Oral Answers to Questions

Will Quince Excerpts

Tuesday 1st November 2022 Commons Chamber

[Anne Marie Morris (Newton Abbot) (Con)]

2. What recent discussions he has had with relevant stakeholders on tackling health and care workforce shortages in rural areas.

[The Minister of State, Department of Health and Social Care (Will Quince)]

Ministers and officials regularly engage with a wide range of organisations to ensure that we are alert to the staffing issues facing the NHS and care sector across our country. We have increased training places for doctors, nurses and allied health professionals and increased access to clinical placements across a wide range of settings. We have also developed apprenticeships and blended learning opportunities to improve access to training that supports remote and rural communities.

[Anne Marie Morris]

In Devon, workforce shortages are acute. One in 10 nursing places remains unfilled, one in eight mental health roles across the south-west is vacant, and there are no dental practices taking on new NHS patients. That gap is too big to be bridged through current training and recruitment plans. Will the Minister create as a matter of urgency an innovative new career pathway, reducing the time to get new staff to the frontline?

[Will Quince]

I thank my hon. Friend for her question. She is a passionate campaigner on this issue. I recently responded to a debate on this issue led by her. She also chairs the all-party parliamentary group on rural health and social care. She is right, and we have developed an apprenticeship route for almost all professions in our NHS, allowing people to join the health and care sector immediately on an earn-as-you-learn basis. We continue to work hard to develop pathways into health and care professions, including via our groundbreaking blended online learning programmes.

[Jim Shannon (Strangford) (DUP)]

In terms of district nursing and community midwifery, is the Minister aware that there are real security concerns about entering homes alone, and that that plays into resignations in many rural areas? Will he address that by providing security devices so that rural, isolated nurses and staff know that they are not alone and are safe?

[Will Quince]

The hon. Gentleman raises an interesting point. It is not something that has come across my desk in the two days I have had this portfolio, but I will of course meet local integrated care system leaders, and if it is something that they are calling for, I will look to see what we can do to assist.

[Mr Robin Walker (Worcester) (Con)]

Worcestershire and Herefordshire are rural areas that suffer from a shortage of doctors at both primary and secondary levels. My hon. Friend is an excellent Minister: will he meet me to discuss the strong case for funding places at the Three Counties Medical School in Worcester—a ready-made solution to the problem—which has already seen 851 applications from home students?

[Will Quince]

I thank my hon. Friend for his compliment. He raises an important issue. I know that my predecessor not only agreed to meet him, but undertook to visit Worcester. I would be happy to make the same commitment.

[Alison McGovern (Wirral South) (Lab)]

Wirral and Cheshire have many rural areas, with all the same problems that have been described. When I met healthcare professionals on Friday, they were clear that the problem is not just recruitment, it is also retention. Which of the changes that have happened over the past 12 years to make working life for NHS staff less good than it needs to be will he reverse?

[Will Quince]

Of course retention is as important as recruitment. Since September, we have had the non-repayable training grant, which is a minimum of £5,000 per academic year, additional funding for certain courses, and extra funding worth up to £3,000 for eligible students to cover childcare costs. That is, of course, on recruitment. On retention, we are looking at more access to mental health support and high-quality support while in training and clinical placement, but of course there is more to do.

[Andrew Jones (Harrogate and Knaresborough) (Con)]

3. What steps he is taking to support people with mental health conditions.

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[Kenny MacAskill (East Lothian) (Alba)]

8. What recent representations he has received on recruitment and retention of the nursing workforce.

[The Minister of State, Department of Health and Social Care (Will Quince)]

We are on target to meet the 50,000 nurses manifesto commitment, with nursing numbers more than 29,000 higher in August this year than they were in September 2019 and more than 9,100 higher than in August last year. We are working across a range of delivery partners to invest in and diversify our training pipeline, conduct ethical international recruitment, improve retention and support return to practice.

[Kenny MacAskill]

Cancer services are buckling both sides of the border and workforce challenges remain the biggest barrier to reducing waiting lists and meeting need. Will the Minister ensure that the long-term workforce plan being developed by NHS England gives consideration to the plans being prepared by NHS Scotland to minimise duplication and try to ensure the best possible patient outcomes in both countries?

[Will Quince]

I thank the hon. Gentleman for his question. We remain absolutely committed to growing and supporting our vital NHS workforce. In addition to the work already in place to continue growing the workforce, we have, as he mentioned, commissioned NHS England to develop a long-term plan for the workforce, looking at the next 15 years. It is important that we do that in tandem and I will have conversations—I think later this week—with my counterpart in the Scottish Government.

[Chloe Smith (Norwich North) (Con)]

Workforce does matter enormously to backlogs and cancer backlogs in particular. I have come here straight from a mammogram two years after being diagnosed with breast cancer. Luckily, I am in rude health. [Hon. Members: “Hear, hear.”] However, for my constituents, the Norfolk and Norwich University Hospitals NHS Foundation Trust has met cancer referral targets only once in the last three years. Staff are working extremely hard, including by running more clinics and scaling up services. Will the Minister support the trust to reduce waiting times for my constituents for tests, results and treatment?

[Will Quince]

I thank my right hon. Friend for her question and I look forward to visiting Norfolk and Norwich University Hospital as soon as possible. She rightly raises cancer referrals. Cancer referrals from GPs are now at 127% of pre-pandemic levels. Cancer treatment levels are at over 107% of pre-pandemic levels, with nine out of 10 people starting treatment within a month. However, as she rightly points out, there is variance across the country and, where trusts have more challenging statistics, we need to address them.

[Andy Carter (Warrington South) (Con)]

9. What steps he is taking to help move patients who no longer need acute care from hospitals into social care settings.

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[Elliot Colburn (Carshalton and Wallington) (Con)]

T7. The Government have given Epsom and St Helier University Hospitals NHS Trust the green light to get on with improving St Helier and building a new hospital in Sutton. We know that the pandemic has had an effect on timetables, so will my hon. Friend facilitate a meeting between his Department, the Treasury and the trust to ensure that we can get a planning application in by the end of the year?

[The Minister of State, Department of Health and Social Care (Will Quince)]

We are fully committed to delivering a new hospital in Sutton, one of the 40 new hospitals to be built by 2030. Officials from the Department and the NHS are working closely with the trust at every step in the process, and I look forward to working with my hon. Friend to deliver this much-needed hospital improvement.

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

T8. In rural areas such as the west country, NHS dentistry is more of a distant memory than a vital service. Does the Minister agree that more must be done to boost NHS dental services in rural areas, and will he commit himself to reforming the NHS dental services contract to ensure that it meets patient need and properly incentivises dentists to take on NHS patients?

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[Stephen Hammond (Wimbledon) (Con)]

Early access to scans and testing can prevent more serious illness, improve health outcomes, reduce health inequalities and reduce pressure on the acute sector. Will my right hon. Friend prioritise increasing the number of diagnostic centres across the United Kingdom and support my campaign for the establishment of one in Wimbledon town centre?

[Will Quince]

My hon. Friend is right to say that we are supporting the NHS to deliver up to 160 community diagnostic centres by March 2025, 89 of which are already operational, as part of £2.3 billion of capital funding, delivering around 2 million additional scans so far. Community diagnostic centres are closer to people’s homes in the hearts of communities, and they will help us not just to reduce and bust the covid backlogs but to tackle health inequalities.

[Grahame Morris (Easington) (Lab)]

As we get older, many of us—individually or our close family and their immediate family—will be touched by cancer. Can the Minister confirm when the 10-year cancer plan will be published in full, and will the Minister agree to meet me and a small delegation from the all-party parliamentary group on radiotherapy to hear more from the experts on the frontline about how we can use this technology to improve cancer outcomes?

World Menopause Day

Will Quince Excerpts

Thursday 27th October 2022 Westminster Hall

[The Minister of State, Department of Health and Social Care (Will Quince)]

It is a pleasure to serve under your chairmanship, Mr Hollobone. It is great to be back and to be reappointed. I congratulate the hon. Member for Swansea East (Carolyn Harris) on securing this important debate about World Menopause Day. With reference to the comments of the hon. Member for Motherwell and Wishaw (Marion Fellows), this has been an education, certainly for me and no doubt for you, Mr Hollobone, as these debates should be.

[Eddie Hughes (Walsall North) (Con)]

I rise as the husband of a menopausal woman. I pay tribute to my wife Clare and to PHS Group for the support that it has given her. Does the Minister agree that all men of all ages need to understand more about the menopause so that they can provide support to colleagues and family members who are experiencing its challenges?

[Will Quince]

I certainly agree with that. I also want to say thank you in passing to PHS Group; it is important that employers play their part, and it is good to hear about what that organisation is doing. I did some work with it on the period product scheme in a previous role as Minister for Children and Families. We should celebrate companies that are doing the right thing by their employees.

Somebody said that the hon. Member for Swansea East—I will call her my hon. Friend—has a lot to answer for. There is no more effective campaigner in the House of Commons. I recognise the incredible work that she has done in raising awareness of the menopause, which affects millions of women across our United Kingdom. I also thank her for chairing the all-party parliamentary group, which recently published its first report, on menopause support.

It will not have escaped your notice, Mr Hollobone, that I am not my hon. Friend the Member for Sleaford and North Hykeham (Dr Johnson). I have stepped in at the last minute, and I wish her well.

The hon. Member for Swansea East said that women are more sceptical and less jubilant. Although I am not the Minister responsible for this policy area or brief, the hon. Lady knows me and knows the issues on which we have campaigned together. She knows that, in me, she has an ally at the Department of Health and Social Care. She referred to men at the football coming to get a selfie with her. I think I speak for all men in the Chamber when I say that I would be honoured to have a selfie with her. In seriousness, I was moved by the stories that she and others told of the impact of the menopause on women in the workplace. In bringing about the change that we all want to see, she has an ally in me. That change is an issue not just for the Department of Health and Social Care but for BEIS. I have heard that loud and clear.

I thank my right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes) for all her work as Chair of the Women and Equalities Committee. Its recent report, “Menopause and the workplace”, to which she referred, demonstrates the significance of the topic to the House. I know that my hon. Friend the Member for Sleaford and North Hykeham has written, albeit today, to my right hon. Friend to explain that we are carefully considering the Committee’s recommendations. We will respond in due course, and I will ensure that that happens—I will chase it up today. I will also speak with BEIS and the Government Equalities Office about the issues my right hon. Friend raised.

I thank all Members who have spoken, whether on behalf of themselves or their constituents, to mark World Menopause Day. It is important to say that 51% of our population will experience the menopause. There is no question but that the stigmatisation of this important part of life must end. That begins with us talking more openly about the symptoms and the treatment and support available. Vitally, when women talk, we have to listen.

