World Sepsis Day

Debate between Rachael Maskell and Maria Caulfield

Wednesday 13th September 2023 Westminster Hall

[The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)]

It is a pleasure to serve under your chairmanship, Ms Fovargue. I start by thanking the hon. Member for Neath (Christina Rees) for introducing this important debate, which is taking place on World Sepsis Day; for her work as chair of the all-party parliamentary group; and especially for her tribute to Dame Cheryl Gillan, who did so much work in this space. I am sure that Dame Cheryl would have been delighted by the way the all-party parliamentary group has been taken forward under the leadership of the hon. Lady.

I was touched by how she shared her personal experience of sepsis because I think that will highlight to people listening or watching how difficult it sometimes is to diagnose sepsis and the very many circumstances in which sepsis can present. Sepsis is a devastating condition and, while many people who develop sepsis survive, every death is tragic. Patients rightly expect it to be recognised and treated promptly because very often they are feeling so poorly that they are not necessarily in a position to raise concerns themselves. Even as the hon. Member for Neath pointed out, just becoming unwell with sepsis has long-term consequences and it can take many months to recover from an episode. She put that extremely eloquently.

The many interventions have moved us all. Many of us will know people who have become worryingly ill or have died from sepsis. It is especially heartbreaking when the family of someone who has died from sepsis feel that more could have been done to save them. Those cases are hard to hear, but it is important for us to listen and learn at all levels of Government, from officials through to frontline clinical staff.

As has been mentioned, we have all been moved to hear about Martha Mills who was 13 when she tragically died from sepsis despite concerns being raised by her family about her care. On what would have been Martha’s 16th birthday last week, her mother spoke about her death and the need for patients and families to be listened to when they think that something is wrong. I echo the words of the hon. Member for Neath. We need to encourage more people to ask that question: could it be sepsis?

I am pleased to add my support to the announcement made by the Health Secretary that the NHS will be exploring the introduction of Martha’s rule in the United Kingdom. The Secretary of State is meeting Martha’s family later today and is looking at how this could be implemented. I am sure he will be updating the House and I am happy to update Members on the follow-up from that meeting and the work that is being done to look at this.

We anticipate that Martha’s rule will be similar to a system in Queensland, Australia, known as Ryan’s rule, which is a three-step process allowing patients and families to request a clinical review of a patient’s condition if they are deteriorating. Such a system would build on initiatives already being tested in the UK, including the Call 4 Concern scheme introduced in the Royal Berkshire Hospital. Evidence from the scheme suggests that patients and their families find it useful, and that it can make a real difference in outcomes for patient care.

[Rachael Maskell]

In the light of the fact that people suffering from sepsis can rapidly deteriorate, will the Minister ensure that a review of a patient could also be undertaken really quickly, without it becoming a bureaucratic process?

[Maria Caulfield]

Absolutely. That is the point: if families want a review, it needs to be done as quickly as possible. If we are going to look at Martha’s law, those processes will need to be looked at. It must not become bureaucratic to make a request. It must be a really practical process that makes a difference.

Sepsis is not a single disease and it cannot be diagnosed with a single test. It varies in presentation depending on the source of infection and the individual. I pay tribute to the UK Sepsis Trust, which today has reiterated the signs and symptoms for people to look out for, including: fatigue; not passing urine; breathlessness; skin being discoloured, which is particularly important for ethnically diverse communities, because the skin colour may be different in different communities; fits and shakes; confusion; and shivers. All those symptoms are signs of potential sepsis, so it is really important that people understand to look out for them. We will never fully eliminate the risk of sepsis or other forms of acute deterioration, but we must do everything we can to ensure that clinicians and other NHS staff working on the frontline can recognise a very sick patient.

As many Members know, 100% of ambulance trusts and 99% of acute trusts in England screen for sepsis using the national early warning score or NEW score, which is carried out in clinical care. Following recommendations from the Academy of Medical Royal Colleges and the National Institute of Health and Care Excellence, we are working to update national guidance on sepsis. I very much take the point made by the hon. Member for Neath about the importance of ensuring that that information is all in step and aligned with guidance across the board, so that there is one clear narrative about recognition of sepsis and the targeted use of appropriate treatment.

