Parkinson’s Disease
Stephen Kinnock Excerpts(1 week, 2 days ago)
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The Minister for Care (Stephen Kinnock)
It is a great pleasure to serve under your chairship, Mr Stuart.
I pay tribute to my hon. Friend the Member for Colne Valley (Paul Davies) for securing this important debate. He spoke with real passion and conviction, as did hon. Members from across the Chamber. I do not know whether we have a full house from Dorset, but we have the hon. Member for West Dorset (Edward Morello), my hon. Friend the Member for South Dorset (Lloyd Hatton) and the hon. Member for Mid Dorset and North Poole (Vikki Slade); it was great to hear their thoughts. We also heard from the hon. Member for Strangford (Jim Shannon), who spoke, as always, with great passion and conviction. This debate follows closely on the heels of the Backbench Business debate on Parkinson’s Awareness Month, which was led by my hon. Friend the Member for Dunfermline and Dollar (Graeme Downie). I thank the Members who have spoken in both debates.
I pay tribute to the invaluable work of NHS clinicians, charities and care workers who spend every single day improving the lives of people with Parkinson’s disease. I am particularly encouraged by the Parky charter, which is raising public and professional awareness about the needs of the Parkinson’s community and the importance of timely diagnosis, comprehensive care and dignity for all people with Parkinson’s. Organisations that fight for patients, such as Parkinson’s UK, are at the heart of our policies for the NHS, which is broken but not beaten. We look forward to working with them to fix the foundations of the NHS and to make it work for people with Parkinson’s in Colne Valley, throughout Yorkshire and across the country.
Parkinson’s disease can severely impact every aspect of a person’s daily life, as well as the lives of their family and unpaid carers. It can put people under immense strain, and they deserve additional support to help them live with the condition. Around 153,000 people live with Parkinson’s in the UK, and it is the fastest growing neurological condition in the world. About 16.5 million people in the UK, or one in six of the population, have a neurological condition, and 600,000 people are diagnosed with one each year. Together, neurological conditions cause around 140,000 deaths every year in the UK—one fifth of all deaths—and they are the leading cause of disability.
In 2019, the NHS spent just under £4.5 billion on neurological conditions and they cost the UK economy £96 billion, so tackling them presents a real opportunity not just for the Government’s health mission but for our growth mission. We must face the fact that patients are facing significant challenges, including not enough people in the places we need them, and delays to treatment and care, with long waiting times. We also listen to patients who tell us that they have experienced a lack of information and support.
We are acting to address those challenges, starting with our workforce. Parkinson’s nurses and neurologists are worth their weight in gold, and they are key to meeting patient demand. This summer, we will publish a refreshed long-term workforce plan, as a first step towards rebuilding our workforce over the next decade and treating patients on time again. We will ensure that the NHS has the right people, in the right places, with the right skills, to deliver the care that patients need when they need it. We will set out in black and white the numbers of doctors, nurses and other professionals who will be needed in five, 10 and 15 years’ time.
Turning to waiting lists, the NHS constitution sets out that patients should start consultant-led treatment within a maximum of 18 weeks from referral for non-urgent conditions. At the start of the year, my right hon. and learned Friend the Prime Minister announced our elective reform plan, which sets out our approach to hitting that target by the end of this Parliament. We have already surpassed our manifesto pledge to deliver an extra 2 million elective appointments, seven months ahead of the deadline; we are now on 3 million appointments and counting. Many of those were appointments for treating Parkinson’s.
I know that there may be some people with Parkinson’s watching the debate at home and shouting at their telly, “Well, I am still waiting for treatment.” Although waiting lists are coming down, and recently fell for six months in a row, they are still high. I completely understand why people who are still waiting feel frustrated. I say to them: we are throwing the proverbial kitchen sink at waiting lists, and we will not stop until you see and feel the results.
The NHS has begun some important initiatives to improve its neurology services, including the neuroscience transformation programme, the Getting it Right First Time initiative, a strengthened clinical reference group and the appointment of a national clinical director for neurology. The NHS is focusing on improving patient experiences, addressing the disparities in care and ensuring that patients are given their medicines on time. The neuroscience transformation programme is focusing on faster diagnoses, better co-ordinated care and improved access to specialist services.
At the at the recent Backbench Business debate—and, of course, in this debate—a number of hon. Members spoke about personal independence payment as an important way of helping people to cope with the extra living costs of a disability or health condition. I am sure all Members would agree that those who can work should work. However, I am happy to reassure colleagues that our “Pathways to Work” Green Paper will make sure that people with the most severe lifelong health conditions who cannot work will see their incomes protected. We are consulting on the Green Paper to hear how best we can support those impacted by our reforms.
We continue to encourage research, which is advancing our understanding of Parkinson’s at breakneck speed, through targeted funding, infrastructure support and collaboration. For example, the UK Dementia Research Institute, sponsored by this Government, is partnering with Parkinson’s UK to establish a new £10 million research centre. The NIHR is supporting research that has discovered that eye scans can detect Parkinson’s disease up to seven years before symptoms appear, which helps people to receive treatment earlier and prepare themselves as best they can.
Research also underpins the entire drug discovery and development process. Produodopa is a groundbreaking new treatment for Parkinson’s disease, particularly for patients with advanced disease and severe motor fluctuations. It is revolutionary because it provides a continuous 24-hour infusion of medication via a small pump, allowing more consistent symptom control. The NHS rolled it out in February last year. It has been shown to improve motor function and has proved its worth by significantly improving the quality of life for people with advanced Parkinson’s.
At the debate on 1 May, many Members emphasised the importance of staying active. Indeed, there is strong scientific evidence that being physically active can help people to lead a healthier and happier life. For example, exercise can reduce the risk of major illnesses and lowers the risk of early death by up to a third. Our social prescribing programme is a key component of the NHS’s universal personalised care and a way for GPs or local agencies to refer people to a social prescribing link worker. Those workers give people time, focusing on what matters to them and taking a holistic approach to people’s health and wellbeing. They connect people to community groups and statutory services for practical and emotional support.
Looking forward, we have committed to publishing a 10-year plan for health to shift the focus of our NHS from hospital to community, from analogue to digital and from treatment to prevention. In the meantime, we have taken steps towards those shifts through the home-based care pathway, which is providing comprehensive support and care for people with Parkinson’s in their own home, and through the NIHR project to test a non-invasive vibrational cueing system, helping people with Parkinson’s to maintain their walking as they go about their everyday lives.
Chris Bloore (Redditch) (Lab)
I congratulate my hon. Friend the Member for Colne Valley (Paul Davies) on securing the debate. I declare an interest as a member of the APPG on Parkinson’s, as the son of a sufferer of Parkinson’s, and as the grandson of someone who died suffering of Parkinson’s. We all agree that, while there are real challenges, we must secure a cure for Parkinson’s. Does the Minister agree that we owe a great debt of gratitude to the partners, spouses and community groups that do so much to support people suffering from Parkinson’s as they go through not only horrific mobility loss but the associated deep psychiatric problems?
Stephen Kinnock
My hon. Friend is absolutely right; our system could not survive without the amazing and heroic work of our unpaid carers. One of our Government’s actions that I am most proud of is the change to the carer’s allowance. We increased the number of hours for which a carer can work and still keep their carer’s allowance by raising the threshold from £151 to £196. I hope that is giving carers the flexibility that they need. Many carers want to work but it is immensely stressful for them to balance their working and caring responsibilities. I was very pleased that we could announce that change back in January, but my hon. Friend is absolutely right that there is a lot more that we can do. I am working with colleagues in DWP and the Department for Business and Trade to look at how we can do more as a Government for unpaid carers. My hon. Friend is absolutely right to pay tribute to them; they are the lifeblood of our care system.
The consultation on our 10-year plan received over 190,000 responses, giving people with Parkinson’s and other conditions a voice in the future of healthcare. I want to conclude this debate by quoting just one of those voices—that of Winston, a former St John Ambulance worker from Lewisham. He said:
“People don’t always see what’s happening to me, or what Parkinson’s looks like on me. They don’t see me early in the morning. They see me looking nice and managing the condition as best I can. But I have to deal with my own bubble sometimes, and it gets burst, and things go all over the place.”
I am pleased that Winston is doing fantastically well and now sharing tips with people on how to improve their public speaking abilities. His words will resonate with anyone who has a long-term condition. Stories like his should remind us why we need a health service that sees the whole person, not just the condition, to give patients the dignity, care and respect that they deserve.
I thank my hon. Friend the Member for Colne Valley again for securing this important debate, and I pay tribute to all Members for making it constructive and powerful. I look forward to working with Members on this matter.
Mental Health Bill [Lords]
Stephen Kinnock ExcerptsMonday 19th May 2025
(1 week, 4 days ago)
Commons ChamberRead Full debate Mental Health Bill [HL] 2024-26 View all Mental Health Bill [HL] 2024-26 Debates Read Hansard Text Watch Debate Read Debate Ministerial Extracts Amendment Paper: HL Bill 93 Running list of amendments – 14 April 2025 - (14 Apr 2025)
The Minister for Care (Stephen Kinnock)
It was truly a privilege to be in the Chamber this evening to hear so many moving, powerful and thoughtful contributions. It really was Parliament at its best, and it is an honour for me to close the debate.
The Bill has been a long time coming. Patients, practitioners, campaigners and charities have all long awaited the introduction of this legislation and have played a hugely important role in getting the Bill to this point. I would like to put on record my thanks on behalf of the Government and pay testament to their commitment to change. I thank Members in both this House and the other place, including our brilliant and esteemed colleague Baroness Merron, for all their work.
As the Bill started in the other place, it has already been through extensive detailed scrutiny under the eyes of peers, many of whom were there when the Act was last revisited in 2007—I am sure they will enjoy me reminding them of that. It is testament to the cross-party consensus that has so far underpinned the Bill that the debates were constructive and largely led to the betterment of the Bill. I trust that this collegiate spirit will now continue in this House, and I thank the Opposition and the Liberal Democrats for the constructive spirit in their approach to this debate.
Every speech we heard sought to improve processes and outcomes for patients and their loved ones, and there is broad cross-party support for the overall ambitions of the Bill. However, some specific issues and queries were raised in the course of the debate that need addressing. Many hon. Members asked about our implementation plans, rightly stating that legislation is only as good as its application. Indeed, we know that community service provision is very far from where it needs to be—an issue that we intend to address alongside the implementation of the Bill.
Our first priority after Royal Assent will therefore be to draft and consult on the code of practice. It is essential that we listen both to practitioners and to those with experience of the Act when we draw up the statutory guidance.
Helen Hayes (Dulwich and West Norwood) (Lab)
The review of the Mental Health Act 1983 is very welcome. It started its life close to my constituency with the work of Professor Sir Simon Wessely, who drew on the experience of many residents in south-east London, particularly with regard to his work on racial inequalities. As the Minister is talking about the implementation of the Bill, I wonder whether he can reassure my constituents, who want to know that this Bill will do the job of eliminating racial inequality from mental health services, by committing to putting the patient and carer race equality framework on the face of the Bill.
Stephen Kinnock
We are already working to reduce inequalities under the Mental Health Act. The patient and carer race equality framework is now a contractual requirement for all providers of NHS-commissioned care. It will support trusts to improve their interaction with racialised and culturally diverse communities and improve governance, accountability and leadership on improving experience of care for those communities and drive concrete actions to reduce racial inequalities within mental health services.
Given that our first priority after Royal Assent will be to draft and consult on the code of practice, it is essential that we listen both to practitioners and to those with experience of the Act when drawing up the statutory guidance that supports the Act’s application. We will therefore engage with people with lived experience, their families and carers, staff and professional groups, commissioners, providers and others to do this. The code will be laid before Parliament before final publication.
