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Category: Health

  • Alison Thewliss – 2021 Speech on the Obesity Strategy

    Alison Thewliss – 2021 Speech on the Obesity Strategy

    The speech made by Alison Thewliss, the SNP MP for Glasgow Central, in the House of Commons on 27 May 2021.

    I want to start by echoing the sentiments of the Obesity Health Alliance; in this debate, weight stigma does not help people lose weight. The right support, evidence-based weight management, and fundamental changes to our obesogenic environment and food systems are all required to tackle this.

    The health harms caused by obesity are well known, but I initially wish to mention one particular aspect that does not get the attention it deserves: liver disease. On average 40 people die of liver disease every day. The Foundation for Liver Research and the British Liver Trust have sent a helpful briefing, but in truth I had already committed to mentioning it in this debate. My husband, Joe, was diagnosed with stage 2 non-alcohol related fatty liver disease in 2019, after wandering around complaining of a wee pain under his ribs for five years. Since his diagnosis, he has made difficult but necessary changes to his lifestyle; he has lost 22 kg, taken up hillwalking, and has been carefully monitoring his weight, and I am very proud of him.

    Some 90% of liver disease is preventable and, luckily for Joe, at stage 2 it can be reversed; however, as it can remain asymptomatic for up to 20 years, three quarters of people are diagnosed at a late stage when it is too late for lifestyle changes or interventions. Liver disease is the third leading cause of premature death in the UK, with deaths increasing by 400% over the past two generations; this is in stark contrast to other major diseases, such as heart disease and cancer, so I urge the UK Government, who have acknowledged liver disease in their obesity plan, to come up with actions, including doing all they can to spread information about this disease and the ways of preventing it.

    The disproportionate harm caused by covid 19 to older people, minority ethnic groups, the people living in greatest deprivation, and those with obesity, diabetes and respiratory and cardiovascular disease has highlighted new vulnerabilities and underscored existing health inequalities. While much focus has been put on the direct health impacts of covid, the SNP recognises that we must also work to shift our focus towards reducing those inequalities and preventing ill health. We want everyone to eat well, be a healthy weight and have equal access to care.

    The ambitious and wide-ranging actions to address this challenge are set out in the Scottish Government’s diet and healthy weight delivery plan. The plan, which has over 60 broad-ranging actions, has a strong focus on prevention, including population-level measures to make it easier for people to make healthier choices, as well as more targeted interventions. Alongside this, the SNP Scottish Government also published “A More Active Scotland: Scotland’s Physical Activity Delivery Plan”. This recognises the importance of physical activity in promoting and maintaining healthy weight. Progress towards the outcomes set out in this delivery plan is being monitored through a dedicated set of indicators linked to the active Scotland outcomes framework”. The SNP Scottish Government are continuing to provide £1.7 million in 2020-21 for improvements to weight management services for children and young people. Earlier this year, the SNP Scottish Government also published the refresh of their diabetes improvement plan, which strengthens the actions in the original plan to improve the prevention and treatment of diabetes and the care of all people in Scotland affected by it.

    The SNP has consistently pressed the UK Government to ban junk food advertising on television and online before the 9 pm watershed, and we welcome that this is finally coming to fruition. Online adverts on social media are an area the UK Government must tackle strongly, as other Members have mentioned, because they are pervasive. In our recent manifesto, the SNP renewed its commitment to halve childhood obesity by 2030 and to significantly reduce diet-related health inequalities by pledging to provide free school breakfasts and lunches to every primary school pupil in Scotland, all year round, and to all children in state-funded special schools in Scotland; and to pilot the provision of free nutritious school breakfasts in secondary schools and explore the feasibility of universal breakfast provision in secondary schools.

    We also want to make Active Schools programmes free for all children by the end of the Parliament, continue to improve nutritional standards of food and drink in schools, and bring forward legislation over the next Parliament to restrict the use of promotions on food and drink that is high in fat, sugar and salt. We will also aim to enshrine the fundamental right to food in law, as the cornerstone of being a good food nation. That will form part of the commitment to incorporate UN human rights charters into Scots law.

    Scotland has one of the world’s best natural larders, but we know that so many people do not eat well and that obesity remains a significant problem. Evidence shows that in less well-off communities it is more difficult to obtain good-quality, fresh food at a price people can afford. Community larder projects, such as the Govanhill People’s Pantry in my constituency, have been springing up all over the place and working hard to try to redress the balance, in this case by working with FareShare to provide access to food in the community.

    The overriding issue of poverty is, of course, key to tackling a lot of the issues; access to sufficient healthy food and the means to cook it is not there for everyone, not least because of policies such as the two-child limit, the upcoming removal of the £20 uplift to universal credit and tax credits, the UK Government’s neglect of people on legacy benefits, and the pretendy living wage. They all contribute to a situation where people cannot afford to eat healthily. If the UK Government want to tackle obesity, they cannot continue to ignore this reality.

    Investment in regenerating neighbourhoods, increasing access to walking and cycling, and improving parks is also significant in getting people out and about and moving. Just last night, alongside local councillors, I met mums and grans from the Calton Community Association, who are desperate to access the newly announced Scottish Government fund for parks so that their kids can benefit from outdoor play. An obesogenic environment, coupled with a culture that allows the insidious influence of food giants and their ultra-processed foods to be advertised not just to us but to our children, has proven to be a recipe for disaster. I am looking forward to watching the latest programme by campaigner Dr Chris van Tulleken, “What Are We Feeding Our Kids?” and urge the UK Government to tune in tonight. The supermarket aisles are heaving with unnecessary infant snack foods, and the new report by the First Steps Nutrition Trust should be essential reading for the Minister.

    One significant point of difference in the UK and Scottish strategies concerns our youngest citizens. Scotland’s healthy weight strategy specifically mentions the significance of breastfeeding, which can of course have a positive effect on maternal weight, as well as that of babies. The UK Government are committed to consulting

    “on our proposals to help parents of young children to make healthier choices through more honest marketing and labelling of infant foods.”

    Ministers could start by doing more to protect babies and pregnant mothers from the rapacious global formula industry, and, in this the 40th year of the World Health Organisation’s international code of marketing of breast milk substitutes, fully adopt the code. That used to be something the UK Government would blame the EU for their inability to do, but they have lost that excuse and must now act. The code sets out to protect all babies, however they are fed. As the chair of the all-party group on infant feeding and inequalities, I do not set this up as any kind of false pro-breastfeeding/anti-formula battle, because I know that for many formula is essential. Many mums want to breastfeed, but are failed by a UK Government who do not see breastfeeding as a priority and do not invest in support. Some years ago, Norway changed its approach and it now has one of the highest rates in the world. Norwegian mums do not have different breasts from us, but they do have a Government who made their needs a priority.

    The Minister said that if adverts did not influence people, they would not be used, and she is correct. Formula companies spend astronomical figures on marketing, a cost that gets passed on to consumers at the tills and makes it challenging for many families to afford formula, and on the promotion of follow-on and specialist formulas, which are not necessary, but exist largely as a means of cross-promotion. I hope the UK Government will also act on that, as they claim they intend to look at honest marketing and labelling. As an example of that marketing, I share the concerns raised by the UK’s Baby Feeding Law Group that the National Trust has formed a partnership with HiPP Organic, a company with many documented violations of the code over the years. We should be under no illusions: these kinds of partnerships exist to benefit the company and boost their brand, and I urge the National Trust to reconsider.

