Hospice and Palliative Care
Jess Brown-Fuller Excerpts(1 week, 1 day ago)
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Jess Brown-Fuller (Chichester) (LD)
I thank my hon. Friend the Member for Wimbledon (Mr Kohler) for securing today’s important debate, and all hon. Members for approaching the conversation with the compassion and thoughtfulness that this topic deserves.
Examples shared across the House show that hospices are a vital part of our healthcare system. They provide outstanding care for patients approaching the end of their lives, offering dignity, comfort and support to families, and they are often driven by hundreds of volunteers, alongside the paid staff. Hospices will play a key role in meeting this Government’s objective to move care from hospitals to the community. This debate is very timely, given that the front pages of the newspapers are reporting today that half a million people were left languishing on trolleys in A&E and in corridors in 2024 because there were not enough beds to admit them.
Hospices, such as the extraordinary St Wilfrid’s in my constituency of Chichester, are the cornerstone of community care. I was blown away during my recent visit to St Wilfrid’s, and I am not ashamed to admit that I was brought to tears by the accounts of the family members, patients and staff I met that day. I applaud the hon. Member for Stoke-on-Trent South (Dr Gardner) for her show of emotion, because it is an emotive topic. St Wilfrid’s provides comfort and compassion to patients and their families during life’s most challenging moments—both directly in the calm and idyllic surroundings of the hospice and out in the community, providing palliative care for 300 people in the comfort of their own homes. It is St Wilfrid’s belief that everybody should be afforded a good death, and it strives to ensure that there is beauty in every day for patients and their loved ones, yet its service is being crippled by rising costs and a lack of sufficient Government support.
Hospices are in the process of setting their upcoming budgets, and many are having to make difficult long-term decisions to cut palliative care because they lack a long-term solution to address the growing financial strain. As the hon. Member for North Herefordshire (Ellie Chowns) mentioned, it is all well and good being able to say you have a lovely car park when you do not have any nurses to park in it. Only 17% of the overall cost of St Wilfrid’s hospice is currently covered by NHS grant funding—well below the minimum requirement across the country.
One of the biggest components of hospice costs is the salary of their expert clinical and other staff. Hospices are trying to match NHS salary increases to ensure that staff can afford to stay with them, and to remain competitive. In addition, they are now burdened with paying increased national insurance contributions, whereas direct NHS providers are exempt. For St Wilfrid’s, the rise in national insurance contributions will cost an additional £210,000, which is a significant financial burden. Although we Liberal Democrats and hospices alike welcomed the capital investment announcement in December 2024, that funding does not address the challenges of day-to-day spend, so there is still a vast gulf between rising expenses and available income. As the hon. Member for Birmingham Erdington (Paulette Hamilton) said, the funding must be the start, not the end.
Hospice UK has warned that around 300 hospice in-patient beds—14% of the total—are currently closed or out of use due to a lack of funding and chronic staff shortages, meaning that fewer patients are able to access the end of life care that they need at one of the most vulnerable times in their lives.
My hon. Friend the Member for Twickenham (Munira Wilson) mentioned the Marie Curie report, as did other Members across the House, which stated that one in four people who need hospice care cannot currently get it. The term “bed blocking” is not one I am particularly comfortable with, but if adequate palliative care is unavailable in the community or in a hospice, those people will remain stuck in hospital, and those hospitals cannot provide the expert care that a hospice can. Our hospices are ready and willing to take on those patients, but they need the support of this Government to do so.
As my hon. Friend the Member for Wimbledon (Mr Kohler), who brought forward this debate, said, people do not want to die in hospital. They want to die at home or in a specialised setting such as a hospice. That is why the Liberal Democrats are calling for hospices to be exempted from the rise in national insurance contributions. This targeted measure would provide immediate relief for a sector that is struggling under the weight of rising costs, and prevent further reductions in capacity or even closures.
We must think long term. Hospices need a sustainable funding model that guarantees they can continue their vital work of providing care for patients, supporting families and easing the pressure on the NHS. Hospices must also be a part of the conversation in the Government’s upcoming 10-year plan for the NHS, and that must include sustainable hospice funding reform. Examples from across the House today showed a shared recognition of the importance of hospice care. Now we need the Government to match that recognition with action for the patients, for the families and for a health service that depends on hospices.
