Recovering Access to Primary Care

Steve Brine Excerpts

Tuesday 9th May 2023 Commons Chamber

[Madam Deputy Speaker (Dame Rosie Winterton)]

I call the Chair of the Health and Social Care Committee.

[Steve Brine (Winchester) (Con)]

I welcome the plan, which I note the Government have released at the first possible moment after the local election purdah period. Members of the Health and Social Care Committee and I will study it carefully, and I know the primary care Minister has already agreed to come before us so that we can give it a good going over. My question is about timing. How quickly can investment in the 8 am scramble part of the policy make a difference to those practices that do not have it? The Secretary of State said that they were already negotiating with the Pharmaceutical Services Negotiating Committee, so how quickly can that very welcome new investment get to the frontline of community pharmacy?

[Steve Barclay]

The short answer is this year, but the Chair of the Health and Social Care Committee is right to focus, as with all recovery plans, on deliverability. I hope he will take comfort from the fact that around half of GP practices already have cloud telephony, which is why we are so confident that it is the right approach. It is one that is already working. We are seeing from patients’ positive feedback that they hugely value online booking and call-back systems, but they also allow primary care to better triage calls to specialists and therefore to use the additional roles we have recruited in an optimum way. That will be rolled out this year, but it is already up and running and we can see that it is working.

Reforms to NHS Dentistry

Steve Brine Excerpts

Thursday 27th April 2023 Commons Chamber

[Steve Brine (Winchester) (Con)]

It is a pleasure to follow the opening speech of the hon. Member for Bradford South (Judith Cummins), who has brought back many happy memories of our time together when I was public health Minister. She has been consistent on this issue over many years.

Today’s debate is timely; it comes in a week when the Health and Social Care Committee, which, as you rightly say, I am privileged to chair, Mr Deputy Speaker, held a crucial oral evidence session with the Minister, who is in his place on the Front Bench.

Dentistry is a subject close to my heart from my time serving as public health Minister in the Department of Health and Social Care. It is also one of the Select Committee’s top priorities. We launched our inquiry on the subject shortly after I became Chair in November last year. We are looking at what steps the Government and NHS England should take to improve access to NHS dental services, and at further reform of the NHS dental contract. Rarely has an inquiry been more needed or welcome. It is clear that there are huge problems facing NHS dentistry. I am sure that every colleague, whether in the Chamber today or not, is familiar with stories of constituents having trouble accessing NHS dentistry. I am no exception to that, as a constituency MP; neither are my family, as patients.

One of the many submissions that the Committee received talked about people extracting their own teeth with pliers, something that should not happen in the 21st century. The problem is particularly acute in some areas of the country—we will hear talk today about dental deserts, I am sure—and among some groups of people, but challenges and capacity issues are experienced across the board. Our inquiry received a wide range of written evidence, including from nearly 30 local Healthwatch groups. We also held two detailed oral evidence sessions examining the problem and, of course, potential solutions. We heard from Healthwatch that the majority of complaints that it receives at the moment are about dentistry. Day in, day out, local Healthwatch groups receive emails and calls about problems accessing an NHS dentist. That is reflected in other evidence that we received; I know it is not easy for some to hear this, but as a Select Committee Chair, I can only follow the evidence that I receive. We have also heard again and again about the challenge of recruiting and retaining NHS dentists.

The Government have, I am pleased to say, started to act, and to pick up where some of the previous tinkering reforms left off—reforms for which I take some of the credit, and some of the responsibility; I did not fundamentally reform the dental contract during my time as dental Minister, either. In July last year, the Government announced several changes to the 2006 dental contract, including a change to the way that units of dental activity are awarded. They also advised longer recall intervals for adults with good oral health, in line with National Institute for Health and Care Excellence guidelines.

In our first evidence session, we heard from Shawn Charlwood from the British Dental Association, who told us that the reforms to the dental contract represented tweaks, rather than the fundamental reform that is needed. He said:

“In essence, what we are doing at the moment is rearranging the deckchairs on the Titanic while the service slowly slips into the sea.”

