Children’s Hospices: Funding
Stephen Kinnock Excerpts(2 months, 2 weeks ago)
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The Minister for Care (Stephen Kinnock)
It is a pleasure to serve under your chairmanship, Mr Twigg. I thank my hon. Friend the Member for Liverpool West Derby (Ian Byrne) for securing this vital debate. I know that this sector—this community—is very close to his heart. I thank him for all his work to support it and raise awareness of the issue generally, and in particular for the heroic work he has been doing for Zoe’s Place. I know Zoe’s Place faces an uncertain future, but I also know that my hon. Friend is spearheading its fundraising campaign and has been part of the discussions with its trustees and builders about securing a new site for the hospice to ensure it has a long-term future. I am very much aware of the work that the Liverpool-based Home Bargains is doing, particularly in pledging an incredible £2.5 million towards the campaign. I wish my hon. Friend and the hospice every success in those vital endeavours, and I pay tribute to Home Bargains for its outstanding community spirit.
I thank the many hon. Members who have attended this important debate and contributed so powerfully to it. We have heard some really excellent contributions. Hon. Members have shown how important this issue is to the House. I thank all the people who work in children’s palliative and end of life care, including in hospices throughout the country, which provide vital care and support to those who need it.
We all recognise the importance of palliative and end of life care services, including hospices, which provide personalised care and support at the most difficult times for children and young people with complex needs, and their families and carers. It is estimated that there are more than 86,000 children and young people with life-limiting conditions in the UK, but it is predicted that, as we continue to make medical advances, that number will increase.
Palliative and end of life care for children with life-limiting conditions is provided by a broad range of organisations and professionals across multiple settings, including primary care, community care, hospitals, hospices, educational settings and children’s own homes. This system-wide approach to providing palliative and end of life care should be sufficient to ensure that the local offer to patients is personalised, of high quality and sustainable. The majority of palliative and end of life care is provided by NHS staff and services, but we recognise the essential part that voluntary sector organisations, including hospices, play in providing support to people at the end of life and their loved ones.
Children’s hospices are a vital part of that system-wide approach, because they provide a wide range of health and care support to meet the physical, emotional, social and, indeed, spiritual needs of children, young people and their loved ones. Care is often provided by a multi-disciplinary team, and often in collaboration with statutory services, to ensure that the entire family is supported.
The support provided by hospices can include practical advice and information; short breaks or respite; specialist therapies such as physiotherapy, art therapy or play therapy; 24/7 end of life care; and bereavement support. Short breaks are a key part of a range of provisions that support disabled children and their families. They can include the provision of day, overnight and weekend activities for children and young people, and can take place in the child or young person’s own home, the home of an approved carer, or a residential or community setting.
Local authorities have a statutory duty to assess the social care needs of disabled children and young people, and to provide respite care where necessary. Where it is appropriate, local authorities can fund respite care provided by hospices, either as a short-term stay or as a service that the hospice team provide to the child or young person in the family home. Local authorities and ICBs regularly liaise to plan and commission the most appropriate package of respite care for children and young people with life-limiting or life-threatening conditions in their area.
The Government do not monitor the use of social care for children with palliative and end of life care needs, but local authorities are required to publish a local short breaks duty statement, which shows what services are available, how they respond to the needs of local carers and how they can be accessed, including any eligibility criteria. Local authorities must consider the needs of local parents and carers when preparing their statements, and they must review them regularly.
Palliative care services are included in the list of services that an integrated care board must commission. That promotes a more consistent national approach and supports commissioners to prioritise palliative and end of life care locally. To support ICBs in that duty, NHS England has published statutory guidance and service specifications, which include specific reference to ensuring that there is sufficient provision of specialist palliative care services and hospice beds, as well as future financial sustainability.
Most hospices are independent charitable organisations that receive some statutory funding from the NHS.
Wendy Morton
If funding for children’s hospices is to go through ICBs—I hope the Minister will take account of the sector’s view—what assurance can he give us that it will actually go to the children’s hospices? I fear that if we are not careful, we will pit one healthcare sector or charitable sector against another, and that would not be in anybody’s interest.
Stephen Kinnock
The right hon. Lady is absolutely right: funding that is earmarked for palliative care must go to palliative care. There is statutory guidance from the NHS, and it is vital that we continue to liaise with ICBs from the centre, to ensure that the allocated funding goes where it needs to go. If she is aware of cases in which that funding is not going where it should go, she should make representations; I am happy to receive a letter from her on the issue.
The amount of funding that each charitable hospice receives varies both within and between ICB areas. That funding will vary depending on demand in an ICB area, but will also depend on the totality and type of palliative and end of life care provision from both NHS and non-NHS services, including charitable hospices, in each ICB area. There are inequalities in access to hospice services, especially for those living in rural or socio- economically deprived areas. That is why including hospices as part of a system-wide approach is so important.
I understand that charitable hospices value their independence and autonomy, which allow them the freedom to provide services beyond the statutory offer, which is one of the wonderful parts of hospice care. That independence also gives a sense of shared purpose, in which the community cares for the hospice, and in turn the hospice cares for the community and is something to be cherished. That is indicative of the compassion that is found in hospices and communities all over the country.
In addition to ICB funding, at a national level, NHS England has supported palliative and end of life care for children and young people through the children and young people’s hospice grant, totalling £25 million in ’23-24. While ’23-24 marked the final year of the grant in its previous format, in ’24-25 NHS England continued to provide £25 million of funding for children and young people’s hospices. A prevalence-based model is used for that funding, which supports the move away from a traditional model of bed-based funding, better reflecting population needs. In ’24-25, that funding was transacted by ICBs on behalf of NHS England for the first time, rather than being centrally administered. I am aware that the shift to an ICB-transacted model for ’24-25 has not been as smooth a transition as we in the Department certainly would have hoped. We are working closely with NHS England to resolve any remaining issues with the ’24-25 funding, and to learn from what did not work so well this year.
We, alongside NHS England, absolutely recognise the importance of sustainable funding for the palliative and end of life care sector, including hospices, and we will consider the future of children’s hospice funding in the context of Budget discussions. I have absolutely heard the representations by hon. Members on both sides of the Chamber today about the need for the Government to maintain the £25-million grant, and I assure hon. Members that I am working very closely with NHS England to get that confirmed as a matter of urgency.
Dr Johnson
The Minister talked about maintaining the grant, but does he recognise that many hon. Members have also raised the increasing costs that hospices are facing? Will he look to not just maintain the grant but increase it?
Stephen Kinnock
We are certainly looking at all those issues in the round, including ensuring that the grant is sustainable and that there is a real-terms financial input to the system. We are working on that as a matter of urgency. I totally recognise and understand why the sector needs certainty and stability; it is very difficult for hospices not to be sure what is happening after this in-year position.
The 2010s were a lost decade for our health and care services, which now too often are not there when we need them. That is also true for hospice care, where we see a postcode lottery for services across the country and variation in quality and access. Hon. Members will know that we have committed to developing a 10-year plan to deliver an NHS and care system that is fit for the future, by driving three shifts in the way that care and health services are delivered.
We will be carefully considering policies, including those that impact children with palliative and end of life care needs, with input from the public, patients, health staff and our stakeholders as we develop the plan over the coming months. That engagement process was formally launched last week, and I strongly encourage the sector, including hospice providers, service providers and their families, and indeed every parliamentarian in this Chamber, to engage with that process: please go on to change.nhs.uk and make your voice heard. That will allow us to fully understand what is not working as well as it should, what the solutions are, and where the opportunities are for the future.
One of the three strategic shifts that our 10-year health plan will deliver is the Government’s determination to shift more healthcare out of hospitals and into the community. Community health teams play a vital role in supporting children and young people with complex health and care needs to live as well as possible, providing proactive care and preventing exacerbations and hospital admissions where possible. That shift from hospital to community includes our commitment to roll out neighbourhood health services to ensure that patients and their families receive personalised care in the most appropriate setting in their community, and indeed as close as possible to home. Palliative and end of life care services, including hospices, will have a major role to play in the fundamental shift from hospital to community, and in shaping that shift.
