As my hon. Friend knows, we inherited an NHS dentistry system in crisis. This Government are determined to fix it with fundamental reform of that vital service by the end of this Parliament. Since last April, we have delivered extra urgent dental appointments nationwide, and last month we announced new measures to get the right care to the right people at the right time, incentivising dentists to offer more NHS care.
The latest NHS statistics show that the Government really have the bit between their teeth as 7,000 more children saw a dentist in 2024-25 than in the previous year in the Humber and North Yorkshire integrated care board area. However, the rate for adults has slipped from 43% to 41% over the same period. How quickly does the Minister think that my adult constituents in Great Grimsby and Cleethorpes will benefit from more appointments and more dentists?
I congratulate my hon. Friend on the pun in her question. There is good news, in that we are making progress on children’s oral health, but we accept that we still have a way to go on the broader picture. We are making 27,196 additional urgent appointments available in the Humber and North Yorkshire ICB area. Our reforms, which I announced in December, will kick in from April of this year. They will significantly increase the unit of dental activity fee rate that we pay for urgent care to incentivise more dentists to do urgent NHS dentistry. We also have the golden hello system and a number of other measures that we are taking to address underserved areas. A lot has been done, but there is still a long way to go.
Topical Questions
Today, we are bringing forward the Medical Training (Prioritisation) Bill. It implements our commitment in the 10-year plan for health to prioritise UK medical graduates and doctors with significant NHS experience for medical training posts. Taxpayers spend £4 billion training medics every year. It is time we protect that investment, ensure that we have a sustainable workforce and give home-grown talent a path to become the next generation of NHS doctors. On that note, Mr Speaker, I also wish to update the House that constructive talks with the British Medical Association’s resident doctors committee are ongoing. Let us see if, collectively, we can do better in 2026 than we did in 2025.
Patients in Worcester are struggling to access urgent care. Far too many are falling through gaps in our system, with devastating consequences and huge amounts of double work, and patients feel that they have to travel too far for treatment. Will the Secretary of State meet me to discuss the results of my deep dive into the failures in Worcestershire’s NHS?
My hon. Friend is right; we have to shift care out of hospitals and closer to people’s homes to make sure that we do not end up with the situation he describes. I know that he is doing a lot of work on that in his community, and I am very happy to meet him to hear about his findings and what we can learn and apply both locally for him and his community and elsewhere.
I call the shadow Secretary of State.
With one in five hospice beds no longer available because of increased costs such as national insurance contributions, it is hardly surprising that doctors are raising concerns about the increase in the number of end-of-life patients in our hospitals. It is therefore concerning to hear that the palliative care modern service framework will not now be available until the autumn. Given that the situation is increasingly urgent, will the Secretary of State commit to accelerating that timescale?
We are moving at pace on the modern service framework, but we have recognised those financial pressures, whether through the continuation of the children’s hospice grant over multiple years so that hospices can plan or through the capital investment we have put into hospices, providing the biggest funding uplift for hospices in a generation. I recognise that there is more to do, and I enjoy a close working relationship with the hospice movement to look at what more we as a Government can do to support the vital work that it does.
Capital funding is welcome, but we cannot pay doctors and nurses with bricks and mortar. Hospice UK has said that without additional support, there will be
“more unnecessary hospital admissions, more unneeded A&E attendances and more patients not getting the care”
they need, so I push the Secretary of State again to accelerate the timescale. Their lordships are considering the assisted dying Bill and they need to see the palliative care MSF before making such an important decision. We must also make sure that we relieve hospices of this Government’s NIC hikes.
I understand the point the shadow Health Secretary makes about capital funding, but I would also say that, through that capital funding, lots of hospices are able to free up their own resources, which would previously have been committed to rebuilding works, to spend on services. I recognise that there is more to do, and we are working closely with the hospice movement. I hope that the right hon. Gentleman is reassured to learn that we will be reporting on the modern service framework initially in spring, so that we can then take on board feedback and reiterate. Then we will get to the autumn, but people will not have to wait until then to hear the direction of travel.
We are committed to delivering 250 centres by 2035, with a progressive roll-out over this Parliament. Early sites are focused on areas of greatest need, with consideration of factors including deprivation and access. Integrated care systems are in the process of planning the best holistic local configuration of a neighbourhood service. I would be very happy to meet my hon. Friend to discuss the potential for a neighbourhood health centre for Long Stratton.
I call the Liberal Democrat spokesperson.