Research is key to improving outcomes the detection of sepsis and finding more effective treatments. We are committed to driving the evidence base to improve our understanding, and the Department is providing funding of over £1 billion a year through the National Institute of Health and Care Research to drive forward research studies in these areas. Since 2017, the national institute has funded 14 research projects on sepsis, with a combined total funding value of £27 million, but further applications will be welcomed, so if there people out there want to undertake research studies, please encourage them to come forward and put in applications.

It is important that I touch on antimicrobial resistance, as the issue is inextricably linked to sepsis. It is critical that we conserve our antibiotics so that if an infection occurs, they remain as effective as possible when they are really needed, including for sepsis. In line with the asks of the declaration, the Government are delivering a five-year national action plan and a 20-year vision to contain and control antimicrobial resistance by 2040.

I am pleased to say that we are working collectively, across the UK, with our counterparts in Northern Ireland, Scotland and Wales on that antimicrobial resistance national action plan. Hon. Members have touched on international collaboration, because no country or Government can tackle this issue alone. A study published last year by the Global Research on Antimicrobial Resistance Project shows that resistance was associated with the deaths of 4.95 million people worldwide, and many of those cases will be because of sepsis related to antimicrobial resistance. By working together with international partners, we can protect ourselves and help to treat sepsis more quickly and easily.

World Sepsis Day is an important reminder that there is more work to be done. In recognition of that and as a reminder of the importance of the issue, the Department is lit up in pink today. Once again, I thank the hon. Member for Neath. I am happy to meet her and anyone she wants to bring with her, because there is still work to be done. We have made great progress, and she is touched on work that is being done, including on Martha’s rule, but I am happy to meet her and the APPG to ensure that, by next World Sepsis Day, we have made further progress with this significant condition.

Question put and agreed to.

Under-age Vaping

Debate between Rachael Maskell and Maria Caulfield

Wednesday 12th July 2023 Commons Chamber

[Maria Caulfield]

As I just said and as the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Harborough (Neil O’Brien) said earlier in the debate, the consultation closed only recently. Officials are going through the evidence and will come forward with the results in the autumn and take them forward.

[Rachael Maskell]

I raised the issue of addiction; although the Minister has said that vaping products are safer, does she agree that if they are drawing more children into addiction, they are clearly not safe in that field?

[Maria Caulfield]

We have to consider the evidence and that is not necessarily what the evidence says. NHS England is reviewing the number of admissions and incidents that it feels are caused by vaping, so we are gathering the evidence on that. We need to take an evidence-based approach and currently there is not the evidence that there is necessarily an addiction problem. But we do need to keep building the evidence base.

As we have set out today, we are committed to taking strong and assertive action to tackle youth vaping, and we are willing to go further as part of our evidence-based approach. We have to work with all parties and across Government. This is not just a health issue: it is an issue for the Department for Education, for the Department for Culture, Media and Sport in terms of advertising, and for DEFRA in respect of how single-use vapes are disposed of.

We are committed to effectively tackling the issue and driving down youth vaping rates, while making sure that vapes are available to smokers as an effective aid to quitting smoking. We are committed to doing all we can to prevent children from starting vaping and we are actively working on ways that we can go further. We will go further in not only protecting children but driving down smoking rates, so that we make a future where people are not damaged by smoking. To meet our smokefree 2030 ambition, we will do all we can to prevent people from starting smoking in the first place and to give people the support that they need to quit.

Question put and agreed to.

Resolved,

That this House is concerned that children are being inappropriately exposed to e-cigarette promotions and that under-age vaping has increased by 50% in just the last three years; condemns the Government for its failure to act to protect children by voting against the addition of measures to prohibit branding which is appealing to children on e-cigarette packaging during the passage of the Health and Care Act 2022 and for failing to bring forward the tobacco control plan that it promised by the end of 2021; and therefore calls on the Government to ban vapes from being branded and advertised to appeal to children and to work with local councils and the NHS to help ensure that e-cigarettes are being used as an aid to stop smoking, rather than as a new form of smoking.

Oral Answers

Debate between Rachael Maskell and Maria Caulfield

Tuesday 25th April 2023 Commons Chamber

[Maria Caulfield]

We also ensure that those eligible for safe and wellbeing reviews get one. Last year about 87% of those who were eligible did so.

