Oral Answers to Questions Debate
Full Debate: Read Full DebateSteve Barclay
Main Page: Steve Barclay (Conservative - North East Cambridgeshire)Department Debates - View all Steve Barclay's debates with the Department of Health and Social Care
(1 year, 1 month ago)
Commons ChamberLast year, we announced a number of reforms to the NHS dental system, making the NHS more attractive and helping patients to access care. Treatments and dental care delivered in England went up by a fifth between 2021 and 2022.
In North Shropshire, the number of adults seen by a dentist between 2019 and 2022 fell by more than 10%, from 47.5% to 35.4%, and the number of children seen by a dentist in that time has fallen by just about 10%, from 59% to 49.8%. Constituents report not being able to access a dentist, and are being turned away from their NHS dentists as they seek to take on only private work. Can the Secretary of State reassure me that he is taking steps to ensure that dentists in rural areas will continue to provide NHS services, because this healthcare problem will continue into the future?
We recognise that we need to do more. That is why we are making NHS dentistry more attractive by creating more bands of units of dental activity, having a minimum UDA value, and increasing to 110% the amount of activity that dentists can do. Indeed, Shropshire, Telford and Wrekin NHS trust, for example, was above the national average in the 24 months until June 2022. We are putting reforms in place to build more capacity.
The elective recovery plan sets out clear steps to eliminate long waits, and that is supported by £8 billion of revenue funding and £5.9 billion in capital over three years.
The waiting list for elective care has risen to more than 7 million people, including one constituent who is unable to work while waiting months for an orthopaedic assessment, and another who has been waiting three years for a prostate operation. Both have had to seek emergency care while they wait for an agonisingly long time. Is it not true that the longer the Conservatives stay in power, the longer patients will wait?
On the last bit of the question, the average waits in Wales are 20.4 weeks as of April, and in England they are 13.8 weeks, which is the exact opposite of the point the hon. Lady raises. We are taking action. We are boosting diagnostic capacity; 111 community diagnostic centres are now open. We are increasing treatment capacity through our surgical hubs programme. We are giving patients choice, which is not available in Wales under the Labour Administration—we are giving them more choice. We are also making better use of the independent sector, which some on the Labour Front Bench support but others do not.
One of my constituents has now been waiting 14 months for a hysterectomy, while another waited years to receive a much-needed hip replacement. That is way over the 18-week standard set out by the NHS Constitution. Can the Secretary of State tell the House what is being done to get wait times down to that 18-week mark?
We recognise the challenges from the pandemic, and that is why we are boosting capacity, particularly through our community diagnostic centres. The additional capacity has already delivered more than 4 million extra tests and scans. We are rolling that programme out with the target of 160, and 111 are already in place.
The hon. Gentleman raises a point of concern across the House that we recognise. That is why we have already taken action, through £3 million to crack down on those selling vapes illegally to children, closing the loophole that allowed free samples to be offered to children, and our call for evidence, so that we can examine what further measures we can take, particularly on the concerns about disposable vapes, which are prevalent among children.
That is helpful, but Labour proposed a new clause to the Health and Care Bill that would have given the Government the primary powers needed to stop the use of sweet names such as gummy bears and Skittles, bright colours and cartoon characters on packaging and labelling of e-cigarettes. The Minister will agree that such promotion aimed directly at young people is highly unacceptable and takes us back to the worst days of cigarette advertising. If the Government are so committed to acting in this space, why did they vote down that new clause?
As I say, we have already taken action. We took measures in April, and the Prime Minister announced further measures in May. We are keen to follow the evidence. That is why we have had a call for evidence. The ministerial team are looking extremely closely at this, and we will take further action to clamp down on something that we all recognise is a risk to children, which is why we are acting on it.
Vapes are smoking-cessation products; they are not confectionery to be sold to children or a way of replacing one generation hooked on nicotine with another. Will my right hon. Friend update the House on the progress that the Medicines and Healthcare products Regulatory Agency has made on licensing e-cigarettes and other inhaled nicotine-containing products as medicines, which would put out a strong message that vaping is a dangerous pastime?
