NHS: Long-term Strategy

Fleur Anderson Excerpts

Wednesday 11th January 2023 Commons Chamber

[Fleur Anderson (Putney) (Lab)]

I am worried and angry about the complacency that I have seen from the Secretary of State towards the NHS. Look, I knew that the situation was bad, but I did not realise how bad until I visited St George’s A&E last week. That hospital, which serves my constituency, had to declare a critical incident because of the situation in its A&E. All the doctors and nurses I spoke to agreed that it was the worst time that they had experienced in their whole careers. The winter ward was opened last year but had to stay open for the whole year, so there is no more space for the extra winter surge. Sixty nurses have resigned from that department because of the stress of the workload and being underpaid.

The additional winter payments that came from the Government were paid only in December and must be spent by March, giving them hardly any real impact. The situation is chaotic. The doctors and nurses are having to practise corridor care for patients for the first time in the hospital, and they are broken-hearted that they have to do so. They have had to stop elective heart surgery since the beginning of December. Mental health patients are being treated in A&E for five days. We need a long-term plan, not to be surprised by winter every year.

Four areas are seen as having critical community care shortages: eating disorders; Korsakoff dementia patients; frail patients who have a stroke after a fall; and functional neurological disorder. Those huge gaps in community care were raised by the staff. I am glad that the Secretary of State is in his place to hear me raise them.

The Conservatives are failing the people of Putney, Southfields and Roehampton. The Conservatives are failing the British people. Labour has a plan to fix this, but they do not. Pain, suffering and preventable deaths are up, GP waiting times are up, A&E waiting times are up, and mental health and cancer assessment times are up. There is only one conclusion: the Conservatives’ time is up.

Government PPE Contracts

Fleur Anderson Excerpts

Tuesday 6th December 2022 Commons Chamber

[Fleur Anderson (Putney) (Lab)]

I am delighted to be able to close today’s debate on behalf of His Majesty’s Opposition, and I share the indignation of my right hon. Friend the Member for Ashton-under-Lyne (Angela Rayner), the shadow Chancellor of the Duchy of Lancaster, that we are once again having to come here to table a Humble Address to force the Government to come clean with the British public. It is all about transparency, and there are questions that need to be answered. Conservative Members can either support today’s binding vote to force Ministers to come clean, or they can be complicit in the continuing cover-up. The choice is theirs, and their constituents are watching.

The VIP lane is a national scandal that will cast a long shadow for years to come. It takes us back to the dark days of 2020 when covid was spreading, when people were dying and when there was not enough PPE for frontline workers. Schools donated goggles. Volunteers sewed gowns in their homes. Nurses and care home workers had to resort to wearing bin bags. My hon. Friends the Members for Blaenau Gwent (Nick Smith), for Brent Central (Dawn Butler), for Bradford West (Naz Shah), for Nottingham East (Nadia Whittome) and for Llanelli (Dame Nia Griffith) have articulated well the anger that is felt by our constituents across the country, who want to have their questions answered.

The shift to procurement was necessary; no one is denying that. We had to have fast procurement, but that did not need to lead to all procurement procedures being jettisoned along the way, resulting in the failure to provide usable PPE, the granting of huge contracts to shell companies, the industrial-scale waste of taxpayers’ money and then an industrial-scale cover-up. A total of £12.6 billion was spent on PPE, but £8 billion of that was written off. We know that £4 billion-worth of PPE was not up to standard and was unusable, that £3.6 billion-worth of contracts raised one or more red flags for possible corruption, according to Transparency International, and that 176 contracts worth £2.6 billion are now in legal dispute.

The consequences continue, as we have heard from Members today. Up to three weeks ago, £770,000 was being spent every day to store the faulty PPE here and in China. I had to check that several times; it could not be right. Were we really spending £770,000 every day? That was over £5 million a week, or £280 million a year. That is enough to pay for free school meals for all the primary schoolchildren in Manchester, Birmingham, Leeds, Liverpool and Nottingham put together, or to pay 8,000 nurses a year. I have heard the clarification from the Minister that the amount has been reduced, and that is welcome, but we are still spending £400,000 a day and 120 million PPE items are being stored in China. What is going on? I speak today for the millions who are sat in freezing homes relying on food banks during this cost of living crisis and hearing that Britain is being ripped off by the Tories.

The British Medical Association’s chair of council said:

“The deadly mismanagement around the supply of PPE is one of the greatest failings of this Government’s handling of the pandemic”.

There must be a reckoning.

The Government had been in power for a decade when covid began, but they did not have good enough emergency plans in place, which is why they did not have enough stockpiles of PPE and had to panic buy. They bypassed existing, scaled-up, British-based providers of PPE, and they chose shell companies that had no experience. They gave huge contracts and jettisoned good contracting procedures. Other countries managed to do it at the time, and we should have been able to do it, too.

It is fair enough to move to emergency contracting, to streamline and speed up contracting, but no checks on companies? No checks to see if the masks met NHS standards? Did no Minister intervene and say, “This is not right. Emergency procurement procedures do not mean no procurement procedures”? Did no Minister say, “Assure me that these companies can deliver. This is taxpayers’ money”? Did no Minister say, “Assure me that the VIP lane is not being used by mates, donors and pub landlords to get contracts ahead of actual PPE contractors”? Did no Minister say, “Assure me that the contracts ensure the taxpayer will not pay for faulty PPE”? It seems not.

What happened was wrong, and it is disappointing that Ministers keep defending it. If Ministers do not own this and admit it was wrong, they will not make the necessary changes, and it could well happen again. Everyone in the country knows it to be true that the first instinct of the Conservative party, if there were another pandemic or emergency tomorrow, would not be to go to correct procurement procedures and to make sure that our taxpayers’ money is not spent wrongly.

I will tell the House about two types of company. The first is Arco, and Members have talked about others. Arco is a Hull-based market leader in PPE production. It has 135 years’ experience, works with 110,000 customers and holds key framework agreements, including with NHS Supply Chain. It is very experienced in providing expert advice and appropriate and compliant PPE during epidemics, including foot and mouth, mad cow disease, swine flu and Ebola.

Arco has its own accredited product assurance lab, a 400,000 square foot national distribution centre and a sourcing team based in China. All of that was in place at the beginning of covid. It had PPE of the required standard manufactured and ready to go. It contacted the Government, and what was the reply? It was ignored. Its offers went unanswered.

PPE Medpro was not even a company until May 2020, yet it was awarded a £120 million contract to provide 25 million gowns and a £81 million contract to provide face masks. PestFix was a pest control company with net assets of £18,000 in 2019. Its director, Joe England, met the chief commercial officer of the Department of Health and Social Care, Steve Oldfield, at the 80th birthday party of Mr Oldfield’s father-in-law. PestFix was referred to the high-priority lane and went on to win nearly £350 million of contracts but was fined £70 million for delivering faulty masks and gowns.