To be fair to the Minister, for whom I have a lot of respect, and who spoke really well before the Select Committee earlier this week, I was delighted to hear him acknowledge in that session that he wants “quite fundamental reform” to the dental contract; that has to be right. He argued that the existing reforms were “welcomed”, but noted that they were “only a start”. That was good to hear, and it was well covered by the media on Tuesday evening. I worry, though, that even if significant reforms to the NHS dental contract were made tomorrow, it would be too late, or an extreme challenge, to bring back those dentists who have already left the NHS dental workforce. It is really hard for people to make that decision; they came into dentistry to work in public service. I fear that once they have made the change, it will be final for them, and it will be very difficult to get them to change their mind. I touched on that with the Minister earlier this week. Perhaps he can tell us a bit more about what he will do to address that issue of return.

In our session, I asked the Minister about his ambition for NHS dentistry. Tony Blair famously said in his 1999 conference speech that his ambition was for everybody to have access to an NHS dentist within two years. It never happened, but it was a clear ambition; I give him credit for that. The Minister said that “the No. 1 thing” on his mind was improving access to a dentist for those who do not currently have that access—quite right. But when I pressed him on whether that meant that everyone would have access to an NHS dentist, he said that he wanted everyone who needed an NHS dentist to be able to access one. That is welcome; it is a repeat of that ambition. It is good that the Government have that ambition—although the key, obviously, is whether and when they deliver on it. I will ask him to expand on that when he sums up.

The Minister also talked about making NHS dentistry more attractive to dentists, which is clearly crucial. He said that the problem is not a shortage of dentists per se, but a shortage of dentists undertaking NHS dentistry. The figures certainly bear that out. Our work has highlighted the point that there is a problem with data as well. There are headcounts for the number of NHS dentists, but we do not know whether they are part-time or full-time and how much NHS activity they do. That gap needs closing.

We need to know about the workforce available to deliver the Minister’s ambition; until then, it is unlikely to be achieved. The Minister reminded us this week that the Government are in the final throes of drawing up their workforce plan, which I understand will include dentistry. That is good. I hope that that plan will be published in the not-too-distant future—maybe once we get past a certain electoral event next Thursday.

I also want to touch on overseas recruitment. According to the General Dental Council, almost a quarter of dentists registered in the UK gained their dentistry qualifications overseas. That is fine, but for those dentists the primary means of assessment is the overseas registration examination, or ORE. The pandemic created a backlog in the number of overseas dentists waiting to take their exams—that is the good part. The ORE is subject to practical and legal constraints that make it difficult to adapt capacity to meet changing demands for places. A recent list of changes should help ease the problems, but are unlikely to make a significant difference in the short term; the Minister can correct me if I am wrong.

One of my constituents, Christopher Hilling of SpaDental Group, who has spoken to me about the subject on several occasions, has outlined the difficulties he is facing. He has a number of dentists waiting for the opportunity to sit the ORE exam, but he has struggled in the past to get accurate information about when the exams will even take place. He is concerned that he might lose more of his overseas dentists due to a lack of exam opportunities and of General Dental Council communication about when those dentists might be able to practise in the UK. Given the delay in the taking effect of changes to overseas registration, what are the Government doing to support the GDC, especially with regard to clearing the backlog of applications?

I was encouraged to hear this week the Minister and chief dental officer Sara Hurley talk in our evidence session about the importance of driving forward work on prevention. That is a passion of mine, and colleagues will know that it is a major inquiry that the Select Committee is undertaking. One of our witnesses at this week’s session talked about the importance of early prevention work, focusing on young children. The expression she used was “getting gums on seats”, and that is a great place to focus. We must get more gums on seats, Mr Deputy Speaker—that is the catchphrase for today’s debate.

Finally, I want to talk about integrated care systems, on which the Select Committee has also done a lot of work. We heard in our session about some of the changes that have come into effect as a result of integrated care boards taking responsibility for commissioning dental services. Some were early adopters, including the Hampshire and Isle of Wight ICB that looks after my constituency. But the boards do not include dentistry. I asked the Hampshire ICB representative, who appeared as one of our witnesses this week, about that. They said that they do not want to make their boards too big. I find that disappointing, surprising and unhelpful. To be fair, some ICBs have managed to include dentistry on their boards without any problems; if they can do it, all should. It sends a strange message to the dental profession if it is not included on integrated care boards. It is a great opportunity for flexibility in commissioning, which is why we created the boards. Dentistry needs to be within them.

