Community Audiology

Richard Foord Excerpts

Thursday 18th December 2025 Westminster Hall

[Richard Foord (Honiton and Sidmouth) (LD)]

It is a pleasure to serve with you in the Chair, Mr Vickers. I am grateful to the hon. Member for Uxbridge and South Ruislip (Danny Beales) for choosing this as a subject for debate.

It was fascinating to hear from the Father of the House about his time in the Honourable Artillery Company, listening to the guns and then perhaps regretting it in later years. It reminds us of our responsibility in this House to try to prevent problems that may emerge later. Last weekend, I was reading about a former colleague of mine, Lieutenant Colonel Rob Page, who has suffered 20% hearing loss off the back of his time testing the Ajax vehicle. Plainly, that is something we have to watch out for.

This debate is about community audiology. In my Devon constituency, I represent people who care a great deal about hearing health. Honiton and Sidmouth has the sixth oldest constituents in the country by demographics. Local health data shows that 7.3% of residents in the Devon ICB area report hearing loss or deafness. That compares with an average in England of 5.8%.

In an ageing population, this is about the older age profile of all of our communities. In my constituency the median age is 57, so hearing loss is very common and hearing care is essential. Johns Hopkins University found that people with moderate hearing impairment are more than twice as likely to experience a fall as those without hearing loss. Falls in older people often lead to hospital admissions and then to a significant loss of independence.

The Health Secretary has characterised the plans for NHS reform as being partly about a shift from sickness to prevention and from hospital to communities. Plainly, community audiology will have to sit at the heart of this. In Devon, community audiology has been complicated by some major changes in provider arrangements. Until March this year, Chime Social Enterprise delivered NHS audiology services and routine community audiology. Chime had its challenges, but it had a local presence, including in a lot of towns that I represent. It had drop-in clinics for people who needed urgent repairs or had urgent issues. However, from 1 April 2025, NHS Devon integrated care board commissioned several new providers in place of Chime for routine and specialist audiology, and that changeover has caused a lot of problems.

One elderly constituent, who has relied on hearing aids for more than 25 years, told me that she had to wait from June until September before she was able to see her usual audiologist. When she finally got to her appointment in Sidmouth, she discovered that the new provider had no access to her medical records, and she was told that she would have to come back in November to have new hearing aids fitted and supplied. Something that should not have taken very long at all took a total of five months. That was not just five months of inconvenience waiting for an appointment; it was five months of struggling to communicate with the rest of the world. I wrote to NHS Devon after being inundated by similar reports, and I received a reply to my letter of 16 June saying that the changeover was happening as fast as NHS Devon could make it happen.

Although waiting times appear to be improving, this disruption is not unique to Devon and it reflects wider pressures across the community. Across NHS community audiology in England, 38% of people were waiting six weeks or more for audiology appointments. That is set against the fact that the national hearing loss charity the RNID reports that about 70% of people who go private receive hearing aids or support within two weeks. Plainly, we are seeing that when community audiology breaks down, patients wait longer for appointments, continuity of care is lost, and those who cannot afford to go private get left behind.

That is not supporting the transition—from hospital to community, and from treatment to prevention—that the Government want. If the NHS is truly to prevent hearing loss in the community, community audiology must work for patients every time, and that includes in rural and coastal areas such as the one I represent.

Sudden Cardiac Death in Young People

Richard Foord Excerpts

Monday 15th December 2025 Commons Chamber

[Chris Vince]

I thank the hon. Gentleman for his intervention and his kind words. He has intervened at the perfect time, because I was just going to go through some of the statistics. Twelve people aged between 14 and 35 die each week in the UK—which obviously includes Northern Ireland—from an undiagnosed heart condition, and as my hon. Friend the Member for Putney (Fleur Anderson) mentioned, 80% of those people show no symptoms, meaning that the first sign is often sudden cardiac arrest. Elite athletes are screened by mandate, but amateur and grassroots athletes are not, despite their facing some of the same exercise-related risks. The NHS currently screens families only after a sudden cardiac death, so Hilary and her family were screened for the condition that took away her daughter’s life, but obviously that is too late for prevention.

[Richard Foord (Honiton and Sidmouth) (LD)]

On the hon. Gentleman’s point about elite athletes being screened, in September I went to Sidmouth college, which was hosting the very elite Exeter Chiefs rugby team. They were being screened alongside pupils from Sidmouth college because of the great work of Marion Hayman, whose son died aged 27 from a sudden cardiac arrest that came out of absolutely nowhere. Does the hon. Gentleman share my view that screening young people can save many, many lives, and that setting up memorial funds in the way Marion did for her son Jonathan can enable us to save more of those lives?