Additionally, the Department, through the National Institute for Health and Care Research, is investing £3 million in a new policy research unit in palliative and end of life care. That unit launched in January 2024 and will build the evidence base on all-age palliative and end of life care, with a specific focus on inequalities. In closing, I thank once again the hon. Member for Liverpool West Derby for securing this vital debate on children’s hospice funding. I again express my heartfelt thanks to all those who support children, young people and their loved ones when they need them most.
World Stroke Day
Stephen Kinnock Excerpts(2 months, 2 weeks ago)
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The Minister for Care (Stephen Kinnock)
I congratulate the hon. Member for Glastonbury and Somerton (Sarah Dyke) on securing a debate on this vitally important issue. It is important not only for her constituents but for her personally, I think, given her family circumstances; I know she really spoke from the heart and we appreciate that.
Good health should be fundamental to all of our lives, but sadly that is not the case for too many people. Over 100,000 people have a stroke in the UK every year—one person every five minutes. One third of them will be left with some form of long-term disability. As the fourth largest cause of death for adults, stroke has a devastating impact on individuals, their families and wider communities across our country.
For decades the NHS has served us well, and it is one of the proudest achievements of the Labour party that we were at the foundation of our NHS. Our staff have tremendous expertise and dedication; they are working hard every day to make a difference. But we have to face up to the reality that we have had 14 years of neglect and incompetence on the part of the Conservative party. We are now facing a very significant set of challenges in looking to get our health and care system back on its feet and fit for the future. That is the important context for this debate.
I am very grateful to the hon. Member for Glastonbury and Somerton for giving me the opportunity to inform her and the House of the work that the Government have been doing since we came into office on 4 July, and particularly as today is World Stroke Day. The House will have seen that we have set out the three transformative shifts that we want to deliver in health and care, moving from care in hospitals to care at home, prioritising prevention over treatment, and advancing from analogue to digital solutions. These three strategic shifts will be the building blocks of our health mission, reducing time spent in poor health, tackling health inequalities and reducing lives lost from the biggest killers, which include cardiovascular disease.
We have to change the NHS so that it is no longer just a sickness service but a prevention service too. Prevention is always better and cheaper than cure. So we have to take preventive public health measures to tackle the biggest killers and support people to live longer, healthier lives. That is why in our health mission to build an NHS that is fit for the future, we have committed to reducing deaths from heart disease and strokes by one quarter within 10 years. The NHS health check, England’s flagship cardiovascular disease prevention programme, aims to prevent heart disease, stroke, diabetes, kidney disease and some forms of dementia. Each year the programme engages over 1.3 million people and, through behavioural and clinical interventions, prevents around 500 heart attacks or strokes.
To improve access to and engagement with this life-saving programme, we are developing a new digital NHS health check, which will be ready for testing in early 2025. It will enable people to undertake a check at home. We are also trialling more than 130,000 life-saving heart health checks in the workplace. These checks can be completed quickly and easily by people at work so that they can understand and act on their cardiovascular risk and reduce their future risk of a stroke.
Around 50% of heart attacks and strokes are associated with high blood pressure. Community pharmacies are providing a free blood pressure check service for anyone over the age of 40. In cases where this results in a high reading, pharmacists can make sure people receive the right NHS support to reduce their blood pressure. We know that there is more to do to prevent the causes of stroke, and the Department and NHS England are working together to tackle this issue.
I am also pleased to announce that on Monday 4 November NHS England is launching a new Act FAST campaign to increase knowledge of the main signs of a stroke and to encourage people to dial 999 immediately in response to any sign. The new campaign builds on the success of the previous Act FAST campaign and uses a revised call to action:
“Face or arm or speech, at the first sign, it’s time to call 999”.
Tessa Munt (Wells and Mendip Hills) (LD)
I pay tribute to a young man who lived in Shepton Mallet named Will. He spotted what was happening to his father. He is a young man with some difficulties himself, but he recognised FAST. He had seen it on television, and it is testament to the power of television and radio campaigns in making sure that those messages get through, because that young man has difficulties in communicating and moving, but he managed to get the rest of his family to realise what was happening to his father sitting there across the breakfast table. I just wanted to mark that.
Stephen Kinnock
I thank the hon. Lady for that telling intervention. She is absolutely right: so much of the challenge and the opportunity before us is about how we use traditional media, social media, all forms of communication and awareness-raising campaigns and techniques. By definition, we are dealing with a situation in which speed is of the essence. It is truly a public health challenge, because it is only the public who can do what Will did in that circumstance. I certainly pay tribute to Will for acting so quickly and to the Act FAST campaign. I am sure Members will welcome that we are looking to build on the success of Act FAST and to replicate and renew it.
That campaign will run in England across TV, radio, social media, national press and ethnic minority TV and radio stations. The campaign includes specific communications for multicultural and disabled audiences. A higher reduction in mortality rates over the next 10 years will require a focus on NHS England stroke priorities, including rapid diagnosis and increasing access to time-dependent specialist acute stroke care. We know that so many deadly diseases can be avoided if we seek help in enough time. That is why we are working to improve access to treatments. Current targets include increasing thrombectomy rates to 10% and thrombolysis rates to 20% through facilitating ambulance service use of pre-hospital video triage and use of AI decision support tools for brain imaging in comprehensive stroke centres. I know that my hon. Friend the Member for Mid Cheshire (Andrew Cooper) has a keen interest in that issue.
Andrew Cooper (Mid Cheshire) (Lab)
Building on the point made by my hon. Friend the Member for York Central (Rachael Maskell), does the Minister agree that stroke patients should have the highest priority for ambulance call-outs—as high as cardiac arrest, for example?
Stephen Kinnock
I am a little wary of generalising too much, because I know that so many decisions have to be made in real time by our skilled ambulance drivers and paramedics and the many others involved, but my hon. Friend makes a valid point. In a general sense, he is absolutely right that stroke needs to take priority. The red thread going through this entire debate is the need for speed. It is all about prioritising and acting quickly; he is absolutely right about that.
In the past year, we have seen a 30% increase in the number of thrombectomies delivered in England. Alongside that, our 20 integrated stroke delivery networks are looking to optimise care pathways. The General Medical Council is addressing critical workforce gaps through its thrombectomy credentialling programme, and our national optimal stroke imaging pathway is improving information sharing.
I am aware of the reconfiguration in the constituency of the hon. Member for Glastonbury and Somerton. NHS Somerset integrated care board has decided to close the hyper-acute stroke unit at Yeovil hospital and to establish a single hyper-acute stroke unit at Musgrove Park hospital in Taunton to provide 24/7 emergency treatment. All service changes should be based on clear evidence that they will deliver better outcomes for patients. A high bar is set out in guidance for intervening in contested reconfiguration cases, and the reconfiguration of services should be a matter for the local NHS. I would expect all avenues of local resolution to have been exhausted before a call-in request is made. The Department has received a formal request to call in NHS Somerset ICB’s decision, and Ministers will make a decision on whether to use their call-in powers in due course.
Unfortunately, there is still significant variation across the country in access and outcomes in relation to stroke. For example, the percentage of suspected stroke patients who received the necessary brain scan within an hour of arrival at hospital varies from 80% in Kent to only around 40% in Shropshire. That variation needs to change, and we need to bring the best of the NHS to the rest of the NHS. That will be one of the central challenges for the Government going forward.
The Government have a profound ambition to improve the lives and health outcomes of people who survive a stroke. At this point, I would like to pay tribute to my hon. Friend the Member for Stratford and Bow (Uma Kumaran) and to the man in the Public Gallery for what they have been through and for their fortitude. It was certainly not easy for my hon. Friend to come to this place and to have to go through the extremely difficult situation that she did. I also pay tribute to all the key partners and stakeholders who worked with her and her family to get through it. That really is a tribute to the immensely important work they do.
Rachael Maskell
As well as looking at acute triage to rapidly diagnose people who have had a stroke, it is important to invest in rehabilitation—something I did for 20 years in the NHS. I would be grateful if the Minister could set out how he proposes to have integrated rehabilitation teams that not only see people through the immediate aftercare, but continue to provide a top-up for them so that they do not backslide in their rehabilitation.
