Oral Answers to Questions

Maria Caulfield Excerpts

Tuesday 19th April 2022 Commons Chamber

[Tom Hunt (Ipswich) (Con)]

3. What steps his Department is taking to tackle the backlog in NHS dentistry appointments.

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

The dental activity threshold has recently been raised to 95% of usual activity. That is another quarter-on-quarter increase to get us towards 100% of pre-pandemic activity. I fully recognise, though, that access to NHS dentistry before the pandemic was patchy and that the crux of the problem is the current NHS dental contract, so work is under way to reform that contract. As negotiations have started, I am limited in what further I can say, but I will update the House as soon as possible.

[Tom Hunt]

A number of my constituents are finding it impossible to access NHS dental care. They include Alison, one of my constituents who worked as a midwife in Ipswich Hospital for 40 years. Some of them have contacted 40 different practices and have not got anywhere. My understanding is that there has been a 30% drop in the number of dentists taking on NHS work in Suffolk. Will the Minister explain what local work is going on between the Department and the local NHS bodies to try to ensure that this issue is addressed?

[Maria Caulfield]

My hon. Friend is quite right in his question and is campaigning hard to increase dental activity in his constituency. One of the key pieces of work is being done through Health Education England, which set out a range of recommendations in its “Advancing Dental Care” review. That will do a number of things, such as increase the skill mix and scope of practitioners across dental teams, and we may well require legislation to bring some of that work forward. Health Education England is also introducing more flexible routes into dental training and doing some workforce modelling to identify the parts of the country with the biggest gaps in provision, so that we can establish centres of dental development in those areas. I will look at Ipswich in particular.

[Emma Hardy (Kingston upon Hull West and Hessle) (Lab)]

My constituent contacted me to tell me that when she broke her canine and went to contact her NHS dentist, she found she had been kicked off the list and was facing a bill of £4,000, which she simply does not have, to have the work done privately. Will the Minister speak to some of the dental practices about the possibility of relaxing their rules on kicking people off their dental lists, especially as covid has meant that patients might have had legitimate reasons for missing appointments?

[Maria Caulfield]

I am sorry to hear about the hon. Lady’s constituent’s experience. There is not actually a list system for dentists as there is for GPs, so patients can see any dentist when they have a dental issue. With that said, we have asked dental practices to update their availability for NHS patients on the website. This morning, I looked at the website to see what availability there was throughout the country and saw that many dentists still have not updated their availability, so I will ask officials—particularly in her constituency—to update the lists so that patients can access NHS dentistry more easily.

[Sir Peter Bottomley (Worthing West) (Con)]

I join the Minister in thanking dentists and their associates for getting so much of the service back. Does she agree that in places such as the Arun parts of my constituency, where people cannot find a dentist and have not been able to for two or three years, there must be a way for people to get on a dentist’s list and get treated, and for dentists to be properly rewarded? Dentists and patients would be grateful for a change in the contract.

[Maria Caulfield]

The Father of the House is quite right that the crux of the problem is that there is a shortage throughout the country not of dentists but of dentists taking on NHS work. The contract is the nub of the problem, which is why work is under way to reform it. We will shortly announce some short-term changes and some longer-term reforms, which will hopefully help my hon. Friend’s constituents.

[Jim Shannon (Strangford) (DUP)]

Bearing in mind that dentists are now determined to turn their practices wholly private as they cannot make ends meet with NHS prices, will the Minister pledge to review NHS payments to stop the haemorrhaging of NHS dentistry provision?

[Maria Caulfield]

The hon. Gentleman is correct that the units of dental activity payments are a perverse disincentive. Sometimes, when someone needs more extensive work, their dentist is paid the same as they would be for, say, one or two simple fillings. That is the nub of the problem and we are currently in negotiations on the matter.

[Mrs Maria Miller (Basingstoke) (Con)]

My hon. Friend the Minister is right to talk about the contracts with dentists, but should she not also look at how dentistry is structured and the regional nature of the contracting? It sits outside our clinical commissioning groups, which reduces co-ordination and accountability in respect of something that is central to our health. Should this not change?

[Maria Caulfield]

My right hon. Friend is right. Health Education England is addressing the overall system of where dentists are training and where the gaps in provision are filled in its “Advancing Dental Care” review. It is also working with commissioners at a local level to develop more opportunities in those places that we term dental deserts, where there is currently a lack of provision.

