Access to GP Services and NHS Dentistry

Rebecca Long Bailey Excerpts

Tuesday 21st June 2022 Commons Chamber

[Rebecca Long Bailey (Salford and Eccles) (Lab)]

According to the Association of Dental Groups, only a third of adults and half of children in England have access to an NHS dentist. As we have heard, the top reason for children being admitted to hospital is tooth extraction. It is 2022, not 1922. Back in 1947, when the NHS and NHS dental services were brought about by the then Labour Government, many of us naively thought that they would be around for ever, that we would always be able to access those services when we needed them. Unfortunately, we now see the return to the poverty-linked ill health that we saw in the 1940s.

As MPs, we hear heartbreaking stories. There was the Salford man with a badly infected tooth who could barely afford to live, let alone pay for private dental treatment. He could not find an NHS dentist who would take him on. He said to me that, had it not been for the fact that he was on anticoagulants, he would have pulled his own teeth out with a pair of pliers. There was the Salford woman with countless abscesses all over her jaw, and no money to go private. She was in acute pain and putting her life at risk from a spreading infection. She had been trying to get on an NHS waiting list for a dentist for over five years. There was also the Salford mother living on the breadline, yet forced to borrow and scrape together the money to go private. She told me that she had to pay £100 just to get on a dentist’s list. There are thousands of stories like this.

Recently, I asked the Government what data they held on the number of people trying to access an NHS dentist in Salford, such as the stories I had heard from my constituents. The Government confirmed that they held no data for my constituency or even across Greater Manchester. Frankly, that is staggering.

So what is at the heart of the decline of NHS dentistry? The British Dental Association details that chronic underfunding and the current NHS dental contract are to blame for long-standing problems with burnout, recruitment and retention in NHS dental services.

On funding, in real terms, net Government spend on general dental practice in England was cut by over a quarter between 2010 and 2020. The £50 million that the Government have announced—as we have already heard today, it is difficult to access that at the best of times—will not even touch the sides given the amount of funding cut from NHS dentistry.

On the contract, the system in effect sets quotas for the number of patients a dentist can see on the NHS and caps the number of dental procedures they can perform in any given year. If a dentist delivers more than they have been commissioned to—say, to try to help a desperate patient in need of urgent care—that dentist is in effect punished. Not only are they not remunerated for the extra work done, but they have to bear the cost themselves of any materials used, laboratory work and other overheads.

It is no wonder that morale among NHS dentists is now at an all-time low, and we are facing an exodus of dentists from the NHS. We are seeing NHS dentistry deserts popping up all over the country, where constituents such as mine in Salford can only dream of trying to get on an NHS dentist’s patient list. Around 3,000 dentists in England have stopped providing NHS services since the start of the pandemic. Staggeringly, for every dentist quitting the NHS entirely, 10 are reducing their NHS commitment by 25% on average, and 75%—75%—of dentists plan to reduce the amount of NHS work they do next year.

It is clear that we face a dental crisis and that the Government must urgently address it. There are a number of actions that I hope the Minister will take. First, they must reform the NHS dental contract with a decisive break from units of dental activity, a greater focus on prevention and the removal of perverse incentives.

Secondly, the Government must provide adequate levels of protected NHS dental funding to ensure investment in new and existing NHS dental services, and they must guarantee the long-term sustainability of NHS dentistry for all who need it.

Thirdly, NHS dentistry must be given the status it deserves. That means sitting right at the heart of local NHS commissioning, rather than being treated as an afterthought—a luxury service, as it were, which is how many seem to perceive it.

Finally, the Government must build and properly fund historic public health commitments to prevention. As we have heard—from Conservative Members, actually—this is a crisis in NHS dentistry, but many of the factors that contribute to this crisis are directly related to poverty, people’s diets and the amount of money they have to spend as a family on oral health and hygiene.

We are in the midst of a cost of living crisis as well as a dental crisis, and the Government need to be doing far more to support families to make sure that they have enough to live on and a decent range of food that provides them with the nutrition they need in order to have healthy teeth. We naively thought that poverty-related ill health, rotting teeth and gum disease had been consigned to the history books when NHS dentistry was established in 1948, but this Government wind the clock back day after day and those afflictions are now back with a vengeance. NHS dentistry hangs by a thread. The Government have a moral duty to stop the rot today because rotting teeth come from a rotting Government. I hope that the Minister will change my mind.

