Stephen Kinnock
MP for Aberafan Maesteg · Labour · United Kingdom
“I thank the shadow Secretary of State for her kind words and look forward to our exchanges across the Dispatch Box. I am ready to engage with her on getting the maximum benefits for the people of Wales.”
“I thank the right hon. Lady and look forward to working with her. My understanding is that there were challenges around the helicopter capability. Decisions were taken by Natural Resources Wales some time ago to change the way that the tendering for helicopter capability works. We certainly need to look at that.”
“I thank my right hon. Friend for his question. Like him, I pay tribute to all those involved in the collective and heroic response to the wildfires.”
“I thank the right hon. Lady for her question. Many of the ideas coming forward for devolving power right across our United Kingdom, beyond Cardiff Bay and Holyrood, are very exciting, and I look forward to exploring them with her.”
“Just to be clear, this is not about staying out of the issue; it is about respecting the devolution settlement, but being prepared to work constructively where we can in partnership with the Welsh Government. The hon.”
“I know about and welcome the right hon. Gentleman’s strong connections to Wales. I recognise the connectivity benefits that WSMR’s proposal could deliver, particularly for passengers in Wales and the west midlands.”
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“The decisions on ENICs and where they are being levied have been made. I think it was made very clear that the line was drawn where it was drawn. Any attempt to try to reverse engineer where that line should be drawn would not really be aligned with the policy decisions that were made at the Budget.”
“I also thank and wish everybody in this Chamber all the very best for the recess, and I look forward to seeing them all on the other side. Question put and agreed to.”
“It has reviewed those proposals, worked at tremendous pace and, as a result, we have managed to deliver the entire £25 million of the first tranche. We are now working closely with Hospice UK on the £75 million and I am confident that that money will be out of the door and into hospices in very quick time this year, based on the outstanding performance on the first £25 million tranche. I therefore hope the hon. Lady will be reassured on that point. In closing, I hope that we at least have a consensus on the vital importance of hospices. The Government are committed to working at pace to ensure that we secure a sustainability and solidity for the sector going forward. I thank the hon. Member for Beaconsfield once again for securing this important debate.”
“I would not dare to speak from this Dispatch Box on behalf of the Chancellor, but I am absolutely clear that when she did the autumn Budget, she knew that she had to dig us out of a very deep hole indeed, and that required levying taxes that she had to levy. The line had to be drawn somewhere and that is where the line was drawn. On the other questions asked by the hon. Member for Beaconsfield, the funding has gone through Hospice UK, so it is not direct funding in that sense. Hospice UK has kindly co-ordinated the process because it is extremely well informed about which hospices across the country have opportunities to upgrade their infrastructure, whether that be IT infrastructure, refurbishment or whatever it might be.”
“We must do more to ensure that everyone who needs support can get it without delay.”
“Raising awareness of eating disorders and improving treatment services is a key priority for the Government, and a vital part of our work to improve mental health services. We know that living with an eating disorder can be utterly devastating, not just for those battling the condition but their loved ones and those who witness their struggle. We know that eating disorders can affect people of any age, gender, ethnicity or background. However, we also know that recovery is possible, and access to the right treatment and support can be lifechanging, as we have heard today. Although record investment and progress has improved access to eating disorder services, the reality is clear: demand has surged, especially since the pandemic, outpacing the growth in capacity.”
“It is a pleasure to serve under your maiden chairship today, Mr Stuart. I am extremely grateful to the hon. Member for Bath (Wera Hobhouse) for securing the debate and raising this important topic. I know that, as a Member of this House and chair of the APPG on eating disorders, she has been a doughty champion for those living with eating disorders, their families and supporters. I am also grateful to other hon. Members for their valuable contributions, many of which were deeply personal and profoundly moving. I pay tribute to hon. Members for making those contributions. I share the desire of the hon. Member for Bath to improve the lives of people affected by an eating disorder.”
“National guidance from the National Institute for Health and Care Excellence is clear that single measures such as BMI or duration of illness should not be used to determine whether to offer treatment for an eating disorder. I am ready to receive any representations from colleagues who have evidence that that is happening, and I would be happy to raise that with the appropriate channels.”
