Rural GPs: Funding

Edward Morello Excerpts

Wednesday 11th February 2026 Westminster Hall

[Esther McVey]

I thank my hon. Friend and constituency neighbour for raising that point. She is absolutely right that the number of new homes that are going to be built in rural areas, putting more pressure on GP surgeries, is significant. Without new GP practices, I am not sure where our residents will go when they need a doctor and need to see somebody about their health.

[Edward Morello (West Dorset) (LD)]

In a similar vein to the previous intervention, one in five GP buildings predate the NHS itself, which is a quite staggering fact, and over a third of GPs say their premises are no longer fit for purpose. In places such as West Dorset, outdated buildings struggle to deal with the current population, let alone the projected future growth as a result of house building, and fewer than a third of practices that applied for capital funding last year were granted funds. Does the right hon. Member agree that GP estate funding must also be expanded to help rural areas deal with the increased population?

[Esther McVey]

I agree with the hon. Member. I will come on to my surgeries that are indeed in Victorian buildings—spread across four—and need to be brought together and modernised. That is in Knutsford in my constituency. I know that there will be many other places like that across the country. The hon. Member raises a valid and pertinent point.

We know that GP services in rural communities are spread across a large geographical area, and many elderly residents in Tatton live alone. Although such independence is cherished, travelling long distances to access healthcare is more difficult. Public transport is often limited or non-existent. Community transport schemes exist in Tatton, but they cannot always accommodate short-notice or urgent medical needs. Often, elderly residents do not drive, so they are left reliant on costly taxis or GP staff taking the time to travel to a patient’s home. That places additional pressures on already stretched services. In Lostock Gralam, despite a population of about 2,800 people, there is no GP practice. That forces patients to make a lengthy journey to Northwich, and without a direct bus service many are left to rely on taxis to make their appointment.

For those communities, recruiting and retaining staff becomes more difficult and more expensive. The Rural Services Network reports that 59% of hard-to-recruit GP speciality training posts are located in rural areas. There is less access to specialists and consultants, which makes their services more expensive. Community services and provision are sparser in rural areas, too. Pharmacies, which help to relieve pressure on GPs in urban areas, are not as common in rural areas. When I secured this debate, I was contacted by the Dispensing Doctors’ Association, which provides an essential role in dispensing medicines to patients who live more than 1.6 kilometres from a pharmacy. It delivers to about 10 million patients across England, but is facing increasing challenges due to its reliance on manual delivery.

In addition, while urban pharmacies move ahead with digital efficiency, rural pharmacies often struggle to keep pace because broadband coverage is often unreliable, rendering remote consultations near impossible and service delivery more difficult. The benefits of digitisation in healthcare are well understood across this House, but they rely entirely on having the right infrastructure in place. Without connectivity, rural practices are simply unable to access or benefit from Government investment in that area. There are lots of people from rural areas here, and we know how unreliable our broadband infrastructure is.

In 2022, the all-party parliamentary group on rural health and care published an inquiry into healthcare in rural areas. It concluded:

“Rurality and its infrastructure must be redefined to allow a better understanding of how it impinges on health outcomes”.

No progress has been made on achieving that. Removing the rurality measure of GPs’ funding entirely would be a step backwards in understanding how settings impact GPs’ ability to provide healthcare.

There is little transparency about who exactly will be consulted in the funding model review. In a written answer to a parliamentary question, the Government confirmed that the review

“will draw on a range of evidence and advice from experts,”

such as the Advisory Committee on Resource Allocation and the British Medical Association general practitioners committee, but there is little information beyond that. There are GPs in Tatton who are keen to contribute but, as of yet, have not been able to.

Oral Answers to Questions

Edward Morello Excerpts

Tuesday 13th January 2026 Commons Chamber

[Karin Smyth]

We absolutely stand by that work, and we are working with NHS England to make sure it is mandated to do exactly that.

[Edward Morello (West Dorset) (LD)]

4. What steps his Department is taking to ensure the accessibility of regular NHS dental check-up appointments in West Dorset constituency.

[The Minister for Care (Stephen Kinnock)]

This Government are committed to ending the gaps in teeth by filing the gaps in local provision, including in rural areas such as Dorset. We will work to introduce fundamental changes to the dental contract before the end of this Parliament, but already from April the reforms to NHS dentistry that I announced last month will mean more NHS appointments and better oral health.

[Edward Morello]

NHS dentistry in West Dorset is in crisis. We have just 15 practices offering any kind of NHS care, and only half of young people have seen a dentist in the last two years. Residents are writing to me about elderly people removing their own teeth and children in A&E with preventable tooth decay. What consideration has the Minister given to requiring supervised trainee dentists on placement at dental training schools to work exclusively on NHS waiting lists rather than taking private appointments, which would help reduce the backlog?

