Healthcare Provision: East of England

Debate between Jerome Mayhew and Clive Lewis

Tuesday 3rd September 2024 Westminster Hall

[Clive Lewis]

I thank the hon. Gentleman for his intervention but will leave the response to the Minister, because it is a question that she would be better able to answer. Frankly, given that the last Government had 14 years to sort out that mess and have handed it over, pretty much complete, to the new Labour Administration, I will not be singing their praises when it comes to dentistry. That will not be going on the record.

I will conclude by looking at the social and economic roots of the healthcare crisis, which are the elephant in the room. As I have outlined, many of the causes of ill health are socially determined. Waiting lists, ill health and mental health issues are signs that our healthcare system is breaking down, but also that we have an economy with a degrading social fabric—one need only look at the race riots this summer to understand that. But do not take my word for it; listen to civil society organisations in my constituency that are at the coalface of this crisis. The Norfolk Care Association says:

“Around 10% of health outcomes result directly from healthcare delivery, with a more significant proportion derived from the physical, social, and economic factors that people experience day to day. The government must do more to tackle poverty, ensure quality housing, and create safe communities, as these are fundamental to improving health outcomes.”

Age UK Norwich says that the key healthcare issue older people face is

“chronic health conditions and limited spend/focus on prevention: around 55% of Norfolk’s older population have one or more long-term health conditions; however, most are treated independently”.

That organisation points to the need for

“Rebalancing healthcare focus and investment to underlying causal factors”—

the “wider determinants” that make up 80% of a person’s overall health status.

Let us have a quick look at some more drivers of ill health. Take, for example, fuel poverty: 10% of people in the east of England live in fuel poverty, and it is almost 12% in Norwich South. Fuel costs in the UK are on average 30% higher than the EU average.

[Jerome Mayhew (Broadland and Fakenham) (Con)]

The hon. Member makes an important point about fuel poverty and its direct link with illness, so will he support his Government’s removal of the winter fuel allowance?

[Clive Lewis]

I thank the hon. Gentleman for his interesting question. I am not happy with the removal of the winter fuel payment—of course I am not—and I do not think anyone on this side of the House will be happy with it, but I also understand that there are two points in the year when you support your Government: the King’s Speech and the Budget. I am not looking to break that, but like many of my colleagues I have severe concerns about the impact this proposal will have on people’s health and wellbeing and on their pockets. I have every confidence that my Government will put in place the best possible response to the £22-billion hole left by Conservative Members. I just do not think that the removal of the winter fuel allowance is necessarily the right way forward, but we shall see what happens in the days and weeks ahead. My question to the Minister is this: does she believe—this almost pre-empts the question asked by the hon. Member for Broadland and Fakenham (Jerome Mayhew)—that the cut to winter fuel payments will improve the situation in terms of fuel poverty and its impact on health?

Another example is financial insecurity. Age UK Norwich told us that 35% of Norwich wards fall within the top 10% of the most deprived areas in England. There has been a 35% rise in food bank use in the city, fuel poverty is at nearly 16%, and 68% of Age UK Norwich inquiries are about money, debt or bills.

Another example is poor housing and malnutrition. We have quite extreme malnutrition in Norwich. Norfolk has the highest malnutrition rate in England; malnutrition affects one in five people in Norfolk and Waveney. Jade Hunter, the headteacher of West Earlham infant and nursery school, told The Guardian:

“We do get a lot of bad chests because they’re in damp homes that are maybe mouldy, and we get a lot of sickness and diarrhoea because the quality of the food they’re eating isn’t great”.

She told me that one way teachers know children are hungry is that they chew their pens and chew sand. That shows that they are not being given what they need to thrive at school.

Before I conclude to allow others to contribute, I would like to ask the Minister some more questions. We know there will be a Government review of NHS England structures. There is an incomprehensible patchwork of bodies covering different geographical areas, including the Norfolk and Suffolk NHS foundation trust, the East of England ambulance service, the NHS Norfolk and Waveney integrated care board—the list goes on. Are there plans to simplify those structures and make those bodies more accountable? I understand that NHS reorganisations and reforms are not always popular, particularly with staff, but I wanted to ask that question.