Oral Answers to Questions
Jess Brown-Fuller Excerpts(2 weeks ago)
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Andrew Gwynne
Attempting to exploit people with addictions is reprehensible. Free drug and alcohol treatment is available in every part of the country and I urge anyone who is struggling right now to visit the NHS addiction website. The Care Quality Commission has said that it could take legal action against companies misusing its logo, and Google has said it would remove search listings from these companies. I am more than happy to meet my hon. Friend to see what more we can do to stop this outrageous activity.
Jess Brown-Fuller (Chichester) (LD)
Social prescribing is one of the primary care services provided for drug and alcohol addiction, and it also supports the Government’s aim of moving from cure to prevention, which is why I was shocked to hear that a primary care network in my constituency is reviewing its social prescribing offering across the Chichester district and proposing to remove it entirely. Does the Minister agree that social prescribing is a key pillar of our primary care services, and does the money used need to be ringfenced to protect that service across the country?
Andrew Gwynne
Social prescribing is one of the tools, and it is an important one in addressing public health concerns in each of our constituencies. This Government are committed to ensuring that we get those shifts from sickness to prevention. We will be ensuring that local areas have public health funding in reasonable time. We are about to announce, in due course, this year’s allocations. We need to make sure that local systems maximise the use of their money, and that certainly includes social prescribing.
NHS Backlog
Jess Brown-Fuller Excerpts(2 weeks, 1 day ago)
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Jess Brown-Fuller (Chichester) (LD)
I thank my hon. Friend the Member for North Shropshire (Helen Morgan) for introducing this important debate on our first day back after Christmas. I also thank all hon. Members from across the House who have contributed to the debate, and specifically the hon. Members for Runnymede and Weybridge (Dr Spencer), for Ashford (Sojan Joseph) and for Bury St Edmunds and Stowmarket (Peter Prinsley), who always bring really valuable contributions because of their background and current professions; it is very much appreciated when talking about the NHS.
My hon. Friend the Member for North Shropshire highlighted in her opening remarks that backlogs are not just about NHS waiting lists, but that there are also problems with mental health backlogs, handover delays, A&E waits, poor access to dentistry, GP appointments, cancer treatment waiting times and staff that are being driven from the NHS because they cannot provide the care they want to give.
Our healthcare system remains the No. 1 issue that I am contacted about. It is not unreasonable for my constituents and people across the country to expect to receive the care they need when and where they need it. I doubt there are many people who have not been affected or know somebody who has been affected by NHS backlogs. Indeed my dad struggled for months to get a face-to-face GP appointment for what he believed was a return of a hiatus hernia. By the time he saw his GP and was referred, the oesophageal cancer that he had was so progressed that palliative care was the only option for him and he passed away shortly after being diagnosed in 2021.
When I asked my constituents to get in touch with examples of personal experiences of the NHS backlogs, I was inundated with emails from people across Chichester, and I will share some of those with the House.
I have Jane, who was at high risk of bowel cancer due to living with ulcerative colitis. She is meant to see her consultant every six months but has not had an appointment since 2019, despite her GP trying on her behalf on multiple occasions. She has no idea if the polyps discovered in 2017 have turned cancerous and is living in constant fear of her health deteriorating further.
Ian got in touch after waiting over a year to receive a scan after he experienced extreme chest pain. The scan revealed heart disease, but the lack of any follow-up appointments has left him anxious and uncertain about his health.
I will also mention a good friend of mine, Rylee, who noticed irregular bruising and a physical change on the back of their leg in 2021 and was finding it harder to walk. After visiting the GP, who sent an urgent referral to the hospital, Rylee waited for months only to discover when chasing the hospital that the referral had gone to the wrong place. They then got added to the waiting list and were told the wait would be between 40 and 50 weeks. We are four years on from the initial changes to Rylee’s leg, and they are finally being treated by leading specialists as Rylee can no longer walk unaided. Amputation of their leg is now being considered. If Rylee had been seen within the expected window of an urgent referral, they would not be facing the prospect of losing their leg in their mid-20s.
These are just a few examples of what is a much larger picture of the NHS, with caring and compassionate staff working within it who are overstretched and overburdened and, as my hon. Friend the Member for North Shropshire said, who cannot provide the care they desperately want to because of a system that cannot meet the demand.
