NHS Dentistry

Seema Malhotra Excerpts

Tuesday 9th January 2024 Commons Chamber

[Victoria Atkins]

I am extremely grateful to the hon. Lady, who makes a fair point about measuring within the system how much work NHS dentists are doing. As I say, we are looking at all of this in the work that we are doing on the dentistry recovery plan. I repeat that I want to make it as simple as possible for dentists to register with the NHS, to continue offering the care that we all want them to, so I am grateful to the hon. Lady for her intervention.

[Seema Malhotra (Feltham and Heston) (Lab/Co-op)]

rose—

[Victoria Atkins]

I am going to plough on, I am afraid.

Earlier, Labour Front Benchers—perhaps not understanding that they were doing so—set out the philosophical difference between our two parties on how to grow the economy. As our economy grows, we on the Conservative side of the House want to attract the best and the brightest from around the world to work in our NHS, in our tech sector, in our life sciences industry, in our movie industry—hon. Members may know that it filmed “Barbie” this year—and in many other thriving industries. Labour, however, apparently wants to shut the door by taxing such people on earnings they make outside the UK. I speak, of course, of non-domiciled tax status.

If I may correct the hon. Member for Ilford North, because I appreciate that he has not spent any time on the Front Bench, last year alone non-domiciled taxpayers paid £8 billion in UK taxes on their UK earnings. That is equivalent to more than 230,000 nurses. Labour wants to put that at risk and put the UK at a disadvantage in the highly paid, highly competitive, highly mobile international labour market. This really is yet another branch of the magic money tree that Labour has always been looking for, to which they apparently want to add £28 billion a year of taxes or increased borrowing and increased inflation.

How they want to spend this money is interesting as well, because in 2022 Labour promised that their non-domiciled taxation would fund a workforce plan. Last September, it became breakfast club meals. Then, by October, it had morphed into 2 million hospital appointments and MRI and CT scanners. Now, apparently, it is funding a dentistry plan. One wonders how all these magic branches on the magic money tree will add up to all the promises made so far.

--- Later in debate ---

[Victoria Atkins]

I think the hon. Member for Oldham East and Saddleworth (Debbie Abrahams) was raising her voice at me, but it was not me who heckled her. I recognise the passion she brings to her intervention, and I simply made the point that this is an Opposition day debate. The hon. Member for Ilford North understandably set out some of his plans, which is his job, and I was merely questioning him on the detail of those plans. Sadly, he was not able to provide that detail.

The long-term workforce plan is about not just training more staff but delivering value for hard-working taxpayers. Currently, around a third of dentists do not carry out any NHS work. This simply is not fair on the taxpayers who fund their training, which is why, through the long-term workforce plan, we are exploring the introduction of a tie-in period that encourages dentists, after they graduate, to spend a minimum proportion of their time delivering NHS care. We have also made it easier for experienced dentists from around the world to come to the UK to ply their trade, which is apparently something with which Labour Members do not agree.

Last year, we brought forward legislation to give the General Dental Council greater flexibility in administering the overseas registration exam. The Government welcome its decision to triple the capacity of the next three sittings of part one of the ORE, from August last year, and to increase the number of sittings of the second part of the exam from three to four, creating an additional 1,300 places. Ministers will continue to meet the GDC to discuss how we can make these flexibilities as effective as possible, to get more dentists into the NHS workforce delivering care for patients.

[Seema Malhotra]

I thank the Secretary of State for giving way. It is worth repeating that the Nuffield Trust has warned that NHS dentistry is at its most perilous point in its 75-year history. That goes alongside recent Healthwatch polling suggesting that one in 10 people in England have ended up paying for private dental treatment in the last 12 months because they could not find an NHS dentist. It has been the same in my constituency, where the majority of dental surgeries are not taking on new patients. Can the Secretary of State explain how on earth things have got this bad?

