Health Services: Cross-border Co-operation

Jamie Stone Excerpts

Tuesday 16th April 2024 Westminster Hall

[Virginia Crosbie]

I thank the hon. Member for his intervention, and in particular for that feedback on how cross-border co-operation actually works. Of course I am focusing on Wales, but he quite rightly highlights that this is the United Kingdom. By working together, we can solve these issues and provide a collaborative approach to healthcare for people across the UK.

I also wanted to add to my list of failures the near-collapse of local NHS dental services. I could honestly stand here and reel off story after story of lives drastically and sometimes irreversibly impacted by the failures of BCUHB. In Holyhead, the largest town in my constituency, two GP practices were merged during the pandemic into Hwb Iechyd Cybi, or Cybi Health Hub. That practice has suffered a series of problems, including twice facing the threat of having no GPs—and that is in Holyhead, the largest town in my constituency.

One of the main things that would make a difference to Hwb Iechyd Cybi and the people it serves would be to co-locate the two original practices. Proposals have been made for that and, in the longer term, for a state-of-the-art healthcare centre for Holyhead. The co-location project would deliver economies of scale that would vastly improve the service that the practices can deliver and, therefore, patient outcomes. The project was allegedly given the go-ahead two years ago, but it has stalled and stalled in BCUHB’s hands, and now it has completely stagnated. Likewise, the integrated health centre has been under discussion for years, but it remains under discussion, with no progress likely. Lack of funding is the problem that is generally cited.

Hwb Iechyd Cybi serves 9,000 patients, and there are around 15,000 people in its catchment area. Holyhead is not a minor backwater in north Wales; it is a large town, yet it has no integrated healthcare. It has an A&E that is 25 miles away across a bridge that closes in high winds, and it has a massive shortage of doctors. I have launched my own petition to raise awareness of this issue and to call on BCUHB to proceed with the co-location project, as well as starting work on the new health centre with urgency. I recognise that the NHS faces significant pressures across the UK, but people are actually moving out of my constituency to live in other parts of Britain because they are scared of becoming ill in north Wales.

There are too many stories of avoidable death and harm. Unfortunately, it is almost impossible to compare the situation across the devolved nations in order to see just how bad it really is, because the Welsh Government produce different data from that produced by the UK Government. That makes it almost impossible to compare patient outcomes across borders.

What we do know are facts like these. In 2023, over 22,000 paramedic hours were lost in Wales just waiting outside A&E. In January 2024, more than 3,000 people in north Wales waited for more than 12 hours to be discharged from A&E, and nearly 60,000 BCUHB patients had been waiting for more than 36 weeks to start treatment; six years earlier, that number was just under 10,000. Over 57,000 people across Wales have been waiting for more than a year to start treatment, with 24,000 patient pathways waiting more than two years. Since 2010-11, the Welsh Government have increased health spending by 30.6%, well short of the UK Government’s increase in England of 38.9%.

We have asked the UK Government for help on behalf of our constituents. Last year, the then Secretary of State for Health and Social Care, my right hon. Friend the Member for North East Cambridgeshire (Steve Barclay), wrote to the Welsh Government to offer a right of access to NHS services in England for people in Wales. Unfortunately, the Welsh Health Minister claims not to have the additional budget to facilitate that proposal, despite the clear benefits it could offer our constituents. The Welsh Government can, however, find an estimated £100 million to increase the number of Senedd Members from 60 to 96; £4.25 million to buy a farm that it now cannot develop; and over £30 million to implement the much-derided default 20 mph speed limit.

The Welsh Government approach is also highly inconsistent. Take the covid pandemic. The Welsh Government seemed to be unaware that they would have to provide their own response to the threat, despite having been in charge of healthcare in Wales for years. They prevaricated and created different measures and responses, but they want to be part of the UK covid inquiry rather than holding their own. They seem to think they can pick and choose when they are accountable. It would be fantastic to see the Welsh Government prioritising health as the UK Government are doing, for example by enabling pharmacies in England to prescribe medication for common conditions such as earache and impetigo. It is challenging to be a UK MP in Wales when a matter such as health is devolved. Many people do not realise that it is devolved and blame Westminster for failings.

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

The hon. Member is making an splendid speech, and my goodness, it rings a bell with me. I have a GP friend in Caithness who developed an aggressive cataract; within a very short space of time she was unable to drive and had to give up her practice. She put her name down with NHS Scotland. Shortly afterwards, she went private and got it dealt with. Fourteen months later, she got a message from the NHS to say she could have a consultation —not a treatment, but a consultation. She would have grabbed it with both hands if she could have got treatment across the border in England. There is a lot wrong with the NHS in Scotland. It is too bad that none of the nationalists are here. They should be pressing for cross-border co-operation as well. Let us hope we get it.

[Virginia Crosbie]

I thank the hon. Member for sharing some background information on the situation in Scotland and his friend’s story of waiting 14 months for a cataract consultation. He makes a very important point: there should be many more Members of Parliament here for the debate. We have the Minister here, and it is an important opportunity to share some of the some of the terrible stories that we hear.

