NHS Dentistry: Recovery and Reform

Diana Johnson Excerpts

Wednesday 7th February 2024 Commons Chamber

[Victoria Atkins]

I have no doubt that with my hon. Friend’s characteristic joy and as an irresistible force of nature, she herself will be an advert for dentists to come to work in her constituency.

[Dame Diana Johnson (Kingston upon Hull North) (Lab)]

A constituent recently told me that when she tried to register members of her family with an NHS dentist, she was told that there was an eight-year wait. We know that workforce is a really big issue. On that basis, will the Secretary of State meet me and a cross-party group of Members of Parliament to talk about how we could develop a dental school at the site of the excellent Hull York Medical School to grow our own dentists for the future?

[Victoria Atkins]

The right hon. Lady will know that part of the focus of the long-term workforce plan is to train people where they are most needed. I will happily arrange for her to meet the relevant Minister. On registration, the current system is not like a GP practice where, once a family is registered, they can only go to that GP. The whole reason that we have been encouraging dentists to update their details on the NHS website is so that people can move around to visit different dentists to get the treatment they need. Today’s plan will help turbocharge those efforts.

Pharmacy First

Diana Johnson Excerpts

Wednesday 31st January 2024 Commons Chamber

[Dame Andrea Leadsom]

My hon. Friend is absolutely right. Investing in technology is vital, but so is investing in the workforce. We have seen a 61% increase in the number of registered community pharmacists since 2010, and we aim in our long-term NHS workforce plan to increase that by a further 50%. We have already increased the number of training places for both pharmacists and pharmacy technicians.

[Dame Diana Johnson (Kingston upon Hull North) (Lab)]

I, too, welcome Pharmacy First, which I think is a very good initiative. In recent weeks we have seen the closure of two pharmacies in my area, on Beverley Road and Chanterlands Avenue. I am also told by leaders in the Humber pharmacy community that our area has one of the largest numbers of temporary closures because of problems accessing pharmacists. Will the Minister look favourably, therefore, on my idea to attach a school of pharmacy to Hull York Medical School? We need a school of dentistry, too. If we could have a centre of excellence in the Humber area, it might solve some of our specific workforce problems.

[Dame Andrea Leadsom]

I am always happy to speak to colleagues on both sides of the House about their ideas for new dental and pharmacy schools. It is an ongoing interest.

England is, in fact, blessed with huge numbers of community pharmacies—well over 10,000—and four in five of us are able to walk to a community pharmacy within 20 minutes. The number of pharmacies in more deprived areas is double the number in more well-off areas. We are very well served by our brilliant pharmacies, and I hope the Pharmacy First programme will improve their footfall and their value in each of our communities.

NHS Winter Update

Diana Johnson Excerpts

Monday 8th January 2024 Commons Chamber

[Victoria Atkins]

I thank my right hon. Friend for her work in the Department. She knows only too well the difference an inspirational leader can make to a local NHS trust, and at regional or national level. Managers who are good and committed to their local area, who work with their clinicians and other healthcare staff to try to look after patients all year round, have been put under the most enormous pressure over the last few weeks because of the strikes. I thank every single one of them for doing what they can to safeguard patient safety. As I say, I trust their judgment. If they have put patient safety mitigations in, it is because they consider, in their professional judgment, that they are needed.

[Dame Diana Johnson (Kingston upon Hull North) (Lab)]

The public health director in Hull published her report recently. She talked about the double jeopardy that my constituents face: from the most disadvantaged communities, they have shorter lives in far poorer health. At the end of last year in A&E, patients were less likely to be treated within the four-hour target than anywhere else in England. Why is that after 14 years of a Conservative Government who are committed, apparently, to levelling up?

[Victoria Atkins]

I am extremely grateful to the right hon. Lady, who will know that our constituencies, albeit not necessarily in the same region, nevertheless share similarities, being relatively close to each other. The work and the progress made on urgent and emergency care is precisely because we were concerned about, for example, ambulance response times and hospital discharges. We worked with NHSE to bring together the urgent and emergency care plan and, for example, bring about 800 new ambulances on to our roads and about 5,000 more core beds into the NHS to try to address those needs. Unfortunately, the strike action that we have seen over recent days has very much militated against those efforts. We all accept that winter is a very difficult time for the NHS, and through the urgent and emergency care plan we have worked with NHSE to try to meet the demands that she so rightly puts forward.