    I wish to touch briefly on the issue of calories on menus, on which I have received many emails, as I am sure other Members have. I can see what the UK Government intend, and I appreciate that for some people having calories listed on menus may be useful—I have certainly eaten fewer Danish pastries since coffee shops started to put calories on the display—but the policy is not about anecdotes and headlines and must be based on evidence. For those with a history of disordered eating, this is a deeply serious issue and such triggers can be very harmful indeed, so I urge Ministers to be cautious in what they are doing and to listen to and learn from the evidence from expert organisations such as Beat and from those affected.

    I commend the Government for taking action on a range of issues to do with obesity but urge them to look more widely at the factors that cause obesity and to follow the Scottish Government’s approach with a healthy weight strategy.

  • Andrew Selous – 2021 Speech on the Obesity Strategy

    Andrew Selous – 2021 Speech on the Obesity Strategy

    The speech made by Andrew Selous, the Conservative MP for South West Bedfordshire, in the House of Commons on 27 May 2021.

    Thank you very much, Mr Deputy Speaker.

    Although we should always talk about obesity with sensitivity and avoid stigma at all costs, we lack courage and fail in our duty if we do not address it. Fundamentally, it is about life chances and social justice, and we want life, and life to the full, for all our constituents.

    We are regularly asked to do more for the NHS, and rightly so. One crucial way we can help the NHS is to focus on the prevention of obesity. The 2019 paper by S. C. Davies produced by the Department of Health and Social Care calculated the medical cost and lost productivity cost of obesity at around 3% of gross domestic product, or £60 billion. As a country, we have the worst rates of obesity in Europe. There is absolutely no doubt that this matter is urgent and needs action now.

    I salute the young people of Bite Back 2030, with their #AdEnough campaign, for their stand against the 15 billion junk food adverts they are bombarded with online every year. One young man told us he had more of those than he had contact from his grandmother. It is excellent that the Government are taking action on that. We should also curtail junk food advertising on radio, outdoors and in cinemas, restrict junk food sponsorship of sports events and teams, and remove child-friendly characters from junk food packaging.

    There is, I am afraid, quite a lot more work to do on reformulation. The 20% reduction target is far from being achieved by this autumn, with only 3% achieved so far. I congratulate Tesco, Asda, Weetabix, Co-op and Aldi on big reductions either overall or in some categories. By contrast, Mondelēz International and Mars Wrigley saw the sales weighted average of sugar per 100g in their sweet confectionery increase. They need to get with the programme. We need to start flooding our supermarkets, schools and the out-of-home sector with healthy, nutritious, delicious and hopefully often home-grown food, and we need to make sure that healthy food is affordable; as the Food Foundation has pointed out, this is often the case in Europe but, bizarrely, not always the case in the United Kingdom. That is something we should concentrate on and we can change, and we need to take it very seriously indeed.

    It has always mystified me that the quality and outcomes framework in primary care does not reward GPs for collecting data on children’s body mass index and ensuring there is a first-class diet, exercise and cooking skills offer online and in person locally. Primary care must be at the front of this campaign to make sure we are a nation of people with healthy weights.

    Bite Back 2030 says that 60% of schools are not upholding school food standards even though it is the law to uphold them. We must strengthen the enforcement mechanism to make that happen, as school food is a great child health opportunity that we are not making the most of and that we need to act on urgently.

  • Alex Norris – 2021 Speech on the Obesity Strategy

    Alex Norris – 2021 Speech on the Obesity Strategy

    The speech made by Alex Norris, the Labour MP for Nottingham North, in the House of Commons on 27 May 2021.

    It is a pleasure to open this important debate on behalf of the Opposition.

    Obesity is a significant public health challenge in this country. It is a growing problem that compounds down the years in missed potential and accelerated poor health. I am glad the obesity strategy recognises that, as well as being a matter for individuals in their personal choices, there is a significant impact from our environment. As such, we have a responsibility in this place to do what we can to help people to maintain a healthy weight.

    Almost two thirds of adults are overweight or living with obesity—I am one of them—and we have heard that a staggering number of our children leave primary school overweight. This is an unequally distributed problem, with hospital admissions due to obesity nearly three times greater in poorer communities than they are in the best-off communities. At a population level, it is clear that excess weight brings with it increased risk of diseases such as diabetes, cancer, heart disease, liver disease and, of course, associated mental health conditions. In 2019-20—this is such as staggering figure—there were over 1 million hospital admissions for which obesity was either the primary or secondary cause. That was up 17% on the year before, and represents a 600% increase on the previous decade. That is an extraordinary changing picture and one that should kick us all into action. We have also seen in the last year that living with excess weight makes us more vulnerable when fighting the effects of covid. As the Minister says, it is one of the risk factors we can actually make a direct and swift impact on. It is clear that we need to act.

    I have said before when we have debated this topic that where the Government bring forward sensible proposals, we shall work with them to implement them in the national interest. Happily, the 2020 strategy contains many such proposals that we are very keen indeed to see implemented. The 9 pm watershed on unhealthy food adverts is prudent. Efforts to curb the promotions and prominent placements of things that we know are bad for us is a good idea, too. Sometimes, even when we are trying to make healthy choices it feels like we cannot escape reminders of those other options. An expansion of NHS weight management services is well overdue, and I hope we will empower such services to use all effective treatments and resource them to be able to do so, too. Traffic lighting is a valued and effective tool in understanding what our food comprises of. We will support proposals that strengthen and develop that system, and I hope we hear a little bit more about that later. A national-level publicity campaign is valuable and we will support its introduction. There is so much to agree with and I have consistently said so to the Minister. Indeed, the only addition I will contribute here is that we need to get on with it and that we do not have time to waste. There are elements, however, that I want to probe and seek reassurance on from the Minister.

    On the total online advertising ban, I do not think it is a secret that the Government do not do online policy very well. I think the ever-running saga of the online harms Bill shows that. Online advertising is complex and sophisticated and is changing all the time. I am conscious of concerted efforts by those in the advertising industry to seek to offer the Government a way of delivering on this goal that reflects their expertise in this area. I hope to get an assurance from the Minister that officials are at least talking to them about that and taking it seriously.

    On the restrictions on retailers, I hope that we will get a proper chance to understand and debate the qualifiers on square footage and staffing levels. I do not think we would want to be in a situation where this ends up affecting relatively few organisations, creating an unlevel playing field or promoting perverse outcomes, such as having fewer staff. I would be interested to hear from the Minister in that regard.

    Crucially, we heard from the hon. Member for Bath (Wera Hobhouse) about calories on menus. I know that that has public support, and support from many campaigners, but if we effect that, it really must be done correctly and properly. I strongly do not believe that before they sought to publicise that and press on the Government have given enough consideration to those with eating disorders who will be negatively impacted.

    Richard Fuller

    I am grateful to the hon. Gentleman for cantering through his support for the Government. I just want to take him up on his first principles and the rationale, from his philosophical point of view, for why he believes the Government have a right and a responsibility to manage what people eat and how they look. Does he put obesity on the same level as the tobacco industry of the past? Obviously, health measures were taken because of the harmful effect that tobacco could have on people. If he does not put it on that level, what level does he put it on? Does he put it on the same level as alcohol, which causes a lot of poor health? If not, does he believe that we ought to be doing more on alcohol?

