Health and Wellbeing Services: East of England

Feryal Clark Excerpts

Wednesday 1st March 2023 Westminster Hall

[Feryal Clark (Enfield North) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Hollobone. I start by thanking and paying tribute to the right hon. Member for Witham (Priti Patel) for securing this important debate and her continued pursuit of the issue, but also for painting a comprehensive picture of the health and wellbeing disparities in her constituency and across the east of England. I welcome her comments about and the enthusiasm she showed for further including pharmacies in the way we deliver health. I support that wholeheartedly.

May I praise the important contributions made by all Members, especially my hon. Friend the Member for Bedford (Mohammad Yasin)? It is clear that patients are being failed in all aspects of health and wellbeing services in the east of England. We have heard about many aspects of those services, but let me start by talking about the front door of the NHS, the GPs. Primary care and GP services are struggling, and patients are struggling to gain access to primary care. The latest patient survey tells us that those who are able to get an appointment are less and less likely to see a GP because of staff shortages.

The right hon. Member for Witham mentioned that patient numbers and needs are growing in the area, but we know that the number of fully qualified GPs in the east of England fell from 3,263 full-time equivalents to 3,020 in December 2022. Across NHS England, there is a shortage of 4,200 GPs, so I welcome the call from the right hon. Member for Chelmsford (Vicky Ford) for the number of medical school places at Anglia Ruskin to be doubled, although I would go further and say that we should do that across the country, maybe every year.

There is also a quality issue. Essex has five inadequate GP services, according to the Care Quality Commission, which is second only to London. Maternity services are also failing communities in the east of England day in, day out. At Mid and South Essex NHS Foundation Trust, such services have been found by the CQC not to have staff with the right qualifications, skills, training and experience to keep women safe from avoidable harm. Since last year, the use of gas and air pain relief at a hospital’s maternity suite has been suspended on and off following a botched repair, which exposed some staff to high levels of nitrous oxide, and routine testing of the maternity suite revealed that midwives had been exposed to excess nitrous oxide levels during their shifts.

It is heartbreaking that services for mothers are so poor, and maternity services are unable even to provide the basics. Access to gas and air pain relief should be a basic when someone goes into maternity, and it is really disappointing that it is not available to mothers in the area.

[Giles Watling]

A moment back, the hon. Lady mentioned inadequate GP services and how some GP services fail, but is it not the job of us MPs to get involved? There were failing GP services in poor practices in Clacton. I got personally involved, we got new management in, and we turned things around. We, the MPs, can get involved. We got involved with what was then the local health authority, and we changed things. We can do that by getting together and being united with our health leaders.

[Feryal Clark]

I welcome those points, and I absolutely agree.

On mental health, the stories that the right hon. Member for Witham set out are devastating. I offer my sincere condolences to all those affected by the loss of loved ones between 2000 and 2020 at Essex mental health services. I also pay tribute to the families and the local MPs—especially the right hon. Member for Chelmsford, who is no longer in her place—for fighting for justice for the loved ones. A mental health unit should be a place of safety for patients, and it is heartbreaking that that was clearly not the case in Essex. It is imperative that the truth of what occurred in Essex is finally heard. As the right hon. Member for Witham said, it is vital that the families and loved ones get answers about what happened, and above all lessons must be learned. That is why the work of the Essex mental health independent inquiry is so important.

Concerns were raised in January, and the Under-Secretary of State for Health and Social Care, the hon. Member for Harborough (Neil O’Brien), said that he expected changes to be made. I will be grateful if the Minister can set out the steps the Government are taking to ensure that the inquiry can effectively investigate what went wrong and can make recommendations so that it never happens again. The inquiry is currently non-statutory. The Government said in January that they would not hesitate to change their approach if we do not see the change we need rapidly. Will the Minister tell us whether there have been any changes? Is there an update on that?

Although there are tragic extremes to health and wellbeing services in the east of England, they reflect issues that we see across the country, including patients not being seen on time and not receiving the care they need and deserve. That ultimately leaves them at risk at of adverse harm. Patients in the east of England—indeed, patients across the country—deserve more.

I would be grateful if the Minister set out the actions the Government are taking to improve care in the east of England and ensure access to primary care, safe maternity care and dentistry. Will she also give us a further update on the mental health inquiry?

