Oral Answers to Questions

Steve Brine Excerpts

Tuesday 20th March 2018 Commons Chamber

[The Parliamentary Under-Secretary of State for Health (Steve Brine)]

Children’s oral health is better than it has ever been, and 72% of five-year-olds in England are now decay free. Of course, that means that 28% are not, which is why our Starting Well programme aims to increase access for young children in 13 high-need areas. NHS England is also looking at making similar approaches available in the areas of greatest genuine local need.

[Tracy Brabin]

In Kirklees, 29% of under-five-year-olds have experience of tooth decay. Nationally, among five to nine-year-olds, tooth decay is the most common cause of hospital admission. Does the Minister agree that the system of penalising dentists for not hitting targets and not paying them when they exceed targets has led to a situation where there are virtually no NHS dentists available for my young constituents? What steps will he take to make more places available?

[Steve Brine]

We are testing the new prevention-focused dental contract, which the hon. Lady knows about, to improve access and outcomes for NHS dental treatment. We have also made great progress on children’s oral health, as I have said. NHS England in her area is currently finalising arrangements for extra funding to support dentists in offering additional access and places. That funding will be available from 1 April, so she and other Members should stand by their phones.

[Philip Davies (Shipley) (Con)]

The hon. Member for Batley and Spen (Tracy Brabin) is absolutely right about this particular issue. The Government have long acknowledged that there is a shortage of dentists in West Yorkshire, and in the Bradford district in particular, where the shortage is pretty chronic. Will the Minister set out what the Government are doing to ensure that there is an acceptable number of NHS dentists in the Bradford district?

[Steve Brine]

I will not pre-empt what the NHS in Yorkshire and the Humber will say to my hon. Friend or to the hon. Lady, because this is a local decision, but I will say that the 13 Starting Well areas—the programme was a manifesto commitment for us—were selected nationally based on overall need and using a wide range of data including access to NHS dental services.

[Julie Cooper (Burnley) (Lab)]

The Minister seems to be in denial. The British Dental Association reports that almost half of all NHS dentists are not accepting new patients—either adults or children. In several regions right across the country, from Yorkshire to Salisbury, patients are having to rely on the third world dental charity, Dentaid, with its now-famous wheelie bin dental surgeries. Does he think that that is an acceptable state of affairs? Will he outline what action he intends to take to improve access to NHS dentists?

[Steve Brine]

It is interesting that the hon. Lady should raise this; it is one of the things that we might be discussing shortly. According to the GP patient survey for January to March last year, whose results were published later last year, 59% of the adults questioned had tried to get an NHS dental appointment in the past two years, and of those, 95% were successful. Those are not bad figures.

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[Stephen McPartland (Stevenage) (Con)]

13. Whether he has plans to establish a satellite radiotherapy unit in Stevenage.

[The Parliamentary Under-Secretary of State for Health (Steve Brine)]

NHS England is working with the East and North Hertfordshire NHS Trust to determine the best way to deliver radiotherapy services to patients in Stevenage. This is part of a system-wide NHS England review of the way in which radiotherapy services are delivered.

[Stephen McPartland]

Hertfordshire has more than 1 million people and no radiotherapy provision. My constituents have to travel more than 80 miles for every treatment, which means thousands of miles during the course of their treatment—there is no public transport. My right hon. and learned Friend the Member for North East Hertfordshire (Sir Oliver Heald) and I have run this campaign for a number of years, and we have all the agreements from every part of the NHS. We are meeting the board of the trust on Friday, so will the Minister give them a direction to get on with building the facility?

[Steve Brine]

All trusts have been directed to get on with the review. The NHS England specialised commissioning team is in discussions with my hon. Friend’s local trust as it develops its five-year strategic plan for the cancer pathways. It is working with his local cancer alliance, including radiotherapy services. It is recognised that a more radical approach and a broader review of the radiotherapy options may be required in future. As my hon. Friend says, he and my right hon. and learned Friend the Member for North East Hertfordshire (Sir Oliver Heald) have that meeting later this week, and I hope the discussions are productive. I feel sure that my hon. Friend will come back to me if they are not.

[Mr Speaker]

Let us hear from the neighbour. I call Sir Oliver Heald.

[Steve Brine]

Obviously my right hon. and learned Friend is right to speak up for services in his area. The review is not about cutting those services, but about making sure that they are in the right places. We have to be mindful that sometimes the services have to be centralised to be in the right place to deliver the right outcomes for cancer patients.

[Mr Speaker]

I will take the next question on condition that Members are exceptionally brief, as time is constrained.

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[Craig Tracey (North Warwickshire) (Con)]

21. What steps he is taking to increase the capacity and availability of GP services.

[The Parliamentary Under-Secretary of State for Health (Steve Brine)]

We of course recognise the shortages in general practice, which is why we remain committed to delivering an additional 5,000 doctors working in general practice by 2020 compared with 2015.

