Oral Answers to Questions

Steve Barclay Excerpts

Tuesday 19th July 2022 Commons Chamber

[Selaine Saxby (North Devon) (Con)]

13. What progress he has made on increasing the availability of NHS dentistry services.

[The Secretary of State for Health and Social Care (Steve Barclay)]

During the pandemic, we took unprecedented action to protect NHS dentistry capacity, providing over £1.7 billion of income protection. We also ensured that those who needed it most could access the available care by establishing 700 urgent care centres nationwide. NHS dentists are now returning to 100% of their contracted activity.

[Chris Loder]

I thank my right hon. Friend for his answer, but in West Dorset we are really struggling with dentist availability; at the moment there is no capacity for new patients, and the NHS appears to be incapable of solving the issue. Could my right hon. Friend tell me what he is doing to help restore dental services in West Dorset for those who need them?

[Steve Barclay]

My hon. Friend raises a very pertinent point. I recognise that there are significant challenges in NHS dentistry, including disparities across regions. Improving access for patients is a priority, and that is why just today the Government, together with NHS England, have announced a package of improvements to the NHS dental system, on which we have worked closely with the sector and the British Dental Association.

[Selaine Saxby]

Having seen the former Minister for dentistry on numerous occasions, we were assured of today’s announcement to tackle the appalling lack of dentists in dental deserts such as my North Devon constituency. Can my right hon. Friend explain how the measures in today’s written ministerial statement will rapidly deliver extra dental appointments?

[Steve Barclay]

I am grateful for my hon. Friend’s campaigning on this issue; it is something she has highlighted on a number of occasions. The sorts of areas where the measures announced today will help include the management of NHS dental contracts, increasing the use of the skills mix in the dental workforce, and rewarding complex treatment to better reflect the complexity of that work.

[Luke Pollard (Plymouth, Sutton and Devonport) (Lab/Co-op)]

There are 18,000 people on the NHS waiting list for dentistry in Plymouth; it is a real crisis. As a city, we have a cross-party plan for the new Cavell centre, a west end health hub as part of a health village in the city centre, with extra dental capacity with our brilliant dental school. However, we urgently need the Government to unlock the funding for it. Will the Secretary of State agree to meet a cross-party delegation from Plymouth to make the case for that, so that we can get on, get spades in the ground and get people’s teeth healed?

[Steve Barclay]

As part of the Government’s wider commitment to levelling up, we are very interesting in taking a place-based approach. Indeed, the essence of the integrated care boards is to help facilitate that. I am very happy to have discussions with colleagues across the House on how we best deliver that.

[Tim Farron (Westmorland and Lonsdale) (LD)]

We all know that NHS dentistry was in crisis long before the pandemic. In my community, only a third of adults have seen an NHS dentist in the last two years, and fewer than half of children have seen a dentist in the last 12 months. It is obvious why: we have an ageing system—units of dental activity—based on a snapshot taken 15 years ago, which is completely unfit for purpose, as dentists and patients around the country are telling the Government. Will the Secretary of State listen to dentists and patients and reform the system urgently?

[Steve Barclay]

I hope the hon. Gentleman will look at today’s announcement, because it shows that the Department has listened. That is why, for example, it will facilitate better contract management, better reflect the floor price for units of dental activity and reward complex treatment, which was one of the key concerns. Equally, I hope that the hon. Gentleman recognises that this Government, through the £1.7 billion of income protection during the pandemic, have done much to facilitate dentistry’s ability to bounce back.

[Robbie Moore (Keighley) (Con)]

2. What steps his Department is taking to help the NHS achieve net zero.

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[Rosie Cooper (West Lancashire) (Lab)]

4. What assessment he has made of the adequacy of the rate of reimbursement for mileage expenses for NHS community care staff.

[The Secretary of State for Health and Social Care (Steve Barclay)]

The reimbursement of travel costs for NHS staff is covered by the NHS terms and conditions, which are agreed jointly by employers and NHS trade unions. The terms and conditions set out the process for reviewing the rate, and that process includes reviewing fluctuations in fuel prices.