Alongside the code, we will develop secondary legislation that will be laid before Parliament, subject to the parliamentary process as set out in the legislation. We have already published policy papers that set out more information on some of the delegated powers in the Bill and provide an early indication of what we intend to set out in regulations. We recognise the appetite to deliver after years of delay and the importance of parliamentary scrutiny and accountability in this crucial work. We have therefore committed to laying an annual written ministerial statement on progress, so that hon. Members will have ample opportunity to hold us to account for progress made and milestones achieved.
We have covered a wide range of topics and questions this evening, and I will not be able to cover all of them in the time allocated to me. I will therefore limit my comments to two areas that have come up repeatedly, namely the implementation plan and the treatment of people with autism and learning disabilities.
Melanie Ward
I thank the Minister for giving way. He is talking, rightly, about the importance of the implementation of legislation. He will be aware that new measures came into force two months ago under the Online Safety Act 2023, which introduced legal powers to remove online content that promotes suicide. Ahead of this, I wrote to Ofcom about a platform that is actively promoting suicide and suicidal ideation, and has been linked to the deaths of almost 100 young people and adults. The Ofcom chief executive replied to say that Ofcom was opening an investigation. Does the Minister agree that it needs to get on and remove this kind of content across the UK?
Stephen Kinnock
Of course, we have the Online Safety Act, and there are measures within that legislation that address this issue. However, my hon. Friend is absolutely right that it is time to crack on and deal with this deeply troubling issue. I pay tribute to her excellent work, and I hope she will continue to press Ofcom to do the right thing, and to do it rapidly.
We know that implementation will take time, as the pre-legislative scrutiny Committee recognised. We estimate that it will take around 10 years to fully implement all Bill’s measures, due largely to the time needed to train specialised workforce groups, including second opinion appointed doctors and tribunal judges, and the need to ensure that the right community support is available for people with a learning disability and autistic people. This timeframe necessarily spans multiple spending reviews and multiple Parliaments, so I am limited in the detail I can give today about future spend and timelines.
However, we have set out in the impact assessment what we think is required in both time and funding. We expect the process of drafting and consulting on the code of practice to take at least a year. Alongside the code, we will develop secondary legislation, which will be laid before Parliament. We have already published policy papers, which contain more information on some of the delegated powers in the Bill and provide an early indication of what will be set out in regulations.
We will then need time to train the existing workforce on the new Act, regulations and code, which will likely be in 2026 and 2027. Although we will commence some clauses, such as on supervised discharge, two months after Royal Assent, the first major reforms, including clauses concerning grounds for detention—excluding the changes to part 2 for people with learning disability and autistic people—and nominated persons, are expected to follow the training in mid-2027. The timelines for later phases are inevitably less defined, but we will expand the workforce and improve community support with the aim of implementing the reforms increasing the frequency of mental health tribunals from 2030-31. These timelines are indicative, and we will iterate the plans as we get more certainty on future funding and wider workforce plans.
The other issue that came up a lot is the treatment of people with autism and learning disabilities. Again, implementation should be well planned to ensure that the proposed legislative changes have the intended effect. The proposed changes to the detention criteria will be commenced only when strong community services are in place so that the alternatives to hospital care are robust. Members will understand that robust implementation plans are dependent on the final legislation that is passed and on future funding, which is subject to future spending reviews.
However, local systems do not need to wait for legislative changes to come into force to begin putting in place the necessary community services for people with a learning disability and autistic people. There is renewed funding in 2025-26 within ICB baselines to continue improving community support provision for people with a learning disability and autistic people.
We should recognise that the Bill is the result of the independent review commissioned by the now Baroness May of Maidenhead during her premiership. Many important contributions have also come from those with lived experience of the Act and their loved ones. It takes real courage to speak openly about those experiences and to channel pain into change.
As my right hon. Friend the Health Secretary said in his opening speech, the Government have demonstrated their commitment to funding mental health properly, and that commitment has been translated into real, tangible delivery: the £150 million multi-year capital investment to improve mental health urgent and emergency care pathways; 600 new or expanded crisis alternative services nationally, including crisis cafés, safe havens and crisis houses, providing an alternative to A&E or psychiatric admission; £26 million in capital investment to open new mental health crisis assessment centres, which aim to provide accessible and responsive care for individuals in mental health crisis; and 8,500 more mental health workers.
We are also committed to improving early intervention and shifting care to the community to support people to live well and thrive. We have committed to improve support for young people, with Young Futures hubs, making support workers more accessible to children. We are piloting in England the 24/7 neighbourhood mental health centre model, which builds on learning from international exemplars.
It is a privilege to be leading this transformational legislation through the House. I know that, because it matters so much, many people will have views on what is needed to get it right, and I look forward to further debates in that constructive and improving spirit. I commend the Bill to the House.
Question put and agreed to.
Bill accordingly read a Second time.
Mental Health Bill [Lords] (Programme)
Motion made, and Question put forthwith (Standing Order No. 83A(7)),
That the following provisions shall apply to the Mental Health Bill [Lords]:
Committal
(1) The Bill shall be committed to a Public Bill Committee.
Proceedings in Public Bill Committee
(2) Proceedings in the Public Bill Committee shall (so far as not previously concluded) be brought to a conclusion on Thursday 26 June 2025.
(3)The Public Bill Committee shall have leave to sit twice on the first day on which it meets.
Consideration and Third Reading
(4) Proceedings on Consideration shall (so far as not previously concluded) be brought to a conclusion one hour before the moment of interruption on the day on which those proceedings are commenced.
(5) Proceedings on Third Reading shall (so far as not previously concluded) be brought to a conclusion at the moment of interruption on that day.
(6) Standing Order No. 83B (Programming committees) shall not apply to proceedings on Consideration and Third Reading.
Other proceedings
(7) Any other proceedings on the Bill may be programmed.—(Anna Turley.)
Question agreed to.
Mental Health Bill [Lords] (Money)
King’s recommendation signified.
Motion made, and Question put forthwith (Standing Order No. 52(1)(a)),
That, for the purposes of any Act resulting from the Mental Health Bill [Lords], it is expedient to authorise the payment out of money provided by Parliament of any increase attributable to the Act in the sums payable under or by virtue of any other Act out of money so provided.—(Anna Turley.)
Question agreed to.
Oral Answers to Questions
Stephen Kinnock Excerpts(3 weeks, 3 days ago)
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The Minister for Care (Stephen Kinnock)
I am pleased to tell my hon. Friend that we have recruited over 1,500 additional GPs since October through an investment of £82 million, helping to fix the front door to the NHS. Today we have announced £100 million to unlock new capacity and more appointments in GP surgeries. We have also launched a red tape challenge and scrapped unnecessary targets in our new GP contract to cut down on bureaucracy and free up time to spend with patients.
Alex Ballinger
My constituents in Halesowen have written to me time and again complaining that they are calling their GP surgeries at 8 am, as instructed, but are still unable to get a same-day appointment. Can the Minister set out how the £100 million investment in GP surgeries, consulting rooms and other facilities will finally put an end to the frustrating 8 am scramble?
Stephen Kinnock
I absolutely share the frustrations of my hon. Friend and his constituents. The investment made today was in response to GPs telling us that they needed more space; the investment will lead to more capacity and better access and outcomes for his constituents. Today’s announcement was only possible thanks to the decisions made in the October Budget, which were opposed by every party opposite. The choice is clear: investment in our NHS with Labour, or cuts with the Tories and Reform.
Rebecca Smith (South West Devon) (Con)
My constituent Dr Toby Nelson, an NHS consultant dermatologist, has started a business that seeks to address the heavy demand on primary care for skin health screening. His business Map My Mole sends an image capture kit to patients to attach to their smartphones. The patients then send a high-resolution image remotely to be reviewed by a specialist consultant, bypassing the need for a GP appointment and freeing up time and resources for both doctor and patient. It has already resulted in a significant drop in skin cancer referrals in pilot GP surgeries. Will the Minister agree to meet Dr Nelson and me to discuss this revolutionary proposal?
Stephen Kinnock
The hon. Lady raises what sounds like an extremely interesting scheme. She will know that we have a strong commitment in our 10-year plan to shift from hospital to community, and indeed from analogue to digital. The digital aspects of that scheme sound very interesting, so I would be more than happy to take further representations from her.
Marsha De Cordova (Battersea) (Lab)
The Minister for Care (Stephen Kinnock)
My hon. Friend is an outstanding campaigner on this issue, as I am sure everybody across the House is aware. She will know that the NHS England accelerator pilots have shown how improved IT connectivity and a single point of access can speed up eye care referrals and allow more patients to be managed in the community. That is a great example of the shift we want to make from analogue to digital. We are developing the 10-year health plan with input from the public, our partners and health staff, and that of course includes the eye care sector.
Marsha De Cordova
I thank the Minister for his response, and I welcome all the work that he and the Secretary of State are doing in rebuilding our NHS. However, we know that there is a capacity crisis within eye healthcare. NHS ophthalmology continues to be the busiest and largest outpatient service. That is essentially what is leading to many people not getting seen soon enough, which is resulting in many of them losing their sight unnecessarily. What we need is a joined-up healthcare plan. Will the Minister ensure that eye healthcare will be part of the Government’s wider 10-year health plan?
Stephen Kinnock
My hon. Friend is right that early intervention is crucial, and the interface between the high street and secondary care is a vital part of that. That means having a joined-up eye health strategy. The 10-year plan will have that joined-up strategy at its heart. She will be pleased to know that, since July, ophthalmology waiting lists have dropped by 24,000, so change has begun. There is still a long way to go to dig us out of the mess left by the Conservative party, but it is thanks to the decisions that the Government have made, opposed by Opposition parties, that we are beginning to see that change gaining traction.
Sir James Cleverly (Braintree) (Con)
Another part of the 10-year health plan is the use of digital technology. Auto-contouring with artificial intelligence reduces waiting times and frees up capacity for radiotherapists, which is why £15.5 million was allocated to it under the Conservative Government; money that has been cut under the Minister’s Government. Why?
Stephen Kinnock
I think that the right hon. Gentleman is referring to the single point of access digital technology, which is game changing in terms of improving the interface between high street and secondary care. It is probably worth reminding him that the question is about eye care. We are absolutely committed to single point of access technology, which we believe can be game-changing technology and is a vital part of our shift from analogue to digital.
Peter Prinsley (Bury St Edmunds and Stowmarket) (Lab)
The president of the Royal College of Ophthalmologists has stated that the widespread outsourcing of NHS cataract surgery to private, for-profit providers risks the integrity of hospital eye surgery departments meaning that there will be few services to treat patients with preventable blindness. How can we reassure the public that such services will be maintained?
Stephen Kinnock
Although the independent sector clearly has an important role to play in tackling waiting lists and backlogs, we will not tolerate any overpriced or sub-par care, and we will not tolerate any distortion of patient choice. The recently published partnership agreement between NHS England and the Independent Healthcare Provider Network commits to ending incentives that can lead to that, and to supporting equal access and genuine choice for all patients. We are working together to deliver on that.
Jess Brown-Fuller (Chichester) (LD)
NHS Sussex ICB is one of only five in England not to commission a minor eye conditions service—known as MECS—in community optometry settings. That means that patients in Chichester with urgent or minor eye issues have to either join the 8 am queue for a GP appointment or go to their hospital rather than being seen quickly on the high street. Given that 99.9% of MECS patients elsewhere in England are seen within 24 hours, will the Minister set out what action he is taking to ensure that those services are commissioned consistently across all ICBs within the 10-year health plan?
Stephen Kinnock
ICBs are responsible for the commissioning of these services, which are clearly extremely important, and the early intervention side of eye care is particularly important. I would be more than happy to look into that issue with the hon. Lady’s ICB if she wrote to me and made further representations.