Stephen Kinnock
I can say a word about our national service model for an integrated community stroke service, which involves a number of specific projects aimed at improving delivery of psychological rehabilitation. The ICSS model is vital to support psychological recovery, return to work and improved quality of life, and I would be more than happy to discuss it further with my hon. Friend.
Before I close, I want to recognise the remarkable work of the charities that help people across the country to rebuild their lives after a stroke. Once again, I thank the hon. Member for Glastonbury and Somerton for this important debate, and I encourage every Member of the House to go to change.nhs.uk and to get involved in the biggest conversation about our health and care service since its foundation in 1948.
Question put and agreed to.
Access to Primary Healthcare
Stephen Kinnock Excerpts(2 months, 4 weeks ago)
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Helen Morgan
I thank the hon. Gentleman for his intervention. That is an important point and I apologise for not making it in my speech. Optometry is really important, and as somebody who spends their whole life looking for their other glasses, I can absolutely appreciate his point.
The Minister for Care (Stephen Kinnock)
This really has been a vibrant and powerful debate. I thank the Liberal Democrats for using their Opposition day constructively to shine a searing spotlight on the challenges that our constituents face. Hon. Members made a series of outstanding contributions, but I thank in particular my hon. Friends the Members for Aylesbury (Laura Kyrke-Smith), for Bury North (Mr Frith), for Calder Valley (Josh Fenton-Glynn), for Ealing Southall (Deirdre Costigan), for Welwyn Hatfield (Andrew Lewin), for Croydon East (Natasha Irons), for Lichfield (Dave Robertson), for Norwich North (Alice Macdonald), for Worthing West (Dr Cooper), for Uxbridge and South Ruislip (Danny Beales), for Thurrock (Jen Craft), for Gloucester (Alex McIntyre), for Bury St Edmunds and Stowmarket (Peter Prinsley), for Blackpool South (Chris Webb) and for Hexham (Joe Morris) for demonstrating why our party always has been, and always will be, the champion of the NHS.
I also congratulate the hon. Members for North Devon (Ian Roome), for Newton Abbot (Martin Wrigley) and for Harrogate and Knaresborough (Tom Gordon) on their excellent maiden speeches. It is quite shocking to note, however, that in spite of the vital importance of this debate to our constituents, there was not a single contribution from the Conservative Back Benches. [Hon. Members: “Shame!”] Not only do the Conservatives refuse to apologise for the last 14 years, but they have run for the hills. Their silence truly speaks volumes.
Labour Members deal with facts and the unvarnished truth. On the subject of today’s debate, the list of facts illustrating the appalling neglect and incompetence of the last 14 years is truly as long as my arm. If I were to pick out just one statistic to summarise the last 14 years, I might choose that the most common reason for children aged five to nine being admitted to hospital is tooth decay. It is a truly Dickensian state of affairs. I could also point to the UK’s decreasing GP numbers, as there are 1,500 fewer compared with seven years ago, against the backdrop of a rising population. Or I could pick the collapse in patient satisfaction from 80% in 2009 to a shocking 35% last year. Or I could single out the fact that more than 1,000 pharmacies have shut their doors since 2017, and that almost six pharmacies a week have left the market in the last year.
The charge sheet is so long that a month of debates in this Chamber could not cover the profound damage that has been done by 14 years of short-termism and sticking-plaster politics, and by the botched top-down reorganisation in 2012. The reality is that the Tories doused the house in petrol and covid lit the match.
John Slinger (Rugby) (Lab)
The reaction to a proposed ward closure in my local St Cross hospital in Rugby shows how concerned the public are about the health system after 14 years of underinvestment by the last Government. In this case, however, the closure is because patients are being cared for closer to home. Does my hon. Friend agree that bringing more services into the community, and into smaller hospitals such as the one in my constituency, is integral to managing present and future demand, and to putting our NHS on a sustainable footing?
Stephen Kinnock
My hon. Friend is absolutely right. This strategic shift from hospitals into the community will be vital and central to our 10-year plan for the future of our health and care system.
Primary care is the NHS’s front door, but the Tories spent 14 years bricking it over. Now it is walled off to millions of people across our country, so it falls to this Labour Government to tear down that wall. We know that there is not a second to waste, not least on mental health. It is unacceptable that so many children, young people and adults are not receiving the mental health care they need. We know that waits for mental health services are far too long, and we are determined to change that. We will recruit 8,500 additional mental health workers across child and adult mental health services, we will introduce a specialist mental health professional in every school, and we will roll out Young Futures hubs in every community.
We will reopen the front door to the NHS by rebuilding general practice on the firm foundations it needs to get the service back on its feet and fit for the future.
Munira Wilson (Twickenham) (LD)
As well as needing more GPs, our GPs need decent premises from which to deliver high-quality care to patients. Park Road surgery in my constituency has been looking for new premises for more than a decade—it serves 13,000 patients out of an old Victorian house—but there simply is not the budget, and the processes are too complex. Will the Minister commit to both looking at the bureaucracy and pressing the Chancellor for more capital investment in primary care?
Stephen Kinnock
As the Darzi review shows, one of the most egregious examples of the neglect and incompetence of the past 14 years is the underspend on capital. We are clear that a number of premises across the country can be repurposed, and that the bureaucracy needs to be cleared out of its way. As the Prime Minister said earlier this week, we will have a mission about smart regulation and clearing the bureaucratic barriers to change.
We are also cutting red tape so that GPs spend less time pushing paper and more time face-to-face with the patients they serve. We are working to bring back the family doctors and to end the 8 am scramble. We have done more for primary care in the last 14 weeks than that lot did in the last 14 years.
On dentistry, we will introduce supervised tooth brushing for three to five-year-olds in deprived areas, ending the national scandal of tooth decay. And we are rebuilding the bridges that the Conservatives burned with the British Dental Association. I have already met the BDA, and we will deliver a rescue plan that gets NHS dentistry back on its feet, with 700,000 additional urgent appointments, starting as soon as possible, in those parts of our country that need them most.
Amanda Martin (Portsmouth North) (Lab)
Given the shocking state the last Government left us in, is it not good that the grown-ups are now in the building and that we have seen the urgency needed in the NHS, commissioning the Darzi report and investing £82 million, alongside making our commitment to tackle dentistry, use pharmacies and reduce the unnecessary burden?
Stephen Kinnock
I thank my hon. Friend for her intervention. I pay tribute to my right hon. Friend the Secretary of State for getting the strikes sorted within a week of us taking power—what a change that has made. We will reform the dentistry contract to make NHS work more attractive, boost retention and deliver a shift to prevention.
On pharmacies, as my hon. Friend the Member for Bristol South (Karin Smyth) made clear, we will shift the focus of our NHS out of hospital and into the community, empowering more pharmacists to prescribe independently, and freeing up GP appointments for those who need them most. That shift from hospital to community is vital for demand management in the primary and acute sectors.
On the whole, this has been an excellent debate, but I find it absolutely extraordinary that not a single word of humility or contrition was uttered by the official Opposition. Where was the apology for the fact that they spent 14 years bringing our NHS to its knees? Where was the mea culpa for the way in which they spent 14 years scapegoating the workforce, dodging the tough questions and passing the buck? Where was the acknowledgment of the fact that they called the election and ran away from their £22 billion black hole and from the multiple crises in our public services?
While the Conservative party continues to live in a parallel universe, we on the Government Benches are living in the real world. We are honest about the scale of the challenge, and we are up for the fight. While the mountain before us is daunting, we are not daunted. Instead, we are focused on the future, reform and rebuilding, and on shifting from hospital to community, from sickness to prevention, and from analogue to digital. Let us roll up our sleeves and get to work.
Question put (Standing Order No. 31(2)), That the original words stand part of the Question.