[Rosie Cooper]

Motorists across the country have seen the cost of fuel increase by as much as 60p per litre since this time last year. Fuel costs are penalising the many NHS staff who treat patients in the community for simply doing their job. The current reimbursement rate of 56p per mile drops to 20p after staff have travelled 3,500 miles, and that has not been adjusted since 2014. Does the Secretary of State agree that if the rate of reimbursement does not rise in line with prices at the pump, those staff can easily obtain jobs in the acute sector, where they will not face the extra fuel costs? Given that we want more people to be treated in the community, that would surely be a catastrophe both for staff and for patients at home.

[Steve Barclay]

This is an important issue, and it affects different parts of the workforce in different ways. The 56p is higher than the rate approved by Her Majesty’s Revenue and Customs, and, as the hon. Lady said, it drops to 20p after 3,500 miles have been travelled. Of course, the Government are taking other measures more widely in their fiscal response to the cost of living, such as cutting fuel duty, but there is a review mechanism in respect of the NHS specifically, which involves looking at these issues in the round.

[Dame Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

5. What steps he is taking to encourage covid-19 vaccine uptake in adults.

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[The Secretary of State for Health and Social Care (Steve Barclay)]

We know that general practices are still under significant pressure and demand for their services is high. We are investing at least £1.5 billion to create an additional 50 million appointments a year by 2024, and of course not all appointments are, or should be, with GPs.

[Judith Cummins]

Last week, hospital clinicians raised with me their serious concerns that they are seeing incoming case notes of vulnerable and frail patients marked with

“telephone consultation during covid-19 pandemic”,

but those consultations were just in the last few weeks. This is clearly unacceptable and is leaving many of my constituents with the very real possibility of either a missed diagnosis or a misdiagnosis. What action is the Secretary of State taking to guarantee face-to-face appointments that are easily available for the elderly and vulnerable patients who need them?

[Steve Barclay]

The number of face-to-face appointments is increasing and in May 2022, excluding covid-19 vaccines, 64% of appointments were face-to-face, up from 55%. But the hon. Lady is right to say that patients should have the choice, and that is why the NHS access improvement programme has been supporting practices experiencing greater access challenges. Indeed, one of the first visits I did in my new role was to a GP practice to look at the practical measures it was putting in place to facilitate greater access for its patients.

[Kate Hollern]

The inverse training law is depriving communities in Blackburn of access to primary care. Blackburn already has one of the lowest ratios of GPs to patients in the country, and it struggles to attract and retain GPs. The Government have committed to provide 6,000 new GPs by 2024, but according to the British Medical Association there are actually 1,737 fewer GPs as of this month. What is the Secretary of State’s Department doing to level up primary care and deliver the incentives for GPs to train and practise in communities such as Blackburn?

[Steve Barclay]

I know this is an issue of concern that the hon. Lady wrote to my predecessor about, and indeed she raised its impact on her constituency in the House last month. There are specific programmes such as the targeted enhanced recruitment scheme that was launched in 2016, and the one-off financial incentives to attract GPs to the more deprived areas. We are also looking at how we can have the right skills mix to boost not just the number of GPs but wider access to appointments.

[Jo Churchill (Bury St Edmunds) (Con)]

I welcome my right hon. Friend to his place. I offer a solution. Will he commit himself to sorting out the transfer of electronic prescriptions between hospital consultants and GPs, which would stop people trying to get appointments for prescriptions written in hospital. That would simplify things enormously, and my GPs would really welcome it. We could also do rural dispensing doctors while we are at it.

[Steve Barclay]

I always welcome solutions from colleagues on both sides of the House. From memory, Tim Ferris, who leads on tech within the NHS, is looking at a tech solution—I think it is in beta testing, although I would have to check. Appointments made shortly after a person has been discharged from hospital are often quite complex cases and create additional pressure on GPs.

Another issue I am keen to explore is GP appointments that can be done through either better use of technology or the wider skills mix so that we can better focus GPs’ time on more complex cases where their expertise delivers the best patient outcomes.

[James Gray (North Wiltshire) (Con)]

A much-needed new medical centre at Calne in my constituency was approved by the NHS in 2021, but there have since been a number of blockages to do with covid and the contractors. Will the Secretary of State look into those problems to find out what the blockages are—I think they are largely bureaucratic—and clear them out of the way to give the people of Calne their much-needed new medical centre?

