Access to NHS Dentistry

Paulette Hamilton Excerpts

Thursday 22nd May 2025 Commons Chamber

[Lizzi Collinge (Morecambe and Lunesdale) (Lab)]

NHS dentistry has been a recurring theme for me both before the election and since, as I know is true for most colleagues, which is why this Labour Government have made it a priority. However, we are starting from a very difficult place.

Let me set out just how bad the situation is in Morecambe and Lunesdale. Last year, I knocked on the door of a man in Morecambe who had lost most of his teeth because he did not have access to dental care. Just yesterday, a constituent wrote to me asking me to speak in this debate. She and her husband travel more than 80 miles four times a year just to see their NHS dentist. They are retired and cannot afford to go private, and, like many older people, they need regular and more complex care. We do not have to look far to see the root of the problem—so to speak. Dentists have been telling us for years that the NHS dental contract is not fit for purpose. The contract creates perverse incentives. Dentists are discouraged from treating the patients who need them the most. I appreciate that this is partly because in the ’90s and early ’00s, the contract incentivised the over-treating of patients, but now the pendulum has swung back too far the other way, and we have to find a balanced approach.

Dental decay is one of the leading causes of hospital admissions in children. In 2023, over 30,000 children ended up in hospital needing their teeth removed.

[Paulette Hamilton (Birmingham Erdington) (Lab)]

The Government have an historic commitment to prevention. Birmingham Erdington is one of the youngest constituencies in the country. Does my hon. Friend agree that we must continue to build on supervised brushing and targeted fluoride applications in early years settings to protect the youngsters?

[Lizzi Collinge]

My hon. Friend is absolutely right. Prevention is always better than cure. When I sat on Lancashire county council’s health scrutiny committee, we took evidence that showed that things such as supervised brushing and help with fluoride were some of the most cost-effective interventions, and they could prevent the horror of 30,000 children going into hospital for preventable tooth removal.

Dental health has become a stark marker of inequality. Without ongoing care and access to that preventive care, children in less well-off families are more likely to suffer worsening dental problems.

The contract was a major problem. It locked in those perverse incentives, but the situation was then worsened by over a decade of neglect of all areas of public health under the previous Government. Too many families do not go to the dentist until it is too late and it is very expensive, so we need those preventive measures that my hon. Friend the Member for Birmingham Erdington spoke about and we need access to NHS dentists. We know that if people are not able to go to the dentist, it means they turn up at A&E, but they are sent away with painkillers and antibiotics, and that does not fulfil their needs.

I am pleased that our Government are taking this issue seriously. I am pleased that we recognise the scale of the problem, and I am pleased that we are taking action not only on NHS dentistry, but on preventive care. We owe it to families in Morecambe and Lunesdale and across the country to fix this broken system. We need a dental contract that actually works, fair funding for local services and access to care that is available when people need it.

NHS and Care Volunteer Responders Service

Paulette Hamilton Excerpts

Monday 19th May 2025 Commons Chamber

[Paulette Hamilton (Birmingham Erdington) (Lab)]

Does the Minister agree with me that as we rebuild our NHS, volunteers at NHS trusts will not be used to plug gaps in service and staff will be allowed to focus on clinical matters?

[Karin Smyth]

I am happy to give my hon. Friend an absolute assurance. Volunteers support and complement the existing workforce; they do not replace it. Including volunteers signals a recognition of the important role they play in supporting staff, services and patients. Many hon. Members are volunteers and we have all seen how those volunteers can support the wider system. However, it is important that we keep our staff and respect their important roles.

Oral Answers to Questions

Paulette Hamilton Excerpts

Tuesday 25th March 2025 Commons Chamber

[Stephen Kinnock]

I thank the hon. Gentleman for that question and I congratulate him again on his 60th birthday. [Laughter.] He raises an important point on teaching and training in dentistry. There is not enough capacity in the system. We absolutely want to ensure that we are building that capacity. As I said, a lot of that will depend on the comprehensive spending review settlement in June. I would be more than happy to discuss the issue with him in greater detail once we have a better sense of where we are on the funding.