As a former Health Minister, my hon. Friend is well aware of the risks posed by vaping. As the chief medical officer has said,
“If you smoke, vaping is much safer; if you don’t smoke, don’t vape”.
That is why we are toughening up the regime. We are also working with industry as part of our call for evidence, but we are clear on the need to go further. That is exactly what we will do.
Again, I agree that disposable vapes are a particular concern: in our view, the growth in youth vaping is largely due to the growth in the use of disposable vapes. That is why we have particularly focused on that issue in our call for evidence, and that is what we are considering.
Last week, on behalf of the Government, I signed a landmark partnership agreement with the pharmaceutical giant BioNTech. It aims to deliver 10,000 personalised mRNA cancer immunotherapies, including vaccines, to UK patients by 2030. This work will harness the groundbreaking mRNA technology that BioNTech used in its world-first cancer vaccine. Cancer vaccines work by stimulating patients’ immune systems to recognise and eliminate cancer cells, preventing their spread. Trials for BioNTech’s colorectal cancer vaccine are under way at multiple sites across the UK. To accelerate trials further, BioNTech is partnering with NHS England’s new cancer vaccine launch pad, a platform that makes it easier for both early and late stage cancer patients to join vaccine trials. In the coming years, hundreds of patients identified by the launch pad will join trials for BioNTech’s personalised cancer therapies, broadening the treatment options available to cancer patients. I hope the whole House will welcome the opportunity the deal offers future patients.
The announcement that a new hospital between Winchester and Basingstoke is going ahead is much welcomed by my constituents who will use it, as well as by those from other constituencies. It will provide a centre of excellence with better medical outcomes. Will my right hon. Friend meet local MPs, so we can update him on why the hospital needs to be built as soon as possible?
I am always very happy for my hon. Friend and other colleagues to meet me or Lord Markham, who leads the capital programme. It is an important scheme. We are delivering it through the standardised Hospital 2.0 approach, using modern methods of construction. We are keen to progress early supported works on site, working closely with colleagues.
Last week, the Health Secretary said that he was willing to offer doctors a higher pay rise. Last night, the Chancellor slapped him down, saying that any increased offer will have to be paid for by cuts. How can the Health Secretary negotiate an end to the NHS strikes when he cannot even negotiate with his own Chancellor?
We have been clear throughout that Government decisions on the pay review bodies’ recommendations are taken on a cross-Government basis. The agreement that we reached with the largest group of NHS staff, those on “Agenda for Change”, has demonstrated that we are willing to work constructively with trade union colleagues, but the demand from junior doctors for a 35% increase is not affordable—indeed, the hon. Gentleman himself has said that he does not support it.
But the worst strikes in the history of the NHS are still to come. The impact of the junior doctors’ strikes and the consultants’ strikes will be devastating for patients. The Secretary of State has failed to stop these strikes for seven months. He has lost the confidence of nurses, radiologists, junior doctors and consultants, and he cannot even successfully negotiate with his Chancellor, so what is his plan to stop these strikes going ahead?
The hon. Gentleman’s message is not even consistent with what he said at the weekend in the media: that he was not in a position to offer more money to the NHS, and that the shadow Chancellor had made that clear—in a vain attempt to demonstrate some sort of fiscal responsibility. The hon. Gentleman has been clear that he does not support the 35% demand from doctors in training. We are demonstrating that we are working constructively with groups such as the “Agenda for Change” group—the largest staff group, made up of over 1 million staff—with which we have reached a deal. We have also been responding constructively to the British Medical Association’s principal demand for consultants, which was for changes to pension taxation. We are willing to engage constructively with trade union colleagues, but the 35% demand is not affordable. He needs to decide on his position. Which is it: his position at the weekend that the Opposition are not offering more money, or his position today, which seems to be that they will?
