NHS Workforce: England — [Mrs Madeleine Moon in the Chair]

Part of the debate – in Westminster Hall at 3:16 pm on 17th July 2019.

Alert me about debates like this

Photo of Tim Farron Tim Farron Liberal Democrat Lords Spokesperson (Communities and Local Government), Liberal Democrat Spokesperson (Communities and Local Government) 3:16 pm, 17th July 2019

Yes, the hon. Gentleman makes an extremely important point. I am certain it is felt across the country. If it is made too difficult to get to the nearest NHS dental surgery—if that is 60 or even 100 miles away, as has been the case on occasion for constituents of mine—people go without treatment, and so do their children.

Last November I managed to secure the agreement of the commissioners to increase the value of the contracts to NHS dentists in Kendal so they could see and treat more patients. “Brilliant,” we thought, “that is really good news.” When NHS England contacted our local NHS dentists they found that not one of them was able to take up their offer. I was told that the practices were already working to capacity within the staffing resources they had available, and were reporting difficulties in recruiting additional staff. Those staff exist, by the way. They are working in the private sector. The treadmill of a contract that is unfair to patients and dentists, and not fit for purpose, keeps them out of the NHS. As Mike Hill says, that hits young people particularly.

The reasons for those difficulties include a contract that pays a set amount for a particular type of treatment, regardless of the number of teeth that a dentist treats. A dentist will get paid, on average, £75 for an entire course of treatment including six fillings, three extractions and a root canal. That is not enough to cover overheads. That is a serious disincentive to people entering NHS dentistry. It hits all areas, but particularly deprived areas, and has a massive impact on the size of the workforce. According to the Department’s website, the Secretary of State for Health and Social Care is responsible for

“oversight of NHS delivery and performance” but if he is unable or unwilling to intervene to correct such absurd commissioning we have to ask what real power he has to perform the role. That is the kind of systemic problem that adds up to the workforce crisis we have all talked about and which proper accountability would go some way to solving.

The website states that the other part of the Secretary of State’s role is

“oversight of social care policy”.

Social care policy is key to NHS workforce planning and supply in England. We all recognise that social care provision is in crisis, and that the crisis gets worse the longer we do not address it. As it grows, so does the pressure on the NHS, which is left dealing with the serious health problems of those who did not receive the routine care they needed. The Government cannot go on delaying simply because of the personal embarrassment of having failed so far. To be fair, they are not the only ones responsible. Neither are they the only ones who can come up with a solution. We need to reach across divides and look for a cross-party solution.

I have written to the Secretary of State for Housing, Communities and Local Government and to Andrew Gwynne, the shadow Secretary of State, to invite them to join me so that between us we can constructively use this deadlocked Parliament to reimagine and then redesign a social care system that could provide us with the care we might want for our parents, ourselves or, indeed, in the future, our children. I hope that we can work together to create a new deal for social care and a chance to turn this logjammed Parliament into one of the most productive in history.

The lack in the workforce has a profound impact in each of the areas I have talked about. Common themes and problems emerge: there is a lack of planning, as well as short-sightedness and a failure to invest in preventive care or to understand that providing healthcare is harder in rural areas, as are recruitment and retention. The Government must plan to overcome those specific challenges as part of their overall strategy. The Government, in not taking responsibility for the workforce crisis, are creating huge problems for generations to come. We need accountability, both for the current workforce crisis and to ensure that we invest in long-term solutions beyond the next Prime Minister, the next Government and even the next generation.