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Tag: 2022

  • Cat Smith – 2022 Speech on Access to GP Services

    Cat Smith – 2022 Speech on Access to GP Services

    The speech made by Cat Smith, the Labour MP for Lancaster and Fleetwood, in the House of Commons on 21 June 2022.

    It is a pleasure to follow the hon. Member for North East Bedfordshire (Richard Fuller). His points on planning resonated with me as a Lancashire MP. Where we see large expansions of housing that do not go hand in glove with expansions in GP practices, school places and public transport networks, it is hard to get buy-in from the current population in those areas for that expansion, with patients already struggling to get GP appointments.

    When I was collecting my thoughts for this debate, I was worried that I might fall into the trap of talking about the huge number of constituents who get in touch with me daily about their frustrations with GPs and dentists, so I will begin by paying tribute to the GPs and dentists who work in my Lancaster and Fleetwood constituency. Having worked very closely with them for seven years, it is clear they are working to the best of their ability in a system that is, frankly, broken.

    I will single out one GP in particular. It is always risky to start naming GPs because there will be someone I miss, but I pay tribute to Dr Mark Spencer. When he recognised the health inequalities, the differences in life expectancy and the increased number of cancers and other conditions among his patients in Fleetwood compared with patients in the rest of the borough of Wyre, he started an initiative called Healthier Fleetwood, which has the buy-in of our town, to promote healthier living and exercise. It is for that work that Healthier Fleetwood was awarded the Queen’s Award for Voluntary Service last month. I congratulate all the volunteers at Healthier Fleetwood and Dr Mark Spencer on having the initiative and foresight to do that. He established it because of those health inequalities, which are exacerbated when access to primary care is made difficult. The reality is that record numbers of people are waiting for care and waiting longer than ever before. When we say that people are waiting longer for care, it is important to remember that people are waiting in pain and in discomfort, and with conditions that become more severe and more difficult to treat.

    Frankly, Tory mismanagement has left England with 4,500 fewer GPs than we had a decade ago. That is in stark contrast to what was promised in the 2019 Tory manifesto, which talked about 6,000 more GPs. Instead, we have 4,500 fewer. It is no wonder that patients are getting frustrated. Many of my constituents at the Lancaster end of my constituency started a Facebook group when they became frustrated with the telephone system of one medical practice in Lancaster. A lot of such issues are down to the fact that there is just not enough capacity to meet demand in that part of my constituency. My constituency feels like two stories. I get far more complaints and grumbles from the Lancaster end of my constituency about struggling to access GP appointments than I do at the Fleetwood end, and that is reflected in the number of GPs recruited.

    When patients cannot access GP appointments, they are directed to urgent care or accident and emergency. That is financially illiterate. The cost of a GP appointment is roughly ÂŁ39. If we direct someone to an urgent care centre, it is ÂŁ77. If they end up at A&E, it is ÂŁ359. By not funding and supporting primary care, and by not recruiting and retaining the GPs we need, it is costing the NHS more to deliver healthcare and making it more frustrating for my constituents.

    Turning to dentistry, I spoke last week to a nursery teacher in my constituency who teaches a class of three and four-year-olds. They had been learning about dental hygiene and they were given a little toothbrush and toothpaste. She talked about their experiences of going to the dentist. She told me that hardly any of those three and four-year-olds had been to a dentist. That concerns me deeply, but it ties in with what I am getting in my mailbag as a constituency MP: constituents are struggling to get NHS dentists for their children. Adults, too, are struggling to get NHS dentists. One of the most obvious ways people fall out of having an NHS dentist is when they move house. I have many people who moved to live in my constituency from other parts of the country and tried to find an NHS dentist. Years and years later, they are still left waiting. I have examples of parents of school-age children who are still on NHS waiting lists to see an NHS dentist.

    One of the most difficult advice surgery appointments I have ever had to sit through was when a constituent put on the table in front of me the teeth he had pulled out of his own mouth. That will, frankly, stay with me forever, but it should never have got to that point. As a result of that case, I have raised the issue of access to NHS dentistry many times in this Chamber, including at Prime Minister’s questions. Last year, 2,000 dentists quit the NHS.

    The number of nought to 10-year-olds admitted to hospital for tooth extractions is going up. I looked up the statistics for my own area. There were 30 children in Lancaster and 40 children in Wyre under the age of 11 who had been admitted to hospital for tooth extractions. Of those children, 30 were five years old or younger. I have to say that we are getting something dreadfully wrong when it comes to NHS dentistry and access to NHS dentistry. If we do not get it right for children and babies, we are storing up a lifetime of health issues that will become more and more expensive to deal with and have a knock-on effect on wider health.

    To wrap up, the Culture Secretary recently admitted that a decade of Conservative mismanagement had left our NHS “wanting and inadequate” before covid hit. It seems that the Conservatives are now breaking their promise to hire the GPs we need and they are overseeing an exodus of NHS dentists. Those who cannot afford to go private are resorting to DIY dentistry or are being left in pain. Frankly, the longer we give the Conservatives in office, the longer our constituents will wait in pain.

  • Richard Fuller – 2022 Speech on Access to GP Services

    Richard Fuller – 2022 Speech on Access to GP Services

    The speech made by Richard Fuller, the Conservative MP for North East Bedfordshire, in the House of Commons on 21 June 2022.

    It is a pleasure to follow the hon. Member for Liverpool, Wavertree (Paula Barker). My observations are based on having, in the past six months, spoken and spent mornings with the people at about 11 of the 13 GP networks in my constituency and on some of their observations, which I have shared with the Minister previously.

    Part of the issue in my area is that the population has grown so significantly. Since 2000, the number of patients per GP has gone up by about 40% in the constituency, which puts on significant pressure, which GPs are responding to, primarily by recruiting other direct care professionals, such as paramedics and various qualified nurses. That has a role in providing support to deal with the problems, but it has not overcome them. Significant efforts are being made to enable my constituents to contact their GP. One interesting issue in those observations was that the practice’s choice of phone system had a significant effect. Practices that chose system A—I will call it that, as I do not want to say a bad word about a particular practice or phone system—would find that the response for the customers, the patients, was terrible. In effect, when 10 people were waiting, the 11th caller got a signal that the number was no longer obtainable. So they would then go to the practice. This was just after covid, so they would go to the practice, try to get in and there would be a big sign on the door saying, “No entry”. These very easy-to-understand problems cannot be solved by the Government but they have a direct impact on people’s experience of primary care.

    However, there are aspects that can be affected by the Government. One of the biggest concerns in my area has been the level and pace of housing development and the absence of an infrastructure-first policy. Can the Minister update the House on her conversations with the Department for Levelling Up, Housing and Communities about implementing infrastructure-first? It means that, before a large housing development can take place, the GP services and the school places need to be there. We should not have people moving into their new houses on some of these estates and then finding that there are no GP places, school places and dentists. This was a manifesto commitment of my party and we should be putting it into law.

    The comments by the hon. Member for Sheffield Central (Paul Blomfield) about dental contracts also go for GP contracts. There seems to confusion in the NHS—the Minister is clear that this is not really a Government responsibility—about whether there is value to the partner model among GPs, or whether we should be moving to a salary model and saying, essentially, that we are not going to pay extra for partners. This is an area where the Government need to set some direction of travel. It is an important direction to set for the NHS. I have my views, but I would be interested to hear whether the Minister believes that is something she can do.

    Something that has been on my mind this week particularly has been the sclerotic process in NHS Estates and in other groups for getting primary care facilities built. The BBC’s “Look East” yesterday carried a story about the new primary care facility being built in Biddenham in my constituency. Eight years since it was first planned, we are hoping—fingers crossed, Madam Deputy Speaker—that that building will be commenced. That is because a lot of people had an interest. The GPs, the CCG, NHS Estates, the local authority, the housing developer and the developer of the facility all had an interest, but who was making the decision? The NHS needs to recognise that in the provision of services it has to be clear on who is saying yes, when, where and how.

    I am grateful to the Minister for saying she will conduct a review of the impact, had infrastructure-first been in place. In my constituency, there is a cramped surgery in Great Barford that could move to a perfectly good, agreeable building opposite that would provide better facilities. Arlesey has had a significant increase in population. I visited its GP practice just two weeks ago. There is no air conditioning, and the doors mean someone could walk in on a GP during their session with a patient. The facility needs upgrading, so we need a decision. I am told that my local authority, Central Bedfordshire Council, has the money ready to convert a site in Biggleswade to primary care, yet the NHS decision process is not making that happen. These planning processes need urgent attention from the Government if change is to be made.

    We have talked about the diversity of primary care roles, which is one of the Government’s positives, as they have said they will increase the number of roles such as emergency care nurses and other types of nurses and paramedics. We saw the Government’s “Data saves lives” paper this week, on how the better use of data can assist in providing solutions. I take the shadow Secretary of State’s criticism of the NHS app. I was going to say it is 19th century, but it is certainly 20th century in its user-friendliness. What is the plan not only to harness data but to make it accessible and to put power in the hands of the patient?

    People can do things with their health information, such as tracking how many steps they take each day. Diabetics can track information on testing. This is a world of improvement that empowers individuals in primary care. The first port of call in primary care provision is each of us managing our own healthcare. What better way to do that than following examples from the rest of the world through NHS applications?

    Will the Minister update the House on the use of artificial intelligence and big data, particularly when it comes to pre-emptive screening? The Government are making a welcome investment in screening centres, but how are we harnessing all this medical data to the task of improving healthcare at a preventive level, rather than later in the day?

    My hon. Friend the Member for Winchester (Steve Brine) has left, but he is absolutely right that the Government are on the right course in opening up more points of presence for primary care by bringing in pharmacies and screening centres, so that each of us can choose where we want to go to get some of the services we want. It is important that legislation and regulation follow as permissive an approach as possible. Let us focus regulations on the patient and patient choice, not on the provider and provider restrictions.

  • Paula Barker – 2022 Speech on Access to GP Services

    Paula Barker – 2022 Speech on Access to GP Services

    The speech made by Paula Barker, the Labour MP for Liverpool Wavertree, in the House of Commons on 21 June 2022.

    I put on record that my husband is a senior manager in the NHS.

    Dr Claire Fuller was commissioned by the Government to lead a national review of primary care. In her introduction to that review, she says that

    “there are real signs of…discontent with”

    general practice,

    “both from the public who use it and the professionals who work within it.”

    Every day, more than 1 million people benefit from primary care professionals and, by Dr Fuller’s own admission, primary care teams are over-stretched “beyond capacity”. Sadly, we have not heard anything today from the Secretary of State to address that issue.

    GPs have been working in local communities for over 100 years. The concept has not changed: GPs are still based in their local community, with the only difference being that the buildings they work in are much more modern. GPs have now moved to a triage system, creating the perception that it is difficult to get a face-to-face appointment, and for some of my constituents that perception is reality. Bookable appointments have now moved to a longer lead-in time, from three to four weeks in advance to seven to nine weeks in advance. Nationally, there were half a million more appointments in January this year than in January 2020, but the number of GPs is roughly the same, despite the Government’s promise in February 2020 that they would recruit 6,000 more GPs by 2024. More than two years down the line, we are simply no further on.

