Community Pharmacies: Devon and the South-west

Vikki Slade Excerpts

Tuesday 17th December 2024 Westminster Hall

[Vikki Slade (Mid Dorset and North Poole) (LD)]

It is a pleasure to serve under your chairmanship, Mr Betts, particularly because I speak after the hon. Member for North Somerset (Sadik Al-Hassan) indicated that it may be his birthday, which means that he and I share our birthday with the Pope.

[Sadik Al-Hassan]

I congratulate the hon. Member on having the best birthday.

[Vikki Slade]

I thank the hon. Gentleman for that intervention.

Like my colleagues, I get a lot of correspondence about community pharmacies, which comes from my constituents and also from the pharmacists of Mid Dorset and North Poole. One of my constituents, Ruth in Wimborne, visited Quarter Jack Pharmacy for me at the weekend to get some data. I asked her to get some examples of drugs for which the price differential between what was paid and what was reimbursed was particularly high. The pharmacist gave her a whole list of drugs for which the money received was substantially less than what he got. He said that the precise amount varied from week to week, including for apixaban, which is prescribed to prevent strokes and which presumably saves the NHS a lot of money. Does the Minister agree that that is unacceptable? What commitment will he give to update the contract urgently?

On the medicines shortfall, I cannot tell Members how many people have told me about having to go around the county to try to find the medication they need. Patients with epilepsy, attention deficit hyperactivity disorder, Parkinson’s and sight loss have all contacted me worried about their health. David explained his issue with epilepsy, which is that stress can increase the chance of seizures. I have a personal example: my husband Paul also has epilepsy, which is controlled by drugs, but if he has one seizure, he will lose his driving licence again. He has just got it back after two years and I really do not want to be driving him around. The idea of people being unable to work or drive is mad. The list of medicines available under prescription includes epilepsy, but not Parkinson’s. Does the Minister agree it is high time that the list was updated, given that it was last changed in 1968?

There has been a recent consultation on allowing non-pharmacists to give out bagged medication, and on pharmacists being allowed to give approved persons the right to issue medication. I wrote to the Minister to ask when we were going to get a result and was told that it was still being considered, so I really hope that, today, he might give us a timeline for when we can expect that for our pharmacists.

Finally, in one of my local villages the GP dispenses out of a side window of the surgery, with patients expected to wait in the cold. When I asked why they could not reduce this inconvenience for patients, who are often out there for 45 minutes, I was told it was because they cannot make up prescriptions for three months instead of one because they get paid per prescription and not for the drugs, so the GP would be out of pocket if they made the prescription for three months. That seems outrageous. If it is true, will the Minister urgently review how that works so that dispensing GPs and pharmacists are not out of pocket for providing a better service to their patients?

Puberty-suppressing Hormones

Vikki Slade Excerpts

Wednesday 11th December 2024 Commons Chamber

[Wes Streeting]

As the report into the failures of the Tavistock clinic shows, a whole range of individuals and organisations did not discharge their duty of care appropriately to an extremely vulnerable group of children and young people. I pay tribute to the whistleblowers of the Tavistock and Portman who laid their careers on the line. They were subjected to the worst kinds of attempts to silence whistleblowers, and in some cases to bully them out of the organisation or vilify them. That was not only a disgraceful way to treat good colleagues who were raising legitimate concerns in the right way, but ironically—I have no doubt that many of the people behaving in that way did so with the best of intentions towards that vulnerable group of children and young people—they set back the national conversation about that group of children and young people and undermined confidence in gender identity services. That cannot be a good thing.

I also pay tribute to those journalists who were willing to report on this issue. I pay particular tribute to Hannah Barnes, whose “Newsnight” investigation took some of these issues to a wider audience, and whose journalism on broadcast media and in print showed how we can expose failure, and expose the risks to a wide range of children, young people and adults, in a thoughtful, evidence-based way.

Finally, the right hon. Gentleman talked about the treatment of other people who have raised concerns in a wide range of contexts in this debate. He mentions Kathleen Stock, and there are others, too. I do not think that has been helpful; in fact, I think it has been actively harmful to having the kind of national conversation we should have more broadly about gender identity and how some women fear their sex-based rights are at risk. If we were able to navigate those issues in a much more thoughtful, considered way, listening to different perspectives and experiences, I feel confident that, despite all the challenges, as a society we could find a way through that not everyone loves, but everyone can live with. We have done that before on same-sex marriage, on sexual orientation and religious freedoms, for example. It is possible, if we are willing to listen, to engage in good faith and to not shout down people raising heartfelt concerns. Perhaps if we engaged in the conversation in a much better way, we would find a better way through as a country.

