Victoria Atkins
MP for Louth and Horncastle · Conservative · United Kingdom
“Oh dear. This may be the last time the Secretary of State gets to give such an inadequate answer to what is a reasonable question about her grip on her Department. But let us look at Labour’s wider chaos.”
“In recent weeks, DEFRA’s quangos have made headlines: the Environment Agency is failing to prosecute waste criminals, instead going after virtuous volunteers who are cleaning up the rivers for it; Natural England is demanding more madcap fish schemes at Hinkley Point C, on top of its recommended £700 million fish disco policy, all of whic…”
“There are many questions still left unanswered in this report, and I hope that the Secretary of State will try to answer them rather than deflect, because that has been noticed. The plan looks to double the funding for Environment Agency inspections. Why are this Government focusing on bureaucracy rather than helping farmers survive?”
“In another leap from reality, the Government’s negotiations with the EU get barely a mention in this document, despite the enormous consequences they will have for farming businesses. CropLife UK has estimated that this EU reset could drain £810 million from UK farms and sacrifice almost 9,000 jobs from our rural constituencies.”
“We Conservatives view DEFRA as a vital economic Department, so we agree with its efforts to recalculate farming and food producers’ contributions to the economy. By the way, I note that Reform calls itself the farmer’s friend, yet there is not a single Reform MP in the Chamber.”
“As Labour MPs and Ministers in the Department for Environment, Food and Rural Affairs voted repeatedly for the family farm and family business taxes, DEFRA Ministers shut down farming payments without notice, including the SFI. Sadly, the record of this Government is rising food prices and a record number of farms closing.”
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“May I thank my hon. Friend for her care and also for sharing her experiences on this subject? Through the drugs strategy, we have committed an extra £532 million of funding over three years to improve alcohol and drug treatment services, with £15.7 million invested in Lancashire. Last year, we saw a further £2.8 million invested nationally in line with guidance for the extra drugs strategy funding, which allows local authorities to fund targeted services for parents in need of treatment and support for their children and families. I will, of course, be happy to meet my hon. Friend to discuss this further.”
“I thank the hon. Gentleman for bringing some insight into how we can best reach families. Of course, it is not just mums, but fathers or carers who can have a huge impact on our children. That is why the Under-Secretary of State for Health and Social Care, my right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom), is investing so much energy and commitment in our family hubs. We believe that they can be the centre for families to make the very best start to a child’s life.”
“Our plan includes opening 5,000 more beds, increasing ambulance capacity, expanding innovative services such as virtual wards and bringing forward covid and flu vaccinations for the most vulnerable. Thanks to the hard work of staff, NHS performance this winter has improved on last year, despite the impact of industrial action.”
“I am sure that the hon. Gentleman is a fair man, and that, being so, he will point out to his constituents, when they call him with their issues, that ambulance response times for category 2 emergency incidents in his local area have in fact been over 30 minutes faster than last year. However, we accept of course that this is a two-year plan and will take time to meet our full ambitions. Interestingly, the latest figures show that we have provided £6.9 million from the community diagnostic centres fund for the development of a community diagnostic centre at Wakefield. Presumably he welcomes that Conservative innovation.”
“My hon. Friend is right to point out that we are in the final few hours of the consultants’ ballot on the pay reform programme that we have offered the British Medical Association. I very much hope that consultants will feel able to support that programme, because it is about bringing together the frankly quite bureaucratic system that they have to deal with at the moment, so that they are assessed in a shorter time with less bother and paperwork, while respecting their need to train and keep up their education and supporting professional activities commitments. I hope that they will agree with us on that. As I have said to the junior doctors committee from this Dispatch Box, should they return with reasonable expectations, we will, of course, reopen negotiations.”
“Again, the plan that we laid out last year is having a real impact at local level on the services being deployed through our accident and emergency services. We have seen discharge rates improving, for example. We appreciate that there can be local differences, but the importance that we put on maintaining that flow through hospitals is critical to ensuring that the waiting lists and waiting times that the hon. Lady describes are reduced. However, I gently remind the Labour party that it has been running the NHS in Wales for some time now, and it is a great shame that the good people of Wales— [ Interruption. ] The good people of Wales are waiting longer for their treatment— [ Interruption. ] They are almost twice as likely—”
“I genuinely want to work with the Scottish Government, because I am troubled, to put it bluntly, that Scotland has some of the worst health outcomes in western Europe. It has the worst level of drug death rates in Europe, the highest alcohol death rates in 14 years, and there was a fall in life expectancy for three years in a row. We offered to allow Scottish patients to receive lifesaving operations in England, but sadly, that offer has been declined. I remain genuinely willing to work with the Scottish Government to help them with their health service.”