To conclude, the picture is bleak, but it does not have to be—it is also improving and there are grounds for optimism. We have a Minister who understands this subject inside out and is committed to providing access to NHS dentists for everyone who needs it and a thorough overhaul of the current system and the contract, as he confirmed to us this week. In integrated care boards, we have the possibility of being able to target local services to local needs. But the time for action is running out. I hope the Minister can outline in his response to the debate that he recognises the urgency of the situation, and that, when my Committee produces its report on dentistry, he will read it and act promptly on our recommendations.

[Several hon. Members rose—]

Oral Answers

Steve Brine Excerpts

Tuesday 25th April 2023 Commons Chamber

[Mr Speaker]

I call the Chair of the Select Committee.

[Steve Brine (Winchester) (Con)]

That urgent and emergency care plan, which was announced in January, was received with acclaim by me and, indeed, with wide acclaim. It was described as a two-year plan to stabilise services by, for instance, returning to the A&E target that the Secretary of State has mentioned. What assessment has he made of the impact of the ongoing industrial dispute among the Agenda for Change cohort, and, of course, the junior doctors, on the delivery of the plan?

[Steve Barclay]

As a result of the fantastic work of Sir Jim Mackey and Professor Tim Briggs through the Getting It Right First Time programme, we have been making significant progress in respect of elective procedures. When it comes to urgent and emergency care, there are lessons coming out of the various strikes which we are keen to adopt, but this situation is also clearly having an impact on patients and the number of cancellations. As my hon. Friend well knows, we publish the figures.

We have been working constructively with the NHS Staff Council. Unison voted by a majority of 74% to support the deal, there will be further votes this week from other key trade unions, and there will be a decision from the staff council on 2 May. Obviously, that will be extremely important when it comes to addressing the concern highlighted by my hon. Friend.

NHS Strikes

Steve Brine Excerpts

Monday 17th April 2023 Commons Chamber

[Mr Speaker]

I call the Chair of the Select Committee.

[Steve Brine (Winchester) (Con)]

Reports over the weekend suggest that the British Medical Association has asked its members not to engage with trusts if they intend to strike, as the Secretary of State has confirmed today. That is putting trust chief executives—and this is not their fault—in an impossible position. They are being asked to meet very challenging targets that we are rightly setting them, not least with respect to the covid backlog. What more can he do by his good offices to break that impasse? It is patients who are losing out.

[Steve Barclay]

I agree; it is extremely surprising that the BMA has asked its members not to liaise with NHS managers as they put in place those contingency plans. I urge the BMA junior doctors committee to think of those colleagues who have to provide the cover for those strikes. I reaffirm my thanks to all those staff in the NHS who provided cover following the Easter period, but it puts more pressure on other NHS staff if the BMA junior doctors committee is not willing for its members to liaise with management on sensible contingency measures, as I urge them to do.

NHS Strikes

Steve Brine Excerpts

Monday 6th February 2023 Commons Chamber

[Mr Speaker]

I call the Chair of the Health and Social Care Committee.

[Steve Brine (Winchester) (Con)]

The NHS Pay Review Body was in front of my Select Committee last week, but it will not produce its report for 2023-24 until the end of April. Surely the longer this process goes on, the slower the resolution will be for those on Agenda for Change. Does the Minister agree that a much earlier remit letter would have been helpful, and when does he expect the Department to produce its evidence to this year’s pay review body round?

[Will Quince]

I thank the Chair of the Select Committee for his question. He is right that we are committed to the independent PRB process, which is the right way to set public sector pay and has operated successfully for over four decades. We are not changing that process, but we decided to take the step to engage with the unions on our respective evidence so that it can be as informed as possible, and we very much thank the trade unions for working with us in that spirit. We need to wait for discussions with unions to finish across Government, so I hope I can use the word “shortly”; I am mindful that we want to get this done as quickly as possible.