Oral Answers to Questions
Stephen Kinnock Excerpts(3 months ago)
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Greg Smith (Mid Buckinghamshire) (Con)
The Minister for Care (Stephen Kinnock)
After 14 years of Tory neglect and incompetence, adult social care is on its knees. The number of people receiving long-term care decreased between 2015 and 2023, and there were a staggering 130,000 staff vacancies in the system. Last Thursday, recognising the central role of our amazing care workforce, we took a critical first step by introducing the groundbreaking legislation that will establish the first ever fair pay agreement for care professionals. I think it fair to say that this Government have done more for our adult social care workers in 14 weeks than the last lot did in 14 years.
Greg Smith
Given unfunded schemes such as the proposed national care service, given the new negotiating body’s aim of establishing a minimum pay floor, and given what clearly amounts to an expensive top-down reorganisation of the care system, can the Minister explain how he will maintain and enhance the role of local authorities, including Buckinghamshire Council, in targeting and delivering care, and how he plans to maintain day-to-day spending alongside this grand plan for reform, without raising taxes?
Stephen Kinnock
It beggars belief that Opposition Members should lecture us on fiscal discipline when there is a £22 billion in-year black hole. We are committed to consulting widely on the design of a fair pay agreement, and we will engage with all who may be affected. We are keen to ensure that all voices are heard so that the financial impacts on the adult social care market, local government and self-funders can be considered, but in a week in which this Government have attracted £63 billion of investment and just days after the publication of the Employment Rights Bill, we are seeing a Government who are pro-business, pro-worker and pro-growth.
Jenny Riddell-Carpenter (Suffolk Coastal) (Lab)
Adult social care is under extreme pressure. One in four hospital beds are occupied by patients with dementia. Will the Minister commit himself to the delivery of a dementia strategy in the current Parliament?
Stephen Kinnock
That is an extremely important question. I recognise that dementia is a huge issue that impacts on the entire country and, indeed, many Members on both sides of the House. We are absolutely committed to the research that is fundamental to addressing the problem, and our fair pay agreement is about not just pay but training and terms and conditions. We will be ramping up dementia training for our adult social care workforce.
Sir John Whittingdale (Maldon) (Con)
The Labour manifesto spoke of the need for a consensus on social care, and the Secretary of State has said that he wants to reach out across the political divide—although the message does not seem quite to have reached the Minister yet. During Health and Social Care questions in July, the Minister said that there would be announcements in the near future, but since then we have heard nothing. We are ready to talk; when will the Government be ready?
Stephen Kinnock
I am not sure if the right hon. Gentleman was listening to my previous answer. We have just set out a groundbreaking piece of legislation to settle the issue of adult social care pay, which is more than the last lot did in 14 years. We are absolutely committed to building cross-party consensus. We know that we need a process that will be sustainable and fix adult social care for the long term. That absolutely includes engagement and dialogue across this House, because we want to build a consensus that works. We recognise that successive Governments have failed to get a grip on this issue, but we recognise the vital role that adult social care will play. It is going to be a hugely important part of our 10-year plan for the future of the NHS, and I look forward to engaging with all hon. Members on this issue.
Lee Anderson (Ashfield) (Reform)
Lee Pitcher (Doncaster East and the Isle of Axholme) (Lab)
The Minister for Care (Stephen Kinnock)
I pay tribute to my hon. Friend for the excellent work he does for the people of Doncaster East and the Isle of Axholme. The scale of the problem that he points out is massive. One of the most shocking statistics I have discovered since taking up this position is that the most common reason for children aged five to nine being admitted to hospital is tooth decay. That is completely and utterly shocking—truly Dickensian. We cannot fix the matter overnight, but we are committed to reforming the dental contract and working with the British Dental Association to focus on prevention and on the retention of NHS dentists. We are also working at pace to ensure that patients can access an additional 700,000 urgent dental appointments.
Lee Pitcher
The horror stories I hear in my constituency are just awful: from the mum on the Isle of Axholme who could not find an NHS dentist after five years and who carries out her own treatment on her son, to a gentleman in Doncaster East whose teeth are crumbling due to illness, causing him horrendous pain, and who cannot get an appointment. The Government’s pledge to provide more emergency appointments is great, but I know that it will take time to rebuild dentistry. Can the Minister reassure me that people in my constituency will be given the priority they deserve?
Stephen Kinnock
My hon. Friend is right. South Yorkshire has the highest level of hospital tooth extractions in England, and I want to assure him that we will target interventions at the areas of greatest need. For example, integrated care boards have started to advertise roles through our “golden hello” scheme, which will drive recruitment of graduate dentists to areas of greatest need for three years. We have inherited a mess and we are working at pace to clear it up.
Jim Shannon (Strangford) (DUP)
The Minister is right to underline the issues for children, but can I remind him of the issues for those above the state pension age—which is increasing to 67, including for ladies—in particular when it comes to certain benefits, such as attendance allowance? Will he look at the contract for those who are elderly and in receipt of such benefits?
Stephen Kinnock
We are in a situation where a staggering 28% of the country—13 million people—have a need that is unmet by NHS dentistry. There are so many issues that we need to resolve. We are looking at the contract with the BDA and I am more than happy to look into the issue raised by the hon. Gentleman.
Saqib Bhatti (Meriden and Solihull East) (Con)
Last month, the Secretary of State for Wales told the Labour party conference that this Labour Government will “take inspiration” from Labour-run Wales on dentistry. That is the same health system in which less than 60% of dentistry courses are being completed in comparison with pre-pandemic figures—a rate that is far lower than in England. Does the Minister agree that the Secretary of State for Wales is right and that Wales is a blueprint for what a Labour Government will do in England, or will they drop the bluster, get serious and commit to the dental reforms set out in the dental recovery plan, including a tie-in to NHS dentistry for graduate dentists?
Stephen Kinnock
I find it extraordinary that yet again we see a total lack of humility and contrition from the Opposition. The key difference that we will see in how our United Kingdom works is that we now have some grown-ups in charge in Westminster, who will work with colleagues in Cardiff Bay to ensure that a rising tide lifts all boats and we improve the state of NHS dentistry across the United Kingdom.
Luke Akehurst (North Durham) (Lab)
Chris Webb (Blackpool South) (Lab)
The Minister for Care (Stephen Kinnock)
Our mental health service is on its knees, thanks to 14 years of Tory neglect and mismanagement. A staggering 1 million people are waiting to access mental health services, and vacancy rates are around 10%, the highest across the NHS. This Government are committed to fixing our broken NHS so that people can be confident of accessing high-quality mental health support when needed. That includes recruiting 8,500 more mental health workers, introducing specialist mental health professionals in every school, rolling out Young Futures hubs in every community and modernising the Mental Health Act.
Luke Akehurst
Patients tell me they cannot get access to community mental health nurses, putting huge pressure on GP practices and leading to people going to A&E in desperation. Can the Minister confirm whether the 8,500 extra mental health staff pledged in Labour’s manifesto will include much-needed nurses in the community?
Stephen Kinnock
I pay tribute to my hon. Friend, who is doing excellent work for the people of North Durham. I would also like to take the opportunity to thank our mental health nurses, who do such vital and valuable work. The Government are committed to shifting from hospital to community, and that of course includes the mental health sector. I can assure my hon. Friend that we are working with NHS England on how best to deploy those additional 8,500 mental health workers.
Chris Webb
I wish to pay my respects to the family of Jamie Pearson, the 27-year-old Blackpool man who sadly took his own life in a local hospital in August after waiting nearly 24 hours to see a mental health worker in A&E. Jamie was in a mental health crisis, but got himself to what should have been a place of safety. What steps is the Minister’s Department taking to ensure that no one is left to suffer in A&E because they cannot access mental health treatment in their community, and will he meet me to discuss that tragic issue, so that we can make sure that it never happens again?
Stephen Kinnock
I thank my hon. Friend for raising that deeply tragic case. Words cannot express the heartbreak caused to Jamie Pearson’s friends and family. I hope it might be some small comfort to them to know that all acute hospitals should now have a 24/7 mental health liaison service in A&E, and we are looking at how best to take forward the Government’s suicide prevention strategy for England. We will do everything in our power to ensure that the tragic circumstances of Jamie’s untimely death are addressed, and that lessons are learned. I am happy to meet my hon. Friend to discuss that further.
