Hospice and Palliative Care

Stephen Kinnock Excerpts

Monday 13th January 2025 Commons Chamber

[The Minister for Care (Stephen Kinnock)]

I pay tribute to the hon. Member for Wimbledon (Mr Kohler) for securing the debate and making such a powerful and thoughtful opening speech. I thank hon. Members from across the House—there are too many to list. It would be impossible to capture the richness of the contributions made. Something like 28 Back-Bench Members made speeches—I am sure Madam Deputy Speaker will correct me if my numbers are not quite right. It was an excellent debate, and I thank everybody for their contribution. I thank all those who work or volunteer in the hospice and palliative care sector for the deeply compassionate care and support that they provide to patients, families and loved ones when they need it most.

This Government are committed to building a society in which every person receives high-quality, compassionate care, from diagnosis through to the end of life. We will 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. The reality is that we have a mountain to climb. Our health and care services are on their knees, but this Government will strain every sinew to build them, and to create a health and care system that is once again fit for the future.

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 that duty, NHS England has published statutory guidance and service specifications. While 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 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 each charitable hospice receives varies both within and between ICB areas. The variation is dependent on demand in the area, and on the totality and type of palliative and end of life care provision from NHS and non-NHS services, including charitable hospices, within each ICB footprint.

We understand the financial pressures that hospices have been facing, which is why last month I was truly proud that this Government announced the biggest investment in hospices in England in a generation. It will ensure that hospices in England can continue to deliver the highest-quality care possible for patients and their families and loved ones.

[Danny Kruger]

I also welcome that, and congratulate the Minister on getting that money out of the Treasury, but will he acknowledge that there is a difference between capital and revenue? Hospices urgently need support for their day-to-day running costs, not just more money to support the capital. They also need capital support, but that is less crucial.

[Stephen Kinnock]

I take the hon. Gentleman’s point, but hospices face a range of pressures. The capital expenditure injection that we have provided will help them in the round. Clearly, anything that helps a hospice with its budget in the round, be it capital or revenue, will help the hospice.

We are supporting the hospice sector through a £100 million capital funding boost for adult and children’s hospices, to ensure that they have the best physical environment for care. There is also £26 million in revenue funding to support children and young people’s hospices. The £100 million in capital funding will deliver much-needed improvements—from refurbishments to overhauling IT systems and better facilities for patients and visitors—during the remainder of 2024-25 and throughout 2025-26. The investment will help hospices to improve their buildings, equipment and accommodation, so that patients continue to receive the best care possible.

Hospices for children and young people will receive a further £26 million in revenue funding for ’25-26 through what was known until recently as the children’s hospice grant. That investment demonstrates the Government’s recognition of the importance of integrating services to improve the treatment that patients receive. Furthermore, through our plans for neighbourhood health centres, we will drive the shift of care from hospitals to the community, which will bring together palliative care services, including hospices and community care services, so that people have the best access to treatment through joined-up services.

[Warinder Juss]

Money is not always the only solution, so will my hon. Friend confirm how the commission on palliative care that the Government announced last month will improve end of life care?

[Stephen Kinnock]

The Government announced a commission on the future of adult social care. A separate commission was announced by my hon. Friend the Member for York Central (Rachael Maskell) on palliative care. We will certainly monitor the findings of that commission very closely.

We will set out details of the funding allocation and distribution mechanisms for both funding streams in the coming weeks.

[Jim Shannon]

In my contribution, I made the House aware that the Northern Ireland hospice has to cut its beds from seven to six for five days of the week, and at the weekend, there are only three. The Minister knows that I respect him greatly. It is all very well to have capital money available, but there has to be money to run the system and provide beds. Otherwise, we can buy beds, but might not be able to keep them and run a service. There must be something seriously wrong with what he is putting forward.

[Stephen Kinnock]

As I said in a previous answer, hospices face a range of pressures that financial contributions from the Government will help to ease. The funding will, of course, have a knock-on impact on hospices budgets in the round.

In spite of the record-breaking package that we have announced, we are certainly not complacent. There is more work to be done, and through the National Institute for Health and Care Research, the Department is investing £3 million in a policy research unit on palliative and end of life care. The unit launched in January 2024 and is building the evidence base that will inform our long-term strategy. A number of hon. Members requested a long-term strategy and plan, which is sorely missing after 14 years of Conservative neglect and incompetence. I agree that we need a long-term plan, and assure Members that conversations are taking place between my officials and NHS England. The research needs to be based on evidence and facts, which the unit will help us to get.

[Dr Ben Spencer]

It is important that this debate is not a political ding-dong, and I really appreciate the tone that all Members, including the Minister, have taken. On evidence and facts, will he look into the impact of the national insurance contribution rises on hospice care and provision, how many hospices are running a deficit, and how many will likely go into deficit as a result of his policies?

[Stephen Kinnock]

The hon. Gentleman will not be surprised to know that I have a section in my speech on employer national insurance contributions. I will get to it.

A number of colleagues raised concerns about regional variations. Facts and evidence are very important in that context. To address that issue, NHS England has developed a palliative and end of life care dashboard, which brings together all the 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.

[Gregory Stafford]

Will the Minister give way?

[Stephen Kinnock]

I will, but I have to finish at 9.58 pm, so there is only about five minutes left of my contribution.

[Gregory Stafford]

It is generous of the Minister to give way, so I shall be brief. Would funding continue to be produced through ICBs, or will the system be funded centrally?

[Stephen Kinnock]

That is precisely the topic of conversation for officials in my Department and NHS England, who are looking at this issue in the round and deciding how we will work. We need a system that empowers ICBs to deliver at the coalface, but we also need accountability from the centre to ensure that things are delivered. Getting the balance right is never easy, as I am sure the hon. Gentleman will understand; that is what we are trying to navigate.

Alongside NHS England, my officials and I will continue to proactively engage with our stakeholders, including the voluntary sector and independent hospices, to understand the issues that they face. In fact, I will meet the major hospices and palliative care stakeholders, including Hospice UK, early next month to discuss potential solutions for longer-term sector sustainability. That will inform our 10-year health plan.

[Munira Wilson]

On the children’s hospice grant, will the Minister confirm that it will be ringfenced, and that it will go beyond the one-year settlement?

[Stephen Kinnock]

Again, that is on the agenda for discussion with officials. Having inherited a disastrous situation, we are using 2025-26 to stabilise and to try to enable the sector to survive. The hon. Lady will understand that as well as doing that, we are looking at long-term reform solutions, but when we came into power on 4 July, it was one minute to midnight, and we had to rescue the sector. That is what we are doing, and we will look at the long-term issues in due course.

A number of Members have raised the concern around employers’ national insurance contributions. Since we came to office in July, we have been completely focused on repairing the catastrophic legacy of 14 years of Conservative neglect and incompetence. The first step was to fix the foundations of the public finances at the autumn Budget, and that enabled the spending review settlement of a £22.6 billion increase in resource spending for our health and care system. Our approach to ENIC exemptions has been consistent with the Office for National Statistics definition and the approach taken by previous Governments. It does not include an exemption for independent contractors, including charities like hospices, although December’s record funding announcement was a clear recognition of our commitment to financially supporting this vital sector more broadly.

I ask Opposition Members from all parties who luxuriate in criticising the means by which we have raised the record funding for hospices what they would do. How would they have raised the £22 billion that our autumn Budget delivered? Which taxes would they raise? Which public services would they cut? Answer comes there none. The Government recognise the need to protect the smallest businesses and charities, such as hospices, which is why we have more than doubled the employment allowance to £10,500, meaning that more than half of businesses and charities with ENIC liabilities either gain or see no change next year.

While the debate is not about assisted dying, I want to say a word on the matter. My hon. Friend the Member for Spen Valley (Kim Leadbeater) put forward her Bill, and it has received its Second Reading. It is vital that our approach to end of life care and patient choice is holistic and driven by an in-depth understanding of patient need.

I thank everybody across the House for this excellent debate. Actions speak louder than words. This Government have acted to deliver the biggest financial contribution to hospices in a generation.

Oral Answers to Questions

Stephen Kinnock Excerpts

Tuesday 7th January 2025 Commons Chamber

[Charlie Dewhirst (Bridlington and The Wolds) (Con)]

2. What assessment he has made of the potential impact of the increase to employer national insurance contributions on social care.

[The Minister for Care (Stephen Kinnock)]

This Government will never shy away from taking the choices necessary to fix the public finances and rebuild our public services. It is thanks to those choices that we are able to invest an additional £3.7 billion in 2025-26 in local authorities that provide social care. We are also delivering the biggest uplift to the carer’s allowance since the 1970s, an £86 million uplift to the disabled facilities grant, and a fair pay agreement for care workers.

[Charlie Dewhirst]

The increase in employer national insurance contributions comes at a time when we simply cannot afford to lose any more provision from care providers. Age UK estimates that 2 million people aged 65 and over already have unmet care and support needs. What assessment has the Minister made of the potential increase in unmet care needs as a result of the increase to employer national insurance contributions?

[Stephen Kinnock]

There is a pattern here. The Conservatives welcome the additional investment in health and care but oppose the choices that we have made to raise the revenue. They need to tell us which services they would cut or which taxes they would raise instead.

[Mr Speaker]

I call the Liberal Democrat spokesperson.

[Helen Morgan (North Shropshire) (LD)]

Coverage Care, a not-for-profit adult social care provider in North Shropshire that operates 11 care homes and employs around 1,000 local staff, has been in touch to say that it expects the impact of the increase in national insurance contributions to be £840,000 in the first full year of implementation. Given that there are huge numbers of vacancies across adult social care in North Shropshire, will the Secretary of State consider exempting social care providers from the national insurance increase? Otherwise we are putting money into social care with one hand and taking it away with the other.

[Stephen Kinnock]

I refer the hon. Lady to my previous answer on the very substantial funding that we are providing to local authorities, which of course are key to the adult social care system. However, funding must always be married with reform. We have brought forward a packed programme of reform—from data sharing and empowering care workers to take on basic healthcare to promoting better use of care technologies—and in the spirit of cross-party collaboration that we believe is absolutely vital and urgent in this area, I gently encourage her to see those reforms as the first step towards rebuilding our care service and making it fit for the future.

