NHS

Peter Bottomley Excerpts

Thursday 23rd May 2024 Commons Chamber

[Madam Deputy Speaker (Dame Rosie Winterton)]

I call the Father of the House.

[Sir Peter Bottomley (Worthing West) (Con)]

I thank the Secretary of State for her answer to the right hon. Member for Kingston upon Hull North (Dame Diana Johnson). I hope that the letter that her Department received from us will get a full reply, and I thank her for her interim words.

I hope that the Secretary of State will be able to come to the opening of the new integrated care centre by the town hall in Worthing—a local authority enterprise carried on by the present administration in Worthing. There has been great concern about dentistry in my constituency. The pressure is coming off, but not fast enough. Would she please encourage everyone in NHS England to ensure that dentists are encouraged to provide the kinds of service that all our constituents want?

[Victoria Atkins]

I congratulate my hon. Friend on the opening of those services. I look forward to attending that opening with him and colleagues across his area. In the dental recovery plan I set out a number of ways in which we will improve the delivery of dental care across England, including immediate, medium and long-term work. The immediate-term work is already seeing results. Having switched on the new patient premium, we are already seeing practices opening. We want to bring forward the golden hellos to encourage dentists into areas that do not have the services that we would like. There was a slightly misinformed Prime Minister’s question yesterday; we are in the middle of tendering our dental vans, because as a rural MP I want services as quickly as possible while we are building the foundations to ensure that people get the care they need.

National HIV Testing Week

Peter Bottomley Excerpts

Thursday 8th February 2024 Commons Chamber

[Sir Peter Bottomley (Worthing West) (Con)]

At the conclusion of the debate, I am going to take an HIV test. I do not expect it to have a surprising result, but I think that unless people like me set an example, we cannot expect others to overcome what might be embarrassment or awkwardness. The same applies to things like giving blood, which I did again this morning, for over the 90th time. If people watched blood being taken, they would be less fearful about giving blood themselves, and if they knew that they could take HIV tests without embarrassment, they would do so.

Each year, about 3 million of us go to sexual health clinics, where there are a lot of acronyms—STIs, STDs, GUM, HIV and AIDS—that all follow from things like blood being given. The first person in my family to take an HIV test was my mother, who had had a number of blood units given to her after an operation and wondered whether she was infected and might infect others in the family. She was clear; many were not so fortunate.

On vectors—person-to-person transmissions—we ought to be far more open, because the only thing we cannot inherit from our parents is celibacy. Celibacy can be adopted or forced on someone, but sex is quite common for the rest of us. On that, I am glad that we now have a vaccination against genital warts, which is included in the cervical cancer vaccination and is now available to young men and boys as well. We will reach herd immunity much faster if both sexes are involved. That also gives protection to men who have sex with men.

I am not an expert on all these things, but we ought to be as careful about this as we are about ensuring that people’s teeth are protected, as we discussed yesterday in the dentistry statement. We should be concerned that the chances of being involved in a conception that ends in a formal termination are about 50% in this country. There is a birth cohort of just over 600,000, and there are over 200,000 abortions a year—the maths is not complicated.

It takes two to tango. As the hon. Member for Warrington North (Charlotte Nichols) said in her remarkable, positive and important speech, we can end HIV transmission if, when people know that they have been exposed to it, they can get treatment for it.

There is no reason for a long debate, or even a long speech from someone like me. I simply say, in solidarity with the people we can protect, that we ought to know our own status, encourage others to find ways of discovering their status and make sure that help is available and offered.

It is odd that, often, when people come into contact with clinical services, they are not encouraged to discover their status in all kinds of ways. Modern treatments are available and they are effective. If we can overcome the embarrassment, we can get to a situation where people can be themselves and live as they choose, without being a risk to themselves or to others. I thank the hon. Lady again for her speech, and I hope that the whole country will pay attention.

--- Later in debate ---

[Preet Kaur Gill (Birmingham, Edgbaston) (Lab/Co-op)]

It is a great pleasure to speak for the Opposition in this debate to mark National HIV Testing Week. We have heard great contributions today from Members on both sides of the House, and it gives me hope that we can continue to make progress on this issue in the years ahead. I thank my hon. Friend the Member for Warrington North (Charlotte Nichols), the hon. Member for Worthing West (Sir Peter Bottomley), the hon. Member for Strangford (Jim Shannon) and my hon. Friend the Member for Hammersmith (Andy Slaughter) for making powerful speeches on the enormous progress made on HIV.