“Through the 10-year health plan, this Government will overhaul the NHS and ensure that those with mental health needs, including those living with eating disorders, are given the support that they need. I share the concern of the hon. Member for Bath about accurate recording of deaths to understand the extent to which eating disorders and other factors have caused or contributed to deaths. This matter is being explored with the national medical examiner for England and Wales, the Office for National Statistics and the Coroners’ Society of England and Wales. Hon. Members also raised concerns about BMI. It is not right that any individual is being refused treatment based on their weight or BMI alone.”
“By improving care in the community, the NHS can improve outcomes and recovery, reduce rates of relapse, prevent children’s eating disorders continuing into adulthood and, if admission is required as a last resort, reduce the length of time that people have to stay in hospital. I am pleased to say that funding for children and young people’s eating disorder services has increased, rising from £46.7 million in 2017-18 to a planned £101 million in 2024-25. With this extra funding, we can focus on enhancing the capacity of community eating disorder teams across the country. We are also committed to providing an extra 8,500 new mental health workers across child and adult mental health services to cut waiting times and ensure that people can access treatment and support earlier.”
“By the summer, robust new protections for children will be enforced through the Act to protect them from harmful content and ensure that they have an age-appropriate experience online. It is right to focus on awareness and early intervention, but we know that some people simply need access to high-quality treatment in order to get better. A key priority of this Government is therefore to expand community-based services to treat eating disorders, so that people can be treated earlier and closer to home. NHS England is working to increase the capacity of community-based eating disorder services.”
“This national network is expected to bring local services together and deliver support for young people facing mental health challenges, including support for those with eating disorders. We should also be concerned about the widespread availability of harmful online material that promotes eating disorders, suicide and self-harm, which can easily be accessed by people who may be vulnerable. We have been clear that the Government’s priority is the effective implementation of the Online Safety Act, so that those who use social media, especially children, can benefit from its wide-reaching protections as soon as possible. Our focus is on keeping young people safe while they benefit from the latest technology.”
“Early support hubs provide open-access drop-in mental health services that assist children and young people with a range of issues, such as eating disorders, at an early stage without the need for a referral or doctor’s appointment. I am pleased to say that this year, thousands more young people will receive support with their mental health, thanks to £7 million of new funding for 24 existing community-based early support hubs to expand their current offer. That funding will deliver 10,000 more interventions such as group sessions, counselling therapies and specialist support over the next 12 months. Looking forward, we are also committed to rolling out open-access young futures hubs in communities.”
“A number of colleagues asked when that guidance will be published; my officials are working hard with specialists on that, and it will be published later this year. The existing mental health support teams, supplemented by the specialist mental health professionals that we will be providing access to in every school in England, will support school staff to raise awareness and identify children and young people showing potential early signs of an eating disorder. Through these interventions, children and young people can be given early support and help to address problems before they escalate. Community-based early support hubs for children and young people aged 11 to 25 also play a key role in providing early support for young people’s mental health and wellbeing.”
“However, we recognise that there is still far more to be done to ensure that patients with eating disorders can access treatment at the right time. The hon. Member for Bath rightly focused the debate on the importance of awareness. Raising awareness of eating disorders is the first step towards early intervention to prevent the devastating impacts that eating disorders can have on people’s lives. To support this, NHS England is currently refreshing guidance on children and young people’s eating disorders. The refreshed guidance will highlight the importance of awareness and early recognition of eating disorders in schools, colleges, primary care and broader children and young people’s mental health services.”
“Figures released last month show that although the number of referrals and demand for services has begun to stabilise during the past year, the number of children entering treatment reached a record high of 2,954 last quarter. This shows that the extra funding is enabling services to begin to meet the extra pressures caused by the pandemic. Similarly, the number of children entering treatment within the target time has reached a record high. Of the 2,954 children entering treatment last quarter, 2,414 were able to access that treatment within the one-week urgent target or the four-week routine target—a rate 81.7%. That is the highest figure recorded since NHS England began collecting that data in 2021.”
“The figures do not mean that the individual had a confirmed eating disorder, but they present a worrying situation that we must address by continuing to promote both awareness and early intervention. The surge in demand has inevitably made meeting our waiting time targets more challenging. However, our services and clinicians, backed by new funding, are supporting more people than ever before. These services are changing and saving lives. As hon. Members will know, we have kept in place the access and waiting time standard for children and young people who are referred with eating disorder issues. This sets a 95% target for children with urgent cases to begin treatment within one week, and for children with routine cases to start treatment within four weeks.”
