Oral Answers to Questions

Debate between Rachael Maskell and Jo Churchill

Thursday 28th October 2021 Commons Chamber

[Jo Churchill]

My hon. Friend and I have already had several discussions on this matter. I hope to have a further meeting with him next week and to visit the site shortly. As part of permitting the regular inspection process, the Environment Agency considers the existing concentration of relevant pollutants in the area surrounding such challenges and, if air quality levels are exceeded because of those impacts, a lower limit can be set by a local authority. We should try to be transparent, but, in these complex matters, we must try to take on board the needs of constituents while driving the right conclusions to sort out this difficult problem.

[Rachael Maskell (York Central) (Lab/Co-op)]

City of York’s Lib Dem/Green council—Oh, the irony of it—is instituting six new car parks in our city centre. As a result, there will be a further threat to people’s lives, particularly with regard to respiratory conditions, given the already challenged air quality. What discussions is the Minister having with the Secretary of State for Levelling Up, Housing and Communities to ensure that councils do not put new car parks in their planning?

[Jo Churchill]

There are many local initiatives going on. The nitrogen dioxide plan, which I spoke about earlier, is the key to driving down emissions, and we are working with the Department for Transport on that. People using their cars less in the city centre and the promotion of cycling and walking in a beautiful city such as York would obviously enhance the city for all its tourists. I am sure that the city of York, the tourist board and indeed everybody would be pleased to see that.

NHS Dentistry and Oral Health Inequalities

Debate between Rachael Maskell and Jo Churchill

Wednesday 25th November 2020 Westminster Hall

[Jo Churchill]

I believe that the workforce, more broadly, is something we must look at properly in the round.

Aerosol-generating procedures present a high risk, as I said, and under initial guidance issued by Public Health England, infection control required that rooms should be rested for up to an hour, as the hon. Member for Bradford South said, to allow the airborne spray to settle. NHS dental practices were allowed to start offering services from 8 June providing that they had appropriate PPE and infection prevention and control measures in place.

In response to the hon. Member for York Central (Rachael Maskell) I would say that all NHS dentists can access the portal. Registration is voluntary, and 5,500—equating to about 81% of all NHS dentists—have signed up, and 50 million items of personal protective equipment have been dispensed. Making sure that our frontline services have what they require is vital, but the e-portal is being used, and I urge the remaining dentists to sign up.

There are more than 6,000 NHS practices in England that should now be offering face-to-face care, in other than exceptional circumstances. Guidance to practices has made it clear that during the difficult period they should prioritise care for vulnerable groups and then address the delayed routine check-ups; but that remains a challenge.

I recognise the comments that the hon. Member for Bradford South made about expectant mothers; I have asked my officials to look at that at speed, and I will come back to her on that. I am determined that we mitigate widening oral health inequalities as much as we can during this difficult period because, as we have alluded to, we know we had a problem beforehand.

NHSEI is keeping more than 600 urgent dental centres stood up to provide additional capacity in the system. My hon. Friend the Member for North Cornwall said he has problems too—and we have them across the country—so making sure that we have that universal coverage with UDCs is important. I must put on record my gratitude to dentists, dental nurses, technicians and all the team, because this has been a really difficult period. Dentists and their staff have kept vital care going through the initial peak, both remotely and in frontline urgent dental centres; many also volunteered to be deployed if needed on the frontline of covid services, and their contribution was very much appreciated.

It is important to ensure that NHS dentists are financially supported as businesses. NHSEI has continued to pay dental contracts in full, minus the running costs for downtime in the initial lockdown, whatever the volume of service to be delivered, and NHS dentists holding NHS contracts have welcomed that support. However, I am mindful that that support was for NHS dentists, and there are challenges in the private sector—and many practices are a mixture of both.

The focus now is on increasing dental provision as fast and as safely as possible. Key work has been done to establish ways to reduce room resting times, and that advice has been made available to the profession. I regularly meet with the chief dental officer, the BDA and other stakeholders, because it is vital that we keep looking at how we can get volumes up. That also means updating the existing dental infection prevention and control guidance, but it does not solve the challenge of delivering dental care at volume through the pandemic. It is an important step forward, but part of the problem is the variability in the estate, as the hon. Member for Bradford South alluded to—the different sizes of practices, where they are located, and so on. NHSEI is in discussion with the profession and is taking clinical advice on the expectations for delivery of services to the end of March.

I met the BDA and other dental stakeholders last week to progress conversations further, and I heard those messages. The challenge is to make sure that we can get the optimal amount of care for our constituents and patients while safely ensuring that dental teams can be protected, but we do need to see increased provision. I am keen to understand what further work can be done to solve the challenges in dentistry and how it faces the pandemic, and I have asked officials and NHSEI to look at potential solutions, including testing, increased use of ventilation and the financing thereof.

I understand the constraints under which the profession is operating and how vital services are. We know without doubt that oral health inequalities are likely to have increased over the period of the pandemic and NHSEI is working hard to ensure that caring for vulnerable communities is prioritised. Poor oral health can have a devastating impact on somebody’s quality of life, particularly a child’s, and dental disease is entirely preventable. In the Green Paper published in 2019 we committed to looking at those barriers, to fluoridation and to consulting on rolling out supervised tooth-brushing schemes in more preschool and primary settings. We are working as hard as we can to make sure we hit the consultation dates, but there are challenges.

[Rachael Maskell]

Will the Minister give way?

[Jo Churchill]

I am all but out of time.