Despite health in Wales not being our gig, it makes up a third of my postbag, and my colleagues and I cannot turn our backs on our constituents. We cannot ignore their problems and blame Wales, because these are life and death situations. We desperately need the UK Government to step in and up the ante on cross-border co-operation. We desperately need the UK Government to take this matter in hand and do something now to protect the wellbeing of British citizens. Will my right hon. Friend the Minister commit to visiting Ynys Môn and meeting my constituents who have suffered as a result of the BCUHB failures and those who desperately need an integrated medical centre in Holyhead?

NHS Dentistry

Jamie Stone Excerpts

Tuesday 9th January 2024 Commons Chamber

[Wes Streeting]

The sound you can hear, Mr Speaker, is the scraping of the barrel. How has the hon. Gentleman got the brass neck to stand up, after 14 years of his party in government, and say that a contract agreed in 2006 is the problem? If only the Conservatives had been in government for 14 years to sort it out.

Here is the other rub: we do not pretend that everything was perfect under the last Labour Government. In fact, reform of the NHS dentistry contract was in Labour’s 2010 manifesto, because we recognised that it needed to change. Had we been elected in 2010, we would have delivered. It was also in the Conservatives’ 2010 manifesto and 2015 manifesto. It was probably in the 2017 and 2019 manifestos, too, and they have not delivered. We have 14 years of Conservative failure. How dare the hon. Gentleman have the brass neck to stand up and blame someone else.

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

It is of great interest, is it not, that there is not one Member from the governing party in Scotland present for this debate? I can tell the House that dental services in my constituency in remote Scotland have gone backwards in a big way, and I am shocked that none of them are here to hear this.

[Wes Streeting]

It is deeply disappointing. Let me assure the hon. Gentleman that as with the last Labour Government—13 years that created a rising tide that lifted all ships across the country, when we had an NHS with the shortest waiting times and the highest patient satisfaction in history—the next Labour Government will deliver a rising tide to benefit people across the country.

Oral Answers

Jamie Stone Excerpts

Tuesday 25th April 2023 Commons Chamber

[Neil O’Brien]

We are looking at the dentist, hygienist and therapist workforces as part of the long-term NHS workforce plan. I can reveal that this is not the first time my hon. Friend has lobbied me on this idea, and I am sure he will continue to do so.

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

11. What progress his Department has made on improving access to NHS appointments.

[The Minister for Health and Secondary Care (Will Quince)]

We are investing at least £1.5 billion to create an additional 50 million GP appointments by 2024. To improve access to hospital appointments we are giving patients choice about their care and offering alternative providers, with shorter waiting times, to long-waiters. We are also investing £2.3 billion in community diagnostic services, which will improve access to tests, checks and scans. One hundred community diagnostic centres are already open, and they have delivered more than 3.6 million additional tests.

[Jamie Stone]

If we have a power cut in north Scotland, people get a text message from SSE saying that engineers are coming out and that they will have power by, say, 3 o’clock. Missed NHS appointments are a waste of resources. I understand that some dental practices in England offer some sort of reminder service, but would it not be helpful if a leaf could be taken out of SSE’s book so that everyone with an NHS appointment receives a text to remind them, “You have a test at 10 o’clock tomorrow,” or possibly, “There is a big queue and there are delays, so your appointment has been changed to 4 o’clock”?

[Will Quince]

The hon. Gentleman is right to raise this issue. Better communication with patients was one of the five principles at the heart of our elective recovery plan, which was published in February. We recommend that all providers use appointment reminders, often through text messages. As he suggests, in some cases that has been shown to reduce “did not attends” by up to 80%. Providers have told us that they see better results when communication is two-way, for example, where patients can reply to cancel their own appointments. Alongside that, we also launched the My Planned Care website, so that patients can access information ahead of their planned appointment, and of course we are doing a lot more with the NHS app. This is just one of the ways in which we are putting patients in control of their own care.

NHS Dentistry: Salford and Eccles

Jamie Stone Excerpts

Monday 19th December 2022 Commons Chamber

[Neil O’Brien]

I am exploring how we can best target the places with the most acute problems. There are problems in a lot of different places, and we are thinking about that actively at the moment. I will come back to that as I make progress.

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

rose—

[Madam Deputy Speaker (Dame Rosie Winterton)]

Order. I gently say to the hon. Gentleman that if he wanted to intervene, he ought to have been here right at the beginning, because it is the hon. Lady’s Adjournment debate, and it is about Salford and Eccles? I leave it to him to decide whether he wishes to intervene.

NHS Workforce

Jamie Stone Excerpts

Tuesday 6th December 2022 Commons Chamber

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

rose—

[Steve Barclay]

I have said that I am going to give way to my hon. Friend the Member for Bosworth (Dr Evans), and then I am going to wrap up. As I was saying, sometimes there are areas where it is more difficult to recruit and we need to look at the data on that.

--- Later in debate ---

[Chris Stephens (Glasgow South West) (SNP)]

It was noticeable that the Secretary of State talked very little about the workforce in the speech we have just heard, although he spoke about many other things. I want to confine my remarks to the workforce, staff wellbeing and their pay.

