Stephen Kinnock MP: speeches 2024

Speeches

• 12 Nov 2024 · NHS Dentistry: South-west · Hansard source

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  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.

• 12 Nov 2024 · NHS Dentistry: South-west · Hansard source

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  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.

• 12 Nov 2024 · NHS Dentistry: South-west · Hansard source

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  As the hon. Gentleman will understand, we are in a sequence: we have the Budget, then the complex negotiations around the spending review. We cannot engage in meaningful, formal discussions and negotiations until we are clear on what exactly the financial envelope is. We are working at pace on that. However, we have been meeting informally to sketch it out, so I would say that the scope of the negotiations is agreed. The formal negotiations will really start only once we have the detailed budget in place. We will listen to the sector and learn from the best practice to improve our workforce and deliver more care. For example, the integrated care boards in the south-west are applying their delegated powers to increase the availability of NHS dentistry across the region through other targeted recruitment and retention activities. That includes work on a regional level to attract new applicants through increased access to postgraduate bursaries, exploring the potential for apprenticeships and supporting international dental graduates. There are two dental schools in the south-west: Bristol Dental School, and Peninsula Dental School in Plymouth. I recently had the pleasure of visiting Bristol Dental School and seeing the excellent work that they are doing there, training the next generation of dental professionals, supporting NHS provision by treating local patients, and reaching underserved populations through outreach programmes. I also know that Peninsula Dental School, which first took on students in 2007, is doing the same for Plymouth and its surrounding areas. I would also like to pay tribute to Patricia Miller of NHS Dorset, Lesley Haig of the Health Sciences University and council leader Millie Earl for working so constructively with my hon. Friend the Member for Bournemouth East (Tom Hayes) on improving oral health in his constituency. A number of hon. Members have rightly highlighted the importance of prevention, and we are working around the clock to end the appalling tooth decay that is blighting our children. We will work with local authorities and the NHS to introduce supervised toothbrushing for three to five-year-olds in our most deprived communities, getting them into healthy habits for life and protecting their teeth from decay. We will set out plans in due course, but it is clear that to maximise our return on investment, we need to be targeting those plans at children in the most disadvantaged communities. In addition to that scheme, the measures that we are taking to reduce sugar consumption will also have a positive effect on improving children’s oral health. Separate from the national schemes, I was pleased to note that NHS Devon integrated care board has committed £900,000 per annum for three years to support further cohorts of children for supervised toothbrushing, fluoride varnish and Open Wide Step Inside, with a new fluoride varnish scheme due to go live in September 2025. Open Wide Step Inside is a local scheme in which a dental outreach team, run by the Peninsula Dental Social Enterprise, goes into schools to deliver 45-minute oral health education lessons across Devon and Cornwall. It is a truly commendable scheme. The steps we take in NHS dentistry will feed into the wider work we are doing to fix our broken NHS. We have committed to three strategic shifts: from hospital to community, from sickness to prevention and from analogue to digital. Our 10-year plan will set out how we deliver those shifts to ensure that the NHS is fit for the future.

• 12 Nov 2024 · NHS Dentistry: South-west · Hansard source

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  It is a real pleasure to serve under your chairship, Mr Vickers. I congratulate the hon. Member for Honiton and Sidmouth (Richard Foord) on securing this very important debate on NHS dentistry in the south-west. My right hon. Friend the Secretary of State has said that this Government will be honest about the problems facing the NHS and equally serious about tackling them. The truth is that we are very far from where we want and need to be. Lord Darzi’s report laid bare the true extent of the challenges facing our health service, including NHS dentistry. Even he, with his years of experience, was shocked by what he discovered. I pay tribute to all the hon. Members from across the House—too many to name in the short time available to me—for helping to highlight and elucidate their concerns. In many ways, those reflected what Lord Darzi set out, but we have also heard today some heartbreaking examples of the experiences our constituents are having. Colleagues across the House have brought those to life today. Lord Darzi’s report is vital because it gives us the frank assessment we needed to face the challenges honestly. Lord Darzi is clear that rescuing NHS dentistry will not happen overnight, but we will not wait to make improvements to the current system, to increase access and to incentivise the workforce to deliver more NHS care. We inherited a broken NHS dentistry system. It is truly shameful and nothing short of Dickensian that the most frequent reason for children of between five and nine years old to be admitted to hospital is to have their rotten teeth removed. That is, frankly, disgraceful. Those are the sort of challenges that we need to face. Some 13 million people in England have an unmet need for NHS dentistry. That is 28% of our country. It is absurd that people cannot access NHS dentistry when each year the budget is underspent—in recent years, that has been to the tune of hundreds of millions of pounds-worth of care going undelivered. That is why we need to reform the dentistry contract. In NHS Devon integrated care board, which includes the constituency of the hon. Member for Honiton and Sidmouth, 34% of adults were seen by an NHS dentist in the 24 months to March 2024, compared with an average of 40% in England. In 2023-24, there were 40 dentists per 100,000 of the population, whereas the national average, across all integrated care boards, was 50 in the same year. We acknowledge that there are areas of the country that are experiencing recruitment and retention issues—including many rural areas, where the challenges in accessing NHS dentistry are exacerbated. As Lord Darzi said, we have enough dentists and dental care professionals at an aggregated national level; the problem is that not enough of them are doing NHS work in the right parts of the country, where they are most needed. The mountain that we have to climb is daunting, but this Government are not daunted and we are working at pace. Take for example the golden hello scheme, which will see up to 240 dentists receiving payments of £20,000 to work in those areas that need them most for three years. ICBs have already started to advertise those posts through that scheme. Nationally, there have been 624 expressions of interest and 292 of those have since been approved. Thirty-eight posts are now being advertised with the incentive payment included. Or take our rescue plan, which will help to get NHS dentistry back on its feet by providing 700,000 additional urgent appointments as rapidly as possible. We know that rescuing NHS dentistry means acknowledging that we need more dentists doing NHS work and we know from survey data that morale among NHS dentists is low. We must turn that around. This Government will do all we can to make NHS dentistry an attractive proposition. Strengthening the workforce is key to our ambitions, but for years the NHS has been facing chronic workforce shortages and we have to be honest that bringing in the staff we need will take time. We are committed to reforming the dentistry contract to make NHS work more attractive, boost retention and deliver a shift to prevention. There are no perfect payment models, and careful consideration needs to be given to any potential changes to the complex dental system, so that we deliver genuine improvements for patients and the profession. We are continuing to work with the British Dental Association and other representatives of the dental sector to deliver our shared ambition to improve access to treatment for NHS dental patients. The Secretary of State met with the BDA on his first day in office, and I engage with it regularly, including at a meeting earlier this month. I share the BDA’s desire for a timeline for negotiations, but we have had to wait for the Budget and the ensuing discussions with the Treasury to initiate and conclude those discussions.