The Liberal Democrats recognise that this is an inherited problem; indeed, the key NHS waiting times standards have not been met for some years. The number of patients waiting longer than four hours in A&E rose consistently between 2015 and 2020. The 62-day waiting time for standard cancer treatment has not been met in recent years, and the consultant-led treatment target in England of 18 weeks has not been met in 2016.
The last Conservative Government left emergency care in a deep crisis. The Darzi review stated that 800 working days were lost every day to handover delays in 2024. Last winter, ambulances across England collectively spent a total of 112 years waiting outside hospitals to hand patients over. In 2024, more than 1 million patients faced waits of more than 12 hours in A&E. The Liberal Democrats welcome new investment in the NHS, but instead of spending money firefighting crisis after crisis, we would invest to save taxpayers’ money in the long run. We would do that by investing in the front door and the back door: in primary care, with GPs and dentists, and by reforming social care.
Some of my constituents would like it noted that they will not be counted on any statistics regarding backlogs, because they cannot get a GP appointment to even get on the backlog list. That is why the Liberal Democrats are calling for everyone to have the right to see their GP within seven days, or 24 hours if it is urgent, with a 24/7 booking system to end the 8 am phone-call lottery to get an appointment. We would also ensure that everybody over the age of 70 and those with a long-term condition have access to a named GP.
We would fix the back door and address the social care crisis now, rather than spending another three years commissioning a report that will find out what we already know: social care is in urgent need of reform. The Darzi review showed that inadequate social care accounts for 13% of hospital bed occupancy, meaning that people who desperately want to get home cannot because of the lack of social care packages available and that others deteriorate at home, because they cannot access the social care they need. In the past year, more than half of all requests for social care were unsuccessful. We would strengthen our emergency services to reduce excessive handover delays by increasing the number of staffed hospital beds and calling for a qualified clinician in every A&E waiting room to ensure that any deteriorating conditions are picked up on to prevent tragic avoidable incidents.
I once again thank the hon. Friend the Member for North Shropshire for bringing forward this incredibly important debate, and I thank those Members who contributed to a conversation that matters to my constituents in Chichester and to people across the country.
Winter Preparedness
Jess Brown-Fuller Excerpts(1 month ago)
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Karin Smyth
I am very pleased to reiterate that safety is the watchword for winter, as it is all year round, and to stress that that is why NHS England wrote about it today. I commend my hon. Friend for meeting her constituents locally, and I urge all Members to do the same. We are getting some fantastic ideas from staff and from patients about how to reform and change the system for the long term.
Jess Brown-Fuller (Chichester) (LD)
One in four people trying to contact their GPs last month were unable to get a same-day appointment, and one in 20 could not get through to their GPs at all. We know that these people end up in A&Es up and down the country, and that hospitals are already buckling under the strain. What is the Minister doing to improve support for GPs and frontline services during this winter crisis, especially while they navigate the challenges of the employer NICs rises?
Karin Smyth
I refer back to what I said in my statement about how we are supporting the system. We absolutely understand the importance of primary care, and of using 111 to make sure that people are directed towards getting the right care in the right place. We know that the system is under pressure, and we will continue to do all we can to support it in the longer term, as well as in the short term.
Lobular Breast Cancer
Jess Brown-Fuller Excerpts(1 month, 1 week ago)
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The Minister for Secondary Care (Karin Smyth)
It is a real pleasure to serve under your chairship, Ms Vaz. I add my thanks to all hon. Members for their contributions and to my hon. Friend the Member for Dulwich and West Norwood (Helen Hayes). First let me say how sorry I am to hear about her friend. Those are very precious friendships and I think my hon. Friend articulated that well today. My deepest sympathies to Heather’s loved ones who are with us today and to her wider family group. It is a really difficult time and this is a very recent bereavement to be talking about. My hon. Friend has used her voice as a parliamentarian to good effect, as she always does, and I congratulate her on doing that. I hope I can go some way to answering the questions she raised at the end of her speech. If I do not and she is not satisfied, I will make sure officials get back to her on the specifics.
I also echo the words of the hon. Member for Hinckley and Bosworth (Dr Evans) about hon. Members raising their personal experiences and the importance of support from partners and wider family members for people who are going through diagnosis, treatment and sadly, often, death.