Incredible advances mean that people living with HIV on effective treatment can now enjoy normal life expectancy and are no longer at risk of passing on the virus. The reality of living with HIV in the 2020s is a world away from the 1980s. As colleagues have remarked today, we might just have the chance to be the generation to make Britain the first country in the world to end new cases of HIV for good. It is an enormous credit to a generation of activists, fantastic organisations such as the Terrence Higgins Trust, many great campaigning MPs across the House and the all-party parliamentary group on HIV and AIDS that we have got to this point. More treatments have become available. Thousands of people are now living with HIV at levels undetectable or intransmissible to others, and the stigma and misinformation that the LGBT+ community suffered through the ’80s is not what it was.

For Labour’s part, we are incredibly proud of our record on HIV. It was the last Labour Government who switched spending so people could get the new drugs as they became available after 1997. We passed the Equality Act in 2010 that gave legal protections to people living with HIV. Chris Smith became the first MP to talk about living with HIV in 2005, and in 2018 my hon. Friend the Member for Brighton, Kemptown (Lloyd Russell-Moyle) was the first MP to talk about living with HIV here in the Commons. But there is much more to be done.

There are around 4,500 people in the UK living with HIV who are undiagnosed. The earlier those people can be found and linked to care, the better their health outcomes will be and the closer we will be to stopping new transmissions. Some 44% of people diagnosed with HIV in England last year were diagnosed at a late stage. Late diagnosis rates are even higher for women, at 51%, and that means some women are diagnosed so late they are already on their death beds.

[Sir Peter Bottomley]

I am glad the hon. Lady is making the important point that women are particularly at risk of non-diagnosis. She rightly mentions some Labour people who made important contributions. We ought to remember Norman Fowler. I do not normally talk about my wife’s work, but if I may say so, when she was Secretary of State for Health, she got the insurance companies in and said, “Do not charge higher premiums, or refuse cover to, people who have taken an HIV test. That is not the way to move forward.”

NHS Dentistry: Recovery and Reform

Peter Bottomley Excerpts

Wednesday 7th February 2024 Commons Chamber

[Mr Speaker]

I call the Father of the House.

[Sir Peter Bottomley (Worthing West) (Con)]

The House enjoyed the words of the Opposition spokesman, the hon. Member for Ilford North (Wes Streeting), although I am not sure how many he wrote himself; some may have seemed rather familiar to anyone who read Matthew Parris this morning on going to Ukraine to have a filling fixed.

In West Sussex, in Worthing and Arun, we want the same situation found in parts of London, where dentists have a sign saying, “New NHS patients welcome”. Has the Secretary of State been working with the British Dental Association and the General Dental Council to bring forward registrations, to get incentives right, and to make sure that dentists are no longer told, “You can’t serve any more patients because you will go above your limits”? Can she confirm that we are taking limits off, so that dentists, especially the young ones, can do as much work as they can, and can help as many patients as possible, so that we can get back to the situation that we were in before Labour changed the rules about 20 years ago?

[Victoria Atkins]

We have focused this plan on introducing the new patient premium—a bonus for new patients. Having discussed this carefully with professionals, we think that is one way that we can incentivise people into NHS practice. Dentists can already work up to 104% of the contract. Many do that, but some sadly do not, so we are trying to encourage those dentists who already have NHS contracts to go the extra mile and use the full slot available to them.

Reforms to NHS Dentistry

Peter Bottomley Excerpts

Thursday 27th April 2023 Commons Chamber

[Peter Aldous (Waveney) (Con)]

I thank the Backbench Business Committee for granting this debate. It is the third in a trilogy that the hon. Member for Bradford South (Judith Cummins) and I have secured, and that in itself tells a sad and sorry story. Complaints about access to NHS dentistry have been the No. 1 item in my inbox for getting on for two years and, while there is a particular challenge in Suffolk and Norfolk, I am conscious that this is very much a national crisis.