Blake Stephenson (Mid Bedfordshire) (Con)
Manuela Perteghella (Stratford-on-Avon) (LD)
The Minister for Care (Stephen Kinnock)
We are already rolling out our manifesto commitment of 700,000 extra urgent dental appointments per year. These appointments are available across the country for those experiencing painful dental issues such as infections, abscesses or cracked or broken teeth. We are committed to reforming the dental contract and making NHS dentistry fit for the future.
Manuela Perteghella
The dental contract imposed in 2006 is widely recognised as a key factor driving dentists out of the NHS. In my constituency of Stratford-on-Avon, there are no NHS dentists currently taking on new patients, and existing NHS patients are being actively pressured to go private or seek care out of county. Will the Minister commit to urgent reform of NHS dentistry, and set out a timeline for negotiations, so that I can reassure my constituents?
Stephen Kinnock
The hon. Member is right to say that the dental contract is fundamentally flawed and needs reform. I met representatives of the British Dental Association on 8 April, and had a productive discussion with them about dental contract reform. Officials from the Department of Health and Social Care are working hard with the BDA and other stakeholders to develop a dental contract that works for patients, for dental professionals and for the public purse. I will of course keep her and the House updated. I know this issue is of huge importance to the country, and to every Member of this House.
Chris Webb (Blackpool South) (Lab)
It is a year today since I was sworn into this House, and every single week, someone has raised with me the issue of getting access to an NHS dentist in Blackpool. Nowhere is taking on adults, and nowhere is looking after pregnant women. This has to change, so can the Minister outline to my constituents when they will be able to get access to an NHS dentist under this Labour Government?
Stephen Kinnock
There is no perfect payment system. We have to look at the issue around units of dental activity, and at options around capitation and sessional payments, and come to a conclusion about what works and about how to ensure that everything that we commit to NHS dentistry is spent on NHS dentistry. We are in a mad situation in which, although demand for NHS dentistry is going through the roof, we have an underspend every year on the contract. We have to fix that. It will take some time to work that out with the British Dental Association and other key stakeholders. What is tragic about this situation is that the Conservatives had 14 years to fix the situation and left it in a terrible mess.
Laura Kyrke-Smith (Aylesbury) (Lab)
Josh MacAlister (Whitehaven and Workington) (Lab)
The Minister for Care (Stephen Kinnock)
The Government have launched a scheme to provide 700,000 urgent dental appointments. There are 57,500 allocated to my hon. Friend’s integrated care board. He will know that ICBs are responsible for commissioning primary care services based on the needs of the population, but I know that he is a strong campaigner for his constituents. I understand that his dialogue with his ICB on this matter has been positive and constructive, and I am sure that he will continue to fly the flag.
Sir Jeremy Hunt (Godalming and Ash) (Con)
Stephen Kinnock
My hon. Friend will know that we have hired 1,500 more GPs, which will help with access. We have also renegotiated the contract, so there will be online booking systems in every practice in the country, and we have changed the contract to incentivise continuity of care in order to bring back the family doctor. There is a suite of reforms coupled with investment, which I hope will deliver for my hon. Friend’s constituents.
Bob Blackman (Harrow East) (Con)
Tessa Munt (Wells and Mendip Hills) (LD)
Stephen Kinnock
As the hon. Lady knows, we now have a commitment to providing 700,000 more urgent dental appointments. Those who do not have an NHS dentist can call 111 and will be prioritised. We are very clear that every integrated care board has a target within those 700,000 appointments, and if they are not hitting that target, we will want to know why.
Olivia Blake (Sheffield Hallam) (Lab)
As someone with ADHD, it is disappointing to hear from many of my constituents about difficulties in accessing diagnosis, medication and other therapeutic inputs for ADHD, and the impact on their lives and livelihoods as a result. Whether for children or adults, waits of two, five or seven years are becoming the norm. What steps are the Government taking to make sure that individuals can exercise their right to choose?
Stephen Kinnock
I pay tribute to my hon. Friend for improving support for ADHD and recognise the valuable perspective that she brings through her lived experience. This Government inherited a broken NHS, with too many people facing long waits for an assessment. NHS England’s ADHD taskforce is looking at how support for people with ADHD can be improved. I look forward to reading its report, and I recently had a very productive meeting with the director of that taskforce.
Mr Peter Bedford (Mid Leicestershire) (Con)
Stephen Kinnock
I give the hon. Member that assurance. We have been clear that every ICB has a target, and that was transparently published, and we will be monitoring it. I am holding regular meetings with officials to check that every single ICB is on track to hit those targets. If ICBs are not on track to hit those targets, we will want to know why.
Markus Campbell-Savours (Penrith and Solway) (Lab)
Earlier this year, I met the Cockermouth and Maryport primary care network, which told me about the increasing challenge of supporting my constituents with their mental health. Has the Secretary of State considered relaxing the additional roles reimbursement scheme funding rules to allow mental health nurses to be employed wholly by a PCN, and not need to be under the employment of a local mental health trust? That flexibility could help GP practices to intervene earlier and reduce referrals to secondary care quickly.
Stephen Kinnock
We have, in fact, relaxed the rules on ARRS so that a mental health worker can be employed by the PCN. My hon. Friend is absolutely right that that is an important part of stepping from hospital to community, but there is more we can do on that. We continue to do whatever we can to ensure that mental health and GP surgeries are actively integrating.
Robin Swann (South Antrim) (UUP)
Getting It Right First Time is a clinician-led programme that leads on improvement and transformation. Can the Secretary State give reassurance that in any restructuring of NHS England, that programme will not just be continued, but expanded and still available to the devolved Administrations?
Catherine Atkinson (Derby North) (Lab)
Last week, this Labour Government announced the freezing of prescription charges, putting pounds back in the pockets of people in Derby. I have visited pharmacies, including the Littleover pharmacy, which provide essential care and support for their communities. The Conservatives underfunded pharmacies and more than 750 closed across England between 2021 and 2024. What is the Minister doing to support community pharmacies so that we do not lose these vital local services?
Stephen Kinnock
After years of neglect, this Government have agreed with the sector a record uplift to £3.1 billion for 2025-26 for this vitally important front door to our NHS. We are also supporting pharmacies to operate more efficiently, including enabling hub and spoke dispensing between all pharmacies later this year. I am pleased to say that the legislation for that has been laid. What a contrast that is with the previous 14 years. I am also pleased to see that the National Pharmacy Association has withdrawn its view on taking collective action. We are moving in the right direction, but there is still a lot more to do.
Calum Miller (Bicester and Woodstock) (LD)
I welcome today’s announcement of new money for GPs’ surgeries, but GPs in my constituency tell me that they cannot get capital out of the integrated care board and that the Valuation Office Agency consistently undervalues the cost of rents, making future building impossible. Will the Secretary of State agree to meet me, and GPs from my constituency, in order to understand the problem better?
Stephen Kinnock
I pay tribute to my hon. Friend, who is a qualified physiotherapist, and who is right to refer to the value of community care. I would be happy to meet her to discuss the important issue that she has raised.
Jim Shannon (Strangford) (DUP)
What steps will be taken to support more community pharmacies that can offer a broad range of services to people in rural areas, to ensure that those who are most isolated from busy towns still have access to those important services?
Stephen Kinnock
As I said earlier, we are giving pharmacies a record 19% uplift to £3.1 billion, and I am pleased to confirm that of all the sectors in the NHS they received the best uplift in the 2025-26 settlement. We have also maintained the pharmacy access scheme, which provides £19 million to support pharmacies in areas where there are fewer of them, including the rural areas that the hon. Gentleman mentioned.
Jon Trickett (Normanton and Hemsworth) (Lab)
Pharmacies play a key role in communities in rural areas such as mine, but it is deeply frustrating when the supply chain breaks down and a pharmacy cannot deliver its medicine. Can the Minister tell me where we are now with the supply chain? Will she also thank all the heroic workers up and down the country who are doing their very best to deliver medicines, and will she thank in particular the 400 Superdrug workers in my constituency who are trying to make the supply chain work?
Community Health: Manchester Rusholme
Stephen Kinnock Excerpts(1 month ago)
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The Minister for Care (Stephen Kinnock)
I congratulate my hon. Friend the Member for Manchester Rusholme (Afzal Khan) on securing this important debate. Before I begin my remarks, I would like to pay tribute to some of the stellar charities that are working to reduce health inequalities: the Health Foundation, which is leading the way with its Health Equals mission; the People’s Health Trust, which is providing funding and support to left-behind communities; and the BHA for Equality, which was founded in 1990 to address the lack of quality information and services for black communities in Manchester.
I am responding on behalf of the Minister for Public Health—the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for West Lancashire (Ashley Dalton)—but I am more than happy to take this debate because I recognise many of the issues that my hon. Friend the Member for Manchester Rusholme mentioned from my own constituency. I am responding not just on behalf of the Government, but as an MP from a constituency with some of the highest levels of deprivation in the United Kingdom.
I agree with my hon. Friend that the levels of inequality between the better-off and worse-off in our country are a national scandal. Fourteen years of austerity measures and stagnant wages have disproportionately affected lower-income households, exacerbating both income and regional disparities. Places such as Manchester and Port Talbot have borne the brunt. The life expectancy for Mancunian men and women is significantly worse compared with their compatriots in the rest of England. A baby boy born in the Manchester royal infirmary can expect to live for just over 75 years, which is four years less than the English average. A baby girl born in Manchester can expect to live to the age of about 79 and a half, which is also four years less than in England as a whole.
My hon. Friend raises some issues that are not within my Department’s remit, including housing, knife crime and fly-tipping, but I completely understand why he has done so, because the determinants of ill health are wide and it is much more than a single factor that predicts healthy life expectancy. The Government know that we cannot address the challenges we face in the north-west with each Department in Whitehall siloed one from another, so we are taking a whole-of-Government approach to tackling inequalities through our health mission. That is chaired by the Prime Minister, who is lending his weight and authority from the centre of Government.
We have a laser focus on addressing the social determinants of health in a truly strategic way, and addressing the wider determinants of health to improve healthy life expectancy for all, while halving the gap in healthy life expectancy between different regions of England. We are prioritising prevention, shifting more care into the community and intervening earlier in life to raise the healthiest generation of children in our history. Addressing healthcare inequity is a core focus of our 10-year health plan to ensure that the NHS is there for anyone who needs it whenever they need it. We have established 11 working groups to take forward policy development that will feed into the plan. That includes working groups focused on how care should be designed and delivered to improve healthcare equity, alongside ensuring that access to healthcare services is effective and responsive. We look forward to updating the House once the plan is published in June.
Proximity to fast food outlets is strongly associated with obesity. Kids living in the most deprived communities are in proximity to twice the number of fast food outlets compared with wealthier areas. Nearly 3,500 schools across the country now have a major food outlet within 400 metres; that is 1,000 more schools than 10 years ago.
We have an outstanding mayor in Andy Burnham. Devolution gives him and other leaders in Greater Manchester the freedom and flexibility to set priorities locally. In December, the Government published the revised national planning policy framework for local authorities, which gave them stronger, clearer powers to block new fast food outlets near schools and where young people gather. This will stop the relentless targeting of children and young people by the fast food industry.
I am delighted that just last week, the Tobacco and Vapes Bill passed its Second Reading in the other place. Smoking is a scourge on deprived communities and contributes to poverty, ill health and a lower life expectancy. Britain is leading the world through landmark legislation to break the cycle of addiction and disadvantage by gradually ending the sale of tobacco products across the country. The Bill contains powers to extend the ban on smoking indoors to certain outdoor settings to reduce the harms of second-hand smoking, particularly around children and vulnerable people.