[Feryal Clark (Enfield North) (Lab)]

NHS dentistry is in crisis. Patients are stuck with either a never-ending wait for an NHS appointment or footing the bill for going private, which is simply not an option for most families suffering rising bills and taxes. With a third of the population experiencing untreated tooth decay, when will this Government, who have had 12 years to do so, finally come up with some practical solutions that put patients’ needs first, rather than the half-baked, unworkable ideas we have heard to date?

[Maria Caulfield]

I am sorry to the hear that tone from the hon. Lady. We are working under Labour’s 2006 dental contract, and she may have missed that dentists were unable to offer any routine care during the pandemic over the last two years, which we have slowly worked up to 95% of usual activity. She may want to play politics with this issue, but perhaps she should speak to her Labour colleagues who run the NHS in Wales, where 6% of dental posts were lost last year. She should get her own side in order before lecturing this side of the House.

[Steve Brine (Winchester) (Con)]

With the exception of the previous question, I do not think that anybody on either side of the House who has raised this issue is playing politics, because a pattern is emerging of a backlog and problems in accessing NHS dentistry. An increasing number of constituents are contacting me having gone to their NHS dentist with an acute dental problem only to be told either that NHS patients are no longer being seen or that they have fallen off the list, as the hon. Member for Kingston upon Hull West and Hessle (Emma Hardy) mentioned. How can Ministers help in the short term? I know the long-term answer is around the contract—I used to give that answer when I was in her seat—but will the Minister please meet me over a cup of tea so that we can try, as a starter for 10, get to the bottom of this?

[Maria Caulfield]

I thank my hon. Friend for his question. We have had many cross-party meetings with colleagues about dentistry, with many raising constituency issues that we have followed up. He could speak to his local commissioners, because there can sometimes be local problems with the commissioning of dental services. However, now that we are moving towards 95% of usual activity—a significant change compared with last year— I hope that his constituents will be able to access services more easily.

[Steve McCabe (Birmingham, Selly Oak) (Lab)]

4. What recent assessment he has made of the adequacy of access to NHS ear irrigation and microsuction treatments.

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

Ear wax services are the responsibility of local commissioners, who are responsible for meeting local healthcare needs. Depending on a local area’s arrangements, services should be undertaken either at local primary care practices or through referrals to appropriate local NHS services.

[Steve McCabe]

Well, I obviously want to thank the Minister for that answer, but I was recently contacted by a constituent who complained that she was told by her GP surgery that such services were no longer available on the NHS and that she should consider obtaining them privately. This is happening despite recent studies that link the effect of impacted cerumen with cognitive decline and dementia. Will the Minister consider writing to clinical commissioning groups to remind them of their obligations and patient entitlements?

[Maria Caulfield]

I thank the hon. Gentleman for his question. There has been no national removal of ear wax services, which can still be commissioned locally. NICE guidance is clear on the types of services that should be commissioned. Traditional methods of manual ear syringing are no longer offered for safety reasons, but electronic irrigation and microsuction should be being offered. If his local CCG is not commissioning such services, I am happy to meet him and them to discuss why not.

[Andrew Selous (South West Bedfordshire) (Con)]

GPs provided the service for decades. We all understand why the NICE guidance means that they no longer offer syringing, but there is a gap in that many clinical commissioning groups are not offering alternative services. We are talking about people with dementia or receiving end-of-life care who literally cannot hear and are going deaf. The Minister must be direct with CCGs on this issue.

[Maria Caulfield]

My hon. Friend is right that there must be consistency across the country in how those procedures are commissioned. After today’s questions I will take this up with officials to see why that is not happening consistently across the country.

[Rushanara Ali (Bethnal Green and Bow) (Lab)]

5. What steps his Department is taking to tackle regional health inequalities.

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

Cancer treatment and diagnosis remained a top priority throughout the pandemic, with 4.4 million urgent referrals during the period and over 1 million people receiving cancer treatment. Thanks to the brilliant work of our NHS staff, first treatments for cancer have been maintained at above 94% of usual levels over the course of the pandemic. However, we know that fewer people came forward, so we are now seeing record numbers of people coming through the system, with November last year having the highest number of 11,000 cancer referrals per working day.