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

10. What recent assessment he has made of the adequacy of the availability of NHS dental services.

Mental Health and Wellbeing Plan

Debate between Rachael Maskell and Maria Caulfield

Wednesday 15th March 2023 Westminster Hall

[Maria Caulfield]

I am not one for reinventing the wheel. Consultation work has been done, and we received a significant response. The hon. Member for Blaydon is right to point out groups such as YoungMinds, who will be in Parliament next week—I hope to meet them to follow up discussions. We will publish the previous call for evidence this spring, because we want to use that work to navigate and develop the mental health part of the major conditions strategy. This is not about undoing the work that was done before; it is about including it with physical illness. Over a third of people with severe symptoms of common mental health disorders also report a chronic physical condition, compared with a quarter of those with no or fewer symptoms of a common mental health disorder. Physical and mental health are very much interlinked, and to address one without the other would be to do a disservice to those patients.

[Rachael Maskell]

I am glad that the Minister has talked about parity of esteem, but only 8.6% of the health budget is spent on mental health. I hope that we will see a real uplift in funding for and investment in people’s mental health. Will the Minister set out the timeline for the publication of the strategy? It feels like the can is being kicked down the road.

[Maria Caulfield]

For the mental health perspective, which is the area that I work on, we will publish the previous consultation responses this spring—in the forthcoming weeks. That will feed into the development of the mental health aspect of the major conditions strategy, which we want to publish very soon. We also have the suicide prevention strategy, which will be a stand-alone strategy that will dovetail into that as well. There are record levels of funding for mental health. I am sure that more will be required, but it is not just about the amount of money; it is about how we spend it. We want to deliver on mental health ambulances, crisis centres and community support. We want to get in as early as possible.

I hope that I have been able to reassure hon. and right hon. Members that, just because this is not a standalone mental health strategy, that does not mean that we are reducing elements of the work that has gone before. It is so important to include it with those other major conditions, which is exactly what NHS England is doing with its Core20PLUS5 strategy to reduce inequalities. We hope to do the same with our strategy.

Question put and agreed to.

NHS Hysteroscopy Treatment

Debate between Rachael Maskell and Maria Caulfield

Tuesday 31st January 2023 Westminster Hall

[Maria Caulfield]

I very much take the hon. Lady’s point. The change to RCOG guidance is not the only way we will change this. The hon. Member for Strangford (Jim Shannon) highlighted his wife’s experience, which also shows why this is so important. The royal college is important because it can bring clinical change on the ground, but it is not enough just to assume that its updated guidance will be enough to change what happens in practice. Its current guidance already sets out that a leaflet should be provided with information about what a hysteroscopy is, what happens, and what the possible risks and alternatives are, but that does not always happen. Women can choose whether to have their hysteroscopy in an outpatient setting or have a general anaesthetic and come in as a day case. They do not always get that leaflet now, so just changing the guidance does not necessarily mean that we change the practice, and that is the key.

It is important that women are in control when it comes to hysteroscopies, which we are talking about today, and many other issues that we have debated. That is the fundamental principle behind the women’s health strategy, which we introduced because women are very often not listened to in all aspects of their healthcare.

The hon. Member for Enfield North touched on the top priorities for the first year of the women’s health strategy. The reason that hysteroscopy did not make that list is that we want to wait for the guidance before we act, but it will be a high priority, and work is starting this year.

One of the key priorities is to provide better information to women and girls about their health. We are setting up a space on the NHS website for women’s health so that women who are going for a procedure have go-to information. If they are thinking, “I don’t know what a hysteroscopy is. I don’t know what sort of tests I need. I am going for an ultrasound, but what else might they suggest to me while I am there?” they can go to that site and get reliable information that will help them make that decision. If they are not sent a leaflet and the procedure is not discussed in the clinic, they will be able to know in advance what to expect. We want that to happen this year so that women have more power when making decisions about their healthcare needs.

Waiting times for gynae procedures have not come up much today, but we know that the covid pandemic has had an impact on them. Gynae procedures are part of the elective recovery plan, which is why we are investing in community diagnostic centres to get those waiting lists down as quickly as possible. It is hoped that by having specialist centres such as community diagnostic centres, which are specialists in doing diagnostic tests, we may be able to improve women’s experience.