Over the past 14 years, a two-tier health system has emerged in our country. People who can afford it are increasingly going private to skip the queue, while those who cannot are left behind. We are determined to end two-tier healthcare in this country, so whether someone is the richest or the poorest person in Manchester, they get timely, quality treatment that is free at the point of use. Our elective reform plan will see more NHS patients able to choose to be treated in a private hospital, where there is capacity, paid for by the state. More capacity will be available for people in working-class areas of the country and for women stuck on waiting lists for gynaecological care. Where we can treat working people faster, we will, and we will make no apology for doing so—working-class patients in this country deserve the same choice, control and convenience as the wealthy expect—and I am delighted that waiting lists have been falling now for six months in a row.
The previous Labour Government did so much to reduce inequality: lifting millions of children out of poverty through Sure Start; giving a lifeline to working families through child tax credits; creating the minimum wage; and fixing the NHS after almost two decades of under-investment. It is a matter of profound regret that so much of that legacy has been undone over the past 14 years, but the people of Manchester don’t just want us to look back in anger; they want us to get on with the job of building homes, fixing the NHS and putting more money in people’s pockets. My right hon. and learned Friend the Prime Minister has spoken about the “class ceiling” that prevents children from getting ahead. I look forward to working with my hon. Friend the Member for Manchester Rusholme to shatter the class ceiling that hangs above his constituency and mine.
Question put and agreed to.
Hospitals
Stephen Kinnock Excerpts(1 month, 1 week ago)
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The Minister for Care (Stephen Kinnock)
I am glad you recognised me from the Chair, Mr Speaker. I have lost some hair since we last spoke.
I beg to move an amendment, to leave out from “it” to end and insert:
“also notes that the Chancellor has announced new fiscal rules to ensure capital budgets can no longer be cannibalised, with transfers from capital to resource budgets not permitted; recognises that the previous Government left a New Hospital Programme which was unfunded, unrealistic and undeliverable; welcomes that the Government has taken action to review that Programme and has published the New Hospital Programme Plan for Implementation, to put the Programme on a sustainable footing; supports the Government’s investment in the Plan, which will increase to up to £15 billion over each consecutive five-year wave, averaging around £3 billion a year from 2030; and further supports the work being done to bring forward construction of the reinforced autoclaved aerated concrete replacement schemes wherever possible, to ensure that patient and staff safety is prioritised.”
The amendment on the Order Paper is in the name of my right hon. and learned Friend the Prime Minister. I thank the Liberal Democrats for using their Opposition day to address a matter of vital importance for so many Members, including many colleagues right across the Chamber and their constituents. I sincerely hope that the Liberal Democrats will work with us on solutions, not on soundbites, because we need to be realistic about the problems we face and serious about how we tackle them.
The new hospital programme was announced by the last Government to much fanfare in October 2020, with a promise to deliver 40 new hospitals by 2030. We were told that there was a plan and a timetable, and we were glibly assured that it was fully funded, but from the outset it was clear that there were not 40 new schemes—some were just refurbishments or extensions. To put it simply, there were not 40 projects, they were not all new and many of them were not even hospitals.
The spin around the programme was widely questioned and challenged before the general election, but nevertheless we were truly shocked by what we found on entering the Department of Health and Social Care. The programme was hugely delayed, by several years more than had already been revealed by the National Audit Office. There was no credible plan to deliver the building projects, let alone to deliver them all in the next five years, and there was not even enough construction capacity in the UK to build all the hospitals in the new hospital programme by 2030. That is why when the hospitals with reinforced autoclaved aerated concrete were brought into the NHP in 2023, even the last Government had the sense to admit that nine schemes would have to be delivered past 2030 in order to prioritise the RAAC hospitals.
Perhaps most shocking of all, the funding for the programme was due to run out a month ago, with no provision whatsoever for future years: the money simply was not there. The programme was built on nothing more than false hope, dodgy claims and disingenuous press releases.
Anna Dixon (Shipley) (Lab)
Does the Minister share my constituents’ anger at the failure of the Tories to back up any of their promises about new hospitals? Will he reassure me that my constituents who are served by Airedale general hospital will finally get a new hospital to deal with the RAAC in an affordable, deliverable timetable, unlike the false promises of the Conservatives?
Stephen Kinnock
My hon. Friend is a doughty champion for her constituents, and she is absolutely right. The point she makes raises the even bigger issue of trust in politics and the trust that her constituents have in this place. That trust was fundamentally undermined by the disingenuous nature of what went on with the previous hospital programme. The British people are grown up enough for us to be able to level with them, be straight with them and say, “This plan is credible and affordable. It’s based on facts, not fantasy.”
Daisy Cooper
On the point of trust, the Conservatives completely blew trust with the constituents of West Hertfordshire. They promised a new hospital—they even said in 2023 that it would be fully funded, and it clearly was not. At the most recent general election, the Labour party promised that Watford general hospital would be a priority. Will the Minister make a new promise to keep that trust by coming to visit that hospital this year?
Stephen Kinnock
I am sure the hon. Lady will appreciate the fact that we have now come forward with a programme built not on sand or smoke and mirrors, but on reality, and the hospital she mentioned will be a part of that. She is very welcome to write to me with any further representations.
The situation I have described is the dog’s breakfast that we inherited from the Conservatives. This is genuinely not a partisan point, because when the previous Government did the right thing—for example, on the Tobacco and Vapes Bill—we were more than happy to support them, but where they failed, fibbed, and fobbed off Members of this House, we will not pretend that they were acting in good faith. It now falls to us to level with the British people about why their hospitals will not be fixed on time.
Our constituents are understandably furious, because our national health service is quite literally crumbling. As Lord Darzi found in his investigation, over the past 14 years our NHS has been starved of capital, with a staggering £37 billion under-investment over the course of the 2010s. I know that we will hear today from hon. Members about many examples of hospital roofs failing or falling, leaky pipes that freeze over in the winter and buckets for catching rainwater in corridors, and I know that capital spending is needed now more than ever.
Although we are deeply shocked by the neglect and incompetence of the Conservatives, it has not prevented us from rolling up our sleeves and clearing up the mess that they left behind. That is why we immediately commissioned a review, which had two core objectives. The first was to put the programme on a firm footing with sustainable funding, so that all the projects can be delivered to a realistic and affordable timetable. The second was to give patients a realistic, deliverable timetable based on facts rather than fantasy.
Chris Vince (Harlow) (Lab/Co-op)
My hon. Friend talks about realistic timelines, which are really important. My constituents in Harlow were promised a new hospital when there was clearly no money, no business plan and not even a site made available for it. Does he agree that this work is so important for the trust that we want to have from our constituents? Certainly in Harlow, we have a realistic timeframe and plan that we can actually meet.
Stephen Kinnock
My hon. Friend is also a doughty champion for his constituents. With each brick we build in the new hospital programme, I hope that we will start to rebuild some trust between his constituents and this place. He is absolutely right to point out that it is much better to have a realistic programme, rather than one built on smoke and mirrors.
Officials reported on the review in the autumn and set out a range of options for a more realistic timetable for delivery. In January, my right hon. Friend the Secretary of State for Health and Social Care announced five-year waves of investment, backed by up to £15 billion of investment over consecutive five-year waves, averaging £3 billion a year from 2030. Our programme is a balanced portfolio of hospital schemes at different development stages, being delivered now and into the future. It is the most efficient and cost-effective way of giving our NHS the buildings it needs, while also giving the construction sector the certainty that it needs to deliver.
Calum Miller (Bicester and Woodstock) (LD)
The Minister referred to the capital needs of the NHS as a whole. As my hon. Friend the Member for North Shropshire (Helen Morgan) mentioned, that applies to many GP surgeries too. In my constituency, we have rapid growth in population. The populations of Woodstock, Heyford Park and Bicester are struggling, because GPs want to expand, but they cannot access the money to do so. Will the Minister look urgently at releasing more funds through integrated care boards so that future revenue can be provided to allow for the capital investment that would give my constituents an expansion in GP surgeries and take some pressure off our much-pressurised hospitals?
Stephen Kinnock
I was very pleased to see the £102 million capital investment in GP primary care. I encourage the hon. Gentleman’s ICB to look very carefully at that fund and to explore the potential that it offers. We are in conversation with colleagues in the Ministry of Housing, Communities and Local Government about ensuring that section 106 processes are working properly, so that when there are new developments, there is proper wraparound in the social infrastructure required to make them sustainable. In the space of just nine short months, we have gone from a charade based on smoke and mirrors to a programme based on serious, systematic delivery.
Jim Dickson (Dartford) (Lab)
The Minister is setting out very articulately what this Government are doing to clear up the mess around the hospital provision that this country needs. Does he agree that the announcement by Dartford and Gravesham NHS Trust last week that it will build a new and expanded intensive care unit at Darent Valley hospital is a big step forward for Dartford residents? It badly needs new facilities to cope with waiting lists and get them down and to cope with the rising population of the area.
Stephen Kinnock
My hon. Friend is a strong campaigner for his constituents. He is right that that development will be a game changer. It will be important that we keep people’s feet to the fire to deliver on what has been promised. I guarantee that he will have my full support and that of the entire ministerial team.
With your permission, Madam Deputy Speaker, I will now address the Liberal Democrat motion, beginning with its point about the cannibalising of NHS capital budgets to keep day-to-day services running. I am delighted to confirm from this Dispatch Box that this Government have drawn a line under that appalling practice, to which the Conservative party was utterly addicted. The Treasury now has new fiscal rules to prevent that from happening again; capital spending is safe in our hands.
Secondly, on reversing the so-called programme that we inherited on 4 July, I hope I have made it clear that that whole sorry mess was a work of fiction. It is not a question of reversing anything, as the Liberal Democrats say in their motion, because there was nothing to reverse. Instead, we have gone back to the drawing board, and systematically designed and built a completely new programme and a completely new approach.
Ms Stella Creasy (Walthamstow) (Lab/Co-op)
As somebody who had to put up with what I think was seven photo opportunities by previous Conservative Ministers—including one who is sat on the Opposition Front Benches now—proclaiming that they were rebuilding Whipps Cross hospital with money that did not exist, it is clear that what needs reversing is the Conservatives’ chutzpah in saying that somehow they are the ones championing change on reforming PFI. Some of us spent years trying to persuade Ministers that we could reform the disgraceful spending on PFI—particularly private finance 2—schemes brought in by the previous Conservative Administration. Under those schemes, some trusts were spending £2 billion a year on repayments—more than they were spending on drugs. That is one way in which we could get some money for the new hospitals, so does my hon. Friend agree that it is this Government, rather than the Opposition, who understand good public finances?
Stephen Kinnock
My hon. Friend, who is a relentless campaigner for her constituents, is right: it was simply government by press release, with so many aspects of policy based on making announcements and unfunded spending commitments. When we came into government, we discovered a £22 billion black hole in the public finances, largely based on promises that had no funding whatsoever attached to them. That is the sort of behaviour that undermines trust in politics.
On the Liberal Democrat proposal to create a taskforce, we have excellent teams working on the programme, and they are getting on with the job. We do not have a second to waste. Setting up a new taskforce would simply mean further delay and distraction through process, rather than a laser focus on delivery.
I know that Members across the House share my outrage at the almost £14 billion backlog maintenance bill facing NHS trusts after years of historic under-investment. I understand that many in the Chamber are concerned about the condition of the health facilities that serve their constituents, and I reassure them that my right hon. Friend the Chancellor has given us the funding to begin immediately reversing the trend of decline that started under the last Government. This financial year, we are backing NHS systems through over £4 billion in operational capital; a lifesaving cash injection of £750 million of targeted estate safety funding, as a vital first step towards fixing our crumbling estate; and £440 million to tackle crumbling RAAC, keeping staff, patients and their families safe. We are empowering systems to manage their capital allocations locally and assign funding to local priorities, ensuring that money is spent as effectively as possible, as soon as possible.