I would like to update the House on the Government’s important work in this area and to reflect on how far we have come and the distance we still have to go, and I will respond to as many of the points raised by hon. Members as I can. For too long, women’s experiences of menopause support have not been good enough. That was the clear message from our call for evidence on the women’s health strategy last year. The menopause was the third most selected topic for inclusion in the strategy. It was chosen by 48% of nearly 100,000 individual respondents.

During last year’s debate on World Menopause Day, the Government committed to listening and to making menopause a priority for our women’s health strategy. I am delighted that the first ever women’s health strategy for England has been published. It contains our 10-year ambitions and the immediate actions we are taking to improve the health and wellbeing of women and girls across our country, from adolescents through to older age. It details an ambitious programme of work to improve menopause care.

It is important to stress that we are not implementing the strategy alone. As I think was said already, we appointed Professor Dame Lesley Regan as the first women’s health ambassador. The hon. Member for Swansea East and I have worked with her on both baby loss and maternal health. She is an expert, and she will do an amazing job as the first women’s health ambassador for England. She will help us to raise the profile of women’s health and break down harmful taboos. I have no doubt that she will bring a range of voices to help us implement the strategy and deliver on our commitments.

Numerous Members raised healthcare support. I bring to the House’s attention the NHS England national menopause care improvement programme, which is improving clinical menopause care in England and reducing disparities in access to treatment. That important work sits alongside a menopause education and training package that the NHS is developing for healthcare professionals.

I turn to the important point of raising awareness. My right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom) said that we know more about Viagra than about the menopause, and she may well be right. Awareness is vital to tackling the stigma around the menopause. We want everyone in this country to be educated about the menopause from an early age. All women going through the menopause and perimenopause should be able to recognise the symptoms and know their options. We are transforming the NHS website into a world-class first port of call for women’s health and have recently updated the menopause page.

As my hon. Friend the Member for North Devon (Selaine Saxby) rightly pointed out, we should educate the next generation of boys and girls to help break taboos and ensure that children growing up today can speak about the menopause openly. Menopause is included—I know this as a former schools Minister—in the statutory relationships, sex and health education curriculum, and we are working across Government to understand women’s health topics that teachers feel less confident about to provide further support.

The hon. Member for Enfield North (Feryal Clark) raised the issue of HRT supply. Although most HRT products remain in good supply, various factors, including increased demand, have led to supply issues with a limited number of products. That has improved significantly recently, and we have been working hard to ensure that women can access the treatment they need. We are implementing the recommendations of the HRT supply taskforce and continuing to use serious shortage protocols where appropriate. We keep that under close review.

The hon. Members for Swansea East and for Enfield North and my right hon. Friend the Member for South Northamptonshire mentioned the cost of HRT—an incredibly important issue. We are committed to reducing the cost of HRT prescriptions through a bespoke prepayment certificate for HRT, which we will introduce from April 2023, subject—here is the caveat—to the necessary consultation with professional bodies. The hon. Member for Swansea East asked me for a cast-iron guarantee, but she knows that I do not make promises that I cannot keep. I am not the Minister responsible, but I do know and firmly believe that politics is the art of the possible, and as long as I am a Minister of State at the Department of Health and Social Care I will ensure that the Department’s feet are held to the fire to deliver on that April 2023 ambition. It is taking longer than any of us would like because we have developed an entirely new system, and we have to create an implementation programme as well.

[Caroline Nokes]

I am not sure that what we have heard is entirely consistent. The Minister, who I know will work hard on this, indicated that there still needed to be a consultation with professional bodies, but he then indicated that the delay was in bringing forward a whole new technical system. Can he clarify that point?

[Will Quince]

My right hon. Friend is right to push me on that point. The reason for any potential delay would only be around the consultation that we would need to have. The delay—as in why we could not have done it before April 2023—is because we needed to design a whole new system. We are confident that that will be okay for April 2023. I am caveating it only because I am not the Minister responsible, and I try wherever possible not to make promises that I definitely cannot deliver on. I will not be the Minister delivering on this, but I have no doubt that the Minister who will be responsible will be able to update my right hon. Friend in due course.

Importantly, numerous Members mentioned menopause in the workplace, and, as I mentioned earlier, there were some very difficult stories. As a former Department for Work and Pensions Minister, I know the impact that that has on individuals who want to go to work and on employers, so we have to tackle that. This summer the Government responded to the independent, Government-commissioned report into menopause in the workplace, and we committed to working with a range of stakeholders to consider what more we can do. That will include an employer-led, Government-backed communications campaign on menopause in the workplace.

My right hon. Friend the Member for Romsey and Southampton North mentioned the civil service and the NHS. They are two of the biggest employers and they have signed Wellbeing of Women’s menopause workplace pledge, which is a public commitment to making our organisations a supportive and understanding place for employees going through the menopause. I encourage all other employers to do the same.

Hon. Members also referenced an employment Bill. Again, that is a promise that I cannot make because it does not fall under the remit of the Department of Health and Social Care. Nevertheless, I will have that conversation with my counterpart at BEIS.

I want to ensure that the hon. Member for Swansea East has plenty of time to sum up, so I will conclude by thanking all right hon. and hon. Members for their contributions to this important debate and for their dedicated work across Parliament to improve the experiences of women in this country going through the menopause. As I said, they have an ally in me at the Department of Health and Social Care. I am glad that we have had the opportunity to discuss this hugely important topic and that I have had the opportunity to update the House on the work under way. It is vital that this conversation continues.

Draft Water Fluoridation (Consultation) (England) Regulations 2022 Draft Health and Care Act 2022 (Further Consequential Amendments) Regulations 2022

Will Quince Excerpts

Monday 24th October 2022 General Committees

[The Minister of State, Department of Health and Social Care (Will Quince)]

I beg to move,

That the Committee has considered the draft Water Fluoridation (Consultation) (England) Regulations 2022.

[The Chair]

With this it will be convenient to consider the draft Health and Care Act 2022 (Further Consequential Amendments) Regulations 2022.

[Will Quince]

It is a pleasure to serve under your chairmanship, Mrs Murray. Tooth decay is a significant yet largely preventable public health problem throughout the country. Water fluoridation is an effective public health intervention to reduce the incidence of tooth decay and oral health inequalities. The water fluoridation provisions of the Health and Care Act 2022 will come into force on 1 November, and in doing so will transfer the power to initiate new schemes, or to vary or terminate existing schemes, from local authorities to the Secretary of State.

[Sir Greg Knight (East Yorkshire) (Con)]

We should make no mistake about what we are doing here. This is compulsory medication, because water is essential to human life. Will the Minister clarify one matter? Paragraph 7.8 of the explanatory memorandum says that it is not intended that consultations will amount to a referendum, and that decisions will depend on

“a range of factors…including…cogency of the argument”.

Who is to decide on the cogency of the argument: an independent arbiter or some pro-fluoridation fanatic?

[Will Quince]

I will come on to talk specifically about the consultation; then, perhaps in my closing remarks, I will go into a bit more detail about the role of the Secretary of State, which I think is the crux of my right hon. Friend’s question. Of course, we dealt with the fundamental principle of water fluoridation in the debates on the 2022 Act, and we do not want to go over those arguments again.

We have always been clear that, in looking at how we decide how to consult on water fluoridation schemes, public consultation will continue to be an important aspect of water fluoridation proposals, and the draft regulations set out the process that any future consultations must follow. Despite there being no statutory requirement to do so before laying the draft regulations, we of course consulted with the public because we know that some people, including my right hon. Friend, have strong feelings on the subject of water fluoridation and consultations relating to it. We are keen to gather public opinion on our suggested consultation approach.

[Chris Green (Bolton West) (Con)]

The fact that this power is being taken from the local authority level up to the Secretary of State would suggest that the Secretary of State, or the previous Secretary of State, believes that the decisions on—or progress of, as it might be seen—the fluoridisation of England’s water have not gone far enough. The Government clearly start with an intent to fluoridise more of England’s water. The intent is already there and the direction is being pushed in regardless of what consultation there is. It is not clear that local voices will be represented, as opposed to the establishment will that currently exists.

[Will Quince]

I note my hon. Friend’s concerns. I will come on to address them, and if I do not do so immediately—because I am going to talk about the consultation and how we propose to undertake it—I will do so in my closing remarks about the duty of the Secretary of State. My hon. Friend is right that it is important that localities have a say on such things as water fluoridisation.

[Chris Green]

The question of localities is important. I am a Greater Manchester MP; will Bolton be the local authority that makes the decision for my area? How much influence will the integrated care board have? Will it be a Greater Manchester Combined Authority decision, or will it be a mayoral decision?

[Will Quince]

My hon. Friend is right to push us on those issues. I will touch on them all, because it is about not just local authorities, metro Mayors and others having a say, but all those who live, work and study in an area. No doubt they will have strong views, notwithstanding me as a Health Minister having a view when it comes to tooth decay and the difference that fluoridation will have in that respect.

We launched a public consultation on 8 April that ran until 3 June. We sought views on whether future water fluoridation consultations should be restricted only to people affected locally and bodies with an interest, such as those referenced by my hon. Friend the Member for Bolton West—incidentally, that had been the case under legislation—or whether we should move to a model in which consultation would open to all, especially given the shift of responsibility from local authorities to central Government. Some people with strong views on water fluoridation may not live in a particular area but may have certain expertise or a particular interest.

We received 1,228 responses to the consultation; of those, 94% came from individuals and 6% came from organisations. The majority of respondents favoured a consultation open to all. The draft regulations will not restrict who can respond to any future consultation on water fluoridation, which I hope my right hon. Friend the Member for East Yorkshire and my hon. Friend the Member for Bolton West agree is the right approach.

To come to the crux of my hon. Friend the Member for Bolton West’s points, we understand that the views of those who are directly affected and living, working and studying in an area in question are incredibly important. For that reason, the regulations also provide for consideration to be given, as part of the decision-making process, to whether additional weight should be given to consultation responses from those who may be particularly affected by any future proposals.

Public opinion and the extent of support for a water fluoridation proposal will continue to be important but, as my right hon. Friend the Member for East Yorkshire rightly pointed out, consultations are not referendums. It is right that regulations provide for a range of other factors to be taken into account when considering a water fluoridation proposal.

[Sir Oliver Heald (North East Hertfordshire) (Con)]

In the consultation, were any of the representations made about the European convention on human rights, particularly articles 5 and 8?

[Will Quince]

The honest answer is that I am not aware of any, but no doubt my officials will look that up and I will be able to respond in my closing remarks.

The wider factors that have to be taken into account in the consultation include but are not limited to the strength of evidence underpinning an argument made by the respondents. It is absolutely right that due regard is given to those arguments and that they are properly supported by sound evidence.

