Steff Aquarone Portrait Steff Aquarone
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I could not agree more. That is one of many respects in which rural and coastal communities around the country have much more in common with each other than with their inland neighbours just a few miles away. Theoretically available treatment becomes practically inaccessible if it requires a journey to be made without reliable toilet access, as in Ian’s case, and in cases where access to private transport is more limited, as in the cases that the right hon. Gentleman raises.

Kelly, Samantha, Ian and so many more are entitled to the same access to good treatment and the same chance of good health as people living in urban and inland communities. It is absolutely right for the Government to pursue this Bill, and I support their aim wholeheartedly, but I challenge them to assess the Bill based on who is left behind, not just who can be helped. Accept this amendment, or explain why rural and coastal communities do not merit explicit protection.

Simon Opher Portrait Dr Simon Opher (Stroud) (Lab)
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My remarks will focus mainly on new clause 69, which is in my name. Getting rid of NHS England is one of the best things that this Government have done. As working clinicians, we can at least now get away from so much admin and management.

My amendment is a simple one about self-care and health literacy. Demand for healthcare has increased enormously. Since 2019, for example, GP consultations in Stroud have gone up 30%. When I started work as a GP, patients saw me on average three times a year; it is now about eight times a year. Indeed, A&E attendance has gone up 20% over the last decade, yet the health of the nation remains the same. This is the demand side of the NHS that we very rarely discuss, and this is what I am asking the Secretary of State to address.

Let me turn to the causes of this increase in demand. There is a concept in medicine called the symptom iceberg. Most of us get symptoms every day, but we do not go to the doctor. We only go to the doctor when we have certain symptoms, and it is a very small number of symptoms, but that has increased over the last 20 years. Then there is the role of something that we call lay referrals; people used to have mums who lived next door, but now they are often much further away. We are socially isolated in an atomised society. We also have a much higher expectation for our health. We cannot fault that, but it means that, for example, people go to the doctor with very minor things. There are also factors such as AI. In my surgery, we use AI, but I believe that creates its own demands. There is also good old Dr Google, who in this country is consulted over 50 million times every year—and those who go to Dr Google usually end up thinking that they have cancer or need an ambulance, so that is clearly driving demand.

There are also doctor factors. If we carry on treating sore throats with antibiotics, people will carry on coming back. Earaches generally get better, and people do not usually need to see a doctor for headaches. We are over-diagnosing and over-medicalising everything. NHS factors includes the algorithms for 111 and litigation. I would also like to talk about health literacy. That means knowing about our health, and understanding that we are not always in totally good health, but we do not have to consult the health service just because we are feeling a little bit low or a little bit tired.

One of my colleagues in Stroud, Dr Hugh van’t Hoff, started Facts4Life, a school-based education service that goes into schools. In the last 10 years, he has worked with over 200 primary schools. He has shown that if we teach young children about health and how it is normal sometimes to feel tired or have a sore throat—stuff like that—we can reduce consultations in the NHS. We can also teach children how to understand information on the internet, so that when they look at statistics, they know what they mean, instead of thinking, “Ooh, my risk of cancer has been doubled by doing this.” That is really important.

We are also over-medicalising patients. In this country, 9 million patients in England alone—one in five adults—are on antidepressants. That is a scandal.

Martin Wrigley Portrait Martin Wrigley
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On interpreting statistics, does the hon. Gentleman agree that when it comes to data, GP confidentiality—in respect of the Palantir federated data platform, for example—is critical, certainly when we come to the single patient record, and that the Bill should not reduce confidentiality or data privacy to achieve the single patient record?

Simon Opher Portrait Dr Opher
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I thank the hon. Member for that comment. He is right. NHS and GP data is a massive resource for our scientists in this country, and I agree with him that it should be owned by the UK. It should be a sovereign wealth issue. I would like to ensure that we realise that over time.

I will return to over-medicalisation. I would like to try to divert patients with mild to moderate mental health symptoms to social prescribing, such as access to nature, arts and culture and exercise—and indeed comedy. Let us try to reduce that figure of 9 million on antidepressants, so that people do not have to come back for review. There would be fewer harms, such as suicide, in the first couple of weeks. Let us also look again at neurodivergence, and try to look for a way of not medicalising so many children with the condition.

If we are serious about reducing waiting lists and making the NHS sustainable for the future, we cannot focus only on supply; we must address rising demand, too. Giving people the knowledge and confidence to look after their own health will empower them, free up clinicians to care for those who need them most, and ultimately build a healthier population. That is what new clause 69 seeks to achieve. I urge the Government to accept it.

Edward Morello Portrait Edward Morello (West Dorset) (LD)
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Only half the children in my constituency have seen a dentist in two years. There has been a 20% decrease in NHS dental practices, and some constituents have written to me recently to say that they have been quoted in excess of ÂŁ7,000 for the most basic of treatments. Amendment 47 would require the Government to establish training hubs in Dorset. It would ensure that dental hubs trained dentists for the future, and would mandate final-year trainees to provide supervised treatment to NHS patients straightaway. Trainees are already providing treatment for free, paid for by the taxpayer, as part of their training. Those appointments should be for the NHS, and not for private patients.

Amendment 48 would ensure that the dental funding underspend is redirected towards additional NHS appointments, shorter waiting times, outreach, and home and school-based services. Amendment 49 would require the dental funding formula to account for rurality, an ageing population, disability, transport costs and recruitment difficulties.