Urgent and Emergency Care Recovery Plan

Steve Brine Excerpts

Monday 30th January 2023 Commons Chamber

[Mr Speaker]

I call the Chair of the Health and Social Care Committee.

[Steve Brine (Winchester) (Con)]

We look forward to going through the plan in detail with the Secretary of State when he speaks to the Select Committee tomorrow. May I just ask him about the ambition on the two-hour response to falls at home of the frail and elderly to prevent them from being admitted into the acute sector? Obviously, he will know that that was committed to in the long-term plan. What does he need to put that ambition into practice?

Oral Answers to Questions

Steve Brine Excerpts

Tuesday 24th January 2023 Commons Chamber

[Mr Speaker]

I call the Chair of the Select Committee.

[Steve Brine (Winchester) (Con)]

The Select Committee looks forward to hearing about the major conditions strategy and engaging with it, as I hope Ministers will engage with our major prevention inquiry, launched last week. One of our national newspapers has contacted 125 acute trusts and asked them about visiting rights. Some 70% of them still have some form of restrictions in place, most commonly limiting the time that people can spend with their loved ones and the number of people who can sit by the bedside. On 19 May last year, the chief of NHS England said that we should return to pre-pandemic levels—

[Mr Speaker]

Order. The hon. Gentleman may be the Chair of the Select Committee, but I have to get other people in—it is not just his show.

NHS: Long-term Strategy

Steve Brine Excerpts

Wednesday 11th January 2023 Commons Chamber

[Steve Brine (Winchester) (Con)]

I only have a short time, so I will make a couple of points.

On strikes, since we have a major strike today, I understand that many of the trade unions are saying they will not engage with the independent pay review bodies for the 2023-24 settlement. That is a catastrophic mistake on their part. The shadow Secretary of State, the hon. Member for Ilford North (Wes Streeting), and I were on a well-known evening news programme together the other night. Far from trashing the pay review body, he said that although it may need reform, it is important. I am glad to hear him say that, because it is important, and the alternative is Ministers directly negotiating pay settlements with unions. They have tried to do that in Scotland in recent weeks, and the Royal College of Nursing rejected the offer out of hand. The pay review process may not be perfect and may need reform—our Select Committee hopes to talk to the NHS pay review body soon—but I think that madness lies in pay negotiations around beer and sandwiches in Ministers’ offices. The unions should engage with the pay review process for next year. That would be the smart thing to do on their part.

My second point is about demand. The GMB came before the Select Committee just before Christmas and told us that the number of calls coming into the ambulance service is about 10 times what it was pre-covid. There are 100 times the number of people with flu in the acute setting than at this time last year. Demand is significantly outstripping supply in the health service right now, and I think it is disingenuous not to face that.

[Aaron Bell (Newcastle-under-Lyme) (Con)]

I am grateful to my hon. Friend for his work in chairing the Select Committee, and for the joint session with the Science and Technology Committee, on which I sit, about the lessons learned from covid. We heard that there are lessons for the NHS to learn for the future. Does he not find it a bit strange that there is no mention whatever of covid in the Opposition’s motion? Clearly, covid—combined with flu and everything else that he talks about—is one of the reasons behind the acute pressures that we have experienced this winter.

[Steve Brine]

I said in the House on Monday that covid has put the health service on its knees—it has done so to health services in the UK and around the world. To repeat what I have just said, it is disingenuous to suggest that the problems faced by our health service right now are not caused by our covid experience. The number of people presenting with suspected cancers is through the roof. That is good—many of those cases will turn out not to be cancer, which is even better—but so many people are coming forward because we suppressed demand during that time, and it is adding to the demand outstripping the supply in the health service right now.

[Karin Smyth]

The hon. Gentleman chairs the Select Committee, so it is really important that he is clear about this. The Government ran the health service at 96% capacity well through the 2010s, well before the pandemic. They were consistently warned that 96% capacity is too much; we should be running at about 85% capacity for staffing and so on. Capacity in the system has been our problem for a long time. Demand is outstripping capacity—supply is about capacity—and he, as Chair of the Health and Social Care Committee, needs to be clear about that point.