The fundamental causes of the collapse of NHS dentistry go back over 25 years, with a gradual withdrawal of funding by successive Governments and the poorly thought-through 2006 NHS contract. Covid was the final straw that brought the edifice crashing down. The challenge now in front of us is to put NHS dentistry on a secured long-term footing, but in a way that enables our constituents, many of whom are in acute agony, to see a dentist straight away.

[Sir Peter Bottomley (Worthing West) (Con)]

I thank my hon. Friend for his part in securing successive debates. On emergency dentistry, in my constituency people are asked to travel an hour and a half by public transport for emergency treatment. Great changes have happened in the last three months, but we must improve on that in the next three months so that that no longer happens.

[Peter Aldous]

I think we all have tales of constituents who have had to go a long way to see an NHS dentist, if they can find one at all. In Lowestoft, people have had to travel to Basildon, which is not straightforward by public transport.

The task of delivering the plan for NHS dentistry is on the shoulders of the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Harborough (Neil O’Brien). From my perspective, the purpose of the debate is to be constructive and to provide him with ideas and suggestions that could be included in his plan. It should be ambitious, visionary and innovative, not just a sticking plaster to get us through the immediate crisis.

To achieve that, and to ensure that our constituents are able to see a truly local NHS dentist quickly, three immediate short-term challenges need to be addressed. First, the up to £500 million due to be clawed back into the main NHS budget should remain available exclusively for NHS dentistry this year. Secondly in the short term, there is a need to recruit more dentists from overseas to address the acute shortage of NHS dentists. I acknowledge the measures that the Government put in place, as the Minister set out in his answer to my question on Tuesday, but more needs to be done to eliminate the queue as quickly as possible. Thirdly in the short term, the 2006 NHS contract needs replacing, and we must move completely away from the discredited UDA system.

In the longer term, the ingredients for rebuilding NHS dentistry and transforming it into a system fit for the 21st century of which we can justifiably be proud, are as follows: first, as I mentioned, we need to put in place that new contract, and address the current contract’s fatal flaw. It should facilitate a focus on prevention and should motivate dentists and dental practitioners to work in rural and coastal areas such as Suffolk and Norfolk. Secondly, a long-term fair funding system should be put in place. I acknowledge that Governments do not like ringfencing, but NHS dentistry must be provided with an assurance that the funds are available to make the long-term strategic investment that ensures that service will be both resilient and robust.

Thirdly, the recruitment and retention arrangements need to be significantly improved. Dentistry must feature prominently in the Government’s forthcoming NHS and social care workforce plan. Many colleagues, including myself, have highlighted the need for dentistry schools in their areas. Locally, both the University of East Anglia and the University of Suffolk have come forward with proposals. In East Anglia, my sense is that a vacuum must be filled, but I am mindful that a strategic approach right across the country needs to be pursued on where dentistry schools are best located. I would be grateful if my hon. Friend the Minister could commit to carrying out such an assessment. In the meantime, I urge him to immediately support the University of Suffolk’s dental community interest company, which has the twin benefits of providing much needed NHS dental treatments and training in such areas as dental therapy and hygiene.

There is also a need to improve the accountability and transparency of NHS dentistry. The move to integrated care boards that happened throughout much of the country on 1 April, including locally with the Norfolk and Waveney integrated care board, is very much a step in the right direction. In our local area it is taking steps to put in place a long-term plan and to ensure proper representation from dentists.

Finally, at the heart of any health strategy must be prevention. Such an approach will help spare people from hours of agony and ultimately impose less of a burden on the public purse. I will briefly outline three possible strands to intervention. First, the Government must press ahead with plans to fluoridate the water supply. All the evidence is that that will bring significant results. Secondly, we must come up with a strategy for promoting better oral healthcare for children. In 2021, with support from local councillors, Lowestoft Rising provided free toothbrushes and toothpaste to the under-sevens. The take-up was high and the feedback was extremely positive, and it recommended that such products should be exempted from VAT. I urge my hon. Friend the Minister to promote that policy with the Treasury. Thirdly, as we have heard, we must not forget the elderly, particularly those in care homes, and that must be covered in the new dental contract.