One of the things that will make the greatest difference is the appointment of Professor Dame Lesley Regan as the first women’s health ambassador—my hon. Friend the Member for Thurrock mentioned her. She is a female gynaecologist, and she completely gets the issues facing women. We also now have the patient safety commissioner, Dr Henrietta Hughes, who was appointed last year. She is a female GP. Dame Lesley has been passionate about this issue for many years and has been working with women’s groups on it. I have asked her and Dr Hughes to discuss hysteroscopies. They are planning a roundtable on the issue to get stakeholders round the table to discuss how we can make things happen in practice. If guidance is issued, how do we make sure that is what is happening on the ground? The roundtable will be chaired by Dame Lesley, and the patient safety commissioner will be attending. I will update Members on their recommendations, which I will take extremely seriously, and I will want to implement them as quickly as possible.

[Rachael Maskell]

I am grateful for the Minister’s response. Will she include women from ethnic minority groups? Their experience of the health system is very different, so it is really important that their voices are heard in this discussion.

[Maria Caulfield]

Absolutely. Dame Lesley has been very keen in some of her first work to ensure that we go out to women, rather than expecting women to come to us with their experiences. Often, if we wait for them to come to us, it is the usual voices that get heard. The people who have the greatest difficulties accessing healthcare are often the ones who get missed, so I can absolutely reassure the hon. Lady about that.

That is why we are setting up women’s health hubs, which are a particular priority of the women’s health ambassador. They are go-to one-stop shops that have experienced women’s healthcare professionals. If someone is going for a smear test, contraceptive advice or perhaps a hysteroscopy, there are experienced practitioners there who can support women’s health needs and perhaps give a better experience than many women have now. We hope to improve women’s experience in those areas.

I say to the hon. Member for West Ham that I absolutely recognise the significance of this issue. It is unacceptable that a test that is so important for women’s health is currently such a painful experience. We changed the tariff in the hope that it would encourage the use of general anaesthetics if that is what women want, because we felt that the previous tariff system worked against that. However, I am really keen that we deliver changes on the ground once we get the royal college guidelines and the roundtable with Professor Dame Lesley Regan and the Patient Safety Commissioner, who are there to advocate for women and patients. I hope that will be within the next few months, and I am happy to meet the hon. Member for West Ham, as I will be meeting the patient campaign groups too.

We can change this behaviour. A woman who is having a hysteroscopy should know in advance what is involved and what her choices are. She should feel confident that if she turns up for her appointment and finds it uncomfortable, which she was not expecting, the procedure can be halted and a separate appointment can be made swiftly to make sure that the procedure is as comfortable as possible. I hope that gives some reassurances that I absolutely take the seriousness of this issue on board, and that we want to make a change and a difference for women.

Strep A Treatments: Supply

Debate between Rachael Maskell and Maria Caulfield

Monday 19th December 2022 Commons Chamber

[Maria Caulfield]

There are sufficient stocks in the country to meet demand.

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

The deputy chair of the British Medical Association’s general practitioners committee told the Health Committee two weeks ago about the challenges faced by GPs in accessing appropriate pharmaceuticals. What are NHS planners doing to ensure that logistics are getting stocks to the appropriate place in a timely way? With strep A, we just cannot wait.

[Maria Caulfield]

Absolutely. That is why wholesalers have expedited deliveries and increased the number of deliveries that are going to pharmacies. We are working with NHS England, with UKHSA and with pharmaceutical bodies to make sure that those supplies are getting to them. But we recognise that even with the expedited and extra deliveries there is still demand on supplies, which is why the SSPs have been issued—so that pharmacists can dispense not just alternative preparations of what has been prescribed, but alternative substitutes.

Abuse and Deaths in Secure Mental Health Units

Debate between Rachael Maskell and Maria Caulfield

Thursday 3rd November 2022 Commons Chamber

[Maria Caulfield]

The Secretary of State will be having discussions around the autumn statement with colleagues not just in local government but across Departments. The failings that we have seen are of in-patient facilities—these young women had accessed treatment—so the issues are interlinked, but my main concern is about the safety of in-patient facilities. That is where my focus will be over the coming days.

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

The challenges are not confined to the Tees, Esk and Wear valleys, because the trust also extends to York. The extent of the trust and the size of the organisation perhaps explain some of the challenges. The reality is that the challenges are systemic and widespread. The trust has had 10 years of failed CQC reports, which should have easily raised a flag with the Department way before these tragedies occurred. As well as the steps that the Minister has proposed today, there should be a judge-led public inquiry into what is happening across mental health facilities. Nothing less will do.