The social care crisis is piling pressure on hospitals, with beds taken up by patients who are fit enough to be discharged. It is also piling pressure on local councils such as Shropshire, where 80% of the budget goes to social care, yet the Government are shifting funding from counties to cities and dragging their heels on the social care crisis. Will the Secretary of State take action by reinstating the cross-party talks on social care as a priority, because we need to fix social care if we are going to fix councils, care and the NHS?
Cross-party working on social care has never been un-instated. I know there is much more to do, but we have been in government for 18 months and we have put in £4 billion of investment, legislated for the first ever fair pay agreements with £500 million committed to that, made significant additional investment in the disabled facilities grant and, in building the workforce plan for the future, we have commissioned Baroness Casey to do her work. She will be reporting soon and we look forward to taking that work forward.
Ahem! I am getting a bad throat because of the Secretary of State.
My hon. Friend is right that NHS mental health, ADHD and autism services have never fully met the needs of the population in a tailored, personalised or timely way. The independent review into prevalence and support for mental health conditions, autism and ADHD will explore the current challenges facing clinical services. My hon. Friend the Minister for mental health is currently overseas on departmental business, but I am sure that he would be delighted to meet my hon. Friend on his return.
We are in negotiation with the British Dental Association about the long-term contract reform that is so clearly needed, but I also draw the hon. Member’s attention to the announcement I made in December about a range of interim reforms, particularly on urgent work, where we are significantly increasing the fee rate for urgent dental activity. That will kick in from April and will make a real difference in access to urgent care.
I am grateful to my hon. Friend for his advocacy on this matter. I know that it has been taken seriously by NHS leaders nationally as well as locally, and they listen carefully to what he says on behalf of his constituents. I have reported to the House this morning on all the action we are taking to drive improvement. We are seeing improvement, but there is so much more to do. We are determined to consign corridor care to the history books, and not just in Ashford but right across the country.
Access to mental health services in rural communities is a challenge when services are stretched and underfunded. What steps is the Secretary of State taking to improve access to mental health services in Yeovil?
The Government increased investment in mental health by an extra £688 million in 2025, with all systems forecast to deliver the mental health investment standard. As our medium-term plan makes clear, we need a new approach to mental health to drive down waits and improve the quality of care, but our expectation is that integrated care boards will be required to protect mental health spending in real terms, rising in line with inflation year on year, ensuring that we meet the needs of constituents in all parts of the country.
I am sure that I will be able to swing by on my rounds. It is so important, especially against the backdrop of the crisis that the NHS has been through over many years, that as well as celebrating the best performance, we celebrate when there is real improvement. My hon. Friend knows as well as I do that there is of course more to do, but it is to the credit of leaders and staff that there has been improvement—lots done, and a lot more to do.
Last summer, Sussex ICB cut its IVF provision from three cycles to one due to budget pressures. There is currently a postcode lottery for IVF, and going through fertility treatment can be harrowing for those families. Given that additional cycles improve success rates, will the Secretary of State commit to a nationally consistent standard for IVF?
This is an issue that the Government are looking at. As with all treatments, we should be following National Institute for Health and Care Excellence guidelines, but I recognise that in this area there is a degree of regional variation in provision in a way that, frankly, I find difficult to justify. We are looking at this and, as we make decisions, we will of course report on progress to the House.
My hon. Friend is right that, although we are making progress on urgent treatment with the urgent dental access centre that he mentioned, there is a real challenge with new routine care in Hartlepool. We are looking to improve that unacceptable situation, which we inherited, by offering dentists £20,000 to work in underserved areas and making it a requirement for new dentists to practise in the NHS. However, he is right to point out that the situation is not acceptable and we have to improve it.
The Government’s interim dental measures will of course be welcomed by residents in North Dorset, but they know, as I do, that we in this place have been discussing the inadequacy of the dental contract for years. What they and I cannot understand is why it will take until the end of this Parliament, as the Minister told us just a little while ago, and not sooner, to sort out that big problem and turbocharge NHS dentistry in rural North Dorset.
I have a huge amount of respect for the hon. Gentleman, but I have to say that I am a little taken aback to be told about the lack of progress when the Conservatives had 14 years to sort out NHS dentistry. Nevertheless, we are engaging intensively with the BDA. The interim reforms, which kick in from April, will make a big difference, as I have said, but we are looking to put the long-term reforms in place from 2027 onwards. We want this situation to be rectified by the end of this Parliament, not to have a new contract by the end of this Parliament.
I know that this is of great concern to my hon. Friend and his constituents. It is a matter for the commissioning officer at his local ICB. I recommend that he keeps talking with them about the best provision for his constituents.