[Victoria Atkins]

I trust that the hon. Lady has been listening to the whole debate, because I set this out in some detail at the beginning of my speech. I will not repeat the impact of the pandemic, but I hope she has taken on board the £1.7 billion of investment that has already seen a sizeable increase in the number of adults and children being treated by NHS dentistry.

I do not pretend that this is the full stop at the end of the sentence. We have a plan and I look forward to our debate when that plan is published, because I suspect it will be welcomed across the House.

Recovering Access to Primary Care

Seema Malhotra Excerpts

Tuesday 9th May 2023 Commons Chamber

[Seema Malhotra (Feltham and Heston) (Lab/Co-op)]

The steps proposed in the statement reflect what Labour has been calling for, and are well overdue. I am glad that at least some steps are being taken, but they fall well short of the scale of the challenge that we face. Pharmacists need to work in a strong primary care environment. We need to see more GPs, an increase in primary care services, and more tests, diagnoses and minor procedures carried out in the community, speeding up primary care and taking the pressure off secondary care.

Three years ago, I met Ministers and officials in the Department to seek advice on and support for the rebuilding of the rundown Heston health centre in my constituency. What is the Government’s strategy on the rebuilding of rundown primary care facilities, not only to assist the recruitment and retention of GPs but to better facilitate the work taking place between GPs, pharmacies and other community healthcare services?

[Steve Barclay]

There seems to be a slightly confused response from the Opposition. They challenge this announcement on the grounds that they are not happy with it, and in the same breath claim that it is part of Labour’s plan or a step in the right direction. They need to make up their mind.

As I said in response to two earlier questions, it is for the integrated care boards to adopt estate strategies in their areas. Not all decisions about estates should be made centrally. However, one of the changes that we are setting centrally involves embracing more modern methods of construction and a more modular approach. The unit cost of that approach is much lower, and when the level of confidence is higher, the contingency cost is much lower as well. So we are changing the way in which we build our estate, but the estate strategy is an issue for the ICBs.

NHS: Long-term Strategy

Seema Malhotra Excerpts

Wednesday 11th January 2023 Commons Chamber

[Seema Malhotra (Feltham and Heston) (Lab/Co-op)]

My hon. Friend is making an outstanding opening speech. My constituent told me last week about his relative who has multiple myeloma and had a stem cell transplant last year. She had a bad viral infection for three weeks, which is a serious issue after chemotherapy and a transplant. My constituent was asked by her consultant to take his relative to another hospital, because no beds were available at the hospital where she was being treated. She was treated in the corridor and waited 24 hours for a bed. Does my hon. Friend agree with my constituent that that hospital and its staff were not to blame and that, with underfunding and no strategy for the NHS now or in the future, the fault lies squarely with this Government?

[Wes Streeting]

I wholeheartedly agree. We hear this time and again. When patients are struggling to get access, and experiencing appalling delays in accident and emergency, they do not blame the staff. They know that the staff of the NHS are busting a gut, but those staff are suffering in the same way as patients because of 13 years of Conservative mismanagement. The only part of the Government’s amendment that I agree with is the part that praises NHS staff. Why is the Secretary of State’s Prime Minister bringing in his “sack the nurses” Bill next week? How many nurses will he sack? How many paramedics or junior doctors will he sack? The only people who need the sack are this Government—[Interruption.] Perhaps the hon. Member for East Worthing and Shoreham (Tim Loughton) agrees.

Oral Answers to Questions

Seema Malhotra Excerpts

Tuesday 1st November 2022 Commons Chamber

[Steve Barclay]

My hon. Friend raises an important point. If one looks at the GP survey of patients, around two in five have a GP that they would like to have continuity of care with, and more than one third of those say that they see them a lot of the time or always. It is more pertinent with complex cases, where that continuity of care adds most value, as opposed to patients who want speed of access on an isolated incident.