Secondly, before the general election, all Norfolk MPs called for an undergraduate dental school to be established at the University of East Anglia. With my hon. Friend the Member for Norwich North (Alice Macdonald) and many others across the region, I have been working on that proposal, so will the Minister tell us whether there has been any news or developments? Such a school will be critical to beginning to end the dental desert in Norfolk and Waveney—dentist provision in Suffolk is in almost as bad a state.

Finally, I campaigned for mental health before I was an MP, I and continue to do so to this day, despite the difficulties. Despite the past 15 years of so-called change and reform in our local mental health service, it is still arguably the worst in the country. Will there be a statutory public inquiry into the systemic failure of mental health services in Norfolk and Suffolk? This scandal—this slow-motion disaster—has gone on too long, disrupted and ruined too many lives, led to people dying unnecessarily, and caused much grief. People need answers, and if we are to learn lessons from what has happened in the past 15 years, we need an independent public inquiry to get to the bottom of these issues.

Levelling Up: East of England

Debate between Jerome Mayhew and Clive Lewis

Tuesday 18th January 2022 Westminster Hall

[Clive Lewis (Norwich South) (Lab)]

It is a pleasure to serve under your chairmanship, Ms McVey. I thank my hon. Friend—I mean the hon. Member for Waveney (Peter Aldous). [Laughter.] I have often thought that the hon. Member is on the wrong side of the House; as a centrist, he would be far better over here on the Labour Benches, where I could berate him for his lack of ideological purity. None the less, he has brought this fantastic and important debate forward. Sorry—I will get him into trouble.

I want to make a few key points and observations, some of which I can pick up from the right hon. Member for West Suffolk (Matt Hancock). One of my appeals is that, when we talk about the regeneration of the east and investing in the east, we must not base that simply on 20th century infrastructure. We must recognise that we have an opportunity in the eastern region, which has been underfunded and under-resourced.

One of the reasons we are net contributors to the Treasury is probably that it spends so little on us in real terms. One of my appeals to the Minister is that we should take that weakness and use it as an opportunity so that we can jump over the failures of the 20th century—the pollution, the carbon, the ecological destruction—and move to a 21st century, sustainable, wellbeing-based economy with mass-transit systems. There may be a need at times to invest in roads, because road infrastructure is required, but let us ensure that we are not simply doing so because that is what we have always done. There is an opportunity to think about rail and public transport, and I think that is critical for the future.

I also want to talk about how devolution is done. I will quickly read an extract from an IPPR report on levelling up, which stated:

“Crucially, the competitive nature of existing devolution deals pitches areas against one another – making them race for increasingly small and centrally controlled pots of money. This has exposed disparities in terms of institutional capacity across local authorities: not all places have a history of cooperation, or indeed the resources, especially after over a decade of austerity, to enter good bids.”

Another area we need to look at is how levelling up is done. The key rule should be subsidiarity, meaning that powers to make decisions on key local political, economic and social issues should be closest to the people affected. Some Members have discussed this already. In my city of Norwich, which is obviously the cultural capital of the east, as most people will acknowledge, we have some cases where infrastructure is being done to us. The Wensum link is deeply unpopular across much of my city because of the ecological damage it will do to vast swathes of our ecosystem.

[Jerome Mayhew (Broadland) (Con)]

It may be unpopular in the hon. Member’s part of the city, but does he recognise that it is very popular in the county of Norfolk?

[Clive Lewis]

Yes, I do. The opposition to the Wensum link is more a cry for a decent public transport system instead of building yet more roads. The evidence shows that the more roads we build, the more cars and congestion we have. This has been happening for 50 years and I see no reason why that should change. We have an opportunity to make a real difference.

