Urgent and Emergency Care

Rushanara Ali Excerpts

Monday 5th September 2022 Commons Chamber

[Rushanara Ali (Bethnal Green and Bow) (Lab)]

We know that 117,000 people have died waiting for treatment on the NHS waiting list, and what we are hearing now is that 500 people a week are dying waiting for ambulances. Can the Secretary of State give us a date by which he can guarantee that people will not lose their lives waiting for an ambulance to come and get them and care for them?

[Steve Barclay]

What I can guarantee is that, through the taskforce, we are prioritising how we get ambulances back on the road and how we speed things up to reduce handover delays. We are looking in particular at the 10 trusts in which the issue is most acute, because there is an unmet need in the community if the ambulance is not there.

On the hon. Member’s point about the backlogs with electives, we announced over the summer, as part of the work that we have been doing, a whole series of surgical hubs and community diagnostic centres. We are working with the Getting It Right First Time team, under Professor Sir Tim Briggs, on different patient pathways. A whole range of work is being done to reduce waiting times, which is why we have already cleared the longest waits—the two-year waits—and are now turning to the 18-month waits.

Oral Answers to Questions

Rushanara Ali Excerpts

Tuesday 19th July 2022 Commons Chamber

[Maria Caulfield]

I thank the hon. Lady, because it is the first I have heard of that and it sounds very exciting. I know how difficult it is with chronic wound management to get wounds to heal. Often these are patients with multiple co-morbidities such as diabetes that make the wounds very difficult to treat. I am keen to visit her constituency and her trust to learn more about it.

[Rushanara Ali (Bethnal Green and Bow) (Lab)]

11. What steps he is taking to help reduce waiting lists for people transferring to a care setting.

[The Minister for Care and Mental Health (Gillian Keegan)]

I assure the hon. Lady and everybody in the House that this is a key focus for the Department as we know that delayed hospital discharges put pressure on the health and care systems and, most importantly, impact our patients. To address delays, we have established a national hospital discharge taskforce, which is running a 100-day discharge challenge, and integrated care systems can now become discharge front-runners to share good practice and ambitious ideas.

[Rushanara Ali]

I thank the Minister for her answer, but Miriam Deakin of NHS Providers has said:

“There is huge pressure on beds…and a lack of social care capacity means that hospital patients can’t be discharged as soon as they could be to recover closer to home”.

The Royal College of Emergency Medicine has estimated that 57% who longer meet the criteria are stuck in hospital. That is putting huge pressure on hospitals such as the Royal London in my constituency, which is doing amazing work. However, it cannot get the job done if the Government do not step up and back local authorities with the resources they need to provide care for those who can be discharged. That is what is needed. Is it not time that the Minister, with the new Health Secretary, got to grips with this problem, which has built up over a decade because of the decimation of social care? That is what is needed. There is a fix; the Government need to get on with it.

[Gillian Keegan]

Between March 2020 and March 2022, we made nearly £3.3 billion available to support discharge, recognising the pressures faced by the health and social care sectors, as they manage the demands of covid-19. Under section 75 of the National Health Service Act 2006, funding can be pooled across health and social care to ensure the effective use of available resources. That allows funds such as the better care fund to be used to support discharges, and I know that many integrated care systems are focused on doing that and pooling more resources.

--- Later in debate ---

[Steve Barclay]

Again, as I am sure my hon. Friend will appreciate, these decisions should not be run from Whitehall and the centre. We should take a place-based approach, letting local decision-makers and commissioners make the decisions to shape the best services through their integrated care boards. My hon. Friend the Minister of State or I will engage with him to ensure that his representations are very much at the heart of any decisions that are taken.

[Rushanara Ali (Bethnal Green and Bow) (Lab)]

T6. An estimated 117,000 people are reported to have died while on NHS waiting lists. A record 6.6 million people are waiting on the NHS for treatment, and they are in pain and suffering and, in many cases, fearful for their lives. This is a direct consequence of more than a decade of mismanagement and incompetence. What will the new Health Secretary do to give the British people the guarantees that they need to make sure that more do not die while waiting for treatment on the NHS?

