Oral Answers to Questions

Tanmanjeet Singh Dhesi Excerpts

Tuesday 15th October 2024 Commons Chamber

[Wes Streeting]

It is precisely because of the situation the hon. Member describes—the poor services and, ironically, the underspends in the dentistry budget—that we will work not only to stand up the 700,000 urgent and emergency dental appointments we promised, but to do the prevention work for children in our schools.

[Mr Tanmanjeet Singh Dhesi (Slough) (Lab)]

T4. Many people in my constituency are grateful that Slough will soon be home to a £25 million community diagnostic centre, which will help to reduce waiting lists, but many are also concerned that the local trust may be contracting out services for MRI scans. Does the Minister agree that, instead of just outsourcing, local trusts should, whenever possible, try to increase expertise and capacity in-house?

[The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)]

We are committed to expanding community diagnostic capacity to build an NHS that is fit for the future. However, we are clear that independent sector providers have a role to play in supporting the NHS as trusted partners to recover elective services.

NHS Winter Update

Tanmanjeet Singh Dhesi Excerpts

Monday 8th January 2024 Commons Chamber

[Victoria Atkins]

My hon. Friend puts it eloquently; there is a real human cost to these strike actions. It is why I did everything I could when we were in negotiations to try to find fair and reasonable settlements for junior doctors. I was very disappointed when they walked out, but we have to find solutions for the sake of our patients and of all 1.3 million people working in our NHS across England. There have been some brilliant examples of local trusts, local clinicians and other members of staff working really hard and pulling together to cover these damaging strikes, but all we ask of junior doctors is to come back to work, do their jobs and look after our patients.

[Mr Tanmanjeet Singh Dhesi (Slough) (Lab)]

NHS waiting lists have trebled since the Conservatives came to power almost 14 years ago. The Prime Minister’s pledge to cut waiting lists has effectively been abandoned, with the Government choosing to blame NHS staff instead of fixing the problems. Is it not the case that the longer we give the Conservative Government in power, the longer patients in Slough and across our country will, sadly, have to wait?

[Victoria Atkins]

Waiting lists are coming down, but they are still too high. Towards the end of last year, we had a period without any strikes in the NHS. We saw the waiting lists fall by tens of thousands—indeed, by 65,000—over the period of October, which shows the impact of the industrial action. Sadly, we know that more than 1.1 million appointments have been rescheduled in the last 12 months. It is having an impact on waiting lists and, for the sake of patients, we ask the junior doctors to come back to work.

Oral Answers to Questions

Tanmanjeet Singh Dhesi Excerpts

Tuesday 17th October 2023 Commons Chamber

[Helen Whately]

As the hon. Member has mentioned, I have a broken ankle, and I am taking my responsibility as Minister with oversight of urgent and emergency care very seriously in making use of several of those services. As for my oversight of integrated care systems, what I am seeing is that they are making a very good job of enabling the integration of services. For instance, we are seeing real success in the growth of virtual wards—or “hospital at home”—which bring together acute and community services to look after people in their homes and help them to be discharged earlier. The NHS has achieved its target of having 10,000 “hospital at home” places ready for this winter.

[Mr Tanmanjeet Singh Dhesi (Slough) (Lab)]

13. What steps he is taking to improve access to primary care services.

[Rob Butler (Aylesbury) (Con)]

21. What steps he is taking to improve access to primary care services.

[The Secretary of State for Health and Social Care (Steve Barclay)]

Our primary care recovery plan supports GP practices in addressing the 8 am rush for appointments, cutting bureaucracy for GPs and expanding community pharmacy services. We have recruited over 31,000 additional primary care staff and have over 2,000 more doctors working in general practice, compared with before the pandemic.

[Mr Dhesi]

People are finding it nigh-on impossible to see their GP when they need to. Labour has pledged to guarantee face-to-face appointments when people want them by training more NHS GPs but, as my constituents point out to me, under the Tories, a two-tier healthcare system is emerging where some are forced to pay to be seen quicker while those that cannot afford it are left behind in agony. Why have the Conservatives broken their promise, made in 2019, to deliver 6,000 more GPs, and when will this GP crisis finally be resolved?