Irish Diaspora in Britain

Rebecca Long Bailey Excerpts

Thursday 17th March 2022 Commons Chamber

[Rebecca Long Bailey (Salford and Eccles) (Lab)]

I speak for many of those celebrating the feast of St Patrick today when I say that we share the values embodied by his story—solidarity, care, kindness and compassion. We stand in solidarity with the people of Ukraine as they struggle to protect their right to live in freedom and peace.

I thank my hon. Friend the Member for Rochdale (Tony Lloyd) for securing this important debate to celebrate the strong cultural, political and business ties between Britain and Ireland and the immense contribution of the Irish diaspora in Britain. As he knows, as my local MP growing up, the contribution of the Irish community in Greater Manchester, of which we are both part, is immense. My mum is from Galway and my dad is from Belfast.

We await the most recent census data, but at the 2011 census, more than 430,000 people living in Britain identified themselves as Irish-born. That is only part of the picture: Bronwen Walter, emerita professor of Irish diaspora studies at Anglia Ruskin University in Cambridge, estimated some years ago that the true figure for those with at least one Irish parent or grandparent was roughly 5 million. As we have heard today, the figure has now increased to 6 million. It is also said that, if someone’s family has lived in Salford or Manchester for more than a generation, the chances are that they have Irish ancestry.

The huge Irish diaspora across the north of England has been recognised by the Irish Government, who have opened the consulate general of Ireland for the north of England. Its establishment reflects a strong commitment to developing the British-Irish relationship and it will strengthen the political, commercial, community and cultural ties between Ireland and the north of England.

Niall Gallagher, chairman of Irish Heritage, described the contribution of the Irish to cultural life in Britain as incalculable. On the contribution of the Irish community in Greater Manchester, Irish President Michael Higgins said that it had given the area countless talented footballers, vibrant cultural festivals, and talented students, writers and businesspeople. Indeed in Salford, it is asserted that it was the Irish community who contributed to the creation of Salford as a city in its own right. During the mid-19th century, there was huge migration of Irish people into the Salford area, partly due to the great hunger in Ireland, and in 1848 Salford Roman Catholic cathedral was consecrated, reflecting Salford’s huge Irish population at the time.

It was also a huge proportion of the Irish community who built the Manchester ship canal, which spurred on the industrial revolution in Greater Manchester. Indeed, the same is true of the railways, the roads and even the channel tunnel. From the early days of industry to the present day housing estates and skyscrapers we see today, the immense contribution of the Irish diaspora to construction in Britain is undeniable. In our NHS, as of September 2021, there were 13,971 members of NHS staff in England reporting their nationality as Irish, including just under 2,500 doctors and 4,500 nurses.

The Irish diaspora has made its mark on culture, too. In Salford, from renowned playwright Shelagh Delaney, a pioneer in women’s writing, who challenged the accepted views of race, gender and class at the time, all the way through to Shaun Ryder of the Happy Mondays, the list of those with Irish ancestry who have made their mark is endless. Interestingly, it is also said that the famous song about Salford, “Dirty Old Town”, that many will be singing in the pub tonight, written by Salfordian Ewan MacColl, has all but taken on its own Irish citizenship. It is a staple favourite tune not just in Salford but in St Patrick’s night celebrations across the world.

In political life, as we can see today from Members of Parliament who are representing the Irish diaspora, Salfordians and Mancunians with Irish ancestry are found in abundance across our political and council chambers, transforming lives in our communities. One of my favourite historical figures is a lady called Eva Gore-Booth, a famous Salfordian suffragette who was instrumental in the creation of the trade union movement, which spurred on the creation of the Labour party.

In business, commercial ties between Britain and Ireland are stronger than ever. When President Michael Higgins came to Manchester 10 years ago, he said that over 55,000 directors who are Irish sit on the boards of British companies. Irish people are present in nearly all the listed occupations of the census in Britain. They have risen to distinction in all professions. That number is of course even greater now.

