Oral Answers to Questions

Neil O'Brien Excerpts

Tuesday 6th June 2023 Commons Chamber

[Richard Thomson (Gordon) (SNP)]

4. If he will make an assessment with Cabinet colleagues of the potential impact of increasing the affordability of sun protection products on levels of skin cancer.

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

Last month was melanoma month and skin cancer month, and people are increasingly aware of the risks of excessive sun exposure without protection. Through the energy price guarantee and our direct support for vulnerable households, we have provided cost of living help worth, on average, £3,300 per household.

[Richard Thomson]

Since the early 1990s cases of skin cancer have doubled, with nearly 16,000 new cases diagnosed each year leading to 2,300 avoidable deaths annually. If some products were more affordable, more of our constituents might be able to use them and bring those numbers down. Will the ministerial team make representations to their Treasury colleagues about the Sun Protection Products (Value Added Tax) Bill, a private Member’s Bill promoted by my hon. Friend the Member for East Dunbartonshire (Amy Callaghan) which would remove VAT from some sun protection products, so that we can start to make an impact on those appalling figures?

[Neil O’Brien]

As the hon. Gentleman knows, tax matters are for the Treasury, but we are absolutely committed to providing cost of living support. By the end of June the Government will have covered nearly half a typical household’s energy bill since October, so we are providing one of the most generous packages in Europe.

[Mr Speaker]

I call the Scottish National party spokesperson.

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

The last time I asked Ministers whether they would support that Bill I was told that the issue of VAT and skin cancer was a matter for the Treasury, and we have just heard a similar answer. Surely this is a matter for joined-up government. What are Ministers doing—instead of imposing more pressure and costs on the NHS—to persuade their Treasury colleagues to consider more cost-effective cost preventive measures such as making skin protection products more affordable?

[Neil O’Brien]

The hon. Gentleman is campaigning for a reduction in the VAT on suncream, but let me put this into perspective. As I have said, our cost of living support is worth, on average, £3,300 per household. That is help on a huge scale. On cancer we are taking more action across the piece, and more people are being given life-saving checks, referrals and treatment than before.

[Kate Hollern (Blackburn) (Lab)]

5. What steps he is taking to improve cancer waiting times and outcomes.

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[Bill Esterson (Sefton Central) (Lab)]

9. Whether he plans to provide funding for a new primary health care facility in East Sefton.

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

The Government are providing record levels of capital to the NHS, with more than £24 billion allocated between 2022-23 and 2024-25, over £12 billion of which is allocated to integrated care boards themselves to invest in local priorities, including primary care facilities, of which just under £700 million has been allocated to NHS Cheshire and Merseyside integrated care board.

[Bill Esterson]

The Minister has just reminded us that the allocations are made by Government to integrated care boards. The problem is that, with a board the size of Cheshire and Merseyside, there are very many competing priorities. Sefton Council has secured more than £1 million from developers for a new health centre in East Sefton. The Health Secretary’s recent predecessors, of which there have been many, have agreed with me that a new health centre there is a priority. Will he and his colleagues match the priority accorded to this by their predecessors, match the ambition of my constituents and support the commitment by Sefton Council and award that additional funding, so that my constituents can get that much-needed health centre in East Sefton?

[Neil O’Brien]

The hon. Member has been campaigning doggedly for this for several years, and I am sure that his local ICB will be strongly seized of that and the strong arguments for it. He raised the issue of developer contributions. One thing that we have done in the most recent primary care recovery plan is set further steps to increase investment from developer contributions so that we match new housing with the much-needed infrastructure, such as primary care facilities.

[Gordon Henderson (Sittingbourne and Sheppey) (Con)]

10. What progress his Department has made on increasing the number of available GP appointments.

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

We are taking action to increase the workforce in general practice. We have managed to hit our target of recruiting 26,000 extra clinicians a year earlier. In fact, we have 29,000 extra clinicians in GP surgeries as well as nearly 2,000 more doctors. Of course, we will go further: as well as increasing the training of GPs to a record level—up from about 2,600 to 4,000 a year—we are also taking action to improve technology to take the burden of bureaucracy off GPs through our primary care recovery plan.

