Healthy Start

Sharon Hodgson Excerpts

Wednesday 22nd May 2024 Westminster Hall

[Mrs Emma Lewell-Buck (South Shields) (Lab)]

I beg to move,

That this House has considered the Healthy Start scheme.

It is a pleasure to see you in the Chair, Mr Dowd. What is not a pleasure is that I am here yet again, still trying to get the Government to do something very simple and impactful to help those who need it the most. Auto-enrolment with an opt-out, as opposed to the current opt-in system, would ensure that the Healthy Start scheme operates as it should, so that every single child gets the best start in life.

The last Labour Government introduced the Healthy Start scheme, which provides financial assistance in the form of a prepaid card to all under-18s who are pregnant, families with young children or pregnant women claiming certain benefits. This is to help with the ever-increasing costs of fruit and vegetables, milk, formula milk and vitamins. The scheme is available in pregnancy and until the child’s fourth birthday, yet the scheme is beset with problems—problems that were caused by this Government and can be easily fixed by this Government.

The child of the north all-party parliamentary group has heard evidence that children in the north are more likely to die before reaching their first birthday than those elsewhere in the country. We have heard about desperate mothers who are seeking an abortion because they simply do not know how they will feed their baby. When I raised that with the Prime Minister only two weeks ago, his response was to advise me that he was

“proud that…the Government have overseen a significant fall in poverty, particularly child poverty.”—[Official Report, 8 May 2024; Vol. 749, c. 570.]

Child poverty has not significantly fallen: it stands at more than 4 million. When expectant mothers have had to make these heartbreaking decisions, bragging about the support put in is crass, to say the least. It was followed up with an equally tone-deaf letter from the Secretary of State for Work and Pensions.

It has been widely reported that some parents, in desperation, have resorted to theft of baby milk and formula or are having to water it down, which is not surprising considering that prices of baby formula are at historically high levels and the current Healthy Start payments do not even cover the cost of formula for one week. Despite this, Healthy Start take-up is dropping. The Government’s 75% target—given to the NHS Business Services Authority, which runs the scheme—was missed last year, and take-up continues to decrease: it stands at just 62.5% across England, Wales and Northern Ireland. The comparable scheme in Scotland, however, has reached 92% take-up. Some local councils and organisations have made a dedicated investment to promote the scheme; not only does this create a postcode lottery, but they were left feeling utterly demoralised after the Government provided false, inflated take-up figures and were then unable to provide accurate uptake data.

An opt-out system would ensure proper data and free up organisations to support families instead of having to try to locate them—a point that is supported by research published earlier this month and funded by the Minister’s own Department. In some areas, the take-up is as low as 44%. About 220,000 babies, young children and pregnant women are missing out on the scheme, and Sustain estimates that that leaves £58 million unclaimed.

Despite the Chancellor’s crowing on this morning’s news, low inflation still means rising prices on top of previous high rises. In short, this is just stemming the pain for families. Only last year, UNICEF found that the UK had the worst rise in child poverty, leaving us bottom among 39 of the world’s richest countries. That is why admissions for malnutrition have increased in children and there has been a resurgence of Victorian diseases such as rickets and scurvy. It is no wonder that the Government blocked the United Nations special rapporteur on the right to food from visiting the UK and investigating poverty. When the previous UN special rapporteur on extreme poverty visited the UK, he was very clear that the rise in poverty was the direct result of Government policies.

Food banks, baby banks, faith groups and charities have now become embedded parts of our welfare state. The Key to Life food bank in my constituency reported a 300% increase in demand last year, coupled with a decrease in donations. It is therefore highly unlikely that the £58 million that is going unclaimed is unclaimed because people do not need it. There is a very clear need for the scheme but, as I have been told time and again, awareness is low among the public and professionals. That is why in 2021 the national food strategy recommended that the Government implement a communications plan related to Healthy Start, but they did not.

In 2021, I and others raised concerns about plans to fully digitalise the scheme by 2022, meaning that paper applications and vouchers would no longer be accepted. The result was that, as of October 2023, more than 20,500 households that were previously in receipt of the vouchers were no longer receiving them, 19 months after digitisation. The NHS Business Services Authority then admitted that technical issues meant that applications were being declined, resulting in parents and pregnant women struggling to get through to the helpline and having their payment cards rejected.

As it stands, the application routes are overly complex and varied. When an application is made online, an automated message claims that a response will be given in two days. This very rarely happens. Some mothers report that they have never heard back and that, after multiple attempts, they have given up.