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[Gideon Amos (Taunton and Wellington) (LD)]

20. What steps his Department is taking to improve access to mental health services.

[The Minister for Care (Stephen Kinnock)]

As Lord Darzi’s independent investigation found, around 1 million people are waiting to access mental health services in England. This Government will fix our broken mental health services by recruiting 8,500 more mental health workers, providing access to specialist mental health professionals in every school and rolling out young futures hubs in every community.

[Tom Gordon]

In my constituency of Harrogate and Knaresborough we have heard harrowing stories from people who have tried to reach out and get access to mental health services before they reach crisis point. Often, people end up facing months-long if not years-long waiting lists. When all too often they reach a crisis point, they end up having to access services as far away as Newcastle or Manchester. What are the Government doing to make sure that we can root local community mental health facilities in communities such as Harrogate and Knaresborough?

[Stephen Kinnock]

In addition to the measures that I just set out, in the Budget the Chancellor made funding available to expand talking therapies to 380,000 extra patients. We have a £26 million capital investment scheme for mental health crisis centres and, as always with this Government, investment goes with reform. We are finally reforming the Mental Health Act—that was first talked about when Theresa May was in 10 Downing Street. This Government are rolling up their sleeves and getting on with the job.

[Gideon Amos]

Taunton and Wellington is a trailblazer in taking mental health from hospital to community and from sickness to prevention. The trust is the first in the country to merge mental health with the hospital trust. Will the Minister meet the trust and me to understand how successful that programme is, and to discuss the much needed maternity and paediatric unit at Musgrove Park hospital?

[Stephen Kinnock]

It sounds like there is some interesting, dynamic and innovative work going on in the areas that the hon. Gentleman mentioned. I would be happy to meet him to discuss it further.

[Peter Prinsley (Bury St Edmunds and Stowmarket) (Lab)]

I have just been visited by my former medical student, a young doctor in Yorkshire working in an intensive therapy unit, who told me that 40 of the 50 patients who were admitted with covid died. Many healthcare workers are suffering from flashbacks and post-traumatic stress disorder. What measures will the Government take to look after the mental health of the healthcare workers who so bravely helped us during the covid pandemic?

[Stephen Kinnock]

My hon. Friend raises an important point, which provides an opportunity for us all to reflect on the incredible work of those working in our health service; they are, in many ways, heroes, and we should absolutely acknowledge that fact. We need to explore the point he has raised—we could meet to discuss it further, or I would be happy to write to him.

[Anna Dixon (Shipley) (Lab)]

In England, more than 200,000 people were waiting for an autism assessment in September 2024. In my constituency, some adults have waited more than two years for an autism assessment, and one child has been waiting eight years—and is still waiting—to receive support from child and adolescent mental health services. These delays have a profound impact on people’s lives. Will the Minister commit to the mental health investment standard and ensure that as the Government reduce waiting times, they do so for both physical and mental health services for young people and adults?

[Stephen Kinnock]

We remain absolutely committed to the mental health investment standard. We have prioritised the expansion of NHS talking therapies and individual placement and support schemes, and provided £26 million of capital funding to open new mental health centres. However, we are not complacent on this issue. My hon. Friend spoke about autism assessments, which is a red light that is flashing on my dashboard. I would be happy to discuss that further with her.

[Sir Desmond Swayne (New Forest West) (Con)]

11. Whether his Department plans to improve integration of counsellors and psychotherapists into the mental health workforce.

[The Minister for Care (Stephen Kinnock)]

Counsellors and psychotherapists form an integral part of the NHS mental health workforce, delivering support to people with mental ill health across a range of settings in services for both children and young people and adults. We will publish a refreshed NHS long-term workforce plan to ensure that the NHS has the right people in the right places with the right skills to deliver the care that patients need.

[Sir Desmond Swayne]

Is there a plan to maintain service provision where psychotherapists and counsellors operating in the charity sector have been hit by eye-watering cost increases as a consequence of the national insurance increase?

[Stephen Kinnock]

As I have said in answers to previous questions, and as my right hon. Friend the Secretary of State has said, there is something of a pattern emerging here: Opposition Members say that they welcome the investment the Government have made, but oppose the revenue-raising measures and refuse to set out whether they would increase taxes or cut services. I still have not heard an answer on that from those Members.

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[Mr Speaker]

Can Members please remember that these are topical questions?

[The Minister for Care (Stephen Kinnock)]

We are making a priority of resuming consultations with the sector to stabilise community pharmacy. Pharmacy First has built on existing services to increase the clinical scope. The conditions treated under Pharmacy First vary across the UK, and the NHS will keep this under review.

[Claire Young (Thornbury and Yate) (LD)]

T3. When we think of social care, we often think of those who are older, but at a recent advice surgery I met the mother of a 20-year-old with complex needs that local services are unable to meet, so the only option that would allow him to engage with his peers is residential care further afield, taking him away from his family. Will the Minister meet with me, my constituent and his mother to discuss how we ensure that those with complex needs are properly supported?

[Stephen Kinnock]

I am sure the hon. Lady will welcome the fact that we have found an £86 million uplift for the disabled facilities grant, but on the specific question she raises, I would be happy to meet her and discuss that further.

[Jo Platt (Leigh and Atherton) (Lab/Co-op)]

T6. Groups such as Action for ME and Long Covid Support tirelessly advocate for improved care for over 2 million people living in the UK. How will the Minister ensure that NHS reforms deliver timely diagnosis, effective treatment and long-term support for those affected?

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[Natasha Irons (Croydon East) (Lab)]

T7. The Family Dental Practice in my constituency has faced significant challenges caused by dental contracts introduced by the previous Government. The pilot scheme it took part in caused long-lasting operational financial damages to the practice. How will the Secretary of State support such practices, and will he consider measures such as rebasing the unit of dental activity targets to help them overcome these challenges?

[Stephen Kinnock]

My hon. Friend is absolutely right: the NHS dental contract simply is not working. We are working with the sector to reform the contract, with a shift to focusing on prevention and the retention of NHS dentists. We will deliver on our pledge to provide 700,000 more urgent dental appointments at the earliest possible opportunity, targeting areas that need them most.

[Tim Farron (Westmorland and Lonsdale) (LD)]

One in five social care jobs in Cumbria are currently unfilled, and the consequences are unbearable for those who are vulnerable; indeed, they are causing pressure on the rest of the NHS. Will the Secretary of State look carefully at the specific needs of rural communities such as ours, where it is so much harder to recruit and retain social care workers?

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[Mr Richard Quigley (Isle of Wight West) (Lab)]

T10. The Isle of Wight does not just have a problem with its ferries, as the House would expect; we also have a huge problem with dentistry. We are a true dental desert. However, the size of our community means that we are an ideal place to try new approaches to dentistry, especially for children. Will the Minister meet me to discuss those approaches and improve dentistry on the island?

[Stephen Kinnock]

My hon. Friend is absolutely right to describe the Isle of Wight as a dental desert. That is perhaps one of the reasons why the good people of that island elected a Labour Member for the first time in history. Our ambition is to make sure that everyone who needs a dentist can get one. Sadly, 28% of adults in England—13 million people—have an unmet need for NHS dentistry. I would be glad to meet my hon. Friend to learn more about how the experience of the Isle of Wight can improve services nationally.

[Rishi Sunak (Richmond and Northallerton) (Con)]

Prostate cancer is the most common cancer in men, yet it has no national screening programme. We worked on this issue in government, and I thank the Secretary of State for taking an interest in this area. Will he join me in commending Prostate Cancer Research’s excellent new report and urge his team to consider the findings, not least on increasing screening of at-risk groups so that we can not just save the NHS money but, more importantly, save thousands of lives?

[Deirdre Costigan (Ealing Southall) (Lab)]

The last Government treated mental health as a Cinderella service, with my constituents waiting days in A&E to be admitted to hospital mental health wards. The Solace Centre in Ealing Southall provides help and support in the community for those with mental health problems, at a fraction of the cost of a hospital stay. How does the Minister intend to move more mental health services from hospital to the community, and to create more great services like the Solace Centre?

[Stephen Kinnock]

I thank my hon. Friend for her excellent question. She is right that it is vital to move services from hospital to community. The Chancellor made funding available for 380,000 more talking therapies for patients and put in place a £26 million capital investment scheme for mental health crisis centres. A lot of work has been done, but there is a lot more still to do.

[Vikki Slade (Mid Dorset and North Poole) (LD)]

Will the Secretary of State confirm what is being done to ensure that patients with rare and complex conditions, such as functional neurologic disorder and achalasia, can access consistent and co-ordinated care, including referrals to the multidisciplinary teams they need for the different symptoms they experience?

Community Pharmacies: Devon and the South-west

Stephen Kinnock Excerpts

Tuesday 17th December 2024 Westminster Hall

[The Minister for Care (Stephen Kinnock)]

It is a real pleasure to serve under your chairship, Mr Betts. I thank the hon. Member for Tiverton and Minehead (Rachel Gilmour) for ensuring that this really important debate can take place today. I start by acknowledging and paying tribute to the outstanding work of community pharmacy teams in Devon, the south-west and right across the country. I have heard so many examples, showing just how many patients and communities rely on pharmacy services, and the lengths to which they go to deliver care. I thank them for their professionalism, hard work and dedication in providing excellent standards of patient care.

It is a credit to them that surveys show that nine in 10 people who visit pharmacies feel positive about the experience. Community pharmacies are often the most accessible part of our NHS, allowing people to access professional healthcare advice right there on the high street. They are also vital in supporting rural communities and people living in remote locations. Furthermore, as community pharmacies provide more clinical services, they help to relieve pressure in other areas of the NHS. That includes freeing up GP appointments, preventing hospital admissions and reducing overall pressure on secondary care.

For far too long, however, Governments have failed to recognise the essential role of community pharmacies in safeguarding the nation’s health. On 4 July, we inherited a system that has been starved of funding, with a 28% cut in funding in real terms. In many ways, it is on its knees, with far too many closures happening across the country. Lord Darzi’s report laid bare the true extent of the challenges facing our health service. Even he, with all his years of experience, was truly shocked by what he discovered. His report was vital, because it gave us a frank assessment—a diagnosis—so that we can face the problems honestly and properly. It will take a decade of national renewal, lasting reform and a long-term plan to save our NHS. We have committed to three key shifts: from hospital to community, from analogue to digital, and from sickness to prevention. Our 10-year plan will set out how we will deliver these shifts to ensure that the NHS is fit for the future.