But leaving all of these achievements aside, it is the everyday actions of people within the wider Irish community that I am so proud of—those who seek to care, nurture and build relationships within their wider community. We have so many amazing charitable and social organisations, such as Irish in Britain, Irish Community Care, Irish Heritage, the Irish World Heritage Centre in Manchester, Irish societies and clubs right across the UK, sports clubs, radio stations, dance and music groups, festivals and even welfare advice services. Of course special mention must go to The Irish Post and The Irish World newspapers, which have been keeping the Irish community in Britain connected for decades—and I was forced to read them on a weekly basis by my mother to find out what was going on. So it is clear that the contribution of the Irish diaspora to all aspects of life in the UK is indeed incalculable, and that the warm connections between Ireland and the UK are going from strength to strength. As President Higgins himself said:

“The closeness and warmth that we laud today was founded to a large extent upon the lives and sacrifices of generations of Irish emigrants who settled in this country—generations of Irish people who came here and contributed so positively to nearly every aspect of British society, who did so much to make Britain what it is today while at the same time fostering understanding, tolerance and co-operation between our two countries.”

Long may this strong bond continue, and Lá fhéile Pádraig sona daoibh—happy St Patrick’s day.

Future of the NHS

Rebecca Long Bailey Excerpts

Monday 31st January 2022 Westminster Hall

[Rebecca Long Bailey (Salford and Eccles) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Gray. I speak in full support of the petition. I would like to make particular mention of the recent Health and Care Bill. The clearest example of what could happen to our NHS if this Bill goes ahead lies in NHS dentistry. Net Government spend on general dental practice in England has been cut by about one third in the last decade. The results of this are stark; there are reports of people resorting to pulling out their own teeth because they cannot afford private treatment.

The British Dental Association states worryingly that the Bill worsens the situation and

“does not ensure that the voice of three quarters of NHS primary care professionals is heard in the making of commissioning decisions”.

Whose voices will be heard, then? The Bill would put private companies right at the heart of NHS decision making and service delivery—on the new integrated care system boards, where they will be given power to make decisions about people’s care and how NHS money is spent. The Bill will allow private healthcare providers to award contracts for clinical care without considering any other bids. The doctor-led campaign organisation EveryDoctor states:

“This Bill will embed private companies in the NHS in England, and give them the power to decide who gets what treatment when.”

Members on the Government Benches might wax lyrical about the NHS being free at the point of use, but what happens when people cannot access the care that they need? It might be because of rationing, or because of lengthy waiting lists due to lack of funds. It might simply be because those with a seat at the integrated care system board table determine that a person’s care should not be available on the NHS, because it is just not profitable enough. The result is this: if a person cannot afford private medical cover, they do not receive treatment. That is already happening in NHS dentistry, where it has been normalised. The risk is that it will be normalised throughout the healthcare system.

This is not a Bill to tackle the crisis facing the NHS. It is not a Bill to tackle the care backlog, or to properly fund our NHS. It is a Bill to reduce our rights to access healthcare and to privatise our NHS. It must be scrapped.

Health Inequalities: Office for Health Improvement and Disparities

Rebecca Long Bailey Excerpts

Wednesday 26th January 2022 Westminster Hall

[Rebecca Long Bailey (Salford and Eccles) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Twigg. I thank my hon. Friend the Member for Bootle (Peter Dowd) for having secured this important debate, and for his eloquent and detailed speech. Salford is currently the 18th most deprived local authority area out of 317 in England, yet it is a tale of two cities: more than 30% of the city’s population reside in a highly deprived area, yet we are also home to some of the wealthiest suburbs in Greater Manchester. That disparity is shown starkly by our life expectancy. It has been improving over the past few decades, but there remains a gap between Salford and the rest of England of three years for males and two years for females.

Male residents living in the most affluent areas of Salford can expect to live more than 11 years longer than those in the most deprived areas, while females in the most affluent areas can expect to live seven years longer. I think we can all agree that that is morally wrong. Sadly, we have known for decades—from the Beveridge report to the Marmot report—that poor health, discrimination, housing, employment and income are inextricably linked, yet we have seen very little action in recent years. Of course, there was a burst of radical policy development in the late 1940s, with the creation of the welfare state and the NHS, for example, and we saw policy approaches in the late 1990s and early 2000s, but since then we have lacked a comprehensive health inequality strategy. What is worse is that austerity has resulted in the unravelling of many of the positive policies put in place and the undermining of the remaining ones.