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

I apologise for missing the first couple of minutes of my hon. Friend’s speech. She is making an excellent speech outlining why the scheme is so needed. She mentions that take-up of the Healthy Start scheme is too low, so proper information about the scheme is needed, along with auto-enrolment. That would cut through the red tape and the hurdles that many families experience. Does she agree that the Government must therefore do more to promote the Healthy Start scheme to families so that people are aware of it, as recommended in the excellent national food strategy?

[Mrs Lewell-Buck]

I thank my hon. Friend for that intervention and for all the work that she does in this space. She has tirelessly championed children for as long as I have known her and for as long as she has been in this place. Charities, organisations and local authorities are using what little money they have to promote a Government scheme, and then when they go to the Government for data about how it is working, they get either false figures or no figures at all, so I could not agree more with my hon. Friend.

The Healthy Start phone number is not freephone, and it is fully automated. There is no option at all for callers to speak to anyone unless they need an interpreter or have inquiries relating to their card. The absurdity of an automated system asking whether callers have problems with cards that they do not yet have is not lost on any of us, I am sure. Worse still, if the application is refused, the parent is not told why and is directed to the phone line: again, they cannot speak to anyone. Research by Manchester Central food bank highlights the fact that those on legacy benefits or with no recourse to public funds have to apply via paper or telephone, but that is completely at odds with the Healthy Start phone line and website, which state very clearly that applications must always be made online. The confusion is completely unnecessary.

Repeated questions to the Secretary of State for Health and Social Care about funding for the scheme and future take-up have been equally frustrating. The Government refuse to say how much money they allocate to the scheme each year. They claim it is allocated on a forecast for take-up, but will not say what that forecast is. A cynic would conclude that if the Government forecast low uptake, it is against their interest to do anything to boost it, as they will not have budgeted for that, or that if they forecast higher uptake but do not reach it, millions of pounds that could have been spent on feeding children will be spent elsewhere. Either way, hungry babies and children are once again the ones losing out.

Back in May 2023, a similar debate was held in which the Government were made fully aware of the problems with Healthy Start. The following month, I introduced my Bill on auto-enrolment, the Healthy Start Scheme (Take-Up) (No. 2) Bill. Over the past two years, I have sent the Health Secretary two cross-party letters, signed by MPs and a multitude of outside organisations. This was followed by more questions and speeches in the Chamber and a full report to the Chancellor in advance of the previous Budget. Forty-eight written questions and two well-supported early-day motions later, here we are again.

I am sure that in her response the Minister will reiterate the excuses her colleagues have given for refusing auto-enrolment: that it is not possible because the prepaid card is a financial product that is therefore subject to financial regulations. However, Mastercard has written to me explaining that it is possible, if only the Minister’s Department and the Department for Work and Pensions will work with it. I have been here long enough to know that the Minister will not be able to commit to auto-enrolment today, but at the very least can she give a commitment to working with her colleagues and other organisations to look at piloting auto-enrolment?

Can the Minister assure us that her Department’s uptake data is now accurate and advise us on the progress of her Department’s promise to me to write to all eligible households that are missing out on the scheme? As we debate this today, there will be mothers and fathers who, instead of excitedly preparing for their newborn or enjoying those early years with their little ones, are worried and distressed about how on earth they are going to provide for them.

I know that auto-enrolment is not a panacea. I know that life will continue to be a hard struggle for so many people. But as I did when I presented my Bill, I want to thank all the parents who have shared with me their stories and their pain. They should always be at the forefront of our mind, because nobody should feel such desperation and hopelessness that they can see no other way than stealing to feed their baby or seeking to terminate their pregnancy. I sincerely hope that the Minister agrees with me about that.

[Andrew Western (Stretford and Urmston) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Dowd. I congratulate my hon. Friend the Member for South Shields (Mrs Lewell-Buck) on securing this important debate. She has done a considerable amount of work—some with me and some in her own right—over the past few years and has followed in the footsteps of my predecessor as Member of Parliament for Stretford and Urmston in campaigning on auto-enrolment.

This is a hugely important issue. We know that those families who are eligible to receive the Healthy Start allowance are some of the poorest in our country. We know, too, just what an important component of the benefits system it is. It ensures that youngsters at risk of malnutrition because of a lack of finance and of available cash in the family home are able to access things like healthy foods, fruits and vegetables, as well as milk formula and other important things to help with babies’ early development.

There are a number of aspects to this. My hon. Friend has focused largely on her important campaign to secure auto-enrolment, but I want to take a moment to broaden the debate with some comments about the uplifting of the allowance, given the significant increases in inflation in recent years.

