NHS Winter Readiness

Helen Morgan Excerpts

Wednesday 30th October 2024 Westminster Hall

[Helen Morgan (North Shropshire) (LD)]

I beg to move,

That this House has considered NHS readiness for winter 2024-25.

It is a pleasure to serve with you in the Chair, Sir Roger, and I am grateful to have secured a debate on the crucial topic of preparing the NHS for winter. This is particularly timely on a day when the Government have delivered the Budget and outlined their priorities for the coming year, and indeed, the years after that.

We all know that due to the Conservative failure to protect the NHS, winter is a time when pressure on the NHS peaks. Every year, we suffer what we describe as a winter crisis. But for the millions of people stuck on waiting lists, the thousands of people treated in corridors and the legions of staff battling to keep people safe, it must feel like the winter pressure never ends.

I am sure we would all agree that the health and care crisis requires long-term action—improving public health, focusing on primary care, training and retaining more doctors, dentists and nurses, fixing the crumbling NHS estate, and fundamentally, finally addressing the crisis in social care. But while we wait for that action, winter is now looming. The clocks have gone back and time to prepare for winter has run out. I am here to find out what the Government are doing both to get the NHS through the upcoming winter and, following the Budget statement, to get the NHS ready for the winters to come.

I am aware that the Chancellor has just announced a £22 billion cash injection into the NHS, although further detail on that was scant, so we will put forward our ideas in this debate and hope that they come to fruition over the next few weeks. For the sake of staff and patients, it is crucial that winter crises become a thing of the past. We have reached the point where winter pressure is normal all year around. We should be striving for the reverse, where pressure is relieved and the forecasted crisis does not happen. I am pleased to hear some of the measures that the Government have outlined today, but I remain worried that fundamental issues are still being ignored—most crucially, the crisis in social care. Until that is resolved, we will not be able to fix the NHS.

So what is the state of play? Dr John Dean, the clinical vice-president of the Royal College of Physicians, warned that the latest NHS statistics show the health service

“is in an extremely concerning position as we head into winter.”

He is not alone in holding such concerns, for it has already been a really busy year for the NHS. In fact, it has been the busiest ever summer for A&E departments in England, with NHS staff managing 6.8 million attendances in just the past three months, according to a briefing by NHS England on readiness for winter. Last month, emergency departments had 2.2 million attendances—the highest such number for a September on record—with more than 38,000 people waiting longer than 12 hours after the decision to admit them. Meanwhile, the weekly average of extra bed days for patients remaining in hospital beyond seven days due to delays in discharge was the highest since December 2022.

A look at my local hospital trust in Shropshire illustrates the situation well. In Shropshire, at the Shrewsbury and Telford hospital NHS trust, our bed occupancy rate is constantly around the 95% mark. That is not unusual; it has become the norm at acute hospital trusts up and down the country, and not just in winter, but all year around. Hospital staff constantly have to juggle resources to try to secure people the care they need. As the wards fill up, A&E becomes crowded and care moves on to corridors.

Every month, I am contacted by constituents who are shocked by what they have encountered in the hospital: being forced to wait for hours in pain on plastic chairs, or having their dignity taken away as they occupy a trolley in a corridor, in agony and in full view of the public. Many people remain unaware of how common that is until they find themselves with a loved one in that situation.

The “Dispatches” documentary filmed at Shrewsbury and Telford hospital trust earlier this year brought the reality home to the nation. The issues with hygiene and infection control were startling enough on their own—I am pleased that the trust is addressing those directly—but most stark was the human impact on the patients. Scenes included that of the elderly man who was forced to urinate while on a trolley in a corridor, in full view of staff, or the woman who cried out in agony for hours, with staff being left in despair at the terrible situation they were trying to deal with. That was not in the depths of winter; it was in April and May.

Corridor care takes a toll on patients and a huge toll on the staff who are forced to attempt to cope. However, the full scale and the impact of corridor care are unknown, because there is only patchy reporting on the level of care in temporary environments. As we seek to better understand and prepare for pressure in the winter, and all year round, will the Government consider mandating the recording and publishing of the number of patients receiving care in temporary environments, such as corridors? Honesty and transparency are key if we are to properly prepare for the winters to come.

Every month, more than 2,000 patients spend more than 12 hours in the A&E department at Shrewsbury and Telford, and one in every three of the many ambulances arriving outside have to wait more than an hour to hand over their patient—not in winter, but in every month of the year. Since April, ambulances have lost around 15,000 hours through waiting outside the two hospitals in Shropshire, and one poor patient was stuck in an ambulance in Shrewsbury for 15 and a half hours. As we have discussed many times, that keeps ambulances off the road, and has a knock-on effect on how long people who may be in life-or-death situations have to wait for help. This leads to situations such as the one in my constituency in April this year, where a carer was left alone performing CPR for 23 minutes while being told by the 999 call operator that no ambulance was available. Tragically, the victim died, and the carer who tried so hard to save her has been left traumatised—as, I would imagine, has the 999 call operator.

As I mentioned in the Chamber a couple of weeks ago, an 11-year-old in my constituency, Charlotte, has an adrenal deficiency that leads to her needing an urgent injection of hydrocortisone if she has some kind of trauma. When that happens, she is logged as needing an automatic category 1 ambulance response. Recently, a car crash happened involving Charlotte and her mother, and when an ambulance was called for, they were told that none was available, and the family had to make their own way to hospital. That is not good enough. It is endangering lives.

The target for a category 1 response time is an average of seven minutes. So far this year in Shropshire, the average has been 11 minutes and 57 seconds. For a category 3 response, which still means that the person urgently needs an ambulance, the average wait is more than two hours, which is more than double the target time. That is not new, but it is very wrong, and it demonstrates the pressure already facing the health service as we head into winter.

Perhaps more worryingly, the situation in many areas this summer has been getting worse, rather than better. West Midlands Ambulance Service, which serves my constituency, described a

“significant, rapid deterioration of delays at hospital in September which has continued further in October.”

The service has been operating with the highest level of risk score for the past year. October is forecast to be the second worst month on record for lost handover hours, with the equivalent of 130 out of 600 ambulance crews in the west midlands being lost to delays every single day—and it is only October. That takes a huge toll on the mental health of the hard-working staff involved at every level. It also undermines staff retention, which will be crucial for any NHS plan, such as the 10-year plan or any winter plan to come. We must retain these experienced professionals; we cannot rely on recruitment alone to solve the staffing crisis in our NHS.

These wonderful staff have been stretched to breaking point by years of neglect and mismanagement by the Conservatives. Labour must do better, yet patients and staff are understandably fearful as we approach winter. According to a recent poll commissioned by the Liberal Democrats, one in four people in Britain have avoided calling an ambulance because they were frightened that it would take too long to arrive.