• 5 Nov 2024 · NHS Dentistry: Rural Areas · Hansard source

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  We are working at pace, and I will say more about that shortly. I share my hon. Friend’s reflections on the complete absence of the Conservatives. They made a complete mess of our public services, called an election and ran for the hills. On 4 July, we inherited a broken NHS dentistry system. It is a national scandal that tooth decay is the leading cause of hospital admission for five to nine-year-olds in our country. It is truly shameful and nothing short of Dickensian. In the area served by the NHS Bath and North East Somerset, Swindon and Wiltshire integrated care board, which includes the constituency of the hon. Member for Chippenham, 33% of adults were seen by an NHS dentist in the 24 months up to March 2024. That compares to a 40% average across England. In 2023-24, there were 44 dentists per 100,000 of the population there, whereas the national average was 50. When we look at the problem in the round, it is not so much that we do not have enough dentists, but that not enough of them are doing NHS work, and they are not in the parts of the country that need them most. That challenge is compounded by the fact that some areas of the country are experiencing recruitment and retention issues, including many rural areas, where the challenges in accessing NHS dentistry are exacerbated. That of course includes Chippenham, where Hathaway dental practice has recently had a request granted to reduce its NHS activity, as the hon. Lady pointed out. I understand, thanks to a freedom of information request by the British Dental Association, that the practice had a £4.2 million underspend on its NHS contract. That is precisely the problem that hon. Members have pointed out. There is a quantum of funding, but the way in which it is structured makes private sector dentistry far more attractive than NHS dentistry. That is the root cause of the problem; we are alive to that issue. Overall, it is clear that we have a mountain to climb. It is a daunting challenge, but we are not daunted, and we are working at pace. The golden hello scheme, for example, will see up to 240 dentists receive payment of £20,000 to work for three years in one of the areas that needs them the most. Integrated care boards have already begun to advertise posts, as we have accelerated that process. In the ICB area of the hon. Member for Chippenham, there have been seven expressions of interest, five of which have been approved. Providers can now include incentive payments when they advertise vacant positions. Alongside that, we will deliver a rescue plan that gets NHS dentistry back on its feet. That will start with providing 700,000 additional urgent appointments as rapidly as possible, as set out in our manifesto. Strengthening the workforce is key to our ambitions, but for years the NHS has faced chronic workforce shortages, so we have to be honest about the fact that bringing in the staff we need will take time.

• 5 Nov 2024 · NHS Dentistry: Rural Areas · Hansard source

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  My hon. Friend points to a specific problem set against the backdrop of the general challenge that we face in dentistry, thanks to the legacy of 14 years of Tory incompetence and negligence. We will of course look into it, and if she would care to write to me, I would be happy to look into the issue. The hon. Member for Chippenham is right to raise the problem of NHS dentistry in rural areas—a problem that will, sadly, be familiar to Members across the House. The truth is that we are very far from where we need to be. Lord Darzi’s review laid bare the true extent of the challenges facing our health service, including NHS dentistry, and even he, with all his years of experience, was shocked by what he discovered. His report was vital, because it gave us the frank assessment we need to face the problems honestly and properly. It will take lasting reform and a long-term health plan to save our NHS. Rescuing NHS dentistry will not happen overnight, but we will not wait to make improvements to the system, increase access and incentivise the workforce to deliver more NHS care. The Government have committed to three seismic shifts: from hospital to community, from analogue to digital and from sickness to prevention. Our 10-year plan will set out how we will deliver those shifts to give the country an NHS that is fit for the future.