There was the mobile phone case designer that recorded a £1 million loss in 2019 but was referred to the high-priority lane by a former Conservative party chairman and received a £13 million contract to provide PPE. Meller Designs was a fashion accessory company, but it was referred by the right hon. Member for Surrey Heath (Michael Gove)—David Meller was a donor to his leadership campaign in 2016—and it received £170 million of contracts.

Ayanda Capital was a family investment firm specialising in currency trading, offshore property and private equity—an obvious go-to for supplying PPE. It was referred by Andrew Mills, an unpaid adviser to the Board of Trade, which is chaired by the right hon. Member for South West Norfolk (Elizabeth Truss)—I advised her that I would be mentioning her. The problem is that Ayanda Capital provided £40 million-worth of unusable face masks, yet it still posted a £25 million gross profit in 2020. The list goes on.

What do we need instead? We need a national resilience strategy. We need a procurement Bill that is not full of loopholes. We need a whole-system approach, not this mad panic and “pick your mates to make money” approach. That is why this matters, and it is why we are asking to see the documents. I hope the whole House will support this motion and ensure that the Government get the most basic responsibility of Government right, which is to keep us safe.

Contact in Care Settings

Fleur Anderson Excerpts

Thursday 27th October 2022 Commons Chamber

[Fleur Anderson (Putney) (Lab)]

I am very keen to speak in this debate and to raise the experiences of many of my constituents. I am grateful to my hon. Friend the Member for Liverpool, Walton (Dan Carden) for introducing this debate, and to the hon. Members for St Albans (Daisy Cooper) and for Chatham and Aylesford (Tracey Crouch) for sponsoring it.

Many constituents I know experienced dreadful times with those restrictions during covid. In saying that, I pay tribute to all the care workers and care staff who worked tirelessly through covid and are still working to take care of care home residents. My daughter is a care worker, so I have seen the impact that this has had on her throughout the pandemic. I also express my condolences to all those affected and pay tribute to the campaigners for Rights for Residents, who have brought this campaign to the fore and continue to ask for action.

My hope is that we will hear from the Minister about some action to make the legislative changes we need to make a difference now and to ensure that we learn the lessons of covid and of all the painful stories and experiences we have heard, so that if we are ever in a pandemic again, the same actions are not taken. It is understandable that visiting restrictions were put in place to save the lives of vulnerable care home residents during covid, but they could have been done differently, with much more consideration for the fact that a visitor is not just a “nice to have”, but an essential part of care, and that leaving care home residents without visitors led to a huge deterioration in their mental and physical health.

Many constituents have written to me about the effects of that isolation and lack of contact with relatives during covid. As one relative of a care home resident said:

“As you are aware my mother-in-law died and that’s attributed to the effects of isolation and forced separation and it’s paramount that we learn lessons from what has happened going forward.”

I visited many local care homes myself—respecting all restrictions in place, obviously—and heard about the lasting effects that isolation is having on elderly residents and the disabled even now; for example, residents who have become very reclusive.

The Government must listen to those care home providers who are also demanding an end to visiting restrictions and are not happy with the status quo. Jeremy Richardson, then chief executive officer of Four Seasons Health Care, the UK’s third-largest care home provider, said:

“We are depriving people of their right to visitors, which is an absolute outrage. The government restrictions at the moment are making it very difficult to give people a quality of life… We run care homes. We do not run prisons.”

The restrictions must be evidence-based. In December 2021, an Oxford University study, conducted by a team of eminent scientists led by epidemiologist Dr Tom Jefferson, found evidence that many vulnerable residents died of thirst, starvation and “broken hearts” during the pandemic. They identified that almost 40% of excess fatalities were not caused by the virus, with many people dying of loneliness and neglect. Without the support of visitors, vulnerable residents were left to deteriorate and die.

“Neglect, thirst, and hunger were—and possibly still are—the biggest killers”.

It is clear that care home staff had a huge amount of additional work during covid, but visitors would have alleviated some of that.

The Joint Committee on Human Rights published a report on the human rights implications of the Government’s response to covid in September 2020 and a report on care home visiting during the pandemic in May 2021. Following on from those, it published a report on protecting human rights in care settings, which recognised the balance between the state’s requirement to protect the lives of care users and other rights, including the right to a private and family life, stating that,

“too often the correct balance has not been struck and too much has been left to individual care settings to determine”,

and that

“insufficient respect was given to ensuring meaningful contact between care users and their family members and loved ones”.

We need legislation to ensure that that does not happen again.

The Committee’s report recommended that care users be given,

“the right to nominate one or more individuals to visit and to provide support or care in all circumstances,”

subject to full infection prevention measures, and that the Government should,

“give the CQC the power to require care settings to inform them of any changes to their visiting status, and to report live data”,

so that there is transparency about changes in visiting rights. The Government have not yet responded to this report, as other hon. Members have mentioned, but I hope to hear a response today.

As we have heard many times in this debate, the CQC guidance is just not enough. Rights for Residents is calling on the Government to take urgent action to pass legislation that would give every care home resident the legal right to nominate at least one essential care supporter, who can maintain contact in all circumstances, regardless of outbreaks, lockdowns, variants and future pandemics, and to ensure that care homes are supported in returning to pre-covid, unrestricted visiting arrangements, without the need for appointments or limits on time, frequency or the number of visitors.

In this place, we have a duty to give a voice to those who do not have one, and to fight against injustice. I feel that this debate has done that. I hope it will be heard and that it will result in long-lasting legislative changes that will save lives.

Breastfeeding: Government Support

Fleur Anderson Excerpts

Tuesday 8th March 2022 Westminster Hall

[Fleur Anderson (Putney) (Lab)]

It is a pleasure to serve under your chairship, Mr Efford. I congratulate the hon. Member for Glasgow Central (Alison Thewliss) on securing this hugely important debate. I hope you can do all you can in the Chair to ensure that we have all the time allocated to this debate that we should have, because we have precious little time on support for breastfeeding, but it is vital to so many people.

I am glad that this issue is getting time in the House, and I completely understand how difficult breastfeeding is, why it is not possible for many women, which is totally understandable, and how often it needs support. The current lack of provision for breastfeeding support and the impact of not restoring services after covid will be the main subject of my speech, and that is what constituents have been contacting me about. I breastfed my four children for a total of five years, so I understand the need for support and also the need to weigh babies frequently and straightaway, alongside breastfeeding, especially at the beginning, which is something else that has been cut. It is heart-wrenching to know that many mothers in my constituency are not getting the support that was easily available for me. Breastfeeding is also intertwined with mental health and can strengthen maternal and infant resilience if it is properly supported.

The Minister knows Wandsworth well, so I am glad to be able to raise the situation there. We saw the near total disintegration of breastfeeding support in the community during covid, and it has not yet returned. Every single health visitor infant feeding team was deployed during the pandemic and every single children’s centre closed, so there were no drop-ins for breastfeeding support. Just one person was left across the whole of Wandsworth and the borough of Richmond during the pandemic to support all the mothers and babies there. That is ridiculous, because the need was the same, but the support was massively reduced. Although the voluntary sector stepped up, there is no substitute for good-quality and accessible statutory services. The Government need to provide urgent funding and support for these dwindling services and to find out which are not being reopened. They should do a survey of all the services to find out what was there before covid and what is there now.

