Building an NHS Fit for the Future

Helen Morgan Excerpts

Monday 13th November 2023 Commons Chamber

[Helen Morgan (North Shropshire) (LD)]

It is my pleasure to speak in this debate in response to the King’s Speech—the King’s first—on behalf of my North Shropshire constituency. I particularly welcomed the Government’s ambition to cut NHS waiting lists, but, frankly, I was shocked to see no reference to some of the most pressing health emergencies in my constituency. There was no mention of emergency care and ambulance waiting times, and no acknowledgement of the lack of access to NHS dentists and GP appointments and, indeed, of our catastrophic cancer treatment situation. Some of those issues are literally ones of life and death in North Shropshire.

The proportion of patients at Shropshire, Telford and Wrekin integrated care board who started cancer treatment within 62 days of an urgent GP referral was just 38% in June, according to Macmillan. The national target sits at 85%. It is shocking that in 2023 access to timely NHS cancer treatment is still a postcode lottery. Liberal Democrats have pledged to give people a legal right to cancer treatment within two months of an urgent referral, and I urge the Government to make a similar commitment, rather than watering down their targets for lifesaving treatment.

I was also disappointed that the crisis in NHS dentistry was overlooked in the King’s Speech. In North Shropshire, the number of adults seen by a dentist between 2019 and 2022 fell by more than 10%, down to just 35.4%, and less than half of local children have seen a dentist in that time. Local dentists report a shocking increase in child tooth decay when a parent is unable to register and take their child along. Seven months ago, the Government promised that a dental recovery plan would be published specifically to deal with this problematic issue, so I am concerned that no reference at all was made to it in the King’s Speech. I would be grateful if the Secretary of State for Work and Pensions provided an update on the progress of the plan in his closing remarks and confirmed on what date we should expect to receive it.

I was frustrated to see a lack of reference to adult social care and carers in general in the King’s Speech. The support that carers provide is a lifeline to elderly and rural residents in my constituency, yet the workforce is shrinking at an alarming rate. In the last few years, the number of vacancies nationally has skyrocketed to 165,000. Of course, that is having an impact on A&E departments and on ambulance services, because hospitals cannot discharge patients and allow a good flow through the hospital for those who are admitted when critically ill. I hope that the promised plan to transform the workforce of the NHS will not ignore the vital but creaking care sector. The Government must resolve the crisis there by reforming staff retention and recruitment; tackling the importance of pay in a sector that is in competition with retail and hospitality for new recruits; and recognising the importance of carers’ roles by providing the sector with minimum professional standards.

In Shropshire, the care sector faces the logistical challenges of delivering these vital services over a large rural area. I hope that the Secretary of State for Work and Pensions will agree that it is vital to consider rurality when drawing up NHS and care workforce plans.

People in North Shropshire know that accessing healthcare is nigh on impossible without access to their own car. I have spoken in this place many times about how poor the public transport links are in my constituency. They prevent people from accessing vital health services, and from accessing job opportunities and higher education. It is welcome that the Government want to improve journeys in the midlands but, to be blunt, in my constituency there are very few public transport journeys to improve. People without a car rely on friends and relatives for lifts—we are resilient and we get by—but when will the Conservatives realise that rural Britain is home to 20% of the population and that we are worth investing in, rather than simply taking us for granted?

The Government have also said, and I welcome it, that they want to ease the cost of living and provide help for businesses. I am glad that both statements were included in the King’s Speech, but I feel it is necessary to spell out exactly what it might look like to deliver that for constituents in places such as North Shropshire. For rural residents, the cost of living has only exacerbated long-standing inequalities. Rural residents earn 7.5% less on average than people in urban areas, but because council services are much more expensive to provide, their council tax payments are on average 20% higher.

Not only that, but off-grid energy users are still waiting for the Government to provide substantial support with their energy costs. The Countryside Alliance has reported that, on average, rural households spend £800 a year more on fuel than those on the grid. The Government need to reassure people in North Shropshire and the rest of rural Britain that their commitment to easing the cost of living crisis includes them, by addressing the lack of an energy price cap for people who live off-grid and extending rural fuel duty relief to those forced to drive long distances for work, for education or to access essential healthcare.

Rural businesses obviously have to battle with the cost of supplies and energy bills, but they also struggle because of a depleted workforce and the lack of digital connectivity. Just 46% of rural businesses have a stable 4G broadband connection, so it is no wonder that the Federation of Small Businesses reported that in 2022, 6% fewer rural businesses reported that they planned to expand. If the Government want to help with this issue, they need to understand the factors that have put rural businesses on the back foot and put in place policies to help them cope with the discrepancies that come with sparse and spread-out populations. I suggest that allowing rural roaming on mobile networks would be a great place to start. Much of my constituency is in a notspot or a partial notspot. Anyone who has tried to phone me will know that a continuous conversation is almost impossible across large swathes of North Shropshire.

The Government have committed to promoting trade with economies in the fastest-growing regions of the world through the comprehensive and progressive agreement for trans-Pacific partnership. It is crucial to ensure that our farming industry has the opportunity to promote the fantastic produce that we grow in the UK and expand its export activities, but the deal endangers farmers’ businesses as well as animal welfare and environmental standards. Because of the deal, imports that have a lower production cost but a much higher animal welfare and environmental one will be for sale in this country, which risks undermining our world-leading British farmers and food producers. Surely future trade deals must avoid any further damage to this vital sector.

I was glad to hear the Government commit to the promise to reform the archaic leasehold system—something that Liberal Democrats have been calling for since Lloyd George. I hope the leasehold legislation will include new protections for homeowners with a freehold who have been trapped into a fleecehold arrangement because the shared areas on their development are managed by a private company and not the local authority. I have been campaigning for this issue to be resolved following shocking cases in my constituency, and I have been contacted by freeholders throughout the country with unbelievable stories of their experiences with rogue developers.

In conclusion, 95% of the land in North Shropshire is used for agriculture. We are typical of rural Britain. I am disappointed to stand here and explain to the Government, yet again, the ways in which they have failed to address the challenges we face. The Government have proven that they have run out of ideas for rural Britain, having taken its votes for granted for so many years. Now, here we are in a debate to discuss ways to get the NHS back on its feet. After eight years of disastrous Tory management, the only viable answer to that question is surely to hold a general election and start afresh.