Health Services: Rural Areas

Karin Smyth Excerpts

Wednesday 17th July 2024 Commons Chamber

[The Minister of State, Department of Health and Social Care (Karin Smyth)]

It is a privilege to be the first Minister of this new Labour Government to respond to an Adjournment debate. I am grateful to the hon. Member for Caithness, Sutherland and Easter Ross (Jamie Stone) for raising this important matter and, indeed, for his kind words.

I hope we can begin this Parliament as we mean to go on, by being candid about the formidable challenges that the NHS faces. As my right hon. Friend the Secretary of State said on his first day in the job, the NHS is broken, and it will be the task of this Government to build a new NHS for the future. That means the NHS in our rural and coastal areas no less than the NHS in our towns and cities. I agree with the hon. Member for Strangford (Jim Shannon) on that point.

Facing these hard truths does not take away from the heroic efforts of the people working in health and care, who have done their utmost in incredibly difficult circumstances. We all owe them, on behalf of our constituents, a debt of unending gratitude.

Instead, we want to focus our attention on what needs to be done, including early action to improve access to primary care, dentistry and dental health services in particular. We await the conclusions of a thorough investigation undertaken by the distinguished surgeon Lord Darzi to properly understand the scale of the problem. The Government will then begin work on an ambitious programme of action—a 10-year plan to put the NHS back on its feet. It is a privilege to be part of a Labour Government who are committed to fixing the NHS and making it fit for the future.

As the hon. Member for Caithness, Sutherland and Easter Ross said, the Department’s responsibility stretches only to the NHS in England. Healthcare is devolved in Scotland, Wales and Northern Ireland, and it will continue to be so.

I congratulate the hon. Gentleman on being first out of the traps to secure this debate on behalf of his constituents. As a committed advocate for his constituents in one of the most rural parts of Scotland, he has a deep understanding of matters affecting rural communities, as we have heard this evening. He also has a deep understanding of care, about which I have often heard him speak in this Chamber. It is good to see him back again doing just that.

I cannot speak in detail about the NHS in Scotland, of course, but I can speak about many of the common issues affecting access to care that are relevant to rural constituencies in England, Scotland, Northern Ireland and Wales. I know how rural the hon. Gentleman’s constituency is, and I know the particular challenges that creates in accessing GPs, dentists and emergency care, and in accessing women’s health and maternity services—an issue he has been passionately raising for so long. Maternity services are a problem across the United Kingdom, but I accept the examples he outlined.

Few places in England are as remote as the hon. Gentleman’s constituency, but I am very aware of similar issues affecting more rural areas near my Bristol South constituency. We have heard from the hon. Members for Glastonbury and Somerton (Sarah Dyke) and for St Ives (Andrew George) about morale and the difficulties we face in the south-west.

I hope that, in the years ahead, we can share and learn from one another across all of our borders. In many rural areas, the challenge of improving access to services is compounded by travel times and by the recruitment and retention of staff. We must recognise the importance of designing services that reflect an area’s particular circumstances, which is a growing challenge. As the chief medical officer has pointed out in his reports, people are moving out of towns and cities to coastal, semi-rural and rural areas as they age. At the time that people are most likely to need care, they are increasingly living in the places where it is most difficult to provide that care.

In England, integrated care systems will have a key role to play in designing services that meet the needs of local people. To do this, they will need to work with clinicians and local communities at place or neighbourhood level. We know that excellent primary care is an essential foundation for improving access, tackling the root causes of poor health and tackling problems early so that people remain in better health for longer, and hopefully do not need to access secondary and tertiary care at the same level. That is why Labour has pledged, as part of our health mission, to train thousands more GPs and bring back the family doctor, and that applies to all the nations.

We are also doing more to use the transformative power of technology. There is enormous potential in ideas such as virtual wards, which allow care to be delivered in people’s own homes. Such models of care can have disproportionate benefit in areas where rurality is a barrier to care.

Equally, we are committed to seeing the NHS app reach its full potential under the new Government. We understand that some people will need support to use that technology and we are aware of the challenges of rural broadband, but we are committed to making the benefits accessible to all.

[Andrew George]

The Minister has committed the new Labour Government to address those issues, but will she specifically address the matter of the two coroners’ reports into avoidable excess deaths as a result of very long waits for emergency services in Cornwall? They were never addressed by the previous Conservative Government. The reports were about not just the hours spent waiting—sometimes elderly, frail people were on the floors for 10 or more hours—but the fact that sometimes 20 or more ambulances greeted patients when they arrived at the emergency department. Two coroners’ reports were sent to the then Secretary of State, but there was never an adequate response. I very much hope the new Labour Government will review the failings of the previous Government and address those very serious concerns, which affect many other rural areas.

[Karin Smyth]

I am aware of the issues facing the south-west and, when in Opposition, I spoke in the local media about some of the ambulance challenges. I am not aware of those reports, but if the hon. Gentleman writes to me with the details, I will happily look into the issue and get back to him.

We also recognise the additional cost of providing services in rural areas, for example in travel and staff time. That is why the funding formula used by NHS England to allocate funds to integrated care boards includes an element to better reflect needs in some rural, coastal and remote areas.

The NHS faces significant challenges. It needs fundamental reform. The Prime Minister is personally committed to resetting the UK Government’s relationship with devolved Governments in Scotland, Wales and Northern Ireland. I echo the Prime Minister’s words today about our commitment to rural constituencies across the entire country and I hope we can work with hon. Members from across the House, including the hon. Member for Caithness, Sutherland and Easter Ross.

[Jim Shannon]

I welcome the Minister’s clear commitment to England, Scotland, Wales and Northern Ireland—and particularly to Northern Ireland. Let me declare an interest: I am a member of the Ulster Farmers Union. I know that the Ulster Farmers Union back home, in conjunction with the NFU here, has been trying to work with the health service and with all those with responsibility in this area on the issue of suicides. Farmers mostly work on their own and suffer from anxiety and depression. They face pressures from finance and pressures from the bureaucracy that exists in farming. I know the Minister is compassionate and understanding—I mean that honestly. When it comes to addressing that issue, does she think that it must be done in conjunction with the farmers unions? Trying to work together to make things better must be a step in the right direction.

[Karin Smyth]

As ever, the hon. Gentleman makes a valid point. I shall certainly ask my colleagues in the Department for Environment, Food and Rural Affairs about that. His point is extremely well made. I know his constituency in Northern Ireland very well. Let me say that we are very committed to working with hon. Members across the House to share ideas. The hon. Member for Caithness, Sutherland and Easter Ross has put forward more ideas about how that can happen. I do not promise to implement all of those things, but I will certainly look at them. We want to work very closely across all jurisdictions so that we can make progress for all our constituents to improve the health outcomes across the four nations of the United Kingdom.

Question put and agreed to.