Oral Answers to Questions Debate
Full Debate: Read Full DebateNeil O'Brien
Main Page: Neil O'Brien (Conservative - Harborough, Oadby and Wigston)Department Debates - View all Neil O'Brien's debates with the Department of Health and Social Care
(10 months, 1 week ago)
Commons ChamberProvisional NHS data shows that opt-out testing has found around 700 cases of HIV during its first year. In total, it has found more than 2,000 cases of blood-borne diseases, including hepatitis B and C.
I welcome the Minister’s news on those figures. He will have seen the impact of opt-out testing—detecting more people, treating them earlier and saving the NHS money. However, if we are to meet our 2030 target on no new infections, we cannot delay a further roll-out of opt-out testing. Will he commit the resources needed to expand it in time for World AIDS Day on 1 December?
I pay tribute to my hon. Friend for all his work on this important issue. We will assess all the evidence and reply before the end of the year. Opt-out testing is not the only thing we are doing to drive down HIV transmission. We have had a 40% rise in the number of people getting pre-exposure prophylaxis, and we have increased the number of people testing, with 20,000 free testing kits handed out this year. We are doing everything we can to meet that visionary goal to stop HIV transmission in this country.
I thank the Minister for his answer to the question from the hon. Member for Darlington (Peter Gibson). It is clear that today, HIV is not the death sentence that it once was, because of the progress of medication and healthcare in prolonging life and improving quality of life. In Northern Ireland we are proactive, as the Minister will know, on PrEP and young people. We are doing progressive things through the Department of Health, Social Services and Public Safety in the Northern Ireland Assembly. Has the Minister had the opportunity to discuss with the Northern Ireland Assembly and the Health Department how we can work better together? I always say we are better together in every case.
The hon. Gentleman is completely correct. He has been a fantastic champion on this issue. The UK is leading the world on this issue, hitting the UN’s 95-95-95 goals, driving down transmission and reducing stigma. People increasingly realise that as well as suppressing the virus, the treatment makes it impossible to transmit, transforming the lives of people with HIV.
We have increased funding for general practice by about a fifth in real terms since 2018. We have increased the workforce by about 30% since 2019 alone, with 2,000 extra doctors and 31,000 extra clinicians going into general practice. With the hard work of GPs, that has enabled about 15% more appointments than before the pandemic. In rural areas we are going further with things such as the targeted in-house recruitment scheme and the elements of the funding formula that favour rural areas.
I am grateful to my hon. Friend for that answer, but I have repeatedly raised with Ministers the specific case of an innovative model from Long Crendon Parish Council to use land secured through planning gain to replace Long Crendon Surgery, which closed during the pandemic. There is an agreement for Unity Health to provide primary care services there, but no money to physically build. My right hon. Friend the Secretary of State has advised consistently that the money be sought from the integrated care board, but after prolonged talks it has said that there is no money. Will the Minister look at this innovative model again? It is a great way of building rural GP provision in the future, with a mind to his Department making it happen.
I will absolutely look closely at that specific case. My hon. Friend has put a huge amount of work into Long Crendon. As he knows, we are already changing the national planning policy framework to enable more developer contributions to flow into such innovative projects. We have more GP practices than we did in 2010, but we continue to look at ways to go further.
We are making NHS work more attractive to dentists. We have started to reform the contracts and create more UDA bands. We have introduced the minimum UDA value to help sustain practices where values are lower, and we are allowing dentists to deliver 110% of their UDAs. We are also reforming the rules to empower both clinicians and commissioners, for example by enabling therapists to start delivering medicines such as anaesthetics. We are rebasing contract values where they are underperforming, and we are growing the workforce with a record commitment to grow the number of dentists in training by 40%—a commitment never made by the Opposition.
UDA rates, the sum paid to NHS dentists for each unit of dental work undertaken, have long been deemed insufficient. Being based on figures from 2005, there are huge differences in rates between practices, with some receiving less than the NHS charges patients for the service. A recent 5% uplift was based on the Government estimate of a 3% rise in costs, a figure that local dentists tell me is more like 10% to 15%, compounding the losses that NHS dentists are already making. What steps is my hon. Friend taking to reform the UDA system and to stop the flow of dentists leaving the NHS?
That is exactly why we have started to reform the UDA system. As well as the introduction of the first ever minimum UDA rate, which will help constituencies such as my hon. Friend’s, we have changed the rules nationally so that commissioners can take UDAs away from dentists who are underperforming and give them to those who want to do more NHS work. As a result, nearly a quarter more NHS dentistry is being done than a year ago.
In addition to the steps we are taking to drive up NHS dentistry everywhere, we are going further in the south-west, with NHSE commissioning additional urgent appointments. There are several hundred extra appointments every week.
I thank my hon. Friend for his answer. It is not sustainable for the people of West Dorset who have needed dental care for some time when there is a £400 million national underspend in the dental care budget. The NHS and local dentists tell me that the incompatibility often relates to the national dental care contract, which is up for review. When does the Minister expect a solution to be found to this contract difficulty? Will he meet me and the NHS Dorset ICB to discuss the matter in detail to find a solution?
Absolutely. I am keen to continue the conversation with my hon. Friend. These issues are exactly why, this summer, we legislated to allow rebasing and to end the inflexibility he describes. We are also in the process of ringfencing local dental budgets, because we do not want to see underspends. We want to see that money going to NHS dentistry.
We have already brought in restrictions on the places that unhealthy food can be sold to stop pester power. That is on top of other measures that we are taking on obesity such as the sugar tax, calorie labelling, the extra money for school sport, and the extra facilities for young people. It is a serious issue and one on which we are taking urgent action.
I was going to ask a question about the shocking statistic of 85,000 people on the waiting list at Norfolk and Norwich University Hospital, but so poor was the Secretary of State’s response to the question of my hon. Friend the Member for Ilford North (Wes Streeting) about the dental desert that I will tell him a quick story. Ukrainian refugees who come to my constituency are travelling back to war-torn Ukraine to have their teeth seen to because there is a better dental service there than in Norfolk and Norwich. What does he have to say to that?
My hon. Friend is right. The amount of NHS dentistry being delivered in his ICB has gone up in the last year, but we want to go further. The NHS has recently commissioned additional children’s orthodontic capacity within his ICB, but through the actions we are going to take, we will go further.