[Maria Caulfield]

I thank the hon. Lady for making those points. As she knows, one of the facilities was closed in 2019 because of failing inspections and it has since reopened under another organisation, so action is taken where failings are found. My concern is that failings are often missed. That is why the director of mental health at NHS England wrote to every single trust on 13 September asking them urgently to review their services. As I said, I am taking advice and will report to the House in the coming days about what action we will be taking.

New Developments on Green-belt Land

Debate between Rachael Maskell and Maria Caulfield

Wednesday 12th October 2022 Westminster Hall

[Maria Caulfield (Lewes) (Con)]

It is a pleasure to serve under your chairmanship, Sir Gary, and I congratulate the hon. Member for Coventry North West (Taiwo Owatemi) on securing this important debate, although I shall start by disagreeing with her slightly.

In the Lewes constituency, we had a good system. We had a local plan in place, and nearly every town and parish in the Lewes district had neighbourhood plans, which were voted on by local people and put together by parish councillors. That was delivering our housing numbers in the right place and delivering the right type of accommodation, which enabled older people to stay in their communities by downsizing and young families to begin their life in their community with a starter home.

Our issue is that in 2019 the Lib Dem-Greens took over the district council and let that local plan go out of date, and with it the five-year land supply. With that, all the neighbourhood plans have fallen, and since then we have been inundated with applications from developers, who seized the opportunity to target every greenfield site in the constituency for housing development.

The local planning authority has refused most of those applications on the principle that they are not in the local plan and not in the neighbourhood plan, but those refusals are being overturned almost daily by the planning inspector, as my hon. Friend the Member for Eastbourne (Caroline Ansell) suggested, and there is inaction from our local council, which is squabbling over housing numbers. Meanwhile, not having a local plan in place means that our communities, parishes and town councils, which worked so hard to accommodate the housing numbers they were given, are being left to face the consequences.

[Rachael Maskell]

Will the hon. Lady give way?

[Maria Caulfield]

I will not because there is little time left.

That is not fair because the housing being built on those sites is not affordable for local families. It is £400,000 or £500,000 for a starter home, and those are three-bedroom or four-bedroom homes that do not allow our older residents to downsize and stay, or our new young families to start their life in their community. This is not the right housing. We were trying to build communities, not just homes, and the system has failed us.

I have seven key asks of the Minister. Many Members have raised the brownfield first strategy, which was highlighted by the previous Prime Minister and hinted at by our current Prime Minister. We need clarity on that. In Lewes town, we had the Phoenix quarter, which would have delivered thousands of new homes. The Government gave the council £1 million to start that scheme, but not a brick has been laid on the site. Meanwhile, our green fields are being concreted over.

We need to be able to force local councils to get their local plans in place. It cannot be right that we had a plan in place that delivered the housing numbers and the housing that our communities wanted, but that the local plan is not happening because the council is squabbling over housing numbers. All that is now a hostage to fortune. It is the same in the Wealden district of my constituency, which I share with my hon. Friend the Member for Eastbourne. There has never been a local plan and the district is holding out for the Government either to scrap housing numbers or to deliver a different housing strategy. Meanwhile, every greenfield site is open to challenge from developers.

The standard method was touched on by my right hon. Friend the Member for South Staffordshire (Sir Gavin Williamson). I have received letters from the previous Housing Minister saying that it is not a target, just an indication, but local councils do not feel confident enough to take matters to appeal, because when they do so the planning inspector does not uphold that view. The 2014 housing numbers, which form the standard method, as has been highlighted, are inaccurate and out of date.

We need to take the heat out of the south-east. Members across the Chamber might not agree with me, but we are talking about applications in their thousands, not their hundreds. We have GPs who have closed their lists because they cannot cope, schools that are full and roads that are congested. At the end of the day, we are just not building the housing that helps our local communities, and residents have had enough.

On the land banking issue, Oliver Letwin did a review a couple of years ago and said there was no problem—“Nothing to see here, folks.” Actually, I agree with the hon. Member for York Central (Rachael Maskell) and my hon. Friend the Member for Eastbourne. Wealden district has 8,000 units that have planning permission, but because they are mainly on brownfield sites, it is cheaper, quicker and easier for developers to challenge the council, win at appeal and build on greenfield sites instead.

We absolutely need to support our local planning authorities. In the case of the proposed Mornings Mill development, the council has refused it twice and it has gone to appeal. I am concerned not about the cost but about the principles behind that decision. What is the point of having planning authorities? We might as well give the decision to planning inspectors in the first place. We have tried to build the housing that we are required to build, we did our local plan and our neighbourhood plan, and it cannot be right that decisions by democratically elected councillors are overturned. Developers have the money and legal expertise to be able to win every single case.

