Coastal Towns

Debate between Anne Marie Morris and John Pugh

Tuesday 6th January 2015 Westminster Hall

[John Pugh]

I agree with my right hon. Friend. He illustrates the point that people who work in coastal towns do not invariably work in the leisure sector. In other words, the vulnerability of resorts to changing leisure trends differs. It can be minimal in some cases and almost total in others, for example those resorts founded around caravan parks and the like. We must also bear in mind that many resorts, for example Bournemouth, are big conurbations in themselves. If we take Greater Bournemouth as an area, it has a population almost equivalent to that of Liverpool.

One thing surprised me in the Hallam research and I will say a little about it. What the research picked up was, in part, a north-south divide as far as resorts are concerned. Hallam says that at the moment the towns doing best off the back of tourism are largely, but not invariably, in the south, and those doing worst are largely in the north; I note that the hon. Member for Blackpool South (Mr Marsden) is here in Westminster Hall today and Blackpool is an example that Hallam cited as one of the resorts that has been most hit by change in leisure trends. So there appears to be some sort of north-south divide—not exclusively, because obviously some areas along the Essex coast have taken a hit too. However, there is probably a different story to be told about those areas and their branding.

It is the upmarket south-coast resorts that are probably faring the best at the moment, and that links back to other areas of Government policy. One of the best ambitions of the coalition is to rebalance the economy, but as far as the north is concerned that has largely been seen as a matter of city deals. There is a logic in that, as cities are obviously crucial, but it can mean that resorts are overlooked. That is because cities in the north, as they develop, can compete in new ways against resorts. We have certainly seen that in my area. Manchester and Liverpool are now very active in the conference sector; in a sense, they have stolen business from places such as Blackpool.

Similarly, Liverpool’s retail expansion has undoubtedly damaged Southport’s more bespoke offer. Hotels and restaurants have massively proliferated in city centres so that their tourism, marketing and hotel offer has become qualitatively different from what it once was. City centres are now sold not as hubs of industry but as leisure destinations in their own right, and cities are better connected, and will be still better connected in the future, than many other areas. That is sometimes to the detriment of resorts. For example, electrification around Manchester may deprive me of a train from Southport to south Manchester. That would be excellent for people who want to get across the country, but it would not be helpful if they want to come to Southport for whatever reason.

That development would not be so bad were it not for the fact that in many parts of the north the key local decision makers do not focus on the coast at all. They tend to be very city-bound. For example, the Merseyside local enterprise partnership is dominated by Peel Holdings, which is legitimately concerned with developing its logistics business out of the docks and is not necessarily tasking itself, night and day, with encouraging tourism further up the coast. Also, the new money—if there is new money at all—tends come in via the cities and not through other routes. Although there is the coastal communities fund, and we are glad to have it, the per capita spend of that fund is a drop in the ocean compared with city deals.

It does not help that traditional council budgets and funding have been—let me put it this way—severely stressed. Many a council has done fairly obtuse things under those circumstances and cut first the activities that bring more people into their area, in order to concentrate on what they regard as their core business, which is often social services and the like; resorts have appreciable expenditure commitments in that regard. Alternatively, councils put up parking charges and drive people away. I have a particular crisis in my own constituency at the moment because the local council has decided to cut back on the iconic botanic gardens in Southport that bring people into the town, as a cheese-paring saving that will further damage the tourist industry.

In addition it does not help that, in an age of retail retrenchment, when chain stores are considering what to do about their retail offer, they look first at those towns that have a 180^o catchment area and—whether or not they are populous—the chains use their models to decide that they will close branches in those towns first.

I am not here today just to complain, harass the Minister and ask for more and better things, although of course I will do all that. I accept that in an age of austerity coastal towns have to make their own weather; in Southport, we make our own weather and it is sunny all the time. However, we need to put Government coastal policy in the context of wider Government policy. We cannot ignore transport and the knock-on consequences of electrification, and think of coastal towns as a separate thing.

[Anne Marie Morris (Newton Abbot) (Con)]

I take my hon. Friend’s point entirely. Surely, however, if anyone looks at the investment along the coastal line going through Dawlish, where we saw the tragedy of the line falling into the sea, they will see that that is exactly an example of where the Government have invested in a coastal community and committed to keeping a rail line going.

[John Pugh]

Yes—it probably took a disaster to engineer that level of investment, and we would not wish for that generally. However, I noticed that there is a good number of Members from northern resorts here in Westminster Hall and there is quite a clear issue at the moment with the Northern franchise and whether it will affect access to their resorts; I think that those Members will probably have something to say about that.

