Oral Answers to Questions

Victoria Atkins Excerpts

Tuesday 5th December 2023 Commons Chamber

[Layla Moran (Oxford West and Abingdon) (LD)]

16. What recent assessment she has made of the potential impact of levels of availability of dentistry appointments on other NHS services.

[The Secretary of State for Health and Social Care (Victoria Atkins)]

May I, through you, Madam Deputy Speaker, wish Mr Speaker a very speedy recovery?

As Secretary of State for Health and Social Care, I want to reform our NHS and social care system to make it faster, simpler and fairer. Dentistry is a critical part of that. Integrated care boards are responsible for identifying areas of local need and determining the priorities for investment. NHS England published guidance in October this year to help ICBs use their commissioning flexibilities within the national dental contractual framework, and I will be looking carefully at how the boards are identifying need and investment across England, including for vulnerable people.

[Kim Johnson]

I am glad that the Minister mentioned ICBs. Liverpool has a very high percentage of children with dental decay, and tooth extraction is the most common hospital procedure for five to nine-year-olds at Alder Hey Children’s Hospital, yet there was a £10 million underspend for primary care dentistry, and instead of investing it in preventive care, NHS England gave permission to all ICBs, including NHS Cheshire and Merseyside, to use the balance to balance their budgets. Will the Minister agree, here and now, to reinstate the ringfenced funding to commission extra capacity for the most vulnerable patients?

[Victoria Atkins]

I am delighted to be able to inform the hon. Member that NHS England has provided guidance for ICBs that requires dental funding to be ringfenced, with any unused resources redirected to improve NHS dental access in the first instance. Interestingly, ICBs will report their expenditure against the dental ringfence to NHS England as part of their in-year financial planning, which will happen at the end of this financial year.

[Kim Johnson]

But the underspend is not being used on dentistry—

[Steve Brine (Winchester) (Con)]

The Government previously committed to publishing a dental recovery plan, which the former dental Minister, my hon. Friend the Member for Harborough (Neil O’Brien), said that the Government would publish shortly. He also told my Committee:

“We do want everyone who needs one to be able to access an NHS dentist”.

We were surprised, but he said it. We were told that the plan would be published during the summer or before the summer recess. When will the plan be published, if that is still the intention? Presumably it will come alongside the response to our “Dental Services” report, which was due on 14 September.

[Victoria Atkins]

I thank my hon. Friend and I look forward to being grilled by him and his Committee in due course—at least, I think I do. Perhaps I can assist him, first, on the very important dental report that his Committee published. I am looking through it myself this afternoon and I will be publishing the response and sending it to the Committee imminently. In relation to the dental plan, both the Under-Secretary of State for Health and Social Care, my right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom), and I are looking carefully into the needs of communities in rural and coastal areas, as well as in more urban areas, to understand not just the need but the answers that we can provide to help with urgent care and, importantly, preventive care, particularly for our children and vulnerable people in our society.

[Justin Madders (Ellesmere Port and Neston) (Lab)]

Last week another dentist in my constituency told my constituents that they were no longer able to provide NHS services. These people have literally nowhere else to go nearby. I want to come back to what my hon. Friend the Member for Liverpool, Riverside (Kim Johnson) asked about the underspend, because we had a meeting with the ICB and it was specifically told that the ringfence was being disapplied. Does the Secretary of State agree that that money should be spent on dental services and that that instruction should be given by her today?

[Victoria Atkins]

I agree, and that is why NHS England has provided guidance, as I set out earlier.

[Derek Thomas (St Ives) (Con)]

I welcome the guidance that ICBs have received. Cornwall ICB has committed to ringfencing money for dentistry next year, but the truth is that, before it took on that commitment, £4.5 million for unmet units of dental activity was returned to NHS England. What can the Secretary of State do to ensure that Cornwall gets the money that was intended for Cornwall to deliver NHS dentistry?