“We are investing an additional £165 million a year to improve maternity and neonatal care, rising to £186 million a year from April. This will increase the number of midwifery posts and improve the quality of care that mothers and babies receive. As of October last year, there were 23,100 full-time equivalent midwives working in NHS trusts and other core organisations in England, which is more than 1,000 more than a year ago and 3,500 more than in 2010.”
“I think we all agree that a career as a midwife is just one of the most rewarding and fulfilling careers that one can hope for. That is why we have placed such priority on retention in the long-term workforce plan that we launched last year. The national retention programme for midwifery and nursing has prioritised five actions to support staff retention, including menopause guidance, because we know that that can be an issue for midwives, and valuing them and their contribution is also a key objective of NHS England’s three-year plan for maternity services.”
“I thank my right hon. Friend for raising her local college, which does amazing work for the whole of the NHS as well as in her local area. I may have to retain a discreet silence over that particular application but I know that if any Member is sure to advocate effectively for their local area, it is my right hon. Friend.”
“I was genuinely delighted to welcome the hon. Lady to the Government’s women’s health summit last week to announce the consolidation, and indeed the improvement, of the women’s health strategy that this Government have launched. We saw significant success last year with hormone replacement therapy improvements and she knows, because she attended the summit, that I have just announced a £50 million research fund looking at maternity disparities and also research into female-specific conditions. Any concern she has about operation times she should take up with the local trust and it will perhaps tell her what impact industrial action has had, sadly, on elective surgery.”
“We have made progress against our target to reduce learning disability and autism in-patient numbers in England by 50% since 2015. For people with a learning disability without an autism diagnosis, there has been a 58% net reduction; for people with a learning disability who are autistic, the net reduction is 35%.”
“I thank my hon. Friend for her interest and, of course, her many years working as a clinical psychologist. She brings that experience to the Chamber. National commissioning guidance to integrated care boards was published in November. It sets out that a mental health in-patient stay for a person with a learning disability “should be for the minimum time possible, for assessment and/or treatment which can only be provided in hospital”. In overseeing implementation of the action plan going forwards, the “Building the right support” delivery board will maintain focus on quality of care and on reducing long stays.”
“I thank the hon. Lady for raising that point. We were all dismayed and upset to see the experiences of residents in those units, and we saw the correct criminal outcomes—if I am allowed to say that—for those involved in those assaults. A review is going on as to how those issues are affecting the estate as a whole, but we are clear that in-patient stays should happen only when they are strictly necessary. We must be mindful that clinicians will be taking many situations into account, including not just the safety of the patient but the safety of the wider community.”
“Friends the Members for Hyndburn (Sara Britcliffe) and for Stafford (Theo Clarke), by March we will make dedicated maternal mental and physical healthcare available to every woman in England.”
“Women’s health needs are often overlooked and under-researched. Through our women’s health strategy, the Government are changing that. Last year, we made menopause a priority, helping almost half a million women get hormone replacement therapy for less than £20 a year. This year, we are building on that work and will have a women’s health hub in every integrated care board area in England. We will promote research into conditions that only affect women, such as endometriosis and lobular breast cancer, and those that affect women differently from men, such as heart attack symptoms. We have also launched the first research challenge—worth £50 million—to tackle maternity disparities that have no place in modern Britain. Following the brave campaigns of my hon.”
“I gently remind the hon. Lady about the statement that I just gave. Last week we held the women’s health summit, at which I announced that we are encouraging research into conditions such as lobular breast cancer. I made that announcement because of two amazing women I met recently who were living with the condition. They were introduced to me by my right hon. Friend the Member for Horsham (Sir Jeremy Quin) and my right hon. Friend—”
“I would be delighted to meet my hon. Friend to discuss that. As always, he is an excellent advocate for his constituency, and I will enjoy listening to the results of his survey.”
“We understand how worrying the possibility of medication shortages can be. There is a supply issue with riluzole 50 mg tablets, caused by a supplier experiencing manufacturing issues. We have a well-established procedure in place to deal with such issues, and are working with the industry, the NHS and others to resolve it as quickly as possible. We have contacted alternative suppliers and have secured sufficient volumes of stock.”