To develop the plan, we must have a meaningful conversation with the country and those who work in the system. We are therefore conducting a comprehensive range of engagement activities, bringing in views from the public, the health and care workforce, national and local stakeholders, system leaders and parliamentarians. I urge Members, their constituents, and staff across health and social care to tell us what is working and what needs to change. They should visit change.nhs.uk and make their voice heard.

The Government are committed to restoring the NHS to its founding promise that it will be there for all of us and our constituents when we need it. However, as identified by Lord Darzi’s review, primary care is under massive pressure and in crisis. I recognise that it is a really challenging environment for colleagues in all parts of the NHS, including in community pharmacy, but we remain resolute and determined to fix this situation.

Pharmacies are based in, and are a key part of, the communities that they serve. They are ideally placed to help to tackle inequalities and to increase the reach of and access to NHS services. This includes delivering a range of health advice and support services, helping to relieve pressure on and improve access to the wider NHS. Community pharmacies are a vital part of our NHS that must be recognised in the development of the Government’s 10-year plan. They are central to the three big shifts in healthcare that I outlined earlier. I know that pharmacies can and should play an even greater role in providing healthcare on the high street. This will be imperative if we are to deliver across the Government’s mission—not just on the health mission, but on growth and opportunity.

A healthy society and workforce are pre-conditions for prosperity and growth. We have a staggering 2.9 million people who want to work, but are unable to do so because they have been failed by our health and care system for the last 14 years. Community pharmacy has a pivotal role to play in getting our economy back on its feet and fit for the future, whether that is by identifying those with risk factors for disease such as high blood pressure, or ensuring that people can access and use their medicines to best effect. As a Government, we are fully committed to working with the sector to achieve what we all want: a community pharmacy service that is fit for the future.

I am keen to unlock the potential of the whole pharmacy team. We want pharmacists to be providing new and impactful clinical services, including our future pharmacies prescribing service. We want pharmacy technicians to have more responsibility in supporting the pharmacists, to help people to deliver the best possible health outcomes.

Every day, pharmacy teams facilitate the safe supply of medicines to patients, enabling them to manage health conditions as part of their daily lives in Devon, the south-west and right across the country. They also provide vital advice on prescriptions, over-the-counter medicines and minor ailments. But pharmacies do not just dispense medicines and offer advice. They do much more. They positively impact patients’ health and support the wider NHS by providing a wide range of clinical services. Many offer blood pressure checks, flu or covid-19 vaccinations, contraception consultations and many more locally commissioned services.

[Dr Evans]

The Minister is espousing brilliantly what community pharmacies do. That all comes under a contractual framework, and one of the key things that pharmacies are asking for is when the negotiations will start and what the terms of reference will be. Will the Minister address that point?

[Stephen Kinnock]

I thank the shadow Minister for that intervention. I am as frustrated as everybody else about the delay. The reason for the delay is that the negotiations did not get over the line before the general election. The general election came, and we have spent a lot of time now clearing up the disastrous mess that the previous Government made of the system. I can say that we are now very focused on getting these negotiations started early in the new year. I know that hon. Members across the House will be very interested in that, in terms of the contractual framework, the medicines margin and all of the funding. We have a statutory duty to consult with the sector before we can make any announcement, but we are confident that we will start the negotiations early in the new year.

We supported Pharmacy First in opposition, and we will build on that programme in the future. We look to create an independent prescribing service, where prescribing is an integral part of the services delivered by community pharmacies. We are also doing a lot of work on the IT infrastructure to make sure that the sector can more easily prescribe and refer through better IT. That is an important part of our shift from analogue to digital. We need pharmacies delivering services that help patients to access advice, prevention and treatment more easily—services that help people to make best use of the medicines they are prescribed and that ease some of the pressures in general practice and across parts of the NHS.

There are more than 10,000 pharmacies in England. They are busy dispensing medicines, offering advice and providing these services. Patients across the country can also choose to access around 400 distance-selling pharmacies that deliver medicines to patients’ homes free of charge. They play a vital role in reaching the most isolated members of our society.

I am very keen to ensure that the hon. Member for Tiverton and Minehead has a minute at the end of the debate to sum up. In the short time I have, I want to say a couple of words about her constituency, where there are 15 pharmacies. We are aware of the closure of one pharmacy in her constituency since 2017 and that the local population instead get their medicines from the neighbouring dispensing GP. I also note that, according to the latest data, there are 203 pharmacies in Devon; across the south-west, there are 916. Where closures have occurred across the south-west, the ICBs are working through the process of approving applications from new contractors. Some applications have already been granted. Following approval, the new pharmacy contractor has 12 to 15 months in which to open a pharmacy, so the ICBs are also working with GP practices and other contractors to minimise any temporary disruption for patients.

Community pharmacies are a vital part of the NHS and communities across our country. The Government are committed to supporting them now and into the future. I look forward to working with pharmacists across the country and hon. Members across this House as we progress our plans to embrace the skills, knowledge and expertise in pharmacy teams.

Dental Healthcare: East Anglia

Stephen Kinnock Excerpts

Wednesday 11th December 2024 Westminster Hall

[The Minister for Care (Stephen Kinnock)]

It is a pleasure to serve under your chairship, Mr Dowd. I thank the hon. Member for Broadland and Fakenham (Jerome Mayhew) for securing this vital debate on dental healthcare provision in East Anglia, and I thank hon. Members on both sides of the House for their important interventions.

The debate follows hot on the heels of a debate on 3 September that my hon. Friend the Member for Norwich South (Clive Lewis) led on healthcare provision in the east of England. We know that huge swathes of the region are dental deserts. These areas are facing great pressures from challenges in the recruitment and retention of dentists, leaving patients struggling to access the NHS dental treatments that they need. As has been pointed out, it is a scandal—frankly, it is Dickensian—that the No. 1 reason for children aged five to nine to be admitted to hospital in our country in 2024 is to have rotten teeth removed.

Norfolk and Waveney integrated care board had 31.5 dentists per 100,000 of the population in 2023-24, which is the lowest number in England. That is why I have met with colleagues from the east of England, including the hon. Member for Broadland and Fakenham, to discuss the specific challenges in the region and to discuss the University of East Anglia’s plans to open a dental school. The UEA’s proposal to begin training dental students is very welcome news. As I said to all the colleagues I met recently, and to the hon. Gentleman at oral questions last month, the Government strongly encourage the UEA to continue its progress towards establishing a dental school by submitting its bid to the General Dental Council as rapidly as possible.

The independent Office for Students is another key player. It has statutory responsibility for allocating funded training places to dental schools. As the hon. Gentleman has pointed out, the OfS is independent from the Government. I cannot make specific commitments about allocating additional training places for future years, because to do so would be to cut across the independence of the OfS. The OfS makes decisions based on its own assessments, following guidance issued by Government. What I can say to the hon. Gentleman is that our guidance is influential, but I cannot guarantee its outcome.

The guidance for the 2026 academic year will be published in due course. Provided that the UEA meets those requirements, it would absolutely be considered for Government-funded dental training places. That would certainly help to retain local dentists in East Anglia. As a Member for a rural constituency, I absolutely understand how important that is to the hon. Gentleman and to the many other hon. Members present who represent his part of the country.

We also need a clear-headed diagnosis of where we are. It is beyond doubt that NHS dentistry was left in an appalling state of disrepair by the previous Government. As the Prime Minister said last week, the precious contract between the state and the British people has been broken. He rightly said that our public services are

“in crisis, unable to perform their basic functions”

and that they are

“unable to provide the timely care and dignity that Britain relies on”.

Almost five years on from the beginning of the pandemic, NHS dentistry has still not recovered to pre-pandemic levels. Only 40% of adults were seen by an NHS dentist in the 24 months to June this year, down from almost 50% before the pandemic. Although 34 million courses of dental treatment were delivered in England in 2023-24, that is down from almost 40 million courses five years ago. As I say, it is disgraceful that having rotten teeth removed is the single most common cause of hospital admissions for children aged five to nine, causing them untold pain and suffering and affecting their ability to sleep, speak and socialise.

On the subject of the general state of dentistry, I thank the National Audit Office for its recent investigation of the previous Government’s dental recovery plan. Its report lays out in black and white something that was already apparent to millions of people across the length and breadth of our country: the dental recovery plan that we inherited did not go far enough. We are reflecting on every line of the NAO report as part of our efforts to rebuild dentistry, get it back on its feet and make it fit to serve people of all ages. We have launched the largest ever national conversation to inform our 10-year plan to reform the NHS, and our workforce will play a central role, because they are key to unlocking improvements across our communities.

The golden hello scheme offers dentists £20,000 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 those areas as we speak. As of 7 November, 64 posts had been advertised. Our manifesto pledged 700,000 more urgent dental appointments, and we are working to ensure that patients can start to access them as soon as possible. They will be targeted at the areas that need them most.

Strengthening the workforce is key to our ambitions, but for years dentistry has faced chronic workforce shortages. We have to be honest that bringing in the staff we need will take time. To rebuild dentistry in the long term and increase access to NHS dental care, we will reform the dental contract with a shift to focusing on prevention and the retention of NHS dentists. There are no perfect payment systems, and careful consideration needs to be given to any potential changes to the complex dental system, so that we deliver a system that is better for patients and the profession.

[Adrian Ramsay]

I thank the Minister for reiterating the Government’s commitment to reforming the dental contract. Please will he set out a timescale for that work commencing?

[Stephen Kinnock]

I was just going to say that we are continuing to meet the British Dental Association and other representatives of the dental sector to discuss how we can best deliver our shared ambition to improve access for NHS dental patients. We are working on this as a matter of urgency. I cannot give a specific timeframe, but it is a top priority for the Department.

[Charlotte Cane (Ely and East Cambridgeshire) (LD)]

I understand that the Government have inherited a big problem, but the situation is urgent. I have a constituent who has heart problems, so his oral health is really important to him. He cannot get an NHS dentist, so constituencies such as Ely and East Cambridgeshire need urgent action.

[Stephen Kinnock]

I share the hon. Lady’s belief that we need urgency and focus. We have a big mountain to climb, but we have to crack on. I completely take her point about the need for urgency.

We need to ensure that the process to register a dentist in the UK is as efficient and fast as possible, while retaining robust safeguards for patient protection. The Department regularly engages with the General Dental Council to understand what it is doing to improve the waiting times for the overseas registration exam. Earlier this year, the Department ran a consultation on introducing a further piece of legislation to give the GDC powers to provisionally register overseas qualified dentists, which will help to address some of the workforce challenges.