[Paulette Hamilton (Birmingham Erdington) (Lab)]

3. What assessment he has made of the adequacy of the provision of health services for women.

[The Minister for Secondary Care (Karin Smyth)]

The Government are committed to improving women’s health outcomes. We have already taken urgent action to tackle the gynaecology list through the elective reform plan, and we recently announced an £11 million trial using AI tools to detect breast cancer cases earlier. The 10-year health plan will set out how we will tackle the factors that lead to poor health outcomes and the improvements we expect to see.

[Paulette Hamilton]

What assessment has the Minister made of the adequacy of research into and the provision of fibroid treatment for women, taking into consideration that fibroids are three times more likely to appear in black women than in white women?

[Karin Smyth]

The Government welcome the work my hon. Friend has undertaken and the work of the Caribbean and African Health Network in highlighting health inequalities for black women. She highlights shocking and unacceptable statistics. The National Institute for Health and Care Research has funded a significant amount of research into women’s health issues, including a £1.5 million trial comparing treatment options for fibroids. I am happy to make sure she is updated on that work and on the details of that work.

Rare Cancers Bill

Paulette Hamilton Excerpts

2nd reading
Friday 14th March 2025 Commons Chamber

[Paulette Hamilton (Birmingham Erdington) (Lab)]

I thank my hon. Friend the Member for Edinburgh South West (Dr Arthur) for bringing forward this important Bill and for his tireless work in championing the need for a greater focus on research into rarer cancers. Having worked as a district nurse for over 25 years, I have seen time and again the devastation cancer brings, not just to those diagnosed but to their families, friends and communities. The harsh reality is that one in two of us will face cancer at some point in our lives; it is an issue that touches all of us in some way.

While we have made significant strides in cancer treatment and survival rates, progress has not been equal. Some cancers, like the rarer, less survivable cancers, have been unjustly left behind. Cancers such as pancreatic, oesophageal, liver, brain and stomach still face staggeringly low survival rates. Currently, the least survivable cancers have a five-year survival rate of just 16%, compared with 55% for all other cancers. This disparity is not just a statistic; it is a failure in our services and the way these cancers are researched, which has cost lives, shattered families and left too many of us without hope.

A key driver of this has been the chronic underfunding and lack of focus on research into these cancers, which has meant that we lack tests and the tools and treatments needed to give people a fighting chance. The consequences of this neglect are devastating.

This issue is deeply personal to me. I have lost loved ones to pancreatic cancer, a disease that steals lives with ruthless efficiency. I lost my best friend, a woman full of life and love, to this cruel illness. She endured months of uncertainty before finally receiving a diagnosis in August, only to pass away shortly after. Her story is of delayed diagnosis, missed opportunities and a system that failed her. Sadly, her story is not unique. I find it truly shocking that in 2025, more than half of those diagnosed with pancreatic cancer will die within three months and only 7% will survive.

Pancreatic cancer is the fifth biggest cancer killer in the UK but receives only 3% of the UK cancer research budget. This lack of investment has meant we are not seeing the treatment breakthroughs that have transformed outcomes for other types of cancer. It does not have to be this way. We know that sustained research funding and strategic focus from the Government can dramatically improve survival rates—we have seen it work for other cancers. I particularly welcome the Bill’s proposal to nominate a named lead to focus on these rarer cancers, ensuring that they are no longer overlooked, as well as its provisions to give people a better opportunity to take part in innovative, cutting-edge trials. That is why I support the Bill.

The Rare Cancers Bill offers a road map to bring real-life, lifesaving changes to those diagnosed with life-threatening diseases. It is not just about policy, but about people; it is about giving hope to those who have been left behind. As chair of the all-party parliamentary group on the less survivable cancers and vice-chair of the Health and Social Care Committee, I firmly believe that through the provisions of this Bill, we can start—I say start—to bring forward access to innovative treatments that could turn the tide. I say to Members of this House, “Let us be bold. Let us make a difference. Let us ensure that future generations have a better chance of survival than those who came before them. Let us send a clear message to patients and their families that they are not forgotten. This is our moment to make a lasting impact—let us make it count. Let us support this Bill.”