Let us recognise, first, the impact on the NHS and staff of not just decisions made in this place on the economy, but of Brexit—that cannot be ignored. For example, the director of the CBI has called on the UK to use immigration to solve worker shortages. The Secretary of State did touch on that, but we really need assurances about the work being done between the Department of Health and Social Care and the Home Office to resolve the many visa issues that the Royal College of GPs had outlined, as other Members have said. According to that research, 17% of international graduates are considering leaving the UK altogether as a result of the challenges they are facing within those visa processes.

Research by the Nuffield Trust has revealed that Brexit has worsened the UK’s acute shortages of doctors in key areas of care and led to more than 4,000 European doctors choosing not to work in the NHS in the UK. Martha McCarey, the lead author of that Nuffield Trust analysis, has said:

“The NHS has struggled to recruit vital specialists…and Brexit looks to be worsening longstanding workforce shortages in some professional groups.”

That has been backed up by a number of organisations that have those very concerns, because the challenges in health and social care are felt in many sectors. What we certainly do not need is some of the right-wing rhetoric on immigration that we hear in this place, because in many areas of the UK we need more rather than less migration.

Clearly, staff pay is a real concern. In Scotland, we have seen discussions between the Scottish Government and the trade unions; a pay offer is on the table to staff and the trade unions have recommended that the staff accept that latest offer. In England, as an excellent Unison briefing is outlining, we are seeing a number of NHS workers considering leaving the service because they do not believe they should be subjected to a pay rise of 70p an hour. That is a very real concern to them and I believe it is simply not enough—it is not enough when food inflation is at 16%, and we have the high energy costs and housing costs that many people across the country are being subjected to.

[Jamie Stone]

The hon. Gentleman is making an interesting contribution, and I am thinking about what he has just said about Scotland. The fact remains, as I illustrated in a question earlier today, that the consultant-led maternity service based in Caithness, which has a close connection to his family, was downgraded to its current deplorable state because it could not hire the people. He has just mentioned housing, and I believe that in order to fill the gaps in the most rural areas of the UK we are going to have to offer a more comprehensive package to encourage them, involving housing, something on the mileage rate people are paid and even transport. If we just go down the ordinary route of recruited people from overseas, they will tend to go to the more central parts of the UK, where there is housing and where transport is much easier. We cannot have the rural, faraway corners of the UK left out.

[Chris Stephens]

The hon. Gentleman knows of my affection for his constituency—many members of my family live there. He raises an important point about rural communities, and in relation not just to the NHS but to the other challenges he outlines. He makes a pertinent point about what all the health services need to consider when applying their services to the areas that he has the privilege of representing, and I thank him for that.

The Secretary of State talked about the autumn statement, but it will not deal with the increasing cost of food and energy, and all the other pressures facing staff. There must be a serious discussion about the NHS workforce, about retention, about giving staff career opportunities and also about wellbeing. I thank NHS staff for what they have done not just during the pandemic, but when I and family members have had health challenges. The work they do and the miracles they perform on a daily basis should be recognised in this place.

Oral Answers to Questions

Jamie Stone Excerpts

Tuesday 6th December 2022 Commons Chamber

[Neil O’Brien]

I saw that important report, and we have to tackle the problem from both the health end and the economic end. Spending on health in the north grew from £36.5 billion in 2018-19 to £52.6 billion in 2020, so there is significant investment in health and preventing ill health in the north. Economic activity stops people sliding into a cycle of ill health and worklessness, and we are working jointly with the Department for Work and Pensions to roll out more disability employment advisers in jobcentres. The underlying key is to tackle and prevent ill health, hence the £3 billion drug strategy and the measures on smoking, energy and housing.

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

I will give the Minister a good example of health inequality. Until quite recently, we had a perfectly good consultant-led maternity service based in Caithness. Following the Scottish Government’s rubber-stamping decisions, pregnant mothers now have to make a 200-mile return journey to Inverness to give birth. That glaring inequality is despicable. I hope His Majesty’s Government will share best practice with the Scottish Government on tackling this problem.

[Neil O’Brien]

I am always keen to work constructively with the Scottish Government. This sounds like a serious problem. My right hon. Friend the Secretary of State set out how we are using our health and capital spend more efficiently, and unfortunately this is an example of where it is not happening in Caithness.

Baby Loss and Safe Staffing in Maternity Care

Jamie Stone Excerpts

Tuesday 25th October 2022 Westminster Hall

[Guy Opperman (Hexham) (Con)]

I thank my hon. Friend the Member for Hartlepool (Jill Mortimer) for bringing forward this debate. This is my first Westminster Hall speech in seven and half years; it is an honour and a privilege to speak on such an important matter.

I have had three children, but was able to take only one home from hospital. Teddy and Rafe came and went in the summer of 2020—briefly—and were loved all too shortly. I welcome the work led by the teams at Oxford and Leicester to ensure that there is clear advice to support health professionals in assessing and documenting signs of life in extremely difficult pre-term births. That is what I want to focus on.

I should put on the record, as I am sure many will, the amazing charities such as Sands and others who work in this sphere and who have helped me get over the trauma, loss and bereavement, as have the Northumbria NHS trust in my constituency and St Thomas’s, where my children were born. I thank my constituent, Sarah Richardson, and all the teams at Hexham Queen’s Hall and Hexham Abbey for their support for baby loss awareness.