The creation in October 2021 of the new Office for Health Improvement and Disparities and the announcement of a new cross-Government agenda to track the wider determinants of health and to reduce disparities were met with cautious optimism. However, since the creation of the OHID, there has been little information on what it will actually do or what it has done so far. Will the Minister clearly set out how the Office for Health Improvement and Disparities will reduce health inequalities? Indeed, what is the new cross-Government agenda? Can she confirm that the Health Promotion Taskforce will be given a remit to act outside of the Department of Health and Social Care, to address the true socioeconomic causes of poor health? Finally, can she set out how OHID will work with the new integrated care systems, and how it will support them to address health inequalities in their area?

As the Inequalities in Health Alliance states:

“If we are to prevent ill health in the first place, we need to take action on issues such as poor housing, food quality, communities and place, employment, racism and discrimination, transport and air pollution. All parts of government and public services need to adopt reducing health inequality as a priority.”

Of course, I fear that the Government will not do that. It would show that an active state that supports communities, industry and workers to increase living standards for all within a new, democratic economy is the only way to do this properly, and that goes against everything the Government believe in. None the less, I hope that the Minister will at least address some of the questions I have asked today.

Support for Carers

Rebecca Long Bailey Excerpts

Thursday 22nd July 2021 Westminster Hall

[Rebecca Long Bailey (Salford and Eccles) (Lab) [V]]

It is a pleasure to serve under your chairmanship, Mr Hollobone, and I thank the right hon. Member for Kingston and Surbiton (Ed Davey) for securing this important debate. I agree with everything he said about the plight of unpaid carers. We must increase and expand the carer’s allowance, properly fund respite breaks and recognise unpaid carers in legislation.

The situation for paid carers is equally dire. The Resolution Foundation found that between 2017 and 2019 more than half of care workers were paid well under the real living wage. Despite this, after a decade of cuts and Government underfunding of care, Salford has done its best to try to lift wages to a standard that carers can actually live on. Salford City Council and Salford clinical commissioning group, following a campaign by Salford City Unison, set aside funds to give care workers a significant wage increase and covid sick pay when isolating. This so-called Salford offer was offered to private care providers, but staggeringly, even when public money is made available, some companies have actually refused to take it if it means improving pay or terms and conditions for workers. What can the Minster suggest to address this?

Sadly, that is only one symptom of the structural problems that exist in care. As the Women’s Budget Group states,

“the structural problems with the sector…have arisen from allowing uncontrolled consolidation by private providers, including private equity.”

Salford City Unison further told me:

“We also see every day that even where we are able to secure contractual guarantees for workers, companies invest so little in back-office services that workers are regularly paid the wrong amount, get rotas at the last minute and find that the days they booked for leave are not recorded in the system and are therefore cancelled at short notice.”

I will read the Minster two quotes from care workers in Salford. Paul says:

“Private companies—and even so-called charities—only care about how much money they make. Not us workers or the people who need our care and support. We want more Government money for social care, but we’ve seen in Salford that loads of private companies would rather turn down public money offered by the council and the NHS, than use it to improve our wages or pay us when we’re off because of COVID.”

Diane, another care worker, says:

“I work in Homecare, often working 7am until 2pm, then back on at 4pm until 10:30pm and then back on at 7am the next day to do it all again. Bear in mind that means I have to get to my first call at 6:30am and don’t get home until 11pm. I am not the same carer when I work that many hours and that breaks my heart. When I ask for holidays, the company asks ‘Are they important? Do you need to be off that long?’ They tell you your days off have changed so that you have to cancel your appointments made in your own time. I am always being given extra calls. Once I actually covered 32 calls in one day. You cannot be a good carer when you are forced to work like that.”

That is not how we should treat those people we charge to look after the most precious people in our lives, is it? It is no way to run a care system. I hope that the Minster agrees that care workers must receive the pay and security they deserve; that unpaid carers must receive the allowances and respite they deserve; and ultimately that the Government must recognise care as a form of public social infrastructure and fund it as such.

Covid-19 Update

Rebecca Long Bailey Excerpts

Monday 17th May 2021 Commons Chamber

[Matt Hancock]

The red, amber and green lists reflect the risks that there are in other places around the world. The amber list means that people need to quarantine at home, the red list means that they need to quarantine in a hotel, and the green list means that we think it is safe to travel. My hon. Friend should get his passport out—he can get on a plane to Portugal or one of the other countries. The system allows for some careful foreign travel. However, my first duty is to protect the lives of people here in the UK, and the best way to do that right now is to make sure that we are cautious on international travel to protect the opening up here at home.

