Oral Answers to Questions

Neil O'Brien Excerpts

Tuesday 6th December 2022 Commons Chamber

[Scott Benton (Blackpool South) (Con)]

8. What progress he is making on negotiating a new NHS dental contract.

[The Parliamentary Under-Secretary of State for Health and Social Care (Neil O’Brien)]

In July, we made some initial changes to the reformed system to support NHS dentistry. We have invested an extra £50 million, reformed the contract to create more UDA—unit of dental activity—bands to better reflect the fair cost of work, and introduced a minimum UDA to help practices where the levels are low, allowing dentists to deliver 110% of their UDAs to provide more treatment. The number of dentists doing NHS work last year was up 2.3% but we are working on plans to go further.

[Scott Benton]

The changes made to the dental contract last week were a step in the right direction, but they fall some way short of the holistic reform required to help the estimated 25,000 of my constituents who do not yet have an NHS dentist. Will the Minister consider a change whereby the NHS funds subsidies to underprivileged areas such as Blackpool, thereby allowing NHS practice to offer a greater financial incentive to attract new dentists into those areas?

[Neil O’Brien]

Absolutely; my hon. Friend and I have talked about this. We are looking urgently at payment models and measures to address areas that are struggling to attract the right workforce. The commissioning of dentistry will be coming down to a more accountable local level in April, and we need to build on that.

[Mary Kelly Foy (City of Durham) (Lab)]

My constituents in Durham have told me tales of DIY dentistry, missing teeth, children in pain and the unfairness of only being able to access dental care if they can afford it. Things should not be this way. The British Dental Association does not accept that the Government’s new plans go far enough to halt the decay in NHS dentistry provision. Will the Minister tell me when the Government will put in adequate funding and reform so that people in Durham can get the dental care that they need and deserve?

[Neil O’Brien]

As well as increasing the number of dentists doing NHS work and the amount of work being done, we are taking further steps to look to the longer term and build NHS dentistry. The number of dental school places is up from 810 in 2019 to 970 in 2021, but of course we want to go further. We are making it easier for dentists to come to the UK to practise. In fact, we laid draft secondary legislation on 11 October to give the General Dental Council more flexibility to do that. Around the country, plans are advancing for centres for dental development to provide not only additional dentists but hygienists and other nurses.

[Mary Robinson (Cheadle) (Con)]

18. What plans he has to reduce health inequalities.

[The Parliamentary Under-Secretary of State for Health and Social Care (Neil O’Brien)]

We are taking action on public health across the board. The £3 billion that we are investing in the drugs strategy will create an extra 50,000 places in drug treatment. We have doubled the duty on cigarettes since 2010 and brought in a minimum excise tax. We now have the lowest smoking rate on record and will go further. The £300 million that we are investing in Start for Life means new or expanded family hubs in 75 local authorities. We are taking action right across Government, from the £55 billion that we are investing in energy support to the measures that we are taking through at the moment to crack down on non-decent housing.

[Peter Gibson]

Levelling up is not just about jobs and infrastructure; it is about healthcare too, and dentistry is a key part of that. However, Darlington faces the potential closure of its surgery, which serves 7,000 patients, because the current system of NHS dentistry makes the business case for that surgery unviable. What will my hon. Friend do to ensure that we level up dental services so that my constituents can get the services that they need?

[Neil O’Brien]

My hon. Friend and I have discussed this, and we are due to meet again shortly. I repeat my offer to speak both to that practice and to local partners so that we can tackle this crucial problem.

[Mary Robinson]

Research by the University of Manchester adds to the significant body of evidence showing that addressing disparities in healthcare is key to levelling up. Inequalities have resulted in a 30% productivity gap in the north, which can be attributed to poorer health. Will my hon. Friend outline how the Government are working to address this and to ensure that residents of the north are not at a health and care disadvantage?

[Neil O’Brien]

I saw that important report, and we have to tackle the problem from both the health end and the economic end. Spending on health in the north grew from £36.5 billion in 2018-19 to £52.6 billion in 2020, so there is significant investment in health and preventing ill health in the north. Economic activity stops people sliding into a cycle of ill health and worklessness, and we are working jointly with the Department for Work and Pensions to roll out more disability employment advisers in jobcentres. The underlying key is to tackle and prevent ill health, hence the £3 billion drug strategy and the measures on smoking, energy and housing.