I was fascinated by the Minister’s earlier answer about the closure of pharmacies, because there has been fantastic news in Lee-on-the-Solent in my constituency: a new pharmacy wants to open there. Local people are desperate for a second pharmacy in Lee-on-the-Solent and the local GP practice supports it. The problem is that the Hampshire ICB has rejected it. Does the Minister share my disappointment that local people are not going to be served in the correct way by pharmacy provision, and will he meet me to discuss this?
That does sound somewhat baffling, given that there is demand for the service. Pharmacies play an absolutely vital role in our communities. I would be happy to meet the hon. Lady to discuss the details further.
My hon. Friend is absolutely right to point out this issue. As I have said, the reforms that we announced in December will make a major difference, because dentists have not been incentivised to do NHS dentistry. That requires us to significantly increase the UDA, as we are doing, but there is a range of other measures that we need to take. I would be happy to meet my hon. Friend to discuss the specific details of that case.
Failed private finance initiative schemes from the noughties in three Leicester hospitals resulted in the NHS being sued for almost £30 million, despite no work being carried out. Leicester hospitals are still without any new buildings. I ask the Minister that expensive, inefficient financial packages—£60 billion of private money costing £306 billion of taxpayers’ money—not be utilised for future projects.
This Government are putting record levels of capital investment into the NHS to correct more than 14 years of Conservative failure. We are using public investment. We are certainly learning the lessons of the past in relation to PFI. We are able to do that only because people voted Labour and elected a Labour Government. I look forward to working with the city’s Labour MPs to deliver the improvements in services that it deserves.
To date, Baroness Casey’s review of adult social care has been pretty impenetrable, but in York we want to engage and innovate. Will my hon. Friend provide Parliament with a briefing on the progress, scope and scheduling of the review? The clock is ticking and the crisis is growing.
My hon. Friend and I have discussed this matter. I hope that her issues in accessing the commission, which I know has made contact with her, have been resolved. The commission is, of course, an independent body, but I am in no doubt at all that parliamentarians will hold it to account through the mechanisms at their disposal—the Select Committee, for example. The Government are not sitting on our hands; we are delivering the fair pay agreement, we have delivered the biggest uplift to unpaid carers since 1976, and we are pursuing a range of other measures to get our adult social care system fixed and fit for purpose.
We have just been notified that William Blake House in my constituency—a residential home for people with severe learning disabilities—has been issued with a winding-up notice, and the court hearing is tomorrow. The families were given no notice of any of this, and no consultation was carried out, so naturally they are worried about what provision will be in place for their loved ones. Will the Minister meet me urgently to discuss putting a contingency plan in place for them?
I thank the hon. Lady for that question. I am not familiar with the details, of course, so might she write to me with the clear details? I am sure that officials will then take the matter up as a matter of urgency.
Parents supported by Harry’s Pals, a small charity, consistently describe the fragmented and emotionally exhausting system of accessing support for children with life-limiting conditions. Will the Secretary of State commit to exploring a dedicated national support pathway for parent carers, including better access to counselling and respite, and will he meet me and Hayley Charlesworth, the founder of Harry’s Pals, who is watching at home today with Harry, to discuss how we can better support families in the Forest of Dean and nationally?
Local authorities must assess disabled children’s social care needs and provide respite care, including funding short breaks where appropriate. We are currently developing an all-age palliative care and end-of-life care modern service framework, and will consider the issue of emotional and practical support, including for parents who are carers, as part of that work. My hon. Friend the Minister for Care chairs a cross-Government meeting with Ministers from the Departments for Work and Pensions, for Business and Trade and for Education, to consider how we can provide care as we improve recognition and support. I would be happy to meet my hon. Friend and the founder of Harry’s Pals.
My local mental health trust is commissioned to deliver just 100 autism assessments and 88 ADHD assessments per year. The team is led by Clare, a constituent from Marple. There are approximately 1,600 people on the waiting list for ADHD alone—that is a 12-year waiting list. That is driving constituents to seek private diagnoses, but their GPs then refuse to sign up to a shared care arrangement, as the numbers just do not add up. What plans do the Government have to review the shared care protocols so that they work for patients and GPs?
I am grateful to the hon. Member for her question. Although of course we are considering prevalence and what is driving the apparent increase in conditions such as autism and ADHD, we are really driving at ensuring that we meet everyone’s needs. I do not want for this country a future in which those who can afford it pay to go private and those who cannot are left behind. Nor do I want to see a situation in which people who have a diagnosis do not receive the care they need. We are looking at those issues with urgency.
I and a number of colleagues have concerns about the upcoming PATHWAYS trial. The Secretary of State has powers to use existing medical records for research purposes. Will he therefore consider using those powers to increase the evidence base and prevent the PATHWAYS trial from proceeding?