Consistency across the NHS is key. People will lose children; that is a fact of life. Pregnancy is, as we all discover, more complicated than we imagined it would be—even in 2022. There is work to be done on the improvement of midwives and maternity staffing levels, but the key for me is a consistent approach across all NHS trusts up and down the country. Why does that matter? Because there should not be a postcode lottery in which a parent in trust A is treated differently from a parent in trust B, and poor souls go on the internet and find out that in trust A they would have been treated in one way, but in trust B in another way.

We all have to accept that mistakes are made and that giving birth is a fragile process, but we should expect the NHS and our Government to promote consistency of approach in dealing with the individual issues that mums and dads have.

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

Does the hon. Member agree with me that the principle that he correctly outlines should also apply to the nations of the United Kingdom, and that equality of service should apply right across Great Britain?

[Guy Opperman]

It is a perfectly fair point that there is a difference of approach in the different countries of the great United Kingdom, and I utterly agree that if someone lives in the United Kingdom, they should have a consistency of approach. There should be a coming together of the various professional boards to drive forward consistent standards. I will give one specific example.

--- Later in debate ---

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

It is a pleasure to serve under your chairmanship, Mr Davies. I recognise that health is devolved to the Scottish Government but, with your permission, I will give a cautionary tale.

Some years ago, we enjoyed a consultant-led maternity service based in Caithness General Hospital in Wick, but NHS Highland decided to downgrade it. The consequence is that pregnant mothers now have to travel 104 miles from Wick to Inverness to give birth to their children, which has caused a huge outcry in my constituency. Thinking about the north of Scotland, Members can imagine what it is like to be in an ambulance or a private car in the winter when the weather changes, which it very often does between Caithness and Sutherland, and people get caught in snowdrifts. Despite repeated demands, the Scottish Government have never conducted a safety audit of the huge change in the service. It is a massive issue in my constituency.

More recently, the NHS decided to similarly downgrade the maternity service based in a town with which the Minister and I are equally familiar—Dr Gray’s Hospital in Elgin. There was a huge outcry about that, and this time the Scottish Government said, “Okay, we’ll review the decision.” My first point is that wherever someone lives in Britain, what is good for the goose is good for the gander.

I will close—I will make it easier for you, Mr Davies, by keeping this a short speech—with two unfortunate tales. In 2019, a mother from Caithness expecting twins was being transported on the long journey to Inverness. As I say, it is 104 miles, as opposed to the distance between Elgin and Inverness, which is 38 miles, and I do not know why they are doing it for Elgin and not for the highlands. In Golspie in Sutherland, she gave birth to her first twin and then had to travel 52 miles to Inverness to give birth to the second twin. Miraculously, both children survived, as did the mother, but if that is not harrowing for an expectant mother, I do not know what is.

In the last few days, we have heard the terrible tale of a couple having to leave from the far north in their own car after the mother’s waters had broken. It was a three-hour journey. Recently, the Public Services Ombudsman ruled that her child suffered brain damage as a result. Can you imagine? Consequently, NHS Highland has been ordered to apologise. In my book, I do not think an apology is good enough. It is a cautionary tale. I recognise that health is devolved, but I feel very strongly that no mother, father, child or unborn baby should suffer increased risk simply because of where they live in our United Kingdom.

Unavoidably Small Hospitals

Jamie Stone Excerpts

Tuesday 6th September 2022 Westminster Hall

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

It is always a pleasure to serve under your chairmanship, Mr Hollobone. Although I may be a Liberal Democrat, if I lived on the Isle of Wight I could be tempted to vote for the hon. Member for Isle of Wight (Bob Seely), because he is assiduous in the pursuit of issues that are important to his constituents. He has repeatedly raised the issue of St Mary’s, and he has my every sympathy.

When listening to the contributions so far, I could have shut my eyes and imagined that I was standing on the high street in Wick, in the far north of Scotland—the far north of this United Kingdom—because the issues are the same there as have been outlined. Recruitment and retention is the deadly issue in the north of Scotland, much as it is on the Isle of Wight. I will say, as the hon. Member for Strangford (Jim Shannon) said, that health is devolved; as he also said, health matters to everyone in the United Kingdom. What I am about to say about the situation in my own constituency is pertinent to the rest of the United Kingdom.

Some years ago, Caithness General Hospital in Wick had a consultant-led maternity service. There was a battle to retain that and it was won by the local people. More recently, the highland health board, NHS Highland, used retention and recruitment as the reason not to have consultants located in the far north of Scotland and to downgrade the service to a midwife-led maternity service. That means that mothers have to travel more than 103 miles from Wick to Inverness to give birth. In the middle of winter, if the A9 road blocks, which it does on occasion, and the air ambulance has been called to a road traffic accident somewhere in Morayshire or West Sutherland, then what is going to happen? We are faced with a very dangerous situation indeed. I give credit to the NHS in Scotland: at long last a dialogue has started between the residents of Caithness and Sutherland and the powers that be. I hope that dialogue will eventually be fruitful.