“We are absolutely clear that every ICB must meet its targets, while also being clear that it is up to the ICB to take decisions as close as possible to the communities that they serve. Sadly, we have seen the prevalence of eating disorders in children and young people sharply increase since 2017. In 2023, NHS England published follow-up results to its survey on the mental health of children and young people. The report found that the prevalence of eating disorders in 17 to 19-year-olds rose from 0.8% in 2017 to 12.5% in 2023. Unfortunately, we are also seeing the prevalence of eating disorders rising among adults. The 2019 health survey for England showed that 16% of adults over 16 screened positive for a possible eating disorder.”
“National funding has increased over the years, as the hon. Lady will know. The question is whether that funding channels through to ICBs. The Government’s view is that ICBs are best placed to make decisions as close as possible to the communities that they serve and to target and, if necessary, reallocate funding accordingly. As a Government, we are constantly trying to get the balance right between setting frameworks and targets and ensuring that those are being met, while also ensuring that ICBs are not being micromanaged from the centre. We do not think it is right that people sitting in Whitehall or Westminster micromanage what is going on at a local level.”
“One person afflicted by an eating disorder is one too many, so the Government will strain every sinew to combat this profoundly debilitating condition.”
“I will follow up on those points and write to the right hon. Gentleman. As he knows, the Green Paper is out for consultation. Although the Government have made decisions about some measures, we are consulting and engaging on a number of others. It is very important that we see all the issues that he raises in the round, and I will follow them up with colleagues, particularly in the DWP, and write to him. I again thank the hon. Member for Bath for raising this important issue and for her tireless efforts in this House to raise awareness of eating disorders. I thank all hon. Members for their thoughtful and moving contributions on behalf of their constituents and, in some cases, their loved ones.”
“The fact that the number of adults and children in Somerset ICB accessing an NHS dentist is even lower than the already struggling rate across England is concerning. Somerset is facing significant workforce pressures, and there are not enough NHS dentists available to do the job. As of March 2024, there were 334 vacancies in the south-west for full-time equivalent NHS general dentists. The 29% vacancy rate is the highest of any English region. It is a shocking fact that the No. 1 reason for children aged five to nine being admitted to hospital in our country is to have their teeth removed, with a primary diagnosis of tooth decay. It is a truly Dickensian state of affairs.”
“It is a pleasure to serve under your chairship again this morning, Mr Stuart. I thank the hon. Member for Frome and East Somerset (Anna Sabine) for securing this important debate on access to dentistry in Somerset. We know that there are challenges in accessing NHS dentistry across the country, with some areas facing acute challenges. Put simply, too many people are struggling to find an NHS appointment. In the two years up to June 2024, just 31% of adults were seen by an NHS dentist in Somerset’s integrated care board, which covers the hon. Lady’s constituency, compared with 40% across England. In the year to June 2024, only 42% of children in Somerset ICB were seen by an NHS dentist, compared with 56% across England.”
“We will absolutely ensure that integrated care boards are delivering to the target they have been set. If we see any evidence of slowing down or backsliding, we will certainly intervene to ensure that appointments are accelerated. I would also be more than happy to receive representations from my hon. Friend if he feels that performance in his ICB is not delivering. The state of NHS dentistry in Somerset, and the nation as a whole, is simply unacceptable and it has to change.”
“My hon. Friend puts her finger on the fundamental problem, which is that the NHS dental contract simply does not incentivise dentists to do NHS work. That is the fundamental reason why we are in this bizarre situation where demand for NHS dentistry is going through the roof, yet there is a consistent underspend in the NHS contract. It is a classic example of a false economy. The Conservatives thought they were being terribly clever by structuring a contract in a way they thought would deliver value for money, but in fact, it simply failed to incentivise dentists to do NHS work and they drifted more and more into purely private sector work. That is the very definition of a false economy.”
