PARLIAMENTARY DEBATE
Topical Questions - 23 April 2024 (Commons/Commons Chamber)

We know that people in work lead happier, healthier lives. However, over 10 million “not fit for work” fit notes were issued last year. Most were repeat fit notes issued without any advice, so we are missing a golden opportunity to give millions of people the support they need to remain in work. That is why we are launching a reform of the fit note process to create a new system in which fit note conversations focus on what people can do, not what they cannot do. As part of this, the Government will consider shifting the responsibility for issuing fit notes away from GPs to reduce the pressures they face and to free up millions of appointments. I thank everyone who has delivered this vital work, and I very much look forward to hearing the results of the call for evidence in due course so that we can reform our welfare system for the sake of our constituents and our GPs.

According to the Association of British HealthTech Industries, it takes, on average, 17 years for lifesaving and life-enhancing technologies to be adopted in the NHS. What steps is my right hon. Friend taking to speed up the adoption of new technologies so that the NHS can save more lives and improve patient outcomes?

I dispute the 17-year figure, as it can vary across innovations. The figure is contested, but my hon. Friend raises an important point. We have a plan to prioritise the acceleration of patient access, thereby ensuring safe, effective and innovative medical technology for patients and the NHS. Our ambition is backed by funding, and we are reforming the medical technology regulatory framework, introducing the innovative devices access pathway pilot and launching frameworks to increase the availability of innovative products for the sake of patients across England and the United Kingdom.

I call the shadow Secretary of State.

The Health Secretary has promised that the Government will provide an extra 2.5 million dental appointments this year, but the dentistry Minister, the right hon. Member for South Northamptonshire (Dame Andrea Leadsom), says the figure has

“a high likelihood of not being reliable”.

Which one of them is wrong?

I am delighted to be able to tell the hon. Gentleman that we have modelled down the ambitions, so the figure we initially provided was higher than 2.5 million appointments. That is because we are focused on delivering the dental recovery plan, rather than overpromising.

The hon. Gentleman finds it easy to call our children short and fat, but he shies away from welfare reform, calling it shameless and irresponsible. He says he is ready to stand up to middle-class lefties, but Labour has never put patients first by condemning the unions that strike. He makes glossy promises about reforming the NHS in England, yet Labour has failed completely—

Order. I gently say that we need to get a lot of Back Benchers in, and I am sure both sides want to do that.

The last Labour Government delivered the shortest waiting times and the highest patient satisfaction in history, which is a record that the right hon. Lady’s Government cannot begin to touch.

Back to dentistry, the chief dental officer says the announcement is “nowhere near enough.” The British Dental Association says:

“This ‘Recovery Plan’ is not worthy of the title.”

It also says that the recovery plan will not stop the “exodus” of dentists and will not meet the Government’s targets. Who should the public trust, and why should they trust the Health Secretary to deliver when her own adviser, her own Minister and, crucially, dentists all say that she is brushing the truth under the carpet?

Again, let us bring ourselves back up to date. I know the Labour party likes looking back to the last time it found favour with the British public, but Wales is the up-to-date record of today. Labour’s lamentable record of running the NHS in Wales speaks for itself. If the hon. Gentleman is so set on reform, why on earth is he not helping his Labour colleagues in Wales to do exactly as he is promising? It is because they are empty promises, and because the hon. Gentleman and, I am afraid, the Labour party will step back from reform rather than grappling with the issues, as we are doing with our recovery plan.

Finally, on the dental recovery plan, within a month of the new patient premium being switched on, hundreds of surgeries have opened to new patients, which means that patients in the hon. Gentleman’s constituency and elsewhere are getting the care they need.

I thank my right hon. Friend for raising that matter. I understand that a consultation was conducted locally and that more than 5,000 local people and staff responded. Their feedback will be analysed by an independent research agency, which will produce a report for the Mid and South Essex ICB, and a meeting is due to take place in public in July. I will, of course, continue to take an interest in this matter.

I call the Scottish National party spokesperson.

The recent announcements on fit note reform are just the latest in a long string of attacks on the most vulnerable people in society. Sick and disabled people are being vilified, when, as the Joseph Rowntree Foundation points out, almost two thirds of those living in destitution live with a chronic health condition or a disability. The UK Government are continuing their track record in failing, and making life more difficult for, disabled people. Does the Secretary of State understand how much more difficult these changes will make people’s lives?

