Rural Communities: Government Support

Debate between James Naish and Sarah Dyke

Wednesday 12th March 2025 Westminster Hall

[Sarah Dyke (Glastonbury and Somerton) (LD)]

It is a pleasure to serve with you in the Chair, Dr Murrison. I also thank my hon. Friend the hon. Member for South Devon (Caroline Voaden) for securing this important debate and for her excellent speech.

Rural communities and farming go hand in hand, as farmers are the backbone of our rural economy. Glastonbury and Somerton is home to more than 800 farms, and a quarter of England’s agricultural holdings and a fifth of England’s total farmed area are in the south-west. Agriculture employs over 60,000 people in the region, with many more indirectly affected by the industry. However, since the Budget, the only topic on farmers’ minds is the lack of support from the Government. They tell me that they did not think their plight could get any worse after the last Conservative Government—because that Government “just didn’t care”—but it has.

This Labour Government do not even seem to want to understand the agricultural industry. Yesterday’s announcement, with no notice, to halt the sustainable farming incentive has sent shockwaves through farming circles. It beggars belief that the largest farming trade body, the National Farmers Union, had only 30 minutes’ notice of the announcement. The absence of warning and communication will only further alarm farmers across the country who are feeling anxious, left behind and forgotten.

The sudden closure of an important scheme has left thousands of farmers cut off from funding, and I worry about the impact this will have on nature-friendly farming. The scheme is vital to incentivising farmers to carry out their work for the public good, such as managing flood water and storing slurry safely—this is of extreme importance in Somerset, given the high threat of flooding.

A beef farmer from Wick, near Langport, recently told me that he has “no confidence” in the Environment Agency to protect his and other people’s land from flooding—it is too slow to pump water off fields, which increases the risk of flooding when it next rains.

The closure of the SFI will now make it more difficult for farmers to put flood management measures in place. The scheme had more than 37,000 live, multi-year agreements, and it had the highest demand since it began. The Government have not announced any plans to replace it. This announcement comes at a time when farmers are already losing the vast majority of basic payments this year, and they should rightly be rewarded for good environmental work.

[James Naish]

Will the hon. Member give way?

[Sarah Dyke]

I will not, because of time. Given that the SFI has now finished, will the Department publish the scheme’s key performance indicators and how they were met? Or will it keep farmers in the dark again?

The Liberal Democrats are deeply disappointed by Labour’s decision to compound the damage done to our farmers by the Conservatives, who left the farming budget with an underspend of hundreds of millions of pounds. Yet again, smaller farmers will be hardest hit, especially hill farmers and those earning significantly less than the minimum wage. We want to see the Chancellor urgently reverse the changes, and we want to see £1 billion a year in support for farmers. We want clarity from the Government about the impact of cutting SFI on farmers’ incomes, nature restoration, food production and rural communities.

Ambulance Response Times

Debate between James Naish and Sarah Dyke

Thursday 6th March 2025 Westminster Hall

[Sarah Dyke (Glastonbury and Somerton) (LD)]

I beg to move,

That this House has considered ambulance service response times.

It is a pleasure to serve with you in the Chair, Ms Jardine. I thank the Backbench Business Committee for scheduling this important debate.

Unacceptable ambulance response times have become endemic in the UK, leaving people in pain and distress and costing lives. An estimated 50,000 people died last year after long A&E waits, according to Office for National Statistics data. One of those was Jim�s wife in Street. She was suffering from aggressive liver and bowel cancer and had to wait seven hours in agony for an ambulance in February last year. When the ambulance arrived, Jim and his wife were told that the crew were not trained to take her downstairs, so they were left to wait for another crew. When they arrived, several hours later, Jim�s wife was too ill to be moved and was told that the journey would kill her. She died shortly after.

Jim told me again today how that experience still makes him angry, yet he recognises the perilous state that the NHS is in, caused largely by the last Conservative Government. Like Jim, many people have lost faith in health services after the NHS was stretched and left grossly underfunded as a result of the last Conservative Government�s neglect.

