GP Contract 2026-27
Stephen Kinnock Excerpts(5 days, 19 hours ago)
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The Minister for Care (Stephen Kinnock)
General practice is the front door of the NHS, delivering millions of appointments each year and providing trusted, continuous care to patients in every community. The Government are committed to supporting general practice, ensuring it is sustainable and at the heart of a modern neighbourhood health service.
I am pleased to inform the House of the outcome of the 2026-27 general practice contract consultation. The final package reflects commitments in the 10-year health plan, including ending the “8 am scramble”, improving timely access to care, tackling GP unemployment and supporting a shift towards prevention. This builds on recent improvements in patient experience, with the monthly health insight survey by the Office for National Statistics showing that in December 2025, over 75% of people said it was easy to make contact with their GP—up from just under 61 % when this Government came into office.
The 2026-27 GP contract includes a £485 million funding uplift, taking total contract investment to over £13.8 billion. This investment is focused on the changes that matter most to patients: easier access to GP appointments and more GPs working in practices. Through an investment in GP recruitment of circa £190 million per annum via the additional roles reimbursement scheme over the past 16 months, the Government have recruited 3,000 newly qualified GPs, preventing them from graduating into unemployment. Growing GP capacity is the most effective way to improve access and for the first time, £292 million of funding is being ringfenced for a practice-level GP recruitment scheme. We estimate this could translate to 1,600 full-time equivalent GPs. The aim is to increase GP capacity that can be specifically focused on improving patient access.
The contract also includes a new requirement that all patients who are deemed clinically urgent by their GP practice must be dealt with on the same day. Delivery of this requirement is supported by the ringfenced GP recruitment scheme.
The contract also strengthens the role of general practice in prevention and neighbourhood health services, including targeted action to improve childhood vaccination uptake. It supports high deprivation areas where coverage has historically been lower, and ensures all those eligible are invited for lung cancer screening through improved data sharing, enables earlier cancer diagnosis. It also includes a £25 million investment to increase referrals into structured weight management and obesity support services for patients who need them most.
This contract embeds advice and guidance into core activity, supporting delivery of the plan for change by enabling more patients to receive the right care without unnecessary referral. This will help reduce pressure on elective services and help tackle waiting lists, while improving patient experience.
This year, the Department of Health and Social Care widened the consultation to engage stakeholders from across the primary care system including GPC England, the Royal College of General Practitioners, National Voices, Institute of General Practice Management, Healthwatch England, the NHS Confederation and the National Association of Primary Care. This broader consultation enabled constructive feedback from across the system, helping to refine proposals and improve the final contract package for both patients and practices.
This demonstrates the Government’s commitment to working constructively with the profession and system partners, and to ensuring that general practice is supported to meet the needs of patients now and in the future.
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Oral Answers to Questions
Stephen Kinnock Excerpts(5 days, 19 hours ago)
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Natalie Fleet (Bolsover) (Lab)
The Minister for Care (Stephen Kinnock)
We know that dentistry was left in crisis by the Conservatives, but this Government are determined to ensure that everyone can access a dentist when they need one. We have recently broadened access to dental appointments, so that patients who need more serious and ongoing treatment no longer miss out. Between April and October 2025, we delivered 1.8 million more treatments than in the same period before the general election.
Callum Anderson
I have a constituent who is awaiting a root canal and crown treatment to save her tooth. She has been quoted £400 for NHS treatment with a 60% chance of success, and £1,300 for private healthcare with a 90% success rate. Hopefully the Minister agrees that this mismatch risks undermining confidence in NHS dentistry. What steps is he taking to reform the NHS dental contract, so that constituents like mine can receive timely and high-quality care that is within financial reach?
Stephen Kinnock
I am very sorry to hear about the plight of my hon. Friend’s constituent, and I would be more than happy to look into the specifics of her case. The sad reality is that after 14 years of Tory neglect and incompetence, we have ended up with a two-tier dentistry system. This Government are determined to ensure that high-quality NHS dentistry is available to everyone who needs it. The 2026 reforms that I announced on 16 December will help patients who have complex needs by creating a new care pathway, backed by tariffs for dentists of between £250 and £700, which could save patients up to £225 in fees. Our 2026 measures, combined with long-term contract reform, will indeed enable timely, high-quality treatment that is within financial reach.
Natalie Fleet
Fourteen years of Conservative rule has consequences for the children in my constituency. A quarter of them have tooth decay—[Interruption.] Conservative Members can shake their heads as much as they like, but this is the real-world impact of the decisions that they made. Those children are some of the most deprived in Derbyshire, and the integrated care board has found that they are more likely than wealthier constituents 3 miles up the road to have tooth decay. I am pleased that we are fixing dentistry. We are getting more urgent dentist appointments and we have the roll-out of supervised toothbrushing in schools, but we need to do more. What more are this Government doing to address this inequality and help the children in my constituency who are in pain?