[Stephen Kinnock]

The hon. Gentleman will have noted that we have committed to tie-ins for future dentists going through the training programme. It costs the taxpayer hundreds of thousands of pounds to train a dentist, and we believe it is absolutely right that a significant percentage of their time should be put into NHS dentistry.

In terms of improving access, in financial year 2023-24 there was a shocking £392 million underspend on NHS dentistry at a time when demand was going through the roof. I made clear that every penny allocated to NHS dentistry must be spent on NHS dentistry, and I am very pleased to report that we have got that underspend down to just £36 million. The decrease in the underspend is leading to an increase in NHS dentistry, but I accept that there is still a long way to go.

Terminal Illness: Mental Health Support

Edward Morello Excerpts

Wednesday 3rd December 2025 Westminster Hall

[Mr Connor Rand (Altrincham and Sale West) (Lab)]

I beg to move,

That this House has considered mental health support for people with terminal illnesses.

It is a pleasure to serve under your chairmanship, Sir Jeremy. I am here today because of my constituent Mike, who I am pleased to say is in the Gallery to watch the debate. In 2019, Mike experienced the devastating grief of losing a partner, but out of the trauma he is pushing for change and campaigning for better mental health support for those with terminal cancer. I pay tribute to Mike: he is a remarkable man. I thank him for bravely sharing his story with me, and I will try my best to do it justice today.

In 2016, Mike’s wife, Sarah, started to suffer with terrible pain in her back, and by the end of that year she was in constant agony. In early 2017, they found out that Sarah had lung cancer, which had spread to her spine, and she was given six months to live. A course of gruelling treatment followed, including major spinal reconstruction surgery and targeted therapy. In September 2019, Sarah succumbed to her illness, passing away a week before her 53rd birthday.

Sarah lived more than a year longer than doctors had initially predicted, and in that sense her treatment was a success, but that does not tell the whole story. There was a gaping hole in Sarah’s treatment: the lack of appropriate mental health support. Not having that support had a huge impact on Sarah’s quality of life, as well as her family and her family’s quality of life. Following her terminal diagnosis, as the devastating impact of cancer started to take its toll on her body, Sarah became deeply depressed and suffered with anxiety.

We know about the physical symptoms of cancer, such as nausea, crippling pain or a loss of mobility, and just how horrendous those symptoms are, but we talk less about the mental health effects, even though they are as common and sometimes the most crushing consequence of this awful illness. That was certainly the case with Sarah. A previously happy, outgoing and vibrant woman, who loved design, gardening and reading books, she became a shell of her former self—unwilling to go outside, not even to sit in the garden she had so lovingly cared for. She cried every day, sometimes all day, and could not eat, could not read a book and did not know what pleasure felt like. As Mike said to me the very first time we met, “Sarah disappeared into herself.” I cannot begin to imagine how hard that was or the toll it took on Sarah, Mike, her entire family and her friends.

Shamefully, Sarah never saw a psychologist or psychiatrist, and she never had a serious or rigorous mental health assessment. Sarah was offered counselling and cognitive behavioural therapy by Macmillan Cancer Support and local NHS services, but we all know the issues with those services. Waiting lists can be months long, and when Sarah did get therapy, it was often for just a few weeks at a time, before she was back on another waiting list.

Too often, as in this case, the kind of therapy offered is not appropriate for the needs of the patient. Sarah would leave her CBT sessions clutching leaflets that she was supposed to go away and read, even though she could not even look at a newspaper. She was once told to go and do some gardening when the debilitating effects of her cancer had already taken that big joy out of her life. What was needed was treatment by a psycho-oncologist—someone who would offer specialist psychological care for someone affected by cancer—but the one psycho-oncologist at her local hospital was badly overstretched and the appointment never came.

As Mike has so eloquently said, this is not a criticism of our dedicated NHS or care staff. They are not to blame for a health culture that has always been more interested in the physical than in the psychological. That deficiency, in reality, is unlikely to change without more scientists and funding bodies devoting time and cash to researching therapies to support the mental health of those with terminal illnesses. From my perspective, there seems to be precious little work being done in this area; I spoke to Macmillan and other charities ahead of this debate, and they said the same. That deficiency is despite the fact that 17% of cancer patients will be diagnosed with depression and anxiety, but almost half will not receive the treatment that they need—that must change.