I thank my hon. Friend for her constructive approach to this difficult issue. She is right to challenge; we must have open and transparent debate. To be very clear—and to refer to my previous answer—the Secretary of State will use that power. We will have a retrospective data linkage study to identify the associations informing patient experience and outcomes, through the analysis of available digital information in health records and other nationally held databases. It will not establish causation but will be an important contribution to the evidence base.
Mr Speaker, I am not ashamed to say that I have had a finger up my bum—not like that! In all seriousness, as a black man in the target age range, and with a family history, I am a keen advocate for prostate cancer screening. One of my constituents has been told by his GP surgery that, as there is no national screening programme for opportunistic testing, they follow national guidance and patients cannot request a screening without GP authorisation. What advice does the Secretary of State have for those of my constituents who are struggling to get screening for prostate cancer? I say a big thank you to the team at Kingston hospital for their swift action in moving my dad from active surveillance to treatment—he raves about them.
I certainly join the hon. Member in his final message and commend him for his declaration, because the more we can break taboo and stigma around these issues and get people talking more openly about the telltale signs of risk, the better protected we will all be. As he will know, we are looking very carefully at the recommendations around screening. I will be convening a group of experts with the chief medical officer to probe some of the recommendations, and I will keep the House informed.
Last Friday, I went on a visit to my fantastic local GP service, Hadwen Health. The team there are already using technology and AI to make sure patients get the right care that they need, but they told me that there is currently no technological solution that allows patients to both be triaged and directed to their hard-working family doctor when booking online. What steps is the Department taking to support the roll-out of technology in GP surgeries like Hadwen Health in Gloucester?
I am a little bit surprised; I think that that technology does exist. I have visited a couple of GP practices where the online booking system gives the patient the option to specify the doctor that she or he would like to see. I would be happy to connect my hon. Friend with relevant officials in the Department, so that they can connect with the GP surgery to resolve that issue.
In NHS Providers data published just before Christmas, we learned that in East and North Hertfordshire NHS trust, the number of people waiting for treatment has fallen more than in any other trust in the country. That is fantastic news for my community. Will my right hon. Friend commend all the staff involved in this success, and does he agree that this is precisely what people voted for when they voted for change in the NHS?
Of course, I endorse what my hon. Friend said. Waiting lists are falling for the first time in 15 years. Lots done, and so much more to do, but with Labour, the NHS is on the road to recovery.
In Bellfields and Slyfield ward in my constituency, the local GP surgery is squeezed into a unit that is part of a parade of shops, and it is clearly no longer the size needed for the growing community. The team do a great job in spite of the challenges. Will the Minister set out the steps the Department is taking to support community health hubs in areas like this ward, in order to bring GP and wider services together locally and improve facilities and access for my residents?
We have the £102 million primary care estate fund, which can help with refurbishments and improving the functionality of primary care, particularly GP surgeries. If the hon. Member writes to me about the specifics of that case, I am sure that the relevant officials can give her the answer she needs.
The Health Secretary has said he is “shocked” at the inability to acknowledge and then remedy state failures. It is now two years since the Hughes report was published, but no timeframe has been set for compensation for the valproate scandal. When will my constituents Colleen and Andy get the redress they need, so that they can make long-term provision for their son?
The hon. Member is quite right to hold the Government’s feet to the fire on this issue. We are having cross-Government discussions about this issue and other groups of victims of state failure. We will keep him and the House updated.
A constituent of mine who attends Dudley Voices for Choice has autism with complex mental health needs and is at risk of self-harm. Despite not being able to use a telephone, they are still required by mental health services to do so, and therefore they cannot be treated. They were told that they are non-compliant, so their support was reduced. What steps is my right hon. Friend taking to ensure that mental health services offer alternative ways to communicate for those who cannot use a telephone? I would like to thank Sarah Offley and the team at Dudley Voices for Choice.
We are recruiting 8,500 more mental health workers by the end of this Parliament. The Mental Health Act 2025 reforms will ensure that people with a learning disability, autistic people and people with the most severe mental health conditions have greater choice and control over their treatment and receive the dignity and respect they deserve.
Constituents of mine have been reporting that they have been directed to hospital for regular blood tests, rather than having them at their GP surgery. Will the Secretary of State outline how he will ensure that blood tests are done in a community setting, which surely must be much better value for the taxpayer and much more convenient for patients?
The hon. Member is absolutely right, and that is why a big part of our modernisation approach is to shift care out of hospital and into the community, making greater use of community diagnostic centres, community pharmacies and GPs. As his question shows, 18 months in, lots done, but a lot more still to do.