    People are frustrated and angry that they are being contacted by GP surgeries to book in for a health check, yet cannot get to see their GP when they feel unwell. While it is undoubtedly important for GPs to carry out health checks, which can enable interventions, that cannot be at the expense of routine appointments. Those health checks are on an enhanced service contract, meaning that the GP is paid for every patient who takes them up. That is in addition to their normal contractual obligations, so it is no wonder that patients are frustrated. At the NHS Confederation last week—the gathering of more than 5,000 senior NHS managers and staff—which the Secretary of State said he attended, the single biggest area of concern was workforce.

    We must ask ourselves why the guidance from NHS England predominantly concentrates on emergency care, rather than urgent care. It talks about how many people are waiting in accident and emergency, how many ambulances are delayed, and how many people cannot be discharged on time. Those are all important subjects, but that emphasis diverts people’s attention from the important point that the part of the NHS that deals with 90% of patient needs, GPs, only receives the crumbs off the table: 9% of the budget. It is time for the Government to deliver on their promises to recruit more GPs. The biggest threat to the NHS is crippling workforce shortages. If those shortages are not resolved, the Government will eventually start saying, “The NHS is failing.” That will, in turn, lead to the hedge funders coming in and taking over.

    Our NHS staff are underpaid, undervalued and under-resourced, and are then blamed by this Government—this Government who have been in power for 12 years. Meanwhile, patients are struggling to get GP appointments and, often, when they call 111, they are advised to present themselves at A&E. This Government are hellbent on turning the NHS into the national hospital service, rather than the national health service. The model of primary care must change, and change for the better, to enable our constituents to access GP services in a timely and appropriate manner. Quite frankly, nothing less is good enough.

  • Peter Aldous – 2022 Speech on Access to GP Services

    Peter Aldous – 2022 Speech on Access to GP Services

    The speech made by Peter Aldous, the Conservative MP for Waveney, in the House of Commons on 21 June 2022.

    With regard to access to GP services, there is a significant challenge that must be met head-on. The solution must address patients’ ongoing concerns, involve long-term strategic workforce planning, and respect, not abuse, the GPs themselves.

    The issue that I wish to focus on is access to NHS dentistry, which after 18 months retains the unenviable and scandalous position of being No. 1 in my postbag. It is quite clear that the situation is replicated for colleagues across the House. Access to NHS dentistry is a problem that has been brewing for a long time. It can be likened to a house built on shallow and poor foundations, which—with the earthquake of covid—have led to the house falling down.

    The impact on people is profound: millions unable to find a dentist; thousands in agony, resorting to DIY tooth extraction; as yet untold numbers of undiagnosed mouth cancers; children suffering and having whole mouth replacements; and the poorest hit hardest. The solutions are fivefold: a secure, long-term funding stream; a strategic approach to recruitment and retention; replacement of the dysfunctional NHS dental contract; a prevention policy promoting personal oral healthcare from the cradle to the grave; and transparent and full accountability through the new emerging integrated care systems.

    To be fair to the Government, measures have been put in place to address the crisis. Locally in Lowestoft, funding has been provided for an established dentist to attend to emergencies. The practice has responded heroically and prevented the system from collapsing. A new long-term NHS contract has been awarded to Lowestoft-based Dental Design Studio. That is welcome, although given that it was not possible to commission similar contracts elsewhere in Suffolk and Norfolk, there is concern that demand for NHS dentistry across the region will continue to outstrip supply, and that the new service could have a large and unserviceable catchment area.

    The Government’s announcement in February of a £50 million dental “treatment blitz” was welcome, but there is concern that the take-up of that funding has been limited because dentists have been too overstretched to take on the extra work. In the long term, the fact that the feasibility of establishing a dental school in Norwich is being considered is also very much welcomed.

    Those initiatives are a step in the right direction, but the underlying causes of the dentistry crisis are yet to be tackled. In May, the Association of Dental Groups’ report highlighted the emergence of dental deserts across the country, where there is almost no chance of ever seeing an NHS dentist. There is a real risk of them merging to form an area of Saharan proportions. The British Dental Association is concerned that the negotiations to reform the NHS dental contract framework are yet to begin in earnest.

    I have mentioned the importance of prevention. Back in February, I attended an event in Lowestoft at which community dental services and Leading Lives—a Suffolk-based not-for-profit social enterprise—launched a toolkit to help improve the oral health of young people with learning difficulties. Leading on from that, Lowestoft Rising, which promotes collaboration between statutory authorities and the voluntary sector, got together with local councillors and supermarkets to buy toothbrushes and toothpaste for primary school students. The initiative is to be applauded, but the feedback that I have received is that so much more could have been done if the group had not had to pay 20% VAT; surely this is a Brexit dividend that is looking us right in the eye.

    As we have seen with the zero rating of women’s sanitary products, we now have more flexibility to vary our fiscal regime. If necessary, such a VAT exemption could apply to children’s dental products in much the same way as it does to children’s shoes. Children’s toothpaste and toothbrushes are distinct and different from those products used by adults. Such a strategy would embed good oral healthcare at an early age, and help to prevent the traumatic and expensive whole mouth replacements that hospitals increasingly have to carry out. Such a policy could form part of the new long-term plan for NHS dentistry that is so badly needed right across the country, and which I look forward to the Government rolling out at the earliest possible opportunity.

  • Paul Blomfield – 2022 Speech on Access to GP Services

    Paul Blomfield – 2022 Speech on Access to GP Services

    The speech made by Paul Blomfield, the Labour MP for Sheffield Central, in the House of Commons on 21 June 2022.

    A range of important issues has been raised by those on both Front Benches and in the interventions on them, but I want to focus specifically on NHS dentistry issues.

    We have all had so many constituents contact us, and I would like to share a small selection of mine. One new resident to the city said:

    “I moved to Sheffield earlier in the year. I am unable to register for an NHS dentist. I am being quoted waiting lists of eighteen months just for a check-up.”

    Another wrote:

    “My partner has been trying to get into a dentist for a check-up for around 18 months. We have rung every dentist within a 6-mile radius to be told they are not taking on NHS patients…and he will need to go private.”

    One woman wrote to me:

    “I have a MATB1 form entitling me to free dental care whilst I’m pregnant and for a year after birth. Unfortunately, I can’t use this as I can’t find an NHS dentist”.

    A young mother told me:

    “We’re told dental care is important and that we should get our children seen early and regularly. We moved to Sheffield in December 2020. I started to look for a dentist. I’ve been on a waiting list for a year with no progress.”

    Another parent told me:

    “Our son was referred for NHS orthodontic treatment by his dental practice in February 2019 at the age of 12. He has now been on the waiting list for 35 months and will turn 15 next month. He still has not had an initial assessment appointment.”

    Lilian Greenwood

    I thank my hon. Friend for giving way; the Secretary of State seemed to forget to do so. Does my hon. Friend share my concern that, even before the pandemic, the No. 1 reason for hospital admission among children aged five to nine was tooth decay? Is that not a shocking indictment of the failure to address health prevention and care for children and their teeth, and is it not a bit galling for the Secretary of State to suggest that this is the fault of the last Labour Government, when before the pandemic his Government had already been in power for 10 years?

    Paul Blomfield

    I thank my hon. Friend for that intervention, and she is absolutely right about how that highlights the crisis we are facing in NHS dentistry. That exists right across England, and it was interesting to hear comments from other nations, because significantly less is spent on dentistry in England than in Wales, Scotland or Northern Ireland. The Secretary of State blames everything on the contract, but the cuts to dentistry have been deeper than in the rest of the NHS, with spending a quarter less than it was in 2010, and I am not surprised that he made no mention of that.

    Last Wednesday, I met our local dental committee to discuss the problem—dentists who are committed to their profession and to NHS provision, and who want a solution—and following our discussion, they commissioned a survey of waiting lists across the city. Some 37 practices responded, which is about half of the city’s providers, but only one practice could offer a waiting time shorter than a year. For 29% it was up to two years and for 32% more than two years. The most significant number was that 35% of practices were unable to add any patients to their waiting lists.

    Across England, the number of dentists providing NHS services fell from 24,700 in 2019-20 to 21,500 now, which is a fall of 15% in just two years—

    The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield) indicated dissent.

    Paul Blomfield

    I see the Minister shaking her head.

    However, there is provision for those who can pay. Healthwatch reported last year:

    “Whilst some people were asked to wait an unreasonable time of up to three years for an NHS appointment, those able to afford private care could get an appointment within a week.”

    That is adding to health inequalities, and it is not because dentists are reluctant to take on NHS patients, but because the system discourages them from doing so. We have patients wanting NHS dentistry and dentists wanting to provide it.

    It is true that there are flaws in the 2006 contract. It is based on units of dental activity using figures from the two years prior to its imposition, which are now massively outdated. It contains huge discrepancies in remuneration rates between practices doing the same work. There are penalties through clawback for underperformance for reasons beyond the control of practices, but no reward for overperformance. I see the Minister smirking, but she has been delivering this contract, and the Government have been operating within it for 12 years. There are limits on how much NHS treatment a practice can provide. That is because of quotas and the way that providers are contractually obliged to spread their NHS work. Dentists have a disincentive to take on new patients, who are more likely to have greater treatment needs, because the fee-per-item system was replaced with a system in which the same is paid for one filling as for 20.

    Maria Caulfield indicated assent.

    Paul Blomfield

    As the Minister is nodding, let us review the position as regards the contract. Back in 2008, the Select Committee on Health declared the system not fit for purpose. The then Health Secretary, Alan Johnson, responded by ordering a review of the system. In 2009, the Steele inquiry reported, and in 2010, we committed to reforming the contracts, but 12 years on, nothing has happened.

    Ministers also blame covid. Clearly, it has had an impact; there was a backlog of 3.5 million courses of dental treatment after lockdown, and patients are inevitably presenting with bigger problems and increased need, which means longer appointments and extra work, for which dentists get no remuneration. The Ministers sitting on the Front Bench have presided over this flawed system. In quarter 4 of 2021-22, 57% of practices faced financial penalties for being unable to meet the targets that those Ministers effectively imposed; the problem is due to the additional infection prevention control requirements and the lack of adjustment to the remuneration system.

    We have reached a tipping point for NHS dentistry. Unless the Government act, the number of complaints that all Members of Parliament are getting will only grow. More practices will move to a private model, which will add to the difficulties, because the system does not work for them.

    Margaret Ferrier (Rutherglen and Hamilton West) (Ind)

    NHS services are devolved, but many concerns about them are shared across the UK. Some of my constituents have concerns about the price of NHS dentistry offered through private dental practices, and about transparency in how final costs are calculated. Does the hon. Gentleman agree that, particularly given the economic climate, practices must give cost breakdowns before treatment begins, so that patients can budget and understand what they are paying for?

