Covid-19: Dental Services
Paul Blomfield Excerpts(3 years, 11 months ago)
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Paul Blomfield (Sheffield Central) (Lab) [V]
Can I, too, express my gratitude to my hon. Friend the Member for Putney (Fleur Anderson) for securing this debate? Dentistry often does not get the attention it deserves when we are looking at health provision for the country, and today is an opportunity to address that.
Clearly, the pressure on dental services preceded covid-19, but the pandemic has exacerbated it. In normal times—if we can remember them—the demand for NHS dentistry in Sheffield was huge, with unmet need amounting to more than 35,000 patients. That clearly has a long-term impact on oral health, and one that is particularly worrying for children.
Then came covid-19, which has hit the sector hard. Frankly, to choose this time to impose new targets, without warning or consultation, shows either a lack of understanding or a lack of regard for the consequences. The 45% target will disrupt the priorities of dentists by imposing penalties for failing to hit levels of what are described as normal NHS activity in what are blatantly abnormal times. It will threaten the viability of practices, and worsen access to dental care across Sheffield and the rest of England.
Dental practices have made huge efforts to be covid-secure, with cleaning and air-clearing procedures that mean they cannot see as many patients as usual. Many have therefore prioritised emergency and urgent care, and this normal activity target will skew their priorities away from those patients most in need. As one dentist explained it to me, they will be
“forced to stop seeing emergency patients…and to push the limits of the sound infection control procedures brought in to protect patients and staff”.
Another simply said:
“These targets are the wrong choice at the wrong time”.
This is not scaremongering, as has been suggested, but a real and genuine concern from dental professionals who care about the services they provide.
Sheffield Central is in the top 10% of areas where NHS dental care was most impacted by the pandemic, according to a survey, and the Association of Dental Groups says that problems are particularly acute in the most deprived urban, coastal and rural areas. Imposing this target will hit those most in need—levelling down, not levelling up. We need to be growing our dental services, not threatening them with damaging targets.
I have great regard for the Minister—we have worked together on other issues, and I know she takes her responsibilities seriously—so I do hope that she will listen to the concerns she has heard today from both sides of the House, talk to colleagues and review this contract.
Public Health
Paul Blomfield Excerpts(3 years, 11 months ago)
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Paul Blomfield (Sheffield Central) (Lab) [V]
Let me start by saying that I will support these measures today, but I simply regret that the Government are acting too late again. Clearly, the measures are necessary, and so is support for those whose lives are being affected by them. Ministers will know that too many have fallen through the gaps in the support schemes provided by the Chancellor, particularly in small businesses and among the self-employed. In my constituency, that is especially true in the hospitality and creative sectors.
We have not got time today to discuss all the ill-considered rules and deadlines, but I would ask Ministers to agree to meet representatives of the excluded, along with those hon. Members who have taken up their cause. As so often in a crisis, those who have the least have been hardest hit by covid. The Government could begin to address the unfairness by making a commitment today that the temporary £20 a week increase to universal credit and working tax credit will be made permanent from April. They could also commit to extending that to the legacy benefits: employment and support allowance, income support and jobseeker’s allowance.
This is a moment to pay tribute to the workers who have kept the country going, and who will do so in the weeks and months ahead. Let us remember them as we move forward by tackling the low pay and fragile employment faced by too many in the private sector, and let us give those in the public sector the pay increase that they deserve, not the pay freeze that they do not.
So much now depends on the vaccine. Let us remember that the first vaccine to enter British arms, and which we should celebrate, was developed by scientists of Turkish origin in Germany with an American company and manufactured in Belgium—an international response to an international crisis. I hope that that will be reflected in our country’s wider response, and I hope Ministers will confirm that, as we roll out the vaccine in the UK, they will work with our partners around the world to ensure it also reaches those who desperately need it in low-income countries. In agreeing to these measures today, let us also resolve to tackle the injustices that have been highlighted by this crisis.
Covid-19 Update
Paul Blomfield Excerpts(4 years ago)
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Matt Hancock
Yes, we are working very hard to get the vaccine to every part of the country, including Cleethorpes. I will look into exactly when the vaccine is arriving in Cleethorpes and get back to my hon. Friend as soon as possible.