[Royston Smith]

Like many other places throughout the country, Southampton is struggling to recruit and retain GPs. There are many reasons for that, but perhaps one is the practice of discouraging medical students from going into general practice while encouraging them to become specialist consultants. Is my hon. Friend aware of that and of how widespread is it? What is he doing to encourage more people into general practice?

[Steve Brine]

The Secretary of State has already outlined the plans for the new medical schools and the record 3,157 GP training places that were filled. I am aware of the practice that my hon. Friend mentions, and that is why we are working with the profession on a range of measures to boost recruitment into general practice. The existing professionals also have a role to pay, and the superb chair of the Royal College of General Practitioners, Helen Stokes-Lampard, is really leading from the front in that respect.

[Steve Double]

Does the Minister agree that part of the way to address some of the pressures that GPs face is to enhance the role of community pharmacies? Will he update the House on what steps he has taken to support pharmacies and further integrate them with general practice?

[Steve Brine]

We know that there are benefits to be had from the better integration of community pharmacies with sustainability and transformation partnerships. Through the pharmacy integration fund, we are integrating pharmacists into primary care. I hear good reports about how that is going and we will have 2,000 of them in general practice by 2020. Community pharmacies themselves should also be integrated, through STPs, because it is one NHS.

[Craig Tracey]

It is great to see that record numbers of medical students are going into general practice this year, but far too many GPs are choosing to retire and leave the NHS when they are in their 50s because of tax penalties on their pension scheme. Does the Minister agree that we need to address that situation so that experienced GPs are not penalised for staying in the NHS?

[Steve Brine]

Along with concerns about workload and, for example, indemnities, pensions are an issue that older GPs often bring up with me. Ultimately, it is a matter for Her Majesty’s Treasury. My hon. Friend the Member for South West Bedfordshire (Andrew Selous) raised a similar issue at Prime Minister’s Question Time last week, and the Chancellor was on the Bench to hear it. I am sure he will read the report of these exchanges, too.

[Gareth Snell (Stoke-on-Trent Central) (Lab/Co-op)]

In Stoke-on-Trent we have some fabulous GPs, not least the wife of the hon. Member for Stafford (Jeremy Lefroy), but too many people present to A&E because their primary carer is not up to dealing with the workload. That means that the A&E is over-logged so fines are levied on the hospital. What is the Secretary of State going to do to make sure that when hospitals pick up the slack from GPs, they are not subsequently fined by clinical commissioning groups for missing targets?

[Steve Brine]

We are going to integrate primary and secondary care properly through the new models of care—for instance, extended access is important in that. The new multidisciplinary teams—for example, I have talked about pharmacists working in primary care—are not only about providing the plaster when the cut happens, but about preventing the cut in the first place. The prevention agenda is very important.

[Chris Bryant (Rhondda) (Lab)]

Do we not need more salaried GPs?

[Steve Brine]

We need more GPs, which is why today’s announcement is very important. I am sure that the hon. Gentleman welcomes them.

[Mr Speaker]

Well, if there are to be more GPs, they will have to be paid.

[Bill Esterson (Sefton Central) (Lab)]

Patients at Hightown GP surgery were promised that their surgery would stay open, but, out of the blue, they were written to and told that the surgery would close on 8 June. The Government are belatedly taking action on the shortage of GPs, but will the Minister intervene to make sure that Hightown surgery is kept open and that a promise is kept to patients?

[Steve Brine]

I will look at Hightown surgery, and if the hon. Gentleman wants to talk to me about it, he is welcome to do so. Of course it is the responsibility of his clinical commissioning group and NHS England in his area to provide primary care services for the patients who are his constituents, but if wants to talk to me further, I am very happy to do so.

[Andrew Lewer (Northampton South) (Con)]

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

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[Mr Ranil Jayawardena (North East Hamp- shire) (Con)]

T5. Although my younger daughter, being at the discerning age of one, is a particularly fussy eater, childhood obesity is becoming one of the most quickly rising and important issues of our time. Does my right hon. Friend recognise that it is something that we really need to tackle, and quickly?

[The Parliamentary Under-Secretary of State for Health (Steve Brine)]

We are already delivering an ambitious plan to address childhood obesity, including taxing sugary drinks and helping children to exercise more, but we need to keep a close watch on this. We have taken the first few steps in a long race, and we are always looking to learn from successful initiatives elsewhere. Last week I was in Amsterdam looking at the system-wide approach there, which has led to very impressive reductions in child obesity. We should be listening and we are.

[Ruth George (High Peak) (Lab)]

T2. Head- teachers in my constituency tell me that they are asked by the child and adolescent mental health services to prove that children have tried to commit suicide before CAMHS is prepared to accept a referral. The Minister has just admitted that less than half of children who are referred are treated, and that under the new plans less than two thirds will get treatment. There is so much rationing going on. Will the Secretary of State please commit to improving the amount of ring-fenced funding now?

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[Ronnie Cowan (Inverclyde) (SNP)]

T4. This morning I met the family of Alfie Dingley and members of the End Our Pain campaign. Alfie’s case, along with those of Murray Gray and Billy Caldwell—and many, many more—highlight the case for medical cannabis. Will the Minister liaise with the Home Office to introduce medical cannabis for the thousands of people who would benefit, but who do not want to be branded as criminals?

