NHS Dentists
Stephen Kinnock Excerpts(2 days, 23 hours ago)
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The Minister for Care (Stephen Kinnock)
I congratulate the hon. Member for North Down (Alex Easton) on securing this important debate. I thank him for his work to raise awareness of the challenges facing dental patients in his constituency and across the United Kingdom. It is vital that we work together, across the four nations of the United Kingdom, to tackle the long-standing problems that adults and children have been facing in accessing an NHS dentist when they need one. I also thank other hon. Members and hon. Friends for their powerful contributions to the debate. I know that access to dentistry is a matter of continuing concern for Members and their constituents.
The concerns Members have raised support the many testimonies I have heard directly from patients, dentists, members of the wider dental team, and their representatives. In July 2024, we inherited a dental system in crisis. That is evident in the adult oral health survey of 2023, which provides the first picture of adult oral health in England for more than a decade, and shows poor oral health in adults. Among adults with their own teeth, over two fifths—41%—showed evidence of obvious decay, 93% had some form of gum disease, and 19% had one or more potentially urgent dental conditions. This Government are determined to fix that.
Our 10-year health plan confirms our commitment to transforming NHS dentistry so that it is fit for future generations. We have established a platform for future success by reducing the NHS dentistry underspend from £392 million in 2023-24 to just £36 million. The decrease in underspend is leading to an increase in NHS dentistry, but I absolutely accept that there is still a long way to go. Over the past 18 months, the Government have made great strides in improving NHS dentistry, not just for patients but for the dental workforce delivering oral care to our nation. My immediate priority when taking up this ministerial post was to ensure that people who need an urgent dental appointment are prioritised and able to access the care that they need quickly. It is essential that we direct care towards those who need it most.
We all have a duty to reduce health inequalities, which are sorely felt in NHS dentistry. That is why, since last April, we have been making extra urgent dental appointments available to ensure that patients with urgent dental needs can get the treatment they require. Those extra appointments are available across the country, and are more heavily weighted towards the areas in which they are needed most. We are also incentivising high street dentists to offer further appointments in order to maximise availability for those in need of urgent care.
We recognise that access to NHS dental services remains a challenge in certain parts of the country. In addition to our urgent appointments, integrated care boards are recruiting dentists through the dental recruitment incentive scheme—known as the “golden hello” scheme. That initiative offers a financial incentive to encourage dentists to work in underserved areas for a minimum commitment of three years.
This Government have heard dentists’ concerns that they do not think the current dental contract is fit for purpose. Talks are under way, including with the British Dental Association, to scope our plans for potential changes. We remain open-minded and keen to consider how different payment models could best improve the delivery of care to dental patients. In reforming the dental contract, we want to focus on matching resources to need, improving access, promoting prevention and rewarding dentists fairly. We also want to enable the whole dental team to work to the top of their capabilities.
But reforming the dental contract is a significant challenge, and there are no quick fixes or easy answers. That is why in our 10-year health plan, we committed to fundamental reform of the dental contract by the end of this Parliament, with significant steps in 2026-27. Talks are under way with the British Dental Association, and we are making progress on these matters.
In addition to delivering fundamental contract reform over the longer term, we have already made significant progress through our 2026 reforms. We held a public consultation last summer on changes to the current NHS dental contract to address the pressing issues that dentists and dental teams said they were experiencing. The Government’s response, published in December, took account of the views of the dental sector as well as people with lived experience. Our reforms will utilise the existing dental contract to deliver the right care to the right people, while incentivising dentists to provide more NHS care. By prioritising patients with the greatest needs and making more efficient use of dentists’ time, the changes will ensure that the NHS dentistry budget delivers value for money for the taxpayer.
From 1 April, we will start to implement the reforms. For the first time, we are introducing provisions in the dental contract to embed urgent dental care appointments, making it easier for patients to access this care. We are increasing payments to dentists to deliver that care from £42 on average to £75 for that unit of dental activity. We are providing new treatment pathways for patients with complex treatment needs, paid at a set fee of around £250 or £700 depending on the pathway, while enabling and encouraging dentists to deliver more preventive care. These reforms will make full use of the existing dental contract, to ensure that patients receive the right care at the right time, while creating clear incentives for dentists to provide more NHS care. As I say, they will kick in from 1 April.
England has more than 38,000 registered dentists, of whom 10,700 are full-time equivalent general dentists delivering NHS care. As we take forward our reform programme to rebuild NHS dentistry, we are clear that strengthening the workforce is key to achieving our ambitions. This Government are committed to publishing a 10-year workforce plan to set out actions to create a workforce that is ready to deliver the transformed service set out in our overall 10-year health plan.
We are taking steps to increase the capacity of our dental workforce. As announced in our 10-year health plan, we will make it a requirement for newly qualified dentists to practise in the NHS for a minimum period. We intend that minimum period to be at least three years. That will mean more NHS dentists, more NHS appointments and better oral health.
Adrian Ramsay
I thank the Minister for highlighting the need for the dental workforce to be strengthened. We have a dental desert in East Anglia. The University of East Anglia stands ready to open a new dental school. It has permission from the General Dental Council but is awaiting the funded undergraduate dental places that will be needed to start training new dentists from 2027. Can the Minister set out how those places will be made available on the basis of regional need, so that dental deserts such as the east of England can start to build a sustainable dental workforce?
Stephen Kinnock
I congratulate the University of East Anglia on its accreditation through the GDC as a dental school. That is a huge step in the right direction, and we strongly support it. The next step is that the Office for Students has to allocate places. The Government have not funded any new dental school places since 2007. I am fighting hard for those dental places to be made available. We are quite close, I hope, to being able to share some positive steps on that. The OfS makes the decisions about allocating the places, but it does take advice from Ministers. My counterpart in the Department for Education and I will be sending a letter to the OfS, with some advice on how it should make decisions about where dental places should be made available, and the fact that UEA has a new dental school is an important factor in those considerations.
I welcome the General Dental Council’s recent announcement confirming the appointment of a new provider for the overseas registration exam—the ORE. The new arrangements are set to more than double the annual number of dentists able to join the register via that route, and it represents a significant step forward in addressing workforce shortages and NHS patient access. I met the General Dental Council at the end of last year to discuss its comprehensive plan to address the current ORE waiting list, and to urge it to get that waiting list sorted, because frankly the backlogs were not acceptable. We are looking at an increase in the supply of overseas qualified dentists joining the GDC register. I expect the measures to be taken by the GDC to deliver substantial improvements to the international registration processes, enabling increased numbers of overseas qualified dentists to join the register more swiftly and efficiently.
We know that prevention is better than cure. Alongside urgently needed reforms to treat existing poor oral health, I am committed to improving oral health in this country, not just for children, but the wider population too. Water fluoridation is an effective public health intervention for reducing the prevalence of tooth decay and improving oral health inequalities. Under this Government, we will see much needed expansion of water fluoridation in the north-east of England, with further feasibility studies for other parts of the country.
We are already investing in integrated care boards to support supervised toothbrushing for three-to-five-year-old children, and our innovative partnership with Colgate-Palmolive will support up to 600,000 children to develop good oral health habits for life. We are working with all sectors of the food industry to make further progress on reducing levels of sugar in the everyday food and drink that people buy. This is to ensure that it is easier for people to make healthier choices. Oral cancer and periodontal diseases are directly caused by tobacco. Dental teams and local stop-smoking services can work collaboratively in a variety of ways.
We have already made important progress, but I accept that there is still a lot more to do and a long way to go. We are determined to ensure that everyone who needs an NHS dentist can secure one. Delivering that ambition will take time, and it is vital that we put in place solutions that work for both patients and the dental professionals who care for them.
Question put and agreed to.
Dementia Support: Hampshire
Stephen Kinnock Excerpts(2 weeks, 3 days ago)
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The Minister for Care (Stephen Kinnock)
I really appreciate serving under your chairship, Ms Lewell—I think it is one of the first times I have done so.
I thank the hon. Member for Eastleigh (Liz Jarvis) for securing this debate; I know that dementia support in Hampshire is a cause that is close to her heart. It is also very close to my heart—sadly, I lost my mother to Alzheimer’s in December 2023—and I know exactly what the hon. Lady means when she talks about what a tough time it is for everybody concerned. I also thank her for her huge efforts to raise awareness of the condition, and for her active participation in the all-party parliamentary group on dementia. Although the hon. Lady has brought to the table the subject of dementia support in Hampshire, I hope she will appreciate that I will cast the net somewhat wider in my response, because it is important to see services in Hampshire in the broader context.
Almost 1 million people across the UK are living with dementia. Every one of those people, as well as their friends, families and carers, have their own unique and important story of living with dementia. Even those united by geography will have vastly different experiences. Our goal is to make sure that those experiences differ because we are all fundamentally different people with different thoughts, feelings and backgrounds, and not because of unequal access to diagnoses, health services or support. As I am sure everyone present will agree, it is vital that every person with dementia receives high-quality, compassionate care from diagnosis through to the end of life.
The first step in delivering great care and support for those living with dementia is ensuring that they are able to get a diagnosis. The Alzheimer’s Society’s recent survey on lived experience told us that 96% of people affected by dementia reported a benefit to getting a diagnosis. It is, therefore, our duty to ensure that as many people as possible can access that benefit.
We know that a diagnosis is the gateway to better care, support and potential treatments, and the least we can do is help those living with dementia, and their friends, families and carers, to step through that gateway. That is why we are committed to increasing diagnosis rates to the national ambition of two-thirds of those with dementia receiving a diagnosis. During the pandemic, we sadly dropped to lows of 61%. At the end of November 2025, the overall estimated dementia diagnosis rate for patients aged 65 and over was 66.5%, while the estimated dementia diagnosis rate for Hampshire was 64%. That is, of course, an overall increase from March 2020, due to sustained recovery efforts.
But even when they are armed with a diagnosis, many people have found that there is varying and unequal access to support. We know that our health system has struggled to support those with complex needs, including those living with dementia. People have braved incredibly difficult circumstances and faced hard, emotionally overwhelming conversations to get their diagnoses, and we cannot abandon them afterwards. That is why, under the 10-year plan, we will make sure that those living with dementia will benefit from improved care planning and better services. By 2027, 95% of those with complex needs will have an agreed care plan.
We have also committed to delivering the first ever modern service framework for frailty and dementia. This will help to deliver rapid and significant improvements in the quality of care and in productivity, and will be informed by phase 1 of the independent commission on adult social care led by Baroness Louise Casey, which is expected this year. The framework will seek to reduce unwarranted variation and to narrow inequality for those living with dementia. It will set national standards for dementia care and redirect NHS priorities to provide the best possible care and support.
We are committed to a well-supported adult social care workforce who are recognised as the professionals they are. The Department is supporting the professionalisation of the adult social care workforce through our recently expanded care workforce pathway, which provides a framework for progression and development opportunities so that people can build their skills and careers in care.
We launched a public consultation on the design of the fair pay agreement process—a major step towards implementing it in 2028. The consultation looked at how the process should operate, including who will be part of the negotiations and how the agreement will be implemented. The consultation closed on 16 January 2026. The regulations to establish the negotiating body and to bring together employer and employee representatives are expected to be laid this year. We expect negotiations on pay, terms and conditions and other matters such as training and career progression to be held in 2027. Once the body has reached an agreement on how the funding should be spent, the fair pay agreement will be implemented in 2028. The Government are backing that with a £500 million investment.
