Dementia Care
Joe Robertson Excerpts(2 weeks ago)
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Dr Chambers
I completely agree with what the hon. Member has just suggested. There is no way that we can approach dementia without a huge amount of compassion and empathy.
Joe Robertson (Isle of Wight East) (Con)
I thank the hon. Member for drawing attention to the issue of not seeking to correct those with dementia on where they think they are. In that respect, dementia care and understanding have come a long way, and in fact it is now standard not to try to do that. I thank the hon. Member, along with my right hon. Friend the Member for Wetherby and Easingwold (Sir Alec Shelbrooke), for raising that issue in the Chamber.
Dr Chambers
I remember trying to explain to my father about the sheepdog, which he loved to train but which he did not recognise as his own any more. That is unusual for a farmer. There was no need to have that discussion; it was heartbreaking. The dog loved my dad and dad not recognising him any more was very upsetting. This all still feels very raw, but as we have heard today, my story is not in any way unique. There are so many families in Winchester and around the country who are experiencing that similar, heartbreaking journey.
Caring for my father is one of the hardest things that my family has ever done. I pay tribute to my mother, who bore the brunt of caring for my father for many years; to my sister Irene, who helped hugely for years and years; to my cousin Patrick; and to our neighbours James and Deborah Hodgson—we could not have managed without them. However, especially nearer the end, we could not have done without the extraordinary support of the care workers who came to help on a regular basis. Their compassion, skill and dedication helped get us through some of the darkest days.
That dedication was extraordinary. Dad loved singing and one of our care workers had printed out some of the songs that he knew—some old Methodist hymns, “The Old Rugged Cross” and “Danny Boy”, which was his favourite song and the song that I am named after. He might not have remembered our dog, but he could remember every word of “Danny Boy” when he was singing it. The dedication of the care workers, to find out someone’s favourite song and then sing it with them, was quite extraordinary.
Care workers, who are vital and skilled, are often underpaid, undervalued and stretched beyond endurance. We just cannot allow that to continue. That is why the Liberal Democrats call for urgent and meaningful reform of social care—reform that starts with recognising and properly rewarding and supporting the workforce who underpin it. We have been calling for a national social care workforce plan—not for the can to be kicked further down the road, but a real plan to address recruitment, retention and training, with practical steps to fix the staffing crisis. We want to establish a royal college of care workers to give care professionals the recognition and career development that they deserve. I pay tribute to Liz Blacklock from Winchester, who runs Lapis Care based in Bishop’s Waltham, where I went on some visits a few weeks ago. Liz has long been calling for a formal register of care workers, which would be one of the functions of any new royal college of care workers.
Liberal Democrats also call for a national carers register, so that all unpaid family carers can be better supported, for example with statutory respite care. We also call for a higher carer’s minimum wage, because paying poverty wages for such emotionally and physically demanding work is not only unjust but short-sighted and drives burnout, turnover and, ultimately, worse care.
Let us be clear: dementia is not going away. One in three people born today will develop dementia. The hon. Member for Worthing West (Dr Cooper), with her public health experience, was insightful in her advice on how we can help to prevent it from developing.
The financial pressures on local authorities, driven in large part by adult social care, are among the most urgent political challenges of this decade. In Winchester, the Chesil Lodge day centre provides essential care for older adults, including those with dementia, and importantly provides respite care for family members. Hampshire county council is threatening to withdraw funding. That could overwhelm unpaid carers, forcing loved ones into residential care, which in the end will cost the council and taxpayers more.
With the political will, proper investment and genuine commitment to value and care work, we can build a system that supports people with dementia with dignity and gives their families the help and hope they so desperately need.
Joe Robertson
As my hon. Friend knows, at the beginning of the year, the Government and NHS England removed dementia from their planning guidance, which sets their priorities for the year ahead. Crucially, they removed the diagnosis targets. That was a cruel blow to people living with dementia and their families. Will the Minister give his view on the Government removing dementia from their targets and priorities?
Dr Evans
I am grateful, first, for my hon. Friend promoting me and, secondly, for his expertise in this area because I understand that he has worked with Dementia UK. He is absolutely right—he has beaten me to the chase. One of the real concerns that charities and patients have raised is exactly that: the removal of this crucial diagnosis target. We only need to look at Wales where that was not the case. The national diagnosis rate is 56%—10% lower than in England.
