Draft General Dental Council (Fitness to Practise etc.) Order 2015

Michael Fabricant Excerpts

Tuesday 19th January 2016 General Committees

[Michael Fabricant (Lichfield) (Con)]

I do not intend to detain the Committee long. It is a personal pleasure to serve under your chairmanship, Mrs Gillan, as you and I share common views on certain matters, but perhaps not on the General Dental Council.

This morning, maybe rather foolishly, I emailed my dentist, whom I am seeing for a check-up on Friday in Bore Street in Lichfield, as I wanted to ask him for his impressions of the order. He has come back to me with a very brief number of points. If it is good enough for the Leader of the Opposition to mention Mary of Marylebone, it is good enough for me to mention my dentist—I will not mention his name—of Lichfield. He makes the point that there has been a massive increase in the number of complaints being made against dentists to the General Dental Council. He says it is up 110% in the past three years, partly because the GDC has been inviting people to make complaints. The GDC is just one of several bodies to which one can make complaints if one is not happy with the service from one’s dentist.

As the Minister and the hon. Member for Ellesmere Port and Neston have said, the whole point is to try to get complaints dealt with faster. That is a good thing in some ways, because it will reduce the stress not only for the patient but for dentists themselves. However, it is important that with the new, faster process, investigations are not skimped on. Can the Minister reassure me and my dentist in Lichfield that the new process will not mean that complaints are not be dealt with thoroughly? Some of them do need to be dealt with thoroughly, perhaps more so than at present.

I also make the point that the Opposition spokesman made about case examiners. It is important that they are seen to be independent, whether or not they are. In fact they have to be independent, but they also have to be seen to be independent. I am not altogether sure that people will be satisfied with the judgments that they make if it is thought that they are biased towards dentists, given that they are employees of the General Dental Council. I will be interested to hear what the Minister has to say about that.

The Opposition spokesman said that the GDC is one of the most expensive regulators in the country—perhaps the most expensive. My dentist makes the point that the GDC has increased its retention fees massively in recent years. Not every dentist is rolling in money, and the fees are quite a strain on their income. This might be slightly outside the remit of the order, but can the Minister assure me and my dentist, and indeed other dentists who might be interested, that the new structure will not directly cause GDC fees to go up for dentists? I look forward to hearing his reply.

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[Ben Gummer]

On the hon. Gentleman’s wider point about the reform of healthcare regulation and why it is happening through section 60 orders at this stage, I understand his frustration. I hope I can reassure him by referring to my written ministerial statement just before Christmas, in which I outlined that we are hoping to take forward the Law Commission’s report and look at the work that the Professional Standards Authority for Health and Social Care has put together on the reform of professional regulation, to see whether there is an ideal combination of the two pieces of work.

I have discussed the order at length with the regulators. They are content with the way we are going, and we will enter a period of extensive consultation, which I hope will lead to substantial reforms. However, that can be done only on a consensual basis. I very much hope to involve the Opposition in that work, because it is clearly important that healthcare regulation remains a non-partisan issue.

That takes me to another point that the hon. Gentleman raised: how we will guarantee the independence of the case examiners. I understand, especially given the recent history of the GDC, that he wants to ensure that independence in the first years. The Professional Standards Authority for Health and Social Care has proved itself a worthy guardian of healthcare regulation in the past few years. Its reports, one of which he quoted in his speech, give an accurate picture of the state of healthcare regulation. It will audit the new system with assiduity and report back in its annual review about whether it is working.

My hon. Friend the Member for Lichfield referred to the fees gathered by the General Dental Council, which have increased in several of the past few years. I understand from the PSA’s last report that the GDC’s performance has improved somewhat over the past year, but it certainly has a great distance to make up. It is not for me to determine fee levels for healthcare regulators. However, with a number of fees having gone up recently, I made clear to all the regulators when we met last that I expected them to do everything within their powers to either freeze fees or, where they find can efficiencies, pass them back to their members if possible.