The 10-year health plan sets out how we will work towards a neighbourhood health service, with more care delivered locally to create healthier communities, spot problems sooner and integrate health into the social fabric of places. This is crucial for those living with dementia. Adult social care is part of our vision for a neighbourhood health service that shifts care from hospitals to communities, with more personalised, proactive and joined-up health and care services that help people to stay independent for as long as possible. Social care professionals will be a vital part of neighbourhood teams, working alongside the NHS to help people to stay independent for longer and playing an enhanced role in rehabilitation and recovery. Over time, the neighbourhood health service and the national care service will work hand in hand to help people to stay well and live independently.
I know it is disappointing that the National Institute for Health and Care Excellence has been unable to recommend the two new disease-modifying treatments for Alzheimer’s—lecanemab and donanemab—in the final draft guidance, but it is right that such decisions are evidence based and taken independently. NICE is a world-renowned health technology assessment body, and I remain confident in its methods and processes for ensuring that any new medicines recommended for use on the NHS provide the most health benefit at a cost-effective price to the taxpayer.
As announced in the life sciences sector plan, we are taking a number of measures to reduce friction and to optimise access to and uptake of new medicines. The measures will boost the speed of decisions and cut administrative burdens for the system and for industry. NICE and NHS England are doing the work to plan for the adoption of any new licensed and NICE-recommended treatments.
Research is crucial to support people living with dementia and their carers. The Government are investing in dementia research across all areas, from causes, diagnosis and prevention to treatment, care and support. The National Institute for Health and Care Research, which is funded by the Department of Health and Social Care, funds and supports impactful research. For example, NIHR infrastructure investment has supported the groundbreaking DROP-AD trial, which has shown that Alzheimer’s disease biomarkers can be detected using finger-prick blood samples. That is a really exciting development that brings us closer to accurate and timely diagnoses of dementia.
Research cannot take place without the incredible people who volunteer to be part of it. Through the NIHR, my Department works closely with charity partners in the delivery of joint dementia research. People with and without a diagnosis of dementia can use an online platform to sign up to take part in vital dementia research. I encourage everybody and anybody who might be watching this debate to register with the service, to help to shape the future for people living with dementia. We will continue to invest in dementia research in Hampshire and across the UK.
We recognise the vital role of unpaid carers and are fully committing to ensuring that they have the support they need. I chair a cross-Government ministerial group with the Department for Business and Trade, the Department for Education and the Department for Work and Pensions, all at the ministerial level. Through the measures in the 10-year health plan, we are equipping and supporting carers by making them more visible, empowering their voices in care planning, joining up services and streamlining their caring tasks by introducing a new “My Carer” section in the NHS app.
To support unpaid carers, on 7 April 2025 the Government increased the carer’s allowance weekly earnings limit from £151 to £196 a week—the equivalent of 16 hours at the national living wage. This was the largest cash increase since the carer’s allowance was introduced in 1976. As a result, more than 60,000 additional people will be able to receive carer’s allowance between 2025-26 and 2029-30.
We are reviewing the implementation of carer’s leave and considering the benefits of introducing paid leave for carers. On 19 November 2025, we published the terms of reference for the review of employment rights for unpaid carers, and in 2026 we will run a public consultation on employment support for unpaid carers. To help local authorities to fulfil their duties, including to unpaid carers, we are making around £4.6 billion of additional funding available for adult social care in 2028-29, compared with 2025-26.
I again thank the hon. Member for Eastleigh for bring forward such an important topic for discussion. Whether on research, the workforce or unpaid carers, we recognise that there is a tremendous amount to do. We have two work streams, one of which is the Casey commission, which will look at how we fundamentally rewire how we do care in our country, and the other is what the Government are doing immediately. We are not sitting on our hands and waiting for the Casey review; we are taking forward the measures that I have, I hope, outlined with sufficient clarity.
I absolutely recognise that there is a huge way to go. We have a mountain to climb on this. We are not going to fix our national health service unless we fix our care service; it is a deeply integrated ecosystem and we have to get both sides of it right. The 10-year plan and our plans for a neighbourhood health service are all about moving from fragmentation to integration, and that is the way we have to go if we are to get our health and care systems back on their feet and fit for the future.
It has been a real pleasure to respond to the hon. Member for Eastleigh. I hope I have reassured her that dementia is a priority for this Government, and that we are going to do all that we can to ensure that those living with dementia, and their loved ones and carers, are supported and cared for.
Question put and agreed to.
Oral Answers to Questions
Stephen Kinnock Excerpts(3 weeks, 4 days ago)
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Edward Morello (West Dorset) (LD)
The Minister for Care (Stephen Kinnock)
This Government are committed to ending the gaps in teeth by filing the gaps in local provision, including in rural areas such as Dorset. We will work to introduce fundamental changes to the dental contract before the end of this Parliament, but already from April the reforms to NHS dentistry that I announced last month will mean more NHS appointments and better oral health.
Edward Morello
NHS dentistry in West Dorset is in crisis. We have just 15 practices offering any kind of NHS care, and only half of young people have seen a dentist in the last two years. Residents are writing to me about elderly people removing their own teeth and children in A&E with preventable tooth decay. What consideration has the Minister given to requiring supervised trainee dentists on placement at dental training schools to work exclusively on NHS waiting lists rather than taking private appointments, which would help reduce the backlog?
Stephen Kinnock
The hon. Gentleman will have noted that we have committed to tie-ins for future dentists going through the training programme. It costs the taxpayer hundreds of thousands of pounds to train a dentist, and we believe it is absolutely right that a significant percentage of their time should be put into NHS dentistry.
In terms of improving access, in financial year 2023-24 there was a shocking £392 million underspend on NHS dentistry at a time when demand was going through the roof. I made clear that every penny allocated to NHS dentistry must be spent on NHS dentistry, and I am very pleased to report that we have got that underspend down to just £36 million. The decrease in the underspend is leading to an increase in NHS dentistry, but I accept that there is still a long way to go.
Mrs Sharon Hodgson (Washington and Gateshead South) (Lab)
Dr Neil Hudson (Epping Forest) (Con)
The Minister for Care (Stephen Kinnock)
Rapid housing and population growth can put real pressure on GP services. That is why we are investing an extra £1.1 billion in general practice, taking total GP funding to £13.4 billion. We are also creating 250 neighbourhood health centres, upgrading surgeries through a £102 million fund, and working with the Ministry of Housing, Communities and Local Government to determine how developer contributions from new housing, through section 106 and the community infrastructure levy, can be improved to enable the delivery of local health services as an integral part of new housing developments.
Dr Hudson
As my constituency neighbour, the Health Secretary will be aware that Chigwell parish has no GP surgery of its own, requiring many of my constituents to travel to his constituency to access primary care. Given the Government’s top-down housing targets, what assurances can the Health Secretary provide that any new developments in Epping Forest will be accompanied by the delivery of adequate primary care infrastructure, rather than placing further pressure on already overstretched services? Will the Government support the long-standing call, championed by me, local Conservative councillors and Chigwell parish council, for the provision of a GP surgery within Chigwell parish?
Stephen Kinnock
I am not familiar with the details of that case, but I get the impression that my right hon. Friend the Secretary of State is. A really important part of our manifesto commitment was to end the 8 am scramble, which is all about access, and that is precisely what we are doing. In September 2024, patient satisfaction with ease of access stood at just 61%; today it stands at 73%. That is huge progress. It is all about getting better access, and building a primary care estate that is fit for purpose is a very important part of that. I would be happy to meet the hon. Gentleman to discuss the details of that specific case.
Stephen Kinnock
I thank the hon. Gentleman for his question and congratulate him on the addition of the facial hair. I am glad to see that he is joining that particular club—I think it is the only club we may both be a member of!
The Government are aware of the pressure on pharmacy; it is a major challenge that we are facing. We gave pharmacy a 19% uplift in the last spending review. Of all the sectors in my portfolio, that was the one that received the largest uplift. We are also looking to secure better progress with the use of technology, and we are looking at the medicines margin and the dispensing fee, recognising the significant financial pressures that pharmacies are under. Through reform and investment, we believe that we can turn the corner and rebuild pharmacy in our country.
Dr Evans
I appreciate the Minister’s answer. However, the answer to my question is: 650 contracts across England and Wales. He only had to look at the newspaper headlines from yesterday to see that—this is his Department and his portfolio.
The chair of the Independent Pharmacies Association, Leyla Hannbeck, has specifically warned that higher business rates and increases in national insurance contributions, which are both set by the Government, are to blame and are driving up costs, while pharmacy income—which, again, is set by the Government—remains fixed. Does the Minister accept that those tax decisions taken by his Government directly increase the costs and contribute to the loss of pharmacy contracts, and will he therefore raise this matter with the Chancellor immediately?
Stephen Kinnock
I think there is some dispute over the number that was on the front page of the Express. We are looking into that number and will certainly come back to the hon. Gentleman on it. On his broader point about the decisions that the Chancellor took at the last Budget, I suppose I have a question back to him: would he be cutting the £26 billion that this Labour Government are investing in the NHS, and if not, how would he be paying for it?
Mr Speaker
I think just stick to the responsibility of being in government, Minister; don’t worry about the Opposition.
Melanie Onn (Great Grimsby and Cleethorpes) (Lab)
The Minister for Care (Stephen Kinnock)
As my hon. Friend knows, we inherited an NHS dentistry system in crisis. This Government are determined to fix it with fundamental reform of that vital service by the end of this Parliament. Since last April, we have delivered extra urgent dental appointments nationwide, and last month we announced new measures to get the right care to the right people at the right time, incentivising dentists to offer more NHS care.
Melanie Onn
The latest NHS statistics show that the Government really have the bit between their teeth as 7,000 more children saw a dentist in 2024-25 than in the previous year in the Humber and North Yorkshire integrated care board area. However, the rate for adults has slipped from 43% to 41% over the same period. How quickly does the Minister think that my adult constituents in Great Grimsby and Cleethorpes will benefit from more appointments and more dentists?
Stephen Kinnock
I congratulate my hon. Friend on the pun in her question. There is good news, in that we are making progress on children’s oral health, but we accept that we still have a way to go on the broader picture. We are making 27,196 additional urgent appointments available in the Humber and North Yorkshire ICB area. Our reforms, which I announced in December, will kick in from April of this year. They will significantly increase the unit of dental activity fee rate that we pay for urgent care to incentivise more dentists to do urgent NHS dentistry. We also have the golden hello system and a number of other measures that we are taking to address underserved areas. A lot has been done, but there is still a long way to go.
Topical Questions
Tom Collins (Worcester) (Lab)
Ben Goldsborough (South Norfolk) (Lab)
The Minister for Care (Stephen Kinnock)
We are committed to delivering 250 centres by 2035, with a progressive roll-out over this Parliament. Early sites are focused on areas of greatest need, with consideration of factors including deprivation and access. Integrated care systems are in the process of planning the best holistic local configuration of a neighbourhood service. I would be very happy to meet my hon. Friend to discuss the potential for a neighbourhood health centre for Long Stratton.