Finally, I will address the issue of local plans and five-year land supplies going out of date. Does it really need to take years? They were good plans, and there are only a couple of sites that did not come to fruition. It should take months to revamp that, and we should be able to keep those local plans and the legal protections they provide for our constituencies.

The odds are stacked against our communities at the moment, and we need the Minister’s help. We want to build housing, but it must be the right type of housing for our communities, and we want to build communities and not just homes.

NHS Dentistry in England

Debate between Rachael Maskell and Maria Caulfield

Wednesday 22nd June 2022 Westminster Hall

[Maria Caulfield]

Absolutely. The whole point of the ICSs is that the commissioning service has not worked up until now. Some commissioners are very good at commissioning dental services, while others do not have anyone with dental experience on their boards and are not so good. ICSs will be accountable, which is the difference from what we have now. I will meet ICSs to ensure that they understand the responsibilities.

[Rachael Maskell]

rose—

[Maria Caulfield]

I will take one last intervention, because I am conscious of the time.

[Rachael Maskell]

I am grateful to the Minister for giving way. When I wrote to her, she kindly replied and said that York could well be one of the areas for a centre of dental development. I would like to know the timescale for such considerations, and what progress has been made since our correspondence.

[Maria Caulfield]

I met Health Education England this morning and we are working through that system. I will be able to update the hon. Lady shortly, because I am keen that we make progress.

A number of Members mentioned prevention. The Health and Care Act 2022 includes provisions relating to fluoridation as standard, and we are working to make progress since it became law recently. We are also working with education colleagues on supervised toothbrushing. As we speak, some of the 75 family hubs that are being set up in the most deprived parts of the country as part of the Start4Life programme are looking at initiatives such as supervised toothbrushing. Where it is not happening at home or where parents need more support, we are ensuring that children are getting that toothbrushing experience.

On the subject of upskilling dental teams, this is about more than just dentists. My hon. Friend the Member for St Ives (Derek Thomas) made the key point that it is about the whole team. At the moment, part of the contract means that only dentists can do certain work. We need to change that. Centres for dental development will be about not just training dentists but upskilling whole teams.

I hope that I have reassured Members from across the House that we are taking this issue extremely seriously. To answer the question put by my hon. Friend the Member for St Ives, the contract changes that we are going to announce will not be the end of it, because there is more reform that we need to do. The Secretary of State is looking at a wider piece of work to provide a long-term, sustainable solution. We are happy to work with the other three nations if they have suggestions and solutions. We are not precious about sharing best practice.

I say to the shadow Minister, the hon. Member for Enfield North, that it would be good if she could come to a dental debate with some suggestions and solutions, rather than constantly criticising. We are determined to solve this issue and I appreciate the urgency that every single one of my colleagues has expressed today.

[Rachael Maskell]

I raised the issue of Ukrainian refugees. The Minister seemed to indicate that she had a response, so could she provide it before she closes?

[Maria Caulfield]

The response is that every overseas dentist, apart from those in the European economic area, currently has to take the overseas registration exam, and that is without exception. That is the work that we are trying to do with the General Dental Council. We are enabling those from Ukraine or Afghanistan, or any refugee from any country, to take part in that process. I am very keen to see mutual recognition with some countries. We are working on that and will enable the legislation to make it happen, but it will be for the regulator to decide; it is not a Government decision.

I hope that I have reassured colleagues that we are on this and appreciate the urgency. I have no doubt that we will return to this Chamber to debate this matter further in the coming weeks and months.

Oral Answers to Questions

Debate between Rachael Maskell and Maria Caulfield

Tuesday 1st March 2022 Commons Chamber

[Maria Caulfield]

I thank my hon. Friend for all her hard work on campaigning for more dental appointments for her constituents. I believe that she met the Secretary of State last night to push him further on this. Her local area has an allocation of £4.7 million from the £50 million fund, and I encourage her to speak to her local commissioners to make use of that allocation. We are also looking at improving dental training so that we can get more dentists into her area.

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

Since dentistry was debated just a few weeks ago, another 10,000 of my constituents have received letters to tell them that they will have to go private. They are already waiting for five years to get an appointment. When will they actually get to see a dentist, or are they expected to have poor teeth?