[Steve Brine]

I will choose my words and the hon. Lady can choose hers. I will come to capacity in the conclusion of my remarks—I promise her that.

I will touch on patient flow. Any acute sector that I speak to or visit at the moment is saying clearly that patient flow is hampering everything happening at the front door and the back door. One of the reasons why those in the ambulance service are striking is that they are so heartbroken about not being able to deliver the service that they want to deliver and cannot get out on the road because they are waiting to dispatch their patients.

I said it on Monday and I will say it again now: I welcome the £250 million that the Government have put forward to buy beds. I repeat that two thirds of social care is domiciliary care—care in people’s homes—and we must not forget that, because it is important to getting people through the acute system. The modular work that the Secretary of State talked about—modular units in and around emergency departments—to add extra capacity and meet some of the extra demand coming through the front door, is also very welcome.

I said that we have to separate the now from the long term, so let me address the long term. The elective recovery taskforce is important; the 15 new elective hubs are important. At Prime Minister’s questions today, the Prime Minister talked about eliminating the two-year wait, and that is good—it is not, of course, the extent of his ambition, and to say so is facile. We do not yet have an elective hub in Winchester. The Secretary of State knows that I am on his case about it, but may I just land that point with him again? The Prime Minister’s primary emergency care plan, which we eagerly expect later this month, will be important. It is also part of a long-term strategy and plan, and I think many people in the ambulance service will be pleased with what they see there. I hope that it will be as ambitious as what we hear in some of the rumours.

Some of the things the Select Committee is looking at feed into what the Secretary of State and the Government are doing. Integrated care systems are a creation of this Government. They are about flattening services across the NHS and breaking down those barriers between health and social care. We are in the middle of a big inquiry into integrated care systems, and we are liaising with the Hewitt review, which is a good thing. We were talking to the Care Quality Commission this week, and the Government have not yet laid the regulations on how the CQC will look at ICSs. Will the Minister please look at that?

This morning we talked about the digital transformation of the NHS. There are huge dividends in digital for the NHS, including simple things, such as the amount of money that the NHS spends on sending letters to patients—not least given that they never get there due to Royal Mail strikes. There are clinical dangers to that. Let us pursue our digital transformation, and I know that the Secretary of State is up for that. In terms of the stuff we will be doing this year, we eagerly await the workforce plan.

[Maria Eagle (Garston and Halewood) (Lab)]

Will the hon. Member give way?

[Steve Brine]

I cannot give way, because I do not have any more time. We eagerly await the workforce plan. When the Minister sums up, will she update us on where we are with the workplace plan and its independent verification, which the Chancellor announced in the autumn statement?

The Select Committee will be looking significantly at prevention this year. I know that the Secretary of State is passionate about some of the upstream prevention measures we will be talking about, and I look forward to him coming before the Select Committee on 31 January to talk to us—many of my fellow Committee members are here—about the work we are doing. I am excited about our work on the future of cancer. We hear all this evidence about there being cancer plans around Europe that lead to better outcomes, so I want to see the new cancer plan.

Finally, we need to be very careful about the language we use and how we talk about the NHS. Are we honest about the reform we need? Do we believe in the independent pay process? Is primary care really fit for purpose as it is? Do the British people want to spend more than the £159 billion that we will spend this year, and how will we pay for it? I think we do need a bigger NHS, and we clearly need more people in the NHS—that is not a point of debate—but we need to be careful about the language we use around the NHS, because otherwise the long-term strategy is nothing more than a moot point of debate in this House.

NHS Winter Pressures

Steve Brine Excerpts

Monday 9th January 2023 Commons Chamber

[Mr Speaker]

I call the Chair of the Select Committee.

[Steve Brine (Winchester) (Con)]

There is no doubt that, in some places more than others, patient flow in acute hospitals is the issue gumming up the system, and the Secretary of State is right to say that demand far outstrips supply, in part because of the very high flu numbers. Today’s injection of funding is very welcome as is the additional surge capacity the Secretary of State spoke about in his statement. His mention of prevention is especially welcomed by me; let us do so much more on this. Another £250 million is a lot of the public’s money. What real-time oversight does he have to ensure that NHS England spends it wisely, and may I make a plea that domiciliary care is not overlooked, because the lack of care in people’s homes is every bit as much the enemy of patient flow as the lack of care home places that he has identified today?