    Alex Norris

    I thank the hon. Gentleman for that contribution. Philosophically, I believe that the state has a responsibility to act when we acknowledge evidence that we have an environment that promotes poor health in this way, so that it goes beyond our personal choices and the way in which we want to lead our lives to things that swamp us. I reject his characterisation of a hierarchy. I would consider the impact that it has on the public and, indeed, the pressures it creates. As for alcohol, I would absolutely support stronger alcohol strategy proposals from the Government, as I would an updated and refreshed version of the tobacco control plan, which we have been waiting on for many months. Again, I would not establish a hierarchy, but I think we can act in those areas and that we ought to.

    The hon. Gentleman recognised the support that I had given so far, but I am afraid that that is now about to change—it is not just because of him, I promise. On calories on menus, we have seen the instrument. The impact assessment is comprehensive—it has five different options, 235 paragraphs, four annexes—yet eating disorders are afforded one mention covering three paragraphs before being discarded in a fourth. I do not think that that is sufficient or that due regard has been paid, and I hope that the Minister will revisit it. Alongside my hon. Friend the Member for Tooting (Dr Allin-Khan), I am seeking to bring together stakeholders who reflect a full range of views on this topic to forge a solution that realises important health benefits for one group but is not injurious to another section of society. I hope that the Minister is still in listening mode on the matter and might seek to do something similar.

    That leads me to what I am saddest about with this strategy; the Minister knows about it, because I have raised it with her many times. Rather than having just an obesity strategy, we ought to have a healthy weight strategy. Eating disorders are increasingly common and can blight people for their whole lives, and their lives and voices are missing from the strategy. I have thought about this for a long time—since last July—and I think we can guess why that is: talking about eating disorders inevitably challenges us to talk about mental health services in this country, and of course, the Government are not keen to do that, as it would offer a reckoning of their leadership in this area over the previous decade. Access to high-quality mental health services of all kinds is too rare. People wait too long and the oft-repeated promises about a parity of esteem approach have not led to meaningful action. That gets worse when we talk about child and adolescent mental health services. The evidence is irrefutable that the root of challenging behaviours around food is at that time in life, but, as every right hon. and hon. Member knows, trying to get a young constituent into CAMHS treatment is simply too hard. We are failing a big and growing part of our population by not addressing that, too, so in that sense the strategy has missed a really important opportunity.

    I turn to public health. As I say, I am glad that these proposals have been brought forward. It has to be said, though, that they follow a decade of the Government’s cutting services that improve the public’s health. I know that it is a core strategy of the current Administration to act as a new Government and run as far away as possible from their record over the last 11 years—I would want to do that if I were them—but they cannot do so.

    The public health grant, even with the recent uplift relating to covid, is nearly a quarter lower in real terms than it was five years ago. I had responsibility for the public health grant in Nottingham for three years prior to entering this place. My experience was that, with the growing pressures for demand-driven services such as drug and alcohol services and sexual health services, added to the consistent cuts to local authorities, there just was not anything left for longer-term services such as those that deal with healthy weight. That has meant a withering of nutrition guidance, shared cooking programmes and specialist support. That has absolutely weakened our approach to taking healthy weight issues head-on in this country. These proposals should have included a commitment to reversing those cuts and, frankly, some humility for having imposed them in the first place. That point needs addressing.

    Of course—I will make this my final point—this is an issue about poverty in this country, too. If we eradicated much of the poverty, we would take a lot of the obesity with it. As I said, there is compelling evidence that obesity is much worse in poorer communities. Again, that makes it all the more mystifying that those massive and ongoing cuts to local authorities have been targeted at the poorest communities, especially in the big cities. That is an extraordinary public policy disconnect and, again, it is something that we ought to address in the strategy if we really want an all-services approach, at all levels of government, to taking on this national issue.

    This is a very important issue and it is right that the Government are seeking to act. We will support them to move at pace to implement evidence-based, effective interventions, but we will push them, too, to close the gaps in the strategy so that it becomes genuinely transformative. The stakes here are lofty, so our ambitions must be lofty too.

  • Jo Churchill – 2021 Statement on the Obesity Strategy

    Jo Churchill – 2021 Statement on the Obesity Strategy

    The statement made by Jo Churchill, the Parliamentary Under-Secretary of State for Health and Social Care, in the House of Commons on 27 May 2021.

    I beg to move,

    That this House has considered implementing the 2020 Obesity Strategy.

    I congratulate my hon. Friend the Member for South West Bedfordshire (Andrew Selous) on securing this important debate on something I know he is passionate about and about which I have met him on many occasions.

    Currently 64% of all adults and 30% of children are classified as overweight or living with obesity. This masks the fact that in some areas the figure is as high as three in four adults. It is a complex issue that has a huge cost not to only the health and wellbeing of the individual but to the NHS and the wider economy. It makes individuals susceptible to a plethora of illnesses. Indeed, my hon. Friend the Minister for Care, who was at the Dispatch Box for the previous debate, commented to me that if we could get the general weight of the population down we would help people with more exercise and a better diet, as well as the health trajectory of those who live with dementia.

    Covid has shone a light on why it is more important than ever that we need to get the nation healthy. Obesity is the only modifiable risk factor for covid-19 and a major modifiable risk factor for other diseases such as diabetes, cardiovascular, and some cancers—in point of fact, many. We are therefore at a teachable moment in which we can change attitudes, educate and influence drivers around less than healthy dietary and physical activity, and motivate behaviours so that they change. Helping people to achieve and maintain a healthy weight is one of the most important things we can do to improve our nation’s health, and we all have a role to play in meeting the challenge. It is complex. There is no silver bullet. There is no single source of responsibility. It will take action from all of us to work together to achieve our ambition—from the producer, to the processor, to the retailer, to the customer, with quite a dollop of influencing the environment through actions we in Government and in Parliament take and are taking.

    Our strategy to meet the challenge, published last July, is far-reaching in its ambition. It reflects the significant work undertaken over the past four years to halve childhood obesity. Currently two out of every five children who enter primary school are overweight or obese. That number rises in the six years they are at primary school to three out of every five children.

    Mr Mark Harper (Forest of Dean) (Con)

    On the Government’s ambition, the Minister said very clearly, and it says in the strategy, that we want to halve childhood obesity by 2030. The strategy also says,

    “reduce the number of adults living with obesity”,

    although I looked and could not find a specific target. Is she able to set out what the Government think that trajectory should look like? What I am concerned about—she will see this when I make my remarks later—is that there are lots of practical measures in the strategy, but I am struggling to see how the Government will actually deliver the result, which is fewer people being overweight or obese. Having some milestones on that journey, rather than just waiting until 2030, would be helpful so we can judge whether it is working and make some course corrections.

    Jo Churchill

    I understand why my right hon. Friend is calling for milestones but, although the problem is a national one, there are different numbers for the proportion of the population that is overweight or living with obesity in each area. We can set milestones, but a national mile- stone may mask whether we are achieving what we need to achieve in the areas—often the more deprived areas in our communities—where we need to help, encourage, support and educate people to get them further on this journey. I will listen attentively to his contribution, as I always do, and then I may come back to him in my closing speech.