[Michael Fabricant]

Can my hon. Friend reassure me that the specific measures in the order will not lead directly, because of excess or extra costs, to increased fees?

[Ben Gummer]

I can assure my hon. Friend that the order will be cost-saving for the General Dental Council—the estimated savings are £2.5 million. It depends slightly on whether the increase in referrals to the GDC continues. If it does, that saving will be eaten up in the increased resources required to process claims. However, if the number of incidents stays the same or reduces, I agree: the logic would be that the GDC might find space to reduce the fees it charges to its members. That is exactly what I have encouraged all the regulators to look at—how can they make justice quicker, which is good for everyone? If they save money in the process, which should only be a secondary consideration, it should be passed on to their members. In some regulated professions, many people, such as nurses or associated healthcare professionals, are not on high wages, and the fee levels make a difference. The regulators are aware of my views, and I put them as strongly as I can without infringing on their independence.

I hope I have answered every one of the shadow Minister’s points.

Oral Answers to Questions

Michael Fabricant Excerpts

Tuesday 5th January 2016 Commons Chamber

[Jane Ellison]

I thank the hon. Gentleman for his words, as does my hon. Friend the Under-Secretary of State for Life Sciences. With regard to the matter that he just mentioned, I know that it is something that NHS England is reviewing and it will come forward with a view in due course.

[Michael Fabricant (Lichfield) (Con)]

Will my hon. Friend join me in praising the work of the Institute of Translational Medicine at the University of Birmingham Medical School? It is doing outstanding, world-wide standard work in developing cures and treatments for such rare diseases, and indeed for more common diseases such as cancer.

[Jane Ellison]

I absolutely join my hon. Friend in that and agree with his very well-deserved words of congratulation. I know that the Under-Secretary of State for Life Sciences has visited the institute and is—as everyone is—hugely impressed with it. I also join my hon. Friend the Member for Lichfield (Michael Fabricant) and others in congratulating Charlie Craddock on his CBE in the new year honours list.

GP Services

Michael Fabricant Excerpts

Thursday 5th February 2015 Commons Chamber

[John Howell (Henley) (Con)]

It is a great pleasure to follow the hon. Member for Halton (Derek Twigg). I congratulate him on securing this debate, which highlights a very important subject.

Over the past few months, I have had discussions with GP practices across my constituency. I have had a number of meetings with GPs, usually during their lunch hour, and we have covered a wide range of topics, some relating to the new hospital being built in Henley as a re-provision of the old one, and some relating to the individual situation of GPs. These discussions arose out of my speaking to a conference of GP practice managers. It is important to stress the crucial role of managers in running GPs’ practices. There was a lot of agreement between myself and the right hon. Member for Oxford East (Mr Smith) about how the health service is organised. My meetings with GPs have also come about as a result of talking to patient groups.

GPs are excited at the possibility of providing a range of services, through new methods, in the hospital in Henley, and are very much part of the discussion with the CCG on this. There is a real possibility of an emergency multidisciplinary unit there.

When talking to GPs, I have raised the subject of access to GPs and services. In my constituency, access is not an issue. If people need urgent appointments, GPs will make themselves available. People can ring for an appointment and be given one very quickly. I have found that to be the case with my own surgery, for example, and I applaud the dedication and the willingness to work in co-operation that have been shown by GPs in these circumstances. Sometimes, though, if people ask to see a specific GP urgently, that may not be possible, but these are small practices where there is good communication and discussion of medical issues between the limited number of doctors there. Access does become a problem when practices are essentially outposts of another practice. This occurs in the north of my constituency in a village called Chinnor, where the practices are outposts of practices across the border in Princes Risborough. Managing that can create certain problems for GPs.

The major problem put to me by GPs is patient expectations. I would not want to limit patients’ genuine expectation of good service provided in a timely manner, but we expect things without a wait, so the issue is the expectation, rather than the GP’s availability.