Paul Blomfield (Sheffield Central) (Lab) [V]
The Secretary of State is right that, at this critical moment, we must think about the NHS staff we were applauding on the streets so recently, and we clearly must do everything possible to protect people from the spread of the virus. May I press him to say how the advice for the Christmas period could be strengthened by the Government to minimise transmission? Does he recognise the need for better financial support for the sectors most affected by the measures that we need, such as hospitality, and particularly for those who have fallen through the gaps in the Chancellor’s schemes?
Matt Hancock
With the decision to move areas into tier 3 comes extra financial support, and as I have said several times, we recommend that people exercise personal caution and responsibility over the Christmas period.
Covid-19 Restrictions: South Yorkshire
Paul Blomfield Excerpts(4 years, 2 months ago)
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Edward Argar
My hon. Friend is absolutely right. I have known him for many years, and he has long taken an interest in and campaigned on this issue. I can reassure him that additional investment has gone into the NHS at all levels, which includes mental health, but he is right: the impact of lockdown and these restrictions on people’s mental health should never be underestimated, so it is right that support and advice are available to people. I know that his local NHS is working very hard to ensure that that package is in place. If he wishes to talk to me subsequently, I am happy to do that.
Paul Blomfield (Sheffield Central) (Lab)
Clearly we have to take the measures necessary to combat the virus, and we have tried to work together on them across South Yorkshire, but the Minister knows that this deal does not meet all the concerns of local leaders, nor does it provide the support that businesses need. The ban on household mixing is clearly necessary, but it makes many cafés, restaurants and pubs with food unviable. It impacts on the music, events and creative sectors, but because they are not being required to close, they will not get the support they need. They are simply being hung out to dry. Will the Government think again and provide the support that those businesses need, to save thousands of jobs across South Yorkshire?
Edward Argar
The hon. Gentleman is always diligent and measured in representing his constituents and businesses in the House. The deal that has been reached is both fair and proportionate and reflective of the fairness across other areas that are in tier 3, and it should be taken in the context of being coupled with the broader national programme. I would not characterise the approach being taken towards hospitality in the way that he did. I pay tribute to our hospitality industry in this country, which I think is what he was seeking to do, and as I say, the support package is there to support businesses across all sectors in this country.
Oral Answers to Questions
Paul Blomfield Excerpts(4 years, 3 months ago)
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Matt Hancock
My hon. Friend has been a tireless advocate for Burnley. He is quite right to praise the people of Burnley, who have had local restrictions put in place. Because of the actions they have taken—because they have followed their duty and followed those tougher rules—and the sacrifices they have made, the case rate has come down in Burnley, and I pay tribute to my hon. Friend and to every single resident of Burnley who has played their part. Absolutely, the enhanced support will continue in Burnley, as it does across those parts of Greater Manchester, East Lancashire and West Yorkshire that we have been able to take out of the most restrictive measures, and we continue to watch with vigilance.
Paul Blomfield (Sheffield Central) (Lab)
Matt Hancock
Of course we have put in over the last two and a half years some very significant pay rises for nurses, and the whole House commends the work that the nursing profession as a whole, and each individual nurse, has done during this pandemic. Of course we are putting unprecedented sums into the NHS, and we work to make sure that everybody has the best possible working conditions, both now and in the future.
Oral Answers to Questions
Paul Blomfield Excerpts(5 years, 4 months ago)
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Jackie Doyle-Price
I certainly will. This recommendation was also made by the Public Administration and Constitutional Affairs Committee following its report into the death of Averil Hart, and we are in discussions with the royal colleges to see what more can be done, in terms of training medical staff and doctors in mental health, because we want to make sure that intervention happens at the earliest possible stage, which means that all our medical professionals need to understand it better.
Paul Blomfield (Sheffield Central) (Lab)
Jackie Doyle-Price
Yes is the short answer, and the hon. Gentleman will be pleased to know that I have regular discussions with colleagues in the DWP to see what we can do to humanise all our processes for benefits claimants, because it is important that when people suffering from mental ill health interact with organisations of the state, we are not causing them harm. I can assure the hon. Gentleman that that is very high on the list of things in my in-tray.