One constituent wrote to me about her awful experience so far. She said that, since covid, a lot of breastfeeding clinics providing support to mothers have closed. The only local clinic that she has managed to find is a two-hour clinic on Fridays in Kingston, which is quite far away. Otherwise, there is no provision in Putney and no way of getting a baby weighed other than by going to A&E or asking for a health visitor—something that is very difficult to get. The Eileen Lecky clinic in Putney was fantastic and used to provide this service, but it has been closed and the building is entirely empty. Before this debate I checked when the clinic would reopen, because I hoped to bring some good news. I found out that it is closed permanently now. No one was told about this; it is absolutely shocking to everyone in the area.

So what do we need? We need proper Government support. I urge the Minister to do everything in her power to restore these NHS services—in-person, easily accessible services at pre-pandemic levels. We need networks of trained peer supporters. That requires a training programme, a co-ordinator, regular supervision and updating under a health professional. We also need a specialist IBCLC—international board certified lactation consultant—clinic for complex cases. It is unacceptable that in 2022 parents are being left on their own and in the dark during one of the most important periods of their lives and their children’s lives. The Government can and must do more.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)]

It is a pleasure to serve under your chairmanship, Mr Efford.

I associate myself with comments on the importance of thinking about the mums and babies in Ukraine at this time, given how difficult it must be for all of them.

I congratulate the hon. Member for Glasgow Central (Alison Thewliss) on calling for and securing this debate, particularly today, which is International Women’s Day. We often talk about many issues affecting mums, but very rarely do we talk about breastfeeding, so it is really important to have this debate. Ensuring that every baby gets the best start in life is really important. As we have heard, positive experiences during this period will have a significant impact on a child’s health and wellbeing, and will inform the course of the rest of their life. Although the hon. Member for Aberdeen North (Kirsty Blackman) did not get the chance to speak for long, I sense her passion on this subject and she made her points very well.

Breastfeeding provides significant health benefits for both mother and baby. It has been shown to reduce the prevalence of common diseases in babies, such as respiratory infections and gastroenteritis and the risk of maternal breast cancer, as well as offering protection against childhood and maternal obesity. Breastfeeding also promotes emotional attachment and parental wellbeing. However, as the hon. Member for Glasgow Central said, we need to be mindful of the women for whom it does not work. We must ensure that they get the support and reassurance they need. As the hon. Member for Bristol South (Karin Smyth) said, it can be a very difficult experience for some.

I want to reassure colleagues that the Government are taking this matter extremely seriously. We want to promote breastfeeding as much as possible. The latest available data from the infant feeding survey, which we discussed, shows that only 1% of mothers in England are still exclusively breastfeeding at six months. More than 80% of mothers who stopped breastfeeding in the first two weeks reported that they would have liked to have carried on for longer and that perhaps, with support, they could have done. Common reasons for stopping include a lack of access to support services, as we have heard today, both in the community and at work, while misinformation, inconsistent advice, negative experiences and sometimes even cultural barriers can also deter women.

There are significant disparities in breastfeeding rates across England and the UK. We heard today about some excellent experiences in Scotland and Northern Ireland. The prevalence of breastfeeding is particularly low among young mothers, those who left education before the age of 18, and those from lower socioeconomic backgrounds. That contributes to a cycle of deprivation and further widens disparities. I agree with the hon. Member for Glasgow Central: it is so important that we teach young girls about breastfeeding in schools, so they learn early on about its importance and what to expect when their time comes.

In light of that, I want to reassure colleagues that the Government are taking action to support breastfeeding and to make that support accessible to everyone who needs it. First, we have the healthy child programme, a national evidence-based programme of interventions to support parenting and healthy choices. It outlines all services that children and families need to receive if they are to achieve optimum health and wellbeing, including breastfeeding and infant support.

Secondly, we have the maternity transformation programme, which seeks to achieve the visions set out by Better Births. National guidelines have been published for midwifery and health visiting services to support breastfeeding. I want to take this opportunity to thank all midwives, health visitors, support workers and those offering peer support. I met March with Midwives just before this debate and I recognise the pressures those workers are under. Sometimes things such as breastfeeding support are reduced or taken away when there is pressure on the service overall. I recognise that, and I am very happy to work with the service to try to improve that.

Thirdly, we have the 2019 NHS long-term plan, which recognises the importance of improving breastfeeding support and sets out a commitment to ensuring that all maternity services have an accredited, evidence-based infant feeding programme by 2024. However, we need the staff and the resources to make that happen. I have heard that loud and clear. We also encourage parents to access support through the Better Health Start for Life campaign, which provides advice and information on breastfeeding.

However, for me the most exciting development is the Government’s vision for the best start for life programme. It is only in England, but I am very happy to work with colleagues in the devolved nations to share best practice. The programme will roll out support to the areas of the country that absolutely need the most help. I thank my right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom) for her inspirational work in this field.

The early years healthy development review has taken the Government’s commitment to improving breastfeeding rates and improving the support to be included as part of the universal offer for all parents and carers, which will include practical support with breastfeeding, early diagnosis of issues such as tongue-tie and help with formula feeding, which is more appropriate in some cases. The review heard repeatedly from parents about the positive impact breastfeeding can have on their confidence and self-esteem, as well as the value of breastfeeding support groups and peer networks.

In the spending review, the Chancellor announced a £300 million investment to transform family hubs and improve Start for Life services with £50 million for breastfeeding support services. Funding will be made available initially to 75 upper-tier local authorities where we feel the most disparities exist. We will be announcing very soon where those 75 authorities will be and where we can support breastfeeding in those communities. Those local authorities will be able to invest in increasing the range of breastfeeding advice, specialist and peer support, and out-of-hours support that is available in person, on the phone and digitally, creating breastfeeding-friendly environments that will help mothers meet their breastfeeding goals.

[Fleur Anderson]

I know that time is pressing; I thank the Minister for giving way. Has the Minister done any assessment of how many clinics there were pre-covid? That number of 75 local authorities is great, but what about everywhere else? Has there been an assessment of initial services, what has been cut and what has been reinstated?

[Maria Caulfield]

I do not have that information, but I was interested to hear about the experience in Putney. I will take that away because I spoke to midwives who were redirected during covid, but I am not aware of which services have and have not restarted. I am keen to look at that, so I will follow that up. I am happy to conclude, Mr Efford, if that would be helpful.

Oral Answers to Questions

Fleur Anderson Excerpts

Tuesday 1st March 2022 Commons Chamber

[Gillian Keegan]

The hon. Gentleman raises a very important point. Clearly, these are distressing enough times without having that commute and those travel arrangements on top of that, but sometimes the services are highly specialised. We are trying to get the right blend between access to highly specialised in-patient services and making sure that we increase community efforts. We have been working very hard to ensure that there are more community efforts, but we have also invested £10 million more in capital for more beds to make sure people can get treatment closer to home.