In conclusion, the emergence of dental deserts across the country, which are now joining up to create an area of Saharan proportions, is a crisis that must be tackled head-on with proper funding, root-and-branch reform and bold and imaginative policies. My sense and my hope is that the Minister is up for the challenge, and I look forward to the publication of the Government’s NHS dentistry plan. As I have said, this is the third Backbench Business Committee debate that the hon. Member for Bradford South and I have secured, and I hope that a fourth will not be necessary.

Oral Answers to Questions

Peter Bottomley Excerpts

Tuesday 19th April 2022 Commons Chamber

[Maria Caulfield]

I am sorry to hear about the hon. Lady’s constituent’s experience. There is not actually a list system for dentists as there is for GPs, so patients can see any dentist when they have a dental issue. With that said, we have asked dental practices to update their availability for NHS patients on the website. This morning, I looked at the website to see what availability there was throughout the country and saw that many dentists still have not updated their availability, so I will ask officials—particularly in her constituency—to update the lists so that patients can access NHS dentistry more easily.

[Sir Peter Bottomley (Worthing West) (Con)]

I join the Minister in thanking dentists and their associates for getting so much of the service back. Does she agree that in places such as the Arun parts of my constituency, where people cannot find a dentist and have not been able to for two or three years, there must be a way for people to get on a dentist’s list and get treated, and for dentists to be properly rewarded? Dentists and patients would be grateful for a change in the contract.

[Maria Caulfield]

The Father of the House is quite right that the crux of the problem is that there is a shortage throughout the country not of dentists but of dentists taking on NHS work. The contract is the nub of the problem, which is why work is under way to reform it. We will shortly announce some short-term changes and some longer-term reforms, which will hopefully help my hon. Friend’s constituents.

Health and Care Bill

Peter Bottomley Excerpts

Consideration of Lords amendments
Wednesday 30th March 2022 Commons Chamber

[Edward Argar]

I am grateful to my right hon. Friend, who is absolutely right. We heard in this House, a little earlier this afternoon, the Secretary of State for Health and Social Care present a statement on the Ockenden review. The review has a number of—not recommendations specifically, but urgent action points. Donna Ockenden was very clear on that and my right hon. Friend accepted all of them. One of the themes that came out in that context is people’s fear of speaking up. We believe that the HSSIB will play an important part in stimulating that culture of openness and transparency, and people coming forward without fear. That is why we reflected very carefully and accepted their lordships’ amendment.

[Sir Peter Bottomley (Worthing West) (Con)]

I want to re-emphasise to the Minister and to others the injustice when Dr Hadiza Bawa-Garba, at an inquest three years after an event, led the police to get her prosecuted for gross negligent manslaughter and then the other actions, which I will not rehearse now. If we are going to have doctors as good as Dr Bawa-Garba and others learning from events, we will do better than the previous system. I am glad the Government are accepting the Lords amendment.

[Edward Argar]

I am grateful to the Father of the House, who I believe, in the course of our discussions about whether to accept the Lords amendment, wrote to me, along with other right hon. and hon. Members highlighting that particular case in the context of an open and transparent learning culture.

--- Later in debate ---

[Jess Phillips]

I had not intended to be here at all today. Sadly, my mother-in-law died of a heart attack very suddenly on Friday, so women’s health and how we treat it is at the very top of how I am feeling at the moment. My mother-in-law, much like my own mother, who sadly died as well, sent her children to women’s liberation playgroup. She would not have forgiven me for not turning up for the opportunity of a free vote, so here I stand. Her name was Diana, and I feel that days like this are often dedicated to the Dianas of this world.

I want to respond to some of what has been said about coercion and control. I respect the hon. Member for Congleton (Fiona Bruce) and her firmly held views, and I would go down fighting for her right to hold those views. Had she allowed me to intervene on her earlier, I would have asked her whether she could tell me which expert agency that deals with violence against women and girls agrees with her. I represent the entirely alternative view. Maybe she and I could just both be honest and say that, largely, the detail in front of us does not necessarily matter: she thinks one way and I think another, and we should just be honest about the reality of that situation.