Of course, many pensioners are particularly fearful this year. Winter is a perilous time for older people, given the additional diseases that they might catch, and many will be more at risk after being denied the winter fuel payment for the first time. This will be the first winter without the payment being universal, and the annual uprating of the state pension will not make up the shortfall until next spring, which will be too late for people to pay their electricity or gas bill—and if someone in my constituency has to top up their oil tank now, it is too late for that, too. There is a danger, as happened when fuel costs increased two years ago, that people will reduce or turn off their heating entirely, with possible consequences for their health and a knock-on effect on the NHS.

So what are the solutions? First, we need to stop throwing money at the fire and instead prepare properly. As we all know, the most cost-effective cure is prevention in the first place. Over the past seven years, the Conservative Government announced an average of £376 million of emergency funding each year to tackle the winter crisis, much of which arrived too late to make any meaningful difference.

The Liberal Democrats want to create a winter taskforce armed with a ringfenced fund of £1.5 billion for the next four years. That would be used to build resilience in hospitals, A&E departments, ambulance services and the discharge of patients, and allow integrated care boards and NHS trusts that are struggling to balance their books to plan their budget more effectively in advance to cope with the winter crisis. The taskforce would bring together senior leaders from the NHS and the Government, along with staff representatives, to ensure better co-ordination and preparation for winter. It would be empowered to deliver rapid changes in day-to-day operations to ensure a co-ordinated response—for example, by deploying more beds to certain hospitals or boosting social care capacity where it is most needed.

Tackling the issue of patient flow is the most fundamental aspect of steering our health system through this winter and the years ahead. If patients are to be treated on time, they need an ambulance to arrive on time, and that ambulance must be able to hand over its patient to A&E as soon as it gets there. If A&E is to have more capacity, we need to reduce the amount of people there in the first place through prevention and investment in primary care. We must make hospital beds available so that patients can be moved out of the A&E department and into the medical or surgical part of the hospital, as appropriate. If we are to move patients on when they are ready to go home, when they would be better served in their own home with the proper therapy, we must invest in social care and deal with its capacity issue, which is at the heart of so many of these problems.

Half a million people in England are waiting for care, stranded in hospital beds that are so important to free up over winter, and those in power have continually ignored social care for many years. I am extremely worried that the Government have not said an awful lot about social care in the Budget today. The additional money announced for local councils, £600 million of which is for social care, will presumably be gobbled up largely by the increase in national insurance contributions and the minimum wage. It is really concerning that those councils will not be able to meet their social care commitments in the future. We urgently need cross-party talks so that, between us, we can commit to a long-term solution to the crisis in social care.

Liberal Democrats believe that we should introduce free personal care along the lines of the model in Scotland. That would help people to stay in their own homes and out of hospital and ease the pressure on the NHS. We should pay for a fairer deal for unpaid carers and a higher carers’ minimum wage, which of course, we saw some movement towards in today’s Budget. We welcome that and look forward to the review of the cliff edge in the unpaid carers’ allowance. Critically, a higher carers’ minimum wage must be fully funded, because councils will be pushed over the edge if they are not given the money to support that, as will many small care providers, which provide the vast majority of paid social care in this country.

We need to ensure that people can see a GP when they need one, so that they do not end up adding to the overwhelming pressure on A&E departments. I recently spoke to someone in my constituency who waited seven weeks for a telephone consultation. We must ensure that we focus on the outcome for the patient, which is why we would give everyone the right to see a GP within seven days, or within 24 hours if the need was urgent, and we need to increase the GP workforce by at least 8,000 to deliver that. As I said, it is crucial that that is done through retention as well as recruitment and more training.

We also need to reform the NHS dental contract and guarantee access to an NHS dentist for anyone needing urgent or emergency dental care, ending the dental deserts that exist in my North Shropshire constituency and the rest of the country. The biggest reason for a child to go into hospital is to have a tooth extracted, because their teeth are in such a poor state. That is scandalous, and I look forward to hearing what the Government will do to address that issue.

We also need to support community pharmacists, who are critical to the preparedness of the NHS, by making sure that everyone has access to the healthcare advice and medicines that they need. Pharmacy First is an excellent idea and helps to relieve the pressure on the NHS, but community pharmacists are closing at an alarming rate, and we risk that good idea going to waste. Are enough people being vaccinated against the “tripledemic” of flu, covid and respiratory syncytial virus, including staff? Analysis by the Health Service Journal showed that 283,000 fewer staff received a flu jab last winter than at the end of 2019, despite the number of frontline staff growing. If staff are not protected, fewer patients will be protected when they get seriously ill, and staff will not be able to go to work to treat ill people. Increasing the awareness of what is on offer at pharmacies and reversing the cuts to the public health grant to increase the health and fitness of people up and down the country are both integral to relieving pressure on hospitals and preparing the NHS for winters to come.

Stories and statistics from up and down the country show that the NHS was already under extremely severe pressure this summer. That has been the case throughout this year and last year. It is autumn now, so it is critical that the Government outline their plans to deal with the added pressure of the winter to come. More fundamentally, we need bold, long-term action so that winter crises become a thing of the past. We need to train, recruit and retain staff, and make them proud and happy, instead of tired and stressed, with them then leaving the system. We need to fix our crumbling hospitals so that money can be spent on care instead of fighting fires and draining floods. We need to invest in all aspects of primary care, including dentists, doctors, pharmacists and optometrists, as I reminded Members in the Chamber last week. Most crucially, we must confront the crisis in social care.

Earlier this week, the Secretary of State said that the Budget will arrest the decline in the NHS, but I am afraid that that is not good enough. The annual winter crisis costs lives, jobs and patient dignity. It also costs the taxpayer more than we can afford. We must invest now; we cannot afford not to do it. We must invest to save so that we have an NHS fit for the future.

--- Later in debate ---

[Helen Morgan]

I thank you, Sir Roger, the Minister, the shadow Minister, all my Liberal Democrat colleagues and the hon. Member for Strangford (Jim Shannon) for coming to this debate on a very busy day. I am grateful for all their contributions, which were positive and constructive, as always. I thank the Minister in particular for her comprehensive response. It is reassuring to hear that she has considerable expertise in this area.

We welcome the investment that was announced in the Budget, including significant investment in day-to-day NHS spending, capital investment and investment to deal with the repairs backlog, which needs urgent attention. We called for the Government to address the backlog in our general election campaign, because we recognise its importance. However, the very nature of the Budget statement means that we have been a bit light on detail today, and that is why we want to provide constructive opposition and ideas to move this forward.

I reiterate my concerns about social care. Little was said about it today, but many social care providers are small businesses that will be heavily impacted not only by the increase in the minimum wage, which is welcome for carers, but by the increase in employer national insurance contributions. We risk a real crisis in those companies and in local government budgets, which are perilously stretched, if we do not have a plan to fund those carers and their wages. I leave the Minister with that thought, and thank everybody for attending.

Question put and agreed to.

Resolved,

That this House has considered NHS readiness for winter 2024-25.