    Paul Blomfield

    We need transparency, and that starts with a new structure for remunerating dentists—a structure that no longer disincentivises them from taking on NHS patients, and that does not push them towards private care. If we do not make those changes, the system will get worse. Some 50% of NHS practices have already reduced their NHS commitment, and 75% are planning to reduce further their contracts. Patients will face frustration and all the pain involved in not accessing help when they need it. As others have commented, children’s oral health will be severely damaged. It is a disgrace—it shames the country—that last year, hospitals in England carried out almost 180 operations a day on children to remove rotting teeth, and it cost the NHS more than £40 million. Those problems will impact those children throughout their life. Poor dental health is linked to endocarditis, cardiovascular disease, pneumonia, premature births and low birth weights, all of which add strain and cost to the NHS.

    The good news is that there is an answer, but it is in the hands of the Government. We need to restore adequate funding to dentistry in England, and we need a commitment that the long-promised contract reform will take place. It must be real reform, and not tweaks at the edges. Otherwise, we face the slow death of NHS dentistry.

  • Sajid Javid – 2022 Speech on Access to GP Services

    Sajid Javid – 2022 Speech on Access to GP Services

    The speech made by Sajid Javid, the Secretary of State for Health and Social Care, in the House of Commons on 21 June 2022.

    I welcome this chance to come to the House to discuss primary care and dentistry, but I have to say that the audition by the hon. Member for Ilford North (Wes Streeting) did not go very well. I hope that he can see the irony—some might even say the hypocrisy—of his sudden interest in access to public services, today of all days. It is thanks to the strikes that he has been so vocal in supporting the fact that people right across the country cannot make their appointments, that GPs and dentists cannot get to work and that patients do not have access to the treatments they desperately need.

    Several hon. Members rose—

    Sajid Javid

    I will take some interventions in a moment.

    The hon. Gentleman has had every opportunity to do the right thing, to put patients first and to condemn these unjustified and reckless transport strikes, yet at every turn he has chosen to back his union paymasters.

    Catherine West rose—

    Sajid Javid

    I hope the hon. Lady will condemn the strikes.

    Catherine West

    The Secretary of State speaks about opportunities. In this House, we had a number of opportunities to get workforce reform, workforce numbers and a plan for our health service into the Health and Care Act 2022. Why did he miss those opportunities?

    Sajid Javid

    We are seeing record investment in the workforce, and we are seeing record increases. For the first time ever, the NHS is also coming up with a 15-year long-term workforce strategy, which I hope the hon. Lady welcomes.

    The Government have always been on the side of patients and the people who care for them. I pay tribute to everyone working in primary care and dentistry for the difference they make day in, day out to their patients’ lives. I know that the pandemic has brought some unimaginable pressures, and equally I know that many of those pressures have not gone away now we are living with covid.

    The hon. Member for Ilford North talks as though he does not know where the pressures have come from—as though he has had his head under a rock for two years. The NHS has said it believes that between 11 million and 13 million people stayed away from the NHS, including their GPs and dentists. Rightly, many of those people are now coming forward for the treatment they need—and I want them to come forward.

    John Redwood

    When the Secretary of State does the much-needed manpower review, will he ensure that a fast-growing area such as Wokingham with lots of new houses gets proper provision for that growth? Will the manpower plan also address how we recruit the doctors we have authority to get?

    Sajid Javid

    I absolutely agree with my right hon. Friend’s important point. In fact, I met my hon. Friend the Member for South West Bedfordshire (Andrew Selous) about that last week, and I agree with them both.

    Hilary Benn (Leeds Central) (Lab)

    Last month, a constituent contacted me who had developed severe dental pain. He phoned 40 dentists and not one of them could take him on as an NHS patient. It got so bad that he phoned 111 but was told that he was not eligible to see an emergency dentist. What advice would the Secretary of State give to someone in those circumstances? Many other hon. Members on both sides of the House will be able to tell similar stories. In the end, my constituent had to pay to go private, but that should not have happened. Why are our constituents being placed in that position?

    Sajid Javid

    I am sorry to hear about the right hon. Gentleman’s constituent. If he will allow me, in a moment, I will come on to the pressures that dentistry is facing and, most importantly, what we are doing about them.

    Those pressures have come about for two reasons. First, there was a fear of infection, which was understandable in a context where 10 minutes in a dentist’s chair during the pandemic could have meant 10 days in self-isolation or, perhaps, worse. Dental practices were almost uniquely at risk of spreading covid, so their activity was rightly severely constrained across the world—not just here in England and across the UK—by the infection prevention rules that were necessary at the time. Despite all the innovations in dentistry over the last few years, dental surgeries do not have a Zoom option.

    Secondly, the British people stayed away because of their innate sense of responsibility during the pandemic. As all hon. Members saw in their constituencies, people understood our critical national mission. Our GPs were doing their duty vaccinating people in care homes and in thousands of vaccination centres up and down the country, protecting the most vulnerable and working hard to keep us all healthy and safe.

    When omicron struck—we all remember that period, which was not that long ago—I stood before this House and asked GPs to stop all non-emergency work once again. I did not take that decision lightly, but we were faced with a stark choice of having more lockdowns or accelerating our vaccine programme. We chose to accelerate, with help from all corners of the NHS and with the backing, at that time, of the hon. Member for Ilford North. I remember him standing at the Dispatch Box pledging his full support for that effort and rightly stating that the Government were acting

    “in the best interests of our NHS, our public health, and our nation.”—[Official Report, 13 December 2021; Vol. 705, c. 795.]

    He recognised that it was the right thing to do then; he has now conveniently changed his mind. I wonder why.

    Mike Amesbury (Weaver Vale) (Lab)

    But people like Mark in my constituency cannot find an NHS dentist. This is not about covid; it was happening before covid. The investment just is not there. He is in pain; he is in agony. The Secretary of State needs to step up, step in and get things right.

    Sajid Javid

    We are putting record amounts of investment into the NHS, including more funding into dentistry—I am about to come on to that right now—which will help with those pressures.

    Clive Efford

    Covid is just a pathetic excuse, because even if it was the sole reason, the Secretary of State should have been planning for when we came out of it, but nothing he has said explains why we had record numbers of patients on waiting lists even before covid started.

    Sajid Javid

    I think that many people working across the NHS will be listening to the hon. Gentleman and realising that he has no idea about the pressures that covid has created for everyone working there, especially those on the frontline.

    Emma Hardy (Kingston upon Hull West and Hessle) (Lab)

    Excuse me for raising this issue, but I want to draw attention to the fact that there has been news released that the Secretary of State’s Government have declined to introduce mandatory reporting of complications resulting from mesh. In the context of problems with waiting lists, and wider issues, if we do not introduce a mandatory reporting scheme to identify problems with a medical product, more people will end up requiring medical intervention and medical treatment, so I urge the Government to look again at their declining to introduce mandatory reporting.

    Sajid Javid

    The hon. Lady raises an important issue. That is why the Government commissioned an independent report. We have responded to that report. We are still listening to what hon. Members such as herself and others are saying on this important issue, and then we will do a follow-up of the report within a year, so that will be later this year. I know that she will take an interest in that.

    Paul Bristow (Peterborough) (Con)

    Does my right hon. Friend agree that a lot of the issues with primary care services are about leadership? In my constituency, we have the brilliant Thistlemoor surgery with Dr Neil Modha and Dr Azhar Chaudhry, who serve 29,500 patients, 80% of whom do not have English as a first language. Same-day, face-to-face GP appointments are the norm in that practice. In contrast, a Thorney surgery has just temporarily closed a surgery in my constituency due to a lack of admin staff, which is not the fault of the admin staff themselves. Will he back my campaign to make sure that that GP surgery is open again serving local people as soon as possible?

    Sajid Javid

    My hon. Friend is campaigning passionately for primary care services in his constituency, and he points to some fantastic practices. I congratulate all the people involved in delivering that and support him in his work with his local commissioners to make sure that they are getting even better local primary care.

    Dr Andrew Murrison (South West Wiltshire) (Con)

    Does my right hon. Friend recognise that the crisis in NHS dentistry, which affects my constituency as it does his, well predates the pandemic, and indeed goes back to at least 2006 when the then Labour Government changed the way in which dentists are paid? Will he undertake to look at the units of dental activity system, which disincentivises dentists from providing dental work particularly in the most disadvantaged communities?

    Sajid Javid

    My right hon. Friend is absolutely right in his analysis, and I can give that undertaking. I will say a bit more about that in a moment.

    If the hon. Member for Ilford North wants to talk about funding for the NHS, I am happy to oblige. Under the last NHS long-term plan, before the pandemic, we made a historic commitment of an extra ÂŁ34 billion a year. Because of the pandemic, we then necessarily put in ÂŁ92 billion of extra funding. At the last spending review, we increased funding still further so that the NHS budget will reach ÂŁ162.6 billion by 2024-25, supported in part by the new health and social care levy.

    We have made sure the NHS has the right level of resourcing to face the future with confidence, but we must also be alive to the consequences. The British people expect every pound spent to be spent well, and they expect us to be honest with them that every extra pound the hon. Gentleman calls for will be a pound less spent on education, infrastructure, housing and perhaps defence. I believe in a fair deal for the British people, and especially for our young people. We will be making plenty of changes alongside this funding.

    Jonathan Edwards

    One of the major problems we face in Wales and across the UK is the need to replace retiring GPs and dentists. There has been a welcome increase in the number of international medical graduates training in Wales, but the British Medical Association informs me that very few GP practices and dental practices in Wales are registered as skilled worker visa sponsors. Will the Secretary of State raise this with the Home Office to see what can be done to help GPs and primary care practitioners retain those international graduates to work in Wales and across the UK, if they so decide?

    Sajid Javid

    We are working with our colleagues in the Home Office on this and other skills and healthcare issues, so I can give the hon. Gentleman that assurance. He talks about the major problem he is facing in Wales, and that major problem is a Labour Government. I hope he agrees—[Interruption.] He is nodding.

    Look at the performance of Labour in Wales, whether on health or education: the median waiting time for outpatients in Wales is almost double the median waiting time in England. People in Wales are waiting more than three years, whereas the longest wait in England is more than two years. Thanks to the covid recovery plan we set out in this House a few months ago, the number waiting more than two years has been slashed by more than two thirds in just four months, and it will be almost zero next month.

    Thousands of people in Wales are waiting two or three years. In fact, one in four patients in Labour-run Wales are waiting longer than a year. In England it is one in 20, which is far too high and will be lowered, but in Wales it is one in four. It is not surprising the hon. Member for Ilford North had nothing to say about his colleagues in power in Wales.

    Kate Hollern (Blackburn) (Lab) rose—

    Sajid Javid

    I would like to hear what the hon. Lady thinks of the Labour Government in Wales and their abysmal performance when it comes to healthcare.

    Kate Hollern

    There is much better performance from the Welsh Government than from the UK Government. The Prime Minister promised 6,000 more GPs, which has not happened.