Countess of Chester Hospital Inquiry

Diana Johnson Excerpts

Monday 4th September 2023 Commons Chamber

[Steve Barclay]

I absolutely agree with my hon. Friend’s sentiment in putting families and their wishes central. I hope he will understand that as part of an independent inquiry, it will be for the judge to decide which hearings are held in public and which are in private. In essence, part of the initial discussion on a non-statutory inquiry and my discussion with the families was about balancing privacy concerns versus the more adversarial and public nature of a statutory enquiry. I know that Justice Thirlwall will be sensitive to the families’ wishes and what is the appropriate balance between hearings held in public and those held in private.

[Dame Diana Johnson (Kingston upon Hull North) (Lab)]

After all that has happened, it was surely a mistake not to implement recommendation 5 of the Kark review. Why does the Secretary of State not just get on with it and bring it in to disbar senior managers in the NHS?

[Steve Barclay]

The Kark recommendations that were accepted, which cover events since those covered at Chester, are believed to have addressed the concerns about the revolving door, but given the issues that have come to light through the case in Chester, I have asked NHSE colleagues to revisit that decision without waiting for the inquiry to look at that. Of course, the inquiry will also look at what is the right balance of regulation for managers.

Recovering Access to Primary Care

Diana Johnson Excerpts

Tuesday 9th May 2023 Commons Chamber

[Steve Barclay]

My hon. Friend is right about the opportunity that tech offers to deliver changes at scale and the fact that this is proven technology that is working and already up and running in many primary care settings. So often within the NHS the challenge is not the initial innovation—we get pockets of wonderful innovation—but how we industrialise it across the wider NHS. This recovery plan focuses on that, looking at how we scale the case studies to which he refers. About half of primary care does have digital telephony. The opportunity here is to target that funding at the other half; that is often the smaller GP practices, as well as those in coastal communities, because they find the transition to tech more difficult. That is why a key part of this recovery plan is about the investment in not just the tech, but in locums, to provide cover so that staff can make the transition to that new way of working.

[Dame Diana Johnson (Kingston upon Hull North) (Lab)]

The NHS workforce plan has been promised for years. Meanwhile, as my hon. Friend the Member for Kingston upon Hull West and Hessle (Emma Hardy) says, we are short of GPs, pharmacists and dentists in Hull. Will the Secretary of State answer the question she put to him: can we please build on the excellent work of the Hull York Medical School to set up a dental training school there, and a school of pharmacy and one for ophthalmologists? That would help in the longer term, but we need a proper workforce plan and the Government need to get on with it.

[Steve Barclay]

As I have said several times, we will publish a workforce plan shortly. We are committed to that and the Chancellor set that out in the autumn statement. Of course, when he was doing this job and when I was previously in the Department, we expanded medical undergraduate places by a fifth, so there was an increase then. I have said that we will also set out a dental recovery plan in due course.

Reforms to NHS Dentistry

Diana Johnson Excerpts

Thursday 27th April 2023 Commons Chamber

[Dame Diana Johnson (Kingston upon Hull North) (Lab)]

I congratulate my hon. Friend the Member for Bradford South (Judith Cummins) and the hon. Member for Waveney (Peter Aldous) on their persistence. Let us hope it starts to pay off and they do not need that fourth debate on the subject.

As my hon. Friend the Member for Bradford South has said, NHS dentistry is in crisis. There is a recruitment and retention crisis, which the Government have allowed to develop and grow to the point that many of my constituents in Hull North have been left with no access to an NHS dentist. We all know what needs to be done to fix the problem, but the Government have continued to drag their feet over the need for a new dental contract, for new dental schools and for expanding the number of dentists that we have in this country. It is almost like they have hoped that those who can afford to do so will go private, and those who cannot will just sit and let their teeth rot.

Right now, people in Hull North are paying for the Government’s time wasting with their dental health. One constituent has told me of waiting lists at a local NHS dentist of more than 1,500 people, and another has tried to call every NHS dentist within 30 miles, but the earliest appointment they have available is January 2025. A concerned parent tells me that their 11-year-old has not seen a dentist since they were six years of age, and their four-year-old has never seen a dentist, despite being on several waiting lists across Hull since they were a baby. I have had headteachers tell me that children do not go to school because of dental pain and being unable to get access to a dentist.

In Yorkshire and the Humber, as my hon. Friend referred to, in the year ending 2022, 4,560 children under the age of 10 were hospitalised for tooth extractions. That shocking figure includes more than 1,500 babies and toddlers under five with cavities so bad that they have had to have their teeth removed. The situation is shocking and considerably worse in Yorkshire, the Humber and the north-east than elsewhere in England.