“We see that as part of a much wider campaign to ensure that we treat the sun safely, by reducing the amount of time we spend in the sun, particularly during peak hours of the day in summertime. I keep all these discussions in play with my Treasury colleagues.”
“I thank my hon. Friend sincerely for her question. The good news is that community diagnostic centres have now delivered over 6 million additional tests and scans since July 2021 thanks to the hard work of NHS staff, but I will of course be delighted to meet her to discuss her plans for her local constituency.”
“We are ensuring that community pharmacists have an even greater role in primary care than they have already. For example, we saw the first stage of the roll-out of Pharmacy First in December, with blood pressure checks and contraceptive care being rolled out. I am very pleased that we are on track to deliver the full roll-out of Pharmacy First by the end of the month.”
“I thank my right hon. Friend for commissioning that vital piece of work. I am giving the matter my closest attention, and I hope very much to be in a position to respond to his points in due course.”
“I am delighted that the House is as happy about that expansion as the hon. Gentleman and I are. I will meet him to go through his plans, because I know how carefully he has campaigned for this important asset in his constituency.”
“The hon. Lady is aware of my knowledge not only of that hospital, but of her local area. I will look into this matter for her, because I want to ensure that the good people of Lancashire, Mr Speaker, are looked after as we would all hope and expect.”
“I thank my right hon. Friend and my hon. Friend the Member for Bishop Auckland (Dehenna Davison) for bringing two amazing women to talk to me about the impact of lobular cancer. For the benefit of Members on both sides of the House, last week we sent out a “Dear colleague” letter and graphics about the women’s health strategy so that we can all help our constituents to understand what this Conservative Government are doing to ensure that the healthcare of women is faster, simpler and fairer.”
“I am determined to fix these issues, and the other problems facing NHS dentistry, so that anyone who needs to can always see an NHS dentist, no matter where they live. Indeed, one of my very first acts as Secretary of State was to respond to the Health and Social Care Committee’s recommendations on dentistry. We agreed to the majority of those recommendations, and we stand firmly behind the ambition that NHS dentistry should be accessible and available to all who need it.”
“We are reforming our NHS and social care system to make it faster, simpler and fairer. Dentistry is a vital part of our NHS and improving dentistry is one of my top priorities. The hon. Member for Ilford North (Wes Streeting) represents a deeply urban seat, so I am pleased that he has presented me with an excuse to boast about the fact that I represent, and am very proud to represent, a rural and coastal constituency. That is why fairness is one of my three priorities for our NHS. I know the challenges that rural and coastal communities face when it comes to accessing an NHS dentist appointment, and the disparities in health that we see between rural and coastal communities and city centres. I will come to some statistics in a moment.”
“I beg to move an amendment, to leave out from “House” to the end of the Question and add: “recognises the impact of a once-in-a-generation pandemic on NHS dental services, with 7 million fewer patients seen in England across 2020 and 2021; notes these challenges were reflected in both Scotland and Wales; acknowledges the steps already taken to recover services in England including the introduction of a minimum rate and increased payments for complex dental activity to better reward dentists for their work; welcomes the publication of the Long Term Workforce Plan which committed to expanding dental training places by 40 per cent; and supports the upcoming publication of the Government’s plan to further recover and reform NHS dentistry and promote good oral health throughout life.” It is a pleasure to update the House on the work the Government are doing to strengthen NHS dentistry across the country.”
“Member for Ilford North missed them out in his speech. The Government delivered 6 million more courses of NHS dental treatment in 2022-23 than in the previous year. [Interruption.] In the two years to June 2023, the number of adults seeing a dentist increased by 1.7 million compared to the number in the previous year, and 800,000 more children saw a dentist in the year to June 2023. Opposition Members cannot have it both ways. While I was reading out those statistics they were saying, “You cannot make those comparisons because of the pandemic”, but that is the point: people did not come forward during the pandemic, so, as we must all know from experience in our own constituencies, there is a backlog that dentists around the country are having to work through—and they are making progress.”
“I am going to make a little progress, but I promise to give way later. The whole House understands that the pandemic placed a long-lasting and heavy burden on NHS dentistry. [Interruption.] I hear groans from Opposition Members, but they cannot ignore the fact that some 7 million people did not come forward for appointments during that long period of the pandemic because dentists had to shut, and we were unable to accommodate those needs within the system because of the severe strictures under which we were all placed as a society. We shepherded the sector through the pandemic with £1.7 billion of direct support to compensate for NHS activity that could not be delivered. As we recover from the pandemic there are no quick fixes, but our recovery is well under way. Let me give the latest statistics, because the hon.”