I ask the Minister to seriously consider the policy suggestions made by Mike: more funding to map service provision across the national health service to identify good and bad practice, including an assessment of the effectiveness of current National Institute for Health and Care Excellence guidelines on mental health support for the terminally ill; more funding to recruit more psycho-oncologists to work in our palliative care system; a commitment to an immediate baseline mental health assessment for patients upon their diagnosis with a terminal illness and, if needed, a clear pathway for referral to an experience psycho-oncologist on diagnosis of terminal illness. I believe that those are practical and, I hope, achievable steps that could make a real difference to cancer patients.

[Edward Morello (West Dorset) (LD)]

I thank the hon. Member for giving us an opportunity to talk about this incredibly important issue. I agree 100% with the recommendations that he is making. I also point to the important work that hospices do. A lot of hospices, such as Weldmar and Julia’s House in West Dorset, provide mental health-led hospice services to communities, yet, at the same time, are under extraordinary funding pressures. Weldmar has a £1 million deficit; Julia’s House gets just 8% of its funding from the NHS, yet it is relieving pressure on the NHS. Does the hon. Member think that, along with his recommendations, a sustainable funding model for hospices providing the kind of care that he is talking about is important?

[Mr Rand]

I am sure that there is recognition on both sides of the House of the incredibly important work that hospices do to support patients in our communities. I am sure that the hospices that the hon. Member mentioned will be grateful for the recognition of their important work. Of course we need to ensure sustainable funding. As he will be aware, this Government have already invested a significant amount in hospice care, but I appreciate the pressures that many hospices still find themselves under.

I would be grateful if the Minister would meet Mike and me to discuss Mike’s policy recommendations in more detail and to see if they could form part of the Government’s welcome review of palliative care services and the framework that has been announced. It feels particularly pressing at this juncture, as the Terminally Ill Adults (End of Life) Bill progresses through Parliament. Although I support that legislation, I worry about the prospects of those with a terminal diagnosis. I am sure that the Minister will want to reflect on that in his response.

Suicide: Reducing the Stigma

Edward Morello Excerpts

Wednesday 19th November 2025 Westminster Hall

[Sojan Joseph (Ashford) (Lab)]

It is a pleasure to serve under your chairship, Mr Mundell. I congratulate the hon. Member for Richmond Park (Sarah Olney) on securing this important debate, and I pay tribute to her constituent, who is in the Gallery to support this campaign.

It is important to reflect on the progress that has been made in this country to remove some of the stigma around suicide, but more progress still has to be made. The more we discuss this issue in this House and in our constituencies, the greater the impact we can have in removing the stigma completely.

This Government inherited a mental health crisis—there are nearly 1.8 million people on NHS waiting lists for mental health treatment. At the same time, after decades of decline, suicide rates have increased since 2007. Worryingly, the suicide rate is now higher than at any time in the 21st century. In my local area of Kent, although the suicide rate has been coming down in recent years, it is still higher than the national average.

As is the case in the rest of the UK, suicide rates in Kent are significantly higher among men than among women. Across the country, 100 men die by suicide each week and men account for approximately three quarters of all suicide deaths in the UK. This trend has been consistent since the mid-1990s. While men are more likely than women to die by suicide in all age groups, that difference is most pronounced among middle-aged men—suicide is the biggest killer of men aged under 50. I welcome initiatives such as Movember, Andy’s Man Club, the Campaign Against Living Miserably and other similar schemes for the work that they do to help men. I particularly welcome the fact that today the Government published the first ever men’s health strategy, as part of which they will be working with the Premier League’s Together Against Suicide initiative. I would be grateful if the Minister could say a bit more about that, and about what will be done to remove the stigma around men’s mental health.

Suicide rates among young people are the lowest of all age groups, but over the past decade there has been a concerning 22% increase. A rise in the number of young people feeling disconnected and isolated after the pandemic lockdowns and an escalation in online bullying are reported to be contributing factors.

Another sector in which the silent tragedy of suicide is all too prevalent is the farming and agriculture industry, in which an average of three people die by suicide every week. Mental Health First Aid England reports that, between 2021 and 2023, suicide deaths among farmers increased year on year.

[Edward Morello (West Dorset) (LD)]

The hon. Gentleman is talking about young people and farming. Those two issues overlap in rural areas such as mine. Our child and adolescent mental health services are centralised in Dorchester, so someone living in the extremities of Lyme Regis, Beaminster or the surrounding villages could be looking at a 30-mile round trip to access them. Given that our part of the country is famous for its unreliable bus network, that is pretty difficult for a lot of young people and for those living in isolated communities. Does the hon. Gentleman agree that improving access to things like CAMHS is vital if we are to protect young people in rural communities?

[Sojan Joseph]

As someone who worked in mental health services for 22 years, I absolutely agree. We need access to mental health services, and not just for young people; everyone is important. Getting help early is key to preventing suicide among young people.

