Oral Answers to Questions

Debate between Maria Caulfield and Feryal Clark

Tuesday 5th December 2023 Commons Chamber

[Feryal Clark (Enfield North) (Lab)]

10. What steps she is taking to improve maternity services.

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

Since 2021, we have invested an additional £165 million a year to improve maternity neonatal care; next year, that figure will rise to £186 million. That investment is leading to progress on outcomes: stillbirths have reduced by 23%, and neonatal mortality rates are down by 30%.

[Feryal Clark]

Women continue to be failed by maternity services across England, as has been highlighted by a string of scandals including East Kent, Nottingham and Morecambe Bay. The Care Quality Commission’s maternity inspections over the past year downgraded many maternity units, branding two thirds of them as dangerously substandard and highlighting shortages of staff, among other problems. What additional steps is the Minister taking to ensure that a woman can go into maternity services knowing that she and her baby will come out alive, and can she tell us whether the recommendations of the Kirkup and Ockenden reviews have been fully implemented?

[Maria Caulfield]

The hon. Lady has touched on three inquiries. The Ockenden inquiry covered the period from 2000 to 2019, the Kirkup review covered the period from 2009 to 2020 and the Morecambe Bay inquiry covered the period from 2004 to 2013, so the Labour Government were also responsible for parts of all those periods.

We are introducing radical changes. We are increasing the number of midwives, which is up 14% since 2010, and the number of midwifery training places has increased by 3,650. We have introduced the maternity disparities taskforce to improve outcomes for those women who face the poorest outcomes, and have also introduced a maternity support programme for those trusts that do badly in CQC inspections—32 trusts are going through that improvement programme right now. Those are some of the things we are doing to improve maternity services.

Oral Answers to Questions

Debate between Maria Caulfield and Feryal Clark

Tuesday 24th January 2023 Commons Chamber

[Mr Speaker]

I call the shadow Minister.

[Feryal Clark (Enfield North) (Lab)]

The women’s health strategy was an opportunity to fundamentally change the inequalities women face. Women were promised a clinical women’s health lead in the NHS, yet a former Health Minister, the hon. Member for Sleaford and North Hykeham (Dr Johnson), admitted that there has not even been a discussion about establishing the role. Women in east Kent were promised change after the damning review of local maternity services, yet the Care Quality Commission is now threatening the trust there with enforcement action. Time after time, women’s voices are at best being ignored and at worst being silenced. So I ask the Minister: when will this Government stop letting women down with empty promises? Is the women’s health strategy worth the paper it was written on?

[Maria Caulfield]

Perhaps the shadow Minister will reflect on her comments when she receives the “Dear colleague” letter later today outlining the eight priorities areas for our first year of the strategy, with work such as the prepayment certificate for hormone replace treatment being done already; it is launching in April and saving women hundreds of pounds on the cost of HRT. May I say that I am gobsmacked by the Labour party’s position on this? Not only does it struggle most days to define what a woman actually is—for reference, it is a female adult human—but it cannot stand up for women either. There was no greater example of that than what we saw in this Chamber last week, when Labour Members were heckling the hon. Member for Canterbury (Rosie Duffield) and intimidating my hon. Friend the Member for Penistone and Stocksbridge (Miriam Cates). Come back to us when the Labour party is reflecting on the behaviour of its own MPs before dictating to us.

NHS Dentistry in England

Debate between Maria Caulfield and Feryal Clark

Wednesday 22nd June 2022 Westminster Hall

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

It is a pleasure to serve under your chairmanship, Mr Stringer. I thank my hon. Friend the Member for St Ives (Derek Thomas) for securing this important debate—even if it is two days in a row that we have highlighted some of these issues. I thank hon. Members on both sides for speaking on the matter.

I am slightly disappointed in the response of the shadow Minister, the hon. Member for Enfield North (Feryal Clark). In yesterday’s debate, it was acknowledged that in all four nations, no matter who is in charge—whether it is the Labour Government in Wales, the SNP in Scotland, or in Northern Ireland, where the Assembly is still being formed after the election—there are exactly the same problems. In my speech yesterday I made reference to the fact that in Labour-run Wales there has been a 71% reduction in dental activity in the last year. The shadow Minister spectacularly failed to answer the intervention from my hon. Friend the Member for Totnes (Anthony Mangnall) on that very point.

It is important to recognise that, yes, there have been problems since before covid, but covid has dramatically impacted—

[Feryal Clark]

Here we go.

[Maria Caulfield]

The hon. Lady says, “Here we go,” but it is important to recognise that for two years there were no routine appointments available due to infection control measures. We are now back up to 95% of activity, but the backlog that existed before is significantly larger than it was.

It is also important to recognise that the nub of the problem around covid has been the dental contract. The shadow Minister may not have heard what I said yesterday, but we have been negotiating a new contract with the BDA; we started those negotiations on 24 March, a final offer went to the BDA on 20 May, and we are awaiting its response. We have been in negotiations; we have not just been waiting for the work to be done. We expect to make an announcement before the summer recess—I said that both at oral questions last week and in the debate yesterday. We will be making an announcement in the coming weeks on those contract reforms.

Oral Answers to Questions

Debate between Maria Caulfield and Feryal Clark

Tuesday 14th June 2022 Commons Chamber

[Feryal Clark (Enfield North) (Lab)]

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?

[Maria Caulfield]

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.

Oral Answers to Questions

Debate between Maria Caulfield and Feryal Clark

Tuesday 19th April 2022 Commons Chamber

[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.