[Steve Barclay]

That is why we have launched a range of initiatives, such as surgery hubs and diagnostic centres, to address the very real backlog resulting from the pandemic. Indeed, the NHS has published its delivery plan for tackling the covid-19 backlog of elective care, and that is focused on four areas: increasing health service capacity, prioritising diagnosis and treatment, transforming the way that NHS provides elective care, and providing better information and support to patients.

Oral Answers to Questions

Rushanara Ali Excerpts

Tuesday 19th April 2022 Commons Chamber

[Maria Caulfield]

My hon. Friend is right that there must be consistency across the country in how those procedures are commissioned. After today’s questions I will take this up with officials to see why that is not happening consistently across the country.

[Rushanara Ali (Bethnal Green and Bow) (Lab)]

5. What steps his Department is taking to tackle regional health inequalities.

[The Secretary of State for Health and Social Care (Sajid Javid)]

I am determined to tackle unfair disparities in health outcomes. That is why I launched the Office for Health Improvement and Disparities. OHID’s regional directors of public health will work with local government and the wider health system to empower local partners with the tools they need to respond to disparities in their regional and local areas. We will also publish a health disparities White Paper later this year, with a strong focus on prevention, to improve health for the whole population.

[Rushanara Ali]

I thank the Secretary of State for his answer, but a decade of under-investment and mismanagement have left 4.5 million people on waiting lists and staff shortages of more than 100,000 people even before we entered the pandemic, which exacerbated health inequalities. I welcome the work his Department is doing, but the reality is that people who live in a constituency such as mine are twice as likely to end up on a waiting list for treatment for more than a year as those in better-off areas. While I welcome what he has announced today, may I ask that he puts in appropriate investment to go along with tackling those appalling health inequalities?

[Sajid Javid]

The hon. Lady is right to talk about the importance of tackling health inequalities; on that we absolutely agree, and I hope she will contribute to the health disparities White Paper that I mentioned a moment ago. However, it is wrong of her to suggest that some of the current challenges we face are because of under-investment or because of a smaller workforce than otherwise. We have the largest investment ever going into the NHS. Its budget this year is bigger than the GDP of Greece. It is the highest amount ever, rising by billions each year. We also have more going to social care than ever before, and the highest level of workforce that the NHS has ever seen in its history.

Access to NHS Dentistry

Rushanara Ali Excerpts

Thursday 10th February 2022 Westminster Hall

[Sir Paul Beresford (Mole Valley) (Con)]

I am delighted that we are being guided by you, Ms Ali. As a dentist—extremely part time—I am fascinated by the interest in this issue. I hope that some dentists read Hansard and find out that somebody actually cares about them. One of my hon. Friends asked why they were leaving the profession. It is a tough job—a really tough job. If I want relief from a couple of hours of dentistry in a week, I come into the House of Commons—it is a lot easier.

I thank my hon. Friend the Member for Waveney (Peter Aldous) for his introduction to the debate. It was a real expedition, right across the whole scene. I will suggest that we create an honorary degree in dental administration especially for him, because he covered it so beautifully.

Let me start very simply. I will not go through all the bits and pieces that everybody else has talked about; I will just cruise across the surface. We have three different groups of dentists: fully private, fully NHS, and mixed. The last group is the largest by far; and, to a considerable degree and in spite of some of the accusations today, that is by patient demand. It is what the patients want. It is not always the case that they feel forced into it because they cannot get the service elsewhere. The comment was made that we do not have enough dentists, but the BDA says that we have. I do not agree with the BDA, but this will not be the first time. We do need more dentists. If we had more dentists, we would get over the problem that my hon. Friend the Member for Broadland (Jerome Mayhew) had of finding someone to live in his little rural area, because if they were looking for a job and there were not jobs in the other areas, they would go there.

It is worth pointing out that dentists working in the NHS are not actually in the NHS; they are independent dentists working for the NHS. That makes quite a difference to the relationship and makes it somewhat more difficult for the Minister to influence dentists as she might well like to. It is also worth pointing out that a number of dental plan organisations are encouraging dentists to abandon the national health service and provide services within their private plan system. I still get dental magazines as a bit of light relief—well, lightish relief—and every one that I get has advertisements promoting dentists coming out of the national health service, for all sorts of reasons, some of which are fictitious.