    Three out of five children are overweight or obese by the time they leave primary school. We know that there is a direct correlation between the dietary habits picked up early in life and behaviour later on. We are working to create the right health environment to support people, and I will set out briefly some of the actions we are taking, starting with out-of-home calorie labelling. Restrictions laid in the House on 13 May will require large businesses in England with 250 or more employees, including restaurants, cafés and takeaways, to display calorie information for non-pre-packed food and soft drink items that they sell. Many have already gone some way in doing that. These regulations will support customers to make informed, healthier choices when eating out or purchasing a takeaway.

    As I said, many businesses have articulated to me that they understand fully the importance of providing information and being proactive in leading the way. They recognise the demand from their customers for more information so that they can pursue a healthier lifestyle. Smaller businesses currently do not fall within the scope of the regulations.

    We have also listened carefully throughout the consultation period to individuals and stakeholders who have the challenge of living with eating disorders. We feel we have been careful and sensitive and have put in reasonable adjustments to help that group. We have also exempted schools from the requirement to display calorie information, given the concern about children in school settings. We have included a provision in the regulations allowing business to provide a menu without calorie information on request.

    Wera Hobhouse (Bath) (LD)

    The Minister knows that I have had a number of conversations about calorie counting. What really concerns me is the evidence base for whether this will really reduce the number of people suffering from obesity. As she knows, I am very concerned about the effects on people suffering from an eating disorder, and so far there is no evidence that it will make a significant difference to those who suffer from obesity. Can she provide me with some numbers or assure me that there will be a constant watch on how this is actually affecting those with obesity?

    Jo Churchill

    If the hon. Lady allows, I will go through the rest of my contribution. I hope she will take away that this is about building blocks. As I said, it is a complex situation, and there is no silver bullet. We must look at the antecedents of both conditions, including the link to mental health for those who suffer from anorexia and certain other eating disorders, and at some of the broader challenges when we are looking at those who are overweight or living with obesity. They need to be taken in the round, but one cannot be cancelled out against the other.

    Mr Harper rose—

    Jo Churchill

    I am going to push on just a bit, and then I will of course come back to my right hon. Friend.

    We are also taking action to stop the promotion of less healthy products by volume and prominent locations online and in store. We want to support shoppers to purchase healthier options and shift the balance of promotions that way by maximising the availability of healthier products. We still need to eat, and we are not banning anything, but we are trying to educate, encourage and make people aware, so that they have the option of a healthier choice by default.

    Last December, we confirmed that we will legislate on the promotion of foods high in fat, salt and sugar in stores and online. This will apply to medium-sized and large businesses—those with more than 50 employees—in England, and it will come into force next year. I would like to congratulate and thank those large retailers that are already taking these steps, because the argument is often put forward that it is unaffordable for a business to do this, yet many of the large retailers are doing it.

    Richard Fuller (North East Bedfordshire) (Con)

    I am grateful to my hon. Friend for outlining some of the measures she is asking businesses to undertake. She will appreciate that the last year has been very difficult for all businesses. As a Health Minister, she perhaps has not been able to have as much engagement with business, so would she take up the opportunity, ahead of the implementation in June, to come and visit Jordans & Ryvita, a cereal manufacturer in my constituency—she may have some familiarity with it—so that she can listen to its points of concern about the proposals she is making?

    Jo Churchill

    My hon. Friend and I have spoken about Jordans. Indeed, my first job was selling Jordans Crunchy bars at county shows when I was—oh—several decades younger. I will of course be happy to talk to him after this, but I would also gently point out that I have British Sugar, which is also in this food group, in my constituency. I not only meet its representatives on a regular basis, but I also met as lately as yesterday representatives from the British Retail Consortium and the Food and Drink Federation.

    Mr Harper

    The intervention I was going to make when the Minister was dealing with the hon. Member for Bath (Wera Hobhouse) was on the impact assessment for the regulations she mentioned. I have looked very carefully at the evidence, and it seems to me that the best case for these regulations is that we will reduce the number of calories consumed by 80, which is an apple, and the worst case will reduce it by about eight, which is a 10th of an apple. It seems to me that the cost of these regulations simply is not justified by the outcomes.

    Because the Minister did not take my intervention at that time, she went on to talk about the legislation for promotions online, and I have looked at this. The Government’s goal for this legislation is that it reduces the calorie consumption by 8 billion calories. That sounds like a lot, but if we look at the number of children in the period that is spread over, it is equivalent to each child eating one fewer Smartie a day. Given that the children who have the most serious obesity problem are consuming up to 500 calories a day, reducing their calorie consumption by three calories a day simply does not do it.

    The Government’s ambition is correct, but I just have a real worry that these particular measures simply will not have the effect that the Government and all of us wish to happen.

    Jo Churchill

    I am very glad that my right hon. Friend is joining me in the ambition of wanting to get the weight of the nation down. I would gently push back, and say that I do not recognise those calorie figures. I am sure we can have a longer discussion over where that evidence base is drawn from, and about the fact that there is actually a much greater impact. As I have pointed out on two or three occasions, this is about the building blocks of all these different measures coming together, and they will be monitored and assessed as we go through.

    Another element of the environment is advertising. Currently, we are failing to protect children from over-exposure to high-fat, salt and sugar products via advertisements on both television and online platforms. I would gently say that if adverts did not influence people, they would not be used. Therefore, to help tackle the current situation, let us just see more advertising of healthy food. It always strikes me as quite interesting when watching a diet programme on the television that each ad break is often interspersed with adverts for high-fat, salt and sugar products. This does not affect the advertising industry’s revenue, because there is still a need to advertise and people still need to eat, but the foods advertised often do not reflect the balance that we need to enjoy a healthy life.

    Richard Fuller

    Will the Minister give way?

    Jo Churchill

    I am going to push on, I am afraid.

    The Queen’s Speech on 11 May confirmed our intention to take that measure forward through the health and care Bill, and the Government aim to publish the consultation response as soon as is practicable. Many people objected to the sugar drinks industry levy, saying that it would mean a decline in sales. Five years on, we have seen a decline of around 44% in sugar in soft drinks. Revenue raised has often been diverted into sports activities in schools and so on, and sales have risen to over 105% of what they were in the beginning.

    Information helps the consumer; it also helps manufacturers and retailers to look at diversifying their products, and much of the customer research, including the McKinsey report—I think it was put out by the Food and Drink Federation, but it might have been the British Retail Consortium—shows that this is the direction in which customers want retailers and manufacturers to go.

    We want to take this measure into alcohol labelling, as well. As we know, each year around 3.4 million adults consume an additional day’s worth of calories each week from alcohol, which is the equivalent of an additional two months’ worth of food a year. Despite that, the UK drinks industry is not required to provide any information on how many calories each drink contains, and up to 80% of adults have no knowledge at all.

    Action to ensure that people can make an informed, educated choice is what we want, and we will be publishing a consultation shortly on the introduction of mandatory calorie labelling on pre-packed alcohol and on alcohol sold in the on-trade sector. Once again, it is interesting to note that this labelling happens to a large degree with most low-alcohol content drinks and in many own brands, so the measure is merely about ensuring that customers can feel fully informed.

    Turning to weight management services, on 4 March, we announced £100 million of extra funding for healthy weight programmes to support children, adults and families to achieve and maintain a healthier weight. More than £70 million of that will be invested into weight management services made available through the NHS and local authorities, enabling some 700,000 adults to access the support that can help them lose weight. It includes digital apps, weight management groups, individual coaches and specialist clinical support.