• 5 Nov 2024 · NHS Dentistry: Rural Areas · Hansard source

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  I have very little time left. We are committed to reforming the dentistry contract to make NHS work more attractive, boost retention, and deliver a shift to prevention. This Government will always make sure that our health and care system has the staff it needs, so that it is there for all of us when we need it. We are already working at pace with the British Dental Association and the dental sector to improve and reform the dental contract. The Secretary of State met the BDA on his first day in office, and I have met it a couple of times, including yesterday. We will listen to the sector and learn from the best practice out there. For example, I know that the ICB of the hon. Member for Chippenham has applied its delegated powers to increase the availability of NHS dentistry across the south-west through other targeted recruitment and retention activities. That includes work on a regional level to attract new applicants through increased access to postgraduate bursaries, exploring the potential for apprenticeships and supporting international dental graduates. In addition, a consultation for a tie-in to NHS dentistry for graduate dentists closed on 18 July, and we are now considering the responses. The Government position on this proposal will be set out in due course. We are also working round the clock to end the appalling tooth decay that is a blight on our children, as I have mentioned. We are working with local authorities and the NHS to introduce supervised tooth brushing for three to five-year-olds in the most deprived communities across the country, getting them into healthy habits for life and protecting their teeth from decay. We will set out plans for that in due course, but it is clear that to maximise return on investment, tooth-brushing programmes must be targeted at children in the most disadvantaged communities. In addition to our supervised tooth-brushing scheme, the measures we are taking to reduce sugar consumption will have a positive effect on children’s oral health. We also know that water fluoridation is a safe and effective measure to reduce tooth decay. It currently covers 6 million people in England, and a decision on expanding that will be made in due course. We find ourselves in an extremely challenging fiscal position, but we remain committed to tackling the immediate crisis, and to fixing NHS dentistry in the long term with dental contract reform. We are committed to: providing 700,000 more urgent dental appointments; the golden hello scheme to recruit more dentists in areas of greatest need; continuing to work with the sector to help find solutions to improve access to NHS dentistry; tackling the disparities that are commonly seen in dentistry; rolling out supervised tooth-brushing for three to five-year-olds in our most deprived communities; making sure everyone who needs a dentist can get one, irrespective of whether they live in a city or in a rural area; and doing the job on long-term dental contract reform, which will take some time. We will clear up the mess we have inherited, we will get NHS dentistry back on its feet, and we will build an NHS dentistry service that is fit for the future. Question put and agreed to.

• 5 Nov 2024 · NHS Dentistry: Rural Areas · Hansard source

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  I start by thanking the hon. Member for Chippenham (Sarah Gibson) for securing this important debate. As my right hon. Friend the Secretary of State has said, we will be honest about the problems and challenges facing our health and care system, and we will be serious about tackling them.

