Excess Death Trends

Debate between Maria Caulfield and Caroline Johnson

Tuesday 16th January 2024 Westminster Hall

[Maria Caulfield]

Not for the moment; let me respond to as many points from hon. Members as I can.

There is an increase in excess deaths. A number of factors contribute to that. We take that seriously, and monitor it constantly. Looking at the past year, for example, there was a high flu prevalence last winter, when there were still ongoing challenges relating to instances of covid-19 and a strep A outbreak, particularly among children. Those had an impact. Statistics from the Office for Health Improvement and Disparities showed that last year, there were almost 26,400 excess deaths in England, and of those excess deaths, 7,300 were due to acute respiratory infections, including flu and pneumonia.

Last winter, the number of positive tests for flu peaked at 31.8%—the highest figure in the last six years. There are schools of thought on that; one is that when people were locked down, they were not exposed to flu for a couple of years, so their immune systems struggle to cope. We have learned those lessons, and that is why, this year, we have brought forward our flu vaccination programme. We have successfully vaccinated over 17.6 million people since the campaign started in September. It is still early in the winter season, but—touch wood—we are seeing fewer admissions from flu and covid than we did last year. We are learning lessons from those excess deaths.

There are also excess deaths from cardiovascular diseases; that was pointed out during the debate. The figure is 6% higher than expected in England, with almost 13,500 excess deaths attributed to cardiovascular disease. Lockdown did have an impact on that. We know that people were not getting their cholesterol tested or their blood pressure checked, and were still smoking. Antihypertensives and statins were not being prescribed. Again, we have taken action. As my hon. Friend the Member for South West Bedfordshire (Andrew Selous) pointed out, we are supporting local authorities to resume normal NHS healthcare checks; between April and June last year, the highest number of checks were offered since the programme began in 2013. We are investing £17 million in innovative new digital health checks, to be rolled out this spring, that will deliver an additional 1 million checks in the first four years. We have a £10 million pilot to deliver up to 150,000 cardiovascular disease checks in the workplace, with free blood pressure checks being rolled out in community pharmacies to people over 40, and we are investing £645 million to include blood pressure checks in our community pharmacy facilities. That is in addition to the work the Prime Minister announced on a smoke-free generation, which will be debated further, through which we want to see smoking rates further reduce.

I turn to the elephant in the room—covid vaccines—because the hon. Member for North West Leicestershire and other hon. Members have raised concerns about their safety. It is true that Office for National Statistics data, published only in August, shows that people who have had a covid-19 vaccine have a lower mortality rate than those who have not been vaccinated. My hon. Friend the Member for Bosworth (Dr Evans) and the hon. Member for North West Leicestershire are absolutely correct that a high number of people who were vaccinated appear in the excess death population, but when 93.6% of the population have had at least one dose of a covid vaccine, there will be a high number of vaccinated people in the excess death numbers. That is prevalence, not causality. It is important that we look at the causes of excess deaths and tackle them.

[Dr Caroline Johnson]

The Minister is saying that the number of people dying who are vaccinated is higher than the number of people who are not. That is to be expected because they are more likely to be older and frailer. Does she have any data that are adjusted for age and frailty—to say whether the vaccinated population are more or less likely to die?

Under-age Vaping

Debate between Maria Caulfield and Caroline Johnson

Wednesday 12th July 2023 Commons Chamber

[Maria Caulfield]

That is the balance we have to create. We do not want unintended consequences whereby we reduce the use of vapes in under-18s but also stop their use among those who are quitting smoking. We know from our evidence that vaping is much safer than smoking. For those communities, very often in deprived areas, where there are higher rates of smoking, we do not want the cost of vapes to be prohibitive and for people not to switch to them instead of smoking.

Our current laws protect children by restricting the sale of vapes to over-18s and limiting nicotine content, and there are regulations on refill bottles, tank sizes, labelling requirements and advertising restrictions. It is important that we remember that regulations are in place, and it is important that they are enforced.

[Dr Caroline Johnson]

The Minister is talking about evidence that vapes are much safer, but I notice that she has not used the 95% figure that is used by the industry. Clearly, the absence of evidence of harm and evidence of the absence of harm are different things, so will the Minister clarify whether she has evidence that vaping devices are much safer? Or does she just not have evidence yet, because they are so new, that they are not dangerous?

Oral Answers to Questions

Debate between Maria Caulfield and Caroline Johnson

Tuesday 6th June 2023 Commons Chamber

[Maria Caulfield]

I thank the hon. Gentleman for his question. We take this issue very seriously, and we have already made interim payments to those infected. The Minister for the Cabinet Office came to the Dispatch Box in April when Brian Langstaff’s review was published, and we are working night and day to respond to those recommendations and get that plan out as soon as possible. We recognise the impact on families, and on those infected and affected.