[Victoria Atkins]

A theme is emerging of underspend in dental work, which is one of the things that the ministerial team and I are looking at. NHS England emphasised in its guidance to ICBs that the funding should be ringfenced. I very much understand the pressures that my hon. Friend and other south-west Members have been raising over many months on the care that their constituents are getting. To ease pressures in the south-west, NHS England has commissioned additional urgent dental care appointments that people can access through NHS 111.

[Madam Deputy Speaker (Dame Eleanor Laing)]

I call the shadow Minister.

[Abena Oppong-Asare (Erith and Thamesmead) (Lab)]

I begin by welcoming the Secretary of State and her Ministers to their posts.

Last year, the Prime Minister pledged to restore NHS dentistry, including a specific promise to protect its budget, yet last month we learned that he will break that promise and allow ICBs to raid dentistry budgets to fill the gaps. Labour has a plan for 700,000 extra appointments, supervised toothbrushing in schools and a targeted dentistry recruitment scheme in left-behind areas. It is all fully funded by abolishing non-dom tax status. We have a plan, but the Government’s plan is four months overdue. Where is it?

[Victoria Atkins]

I thank the hon. Lady for her warm welcome. I look forward to discussing these matters with her over the Dispatch Box.

Over the weekend, I was rather pleased to see the Leader of the Opposition’s damascene conversion to the Conservative cause. As the shadow Secretary of State is on his world tour investigating what other health systems are doing, the Labour party may wish to bear in mind the words of wisdom from the great lady herself: “The problem with socialism is that at some point you run out of other people’s money.”

[Michael Fabricant (Lichfield) (Con)]

2. What recent steps she has taken to help prepare for a future pandemic.

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[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

9. What steps she is taking to help reduce health inequalities.

[The Secretary of State for Health and Social Care (Victoria Atkins)]

I am pleased to reiterate to my right hon. Friend the Member for Witham (Priti Patel) that Essex is receiving funding from the National Institute for Health and Care Research, which is funded by the Department of Health and Social Care, to promote research into health inequalities and support better health outcomes for her constituents and all residents in Essex.

[Priti Patel]

I thank the Secretary of State for her response and welcome her to her new role; it is a real pleasure to see her in her position today. My Witham constituents have one of the highest patient-GP ratios in the country. That brings many challenges in accessing the NHS, from primary care to dentistry, social care and hospital appointments, some of which have been exacerbated by industrial action. Will she give an update on the work she is leading to address some of those issues and will she support my work and campaign locally to get a new primary health centre in Witham town?

[Victoria Atkins]

I thank my right hon. Friend very much for her kind words. She will remember how much I enjoyed sitting on the Front Bench alongside her when we were in the Home Office. In terms of her work in Essex, she is a formidable campaigner and she will know that the decision on such a healthcare centre lies with her integrated care board, to which the Government have given some £183 million of capital funding between 2022 and 2025. I am sure she will make a compelling case to the ICB for such a centre in her constituency. Interestingly, the Mid and South Essex integrated care board is one of seven sites receiving additional support and funding from NHS England to address health inequalities, and I know she will pay close attention to how that is spent.

[Debbie Abrahams]

There were multiple warnings from experts such as Professor Sir Michael Marmot of the widening health inequalities that started in 2015. Covid just exposed and amplified those inequalities, so that in the north there were 17% more deaths, or more than 2,500 avoidable deaths. While I welcome the new Health Secretary to her post and I welcome her announcement this morning, what else is she going to do to address in particular the socioeconomic inequalities that drive those health inequalities?

[Victoria Atkins]

I thank the hon. Lady for her welcome. Having grown up in Lancashire myself, I very much understand why she is speaking up on behalf of her constituents. There are many different ways that we deal with this, but let me use a couple of headline points. First, we are increasing the public health grant to local authorities, providing more than £3.5 billion this year, so per capita public health grant allocations for the most deprived local authorities are nearly two and a half times greater than for the least deprived.