Hospice and Palliative Care

Paulette Hamilton Excerpts

Monday 13th January 2025 Commons Chamber

[Paulette Hamilton (Birmingham Erdington) (Lab)]

I thank the hon. Member for Wimbledon (Mr Kohler) for securing this important debate. As a nurse for 25 years and as co-chair of the all-party parliamentary group on hospice and end of life care, hospice and palliative care has always been at the heart of my work, both in this Chamber and in my community.

I start by acknowledging the fantastic decision by the Government to boost investment in hospices by £100 million—the largest funding uplift in a generation. That is a clear sign that the Government are listening to the hospice sector and responding with actions, not just words. However, this uplift must be the beginning and not the end. This new money will not last forever. We must now take concrete steps to ensure that the awful conditions in the hospice sector that we inherited are never repeated. It is worth noting that while the independent commission on palliative and end of life care recently created by my hon. Friend the Member for York Central (Rachael Maskell) is welcome, it will mainly be about delivery and not funding. We simply cannot wait for a palliative care taskforce to complete its report; that could take months, which this sector cannot spare.

In my role, I hear time and again about postcode lotteries and the chronic lack of funding that plagues this vital sector. Through no fault of its own, John Taylor hospice, which does fantastic work in my constituency, is facing a crisis in funding; it has had to announce redundancies and a reduction in in-patient beds due to the funding shortfall. That story is being repeated all over the country—I am sure many Members in this Chamber have a similar situation that they could share. Hospice care still relies heavily on charity, bake sales and donations to fund much of the work that supports families during their most vulnerable moments. That must change. This postcode lottery not only is unfair, but undermines the principles of universal healthcare. We cannot allow end of life care to depend on where someone lives and how much money they have.

Hospices across the UK provide care and support to 300,000 people every year. They are an absolutely essential part of our healthcare system, although they are in the charity sector. Every single day, hospices face rising costs of energy, food and medicine; every single day, they deliver exceptional care, even as pressures mount; and every single day, they battle deficits that threaten their ability to continue. Despite all those challenges, our hospices save the NHS millions each year by alleviating pressures on hospitals and providing community-based care. However, their ability to continue this vital work is at risk, and they need long-term sustainable support. We need to face the future head on and fix their funding model permanently.

While I absolutely understand that hospices are under pressure, the integrated care boards that fund them are similarly under a great deal of pressure due to year-on-year budget reductions from NHS England. Asking ICBs to find extra money without it being allocated centrally as revenue is impossible.

Death is a part of life, as the hon. Member for Wimbledon said, and as we all know. Nobody would say we should neglect healthcare, so why are we neglecting the hospice sector by not securing a sustainable funding formula? To truly address the gaps in our system, we need a sustainable funding model that ensures hospices can meet growing demands without being forced to cut services. The people of this country deserve a future where every family, no matter their circumstances, can access the highest quality of end of life care without worry, one where hospice care is not a postcode lottery but a promise.

Let us turn this moment into an opportunity. We must act urgently to implement and improve a sustainable funding package for hospices and palliative care. With constructive action, we can build a system that uplifts the most vulnerable among us, strengthens the NHS and shows the best of what we can achieve as a nation. Let us ensure that the legacy of this debate is not one of uncertainty, but one of determination and passion, and that when we see the 10-year plan, hospice and palliative care will be fully funded going forward.

Oral Answers to Questions

Paulette Hamilton Excerpts

Tuesday 19th November 2024 Commons Chamber

[Paulette Hamilton (Birmingham Erdington) (Lab)]

T3. Many of my constituents are worried that online GP appointments are too often used as a substitute for face-to-face consultation, which risks adding pressures to NHS waiting lists further down the line. Will the Secretary of State reassure my constituents that they will receive timely, in-person GP access and the quality of care that they deserve?