[Chris Vince]

I absolutely agree with the hon. Gentleman. I know of the funding Hilary was able to raise in memory of her daughter Clarissa to do just that, and of the work that Kieron did in the name of his son Connor to raise funds for exactly that purpose. I will come on to some of my recommendations and key asks in a moment, but what the hon. Gentleman has described is one of them, so I thank him for his intervention.

As I said, the NHS screens families only after a sudden cardiac death. It screens young people with symptoms, but many active young people are dismissed without tests because they do not show those symptoms. There are currently no screening pathways for asymptomatic young people, who make up the majority of those in risk. The National Screening Committee previously rejected screening, but I believe it is now reviewing a targeted programme for amateur athletics.

Finally, I come to some of the key asks.

Unpaid Carers: Inequalities

Richard Foord Excerpts

Thursday 20th November 2025 Westminster Hall

[Richard Foord (Honiton and Sidmouth) (LD)]

It is an honour to serve with you in the Chair, Ms Vaz.

The Office for National Statistics estimates that around 130,000 people in Devon provide unpaid care. That is roughly one in six Devon residents. To understand what that means in real life, I want to share the story of Emma Donovan from Sidmouth. Emma cares for both her parents: her mum who lives with Parkinson’s and dementia, and her father who is a veteran whose injuries have worsened with age. At the same time, she runs a non-profit, she works two part-time jobs, she volunteers as a Rotarian and she still tries to live a life of her own.

Through her start-up, In a Pickle Services, Emma provides hygiene and wellness packs to people experiencing homelessness, but because statutory support has fallen away, her organisation is having to restart an unpaid carers’ support group, inspired by the excellent Honiton Carers Support Group. The new group in Sidmouth will launch in January and will help unpaid carers to manage the day-to-day reality of caring. The average age of Sidmouth residents is 59, which means that it has one of the highest proportions of carers of anywhere in the country. Emma’s experience mirrors that of countless carers across Sidmouth, Seaton, Axminster and Cullompton: constant pressure, limited respite and a system that too often leaves people to cope on their own.

A recent report by Healthwatch in Devon, Plymouth and Torbay found that a third of unpaid carers provide more than 20 hours of care a week. That is sustainable only with proper support. The report highlighted poor communication, long waits for help and carers not being identified early enough. Many carers said that their mental and physical health is deteriorating because caring leaves them no time. Even when people do apply for help, carer’s allowance is paid only to those who prove that they provide at least 35 hours of care a week, and because it is an allowance and not a wage, it does not increase should the carer do more hours in a week than the minimum 35, which leaves some effectively receiving less than £2 an hour.

The Carer’s Leave Act 2023, introduced by my hon. Friend the Member for North East Fife (Wendy Chamberlain), was a major step forward, giving working carers up to five days of unpaid leave per year. But that is still not enough. We Liberal Democrats are calling for paid carer’s leave and guaranteed respite, so that people are not forced to choose between their jobs and those they love. Our wider package of reforms would raise carer’s allowance by £20 a week and widen eligibility, recognising that too many carers miss out.

People like Emma give so much to their families, their communities and to our country. They should not be left to struggle on their own. I thank the hon. Member for Shipley (Anna Dixon) for securing both this debate and the presence of the Minister. We look forward to hearing from him the latest on the Government’s plans to support carers.

--- Later in debate ---

[The Minister for Care (Stephen Kinnock)]

It is a pleasure to serve under your chairship, Ms Vaz. I thank my hon. Friend the Member for Shipley (Anna Dixon) for securing this vital debate. I pay tribute to her for her career-long dedication to adult social care and so many of the issues we are debating today. I also pay tribute to all the powerful and moving contributions we have heard today, many about personal experience, engagement with constituents and the stories we hear every day about the pivotal role that unpaid carers play in our care system, which are truly inspiring and uplifting.

Every day, unpaid carers step up to sustain the health and wellbeing of millions of people across our country. Every day, they step up quietly and without expectation to support loved ones, neighbours and friends. I offer my heartfelt thanks, particularly on Carers Rights Day: thank you for the compassion, the commitment and the resilience you show.

As Minister for Care, it has been my priority to listen directly to unpaid carers through discussions with carers of all ages, including during Carers Week. I have heard at first hand the realities of balancing care, work, education and personal wellbeing. Those conversations have been moving, honest and often humbling. They have reinforced just how essential it is that we continue to recognise and support the people who provide so much care to so many, and who hold so much of our health and care system together.