Tim Farron (Westmorland and Lonsdale) (LD)
Those providing child and adolescent mental health services in south Cumbria do an outstanding job, but they are without a dedicated crisis team, unlike the rest of Lancashire and South Cumbria NHS Foundation Trust. That is devastating and dangerous for my constituents. Will the Minister use his power to intervene with the integrated care board and Lancashire and South Cumbria to make sure that young people in our communities have access to a crisis team?
Stephen Kinnock
I thank the hon. Gentleman for that question and the passion with which he put it. We are committed to rolling out Young Futures hubs across the country and, of course, we need to prioritise areas of particular need. I would be happy to meet him to discuss that further.
Munira Wilson (Twickenham) (LD)
A recent review of children’s mental health services in my local authority, the London borough of Richmond, found that, staggeringly, children with mild to moderate needs in tier 2 waited on average 15 months before receiving treatment, and those with more severe needs waited on average nine months. The Minister does not need me to tell him that during that time, children’s conditions get worse; they need greater treatment and, sadly, too many present at A&E self-harming and attempting to take their own life. As well as committing to mental health professionals in every school, will he put some money into acute provision, so that children do not end up in A&E?
Stephen Kinnock
We are absolutely committed to the three shifts: from hospital to community, from sickness to prevention and from analogue to digital. The sickness to prevention aspect is important in the question that the hon. Member raises. Treatable mental health conditions such as anxiety and depression should be identified early to prevent them from developing into something more serious and into a crisis, so I absolutely share the sentiment behind her question. They will be at the heart of our 10-year strategy for the future of our health.
Clive Jones (Wokingham) (LD)
Warinder Juss (Wolverhampton West) (Lab)
The Minister for Care (Stephen Kinnock)
As identified in Lord Darzi’s review, primary care is broken. Satisfaction with GP services has fallen from a peak of 80% in 2009 to just 35% last year—a truly damning indictment of 14 years of Tory failure. We will rebuild general practice. We have invested £82 million to recruit 1,000 new GPs, we have launched our red tape challenge, and we are committed to improving continuity of care and ending the 8 am scramble. On primary care more broadly, we are committed to boosting the role of community pharmacies, enabling patients to be treated for certain conditions by their local pharmacists, without the need to see a GP.
Clive Jones
The Arborfield Green community in my Wokingham constituency has around 10,000 residents in new homes, with many more to come, but there is no local primary care provision. To see a GP, residents must travel to neighbouring villages, which are often inaccessible because of a lack of public transport. What steps will the Minister take to guarantee that there will be enough GPs in any major new developments that come down the line?
Stephen Kinnock
The hon. Member is absolutely right: there are seriously under-doctored areas of the country. Given the finite resources that we have, we must focus on areas with the greatest need. I would be more than happy to meet him to discuss how that might best be reflected in his constituency.
Katrina Murray
Access to GP appointments is consistently raised with me in Cumbernauld. A number of constituents have informed me that, having made complaints, they have been removed from the list of the general practice at which they have been patients for many years. Will the Minister raise the matter with the Scottish Government’s Cabinet Secretary for Health and Social Care, so that we can get some resolution for my constituents?
Stephen Kinnock
Patients have an absolute right to complain about NHS services, and they should not be removed from a practice’s list because of a complaint they have made. Health is of course devolved, but I have asked officials in the Department to engage with their Scottish Government counterparts on that matter to ensure that patients in my hon. Friend’s constituency are treated with the respect and compassion that they deserve.
Catherine Atkinson
Residents in Mickleover have been queuing from 7 am to get an appointment with their GP, and Healthwatch says that seven in 10 people in Derby find it very difficult to book appointments. That is the legacy of the previous Government. With new homes being built in and around Mickleover, we need even more additional capacity. Does the Minister agree that GP capacity must be a priority?
Stephen Kinnock
We are absolutely committed to the challenge of cutting red tape and reducing the administrative burden for staff to help patients get the care that they need. An important element of our plan will be streamlining access to registration in order to move it online, and we are working at pace to make online registration available in all practices. I am very happy to come back to my hon. Friend on the constituency issue that she raises.
Warinder Juss
Lord Darzi’s report on the NHS states that people are struggling to see their GPs. Prevention is better than cure, and interventions to protect health tend to be far less costly than dealing with the consequences of illness, both financially and in terms of outcomes. Early and quick access to primary care is therefore crucial. I accept that it is not always necessary to see a GP—an appointment with a nurse may suffice—but what steps are being taken to ensure that patients in my Wolverhampton West constituency have quick, easy and direct access to GP surgeries?
Stephen Kinnock
I note that Wolverhampton West has seen a decrease of 28 full-time equivalent GPs since 2018, which of course massively exacerbates the issues to which my hon. Friend refers. We will introduce a modern booking system to end the 8 am scramble and make it easier for patients to contact their GP. In particular, we are committed to increasing the use of the NHS app to view patient records and order repeat prescriptions. All of that will take pressure off the booking system.
Patrick Spencer (Central Suffolk and North Ipswich) (Con)
Last week, NHS Suffolk and North East Essex integrated care board announced plans to scrap the super-surgery in north Essex. To say that my constituents were incandescent would be an understatement; many of them have waited since 2021 for a replacement to closed surgeries in Bramford, Claydon and Great Blakenham. Many have to use Needham Market surgery, which is also awaiting plans to move to larger premises with increased capacity. Will the Secretary of State meet me to discuss how we can expedite plans to expand primary care in north Ipswich and the surrounding villages?
Stephen Kinnock
I thank the hon. Gentleman for setting out a list of all the failures of the past 14 years. He is dealing with that mess thanks to Members on the Benches he sits on. I strongly encourage his constituents to get actively involved in the 10-year plan that we will launch. There will be an important national engagement exercise on shifting from hospital to community, from sickness to prevention and from analogue to digital, because given the total and utter chaos that we inherited, we need systemic reform.
Dr Kieran Mullan (Bexhill and Battle) (Con)
I recently met representatives of Martins Oak and Oldwood surgeries in my constituency. Both surgeries have ambitious plans to move to bigger premises so that they can see more patients, but they face numerous challenges, including the gap between the lease lengths that the integrated care board will support and those that GP practices can get developers to sign up to. There are other challenges that I am sure the Minister can help unpick, so will he meet me to see whether we can help bring those ambitious plans for new surgeries to fruition?
Stephen Kinnock
The hon. Gentleman has considerable expertise in this area, given his background. I would be happy to discuss that issue with him, but I remind him that although there may well be specific issues, there is a generic problem: the total and utter failure to ensure investment, reform and strategic thinking about our system.
Chris McDonald (Stockton North) (Lab)
Lola McEvoy (Darlington) (Lab)
The Minister for Care (Stephen Kinnock)
By cutting mental health waiting lists and intervening earlier, we can get this country back to health and back to work. There are 2.9 million people who are economically inactive, a large proportion owing to mental health issues. Many people can be helped back into work through talking therapies. We will put a mental health professional in every school and roll out 8,500 specialists. I would be happy to meet my hon. Friend to discuss the matter further.
Ruth Jones (Newport West and Islwyn) (Lab)
Stephen Kinnock
Obviously, health is a devolved matter and funding for pharmacies in Wales is the responsibility of the Welsh Government. Nevertheless, I pay tribute to the Welsh Government for securing a deal with pharmacies in Wales in line with DDRB—the review body on doctors’ and dentists’ remuneration—pay recommendations. I know that arrangements in England affect matters in Wales and I am working as a matter of urgency to conclude the consultation on the community pharmacy contractual framework.
Bob Blackman (Harrow East) (Con)
Health Services: Bridlington
Stephen Kinnock Excerpts(3 months, 1 week ago)
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The Minister for Care (Stephen Kinnock)
I congratulate the hon. Member for Bridlington and The Wolds (Charlie Dewhirst) on securing the debate and on the constructive tone in which he put his comments forward.