[Steve Barclay]

I am very happy to look into that specific issue, which I know my hon. Friend has raised with the Department. I am happy to have further conversations with him.

[Simon Lightwood (Wakefield) (Lab/Co-op)]

The GP survey out last week shows that the proportion of people reporting their overall GP experience as very poor or fairly poor doubled between 2021 and 2022. Instead of picking a fight or blaming someone else, will the Secretary of State tell us what he will do to ensure that people in places like Wakefield can see their GP when they need to?

[Steve Barclay]

Far from blaming anyone else—notwithstanding the fact I have been in post for less than two weeks—I have set out a range of things we need to do, because this is a shared challenge that affects all our constituents, and it is within the context of increased demand. The May figures show a significant increase in appointments—1.31 million appointments per working day this year compared with 1.24 million last year. There is increasing demand, and we need to harness GP time, the skills mix and better use of technology.

[Mr Robin Walker (Worcester) (Con)]

We need more GPs and junior doctors in Worcestershire, and there is strong support from our local GPs, our acute trust and neighbouring trusts for the Three Counties Medical School in Worcester. Will my right hon. Friend meet me to discuss the case for providing funded places as swiftly as possible?

[Steve Barclay]

My hon. Friend will be aware that, through this Government’s funding, we have opened five new medical schools and, from memory, 1,500 additional undergraduate places. That is thanks to the work of the former Secretary of State, my right hon. Friend the Member for South West Surrey (Jeremy Hunt), who championed this specific initiative to address workforce pressure.

More widely, I am always happy to meet my hon. Friend the Member for Worcester (Mr Walker) to discuss issues in Worcester.

[Kim Leadbeater (Batley and Spen) (Lab)]

Does the Secretary of State agree that one way we can take some of the pressure off overstretched GP services is to ensure that pharmacists can continue to play their vital role in looking after the health and wellbeing of patients? Pharmacies across the country are closing because of financial pressures, so will he urgently look into extra support for them to recruit and retain staff?

[Steve Barclay]

The hon. Lady raises a valid and important point about getting the right service to patients, which can often best be delivered by a pharmacist. That is why, as I signalled earlier, we need better use of tech to support patients in understanding where they can best access the advice they need.

[Kate Griffiths (Burton) (Con)]

Access to GPs is a huge problem across my constituency of Burton and Uttoxeter, as it is in other constituencies. A walk-in centre in Burton would significantly ease some of the load on our GPs and hospital services. Will my right hon. Friend meet me to discuss this possibility?

[Steve Barclay]

I have had quite a few meeting requests this morning, and I am always keen to meet colleagues. My hon. Friend will be well aware that part of the reason for having integrated care boards within the place-based approach is that commissioners can determine the best mix of services in the locality, including in Burton.

[Matt Western (Warwick and Leamington) (Lab)]

7. What recent estimate he has made of the average waiting time for emergency care.

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[Ian Byrne (Liverpool, West Derby) (Lab)]

T1. If he will make a statement on his departmental responsibilities.

[The Secretary of State for Health and Social Care (Steve Barclay)]

I am honoured to have taken on the role of Secretary of State for Health and Social Care, and to have responsibility for incredibly important services that touch all our lives. I pay tribute to my predecessor, my right hon. Friend the Member for Bromsgrove (Sajid Javid), for everything he achieved in this role, and for the dedication he showed. I also welcome my new ministerial team.

Since my appointment, I have been relentlessly focused on the urgent pressures facing health and care, including this week’s extreme weather. Yesterday I updated the House on the strong support we are giving, including extra ambulance capacity and more call handlers, and we will stay vigilant so that we can make sure our health and care system is there for those who need it.

Today marks one year since we lifted covid restrictions. While the virus has not gone away, we are able to enjoy our freedoms, thanks to the incredible vaccine roll-out. I have accepted the Joint Committee on Vaccination and Immunisation’s advice for a covid and flu autumn and winter booster campaign, in which we will roll out that vaccine further.

[Ian Byrne]

I have been contacted by many constituents working in the NHS who are struggling to cope with financial pressures, exhaustion and stress. I recently spoke to a district nurse using our food pantry in West Derby, and it was a heartbreaking example of how the cost of living crisis is impacting people across our communities. That nurse was going to lose their home and was struggling to feed their children. How does the Secretary of State plan to address the dire situation that the very people he applauded as heroes during the pandemic now face? Maybe a start would be giving NHS workers an inflation-proof rise.