We know that this is having a devastating impact on patients, but it is also impacting the incredibly hard-working medical staff. The 2023 NHS staff survey showed that 39% of ambulance staff respondents often or always felt burnt out. The number is higher for control room staff, at 44%, and higher still for ambulance technicians and paramedics, at 45%. I am sure that Members across the House will join me in thanking and paying tribute to everyone working in the ambulance service whose hard work, dedication and commitment to patient safety is second to none.

Most people in Somerset will sadly know of someone who has faced a heartbreakingly long wait for an ambulance. The family of an 89-year-old Somerton resident told me how they faced a 10-hour wait, stuck in agony on the floor, as no ambulances could come to help them. Another resident told me about their ordeal of having to prop their mother up on the toilet after she had had a fall. They then had to spend 13 long hours waiting for an ambulance to arrive. I am sure other Members will have similar heartbreaking examples.

It is important to understand the context of these examples, so I will briefly outline the NHS targets: seven minutes for category 1 calls, for which 90% of ambulances should arrive within 15 minutes; 18 minutes for category 2 calls, for which 90% of ambulances should arrive within 40 minutes; while 90% of ambulances for category 3 and 4 calls should arrive within two and three hours respectively.

Those targets remain unmet in the south-west, where we have the worst-performing ambulance service in the country. In January 2025, South Western Ambulance Service failed to meet the targets for category 1 and 2 calls. The average time it took to respond to a category 2 call was 51 minutes and 45 seconds�nearly three times slower than the NHS target. This has serious repercussions for people�s health. In every minute that a stroke is left untreated, nearly 2 million brain cells die, and lifesaving treatments such as clot-busting drugs need to be delivered quickly, often within four and a half hours.

I have heard from many constituents across Glastonbury and Somerton who are deeply concerned by the delays in stroke treatment due to ambulance waiting times. These fears are compounded by the planned closure of Yeovil district hospital�s hyper-acute services. The reconfiguration of services will mean that all patients who have suffered a serious life-threatening stroke will be taken to hyper-acute stroke units in Dorchester or Taunton to receive care.

As much as these new cutting-edge services and facilities are welcome in the south-west, the fact remains that if stroke patients or any patient needing emergency treatment gets to hospital too late, the results will be catastrophic without improvements to the ambulance service, and all the best equipment, drugs and treatment by clinicians will have minimal impact on patient outcomes. I have spoken about the impact of these changes on stroke care in this place before. I do not feel it necessary to go into detail again today, suffice to say that ambulance delays only increase the pressure on stroke services. The Liberal Democrats have demanded that localised data on ambulance delays is published, so rural areas like Somerset that are underperforming can receive focused and appropriate support. I would welcome the Minister�s comments on that.

Lengthy delays are made all the worse when we consider the impact of drawn-out handover times, meaning ambulance crews are unable to head back out on to the road to pick up more patients. The Darzi review laid bare just how dire the situation has become. In 2024, around 800 working days each day were lost due to handover delays. Incredibly, that is the full-time equivalent of nearly 14,000 paramedics over a year. In addition, ambulances across England collectively spent 112 years waiting outside hospitals to hand over patients in 2023-24.

[James Naish (Rushcliffe) (Lab)]

I was in my local hospital, Queen�s medical centre in Nottingham, where they are currently trialling 45-minute handovers, to make sure that paramedics get back on the road as quickly as possible, while also making sure that patients are safely handed over into the target speciality care they need. Does the hon. Member welcome that sort of trial, given the challenges she describes?

[Sarah Dyke]

I thank the hon. Gentleman for his intervention. I will come to that point a little later.

With the stark realities facing people in an emergency and the distressing sight of ambulances backed up at hospitals now commonplace, leaving my constituents in Glastonbury and Somerton in despair, it is time to properly address these failures. The NHS standard contract states that handovers between ambulance and emergency departments should be 100% within 60 minutes, 95% within 30 minutes and 65% within 15 minutes, but these targets are left unmet. Between October 2023 and June 2024, 3.7 million handovers took an average of 35 minutes and one second, resulting in over 900,000 hours lost. It is even worse in the south-west. In January 2025, over half the handovers took over 30 minutes, which is nearly 30% higher than the England average.