These reforms are being brought forward because of a simply unsustainable rise in the number of people being given fit notes so that they cannot re-enter the world of work. We want to support people into work, not only because we believe that it is the best way to help them to recover, but because it helps us to fund the NHS. It is funded by people who work and pay their taxes. Again, I draw the hon. Lady’s attention to matters a little closer to home; sadly, Scotland’s record on health is very difficult to read and it includes the worst level of drug deaths in Europe. I encourage her to concentrate on how the SNP is running health services in its local area.

That is an important point. We know how vital it is to support everyone who is working so hard in our NHS to support patients. NHS England is reviewing mental health services for all staff who need them, to ensure that they can access the support they need. It is working collaboratively with regions and integrated care systems to agree the best approach to doing that.

The hon. Lady makes an important point. As part of the NHS long-term plan, we have an ambition to diagnose 75% of all stageable cancers at stage 1 or 2 by 2028. That means that we need to make significant improvements on the harder-to-detect cancers such as bowel cancer. We are working across systems to deliver those improvements, not only with better screening programmes, but by improving patient pathways. However, I am more than happy to meet her if she wants to have a further conversation specifically about bowel cancer.

Following discussions with constituents who are living with Parkinson’s and with Parkinson’s UK, I am concerned that North Yorkshire has only one dedicated Parkinson’s nurse. Given the complexity of the condition, what steps are being taken further to incentivise nurses to specialise in Parkinson’s and on long-term delivery?

My hon. Friend makes an important point. I know the huge value of Parkinson’s nurses to local patients in my constituency. Under the NHS long-term workforce plan, backed by more than £2.4 billion over the next five years, the NHS will focus on expanding the number of clinicians training for enhanced and advanced roles working as part of multidisciplinary teams with the right skills to meet the changing needs of patients.

We switched on our fully funded dental recovery plan, in case the hon. Gentleman was not listening carefully earlier, on 1 March. Nearly 500 more practices in England are accepting new adult patients than at the end of January, and even more will do so under the dental recovery plan. We have plans to bring in new dental vans to help our most isolated communities. We are also bringing in the Smile4Life programme for children, because prevention must be a critical part of our dental recovery plan.

I call the Chair of the Health and Social Care Committee.

Ministers will be aware of a rather boastful claim last weekend by the makers of Elfbar and Lost Mary vapes. They have already launched rechargeable, refillable products, which, with a coil in each pod, are not by definition single-use or disposable according to the published regulations. Can the Minister reassure the House and parents that they are alive to that and will pivot as necessary now that the Tobacco and Vapes Bill is going into Committee?

I thank my hon. Friend for raising that matter, which shows the cynicism with which the tobacco and vaping industry is approaching these landmark public health reforms. On vapes, we have committed to consulting on the powers that we are adopting in the Bill precisely because we want to ensure that the regulations, when they come to the fore, address the realities of the market and the cynicism of the companies behind it, and help to ensure that our children do not continue being plied with these horrible items to get them hooked on nicotine.

This is a very serious matter, which I have raised with the chief executive of NHS England, and asked her to raise with the regional director and Nottinghamshire integrated care board. We have done so because we believe that it might be a breach of the Nolan principles.

Just yesterday, the Office for National Statistics released data showing that alcohol-specific deaths in 2022 were 4.2% higher than in 2021 and a massive 32.8% higher than in 2019. Will my right hon. Friend now seriously consider a stand-alone alcohol strategy based on this worrying trend and agree to meet me and other interested parties to discuss a way forward to tackle alcohol-specific deaths?

My hon. Friend was an incredibly hard-working health Minister and I pay tribute to her for all she did in this area. She will be aware that our groundbreaking drug and alcohol strategy commits more than half a billion pounds of new funding over the spending review period to rebuild drug and alcohol treatment services, with plans to get an additional 15,000 alcohol-dependent people into substance misuse treatment by 2024-25, which we are currently on track to achieve. I would be delighted to meet her to talk about it further.

At my last surgery, a young woman told me that, thanks to the delay in her GP diagnosing her ovarian cancer, she is now infertile and receiving aggressive treatment. She had made four GP appointments over several months for her unexplained stomach cramps. Only in an emergency admission in another country was the ovarian cancer diagnosed and the tumour removed. How long will it be before the symptoms of female-specific conditions are taken seriously by our medical establishment, from initial training onwards?

I thank the hon. Lady for raising this, and I very much send our best wishes to her constituent. The hon. Lady raises a really important point. The symptoms that women can experience are often very different for conditions relating not just to cancer, but to heart attacks, for example. Part of my prioritisation of women’s health is to get that message out to clinicians so that, as this case demonstrates so tragically, they are able to make the best and most prompt diagnosis for all women.