--- Later in debate ---

[Helen Whately]

It is very good to hear that update. I refer my hon. Friend to the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Lewes (Maria Caulfield), who has oversight of mental health in the ministerial team and who can go further into the progress of the inquiry. It is good to hear that he is taking such an active interest in the work of the inquiry, because it is clearly important, and I thank him for that.

Hon. Members have touched on community diagnostic centres. We in Government see them as incredibly important, because we know that many patients across the east of England, and more widely across England, are waiting for a diagnosis for their condition. Waiting for a diagnosis can be one of the most worrying times, particularly if someone is concerned that they may have cancer, which is why the Government have been opening more community diagnostic centres across the country—an innovation to provide easier access to vital community diagnostic services and to speed up diagnosis. By separating some of these services from acute hospitals—the hot site, I suppose—we can ensure efficient processes to diagnose as many people as possible at pace. The good news is that we have recently announced the approval of two new community diagnostic centres via the mid and south Essex integrated care board, and there are more in the pipeline with other Essex integrated care boards. I encourage my right hon. Friend the Member for Witham and others to keep an eye on our progress with community diagnostic centres, as I am sure she is doing.

Finally, I want to talk about integration and the broader question of health and wellbeing in our communities. My right hon. Friend the Member for Witham spoke about the health challenges and disparities in her constituency and across the east of England. We see real differences and inequalities, not only in life expectancy but, crucially, in healthy life expectancy. That means people’s ability to work and have fulfilling, independent lives, to have relationships and the quality of life we would like for everybody.

The Government are determined to improve that—for instance, under the auspices of levelling up in healthcare. Crucial to achieving that is the work of our integrated care system, the integrated care boards and integrated care partnerships. They bring together all the organisations across the national health service, local authorities, social care and third sector organisations, which play an important part in our health and social care systems. Indeed, joining up NHS organisations is an important part of that in its own right. All of us who spend time with the NHS in our constituencies know that it is not one thing; it is multiple organisations. Bringing them together, along with the wider health and social care system, is important.

It is crucial for our integrated care boards and integrated care partnerships to look at the needs of populations, looking at the population as a whole, and to set out strategies for reducing health disparities and, as my right hon. Friend the Member for Witham talked about, for closing the gap—levelling up for those with a lower healthy life expectancy. That is absolutely crucial to the work of integrated care systems. It is relatively early days for these entities. The extent to which they are established varies around the country, but we are seeing an excitement and a willingness in those organisations to come together.

I have spoken to many chief executives and chairs of integrated care boards, as well as local authorities around the country. We have talked about integration many times before; it has been a buzzword for decades in health and social care. What I am hearing from the frontline is that this time it really feels like it is working and making a difference. As part of those conversations, I have spoken to many about the work they are doing on looking upstream at prevention, crucially, and the steps we can take jointly between the health system and local authorities to prevent ill health.

[Feryal Clark]

The Minister mentioned prevention and the role of local authorities. She will know that the public health funding formula for local authorities was set in 2013 and has not been reviewed. There are real disparities across the country in how they are funded. Do the Government have a plan to review that, to ensure that areas such as the east of England get the fair funding they deserve?

[Helen Whately]

The hon. Lady will know very well that we are under substantial fiscal constraints as a Government, recognising the extra spending we put in through the pandemic to keep our economy going and come out as strongly as we have. We also face challenges with inflation and the cost of energy. She will also know that in the autumn, against those constraints, the Chancellor showed the Government’s commitment to health and social care by putting an extra £14.1 billion into health and social care, including a record funding increase for social care of £7.5 billion over the next two years.

The Government’s commitment to health and social care should be clear to the h L. We are driving efforts behind the establishment of the effective working of integrated care boards and integrated care partnerships, because of the importance of joining up the system. It is not just about the public health budget; what we need to do to prevent future ill health and reduce disparities is much broader than that.

In conclusion, I thank my right hon. Friend the Member for Witham and other hon. Members for this important conversation, which has shown the complexity and the interconnections in our health and social care system. It is important to have joined-up systems, not only to treat people in the here and now, but crucially to intervene earlier and prevent ill health. We want to achieve not only longer lives for our constituents, but healthier and happier lives.