Covid-19: Government Handling and Preparedness

Mohammad Yasin Excerpts

Thursday 27th May 2021 Commons Chamber

[Matt Hancock]

The last point is very tempting, but I will leave it to the independent regulator to make that decision and determine its timing—but we are all very excited about the progress of the Teesside vaccine, as my hon. Friend calls it, the Novavax vaccine. He is also right to raise the point about vaccinations around the world. The UK can be very proud of having played such a critical role because of the investment we made in the Oxford-AstraZeneca vaccine right at the start of this pandemic, and because we decided together with Oxford university and AstraZeneca to make this vaccine available at cost around the world. I can give the House an update: over 450 million doses of the Oxford-AstraZeneca vaccine have now been deployed around the world at cost. That is the single biggest gift to the world that we could make with respect to vaccines. It is because of the attitude that the Government took, working with one of our greatest universities and working with one of our greatest industrial partners. It is another example of the big team effort that is helping in this case the whole world get out of this pandemic.

[Mohammad Yasin (Bedford) (Lab) [V]]

At Prime Minister’s Question Time in July, I raised concerns of a care home owner in Bedford who was told as late as 21 May that, if she refused to accept the return from hospital of a covid-positive patient, they would be discharged to an unfamiliar home. I know the Secretary of State is desperate to dismiss Mr Cummings’ version of events on care homes, but to do so would mean calling the care home owner a liar. Who is responsible for the high numbers of unnecessary deaths: the Health Secretary or the Prime Minister?

[Matt Hancock]

As I said, we have answered this question many times before. What I would add to those answers is that it is another example of constantly learning about the virus. As we learned the impact of asymptomatic transmission in particular, we changed the protocols in care homes over the summer and put in place the winter plan that led to a greater degree of protection in care homes over the second peak. We are constantly looking to make sure that we can learn as much as possible and work with the sector to help people to stay as safe as possible.

Oral Health and Dentistry: England

Mohammad Yasin Excerpts

Tuesday 25th May 2021 Westminster Hall

[Mohammad Yasin (Bedford) (Lab) [V]]

I beg to move,

That this House has considered oral health and dentistry in England.

It is a pleasure to serve under your chairmanship, Ms Bardell. I was compelled to call for this debate after an NHS 111 call handler contacted me to describe the hardship that they experienced in trying to get patients in severe pain emergency dental appointments—too often without any success. Dental practitioners and lab technicians have also approached me, detailing the many obstacles in their profession that are preventing them from giving the care that they so desperately want to give their patients. The different perspectives make it blatantly clear that dentistry in this country is in crisis and patients, including children, are not getting the care that they need.

There is a lot of work to be done to fix what has long been a broken system, so let me start with thanks to all my colleagues who are contributing to this debate and to all those organisations, including the British Dental Association, the Association of Dental Groups, the Faculty of Dental Surgery and Healthwatch, and dentists in my constituency, who not only briefed me for the debate but have been working day in, day out, for years to raise the serious issues that I will go on to mention and who have the solutions, if only the Government would listen.

I hope that the Minister will come to the table today with a response that matches the gravity of the situation, because access to dental care in England is in a parlous state. A constituent employed by the NHS 111 service first got in touch with me in September 2020, in the midst of the pandemic, to tell me, in his words,

“about the woeful state of the dental service or more precisely the lack of a dental service”.

He covered Hertfordshire, Bedfordshire and Essex, but was aware that his comments applied nationwide. He told me that he spent the majority of his day speaking to people who were literally crying out for an appointment and even emergency treatment, but he had absolutely nothing to offer them. He told me that if someone is lucky and already registered with a dentist, they might be offered an appointment at some future date, often weeks in advance, but if not, they had no chance of being taken on. He said that that applied to everyone, including children and pregnant women. That was of course during lockdown, but many of the barriers to finding appointments persist.

I contacted the constituent again in February and he told me that, if anything, the situation was worse. He worked almost exclusively on dental calls; they were coming in relentlessly. He described it as a Catch-22 situation. If people are not registered at a practice, NHS 111, virtually without exception, can only tell the callers that practice books are closed to new NHS patients for the foreseeable future. If a patient is registered, they will be told that their practice cannot offer treatment—often for weeks ahead. Let us remember that patients call 111 only as a last resort and are mostly in considerable distress. They mistakenly believe that the NHS runs the dental service, and have nowhere else to go. Many turn up at A&E in desperation, which only adds to the pressure on NHS hospitals which do not have the capacity, expertise or tools to fix dental problems.