This Government are committed to fixing our broken health and care system. As my right hon. Friend the Secretary of State has said, we will be honest about the problems facing the NHS and serious about tackling them. The hon. Gentleman is absolutely right to raise the problems in Bridlington, which sadly will be familiar to colleagues right across the House. The truth is that we are very far from where we need and want to be, as he so rightly set out. He talked a lot about Lord Darzi’s report, and I am pleased that he has read it and appears to agree with the true extent of the challenges it sets out. Even Lord Darzi, with all his years of experience, was shocked by what he discovered.
The report is vital because it gives us the frank assessment we need to 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 big 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 ensure that we have a health and care system that is fit for the future, in Bridlington and across the United Kingdom.
To develop that plan, we must have a meaningful conversation with the public and those who work in the health system. We will conduct a comprehensive range of engagement and consultation activities, launching very soon, bringing in views from the public, the health and care workforce, national and local stakeholders and system leaders. Importantly, given the hon. Gentleman’s comments, parliamentarians will also have an opportunity to feed into this important national conversation. It will be the biggest national conversation about our health and care system since the NHS’s foundation in 1948.
The Government are committed to restoring our health and care system to its founding promise that it will be there for all our constituents when they need it. I hope that context helps the hon. Gentleman to understand that we are taking this very seriously, and that we do not want to make policy in the ivory towers of Westminster or Whitehall. This needs to be a national conversation, feeding into a 10-year plan that will be published in the spring of next year.
I will now address some of the hon. Gentleman’s specific points. First, I share his concern about dentistry access. The single biggest cause of children aged between five and nine being admitted to hospital is to have their rotten teeth taken out, which is frankly a disgrace. As the Prime Minister said a few weeks ago, it is soul-destroying for those young people, and it can so easily be prevented. That is why we will work with the sector to reform the dental contract, with a focus on prevention and the retention of NHS dentists.
In the meantime, we know that patients cannot wait. We will not wait to make improvements to increase access in the current system. That is why we are working to deliver our rescue plan to provide 700,000 more urgent dental appointments. These will be available across the country, including, of course, for the residents of Bridlington. I am aware that an initial procurement for the additional service in Bridlington was unsuccessful. The ICB has since reviewed the specification and is working to further understand what may work best for the town, with preferred options for procurement due to be approved this month.
Unfortunately, people across the country will recognise the picture that the hon. Gentleman describes of GP access in Bridlington. Almost everywhere, patients are finding it increasingly difficult to see a GP. When they cannot get an appointment, the chances are that they will end up in accident and emergency. This is unacceptable, as it is worse for patients and more expensive for the taxpayer. Lord Darzi is clear that the situation is particularly acute in certain areas—that speaks to the hon. Gentleman’s point about health inequalities—and Bridlington is one such area.
Our plan starts with recruiting over 1,000 newly qualified GPs through an £82 million boost to the additional roles reimbursement scheme. In the longer term, we are committed to training thousands more GPs, guaranteeing face-to-face appointments for all those who want one, delivering a modern appointment booking system to avoid the 8 am scramble and, ultimately, shifting resources from acute care into primary and community care.
The hon. Gentleman raised the recent merger of GP practices in Bridlington, where six practices have been consolidated into two larger practices. These decisions are, of course, made by local commissioners, who determine what services and care pathways best serve the needs of patients in the area. I am pleased that performance has improved in both practices, with one demonstrating some of the best access within the integrated care board footprint. Of course, there are still issues, and the people of Bridlington deserve better, which is why we are committed to delivering our plan for primary care.
The hon. Gentleman also mentioned Bridlington hospital, which currently provides a range of services, including an urgent treatment centre, radiology, rehabilitation, in-patient surgical wards and out-patient clinics. Patients attending those services can, and often do, come from outside the Bridlington area. I am aware that there is more space at the hospital that can be used, and I can assure him that we are looking carefully at capital requirements as part of the spending review. We will know more about that on 30 October.
I hope I have addressed some of the hon. Gentleman’s concerns. I absolutely agree with his view about health inequalities, and it is quite shocking to hear the difference between one ward and another in his constituency. Those gaps have to be narrowed, and a lot of this is about ensuring that people are not only living longer but living healthier lives. The increase in complex conditions that we are now seeing at younger ages is creating huge pressure on our health system, and it is not good for his constituents either. I absolutely understand and see the context in which we are operating, and that is a top priority for the 10-year health plan we are bringing forward.
In conclusion, I thank the hon. Gentleman for bringing forward the issue and giving me the opportunity to reiterate from the Government Dispatch Box our promise to fix our broken health and care system and deliver for people in Bridlington and across Yorkshire. Sadly, the situation he describes resonates with the broader findings of Lord Darzi’s review. The health and care system is in a critical condition, but I assure him that this Government are committed to getting our healthcare system back on its feet and fit for the future.
Charlie Dewhirst
On the particular issue of coastal towns, Bridlington is not unique in the challenges it faces. Will the Minister pledge to look at the broader recommendations in Sir Chris Whitty’s report of 2021?
Stephen Kinnock
The hon. Gentleman makes an important point. One of the trends we are seeing is that an older demographic is moving to coastal towns. Those towns are often most the challenged because they are under-doctored, dental deserts and lacking in social care facilities. A toxic combination is caused by the additional pressures brought by that demographic and a lack of the required facilities on the supply side. The hon. Gentleman is right to identify the issue of coastal towns. I know our chief medical officer, Chris Whitty, is alive to the issue, and it will have to be factored into the 10-year plan. The 10-year plan cannot just be about the sectors we are looking at; it is also about geography and the lived experience of people in particular parts of the country.
Question put and agreed to.
Unpaid Carers
Stephen Kinnock Excerpts(4 months, 1 week ago)
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The Minister for Care (Stephen Kinnock)
I thank the hon. Member for North East Fife (Wendy Chamberlain) for securing this debate on this critical issue. As she rightly stated, it touches the lives of millions of people across our country, and I agree that it requires our full attention.
I want to start by paying tribute to our unpaid carers and young carers, who play such an important role in our communities. They give so much to others, and I want to take a moment to thank them for the enormous contribution that they make. Let us also recognise and appreciate the work that the hon. Member has accomplished in bringing about the Carer’s Leave Act last year. It is an important piece of legislation, which takes a significant step towards helping unpaid carers juggle work and their caring responsibilities. As she will be aware, this Government are committed to reviewing the implementation of carer’s leave and to examining all the benefits of introducing paid carer’s leave.
This Government are also committed to ensuring that families have the support that they need. We want to ensure that families are better able to look after their own health and wellbeing, not just that of those they care for. We are aware of the importance of unpaid carers having a break from caring. The better care fund includes funding that can be used for unpaid carer’s support, including short breaks and respite services for carers.
I have heard the calls for a cross-Government carer’s strategy. This must be addressed in the wider context of the urgent need for a renewed vision for adult social care. As part of that renewed vision we will consider how best to support unpaid carers, because the reality is that our adult social care system is facing immense challenges. Too many people, including unpaid carers, are left navigating a complex and often inadequate system to secure the support they need. Reports of inconsistent service standards, chronic staff shortages and a lack of dignity in care must drive us to action. Everyone deserves the chance to live independently and with dignity. Our approach is to create a sustainable health and care system built on national standards, but tailored to local needs.
However, we must be clear about the appalling economic circumstances we have inherited. We take very seriously our responsibility to deal with the £22 billion black hole that has been left to us by the previous Administration. As a result we have had to make, and will continue to have to make, some difficult decisions, but that in no way diminishes our commitment to reforming adult social care. It will not be easy, but we are committed to taking the steps needed to build a national care service.
I also recognise that many unpaid carers can face challenges balancing employment with caring. The Government’s plan to make work pay sets out a significant and ambitious agenda to ensure workplace rights are fit for a modern economy. That includes empowering working people who provide unpaid care. Flexible working can play a vital role in enabling carers to stay in work alongside those they support. Making flexible working pay, the default from day one for all workers except where it is not reasonably feasible, is a key element of our plan to make work pay.