Of course we have regular discussions, not just with Cabinet colleagues, but with our counterparts across the UK. I had a meeting just yesterday with Health Ministers, including my counterpart in Scotland, on the shared challenges. On the issue that the hon. Lady raises, as the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Harborough (Neil O’Brien) said a moment ago, we are providing significant support for households—over £3,300 in support—but we also have measures that target schools, including holiday support measures and wider health and wellbeing measures, such as our significant investment in school sport.
We are taking action, which is why the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Harborough met my hon. Friend recently. In his area of Humber and North Yorkshire, there has been an increase in the number of children seen by NHS dentists over the previous 12 months, so the picture is improving, but we recognise that there is more to do; that is why we have made a number of reforms to the dental contract and why we will announce further plans shortly.
A recent freedom of information request by the Labour party revealed that mental health patients were left waiting more than 5.4 million hours for treatment in A&E last year. Last week, one of my constituents spent five days in A&E waiting for a bed on a psychiatric ward. When will the Government bring an end to this shameful situation?
We are taking significant action on mental health, which is why we are investing £2.3 billion more, compared with four years ago. We have targeted measures as part of our urgent and emergency care recovery plan, including 100 mental health ambulances. We are putting in additional capacity, such as crisis cafés, to support emergency departments. We are also making mental health support available through 111 for the first time, which will allow us to get to issues early, before people are admitted to hospital.
Four in 10 people who visit low vision clinics have been diagnosed with clinical depression. It is vital that blind and partially sighted people have access to psychological therapies throughout their sight loss journey to address the impacts. However, National Institute for Health and Care Excellence guidance does not include psychological support in the eye care pathway. Will the Secretary of State commit to reviewing the NICE guidance to ensure that psychological therapies are integrated into the eye care pathway?
The hon. Lady raises an important issue. I would be keen to take it away and look at it to see how we can work together to pick it up.
Not only do I agree, but I have been with my hon. Friend to see this scheme at first hand. He has championed the scheme vociferously and helped to secure that investment for his constituents. I look forward to working with him to ensure it is delivered as quickly as possible.
Plans to remove overnight primary care clinicians from Westmorland General Hospital three nights a week are a massive risk to our community and mean that, overnight, people will be reliant on Barrow or Penrith for an out-of-hours doctor. Will the Secretary of State instruct the ICB to intervene to protect people in South Lakeland from this massive reduction in the quality and accessibility of services?
Some of us remember when the Lib Dems were for greater localism. One of the things we are looking at is how to empower commissioners, on a place-based basis, to make decisions on where best to place services. We need to move more services into the community upstream, to address the frail elderly before they get to hospital and to have more community services. I am happy to look at the specific issue the hon. Gentleman raises, but I would have thought the Lib Dems would support the general trend of empowering integrated commissioning systems to make place-based decisions.
Several important pharmacies in my constituency, including the one in Hawkhurst, have been experiencing pressures, with long queues of customers sometimes going outside the door. It is said that access to trained pharmacists is proving very challenging. Will the Secretary of State comment on the situation and say what steps he might be able to take to alleviate the pressure?
There are a number of measures in the primary care recovery plan, from how we better use the skills mix within pharmacies to how we deregulate some of the tasks that take up pharmacists’ time, such as the requirement for a pharmacist to be present after drugs have already been prepared or to clip out tablets because they do not match the number prescribed by a GP. There are a number of areas in which we can better use the skills mix, and there are areas where we can take load off pharmacists. We are also funding additional services through Pharmacy First to support the pharmacy model.
The number of deaths increased by 13.5% in December 2022, particularly around influenza and pneumonia—up by 26.2%—so York’s public health team want to know what the Government are going to do about winter planning and when.
We set out comprehensive plans for winter preparation in the urgent and emergency recovery plan. Similar to what I said a moment ago, this includes making much better use of community schemes, particularly those targeted at the frail elderly, and making better use of technology through schemes such as virtual wards. It has also put additional bed capacity into hospitals, with more than £1 billion of funding for 5,000 more permanent beds to help alleviate the pressure on bed occupancy and get flow through hospitals, which is so important to addressing the pressure on ambulances.