My constituent told me it was heart-wrenching to have to listen to these calls for six hours a day. Last week, when I asked for his permission to raise his concerns in this debate, he told me that

“there is real anger and desperation brewing.”

I hope that the Minister is listening carefully to my constituent’s experience, because this is the situation on the ground. I am sorry to say that he has now decided that enough is enough—he will leave his role because he says he

“can see no possibility of any improvement this year.”

NHS dentistry is facing an unprecedented backlog in care that will take years to clear. The BDA estimates that a staggering 30 million NHS dental appointments have been lost since the start of the pandemic, and a report published yesterday by Healthwatch found that 80% of people struggled to access timely care during lockdown.

Even before the pandemic, only enough NHS dentistry to cover just over half of England’s population was commissioned. Over a quarter of people either struggle to or cannot pay, so they avoid dental treatment altogether. Capacity is severely limited by infection control measures, and access problems have now reached an unprecedented scale in every community, with deep existing inequalities set to widen even further.

If the Government are serious about levelling up, tackling health inequalities needs to be at the top of the agenda. Healthwatch found that, among people living in the north-east of England, those on low incomes and ethnic minority groups were hardest hit by the twin crises of access and affordability.

The Care Quality Commission’s “COVID-19 Insight: Issue 10” report published last week rightly questions whether enough NHS dental capacity is being commissioned, and challenges NHS policy leaders to deal with the demand and ensure that everyone—especially the most vulnerable—has equal access to NHS care.

The system has long suffered from chronic underfunding. Even if you factor in the income from patient charges, which have been increased by an inflation-busting 5% in each of the last five years, the total NHS dental budget was lower in cash terms just before the pandemic than it was when Labour left power in 2010.

The dental contract introduced in 2006 is structured with ridiculous, counterproductive targets which do not make things any easier. Totally discredited and unfit for purpose, it is incompatible with providing safe and sustainable services for patients, both during and after the pandemic, and must be reformed. The peculiar Units of Dental Activity system effectively caps the number of patients a dentist can see on the NHS and actively disincentivises dentists from taking on new NHS patients, especially in poorer areas where a new patient is more likely to have large, unmet dental care needs.

I am grateful to the Parliamentary Engagement team, who ran a survey in relation to this debate. When asked what key changes would enhance their ability to do their job every single respondent, 78% of whom were oral health professionals, wanted to abolish what one described as

“the aberration that is the UDA system.”

Another said that they would have no problem committing to provide 100% NHS dentistry if they were paid for the work they did. However, under the current system, a root canal treatment—which can take up to three hours of highly technical and skilled work—is renumerated the same as a little filling that may take 30 seconds to place.

Why can the Government not understand that a work- force work best when they are respected and incentivised? We need to get more patients through dentists’ doors, but aggressive and punitive activity targets are not the way to go about this. The targets have been the driving factor behind the recruitment and retention crisis in NHS dentistry. While the Minister is keen to point out that the headcount of dentists providing NHS services has been pretty stable, when dentists need to do only an hour of NHS work a week to be considered an NHS dentist, that is meaningless smoke and mirrors.

In reality, many dentists have been reducing the NHS work they do, and the Minister’s written answer last week revealed that the number of practices providing NHS dentistry in England fell by 1,253 between 2015 and 2020. As in other parts of the NHS, the pandemic has brutally compounded the pre-existing problems in the dental system.

I appreciated and welcomed the Government’s support for NHS dentistry in the early stages of the pandemic. The Minister quite rightly decided to pay dentists their historical contract values when they were told to close their doors to patients in the first lockdown. After dental practices reopened last summer, dentists were asked to work their way through the backlog, prioritising patients on the basis of need, instead of focusing on delivering units of dental activity.

Just before Christmas, however, the Government changed course. Despite standard operating procedure continuing to severely limit the number of patients that can be seen safely, the Government expected dentists in England to deliver 45% of their historical activity between January and March or face financial penalties. This target was further increased to 60% in April. The BDA members survey suggests that a large proportion of dentists managed to meet the target only by taking extraordinary measures, such as cancelling all annual leave and working beyond their contracted opening hours—all of this while working many hours a day in heavy-duty personal protective equipment.

Dentists in my constituency tell me the same story: the situation is not sustainable. To put this in context, the Labour Government in Wales have not introduced any such targets, recognising that chasing activity measures is good for neither patients nor dentists in the context of a pandemic. I would welcome the Minister’s explanation of the extreme difference in approach between England and the rest of the UK, and I urge her to follow the lead of the Administrations in Wales and Northern Ireland, who have committed capital funding towards buying high-capacity ventilation equipment, which can drastically cut down the fallow time required between treatments. This sensible investment allows dentists to see more patients safely and will pay for itself in increased patient charge revenue.