We must also ensure that carers are supported by the benefits system. We know there has been an increase carer’s allowance overpayments. We are keen to establish all the facts to understand fully what has gone wrong. Once we have done that, we will set out a plan to make it right. The Department for Work and Pensions is progressing an enhanced notification strategy as part of its existing commitment to improve customer engagement and make better use of data provided by His Majesty’s Revenue and Customs, building on its existing communications with customers. It is considering all forms of targeted contact to find the most effective and efficient solution to encourage claimants to contact the DWP about changes in their income. This will help claimants understand when they may have received an earnings-related overpayment or are at risk of doing so. Indeed, the Minister for Social Security and Disability, my right hon. Friend the Member for East Ham (Sir Stephen Timms) recently met Carers UK and individual carers to hear their views and experiences. That is key to helping us to establish the facts and make more informed decisions. More broadly, the DWP will keep the carer’s allowance under review to see whether it is continuing to meet its objectives. The previous Work and Pensions Committee made a number of recommendations for changing the rules. We will respond to those recommendations in due course.
Our goal must be centred on reform. We are committed to building consensus for the longer-term reforms that are needed to create a sustainable national care service that our entire country can be proud of.
Rachel Blake (Cities of London and Westminster) (Lab/Co-op)
Does the Minister agree that informal networks, such as the City of London Carers, provide a vital way for unpaid carers to keep in touch with each other and understand what services might be available through the adult social care system?
Stephen Kinnock
I thank my hon. Friend for that intervention. She is absolutely right that many such networks, often informal, play a vital role in the community in providing that support and peer-to-peer support. So often unpaid carers can end up feeling quite isolated. Informal networks like the one she describes are vital and I commend the work of that network in achieving the objectives we all want to see.
Jim Shannon
The Minister outlines the need for reform. I think many of us in the Chamber would like compassion and understanding to be key to that. Reforms are okay, but they need compassion and understanding to make them work.
Stephen Kinnock
I thank the hon. Member for that intervention. He has reminded the House that caring for friends and family is an important part of what it means to be human. It is at the heart of the desire to support one’s community, as well as one’s friends and family.
We must always approach this issue with compassion. We know that we have certain constraints as a Government in terms of what we are able to do, but I can assure the hon. Member that we are absolutely committed to fixing what is, broadly speaking, a broken system; indeed, my right hon. Friend the Secretary of State for Health and Social Care has described the health and social care system as broken. We have to fix the foundations of that system, and unpaid carers are absolutely part of those foundations. We also have to ensure that unpaid carers have a strong voice in the consensus that we want to build around fixing the system. We know that if we are to build a national care service of which our entire country can be proud, we will need those reforms, but they must truly embody person-centred care and the role played by unpaid carers. To achieve that, I will engage with my counterparts across Government, with unpaid carers and with sector partners such as Carers UK and Carers Trust to ensure that their voices are heard.
I know that many of us were profoundly moved by the experiences of caring shared by the right hon. Member for Kingston and Surbiton (Ed Davey) during the general election campaign. As we have heard this evening, this is a subject of great significance for, and close to the heart of, Members on both sides of the House—including, of course, the hon. Member for North East Fife. I look forward to engaging with colleagues throughout the House on a cross-party basis, because we know that the consensus we need to build transcends narrow party political partisan divides. This is about building a system that is truly fit for the future, and fit for the country in which we live. So let us forge ahead together with the promise of that future in which unpaid carers are visible, valued and supported.
Question put and agreed to.
Adult Social Care Workforce
Stephen Kinnock Excerpts(5 months, 2 weeks ago)
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The Minister for Care (Stephen Kinnock)
This Government are being honest about the appalling economic circumstances we inherited, and take seriously their responsibility to help manage down overall fiscal pressures in 2024-25. As a result, we have decided that the adult social care training and development fund proposed by the last Government, decisions around which had been suspended since the announcement of the election, will not be continued.
While the adult social care training and development fund will not be taken forward, we still intend to provide funding for adult social care learning and development, with the budget maintained at the level we spent last year. Further details about how and when this would be administered will be shared in due course. We also confirm that we will continue to develop a care workforce pathway—the new national career structure—for adult social care and that, linked to this, a new level 2 care certificate qualification has been developed and launched. In addition, the commitment to Oliver McGowan mandatory training and supporting the sector to deliver this remains.
We are committed in our support for the adult social care workforce. Our long-term plans will include a new deal for care workers through a fair pay agreement. We will also take steps to create a national care service underpinned by national standards, with the aim of delivering consistency of care across the country.
[HCWS50]
Oral Answers to Questions
Stephen Kinnock Excerpts(5 months, 3 weeks ago)
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Steff Aquarone (North Norfolk) (LD)
The Minister for Care (Stephen Kinnock)
I thank the hon. Gentleman for his question and welcome him to his place. Thanks to what the Conservative party has done to NHS dentistry over the past 14 years, a staggering 13 million people are unable to see a dentist. I know that the hon. Gentleman represents the constituency that has the lowest number of dentists per head in the entire country. Our rescue plan will provide 700,000 more urgent dental appointments and recruit dentists to areas that need them. We will rebuild the service for the longer term by reforming the dental contract.
Steff Aquarone
As the Minister has alluded to, we in North Norfolk have suffered in particular from unallocated units of dental treatment being moved to other parts of the country. The integrated care board has been told that it will have to return this year’s unused money to the Treasury. Will the Minister commit to protecting unallocated dental funds in my constituency?
Stephen Kinnock
As my right hon. Friend the Health Secretary stated, on the Monday after the general election, he met the British Dental Association to look at a range of issues around the long-term NHS contract. That is an ongoing dialogue—it includes units of dental activity, of course—and we need to ensure that we have the negotiations rapidly. We will work at pace to address some of those long-term issues, but let us not forget that the Conservative party allowed the NHS contract to atrophy and took NHS dentistry to the brink of collapse in our country.
Claire Hazelgrove (Filton and Bradley Stoke) (Lab)
I congratulate my right hon. Friend the Secretary of State for Health and Social Care and his fantastic team on taking their new place on the Government Front Bench. I also thank my right hon. Friend for his advocacy in the last Parliament for people across my constituency who lack dental access.
What assurances can the Minister provide that the important issues of infrastructure and housing will be linked together? As we look to build those much-needed 1.5 million homes across the country, it is vital to make sure that we do not have more dental deserts and that we have the infrastructure we need. How will he work in a cross-departmental way to ensure we achieve that?
Stephen Kinnock
I thank my hon. Friend for her question, and warmly welcome her to her place and congratulate her on her election. The key aspects of our dental rescue plan include 700,000 more appointments through extra funding that we will generate by cracking down on tax dodgers and closing other loopholes. We will incentivise new graduate dentists to come to areas that are underserved to ensure that we plug the gaps—there will be golden hellos to make that happen. We are also working hard on things like supervised toothbrushing for three to five-year-olds, because prevention is always better than cure.
Bill Esterson (Sefton Central) (Lab)
George Freeman (Mid Norfolk) (Con)
The Minister for Care (Stephen Kinnock)
I thank the hon. Gentleman and congratulate him on his survival instincts in getting re-elected to this place.
NHS dentistry needs urgent action thanks to 14 years of chaos, failure and neglect. Our rescue plan will get NHS dentistry back on its feet, followed by contract reform to make NHS dentistry more attractive. 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 and I will keep the House updated on this matter.
George Freeman
I thank the hon. Gentleman for that answer and congratulate him and his colleague the Secretary of State on their appointments. All of us who are serious about the health service and the need for reform, about which the Secretary of State has spoken, have their back in pushing for reform. The hon. Gentleman has his moment of triumph, but may I gently encourage him to reach out and build a cross-party coalition of support for serious reform? The NHS is broken not by Tory cuts but by years—[Interruption.] For years we have been pouring money in; it needs to modernise for the 21st-century.
In the spirit of which, on dentistry, may I encourage the Front-Bench team to reach out and have a meeting—a rainbow coalition meeting including the new hon. Members for Norwich North (Alice Macdonald) and for North Norfolk (Steff Aquarone)—of all MPs in Norfolk, which has suffered more than most counties? We desperately need that University of East Anglia dental school.