As I said at the Carers UK “State of Caring” conference earlier this year, we have made genuine progress over the last three decades. The profile of the role of unpaid carers has undoubtedly grown, and awareness of their contribution is undoubtedly greater. Despite that, true equality of opportunity remains out of reach for far too many. My ambition is clear: that carers who want to work can do so without being penalised; that young carers can learn, develop and dream, just like their peers; and that caring must not lead to long-term damage to a person’s health, wealth or wellbeing.

The data shows the scale of the challenge: unpaid carers are 16% more likely to have multiple long-term health conditions, and providing just 10 hours of care a week can significantly reduce someone’s likelihood of being employed and increase their risk of loneliness. These pressures compound existing inequalities linked to gender, ethnicity, socioeconomic background or age. We must continue to shine a light on these disparities, listen to carers’ voices and design support that genuinely helps them to thrive.

The Government remain committed to ensuring that unpaid carers receive the right support at the right time in the right way. Under our 10-year health plan, unpaid carers will be recognised as partners in preparing personalised care and support plans. Their practical knowledge and experience will help to shape more responsive and realistic plans for the people they support.

Early identification remains key. Too many carers still go unnoticed and unsupported. We will increase the information captured across the health and care system, enabling earlier intervention and more tailored help. We will also introduce a dedicated “My Carer” section in the NHS app, which will allow carers to book appointments, access information and communicate more effectively with clinical teams. That will not only support carers but streamline interactions across the system.

Our shift towards a neighbourhood health service will increase the integration of health and care services, and it will bring multidisciplinary teams—GPs, nurses, social care professionals, pharmacists and others—closer to people’s homes. Working alongside unpaid carers, these teams will be better placed to deliver joined-up, community-centred support, focused on the health and care that people really need.

We know that caring can have a profound impact on mental health. That is why we are expanding access to talking therapies and digital tools, and piloting neighbourhood mental health centres, offering round-the-clock support for people with more severe needs.

[Richard Foord]

Can I ask the Minister what definition of neighbourhood he is using, and does it recognise communities such as market towns?

[Stephen Kinnock]

As a ballpark figure, we are looking at 50,000 residents, but we will be open to developing multi-neighbourhood infrastructure that would cover closer to something like 250,000 residents. It will depend, to some extent, on how it works in the 43 pilot sites in our neighbourhood health implementation plan. We do not want to have too many top-down diktats like the disastrous 2012 Lansley reforms; this is much more about a bottom-up, organic approach to developing a neighbourhood health service. Approximately 50,000 residents will be the starting point.

Jhoots Pharmacy

Richard Foord Excerpts

Wednesday 15th October 2025 Commons Chamber

[Stephen Kinnock]

That is an excellent suggestion; I will do that. We are hearing colleague after colleague say that staff are not being paid, and if there is clear evidence of a breach of employment law, we absolutely need to look at that. I will follow up on my hon. Friend’s suggestion.

[Richard Foord (Honiton and Sidmouth) (LD)]

We have heard again this afternoon the line from the Minister that pharmacy staff are employed not by the NHS but by pharmacy businesses, and that this is just a dispute between staff and the pharmacy business that should be raised in the first instance with ACAS. Holli Froggatt from Sidmouth, a former member of Jhoots staff, has written to me to say that staff have emailed Jhoots begging for their wages as they have empty bank accounts. In normal circumstances, the Government like to lean on pharmacies to take the pressure off GPs, with such schemes as Pharmacy First, so how can the Minister simply wash his hands of this situation when staff have gone for three months without pay?

[Stephen Kinnock]

I do not think that is an accurate characterisation of what I am saying. I am saying that we are taking action against Jhoots from the regulatory point of view, and there is clearly a glaring issue with the payment of staff. That needs to be taken forward through the industrial relations process, both through ACAS and the PDA. We will give all the support we can to both those organisations to ensure that Jhoots is held to account.

Eating Disorders: Prevention of Deaths

Richard Foord Excerpts

Tuesday 2nd September 2025 Westminster Hall

[Mr Richard Quigley (Isle of Wight West) (Lab)]

I beg to move,

That this House has considered the matter of the prevention of deaths from eating disorders.

It is a great pleasure to serve under your chairship, Sir Desmond. I thank all hon. Members for attending this debate on a topic extremely close to my heart. As hon. Members may know by now, I am the very proud Member for Isle of Wight West and do my utmost to champion the island in this place, but I have brought forward this debate not only as an MP, but as a father who for some years was genuinely fearful as to whether I would see my child reach their 18th birthday.