Morale in the profession is at an all-time low, and there is a real danger that the pressures will turbocharge the flight of dentists from the NHS, driving them into private dentistry or early retirement, and making the problems with access for patients a permanent feature of our dental health service. That is on top of the significant loss of overseas dentists as a result of Brexit. The backlog created by the pandemic cannot be tackled if we have no workforce left to do it. Dental practitioners must urgently be added to the shortage occupation list. I hope that the Minister will outline the Government’s road map out of the current high-intensity infection prevention and control measures.

There can be no more kicking the can down the road when it comes to contract reform. It is now a matter of urgency. I would welcome the Minister’s assurances that the new system will be rolled out more quickly, and certainly without any further delays, and that it will decisively break with the discredited units of dental activity and instead prioritise increasing access for patients, and prevention. It is vital that the Government seriously invest in preventive measures.

Oral health is an essential precondition and indicator of overall health, and it deserves to be given priority in our health system. One in eight children in Bedford has obvious tooth decay by the time they are three, and the figure rises to one in five by the time they turn five. The Government are letting children down. In the year before the pandemic, over 23,000 children between five and nine were admitted to hospital because they had tooth decay. It is absolutely shameful that a completely preventable disease continues to be the No. 1 reason why young children in England are admitted to hospital. In the last five years, 540 children in Bedford have been admitted to hospital for tooth extractions, wasting over £500,000 of precious NHS resources just in our town, as well as causing pain and stress.

Procedures under a general anaesthetic are another area of dentistry where the pandemic has taken a heavy toll. They are often necessary in children with extensive decay and adults with special needs, and waiting times were very long even before the pandemic, with patients often waiting in excess of a year. The suspension of most non-urgent surgeries has left tens of thousands of patients in pain for months, with some taking huge amounts of painkillers or resorting to do-it-yourself interventions or multiple rounds of avoidable antibiotics while they wait for this completely preventable surgery.

I welcome the plans to legislate to recentralise water fluoridation as a preventive measure, but would welcome assurances that changes to the legal framework will be accompanied by proper funding, otherwise it will be meaningless. Water fluoridation is highly effective, but it will take years before we see its effects, so proper investment in preventive oral health programmes, such as supervised toothbrushing, is needed. Supervised brushing is estimated to save over £3 for each £1 invested over five years. I hope we will see a consultation and a roll-out of this sensible and highly effective intervention very soon.

Finally, I turn to the forthcoming health and social care Bill. Beyond the measures on fluoridation, the White Paper barely mentions dentistry at all. I hope to hear a commitment today that dental services will be properly represented in the governance structures of the integrated care systems, and that the changes to commissioning structures—and particularly any possible pooling of primary care budgets—do not result in further cuts to dental budgets.

Covid-19

Mohammad Yasin Excerpts

Tuesday 25th May 2021 Commons Chamber

[Nadhim Zahawi]

I absolutely agree with my hon. Friend. If the virus were designed to test liberal democracies, because the only way we could combat it was to withdraw people’s freedoms with the dreaded non-pharmaceutical interventions, the vaccine has played to the real strengths of the four nations that make up the peoples of these isles. We have had that Dunkirk spirit of coming together as 1,000 flotillas: the 80,000 volunteer vaccinators, the doctors, the nurses, the pharmacists and, of course, our armed forces and local government colleagues, who have stepped up not only to identify communities that we need to protect, but to find sites.

We are already making plans for the booster jab to be ready by September. I remind the House that the clinical decision has not yet been made, but when it is—whether that is in September, in October, in November or early in the new year—we will be ready to go. We are also planning how it will dovetail with our flu vaccination programme and seeing how we can increase the uptake in flu vaccination, because the worst of all worlds would be to do well against covid and then be hit by a heavy flu season in the autumn.

[Mohammad Yasin (Bedford) (Lab) [V]]

Last evening, I learned that the Government had sneaked Bedford borough into local lockdown without even bothering to warn the public health team. The Minister knows that for almost two weeks I have been calling for surge vaccines in Bedford for all over-16s, yet until last Friday many of my constituents were forced to travel miles to access the Pfizer vaccine. The variant first identified in India has been imported here because of the Government’s lax approach to border control. Why are the people of Bedford paying for the Government’s gross negligence and incompetence once again?