Stephen Kinnock
The hon. Gentleman was doing so well at the start, and then he kind of blew it a bit towards the end. It is absolutely right that we put country before party, and we will work with whoever has the best interests of rebuilding our public services at heart. The issue that he raises specifically sounds interesting. What I would say is that unless we get the bigger picture sorted, and unless we make NHS work pay for dentists, we will not be able to rebuild the NHS dentistry system that we should be cherishing and seeking to reform. I am of course always open to conversations with him.
Rachael Maskell (York Central) (Lab/Co-op)
Just 39.2% of my constituents were able to access an NHS dentist over the past two years. That is an absolute disgrace, but the Health and Social Care Committee put together a report into NHS dentistry, setting out a blueprint for how to resolve the challenges, including access, looking at tie-ins and ensuring that we get more dentists registered. Will the Minister look at that report and follow its recommendations?
Stephen Kinnock
I congratulate my hon. Friend on her re-election; it is wonderful to see her back in her place. She is absolutely right that the tie-in consultation deadline was 18 July. We are considering those responses with an open mind. On the broader issues that she mentions, our rescue plan is 700,000 more appointments, incentives for new graduates to go to under-served areas, reform of the dental contract and making work pay for dentists. That plan is at the heart of the reforms that she mentioned and that is what we will be doing.
Mohammad Yasin (Bedford) (Lab)
Tim Roca (Macclesfield) (Lab)
The Minister for Care (Stephen Kinnock)
I congratulate my hon. Friend the Member for Bedford (Mohammad Yasin) on his re-election and my hon. Friend the Member for Macclesfield (Tim Roca) on his election. More than a million people with mental health issues are not getting the support they need. This Government will fix our broken NHS. That will include recruiting 8,500 mental health workers, including specialist mental health professionals in every school and rolling out young futures hubs in every community. As announced in the Gracious Speech, we are bringing forward legislation to modernise the Mental Health Act 1983, which is a hugely significant step that has been warmly welcomed by service users, campaigners and, indeed, the former Conservative Prime Minister Theresa May.
Mohammad Yasin
I welcome the Minister to his place. Funding to bring desperately needed in-patient mental health services back to Bedford has been sitting in the accounts of our local mental health trust for years, but it cannot be used because of the previous Government’s capital expenditure limits. Will the Minister therefore meet me to discuss a way forward to get this urgently needed mental health facility back in Bedford, so that my constituents do not have to travel miles to access this vital service?
Stephen Kinnock
I know that my hon. Friend has been campaigning with great passion and conviction on this issue for some time, and I am in no doubt that his integrated care board will have listened carefully to every word that he has said today. I would be pleased to meet him so that we can discuss this matter in greater detail.
Tim Roca
The Prime Minister has been clear that the Government will make, unlike their predecessor, evidence-based policy. While the NHS has made some high-level progress, the figures for those waiting for mental health elective care remains unacceptably high, but the data is incomplete. Does the Minister agree that comprehensive data is crucial if we are to serve the patients we care about?
Stephen Kinnock
I welcome my hon. Friend warmly to his place. I hope he will not mind if I use this analogy, which is that you cannot make a prescription unless you have the diagnosis, and you cannot make policy on the hoof. We cannot have the chaos, neglect and failure that we have seen from the Conservatives for the past 14 years because they have not made policy based on evidence and data. I am absolutely on board with what my hon. Friend says, and I would be more than happy to discuss it with him further at his convenience.
Mr Richard Holden (Basildon and Billericay) (Con)
I welcome those on the Opposition Front Bench to their roles and those on the Government Front Bench to their new roles. One of the things that we did very well over the past few years on a cross-party basis was tackling the disparity between mental and physical health. Since 2018, £4.7 billion extra has gone into NHS mental health services. Will the Government commit to that going forward and ensure that the proportion of funding towards mental health services will increase in the coming years?
Stephen Kinnock
I thank the right hon. Gentleman for his question, but he appears to be living in a parallel universe. We are in the midst of a mental health crisis as a result of 14 years of Tory chaos, neglect and failure. We have a plan, with 8,500 more mental health workers, young futures walk-in hubs, specialist mental health support for young people and mental health specialists dealing with talking therapies. Of course, we will also introduce legislation following the Gracious Speech to deal with helping people who have more severe conditions. That is a plan of action with which I hope we can once again make our country proud of how we deal with this extremely serious issue.
Sarah Dyke (Glastonbury and Somerton) (LD)
Mental health pressures in the farming community are rising, with the Farm Safety Foundation survey finding that 95% of farmers under 40 agree that poor mental health is the biggest hidden problem facing the industry. Will the Minister work with colleagues in the Department for Environment, Food and Rural Affairs to improve access to NHS mental health services in rural areas and support the continued roll-out of rural health hubs?
Stephen Kinnock
I thank the hon. Lady for raising that extremely important question. We are indeed looking at that issue through our 10-year plan for the future vision of our health service. Issues around isolation and the huge pressure on what are often family businesses are creating tremendous strains for that community. We take that seriously and will of course work with our colleagues in DEFRA to address it.
Dr Ben Spencer (Runnymede and Weybridge) (Con)
May I congratulate those on the Government Front Bench on their appointments? I should declare that I am a former NHS consultant psychiatrist, my wife is an NHS doctor and I participated in the Wessely Mental Health Act review. While I no longer have a licence to practise, I may gently correct the Minister in that it is possible to provide a prescription without a diagnosis. [Laughter.]
The Opposition are pleased that the Government intend to build on the work of Conservative Governments, kick-started by the former Member for Maidenhead, to reform the Mental Health Act 1983. We will work constructively with them to make such legislation as effective, fair and compassionate as possible. With that in mind, does the Minister intend to make changes to the code of practice to the Mental Health Act now so that non-statutory changes and protections can be enacted while the Bill works its way through Parliament?
Stephen Kinnock
I welcome the shadow Minister to his place and congratulate him on his appointment. It is a little bit rich to receive a question like that, given that the Conservatives had 14 years to address the issue; I have been in this position for 16 days. If he looks at the plan that we are bringing forward, he will see that we have more ambition and more boldness in our plans than what we have seen in the last 14 years. We will introduce legislation that will address those extremely important issues for people who have some of the more severe conditions.
To the shadow Minister’s specific point on a code of practice, the first step will be to see the legislative process moving forward. But, of course, we remain open to looking at any solution or reform that will help to address this extremely important issue.
Cat Smith (Lancaster and Wyre) (Lab)
Matt Western (Warwick and Leamington) (Lab)
The Minister for Care (Stephen Kinnock)
I thank my hon. Friend for that question and welcome him to his place. This issue is personal for me, and I am sure it is for many others across this House. A number of potential new disease-modifying drugs for Alzheimer’s are in the pipeline, including lecanemab and donanemab. We are committed to ensuring that clinically effective and cost-effective medicines reach patients in a timely and safe way. The National Institute for Health and Care Excellence is appraising lecanemab and donanemab to determine whether they will be made available in the NHS.
Simon Hoare (North Dorset) (Con)
Nearly 10 children a month die from brain tumours, and I know that the public health Minister takes this issue seriously. He was familiar with the work of the Brain Tumour Charity’s HeadSmart campaign. Will he agree to meet me and my fierce campaigner constituent Sacha Langton-Gilks, who lost her son to a brain tumour, to discuss how NHS England could be persuaded to do more to inform and educate parents to identify the symptoms, so that collectively we can reduce the number of deaths?
Wendy Chamberlain (North East Fife) (LD)
My constituents have struggled to get pre-diagnosis ADHD and autism support for their young daughters. We cannot diagnose children at a very young age, but that does not mean that families do not need help. Can the Minister confirm what engagement he will have with support organisations such as the National Autistic Society to ensure that best practice means that families are not struggling for support?
Stephen Kinnock
I welcome the hon. Lady to her place. She raises a vital issue. We have a plan for improving mental health services, including 8,500 more mental health workers. Autism is, of course, a vital part of that, and I will be more than happy to meet her to discuss further how we might be able to take it forward.