“By the time I came into government, the Nuffield Trust was describing the state of NHS dentistry as “at its most perilous point in its 75-year history.” As of March 2024, there are over 36,000 dentists registered with the General Dental Council in England, yet there are fewer than 11,000 full-time equivalent dentists working in the NHS.”
“I am pleased to confirm that I am meeting the BDA in the coming days. The negotiations are moving forward. There is no perfect payment system, and there is a need to get the balance right between ensuring that we have a viable system that does not deliver underspends in the NHS contract, which is absurd, and that we deliver as much NHS dentistry as possible to the communities and people who need it. That is a complex process and it will take some time. The Government have taken intermediate measures, such as the 700,000 urgent appointments and supervised toothbrushing, which we will work on at pace over the course of the coming financial year while also working on a radical overhaul of the contract.”
“In the past five years, there has been a 15% reduction in courses of dental treatment being delivered across England, and 28% of adults in England—a staggering 13 million people—have an unmet need for NHS dentistry. As a result, we hear too many stories about people who are unable to access the care they need, and some horrific accounts of DIY dentistry that nobody should have to resort to. Dentistry rightly receives a lot of attention because of its dismal state, and I am grateful to the National Audit Office and Public Accounts Committee for their interest in the previous Government’s dentistry recovery plan. It is evident that the plan did not go far enough.”
“I absolutely agree. Two big things need to happen. First, the General Dental Council needs to do more to get more exams in place for those very well-qualified dentists. Of course, they have to pass the British exam. We cannot have people practising in Britain who have not passed that exam, but the availability of the exam has been too limited and that needs to change. The other thing is provisional registration. Some work can be done to expedite the registration of an international dentist, but more needs to be done on that as well. I will meet the head of the General Dental Council shortly, and I will convey those messages to him. Recruitment and retention issues are not limited to dentists; there are difficulties across the whole dental team, including dental nurses, hygienists, therapists and technicians.”
“Gentleman that once we have got a contract that works, we must ensure that every penny that is committed to NHS dentistry is spent on NHS dentistry, rather than the absurd situation that we have now, in which we constantly have underspends in the NHS dentistry contract while demand for NHS dentistry goes through the roof. It is a truly bizarre situation. I return to the subject of the dentistry recovery plan. The new patient premium, introduced by the previous Government, aimed to increase the number of new patients seen, but that has not happened. In reality, since the introduction of the previous Government’s plan, there has been a 3% reduction in the number of treatments delivered to new patients. It is clear to this Government that stronger action is needed, and we are prepared to act to stop the decay.”
“I take the hon. Gentleman’s point about the ringfence, but in a way, ringfencing addresses the symptoms, rather than the cause, of the problem. The fundamental cause of the problem is the amateurish way in which the previous Government set up the NHS dentistry contract so that it does not incentivise dentists to do NHS work. That is what leads them to drift off. In a sense, we can do all the ringfencing we like, but if the workforce that we need is not incentivised to do the work that we need them to do, we are going to have that problem, because they vote with their feet. That is why the radical overhaul of the dentistry contract is the key point. However, I agree with the hon.”
“The recruitment process is well under way, with posts being filled by dentists in these areas as we speak.”
“We recognise the incredible work that dentists and dental professionals do, and we know that the current NHS dentistry contract is not fit for purpose. We need to build an NHS system that works for patients and their dentists. A central part of our 10-year plan will be workforce, and we will ensure that we train and provide the staff, technology and infrastructure that the NHS needs to care for patients across our communities. We will publish a refreshed long-term workforce plan to deliver the transformed health service that we will build over the next decade, and to treat patients on time again. We know that some areas face challenges in recruiting and retaining the dental workforce they need. The golden hello scheme offers 240 dentists a £20,000 joining bonus to work in underserved areas of the country for three years.”
“Our additional funding will help to secure and expand supervised toothbrushing based on local needs. This is extra resourcing to support targeted work by the local authority and its partners. I am determined that we will reduce inequalities faced by children living in the most deprived areas, helping them to brush their teeth daily in the nurseries and schools that they attend. Alongside this, we have launched an innovative partnership with Colgate-Palmolive, which is donating more than 23 million toothbrushes and toothpastes over the next five years. This is of incredible value for the taxpayer, and a fantastic example of how business and Government can work in partnership for the public good. A strong dentistry system needs a strong workforce.”
