan for social care, and it is working: the care workforce grew by over 20,000 last year, vacancies in social care are down, and retention is up. We are reforming social care so that it works as a career. That is why, as I said a moment ago—I wish the hon. Member had been listening—we have introduced the first ever career pathway for social care workers and a new national care qualification.
Andrew Gwynne (Denton and Reddish) (Lab)
But according to Care England and Hft, 54% of social care providers have increased their reliance on agency staff; 44% have turned down new admissions; and 18% have had to close services altogether. Labour’s fair pay agreements will ensure that staff in the sector are treated with the dignity and respect that will make them want to stay, but after 14 years, why do Ministers not have a proper plan to address the workforce crisis facing adult social care? Is it because it is a crisis of their making?
Victoria Atkins
I thank my right hon. Friend for raising her local college, which does amazing work for the whole of the NHS as well as in her local area. I may have to retain a discreet silence over that particular application but I know that if any Member is sure to advocate effectively for their local area, it is my right hon. Friend.
Abena Oppong-Asare (Erith and Thamesmead) (Lab)
Recruiting and retraining more NHS staff is crucial if women are to get gynaecology, obstetric and maternity care. I would like to share the story of Sandy Simmons. She was told 11 months ago that she needed surgery for a uterine prolapse; today, after nearly a year of pain, she is still waiting. Labour candidates such as Keir Cozens in Great Yarmouth are speaking up for women like Sandy and the 905 women waiting more than a year for treatment in Norfolk and Norwich University Hospital. Will the Secretary of State apologise to these women—or, like the Prime Minister, will she just walk away?
Jeff Smith
If only the reality was that rosy. The entire sector is calling out for reform of the Mental Health Act 1983. With our mental health services in crisis, why did the Government scrap the long-awaited and overdue mental health Bill, which could have started to alleviate pressures on trusts by reducing the numbers of people detained inappropriately and making services more fit for purpose? Is it not true that we need a Labour Government to take action on this issue?
Maria Caulfield
I have news for the hon. Gentleman, because we have a plan and it is working. Our investment of £143 million into crisis support is showing early evidence of reducing admissions—admissions are 8% lower. With the crisis telephone services, which are available 24/7, we have admissions down 12%. More importantly, detentions under the Mental Health Act are 15% lower. We have a plan, and it is working.
Ruth Cadbury
I recently met two constituents with experience of invasive lobular breast cancer. Invasive lobular carcinoma is the second most common form of breast cancer, but it is not generally picked up by mammograms, and it behaves differently from other breast cancers. However, lobular breast cancer has been understudied and underfunded, and it urgently needs research funding. Will the Secretary of State tell the House what specific actions her Government are taking to address those gaps? Will she also reply to the Lobular Moon Shot Project, to which she—
Victoria Atkins
I gently remind the hon. Lady about the statement that I just gave. Last week we held the women’s health summit, at which I announced that we are encouraging research into conditions such as lobular breast cancer. I made that announcement because of two amazing women I met recently who were living with the condition. They were introduced to me by my right hon. Friend the Member for Horsham (Sir Jeremy Quin) and my right hon. Friend—
Mr Speaker
Order. Please can I just say that these are topicals? I have got to get through a big list, and lots of Members are standing. We need short, punchy questions, and the same with answers.
Andrew Jones (Harrogate and Knaresborough) (Con)
Victoria Atkins
I would be delighted to meet my hon. Friend to discuss that. As always, he is an excellent advocate for his constituency, and I will enjoy listening to the results of his survey.
Andrew Gwynne (Denton and Reddish) (Lab)
Mike Reader, Labour’s candidate for Northampton South, shared with me the horrific experience of Stanley, who had severe abdominal pain and called an ambulance, only to be told it would take hours and to go to A&E. There, he was told to wait for assessment on a patio chair outside. It was 3°. Who is to blame?
Victoria Atkins
We understand how worrying the possibility of medication shortages can be. There is a supply issue with riluzole 50 mg tablets, caused by a supplier experiencing manufacturing issues. We have a well-established procedure in place to deal with such issues, and are working with the industry, the NHS and others to resolve it as quickly as possible. We have contacted alternative suppliers and have secured sufficient volumes of stock.
Amy Callaghan (East Dunbartonshire) (SNP)
Cancer Research UK has found that too much UV radiation is the third biggest cause of cancer across these isles. Does the Secretary of State recognise that cost is a barrier for people wishing to protect their skin from the sun, and will she commit to having conversations with Cabinet colleagues to remove VAT on sun protection products, which will help protect NHS budgets and ultimately save lives?
