GP Funding: South-west England

Rachel Gilmour Excerpts

Wednesday 25th June 2025 Westminster Hall

[Stephen Kinnock]

Integrated care boards in the south-west have received almost £1.3 billion in their primary medical care allocation for ’25-26, which is an increase of nearly 13% compared with ’24-25, so I am not quite sure where the hon. Lady is getting her figures. For me, a 13% increase is not a cut.

That growth in local resources includes the south-west’s share of the additional £889 million agreed for the GP contract, as well as the transfer of some additional roles reimbursement scheme funding that had previously been held centrally by NHS England. Those funding allocations will be further uplifted to fund in full the pay recommendations of the DDRB and the NHS Pay Review Body.

[Rachel Gilmour (Tiverton and Minehead) (LD)]

I appreciate that recruitment, including of GPs, is extraordinarily difficult in the south-west. In Minehead, there is one GP practice and just one doctor. He is outstanding, and everybody knows him—to that extent, he fits the named GP pledge—but he serves 11,000 people. Rural premium or not, would the Minister agree that that is simply unacceptable and unsustainable, irrespective of where in the country one might be?

[Stephen Kinnock]

That is an extraordinary statistic. There are clearly major imbalances in the way the system works and general practice is funded in our country. A little later I will come to the Carr-Hill formula; I am sure hon. Members will have seen announcements trailed in the media today about what my right hon. Friend the Health Secretary will say shortly in a speech in Blackpool. The issue raised by the hon. Member for Tiverton and Minehead (Rachel Gilmour) is directly pertinent to the work we are doing around the formula for funding GPs, to ensure that it is needs based, unlike the current, deeply anachronistic and dysfunctional funding system.

On funding, general practices are funded through a range of streams, the majority from core payments known as global sum payments. The rest is made up of incentive schemes, premises payments and enhanced and additional services. The Carr-Hill formula is applied as a weighting of 50% to 60% of GP funding allocated through the core contract, and is a workload-based formula designed to reimburse practices for their expected workloads.

The formula takes into consideration patient demographics, such as age and gender, and factors such as morbidity, mortality, patient turnover and geographical location. I am truly proud that today my right hon. Friend the Health Secretary is in Blackpool to announce that we are reviewing the Carr-Hill formula, which is outdated and not fit for purpose. Currently, GP surgeries that serve working-class areas receive on average 10% less funding per patient than practices in more affluent areas, and that needs to change.

Politics is about choices. For 14 years, the Conservatives —propped up for five years by the Liberal Democrats, I am afraid to say—chose to favour the richest. Who can forget the right hon. Member for Richmond and Northallerton (Rishi Sunak) boasting about how he had deliberately redirected funding from deprived urban areas to leafy suburbs? This Labour Government are reversing that ethos. Our decision to reform the Carr-Hill formula is a clear example of how we are putting our Labour values into practice.

We recognise the importance of ensuring funding for core services is distributed equitably between practices across the country. In our upcoming 10-year health plan, that is what we will do, through our review and reform of the Carr-Hill formula. Alongside that work, the Advisory Committee on Resource Allocation—ACRA—will be asked to advise on how the setting of ICB allocations can better support the reduction of health inequalities, to ensure that resources are targeted where they are most needed.

On workforce and recruitment, we recognise the difficult situation whereby patients have been unable to get GP appointments and recently qualified doctors have been unable to find jobs. That is why, in August last year, we announced £82 million in ringfenced funding, allowing primary care networks to recruit newly qualified GPs through the additional roles reimbursement scheme. More than 1,700 GPs have now been recruited through that scheme.

As part of the 2025-26 GP contract package, we made the additional roles reimbursement scheme more flexible, to allow PCNs to accommodate local workforce needs better. That includes removing restrictions on the number or type of staff covered, including GPs and practice nurses. When I took up my ministerial responsibilities in July, I was astonished to find that it was not possible to recruit GPs through the ARRS. We have bulldozed that red tape, which has resulted in a dramatic increase in the number of GPs on the frontline.