[Steve Brine]

Obviously, everybody in the House is aware of this case, and our thoughts are with Alfie and his family. The policing Minister has met Alfie’s family and discussed options that may assist him. No decisions have been made, and any proposal would need to be led by Alfie’s clinicians using sufficient and rigorous evidence.

[Maria Caulfield (Lewes) (Con)]

Despite not hearing it from Opposition Members, I am sure that all Members in this House welcome the five new medical schools announced today. Will the Minister also welcome the extra medical school places in Brighton and Sussex Universities, supporting my constituents, and the launch last week of the new nursing apprenticeship scheme by the University of Brighton, which will enable more nurses to enter the profession?

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[Alan Brown (Kilmarnock and Loudoun) (SNP)]

T7. Over a third of children in the UK are either overweight or obese. The Royal College of Paediatrics and Child Health has warned that a trade deal with the US could lead to an influx of junk food with high fat, sugar and salt content. Will the Health Secretary make sure that health is put above trade going forward?

[Steve Brine]

As I have said, we are concerned about child obesity, which is probably the big public health challenge, not least in the impact that it can have on diabetes, heart disease and cancer. That is why I so welcome Cancer Research UK moving into this space. We have one of the most ambitious plans in the world. We have already said that it is the start of a conversation, not the end, and if we need to go further, we will.

[Helen Whately (Faversham and Mid Kent) (Con)]

May I welcome today’s announcement on a new medical school for Kent? In an area that struggles to attract doctors, this will make a huge difference: it is genuinely a game changer. Will my right hon. Friend congratulate the University of Kent and Canterbury Christ Church University on their successful bid?

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[Stephen Lloyd (Eastbourne) (LD)]

Bowel cancer remains a major killer in the UK. The National Institute for Health and Care Excellence recognises the new FIT—faecal immunochemical test—to be a far more effective bowel screening process, but there remains a lack of clarity about when it is going to be rolled out nationally. Will the Minister provide that clarity today so that people can be saved down the line?

[Steve Brine]

The UK National Screening Committee has recommended that FIT be the primary screening test for bowel cancer, and NHS England remains absolutely committed to implementing it in 2018-19. We expect to make a decision very shortly on when that will be.

[Sir Edward Leigh (Gainsborough) (Con)]

You wanted short, Mr Speaker. I thank the Secretary of State for our new medical school at Lincoln.

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[Judith Cummins (Bradford South) (Lab)]

My local paper, the Bradford Telegraph and Argus, has recently launched its “Stop the Rot” campaign, as children in Bradford have some of the worst dental health outcomes of anywhere in the country. Does the Minister agree that prevention is key to improving children’s dental health? Can he tell us what steps the Government are taking to ensure that prevention is a key element of any new dental contract?

[Steve Brine]

I think that would be the brilliant Bradford Telegraph and Argus. As I said, 75 dental practices are continuing to test the preventive focus clinical approach alongside the new remuneration system, which supports an increased focus on prevention through the dental contract. I know it is taking time, but I want to get it right.

[Mary Robinson (Cheadle) (Con)]

We know that early diagnosis of cancer is crucial for successful treatment outcomes, but for many cancers, such as pancreatic and ovarian cancer, early symptoms can be vague and the chance to diagnose early easily missed. What are the Government doing to ensure that hard-to-detect cancers are diagnosed early?

[Steve Brine]

That is an excellent question. We are testing the new Accelerate, Co-ordinate, Evaluate programme—ACE—which I visited recently at the Churchill Hospital in Oxford. Patients with vague symptoms can be referred for multiple tests and often receive a diagnosis or an all-clear on the same day. I do not get excited very easily, but that promises great excitement.

[Mr Speaker]

It is a delight to see the Minister in a state of high excitement. We hope to see it repeated on innumerable occasions.

[James Frith (Bury North) (Lab)]

Seventy MPs from across the House in yesterday’s Westminster Hall debate all agreed that we need Orkambi on the NHS now. Can the Minister tell me what he will be doing differently for sufferers of cystic fibrosis and when we will hear news of a breakthrough? Sufferers of cystic fibrosis are slowly drowning in their disease without access to Orkambi.

[Steve Brine]

It was a very good debate, and the hon. Gentleman spoke very well in it on behalf of his constituents. We have made a counter-offer to Vertex. I call on Vertex to be reasonable, and I call on Vertex and NHS England to get back round the table and get this sorted.

[Several hon. Members rose—]

[Henry Smith (Crawley) (Con)]

I would like to thank the Under-Secretary of State for Health, the hon. Member for Winchester (Steve Brine), for his response to the all-party parliamentary group on blood cancer report. Will he continue to ensure that cancer alliances and GPs are diagnosing early?

[Steve Brine]

That is an easy one—absolutely, yes.

[John Grogan (Keighley) (Lab)]

With a significant amount of public money at stake, should not NHS trusts that are proposing to set up subsidiary companies publish their full business cases?