Mr James Frith (Bury North) (Lab)
Stephen Kinnock
My hon. Friend is right that NHS mental health, ADHD and autism services have never fully met the needs of the population in a tailored, personalised or timely way. The independent review into prevalence and support for mental health conditions, autism and ADHD will explore the current challenges facing clinical services. My hon. Friend the Minister for mental health is currently overseas on departmental business, but I am sure that he would be delighted to meet my hon. Friend on his return.
Ian Roome (North Devon) (LD)
Stephen Kinnock
We are in negotiation with the British Dental Association about the long-term contract reform that is so clearly needed, but I also draw the hon. Member’s attention to the announcement I made in December about a range of interim reforms, particularly on urgent work, where we are significantly increasing the fee rate for urgent dental activity. That will kick in from April and will make a real difference in access to urgent care.
Sojan Joseph (Ashford) (Lab)
Mr Jonathan Brash (Hartlepool) (Lab)
Stephen Kinnock
My hon. Friend is right that, although we are making progress on urgent treatment with the urgent dental access centre that he mentioned, there is a real challenge with new routine care in Hartlepool. We are looking to improve that unacceptable situation, which we inherited, by offering dentists £20,000 to work in underserved areas and making it a requirement for new dentists to practise in the NHS. However, he is right to point out that the situation is not acceptable and we have to improve it.
Simon Hoare (North Dorset) (Con)
The Government’s interim dental measures will of course be welcomed by residents in North Dorset, but they know, as I do, that we in this place have been discussing the inadequacy of the dental contract for years. What they and I cannot understand is why it will take until the end of this Parliament, as the Minister told us just a little while ago, and not sooner, to sort out that big problem and turbocharge NHS dentistry in rural North Dorset.
Stephen Kinnock
I have a huge amount of respect for the hon. Gentleman, but I have to say that I am a little taken aback to be told about the lack of progress when the Conservatives had 14 years to sort out NHS dentistry. Nevertheless, we are engaging intensively with the BDA. The interim reforms, which kick in from April, will make a big difference, as I have said, but we are looking to put the long-term reforms in place from 2027 onwards. We want this situation to be rectified by the end of this Parliament, not to have a new contract by the end of this Parliament.
Dame Caroline Dinenage (Gosport) (Con)
I was fascinated by the Minister’s earlier answer about the closure of pharmacies, because there has been fantastic news in Lee-on-the-Solent in my constituency: a new pharmacy wants to open there. Local people are desperate for a second pharmacy in Lee-on-the-Solent and the local GP practice supports it. The problem is that the Hampshire ICB has rejected it. Does the Minister share my disappointment that local people are not going to be served in the correct way by pharmacy provision, and will he meet me to discuss this?
Stephen Kinnock
That does sound somewhat baffling, given that there is demand for the service. Pharmacies play an absolutely vital role in our communities. I would be happy to meet the hon. Lady to discuss the details further.
Emma Foody (Cramlington and Killingworth) (Lab/Co-op)
Stephen Kinnock
My hon. Friend is absolutely right to point out this issue. As I have said, the reforms that we announced in December will make a major difference, because dentists have not been incentivised to do NHS dentistry. That requires us to significantly increase the UDA, as we are doing, but there is a range of other measures that we need to take. I would be happy to meet my hon. Friend to discuss the specific details of that case.
Shockat Adam (Leicester South) (Ind)
Failed private finance initiative schemes from the noughties in three Leicester hospitals resulted in the NHS being sued for almost £30 million, despite no work being carried out. Leicester hospitals are still without any new buildings. I ask the Minister that expensive, inefficient financial packages—£60 billion of private money costing £306 billion of taxpayers’ money—not be utilised for future projects.
Rachael Maskell (York Central) (Lab/Co-op)
To date, Baroness Casey’s review of adult social care has been pretty impenetrable, but in York we want to engage and innovate. Will my hon. Friend provide Parliament with a briefing on the progress, scope and scheduling of the review? The clock is ticking and the crisis is growing.
Stephen Kinnock
My hon. Friend and I have discussed this matter. I hope that her issues in accessing the commission, which I know has made contact with her, have been resolved. The commission is, of course, an independent body, but I am in no doubt at all that parliamentarians will hold it to account through the mechanisms at their disposal—the Select Committee, for example. The Government are not sitting on our hands; we are delivering the fair pay agreement, we have delivered the biggest uplift to unpaid carers since 1976, and we are pursuing a range of other measures to get our adult social care system fixed and fit for purpose.
Sarah Bool (South Northamptonshire) (Con)
We have just been notified that William Blake House in my constituency—a residential home for people with severe learning disabilities—has been issued with a winding-up notice, and the court hearing is tomorrow. The families were given no notice of any of this, and no consultation was carried out, so naturally they are worried about what provision will be in place for their loved ones. Will the Minister meet me urgently to discuss putting a contingency plan in place for them?
Stephen Kinnock
I thank the hon. Lady for that question. I am not familiar with the details, of course, so might she write to me with the clear details? I am sure that officials will then take the matter up as a matter of urgency.
Matt Bishop (Forest of Dean) (Lab)
Parents supported by Harry’s Pals, a small charity, consistently describe the fragmented and emotionally exhausting system of accessing support for children with life-limiting conditions. Will the Secretary of State commit to exploring a dedicated national support pathway for parent carers, including better access to counselling and respite, and will he meet me and Hayley Charlesworth, the founder of Harry’s Pals, who is watching at home today with Harry, to discuss how we can better support families in the Forest of Dean and nationally?
Alex McIntyre (Gloucester) (Lab)
Last Friday, I went on a visit to my fantastic local GP service, Hadwen Health. The team there are already using technology and AI to make sure patients get the right care that they need, but they told me that there is currently no technological solution that allows patients to both be triaged and directed to their hard-working family doctor when booking online. What steps is the Department taking to support the roll-out of technology in GP surgeries like Hadwen Health in Gloucester?
Stephen Kinnock
I am a little bit surprised; I think that that technology does exist. I have visited a couple of GP practices where the online booking system gives the patient the option to specify the doctor that she or he would like to see. I would be happy to connect my hon. Friend with relevant officials in the Department, so that they can connect with the GP surgery to resolve that issue.
Andrew Lewin (Welwyn Hatfield) (Lab)
In NHS Providers data published just before Christmas, we learned that in East and North Hertfordshire NHS trust, the number of people waiting for treatment has fallen more than in any other trust in the country. That is fantastic news for my community. Will my right hon. Friend commend all the staff involved in this success, and does he agree that this is precisely what people voted for when they voted for change in the NHS?
Zöe Franklin (Guildford) (LD)
In Bellfields and Slyfield ward in my constituency, the local GP surgery is squeezed into a unit that is part of a parade of shops, and it is clearly no longer the size needed for the growing community. The team do a great job in spite of the challenges. Will the Minister set out the steps the Department is taking to support community health hubs in areas like this ward, in order to bring GP and wider services together locally and improve facilities and access for my residents?
Stephen Kinnock
We have the £102 million primary care estate fund, which can help with refurbishments and improving the functionality of primary care, particularly GP surgeries. If the hon. Member writes to me about the specifics of that case, I am sure that the relevant officials can give her the answer she needs.
James Wild (North West Norfolk) (Con)
The Health Secretary has said he is “shocked” at the inability to acknowledge and then remedy state failures. It is now two years since the Hughes report was published, but no timeframe has been set for compensation for the valproate scandal. When will my constituents Colleen and Andy get the redress they need, so that they can make long-term provision for their son?
Sonia Kumar (Dudley) (Lab)
A constituent of mine who attends Dudley Voices for Choice has autism with complex mental health needs and is at risk of self-harm. Despite not being able to use a telephone, they are still required by mental health services to do so, and therefore they cannot be treated. They were told that they are non-compliant, so their support was reduced. What steps is my right hon. Friend taking to ensure that mental health services offer alternative ways to communicate for those who cannot use a telephone? I would like to thank Sarah Offley and the team at Dudley Voices for Choice.
Stephen Kinnock
We are recruiting 8,500 more mental health workers by the end of this Parliament. The Mental Health Act 2025 reforms will ensure that people with a learning disability, autistic people and people with the most severe mental health conditions have greater choice and control over their treatment and receive the dignity and respect they deserve.
Blake Stephenson (Mid Bedfordshire) (Con)
Constituents of mine have been reporting that they have been directed to hospital for regular blood tests, rather than having them at their GP surgery. Will the Secretary of State outline how he will ensure that blood tests are done in a community setting, which surely must be much better value for the taxpayer and much more convenient for patients?
Community Audiology
Stephen Kinnock Excerpts(1 month, 2 weeks ago)
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Sir Edward Leigh (Gainsborough) (Con)
I congratulate the hon. Member for Uxbridge and South Ruislip (Danny Beales) on moving this timely motion. I declare an interest: I am someone who suffers from hearing loss—it is good to be honest about these things. I recently found a picture of myself in uniform in the pouring rain, looking very miserable in Germany or on Salisbury plain, leaning against a 25-pounder. I can assure Members that those guns went off next to my ear on many occasions, and it is a very loud bang indeed.
I am not alone in suffering from some hearing loss. As the hon. Gentleman made clear, if we group together deafness, hearing loss and tinnitus, some 18 million people in the UK are affected by hearing conditions. Of those among us who are 55 or over, more than half suffer from hearing loss, as he said. Of those of us who are 70 and older—Mr Vickers, you and I were born just weeks apart—over 80% have some form of hearing loss. Some 2.4 million adults across Britain have hearing loss that is severe enough for them to struggle with conversational speech in some situations.
We all know that an ounce of prevention is worth a pound of cure. That is even more true in medicine than in any other walk of life. I am one of 2 million people in the UK who use a hearing aid. People should not be ashamed of using a hearing aid. People are not ashamed of wearing glasses—the Minister, Mr Vickers, and the distinguished consultant from Suffolk, the hon. Member for Bury St Edmunds and Stowmarket (Peter Prinsley), are all wearing glasses. It is a fact of life, and we should support people.
The British Academy of Audiology estimates that there are 6.7 million people who could benefit from a hearing aid but do not currently use one. The impact is not limited to wives, irritated that we have not heard them—although I must admit that if someone is known in the family to have hearing loss, it is very convenient. I am frequently ticked off by my wife because I am generally completely useless, and sometimes I pretend I have not heard her, so there are some benefits.
Sir Edward Leigh
At the risk of giving in to economic reductionism, there is a significant impact on the economy. The Royal National Institute for Deaf People has estimated that untreated hearing loss costs the UK economy around £30 billion per year in lost productivity. Adults of working age with hearing loss have an employment rate of 65%, compared with 79% for those without any disabilities. Hearing loss has a social cost as well, as it has an impact on daily life and often increases isolation. Too often, we are embarrassed by hearing loss when we should be tackling it head on.
Another problem is a lack of audiologists. Unwisely, the Government have maintained the cap on the number of people allowed to study medicine—a restrictive measure that the doctors’ unions cling to regressively. The first priority should be the health of the public. We should allow anyone who meets the high standards that we expect of those studying medicine to do so.