[Mrs Hodgson]

I can see that my hon. Friend is going to make an excellent speech; he has made some important points already. Hon. Members may be aware that an event was held yesterday by Diabetes UK that discussed the shocking rise in the prevalence of type 2 diabetes in young people. They mentioned early years nutrition and the important part that that period plays in establishing the lifelong health of an individual. Does my hon. Friend agree that that very early food system and what food children consume in those very early years is so important, and that schemes such as the Healthy Start scheme should be thought to be central to a good public health mission?

[Andrew Western]

My hon. Friend is correct to make that point and to link diabetes and other negative health experiences that can happen as a result of poor nutrition in early years. She has spent many years campaigning for children and their health in this place, not least during her time as the shadow Minister, and I know that many families up and down the country will be grateful to her for that.

I turn back to the issue of inflationary pressures and the lack of uplift in the Healthy Start allowance since 2021, when it was uplifted for the first and only time since the Government came to power in 2010. We all know the inflationary pressures that we have seen since then; food, in particular, has outstripped other parts of our economy, with an average 30% increase in food prices. That pressure has been especially acute in the price of milk formula.

My hon. Friend the Member for South Shields mentioned our last Westminster Hall debate. I called that debate a year ago yesterday, and things have worsened since then. As my hon. Friend said, uptake has decreased, as prices—although they are not growing as quickly—have continued to rise. Twelve months ago, we were at the point at which there was not a single milk formula product on the market that could be afforded under the Healthy Start allowance. That is a terrible situation to be in, not least because of the other pressures we have seen on family finances in recent years.

I turn to auto-enrolment. Uptake is problematic: it has decreased over the past two months. As I said, these are the poorest families and those in the most need. Families are not deciding that they do not require that money. Families are looking, as my hon. Friend the Member for South Shields so ably outlined, at an opaque and challenging system to navigate. That, as well as a lack of knowledge that this allowance even exists for families, is one of the primary causes, if not the only cause, of this damagingly low uptake.

I am interested to hear the Government’s thoughts on the thorny issue of auto-enrolment, although I am not sure why it is so thorny. I also wish to broaden out my hon. Friend’s comments about the interim proposal that she and I put forward to Government of writing to those families who are eligible for the Healthy Start allowance but who are not taking it up. We have had a number of excuses from the Government over the past 12 months, similar to those that my hon. Friend outlined on data sharing and a financial agreement through a card system, which have since been quashed by Mastercard.

I have submitted a number of written questions about where we are with the data, given previous undertakings from Ministers that they would draw the data together to write to those families. In September 2023 I was told that that data was being brought forward. In November I asked again, in pursuance of the previous question, and we were told that the data would be available in early 2024. My hon. Friend the Member for South Shields and I seem to dovetail on this issue a lot: she then submitted a question in March this year. There was still no sign, despite previous suggestions that the data would be available in early 2024 for that work to happen.

There is a lack of transparency and accessibility in the application process. The Government are not helping to disavail people of that view when they refuse to let even those who are eligible for the scheme know that that is the case. The impact on our communities is significant. In my constituency of Stretford and Urmston, one child in five lives in poverty. My local food bank in Stretford told me recently that 40% of the people it serves are first-time users, such is the enormous increase in demand that it has seen of late. Most damningly of all, in my community they also tell me that there has been an 80% increase over the past 12 months in the number of families with children that they are supporting.

We are in crisis. Families are struggling. The allowance is targeted at those in the greatest need, yet just this weekend, in Old Trafford in my constituency, residents were having a real-time WhatsApp conversation about the fact that milk formula and milk itself are security-tagged in some—not all—supermarkets up and down this country. There was a debate going on: if they were a retail worker, would they stop somebody who was clearly in need from taking milk or baby formula?

I said 12 months ago that people were watering down formula, and my hon. Friend the Member for South Shields mentioned it today. Worse still, as Sky News covered at the time, in some cases there were suggestions that mothers were adding flour and other such substances into milk formula to pad it out further. The impact that that can have on a baby’s digestion is significant and risks long-term health problems. This is the scale of the challenge that we face.

I would be incredibly grateful for an update on the Government’s thinking about whether they should be uprating the Healthy Start allowance in line with inflation, given the significant pressures on the price of food and especially on milk formula since the allowance was last uprated in 2021. Are the Government serious about the issue of auto-enrolment? If not, why on earth is more not being done to bring together the data that is required? That would at least let families know whether they can embark on this admittedly opaque process to try to bolster their family budgets and try to ensure that their babies, their children under the age of four or they themselves, if they are more than 10 weeks pregnant, can access healthy things such as fruit, vegetables or milk for their baby.