[Michael Fabricant (Lichfield) (Con)]

Does my hon. Friend agree that another problem facing GPs and the NHS in general is patients who make appointments with GPs and consultants and do not turn up?

[John Howell]

If my hon. Friend will give me a chance, I will come to that very point, which is one that I discussed with GPs and patient groups.

There is also the expectation of what a GP can do. The number of visits per patient may be up, which is increasing demand, but the causes, according to GPs, are, first, the desire for an instant cure. People are not giving minor ailments time to heal themselves, but expect medicine on tap for everything. Thus going to a GP as soon as symptoms occur is part of the expectation. Secondly, people are motivated to see their GP by advertisements listing symptoms and encouraging people to go to a GP if they have them.

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[Stella Creasy]

It is unusual for me to agree with the hon. Gentleman, but I agree that we need to look at how we can attract and retain doctors. We also need to look at what these problems do to the rest of the NHS.

Let me tell the hon. Gentleman about a constituent of mine who had a problem with his eyesight that was caused by high blood pressure. Because he could not get a doctor’s appointment, he left the condition alone. He has now gone blind in one eye and his other eye is at risk. His elderly wife came to me because she did not want to bother the doctor. We have to change that culture and to consider the consequences of not using our resources to deal with those early problems. When we leave somebody like that and they end up going blind, the cost to all of us to help them is much greater than if they had been able to access a GP. We must look at the terms of the job, but also at where the resources are not going. I have been raising those questions with local health care providers.

[Michael Fabricant]

I am very interested in what the hon. Lady has to say. She said that in her constituency—she must tell me if I have got this wrong—there are a large number of single-doctor practices. Does she not think that that is the cause of the problems, and that the Government should encourage practices to consist of a number of doctors working together?

[Stella Creasy]

Although I am a doctor, I am not a medical doctor, so I warn the hon. Gentleman that if he needs treatment, he should not come and see me. However, I could tell him why he has no friends—that is the sort of doctorate I have.

There are many issues and the number of single practices might be one of them. My point is that nobody has got a grip of this issue over the past couple of years, despite the fact that I, as the Member of Parliament, have raised concerns. In 2011, the complaints about access to GPs started coming in. I went to the primary care trust, but because of the reorganisation of the NHS, nobody was interested in the case that we were trying to make. The PCT said, “Wait until the CCG is organised.” I tried the new CCG, but six months after saying that it would look into the repeated complaints that I had raised, it said that this was not its issue and told me to go to NHS England.

Initially, NHS England told me that I could not raise the issues on behalf of patients because of patient confidentiality. It could not respond to any of the concerns that I was raising because they related to patient records. It then tried to say that unless the residents had complained to the GPs about GP access, it would not look into the issue, even though I had a binder full of complaints, which showed that it was a problem not just with an individual practice, but with many local practices in my local community. There was widespread concern. The problem continued and, eventually, NHS England came back to me and said, “It’s all right. We’ve spoken to the practices and they have said that if people want an appointment, they can ring up and get one.” It was a circular and deeply frustrating experience.

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[Sarah Newton]

I welcome the Minister’s intervention. That sounds like an excellent initiative and I am sure that more will follow, because we need to use the talents of everyone in our nation to address the challenges that we face. Women can play an enormously important role in the NHS, as they can in all other walks of life.

[Michael Fabricant]

I was very interested in the intervention from the Minister, who is of course also a GP. I was also impressed by some of the points made by the hon. Member for Walthamstow (Stella Creasy) about sole GP practices. If we are to have flexibility, so that people can go and see doctors quickly and to enable women and others to go back to work as GPs, it surely requires multi-GP practices, not sole practices. Otherwise, it is just not practical.

[Sarah Newton]

That is a good point. We have to look at how general practices are set up these days. Not all general practitioners want to be part of the old partnership model, which is a sort of small business. Many now would like to be salaried and work particular hours in particular settings. I would not want to prescribe a particular model: we need to look flexibly at different models of provision that meet patients’ needs, taking into consideration what the work force need to enable them to play their full part.