Andy Slaughter
My local hospitals were evicted from the new hospital programme when the RAAC schemes came along. There was nothing to delay—there was no money there at all. Does the Minister recognise that some very innovative schemes are now going on locally? We in the Imperial College healthcare trust are partnering with Paddington Life Sciences, Imperial College in South Kensington and White City, and the Hammersmith and Fulham industrial strategy to maximise the available resources so that we can rebuild three world-class hospitals.
Stephen Kinnock
My hon. Friend is making some very strong points on behalf of his constituents. We would certainly be very happy to work more with him on some of those innovations. So often, hospitals are anchor institutions—alongside universities—for driving forward innovation, harnessing the power of technology and contributing to the Government’s growth mission. There are huge opportunities there, and I would be happy to explore them further with my hon. Friend.
Manuela Perteghella (Stratford-on-Avon) (LD)
Despite overwhelming support, the Coventry and Warwickshire integrated care board has decided to cut all beds at the Ellen Badger hospital in Shipston-on-Stour, an anchor building and community hospital that is at the heart of our town. Does the Minister agree that cutting such vital services is unacceptable, and that community hospitals play an important role in rural areas by providing equality of access to our health services?
Stephen Kinnock
The hon. Lady is absolutely right that community hospitals play a vital role, and I share her disappointment with the decisions that are being made. The fact of the matter is that we are in a hole, and we have to dig ourselves out of that hole. It is going to take some time to do that. We are getting the public finances back on an even keel, we are getting our public services back to where they need to be, and we are getting the economy back on a sounder footing. As we make those achievements, I hope that we will be able to reverse some of the decisions that are being made—decisions that are, of course, damaging to the hon. Lady’s community—but we are in a very difficult position, and it will take some time for us to get over that.
Several hon. Members rose—
Stephen Kinnock
If hon. Members will bear with me, I will make a little bit more progress and then come back to them.
Many Liberal Democrat colleagues have made the argument that with hospitals in the state they are in, it is more important than ever to have a robust social care system in place. As the Minister for Care, I agree with them wholeheartedly, but it is simply not true to portray the Government as sitting on their hands while Baroness Casey gets cracking on her vital work. In fact, we have hit the ground running through a plethora of measures. We have legislated for the first ever fair pay agreement for social care in order to tackle the 130,000 vacancies we see today. We have delivered an extra 7,800 home adaptations through the disabled facilities grant to change the lives of thousands more disabled people for the better. In the Budget, the Chancellor provided the biggest increase in carer’s allowance since the 1970s, worth £2,000 a year to family carers and with an extra £3.7 billion for local authorities.
We are not hanging around on more structural reforms, either. We are introducing new standards to help people who use care, their families and providers to choose the most effective new technology as it comes on the market. We are joining up care and medical records, so that NHS and care staff have the full picture they need to provide the best possible care, and we are training more care workers to perform more health interventions, helping people to stay well and at home. Just two weeks ago, we announced a new qualification for social care staff, training them in artificial intelligence to automate routine tasks and motion sensors to detect falls. We are seizing the opportunities of care tech and harnessing it for the benefit of thousands who draw on care across our country.
Layla Moran (Oxford West and Abingdon) (LD)
We are desperate to help the Minister in this endeavour, and look forward to receiving our invitations to the cross-party talks, which have yet to be issued. However, the Health and Social Care Committee heard today from an organisation called Think Ahead, which is the only organisation in the country that trains mental health social care workers. I have just heard that the Department of Health and Social Care is not refunding that organisation. Can the Minister explain why?
Stephen Kinnock
I thank the hon. Lady for that intervention. Baroness Casey is working at pace to get the commission up and running, and that will be launched this month. On her point about Think Ahead, the fundamental challenge we had with that programme was its relatively high unit costs. We are aiming to ensure that we deliver value for money for the taxpayer—I am sure that the hon. Lady shares that objective. We have to ensure that we deliver a programme for mental health social care work that delivers not only the best possible outcomes for our communities, but the best possible value for taxpayer money.
A lot has been done in the nine months since the election, but there is a huge amount more to do, and this Government are getting on with the job. Alongside the work I have described, the Government are putting record levels of investment into healthcare, with capital spending rising to £13.6 billion over this year and the next. That includes £1.5 billion for new surgical hubs, diagnostic scanners and beds across the NHS estate, as well as new radiotherapy machines to improve cancer treatment; over £1 billion to tackle RAAC and make inroads into the backlog of critical maintenance, repairs and upgrades across the NHS estate; and over £2 billion to be invested in NHS technology and digital. We are also taking the pressure off our hospitals through care in the community, and I am sure the whole House will welcome the fact that we have recruited 1,500 extra GPs on to the frontline.
Martin Wrigley (Newton Abbot) (LD)
Coming back to community hospitals, I came to this House to try to save Teignmouth community hospital, which has been under threat of closure because Torbay, its parent hospital, has such a massive maintenance backlog that it cannot afford to maintain both itself and Teignmouth hospital, so it is shutting down community hospitals. In Devon, we have just three principal hospitals: North Devon, which we understand is under pressure, Torbay, which is under pressure, and Exeter. We need the community hospitals. Will the Minister stop Teignmouth hospital from being shut, so that we can maintain it until it can be rebuilt?
Stephen Kinnock
These decisions are the responsibility of ICBs, and the ICB is having to balance a range of pressures, as the hon. Member points out, created largely by the neglect and incompetence of the previous Government. It is now a question of ICBs having to cut their cloth to make the finances work with the limited resources they have. I am afraid that is symptomatic of the mess we found when we took over on 4 July.
Chris Ward (Brighton Kemptown and Peacehaven) (Lab)
The Royal Sussex in my constituency is in desperate need of a new cancer centre, and I am delighted that the centre is being added to wave one. I would be even happier if the Minister also added a new accident and emergency department, but we will come back to that another day. Is the reality not that we all want to build these new hospitals, but we all have to be honest with the public about how we will pay for them? The Liberal Democrats never are, and the motion is not. Bringing forward construction dates is a multibillion-pound commitment, but all the motion talks about is creating a taskforce. Is that not fundamentally unserious? This is an incredibly serious issue, and we should put forward proper proposals.
Stephen Kinnock
My hon. Friend is an outstanding champion for his constituents. I noted the point he made about A&E; that was nicely done. He is right in what he says about the motion. The broader point to make is that thanks to the necessary decisions that my right hon. Friend the Chancellor of the Exchequer made in the autumn Budget, we have generated the revenue that we will need to rebuild public services, and in particular our NHS, which was brought to its knees by the previous Government. I cannot claim to be a careful student of the Liberal Democrat manifesto for the last election, but I did notice that the revenue that would be generated by their measures was, I think, about £8.4 billion. Last time I checked, that was significantly lower than the £23 billion raised by the Chancellor’s Budget. The Liberal Democrats should probably get their calculators out and figure out exactly how they will generate this revenue, rather than criticising us constantly for the decisions we have taken.
Several hon. Members rose—
Stephen Kinnock
I will just make a little more progress, if I may. We are committed to rebuilding our NHS and rebuilding trust in Government. We will never play fast and loose with the public finances, and we will never try to pull the wool over the public’s eyes. Everyone in this House remembers, or should remember, that the last Labour Government cut waiting lists to their lowest level in history, raised patient satisfaction to the highest level in its history, and brought in historic health interventions, such as the smoking ban. What is less remembered is that they also delivered the largest hospital building programme in NHS history. All that meant that when the coalition took over in 2010, it was presented with a strong national health service that was firing on all cylinders. Tragically, that coalition Government and their successor Governments set about weakening and undermining every aspect of our precious NHS, to the extent that by the time this Government took over in July, the NHS was well and truly on its knees. Today, it once again falls to a Labour Government to take the necessary and right decisions for the future.
We have now put the new hospital programme on a sustainable footing. It has a timeline that can be met, and a budget consistent with our fiscal rules. That is how we have turned the programme from empty rhetoric into reality, and in doing so, we have provided the construction industry and its supply chains with vital certainty, while also restoring confidence in public sector procurement. We are on the side of the builders, not the blockers. Our plan is credible, achievable and fully funded. It is a programme grounded in fact, not fiction. I was born in Tredegar, the very same town as Aneurin Bevan, so it is the privilege of a lifetime to be part of a Government who are carrying his torch into the 21st century, building a generation of hospitals that would do Nye proud.
General Practitioner Recruitment
Stephen Kinnock Excerpts(1 month, 3 weeks ago)
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The Minister for Care (Stephen Kinnock)
General practice sits at the heart of our NHS and is its front door, but it has been neglected for far too long.
We are committed to getting primary care back on its feet and have already taken decisive action to get more GPs onto the frontline. This Government inherited a ludicrous situation where patients could not get a GP appointment, while GPs leaving training could not get a job.
Within weeks of coming into office, we committed to recruiting over 1,000 recently qualified GPs through an £82 million boost to the additional roles reimbursement scheme over 2024-25, as part of an initiative to address GP unemployment and secure the future pipeline of GPs. I am delighted to announce the Government have exceeded this target.
By cutting red tape and investing more in our NHS, we have put an extra 1,503 GPs into general practice to deliver more appointments. See: GPs recruited through the Additional Roles Reimbursement Scheme (ARRS) - NHS England Digital. https://digital.nhs.uk/supplementary-information/2025/arrs-claims-for-gps---to-31-march-2025
The recruitment boost, part of the Government’s plan for change, will help to end the scandal of patients struggling to see a doctor—easing pressure on GPs and cutting waiting times. Alongside changes to the GP contract for 2025-26, these additional GPs will help end the 8 am scramble for appointments, which so many patients currently endure every day.
Previously, primary care networks were limited in how they could use their funding. We have changed that. Now they can hire recently qualified doctors through the additional roles reimbursement scheme—a practical solution that is boosting GP numbers across the country. For 2025-26 we have gone further, delivering more flexibilities to the scheme to allow local systems to respond better to local workforce needs. GPs will be central to our 10-year health plan and shifting healthcare from hospitals to the community.
In February we reached agreement with the British Medical Association on a new GP contract for the first time in four years. We are investing an additional £889 million in general practice to fix the front door of the NHS. That comes alongside reforms to improve access, incentivise greater continuity of care and streamline targets to focus on preventing the biggest killers. And at the autumn Budget, the Chancellor announced £100 million of capital for GP estate upgrades over the next financial year, the biggest central GP capital investment since 2019-20.
Thanks to these decisions, the Government have already delivered over 2 million additional elective appointments since July, meeting their target seven months early, and brought the referral to treatment waiting list down by 193,000. But we are not complacent, and we know the job is not done. We are determined to go further and faster to deliver more appointments, faster treatment, and an NHS that the British public deserve as part of our plan for change.
[HCWS586]
Hospice Funding
Stephen Kinnock Excerpts(1 month, 3 weeks ago)
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The Minister for Care (Stephen Kinnock)
I thank the hon. Member for Beaconsfield (Joy Morrissey) for securing this important debate. I wish to take this opportunity to thank all those who work or volunteer in the hospice and palliative care sector for the care and support that they provide to patients, families and loved ones when they need it most.
This Government want a society in which every person receives high-quality, compassionate care from diagnosis through to end of life. We are determined to shift more care out of hospitals and into the community, to ensure that patients and their families receive personalised care in the most appropriate setting. Palliative and end-of-life care services, including hospices, will have a vital role to play in that shift.
In England, integrated care boards are responsible for the commissioning of palliative and end-of-life care services to meet the needs of their local population. To support ICBs in this duty, NHS England has published statutory guidance and service specifications. Although the majority of palliative and end-of-life care is provided by NHS staff and services, we recognise the vital part that voluntary sector organisations, including hospices, play in providing support to people at the end of life, as well as to their loved ones.