This is a crisis. The need is there. We all see it in our communities. The time to act is now, and I beg the Minister to do it urgently.

Liver Disease and Liver Cancer

Sharon Hodgson Excerpts

Thursday 25th April 2024 Westminster Hall

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

It is a pleasure to serve under your chairmanship today, Sir Christopher. I thank my hon. Friend the Member for Stockport (Navendu Mishra) and the hon. Member for Glasgow Central (Alison Thewliss) for securing this important debate, and hon. Members for their excellent opening speeches, setting the scene.

Addressing liver disease and cancer has for far too long been put on the back burner. Despite the vital work of organisations like the British Liver Trust and Liver Cancer UK, liver disease remains a leading cause of premature death, and is now the fastest rising cause of cancer death in the UK, yet 90% of liver disease is preventable, and it is in many cases reversible. It is a travesty, and an indictment of the state of our healthcare system, that three quarters of people living in the UK are diagnosed when it is too late for effective intervention or treatment.

I am acutely aware of the effect that liver disease has, because Washington and Sunderland West is at the heart of this public health crisis, which disproportionately affects those living in the north-east. In Sunderland, hospital admission rates due to liver disease were, shockingly, 84% higher than the national average in 2022-23, and the region suffers one of the worst hospital admission rates in England for women with liver disease. We see the hand of inequality stretch even further, as over a third of all premature deaths reported in 2022 were in the north of England, despite the Government’s manifesto pledge and levelling-up mission to narrow the gap in healthy life expectancy. The Government’s inaction on tackling health inequality is clearly indicated by the simple fact that, since the Marmot review was published in 2010, health inequalities have widened.

If we are to tackle this issue, we must finally start to tackle its root causes. We must reform our approach to liver disease and cancer, no longer allowing the prevailing myth of it being self-inflicted—as my hon. Friend the Member for Stockport said in his opening speech—to impact policy decisions, when we know the fatal consequences of the status quo. Despite hospital admissions caused by liver disease having risen by almost 80% over the last decade, liver disease was omitted from the major conditions strategy and was overlooked in the core modalities for community diagnostic centres.

We owe it to all those affected by liver disease to set out a proper plan to improve diagnosis and treatment. We must take a holistic approach, focusing on improving every area, from research to prevention to treatment. I believe the creation of the new nationally endorsed diagnostic pathway will be key to ensuring earlier diagnosis, with less regional disparity. In the short term, I urge Ministers to deliver a prompt and comprehensive review of adult liver services by NHS England, and to ensure that local health commissioners learn from areas where fully effective pathways for the early detection and management of liver disease are already in place.

We must no longer ignore the simple truth that we cannot improve outcomes for liver disease and cancer if the staffing crisis, long waiting times for diagnosis and barriers to accessing specialist care once diagnosed continue. We are seeing it with liver disease, where the cross-over of specialist services means that those affected experience the pressures on the NHS acutely, but the same story is told in every aspect of healthcare. We must deliver more scans and more appointments every year if we are to catch cancer early.

I am pleased that Labour has committed to a £171 million a year investment to provide the NHS with state-of-the-art equipment and new technology to cut waiting times and speed up diagnosis and treatment. I very much hope we can take momentum forward from this debate and push the Government to finally implement measures to increase diagnostic rates, invest in preventative measures and improve treatment for liver disease and cancer, because those seeking treatment cannot afford for us not to.

Oral Answers to Questions

Sharon Hodgson Excerpts

Tuesday 5th March 2024 Commons Chamber

[Helen Whately]

My hon. Friend is right about the importance of the social care workforce: social care is its workforce. I can assure him that we already have a plan for the care workforce, set out in the “People at the Heart of Care” White Paper, and now we are putting it into practice. Our care workforce pathway is already being implemented, our new accredited qualification for care workers will be launched later this year, and we are backing social care with up to £8.6 billion in extra available funding.

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

I was concerned to hear that a constituent of mine was initially denied access to social care for his mother who suffers from Alzheimer’s despite her inability to administer her own medication. Will the Government look to broadening the criteria of the Care Act 2014 to include those requiring support with administering medication?

[Helen Whately]

We very much want everybody who needs care to get it and everyone who is eligible for financial support should get it. That, of course, is assessed by local authorities. We are introducing Care Quality Commission assurance of social care commissioned by local authorities, to make sure people get the care they deserve and to shine a light on where local authorities are doing a really good job and where others could do better.

Oral Answers to Questions

Sharon Hodgson Excerpts

Tuesday 17th October 2023 Commons Chamber

[Maria Caulfield]

We have had a huge response to the opening of the grant, with over 1,800 applications from voluntary groups and organisations. We are assessing those bids and hope to make an announcement before the end of the year.