There is also interesting work going on with family hubs. Indeed, the Under-Secretary of State for Health and Social Care, my right hon. Friend for South Northamptonshire (Dame Andrea Leadsom), who has responsibility for start for life, is leading on that. The family hubs and start for life programme will deliver a step change in outcomes for babies, children and parents in 75 local authorities in England with high deprivation. We believe strongly that if we can give the best start in life to our babies and children, it will bode extremely well for their future years.

[Maggie Throup (Erewash) (Con)]

A report that is to be published shortly by the all-party parliamentary group for diagnostics, which I chair, has highlighted that community diagnostic centres are essential for tackling health inequalities. I welcome my right hon. Friend to her new role. Will she honour her predecessor’s commitment to meet the all-party group to discuss the benefits of diagnostics in general and the preventive role that they can play in reducing health inequalities across the country?

[Victoria Atkins]

Not only am I delighted to accept my hon. Friend’s kind invitation, but I am also extremely grateful for her work in that area. Of course, we think that community diagnostic centres are an important and exciting part of healthcare in this country. We have 136 centres operational at the moment, and we know that they have provided 5 million additional tests since July 2021. That is the future and we very much support it.

[Kirsten Oswald (East Renfrewshire) (SNP)]

We know that socioeconomic inequalities drive health inequalities and that poverty increases adverse health effects. Research by the Trussell Trust shows that one in seven people faces hunger across the UK because they simply do not have enough money. Will the Secretary of State raise with her Cabinet colleagues the Trussell Trust joint campaign with the Joseph Rowntree Foundation calling for an essentials guarantee in universal credit to ensure that the basic rate at least covers life’s essentials so as to ensure that people can afford essentials such as food and heating and to mitigate against health inequalities?

[Victoria Atkins]

Of course, conversations continue between Ministers across Government in terms of helping not just with health inequalities but with inequality of opportunity. That is why I very much hope that the hon. Lady and her colleagues will welcome the thoughtful focus that both the Chancellor and the Secretary of State for Work and Pensions have put into the back to work plan. We know that getting people into work can have enormous benefits, not just financially but, importantly, for their wellbeing. The idea behind the back to work plan is that we do it by working with people to draw out their full potential and help them to lead healthy lives.

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op)]

8. If she will review the provision of health services for people living with (a) Ehlers-Danlos syndromes and (b) hypermobility spectrum disorder.

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[Marion Fellows (Motherwell and Wishaw) (SNP)]

T1. If she will make a statement on her departmental responsibilities.

[The Secretary of State for Health and Social Care (Victoria Atkins)]

My priority as Secretary of State is to reform our NHS and social care system to make it faster, simpler and fairer. Since my appointment, we are making progress. To make our system faster, we have hit our manifesto target to recruit and retain 50,000 more nurses for our NHS, and to deliver 50 million more GP appointments, achieving both commitments months ahead of time. We have made an offer to health unions that I hope will end the consultants’ strike, which has disrupted care for the public and put a strain on staff. To make our system simpler, we have announced Pharmacy First, which will make it quicker and easier for millions of people to access healthcare on the high street. To make our system fairer, we have agreed a deal with pharmaceutical companies that will save the NHS £14 billion in medicine costs and give patients access to more life-saving treatment. The NHS is one of the reasons I came into politics—[Interruption.] I know Labour Members do not like to hear that, but I look forward to working with patients and staff across the country—[Interruption.]

[Madam Deputy Speaker]

Order. I do not need any help, thank you. The Secretary of State has answered the first question at length. I am sure that means she will answer the other questions much more briefly.

[Marion Fellows]

People with disabilities and serious health conditions already have higher living costs, and the proposals in the work capability assessment activities and descriptors consultation will mean that if they are reassessed they will lose £390 a month. I appreciate that the Secretary of State is new to her role, but will she commit as a priority to taking this up and consulting Cabinet colleagues, to ensure that people who are disabled and have serious health conditions are not pushed even further into dire poverty?

[Victoria Atkins]

As I said earlier, careful thought has gone into the announcements that were made in the autumn statement, and of course I will work with the Secretary of State and the Chancellor to ensure that the commitments we already have to people living with disabilities are maintained, and that we have their wellbeing at the heart of all our policy making.