The situation is worse among men working in the farming industry. The likelihood that a male farm worker will die by suicide is three times higher than the national average for men. Earlier this year, a Farm Safety Foundation report revealed that over 90% of farmers said that poor mental health is the biggest hidden problem in the industry.

What is contributing to that poor mental health and the increased risk of suicide among those working in the agricultural sector? It is driven by a combination of isolation—many work alone in remote areas—and financial pressure from market volatility, debt and rising costs. Long working hours, often exceeding 60 hours per week, lead to exhaustion and poor mental health. There is also a strong stigma around seeking help, which means that many farmers suffer in silence.

The connection between suicide and mental illness is well documented, but reducing the stigma of suicide should not be viewed solely as a mental health issue. Many individuals who die by suicide have never engaged with mental health services or displayed obvious symptoms, and not all have a diagnosed condition. People at risk often face a complex mix of personal, relational, community and societal factors. As the suicide prevention strategy highlights, common risk factors include physical illness, financial hardship, gambling, substance misuse, social isolation, loneliness and domestic abuse. Although mental health support is important, the strategy stresses that reducing stigma extends far beyond that. Focusing only on mental health risks overlooking those in acute distress who do not meet the diagnostic criteria. It also places the burden on mental health services, when in reality reducing the stigma of suicide requires a collective effort from local authorities, employers, schools, the justice system and society at large.

Jhoots Pharmacy

Edward Morello Excerpts

Wednesday 15th October 2025 Commons Chamber

[Edward Morello (West Dorset) (LD)]

(Urgent Question): To ask the Secretary of State for Health and Social Care if he will make a statement on the adequacy of Jhoots as a pharmacy provider.

[The Minister for Care (Stephen Kinnock)]

I congratulate the hon. Member on securing this important urgent question.

Pharmacies play a vital role in our healthcare system. They are at the heart of our high streets and are the cornerstone of communities up and down the country. That is why this Government have given pharmacies a funding boost of almost £500 million this year, which is more than any other area of the NHS and the biggest uplift in years. Indeed, we have provided a 19% uplift over the two-year period.

The vast majority of pharmacies provide excellent care to their patients, but unfortunately there are some that fall short of the standards we expect. Sadly, the services provided by Jhoots are falling well below the mark. Hon. Members will know that several integrated care boards have been deploying contract management actions against Jhoots, initially in the form of breach notices. Integrated care boards enforce the NHS terms of service on pharmacies for such things as their opening hours, and the General Pharmaceutical Council regulates pharmacy premises and pharmacy professionals. Both ICBs and the General Pharmaceutical Council have powers to address problems in pharmacies and they are actively using those powers, including in relation to stores that are part of Jhoots.

I have written to the hon. Gentleman about this case. As he will understand, it is difficult for me to go into detail about one pharmacy chain, at least on the specifics of the measures we are taking, but I can tell him that where there are problems with access to medicines, ICBs are supporting affected patients in the short term, for example by allowing local dispensing doctors to provide dispensing services to those patients. Where pharmacy stores regularly breach their terms of service, ICBs can give them notice that they are being removed from the pharmaceutical list. This power applies to any and all pharmacies, including, of course, Jhoots, and means that pharmacies would no longer be able to provide NHS services. Such notices can be appealed against, so it does take some time to work through the system. I stress to hon. Members that pharmacies are private businesses and must be responsible business owners. We can regulate what pharmacies should and should not do as part of their NHS terms of service, but it is not possible to prevent pharmacies from, for example, not paying their staff.

In conclusion, if pharmacies breach their terms of service, for example by not being open when they should be or where there are patient safety concerns, we take action. The General Pharmaceutical Council is taking regulatory action. ICBs are taking regulatory action and are supporting patients with access to medicines where necessary. This is aimed at improving pharmacies’ behaviour, but can ultimately lead to pharmacies being forced to close their business. I have also asked my officials to explore whether we can strengthen the regulatory framework to be able to deal more quickly with pharmacies that do not play by the rules. My officials are working on that as a matter of urgency. My office is also setting up a meeting with the hon. Gentleman to discuss this matter further and I will keep the House updated in the usual way.

[Edward Morello]

I would be grateful, Madam Deputy Speaker, if you could pass on my thanks to Mr Speaker for granting this urgent question. I thank the Minister for his response.