In summary, this is an immense challenge. There are no quick fixes or easy answers, but we will choose change, not because it is easy but because it is what we have to do. We have to do the hard yards, and I look forward to working with the hon. Member for Broadland and Fakenham and other colleagues to deliver what is needed.

Question put and agreed to.

Suicide and Mental Health of Young People: Tatton

Stephen Kinnock Excerpts

Tuesday 26th November 2024 Westminster Hall

[The Minister for Care (Stephen Kinnock)]

It is a pleasure to serve under your chairmanship, Mr Dowd. I am grateful to the right hon. Member for Tatton (Esther McVey) for securing this debate and raising many important issues. I also thank her for sharing the tragic story of Olivia. My heart goes out to Olivia’s family and loved ones; it is a truly heartbreaking situation and process that they have gone through.

The right hon. Lady made a number of important points about withdrawal from SSRI antidepressants. A number of those points are quite specific, and I do not have in specific responses my notes. With her leave, I would like to write to her with responses on those points. She made a point about the coroner’s advice, which contained a lot of useful counsel on how we might address and tackle the issues raised. I will certainly look at that in detail, and will happily take those matters forward with her. We have a shared interest in addressing the issue. If the system is not working and people who are on that antidepressant are not being supported with withdrawal, we need to look at that in detail. We need to tackle it—I share her views on that.

I will turn to some more general points about the Government’s position on mental health. We have made suicide prevention and mental health a priority, especially for young people. Many of the issues raised today are symptomatic of an NHS that is broken. Looking at the figures, the challenges that face the NHS are truly sobering.

About 50% of lifetime mental health conditions are established by the time an individual is 14 and 75% by the time they are 24. Evidence suggests that the prevalence of mental health conditions is rising among children and young people. In 2023, 20.3% of eight to 16-year-olds had a probable disorder, compared with 12.5% in 2017. Of course, the covid-19 pandemic exacerbated needs, with analysis showing that 1.5 million children and young people under the age of 18 could need new or increased mental health support following the pandemic.

According to the Darzi review, 343,000 referrals for children and young people under the age of 18 are waiting for mental health services, including 109,000 referrals waiting for more than a year. Under the NHS Cheshire and Merseyside integrated care board, as of the end of September 2024, 10% of children and young people still waiting for first contact with NHS-funded mental health services were waiting for more than 951 days, equating to 1,301 people. Half of those still waiting had been waiting for more than 300 days. There are 13,010 children and young people still waiting for first contact with NHS-funded mental health services.

Until recently, there had been an upward trend in suicide rates for children and young people. For women between the ages of 10 and 24, the rate has nearly doubled since 2012, rising from 1.6 per 100,000 to 3.1 per 100,000 in 2023.

[Helen Grant (Maidstone and Malling) (Con)]

Over the past 10 years in England and Wales, one student has died every four days as a result of suicide. Despite that forlorn tragedy, the law remains unclear about the duties and responsibilities universities have towards their often very vulnerable young students. Will the Minister meet me and members of the LEARN Network and ForThe100 to discuss the introduction of a statutory duty of care for all higher education providers?

[Stephen Kinnock]

I thank the hon. Lady for that important intervention. I am happy to meet her and the LEARN Network. The Government cannot do all this alone; we need to work in partnership with all sorts of different stakeholders, including universities and the higher education sector. We would support any partnership working that we can do.

Until recently, there had been an upward trend in suicide rates for children and young people. For women between the ages of 10 and 24, the rate has almost doubled, but the trend for children and young people has flattened in the past year, despite overall increases in suicide. Although those rates are low compared with those for other age groups, children and young people are a priority group in our mission to tackle suicide. The Department is commissioning research via the National Institute for Health and Care Research to advance our understanding of why rates of suicide have been increasing in certain age groups.

We are committed to reforming the NHS to ensure that we give mental health the same attention and focus as physical health. It is unacceptable that too many children, young people and adults are not receiving the mental health care that they need. We know that waits for mental health services are far too long. We are determined to change that. That is why we will recruit 8,500 additional mental health workers across children’s and adult mental health services. We will also introduce a specialist mental health professional in every school and roll out young futures hubs to provide timely mental health support to our children and young people.

We are working with our colleagues at NHS England and the Department for Education as we plan delivery of those commitments. Furthermore, the Government are also committed to tackling suicide as one of the biggest killers in our country. The suicide prevention strategy proposes targeted support for priority groups such as children and young people. The Department for Education is reviewing the statutory guidance on relationships, sex and health education, and the Secretary of State for Education is clear that children’s wellbeing should be at the heart of it.

Some 79 voluntary, community or social enterprise organisations up and down the country have been allocated funding through the Department of Health and Social Care’s £10 million suicide prevention grant fund over the two years to March 2025. These organisations—from local and community-led through to national—deliver a broad and diverse range of activity that will prevent suicides and save lives.

Early intervention on mental health issues is vital if we want to stop young people reaching crisis point. Schools and colleges play an important role in that early support, which is why we have committed to providing a mental health professional at every school. Mental health support teams help to meet the needs of children and young people in education settings; such teams, which are made up of mental health practitioners and education mental health specialists, are available in schools in Tatton.

However, it is not enough to provide access to a mental health professional when young people are struggling. We want the education system to set young people up to thrive, and we know that schools and colleges can have a profound impact in promoting good mental health and wellbeing. Doing this well takes a holistic approach, drawing in many aspects of the school or college’s provision. Many schools are already doing that, and my Department is working alongside the Department for Education to understand how we can support such good practice across the sector, and across the length and breadth of our country.

The opportunity mission will break the link between people’s background and their success. The mission will build opportunity for all by giving every child the best start in life: high-quality early education, early child health, home learning environments and family support. The mission will also support children to achieve and thrive, ensuring high school standards with a broad curriculum, excellent teachers and targeted interventions, an inclusive approach to special educational needs and disabilities, mental health support, access to arts, culture and sport, and youth services and provision.

In our manifesto, the Government committed to rolling out young futures hubs. This national network is expected to bring together local services, deliver support for teenagers at risk of being drawn into crime or facing mental health challenges, and, where appropriate, deliver universal youth provision. The hubs will provide open-access mental health support for children and young people in every community.

We are concerned about the widespread availability of harmful material online, promoting content on eating disorders, suicide and self-harm, that can easily be accessed by people who may be young and/or vulnerable. We have been clear that the Government’s priority is the effective implementation of the Online Safety Act 2023, so that those who use social media—especially children—can benefit from its wide-ranging protections as soon in their lives as possible. Earlier this year, Ofcom concluded its consultations on the draft illegal content and child safety codes of practice. We expect the illegal content codes to be in effect by spring 2025, with the child safety codes following in the summer.

I will turn to other aspects of our plans to improve mental health services. The Mental Health Bill, which was announced in the King’s Speech, will deliver the Government’s manifesto commitment to modernise the Mental Health Act 1983 by giving patients greater choice and autonomy and enhanced rights and support, and aims to ensure that everyone is treated with dignity and respect throughout their treatment. It is important to get the balance right to ensure people get the support and treatment they need when necessary for their protection and for that of others.

I am pleased to say that the Bill has been introduced in the Lords and will be coming to the Commons in the new year. The Bill will make the Mental Health Act fit for the 21st century, redressing the balance of power from the system to the patient and ensuring that people with the most severe mental health conditions get better, more personalised care. It will limit the scope to detain people with a learning disability and autistic people under the Act unless they have a co-occurring mental health disorder that needs hospital treatment.

I conclude by once again commending the right hon. Member for Tatton for securing the debate and colleagues from across the House, including the hon. Members for Maidstone and Malling (Helen Grant) and for Strangford (Jim Shannon), for sharing their insight on the vital issue of suicide prevention and mental health care for children and young people. I am committed to working with the right hon. Member for Tatton and her hon. Friend, the hon. Member for Maidstone and Malling, to take forward these issues, and I hope that we can, together—across the House—address this vital issue.

Question put and agreed to.

Oral Answers to Questions

Stephen Kinnock Excerpts

Tuesday 19th November 2024 Commons Chamber

[Jerome Mayhew (Broadland and Fakenham) (Con)]

4. What estimate he has made of the number of new dental training places needed in the east of England.

[The Minister for Care (Stephen Kinnock)]

Fourteen years of Conservative neglect and incompetence have left huge swathes of the east of England as dental deserts. As part of our 10-year plan, we will be working with NHS England to assess the need for more dental trainees in areas such as the east of England where we know that many people are struggling to find an NHS dentist. I am aware of the University of East Anglia’s plans to open a dental school and I recently met MPs from the east of England, including the hon. Gentleman, to discuss that process. I encourage the UEA to continue with its bid for a new dental school.

[Jerome Mayhew]

The Minister well knows that there is a lack of dentists in the east of England, because there is no undergraduate training facility. The nearest place is either Birmingham or London. He has kindly mentioned the University of East Anglia, which is ready to go with a new building under construction. It has wide cross-party support, as he also knows from the meeting that he held recently, so when will he make the announcement?

[Stephen Kinnock]

I thank the hon. Gentleman for that follow-up question, but he will recall that, when we met, I and my officials made it clear to him that the UEA has not yet submitted its bid for a dental school. In that meeting, we said: “Please go back to the UEA and encourage them to submit that bid. When they do, we will look at it very carefully.”

[Mohammad Yasin (Bedford) (Lab)]

Many of my constituents in Bedford are struggling to get an NHS dentist. I am also hearing from those who have tried to book an appointment only to discover that they have been removed from the NHS list without any warning. The Government have committed to improve the dental contract. In doing so, will they ensure that dentists can no longer drop people from their books—leaving them without any access to care—without prior notice?

[Stephen Kinnock]

My hon. Friend is right: we will reform the dental contract to rebuild dentistry in the long term and to increase access to NHS dental care, with a shift to focusing on prevention and the retention of NHS dentists. We continue to meet representatives from the British Dental Association and other representatives of the sector to discuss how we can best deliver our shared ambition to improve access for NHS dental patients.

[Wendy Chamberlain (North East Fife) (LD)]

5. What recent assessment he has made of the potential impact of proposed changes to employer national insurance contributions on staffing costs for health and care providers.