Instead, the doctors’ unions ensure there is a lack of domestic supply to protect their bargaining position, but that means we are forced to make up the shortfall by importing doctors from other countries, often less developed ones. Many countries, not just fully developed ones, have high standards of medical education. It seems to me, and to many others, morally dubious for the NHS to pick the cream of doctors from any developing country and bring them here. Their diligence, training and expertise are much needed in their home countries. Meanwhile, we have excellent people here who cannot get into medical school—not because they are not good enough, but because the numbers are capped.
The shortfall in audiology is yet another reason why we need to address this issue. We have over 3,000 registered audiologists working in the UK, across the NHS, the private sector and educational settings. Figures from the British Academy of Audiology show that 48% of services have reported reduced staff, with an overall decline of 8% in the audiology workforce. Nearly one in 10 clinical posts in audiology are currently vacant, and 65% of audiology services have at least one vacancy. Those shortages exist across multiple salary bands, from junior to senior clinicians.
I am not blaming this Government, by the way; I am not being party political. This problem is the fault of successive Governments and Health Secretaries, who have failed to address it. Back in 2006, the Royal National Institute for Deaf People pointed out in evidence to the Health Committee:
“A recent NHS workforce project has suggested an additional 1,700 qualified audiologists are required to cope with current pressure. This could take between 10 and 15 years to realise under the current training programmes.”
That was back in 2006, so what has happened since then? It will not surprise the experienced observer that not enough action was taken. Hearing loss is one of the most prevalent long-term conditions in England, yet it is often treated as a low-priority service. If we treated it as a core part of prevention and independence, the rewards would be innumerable. As I said, an ounce of prevention is worth a pound of cure.
Demand for audiology services is rising, and the International Longevity Centre estimates that by 2031, one in five Britons will have hearing loss. There is at least increasing public awareness, but with an ageing population, the demand for audiology services is rising. That puts additional pressure on the workforce and on service capacity. Community audiology should not be a marginal service. It is a preventive intervention with clear implications for the wellbeing of individuals and families, economic productivity and long-term public spending. Delivering audiology close to home is ideal, particularly for older patients and those managing long-term conditions.
The current model relies heavily on local commissioning decisions. There is wide variation in access, as well as in the scope and quality of provision across England. Patients in some areas benefit from straightforward self-referral and timely community services, while others face longer waits or unnecessary hospital referrals. I suspect that the service in London and other big cities is better than that in our home county of Lincolnshire, Mr Vickers.
We need to improve the way we collect data on audiology services, so that we can evaluate their impact across the country. Good data will help us to focus on outcomes, as any reform should. National minimum service standards would provide clarity without imposing uniform delivery models. We should preserve local flexibility while ensuring that patients know what level of service they are entitled to expect. Community audiology should be integrated into broader prevention and healthy ageing strategies.
Hearing care supports people to remain economically active and socially connected for longer. That is immensely central to maintaining human dignity as we all get older. Early intervention reduces downstream costs in social care and mental health services. The social and economic impact is huge. There is much we can do now that will produce worthwhile results, so we need action from the Minister.
The Minister for Care (Stephen Kinnock)
It is a pleasure to serve under your chairship, Mr Vickers. I start by thanking my hon. Friend the Member for Uxbridge and South Ruislip (Danny Beales) and congratulating him on securing this important debate. Having now been in the same room as a specialist in ear, nose and throat, a former GP and a vet, I am not sure that I am entirely qualified, and I approach this debate with some trepidation. I certainly enjoyed the debate and, as the Father of the House rightly said, it was a privilege to be able to hear some of the insights, direct experience and expertise of hon. Friends and Members.
My hon. Friend the Member for Uxbridge and South Ruislip has also been doing a huge amount of good work in promoting the flu vaccine ahead of winter, in his constituency and more widely, and I pay tribute to him for that. It was a pleasure to visit his constituency a few weeks ago, where I met the incredible team at the Pembroke centre in Ruislip Manor to hear about how they are delivering, designing and developing their thoughts about neighbourhood health hubs and the neighbourhood health service, which will be a pivotal part of our 10-year plan.
The Royal National Institute for Deaf People estimates that one in five people in the UK—almost 12 million adults—are deaf, have hearing loss or experience tinnitus, and by 2035 that figure is projected to rise to over 14 million. For people with cognitive disabilities, hearing loss can have a real impact on their quality of life, causing confusion for people with dementia, making communication and social interaction more difficult and increasing loneliness and isolation.
That is why our community audiology services are so important. They represent a comprehensive range of hearing care delivered in local, accessible settings, such as GP surgeries, community clinics and community diagnostic centres. They help people of all ages, offering assessments, hearing aid fittings and support for those with tinnitus and balance issues. They advise on equipment such as amplified telephones and alerting devices, while working alongside occupational therapists to support people to stay independent. They form part of a wider team with speech, language and other community services, acute care, and the ear, nose and throat department for issues that cannot be managed in the community.
Community audiology services face challenges, particularly on waiting lists and inequality of provision. Members across the Chamber raised some of those points. The Father of the House rightly pointed out that there are 6.7 million people who should use a hearing aid but do not. We must overcome the stigma associated with hearing loss.
The hon. Member for Honiton and Sidmouth (Richard Foord) was right to talk about the connection between hearing loss and the propensity for falls. My hon. Friend the Member for Bury St Edmunds and Stowmarket (Peter Prinsley) shared his tremendous expertise as an ear, nose and throat surgeon, and I thank him for his insights about the Hear for Norfolk project, which is a very interesting model indeed. Perhaps we can follow up on it in the new year.
The hon. Member for Winchester (Dr Chambers) gave a remarkable exposition on hearing loss in dogs—I have to say that I did not have that on my bingo card for this afternoon—from which we all learned a tremendous amount. He also made a number of important points about hearing loss in humans, and we absolutely take them on board.
The hon. Member for Hinckley and Bosworth (Dr Evans) rattled off a number of questions for me, and I desperately tried keep track of them. I got some of them and did not get others, so I will happily write to him on the points that I am unable to address now. He raised an important point about self-referral, which of course depends on local commissioning arrangements. There is inequality and unwarranted variation in the ability to self-refer. We want more self-referral. We think there are opportunities in upgrading the functionality of the NHS app. Our objective is absolutely to be able to do this without having to go through a GP. There are some technology-related solutions, but I want to assure him that there is no conscious decision from the Government to deprioritise self-referral; I just think that there are some variations.
The old chestnut that we are constantly trying to crack is around devolving to ICBs the power and agency that they should have because they are closest to the health needs of their population, while ensuring that they are clear about the outcomes, frameworks and standards that we expect. We honestly hold our hands up and say that we have not got that right in all cases, but we are committed to self-referral as a principle and as a really important part of the shift from hospital to community.
On ICB budgets, we have secured £6 billion through the spending review process for capital upgrades. A lot of that will help us to ramp up what we are doing on community diagnostics. That is one way to square the circle around the investment that we need on the ground for ICBs to be able to do more in terms of the services they provide by improving the equipment, the kit and the technology they have. Part of the answer to the hon. Member for Hinckley and Bosworth’s question relates to capital investment really helping to boost the services provided.
The workforce plan is coming in the spring of 2026. I absolutely hear what the hon. Member says about the need to move forward on that. It has been a complex process. Obviously some of the changes and restructuring around what we are doing on NHS England have also had an impact on the process of putting the workforce plan together, but I am reliably informed that that will be in the spring of 2026.
Timely access and effective support to services can make all the difference to someone’s quality of life, wellbeing and independence. As part of our effort to shift care from hospital to home, this Government want to support people to live independently in the community, and community audiology will play an essential part in making that happen. Community audiology is commissioned locally by integrated care boards. Funding is allocated to ICBs by NHS England. Each ICB commissions the services it needs for its local area, taking into account its annual budget, planning guidance and the wider needs of the people that it serves.
This year, my right hon. Friend the Chancellor confirmed the Government’s commitment to getting our NHS back on its feet and fit for the future, with day-to-day spending increasing by £29 billion in real terms over the next five years. By the end of this Parliament, the NHS resource budget will reach £226 billion. That funding will support the growing demand for community health services, including audiology. It will help integrated care boards to expand diagnostic capacity, invest in local estates and equipment, and sustain the workforce needed to deliver high quality hearing care for patients of all ages. For the first time, we have published an overview of the core community health services, which include audiology, for ICBs to consider when planning for their local populations and commissioning processes.
Our medium-term planning framework for the next financial years sets out our ambition to bring waiting times over 18 weeks down, develop plans to bring waits over 52 weeks to zero, and to increase capacity to meet growth in demand, which is expected to be around 3% nationally every year. We are asking systems to seek every opportunity to improve productivity and get care closer to home, from getting teams the latest digital tools and equipment they need so they can connect remotely to health systems and patients, to expanding point-of-care testing in the community. Systems are also asked to ensure that all providers in acute, community and mental health sectors are onboarded to the NHS federated data platform and use its core products.
Our 10-year health plan sets out how we would make the shift from analogue to digital by making the NHS app the digital front door to services. We will make it easier for patients to access audiology services through self-referral. This will transform the working lives of GPs, letting them focus on care where they provide the highest value-add. This is how we will make sure everyone can self-refer—not just the most confident and health-literate. Patients can access NIH-funded audiology services directly without having to wait for a referral from their GP. That means improved access to care and shorter waiting times.
My hon. Friend the Member for Uxbridge and South Ruislip and other hon. Friends stood, as I did, on a manifesto to halve health inequality between the richest and poorest areas of our country. I know he will agree that access should not be based on where we live. A key part of our elective reform plan, published at the start of the year, is transforming and expanding diagnostic services so we can reduce waiting times for tests and bring down overall waits. NHS England is working closely with services to improve access to self-referral options, aiming for a more consistent offer right across the country.
Dr Luke Evans
I am grateful that a comprehensive plan is coming forward. One problem we have is joining the leadership up. The Kingdon review, which was launched in May and finished in November, made 12 recommendations that will help align with all the missions the Minister is bringing forward. Can he tell us when the Kingdon review will be accepted and analysed by the Government, and their position on the recommendations, because it is a key thread to delivering all the ambition that he has rightly put forward?
Stephen Kinnock
I can—we are absolutely committed to responding to the Kingdon review next year. We are working on pulling together our response to the report. It is extremely important, and there are serious lessons to be learned from it. We think Dr Kingdon has done an excellent piece of work, and we are very keen to build on it and take it forward.
Community diagnostics, such as local hearing assessment clinics and testing in community settings, are being rolled out more widely through the expansion of our community diagnostic centres. We are opening more of these centres—12 hours a day, seven days a week, offering more same-day tests, consultations and a wider range of diagnostics. I am very proud that we now have 170 CDCs across England.
Almost 2 million audiology assessments have been carried out by NHS staff since this Government took office, including 136,000 tests in October—the highest number of audiology tests for a single month in the history of the NHS. This is a crucial step in supporting the NHS to meet its constitutional standards and deliver quicker care to patients. I also want to salute the work of the Welsh Government, who have been pioneers in many respects with their plan, published this week, showing how Wales is also leading in audiology services on care in the community, training and infrastructure.