The point has been made that there is an additional cost for locums—the stand-ins and so on. That is absolutely true, and it hits us as much as it hits the Isle of Wight or Yorkshire. There is also an issue whereby the change of locum and personnel can be disadvantageous to the patient, because they have to go back through the same old story with a new person—the patient tends to repeat themself. In the highlands of Scotland, that issue is particularly acute on the mental health front. I have heard horror stories of people having to see a variety of different professionals and repeat themselves again and again before anything can be done. That is extremely worrying.

The solution is partly money. Like the hon. Member for Strangford, I urge the Minister, or Her Majesty’s Government—as they run the health service in England—to exchange best practice, as and when we have it, with the Scottish Government. We can learn from each other about how things can best be done.

I have outlined the mental health issue. There is a final point. The hon. Member for Isle of Wight made the point that there are double standards. It was recently proposed that the maternity service in Morayshire, which is based in Dr Gray’s Hospital in Elgin, in the constituency of the leader of the Scottish Conservatives, the hon. Member for Moray (Douglas Ross), should be downgraded. There was a huge outcry about that and the Scottish Government eventually said they would look again at the situation and see whether there is a solution whereby people do not have to travel from Morayshire to either Inverness—a distance of 38 miles from Elgin—or Aberdeen.

That sits ill with what I have just described in Caithness and Sutherland. The distance from Wick to Inverness is 103 miles, yet the Scottish Government have not agreed to look again at maternity services. However, there is a dialogue now—thank heavens. I pay tribute to Caithness Health Action Team—known as CHAP locally—and to one councillor in particular, Ron Gunn, and his colleagues, who have been absolutely instrumental in ensuring that this issue is never off the top of the agenda.

It is a fact that every citizen of the United Kingdom should deserve an equal right to health services, regardless of where they live. It is a fact that unavoidably small hospitals in England face the same problems as hospitals of the same size in Wales, Northern Ireland and Scotland. The bottom line is that health matters hugely to us all. I sincerely hope that the new members of the UK Government, both in the Cabinet and as junior Ministers, can look at the issue as a matter of absolute urgency. My telephone is always switched on. Ministers can call me, and I will again and again bang the drum on behalf of my constituents in Caithness and Sutherland, who deserve rather better than they are getting at the moment.

[Selaine Saxby (North Devon) (Con)]

It is a pleasure to serve under your chairmanship, Mr Hollobone, and I thank my hon. Friend the Member for Isle of Wight (Bob Seely) for securing this important debate.

My hospital is the second most remote on the list, and the most remote on the UK mainland. Obviously, as the representative of North Devon, I would not have to go to hospital by boat, although constituents of my neighbour, my right hon. and learned Friend the Member for Torridge and West Devon (Sir Geoffrey Cox), who live on Lundy do go by boat or fly to hospital. Most of my constituents in beautiful North Devon travel to hospital on a road that is described as the longest no-through-road in the country, and we are not only rural, but coastal. As Professor Chris Whitty has highlighted, coastal communities’ health outcomes are particularly poor.

I want to thank the fantastic team at North Devon District Hospital. They are remarkable, and I am delighted that the Minister has had the opportunity to come and meet some of them. We visited the first covid catch-up ward in the country. My hospital might be small, but it is pretty perfectly formed. It was the recipient of £1.9 million last December for a covid catch-up elective ward, which was opened in time for the jubilee. It is named the Jubilee ward and the staff are conducting—seven days a week—hip and knee replacement surgery with most patients going home the same day. That is a truly remarkable achievement, which was delivered by some of the Nightingale teams.

I made a plea to the Minister then that I will repeat today. My hospital is highlighted as one of the 40 that are due a rebuild. The plans are written, this is a modular build, and the team have demonstrated that they can deliver on time and on budget. They can also show the need for the improvement to the facilities at the site, so, if the Minister is not in post next week—I very much hope she is—will she leave a note on the way out to let people know that North Devon District Hospital is ready to start the building programme if the funds are released?

The facilities team at North Devon—owing to the size of the hospital and the problems with issues that have been spoken about, such as recruitment and retention, as well as the fact that the site is in need of work—is innovative and creative. We are fortunate to have linked up with Exeter, and in many ways that link has secured the site. It gave us the opportunity to establish virtual wards, which are now running, so consultants from Exeter and North Devon can share the patch among them. However, the age profile of the population, which has been mentioned, changes the nature of the hospital—for example, there is more demand for certain services, and less demand for others, such as maternity, which are used much less. Therefore, it is much harder to attract consultants in some of the specialisms.

My hon. Friend the Member for Thirsk and Malton (Kevin Hollinrake) spoke about distance to be travelled, and in North Devon people make choices about their cancer treatment based on the distance they would have to travel. Most people have to travel 60 miles to Exeter Hospital, and if they have to travel daily or weekly for radiotherapy, a journey of 120 miles might be a choice they decide not to make. As we look to how to tackle the issue of health outcomes in remote rural communities, I hope we can ensure that patients have access to the best care, rather than the care nearest to them.