The collapse of service provision in some places, the constant closures in others and the general governance at Jhoots pharmacy, which operates 150 branches across England, demands immediate ministerial intervention. In West Dorset, Jhoots branches in Lyme Regis and Bridport have been closed for months, leaving thousands without access to essential medication and placing a huge strain on overstretched neighbouring pharmacies. Jhoots staff have gone months without pay, despite payslips being issued, tax deductions made and pension contributions not deposited. I have been contacted only this morning by staff who have not been paid for the third month. Many are unable to buy food or pay rent. They are relying on food banks and the amazing communities that have stepped up to support them. There have been reports of staff recruited by Jhoots under skilled worker visas being left without income or resource. I have also been made aware of deeply troubling reports of controlled drugs being removed without proper documentation or process, which if proven true may constitute a breach of the Misuse of Drugs Act 1971.

I have raised my concerns with the General Pharmaceutical Council, His Majesty’s Revenue and Customs, the NHS Business Services Authority, the ICB and the Minister, whom I thank for his response. I understand that processes must be followed, but this situation requires immediate action. Jhoots staff are not being paid and people across the country do not have access to vital medicine. Will the Minister please confirm what steps are being taken to ensure that all Jhoots staff are paid without delay? What discussions have taken place with the NHS BSA, the General Pharmaceutical Council and other regulators about Jhoots’s business practices? Finally, will the Government commit to urgently reviewing Jhoots’s suitability as an NHS pharmacy provider, outline what safeguards will be introduced to prevent this from happening again and review the pharmacy funding model?

[Stephen Kinnock]

I agree with everything the hon. Gentleman has said. It is completely and utterly unacceptable if a business such as Jhoots is not paying its staff. If there are indeed these reports that controlled drugs are not being handled properly, I would strongly recommend that any mishandling of drugs be reported to the General Pharmaceutical Council, which regulates pharmacy professionals and premises, so that appropriate action can be taken.

The hon. Gentleman asked about the payment of staff. Pharmacy staff are vital parts of the NHS part of what a pharmacy does. Pharmacy staff provide vital services to our communities and should be paid according to their contracts; any failure to do so is completely unacceptable. Of course, pharmacy staff are employed not by the NHS, but by the businesses they work for, so any dispute between staff and a pharmacy business should be raised with the Advisory, Conciliation and Arbitration Service, ACAS. I am also in touch with the Pharmacists’ Defence Association—the PDA—which is doing important work representing its members. I will be meeting them soon as well. Of course, we have responsibility for the NHS part of the work, but it is up to individual businesses to ensure that their employees are treated fairly.

The hon. Gentleman rightly mentions the review of suitability to operate, and we are now looking at that across the board. We are looking at the role of the General Pharmaceutical Council and what is taking place with ICBs taking contract action. Where there is no sign of improvement and pharmacies continue to be in breach, the next escalation is to strike them off the pharmaceutical register, which takes some time, because certain pharmacies—I am not going to name names, but I am sure the hon. Gentleman can imagine who—are trying every single thing they can to appeal, push back and stop the actions that we are seeking to take, which is elongating the process. However, I want to be clear: if there is clear breach and action is not taken to remedy that breach, pharmacies will be struck off the pharmaceutical register.

Oral Answers to Questions

Edward Morello Excerpts

Tuesday 22nd July 2025 Commons Chamber

[Karin Smyth]

My hon. Friend outlines a horrific case in her constituency, where she has been a fantastic campaigner since last year. Information sharing between 111 and 999 already exists in many places. We want standards in place to ensure that that happens safely across the country. That is a key part of what we are trying to do in our 10-year plan by bringing together single patient records and records within systems. I am very happy to follow up with her in more detail on the case she mentions, if that would be helpful.

[Edward Morello (West Dorset) (LD)]

Many GPs say that their buildings are not fit for purpose and lack digital infrastructure. Without fully integrated electronic patient records and better systems, including the electronic prescription service across all hospitals and community trusts, we risk wasting time and money while increasing pressure on frontline staff. Will the Minister outline the steps being taken to full integrate the electronic prescription service across all settings in Dorset?

[Karin Smyth]

The hon. Member highlights the importance of getting this right not only from hospital to discharge but, crucially, in primary care, where 90% of patient contacts happen across the system. That is why a central plank of our 10-year plan has been moving the entire system from the analogue to the digital age. We have allocated £10 billion, particularly in this spending review, to address this issue and make sure we get this right for the system and for patients.

GP Funding: South-west England

Edward Morello Excerpts

Wednesday 25th June 2025 Westminster Hall

[The Minister for Care (Stephen Kinnock)]

It is a real pleasure to serve under your chairship, Dame Siobhain. I thank the hon. Member for Newton Abbot (Martin Wrigley) for securing this debate and raising this important issue. I pay tribute to every hon. Member who has taken part in the debate for their insightful contributions.

The health and wellbeing of constituents across the south-west remains a top priority for us all; I welcome the opportunity to address the concerns that have been raised today. The issue strikes at the very heart of the NHS and its ability to serve our communities effectively. General practitioners are the cornerstone of the NHS. They provide the first point of contact for millions of patients, enabling access to specialist services, managing long-term and chronic conditions, and delivering preventive care.