On top of that, the Government are presiding over a major top-down restructuring with cuts to integrated care boards and NHS England, while forcing through devolution on the 21 county-run authorities responsible for social care, while raising taxes in the employment national insurance contribution on care providers, which will get passed on to local councils, while raising taxes on the very dementia charities and others that provide support, while ditching the fast-track social work scheme as we learned last week, while terminating the NHS and care volunteers response that helps support care, and while scrapping the cross-party talks on social care and instead swapping it to an independent commission led by Baroness Casey, who still seconded to the Home Office. We can all see what is being taken away and taxed. It is what is going to benefit dementia support and care that is much harder to spot.
In the rough and tumble of this place, it is not lost on me how much this issue touches the Minister himself. He has spoken bravely and openly about his family’s struggle, and I have the utmost respect for him and what he has been through, and I have been through similar with my grandmother Dot. I do not question his heart; I simply gently challenge the Government on their policies to achieve better dementia care for all.
To that end, I have a couple of questions. Will the Government commit to setting a new target to increase dementia diagnosis rates across England? With integrated care systems facing restructuring and budget resolutions, how does the Government plan to hold local systems to account on dementia diagnosis, especially across the NHS and social care? We have seen in Wales how irregular data collection on dementia diagnosis affects overall diagnosis rates. What steps will the Government take to improve the quality of data in dementia diagnosis, particularly when it comes to follow up? Given the growing prevalence of dementia in our care homes, what steps will the Government take to support providers and ensure that the social care workforce is trained effectively to meet the needs of care users?
With the upcoming spending review and the long-awaited 10-year plan for the NHS expected in the next couple of months, I trust the Minister sitting in front of me. He is the right person to highlight to the Government the seriousness and importance of tackling dementia, just like the last Government understood.
I return to where I started: dementia steals the most from those left remembering, because the greatest heartbreak is losing someone who is still here. But with compassion for families, dignity for those who suffer and the relentless pursuit of a cure, we can offer not just care, but hope.
The Minister for Care (Stephen Kinnock)
I thank the hon. Member for South Devon (Caroline Voaden) for securing this debate, and I commend her for her work as a member of the all-party parliamentary group on dementia. It has been a thoughtful and constructive debate, with a number of truly powerful and moving personal contributions from Members across the Chamber.
This is a cause that is close to my heart. I thank all Members for their kind words about my own family, but our history is far from unique. We know that one in two of us will be affected by dementia in our lifetime—by caring for someone with the condition, developing it ourselves, or both. It is predicted that just under 1.5 million people in England will be living with dementia by 2040. Each person, along with their loved ones and carers, has a unique journey and their own heartbreaking stories. On behalf of the Government, I thank everyone working to support people with dementia, as well as their friends, families and carers. This Government will back them every step of the way. We are also backing our scientists to deliver new treatments and ways to care for people living with dementia, and I recently had the pleasure of visiting the UK Dementia Research Institute’s centre for care and technology, where I saw some of its innovative smart-home tools.
A timely diagnosis is vital to ensure that everyone can access the advice, information and support that can help them to live well with dementia and remain independent for as long as possible. This Government remain committed to the national ambition for two thirds of people living with dementia to receive a formal diagnosis. We are funding evidence-based improvement projects to pilot the diagnosing advanced dementia mandate in 14 trusts. I am delighted that best practice is currently being shared and promoted with regional and local partners, following an impact assessment of the pilots.
Dementia can impact anyone, but there is varying and unequal access to health services. That is why the Office for Health Improvement and Disparities is working to make our country fairer by developing a tool that provides a clear assessment of population characteristics, such as rurality and socioeconomic deprivation.
Joe Robertson
I welcome the Minister’s confirmation of his commitment to the diagnosis target of two thirds. Will he put that in a key document—the equivalent of the planning guidance for NHS England? Will he ensure that that is well documented and set out in a strategic document, so that we can be absolutely clear and are not relying on his oral assertions in this Chamber?
Stephen Kinnock
We are absolutely on the record with the 66.7% target.
I want to take this opportunity to set out what appears to be a philosophical difference between this Government’s approach to our health and care system and that of many Opposition Members. We believe in devolution, we believe in decentralisation, and we believe in empowering those who are closest to the citizen to make the decisions that need to be made. If others have a more centralising and deeply anachronistic approach to managing our health and care system, which I heard from Liberal Democrat and Conservative Members, that is up to them, but we believe in modernising our system, not micromanaging or having shopping lists of targets. It is about providing support and agreeing on outcomes, but leaving those who are best placed at the coalface to decide how best to meet the unmet needs of their communities. That is a very clear dividing line between us.