[Fleur Anderson (Putney) (Lab)]

18. What assessment the Government have made of the adequacy of support for young carers.

[The Minister for Care and Mental Health (Gillian Keegan)]

We have introduced significant changes to support for young carers, with statutory entitlements to young carers’ assessments from April 2015. Local authorities are held to account for such assessments and support through the social care inspection framework. Further, as we set out in our adult social care White Paper, we will amend the school census at the earliest opportunity to include young carers, allowing us to establish a wealth of evidence on this cohort.

[Fleur Anderson]

I welcome more information being found out about young carers, because this is a hidden health crisis. A constituent came to see me. She is a young person now and has been a young carer for many years. The impact on her educational attainment, physical health and mental health has been devastating. There are 800,000 young carers in the UK, with 800 of them in Wandsworth where support services have been slashed. Does the Minister recognise the impact of that unpaid child labour and does she have a plan to tackle it?

[Gillian Keegan]

Very much so. Young people should be protected from inappropriate and excessive caring responsibility, and adult and children’s services need to work together better. We recognise, though, the lack of hard data and evidence on outcomes for young carers. That is where we are and that is why we have made the commitment, with the Department for Education, to amend the school census. We intend to introduce that as early as 2022-23 and each year thereafter. The data will be collected at primary school and secondary school, so we will be able to look at all kinds of outcomes for this particular cohort and take actions.

Covid-19: Forecasting and Modelling

Fleur Anderson Excerpts

Tuesday 18th January 2022 Westminster Hall

[Fleur Anderson (Putney) (Lab)]

Thank you, Sir Edward; it is a pleasure to serve under your chairship. I congratulate—I think—the hon. Member for Isle of Wight (Bob Seely) on securing the debate, because I welcome impartial and honest interrogation of the science, as well as decisions made over the last two years that have been important for our country. I also welcome extreme scepticism about some of the decisions made by the Government. This debate has not been an honest and independent inquiry into the science, however. It clearly comes with an ideological bent, so it has to be taken in that light.

I also begin by paying tribute to our public servants and Government scientists.

[Mr Baker]

Will the hon. Lady give way?

[Fleur Anderson]

I think I will make some progress first.

[Mr Baker]

I am not being rude; I just want to ask a question about what the hon. Lady has said.

[Fleur Anderson]

The hon. Gentleman has not even heard what I have to say yet.

[Mr Baker]

The hon. Lady said that we have made points that require an ideological bent. I invite her to look at what I said and identify at least three points that required any kind of ideological justification. Contrary to the point made by the hon. Member for Argyll and Bute (Brendan O'Hara), nothing that I said required libertarian political philosophy.

[Fleur Anderson]

That was another speech. I have never been in a room with so many software engineers who are also MPs. I begin by paying tribute to our public servants, our Government scientists, epidemiologists, and the scientific community who have worked tirelessly and put everything on the line to keep the public safe. That is what they have been trying to do over the past two years: keep people safe and save lives—and they have. They have shouldered the fear, anguish and hope of an entire nation that was experiencing deep trauma. They have, magnificently, been prepared to put their head on the block, if needs be. I hope the Minister will agree with me that it is very disappointing to hear them come under attack today from certain colleagues, despite everything that they have done.

I would remind those who seek to attack SAGE and our Government scientists that, while they were looking forward, planning and working hard on the evidence of what the virus might throw at us next, it was freshers week in Downing Street. They are not the enemy here. In fact, had a bit more attention been paid to their models, had there been more modelling before the start of the pandemic and had more action been taken in February and March 2020, thousands of lives could have been saved. It is not modelling that is the intrinsic problem here—it is decision making.

Modelling is a hugely important tool for managing epidemics that is tried and tested, with constant efforts to improve it. I agree with earlier comments that there should be more models; there should be models about the impact on mental health, education, poverty and models to learn from other countries in order to inform our decisions. As Graham Medley, one member of SAGE, explains very clearly, models are not predictions and are not meant to be seen as such; they are the “what ifs” that can be used by Governments to inform decisions and guide them as to what they might need to prepare for, which should include the worst-case scenarios—that is a crucial distinction. Accurate predictions cannot be made with such an unpredictable virus, when individual behaviour is also unpredictable, so models and scenarios are the best tools to give us the parameters for the decisions that will be made. As Graham Medley said, SPI-M—the Scientific Pandemic Influenza Group on Modelling—the sub-committee of SAGE that he chairs, produced

“scenarios to inform government decisions, not to inform public understanding directly. They are not meant to be predictions of what will actually happen and a range of scenarios are presented to policymakers with numerous caveats and uncertainties emphasised.”

Who would want it any other way?

My question to the sceptical Members present here today is: what is the alternative? We need to have those parameters. The alternative is guessing without parameters and knowledge.

[Mr Baker]

I am very happy to answer that question.

[Fleur Anderson]

I am going to move on. I do not want another speech from the hon. Member, given the time constraints. I am waiting for the Minister to answer my questions.

The Public Administration and Constitutional Affairs Committee also had problems with the communication of the modelling. It is there that I might have some common ground with the hon. Members who have spoken earlier. The Committee said in its report last March that communication has not always been transparent enough, and accountabilities have been unclear. I agree with this. If the time is not taken carefully to explain what modelling actually is to the public and media, and instead room is allowed for scenarios to be interpreted as predictions, inevitably the practice of modelling and forecasting will be rubbished and scoffed at and Government scientists blamed as doom-mongers. Not communicating the data and models properly creates more uncertainty and misery for small businesses, who have been asked enough as it is, as we saw over the Christmas period.

[Greg Smith]

Will the hon. Member give way?

[Fleur Anderson]

No. The PACAC report makes it clear that no one in Government has taken responsibility for communicating the data. The report states:

“Ministerial accountability for ensuring decisions are underpinned by data has not been clear. Ministers have passed responsibility between the Cabinet Office and Department of Health and Social Care,”.

That is why, as a member of the shadow Cabinet, I am responding to this debate. There are questions about the use and communication of the data.

I want to come to why we needed to rely on modelling and forecasting. Significant mistakes made throughout the last 10 years of Conservative government are the problem. There could have been much better information, and we could have been much better informed, if there had been better pandemic and emergency preparedness.

[Bob Seely]

Will the hon. Member give way?

[Greg Smith]

Will the hon. Member give way?

[Fleur Anderson]

I will give way—

[Sir Edward Leigh (in the Chair)]

Order. I think we need to move on.

[Fleur Anderson]

I agree, Sir Edward. Labour invested in pandemic planning in the Civil Contingencies Act 2004, but the Tory Government did not continue that investment. Operation Winter Willow in 2007 involved 5,000 people from all walks of life simulating a pandemic. The need for PPE, PPE training and wide-ranging social and economic disruption was identified. The Labour Government, then led by Gordon Brown, made heavy investments in pandemic planning.