We know that too many cancer patients are being failed. They are waiting too long for life-saving treatments and receiving a diagnosis too late. As my right hon. and learned Friend the Prime Minister reiterated last week, we have inherited a broken NHS but it is not beyond repair. We know it needs to be fixed and there is not a single solution. To ensure that more people survive cancer, including lobular breast cancer, we have to take a multi-pronged approach—catching it earlier so more treatments are available, raising awareness of its specific symptoms, and investing in equipment and research, as many hon. Members have raised today. All those actions are part of our plan to put the NHS on the road to recovery.
As we have heard today, according to Cancer Research UK lobular breast cancer is the second most common type of breast cancer. Also known as lobular carcinoma, it impacts the lives of many—around 15 in every 100 breast cancers are invasive lobular. Treatments for lobular breast cancer are broadly similar to those for other breast cancers. Surgery and radiotherapy are effective for most patients with primary invasive types, meaning those which have not spread to other parts of the body. Systemic therapy such as chemotherapy, hormonal treatment, targeted therapy or immunotherapy are usually offered based on the stage at which the NHS catches that cancer.
Another factor which can determine clinicians’ decisions on the best treatment option is how the cancer has spread or developed in each patient’s case and we understand that is different for different patients. Sadly my understanding is that when cancer is growing in more than one location, as is more common in lobular breast cancer, treatment is more challenging. The same is true when a cancer has spread to other parts of the body. To improve outcomes in such challenging cases, NHS England funded an audit into both primary and metastatic breast cancer that has spread. The scoping for this audit began in October 2022 and the results were published in September this year. NHS England are hopeful that the results will help to improve the consistency of treatments offered, as well as stimulate improvements.
We know that for far too many women, lobular breast cancer is diagnosed at a later stage, which means that treatment options are more limited. The key to improving survival must lie in raising awareness, and early detection and diagnosis. I am not sure I can do it as well as the shadow Minister, but I want to use this opportunity to raise awareness of the fact that not all breast cancers form a firm lump. I think he articulated really well what women should be looking for. Lobular breast cancer patients are more likely to have thickened areas of breast tissue. Possible symptoms include an area of swelling, a change in the nipple or a change in the skin, such as dimpling. I encourage everyone to check their breasts regularly and to consult their GP straightaway if they have any concerns. While more people are surviving breast cancer than ever before, we know that lobular breast cancers can be particularly hard to detect.
Another measure to support earlier diagnosis of breast cancer is screening before people notice symptoms. Our screening programme sends women their first invitation at the age of 50. To support detection, the NHS carries out approximately 2.1 million breast cancer screens each year in hospitals and mobile screening vans, usually in convenient community locations, but—this is a really shocking figure that I learned recently in another debate in Westminster Hall, which shows how important it is that Members raise these issues—take-up of breast cancer screening is currently below 70%. That is worryingly low, and we are determined to improve it. Every effort that hon. Members here and people listening to this debate can make to improve that take-up rate will help save lives. If someone is eligible for screening, they should come forward and take up that important offer.
Unfortunately, even for those women who come forward for a mammogram, we know that lobular breast cancer can be more difficult to catch than other types of breast cancer. We have heard some shocking stories and examples today. To ensure that women survive, we need to be relentless in researching every possible avenue of treatment and diagnosis. Examples of innovation supported by my Department include £1.3 million invested in a Bristol-based FAST MRI project, which will determine whether different types of scans can help detect cancer in a cost-effective manner. The FAST MRI project focuses on an abbreviated MRI, which is a shortened version of a breast MRI. This type of imaging can help to detect the most aggressive forms of breast cancer sometimes missed by screening through mammography, including lobular breast cancer.
My Department is also working closely with UK Research and Innovation and the Medical Research Council. These bodies are responsible for studies that look to understand the basic mechanisms of disease. Combined, they spend £125 million on cancer research each year. My officials also meet regularly with partners to discuss a wide range of our research investments and ways to stimulate new proposals. These include those for lobular breast cancers.
Through the National Institute for Health and Care Research, my Department will continue to encourage and welcome applications for new research in this area. I hope this addresses the shadow Minister’s point, but funds for research are still available through the NIHR. Funds are awarded through open competition informed by expert peer review, with active involvement of patients and the public. The Department and NIHR also advise the campaign on the Lobular Moon Shot Project. It has already contracted £29 million, which I think is the figure the shadow Minister referred to, to the Institute of Cancer Research and its partner at the Royal Marsden. This proposal included work on lobular breast cancer. I hope I have addressed that point, but if I have not, then please let me know.