    I wrote to the Secretary of State about Blackburn having only 33 GPs per 100,000 people, whereas the south-west has 73. I wrote to him about a young man whose cancer was misdiagnosed, but I have not had a response. I would say Wales is doing much better than the Secretary of State.

    Sajid Javid

    That is a very strange comment about the hon. Lady’s colleagues in Wales. Either she does not know or she is deliberately saying something she does not quite believe. Perhaps I can make her aware of the facts in Wales, where the number of people waiting more than two years for treatment currently stands at more than 70,000. That is more than three times the figure in England. That is more than three times the figure in England. It is at 70,000, and the hon. Lady seems to be very comfortable with that. I am surprised—it tells us all we need to know about Labour’s ambitions for government if she thinks that is acceptable.

    Sarah Champion (Rotherham) (Lab) rose—

    Sajid Javid

    Maybe the hon. Member for Rotherham (Sarah Champion) can tell us whether she agrees with her hon. Friend the hon. Member for Blackburn (Kate Hollern) on Wales.

    Sarah Champion

    The Secretary of State knows we are having a debate about the whole UK, but I am asking him specifically about England and his responsibility. Can he answer the original question from my hon. Friend the Member for Blackburn (Kate Hollern), which was about the Prime Minister’s 2019 commitment to 6,000 extra GPs? We know there are 1,000 newly qualified foreign GPs who are about to be deported by his Government, plus students who are unable to complete their studies because this Government are not providing them with the money for the final years. Under the management of the Secretary of State’s Government in the last decade, we have lost 4,500 GPs. Can he talk about what he plans to do to replace them?

    Sajid Javid

    I am happy to talk about that. Because of the record funding this Government have put in, both pre and post pandemic, we are seeing record increases in the workforce across the NHS. When it comes to GPs, since March 2019 we have seen an increase of some 2,389. On top of that, we have seen a further increase of more than 18,000 full-time equivalent staff working in other important primary care roles. That is in England—I am talking about England numbers.

    Of course, we are working hard towards the targets we have set. We are also seeing more GPs in training in our medical schools than ever before, with more medical schools operating than ever before. I hope the hon. Lady will welcome that result and that investment.

    Steve Brine (Winchester) (Con)

    We are talking about GP and dentistry services today, but the wider primary care family includes community pharmacy and ophthalmology, the vast majority of which are not NHS providers but operate under contract providing NHS services. In my excellent right hon. Friend’s second year in the Health Secretary job, will there be a ruthless focus on the wider primary care landscape? When it comes to prevention, surely those people must be the front door of the NHS to ensure that the system is sustainable in the long term.

    Sajid Javid

    Yes, absolutely. I know my hon. Friend speaks with great experience in this area. I am just about to come on to some of the changes we will be making to primary care, which I am sure he will welcome.

    Andrew Selous

    When the Secretary of State goes back to the Department, will he have a quick look at how it is that, in Leeds, north-east Lincolnshire, Fylde and Wyre and Stockport in the past six-and-a-half years, we have increased the number of GPs by between 18% and 22%? I am curious to know whether there are any lessons we can draw from those areas for the rest of the country. Will he ask his officials to look into that to see whether there are useful points for us?

    Sajid Javid

    I will, and I will get back to my hon. Friend on that issue with more detail. I hope he welcomes the investment we are seeing and the record numbers of doctors and GPs in training.

    Richard Fuller

    I know my right hon. Friend is coming on with some more ideas, but from talking to GPs across my constituency, one of the issues I have found is that, as we have diversified primary care staff beyond GPs to paramedics and others, the role of what might be called receptionists and telephonists has moved far more into triage. It is now a more complicated role. Is he attracted to the idea in the Policy Exchange document of creating an NHS gateway to provide more medically qualified staff at that first point of entry to GPs, but on a nationalised basis, available via internet, telephony and the cloud?

    Sajid Javid

    Yes, I am. I have seen the report my hon. Friend refers to and have discussed aspects of it with its authors, so the short answer is yes.

    Imran Hussain (Bradford East) (Lab)

    Will the Secretary of State give way?

    Sajid Javid

    I will later.

    In terms of the changes we are making, let me first turn to primary care. The hon. Member for Ilford North, in his motion today, is calling on me to

    “urgently bring forward a plan to fix the crisis in primary care”,

    as he puts it. That is his motion. He is probably too busy supporting the strikers to have read my speech to the NHS Confederation last week. Had he bothered to listen to or read what I said in that speech, or the similar words from Amanda Pritchard, the chief executive officer of NHS England, he would have heard me acknowledge that our current model of primary care simply is not working. I have made no secret of that, or of my desire for change.

    We are now working on a plan for change and, based on today’s motion, I will be glad to count on the hon. Gentleman’s support when we bring those plans forward, because what he has asked for, we are already doing. Our plans, for example, include a much bigger expansion in what our fantastic pharmacists can do. In fact, on the very day that I made that speech in Liverpool, we also announced a new pilot scheme to allow people with signs of cancer to be assessed and referred by pharmacists. That is yet another example of how we are working hard to enhance the role of our brilliant pharmacists and thereby freeing GPs to spend more time with their patients.

    Imran Hussain

    Thus far, if I have got this right, the Secretary of State has told us that there have been record levels of investment across our NHS services, including GPs and hospitals, and that any minor concerns that have arisen are because of the covid years. Does he think that the British public have been asleep for the last 12 years? Does he think that the British public will buy this? The stark reality on our streets—the Secretary of State may want to go and have a look—is as dire as it has ever been.

    Sajid Javid

    As I said—I am glad that the hon. Gentleman was listening—there have been record levels of funding in the NHS, and, as we set out in our spending plans, that will continue. But that is no thanks to the hon. Member for Ilford North and his colleagues, who all voted against that record funding. They wanted to deny those resources to their constituents. He should reflect on the impact of that had their wish gone through the House.

    On the changes that we are making, we are going further, from improving telephone services to letting others such as nurses and pharmacists complete fit notes. Appointment numbers are already exceeding pre-pandemic levels—for example, in April, GPs and their teams were delivering 1.26 million appointments per working day. That is a phenomenal achievement, which the hon. Gentleman should be commending, not castigating.

    The hon. Gentleman raised Wakefield and primary care. He was using dodgy numbers, so he was corrected by my hon. Friend the Member for South West Bedfordshire. He also gave out further dodgy information by somehow claiming that the King Street walk-in centre was under threat. I do not know if you have seen this in the by-elections, Mr Deputy Speaker, but the Labour party has a history of just making things up and creating fake news to scare local people. That is the respect that they show for local people. The walk-in centre has never been under threat. The local clinical commissioning group has confirmed that it has never been under threat. If he had any decency, he would stand up and withdraw his remarks. I give him that chance.

    Wes Streeting

    I would have thought that the Secretary of State would have learned by now that it is silly to give way to me when he makes these facile points. It is absolutely the case that the walk-in centre’s future was in jeopardy. It is absolutely the case that Simon Lightwood campaigned to save it. If that is what Simon Lightwood can achieve as a candidate, imagine what he will do as Wakefield’s next Labour MP.

    Sajid Javid

    The hon. Gentleman is now using the past tense. A moment ago, he claimed that it was under threat. He clearly has no issues with giving false information in this House. The truth is that, if Wakefield wants a better future, as everyone in Wakefield deserves, only one by-election candidate can provide that, and that is Nadeem Ahmed.

    We intend to go much further to build a truly 21st-century offer in primary care. That includes Dr Claire Fuller’s independent review, which I found to be extremely valuable, and the changes that will stem from that as well as the many others that we will bring forward shortly. We will work with the population and the profession alike. The hon. Gentleman was right to focus on the importance of the profession, but he did forget to mention, as I referred to earlier, that since March 2019 we have more than 2,380 additional GPs in primary care, record numbers of doctors in training and more than 18,000 additional primary care professionals.

    Let me turn briefly to the important steps we are taking in dentistry. Urgent care has been back at pre-pandemic levels since December 2020, and the 700 centres for urgent care that we set up to provide treatment for patients during this difficult period have helped thousands of patients across the country. At the start of this year we put an additional ÂŁ50 million into NHS dental services, which boosted dental capacity by creating 350,000 extra appointments. Dentists are currently required to deliver 95% of pre-covid activity, and we are planning to return to 100% shortly. I commend all the dentists who are already achieving that.

    Paul Blomfield (Sheffield Central) (Lab)

    The Secretary of State referred to an additional ÂŁ50 million. As he knows, the way in which that was framed made it difficult for dentists to draw down the money. Will he tell the House how much of it has been drawn down and used?

    Sajid Javid

    I do not have the exact figures to hand, but I know that millions of pounds were drawn down and used to deliver tens of thousands of appointments across the country. That made a huge difference to a great many people.

    Greg Clark (Tunbridge Wells) (Con)

    The urgent care centres are an important innovation, but it is also important for them to be accessible throughout the country. There are seven in Kent, but the one nearest to my constituents is 33 miles away. Could my right hon. Friend intervene with the NHS in the south-east to bring about a more even distribution?

    Sajid Javid

    My right hon. Friend’s point is important and well made, and I will look at the issue closely and get back to him, if I may.

    As we have already heard today—but it is such an important point—the challenge for NHS dentistry predated the pandemic. It is not just about the number of dentists in England, but about the completely outdated contracts under which they are working, which were signed under a Labour Government. [Interruption.] Labour Members do not like it, but it is true. These contracts mean that we are operating almost with one hand tied behind our backs. They do not incentivise prevention, they hold back innovation, and they mean that hard-working families cannot get the dental services that they deserve. However, we will now be changing that; our work with the sector, along with the work of Health Education England on recruitment and retention, will be vital for the future.

    Lilian Greenwood

    Will the Secretary of State give way?

    Sajid Javid

    I will in a moment.

    If there is one thing that unites all our work on primary care and dentistry, it is this. We are shifting to a new mode of operating—one that is about helping the whole population to stay healthy, not just about treating those who ask for help. We need to get to a place where we are healthier for longer, because freedom is hollow without our health.

    Our new Health and Social Care Act 2022 is an important step in that ambition. Statutory integrated care systems will be responsible for the funding to support the health of their respective areas—not just treating people, but helping people to stay healthy in the first place. The Act also allows us to make safe and effective public health interventions such as water fluoridation, and we will set out further plans for that shortly.

    Prevention, personalisation, people and performance: those will be our watchwords for modernising NHS services. They will sit at the heart of everything to come, from the health disparities White Paper to the update of the NHS long-term plan. While the Opposition continue to go off the rails, we remain firmly on track, laying down our plans to deliver a truly 21st-century offer for the profession and, most of all, for patients.

  • Wes Streeting – 2022 Speech on Access to GP Services

    Wes Streeting – 2022 Speech on Access to GP Services

    The speech made by Wes Streeting, the Labour MP for Ilford North, in the House of Commons on 21 June 2022.