[Steve Barclay]

There is a two-tier approach within the UK, between what is going on with the NHS in Wales and what is going on in England. We have more appointments, more staff—over 2,000 more doctors and over 31,000 additional roles—and more tech, with £240 million invested in delivering the digital telephony and the online booking system so that we can get patients to the right level of care with an appointment as part of our commitment to 50 million more appointments in primary care.

NHS Long-term Workforce Plan

Tanmanjeet Singh Dhesi Excerpts

Monday 3rd July 2023 Commons Chamber

[Steve Barclay]

Those are both fair points. I know that my hon. Friend comes at this with great commercial experience, and I hope he knows that I have an interest in those issues. Just to reassure him, the plan is iterative; it is not a one-off. It is a framework from which we will do further work. Indeed, one of the areas that I am often criticised for is my interest in data and variation in data across the NHS—he and I probably agree on that more than some of those who are critical. That speaks to his point—the Chair of the Health and Social Care Committee’s point relates to this—that in a system the size of the NHS, data on the performance of the integrated care boards and their role in terms of the workforce is one area that the House will want to return to.

[Mr Tanmanjeet Singh Dhesi (Slough) (Lab)]

We know a Government are out of ideas when they copy the Opposition’s plan to train the doctors and nurses that the NHS so desperately needs. The majority of those policies will not be implemented until after the general election—long after the British public have booted the Conservatives out of power because of their industrial-scale incompetence, which included crashing the economy.

The Secretary of State will be aware that the NHS is short of more than 150,000 staff right now. Will he take responsibility for those shortages and admit that, had the Government acted more than a decade ago, the NHS would have the staff that it needs right now?

World AIDS Day

Tanmanjeet Singh Dhesi Excerpts

Thursday 1st December 2022 Commons Chamber

[Nicola Richards (West Bromwich East) (Con)]

I thank the hon. Member for Brighton, Kemptown (Lloyd Russell-Moyle) for leading this debate and for his commitment to this cause. As the number of new HIV cases in this country falls, the importance of the issue does not. We stand on the shoulders of giants and of the 38 million globally lost to AIDS-related illness. Their early passing will not be forgotten. In fact, it inspires us to work harder and quicker.

This Government are proud to be one of the first in the world to commit to ending new HIV cases by 2030, and we are proud to put our money where our mouth is. This time last year, my right hon. Friend the Member for Bromsgrove (Sajid Javid), as Health Secretary, provided £20 million to fund opt-out testing in London, Brighton and Manchester. Thanks to the campaign of the Terrence Higgins Trust and my hon. Friend the Member for Blackpool South (Scott Benton), Blackpool was also rightly included. This investment has had remarkable results and is already garnering savings for the NHS.

In the first 100 days of this programme, around 128 people were newly diagnosed and roughly 65 people who were previously diagnosed returned to the care of an HIV clinic. On top of all the standard HIV testing, that is almost 200 people who no longer have HIV attacking their immune system and who cannot pass on the virus to others. What a triumph. Adding that half the hospitals also tested for hepatitis and found 325 cases of hepatitis B and 153 cases of hepatitis C, the success only builds. Well over 500 people have been prevented from becoming very unwell on our watch.

Having spent about £2.2 million on four months of testing, the savings are calculated at between £6 million and £8 million. These are not pipe-dream savings but a real reduction in the pressure that accident and emergency departments and hospitals face this winter. When Croydon Hospital started opt-out testing, the average hospital stay for a newly diagnosed HIV patient was 34.9 days. Two years later, it is 2.4 days. I know a few hospitals that could also do with such pressures being released.

In the west midlands we have five areas of high HIV prevalence, and my borough of Sandwell is among them with a prevalence of 2.92 cases per 1,000 adults, which is well above the national average. The National Institute for Health and Care Excellence says that areas such as Sandwell should

“offer and recommend HIV testing on admission to hospital, including emergency departments, to everyone who has not previously been diagnosed with HIV and who is undergoing blood tests for another reason.”

Such testing is not yet happening in Wolverhampton, Coventry, Sandwell, Birmingham or Walsall. We have to find our undiagnosed and lost-to-care residents and get them into treatment as soon as possible.