Oral Answers to Questions
Paul Blomfield Excerpts(5 years, 6 months ago)
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Paul Blomfield (Sheffield Central) (Lab)
Ellie Reeves (Lewisham West and Penge) (Lab)
The Parliamentary Under-Secretary of State for Health and Social Care (Seema Kennedy)
The Government are taking a world-leading approach to obesity. We have held consultations on ending the sale of energy drinks to children, calorie labelling in restaurants, restricting promotions of sugary and fatty foods by price indication, and further advertising restrictions, including a 9 pm watershed. We are considering all the feedback, and will respond later this year.
Paul Blomfield
Alongside prevention, we have to do more to help the growing number of children who are already overweight or obese. It is more than a year since the Health and Social Care Committee highlighted the lack of tier 3 and 4 services. Voluntary groups such as Shine Health Academy in my constituency fill the gap. They take children on referral from GPs, but they do not receive any public funding. There can be no other serious health condition affecting children where the NHS says, “Sorry, we can’t help.” Will the Minister take action and agree to meet me to discuss it?
Seema Kennedy
I completely agree with the hon. Gentleman that childhood obesity is a massive challenge to our nation. It is a problem internationally, and we are taking serious steps to tackle it. I am happy to meet the hon. Gentleman to hear more about Shine.
Mental Capacity (Amendment) Bill [Lords]
Paul Blomfield ExcerptsTuesday 18th December 2018
(6 years ago)
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Matt Hancock
Yes, absolutely I will. I know that the right hon. Gentleman met the Minister for Care, my hon. Friend the Member for Gosport (Caroline Dinenage), yesterday to discuss this question. Of course this ought to be a collaborative process. Improvements were made to the Bill in the other place—I shall talk about those in a moment—but we recognise that further improvements could still be made. Ultimately, there is a careful balance to be struck between the need to protect people who do not have the full mental capacity to take care of themselves and the need to ensure that we do not deprive people of their liberty unnecessarily. That is a careful balance, and we should take this forward on the basis of open discussion and deliberation, rather than of a party political ding-dong.
Paul Blomfield (Sheffield Central) (Lab)
The Secretary of State is clearly right about the system being broken, and one aspect of that is the shockingly low rate of appeals under deprivation of liberty orders, which currently stands at about 1%. Although the case law has become clearer, in most situations there is a positive obligation on advocates to progress cases to court where somebody is objecting to their deprivation of liberty, either directly or even through their behaviour. In contrast, 47% of detention decisions under the Mental Health Act 1983 are appealed. The Bill’s impact assessment predicts that the number of appeals will halve under the new procedure. Given the amendments that were made to the Bill in the Lords, does the Secretary of State think that the Government should now review that figure?
Matt Hancock
All such considerations should be taken into account and looked at in Committee. We made changes to that area in the Lords, and we are determined to reach the right balance, but I take the hon. Gentleman’s important point seriously. Like anyone who has read the Bill, he will know that it makes a significant improvement in this area. Rather than cases being immediately passed on to the courts, there is a process in place both before the deprivation of liberty where that is possible, which is a big improvement, and then later on when the deprivation is questioned. I accept the thrust of the hon. Gentleman’s intervention, but the Bill makes significant progress, and if he has suggestions for how the details may be nuanced still further, we are all ears because this is very much a collaborative process.
Matt Hancock
It could easily be a carer, yes. Some people have no family and in others cases the family are not the appropriate people to be the spokesperson for those who are mentally incapacitated. The appropriate person—the families and carers—will have greater powers to intervene or to object. Crucially, where there is no family or an appropriate person to advocate for the individual, the person has the right to an independent mental capacity advocate. So in all cases there should be a person whose role in the system is to advocate on behalf of the person whose liberty is being restricted.
Paul Blomfield
Does the Secretary of State accept that that access to an advocate should not be necessarily subject to a best interest test, as is being proposed, but should be a right?