Cut to 2016, Operation Cygnus made 26 key recommendations about PPE, urgent and drastic improvements to the NHS, and the likely impact on care homes. Most of that was ignored. PPE training stopped, stocks were run down—much of it left to go out of date—and there were no gowns, visors, swabs or body bags at all. The UK pandemic plan was mothballed and we were unready for the pandemic. No wonder we had to rely so much on modelling and forecasting.

We could have been much more ready. The Cabinet Office should have stepped up to enable cross-departmental organisation, and organisation with the devolved authorities based on plans, informed by the results of exercises and earlier modelling, but it did not. I hope that the Minister will echo that, distance herself from some of the earlier comments and criticism of our scientific community and respond to the points about pandemic planning and what we can learn.

Finally, I know that the hon. Member for Isle of Wight (Bob Seely) has asked for an inquiry into modelling. I welcome the inclusion of that in the covid inquiry. I hope that the Government will launch that inquiry. They have appointed a chair, but that chair is waiting for the powers she needs to begin getting evidence from scientists, software engineers and everyone she needs to hear from.

[Sir Edward Leigh (in the Chair)]

Will the Minister allow a short time for closing remarks?

Public Health

Fleur Anderson Excerpts

Tuesday 14th December 2021 Commons Chamber

[Fleur Anderson (Putney) (Lab)]

I thank everyone across the country who has had their booster—everyone who has been lining up at centres across the country and taking the time to ensure that they have done the right thing by getting their booster. I thank all those NHS staff who are enabling that and who are putting in a mighty push to change all their ways of working to get the booster into as many people as possible.

I thank all those who have written to me about the issues being debated today. There are those who say that we should have more measures and that they will feel safe to go out into public spaces or to take up NHS appointments only if more measures are put in place. There are also those who have written to me about their concerns about more measures being put in place and more restrictions on our lives.

It is clear that omicron is a threat. It is highly contagious with cases doubling every two days. Most cases in London are now omicron cases and the numbers are increasing all the time. Two vaccines do not reduce the rate of transmission as much as they did for delta, so it is clear that action must be taken. We know that it is more contagious, but although we do not yet know its severity, we cannot wait. Last year, at the beginning of the coronavirus pandemic, the Government waited too long. They delayed, sometimes for weeks, and we saw the effects. We have to act now.

This is a measured and proportionate set of actions. On masks, I do not think we should have dropped that measure in the first place. We should never have stopped wearing masks on public transport and in shops to keep shop workers safe, so I welcome that.

On vaccine passes, which are not vaccine passports, I am glad that the Government have listened to the Opposition saying that there need to be options. It is absolutely proportionate for people to show proof of double vaccination or a negative lateral flow test to enable big venues and our hospitality venues to stay open, which is so important after last year and the loss of so much income.

Those venues need to stay open, so this is a freedom to go out and to enjoy events and be out with people while staying as safe as possible. We know that there will be a peak in the number of cases in a couple of weeks, and that a couple of weeks after that, in the new year when we return to this place, there will be a peak—or not—in hospitalisations. It is right that we take these measures now to stop hospitalisations later. I welcome the change on the red list of countries, which the Minister announced earlier. If it is not having any effect, there is absolutely no reason for so many of my constituents to be unable to visit their families in South Africa, but also to pay huge amounts of money to be quarantined. I also welcome the Minister saying that he will look into the quarantine costs of those who were unfairly stuck in the middle of a couple of weeks when they needed to pay. Some of my constituents who have written to me are NHS workers who have had to pay thousands of pounds they cannot afford.

I will welcome the engagement with the Elections Bill of all those on the Conservative Benches who are now so worried about civil liberties. It certainly will be a “Papers, please” society when we are asked to show our ID to vote. That is far more of an infringement of our civil liberties. Voting is such a fundamental thing compared to going to clubs or large events.

We absolutely need the schools programme to ramp up. School transmission rates are very high in primary schools in my constituency, but all those facing exams this year must be able to do them. This is not a slippery slope to covid passports, and I am grateful for the assurance on that. We need to ramp up communication and engagement with health staff who face measures later on in the year if they do not get the vaccine. We must see an increase in statutory sick pay. That is only fair.

In conclusion, the Chief Medical Officer gave a chilling briefing to MPs earlier today, saying that when it comes to the omicron variant the brakes are off. We have to put the brakes on. Too many people have died, and we mourn every single one. Now is the time to take action, and I encourage everyone to get their booster jab.

Reducing Baby Loss

Fleur Anderson Excerpts

Tuesday 20th July 2021 Westminster Hall

[Fleur Anderson (Putney) (Lab)]

It is a pleasure to serve under your chairship, Mr Gray, and to follow my hon. Friend the Member for Nottingham South (Lilian Greenwood). I congratulate and thank the hon. Member for Truro and Falmouth (Cherilyn Mackrory) for securing this incredibly important debate. I am so sorry for her loss but I thank her for her bravery in sharing it and for her ongoing campaigning in this area.

I also thank campaigning organisations, including the Stillbirth and Neonatal Death Society, Tommy’s and the Lullaby Trust, and all the members of the Pregnancy and Baby Charities Network, as well as bereavement organisations such as the Good Grief Trust for all they do to support parents and families and for their continued campaigns for change.

I thank all my constituents who have recently written to me about this important debate, underlining the reason for having this debate now and why we need to look again at the plan for the national ambition to reduce baby loss and at progress towards that. I am certain that all Members present share my ambition that the UK should be the safest place in the world to have a baby. However, as broken-hearted mothers and fathers across the UK can testify, it is not, and that is the reason for the debate today.

There are stark inequalities: background makes a difference, as well as where mothers have their babies. That should not be case—the highest standards should be equally available across our country. Recent reports from the Health and Social Care Committee, the Ockenden review of maternity services at Shrewsbury and Telford Hospital NHS Trust, the ongoing investigation at East Kent Hospitals University NHS Foundation Trust, and the devastating revelations from Nottingham University Hospitals NHS Trust—which have been outlined by my hon. Friend the Member for Nottingham South—plainly demonstrate just how much more there is to do.

Although huge strides have been made over the past two decades, that progress has now plateaued and we need to know why and address this. In 2019, the neonatal mortality rate in England and Wales was 2.8 deaths per 1,000 live births, the same as it was in 2017—the third consecutive year of no change. The latest statistics for neonatal mortality published by the World Bank rate the UK as the 37th country globally, making us one of the worst-performing countries in the developed world in this area. As the hon. Member for Truro and Falmouth highlighted, the recent report into progress on maternal mortality said that

“No discernible progress has been made towards reducing the 2010 rate of maternal deaths by 50% by 2025.”