Access to Primary Healthcare

Helen Morgan Excerpts

Wednesday 16th October 2024 Commons Chamber

[Helen Morgan (North Shropshire) (LD)]

I beg to move,

That this House regrets that the NHS has been plunged into crisis by years of neglect by the previous Government, leaving far too many people waiting weeks to see a GP or unable to find an NHS dentist, and children and adults waiting months or even years to receive the mental health care they need; believes that everyone should be able to access high-quality primary care services when they need them and where they need them; condemns the previous Government for presiding over a fall in the number of full-time equivalent fully qualified GPs and NHS dentists in the last Parliament; further regrets that the Government has not yet set out a plan to invest in primary care at the level needed to meet demand; calls on the Government to boost access to GPs, NHS dentists and community pharmacists; and further calls on the Government to give everyone the right to see a GP within seven days or within 24 hours if they urgently need to and to guarantee access to an NHS dentist for everyone needing urgent and emergency care.

It is a real honour to open this debate on the Liberal Democrats’ first Opposition day for 15 years. Primary care is the front door to the health service, but for too many people at the moment, that door is closed. Whether they are waking up and dealing with the 8 am calling frenzy to get a GP appointment, frantically ringing every dental practice in their area for an NHS dentist, or turning up at their local pharmacy to pick up a prescription for their loved one or themselves and finding it unexpectedly closed or the medicine out of stock, primary care is in terrible trouble and it needs fixing urgently. That is not only to make lives better for the people who are suffering because they cannot access the primary care they need, but to allow the NHS to function more efficiently. Accident and emergency is not a decent substitute door to the NHS.

I am an asthmatic and as a young person I had quite serious asthma. I can remember when primary care was absolutely there for me in the middle of the night. On lots of occasions when I needed help, my dad did not have to take me to the hospital in an ambulance. Somebody came to me with a nebuliser and got me sorted out within a couple of hours, and then we all went back to bed. Now, that is not an option for a lot of people. The NHS is in a crisis, and that is causing pain and suffering unnecessarily.

The crisis is also costing far more than we can afford. It is costly because early intervention and dealing with people in their community or at their home is so much more efficient than taking somebody to hospital, even if that is in a private car. And it is costly because it causes people genuine pain: the BBC reported that in Oswestry in my constituency this year, a man removed his molar with a pair of pliers because he could not find an NHS dentist. But it is also costly because people are unable to access work, and that is costing the economy. Polling commissioned by the Liberal Democrats showed that one in four people had been unable to go to work while waiting for a primary care appointment. That is not good for an economy that urgently needs to grow. We need urgent investment in primary care—in doctors, dentists and community pharmacists—to save people from having to go to hospital.

[Adrian Ramsay (Waveney Valley) (Green)]

On pharmacies, a new report from Healthwatch England reveals a worrying picture of pharmacy closures and reduced hours hitting older people and rural communities the hardest. NHS Norfolk and Waveney integrated care board, which covers much of my constituency, has reported the highest number of hours lost per pharmacy. Does the hon. Lady agree that we urgently need a national evaluation of pharmacy funding, including the size, role mix and distribution of the pharmacy workforce?

[Helen Morgan]

That is an important point. In my constituency, carers who go to pick up prescription medicines are finding that the pharmacists are not there because they are relying on locums. The pharmacy funding problem needs to be addressed as a matter of urgency, and I will say more about that later.

Growing the economy is so important that we need to get people off the waiting and referral lists and back into work. Liberal Democrats believe that people should be in control of their own lives, not “chained up” at home, unable to get out of bed, because they have no access to healthcare. They should be able to get the help that they need, when they need it, in their own homes and communities.

Let us start with GPs. The Liberal Democrat manifesto—it was well received, which is why there are so many Members sitting behind me on these Benches—called for the right to see a GP within seven days or 24 hours if the situation is urgent, and for those aged over 70 or with a chronic health condition to have access to a named GP. Those rights are extremely important. People who go to the same GP for more than 15 years have a 25% lower chance of dying than those who have seen a new GP in the last year. Primary care networks tell me that their inability to deliver continuity of care because of the shortage of GPs is one of the problems that worry them most.

[Tim Farron (Westmorland and Lonsdale) (LD)]

My hon. Friend is making a brilliant introductory speech. Is she aware that perhaps only a third of those leaving medical school and seeking to go into general practice are able to find jobs, partly because the additional roles reimbursement scheme—which does exist—cannot be extended to enable some of those would-be GPs to be recruited? Is it not mad that although we are creating enough potential GPs through medical school, we cannot give them jobs because of the funding mechanisms that this Government inherited from the last one? We are losing them from general practice, and, in some instances, losing them from the country altogether.

[Helen Morgan]

My hon. Friend is entirely right. I believe that the Government are taking steps to address that, but he has made an important point about the need for flexible GP funding. A general practice may have money to spend on professionals and need more fully qualified doctors to deal with its patient list, but can only spend that money on another pharmacist or another nurse. That is a ridiculous situation, and I am pleased that the Government are dealing with it.

[Shockat Adam (Leicester South) (Ind)]

Will the hon. Lady give way?

[Helen Morgan]

No, I will make some progress.

People do much better if they have access to continuity of care, but 8,000 more GPs are needed to deliver the rights that we laid out in our manifesto. We do not shy away from the fact that that is an ambitious objective, and we accept that it cannot be achieved through training and recruitment alone: we need to retain and incentivise our existing workforce. As I said earlier, seeing people in their communities avoids hospital admissions and saves money. Unfortunately, although the Conservatives promised us 6,000 more GPs in 2019, we ended up with 500 fewer. That is why people are so frustrated. According to the findings of research carried out by the House of Commons Library, GP funding has fallen by £350 million in real terms since 2019. As a result, not only are people struggling to gain access to basic care in their communities, but there is a postcode lottery when it comes to availability of that care.

In the area where I live, which is covered by NHS Shropshire, Telford and Wrekin, the number of fully qualified GPs fell from 280 in 2016 to 242 in 2023, despite an increased and increasingly ageing population with a much higher level of demand, while 43% of patients are waiting more than 28 days for non-urgent appointments. The Darzi report showed that the number of people waiting for long periods for appointments is rising throughout the country: it is a national issue. We know that from our own doorstep conversations.

Members might ask me, “Where are you going to get 8,000 more GPs from? That is a big number.” Apart from training new ones, we should value greatly our experienced ones. A recruitment and training programme is one idea, and, as my hon. Friend the Member for Westmorland and Lonsdale (Tim Farron) pointed out, using the dentists we have trained properly is extremely important, but we also need to focus on retention and incentivising our existing GPs, to ensure that we hold on to valuable experience and valuable patient continuity.

Let me move on from GPs to local pharmacies. Pharmacy First was a great idea of the previous Government —I am willing to give them credit—but pharmacists are under huge strain. According to the Darzi report, some 1,200 have closed since 2017, and spending under the community contract has fallen. Tomorrow I am going to visit Green End pharmacy in Whitchurch, in my constituency, which wrote to me:

“As an independent pharmacy, we’re unable to keep on absorbing costs with losses on dispensing.”

The pharmacy is struggling because it is making losses on the drugs that it gives out on prescription. Given that it is a small, independent pharmacy, it does not have a massive shop from which to make profits to subside that work.