The Mayor of the west midlands, Andy Street, has written to the Health Secretary asking for this “invest to save” resource for our region, and I add my voice to his call and ask the Minister if he can help level up the HIV response outside London. With funding for opt-out HIV testing, we can put the west midlands on track to end new HIV cases by 2030.

Andy Street rightly said

“This is not a World AIDS Day stunt but a serious call for action. I don’t want ‘The Ribbons’ to simply be a tribute. It needs to be a reminder that HIV is still happening to many”.

I know my hon. Friend the Member for Birmingham, Northfield (Gary Sambrook) and local councillors in Sandwell, such as Councillor Scott Chapman, join Andy and me in asking for an extension to opt-out testing to cover my West Bromwich East constituency.

We have made such incredible strides. As well as remembering the devastation that HIV has caused for so many around the world, we have to celebrate how far we have come. We have preventive drugs available on the NHS—drugs that stop any trace of HIV so that those who contract it cannot pass it on to others—and we are now seeing the major success of opt-out testing in some of the country’s worst HIV hotspots. In an odd way, the medical question is not really the problem; it is the stigma.

I recently met Harry Whitfield, also known as Charity Kase, who last year made his debut on “RuPaul’s Drag Race UK” to showcase his incredible talents. He talked about how hard it was to deal with his HIV diagnosis. For last year’s World AIDS Day, Harry said:

“The stigma around HIV is far worse than the disease itself. I take one tablet per day to stay healthy and completely undetectable so I can’t pass the disease on. I’m thriving in my life every day, but that’s not the narrative that gets told when talking about HIV.”

Last year, like so many, I was completely engrossed in “It’s A Sin.” Until then, I had not thought that much about HIV. Probably because of my age, I had not properly considered how terrifying that period of time was for so many. When I was sent an HIV test to raise awareness during testing week, I took the test and posted about it on social media. I knew it had the potential to create some odd feedback, but I felt it was important. Some of the comments came from people who thought HIV was a thing of the past, and they accused me of talking about it only as a means to control people now that we are out of the covid pandemic. It showed me the importance of keeping this issue alive.

My experience is similar to that of my right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes), with people questioning why I thought it was necessary to take a test and what I had been up to. However, one constituent thanked me. He said:

“I’m a victim of this myself. I was fortunate to be born at the right time for effective treatments. But only just. These new tests were not around when I was diagnosed. I just happened to randomly find out through routine MOT as they call it.”

He also said told me that the stigma is the main issue.

[Mr Tanmanjeet Singh Dhesi (Slough) (Lab)]

I congratulate my hon. Friend the Member for Brighton, Kemptown (Lloyd Russell-Moyle) on securing this important debate on World AIDS Day. Like the hon. Member for West Bromwich East (Nicola Richards), my Slough constituency has a relatively high prevalence of HIV. It is vital that our town is properly supported in the fight against HIV and AIDS in order to meet the 2030 target, which is why I wrote to the Health Secretary to request that Slough be included in the opt-out HIV testing scheme.

Does the hon. Lady agree it is important that the Government support areas like ours so that we get the right level of support? Without that support, we could experience a resurgence that none of us wants.

[Nicola Richards]

I completely agree with the hon. Gentleman. Opt-out testing is one of the easiest ways to end the transmission of HIV and become the first country to be HIV-free by 2030, which would be incredible. Opt-out testing is clearly a great route to do that.

“It’s A Sin” has helped to bring this issue back to life, not just as a reminder of the 38 million people around the world lost to AIDS-related illness, but as a reminder of how far we have come. The series also makes it glaringly obvious that we have more to do to tackle the stigma.

I place on record my thanks and appreciation for the Terrence Higgins Trust. It is 40 years since the death of Terry Higgins, one of the first to die of an AIDS-related illness. The trust does incredible work to end the stigma around HIV, which is one of the biggest barriers that stops people getting testing, and therefore one of the biggest barriers to ending the transmission of HIV by 2030.

HIV is no longer a death sentence. It is no longer the terrifying disease that “It’s a Sin” so intensely brought to life for people like me who did not live through those incredibly difficult times. I thank the Government for supporting opt-out testing, and I call one last time for the pilot to be extended to other hotspots, including the west midlands.