“We want to ease the strain on the NHS and create the healthiest generation of children ever. As colleagues will be aware, too many children are growing up with tooth decay, which is largely preventable. That is why we have invested £11.4 million to roll out a national supervised toothbrushing programme for three to five-year-olds that will reach up to 600,000 children a year in the most deprived areas of England. The latest data shows that the rate of tooth decay for five-year-olds in Somerset is 20.2%, which is lower than the 22.4% for England but still far too high. We are taking a targeted approach to support those in the most deprived areas, which is why we have been able to allocate £50,000 of funding to Somerset to support around 2,000 three to five-year-olds.”
“The urgent appointments will be available to NHS patients who are experiencing painful oral health issues, such as infections, abscesses, or cracked or broken teeth. Somerset integrated care board has been asked to deliver 13,498 of those appointments. That is 13,498 more chances for the hon. Lady’s constituents to get the urgent dental support that they need, every single year. Across the south-west region, there will be 106,776 extra appointments—that is more chances for patients in urgent need of care. However, to have a truly effective dental system, we cannot focus just on those who are already in pain; we must have a system that prioritises prevention. A cornerstone of the Government’s mission to prevent ill health is supporting children to live healthier lives.”
“We are very keen to ensure that targets are being met, and the ICB clearly needs to ensure that that is happening, so I would be happy to do that. Perhaps the hon. Lady could write to me so that we can get all the facts on the table, then we can take action accordingly. We will make the difficult decisions necessary to restore NHS dentistry to ensure that patients can access the care that they need, at the best value for taxpayers. Since coming into office, we have focused on implementing new initiatives and stopping the things that are not working. From today, 1 April 2025, the public will see 700,000 additional urgent dental appointments being delivered every year, as we promised in our manifesto.”
“Fixing our broken dentistry system will not be easy, but I want to reaffirm our commitment to making bold changes and tough decisions to stop the decay and to rebuild the foundations of NHS dentistry. This is an immense challenge—there are no quick fixes and no easy answers—but people in Somerset and across the country deserve better access to dental care, and we are determined to make that a reality. We are committed to rebuilding a system that puts patients first, ensuring that no one is left without the dental care that they need. Question put and agreed to.”
“Where we identify opportunities, we will make improvements to the current system when those can increase access and incentivise the workforce to deliver more NHS care. I am pleased that work to improve access has also been taking place at the local level, and that Somerset ICB is opening three new practices in Wellington, Crewkerne and Chard. Those services will provide much-needed additional capacity in Somerset. The ICB is committed to delivering additional urgent dental appointments and increasing access for residents facing the greatest health inequalities—although I do recognise what the hon. Member for Tiverton and Minehead (Rachel Gilmour) said about the concerns that she raised.”
“I thank the hon. Member for that intervention. It is an excellent idea, and it is something that we have seen in other parts of the country. If he would care to write to me about that, I would be more than happy to take that issue up. In the south-west, the golden hello scheme has already led to seven new dentists on the ground delivering NHS dentistry to patients, and a further six have been recruited and are waiting to start their roles. With 64 live adverts across the region, we are confident that the numbers will grow. And, for the first time in more than a decade, we have increased payments for practices training a foundation dentist. We will not stand idly by while the fundamental reforms to the contract are developed.”
“The first is that the Secretary of State may not lay regulations before either House under subsection (1) unless an impact assessment of those regulations is also laid before both Houses. The second is that the impact assessment must include an assessment of the impact of the regulations both on the health professional workforce and on the NHS itself. Impact assessments are routinely prepared to accompany secondary legislation. However, the amendment would impose a statutory requirement on the Secretary of State to prepare an impact assessment, which would need to be laid before both Houses. It would therefore create a legal requirement that is not the standard for secondary legislation.”
“That would limit the scope of the Secretary of State’s powers to ensure that assistance is available in the absence of a definition. The meaning of “public authority” might be unclear. Amendment 529 would remove the power to amend, revoke or repeal legislation via regulations made under clause 32(1) concerning arrangements for assistance, where passed or made before the end of the Session in which the Bill is passed. That could lead to gaps in the Secretary of State’s regulation-making powers and in other legislation. It could also have an impact on the workability of arrangements for assistance and, ultimately, the Bill. Amendment 530 would add two requirements when making regulations under clause 32, which sets out the Secretary of State’s powers to ensure that assistance is available.”