[Seema Malhotra (Feltham and Heston) (Lab/Co-op)]

We have seen a cut of almost 5,000 GPs and the closure of hundreds of practices in the past 10 years. My constituents are having a terrible time trying to get GP appointments and, when they do, the lack of continuity of care is impacting the effectiveness of that care; it is a strain to tell the same story again and again, particularly for older people and those with complex conditions. Can the Secretary of State outline what he is actually going to do about it?

[Steve Barclay]

In fact, around 80,000 more GP appointments a day are happening, so significantly more demand is being met. The Government have invested an extra £1.5 billion to create an additional 50 million general practice appointments by 2024, increasing and diversifying the staff available for those patients seeking care.

Children’s Mental Health

Seema Malhotra Excerpts

Tuesday 8th February 2022 Commons Chamber

[Seema Malhotra (Feltham and Heston) (Lab/Co-op)]

Children in Feltham and Heston and across the country face many challenges both online and offline against which they battle for their own wellbeing, their confidence and their achievement. Today, in Children’s Mental Health Week, I want to speak in support of Labour’s motion and thank my hon. Friend the Member for Tooting (Dr Allin-Khan) for her passion and leadership in bringing this debate forward.

We have all been concerned about the impact of the coronavirus pandemic on the mental health of young people, many of whom have also tragically lost loved ones. If covid has been scary enough for adults, just imagine how scary it has been for children. In truth, though, covid has only compounded the issues that were already there. I thank teachers, parents and all who work with children for helping to deal with this crisis that we face.

In north-west London, a staggering 71% of children are not seen within four weeks of being referred to children’s mental health services. The headline message from my local heads, including those from Reach Academy, Springwest Academy and Cranford Community College, is that the need for mental health support is very high. Timely access to the right support is a key challenge, and the support that exists could be joined up. That is why it is right that Labour is calling for a guarantee for mental health treatment within a month for children who need it, for a full-time mental health professional in every secondary school and a part-time professional in every primary school, and mental health hubs for children and young people in every community. These are vital to achieve three key things: support our young people, support our teachers to help them, and support parents to help their children.

Schools have sought to do what they can. In one school, 40 pupils—5% of the total cohort—are being seen weekly by an in-house counsellor. Such a resource that this school has introduced reduces pressure on external services and helps children and young people to get that support early. It is the business case for why we need these measures that we are debating today.

Professionals based in schools are critical because they can also join up work with parents and teachers so that support for children becomes more joined up and aligned. Far too much support is too siloed, and what teachers are telling me is that, in terms of catch-up, mental health treatment is the most acute need, but the support and the expertise that are needed are not there in schools.

We know that when children are waiting for weeks—even up to four weeks—for treatment, it is already too late. It is affecting their learning and their lives, and at that point they are already falling behind, exacerbating their mental health issues, causing anxiety for them and their parents.

In conclusion, we have shared some real stories today—stories of the real lives of children in my constituency right now. These are children who have not returned to school and who do not leave their bedrooms because of their anxiety. It is the same across the country. For goodness sake, let us step up to the challenge and bring forward the measures that we need today.

Covid-19: Purchasing Effort

Seema Malhotra Excerpts

Thursday 3rd February 2022 Commons Chamber

[Edward Argar]

I welcome the hon. Lady to her place. I do not think I have had the opportunity to respond to a question or a speech from her previously, so I congratulate her, slightly belatedly, on her election and welcome her to this place. I will just correct one thing. She mentioned £9.7 billion. The sum involved is actually £8.7 billion.

To the hon. Lady’s point, first, it is not wasted. As I made clear, it purchased PPE. There is a small amount in these accounts which has been made clear. The shadow Secretary of State said that it was snuck out. If I recall, I tabled a written ministerial statement to draw attention to these issues to be open and transparent with the House, as I always endeavour to be. We did whatever was needed at the time, in the context of the highly inflated pricing in the midst of a global pandemic.