In 2023, Community Pharmacy England warned of

“systemic pharmacy funding cuts of at least 25% in real terms since 2015.”

That has led to a postcode lottery of access, and to many pharmacies being unable to have a full-time pharmacist and relying on locums, which has led to a really poor and insecure level of service. That is impacting on people who just need to go and pick up their prescription and get on with their day.

[Wendy Chamberlain (North East Fife) (LD)]

The NHS is devolved in Scotland, but the UK Government have responsibility for continuity of supply of medications. I have constituents with attention deficit hyperactivity disorder who have been waiting for up to a year to secure that continuity of supply. Does my hon. Friend agree that we need to see more action from the Government, who should be proactive in that regard?

[Helen Morgan]

That is a really important point. A lot of people in my constituency have contacted me for help with drugs—for example, to deal with ADHD. People need to be able to access important medication readily.

We must not forget the dentistry element of primary care. A generation of children are at risk of poor oral health because of the mess in which dentistry has been left by the previous Government. Tooth decay is the biggest cause of children being admitted to hospital, with over 100,000 admitted since 2018. That is totally unacceptable. Some 4.4. million children have not been seen by an NHS dentist in the last year, according to the House of Commons Library.

Dentistry is really important for children—they have to keep their teeth for the rest of their lives—but this issue affects adults too. My constituent Ron Kelly, who is 62, is disabled and lives in Market Drayton. Members who have been around a while might know that it is not easy to catch a bus to anywhere from Market Drayton. He has not been able to find a dentist since 2019, and my caseworkers have rung every NHS dentist in our constituency. None of them is taking on new patients, so even if he was able to use the bus, he would not be able to find an NHS dentist in North Shropshire at the moment.

Office for National Statistics data released last week shows that, in the midlands, 99% of people who do not have an NHS dentist, and who are trying to find an appointment, cannot access one—99%! It is just unbelievable in a modern country in the 21st century.

[Lisa Smart (Hazel Grove) (LD)]

My hon. Friend mentions the challenges that many of our constituents face when trying to get access to NHS dentistry. I am thinking about some of my own constituents who have talked to me and, indeed, shown me their home dentistry results. [Hon. Members: “Urgh!”] Yes. Does my hon. Friend agree that we should learn from good practice that is taking place across the country? My Hazel Grove constituents were struggling to find dentists, but because of some reallocation of existing funding in Greater Manchester, new appointments have been made available. Does she agree that we should look at good practice to learn what can be delivered elsewhere across the country?

[Helen Morgan]

Flexibility of contracting is critical, and learning from best practice elsewhere in the country will help to address the problem.

I want to highlight how silly it is that people cannot find an NHS dentist when they need one, because NHS dental funding is actually going unspent. In Shropshire, Telford and Wrekin, the area I know about, £1 million was clawed back in 2022-23 because dentists were unable to spend the money allocated to them; they do not have enough staff to work the contracts with them. I met someone last year who had not had a day off work—we were in October by that point—and he had to hand back his contract. The Government have proposed golden handshakes, but I have heard on the ground that they do not work, certainly in Shropshire. We need a reformed contract, flexible commissioning, a proper statutory requirement for workforce planning, and the ability for dentists to use their funding to manage their own practices in a way that allows them to make a bit of money out of treating patients on the NHS.

I also want to highlight the public health grant cuts by the Conservatives and how important it is to reverse them is. It is a complete false economy to cut programmes that help with oral health and prevent poor teeth and future dental problems, when we could spend the money up front so that it would cost far less in the future.

[Iqbal Mohamed (Dewsbury and Batley) (Ind)]

Will the hon. Lady give way?

[Helen Morgan]

I will make some progress now, if that is okay, because I am conscious that lots of people want to get in and make full speeches.

We have called for a guarantee for urgent and emergency dental care. Check-ups for those people who are already eligible and those needing check-ups before things such as chemotherapy and surgery were also in our manifesto. It is only going to be possible to offer those guarantees if we deal with the issues in the dental contract and the flexibility of commissioning.

Primary care is the front door to the NHS, as I mentioned at the beginning, and Lord Darzi pointed out in his report that that is where we should be investing. At the moment, money is flowing to secondary care—to hospitals—yet most people’s experience of the NHS is with their doctor or dentist. We must ensure that that first point of call is a good point of call, and reduce the numbers of people going to A&E. That is so much more cost-effective, but it is also so much better for those people who could manage their health condition without a crisis and without ever having to go near a hospital.

We should also think of the knock-on impacts on those hospitals. We all have horror stories of ambulances queued up outside hospitals because so many people are in A&E and so few people can flow through the hospital. The issues around that are complex, and they link in to social care as well, but the reality is that if we can treat people in the community, we will save the lives of people who need emergency care. This is absolutely fundamental: we need investment in our GPs and in dental and pharmacy contracts because we cannot afford not to do it.

[Shockat Adam]

In addition to pharmacists and dentists, I would like to mention my profession. Optometrists can really play a role in reducing the strain on primary and secondary care.

[Helen Morgan]

I thank the hon. Gentleman for his intervention. That is an important point and I apologise for not making it in my speech. Optometry is really important, and as somebody who spends their whole life looking for their other glasses, I can absolutely appreciate his point.

[The Minister for Care (Stephen Kinnock)]

Should’ve gone to Specsavers! [Laughter.]

--- Later in debate ---

[Ed Davey (Kingston and Surbiton) (LD)]

Other opticians are available.

[Helen Morgan]

Other opticians are available, but I did!

The Liberal Democrat manifesto suggested solutions to these problems, and they have been well received, as I mentioned before. We have a record number of MPs, and that is because we put this issue front and centre of our election pledge. I urge the Government to reverse the catastrophic state that the NHS has been left in by the Conservatives, to take our ideas on board and to invest in primary care as soon as possible.

[Several hon. Members rose—]

Oral Answers to Questions

Helen Morgan Excerpts

Tuesday 15th October 2024 Commons Chamber

[Mr Speaker]

I call the Liberal Democrat spokesperson.

[Helen Morgan (North Shropshire) (LD)]

My constituent Mel Lycett has terminal cancer. After repeated visits to her GP, she was referred to a two-week urgent pathway in May. She was not diagnosed until the end of July, and she still has not started treatment. Every single target for her diagnosis and treatment was missed. That is not uncommon in Shropshire, and it is not uncommon in the rest of the country. Can the Secretary of State reassure me of what he is doing to deal with this terrible legacy left behind by the Conservative Government? How will he ensure that cancer patients are treated in a timely manner?

[Wes Streeting]

I welcome the hon. Lady to her role. I am afraid that this case is just one of countless stories of people whose lives might have been saved had the NHS been there for them when they needed it. It is bad enough when people receive a late diagnosis that equates to a death sentence; it is worse still when people in that position are not given the fighting chance of urgent, life-extending treatment.

The inheritance we have received is truly shameful. I assure the hon. Lady, as a cancer survivor myself—because the NHS was there for me when I needed it—that we will work tirelessly through a national cancer plan to make sure that we deliver the cancer waiting time standards that the last Labour Government met, and that are sorely needed today.