Stephen Kinnock
My hon. Friend is absolutely right. The Conservatives failed our children’s health; tooth decay is the most common reason for hospital admissions for five to nine-year-olds. That is a truly shameful, Dickensian state of affairs. We have provided Derbyshire county council with £82,000 for this year’s supervised toothbrushing programme, with further funding agreed till 2028-29. I am delighted that, of the 42,000 increase in the number of treatments in the Derby and Derbyshire ICB area, 19,000 were for children, and by extending the soft drinks industry levy we will protect kids’ teeth from decay—a policy that is emblematic of the shift from treatment to prevention that is at the heart of our 10-year plan.
Sir Ashley Fox (Bridgwater) (Con)
My constituents continue to find it very difficult to get an appointment with an NHS dentist. What steps is the Minister taking to encourage dentists in rural areas, so that my constituents can have access to an NHS dentist?
Stephen Kinnock
We come to this Chamber month in, month out for these oral questions but we never hear an apology from those on the Opposition Benches for the mess in which they left NHS dentistry. For the Conservatives, sorry really does seem to be the hardest word.
With regard to the hon. Gentleman’s question, we have delivered 1.8 million additional appointments between April and October 2025, compared with the same period before the general election. I would be happy to furnish him with the precise numbers of how many more have been provided in his constituency and his ICB area. He can watch his post box for that information.
Adrian Ramsay (Waveney Valley) (Green)
The Daily Mirror reports that of the nearly 1 million urgent dental appointments that have been commissioned by integrated care boards since April, 900,000 have not been taken up because of strict rules around the scope of treatment. Meanwhile, in my constituency and around the country, too many people are going without the treatment that they need. Will the Minister update us on when the Government expect to meet their targets on urgent appointments?
Stephen Kinnock
Our manifesto commitment was about improving access to urgent dental care, and that is precisely what we have done by commissioning hundreds of thousands of additional urgent treatments. It became clear as we were working through that process that the clinical definition was too narrow and out of step with the common-sense interpretation, so we acted on the advice of the chief dental officer and broadened the definition. From this April, urgent care will be embedded in the contract, and of course we continue to work with the sector on long-term contract reform.
Helen Morgan (North Shropshire) (LD)
Everyone in this House knows that NHS dentistry was allowed to fall apart under the Conservatives, resulting in DIY tooth extractions, people being forced to go to A&E because they are in pain, and children suffering in every corner of the country. Last year, 38,000 children in Shropshire did not see a dentist. In Surrey, that number was 100,000 and in Sussex it was 133,000. That is a disgrace. The Government promised an extra 700,000 urgent appointments to fight this crisis, but that promise looks set to have been broken in the previous year. Will the Minister today highlight in black and white how many extra urgent appointments were actually delivered last year, rather than simply commissioned?
Stephen Kinnock
As I have just pointed out to the hon. Member for Waveney Valley (Adrian Ramsay), we have broadened the definition, because the clinical definition of “urgent” was simply not in line with the common-sense interpretation. People removing their own teeth in DIY dentistry were not fitting into the classification of “urgent”. We have changed that categorisation. As a result of that, I am pleased to confirm that we have delivered 1.8 million additional appointments and treatments this year compared with the same period last year—April to October 2025. We will continue to work on that basis of embedding urgent care into the contract, as I announced on 16 December, in the 2026 reforms that we are carrying out.
Sureena Brackenridge (Wolverhampton North East) (Lab)
Lizzi Collinge (Morecambe and Lunesdale) (Lab)
The Minister for Care (Stephen Kinnock)
We inherited a broken NHS dental system in which many people were unable to access a dentist when they need one, including in my hon. Friend’s constituency, but we are making real progress, having increased the number of NHS treatments by 1.8 million between April and October 2025 compared with the same period before the general election. As a result of this nationwide increase, I am pleased to report that 89,000 more NHS dental treatments were delivered between April and October last year in the Lancashire and South Cumbria integrated care board area, which of course includes my hon. Friend’s constituency.
Lizzi Collinge
One of my constituents contacted me because their spouse is bedbound and cannot get dental care at home, so he gets no routine care. He recently waited three months for an emergency extraction—something he could have had on the same day if he was not disabled. What work is going on to help my constituents access the care they need?