• 31 Oct 2024 · Cancer Strategy for England · Hansard source

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  It is a real pleasure to serve under your chairship, Mr Betts. I thank the hon. Member for Wokingham (Clive Jones) for raising this vital debate about the future of cancer care and the potential merits of a cancer strategy. I am aware of the impressive work he has done on access to primary care on behalf of his constituents in Wokingham and that, as he very movingly set out in his speech, he is a cancer survivor. I welcome and commend his efforts in campaigning for cancer charities. I understand that he has raised a mind-boggling £800,000 for charity, so I pay huge tribute to him. I also thank and pay tribute to every Member who has spoken today. They have spoken with such clarity and passion, and it became clear that many present have personal experiences of cancer, which adds a poignancy to our discussion that makes it even more powerful. Access to cancer care is an important issue for many people, and it is at the heart of this Government’s health mission to build an NHS that is fit for the future and to reduce the number of lives lost to the biggest killers. Our work will focus on three shifts: from hospital to community, from analogue to digital, and from sickness to prevention. On cancer services, I reassure the hon. Member for Wokingham and other hon. Members that the Government are absolutely committed to fighting cancer on all fronts, from prevention to diagnosis, from treatment to research. The NHS can be world-leading on cancer care as part of a wider health system that incorporates innovation and technology. It also benefits from access to world-class research and medicines, and we will look to realise the potential of both. Nearly a third of patients are waiting more than two months for their referral before starting treatment. That is unacceptable, and the Government have made reducing those waiting times a core part of our health mission. Thanks to the hard work of NHS staff, we are now meeting the faster diagnosis standard so that more than 75% of patients get an all-clear or cancer diagnosis in 28 days. However, we know that there is much more to be done. The Chancellor set out yesterday how we will invest in the NHS to deliver 40,000 additional operations, scans and appointments per week as part of our commitment to cut waiting lists, and how we will invest in new radiotherapy machines so that cancer patients have access to the most effective treatment. NHS England is also working to make cancer diagnosis and treatment faster and more efficient through the use of innovative approaches such as teledermatology and faecal immunochemical test kits for risk stratification in bowel cancer. The NHS has made historic strides in cancer care. Ten-year survival has doubled since the early 1970s—but that rate of improvement slowed in the 2010s, and there is still a lot of work to be done. Early diagnosis and innovative treatments are key to enhancing survival rates and quality of life for cancer patients, so we will ensure that the Government and the NHS work hand in hand with life sciences research institutions and industry to drive the development of new treatments and diagnostics. Members of all parties have rightly raised some of the deadliest cancers, including pancreatic and bowel cancers and cancers affecting children and teenagers. We recognise that different tumours have different diagnostic and treatment pathways, and will consider that as part of our cancer strategy. Since taking office, this Government have wasted no time in taking steps to accomplish our vision. Earlier this month, we announced funding for a raft of new UK-created therapies for cancer that will be trialled in the UK. Developing early diagnosis technologies is a key aim of the National Institute for Health and Care Research funding. The potential to find cancers earlier will give patients more choice of treatment and enable us to save lives. We also commissioned an independent investigation of the health service in England, carried out by Lord Darzi. Published in September, Lord Darzi’s report set out in stark terms the profound challenges faced by the health service, and he was honest about the scale of the work that will be needed. He highlighted that people in the UK are more likely to die from cancer than in any other European and English-speaking country, and that improvements to survival rates have slowed. He also pointed to the need to improve waiting times for cancer treatment—particularly curative radiotherapy—and expand access to the most sophisticated treatment options, such as genomic testing. Not enough progress has been made on increasing the number of patients diagnosed at stages 1 and 2—the best way to improve survival. However, Lord Darzi said that there are signs of hope, thanks to the success of initiatives such as the targeted lung health check programme. We are not daunted by the scale of the challenge; we know that we need to roll up our sleeves and get to work. In response to the Darzi report, and as part of our mission to build an NHS fit for the future, we have launched an extensive programme of engagement to develop a 10-year health plan. The plan will set out a bold agenda to deliver on the three big shifts that I outlined earlier. This will be a team effort. We will listen to, and co-design the plan with, the public, the health workforce, charities, academics and other partners. I encourage every parliamentarian, in this Chamber and right across the House, to get involved in this big national conversation—the biggest conversation we have had about our healthcare and care system since the NHS was founded in 1948. Please go to change.nhs.uk and get involved. There will also be approximately 100 deliberative events around the country so that Members and their constituents can get involved in the big conversation, which will lead to the publication of our 10-year plan strategy in spring 2025. Organisations such as Cancer Research UK have been at the forefront of advocating for a robust cancer strategy. Their reports highlight the importance of dedicated cancer strategies in driving efforts and impact towards improving cancer research, diagnosis and care. We have launched the Change NHS online portal to facilitate that national conversation and help develop the 10-year health plan. The journey of developing a plan is as important as the plan itself. We want the public and healthcare staff in England, and all other stakeholders and people who care about the future of our health and care system, to share their views, experiences and ideas. The portal opened on 21 October and will run for several months. To build an NHS fit for the future, we first need to listen. To reduce the number of lives lost to the biggest killers, like cancer, we need to learn from people with lived experience, researchers and our NHS staff. We also recognise the need for leadership by the Government, and my right hon. Friend the Secretary of State has been clear that there needs to be a national cancer plan. We are now in discussions about what form that plan should take and what its relationship to the 10-year health plan and this Government’s wider health mission should be. However, we are clear that we must develop and publish the 10-year health plan in spring 2025, before we can publish a stand-alone cancer strategy. We will provide updates on that in due course. The sequencing is important; it is best to set the strategic framework through the 10-year plan, and then a stand-alone cancer plan will flow from that. I have absolutely heard the message about the need for a cancer strategy loud and clear from hon. Members, and I will convey it to my ministerial colleagues and to officials. I thank the hon. Member for Wokingham for bringing this important matter to the House, and once again I thank all hon. Members who contributed. I also thank the hon. Member for Runnymede and Weybridge (Dr Spencer) for the constructive way in which he has engaged in this debate. He asked me a vast range of questions. It is probably better, in the short time that I have available, to say that I will write to him so that I can respond in the detail that is required, which I do not think I can today. I am pleased to assure hon. Members that rebuilding our NHS and delivering world-class cancer services for every person remains a top priority for this Government. We have wasted no time in taking action, announcing funding that will make innovative treatments accessible to cancer patients. We have published an independent investigation of the health service in England, which has highlighted the challenges that cancer patients face and the scale of the work needed. With input from members of the public, researchers and NHS staff, we are now developing a plan to make the health service fit for the future and to reduce the lives lost to the biggest killers, including cancer. The foundation of the NHS was, of course, one of the proudest achievements of the Labour Government of 1945 to 1951. We created a service that was right for the 20th century at that time. It now falls to the Labour Administration of 2024 to shape a health and care service that is fit for the 21st century, so let us work together to get our health and care service back on its feet and ready to tackle the scourge of cancer.

