Oral Answers to Questions Debate
Full Debate: Read Full DebateMaria Caulfield
Main Page: Maria Caulfield (Conservative - Lewes)Department Debates - View all Maria Caulfield's debates with the Department of Health and Social Care
(2 years, 2 months ago)
Commons ChamberThe best way to improve access to NHS dental services nationally is through our reforms of the NHS dental contract, which will aim to pay dentists more fairly for their work. Specifically on Weston-super-Mare, a number of measures are taking place in Somerset to open up dental access there, including a nurse-led dental helpline to open up the available appointments.
I thank the Minister for her answer. Even before the pandemic, the NHS commissioned enough dentistry to cover only about half the population of England. Covid has massively increased backlogs and inequalities in Weston-super-Mare and many other parts of the country. Dentistry is now the No. 1 problem raised with Healthwatch, and four in five people say that they cannot find timely care. I agree with her that reforming the NHS dental contract is absolutely essential and urge her to redouble her efforts to fix it as fast as possible.
My hon. Friend is absolutely right that the nub of the problem is the dental contract. Negotiations have started and the details are with the British Dental Association as we speak. We expect to make an announcement before the summer recess.
Like the hon. Member for Weston-super-Mare (John Penrose), I have a number of constituents who have had real problems reaching dentists before and since covid, but there have been some particularly distressing cases since covid. There has never been the right package to pay dentists to do the work, which is driving them out of the business, but the inefficiencies of having to go through the central NHS systems for an emergency appointment are costing the taxpayer dear. When will we see proper certainty around the measures that the Minister just described, so that dentists know that it is worth their while sticking with NHS patients?
As I said, the contract is the nub of the problem; it is currently a perverse disincentive for dentists to take on NHS work. We are serious about reforming it, we are in discussions with the BDA, and we will make the announcements before the summer recess.
I thank my hon. Friend for her work on pushing that contract reform through, because it is key to shifting the dial. In areas such as mine, where people are waiting to get on to waiting lists for dentists, there is a huge dearth of dentists to provide treatment. Can she speak about the recruitment challenge that we will have to meet when the reform comes through?
My hon. Friend is right that the issue is not just about the contract, although that is a key aspect of trying to get more dentists to take on NHS work. We are working on a number of incentives to increase recruitment, including working with Health Education England on centres for dental development to train more dentists in those hard-to-reach areas, which tend to be coastal and rural areas.
We are also looking at how we can reform the overseas dentist policy. We are working with the General Dental Council on that and may be bringing legislation forward towards the end of the year to improve that, too.
Kathryn Townsend got in touch with me about her son Max, who has severe complex sensory issues and learning difficulties. He waited up to two years for an appointment. In that time, several rotten teeth have had to be removed. Conservative Governments have had 12 years now to get things right. When will the Minister get an urgent grip of the situation?
The hon. Gentleman says that we have had 12 years, but he may recognise that, during the pandemic—two of the years that he talks about—routine dental appointments were not available because of the type of aspiration procedures that they involve. Only urgent appointments were available. We are now enabling 95% of the usual activity to take place, and that will soon be 100%. That means that there is still quite a backlog to get through, but we are in a better place than we were this time last year.
Like colleagues, I have many constituents struggling to access an NHS dentist. I recently met with Uttoxeter Dental Practice, which has significant concerns about the UDA—units of dental activity—system, as it is not working for dentists or patients. I understand that a review has been promised for many years. Can my hon. Friend update me on when it might take place?
My hon. Friend is right: there is a perverse disincentive in the current contract in that under the UDA dentists are not paid in relation to the level of activity or work they have to do for an appointment. That is the nub of the problem and we are in discussions with the British Dental Association right now; it is reviewing our proposals and we hope to have news very soon.
People with dementia deserve to be treated with dignity and respect. There are ways to enable those living with dementia to lead the lives they want. This is what the all-party group on dementia inquiry is currently investigating. Will the Secretary of State commit to attending the all-party group’s inquiry—
Members across the House have been calling on the Minister to fix the crisis in NHS dentistry, but she seems intent on burying her head in the sand. The Government have no plan, with the Minister running scared from even talking to dentists at a conference last week. Patients are suffering as a result, with a third of adults and half of all children not having access to an NHS dentist. In Wakefield alone, a child under 11 is admitted to hospital every day for tooth decay. Does the Minister agree that the people of Wakefield should bear this in mind next Thursday?
I am sure the people of Wakefield are as frustrated as I am that the Labour dental contract, put in place in 2006, is the nub of the problem. If the hon. Lady were to meet with dentists, she would hear loud and clear that the dental contract is causing the problem. [Interruption.] She might not have listened to my previous answers because she is not listening now, but we will be announcing changes before the summer recess.
At the start of this year the Government announced £50 million to create some new dentistry appointments, but that money resulted in exactly zero new appointments in my constituency. I wrote to every single dental practice in my constituency and they said that was because the funding offer was too limited in scope and time and they were given only a week to reply.
On 25 April, I wrote to the Minister asking how many appointments had been created from this money across England and where that money had gone. I have not received an answer. Will we get one today?