“As I have explained, in relation to dentistry but also in relation to wider healthcare, the long-term workforce plan, which was requested by NHS England and by clinicians, is the means of laying those foundations for the future of the NHS. I will now give way to the hon. Member for Wallasey (Dame Angela Eagle).”
“The hon. Lady has raised an interesting and important point, because, of course, dentists are independent contractors to the NHS, and I have to work with the levers that are available to me. As I have said, we have already invested £1.7 billion to try to help with the recovery, and the House will, I hope, look forward to our dentistry recovery plan when it comes to other ways in which we can improve that. The important point, however, is that because those dentists are independent contractors, we must work with the profession to encourage them back to the NHS to offer the services that we all want to see.”
“I thank my right hon. Friend, and indeed my friend, my Lincolnshire neighbour, who knows as well as I do the pressures that we face in ensuring that our constituents receive the same quality of care that we expect across England. He was right to draw attention to the—I would argue—badly drafted contract of 2006, but he also touched on the complexity involved in finding systems that would work better.”
“I cannot wait to reach the part of my speech that will deal with the hon. Gentleman’s suggestions, but first I will allow him to intervene, because I enjoy this back and forth.”
“As he knows full well, “shortly” is a little shorter than “in due course” and a little longer than “imminently”. We have introduced several simple and effective measures to improve the nation’s dental health. The Health and Care Act 2022 made it simpler to expand water fluoridation schemes, because raising the fluoride level to 1 mg per litre is a straightforward way to prevent tooth decay. It has proved effective in parts of England as well as Canada, the United States, Ireland and Australia, and the chief medical officer has concluded that there is “strong scientific evidence” that water fluoridation can drive down the “prevalence of tooth decay”.”
“I am grateful to the hon. Gentleman for raising that point, because according to the latest statistics available to me, 18.1 million adults were seen by an NHS dentist in the 24 months up to 30 June 2023. That is an increase of 10%, and what does it mean in reality? It means that over 1.7 million more adults were seen than in the previous year. I know that we are all concerned about the health of children; some 6.4 million children were seen by an NHS dentist in the 12 months up to 30 June 2023, an increase of 14%, which means, in real terms, an increase of 800,000 on the previous year. I accept, of course, that there is more to do, and we will be setting that out in our dental recovery plan shortly, but this is not just about big numbers. [Interruption.] The hon. Gentleman asks when “shortly” will be.”
“That has indeed been proven to drive down oral health inequalities, which is why we have already introduced a toolkit that local authorities are using to introduce supervised tooth brushing across schools, nurseries and family hubs. We have been clear that we want to see that happening in more areas. I would encourage any colleague who is concerned about that, rather than waiting for some mythical date in the future, to ask our local authorities whether they are using these toolkits, because they are freely available, and they can and should put them in place.”
“I am going to make some progress. I am very pleased that, subject to a public consultation which will be published shortly, we have secured funding to expand water fluoridation schemes across the north-east of England. [Interruption.] The hon. Member for Ilford North may be interested to know why we have identified the north-east, given that he read out so many constituency names in his speech. The north-east was chosen because natural fluoride levels there are among the lowest in the country, and the proportion of five-year-olds with teeth extracted because of tooth decay is among the highest. We have wanted to address that very real health inequality to ensure that more than 1.6 million people in the area can benefit from this expansion, subject, as I have said, to a public consultation. Supervised tooth brushing has been raised.”
“I thank the hon. Lady, and particularly for the constructive tone of her intervention, because she is right. This is not simply about teeth health; it is also about the conditions that dentists check for—probably without anyone quite realising that they are doing so. I will take the hon. Lady up on her invitation to write to her on the figures, but that is why we are looking at health inequalities across the country and, importantly, focusing on encouraging dentists to re-register with the NHS if they have left, because it is vital for tackling much wider health conditions in addition to the pain and discomfort that tooth decay can bring.”
“These reforms have improved access to dentistry and ensured that the system better supports dentists and their teams, so they were well received by dentists, their representatives and patient groups across England, with Healthwatch’s national director recognising that these reforms show that the Government are listening to patients and taking action, and these reforms can help ensure that dental care is accessible and affordable to everyone who needs it.”
