Oral Answers to Questions Debate
Full Debate: Read Full DebateSteve Brine
Main Page: Steve Brine (Conservative - Winchester)Department Debates - View all Steve Brine's debates with the Department of Health and Social Care
(6 years, 6 months ago)
Commons ChamberThe Department does not issue guidance specifically to NHS England on the redistribution of funding that is recouped from dental contracts. Of course, any decisions on the provision of healthcare are rightly a matter for the local NHS, because local commissioners are best placed to assess the dental needs and priorities among their local population, including the one that the hon. Gentleman represents in Bradford.
People in Bradford cannot get an NHS dentist, child tooth decay rates are soaring, and people are being admitted to hospital because they cannot get dental care. It was announced over the weekend that Bradford will receive an extra £332,000, which I of course welcome, but between 2014 and 2017, more than £300,000 was taken from dental care funding in the district. Is it not the case that the new funding is just a misleading announcement?
I think that is what is known as a back-handed welcome. We have made great progress on improving access to dentistry in England, but we know that there are parts of the country, including the hon. Gentleman’s area, in which we can do more. That is why NHS England in Yorkshire and the Humber—with which I liaise on matters raised by a number of Opposition colleagues—is finalising plans to improve access to dentistry throughout the region, paying particular attention to 20 areas. Bradford East is one of those areas and, as the hon. Gentleman said, will shortly receive additional recouped funding to support his constituents.
Why are dentists, such as my constituent Peter Sharp in Thornaby in Stockton South, funded less per unit of dental activity than his colleagues who are working in more affluent areas? Surely, to reduce health inequalities, it should be the other way round?
That goes to the heart of why we are reforming the dental contracts. Our 73 high street dental practices are continuing to test the preventive focused clinical approach to a new remuneration practice. [Interruption.] Someone on the Opposition Front Bench has just said “when” from a sedentary position. It will be when we have got it right.
The hon. Member for Tonbridge and Malling (Tom Tugendhat) has beetled into the Chamber like a perspiring postman just in time. It is very good to see the fellow.
The Government remain committed to tackling all alcohol-related harms, which is why we are developing a new alcohol strategy. As part of that, I am commissioning Public Health England to undertake a review of the evidence for minimum unit pricing in England.
That is welcome news. The Scottish National party Government have taken the lead in this matter by taking the bold step to set a minimum unit price for alcohol as part of wider interventions to help tackle excessive consumption. In particular, they want to end the days of strong white ciders being sold at pocket money prices. The British Medical Association has long called for that, so at what stage will we learn of further progress in the Government’s thinking?
The previous consultation in 2013 found that the evidence, as it stood at the time, was not entirely conclusive. That is still the case, which is why the Government intend to keep the policy under review. Many times in this Chamber we are given the benefit of experience north of the border as to whether a policy has been a success, but it is not always strictly spot on. Given that the policy only came in last week, it is probably premature to say that it is a success, but we will welcome the opportunity to see the evidence emerge from Scotland’s implementation of minimum unit pricing, and we will be watching very closely.
Does the Minister agree that it is significant that major pub companies and brewers such as Greene King, Coors and Tennent’s now support minimum pricing, and that what is good for the nation’s health is good for the nation’s pubs and the promotion of sensible drinking?
We want to get on and tackle all avoidable harms, including alcohol. The vast majority of our constituents enjoy a drink and have a healthy relationship with alcohol, but that is not the case for everybody. Some people can harm themselves, society and, as we have heard, their children. What is happening north of the border in Scotland is very welcome. I think that there will be an early evaluation there at the one-year point, and we will be watching that like a hawk.
Evidence from cities such as Manchester and London is very clear that centralising stroke treatment in hyper-acute stroke units considerably improves outcomes, with patients having access to a specialist at all times and immediate access to imaging and investigative facilities, giving them the best chances in terms of outcome.
My 82-year-old constituent, Freda, is recovering well from a serious stroke, but she has been told that there is an 18-week wait for physiotherapy and that this is the NHS standard. Does the Minister think that that is good enough?
I cannot comment on the individual case, but I can say that NHS England and we at the Department are working closely with the Stroke Association to develop a new national plan for stroke in England which we expect to publish this summer. The hon. Lady’s constituents and mine will benefit from the national policy narrative, but they will also benefit from some brilliant charities that work on the ground with constituents. Yesterday, I saw Chandlers Ford Stroke Support Group at the amazing Funtasia in my constituency. That group does a lot to support people in stroke as well.
In Worcestershire, we are fortunate to have some excellent stroke services serving my constituents across the whole county. Does the Secretary of State agree that the most important aspect of any service is leadership? With that in mind, will he update the House on his progress in appointing a new chair for our trust to deliver stroke services and other services to Redditch?
I am not close to that issue, but I am told that we have some excellent candidates, and I think that my hon. Friend will be pleased.
The most important service that stroke patients need is priority in getting to hospital for the treatment they need. A patient in my constituency recently had to wait five hours for an ambulance, with a GP sitting next to her begging the service to send one. East Midlands Ambulance Service has now had a review and will be getting an increase in its funding, but can that be made faster over the next two years?
The new ambulance standards are designed to do exactly that. I note the hon. Lady’s welcome for that in her area. That is critical, but of course it is critical that people get to the right place and get the right treatment. That is why I said at the start of these exchanges that centralising stroke treatment is not always popular but is often the best thing for clinical outcomes.
Access to NHS dentistry remains consistently high. The most recent figures show that 22 million adults were seen by an NHS dentist in the 24 months from January ’16 to Christmas last year and 6.9 million children visited a dentist last year.