On research, it is worth pointing out that we have done studies with UK Research and Innovation, the Alzheimer’s Society and the People’s Postcode Lottery. We have found that through our investment, ADAPT and READ-OUT are working to produce clinical and economic data that could bring blood tests to the NHS within five years to support the diagnosis of dementia. All of this means that the rate of diagnosis is improving. The latest data from April shows that the diagnosis rate has inched up to 65.5%, up 0.3% since July 2024, and it is worth noting that the 66.7% ambition has not been met since 2020.
The quality and availability of care services is variable, as Members have pointed out. We are empowering local leaders with the autonomy they need. We are supporting integrated care boards. I am pleased to say that we recently published the Dementia 100 pathway assessment tool, which brings together multiple resources into a single, consolidated training tool. That launched last month, and there has been huge interest and support from the sector, with 1,000 people registering to attend the launch webinar. We have the dementia care pathway full implementation guidance, and we are supporting the implementation of that guidance through a dashboard, to enable targeted support where it is needed.
All those who have dementia deserve to receive high-quality care. We must have a workforce that is equipped with the skills that are needed. We are incredibly proud of everyone who works in the care sector, and they deserve the training that many Members have mentioned. The care workforce pathway provides guidance for progression and development for professionals across adult social care with the knowledge, skills, values and behaviours that our carers need. It links learning outcomes to existing frameworks, including the dementia training standards framework.
Some of those learning outcomes can be achieved through the training and qualifications eligible for funding under the learning and development support scheme. That scheme, launched in September last year, supports adult social care employers to invest in their workforce through funded training opportunities, including a range of dementia-related qualifications. I am pleased to confirm that we have backed the scheme with a £12 million investment. Pay and conditions are also vital elements of our workforce strategy, so I am sure Members across the House will welcome our groundbreaking fair pay agreement legislation in the Employment Rights Bill for adult social care workers, which is hugely significant in this context.
On the question of our care workforce, a number of Members have highlighted the vital role that unpaid carers play. To support them, on 7 April the Government increased the carer’s allowance weekly earnings limit from £151 a week to £196 a week, which is the equivalent of 16 hours at the national living wage—the largest increase in the earnings limit since the carer’s allowance was introduced in 1976. We are very proud of that change.
I understand that every person with dementia, alongside their friends, families and carers, has their own unique and important story of living with dementia. I know that I am not alone in this fight. I want to pay tribute to the Alzheimer’s Society, Dementia UK and Alzheimer’s Research UK for all their vital work. Together, we will build a society where every person with dementia receives high-quality care from diagnosis through to the end of life. I once again thank the hon. Member for South Devon for raising this vital topic.
Oral Answers to Questions
Joe Robertson Excerpts(1 month, 1 week ago)
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Wes Streeting
Young people’s mental health is a priority for this Government. That is why we set out in our manifesto our commitment to making sure that mental health support is available in every primary and secondary school in the country. We have walk-in mental health services in every community, and we invest in the mental health workforce, so that we can cut waiting times. I am also working closely with the Secretary of State for Education to make sure that our education and health services work together, so that children get the very best start in life, and so that we look after mind, body, soul, aspiration and futures.
Joe Robertson (Isle of Wight East) (Con)
The Chancellor increased the cost of employing people in social care by raising national insurance contributions for social care employers, and then exempted NHS employers from those increased costs. When will this Government properly support social care and relieve the sector from pressures caused by the Chancellor under this Government?
Wes Streeting
Thanks to the decisions taken by this Chancellor, we are putting £26 billion more into health and social care. Thanks to the decisions taken by this Chancellor, the spending power of local authorities has risen. Thanks to the decisions taken by this Chancellor, we have delivered the biggest expansion of carer’s allowance since the 1970s. Thanks to the decisions taken by this Chancellor, we have significantly increased the disabled facilities grant, not just last year but this year. That is the investment delivered by a Labour Government, and opposed by the Conservatives and Reform, and it shows that only Labour can be trusted with our NHS.
Department of Health and Social Care
Joe Robertson Excerpts(3 months, 1 week ago)
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Joe Robertson (Isle of Wight East) (Con)
I commend my hon. Friend the Member for North Cotswolds (Sir Geoffrey Clifton-Brown) for his introduction to the debate. I agree with the majority of what I have heard so far.