What we need are more NHS dentists. We need to recruit more NHS dentists, and if we want to tackle the dental recruitment problems, we obviously need to train more NHS dentists. Years ago, the University of Hull, in partnership with the University of York—I am very pleased to see in her place my hon. Friend the Member for York Central (Rachael Maskell), who represents that university—put in a joint bid for a dental school.

It was to go alongside the brilliant Hull York Medical School, which had been established under the Labour Government when there was a real need for more doctors to be trained. The idea was that we would “grow” our own doctors from the area where the medical school was based. Let us imagine what would have happened and the situation we would be in today if we had been allowed to have that Hull York dental school.

After all the dither and delay that we have been talking about, we can correct our course today. There is plenty of existing support and the capability to deliver a high-quality training facility in the Humber area, which could directly serve one of the worst affected regions in the country, but we need the Government to step up to give us the resources and provide the funding for places.

I am, however, grateful to the Under-Secretary of State for Health and Social Care, the hon. Member for Harborough (Neil O’Brien), for agreeing to meet me after I raised this issue in Tuesday’s Health questions. I also commend him for the speed with which his office contacted mine to arrange that meeting. Getting a ministerial meeting that quickly is unusual these days, so I thank him for that. A Hull dental school could be part of a long-promised workforce plan for the NHS. It could mean that we have sufficient UK-trained, highly qualified dentists and, with the necessary changes to the dental contract, a decent reward for their hard work. We also need to remember that we are competing in a global market for dentists. I was struck by the fact that if a dentist goes to Canada, they receive a £63,000 golden hello and the offer of residence. That is clearly tempting for many dentists who train in this country and feel they are overworked and get too little pay.

To date, the Government have been missing in action, dentists have been voting with their feet and patients in Hull have been paying with their teeth. We need more NHS dentists. Let us train them. Let us get on with it and do it now, and let us do it in Hull.

Oral Answers

Diana Johnson Excerpts

Tuesday 25th April 2023 Commons Chamber

[Will Quince]

My hon. Friend is right to raise this issue. Over 12,000 more participants a month are recruited into clinical trials than before the pandemic, but we recognise that there is much more to do in order to be internationally competitive, including around regulation and speed of approval. I am pleased to say that in the coming weeks, Lord O’Shaughnessy will publish his independent review into UK clinical trials, and I very much look forward to receiving his recommendations.

[Dame Diana Johnson (Kingston upon Hull North) (Lab)]

T10.   When we had a shortage of doctors, the last Labour Government established the Hull York Medical School. We now have a shortage of dentists, so it is time for a Hull York dental school. This proposal has cross-party support in the Humber, so I wonder whether a delegation of MPs could meet the Minister to discuss taking the initiative forward.

NHS Strikes

Diana Johnson Excerpts

Monday 17th April 2023 Commons Chamber

[Steve Barclay]

I very much agree with my hon. Friend, and he is right to highlight the wider issues that we want to discuss. The previous negotiation with the junior doctors included, for example, setting up a higher pay band, which has meant that there has been a cumulative increase of over 24% over four years. It included targeted action such as a £1,000 a year allowance for junior doctors who work less than full time, and targeted action around unsocial hours and weekend work. Those are the meaningful discussions that we want to enter into with junior doctors, but that has to be on the basis of a realistic and deliverable discussion, and 35% is not that.

[Dame Diana Johnson (Kingston upon Hull North) (Lab)]

I am not sure the Secretary of State understands just how angry people are. My constituents are absolutely furious with the Government’s stewardship of the NHS. Hull is the most under-doctored area in the country; we have the longest waits in A&E in the country; and we have had a very poor Care Quality Commission report on our local hospitals. On the junior doctor strikes, when will the Secretary of State start to put patients first? I want to make sure that he goes away from this Chamber and gets ACAS involved, so that we can get the junior doctors back at work, with no further delays and cancellations for my constituents and patients in Hull.

[Steve Barclay]

The rather odd thing is that we have a larger cash offer on the table for 2022-23 than the Labour Government in Wales, and we have reduced our longest waits far more than they have in Wales. We have a deal that the trade union leaders themselves have recommended, that the majority of staff councils have recommended and that the largest health union has voted emphatically in support of. It is right that we allow time for that deal to go through, and we stand ready to have similar meaningful and constructive engagement with the junior doctors once they move from what is an unrealistic position.