Department of Health and Social Care

Rachel Gilmour Excerpts

Tuesday 24th June 2025 Commons Chamber

[Rachel Gilmour (Tiverton and Minehead) (LD)]

There are very legitimate concerns about rumoured plans to merge integrated care boards across the country. When ICBs merge, the promise of unified oversight gives way to a bureaucratic structure that prioritises large-scale efficiency over the nuanced understanding of local communities. Each locality and its environs has its unique challenges, such as variable demographics, socioeconomic disparities and distinctive health issues that demand targeted solutions. A merged ICB risks offering one-size-fits-all strategies that overlook the finer details of local care. The resultant dilution in responsiveness not only alienates patients, but stifles innovative local approaches that have proved successful in addressing community-specific challenges. While attempts at driving efficiency are certainly laudable, we risk sacrificing the local approach for local needs.

In my constituency of Tiverton and Minehead, community hospitals in Williton, Minehead, Tiverton and Dene Barton in Cotford St Luke are anchor institutions providing essential care for my constituents. Communities in rural areas simply cannot afford to lose them. These facilities are often the only nearby source of medical attention, and that is critical when timely treatment can mean the difference between life and death.

Moreover, community hospitals offer the family and friends of patients the opportunity to visit and check on them without having to travel great distances to do so. As we know, this familiar contact is so often a crucial part of a patient’s journey to recovery. It is certainly true in Tiverton and Minehead that community hospitals help to reduce the health disparities found in rural settings compared with urban centres. Without them, residents in more remote areas would simply not have access to the same level of healthcare as those in more built-up areas. That is why, where possible, we must resist administrative reforms that ignore local distinctiveness, and at the same time invest robustly in the community pharmacy network and community hospitals.

NHS Funding: South-west

Rachel Gilmour Excerpts

Wednesday 11th June 2025 Westminster Hall

[Rachel Gilmour (Tiverton and Minehead) (LD)]

My constituency, which straddles the Devon-Somerset border, has a disproportionately elderly population. We have perhaps even greater and more regular healthcare needs than some other parts of the country, but significant funding shortfalls have hit GP practices particularly hard.

In the coastal west Somerset area, we have what are termed dental deserts. The percentage of adults in my constituency seen in the last two years by a dentist falls well under the national average. A&E departments see the effects of that down the line. The failure to treat ailments at an earlier stage often leads to conditions deteriorating and to serious complications, leaving A&E departments overwhelmed.

Let us not kid ourselves: the strains on A&E capacity are downstream from the insufficiency of GP and dental services, whose raison d’être is to provide routine and preventive care. We need a systemic overhaul to shore up GP and dental services so that they are fit to tackle the problems at their onset and remove some of the pressure on accident and emergency.

I am all too aware that healthcare professionals tend to practise where they trained, so we want to swell the ranks of our nurses, doctors and dentists in Tiverton and Minehead by providing locally based training colleges. In Tiverton and Minehead, we also have a shortage of pharmacies. Let us be clear: this is about essential medication. Finally, I have often talked about the lack of transport facilities in my constituency. The paucity of healthcare provision across my constituency coupled with the significant shortcomings in public transport creates a bleak picture indeed.

Attention Deficit Hyperactivity Disorder

Rachel Gilmour Excerpts

Tuesday 10th June 2025 Westminster Hall

[Freddie van Mierlo]

The hon. Gentleman is right to point out that increased awareness of a condition naturally leads to an increase in the number of people seeking diagnosis. I believe the same was true of left-handedness when that became less of a taboo.

I am told that seeing every person who is on a waiting list could cost as much as £3 billion to £4 billion. We must therefore find a way to target urgent, psychiatrist-led care where it is most needed, and to triage early so that the most severe cases get support, along with those who are already taking powerful medication. To that end, I welcome and commend the Government on the launch of the taskforce in March 2024. From the discussions that I have had, however, I know that the communication with ICBs has not been good enough.