Covid, in spite of what one hon. Gentleman said, has been a huge problem—not just for medical services but for dentistry. With the initial lockdown, all dental surgeries were required to close. Emergency clinics were set up and they were successful, but extremely limited—“a bit brutal” would be one way to put it. Fortunately, the closure of surgeries was relatively short-lived. After a period, they reopened—understandably, under heavy covid hygiene procedures. Those procedures really jammed up the works. This is of course understandable, because at that stage we did not have vaccinations, and with the aerosol spray from the dentist working on the patient’s mouth, you could almost see covid spread across the room. The cleaning down and waiting time between patients—fallow time—really damaged productivity. But we are getting past that now. I hear the Prime Minister is going to tell us that we are all lovely, everything is fine, covid has gone and so on. That is slightly tongue in cheek—sorry, I should not really say “tongue in cheek”, should I? By the way, the hon. Member for York Central (Rachael Maskell) talked about dentistry and teeth being part of all health. The chief dental officer has a lovely saying, which is that we should put dentistry, or the mouth, back in the body. That is really important.

The combination of the restrictions, all the rules and then, as I have discovered, the extremely heavy regulation requirements of the Care Quality Commission meant that a considerable number of dentists thought, “I have had enough” or, “I’ve possibly had enough,” and then said, “I’ve had enough,” and retired. Progressively, the surgery cleaning down and fallow time has been better understood by dentists and they have been quicker at it and faster, but I still feel that there is an opportunity now, with what the Prime Minister is going to tell us, for us to cut that out. The Government do not always do very nice things for dentists, but one nice thing that they did for dentists was that they gave them the inoculations early on. They gave them not just for the dentists but for all the staff, even down to the cleaner. That is vital, because it will, I think, give us an opportunity to remove the fallow time—get rid of it.

For decades pre-covid, there was a shortage of dentists. There was certainly a shortage of dentists providing NHS services in particular areas. The way to get around that, as I have said, is to have more dentists. If we have more dentists for fewer jobs, they will go to other areas to work. Dentists are independent, so they have an opportunity to change that. Sourcing and increasing the number of dental practitioners is slow and relatively limited.

The most obvious solution is dental schools; we have touched on that. Every second place in the country wants a new dental school next to its hospital. I am sure that would solve the problem, but goodness knows how we would afford it, let alone get the people to teach in them. We have to remember that the basic dental degree takes five years, and the practitioner that comes out after five years needs a two-year apprenticeship before I would let them loose on my cat or dog, let alone one of my children.

Another way to get dentists is to attract them from overseas. My hon. Friend the Member for Waveney mentioned that; it is a great source. When I came here, every second dentist had an Australian accent. The practice I worked at for many years—quite a big one in south-west London—was staffed only by Australians and New Zealanders, and occasionally a South African. The principal got into real trouble with the Commission for Racial Equality. He rang up the agency and said, “I want another dentist. Can you find one? They’ve got to come from Australia or New Zealand.” He was told, “That’s racist. You can’t do that,” but there were hundreds if not thousands of them coming over from the Commonwealth.

The problem with people coming over here has been touched on: they have to go through courses and all the rest of it to become registered. We did not have that then and we do not have to have it now. Wherever the school is, it is the school that needs to be assessed. If the school passes its assessment, any student that passes and becomes a qualified dentist should be allowed in—just like that. That is what happened when I came. I handed over my certificate and the General Dental Council, bless it, stamped it and said, “Thank you very much. Off you go.” We should be doing that.

I had a complaint from the GDC that the people it sent out to assess the University of Otago in New Zealand, for example, did a quick tour of the dental hospital and then disappeared off to the vineyards. I am sure there was no truth in that. But we could get dentists from the Commonwealth, and we could keep bringing people in from the EU. People from the Commonwealth stopped coming when we joined the EU and they went to the United States. I ran a big function here for Otago graduates, and a vast number of professors of dentistry from Otago University came over from the United States. Normally, they would have come here; normally, we would have had them. Normally, we understand their English a little bit better, even if they are Australian, than the Americans do. That has to be an attraction. We should still be able, as I have said, to get European and Scandinavian dentists. That has to continue, because it would help massively.

