Cass Review
Ben Bradshaw Excerpts(5 days, 6 hours ago)
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Victoria Atkins
My hon. Friend’s observations about Members from other parts of the Chamber and their response to this are well made, frankly. [Interruption.] Gosh, I am being told they are not true. Crikey, Opposition Members may have just opened up a Pandora’s box. On my hon. Friend’s point about supporting people who have gone through the process and are trying to detransition, she is absolutely right that they need particular care. I am actively looking into what NHS England needs to provide to look after the very complex needs that such people have.
Mr Ben Bradshaw (Exeter) (Lab)
Has the Secretary of State seen today’s very sad interview with Judge Victoria McCloud, Britain’s only senior transgender judge, who has been driven from her job because of anti-trans hate, particularly the trend among some politicians and opinion formers to describe being transgender as “an ideology”? The Secretary of State has used the term “ideology”, as have a number of her colleagues, during this statement. For the benefit of the House and trans people, will she clarify that she does not believe that being transgender is “an ideology”?
Pharmacy First
Ben Bradshaw Excerpts(2 months, 2 weeks ago)
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Dame Andrea Leadsom
Yes, there will be a significant communications package, beginning today.
Mr Ben Bradshaw (Exeter) (Lab)
The Minister does not appear to be concerned about the record number of community pharmacy closures under this Conservative Government. Why does she think it is happening?
Dame Andrea Leadsom
There has been a 61% increase in registered pharmacists since 2010, with plans to increase that number by 50% in the next few years.
NHS Dentistry
Ben Bradshaw Excerpts(3 months, 1 week ago)
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Wes Streeting
I wholeheartedly agree with my hon. Friend. In fact, he has the ability, as the Labour MP for Stockton North, to speak for his residents. If only other people across the country had MPs standing up for them. Chris Webb, Labour’s candidate in Blackpool South, reported to me that pregnant mothers have been telling him they cannot get an NHS dentist, despite being entitled to free NHS check-ups and treatment. Alice Macdonald, Labour’s candidate in Norwich North, reported similar conversations to me. Expectant mothers have told her that they have been travelling hundreds of miles to see a dentist when we know that pregnant women probably need that support more than many others. What an indictment of 14 years of Conservative Government.
Mr Ben Bradshaw (Exeter) (Lab)
Did my hon. Friend see the report in today’s Times that showed that NHS dentists are performing only 75% of the procedures they are contracted to do? In Devon and Somerset, where the situation is the worst in the country, it is only 26.5% and 30%. Not only have this Government delivered an NHS desert in Devon and Somerset, but they are wasting masses of public money. What is my hon. Friend going to do about it when he is Health Secretary?
Wes Streeting
I strongly agree with my right hon. Friend. Things are so desperate. He mentioned the south-west in particular, and Devon and Cornwall have been particularly poorly served. Jayne Kirkham, Labour’s candidate in Truro and Falmouth for this year’s general election, reported to me that a local dentist handed their contract back before Christmas, meaning that 3,000 people lost their NHS dentist overnight. There are currently no dentists in Truro and Falmouth taking on adult NHS patients. Contract reform is urgent, so where is it? They have had 14 years, so where is the recovery plan that the Health Secretary mentions in her amendment?
Oral Answers to Questions
Ben Bradshaw Excerpts(4 months, 2 weeks ago)
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Dame Andrea Leadsom
I am glad that my hon. Friend has raised this issue. He is absolutely right; in local authorities we need mayors and integrated care boards supporting primary care and not listening to the Opposition, who talk it down the whole time. The 50 million more GP appointments is something to celebrate.
Mr Ben Bradshaw (Exeter) (Lab)
Given that obesity now costs the NHS and our economy much more than smoking, why does the Secretary of State support a total ban on smoking but think that measures to tackle obesity are nannyish?
Dame Andrea Leadsom
The right hon. Gentleman raises a completely artificial barrier. Smoking is totally preventable; it is the cause of one in four cancers and 75,000 deaths. It is unbelievably appalling. Obesity is a complex area and one that the Government are focused on. We need to tackle it, but it is entirely different.
Countess of Chester Hospital Inquiry
Ben Bradshaw Excerpts(7 months, 2 weeks ago)
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Steve Barclay
The key reforms include Getting It Right First Time, the work of Professor Tim Briggs—I raised with him the issue around Chester and the fact that his team have been reviewing that data—the strengthening of the freedom to speak up guardians, the appointment of a new patient safety commissioner, the strengthening of the Public Interest Disclosure Act, the role of child death overview panels and the scrutiny they provide, and the expanded role of medical examiners, which were not in place. So significant actions have been taken, but it is right that through the inquiry we look at the specific issues raised at Chester and any further steps that are appropriate.