“However, it is doubtful that those arrangements could be made through the NHS; rather, the Secretary of State could, for example, make arrangements for another body to provide assistance. The effect of amendment 537, as drafted, is potentially ambiguous. However, the Government’s assessment is that it could be interpreted as allowing regulations to enable the provision of assisted dying by a registered charity, while not allowing provision as part of the health service. That could put into doubt whether assisted dying could be provided as part of the NHS in England and Wales. Amendment 528 would prevent any body other than a public authority from being authorised by regulations to provide assistance as set out in the Bill, regardless of whether that body is contracted to do so by a public authority.”
“It is a great pleasure to serve under your chairship this afternoon, Mrs Harris. The Government remain committed to ensuring the legal robustness and workability of all legislation. For that reason, we have worked with my hon. Friend the Member for Spen Valley on some amendments to the Bill. Where changes have been mutually agreed by my hon. Friend and the Government, I will offer a technical, factual explanation and a rationale for the amendments. Amendment 525 would remove the Secretary of State’s explicit power to make regulations enabling the provision of assistance as part of the health service in England and Wales. It might therefore prevent such assistance from being provided by the NHS. The Secretary of State would still have the power to make arrangements for the provision of assistance or to delegate the making of arrangements.”
“New clause 36 creates the basis for the provision of assisted dying services, in compliance with all the legislation that defines how the national health service works. If the new clause is agreed by the Committee, and ultimately by Parliament, further amendments and changes will not be required. It will be the basis for the provision of the assisted dying service, within the framework of all the legislation that defines how the NHS works.”
“New clause 36 specifies that the Secretary of State will, by regulation, set out the operating framework for the delivery of the assisted dying service. That will be the change to the legislation that is required. I apologise to the hon. Gentleman if I am missing something. I do not know whether we are talking at cross purposes here. What I am saying is that new clause 36 provides the basis for the delivery of the service. I am sorry if I am missing his point, but that is my understanding.”
“Amendment (a) to new clause 36 would prohibit regulations being made that authorise the provision of voluntary assisted dying services by the NHS in England. The Secretary of State would still have a duty to ensure that arrangements are made for the provision of assistance, but not by the NHS. The Secretary of State could, for example, make arrangements for another body to provide assistance, which would mean that the Secretary of State could not ensure that assistance was provided in accordance with the Bill or through the NHS in England. This would apply only to England, not Wales. Welsh Ministers could still make regulations for the provision of voluntary assisted dying services by the NHS in Wales. This could result in a divergence between England and Wales in the provision of assisted dying services.”
“I thank my hon. Friend for that clarification. It is very helpful, because I perhaps did not quite understand what the hon. Member for East Wiltshire said. My hon. Friend sets out very clearly the optionality represented in new clause 36. The new clause further ensures that voluntary assisted dying services provided as part of the health service must be free of charge, unless charging is expressly provided for. Subsection (6) confirms that regulations made under this new clause can make provisions with the same effect as an Act of Parliament, including amending other primary legislation. However, they cannot amend the provisions in this Bill. The amendment also defines voluntary assisted dying services.”
“It is possible that being unable to do so here may present operational challenges. The amendment applies only to England, and the restriction does not apply to Welsh Ministers. That could result in a divergence between England and Wales in the provision of voluntary assisted dying services. Amendment (d) to new clause 36 seeks to limit the Secretary of State’s power to amend, revoke or repeal other legislation for the purpose of making provision for assisted dying services.”
“This could result in a divergence between England and Wales in the provision of assisted dying services, as Welsh Ministers could amend section 1 of the National Health Service (Wales) Act 2006. Amendment (c) to new clause 36 would limit the scope of the Secretary of State’s power in subsection (1) of new clause 36 to make regulations that secure arrangements for the provision of voluntary assisted dying services in England. Under this amendment, such regulations cannot authorise the provision of assistance by a body other than a public authority, even if that body is contracted by a public authority to do so. That would effectively prevent the NHS from contracting with private providers to provide assistance. The NHS regularly contracts private providers to provide NHS services.”