From the moment someone becomes a parent, their instinct is to protect and nurture their children—often, admittedly, much easier said than done—yet nothing can truly prepare anyone for the overwhelming sense of powerlessness that comes when their child develops an eating disorder. Eating disorders, in all their destructive forms, are one of the few types of illness where the person affected does not want to recover and they actively work against you. Watching your child struggle not only with the illness but with the very treatments meant to help them is truly something I would not wish on any parent, yet it is the reality faced by thousands of parents, families and friends up and down the country.

We all know by now that the pandemic has taken a wrecking ball to children and young people’s mental health, but we cannot pretend that these issues do not predate 2020. Since the mid-1990s, eating disorders have been found to carry the highest mortality rate of any psychiatric illness. However, in the UK, we are unable even to quantify the true havoc that eating disorders cause, because of the lack of a national register for eating disorder deaths. The most recent year with confirmed data from the Office for National Statistics is 2019, when 36 deaths were recorded. However, a US study suggests that the real figure in the UK could be closer to 1,860 deaths, which I am sure people in this room would more than agree with.

[Richard Foord (Honiton and Sidmouth) (LD)]

A constituent got in touch with me because sadly his daughter did not see her 30th birthday owing to an eating disorder. The point that my constituent made was that that was in part because of a lack of adequate services for those affected by these life-threatening conditions. Does the hon. Member agree?

[Mr Quigley]

I agree entirely. We are fully aware of the political situation and the condition that the NHS was left in under the previous Government, but the point of today’s debate is not to make cheap political attacks; it is to focus on the matter in hand, which is eating disorders, so I thank the hon. Member for his intervention.

With widespread under-reporting, misclassification and inconsistencies across the country, many of these deaths are wrongly recorded as organ failure, masking the true role of eating disorders and preventing us from fully grasping the scale of the crisis, especially among otherwise healthy young people.

Oral Answers to Questions

Richard Foord Excerpts

Tuesday 17th June 2025 Commons Chamber

[Wes Streeting]

I am really grateful to my hon. Friend for her question. She is right to highlight the importance of funding following inequalities to redress that imbalance. I think she will be pleased with where we are with the 10-year plan for health, and I would be delighted to meet her to discuss it.

[Richard Foord (Honiton and Sidmouth) (LD)]

People in East Devon have been told that they must now travel to Exeter for audiology services that they previously received at their local community hospital. What steps are the Government taking to encourage new providers to restore accessible audiology services?

[Wes Streeting]

That has been a running theme this morning, which will not be lost on Ministers. We will ensure, as we deliver neighbourhood health services, that people can receive care closer to home, wherever they live. We have heard that message loud and clear today, and I think the hon. Member will see that priority reflected in our 10-year plan for health.

Covid: Fifth Anniversary

Richard Foord Excerpts

Thursday 12th June 2025 Commons Chamber

[Richard Foord (Honiton and Sidmouth) (LD)]

I pay tribute to the hon. Member for West Ham and Beckton (James Asser) for securing the debate, which takes place five years after covid-19 swept across the country. It is right that we take a moment to reflect not only on what we have lost, but the duty we have to those who continue to carry the burden of the pandemic. Today I speak for some of the families who caught covid and never recovered. For them, the pandemic is not history, a chapter from their past; it is still very much with them today. I speak particularly for those in my constituency who did the right thing, followed the rules, took the vaccine and were harmed.

In particular, I want to share the story of Adam Bounds, who came from Axminster. He was 41 years old. He was a devoted father, a hard-working man and deeply loved by his family. On 20 May 2021, he received his first dose of the AstraZeneca vaccine, and 11 days later he died of vaccine-induced thrombotic thrombo- cytopenia, which is a rare but now medically recognised side effect—essentially, blood clots. My constituent—Adam’s father Leslie—has fought a dignified and determined campaign to get compensation for Adam’s son, his grandson, through the vaccine damage payment scheme. It has taken two years and considerable stress and anxiety. The family has now received the £120,000 payment, and Leslie has dealt with it all, causing him an enormous amount of trauma, frankly—two years of form filling, chasing departments and reliving that awful historic period.

If we want people to have faith in vaccines, and I do, we must ensure that we have a proper, functioning compensation system that is swift, supportive and responsive to the needs of grieving families. Justice is about not only those who died, but those who live with the aftershocks. In Devon, 20,000 people are reported to have long covid.