Mr Ben Bradshaw (Exeter) (Lab)
When I saw the list of hospitals that the former chief executive of Chester hospital went on to after the Lucy Letby case, I could tell—I speak as a former Health Minister—that it had an eerily familiar ring about it, because failed managers from previous scandals went on to at least some of the same hospitals. Why is the Secretary of State waiting for another review or for the inquiry before finally closing this revolving door and introducing independent regulation for hospital managers similar to that to which medical staff are subjected?
Steve Barclay
Just to reassure the right hon. Gentleman, it is not that we are waiting. Having discussed it with NHS England, not least in last week’s meeting looking at the Kark recommendations that were accepted and why recommendation 5 was not accepted, the view at the time was that the accepted recommendations were sufficient in addressing the concern about the revolving door. It is right that we test that, but it is also right that we get the balance right.
The right hon. Gentleman mentions concerns that certain trusts may be seen as more difficult to manage. We do not want to create an environment where people are unwilling to go to those more difficult trusts because they fear the risk that they carry. It is important that we get the right support for managers, particularly around some of the more difficult trusts to manage, alongside having the accountability. Getting that detail right requires us to work closely with NHS England and the wider NHS family. [Interruption.]
Oral Answers
Ben Bradshaw Excerpts(12 months ago)
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Mr Ben Bradshaw (Exeter) (Lab)
The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)
NHS England does not routinely collect or publish data on waiting times for treatment for gender dysphoria, but I can tell the right hon. Gentleman that as of February this year 28,290 adults were waiting for a first appointment in England.
Mr Bradshaw
Four years on average for an initial appointment, and seven years at the south-west clinic in Exeter. With healthcare for trans people in effect non-existent, the Government planning to remove trans human rights from the Equality Act 2010, breaking their promise to ban conversion therapy and to reform the gender recognition process, and now threatening to force schools to out trans students to their parents, can the Minister see why this tiny and particularly vulnerable minority feels under attack by the Government, and that some who can afford to are even leaving the country for a less hostile environment?
NHS Strikes
Ben Bradshaw Excerpts(1 year, 2 months ago)
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Will Quince
Opposition Members keep saying, “Get round the table and negotiate.” I encourage the next one who says that to tell me exactly where each block of 1%, each £700 million, will come from out of our NHS budget. [Interruption.] They point at me, but I remind the hon. Gentleman that we accepted the independent pay review body’s recommendations in full. We stand ready to look at the independent pay review body’s recommendations for next year, which of course is only two months away, because it starts in April. It is really important that we all engage with that process, so we can get it right and address many of the issues the hon. Gentleman and others raise.
Mr Ben Bradshaw (Exeter) (Lab)
What is the Minister’s estimate of the number of people in England who have had their appointments or operations cancelled today, compared with Wales and Scotland where there are no strikes? Why are the Conservative Government so indifferent to the suffering of patients in England that they refuse to do what the Governments in Scotland and Wales have done, which is to get round and negotiate a settlement?
Will Quince
We do not, as yet, have the details of today’s and tomorrow’s industrial action, but we will certainly be able to publish that information in due course. I can tell the right hon. Gentleman, as I mentioned in my opening response to the urgent question, that over 88,000 appointments have been rescheduled so far and over 58,000 shifts have been missed. Of course I deeply regret that and wish that there was no strike action. [Interruption.] Of course I do.
If we had not accepted in full the independent pay review body’s recommendations, the right hon. Gentleman and others would have an argument to make to say that we had not, but we did accept them in full. We accepted them in full last year, too, despite them being over and above the evidence submitted by the Government in respect of affordability. That is why I look forward to the next independent pay review body process, and why it is so important that the unions and others engage with that process so that we get it right.
NHS Winter Pressures
Ben Bradshaw Excerpts(1 year, 3 months ago)
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Steve Barclay
My right hon. Friend is absolutely right. That is where virtual wards have potential significant benefits in both demand management—avoiding elderly, frail patients coming to emergency departments in the first place—and releasing capacity in hospitals. The virtual ward at Watford General Hospital, equivalent to an additional ward of the hospital, is able to release patients with the comfort of knowing that they are still under supervision. Their medical information is being tracked and monitored and they get a daily phone call from a nurse. They also know that, if they need to come back to the hospital, they can do so much more quickly. That gives patients the comfort and confidence to recover at home, which is often where they want to be. Indeed, patient satisfaction from that trial at Watford was over 90%.
Mr Ben Bradshaw (Exeter) (Lab)
Given that there are currently 165,000 vacancies in social care—a 51% increase in just a year—where will the Secretary of State magic up the people to look after those he wants to put in hotels?