• 30 Oct 2024 · Children’s Hospices: Funding · Hansard source

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  It is a pleasure to serve under your chairmanship, Mr Twigg. I thank my hon. Friend the Member for Liverpool West Derby (Ian Byrne) for securing this vital debate. I know that this sector—this community—is very close to his heart. I thank him for all his work to support it and raise awareness of the issue generally, and in particular for the heroic work he has been doing for Zoe’s Place. I know Zoe’s Place faces an uncertain future, but I also know that my hon. Friend is spearheading its fundraising campaign and has been part of the discussions with its trustees and builders about securing a new site for the hospice to ensure it has a long-term future. I am very much aware of the work that the Liverpool-based Home Bargains is doing, particularly in pledging an incredible £2.5 million towards the campaign. I wish my hon. Friend and the hospice every success in those vital endeavours, and I pay tribute to Home Bargains for its outstanding community spirit. I thank the many hon. Members who have attended this important debate and contributed so powerfully to it. We have heard some really excellent contributions. Hon. Members have shown how important this issue is to the House. I thank all the people who work in children’s palliative and end of life care, including in hospices throughout the country, which provide vital care and support to those who need it. We all recognise the importance of palliative and end of life care services, including hospices, which provide personalised care and support at the most difficult times for children and young people with complex needs, and their families and carers. It is estimated that there are more than 86,000 children and young people with life-limiting conditions in the UK, but it is predicted that, as we continue to make medical advances, that number will increase. Palliative and end of life care for children with life-limiting conditions is provided by a broad range of organisations and professionals across multiple settings, including primary care, community care, hospitals, hospices, educational settings and children’s own homes. This system-wide approach to providing palliative and end of life care should be sufficient to ensure that the local offer to patients is personalised, of high quality and sustainable. The majority of palliative and end of life care is provided by NHS staff and services, but we recognise the essential part that voluntary sector organisations, including hospices, play in providing support to people at the end of life and their loved ones. Children’s hospices are a vital part of that system-wide approach, because they provide a wide range of health and care support to meet the physical, emotional, social and, indeed, spiritual needs of children, young people and their loved ones. Care is often provided by a multi-disciplinary team, and often in collaboration with statutory services, to ensure that the entire family is supported. The support provided by hospices can include practical advice and information; short breaks or respite; specialist therapies such as physiotherapy, art therapy or play therapy; 24/7 end of life care; and bereavement support. Short breaks are a key part of a range of provisions that support disabled children and their families. They can include the provision of day, overnight and weekend activities for children and young people, and can take place in the child or young person’s own home, the home of an approved carer, or a residential or community setting. Local authorities have a statutory duty to assess the social care needs of disabled children and young people, and to provide respite care where necessary. Where it is appropriate, local authorities can fund respite care provided by hospices, either as a short-term stay or as a service that the hospice team provide to the child or young person in the family home. Local authorities and ICBs regularly liaise to plan and commission the most appropriate package of respite care for children and young people with life-limiting or life-threatening conditions in their area. The Government do not monitor the use of social care for children with palliative and end of life care needs, but local authorities are required to publish a local short breaks duty statement, which shows what services are available, how they respond to the needs of local carers and how they can be accessed, including any eligibility criteria. Local authorities must consider the needs of local parents and carers when preparing their statements, and they must review them regularly. Palliative care services are included in the list of services that an integrated care board must commission. That promotes a more consistent national approach and supports commissioners to prioritise palliative and end of life care locally. To support ICBs in that duty, NHS England has published statutory guidance and service specifications, which include specific reference to ensuring that there is sufficient provision of specialist palliative care services and hospice beds, as well as future financial sustainability. Most hospices are independent charitable organisations that receive some statutory funding from the NHS.

• 30 Oct 2024 · Children’s Hospices: Funding · Hansard source

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  The right hon. Lady is absolutely right: funding that is earmarked for palliative care must go to palliative care. There is statutory guidance from the NHS, and it is vital that we continue to liaise with ICBs from the centre, to ensure that the allocated funding goes where it needs to go. If she is aware of cases in which that funding is not going where it should go, she should make representations; I am happy to receive a letter from her on the issue. The amount of funding that each charitable hospice receives varies both within and between ICB areas. That funding will vary depending on demand in an ICB area, but will also depend on the totality and type of palliative and end of life care provision from both NHS and non-NHS services, including charitable hospices, in each ICB area. There are inequalities in access to hospice services, especially for those living in rural or socio- economically deprived areas. That is why including hospices as part of a system-wide approach is so important. I understand that charitable hospices value their independence and autonomy, which allow them the freedom to provide services beyond the statutory offer, which is one of the wonderful parts of hospice care. That independence also gives a sense of shared purpose, in which the community cares for the hospice, and in turn the hospice cares for the community and is something to be cherished. That is indicative of the compassion that is found in hospices and communities all over the country. In addition to ICB funding, at a national level, NHS England has supported palliative and end of life care for children and young people through the children and young people’s hospice grant, totalling £25 million in ’23-24. While ’23-24 marked the final year of the grant in its previous format, in ’24-25 NHS England continued to provide £25 million of funding for children and young people’s hospices. A prevalence-based model is used for that funding, which supports the move away from a traditional model of bed-based funding, better reflecting population needs. In ’24-25, that funding was transacted by ICBs on behalf of NHS England for the first time, rather than being centrally administered. I am aware that the shift to an ICB-transacted model for ’24-25 has not been as smooth a transition as we in the Department certainly would have hoped. We are working closely with NHS England to resolve any remaining issues with the ’24-25 funding, and to learn from what did not work so well this year. We, alongside NHS England, absolutely recognise the importance of sustainable funding for the palliative and end of life care sector, including hospices, and we will consider the future of children’s hospice funding in the context of Budget discussions. I have absolutely heard the representations by hon. Members on both sides of the Chamber today about the need for the Government to maintain the £25-million grant, and I assure hon. Members that I am working very closely with NHS England to get that confirmed as a matter of urgency.

• 30 Oct 2024 · Children’s Hospices: Funding · Hansard source

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  We are certainly looking at all those issues in the round, including ensuring that the grant is sustainable and that there is a real-terms financial input to the system. We are working on that as a matter of urgency. I totally recognise and understand why the sector needs certainty and stability; it is very difficult for hospices not to be sure what is happening after this in-year position. The 2010s were a lost decade for our health and care services, which now too often are not there when we need them. That is also true for hospice care, where we see a postcode lottery for services across the country and variation in quality and access. Hon. Members will know that we have committed to developing a 10-year plan to deliver an NHS and care system that is fit for the future, by driving three shifts in the way that care and health services are delivered. We will be carefully considering policies, including those that impact children with palliative and end of life care needs, with input from the public, patients, health staff and our stakeholders as we develop the plan over the coming months. That engagement process was formally launched last week, and I strongly encourage the sector, including hospice providers, service providers and their families, and indeed every parliamentarian in this Chamber, to engage with that process: please go on to change.nhs.uk and make your voice heard. That will allow us to fully understand what is not working as well as it should, what the solutions are, and where the opportunities are for the future. One of the three strategic shifts that our 10-year health plan will deliver is the Government’s determination to shift more healthcare out of hospitals and into the community. Community health teams play a vital role in supporting children and young people with complex health and care needs to live as well as possible, providing proactive care and preventing exacerbations and hospital admissions where possible. That shift from hospital to community includes our commitment to roll out neighbourhood health services to ensure that patients and their families receive personalised care in the most appropriate setting in their community, and indeed as close as possible to home. Palliative and end of life care services, including hospices, will have a major role to play in the fundamental shift from hospital to community, and in shaping that shift. Additionally, the Department, through the National Institute for Health and Care Research, is investing £3 million in a new policy research unit in palliative and end of life care. That unit launched in January 2024 and will build the evidence base on all-age palliative and end of life care, with a specific focus on inequalities. In closing, I thank once again the hon. Member for Liverpool West Derby for securing this vital debate on children’s hospice funding. I again express my heartfelt thanks to all those who support children, young people and their loved ones when they need them most.