The initial data from the taskforce shows that an estimated 2.5 million people in England have ADHD, with more than half a million on waiting lists. To end this farce, we need a system that is adapted to manage the new volume of patients with appropriate levels of care. It does not help to say that there is an overdiagnosis of mental health conditions, as the Health Secretary has said; rather, we need to look at models that will diagnose and treat all patients using the most appropriate tool for their level of need. A good start would be to include ADHD in the 18-week pledge on first appointments. Currently, ADHD treatment is not considered a consultant-led area, even though GPs cannot diagnose. Waiting times should be defined by ICBs, with NICE guidance.

The consequences of getting it wrong are clear. ADHD is a leading cause of school exclusions, lower academic achievement and increased drop-out rates, and 25% of the UK prison population has ADHD, with untreated symptoms often driving impulsivity and crime. Untreated ADHD is also strongly linked to substance misuse, family breakdowns and severe mental health issues.

[Rachel Gilmour (Tiverton and Minehead) (LD)]

I speak as the mother of man who was not diagnosed with ADHD until he was 31. Fortunately for him, he has a very good employer who has made his life considerably easier than it might otherwise have been. However, I am appalled to have found out recently that great institutions such as the British Army, the RAF, the Royal Navy and the police actively discriminate against people with ADHD and simply will not employ them. Does my hon. Friend agree that that is simply outrageous? Will he join me in calling on the Minister to change that?

--- Later in debate ---

[Karin Smyth]

I am not aware of the detail of the pathway in the hon. Member’s ICB. I suggest that that is a matter for him to discuss with the ICB, which will have heard his question about how it is delivering those services on the ground.

Members raised issues around shared care agreements and the difficulties that people with ADHD are experiencing in accessing medication through such agreements, particularly when they have received a diagnosis through a private provider. It is the responsibility of secondary care specialists such as consultants, rather than GPs, to initiate treatment of ADHD. However, sometimes a shared care agreement, in which the GP takes over monthly prescriptions and routine monitoring once the patient is happy with their medication and dosage, can be put in place. The General Medical Council, which regulates and sets standards for doctors in the UK, has issued guidance to help GPs decide whether to accept shared care responsibilities for any condition. NHS clinicians need to be content that any prescriptions or referrals for treatment for any condition are clinically appropriate. All shared care arrangements are voluntary, so even where arrangements are in place, practices can decline shared care requests on clinical or capacity grounds.

If I may, Ms Jardine, I will take the opportunity to update the House on the supply of medicines, which has also been raised by colleagues; I understand that it was raised at business questions recently, too. The Government recognise the difficulties that some people have experienced with accessing ADHD medication due to medicine supplies. We know how worrying and frustrating those shortages are for patients and families. I am pleased to say that we have resolved many of the outstanding issues affecting the supply of lisdexamfetamine, atomoxetine capsules, atomoxetine oral solution and guanfacine prolonged release tablets. However, some specific manufacturers continue to have issues with methylphenidate.

We continue to work with manufacturers to resolve remaining issues. In fact, I met the medicine supply team this morning, as I do very regularly, to make sure we are on top of these issues as much as we can be. The team is working hard to make sure that the situation improves. Where issues remain, we are directing suppliers to secure additional stocks, expedite deliveries where possible, and review plans to support continued growth in demand for the short and long term. We have worked with specialist clinicians during this time to provide comprehensive guidance to healthcare professionals where there is a disruption to supply. We keep the Specialist Pharmacy Service website up to date with the latest availability of ADHD medicines. I commend it to people listening to the debate and to hon. Members. It also provides comprehensive guidance on switching to alternative treatments, supporting clinicians to make informed choices with their patients.

I can assure colleagues that, as the Minister responsible for medicine supply, I will instruct officials to keep a close eye on this issue, so we do not see any of the progress we have made undone. I plan to hold an event, hopefully in Parliament and possibly in the autumn, to keep updating hon. Members on this issue, because I know it is one that concerns us all.