Most hospices are charitable, independent organisations that receive some statutory funding for providing NHS services. The amount of funding that each charitable hospice receives varies, both within and between ICB areas. This variation is dependent on demand in that area and on the totality and type of palliative and end-of-life care provision from both NHS and non-NHS services, including charitable hospices within each ICB footprint.
This Government understand the financial pressures that hospices have been facing, which is why we have announced the biggest investment to hospices in England in a generation. We are ensuring that hospices in England can continue to deliver the highest quality end-of-life care possible for patients, and for their families and loved ones. We are supporting the hospice sector with a £100 million capital funding boost for adult and children’s hospices, to ensure that they have the best possible physical environment for the care they give.
We are pleased to confirm that the Government have released the first £25 million tranche of the £100 million capital funding, with Hospice UK kindly allocating and distributing the money to hospices throughout England. An additional £75 million will be allocated in the coming weeks for use in the 2025-26 financial year. The £100 million capital funding will help hospices to provide the best end-of-life care to patients and their families in a supportive and dignified physical environment. Funding will help support hospices and will enable much-needed improvements, including refurbishments, the overhauling of IT systems and improvement of facilities for patients and visitors.
We are also providing £26 million in revenue funding to support children and young people’s hospices. This is a continuation of the funding that, until recently, was known as the children and young people’s hospice grant. ICBs will once again administer the funding to their respective children and young people’s hospices on behalf of NHS England. This is in line with NHS devolution policies, and it promotes a more consistent national approach by supporting commissioners in prioritising the palliative and end-of-life care needs of their local population. I am pleased to confirm that NHS England has now communicated the details of the 2025-26 funding allocation and dissemination to individual hospices.
I do accept that there is unwarranted variation and inequality in access to, and quality of, palliative and end-of-life care in England, but we are working to reduce these variations. NHS England has published statutory guidance and service specifications to support commissioners in prioritising palliative and end-of-life care. It has also developed a palliative and end-of-life care dashboard, which brings together all relevant local data in one place. The dashboard helps commissioners to understand the palliative and end-of-life care needs of their local population, enabling ICBs to put plans in place to address and track the improvement of health inequalities and to ensure that funding is distributed fairly, based on prevalence.
NHS England has also published the ambitions framework, which sets out our vision to improve end-of-life care through partnership and collaborative action between organisations at a local level throughout England. Additionally, NHS England has developed an assurance system with specific steps and deadlines to ensure the timely dissemination of the £26 million revenue funding to children and young people’s hospices, because we know that there were some quite significant problems last year with the transmission from NHS England through the ICBs to hospices. These steps include regular oversight sessions with ICBs, regions and hospices and giving ICBs a hard deadline within the first quarter of the financial year by which they are expected to disseminate the funding to hospices, including escalating to NHS England if any ICB is unable to meet the deadline. If the deadline is missed, NHS England has put steps in place to ensure that all hospices receive the funding within the timescales outlined.
We, alongside key partners and NHS England, will continue to engage proactively with our stakeholders, including the voluntary sector and independent hospices on an ongoing basis to understand the issues they face. In fact, I recently visited Katharine House hospice in Stafford and heard from staff how important our record investment has been to them. More widely, in February I met key palliative and end of life care and hospice stakeholders in a roundtable format to discuss long-term sector sustainability in the context of our 10-year health plan.
I recognise the concerns that hon. Members have raised about funding and employer national insurance contributions. In July last year we inherited public finances in their worst state since the second world war, and we took the necessary decisions to fix the foundations in the public finances at the autumn Budget, enabling the spending review settlement of a £22.6 billion increase or uplift in resource spending for the Department of Health and Social Care from 2023-24 out-turn to 2025-26.
I gently point out to the Conservative party that while I believe it has welcomed that unprecedented settlement, to my knowledge it has been silent on its preferred means of generating that revenue. I gently say that Opposition Members cannot have it both ways. They cannot welcome the £22.6 billion on the one hand but, on the other hand, condemn the way in which the money is to be raised without coming up with their own plan and proposals for how they would raise those funds.
Rachael Maskell
We have to recognise that the hospice sector is in quite a difficult place financially. However, if there is good advance care planning, money currently spent in secondary care could be invested in the hospice sector and in more community provision. Surely that must be a first step that would not only get better clinical outcomes but be better for the whole of the palliative care pathway.
Stephen Kinnock
My hon. Friend speaks with tremendous and deep knowledge of the sector. I welcome the work that she is doing on the commission on palliative and end-of-life care, and we very much look forward to seeing the outcomes and results of that.
My hon. Friend is right that if we are to make the three big shifts at the heart of our 10-year plan—the shifts from hospital to community, from sickness to prevention, and from analogue to digital—the delivery of that will require a left shift in terms of both funding and reform. It is absolutely right that we take a hard-headed look at funding across our NHS and ensure that funding is going to where it is needed. She will know that the share that hospitals get of overall NHS funding has gone up dramatically since the early 2000s, to the detriment of primary care, community care and palliative care—all the things that happen outside hospital. That is something that we must address and shift upstream, because we will never solve the considerable challenges that our NHS is facing until we make that left shift.
I note that the funding announcement was warmly welcomed by the sector. Toby Porter, chief executive of Hospice UK, said:
“Today’s announcement will be hugely welcomed by hospices, and those who rely on their services. Hospices not only provide vital care for patients and families, but also relieve pressure on the NHS. This funding will allow hospices to continue to reach hundreds of thousands of people every year with high-quality, compassionate care. We look forward to working with the government to make sure everyone approaching the end of life gets the care and support they need, when and where they need it.”
I hope that the measures I have outlined in my response to the hon. Lady will go some way to reassuring all Members of this Government’s unwavering commitment to the sustainability of the hospice and wider palliative and end-of-life care sector.
Joy Morrissey
I thank the Minister for outlining what the Government are doing. Will he consider looking at the exemption to the national insurance increase for workers and at allocating more funding directly to hospices so that they can conduct the palliative care that is needed in the out-of-hospital care provision? Although the Government may want to give it to palliative care, there is no directive that does so at this time, aside from capital expenditure. Therefore, could more money be allocated to hospices for operational costs?
Stephen Kinnock
The definition of where employer national insurance will be levied is based on the Office for National Statistics’ definition of where it should be, and it is the same definition used by previous Governments. I do not think that point is up for debate.
Joy Morrissey
To clarify, the NHS and the staff within it are exempt from the changes. How is that part of the national statistical average, when everyone in healthcare who is under the NHS umbrella is exempt from the changes? All I am asking is for hospice care, which is out-of-hospital care provision and which technically falls within adult social care, to be incorporated into the exemptions already given to the NHS.
Stephen Kinnock
The exemption was given to 100% full-time workers within the NHS; in essence, hospitals. As regards GPs, dentists and care providers, ENICs are being levied on those other parts of the health and care sector. Every aspect of my portfolio is therefore seeing ENICs being levied.
Rachael Maskell
A suggestion to the Minister would be to integrate the staff working in hospices into the NHS payroll. It would be that simple to exempt them from those national insurance increases.
Stephen Kinnock
The decisions on ENICs and where they are being levied have been made. I think it was made very clear that the line was drawn where it was drawn. Any attempt to try to reverse engineer where that line should be drawn would not really be aligned with the policy decisions that were made at the Budget.
Sir Bernard Jenkin
Was it the Government’s intention to put an additional tax on hospices? Is that exactly what the Government intended to do, or is that an unforeseen consequence?
Stephen Kinnock
I would not dare to speak from this Dispatch Box on behalf of the Chancellor, but I am absolutely clear that when she did the autumn Budget, she knew that she had to dig us out of a very deep hole indeed, and that required levying taxes that she had to levy. The line had to be drawn somewhere and that is where the line was drawn.
On the other questions asked by the hon. Member for Beaconsfield, the funding has gone through Hospice UK, so it is not direct funding in that sense. Hospice UK has kindly co-ordinated the process because it is extremely well informed about which hospices across the country have opportunities to upgrade their infrastructure, whether that be IT infrastructure, refurbishment or whatever it might be. It has reviewed those proposals, worked at tremendous pace and, as a result, we have managed to deliver the entire £25 million of the first tranche. We are now working closely with Hospice UK on the £75 million and I am confident that that money will be out of the door and into hospices in very quick time this year, based on the outstanding performance on the first £25 million tranche. I therefore hope the hon. Lady will be reassured on that point.
In closing, I hope that we at least have a consensus on the vital importance of hospices. The Government are committed to working at pace to ensure that we secure a sustainability and solidity for the sector going forward. I thank the hon. Member for Beaconsfield once again for securing this important debate. I also thank and wish everybody in this Chamber all the very best for the recess, and I look forward to seeing them all on the other side.
Question put and agreed to.
Congenital Hyperinsulinism
Stephen Kinnock Excerpts(1 month, 3 weeks ago)
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The Minister for Care (Stephen Kinnock)
It is a pleasure to serve under your chairship, Ms Butler. I thank my hon. Friend the Member for Warrington South (Sarah Hall) for securing this important debate, which really is a tribute to her and to her constituents, Ibbie and her family, who have clearly been through a very challenging time but have shown tremendous strength, bravery, love and compassion. I would be grateful to my hon. Friend if she could pass on our very best wishes to the family and thank them for helping us to look at this issue.
The birth of a new member of the family should be a moment of excitement, celebration and, indeed, exhaustion. Realising that their baby might have a serious illness should be the last thing on any new parent’s mind. That is why getting help quickly is so important, as is ongoing support. Around 95 children are born with congenital hyperinsulinism in the UK each year. Although that means it is a rare disease, it should not be overlooked.
The Government are committed to improving the lives of people living with rare diseases. On that point, I have carefully noted the seven asks that my hon. Friend the Member for Warrington South listed, including her request to meet the relevant Minister. I should say that the lead Minister in this area is our colleague the Minister of State for Health, who is not present today—I am standing in for her. My officials will pass on to her all my hon. Friend’s asks, including the one for a meeting. I am sure that the Minister of State for Health will be happy to follow up on those points.
Rare diseases like congenital hyperinsulinism are individually rare but collectively common. There are more than 7,000 rare conditions, meaning that one in 17 people will be affected by one over their lifetimes. Each condition will have different symptoms and experiences, and every person is unique. Despite that, across all rare diseases there are shared challenges, which have shaped the approach of the UK rare diseases framework and England’s annual action plans. The national conversation on rare diseases in 2019 identified four priorities for the framework: ensuring that patients get the right diagnosis faster; increasing awareness of rare diseases among healthcare professionals; the better co-ordination of care; and improving access to specialist care, treatment and drugs.
Graeme Downie (Dunfermline and Dollar) (Lab)
I congratulate my hon. Friend the Member for Warrington South (Sarah Hall) on securing this important debate. I had not intended to intervene, but my hon. Friend raised issues similar to those in my constituency in respect of young boys diagnosed with Duchenne muscular dystrophy, who are having difficulty accessing the drug Givinostat in Scotland. I am aware that the Minister might not be able to respond immediately, but will he meet me to discuss access to that drug in Scotland, and how we can help other young people affected by a rare disease?
Stephen Kinnock
I am happy to look into that. Healthcare in Scotland is devolved, but all the nations of the United Kingdom can learn a huge amount from each other—nobody has a monopoly on good ideas—and it would be excellent to find out a little more about the issues my hon. Friend referred to.
The four framework priorities form the “what” of what we do, and are supported by underpinning themes—the “how” of how we get there. The themes include keeping the patient voice at the heart of all we do. I pay tribute to advocacy groups such as the Children’s Hyperinsulinism Charity and Genetic Alliance UK for their excellent work supporting families and continuing to raise important issues that help to make things better for people with congenital hyperinsulinism.