• 29 Oct 2024 · World Stroke Day · Hansard source

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  I thank the hon. Lady for that telling intervention. She is absolutely right: so much of the challenge and the opportunity before us is about how we use traditional media, social media, all forms of communication and awareness-raising campaigns and techniques. By definition, we are dealing with a situation in which speed is of the essence. It is truly a public health challenge, because it is only the public who can do what Will did in that circumstance. I certainly pay tribute to Will for acting so quickly and to the Act FAST campaign. I am sure Members will welcome that we are looking to build on the success of Act FAST and to replicate and renew it. That campaign will run in England across TV, radio, social media, national press and ethnic minority TV and radio stations. The campaign includes specific communications for multicultural and disabled audiences. A higher reduction in mortality rates over the next 10 years will require a focus on NHS England stroke priorities, including rapid diagnosis and increasing access to time-dependent specialist acute stroke care. We know that so many deadly diseases can be avoided if we seek help in enough time. That is why we are working to improve access to treatments. Current targets include increasing thrombectomy rates to 10% and thrombolysis rates to 20% through facilitating ambulance service use of pre-hospital video triage and use of AI decision support tools for brain imaging in comprehensive stroke centres. I know that my hon. Friend the Member for Mid Cheshire (Andrew Cooper) has a keen interest in that issue.

• 29 Oct 2024 · World Stroke Day · Hansard source

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  I am a little wary of generalising too much, because I know that so many decisions have to be made in real time by our skilled ambulance drivers and paramedics and the many others involved, but my hon. Friend makes a valid point. In a general sense, he is absolutely right that stroke needs to take priority. The red thread going through this entire debate is the need for speed. It is all about prioritising and acting quickly; he is absolutely right about that. In the past year, we have seen a 30% increase in the number of thrombectomies delivered in England. Alongside that, our 20 integrated stroke delivery networks are looking to optimise care pathways. The General Medical Council is addressing critical workforce gaps through its thrombectomy credentialling programme, and our national optimal stroke imaging pathway is improving information sharing. I am aware of the reconfiguration in the constituency of the hon. Member for Glastonbury and Somerton. NHS Somerset integrated care board has decided to close the hyper-acute stroke unit at Yeovil hospital and to establish a single hyper-acute stroke unit at Musgrove Park hospital in Taunton to provide 24/7 emergency treatment. All service changes should be based on clear evidence that they will deliver better outcomes for patients. A high bar is set out in guidance for intervening in contested reconfiguration cases, and the reconfiguration of services should be a matter for the local NHS. I would expect all avenues of local resolution to have been exhausted before a call-in request is made. The Department has received a formal request to call in NHS Somerset ICB’s decision, and Ministers will make a decision on whether to use their call-in powers in due course. Unfortunately, there is still significant variation across the country in access and outcomes in relation to stroke. For example, the percentage of suspected stroke patients who received the necessary brain scan within an hour of arrival at hospital varies from 80% in Kent to only around 40% in Shropshire. That variation needs to change, and we need to bring the best of the NHS to the rest of the NHS. That will be one of the central challenges for the Government going forward. The Government have a profound ambition to improve the lives and health outcomes of people who survive a stroke. At this point, I would like to pay tribute to my hon. Friend the Member for Stratford and Bow (Uma Kumaran) and to the man in the Public Gallery for what they have been through and for their fortitude. It was certainly not easy for my hon. Friend to come to this place and to have to go through the extremely difficult situation that she did. I also pay tribute to all the key partners and stakeholders who worked with her and her family to get through it. That really is a tribute to the immensely important work they do.

• 29 Oct 2024 · World Stroke Day · Hansard source

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  I can say a word about our national service model for an integrated community stroke service, which involves a number of specific projects aimed at improving delivery of psychological rehabilitation. The ICSS model is vital to support psychological recovery, return to work and improved quality of life, and I would be more than happy to discuss it further with my hon. Friend. Before I close, I want to recognise the remarkable work of the charities that help people across the country to rebuild their lives after a stroke. Once again, I thank the hon. Member for Glastonbury and Somerton for this important debate, and I encourage every Member of the House to go to change.nhs.uk and to get involved in the biggest conversation about our health and care service since its foundation in 1948. Question put and agreed to.