In closing, I want to address the young people who may be watching or tuning into the debate at home. I know it is tough for many neurodivergent kids today. You might be stuck on a waiting list, suffering at school or struggling to find your medicine. We really do care about this. We are trying to get to grips with some of the problems we found when we came into office, and I hope you will start to feel that progress within the next few years.

[Rachel Gilmour]

May I bring the Minister back to the subject of my earlier intervention? Will she, as a matter of urgency, take it up with the Home Secretary and get a decision? We should not discriminate against people with ADHD by preventing them from joining the services, whether it be the police, the Army, the Royal Navy or the RAF. I am so shocked about this I am like a dog with a bone—I cannot let it go.

[Karin Smyth]

I will ensure that the hon. Lady gets a reply on that issue.

I thank the hon. Member for Henley and Thame for securing this important debate and for giving me the chance to put on the record some of the issues the Government are addressing. The Government know there is much more to be done to get better access to timely diagnosis and support for all our constituents, but I hope the actions I have set out today provide some reassure to the hon. Gentleman and other colleagues.

Question put and agreed to.

Dementia Care

Rachel Gilmour Excerpts

Tuesday 3rd June 2025 Commons Chamber

[Rachel Gilmour (Tiverton and Minehead) (LD)]

Dementia is a uniquely tragic disease because it is, after all, an attack on the mind and on one’s memories. It is a terminal malady for which there is currently no cure and which affects almost every family in the country. My constituent, Timothy, said this of his family’s experience with the disease:

“My wife, to whom I was married for 65 years, slipped into dementia about three years ago. When dementia strikes, it comes slowly. We did not know what was happening, and though our children were very supportive, they could not know why one parent had dementia and the other didn’t. Household management got worse, making each day a strain. My wife had been a superb cook, but I was a poor substitute. Our children tried to help, but they had their own lives to live.”

In my constituency of Tiverton and Minehead, it is estimated we have 1,877 people living with dementia—a figure that far exceeds the national average—and yet in my constituency and in rural areas around the country, the paucity of care provision coupled with significant transport challenges means that the impact of dementia is felt even more acutely. The lack of access to dementia care only exacerbates feelings of abandonment and isolation.

It is no secret that we are an ageing society. Projections from the national health service indicate that we are on course to have over 1 million people living with dementia by 2030, and as many as 1.6 million by the mid-point of this century. This significant demographic shift underscores the need to expand and strengthen the workforce in the care sector through upskilling, training and retention strategies. I speak with particular thrust as the Member of Parliament for an overwhelmingly rural area. I am all too aware of the recruitment and retention woes in remote communities where geographical isolation and resource constraints make things additionally challenging.

Several Members of my party have made the point about social care and I know that my party leader makes it on a weekly basis at Prime Minister’s questions, so I will not revisit the need for social care as it runs alongside the NHS. However, we must support our carers. Increased pay for carers is not merely a matter of fairness; it is an investment in a future where better care will inevitably lead to better outcomes for those with dementia. After all, a rising tide lifts all boats. According to the UK Dementia Research Institute, 85% of people with dementia wish to remain in their own home, so it is about time that unpaid carers—those silent heroes—were afforded the right to carer’s leave and a statutory guarantee of regular respite breaks.

Unlike other speakers, I have not talked about my family’s experience with dementia until the end of my speech because, quite frankly, I thought I would cry. My three brothers and I were lucky enough to be brought up by an intellectual colossus: my mother, M—Cambridge educated, a City solicitor, and a wonderful mother and grandmother. Fortunately, my family is able financially to look after her, and I am endlessly grateful to my brother and sister-in-law for looking after her as well as they do, and to her carer, Nicolette, who comes from Romania and who has literally changed her life.

Somebody earlier said that it is important not to look at the sad side of things, but to look at the best side. I rang my mother—mummy—last Sunday. We were laughing so much that I nearly had to put the phone down. She might not be able to remember everything, but she still has a sense of humour, she still has a good appetite, and she always enjoys a wee glass of sherry. She will be here with me next Wednesday for parliamentary questions. Mummy, I can’t wait to see you. I love you.