--- Later in debate ---

[Helen Morgan (North Shropshire) (LD)]

In England, 4.4 million children have not seen a dentist for at least a year. Meanwhile, in Shropshire, Telford and Wrekin integrated health board, £1 million of dental funding went unspent in 2022-23. The system is clearly broken. When can we expect the Secretary of State to fix it?

[Wes Streeting]

It is precisely because of the situation the hon. Member describes—the poor services and, ironically, the underspends in the dentistry budget—that we will work not only to stand up the 700,000 urgent and emergency dental appointments we promised, but to do the prevention work for children in our schools.

Maternity Services: Gloucestershire

Helen Morgan Excerpts

Wednesday 9th October 2024 Westminster Hall

[Helen Morgan (North Shropshire) (LD)]

It is a pleasure to serve with you in the Chair, Sir Christopher. I congratulate my hon. Friend the Member for Cheltenham (Max Wilkinson) on securing this important debate. Maternity services affect every single one of us at least once in our lives, so it is important that we protect them to ensure that, for all of us, that moment—obviously, many of us experience it more than once—is a safe one.

I will not mention all the hon. Members who have spoken, but I am pleased to see so many of my Liberal Democrat colleagues, who have all made excellent speeches and powerful points. I particularly thank my hon. Friend the Member for Thornbury and Yate (Claire Young) for sharing her experience, and the hon. Members for Gloucester (Alex McIntyre) and for Stroud (Dr Opher) and my hon. Friend the Member for Tewkesbury (Cameron Thomas) for sharing theirs. Obviously, the hon. Member for Stroud has his own medical expertise, which is very important. Finally, my hon. Friend the Member for Winchester (Dr Chambers) described his constituent’s shocking experience, which I think we were all upset to hear about.

This is not the first debate we have had on maternity services—not even the first in this Parliament—and the reason for that is the shocking under-investment in those services. On 19 September, during recess, the Care Quality Commission issued a report, and its contents are hugely disappointing if not surprising. As has been mentioned, it spoke of the risk of normalising avoidable harm, which is an unacceptable situation to be in.

Hon. Members might be aware that my interest in maternity care came about because I am from Shropshire—I represent North Shropshire—and my constituents Kayleigh and Colin Griffiths lost their daughter Pippa at Shrewsbury and Telford hospital NHS trust. They fought tooth and nail alongside Rhiannon Davies and her husband Richard Stanton to bring about the Ockenden review into the scandal that unfolded at the trust.

Since then we have had a report on East Kent, and there is a review going on in Nottingham. None of that is news to us, which is shocking. I sat on the all-party parliamentary group on birth trauma, which was brilliantly led by the former Member for Stafford, Theo Clarke, and on the baby loss APPG, and I am currently trying to reconstitute the maternity APPG. All those groups have found the same failings over and over again.

The CQC report tells us what we already know: 40% of maternity services are rated as requiring improvement and 18% are rated inadequate. That means that less than half are rated as acceptable, which is not excusable, particularly given that we have had so many high-profile scandals and so many commitments—I believe they were made in good faith—from the Dispatch Box that these things will not happen again, but they are happening every single day.

We know from all those reports that unsafe staffing is at the root of most of the problems and that it is pushing hard-working midwives, in particular, to the brink. They work their socks off to share in what should be the most joyful moment of each individual’s life. When I had my baby nearly 16 years ago in an emergency situation, the midwife, who had been with me all afternoon, stayed on at the end of her shift to make sure that I and my baby were okay. We received excellent care and were both fine in the end, thank goodness. However, we have all relied so much on the good will of those individuals that they are experiencing burnout at an alarming rate.

I was canvassing in my constituency during the general election when a midwife came running across the road in her dressing gown and slippers to tell me that she was emigrating because she had had enough and that two other midwives she knew in the county were taking the same step because they had experienced burnout on such a shocking level. Any workforce plan needs to deal urgently with that problem.

Staffing is one problem, but unsuitable buildings are another. In the shocking inquiry into the Lucy Letby case at the Countess of Chester hospital, which is slightly unrelated, I read that sewage was coming up into the hospital’s sinks. How can we control infection when there is literally raw sewage in the building? It is unacceptable. We need to ensure that this Budget invests not just in the GPs, healthcare workers and midwives we so urgently need, but in the fabric of our hospitals.

We have repeatedly heard that there is a failure to learn when things go wrong and that hospitals focus too much on protecting their reputation rather than on learning from terrible mistakes that might have happened—and that will inevitably happen on occasion, even with the best staff in the world, because sometimes things go wrong. Hospitals must learn from those mistakes.

Finally, there is a failure among hospitals to have an open culture, so staff who have concerns are unable to raise them. The duty of candour law, to which the Government have committed, is so important, and I urge the Minister to ensure that the people to whom workers in hospitals can speak up are independent of the hospital manager and the clinical director. If workers are reporting to the person responsible for giving them their jobs, that is not a safe process. We must have independent whistleblowing procedures for people raising clinical concerns. I am sure my constituents share my anger that we have to return to this topic again and again, when we should be looking at how far we have come since the Ockenden review over two years ago.

I want to touch on the point made by my hon. Friend the Member for Carshalton and Wallington (Bobby Dean) about outcomes. Black and Asian women and their babies have a far worse probability of surviving birth than white women. If that was happening in a single trust, we would have another big, important review, but because it is spread out across the country, it is being lost, so we must return to it. It is not acceptable in this country in the 21st century that ethnic or socioeconomic background is a determinant of whether having a baby is safe. We are not on track to meet our 2025 targets for reducing stillbirth and neonatal death, and those targets have not been renewed. I urge the Minister to renew them and to ensure that there is a plan in place to meet them.

Finally, my hon. Friend the Member for Winchester made the critical point that spending more on medical negligence than maternity services is totally unacceptable. This country cannot afford for that to continue. We must make maternity services safe, because it is better for the mothers, better for the babies and better for the taxpayer. I look forward to hearing the Minister’s response.

NHS Performance: Darzi Investigation

Helen Morgan Excerpts

Monday 7th October 2024 Commons Chamber

[Helen Morgan (North Shropshire) (LD)]

The findings in Lord Darzi’s report are shocking, but Liberal Democrats—there are many of us here today—find that they echo the hundreds of thousands of conversations we had with people on the doorstep across the country throughout the election campaign. In too many ways, the NHS just is not working as it should, and that is a tragedy, because we all cherish the NHS and want it to succeed. It is one of our country’s greatest inventions and a great Liberal idea. It is one of the things that makes us proud to be British.

We all owe so much to the NHS and the incredible hard-working staff who have kept it going under the most intense pressure imaginable. Despite their heroic efforts, there is no doubt that we have a major crisis in the NHS. Let us not forget, because it is so important—these things are intrinsically linked—that we also have a major crisis in care. The message that the British people sent at the general election in July was clear: fixing the health and care crisis must be this Government’s No. 1 priority.