[Nadhim Zahawi]

The hon. Gentleman and I discussed the turbocharging of the vaccination programme in Bedford, which I know he appreciates. The real difficulty is that, if we now begin to vaccinate people who are 18, outside the JCVI’s advice, we are taking vaccine away from others who are eligible and need that protection. So the strategy we are pursuing is to turbocharge. I need to explain that a little. We are effectively putting in more resource, later opening and mobile vaccination centres and we are expanding vaccination centres, so that those who are already eligible and, for whatever reason, have been unable to access the vaccine or have been waiting to see, can get the protection of the first dose. Of course then we get the second dose into all those over the age of 50, because we know that the two doses in those areas, against the B.1.617.2 variant, make a huge difference.

Women’s Health Strategy

Mohammad Yasin Excerpts

Monday 8th March 2021 Commons Chamber

[Ms Dorries]

Absolutely, and I thank my hon. Friend for her question and for highlighting that case. I urge her constituent to contact us and share her experiences with us. Fertility clinics across England have remained open throughout the last lockdown. Clinics obviously have to meet robust criteria to assure the Human Fertilisation and Embryology Authority that safe and effective treatment can be offered. I am not sure of the geography that my hon. Friend was talking about, but I am disappointed to hear the difference between two care commissioning group areas and would ask her to ask her constituent to contact us and let us know more details about her experience.

[Mohammad Yasin (Bedford) (Lab) [V]]

In January, Bedford Hospital’s maternity services were downgraded to inadequate due to significant concerns on the part of the Care Quality Commission about staffing levels and insufficient training. Maternity staff are facing extreme burnout during this pandemic. The hospital has taken steps to improve services, but will the Minister tell me what her Government’s plan is to urgently train, recruit and retain more midwives so that all women can receive safe maternity care?

[Ms Dorries]

One of our objectives is to be the safest country in the world in which to give birth, and we have made tremendous progress by halving stillbirths and neonatal deaths. This is an area in which we are making huge progress, and I would ask the hon. Member to ask those with whom he is discussing these issues to respond to today’s call for evidence.

Covid-19 Update

Mohammad Yasin Excerpts

Tuesday 2nd March 2021 Commons Chamber

[Matt Hancock]

That is an important point. We do not have mandatory vaccinations in this country. We do encourage as much uptake is possible, but with the percentages for uptake well into the 90s among the groups who have been offered the vaccine, it is clear that we will be able to get very high levels of coverage and therefore lift restrictions. I hope will be able to lift restrictions on the basis of the dates in the timetable set out but, as per my answer earlier, we will also monitor the data on the impact between each one.

[Mohammad Yasin (Bedford) (Lab) [V]]

Anita Barker, the headteacher of Scott Primary School in Bedford, is doing all she can to keep her school safe and open, but she knows that more can be done and wants her staff to be vaccinated. I understand the JCVI’s reasoning on priority, but we have already made a special case for schools. The success of the road map hinges on schools going back safely, so does the Secretary of State have the political will to do all that he can to prevent further school closures and recognise that that means vaccinating school staff as soon as possible?

[Matt Hancock]

I am very happy to ensure that, as much as possible, school staff are vaccinated whenever they possibly can be within the JCVI categorisations, but we have to follow the clinical advice on this, because there is no evidence of teachers being worse affected by covid than other professions. It is incumbent on us all to ensure that the message gets across that the prioritisation—the order of the queue, so to speak—is based on the best clinical advice as to how to save the most lives most quickly. I am sure that is something in which everybody wants to share.

Future of Health and Care

Mohammad Yasin Excerpts

Thursday 11th February 2021 Commons Chamber

[Matt Hancock]

That is the goal, exactly as my hon. Friend sets out. In particular, I am glad that she raised data sharing as part of the integration. It is critical that we have high-quality data sharing, with data protected for the individual but shared among those who need it for the purpose of joining up care. If someone goes to hospital, they will not have to give all their details over and over again, and their GP will know about it. Care homes, GPs and hospitals, for instance, will be able to care better for an individual without having repeatedly to diagnose. This is a very important agenda for the NHS, which it should approach with confidence as a core part of joining up care.

[Mohammad Yasin (Bedford) (Lab) [V]]

In my constituency of Bedford and Kempston, patients are being left in unimaginable pain as they struggle to access even emergency dental treatment. Dental practices are struggling to stay open with the impact of covid on their businesses, and those who have survived are struggling to cope with the backlog. Imposing targets is not working, so will the Secretary of State include oral health in his future plans and agree a sustainable funding solution with NHS dentists to end the crisis in oral healthcare?

[Matt Hancock]

The crisis has been very tough on dentistry. By the nature of dentistry, the infection prevention and control systems in place are a challenge. I look forward to working with dentists to ensure that this sort of integration can help them appropriately. I am happy to arrange a meeting between the hon. Gentleman and the Minister responsible for dentistry to discuss these concerns.