Yeovil Hospital: Maternity Unit

Rachel Gilmour Excerpts

Tuesday 3rd June 2025 Commons Chamber

[Adam Dance (Yeovil) (LD)]

I start by thanking the fantastic staff at Yeovil district hospital’s maternity unit and paediatric staff across the country for their hard work. I also thank the Minister for Secondary Care for coming to the Chamber this evening to respond to the issues raised, which are important for Yeovil and South Somerset.

In January, the Care Quality Commission inspected paediatric services at Yeovil district hospital. It issued a section 29A notice because it assessed that the hospital failed to meet regulations relating to staffing and governance, and therefore required significant improvement. On Monday 12 May, the hospital trust decided to temporarily close the special care baby unit at YDH from 19 May, initially for six months. That means that the hospital will also be unable to safely provide care during labour and birth at the maternity unit, meaning that the unit is effectively closed. Care of pregnant people due to give birth will now be transferred to Musgrove Park in Taunton, Dorchester county hospital, the Royal united hospital in Bath or Salisbury hospital.

[Rachel Gilmour (Tiverton and Minehead) (LD)]

I am sure that my hon. Friend knows about the problems that we have had at Tiverton district hospital. I was lucky enough to have had my three sons at the old Tiverton hospital. I am sure that people not being able to go to Yeovil hospital to give birth will push down—literally—into Tiverton hospital, but I remind my hon. Friend that there was an incident a couple of years ago when one of my constituents delivered her fifth child in a pub car park, because Tiverton hospital did not have the capacity to take her in. Does he agree that the closure of maternity services at Yeovil hospital impacts not just Dorset and Somerset, but the hospital in my constituency?

[Adam Dance]

I agree with my hon. Friend and I will come to that point later in my remarks.

In letters and at meetings, I have directly asked senior leaders at the trust for reassurance that the service will reopen after six months, but they have been unable to give it. My No. 1 priority is my constituents’ health and safety. I appreciate that the decision was difficult and that patient safety was at its heart. The safety of mothers and their babies must come first, but the way in which the decision was reached and implemented has been disgraceful. It has created huge fear and anger in Yeovil and may put people’s health at risk.

The hospital trust’s leadership team says that high levels of sickness among senior hospital staff caused gaps in the rota, but I have been informed that those staff are off sick because of work-related stress that was reportedly caused by a lack of support, a toxic work culture and bullying from management. That is not good enough. Clinicians have been working desperately hard to provide quality care and have been trying to work alongside management to improve the service, but they have found management to be unsupportive. It seems that the real issue is about management and about supporting and retaining staff.

After the CQC inspection, it was up to the hospital trust to plan a clear response and to ensure safe maternity services at Yeovil hospital. Despite money apparently not being a problem, there was a lacklustre attempt at recruitment and locums were brought in. The hospital leadership team waited until the last minute to reach a decision, and closed the maternity unit with little or no consultation with staff, patients and stakeholders, such as Somerset council and MPs like me. It is an insult that the hard-working staff knew about the closure only six days before it was due to happen. Some of them were told on Teams and others found out on social media—that is not how to treat staff.

It is a disgrace that expectant parents were given such short notice and that the hospital trust did not provide them with advanced and detailed information about the temporary closure. Yeovil hospital charity has been fundraising over the last few months for the maternity unit. It had already raised £2,000 and was due to have another huge fundraiser this month. The charity does great work for the hospital, but it too was left in the dark, which is not good enough.

It is especially worrying that a decision made to protect people may put their health at risk. Many expectant parents have told me about their fears about capacity at other hospitals and about travel times to Taunton, Dorchester or Bath. Last year there were approximately 1,300 births at Yeovil hospital. Most of the patients who would have been cared for at Yeovil hospital will go to Musgrove Park in Taunton, where staff have already raised concerns about not having enough capacity to manage their own patient numbers.