We have to recognise that we will not have an instant or even a fast solution to the problems laid out today. Everybody has laid out problems, and a few people have come up with ideas. I am sorry for the Minister, because she is getting hammered for the problems, and she will not be able to provide a fast solution. It is not a case of money; it is a case of having the dentists to do the work.

Our best long-term hope, which one or two people have touched on, is prevention. The chief dental officer and others have an ongoing campaign to teach children, especially little children in day nurseries and so on, about toothbrushing. Having worked in the east end for some time, I know that when we ask a child, “What’s your toothbrush like?”, they sometimes say, “What’s a toothbrush?” We have to get that across to the kids. Kids love brushing their teeth. The mess is phenomenal, but they love it. The campaign is really starting to work. Wales and Scotland are ahead of us on that, but we are catching up, and it is making a noticeable difference. We can actually see the difference.

Our second hope, of course, is fluoridation. In other countries—Australia, New Zealand, Canada and so on—fluoride is in between 60% and 80% of water supplies. It makes a huge difference, and with no possible detriment to health. In this country, 10% of water supplies are fluoridated. It is pathetic. The Bill going through at the moment represents an opportunity to change that, but some nations have suddenly realised the real difference that can be made. New Zealand, if I dare mention that country again, is thinking of saying that every single water supply throughout the nation—it is a biggish country, about the same size as this one, but the population is tiny—will be fluoridated. That is a dramatic step, but we could do it. If we did, along with promoting fluoride toothpaste and teaching kids how to brush their teeth and cut down on sugar, then instead of being one of the worst dental states in the western world, we could be one of the best. It is a real opportunity and something we could achieve.

I know that the Minister cannot do anything overnight, and we have to accept that—

[Rushanara Ali (in the Chair)]

Order. Can I ask the hon. Gentleman to wrap up his speech?

[Sir Paul Beresford]

I am wrapping up right now.

I know that the Minister cannot do anything overnight, but I wish her the best of luck with the struggle.

--- Later in debate ---

[Rushanara Ali (in the Chair)]

I am most grateful. I have two more speakers to get in. To ensure that the Minister and shadow Minister have time to respond, I would be grateful if hon. Members could adopt an informal limit of three to four minutes.

Covid-19 Update

Rushanara Ali Excerpts

Monday 6th December 2021 Commons Chamber

[Sajid Javid]

Yes and yes.

[Rushanara Ali (Bethnal Green and Bow) (Lab)]

Will the Health Secretary update the House on whether we should expect an economic support package not just for the aviation sector but for tourism and other sectors that might be affected if further restrictions apply? Will he also say more about how we can ensure that provision of the covid vaccine, which is a global public good, can be accelerated so that countries that are at risk get the support they need? If we had acted faster, earlier, this particular variant might have been prevented. We need much more international leadership, led by our Government.

[Sajid Javid]

On vaccine donations, I refer the hon. Lady to the answer I gave to a similar question. In terms of transport, I also refer her to an answer I gave previously.

Oral Answers to Questions

Rushanara Ali Excerpts

Tuesday 19th October 2021 Commons Chamber

[Sajid Javid]

My hon. Friend is right to raise the importance of mental health and suicide. This is important, and I listened carefully to what he said. He knows that pharmacology already plays an important role in helping people with their mental health challenges, but he raises an interesting potential emerging treatment. He will know that scheduling is an issue for the Home Office, but I will be happy to meet him myself to discuss it further.

[Rushanara Ali (Bethnal Green and Bow) (Lab)]

T6. As the Secretary of State knows, the NHS is facing extreme pressure because of rising covid infection rates and hundreds of people still dying every week, and that is in the context of 5.6 million people on NHS waiting lists. Is it not time for the Health Secretary to revert to making mask wearing mandatory and to commit to suspending the reckless decision to charge for lateral flow tests in the coming months?

[Sajid Javid]

We have a plan for both the pandemic and other challenges over the winter, which we set out in detail. I remind the hon. Lady that we do not charge for lateral flow tests.