We know that we must do more to rise to the growing challenge that cancers including lobular breast cancer represent, but for our efforts in detecting and understanding this complicated disease to be effective, we need to back fundamental reform in the health service. That is why we have launched the biggest national conversation about the future of the NHS since its birth to shape the 10-year plan. We need suggestions from hon. Members on how to go further in preventing cancer where we can. I urge everyone to visit the website change.nhs.uk to do so.
Jess Brown-Fuller (Chichester) (LD)
The risk of all breast cancers in women is reduced by 4.3% for every 12 months of breastfeeding, but the UK has one of the lowest breastfeeding rates in the western world: only 1% of children are still exclusively breastfed at six months. Does the Minister agree that community initiatives to encourage women to breastfeed for longer support the Government’s mission to reduce the risk of breast cancers and improve health outcomes overall?
Karin Smyth
I thank the hon. Lady for that really important point. She highlights another important issue affecting the health of women and children, and I agree with her.
My hon. Friend the Member for Dulwich and West Norwood spoke about women’s health overall, which is an important priority for this Government, as are these forms of cancer and the wider preventive agenda. That is another point that can be made on the change.nhs.uk website, which I will keep plugging. The issues that have been raised on it by the public and staff are really interesting and informative.
My right hon. Friend the Secretary of State has been clear that there should be a national cancer plan. The hon. Member for Wokingham (Clive Jones) made helpful points about that opportunity. I will not take up his invitation for a meeting; his point would be better made by being inputted into the process with the organisations he is in touch with. That would help to shape the national cancer plan, which we can all buy into as a country. The plan will include more details about how to improve outcomes for all tumour types, including lobular breast cancer, and ensure that patients have access to the latest treatments and technology. We are now in discussions about what form that plan should take and what its relationship with the 10-year health plan and the Government’s wider health missions should be. We will provide updates on that in due course.
I thank my hon. Friend the Member for Dulwich and West Norwood for bringing this important matter to the House.
Infant Formula Regulations
Jess Brown-Fuller Excerpts(2 months, 1 week ago)
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Chris Webb (Blackpool South) (Lab)
I am grateful to have secured my first Adjournment debate on an issue that affects so many families in my constituency and across the country: the cost of infant formula and the regulations that govern its sale.
The infant formula market is rightly highly regulated, and should remain so. Regulations have a key role in supporting public health goals and breastfeeding. However, not all parents can or want to breastfeed, and recent stats show that 95% of babies in the UK have had some formula by the age of nine months. As the father of a nine-month-old baby, I know how emotionally charged and difficult it is to navigate infant feeding. The infancy period is crucial for a child’s development. In their first year, they will triple their birth weight, and the foundations of their health are determined for the rest of their life. It is vital that parents have access to safe and affordable food during infancy. The fact that, for too many families, that is not the reality is a public health crisis.
Recent data from YouGov shows that one in four mothers are struggling to afford formula milk. Over the past two years, the price of the cheapest brand of formula has risen by 45%, with an average price hike across all brands of 25%. Those increases are putting immense pressure on families.
Jess Brown-Fuller (Chichester) (LD)
I thank the hon. Member for bringing forward this important debate and allowing me to intervene briefly. A recent Competition and Markets Authority report highlighted the insufficient marketing regulations in the formula industry, which enable brands to exploit vulnerable parents by presenting their products as distinct or superior, despite all formulas being required to meet the same nutritional standards, whether the box costs £7 or £14. Does he agree that an NHS-branded formula in plain packaging could be considered? It could be sold at cost price. That would give those families who choose not to, or who cannot, breastfeed confidence that their decision is best for their child, regardless of the cost.
Chris Webb
I completely agree, and I will come to that later in my speech. I look forward to working with the hon. Lady and other members of the all-party parliamentary group on infant feeding when it is established in the coming weeks.
In my constituency alone, where child poverty has increased by 30% in the past year, 12,500 children are going without enough food each day. Formula is an essential product for many, but the average tub now costs a staggering £14.50, so many parents are resorting to extreme and unsafe measures to feed their babies. A black market has sprung up for infant milk, and it is one of the most commonly shoplifted items. Rather than working to reduce its cost, some supermarkets have resorted to locking formula in cages or attaching security tags to it. Certain stores have even gone as far as to prevent customers from entering unless admitted by staff—that is happening in convenience stores across my constituency.
