Care in the Community

We are getting the NHS back on its feet and making it fit for the future by shifting care to the community with £889 million more for GPs, 1,700 additional frontline GPs, 700,000 extra urgent dental appointments annually and a 19% uplift to the community pharmacy contract. Looking to the future, our commitment to building a neighbourhood health service is right at the heart of our 10-year plan.

I am delighted by the Government’s commitment to moving healthcare closer to the community, including through the establishment of neighbourhood health centres. That is exactly what we need in Aylesbury, and I am pleased that all our key healthcare providers, including the NHS trust and several GP practices, are already working together to better integrate their care, which is an important step in the right direction. Will the Minister update me on his progress towards the model of neighbourhood-based healthcare? Can he advise what more Aylesbury’s healthcare providers can do to ensure that my residents benefit from the Government’s work in this area?

It is really good to hear about the fantastic work going on in my hon. Friend’s constituency. We are working with systems to move to a neighbourhood health model by building on existing good practice, particularly around the development of multidisciplinary teams. Aylesbury is an outstanding example of that. Ahead of the 10-year health plan’s publication, local communities can continue to make progress by utilising the neighbourhood health guidelines that were published back in January.

Dental patients with untreated need end up in hospitals. In places like Hedon in my constituency, we have seen more and more dental practices moving away from the NHS. I have a constituent who found it took her three years to get her child their first check-up, and that dental practice has now ceased to look after NHS patients. She also cannot get the NHS treatment she deserves herself, even though she had a child in February. What in the 10-year plan will change that and ensure that everyone can get access to NHS dentistry?

The right hon. Member is right to point to children’s dental health. After we won the election in July, I looked across my portfolio and it was pretty much a car crash in every aspect, thanks to the incompetence of previous Governments. Perhaps the most shocking statistic of all is that the biggest reason five to nine-year-old children are admitted to hospital is to have their rotten teeth removed. That is a Dickensian state of affairs. We are working with the British Dental Association on contract reform. We have got to incentivise NHS dentistry, do away with the false economy set up under the last Government and get dentistry back to where it needs to be.

The saying goes that it takes a village to raise a baby, meaning that those in our community provide families with vital support. Does the Minister agree that we need to invest in more community midwives to ensure that families are properly supported through the whole of pregnancy and after birth?

I thank my hon. Friend for that important question. The role that midwives play, alongside other community health services such as district nurses, has been chronically underfunded and neglected over the past 14 years. She will be pleased to know that the role of community healthcare is front and centre in our 10-year plan, and I think she will be interested in and pleased with what she sees when that plan is published.

The Darzi report pointed out that 13% of hospital beds are occupied by people who are fit for discharge but who cannot get out because social care is broken. Lord Darzi said that we cannot fix the NHS until we fix social care. It is nearly six months since the Secretary of State promised cross-party talks and a commission, but the talks were cancelled and never rescheduled and the commission is delayed. Please, when will the Government stop going slow on social care? Please, when can we all get around the table to talk about fixing social care so that everyone gets the care they deserve?

I have to correct the hon. Lady: the commission is up and running, Baroness Casey has started meetings and she had a roundtable just a few weeks ago with people who have lived experience. The hon. Lady is therefore not correct on that point and I am sure that she will want to correct the record. On the point about delayed discharge, the hon. Lady is absolutely right. We are reforming the better care fund to get much better interface between hospitals, care and local authorities. That system and those relationships can and should work much better, but there are pressing, long-term challenges. We are conscious of that and are working at pace with Baroness Casey to ensure that those reforms are delivered.

I call the Liberal Democrat spokesperson.

As we have just heard, it is widely acknowledged that the crisis in social care is a cause of dangerously high occupancy rates in hospitals that lead to the horrors of corridor care, the dreadful ambulance waiting times that we have seen and a knock-on effect on the community. When I was contacted by the family of a terminally ill man in Wem in my constituency last month, I was reminded that not only is care often provided in the wrong place, but it is often not available at all. Will the Government bring forward the timeline for the horribly delayed Casey review to report back, get it done this year and heed Liberal Democrat calls for cross-party talks so that we can agree on a long-term solution for the crisis?

May I just tackle the idea that we are not working at pace on these issues? We have had the unpaid carer’s uplift from £151 to £196, which is the biggest uplift in carer’s allowance since the 1970s when the policy was brought in; hundreds of millions of pounds’ uplift in the disabled facilities grant; and groundbreaking legislation for a fair pay agreement for care workers. Those are just some of the immediate steps that we have taken. The first phase of the Casey review will report next year and we continue to work closely with Baroness Casey to deliver the reforms that are so desperately needed after 14 years of neglect, including a number of years when the Liberal Democrats were in government.