• 29 Oct 2024 · World Stroke Day · Hansard source

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  I congratulate the hon. Member for Glastonbury and Somerton (Sarah Dyke) on securing a debate on this vitally important issue. It is important not only for her constituents but for her personally, I think, given her family circumstances; I know she really spoke from the heart and we appreciate that. Good health should be fundamental to all of our lives, but sadly that is not the case for too many people. Over 100,000 people have a stroke in the UK every year—one person every five minutes. One third of them will be left with some form of long-term disability. As the fourth largest cause of death for adults, stroke has a devastating impact on individuals, their families and wider communities across our country. For decades the NHS has served us well, and it is one of the proudest achievements of the Labour party that we were at the foundation of our NHS. Our staff have tremendous expertise and dedication; they are working hard every day to make a difference. But we have to face up to the reality that we have had 14 years of neglect and incompetence on the part of the Conservative party. We are now facing a very significant set of challenges in looking to get our health and care system back on its feet and fit for the future. That is the important context for this debate. I am very grateful to the hon. Member for Glastonbury and Somerton for giving me the opportunity to inform her and the House of the work that the Government have been doing since we came into office on 4 July, and particularly as today is World Stroke Day. The House will have seen that we have set out the three transformative shifts that we want to deliver in health and care, moving from care in hospitals to care at home, prioritising prevention over treatment, and advancing from analogue to digital solutions. These three strategic shifts will be the building blocks of our health mission, reducing time spent in poor health, tackling health inequalities and reducing lives lost from the biggest killers, which include cardiovascular disease. We have to change the NHS so that it is no longer just a sickness service but a prevention service too. Prevention is always better and cheaper than cure. So we have to take preventive public health measures to tackle the biggest killers and support people to live longer, healthier lives. That is why in our health mission to build an NHS that is fit for the future, we have committed to reducing deaths from heart disease and strokes by one quarter within 10 years. The NHS health check, England’s flagship cardiovascular disease prevention programme, aims to prevent heart disease, stroke, diabetes, kidney disease and some forms of dementia. Each year the programme engages over 1.3 million people and, through behavioural and clinical interventions, prevents around 500 heart attacks or strokes. To improve access to and engagement with this life-saving programme, we are developing a new digital NHS health check, which will be ready for testing in early 2025. It will enable people to undertake a check at home. We are also trialling more than 130,000 life-saving heart health checks in the workplace. These checks can be completed quickly and easily by people at work so that they can understand and act on their cardiovascular risk and reduce their future risk of a stroke. Around 50% of heart attacks and strokes are associated with high blood pressure. Community pharmacies are providing a free blood pressure check service for anyone over the age of 40. In cases where this results in a high reading, pharmacists can make sure people receive the right NHS support to reduce their blood pressure. We know that there is more to do to prevent the causes of stroke, and the Department and NHS England are working together to tackle this issue. I am also pleased to announce that on Monday 4 November NHS England is launching a new Act FAST campaign to increase knowledge of the main signs of a stroke and to encourage people to dial 999 immediately in response to any sign. The new campaign builds on the success of the previous Act FAST campaign and uses a revised call to action: “Face or arm or speech, at the first sign, it’s time to call 999”.

• 16 Oct 2024 · Access to Primary Healthcare · Hansard source

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  As the Darzi review shows, one of the most egregious examples of the neglect and incompetence of the past 14 years is the underspend on capital. We are clear that a number of premises across the country can be repurposed, and that the bureaucracy needs to be cleared out of its way. As the Prime Minister said earlier this week, we will have a mission about smart regulation and clearing the bureaucratic barriers to change. We are also cutting red tape so that GPs spend less time pushing paper and more time face-to-face with the patients they serve. We are working to bring back the family doctors and to end the 8 am scramble. We have done more for primary care in the last 14 weeks than that lot did in the last 14 years. On dentistry, we will introduce supervised tooth brushing for three to five-year-olds in deprived areas, ending the national scandal of tooth decay. And we are rebuilding the bridges that the Conservatives burned with the British Dental Association. I have already met the BDA, and we will deliver a rescue plan that gets NHS dentistry back on its feet, with 700,000 additional urgent appointments, starting as soon as possible, in those parts of our country that need them most.

• 16 Oct 2024 · Access to Primary Healthcare · Hansard source

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  This really has been a vibrant and powerful debate. I thank the Liberal Democrats for using their Opposition day constructively to shine a searing spotlight on the challenges that our constituents face. Hon. Members made a series of outstanding contributions, but I thank in particular my hon. Friends the Members for Aylesbury (Laura Kyrke-Smith), for Bury North (Mr Frith), for Calder Valley (Josh Fenton-Glynn), for Ealing Southall (Deirdre Costigan), for Welwyn Hatfield (Andrew Lewin), for Croydon East (Natasha Irons), for Lichfield (Dave Robertson), for Norwich North (Alice Macdonald), for Worthing West (Dr Cooper), for Uxbridge and South Ruislip (Danny Beales), for Thurrock (Jen Craft), for Gloucester (Alex McIntyre), for Bury St Edmunds and Stowmarket (Peter Prinsley), for Blackpool South (Chris Webb) and for Hexham (Joe Morris) for demonstrating why our party always has been, and always will be, the champion of the NHS. I also congratulate the hon. Members for North Devon (Ian Roome), for Newton Abbot (Martin Wrigley) and for Harrogate and Knaresborough (Tom Gordon) on their excellent maiden speeches. It is quite shocking to note, however, that in spite of the vital importance of this debate to our constituents, there was not a single contribution from the Conservative Back Benches. [Hon. Members: “Shame!”] Not only do the Conservatives refuse to apologise for the last 14 years, but they have run for the hills. Their silence truly speaks volumes. Labour Members deal with facts and the unvarnished truth. On the subject of today’s debate, the list of facts illustrating the appalling neglect and incompetence of the last 14 years is truly as long as my arm. If I were to pick out just one statistic to summarise the last 14 years, I might choose that the most common reason for children aged five to nine being admitted to hospital is tooth decay. It is a truly Dickensian state of affairs. I could also point to the UK’s decreasing GP numbers, as there are 1,500 fewer compared with seven years ago, against the backdrop of a rising population. Or I could pick the collapse in patient satisfaction from 80% in 2009 to a shocking 35% last year. Or I could single out the fact that more than 1,000 pharmacies have shut their doors since 2017, and that almost six pharmacies a week have left the market in the last year. The charge sheet is so long that a month of debates in this Chamber could not cover the profound damage that has been done by 14 years of short-termism and sticking-plaster politics, and by the botched top-down reorganisation in 2012. The reality is that the Tories doused the house in petrol and covid lit the match.