In England, we published the fourth rare diseases action plan on 28 February, which is otherwise known as Rare Disease Day. The plan provides updates on the progress made since the beginning of the framework in 2021. I am pleased to say that it also includes three new actions for the future, which aim to improve the co-ordination of care, make things easier for families who need to visit multiple specialists, and improve the environment for research on rare diseases in the UK.
Receiving the right diagnosis as soon as possible is vital, particularly for conditions that present in infants and young children, such as congenital hyperinsulinism. The Exeter Genomics Laboratory is the national provider of hyperinsulinism genetic testing and the research centre of excellence. That lab, the paediatric endocrinologist community, and highly specialised service units have a close relationship, so patients can be diagnosed rapidly and managed effectively via a multidisciplinary team framework.
A diagnosis means that the right treatment can be given early, ultimately helping to improve health outcomes. Advances in genomics represent a huge opportunity to find children with rare diseases as soon as possible. The generation study, which commenced last year, is run by Genomics England and is piloting the use of whole-genome sequencing in newborns to identify more than 200 rare conditions, including congenital hyperinsulinism. The study is now under way and recruiting across 18 NHS trusts. It aims to screen 100,000 babies.
Diagnosis is only the start of managing a rare disease, and I know that there is still unmet need. Too many people continue to struggle with challenges, including lack of access to reliable information or specialist treatment. Only 5% of rare conditions have an approved and effective treatment—that is a shocking statistic. To improve the situation, we have made pioneering research another underpinning theme of the UK rare diseases framework. The highly specialised technologies programme of the National Institute for Health and Care Excellence evaluates technologies for very rare, and often very severe, diseases. We are working with the regulatory system to look at access schemes such as the early access to medicines scheme, the innovative licensing and access pathway, the innovative devices access pathway and the innovative medicines fund. Those schemes are all designed to support the earlier availability of innovative treatments to patients who need them, and they must also work for rare diseases.
Many people struggle to access reliable information on rare diseases. With over 7,000 different rare diseases, which often need highly specialised input, the NHS website is not always the best place for such information—although I note the point that my hon. Friend the Member for Warrington South made about the website, and we will look into that. Patient organisations and charities play an important role in creating high-quality information on rare conditions. Therefore, in this year’s action plan we have set out the steps we are taking to support organisations to get the information they produce accredited under the Patient Information Forum’s trusted information creator—or PIF TICK—scheme, so that families will know they can rely on trustworthy information.
Living with or caring for someone with a rare disease can be mentally tough. We know that people living with rare conditions, and their families and carers, often struggle to access mental health and psychological support. This is not right. Alongside the wider steps that we are taking to improve mental health access, the NHS genomics education programme has this year published new resources on rare diseases and mental health, aimed at healthcare professionals. It has also developed a communications tool to help healthcare professionals with sensitive conversations, to ensure that patients and families feel supported throughout the diagnosis of a rare condition.
I close by again thanking my hon. Friend the Member for Warrington South, as well as those affected by congenital hyperinsulinism and organisations that advocate on their behalf. Although the five-year UK rare diseases framework will come to a close at the start of next year, we remain committed to improving the lives of those with rare diseases. The Under-Secretary of State for Health and Social Care, my hon. Friend the Member for West Lancashire (Ashley Dalton) will work with officials and colleagues in the devolved Governments to chart a course forward and maintain the momentum we have built.
Question put and agreed to.
Eating Disorder Awareness
Stephen Kinnock Excerpts(1 month, 4 weeks ago)
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The Minister for Care (Stephen Kinnock)
It is a pleasure to serve under your maiden chairship today, Mr Stuart. I am extremely grateful to the hon. Member for Bath (Wera Hobhouse) for securing the debate and raising this important topic. I know that, as a Member of this House and chair of the APPG on eating disorders, she has been a doughty champion for those living with eating disorders, their families and supporters. I am also grateful to other hon. Members for their valuable contributions, many of which were deeply personal and profoundly moving. I pay tribute to hon. Members for making those contributions.
I share the desire of the hon. Member for Bath to improve the lives of people affected by an eating disorder. Raising awareness of eating disorders and improving treatment services is a key priority for the Government, and a vital part of our work to improve mental health services. We know that living with an eating disorder can be utterly devastating, not just for those battling the condition but their loved ones and those who witness their struggle. We know that eating disorders can affect people of any age, gender, ethnicity or background. However, we also know that recovery is possible, and access to the right treatment and support can be lifechanging, as we have heard today.
Although record investment and progress has improved access to eating disorder services, the reality is clear: demand has surged, especially since the pandemic, outpacing the growth in capacity. We must do more to ensure that everyone who needs support can get it without delay.
Wera Hobhouse
The Minister is making a powerful point. Demand is surging, yet it seems that investment from ICBs is going to fall. How can that be possible, and how is it morally acceptable?
Stephen Kinnock
National funding has increased over the years, as the hon. Lady will know. The question is whether that funding channels through to ICBs. The Government’s view is that ICBs are best placed to make decisions as close as possible to the communities that they serve and to target and, if necessary, reallocate funding accordingly. As a Government, we are constantly trying to get the balance right between setting frameworks and targets and ensuring that those are being met, while also ensuring that ICBs are not being micromanaged from the centre. We do not think it is right that people sitting in Whitehall or Westminster micromanage what is going on at a local level. We are absolutely clear that every ICB must meet its targets, while also being clear that it is up to the ICB to take decisions as close as possible to the communities that they serve.
Sadly, we have seen the prevalence of eating disorders in children and young people sharply increase since 2017. In 2023, NHS England published follow-up results to its survey on the mental health of children and young people. The report found that the prevalence of eating disorders in 17 to 19-year-olds rose from 0.8% in 2017 to 12.5% in 2023. Unfortunately, we are also seeing the prevalence of eating disorders rising among adults. The 2019 health survey for England showed that 16% of adults over 16 screened positive for a possible eating disorder. The figures do not mean that the individual had a confirmed eating disorder, but they present a worrying situation that we must address by continuing to promote both awareness and early intervention.
The surge in demand has inevitably made meeting our waiting time targets more challenging. However, our services and clinicians, backed by new funding, are supporting more people than ever before. These services are changing and saving lives. As hon. Members will know, we have kept in place the access and waiting time standard for children and young people who are referred with eating disorder issues. This sets a 95% target for children with urgent cases to begin treatment within one week, and for children with routine cases to start treatment within four weeks.
Figures released last month show that although the number of referrals and demand for services has begun to stabilise during the past year, the number of children entering treatment reached a record high of 2,954 last quarter. This shows that the extra funding is enabling services to begin to meet the extra pressures caused by the pandemic. Similarly, the number of children entering treatment within the target time has reached a record high. Of the 2,954 children entering treatment last quarter, 2,414 were able to access that treatment within the one-week urgent target or the four-week routine target—a rate 81.7%. That is the highest figure recorded since NHS England began collecting that data in 2021.
However, we recognise that there is still far more to be done to ensure that patients with eating disorders can access treatment at the right time. The hon. Member for Bath rightly focused the debate on the importance of awareness. Raising awareness of eating disorders is the first step towards early intervention to prevent the devastating impacts that eating disorders can have on people’s lives. To support this, NHS England is currently refreshing guidance on children and young people’s eating disorders.
The refreshed guidance will highlight the importance of awareness and early recognition of eating disorders in schools, colleges, primary care and broader children and young people’s mental health services. A number of colleagues asked when that guidance will be published; my officials are working hard with specialists on that, and it will be published later this year.
The existing mental health support teams, supplemented by the specialist mental health professionals that we will be providing access to in every school in England, will support school staff to raise awareness and identify children and young people showing potential early signs of an eating disorder. Through these interventions, children and young people can be given early support and help to address problems before they escalate.
Community-based early support hubs for children and young people aged 11 to 25 also play a key role in providing early support for young people’s mental health and wellbeing. Early support hubs provide open-access drop-in mental health services that assist children and young people with a range of issues, such as eating disorders, at an early stage without the need for a referral or doctor’s appointment.
I am pleased to say that this year, thousands more young people will receive support with their mental health, thanks to £7 million of new funding for 24 existing community-based early support hubs to expand their current offer. That funding will deliver 10,000 more interventions such as group sessions, counselling therapies and specialist support over the next 12 months. Looking forward, we are also committed to rolling out open-access young futures hubs in communities. This national network is expected to bring local services together and deliver support for young people facing mental health challenges, including support for those with eating disorders.
We should also be concerned about the widespread availability of harmful online material that promotes eating disorders, suicide and self-harm, which can easily be accessed by people who may be vulnerable. We have been clear that the Government’s priority is the effective implementation of the Online Safety Act, so that those who use social media, especially children, can benefit from its wide-reaching protections as soon as possible. Our focus is on keeping young people safe while they benefit from the latest technology. By the summer, robust new protections for children will be enforced through the Act to protect them from harmful content and ensure that they have an age-appropriate experience online.
It is right to focus on awareness and early intervention, but we know that some people simply need access to high-quality treatment in order to get better. A key priority of this Government is therefore to expand community-based services to treat eating disorders, so that people can be treated earlier and closer to home. NHS England is working to increase the capacity of community-based eating disorder services. By improving care in the community, the NHS can improve outcomes and recovery, reduce rates of relapse, prevent children’s eating disorders continuing into adulthood and, if admission is required as a last resort, reduce the length of time that people have to stay in hospital.
I am pleased to say that funding for children and young people’s eating disorder services has increased, rising from £46.7 million in 2017-18 to a planned £101 million in 2024-25. With this extra funding, we can focus on enhancing the capacity of community eating disorder teams across the country. We are also committed to providing an extra 8,500 new mental health workers across child and adult mental health services to cut waiting times and ensure that people can access treatment and support earlier. Through the 10-year health plan, this Government will overhaul the NHS and ensure that those with mental health needs, including those living with eating disorders, are given the support that they need.
I share the concern of the hon. Member for Bath about accurate recording of deaths to understand the extent to which eating disorders and other factors have caused or contributed to deaths. This matter is being explored with the national medical examiner for England and Wales, the Office for National Statistics and the Coroners’ Society of England and Wales.
Hon. Members also raised concerns about BMI. It is not right that any individual is being refused treatment based on their weight or BMI alone. National guidance from the National Institute for Health and Care Excellence is clear that single measures such as BMI or duration of illness should not be used to determine whether to offer treatment for an eating disorder. I am ready to receive any representations from colleagues who have evidence that that is happening, and I would be happy to raise that with the appropriate channels.
John McDonnell
I raised with the Minister the reform of disability benefits, which will have implications for sufferers and their carers. My understanding is that the universal credit health element is to be denied to those under the age of 22. In addition, it will be halved and then frozen, and the PIP criteria are changing. As I said, I simply want the Minister to check with his colleagues in the Department for Work and Pensions what the implications are for sufferers of these conditions and their carers. We need specific action to protect them in the consultation; otherwise, people who are already suffering financially as a result of such conditions—particularly when the whole family supports the sufferer—will be further harmed.
Stephen Kinnock
I will follow up on those points and write to the right hon. Gentleman. As he knows, the Green Paper is out for consultation. Although the Government have made decisions about some measures, we are consulting and engaging on a number of others. It is very important that we see all the issues that he raises in the round, and I will follow them up with colleagues, particularly in the DWP, and write to him.
I again thank the hon. Member for Bath for raising this important issue and for her tireless efforts in this House to raise awareness of eating disorders. I thank all hon. Members for their thoughtful and moving contributions on behalf of their constituents and, in some cases, their loved ones. One person afflicted by an eating disorder is one too many, so the Government will strain every sinew to combat this profoundly debilitating condition.