[Mr Perkins]

I asked specifically about Derbyshire, but I did not get an answer. Derbyshire clinical commissioning group has failed to reach any of the cancer referral targets for the most recent 12 months. Although this is a national failure, the shortages are particularly acute in Derbyshire. These failures have tragic consequences. My constituent Paul Bryan is just 58. He has been attending his surgery for two years; he kept getting dismissed and was not tested, and now the prostate cancer that was undiagnosed for all that time has spread to his ribs, spine and bones, and his diagnosis is terminal. His family are urging the Government to show more urgency to improve outcomes, so that other families do not have to experience such needless heartbreak. Will the Minister explain to the Bryans why the Government rejected the workforce planning amendment to the Health and Care Bill that could have helped our NHS get the cancer specialists it needs and prevented heartbreak like the Bryans in other families?

[Maria Caulfield]

I am sorry to hear about the case of the Bryan family, but I reassure the hon. Gentleman that, in Derby and Derbyshire, 92% of treatments start within 30 days, despite record numbers of patients coming forward. To tackle the issue of getting people diagnosed earlier, which is key to getting more successful treatment, we are rolling out rapid diagnostic centres across the country so that people can access screening and testing much more quickly and easily. We have 159 of those live right now, with more to follow.

[David Simmonds (Ruislip, Northwood and Pinner) (Con)]

9. What steps he is taking to increase the delivery of personalised healthcare.

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[Mr Speaker]

Come on; we have got to get others in.

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

I thank the hon. Lady for her question, and we have met to discuss this previously. I am happy to discuss with Health Education England whether one of its centres for dentist development could be suitable for her constituency.

[Mr Peter Bone (Wellingborough) (Con)]

T6. In 2019 Kettering General Hospital, which serves my constituency, was promised £46 million for a major upgrade. Three years later the hospital still has not got the money. Secretary of State, will you go out and buy a very big pair of scissors, cut through the red tape and get it sorted?

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[Ruth Edwards (Rushcliffe) (Con)]

One of the best ways to maximise NHS capacity is to increase people’s access to GP appointments and treatments such as mental health services and physiotherapy in their own communities. Will the Minister join me in backing our bid for a new health centre in East Leake and in calling on Nottinghamshire’s clinical commissioning group to prioritise funds for this vital service?

[Maria Caulfield]

I thank my hon. Friend for her question. I had an excellent visit to the surgery in East Leake, and I look forward to the submission of the business case so that we can look at it further. She is right that investing in primary care does a huge amount to support the health of the local community.

[Helen Hayes (Dulwich and West Norwood) (Lab)]

T10. A survey by the charity stem4 has found that 95% of GPs believe that children and adolescent mental health services are in crisis, with children and young people waiting up to two years for treatment after referral. Will the Secretary of State stop treating children as an afterthought and act to provide open access mental health hubs for young people in every community, to put an end to these agonising waits?

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[Simon Jupp (East Devon) (Con)]

At Prime Minister’s questions, I raised a local campaign for a specialist menopause clinic in Devon. I am pleased the Minister agreed to meet me. Will my hon. Friend encourage local NHS leaders to fund specialist menopause centres?

[Maria Caulfield]

The Government recognise that menopause services need to improve, which is why menopause is a priority area in our women’s health strategy. We recognise such services are often best provided in primary care, but that some women need specialist services. We are looking at that in our women’s health strategy and the menopause taskforce.

[Kate Osborne (Jarrow) (Lab)]

In December last year, the Department of Health and Social Care promised three urgent actions to tackle the gender health gap: the appointment of a women’s health ambassador; legislation to ban hymenoplasty; and the publication of the women’s health strategy for England in spring 2022. Can I ask the Minister when those vital actions are actually going to happen?

[Maria Caulfield]

I can let the hon. Lady know that interviews have taken place for a women’s health ambassador. We are expecting an announcement on the appointment any day now. We will be publishing the women’s health strategy in the coming weeks.

[Sir David Evennett (Bexleyheath and Crayford) (Con)]

I welcome all that my right hon. Friend is doing to address health inequalities. However, could I ask him to look carefully at public health funding for my borough of Bexley, as we are seriously underfunded compared with similar boroughs in London?