[Vikki Slade (Mid Dorset and North Poole) (LD)]

While I am deeply disappointed, on behalf of our trans children, by the Secretary of State’s statement, I thank him for speaking directly to those children. I know that they will appreciate his sentiments. Trans young people in Mid Dorset and North Poole already rely increasingly heavily on their GPs, their schools and CAMHS, with many leaving education entirely, doing serious harm to themselves and losing their lives while on the waiting list.

The former director of Tavistock told me that no data was collected on incidents of assisted suicide and deaths of children who were on the waiting list. Data was collected only of children and young people who had already started treatment. As a result, we have no information about the harms that young people and their families are going through in those years leading up to treatment.

What assurance can the Secretary of State give me that those already under the care of CAMHS and paediatricians will be treated urgently? Can he update me on progress on how long those already on the list might expect to wait? Will he commit to collecting data from families on the waiting list, so that we can truly understand their experiences?

Tobacco and Vapes Bill

Vikki Slade Excerpts

2nd reading
Tuesday 26th November 2024 Commons Chamber

[Tristan Osborne]

We have age restrictions on alcohol sales and the Bill proposes doing the same. Similarly, for other substances in society, we look in a proportionate way at their health consequences; for instance, we class particular categories of drugs as A, B and C. All those things need to be taken as individual elements. Certainly, we will look at other proposals, but on this particular element, smoking and tobacco have been widely acknowledged as a public concern over many decades.

The vaping industry has seen some positive outcomes, with people transferring from cigarettes to vaping, as my hon. Friend the Member for Newcastle upon Tyne East and Wallsend (Mary Glindon) pointed out. Indeed, that use for those products has been acknowledged by the NHS. As a former teacher, however, I have also seen the consequences for young people and that has been acknowledged by many parents in the Chamber. I have unfortunately seen in the classroom, through confiscation and the illicit behaviours of some young people, that blue razz lemonade, watermelon bubble gum and strawberry raspberry cherry ice are all flavours of vapes. They are being marketed at young people, whether directly or indirectly, because we know, as does the tobacco industry, that young people are where the use of tobacco-based products starts.

I have seen at first hand the consequences of the proliferation of vaping in schools and its ubiquitous presence across my area in Chatham and Aylesford. I agree that the Bill’s removal of disposable, single-use vapes, which are currently so easily accessible and cynically marketed, is a sensible move and should reverse the recent trend of young people who have never smoked turning to vapes as an initial access point. It should also stop vapes being seen as a gateway to other types of drugs. Sadly, I have to report that cannabis-based products and other illicit products are gaining ground among disposable vape products.

At the same time, millions of single-use electrical devices blight our local landscapes. Many disposable vapes are deposited on roadsides and in parks, and while it is not specifically part of the content of the Bill, the reality is that vapes have environmental consequences.

The branding of some flavours has been a key driver of youth take-up. To prevent under-age appeal, flavours should be adult-focused and restricted to such flavours as tobacco, menthol and a handful of responsibly branded fruit flavours. I note that some in the industry are already promoting that agenda.

The age restrictions are sensible, and I think that the rising age escalator will be enforceable. Indeed, many supermarkets already have an age limit well above that which is legally required and challenge at the point of disposal.

[Vikki Slade (Mid Dorset and North Poole) (LD)]

Does the hon. Gentleman agree that the upper-age escalator could prove difficult later on, particularly in respect of the ability of those who sell tobacco? At the moment, if a young person sells alcohol, they have to get a supervisor who is older to allow it. When the people selling alcohol are in their thirties, but were born after 2009, and everyone else in the shop is in their thirties, who will be allowed to sell the tobacco? Does he have any thoughts on that?

[Tristan Osborne]

The licensing regime will be looked at in detail, but the reality is that, when I am buying alcohol in a supermarket, I might be challenged on my age by someone at the counter who is over the age of 16. I think I am correct in saying that I would then have to prove my age at point of sale. I am happy to be corrected if I am wrong on that.

Enforcement is very welcome. As a former council portfolio holder for licensing, it was always very difficult to respond to emails from residents seeking redress around the sale of vaping products. Some products were being sold over the counter in unlicensed premises, so enforcement was very difficult. Other products were being marketed using very aggressive advertising. I welcome the licensing element of the Bill and look forward to hearing more details. Councils, I believe, are ready to take on the mantle of licensing. They license many other types of premises, and I suspect that this latest measure will just be an addition to the existing regime. The measure will challenge bad faith actors and illicit products. I have been asking questions about a digital tax on vaping products to see whether we can treat this sector in a similar way to other tobacco-based products.