Access to NHS Dentistry

Rachel Gilmour Excerpts

Thursday 22nd May 2025 Commons Chamber

[Edward Morello (West Dorset) (LD)]

I congratulate the hon. Member for Great Grimsby and Cleethorpes (Melanie Onn) on securing the debate. I was delighted to be able to support her application, because this issue deeply affects my constituents.

Dentistry is in crisis nationally, and nowhere is that felt more so than in rural communities such as West Dorset. In my constituency we have just 15 dental practices offering any form of NHS dental care, serving a population of more than 94,000.

[Rachel Gilmour (Tiverton and Minehead) (LD)]

I have to confess that I rather envy my hon. Friend for having 15 dental practices, as I have a mere nine. In fact, as became evident in the Public Accounts Committee inquiry, which I attended as a Committee member, Minehead has fewer dentists than anywhere else in the United Kingdom. It is really important that we carry on lobbying the integrated care boards, because they can give out contracts.

[Edward Morello]

I know that my hon. Friend’s constituency suffers from a lot of the same issues as West Dorset, given their similarity.

The consequences of the lack of NHS dental care are stark: only 36% of adults in West Dorset have seen a dentist in the past two years, and just 50% of children have had a dental appointment in that time—an alarming 9% lower than in 2019. I know that the Government have announced a rescue plan to provide 700,000 more urgent dental appointments and to recruit new dentists to the areas that need them most. That is welcome news, but how exactly are the areas with the most need being assessed? What specific provisions are being made to ensure that rural areas such as West Dorset, where the population density is low but unmet demand is high, are not left behind once again?

Access to Dentistry: Somerset

Rachel Gilmour Excerpts

Tuesday 1st April 2025 Westminster Hall

[Anna Sabine]

I totally agree. I was coming on to say something similar: the roll-out of the 700,000 extra urgent appointments is a positive start, but it covers less than a third of the need for urgent care appointments. The Government must put more money into dentistry so that people can get the help they need.

[Rachel Gilmour (Tiverton and Minehead) (LD)]

The area around Minehead, in my constituency, has the smallest number of dentists in the country. Does my hon. Friend agree that the fact that the area is both rural and coastal presents a unique set of problems because of deprivation and neglect, which means that the dental desert there is felt very acutely indeed?

[Anna Sabine]

I absolutely agree. Given the time limitations, I have not come on to discuss the challenges that places such as Somerset face due to their rurality, including the difficulties in getting to services, but my hon. Friend is absolutely right.

The BDA’s asks and policy proposals are clear: the Government must invest in dental services and secure a long-term funding settlement for NHS dentistry that keeps pace with demand, and budgets allocated to NHS dentistry must be ringfenced. The BDA also agrees with the Liberal Democrats that NHS dental practices must be offered relief on the national insurance contributions rise announced in the most recent Budget. The Lib Dems believe that such relief should be extended to the wider health and social care sector, including GP surgeries, care homes, hospitals and pharmacies.

Parents and families across Somerset are crying out for extra support with accessing affordable and reliable dentistry, and access to an NHS dentist should be guaranteed to everyone needing urgent and emergency care. To catch up with the national average, Somerset needs extra investment, and it needs it quickly.

--- Later in debate ---

[Stephen Kinnock]

I take the hon. Gentleman’s point about the ringfence, but in a way, ringfencing addresses the symptoms, rather than the cause, of the problem. The fundamental cause of the problem is the amateurish way in which the previous Government set up the NHS dentistry contract so that it does not incentivise dentists to do NHS work. That is what leads them to drift off. In a sense, we can do all the ringfencing we like, but if the workforce that we need is not incentivised to do the work that we need them to do, we are going to have that problem, because they vote with their feet. That is why the radical overhaul of the dentistry contract is the key point. However, I agree with the hon. Gentleman that once we have got a contract that works, we must ensure that every penny that is committed to NHS dentistry is spent on NHS dentistry, rather than the absurd situation that we have now, in which we constantly have underspends in the NHS dentistry contract while demand for NHS dentistry goes through the roof. It is a truly bizarre situation.