“Thanks to our reforms, dentists now receive five units of dental activity when they treat three or more teeth, which is a significant increase from the old maximum of three. Root canal treatment on molar teeth is now rewarded with seven units of dental activity, as opposed to three, meeting one of the British Dental Association’s key demands. We also recognise the barriers that too many communities have faced when accessing NHS dentistry, with people left phoning around practices to see who was taking on NHS patients. That is why we have made it a contractual requirement for dentists to update the NHS website regularly, making it clear whether their practices are taking on new patients, as well as explaining the services that they offer, thus making it easier for patients to find a dentist that can deliver the care they need.”
“We have created more bands for units of dental activity, so that dentists are properly rewarded for taking on more complex care, and the best-performing practices can see more NHS patients. Previously, regardless of the amount of time the dentist took on each patient, they received the same payment for every individual treatment package in band 2, which covers fillings and tooth extraction. Perversely, that meant they received the same payment for doing one filling as for three. That left many dentists unable to afford to take on patients who had not seen a dentist for some time and therefore needed extensive treatment. That needed to be put right for the sake of both patients and dentists.”
“I am extremely grateful to my hon. Friend. His intervention shows the level of detail that colleagues on the Conservative Benches have gone into in trying to address the understandable concerns that local NHS providers are voicing. I will look into that. I am very keen on my three words: faster, simpler, fairer. I want to make it as simple as possible for dentists to rejoin and join the NHS. I will say more on that later. The choice of whether patients are offered NHS exams and treatment lies with the dentists, who are independent contractors to the NHS. As well as making simple, common-sense changes, in July 2022 we announced a package of far-reaching reforms to make NHS work more attractive to dentists.”
“I am extremely grateful to the hon. Lady, who makes a fair point about measuring within the system how much work NHS dentists are doing. As I say, we are looking at all of this in the work that we are doing on the dentistry recovery plan. I repeat that I want to make it as simple as possible for dentists to register with the NHS, to continue offering the care that we all want them to, so I am grateful to the hon. Lady for her intervention.”
“Then, by October, it had morphed into 2 million hospital appointments and MRI and CT scanners. Now, apparently, it is funding a dentistry plan. One wonders how all these magic branches on the magic money tree will add up to all the promises made so far.”
“Member for Ilford North, because I appreciate that he has not spent any time on the Front Bench, last year alone non-domiciled taxpayers paid £8 billion in UK taxes on their UK earnings. That is equivalent to more than 230,000 nurses. Labour wants to put that at risk and put the UK at a disadvantage in the highly paid, highly competitive, highly mobile international labour market. This really is yet another branch of the magic money tree that Labour has always been looking for, to which they apparently want to add £28 billion a year of taxes or increased borrowing and increased inflation. How they want to spend this money is interesting as well, because in 2022 Labour promised that their non-domiciled taxation would fund a workforce plan. Last September, it became breakfast club meals.”
“I am going to plough on, I am afraid. Earlier, Labour Front Benchers—perhaps not understanding that they were doing so—set out the philosophical difference between our two parties on how to grow the economy. As our economy grows, we on the Conservative side of the House want to attract the best and the brightest from around the world to work in our NHS, in our tech sector, in our life sciences industry, in our movie industry—hon. Members may know that it filmed “Barbie” this year—and in many other thriving industries. Labour, however, apparently wants to shut the door by taxing such people on earnings they make outside the UK. I speak, of course, of non-domiciled tax status. If I may correct the hon.”
“I will resist, but only because I am going to ask the hon. Gentleman to intervene in a moment—he should be careful what he wishes for. I also notice that he talked about reform of the dental contract but did not give any detail. Government is not as easy as selling a book. It cannot be cut and pasted from Wikipedia, as some on the Labour Front Bench seem to like to do. It is about being clear on what you would do differently. Now, Labour in Wales is of course running the Welsh NHS. They do like to do things differently. People there are almost twice as likely to be waiting for health treatment as in England.”
“I thank my hon. Friend, who represents a Welsh constituency. The chair of the British Dental Association wrote to the Labour Welsh Government to complain about their plan and, I understand, used words such as “toxic mix of underinvestment” and “untested targets.” The picture in Wales, if it is the Leader of the Opposition’s blueprint, is perhaps not as convincing as the shadow Health Secretary would have us believe. The fundamental difference between the current systems in England and Labour-run Wales is that Wales has a capitated list system for dentistry. I am willing to give way so that the shadow Health Secretary can clarify whether he wants to bring in that system.”