On evidence, a point that my right hon. Friend the Member for East Yorkshire alluded to, we are committed to scientific evidence on water fluoridation. It has to underpin any proposal that we put forward. The Department continues to review scientific papers published both in this country and internationally as part of the continuous monitoring of the evidence. That includes papers on the epidemiology and toxicology of water fluoridation. Every four years, the Department will continue to publish a summary report on our knowledge, in line with the Secretary of State’s responsibility for monitoring the effects of the water fluoridation arrangements on the health of the populations that are served by existing schemes.

[Chris Green]

What is the Government’s view of side effects? As far as the Government are aware, are there zero side effects from the fluoridation of water?

[Will Quince]

I will come to that point. The common finding of several authoritative scientific reviews is that there is no convincing scientific evidence that fluoride in drinking water, at levels used in fluoridation schemes, is a cause of adverse health effects. Let me provide further assurance that if the balance of evidence in favour of water fluoridation as a public health measure were to change, a review of the current water fluoridation policy would take place.

I am conscious that I was not the Minister when the Act was passed, but this same point was made during the passage of the 2022 Act. We have 57 years of experience in England and 75 years of experience internationally of water fluoridation schemes. There continues to be no convincing evidence of health harms associated with the levels of water fluoridation use in this country. In fact, what we have seen internationally is more countries moving in that direction because of the benefits of tackling tooth decay, particularly in children.

[Sir Greg Knight]

The Minister is being generous in giving way. What is the duty to monitor and sample water where fluoride has been added to ensure that the dosage of fluoride is not excessive?

--- Later in debate ---

[Will Quince]

I do not know the answer off the top of my head. My officials can certainly look it up. If I can get that before my closing speech, I will. Failing that, I will of course write to my right hon. Friend and all members of the Committee to furnish them with that evidence.

Another important factor is the cost-benefit analysis, because the schemes are not cheap. They have a huge benefit, but they also come with a sizeable cost. One element in deciding whether we proceed with a water fluoridation proposal is of course a cost-benefit analysis of said proposal, and any new proposal would have to demonstrate that the benefit to health represents good value for the investment of public money being proposed.

As I have set out, where the conditions are met, we want more of the country to benefit from water fluoridation. I am pleased to announce that, subject to the outcome of this debate and any future consultations, funding has been secured to begin expansion across the north-east into Northumberland, County Durham, Sunderland, South Tyneside and Teesside, including Redcar and Cleveland, Stockton-on-Tees, Darlington and Middlesbrough. I know that the local authorities in those areas are strong supporters of water fluoridation.

In accordance with the regulations we are debating—my hon. Friend the Member for Bolton West will appreciate this because he rightly makes the point that we need to consult the public—we will hold a public consultation on the proposal next year. It is important to stress that the expansion will enable an additional 1.6 million people to benefit from water fluoridation. It will help to reduce the levels of tooth decay in the area and, over time, reduce the numbers of children who need to be admitted to hospital for tooth extractions because of decay. As children in more deprived areas are at greater risk of tooth decay, expansion will help to level up dental health for the children and families who need it most. I am conscious there were some other questions and will try to come back to as many as I can in my closing remarks.

Let me turn to the draft Health and Care Act 2022 (Further Consequential Amendments) Regulations 2022, and start with the mandatory learning disability and autism training. People with a learning disability and autistic people face barriers in accessing the right care and support. I know that from my time as Minister for Children and Families at the Department for Education. We know that, compared with the general population, people with a learning disability are more than three times as likely to die from an avoidable medical cause of death.

The introduction of mandatory training on learning disability and autism is an important way to address persistent disparities in health and care outcomes for the affected group of people, and it will ensure that staff have the right skills and knowledge to deliver safe and good quality care. That is why the Government introduced, from 1 July, a new requirement that Care Quality Commission-registered providers have to ensure that their health and social care staff receive training on learning disability and autism appropriate to their role.

The Health and Care Act 2022 also creates a duty for the Secretary of State to publish a code of practice that will outline how to meet the new requirement, which will include the content of training, its delivery, and the ongoing monitoring and evaluation of said training. The code of practice is being developed and we expect to publish a draft for consultation next year.

The 2022 Act amends section 20 of the Health and Social Care Act 2008 so that regulations must require service providers to ensure that their employees receive training on learning disability and autism. Section 23(1) of the 2008 Act requires the CQC to issue guidance about complying with the requirements of the regulations under section 20. In its current form, the 2022 Act imposes a duty on the CQC to issue statutory guidance about the new training requirements for service providers. The CQC published the guidance on 1 July, so if it is left unchanged, service providers will have two sets of guidance—statutory guidance that is issued by the CQC and a code of practice issued by the Secretary of State.

To avoid duplication and to ensure that service providers have a single source of information, this tidying-up regulation seeks to improve the situation by removing the requirement for the CQC to issue statutory guidance about the training requirements by amending section 23(1) of the Health and Social Care Act 2008. As agreed with the CQC, the statutory guidance that it has published will be accessible for service providers until the code of practice is published.

Let me turn to virginity testing and hymenoplasty. Safeguarding vulnerable women and girls is a top priority for the Government, which is why we were one of the first countries in the world to ban virginity testing and hymenoplasty. Virginity testing and hymenoplasty have no scientific merit or clinical indication and they are a violation of human rights. They have an adverse impact on women and girls’ physical, psychological and social wellbeing; they are degrading and intrusive acts; and they can lead to extreme psychological trauma in the victim, including anxiety, depression, post-traumatic stress disorder and suicide.

Virginity testing and hymenoplasty can be physically harmful. They can result in damage to the hymen, tears and damage to the wall of the vagina, and bleeding and infection. The risk of infection is particularly high in hymenoplasty, which has the added risks of acute bleeding during the procedure, scarring, the narrowing of the opening of the vagina and sexual difficulties. As such, we are proud that the 2022 Act made carrying out, offering and aiding and abetting virginity testing and hymenoplasty illegal.

As the offences are new, certain changes to other legislation are necessary to protect vulnerable groups. The Scottish Government have requested that a change be made to the Foster Children (Scotland) Act 1984, which contains a list of matters that seek to disqualify a person from fostering a child in Scotland. The consequential amendments proposed today would add to that list the conviction of an offence of virginity testing or hymenoplasty in relation to a child. This change would also flow through to assessments by adoption agencies in Scotland under the Adoption Agencies (Scotland) Regulations 2009 with regard to the suitability of prospective adopters.

The 2009 regulations require suitability assessments to be carried out with reference to a range of information, including whether the prospective adopter or any member of their household has been disqualified or prohibited from keeping a foster child under the 1984 Act. The change would have the effect of disqualifying or enabling the disqualification of individuals convicted of virginity testing or hymenoplasty offences from fostering or adopting in Scotland. Similar changes are already in place in equivalent English and Welsh law, and this will help to protect girls and young women from so-called honour-based abuse. I commend the regulations to the Committee.

[Feryal Clark (Enfield North) (Lab)]

It is a pleasure to serve under your chairmanship, Mrs Murray.

Poor oral health is far too common in 21st century Britain and, as is so often the case, it has the most significant impact on already vulnerable and disadvantaged people. Oral health has suffered from a chronic lack of investment, with a number of opportunities missed to make a serious impact on interventions. Those interventions have long since disappeared given the deep cuts made to public health budgets throughout the country, but one such measure that remains is putting fluoride in our water, which is an effective, evidence-based intervention on oral health—nothing more and nothing less. Given that fact, and the major health inequalities we face, we should actively pursue the rolling out of these schemes to the communities that would benefit the most.

When pursuing water fluoridation, it is vital that we start where communities are and bring them with us. I am therefore particularly pleased to see the emphasis the regulations place on the need for proactive engagement and consultation with local communities when the plans are rolled out. Given the mismatch of local authority and water-provider boundaries, the centralisation of the process is understandable, but it makes engagement even more important, as the Minister set out.

Given the regulations’ positive intention to improve oral health, where is the action to address the crisis of access to NHS dentistry? The Government spend on general practice in England has been cut by more than a third over the past decade, with the number of NHS dental practices in England falling by more than 1,200 in the five years prior to the pandemic. Tooth extraction remains the No. 1 cause of children being admitted to A&E. We welcome the regulations on fluoridation, but I gently remind the Minister that if we are to see progress on oral health, much more needs to be done.

On the second set of regulations, it is good to see the tidying up of the Health and Care Act 2022. I want to ask the Minister if it is correct that the regulations cover the statutory guidance on training for learning disabilities and autism?

[Will Quince]

I believe so, yes.

[Feryal Clark]

I just wanted to check, because the Minister mentioned virginity tests and hymenoplasty. I want to make clear our support for the change in that guidance on learning disability and autism training. The regulations are welcome, and their implementation is now a task for the Government.

Virginity testing and hymenoplasty are serious practices with no medical benefits that do not work in service of the goal they are supposedly pursuing. They are not medical practices; they are nothing more than abuse. Both practices are a violation of women’s and girls’ human rights. As the Royal College of Obstetricians and Gynaecologists has stated,

“Both are harmful practices that create and exacerbate social, cultural and political beliefs that a woman’s value is based on whether or not she is a virgin before marriage.”

Women need and deserve ownership of their sexual and reproductive health. It is our right. Those who deny women that right in any part of our country are criminal. They must not have the right to foster a child. We cannot and must not entrust the care of a child to anyone who has committed such a heinous crime. We welcome the regulations and support the measures.

[Will Quince]

I thank colleagues for their contributions, and the Opposition for their constructive response and the tone of their questions. I will focus on water fluoridation and then come to dental access, which is not entirely related, but is important and a priority for me.

Consultations seem to be the key issue, so let me focus on them. I am happy to meet my right hon. Friend the Member for East Yorkshire and my hon. Friend the Member for Bolton West to discuss this issue at greater length as we progress toward consultations. On the additional weighting that will be given to local views, which is important, the regulations require the Secretary of State to take into consideration a range of factors when making a decision on water fluoridation. That includes giving consideration to whether the views are of individuals directly affected and constitute bodies with an interest. If they are, they should be given additional weight. There are clearly established public law principles that require public bodies to act lawfully, rationally, fairly and compatibly with the human rights of those affected by their actions. We would quite rightly have to justify any decisions taken on a future scheme as part of the decision-making process.

One of the questions asked was on the methodology of the extra weight given to local people as per the regulations. Under the Water Industry Act 1991, as amended, Parliament granted the Secretary of State the power and discretion to make decisions on future fluoridation steps in England, including establishing, varying and terminating fluoridation agreements. To give those powers additional weight, the Secretary of State will be bound by the regulations to do that in an appropriate manner, in accordance with the public law principles of rationality that I have just set out.

