Department of Health and Social Care

Helen Morgan Excerpts

Wednesday 5th March 2025 Commons Chamber

[Helen Morgan (North Shropshire) (LD)]

I thank the Chair of the Public Accounts Committee, the hon. Member for North Cotswolds (Sir Geoffrey Clifton-Brown), for securing this debate and for his excellent opening speech.

We all know that we have reached a crisis point across the NHS and care sectors, with more patients than ever waiting for treatment. That is affecting not just those in need of care and treatment, but those who work tirelessly across the NHS and care sectors, who are feeling the full brunt of the crisis. The Conservatives have a legacy of hours-long waits for ambulances, treatment in crowded hospital corridors—captured in horrifying detail by the “Dispatches” documentary, which looked into the hospital that serves my constituents in North Shropshire—and communities grinding to a halt under the weight of all sorts of waiting lists and backlogs. We urgently need to move forward.

The Secretary of State has repeatedly outlined the need to shift from treatment to prevention and from hospital to community, and the Liberal Democrats absolutely support him in that endeavour—indeed, we called for many measures that would achieve that shift in our own manifesto. Stronger primary care and community services were the strong recommendations of Lord Darzi’s report, which was commissioned by the Secretary of State and has been broadly welcomed.

There has been a great deal of consensus across the House today that we need to take those measures, but I fear that these estimates paint a picture of an NHS that continues to pour money into the previous, failing model in which capital budgets are drained to pay for day-to-day services and a huge proportion of increased spending goes on NHS staffing, while community care and primary care providers wrestle with the huge increase in employer national insurance contributions.

When that is combined with the decision to scrap targets on mental health and community services for the sake of prioritising targets on elective care, we must ask: when will the stated objectives of the Secretary of State really be matched by actions? The latest estimates are an indictment of the broken state of the NHS after years of Conservative neglect, but we urge the Government to go further and faster to address the failure.

[Ben Coleman]

Having heard the hon. Lady’s comments and the comments of those on the Conservative Benches, may I share with her my confusion? She seems surprised that she has not heard the full solution of what this Government are going to do with the NHS, when it is quite clear that there will be the three shifts, a 10-year plan and a huge amount of reform coming down the line. As that seems to have escaped the Opposition’s attention, has it also escaped hers?

[Helen Morgan]

There is clearly a point in the debate at which we need to urge the Government to go further and faster. As a constructive Opposition, that is exactly what we will do.

Primary care providers are on their knees, and I am afraid to say that that has been made worse by the national insurance hike announced in the Budget. They cannot meet demand for local appointments as things stand, and in many cases the constraining factor is the estate in which they operate. Prescott surgery in Baschurch in North Shropshire wants to provide additional services to the community and keep people away from hospital, but the surgery is physically not big enough. A local developer has provided land for a new surgery, and the local council has community infrastructure levy funding for that building, but it cannot be done because the ICB will not pay the notional rent, which everybody has agreed to forfeit. It is crazy. I hope that the Minister can commit to finding some kind of easy solution to that kind of nonsensical situation that we find ourselves in.

[Nesil Caliskan]

On the point about the inability of ICBs sometimes to get things going, in my constituency it has taken the ICB nine months to procure something very similar. Does the hon. Lady agree that it is about not just their ability to pay, but their procurement processes?

[Helen Morgan]

I fundamentally agree. There are many such instances, and I chose that one because I spoke to the providers there recently.

I will come on to community pharmacy, because I am particularly concerned about pharmacies, which are a key pillar of care in the community, dispensing prescriptions and providing over-the-counter medicines and advice. Critically, they also provide Pharmacy First, but they are closing at an alarming rate. Analysis by the National Pharmacy Association predicts that another 1,000 pharmacies will close—900 of them by the end of 2027—if the current rate of closures continues. That is because of a 40% real-terms cut in their funding since 2015.

In fact, community pharmacies are essentially subsidising the NHS by making a loss on many of the prescription drugs that they dispense. In a few weeks’ time, in April, they will be clobbered by not only the NICs hike, but the increase in business rates, which will affect high street retailers. Shamefully, they have not even had their funding rates for the current financial year confirmed—the one that ends in three weeks’ time.

Pharmacy First, the flagship plan to move care into the community, has not had its funding confirmed beyond the first week of April this year, which is in just a few weeks’ time, according to the National Pharmacy Association. In her remarks, will the Minister confirm the future of Pharmacy First? Is there a funded plan to deliver that service? What steps are being taken to keep our community pharmacies in business? If we want to see care in the community, it is essential that we support them.

I want to mention dentistry. In Shropshire, Telford and Wrekin, the number of NHS dentists fell by 12.3% from 2019-20 to 2023-24. Many of my constituents cannot access a dentist, and the Government have committed to improving the situation, so can the Minister confirm when the negotiations on the new dental contract will begin?

The crisis that the social care system faces is daunting, not least because of the additional national insurance hike that will take place in a couple of weeks’ time. Last week, caring organisations launched an unprecedented day of action, with thousands of people marching on Westminster to highlight the precarious state of the organisations that provide care. The Darzi review found that people waiting to access social care account for 13% of NHS hospital beds. We all understand the urgency of tackling social care, but the cross-party talks collapsed last week—they have not started. There is no date for a new meeting, and there are no published terms of reference. We think that 2028 is far too late to resolve this problem, so can the Government urgently reinstate those talks and act now to deal with the social care crisis?

Before I conclude, I will talk about mental health. As Lord Darzi has said,

“There is a fundamental problem in the distribution of resources between mental health and physical health. Mental health accounts for more than 20 per cent of the disease burden but less than 10 per cent of NHS expenditure. This is not new. But the combination of chronic underspending with low productivity results in a treatment gap that affects nearly every family and all communities across the country.”

He is dead right. By April 2024, about 1 million people were on a waiting list for NHS mental health services, of whom 340,000 were children. My casework is full of children who wait months and months for the diagnosis and treatment that they need. The Government have removed the targets for mental health waiting lists; I urge them to reinstate those targets, so that we have parity between mental and physical health in our health service.

I am very conscious of time, so in conclusion, I will just reiterate our asks. Those are to ensure that social care talks start immediately; to deal with the problems with pharmacies; and to make sure that mental health and social care receive parity.

[Madam Deputy Speaker (Judith Cummins)]

I call the shadow Minister.