There are huge inequalities in the experience of maternal mortality and baby loss that have gone unaddressed for too long. Babies from minority ethnic and socioeconomically deprived backgrounds remain at an increased risk of death: if a woman is black or poor, it is more likely that she will die or that her baby will die, which is absolutely unacceptable. In 2017, babies born to black or black British parents had a 67% increased risk of neonatal death compared with babies of white ethnicity, and babies born to Asian parents had a 72% increased risk of neonatal death compared with babies of white ethnicity. The 2020 MBRRACE-UK “Saving Lives, Improving Mothers’ Care” report shows that the risk of maternal death in 2016 to 2018 continued to be four times higher among women from black ethnic minority backgrounds than among white women, and that that risk is twice as high for women from Asian backgrounds as it is for white women.

The Office for National Statistics’ latest “Births and infant mortality by ethnicity in England and Wales” report, published in May this year, highlighted substantial inequalities in infant mortality rates among black and other ethnic minority groups. Some of this variation may be explained by other areas of inequality, including deprivation, but the association between social deprivation and child mortality is clear, and there are modifiable factors that can make a difference. This can be addressed—it can be changed. I have raised this issue with NHS South West London Clinical Commissioning Group, and it must be addressed in partnership with those who have relevant lived experience and build on the knowledge of specialist agencies in each area.

Two further issues that need action have been raised with me by constituents. The first is miscarriage: a constituent has raised with me the issue of access to information and support following a miscarriage, and Tommy’s is campaigning on this issue as well. I met with a constituent yesterday who told me that women in the UK have to endure three consecutive miscarriages before they are referred for full investigation. She feels very angry about this situation and how it has affected her and women across the country. It is simply unacceptable for a couple to go through that much suffering and uncertainty and for it not to be addressed until there have been three miscarriages.

Another issue is that of culture. We are talking a lot today about funding: there is a need for increased funding, for staffing in particular, but there is also the issue of culture, which was raised by my hon. Friend the Member for Nottingham South. One constituent wrote to me to say that there had been a lack of investment over a long period of time and that that had played a big part in why the services are what they are today, but she also wanted to highlight behavioural issues within maternity—with bullying and hostile attitudes among members of staff. She said that trainees in obstetrics and gynaecology report a high rate of being undermined, higher than other medical specialities.

It is also well known that, in some services, hostility between midwives and obstetricians contributes to services being unsafe. These issues, not only about resources but about culture, need to be addressed and understood: there needs to be a cultural shift. Reporting should be welcomed within NHS trusts, and change should result from such reporting.

I have some requests for the Minister today. First, I underline the calls from Members earlier in the debate about the need for enhanced data collection and sharing. What gets counted counts, and the first thing anyone sitting down and looking at this area sees is that there are big gaps. Secondly, there should be a review of the impact of covid on our neonatal services.

Thirdly, there should be a plan to increase staffing levels; as has been outlined, we need to increase those. How much will they be increased by next year, the year after and the year after that, so we can achieve those 2025 levels? There needs to be action on ethnic disparity and much more focus within every clinical commissioning group on why those differences exist, learning from each other and from best practice and building on that, with a change in culture where needed.

What additional measures is the Minister taking to achieve the national ambition to halve stillbirths, neonatal deaths, maternal deaths and brain injuries by 2025? As we have seen in the debate and from the recent reports and statistics, business as usual is not going to achieve those aims at all. Will the Government commit to publishing specific national targets before the end of 2022—earlier, ideally—that reflect a bold commitment to action on inequalities due to ethnicity and deprivation, underpinned by specialist pathways and workstreams in every local maternity system?

I pay tribute to all the midwives working so hard across our country for all that they have had to change and go through in the last year, and to all the families affected by the issue. Ambition is all well and good, but it needs to be matched by action and boldness. A lack of both is currently letting down parents and babies across the country and it has to change, starting today.

Covid-19: Contracts and Public Inquiry

Fleur Anderson Excerpts

Wednesday 7th July 2021 Commons Chamber

[Fleur Anderson (Putney) (Lab)]

I apologise, Madam Deputy Speaker, for missing the first couple of minutes of the debate. I did, however, hear the excellent contribution by the leader of the SNP, the right hon. Member for Ross, Skye and Lochaber (Ian Blackford). It is no reflection on my feeling about the importance of this debate not just for us as Opposition parties, but for the people of the whole of Britain who are listening to these questions and who want more answers than those we have just heard. Maybe we will have them at the end of this debate.

On the Opposition Benches, we share the conclusion that the right hon. Gentleman came to in his remarks, which is that Government procurement over the past 16 months has been marred by huge waste to the taxpayer and brazen cronyism. That is not to say that the vaccine roll-out has not been an enormous success, but if that is all we going to hear from Conservative Members we will not get to the heart of the debate. At the same time as we were rolling out the vaccine, these crony covid contracts were being made and there are questions that must be answered for contracts being given now and for the future, as well as those given last year.

[Joanna Cherry]

The hon. Lady will have heard the Minister suggest that the same processes have been followed in Scotland and Wales as were followed by the British Government; but does she agree with me that it is only the British Government who have been found, twice, to have acted unlawfully?

[Fleur Anderson]

I agree with the hon. and learned Lady. This is not about the processes and whether they have been followed, but about what undue weight was given to the resulting contracts that came out of those processes. Some of them have been taken up in court, so there are questions to be answered.

For over 12 months now, my colleagues and I in the shadow Cabinet Office team have been asking some very simple questions again and again of the Chancellor of the Duchy of Lancaster and Minister for the Cabinet Office, the right hon. Member for Surrey Heath (Michael Gove), and his team over their procurement policy during the pandemic. Every time, we have been met with deflection and non-answers. Those questions have not been getting an answer, so I will try again today. That is not very impressive for the Department responsible for increasing transparency across Whitehall, and it is transparency that we are talking about today. But it is not only about transparency. Were those contracts given to the right companies to save lives at the right time? Without question, we needed speed. Without question, we needed the best companies to be chosen. The question is, when it comes to another emergency, pandemic or crisis, do the Government throw due transparency out of the window and just start talking to their friends?

[Alec Shelbrooke]

The hon. Lady said that shadow Cabinet Office Ministers have been asking the Chancellor of the Duchy of Lancaster questions about the things going on. However, I warn the hon. Lady—I say this to draw us back to where we were 12 or 15 months ago —that the then shadow Chancellor of the Duchy of Lancaster, the hon. Member for Leeds West (Rachel Reeves), wrote to the Chancellor of the Duchy of Lancaster saying that he was not awarding PPE contracts quickly enough, and that he should be bypassing the system to get them out there. She then gave a list of companies in my city of Leeds that had offered support, and they included a football agent, an historical clothing company, an events company in Surrey and a private legal practice in Birmingham. All I say to the hon. Lady is that there are lessons to be learned, but in terms of what she is trying to say, please do not think that Opposition Members were all innocent and that the Government were guilty and need to follow some lesson, because the reality is that the then shadow Chancellor of the Duchy of Lancaster put it in writing.

[Fleur Anderson]

Of course there are questions to be asked, and that is what we are doing—we are asking these questions. I hope that there is a real-time review going on right now, and I hope that all the questions we are asking will be in the public inquiry to come. All these questions need to be looked into.

