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.

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[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.

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[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.

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[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?

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[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.

Children’s Hospices: Funding

Stephen Kinnock Excerpts

Wednesday 30th October 2024 Westminster Hall

[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

Tuesday 29th October 2024 Commons Chamber

[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

Wednesday 16th October 2024 Commons Chamber

[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)]

Should’ve gone to Specsavers! [Laughter.]

--- Later in debate ---

[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

Tuesday 15th October 2024 Commons Chamber

[Greg Smith (Mid Buckinghamshire) (Con)]

3. What steps he plans to take to reform adult social care.

[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.

[Mr Speaker]

I call the shadow Minister.

[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)]

4. What assessment he has made of the adequacy of treatment for post-sepsis syndrome.

--- Later in debate ---

[Lee Pitcher (Doncaster East and the Isle of Axholme) (Lab)]

9. What assessment his Department has made of the effectiveness of the NHS dental contracting framework.

[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)]

10. What assessment he has made of the adequacy of access to NHS mental health services.

[Chris Webb (Blackpool South) (Lab)]

15. What assessment he has made of the adequacy of access to NHS mental health services.

[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)]

11. What steps his Department is taking to improve access to GP appointments.

--- Later in debate ---

[Warinder Juss (Wolverhampton West) (Lab)]

20. What assessment his Department has made of the adequacy of patient access to primary care services.

[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)]

T1. If he will make a statement on his departmental responsibilities.

--- Later in debate ---

[Lola McEvoy (Darlington) (Lab)]

T2. Will the Secretaryof State meet me to discuss a cross-departmental pilot in my constituency, bringing together the Department for Work and Pensions, the Department for Education and the Department of Health and Social Care, to tackle some of the immediate pressures that face child and adolescent mental health services in my area, and the impact on schooling, the local work force and family outcomes?

[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.

[Mr Speaker]

I call the Liberal Democrat Health spokesperson.

--- Later in debate ---

[Ruth Jones (Newport West and Islwyn) (Lab)]

T5. Alan Petersen is a senior pharmacist in my constituency. He tells me that pharmacies have experienced high volatility in drugs pricing and big increases in bills in recent years. At the same time, they are expected to do far more in direct consultation with the public. Given the UK Government’s jurisdiction over funding dispensing services in England and Wales, when do they plan to review pharmacy funding?

[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)]

T6. To correct the Secretary of State, the Tobacco and Vapes Bill went through its Committee stage in the previous Parliament, with several amendments proposed across the Chamber, which the then Minister, Andrea Leadsom, agreed to take away and bring back. Will he incorporate those amendments so that we strengthen the Bill?

Health Services: Bridlington

Stephen Kinnock Excerpts

Tuesday 8th October 2024 Commons Chamber

[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.