The south-west is a unique part of our country with a population that faces distinct challenges, from its rural geography and dispersed communities to an ageing demographic and areas of health inequality. The dedication of GPs and primary care teams, often working under difficult conditions, is a testament to the NHS’s commitment to accessible healthcare. I thank those professionals for their invaluable service.

I was pleased to see the fantastic interest and engagement that we had from the south-west in our 10-year health plan consultation. The hon. Member for Newton Abbot and his colleagues from the area will be pleased to note that the south-west had a higher than average response rate compared with the rest of the country on our change.nhs.uk platform. We also saw that 126 community-led events were run in the south-west using our “workshop in a box” toolkit, which demonstrates just how important reforming the NHS is to people in the region.

The Government recognise that GP practices in rural and remote areas face specific pressures, including recruitment difficulties and population fluctuations due to tourism. We also acknowledge the demographic reality. The south-west has a higher proportion of older residents, which increases the demand on primary care for managing complex, long-term conditions. These challenges require tailored and effective responses.

Since taking office, the Government have made primary care a central pillar of NHS reform. We have committed to strengthening GP services nationwide through a series of measures designed to increase funding, support workforce growth and improve patient access. These measures support progress towards a neighbourhood health service, with more care delivered locally to create healthier communities, spot problems earlier, and support people to stay healthier and maintain their independence for longer.

[Edward Morello (West Dorset) (LD)]

The Minister mentions the ageing demographic of the south-west. I do not know if it is actually a fact, but one of my favourite things that I have ever been told about the population of West Dorset is that if we were a country, we would have an older population than Japan—we would be the oldest country in the world. The only things older than our population are some of our GP buildings; about one in five predates the NHS itself. Can the Minister outline how the Government intend to help GP surgeries to upgrade their facilities?

[Stephen Kinnock]

I thank the hon. Gentleman for his intervention and for that fun fact. I will come on to it a bit later in my speech, but the £102 million primary care utilisation fund will make a major contribution to upgrading the creaking primary care estate. He is right to identify that as a major challenge. It is also major drain on productivity. We must ensure that our GPs have the tools at their disposal to do the work they need to do.

NHS Funding: South-west

Edward Morello Excerpts

Wednesday 11th June 2025 Westminster Hall

[Edward Morello (West Dorset) (LD)]

I congratulate my hon. Friend the Member for Torbay (Steve Darling) on securing the debate. I will be as brief as I can. I would love to talk about the lack of NHS dentist appointments in West Dorset or the problem with the funding model for community pharmacies, but instead I will just make the point that integrated care boards such as NHS Dorset are being asked to cut their staff by 50% on top of previous cuts of 30%. These are the people who ensure that frontline services run smoothly, and I am concerned that gutting their capacity in such numbers so quickly risks destabilising the very system that we are trying to fix.

Although NHS Dorset has a plan in place to break even, it is reliant on delivering £190 million in savings. The trust has requested £14 million in additional financial support, but remains £22 million short of its funding target. There is also a pressing need for capital investment in digital infrastructure to help modernise hospital estates, such as Dorset county hospital, to streamline services.

The closure of the maternity unit at Yeovil means that Dorset county hospital in Dorchester is picking up much of the slack; it is looking after more patients with no additional cash. The fact is that delivering services in rural communities in the south-west is more expensive than it is in urban areas. What steps are the Government taking to ensure that rural communities are no longer left behind?

[Several hon. Members rose—]

Access to NHS Dentistry

Edward Morello Excerpts

Thursday 22nd May 2025 Commons Chamber

[Edward Morello (West Dorset) (LD)]

I congratulate the hon. Member for Great Grimsby and Cleethorpes (Melanie Onn) on securing the debate. I was delighted to be able to support her application, because this issue deeply affects my constituents.

Dentistry is in crisis nationally, and nowhere is that felt more so than in rural communities such as West Dorset. In my constituency we have just 15 dental practices offering any form of NHS dental care, serving a population of more than 94,000.

[Rachel Gilmour (Tiverton and Minehead) (LD)]

I have to confess that I rather envy my hon. Friend for having 15 dental practices, as I have a mere nine. In fact, as became evident in the Public Accounts Committee inquiry, which I attended as a Committee member, Minehead has fewer dentists than anywhere else in the United Kingdom. It is really important that we carry on lobbying the integrated care boards, because they can give out contracts.

[Edward Morello]

I know that my hon. Friend’s constituency suffers from a lot of the same issues as West Dorset, given their similarity.