Sugar plays a crucial role as well, and dental professions are important in healthcare more broadly: diet, spotting oral cancers, diabetes and so on. NHS England is working on a number of key initiatives to reduce inequalities for children, the elderly and the frail. I know that all dentists seek to put prevention at the heart of what they do, recognising that good oral hygiene and diet are the foundation of a lifetime of good oral health.

Through more flexible commissioning, dentists can be partially remunerated for carrying out initiatives such as outreach to schools, care homes and other settings—the homeless are often very compromised with their teeth as well. I hope that provides some reassurance that we are determined to tackle both the long and short-term issues with dental access and the continuing and very concerning inequalities around health, and I am happy to continue this conversation informally.

Question put and agreed to.

Local Contact Tracing

Debate between Rachael Maskell and Jo Churchill

Wednesday 14th October 2020 Commons Chamber

[Jo Churchill]

I will push on a little and then I will give way to my hon. Friend.

Today’s motion talks about local contact tracing, which has been rolled out since August and is something that NHS Test and Trace is actively driving forward in its commitment to local systems. Since August, NHS Test and Trace has provided local authorities with dedicated teams of contact tracers working alongside local public health officials to assist and give a more specialist service. Local public health officials can access and use the data shared by the NHS on a daily basis. Together we can increase the number of people contacted. We have more than 95 lower-tier local authorities across the country that have gone live with local tracing partnerships. There are more going live in the coming weeks, and any local authority that wants to be involved can be. The national programme is doing an unbelievable job of helping people who might unknowingly be putting their loved ones at risk, but so is the local programme.

In England we have reached more than 650,000 people who have tested positive and their contacts and advised them to self-isolate. Every person who tests positive is contacted by NHS Test and Trace, which consistently reaches more than 80% of contacts when details are given. Because everybody, whether national or local, is locked on to the same system—this is vital—we can see how the virus is spreading. It gives us important knowledge. All the data that we publish on NHS Test and Trace include data on local performance. At this point, I recommend to everyone the coronavirus dashboard, which has been improved and updated, and gone live only this morning. It gives fantastic information about what is happening locally. As local testing partnerships are rolled out, we expect to see performance improving further.

[Rachael Maskell (York Central) (Lab/Co-op)]

As my hon. Friend the Member for Leeds West (Rachel Reeves) set out, the system is not working. The statistics speak for themselves and, while the system in Wales is delivering, it is not in England. Will the Minister say why the private companies do not just hand the test and trace system over to local directors of public health? Are there any financial penalties or anything in their contracts that preclude them from doing so?

[Jo Churchill]

We are better together. It is as simple as that. It is about a national programme. Let us imagine that the national programme is the spine and the local authorities are the ribs that wrap around us. The combination of the rigid spine and those solid ribs protects the organs, and this is what test and trace will do. We need both elements of the system.

Community Pharmacies

Debate between Rachael Maskell and Jo Churchill

Wednesday 2nd October 2019 Westminster Hall

[Jo Churchill]

If the hon. Gentleman will just bear with me for a second, he will hear me largely repeating what the right hon. Member for Rother Valley said when he so beautifully laid out the skills and expertise that lie in the pharmacy sector, and how they can be utilised better.

As I said, the deal sets out a programme of work we shall be working on. Our aim is that collaborative working across the system will deliver an integrated and accessible community health service for all. I want to name-check the hon. Member for Strangford here because, as he articulated, communication lies at the centre of this issue. One instance might be the digital expertise that the hon. Member for Washington and Sunderland West said exists in Gateshead, where people’s greater readiness to get services from pharmacists, and the fact that pharmacists can do more, is having a positive effect for patients.

First, pharmacists told us that we must utilise and unlock the potential of the highly skilled pharmacy teams that are embedded in communities throughout the country, including in the constituency of the hon. Member for Halifax, with everyone celebrating what pharmacists can deliver. That is why the settlement aims to deliver more fulfilling, patient-facing careers for community pharmacists and technicians, as highly valued members of the NHS team. Additionally, populations will be helped by much better services.

Secondly, pharmacists told us that they wanted continuity. The settlement funding over five years gives certainty, and gives community pharmacists the confidence to invest in their business. However, there is no one size fits all. Being in the centre of a town is not the same as being in a rural village. Looking at these things in the round is why we want this to be collaborative.

[Rachael Maskell]

How will the Minister measure the impact of the settlement, particularly on independent pharmacists? If more of them close or are struggling financially, what other interventions does she plan to make?

[Jo Churchill]

As I said, there is no one size that fits all. As the hon. Lady articulated in her speech, the difficulty is that we are not looking at a system where businesses are run on the same scale model. At any one point, there are single pharmacists. She stated that the pharmacy she visited was part of a seven-strong business. Then there are the multiples. We need to look at what is the best scheme. However, I would argue that independents have a much higher footfall from their local population, because they are more trusted than many of the multiple pharmacies due to the continuity that comes from their having been in their communities for longer. There are opportunities there for independents.

We know we will need to design new ways of working to make a success of this, and we will need patients to be confident in how they use the services. The enhanced role for community pharmacy will support patients in getting access to help where required and in using the NHS in the best possible way. When people are suffering from minor conditions such as earaches or sore throats and need health advice, we want them to think “Pharmacy First”.

We want to build on that, with other parts of the NHS proactively signposting to local pharmacists. We want everyone to recognise the high-level skills held by pharmacists and to get people to understand that we need them as a first-line service to go to. That will grow trust in the system and spread the load. We will, of course, need to reform the way we work to free up pharmacists’ time so that they are able to deliver these new services.