[Gordon Henderson]

Although I appreciate the Minister’s response, Sittingbourne and Sheppey still has one of the highest patient to GP ratios in the country. Without more GPs, no initiative to increase appointments will succeed. Our local integrated care board is doing its best to bring more doctors to our area. What help can my hon. Friend give to the ICBs so that they can provide my constituents with the GPs they need?

[Neil O’Brien]

My hon. Friend is quite right that we absolutely need to go further. That is why, through the primary care recovery plan, we are taking some of the pressure off general practice, investing £645 million in the new Pharmacy First service, which will free up about 10 million GP appointments a year. That is why we are investing about £60,000 per practice in new IT and modern online systems. None the less, he is totally right: we need those doctors in general practice. We have about 2,000 more now than we did in 2019, but we will go further. We have already increased GP training and we are looking at building on that further.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

Can the Minister clarify when Oldham will receive its share of the 6,000 additional GPs that were promised in the Conservative 2019 general election manifesto? Today we are running with fewer GPs, and that is not helpful to anyone.

[Neil O’Brien]

I have already noted that we have increased the number of doctors in general practice by nearly 2,000 since 2019 alone. The number of direct patient-facing staff in general practice is 50% higher in total than in 2019, and that is up right across the country. However, of course we will go further and grow the number of clinicians in general practice, building on what we have already done.

[Matt Warman (Boston and Skegness) (Con)]

The primary care recovery plan includes excellent measures to extend visas for international medical graduates, but can my hon. Friend say whether that extension will be automatic, answering the concerns of the Royal College of General Practitioners, and whether it will be in place for the 1,000 or so graduates coming this June and August?

[Neil O’Brien]

My hon. Friend modestly does not mention his role in advocating for that important reform, which will help to increase the number of highly qualified GPs coming from other countries to work in the NHS. We will ensure that that extension is automatic, so that people have extra time to make sure they get the right placement in general practice.

[Tim Farron (Westmorland and Lonsdale) (LD)]

There was a net loss of 577 full-time equivalent GPs last year. A contributing factor in rural communities was the Government’s decision a few years ago to remove the minimum practice income guarantee, making it unsustainable for small surgeries—and many rural surgeries are necessarily small—to survive. Will the Minister consider whether it is time to reintroduce a strategic small surgeries fund, to allow smaller rural surgeries in communities such as mine to survive and thrive?

[Neil O’Brien]

The funding formula already takes account of rurality. I hear the hon. Gentleman’s argument, but it is worth noting that our GPs are doing more than ever before. In the year to April there were nearly 10% more appointments than before the pandemic, or 20 more appointments in every GP practice per working day. GPs are working incredibly hard, as well as putting in extra staff, and I pay tribute to them for the sheer amount of work they are doing.

[Paul Bristow (Peterborough) (Con)]

The Minister recently joined me at the Thistlemoor medical centre at the heart of my constituency. Led by the inspirational Modha family, the team prioritise making face-to-face appointments available for patients by having amazing admin and support staff who speak a variety of languages. That means that, by the time the patient sees the GP, all the relevant checks have been done and the GP has all the relevant information. How can we better use admin and support staff at GP surgeries so that doctors can maximise their time and operate at the very top of their licences?

[Neil O’Brien]

It was an absolute pleasure to meet the Modha family and see the inspirational work happening in my hon. Friend’s constituency. In our primary care recovery plan we are learning some lessons from that work, particularly about focusing GPs’ time on the jobs only they can do—hence the investment in the extra 29,000 additional roles reimbursement scheme staff, the detailed plan in the primary care recovery plan to improve communication between hospitals and GPs, the cutting back of unnecessary bureaucracy, and the freeing up of resources by simplifying the investment and impact fund and the quality and outcomes framework. It is brilliant to learn from the inspirational work happening in his constituency.

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

Recent research from the Nuffield Trust shows that Brexit—a Brexit supported by both the Government and the Labour party, it has to be said—has worsened the shortage of NHS staff across the UK. Indeed, it has led to more than 4,000 European doctors choosing not to work in the national health services across the UK, due to higher costs, increased bureaucracy and uncertainty over visas. Can the Minister tell me whether that is one of the success stories of Brexit that we keep hearing about?