We must understand the context of the large figures announced by the Government. In particular, the £10 billion for the NHS next year sounds like a big figure, but as my colleague and Chair of the Health and Social Care Committee, the hon. Member for Oxford West and Abingdon (Layla Moran), was right to inform us, the vast majority of that money—around £8 billion to £9 billion—will be taken up by union pay deals, the national insurance increases brought about by the Chancellor, and inflation. When all the essential costs that the NHS must meet are taken into account, the £10 billion represents a shortfall. The NHS will be able to deliver only if it produces productivity gains. We must understand that £10 billion will not even meet the required costs of the NHS.
Joe Robertson
I agree with all those things, and I am happy that the hon. Lady and I agree with each other. I hope that she acknowledges that £10 billion does not cover the basic requirements of the NHS. It delivers nothing more; in fact, it delivers less. The NHS will be able to continue to grow only if it delivers productivity gains, and it should.
Gregory Stafford
Does my hon. Friend remember, as I do, that when the Secretary of State was in opposition, he was very clear that there would be no pay increases unless there were productivity gains and reforms to the way the NHS operates? Now that Labour is in government, that seems to have completely evaporated.
Joe Robertson
I remember that clearly. I would like the Minister to spell out how she will deliver those productivity gains through reform. We want to hear more detail so that we can be confident that the NHS is secure.
Let me turn to one area that the Minister might like to reflect on: the use of technology. Penny Dash, the candidate to take over as chair of NHS England, told the Health and Care Committee clearly that she would like technology to deliver and that she sees lots of opportunities. She herself remarked that basic technology in the NHS is not working. I recall that she used the example of nurses taking half an hour to turn on a computer system and having to use five passwords to access it. I said to her that it is hardly sensible to try delivering technology gains around artificial intelligence and all the opportunities that it might bring if we cannot deal with very basic, low-tech problems throughout the NHS. She agreed and accepted that is a challenge. I would like to see how the Secretary of State will, through the Minister, support NHS England in delivering that.
I would also like to see the dementia diagnosis target brought back into the planning guidance document for NHS England. It was taken out this year, in consultation with the Secretary of State—so he allowed that. Diagnosing dementia is the most important thing we can do for people living with dementia and their families. Taking that diagnosis rate target out is inexcusable. I accept the wider point that if everything is a target and a priority, then nothing is a priority, but I think we can all agree that dementia—the biggest killer in this country—must be a priority for the NHS. That target for diagnosis rates must come back into the planning guidance next year. Indeed, the word “dementia” does not even feature in the guidance, which is shameful, frankly.
Let me finish by talking about where the money is spent. We can have disagreements about how much is needed, but Lord Darzi was very clear that it is not being spent in the right places. Too much money in the NHS is being spent on hospitals, and not enough is being spent in the community. The Secretary of State will have to take some tough decisions, which he accepts, and one of them will have to be to reduce the proportion of money spent on hospitals. That is politically difficult, but across the House we are prepared to back him, if it is part of a plan to deliver meaningful change and to move more people out of hospitals and into communities, which is where they most want to be treated. Nobody wants to be in hospital if they have no medical reason to be there.
Finally, the Chancellor must understand that every decision she takes must be coherent and consistent with delivering the three shifts. When she came to the Dispatch Box to deliver the Budget in October, she recognised that national insurance increases were going to be crippling for healthcare. That is why she exempted the NHS from those increases. However, she failed to exempt other key providers of healthcare, particularly in primary care, such as GPs, so it is no good now saying that the GP pay deal is a record deal, because the money that they must pay in national insurance contributions represents more than 50% of the money that the Government have given them. The Chancellor must back up the left shift with the fiscal decisions she announced at the Dispatch Box.
Several hon. Members rose—
Oral Answers to Questions
Joe Robertson Excerpts(4 months ago)
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Stephen Kinnock
I am working very closely with colleagues in the DFE on how we mainstream SEND provision more effectively, get more rapid education, health and care plans and autism diagnoses, and on a whole range of issues that require strong cross-party work. I would be happy to brief my hon. Friend on that separately.
Joe Robertson (Isle of Wight East) (Con)
The Secretary of State for Health and Social Care (Wes Streeting)
The dementia diagnosis rate target was not met for the last five years of the Conservative Government, and it declined over the course of the last Parliament. This Government are committed to ensuring that at least two thirds of people living with dementia receive a diagnosis. The Government are investing in dementia research across all areas, from causes, diagnosis and prevention to treatment, care and support, to help people live with this condition.