    I beg to move,

    That this House notes that primary care is in crisis, with people across the country struggling to access GP services and dental treatment; believes that everyone should be able to get an appointment to see a doctor when they need to and has the right to receive dental treatment when they need it; is concerned by the Government’s failure to remain on track to deliver 6,000 additional GPs by 2024-25; and therefore calls on the Secretary of State for Health and Social Care to urgently bring forward a plan to fix the crisis in primary care, meet the Government’s GP target and ensure everyone who needs an NHS dentist can access one.

    Mr Speaker, thank you for the opportunity to open this debate on the future of primary care, access to GPs and access to dentists. It is a particular delight to see the Secretary of State here. I so enjoyed our exchange of letters last week that I cannot wait to repeat the exchange in real life.

    Primary care is the front door to our NHS—for most of us, the general practitioner is the first port of call when we are worried about our health—but after 12 years of Conservative mismanagement and underfunding of our health service, the front door is jammed. Patients are finding it impossible to book GP appointments, serious conditions are going undiagnosed, patients are waiting longer than is safe for treatment, with backlogs building up and greater pressure placed on the rest of the health service, and millions of people are waiting more than a month to be seen, often in pain and discomfort.

    Catherine West (Hornsey and Wood Green) (Lab)

    My hon. Friend has made an excellent beginning to his speech. What is his view of my local hospital, where, instead of 350 people daily, we have 710 people coming into accident and emergency at the North Middlesex Hospital? What response does he have to that kind of demand? Where is it going to lead if people cannot see a GP? They are going to end up in A&E.

    Wes Streeting

    My hon. Friend is absolutely right to highlight that problem. If the front door of the NHS in primary care is jammed, people end up presenting in A&E. As I shall outline in my speech, this is not only a great inconvenience and burden to patients; it comes at an additional cost to the NHS and we all pay the price for that in every respect.

    Alex Cunningham (Stockton North) (Lab)

    At the GP practice in Norton in my constituency, it is almost impossible to get an appointment on the phone. I have dozens of cases of individuals unable to access vital care. One tried 196 times. The Care Quality Commission has not inspected this practice since 2015. Does my hon. Friend agree that it ought to be doing so now?

    Wes Streeting

    Even in the context of the pressures that we see right across primary care—I think every GP practice would acknowledge they face challenges—the case my hon. Friend has just described sounds extreme. We cannot allow the decade or more of mismanagement we have seen from this Government to excuse that kind of care, or indeed absence of care, for patients, and that brings me on to the next point I want to make.

    We know why patients are forced to wait: Conservative Governments have cut 4,500 GPs over the last decade, they have closed 300 practices since the last election and they have failed to provide any meaningful reform of the system. The public are sick and tired of waiting. Public satisfaction with GP services stands at the lowest level on record as patients become ever more frustrated with not getting an appointment when they need one, or in a manner to suit them.

    It says so much about the NHS at the moment that, while we have the lowest level of patient satisfaction since 1997, when we ask the public whom they trust, nurses and doctors are right up at the top of the list. The public understand that the staff who work in the NHS are trying to grapple with the biggest crisis in its history. Of course, the Government will want to pin that simply on the pandemic, but that does not explain why we went into the pandemic with NHS waiting lists already at record levels, with 100,000 staff vacancies in the NHS and with a decade or more of under-investment, leaving us ill-prepared for the pandemic—or, in the words of the Culture Secretary, “found wanting and inadequate”—but also now struggling to get the recovery from the pandemic that we need to build the health and care service we need for the future.

    John Redwood (Wokingham) (Con)

    The shadow Secretary of State says that we need GP reform. What kind of reform does he have in mind? What does he think should be the right balance between in-person, online and telephone consultations?

    Wes Streeting

    I am grateful to the right hon. Gentleman for that intervention. I will conclude my speech by talking about what a Labour Government will do, but let me answer his direct point about the range of options through which people should be able to access their GP. I value patient choice. Thinking back to my experience of accessing NHS services last year—as many people know, I did quite a lot of mystery shopping on the NHS—I had a range of interactions with GPs. Some were face-to-face. Some interactions at my GP surgery were not with my GP but with a nurse, which was entirely appropriate and much appreciated. Some of my engagements with my GP were over the telephone. I also had a video consultation with a dermatologist. I really valued that flexibility and range of approaches.

    I think that the future for primary care has to be different courses for different horses. Of course, people should have a right to see their GP when they want to see their GP—I am clear about that—but there is also a range of ways in which we can offer more flexible access to GPs, particularly for working people who do not necessarily want to traipse down to the GP surgery in the middle of the afternoon if it is something that could be dealt with over the phone or on a video call.

    Layla Moran (Oxford West and Abingdon) (LD)

    The shadow Secretary of State is making a powerful speech. I commend in particular the point he made that people still trust their doctors. They are desperate to see them, even if it is online. A 74-year-old constituent of mine contacted me and said that he asked for an online appointment but it would take him 30 days to get there. He appreciates that the issue is not with GPs but with the Government’s lack of planning for the number of GPs who can provide that service in Oxfordshire.

    Wes Streeting

    The hon. Lady makes a powerful point. How is it that the NHS can be one of the largest employers in the world—it employs 1.2 million people—but does not have a workforce plan and strategy that says, “This is the workforce need that we have today, this is what the workforce need will be in the foreseeable future and, in the longer term, this is how we need to change the shape of the workforce to take into account advances in medicine and modern technology, and the changing demographics of our society”?

    We gave the Government the opportunity to commission such a report when we debated the Health and Care Bill. It was supported on a cross-party basis, including by the Chair of the Health and Social Care Committee, the right hon. Member for South West Surrey (Jeremy Hunt)—sadly, he is not able to be with us at the moment—yet the Government voted against it. What is it about the ostrich mentality of the Secretary of State and his ministerial team—or, I suspect even more, that of the Treasury—that they would rather bury their heads in the sand, pretend there is no problem with workforce and not even count the numbers of doctors and nurses needed because they worry that the Treasury might face up to the reality of what they need to provide?

    Alison McGovern (Wirral South) (Lab)

    Is it not the case that, in the pandemic, the Government fundamentally misunderstood the connection between the health of the nation and its economic success? All the argument the shadow Secretary of State makes about the NHS workforce and what they can achieve for our country shows that the Government are still making the very same mistake.

    Wes Streeting

    I wholeheartedly agree with my hon. Friend, who understands well the link between the health of the nation and the health of the economy. Given the labour market challenges in this country, it is simply not acceptable that we are losing so many people who could be in the labour market to ill health. We are also losing so many people from the labour market who are caring for relatives, because there is a disproportionate burden on families. Who disproportionately bears the burden of that care? It tends to be women, so we are losing a whole tranche of women from the labour market who could be contributing to the growth of the nation and the economy.

    Several hon. Members rose—

    Wes Streeting

    I will give way one more time and then I need to make some progress.

    Jim Shannon (Strangford) (DUP)

    It is not just about GPs and surgeries; it is about dental access as well. In my constituency and across the whole of the United Kingdom of Great Britain and Northern Ireland, dentists are prepared to take private care and monthly care, but they will not take NHS patients. As poverty levels and prices rise, dentistry is at the end of the queue. Does the hon. Gentleman agree that dentistry is at crisis point and that Government intervention is absolutely critical?

    Wes Streeting

    The hon. Gentleman is right to describe the state of dentistry and I will be getting my teeth into that issue very shortly.

    [Hon. Members: “Groan!”] It had to happen at some point. I had to get it in at some point. Let me touch on the other issue he mentions, which is about inequality and inequality of access.

    The system in primary care is entirely unequal. Some areas have twice as many doctors as other parts of the country, with as many as 2,800 patients fighting over one family doctor. Patient safety is being put at risk. Last week, the BBC revealed the scale of the crisis in GP surgeries with its investigation into Operose Health. Patients who can get an appointment are seen by less qualified staff, standing in for GPs without supervision. Patient referrals and test results were left unread for up to six months: private profit placed above patient safety. When the Health Secretary was asked about that last week, he said:

    “we expect local commissioners to take action.”—[Official Report, 14 June 2022; Vol. 716, c. 140.]

    Well, it is not good enough to sit back and wait for others to act. Is an investigation happening? Can he tell us? If not, why on earth has he not launched one? [Interruption.] The Under-Secretary of State for Health and Social Care, the hon. Member for Lewes (Maria Caulfield), from a sedentary position, talks about the last Labour Government. When are the Conservatives going to wake up to the fact that they have been in government for 12 years? Twelve years! It is remarkable. Twelve years they have been in government.

    Felicity Buchan (Kensington) (Con) rose—

    Wes Streeting

    Perhaps the hon. Lady could tell us why they want to run away from their record of 12 years.

    Felicity Buchan

    I thank the hon. Gentleman for giving way. He makes grand statements in support of the NHS, but I am afraid his actions do not support the NHS. He has backed these train and tube strikes today, which have meant that in my constituency patients cannot get to hospital, and nurses and doctors cannot get to their places of work. Can we have better action, rather than words?

    Wes Streeting

    I am very, very grateful to the hon. Lady for that intervention. Our party has been clear: we did not want to see the strikes go ahead. We believe the strikes could have been averted if the Government had shown responsible action. The absolute brass neck of the Secretary of State! It is one thing pretending they have not been in government for the last 12 years; now they are pretending they are not in government today and that, somehow, it is down to me, the shadow Health Secretary. Somehow, if I had uttered the magic words, “Don’t go ahead,” the RMT would have said, “Oh no, the shadow Secretary of State for Health has spoken now. We better put a stop to it.” [Interruption.]

    Mr Speaker

    Order. I want to help a little bit. We do not want to open up a debate that is not down for today. We have got a little bit carried away. The hon. Member for Kensington (Felicity Buchan) got in, and I was quite right to allow a response, but I think we have heard enough now.

    Wes Streeting

    Thank you, Mr Speaker.

    I was about to quote the great political philosopher, Jonn Elledge, who, in response to what the Secretary of State said, commented on Twitter that we are

    “all as ants before the might of the all powerful shadow health secretary”.

    When is the Health Secretary going to wake up to the fact that he is in government, he has responsibilities, he is discharging the greatest crisis in the history of the NHS and he is doing nothing about it? Instead of lecturing the Opposition, when is he going to show some leadership and get on with governing?

    Clive Efford (Eltham) (Lab)

    The “Panorama” programme also exposed the fact that GP practices are being hoovered up by the private sector. Operose Health now owns 70 practices, with more than 600,000 patients. That exposes the fact that there is now a value to GP patients lists and that they are being sold on. They are collected by GPs, free of charge and then, as they are amassed in great number, they are sold to the private sector. Is my hon. Friend, like me, concerned about that practice?

    Wes Streeting

    I wholeheartedly agree with the point my hon. Friend makes. It is simply not good enough for the Minister to keep on talking about what the last Labour Government did. If she does not agree with the situation described by my hon. Friend, which is happening on her watch, why does she not legislate? If she is incapable of governing, she should make way for people who can govern.