I remind the Committee that implied in the Secretary of State’s existing direction is the power to grant additional weight to any person or persons whom she deems fit. In effect, all this provision does is to compel the Secretary of State to give due consideration to doing so. As I say, I would be very happy to pick that point up in more detail with my right hon. Friend the Member for East Yorkshire and my hon. Friend the Member for Bolton West.

Questions were raised about the duty of sampling water to ensure that a dosage is not too high. Clear regulations on water supply were laid in 2018. They allow up to 1.5 mg of fluoride per litre in public water supplies. I would be happy to write to my right hon. Friend the Member for East Yorkshire about how water authorities are held to account to ensure that water is monitored and that limit adhered to.

Finally, I hear what the hon. Member for Enfield North says about dental access. Access to dentistry is difficult in too many parts of the country, especially when people do not have ongoing relationships with a dentist. In July, we announced a package of improvements to the NHS dental system, which was detailed in our plan for patients. The Committee will have noted that the Secretary of State has her A, B, C and D priorities, and D stands for doctors and, importantly, dentists. As the Minister with responsibility for primary care, I can tell the hon. Lady that dentistry is a priority for me. I know that the delivery of dental care suffered considerably during the pandemic, but it continues to improve as we recover. Many dentists are already delivering at or above 100% of their contracted activity, but I recognise that we need to go further, and I am meeting stakeholders in the profession to see what further steps we need to take.

[Sir Oliver Heald]

Were any consultees concerned about human rights issues, and would that impact on consulting and on the way in which the measures on sampling and so on are implemented?

[Will Quince]

I was not avoiding my right hon. and learned Friend’s question, but I do not have an answer for him as my officials have not been able to find one in the short time that they have had. I will certainly commit to writing to him and to any other Committee member who is interested. Of course, if people made challenges or raised concerns on those grounds, they would be given weight as part of any consultation.

I understand that this is an emotive subject and that there are strong views on either side of the debate. That debate has already been had as part of the passage of the Act, but I trust that my answers—notwithstanding the one that I have failed to deliver for my right hon. and learned Friend the Member for North East Hertfordshire—have provided some reassurance on the benefits of water fluoridation and, in particular, on the importance of the consultation regulations. The regulations reflect the consultation responses from the public, and will not restrict those who want to respond to future public consultations on water fluoridation schemes.

I hope that my answers have also provided some reassurance on removing the requirement of the CQC to issue statutory guidance on mandatory learning disability and autism training. Let me be clear: that will not leave service providers without clear information. It will not be removed until it has been replaced with the code of practice.

[Sir Greg Knight]

Will the Minister reassure us that if he writes to any single member of the Committee on any issue that has been raised, he will write to us all?

[Will Quince]

I can certainly give that commitment and assurance to my right hon. Friend. With that, I commend the regulations to the Committee.

Question put and agreed to.

DRAFT HEALTH AND CARE ACT 2022 (FURTHER CONSEQUENTIAL AMENDMENTS) REGULATIONS 2022

Resolved,

That the Committee has considered the draft Health and Care Act 2022 (Further Consequential Amendments) Regulations 2022.—(Will Quince.)

NHS Dentistry

Will Quince Excerpts

Thursday 20th October 2022 Commons Chamber

[The Minister of State, Department of Health and Social Care (Will Quince)]

I thank the hon. Member for Denton and Reddish (Andrew Gwynne) for his kind words. He will be pleased to know that, despite what he said, I scribbled my own speech today and I can confirm that it will be a fudge-free zone. In fact, I have not had any fudge for about three years and I do not intend to start now—not least because it would not be great for my teeth.

I congratulate my hon. Friend the Member for Waveney (Peter Aldous) and the hon. Member for Bradford South (Judith Cummins) on securing time for this hugely important debate. I thank the Backbench Business Committee for allowing the time and all right hon. and hon. Members who have made constructive contributions to the debate. It would be remiss of me not to thank all those who work in NHS dentistry, not just for their work throughout the pandemic, but for the work that they continue to do serving people up and down the country.

In the relatively short time that I have available—I am conscious that there is another important debate to follow—I will endeavour to respond to as many of the points, themes and questions raised as possible. I hope that right hon. and hon. Members know me well enough already, however, to know that my door is always open. I have never turned down a meeting with a parliamentary colleague and I do not intend to start now. This is an important issue and I hope that we can continue to talk about it at length, even if not in this Chamber.

As the new Minister—or new new Minister—for primary care and therefore dentistry, I have spent the first few weeks in post learning more about NHS dentistry, including by meeting dentists; meeting people at the coalface and the grassroots is really important. Of course, I have my constituency experience too. Despite the events of today, I very much hope to be here for some time to come.



Let me say at the outset, in response to I think nearly all of the contributions made today, that I get it—I really do get it. I know that in many parts of our country access to NHS dentistry is difficult or far more difficult than it should be, and I want to make it clear that dentistry is an incredibly important part of the NHS. The Government and I are committed to addressing the challenges that NHS dentistry continues to face across the whole country, and as the hon. Member for Denton and Reddish rightly pointed out, it is in our ABCD strategy.

I turn to some of the themes raised. The first is access, which was raised by my hon. Friend the Member for Waveney, the right hon. Member for Knowsley (Sir George Howarth), my hon. Friends the Members for Mole Valley (Sir Paul Beresford), for Gloucester (Richard Graham) and for Salisbury (John Glen), the hon. Member for Bootle (Peter Dowd) and my hon. Friend the Member for North Devon (Selaine Saxby). Access to NHS dentistry varies across the country—we know that—and it was an issue, as the hon. Member for Denton and Reddish rightly pointed out, even before the pandemic, but the pandemic has exacerbated it and added further pressure to the system.

The Government are taking a number of important steps that will improve dental access for patients and make NHS dentistry a more attractive place for dentists and their teams to work in. I will outline just some of those. These changes include improvements to the current NHS dental contracts—I will come on to that in a moment—and of course to the recruitment and retention of dental professionals. I say dental professionals specifically because this is of course about far more than just dentists, as important as they are. As the hon. Member for Denton and Reddish pointed out, rightly, we have seen an additional 539 more dentists returning to NHS dentistry last year, which of course means they are able to treat more patients, but I recognise the point he rightly made, and we do need to go further and faster.

On the steps taken, notwithstanding the points made by the hon. Member for Bradford South, we made £50 million of extra funding available for NHS dental services at the end of 2021-22, which provided more appointments and increased capacity in NHS dental teams. I noted her points, and we have learned from that. Given that experience, I would certainly want to do things a little differently if we considered such a proposal again. We announced a package of improvements to the NHS dental system on 19 July, as a number of Members have pointed out, which was set out in our plan for patients. These are an important first step to system reform and are designed to improve access to dental care for patients, particularly patients with the most complex treatment needs.

A number of hon. Members raised the much criticised—and that is as far as I will go, the hon. Member for Denton and Reddish will be pleased to know—2006 contract. We are making improvements to ensure that dentists are more fairly remunerated, especially for more complex oral health needs. The one example we hear very often is of dentists getting paid the same for doing one filling as for six fillings. As numerous hon. Members have pointed out, we have also set a £23 minimum UDA value, notwithstanding the points made about the variation around the country.

My hon. Friend the Member for Gloucester raised accountability locally, including to Members of Parliament. In part the answer to that is their coming within the remit and purview of integrated care systems. I have no doubt that my hon. Friend is well aware of the chief executive of his integrated care system, and will know how to contact and meet them on a regular basis.

[Richard Graham]

The Minister is absolutely right: not only do we know the chief executive, but all Gloucestershire MPs have had regular meetings with them, including one specifically on this issue. That is why I raised the importance of their being given the opportunity to take responsibility, which I hope my hon. Friend will welcome.

[Will Quince]

I certainly do welcome that, because this is not just about commissioning, but about accountability and oversight.

Our changes will allow NHS commissioners to have more flexibility in commissioning, and I think that is really important, because if they have that flexibility in commissioning additional dental services, they are the ones who know the local need within their area. I want to see far more responsive management of contracts, so if they have underperforming practices and practices that can do more, we should enable such practices to do that. For example, a high-performing practice should be able to deliver beyond its existing contract to make up for the fact that a neighbouring practice is not doing so. That addresses some of the points made by my hon. Friend the Member for Waveney about the clawback of UDA funding at the end of the year, and then its not necessarily being spent on dentistry. As part of that, I also want and expect more transparency. We will make it a requirement for NHS dentists to update the information on their NHS website, so people can see which dentists are accepting new NHS patients for treatment.

On that point, I want to bust the myth about being registered with a dentist. There is no such thing as being registered with a dentist or a dental list. People approach an NHS dentist for specific treatment. They go on their list, register and have the treatment. They can have an ongoing relationship with a dentist, but anyone can book an appointment with any dentist with an NHS contract, regardless of where they live in the country. It is important to get that message out, because when our constituents say to us, “I can’t get a dentist locally”—I want to address that point—I want to ensure that they know that they could travel to a neighbouring town or city. They could travel half way across the country if they wanted to, for example if they had relatives there, if there was a NHS dentist who had capacity to see them.

[Wera Hobhouse]

Does the Minister recognise that because of the abnormalities of the dental contract, and dentists not knowing which patients they are getting, NHS dentists would rather take a patient whom they already know, and whose history of dental problems or otherwise they know, rather than taking somebody they have never seen? There is a disincentive to take on new patients, but there is a continuity for those who are already with an NHS dentist.

[Will Quince]

Of course I take that point—it is a fair one—and when those who seek NHS treatment have an ongoing relationship with a dentist, they are more likely to get seen. When considering reforms to the system we will certainly take that point on board.

[Sir George Howarth]

The description that the Minister gave of the existence, or otherwise, of lists is accurate, but when anyone seeking to get NHS treatment in a dental practice rings up, they are most likely to be told by the receptionist that the practice is not taking NHS patients. The difference between the two situations, while technically correct, is not there in practice. Before he concludes his remarks, will he address the issue I raised about the short-term measures that can be, and I believe should be, taken to improve the situation?

[Will Quince]

I am conscious of your advice, Madam Deputy Speaker, but I am certainly willing to meet the right hon. Gentleman to consider what short-term measures we can take.

There is so much I want to say about the contract and my ambitions for the future, but politics is the art of the possible and deliverable, and I will be honest and frank with the House, and with stakeholders across the sector, about what we can deliver. We will then work towards what is within the art of the possible. International dentists are a vital part of the UK’s dentistry workforce, and I am happy to meet hon. Members to set out exactly what we are doing. I hope to bring forward legislative changes later this year. On dental training, I would love to talk more about the Advancing Dental Care review and the centre for dental development, but that may have to wait for another day—you have advised me about the time, Madam Deputy Speaker.