--- Later in debate ---

[Antonia Bance (Tipton and Wednesbury) (Lab)]

6. What discussions he has had with Cabinet colleagues on staff salaries in the care sector.

[The Minister for Care (Stephen Kinnock)]

I was proud that the Chancellor raised the salaries of hundreds of thousands of care workers in the Budget. Last month, the Government introduced legislation to deliver the first ever fair pay agreement for adult social care. While we were giving care workers a pay rise, the Leader of the Opposition was belittling their work as merely wiping bottoms. I gently say to the Conservative party that it is better to be wiping bottoms than talking out of them. This is an important issue, and I am dealing with ministerial colleagues on it.

[Antonia Bance]

According to last month’s Skills for Care report, most care workers are paid only a couple of pennies above the national minimum wage, while the sector cannot recruit and retain the people it needs. Will the Minister set out the timetable for establishing the fair pay agreement and adult social care negotiating body, and will he give the House an assurance that the care trade unions will be closely involved in its design?

[Stephen Kinnock]

We took quick action on the Employment Rights Bill, which includes the fair pay agreement, within 100 days of taking office. The consultation process on the negotiating body can begin only once the Bill has become an Act. We are engaging widely with stakeholders, and I assure my hon. Friend that unions will play a central role in that process, but let us remember that, through the national living wage, we are giving the lowest-paid full-time care workers a pay increase of £1,400 per year.

[Seamus Logan (Aberdeenshire North and Moray East) (SNP)]

One barrier to better staff salaries in the care sector is the additional employer national insurance contributions. Are the Minister and his colleagues considering an exemption for GP practices, charities and hospices from national insurance employer contributions?

[Stephen Kinnock]

As my right hon. Friend the Secretary of State for Health and Social Care pointed out, when we won the general election on 4 July, we inherited public finances in their worst state since the second world war. Through the Chancellor, we have taken responsible action to deal with those issues. My right hon. Friend the Secretary of State has also said that we are looking at the Budget in the round, and we will report on that in due course.

[Andrew Pakes (Peterborough) (Lab)]

7. What assessment his Department has made of the adequacy of access to NHS dentists.

[Dan Aldridge (Weston-super-Mare) (Lab)]

23. What assessment his Department has made of the adequacy of access to NHS dentists.

[The Minister for Care (Stephen Kinnock)]

After 14 years of Tory neglect and incompetence, NHS dentistry in England has been left in a parlous state. Tooth decay is the most common reason why children aged five to nine are admitted to hospital, and 28% of the country—13 million people—have an unmet need for dentistry. Rescuing NHS dentistry will not happen overnight. We will expand the provision of urgent dental appointments across the country, and we are working with the sector to reform the dental contract in order to increase access and incentivise more NHS care.

[Andrew Pakes]

Yesterday, I heard from a disabled constituent who has spent over a year trying to find an NHS dentist, but without success. The only solution was to come to London for emergency treatment—that became a shockingly common story under the previous Government. As a first step, our integrated care board is putting 12 extra dentists into Peterborough and the surrounding towns to increase access. Will the Minister update the House on progress and on how we will further improve access to NHS dentistry?

[Stephen Kinnock]

I am very pleased to hear about what my hon. Friend’s ICB is doing. Working with the dental sector, we will deliver measures to improve access, targeting areas that need it most. Those measures include 700,000 additional urgent appointments and reform of the dental contract. The golden hello scheme, which incentivises dentists to work in underserved areas, is under way across the country, and dentists are also being offered a new patient premium to treat new patients.

[Richard Baker]

Does the Minister agree that it is unacceptable that more than 40,000 people in Fife are not registered with an NHS dentist? Will he share any learning from this Government’s action to increase access to dentistry with his colleagues in the Scottish Government, and urge them to fulfil their responsibilities so that people in my constituency can get the dental treatment that they need?

[Stephen Kinnock]

Responsibility for dental services in Scotland is of course a matter for the Scottish Government, but Governments across the UK work together to spread best practice and deliver on our common goals. The Scottish National party Government have an extra £1.5 billion this year, and £3.4 billion next year, through the Barnett formula. I hope that they will prioritise health, including dentistry, and undo some of the damage that they themselves have done to dentistry in Scotland.

[Dan Aldridge]

Some 37% of five-year-olds in Weston-super-Mare have enamel or dental decay—a figure well above the national average. The Better Health North Somerset team does amazing work to promote good oral health, but regular dentist check-ups are the oral health silver bullet. Will the Minister explain and outline the work he is doing to ensure that children in Weston and Worle and across the country get the dentistry service that they so desperately need?

[Stephen Kinnock]

My hon. Friend is absolutely right to raise this vital issue. Prevention is of course always better than cure, so I am very proud of the fact that we are introducing supervised toothbrushing for three to five-year-olds in the most deprived communities and where there is the most unmet need. We are also working to sort out the NHS contracts so we can ensure that children get the care they need.

[James Wild (North West Norfolk) (Con)]

Having training locally at the University of East Anglia is important for my constituents, but in the short term, what steps is the Minister taking to speed up the process by which dentists get on the dental performers list, so that they can work in the NHS and not just privately? Is he also considering bringing in a provisional overseas registration scheme?

[Stephen Kinnock]

I thank the hon. Gentleman for that question. We are looking at provisional registration. As I also mentioned to his hon. Friend the Member for Broadland and Fakenham (Jerome Mayhew), we are very open to the idea of a dental training school at the University of East Anglia. We need to ensure that we push on the full spectrum of all these measures, because there is a crisis in NHS dentistry and we need to get on and fix it.

[Ben Obese-Jecty (Huntingdon) (Con)]

Toothless in Huntingdon in my constituency has written to me highlighting that 36% of patients under Cambridgeshire and Peterborough integrated care system no longer have an NHS dentist. It wants dental practices to provide access to those needing emergency treatment and a priority pathway for referrals from hospital departments such as cardiology and oncology. To that extent, what steps are being taken in Huntingdonshire to improve dental access across rural Cambridgeshire? How are the Government helping the Cambridgeshire and Peterborough integrated care system to address those issues?

[Stephen Kinnock]

Obviously the golden hello scheme for rural areas is very important. We are pushing forward on that, and I am pleased to say that hundreds have expressed interest in it and appointments are starting on that basis. The hon. Gentleman is right about training places. As I have already mentioned, we are very open to establishments and institutions coming forward with proposals for that. We are living in a country where the biggest cause of hospital admission for five to nine-year-olds is having their rotten teeth removed. That is a truly Dickensian state of affairs, and it needs to be fixed as a priority.

[Tom Gordon (Harrogate and Knaresborough) (LD)]

Earlier this year, I was at an orthodontist’s practice that carries out work on behalf of the NHS. It said the issue is that when people are referred to it by their general dentist, it cannot go on to do the orthodontic work because their teeth are in too bad a state, so they are referred back to the dentist, but they cannot get in because of waiting lists and issues. When we look at reforming dental contracts, will we look at orthodontic ones too?

[Stephen Kinnock]

Absolutely. As my right hon. Friend the Secretary of State has said, we have already met with the British Dental Association, and no issues are off the table. We absolutely need to look at orthodontists in the round as part of the contract negotiations, and we will certainly report back on that in due course.

[Tristan Osborne (Chatham and Aylesford) (Lab)]

9. What plans he has to reform NHS health and social care services.

--- Later in debate ---

[Helen Morgan (North Shropshire) (LD)]

The Conservatives’ disastrous legacy on dentistry means that more than 4.4 million children have not seen a dentist in the past year. In Shropshire, dentists continue to hand back their contracts, including one in Wem in recent weeks. Will the Minister outline his plan to reverse that terrible decline and ensure that the issue is addressed in rural areas where there are dental deserts?

[The Minister for Care (Stephen Kinnock)]

There will be 700,000 extra urgent appointments, golden hellos, and a prevention and supervised toothbrushing scheme for three to five-year-olds.

--- Later in debate ---

[Damien Egan (Bristol North East) (Lab)]

T6. On the doorstep in Bristol North East, people regularly talk to me about the difficulties they have getting a GP appointment. Will the Minister assure primary care services in my constituency, such as Kingswood health centre, that the Budget will help them and marks the first steps in transforming our NHS?

[Stephen Kinnock]

We have pledged to bring back the family doctor, and we have already invested an additional £82 million in the additional roles reimbursement scheme to recruit 1,000 more newly qualified GPs in 2024-25. We are also committed to fixing the front door of the NHS, for example through £100 million of capital funding that was announced in the Budget. We are fully aware of the pressures, and we will set out further details on funding allocations for next year in due course.

[Charlie Maynard (Witney) (LD)]

T5. Will the Secretary of State give a clear date by which QR codes will be incorporated into the NHS app at the point of care, thereby making the process faster and safer, as was highlighted to me by Dr Steve Bright at the Windrush health centre in Witney?

--- Later in debate ---

[Mr Lee Dillon (Newbury) (LD)]

When the Secretary of State reviews GP funding, will he also consider the burden that sits on GP practices when they have to hold the lease for their surgeries and what role integrated care boards could have in holding that risk, which is stopping the recruitment of GPs to join practices as partners?

[Stephen Kinnock]

NHS England currently accepts ICBs holding leases only as a last resort or by exception due to the significant capital required. While we know that is not the most effective use of ICB resources, it is an important safeguard. We are committed to fixing the front door of the NHS by supporting GPs and ICBs through, for example, the £100 million of capital funding announced at the Budget for GP estate upgrades.

[Jacob Collier (Burton and Uttoxeter) (Lab)]

My constituent Ollie Horobin’s life has been completely transformed after contracting covid, leaving him wheelchair-bound with a feeding tube and battling debilitating symptoms every single day. His story is a stark reminder of the devastating impact that long covid can have. Will the Minister commit to meeting Ollie and me to hear about his experience at first hand, and prioritise further research into the causes, treatments and long-term impacts of extreme long covid?

Infant Formula Regulations

Stephen Kinnock Excerpts

Wednesday 13th November 2024 Commons Chamber

[The Minister for Care (Stephen Kinnock)]

I thank and congratulate my hon. Friend the Member for Blackpool South (Chris Webb) for securing this debate on such a vital matter. He is a true champion for his constituents, and he is rightly concerned about people and families in his constituency who are struggling with the cost of living. I am aware that his constituency experiences high levels of deprivation, which creates challenges for the people who live there.

