Hospitals

Laura Kyrke-Smith Excerpts

Wednesday 23rd April 2025 Commons Chamber

[Laura Kyrke-Smith (Aylesbury) (Lab)]

It is a pleasure to speak in the debate. The previous Government made off-the-cuff commitments to new hospitals that were never going to be affordable or deliverable; I am really proud to be part of a Labour Government who commit only to what we can afford. We stick to our promises and deliver them. The rapid progress that we have made towards improving the NHS, reorienting it towards frontline delivery, is a fantastic example of that.

Over 3 million more appointments were delivered in the first nine months of this Government—that is well ahead of the target—and over 100,000 people have been treated on time. Those are great statistics, but when I knock on doors and meet residents, I hear about the difference that that has made to them and their families. People are back on their feet, back at work, and back being active parents and grandparents sooner than they could have imagined. This is politics that is delivering for people. It is not the politics of easy answers, but the politics of progress, and of change to people’s lives.

I will highlight one change that will be particularly important in my constituency of Aylesbury as we continue the work of transforming the NHS, including through the new hospital programme: the need to better integrate primary and secondary care. There is great potential for savings there, if we think about the secondary and primary care estates in the round. More importantly, that will help bring traditionally hospital based-care closer to the community; it will be better care that has better outcomes for people.

As I have said in this place before, we face an acute challenge in Aylesbury with our GP surgeries. We had new housing estates built in a poorly planned way under the previous Government, without the necessary GP services being provided. We also have particularly high levels of deprivation in Aylesbury and the county of Buckinghamshire—it is really marked by inequalities—which contributes to the pressures on our GP services.

The Government have already made significant progress in improving GP provision; 1,500 new GPs have been recruited, and successful negotiations with the British Medical Association have resulted in the biggest uplift in funding for GPs in years. I think that will start to make a real difference.

[Lincoln Jopp (Spelthorne) (Con)]

Has the hon. Lady had any feedback, in conversations with her GPs, about what the increased employer national insurance contributions will do to their growth of provision?

[Laura Kyrke-Smith]

I am in regular contact with my GPs, and I know that they are really pleased, actually, with the uplift in funding that they have received through the contract, and with what they will be able to deliver with that.

As we think about the future of hospital provision, we must think about our healthcare in the round—what each community needs more broadly, and how we join up hospital services with those provided by our GPs, and with other community services. I am really excited by the work already under way in Buckinghamshire to establish integrated neighbourhood teams and I am pleased at this Government’s commitment to neighbourhood health centres.

In Buckinghamshire, and particularly in Aylesbury, all our key health organisations are coming together—including the acute and community NHS trusts, primary care, the local authority, public health, the mental health trust and voluntary sector organisations—to agree a collective plan for the next 10 years, which I think could be transformative. They are pooling their collective resources and teams across Stoke Mandeville hospital and three primary care networks, and looking not only at creating a centre in Aylesbury for shared delivery of services, but at providing better care out in the communities.

As we build our hospitals of the future across the country, it is essential that we plan in that way—not just for in-hospital care, but for a joined-up approach across all our services, bringing that care closer to our communities. Ultimately, that is what people want and what people need: a future healthcare system in which as many people as possible can access care close to home and manage their health in their own homes and their own communities as best as possible.

NHS England Update

Laura Kyrke-Smith Excerpts

Thursday 13th March 2025 Commons Chamber

[Wes Streeting]

The reports relate to the deficits sent into NHS England ahead of the 2025-26 financial year. Those are completely unaffordable for the NHS and completely unrealistic. Those financial plans are being revised as we speak, which is why leaders have gathered in London today to receive that message and that set of instructions. I am asking frontline leaders to improve services and reform ways of working, and they will have my support in doing that. As for the resources that are going in, I gently point out that the investment that the Chancellor unlocked for the NHS and social care in her Budget dwarfs that which was promised in the Green party’s manifesto.