Prevention and oral health has been raised by many Members and is an important part of our strategy. I am looking closely at what more we can do with other Departments, especially around supervised toothbrushing, but also fluoridation, which was raised by numerous Members. Access to urgent care is important, and if people struggle to get an appointment they should call 111. This is the beginning of our work to improve NHS dentistry, not the limit of my ambition. This is just the start, and we are committed to long-term improvements, including changes to improve access to urgent care, and further work on workforce and payment reform. In the meantime there is lots we can do to improve access to urgent care, provide better access for new patients, and make important changes to workforce and payment reform. With that short response I hope I have assured hon. Friends and Members that action is being taken now to address the challenges of access to dental care, especially around recruitment and retention. I also want to reassure Members of my personal ambition and passion for bringing about the medium to long-term positive change that we want for NHS dentistry.

Edenfield Centre: Treatment of Patients

Will Quince Excerpts

Thursday 13th October 2022 Commons Chamber

[Christian Wakeford (Bury South) (Lab)]

(Urgent Question): To ask the Secretary of State for Health and Social Care if she will make a statement on the treatment of patients at the Edenfield Centre.

[The Minister of State, Department of Health and Social Care (Will Quince)]

I am grateful to my hon. Friend for this important question. Like him, I have been horrified by the treatment of vulnerable people at the Edenfield Centre, which has been brought to light by undercover reporting from the BBC. There is no doubt that these incidents are completely unacceptable. The Under-Secretary of State for Health and Social Care, my hon. Friend for Sleaford and North Hykeham (Dr Johnson), has met the Greater Manchester Mental Health NHS Foundation Trust, and a number of steps are being taken.

As a matter of first priority, my Department is working with the trust to ensure that all affected patients are safe, and a multidisciplinary team has completed clinical reviews of all patients. Secondly, a significant number of staff have been suspended pending further investigation. Thirdly, the trust has agreed that there will be an independent investigation into the services provided at the Edenfield Centre. Fourthly, Greater Manchester police are investigating the material presented by BBC “Panorama”. For that reason, as you rightly pointed out, Mr Speaker, I will not be commenting on the specifics of the case. The trust will continue to work closely and collaborate with local and national partners, including NHS England, the Care Quality Commission, the police and, of course, my Department.

These are important first steps, but they are by no means the last. There are serious questions that need to be answered, especially in the light of other recent scandals. I want to put on record my thanks to the whistleblowers, to the BBC and, above all else, the patients and families who have been so grievously affected. Anyone receiving mental health treatment is entitled to dignity and respect. On that principle there can be no compromise, and this Government will work with whoever it takes to put this right.

[Christian Wakeford]

Thank you for granting this urgent question, Mr Speaker. It has been 15 days since “Panorama” aired the deeply distressing scenes from the Edenfield Centre in my constituency, which brought tears across the country, including my own, yet we have heard nothing from the Department. The programme showed some of the most vulnerable people in society being physically abused and goaded, sexualised behaviour from staff to patients, falsifying of medical records and patients locked in isolation for months on end. Seclusion seemed to be used for the convenience of staff, rather than as punishment. All this happened while the CQC was on site and did not issue a notice; it even praised bosses.

I have received an unprecedented amount of correspondence from individuals who have worked at the Edenfield Centre in the past or families with relatives there now or in the past. They all speak of failings of leadership, along with a culture of bullying. I have spoken with the families of those featured in the programme, and they advise that they are still being blocked from contacting their relatives, who are desperate to move out of the Edenfield Centre, and some are even still in seclusion. I pay tribute to Alan Haslam, who went undercover for three months. He received a crash course and was thrown in to care for these incredibly vulnerable people, many with complex needs.

What is the Minister doing to address the issue of sufficient training levels in the NHS for those providing mental health care? Can he outline how much additional funding the Government are giving the NHS for mental health services? Will he apologise to those families for what happened at Edenfield and support my call for a public inquiry, as Edenfield cannot be trusted to mark its own homework? Finally, will he outline how he is ensuring that the correct care is being given to those featured in the programme, such as Olivia and Harley, who desperately need it, and how the families will get the justice they deserve?

[Will Quince]

I thank my hon. Friend for his further question. I know that he has met the Under-Secretary, NHS England and the trust, and has had an opportunity to ask questions. On his points on training, I suggest he has a further meeting with my colleague at the Department, who has responsibility for mental health, so that she can set out those plans.

My hon. Friend asked whether I will apologise to the patients and their families. Of course, I will do so unequivocally. It should not have happened, and it is our role as Ministers—in fact, it is the role of all those who work in the NHS—to do all we possibly can to prevent it from happening again. He asked for an independent inquiry, and I believe it does the meet the threshold for that.

Finally, my hon. Friend mentioned NHS funding. The NHS long-term plan commits to investing at least an additional £2.3 billion a year, which takes the total to about £15 billion last year, and there is an additional £10 million for winter pressure this year.

[Andrew Selous (South West Bedfordshire) (Con)]

I have a terrible feeling of déjà vu because I remember standing on a previous statement on an issue such as this, and here we are again. We are talking about the most vulnerable people, who cannot tell their own story, so I want to ask the Minister, who I know cares deeply about these issues, what more we can do to provide the proactive, independent evidence by any means necessary so that we nip this sort of behaviour in the bud. We have to care for these people, and I think that the overwhelmingly decent workforce in this industry will be equally appalled about what has happened in the Edenfield Centre. Will the Minister think about independent, verifiable, proactive evidence to stop this from continuing to happen?

[Will Quince]

I thank my hon. Friend for his question, and he is absolutely right that patients and their families deserve and indeed expect the highest standards of care quality. Safe services are by no means—never, in fact— optional extras, and where there are failures to deliver to those standards, we must continue to be transparent so that we can learn and improve. Whether it is in the CQC or local trusts, I know that the Under-Secretary, my hon. Friend the Member for Sleaford and North Hykeham, will look at any and all options to improve transparency, and to make it far clearer where cases of this nature do take place. He is also absolutely right to point out that the vast, vast majority of those who work in our NHS provide the most incredible world-class care, and where they are let down by a tiny number of individuals, as they have been in this case, such people are letting down everyone who works in the NHS.

[Mr Speaker]

I call the shadow Minister.

--- Later in debate ---

[Will Quince]

The Government are absolutely committed to ensuring that all patients receive safe and high-quality care in all settings. As the hon. Lady pointed out, we are investing more than ever before in NHS mental health services through the NHS long-term plan, which will see an additional £2.3 billion in funding per year by 2023-24.

The hon. Lady asked what work is underway. There is work under way at a national level to improve the way we safeguard patients and ensure they receive high-quality care through a new mental health safety improvement programme, which has set up new mental health patient safety networks across all regions in England. We are reviewing everyone with a learning disability and all autistic people in long-term segregation in a mental health in-patient hospital. The Care Quality Commission is introducing a new approach to inspections from next year, which will be more data driven and targeted, and we have commenced the Mental Health Units (Use of Force) Act 2018.

I can absolutely assure all hon. Members that this Government will continue to work with our partners across the NHS, social care and other sectors to consider what more action is needed to tackle toxic and closed cultures, looking at the available evidence base and, most importantly, hearing from the people affected and their families.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

NHS guidance has been clear for many years that abuse of this kind, including punitive seclusion and overuse of restraint, should never be allowed, yet it has persisted, as other hon. Members have said, including at Winterbourne View, Whorlton Hall, Cygnet Yew Trees, Cawston Park and now the Edenfield Centre. There will be other places, too, that have not had media attention, but where families of patients are seeing abuse and have no mechanisms to change things.

Harley is a young autistic woman who was detained at the Edenfield Centre and experienced punitive seclusion for weeks at a time. She said in the programme:

“Staff provoke a patient and then my reaction is used against me. But they’re provoking us. It’s disgusting. I’ve been treated like I’m an animal.”

There are over 2,000 autistic people and people with learning disabilities locked in inappropriate in-patient units in this country, often for 10 years or more. The policy of the use of inappropriate in-patient units for autistic people and people with learning disabilities is a choice. They could have support in the community with skilled and experienced staff. Will the Minister promise to end the culture of abuse for Harley and so many people like her?

[Will Quince]

The hon. Lady is right. I believe what I saw to be disgusting too. She specifically referenced those with learning disabilities and autistic people in long-term segregation. NHS England is undertaking independently chaired care education and treatment reviews for everyone with a learning disability and all autistic people in long-term segregation in mental health in-patient hospitals. A senior intervenor pilot is also underway. These actions will help support people in long-term segregation to move to a less restrictive setting or to leave hospital. A programme of safety and wellbeing reviews for the care and safety of people with learning disabilities and autistic people is now complete, and NHS England will be publishing the findings of a national thematic review later this year.

[Steve Double (St Austell and Newquay) (Con)]

Recruiting the right staff is key to providing the right mental health support. I know from conversations I have had with providers in Cornwall that they are facing a huge challenge in recruiting staff. Will the Minister lay out what steps the Government are taking to attract more of the right people to work in mental health provision?

[Will Quince]

I thank my hon. Friend for his question. We know this issue is not exclusive to mental health practitioners, and it can be a particular challenge in rural, remote and coastal areas. The Secretary of State is currently working on a workforce plan, which we hope to publish in due course. Talking more broadly about those working in mental health in the NHS, as raised by the hon. Member for Tooting (Dr Allin-Khan), we have 6,900 more mental health professionals in the workforce than in 2021, which is a 5.4% increase since then and a 12.2% increase on June 2010.

[Mike Kane (Wythenshawe and Sale East) (Lab)]

Jemima Burnage, the interim director of mental health at the CQC, described the BBC’s footage of the Edenfield Centre as “appalling, inhumane and degrading”. The people of Greater Manchester deserve better than that. Does the Minister therefore agree with local authority calls for a public inquiry?

[Will Quince]

Having seen some of the footage, it is hard for me to disagree with the words that the hon. Gentleman has used. I know that the Greater Manchester Mental Health NHS Foundation Trust has already identified and suspended staff involved in the behaviour at Edenfield that was revealed in that documentary, the police have launched an investigation into the allegations, and disciplinary proceedings have now commenced post broadcast. As I said, does that meet the threshold for an independent inquiry? My view is that it does.

[Munira Wilson (Twickenham) (LD)]

As this shocking investigation shows, the Mental Health Act 1983 often leaves vulnerable people at risk of cruelty and a distinct lack of care, and too many people have endured poor treatment or been detained for many years against their wishes. Reform of the 40-year-old Act is long overdue. We had the Wessely review back in 2018 and the White Paper in 2021. When will we see legislation come to the Floor of the House so that we can finally get that overdue reform?