Joe Robertson
Nearly 1 million people are living with dementia—it is the biggest cause of death in the country today—and by the end of the 2030s that figure is set to rise to 1.4 million. Early diagnosis is one of the best things we can do to support people living with dementia, so will the Secretary of State explain why the dementia diagnosis target no longer features in NHS England’s priorities, as published two weeks ago? Will he commit to reinstating both dementia and the commitment to a diagnosis target in NHS England’s priority guidelines?
Wes Streeting
I just restated the Government’s commitment to ensuring that at least two thirds of people living with dementia receive a diagnosis. Our investment and reform agenda will speed up diagnostics across the board. Under the last Government, NHS planning guidance was a wish list of fantasy targets, most of which were never met. As the NHS got worse and worse, they piled on more targets to make themselves look busy. This Government are ending the micromanagement, turning our NHS around and clearing up their mess.
Health and Social Care: Winter Update
Joe Robertson Excerpts(5 months ago)
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Wes Streeting
That is an excellent question from my hon. Friend. This Government have been walking the talk on primary care since we came into office. There was an immediate release of funding, within weeks, for 1,000 GPs, who are to be employed on the frontline by this April, and an £889 million uplift in funding for general practice that we announced prior to Christmas. I think that care in the home and care closer to home will be how we not only get the NHS back on its feet, but make sure it is fit for the future. That shift from hospital to community is one of the three big shifts that will lie at the heart of our 10-year plan for the national health service.
Joe Robertson (Isle of Wight East) (Con)
The Secretary of State referred to social care in his update on winter pressures, and he is of course right that social care has an important role to play in taking pressure off hospitals. However, surely he can understand the frustration that the sector and those in receipt of social care feel about his pushing the issue into a three-year review, which Sir Andrew Dilnot says is an inappropriately long time. Why will it take so long? Please can he put pressure on the review? I am sure that Baroness Casey is well capable of doing it in a shorter time.
Wes Streeting
I am happy to report that people will not have to wait three years for action on social care. In fact, we have seen lots of it in the last six months. We have had the biggest expansion of carer’s allowance since the 1970s; the legislation for fair pay agreements in the Employment Rights Bill, brought in within the first 100 days of this Government; the uplift in funding provided by the Chancellor through her Budget; and the expansion of the disabled facilities grant. There will be more for us to do this year, including reform to make the better care fund more effective. Baroness Casey’s first report will in fact be next year. It will set out the action required on social care throughout this Parliament. I hope that reassures people right across the House and, more importantly, right across the country that social care is a priority for this Government. We will seek to do better than our predecessors of all parties—I have made this point before—because we have to tackle this generational challenge facing our country.
Tobacco and Vapes Bill
Joe Robertson ExcerptsTuesday 26th November 2024
(6 months, 3 weeks ago)
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Mr Jonathan Brash (Hartlepool) (Lab)
It is a rare thing in politics to have a moment when there is an absolute right thing to do, but consigning smoking to the history books for our children, our grandchildren and every generation that follows is one of those times. We should be under no illusion that the decision that we take today will, at some point in the future—long after we have left this place—result in a time when nobody smokes. That will be the legacy of this decision today.
I ask the House to indulge me for a moment. Let us imagine that, at that point in the future, somebody brings forward a Bill to decriminalise smoking, and the Minister, clutching their impact assessment, tells the House that it will kill only 80,000 people a year, that it will cost our NHS £3.6 billion and that 80% of the people who take it up will be under 20. Which one of us would vote for it? Which party leader would refuse to direct their troops in such a vote? Who would argue that it is freedom of choice to smoke in those circumstances? It is nonsense. The decision we are taking today is clear and it is for the good of this country.
Joe Robertson (Isle of Wight East) (Con)
The hon. Member talks about choice. I agree with what he has said so far, but does he agree that, when it comes to the banning of smoking for people born after 1 January 2009, there is no removal of choice in the Bill, because they cannot smoke anyway at the moment? Therefore, there is no removal of choice from those people.
Mr Brash
The hon. Member is completely correct in what he says, and it is the proportionate way to do it. Some of the arguments that I have heard today about freedom of choice are genuinely confusing. One Member asked earlier why we do not ban sugary foods or alcohol on that basis. I say that we have to draw the line somewhere. That is an argument for the decriminalisation of everything—cocaine, heroin, you name it, let’s go for it. No, we have to draw the line somewhere and, given the statistics around smoking, it is clear that this is the right line to draw.