What is the Secretary of State doing to ensure that the UK Health Security Agency has the budget and the capabilities it needs? The recent expansion of bird flu among mammals in the United States is a salutary lesson. Thankfully, there are no signs yet of human-to-human transmission, but it reminds us of the incredible value and importance of being vigilant in this space and having the best possible technology ready to respond as soon as possible.

I thank my right hon. Friend for his question, and of course for his integral role not just during the pandemic, but in setting up the UKHSA. He will understand that I and others are keeping this under very close review, and the chief medical officer is briefing me as and when needed.

The hon. Lady raises an important point, and I ask her to write to me, please, so that we can look into it.

Given the importance of the UK’s life sciences sector, could my right hon. Friend update the House on commercial clinical trial recruitment?

Thanks in part to the sterling work of my hon. Friend, monthly average patient recruitment to commercial clinical trials is almost five times the figure it was back in June 2023. That is hugely positive, but there is clearly more to do in this space.

For over a decade, the Camberwell dialysis unit has provided high-quality NHS care to patients in south London, so my constituents were shocked to hear that these services are to be outsourced to Diaverum, a multinational for-profit health corporation, which has already had one of its clinics rated inadequate and put into special measures. Does the Minister accept that privatising the NHS bit by bit has disastrous implications for care, and will he listen to patients in my constituency and commit to maintaining our NHS dialysis provision?

That sums up the usual contradiction on privatisation between Labour Front Benchers and Back Benchers. Any service changes should be based on clear evidence that they will deliver better patient outcomes. In Lambeth, patients who receive dialysis at the new site in Brixton will receive care in a significantly improved environment with brand new facilities, in a great example of an innovative public-private partnership. NHS England has established the renal services transformation programme to reduce unwarranted variation in the quality of access to renal care.

Will my hon. Friend join me in recognising the good work that the Essex Partnership University NHS Foundation Trust has been doing to improve mental health outcomes, including the creation of a pioneering 24/7 urgent mental health care centre, providing urgent help when it is needed. Is that a model that could be rolled out across the country to improve access to mental health for all?

My hon. Friend rightly flags the excellent work going on to improve access to mental health services across the country. Last year, 3.6 million people got mental health support. That is an increase of around 30% in just three years, supported by record funding of over £16 billion into mental health care.

Mandatory fortification of flour with folic acid could save many thousands of children from spina bifida, so why is it happening so slowly, at such a low level and applied to too few products?

I assure the hon. Member that we remain firmly committed to the mandatory fortification of flour with folic acid. That will help to protect around 200 babies each year from being born with neural tube defects. The policy is being delivered across the UK as part of a wider review of bread and flour regulations. In January we published our consultation response, and we will bring forward legislation to implement the policy later this year.

The hon. Member raises the performance of the A&E department in her local hospital. I have worked closely with the NHS over the past year to improve the performance of urgent and emergency care. Since this time last year, we have seen ambulance response times improve by over a quarter and waits in A&E cut. I am happy to meet her to talk about her specific A&E department.

I again thank the Secretary of State for visiting Watford General Hospital earlier this year, where we shared exciting plans for the new hospital, with preparation work starting this year, and construction starting by the end of 2026. I spoke with the West Hertfordshire NHS Trust leadership team this week, who confirmed that they are on track for that delivery within those timescales. Will my right hon. Friend please join me in thanking them for their hard work on that?

I would be delighted to join my hon. Friend, and I thank him again for a really positive visit to his local hospital. That is a great example of a local MP working in his local area for his constituents and, what is more, delivering for them.

As a practical measure to improve radiotherapy waiting times, will the Minister agree to further work on the radiotherapy dataset, to include the collection of data on delays at each stage of the radiotherapy pathway, and by tumour type, so that we can better understand pinch points in services?

We are working to improve radiotherapy services across the NHS, and I would be happy to meet my hon. Friend to discuss that in more detail.

West Hertfordshire Hospital Trust is at the front of the queue for the new hospital programme. We have the land, planning permission, building design, political and staff support, and enabling works are under way. But, like many other trusts around the country, the hospital trust is being asked to submit business case after business case. Will the Secretary of State clarify whether those delays are down to bureaucracy and the new hospital programme, or are they deliberate delaying tactics by a Government who do not want to release funds to hospitals before the general election?

Normally, a Secretary of State would appear at the Dispatch Box after a question like that and say, “I refer the hon. Member to the answer I gave earlier.” On this occasion I will refer her to the question from my hon. Friend the Member for Watford (Dean Russell). He has just set out the business case for Watford General, which is great news, and I hope she will join him and me in welcoming that new hospital when it is open.