[Rebecca Long Bailey (Salford and Eccles) (Lab) [V]]

The Secretary of State will know that analysis of the data published by Public Health England shows that the spike in cases in Bolton so far is mostly confined to schoolchildren and young adults who are socially mobile and have not yet been vaccinated. There are valid concerns, therefore, that as lockdown eases today, it might lead to a rise in cases within unvaccinated cohorts across Salford, which borders Bolton. Can he confirm that he will act now to protect people in Salford by curbing any spread beyond surge hotspots and accelerating the vaccine roll-out programme in Salford not just for second doses, but for first doses for young, unvaccinated cohorts?

[Matt Hancock]

Yes, we are opening up vaccinations for those aged 37 tomorrow, and anybody in Salford who is in one of the eligible groups and has not been vaccinated should come forward. If you are in Salford and you were vaccinated more than eight weeks ago but have not yet had your second jab, please come forward. We now have a very good surveillance system in this country and we publish all the data from it so that we can all see the cases day by day. We can also see the impact on hospitalisations. I am glad to say that, thankfully, the almost inexorable link from cases through to hospitalisation and death that we saw in the past is now broken. The link is not completely severed, but it is much, much weaker because of the protection of the vaccine. Those are the things that people can do in Salford, and I look forward to working with the hon. Lady to get those messages out to everybody.

Health and Social Care Update

Rebecca Long Bailey Excerpts

Thursday 18th March 2021 Commons Chamber

[Matt Hancock]

Yes, my hon. Friend puts it characteristically well. It is very important to take all considerations into account when making decisions like these. Of course, the precautionary principle is important, but when there are such huge benefits to vaccination, over-precaution is a mistake. We have to take overall public health into account.

[Rebecca Long Bailey (Salford and Eccles) (Lab) [V]]

The Salford system has delivered the covid vaccine in an unprecedented way. Everyone from cohorts 1 to 9 has been invited at least once—some three or four times—and I understand that, even with the vaccine shortage and guaranteed second doses factored in, we will run out of people in cohorts 1 to 9 to give our current vaccine supply to. Will the Secretary of State authorise Salford to proceed to cohorts 10, 11 and 12 and begin to prioritise the vulnerable members in those age groups, so that we can maximise the doses we have?

[Matt Hancock]

No. What everybody in Salford and around the country needs to do is make sure that every last effort is made to reach every last person in groups 1 to 9, because they are the most vulnerable. Only in exceptional circumstances should people under the age of 50 who are not in groups 1 to 9 be invited for vaccination. The message is incredibly clear and I speak very directly to the whole team, including in Salford: please put all your efforts in the forthcoming weeks into delivering vaccines for groups 1 to 9.

Covid-19: Vaccinations

Rebecca Long Bailey Excerpts

Monday 11th January 2021 Commons Chamber

[Nadhim Zahawi]

I am grateful to my hon. Friend, who always asks very important practical questions. He is absolutely right to say that it has been challenging. Part of the challenge, which I think we have addressed today, is the amount of notice primary care networks and GPs have of a delivery. That will only get better as we stabilise deliveries to the warehouses and are then able to take them out into the primary care networks and hospitals. I will of course work with primary care networks and the whole of the NHS family to make sure our communications get better and better.

[Rebecca Long Bailey (Salford and Eccles) (Lab) [V]]

In Salford, we receive little or no notice that a delivery of the vaccine from the Government is due. Some batches have not turned up at all. When they do arrive, we act quickly. It was therefore staggering when, late last night, our clinical commissioning group was instructed to cancel 924 pre-existing second dose Pfizer appointments, with little time to book new appointments before the batch expires at midday on Wednesday. Will the Minister now allow local CCGs to plan and order their own vaccine batches? Can he assure those whose time before their second Pfizer dose has been elongated that they will be 70% to 90% protected for up to 12 weeks?