Steve Barclay
The whole purpose of the £500 million is to put more support into local authorities’ funding for social care. About a quarter of that funding is going specifically on workforce interventions, but we are also using other measures. One of the other things we have been doing is boosting workforce recruitment through international recruitment, with care sector staff on the shortage occupation list.
NHS Dentistry: Bristol and the South-west
Ben Bradshaw Excerpts(2 years, 2 months ago)
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Darren Jones
I thank the hon. Member, because it sounds as if his constituents are suffering the same problem as mine. Many have rung eight, nine or 10 NHS service providers, to be told that they could be accepted only as a private fee-paying patient. Going private is simply not an option that many of my constituents can afford. Some have been left with no other choice and others have just not been able to see a dentist at all. Outside of emergency cases, it seems that dentistry in our country has become merely a private healthcare service, with all the unacceptable inequalities that that presents.
Mr Ben Bradshaw (Exeter) (Lab)
In many cases even emergency appointments are simply not available, given the number of people asking for them. The waiting time to get an NHS dentist in Exeter is currently two years. We have thousands and thousands of people in Devon as a whole with no access to an NHS dentist. They cannot afford to go private and they cannot get access, in pain, to emergency treatment. It is an absolute disgrace, and for the last eight years this Government have done nothing about it.
Darren Jones
I agree, and I thank my right hon. Friend for raising the case in Exeter, which seems similar to the many other cases we are hearing about this evening.
When I surveyed my constituents, 79% of those who responded said that they did not feel that they could access a timely dental care appointment when they needed it, while 60% had not had any form of dental treatment during the past year. Twenty five per cent. detailed that they had contacted 11 or more dental practices to try to register for NHS treatment but were unable to do so.
Information compiled by the Association of Dental Groups puts those conclusions in context. The ADG highlights that 43% of patients across Bristol alone were unable to book an appointment when they wanted to do so. That figure increases to over 50% of patients when considering the south-west altogether.
In its 2021 “Great British Oral Health Report”, mydentist found that those in the south-west who have had a dental appointment in the last year lived, on average, over 5 miles away from their closest surgery. More concerningly, those who had not had a dental appointment in the last 12 months were twice as likely than the national average to live over 30 miles away from their closest surgery. That seems to suggest that there is a correlation between someone’s proximity to an NHS dentist and the amount of time that has elapsed since their last appointment, adding geographical inequality to income inequality in the often privatised dental care system—no doubt a levelling-up priority for the Government.
This is a growing problem, with increasing numbers of NHS dentists closing and a shortage of dentists available to do the work. For those familiar with the south-west’s regional news, Thursday’s BBC “Spotlight” reported that the number of NHS dentists practising across the south-west had fallen by more than 200 between 2017 and 2021. Across the country, 45% of patients have been forced to pay for private care due to the closure of a local NHS dentist.
The good news is that there are several actions that the Minister can take to address these issues. First, the Government should consider measures to reverse the decline in the number of dentists offering NHS services. Research from mydentist shows that nearly 1,000 dentists ceased providing NHS treatment in 2020-21, and in response to a survey, 47% of the British Dental Association’s membership said that they were considering reducing the provision of NHS dentistry due to the pressures being faced. I understand that the Government have announced a south-west dental reform programme. I would be grateful if the Minister could provide some detail as to how it could be deployed to increase dentistry numbers.
Secondly, the Government should look again at how they recognise international dentistry qualifications. The overseas registration examination has only 500 places available annually in the UK. The ADG has recommended that part of the examination could be taken in the candidate’s home country as a way of reducing some of the pressures, and that the overall number of places available should be increased. Furthermore, both the ADG and mydentist have recommended that the Government take swift action to reduce the impact that Brexit will have on those who have received their training in the European Union but whose qualifications are not recognised in the UK, and therefore on the number of dentistry providers in the UK. At present, the Government have agreed to recognise dentistry qualifications achieved in the EU until the end of the year, but given that 22% of dentistry care and treatment is provided by dentists from the European economic area, it is vital that certainty about the future is provided to those dentists and their patients as soon as possible. It is ridiculous that Ministers would prevent EU dentists from being able to work in the UK. I would be grateful if the Minister could update the House on that particular issue.
Finally, and most importantly, the Government need to bring forward long overdue reforms to the NHS dental contract, which was established in 2006. Local dentists in Bristol North West have contacted me to highlight their frustration with the current contract, which prevents them from seeing NHS patients when they need to be seen. They have explained that they have been expected to meet higher patient targets due to local closures, despite the need for covid-19 safety measures and without the full payment usually required to see those extra patients. Those pressures are in addition to the backlog from the pandemic, with more than 350,000 dental appointments lost in Bristol alone between April 2020 and November 2021. Reforming the NHS dental contract is vital to solving the underlying issues with access to NHS dentistry, and I would welcome an update from the Minister on the status of that work.