[Wes Streeting]

We all know that general practice is under enormous pressure, and that will be a big part of this Government’s agenda. I reassure my hon. Friend that our view is that there should be patient choice, patient control and different courses for different horses. I value online and over-the-phone appointments, but they will not be right for everyone on every occasion. Patients should have a voice and a say.

Oral Answers to Questions

Paulette Hamilton Excerpts

Tuesday 23rd April 2024 Commons Chamber

[Andrew Stephenson]

The SNP, as usual, is a broken record. We all know that diabetes medicine shortages are a global issue affecting countries not just across the whole of the European Union, but across the whole world. Medicine supply chains are highly regulated, complex and global. Issues can occur for multiple reasons, including manufacturing difficulties, regulatory non-compliance, surges in demand, availability of raw materials, sudden spikes in demand, and issues related to the distribution of the product. But once again, as always, the grievance culture of the SNP is: blame everything on Brexit.

[Mrs Paulette Hamilton (Birmingham, Erdington) (Lab)]

7. What steps she is taking to increase levels of nurse recruitment and retention in GP practices.

[The Parliamentary Under-Secretary of State for Health and Social Care (Dame Andrea Leadsom)]

We hugely appreciate the work that general practice nurses do. I know that the hon. Lady was a nurse in her previous life, and I absolutely pay tribute to her for her service. She will be aware that last year the Government provided additional funding for the general practice contract to uplift pay by 6%, in line with the pay review body’s recommendations. We are very much aware of the need to try to ensure that general practice nurses feel appreciated and are keen to be retained in GP practices, which is one of the reasons I have launched a taskforce on the future of general practice. As she will know, it is for GP practices themselves to determine the pay uplift for their nurses. I am looking closely at that, because we know that sometimes the pay rise provided by the Government was not passed on.

[Mrs Hamilton]

We have all seen images of people queuing around the block for an appointment at their GP surgery, and in my local integrated care board, there has been a decline in general practice nurses since June 2020. It currently takes 12 months to train nurses wishing to move into general practice. Will the Minister tell me and my constituents in Erdington, Kingstanding and Castle Vale what she is doing to ensure that the retention of experienced nurses and the training of new nurses does not add to the pressure that GPs are already facing?

[Dame Andrea Leadsom]

The hon. Lady raises an important point. The long-term workforce plan commits to increasing the number of general practice nurses by more than 5,000 by 2036-37. In her area, the number of doctors in general practice in the NHS Birmingham and Solihull ICB increased by 134 full-time equivalents between 2019 and 2023, but the number of nurses decreased slightly, by 34 full-time equivalents. However, over the same period, direct patient care staff increased by 1,195 full-time equivalents. I think that demonstrates to the hon. Lady that the actual resources in GP practice are increasing, with specialisms such as physiotherapy and pharmacy, as well as nurse prescribers, to provide patients more access to good healthcare.

Hospice Funding

Paulette Hamilton Excerpts

Monday 22nd April 2024 Commons Chamber

[Mrs Paulette Hamilton (Birmingham, Erdington) (Lab)]

I thank the hon. Members for Hastings and Rye (Sally-Ann Hart) and for Darlington (Peter Gibson) for securing an excellent and important debate. We think of hospices as places where people go to die, but they are not; they are places where people go to live comfortably, supported and cared for while they are ill, until that moment of death and—for many of the families—beyond. I might not be the only MP in the Chamber for whom this debate has made me remember my mortality, but I think we would all agree that when we come to that time, we want to be looked after by kind, supportive staff who can give us the care and attention we need. Those staff should be able to look after patients and their families without worrying about how they will feed their own children. Rooms should be warm, and directors of hospices should be thinking about how they can support as many people as possible, not when they will have to switch off the heating or turn someone away.

Hospices across the UK provide care and support to 300,000 people every year. They are absolutely vital to our health and social care system, but unfortunately, they are facing serious financial challenges. It has now become a postcode lottery for many of our constituents.