Oral Answers to Questions

Debate between Maria Caulfield and Feryal Clark

Tuesday 18th January 2022 Commons Chamber

[Maria Caulfield]

I thank my hon. Friend, who is pushing me constantly to improve access for her constituents, but can I reassure her that the announcement, the funds and the support are making a difference? In November last year, there were on average 1.39 million general practice appointments per working day, compared with 1.31 million in November 2019, but crucially, 62.7% of those appointments were face to face, so this is really making a difference for patients.

[Feryal Clark (Enfield North) (Lab)]

A nurse wrote this week about working on covid wards during the height of the pandemic:

“There were no vaccines or treatments then and we worked for hours in full PPE to protect ourselves and try not to bring the virus home to our families. There were no after work drinks for us…It is clear that there was a culture inside Number 10 where even if rules were not technically broken, the spirit of the rules were, and this is completely unacceptable.”

The nurse is the Minister. Surely she must agree that the Prime Minister should now resign.

[Maria Caulfield]

I am very disappointed by the hon. Lady’s question. Serious issues are facing the NHS and patients, and instead of playing party politics at the Dispatch Box, perhaps she needs to ask her own leader what he was doing in May last year.

Access to Radiotherapy

Debate between Maria Caulfield and Feryal Clark

Wednesday 12th January 2022 Westminster Hall

[Maria Caulfield]

There are satellite services—absolutely. We have seen them not just for radiotherapy, but for chemotherapy and even surgery. But it has to be a local decision, because local oncologists have to feel that they are able to support the multidisciplinary team who support the radiotherapy process, ranging from diagnostics through to the treatment itself. That has to be in place, so it does absolutely need to be done on a local basis, but I am happy to meet colleagues if they feel that the case is not being heard locally.

I want to emphasise this point, because a number of hon. Members talked about the commitment to cancer services. Our elective recovery programme has committed £2 billion this year and £8 billion over the next three years to step up activity and tackle backlogs. That will have a knock-on effect in improving radiotherapy access, because some patients cannot have radiotherapy until they have had surgery. Ensuring that we are tackling some of the backlogs to treatment resulting from covid is absolutely important.

There have been huge improvements in radiotherapy over recent years, not just in provision but in technique. We are able to deliver more targeted treatment, resulting in fewer hospital visits, because we can now give radio- therapy to a more targeted area of the body, resulting in fewer side effects from the treatment, and also give fewer fractions of radiotherapy, so that patients can get their total dose much more quickly. That maximises service capacity and minimises patient time in hospital.

Furthermore, we have invested £250 million into two proton beam therapy facilities, one based at the Christie in Manchester and the other at University College London. In addition, all radiotherapy centres in England are now able to deliver stereotactic ablative body radiotherapy. Both these treatments are able to target radiation at cancer cells more accurately, improving patient outcomes. I am really pleased to say that, as part of this year’s spending review, £32 million was made available to support the replacement of 17 linear accelerators aged over 10 years, all of which are on order and will be delivered by the end of March 2022.

NHS England is committed to improving the facilities for cancer patients, and has also offered NHS radiotherapy providers the opportunity to participate in a cloud-based technology called ProKnow. To date, 43 of the 49 radio- therapy providers have joined up. This technology, which will help satellite units, enables clinicians to collaborate virtually within and across organisations, to plan treatments, undertake peer-review assessments and participate in large-scale audits and quality improvement processes, ultimately benefiting patients.

A number of Members talked about the cancer workforce, because it is great to have state-of-the-art technology and multiple units providing radiotherapy, but if we do not have the staff to manage them and provide treatment we shall not make progress. Health Education England is continuing to take forward the cancer priorities identified in the NHS’s long-term plan. It is prioritising the training of 250 nurses to become cancer nurse specialists, 100 chemotherapy nurses and 58 biomedical scientists, and it is updating the advanced clinical practice qualification in oncology.

Further than that, particularly around radiotherapy, Health Education England is investing £52 million in the cancer and diagnostic workforce, increasing the number of clinical endoscopists and training more radiographers in image interpretation. That is all part of the radiotherapy process. As of August there have been an additional 4% of doctors working in clinical oncology, which is the field that manages radiotherapy, and there have been a further 5% working in radiology since August 2020.

We are making progress, but it is not just about the numbers of staff; it is about the skill mix and ongoing staff training. Very often, not being able to expand a role or take on exciting and innovative developments can make staff feel frustrated, but the cancer workforce is growing. Between 2016-17 and 2019-20, the cancer workforce grew by 3,342 full-time equivalents, compared with the ambition of 2,943. We are ensuring that there are more staff coming through into the workforce to deliver radiotherapy.

The shadow Minister touched on the importance of not only recruiting staff but retaining and developing them. I fully take on board colleagues’ comments and concerns. We are committed to investing in radiotherapy equipment, the staff that deliver radiotherapy and the innovation in radiotherapy. We are also committed to making it more accessible to patients, and to reducing the side effects—there are side effects from radiotherapy as well—and to making sure it is a fundamental part of cancer treatment, whether that is in the neoadjuvant setting, adjuvant or for those with metastatic cancer as part of the palliative treatment service.

[Feryal Clark]

I thank the Minister for all the information about the machines and investment into radiotherapy. Are the figures that she set out for replacing what is already out of date, or is there a plan to increase investment in radiotherapy treatment? As we have all said, radiotherapy accounts for 5% of the cancer budget. Is there a plan to increase that, or is it about replacement and keeping up what we already have?

[Maria Caulfield]

It is about replacing existing equipment, but also investing in new. Some of the equipment is 10 years old. Radiotherapy has changed a lot over those 10 years, so the replacement equipment can do more than what it replaces. As I pointed out, we are also investing in new radiotherapy equipment, with £250 million into two proton beam therapy facilities at Christie’s and at UCL—new facilities that will be able to provide state-of-the-art radiotherapy treatment. I hope I have reassured Members that we are addressing this as a top priority.