I am very disappointed: that £50 million of funding was for dentistry to access and be able to afford more appointments, and if local commissioners in an area did not bid for that money or ask dentists to take that money on, that is extremely disappointing—those in other parts of the country certainly did. We are putting £3 billion a year into dentistry. Local MPs have a role to play in this: if there was a problem, I would have expected the hon. Lady to have come and seen me before now to lobby for more funding for her local area.
On 1 November 2018 this Government changed the law to allow the prescription of cannabis-based products for medicinal use by a specialist when clinically appropriate. Licensed cannabis-based medicines such as Sativex and Epidiolex are routinely available on the NHS.
I am grateful to my hon. Friend for that answer, particularly as she mentioned 2018, because it was of course her boss, the Secretary of State for Health, who was the pioneer in all this when he was Home Secretary. But there is a “but” coming, and it is that young children are not getting this vital medicine on the NHS. Some are having to pay £2,000 a month, and in the last three years only three prescriptions have been issued on the NHS. How can we improve the situation?
My hon. Friend has been campaigning on this issue for a long time, particularly on the tragic case of his constituent, Vicky Clarke. I have met the all-party parliamentary group on medical cannabis under prescription and we have had debates on the issue in this place and in Westminster Hall. The key is to get those products licensed, and we have been in discussion with the Medicines and Healthcare products Regulatory Agency on how to do this. It is about gathering the evidence base. I am pleased to say that NHS England and the National Institute for Health and Care Research have recently announced two clinical randomised controlled trials to try to build that evidence base to get more of these products licensed.
We now come to the Scottish National party spokesperson, Martyn Day.
The lack of evidence on the quality, safety and efficiency of cannabis-based products for medical use is the main barrier to their being prescribed by NHS clinicians, which is why the SNP continues to support the development of clinical trials. Without proper funding, the UK Government are holding back potential successful health outcomes, so what steps are they taking to increase the priority of medicinal cannabis in research funding?
I met the responsible Scottish Minister in April to discuss this issue. There is not a lack of funding. The National Institute for Health and Care Research has funding available but we are not seeing bids, so this is a plea to the clinicians, researchers and groups for those to come forward. The NHRA is also happy to meet any groups considering undertaking clinical research to ensure that it is the type of research that will provide the evidence they need to licence these products.
NHS England is making £127 million of investment in maternity systems in the next year to go specifically towards the workforce. This is on top of the £95 million already promised for the recruitment of 1,200 midwives and 100 more consultant obstetricians.
South Tyneside District Hospital’s maternity unit was award winning. In 2019, despite widespread opposition, it changed to a midwife-led birthing centre. It has since been closed, since January. Recently, a whistleblower explained that midwives and expectant mums are being kept in the dark about the future of the unit, staffing levels and bed capacity across the trust. These changes are a direct result of this Government’s forced cuts, so what is the Minister going to do to make sure that babies can be born in south Tyneside?
I have just been very clear that we are investing about £200 million in that workforce. In the hon. Lady’s area, there were staffing pressures during the omicron variant, with high levels of staff sickness, which meant that South Tyneside District Hospital had to make that difficult decision. My understanding is that those staffing numbers are much better, particularly for sickness absence. If she is struggling to find out from the trust when it hopes to reopen the unit, I am very happy to meet her and members of the trust.
When I wrote to the Minister recently about my concerns about NHS dentistry waiting times, I was advised that my constituent was not restricted by geography, which implied that he should travel for an appointment, but the whole of the east of England has been identified by the Association of Dental Groups as a dental desert. The Minister is well aware of this problem, the severe workforce shortages and the broken dentistry contracts. When will the Government stop blaming the dental practices, get on with the job and get the workforce this country needs?
This Government are not blaming dentists for the pressures they are facing. If anyone is to blame, it is the Labour Government for their 2006 contract. We are amending that contract, and will make an announcement before the summer recess.
Suicide prevention organisations such as the Campaign Against Living Miserably and Papyrus are, sadly, needed more than ever, yet in the current economic climate, because they tend to rely on charitable donations, they are struggling to provide the services to meet demand. What will the Government do to make sure they survive and provide the life-saving services that are so badly needed?
As IVF treatment is incredibly time sensitive, will the Secretary of State consider increasing the funding available to allow couples to make use of private facilities on the NHS, to help families have the children that they so much want?
I cannot comment on health in Northern Ireland specifically as it is a devolved matter. IVF will be a significant factor in the women’s health strategy, because we recognise the disparities that exist across the country in how couples currently access IVF.
The site for the new Leeds children’s hospital and the adult hospital building, the Leeds General Infirmary, will be cleared by the end of this month. The trust is raring to go to build these wonderful new facilities. Can the Secretary of State tell me when the final go-ahead for the construction will be given?
As was pointed out by the hon. Member for Lichfield (Michael Fabricant), this Government promised medical cannabis on the NHS 1,183 days ago. Since then, a child with epilepsy will have experienced, at a modest estimate, 35,490 seizures. We have free NHS prescriptions, which proves that the medicine exists and is approved for use in the United Kingdom. How much longer must those children suffer?
As I have said, I met the Scottish Minister on this. Scotland is facing exactly the same problem. Where medicinal cannabis is licensed, 9,631 prescriptions have been issued in primary care and 58,000 in secondary care, thanks to my right hon. Friend the Secretary of State who changed the law at the time.