Before I turn to the Government’s plans, it is worth reminding ourselves of the scale and urgency of the challenge. Far too many people wait weeks to see a GP or NHS dentist, if they can find one. Far too many wait months or even years to start vital treatment for serious conditions. Far too many wait for hours in pain and distress for an ambulance to arrive. I recently spoke to a constituent, Emma, whose 11-year-old daughter Charlotte suffers from a medical condition that means she is red-flagged, or a category 1 priority patient, in the case of a medical emergency. Unfortunately, Emma and Charlotte were recently involved in a car crash. Charlotte urgently needed an ambulance, but after two hours of waiting, her father decided to take her to hospital in the back of his car. She starts her journey to senior school this autumn. Her family have had to devise their own response network to keep her safe and secure, and to allow her to attend school in confidence. Our ambulance service failed Charlotte and her family when they were in crisis, and we cannot let that continue.

The problems do not stop there. Across the country, almost 6.5 million people are stuck on hospital waiting lists. That is one in every nine people in England. Two million of them have been waiting for more than six months. Over the past year, more than 100,000 people have waited more than two months to start cancer treatment after an urgent referral. In my constituency of North Shropshire, almost 20% of urgent referrals took more than 43 days and 10% took more than 62 days. The target is 28 days. It is truly heartbreaking. We know that every day counts when patients are battling cancer.

Young people needing help with their mental health are waiting months and even years to access child and adolescent mental health services. There is no help for them until they are in crisis. As if all that was not bad enough, we have hospitals that are literally crumbling. There is a maintenance backlog of £11.6 billion. Buildings are decades past their use-by date. It is shocking but, as my Liberal Democrat colleagues and I know, far from exceptional. Most of these problems go back decades. The truth is that Governments of all parties have failed to put enough capital investment into the NHS. They have failed to face up to the challenge of an ageing population and, crucially, they have failed to tackle the care crisis, with one honourable exception: the Care Act 2014 was passed by Liberal Democrat Ministers a decade ago, with cross-party support. Sadly, it was ripped up by the Conservative Government after 2015.

The failure and neglect of the Conservative Government left the NHS teetering on the brink. There were so many grand promises—6,000 more GPs, 40 new hospitals and cross-party talks on social care—but they were all fantasies. In Shropshire—which is not an outlier—the Royal College of General Practitioners found that the average GP is seeing 475 more patients than they were in 2016. Patients and their loved ones have been let down so badly.

When the scale of challenges across health and social care is so enormous, it would be easy to succumb to pessimism and defeatism—doom and gloom—but we cannot afford to do that. The patients of today and tomorrow cannot afford for us to do that. This moment demands the same urgency, ambition and vision that drove the creation of the NHS all those years ago. We very much hope that the Government will show that ambition. I welcome the Secretary of State’s recognition of the fundamental importance of shifting more focus to primary care—to GPs, dentists, mental health practitioners and community pharmacists—for our young people.

[Dr Danny Chambers (Winchester) (LD)]

As the newly appointed Liberal Democrat spokesperson on mental health, I was really concerned to see in the report that mental health is about 20% of the NHS’s burden yet receives only 10% of its funding. Certainly in Winchester—it will be the same for nearly all hon. Members in the Chamber—mental health, and especially the mental health of children, is one of the most commonly brought up subjects.

I know that the Secretary of State agrees that mental health and physical health need to be treated with the same level of importance, but I urge us to recognise that we cannot treat it with the same level of importance if the level of funding does not accord with the demand it is putting on the service. It is not just about funding; it is about making sure that the mental health support that is needed is there in schools, in social care and for people struggling with debt. So many non-medical factors contribute to mental health that we need a cross-departmental look at how we support people’s mental health.

[Helen Morgan]

My hon. Friend is exactly right, and we put mental health and access to primary care and health prevention front and centre of our manifesto for that very reason. I encourage the Secretary of State to take our plans where they are complementary to his and run with them. We are happy to have our ideas plagiarised—we will welcome it.

Welcome as that focus is, some of what we have heard gives me cause for concern. First, some weeks ago the Prime Minister suggested that investment can come only after reform. I warn the Secretary of State that I do not think that that will work. The reforms that our NHS needs cannot be done on the cheap. Improving access to primary care means investing in more GPs, more NHS dentists and more community pharmacists. Boosting productivity means investing in better IT systems and bringing hospitals up to date with the new facilities they need. I agree that it cannot be just more investment without reforms, but nor can it be just reform without more investment. We need that investment now. The reports that we have heard of potential cuts to spending in the Budget are deeply concerning. I urge the Secretary of State to guarantee today that they will not happen.

Finally, I am afraid that there still seems to be nowhere near enough focus or urgency when it comes to care. We simply cannot fix the crisis in the NHS without fixing the crisis in care. Right now, more than 12,000 people in hospital are ready and well enough to go home but stuck there because the care they need is not available. That is awful for them and their families, and it is awful for the NHS that 12,000 beds that should be getting used by patients who need them and allowing better patient flow through hospitals are being held up because the care system is in crisis. I urge the Secretary of State again not to put this off any longer but to set up a cross-party commission now so that we can agree a long-term solution to ensure that people get the care they need, when and where they need it, and that carers are properly supported, too.

[Mr Richard Holden (Basildon and Billericay) (Con)]

I support what the hon. Lady is saying about a having cross-party group look at social care, which is a sensible long-term thing that we need to do, and discharges from hospital are an important part of that. Does she agree that discharges from mental health units are also an important part of that? On a recent visit to Basildon hospital, I saw that discharges were not happening in mental health units. That is perhaps as much of an issue in mental health social care as it is in older people’s social care, which the House is more attuned to.

--- Later in debate ---

[Helen Morgan]

I thank the right hon. Gentleman for his intervention. There is a general problem with care in the community of all types not being there for people. We have people in places where they will not get better as quickly—in some cases, their situation may be deteriorating—because that care is not available. Mental health provision in my constituency is absolutely appalling. People register with a doctor over the border just to access better mental health care. I could not agree with him more.

In conclusion, the Darzi report is shocking, but it is not surprising based on the experience of my constituents. Poor access to primary care—whether that is GPs, dentists or early mental health intervention—is leaving people in pain and distress. Long waiting lists and crumbling hospitals are leaving people unable to get back to work, with their situation deteriorating, and the crisis in social care—the elephant in the room—is depriving people of their independence and leaving them in hospital when they could be at home. The new Government must make fixing the NHS and care their No. 1 priority. Liberal Democrats will be here to provide constructive opposition to ensure that they do.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I call Ben Goldsborough to make his maiden speech.

Preventable Baby Loss

Helen Morgan Excerpts

Wednesday 4th September 2024 Westminster Hall

[Helen Morgan (North Shropshire) (LD)]

The hon. Gentleman is making a powerful speech. It is good to hear the story of Agnes, and I hope that he will agree with me that sympathising with our constituents who have suffered such awful circumstances and telling their stories in Parliament is a good way to ensure that they are heard in the future.