There is no evidence that coercion will be a concern any more than it already is. That is not my experience, from years of working with victims of sexual violence, sexual exploitation and abuse. The problem is not usually that they are forced to have abortions but the alternative: they are forced to go to term. They are scared. I worked with a beautiful woman called Natasha who was killed when her violent ex-partner found out that she had had an abortion. He murdered her. That is the normal pattern.

[Sir Peter Bottomley]

The evidence that has been given to me is that virtually every group concerned with violence against women and girls supports the use of telemedicine, as do Dame Clare Gerada and Dame Lesley Regan, who are leading doctors, gynaecologists and obstetricians. Lastly, with telemedicine consultations, the period of time before an abortion has been halved, not increased.

[Jess Phillips]

I agree 100% with every word that the Father of the House has just said. There is no expert opinion group that agrees with the view put forward by the hon. Member for Congleton, who cited the secretariat of a pro-life group. By the way, I am pro-life: I am pro the people who live being able to make choices. I am incredibly pro-life—I am just also pro-choice. I hate the terminology that suggests somehow one side is pro-life; what is the alternative?

Access to NHS Dentistry

Peter Bottomley Excerpts

Thursday 10th February 2022 Westminster Hall

[Sir Peter Bottomley (Worthing West) (Con)]

I agree with Sir Robert Francis and with the hon. Member for Bradford South (Judith Cummins). I also agree with, and am grateful to, my hon. Friend the Member for Waveney (Peter Aldous).

Mr Efford, I would just clear my throat by saying that I am only Father of the House because of 1992, so I pay tribute to you for your part in my still being here. I would also say that, after Stephen Lawrence was attacked, I did the right thing in going to see the Commissioner of Police, but I also did not do the right thing; I should have gone with you to ask the Home Secretary for an inquiry into the attack. I pay you public tribute for that, and I shall forever be grateful that you did what I had not done.

I hope that the Minister has met the Toothless campaigners, Mark Jones and Steve Marsling, who have given some of us leaflets spelling out some of the things that are required.

With the participation of patients, we ought to be able to get this right. It needs dealing with, first as an emergency, then in the medium and long term. Fluoridation should not be delayed, but the beneficial impact will come later. Getting more dentists through training and getting more well-qualified dentists from overseas will help in the medium term, but the emergency goes beyond the end of March this year.

I will send to the Minister the letter that I received on 10 February from NHS England and NHS Improvement about the situation. It is a well-meaning letter, but it does not deal with the problem, as she will know, because, on the south coast, we face the same problems as in East Anglia and in Yorkshire—and throughout the country, for that matter.

We know the impact that covid had in reducing the number of sessions that were possible, with the space required between treatments, but as the hon. Member for Bradford South said, it is not just about covid; the problems were there before. I take the view that the general practitioners contract in 2006 was wrong; the dentistry contract was wrong. Those watching this debate may hear about UDAs—units of dental activity. Why is it that one filling attracts three UDAs, and yet five fillings, a root canal and an extraction get the same?

I am grateful to those dentists who have written to me, many of whom are doctors. One says:

“I spend around 40-50% of my time on NHS work (clinical and non-clinical) but it only accounts for around 10% of my income.”

My mother used to explain to me that young dentists would take on a lot of NHS work and work really hard and intensively, then, as they grew through middle age and towards their last 10 or 15 years, they would go more private and have more time, and others would come up and take over their work. There would be a sort of succeeding life cycle of dental activity.

I am not against private dental treatments and attention, but I do not believe that it should be required. People ought to have the option of NHS treatment. My wife and I always used that for our family, until we were a bit older, and others should be able to do the same. We need a system in which anybody who asks for an NHS examination can get one, without significant delay.

One dentist talks about an awful lot of time spent on data capture for the NHS Business Services Authority—at least it is one; it was combined from five other bodies. It is important that the amount of admin that dentists complete be reduced as far as possible.

Those practices that still provide NHS dentistry try to continue with their contract but say that they are unable to take on new patients due to UDA limits. They get many calls a day from people saying that they cannot get care because their practice no longer accepts NHS patients. That has to change, and it has to change fast.