The hon. Member for Hinckley and Bosworth asked about the Kingdon report, and in this debate on audiology services, I must take this opportunity to thank Dr Camilla Kingdon for the excellent review that she chaired into failures in children’s hearing services. As I have just told him, the Government are committed to responding to the recommendations made by Dr Kingdon, and we will publish a comprehensive response next year.
Community audiology services face challenges, with long waits and inconsistency in access to services, but we are taking action through the medium-term planning framework, by expanding community diagnostic centres and as an integral part of our 10-year plan. My hon. Friend the Member for Uxbridge and South Ruislip and I come from a political tradition based on solidarity, and this Government stand for a health service that leaves no person behind. I know that he shares my determination to get timely access to community audiology services for all 12 million of our compatriots who need them.
I thank my hon. Friend once again for bringing forward this extremely important debate, and I thank all Members who have spoken. It only remains for me to wish you, Mr Vickers, as well as your entire team and everyone else in the Chamber, all the very best for Christmas and the new year.
Palliative Care: North Derbyshire
Stephen Kinnock Excerpts(1 month, 3 weeks ago)
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The Minister for Care (Stephen Kinnock)
It is a real pleasure to serve under your chairship, Dr Huq, and I really thank my hon. Friend the Member for Chesterfield (Mr Perkins) for raising this important issue.
This year, I have seen at first hand—at the Wigan and Leigh hospice, the Noah’s Ark Children’s hospice in Barnet, and Katherine House hospice in Staffordshire—the vital role that hospices play in our communities, so I completely understand why my hon. Friend speaks so passionately about Ashgate hospice. And I will take a moment to thank everyone working or volunteering in the hospice care sector over Christmas, especially those who are spending Christmas day away from their own families just to bring a bit of joy to the people they care for.
This Government want a society where every person receives high-quality and compassionate care, from diagnosis through to the end of life. Hospices and wider palliative and end-of-life care services will play a key part in our efforts to shift more care out of hospitals and into the community. However, we inherited a palliative and end-of-life care system that is under pressure and we absolutely recognise the financial challenges that hospices face as a result of rising costs and reduced charitable income.
Let me echo what my hon. Friend said by also commending his constituents who came together to put their time, effort and money into fundraising. The fact that they managed to save two beds at Ashgate hospice from closing shows how important the hospice is to the wider community, even if challenges clearly remain.
Most hospices are charitable and independent organisations that receive some statutory funding for providing NHS services. The amount of funding that charitable hospices receive varies, both within and between ICB areas. Such variation can often be explained by the level of demand in a particular area, but it can also be explained by the totality and the type of provision from both NHS services and non-NHS services, including charitable hospices, within each ICB area.
Although the majority of palliative and end-of-life care is provided by NHS staff and services, of course voluntary sector organisations also play a vital part in supporting people at the end of their life. That is why a year ago, almost to the day, we announced a £100 million capital funding boost for adult hospices and children’s hospices, in order to ensure that they have the best physical environment in which to provide care.
Ashgate hospice is receiving over £845,000 of that money over the two years of funding and Blythe House hospice, another hospice in north Derbyshire, is receiving just under £160,000. All of this capital funding is a once in a generation investment into hospices in England, which will guarantee future savings by making them more sustainable, including by fixing draughty windows, repairing old boilers, installing solar panels, fixing roofs, etc.
We are also providing £26 million in revenue funding to support children and young people’s hospices that serve north Derbyshire. This year, Bluebell Wood children’s hospice is receiving £986,000, and Rainbows hospice for children and young people is receiving £1,462,000. Our priority was to protect children’s hospices from facing a cliff edge of yearly funding cycles through multi-year settlements, so we were delighted to confirm that this funding would be in place for the next three financial years. This money will be at least £26 million each year, adjusted for inflation, allocated via ICBs to children’s hospices in England, or around £80 million over the three years in total.
Having said all that, I do not for one second want to give the impression that I am downplaying the issues that my hon. Friend the Member for Chesterfield has raised, nor do I believe that this money is a silver bullet for all the issues we face. As he points out, integrated care boards are responsible for the commissioning of palliative care services to meet the needs of the people they serve. My understanding is that what NHS Derby and Derbyshire ICB calls its core contract value—the baseline funding in the contract with Ashgate hospice—has increased by 55% since 2022, which represents a higher share compared with uplifts the ICB has provided for other NHS services through its hospital trusts and other providers.
I am aware that the ICB has been working with the Ashgate team over several months to understand why their costs have risen significantly over the last financial year. It has also offered £100,000 towards an independent review, which would be linked to a future service specification—in other words, the way in which the ICB provides funding to the hospice in future. Derby and Derbyshire ICB has committed to develop a new service specification for palliative and end-of-life care to inform its contracting going into 2026-27, and to engage on a new model of palliative and end-of-life care across the ICB cluster, aligning to the three shifts set out in the 10-year plan and delivered through the neighbourhood health model of delivery.
However, it is clear from my hon. Friend’s speech that there are two sides to this story. It appears that there is a gulf in understanding between the ICB on the one hand and the management team of Ashgate and the community on the other—that is clear from everything my hon. Friend has said and from other interventions. I would therefore be more than happy to broker a discussion between the ICB, concerned Members of Parliament and the hospice to get to the bottom of what is going on, so that everyone is on the same page as to what is happening with the costs, where the problems lie in terms of provision and ensuring we do everything we can to retain this vital service. It feels like the dialogue between the ICB and the management team at the hospice is not working, and I am more than happy to intervene, to help to make that work. Perhaps I could sit down and discuss that further with my hon. Friend and other colleagues.
As I said earlier, the delivery of healthcare is largely devolved in England, and ICBs are responsible for the commissioning of palliative care services to meet the needs of local people. Beyond the £100 million of capital funding and the £80 million of revenue funding for children’s hospices, we are not able to offer additional funding from the centre as things stand, although we are looking at and exploring other opportunities. As I told the sector in a speech to the Hospice UK conference in Liverpool last month, I know that this is not the message the sector wants to hear, and it is certainly not the message that I want to deliver. But with the public finances in the state they are in—the state that we inherited them in—I have to recognise that the Chancellor has made some tough trade-offs to support our public services, especially the NHS, in the context of our debt interest payments surpassing the entirety of our education budget as things stand.
In these challenging circumstances, we are trying to support the sector in other ways. We are developing the first ever palliative care and end-of-life care modern service framework, or MSF, for England. That will be aligned with the ambitions set out in our 10-year health plan. We will closely monitor the shift towards strategic commissioning of palliative and end-of-life care services to ensure that services start bringing down variation in access and quality. While there is a lot of diversity in contracting models across the hospice sector, we will consider contracting and commissioning arrangements as part of this framework. In the long term, this will aid sustainability and help hospices to plan ahead.
The MSF will not just drive improvements to services that patients receive at the end of life; it will start helping ICBs to address challenges and variation in access, quality and sustainability. Further support is being provided to ICBs through the recent publication of NHS England’s strategic commissioning framework and medium-term planning guidance, which set out in black and white how ICBs should understand current and projected demand on services and associated costs, creating an overall plan to more effectively meet these needs through neighbourhood health. The medium-term planning guidance acknowledges the importance of high-quality palliative and end-of-life care. The guidance makes it clear that, from April next year, ICBs and providers must focus on reducing unnecessary non-elective admissions and bed days from high-priority cohorts—which include, importantly, people with palliative care and end-of-life care needs—and on enabling patients who require planned care to receive specialised support closer to home. That will be at the heart of the neighbourhood health service that we look to build. It is important to emphasise that the cohort of people who are reaching the end of life is a prioritised cohort within the framework of the shift to a neighbourhood health model.
I hope that those measures will reassure my hon. Friend the Member for Chesterfield of this Government’s commitment to the sustainability of the palliative and end-of-life care sector, including hospices such as Ashgate hospice. We will continue to work with NHS England in supporting ICBs to effectively commission the palliative and end-of-life care that is needed by their local populations. The work that our hospices do to support people in the sunset of their lives, to support families in their grief and to give such families bereavement counselling at their most vulnerable moments is utterly priceless. It is a sad reflection of the dire fiscal position that we inherited and the dire state of our public services in general that we cannot give more than the extra support that I have outlined, but we are doing everything that we can to support the sustainability of the sector in the long term while tackling inequalities and unwarranted variation in the quality and quantity of service provision.
To sum up, strategic commissioning of palliative and end-of-life care services is not working anything like as well as we want, frankly, across the country. It is clear that where there are gaps in an ICB’s understanding of the totality of the health and care needs of its population and in the capacity of partners and stakeholders in its ICB area to meet those needs, that process is not working as well as it needs to. That is what the modern service framework for palliative and end-of-life care seeks to address. We do not have many MSFs—we have commissioned, I think, three or four in total across the entirety of what the Department of Health and Social Care is doing—so that MSF reflects the importance that we attach to palliative and end-of-life care.
In the medium-term planning guidance, we have also emphasised that the palliative and end-of-life care cohort will be a top priority for our neighbourhood health strategy and the shift from hospital to community. That is what is happening at the strategic level, but I understand that at the constituency level, it also matters what is really happening for the community of my hon. Friend the Member for Chesterfield and the worrying issues around Ashgate hospice. On the detail of what is going on there, I would be very happy to work with him to see what we can do with the ICB and other key players and stakeholders to address the specifics of that issue. There is a strategic challenge, but also an opportunity, for us and a more specific issue on which I would be happy to work with him. Dr Huq, I am happy to give the floor back to my hon. Friend for any closing remarks he wishes to make.
Dr Rupa Huq (in the Chair)
This is a 30-minute debate so, as I said in the preamble, a wind-up speech is prohibited, but the two of you can confer after the debate.
Mr Perkins
I welcome tremendously what the Minister said. It is important to get on record the 55% increase since 2022 because many people contact me to say, “Why have you made cuts?”. Actually, though Ashgate has a £250,000 a month shortfall in what it is spending, there have not been any cuts—it is important that people understand that. I welcome the Minister’s intention to broker a discussion; I am keen to take him up on that offer. Neither staff nor fundraisers are sure of what they know on this issue. They would welcome someone independent coming in to provide that space between the ICB and the hospice. I welcome what the Minister said about the neighbourhood funding model and his recognition that the sector is in crisis, but right now we need, on a local basis, to address the matters that he has raised. I thank him for his commitment to do so.
Stephen Kinnock
We have a plan for next steps and I look forward to discussing those with him further.
Motion lapsed (Standing Order No. 10(6)).
Government Response to NHS Dentistry Consultation: Quality and Payment Reforms
Stephen Kinnock Excerpts(1 month, 3 weeks ago)
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The Minister for Care (Stephen Kinnock)
I wish to update the House following the Government’s recent public consultation on quality and payment reforms to the NHS dentistry contract.
Restoring NHS dentistry is one of the Government’s top priorities.
The Government remain committed to fundamental reform of the dental contract by the end of this Parliament, with a focus on matching resources to need, improving access, promoting prevention and rewarding dentists fairly, while enabling the whole dental team to work to the top of their capability. This is our ambition, and it will take time to get right.