Back to NHS dentistry, I am afraid. Later this week, the Select Committee will publish its report on NHS dentistry services. Spoiler alert: it will be uncomfortable reading for some. Will the Secretary of State tell us when and how he plans to bring forward plans for the tie-in of newly qualified dentists? Could that go hand in hand with a “return to the NHS” campaign for dentists who have already left that part of the service?
It is characteristically astute of my hon. Friend to zero in on the tie-in, which is an important part of the long-term workforce plan. Around two thirds of dentists do not go into NHS work after training, so having a tie-in is more pertinent there than it might be elsewhere in the NHS workforce. I look forward to the Select Committee’s report but, with some of the reforms already in place, we are boosting the number of patients treated. There were a fifth more dental treatments in 2022 than in the previous year. We are also making NHS dentistry more attractive with some of the changes to the previous 2006 contract, but we recognise that there is more to do, which is why we will shortly set out our dental recovery plan.
I have received a wave of concern from clinicians on the safety of using physician associates, following my Adjournment debate last week in which I raised the death of Emily Chesterton, the 30-year-old daughter of my constituents Marion and Brendan. Emily died of a pulmonary embolism after being seen twice by the same physician associate at her GP practice. The physician associate failed to refer her to a doctor or to a hospital emergency unit for tests, which the coroner concluded could have prevented her death.
Yesterday, on “Good Morning Britain”, the Secretary of State boasted of increasing the number of people working in primary care, presumably including the workforce plan proposal to triple the use of physician associates. Will he look urgently at the details of Emily Chesterton’s case and ask himself whether lessons can be learned to avoid other preventable deaths?
Dr Alex George does a lot of fantastic work. I am due to meet him shortly in the coming days, and I look forward to that discussion. My hon. Friend is right to highlight the importance of getting more mental health support into the community, which is exactly what our additional funding is focused on delivering.
Eighteen community pharmacists in my constituency are reporting challenges on medicine supplies. What more is the Minister going to do to get a grip of this situation?
We have a long-standing team in the Department focused on medical supplies, which are a continual issue; as a matter of routine business, there are often challenges in that area. If the hon. Gentleman has specific issues he wishes to raise, we would be happy to look at them, but we have a dedicated team in the Department that focuses on that exact point.
As my right hon. Friend knows, I have been campaigning for £118 million of capital funding, the majority of it for Southend University Hospital, ever since I was elected. I am grateful that he has recently confirmed that the funding is secure. A new business plan is being submitted, including £9 million of enabling funding. Will he look upon that favourably and swiftly?
As my hon. Friend knows, I have already met her to discuss this scheme, and the impediment was the business plan that came forward from the local trust—further work was being done on that. She is right to highlight our capital investment more widely. This Government have committed to investing in the biggest ever hospital building programme, with more than £20 billion. That is in addition to our long-term workforce plan—the first time the NHS has done this—in which we are making a further £2.4 billion of investment.
Is the Minister aware that the NHS North East and North Cumbria mental health and wellbeing hub is due to close this September? With mental health care in crisis in County Durham, that is an insult to the health and social care staff who desperately rely on those services. Will the Minister reverse that decision?
There are two issues here. One is how much investment we are prioritising towards mental health; the other is how local commissioners choose to prioritise services within those communities, and whether we try to run all of those decisions from the centre in Whitehall or embrace the 42 integrated care systems and allow them to make commissioning decisions. The bottom line is that we are spending much more on mental health, with an increase of £2.3 billion compared with the position four years ago. That is allowing us to replace 500 dormitory beds and provide 100 mental health ambulances, three new mental health hospitals, 160 projects such as crisis cafés to support accident and emergency, and £75 million to help those with mental health challenges get back into work, which is one of the best prevention measures we can take for people who are suffering with their mental health.