Another of my dentists has sent me some pretty clear figures. They say that they cannot find the 1.5 to 2 full-time-equivalent dentists that they need to recruit. They also bring up the issue of training and the flawed contract, and note that contract reform has been promised by every Government since the current contract was introduced in 2006.

We cannot delay any longer. Even if it were just an interim contract, that would provide an incentive, money, encouragement, recognition and a change to patients’ circumstances. As has been said, many more things need to be done.

I have found the British Dental Association to be very co-operative and positive, acting in the interests of patients and of its members as clinicians and as businesses.

Let us try to get people together and take an urgent approach. And when we meet in six months’ time, let us be able to say that significant improvements have been made and that more are coming. Then, perhaps in three or four years’ time, we will not have to have these discussions.

--- Later in debate ---

[Andrew Selous (South West Bedfordshire) (Con)]

Like other colleagues, I pay tribute to my local dentists and the whole team of dental staff who support them. They do amazing work, and almost all of them went above and beyond during the pandemic.

I have to express a bit of concern about the information that the Minister’s officials may be feeding her. I got a letter on 16 December from NHS East of England direct commissioning, which said: “Having conducted a search of dental practices in the Leighton Buzzard area, I can confirm that of the 47 dental practices, six are accepting new NHS patients.” The letter goes on to say that there are 30 others that have not been heard from. I received an email only this morning from a couple in Leighton Buzzard who said that they have given up trying to find an NHS dentist. A lady in Dunstable wrote yesterday to say that the local waiting list is two years. Another constituent wrote to say that they had been turned away by emergency dentists to which NHS 111 had referred them.

[Sir Peter Bottomley]

Would it be too difficult for the NHS to have a list, for every constituency, of every dental practice and its situation? That way, the NHS, patients and MPs would know what the situation is, and we could change that situation.

[Andrew Selous]

The Father of the House is absolutely right; the point was also made by my right hon. Friend the Member for Basingstoke (Mrs Miller) earlier. I do not think that the data are nearly good enough, and I do not see how Ministers can have proper oversight if we do not actually know what is happening.

When the letter of 16 December says, “having conducted a search of dental practices in the Leighton Buzzard area,” I fear that the person who wrote it sat at their desk and went on Google to find out. I do not think they actually came to the town. I do not think that they walked around and spoke to the dentists, the local Healthwatch, or the people in the town. How can the Minister have accurate information if what we get from the officials—that was from an official letter from the NHS to me—does not actually reflect what is happening in the town?

We are struggling now, but my area, like that of my hon. Friend the Member for North East Bedfordshire (Richard Fuller), is scheduled to have another 14,000 houses; they have been consented and are being built now. I have a major campaign on ensuring that general practice capacity keeps up with major new housing developments. How can we do that for dentists too if we already have a deficit? Will the money follow those huge new housing developments in many of our constituencies? We need answers on that too. If the Minister is able to give further information on that, either when she replies, or perhaps by letter afterwards, that would be really helpful.

We have heard from many colleagues about the issue of children’s teeth. I am informed that tooth decay is the No. 1 reason for hospital admissions of young children. That shows the importance of prevention and getting it right, and the whole issue of sugary drinks. I recognise the help that fluoridisation gives, but children’s oral health is a huge issue.

One or two colleagues—including, I think, the hon. Member for York Central (Rachael Maskell)—mentioned older people’s dental care; I had a debate on that in the Chamber. It is a subject that we often do not talk enough about, particularly with people in care homes. Do the managers of those homes ensure that staff help the patients to brush their teeth? What about the oral care of people receiving domiciliary care? Is that budgeted in? It is serious; it can lead to malnutrition and all sorts of problems. There was a major Care Quality Commission report, which was only on the care home sector, in June 2019, called “Smiling matters”. It would be good to have an update from the Minister on how we are doing in ensuring that older people’s dental care is also taken proper care of.

We know that the current contract, about which most of us have been complaining, was introduced in 2006—so quite some time ago—but back in June 2009, there was an excellent independent review about what we needed to do about it by Professor Jimmy Steele. I will quote from one paragraph of it:

“Through the NHS, dentistry could take a huge step forward but in order to do that, one concept is critical. So long as we see value for taxpayers’ money as measured by the production of fillings, dentures, extractions or crowns, rather than improvements in oral health, it will be difficult to escape the cycle of intervention and repair that is the legacy of a different age.”