Twelve thousand of those people in my constituency were left without a dentist when the Queensway practice in Billingham, in common with many dentists across the country, ditched NHS work. People are trying to build capacity there, but the funding system for dentists is a major impediment. What plans do the Government have to address the crisis in NHS dentistry, encourage dentists to stay with the NHS, and make dental health a priority?
We have been in correspondence about the Queensway practice, as the hon. Gentleman knows. When a dental contract ends and patients need to find another dentist, NHS England has a legal duty, as he knows, to commission alternative services to meet local need. I understand that that is happening in his area and that he is being kept regularly updated on the situation. In answer to a previous question, I mentioned the dental contract, which is a key part of our reforms to keep people in, and attract people into, the dental profession.
It is shameful that our older and vulnerable residents living in care homes do not have the access to dental treatment that they need. The Minister revealed in a written answer to me that older people living in care homes are less likely to have any natural teeth and are more likely to have serious tooth decay, but still no specific action has been taken. Will the Secretary of State meet me and commit to do everything he can to help prevent serious tooth decay for our older and most vulnerable residents?
As I said, NHS England has a legal duty to commission dental services and primary care dental services for the hon. Lady’s constituents. If she wants to bring a specific example from her constituency to me, I will be happy to look at it.
I will be very happy to meet the hon. Gentleman to look at his local issue.
I welcome the Green Paper on mental health in schools, which was published earlier this year, but it does prompt a question about the mental health of students in further and higher education. Does my right hon. Friend have any plans to look into that issue? If he does not, may I urge him to do so?
Obesity has rightly had a strong outing today. We know that it is a leading cause of type 2 diabetes; supporting people to live healthier lifestyles can only reduce the incidence of the disease. So far, more than 170,000 people have been referred to the national diabetes prevention programme. Those who are referred receive tailored, personalised help, including education on healthy eating and lifestyle choices, and bespoke physical exercise programmes.
Is my right hon. Friend aware that following his decision to make the capital allocation to Shrewsbury and Telford Hospital NHS Trust before Easter, that trust has had sufficient confidence to successfully appoint five additional consultants in 10 days in April, thereby improving resilience in acute healthcare in Shropshire?
Dispensing practices are a lifeline in rural constituencies such as Sleaford and North Hykeham. Does my right hon. Friend agree that patients who live far from a pharmacy and attend their local dispensing practice should all have access to that dispensing service?
Yes, I do: dispensing practices are an important part of the widening primary care mix. That is important for constituents in rural areas such as my hon. Friend’s. Community pharmacy and dispensing practices, which she refers to, are increasingly important when they are part of an integrated primary care pathway. That has got to be the future.
This issue has received a lot of publicity in recent weeks. My noble Friend Lord O’Shaughnessy and I wrote to Vertex following that debate and asked it to be reasonable and continue, with vigour, its negotiations with NHS England. That letter was made public, as was the company’s actually quite positive response last week. I urge the company again to come to a reasonable conclusion.
Healthcare delivered by app and other new technologies is increasingly popular with patients. Will my right hon. Friend undertake to ensure that the NHS fully explores the possibilities of new technologies when delivering front-line services?
Does the Minister agree that eating a nutritionally balanced meal can reduce snacking between meals and therefore help to reduce childhood obesity? If so, will he speak to his colleagues in the Department for Education and ask them to ensure that the 6,400 children in Kirklees who are set to lose out on a well balance nutritious free school meal do not?
I talk to colleagues across Government all the time. The first round of the child obesity plan—it was maligned earlier—contained many good things, such as the sugary drinks tax. A couple of months ago we launched, with Public Health England, changes in relation to the nutrient profiling of foods marketed to children. That is positive for the hon. Lady’s constituents and for mine.
Five years on from the Francis report, how does my right hon. Friend assess patient safety in the NHS?
Will the Minister update me on the FIT—faecal immunochemical test—for bowel cancer? It has long been promised and we know it saves lives. When will it materialise?
I updated Members on this last week in a Westminster Hall debate. Bowel cancer is the fourth most common cancer in the UK and the second leading cause of cancer deaths. My hon. Friend is right that the FIT has long been promised. There have been a lot of challenges—making sure we get it right and referrals into the secondary sector—but the FIT will be rolled out from autumn.
The European health insurance card enables British citizens to get medical treatment in the EU, including kidney patients who need dialysis. Without it, many of them simply could not go on holiday at all. Will the Secretary of State tell the House whether it remains the Government’s objective to keep the EHIC in place after we have left the EU, and, if so, what progress is being made to ensure that that happens?
Will the Minister explain how and when the community pharmacy sector will gain access to the pharmacy integration fund? Millions have been promised. When will it be delivered?
The pharmacy integration fund is a great success. It needed to be ramped up and it is being ramped up. Pharmacists, working within general practice, are making a great difference to the multidisciplinary team within primary care.
Several of my constituents have contacted me to welcome the Government’s recent announcement of additional investment for prostate cancer funding. Will the Minister update the House on what the money is and what it will be spent on?
Gladly. Prostate cancer survival rates are at a record high, but we want to do even better, so last month the Prime Minister announced £75 million to support new research into the early diagnosis and treatment of prostate cancer. The National Institute for Health Research will recruit 40,000 more patients, which is a lot, for more than 60 studies into prostate cancer over the next five years.
I welcome the recent news that NHS England has committed to redirecting extra funding for dental services to Bradford as an area of need—it comes after a high-profile campaign in the Bradford Telegraph and Argus—but I urge the Minister to recognise the need for long-term reform of the dental contract and for a sustainable funding settlement for all. Will he meet me and others campaigning on this issue to discuss what progress has been made?
Yes. The dental contract has had a good outing this afternoon. I am always happy to see the hon. Lady and I can tick the Telegraph and Argus off my bucket list if they come along as well.