Accident and Emergency Services

Debate between Anne Marie Morris and John Pugh

Tuesday 14th September 2010 Westminster Hall

[Anne Marie Morris (Newton Abbot) (Con)]

This has been an interesting debate and I commend hon. Members on their contributions. It is clear that accident and emergency is close to all our hearts. I am particularly blessed with two very good district general hospitals—one is at Torbay and the other is the Royal Devon and Exeter hospital. I am extremely fortunate. However, there are three minor injury units in the smaller towns of Newton Abbot, Teignmouth and Dawlish. The challenge for me is in many ways an echo of the points raised by my hon. Friend the Member for Southport (Dr Pugh). Clearly, the issue is access. I am concerned to ensure that we use the minor injury units to their fullest extent. For my constituents the journey to Torbay or the Royal Devon and Exeter is quite a long one. My concerns, on which I hope the Minister will look favourably, are that we should think about making better use of the minor injury units. If we do so, we shall help the overall NHS budget very much.

I do not know how many people realise that the number of people who attend A and E is growing faster and faster. In just the past three months of this financial year, 5.49 million people have been seen at A and E. Mathematically, extending that over the year gives a figure of 22 million people visiting A and E throughout the country. That breaks last year’s record of 20.5 million. Such a figure would mean 40% of the population visiting A and E at least once, assuming that each individual who visited was responsible for only one attendance. That is a huge figure. The challenge for the Government and the country, given the current economic climate, is how we afford that. One of the issues is the number of people who inappropriately attend A and E—not through any fault of their own.

Just going through the door at an average hospital costs the NHS £100. By comparison, the average cost to go through the doors of a minor injury unit is £50. Those figures are averages, but the cost differential is significant.

[Dr Pugh]

The hon. Lady has mentioned the statistics and the increased number of inappropriate self-referrals. She is probably also aware, because she is extraordinarily well informed on the issue, that GPs are referring more people than hitherto to A and E. Therefore primary care—the GP setting—is not the answer. The answer is probably the minor injuries unit.

[Anne Marie Morris]

I thank the hon. Gentleman for that valuable contribution; I agree with the earlier comments that the answer is probably an appropriate network of different provision. However, we need that to be clearly signposted. That is the way forward.

The challenge for the Government and the Minister is to quantify the percentage of people who present at A and E who would be better dealt with in, for example, an MIU. People have tried to quantify that, but the figures vary wildly, from 60% to a more modest 10% to 30%, which is the latest finding of the Primary Care Foundation. Further work on that would be very worth while. However, the Minister could sensibly consider several steps now, even before that investigative work, to examine how we can manage A and E attendance more effectively. The figures show that 20% of presentations at A and E are alcohol-related. We all know that is a huge burden on the NHS and the country as a whole, because of crime and other issues. Minimum alcohol pricing and improving education in schools might make a significant difference to the Minister’s problem.

Secondly, I suggest that the Minister and his colleagues consider the availability of other services, such as dental care, in communities. Often, it is because there is not adequate NHS dental care that patients present themselves at A and E units. A and E services are cheap, they are there, and they are now. If we could fix that situation it would make a big difference. Such problems cannot be the right reason to attend A and E. Although the PCTs have tried to assist the public’s understanding of where to go for which service, it is abundantly clear that they have failed. People know about 999 and A and E, and that is where they go. We need to find a much more effective way of educating them. I commend the Minister on the commencement of the 111 service, which is excellent, if we can educate people to use it appropriately.

The Minister might also like to take into account how we give prominence to and promote MIU services. However, to do it effectively we need to ensure that across the country everyone knows what the service is and that it is consistent—for example, that opening hours are consistent. In my constituency, it depends on which MIU someone attends; if they turn up at Dawlish after 6 o’clock, the door will be closed, but that would not be the case if they turned up at Newton Abbot. It is equally bizarre that for someone who needs an X-ray, the X-ray unit is not coterminous with the MIU opening hours. Those are exactly the sort of things that put people off going to an MIU. In that regard, some steps forward would be extremely helpful.

If I may, I shall take the opportunity to refer to a couple of helpful things that my local health community is doing in my constituency. First, in Torbay hospital, local GPs attend A and E at the point of entry, so, rather than going through standard A and E routes, some patients see GPs, which reduces costs. The second good initiative in my constituency comes from our mental health practitioners recognising that, often, a stay in hospital is extended because someone has the symptoms of depression. Devon Partnership NHS Trust, which is responsible for mental health care in my constituency, has placed mental health care practitioners in hospitals to assess individuals, and, as a result, is beginning to reduce the time that individuals stay.

I am grateful to hon. Members for their contributions and to the Minister for his attention. I commend to him the idea of looking further at consistency in MIUs, how to reduce alcohol-related admissions, using mental health care practitioners to reduce the length of stay in A and E, and making other services, such as dentistry, available, as they should be, to avoid people unnecessarily going to A and E.

[Dr Pugh]

On alcohol-related admissions, which the hon. Lady mentioned twice, one problem that besets many A and Es is repeat customers—chronic alcoholics who appear again and again. Clearly, alcohol pricing would make little difference to them, so a linkage between A and E and other services in the community is normally required in those contexts. In many parts of the country, that linkage simply does not exist, which creates repeat custom for A and E.

[Anne Marie Morris]

I have finished my speech.