We are seeing something that should be unthinkable in modern Britain: formula foraging. I regularly read heartbreaking posts on local forums from parents begging for baby milk to tide them over until the next payday—they are in utter despair—but by seeking out cheap or free milk online, they risk feeding their babies a product that could be out of date or already opened and potentially laden with bacteria. Studies have shown that the inability to afford formula can lead to unsafe feeding practices such as skipping feeds, ignoring expiry dates, and over-diluting powdered formula or bulking it out using unapproved alternative foods such as porridge, all of which can harm an infant’s health.
New NHS England figures show a worrying rise in childhood malnutrition. Up to 47% of hospitalised children are at risk of undernourishment. Last year, admissions for malnutrition at Blackpool teaching hospitals had almost doubled on the previous year. Gastroenteritis has become an alarmingly common illness in infants, with many now suffering more than one episode a year. In Blackpool, hospital admissions for under-ones with gastrointestinal problems are almost triple the national average. Dehydration—a common complication of gastroenteritis—is a particularly serious risk, and it is exacerbated by parents’ inability to access or properly prepare formula. Parents should not be forced into those dangerous choices when they are simply trying to feed their babies. This scandal demands the urgent attention of the House.
Income Tax (Charge)
Jess Brown-Fuller Excerpts(2 months, 2 weeks ago)
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Jess Brown-Fuller (Chichester) (LD)
I start by recognising that this Government face an enormous challenge in clearing up the mess of a decade of Conservative mismanagement in this country, and that failure is nowhere more apparent than in our NHS and care sector. Every day, thousands of patients across the country face agonisingly long waits, often in severe pain, just to see a GP or get an appointment with a dentist.
Yesterday, I met a constituent whose 45-year-old husband—a well-loved, energetic and creative man—never regained consciousness after being left in the A&E waiting room of my local hospital for six hours after suffering a brain haemorrhage. James Palmer-Bullock leaves behind three wonderful children, a loving wife and a devastated community. His wife’s request to me was to ensure that no family ever suffers the same neglect again. I hope the Secretary of State will meet me to discuss the experience that my constituent faced and what can be done to prevent it in future.
New funding for day-to-day spend in the NHS is welcomed across this House, and it is desperately needed if we are ever to address the crisis in the NHS. However, there is no point in pouring money into a leaky bucket if that money does not get where it needs to go.
Bradley Thomas (Bromsgrove) (Con)
It is not just public services that we need to focus on: the third sector provides vital services that many of our constituents rely on, particularly children’s hospices. I would like to highlight to the House the Acorns children’s hospice in my constituency, which provides vital support to many local families in a really acute moment of need. In 2019, NHS England decided to increase the children’s hospice grant—
Madam Deputy Speaker (Caroline Nokes)
Order. That intervention was far too long.
Jess Brown-Fuller
I thank the hon. Member for his intervention. He will be pleased to know that I am going to mention hospices later in my speech.
To fix the NHS, we must fix both the front and the back door. Taking the pressure off secondary care can only be achieved by properly funding primary care. That is why the decision to increase employer’s national insurance contributions is a significant mistake, as it risks worsening the crisis in the NHS and care sector. Increasing that rate will drive up GP surgery costs, significantly raising the annual expense of GP practices. Those practices are not eligible for the employment allowance that protects our small employers, so surgeries in Chichester and across the country will bear the full weight of that rise—a burden that they and my constituents simply cannot afford. Surgeries such as Southbourne surgery, Langley House surgery and Selsey medical practice have already reached out to me with concerns about their ability to continue providing services amid those financial challenges. They all agree that this increase will directly undermine patient access and care.
Charities have long suffered the burden of failing statutory services. Chichester boasts some of the most amazing charitable organisations, and one of the great pleasures of my role is to spend time with the people at the heart of those organisations. Charities such as Stonepillow, which works to prevent homelessness in our area, face an increase in costs of £125,000. I also visited St Wilfrid’s hospice after the Budget announcement—an incredible hospice that provides palliative care for hundreds of people every year, both in the hospice and in the community. It now faces an increased bill of £175,000—money that it needs to find annually, with only 17% of its annual budget covered by the NHS. I urge the Government to consider exempting the health and social care sector from the national insurance rise, so that the Treasury is not giving with one hand and taking with the other.