[Victoria Collins (Harpenden and Berkhamsted) (LD)]

My hon. Friend speaks passionately about an issue that also affects constituents of mine, such as Anna in Harpenden, a 12-year-old who lives with long covid. She has headaches and stomach issues day in, day out. Does he agree that we need to have a covid register and care pathway to ensure that those living with the consequences of covid are properly looked after?

--- Later in debate ---

[Richard Foord]

My hon. Friend is absolutely right. A covid register makes good sense. She mentioned symptoms, and those can also include tiredness, struggling for breath, memory problems and heart palpitations. We should remember that many of the people affected by long covid are the very people who took the brave decision to expose themselves right at the beginning. They are the people we pay tribute to, such as care workers, shop assistants, health staff and teachers—those who kept society going while others were isolating.

Last month, I was speaking with residents in Sidmouth and met a constituent who shared the impact that long covid continues to have on his daughter. She was somebody who was hard-working and determined but now finds that her energy has almost vanished. She is unable to work and is often confined to her bed, and her social life has disappeared. Like thousands of others across the UK, she faces the potential hammer blow of the Government’s proposed welfare reforms. Most people with fluctuating invisible conditions like long covid or ME will not be eligible, as we understand, for personal independence payments under the new assessment.

According to the Office for National Statistics, 3.6% of adults say they have experienced long covid at some point. If we want a society that is prepared for the next crisis, we must learn the lessons of the last one. We owe it to Leslie Bounds and others in Sidmouth and to everyone across the country who suffered from covid.

NHS Funding: South-west

Richard Foord Excerpts

Wednesday 11th June 2025 Westminster Hall

[Alison Bennett]

My hon. Friend makes an excellent point about rurality, which is obviously a big issue in the south-west. It is also a serious issue in Sussex where we have things in common with the south-west, such as having an older than average population and all the challenges that come with that, as hon. Members have mentioned.

Hospitals want to be able to sort those issues out, but they are left juggling priorities, barely scraping by with the current levels of funding. Things do not work if we do not look after them, and if we do not look after our health system, it will not be able to look after us or our loved ones. Although I am sure that the Minister will make the point about capital investment in the NHS, which is welcome, the future looks very uncertain and precarious for our ICBs, as a number of hon. Members have said.

Soon after ICBs were first created, they had to cut their budgets by 30%. They have now been asked to cut their budgets by 50% on average. Indeed, for Sussex, the cut is more than 50%—it is 53%. It is no surprise that Sussex and Surrey have formally proposed merging their ICBs, which, by running at the same time as local government reorganisation and the creation of a mayoralty, means we will end up with an ICB that does not have the same footprint as the new incoming mayor.

[Richard Foord (Honiton and Sidmouth) (LD)]

What does my hon. Friend think about how ICB funding is weighted? I contend that the formula overemphasises the size of each ICB and the size of the registered population, but does not account sufficiently for age, given that older people require more funding spent on them.

[Alison Bennett]

My hon. Friend makes a really good point. It is vital that when we look at per head of population funding, we think about the different factors that actually drive up the true cost of delivering healthcare across the country, which obviously varies by region.

On ICBs, I will press the Minister on three points. First, on the timescale for cuts to be delivered by ICBs, they have to be completed by the end of 2025. The Sussex ICB had about three weeks to make that initial submission to the Department. Does the Minister think that those timescales are realistic and achievable? Secondly, what will the cost of the redundancies be for ICBs? Has that calculation been done? For Sussex, we are looking at more than half the workforce losing their jobs. Thirdly, what is the impact assessment for patients and the service that they will receive as a result of cuts to ICBs?

For too long, social care has been treated like the back door of our public services. It has been overlooked, underfunded and taken for granted. That must change. That is why we must once again ask for more urgency on social care reform. I believe that personal care should be free at the point of use, just like the NHS—

--- Later in debate ---

[The Minister for Secondary Care (Karin Smyth)]

It is a pleasure to serve under your chairmanship, Dr Huq. I thank the hon. Member for Torbay (Steve Darling) for securing the debate. We could have had more time, as this is an important issue for us all across the whole south-west. I thank colleagues for taking part.

The hon. Gentleman is right that the system has real challenges receiving deficit funding in our part of the NHS recovery support programme. He will rightly be following that closely. In the autumn Budget, which I think virtually everyone in this room disagreed with, the Chancellor took the necessary decisions to put our NHS on the road to recovery, with a more than £22.5 billion increase in day-to-day health spending and over £3 billion more in the capital budget over this year and the last. Today, the Chancellor has announced the conclusion of the spending review, with £29 billion more day-to-day funding in real terms than in 2023-24. There is a £2.3 billion real-terms increase in capital spending over the spending review period—something I hope everyone welcomes.