We in the south-west face specific issues due to our rurality. Analysis by the Liberal Democrats revealed that waits for life-threatening calls were 45% longer in rural areas than in urban areas. The South Western Ambulance Service has responsibility for the provision of ambulance services across 10,000 square miles, covering an incredible 20% of mainland England. Rural regions have a lower capacity to divert ambulances to other hospitals during periods of significant pressure, largely due to the vast distances between emergency departments.

We may now see ambulance teams in Somerset adopt a �drop and go� policy, which involves leaving patients in certain areas in a hospital without an official handover to A&E staff. The nationally defined target for hospitals included in the NHS standard contract states that after 15 minutes of waiting, the patient in the ambulance becomes the responsibility of the hospital. If no formal handover to A&E happens within 45 minutes, the ambulance crews can just leave the patient within the department and get back on the road.

The South West Ambulance Service is moving towards this approach with hospitals from Swindon and Bristol to Cornwall and Plymouth. Although this policy might alleviate some of the pressure on ambulance crews, it would fail to ease the struggles that underfunded and overstretched A&E departments in Somerset are facing. Somerset has an ageing population: within the next decade, one in three people in Glastonbury and Somerton will be 65 or older. That may make it harder to quickly discharge patients, as some may also require onward social care provision. It is inevitable, therefore, that delayed discharge due to internal processes such as waiting for pharmacy diagnostics and therapy assessments, and a lack of capacity in adult social care, will lead to poorer ambulance service performance. The social care crisis has a devastating effect on the healthcare system.

Last year, Care England said that

�over 45% of hospital discharge delays are linked to social care�.

One in seven hospital beds are taken up by people who are medically fit to be discharged. For patients, delayed discharge can lead to an increased risk of hospital infections and the loss of mobility or cognitive function, and can make it harder for them to regain their independence. The problems in the healthcare system will never be fixed unless we urgently address the social care crisis. Only last week, social care providers felt the need to protest against Government inaction for the first time ever.

The Liberal Democrats have been campaigning to fix social care by introducing free personal care based on the model introduced in Scotland, so that provision is based on need, not ability to pay. We also welcome the cross-party commission to forge a long-term agreement on social care, but we believe it can be completed within a year, not three. We cannot afford to kick this can any further down the road, and I urge the Government to listen to the Liberal Democrats� calls.

We also need to solve the hospital bed shortage in the UK. The lack of available beds negatively impacts hospital flow. As a comparison, the OECD EU nations have about five beds per 1,000 people, whereas the UK has only 2.4. The Royal College of Physicians revealed that four out of five doctors were forced to provide corridor care in the past month due to a lack of hospital beds. According to the Royal College of Emergency Medicine, bed occupancy is at a staggering 93%. The Liberal Democrats want to bring that down to a safe 85% by increasing the number of staffed hospital beds.

We are waiting for the Government to publish the urgent and emergency care improvement plan soon, along with the 10-year health plan. It is vital that we urgently wrestle with the problems that the Conservatives left behind to ensure the safety of patients. Over the past seven years, the previous Conservative Government were forced to find an average of �376 million of emergency funding each year to tackle the NHS winter crises. Under the Liberal Democrat proposals, a new winter taskforce would instead manage a ringfenced fund of �1.5 billion over the next four years to build resilience in hospital wards, accident and emergency departments, ambulance services and patient discharging. That would allow integrated care boards and NHS trusts to plan their budgets more effectively to prevent winter crises, instead of just receiving emergency funding from the Government at the last minute.

We urgently need to give our healthcare services the ability to forward plan. They must not be forced to deal with crises on the fly as situations unfold. Somerset�s ambulance services, like all services across the country, desperately need and deserve support. Localised data must be published to help pinpoint specific improvements that can be made in rural areas. The Government have outlined their desire to improve urgent and emergency care�they accept that ambulance waiting times are unacceptable�but now is the time to act to achieve those objectives; otherwise, more people will suffer and sadly some lives will be lost. That must be part of a serious rethink about the way we fund social care; otherwise, we will never move towards a solution that works.