    Catherine McKinnell (Newcastle upon Tyne North) (Lab)

    I commend my hon. Friend for the tone of the speech that he is making, because it is vital that we stand up for our NHS, which the Government are failing to do. They seem happy to let everybody be angry with their GPs and about their inability to seek the medical help they need, but very unwilling to do something about it. Is this argument not really one to be had with the Government entirely? They should be making sure that we have sufficient GPs to treat the people in this country.

    Wes Streeting

    I wholeheartedly agree with my hon. Friend; it is the trend with this Government to seek division, sow division, pass the buck, devolve the blame and not take responsibility for anything. What Opposition Members would not give for just one day of being able to govern in the interests of the people in this country! This Government want to give the appearance of being in office but not governing at all. That is what is happening on their watch. If that is not bad enough, against a difficult economic backdrop, with scarce resources, not only is the way in which they manage and govern bad for patients, but it is squandering taxpayers’ money.

    Dr Caroline Johnson (Sleaford and North Hykeham) (Con) rose—

    Wes Streeting

    I will give way in just a moment. The problems in general practice are storing up problems for the rest of the NHS; as we have heard, people are presenting in accident and emergency because they cannot see a GP. That failure is costing the taxpayer dearly. A GP appointment costs the NHS £39, but a visit to an urgent care centre costs it £77 and a visit to the emergency department costs it £359. The Government’s failure to invest in new GPs may be penny-wise but it is pound-foolish. It is wasting money and inconveniencing patients, and it is not the way to manage the NHS. One of my constituents wrote to me yesterday to say that if she wants a same-day appointment for her baby, her GP sends her to A&E. She wrote:

    “I was sent to A&E to check a newborn baby’s suspected ingrown toenail that had no sign of infection. How is going to A&E for a non-urgent matter a good thing for anyone.”

    Yet that is what our constituents are forced to do, because they cannot get a GP appointment. I hope the hon. Member for Sleaford and North Hykeham can give us some insight as to why.

    Dr Johnson

    As part of that, I suggest that the hon. Gentleman remembers that GPs take 10 years to train. He is right to say that we have been in government for 12 years, but most of the current GP shortage is because the previous Labour Government did not train those GPs at the time. One of the first things the Conservative Government did was to set in train the opening of five medical schools to increase the number of medical students. We had enough doctors but they do take 10 years to train. The reason I stood up to intervene on the hon. Gentleman was to say that one of the challenges that doctors—I refer to my entry in the Register of Members’ Financial Interests, as a doctor—and members of staff face is being abused in a surgery. I wonder whether he would like to apologise for some of the comments he has made on social media—

    Mr Speaker

    Order. Interventions are meant to be questions. I know that the hon. Member is down to speak. I would not want you to use up your speech now; I want you to save something for later.

    Wes Streeting

    Let me first say in response to the final point the hon. Lady made that there is absolutely no excuse for abusing NHS staff whatsoever. Most people in this country do not blame NHS staff for the state of the NHS; they place the blame squarely where it belongs, with the Government who have been in power for the past 12 years. Her first point would be more powerful if we did not have 1,500 fewer full-time equivalent GPs now than we did when her party came to power. Her point would have been more powerful if her party had not whipped its MPs to vote against having a workforce plan for the NHS, but I am afraid that that is what it did. Conservative Members cannot run way from their choices and decisions, and from the fact that they have now been in government for 12 years and there is no one else to blame but themselves. In communities right across the country, we now see the consequences of their mismanagement.

    Jonathan Edwards (Carmarthen East and Dinefwr) (Ind)

    I regret to inform the hon. Gentleman that the situation in Wales is not much better, but I do not want to make a party political point. Will he commend the potential role that pharmacists can play in alleviating pressure on GPs? I have an excellent pharmacist in my home village of Pen-y-Groes, which provides an invaluable service for the communities in my area.

    Wes Streeting

    I wholeheartedly agree with the hon. Gentleman’s point about the importance of looking at primary care as a whole and the really powerful and valuable contribution that community pharmacies can make, alleviating pressures on other parts of the primary care system, particularly general practice.

    Communities across the country are experiencing those problems; let me take one place at random to illustrate the scale of the challenge. Today, after a decade of Conservative mismanagement, the city of Wakefield has 16 fewer GPs than in 2013. In fact, Wakefield has not seen a single additional GP since the Prime Minister promised 6,000 more at the last election, and since Wakefield has been served by a Conservative MP—albeit, thankfully, no longer—it has seen three GP practices close, with some surgeries so short-staffed that 2,600 patients are left to fight over one family doctor. Last month, patients in Wakefield were able to book 25,000 fewer GP appointments than in November 2019, the last month in which they were served by a Labour MP. The only good news for general practice in Wakefield in recent years has been that Simon Lightwood, an NHS worker and brilliant candidate in Thursday’s by-election, has successfully campaigned to save the King Street walk-in centre. [Interruption.] They don’t like it. Conservative Members shout in protest and point the finger at us, but they have been in government for 12 years.

    Richard Fuller (North East Bedfordshire) (Con)

    The hon. Gentleman is talking about problems, but his motion does not include one solution. He has now been speaking for 20 minutes, and he has not outlined one solution. If he wishes to be taken seriously as a politician, will he now turn to some solutions to the problems he has outlined?

    Wes Streeting

    It is certainly true that I am saving the best until last in my speech, but the hon. Gentleman may have missed the point I have made repeatedly, which is that the NHS—an organisation that employs more than 1.2 million people—needs a workforce strategy. It needs a proper analysis of what its workforce needs are today, the workforce needs of tomorrow, and the future shape of the workforce. We gave Government Members the opportunity to vote for that; the hon. Gentleman voted against it, and he wants to lecture me about being taken seriously as a politician. Who is he trying to kid? I do not know how the hon. Gentleman voted, because it was a secret ballot, but the fact that a majority of Government Members voted to keep the current Prime Minister in office means that they are not in any position at all to lecture anyone else on who is and is not a serious politician.

    Andrew Selous (South West Bedfordshire) (Con)

    I am very grateful to the shadow Secretary of State for giving way. I have in front of me figures from the House of Commons Library on the increase in GPs per 100,000 population between September 2015 and April 2022, which show an 8% increase for Wakefield.

    Wes Streeting

    I notice that the hon. Gentleman has played the old trick of selecting figures from a specific set of years, but nothing he has said contradicts the facts that I have outlined. In any case, the people of Wakefield will draw their own conclusions on Thursday when they go to vote. The fact is that the Government have had more than enough time to reform general practice in this country, and they have no one other than themselves to blame for the crisis we are in.

    Since the Conservative party has been in government for the past 12 years, I thought I would take a trip down memory lane to remind us, the House and the British people exactly what they have been promising since they were first elected in 2010. The 2010 Conservative party manifesto promised that GP surgeries would be open 12 hours a day, seven days a week. The Government failed to deliver that—maybe they blame their coalition partners, although I do not think the Liberal Democrats would have disagreed with GP surgeries being open for that long—so they promised the same again in 2015. That time, they set themselves a deadline of 2020, and guess what? They missed that, too.

    In 2015, they promised that everyone over the age of 75 would get a same-day appointment—another promise broken. They said they would hire 5,000 more GPs by 2020—another promise broken. In 2019, they promised 6,000 more GPs, but the Health Secretary has already admitted that he is on course to break that promise, too. They promised 50 million more GP appointments a year, but as the British people know from their experience, appointments are down. That is today’s Conservative party: over-promise and under-deliver, never take responsibility, and leave patients paying the price.

    Lilian Greenwood (Nottingham South) (Lab)

    This morning, one of my constituents contacted me to say she was standing outside her GP practice at 7.15 am in order to secure an appointment. She said that she was successful in securing an appointment, but a number of people who were also standing outside did not. Does my hon. Friend remember the Health Secretary promising that people would have to do that in order to secure a GP appointment?

    Wes Streeting

    I wholeheartedly agree with my hon. Friend. This is the problem: they overpromise and underdeliver. If they will not hear it from me, Mr Speaker, let us remind ourselves of what some of the Secretary of State’s colleagues have said. The hon. Member for South West Bedfordshire (Andrew Selous), who is in the Chamber, said in Prime Minister’s questions only last week:

    “At one of my surgeries, which has double the recommended number of patients per GP, the bowel cancer diagnosis of a 51-year-old father of four was missed and is now terminal.”—[Official Report, 15 June 2022; Vol. 716, c. 283-4.]

    Earlier this month, the hon. Member for Telford (Lucy Allan) read a letter from a constituent to the Health Secretary. It said:

    “Trying to get basic healthcare is a joke in Telford. Maybe I would be better off in…a third-world country”.

    If the Secretary of State is not going to listen to us, he should at least listen to his own side. Before Conservative Members leap to the defence of their Government’s record, they should probably go back and check the record to make sure that they had not agreed with us in the first place.

    As for dentistry, 2,000 dentists quit the NHS last year, around 10% of all dentists employed in England. It is an exodus under the Government’s watch. Four million people cannot access NHS dental care and cannot afford to go private either.

    Alex Sobel (Leeds North West) (Lab/Co-op)

    My hon. Friend is making an excellent speech. My constituent, Ellie Cokeley, wrote to me. She works as a receptionist in a local dental practice and gets hundreds of calls a week from upset members of the public who are unable to find an NHS dentist. She said that it feels greatly unjust that the poorest in our society are being forced to pay huge amounts for vital dental care or, worse still, having to continue without any at all. Are the Government not failing people in this country when it comes to the care of their teeth? It is vital that we get more dentists in the system.

    Wes Streeting

    My hon. Friend is absolutely right. Some places, such as Somerset, are dentistry deserts because the remaining NHS dentists are not taking on new patients.

    Several hon. Members rose—

    Wes Streeting

    I will give way first to my hon. Friend the Member for Washington and Sunderland West (Mrs Hodgson), then to my hon. Friend the Member for Hackney South and Shoreditch (Dame Meg Hillier) and then to the hon. Member for Caithness, Sutherland and Easter Ross (Jamie Stone).

    Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)

    My hon. Friend mentioned Somerset, but can I also mention Sunderland, to keep up the alliteration? In Sunderland, we cannot find an NHS dentist and the few good ones we have are now turning to private practice to make it work. It is an existential crisis in dentistry—it really is at breaking point. Does my hon. Friend agree that the blame lies squarely with the Conservative Government, with backlog Britain, and that this is the effect on our constituents?

    Wes Streeting

    My hon. Friend is absolutely right about the state of dentistry. It is not alliterative, but I suspect that my hon. Friend the Member for Hackney South and Shoreditch has similar points to make.

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

    A constituent of mine told me that she had a terrible toothache, rang 111 and was assigned to an emergency dentist. The system worked, but does my hon. Friend agree that that that costs the taxpayer so much more money? My hon. Friend talks about overpromising and underdelivering, but with dentistry the Government have not even promised anything and they are underdelivering.