The SR puts the NHS on a sustainable footing by cutting waiting lists so that by the end of this Parliament 92% of patients will start consultant-led treatment for non-urgent health conditions at 18 weeks, delivering on the Prime Minister’s plan for change commitment and prioritising people’s health. To respond to the hon. Member for Bath (Wera Hobhouse), we do encourage use of the independent sector for capacity, and that is a decision for ICBs to make sure they achieve those standards. The settlement also supports the shift from analogue to digital, with a total investment of up to £10 billion in NHS technology and transformation between ’26-27 and ’28-29, and an almost 50% increase from ’25-26. I agree with the right hon. Member for Salisbury (John Glen) that technology offers huge opportunities in geographies like ours.

Thanks to the Chancellor, we are taking the necessary steps towards fixing the foundations of our NHS and making it fit for the future. Since coming into office, the Government have published our urgent and emergency care plan, which will support the NHS across England to improve the timeliness and delivery of care to patients requiring urgent and emergency care over the next year, including for next winter. We are delivering on our plan for change through the accelerated roll-out of the NHS app. We will create an NHS fit for the future and continue to invest in the latest technology, shifting healthcare from analogue to digital.

Our investment and reform in general practice, to fix the front door to the NHS and bring back the family doctor, includes an additional investment of £889 million. We have published our elective reform plan, which will cut waiting times from 18 months to 18 weeks. We have exceeded our pledge to deliver an additional 2 million appointments, tests and operations—we have delivered over 3 million more. Waiting lists have fallen for the sixth month in a row and have now been cut by over 219,000 since we came to office. The Government have committed to a10-year health plan that will lead the NHS to meet the challenges set out in the plan for change to build the NHS for the future, and it will be coming very soon.

I know that hon. Members across the House share the concerns of the hon. Member for Torbay about the crumbling NHS estate after years of neglect. I wish to assure Members that my right hon. Friend the Chancellor has given us the funding to begin reversing the trend of decline in the south-west and nationwide, with health capital spending rising to £13.6 billion this year.

In the south-west region, allocations have been made totalling £448 million in operational capital, empowering systems to allocate funding to local priorities; over £238 million from our constitutional standards recovery fund to support NHS performance across secondary and emergency care; and £83 million from the £750 million estates safety fund to deliver vital safety improvements, enhance patient and staff environments and support NHS productivity. This includes £7.3 million for Torbay hospital in the constituency of the hon. Member for Torbay; £10 million from our primary care utilisation fund for improvements in the primary care estate; and almost £5 million to help to reduce inappropriate out-of-area placements for mental health patients in the south-west.

ICB allocations have been talked about a lot today. For the south-west, they have been confirmed as totalling £11.5 billion out of a total of £116.7 billion allocated for England. The regional allocation per capita for the south-west is above the national average. We heard from my hon. Friends the Members for South Dorset (Lloyd Hatton) and for Bournemouth East (Tom Hayes) that the signs are being seen in their constituencies.

[Richard Foord]

Will the Minister give way?

[Karin Smyth]

I am going to just complete these points, so that I can try to address as many points as possible.

In the constituency of the hon. Member for Torbay, the local ICB, NHS Devon, receives £2.5 billion of the £11.5 billion for the south-west. The allocation per capita for Devon is higher still, and above the south-west regional average. Likewise, NHS Cornwall and the Isles of Scilly ICB received just over £1.2 billion of that £11.5 billion total. The allocation per capita for Cornwall and the Isles of Scilly is above the south-west regional average and national average.

To respond to the hon. Member for St Ives (Andrew George), I understand from NHS England that the ICB has had the debt written off, so that might be something he wants to follow up. My hon. Friend the Member for Truro and Falmouth (Jayne Kirkham) and others talked about funding allocations—we could talk about this for a very long time. They are difficult things to get right, and are controversial, but the funding formulation does account for older people and for rural populations.

The latest financial performance position publicly available is for quarter three of last year. It showed an overall deficit position of £51.7 million against the year-to-date plans, of which Dorset ICS had the largest variance of £27.7 million. Final end-of-year positions are still being finalised and will be made publicly available in due course. For ’25-26, NHS systems overall have received £2.2 billion of deficit support funding in their allocations. All systems in the south-west have now agreed a balanced plan for ’25-26. The position on deficit support for ’26-27 will follow the spending review settlement for individual organisations agreed as part of the planning guidance process.