I return to the subject of the dentistry recovery plan. The new patient premium, introduced by the previous Government, aimed to increase the number of new patients seen, but that has not happened. In reality, since the introduction of the previous Government’s plan, there has been a 3% reduction in the number of treatments delivered to new patients. It is clear to this Government that stronger action is needed, and we are prepared to act to stop the decay.

[Rachel Gilmour]

In Minehead, in my constituency, a dental surgery responded to the ICB in October and said that it would provide 12 NHS appointments a week for people who currently do not have a dentist. I have chased that ICB on five occasions, but we still do not have a result. That is 48 appointments a month that my constituents are missing out on. Would the Minister please agree to write a letter, on my constituents’ behalf, to the Somerset ICB?

[Stephen Kinnock]

We are very keen to ensure that targets are being met, and the ICB clearly needs to ensure that that is happening, so I would be happy to do that. Perhaps the hon. Lady could write to me so that we can get all the facts on the table, then we can take action accordingly.

We will make the difficult decisions necessary to restore NHS dentistry to ensure that patients can access the care that they need, at the best value for taxpayers. Since coming into office, we have focused on implementing new initiatives and stopping the things that are not working. From today, 1 April 2025, the public will see 700,000 additional urgent dental appointments being delivered every year, as we promised in our manifesto. The urgent appointments will be available to NHS patients who are experiencing painful oral health issues, such as infections, abscesses, or cracked or broken teeth. Somerset integrated care board has been asked to deliver 13,498 of those appointments. That is 13,498 more chances for the hon. Lady’s constituents to get the urgent dental support that they need, every single year.

Across the south-west region, there will be 106,776 extra appointments—that is more chances for patients in urgent need of care. However, to have a truly effective dental system, we cannot focus just on those who are already in pain; we must have a system that prioritises prevention. A cornerstone of the Government’s mission to prevent ill health is supporting children to live healthier lives. We want to ease the strain on the NHS and create the healthiest generation of children ever. As colleagues will be aware, too many children are growing up with tooth decay, which is largely preventable. That is why we have invested £11.4 million to roll out a national supervised toothbrushing programme for three to five-year-olds that will reach up to 600,000 children a year in the most deprived areas of England.

The latest data shows that the rate of tooth decay for five-year-olds in Somerset is 20.2%, which is lower than the 22.4% for England but still far too high. We are taking a targeted approach to support those in the most deprived areas, which is why we have been able to allocate £50,000 of funding to Somerset to support around 2,000 three to five-year-olds. Our additional funding will help to secure and expand supervised toothbrushing based on local needs. This is extra resourcing to support targeted work by the local authority and its partners.

I am determined that we will reduce inequalities faced by children living in the most deprived areas, helping them to brush their teeth daily in the nurseries and schools that they attend. Alongside this, we have launched an innovative partnership with Colgate-Palmolive, which is donating more than 23 million toothbrushes and toothpastes over the next five years. This is of incredible value for the taxpayer, and a fantastic example of how business and Government can work in partnership for the public good.

A strong dentistry system needs a strong workforce. We recognise the incredible work that dentists and dental professionals do, and we know that the current NHS dentistry contract is not fit for purpose. We need to build an NHS system that works for patients and their dentists. A central part of our 10-year plan will be workforce, and we will ensure that we train and provide the staff, technology and infrastructure that the NHS needs to care for patients across our communities. We will publish a refreshed long-term workforce plan to deliver the transformed health service that we will build over the next decade, and to treat patients on time again.

We know that some areas face challenges in recruiting and retaining the dental workforce they need. The golden hello scheme offers 240 dentists a £20,000 joining bonus to work in underserved areas of the country for three years. The recruitment process is well under way, with posts being filled by dentists in these areas as we speak.