• 16 Oct 2024 · Access to Primary Healthcare · Hansard source

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  Should’ve gone to Specsavers! [ Laughter. ]

• 16 Oct 2024 · Access to Primary Healthcare · Hansard source

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  I thank my hon. Friend for her intervention. I pay tribute to my right hon. Friend the Secretary of State for getting the strikes sorted within a week of us taking power—what a change that has made. We will reform the dentistry contract to make NHS work more attractive, boost retention and deliver a shift to prevention. On pharmacies, as my hon. Friend the Member for Bristol South (Karin Smyth) made clear, we will shift the focus of our NHS out of hospital and into the community, empowering more pharmacists to prescribe independently, and freeing up GP appointments for those who need them most. That shift from hospital to community is vital for demand management in the primary and acute sectors. On the whole, this has been an excellent debate, but I find it absolutely extraordinary that not a single word of humility or contrition was uttered by the official Opposition. Where was the apology for the fact that they spent 14 years bringing our NHS to its knees? Where was the mea culpa for the way in which they spent 14 years scapegoating the workforce, dodging the tough questions and passing the buck? Where was the acknowledgment of the fact that they called the election and ran away from their £22 billion black hole and from the multiple crises in our public services? While the Conservative party continues to live in a parallel universe, we on the Government Benches are living in the real world. We are honest about the scale of the challenge, and we are up for the fight. While the mountain before us is daunting, we are not daunted. Instead, we are focused on the future, reform and rebuilding, and on shifting from hospital to community, from sickness to prevention, and from analogue to digital. Let us roll up our sleeves and get to work. Question put (Standing Order No. 31(2)), That the original words stand part of the Question.

• 16 Oct 2024 · Access to Primary Healthcare · Hansard source

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  My hon. Friend is absolutely right. This strategic shift from hospitals into the community will be vital and central to our 10-year plan for the future of our health and care system. Primary care is the NHS’s front door, but the Tories spent 14 years bricking it over. Now it is walled off to millions of people across our country, so it falls to this Labour Government to tear down that wall. We know that there is not a second to waste, not least on mental health. It is unacceptable that so many children, young people and adults are not receiving the mental health care they need. We know that waits for mental health services are far too long, and we are determined to change that. We will recruit 8,500 additional mental health workers across child and adult mental health services, we will introduce a specialist mental health professional in every school, and we will roll out Young Futures hubs in every community. We will reopen the front door to the NHS by rebuilding general practice on the firm foundations it needs to get the service back on its feet and fit for the future.

• 15 Oct 2024 · Topical Questions · Hansard source

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  By cutting mental health waiting lists and intervening earlier, we can get this country back to health and back to work. There are 2.9 million people who are economically inactive, a large proportion owing to mental health issues. Many people can be helped back into work through talking therapies. We will put a mental health professional in every school and roll out 8,500 specialists. I would be happy to meet my hon. Friend to discuss the matter further.

• 15 Oct 2024 · Topical Questions · Hansard source

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  Obviously, health is a devolved matter and funding for pharmacies in Wales is the responsibility of the Welsh Government. Nevertheless, I pay tribute to the Welsh Government for securing a deal with pharmacies in Wales in line with DDRB—the review body on doctors’ and dentists’ remuneration—pay recommendations. I know that arrangements in England affect matters in Wales and I am working as a matter of urgency to conclude the consultation on the community pharmacy contractual framework.

• 15 Oct 2024 · Adult Social Care · Hansard source

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  It beggars belief that Opposition Members should lecture us on fiscal discipline when there is a £22 billion in-year black hole. We are committed to consulting widely on the design of a fair pay agreement, and we will engage with all who may be affected. We are keen to ensure that all voices are heard so that the financial impacts on the adult social care market, local government and self-funders can be considered, but in a week in which this Government have attracted £63 billion of investment and just days after the publication of the Employment Rights Bill, we are seeing a Government who are pro-business, pro-worker and pro-growth.

• 15 Oct 2024 · Adult Social Care · Hansard source

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  After 14 years of Tory neglect and incompetence, adult social care is on its knees. The number of people receiving long-term care decreased between 2015 and 2023, and there were a staggering 130,000 staff vacancies in the system. Last Thursday, recognising the central role of our amazing care workforce, we took a critical first step by introducing the groundbreaking legislation that will establish the first ever fair pay agreement for care professionals. I think it fair to say that this Government have done more for our adult social care workers in 14 weeks than the last lot did in 14 years.