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

I will give the Minister a good example of health inequality. Until quite recently, we had a perfectly good consultant-led maternity service based in Caithness. Following the Scottish Government’s rubber-stamping decisions, pregnant mothers now have to make a 200-mile return journey to Inverness to give birth. That glaring inequality is despicable. I hope His Majesty’s Government will share best practice with the Scottish Government on tackling this problem.

[Neil O’Brien]

I am always keen to work constructively with the Scottish Government. This sounds like a serious problem. My right hon. Friend the Secretary of State set out how we are using our health and capital spend more efficiently, and unfortunately this is an example of where it is not happening in Caithness.

[Helen Morgan (North Shropshire) (LD)]

It is well documented that people in rural areas have worse health outcomes than people in urban areas. One driver is that the most vulnerable people lack access to the services they need. Will the Minister consider working with his colleagues in the Department for Transport to figure out how the most vulnerable people can access the healthcare they need?

[Neil O’Brien]

We are rolling out community diagnostic centres to bring services closer to those who need them, and we are investing in 21,200 extra people working in general practice to make sure that rural services, as well as services in the rest of the country, are improved.

[Mr Speaker]

I call the shadow Minister.

[Andrew Gwynne (Denton and Reddish) (Lab)]

In 2019, the Tories promised to extend healthy life expectancy by five years, but on this they are failing. In the last year, the health disparities White Paper has disappeared, the tobacco control plan has been delayed and they have chickened out on implementing the obesity strategy because the Prime Minister is too cowardly to stand up to his Back Benchers. Health inequalities are widening as a consequence. Does the Minister plan to revive any of these strategies, or have the Conservatives completely given up on prevention?

[Neil O’Brien]

I have already talked about some of the things we are doing to crack on with improving public health and narrowing inequalities, but I will add some more. We are driving up blood donations from shortage groups and vaccine uptake in areas with the lowest uptake. I mentioned the extra £900 million for drug treatment, taking the total to £3 billion over three years. I will not repeat all the things I mentioned but, across the board, we are working at pace to improve public health and narrow health inequalities.

[Margaret Ferrier (Rutherglen and Hamilton West) (Ind)]

10. What steps his Department is taking to improve survival rates from sudden cardiac arrest.

--- Later in debate ---

[Sir Greg Knight (East Yorkshire) (Con)]

13. What recent steps his Department has taken to increase the number of dentists working in the NHS.

[The Parliamentary Under-Secretary of State for Health and Social Care (Neil O’Brien)]

As well as making it more attractive to practise in the NHS, the number of dental school places is up from 810 in 2019 to 970 in 2021, making it easier for qualified dentists to come to the UK. We are putting through secondary legislation on that and encouraging new centres for dental development.

[Sir Greg Knight]

Is the Minister aware that there is a particular problem in Bridlington in my constituency, where an increasing number of residents are finding it not just difficult to access NHS dental care, but impossible to do so? Recently, a dental practice in the town has closed. Will he agree to meet me on this matter to see what can be done to resolve the issue, hopefully sooner rather than later?

[Neil O’Brien]

Of course, I would be keen to meet to try to address those issues and to build on the work that we are doing nationally.

[Rachael Maskell (York Central) (Lab/Co-op)]

York has had a dental desert for years. It is six years now to see an NHS dentist and the Government have made no change to improve that situation, or to bring more NHS centres into my area. In March, dentistry will be moving into integrated care systems and integrated care boards. How are they going to solve the problem?

[Neil O’Brien]

One problem has been that having large, remote regional commissioning for dentistry has meant that it is more unlikely that specific local problems will be picked up. That is why we are taking the step that the hon. Member has described. She is now complaining about it, even though it is a measure to get more local accountability over the way that services are commissioned.

[Michael Fabricant (Lichfield) (Con)]

14. What recent discussions he has had with the Secretary of State for Education on increasing the number of university places for medical students; and if he will make a statement.