The consequences of the lack of NHS dental care are stark: only 36% of adults in West Dorset have seen a dentist in the past two years, and just 50% of children have had a dental appointment in that time—an alarming 9% lower than in 2019. I know that the Government have announced a rescue plan to provide 700,000 more urgent dental appointments and to recruit new dentists to the areas that need them most. That is welcome news, but how exactly are the areas with the most need being assessed? What specific provisions are being made to ensure that rural areas such as West Dorset, where the population density is low but unmet demand is high, are not left behind once again?

[Steve Darling (Torbay) (LD)]

In Devon we have a budget of £377,000 to recruit new dentists. Sadly, only two of the 22 dentists have actually been recruited. Does my hon. Friend agree that this demonstrates that the Conservatives’ golden hello scheme has completely failed, and that we desperately need a new contract now?

[Edward Morello]

My hon. Friend is right that a lot of this comes down to the funding model. When funding is allocated under the current model, it is always rural communities that lose out. I ask that the rurality of places such as West Dorset be recognised in both the workplace planning and the resource allocation, because the south-west has the highest rate of dental-related A&E visits—217 per 100,000 people. That is one in every 460 people turning to emergency care because they cannot get an NHS dentist’s appointment. Preventable oral health issues are flooding our hospitals because we have failed to resource our community dental services.

The Government have made some minor tweaks to the dysfunctional NHS contract, which is welcome, but morale is at an all-time low. Over 60% of dentists in England are thinking of leaving the NHS all together. The current contract often leaves dentists losing money on every NHS patient they see—for example, a typical dentist loses £42.60 per denture fitted. That is unsustainable, and it is time to reform the system as a whole, because change cannot wait. I ask the Government to come forward with a clear timeline for negotiating on contract reform, and to properly support integrated care boards, as my hon. Friend the Member for Tiverton and Minehead (Rachel Gilmour) said, with ringfenced funding for dental services.

The Liberal Democrats are calling for a comprehensive dental rescue package that would guarantee access to an NHS dentist for everyone in need of urgent or emergency care. It would also ensure NHS dental check-ups for those already eligible, including children, pregnant women, new mothers and people on low incomes. In addition, the package would guarantee that anyone beginning chemotherapy, undergoing a transplant or facing critical treatment receives the essential dental assessments that they need beforehand.

I would like the Government to reverse the cuts to public health grants, which have fallen by 26% in real terms since 2015, to restore funding for preventive oral health programmes, to expand supervised toothbrushing for children in schools and nurseries, and to scrap the VAT on children’s toothbrushes and toothpaste. I ask the Government to act now. On behalf of my constituents and all rural communities, I ask that communities such as mine in West Dorset are not treated as an afterthought in the funding model, but are given priority.

Parkinson’s Disease

Edward Morello Excerpts

Wednesday 21st May 2025 Westminster Hall

[Edward Morello (West Dorset) (LD)]

It is a pleasure to serve under your chairship, Mr Stuart—especially after that flattery. I congratulate the hon. Member for Colne Valley (Paul Davies) on securing this important debate.

Parkinson’s, as has been said, is the fastest growing neurological condition in the world. But behind every statistic is a family, a carer, a friend—someone whose daily life is shared by this illness. My constituents have written to me about their experiences of loved ones living with the disease. The stories they have shared are heart-breaking, with long waits for specialist care, difficulties accessing the right medication on time, and exhausting battles for financial and social support. I know I speak for many here when I say that we must do more.

Parkinson’s is a progressive condition, with more than 40 possible symptoms affecting movement, sleep, mental health, speech, eating and swallowing. Nearly half of those living with it will experience anxiety or depression, and more than half will develop psychotic symptoms as the condition progresses. Across the country, there are long waits for specialist care, a lack of multidisciplinary teams with Parkinson’s experience, and serious difficulties in accessing vital medication in a timely and consistent way.

We urgently need to overhaul the way that care is provided for people with Parkinson’s, particularly in rural areas. That begins with primary care. GPs are the front door to the NHS, yet we know that continuity of care is beginning to be eroded. That is why the Liberal Democrats are calling for everyone with a long-term condition such as Parkinson’s to have access to a named GP—someone who can understand their history and needs, and can advocate for timely referrals and co-ordinated care.

This is not just about funding more; it is about funding smarter. Primary and community care can prevent some hospital admissions and provide medication and essential support for those who cannot easily travel. That is especially important in rural areas like mine, where distance, isolation and sparse public transport already pose significant barriers to treatment.