[Steve Barclay]

On NHS pay, I expect to announce a response to the integrated pay review bodies shortly. We are putting more funding into the NHS, as I signalled in my statement yesterday.

[Dr James Davies (Vale of Clwyd) (Con)]

T2. Making a diagnosis of dementia is important to allow appropriate treatment, support and time to plan for the future. Pre-pandemic, the diagnosis rate for dementia in England was meeting the two thirds target, but today it is 61.9%. In Wales, data capture and quality is poor, but the equivalent rate is thought to be just 50%. Will my right hon. Friend outline what steps he is taking to improve the situation?

[Steve Barclay]

My hon. Friend will be aware that the matter is devolved to the Welsh NHS, but I can say that in the last financial year, the Government allocated £70 million to NHS England to specifically address dementia waiting lists and increase the number of diagnoses. To further support recovery of the dementia diagnosis rate and access to post-diagnostic support, NHS England is funding two trusts in each region to pilot the diagnosing advanced dementia mandate tool, which will improve access to diagnosis.

[Mr Speaker]

I call shadow Secretary of State, Wes Streeting.

[Wes Streeting (Ilford North) (Lab)]

I welcome the Secretary of State to his first oral questions and, as this is likely to be his last oral questions, also wish him the best for the future. I associate myself with his remarks about his predecessor, who of course resigned from the Government on a point of principle as others chose to remain loyal; on that note, I also pay tribute to the former Minister, the hon. Member for Charnwood (Edward Argar), for the diligent approach he took to his work and the spirit in which he engaged with the Opposition. One of the contenders for the Conservative leadership says that public services are in a state of disrepair. Another describes the NHS backlog as frightening. A third called ambulance waiting times appalling, and of course the Secretary of State for Culture, Media and Sport said that the former Health Secretary’s preparation for a pandemic was “found wanting and inadequate”. They are right, aren’t they?

[Steve Barclay]

The Government are committed to putting increased funding into our NHS. I set out yesterday the position on the resource departmental expenditure limit. Just to remind the House of the capital departmental expenditure limit, capital investment in the spending review was £32.2 billion between this year and 2024-25. The Government are committed to putting record funding into our NHS. We are also committed to funding 40 new hospitals and have allocated £3.7 billion to that programme.

[Wes Streeting]

I cannot believe that the Government are still talking about 40 new hospitals with a straight face. Nobody believes that it is true. As for capital investment, we have the lowest in the OECD and we lag significantly behind.

We have the longest waiting lists in NHS history and record waits for ambulances. People are finding it impossible to book a GP appointment. There are 400,000 delayed discharges each month because the social care support is not there. The Government are finally acknowledging that covid is still a challenge, and that the hot weather is a challenge, but they do not want to talk about their record, which is, I am afraid, at the heart of the challenge. Does the Secretary of State really believe that it is reasonable to expect NHS employers to meet the pay rise for NHS staff from existing budgets?

[Steve Barclay]

We will respond shortly to the independent pay review body, which, as part of its recommendations, weighs up the pressures on the cost of living and the other factors within its remit. The Government are delivering more doctors, more nurses, more appointments and more treatments, investing in our estate and planning for the future. That includes investment in research and development, and in future technology through our life sciences. That not only delivered the vaccine that allowed us to lift the covid restrictions that the Opposition wanted to retain, but will unlock the technologies of the future.

[Mr Speaker]

I call the Chairman of the Health and Social Care Committee, Jeremy Hunt.

[Jeremy Hunt (South West Surrey) (Con)]

May I recommend some scintillating summer reading to the Secretary of State: the study of 4.5 million patients that showed that people who see the same GP over a long period are 30% less likely to go to hospital and 25% less likely to die? Will he, after reading that, consider changing the GP contract to get rid of the micromanagement, and replace it with what doctors and patients want, which is the ability to have a long-term relationship?