We held a public consultation over July and August, on a package of proposals to address some of the pressing issues that dentists and dental teams are experiencing. Ensuring payment reflects the support patients require, creating a culture that rewards and improves quality of care, and further embedding the principles of skill mix within NHS delivery are all critical steps to improve access to NHS dental services for those who need it most.
We received over 2,250 responses to the consultation, including from members of the dental sector as well as members of the public. I want to thank those who shared their thoughts and experiences, which have helped us to refine our proposals.
Overall, the response to the consultation was positive and therefore the Government intend to proceed with implementing all the proposed changes, with some adjustments to specific proposals in response to consultation feedback. For example, we have revised and improved the payment structure for the unscheduled and urgent care proposal, to work better for dentists and patients.
The final set of changes are designed to help deliver our mission to build an NHS fit for the future, and are intended to:
secure the manifesto commitment to provide additional urgent dental care appointments by embedding urgent care into the dental contract, supported by increased payments for dentists delivering this care, making it easier for patients to get rapid support for urgent dental needs through the NHS;
introduce new clinical and payment structures specifically designed to provide better care for patients with gum disease or significant decay who require more intensive treatment;
support increased use of cost-effective evidence-based prevention interventions for children, reducing the opportunities for tooth decay;
introduce a new payment for denture modifications, relining and repairs, better supporting providers to manage the costs associated with delivering these treatments;
support a reduction in clinically unnecessary check-ups, helping dentists to focus care on patients with the greatest need and avoiding patients being overtreated, and therefore overcharged for care;
improve care quality by introducing quality improvement activities and funded appraisals, allowing teams to focus on the quality of care they deliver and to evaluate performance; and,
provide support to the profession by extending discretionary support payments and developing a model contract and NHS handbook for dental teams, helping them to feel part of the wider NHS.
The proposed changes are intended to deliver benefits for both patients and the profession and represent a move away from some of the features of the current unit of dental activity payment model, which dental teams have told us is a barrier to delivering NHS care.
The Government will introduce the proposals from April 2026 onwards and the specific timing for the delivery of each proposal will be communicated to the sector in due course.
These changes build on the Government’s wider dental rescue plan, including providing additional urgent dental care appointments and £11 million in 2025-26 for the national supervised toothbrushing programme for three to five-year-olds including over 4 million free toothbrushing products in the most deprived areas to protect children’s teeth, thanks to a groundbreaking partnership between the Government and Colgate-Palmolive. In addition, community water fluoridation will be expanded across the north-east of England, to reduce tooth decay and inequalities in dental health.
[HCWS1172]
Mental Health Bill [Lords]
Stephen Kinnock ExcerptsMonday 8th December 2025
(1 month, 4 weeks ago)
Commons ChamberRead Full debate Mental Health Act 2025 View all Mental Health Act 2025 Debates Read Hansard Text Watch Debate Read Debate Ministerial Extracts Amendment Paper: Commons Consideration of Lords Message as at 8 December 2025 - (8 Dec 2025)
The Minister for Care (Stephen Kinnock)
I beg to move, That this House agrees with Lords amendments 19B and 19C.
It is a privilege to return to the Mental Health Bill in this House for what I hope will be the final time in its passage. Thanks to the constructive and collaborative approach from Members across this House and noble Lords in the other place, we have been able to reach an amended and improved version of the Bill so that we can begin our vital work on the code of practice. In particular, I pay tribute to my ministerial colleague, Baroness Merron, for her outstanding work on this Bill.
The Bill sits alongside the 10-year plan, which sets out our ambitious reform agenda to transform the NHS and make it fit for the future. We know that there is much more to do to improve outcomes, to tackle unacceptable waiting times for care and to fully meet the needs of the population in a tailored, personalised and timely way. We will overhaul how mental health support is delivered in England to drive down waits and improve the quality of care, backed by a whole-of-society approach to preventing mental illness and to intervening early.
Last week, we announced the launch of an independent review into prevalence and support for mental health conditions, attention deficit hyperactivity disorder and autism. We are launching this review to understand the rises in prevalence and demand on services, to ensure that people receive the right support at the right time and in the right place. People who need it will access high-quality and compassionate mental health support at an earlier stage, and more people will recover or live well with mental illness.
We will go further to improve the quality and transparency of care, working with experts and people with lived experience. We will publish a new modern service framework for severe mental illness, setting consistency in clinical standards across the country so that patients and families get the best-quality, evidence-based treatment and support.
Jim Shannon (Strangford) (DUP)
First, I welcome what is coming forward. I ask for clarification on something that has been brought to my attention. I seek the Minister’s advice and support. Lords amendment 19B relates to the appointment of a nominated person where no local authority holds parental responsibility for the patient. Does the Minister agree that there must be more emphasis on the voice of the child in the legislation, and that the child should have some preference when it comes to representation?
Stephen Kinnock
Yes, we absolutely do agree. As the hon. Gentleman will hear as I proceed with my speech, we have three options in respect of what will happen in exactly the scenario that he has mentioned, and that has been very much the spirit of the amendment on which we have agreed with the other place.
We will put patient feedback and outcomes front and centre by improving the transparency of reporting across in-patient and community mental health services. We will introduce an early warning system so that we can intervene earlier, using patient and staff feedback and clinical information to identify services that are at risk of providing poor-quality care. That is alongside our commitments to roll out mental health support teams in schools and colleges to full national coverage by 2029, to employ an extra 8,500 mental health workers by the end of the Parliament, and to pilot new 24/7 neighbourhood mental health centres across the country. Once implemented, this long-awaited and transformational Bill will give patients greater choice and autonomy and enhanced rights and support, and will ensure that everyone is treated with dignity and respect throughout their treatment.
Let me now briefly outline some of the commitments made by my ministerial colleague Baroness Merron in the other place. In response to the amendment tabled by Baroness May, the Government announced plans to launch a consultation on emergency police powers of detention. The consultation will look at in particular, but will not be limited to, sections 135 and 136 of the Mental Health Act 1983, as well as exploring joint working approaches across organisations. We have committed ourselves to working with stakeholders as we define the scope of the consultation.
In the other place, following engagement with Baroness Berridge, the Government tabled amendments in lieu regarding the appointment of a nominated person for a child under 16 who lacks competence. The amendment states that if no local authority has parental responsibility, an approved mental health professional—an AMHP—must appoint a person who has parental responsibility, a person named in a child arrangements order as a person with whom the relevant patient is to live, or a person who is a special guardian. If there is no suitable person with parental responsibility who is willing to act, the AMHP must consider the child’s wishes and feelings when deciding whom to appoint.
This amendment clarifies whom AMHPs should appoint as the nominated person, and gives priority to those with parental responsibility. We intend to use the code of practice to outline what factors and nuances an AMHP should consider when making the appointment decision. If the AMHP later discovers that another of those on the list is more suitable to act as the nominated person, the legislation allows him or her to terminate the appointment of the nominated person and appoint the special guardian instead.
I thank Members on both sides of the House for their support for the Bill, and look forward to hearing their contributions.
Dr Luke Evans (Hinckley and Bosworth) (Con)
I have talked about roads and bridges throughout the duration of the Bill. We have now reached the end of the long road that was, of course, embarked on by Baroness May in 2018 with the independent Wessely report, which was the foundation of this legislation. It constitutes a cross-party, cross-departmental look at how we can improve the lives of people with the most serious mental health issues.
I was pleased to hear the Minister start to talk about the difference between mental health and mental wellbeing. That is fundamental when it comes to dealing with our policies and how we will take the country forward, because while not everyone has a serious mental health problem, everyone has problems with their mental wellbeing. Ensuring that we have that distinction worked out will be vital to providing the right support for the right people in the right place, and, ultimately, that is what the Bill is dedicated to doing. I have talked in the House about why that is so important. This Bill, above all others, deals with the most vulnerable people in society—those who are seriously mentally unwell—so I am pleased that we have reached a stage at which we can take it forward and put it into law.
I was also pleased to hear the Minister comment on the amendment from the other place, and the concerns raised by Baroness Berridge. I understand the points that he has tried to make and the clarifications that the Government have tried to introduce in relation to the amendment. He has said that he will look at the code of conduct in respect of the seriously difficult positions in which mental health professionals might find themselves during an evening of dealing with a parent who is contesting with a child the question of who is to be the nominated person. I am glad that the Government are looking at the code of practice, and we will not be dividing the House tonight.
That being said, as with the 10-year plan that the Government have brought forward, there is a synergy here. The synergy is this: Members on both sides of the House agree with the thrust of the 10-year plan and this Bill, but the problem is that there is no delivery chapter. That was the Opposition’s concern when the Government were taking the Bill forward. As the Minister conceded in Committee, it will be a challenge, but without a delivery plan it becomes very difficult.
Dr Danny Chambers (Winchester) (LD)
I thank Members across the House for the constructive way in which they have all contributed towards this long-awaited Bill. In the last 40 years, attitudes to mental health and the treatments available have changed significantly, so these reforms and updates are very much needed and very much supported by everyone here.
On Lords amendment 19B, we welcome the important addition. All children and young people deserve appropriate care and support when undergoing treatment for mental health problems, including the safeguarding of a nominated person. Each and every child going through the system deserves to be properly represented by a responsible adult, so we are grateful for the amendment and we are pleased to lend it our support. While we understand that the remit of this Bill very much focuses on in-patient mental health care, we cannot ignore the wider context in which this Bill needs to operate. Even the best in-patient system will struggle if we fail to invest in the preventive and early intervention services that keep people well in the first place.
The hon. Member for Hinckley and Bosworth (Dr Evans) mentioned the difference between mental wellbeing and mental health issues, and ensuring that we protect people’s mental wellbeing before they go on to develop mental health issues. If we are serious about preventing people from reaching crisis point, we need to ensure that the many community-based initiatives, which the Minister and others have spoken about, are strengthened. That is why we will continue to champion walk-in mental health hubs, having a mental health professional in every school and a sort of mental health MOT check-up at key points in individuals’ lives.
It has been an honour to contribute to this Bill. I want to thank the Minister for his meaningful engagement with all Members across this House for the best part of a year. My one ask of him tonight is to again consider restoring the suicide prevention grant to voluntary, community and social enterprise organisations, because I keep meeting charities and organisations that have benefited from it. It is really important that we support community organisations that can help identify when someone is reaching crisis point, because so many people who take their own lives are not in contact with NHS services.
Finally, I pay tribute to all the frontline workers in mental health in clinical and community settings. Nurses, counsellors, psychiatrists, doctors, therapists, support staff, carers and charities prop up a system that is complicated, underfunded and challenging to work in, and we want them to know that we appreciate all the efforts that they continually make. The Liberal Democrats will keep pushing until mental health is given the same urgency, care and attention as physical health.
Stephen Kinnock
With the leave of the House, I will make some brief concluding remarks. I am very grateful to Members of this House for their contributions both today and throughout the passage of this Bill. I believe that by drawing on the lived experience of both Members and our constituents, we will be able to strengthen the intended impact of this legislation on people with serious mental illness and their loved ones. The passage of this Bill has seen the best of parliamentary commitment and co-operation, and the conduct of Members and peers has been collaborative and well-intentioned throughout.