[Will Quince]

I thank the hon. Lady for her question. I understand that a Bill to reform the Mental Health Act is in the Lords. I cannot give her a further update on that as I am not the responsible Minister, but it is important to stress that it is part of a number of measures that the Government have taken to improve on some of the challenges that she rightly pointed out. Whether that is the use of force Act, the NHS patient safety strategy, the mental health safety improvement programme, the patient safety networks that I mentioned, the new requirement for learning disability and autism training for staff or the HOPE(S) model, a lot is going on. I know that the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Sleaford and North Hykeham (Dr Johnson), will be happy to meet her to update her further.

[Justin Madders (Ellesmere Port and Neston) (Lab)]

If a test of the Government is how the most vulnerable in society are protected, I am afraid that this is yet another failure—as has been said, this is not the first time that it has happened. The CQC inspected the trust only a couple of months before the documentary was aired, which raises serious questions about the efficacy of CQC inspections. What challenge has it been given about its findings?

[Will Quince]

I thank the hon. Gentleman for his question. As a former Children’s Minister who every week read the serious incident notification report, I am a little bit disappointed in it for one reason. I mentioned some of the steps that the Government are taking, and yes, we always need to do more, but no Government can ever legislate for or produce procedure or guidance that will stop anyone who is not acting with empathy and kindness. In this case, we have seen some of the most horrific abuse. No Government can legislate to stop that, but we must do all in our power to identify it and prevent it. The CQC has an important role in that. My understanding is that, as soon as a whistleblower brought the matter to its attention, it investigated. We then understand that there was the BBC investigation. Of course, we will look at how the CQC responded and hold it to account.

[Barry Gardiner (Brent North) (Lab)]

What was the earliest date on which a whistleblower or member of a family contacted either the Department or the CQC? With respect to what the Minister said about the CQC, given that we have repeatedly seen such degrading behaviour at Winterbourne View and other places, what confidence does he have that it can assure the public that care is being given at the quality that is required?

[Will Quince]

On the hon. Member’s first question, I am a little cautious only because I am not the responsible Minister, but my understanding—I have not heard this at first hand—is that the first whistleblower complaint was made around Easter. I know that the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Sleaford and North Hykeham, will write to him on the specifics about the point at which the CQC was first notified.

Is this in any way acceptable? The answer is no. Do we therefore need to look at processes and how the CQC investigated, how it acts and its ability to identify? Yes, of course we do. But, in the same way, going back to my time as Children and Families Minister, I know that when people act in a way in which they know they should not, they deliberately hide that from the authorities and investigative bodies. So we do need to cut the CQC a little bit of slack, because this is often not in plain sight. Where it is, it is easier to identify. However, the hon. Member is right that where there is a whistleblower complaint, we must act, and we must act swiftly.

[Rachel Hopkins (Luton South) (Lab)]

We hear far too often of staff being completely overstretched, with far too many vacancies in mental health services. That was cited as one of the factors in the Edenfield scandal, but it is all too common. The Government were happy to clap for key worker staff, but they refuse to treat them with dignity and respect. Labour has pledged to invest in the NHS mental health workforce. We will recruit 8,500 extra staff. Why will the Minister not make the same commitment?

[Will Quince]

We are absolutely fully committed to attracting, training and recruiting the mental health workforce of the future. Through our plans set out in “Implementing the Five Year Forward View for Mental Health” and “Stepping Forward to 2020/21: the mental health workforce plan for England”, we have expanded and diversified the types of roles available. The hon. Lady asks us for our plans. Our aim is an additional 27,000 mental health professionals in the workforce by 2023-24 to deliver the transformation of mental health services in England that we all want to see.

[Jim Shannon (Strangford) (DUP)]

I thank the Minister for his answers, and I welcome him to his place. Having seen a very similar issue with the treatment of vulnerable patients in Muckamore Abbey Hospital in Northern Ireland, it would appear that how we balance the safety of staff with the treatment of patients needs an overhaul, and that must be UK-wide. Will the Minister make contact with the devolved Administrations, in particular the Northern Ireland Assembly, to ensure that lessons learned can be lessons shared for the safety of patients, but also for staff who have to deal with these things throughout the whole of the United Kingdom of Great Britain and Northern Ireland?

[Will Quince]

The hon. Gentleman is absolutely right. There is no monopoly on best practice and where it does exist, we have to ensure it is shared. Where we identify the very poorest practice, we must ensure the lessons are learnt not just in England, but across our United Kingdom.

Rural Healthcare

Will Quince Excerpts

Wednesday 12th October 2022 Westminster Hall

[The Minister of State, Department of Health and Social Care (Will Quince)]

It is a pleasure to serve under your chairmanship, Ms Elliott. Before I start, let me pay tribute to the work of those in the NHS and social care services across England, who are delivering excellent care now and have done so throughout the pandemic. The country is rightly proud of each and every one of them.

I congratulate my hon. Friend the Member for Newton Abbot (Anne Marie Morris), who has been a champion not only for her constituency but, more widely, for the importance of improving health services in rural areas. I thank her for securing this important debate, and I pay tribute to her work and that of the APPG, whose report I read with interest.

Although my constituency of Colchester, a relatively new city, does not share the rural characteristics of Newton Abbot, I am committed to excellent healthcare outcomes for all people in rural and urban areas across our country. I probably cannot cover every single aspect of the report, or even all the issues raised by my hon. Friend today, but I will certainly try to cover as many of them as I possibly can. Of course, I am very happy to meet her and any other colleague who would like to meet. I am proud never to have turned down a meeting with a colleague, and that is a record I intend to keep.

We certainly recognise many of the challenges caused by rurality, including the distinct health and care needs of rural areas and the challenges of access, distance and ensuring a sufficient population to enable safe and sustainable services. I assure my hon. Friend that this Government will remain committed to improving health services in rural areas, as we are committed to doing across all of England.

[Tim Farron]

The Minister alludes to GP surgeries in rural areas, which the hon. Member for Newton Abbot (Anne Marie Morris) also mentioned. Generally speaking, they serve smaller numbers of people over much larger areas. They were supported in their sustainability by something called a minimum practice income guarantee. That disappeared a few years ago, leading to many closures. In Ambleside and Hawkshead in the Lake district in my constituency, some surgeries are facing potential closure because of the removal of that funding. Will the Minister consider introducing a specific rural surgeries subsidy fund to help ensure that surgeries in rural communities in Cumbria and elsewhere are sustainable?

[Will Quince]

I thank the hon. Member for his question. I am not going to make policy on the hoof, so I will not say yes now, but we are fast approaching the next GP contract, which will run from April 2024, so we have an opportunity to look at all these things in the round. I am passionate about securing access to GPs in rural and remote areas. Perhaps we can double-tag our meeting, make it twice as long and discuss that issue too. I will respond to some of the issues raised about GPs in a moment.

I reassure my hon. Friend the Member for Newton Abbot that we are in full agreement that the NHS needs to be flexible enough to respond to the particular needs of rural areas. That is vital, and that is why we passed the Health and Care Act 2022. The Act embeds the principle of joint working right at the heart of the system, promoting integration and allowing local areas the flexibility to design services that are right for them. Integrated care boards and integrated care partnerships give local areas forums through which to design innovative care models, bring together health and social care, and, importantly, prioritise resources to ensure that they best align with the needs of individual areas.

We are also enabling the NHS to establish place-based structures covering smaller areas than an integrated care system. That could match the local authority footprint, for example, or in some cases it could be even smaller—a sub-division based on local need. That is fully in line with the view expressed in the APPG report that the NHS should foster and empower local place-based flexibility. I think that is at the heart of the report.

As my hon. Friend knows, in establishing those models for the NHS to follow, we have set the framework but have left it to individual areas to tailor them to local needs. I think that is the right approach, because local areas know better than Ministers. We do not always hear Ministers say that, but I think local areas often know better than I do, sitting here in Whitehall, how best to organise themselves, and how to design and, importantly, deliver the best possible care for patients. While we in Westminster can support, guide, hold accountable and occasionally chest prod, it is right that we also protect local flexibility.

[Bob Seely]

When the Minister talks about local flexibility, I interpret that through the guise of funding. Does he accept that there is a funding issue for the 12 unavoidably small hospitals in England and Wales, and will he look at the funding mechanism that was established in 2019? It gives more money to unavoidably small hospitals, but arguably only about 50% to 60% of what is needed.

[Will Quince]

I have made a note of my hon. Friend’s question and I am going to come to it in a moment. The answer is no, but only because it is not my responsibility. It is the Minister of State, Department of Health and Social Care, my right hon. Friend the Member for Newark (Robert Jenrick), who has responsibility for hospital funding, and in the next seven minutes I intend to commit him to lots of meetings with every single Member present.

Let me turn briefly to the question of resources, about which I know a number of Members are concerned, and which has just been raised by my hon. Friend the Member for Isle of Wight (Bob Seely). It is vital that we allocate resources fairly, as my hon. Friend the Member for Newton Abbot mentioned. That is why NHS England asked the Advisory Committee on Resource Allocation to consider the issue and provide a formula for allocations to integrated care boards. That formula took into account various factors, including population, age and deprivation —but we changed it.

In 2019-20, we produced a new element of the formula, recognising the points that my hon. Friend the Member for Newton Abbot makes, to better reflect the needs of some rural, coastal and remote areas, which on average tend to have a much older population. With an older population very often comes complex health needs. NHS England is using that formula to make allocations accordingly, but we recognise that some systems are significantly above or below target, and NHS England has a programme in place to manage convergence over several years. We also recognise the important challenge in ensuring that rural areas have the workforce—another point rightly raised at length—to provide the integrated patient-centred services that we all want to see.

We know that doctors are more likely to stay in the places where they trained, as my hon. Friend said. That is why, as part of a 25% expansion of medical school places between 2018 and 2020, we opened five new medical schools in rural and coastal locations that historically have been hard to recruit in: Sunderland, Lancashire, Chelmsford, Lincoln and Canterbury. I am conscious that my hon. Friend would want far more; that is perhaps a conversation to have at a later date. We hope—in fact, we expect—that graduates from those schools will stay in the area and will have a far greater understanding of the lives, needs and challenges of the people they serve in the locality.

My hon. Friend mentioned ambulances. As part of our plan for patients, which we launched in July, there is an extra £150 million for 2022-23 to address issues relating to ambulances. I hear what she says about differential pay rates, particularly in rural areas, between different blue light services, and I will take that away. Ambulances fall under the remit of my right hon. Friend the Member for Newark, and I know that he would be delighted to meet my hon. Friend the Member for Newton Abbot to discuss that issue.

On backlogs, I completely understand the points that my hon. Friend makes about recruitment challenges. I will take away her point about incentives not working, and I will look at other measures to attract people to rural and coastal areas, because we know that is a particular challenge.

The hon. Member for Westmorland and Lonsdale (Tim Farron) raised cancer wait time variance. As the Minister with responsibility for cancer, that absolutely concerns me. We are opening new diagnostic centres, but we have to look at more.