[Sarah Owen (Luton North) (Lab)]

I am listening to my hon. Friend’s impassioned speech, and the experience that she brings to this House is valuable. The brilliant Keech Hospice serves so many in Luton North. It does amazing work, not just on end of life care, but on vital bereavement support for everyone, including children. In the past year alone, Keech’s energy costs have increased by a quarter of a million pounds. That, combined with the cost of living crisis, puts financial pressures on fundraising, which makes up two thirds of its total funding. Does my hon. Friend agree that we need sustainable funding models for hospice care? Failure to provide that puts much-needed services at risk.

[Mrs Hamilton]

I absolutely agree with what my hon. Friend says. We absolutely need those models. As I go through my speech, I will be agreeing with what she has just said.

John Taylor Hospice in my constituency, which is run by Birmingham Hospice, does unbelievably important work to support my constituents and their families in Erdington, Kingstanding and Castle Vale. The staff work day and night to make sure people are cared for while they are ill, and I could not be prouder to support them in this Chamber today. I must add that I have worked there in the past. Birmingham Hospice cares for almost 1,000 local people with a life-limiting illness every day. Last year, it cost more than £16 million to run its services, some 40% of which needs to be recovered through fundraising income. Over the past few years, the hospice has seen a significant increase in costs, including the price of energy, food and vital medicines, and a shortfall in funding for staff pay awards. At the same time, fundraising has declined across the hospice sector with the cost of living crisis hitting poorer areas like mine the hardest.

Birmingham Hospice is currently losing £200,000 a month. With inflationary costs and falling voluntary income, the only option to keep the hospice going is to reduce the services it provides. A reduced service will increase inequality across our city of Birmingham and the country. Sadly, more people will die in hospital or A&E as a result, when they could have had outstanding care at the hospice or at home with the support of the community team.

The hospice is dedicated to ensuring that outstanding care at the end of life is available to all, but it has recently been in the difficult position of having to make essential staff redundant to maintain financial security. That is not just happening in Birmingham; nationally, Hospice UK estimates that 100,000 people in the UK who could benefit from palliative care die without receiving it each year. Hospices play a huge role in alleviating pressure on our NHS, and they do not have the ability to reset their budgets on 1 April each year, as the NHS does. Instead, their deficits continue and the valuable care that they provide to local communities such as mine is at risk of being lost. I have worked in the health service all my adult life. When we speak about hospices, we rarely mention the vital role that they play in providing respite care and support to the family of someone who is ill.

[Ms Marie Rimmer (St Helens South and Whiston) (Lab)]

I thank my hon. Friend for her wonderful contribution to the debate. Many people want to stay at home—I have stayed with four people right through to their deaths at home—but hospices give a different care from hospitals. If you go into hospital, you might not get into the hospice. We have 10 beds in the most beautiful hospice, which is funded 71% from fundraising. If they are not in a hospice, and they do not have care at home—not everybody can do it at home; they might not have the family to provide the care they need—they can end up in a hospital for hours. Does my hon. Friend find that in her area? They can get triaged in an ambulance outside the hospital, and they do not get the palliative care and support, and their families do not get support—it is a completely different service. Do you agree that we should be looking for more hospice care, not less, but we should not be changing it to a hospital ward? It is a different atmosphere in a hospice. Do you find that is the case? That is not decrying hospitals, but hospital is not somewhere to die.

[Mrs Hamilton]

I absolutely agree with your sentiments and statement. As was said earlier, we need to move away from looking at individuals to look at population health and how we will support the local community. I will move on swiftly so that I can finish.

My constituency is the fifth poorest in the UK, and our communities are in some of the UK’s so-called left behind neighbourhoods. For places like mine, respite care is so important to ensure that carers get the break and support they need to keep them doing the incredible work that they do.

I am a nurse, and it breaks my heart that the NHS is in the worst state it has ever been in. Throughout the 14 years of this Tory Government, I have seen doctors striking, nurses striking, technicians striking, people queuing around the block for a GP appointment, people pulling out their own teeth, the highest waiting times in history, and complete disdain for the service that quite literally serves us from birth to death. We must have a national care service and we must properly invest in our NHS. It is no longer acceptable for hospices to rely on charitable donations to try to survive. Now more than ever, our hospices and our NHS need a Labour Government.