[Jim Shannon]

I thank the hon. Lady for that. The story of Agnes’s son is this: her stillborn son was born sleeping in the early ’70s and was buried. Agnes came to see me over 50 years later.

--- Later in debate ---

[Helen Morgan (North Shropshire) (LD)]

It is a pleasure to serve with you in the Chair, Mr Dowd. I start by thanking the hon. Member for Ashfield (Lee Anderson) for securing this important debate. Sadly, we have revisited this issue a number of times, even in the short period since I was elected in 2021.

Members’ speeches today have been excellent, and I will touch on them briefly. I thank the hon. Member for Ashfield for telling the stories of his constituents who have come along today, and I thank them for sharing their stories, which were very moving. It is tragic that they have been through such experiences.

The hon. Member for Clacton (Nigel Farage) addressed the fact that the subject is taboo and that we need to get over that if we are to support families properly. The hon. Member for Morecambe and Lunesdale (Lizzi Collinge), who I welcome to this place, stressed the importance of providing support for bereaved families and of the groups in her constituency that do that. The hon. Member for Strangford (Jim Shannon) told us the moving story of his constituent Agnes, who felt her loss for the rest of her life.

The hon. Member for Washington and Gateshead South (Mrs Hodgson) has been a pioneering campaigner on this issue. In particular, she has campaigned successfully on the issue of the birth and death certificate for a lost baby, and I am sure everybody is grateful to her for that. The importance of making memories for bereaved families is so important. The hon. Member for Rossendale and Darwen (Andy MacNae) pointed out the important statistics we need to consider and the importance of effective bereavement support. The hon. Member for Sheffield Hallam (Olivia Blake), who has also been an effective and tireless campaigner on the issue of miscarriage, made an excellent speech.

I became co-chair of the APPG on baby loss shortly after I was elected, because of the scandal at Shrewsbury and Telford hospital NHS trust and the Ockenden report, which was issued shortly afterwards. There have been similar incidents at Morecambe Bay and East Kent, and we suspect there is a similar issue emerging at Nottingham, with the review by Donna Ockenden currently under way. The fact that scandals have emerged across the country means that there are endemic failings that we need to address, rather than blaming individual trusts.

The reports on Morecambe Bay and East Kent were by Dr Bill Kirkup, while the Ockenden report was for Shrewsbury and Telford. They raised very similar issues, albeit in quite a different style. The first issue was the importance of safe staffing in ensuring that babies do not die unnecessarily on maternity wards. Sands and Tommy’s have also led a campaign on that, which the APPG supported. The former Government responded quite well in trying to improve midwife numbers and ensure that maternity units are safe places to be. Shrewsbury and Telford hospital NHS trust has achieved its targets on safe staffing. We need to keep the focus on that area, because safe staffing obviously needs to be maintained; it is not a one-off thing that we can do and then hope for the best for the future.

Other issues that came up include learning from mistakes, listening to mothers and their families, and doing a proper review when something goes wrong, as it inevitably occasionally will, to make sure that lessons are learned. It feels like that has not happened across the NHS as a whole. In every review, we have heard about a lack of openness and transparency with the families and about blame being passed on to mothers who have lost their babies. We have heard about a toxic environment in some hospital trusts and about a willingness to cover up what has gone wrong rather than be candid and learn from mistakes. Those issues have been highlighted time and again, and it is important that the three reports—we are expecting a fourth—do not just gather dust on a shelf somewhere. Action must be taken to ensure that those mistakes do not keep happening.

The hon. Member for Morecambe and Lunesdale raised the fact that there is an obsession with natural birth, and I feel that very strongly. After having an emergency C-section, I was asked by a midwife whether I felt like a failure for having been through that emergency medical procedure. The answer was, “No, not until you suggested that maybe I ought to,” but hon. Members can probably imagine the shame, guilt and depression that followed. We must get away from this obsession with natural childbirth. It is the best option for mothers with low-risk pregnancies, but it is not great for anybody who has a medical issue. We must not let ideology lead the evidence and science.

I am conscious of time, so I will not take too long. Shrewsbury and Telford hospital NHS trust has made great inroads in implementing the immediate and central actions that Donna Ockenden recommended, but I would welcome an update from the Minister on progress on the national actions. If the disparity for ethnic minority women—whether they are black, Asian or from another ethnic minority—was happening in an individual trust, we would be up in arms and would get in a professional to investigate what was going wrong. We must not lose sight of that disparity and inequality. We must deal with the terrible outcomes for some of these women, as well as with the wider situation in the NHS.

Independent whistleblowing is particularly important. In Shrewsbury and Telford hospital NHS trust, the freedom to speak up guardians report into hospital management, and people frequently report that they do not feel safe whistleblowing. I urge the Government to look at safe whistleblowing and to create an independent office of the whistleblower to ensure that when people raise medical concerns about safety, they are listened to, are not closed down and do not fear losing their jobs.

These scandals do not apply to a single hospital trust; there is huge variety in the quality of care across the country. I urge the Government to look at maternity care across the country and to ensure that getting safe care is not a postcode lottery but is consistent and fair for all women.

World ME Day

Helen Morgan Excerpts

Wednesday 1st May 2024 Westminster Hall

[Sir Sajid Javid]

I assure my hon. Friend that that is definitely what I want to see in the plan; perhaps more important now, however, is to hear that commitment from the Minister. It is touched on in the interim plan, but we all want to see that issue, among the others, addressed in that final cross-Government plan.

The interim delivery plan set out some of the current challenges that we must address to improve outcomes and experiences for individuals with ME. We must ensure that the final delivery plan focuses at least on two key areas: outcomes and experiences. However, making progress in these areas also requires us to address more fundamental problems. For example, there is a huge cultural problem, when it comes to ME, with a lack of medical understanding and awareness. There is a critical lack of data and research, and there is still no existing cure or even treatments. It is estimated—this number is often cited; I use it myself—that about 250,000 people are living with ME in the UK, but even that figure is 10 years old, highlighting the lack of data and research in this field. Without a clear dataset and understanding, tackling the issue of course becomes an even bigger uphill battle.

That is why there are research projects such as DecodeME. They are vital because they help to increase understanding and they serve as a critical platform for future work.

[Helen Morgan (North Shropshire) (LD)]

Does the right hon. Gentleman agree with me that another issue faced by constituents is that the National Institute for Health and Care Excellence guidelines that were introduced are not being used by every single trust in the country? I think that only 28% of NHS trusts are using the NICE guidelines. Does he agree that consistency of treatment and approach would be an important step in ensuring that people can get the care that they need?

[Sir Sajid Javid]

Yes, I agree with the hon. Member. Indeed, those guidelines were changed while I was Secretary of State for Health and Social Care. I remember welcoming them, but the expectation of course was that they would be properly followed. As the hon. Member says, in some 70% of cases that does not seem to be the case. We all want that to be addressed. I hope that the Minister will be able to pick up that point when he responds.