Care services are struggling with conditions like Parkinson’s and have been stretched to breaking point by Government decisions and a lack of funding. Weldmar Hospicecare in West Dorset is a lifeline for so many families. Earlier this year, NHS Dorset announced a £400,000 cut to its fast-track funding, starting next April. Weldmar also faces a £600,000 increase in costs as a result of rising national insurance contributions and other pressures. It already raises 60% of its NHS-commissioned care through charitable donations, and that is unsustainable in the long term.

The same goes for our community pharmacies, which are vital for people with Parkinson’s, especially in rural communities. They are not just dispensaries; they provide healthcare consultations, medical reviews and early advice, often acting as the first point of contact for worried patients. Yet the funding model they rely on is outdated and inadequate, leaving many rural pharmacies on the brink of collapse. If we are serious about reducing health inequalities, we must ringfence funding for essential services and not allow it to disappear into ever-wider budget allocations.

We owe it to everyone living with Parkinson’s, and to the families, the carers and the health workers supporting them, to do better. That means listening to the voices of those people affected, ending the postcode lottery and making sure that no one, wherever they live, faces this devastating disease alone.

[Graham Stuart (in the Chair)]

Admirably delivered.

--- Later in debate ---

[Vikki Slade (Mid Dorset and North Poole) (LD)]

It is a pleasure to serve under your chairmanship, Mr Stuart. I thank the hon. Member for Colne Valley (Paul Davies) for securing the debate. It is interesting that three of the five Back Benchers who have spoken in it are from Dorset. I do not know what that says about our population, but there we go.

[Edward Morello]

I will answer that with one of my favourite facts about Dorset: if we were a country, we would be the oldest in the world by population age. We are older than Japan.

[Vikki Slade]

My hon. Friend and constituency neighbour is correct. We have the Jurassic coast, but we are also the oldest county.

My daughter is currently undertaking a PhD in the causes of Parkinson’s, and I should also declare that I am a member of the all-party parliamentary group on Parkinson’s. Although life expectancy for those living with Parkinson’s is much improved, their quality of life is deeply impacted. They are incredibly vulnerable to falls and infections, limiting their ability to work. The recent changes to PIP are causing deep distress to the community. I look forward to hearing how the Government will recognise the needs of those with fluctuating neurological conditions in assessments.

However, I want to focus on the issues of treatment and care for patients. There are 216 people currently registered as living with Parkinson’s in my constituency. I have been told that there is virtually no service of specialist nurses or active phone line support in my community. That leaves vulnerable people isolated and at higher risk of traumatic, expensive and often unnecessary hospital admissions.

The Minister will be aware that an absolute diagnosis of Parkinson’s is possible only post-mortem—I pay tribute to the work of the brain bank at Imperial and that of the similar motor neurone disease brain bank at King’s College London. We therefore rely on specialists to focus on the symptoms in order to make a diagnosis, but there is a significant problem, which was explained to me this week by a GP at Walford Mill surgery in Wimborne when I spent the morning shadowing him. He told me that wait times for diagnosis for Parkinson’s can be more than six months, so experienced GPs who are able to prescribe medications have a dilemma. They can help their patients by prescribing medications to reduce the symptoms, but in doing so they make it more difficult for the specialists to diagnose the condition. If the referral-to-treatment times were dramatically improved, GPs could ask people to wait, but with the current delays, it seems cruel to ask both those living with symptoms and their family doctor to do that.

That takes me to my next point: the lack of neurologists. The UK is 44th out of 45 countries in Europe for number of neurologists per head of population, and the waiting list for neurological conditions stands at a staggering 232,994 people. According to Alzheimer’s Research, neurological conditions are the leading cause of global ill health, with 3.4 billion people suffering from one, which makes it seem even crazier that we have this problem. It is not only that: Parkinson’s, along with other neuro conditions such as functional neurological disorder and achalasia, which I have raised previously, require multidisciplinary teams to look after patients, and local NHS systems just are not set up to do that properly. Will the Minister ensure that the NHS 10-year plan will deliver ways of working that will support those with such conditions?

Finally, I will touch on prescription charges. I know the issue has been raised before, but the list of conditions for free medication has not changed since 1968. It is shocking that Parkinson’s is not one of those conditions. My constituent, Carole, who was diagnosed aged just 46, is finding that really tough and believes, as I do, that a full review of these conditions for working-age people should be undertaken now.

The final word must go to two of my constituents. Malcolm, from Wimborne, said:

“I have suffered from Parkinson’s for 10 years. It has changed my life completely for the worse. I cannot speak, I have frequent falls, we need better support.”

Danielle, also from Wimborne, who was diagnosed at 38, said:

“This is becoming more common with younger people…The impact of this disease on my life is immeasurable. It is more than a struggle. It is a fight every day. We need these issues addressed urgently to reduce the burden.”

I hope that the Minister will be able to offer us some comfort.