Covid-19: PPE Procurement

Tanmanjeet Singh Dhesi Excerpts

Thursday 24th November 2022 Commons Chamber

[Neil O’Brien]

I do not have that information to hand, but I have a seat on the edge of Leicester, an important textiles town, and I had loads of constituents get in touch with me to ask, “Where can I go?” We sent them on to a mailbox, and after they were in that mailbox, they went through the usual process that every other supplier went through.

[Mr Tanmanjeet Singh Dhesi (Slough) (Lab)]

For Tory peers and other chums of the Conservative party to have been profiteering at taxpayers’ expense from shoddy, unusable PPE, especially through the VIP procurement lane, at a time when people were locked down in their homes and tens of thousands of people, including my loved ones, were dying is absolutely sickening, shameful and unforgiveable. Given that The BMJ estimates that the Government have written off approximately £10 billion in unusable, undelivered or shoddy PPE, will the Minister take the opportunity to apologise to bereaved families for the amazing lack of integrity at the heart of the whole process?

[Neil O'Brien]

I set out earlier what the high priority route was and was not: it was absolutely not a guarantee of any kind of contract; it was a way of managing the huge numbers of contacts and offers for help that we were all receiving. It delivered something in the order of 5 billion items of PPE, all of which helped to save lives and protect workers in our NHS and social care settings. Of course, we had to take up those offers of help and respond to them when people wanted to help in the middle of a huge national and global crisis. We had to process those offers, but they were processed in exactly the same way as every other bid for a contract.

Access to NHS Dentistry

Tanmanjeet Singh Dhesi Excerpts

Thursday 10th February 2022 Westminster Hall

[Mr Tanmanjeet Singh Dhesi (Slough) (Lab)]

Thank you, Mr Efford. It is a pleasure to serve under your chairmanship. I thank the hon. Member for Waveney (Peter Aldous) and my hon. Friend the Member for Bradford South (Judith Cummins) for securing this important debate and the Backbench Business Committee for ensuring valuable parliamentary time is dedicated to the issue.

I place on record my gratitude to dentists, nurses, technicians, hygienists and all those who have worked in dental practices across our country, and in particular in my Slough constituency, over the pandemic, continuing to serve people throughout such uncertainty and disruption as best they could.

As hon. Members know, although clinics were not shut for long, the ongoing repercussions nearly two years later have been astronomical. An estimated 38 million appointments were missed during the pandemic. Despite best efforts, such as opening more than 600 urgent dental hubs and staff working overtime on weekends and evenings, achieving a pre-pandemic level of service has certainly not happened for my Slough constituents, with nearly two thirds of practices estimating that they are continuing to operate at less than 70% of pre-covid capacity.

[Rushanara Ali in the Chair]

Returning to so-called normal was never going to be straightforward, but the chronic lack of support for dentists now and prior to the pandemic is taking its toll. As hon. Members have eloquently highlighted, shockingly, Government spending on NHS dentistry has decreased by more than a third in the past decade. As with other health services, we cannot allow Government to use covid as a smokescreen for what was already a decimated profession.

In the five years before the start of the pandemic, the number of practices providing NHS dentistry fell by 1,253. In December 2021, a survey showed the true toll that has taken on dentists, with more than 40% planning a change of career or retirement over the next year. Tory cuts have consequences, and the pandemic has drastically revealed them.

Since the reopening of practices, I have been contacted by dentists concerned about meeting their targets without adequate support, and patients waiting months, sometimes years, to be seen. The long-term lack of support has created a double-edged sword, failing both patients and practitioners, so I welcome the Government’s recently announced funding, which I hope will achieve their aims of securing 350,000 extra dental appointments, particularly for more vulnerable groups. We are the only country in the UK that failed to provide such support until now, so I fear that it is too little too late. As with all catch-up plans, we need to listen to those who are impacted.

Following the announcement, the British Dental Association noted:

“After a decade of cuts, a cash-starved service risks being offered money that can’t be spent. Hard-pressed practices are working against the clock and many will struggle to find capacity ahead of April for this investment to make a difference.”

I have seen that happening for constituents who contact me: the waiting list for appointments in Slough is more than a year long, orthodontist referrals go back to 2018, and patients are asked to go private if they wish to receive any treatment promptly, paying hundreds of pounds just to be pain-free. That situation is sadly going to get worse, as more than half of dentists state that they are likely to reduce their NHS commitments because they are overworked and undervalued. Is this privatisation by stealth?