Stephen Kinnock
I am sorry to hear about the plight of my hon. Friend’s constituent. I will, of course, be more than happy to meet her and look into the specifics of the case. Specialised dental services have a vital role to play in providing dental treatment to vulnerable people in settings such as care homes. In many cases, this is about teamwork and integration, ensuring that primary dental care is working in lockstep with adult social care. There is clearly some room for improvement in some areas. I would be happy to work with her to ensure that this issue gets resolved.
Naz Shah (Bradford West) (Lab)
Alison Griffiths (Bognor Regis and Littlehampton) (Con)
The Minister for Care (Stephen Kinnock)
Through our 10-year health plan and the shift from hospital to community, our new neighbourhood health service will benefit millions. It is underpinned by 120 new neighbourhood health centres by 2030, alongside the supercharging of community diagnostic centres, which will deliver faster, more accessible care, with over 100 sites open 12 hours a day, seven days a week. This massive expansion will transform community access for millions of patients, regardless of postcode.
Alison Griffiths
I am delighted to hear the Minister’s response. Zachary Merton hospital in Rustington was closed temporarily, but that closure became permanent and the site is being progressed for disposal. More than half of residents in Rustington are elderly, and rely on intermediate and step-down care. They have not been consulted on the permanent closure, despite assurances from Sussex community NHS foundation trust and NHS Sussex integrated care board. Will the Minister confirm whether he considers that a substantial variation in NHS services? Will he consider exercising his call-in powers before the site is irreversibly sold?
Stephen Kinnock
I am not familiar with the details of that case, but if the hon. Lady writes to me I would be more than happy to take the issue up. These matters are determined by the ICBs and trusts, and the Government are not in the business of micromanaging what is happening out there in the field. We believe that people who are closest to our citizens are the best people to take those decisions, but we do expect the right outcomes. I would be happy to work with the hon. Lady on that basis.
Ms Abena Oppong-Asare (Erith and Thamesmead) (Lab)
Women with the painful and incurable condition of endometriosis have suffered stigma and ill health for far too long, and despite the condition impacting one in 10 women, a diagnosis takes over eight years on average. Will the Minister make sure that the new women’s health strategy includes stronger training, better awareness, and faster support for women?
Stephen Kinnock
This is a vital issue. Endometriosis is a serious challenge for so many women across our country, and I confirm that it is an integral part of the strategy. I am sure she will be pleased to see the outcome of that strategy as it moves forward.
Ian Byrne (Liverpool West Derby) (Lab)
Victoria Collins (Harpenden and Berkhamsted) (LD)
Catherine from Redbourn has shared that she has to wait weeks for a GP appointment, yet her village faces an increase in residents of up to 70%, which means thousands of new patients. Some of that is through speculative developments. Does the Minister agree that councils should have the powers to ensure that planning approvals are dependent on first securing healthcare to serve those new residents? Will he commit to ensuring that NHS planning cycles are aligned with housing developments to ensure that communities do not have to wait for weeks, months or years?
The Minister for Care (Stephen Kinnock)
On the subject of GP access, I am delighted that 75% of patients now say it is easy to contact their GP, which is a sizeable increase of 14 percentage points since July 2024—that is a really positive development that I am sure the hon. Lady welcomes. Turning to planning, it is very important that the integrated care board, the council and the developers are joined up together, and we need to ensure that happens. There is also the primary care utilisation and modernisation fund, which the hon. Lady’s constituents may be interested in.
Peter Swallow (Bracknell) (Lab)
Shockat Adam (Leicester South) (Ind)
Vista is a 160-year-old charity serving people in Leicester and Leicestershire who are suffering from visual disabilities. Last year alone, it served 21,000 people, but sadly, it faces imminent closure if it cannot raise £2 million by the end of March. If that happens, the devastating effect on the national health service and the social care service will be unimaginable, so will the Minister meet me and other local MPs, as well as representatives of University Hospitals of Leicester, to discuss what we can do to save Vista?
Stephen Kinnock
I thank the hon. Gentleman for that question, and pay tribute to Vista for the outstanding work it is doing. Improving IT connectivity is a vital part of what we are doing, and the single point of access project is of relevance in that context. I would be more than happy if the hon. Gentleman wrote to me so that we can look at the issue he has raised.
Paul Waugh (Rochdale) (Lab/Co-op)
In Rochdale, we need more midwives to provide the safe staffing levels that our mums-to-be rightly expect, but newly qualified student midwives often find it difficult to find jobs when they qualify. Can the Minister explain exactly when the NHS workforce plan is due so that they can give reassurance to those newly qualified midwives that they will have a career in the NHS?
Adult Social Care, Tobacco and Vapes Consultation, and Urgent Dental Care
Stephen Kinnock Excerpts(6 days, 19 hours ago)
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The Minister for Care (Stephen Kinnock)
I would like to inform the House of several updates from the Department of Health and Social Care over the February recess.