More broadly, the hon. Lady touched on NHS funding and pressures. I appreciate that she was not a Member of this House at the time, but this Government have put in record funding for our NHS. One of the first Acts after the 2019 election enshrined in law a £33.9 billion increase by 2023-24, and we are also putting in place the health and care levy to both assist our NHS and provide that sustainable footing for social care in the future. I acknowledge entirely that she was not a Member of this House, so it would be wrong to draw any inference as to how she may have voted, but I want to put that record investment on the record.

I also gently say that the Liberals’ stance on this issue shows, even by their standards, a degree of political contortion and a stretching of credibility. I think I am the only Member who has been a Health Minister throughout this pandemic, and I recall them desperately calling in 2020 for whatever it took to get and buy more PPE to protect the frontline. I agreed with that stance, but now they are suggesting that the Government got it wrong by prioritising whatever it took to get the PPE that the frontline needed.

[Seema Malhotra (Feltham and Heston) (Lab/Co-op)]

The Minister has said that we were prepared for all eventualities, but I think he knows that the truth is that that was not the case. As illustrated in comments by Members across the House, we did not plan ahead sufficiently for what was needed in a pandemic.

The Minister said in his statement that 97% of the PPE ordered was suitable for use. Obviously, that means that 3% was not. He also said that the Government are actively seeking to recover costs from suppliers where possible in those cases. Does he not realise that that is a very weak way of responding to that challenge? What safeguards were put in place in those contracts, and will he publish for the House updated data on suppliers that are not refunding the taxpayer—suppliers that took public funds and did not deliver the goods?

[Edward Argar]

I am grateful to the hon. Lady for asking a sensible and serious question. We have already recovered, through prevention or termination of contracts, £157 million of potential fraud. We continue, with our anti-fraud unit, to look into a number of contracts where there is either a contractual dispute or a risk of fraud. There are contractual mechanisms for reconciling or trying to manage situations in which both parties have different interpretations of whether what was delivered is what was ordered. We are already looking into more than 100 contracts in that respect. As those investigations develop, I hope I will be able to update the House further, but it necessarily takes time to have conversations with contractors through those contract dispute mechanisms and to investigate. I hope that, as we are able to bring forward more information, we will make it available to the House.

Public Health

Seema Malhotra Excerpts

Tuesday 14th December 2021 Commons Chamber

[Wes Streeting]

I shall take one or two more interventions and then I shall conclude.

[Seema Malhotra (Feltham and Heston) (Lab/Co-op)]

My hon. Friend is making a very important point: we need to make decisions on the evidence that is available. Does he agree that having the debate today and passing these measures tonight is urgent? We have heard that the doubling rate of omicron is shortening. If we are to protect the public, our families, our communities, and the NHS in the run-up to Christmas and beyond, these measures need to pass today.

[Wes Streeting]

I agree with my hon. Friend, and particularly in this city. The reproduction rate of this virus is shortening every day and the numbers that the Secretary of State set out in his opening remarks should concentrate minds before people walk through the Division Lobby this afternoon. Fun though it might be to see the Government in hot water and struggling in votes, it is not in the national interest and that should be the thing at the forefront of our minds.

Randox Covid Contracts

Seema Malhotra Excerpts

Wednesday 17th November 2021 Commons Chamber

[Gillian Keegan]

Can I please just get some of these points out?

Of course, there are a phenomenal set of safeguards in place. The National Audit Office has reviewed the testing contract, and it has confirmed that all the proper contracting procedures were followed.

[Seema Malhotra (Feltham and Heston) (Lab/Co-op)]

The Minister has just said that there would be a review of what information is available that is “within scope”. Will she just make it clear to the House what she understands to be within scope?

[Gillian Keegan]

I do not have a definition of what is within scope, but we will provide that information.

The NAO report said that

“the ministers had properly declared their interests, and we found no evidence of their involvement in procurement decisions or contract management.”