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

Campaigns such as 3 Dads Walking and Just 3 Mums Walking have worked incredibly hard to raise awareness of suicide prevention. Has the Minister had time to meet with either of those campaigns yet?

[Maria Caulfield]

I have met with 3 Dads Walking; I have not met the mums group but am very happy to do so. Because of their intervention and campaigning, we were able to successfully put their campaign about improving mental health awareness in the school curriculum into our suicide prevention strategy. It is a cross-Government strategy, and the Department for Education has very much taken their points on board.

Oral Answers to Questions

Sharon Hodgson Excerpts

Tuesday 11th July 2023 Commons Chamber

[Helen Whately]

The hon. Member is right that the duration is very important. One reason why we are focused so much on increasing early diagnosis is because we know that the sooner we diagnose people, the more likely they are to have a successful outcome from cancer treatment. We are seeing improvements in cancer survival. For instance, in 2010, two thirds of people would survive for one year after a cancer diagnosis; now the figure is three quarters. The NHS is working very hard on further improving cancer diagnosis, and we have reduced the number of people waiting more than 62 days since the pandemic by over a third.

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

4. What steps he is taking to increase awareness of (a) cervical screening and (b) ovarian cancer.

[The Minister for Social Care (Helen Whately)]

We are catching more cancers early than ever before, and work to raise awareness of cancer signs and symptoms, screening programmes and investment in early diagnosis are all playing their part. We fund community events to raise awareness of ovarian cancer, and NHS England is working to increase cervical screening take-up by providing more convenient appointments, including at weekends and evenings.

[Mrs Hodgson]

I thank the Minister for that answer, but Target Ovarian Cancer has found that 40% of women in the UK wrongly believe that their smear test will detect ovarian cancer. There is currently no viable screening process for ovarian cancer. However, messaging remains unclear when women are going for their smear test. What steps are being taken to ensure that information provided at such screening is clear?

[Helen Whately]

On the one hand, cervical screening is incredibly important and very effective at saving lives from cervical cancer—we estimate that it saves around 5,000 lives per year. There is no evidence to support a screening programme for ovarian cancer, and I will take away the hon. Lady’s question about whether there should be communications about that when people go for a cervical smear.

Reforms to NHS Dentistry

Sharon Hodgson Excerpts

Thursday 27th April 2023 Commons Chamber

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

Sadly we have been here before, time and again, and this Conservative Government still refuse to act, consigning yet another public service to the scrapheap. Once again my constituents are paying more and getting less under this Tory Government. I thank my hon. Friend the Member for Bradford South (Judith Cummins) and the hon. Member for Waveney (Peter Aldous) for securing this very important debate. We need this crisis to be urgently addressed.

It cannot be denied any longer: we face an existential crisis in NHS dentistry. It really is at breaking point. The latest area in my constituency to be affected is Pennywell in Sunderland, where the Bupa branch will close its doors in June, affecting 7,800 NHS patients. Not a week goes by without correspondence from a constituent in dire need, in despair and often in acute pain, unable to find an NHS dentist and unable to afford a private one. The nearest NHS practice accepting new patients for those constituents is in South Shields, nearly an hour away from Pennywell on public transport. That is completely unacceptable.

We cannot accept dental care becoming a luxury available only to those who can afford it. To add insult to injury, during this Conservative cost of living crisis the Government have hiked dental care prices by 8.5%. Those choices are being made by the Prime Minister and his billionaire buddies, who have never had to worry about the cost of anything such as this and do not understand the effect that that record increase will have on the cost of living pressures facing ordinary people in my constituency and across the north-east. The hike will not put a penny into NHS dentistry, either; it will just force millions to reconsider whether they can afford necessary dental treatment. We risk the horror of DIY dentistry becoming the norm.

Across 13 years, the Conservatives have chosen millions of pounds of short-term cuts, but the long-term cost of health inequalities is a price my constituents will pay for generations. The Government chose not to listen to dentists and they knew that the woefully inadequate NHS dentistry contract was not fit for purpose. That is not a new problem. Make no mistake, not only are the Conservatives allowing this crisis to worsen, but their inaction suggests to me that this is actually the result they desire.

My constituents are furious, as am I. They are either forced to pay over £100 more for the exact same NHS care they could get under a Labour Government in Wales or they are left unable to access any treatment at all. We need a Labour Government who will prioritise healthcare access for all, clear up 13 years of Tory underfunding and mismanagement, and abolish the Prime Minister’s precious non-dom status in order to provide the treatment and dental care that the British people deserve. The people of Sunderland and Washington should not have to suffer because of Tory chaos and managed decline that leave dental care a luxury for the few.