Oral Answers to Questions

Rushanara Ali Excerpts

Tuesday 13th July 2021 Commons Chamber

[Sajid Javid]

Throughout the pandemic, my predecessor and other Ministers have rightly been working with the devolved Administrations, and of course that work continues; it will remain a priority. I myself have already started weekly meetings with all my counterparts in the devolved Administrations. We discuss a number of issues and keep each other informed, but we also respect that in certain areas, in dealing with this pandemic, we may take a different course.

[Rushanara Ali (Bethnal Green and Bow) (Lab) [V]]

I congratulate the Secretary of State on his appointment. Cases of covid rose by 30% last week compared with the previous week, and on 10 July we saw over 35,000 new cases, the highest since 22 January. By mid-August we could see 1,000 people a day being hospitalised, and up to 200 people a day could die, despite the excellent vaccination programmes. Given that the Secretary of State now considers it irresponsible not to wear masks, is it not equally irresponsible for the Government not to require people to continue to wear masks rather than leaving it as an option?

[Sajid Javid]

The hon. Lady understandably talks about the link between case numbers and hospitalisation. She will know that the last time we saw cases at 30,000 and above on a daily basis, we saw a lot more hospitalisations. The reason for the difference now is the vaccine wall of defence. Masks do have an important role to play, but we think that that role can be played by moving from regulation to guidance.

Covid-19: Government Handling and Preparedness

Rushanara Ali Excerpts

Thursday 27th May 2021 Commons Chamber

[Matt Hancock]

I am very grateful to my hon. Friend for that question. I will continue to compliment him while I think of how to respond. The honest truth is that, from the start, I have been totally focused on how to get out of this pandemic. It is absolutely true that the operation and functioning of Government has got easier these last six months, and I think all the public can see that. We are laser focused on getting through this, getting this country out of it and delivering the vaccine programme that we have now been working on for almost a year and a half, which is remarkable. I pay tribute to all those who have been working on this effort. The way to fight a pandemic is by bringing people together and inspiring hope.

[Rushanara Ali (Bethnal Green and Bow) (Lab) [V]]

Five hundred and nineteen residents in my borough of Tower Hamlets have lost their lives to covid—in my own family, we have lost five of our relatives—and their family members are grappling with that loss to this day. The hearings yesterday were incredibly distressing. Mr Cummings has admitted to Government failures in handling the pandemic, and said that it meant

“tens of thousands of people died who did not need to die”.

Out of respect for the over 128,000 families of people who have lost their lives, will the Secretary of State admit to the failures today and apologise? Will he, instead of his simple no to the earlier question, bring forward urgently the date of the inquiry, because families like ours, those of my constituents and all those who have lost loved ones up and down the country deserve answers now and deserve for lessons to be learned so that these mistakes are never made again?

[Matt Hancock]

The pandemic has taken far too many people away far too soon, and that has happened in the hon. Member’s family and it has happened in mine. She is absolutely right that we need to ensure that we learn as a country how to prepare as well as we possibly can for pandemics in the future—because it is likely that pandemics will become more frequent, not less—and it is vital that people have the opportunity to get answers. We must learn the lessons all the way through, not just wait until afterwards, and we must have a full inquiry afterwards, so that we can ensure that every detail is assessed and everybody has the opportunity to ask those questions. I think that is the right approach.

Covid-19 Vaccine: Take-up Rates in London

Rushanara Ali Excerpts

Tuesday 9th March 2021 Westminster Hall

[Rushanara Ali (Bethnal Green and Bow) (Lab) [V]]

It is a pleasure to join this very important debate, Sir Christopher, and I congratulate my hon. Friend the Member for Hammersmith (Andy Slaughter) on securing it.

The speed of the roll-out of the vaccination programme is a great source of hope for all of us. Those of us who have lost loved ones are particularly grateful to the NHS, to the scientists and to so many people who have come together to produce this vaccine, because we all know how important it is to protect our constituents, and our friends and family.

Locally, I pay tribute to my local authority, which has set up a helpline that is proactively contacting people who have not been vaccinated, and addressing and answering their questions. Government resources will make a big difference to other local authorities to help support that effort, and we need that back-up from Ministers.

I also thank the Royal London Hospital, Queen Mary University, GPs’ surgeries, the London Muslim Centre and other partners who have been helping with the vaccination effort in my constituency. Many people will be aware that in the first wave Tower Hamlets had the fourth-highest age-standardised death rate in the country. Although we are a young population, relatively speaking, there are huge health inequalities and huge issues with deprivation, severe overcrowding, intergenerational households and many other factors that, as other colleagues have said, make inner London extremely vulnerable to this pandemic.