[Laura Kyrke-Smith (Aylesbury) (Lab)]

I held a public consultation in my constituency on the future of the NHS. Participants were crystal clear that we need to cut bureaucracy and get resources to the frontline. When they talk about the frontline, they mean not just hospitals but people out in the community, and, crucially for my constituency, GP practices. Will the Secretary of State share more about how he intends to make that shift?

Maternal Mental Health

Laura Kyrke-Smith Excerpts

Wednesday 5th February 2025 Westminster Hall

[Laura Kyrke-Smith (Aylesbury) (Lab)]

I beg to move,

That this House has considered maternal mental health.

It is a pleasure to serve under your chairship, Ms Furniss. I am so glad to have secured this debate on maternal mental health, which I know really matters to people in my constituency and across the country, yet it is still too easily overlooked. For me, it is also very personal. In 2021, I lost one of my best and most brilliant friends, Sophie, to suicide. She left behind her wonderful husband and three little girls, aged six, three and just 10 weeks at the time. Her death was an awful shock to us all, and I will never forget the moment I received the message from her husband, which said:

“I do not know how to say this and I cannot believe I am writing this, but Sophie died this morning.”

It was still the covid pandemic at the time. Sophie was very isolated, recovering from a C-section, staying at home, trying to protect herself and her baby from covid, and not wanting visitors, but we were in regular touch on WhatsApp, helping each other to navigate life with a little baby and two older siblings. Sophie was getting more and more concerned about her baby’s feeding, and it was causing her to suffer from increasingly bad insomnia. She took herself to A&E with concerns about the baby’s milk intake, which I suspect were more a reflection of her own anxiety than the baby’s feeding, and she spent a night there before being discharged. I do not know whether they asked her about her own mental health. What I do know is that the next day her messages were increasingly distressed, and two days later she took her own life.

Unfortunately, what Sophie went through is not uncommon. At least one in five people who give birth experience a mental health problem during pregnancy or after birth. In fact, while we hear a fair amount about physical conditions such as gestational diabetes and pre-eclampsia, it is mental ill health that is the most common complication of pregnancy in the UK.

[Jim Shannon (Strangford) (DUP)]

The fact that there are so many Members present is an indication of the importance of this subject. Does the hon. Lady agree that support is an essential component of maternal health and that, for those families who do not have extended support, charities such as Home-Start in my constituency, which have volunteers to go to help, are essential and should be more widely funded to help more young mothers who feel they are drowning to get a lifeline back to the surface?

[Laura Kyrke-Smith]

I agree with the hon. Member; that support is needed, and I will come on to that.

The causes of these mental health challenges are really varied. Some people will have past experiences of mental health problems or difficult childhood experiences. Some will struggle after a traumatic birth. Some will be experiencing stressful living conditions. Some evidence suggests there are biological or hormonal factors, and some people are at higher risk than others: young mums face particular risks, with post-natal depression up to twice as prevalent in teenage mothers compared with those aged 20 or over, and data suggests that post-natal depression and anxiety are 13% higher in black and other ethnic minority mothers than in white mothers.

People’s experiences of mental health are also really varied, ranging from mild to moderate conditions such as low self-esteem, anxiety and depression to more serious conditions including post-traumatic stress disorder and post-partum psychosis. While most people find a way through, perinatal mental health can be incredibly serious, as it was for Sophie.

[Robin Swann (South Antrim) (UUP)]

I thank the hon. Member for bringing this very important issue to the House. With regard to perinatal support, does she agree that it is very important we have those professional teams in place, and that we get the additional value that comes from a physical mother and baby unit, where specialist support can be given to not just the mother and child but the family as well?

[Laura Kyrke-Smith]

I agree: mother and baby units are vital.

For women in the period from six weeks after giving birth to one year after giving birth, the leading cause of death is suicide. While I want to speak more widely today, I want us to be very conscious of that extreme end of the risks that women face. Despite the potential seriousness, the stigma around these problems is huge. Some 70% of women will hide or underplay maternal mental health difficulties, and in turn, they will never get the support they need.