[Steve Barclay]

I think my right hon. Friend knows me well enough to know that I will have a close interest in reading anything over the summer that is data driven. He highlights an extremely important issue. Just yesterday, I met with Andrea and Simon Brady, whose daughter tragically died of cancer at the age of 27. One of the key concerns that they raised with me was the lack of consistency when it came to the GP that Jessica went to see, and the fact that she kept seeing different people, and there was not continuity of care. Specific cases that I am looking into speak to this issue, and I am happy to look at the data that my right hon. Friend can share.

[Janet Daby (Lewisham East) (Lab)]

T3. As the chair of the all-party parliamentary group on sickle cell and thalassaemia, I and the chief executive officer of the Sickle Cell Society were due to meet the Secretary of State’s predecessor to discuss the experiences of and health failings for people living with sickle cell and, indeed, sickle cell patients. Will the Secretary of State meet me—if he is still in post in September—or urge his predecessor to meet me and the CEO of the Sickle Cell Society?

[Steve Barclay]

I am not sure that I will urge my predecessor to do so, but if indeed there is a successor, I will be happy to share that with them. The hon. Lady raises an important point, and I am happy to look into it.

[Tracey Crouch (Chatham and Aylesford) (Con)]

We are becoming more aware of how poor lifestyles, including with respect to diet, physical activity and stress, can contribute to an increase in the risk of cancer. Research is also highlighting that exercise, particularly moderate-intensity aerobic training, reduces side effects from treatment, anxiety, depression and recurrence rates. With that in mind, will the Secretary of State ensure that alongside diagnostics and treatment, exercise forms a fundamental part of the forthcoming 10-year cancer strategy, not only for preventing cancer but for reducing its recurrence?

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[Edward Argar (Charnwood) (Con)]

One of the great privileges of the three years that I spent at the Department of Health and Social Care was seeing at first hand the amazing work of our NHS workforce; I put on record once again my gratitude to them. Growing that workforce is vital to meeting the future health needs of our population, so will my right hon. Friend the Secretary of State, whom I welcome to his post, reconfirm the Government’s commitment to the target of 50,000 more nurses, and update the House on progress towards that target?

[Steve Barclay]

May I take the opportunity to thank my hon. Friend for his service as Minister of State? I think he was one of the longest-serving Ministers in that role; in fact, I think he took over from me, or shortly after me. He carried out the role with great distinction, as I am sure the whole House recognises.

I am very happy to reconfirm our commitment. I think the number is at about a third of a million, and great progress is being made. That enlarged measure is down to my hon. Friend’s work as Minister of State.

[Kate Hollern (Blackburn) (Lab)]

T5. I wrote to the Secretary of State’s immediate predecessor on 16 May and followed that letter with one to the Prime Minister about the case of a young man in my constituency, Elliott Simpson. Sadly, I have not had a response. Elliott was misdiagnosed with a water wart in a telephone consultation with a GP. When Elliott finally got to see someone face to face, he had late-stage skin cancer. National Institute for Health and Care Excellence guidelines do not currently allow him to receive the necessary life-saving treatment. Will the Secretary of State meet me and Elliott’s family to discuss what can be done to get this young man the treatment that he desperately needs?

[Steve Barclay]

I am very sorry, as I am sure the whole House is, to hear of the circumstances that the hon. Lady sets out. I am happy to look at the case, as I said to her ahead of this sitting, when I discovered that she had written to my predecessor. As I also flagged earlier, the number of face-to-face appointments is increasing. Telephone consultations are not a new thing; they have been around for a long time and are an important part of the mix—indeed, some patients prefer the flexibility that they offer. But of course I am happy to meet the hon. Lady in due course.

[Greg Smith (Buckingham) (Con)]

Long Crendon Parish Council in my constituency has an exciting proposal for an innovative new health and wellbeing centre, including GP services. It has the land from planning gain, and it has an agreement to put Unity Health in as the GP partnership, but we are stretched for funds to build it. I am grateful to my hon. Friend the Member for Charnwood (Edward Argar) for his engagement over the past year. Will my right hon. Friend the Secretary of State meet me over the summer to discuss how we can move the project forward?

[Steve Barclay]

Again, as I am sure my hon. Friend will appreciate, these decisions should not be run from Whitehall and the centre. We should take a place-based approach, letting local decision-makers and commissioners make the decisions to shape the best services through their integrated care boards. My hon. Friend the Minister of State or I will engage with him to ensure that his representations are very much at the heart of any decisions that are taken.