NHS Winter Readiness
Jess Brown-Fuller Excerpts(2 months, 3 weeks ago)
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Jess Brown-Fuller (Chichester) (LD)
It is a pleasure to serve under your chairmanship, Sir Roger. I thank my hon. Friend the Member for North Shropshire (Helen Morgan) for bringing forward this important debate on a very busy day for all Members, given the Budget announcement in the Chamber.
Last winter was nothing short of a catastrophe for the NHS and everyone who depends on it. NHS figures show that, between November 2023 and March 2024, nearly three quarters of a million people endured A&E waits of more than four hours and nearly a quarter of a million waited for more than 12 hours. In west Sussex alone, there have been 25,000 cases of 12-hour A&E waits so far this year—a 36% increase on the same period last year. Those figures leave patients and staff in my constituency of Chichester deeply anxious as we approach another winter, especially given that we have had the busiest summer on record, with NHS staff managing a staggering 6.8 million attendances over just three months.
In many cases, being seen quickly is literally a matter of life or death, especially in acute and emergency settings. Rory Deighton, the director of the NHS Confederation’s Acute Network, warned us that:
“Without immediate funding there is a very real risk the NHS falls into crisis this winter, with ambulance response and handover delays, overcrowded A&Es and people stuck in hospital beds because of a lack of community and social care.”
It is evident that many of my constituents in Chichester have lost faith in emergency health services. A recent poll conducted by the Liberal Democrats showed that one in four Britons has avoided calling an ambulance for fear that it will take too long to arrive. NHS paramedics, nurses and doctors consistently go above and beyond, and yet the system they are working in has stretched them to breaking point. Patients are bearing the consequences: they suffer each winter as the NHS crisis intensifies.
The Chancellor’s Budget announcement today that a 10-year plan will be introduced in the spring will not address the immediate crisis on our doorsteps. It was disappointing to hear very little attention paid to social care, which we know causes a huge number of beds to be used in hospitals. We cannot fix the bed crisis by just buying more beds; we must invest in the workforce that supports those beds. We must ensure that, this winter, my constituents in Chichester do not sleep in corridors or wait in uncomfortable waiting rooms—an experience that is all too familiar for me because, last winter, my grandmother ended up in a corridor, after being admitted in agony, in full view of the public. That would be an incredibly distressing experience for anybody, let alone somebody suffering with acute dementia.
There is no point in throwing money at a leaky bucket if the funding will not get where it needs to go to address the issues across the healthcare system. In my role as Liberal Democrat spokesperson for hospitals and primary care, I have had the opportunity to meet professionals from across primary and secondary care and hear what they are calling for so they can successfully provide a service across the board this winter. They are asking to be able to plan, with budgets that have a shelf life longer than 12 months, and allow them to innovate for the future. Year after year, the previous Conservative Government resorted to spending hundreds of millions of pounds in emergency funds every year to manage the winter crisis.
That emergency funding was a short-term fix that often arrived in those hospitals far too late to address the problem, as my hon. Friend the Member for North Shropshire pointed out. It was short-term fix rather than a comprehensive long-term plan to invest ahead of the crisis. Liberal Democrats have long called for a winter taskforce to oversee a dedicated, ring-fenced fund to build resilience for hospital wards, A&E departments, ambulance services and patient discharge pathways over the next four years.
I have no doubt that this will not be the last time we talk about NHS preparedness for winter. I fear that the Budget today will not have alleviated the concerns and fears of my Chichester constituents, nor those of the staff working in health care in my area. I urge the Government to use our ideas and prepare the NHS for not just this winter but future ones. We are ready to work constructively with the Government to that end.
Access to Primary Healthcare
Jess Brown-Fuller Excerpts(3 months ago)
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Jess Brown-Fuller (Chichester) (LD)
Today marks the first Liberal Democrat Opposition day in this House for 15 years, and we have dedicated it to the topics that are fundamental to constituents up and down the country: carers, the provision of care, and the NHS. As the Liberal Democrat spokesperson on hospitals and primary care, it is my honour to close today’s debate and to pay tribute to the many excellent contributions from my hon. Friends and hon. Members across the House.
I commend my hon. Friends the Members for North Devon (Ian Roome), for Newton Abbot (Martin Wrigley), and for Harrogate and Knaresborough (Tom Gordon) for their passionate tributes to their constituencies in their maiden speeches. I also pay tribute to the hon. Members for Worthing West (Dr Cooper), for Bury St Edmunds and Stowmarket (Peter Prinsley), and for Hinckley and Bosworth (Dr Evans), who bring such valuable knowledge to the Chamber during debates on healthcare.