For too long, mental health reform legislation has sat on the shelf. This Government made a manifesto commitment to modernise the Mental Health Act 1983, and we have delivered that within our first Session, providing an opportunity to transform the way we support those with severe mental illness and providing patients with greater choice and autonomy. I am reminded of what a patient in the 2018 independent review said:
“I felt a lot of things were done to me rather than with me”.
This Bill takes forward many of the changes put forward by the independent review, the recommendations of which were rightly shaped by the views of patients, carers and professionals.
Many have asked about next steps and implementation. Post-Royal Assent, our first priority will be to draft and consult on the code of practice. We will engage with people with lived experience and their families and carers, staff and professional groups, commissioners, providers and others to do that. The code will go to public consultation, as well as being laid before Parliament before final publication. Alongside the code, we will develop the necessary secondary legislation. We will then need time to train the existing workforce on the new Act, regulations and the code. We estimate full implementation will take around 10 years due to the time needed to train the workforce and the need to ensure that the right community support is available. This timeframe necessarily spans multiple spending review periods and multiple Parliaments, so we are limited in the detail we can give about future spend and timelines. But we have committed to an annual written ministerial statement on implementation. This commitment will last for the 10 years or until the Bill is fully implemented, whichever is sooner.
Stephen Kinnock
Yes, I was just coming on to that, because the hon. Gentleman raised it in his speech. We are protecting the mental health investment standard in real terms, as it will rise in line with inflation. Our position is quite straightforward. We feel that for far too long the NHS has been run by a series of input-based targets which micromanage frontline leaders, while failing to ensure improvements in patient experience and care. We are bringing the era of command and control to an end, setting frontline leaders free to innovate and run their services as they know best.
I also remind the Opposition spokesman that we are investing £473 million in capital funding in mental health nationally over 2026-27 to 2029-30. That funding will: support the establishment of a 24/7 neighbourhood mental health service; deliver mental health emergency departments, known as crisis assessment centres; expand neighbourhood mental health services; eliminate inappropriate out-of-area placements; and increase crisis accommodation for people with learning disabilities and autism. I gently say to the hon. Gentleman that when we see a rising tide lifting all the boats, we are connecting our mental health spend to that rising tide. We are then seeing a rise in real terms on what this Government are spending on mental health across the board.
I am very happy to again meet the hon. Member for Winchester (Dr Chambers), the Liberal Democrat spokesman, and look at that particular issue. He raised it in Committee. I hope that some of the things I have just set out will help very much on the tragedy of suicide in our country. We are very conscious of how much we need to do to combat that.
I put on record my thanks to all Members and noble peers who have paid such a close interest in the development of the proposals, along with the officials and parliamentary staffers who have supported us to do so. The officials involved in the Bill are too many to mention, but I would like to pay tribute to colleagues in my private office, Emily Cowhig and Penny Sherlock, who have done such sterling work on the Bill, supporting me and the entire team throughout.
Transforming mental health care for the most vulnerable patients with serious mental illness requires the Bill to pass into statute. I am therefore grateful to hon. Members for their support in enabling us to do so.
Lords amendments 19B and 19C agreed to.
Oral Answers to Questions
Stephen Kinnock Excerpts(2 months, 1 week ago)
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Ben Goldsborough (South Norfolk) (Lab)
The Minister for Care (Stephen Kinnock)
NHS dentistry is out of reach for too many people, and that issue is felt particularly acutely in rural areas such as Norfolk. This Government are rolling out extra urgent dental appointments across the country, and we will be making further improvements for patients to come in from April 2026. NHS dentistry was left to rot for 14 years under the Conservatives; Labour is putting it on the road to recovery.
Ben Goldsborough
After 16 months of a Labour Government, the share of adults in Norfolk seen by a dentist has risen from barely scraping 30% to well over 40%—lots done, but lots more to be done. The University of East Anglia proposed a dental school as part of the solution. Will the Minister work with Department for Education colleagues to ensure that the Office for Students and other bodies give it the green light?
Stephen Kinnock
I, too, am absolutely delighted that more patients can see a dentist in Norfolk but, as my hon. Friend says, there is a long way to go. We are certainly not complacent, but we are showing that it is possible to turn things around. I am also pleased that the University of East Anglia has been approved as a dental school by the General Dental Council. The Office for Students has statutory responsibility for allocating dental school places, but I fully agree that UEA would be a good candidate for any additional Government-funded places allocated in future.
Several hon. Members rose—
James Wild (North West Norfolk) (Con)
The Minister told the Health and Social Care Committee that the spending envelope for dentistry would be confirmed by the end of the summer at the latest. Is the Office for Students still waiting for a ministerial direction to launch that competition for new places, so that UEA can bid along with others and so that we can get training places in Norfolk for the first time?
Stephen Kinnock
The hon. Gentleman is right: it is the Government’s responsibility to give a steer to the Office for Students, and we are very close to being able to put that together. I am expecting some advice from my officials later in the week, and I shall be happy to keep the hon. Gentleman updated on further progress.
Josh Dean (Hertford and Stortford) (Lab)
Gregory Stafford (Farnham and Bordon) (Con)
The Minister for Care (Stephen Kinnock)
I am delighted to have announced in a written ministerial statement yesterday that the Government are developing a palliative care and end-of-life care modern service framework for England. The modern service framework will be aligned with the 10-year health plan, prioritising shifting care out of hospitals and into the community to ensure personalised, compassionate support for individuals and their families.
Gregory Stafford
There has been cross-party and cross-charity campaigning for this strategy, so I welcome the fact that the Minister has announced it. However, hospices across the country and especially in my constituency are telling me that their biggest problem is the national insurance rise. For example, a children’s hospice that covers my constituency tells me that the £90,000 extra it has to pay in national insurance could have funded three nurses. What discussions has the Minister had with the Chancellor ahead of tomorrow’s Budget to ensure that hospices, and indeed other health and social care organisations, are exempt from any national insurance rises, either in the past or in the future?
Stephen Kinnock
I thank the hon. Gentleman for his question. I notice he did not welcome the fact that we are supporting the hospice sector with a £100 million capital funding boost and £80 million in revenue funding for children’s hospices over three years. We also notice that Conservative Members do like to welcome the additional investment generated from the last Budget, but they do not seem to welcome the means by which it was generated, so I would say to them: what would they cut or what taxes would they put up to pay for what we are doing to get our NHS back on its feet and fit for the future?
Alistair Strathern (Hitchin) (Lab)
I welcome the Government’s commitment to a strategy for palliative care, which is as overdue as it is important, but it will mean nothing for hospices that are not able to last out until it comes into effect. Garden House hospice in my constituency is facing a crucial funding shortfall, and although the capital funding from the Government that came through earlier this year is incredibly welcome, it is still just short of filling the cash-flow gap it needs to fill to secure its operations. Would the Minister meet me to see what further work the integrated care board may be able to do to protect this vital hospice serving my constituents?
Stephen Kinnock
I am very pleased that the measures we have taken have provided financial support. I absolutely recognise the challenging financial position, and I would of course be more than happy to meet my hon. Friend to discuss that further.
Mr Connor Rand (Altrincham and Sale West) (Lab)
Jacob Collier (Burton and Uttoxeter) (Lab)
The Minister for Care (Stephen Kinnock)
I thank my hon. Friend, who is a tireless campaigner on this issue. We want to see more dentists in Burton and Uttoxeter, and across the country, which is why we are offering dentists £20,000 to work in underserved areas. We are making it a requirement for new dentists to practice in the NHS through our tie-in policy. We are also making additional urgent appointments available across the country, including for my hon. Friend’s constituents in Burton and Uttoxeter.
Katrina Murray (Cumbernauld and Kirkintilloch) (Lab)
Stephen Kinnock
My hon. Friend raises an important point, and I would be more than happy to meet her to discuss it, because I think the complexity of what she raises needs some detail.
Sarah Dyke (Glastonbury and Somerton) (LD)
Stephen Kinnock
We have the interim reforms, and our response on those will be published very soon. We are working on the long-term reform of the NHS dentistry contract with the British Dental Association, and I would be happy to keep the hon. Lady updated on our progress.
Mr Connor Rand (Altrincham and Sale West) (Lab)
Pippa Heylings (South Cambridgeshire) (LD)
Peter Swallow (Bracknell) (Lab)
Bracknell is a life sciences superpower, with Eli Lilly, Sandoz and Boehringer Ingelheim all having a footprint in our town. What can we do to speed up clinical trial set-up to help to deliver the next generation of treatments for our NHS?
Sonia Kumar (Dudley) (Lab)
I have seen at first hand how severe musculoskeletal conditions such as lower back pain can devastate someone’s ability to work, have relationships and sleep, as well as their overall wellbeing. The education of more than 1 million children is disrupted by MSK conditions due to missed schooling and fragmented, hard-to-navigate services. Will the Minister therefore prioritise MSK conditions in phase 2 of the modern service framework and confirm when that will be published?
Stephen Kinnock
I pay tribute to my hon. Friend for saving the Ladies Walk health centre in her constituency, which the Conservatives were trying to shut. We are advancing modern service frameworks for conditions where we can swiftly and significantly raise the quality of care. The National Quality Board makes recommendations on future modern service frameworks; its next meeting is on 8 December.
Sir Roger Gale (Herne Bay and Sandwich) (Con)
It is estimated that there are some 200 highly qualified Ukrainian dentists resident as refugees in the United Kingdom. They could be working for the health service, but, because of the moribund attitude of the General Dental Council, they are not allowed to do so. Can we try to drag the GDC into at least the 20th century so that those talents can be utilised?
Stephen Kinnock
I thank the right hon. Gentleman for that question. I met the GDC recently. It has completed the procurement of the new management agent to run the overseas registration examination, and I am confident that we will see a significant boost in the numbers—that is coming onstream very quickly. However, I agree with the right hon. Gentleman: it has been too slow, and it needs to speed up.
Sarah Smith (Hyndburn) (Lab)
About 38% of children in my constituency are sadly growing up in poverty. This Government are committed to ensuring the best start in life for all children, so in addition to the increase in mental health support teams in schools, does the NHS workforce plan currently address the vital need for trained specialist community public health nurses in schools?
Palliative Care and End-of-life Care
Stephen Kinnock Excerpts(2 months, 2 weeks ago)
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The Minister for Care (Stephen Kinnock)
I am delighted to announce to the House today that the Government are developing a palliative care and end-of-life care modern service framework for England, with a planned publication date of spring 2026. This will be aligned with the ambitions set out in the recently published 10-year health plan, which prioritises shifting care out of hospitals and into community settings to ensure personalised, compassionate support for individuals of all ages and their families.
This Government recognise that there are increasing numbers of people living with multiple complex conditions, that we have an increasing ageing population, and that there are tens of thousands of children and young people with life-limiting or life-threatening conditions.
We acknowledge the significant challenges currently facing the sector, including:
Delays in early identification of individuals approaching the end of life;
Inconsistencies in commissioning practices across integrated care boards;
Workforce challenges in both universal and specialist services;
Gaps in 24-7 palliative care provision; and
Limited uptake and integration of personalised care and support planning, including advance care planning.