[Maria Caulfield]

I am not sure where those constituents’ letters have come from, but if a contract has been handed back and that is the reason for the letter, the local commissioners should be looking for new providers, so I am very happy to meet the hon. Lady and her commissioners to see what is going on to make that happen.

GP Appointment Availability

Debate between Rachael Maskell and Maria Caulfield

Tuesday 26th October 2021 Westminster Hall

[Maria Caulfield]

We are committed to increasing GP numbers, as in our manifesto commitment. However, that does not stop us increasing the numbers of other healthcare professionals. We need to get the message out to patients that seeing a nurse, physio or paramedic at the GP surgery is not second best. These are highly qualified, experienced and educated professionals who often are better placed—though I do not want to upset the shadow Minister—to see a patient than a doctor. They can make a considerable difference, but very often patients feel they are being fobbed off or seeing the second best. We need to do a lot of work to reassure patients on that.

We have already recruited 10,000 of the additional 26,000 staff we stated in our manifesto would be working in general practice by the end of 2023-24. We are strengthening our plans to increase the number of doctors in general practice. To reassure Members, so far we have filled a record number of GP speciality training places this year, with the latest data showing that there are already 1,200 more full-time equivalent doctors in general practice than two years ago. It is a challenge; I am not going to say it is not, but we are making progress.

I feel particularly passionate about the use of community pharmacists. In many other countries, the pharmacist is the first port of call for minor ailments. They are highly qualified professionals with over five years of clinical training who are able to assist patients. Over 800 practices have already signed up to participate in the community pharmacist consultation service, which enables patients to see a pharmacist, on the same day in many cases, to deal with minor conditions. That will not only help patients, but it will free GPs up to see the patients that really need to see them for clinical conditions.

[Rachael Maskell]

Will the Minister also ensure that the funding goes into community pharmacies in the right way if they are to be utilised? Likewise, with the voluntary sector involved in providing support for people through different forms of wider health support, will she ensure that it too gets proper funding?

[Maria Caulfield]

I thank the hon. Lady. The spending review tomorrow may have further updates on that, so I will not comment on the funding for now. NHS England and the Department of Health and Social Care have asked the Royal College of General Practitioners to provide GPs with more guidance on how to blend face-to-face with virtual appointments. We do need a mix of both going forward, and the comms, as has been said so much this afternoon, will make a difference, so that patients know where to go, what is available and who they can see for their particular condition.



The issue of abuse has featured heavily this afternoon. The hon. Members for Batley and Spen and for Linlithgow and East Falkirk (Martyn Day), my hon. Friend the Member for Bracknell and for Waveney (Peter Aldous) and others have mentioned the impact of abuse. When patients have been waiting a long time to see a GP, cannot get through on the phone and are feeling unwell in very distressing situations, they often take it out on practice staff. It is unacceptable, and we all have a role in this place to say that we have zero tolerance for that.

We know as MPs what it is like to face a torrent of abuse. If it is not acceptable for us, it is certainly not acceptable for them. My message to general practice staff is that we are four-square behind them on this and will support them. As part of the winter support package, there is £5 million to facilitate extra security, be that CCTV, extra screens or door entry systems—whatever practices feel will make their staff more secure, that funding is available to them. That is not the only solution, and they should not face abuse in the first place, but we are taking it extremely seriously.

In the few minutes that I have left, I want to say that there are two main issues here. There is the short-term covid issue, which has seen a tsunami of patients whom we need to support as we come out of the covid period. There is the £250 million winter package, and there is support around opening up community pharmacies and enabling other healthcare professionals to see patients, which will take some of the bureaucracy away from GPs while we support them to get through the period. However, there are some longer-term solutions as well. General practice and primary care were creaking before covid, and we need to ensure that they are supported in the long term going forward.

I thank my hon. Friend the Member for Beaconsfield for securing this afternoon’s debate. She has raised some really important points. On Thursday, I am holding a cross-party call for MPs to raise some of their constituency GP issues. I urge them to feed back to me as the Minister where it is working well, because there are some brilliant examples out there. Where it is not working so well, it is not the fault of GPs. There are some fundamental solutions that we can help them with, but it is important that we hear about the problems so that we can support them. If Members have specific issues from their constituencies, they should join the call. We are hoping to hold such calls on a regular basis, if that is needed by colleagues, and I am keen to work with everyone across the House to support general practice, because that is the only way we will support patients in the end.