I have 15 questions for the Minister today, which I hope she will be able to answer. Question 1: what assessment has she made of the accuracy of the Prime Minister’s official spokesperson’s statement on 28 June 2021 on the conduct of ministerial Government business through departmental email addresses? The Parliamentary Secretary, Cabinet Office, the hon. Member for Hornchurch and Upminster (Julia Lopez), said, only two hours after the statement that day, that

“a huge volume of correspondence was coming to Ministers via their personal email addresses”.—[Official Report, 28 June 2021; Vol. 698, c. 33.]

The Minister will have seen the leaked minutes from the Department of Health and Social Care meeting on 9 December, confirming that. So was the Prime Minister’s spokesperson not telling the truth, or just wrong, and will the Prime Minister be correcting the record? The use of private email addresses, how it all came to be and the murky times around that time need to be opened up to transparency.

It is hugely welcome news that the Information Commissioner’s Office will be investigating that point. The Government must co-operate fully. It is not just about freedom of information law and data protection law, important as that is; it is about taxpayers’ money being dished out secretly on private emails. Labour expects the Government to ensure that they come clean on private email use in other Departments, and that anyone found to have acted unlawfully or inappropriately in ministerial office faces the consequences.

Question 2: in her response to last week’s urgent question, the Parliamentary Secretary said that 47 offers of PPE supplies were processed through the Government’s priority mailbox. The Government have said that the details of all contracts will be published, but have refused to name the 47 companies. Who are those 47 companies, why are they not being named, and will those names be published now?

Question 3: can the Minister tell us which Ministers formally approved contracts awarded under the emergency procurement process during the covid pandemic? The Minister will have no doubt read the Public Administration and Constitutional Affairs Committee’s recent report on decision making during the pandemic, and it has a whole slew of other questions. It concluded:

“Ministers have passed responsibility between the Cabinet Office and Department of Health and Social Care”.

So who was responsible for actually signing off those contracts?

That leads me to question 4: which Minister made the decision to award a contract to Public First for contact focus group testing in March 2020? The Cabinet Office has stated that the Chancellor of the Duchy of Lancaster did not personally sign off the decision, so if he did not, who did?

Question 5, which was raised earlier in this debate: what role do the army of non-executive directors currently employed across Whitehall have in influencing the award of contracts? Did they have a say in the process or the decisions behind the award of those contracts? For instance, how can the Minister explain the fact that Kate Lampard, the lead non-executive director on the Department of Health and Social Care board, is also a senior associate at the consultancy firm Verita, which in May was awarded a contract by the same Department, worth £35,000, to assist Public Health England? It is not just about how people vote when they are awarded these positions. It is not about their voting tendency. It is their closeness to Ministers and others, and their closeness to some of the contracts being given out, that the public need to know more about.

This brings me nicely on to question 6. What steps were taken by the Department to identify and address conflicts of interest in relation to the contracts awarded through the VIP lane? Is the Minister confident that all meetings between Ministers and companies that were awarded contracts have been fully disclosed and added to the transparency data? Can we be assured of that today?

Question 7: I mentioned the leaked minutes of the December meeting of the Department of Health and Social Care. In that meeting the second permanent secretary used the term “sub-approval”. Can the Minister enlighten us on the sub-approval process? What does it mean in relation to Government covid contracts? The public have so many questions about what was going on in the contracting last year.

Question 8: the Parliamentary Secretary, Cabinet Office, the hon. Member for Hornchurch and Upminster, spoke in a Westminster Hall debate on Monday 21 June, which I attended, about the market conditions facing suppliers in China. There have been questions about links with China. In that same debate, I referenced evidence uncovered by the Good Law Project that showed officials in the Department of Health and Social Care were aware that an agent working for PestFix, the pest company that got a covid contract, may have been bribing officials in China. The point was not addressed by the Parliamentary Secretary, Cabinet Office, in that debate, so I ask the Minister to comment on it today. Is she aware of this allegation? Does she agree that, no matter how difficult market conditions were at the time, it warrants urgent investigation?

Question 9: I also asked in that debate whether the Cabinet Office would commit to auditing in detail all the contracts identified by Transparency International as raising red flags for possible corruption, and to commit to publishing the outcome of that audit. This would go a long way to restoring public trust. If it cannot be done, why not? What do the Government have to hide? I am afraid this is a question to which I did not receive an answer in that debate, so I hope to receive an answer this afternoon.

Question 10: the Parliamentary Secretary, Cabinet Office, said she believes there are cases where clawback is taking place, and other Ministers have mentioned it, too, but we do not know when it has happened and what was in the contracts for those that failed, by millions of pounds in some cases. Is the Minister in a position to provide more detail?

In the past 12 months, the Government have awarded £280 million of contracts for masks that did not meet the required standards, at a time when we were crying out for PPE that would save lives. I presume those masks had to be mothballed. I do not know where they are.

The Government spent £100 million on gowns without carrying out technical checks, so they could not be used. It is incredibly important that as much of this taxpayers’ money as possible is retrieved as soon as possible. Perhaps the Minister can explain to the nurses facing a pay cut, and to the 3 million who have been excluded from any help, that the money has gone to boost the profits of the firms that received these contracts, rather than coming back to the public purse.

Similarly, my eleventh question is about how much money the Government have spent defending themselves in court against the unlawful decisions that have been made.

[James Cartlidge]

How much does the hon. Lady think the investigation into the former Mayor of Liverpool will cost?

[Fleur Anderson]

I do not know how much further investigations will cost, but that does not preclude from needing to investigate this point. We cannot deflect by looking at other investigations; we need to have an investigation into this point.

Hundreds of millions of pounds have been spent on masks that have been mothballed and on gowns that could not be used because the contracts were not good enough. At a time of public emergency, we need the Government to be excellent in their competence in contracting, and not to throw the rules out of the window and end up with these failed contracts.

Question 12: why, despite all the evidence uncovered this year, will the Government still not commit to ensuring these contracts are in the public inquiry? I hope to hear confirmation that this will happen.

[Liz Saville Roberts (Dwyfor Meirionnydd) (PC)]

The hon. Lady is asking a series of highly pertinent questions, and I wonder whether we will receive the answers with any haste. Does she agree that we also need an urgent inquiry in Wales, where it has become apparent that almost 2,000 deaths occurred from infections that probably, or definitely, took place in hospitals and were therefore the responsibility of the Welsh Government, and that we need that inquiry urgently?

[Fleur Anderson]

Inquiries need to happen in real time, as we are learning, because we are making decisions all the time that affect our lives. There also need to be major Government inquiries, and I hope that all of this will be included in the Government inquiry to come.

The Minister made much of the Boardman review, saying, “There has been an inquiry. Don’t worry. The Boardman review has done it,” but this is my thirteenth question. It is, again, a question that I have asked before and received no answer to: does she seriously believe that the Boardman review is an independent and unbiased review, and good enough? How can she think that when Mr Boardman’s law firm has been the recipient of Government contracts in the past year, and given that Mr Boardman once ran to be a Conservative councillor—far more than just voting for one party or another? It looks more and more as if the Conservatives are set on glossing over the cronyism in their ranks, so that they can carry on as if nothing has happened.