Our NHS was once the envy of the world. The care, compassion and accessibility that it offered were unparalleled. Sadly, after years of Conservative mismanagement, our NHS and care sector are in crisis. Every day, thousands of patients face agonisingly long waits, often in terrible pain, while trying to see a GP or get an appointment with a dentist. Lord Darzi’s report highlights the fact that primary care services are heavily underfunded, which is leading to unnecessary hospital admissions. There are clear economic benefits to investing more in primary care. With the first Budget of the new Government due to come to the House soon, I remind the Chancellor that every £1 spent in primary care is estimated to save £10 in urgent and secondary care.
In my constituency of Chichester, people are deeply worried about accessing GPs, a concern echoed throughout the general election campaign and reflected in my surgery appointments with residents. The public’s trust in the NHS has been eroded due to the consequences of poor Conservative management. As my hon. Friend the Member for Esher and Walton (Monica Harding) pointed out, the Conservative Government promised 6,000 more GPs in 2019, but instead GP numbers have fallen by almost 500 and GP practice funding has been cut by £350 million in real terms since 2019.
Healthcare is not a luxury; it is a necessity. As Liberal Democrats, we believe everyone should have a legal right to see a GP within seven days, or within 24 hours if it is urgent, so we would pledge to recruit 8,000 more GPs to deliver on this promise. We also want those over 70 and those with long-term conditions to have access to a named GP, ensuring continuity of care, which helps to prevent unnecessary hospital admissions. As the Chair of the Health and Social Care Committee, my hon. Friend the Member for Oxford West and Abingdon (Layla Moran), mentioned, continuity of care is vital for patient trust and staff morale.
This is not the first time I have mentioned this in the Chamber to the Secretary of State, but the collapse of a not-for-profit GP federation serving Chichester and the south coast last month was a stark reminder of the system’s fragility. Patients’ appointments were cancelled, services were threatened and 130 staff were left unpaid. The collapse was due to the erosion of contract values with primary care networks and NHS Sussex. When GPs are sitting in my surgery telling me they want to work but they cannot, with no reassurance that they will be paid for the work that they have done, something has gone terribly wrong.
Dental care is another critical area within primary care. We have heard today about dental deserts across the country. During this afternoon’s debate, I began trying to list every Member who mentioned their dental desert and I gave up. It was shocking to hear the statistics and the harrowing case studies from across the House. The Liberal Democrats are calling for a dental rescue package that includes investment in more dental appointments, reforming the broken NHS dental contract and using flexible commissioning to meet patient needs. Workforce planning for health and social care must also be written into law, ensuring that we have enough dentists to meet demand.
Lastly, we must reverse the Conservatives’ cuts to public health grants, in order to support preventive dental care, including oral health programmes and promoting healthy eating choices, which will reduce the pressure on our NHS dental services. The Government have an opportunity to turn around a decade of Conservative chaos and mismanagement of our precious NHS and to give primary care the attention and focus it deserves, and we will work constructively with them to ensure that patients in Chichester and across the country get the care that they deserve.
NHS Performance: Darzi Investigation
Jess Brown-Fuller Excerpts(3 months, 2 weeks ago)
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Wes Streeting
I am grateful to the hon. Member for her question. No, I do not think that the take-up rate is where it should be. That is why in the short time we have been in office we have put more effort and energy into vaccine take-up, but there is more to do. I welcome her to the House, and will not have a go at her for the record of the people who sat on the Government Benches just before the general election.
Jess Brown-Fuller (Chichester) (LD)
At the end of September, a large GP federation serving patients across Sussex suddenly went bust, causing 130 redundancies; patient care was severely affected. The federation reported that the cause was a failure to obtain long-term contracts from any of its major clients, and the erosion of the real-terms value of contracts with both primary care networks and NHS Sussex. Does the Secretary of State agree that protecting continuity of service is key to public confidence in primary care, and will he meet me to discuss this case?
Wes Streeting
I am grateful to the hon. Member for her intervention. I wish that this was a challenge only in her constituency; it is a challenge right across the country. As I said to the Royal College of GPs last week, it will take time to rebuild general practice, so that it is back where we want it to be. We would be delighted to hear more from her; I will ensure that my Department makes contact, and that a Minister is in touch about the challenge in her constituency.