NHS Winter Pressures

Diana Johnson Excerpts

Monday 9th January 2023 Commons Chamber

[Steve Barclay]

First, integrating health and social care through the integrated care boards. That is what we put in place from July, recognising that actually the pressures on the NHS are often as much about pressure on social care as they are about pressures in the NHS itself. In particular, if we look at ambulances, we see that often it is the delay in domiciliary care that is driving the blockage on the wards, which in turn applies there. Secondly, it is recognising that there are workforce pressures, which is why NHS England has been working on the workforce plan that has been set up.

Thirdly, we have already set out our elective recovery plan. Over the summer, the longest waits—those of over two years—were largely cleared. [Interruption.] Opposition Front Benchers chunter, “How’s it going?” Let us look at how it is going, compared with the Labour Government’s two-year clearance in Wales. Before Christmas, there were about 60,000 people in Wales who had been waiting for more than two years; in England there were fewer than 2,000. We are making progress on the longest waits through the work of Jim Mackey, Professor Tim Briggs and Getting It Right First Time. We are innovating with the surgical hubs and the community diagnostic centres. That, in turn, gives greater resilience to the electives that used to be cancelled when there was winter pressure. With hot and cold sites, they are much more resilient.

Finally, I must take issue with what my right hon. Friend says. In France, Germany, Canada and many other countries, the massive spike in flu and covid pressure, combined with pressures from the pandemic, has placed similar strains on healthcare systems. It is simply not the case that the issue affects England alone.

[Dame Diana Johnson (Kingston upon Hull North) (Lab)]

I am really not clear how, despite all the warnings, the Government have got themselves into this position after the biggest crisis in the NHS. We all know that it is a no-brainer to invest in social care to reduce bed blocking, so what exactly is the purpose of the pilot that has been announced for Hull and the Humber? It will tell us what we already know: that what we need is investment in social care and reform of social care.

[Steve Barclay]

We recognised very early—in fact, NHS England recognised it in the summer—that this winter was likely to be extremely hard, both because population resilience to flu would be lower as a consequence of the pandemic and because of the combination of pandemic backlogs with the ongoing level of covid admissions. As I have said, we have more than 9,000 patients in hospital with covid and a further 5,000 with flu; that comes on top of the other strains from the pandemic that we have seen. The measures taken, such as boosting the vaccination programme, extending it to the over-50s and being the first place to have the bivalent vaccine, were part of the package in NHS England’s operational plan.

We also recognised—this point goes to the heart of the right hon. Lady’s question—that social care is central. That is why, notwithstanding the other economic pressures that the Government faced, health and education were prioritised in the autumn statement, with an extra £6.6 billion in funding for the NHS over the next two years and an extra £7.5 billion in funding for social care. That was recognised with a clear prioritisation in the autumn statement. The reality is that we have had a massive spike in flu cases, meaning that there have been 100 times as many hospital admissions for flu as there were last year.

Women’s Health Strategy for England

Diana Johnson Excerpts

Wednesday 20th July 2022 Commons Chamber

[Steve Barclay]

I know from my own involvement in the mesh campaign just how central the hon. Lady’s role was in it, and I pay tribute the work that she has done on that and a number of other campaigns over recent years. In respect of mesh, she will be aware that an annual review is published. On the workplace issue, a key thing that comes out of the report is the significance of the time off work that many women are experiencing, with the difficulty, quite often, in having these conversations with employers. It is very welcome that the civil service has taken a lead, as has the NHS, in certain aspects of that, but there will clearly be more to do, and the point she raises will be part of that wider conversation.

[Dame Diana Johnson (Kingston upon Hull North) (Lab)]

I welcome the appointment of the women’s health ambassador, Dame Lesley Regan. It is an excellent appointment to that role.

The 2020 report on access to contraception by the all-party parliamentary group on sexual and reproductive health found that the current fragmented commissioning arrangements have a severe impact on women’s access to contraception due to a lack of joined-up services. With 45% of pregnancies in England being unplanned, what specific plans does the Secretary of State have to remove the barriers to co-commissioning of reproductive healthcare to require different parts of the system to work together to meet women’s healthcare needs?

[Steve Barclay]

I welcome the hon. Lady’s acknowledgement of the expertise that Professor Dame Lesley Regan brings as ambassador. I think she will be fantastic in that role. A key part of this strategy is addressing the fragmented health system and how that impacts on areas such as contraception. That is why we are having, for example, the women’s health hubs to provide a one-stop shop and centre of expertise so that we can better identify the services that people need.