Mr Deputy Speaker (Sir Lindsay Hoyle)
Order. Just to help everybody, let me say that we have 11 speakers, we still have to hear from the Opposition shadow Minister and we have the wind-ups. So I hope we can take that into account, although I recognise that the Minister is being very generous.
Nursing: Higher Education Investment
Paul Blomfield Excerpts(6 years, 1 month ago)
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Paul Blomfield (Sheffield Central) (Lab)
I congratulate my hon. Friend the Member for Wolverhampton South West (Eleanor Smith) on securing this debate, and the RCN student nursing campaign, “Fund Our Future”, on putting the issue firmly on the agenda. I cannot speak with her authority from experience, but I am chair of the all-party group on students and also represent a significant number of student nurses, midwives and allied health professionals in training at Sheffield Hallam University.
It is disappointing that we have to be here debating this issue again, because we have been over the argument several times. I remember the debate that we had in this Chamber in January 2016 when the Government first proposed to end the previous funding system and introduce loans and fees. I remember a powerful speech from the hon. Member for Lewes (Maria Caulfield). She talked about how hard it was to be a student nurse; how she bore the scars of her nurse training; and how nurses had to learn, take exams and also go through placement changes every eight to 12 weeks, which presented significant challenges for mature students. She also clarified that when we talk about mature students, in many cases we are talking about people not in their 40s and 50s but in their 20s and 30s—people with young families and single mums.
One of the students from Sheffield Hallam University who contacted me ahead of today’s debate was Clary Manners, who echoed many of those points from her current experience. She said she gave up a well-paid job to train as a mental health nurse. She currently does 37 hours a week on placement and has a three-hour round drive there and back each day for the placement. She pays £10 in parking charges when she gets to the hospital. She takes no holidays. She has little spare time because she takes bank nursing jobs to boost her family income, but still her four children are on free school meals because of the struggle to get by on her income.
In the debate in 2016, the hon. Member for Lewes said—this view was echoed throughout the Chamber—that encouraging people to take on debt would
“definitely put them off entering nursing, and to say otherwise is madness.”—[Official Report, 11 January 2016; Vol. 604, c. 217WH.]
The then Health Minister, Ben Gummer, assured us that what the Government were trying to do—you could not make this up—was to share the benefits of the funding system for other students with nursing, midwifery and allied health students. Some of us questioned in what way a £50,000 debt was a benefit, but he was insistent that we would see an increase in applications. Now we know he was wrong. UCAS figures published earlier this year show that applications for the current year were down by a third on the same point in 2016—it is a continuing trend—and by 13% in the past year alone.
The changes have been a particular barrier to those from lower-income families, which is hugely important because nursing and midwifery has been one of the channels of social mobility available for many who do not enter conventional university. We have heard how the profession has traditionally been dominated by mature students, who have been particularly hard-hit in the fall-off in numbers. Overall, compared with when the changes to nursing degree funding were made in 2016, we have almost 1,800 fewer nurses due to start at university. I remind Government Members that although they talk about the 13,000 extra nurses now on the wards, many of them started their training before 2010 under a Labour Government. There is a pipeline for nursing supply, and the current system benefits from the pipeline that we put in place.
There are almost 42,000 nursing vacancies in England. Without action now, that could rise to 48,000 in the next five years. The Government have a responsibility to fix that, and they can do it by introducing a student funding system that is fit for purpose and that can reverse the drop in applications and encourage people to take up nursing in the way that they did previously.
Stephen Hammond
I will talk about that issue in more depth later, but if the hon. Lady wishes to write to me, I will look at her constituent’s case. I will point out that the learning support fund already offers a number of opportunities, including child dependants allowance, travel costs and an exceptional hardship allowance. I hope her constituent knows about and is taking advantage of those opportunities.
The hon. Member for Ellesmere Port and Neston (Justin Madders) asked whether the Government will publish an update on the impact of the reforms. That is currently being worked on with education and health organisations and stakeholders. We will look at the most appropriate way of making sure that, following receipt of the proposals by the RCN, and in the context of the long-term plan and the chapter on workforce planning, the higher education funding review takes place and feeds into that update. We will set that position out in due course—I dare say that the hon. Gentleman and I will debate it in due course as well.