[Rushanara Ali (Bethnal Green and Bow) (Lab)]

T6. An estimated 117,000 people are reported to have died while on NHS waiting lists. A record 6.6 million people are waiting on the NHS for treatment, and they are in pain and suffering and, in many cases, fearful for their lives. This is a direct consequence of more than a decade of mismanagement and incompetence. What will the new Health Secretary do to give the British people the guarantees that they need to make sure that more do not die while waiting for treatment on the NHS?

[Steve Barclay]

That is why we have launched a range of initiatives, such as surgery hubs and diagnostic centres, to address the very real backlog resulting from the pandemic. Indeed, the NHS has published its delivery plan for tackling the covid-19 backlog of elective care, and that is focused on four areas: increasing health service capacity, prioritising diagnosis and treatment, transforming the way that NHS provides elective care, and providing better information and support to patients.

[Dame Caroline Dinenage (Gosport) (Con)]

I welcome both the Secretary of State and the new Minister to their places and warn them that the one statistic that they will hear me say time and again is that cancer is the biggest cause of death of children under the age of 14. Both of their predecessors met my constituent Charlotte Fairall, who lost her daughter, Sophie, to a very aggressive form of rhabdomyosarcoma. Their story inspired the speech that the former Secretary of State, my right hon. Friend the Member for Bromsgrove (Sajid Javid), gave when he launched the 10-year cancer strategy. With that in mind, I would really appreciate it if the new Secretary of State restated his commitment to that strategy and to including a childhood cancer mission at its very heart.

[Steve Barclay]

The House recognises how my right hon. Friend has championed this issue over many years. There can be few more emotive issues than the one she draws to our attention. Of course, in keeping with my predecessors, I would be very happy to engage with her on this important issue.

[Ronnie Cowan (Inverclyde) (SNP)]

T7. [R] I refer hon. Members to my entry in the Register of Members’ Financial Interests. I am asking specifically about intractable epilepsy. Three NHS prescriptions have been written for the appropriate medicine, so we have proven that that can be done and that the medicine can be provided free on the NHS. When can families and friends, who scramble every month to raise thousands of pounds to pay for private prescriptions, reasonably expect to receive this medicine on the NHS?

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[Beth Winter (Cynon Valley) (Lab)]

T8. Today, the Office for National Statistics reports that real pay is dropping at the fastest rate since records began in 2001. However, it is reported that the Government are going to punish our hard-working NHS staff even further by forcing through a real pay cut of between 5% and 6%. Will the Minister please dispel that by confirming that NHS staff will be awarded an inflation-proof pay rise?

[Steve Barclay]

The Government have committed to giving NHS workers a pay rise this year, on top of last year’s 3% rise when pay was frozen in the wider public sector. The independent pay review bodies base their recommendations on a number of factors, which include but are not limited to the cost of living and inflation, as well as the economic context and issues such as recruitment and retention. The Government are considering carefully the content of the pay review body’s report and will respond shortly.

[Alicia Kearns (Rutland and Melton) (Con)]

I want to raise the case of 10-year-old Lucas from my constituency, who has a rare form of cancer called DIPG—diffuse intrinsic pontine glioma. The only drug that would prolong his life has to come from Germany. The family have raised the funds to pay for the drug, but they are now being charged £530 per shipment in import duty. Will my right hon. Friend please help me to lobby the Treasury for an exemption, because it should not be making money off the back of this poor boy’s lasting difficulties?

[Steve Barclay]

As my hon. Friend recognises in her question, that is a decision for Her Majesty’s Treasury, but I am very happy to highlight with the Chancellor the case that she brings to the attention of the House.

[Christian Wakeford (Bury South) (Lab)]

T9. Many people in the Chamber will know of my passion for addressing alcohol harm and addiction. However, 2022 marks a decade since the last alcohol strategy was introduced, and a decade of Government inaction. With deaths reaching the highest level in 20 years and the number of those drinking at high risk rising steadily, what plans do Ministers have to introduce a new comprehensive alcohol strategy to reduce the number of lives lost to alcohol harm and save the vast cost that alcohol imposes on our society?