The rurality of North Devon is a driver in the struggle people have to come and work there: we had a recruitment issue in North Devon long before the pandemic, and one nursing post in five is now vacant. Not only is it hard to get to North Devon; it is hard to move and live there. My hon. Friend the Member for St Ives (Derek Thomas), who represents the Isles of Scilly, and I spend a lot of time talking about housing and the housing challenges in the south-west of England, and we find that it is almost impossible to buy a house in North Devon. The rental market has also collapsed, so it is near impossible for public sector workers and those who work in many other jobs, such as hospitality, to move there.

That situation is now overlaid by the situation in social care. My fantastic hospital has more beds full of patients who could go home than it would normally have at this time of year. That is not because the social care teams in North Devon are not also fantastic, but it is just very hard to recruit, and the costs of providing social care have escalated hugely with the increased costs of energy. For those fantastic teams who travel around and look after mostly elderly people in their homes, the cost of getting there has now shot up. There are also the issues around recruitment, and we are paying far more in that sector to attract and retain those great individuals who do such valuable work.

[Jamie Stone]

The hon. Member is making a very good speech indeed. Does she agree that it might be a good idea to revisit the taxation regime that covers the remuneration for mileages for some health workers who have to drive? They have been penalised rather and perhaps the number of miles could be raised. It would not attract taxation.

[Selaine Saxby]

Indeed, I agree in many ways. My right hon. Friend the Member for Richmond (Yorks) (Rishi Sunak) and I had similar conversations in a previous life. Much could be done, and personally I want to give social care workers electric cars, so they are taken out of that and can decarbonise at the same time.

As the new Administration comes in, I hope that there will be some revisiting of how to tackle the challenges of social care without the ringfenced money if that plan is to go ahead. We need to look after everybody who is unwell in our society. When visiting a social care organisation over the recess, it was frustrating to hear that they have the work for so many extra people. They can recruit internationally and they are. They advertised six jobs and overnight they had 70 applicants. They could take all 70, but there is nowhere for them to live. Until we in northern Devon find a way to address our housing challenges, I will work tirelessly here to tackle them. As a community, we need to find a way to ensure that people who need to work and live in our community can afford to do so before the situation gets worse as we head into the winter.

Talking about the winter and seasonality, I want to highlight the remarkable work that goes on within A&E at North Devon District Hospital. Unlike many hospitals that have a big winter peak, my population increases fivefold during the summer months. My A&E is busy all year round, which has its benefits in that we do not have those peaks and troughs, but I am not sure that the funding truly reflects the seasonal influx of those visitors and the changes. Obviously, the injuries people secure on a beach are quite different to the issues that affect my elderly population. I think there is some work to be done to understand the rurality, seasonality and locality of the fabulous North Devon District Hospital. My parting comment to the Minister is that quick reminder that we are one of the 40 and we are ready to go.

Access to GP Services and NHS Dentistry

Jamie Stone Excerpts

Tuesday 21st June 2022 Commons Chamber

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

I thank the shadow Secretary of State for giving way. He is very civil. Can I also go down memory lane? We have had a Government of a rather different colour in Scotland since 2007, and today I have constituents coming to me and saying, “I cannot get on an NHS dentist’s list”. That echoes the point made by the hon. Member for Strangford (Jim Shannon). Does the shadow Secretary of State agree that in the event of the present Government sorting this situation out, they would do well to share what they did with the Scottish Government? And in the event of a change of Government after the next general election, will the shadow Secretary of State commit to giving advice to the Scottish Government?

[Wes Streeting]

This is the thing that the First Minister of Scotland does not want to acknowledge, but for all her noise, bluff and bluster she knows full well that a Labour Government here in Westminster would be good for the people of Scotland. The investment and reform that we would put into the NHS to deliver the same kind of results as the previous Labour Government did would be good for the people of Scotland. I look forward to the day when I can phone the Scottish Government to give them some advice and I look forward to the day when the Governments in Westminster and Edinburgh are Labour Governments delivering for people across the United Kingdom.

The hon. Member for Caithness, Sutherland and Easter Ross (Jamie Stone) mentioned the trip down memory lane. The Under-Secretary of State for Health and Social Care, the hon. Member for Lewes, regularly blames Labour for what is happening in dentistry. That is because of something that happened 16 years ago: it was a contract that was put in place by the last Labour Government, which we committed to reform in our 2010 manifesto. Unfortunately, that manifesto was never implemented. The tragedy is that the Conservative manifesto that promised reform of the dentistry contract was not implemented either.

In 2010, the Conservatives promised to introduce a new dentistry contract. In 2017, they also promised to introduce a new dentistry contract. What is the Minister’s policy today? She promises to introduce a new dentistry contract. She must make up her mind: either, the current contract is so good that every time she tries to change it, she cannot find a way of improving it, or, the Minister’s Department, her Secretary of State and her Government are so incompetent, so distracted, or so indifferent, that they simply cannot get the job done. It is no good their blaming the Labour party for the problems in NHS dentistry. They have been asleep at the wheel for 12 years. They have failed to do anything to improve the service, and now 4 million people cannot access a dentist. The consequences are severe.