Sir Jeremy Quin (Horsham) (Con)
I warmly welcome what my right hon. Friend said last week about encouraging research on lobular breast cancer, and I look forward to meeting the Under-Secretary of State for Health and Social Care, the hon. Member for Lewes (Maria Caulfield), shortly to work out how we can operationalise what is her clear ambition.
Hospice Funding: Devon
Lindsay Hoyle Excerpts(10 months, 1 week ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Jim Shannon
It is to do with the hospices and charities that the hon. Gentleman referred to.
Mr Speaker
This debate is about funding in Devon. I am sure the hon. Member for Strangford could say something that relates to funding in Devon.
Jim Shannon
Thank you, Mr Speaker. The hon. Gentleman is right to refer to hospice funding in Devon, but while the hospice funding and charity giving in Devon is good, I suggest that it may be even better in Strangford. Each year in Northern Ireland, our fundraisers add £15 million to the four hospices; without that money, those hospices could not function. Does the hon. Gentleman agree that the Government must stop relying on people’s charity to fill the gap, and increase funding immediately to meet that need? I know that his charity givers in Devon do well, but the ones in Strangford do equally well.
Helen Whately
The hon. Member raised that question in the Westminster Hall debate I referred to. He is talking about a specific situation. Rather than spending the limited time I have addressing that, I am keen to respond to my hon. Friend the Member for East Devon, who has secured this debate on hospice funding in Devon.
I was talking about the enormous importance of hospices and their role in our communities, and the strengths of having hospices in our communities add to the significance of the care they provide. I mentioned my own experience. Hospices do this thing of making a time that can seem completely unbearable become somehow bearable. That makes a difference not only for the individual cared for by the hospice but for all those around them.
Let me turn to Devon specifically. Devon does reflect the national picture, with NHS palliative and end of life services such as a specialist NHS team, community nursing care and a Marie Curie night care service. I mention that because some people may think of hospices as the sole provider end of life care in any community. The picture is broader than that, but of course hospices are important. Indeed, NHS Devon has grant arrangements with four Devon hospices that operate in-patient beds. In East Devon specifically, patients can receive end of life care in hospital, at home, in a care home, or from Hospiscare or Sidmouth Hospice at Home, to which my hon. Friend referred.
In England, integrated care boards are responsible for the commissioning of end of life and palliative care services to meet the reasonable needs of their local populations. As part of the Health and Care Act 2022, palliative care services were specifically added to the list of services that an ICB must commission, reflecting the importance of end of life and palliative care in our healthcare system. Adding that will ensure a more consistent national approach and support commissioners in prioritising palliative and end of life care. In July 2022, NHS England published statutory guidance on palliative and end of life care to support commissioners with that duty. That includes specific reference to ensuring that there is sufficient provision of specialist palliative care services, hospice beds and future financial sustainability.
I acknowledge that hospices, like many organisations—and indeed households—are having to contend with financial pressures including rising energy costs. That is why charities including hospices have already benefited from the energy bills discount scheme, which provides a discount on high energy bills and is running until 31 of March 2024. Hospices may also be entitled to a reduction in VAT from 20% to 5%. In addition to that, in 2022 NHS England released £1.5 billion in additional funding to ICBs to provide support for inflation. ICBs were able to distribute that funding according to local need. It was therefore an option for them to support palliative and end of life care providers, such as NHS contracted hospices, with rising costs from inflation.
I recognise the financial challenges that hospices continue to face and the difficulty there is in raising funds from local communities when people themselves are facing pressures with the cost of living. My hon. Friend made a clear case for the financial support that the hospice in his area deserves. I encourage him to continue to argue that point. It is good to hear that he has been in touch with his local integrated care board, which is the organisation responsible for assessing palliative care needs in his community and ensuring that the need is met.
My hon. Friend is not the first Member to ask to meet me to discuss this topic, or to call a debate on it. I am working to increase the transparency and the information available to colleagues and our constituents, so that they can be assured about the provision of palliative and end of life care. To that end, I have organised a meeting next week with representatives from NHS England, and have invited Members from across the House to attend it, for an update on palliative and end of life care and to ask questions directly of NHS England on this topic.
I have welcomed the opportunity this evening to talk about the wonderful work of hospices not only in Devon but across the country. I assure my hon. Friend and other Members present that I am committed to supporting hospices to continue what they do so well in our communities, and to improving access to palliative and end of life care for people across the country, whether that care is given by a hospice or by the national health service.
Mr Speaker
We are so lucky to have the hospice movement, including St Catherine’s and Derian House in my constituency.
Question put and agreed to.