[Tim Farron]

rose—

[Will Quince]

I am conscious of time, so I will have to come back to the hon. Gentleman. We are going to meet, and we can discuss that at length. I know it is a concern of his.

[Tim Farron]

This is about treatment, not diagnosis.

[Will Quince]

Yes—absolutely right.

My hon. Friend the Member for Truro and Falmouth (Cherilyn Mackrory) raised seasonal visitors. I know that is an issue across Cornwall and Devon, and I would be very happy to look at that. My hon. Friend the Member for Bosworth (Dr Evans) raised the issue of GPs, and extending training and career opportunities in rural areas. I totally agree, and we will soon have a date in the diary to meet and discuss that.

My hon. Friend the Member for Newton Abbot was right to raise community hospitals. Again, my right hon. Friend the Member for Newark will be delighted to meet to discuss that at great length, as he would be to discuss unavoidably small hospitals, which I know my hon. Friend the Member for Isle of Wight has raised with the Secretary of State.

My hon. Friend the Member for Newton Abbot and others mentioned doctors. I entirely hear what she says about data. Data is important for choice, but I completely understand that in some rural, remote and coastal areas, there is no choice; there is just one GP, pharmacist and dentist, so we have to look at it differently. But data is important, because it allows the local integrated care board to identify where there are challenges and which practices are struggling. From November, for the first time, we will be publishing practice-level data on appointments and missed appointments. That is important because the patient deserves to see how their tax money is being spent. It also enables us to hold the integrated care board to account for how it is holding to account the practice and ensuring it modernises, is more efficient, and addresses the issues that its patients face. As part of our plan for patients, we are looking at that at great length.

Dentists are a real passion of mine. Dentistry is not looked at in the depth that it should be as part of wider NHS services. My hon. Friend rightly pointed out a number of reforms that were put in place in July. They are starting to take effect, and she will see more as they come to fruition. It is a top priority for me, and I am looking for areas for potential further reform. I encourage my hon. Friend to talk to her integrated care board about what more can be done on centres for dental development.

We absolutely recognise the importance of giving rural areas special consideration. They face a different range of challenges to the NHS in urban and suburban areas, and it is right that we give local systems the flexibility to respond to that. I hope I have reassured my hon. Friend and others that the current system does that. I am sure she will want to continue her work and the important work of the all-party parliamentary group. I certainly look forward to working with her.

Question put and agreed to.

Dental Training College: East Anglia

Will Quince Excerpts

Tuesday 11th October 2022 Commons Chamber

[The Minister of State, Department of Health and Social Care (Will Quince)]

I congratulate my hon. Friend the Member for Broadland (Jerome Mayhew) on securing this debate on the potential merits of establishing a dental training college in East Anglia. It is clear that he has support from his neighbouring MPs—I know that one of them cannot be here this evening, but very much supports this endeavour—and from colleagues further afield and across East Anglia. I also thank him for raising the issue of access to dentistry in rural and coastal areas, particularly the challenges of seeing a dentist in Norfolk.

As the new Minister for dentistry, I understand that areas across our country, as my hon. Friend has highlighted, have faced difficulties with recruitment and retention, including in his constituency of Broadland and in the east of England more widely. Those challenges have a significant impact on the provision of NHS dentistry and on patients’ ability to receive NHS care. My hon. Friend is right that we cannot ignore the problem, which I can assure him is a priority for me and for the Secretary of State. I hope that it will not have escaped my hon. Friend’s notice that dentists are a key element of the Secretary of State’s ABCD approach and of “Our plan for patients”.

I am aware that my hon. Friend, alongside my hon. Friend the Member for North Norfolk (Duncan Baker), attended meetings with my predecessor, and I think even with my predecessor’s predecessor, to discuss the construction of a dental school in Norfolk. It is a testament to the character of my hon. Friend the Member for Broadland that he brought the issue to my attention just days after my appointment as a Minister in the Department of Health and Social Care. If I may say so, his constituents are fortunate to have such a passionate and persistent advocate in their corner.

My hon. Friend set out in his speech to make a positive case for doing something about a long-term problem, and I think everyone in the Chamber this evening will agree that he has done so. He makes the case for a new dental school in Norfolk—a case that I know has the backing of my hon. Friend the Member for North Norfolk, who cannot be here this evening. On the face of it, it is a compelling case and is worth further exploration.

I think that my hon. Friend the Member for Broadland knows me well enough to know that I am not someone who likes saying no to parliamentary colleagues, although sadly that is a responsibility that all too often comes with the job. On this occasion, it is a no, but it is “No for now, and let’s very much keep talking.” Let me explain why.

Establishing a new dental school takes several years and would not influence service provision in the short term, as my hon. Friend rightly identified. Notwithstanding the strong case that he makes, it also would not guarantee the ongoing sustained retention of dentists or support staff in the area. Our focus is not just on training more dentists, important as that is, but on the better use of the full dental team and the progression and retention of all dental care professionals in the NHS. There is, of course, an argument about the medium to long term, which is why I suggest that we keep talking, and of course I would be delighted to meet my hon. Friend, as he requests, to further discuss his ideas and plans.

My hon. Friends the Members for Broadland, for Waveney (Peter Aldous) and for Ipswich (Tom Hunt) all mentioned centres for dental development, the alternative training model identified by Health Education England in its 2021 “Advancing Dental Care” review report—that is a mouthful! The centres for dental development model would specifically benefit localities in which there is a shortage in provision and there are no nearby dental schools—as is the case in East Anglia, as my hon. Friend the Member for Broadland rightly pointed out.

The premise is that the centres would build on any existing dental infrastructure in the area, bringing together training and the resultant provision of NHS treatment to patients in a co-ordinated way. Things like postgraduate training opportunities are more likely to be compatible than early undergraduate placements, as they would increase access to the more complex and specialist care that we know is often most lacking in certain areas of the country, otherwise known as dental deserts. This would work towards the aim, specified in the “Advancing Dental Care” report, to produce the skilled “multi-professional oral healthcare workforce” that could best support patient and population needs within the NHS. A further advantage of the centres for dental development model is that they would be tailored to suit the local workforce requirements, in addition to the education and training needs of the area, contributing to stronger, multi-disciplinary dental teams and local area workforce retention.

Given that the centres would focus on postgraduate training or the later stages of undergraduate training, they could provide support in transitions from undergraduate to dental foundation training and more specialised training beyond those, all of which involve—as my hon. Friend mentioned—important decision-making moments in terms of career development and where dentists are likely to base their careers and practices. We believe that a broader range of placements across the country and in different clinical environments would enhance the student experience. The centres could offer a constructive alternative to dental schools, while acknowledging and addressing recruitment, retention and training gaps. I am sure my hon. Friend will be pleased to learn that Health Education England has now moved into its four-year implementation stage through its dental education reform programme—another mouthful!—following the “Advancing Dental Care” report and its recommendations.

My hon. Friend rightly raised the subject of collaboration. With regard to establishing a centre for dental development in East Anglia—this has been mentioned by my hon. Friend and others—the University of Suffolk and the NHS Suffolk and North East Essex integrated care board have announced plans for a centre in Ipswich. I am informed—this also covers my area, so I have an interest in it as well—that the initial plans include proposals to offer postgraduate educational opportunities as well as wider training opportunities for newly qualified dentists, alongside the training of the dental therapists, hygienists and dental technicians who form a vital part of the dental workforce. I pay tribute to my hon. Friends the Members for Waveney and for Ipswich for the work that they have done in pushing so strongly for that development, along with the integrated care board, which is a trail-blazer in this regard. It would be wrong, at this juncture, for me not also to pay tribute to my hon. Friend the Member for Bury St Edmunds (Jo Churchill). She has pushed strongly for this as well, and, moreover, is—dare I say—a much-missed Minister at the Department of Health and Social Care. She has a passion for dentistry, and, within the Department, she really put it on the map. That is a legacy that I intend to continue.

I strongly encourage my hon. Friend to meet the NHS and HEE regional teams for his areas, as centres for dental development are very much a local solution, tailored to the existing infrastructure and needs of an area. I, and those in my office, would be delighted to help facilitate such a meeting.

I have mentioned integrated care systems and integrated care boards. As we make the transition to integrated care systems—this point was made by my hon. Friend the Member for Waveney—commissioning roles for dentistry will be delegated. This will ensure that dentistry decisions are considered at a local level, and that, for example, local workforce as well as local population health requirements are taken into account. I therefore encourage my hon. Friend to meet the integrated care board—I am sure he has already done so, but I think an ongoing dialogue would make sense—to discuss its plans further, and to talk about how they will affect Broadland and the rest of East Anglia.

My hon. Friend touched on recruitment and retention, which I know is a particular issue in his constituency and more broadly. I have referred to the changes that we have made nationally through system reform, but NHS England in the East of England region has been working closely with the organisations that train dentists to improve the recruitment and retention of NHS dentists in East Anglia, and will continue to help those training organisations to develop the dental workforce. I am pleased to say that, in 2021-22, there was an increase of 539 dentists performing NHS dentistry compared with the previous year. In the East of England, there was a 3.5% increase, with an additional 105 dentists. However, as my hon. Friend pointed out, that is not enough: we need more dentists, and we need more dentists on NHS contracts.

More broadly, I know that my hon. Friend will want to know what improvements are being made now which will improve access to dentistry for his constituents. He rightly focused on the medium to long term, but I know from my postbag that the pressing concern is often the here and now. We plan for the dental system improvements announced on 19 July as part of “Our plan for patients” to begin to take effect by the end of this year, and some of the improvements in the package have already taken effect and are beginning to bear fruit. The Secretary of State and I are looking at a number of further measures that we can take to aid recruitment and retention—I know that that is one of the key concerns of my hon. Friend and others, and I think my hon. Friend touched on one of the ideas that we are considering—and, in turn, improve access for constituents. As I have said, this is a priority for me, and I hope to share more details with my hon. Friend and the House in due course.

I am committed to playing my part to improve access to NHS dentistry, particularly for those most in need of dental care, and I know that recruitment and the dental workforce will play a pivotal role in that. I hope my hon. Friend has been reassured that action is being taken to address the challenges in recruitment and retention across the country, and particularly in his constituency. I look forward to working with him as we develop our ambitious plans, and I know he will continue to be a champion for his constituents and hold the Government’s metaphorical feet to the fire as we deliver the improvements in dentistry access that we all want to see.

Question put and agreed to.