    There has been a fantastic response from local authorities to the planned roll-out of these services. It shows the widespread need and support for helping people achieve a healthier weight and is an example of the importance of partnership in action. The remaining £30 million will go to: funding initiatives to help people maintain that weight, because we know that weight lost can often be quickly regained; giving access to the free NHS 12-week weight loss plan app; continuing the Better Health marketing campaign to motivate people to make healthier choices; improving services and tools to support healthy growth in early years and childhood; and helping up to 6,000 families and their children to grow, develop and have a healthier lifestyle and weight. In addition, we will invest in helping people access the weight management services and support they need through a range of referral routes across the health system.

    We are also looking at incentives and incentivising healthier behaviours. We have committed £6 million to developing a new approach to health incentives. The aim is to support people towards adopting healthier behaviours. That work will be supported by Sir Keith Mills, who pioneered reward programmes such as air miles and Nectar points. It will look at the best innovation to motivate people drawn from not only the public sector, but the private sector.

    Since it is critical that a child has the best start in life, we are also working to improve infant food and the information around it. We will consult shortly on proposals to address the marketing and labelling of commercial food and drink products for infants and young children—to reiterate what Dame Sally Davies has said, there is the halo effect, where we think what we are purchasing for our children is healthy, but potentially it is not—so that parents and carers can have clear and honest information that aligns with advice on the products that they feed their children and babies, giving every child the best start in life.

    We are not alone in working to address the challenges of obesity; it is pretty much a global problem. The effect of collaboration internationally is critical for us all to learn. The UK has established effective working partnerships with, for example, Mexico, Chile and Canada, as well as international organisations such as the World Health Organisation. I have had discussions with some of my counterparts across the world, including those leading on measures such as health incentives. Through partnerships we share best practice and ensure our interventions are based on experience and the evidence.

    Tackling obesity and helping people to maintain a healthy weight is, as I have said, an extremely complex issue, and that is reflected by the wide range of action we are taking. Of course, we would like to move more quickly and have a magic solution, and there is more that we want to do, but I recognise the scale of the policy we are bringing forward. It is a far-reaching and radical plan to reduce obesity in our society; I do not want us to carry on being second in a league table in which we should not be proud of being second.

    The high prevalence of obesity in adults and children has been decades in the making. It is going to take time to see results from our interventions, and we may want to go back and change some of them. There is no single fix and no single point of responsibility. We all have a part to play and it is vital for us all—Government, Parliament, industry, employers, the health service, the wider public sector and all of us as individuals—to work together. I am really looking forward to what I anticipate will be a very varied set of contributions this afternoon.

  • Jo Churchill – 2021 Speech on NHS Dentistry

    Jo Churchill – 2021 Speech on NHS Dentistry

    The speech made by Jo Churchill, the Parliamentary Under-Secretary of State for Health and Social Care, in the House of Commons on 25 May 2021.

    First, I congratulate my hon. Friend and Suffolk colleague the Member for Waveney (Peter Aldous) on securing time for this important debate. I also congratulate my hon. Friend the Member for North Norfolk (Duncan Baker), who for the second time today has spoken about the challenges of dentistry that we have.

    As my hon. Friend the Member for Waveney said, this is not a new problem; it was a problem and challenge pre-covid. The pandemic has definitely shone a light, and things have become much more challenging in the world of dental provision during the pandemic. Dentistry has been significantly impacted because of the risks associated with the aerosol-generating procedure that dentists do and, obviously, with the saliva generated when someone is carrying out a procedure on someone else’s mouth. In response, dental practitioners have been required to wear full personal protective equipment to keep them, their teams and their patients safe.

    Public Health England is reviewing the current guidance on infection prevention and control. I mention this because it goes to my hon. Friend’s point on fallow time—the time between the dentist putting their instrument down and cleaning down their room, and then seeing the next patient. These things have been big constraints in trying to have a rapid throughput of patients through the consulting room. Fallow time now is as low as 10 minutes in many cases, although that does depend on material factors such as the ventilation and so on.

    I am talking to NHS England about the use of ventilation and the ability to support dental practices in putting ventilation in, but I gently point out that what sounds easy in a sentence in this place is often challenging. The buildings are not always owned by the dental practices, and in order to put ventilation systems in we have to take the rooms being used to deliver care out. So there is that combination of challenges, but there is new research on ventilation and lighting, and we are constantly looking at these things to see how we can further support the profession.

    An important step forward has been to reduce the amount of time between seeing patients, in order to facilitate more care for more patients, but we have taken the action we have because infection control sits at the heart of what we have to do. I stress that because, with the variant of concern in some of our towns and cities around the country, we have to very mindful that we are looking for progress as to how we proceed with dentistry. I agree with much of what my hon. Friend said about making sure we are looking for opportunities, but we have to be mindful of the fact that we are not yet clear of this pandemic, and that brings enormous constraints.

    The thresholds that have been set for dental practices since the start of the year have been based on data on what is achievable while also complying with infection prevention and control. My hon. Friend alluded to the 45%, which was the level of dental activity placed on practices in the fourth quarter of last year. That figure is now 60%, and 80% through orthodontics. This is the tension that exists in this whole area. Sixty per cent is still 40% lower than what we delivered in pre-covid times—obviously. The challenge is to make sure that we are able to see the backlog, that we drive forward with looking after the most vulnerable and those with the highest degree of need, and that we do not lose ground on what has gone before, while also having to deal with complexities such as retirements and contracts coming back and so on and so forth. However defective the 2006 UDA contract is, it is not just a question of swapping one for the other.

    The current thresholds are monitored on a monthly basis, and the new thresholds have been put in place for six months. Dental practices have been asked to deliver as much care as possible, prioritising urgent care, particularly for vulnerable groups. They are delaying planned care, ensuring that they are dealing on a needs basis with those in the most acute need.

    In addition to these activity thresholds, NHS England has provided a flexible commissioning toolkit. I am very keen for the profession to get real-world examples of what can help deliver the service, based on the successes that have been achieved locally. Some of those successes have been achieved in our own particular area. Flexible commissioning is used to convert units of dental activity, or UDAs as my hon. Friend has referred to them, to activity that focuses on priority areas, such as improving access to urgent care, or targeting high-risk patients, which was exactly what he was asking us to look at in his speech. We are already doing that. It is good practice and regional commissioners can implement it. I am very keen to make sure that that practice is being used as much as it possibly can be. I am having very frequent discussions with NHS England to make sure that we are monitoring the use of these measures.

    As well as flexible commissioning, support is also available to local NHS commissioners to put that capacity where we need it most. In the east of England, NHS England has developed the transformational dental strategy, the aim of which is to prioritise urgent care, prevention and inequalities. Despite our efforts to increase services, we know that patients are still experiencing acute difficulty in finding an NHS dentist—that is also true in my constituency.

    A feature of the debates that we have had today is the availability of private provision in areas where there is no NHS provision. NHS England is charged with commissioning to the need in an area. Making sure that we commission to the need in an area is something that contract change, which I am very keen to see delivered by April 2022, addresses, but it is highly complex. I have met stakeholders in the UK. Some people suggest that the Welsh system is better. Others favour the French system or the one that exists in some of the Scandinavian countries. I have met members of the dental profession from all those places and, actually, no one has a perfect system. We are trying to take what is good about the various systems and ensure that we deliver in localities so that people can have access to care when they need it, with a particular focus on prevention.