NHS England will continue to support all organisations to deliver financially sustainable healthcare through a range of improvement measures, some of which we have heard about today. Devon integrated care board, and three trusts within the ICB, are currently part of the recovery support programme, which provides intensive support to challenged organisations. Where organisations are struggling significantly, the Department of Health and Social Care provides cash support to support the continuity of patient services—obviously, that is critically important. So that colleagues are aware, I am personally meeting with finance colleagues from NHS England and the Department of Health every week to support that work. We are clear as a Government that we need to be certain that every pound of taxpayers’ money is used to best effect, and that best practice is followed in this region and across the entire NHS.

The hon. Member for Torbay asked about coronary services, and that is a local decision. NHS Devon and Torbay Foundation Trust have proposed undertaking a test-and-learn process for out-of-hours primary percutaneous coronary intervention. That service will be provided in Torbay and Exeter, which would involve a temporary change to provide out-of-hours services at Exeter only. Members will be aware that the ICB was due to make a decision on the pilot at its board meeting in May. However, following significant local feedback, the ICB has decided to reflect on those issues raised, and I am sure the hon. Member for Torbay will be following up on that. The ICB will be providing an update at its board meeting in July.

In conclusion, the Government are taking the necessary steps to fix the NHS, and the Chancellor’s spending review settlement puts the NHS further on the road to recovery. I assure Members that we will write back to them on any other individual points raised.

UK Health Security Agency: Porton Down

Richard Foord Excerpts

Wednesday 21st May 2025 Commons Chamber

[John Glen]

I thank the hon. Gentleman who is very gracious in the way he puts over his point. It would be helpful for everyone in both our constituencies and for the country as a whole to know what is happening.

[Richard Foord (Honiton and Sidmouth) (LD)]

In addition to the HSA, the right hon. Gentleman’s constituency is home to the Defence Science and Technology Laboratory, and both do vital work on antimicrobial resistance. Does he know of any work that has been done by the Government to consider the implications for the UK’s AMR research of moving the two institutions apart?

[John Glen]

I am extremely grateful for that very helpful intervention, because the hon. Gentleman points out the co-location of DSTL and the UKHSA at Porton, and that is a really important fact. The possibility of sharing category 4 facilities—something that has been resisted sometimes by one party or the other—is a material consideration when trying to mitigate excessive costs.

Last year’s NAO report set out that in February 2022, the programme had a staff team of 92 full-time equivalents based across multiple sites including Porton Down, London and other regional UKHSA centres, working across programme operations, management, delivery and capability, in addition to construction, finance and commercial and leadership teams. In November 2023, there were 69 FTE staff on the programme. The programme team is made up of civil servants and service providers, and has input from colleagues from other parts of the UKHSA.

It is very ironic to me that as I read over about 13 mentions of Porton Down that I have made in this Chamber over the last 15 years, so many of the Ministers who responded are now either retired, deposed or in the other place. I am concerned that the civil service people, for whom I have great respect having worked closely with lots of civil servants, have been blissfully unaccountable to any enduring authority or direction on this, while all of this work has been going on in the background. That just cannot be right.

Access to Dentistry: Somerset

Richard Foord Excerpts

Tuesday 1st April 2025 Westminster Hall

[Anna Sabine (Frome and East Somerset) (LD)]

I beg to move,

That this House has considered access to dentistry in Somerset.

It is a pleasure to serve under your chairmanship, Mr Stuart. My grandfather might not have been a toolmaker, but he was dentist. He worked near Slough, and as a child I loved visits to the dentist because we got to play in the electric chair and dissolve bright pink mouthwash tablets in plastic cups, and we always got a Lambrusco and lemonade afterwards, which was of course entirely appropriate.

That regularity of dental treatment means that, at 45, I am lucky enough to have no fillings at all, and I am not particularly scared of dentists. Many children growing up today in my constituency of Frome and East Somerset are not so lucky: one in five children in Somerset has tooth decay by the time they are five. Although we know that difficulty in accessing an NHS dentist is a nationwide challenge, data reveals that the south-west is particularly neglected. The most recent Office for National Statistics data shows that it has the worst access problems of all regions in England, with 99% of people without a dentist failing to secure the NHS treatment they needed in the last month.