I have two more questions, and then I will close. Question 14: when will we see a return of all public sector procurement to open competitive contracting as a default? The Minister said that emergency procurement procedures are still continuing, but they do not need to anymore. We need a way of having a contract in good time but with all the open competitiveness that the public need to see. There is no justification for the continuation of emergency procedures. They should be wound down immediately, and ways found to make contracting work without being secretive.

Finally, my fifteenth question: where is the Chancellor of the Duchy of Lancaster to answer these questions? The Cabinet Office is responsible for overseeing transparency across Government, and these are the fundamental questions that we have today. Why has he once again dodged an opportunity to explain the decisions made by his Department? Will he ever take responsibility and stop getting other Ministers to do his explaining for him, as has happened in many previous debates on this issue? The public will not stop asking these questions. We on the Opposition Benches will not stop asking these questions. We need some answers.

I have a lot of sympathy for the Minister, who will have to field some incredibly difficult questions about serious allegations. When such debates come up I can imagine that the conversation that Ministers have about who will reply is not a pleasant one. There are some very serious allegations, and I hope to hear the answers this afternoon.

[Madam Deputy Speaker (Dame Eleanor Laing)]

I hope that we can manage the debate without a time limit. We will do so if everyone takes around six minutes. That will mean plenty of time for interventions and real debate.

Oral Health and Dentistry: England

Fleur Anderson Excerpts

Tuesday 25th May 2021 Westminster Hall

[Fleur Anderson (Putney) (Lab)]

It is a pleasure to serve under your chairship, Ms Bardell, and I congratulate my hon. Friend the Member for Bedford (Mohammad Yasin) on securing this hugely important and timely debate. It is certainly very important for my constituents in Putney, Roehampton and Southfields.

I sponsored a Back-Bench debate on this topic back in January, and here we are again. In that debate, there was real agreement from Members from different parties that there was an impending crisis facing UK dentistry, and that the actions that needed to be taken to avoid it were clear, yet the crisis remains. Patients in my constituency and across the country still have huge concerns about accessing dentistry and getting the care that they need.

Not enough action is being taken, so the Government should not have been surprised to wake up and find this morning’s front pages covered in reports of a three-year waiting list for some patients to see an NHS dentist. According to a new survey of dentists in England, nearly half indicate that they are now likely to seek a change of career or early retirement in the next 12 months should the covid restrictions stay in place. The same proportion say they are likely to reduce their NHS commitment. That is very important, because we particularly need to save NHS dentistry.

In the five years before the start of the pandemic, the number of practices providing NHS dentistry fell by 1,253. Some 85% of dental practices are now closed to new NHS patients, and 60% are closed to child patients. I can see this in my constituency in London and across the country. It is no exaggeration to say that the future of NHS dentistry hangs in the balance right now, and it is people who are on lower incomes who are the most affected. The Government have been warned time and again by MPs, the British Dental Association, mydentist, patients and dental practitioners, yet we feel that their warnings are falling on deaf ears. I hope we hear differently from the Minister.

As colleagues know, and as has been said, 20 million appointments were lost between March and November, which has created a huge backlog that will take years to clear unless it is addressed now. In my own borough of Wandsworth, nearly 6,000 fewer courses of treatment took place in the final quarter of 2020. One child is hospitalised for a tooth extraction every 10 minutes. I am a mother who took my child to hospital for a tooth extraction. I have seen many other children there and I know how devastating it is at the time. It can have long-term implications for the child’s health as well, but that can be prevented, so I will go through some of the preventive measures.

I welcome the Government’s renewed commitment to dental contract reform, which is essential. The new contract must break with units of dental activity. It must prioritise prevention and ensure that NHS dentistry is available to all who need it. After a decade spent developing new systems, it is crucial that the Government deliver on their commitment to roll out new contractual arrangements by April 2022. It is also important to make it clear that the roots of the crisis we face go back to well before the pandemic. This is not just about covid prevention measures. It has been a long time coming and the pandemic has only lit the touchpaper.

There is a huge disparity in funding across the UK. The Labour Government in Wales spend approximately £47 per year on primary care dentistry per head of population compared with only £34 in England. As capacity across the service continues to be severely limited by infection control measures, access problems have now reached an unprecedented scale in every community, with the existing deep inequalities of both access and outcomes set to widen even further. When the Minister responds, I would like to hear reassurances about action on prevention, about current practices and ventilation, and about dentist retention, especially recruitment, which I will focus on.

First, prevention. There has been a lack of face-to-face health visiting, especially for early years. In early years settings, supervised brushing and encouraging parents and teaching them about supervised brushing has been limited. There needs to be a real upgrade and fast tracking of check-ups in the early years settings so that we do not have a huge backlog of issues in later years. There needs to be dedicated funding for new water fluoridisation schemes, as many other Members have said—I am fully in favour of those—and further measures to reduce sugar consumption.

On recruitment, my dentist is the main provider of NHS dental care, and they consider this a priority issue for now. There are not enough places to train UK dentists in the UK, and the intake is dropping, not increasing as we need it to. Even if the numbers were to increase, it would take six years to have an effect because it takes six years to train a dentist, so there needs to be secondary legislation to change the overseas registration process. That would not cost anything, which I am sure the Minister would welcome. It has a huge amount of support from dental associations and practices, and it could be relatively simple and quick to see an effect with more dentists coming from overseas to this country. A simple change in the way that dental qualifications are recognised would make a difference.

The overseas registration process has to be carried out in the UK. It costs £4,000 and takes 12 months. If the overseas registration exam process could be equivalent for dentists and medics, including part 1 to be carried out overseas and increasing spaces on that exam, it would make a huge difference. Such small changes could transform dental care in this country.

Prior to 2001, the General Dental Council pre-approved certain dental qualifications outside of the European economic area. That was due to our membership of the European Union, but it changed because of Brexit. Now—I do not say this very often—we could take advantage of Brexit and return to the pre-2001 system of prioritising Commonwealth dental schools by recognising select qualifications.

We must support all practices to enable them to increase the number of patients. As the hon. Member for Mole Valley (Sir Paul Beresford) and others have said, they must have capital expenditure for new ventilation equipment and also a road map out of the use of heavy-duty PPE, which is bringing down morale and will not be needed in future. Also, the fallow times need to be brought down. We need to prioritise dentistry in the upcoming reforms of the healthcare system, particularly in the health and social care Bill, and we need an urgent review of the whole system, especially new targets—not for dental activity but for increased retention of NHS dentists.

It is time to stop the slide into the privatisation of dentistry. It is time to stop treating dental health as a kind of luxury instead of there being free oral health at the point of need. We are sleepwalking into the biggest oral health crisis since the creation of the NHS. It is time the Government took responsibility and rescued UK dentistry before it is too late.