[Priti Patel (Witham) (Con)]

T4. The Secretary of State’s predecessor took a strong interest in the deaths that took place in the Essex mental health trusts, and a statutory inquiry is now taking place. Will she meet me and our Essex colleagues, and the families, to discuss that important inquiry, so that they can have justice for the loved ones they have lost?

[Victoria Atkins]

I would be very pleased to meet my right hon. Friend, the families and other Essex MPs to discuss that important inquiry.

[Madam Deputy Speaker (Dame Eleanor Laing)]

I call the shadow spokesman.

[Ashley Dalton (West Lancashire) (Lab)]

With your indulgence, Madam Deputy Speaker, I welcome the Secretary of State and the new members of her Front-Bench team to their roles. I am honoured myself to stand at the Dispatch Box today for the first time on behalf of the shadow Secretary of State for Health, my hon. Friend the Member for Ilford North (Wes Streeting), who is currently in Australia exploring international best practice in healthcare.

Talking of best practice, on this Government’s watch, people with suspected breast cancer are not getting it. The two-week target from GP referral to a first consultant appointment for breast cancer has not been met since March 2020. I know from my own experience of breast cancer that the waiting is terrifying, wondering whether it has been left too late and the cancer has become incurable. How much longer will patients have to wait before the Government can meet their own targets and deliver the timely care that patients need and deserve?

[Victoria Atkins]

I genuinely thank the hon. Lady for her warm welcome, and indeed I welcome her to her first outing at the Dispatch Box. As she was describing where the hon. Member for Ilford North (Wes Streeting) is, I had images of “I’m a Celebrity… Get Me Out of Here!” Sadly for citizens in Wales, they are experiencing what it is like to live under a healthcare system run by Labour, and they might fully agree with that sentiment.

The hon. Lady raises the important issue of breast cancer, and the NHS has an ambition to diagnose 75% of cancers as stages 1 or 2 by 2028. In January last year we provided £10 million of funding for 28 new breast screening units and nearly 60 life-saving upgrades to services in the areas where they are most needed, because we understand our constituents’ concerns and also their determination that we continue to improve cancer survival rates.

[Ashley Dalton]

Unfortunately, the reality is that cancer referrals have only got worse with the Conservatives in government. In September 2023, only 74% of urgent cancer referrals to a consultant met that two-week target. That is the second-lowest rate for two-week referrals since 2009. When can the public expect this performance to improve?

[Victoria Atkins]

We have in fact made progress by delivering record numbers of urgent cancer checks, and levels of first treatments following an urgent cancer referral have been consistently above pre-pandemic levels, with activity in September standing at 108% of pre-pandemic levels on a per working day basis.

[Peter Gibson (Darlington) (Con)]

T6. Some six months ago, the dentist based at Firthmoor community centre, serving 8,000 of my constituents, handed back its contract to the integrated care board. I was shocked last week to learn that the ICB has still not commenced the tender process to replace that provision. What advice can the Minister give me to ensure that our ICB is doing what it needs to do?

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[Dr Luke Evans (Bosworth) (Con)]

T9. My local practice, on Heath Lane in Earl Shilton, released its “did not attend” figures. Between 20 November and 24 November, 69 appointments—including 36 GP appointments and 28 nursing appointments—were missed. That was 12 hours lost in five days. If that is happening up and down Hinckley and Bosworth and across the country, that is thousands of hours being missed. I know that the Government are keen to see more on data, so will they consider statementing patients on how much missed appointments cost, because clinically that would make a big difference to the awareness of what people are cashing out on?

[Victoria Atkins]

May I thank my hon. Friend for bringing his professional expertise to the Chamber? Of course, minimising “did not attends” is a critical part of ensuring that clinical time is optimised, and I will take his suggestion away and mull it over.

[Kate Hollern (Blackburn) (Lab)]

T2. I understand that pathology staffing levels at Royal Blackburn Hospital have not been reviewed for 15 years and the workload is up 300%. The national deficit in pathology is a ticking time bomb, as hospitals are unable to offer surgical and emergency services. What steps is the Minister taking to address recruitment and ensure that staff and patients are safe?