[Nadhim Zahawi]

I shall take the hon. Lady’s questions in reverse. The four chief medical officers have looked at the issue of the up-to-12-week dosing and all agree that it is the right thing to do. I apologise to the people Salford for that cancellation, if that is what happened yesterday. We have touched on this, but part of the issue has been the lumpiness in the deliveries in the early days, which will begin to become much smoother. The NHS central team, with Brigadier Prosser and the 101 Logistic Brigade, are absolutely focused on making sure that we give as much notice as possible to primary care networks so that they can plan ahead, and that will only get better and better as we smooth out the delivery process from manufacturer into warehouse.

Public Health: Coronavirus Regulations

Rebecca Long Bailey Excerpts

Tuesday 13th October 2020 Commons Chamber

[Rebecca Long Bailey (Salford and Eccles) (Lab)]

Madam Deputy Speaker,

“I am not confident, and nor is anybody confident, that the tier 3 proposals for the highest rates…would be enough to get on top of it.”

Those were the words last night of the chief medical officer, but sadly the Government knew this in September, when SAGE scientists advised the immediate introduction of a list of measures including a circuit breaker. In the following days, the Prime Minister went ahead with only the work-from-home U-turn and the 10 pm curfew. Now we know the truth. Last night, we saw that the SAGE minutes clearly stated that the curfew measure was likely to have a marginal impact, as it also seems the Government’s tiered approach will do.

Further, after the initial lockdown, any semblance of economic normality that would have kept the public safe was predicated on a comprehensive test, track and trace system, but with people still making vast round trips to get a test and risking their details being lost in an Excel spreadsheet never to be seen again, it is clear that we do not have a comprehensive testing system. And how can we forget Operation Moonshot? Salford was to be one of the pilot areas testing the Moonshot programme. However, my local council confirmed to me this morning that, some time ago now, it asked the Department of Health and Social Care to share the clinical validity data behind this new technology. To date, that query remains unanswered, and until this morning Salford City Council had been told to pause the programme. So can the Secretary confirm his current plans for the development of mass testing?

We all know what needs to be done. Any resumption of normal life depends on bringing the infection rate down, followed by robust test, trace and isolate systems, but for this to happen, we need clear direction from Government, and our businesses and workers need economic support to do what is required of them. So far, the Chancellor’s support still does not extend to the more than 3 million people who are excluded, and the watering down of economic support means that, even under tier 2, many businesses and workers across Greater Manchester will see a significant drop in income that they will not be able to sustain. So it seems we have a choice here: either we do not follow the science and instead impose the misery of prolonged tier 2 and tier 3 restrictions in many areas with little economic support, and cases and deaths will rise; or we follow the science and bring down transmission with a short national circuit breaker and a reform to test, track, trace and isolate. Frankly, the pandemic strategy so far has been akin to throwing a glass of water on a chip pan fire, and the Government need to change course today.

Coronavirus Act 2020 (Review of Temporary Provisions)

Rebecca Long Bailey Excerpts

Wednesday 30th September 2020 Commons Chamber

[Rebecca Long Bailey (Salford and Eccles) (Lab)]

I have listened to the Secretary of State’s comments and the revocations that he has set out have been welcome, but they are cosmetic and they certainly do not go anywhere near restoring the safeguards that those suffering from mental health problems, disabled people and those in need of care deserve. As for his promise for parliamentary scrutiny, frankly, it is nothing more than a gentlemen’s agreement.

The Act in its current form allows clumsy and asymmetric authoritarianism. Powers to restrict mass gatherings might well have been necessary, but broad police powers under schedule 21 to detain potentially infectious people have led to unlawful prosecutions 100% of the time. Where were the extra powers—the resources to inspect or restrict unsafe workplaces or to requisition private lab space, healthcare or other facilities for mass testing? Where were the powers to take charge of food supply in the event of future lockdowns to avoid further panic buying and ensure that shielding and vulnerable people receive the food that they deserve?

The Government demand that their citizens give up their liberties and livelihoods in the pandemic, yet they do not stand beside them. The Secretary of State’s comments today certainly do not deal with the issues that many of our constituencies face, and some of us begin to worry that the Government’s confused and often contradictory public messaging is not mere incompetence, but a studied chaos, designed to blame ordinary people instead of taking democratic political responsibility for some of the worst pandemic management in the world. The Government are at real risk of squandering public sentiment and public good will, and, at the very least, they must set out to revoke the most insidious parts of this Act tonight.