[Steve Barclay]

My hon. Friend raises an important issue about getting flow into the system, not least because delays in ambulance handovers lead to the highest risk in what is a whole-of-system issue where the patient is not seen and treatment is delayed. That is why flow through discharge is so important, because, while that often concerns the back door of the hospital, it is actually the pressure at the front door that is most acute. The Government recognised that in the autumn statement and that is why there was additional funding with the £500 million for delayed discharge. That has taken some time to ramp up, but we recognise that because of the flu there is an immediacy in the pressure on A&E that we need to address.

My hon. Friend’s point speaks to one of the key lessons from the covid period. It is not simply about releasing patients from hospitals who are fit to discharge; it is also about the wraparound services provided for those patients so that they do not get stuck in residential care for longer, and they are still able to go home and get the domiciliary care packages. NHS England is focused on that so that they have the wraparound services alongside that discharge.

Aortic Dissection: Patient Pathways and Research Funding

Steve Brine Excerpts

Tuesday 13th December 2022 Westminster Hall

[Mrs Latham]

I thank my hon. Friend for his intervention, knowing as he does what it is like to work in an emergency department. A lot of people come through the department, but the study he refers to about the abdominal aortic aneurysm was only for men of a certain age. This affects people from 17, or even younger, to 90. Although that sounds like a good idea, I am not sure that it would work in practice. We need more CT scanners used more frequently in emergency departments, and that is what is missing in part from emergency medicine settings.

The next phase in the patient pathway for those who have been correctly and speedily diagnosed is treatment. As I mentioned, 80% of those diagnosed survive. That is not enough and research is ongoing into better methods of treatment. However, one area where we can certainly improve is long-term treatments that do not require further medical interventions. There is currently a call for research proposals into that from the National Institute for Health and Care Research. That is excellent news and I encourage the Minister to make as much money as possible available for this area of research.

After treatment, it is imperative that the follow-up treatment for aortic dissection patients and their families is of the highest quality. Two thirds of survivors of aortic dissections have some kind of post-traumatic stress disorder. They need specialist treatment by somebody who understands their conditions. Furthermore, aortic dissection survivors have a long-term condition that places them at risk of future complications. They need to be monitored by specialist teams and currently, that provision is highly variable. Teams exist in some specialist hospitals, but not all patients are reliably followed up, and too often that is a failure to take a holistic approach to follow up. The employment of specialist nurses in every aortic centre, similar to those in cancer and palliative care, would greatly strengthen follow-up.

The massive improvement in the patient pathway would not be expensive. Although I understand that every penny is being counted in the current situation, to provide a specialist nurse in each of the 29 NHS centres in the country that deal with aortic dissection, for two days a week, would cost less than £400,000 in total per year. The charity has explored the replication of the Macmillan nursing model for aortic nurses and, with funding, would be well positioned to support the design and roll-out of that initiative. Given the enormity of the NHS budget, I hope that is something that the Minister will confirm that she will look into.

The final stage of the patient pathway is genetic screening. About a third of patients who suffer an aortic dissection have some sort of genetic predisposition to the condition. That is why I welcome funding. Screening relatives of sufferers can detect those at risk and proactive treatment can significantly reduce their risk. However, that requires specialised clinical genetics input, access to which is, again, very variable. The technology exists to do that, and it would certainly save lives every single year.

There are two steps the Minister could take to improve this stage of the patient pathway. First, the employment of the specialist nurses I mentioned would be of great assistance. They would lead on the patient’s follow-up plan, part of which would include screening for their relatives. The second step would be for the Minister to facilitate a series of meetings between the relevant professional societies and appropriate NHS staff, to agree and implement a set of NHS guidelines for genetic screening for those suffering aortic dissection and for their relatives.