My hon. Friend the Member for Sleaford and North Hykeham (Dr Johnson) described what an excellent training scheme should look like, which was very helpful and powerful. My hon. Friend’s experience as a clinician is invaluable, and hopefully my speech will address a number of the points that she raised. I listened carefully to the asks of my hon. Friend the Member for Chelmsford (Vicky Ford). Some are in my power and some are not, but she made a point about mature students, and the Government recognise that the number of mature student applications has dropped across the wider higher education sector as well as in nursing. We are working with organisations in the sector to see how we can attract more mature students and whether specific funding can be targeted more effectively towards those students via the learning support fund.
It does not really need saying that, at the national level, the Government understand how important nurses are. We are committed to making sure that the nursing workforce are properly supported and funded. In her contribution, the hon. Member for Wolverhampton South West made the point that funding to the NHS is increasing: by 2023-24, it will receive £20.5 billion a year more than it currently does, and the Government expect the long-term plan to set out a strategy for the NHS to ensure a sustainable supply of nurses, rolling that supply across the whole range of pathways. We expect NHS England to clearly set out its commitment to the nursing workforce in the long-term plan, and ensure that there is a clear way for that plan to be implemented. A number of significant interventions are already in place to boost the supply of nurses, including training more nurses, offering new routes and enhancing reward packages. As my hon. Friend the Member for Sleaford and North Hykeham pointed out, there are over 11,900 more nurses on our wards than there were in May 2010.
However, the Government, and I as the new Minister for Health, should never be complacent, so I will set out a few other things that I regard as priorities. Our priority is to get more nurses on to our wards. As has been referred to, the education funding reforms, which moved student nurse funding into the student loans system, were introduced to unlock the cap that constrained the number of pre-registration nursing training places. Those reforms allow more students to gain access to nurse degree training courses. We have announced funding for 5,000 more clinical training places to make sure that those placements can be put in place. We have also increased midwifery training places by more than 3,000 over the next four years, and in 2017, there were 22,575 acceptances—the second-largest number since nursing became a degree-only profession.
It is also important to note that the loans system gives more cash when compared with the bursary system—effectively, up to 25% more. A mature student with two children will receive up to an extra £7,500 a year. I recognise that a number of other things need to be, and should be, put in place and known about more widely. The Government have also targeted support for healthcare students on courses through the learning support fund, which provides additional non-repayable grants. Up to £1,000 is available for eligible students in childcare allowances and hardship funding provisions. None of that, of course, was available under the bursary scheme. More nurses are in training, and the Government are working with Health Education England and the university sector to ensure that students continue to apply for nursing courses up to the end of clearing this year. I am pleased to say that, this year, we have seen a 6% increase in the number of 18-year-olds applying for courses and being accepted.
As an hon. Friend pointed out, there continues to be strong demand, specifically for younger people. I have made the point that we need to address the issues faced by more mature students who wish to enter, or re-enter, the profession. That should be a key priority in the long-term plan. The Government, and I as the new Minister, recognise that we need to do much more to continue to encourage people to apply for nursing courses, particularly more mature students. Therefore, my officials are actively engaging with the Royal College of Nursing, the Council of Deans of Health, and Universities UK—all of those organisations have a role to play. The Government will be consulting on the detailed proposals on future funding for higher education that the RCN has put forward today. I said this earlier, but I want to recommit and make it clear that we regard those as serious proposals, and will be writing to the RCN to engage on those proposals. We will start that work straightaway.
Paul Blomfield
I appreciate that the Minister is new to his post, and that it may be more appropriate for him to write to me in response to this point. I wonder whether he will address the attrition rates question asked by my hon. Friend the Member for Ellesmere Port and Neston (Justin Madders). There is a relationship between the falling number of applications, the funding regime, and the higher attrition rates. Does the Minister have numbers on that, and what consideration are the Government giving to it?
Stephen Hammond
Inspiration has just reached me. As the hon. Gentleman will know, Health Education England recently published a report on attrition rates on nursing courses—I made the point earlier that the rate of attrition among all people applying for university places has gone down. However, I will write to the hon. Gentleman. The report published by Health Education England describes how attrition rates on those courses have fallen considerably over the past few years, but I will write to him to be absolutely clear. He may then choose to make that letter available.