[Maya Ellis (Ribble Valley) (Lab)]

I thank my hon. Friend for bravely sharing the devastating story of her friend. I also have a wonderful friend, Sarah, whose daughter was a month old when the covid lockdown hit. She was so worried about breaking lockdown rules that she did not lean on friends and family and ended up having a mental breakdown. Does my hon. Friend agree that maternal mental health should be a high priority in any future emergency planning?

[Laura Kyrke-Smith]

I absolutely do, and I am sorry to hear of the experience of my hon. Friend’s friend.

What are the consequences of all this? The human suffering is immense, but maternal mental health has economic consequences and costs, too—an estimated £8.1 billion each year in the UK, according to research from the London School of Economics, and nearly three quarters of that cost relates to adverse impacts on the child rather than the mother.

I want to suggest four ways in which maternal mental health support can be improved, and I will be as brief as I can. The first is improving specialist perinatal mental health services. The second is better embedding mental health support in routine maternity care. The third is improving community support, and the fourth is education and awareness raising.

[Olivia Bailey (Reading West and Mid Berkshire) (Lab)]

I thank my hon. Friend for the powerful speech she is making, and I am so sorry to hear about her friend. Does she agree that we also need specialist support for those experiencing post-adoptive depression? Although they have not gone through the same physical process as birth parents, it can be equally devastating.

[Laura Kyrke-Smith]

Absolutely—that is one way in which people can experience severe mental health challenges and consequences, and it needs to be considered. I also want to acknowledge that new dads and partners experience mental health challenges too, but given our limited time, I am focusing today on maternal mental health.

[Irene Campbell (North Ayrshire and Arran) (Lab)]

Does my hon. Friend agree that stigma around mental health, particularly maternal mental health, can be used by abusers as a barrier to women getting help? Domestic violence during the perinatal period and the effects on mental health require widespread attention, so that survivors can feel comfortable and safe when asking for support.

[Laura Kyrke-Smith]

I agree; we need to shed more light on this, precisely for that and other reasons.

I will touch briefly on my first recommendation, which is to ensure that specialist perinatal mental health services are protected. In the last 10 years, there have been significant steps forward. Mother and baby units in particular can be an important part of someone’s treatment and recovery, as well as having significant benefits for the parent-infant relationship.

Tragically, there are still too many stories of women not being able to access those units. They are perhaps too far away from where a woman lives, or there is not a bed available, or the need for a mother to get that care has not been identified properly. We are still seeing mothers with newborns being put into adult psychiatric units and separated from their babies, despite the national guidance saying that mother and baby units are best practice. Continued support for these services is crucial, both in mother and baby units and in the community, and that must include research to develop the best interventions and robust evaluations of the care provided.

The Mental Health Bill is a sorely needed piece of legislation, and I really welcome it, but I wonder whether it might include a provision to ensure that all women who have given birth within the 12 months prior to admission to a psychiatric unit are given the option of being admitted to a ward where they can remain with their baby. That could help to prevent women from falling through the cracks in the system, as they do currently.

Secondly, I turn to routine maternity care, which is where the mental health support for the vast majority of women can and should sit. Again, we have seen progress, with some vital new services in place, including care for women experiencing baby loss, severe fear of childbirth, birth trauma and loss of custody at birth.

[Anna Sabine (Frome and East Somerset) (LD)]

I thank the hon. Member for calling this debate, which is clearly so important to her. In my constituency there is an excellent charity called HeartTalks that works with mothers who have experienced baby loss. Would she agree that post-partum check-ups are really important for all women, but particularly those who have suffered baby loss, regardless of the trimester it occurred in?

[Laura Kyrke-Smith]

I absolutely agree. A recent report from the Maternal Mental Health Alliance highlighted huge variation in the support services available locally, with confusing referral pathways, inequitable referral criteria and long waiting lists—some women have to wait six months for an assessment and up to a year for treatment. Too often, as I have noted, women are cared for unequally. Those who have existing disadvantages experience stubbornly poorer outcomes.