    We have a web-based programme in the east called service provider, which provides up-to-date information on dental services that are available. Patients experiencing difficulties are able to contact NHS England’s customer care centre and call 111 for help in accessing emergency dental care. All NHS dental practices in the east of England have been asked to reserve at least one slot per day for urgent dental care to improve capacity and, as my hon. Friend the Member for Waveney said, allow greater access. In addition, we have not stood down the 600 urgent dental centres that we had across the country during the height of the pandemic; we have left those in place, and we have a network of them across both Norfolk and Suffolk.

    However, we know that information on NHS dentists is not always easy to access. Alongside increasing access for patients, it is crucial to support NHS dental practices and mixed practices—and, arguably, private practices—in order that we can start to have a more balanced approach. As my hon. Friends the Member for Waveney and for North Norfolk mentioned, part of the challenge that we have is retention. That is the case particularly in our area, but it is something that I have discussed with Cornish colleagues too; my hon. Friend the Member for St Austell and Newquay (Steve Double) and I have discussed at length how the problem is not unique to the east of England.

    Practices have continued to receive their full contract payments minus agreed deductions, providing that levels of activity are met. An exceptions process has also been put in place for practices that have been disproportionately impacted by the pandemic. It is wrong to say that we want anyone to feel that they are not supported to deliver what they can. We have also made personal protective equipment available free of charge through a dedicated portal; and as of a week ago, we had delivered more than 367 million items free to dentists, orthodontists and their teams.

    If it has done anything, the pandemic has continued to highlight the fact that transformation in dentistry is necessary, particularly if we want to make sure that we drill down on the oral health inequalities that exist across the country. I am meeting the chair of Healthwatch tomorrow, and I am sure that, among other things, we will discuss access to dentistry at some length. We need to develop a sustainable, long-term approach to dentistry that is responsive to the population. It needs to provide high-quality, urgent treatment and then restorative care where clinically necessary, but prevention must sit at its core.

    The majority of oral health failures are preventable. My hon. Friend the Member for Waveney spoke about children. There is nothing more upsetting than a child being in acute pain and having all their teeth removed. That is a broader problem. Through flexible commissioning, we can ensure that we are doing supervised tooth brushing by encouraging local authorities to put that in, but we can also enable parents to do their part and ensure that they can help their children learn good habits right from the early days. Parents can encourage their children to look after their teeth by rubbing their gums before their teeth even appear, making sure that they understand how important it is.

    In addition, any system that we design must improve patient access and oral health, and offer value for money for the taxpayer. It must also be designed in conjunction with, and be attractive to, the profession. NHSE is leading on dental contract reform work. Importantly, it is engaging with stakeholders, including the ADG, which my hon. Friend spoke about. It will be looking at what changes can be made to dental contracts in the short term to offer some improvements and some relief and respite to everyone, while details of the next stage of reform will be agreed by April 2022. Making NHS dental contracts more attractive to the profession will help with vital recruitment and retention, and I know that all my hon. Friends in the Chamber, particularly across rural and coastal areas, will welcome that.

    Health Education England’s Advancing Dental Care programme has also been exploring opportunities for flexible dental training pathways and how we train our dental workforce to improve recruitment and retention. I am also very keen to make sure that we use the broader dental team as efficiently as we can, because dental technicians, dental nurses, hygienists and so on hold many skills that, particularly, could be used for prevention. However, with another hat in my portfolio on, I think of the obesity agenda and making sure that we all look after ourselves a bit better and have healthier lifestyles. Everything that we consume goes in through our mouths. Dentists are wonderfully placed, as are their teams, to help to encourage us to have a healthier lifestyle and to eat a little less sugar.

    We remain committed to prevention and improving oral health, and I am pleased that my hon. Friend the Member for Waveney supports—I think, from his asks—the direction that we are trying to go in by changing the UDAs, concentrating on making sure that we have the skill mix right, focusing on prevention and looking at retention. As he said, however, this is a complex area. I am also having discussions with the GDC—he spoke about recognising dentists who have trained overseas and making sure that once we are assured of standards of education and so on, things are a bit simpler.

    On making sure that we can expand schemes, subject to funding being secured and consulted on, I want to look at the expansion of fluoridated water. As my hon. Friend said, it is one of the simplest ways that we can improve oral health intervention, and we could significantly improve children’s health across the country. It is unacceptable in this day and age that young children have total dental clearances due to preventable tooth decay. The return on investment on fluoridation is very compelling and there needs to be a renewed focus on the investment in prevention.

    We are committed to increasing dental access both in the short and the long term so that we can ensure equality of access no matter where in the country a patient lives. But this is complex. We are working hard at it. We are working with the profession, but we all need to double down both on prevention and making sure that we are all walking in the same direction to bring accessible oral healthcare to people.

  • Peter Aldous – 2021 Speech on NHS Dentistry

    Peter Aldous – 2021 Speech on NHS Dentistry

    The speech made by Peter Aldous, the Conservative MP for Waveney, on 25 May 2021.

    Thank you, Mr Deputy Speaker.

    There has been an underlying problem with NHS dentistry in the Lowestoft and Waveney area for a long time, with dentists retiring, leading to resources and dental capacity being taken away from the area, notwithstanding the need and demand for NHS dentistry. Many, but not all, of the remaining practices have difficulties in recruiting and retaining dentists. The situation has been exacerbated by a lack of funding, with net Government spending on general dental practice reduced by a third over the past decade. In recent months the situation has reached crisis point, due partly to covid but primarily to the closure due to retirement of two NHS dentist practices in Lowestoft and the closure of the mydentist practice at Leiston in the constituency of my right hon. Friend the Member for Suffolk Coastal (Dr Coffey). The latter was due to the difficulty of recruiting dentists to work in the area.

    This is a national crisis. Official figures in March 2020 showed that 26% of new patients could not get access to an NHS dentist. The situation has worsened during covid, with more than 20 million NHS dental appointments lost nationally since the start of the pandemic. As has been reported today, the British Dental Association’s members survey reveals that almost half the respondents intend to stop working in NHS dentistry in the next 12 months, and two thirds estimate that they will not meet the new 60% activity targets they have been set. This is the worst survey that the BDA has ever carried out, and urgent action is required to stop dentists leaving the NHS in their droves.

    The situation is worse in Waveney. Community Dental Services, an employee-led social enterprise, has recently opened a new dental clinic in the old magistrates court in Lowestoft. That investment is greatly welcomed, although CDS highlights the challenges that it is facing in the area. It is concerned about the lack of access to NHS dental services. Lowestoft and Waveney is an area of high need for dental services, yet there is a serious lack of provision, which has been exacerbated by the backlog caused by covid and, as I have mentioned, by the retirement of well-established local general practitioners. The perceived remote location of the Waveney area and the distance from all the existing centres of dental training make recruitment difficult.

    CDS emphasises the need for a focus on prevention, particularly among children. The treatment of children under general anaesthetic for the removal of teeth that cannot be saved is the highest cause of admittance to hospital for general anaesthetic treatment in England and Wales. CDS advises that the reduction in local authority funding to support targeted or universal prevention—I am not attacking local authorities for this—has had a significant impact on the Waveney population due to reduced oral health improvement services. This limits CDS’s ability to reach out to all the people who need its services.