I welcome the Bill because it will put us back on the front foot as a world leader in tobacco harm reduction, and help us lead the way in improving standards in cigarette alternatives. If we get this right, which I believe we will with this Bill, we can maintain a healthy balance, with vape usage targeted at the adult market and used as a means to reduce addiction to other nicotine-based products. The Bill balances the liberty of individuals to make choices with the responsibility of the state to uphold the public health of the most vulnerable and our young people, and I urge colleagues to support it.

NHS Dentistry: South-west

Vikki Slade Excerpts

Tuesday 12th November 2024 Westminster Hall

[Vikki Slade (Mid Dorset and North Poole) (LD)]

It is a pleasure to serve under your chairmanship, Mr Vickers. It is interesting that the hon. Member for Truro and Falmouth (Jayne Kirkham) mentions dental vans: we were due to have one in Dorset, but I heard from my local NHS dentist in Corfe Mullen that they were seriously concerned about the prospect. They were worried that if they took it out to their rural community, there would be mayhem and frustration on the part of people who had not seen a dentist in so long. They were actually in fear for their staff, so they decided not to take the dental van. They also noted that it was 2.4 times more expensive than operating a practice, so they decided that they would invest the practice’s extra money in an additional graduate dentist. I met her a few weeks ago: her name is also Vicky. I am really excited about the work she could do, particularly in children’s health, but the decision to increase national insurance without exempting dentists means that the equivalent of half her salary will now go on additional national insurance for the staff within the practice. That is jeopardising the opportunity for practices like Corfe Mullen dental surgery to take on such staff.

It is interesting that dental care was available on the NHS from its inception. The original advert for the NHS stated that it would provide

“all medical, dental and nursing care”

for everyone—

“rich or poor, man, woman or child”.

I am sure Beveridge and Bevan would turn in their graves if they thought that adults were pulling out their own teeth and children were being hospitalised for tooth extraction. It has already been said that fewer than a third of adults in the south-west are receiving dental care. When we describe it as a desert, we are not talking about our wonderful beaches. It is genuinely a dental desert.

I find it hard because NHS Dorset has told us that it had a £9 million underspend in the last year, yet people are spending hours on the phone, begging for help. I am pleased that our ICB has approved an increase in the price of the unit of dental activity, but why is that being delayed until next year, and why are we not going further? Why is it that our hospital can find the money to go to a private hospital and sort out all the knee replacements, but our dentists cannot be brought online to deal with urgent cases? I ask the Minister to instruct ICBs across the south-west and beyond to ringfence the underspend in dental budgets, so that it cannot be used to plug the gap elsewhere in the service while people are struggling.

Katie in Bearwood told me that she will lose her front tooth if she does not get help soon. She wakes up every day with blood on her pillow and all over her teeth. The pain is so unbearable that it has her in tears, and she has lost two stone in weight as she can barely eat. She cannot get a referral to hospital without paying to see a private dentist. She is ashamed to go out in public. She said that she will have to pay £1,000 in private costs before she can be seen, but nobody will give her a loan. Zoe in Wimborne told me it has been nine years since she has seen a dentist, and that she is close to using the old-fashioned method of string and a door. It is absolutely ridiculous. It cannot be allowed to carry on.

I cannot not talk about the children in our area. It is wonderful that the Government are bringing in supervised toothbrushing, but what is the point if children then cannot see a dentist? I was mortified in 2022 when I took a foster child who had come to live with me to my dentist, because I had assumed that, as with GP practices, looked-after children would automatically be added to a family’s NHS practice. How wrong I was. We did not realise, so we insisted on telling the dentist that they had to see this child. He was 11 years old and he had seven teeth gone already. He needed those teeth replacing for his future and for his smile. If we cannot do it for the adults, we must at the very least do it for our children, especially our looked-after children.

--- Later in debate ---

[Stephen Kinnock]

The first thing I will say is that I am not going to take any lectures from any Conservative Member about the state of our dental system. What brass neck we see from that party, both in the Chamber and in this place—lecturing us, given the disgraceful state of our NHS and the fact that the biggest cause of five to nine-year-olds going to hospital is to have their rotten teeth removed! I will not be taking any lectures on that from the Conservative party. Of course, I am more than happy to answer the hon. Lady’s detailed questions, many of which I feel I have already answered in my preceding comments. I will not take any more interventions from her because I need to finish shortly.

Our 10-year plan will set out how we deliver these shifts to ensure the NHS is fit for the future. To develop the plan, we must have a meaningful conversation with the public and those who work in the health system. We are going to conduct a range of engagement activities, bringing in views from the public, the health and care workforce, national and local stakeholders, system leaders and parliamentarians. I urge hon. Members from across the House to please get involved in this consultation—the largest in the history of the NHS—at change.nhs.uk. I urge them to make their voices heard in their constituencies, through the deliberative events.