I think that the Steele report got it right. However, that was under the previous Administration, in June 2009. I am told that the work on reform started in 2011, and yet here we are, in 2022. I think that what we are all saying to the Minister—who is diligent and I know cares about these matters—is that we really need some urgency.

On the number of dentists, perhaps slightly surprisingly, and perhaps contrary to some of what we have heard today, I had an email yesterday from the British Dental Association saying,

“We don’t really have a shortage of dentists in England—the number of dentists registered with the General Dental Council is in fact almost 2,000 higher now than it was in 2018. The key problem is that these dentists increasingly don’t want to work in the NHS—almost 1,000 quit the NHS in the last year alone.”

The email goes on to say that if dentists move to private provision, they do not actually earn any more. They are not just leaving NHS work because of the money but because they cannot look after their patients properly under the contract. It says that it is soul destroying, chasing these NHS units of dental activity. It is stressful and demoralising, so what do they do for the same money—not for more money? They go—this is what the British Dental Association says—to private practice, where they can spend more time with their patients, providing the level of care that their patients deserve.

We are not doing it right. To try to guard taxpayers’ money through efficiency, we are driving dentists out of the service. We are measuring the wrong things. I do not think that we are measuring enough, as we do not seem to have enough measurement, and where we are measuring, we are measuring the wrong things. It is not possible to get improvement unless we have the correct data. I have confidence in the Secretary of State and in the Minister, but I think we are all saying that this is urgent and please get on with it with proper reforms.

Dentist Industry and NHS Backlogs

Peter Bottomley Excerpts

Monday 7th February 2022 Commons Chamber

[Andy Carter (Warrington South) (Con)]

All of us at some point will suffer from toothache. We would like to think that getting treatment through the NHS would be a relatively painless thing to achieve. Indeed, most of us have grown up with the thought that a regular check-up and work when it is needed is something we can access through our local NHS dentist, but in reality the presence of an NHS dentist in towns and villages has slowly been eroding, and charges have been in place for NHS dental treatment for some time, with only a limited number of people eligible for free treatment, including young children and those on very low incomes. The likelihood of being able to find a dentist who will do the work on the NHS is becoming more and more remote. The reasons that sit behind these changes and the necessary support needed to improve access to NHS treatment is the issue I want to raise in this debate with the Minister.

I know I am not alone in receiving correspondence on this topic, but hearing from constituents in Warrington South, reading their letters and trying to help them find a dentist has led me to the conclusion that the system needs radical changes. These problems are not all as a result of the pandemic, but it is worth saying that dentists are struggling in relation to their NHS contracts at the present time because of their experiences in recent months. NHS dental statistics show that only 12 million courses of treatment were carried out by general dentists in the year 2020-21, which is down almost 79% compared with the figure for the previous year.

[Sir Peter Bottomley (Worthing West) (Con)]

The whole House will be grateful to my hon. Friend for raising an issue that matters to every Member of Parliament. Our local newspapers point out that trying to find a dentist is like trying to find a needle in a haystack. Most of us have fewer dentists than we had in 2017, and the sooner his encouragement brings about a big change in co-operation with the British Dental Association and individual dentists, the better it will be for our patients, many of whom have aching teeth.

[Andy Carter]

I thank the Father of the House for his intervention, and I agree with him—the needle in a haystack analogy is absolutely right. In my role as a local MP, I am representing both providers of dental treatment and patients who want to access that treatment. So I have tried to take time in the past couple of weeks to speak to dentists in my constituency about their experiences and how the system is operating today. Many of them have been providing NHS services for many decades.

Elective Care Recovery in England

Peter Bottomley Excerpts

Monday 7th February 2022 Commons Chamber

[Edward Argar]

I am grateful to the shadow Secretary of State. As he said, 2 million of those on the waiting list have entered that waiting list since the pandemic began. There is undoubtedly a huge covid backlog, as we had to put in place infection prevention and control measures and ensure the availability of beds for those with covid. I am with him, I suspect, on at least one point, which is that I, like him, entirely understand the impact that this has on people’s lives, their anxiety and their health outcomes. That is why this Government are determined to tackle that waiting list. As I said, this is a once-in-a-generation challenge and it is absolutely right that we make sure we get the plan right. We need to ensure that we have the right plan, delivering the right outcomes.