--- Later in debate ---

[Jill Mortimer (Hartlepool) (Con)]

I, too, thank everyone involved in securing this important debate, including the hon. Member for Bradford South (Judith Cummins), who so eloquently laid out the terrible state of NHS dental services in this country today and the desperate need for reform of that terrible Labour 2006 contract, which, in effect, destroyed NHS dental services in the UK. That is why I welcome the general direction of the Government’s plans for NHS dental reform, as outlined in the statement on 19 July last year. It is a good start, but we must do more. We must take this opportunity to not only put NHS dentistry back on track after disruptions during covid, but ensure we create a long-term sustainable plan to enable good NHS dentistry for all who want it.

I wholeheartedly agreed with the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Lewes (Maria Caulfield), when she said that

“the contract is the nub of the problem; it is currently a perverse disincentive for dentists to take on NHS work.”—[Official Report, 14 June 2022; Vol. 716, c. 135.]

That contract is the primary structural issue in NHS dentistry at the moment and has been since 2006. I have spoken to a dentist who owns 17 NHS practices across England, including two in my constituency. They are struggling financially to keep those practices going, but are totally committed to providing NHS dental services to my constituents and so push on despite the difficult environment.

[Mrs Hodgson]

Will the hon. Lady give way?

[Jill Mortimer]

No, I want to make progress.

That dentist’s many problems include the unfair way UDA rates are calculated, which ironically disadvantages areas such as Hartlepool, which have severe health deprivation. That has knock-on effects on their ability to employ staff at competitive rates and leads to a reliance on expensive locum dentists, further stretching the viability of the business. Dentists find a way to make their practices work with access contracts, but the lack of certainty they face because of the difference in competences between different integrated care boards adds further issues. For example, under one ICB’s access contract they were provided with clarity for a two-year period, but under our ICB they were still waiting to hear at the end of the month whether a contract would be renewed four days later. Not only did the survival of the practice and the jobs of 30 staff depend on that contract, but the dental care of 20,000 patients also depended on it. Thankfully it was renewed, but it is unacceptable that the ICB provided them with no indication of whether the contract would be renewed so close to its end. No business can run like that.

For areas such as mine that have a desperate need of NHS dental services, we should be fully valuing and supporting good dentists like that to ensure the survival of their essential services. I urge the Minister to consider radical reform of the way in which NHS dental service contracts are remunerated, so that established NHS dentists continue to offer NHS services to new patients. I would also like to see changes to stop newly qualified dentists being tempted into private work. It costs the taxpayer a significant amount of money to train a dentist, but they are not then required to work in the NHS. It is only fair on working people who have subsidised these professionals to train in their chosen career to expect a degree of payback. I would therefore welcome the Minister looking into the possibility of a staggered mandatory amount of NHS work per year for the first few years after qualification.

Good dental care starts with good preventive care, and I want to see a day when everyone who wants it can access NHS dental services for all routine procedures and check-ups, not just emergencies, without the difficulties that my constituents are currently facing.

--- Later in debate ---

[Mrs Hodgson]

I am listening intently to what the Minister is saying. When I go back to speak to my local dentists, what do I tell them about the “when”? He is saying all the things that we would like to do and the Government would like to do. We want to see all that happen, but when will this contract that has needed changing since 2010—[Hon. Members: “2006!”.] We had changing it in our 2010 manifesto; we said we would update it in 2010. The Government have had 13 years to fix this, so when is it going to happen?

[Neil O’Brien]

I have mentioned some things that are already changing—some of the first reforms to the contract since 2006 that we have started to bring in. We are working on the plan at pace. There is no date for its publication yet, but we are working on it at pace because we are conscious of the urgency.

I thank the hon. Member for Bradford South and my hon. Friend the Member for Waveney for securing this important debate. I hope they have been assured that we have started to reform dentistry, that we are seized of the importance of the issue, and that we recognise that we can and must go further to further strengthen NHS dentistry.

Access to GP Services and NHS Dentistry

Sharon Hodgson Excerpts

Tuesday 21st June 2022 Commons Chamber

[Wes Streeting]

I will give way first to my hon. Friend the Member for Washington and Sunderland West (Mrs Hodgson), then to my hon. Friend the Member for Hackney South and Shoreditch (Dame Meg Hillier) and then to the hon. Member for Caithness, Sutherland and Easter Ross (Jamie Stone).