I do not want to say a great deal more on this issue other than to reflect on the conversations that I have had with my children. We have been on a long journey when it comes to smoking in this country. I remember telling my children that they could eat a meal in a restaurant, and that those on the table next to them, in the smoking zone, would be smoking while they ate. They thought I was mad. I remember going to school on the bus and seeing the little cigarette holders in front of me because people used to be able to smoke on the bus. My children think that is madness. I can only hope that not long in the future children will look back and think that it was mad that we smoked at all.
I was asked about this Bill soon after I was elected by a friend, who is a parent. He knew it had fallen prior to the general election. He asked, “Will it be back?” and I said, “I am confident that it will be back.” He said, “But will it be in time?” and I said, “In time for what?” He said, “In time for her” and pointed to his teenage daughter. I am pleased to say to Mark, Kim and their daughter Bella that we are bringing it back in time and that it will make a massive difference to the lives of people in this country.
Healthcare: Hampshire
Joe Robertson Excerpts(6 months, 4 weeks ago)
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Dr Chambers
I agree with the hon. Gentleman; when there is a lack of communication with residents, decision makers and any other interested stakeholders, that is when there are difficulties, such as rumours and unnecessary anxiety. Improved communication, whether in healthcare or in any Government Department, solves a huge number of problems.
On the point made by the hon. Member for Strangford (Jim Shannon) about accessing healthcare when people live in rural areas, I have a story about Margaret, who lives just south of Winchester and who wrote to me saying that she had been given an appointment at Basingstoke for a particular type of X-ray. Her journey to Basingstoke hospital took well over an hour and involved multiple buses and a train, plus considerable walking time. Margaret has chronic obstructive pulmonary disease and gets exhausted walking long distances, and she cannot easily afford a taxi all the way from Basingstoke back to Winchester. She asked me whether people without cars were to become second-class citizens and be denied access to decent healthcare options. We have to look at individuals’ situations, and that can include needing really good public transport. The more community care we have in people’s towns and villages, the quicker they can get there from their homes.
The other side of emergency care and A&E departments is social care. We have said many times that we cannot fix the NHS without fixing social care. We know that in the Hampshire hospitals NHS foundation trust, there are between 160 and 200 people at any given point who are well enough to be discharged and more appropriately cared for in the community with social care packages, but who are currently stuck in a hospital bed and cannot be discharged. That means that patients cannot be moved out of A&E and people cannot be removed from ambulances as quickly as they could be, which means that ambulance waiting times are longer.
When I spoke to the CEO of Winchester hospital, he said that the single biggest help they could get from Government would be another 160 social care packages. Although people ask where the money will come from, we know it is more expensive to keep someone in a hospital bed than to give them a social care package. We have winter pressures coming up—indeed, winter has already started—and the CEO has told me on more than one occasion that, to help with those winter pressures, more social care packages would probably be the single biggest intervention that would make a huge difference. Local authorities struggle to afford social care packages and the NHS trusts have to fund some of those packages out of their NHS budget, which is primarily meant for treating people in hospital.
One of the biggest concerns raised by Winchester residents is the potential removal of consultant-led maternity services at Winchester hospital. That means that if a woman were to haemorrhage or require an emergency C-section during labour, she would need to be transferred. To put that into perspective, in April 2024, 22.7% of births were performed via emergency C-section at Winchester hospital. It is clear that surgical interventions are not an unusual eventuality, but something that will affect more than one in five mothers.
An emergency transfer in such a situation would inevitably put the lives of some women and babies at serious risk and, tragically, some could be lost. A constituent wrote to me about her daughter, who had recently haemorrhaged badly after giving birth to a baby who was in a breech position. The blood transfusion and lifesaving surgery to remove her placenta needed to happen within minutes, and it is unthinkable what would have happened had there been no consultants on hand. As someone who has performed many emergency caesareans—on animals rather than on humans—I know that time is of the essence, and anything that delays surgical intervention can make a huge difference, not just to whether the person and the baby survive but to whether the baby has potential brain damage and other life-changing complications.