The hon. Gentleman mentioned delays, and I have to say that this plan is delayed. This is a plan we anticipated publishing in December. The reason that we did not do that was because of the omicron variant and the impact it has had on our health services over the winter. We have made sure that we get this plan right.

The hon. Gentleman also mentioned Her Majesty’s Treasury. I have to say, speaking as a Minister in the Department of Health and Social Care, that we could not wish for better partners than Her Majesty’s Treasury and this Chancellor. They have shown strong support to our health and care system throughout the pandemic, with record levels of funding to support it through the pandemic and to help performance to recover subsequently.

Even before the pandemic, when the current Secretary of State for Health was Chancellor, this Government had already put in place a £33.9 billion increase in funding, enshrined in law. It was one of the first pieces of legislation passed by this Government after the election. We have also set out our long-term funding plans through the health and care levy, which I recall the hon. Gentleman’s party did not support.

[Sir Peter Bottomley (Worthing West) (Con)]

We are grateful to the Opposition spokesman, the hon. Member for Ilford North (Wes Streeting), for his sub-leadership bid in raising this important topic. I say to the Minister that today was not an unusual day, in that a constituent wrote saying that she had nothing but praise for the hospital treatment she was getting. Can I pass on my thought, which is that instead of using the word “elective” we should use the words “planned care”, as my hon. Friend did in his response? Through him, I also remind the House that two years into the last Labour Government there was an edict saying that no hospital could do elective care—planned care—until two years past the time when it was booked. Things are much better now and most of us are grateful.

[Edward Argar]

I am grateful to the Father of the House, who once again brings his typical wisdom and experience in this House to our deliberations in the final point that he makes. He is absolutely right. I am happy to join him and his constituents in expressing gratitude to all those who work in the NHS for the work they have been doing throughout the pandemic and that they do every day, irrespective of the pandemic. I know that those on both sides of the House will share in that. The term “elective” is a technical term used within the NHS, but I take his point that it is easy for us in this House to use the technical terms used within our Departments or in the system, but that it is often helpful if we talk in rather more simple terms that mean something to all our constituents.

Public Health

Peter Bottomley Excerpts

Tuesday 14th December 2021 Commons Chamber

[Sir Peter Bottomley (Worthing West) (Con)]

I think the House will want to acknowledge the power of the speech that the Opposition spokesman, the hon. Member for Ilford North (Wes Streeting), has just given. We wish his predecessor well. One thing we can say about the hon. Gentleman is that his voice carries very well around this Chamber.

The Government are right to ask for support for these regulations. I am glad the Opposition will in general be supporting them, and I will do so as well. If the public health risk increases, we must ask what changes to regulations are proportionate and appropriate.

It may have been missed by some who have written to me, but some of the regulations are relaxations; others are not. The regulations are intended to make sure that some places can stay open if people abide by sensible precautions.

One constituent who has written to me today says he and his family and many of his friends will not go to places of public congregation because too many people are not vaccinated or showing they are not infected by the virus. That may be a minority view expressed, but I think it is one that is held in the hearts and minds of many of our constituents.

To those who have said an impact assessment has not been made, I say that it has and it has been published; those who invigilate assessments do not think it is adequate, but that is a side point. Annex B on pages 54 and 55 shows the proportion of people by age in the national health service who have been vaccinated.

We must recognise that one reason why half of those who are unvaccinated are aged under 40 is that the opportunity for vaccination came later for them than for those who are older. But if they do not think it matters to them, I would say to them that it does, for the reasons that our hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter), the practising doctor, gave. When caring for people who are vulnerable—obviously, people in medical care are, in the same way as those in social care—the most we can do to protect ourselves also has the impact of protecting them. If in doubt, get the protection that the vaccine and the booster give.

I was going to make a rather longer speech, but I will stop now because many hon. Members want to contribute, many of whom will disagree with me. I will respect what they have to say, but I will say very clearly that I back the Government in these regulations.