[Neil O’Brien]

International recruitment is up. In fact, we have 38,000 more doctors and 54,000 more nurses in the NHS than in 2010. In England at least, we are taking every step we can to draw on that international talent and we are using it to grow staffing in the NHS.

[Mr Speaker]

I call the shadow Minister.

[Karin Smyth (Bristol South) (Lab)]

From Sittingbourne via Bristol and Oldham, people are fed up with not being able to speak with a GP when they need to. GPs are warning that rising demand and increased costs may lead to workforce cuts or even closures. They are fed up with the bamboozling of numbers—more of which we have heard this morning—whether on GPs, full-time trainees, locums and now appointments. Whatever the metric, can the Secretary of State or the Minister tell us how many more GPs or GP appointments they think are necessary for people to access the care that they need?

[Neil O’Brien]

We committed in our manifesto to increasing the number and availability of appointments by 50 million. We are well on our way to meeting that target, as I have mentioned—we had 10% more appointments in the year to April than in the year before the pandemic. That is the result of the additional staffing that we are putting in: the extra 29,000 other clinicians and the nearly 2,000 more doctors in general practice. We have made that investment, but the reason why GPs are doing more appointments is not just that we have provided a fifth more funding since 2017 up to 2021; it is also that GP teams are working incredibly hard, and I pay tribute to them for all they are doing.

[Luke Hall (Thornbury and Yate) (Con)]

11. What steps he is taking to provide funding for new hospitals and health centres.

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[Anthony Mangnall (Totnes) (Con)]

12. When he plans to publish a dental recovery plan.

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

Our dental plan will be out shortly. We are already taking steps to reform the contract. We have created more bands for units of dental activity, to better reflect the fair cost of work and to incentivise NHS work. We have introduced a minimum UDA value to sustain practice where it is low, allowing dentists to deliver 110% of their UDAs. As a result, the amount of dental activity being delivered is up by about a fifth on a year ago, but we know that we must go further.

[Anthony Mangnall]

I welcome the Minister’s response and his comments in a recent Westminster Hall debate. It is clear that there is still a problem, and many of us are still asking for the recovery plan to come forward. I am afraid that “soon” is not good enough. Nearly every single one of the NHS dentists in my constituency is either not taking on new patients or leaving the area. “Soon” needs a date. Can we have this plan either immediately or sooner?

[Neil O’Brien]

I was seized by the thoughtful comments that my hon. Friend made in that Westminster Hall debate. We are working on all those ideas, and the plan will be out very shortly.

[Jim Shannon (Strangford) (DUP)]

I thank the Minister for his response. Would he consider encouraging more students to go into dental work by writing off student loans for those who go into NHS dental work for a five-year period—in other words, we get something back if we invest in them?

[Neil O’Brien]

At every stage, we are taking action to get more dentists doing NHS work. There are 6.5% more dentists doing NHS work than in 2010. The hon. Gentleman has an important idea. We are doing other things to retain NHS dentists, such as the important reforms that we made to pensions, which have helped both GPs and NHS dentists.

[Dr Luke Evans (Bosworth) (Con)]

13. What progress he has made on improving hospital facilities.

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[Maggie Throup (Erewash) (Con)]

T4. Just a couple of weeks ago, the Obesity Health Alliance launched its manifesto to tackle the high levels of diet-related ill health and the impact that has on our economy and society. Can my hon. Friend update the House on the progress being made on implementing the measures in section 172 of and schedule 18 to the Health and Care Act 2022 on the advertising of less healthy food and drink?

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

We are still committed to reducing the advertising of unhealthy food, including the junk food watershed that will be implemented in 2025. Ahead of that, we are taking action on obesity across the board, including the sugar tax, which has cut the average sugar content of affected drinks by 46%, the calorie labelling that we have on out-of-home food in cafés and restaurants, and the location restrictions on less healthy food that are coming in from October.

[Mr Speaker]

I call the SNP spokesperson.

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[Mr Speaker]

The question cannot go on forever; let us get an answer.