    The impact on young people needs particular focus. In Suffolk, the proportion of children who saw an NHS dentist fell by half due to the pandemic: 60% in 2019 compared with just 31% in 2020. This translates to 43,000 local children missing out on their dental appointments compared with the year before. CDS, which is a paediatric dental specialist, has a high number of referrals from other practices of children with multiple decayed teeth that require complex treatment, quite often under general anaesthetic. The lack of general dental services locally makes safe discharge difficult, if not impossible, thereby creating further pressure on services. This has a devastating impact on children’s life chances, and could well prevent them from achieving the best start in life.

    Covid has made the situation worse. The interruption of routine dental care and the subsequent reduction in patient appointments has created a backlog of patients. The pandemic has also meant the cancellation of and significant interruption to the dental general anaesthetic list at the James Paget Hospital at Gorleston in the constituency of my right hon. Friend the Member for Great Yarmouth (Brandon Lewis), which causes greater problems. The list will recommence on 1 June, and the backlog of patients needing urgent care is substantial, but this increases the pressure on dental practices, which have responsibilities for their patients’ dental care. It should also be pointed out that there has been no consultant orthodontist at the James Paget since mid-2020, resulting in patients having to travel further for care, and for children this disrupts their education.

    I am receiving approximately 10 emails a week from constituents, many of whom are in agony, looking for an NHS dentist. Some will go private, but for many who are on relatively low wages this option is not open to them and is one they cannot afford. One constituent has been quoted £2,400 for a new front tooth and £2,000 for a bridge repair. Others who are in need of urgent attention, as I have mentioned, go to A&E at the James Paget in Gorleston. There, all that the exasperated consultants can do is to prescribe them antibiotics and painkillers. This is completely unacceptable. Another constituent, who had a new denture fitted in 2019, needed it to be adjusted as it made his mouth sore and had a poor bite. He had no option but to use his old dentures, which were worn down and had a tooth missing. He has only just seen a dentist and is now awaiting the new dentures. These are just a few cases that highlight the agonies that many people are going through.

    Andy Yacoub, the chief executive of Healthwatch Suffolk, summarised the situation well. He said:

    “We are living through a dental disaster, with little to no clear sign of when these problems will ease.”

    He also said:

    “This latest review by Healthwatch England strongly supports our own local view that there is huge inequality in the availability of NHS dental care amongst our population…This includes that some people have waited unreasonable lengths of time to get an NHS dentist appointment, while being told private appointments were available within a week.”

    In Suffolk, he said that we are being

    “inundated by feedback on a daily basis from those struggling to access these services. One individual revealed to us”—

    Healthwatch Suffolk—

    “that they required urgent hospital treatment after overdosing on painkillers to combat their symptoms,”

    while another

    “told us they couldn’t find a dentist to treat a tooth which had reached a point where it was decaying.”

    Duncan Baker (North Norfolk) (Con)

    I confess I have a slight self-interest in this, because my father was the NHS dentist in Fakenham for 34 years. The problems in North Norfolk with dentistry are terrible, with long waiting lists and people not being able to be seen. The Healthwatch report from the past day or so corroborates that. It strikes me that the contracts are some of the root causes of that, as is the disparity between the private and public sectors. What can we do to try to get more people to join this profession? I have one example in North Norfolk where, for more than 10 years, no newly recruited dentist has wanted to come and work at the surgery.

    Peter Aldous

    I thank my hon. Friend for that intervention. The situation is very bad in Waveney. It is also bad in other parts of East Anglia, not least in North Norfolk and in the constituency of my hon. Friend the Member for Peterborough (Paul Bristow). It is particularly bad in East Anglia, and one reason for that is that we are perhaps a little away from the centre of things, and it can be difficult to recruit people to work in the area. My hon. Friend is right that one solution is to reform the existing contract, which dates from 2006, and I will come on to that as I look at some short and long-term solutions that need to be instigated immediately.

    In the short term, I urge my hon. Friend and Suffolk colleague the Minister to take the following actions. First, we must reduce units of dental activity targets. The previous target of 20% was appropriate, but the new 45% target is wholly unrealistic. Many practices will be forced substantially to reduce the number of emergency cases that they provide and to replace them with routine check-ups that are less time-consuming, resulting in an even longer backlog of outstanding emergency and urgent care cases.

    Money that is currently clawed back by the NHS if dentists do not deliver UDAs must be reinvested in the Waveney area. Dentists under-delivering does not indicate low local demand, and any clawback should be reinvested into local dental services, not transferred to other areas. That situation is particularly prevalent in East Anglia. In 2019-20, 9.1% of total contract value was clawed back in the region, compared with 4.8% nationally across England.

    I confess that I do not completely understand the opaque world of UDAs, but I know that the system is short-changing my constituents, many of whom are in agony. For children, there could well be lifelong consequences. Some NHS dentistry practices in the Waveney and Norfolk area want to take on more patients, but they are not able to do so as the UDAs are not available. John Plummer & Associates is a privately owned family dental practice with 10 NHS practices in Norfolk and Waveney. As NHS dental practices in the Lowestoft area have closed in recent years, dentists from those practices have joined John Plummer. Naturally, their patients would like to follow them, but because no more UDAs are now available, the dentists have been unable to treat them, as they will not be able to provide adequate treatment for their regular patients. Those UDAs are then lost to the Waveney area forever. So much more NHS dentistry could be provided in the Waveney area if more NHS dentistry was allowed. John Plummer & Associates would open a walk-in emergency NHS dental service, but it is not able to do so as it is not allowed to do any more NHS work.

    The continuing problem with covid is limiting the number of people that dentists can see each day. That can be eased by installing high-capacity ventilators in dental surgeries. That will reduce the period between appointments, during which the rooms are cleaned, but most practices cannot afford that. I recognise that there is quite a bit of devil in the detail, but the Government can directly increase access to NHS dentistry by providing capital funding for this equipment, as the devolved Administrations in Wales and Northern Ireland plan to do.

    In the long term, root-and-branch reforms need to be instigated immediately. There is a need to get more NHS dentists practising in this area, and the Association of Dental Groups has put forward a six-point plan to achieve this. First, the number of training places should be increased. Earlier this month, Healthwatch Norfolk called for a dental school to be set up: based in Norwich, it would be able to serve the Waveney area and, indeed, the constituency of my hon. Friend the Member for North Norfolk (Duncan Baker). As quickly as possible, the Government must instigate a recruitment drive, increasing the number of UK dentistry training places and introducing incentives for dentists to relocate to areas such as Suffolk and Norfolk.

    Secondly, EU-trained dentists should be recognised. Their role is vital, and there must be continued access to NHS dentistry for EU-trained professionals, thereby preventing further shortfalls from arising. Thirdly, overseas qualifications should be recognised. The General Dental Council’s recognition of dental qualifications should be automatically extended to approved dental schools outside the European economic area, ensuring a smooth process for suitably qualified dentists to work in the UK—notably those from countries such as India. That should also include the doubling of places available under the overseas registration examinations.

    Fourthly, the complex and lengthy process of completing the performers list validation by experience examinations—known as the PLVE—for overseas dentists should be speeded up, simplified and harmonised right across the country, with additional measures introduced to ensure that the process takes no longer than eight weeks.

    Fifthly, whole dentistry teams should be allowed to initiate treatments. Allied dental professionals are, at present, not able to open a course of treatment. This means that they cannot raise a claim for payment of work delivered, with many practices unable to fully utilise therapists as a result; allowing whole dentistry teams to initiate treatments would address this problem.