The managed decline of Britain’s public services, overseen and supervised by this Conservative Government, has to stop. We all know who will lose out if it continues: the most vulnerable in our society, particularly young people. If we do not properly address this now, we lay the path for a litany of future health issues for children and young people. In my Slough constituency, which is officially the youth capital of Britain as it has the lowest average age of any town or city in our country, this will be devastating. In 2019, 41.5% of five-year-olds in Slough suffered from tooth decay, compared with the national average of 23%, and often required general anaesthetic to remove the impacted teeth, leading to other health risks and impacting their education through missed school days.

Even prior to the covid pandemic, tooth decay was the No. 1 reason for hospital admissions among young people, with a waiting list of a year being standard for the procedure. We already know the disproportionate impact that the pandemic has had on certain groups, including older people; people living in deprived areas; black, Asian and minority ethnic groups; and the most vulnerable groups in our society.

Sadly, that impact has extended into dentistry. NHS England and the Office of the Chief Dental Officer have highlighted that

“Evidence suggests that existing health inequalities have been compounded by COVID-19…The long-term economic impact of the pandemic is likely to further exacerbate oral health inequalities.”

If dentistry moves towards a privatised model, or patients simply cannot be seen due to NHS demand, that widens and entrenches inequalities in our society and, in the long term, it doubles pressure on the NHS for avoidable treatments. Our NHS dentistry should function on the founding principle on which it was created: being accessible for all, regardless of one’s ability to pay.

Health and Care Bill

Tanmanjeet Singh Dhesi Excerpts

Report stage
Tuesday 23rd November 2021 Commons Chamber

[Mr Tanmanjeet Singh Dhesi (Slough) (Lab)]

Many of my constituents find it increasingly difficult to book an appointment with an NHS GP or dentist, forcing them either to go private or to suffer without treatment. Does the shadow Minister agree that, after a decade of failure and misguided policies, the Government must take urgent remedial action? However, the term “waiting time”, to which he has just referred, is not mentioned once in the Bill.

[Justin Madders]

My hon. Friend is right that one of the criticisms we have levelled against the Bill is that it does not address the issues and challenges facing the NHS. I will take no further interventions, because I am conscious that many Members have contributions to make.

I will move swiftly on to our two amendments dealing with inequality and to new clause 64 in the name of my hon. Friend the Member for Oldham East and Saddleworth (Debbie Abrahams). To show that this is an NHS and social care Bill, not just an NHS Bill, local authorities need to be more involved and more emphasis must be placed on wellbeing and better outcomes. We support the NHS triple aim—improving health, quality of care and cost control are, of course, important functions. Nevertheless, we live in a country where significant inequalities remain, and narrowing those gaps should be a national priority.

Research from the IPPR last month highlighted the 10-year gap in life expectancy between a person living in the poorest community and a person in the best off. That gap doubles when we talk about healthy life expectancy. Tackling that disparity must be a priority in the Bill. The Secretary of State for Health and Social Care said in his first speech that said he wanted to tackle the “disease of disparity”, so why is that missing?

Turning to clause 39—one of my favourites—why it remains in the Bill is a mystery given that the previous Secretary of State, the right hon. Member for West Suffolk (Matt Hancock), who requested these powers, is no longer in the role. Perhaps he will give us his insight into that later on. It is the absolute antithesis of the Lansley view that politicians should be distanced from NHS operational issues and makes a mockery of the overall thrust of this Bill, which is about encouraging local decision making. It is no exaggeration to say that, taken literally, clause 39 and its accompanying schedule 6 require the Secretary of State to be told if there are, or even if there might be, proposals to vary service—even moving a clinic from one location to another nearby.

As has been pointed out by wise heads, the power is not one that many Secretaries of State should want to get involved in. A Secretary of State who used it could be accused of favouring certain areas or decisions for political purposes. The well-articulated fear is that it will be used to block necessary but unpopular changes and that expediency will rule. Such decisions should be left to the clinicians or maybe the health economists but not politicians. Labour opposes this new power and would gently say to the Minister, “Be careful what you wish for.”