As I have set out, there are improvements to be made all along the patient pathway, which would go a long way towards saving many of the 2,000 patients every year who would otherwise die from aortic dissections. If nothing is done, that number will only increase in the coming years, so it is crucial that we act now.

Turning to the opportunities for investment in research, which would make a huge difference to the diagnosis and treatment of aortic dissection.

[Steve Brine (Winchester) (Con)]

On the point about genetics and screening, the Health and Social Care Committee, which I chair, will be doing a big inquiry next year on prevention, and one of the things we will be looking at is upstream prevention for cancers and some of the other big killers. I extend the offer to my hon. Friend and the charity to get in touch with us when we launch that inquiry to give evidence on the screening that they are proposing. We would be interested in looking at that and to take evidence in written or oral form. That inquiry is all about saving lives. What she has said makes a lot of sense to me—it could do just that.

[Mrs Latham]

I thank my hon. Friend. I am sure the charity would be delighted to come and give evidence. This is a condition that nobody has ever heard of; it is not just about raising awareness, but changing outcomes, and I hope that the Committee’s inquiry into saving lives can help to save some of those 2,000 people. Obviously, they will not all be saved, but 2,000 is a huge number—it is not a very rare condition, but nobody knows about it until it devastates their family. I am delighted to accept that offer on behalf the charity.

Two studies that the charity is supporting known as DAShED—diagnosis of aortic syndrome in the emergency department—and ASES, the aortic syndrome evidence synthesis, are looking at the development of decision tools for use in emergency medicine to ensure that aortic dissections are diagnosed as quickly as possible and can then be effectively treated. These studies are designed to look at the available evidence to improve diagnosis of aortic dissection. Once concluded, there will need to be a second round of funding to measure the impact of implementing those recommendations. Studies that focus on improved diagnosis, while important, are just the first step. The critical breakthrough will be made by the identification of biomarkers and artificial intelligence to detect unusual patterns of presentation of aortic dissection. This research has the potential to save 10 lives a week according to the charity, and I hope that the Minister will comment on what her Department is doing to increase the funding available for research into better diagnosis for aortic dissection.

As I mentioned, this is not just about diagnosis but about treatment. The NIHR has issued a call for research proposals into methods of treatment that would reduce the need for further medical intervention down the line. I know that budgets are likely to remain tight for some time, given the current economic conditions, but I repeat my plea for the Minister to find some money and recommit to the importance of research funding. We must improve how we diagnose and treat these conditions. Of course, the better we diagnose and treat aortic dissection, the less money we will spend in future on treating so many cases. Some 45% of people who have an aortic dissection are under the age of 60, so being diagnosed and treated early allows them to live a life with their family and continue to contribute economically to society.

It is not an exaggeration to say that the improvements I set out both in the patient pathway and on research funding have the potential to save hundreds of lives a year. As I have explained, the number of aortic dissections will only increase with our ageing population, so it would be wise to act now. The charity is partnering in the implementation roll-out of the NHS aortic dissection toolkit across the country, and it has already received a positive and enthusiastic response, but there is more to be done. As I mentioned, there is an opportunity for the Minister to endorse the design and implementation of further toolkits to address the current challenges with diagnosis, elective surgery follow-up and aftercare, covering those aspects of the patient pathway that are not included in the existing toolkit. Improvements in the patient pathway and research funding, such as those that I have set out, are greatly needed, and I hope that the Minister can carefully consider all the recommendations.

Too often in government and in this place, we speak about tragedies in terms of scale—of the numbers of lives lost or numbers of people affected by a catastrophe—but it is all too easy to forget that behind every single statistic there is a family whose lives have been upended by these terrible events. While 4,000 aortic dissection patients a year is a huge number, we must remember that it is much more than that: it is 4,000 people with a family—parents, children, husbands, wives, siblings, relatives and friends. None of them are likely to be aware of aortic dissection before it happens. In Ben Latham’s case, the family was mine, and every single one of us is still feeling the effects of this awful condition that we did not know existed. It has been important for me, as for the other trustees and ambassadors of the charity, to do everything we can to improve the survival rates and treatment of future sufferers, so that other families do not have to go through what we have been through.