In the second wave, we saw that the spread of the virus caused more deaths, which is why it is vital that we get to those who have not yet been vaccinated and those who have underlying health conditions by increasing the supply of the AstraZeneca vaccine, and that we get to those who did not take up the vaccine when they were offered it, for a number of complicated reasons, as other colleagues have mentioned. In some cases, it is about reticence, but it is also about practicalities and about deprivation. It is not just ethnic minority communities who are affected, although we have seen big differentials; it is also those from white disadvantaged backgrounds and from working-class backgrounds who have been disproportionately affected, both in terms of death rates and in lower take-up of vaccines.

What we need to do now is make sure that the vaccines are in the right places. The centralised hubs are, of course, useful and important, but it is also vital that we get vaccines to local GP surgeries. As I have said to the Minister time and again, it is vital that we get more vaccines to pharmacies and that pop-up clinics get up and running. The ones that we have are very good and very helpful, but the unpredictability of supply, the inability to plan and the lack of local flexibility are all leading to sub-optimal outcomes, when we could have better outcomes.

So today I call on the Minister, once again, to get the vaccines to the local providers and to provide local authorities with additional support, so that they can do the chasing, as is the case in my local authority. What we have seen is that when GPs are responsible for getting vulnerable patients, including homebound patients, vaccinated in my borough, 95% of those patients have been vaccinated. So this is not rocket science; we can address the gaps.

I am grateful to the Minister for the work that he has done so far and I appreciate that in him we have a listening ear. I hope that he listens to the arguments that have been made—not just by Members in my party, but by Members in his own: we have to get the supplies in. Going forward, as other colleagues have pointed out, we also need to address some of the deeper underlying conditions and to make sure that people’s vulnerabilities are addressed.

There is one final issue. Ramadan is coming, so we are in a race against time to vaccinate vulnerable constituents from the Muslim community in our city, because if we do not vaccinate them there will be even greater risks. So I hope the Minister will address that point, as well as the importance of getting more supplies into London—

[Sir Christopher Chope (in the Chair)]

Order. I call Fleur Anderson.

Covid-19

Rushanara Ali Excerpts

Monday 22nd February 2021 Commons Chamber

[Rushanara Ali (Bethnal Green and Bow) (Lab)]

I start by paying tribute to all those in the NHS across our local communities, including in my constituency, for everything that they have done to support people during the pandemic. My thoughts are with all those who have lost loved ones. As many will be aware, black and minority ethnic groups and those from socially disadvantaged communities have been hit the hardest by this pandemic, with Pakistanis and Bangladeshis facing the largest number of deaths in the second wave. I know how hard this is, as, in the past week, I have lost a very close relative. Early in January, we lost another beloved member of our family. This is the experience of many in our communities up and down the country, which is why it is absolutely vital that as we move towards easing the lockdown and open up schools, we make sure that families are protected. We must ensure that those who still have not been vaccinated, particularly in intergenerational families living in overcrowded conditions in high-density parts of the country like my constituency, are properly supported as we move towards opening up our society.

In Tower Hamlets, we have seen a very intensive effort by local providers—by the council in partnership with the Royal London Hospital, Queen Mary University of London, our GPs, the clinical commissioning group and others, including the London Muslim Centre and inter-faith communities—who have come together to tackle some of the reticence around people getting their vaccinations, to deal with misinformation and misunderstanding, and to make sure that people get vaccinated.

We are facing a race against time, so I will focus my remarks on what we desperately need the Government to do to support local communities such as those in my constituency. We need the Government to make sure that GP surgeries have more of the AstraZeneca vaccines so that they can contact local residents, who trust them, and get to people who need to be vaccinated and still have not been. We have seen an improvement in the numbers, but the differentials are still huge between black residents and south Asian residents compared with their white counterparts. We need to redouble our efforts, so I call on Ministers to provide extra support to local GP surgeries to make the vaccines available so that as we open up our schools and our economy, people who are still at risk can get the vaccination and be protected.