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[Imran Hussain (Bradford East) (Lab)]

T5. The Health Secretary declared at the weekend that the Government will miss their target to cut NHS waiting times if doctors strike to defend their pay and conditions, but she seems to forget that since the Tories took power in 2010, waiting lists for hospital treatments are up, A&E waiting times are up, cancer referral times are up and ambulance response times are up. The only thing that has fallen is not waiting times; it is public confidence in the Government. Will the Minister finally admit that the threat to waiting time targets is not striking doctors, but her party being in government?

[Victoria Atkins]

I assume from the hon. Gentleman’s question that he fully supports our efforts to get consultants back into hospitals as well as junior doctors and doctors in training. It is all very well to sit there commenting, but we on the Government side of the House are working with doctors to try to help them look after the NHS for us all.

[Selaine Saxby (North Devon) (Con)]

While I recognise that money does not grow on trees, neither do teeth. Can my right hon. Friend advise me of how quickly my North Devon constituents will be able to see the NHS dentists they so desperately need?

[Patricia Gibson (North Ayrshire and Arran) (SNP)]

T7. Last week, the former Health Secretary admitted at the covid inquiry that sick pay across the UK is “far too low”. It is far lower than the European average and encourages people to go to work when they should be getting better. Does the Secretary of State agree with her predecessor? What discussions will she have with her Cabinet colleagues to improve the inadequate sick pay system?

[Victoria Atkins]

I will not comment on evidence from the covid inquiry, given that it is an independent inquiry. However, on the general principle of encouraging people back into work, we have the plans set out by the Secretary of State for Work and Pensions and the Chancellor at the autumn statement. We want to encourage people back into work and to support them when they fall ill and need help from the state.

[Anna Firth (Southend West) (Con)]

Last year, I asked the Government to show me the money with respect to £118 million of long-awaited capital funding for south Essex hospitals. With £8 million now delivered and the other £110 million now confirmed to be on its way, will the Secretary of State please come with me to Southend Hospital and see how that vital money will transform care in Southend and Leigh-on-Sea?

[Victoria Atkins]

I will be delighted to visit that hospital with my hon. Friend—I suspect that I will be visiting a lot of hospitals.

[Paul Blomfield (Sheffield Central) (Lab)]

T8. Was the Secretary of State consulted about yesterday’s announcement by the Home Secretary? If she was, did she agree with him that it will have no impact on overseas recruitment, or does she hear the fear of care providers about its consequences?

[Victoria Atkins]

Yes, I was. What is more, we looked carefully at the figures in relation to overseas care workers. We are grateful to all international people who work in our NHS and our care system, but we need to tackle the migration rate, which is too high. The package presented yesterday by the Government is a thoughtful and careful one to tackle legal migration.

[Siobhan Baillie (Stroud) (Con)]

Stroud Maternity Hospital is doing a great job, but the post-natal beds are still not open. We have been chasing a ministerial meeting about that for some time. Will my hon. Friend meet me and the Gloucestershire NHS scrutiny chair, Andrew Gravells, to discuss the issue? We think that we need some help with the Care Quality Commission.

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[James Sunderland (Bracknell) (Con)]

Would the Health Secretary please agree to meet me to discuss improved access to GPs and dentists in Bracknell Forest and Wokingham boroughs?

[Victoria Atkins]

I will; it would be a pleasure.

[Pete Wishart (Perth and North Perthshire) (SNP)]

My constituent Air Marshal Dr David Walker, an inspirational leader and academic, sadly died of glioblastoma in June. When diagnosed, he and his wife Catherine were shocked to learn of the woefully low funding for brain and other less survivable cancers and established the charity the Right to Hope with Cancer. Will the Minister show the courage and leadership so epitomised by the life of Air Marshal Walker, and properly resource and fund less survivable cancers, so that everyone living with cancer has some sort of hope?