In recognition of these challenges, we are prioritising this cohort, as referenced in NHS England’s medium-term planning framework, which commits to an immediate focus on reducing unnecessary non-elective admissions and bed days from high-priority cohorts, including those at the end of life.
A palliative care and end-of-life care modern service framework will drive improvements and enable ICBs to address these challenges through the delivery of high-quality, high-value, personalised and equitable care.
Consequently, the modern service framework will put in place a clear and effective mechanism to deliver a fundamental improvement to the care provided. This will enable adoption of evidence-based interventions that are proven to make a difference to patients and their families. Examples include earlier identification of need, care delivered closer to home by integrated generalist and specialist teams and strengthened out-of-hours community health support, including dedicated telephone advice.
We have already begun to engage with sector stakeholders on how to improve access, quality and sustainability in palliative care and end-of-life care and will continue to engage with them to shape and deliver this vision. We want a society where every person receives high-quality, compassionate care from diagnosis through to the end of life, and we recognise that access to high-quality, personalised palliative care and end-of-life care can make all the difference to patients and their loved ones.
[HCWS1087]
Unpaid Carers: Inequalities
Stephen Kinnock Excerpts(2 months, 2 weeks ago)
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The Minister for Care (Stephen Kinnock)
It is a pleasure to serve under your chairship, Ms Vaz. I thank my hon. Friend the Member for Shipley (Anna Dixon) for securing this vital debate. I pay tribute to her for her career-long dedication to adult social care and so many of the issues we are debating today. I also pay tribute to all the powerful and moving contributions we have heard today, many about personal experience, engagement with constituents and the stories we hear every day about the pivotal role that unpaid carers play in our care system, which are truly inspiring and uplifting.
Every day, unpaid carers step up to sustain the health and wellbeing of millions of people across our country. Every day, they step up quietly and without expectation to support loved ones, neighbours and friends. I offer my heartfelt thanks, particularly on Carers Rights Day: thank you for the compassion, the commitment and the resilience you show.
As Minister for Care, it has been my priority to listen directly to unpaid carers through discussions with carers of all ages, including during Carers Week. I have heard at first hand the realities of balancing care, work, education and personal wellbeing. Those conversations have been moving, honest and often humbling. They have reinforced just how essential it is that we continue to recognise and support the people who provide so much care to so many, and who hold so much of our health and care system together.
As I said at the Carers UK “State of Caring” conference earlier this year, we have made genuine progress over the last three decades. The profile of the role of unpaid carers has undoubtedly grown, and awareness of their contribution is undoubtedly greater. Despite that, true equality of opportunity remains out of reach for far too many. My ambition is clear: that carers who want to work can do so without being penalised; that young carers can learn, develop and dream, just like their peers; and that caring must not lead to long-term damage to a person’s health, wealth or wellbeing.
The data shows the scale of the challenge: unpaid carers are 16% more likely to have multiple long-term health conditions, and providing just 10 hours of care a week can significantly reduce someone’s likelihood of being employed and increase their risk of loneliness. These pressures compound existing inequalities linked to gender, ethnicity, socioeconomic background or age. We must continue to shine a light on these disparities, listen to carers’ voices and design support that genuinely helps them to thrive.
The Government remain committed to ensuring that unpaid carers receive the right support at the right time in the right way. Under our 10-year health plan, unpaid carers will be recognised as partners in preparing personalised care and support plans. Their practical knowledge and experience will help to shape more responsive and realistic plans for the people they support.
Early identification remains key. Too many carers still go unnoticed and unsupported. We will increase the information captured across the health and care system, enabling earlier intervention and more tailored help. We will also introduce a dedicated “My Carer” section in the NHS app, which will allow carers to book appointments, access information and communicate more effectively with clinical teams. That will not only support carers but streamline interactions across the system.
Our shift towards a neighbourhood health service will increase the integration of health and care services, and it will bring multidisciplinary teams—GPs, nurses, social care professionals, pharmacists and others—closer to people’s homes. Working alongside unpaid carers, these teams will be better placed to deliver joined-up, community-centred support, focused on the health and care that people really need.
We know that caring can have a profound impact on mental health. That is why we are expanding access to talking therapies and digital tools, and piloting neighbourhood mental health centres, offering round-the-clock support for people with more severe needs.
Richard Foord
Can I ask the Minister what definition of neighbourhood he is using, and does it recognise communities such as market towns?
Stephen Kinnock
As a ballpark figure, we are looking at 50,000 residents, but we will be open to developing multi-neighbourhood infrastructure that would cover closer to something like 250,000 residents. It will depend, to some extent, on how it works in the 43 pilot sites in our neighbourhood health implementation plan. We do not want to have too many top-down diktats like the disastrous 2012 Lansley reforms; this is much more about a bottom-up, organic approach to developing a neighbourhood health service. Approximately 50,000 residents will be the starting point.
Jim Shannon
What the Minister is referring to is very positive; as always, I have a quick ask. The policy he is outlining seems very plausible and workable, so can I ask him to share those thoughts with the Northern Ireland Assembly and the Health Minister, Mike Nesbitt? I think that the two Ministers are in regular contact, so it could be done through that.
Stephen Kinnock
I will be very happy to do that. We have launched the 43 sites, so I would be happy to share the documentation on how we launched them and the terms of reference. [Interruption.] I can see the representative from my private office is taking notes.
Daniel Francis
I do not expect an answer now, but can I also ask the Minister to take away a point about the complexity of some of these disabilities? Sometimes people are under several different consultants in several different hospitals, perhaps for a neurological condition, for their sight, for epilepsy and so on. I am thinking about both the complexity of the different apps, and different parts of apps, used by different NHS trusts and hospitals, and the complexity of the distances travelled —it is the carer who manages all those aspects. How can we take that away and support the carer in managing the care of the person for whom they are caring?
Stephen Kinnock
I absolutely agree with my hon. Friend’s points; I think that neighbourhood health, as a strategy, addresses his points about both the proximity and complexity. By definition, through shifting from hospital to community, we are addressing the proximity point. The fact that neighbourhood health will be based on multidisciplinary teams creates the idea of a one-stop shop for the patient, where their complex needs are addressed in one place.
To ensure that local areas can meet their duties under the Care Act, the 2025 spending review allows for an increase of more than £4 billion in additional funding for adult social care in 2028-29, compared with 2025-26, to support the sector in making improvements. The Health and Care Act 2022 strengthened expectations around identifying and involving carers and ensuring that services are shaped by carer feedback.
NHS England is helping local systems to adopt best practice through co-produced tools, case studies and events such as Carers Week and the Commitment to Carers conference. Initiatives such as GP quality markers for carers, carer passports and digital proxy access are already making a real difference and increasing the number of carers who are identified in the NHS.
Balancing paid work and caring responsibilities remains a significant challenge, and too many carers risk financial hardship as a result. That should never be the case. Supporting carers to remain in or return to work is central to our plan for a modern, inclusive labour market. Employers benefit enormously from the skills, dedication and experience that carers bring. That is why in April we increased the carer’s allowance earnings limit to £196 a week—the largest rise since its inception in the 1970s—meaning that carers can now earn up to £10,000 a year without losing the allowance.
The Carer’s Leave Act, which came into force in April 2024, gives employees one week of unpaid leave each year to help to manage planned caring commitments. We are now reviewing how the Act is working in practice, listening to carers and to employers of all sizes. That includes exploring the potential benefits and implications of introducing paid carer’s leave. To ensure transparency, and as hon. Members have noted, the Department for Business and Trade yesterday published the terms of reference for that review and we will hold a public consultation in 2026 on employment rights for people balancing work and care.
Young carers make an extraordinary contribution, often taking on responsibilities far beyond their years. Our ambition is that every young carer should receive the support that they need to succeed at school and beyond. This autumn, we published key stages 2 and 4 attainment data for young carers for the first time—an important step in understanding and addressing the educational disadvantage that they face. Reforms across education and children’s social care will strengthen identification and support. Ofsted’s new inspection framework, introduced on 10 November, explicitly references young carers in the expected standards for inclusion, safeguarding and personal development.
Local authorities must identify young carers who may need support and assess their needs when requested. We strongly support the “No Wrong Doors for Young Carers” memorandum of understanding that promotes collaboration across children’s and adults’ services, health partners and schools. I encourage all local authorities to adopt it.
NHS England is supporting the identification of young carers through GP guidance and improved data sharing. It is also leading a cross-Government project, co-produced with young carers and voluntary, community and social enterprise partners, to support identification, strengthen support pathways and join up services across education, health and local organisations. Engagement workshops have already helped to shape the next young carers summit, in early 2026.
Our 10-year plan sets out strong foundations for change, and we are now fully focused on delivery. Baroness Casey’s independent commission will shape the cross-party and national consensus around longer-term reforms, including proposals for a national care service. As noted by the shadow Secretary of State, the right hon. Member for Daventry (Stuart Andrew), however, supporting unpaid carers requires commitment across Government. That is why I chair a ministerial working group, working closely with my counterparts at the DWP, the DBT and the Department for Education, to ensure that our policies reflect the realities of caring.
My hon. Friend the Member for Shipley and others asked about the Government’s response to the Sayce review. I can confirm that we will publish that response this year and I am receiving regular updates from DWP colleagues on that matter. Additionally, our research arm, the National Institute for Health and Care Research, is evaluating local carer support programmes to identify what works and where improvements are needed.
As we look to the future, prevention must sit at the heart of our approach. Too many carers reach crisis point before they receive help. That not only places huge strain on families, but leads to avoidable pressure on hospitals, primary care and social services. By intervening earlier—through better identification in primary care, strengthened community networks and improved signposting —we can ensure that carers receive the right support before challenges escalate.
Anna Dixon
I thank the Minister for his response. Given what we know about carer burnout and the need for short breaks, and given the data that suggests local authority funding cuts have resulted in less support being available, will there be work between the NHS—with its increased budget—and local authorities to look at how we can get back to having more breaks for carers?
Stephen Kinnock
There is a consistent message that comes through in my conversations with carers about the importance of respite and regular breaks. We know that they are not a luxury. When carers reach exhaustion, the wellbeing of the carer and the person they support is compromised. We are working with local authorities and integrated care boards to ensure that they meet their statutory duty for carers’ breaks and that provision is transparent, fair and personalised. I absolutely take my hon. Friend’s point: that duty is clear, written down and statutory; the question is about making it happen in practice. We must monitor that closely.
Addressing the inequalities faced by unpaid carers requires a cultural shift as much as a policy one. We must build a society that values care, where caring is recognised as a shared responsibility rather than a private burden, and where employers, communities and public services all play their part. Changing culture takes time, but we have already seen encouraging progress. Businesses are increasingly recognising the value of carer-friendly workplaces. Schools are becoming more aware of the pressures faced by young carers. Health professionals are finding new ways to involve carers as genuine partners. These changes—these shifts—matter, as they represent the foundations of a more compassionate and inclusive society.
As we continue this vital work, I remain committed to ensuring that the voices of carers young and old inform every stage of policy development. It is only by listening attentively, engaging meaningfully and responding boldly that we can continue to deliver the change that carers rightly expect. I hope that today’s debate has given everyone a sense of what the Government are working on and, once again, I pay tribute to all hon. Members who have spoken.