Furthermore, only 32% of adults in Somerset saw an NHS dentist in the two years to June 2024, which is much lower than the national average of 40%. The picture for children in Somerset is equally shocking: only 42% were seen by a dentist in the year to June 2024, well below the national average of 55%, and way below pre-covid averages.

[Richard Foord (Honiton and Sidmouth) (LD)]

My hon. Friend’s point about the south-west is absolutely right. Some 217 visits per 100,000 to accident and emergency are for dental-related issues, compared with 154 for the next highest region. So the south-west is a real outlier, and not in a good way. Does my hon. Friend think that that is having a detrimental effect on hospitals and A&E?

[Anna Sabine]

Yes, I absolutely agree, and I will talk later about how poor access to dentistry impacts other parts of the health sector.

Yesterday, I was lucky enough to visit a local primary school in Frome, along with a friend who is a dentist. We started with an assembly about the many superpowers the mouth has, in which I was delighted to be given the leading role of saliva. Then we moved on to taking two reception classes through a supervised toothbrushing session. The school is part of the Government’s supervised toothbrushing scheme, an initiative I welcome. Sadly, of the 30 children in the room, 10 did not have consent for the toothbrushing—some because forms had not been returned, and some because there was a parental objection to the activity or to the use of fluoride. To ensure that they did not feel left out, my dentist friend played a game where they counted their teeth instead. She said that, based on what she could see from that game, that group of 10 children had 50 obviously decayed teeth, and one child had at least 10 teeth that would need to be removed under general anaesthetic. Those children were four and five years old. Although the scheme overall is to be welcomed, I hope consideration will be given to having an opt-out rather than an opt-in, to ensure that the children who most need the scheme are actually benefiting.

Somerset used to be well above the national average on access to dentistry. As recently as 2018, 55% of adults were seen by an NHS dentist in a two-year period, compared with 50% nationally.

--- Later in debate ---

[Stephen Kinnock]

I absolutely agree. Two big things need to happen. First, the General Dental Council needs to do more to get more exams in place for those very well-qualified dentists. Of course, they have to pass the British exam. We cannot have people practising in Britain who have not passed that exam, but the availability of the exam has been too limited and that needs to change. The other thing is provisional registration. Some work can be done to expedite the registration of an international dentist, but more needs to be done on that as well. I will meet the head of the General Dental Council shortly, and I will convey those messages to him.

Recruitment and retention issues are not limited to dentists; there are difficulties across the whole dental team, including dental nurses, hygienists, therapists and technicians. In the past five years, there has been a 15% reduction in courses of dental treatment being delivered across England, and 28% of adults in England—a staggering 13 million people—have an unmet need for NHS dentistry. As a result, we hear too many stories about people who are unable to access the care they need, and some horrific accounts of DIY dentistry that nobody should have to resort to.

Dentistry rightly receives a lot of attention because of its dismal state, and I am grateful to the National Audit Office and Public Accounts Committee for their interest in the previous Government’s dentistry recovery plan. It is evident that the plan did not go far enough.

[Richard Foord]

The Minister talks about the previous Government’s dental recovery plan, and part of that was to impose a firmer ringfence on dentistry spending so that there was not an underspend that was reallocated elsewhere. The previous Government tasked NHS England with collecting monthly returns from ICBs to establish spending as against the allocation. Now that NHS England is being scrapped, will we still see that monitoring of ICBs to ensure that the spending matches the allocation?

[Stephen Kinnock]

I take the hon. Gentleman’s point about the ringfence, but in a way, ringfencing addresses the symptoms, rather than the cause, of the problem. The fundamental cause of the problem is the amateurish way in which the previous Government set up the NHS dentistry contract so that it does not incentivise dentists to do NHS work. That is what leads them to drift off. In a sense, we can do all the ringfencing we like, but if the workforce that we need is not incentivised to do the work that we need them to do, we are going to have that problem, because they vote with their feet. That is why the radical overhaul of the dentistry contract is the key point. However, I agree with the hon. Gentleman that once we have got a contract that works, we must ensure that every penny that is committed to NHS dentistry is spent on NHS dentistry, rather than the absurd situation that we have now, in which we constantly have underspends in the NHS dentistry contract while demand for NHS dentistry goes through the roof. It is a truly bizarre situation.

I return to the subject of the dentistry recovery plan. The new patient premium, introduced by the previous Government, aimed to increase the number of new patients seen, but that has not happened. In reality, since the introduction of the previous Government’s plan, there has been a 3% reduction in the number of treatments delivered to new patients. It is clear to this Government that stronger action is needed, and we are prepared to act to stop the decay.