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

I refer Members to my entry in the Register of Members’ Financial Interests. Today Dr Mike McKean, a respiratory consultant and vice-president of the Royal College of Paediatrics and Child Health, said that vaping is “fast becoming an epidemic” among children. The Royal College of Paediatrics and Child Health said that we should ban disposable cigarettes—e-cigarettes—“without a doubt”. Will the Minister do all he can to prevent children from starting vaping, and will he back my ten-minute rule Bill, which was first introduced in this place in February, to ban disposable e-cigarettes?

NHS Dentistry: Lincolnshire

Debate between Maria Caulfield and Caroline Johnson

Wednesday 20th October 2021 Commons Chamber

[Maria Caulfield]

My hon. Friend makes a good point, and across Government Departments we are discussing the provision of both general practitioners and dentists for new developments. I am keen that dentistry is on a par with GP provision, because it is often an afterthought. I am keen that we push it up the agenda, and this debate helps.

[Dr Caroline Johnson]

Will dentists have a voice on care panels in the new integrated care systems?

[Maria Caulfield]

I thank my hon. Friend for that query. I am keen that dentistry has a louder voice than it does now.

As I was saying, part of this debate is about raising the profile of the issue. I reassure her that there are a number of things happening, particularly in her region. NHS England Midlands and East, which covers the east of England, is putting in place a number of initiatives, about which I wish to reassure her. Additional weekend dental sessions are going to be commissioned, to take place up to March next year. There will be additional clinical capacity to reduce waiting lists where a general anaesthetic is required, particularly for children. NHS England has also begun a procurement exercise to address the lack of orthodontic access across the region, particularly in Lincolnshire. To get us through the pandemic recovery phase, we will work closely with NHS England to ensure that that is happening as fast as possible.

In the short time available, I wish to turn to the long-term plan to address the shortfall that was there before the pandemic. We are taking up some of the suggestions that my hon. Friend has made so eloquently in this debate. The core of that is about ensuring that the NHS dental contract is renewed, because we are in a perverse situation where the contract sometimes acts as a disincentive. She made points about over-delivering or under-delivering; people can be penalised, and we can understand why dentists walk away from NHS contracts. This Government are focused on addressing that.

--- Later in debate ---

[Maria Caulfield]

I am happy to meet my hon. Friend to discuss that issue with her. She represents a coastal constituency, and this emphasises the point about where there seem to be gaps in provision.

I am pleased that we are being able to take specific action, both nationally and locally, to improve recruitment and retention, because that is key. This includes widening access to dental careers and utilising the skill mix in dental practices. It is not always the dentists who need to be used and we need to upskill some of the dental workers in dentistry too, so that we can understand the oral health needs of patients in specific communities. As part of that work, Health Education England is looking to address regional shortages by ensuring that training place numbers are better aligned with the needs of local populations and that we are targeting provision. I take the point made by my hon. Friend the Member for Sleaford and North Hykeham about a dental school and I will look at that suggestion. She rightly says that students tend to stay where they train, and we need to look at where the gaps are. The number of dental school places is increasing and we are getting more students through, but I will look at her suggestion.

I feel that I have not specifically addressed the situation in Lincolnshire as a whole, which is the subject of the debate, so let me reassure my hon. Friend that a number of measures are in place to address the issues there. We have introduced additional face-to-face weekend dental sessions from August this year through to March next year; there are dedicated urgent dental slots for 111 patients; and we are trying to address some specific local gaps in Mablethorpe by commissioning urgent NHS dental care sessions on a temporary basis. We also want to improve recruitment and retention specifically in my hon. Friend’s area. Health Education England is working in Lincolnshire to recruit newly trained dentists but should perhaps look at a dental school to support that effort even further.

My hon. Friend raised orthodontic issues, which are very important for young people’s health. NHS England Midlands and East has begun a procurement exercise to address some of the backlog. Patients with a clinical need to start treatment quickly will be contacted. I reassure the House that any patient who was referred before they turned 18 but has not yet started treatment will still get free treatment, even after their 18th birthday, because the backlogs are not their fault.

I know that I have not answered all my hon. Friend’s questions, but I hope she knows that we take this issue extremely seriously. The provision of dentistry is a complex policy area for which there is no quick solution, so I shall not make promises tonight that we cannot deliver, but we are serious about trying to address the issues. I hope I have been able to provide some reassurance that, although this issue is challenging, as the new Minister responsible for dentistry I am committed to playing my part in not only supporting the covid recovery but driving forward long-term improvements. We want to see a contract that is attractive for professionals and that ensures equality of access for all, across rural regions and coastal regions.

[Dr Caroline Johnson]

Before the Minister sits down, may I ask her to meet me later this week, or perhaps next week, to discuss further the impact on military personnel in particular?

[Maria Caulfield]

Yes, absolutely. I have not been able to address that in my speech but I am keen to meet my hon. Friend and other colleagues who have particular shortages in their areas. I want to hear what is happening on the ground and make sure, as we go forward, that the problems are addressed and we start to see improvements. I would be happy to meet my hon. Friend and other colleagues.

Question put and agreed to.