Another example of research is a groundbreaking project on long covid and ME diagnostics called LOCOME. It is co-led by Action for ME, the University of Edinburgh and a computational biology company called PrecisionLife. It is hoped that that new project, which is utilising the data that has been gathered from the DecodeME project, will provide insights that will be able to create the first predictive diagnostic tools for ME and long covid. I take this opportunity to thank the charity Action for ME for its world-leading work on the project, its crucial support and the research and campaigning that it does to improve ME research and outcomes.

It is vital that we continue to support organisations such as Action for ME and researchers in this way. The focus of World ME Day in 2024, this year, will be to build a “Global Voice For ME”. In that spirit, it is important that we collaborate with allies across the globe to further research in this area. However, we know that, even with more research, it will be a long journey to achieve our desired outcomes. That is why improving the experiences of those living with ME, and their families, is also vital.

I know from my own engagement that individuals with lived experience often feel dismissed. I recall a recent Channel 4 report that even highlighted the case of a family who saw social services investigate the care of their daughter because they believed that she was being kept in bed against her will. If it were not for campaigning organisations such as Action for ME, the ME Association, the all-party parliamentary group on myalgic encephalomyelitis, Forward ME and the World ME Alliance as well as the work of incredible individuals such as Sean O’Neill, who I believe joins us today and who has led an inspiring campaign in memory of his daughter, Maeve, the situation would feel almost hopeless. That is how it would feel if we did not have these people battling for more work to be done on ME. It is because of them that the case of this community is being heard, and having served in Government for so long myself, I know that when people speak up with the support of many honourable colleagues from right across the House, the Government must listen.

This year, 2024, marks 55 years since the World Health Organisation officially acknowledged ME. For too long, we have failed to recognise the severity of the condition for thousands of people across the UK. As we mark World ME Day on 12 May, we must renew our commitment to improving outcomes and experiences for everyone affected. It is great to see so many hon. Members from across the House in the Chamber, and I am grateful to everyone who has attended today’s debate in the Public Gallery, as well as those who may be joining online. Where such support exists, there is always hope.

The ambition is to improve the lives of people with the condition today, and to ensure that future generations have a brighter future. Helping make that ambition a reality is now the responsibility of the Minister, and I look forward to his response and the contribution of other hon. Members.

Oral Answers to Questions

Helen Morgan Excerpts

Tuesday 5th March 2024 Commons Chamber

[Helen Whately]

I know that the hon. Gentleman is a great campaigner on this issue; he has worked very hard on it with me in the past, and he now does so with my right hon. Friend the Minister for Health and Secondary Care. I assure him that we are in the process of revising the draft strategy, taking on board feedback from patients, their families, charities and the NHS, and we will publish the strategy in due course. I thank all stakeholders for their continued efforts.

[Helen Morgan (North Shropshire) (LD)]

In January, the average category 2 response time for west midlands ambulance service was over 43 minutes. We know that the problems are worse in Shropshire, following stories such as that of a lady who waited 18 hours before seeing a doctor, having contracted an infection following radiation therapy for her cancer treatment. The situation in Shropshire does not seem to be improving as fast as we would like. What steps is the Minister taking to resolve the problem?

[Helen Whately]

Across the country, ambulance response times have come down by a third. We have worked very hard, particularly with areas that face greater challenges, including Shropshire. I have spoken to leaders in the local health system about the ongoing challenges. We are learning lessons about what has worked over the past year, and from where we have not made so much progress, to ensure that we do better in areas such as the hon. Lady’s over the year ahead.

Pharmacy First

Helen Morgan Excerpts

Wednesday 31st January 2024 Commons Chamber

[Dame Andrea Leadsom]

I would be very happy to meet my right hon. Friend.

[Helen Morgan (North Shropshire) (LD)]

The community pharmacy in Wem in my constituency has struggled to find a full-time pharmacist, relying instead on locums. That means that opening times are erratic, people cannot rely on the service, and the pharmacy is loss-making because locums are so expensive. How will the Minister help pharmacies in rural areas to recruit the full-time pharmacists and reduce their reliance on locums?

[Dame Andrea Leadsom]

The hon. Lady will be aware that, although a few are owned by GP practices, community pharmacies are usually private businesses. We are training the registered community pharmacists that we need. Obviously, it would be for that local area to put in place its own recruitment policies, but I would be happy to meet her to discuss that further.

NHS Dentistry

Helen Morgan Excerpts

Tuesday 9th January 2024 Commons Chamber

[The Secretary of State for Health and Social Care (Victoria Atkins)]

I beg to move an amendment, to leave out from “House” to the end of the Question and add:

“recognises the impact of a once-in-a-generation pandemic on NHS dental services, with 7 million fewer patients seen in England across 2020 and 2021; notes these challenges were reflected in both Scotland and Wales; acknowledges the steps already taken to recover services in England including the introduction of a minimum rate and increased payments for complex dental activity to better reward dentists for their work; welcomes the publication of the Long Term Workforce Plan which committed to expanding dental training places by 40 per cent; and supports the upcoming publication of the Government’s plan to further recover and reform NHS dentistry and promote good oral health throughout life.”

It is a pleasure to update the House on the work the Government are doing to strengthen NHS dentistry across the country. We are reforming our NHS and social care system to make it faster, simpler and fairer. Dentistry is a vital part of our NHS and improving dentistry is one of my top priorities. The hon. Member for Ilford North (Wes Streeting) represents a deeply urban seat, so I am pleased that he has presented me with an excuse to boast about the fact that I represent, and am very proud to represent, a rural and coastal constituency. That is why fairness is one of my three priorities for our NHS. I know the challenges that rural and coastal communities face when it comes to accessing an NHS dentist appointment, and the disparities in health that we see between rural and coastal communities and city centres. I will come to some statistics in a moment.

I am determined to fix these issues, and the other problems facing NHS dentistry, so that anyone who needs to can always see an NHS dentist, no matter where they live. Indeed, one of my very first acts as Secretary of State was to respond to the Health and Social Care Committee’s recommendations on dentistry. We agreed to the majority of those recommendations, and we stand firmly behind the ambition that NHS dentistry should be accessible and available to all who need it.

[Helen Morgan (North Shropshire) (LD)]

rose—

[Richard Foord (Tiverton and Honiton) (LD)]

rose—

--- Later in debate ---

[Victoria Atkins]

In fairness, I will give way to the hon. Member for North Shropshire (Helen Morgan) first, because she rose earlier.

[Helen Morgan]

Like the Secretary of State, I represent a rural community, and the reason dentists are handing back their NHS contracts where I live is that they cannot recruit another dentist to come and help them. They have not had a day off, they cannot meet their commitments under their contracts, and they cannot recruit. They have offered golden hellos of 25%, but they have not been able to get anyone to come and work with them. What will the Secretary of State do to recruit the dentists whom we need to see the people in dental deserts such as North Shropshire?

[Victoria Atkins]

As I have explained, in relation to dentistry but also in relation to wider healthcare, the long-term workforce plan, which was requested by NHS England and by clinicians, is the means of laying those foundations for the future of the NHS. I will now give way to the hon. Member for Wallasey (Dame Angela Eagle).