[Neil O’Brien]

I had a useful conversation with the Scottish public health Minister where we discussed many of these issues. We are providing huge cost of living support—some of the most generous in Europe, worth £3,300 a household—and taking action across the piece. Whether it is smoking or obesity, we are tackling the underlying causes of the health inequalities that the hon. Gentleman mentions.

[Sir Edward Leigh (Gainsborough) (Con)]

T8. Under the Human Rights Act, do the Government not have a duty of care to deal with the housing of illegal migrants? How can the Government ensure the health of 2,000 migrants cooped up in the former RAF Scampton? In particular, how will they ensure their health given the fact that the site is riddled with asbestos and contamination from 100 years of RAF usage? I see a case coming to the European Court of Human Rights.

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[Anna Firth (Southend West) (Con)]

T9. Last week, not a single dentist across the city of Southend said that they were taking on new NHS patients, which is concerning for my constituents. Can my hon. Friend confirm again what steps he is taking to make sure that my constituents get the NHS dental treatment that they deserve?

[Neil O’Brien]

This is absolutely the top priority I am working on at the moment. I am totally seized of the challenge that my hon. Friend mentions. I have mentioned some of the reforms we are already making, which have increased dental activity by about a fifth in the year to March, but we know that we have to go further and we will do so shortly.

[Nadia Whittome (Nottingham East) (Lab)]

T6. More than one in 10 social care roles are vacant, and the biggest culprit in this recruitment and retention crisis is low pay. According to recent TUC analysis, a £15 an hour minimum wage for care workers would not only tackle staff shortages, but level up places such as the east midlands, introducing an £800 million economic boost. Will the Government introduce that?

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[Simon Lightwood (Wakefield) (Lab/Co-op)]

In Wakefield, I am pleased to say that our campaign to save our city centre walk-in service has been successful, but every day people are still struggling to get a GP appointment. The latest NHS statistics show that, in April, 12,586 people waited more than 28 days. Quite simply, there are not enough fully qualified GPs. Labour has a workforce plan that is ambitious and costed. Where is the Government’s delayed and fully funded workforce plan?

[Neil O’Brien]

I have already mentioned that we have nearly 2,000 more doctors in primary care than we did in 2019, as well as the early delivery of the 26,000 extra clinicians we have brought into primary care. [Interruption.] The Opposition may not want to hear it, but the truth is that we have increased funding for general practice by about a fifth in real terms. We have more doctors and other clinicians, and GPs are doing 10% more appointments every month. We want to continue to build on that, which is why we have the primary care recovery plan and why we have invested a further £645 million in enabling people to get treatment from their pharmacists, freeing up 10 million more GP appointments. We know we must go further, but we are making progress.

[Aaron Bell (Newcastle-under-Lyme) (Con)]

I know the Minister is very keen to see the numbers of elective waits fall, and they have been falling. My constituents in Newcastle-under-Lyme share that aim. So will he welcome the local hospital trust opening not only a new modular theatre for specialised hand surgery, but a central treatment suite for day patients at the County Hospital in Stafford funded by NHS England’s elective recovery plan, which will help cut waits for planned procedures?

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[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?

[Neil O’Brien]

I pay tribute to my hon. Friend and her leadership on this issue. Many of the ideas that she has been putting forward are already in the plan that we set out to tackle youth vaping, including the creation of the “flying squad”, the ongoing call for evidence on youth vaping, and all the different things we could do to continue to drive it down.

[Stephanie Peacock (Barnsley East) (Lab)]

The non-surgical breast cancer service in South Yorkshire is facing a critical shortage of oncologists. The shortage is so severe that patients are being told to expect months between referral and appointment. What immediate steps are the Government taking to ensure that patients, no matter their postcode, see a specialist as soon as they need to do so?

[Jack Brereton (Stoke-on-Trent South) (Con)]

A number of dentists across north Staffordshire are stopping NHS treatment, which is extremely concerning. Some of my constituents have reported that they are being told they will have to pay either £120 a year or £14 a month to stay on the books. Will my hon. Friend look into those serious concerns and meet me to discuss the matter further?

[Neil O’Brien]

I am happy to meet my hon. Friend to discuss those important issues further.