We need better integration of mental health into all routine contacts during pregnancy and after birth for all women who need it. During that period, women have an average of at least 16 routine contacts with health professionals, including GPs, midwives and others, and they are an ideal opportunity to ensure that women are routinely and compassionately asked about their mental health. I wonder if any healthcare professionals asked Sophie not just how the baby was but how she was. I wonder if the discussions about her baby’s feeding were had in a way that sought to reduce her anxiety. I wonder if she was given less attention because this was her third child, and her earlier experiences had been smoother—but I will never know.

In the same way that many physical health complications are dealt with by multidisciplinary maternity services, the same should be true for mental health care. That means midwives, health visitors and others being trained to ask the right questions and assess the risks, and then psychological therapists, equivalent to those employed in talking therapies, integrated into maternity teams to support women’s care where necessary. They would understand the specific needs and risks of the perinatal period, and be able to intervene quickly where that is needed.

Thirdly, I want to acknowledge the importance of community support for pregnant and new mums, as we have heard from other Members, and I recommend its expansion. There are fantastic voluntary groups providing some support, and in some places family support hubs are up and running, but often the postcode lottery kicks in again. We are a long way from the broader and more reliable provision that was established under the last Labour Government—notably the Sure Start model, which all the long-term evidence shows was so effective. As part of our national health mission to shift care from hospital to the community, we need to rebuild those community services, including for pregnant and new mums. We need them to be across the country and widely accessible, with clear maternal mental health guidance embedded in them.

Finally, it is incumbent on all of us to keep building a society where everyone understands the mental health challenges in the perinatal period, including the suicide risk in the most serious cases. Crucially, we all need to learn to be good allies to people who are struggling. I think about that a lot in relation to Sophie. When Sophie sent me messages saying, “Feeling desperate today”, and,

“I’m just not sure I have it in me to keep going”,

did I do enough? Did I worry about her anxiety? Yes. Did I worry about her being depressed? Yes. Did I worry about suicidal thoughts? Honestly, yes. But did I think she might take her own life? No. I have struggled with the guilt that I did not somehow do something to stop it, but I also recognise how ignorant I was and how hard this is.

I have had good conversations with Sophie’s dad about what needs to change. He is part of a group called Facing the Future—a support group for people who have lost family to suicide. One of his group members said:

“I think what I’d like to see is a more proactive and visible campaign to target those who are at risk. Not just for those at risk, but for their families/friends/carers/loved-ones. Let people know that it’s okay not to be okay...Give people the knowledge and confidence to ask someone they are concerned about how they are feeling, to know what to look for and ask, and to know where to go for help.”

That is absolutely right. There are some fantastic charities and campaigns out there. I know the Government are listening; I am particularly pleased that not just mental health, but suicide prevention are woven into our health mission, where moving from treatment to prevention is such an important focus more broadly. But there is more to do.

I conclude by saying that I do not want Sophie’s life to be defined by her death. I want it to be defined by her first-class Cambridge degree, her talents as a writer and actress, her Foreign Office career, her friendships, her playful sense of humour, and the beautiful family that she began to raise. I talk about her death because I hope her experience can be a catalyst for change.

While her story—every story like hers—and the wider statistics can seem bleak, the real story here is one of hope and potential. With the right support in place at this crucial and pressured time in women’s lives, they do surmount great mental health challenges and recover, often quickly and well—and their babies get off to a good start in life. The Government have embarked on transformative work to improve the country’s health, and better maternal mental health outcomes must be one test of our success.

[Gill Furniss (in the Chair)]

Members should stand if they wish to speak. You have a very short amount of time.

Winter Preparedness

Laura Kyrke-Smith Excerpts

Wednesday 18th December 2024 Commons Chamber

[Karin Smyth]

The hon. Gentleman is wholly wrong to say that winter crises happen under every Government in every year. They happened, and became a fact of the NHS, under his party’s Government. The key difference this year, which the Conservatives will still not address, is the fact that doctors are not on strike. Doctors are working in the system, caring for patients and doing their job, because this Government, on day one and week one and week four, delivered the negotiated settlement with the doctors. We cannot run the NHS and we cannot manage a winter crisis without doctors in the frontline, and that is where they are. That is what the difference is.