    The Association of Dental Groups’ sixth and final point is that the Government should create a new strategy to promote NHS workforce retention. They must reform the NHS contract, which is the major driver of dentists leaving NHS dentistry. A new contract, focused on the oral health needs of patients and targeting improved access and preventive care, should replace it.

    With regard to the forthcoming health and social care Bill, with the commissioning of dentists set to move to integrated care systems, it is vital that dentists have a voice and are properly represented on ICSs. There is a worry that the possible pooling of budgets across primary care could lead to further cuts to NHS dentistry, and everything must be done to ensure that this does not happen.

    Fluoridation of water can play a key preventive role in oral health, and it is very important that changes to the framework under which fluoridation schemes are carried out are accompanied by the capital funding that is necessary for those schemes to actually be put in place. I anticipate that we will consider this matter in more detail over the next few weeks when we debate the Bill.

    I now come to the topic of new dental contract arrangements. As mentioned, underlying most of the problems of NHS dentistry is the fact that the current contract, which dates from 2006, is inadequate and now completely unfit for purpose. It must be replaced as quickly as possible. The BDA is looking for this to happen by April 2022 at the latest, and the new contract must break with the units of dental activity, ensure that NHS dentistry is available to all those who need it and prioritise preventive care.

    My hon. Friend and Suffolk colleague the Minister is faced with a major task. From her perspective, it is unfortunate that the music has stopped on her watch. In summary, there are three things we need to be doing. I urge her, in the very near future, to provide practices, such as John Plummer & Associates, that will tackle the enormous the backlog of work with the resources to do so. We must end the cycle of retirements leading to funds being removed from the Waveney area, never to return. Secondly, we must tackle the growing scandal of children having to undergo major dental surgery. That requires much work in the short term in hospitals such as James Paget University Hospital, but in the longer term the introduction of major public awareness preventive initiatives is vital. Thirdly, the dysfunctional 2006 contract should be replaced as soon as possible.

  • Nadine Dorries – 2021 Statement on Force in Mental Health Units

    Nadine Dorries – 2021 Statement on Force in Mental Health Units

    The comments made by Nadine Dorries, the Minister for Patient Safety, Suicide Prevention and Mental Health, in the House of Commons on 25 May 2021.

    Today, I am pleased to announce the launch of the Government’s consultation on the statutory guidance for the Mental Health Units (Use of Force) Act 2018.

    The Mental Health Units (Use of Force) Act 2018, also known as Seni’s Law, was introduced into the House of Commons by the hon. Member for Croydon North (Mr Reed) in July 2017 and received Royal Assent in November 2018. The Act is named after Mr Olaseni Lewis, who died as a result of being forcibly restrained while he was a voluntary patient in a mental health unit.

    The purpose of the Act is to clearly set out the measures which are needed to both prevent the use of force and then ensure accountability and transparency about the use of force in mental health units. By promoting good practice, identifying poor practice, and through a greater understanding of where there are problems or issues for specific groups, we can address this nationally as well as locally. The statutory guidance sets out how we expect mental health units to meet the requirements of the Act. This consultation will seek views on the clarity, content and approach of the proposed guidance.

    This is vitally important to minimise restrictive interventions in mental health units which affected 12,000 individuals in 2019-20, and disproportionately those with protected characteristics under the Equality Act 2010.

    This is a landmark piece of legislation which enjoys the support of patients, people with lived experience, voluntary and charitable sector organisations and the NHS. Today’s launch represents a significant step forward in our efforts to prevent the use of force in mental health units which would not have been possible without the tireless campaigning of the hon. Member for Croydon North and the Lewis family.

    This consultation is part of the Government’s wider reform agenda to improve support for individuals with severe mental illnesses. The Government published their Mental Health Act White Paper on 13 January 2021, which sets out proposals for once in a generation reforms to the Mental Health Act, responding to and building on Sir Simon Wessely’s review of the Act. We are also working hard to achieve our NHS long-term plan commitment to give 370,000 adults and older adults with severe mental illnesses greater choice and control over their care and support them to live well in their communities by 2023-24.

    The consultation will conclude on 17 August 2021. The Government’s intention is to publish the final statutory guidance and begin commencement of the Act in November 2021.

  • Jonathan Ashworth – 2021 Comments on Local Lockdowns

    Jonathan Ashworth – 2021 Comments on Local Lockdowns

    The comments made by Jonathan Ashworth, the Shadow Secretary of State for Health and Social Care, on 25 May 2021.

    Where is the Secretary of State?

    Communities like mine in Leicester or towns and boroughs like Burnley, Bedford and Bolton bore the brunt of this crisis these last 15 months; often in lockdowns longer than elsewhere, felt abandoned without adequate financial support, and families have struggled.

    Can the minister understand how insulting and upsetting it is to us to have new restrictions imposed – a local lockdowns by the back door – and the Secretary of State doesn’t even have the courtesy to tell us.

    Why was this guidance simply plonked on a website in Friday night and not communicated to anyone?

    Why were local Directors of Public Health and local authority leaders not consulted?

    Why were MPs not informed?

    What does it mean for our constituents?

    The family in Leicester who have booked a few days away by the coast in next week’s half term – do they now have to cancel their break?

    Can University students in Leicester travel home after exams, can prospective students come to Leicester to look around the campus?

    The parents in Bolton taking their children to see their grandparents on the other side of Greater Manchester this bank holiday Monday, do they now have to rearrange their plans?

    The young couple in Burnley who have postponed their wedding for over a year and have invited friends and family from across the country to celebrate their special day, is the message to them that the wedding is delayed again?

    Can he take a message from me the MP for Leicester South to the Secretary of State:

    Withdraw this guidance now.

    And convene a meeting of the relevant Directors of Public Health this afternoon to produce a plan involving isolation support, enhanced contact tracing and – because we know from PHE a single dose of the vaccine is less effective against this variant – the rollout of vaccination for everyone and including bring forward second doses for a larger cohort.

    A year ago minister were defending Dominic Cummings on twitter, Mr Cummings now tweets about the lack of competent people in charge. Based on the handling of this latest fiasco, he has a point doesn’t he?

  • Jonathan Ashworth – 2021 Comments on the Indian Variant

    Jonathan Ashworth – 2021 Comments on the Indian Variant

    The comments made by Jonathan Ashworth, the Shadow Secretary of State for Health and Social Care, on 20 May 2021.

    This is deja vu and echoes the mistakes made last year with Boris Johnson’s ‘whack-a-mole’ approach.

    It beggars belief that yet again local health experts on ground have been left in the dark for two weeks when we know acting with speed is vital to containing an outbreak.

    Ministers need to explain what’s gone wrong and provide local health directors with all the resources they need to push infections down.

  • Matt Hancock – 2021 Comments on Vaccination Rollout

    Matt Hancock – 2021 Comments on Vaccination Rollout

    The comments made by Matt Hancock, the Secretary of State for Health and Social Care, on 17 May 2021.

    We have more great news about the vaccination rollout and are making extraordinary strides as 20 million people now have the fullest possible protection from this virus – huge thanks to the team for hitting this milestone.

    The latest real-world data has once again demonstrated how effective the vaccine is at providing life-saving protection, with 2 doses of the Pfizer vaccine providing 97% protection against mortality.

    Receiving a second dose is vital to ensure you have the ultimate protection from this deadly virus – I encourage everyone to book their jab as soon as they are offered it.