Accessibility of Radiotherapy

Rachel Gilmour Excerpts

Tuesday 4th February 2025 Westminster Hall

[Tim Farron]

Yes. By definition, almost all of the radiotherapy deserts—those places that are beyond sensible and safe travelling times—are rural communities. As a result, they have terrible public transport. It is not just about the cost. The increase in the bus fare cap is hugely damaging, but for many of our communities—my hon. Friend’s and mine alike—it almost does not matter what the bus cap is; if there is no bus to spend the fare on, people are stuffed, really. That has a huge impact on their cancer outcomes, which means whether they survive or not.

[Rachel Gilmour (Tiverton and Minehead) (LD)]

Could the reason that radiotherapy is used in only 35% of cases, rather than 50% of cases, be that local transport just does not exist to take people to have the treatments that they need?

[Tim Farron]

My hon. Friend makes a good point. There is a combination of reasons, which I will come on to in a moment, but distance from treatment is undoubtedly the critical point that decides whether people can access and take advantage of lifesaving and life-prolonging treatment.

NHS Backlog

Rachel Gilmour Excerpts

Monday 6th January 2025 Commons Chamber

[Dr Johnson]

I will not, because I have a time limit.

I was pleased to hear that the Government will continue many Conservative initiatives, such as expanding the surgical hubs programme and extending the work of community diagnostic centres, but some of the other parts were a little confusing. Patients are to have a choice of where they are treated, but they already do. They are also to receive text messages to remind them of appointment times. That is great, but it is already happening. In fact, a look back through my phone revealed that the earliest text message I could find reminding me of an appointment for my child at Peterborough city hospital was sent on 28 July 2015, so this is not a new initiative. Patients are to get results online. Well, again, they already do. If the Minister has not seen that, I urge her to visit Addenbrooke’s hospital, where, via the MyChart system, patients can already log on and read their MRI or blood results or reports. Spreading good practice is to be welcomed, but it is not a revolution. It also faces significant headwinds.

The Government are to direct activity to general practice, but GPs are already rather busy and facing financial challenges caused by national insurance contributions. How will shifting pressure improve capacity? When will GPs be able to budget? Will the funding settlement be greater than their increased costs from national insurance contributions? If resources are moved to general practice, how will that deliver more secondary care appointments? One person can only do so much work. What is the Government’s plan for the workforce, which will be so key?

Of course, it is not just GPs who are affected by the national insurance contributions. The Secretary of State talked about record investment in hospices, but before Christmas the Minister was repeatedly unable to say whether that record investment would cover the rise in national insurance contributions that those same hospices are facing. Can she update the House now?

Patients are to have the choice on whether to have follow-up appointments, which will apparently reduce a million unnecessary appointments every year. Will that be a choice for patients to have a desired follow-up appointment that is not recommended by clinical staff—in which case, that could actually increase the number of appointments required—or will it be a choice not to have an appointment that a doctor or clinician has recommended? In that case, is that wise?

It is cold outside, Madam Deputy Speaker. In fact, this morning I woke up to blizzard conditions at my window. What estimate has the Minister made of the number of extra admissions that have occurred this winter for elderly patients who have been cold due to the removal of their winter fuel allowance?

[Rachel Gilmour (Tiverton and Minehead) (LD)]

Will the hon. Lady give way? She has heard me.

[Dr Johnson]

I have heard the hon. Lady but will not give way, because the Deputy Speaker has been clear about the time constraints in the debate.

Has the Minister made an estimate of the number of extra admissions caused by elderly people who are cold due to the removal of the winter fuel allowance, what impact that is having on hospitals, and how many elective appointments that would otherwise have occurred have been cancelled as a result? We heard the hon. Member for Bury St Edmunds and Stowmarket (Peter Prinsley) talk about his cancelled ENT list from this morning.

We have had six months of a Labour Government. They have cancelled the building of 24 hospitals, they have launched a series of reviews, they have significantly increased costs on indirectly provided NHS services because of national insurance, and they have re-announced what has already been happening, in some cases for many years. I am a doctor and I am a patient, and I really want the Government to succeed in improving the NHS; we all do—we have heard too many troubling tales from our constituents and again this evening—but stating aims does not make them happen, and launching reviews and press releases is simply not enough.