[Laura Kyrke-Smith (Aylesbury) (Lab)]

It is great to be going into the winter for the first time in four years without doctors being on strike. Last week I visited the new emergency medical receiving unit at Stoke Mandeville hospital, a 21-bed facility to provide quicker care for patients who come in from ambulances and as a result of GP referrals but require only short admissions. The early results look very promising. Does the Minister agree that we must take these pockets of good practice from across the NHS and ensure that other parts of the NHS learn from and adopt them to help us get through this winter and future winters?

Access to Primary Healthcare

Laura Kyrke-Smith Excerpts

Wednesday 16th October 2024 Commons Chamber

[Laura Kyrke-Smith (Aylesbury) (Lab)]

I hear from many constituents in Aylesbury who are struggling to see their GP. For some, this is a frustration—a repeated one. For others, it is a tragedy. I sat with a constituent who shared a heartbreaking story about a missed cancer diagnosis because it was impossible to get an appointment.

The reasons for the challenges are clear, as the Minister set out. In Aylesbury, two additional factors are creating particular pressures. First, many new housing developments have been built in the last 14 years without the necessary services to accompany them—for example, the promised GP surgery in Kingsbrook that was never built, adding pressure to other surgeries, such as Poplar Grove. Secondly, there are high levels of deprivations in parts of Aylesbury. The well documented link between poverty and ill health leads to patients having increased and complex physical and mental health needs that GP surgeries are not funded or equipped to meet.

Let us be clear about the cause of these challenges, which are not the fault of patients, who like all of us are just trying to stay in good health, or of GPs, who often work incredibly long hours in a system that lets them down and wears them down. The problem is the broken system that this Labour Government have inherited after 14 years of Conservative government.

Let me turn to the solutions. The early steps that we have taken are a clear signal of our intent: the ending of the junior doctor strikes, the red tape challenge that the Secretary of State launched with NHS England, and the measures that we took within weeks of being elected, including finding £82 million of additional funding to enable the immediate recruitment of 1,000 more GPs. I know from the GPs I am in touch with that that has made a real difference.

There is still much work to do. I will highlight three areas of necessary focus. First, we must expand the range of care available in the community. GP surgeries waste time referring patients to hospital-led community services when they know that they could treat those patients directly but do not have the funding or permission to do so. Meanwhile, patients tell me that they have had to go to A&E for minor issues because there is no support closer to home. Our ambition for an expanded range of support and services through neighbourhood health centres is absolutely right, and we are getting straight to work on that.

Secondly, on technology, I hear time and again of GPs spending hours trying to make referrals to and from the hospital, battling IT systems that are not intuitive and do not speak to each other. Meanwhile, patients tell me that they cannot fathom why there is not a better system for booking appointments. There are great pilot schemes that could be rolled out more widely. At the GP surgery in Edlesborough in my constituency, for example, a carefully designed AI chatbot answers patients’ questions where it can, and helps GPs to prioritise which patients to see.

Thirdly, we need a firm emphasis on prevention in public health by driving up public awareness of health risks. On a recent visit to the main mosque in Aylesbury, for example, I saw a stand with information about diabetes. That is exactly the right way to get the right information in front of people. Once public health risks are identified, we must empower patients to manage their own health as best they can. As Vernon Sharples, a mental health nurse in my constituency, said to me:

“There is too much prescribing, too much emphasis on being ill, and not enough emphasis on being and staying well.”

To me, taking public health, including mental health, seriously, and building a society that understands and promotes wellbeing to keep people healthy before they need to seek treatment with a GP, is what a good preventive approach looks like.

Achieving that vision will take a long time, and change cannot come soon enough for people in my constituency who so desperately need to see their GP today or tomorrow, but we have started as we mean to go on, and we will not stop until we have achieved the change that we so desperately need.

[Several hon. Members rose—]