As the Liberal Democrat mental health spokesperson, I see this debate as a chance to highlight how desperately we need more resources put into mental health, alongside a more holistic approach to treatment. When speaking to residents in Winchester, one of the most common concerns is the difficulty in accessing mental healthcare, and that is especially true for parents who are struggling to access mental healthcare for their children.
I spoke to a constituent near Swanmore who was struggling to access the mental healthcare and support they needed for their child who was anorexic and had an eating disorder. They had been informed that their child had to reach a lower BMI to qualify for the threshold to get treatment, because resources are so stretched. That would not be considered even remotely acceptable for any other disease. A person with cancer would never be told that they needed to reach stage 4 before they qualified for treatment. We know that outcomes with delayed treatment for mental and physical health disorders, of which eating disorders are a combination of both, will be much less successful and much less cost-effective, requiring longer and less successful treatment the longer that the condition is left. I urge the Minister to look with particular concern at the mental health of young people and children. Delays in mental health treatment for anyone can be catastrophic, but a three-year delay for someone who is only 13, 14, or 15 is a huge chunk of their life.
As part of that, we urgently need to invest in primary care. Failing to address this will only place greater pressure on our already overstretched hospitals. I have spoken to people who have spent extended amounts of time in hospital beds, because they cannot get the mental healthcare that they need.
Similarly, the lack of NHS dentists often forces patients to turn up to hospital, sometimes needing a general anaesthetic, to sort out tooth root abscesses, which costs more than providing NHS dental care. It seems as though all the dentists I speak to say that their current contract for performing NHS care is not fit for purpose. I urge the Minister to look at this as an urgent priority, because so many people are not receiving the dental care that they need. It seems as though this whole issue will not be resolved until the NHS contract is looked at.
The other issue that affects people getting healthcare in their communities, especially around Hampshire, Winchester and the Meon Valley, relates to struggling pharmacies. The situation for pharmacies seems to be very similar to that of the dentists in that their arrangement with the Government for providing prescription services does not seem to be fit for purpose. It seems to be costing pharmacies money to provide prescription drugs, and they are telling me that their businesses are no longer viable. The more pharmacies that we lose, the further people will have to travel to not only collect drugs, but get medical advice and vaccines.
In conclusion, I wish to pay tribute to NHS staff. I imagine that they dread the winter coming up. Every year, it is a stress for them. Every year, they are overworked. And every year, we know that both clinical and non-clinical staff will work longer hours than they are contracted to do. I know that they will be bracing themselves right now. They will be busier, and they will be putting themselves at risk from getting things such as flu, covid and the other respiratory diseases that we see in the winter. One thing that we can all do, both as the public and the Government, is to encourage everyone to get vaccinated ahead of these winter pressures. Anything we can do to prevent a trip to hospital will make their job easier and make it less likely that they will get sick.
Joe Robertson (Isle of Wight East) (Con)
The hon. Gentleman speaks eloquently on a wide range of healthcare challenges in Hampshire. Does he agree that our shared integrated care board for Hampshire and the Isle of Wight must do all that it can to make the best of the situation, particularly in relation to NHS dentistry and funding for hospices across Hampshire and the Isle of Wight?
Dr Chambers
The hon. Member makes a good point about hospices in particular. Only about a third of hospice funding is provided by the Government. It is a hugely emotive subject, which affects not only the people in the hospice but the whole family, who are trying to care for a loved one who often has only weeks or months left to go. We have two hospices in Winchester, one of which is a children’s hospice, Naomi House. Some of the most moving visits I have ever done have been to hospices, where the staff and patients are incredibly brave. We have a debate coming up on assisted dying. We will really have to look at palliative and hospice care and how it is funded, and how we make it sustainable and fit for purpose. I thank him for that important intervention.
Many constituents write to tell me about the excellent care that they receive in hospitals, and how much they appreciate the hard work of NHS staff. A Winchester resident called Owen wrote to tell me that he honestly does not believe that he would be alive today were it not for Winchester hospital. Owen sadly suffers from a brain tumour in the pituitary gland, and has needed many emergency treatments. Owen lives five minutes from the hospital and has managed to have lifesaving treatment there on multiple occasions.
We need to avoid the trap of cutting short-term costs, such as by not investing in social care, which has ended up costing the state so much more money in the long run. We need a comprehensive plan to give people adequate local healthcare throughout their lives, and escape the endless cycle of crisis after crisis. We know that winter is coming this year, and coming next year. What are we doing to ensure that we will not have an NHS crisis in Hampshire next winter as well?