Let me tell the Health Secretary about a constituent of my right hon. Friend the Member for Normanton, Pontefract and Castleford (Yvette Cooper). She tells me that this constituent cannot get a dentist appointment anywhere for an unbearable toothache, and that they are in too much pain to sleep through the night. When they contacted a dentist, they were told that they would have to wait two years for an appointment. They wrote in an email:

“I am in such agony that I took Ibuprofen, drank whisky and tried to pull it out myself with plyers, but they kept slipping off and it was agony.”

What kind of country have we become when the most common reason for children to go to hospital is to have their teeth extracted? We have 78 children going to hospital every day to have their teeth extracted. [Interruption.] There is no point Members arguing from a sedentary position that it is because of fizzy drinks. That is their approach all the time. The system is broken, so let us blame the patients. It is absolutely outrageous. DIY dentistry in one of the richest countries on the planet, and their answer is to blame the patients. They should get real. This is so far from that original promise of the NHS, where care is provided to all who need it, when they need it.

To be fair to the Health Secretary, he has been in the role for just under a year, and, on that note, I would like to wish him a happy anniversary this Sunday for one year in the job. But I am afraid that that is where the niceties end, because I will now run through what he has said and done in his year in charge. He had a big media splash on “league tables for practices” to pressure them into doing more face-to-face appointments and then he backed down. He achieved great headlines on “nationalising GPs” in January—imagine the excitement—but there has been no action since. He talks about bringing the NHS into the Netflix age. Has he ever actually used the NHS app? I cannot even book a GP appointment through the app because my GP is not on it. Why is it still not available to every patient as a way to book appointments? I visited Israel recently—I refer to my entry in the Register of Members’ Financial Interests—where it has embraced the technological advances in medicine over recent years to massively improve access to healthcare for patients.

I was talking to a start-up, which is developing an app that tracks the recovery of stroke victims, and notifies them when they need to see a physio. I then showed the staff what the NHS app can do and what it cannot do and they laughed. In some senses, the Health Secretary had a point: the NHS is not as modernised as it needs to be to deliver for patients, and nowhere is that more true than in primary care. It is an analogue service in a digital age. Patients should not have to wake up at 8 in the morning and wait on the phone for an hour for an appointment. They should not be told to expect a call back, but given no indication as to what time that will be, and then be considered a missed appointment if they do not pick up because they are at work, or are busy, or are picking up the kids and doing everything else that people do between nine and five.

People have never been so well-informed about their own health. We carry around with us devices that can measure our exercise, our heart rate, how well we sleep, and so much more. Yet our healthcare system puts none of this to use and keeps all the pressure on GPs.

Let me conclude by outlining some of what a Labour Government would do to address this crisis—[Interruption.] I am not surprised that Conservative Members are excited; they must be as fed up as we are. First, we would take immediate practical steps to boost the number of GPs available. Why have the Government sat idly by while doctors are forced to retire early, for no other reason than that the cap on their pension contributions means they pay a financial penalty for staying on? Let us change the rules to keep the good doctors we have. Why is it that, at the last count, 800 medicine graduates had not been able to find junior doctor posts? Let us get them to work immediately—

Support for Carers

Jamie Stone Excerpts

Thursday 22nd July 2021 Westminster Hall

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

It is a pleasure to serve under your chairmanship today, Mr Hollobone, and I thank my right hon. Friend the Member for Kingston and Surbiton (Ed Davey) for securing this massively important debate. I should declare an interest, because I am a carer, and have been for the past 22 years; however, I do not want to talk about that today.

Although I thought I knew everything there was to know about caring as an individual, I was taken by surprise at a clinic I held when I was a Member of the Scottish Parliament. I was at a clinic in Castletown in Caithness, and a gentleman in his early 60s came to see me. He was a bachelor; he was on a very low pension; and he told me how he was looking after his mother, who was bedridden and incontinent. He told me that he was not going to put her in a home; she had looked after him all his life, and he was now going to look after her. He then broke down in the middle of the clinic, which as a new Member of the Scottish Parliament I found rather disturbing, and told me his tale. The national health service had afforded him an allowance of four adult diapers—nappies—for his mother, per day. Each fortnight, or month—whatever the period was—the requisite number of diapers would be delivered to his household. He then told me that what was awful was that, at the flick of an unknown health mandarin’s pen, this allowance had been decreased to three diapers a day. He said that the reason he broke down was, “I’m not in my first youth—I’m not as young as I was. It’s the bed linen. It’s nighties. I can’t cope with this. I can’t cope. I’m desperate.” I gritted my teeth and said that, “If I do nothing else as a Member of the Scottish Parliament, I’ll sort this for you.”

I was so angry the next day that I went to Heather Macmillan, who runs my constituency office, and said, “Take a letter! Words fail me. I cannot believe it.” She said, “Jamie, go for a walk. I’ll write the letter. I’ve got the gist of the problem.” We got it sorted and he got back up to four diapers a day. One little thing had been destroying his life, and that was an unexpected aspect of caring that I had not foreseen—it was a real curveball. I can only tell this anecdote now because the gentleman concerned is no longer with us—I have kept quiet all these years—and the point of it is that there are things that can impinge on caring that can be entirely unexpected. It is not always about money; it is about a clumsy and thoughtless decision that was, I fancy, taken far away from where this man lived in Caithness.