After 14 years of Tory neglect and incompetence, this Government are committed to improving the lives and health of everyone. However, as my hon. Friend will be all too aware, we have a significant challenge on our hands in transforming our health services so that they work better for the people who need them. When we came to office on 4 July, we made it clear that we would fix our broken NHS. We commissioned Lord Darzi, who published a report that laid bare the true extent of the challenges facing our health service, giving us the frank assessment we needed in order to face those problems honestly and to do the hard work required to fix them. That is why, in the Budget, we announced an additional £25.7 billion of health spending over this year and next.

However, investment works only if it is coupled with reform. That is why we have launched our 10-year health plan, which will address the root causes and fix the foundations by investing in preventive care, expanding mental health services and modernising NHS infrastructure to radically reform the NHS based on three seismic shifts: from hospital to community, from sickness to prevention and from analogue to digital. Our health mission also aims to reduce the time people spend in ill health by tackling health inequalities and driving economic growth.

My hon. Friend will be aware that children are at the centre of our health mission and that we are committed to raising the healthiest ever generation of children. Infant feeding is critical to a baby’s healthy growth and development. We are committed to giving every child the best start in life, and that includes helping families to access support to feed their baby. The family hubs and start for life programme is central to that. Through that programme, 75 local authorities across England are improving their infant feeding support for families, including breastfeeding support. Those services are helping parents to access face-to-face and virtual support whenever they need it, and in a location that suits them, be that in their home, their family hub or a hospital setting. We want to build on the actions that local areas are already taking through the programme, so that families can access the support they need when they need it to meet their infant feeding goals.

Breastfeeding has significant benefits for mothers and babies, but breastfeeding rates in England remain low compared with those in other countries. Data shows that around 53% of babies were breastfed at six to eight weeks, but that that dropped significantly by six months. My hon. Friend will know that in response to concerns about breastfeeding internationally, the World Health Organisation instigated an international code to promote breastfeeding and restrict the inappropriate marketing of breast milk substitutes that can discourage breastfeeding. The UK Government are absolutely committed to implementing that code.

Although breastfeeding has significant health benefits, we recognise that it is vital that families who cannot or choose not to breastfeed have access to infant formula that is both affordable and high quality. The price of infant formula has been brought back into the spotlight with the publication of the Competition and Markets Authority’s interim report last week on competition in the infant formula market. It highlighted the fact that the price of some infant formula has increased by more than 25% in recent years, and as my hon. Friend pointed out, parents and carers have had to bear the brunt of those price increases.

The Government’s infant formula regulations do not set the price of infant formula, which is agreed by infant formula manufacturers and retailers. Instead, they ensure that parents and carers have access to the highest quality and safe infant formula. The regulations cover infant formula and follow-on formula, which covers the first 12 months of a baby’s life. They require all infant formulas to comply with robust nutritional and compositional standards, meaning that they meet all the nutritional needs of babies, regardless of price or brand. However, the regulations rightly restrict the inappropriate marketing and promotion of infant formula. That is because there is considerable evidence that advertising directly to the consumer influences people’s decision on how to feed their babies.

My hon. Friend has raised questions about loyalty card points and vouchers from food banks or local authorities being used for purchasing infant formula. The regulations seek to restrict inappropriate marketing techniques that induce the sale of infant formula, including special sales or discounts, so as not to discourage breastfeeding. Loyalty card points on their own are not contentious within the infant formula regulations, and the regulations do not specifically mention them. I agree that consumers should be able to use their loyalty card points to achieve a saving on their shopping. However, my hon. Friend will be aware that numerous loyalty and reward card schemes are available, and they vary significantly between retailers. Some may offer special discounts beyond awarding loyalty points. Loyalty card points should not be used as an incentive or as a reward to purchase infant formula. There is unlikely to be a one-size-fits-all approach, and it is for businesses to ensure that their activities are in compliance with the regulations.

My hon. Friend asked about food banks, and I wish to be clear that the regulations do not prohibit infant formula from being distributed via food banks, including where they may issue vouchers to families. Food banks set their own policies on whether to distribute infant formula. I recognise the important role that they play in supporting some of our most vulnerable families. We have published guidance to businesses on the regulations, and can provide further clarity on those issues where needed.

My hon. Friend rightly mentioned the CMA’s report, and I wish to address that in more detail. The CMA looked at competition across the infant formula sector, including the regulatory framework, consumer behaviour and manufacturer behaviour, and it assessed the impact on market outcomes. It concluded that multiple factors are resulting in poor market outcomes for consumers, including the behaviour of infant formula manufacturers and retailers, and that those require a response beyond the regulations alone. The CMA has been clear that it recognises the public health importance of the regulations, and that they ensure that all infant formula is suitable for meeting the health and development needs of babies, regardless of price. However, it suggests that restrictions in the regulations on price promotions may be softening competition on prices, and it is also concerned about enforcement of the regulations.

Furthermore, the CMA is concerned that parents and carers are not being provided with sufficient information to make well-informed choices, and that their choices are often made in vulnerable situations after giving birth in healthcare settings. In these circumstances, they are unable to make choices that best meet their needs and budgets. The CMA has other market-based concerns about infant formula being indirectly promoted by infant formula manufacturers via the marketing of follow-on formula and growing-up milks, and about how statements on products may influence parent and carer choices.

To understand how the visibility of products online, in-store and in hospitals drives choices, the CMA commissioned qualitative research, which it published alongside its interim report. We will be carefully considering all the issues and options put forward by the CMA as it develops its final recommendations for Government early next year.

I understand that many families are struggling to meet the cost of feeding their baby, and the Government are committed to helping families most in need to access support. The Budget announcement on extending the household support fund will help those facing financial hardship with the cost of essentials. The Government’s Healthy Start scheme promotes a healthy diet for pregnant women, babies and young children by providing funds that can be used to buy or be put towards the cost of infant formula, as well as fruit and vegetables, pulses and milk. My hon. Friend has suggested that the value of the Healthy Start scheme should be increased. He may be aware that in April 2021, the value of the scheme increased by 37%.

[Caroline Voaden (South Devon) (LD)]

The Government have repeatedly said that they will not consider lifting the two-child benefit cap, but as we have been hearing from Members, the cost of infant formula can be prohibitive for parents who are not particularly well off. Will the Minister again consider lifting the two-child benefit cap, which we know is the biggest driver of child poverty in the UK? That would mean that fewer parents face difficult choices when it comes to paying for good-quality food.

[Stephen Kinnock]

When this Government came into office on 4 July, we inherited the worst public finances since the second world war. We were elected on the basis of a manifesto that stated we would return fiscal responsibility and discipline to the management of the British economy. All of that means that we have had to take some hard choices. I do not think that a single member of the parliamentary Labour party wants to have the two-child cap in place, but the reality is that the profound irresponsibility and recklessness of previous Conservative Governments has left us with no choice but to take some difficult decisions. I hope that as we start to instil fiscal responsibility and bring growth back into our economy, we will be in a position to look again at the public finances, but we have to take it one step at a time because of the catastrophic situation left to us by preceding Administrations.

On the Healthy Start scheme, I add that pregnant women and children under four and over one each receive £4.25 a week, and children aged under one each receive £8.50 a week.

I once again thank my hon. Friend the Member for Blackpool South for raising this really important matter. I fully appreciate that there is no quick fix to reduce the prices of infant formula, which are set by manufacturers and retailers, but I have outlined the help available through Healthy Start for eligible families. I want to assure him that we are committed to addressing the concerns raised by the CMA so that the infant formula market delivers the better outcomes that parents deserve.

Question put and agreed to.

NHS Dentistry: South-west

Stephen Kinnock Excerpts

Tuesday 12th November 2024 Westminster Hall

[The Minister for Care (Stephen Kinnock)]

It is a real pleasure to serve under your chairship, Mr Vickers. I congratulate the hon. Member for Honiton and Sidmouth (Richard Foord) on securing this very important debate on NHS dentistry in the south-west.

My right hon. Friend the Secretary of State has said that this Government will be honest about the problems facing the NHS and equally serious about tackling them. The truth is that we are very far from where we want and need to be. Lord Darzi’s report laid bare the true extent of the challenges facing our health service, including NHS dentistry. Even he, with his years of experience, was shocked by what he discovered.

I pay tribute to all the hon. Members from across the House—too many to name in the short time available to me—for helping to highlight and elucidate their concerns. In many ways, those reflected what Lord Darzi set out, but we have also heard today some heartbreaking examples of the experiences our constituents are having. Colleagues across the House have brought those to life today.

Lord Darzi’s report is vital because it gives us the frank assessment we needed to face the challenges honestly. Lord Darzi is clear that rescuing NHS dentistry will not happen overnight, but we will not wait to make improvements to the current system, to increase access and to incentivise the workforce to deliver more NHS care.

We inherited a broken NHS dentistry system. It is truly shameful and nothing short of Dickensian that the most frequent reason for children of between five and nine years old to be admitted to hospital is to have their rotten teeth removed. That is, frankly, disgraceful. Those are the sort of challenges that we need to face.

Some 13 million people in England have an unmet need for NHS dentistry. That is 28% of our country. It is absurd that people cannot access NHS dentistry when each year the budget is underspent—in recent years, that has been to the tune of hundreds of millions of pounds-worth of care going undelivered. That is why we need to reform the dentistry contract.

In NHS Devon integrated care board, which includes the constituency of the hon. Member for Honiton and Sidmouth, 34% of adults were seen by an NHS dentist in the 24 months to March 2024, compared with an average of 40% in England. In 2023-24, there were 40 dentists per 100,000 of the population, whereas the national average, across all integrated care boards, was 50 in the same year.

We acknowledge that there are areas of the country that are experiencing recruitment and retention issues—including many rural areas, where the challenges in accessing NHS dentistry are exacerbated. As Lord Darzi said, we have enough dentists and dental care professionals at an aggregated national level; the problem is that not enough of them are doing NHS work in the right parts of the country, where they are most needed.

The mountain that we have to climb is daunting, but this Government are not daunted and we are working at pace. Take for example the golden hello scheme, which will see up to 240 dentists receiving payments of £20,000 to work in those areas that need them most for three years. ICBs have already started to advertise those posts through that scheme. Nationally, there have been 624 expressions of interest and 292 of those have since been approved. Thirty-eight posts are now being advertised with the incentive payment included. Or take our rescue plan, which will help to get NHS dentistry back on its feet by providing 700,000 additional urgent appointments as rapidly as possible.