The NAO has confirmed that all the proper contracting procedures were followed. As with all Government contracts, contracts with Randox are published online and can be found through Contracts Finder. I think that hon. Members will find that the date of the contract precedes any minutes or meetings that we have been talking about. In case any Opposition Members have forgotten, Ministers have no role in the evaluation of Government contracts, in the procurement process, in the value of contracts, in the scope of contracts or in the length of contracts. From start to finish, the procurement process is rightly carried out by commercial professionals, who are governed by a strict regulatory framework. I know this, because I was a procurement manager for much of my career before coming here.

Menopause (Support and Services) Bill

Seema Malhotra Excerpts

2nd reading
Friday 29th October 2021 Commons Chamber

[Carolyn Harris]

I certainly agree. The information that would explain the situation with HRT is out there, but because we are not looking for it, we do not find it. There is really good information that debunks the myths on HRT, which has moved on a lot. It is a phenomenally different product from what it was in the day when too many people were prepared to criticise the use of it. Unfortunately, if someone does not look for that information, they will not find it and they do not prescribe HRT.

Someone understanding their own menopause is so important. Although we are, I hope, heading towards a time when women will discuss their experiences with family and friends, there is also a lot to be done in workplaces, where talking about symptoms can be a lot harder. Employers have a huge role to play in ensuring that support is available and understanding what their staff are experiencing. I have heard far too many accounts of women being given warnings, being sacked or even being made to feel that they have no choice other than to resign due to menopausal symptoms.

[Seema Malhotra (Feltham and Heston) (Lab/Co-op)]

I congratulate my hon. Friend on this most excellent Bill and on the work of the all-party group on menopause. The work of the group also helped to inspire activity with employers across the country. I attended an event on the menopause with Shevaun Haviland, the new head of the British Chambers of Commerce, and the Dorset chamber. There was tremendous engagement from employers, who had never been able to have this kind of conversation. Does my hon. Friend agree that, alongside improving awareness in the medical profession and in society to help to encourage discussion in families, supporting employers to have this conversation is vital for their understanding and for women’s employment?

--- Later in debate ---

[Carolyn Harris]

What I would say to the hon. Gentleman is that communication is key here; you cannot provide if you do not know what is needed. Do not be embarrassed and do not shy away from that conversation. If staff members do not feel comfortable talking to one person about it, find someone they will talk to. It is so important that you ask them what they need, not tell them what you are prepared to do. Communication and adaptation to suit the individual is key.

[Seema Malhotra]

I, too, just want to pick up on the point that my hon. Friend made about women and the workplace. We know that, according to the Centre for Ageing Better, 800,000 people over 50 were wanting to work more and were under-employed—that was the case a year ago, at least. Does she agree—

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. The hon. Lady has already had one intervention, which was very long. I allowed that, but her second intervention is heading towards being very long and I cannot construct this debate like that. About 30 people wish to speak this morning. I am sure that the promoter of the Bill wants to make sure that as many people as possible get to speak, but that she also will not want to talk out her Bill. I hope that those who support the Bill will not make long interventions and long speeches, because otherwise the Bill will be talked out and we will not achieve the result we are intending to achieve. So I ask for brevity, please, on all sides.

Covid Vaccine Passports

Seema Malhotra Excerpts

Wednesday 8th September 2021 Commons Chamber

[Nadhim Zahawi]

My right hon. Friend asks an important question. When I or a Minister from the Cabinet Office stands at the Dispatch Box and shares the detail of the implementation, we will address that issue in full.

[Seema Malhotra (Feltham and Heston) (Lab/Co-op)]

The Night Time Industries Association and others have expressed concerns about the practical implementation of this policy. As the Minister has highlighted, those questions remain and need to be answered quickly. Will the Minister also publish clear guidance on which events and venues will require a covid passport? There will also be increased costs for businesses at a time when they are recovering, so will they also be getting extra funding, and when will that be announced?

[Nadhim Zahawi]

Absolutely, we will issue clear guidance about venues. Nightclubs are a particular concern when it comes to evidence from other countries of super-spreader events, but, absolutely, we will do that.