Finally, the issues around discharge to assess are complex. As we worked our way through in Committee, we heard evidence from many stakeholders, and it is fair to say that views on the matter were polarised. We are led to believe, and have some confirmation, that this development is working well for some acute settings, helping ease the perennial and disruptive issues around delayed transfers of care, but in other places we hear voices calling for much greater caution and for tougher safeguards or even, as amendment 60 requests, to stop it altogether. While we have sympathy with amendment 60, it would only pose more problems for the NHS if it was passed, so we have opted in our amendment 73 just to tighten up on safeguards.

Of course the real solutions are far more complex and would require higher investment both in the NHS and in social care. It should be mandatory that all aspects of ongoing care have been properly discussed and agreed with the patient and carers prior to discharge. An assessment should include carers with special attention if a child carer is involved, and there is a concern that unpaid carers will not be identified and consulted at the point of discharge.

The system for step-down care outside acute hospitals must be adequate, and there must be sufficient high-quality and funded places in care settings of all kinds. We are literally a whole generation away from having that kind of system, even if the funding started to become available today. On a related point, new clause 63 from the hon. Member for St Albans (Daisy Cooper) also deserves support.

I will leave my comments there, as I know many hon. Members want to speak.

NHS Integrated Care System Boundaries

Tanmanjeet Singh Dhesi Excerpts

Tuesday 29th June 2021 Commons Chamber

[Sir Bernard Jenkin]

I will come to that point later; I shall not want to repeat myself.

[Mr Tanmanjeet Singh Dhesi (Slough) (Lab)]

I congratulate the hon. Member on having secured the debate on changes to the NHS integrated care system boundaries on the night that England have beaten Germany and qualified for the quarter finals of Euro 2020. Does he agree that although these plans may satisfy the political ambitions of some, they do not deliver the best outcomes for our constituents, including my Slough constituents, who are already well served by the successful Frimley ICS, which should not be broken up? If something is not broke, why needlessly try to fix it?

[Sir Bernard Jenkin]

I was anxious to give way to the hon. Gentleman to show that there is cross-party concern about this matter; I am sure that his point will be enlarged upon by my right hon. Friend the Member for Maidenhead (Mrs May).

All this is being put at risk at a time when the NHS is still reeling from the impact of covid-19. The new Bill will place ICSs on a statutory footing, which is a good thing, but there is also a proposal that the ICS boundaries should be redrawn to be coterminous with upper-tier local authority social care boundaries, and that is what we are questioning.

I am most grateful for the way my right hon. Friend at the Dispatch Box has listened recently to MPs affected by these proposed changes and has consulted us. He therefore already understands why I and others remain so concerned, but I must put it on the record that the rest of the consultation process has been not just inadequate but in defiance of proper transparency and accountability.

Social Care Reform

Tanmanjeet Singh Dhesi Excerpts

Wednesday 23rd June 2021 Commons Chamber

[Helen Whately]

I would not want to upset the Chancellor by talking about tax policy at the Dispatch Box, but, as I have said to colleagues—and, in fact, as the Prime Minister has said—one of the things that we are committed to as part of our social care reforms is ensuring that nobody should have to sell their home to pay for their care.

[Mr Tanmanjeet Singh Dhesi (Slough) (Lab)]

People across our country will have breathed a huge sigh of relief when the Prime Minister stood on the steps of Downing Street and exclaimed that he had a “clear” and “prepared” plan to solve the social care crisis, but almost two years have passed and there is still no plan in sight. Indeed, the Minister has said today that the Government are still working on a plan. What is the hold-up? Who is obstructing the Prime Minister—or was he simply misleading the nation as usual?

[Helen Whately]

The hon. Member asks about the hold-up. As I have said quite clearly, we have had a pandemic, which has been an unprecedented challenge for our country, our Government and our social care system. In fact, all those working on social care in the Department have been focused on our pandemic response for most of the past 18 months— perfectly rightly, I think the House would say. Thankfully, as we emerge from the pandemic—thanks to the fantastic vaccination efforts across the country, meaning that a huge number of those in care homes and care workers have been vaccinated against covid—we are now able to focus our attention on social care reform. That is why we will be able to bring forward our proposals for reform later this year.