Covid-19 Update

Mohammad Yasin Excerpts

Thursday 15th October 2020 Commons Chamber

[Matt Hancock]

I love the idea of work out to help out. It is undoubtedly true, from the science that I have seen, that obesity contributes to a worse impact for those who catch coronavirus. This is something the Prime Minister has spoken about with great passion, and it is something we want to tackle, so I will absolutely look into that idea. I would also say that we have changed the proposals for people who are shielding, even in the highest risk, tier 3 areas, who should always be clear that outdoor exercise is a good thing.

[Mohammad Yasin (Bedford) (Lab)]

My constituents are being denied routine blood tests because the Swiss company, Roche, that supplies the labs in Bedford is having supply chain issues. If one company with one supply chain problem can cause a national shortage of medical components that are vital to patient care for at least three weeks, is the Secretary of State as concerned as I am about the disruption to medical supply chains during a pandemic when we leave the EU in just over two months?

[Matt Hancock]

We have prepared for years to ensure that we have the supplies that are needed, and I have of course been in contact with Roche over this distribution issue. It is actually an issue about distribution from a warehouse in England, and these distribution issues do happen from time to time in very large organisations such as the NHS. We are working closely with Roche, and I thank it for all its efforts to solve this technical problem.

Coronavirus

Mohammad Yasin Excerpts

Tuesday 7th July 2020 Commons Chamber

[Matt Hancock]

Yes, mental health services absolutely are open and people who need support with mental ill health should come forward. They should go to their GP in the first instance. The good news in this area is that telemedicine is particularly effective for psychiatry. Of course, it cannot be effective for all mental illnesses, but it can for many, and it is being used very effectively by psychiatrists across the country.

[Mohammad Yasin (Bedford) (Lab) [V]]

The initial findings of the investigation into Bedford’s now decreasing infection rate shows that women between 30 and 59 have been most affected. Will the Secretary of State remind everyone that this invisible virus does not just affect the older generation? Does he agree that the published data must include details on ethnicity, the older generation and workplace factors if we are to eliminate the virus and keep the public safe?

[Matt Hancock]

Yes; we are publishing more and more data about the virus and who has caught it, in the same way that we are giving more and more information to directors of public health so that they can use it for the same purposes. The hon. Gentleman is quite right to say that the virus does not only affect those who are older. Although more people who are older tend to die from the disease, anybody can transmit it, and that is the big risk. I am glad to say that the numbers of cases in Bedford are coming down. We keep a watchful eye to ensure that that continues to be the case.

Covid-19 Response

Mohammad Yasin Excerpts

Monday 18th May 2020 Commons Chamber

[Matt Hancock]

Yes, of course I can. I will take that up immediately and we will try to get a resolution. Thankfully, we have the testing capacity to be able to resolve such problems.

[Mohammad Yasin (Bedford) (Lab) [V]]

One of my constituents has written to me as a worried grandmother and the mother of a teacher. When scientists are divided over the coronavirus risk for children and how they might spread the virus, is this grandmother not right to ask me why Parliament is virtually empty due to social distancing measures, but her grandchild, who is least able to socially distance, is expected to return to school?

[Matt Hancock]

We have taken a cautious, balanced and safety-first approach to restarting schools. That is why we have we taken the approach of just three years being proposed for return in the first instance, to ensure that there can be more social distancing at schools. Of course, as the father of three small children I get that that is more challenging than among adults, but it is necessary. The approach that we propose is safe and is signed off by medical advisers as safe. Of course, because there is hardly any impact on children of this disease—a very small number of children are badly affected—that means that parents can be confident that if they send their child to school, it is a safe environment for them.

Covid-19

Mohammad Yasin Excerpts

Monday 16th March 2020 Commons Chamber

[Matt Hancock]

I have discussed that point with my German counterpart, and I am afraid that I wish there was something we could learn because it is important. We think that the reason for the difference in ratio is that the early cases in Germany were largely people who had been skiing in northern Italy and therefore were more healthy, whereas the mortality of this disease is very strongly correlated with age.

[Mohammad Yasin (Bedford) (Lab)]

I live with my 80-year-old mother, my wife who has a heart condition, my daughter and sons, who attend educational settings, and my three-year-old grandson. What advice can the Secretary of State give to multi-generational households such as mine, where self-isolation is not a viable option and alternatives are far from obvious?

[Matt Hancock]

That point is incredibly important and is directly addressed in the advice that will be on the gov.uk website.