We know that rescuing NHS dentistry means acknowledging that we need more dentists doing NHS work and we know from survey data that morale among NHS dentists is low. We must turn that around. This Government will do all we can to make NHS dentistry an attractive proposition. Strengthening the workforce is key to our ambitions, but for years the NHS has been facing chronic workforce shortages and we have to be honest that bringing in the staff we need will take time.

We are committed to reforming the dentistry contract to make NHS work more attractive, boost retention and deliver a shift to prevention. There are no perfect payment models, and careful consideration needs to be given to any potential changes to the complex dental system, so that we deliver genuine improvements for patients and the profession. We are continuing to work with the British Dental Association and other representatives of the dental sector to deliver our shared ambition to improve access to treatment for NHS dental patients.

The Secretary of State met with the BDA on his first day in office, and I engage with it regularly, including at a meeting earlier this month. I share the BDA’s desire for a timeline for negotiations, but we have had to wait for the Budget and the ensuing discussions with the Treasury to initiate and conclude those discussions.

[Mr Amos]

Is the Minister able to say when the timeline for those negotiations will be available?

[Stephen Kinnock]

As the hon. Gentleman will understand, we are in a sequence: we have the Budget, then the complex negotiations around the spending review. We cannot engage in meaningful, formal discussions and negotiations until we are clear on what exactly the financial envelope is. We are working at pace on that. However, we have been meeting informally to sketch it out, so I would say that the scope of the negotiations is agreed. The formal negotiations will really start only once we have the detailed budget in place.

We will listen to the sector and learn from the best practice to improve our workforce and deliver more care. For example, the integrated care boards in the south-west are applying their delegated powers to increase the availability of NHS dentistry across the region through other targeted recruitment and retention activities. That includes work on a regional level to attract new applicants through increased access to postgraduate bursaries, exploring the potential for apprenticeships and supporting international dental graduates.

There are two dental schools in the south-west: Bristol Dental School, and Peninsula Dental School in Plymouth. I recently had the pleasure of visiting Bristol Dental School and seeing the excellent work that they are doing there, training the next generation of dental professionals, supporting NHS provision by treating local patients, and reaching underserved populations through outreach programmes. I also know that Peninsula Dental School, which first took on students in 2007, is doing the same for Plymouth and its surrounding areas.

I would also like to pay tribute to Patricia Miller of NHS Dorset, Lesley Haig of the Health Sciences University and council leader Millie Earl for working so constructively with my hon. Friend the Member for Bournemouth East (Tom Hayes) on improving oral health in his constituency.

A number of hon. Members have rightly highlighted the importance of prevention, and we are working around the clock to end the appalling tooth decay that is blighting our children. We will work with local authorities and the NHS to introduce supervised toothbrushing for three to five-year-olds in our most deprived communities, getting them into healthy habits for life and protecting their teeth from decay. We will set out plans in due course, but it is clear that to maximise our return on investment, we need to be targeting those plans at children in the most disadvantaged communities. In addition to that scheme, the measures that we are taking to reduce sugar consumption will also have a positive effect on improving children’s oral health.

Separate from the national schemes, I was pleased to note that NHS Devon integrated care board has committed £900,000 per annum for three years to support further cohorts of children for supervised toothbrushing, fluoride varnish and Open Wide Step Inside, with a new fluoride varnish scheme due to go live in September 2025. Open Wide Step Inside is a local scheme in which a dental outreach team, run by the Peninsula Dental Social Enterprise, goes into schools to deliver 45-minute oral health education lessons across Devon and Cornwall. It is a truly commendable scheme.

The steps we take in NHS dentistry will feed into the wider work we are doing to fix our broken NHS. We have committed to three strategic shifts: from hospital to community, from sickness to prevention and from analogue to digital. Our 10-year plan will set out how we deliver those shifts to ensure that the NHS is fit for the future.

[Dr Johnson]

The Minister has iterated the problem, and he has spoken warm words about listening, talking and working with people. However, he has said little that is concrete, except about things that were happening already, either locally or as a result of the previous Government. With a minute left to answer all the questions he has been asked, can he commit to answering in writing those he does not have time to answer in the remaining minutes?

[Stephen Kinnock]

The first thing I will say is that I am not going to take any lectures from any Conservative Member about the state of our dental system. What brass neck we see from that party, both in the Chamber and in this place—lecturing us, given the disgraceful state of our NHS and the fact that the biggest cause of five to nine-year-olds going to hospital is to have their rotten teeth removed! I will not be taking any lectures on that from the Conservative party. Of course, I am more than happy to answer the hon. Lady’s detailed questions, many of which I feel I have already answered in my preceding comments. I will not take any more interventions from her because I need to finish shortly.

Our 10-year plan will set out how we deliver these shifts to ensure the NHS is fit for the future. To develop the plan, we must have a meaningful conversation with the public and those who work in the health system. We are going to conduct a range of engagement activities, bringing in views from the public, the health and care workforce, national and local stakeholders, system leaders and parliamentarians. I urge hon. Members from across the House to please get involved in this consultation—the largest in the history of the NHS—at change.nhs.uk. I urge them to make their voices heard in their constituencies, through the deliberative events.

[Vikki Slade]

I have been on to the survey, and it is incredibly limited. It would be helpful if there were a way for the public to be encouraged to introduce more freeform responses.

[Stephen Kinnock]

I am slightly surprised to hear that. The presentation I received on the portal showed there was a clear channel through to having a more discursive engagement with the platform. I will take that feedback away and, through officials, will come back to the hon. Lady on that point.

I thank the hon. Member for Honiton and Sidmouth once again for bringing the issue of dentistry in the south-west to this debate. On 4 July, we inherited a profoundly challenging fiscal position, but I can assure him that we remain committed to tackling the immediate crisis facing NHS dentistry, and that we are taking steps to make delivery more efficient through long-term reform.

To recap, we are committed to providing 700,000 more urgent dental appointments, delivering the golden hello scheme to recruit more dentists in areas of greatest need, bringing in preventive measures to improve our children’s oral health and negotiating long-term contract reforms to make NHS dentistry more attractive. Those steps will help tackle the place-based disparities commonly seen in dentistry, and ensure that everyone who needs to access NHS dentistry can get it, including in the south-west.

Our NHS dentistry is broken after 14 years of Tory neglect and incompetence, but it is not beaten. In 1945, it fell to Clement Attlee’s Labour Government to create a health system for the 20th century. Now, 79 years later, it falls to this Government to clear up the mess we have inherited, to get NHS dentistry back on its feet and to build an NHS dentistry service fit for the 21st century. That is what we shall do.

NHS Dentistry: Rural Areas

Stephen Kinnock Excerpts

Tuesday 5th November 2024 Commons Chamber

[The Minister for Care (Stephen Kinnock)]

I start by thanking the hon. Member for Chippenham (Sarah Gibson) for securing this important debate. As my right hon. Friend the Secretary of State has said, we will be honest about the problems and challenges facing our health and care system, and we will be serious about tackling them.

[Mrs Sarah Russell (Congleton) (Lab)]

In my constituency, there has been an 11% decline in the number of adults who have seen an NHS dentist in just the last few years—it has been precipitous. There is a specific problem, however, with adults in care homes. I spoke to a local dentist, and she explained that the standard insurance for dentists no longer covers them visiting and performing services in care homes in the community. Can the Minister look into that, and does he agree that it is a huge problem that when vulnerable people cannot come to a dental practice, dentists cannot go to them?

[Stephen Kinnock]

My hon. Friend points to a specific problem set against the backdrop of the general challenge that we face in dentistry, thanks to the legacy of 14 years of Tory incompetence and negligence. We will of course look into it, and if she would care to write to me, I would be happy to look into the issue.

The hon. Member for Chippenham is right to raise the problem of NHS dentistry in rural areas—a problem that will, sadly, be familiar to Members across the House. The truth is that we are very far from where we need to be. Lord Darzi’s review laid bare the true extent of the challenges facing our health service, including NHS dentistry, and even he, with all his years of experience, was shocked by what he discovered. His report was vital, because it gave us the frank assessment we need to face the problems honestly and properly. It will take lasting reform and a long-term health plan to save our NHS. Rescuing NHS dentistry will not happen overnight, but we will not wait to make improvements to the system, increase access and incentivise the workforce to deliver more NHS care.

The Government have committed to three seismic shifts: from hospital to community, from analogue to digital and from sickness to prevention. Our 10-year plan will set out how we will deliver those shifts to give the country an NHS that is fit for the future.

[Tim Roca (Macclesfield) (Lab)]

I share the astonishment of other Members that not a single Conservative Member is here, in a debate on NHS dentistry in rural areas. I am a bit old-fashioned and I want a functioning Opposition. It is sad that they are not here to take part in this debate. When I contacted surgeries in Macclesfield to find out the state of play, 15 said that they do not accept NHS patients at all. That is the legacy that the Conservatives have left us. Can the Minister confirm that the Government will move urgently and quickly on NHS dentistry reform?

[Madam Deputy Speaker (Ms Nusrat Ghani)]

Order. Interventions should be short, and the Minister must respond to the Member whose debate it is.

[Stephen Kinnock]

We are working at pace, and I will say more about that shortly. I share my hon. Friend’s reflections on the complete absence of the Conservatives. They made a complete mess of our public services, called an election and ran for the hills.

On 4 July, we inherited a broken NHS dentistry system. It is a national scandal that tooth decay is the leading cause of hospital admission for five to nine-year-olds in our country. It is truly shameful and nothing short of Dickensian. In the area served by the NHS Bath and North East Somerset, Swindon and Wiltshire integrated care board, which includes the constituency of the hon. Member for Chippenham, 33% of adults were seen by an NHS dentist in the 24 months up to March 2024. That compares to a 40% average across England. In 2023-24, there were 44 dentists per 100,000 of the population there, whereas the national average was 50.

When we look at the problem in the round, it is not so much that we do not have enough dentists, but that not enough of them are doing NHS work, and they are not in the parts of the country that need them most. That challenge is compounded by the fact that some areas of the country are experiencing recruitment and retention issues, including many rural areas, where the challenges in accessing NHS dentistry are exacerbated. That of course includes Chippenham, where Hathaway dental practice has recently had a request granted to reduce its NHS activity, as the hon. Lady pointed out. I understand, thanks to a freedom of information request by the British Dental Association, that the practice had a £4.2 million underspend on its NHS contract. That is precisely the problem that hon. Members have pointed out. There is a quantum of funding, but the way in which it is structured makes private sector dentistry far more attractive than NHS dentistry. That is the root cause of the problem; we are alive to that issue.