Budget Resolutions
Paul Blomfield Excerpts(6 years, 1 month ago)
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Paul Blomfield (Sheffield Central) (Lab)
It is a pleasure to follow the hon. Member for Totnes (Dr Wollaston), who made a characteristically thought-provoking speech. This year’s Budget, like last year’s, comes after my annual community consultation, where I use the three weeks of the conference recess to talk to people across the constituency. Last year, the view I shared with the House was:
“Like towns and cities across the country, Sheffield is at a tipping point.”—[Official Report, 27 November 2017; Vol. 632, c. 123.]
It was at a tipping point because of the collapse in the social fabric and in the ability of services to deal with the problems people were facing. So where are we 12 months on? In more than 60 hours of discussion at more than 40 events in this year’s consultation, all I found was greater concern and the feeling that we are closer to that tipping point. There was greater fear of the rise in violent crime and antisocial behaviour. We have some really impressive and committed police officers leading the fight against knife crime in Sheffield, supported by some great community groups, but we need to recognise the perfect storm that has been created by a combination of Government policies. Eight years of deep cuts to local services have decimated youth provision, led to rising school exclusions and seen falling police numbers—we have lost about a third of our police staff across South Yorkshire.
From the National Audit Office to the Police Federation, and to the Home Secretary himself, everyone agrees that police forces are underfunded. So when the Prime Minister promised the end of austerity, we might have anticipated that things would change in the Budget, but they did not change—not a bit. There was not a penny more for core police funding, nor were there any funds to rebuild youth services.
Nor was there an adequate response to the crisis in mental health, which was another significant issue raised right across my constituency. People told me of their difficulties in accessing services and of treatment waiting times that are simply too long. Young people in particular told me that they were waiting more than six months from referral to their first appointment with child and adolescent mental health services. So although I welcome the extra funding for mental health, we must recognise that it is simply mental health crisis provision, as the Chancellor described it. Of course, such provision needs to be properly funded, because we have a crisis in mental health, particularly for our young people. They want to know why they need to get to crisis point in their mental health before the system responds. A mental health crisis hotline is no substitute for proper face-to-face support. And what has happened to parity of esteem between mental and physical health? The £2 billion going to mental health is just 10% of the funding allocated to the NHS overall, so there is no parity of esteem there—in fact, we are moving further in the wrong direction, and that is a missed opportunity.
The Chancellor missed another opportunity to do the right thing by pushing back the start of the £2 maximum stake for fixed odds betting terminals to October 2019. That delay means that people will die—people like my constituent, Jack Ritchie, who took his own life aged just 24, having been, in the words of his mum Liz, “groomed by gambling companies”. Jack began gambling while at secondary school, playing on fixed odds betting machines at the nearby bookies. We all know, and the Government have admitted, that these machines are the “crack cocaine of gambling”, with players winning or losing up to £100 every 20 seconds. So what is the Chancellor’s answer for Jack’s grieving family, whose charity Gambling with Lives is to be launched here in Westminster in a couple of weeks? What is the explanation for the decision to push back the introduction of the lower stake? The Budget has no answer for Jack’s family, who are to be hugely commended for their work to try to prevent other young people from getting to crisis point. It has no answer for the young people who tell me that they have to get to crisis point before their mental health problems will even begin to be addressed, and it has no answer for my constituents who increasingly fear the violent crime and antisocial behaviour that corrodes our communities.
This is a cruel Budget, not only because of the lie that it marks an end to austerity, but because it fails the strivers and grafters of whom the Chancellor spoke, giving priority to higher earners. His tax adjustments reduce tax for basic rate payers by £130, but we MPs, like other high earners, will gain £860 a year. It is part of a pattern, as the Resolution Foundation has pointed out. In total, the tax and benefit changes since 2015 have given the richest fifth of households an extra £390 a year, while the poorest fifth have not simply gained less, but have lost £400 a year. Failing to end austerity and failing on social justice, this Budget fails our country.