Income Tax (Charge)
Joe Robertson Excerpts(7 months, 1 week ago)
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Joe Robertson (Isle of Wight East) (Con)
This is not a Budget for growth. On the Treasury’s own figures, growth will decline from 2% next year for the rest of the decade. On the OBR’s analysis, this Budget is inflationary. It is not on small businesses that the responsibility should land. Small businesses employ people. Small and medium-sized businesses drive the UK economy. If we tax them, we tax growth. If we tax their greatest assets—the people who work for them—then we take away employment opportunities for hard-working people.
I will talk more substantively about the dire impact of the Budget on health and social care, including health and social care providers that are not part of the NHS. The increase in employer’s national insurance contributions will cause great difficulty and hardship for GP practices; charities, including hospices; dentists; pharmacies, which are crucial providers of health services; and social care providers. Those organisations, charities and businesses thought that they might have a friend in a Labour Government, but I assure Government Members that they do not feel as though the Labour Government are a friend right now. I have been speaking to those in GP practices in my constituency on the Isle of Wight. One said:
“Our increase in tax from this Budget is the equivalent of the salary of a practice nurse. There will be no new practice nurse for us.”
Graham Stuart
Does my hon. Friend agree that no one would think less of the Government if they listened to these arguments, heard the message and changed? For instance, there is the message about social care being hit by £2.5 billion of extra costs. The £600 million that has been given to local authorities will not cover those costs. If the Government simply listened and changed, people would think much better of them, and we would have a social care system that supported the NHS, rather than one that stops the NHS being able to do what it needs to do.
Joe Robertson
I agree with my right hon. Friend. In fact, there has been one common theme running through this debate: GP practices, charities such as hospices, dentists, pharmacists and social care providers are all being taxed by this Government. At a time when they need Government most, these providers find increased pressure on their ability to employ and provide services to the British people. There would be no shame if the Labour Government were to do something about this gross problem with their own Budget.
Moving on to social care, the Secretary of State for Health and Social Care said that there would be no more money for the NHS without reform, yet the Chancellor provides £22 billion for day-to-day spending unattached to reform. She and the Secretary of State are giving the equivalent of just 2.5%—£600 million—of that £22 billion for social care. That is a tiny fraction, yet the biggest reform that our NHS needs is fairer funding for social care. Money would be better spent on relieving the pressure on hospitals, and getting people out of hospital beds who do not need or want to be there, but who have nowhere safe to go to. Through this Budget, social care providers not only face the full burden of increased national insurance contributions, as employers, but receive a small fraction of the funding that the NHS receives. I urge the Government to go back to the drawing board and provide for our GPs, dentistry, pharmacies, hospices and social care.
Oral Answers to Questions
Joe Robertson Excerpts(10 months, 3 weeks ago)
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Wes Streeting
I am grateful to the hon. Member for her question and congratulate her on her re-election to the House. She is right to point to the detrimental impact that the Conservatives’ failure is having on people’s lives. In fact, in 1948, when the national health service was founded, Nye Bevan received a letter from a woman who had worked her entire life in the Lancashire cotton mills about how the dentistry she was given by the national health service had given her dignity and the freedom to associate in any company. What a tragedy that 76 years later, the Conservative party has squandered and destroyed that legacy to the point where people are suffering not just pain and agony, but the indignity of being unable to find a job and unable to socialise in polite company because they are ashamed of the state of their rotting teeth.
The hon. Member is absolutely right: Lord Darzi is conducting a review on the state of the NHS, and it will report in September. That is not preventing us from making progress, talking to the BDA and working within the Department and across the sector to get those 700,000 appointments up and running as a matter of urgency. I look forward to reporting the progress to her and other right hon. and hon. Members.
Joe Robertson (Isle of Wight East) (Con)
As the right hon. Gentleman is aware, there is a particular shortage of NHS dentists in coastal and rural communities such as mine on the Isle of Wight. Will he therefore commit to the previous Government’s plan for 240 golden hellos for newly qualified dentists by the end of the year to address that issue?
Wes Streeting
I welcome the hon. Member to the House—it is a rare thing to welcome new Conservative Members, and he is welcome. He is absolutely right to touch on the workforce issues in NHS dentistry, and to say that we need to incentivise dentists, on two fronts: we need them to commit to and do more work in the NHS—we are looking at a range of things in that regard—and we need to ensure that we get more dentists to the areas in which they are most needed. We will certainly support incentives to that effect.