My city has the second worst social mobility in the country, and our city council has been the worst hit by central Government. The key thing when we are talking about devolution and levelling up is—I take this analogy from my time in the military—mission command. Basically, that means centralised intent with decentralised execution; the Government set the “what” and the local people do the “how”. If we can apply those principles and give people a real say in how they get to those objectives, we can make devolution work. In Norwich, we know what our priorities are. They often interlink with the Government’s priorities, but let us get there in our way. Give us the resources to do that. If we are given the opportunity, we will add to this country’s economic and wellbeing output, as will the rest of our region. I hope that the Minister listens to that.

[Jerome Mayhew (Broadland) (Con)]

I am grateful to my hon. Friend the Member for Waveney (Peter Aldous) for calling this debate. We have limited time, so, inevitably, all the high-falutin’ arguments that I was going to express have been ditched in favour of the shopping list. I apologise in advance for that.

So what are we talking about? I think levelling up is about investment. If I were to put my finger on it, I would say that it is about increasing productivity for the future so that we get the growth in the east of England that then pays for all the good stuff that everyone in the Chamber wants for our residents.

If we want to increase productivity in the east, the key element will be connectivity in all its forms. Levelling up is not really about north versus south, as it is often portrayed; really, it is about urban versus rural. In rural areas, we are under-served by the connectivity, both physical and digital, that is increasingly important in the developing economy.

That starts with mobile phone coverage. According to a relatively recent survey, 82% of calls by mobile phone in Norfolk are connected. That means that 18% failed. That is incredibly annoying and makes it much harder to undertake business as well as everyday life. I very much welcome the shared rural network project, but the 95% coverage that was promised by, I think, about 2030 is only for coverage outside buildings. That is fine if people are in the garden, but in rural areas where we have quite substantial buildings, typically of stone or brick construction, connectivity inside buildings is much worse. I invite the Government to look at that.

Superfast broadband is a huge opportunity, particularly for rural growth. Some 80% of rural businesses tell us that the single biggest thing that the Government can provide to improve their economic prospects is superfast broadband, so let us focus on that. As I said, the first priority is mobile phone coverage, and the second is superfast broadband. I welcome Project Gigabit and I celebrate the recent milestone of 50% coverage in the UK, but we need to go further, particularly in the east.

Not all connectivity is digital; we also need physical access to markets. I disagree with the hon. Member for Norwich South (Clive Lewis) about the western link road. We have created, essentially, an orbital route around Norwich, but rather like the situation with the M25 and the Thames, we have decided not to build the bridge. It is very damaging to connectivity, particularly for the north-east of the county getting access to the physical markets in the rest of the country—

[Clive Lewis]

The hon. Gentleman talks about a bridge over the Thames, but this is a massive road bulldozed through an ecologically sensitive area. There were options to go over the most ecologically sensitive parts, but they were a bit more expensive and were rejected. I think that point needs to be made.

[Jerome Mayhew]

I am grateful for the hon. Gentleman’s intervention. It is also a bridge over the River Wensum, as he knows. A consultation was undertaken and, taking that into account, the best route was reached. It deals with a huge amount of rat-running and links north Norfolk to the rest of the country.

In relation to the A47, I welcome the imminent work for the Tuddenham to Easton dualling, but what about the Acle Straight? What about linking Great Yarmouth to the rest of the country? That is overdue and much needed.

On rail, regularity of services is an issue. Norwich to London takes about two hours; London to Birmingham, which is a shorter distance, takes about 80 minutes. That has a huge impact on the economic potential of our part of the country. It is the same for the Ely junction and the Haughley narrows.

We need access to markets, and that means access to staff. We lose 50% of our graduates from Norfolk. We need to change that, and one thing that we have to look at is the quality of life in our community. That includes health and dental services. We have a real paucity of dental services in the county. It would assist the situation if we had a teaching facility at UEA. I have run out of time, so I will have to conclude at this point.