Another point, to echo what other Members have said, is about young carers. In my constituency, we are very fortunate to have an organisation called Tykes Young Carers, based in Golspie, Sutherland. I have waited a long time to go on the record and commend that organisation here in this place. I take my hat off to it. Having met its representatives over the years, I have learned certain things and I am sure that all Members will be familiar with similar examples. A young carer who returns home from school, perhaps to a remote croft in the highlands, might have to look after a single parent who is alcoholic and feed and look after younger siblings. Then, when they go back to school the next day, they get roasted by the teacher for not having done their homework. That is an oversight on the teacher’s part, but the teacher cannot be blamed for not knowing all the facts about that particular family. That, however, is another unintended occurrence for carers. Over 22 years of looking after my better half—as we say in the highlands—I thought I knew it all, but I did not.

My appeal to the Minister is, as the hon. Member for Blaydon (Liz Twist) has just said, for the Government to take an overall look at this situation. Yes, it is about resources, but it is also about having the radar, being truly three-dimensional and working this way and that way to identify all the things that can go wrong with caring—they need not necessarily be related to money—and make a care giver’s life truly miserable. I go back to my fist anecdote: what was the cost of one adult diaper? It was probably a fraction of a penny—it was not so difficult to provide. However, because of the bureaucracy, and because the unknown mandarin’s pen ticked what it did, that gentleman’s life had been destroyed. I often wonder whether I did any good as a Member of the Scottish Parliament; I like to think that, if I did nothing else, at least I sorted that chap’s life out.

--- Later in debate ---

[Helen Whately]

Of course, there are financial pressures across public services, and more widely across our economy we face an extremely challenging time, but we have given significant extra funding to local authorities to support them through the pandemic. That is why I urge them to prioritise this issue. I emphasise the importance of the carer’s needs assessment that local authorities carry out, because that is such a crucial way of identifying what support a carer may need for themselves and their wellbeing, including the need for respite and taking a break from caring, and then making sure that that happens.

[Jamie Stone]

Further to what the Minister just said, Migdale Hospital in my constituency has in recent times lost a lot of beds. That is a combination of the NHS, and—because healthy policy is devolved—the Scottish Government. Does the Minister agree that that is a real problem? This is not joined-up government. Whatever influence she can bring to bear on the Scottish Government to reverse those decisions, which fly in the face of good government, would be helpful.

[Helen Whately]

The hon. Gentleman has made his point very clearly. He knows that that is a devolved matter, but SNP Members are listening, and I hope that they take up his concern.

Effective support for carers can never be created or offered in isolation, and it is critical to me that the views of carers are central to how my Department develops policy. Just a few weeks ago, Carers Week provided an opportunity to highlight the invaluable contribution of carers and for others to commit to improving their quality of life. I personally made a pledge to work nationally and locally in my constituency to promote caring communities, and I wrote to all MPs urging them to do the same.

I will continue to play my part and will listen to and champion the needs of all carers as our country continues its recovery to a new kind of normality. I have and will continue to meet a wide range of carers’ organisations and to speak to Ministers from across Government to ensure that our regulations, policies and services are fit for purpose and consider the needs of carers. That engagement has included roundtable discussions and regular calls with individual carers charities, including Carers UK, Carers Trust and the Children’s Society, and I will continue to work with colleagues across Government, MPs and local authorities to increase our support for carers.

The Government do not have all the answers. Several hon. Members have spoken today about local organisations and initiatives that support carers. Local carers’ groups play such an important role—by putting carers in touch with others in similar situations, for instance, so that they discover that they are certainly not alone; and by providing practical support, advice and respite. That is from Carers UK and the Carers Trust to any number of local groups; during the debate, I have heard mention of Kingston Carers’ Network, Gateshead Carers, a young carers organisation in Bath, Tykes Young Carers in Sutherland and Sheffield Young Carers. I should mention Crossroads Care Kent, who I met the other day in my capacity as the Member for Faversham and Mid Kent. I heard about the excellent work that it does. Across the country, these voluntary groups, charities and charitable organisations do such an important thing in supporting carers, and I recognise that.

Several hon. Members mentioned social care reform, and they know well that we are committed to bringing forward proposals this year for reform of the adult social care system. As part of those proposals, we are absolutely considering unpaid carers. We want to build a system in which unpaid carers are truly supported and those who receive care have more choice and control over their lives. We are working closely with local and national organisations so that our approach to reform is informed by diverse perspectives, including those with lived experience of the care sector.

On the Health and Care Bill, I want to ensure that the voices of unpaid carers, as well as care home residents and others who receive care and support, are truly heard in integrated care systems. That is why the Bill places new duties on integrated care boards and NHS England to involve carers.

I thank hon. Members for their contributions on this important topic. I know that all those who have spoken share my deep commitment to supporting our unpaid carers and young carers, who have sacrificed and given so much, especially in the past 16 months, and continue to do so. As Minister for Care, I have seen at close hand how challenging and unwelcome the pandemic has been for people caring, as well as those being cared for.

We should all be humbled, inspired and strengthened by everyone who has endured this most stressful of times. I hope that the House will join me in a heartfelt thank you to each and every carer and young carer across the country for all that they are doing to support, protect and care for their loved ones.