Overall, it is clear that we have a mountain to climb. It is a daunting challenge, but we are not daunted, and we are working at pace. The golden hello scheme, for example, will see up to 240 dentists receive payment of £20,000 to work for three years in one of the areas that needs them the most. Integrated care boards have already begun to advertise posts, as we have accelerated that process. In the ICB area of the hon. Member for Chippenham, there have been seven expressions of interest, five of which have been approved. Providers can now include incentive payments when they advertise vacant positions.

Alongside that, we will deliver a rescue plan that gets NHS dentistry back on its feet. That will start with providing 700,000 additional urgent appointments as rapidly as possible, as set out in our manifesto. Strengthening the workforce is key to our ambitions, but for years the NHS has faced chronic workforce shortages, so we have to be honest about the fact that bringing in the staff we need will take time.

[Alison Bennett (Mid Sussex) (LD)]

Will the Minister give way?

[Stephen Kinnock]

I have very little time left.

We are committed to reforming the dentistry contract to make NHS work more attractive, boost retention, and deliver a shift to prevention. This Government will always make sure that our health and care system has the staff it needs, so that it is there for all of us when we need it.

We are already working at pace with the British Dental Association and the dental sector to improve and reform the dental contract. The Secretary of State met the BDA on his first day in office, and I have met it a couple of times, including yesterday. We will listen to the sector and learn from the best practice out there. For example, I know that the ICB of the hon. Member for Chippenham has applied its delegated powers to increase the availability of NHS dentistry across the south-west through other targeted recruitment and retention activities. That includes work on a regional level to attract new applicants through increased access to postgraduate bursaries, exploring the potential for apprenticeships and supporting international dental graduates. In addition, a consultation for a tie-in to NHS dentistry for graduate dentists closed on 18 July, and we are now considering the responses. The Government position on this proposal will be set out in due course.

We are also working round the clock to end the appalling tooth decay that is a blight on our children, as I have mentioned. We are working with local authorities and the NHS to introduce supervised tooth brushing for three to five-year-olds in the most deprived communities across the country, getting them into healthy habits for life and protecting their teeth from decay. We will set out plans for that in due course, but it is clear that to maximise return on investment, tooth-brushing programmes must be targeted at children in the most disadvantaged communities. In addition to our supervised tooth-brushing scheme, the measures we are taking to reduce sugar consumption will have a positive effect on children’s oral health. We also know that water fluoridation is a safe and effective measure to reduce tooth decay. It currently covers 6 million people in England, and a decision on expanding that will be made in due course.

We find ourselves in an extremely challenging fiscal position, but we remain committed to tackling the immediate crisis, and to fixing NHS dentistry in the long term with dental contract reform. We are committed to: providing 700,000 more urgent dental appointments; the golden hello scheme to recruit more dentists in areas of greatest need; continuing to work with the sector to help find solutions to improve access to NHS dentistry; tackling the disparities that are commonly seen in dentistry; rolling out supervised tooth-brushing for three to five-year-olds in our most deprived communities; making sure everyone who needs a dentist can get one, irrespective of whether they live in a city or in a rural area; and doing the job on long-term dental contract reform, which will take some time. We will clear up the mess we have inherited, we will get NHS dentistry back on its feet, and we will build an NHS dentistry service that is fit for the future.

Question put and agreed to.

Cancer Strategy for England

Stephen Kinnock Excerpts

Thursday 31st October 2024 Westminster Hall

[The Minister for Care (Stephen Kinnock)]

It is a real pleasure to serve under your chairship, Mr Betts. I thank the hon. Member for Wokingham (Clive Jones) for raising this vital debate about the future of cancer care and the potential merits of a cancer strategy. I am aware of the impressive work he has done on access to primary care on behalf of his constituents in Wokingham and that, as he very movingly set out in his speech, he is a cancer survivor. I welcome and commend his efforts in campaigning for cancer charities. I understand that he has raised a mind-boggling £800,000 for charity, so I pay huge tribute to him. I also thank and pay tribute to every Member who has spoken today. They have spoken with such clarity and passion, and it became clear that many present have personal experiences of cancer, which adds a poignancy to our discussion that makes it even more powerful.

Access to cancer care is an important issue for many people, and it is at the heart of this Government’s health mission to build an NHS that is fit for the future and to reduce the number of lives lost to the biggest killers. Our work will focus on three shifts: from hospital to community, from analogue to digital, and from sickness to prevention. On cancer services, I reassure the hon. Member for Wokingham and other hon. Members that the Government are absolutely committed to fighting cancer on all fronts, from prevention to diagnosis, from treatment to research. The NHS can be world-leading on cancer care as part of a wider health system that incorporates innovation and technology. It also benefits from access to world-class research and medicines, and we will look to realise the potential of both.

Nearly a third of patients are waiting more than two months for their referral before starting treatment. That is unacceptable, and the Government have made reducing those waiting times a core part of our health mission. Thanks to the hard work of NHS staff, we are now meeting the faster diagnosis standard so that more than 75% of patients get an all-clear or cancer diagnosis in 28 days. However, we know that there is much more to be done. The Chancellor set out yesterday how we will invest in the NHS to deliver 40,000 additional operations, scans and appointments per week as part of our commitment to cut waiting lists, and how we will invest in new radiotherapy machines so that cancer patients have access to the most effective treatment. NHS England is also working to make cancer diagnosis and treatment faster and more efficient through the use of innovative approaches such as teledermatology and faecal immunochemical test kits for risk stratification in bowel cancer.

The NHS has made historic strides in cancer care. Ten-year survival has doubled since the early 1970s—but that rate of improvement slowed in the 2010s, and there is still a lot of work to be done. Early diagnosis and innovative treatments are key to enhancing survival rates and quality of life for cancer patients, so we will ensure that the Government and the NHS work hand in hand with life sciences research institutions and industry to drive the development of new treatments and diagnostics. Members of all parties have rightly raised some of the deadliest cancers, including pancreatic and bowel cancers and cancers affecting children and teenagers. We recognise that different tumours have different diagnostic and treatment pathways, and will consider that as part of our cancer strategy.

Since taking office, this Government have wasted no time in taking steps to accomplish our vision. Earlier this month, we announced funding for a raft of new UK-created therapies for cancer that will be trialled in the UK. Developing early diagnosis technologies is a key aim of the National Institute for Health and Care Research funding. The potential to find cancers earlier will give patients more choice of treatment and enable us to save lives.

We also commissioned an independent investigation of the health service in England, carried out by Lord Darzi. Published in September, Lord Darzi’s report set out in stark terms the profound challenges faced by the health service, and he was honest about the scale of the work that will be needed. He highlighted that people in the UK are more likely to die from cancer than in any other European and English-speaking country, and that improvements to survival rates have slowed. He also pointed to the need to improve waiting times for cancer treatment—particularly curative radiotherapy—and expand access to the most sophisticated treatment options, such as genomic testing. Not enough progress has been made on increasing the number of patients diagnosed at stages 1 and 2—the best way to improve survival. However, Lord Darzi said that there are signs of hope, thanks to the success of initiatives such as the targeted lung health check programme. We are not daunted by the scale of the challenge; we know that we need to roll up our sleeves and get to work.

In response to the Darzi report, and as part of our mission to build an NHS fit for the future, we have launched an extensive programme of engagement to develop a 10-year health plan. The plan will set out a bold agenda to deliver on the three big shifts that I outlined earlier. This will be a team effort. We will listen to, and co-design the plan with, the public, the health workforce, charities, academics and other partners. I encourage every parliamentarian, in this Chamber and right across the House, to get involved in this big national conversation—the biggest conversation we have had about our healthcare and care system since the NHS was founded in 1948. Please go to change.nhs.uk and get involved. There will also be approximately 100 deliberative events around the country so that Members and their constituents can get involved in the big conversation, which will lead to the publication of our 10-year plan strategy in spring 2025.

Organisations such as Cancer Research UK have been at the forefront of advocating for a robust cancer strategy. Their reports highlight the importance of dedicated cancer strategies in driving efforts and impact towards improving cancer research, diagnosis and care. We have launched the Change NHS online portal to facilitate that national conversation and help develop the 10-year health plan. The journey of developing a plan is as important as the plan itself. We want the public and healthcare staff in England, and all other stakeholders and people who care about the future of our health and care system, to share their views, experiences and ideas. The portal opened on 21 October and will run for several months.

To build an NHS fit for the future, we first need to listen. To reduce the number of lives lost to the biggest killers, like cancer, we need to learn from people with lived experience, researchers and our NHS staff. We also recognise the need for leadership by the Government, and my right hon. Friend the Secretary of State has been clear that there needs to be a national cancer plan. We are now in discussions about what form that plan should take and what its relationship to the 10-year health plan and this Government’s wider health mission should be. However, we are clear that we must develop and publish the 10-year health plan in spring 2025, before we can publish a stand-alone cancer strategy. We will provide updates on that in due course. The sequencing is important; it is best to set the strategic framework through the 10-year plan, and then a stand-alone cancer plan will flow from that. I have absolutely heard the message about the need for a cancer strategy loud and clear from hon. Members, and I will convey it to my ministerial colleagues and to officials.

I thank the hon. Member for Wokingham for bringing this important matter to the House, and once again I thank all hon. Members who contributed. I also thank the hon. Member for Runnymede and Weybridge (Dr Spencer) for the constructive way in which he has engaged in this debate. He asked me a vast range of questions. It is probably better, in the short time that I have available, to say that I will write to him so that I can respond in the detail that is required, which I do not think I can today.

I am pleased to assure hon. Members that rebuilding our NHS and delivering world-class cancer services for every person remains a top priority for this Government. We have wasted no time in taking action, announcing funding that will make innovative treatments accessible to cancer patients. We have published an independent investigation of the health service in England, which has highlighted the challenges that cancer patients face and the scale of the work needed. With input from members of the public, researchers and NHS staff, we are now developing a plan to make the health service fit for the future and to reduce the lives lost to the biggest killers, including cancer.

The foundation of the NHS was, of course, one of the proudest achievements of the Labour Government of 1945 to 1951. We created a service that was right for the 20th century at that time. It now falls to the Labour Administration of 2024 to shape a health and care service that is fit for the 21st century, so let us work together to get our health and care service back on its feet and ready to tackle the scourge of cancer.