--- Later in debate ---

[Mary Robinson (Cheadle) (Con)]

T2. At 1 o’clock today, patient safety expert Dr Bill Kirkup will be speaking to MPs at the all-party parliamentary group for whistleblowing, to which all colleagues are invited. It is a timely meeting following last week’s “Newsnight” programme, which highlighted yet another NHS trust where a culture of fear left staff unable to speak up on patient safety concerns. It is clear change is needed. Does my hon. Friend agree that supporting whistleblowers in the NHS is crucial to patient safety?

[The Parliamentary Under-Secretary of State for Health and Social Care (Neil O’Brien)]

My hon. Friend is so right. I praise her work with the APPG and I know many colleagues will want to attend. Whistleblowers can save lives and improve healthcare, as I have seen in my own constituency, and she is right to be pressing on this matter.

[Mr Speaker]

I call the shadow Secretary of State.

--- Later in debate ---

[Bob Blackman (Harrow East) (Con)]

T4. There have been several changes of Ministers, as we know, but officials have carried on working through these changes, so can we know on what day, date and time the long-promised and overdue tobacco control plan will finally be published?

[Neil O’Brien]

Whatever format our next steps forward are set out in, we will be pushing forward very quickly and aggressively on this. This year, we are putting £35 million into the NHS to support our services for everyone who goes in to stop smoking. We have doubled duty on cigarettes and brought in a minimum excise tax. Women who are pregnant now routinely get a carbon monoxide test. National campaigns such as Stoptober have now helped 2.1 million people to quit smoking. We are also supporting a future medically licensed vaping product as a quitting aid. We will be pressing forward at the greatest speed.

[Mr Speaker]

I call the SNP spokesperson.

--- Later in debate ---

[Alexander Stafford (Rother Valley) (Con)]

T7. Several GP practices in Rother Valley, such as Swallownest Health Centre, operate a policy of having to ring the doctor’s surgery at 8 am for an appointment. Residents find themselves being placed 50th or 60th in the queue, and are then told that no appointment is available and to call back the next day. This is clearly an unacceptable way to offer appointments. What steps are my hon. Friends taking to stop the current failed booking system and instead guarantee a system of pre-booked appointments at all GP surgeries?

[Neil O’Brien]

That is something that we are working on very actively. As well as financially supporting GPs to roll out new and better ways of managing their appointments, we are looking at what criteria we expect from GPs. We already set out some moves in our summer action plan, but we will be looking further at preventing the lamentable situation my hon. Friend describes of people being asked to ring back or being held in long phone queues. That is not acceptable.

[Karl Turner (Kingston upon Hull East) (Lab)]

T3.   The public are not daft. They know that the backlogs in the NHS existed well before the pandemic, they know that the NHS was already on its knees, and they know that it was this Tory Government who brought it to its knees. So why do the Government not take up Labour’s policy of scrapping non-dom status, use the £3.6 billion to train nurses, doctors and midwives, and get the NHS back on its feet? People in east Hull want nurses, not non-doms.

--- Later in debate ---

[Dr Rupa Huq (Ealing Central and Acton) (Ind)]

In a case that is sadly all too typical, a GP in Ealing, who has seen their patient list go up from 3,000 to 9,000 in the last decade, had plans approved for expansion, but NHS estates now will not cough up. What are the Government doing to support doctors in inadequate premises who cannot increase their patient lists to expand and modernise in the current climate?

[Neil O’Brien]

The total activity done by GPs was about 7% up in October compared with the previous year. We are actively looking at the way that capital works and the contributions of section 106 and the local integrated care board, to ensure that, as well as having those 2,300 extra doctors and 21,000 extra staff, GPs also have good facilities to work in.

[Robert Courts (Witney) (Con)]

Access to dentistry is an acute issue for West Oxfordshire. Can Ministers explain what they are doing to help rural areas such as mine, and can we meet to discuss it further?

[Neil O’Brien]

I have mentioned the fact that the number of NHS dentists was up 2% to 2.3% last year, as well as the extra £50 million and the reforms we have made to the contract, but we will go further. We want to address those areas, and particularly rural areas, where more provision is urgently needed.

[Patricia Gibson (North Ayrshire and Arran) (SNP)]

The chair of the Royal College of General Practitioners has expressed concerns about patients with chronic conditions such as asthma, diabetes and even serious mental health conditions refusing sick notes because they cannot afford time off work. What discussions has the Secretary of State had with Cabinet colleagues about the adequacy of statutory sick pay during this cost of living crisis?