In the round, NHS dentistry is broken and the problems are getting worse. The system works only for those with dental emergencies—and that is if they are lucky—while everyone else is left largely to pay private fees in a private dental system that costs significant sums of money. The closure of so many NHS dentists is adding geographical inequalities to the income inequalities created by the private sector-led dentistry system, and the shortage of dentists in the country is being exacerbated by a failure to recognise European Union dentists and an unwillingness to make it easier to welcome dentists from other countries around the world.
From my experience with Ministers and officials, I get the sense that dentistry in this country is now nothing more than an afterthought, placed in the “too difficult for Government action” box.
Maria Caulfield
I will come on to the contract, which was developed in 2006 under the last Labour Government, and highlight the impact it is still having on dentistry—
Maria Caulfield
This Government are always clearing up the mess of the last Labour Government. I am hoping to have a constructive debate but obviously Opposition Members are not willing to engage in that.
Despite all our efforts to increase services, we know that patients are experiencing difficulty gaining access to dentists. There are a number of options that are helping patients to locate their nearest dentist. Patients can call 111 to find out which dentists are taking on patients. [Interruption.] If Opposition Members are not serious about this and make funny head-in-hands gestures, it is really not helpful.
Maria Caulfield
No, I will not give way. The right hon. Gentleman is obviously not interested in my response.
In Bristol, North Somerset and South Gloucestershire, a dental helpline has been set up to help patients to find an NHS dentist for routine care and to arrange urgent treatment. In addition, we have written to dental practices asking them to update their online information on the nhs.uk website. It is really important that this is available so that patients can find out which dentists are taking on NHS patients and which are not. It is crucial that that is kept up to date because it does change on a significant timescale.
Dentists are also being asked to maintain a short-notice cancellation list so that they can proactively contact patients who are on their waiting list if a patient cancellation occurs. All these measures help with the underlying problem of gaining access to NHS dentists. Later this week, there will be an announcement on some extra funding so that local commissioners will be able to commission services, because in some areas there would be more capacity if extra funding were available. Colleagues across the House will see the details of that in the coming days. My hon. Friend the Member for Thornbury and Yate (Luke Hall) intervened on a similar point. I am happy to meet him to discuss the issue around Frampton Cotterell, as I am happy to meet all Members if they want to raise specific local issues around dentist availability in their constituencies.
To get to the crux of the long-term issues, we hope to get to 100% capacity at some point post the pandemic. However, as mentioned by many colleagues, there is an issue with the dental contract, which has perverse disincentives within the UDA—units of dental activity—system, which dentists struggle with because they are paid similar rates when they are taking out one tooth or doing one filling as compared with doing extensive dental work. This is a disincentive to dentists to take on NHS patients, or sometimes to hand back NHS contracts.
Work has already commenced on dental contract reform. The Department and NHS England are working with key stakeholders, including the British Dental Association, to look at alternative ways of commissioning services, because only when we address the fundamental of the contract that dentists are working on will we get to the crux of the matter of the poor uptake of dental contracts and the reluctance of dentists to take on NHS work. Our aim in contract reform is to improve patient access, reduce health inequalities and make the NHS a more attractive place to work for dentists, making them feel more valued and helping to recruit and, more vitally, retain the experienced dentists who do so much to protect and promote oral health in this country. I am sure that the hon. Member for Bristol North West will welcome that. We are making some building blocks in terms of work that is already happening.
A number of Members touched on the issue of recruitment and retention of dentists. Only in September last year, Health Education England published its “Advancing Dental Care” review report on a four-year programme of work to recruit, retain and train not just dentists but dental teams. We have identified more effective ways of utilising the skills mix in the dental workforce. We are widening access and participation to training, we are allowing more flexible entry routes, including for overseas dentists, and we are developing training places for dental professionals, not just dentists; we want to upskill dental technicians and dental associates by providing them with more skills so they can provide a greater range of services. We are also looking at providing training in areas where we have dental deserts—where we do not have dental provision that local commissioners can commission. Importantly, we know from GP trainees that those who train in an area are more likely to stay in the area. We want to facilitate that. Health Education England is doing a huge amount of work to make that happen.
Vaccination Strategy
Ben Bradshaw Excerpts(2 years, 3 months ago)
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Maggie Throup
I reassure my right hon. Friend that we will not have the restrictions in place for a day longer than necessary. He is aware that the current plan B restrictions will be reviewed on 26 January.
Mr Ben Bradshaw (Exeter) (Lab)
Many hon. Members have constituents whose long-awaited treatments and operations are being cancelled because hospitals are full of the unvaccinated. We in England have one of the most indulgent approaches to the unvaccinated. Why does the Minister not follow the example of New Zealand, Australia and the rest of Europe and do much more to incentivise people to get vaccinated?