    Wes Streeting

    My hon. Friend knows exactly what she is talking about. Of course, there is no one better in this House to make the point about the waste of public money. That is the outrageous thing about all of this. People are paying more and getting less. Their taxes have been put up, justified in the name of the NHS, but the money is not being directed in the right way to deliver better care. In fact, the Government admit that even with the investment they are putting in, people will be waiting longer for care and that is a disgrace.

    Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)

    I thank the shadow Secretary of State for giving way. He is very civil. Can I also go down memory lane? We have had a Government of a rather different colour in Scotland since 2007, and today I have constituents coming to me and saying, “I cannot get on an NHS dentist’s list”. That echoes the point made by the hon. Member for Strangford (Jim Shannon). Does the shadow Secretary of State agree that in the event of the present Government sorting this situation out, they would do well to share what they did with the Scottish Government? And in the event of a change of Government after the next general election, will the shadow Secretary of State commit to giving advice to the Scottish Government?

    Wes Streeting

    This is the thing that the First Minister of Scotland does not want to acknowledge, but for all her noise, bluff and bluster she knows full well that a Labour Government here in Westminster would be good for the people of Scotland. The investment and reform that we would put into the NHS to deliver the same kind of results as the previous Labour Government did would be good for the people of Scotland. I look forward to the day when I can phone the Scottish Government to give them some advice and I look forward to the day when the Governments in Westminster and Edinburgh are Labour Governments delivering for people across the United Kingdom.

    The hon. Member for Caithness, Sutherland and Easter Ross (Jamie Stone) mentioned the trip down memory lane. The Under-Secretary of State for Health and Social Care, the hon. Member for Lewes, regularly blames Labour for what is happening in dentistry. That is because of something that happened 16 years ago: it was a contract that was put in place by the last Labour Government, which we committed to reform in our 2010 manifesto. Unfortunately, that manifesto was never implemented. The tragedy is that the Conservative manifesto that promised reform of the dentistry contract was not implemented either.

    In 2010, the Conservatives promised to introduce a new dentistry contract. In 2017, they also promised to introduce a new dentistry contract. What is the Minister’s policy today? She promises to introduce a new dentistry contract. She must make up her mind: either, the current contract is so good that every time she tries to change it, she cannot find a way of improving it, or, the Minister’s Department, her Secretary of State and her Government are so incompetent, so distracted, or so indifferent, that they simply cannot get the job done. It is no good their blaming the Labour party for the problems in NHS dentistry. They have been asleep at the wheel for 12 years. They have failed to do anything to improve the service, and now 4 million people cannot access a dentist. The consequences are severe.

    Let me tell the Health Secretary about a constituent of my right hon. Friend the Member for Normanton, Pontefract and Castleford (Yvette Cooper). She tells me that this constituent cannot get a dentist appointment anywhere for an unbearable toothache, and that they are in too much pain to sleep through the night. When they contacted a dentist, they were told that they would have to wait two years for an appointment. They wrote in an email:

    “I am in such agony that I took Ibuprofen, drank whisky and tried to pull it out myself with plyers, but they kept slipping off and it was agony.”

    What kind of country have we become when the most common reason for children to go to hospital is to have their teeth extracted? We have 78 children going to hospital every day to have their teeth extracted. [Interruption.] There is no point Members arguing from a sedentary position that it is because of fizzy drinks. That is their approach all the time. The system is broken, so let us blame the patients. It is absolutely outrageous. DIY dentistry in one of the richest countries on the planet, and their answer is to blame the patients. They should get real. This is so far from that original promise of the NHS, where care is provided to all who need it, when they need it.

    To be fair to the Health Secretary, he has been in the role for just under a year, and, on that note, I would like to wish him a happy anniversary this Sunday for one year in the job. But I am afraid that that is where the niceties end, because I will now run through what he has said and done in his year in charge. He had a big media splash on “league tables for practices” to pressure them into doing more face-to-face appointments and then he backed down. He achieved great headlines on “nationalising GPs” in January—imagine the excitement—but there has been no action since. He talks about bringing the NHS into the Netflix age. Has he ever actually used the NHS app? I cannot even book a GP appointment through the app because my GP is not on it. Why is it still not available to every patient as a way to book appointments? I visited Israel recently—I refer to my entry in the Register of Members’ Financial Interests—where it has embraced the technological advances in medicine over recent years to massively improve access to healthcare for patients.

    I was talking to a start-up, which is developing an app that tracks the recovery of stroke victims, and notifies them when they need to see a physio. I then showed the staff what the NHS app can do and what it cannot do and they laughed. In some senses, the Health Secretary had a point: the NHS is not as modernised as it needs to be to deliver for patients, and nowhere is that more true than in primary care. It is an analogue service in a digital age. Patients should not have to wake up at 8 in the morning and wait on the phone for an hour for an appointment. They should not be told to expect a call back, but given no indication as to what time that will be, and then be considered a missed appointment if they do not pick up because they are at work, or are busy, or are picking up the kids and doing everything else that people do between nine and five.

    People have never been so well-informed about their own health. We carry around with us devices that can measure our exercise, our heart rate, how well we sleep, and so much more. Yet our healthcare system puts none of this to use and keeps all the pressure on GPs.

    Let me conclude by outlining some of what a Labour Government would do to address this crisis—[Interruption.] I am not surprised that Conservative Members are excited; they must be as fed up as we are. First, we would take immediate practical steps to boost the number of GPs available. Why have the Government sat idly by while doctors are forced to retire early, for no other reason than that the cap on their pension contributions means they pay a financial penalty for staying on? Let us change the rules to keep the good doctors we have. Why is it that, at the last count, 800 medicine graduates had not been able to find junior doctor posts? Let us get them to work immediately—

    The Secretary of State for Health and Social Care (Sajid Javid)

    That is rubbish!

    Wes Streeting

    It is rubbish, but it is his record.

    Why is it that so many people are accessing NHS services because of a failure to invest in social care, where staff can be recruited and deployed a lot faster? On the dentistry contract, the last Labour Government acknowledged that the 2006 contract was not good enough, which is why we put the reform of that contract in our 2010 manifesto. The difference is that we will not wait 12 years to deliver the promise after the election of the next Labour Government. Those are just some of the practical steps that we would take immediately and that the Government could take immediately.

    Let me tell the House about some of the fundamental issues we would fix. First, mental health services in this country are in such a state that GPs are seeing more and more of their own cases present with mental ill-health. A Labour Government would recognise that there has been a surge in mental ill-health following the pandemic and we would not leave it to overwhelmed GPs to see them. That is why we have committed to recruiting 8,500 new mental health professionals, including specialist support in every school and mental health hubs in every community. We would pay for that by ending the charitable status of private schools and closing the tax loopholes enjoyed by private equity fund managers—and do not tell me the Health Secretary does not know where they are; he was using them before he became a Member of Parliament.

    That policy—[Interruption.] Conservative Members are funny. They ask for our policies but they do not like it when we provide the answers, because we have them and they do not. That policy, which would put mental health hubs in every community and support in every school and speed up access to treatment for everyone in our country, would help to reduce pressure on GPs and to deliver better mental health treatment in every community and faster access to a GP for everyone else who needs to see them. It also tells you something about the choices we would make and the priorities we would have as a Labour Government: better public services enjoyed by the many, paid for by closing tax perks for the few.

    I know that there is lots of cynicism about politics. We have a Prime Minister who wants people to believe that we are all the same, that things cannot change and that his shambles of a Government are the best that Britain can do. All I would say to the people of Britain is this: judge them on their record and judge Labour on ours. They have been in power now for 12 years. They delivered the highest NHS waiting lists in history, before the pandemic. They delivered record staffing shortages in the NHS with 100,000 vacancies, before the pandemic. They delivered cancer care that worsened in every year since they came to office, before the pandemic. Now they tell us that patients will be paying more and waiting longer.

    The last Labour Government were in power for 13 years, and we delivered the highest patient satisfaction in the history of the NHS, the lowest waiting times on record and more doctors, nurses and new hospitals. There were no threats of strikes in the NHS when we were in government because staff could see the difference we were making and so could the patients. We did not get everything right—nobody is perfect—but Labour’s record on the NHS is one that this Government could not even begin to touch. The longer we give the Conservatives in power, the longer patients will wait. Well, people are sick, and they are tired of waiting. This Government’s time is up.

  • Anne-Marie Trevelyan – 2022 Comments on UK Trade Deal with Gulf Nations

    Anne-Marie Trevelyan – 2022 Comments on UK Trade Deal with Gulf Nations

    The comments made by Anne-Marie Trevelyan, the Secretary of State for International Trade, on 21 June 2022.

    Today marks the next significant milestone in our 5-star year of trade as we step up the UK’s close relationship with the Gulf.

    Our current trading relationship was worth £33.1 billion in the last year alone. From our fantastic British food and drink to our outstanding financial services, I’m excited to open up new markets for UK businesses large and small, and supporting the more than ten thousand SMEs already exporting to the region.

    This trade deal has the potential to support jobs from Dover to Doha, growing our economy at home, building vital green industries and supplying innovative services to the Gulf.

  • Gillian Keegan – 2022 Speech on Battersea Funfair Disaster

    Gillian Keegan – 2022 Speech on Battersea Funfair Disaster

    The speech made by Gillian Keegan, the Minister for Care and Mental Health, in the House of Commons on 21 June 2022.

    I congratulate the hon. Member for Battersea (Marsha De Cordova) on securing the debate. I must admit that I was not aware of the tragic events that unfolded 50 years ago, on 30 May 1972, and I am sure that others were not, either, so it is fantastic that she secured the debate to remind us all. However, I discussed it with my husband when I got home last night. At the time, he was a 10-year-old boy growing up in London. He was very much aware of what happened and he vividly remembers it. What should have been a happy day in Battersea Park, on the bank of the River Thames, resulted in five children losing their lives and a further 13 being injured, and it shocked many more.

    I very much hope that the survivors’ campaign for a permanent memorial in Battersea Park is ultimately successful, so that that terrible event is never forgotten—maybe that is the plaque the hon. Lady referred to, or maybe there is something else that they are still campaigning for.

    Undoubtedly, many affected by the Battersea funfair disaster will have suffered from what we now call post-traumatic stress disorder, but let us not forget that PTSD was not even added to the International Classification of Diseases until the ’80s, and guidance from the National Institute for Health and Care Excellence was not published until 2005. Events have taught us that people affected by any traumatic incident must be able to access timely mental health support when and if needed, but I am not sure there was the same understanding all those years ago.

    Luckily, PTSD can be successfully treated even when it develops many years after a traumatic event. The treatment depends on the severity of symptoms and how soon they occur after the traumatic event. The hon. Lady reports that survivors of the tragedy remain concerned that mental health support for children who have suffered trauma has not changed much since 1972. I too would be very concerned if that was the case, but I must respectfully disagree with that assessment.

    If a child has witnessed or experienced a traumatic event, it is quite natural for them to be stressed, upset or frightened. That should not usually last beyond four weeks, but if it does, it may indicate post-traumatic stress disorder and it is then important to seek help via their GP. There are now some really effective treatments, including cognitive behavioural therapy, for children and young people who are experiencing the effects of trauma.