Social care: allowances uplift for working age adults & disabled facilities grant 2026-27
The Government have confirmed that they will be uplifting the social care allowances, which ensure that people drawing on adult social care retain sufficient income to cover essential living costs.
From 6 April 2026, these allowances will rise in line with consumer prices index inflation—3.8%—recognising pressures from rising food, clothing and utility costs. For working-age adults, we are going further: the minimum income guarantee will increase by 7%, the first above inflation rise in over a decade. This will put over £400 more a year into the pockets of more than 150,000 working-age disabled adults, or around £510 for those also receiving the disability premium.
This uplift protects disabled people on low incomes, supports greater choice and control, and forms part of our wider programme to build a stronger, fairer national care service. We will continue to work closely with local government, disabled people’s organisations and sector partners to ensure the system remains sustainable and responsive to people’s needs.
The Government can also confirm that £723 million will be made available for the disabled facilities grant in 2026-27. This grant helps eligible older and disabled people on low incomes to adapt their homes to make them safe and suitable for their needs so that they can remain independent. Practical changes include installing stairlifts, level-access showers, or ramps. The Government are also taking action to allocate disabled facilities grant funding to local authorities in England in a fairer, more evidence-based way from 2026-27, with transitional protections to allow local authorities time to adjust. The Ministry of Housing, Communities and Local Government has published the details of local authority allocations here. We expect funding to be distributed to local authorities in May.
Launch of consultation on smoke-free, heated tobacco-free and vape-free places in England
Smoking is the number one preventable cause of death, disability and ill health in England. Vaping is less harmful and can help adult smokers quit, but it is not without risks, and the long-term health effects are still being studied. Exposure to second-hand smoke can be particularly damaging for children, pregnant women and people with existing health conditions.
A consultation on smoke-free, heated tobacco-free and vape-free places in England is open until 6 May 2026. It sets out proposals to extend current indoor smoking restrictions to some outdoor places, specifically public children’s playgrounds, and outside certain health and social care settings and education settings.
The consultation also proposes to make indoor places that are already smoke-free places, heated tobacco-free and vape-free as well, and extending these restrictions to some outdoor places.
The consultation does not propose extending any measures to outdoor hospitality settings or private outdoor spaces.
Responses will inform the measures that are ultimately taken forward and following the consultation, we intend to make and implement secondary legislation during the course of this Parliament.
Urgent dentistry appointments
The Government are committed to ensuring people can access urgent dental care when they need it. Over the past year, integrated care boards have been commissioning additional urgent dental appointments and there is now an urgent care safety net available in all areas of the country.
From April 2026, we will cement our commitment to urgent care by making it a requirement for high street dentists to offer a minimum number of urgent appointments, including to patients who are new to the practice.
We have listened to clinical advice from the chief dental officer for England, as well as feedback from the sector that the current definition of the national target, focused on clinically urgent care, is too narrow and has meant that some patients with serious and ongoing needs are still missing out.
We will therefore broaden the scope of our pledge to deliver not just additional urgent appointments, but more appointments of all types. This will open up capacity to more patients, preventing people resorting to DIY dentistry, while retaining the urgent care safety net.
Data published on Thursday 19 February shows that the NHS delivered an extra 1.8 million courses of dental treatment over the first seven months of 2025-26 compared to the same period in the year up to the general election and almost half of these were delivered to children.
[HCWS1345]
Oak Park Community Clinic
Stephen Kinnock Excerpts(2 weeks, 5 days ago)
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The Minister for Care (Stephen Kinnock)
I note that the policy lead for this area is the Minister for Secondary Care, my hon. Friend the Member for Bristol South (Karin Smyth). She is unable to be here today and sends her apologies, but I will report back to her and am sure that she will be more than happy to accept the request for a meeting to have further discussions.
I congratulate the hon. Member for Havant (Alan Mak) on securing this debate on the provision of diagnostic services in Havant, specifically at Oak Park community clinic. This matter is very important to his constituents, and it resonates more broadly in communities right across our country.
Diagnostic services are a critical part of our NHS. They are crucial for helping patients to get peace of mind about their symptoms or clarity on the next stage of their care. Reducing the waiting times for diagnostic tests is critical to achieving both our elective waiting time and cancer waiting time ambitions. Prior to this debate, the Department has received correspondence from GPs working in the hon. Member’s constituency on this very issue. I therefore completely understand his concerns and those of his constituents, and I hope that I can provide a helpful update on the situation and set out the steps being taken to resolve this issue.