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

My hon. Friend mentioned Somerset, but can I also mention Sunderland, to keep up the alliteration? In Sunderland, we cannot find an NHS dentist and the few good ones we have are now turning to private practice to make it work. It is an existential crisis in dentistry—it really is at breaking point. Does my hon. Friend agree that the blame lies squarely with the Conservative Government, with backlog Britain, and that this is the effect on our constituents?

[Wes Streeting]

My hon. Friend is absolutely right about the state of dentistry. It is not alliterative, but I suspect that my hon. Friend the Member for Hackney South and Shoreditch has similar points to make.

Oral Answers to Questions

Sharon Hodgson Excerpts

Tuesday 14th June 2022 Commons Chamber

[Sajid Javid]

I thank my hon. Friend for her tireless campaigning on the issue, which she brought up recently in the Health and Social Care Committee. I am pleased to tell her that elective orthopaedic surgery at the Princess Royal Hospital will resume from 20 June.

My hon. Friend is right about the importance of the Messenger review. There were many examples of excellent leadership in it, but sadly there were also examples of poor leadership, including bullying and blame cultures. That is why it is essential that we have this huge reform.

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

As hard as all hospital leaders and managers work, sometimes something goes wrong on their watch. What follows is one such example.

On Friday, I met Joanna, a lovely mum of two young children, who was diagnosed with secondary cancer three months ago. Since then, she has been passed from pillar to post and has received no treatment at all. Unfortunately, she is now receiving palliative care. What Joanna wants more than anything is to stop what happened to her happening to anyone else. Will the Secretary of State personally look into Joanna’s case to make sure that she finally gets the treatment she urgently needs, and that no one else is failed by the system as Joanna has been?

[Sajid Javid]

Yes, of course I can give the hon. Lady that commitment. I am very sorry to hear about Joanna; I think of her, her loved ones and her two children. I will absolutely look personally into the case. I hope that the hon. Lady agrees that where we see poor outcomes, it is important to make sure that we have the best possible leadership in place.

Cancer Care: Young Adults

Sharon Hodgson Excerpts

Wednesday 8th June 2022 Westminster Hall

[Julie Marson]

I appreciate my right hon. and learned Friend’s intervention. I will come on to talk about some of the things he raised, because he puts his finger on some of the most important aspects of how GPs manage their diagnosis process. The diagnostic centres are fantastic, but they need to have patients referred to them, which goes back to what we are trying to achieve with Jess’s law.

Cancer charity CLIC Sargent found that around half of young people visited their GP at least three times before their cancer was diagnosed. Almost 10% of all new cancers are diagnosed in people aged between 25 and 49, with almost twice as many cases in females as in males in that group.

Simon and Andrea Brady created a petition in Jess’s name. My right hon. and learned Friend the Member for North East Hertfordshire and I joined them to hand it into Downing Street. Its plea was to increase the awareness of diagnosis of cancer in young adults. It currently has an incredible 240,000 signatures, and has highlighted the scale of the problem for young adults. The petition makes for heartbreaking reading. Countless people tell stories of their young family members who have had their lives curtailed by late or non-existent cancer diagnoses. The disproportionate occurrence of females is also deeply troubling.

Being told you are too young for cancer has been happening for years, and it is simply not acceptable. Young people have their symptoms explained away with other diagnoses. As I said, Jess was told she had long covid, despite never having tested positive. The explanations given to other patients for poor health are endless: irritable bowel syndrome, pulled muscles, fatigue, stress, migraine—the list goes on.

I welcome the significant roll-out of rapid diagnostic centre pathways across hospitals in England. I know we have just achieved one million tests and scans via our community diagnostic centres, which is a huge achievement and critical in tackling the covid backlog. Of course, patients still have to be referred by a GP, and that vital link is what we are focusing on here today, particularly the escalation of patients with undiagnosed symptoms within a GP’s surgery or to a specialist, as per Jess’s law.

There are other issues that relate to GPs, including having a dedicated GP lead for a patient. The general practitioners’ contract requires practices to provide a named accountable general practitioner to all registered patients. That GP must take the lead in ensuring that any primary medical services considered necessary to meet the needs of a patient, including appropriate referrals to specialist care and liaison with other health professionals involved in the patient’s care, are co-ordinated and delivered to that patient.

However, Jessica’s case demonstrates that that does not always happen. Jessica was not seen by just one GP at her surgery. In her case, four doctors spoke to her and prescribed medication. Although Jess was told on one occasion that she had been discussed at a practice meeting, it was obvious that there was no one person overseeing her case. She was never seen or contacted by her named GP. It is also vital that GPs are required to maintain their continuing professional development through up-to-date training and awareness of cancer, including in young people.