[Mr Deputy Speaker (Mr Nigel Evans)]

I gently remind the House that when people use the word “you”, they are referring to me, so please try to resist that.

Dentistry: Access for Cancer Patients

Paulette Hamilton Excerpts

Wednesday 17th April 2024 Westminster Hall

[Mrs Paulette Hamilton (Birmingham, Erdington) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Dowd. I thank my hon. Friend the Member for Stretford and Urmston (Andrew Western) for securing this important debate.

As someone who has lost family members and friends to cancer, I frequently come to this place to try to shine a light on the huge problems in our health service, which disproportionately impact people with cancer and their families. Dentistry is no exception. Like many colleagues, I have been contacted by constituents, in Erdington, Kingstanding and Castle Vale, because they are unable to find an NHS dentist. There are more than 100,000 people living in my constituency, but only seven dental surgeries, and at least three of those are not accepting any new adult patients. A constituent without a dentist contacted me and said: “I am desperate for an NHS dental repair. I now have an abscess in my jaw. Please help me”. That case is one of many. The response I received from NHS England advised my constituents to call 111 for any urgent care services and said that it is

“working to address the challenges facing the service right now”.

The challenges in our dental system are exacerbated for people in our communities living with cancer. The Less Survivable Cancers Taskforce states that 90,000 people in the UK are diagnosed with one of the less survivable cancers every year, which is an average of nearly 250 every day. People with less survivable cancers are twice as likely as people with a more survivable cancer not to be diagnosed until symptoms are severe enough for them to go to hospital. I personally know that that is far too long. Some 80% of people with pancreatic cancer are diagnosed at stages 3 and 4.

People with cancer need fast and effective dental services in a system that recognises the difficulties they will face during their treatment. Dentists also play a huge part in detecting, diagnosing and managing oral cancers, which kill more than 3,000 people a year in the UK. Unlike the less survivable cancers, oral cancers have a survival rate of 90% when diagnosed early, as the hon. Member for Tiverton and Honiton (Richard Foord) said, so it is crucial that dentistry can be accessed quickly and treatment is free for those people.

Both those issues come down to one main problem: money. Over the past decade, dental charges have increased by 45%, and last year YouGov found that nearly a quarter of respondents to its survey in England about dentistry delayed or went without dental treatment because they just could not afford it.

There are hidden costs in cancer care, such as increasing energy bills and the cost of frequent travel to and from hospital, and the burden of rising dental costs is too great for people with cancer. Although I think that it is a great idea to introduce free dental treatment for all cancer patients, we need to think bigger. We must reform the NHS and make it fit for the future.

There are two huge problems facing our health service—a crisis in both cancer care and NHS dentistry—with waiting lists for both at record highs. As a nurse, it breaks my heart to say that the NHS has never been in a worse state. The last Labour Government delivered the shortest waiting times and the highest level of patient satisfaction in history, because we invested properly in our NHS. It is high time that we did so again.

NHS Dentistry: Recovery and Reform

Paulette Hamilton Excerpts

Wednesday 7th February 2024 Commons Chamber

[Victoria Atkins]

May I thank my hon. Friend for all the work she did in the Department and has done on this subject? We are taking a long-term view with training dentists. As I said, last year, through the long-term workforce plan, we set out an ambition to train up to 40% more dentists by 2031. As we also begin the consultation on a tie-in with those graduates, we are confident that we will see a greater supply of dentists to our NHS services.

[Mrs Paulette Hamilton (Birmingham, Erdington) (Lab)]

The £200 million pledged today is less than half last year’s record-breaking underspend. The plan says that any underspends will be ringfenced for dentistry. That was promised by a Minister last year, but it did not happen because integrated care boards were using that underspend. Why should the 73% of dentists in the west midlands who cannot and are not accepting any new patients believe it will be any different this year?