Until recently, a range of diagnostic services were provided at Oak Park community clinic. Services were delivered in partnership between the NHS Hampshire and Isle of Wight integrated care board and an independent healthcare provider, Practice Plus Group. As the hon. Member has said, Practice Plus Group took the decision, with limited notice, to move equipment for non-obstetric ultrasound, X-ray and echocardiography away from Oak Park community clinic to St Mary’s community hospital in Portsmouth. With regard to the request to meet to discuss the circumstances of the suspension of these services at Oak Park clinic, I will ensure that a request is passed on to my colleague, the Minister for Secondary Care.
I can inform the hon. Member that the closure took place because Practice Plus Group took the view that the lease no longer represented value for money. I can fully appreciate the disruption that this is causing in the Havant area for patients who now face longer travel times and inconvenience to receive care. I am aware that the ICB has communicated with all the referring organisations affected and is working to mitigate disruption, including reviewing alternative provision to ensure continuity of diagnostic services for patients in the Havant area. In the meantime, patients can be referred to Practice Plus Group services at the St Mary’s community health campus in Portsmouth for those diagnostic tests. The Queen Alexandra hospital in Cosham is also providing diagnostic services and is of course accessible to many patients across Havant. For some, it is likely that this will be more convenient and should be offered as a location for diagnostic tests.
The hon. Member will be aware that the Oak Park community diagnostic centre is also located at the Oak Park community clinic. The non-obstetric ultrasound service at the Oak Park community clinic was, until recently, provided as part of the community diagnostic centre. X-ray and echocardiography, while provided at the same site, are separate from the CDC operations. When the community diagnostic centre was first approved, Portsmouth hospitals university NHS trust commissioned Practice Plus Group to deliver non-obstetric ultrasound activity for the centre. This arrangement would utilise Practice Plus Group’s equipment and rooms, with sonographers employed by the trust delivering the tests.
I can today confirm to the hon. Member and to the House that Portsmouth hospitals university NHS trust is preparing to recommence non-obstetric ultrasound at the Oak Park CDC this month. With financial support from NHS England’s national diagnostic programme, the trust has been able to purchase an additional scanner for this site. In the meantime, the Oak Park CDC continues to provide symptomatic mammography, ophthalmology assessment and peripheral neurophysiology assessments at the Oak Park community clinic site. The hon. Member asked about the possibility of temporary pop-up facilities to restore all services at Oak Park. I am informed that the ICB is working closely with Practice Plus Group to resolve this issue, and is looking for a solution to restore X-ray and echocardiography at the Oak Park community clinic for patients.
Community provision of diagnostic services, such as those at the Oak Park clinic, are a central plank of our plan to make the NHS fit for the future. We are committed to bringing more diagnostic services into community settings and to making healthcare more accessible to patients who might face barriers to hospital access, including those with mobility issues, caring responsibilities or limited transport options. We have committed, as part of our elective reform plan, to build up to five more CDCs as part of our £600 million capital investment for diagnostics in 2025-26.
We are also working to ensure that more CDCs are open 12 hours a day, seven days a week, to deliver more same-day tests and consultations, and an expanded range of tests. Since the Government came into office in July 2024, CDCs have delivered more than 10.9 million tests and scans. CDCs are a vital step in supporting our shift from hospital to community. They provide access to vital tests, scans and checks, closer to home, for patients with busy working lives. We are setting clear diagnostic performance expectations for NHS providers. Our medium-term planning guidance sets out the ambition for improvement in performance against the diagnostic six-week wait constitutional standard, so that, by March 2029, no more than 1% of patients wait more than six weeks from referral for a diagnostic test. We have set the interim milestone that, by March 2027, no more than 20% of patients wait over six weeks.
We recognise that significant improvements will be required in the performance of NHS Hampshire and Isle of Wight ICB. Performance is currently at 29.5%, as of November 2025, so there is clearly a long way to go. In 2025-26, NHS Hampshire and Isle of Wight ICB was allocated £49.3 million of capital funding from the constitutional standards recovery fund announced by the Chancellor at the spending review, with the aim of supporting NHS performance across secondary and emergency care, including by supporting new capacity and productivity improvements in diagnostic services. It is part of over £6 billion of additional capital investment over five years across new diagnostic, elective and urgent care capacity, to deliver the improvements to the NHS that patients need and deserve, so that the NHS is there for them when they need it.
I thank the hon. Member for securing this important debate.
Question put and agreed to.
NHS Dentists
Stephen Kinnock Excerpts(3 weeks, 3 days 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(1 month, 1 week 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(1 month, 2 weeks 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(2 months, 1 week 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(2 months, 1 week 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(2 months, 1 week 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.
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