GP practices in my area are expanding the range of services that they are able to provide to the community. As hon. Members will know, I represent a large, remote, sparsely populated part of the country, and such expansion is especially important for rural areas. One example is the Probus surgery of GPs, which serves many villages in its rural community. It is expanding into many areas, including minor surgery. I have yet to come across anyone who has anything other than praise for the Probus surgery, which provides the normal services one would expect from a surgery, but also works closely with its primary care partners and district nurses. It also links up with care managers for people with chronic conditions and elderly people living at home.

By comparison, a very different group of GPs work at Penryn surgery. They serve a large campus that is home to Exeter university, Falmouth university and parts of Plymouth university. There is a growing student population and the surgery has been able to expand its services to provide mental health services, prescribing services and on-campus surgeries. In attracting additional funding for services to meet the needs of the young people—we welcome them into the constituency to study there—they have additional resources from which the whole community can benefit.

Those are two very different examples of how GPs are working positively and constructively with local commissioners to expand services, bring in additional resources and improve patient outcomes for the local community.

Oral Answers to Questions

Michael Fabricant Excerpts

Tuesday 13th January 2015 Commons Chamber

[Mr Hunt]

I believe that NHS managers have a responsibility to be sensible about their own pay. This is not decided centrally, but when we are asking NHS staff to make sacrifices in their own pay to make sure that we can recruit enough staff, NHS managers should set an example.

[Michael Fabricant (Lichfield) (Con)]

The Institute of Translational Medicine at Birmingham university medical school is probably the top place in Europe for genetic research into innovative cancer cures. I have visited it. Will the Secretary of State visit it, and will he ensure that funding continues for that department?

[The Parliamentary Under-Secretary of State for Health (Jane Ellison)]

My hon. Friend is right to champion that project. The Prime Minister’s 100,000 genomes project is leading the world and has the potential to transform the future of health care. The Institute of Translational Medicine in Birmingham will accelerate access to new diagnostics, new drugs and medical devices and provide a focus for life sciences. My hon. Friend will be pleased to know that my colleague with responsibility for life sciences, my hon. Friend the Member for Mid Norfolk (George Freeman), plans to visit on 3 March.

Oral Answers to Questions

Michael Fabricant Excerpts

Tuesday 10th June 2014 Commons Chamber

[Dr Poulter]

A recent HealthWatch report highlighted this issue in west Yorkshire, where access to dental services has been a long-standing challenge. NHS England is looking at the financial arrangements in west Yorkshire and will report back soon. I am happy to meet my hon. Friend and representatives from the local NHS to take this issue further forward and ensure that local patients get the service they deserve.

[Michael Fabricant (Lichfield) (Con)]

9. What steps he is taking to ensure that whistleblowers in the NHS are protected from (a) dismissal and (b) other punitive measures by their employers.

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[Mr Hunt]

I am most grateful for any encouragement I can get.

The NHS needs to change its culture to be much more open to whistleblowers. That is why we have banned gagging orders in contracts and funded a whistleblowing helpline and website, and why we are working with brave whistleblowers, such as Helene Donnelly from Mid Staffs, to reform the training of NHS clinicians to make it easier.

[Michael Fabricant]

I am grateful for that answer. About 10 years ago, two people, a nurse and a consultant surgeon from the same hospital, came to my surgery and showed me evidence of filth—mouse droppings—in even consulting rooms and the operating theatre. They were frightened to leave the documentation with me, because they thought they would be sacked if it was found that they were the whistleblowers. Will they now have the assurance that they could give me or others evidence without fear of retribution?

[Mr Hunt]

I hope so, but I want to be honest with the House. It takes time to change a culture, and that is the big change we have to make. Whistleblowers are now coming forward from Coventry, Cambridge, Ealing and all over the country. That is why I am afraid that I profoundly disagree with the shadow Health Secretary, who said that the lessons of the Francis report were about a local failure. This is about a systemic problem and we have to change it across the NHS.