[Vikki Slade]

I have been on to the survey, and it is incredibly limited. It would be helpful if there were a way for the public to be encouraged to introduce more freeform responses.

[Stephen Kinnock]

I am slightly surprised to hear that. The presentation I received on the portal showed there was a clear channel through to having a more discursive engagement with the platform. I will take that feedback away and, through officials, will come back to the hon. Lady on that point.

I thank the hon. Member for Honiton and Sidmouth once again for bringing the issue of dentistry in the south-west to this debate. On 4 July, we inherited a profoundly challenging fiscal position, but I can assure him that we remain committed to tackling the immediate crisis facing NHS dentistry, and that we are taking steps to make delivery more efficient through long-term reform.

To recap, we are committed to providing 700,000 more urgent dental appointments, delivering the golden hello scheme to recruit more dentists in areas of greatest need, bringing in preventive measures to improve our children’s oral health and negotiating long-term contract reforms to make NHS dentistry more attractive. Those steps will help tackle the place-based disparities commonly seen in dentistry, and ensure that everyone who needs to access NHS dentistry can get it, including in the south-west.

Our NHS dentistry is broken after 14 years of Tory neglect and incompetence, but it is not beaten. In 1945, it fell to Clement Attlee’s Labour Government to create a health system for the 20th century. Now, 79 years later, it falls to this Government to clear up the mess we have inherited, to get NHS dentistry back on its feet and to build an NHS dentistry service fit for the 21st century. That is what we shall do.

Children’s Hospices: Funding

Vikki Slade Excerpts

Wednesday 30th October 2024 Westminster Hall

[Vikki Slade (Mid Dorset and North Poole) (LD)]

It is a pleasure to serve under your chairmanship, Mr Twigg. I thank the hon. Member for Liverpool West Derby (Ian Byrne) for securing this debate. Every time I meet a parent whose family is supported by a children’s hospice, I am immensely moved by their resilience. Gemma, whose three-year-old son Finlay has been cared for by Julia’s House for more than two years, wrote an incredible blog about parental mental health, which can be found on the Julia’s House website. In the debate about money, we should never forget that there are not only children whose lives will be shortened, but parents whose capacity to follow their careers and support their wider family is curtailed and siblings whose childhoods will look very different—so-called glass children, who look strong on the outside but are so fragile they could smash to a thousand pieces.

Children’s hospices and other charities that support young carers and siblings, such as MYTIME Young Carers and Mosaic in Dorset, deserve our unwavering support. They should not have to rely on charity shops and crazy challenges to make ends meet—although this crazy MP has agreed to do a crazy challenge for her children’s hospice next year. My local children’s hospice, Julia’s House, is just half a mile from my home on the border of Broadstone and Corfe Mullen and I have visited numerous times since it opened 20 years ago. It has one of the lowest public funding streams across the hospice sector, with only 8% of its funding coming from the NHS. I had no idea that the support it provides for a child in the last six weeks of life is effectively unfunded. I find it shocking that we expect the NHS to fund the birth of our children, but we are relying on charity to fund care at a child’s death.

When I visited Julia’s House on Monday, I was greeted by a nurse clutching her mobile phone. She showed me the rooms that were prepared for a family who were expected to arrive at any time because their child was approaching the end of their life. The mermaid suite, which was built to support a child’s needs both before and after their death, was ready to welcome them. However, I heard that the nurses would need to be available around the clock and would receive no funding from the NHS, despite the fact that hospice care releases intensive care hospital beds. The cost of end of life care was three times the hospice’s usual per-child funding because of the medication and end of life support. The hospice would have to take that money from the respite, sibling support and regular care programmes to make sure that the family could be given the choice they are entitled to under the NHS gold standard.

Annabelle’s family have been through that already. Annabelle had a genetically inherited condition and was a frequent visitor to Julia’s House, where she enjoyed respite stays, made friends, joined the hospice choir and even got to meet a member of her favourite pop band, the Vamps. She passed away earlier this year at the age of just 18, and her family now face the agonising prospect of losing Robbie to the same condition. He is now receiving care at Julia’s House. But it is not just Robbie; another sibling is also receiving care and support through counselling, and both parents benefit from the respite breaks that will ultimately give them a chance of staying together. I dread to think what will happen to such families if hospice services are cut back.

The hospice grant has not been confirmed beyond 2025. It needs to be guaranteed in the long term and cover every child that meets the threshold, right up to the point of their death. In Dorset, seven months into the financial year, the contracts with local health services have not yet been confirmed by NHS Dorset and NHS Bath and North East Somerset, Swindon and Wiltshire. I ask the Minister to write to the ICBs and insist that they passport 100% of the grant to our precious children’s hospices and commit to a sustainable future for our children’s hospices.