    To respond to the hon. Lady’s specific question, NHS England and NHS Improvement have issued guidance on responding to the needs of people affected by incidents and emergencies, which stresses that plans for incidents and emergencies must provide psychosocial and mental health care for people affected, since early intervention for people at risk of developing mental health problems may reduce their severity and chronicity and, ultimately, related costs.

    In general, psychological support can be accessed four to six weeks after the event for those who are exhibiting signs of needing professional help, as per NICE guidelines. Those who require urgent support may be referred to services sooner than that, and it is important to ensure that messaging about support services is appropriate. Not all people need psychological support, and many recover over the course of time without specific interventions, but it is still important that such people continue to look after their health and wellbeing after a traumatic incident. That includes getting enough rest, eating well, returning to their routine and staying connected with others.

    Marsha De Cordova

    I just want to ask about the support that is available via NHS England and ensuring that it is available, as the Minister says, within a four to six week period. Can she assure me that that is actually happening? Is there any evidence base to ensure that children who experience trauma or post-traumatic stress disorder are getting that support in a timely fashion?

    Gillian Keegan

    Yes, and of course we always try to ensure that, as the targets we put in are worked throughout the system, those targets are met. That is why we measure those things. Maybe it would be helpful to the hon. Lady if I gave some recent examples. In the wake of the Manchester Arena terrorist attack, which sadly affected many children and young people, the Greater Manchester Resilience Hub was set up to provide a central point for mental health advice for those directly affected, including children and emergency responders. The hub worked with other agencies to develop packages of care.

    In response to the tragic fire at Grenfell Tower, more than ÂŁ10 million has been spent on treating the mental health of those affected. In the year after the fire, 2,674 adults and 463 children were screened for symptoms of post-traumatic stress disorder, and the St Charles Centre for Health and Wellbeing was opened up so that those affected could be treated in dedicated therapy suites. I hope the hon. Lady will recognise that we have seen a dramatic change in both attitudes towards mental health since the days of the Battersea disaster, and the NHS services available to support people with their mental health.

    Jim Shannon

    I am very encouraged by what the Minister has just said. In my intervention on the hon. Member for Battersea (Marsha De Cordova) I suggested some contact with the authorities in Northern Ireland, which unfortunately have a long 30 years’ experience of trauma, especially among children. Has that happened?

    Gillian Keegan

    I have not met my counterpart in Northern Ireland but, having heard the hon. Gentleman’s intervention, I sent a WhatsApp message to request that a meeting be set up, because it is probably long overdue. We can learn a lot from each other, and I am always keen to learn from anyone I can.

    Over the past 50 years, we have seen the transformation of NHS mental health services for children and young people. From the passing of the Mental Health Act 1983 and the establishment of mental health trusts to more recent developments including the Time to Change campaign, which between 2007 and 2021 helped to improve the attitudes and behaviours of some 5.4 million people towards those living with mental health problems, these are all important steps along the way towards destigmatising mental health.

    The publication of the five-year forward view for mental health in 2016 made the case for transforming mental healthcare in England. The implementation of the “Transforming children and young people’s mental health provision” Green Paper from December 2017 has seen the introduction of senior mental health leads and mental health support teams in schools and colleges. We regularly talk about that programme, and I am sure it will make a massive difference to young people, particularly those affected by the pandemic. The 2019 NHS long-term plan commits to expanding and transforming mental health services in England so that an additional 345,000 children and young people will be able to access NHS-funded specialist mental health treatment by 2023-24.

    We are continuing to build up those services and the staff, as in some cases demand outstrips supply. As part of this work, we have all-age 24/7 urgent mental health helplines in all areas of England so that people experiencing a mental health crisis, or those worried about someone experiencing such a crisis, can speak to a trained professional. The helplines were established during the pandemic, so they are a relatively new addition to the landscape, but I am sure they are very welcome because many people have sought these services.

    We are also accelerating the coverage of mental health support teams in schools and colleges from the 287 currently in place to over 500, covering around 35% of pupils by 2023-24. There are currently 16 mental health support teams operating in or planned for south-west London, so they have already started to roll out.

    Our hard-working NHS community mental health services treated over 420,000 children and young people in 2020-21, an increase of around 95,000 on the previous year, so we can see there has been a massive increase in demand for these services, which is why we are working very hard to try to build up the mental health workforce.

    Although none of us wishes to see a repeat of the events in Battersea Park and the many things that have happened since, not only in mental health but in safety, I assure hon. Members that the NHS will always be there to support the survivors of such tragedies. However, it is important that we never forget. I am therefore grateful to the hon. Member for Battersea for securing this debate and for making us all aware of something that happened. This issue is important to her constituents, and this debate will ensure that we all remember the tragedy and learn from the events of that day.

  • Marsha De Cordova – 2022 Speech on Battersea Funfair Disaster

    Marsha De Cordova – 2022 Speech on Battersea Funfair Disaster

    The speech made by Marsha De Cordova, the Labour MP for Battersea, in the House of Commons on 21 June 2022.

    This year is the 50th anniversary of the Battersea funfair disaster. I want to start by remembering the victims, their families, and the survivors. I also want to pay tribute to and thank two of the survivors, Hilary Wynter and Liz Haigh-Reeve, for their tireless campaigning to have the tragedy recognised and remembered.

    The Big Dipper rollercoaster was the main attraction of the Battersea Park funfair which opened as part of the festival of Britain. Tragically, on 30 May 1972, a carriage of the rollercoaster broke loose and plummeted backwards through a barrier killing five children—Alison Comerford, Thomas Harmer, Shirley Nash, Debora Robertson and David Sait—and leaving 13 injured. The disaster is one of the deadliest rollercoaster crashes in history. However, it has largely been forgotten and there has been no justice for the victims, their families and the survivors.

    To mark the anniversary of the disaster, I attended a special memorial ceremony together with families and survivors in Battersea Park where a plaque was unveiled and a tree was planted. That is the first step to creating a new legacy and a permanent memorial.

    There is another silent tragedy associated with the incident, on which I will focus the rest of my speech. It is something that I am determined to change. Survivors have spoken about the devastating impact that childhood mental trauma has had on their lives. As one told me,

    “bones are mended, physical injuries fixed, but the dreadful damage to our mental health goes untreated.”

    Damage from trauma is not necessarily skin deep: some wounds penetrate through to our minds, leaving lasting damage that can be just as debilitating. Although the funfair and the big dipper are long gone, some of the survivors of the disaster still struggle to go to Battersea Park, and have been unable to shake off their horrific memories of that incident. I am sure many survivors of other tragedies, such as Hillsborough, the Manchester Arena terrorist attack and the Grenfell Tower fire, have been through similar experiences.

    Jim Shannon (Strangford) (DUP)

    I commend the hon. Lady on securing this debate on childhood trauma support services. I would mention helpfully to her, and probably to the Minister as well, that we in Northern Ireland have faced 30 years of a terrorism campaign during which many young children, women and men have lost their lives. Such trauma can last way beyond the time that it happened. Does the hon. Lady agree that some discussions with the responsible Minister in Northern Ireland might be helpful when it comes to devising a policy and a strategy to address trauma and child mental issues, which I know she wishes to see?

    Marsha De Cordova

    The hon. Gentleman is right: we can all learn, and it would be useful for the Minister to say whether she would like to meet Ministers in Northern Ireland to look at what works well.

    Childhood trauma can have a lifelong effect, and can have lasting consequences for a child or young person’s development, including psychological, behavioural and emotional problems. Those problems can occur into and throughout adulthood, presenting related challenges in many aspects of that person’s life. According to the UK Trauma Council, childhood trauma refers to the ways in which some events and experiences are so extreme that they overwhelm a child’s ability to cope. Many different experiences can lead to such trauma: for example, physical or sexual abuse can be traumatic for children. One-time events like the tragedies I have mentioned can take a psychological toll on children as well. Ongoing stress such as the effects of the pandemic can also be traumatic for a child, even if it just feels like everyday life to an adult.

    We know that the pandemic has had a huge negative impact on children and young people’s mental health and wellbeing. The Children’s Commissioner’s Big Ask survey found that one in five children was not happy with their mental health, and that figure rose to two in five for some groups. Childhood trauma does not have to involve experiences that are directly related to the child: for instance, watching a loved one endure major issues can be extremely traumatic, as has been highlighted by the impact of the cost of living crisis on children’s mental health. According to the Childhood Trust’s latest report, 47% of children surveyed felt stressed, 21% of parents said that their children smiled less, and most concerningly, 9% of parents claimed that their children had started self-harming. The results of that report should worry us all, as all those types of trauma will affect children’s development and wellbeing.

    The Government need to invest in mental health services to ensure that children who experience trauma today do not face the same painful ordeal that survivors of the Battersea funfair disaster have gone through over the past 50 years. Spending on children’s mental health remains behind investment in adult mental health services. It is worrying that children and young people’s mental health services are among the most under-resourced and that the quality of care varies between different parts of the country. A BBC freedom of information request revealed that 20% of children are waiting more than 12 weeks to be seen for mental health support. That is why I was pleased to secure this debate on better provisions for children’s mental health services and childhood trauma.

    The Government need to correct the historical underinvestment in children and young people’s mental health and the postcode lottery of services and support provision. To do that, they must create a comprehensive child mental health strategy, and childhood trauma services must be prioritised as part of that. The UK Trauma Council has called for the Government to invest in the development and delivery of specialist trauma provision so that children and young people have access to the support that they need. It also called on the Government to equip all professionals who work with children and young people with the skills and capacity to support those who have experienced trauma.

    Labour has already set out its plan on tackling the mental health crisis, which includes giving adequate funding to mental health services. We have also committed to radically expanding the mental health workforce, including, crucially, investment in children’s mental health that includes putting open-access mental health hubs for children and young people in every community and ensuring that a full-time mental health professional is in every secondary school and a part-time professional is in every primary school.

    Labour’s focus on early intervention is so important, because it can prevent the ongoing effects of trauma into adulthood. It would ensure that children are properly supported and resolve problems before they escalate. I will therefore ask the Minister about the Government’s plan for children’s mental health services and, specifically, childhood trauma care. When will her Government introduce a comprehensive child mental health strategy that includes prioritising trauma and investment in the development and delivery of evidence-based trauma service provision? How are they ensuring that children’s mental health services are a high priority in the NHS? That includes increased investment.

    The Government have made £139 million available to support children and young people’s mental health in the community, but we need to see more investment. How are the Government working with professionals in contact points including in schools and the third sector so that children can access support when problems emerge?

    Much work also needs be done to ensure that every child and young person gets the support that they need for their mental health and wellbeing. We need to step up as a society and be more ambitious in our call for better support for children and young people’s mental health. More funding and resources will be an investment in our children’s future. It is time for the Government to act and listen to the voices of children and young people, especially those suffering from trauma. If we do not act now, when will we?