Children’s Mental Health

Will Quince Excerpts

Tuesday 8th February 2022 Commons Chamber

[The Parliamentary Under-Secretary of State for Education (Will Quince)]

I start by thanking all Members in all parts of the House for their valuable contributions to this important debate. It is, I hope, one of those debates in which all of us fundamentally want the same thing, and I think we have heard an awful lot of agreement across the House today. In Children’s Mental Health Week, it is important that we raise awareness of this important issue. Like the hon. Member for Tooting (Dr Allin-Khan), I congratulate and thank Place2Be for all the work it does to raise awareness nationally. It is right that we have a spotlight on children and young people’s mental health, and I join hon. Members in thanking all those who work in mental health services up and down our country.

As many Members rightly pointed out, the pandemic has proved to be hugely challenging for children and young children, but they have shown incredible resilience in the most difficult circumstances. The pandemic has been difficult for many families. We all know this and many examples have been cited today, but we should not overlook the impact on children from not being able to attend school or go to after-school clubs, from not being able to see friends and family or play the sport they love, and from being stuck at home with their parents, as my children regularly said. There was disruption to their lives, and I thank teachers and support staff throughout the country for helping us to reopen schools and get children where we know it is best for them to be and they wanted to be. Whenever I visit a school, I ask about mental health and mental wellbeing. Immediately before this debate, I was in Trinity Church of England School in London, alongside Instagram and “Love Island” star Dr Alex George, to meet the mental health support team. They are doing incredible work, which I want to see rolled out further and faster; I will cover that in more detail later.

As Minister for Children and Families, I have a cross-Government role, but I hope the House understands that my focus today is on education. I will try to answer as many of the points raised by colleagues on both sides of the House as possible, but first—perhaps unusually for an Opposition day debate—I want to say how much I welcome the Opposition raising this subject and pushing the Government to go further and faster. As Children’s Minister, let me say that one child or young person waiting too long for mental health support is one child too many. The health, both mental and physical, of children and young people is something that I and this Government take incredibly seriously. Are we doing a lot already? Yes. Can we do more? Yes, and we must. Our children and young people deserve nothing less.

[Marco Longhi]

Does the Minister agree that mental health is not something we can consider under one umbrella? In my Dudley constituency, Priory Park boxing club is doing fantastic work with children who are excluded from school. It is a great place not only for their physical wellbeing but for their mental health. The new hubs need to be integrated with other stakeholders in the community.

[Will Quince]

My hon. Friend is absolutely right. I will come on to talk about family hubs and the role that they can rightly play.

I am no expert in this field, but I listen closely to those who are and I split mental health and mental wellbeing into three categories: resilience, identification and intervention, and specialist support. On the first, what can we do to help children and young people to be more resilient? We do that through our relationships, sex and health education, which is now compulsory between five and 16 years old, through our behaviour in schools guidance, through the sports and extracurricular activities that we have in schools throughout our country, and through things like forest schools, which have been mentioned and which are absolutely brilliant.

How can we identify emerging problems sooner and provide that all-important support? We can do that through measures such as mental health lead training and rolling out mental health support teams across the country. For access to specialist mental health support, we have the NHS long-term plan and additional investment of £2.3 billion a year by 2023-24, allowing at least an additional 345,000 children and young people to access NHS-funded mental health support, which of course comes under the Department of Health and Social Care.

[Robert Largan]

Does the Minister agree that we must not forget the acute services as well? It is fantastic news that we are putting £4.8 million into building a new psychiatric intensive care unit at Tameside General Hospital, which will be a big boost for the fantastic staff at the Cobden unit at Stepping Hill Hospital too.

[Will Quince]

My hon. Friend is absolutely right: acute services, which are of course a Department of Health and Social Care lead, are very important. In the Department for Education, we have a role to play in doing as much prevention as we can and getting early identification and support in place for people so that they do not need to attend the acute unit, which then frees up space for those who desperately do need it.

Let me turn to some specific points made by hon. Members from across the House. Time is relatively short, but I will cover as many as I can. I remind the House that my door is always open; Members can come to see me if I do not address any of these points and I will be happy to meet them to discuss them in person.

The hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron)—I have probably pronounced her constituency wrongly, so I apologise for that—and my hon. Friend the Member for Burnley (Antony Higginbotham) made positive and constructive comments about how it is so important that we remove the stigma and break the taboo about mental health, and put children and young people at the heart of our recovery. My hon. Friend mentioned Burnley FC and its work through football in the community. It does hugely important work and I echo his comments about it. Those Members, along with my hon. Friends the Members for Sevenoaks (Laura Trott) and for Penistone and Stocksbridge (Miriam Cates), raised the issue of online harmful content, particularly about self-harm and suicide. They rightly said that the Online Safety Bill must tackle this issue, and I can certainly give the House the commitment and confirmation that the strongest protections in the Bill are on the safeguarding and protection of children.

My hon. Friend the Member for Aylesbury (Rob Butler) raised the issue of the Youth Concern charity in his constituency, rightly praising its work, and I echo his comments. He also rightly raised the issue of waiting times, which are too long in too many cases. We need to address them, and we are doing that in part with the NHS long-term plan. His experience of the Youth Custody Service is hugely welcome, and we will certainly be calling on him to discuss that further.

The hon. Members for Batley and Spen (Kim Leadbeater) and for Brighton, Kemptown (Lloyd Russell-Moyle) rightly referenced the serious point about suicide. Of course every suicide is a tragedy, especially so when it involves a child or young person. DHSC has a suicide prevention plan, and we are investing £57 million in suicide prevention by 2023-24, as part of the NHS long-term plan. I know that the Minister for Care and Mental Health, my hon. Friend the Member for Chichester (Gillian Keegan) will be happy to meet both of them to discuss that issue further.

My hon. Friends the Members for Milton Keynes North (Ben Everitt) and for Truro and Falmouth (Cherilyn Mackrory) discussed the importance of green open spaces—I am amazed at the number of people in Cornwall who have not had access to the sea, so we certainly need to look at that. They also mentioned the importance of being in school wherever possible, and I have to say that there are no greater champions for the people of Milton Keynes, and Truro and Falmouth than my hon. Friends. The hon. Member for Ealing North (James Murray) raised the issue of mental health professionals in schools. We are rolling out mental health support leads and mental health support teams up and down the country, and I welcome his interest in this area.

My hon. Friend the Member for Stoke-on-Trent South (Jack Brereton), a passionate advocate for children and young people in Stoke-on-Trent, has made a compelling case for family hubs and the family hub model and investment in Stoke-on-Trent, and we will no doubt discuss that further down the line. The hon. Member for Blaydon (Liz Twist) raised the issue of the importance of early intervention, and I totally agree on that; we are doing this in schools and colleges, and she was right to praise two schools in her constituency, in Whickham and Kingsmeadow.

My hon. Friend the Member for Ipswich (Tom Hunt) is a passionate advocate for children and young people with SEN and disabilities, and I am happy to discuss this issue with him later at greater length. I agree with him on the importance of early diagnosis. My hon. Friends the Members for Devizes (Danny Kruger) and for Sevenoaks, and the hon. Members for Bath (Wera Hobhouse)—I wish her a happy birthday—and for Sheffield, Hallam (Olivia Blake) rightly raised the issue of eating disorders. We have put additional investment in, and there is a new waiting time standard, but I know we need to do more in this area, and I would be happy to work with the hon. Lady.

I am proud of our record in supporting children and young people, and I am grateful for the ongoing support that hon. Members have given to this agenda. Can we do more? Yes. Can we always do more? Yes. We must do more and we will do more. I welcome the spotlight on this issue. Let me assure the House that good mental health and wellbeing for our children and young people remains a priority for me and this Government, and it will continue to be a priority as we recover and build back better from this pandemic, improving children’s futures and the future of our country.

[Sir Alan Campbell (Tynemouth) (Lab)]

claimed to move the closure (Standing Order No. 36).

Question put forthwith, That the Question be now put.

Question agreed to.

Main Question accordingly put.

Question agreed to.

Resolved,

That this House recognises the importance of Children’s Mental Health Week; is concerned about the impact of the coronavirus pandemic on the mental health of young people and that there has been a 77% rise in the number of children needing treatment for severe mental health issues since 2019; calls on the Government to guarantee mental health treatment within a month for all who need it and to provide specialist mental health support in every school, including a full-time mental health professional in every secondary school and a part-time professional in every primary school; and further calls for the Government to establish open access mental health hubs for children and young people in every community to ensure the best start to life for future generations.

NHS 10-Year Plan

Will Quince Excerpts

Tuesday 19th February 2019 Commons Chamber

[Will Quince (Colchester) (Con)]

Colchester Hospital has always been a good hospital, with caring compassionate staff. It has not been without its difficulties—it was in special measures from 2013 to 2017—but I am pleased to report that our hospital has turned a corner. It took hard work, determination and passion to get Colchester Hospital out of special measures, and I must pay tribute to all those who made it happen: the doctors, nurses, healthcare assistants, porters, cleaners, administrators and managers. In particular, I would like to praise Nick Hulme, the chief executive, who displayed incredible leadership in helping to change the culture of the organisation, moving the emphasis away from getting out of special measures and instead simply concentrating on improving care.

The future of our hospital looks really bright. We have a merger with Ipswich Hospital creating resilience in the organisation, a world-class radiotherapy centre and a new imaging centre—the first of its kind in the country. It is now one of the best-performing hospitals for delivering the A&E four-hour standards. It is one of the best in the east of England for ambulance handovers and we have one of the lowest nurse vacancies for years. Staff want to come and work in Colchester, and that is fantastic.

As for the future, a new cancer centre is being built. I would like to thank all the kind donors and members of the public in Colchester and beyond who are helping to fund it. We still have about £200,000 to go, so I encourage people to support CoHoC, the Colchester Hospitals charity. The merger with Ipswich will create economies of scale and the potential for specialism and resilience. It will make our hospital trust more attractive to current staff as well as for recruitment. I thank the Minister for the £35 million of capital investment, the largest and most significant investment in decades. That will see an open, modern spacious entrance, and additional space in our A&E and urgent care centre. The key to the future of Colchester hospital is investment in primary care. We want fewer people having to go to our hospitals. Instead, we want them to be treated locally at super GP practices.

Finally, we want to see real and demonstrable improvements in primary care, not just richer GPs. We want to make sure that we are not taking staff from our hospitals and ambulance service, but bringing new people into our NHS. Otherwise, that will be counterproductive.

Oral Answers to Questions

Will Quince Excerpts

Tuesday 19th February 2019 Commons Chamber

[Matt Hancock]

As I have said, last month we doubled the availability of PrEP, which is an important step in the right direction.

[Will Quince (Colchester) (Con)]

Colchester is one of the sites that is now closed to men who have sex with men who want to access the HIV prevention drug PrEP. When will the Government’s commitment, made almost three weeks ago, to double the number of places on the PrEP trial be implemented across all trial sites?

[Matt Hancock]

It is being implemented as we speak. I am very happy to talk to my hon. Friend about when it will be rolled out in Colchester.