CLIC Sargent’s Young Lives vs Cancer is a charity dedicated to supporting children and young people with cancer, and ensuring that their voices are heard in the context of cancer care. It has identified several challenges faced by GPs that hamper early diagnosis. Those include limited training and awareness, and time pressures. Of course, the effect of the pandemic is exacerbating existing issues. One third of GPs reported inadequate opportunities to gain experience in the care of children and young people during their initial training as one of the top barriers to identifying cancer in children and young people.

The Health and Social Care Committee’s review into cancer services, published on 5 April, concluded:

“The single most effective way to improve overall survival rates will be to diagnose more cancers earlier. Diagnosing bowel cancer at stage 1 means that 90% of people will live for five years compared to just 10% of people diagnosed at stage 4.”

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

The hon Lady is making a powerful speech. I apologise for missing the start of it. My condolences to Jessica’s parents. That point on early diagnosis is absolutely key. I am chair of the all-party parliamentary group on ovarian cancer and vice chair of the APPG on breast cancer. I have done a lot of work in this area. The number of people—especially women with ovarian cancer —who are diagnosed only in A&E, when it is almost stage 4 or too late, really has to stop, and that all starts with symptom awareness. What is being called for in that petition, therefore, is so necessary. Sometimes people have been back and forward to the GP so many times. Does the hon. Lady agree that that is the one thing that would have made a massive difference in Jessica’s case?

[Julie Marson]

I very much welcome the hon. Lady’s intervention. She is absolutely right. Her work to raise awareness of ovarian and breast cancer is all part of that hugely important process. I lost a dear friend to ovarian cancer, and it is a very difficult and unspecific thing to diagnose, or even for someone to realise that they might have the relevant symptoms. Breast cancer we have made a lot of progress with, and we have to keep that up. There are different cancers, with different symptoms, and awareness of the range of symptoms and how those might impact on different people is key to early diagnosis, to self-diagnosis so that people say, “Let’s go to a GP now”, and to get that GP to take things forward to identify the real underlying issue. I thank the hon. Lady.

The pivotal role that general practice doctors play in diagnosing patients early cannot be overstated. People—our sons, daughters, mothers, fathers, family, friends and neighbours across the board, regardless of age, race, sex or any characteristic—are equally deserving of diagnostic testing and referral. Patients must be accorded the time, space and physical contact to voice their concerns when presenting with recurrent and progressively aggressive symptoms. Listening and acting are key.

I know that the Minister is listening. We have met and discussed the issue, and her own experience in the nursing profession gives her great empathy and insight. I look forward to hearing her response in a moment. I also take this opportunity to thank my right hon. Friend the Secretary of State for Health and Social Care, who is arranging to meet Mr and Mrs Brady to discuss Jessica’s experience, what we can learn from it and how we might be able to implement Jess’s law.

I am also grateful to all those who have contributed today, in particular my right hon. and learned Friend the Member for North East Hertfordshire, who stands shoulder to shoulder with the Brady family. Finally, but most importantly, I reiterate my thanks to and deepest sympathy for Simon and Andrea Brady and their family. We do not want to hear tragic stories such as Jess’s—not because we do not care, but precisely because we do.

To conclude, I will repeat a detail of Jess’s story that I think illustrates the high regard in which she was held. On the day of her funeral, a satellite that she helped to design was launched into space from Cape Canaveral. It was inscribed with the words, “Thank you, Jess!” In honour of Jessica Brady, let us implement Jess’s law, so that other young adults who face the trauma of cancer in future can also say, “Thank you, Jess.”

Oral Answers to Questions

Sharon Hodgson Excerpts

Tuesday 19th April 2022 Commons Chamber

[Edward Argar]

I did indeed have a positive and constructive meeting with my hon. Friend. It is right that we have access geographically spread to A&E services, but the decisions are rightly taken by clinical commissioners on the basis of clinical evidence. I know that she will continue fighting the corner for the reopening of her local A&E with tenacity and passion.

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

T8. The 10-year cancer plan that the Secretary of State has announced is a key opportunity to ensure that future services are designed with the patient at their core, especially for those living with cancer. What steps is his Department taking to engage with under-represented groups in the development of the 10-year cancer plan, and will he agree to meet with Macmillan Cancer Support to discuss how it can provide support in this key area?

[Sajid Javid]

I would be pleased to have the meeting that the hon. Lady has suggested. She should know that we just closed the consultation on the 10-year cancer plan. There has been a fantastic response. She may also have seen the announcement that we made today about lung cancer health checks. With improvements like that, we intend to do a lot more.