Access to Dentistry: Somerset
Stephen Kinnock Excerpts(1 month, 4 weeks ago)
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The Minister for Care (Stephen Kinnock)
It is a pleasure to serve under your chairship again this morning, Mr Stuart. I thank the hon. Member for Frome and East Somerset (Anna Sabine) for securing this important debate on access to dentistry in Somerset.
We know that there are challenges in accessing NHS dentistry across the country, with some areas facing acute challenges. Put simply, too many people are struggling to find an NHS appointment. In the two years up to June 2024, just 31% of adults were seen by an NHS dentist in Somerset’s integrated care board, which covers the hon. Lady’s constituency, compared with 40% across England. In the year to June 2024, only 42% of children in Somerset ICB were seen by an NHS dentist, compared with 56% across England. The fact that the number of adults and children in Somerset ICB accessing an NHS dentist is even lower than the already struggling rate across England is concerning.
Somerset is facing significant workforce pressures, and there are not enough NHS dentists available to do the job. As of March 2024, there were 334 vacancies in the south-west for full-time equivalent NHS general dentists. The 29% vacancy rate is the highest of any English region.
It is a shocking fact that the No. 1 reason for children aged five to nine being admitted to hospital in our country is to have their teeth removed, with a primary diagnosis of tooth decay. It is a truly Dickensian state of affairs.
Chris McDonald (Stockton North) (Lab)
We have heard about the dental desert in Somerset. Stockton in my constituency has also been branded a dental desert. I welcome the 4,000 new appointments that the Government have granted for Stockton North and the surrounding area. However, given the urgency that he has described, particularly for children’s health, I ask the Minister whether the Government are taking any measures to accelerate the roll-out of those appointments.
Stephen Kinnock
We will absolutely ensure that integrated care boards are delivering to the target they have been set. If we see any evidence of slowing down or backsliding, we will certainly intervene to ensure that appointments are accelerated. I would also be more than happy to receive representations from my hon. Friend if he feels that performance in his ICB is not delivering.
The state of NHS dentistry in Somerset, and the nation as a whole, is simply unacceptable and it has to change.
Olivia Bailey (Reading West and Mid Berkshire) (Lab)
I welcome the action that the Government are taking to fix our dentistry crisis. In my constituency, only two dental practices accept adult patients, and vast swathes of the rural areas have no practice at all. Will the Minister set out how the Government’s plans will support my constituents to access the dental care that they need?
Stephen Kinnock
My hon. Friend puts her finger on the fundamental problem, which is that the NHS dental contract simply does not incentivise dentists to do NHS work. That is the fundamental reason why we are in this bizarre situation where demand for NHS dentistry is going through the roof, yet there is a consistent underspend in the NHS contract. It is a classic example of a false economy. The Conservatives thought they were being terribly clever by structuring a contract in a way they thought would deliver value for money, but in fact, it simply failed to incentivise dentists to do NHS work and they drifted more and more into purely private sector work. That is the very definition of a false economy.
Anna Sabine
I just draw the Minister back to my specific point about whether he can confirm that he is having discussions with the British Dental Association. The association agrees that the contract is wrong, and it wants to speak urgently to the Government about how it can be amended.
Stephen Kinnock
I am pleased to confirm that I am meeting the BDA in the coming days. The negotiations are moving forward. There is no perfect payment system, and there is a need to get the balance right between ensuring that we have a viable system that does not deliver underspends in the NHS contract, which is absurd, and that we deliver as much NHS dentistry as possible to the communities and people who need it. That is a complex process and it will take some time. The Government have taken intermediate measures, such as the 700,000 urgent appointments and supervised toothbrushing, which we will work on at pace over the course of the coming financial year while also working on a radical overhaul of the contract.
By the time I came into government, the Nuffield Trust was describing the state of NHS dentistry as
“at its most perilous point in its 75-year history.”
As of March 2024, there are over 36,000 dentists registered with the General Dental Council in England, yet there are fewer than 11,000 full-time equivalent dentists working in the NHS.
Sir Ashley Fox
I understand that at least 100 Ukrainian dentists in this country are unable to practise with the NHS because they are waiting to take examinations. Can the Minister do anything to expedite their ability to practise in this country?
Stephen Kinnock
I absolutely agree. Two big things need to happen. First, the General Dental Council needs to do more to get more exams in place for those very well-qualified dentists. Of course, they have to pass the British exam. We cannot have people practising in Britain who have not passed that exam, but the availability of the exam has been too limited and that needs to change. The other thing is provisional registration. Some work can be done to expedite the registration of an international dentist, but more needs to be done on that as well. I will meet the head of the General Dental Council shortly, and I will convey those messages to him.
Recruitment and retention issues are not limited to dentists; there are difficulties across the whole dental team, including dental nurses, hygienists, therapists and technicians. In the past five years, there has been a 15% reduction in courses of dental treatment being delivered across England, and 28% of adults in England—a staggering 13 million people—have an unmet need for NHS dentistry. As a result, we hear too many stories about people who are unable to access the care they need, and some horrific accounts of DIY dentistry that nobody should have to resort to.
Dentistry rightly receives a lot of attention because of its dismal state, and I am grateful to the National Audit Office and Public Accounts Committee for their interest in the previous Government’s dentistry recovery plan. It is evident that the plan did not go far enough.
Richard Foord
The Minister talks about the previous Government’s dental recovery plan, and part of that was to impose a firmer ringfence on dentistry spending so that there was not an underspend that was reallocated elsewhere. The previous Government tasked NHS England with collecting monthly returns from ICBs to establish spending as against the allocation. Now that NHS England is being scrapped, will we still see that monitoring of ICBs to ensure that the spending matches the allocation?
Stephen Kinnock
I take the hon. Gentleman’s point about the ringfence, but in a way, ringfencing addresses the symptoms, rather than the cause, of the problem. The fundamental cause of the problem is the amateurish way in which the previous Government set up the NHS dentistry contract so that it does not incentivise dentists to do NHS work. That is what leads them to drift off. In a sense, we can do all the ringfencing we like, but if the workforce that we need is not incentivised to do the work that we need them to do, we are going to have that problem, because they vote with their feet. That is why the radical overhaul of the dentistry contract is the key point. However, I agree with the hon. Gentleman that once we have got a contract that works, we must ensure that every penny that is committed to NHS dentistry is spent on NHS dentistry, rather than the absurd situation that we have now, in which we constantly have underspends in the NHS dentistry contract while demand for NHS dentistry goes through the roof. It is a truly bizarre situation.
I return to the subject of the dentistry recovery plan. The new patient premium, introduced by the previous Government, aimed to increase the number of new patients seen, but that has not happened. In reality, since the introduction of the previous Government’s plan, there has been a 3% reduction in the number of treatments delivered to new patients. It is clear to this Government that stronger action is needed, and we are prepared to act to stop the decay.
Rachel Gilmour
In Minehead, in my constituency, a dental surgery responded to the ICB in October and said that it would provide 12 NHS appointments a week for people who currently do not have a dentist. I have chased that ICB on five occasions, but we still do not have a result. That is 48 appointments a month that my constituents are missing out on. Would the Minister please agree to write a letter, on my constituents’ behalf, to the Somerset ICB?
Stephen Kinnock
We are very keen to ensure that targets are being met, and the ICB clearly needs to ensure that that is happening, so I would be happy to do that. Perhaps the hon. Lady could write to me so that we can get all the facts on the table, then we can take action accordingly.
We will make the difficult decisions necessary to restore NHS dentistry to ensure that patients can access the care that they need, at the best value for taxpayers. Since coming into office, we have focused on implementing new initiatives and stopping the things that are not working. From today, 1 April 2025, the public will see 700,000 additional urgent dental appointments being delivered every year, as we promised in our manifesto. The urgent appointments will be available to NHS patients who are experiencing painful oral health issues, such as infections, abscesses, or cracked or broken teeth. Somerset integrated care board has been asked to deliver 13,498 of those appointments. That is 13,498 more chances for the hon. Lady’s constituents to get the urgent dental support that they need, every single year.
Across the south-west region, there will be 106,776 extra appointments—that is more chances for patients in urgent need of care. However, to have a truly effective dental system, we cannot focus just on those who are already in pain; we must have a system that prioritises prevention. A cornerstone of the Government’s mission to prevent ill health is supporting children to live healthier lives. We want to ease the strain on the NHS and create the healthiest generation of children ever. As colleagues will be aware, too many children are growing up with tooth decay, which is largely preventable. That is why we have invested £11.4 million to roll out a national supervised toothbrushing programme for three to five-year-olds that will reach up to 600,000 children a year in the most deprived areas of England.
The latest data shows that the rate of tooth decay for five-year-olds in Somerset is 20.2%, which is lower than the 22.4% for England but still far too high. We are taking a targeted approach to support those in the most deprived areas, which is why we have been able to allocate £50,000 of funding to Somerset to support around 2,000 three to five-year-olds. Our additional funding will help to secure and expand supervised toothbrushing based on local needs. This is extra resourcing to support targeted work by the local authority and its partners.
I am determined that we will reduce inequalities faced by children living in the most deprived areas, helping them to brush their teeth daily in the nurseries and schools that they attend. Alongside this, we have launched an innovative partnership with Colgate-Palmolive, which is donating more than 23 million toothbrushes and toothpastes over the next five years. This is of incredible value for the taxpayer, and a fantastic example of how business and Government can work in partnership for the public good.
A strong dentistry system needs a strong workforce. We recognise the incredible work that dentists and dental professionals do, and we know that the current NHS dentistry contract is not fit for purpose. We need to build an NHS system that works for patients and their dentists. A central part of our 10-year plan will be workforce, and we will ensure that we train and provide the staff, technology and infrastructure that the NHS needs to care for patients across our communities. We will publish a refreshed long-term workforce plan to deliver the transformed health service that we will build over the next decade, and to treat patients on time again.
We know that some areas face challenges in recruiting and retaining the dental workforce they need. The golden hello scheme offers 240 dentists a £20,000 joining bonus to work in underserved areas of the country for three years. The recruitment process is well under way, with posts being filled by dentists in these areas as we speak.
Sir Ashley Fox
I ask the Minister to reply to my suggestion that students from the University of Bristol Dental Hospital do some part of their training in Somerset, where they can benefit the population.
Stephen Kinnock
I thank the hon. Member for that intervention. It is an excellent idea, and it is something that we have seen in other parts of the country. If he would care to write to me about that, I would be more than happy to take that issue up.
In the south-west, the golden hello scheme has already led to seven new dentists on the ground delivering NHS dentistry to patients, and a further six have been recruited and are waiting to start their roles. With 64 live adverts across the region, we are confident that the numbers will grow. And, for the first time in more than a decade, we have increased payments for practices training a foundation dentist. We will not stand idly by while the fundamental reforms to the contract are developed. Where we identify opportunities, we will make improvements to the current system when those can increase access and incentivise the workforce to deliver more NHS care.
I am pleased that work to improve access has also been taking place at the local level, and that Somerset ICB is opening three new practices in Wellington, Crewkerne and Chard. Those services will provide much-needed additional capacity in Somerset. The ICB is committed to delivering additional urgent dental appointments and increasing access for residents facing the greatest health inequalities—although I do recognise what the hon. Member for Tiverton and Minehead (Rachel Gilmour) said about the concerns that she raised.
Fixing our broken dentistry system will not be easy, but I want to reaffirm our commitment to making bold changes and tough decisions to stop the decay and to rebuild the foundations of NHS dentistry. This is an immense challenge—there are no quick fixes and no easy answers—but people in Somerset and across the country deserve better access to dental care, and we are determined to make that a reality. We are committed to rebuilding a system that puts patients first, ensuring that no one is left without the dental care that they need.
Question put and agreed to.